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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. State of California Department of Alcohol and Drug Programs. 1. Overall Strategic Goal.

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California Department of Alcohol and Drug Programs

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  1. 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

  2. Overall Strategic Goal To develop and maintain a comprehensive, integrated statewide prevention and treatment system. State of California Department of Alcohol and Drug Programs 2

  3. 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 Drug Programs 3

  4. 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 Drug Programs 4

  5. Annual Fiscal Cost to CA • Alcohol abuse: $38.4 billion • Illicit Drug Abuse: $23.8 billion State of California Department of Alcohol and Drug Programs 5

  6. 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 Drug Programs 6

  7. 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 Drug Programs 7

  8. 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 Drug Programs 8

  9. 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 Drug Programs 9

  10. Treatment Admissions State of California Department of Alcohol and Drug Programs 10

  11. Client Demographics – By Gender • 64% Male • 36% Female State of California Department of Alcohol and Drug Programs 11

  12. Client Demographics – By Race/ Ethnicity State of California Department of Alcohol and Drug Programs 12

  13. Client Demographics – By Age State of California Department of Alcohol and Drug Programs 13

  14. Source of Client Referral State of California Department of Alcohol and Drug Programs 14

  15. 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 Department of Alcohol and Drug Programs 15

  16. 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 Department of Alcohol and Drug Programs 16

  17. 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 Department of Alcohol and Drug Programs 17

  18. ADP Budget by Fund Source Other Funds $28.1 4.5% Federal Funds $260.1 41.2% General Fund $222.1 35.2% DMC FFP $120.1 19.1% State of California Department of Alcohol and Drug Programs 18

  19. 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

  20. 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 Department of Alcohol and Drug Programs 20

  21. 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 Department of Alcohol and Drug Programs 21

  22. The Realignment Proposal Non Drug Medi‑Cal Regular $ 5.2 m Non Drug Medi‑Cal Perinatal 20.5 m Drug Court Partnership Act 6.8 m Comprehensive Drug Court Implementation Act 15.7 m Dependency Drug Court Program 4.3 m Drug Medi‑Cal Program 130.7 m State Support 0.8 m Total Realignment $184 m State of California Department of Alcohol and Drug Programs 22

  23. 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 Department of Alcohol and Drug Programs 23

  24. 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 Department of Alcohol and Drug Programs 24

  25. 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 Department of Alcohol and Drug Programs 25

  26. 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 Department of Alcohol and Drug Programs 26

  27. 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 Department of Alcohol and Drug Programs 27

  28. 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 Department of Alcohol and Drug Programs 28

  29. 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 Department of Alcohol and Drug Programs 29

  30. 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 Department of Alcohol and Drug Programs 30

  31. 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 Department of Alcohol and Drug Programs 31

  32. 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 Department of Alcohol and Drug Programs 32

  33. 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 Department of Alcohol and Drug Programs 33

  34. 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 Department of Alcohol and Drug Programs 34

  35. 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 Department of Alcohol and Drug Programs 35

  36. 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 Department of Alcohol and Drug Programs 36

  37. 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 Department of Alcohol and Drug Programs 37

  38. 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 Department of Alcohol and Drug Programs 38

  39. California Department of Alcohol & Drug Programs Thank You www.adp.ca.gov State of California Department of Alcohol and Drug Programs 39

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