Evaluation of Maine DOC's Medication-Assisted Treatment Pilot Program
Population Health and Health Policy, corrections, jails, Maine, evaluation, medication-assisted therapy, substance use
Maine is among the states hardest hit by a national trend of non-medical uses of opioid prescription drugs and illicit opioids, with subsequent increases in opioid-related morbidity and mortality. While there are significant state and local efforts underway in Maine to improve access to treatment and recovery support services for individuals with OUD, rates of opioid related overdoses and deaths continue to remain high, particularly among individuals who have interacted with the criminal justice system.The Cutler Institute at the University of Southern Maine was contracted by the Maine Department of Corrections to conduct an independent evaluation of the rollout of the Maine Department of Corrections MAT pilot program. This program evaluation was designed to offer a summative assessment of the implementation experience; to document programmatic policies and procedures to examine whether and/or how these approaches affect program delivery; and to provide feedback to Maine DOC and other key stakeholders to help guide the refinement and expansion of the delivery of MAT in Maine correctional facilities. The principal goal of the evaluation of the MAT pilot program was to provide the Maine DOC and other relevant stakeholders with feedback on the planning and implementation of the MAT pilot program. Our evaluation questions were focused on examining four key domains of interest: infrastructure and system change; planning and implementation; care delivery and satisfaction; and care coordination. This evaluation includes a strong public health perspective grounded in the use of the CDC’s evaluation framework that applies a population health model ideal for evaluating multi-sector interventions like the Maine DOC MAT pilot program. Evaluation activities were also rooted in the Reach, Efficacy,Adoption, Implementation, Maintenance (REAIM) framework and the Consolidated Framework for Implementation Research (CFIR). This evaluation has shown that the Maine DOC MAT Pilot Program is uniquely situated to provide critical treatment services to individuals who are at significantly higher risk for the negative consequences associated with SUD. Using a comprehensive planning process which included broad stakeholder engagement; collaboration across organizations and sites; training and education for facility staff; and the development of policies and procedures that address the specific needs of participating facilities, the Maine DOC, has been able to significantly expand their capacity to deliver MAT to individuals in carceral settings throughout Maine. Findings indicate that, while there are opportunities to continue to refine the program, overall the implementation of the Maine DOC MAT Pilot Program has been successful. Feedback from participants indicates that the program is meeting their treatment needs and has helped them to maintain access to care as well as sustain their recovery post-incarceration.
Maine Department of Corrections
Smith, M. L., Shaler, G., Dooley, O., & Ali, E. (2020). Evaluation of Maine DOC's Medication-Assisted Treatment Pilot Program. University of Southern Maine, Muskie School of Public Service, Cutler Institute.