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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
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
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

statewide needs assessment planning
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

consequences of aod abuse
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

annual fiscal cost to ca
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

aod treatment need
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

subpopulation aod treatment need
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

subpopulation aod treatment need continued
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

system performance
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

treatment admissions
Treatment Admissions

State of California

Department of Alcohol and Drug Programs

10

client demographics by gender
Client Demographics – By Gender
  • 64% Male
  • 36% Female

State of California

Department of Alcohol and Drug Programs

11

client demographics by race ethnicity
Client Demographics – By Race/ Ethnicity

State of California

Department of Alcohol and Drug Programs

12

client demographics by age
Client Demographics – By Age

State of California

Department of Alcohol and Drug Programs

13

source of client referral
Source of Client Referral

State of California

Department of Alcohol and Drug Programs

14

treatment outcomes
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

statewide needs assessment planning priorities
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

adp fy 2011 12 budget
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

adp budget by fund source
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

adp budget by category
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
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

main tenets of realignment
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

the realignment proposal
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

drug medi cal dmc 130 7 million
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

non dmc regular perinatal 25 7 million
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

drug courts 26 8 million
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

impact on clients
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

maintenance of effort moe
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

phase 1 fy 2011 12
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

roles functions of adp
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

roles functions of adp continued
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

benefits risks benefits
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

benefits risks risks
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

aca overarching goal
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

aca requirements for sud services
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

aca requirements for sud services continued
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

major aca sud related tasks
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

major aca sud related tasks continued
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

major aca sud related tasks continued1
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

slide39

California Department of Alcohol & Drug Programs

Thank You

www.adp.ca.gov

State of California

Department of Alcohol and Drug Programs

39