1. UCLA Integrated Substance Abuse Programs Richard Rawson, Ph.D. Rachel Gonzales, Ph.D. Funded by: California Alcohol and Drug Programs CalOMS Training for Counties

2. Learning Objectives Goals of the CA Data System Importance of using data to improve treatment Basic models for disseminating CalOMS data

3. Goals of CA Data System Provide a comprehensive data collection and management system To establish greater accountability of the treatment system for providing quality services Ensure efforts are in accordance with SAMHSA’s National Outcome Measurement System – NOMS – essential Indicators used to evaluate the quality of substance abuse treatment

4. Importance of CalOMS Data CalOMS data are standardized –same data are collected across programs/counties at admission (t1) and discharge (t2) CalOMS data are comprehensive - allows for understanding: –Client’s in treatment (Demographic data) –Treatment patterns (Service data) –How programs are performing (Performance data) –Impact of treatment on client outcomes (Outcome data) CalOMS data helps us keep up to date with treatment improvement initiatives: Use data to improve treatment

5. Step 1: What do you want to know: Tx Priority Step 2: Identify CalOMS Data Needed (demographic, service, performance, outcome) Step 3: Request Data/Run Data Report Step 4: Examine & Analyze Results Step 5: Determine, what, if any, changes should be made to improve service delivery Steps: Using CalOMS Data

6. Exercise: CalOMS Demographic Data Who’s in treatment? –Primary substance problem (e.g., alcohol, marijuana, cocaine, opiates, prescription, meth) –Special needs: Pregnant (e.g., injectors, homeless, youth, disabled, veterans, criminal offenders, mentally ill) Apply CalOMS demographic data to treatment improvement initiatives

7. Primary Substance Problem CalOMS Treatment Admission Report

8. Clients with Special Needs 6% of admissions were pregnant women Meth most commonly reported among pregnant women

9. Exercise: CalOMS Service Data What are treatment trends? –Service utilization (e.g., detox, outpatient, residential, NTP) –Treatment referral sources (e.g., SACPA, Self, DMC) Apply CalOMS service data to improve treatment

10. Service Utilization & Referral Most admissions are to outpatient programs ½ of referrals are from criminal justice system CalOMS Assessing Services Report

11. What is Performance Data? Desired Outcomes Access Retention/Completion Continuity of Care Treatment Performance indicators measure the treatment process at the program level

12. Exercise: CalOMS Performance Data  Access  Retention  Continuity of Care Applying CalOMS performance data to improve treatment

13. Access (Wait time) Research supports: reduced wait time is associated with improved engagement and retention in treatment… CalOMS Assessing Services Report

14. Access for Priority Populations

15. Retention (Length of stay) Research supports: without an adequate amount of time in treatment, few improvements are observed….

16. <30 days <90 days >90 days CalOMS Service Utilization Report

17. What do the data indicate? Outpatient Treatment Sub-optimal < ½ Optimal Dose

18. < 1% are staying 365 days or more 40% not retaining during initial 30 days

19. Continuity of Care Measure  Do individuals who enter treatment proceed through appropriate levels of care?  Per CalOMS: matched admission-discharge treatment service sets that occur within 30 days of a prior discharge (via client unique client ID)

20. Treatment Episode Continuing Care/Aftercare Programs Detox/ Inpatient Long-term Residential Treatment Intensive Outpatient/Psychosocial Behavioral Treatment Sober Living Residence

21. Continuity of Care Patterns Majority of clients only receive 1 service (level of care) 75% of clients in detox do not go to another level of care

22. What is Outcome Data? Desired Outcomes Substance use Employment/Education Criminal Activity Housing Stability Social Connectedness Treatment Outcome indicators measure client status at the client level

23. Exercise: CalOMS Outcome Measures Interested in treatment impact Stopping or Reducing –Substance use –Unemployment –Crime –Homelessness –Family conflict Applying CalOMS Outcome data to improve treatment

24. Reductions in Criminal involvement and crime Changes During Treatment Reports

25. Improvements in Client Outcomes

26. Step 5: Using Data to Improve Treatment Desired Program/Policies/Services Data What’s being done What NEEDS to be done

27. What To Look At? Start at the… Program and Provider Level ACTIVITIES: Use of evidence based practices FACTORS: Staff, license/training, resources, tx environment PERFORMANCE MEASURES Access, retention, continuity of care

28. Tx Improvement: What changes are needed? What program elements can affect performance measures? –Improved screening and placement –Timeliness & rapid response –Comfortable, friendly environments –Flexibility –Case management

29. Strategies for Enhancing Service Linkages Active referral/transfer Case management processes Integrating staff at different tx levels Creating personal linkages Arranging transportation Referring to appropriate geographical location

30. Illustration: NIATX Strategies Improve Access & Retention Screening/PlacementTimeliness/ Rapid Response Enhanced Tx Enhanced TxResponse Contact your ATTC Representative

31. Summary: Utility of CalOMS Data  Provides Evidence  Establish Priorities  Decision-Making  Improvement and …

32. .... increase and sustain Community & Financial Support $$$ For Services & Programs

33. Remember Data in a system is only as good as how the data is collected… Data quality efforts are essestial Data Validity is Essential

34. Goal: Improved Measures More work is needed to improve upon CalOMS performance and outcome measurement Standard data collection of discharge is necessary for valid data and assessing treatment quality & effectiveness Continued Training is Critical

35. Disseminate the Data Demonstrates utility Gives feedback on services and outcomes Increases buy-in & engagement Improves data collection Greater data quality & valid data

36. Effective Dissemination Models Using CalOMS data you can create: Program Site Reports (report card) Brief Treatment Updates Fact Sheets on specific topics State CalOMS Reports

37. Program Site Reports Report Style Executive Summary Highlight Program Performance Tables/Graphs with Outcomes Engaging

38. Treatment Updates Specific data topic Newsletter Style One-page Format Graphs/Tables Short Summary

39. Treatment Updates Innovative Quick Reference Targeted Subject Concise

40. Fact Sheets Comprehensive Visual Summary of major trends Downloadable

41. State CalOMS Reports

42. CalOMS Resources Data Dictionary Data Collection Guide Reports User Guide & Instructions Data Quality Standards http://www.adp.ca.gov/CalOMS/CalOMSmain.shtml

43. Contact Information Richard Rawson rrawson@mednet.ucla.edu Rachel Gonzales rachelmg@ucla.edu www.uclaisap.org