# RFA-CE-22-010 Evaluation of Kentucky Access to Recovery Linkage Strategy

> **NIH ALLCDC R01** · UNIVERSITY OF KENTUCKY · 2024 · $749,996

## Abstract

The CDC National Center for Health Statistics (NCHS) estimates that for the 12-month period ending
September 2021 in the United States, (US) there were 99,543 drug overdose deaths. Kentucky had the 2nd
highest age-adjusted drug overdose fatality rate (51.5 deaths/100,000 persons) in the US in 2020. To
address the high numbers of drug overdose fatalities, effective strategies are needed to link persons in SUD
treatment or those with illicit SUD not yet in treatment with recovery support services (RSSs) to build and
maintain recovery, and reduce resumption of illicit substance use and drug overdoses. Access to Recovery
(ATR) is a linkage strategy supported by Substance Abuse and Mental Health Services Administration
(SAMHSA) that was implemented by Kentucky in 2019 to link vulnerable populations with opioid and/or
stimulant SUDs to RSSs using a voucher system and re-link clients to RSSs following resumption of
substance use. The Kentucky ATR (KATR) strategy is a 25-county program that links county residents at or
below the 200% national poverty level who have illicit SUDs and are in treatment or early recovery to
evidence-based RSSs such as recovery housing, and to other RSSs. Priority KATR clients set by KATR are
justice-involved, veteran, pregnant/ postpartum, and parenting populations. To address the gap in
accessibility of RSSs that often occurs in vulnerable populations, the KATR linkage approach uses
vouchers as a linkage strategy for individuals in SUD treatment who have no other funding options to
acquire critical RSSs. As such, KATR’s linkage through vouchers is a “last resort” approach for linking to
RSSs. The purpose of this proposal is to perform a rigorous process and outcome evaluation of this last
resort voucher strategy of linking by accomplishing the following specific aims: Specific Aim 1: Conduct a
process evaluation of the KATR linkage strategy to determine whether the KATR strategy is acceptable and
accessible to vulnerable populations with illicit SUD who are linked to RSSs; identify barriers and facilitators
to KATR implementation; and assess the extent to which the KATR strategy was implemented as designed.
Specific Aim 2: Conduct an outcome and impact evaluation of the KATR linkage strategy. Specific Aim 3:
Evaluate the long-term effectiveness of implementing vouchers as a linkage strategy in a population
requiring RSSs when no other funding sources are available. A within-subjects design will be used to test
the effectiveness of the KATR voucher linkage approach to reducing the risk of nonfatal and fatal overdoses
by increasing an individual’s recovery capital; reducing resumption of illicit substance use; and promoting
relinking to RSSs if illicit substance use is resumed. Study results may enhance current state ATRs that
serve individuals experiencing similar SUD health access disparities.

## Key facts

- **NIH application ID:** 10830360
- **Project number:** 5R01CE003513-03
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** TERRY LEE BUNN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $749,996
- **Award type:** 5
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10830360

## Citation

> US National Institutes of Health, RePORTER application 10830360, RFA-CE-22-010 Evaluation of Kentucky Access to Recovery Linkage Strategy (5R01CE003513-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10830360. Licensed CC0.

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