Transcript San Diego County

California Department of Alcohol and Drug Programs
Coalition of Alcohol &
Drug Associations
Annual Public Policy
Conference
CSAC Conference Center
ADP Planning & Budget for
FY 2011-12
April 12, 2011
State of California
Department of Alcohol and Drug1 Programs
Overall Strategic Goal
To develop and maintain a
comprehensive, integrated
statewide prevention and
treatment system.
State of California
Department of Alcohol and Drug2Programs
Statewide Needs
Assessment & Planning
The Statewide Needs Assessment
and Planning (SNAP) process has
been established within ADP
business operations to develop a
data informed planning and
decision making process.
State of California
Department of Alcohol and Drug3Programs
Consequences of AOD Abuse
Over 20,000 alcohol involved fatal &
injury collisions
Over 287,000 AOD related
hospitilazations
Over 279,000 AOD related
emergency visits
Over 636,000 AOD arrests
State of California
Department of Alcohol and Drug4 Programs
Annual Fiscal Cost to CA
Alcohol abuse:
$38.4 billion
Illicit Drug Abuse:
$23.8 billion
State of California
Department of Alcohol and Drug5 Programs
AOD Treatment Need
Approximately 3.3 million age 12 & older
need, but are not receiving AOD Tx
Of 18 – 25 year olds 24% (over 1 million)
need, but do not receive AOD Tx
Nearly 2 million 26 and older need, but do
not receive AOD Tx
Males have higher percentage than females
of need but are not receiving AOD Tx
State of California
Department of Alcohol and Drug6 Programs
Subpopulation AOD Treatment Need
10% American Indian & 9% Hispanics
need, but are not receiving AOD Tx
Over 1 million Hispanics & Whites need, but
are not receiving AOD Tx
Approximately 107,000 pregnant women in
CA used AOD during pregnancy in 2008
Over 1 million adults 60 and older need
treatment for alcohol & prescription drug
misuse
State of California
Department of Alcohol and Drug7 Programs
Subpopulation AOD Treatment Need
(continued)
Over 100,000 CA homeless need AOD Tx on any
given day
Approximately 416,000 CA veterans need AOD Tx
Approximately 275,000 CA adults with serious
mental illnesses also need AOD Tx
Adults age 21-25 exhibit greatest harm related to
risky & excessive use
Between 750,000 and 1.3 million adults age 21-25
could benefit from early intervention services
(such as SBIRT)
State of California
Department of Alcohol and Drug8 Programs
System Performance
In SFY 2008-09 there were approximately
262,000 unique clients served in:
833 licensed residential facilities
842 certified outpatient facilities
222 licensed detox facilities
145 licensed NTP facilities
State of California
Department of Alcohol and Drug9Programs
Treatment Admissions
19%
ODF Non-NTP
ODF NTP
ODF Detox
12%
57%
5%
RES Detox
RES
7%
State of California
Department of Alcohol and Drug Programs
10
Client Demographics –
By Gender
64% Male
36% Female
State of California
Department of Alcohol and Drug11Programs
Client Demographics – By Race/ Ethnicity
42%
34%
17%
White
Hispanic
African
American
4%
2%
1%
Asian/Pacific
Islander
American
Indian/AK
Native
Other
Race/MultiRacial
State of California
Department of Alcohol and Drug Programs
12
Client Demographics – By Age
30%
24%
25%
20%
15%
23%
18%
18%
12%
10%
5%
5%
0%
Under 18
18-25
26-35
36-45
46-55
56 +
State of California
Department of Alcohol and Drug Programs
13
Source of Client Referral
7% 3%
13%
43%
Criminal
Justice
Individual
Self Referral
Community/
Health/Work
AOD
Program
School
34%
State of California
Department of Alcohol and Drug Programs
14
Treatment Outcomes
87% increase in job training
65% increase in abstinence from AOD use
58% increase in recovery activities
33% increase in employment
12% increase in number of no arrests
10% increase in independent living
8% reported no health problems
State of California
15Programs
Department of Alcohol and Drug
Statewide Needs Assessment
& Planning Priorities
Employ more science-based, population level
prevention strategies and identify new
funding or resource strategies to expand
evidence-based prevention activities in
California
Build the AOD System capacity for early
intervention strategies, such as SBIRT
Planning for Health Care Reform activities
State of California
16Programs
Department of Alcohol and Drug
ADP FY 2011-12 Budget
ADP’s proposed budget for
FY 2011-12 is $630.4 million
This is a total increase of
$24.3 million
State of California
17Programs
Department of Alcohol and Drug
ADP Budget by Fund Source
Federal Funds
Other Funds
$28.1
4.5%
General Fund
$222.1
35.2%
$260.1
41.2%
DMC FFP
$120.1
19.1%
State of California
Department of Alcohol and Drug Programs
18
ADP Budget by Category
Local Assistance
$587.9
93.3%
State Support
$42.5
6.7%
State of California
Department of Alcohol and Drug Programs
19
Governor’s Realignment Proposal
$184 million in General Fund is
proposed to be realigned to the
counties to fund the
responsibilities of providing
substance abuse disorder
treatment services
State of California
20Programs
Department of Alcohol and Drug
Main Tenets of Realignment
Flexibility for decision making
Adhere to minimum federal
requirements
Maximize federal resources
Minimize adverse impacts to
clients and patients
State of California
21Programs
Department of Alcohol and Drug
The Realignment Proposal
Non Drug Medi-Cal Regular
Non Drug Medi-Cal Perinatal
Drug Court Partnership Act
Comprehensive Drug Court
Implementation Act
Dependency Drug Court Program
Drug Medi-Cal Program
State Support
Total Realignment
$ 5.2 m
20.5 m
6.8 m
15.7 m
4.3 m
130.7 m
0.8 m
$184 m
State of California
22Programs
Department of Alcohol and Drug
Drug Medi-Cal (DMC)
$130.7 Million
The DMC funding for realignment
includes the funding for NTPs.
Twenty nine counties currently operate
or contract for NTP services
ADP currently contracts directly with
providers in 8 counties that choose
not to provide the services under their
county contract with ADP.
State of California
23Programs
Department of Alcohol and Drug
Non-DMC – Regular & Perinatal
$25.7 Million
Funding for the Women and
Children’s program is included in
the realignment proposal
For the perinatal program, there is
a federal perinatal MOE
requirement being factored in
State of California
24Programs
Department of Alcohol and Drug
Drug Courts - $26.8 Million
Counties may have flexibility to
determine if they choose to operate
Drug Courts
If they choose to do so, they are
expected to adhere the Drug Court
best practices
State of California
25Programs
Department of Alcohol and Drug
Impact on Clients
No immediate impact to the individuals
served by the treatment programs is
anticipated
Counties are better able to tie local needs
and priorities
The effectiveness and efficiency of
treatment programs will increase with the
control of fiscal and programmatic
decision making
State of California
26Programs
Department of Alcohol and Drug
Maintenance of Effort (MOE)
The federal SAPT Block grant MOE
requirements are being included in
determining the processes and
procedures for realignment in order to
ensure that the expenditures and
services funded can continue to be
counted toward the MOE requirement
State of California
27Programs
Department of Alcohol and Drug
Phase 1 - FY 2011-12
The substance abuse treatment component of
realignment is planned for Phase I, beginning in
FY 2011-12
One step is to solicit the input of our stakeholders to
identify the issues, questions and concerns
Use stakeholder input to establish processes and
procedures that work for both counties and
providers and minimize burdens
Clarify the expected roles and functions of the State and
counties
State of California
28Programs
Department of Alcohol and Drug
Roles & Functions of ADP
Serve as SSA for AOD, SAPT Block
Grant, and other discretionary grants
Delegated administration of DMC
Licensure and certification for
programs and counselors
Data collection, reporting, and
analysis
State of California
29Programs
Department of Alcohol and Drug
Roles & Functions of ADP
(CONTINUED)
Establish AOD Prevention & Treatment
standards
Statewide needs assessment and planning
TA - Translating research into practice
Auditing and fiscal oversight
Public education and information
dissemination
State of California
30Programs
Department of Alcohol and Drug
Benefits & Risks - Benefits
Increased flexibility and local control
Promotes local decision making for
fiscal and programmatic decisions
Flexibility to establish priorities and
tie program and fiscal together
Transfers program oversight and
provider selection to the local level
State of California
31Programs
Department of Alcohol and Drug
Benefits & Risks - Risks
Funding source does not take caseload
growth into account
Negatively effects the MOE
Potential litigation
AOD services become low priority for
funding
State of California
32Programs
Department of Alcohol and Drug
ACA Overarching Goal
The Patient Protection and Affordable Care
Act (ACA), as amended by the Health Care
and Education Reconciliation Act of 2010, has
one major goal:
To transform the way health care is
provided and paid for in the United States
in order to provide quality and affordable
health care for all Americans
State of California
33Programs
Department of Alcohol and Drug
ACA Requirements for SUD
Services
Greater access to treatment by Medicaid
expansion
New marketplaces to purchase health plans
Inclusion of SUD providers & individuals
with SUD conditions in Medicaid; medical
homes as a state option for chronic
conditions
SUDs listed as a national priority
State of California
34Programs
Department of Alcohol and Drug
ACA Requirements for SUD
Services (continued)
The minimum essential health benefits
include substance abuse and mental health
services
Health plans must cover SUDs as essential
health benefit &include evidence based
preventive health services such as SBIRT
Parity coverage of SUDs
State of California
35Programs
Department of Alcohol and Drug
Major ACA SUD Related Tasks
Determine SUD basic benefits
Determine Medi-Cal SUD services &
delivery system changes
Determine population to be served by
public programs
Determine populations and services
to be covered by SAPT Block Grant
State of California
36Programs
Department of Alcohol and Drug
Major ACA SUD Related Tasks
(continued)
Develop & implement plan to integrate with
primary care
Prepare SUD workforce
Facilitate interagency collaboration and
planning
Facilitate SBIRT adoption as a standard of
care
Plan & implement preventive services
State of California
37Programs
Department of Alcohol and Drug
Major ACA SUD Related Tasks
(continued)
Provide TA on ACA
Make necessary statutory & regulatory
changes
Redesign HIT system data collection, reporting
& sharing processes
Redesign SUD financing & administrative
systems
Develop & implement quality improvement
processes & measures
State of California
38Programs
Department of Alcohol and Drug
California Department of
Alcohol & Drug Programs
Thank You
www.adp.ca.gov
State of California
39Programs
Department of Alcohol and Drug