Alabama Substance Alabama Substance Abuse Systems Abuse Systems

Improvement InitiativeImprovement InitiativePresentation to Conference of Presentation to Conference of

Community Mental Health Community Mental Health BoardsBoards

August 24, 2006August 24, 2006

PanelistsPanelists►Kent Hunt, Associate Commissioner for Kent Hunt, Associate Commissioner for

Substance Abuse ServicesSubstance Abuse Services►Sarah Harkless, Executive Assistant to Sarah Harkless, Executive Assistant to

the Associate Commissioner for the Associate Commissioner for Substance Abuse ServicesSubstance Abuse Services

►Bob Wynn, Director of Treatment Bob Wynn, Director of Treatment Services for Substance AbuseServices for Substance Abuse

►Kristopher Vilamaa, Director of Kristopher Vilamaa, Director of Information Services for Substance AbuseInformation Services for Substance Abuse

SummarySummary►HistoryHistory► PreventionPrevention► TreatmentTreatment

StandardsStandards Screening and EnrollmentScreening and Enrollment Standardized AssessmentStandardized Assessment Waiting List ManagementWaiting List Management

► Claims and Revenue EnhancementsClaims and Revenue Enhancements►Data Collection and ReportingData Collection and Reporting

HistoryHistory

HistoryHistory►Prevention:Prevention:

Children’s Policy Council surveysChildren’s Policy Council surveys Alabama specific youth surveysAlabama specific youth surveys Majority of prevention activities are not Majority of prevention activities are not

focused on priority populationsfocused on priority populations All areas of Alabama are under fundedAll areas of Alabama are under funded No formal collaboration in many areasNo formal collaboration in many areas

HistoryHistory►TreatmentTreatment

Alabama Treatment Needs AssessmentAlabama Treatment Needs Assessment National Survey of Drug Use and HealthNational Survey of Drug Use and Health Gap between those needing treatment Gap between those needing treatment

and those getting treatmentand those getting treatment DemandDemand Waiting listsWaiting lists

HistoryHistory►Treatment continued:Treatment continued:

Assessment and placementAssessment and placement CollaborationCollaboration Inadequate fundingInadequate funding Clinical monitoringClinical monitoring Fiscal monitoringFiscal monitoring Length of treatmentLength of treatment

HistoryHistory►General:General:

Priority populationsPriority populations Science and evidenced based practicesScience and evidenced based practices Capacity managementCapacity management Core servicesCore services Advocacy supportAdvocacy support Outcome measurementOutcome measurement Maximization of fiscal resourcesMaximization of fiscal resources

HistoryHistory►Why do we need a Systems Why do we need a Systems

Improvement Initiative?Improvement Initiative? Alabama citizens deserve the best system Alabama citizens deserve the best system

the resources will provide the resources will provide It is our responsibility to meet this It is our responsibility to meet this

expectationexpectation

TreatmentTreatment►Revised StandardsRevised Standards►Contract ReviewersContract Reviewers►New StaffNew Staff►Co-Occurring DisordersCo-Occurring Disorders

PreventionPrevention►Revision of StandardsRevision of Standards►New Rate StructureNew Rate Structure

Emphasis on Community-Based Process Emphasis on Community-Based Process and Environmental Strategiesand Environmental Strategies

►Focus on Targeted InterventionsFocus on Targeted Interventions

Alabama Substance Abuse Alabama Substance Abuse Information System (ASAIS)Information System (ASAIS)

►Meets all federal reporting requirements, Meets all federal reporting requirements, which are not being met todaywhich are not being met today Unique Identifier for all clientsUnique Identifier for all clients All required admission and discharge elements All required admission and discharge elements

collectedcollected► Allows for active management of waiting Allows for active management of waiting

lists and access to care information across lists and access to care information across the statethe state

► Timely processing of claims will help improve Timely processing of claims will help improve cash flowcash flow

Screening and EnrollmentScreening and Enrollment►All clients, across the system, will go All clients, across the system, will go

through a brief screening process and through a brief screening process and a unique identifier will be assigned, or a unique identifier will be assigned, or reported if the number already existsreported if the number already exists

►The screening information will be The screening information will be available to any future service available to any future service provider working with that clientprovider working with that client

Standardized AssessmentStandardized Assessment►All clients will have minimum All clients will have minimum

information reported and collected information reported and collected from their standardized assessmentfrom their standardized assessment SASD is still exploring options to allow SASD is still exploring options to allow

providers to share the full assessment providers to share the full assessment through ASAISthrough ASAIS

►The assessment information will be The assessment information will be available to any future service available to any future service provider working with that clientprovider working with that client

Waiting List ManagementWaiting List Management►Referrals will be sent through ASAIS to Referrals will be sent through ASAIS to

other locationsother locations► Information on waiting lists for all Information on waiting lists for all

providers will be available in ASAISproviders will be available in ASAIS

Claims and Revenue Claims and Revenue EnhancementsEnhancements

►All enrolled clients will be checked for All enrolled clients will be checked for Medicaid eligibility on a monthly basisMedicaid eligibility on a monthly basis

►Claims that have a Medicaid eligible Claims that have a Medicaid eligible service paired with a Medicaid eligible service paired with a Medicaid eligible client will be sent to Medicaid for client will be sent to Medicaid for paymentpayment

►There will be either a Medicaid or Block There will be either a Medicaid or Block Grant/State Funds check-write every Grant/State Funds check-write every week after go live – providers can receive week after go live – providers can receive payments weekly, if desiredpayments weekly, if desired

Our GoalOur Goal

To serve Alabamians impacted by To serve Alabamians impacted by substance abuse…bettersubstance abuse…better

To Serve…To Serve…►To work for…To work for…

►To be of assistance to…To be of assistance to…

►To promote the interest of…To promote the interest of…

AlabamiansAlabamians►50% of all admissions to SASD funded 50% of all admissions to SASD funded

programs live in 5 Alabama countiesprograms live in 5 Alabama counties►Nearly one-third of Alabama’s counties Nearly one-third of Alabama’s counties

have no substance abuse treatment have no substance abuse treatment servicesservices

►Pregnant women account for less than 3% Pregnant women account for less than 3% of admissions to SASD funded treatment of admissions to SASD funded treatment programsprograms

►The community impact of SASD funded The community impact of SASD funded prevention services is unknownprevention services is unknown

Alabamians…Alabamians…

All who are impacted by Substance All who are impacted by Substance AbuseAbuse

Better…Better…►Not bestNot best►A continuous processA continuous process►Each day providing a new opportunity Each day providing a new opportunity

to exceed the one beforeto exceed the one before

Better…Better…► Access to CareAccess to Care

Treatment and Prevention Services in Every Treatment and Prevention Services in Every CountyCounty

Easy access to information and referralEasy access to information and referral Specialized services to meet targeted needsSpecialized services to meet targeted needs

►Detox ServicesDetox Services►Medication Assisted TreatmentMedication Assisted Treatment►Adolescent ServicesAdolescent Services►Low Intensity Housing ServicesLow Intensity Housing Services►Vision, language, and hearing accommodations routineVision, language, and hearing accommodations routine►Children’s ServicesChildren’s Services

Better…Better…► ServicesServices

Expanded treatment modalities that match the Expanded treatment modalities that match the ASAM levels of careASAM levels of care

A variety of services to aid in treatment planning A variety of services to aid in treatment planning available under each level of careavailable under each level of care

All treatment programs co-occurring capable, All treatment programs co-occurring capable, many enhancedmany enhanced

Treatment services based upon ongoing Treatment services based upon ongoing assessment of client needsassessment of client needs

Prevention services based upon ongoing Prevention services based upon ongoing assessment of community needsassessment of community needs

Evidence-based treatment and prevention servicesEvidence-based treatment and prevention services Reimbursement processes for services providedReimbursement processes for services provided

Better…Better…►Human ResourcesHuman Resources

Improved organization to enhance Improved organization to enhance customer servicecustomer service

Better…Better…►Technical Assistance and TrainingTechnical Assistance and Training

Based upon assessment of the needs of Based upon assessment of the needs of our customersour customers

Full access to our in-house resources as Full access to our in-house resources as well as TA and training available through well as TA and training available through our State and Federal Partnersour State and Federal Partners

Routine program monitoring in addition to Routine program monitoring in addition to certification site visitscertification site visits

Better…Better…► CollaborationCollaboration

Clients and their familiesClients and their families Contract ProvidersContract Providers Certified ProvidersCertified Providers Other Divisions within DMH/MROther Divisions within DMH/MR Other state agenciesOther state agencies Community agenciesCommunity agencies The Alabama State LegislatureThe Alabama State Legislature The Governor’s OfficeThe Governor’s Office Federal and State funding sourcesFederal and State funding sources Medical CommunityMedical Community Private IndustryPrivate Industry Etc. Etc.Etc. Etc.

Better…Better…►DataData

ASAISASAIS Alabama Epi Work GroupAlabama Epi Work Group

Better…Better…

Outcomes:Outcomes:

Individuals getting wellIndividuals getting wellFamilies reunitingFamilies reuniting

Communities stopping the devastation Communities stopping the devastation of substance abuseof substance abuse

Alabama Department of Alabama Department of Mental Health and Mental Mental Health and Mental

RetardationRetardationSubstance Abuse Services DivisionSubstance Abuse Services Division

http://www.mh.alabama.govhttp://www.mh.alabama.gov