1. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Introduction - Who are We? County of San Luis Obispo (California) Drug and Alcohol Services (DAS) is the grant recipient and treatment provider Dependency Drug Court: parents with substance use disorders resulting in loss of custody of children due to child abuse/neglect Team: Child Welfare Services, Dependency Court, Outpatient treatment provider (DAS), attorneys, CASA, and residential treatment

2. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net AIM (plan) NIATx Aims: Increase Admissions into Dependency Drug Court Increase Referrals from Child Welfare Services What keeps the CEO up at night?

3. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net CHANGE (do) Cycle #1 Data & Drug Court Coordinator Drug Court Coordinator staffing change was coincidental/instrumental to the change Drug Court Coordinator would review all CWS court petitions with drug and alcohol issues Drug Court Coordinator would go to the initial court hearing and make a treatment referral with the family at the time of the hearing

4. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net CHANGE (do) Cycle #2 No Waiting Period Sought information from other DDCs Decided to increase admissions first and then worry about retention and failure rates later Removed “waiting period”—wanting clients to be stable prior to admission Admitted residential referrals

5. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net CHANGE (do) Cycle #3 Pain Management Based upon review of the reasons people were not admitted to DDC Implemented pilot specialized Pain Management program

6. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net CHANGE (do) Cycle #4 Improving Relations with Referring Partner (Child Welfare Services Coordinator conducted Focus Group Survey with Social Workers “what’s the problem with DDC?” Corrective Action Plan developed Presentations to Social Workers Answered questions about residential placements, use of the ASAM-PPC

7. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net RESULTS (study)

8. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net NEXT STEPS (act) Change Cycle 1 (Data/Coordinator): Adopted Change Cycle 2 (No Waiting): Adopted Change Cycle 3 (Pain Mgmt): Adopted Change Cycle 4 (Relations): Adopted

9. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net IMPACT (lessons learned) Met admissions numbers in the grant Analyze your data—it can tell you what the problem is—it’s continuous First change cycle—consider systems that you have control over (not across systems). Cross-systems changes come later