Data, Performance Outcomes and Substance Use Disorder Services

1. Data, Performance Outcomes and Substance Use Disorder Services Office of Substance Abuse Services DMHMRSAS

2. History of Performance Outcome Measurement Systems in Virginia • 1992 - Statewide Client Automated Data System (SCADS) – Expanded version of the Treatment Episode Data Set (TEDS Plus) • 1996 - State Performance Outcome Measurement System (POMS) process • 1998-2002 - Treatment Outcomes and Performance Pilot Studies II (TOPPS II) • 2002-2004 - SCADS/CCS • 2005 – PPG reporting • Data Sources: SCADS, CARS, POMS, Special Projects ED Forum March 2004

3. SCADS/TEDS • Data collection • since 1992 • submitted electronically on a quarterly basis • Oct 2001 OSAS started paying attention to the quality and quantity of data • Oct 2002 all CSBs were reporting data • January 2003 OSAS started reporting on data • SCADS Products • Quarterly data quality and performance outcome indicator reports sent electronically (with CCS the frequency will increase to monthly) • On-site technical assistance visits ED Forum March 2004

4. SCADS Submission ED Forum March 2004

5. Data Quality Report ED Forum March 2004

6. Performance Outcome Reports ED Forum March 2004

7. Outcome Reporting ED Forum March 2004

8. SCADS and CARS ED Forum March 2004

9. SCADS and CARS ED Forum March 2004

10. Transition from SAPT to PPG • Currently required data reporting on service utilization, cost and client demographics are aggregate. • The philosophical shift from the SAPT BG to the PPG is due to the increasing focus on accountability. • States will be monitored for performance, not entirely on expenditures. • This shift in focus requires client-based data from the provider. ED Forum March 2004

11. PPG Indicators • Core Outcome measures • Change in frequency of alcohol use • Change in frequency of other drug use • Change in employment status • Change in criminal justice involvement • Core Process Measures • Appropriateness of services for consumers with Co-occurring SA and MH disorders, TB, HIV/AIDS • Access to SA services for Pregnant Women ED Forum March 2004

12. Individuals with Co-Occurring SA and MH • Percentage of clients (adults and children/adolescents) in mental health and substance abuse programs with symptoms of corresponding co-occurring problem • Percent of treatment programs that • Screen for co-occurring orders • Assess & diagnose co-occurring disorders • Provide treatment to clients through collaborative, consultative, and integrated models of care • Percentage of clients who experience reduced impairment from their co-occurring disorders following treatment ED Forum March 2004

13. Individuals with TB • Checklist of state AOD agency policies communicated through administrative mechanisms. The checklist may include: • MOUs and other linkage agreements • Conduct screening of clients and staff • Referrals for treatment • Assisting clients in medications compliance • Other (BG requirements for documentation) ED Forum March 2004

14. Individuals with HIV/AIDS • Checklist of state AOD agency policies communicated through administrative mechanisms. The checklist may include: • MOUs and other linkage agreements • HIV/AIDS counseling programs • Pre- and post test counseling • Conduct testing • Referrals for treatment • Interim services • Other ED Forum March 2004

15. Developmental or Optional PPG Indicators • Homelessness (outcome or process) • Penetration • Utilization equity • Unduplicated client count • Wait time/Wait lists • Appropriateness of services Length of stay • Outcomes for treatment completers and non-completers • Cost of services • Involvement in AA, NA, or other self-help groups • Capacity (service, data, etc) • Workforce development and competence ED Forum March 2004

16. Potential Issues/Challenges for PPG • Data needs to be updated in the MIS systems at admission and discharge to demonstrate change given the design of CCS • Discharge date (administrative vs. last date of contact): Length of Stay • Unique client ID ED Forum March 2004

17. Summary • To meet the requirements for PPG, the Commonwealth of Virginia will use • Primary data collected on all SA consumers at admission and discharge • Annual survey to collect data on process measures ED Forum March 2004

18. Sources for information • http://wwwdasis.samhsa.gov/dasis2/manuals/teds_adm_manual.pdf • http://www.dmhmrsas.state.va.us/Organ/CO/Offices/OSAS/RE/NewsLetters/Vol1Issue5.doc • Office of Substance Abuse Services http://www.dmhmrsas.state.va.us/Organ/CO/Offices/OSAS/defaultRE.htm 804-786-3906 or 804-371-0802 ED Forum March 2004

19. Who should be in SCADS? ALL clients who are admitted for SA Tx to any program receiving public funds An admission is defined as the formal acceptance of a client into SA Tx. An admission has occurred if and only if the client begins Tx. Therefore events such as initial screening, referral, and wait-listing are considered to take place before the admission to treatment and are NOT reportable to SCADS/TEDS. ED Forum March 2004