Beginning in 1996, legislation has been enacted to move those with alcohol and other drug use (AOD) problems off public assistance and into self-sufficiency by requiring work and limiting the time period of welfare receipt. The impact of change in welfare on substance abusers receiving public assistance and the publicly funded treatment system could be profound. Unfortunately, the inherent difficulty of examining this area has limited the number of high quality research studies looking at the treatment of alcohol problems in the context of welfare reform. This application capitalizes on a unique opportunity to test the effectiveness of three intervention approaches for welfare recipients who have been identified in a welfare setting as requiring substance abuse treatment. Participant will be randomly assigned to three conditions: 1) triage and referral to a treatment program (usual care); 2) referral to a treatment program and case management services designed to link them with auxiliary services (case management); and 3) case management services and referral to a substance abuse program that provides integrated medical, mental health, family, employment, and child care services (case management with integrated services). Participants (N=450) will be assessed in-person at baseline and months 1, 3, 6, and 12. In addition, administrative data on labor and welfare outcome will be available for outcomes up to three years following recruitment. Biological and collateral verification will be used to verify self-report of substance use. HLM will be used to test the impact of the interventions on substance use, employment, and other psychosocial outcomes. The grant money we are requesting will fund the evaluation of these conditions as well as the substance abuse program in the integrated services condition. Funding for the usual care group and all case management has already been provided for by Human Resources Administration (HRA).
