ADP

 

 

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Director’s Corner

This has been a very busy time for ADP, as you will see from the update messages from our divisions. It amazes me how much we have been able to accomplish, despite having three furlough days per month, which means less time to do just as much or more work. Unfortunately, we got off track on our schedule for this newsletter, but we are now back on track and you will be receiving FOCUS on a quarterly basis.

We developed FOCUS to keep providers informed about what ADP is up to. Having worked in treatment facilities for more than 30 years myself, I know how important it is to be in contact with the state and to be kept informed about what is going on. Knowledge is power and my goal is to empower you.

In the three years I have been Director, I have visited more than 70 providers across the state. I have also spoken at numerous conferences and personally gotten to know so many wonderful people. I love visiting prevention programs and treatment centers and meeting with the staff. I have seen up close the incredible results that you have achieved and the lives that you have touched. I gain more valuable information about issues, problems, and concerns from you with each visit and I am grateful for that.

When I first came to the state, I visited Kern County. Lily Alvarez brought together some 30 providers to meet with me and they were more than willing to share their concerns. One man said, “I’ve worked here for 30 years and you are the first person at your level who has come to talk to us. The only time we hear from the state is when it is auditing us or wants money.”

I made up my mind at that moment that that was going to change—and I’ve worked hard at doing that. We have put together a huge mailing list of provider email addresses to stay in touch and tell you about a valuable training that may be coming up, or some new policy we are implementing, or how to deal with the H1N1 flu virus, or any other item of concern to you or to us.

Communication is a two-way street and it is my goal to give that street lots of traffic.


UPCOMING EVENTS

SARC Consortium: May 24

ADP invites you to attend the 41st Semi-Annual Substance Abuse Research Consortium to be held on Monday, May 24, 2010, at the Hilton Arden West Hotel in Sacramento. The meeting’s focus will be “Implementation of Evidence-Based Practices in the Treatment of Criminal Justice-Involved Clients”, a topic you won’t want to miss. Policymakers and treatment providers have turned increasingly to evidence-based practices (EBPs) to deliver higher quality treatment and to ensure that scarce funds are spent on techniques shown to be effective. This SARC research-to-policy consortium will bring top national experts in EBP research and implementation together with treatment providers to discuss the challenges of identifying and implementing EBPs for criminal justice-involved clients and to discuss next steps needed at policy, practitioner, and research levels. For more information and registration, please go to: http://www.adp.ca.gov/new.shtml



ADP Training Conference: October 12-14

Originally scheduled for June, ADP’s training conference has been rescheduled to October 12-14, 2010, to comply with the Governor’s executive order canceling conferences for the remainder of this fiscal year. Be sure to save the dates and plan on attending! The conference will be held at the Radisson Hotel in Sacramento with the theme “Strongest Together: Building Quality Services During Challenging Times.”  We have gathered a host of brilliant men and women as keynoters and workshop presenters who will bring new energy and perspective to the current environment. Dr. Thomas McLellan, one of our nation's leading drug and alcohol experts who will soon be leaving his post as deputy director of the White House Office of National Drug Control Policy and Susan Kennedy, chief of staff for Governor Arnold Schwarzenegger, will kick off our conference as keynote speakers. For more information on speakers and workshops, go to http://www.cce.csus.edu/conferences/adp/10/



ONDCP’s McLellan to Visit California

Dr. A. Thomas McLellan, currently deputy director of the White House Office of National Drug Control Policy, is coming to Sacramento within the next several months to brief California’s legislators on changes in national drug control policy that will impact healthcare reform, as well as welfare, education and sentencing reform in our state. McLellan’s contributions to the advancement of substance abuse research—and the application of his findings to treatment systems and public policy—have changed the landscape of addiction science. His visit provides an opportunity to hear the latest news from Washington from a respected expert in our field. Watch your inbox for more information as it becomes available.



FEATURE ARTICLE

Dual Diagnosis Capability in Addiction Treatment

Treating patients with both mental illness and substance abuse disorders is one of the more difficult aspects of both the mental health and alcohol and other drug (AOD) fields.  This combination of problems is commonly called either dual diagnosis or co-occurring disorders (COD). 

One of the challenges of professionally treating someone with COD is in determining if your program is up to the challenge.  In California, while there are regulations and standards for programs that treat either mental health or AOD-affected clients, there are no standards or regulations for programs that treat patients suffering from COD. 

Past practice has been to treat first one disorder and then, when that one appears to be under control, treat the other disorder.  Several studies have shown that this process does not work well, if it works at all.  Evidence-based best practices strongly indicate that integrated treatment, where both disorders are treated at the same time by a team of professionals from both fields working together toward the goal of an individualized integrated treatment and recovery plan, works best.

A team of researchers at Dartmouth University in Vermont led by John P. McGovern, Ph.D., created a tool to help programs determine if they have the tools and processes to treat patients with COD.  After several years of research and testing, the team released the Dual Diagnosis Capability in Addiction Treatment fidelity index (DDCAT).  This tool uses a matrix with seven domains and 35 total dimensions to determine if a recovery program is best suited to treat AOD problems only, offer a COD program, or is capable of offering a high level COD recovery and treatment program.  In the final scoring, the tool indicates which areas need improvement, which also makes it a valuable quality improvement tool.

The DDCAT has been widely accepted for use in the AOD field and is currently in use in more than 20 states.  The United States Substance Abuse and Mental Health Services Administration endorses its use both as a self-evaluation tool and as a tool for outside agencies, which need to evaluate programs. Due to positive response and requests from the mental health field, a companion tool—the Dual Diagnosis Capability in Mental Health Treatment (DDCMHT)—has been developed and is in widespread use as an evaluation tool for mental health programs.

ADP’s Program Services Division ran a two-year pilot program using the tool to determine if the DDCAT is appropriate for use in California.  One of the anticipated problems was that no one would volunteer for the pilot program.  This turned out to be a non-issue; there were more programs volunteering than could be used in the pilot program.

At the end of the pilot program it was determined that any apprehension about the DDCAT’s utility in California was unfounded.  The DDCAT performed as its promoters said it would. A wide variety of scores were given to the volunteer programs, depending on their proven capability in dual diagnosis treatment, and ADP can recommend its use as an evaluation tool for this purpose.

As there is no current mandate to license and certify COD-capable programs, ADP and the Department of Mental Health are not empowered to issue such licenses or certifications.  However, ADP can and does recommend the DDCAT for use as a self-evaluation tool and as a quality improvement tool. For more information, visit http://dms.dartmouth.edu/prc/dual/atsr/



ADP DIVISION UPDATES

Grants Management: 2011 SAPT Block Grant

The Office of Grants Management has begun work on the Federal Fiscal Year 2011 Substance Abuse Prevention and Treatment (SAPT) Block Grant application.  The grant is a major source of funding for substance abuse prevention and treatment in California.  Each year, ADP begins work in February to prepare the 400+ page application.  The application must be submitted to the Substance Abuse and Mental Health Services Administration by the statutory deadline, and then approved by federal agency before ADP can receive funding.



Legislative and External Affairs: Legislation

The Office of Legislative and External Affairs (OLEA) is currently reviewing and assigning more than 40 bills for analysis within ADP that affect the fields of substance use disorders and problem gambling.

OLEA staff are in negotiations with key stakeholders and three certifying organizations (CAARR, Breining Institute, and CAADAC) on appropriate language for administration-sponsored legislation for a counselor certification and licensure bill. Staff are also working with stakeholders on AB 2268 (Chesbro), which will allow physicians to prescribe or dispense buprenorphine from their offices.

ADP’s Director’s Advisory Council (DAC) met on April 6 and discussed issues of concern to the field. Recommendations for the Director's Advice Seeking System are now under review by ADP’s Executive Staff. OLEA staff will oversee a joint Constituent Committee meeting on June 14 in Sacramento.

OLEA is in the process of drafting request for proposals for Native American Technical Assistance and Special Populations Technical Assistance. Check the following website for postings toward the end of June (http://www.bidsync.com).



Information Management Services Division: Short/Doyle Medi-Cal II (SMART)

The Information Management Services Division (IMSD) is nearing completion on ADP applications for the Short/Doyle Medi-Cal II project, known as SMART.  IMSD has completed the Office of Technology Services (OTech) Move project.  Both projects will improve the way ADP works with the field in California. We are pleased to report that the development work on the SMART project, as well as the technology support on the OTech move were performed by state staff and not outside contractors, thus saving on overall costs.

The SMART project improves the way in which Drug Medi-Cal providers and counties submit claims to ADP. It is fully compliant with Health Insurance Portability and Accountability Act requirements for transmitting and receiving Personal Health Information. The project was implemented in collaboration with the departments of Health Care Services and Mental Health, as well as the State Controllers Office. 

The OTech project involved physically moving servers that house mission critical ADP data systems—such as the California Outcomes Measurement System Treatment (CalOMS Tx) and the Drug and Alcohol Treatment Access Report (DATAR)—from one OTech data center to another.  After the servers were moved, the software that supports the data systems was upgraded to ensure the stability of the data systems used by providers and counties when they submit data.

IMSD is currently assessing a variety of projects that would further improve the stability of ADP data systems and the accuracy and integrity of provider data. We are also looking at ways to enhance our opportunities to communicate using the Internet and our ability to share data with providers.  IMSD is exploring options for the development of an Electronic Health Record (EHR) publicly-funded AOD system in California.



Licensing and Certification Division: Improved Customer Service

In a meeting with the Counselor Certification Advisory Committee, staff from ADP’s Licensing and Certification Division (LCD) discussed a simplified process for reporting complaints of counselor misconduct.  Based on recommendations from the Committee, LCD set up a dedicated toll-free telephone number to the Program Compliance Branch. ADP sent an announcement to all providers, counselor certifying organizations, and county administrators in April notifying them that the number (1-877-685-8333) is now operational.

Recognizing the importance of ensuring access to treatment, LCD has committed to improving the timeliness of application processing. To that end, staff initiated a plan to decrease the time it takes to review applications for facility licensure and program certification using quality improvement methodology.  In addition to focusing on processes for greater efficiency, the Division has begun to move staff between divisions in response to workload demands.  As a result, the backlog of applications over 90 days old has been reduced by approximately 40 percent. We will continue this effort with a goal of completing the application review process in 90 days or less.



Program Services Division: Treatment Services

Veterans Awareness Initiative

In 2009, ADP initiated a Veterans Awareness Initiative (VAI), and, together with the California Department of Veterans Affairs, co-chairs a bi-monthly forum that includes local county administrators and stakeholders, organizations serving the military, federal Veterans Administration, Department of Mental Health, and California National Guard representatives.  A few of the objectives of the VAI  are to provide veterans access to substance abuse services, if needed; increase awareness of the specific issues and concerns of those who serve or have served in the military; provide training to the substance use disorder field; and provide a forum to disseminate information and share issues and concerns impacting this population.  If you are interested in becoming a member or just listening in on the bi-monthly conference calls, go to http://adp.ca.gov/veteran/VAI.shtml for more information.

We want to share a pat on the back that ADP received recently from the California National Guard for our work in behalf of military personnel in the state through the California Access to Recovery (CARE) Program and through our Veterans Awareness Initiative. This comes from SSG J'neen Rice, Prevention Coordinator for the National Guard, who serves on ADP’s Governor’s Prevention Advisory Council:

“CA ADP has been a tremendous asset in supporting not only National Guardsmen that have served in Iraq and Afghanistan, but those who have not yet deployed and are still in need of services. The CARE program provides Soldiers and Airmen access to treatment and support services when no other means have been available.... I've seen the depth of concern and support from ADP through the stakeholder's meetings where all parties have an opportunity to collaborate to support our Military Members and Veterans. It's heartwarming to see so many agencies working together to combat and prevent substance use disorders for the Military Members, Veterans, and their families.”  -- SSG J’neen Rice, Prevention Coordinator



California’s Operation Welcome Home & CalVet Corps

California’s Operation Welcome Home is the combined effort of a multitude of government agencies, departments, non-governmental entities and volunteer organizations. Its mission is to connect with the 30,000+ California veterans who return from deployment annually to ascertain needs and direct them to services to help them make a successful transition from military service to the civilian sector.
The initiative also helps military personnel transfer diverse military skills into the civilian workforce. As a comprehensive streamlining of services, Operation Welcome Home aims at breaking down government bureaucracy to give veterans straightforward and quick access to benefits and services including:

  • Employment help, job training assistance, and employment benefits
  • Education opportunities
  • Housing information and help
  • Healthcare (mental and physical)
  • Benefits provided by the US Department of Veterans Affairs
  • Support for families

The program consolidates the efforts of all participating governmental entities and volunteer organizations into Regional Outreach Teams. The California Department of Veteran Affairs is building a network of outreach coordinators whose job it will be to directly touch veterans throughout the state.

The CalVet Corps is a coalition of people from government, nonprofit organizations, and volunteer groups that will target and contact California veterans individually. For more information: www.cdva.ca.gov



Program Services Division: Prevention Services

Town Hall Meetings on Underage Drinking

As part of a nationwide effort sponsored and funded by the Substance Abuse and Mental Health Services Administration of the US Department of Health and Human Services, more than 100 communities across California are holding Town Hall Meetings to discuss underage and binge drinking by youth.

ADP issued a press release to metropolitan and community newspapers, as well as television stations, in all 58 California counties to encourage coverage of the 104 local meetings planned. We are happy to report that media responded with enthusiasm to our release and sent reporters to cover the gatherings throughout the state. The Town Hall Meetings began in March and will continue through November. The goal of each community gathering is to raise awareness and promote legislation to reduce access and availability of alcohol to youth. 

The Governor’s Prevention Advisory Council Underage Drinking Prevention Workgroup created a toolkit which includes Town Hall Meeting preparation tools, information on state programs to reduce access and availability of alcohol to youth, and valuable information on binge drinking and alcoholic energy drinks.  For more information and to find the location of a Town Hall Meeting in a community in California visit http://stopalcoholabuse.gov/TownHallMeetings/map/eventlist.aspx?id=6



Free Prevention Publications

The Community Prevention Initiative (CPI) contract for prevention technical assistance includes briefs on issues of importance to those conducting and delivering prevention programs. All are well designed to give the reader a better understanding of specific issues in the field.  They can be downloaded any time at no cost at
http://www.ca-cpi.org/Publications/publications_main_page.htm

Two recent issues of the “Tactics” include “Selecting Evidence-Based Approaches for Substance Abuse Prevention” available at…
http://www.ca-cpi.org/Publications/Prevention_Tactics/PT9.06.EvidenceBasedApproaches.pdf

…and, “Creating a Policy to Manage Donations,” available at
http://www.ca-cpi.org/Publications/Prevention_Tactics/PT9.05.IndustryTactic.pdf

Check out a new product, “Research to Practice,” which includes information on non-medical use of prescription drugs, available at
http://www.cars-rp.org/publications/ResearchToPractice/R2P_PerformanceEnhancement_20100319.pdf 



Alcoholic Energy Drinks

The Governor’s Prevention Advisory Council (GPAC), administered by ADP’s Program Services Prevention Branch, includes 17 state agency members unified by their common interest in effective alcohol, tobacco and other drug (ATOD) prevention.  Problems related to ATOD impact their various missions and GPAC provides a forum through which to identify and address common goals. 

GPAC’s Underage Drinking Prevention Workgroup created a website dedicated to raising awareness about the dangers posed by Alcoholic Energy Drinks (AEDs). Learn about AED products, marketing schemes, health and safety risks and federal, state, and local efforts to reduce access and availability of AED’s by visiting http://www.adp.ca.gov/youth/aed_index.shtml  

Also available on the website is a wealth of resources including printable brochures and posters. See the “What You Can Do” link at the bottom of the page for valuable information and steps you can take to mitigate the problem of AEDs.  



Office of Problem Gambling: Expanded Services

The Office of Problem Gambling (OPG) recently announced that one of its most popular publications—“Freedom from Problem Gambling”—is now available in an additional thirteen languages. In its quest to facilitate cultural competency throughout California, OPG has worked through the past year to translate its program materials into the multitude of languages spoken by California’s multicultural population. This useful booklet was originally offered in English, Spanish, Chinese, Korean, Vietnamese and Mien.  Additional translations are now available on the OPG Website in Arabic, Cambodian, Hmong, Laotian, Russian, Tagalog, Ukrainian, Armenian, Farsi, Japanese, Punjabi, Samoan, and Thai. Read and download them at http://www.adp.ca.gov/OPG/index.shtml
 

In order to expand treatment resources for problem gamblers and their families, OPG is in the process of training licensed therapists to minister to the specific needs of problem gamblers. During Phase I of the California Problem Gambling Treatment Services Program, OPG conducted training seminars in major regions around the state. By the end of June 2010, it will have trained 275 therapists who are bilingual in 18 different languages. Phase II will be the implementation of a treatment reimbursement program for the therapists trained in the program. For more information, visit the OPG website.