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ACCESS TO RECOVERY (ATR)

ACCESS TO RECOVERY (ATR). Mady Chalk, Ph.D. Director, Division of Services Improvement Center for Substance Abuse Treatment SAMHSA. What is the Access to Recovery Program?.

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ACCESS TO RECOVERY (ATR)

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  1. ACCESS TO RECOVERY (ATR) Mady Chalk, Ph.D. Director, Division of Services Improvement Center for Substance Abuse Treatment SAMHSA

  2. What is the Access to Recovery Program? • ATR is an innovative program that provides both a new source of funding for substance abuse treatment and recovery support services and, by using a voucher mechanism, supports client choice of service provider.

  3. What Are the Goals of ATR? • To insure genuine and independent client choice of treatment and recovery support services at the appropriate level of care. • To increase the array of community-and faith-based programs that provide clinical treatment and recovery support services.

  4. What Are the Goals of ATR? • To provide an additional source of funding for services (vouchers) and, thereby, increase access to clinical treatment and recovery support services.

  5. ATR Funding • The ATR grants were funded in August, 2004. • There are 14 States and 1 Tribal grantee. • The sites have only just begin to fully implement the ATR program. • Significant ramp up time was needed to develop the infrastructure needed to support the program, e.g., clinical assessment systems, voucher tracking and monitoring, eligibility standards, and reimbursement rates.

  6. What is Expected of Grantees? • Grantees are expected to: • Conduct significant outreach to a wide range of new service providers, including faith-based providers. • Develop an eligibility system for new providers who have never before received Federal funds, provide technical assistance as needed, and maintain up-to-date lists of all eligible providers.

  7. What Is Expected of Grantees (con’t)? • Develop assessment, level of care determination, and referral processes for clients that include choice of service providers. • Be accountable for service outcomes.

  8. What Are The Service Outcomes? • Abstinence from Substance Use • Employment/Education • Criminal or Juvenile Justice Involvement • Family and Living Conditions • Social Support of Recovery • Access/Capacity • Retention

  9. How Are ATR Voucher Funds Used? Grantees have chosen a variety of ways to use voucher funds: • For specific substances of abuse • For a defined population • For specific geographic areas • For a defined modality of treatment • For identified recovery services

  10. What Services Can Be Paid for Using ATR Vouchers? Grantees have determined what services they will cover using vouchers, e.g., • Employment coaching • Recovery management • Life skills training • Family services • Sober housing • Group counseling

  11. What Do Grantees Need to Do to Track Individuals and Vouchers? • Grantees must assign voucher recipients unique identifiers that are maintained throughout what may be multiple treatment and/or recovery support episodes. • These episodes may occur at different points in time and with different providers. They may also involve multiple services, which may be included in a single voucher.

  12. Research and Evaluation Issues • Program Evaluation Questions: • Has the program led to an increase in the numbers of treatment and recovery support providers, especially those new to Federal funding, including faith-based programs; • Do client’s have great choice of providers; • Are States able to tracking clients and vouchers, including vouchers that contain multiple treatment and recovery-support services?

  13. Research and Evaluation Issues • Research Questions: • How do outcomes differ given when appropriate recovery support services are provided: before, in parallel with, or post acute treatment or any combination of the above? • How do the episode costs differ, given differences in the timing of recovery support services? • What are the differences in the client’s perception of care given choice?

  14. Research and Evaluation Issues • What are the systemic changes at the State and provider level that result from implementation of the voucher method of payment? • How does adding an additional source of funding for purchase of services affect the organization and costs of services in the State or Tribe as a whole?

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