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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
                                                                  1
                                    Department of Alcohol and Drug Programs
Overall Strategic Goal

 To develop and maintain a
 comprehensive, integrated
  statewide prevention and
      treatment system.

                                       State of California
                                              2
                Department of Alcohol and Drug Programs
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
                                                  3
                    Department of Alcohol and Drug Programs
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
                                                    4
                      Department of Alcohol and Drug Programs
Annual Fiscal Cost to CA

  Alcohol abuse:
  $38.4 billion
  Illicit Drug Abuse:
   $23.8 billion

                                        State of California
                                               5
                 Department of Alcohol and Drug Programs
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
                                                        6
                          Department of Alcohol and Drug Programs
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
                                                        7
                          Department of Alcohol and Drug Programs
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
                                                               8
                                 Department of Alcohol and Drug Programs
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
                                                         9
                           Department of Alcohol and Drug Programs
Treatment Admissions

       19%
                                      ODF Non-NTP


                                      ODF NTP


                                      ODF Detox
 12%
                57%                   RES Detox

  5%                                  RES

       7%
                                      State of California
               Department of Alcohol and Drug Programs      10
Client Demographics –
By Gender

 64% Male
 36% Female



                                     State of California
                                           11
              Department of Alcohol and Drug Programs
Client Demographics – By Race/ Ethnicity

   42%

           34%




                       17%



                                                                         4%
                                    2%                1%

  White   Hispanic    African   Asian/Pacific     American            Other
                     American     Islander       Indian/AK          Race/Multi-
                                                   Native             Racial


                                                             State of California
                                      Department of Alcohol and Drug Programs      12
Client Demographics – By Age

30%

25%                      24%     23%

20%              18%                              18%

15%    12%
10%
                                                                    5%
5%

0%
      Under 18   18-25   26-35   36-45           46-55             56 +



                                                         State of California
                                  Department of Alcohol and Drug Programs      13
Source of Client Referral
       7% 3%
                                             Criminal
                                             Justice
 13%
                                             Individual
                                             Self Referral
                  43%                        Community/
                                             Health/Work
                                             AOD
                                             Program
                                             School



   34%
                                        State of California
                 Department of Alcohol and Drug Programs      14
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
                                                             15
                                Department of Alcohol and Drug Programs
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
                                                       16
                          Department of Alcohol and Drug Programs
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
                                               17
                  Department of Alcohol and Drug Programs
ADP Budget by Fund Source
                Other Funds
                   $28.1
Federal Funds      4.5%                        General Fund
   $260.1                                         $222.1
                                                  35.2%
   41.2%




                          DMC FFP
                           $120.1
                           19.1%



                                                       State of California
                                Department of Alcohol and Drug Programs      18
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

  $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
                                                  20
                     Department of Alcohol and Drug Programs
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
                                                 21
                    Department of Alcohol and Drug Programs
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
                                                             22
                                Department of Alcohol and Drug Programs
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
                                                     23
                        Department of Alcohol and Drug Programs
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
                                                    24
                       Department of Alcohol and Drug Programs
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
                                                    25
                       Department of Alcohol and Drug Programs
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
                                                        26
                           Department of Alcohol and Drug Programs
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
                                                    27
                       Department of Alcohol and Drug Programs
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
                                                                28
                                   Department of Alcohol and Drug Programs
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
                                                   29
                      Department of Alcohol and Drug Programs
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
                                                     30
                        Department of Alcohol and Drug Programs
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
                                                    31
                       Department of Alcohol and Drug Programs
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
                                                   32
                      Department of Alcohol and Drug Programs
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
                                                        33
                           Department of Alcohol and Drug Programs
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
                                                        34
                           Department of Alcohol and Drug Programs
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
                                                        35
                           Department of Alcohol and Drug Programs
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
                                                   36
                      Department of Alcohol and Drug Programs
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
                                                        37
                           Department of Alcohol and Drug Programs
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
                                                         38
                            Department of Alcohol and Drug Programs
California Department of
Alcohol & Drug Programs


    Thank You

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

				
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