Title: Using Vouchers to Deliver Substance Abuse Treatment and Recovery Services: The Access to Recovery Pr
1Using Vouchers to Deliver Substance Abuse
Treatment and Recovery Services The Access to
Recovery Program (ATR)
- Andrea Kopstein, Ph.D., M.P.H.
- June 4, 2007
- ACF 10th Annual Welfare Research and Evaluation
Conference
2Press Release
- John Walters Addiction is not a
one-size-fits-all disease. This program
represents the next step in our ability to treat
this disease, opening the door to a full range of
treatment providers, and offering treatment
access to thousands of Americans who would
otherwise remain trapped in the maze of addiction
3- Many people who seek help are unable to find
care. This ATR program was planned to provide
grants to States/Tribes to support provision of
vouchers to pay for the addiction treatment care
people need at a level consistent with the
severity of the disease, or, the level of support
needed to sustain sobriety.
4What Are the Goals of ATR (three main
objectives)?
- 1) Allowing recovery to be pursued through many
different and personal pathways. Grantees must
insure genuine and independent client choice of
treatment and recovery support services at the
appropriate level of care.
5What Are the Goals of ATR?
- (2) Grantees are required to manage performance,
based on outcomes that demonstrate patient
successes
6What Are the Goals of ATR?
- (3) expanding capacity by increasing the number
and types of providers who deliver clinical
treatment and/or recovery support services
7Who Was Eligible to Apply and What Was the Review
Process?
- States, Territories, Tribal Organizations, and DC
were eligible to apply for an ATR grant. - Sixty-six grants were reviewed face-to-face by
three committees forty-four States, DC, and
twenty-one tribal organizations.
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9Voucher Functions
- Referral to Program of Clients Choice
- Eligibility Confirmation
- Assessment Results Enforcement
- Obligating Instrument
- Initiate an Invoice
- Set up an Audit Trail
10Whats on a Voucher?
- Client Identification
- Service Type
- Provider Identification?
- Not To Exceed (NTE) Amount
- Date Voucher Issued
- Date Voucher Expires
11Whats on a Redeemed Voucher
- Provider (if not on New Voucher)
- Actual Services
- Actual Dates of Service
- Actual Reimbursement Claim
- Signatures (physical or electronic)
12What is Required of Grantees?
- Grantees are required to
- Conduct significant outreach to a wide range of
new service providers. - Develop an eligibility system for new providers
and maintain up-to-date lists of all eligible
providers.
13What is Required of Grantees?(continued)
- Grantees are required to
- Develop assessment, level of care determination,
and referral processes. - Be accountable for service outcomes
14How Are ATR Voucher Funds Being Used?
- Grantees have chosen a variety of ways to use
voucher funds - For a specific substance of abuse
- For a defined population
- For an identified modality of treatment
- For identified recovery services
15Are All Service Providers Licensed or Certified?
- All clinical treatment and recovery support
services providers are required to adhere to
standards established by the grantee (State,
Territory, Tribe, District of Columbia).
16What Services Can Be Paid for Using ATR Vouchers?
Grantees may determine what services they cover
using vouchers examples
- Detoxification
- Brief intervention
- Group counseling
- Case management
- Family services
- Sober housing
- Employment coaching
- 12-step groups
- Recovery coaching
- Other
17Do Grantees Need to Track Individuals and
Vouchers?
- Grantees must assign unique identifiers to
voucher recipients 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.
18What Data Are Grantees Expected to Submit?
- Grantees are required to submit the same GPRA
data as are all discretionary grant program
grantees. These data include financial as well as
performance and outcome data in the seven
domains.
19What Are The Seven Domains?
- Abstinence from Substance Use
- Employment/Education
- Criminal or Juvenile Justice Involvement
- Family and Living Conditions
- Social Support of Recovery
- Access/Capacity
- Retention
20Who Are the ATR Grantees?
21Lessons Learned
- There is a tremendous need for the services
accessed through ATR - Recovery support services make a big difference
- Increased trainings for non-traditional providers
is usually necessary
22Lessons Learned
- Partnerships to build referral sources
- Communications with SAMHSA, providers, clients
- Voucher tracking and analyses
- Financial management
- FWA
- Meeting your project goals
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24SAIS March 31, 2007
25SAIS December 31, 2006
26SAIS December 31, 2006
27What is the Focus of Each of the ATR Grants?
- California Regional, four target cities, youth
between 12 and 20 years of age - Large unmet need for residential youth treatment
- Plan to involve the families
- CA Urban Indian Health Bd. Statewide, American
Indian, adults and adolescents
28What is the Focus of Each of the ATR Grants?
- Connecticut Statewide, payer of last resort,
nondependent adults, populations with significant
barriers in access to care - Florida Regional, 18 and older, criminal
justice, families, co-occurring disorders,
prescription drug abuse
29What is the Focus of Each of the ATR Grants?
- Idaho Statewide, adolescents and adults
- Illinois Statewide, probationers referred by
circuit courts - Louisiana
30What is the Focus of Each of the ATR Grants?
- New Jersey Statewide with initial focus on
Newark, payer of last resort, individuals who are
medically indigent and have a DSM-IV diagnosis,
aging out adolescents, adults aged 16-34, heroin
users - New Mexico
31What is the Focus of Each of the ATR Grants?
- Tennessee Methamphetamine users, adults, low or
below median income who otherwise cannot afford
treatment - Texas Statewide, drug court participants
- Washington State Regional, six counties,
families with children in protective services,
residents in supported housing, detoxification,
low-income clients using migrant health clinics
32What is the Focus of Each of the ATR Grants?
- Wisconsin Regional, initial focus on Milwaukee
County residents, emphasis on families with
children, criminal justice population - Wyoming Statewide, adolescents in the criminal
justice system and their families
33In summary..
- States are responsible for reporting on common
performance measures to illustrate effectiveness
and these performance measures will be used to
measure treatment success and the ultimate
success of the voucher program itself.
34Where are we now?
- The 2004 cohort of ATR grants is in their third
and final grant year - We are accepting applications for a new cohort of
ATR grantees - awards will be made in August or
September of 2007
35In summary..
- There is a external cross site evaluation of the
2004 cohort of ATR grantees funded to begin in
2008
36QUESTIONS?