house special committee on drug and alcohol abuse peter f. luongo, ph.d. october 2, 2007
TRANSCRIPT
House Special CommitteeOn Drug and Alcohol Abuse
Peter F. Luongo, Ph.D.October 2, 2007
Treatment Effectiveness
Alcohol and Drug dependent people who participate in drug treatment
Decrease substance use Decrease criminal activity Increase employment Improve their social and intrapersonal functioning Improve their physical health
Drug use and criminal activity ⇓⇓ for virtually all who enter treatment results the longer they stay in treatment.
Statewide Maryland Automated Record Tracking (SMART)
SMART is a full electronic clinical record (EHR) All funded treatment providers report data online
SMART addresses key EHR concerns: Admission, treatment encounters and discharge Privacy, Practitioner control, Administrative oversight Interoperability = shares information through XML
Additional Modules eCourt Contract Monitoring and Billing
Under development
Stand Alone Data Analyzer – December 2007 Real time access to data
Providers Jurisdiction decision makers State oversight (ADAA)
Automated Drug Testing – January 2008 Additional Clinical Assessments and
Screening Homicide and suicide lethality assessments HIV and TB risk assessments Many Others
Treatment Funding
2003 2007 % change
Appropriation $119,219,304 $126,447,179 6%
Individuals Treated* 45,722 52,306** 14%
Cost per Individual $2,607 $2,417 (7%)
FY 2003 – FY 2007
*Unduplicated individuals treated **Estimate based on 10 month data
Outpatient Adult Community Treatment
2003 2007 % change
Completed Treatment 37% 43% 16%
LOS ≥ 90 days 56% 59% 5%
Reduction in Substance Users 10% 33% 230%
Increase in Employment 10% 13% 30%
Selected OutcomesFY 2003 – FY 2007
Level III.1 Residential Treatment*
Selected OutcomesFY 2003 – FY 2007
2003 2007 % change
Completed Treatment 36% 42% 16%
LOS ≥ 90 days 54% 56% 4%
Reduction in Substance Users 0% 34% -
* Variable length of stay moderate intensity
FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004
Abstinent from Alcohol
Maryland 35 States
0
10
20
30
40
50
60
70
80
90
62.7
43.5
83.5
62.5
Admission Discharge
+33.1% +44.0%
FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004
Abstinent from Drugs
Maryland 34 States
0
10
20
30
40
50
60
70
80
44.534.5
71.5
56.2
Admission Discharge
+60.7% +62.9%
FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004
Employment
Maryland 38 States
0
5
10
15
20
25
30
35
40
33 30.7
39.134
Admission Discharge
+18.5% +10.8%
FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004
Arrested During Prior 30 Days
Maryland 34 States
0
5
10
15
20
25
30
35
40
8.8
37.1
2.4
11
Admission Discharge
-72.7% -70.4%
FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004
Homelessness
Maryland 34 States
0
1
2
3
4
5
6
7
8
9
8.57.5
4.55.4
Admission Discharge
-47.1% -28.0%
Summary Table
Treatment Awards Utilizing Performance Compensation
TreatmentCategory
Total Award
Amount of GrantFunding subject to
PerformanceCompensation
% PerformanceCompensation
Residential $ 41,207,873 $ 21,431,628 52%
Non-Residential $ 73,029,601 $ 24,819,233 34%
$114,237,474 $ 46,250,861 40%
Pay for Performance Pilot
Pilot based on:January – April 2007Data from Outpatient Programs – excluding:
AdolescentsJail-based population
Data in the system as of July 1, 2007
Performance Standards
>65% retained at least 90 days >50% successful completion
Both standards = 100% performance payment
One standard = 50% performance payment
Pay for Performance Incentive BreakdownCounty Discharges LOS >= 90 Complete
Jurisdictional Category A 1-2 Outpatient ClinicsCaroline 91 68.1% 52.7%Cecil 132 68.2% 37.1%Charles 273 72.9% 58.2%Dorchester 26 50.0% 34.6%Frederick 117 49.6% 32.5%Garrett 80 36.3% 28.8%Kent 92 54.3% 43.5%Queen Anne's 88 61.4% 47.7%Talbot 84 60.7% 53.6%Wicomico 126 61.9% 38.9%
Jurisdictional Category B 3-6 Outpatient ClinicsAllegany 171 54.4% 42.7%Carroll 139 66.9% 54.7%Harford 89 51.7% 38.2%Howard 63 57.1% 27.0%Montgomery 352 67.9% 45.5%Somerset 80 73.8% 50.0%St. Mary's 89 78.7% 65.2%Washington 214 74.3% 57.5%Worcester 153 51.6% 42.5%
Jurisdictional Category C 7+ Outpatient ClinicsAnne Arundel 579 63.6% 43.0%Baltimore County 406 63.3% 51.2%Prince George's 249 55.0% 41.8%Baltimore City 1043 49.6% 31.2%Statewide 36 55.6% 30.6%
Pay for Performance Incentive Breakdown
Full Incentive - 100% of Standards Met
County Juris. Cat. Discharges LOS >= 90 Complete
Caroline A 91 68.1% 52.7%
Charles A 273 72.9% 58.2%
Carroll B 139 66.9% 54.7%
Somerset B 80 73.8% 50.0%
St. Mary's B 89 78.7% 65.2%
Washington B 214 74.3% 57.5%
Partial Incentive - 50% of Standards Met
County Juris. Cat. Discharges LOS >= 90 Complete
Cecil A 132 68.2% 37.1%
Talbot A 84 60.7% 53.6%
Montgomery B 352 67.9% 45.5%
Baltimore Co. C 406 63.3% 51.2%
Jurisdiction Annual Incentive Prorated (4months)
A $15,000 $5,000
B $20,000 $6,667
C $30,000 $10,000
Full Incentive - 100% of Standards Met
County Jurisdiction Category Prorated
Caroline A $5,000
Charles A $5,000
Carroll B $6,667
Somerset B $6,667
St. Mary's B $6,667
Washington B $6,667
Partial Incentive - 50% of Standards Met
County Jurisdiction Category Prorated
Cecil A $2,500
Talbot A $2,500
Montgomery B $3,334
Baltimore County C $5,000
Financial IncentiveFor the initial year, a prorated amount is assigned to each classification. The following
table shows both the annualized and the prorated figures.
Method of Allocation
Method of AllocationPercent
of Total Award
Historic 45%
Earmarks 28%
Competitive 6%
Formula 21%
Total 100%
Central Region
Jurisdiction 2005 2006 2007
Baltimore City $47,241,235 $47,158,994 $48,720,080
Baltimore County $6,623,455 $7,435,398 $7,799,615
Harford County $2,084,304 $2,095,246 $2,386,649
Howard County $1,775,466 $1,780,466 $1,924,057
Total Regional Awards $57,724,460 $58,470,104 $60,830,401
Total Awards $123,232,702 $124,638,995 $130,782,647
Eastern Shore Region
Jurisdiction 2005 2006 2007
Cecil County $1,395,736 $1,400,736 $1,530,147
Dorchester County $1,323,836 $1,323,836 $1,428,273
Caroline County $633,774 $633,774 $718,891
Kent County $1,017,613 $1,017,613 $1,077,963
Queen Anne's County $789,650 $821,576 $881,194
Somerset County $1,077,933 $1,077,933 $1,109,440
Talbot County $941,422 $941,422 $968,916
Wicomico County $2,189,504 $2,228,034 $2,350,539
Worcester County $3,057,225 $3,226,325 $3,380,054
Total Regional Awards $12,426,693 $12,671,249 $13,445,417
Total Awards $123,232,702 $124,638,995 $130,782,647
Southern Region
Jurisdiction 2005 2006 2007
Anne Arundel County $4,821,491 $5,171,491 $5,415,712
Calvert County $1,120,131 $1,162,131 $1,203,021
Charles County $2,262,221 $2,304,802 $2,474,993
Prince George's County $10,806,803 $11,335,622 $11,628,634
St. Mary's County $2,798,750 $2,922,782 $3,118,274
Total Regional Awards $21,809,396 $22,896,828 $23,840,634
Total Awards $123,232,702 $124,638,995 $130,782,647
Western Region
Jurisdiction 2005 2006 2007
Allegany County $2,082,266 $2,362,756 $2,428,723
Carroll County $1,746,151 $1,752,756 $1,824,306
Frederick County $2,570,355 $2,596,089 $2,745,139
Garrett County $1,080,620 $1,087,120 $1,118,015
Montgomery County $4,961,899 $5,036,312 $5,265,177
Washington County $3,867,216 $3,867,216 $4,033,438
Total Regional Awards $16,308,507 $16,702,249 $17,414,798
Total Awards $123,232,702 $124,638,995 $130,782,647