california department of alcohol and drug programs
DESCRIPTION
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 Drug Programs. 1. Overall Strategic Goal. - PowerPoint PPT PresentationTRANSCRIPT
1State of California
Department of Alcohol and Drug Programs
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
2
To develop and maintain a comprehensive, integrated statewide prevention and
treatment system.
Overall Strategic Goal
State of CaliforniaDepartment of Alcohol and Drug Programs
3
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.
Statewide Needs Assessment & Planning
State of CaliforniaDepartment of Alcohol and Drug Programs
4
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
Consequences of AOD Abuse
State of CaliforniaDepartment of Alcohol and Drug Programs
5
Alcohol abuse: $38.4 billion
Illicit Drug Abuse: $23.8 billion
Annual Fiscal Cost to CA
State of CaliforniaDepartment of Alcohol and Drug Programs
6
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
AOD Treatment Need
State of CaliforniaDepartment of Alcohol and Drug Programs
7
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
Subpopulation AOD Treatment Need
State of CaliforniaDepartment of Alcohol and Drug Programs
8
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)
Subpopulation AOD Treatment Need (continued)
State of CaliforniaDepartment of Alcohol and Drug Programs
9
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
System Performance
State of CaliforniaDepartment of Alcohol and Drug Programs
Treatment Admissions
10
State of CaliforniaDepartment of Alcohol and Drug Programs
19%
12%
5%
7%
57%
ODF Non-NTP
ODF NTP
ODF Detox
RES Detox
RES
11
Client Demographics – By Gender
State of CaliforniaDepartment of Alcohol and Drug Programs
64% Male
36% Female
Client Demographics – By Race/ Ethnicity
12
State of CaliforniaDepartment of Alcohol and Drug Programs
42%
34%
17%
2% 1%4%
White Hispanic AfricanAmerican
Asian/PacificIslander
AmericanIndian/AK
Native
OtherRace/Multi-
Racial
Client Demographics – By Age
13
State of CaliforniaDepartment of Alcohol and Drug Programs
12%
18%
24% 23%
18%
5%
0%
5%
10%
15%
20%
25%
30%
Under 18 18-25 26-35 36-45 46-55 56 +
Source of Client Referral
14
State of CaliforniaDepartment of Alcohol and Drug Programs
43%
34%
13%
7% 3%
CriminalJustice
Individual Self Referral
Community/Health/Work
AODProgram
School
15
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
Treatment Outcomes
State of CaliforniaDepartment of Alcohol and Drug Programs
16
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
Statewide Needs Assessment & Planning Priorities
State of CaliforniaDepartment of Alcohol and Drug Programs
17
ADP’s proposed budget for FY 2011-12 is $630.4 million
This is a total increase of $24.3 million
ADP FY 2011-12 Budget
State of CaliforniaDepartment of Alcohol and Drug Programs
ADP Budget by Fund Source
18
State of CaliforniaDepartment of Alcohol and Drug Programs
Other Funds$28.14.5% General Fund
$222.135.2%
Federal Funds
$260.1
41.2%
DMC FFP$120.119.1%
ADP Budget by Category
19
State of CaliforniaDepartment of Alcohol and Drug Programs
Local Assistance$587.993.3% State Support
$42.56.7%
20
Governor’s Realignment Proposal
State of CaliforniaDepartment of Alcohol and Drug Programs
$184 million in General Fund is proposed to be realigned to the counties to fund the responsibilities of providing substance abuse disorder
treatment services
21
Main Tenets of Realignment
State of CaliforniaDepartment of Alcohol and Drug Programs
Flexibility for decision making
Adhere to minimum federal requirements
Maximize federal resources Minimize adverse impacts
to clients and patients
22
The Realignment Proposal
State of CaliforniaDepartment of Alcohol and Drug Programs
Non Drug Medi‑Cal Regular $ 5.2 mNon Drug Medi‑Cal Perinatal 20.5 mDrug Court Partnership Act 6.8 mComprehensive Drug Court Implementation Act 15.7 mDependency Drug Court Program 4.3 mDrug Medi‑Cal Program 130.7 mState Support 0.8 m
Total Realignment $184 m
23
State of CaliforniaDepartment of Alcohol and Drug Programs
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.
24
State of CaliforniaDepartment of Alcohol and Drug Programs
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
25
State of CaliforniaDepartment of Alcohol and Drug Programs
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
26
State of CaliforniaDepartment of Alcohol and Drug Programs
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
27
State of CaliforniaDepartment of Alcohol and Drug Programs
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
28
State of CaliforniaDepartment of Alcohol and Drug Programs
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
29
State of CaliforniaDepartment of Alcohol and Drug Programs
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
30
State of CaliforniaDepartment of Alcohol and Drug Programs
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
31
State of CaliforniaDepartment of Alcohol and Drug Programs
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
32
State of CaliforniaDepartment of Alcohol and Drug Programs
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
33
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
ACA Overarching Goal
State of CaliforniaDepartment of Alcohol and Drug Programs
34
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
ACA Requirements for SUD Services
State of CaliforniaDepartment of Alcohol and Drug Programs
35
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
ACA Requirements for SUD Services (continued)
State of CaliforniaDepartment of Alcohol and Drug Programs
36
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
Major ACA SUD Related Tasks
State of CaliforniaDepartment of Alcohol and Drug Programs
37
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
Major ACA SUD Related Tasks (continued)
State of CaliforniaDepartment of Alcohol and Drug Programs
38
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
Major ACA SUD Related Tasks (continued)
State of CaliforniaDepartment of Alcohol and Drug Programs
39
State of CaliforniaDepartment of Alcohol and Drug Programs
Thank You
www.adp.ca.gov
California Department of Alcohol & Drug Programs