Strategies for Expanding Resources for Addiction Treatment: Cases from the field'

1
Strategies for Expanding Resources for Addiction
Treatment Cases from the field.

• Victor Capoccia, ____, Open Society Institute
• John OBrien, Legal Advocacy Center Associate

2
What Do We Know About the Treatment Gap?

• Four out of five Americans who need drug and
  alcohol addiction treatment are unable to get it.
• Social and economic costs information

3
Towards A National Campaign

• Campaigns Focus
• InsuranceAddiction diagnosis and treatment
  should be recognized as a health/medical
  condition covered by specific benefits in all
  existing and future public, semi-public and
  private health plans.
• AppropriationsThe expansion of public
  appropriations to pay for treatment is necessary
  at all levels until universal health plan
  coverage reduces the need for special categorical
  funding.
• EfficiencyExpediting the engagement, integration
  and retention of individuals into treatment is
  critical to using existing resources more
  effectively.

4
Towards A National Campaign

• What Are the Goals?
• Increased number of consumers receiving high
  quality care
• Increased resources available to pay for
  treatment
• Effective practices or models for change created
  by grantees that are applicable in other
  jurisdictions

5
What Are the Models?

• Baltimore
• Developed a broad-based advocacy and
  communications to increase appropriations
• Developed a new city-wide administrative entity
  to purchase and monitor treatment services.
• Used data to track performance aggressively and
  improve the efficiency and to effectiveness of
  individual programs.
• The results
• Funding for the treatment system increased from
  20.3 million in 1997 to 52.9 million in 2005,
• Number of people receiving drug treatment in
  publicly funded programs increased from 18,449 in
  1997 to 28,672 in 2005.

6
What Are the Models?

• Florida
• No clearly defined Medicaid SA benefit (gt 10
  million annuallyredefined mental health coverage
  to include SA and created intensive TA for
  providers
• Service gapsinitiated several new covered
  services for Medicaid recipients
• Little new state fundingpartnered with counties
  to identify local dollars and leverage federal
  funds

7
What Are The Models

• ConnecticutDepartment of Mental Health and
  Addiction Services
• Three state agencies had different contractual
  requirements for similar SA servicescreated one
  contract
• Had multiple and different monitoring processes
  for same SA providerscreate a single monitoring
  process
• Paid vastly different amounts for the same
  services to the same providersreviewing
  opportunities for developing a consistent
  reimbursement methodology

8
Future DirectionsClosing the Addiction Treatment
Gap (CATG)

• A 10 million national program of the Open
  Society Institute (OSI).
• Designed to create an awareness ofand increase
  resources to closean alarming treatment gap.
• Seeks to mobilize public support for expanded
  treatment by increasing public funding,
  broadening insurance coverage and achieving
  greater program efficiency.

9
CATG Summary

• 35 Applications were submitted in April
• 8 sites recommended for participation
• Final decision will be announced in mid-July
• Work at sites will commence 8/2008

10
CATG Areas of Focus

• Financing
• Increase in the scope of benefits covered by
  public payers (e.g. Medicaid, Medicaid contracted
  health plans and other state agencies)
• Shift in expenditures from inpatient, emergency
  departments and corrections to community services
• More opportunities for cross system financing and
  creating purchasing effecincies

11
CATG Areas of Focus

• Implementing strategies to expand addiction
  treatment capacity, including
• One of the following efficiency strategies
• Expand the use of proven interventions to improve
  outcomes and reduce relapse
• Develop recovery support systems
• Use established system redesign and improvement
  strategies to expand treatment access

12
CATG Areas of Focus

• Utilize the following cross-cutting advocacy and
  communication strategies to advance the treatment
  expansion strategies
• Develop and disseminate empirical data to
  publicize the costs and consequences of the
  treatment gap
• Create and implement a communication strategy
• Identify and involve key-stakeholders
• Conducted targeted surveys and polls

13
What Will Grantees Experience?

• Participate in a series of educational activities
  that will inform and support the projects,
  including
• Virtual Learning Community comprised of grantees
  and participating experts with relevant content
  knowledge and experience
• Annual meetings with grantees and other
  interested parties
• Teleconferencestopic-specific information and
  strategies that can support grantees efforts
  (blending funding)
• Coaching provided on advocacy financing and
  communications

14
Other Project Components

• National communication strategywork closely
  within and among grantees to facilitate effective
  communication strategies
• External evaluation that grantees will be
  requested to participate, provide data,
  participate in interviews, etc.

15

• Track the CATG Initiative _at_
• www.treatmentgap.org.