“Recovery from a substance use disorder requires support, guidance, and assistance addressing an individual’s physical, emotional, and financial needs. First and foremost, people need quality health care, including access to medication-assisted treatments and counseling to support both physical and mental well-being, comprising the foundation for SUD treatment. […] Living in a community with a high quality of life (including quality employment) improves overall well-being and life satisfaction and in turn reduces the likelihood of substance use disorder.”Addressing Appalachia’s Substance Use Disorder Crisis Through Recovery-to-Work

After the Match: Supporting People and Companies for Continued Success

Expanding Partnerships to Support Job Retention and Growth

Now that your region is successfully matching people in recovery with companies and jobs in the region, how can you support their long-term success in the workplace? Research on treatment and recovery outcomes demonstrates that: (1) employment is significantly tied to sustaining recovery and (2) service integration and wraparound services improve employment and treatment program effectiveness.

Evidence: Employment Drives Improved Recovery

A report by the Substance Abuse and Mental Health Services Administration (SAMHSA), SAMHSA Substance Use Disorders Recovery with a Focus on Employment and Education, provides a comprehensive overview of the evidence base for employment being linked to improved recovery outcomes and presents two models for supporting people in recovery in the workplace:

  • Therapeutic Workplace, which uses access to employment and wages to promote therapeutic behavioral changes; and
  • Individual Placement and Support, a model of supported employment that helps individuals work in competitive jobs of their choice.

SAMHSA recommends service integration as one element that improves the effectiveness of employment programs. When services are integrated, employment staff focus on employment services, case managers address social services needs like housing and transportation, and clinicians provide counseling to support overall recovery.

DDAA has developed a community of practice across Appalachia that has brought together practitioners to share their on-the-ground experience through peer meetings, technical assistance workshops, and webinars. (Findings from DDAA’s community of practice work are captured in .) One theme that rises to the top across DDAA’s work with communities in Appalachia is that people in recovery  need additional support for long-term employment success and growth, particularly in the areas of housing, transportation, and childcare.

Expanding partnerships can help provide the support services people in recovery need for success, like affordable childcare, stable housing, and reliable transportation. This support can be particularly challenging to provide in rural areas. Providing seamless wraparound support is work that cannot be done by one organization alone – it is the work of many and may involve creating new partnerships or expanding those created earlier in the ecosystem building process.

After completing phase 4, you should have the following outcomes:

A better understanding of the gaps in support services in your region.

New partnerships or programs that directly address real barriers faced by people in recovery keeping long-term employment.

Increased services supporting the long-term employment of people in recovery.


Identify Gaps in Wraparound Services in your Region

Start by identifying gaps in the wraparound services in your region. Learn directly from people in recovery who have successfully found jobs: what do they need to keep that job? Where are they experiencing the greatest challenges or barriers? Learn from companies in the region: where do they see gaps in support for the people who work for them? What do they see as the barriers to job retention for people in recovery? Meet with your ecosystem champions team to discuss the gaps and brainstorm shared solutions.

Resource: The website Findhelp.org can be used to identify services (in a range of categories, including housing, transportation, and childcare) by zip code. This site can be used as a starting point for understanding existing programs, partners, and gaps in a community.

  Activity: Referencing the previously completed ecosystem self-assessment, discuss as a group 2-4 immediate opportunities for expansion with new partnerships and/or resources identified in the first three phases. Discuss opportunities specific to wraparound services. What stakeholder pathways can be connected today at no additional cost?


Improve Connections to Wraparound Services

Once your region has identified gaps and opportunities in wraparound services, work together to build new partnerships and programs to address them. Learn from other regions and communities that have developed best practices in addressing barriers around childcare, housing, and transportation. Develop memorandums of understanding (MOUs) to formalize your partnerships and streamline pathways for workers and employers.

Spotlight: The city of Roanoke, Virginia used federal American Rescue Plan Act (ARPA) funding to create the Star City Works program, which is administered by the Greater Roanoke Workforce Development Board, and provides funding for businesses to provide both on-the-job training and stipends for those attending the training to access wrap-around supportive services like transportation, childcare, food assistance, and utility/mortgage assistance.

Resource: The Rural Health Information Hub’s Rural Services Integration Toolkit includes evidence-based and promising models and resources that helps rural communities integrate programs.

  Resource: New Addiction Recovery Support Institutions: Mobilizing Support beyond Professional Addiction Treatment and Recovery Mutual Aid

  Resource: A Guide to Memorandum of Understanding Negotiation and Development


Partner with Employers on Workplace Wellness and Caring Workplace Initiatives

Employer interest in workplace wellness programs may be a starting point for connecting them with support services that are often needed by people in recovery. Workplace wellness programs may increase workplace attendance, performance, and job satisfaction.

Resource: The Power of Wellness: How Prioritizing Employee Health Boosts Business Performance

Resource: Understand Workplace Wellness – Next Level Recovery Associates

Resource: The Value of Workplace Well-Being – LEAF 

Spotlight: The First Tennessee Development District’s Caring Workplaces initiative helps employers create a culture of support to enhance the potential for long-term, sustainable success for individuals and their families. The Caring Workplaces Initiative includes peer navigation services, support and training to employers, and creating referral partnerships and processes for services and employment.

Spotlight: The LEAF Council on Alcoholism and Addiction used an interview-based outreach plan to connect with local businesses. Through interviews and surveys, LEAF developed a better understanding of business wellness needs and was able to provide resources and encourage workplace wellness policies and trainings. LEAF connected with over 200 businesses using this model. 


Learn from other Regions and Communities about Childcare, Housing, and Transportation Best Practices

Regions across Appalachia and the country are creating solutions to housing, transportation, and childcare challenges. Use this section of the guide as a starting point for understanding best practices and finding existing solutions that might work for your community.

Resource: The Recovery to Work Community of Practice hosted a webinar on housing and transportation assistance for individuals struggling with substance use disorder (SUD). The webinar included three presentations and a discussion with peers who are working to provide both housing and transportation assistance in their communities. View the webinar here.

Housing Best Practices

Resource: A Primer on Recovery Residences: FAQs from the National Association of Recovery Residences

Resource: Innovative State Initiatives and Strategies for Providing Housing-Related Services and Supports under a State Medicaid Program to Individuals with Substance Use Disorders who are Experiencing or at Risk of Experiencing Homelessness (U.S. Department of Health and Human Services)

Resource: Best Practices for Recovery Housing (Substance Abuse and Mental Health Services Administration)

Resource: Association of Recovery Community Organizations (ARCO) searchable member map and member list.

Resource: National Alliance for Recovery Residences (NARR) state affiliate map and list. NARR is a membership association dedicated to expanding the availability of well-operated, ethical and supportive recovery housing.

Resource: Oxford House Directory. Oxford House, Inc. charters over 3,000 self-run, self-supported recovery residences nationally. Employers may wish to contact the organization to explore the possibility of partnering.

Transportation Best Practices

Resource: Rural and Small Urban Mobility Innovations Workshop Resources(National Association of Development Organizations)

Resource: The Rural Health Information Hub’s Rural Transportation Toolkit shares promising models and resources to support organizations implementing transportation programs in rural communities.

Spotlight: The Ohio Department of Transportation (ODOT) administers and oversees a statewide Mobility Management program to better serve the transportation needs of senior citizens, disabled persons, veterans, persons in substance abuse recovery, and other at-risk populations. The program has an online trip planning tool that provides a range of options for users to plan routes, including carpool matching.

Childcare Best Practices

Resource: Supporting Access to High-Quality Family Child Care: A Policy Assessment and Planning Tool for States, Territories, and Tribes (National Center on Early Childhood Quality Assurance)

Resource: Childcare Aware is a repository of childcare resources in every state.