Question: As a result of COVID-19, we cannot provide separate housing for participants in our RSAT program. They used to be in a separate pod, isolated from the general population as required. Does this mean we are no long eligible for RSAT funding that we rely on?
Answer: It is true that Congress specifically limited RSAT state grants to jail and prison programs that provided separated housing for RSAT participants. Housing participants together away from the general population promotes a learning if not a therapeutic community that supports and fosters recovry. However, Congress has also recently amended the RSAT statute to create a new category of funding for non-residential jail substance abuse treatment programs, also allowing RSAT money for the first time to be used to provide treatment for pretrial detainees, not just sentenced offenders. The only requirement for these non-residential jail programs is that they be “effective and science-based.” While the statute does not provide any further description of what that means, we know, for example, that jail programs that provide medications for alcohol and opioid use disorders, including methadone, buprenorphine or naltrexone for OUD and naltrexone, disulfiram and acamprosate for AUD, are evidence-based. We know from the research that providing these medications, even for a short period of time before individuals reenter the community, improves post-release retention. We also know that substance use disorder treatment less than 90 days is not effective. Therefore jail programs that are less than at least 90 days must be constituted as the first phase of a longer term program that continues after individuals leave the jail. This requires these non-residential jail RSAT programs to collaborate and join with community treatment providers. But even a short term jail RSAT program can be very beneficial by motivating individuals and making them treatment-ready as well as introducing them to and screening them for appropriate medications. The non-residential RSAT awards are only available to jail programs, not prison programs.