Agree to Participate

Appendix_D_Agree_to_participate_.doc

Evaluation of the Reintegration of Ex-Offenders—Adult Program (RExO)

Agree to Participate

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Agreement to Participate in the RExO Study

Y

RExO Evaluation Team

SPR MDRC NORC

ou have been invited to take part in a study of the Reintegration of Ex-Offenders (RExO) program. In describing RExO, someone may have called it the Prisoner Re-entry Initiative, PRI or another name specific to your area. This form describes the study and explains what it means for you to be in it. By signing this form, you are agreeing to be in the study. We hope you will agree to participate.


The goal of the study is to learn about the ways in which RExO programs help ex-offenders re-enter their communities, find work and avoid returning to prison or jail. RExO programs are being run by 24 organizations located around the country and are funded by the U.S. Department of Labor. The research is being conducted by three organizations: Social Policy Research Associates, MDRC and the National Opinion Research Center.


What is the RExO program?

RExO programs provide case management, job placement assistance and mentoring. Their goal is to help ex-offenders find work and avoid returning to jail or prison. Each RExO program is different. If you have questions about the program in your city, please ask the staff person leading you through this document.


Who is eligible to be in RExO?

You are eligible to participate in a RExO program if you:

        • are 18 years of age or older;

  • have been convicted as an adult and imprisoned according to federal or state law;

  • will be enrolled within 180 days of your release from prison, jail or a halfway institution;

  • have never been convicted of a sex-related offence; and

  • meet the requirements of your local program and state concerning violent crimes.


What does it mean to be a part of this study?

Because there are not enough funds to help everyone eligible to participate, and because the research team plans to study the ways in which RExO helps ex-offenders find work and avoid returning to jail or prison, a process called “random assignment” will be used. Random assignment is like a lottery. It has nothing to do with your age, race, gender or other personal traits. If you agree to be a part of the study, by signing this form, you will be placed into one of two groups:


  • RExO Program Group: You will have a 60 percent chance of being assigned to the RExO program group, which means that you may enroll in a RExO program.

  • Control Group: You will have a 40 percent chance of being assigned to the control group, which means that you will not be able to enroll in a RExO program for one year, but you may still enroll in other similar programs and services in your community.


What information will the research team collect?

The research team will collect three types of information from everyone who agrees to be a part of the study:


  1. Background and contact information. You will be asked to provide information about yourself such as your age, race, gender, social security number, employment, education, and history with the justice system.


  1. Contact data. In the future, the research team will contact you to complete a survey about your work experience, life after incarceration and/or experience with RExO. To help contact you then, you will be asked to list the names of people who know how to reach you.


  1. Other information. By signing this form, you give the research team permission to collect additional information for up to three years:

  • The Department of Labor will provide the research team with information on your participation in the RExO program if you are assigned to the RExO program group.

  • Researchers will collect information from state and federal agencies about things like your quarterly earnings and any involvement you have had or will have with the criminal justice system. The research team will use your social security number and criminal justice or prison ID numbers to get this information.

  • Researchers may collect information from service providers in the community about your participation in other programs.

  • The research team may contact you in the future to complete a survey.


How will my information be kept private?

The research team will follow strict rules to protect your privacy. All research staff working on this project are trained to protect personal information and have signed a privacy pledge.  Any papers that include your name or other identifying information will be kept in a locked area, and any computer files with your name will be protected by a password. Your name will never be used in any report written for the project.


However, please keep in mind that we will have to report to the authorities in accordance with any applicable laws, for example if you tell the research team about someone being harmed or that you want to harm someone. Also, we would have to disclose information about you, if a court orders us to do so.  

What are the benefits and risks of participating in the study?

You have a 60 percent chance of being able to enroll in a RExO program and to take advantage of those services. Also, you will help the research team and policymakers learn how to create better programs for people in the same situation you are in.


The risks are small. Even if you are assigned to the control group, you will have access to other employment and social services available in your community. Furthermore, as a study participant, you do not have to answer any questions that make you feel uncomfortable.

You are not required to take part in the study.

If you decide not to be in the study, there is no penalty. Your decision should not affect your parole status or other terms of your release. However, your only opportunity to be in a RExO program will be by agreeing to take part in this study. You may drop out of the study at any time by contacting the person listed below. If you choose to drop out, the research team may still use information that was collected about you while you were in the study.

When does my participation begin?

This agreement is effective from the date you sign it (below) until the end of the study.

What does signing this form mean?

I have read this form and agree to be in the Reintegration of Ex-Offenders study. I know that my participation is voluntary, that all information about me will be kept private, and that my name will never appear in any public document. I know that I can withdraw from the study at any time without penalty. I understand that the research team will get information about me from programs and agencies, as described above, and that they will use my Social Security Number and criminal justice ID numbers to collect this information.”



__________________________________________________________________________________________ Your Name (Print) Your Signature Date



If you have questions about the study, please contact Andrew Wiegand, Project Director at SPR: by phone at 510-763-1499 or by mail at 1330 Broadway, Suite 1426, Oakland, CA 94612. If you have questions about the RExO program, please speak with a staff person.

R

For Staff Only

PRI Participant ID:

ExO Informed Consent Form, page
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File Typeapplication/msword
File TitleYou have been invited to take part in a study of the Reintegration of Ex-Offender (RExO) program, also known as the Prisoner Re-
Authorcgeckeler
Last Modified Bynaradzay.bonnie
File Modified2012-01-20
File Created2012-01-20

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