Section 35 Commission

Treatment Statistics from

BSAS Programs

Feburary 28, 2019

Overview

Section 35 programs

Section 35 Capacity

Court clinic evaluation results

DPH/BSAS data

Demographics

Outcomes

2

Section 35 Commitment Criteria

• The respondent is an individual with an alcohol or

a substance use disorder, as defined in G.L.c.

123, S35;

AND

• There is a likelihood of serious harm, as defined in

G.L.c. 123, S1, as a result of the respondent’s

alcoholism or substance use disorder, to the

respondent, the petitioner, or any other person.

3

Section 35 Programs

DPH/BSAS Managed Programs

Women’s Addiction Treatment Center (WATC)

Highpoint Treatment Center at Shattuck

Men’s Addiction Treatment Center (MATC)

DMH Managed Program

Women’s recovery from Addiction Program (WRAP) in Taunton

DOC Managed program

Massachusetts Alcohol and Substance Abuse Center (MASAC)

First Step Program, MCI Framingham

HOC Managed program

Stonybrook Stabilization and Treatment Center-Ludlow

Stonybrook Stabilization and Treatment Center- Springfield

4

Section 35 Program Capacity

5

Site Name No. of Beds

(Gender)

Services Provided

& No. of Beds

DPH

Women’s Addiction Treatment Center

(WATC)

102 (F) 30 ATS and 72 CSS

Highpoint Treatment Center at Shattuck (JP) 32 (F) 16 ATS and 16 CSS

Men’s Addiction Treatment Center (MATC) 108 (M) 32 ATS and 76 CSS

DMH Women’s recovery from Addiction Program

(WRAP) in Taunton

45 (F) 15 ATS and 30 CSS* All 45

beds are capable for detoxing

clients.

DOC

Massachusetts Alcohol and Substance

Abuse Center (MASAC)

251 (M) 42 ATS and 209 CSS

MCI Framingham First Step Program N/A; Dual Status

must have bail(F)

Detox and CSS

HOC

Stonybrook Stabilization and Treatment

Center-Ludlow

48 (M) 48 ATS and CSS

Stonybrook Stabilization and Treatment

Center- Springfield

32 (M) 32 CSS

Average number of Female Section 35

Beds available on a given day; FY 2018

6

24.5

21.7

20.4

17.7 14.5

11.5

10.6

9.9

4.4

10.2

22.7

36.5

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

AverageNumber ofAvailableBeds

Nu

mb

er

Priority Admissions to Residential

Programs for Section 35 Clients

7

Transitional Support Service

Programs (TSS)

Residential Recovery Service

Programs (RRS)

High Point TSS

(Co-ed)-Taunton

Community Health Link RRS- Beryl’s House

(Women) -Worcester

Community Health Link TSS

(Co-ed)- Worcester

Center for Human Development RRS- Two

Rivers

(Women)-Greenfield

High Point RRS- New Chapters

(Men)-New Bedford

Behavioral Health Network RRS-

Coles Place

(Men)- Springfield

Admissions to these programs are prioritized for civil commitments who are

stepping-down to community programming upon commitment completion.

All commitments are eligible to receive CSP (Community Support Program)

case management services for up to 12 months from the time of release.

Section 35

Petitions/Evaluations/Commitments

FY 2018

• Total number of petitions 10,770

• Total number of evaluations conducted

7,244

• Total number of commitments 5,716

8

Court Clinic Evaluations

FY 2018

Demographic breakdown from court clinic

evaluations (7,244):

Race:

• 85.7% White

• 6.3% Black

• 0.47% Asian

• 7.4 % Other

Gender:

• 36.4% Female

• 63.4% Male

Client Region:

Central 2,669

Southeast 1,857

Northeast 1,066

Western 946

Boston 507

Homelessness:

• 23.7% homeless

9

10

Section 35 Enhanced Rate

• DPH Section 35 programs bill an enhanced rate in addition to the bed

day rates for ATS or CSS for treatment of civilly committed individuals

101 CMR 346: Rates for certain substance-related and addictive

disorders programs

Code: H0011-H9

Rate: $36.03

Description: Alcohol and/or drug services; acute detoxification

(residential addiction program inpatient) (court ordered) (Treatment for

Civilly Committed Persons Add-on)

• This allows them to offer an enhanced level of care that includes transportation,

extra medical, psychiatric, recovery specialist care, family counseling, and

additional administrative staff for the intake

BSAS Section 35 Programs

• The remainder of this report is based on data submitted to BSAS

by DPH/BSAS managed programs highlighted in earlier slide.

• Section 35 enrollments are compared to a BSAS population

receiving similar treatment (ATS enrollments entering CSS

within 48 hours of disenrollment from ATS)

• 5,065 ATS+CSS enrollments were compared to 3,239 Section

35 enrollments.

• 2017 BSAS data was used in this report in order to present 12

month follow up outcomes.

• A significant number of commitments are not included in this

report. Those include male commitments receiving services from

MASAC (DOC) and Stoney Brook (HOC) and female

commitments receiving services from WRAP (DMH).

11

Demographics of BSAS Enrollments:

Race/Ethnicity

12

74.6

7.0 13.1

5.4

82.6

5.0 7.5 4.9

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0W

hite

, N

on

-H

isp

anic

Bla

ck, N

on

-H

isp

anic

His

pa

nic

Mu

lti-

Racia

l/O

the

rs

ATS&CSS

Section 35

Pe

rce

nta

ge

ATS+CSS and Section 35 Enrollments by Race/Ethnicity; FY 2017

Demographics of BSAS Enrollments:

Age

0.95

11.66

24.89

32.8

17.6

10.89

0.89 0.32

12.61

4.58

20.32

23.38 24.46

13.61

10.79

1.3 1.58

24.9

0

5

10

15

20

25

30

35

18-20 21-25 26-30 31-40 41-50 51-60 61-64 65+ 18-25

Pe

rce

nta

ge

ATS+CSS and Section 35 Enrollments, by Age Group; FY 2017

ATS&CSS

Section 35

Median and Mean Age Median Mean

ATS+CSS^ 33 35.9 Section 35 31 34.5

13

Demographics of BSAS Enrollments:

Housing & Employment

41.51

8.52

76.04

19.46

0

10

20

30

40

50

60

70

80

Housed Employed

Pe

rce

nta

ge

ATS+CSS and Section 35 Enrollments by Housing and Employment; FY 2017

ATS&CSS

Section 35

14

Primary Drug Reported

28.09

66.73

5.18

37.45

52.38

10.17

0

10

20

30

40

50

60

70

80

Alcohol Heroin/OtherOpiates

Other Drugs

Pe

rce

nta

ge

ATS+CSS and Section 35 Enrollments by primary drug; FY 2017

ATS&CSS

Section 35

15

Primary Drug Reported By Age

16

6.1

10.5

15.9

22.5

44.1

64.7 64.4

40.0

18.4 12.8

18.5

34.4

70.7

83.7 85.7

92.2

85.7 84.6

79.5

71.2

50.2

32.8 31.1

60.0

64.6

74.9

70.5

54.3

22.5

11.5 11.9

5.9 8.2

4.9 4.5 6.3 5.6

2.6 4.4

0.0

17.0

12.4 11.0 11.4

6.8 4.9

2.4 2.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

18-20Years

21-25Years

26-30Years

31-40Years

41-50Years

51-60Years

61-64Years

65+ Years

Alcohol-ATS&CSS

Alcohol-Section 35

Heroin/Other Opiates-ATS&CSS

Heroin/Other Opiates:Section 35

Other Drugs:ATS&CSS

Other Drugs: Section35

Pe

rce

nta

ge

ATS&CSS and Section 35 Enrollments by Primary Drug Use and Age

Group; Fy 2017

Primary Drug Reported by

Race/Ethnicity

17

27.6

49.0

18.4

31.3

37.2

51.5

32.0

35.9

66.7

45.9

78.8

64.4

53.5

32.5

52.9 53.8

5.6 5.1 2.7

5.1

9.4

16.0 15.2

10.3

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Wh

ite

, N

on

-H

isp

anic

Bla

ck, N

on

-H

isp

anic

His

pa

nic

Mu

lti-

Ra

cia

l/O

the

r

Alcohol-ATS& CSS

Alcohol-Section 35

Heroin/OtherOpiates-ATS& CSS

Heroin/OtherOpiates-Section 35

Other Drugs-ATS&CSS

Other Drugs-Section35

Pe

rce

nta

ge

ATS&CSS and Section 35 Enrollments by Primary Drug Use and

Race; FY 2017

History of Lifetime Overdose

56.18

33.69

10.13

62.93

30.77

6.31

0

10

20

30

40

50

60

70

No Overdose 1-5 times Overdose 6+ times Overdose

Pe

rce

nta

ge

Lifetime Overdose History Among ATS+CSS and Section 35 Enrollments; FY 2017

ATS&CSS

Section 35

18

History of Mental Health Treatment

19.87 17.32

62.8

31.5 27.49

41.01

0

10

20

30

40

50

60

70

Prior Counseling Prior Hospitalization(s) No Prior History

Pe

rce

nta

ge

History of Mental Health Treatment among ATS+CSS and Section 35 Enrollments; FY 2017

ATS&CSS

Section 35

19

History of Mental Health

Medication

20

29.16

45.91

0

5

10

15

20

25

30

35

40

45

50

ATS&CSS Section 35

Pe

rce

nta

ge

Reported history of Mental Health Medication in the Past Year for

ATS+CSS and Section 35 Enrollments; FY 2017

Outcomes

Treatment completion

LOS

Treatment follow up

Findings from Chapter 55 Study

21

Completion Status

22

29.5

61.8

3.5

92.6

0

10

20

30

40

50

60

70

80

90

100

Dropped Out Completed

ATS&CSS

Section 35

ATS+CSS and Section 35 Dis-enrollments, by

Completion Status; FY 2017

Pe

rce

nta

ge

Post Discharge Transitions

23

3.4

53.9

2.2

19.37

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Relapsed Enrolled into other BSAS Programs

Pe

rce

nt

of

dis

en

roll

me

nts

(%

)

14-Day Transitions for ATS+CSS and Section 35 Dis-enrollments that Completed Treatment; FY2017

ATS&CSS

Section35

Post Discharge Transitions

24

42.9

3.4

46.3

1.2 4.1

2.2

78.4

2.2

14.8

0.8 3.3

0.5 0

10

20

30

40

50

60

70

80

No Transition DetoxServices

ResidentialServices

MedicationAssisted

Treatment(MAT)

OutpatientServices

Others

ATS&CSS

Section 35

14-day Transitions for ATS-CSS and Section 35 Dis-enrollments

that Completed Treatment; FY 2017

Pe

rce

nta

ge

Length of Stay

25

20.2

19

22

20

17.5

18

18.5

19

19.5

20

20.5

21

21.5

22

22.5

Mean Median

ATS+CSS

Section 35

Average Length of Stay for ATS+CSS and Section 35

Completed Dis-enrollments; FY 2017

LO

S (

in n

um

ber

of

days

)

Findings from Chapter 55: Voluntary vs Involuntary Treatment and Opioid Related

Overdoses

• Study population: 73,620 BSAS clients with a history of

opioid-related enrollment, of which 8,181 people had a

history of involuntary commitments (2011-2015 BSAS

Treatment System)

• 1,908 opioid-related overdose deaths occurred among

BSAS population listed above

26

Findings from Chapter 55: Voluntary vs Involuntary Treatment and Opioid Related

Overdoses

Risk of Opioid Overdose Death by Treatment Type

No Involuntary

Treatment

Any Involuntary

Treatment

Fatal Opioid-related

Overdose

1611 297

Total Individuals 65,439 8,181

Percent Fatal

Overdoses

2.5% 3.6%

27

When compared to clients without a history of involuntary

treatment, clients with a history of involuntary treatment were • 1.4 times as likely to die of opioid related overdoses

• 1.2 times as likely to die of any reportable cause

Connect with DPH

28

@MassDPH

Massachusetts Department of

Public Health

DPH blog https://blog.mass.gov/publichealth

www.mass.gov/dph

Thank You!