Using Vouchers to Deliver Substance Abuse Treatment and Recovery Services: The Access to Recovery Pr - PowerPoint PPT Presentation

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Using Vouchers to Deliver Substance Abuse Treatment and Recovery Services: The Access to Recovery Pr

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Access/Capacity. Retention. Who Are the ATR Grantees? Wisconsin. New Mexico. New Jersey ... Illinois Statewide, probationers referred by circuit courts. Louisiana ... – PowerPoint PPT presentation

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Title: Using Vouchers to Deliver Substance Abuse Treatment and Recovery Services: The Access to Recovery Pr


1
Using 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

2
Press 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.

4
What 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.

5
What Are the Goals of ATR?
  • (2) Grantees are required to manage performance,
    based on outcomes that demonstrate patient
    successes

6
What 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

7
Who 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.

8
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9
Voucher Functions
  • Referral to Program of Clients Choice
  • Eligibility Confirmation
  • Assessment Results Enforcement
  • Obligating Instrument
  • Initiate an Invoice
  • Set up an Audit Trail

10
Whats on a Voucher?
  • Client Identification
  • Service Type
  • Provider Identification?
  • Not To Exceed (NTE) Amount
  • Date Voucher Issued
  • Date Voucher Expires

11
Whats on a Redeemed Voucher
  • Provider (if not on New Voucher)
  • Actual Services
  • Actual Dates of Service
  • Actual Reimbursement Claim
  • Signatures (physical or electronic)

12
What 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.

13
What is Required of Grantees?(continued)
  • Grantees are required to
  • Develop assessment, level of care determination,
    and referral processes.
  • Be accountable for service outcomes

14
How 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

15
Are 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).

16
What 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

17
Do 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.

18
What 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.

19
What 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

20
Who Are the ATR Grantees?
21
Lessons 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

22
Lessons Learned
  • Partnerships to build referral sources
  • Communications with SAMHSA, providers, clients
  • Voucher tracking and analyses
  • Financial management
  • FWA
  • Meeting your project goals

23
(No Transcript)
24
SAIS March 31, 2007
25
SAIS December 31, 2006
26
SAIS December 31, 2006
27
What 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

28
What 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

29
What is the Focus of Each of the ATR Grants?
  • Idaho Statewide, adolescents and adults
  • Illinois Statewide, probationers referred by
    circuit courts
  • Louisiana

30
What 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

31
What 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

32
What 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

33
In 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.

34
Where 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

35
In summary..
  • There is a external cross site evaluation of the
    2004 cohort of ATR grantees funded to begin in
    2008

36
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