Post-Incarceration Engagement (PIE)
Last updated
Share PrintVeterans leaving incarceration face many challenges. The Post-Incarceration Engagement (PIE) program is a peer-support intervention that supplements the VA’s Health Care for Re-entry Veterans (HCRV) and Veterans Justice Outreach services. Linkage and referral efforts focus on helping Veterans connect to and stay engaged in appropriate VA primary care, mental health, and substance use treatment services. It also includes active support accessing housing, employment, benefits, legal services, and community-based resources. Re-entry peers meet frequently with justice-involved Veterans to help prioritize goals and identify steps to achieve their goals. Peers provide mentoring and role modeling to help Veterans reestablish their lives during a challenging adjustment period.
Origin:
November 2017, Edith Nourse Rogers Memorial Veterans' Hospital (Bedford)
Adoptions:
7 successful, 1 unsuccessful
Partners:
Homeless, Quality Enhancement Research Initiative
Recent Updates
Overview
The problem
The US Department of Justice reports that over 650,000 individuals are released from state and federal prisons annually; approximately two-thirds will be rearrested within 3 years. More are released from local and county jails. Ex-offenders are at risk of homelessness and unemployment and often have physical, mental health, and/or substance abuse condition
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The US Department of Justice reports that over 650,000 individuals are released from state and federal prisons annually; approximately two-thirds will be rearrested within 3 years. More are released from local and county jails. Ex-offenders are at risk of homelessness and unemployment and often have physical, mental health, and/or substance abuse conditions. They are at increased risk of suicide following release,
These can lead to poor outcomes, including recidivism and death. The VA's Health Care for Re-entry Veterans (HCRV) program began in 2007 and case managers work with individuals leaving prison. The VA's Veterans Justice Outreach case managers work with veterans leaving jails. The PIE intervention adds a specially trained forensic peer specialist to support returning citizens leaving prison or jail with community reintegration. See more
These can lead to poor outcomes, including recidivism and death. The VA's Health Care for Re-entry Veterans (HCRV) program began in 2007 and case managers work with individuals leaving prison. The VA's Veterans Justice Outreach case managers work with veterans leaving jails. The PIE intervention adds a specially trained forensic peer specialist to support returning citizens leaving prison or jail with community reintegration. See more
The solution
Post-Incarceration Engagement (PIE) peer specialists work with VA reentry case managers by providing support during incarceration, on the day of release, and post-release. Peers provide hope, help reentry Veterans identify and pursue goals, and act as role-models. They may provide transportation and link Veterans to housing, healthcare, benefits, employment
...
Post-Incarceration Engagement (PIE) peer specialists work with VA reentry case managers by providing support during incarceration, on the day of release, and post-release. Peers provide hope, help reentry Veterans identify and pursue goals, and act as role-models. They may provide transportation and link Veterans to housing, healthcare, benefits, employment, and community resources. They help Veterans meet legal obligations. PIE services enhance chances of successful reintegration.
See
more
Images
Above:
Post-Incarceration Engagement - Peer Roles and Activities
The results
PIE peer specialists provided tailored services to justice-involved Veterans and worked in conjunction with a Health Care for Reentry Veterans case manager. PIE participants were placed in housing upon release often in VA domiciliary programs or Veterans temporary housing programs. PIE participants had higher rates of access to outpatient substance use and
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PIE peer specialists provided tailored services to justice-involved Veterans and worked in conjunction with a Health Care for Reentry Veterans case manager. PIE participants were placed in housing upon release often in VA domiciliary programs or Veterans temporary housing programs. PIE participants had higher rates of access to outpatient substance use and mental health care relative to a historical comparison group. Everyone received social support post-release: 91% were linked to concrete services or resources, 88% were transported by the peer and 75% received help completing applications for housing and resources. They had a lower rate of recidivism (7%) compared to the state average (11%) in the first year post-release. Attendees found a weekly drop-in reentry group led by the peer and HCRV case manager to be helpful as they transitioned to community settings.
See
more
Images
Above:
PIE Impact Model
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
Above:
Re-entry kit. Clothing and toiletries may be available from VA (volunteer services or homeless programs) or community.
Implementation
Timeline
-
Month 1
Obtain Veteran Justice Programs (VJP) and Homeless Programs Office (HPO) support for PIE initiative at your facility. Your local Network Homeless Coordinator may be able to assist. -
Month 1
Identify administrative supervisor (and champion for the program) who will manage PIE. Also identify someone who will provide clinical supervision for the peer (may be different from the administrative supervisor). -
Months 2-5
Hiring: Peer identified and hired to implement the PIE model and provide reentry peer services to Veterans. VJP peer specialist may be internal candidate who wants new peer role and duties transferred or peers may be hired from outside of the VA. -
Months 2-4
Adjust the PIE manual and worksheets to reflect conditions and resources at your VA, and the relationships with your state Department of Corrections (DOC) and county correctional facilities -
Months 2-4
Conduct meetings with reentry specialists at state DOC and/or county correctional facilities to obtain buy-in and cooperation with the PIE initiative -
Months 3-5
Training to include all VA required trainings, use of medical record system (e.g. CPRS) and specialized training in the PIE model. Peer(s) trained with PIE manual, shadow peer specialists (possibly from HUD-VASH or homeless programs) and HCRV/VJO case manager(s). Trainings may also be required for corrections to enter facilities.This will take longer if someone is hired from outside the VA. If a GS-5 peer apprentice is hired, that individual must also complete peer certification (specialized training) within the first year of hire. -
Months 3-5
With guidance of HCRV/VJO specialist(s), VJP peer should initialize and complete any DOC or county trainings to permit entrance to correctional facilities (may include federal or state prisons or jails). -
Months 3-5
Peer(s) begin re-entry work with Veterans. If an existing VA peer is hired, they may be able to be trained and start working sooner. Peers may begin post-release work with Veterans while awaiting entrance to incarceration facilities. -
After 6 months
Ongoing program is sustainable. By the end of 6 months we anticipate the VJP peer's caseload will be approximately 12-15 unique post-release Veterans each month. In addition, where possible, the PIE peer will be able to make pre-release visits to incarceration facilities to meet with inmates to tell them about the PIE program and help them plan for release. As part of this pre-release work, the peer may run groups in those carceral institutions. This relationship-building can help decrease transitional anxiety upon release.
Departments
- Mental health care
- Social work
- Fleet vehicle
- Social services
- Homeless Veteran care
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
TOOLS |
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Links
- 2017 study protocol for the Post-Incarceration Engagement quality improvement project by Molly Simmons et al. A two-state comparative implementation of peer-support intervention to link veterans to health-related services after incarceration: a study protocol
- 2021 peer-reviewed paper by Justeen Hyde et al reporting qualitative findings from the PIE project found high levels of transitional anxiety “I've just never done that:” The influence of transitional anxiety on post-incarceration reentry and reintegration experiences among veterans
- 2022 Peer-reviewed paper with findings from PIE pilot Enhancing Community Integration After Incarceration: Findings from a Prospective Study of an Intensive Peer Support Intervention for Veterans with Historical Comparison Group
Risks and mitigations
| Risk | Mitigation |
|---|---|
| VA Facility lacks resources to hire a new peer or repurpose an existing peer. | Meet with leadership early on – especially services lines for mental health, social work, homelessness. Also contact suicide prevention teams and opioid teams because of their potential interest in this kind of initiative working with a high risk population. |
| VA facility prefers peers to have primarily an on-campus role. This limits the VJP peer’s ability to interact with Veterans in the correctional facilities, on day of release, and in the community to help the Veteran meet correctional supervision conditions such as parole and probation, or to provide Veterans with initial housing options if they are not interested in a VA program such as domiciliary. | Provide data from PIE (reports and publications) indicating the benefits of being equally active in the community as on the VA medical center campus. |
| State Department of Correction (DOC) and/or county correctional programs do not share data on Veteran inmates which would allow the peer (with the HCRV program) to easily link with these Veterans prior to their release. | Conduct meetings with DOC and county officials early on, and continue to foster those relationships. See if they will use VRSS system. |
About
Origin story
Our facility data systems improved and enabled the identification of Veterans who had less than 12 months before release. Healthcare for Re-entry Veterans (HCRV) case managers tried to meet with each Veteran prior to their release from incarceration and to assist with re-entry post-release. However, sheer numbers and geographic spread of prisons and jails m
...
Our facility data systems improved and enabled the identification of Veterans who had less than 12 months before release. Healthcare for Re-entry Veterans (HCRV) case managers tried to meet with each Veteran prior to their release from incarceration and to assist with re-entry post-release. However, sheer numbers and geographic spread of prisons and jails made service provision by one individual impossible. A solution was seen in peer specialists who could be an extension of the HCRV specialist. Peers also brought the advantages of lived experience as a Veteran, experience in recovery, and knowledge of the criminal justice system. Shared knowledge and experience helped build relationships and trust with re-entry Veterans.
Original team
Carly Wilson
HCRV Social Worker
Michael Kane
PIE Certified Peer Specialist
Beth Ann Petrakis
Program Manager
Keith McInnes
Research Investigator/Principal Investigator
Justeen Hyde
Research Investigator/Co-Investigator
Comment
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