First Day Forward Program: An Overview
Created through a Rural Communities Opioid Response Program (RCORP)-Implementation grant, First Day Forward (FDF) is a jail reintegration program that aims to connect individuals to resources, both during incarceration and after their release. This project by St. Claire HealthCare, a member of the Northeast Kentucky Substance Use Response Coalition, strives to give those with substance use disorder (SUD) a true “First Day Forward” as they re-enter the community.
the first day forward initiative really
grew out of the inmate interviews that
we have done in gosh i guess at this
point in six jails across northeastern
kentucky where we
sat down with individuals that had been
arrested on drug related charges uh had
a self-identified
substance use disorder
and were willing to be interviewed about
what had led them to their current
situation uh what program it was
available to them in the jail and what
programming we could put together as a
coalition
upon their release so that's led us to
do some brainstorming we came up with
the idea for a program and one of dr
maclean's colleagues uh wendy fletcher
was actually the person who coined the
phrase first day forward that
really targeting
education to inmates father still
incarcerated but really focused on that
first day of release first day forward
uh takes these peer support individuals
from across our region links them with
those
inmates does a month to three months of
engagement while they're still
incarcerated
picks them up from the jail at the day
of their release gives them uh whatever
necessities they might need at that
point
during their incarceration we've been
working with them to make sure where you
go in upon release do you
need uh
any kind of treatment linkages upon the
point of your release what are you
thinking in terms of employment so we're
working with them on all those types of
activities uh to make sure that uh that
they have a a chance i mean that that's
all these individuals want and need is a
chance to
to get a the right path toward recovery
upon their release so so firstly forward
we're currently uh providing that
service in three counties within our
region we've had phenomenal success uh
just recently one of our the first
inmates that we engaged with uh had
gotten released and uh had gone through
uh the the year of um sobriety and then
went and got the training to become a
pure uh support uh individual himself so
that is as big of a success story as you
can possibly have somebody who was in
jail that we connected with them and now
they are doing what we want to have
others in the region do tell their story
and and be an inspiration to others
the incarcerated population is
considered very vulnerable and high risk
from a addiction or moud standpoint
when they go into jail if they've been
utilizing or using illicit drugs
heroin
they have developed a tolerance to it so
their tolerance is very very high
during incarceration
they go through the withdrawal
that tolerance is gone they get out
they have a high high risk of
sudden death from overdose that's the
number one cause of death within the
first two to four weeks of release for
inmates
because they don't understand
the risk of going and using
in addition
now that we have the fentanyl
on board and being laced in the heroin
that also increases
the risk of death to these patients who
who
were
incarcerated and now released by without
any
education or knowledge and so
part of hopefully the first day forward
is some of that education
regarding the tolerance
to
to
to the heroin going in and then the lack
of tolerance coming out and the
increased risk
employment is so key to this i mean you
can have various other things in place
but if these individuals upon release
can't find a job
then the chance of them relapsing being
right back in that same situation are
much higher so we've done a lot of
programming within our region to try to
put things into place to to change the
stigma
that so many individuals unfortunately
still have
about
individuals who who even even if it was
in their past there's still so much
stigma out of people that that ever
misused
prescription medications or abused
illicit drugs so we're currently doing
employment forums across the region
where we have
uh peer support specialists that are
doing presentations to employers across
the region telling their story about how
they once were
addicted now they're in recovery and
that there are numerous other
individuals like them across the region
that uh that can be very good employees
uh for uh those employers across the
region and can really be a new source of
employment and uh and workforce
development within the region
FDF began with a focus on three counties in northeastern Kentucky: Clark (started September 2020), Mason (started September 2021), and Powell (starting September 2022). Through a second RCORP-Implementation grant, FDF was initiated in the Montgomery County Regional Jail in September 2021 as well. Peer support specialists are screening individuals for program criteria including anticipated release to one of these counties, self-identified SUD, and willingness to participate.
When candidates are accepted into the program, peer support specialists immediately begin working with them. They provide cognitive life skills education and work with participants on their personalized pre-release and post-release case plans. Peers can help with a range of other steps, including expungement information, social security card applications, birth certificate requisition forms, applications for medical cards, naloxone training, local resource guides, employment opportunities, and treatment options. Ideally, peers begin meeting with individuals a month before their release.
After release, the participant’s post-release case plan begins. The peer provides a safe ride from the corrections facility directly to the community or to a treatment center and makes sure the participant’s basic needs are met. The peer connects the individual to community resources such as housing, employment opportunities, self-help meetings, medications for opioid use disorder (MOUD) treatment if desired, primary care, and case management. The peer is also available to attend doctors’ visits and NA/AA meetings and appointments to apply for Medicaid, an identification card, Supplemental Nutrition Assistance Program, etc.
For the first 30 days after release, the participant has weekly face-to-face contact with the peer. Days 31 through 60, that face-to-face contact occurs biweekly. Days 61-120, the participant has monthly phone calls with the peer that continue for the duration of the grant project.
As of September, FDF had begun serving 45 participants, both male and female, in Clark County. At this time, most participants are still incarcerated. Eight have been released into an SUD residential treatment facility.
FDF’s new RCORP grant from the Health Resources and Services Administration is supporting provision of pre-release naltrexone injections to those who are interested in this treatment. Pre-release naltrexone suppresses cravings for opioids that can lead to relapse and overdose for individuals whose tolerance has been reduced during incarceration. The new grant allows First Day Forward to expand to Montgomery County and to provide pre-release naltrexone injections for the Rowan County jail’s reentry program.
Below are testimonials from three participants in the program:
The benefits of the FDF program have been amazing for me personally. I can now see what makes me tick and what leads me to think that I can use. It's all excuses. I have to work on myself and figure out why I turn to use before I can live a better life. The reason I ended up with a record is because I would rob anyone to make myself feel “well.” This is true for most people like me. When it comes to my anger, I have learned I use it as an excuse because I can't let go of my trauma. Until I get to the root of my past, I will continue to make the same mistakes. This program helped me to realize all of this. It's refreshing to finally have something that helps me understand where I went wrong.
—Donnie, FDF participant, Clark County
First Day Forward was really beneficial for my recovery. It helped me connect to the recovery community within Clark County and the resources I needed to attain long term recovery. If it wasn’t for this wonderful program I would have gone back to using drugs/alcohol. This would have ultimately led to death or jail. I am forever grateful for this program and encourage all who can to participate. I have been moving forward since the first day of my release!
—Brandon, FDF participant, Clark County
My name is Casey, I am a 35-year-old heroin addict from Winchester, KY. My clean date is 11/05/20. I am a client of ART [Achieving Recovery Together] and in a program called First Day Forward. … this is how it helped save my life.
I can remember sitting in jail as a result of my addiction feeling hopeless, alone, and totally lost. Having zero ties to anyone in recovery or any support to help me stay clean outside of jail. I heard about a program called First Day Forward that ART had just started and all I knew is that it was for addicts like me. So I signed up. I am so grateful for that decision because I know it’s a big part of why I am still clean today.
First Day Forward gave me hope and the support I truly needed. They helped me start my recovery from inside the jail. The program helped me with so many things from finding me a bed at a treatment center, driving me from jail to the treatment center. They bought me clothes, hygiene items, helped me get my birth certificate, social security card, just so many things, … but most of all they gave me hope and support. They helped love me back to life and gave me the strength in knowing I wasn’t alone anymore. It’s a group of people just like me and I love them all.
First Day Forward changed my life and put people in my path who believe in me and helped me to believe in myself. Thank you, with all of my heart, First Day Forward and everyone at ART!
—Casey, FDF participant, Clark County
First Day Forward could have a positive impact for individuals like Donnie, Brandon, and Casey and for communities. Data will be collected throughout the project to assess recidivism, employment rates, housing linkages, and other outcomes. Having expanded the program to Montgomery County and to provide support to the re-entry program in Rowan County, St. Claire is in the process of submitting a new grant to replicate FDF in Carter County.
This article was adapted from content provided by St. Claire HealthCare.