House Special Committee On Drug and Alcohol Abuse Peter F. Luongo, Ph.D. October 2, 2007

Treatment Effectiveness Alcohol and Drug dependent people who participate in drug treatment Decrease substance use Decrease criminal activity Increase employment Improve their social and intrapersonal functioning Improve their physical health Drug use and criminal activity for virtually all who enter treatment results the longer they stay in treatment.

Statewide Maryland Automated Record Tracking (SMART) SMART is a full electronic clinical record (EHR) All funded treatment providers report data online SMART addresses key EHR concerns: Admission, treatment encounters and discharge Privacy, Practitioner control, Administrative oversight Interoperability = shares information through XML Additional Modules eCourt Contract Monitoring and Billing

Under development Stand Alone Data Analyzer – December 2007 Real time access to data Providers Jurisdiction decision makers State oversight (ADAA) Automated Drug Testing – January 2008 Additional Clinical Assessments and Screening Homicide and suicide lethality assessments HIV and TB risk assessments Many Others

Treatment Funding % change Appropriation$119,219,304$126,447,1796% Individuals Treated*45,72252,306**14% Cost per Individual$2,607$2,417(7%) FY 2003 – FY 2007 *Unduplicated individuals treated **Estimate based on 10 month data

Outpatient Adult Community Treatment % change Completed Treatment37%43%16% LOS 90 days56%59%5% Reduction in Substance Users10%33%230% Increase in Employment10%13%30% Selected Outcomes FY 2003 – FY 2007

Level III.1 Residential Treatment* Selected Outcomes FY 2003 – FY % change Completed Treatment36%42%16% LOS 90 days54%56%4% Reduction in Substance Users0%34%- * Variable length of stay moderate intensity

FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004 Abstinent from Alcohol

FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004 Abstinent from Drugs

FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004 Employment

FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004 Arrested During Prior 30 Days

FY 2006 ADAA-Funded Data and National Outcome Measures (NOMS) Data for Reporting States in 2004 Homelessness

Summary Table Treatment Awards Utilizing Performance Compensation Treatment Category Total Award Amount of Grant Funding subject to Performance Compensation % Performance Compensation Residential$ 41,207,873$ 21,431,62852% Non-Residential$ 73,029,601$ 24,819,23334% $114,237,474$ 46,250,86140%

Pay for Performance Pilot Pilot based on: January – April 2007 Data from Outpatient Programs – excluding: Adolescents Jail-based population Data in the system as of July 1, 2007

Performance Standards >65% retained at least 90 days >50% successful completion Both standards = 100% performance payment One standard = 50% performance payment

Pay for Performance Incentive Breakdown County DischargesLOS >= 90Complete Jurisdictional Category A 1-2 Outpatient Clinics Caroline9168.1%52.7% Cecil %37.1% Charles %58.2% Dorchester2650.0%34.6% Frederick %32.5% Garrett8036.3%28.8% Kent9254.3%43.5% Queen Anne's8861.4%47.7% Talbot8460.7%53.6% Wicomico %38.9% Jurisdictional Category B 3-6 Outpatient Clinics Allegany %42.7% Carroll %54.7% Harford8951.7%38.2% Howard6357.1%27.0% Montgomery %45.5% Somerset8073.8%50.0% St. Mary's8978.7%65.2% Washington %57.5% Worcester %42.5% Jurisdictional Category C 7+ Outpatient Clinics Anne Arundel %43.0% Baltimore County %51.2% Prince George's %41.8% Baltimore City %31.2% Statewide3655.6%30.6%

Pay for Performance Incentive Breakdown Full Incentive - 100% of Standards Met CountyJuris. Cat.DischargesLOS >= 90Complete CarolineA9168.1%52.7% CharlesA %58.2% CarrollB %54.7% SomersetB8073.8%50.0% St. Mary'sB8978.7%65.2% WashingtonB %57.5% Partial Incentive - 50% of Standards Met CountyJuris. Cat.DischargesLOS >= 90Complete CecilA %37.1% TalbotA8460.7%53.6% MontgomeryB %45.5% Baltimore Co.C %51.2%

JurisdictionAnnual IncentiveProrated (4months) A$15,000$5,000 B$20,000$6,667 C$30,000$10,000 Full Incentive - 100% of Standards Met CountyJurisdiction CategoryProrated CarolineA $5,000 CharlesA $5,000 CarrollB $6,667 SomersetB $6,667 St. Mary'sB $6,667 WashingtonB $6,667 Partial Incentive - 50% of Standards Met CountyJurisdiction CategoryProrated CecilA $2,500 TalbotA $2,500 MontgomeryB $3,334 Baltimore CountyC $5,000 Financial Incentive For the initial year, a prorated amount is assigned to each classification. The following table shows both the annualized and the prorated figures.

Method of Allocation Percent of Total Award Historic 45% Earmarks 28% Competitive 6% Formula 21% Total100%

Central Region Jurisdiction Baltimore City$47,241,235$47,158,994$48,720,080 Baltimore County$6,623,455$7,435,398$7,799,615 Harford County$2,084,304$2,095,246$2,386,649 Howard County$1,775,466$1,780,466$1,924,057 Total Regional Awards$57,724,460$58,470,104$60,830,401 Total Awards$123,232,702$124,638,995$130,782,647

Eastern Shore Region Jurisdiction Cecil County$1,395,736$1,400,736$1,530,147 Dorchester County$1,323,836 $1,428,273 Caroline County$633,774 $718,891 Kent County$1,017,613 $1,077,963 Queen Anne's County$789,650$821,576$881,194 Somerset County$1,077,933 $1,109,440 Talbot County$941,422 $968,916 Wicomico County$2,189,504$2,228,034$2,350,539 Worcester County$3,057,225$3,226,325$3,380,054 Total Regional Awards$12,426,693$12,671,249$13,445,417 Total Awards$123,232,702$124,638,995$130,782,647

Southern Region Jurisdiction Anne Arundel County$4,821,491$5,171,491$5,415,712 Calvert County$1,120,131$1,162,131$1,203,021 Charles County$2,262,221$2,304,802$2,474,993 Prince George's County$10,806,803$11,335,622$11,628,634 St. Mary's County$2,798,750$2,922,782$3,118,274 Total Regional Awards$21,809,396$22,896,828$23,840,634 Total Awards$123,232,702$124,638,995$130,782,647

Western Region Jurisdiction Allegany County$2,082,266$2,362,756$2,428,723 Carroll County$1,746,151$1,752,756$1,824,306 Frederick County$2,570,355$2,596,089$2,745,139 Garrett County$1,080,620$1,087,120$1,118,015 Montgomery County$4,961,899$5,036,312$5,265,177 Washington County$3,867,216 $4,033,438 Total Regional Awards$16,308,507$16,702,249$17,414,798 Total Awards$123,232,702$124,638,995$130,782,647