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HomeMy WebLinkAboutMINUTES - 12162003 - C96 FHS#32 TO: BOARD OF SUPERVISORSContra ,• FROM: FAMILY AND HUMAN SERVICES COMMITTEE DATE: DECEMBER 16,2003 °' � �' Costa SUBJECT: ALCOHOL AND DRUG TREATMENT PROGRAMSo �''' -'` r,�"c 1iia� �1 1ty FOR YOUTH 4r s SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: ACCEPT the report on Alcohol and Cather Drugs Youth, Family and Community System of Care, as recommended by the Family and Human Services Committee. FISCAL I'M'PACT: None BACKGROUND: Alcohol and other drugs treatment programs for youth were evaluated in 1398, with review of that evaluation and subsequent follow-up referred to the Family and Human Services Committee. Since the initial referral,there have been annual and periodic reports presented to the Board of Supervisors through the Family and Human Services Committee on the status of alcohol and other drugs programs for youth. The enclosed report describes service distribution and fiscal allocation of primary prevention and youth treatment services,the Contra Costa County Juvenile Drug Court Program, and the Safe and Drug Free Schools and Communities Grants for Rodeo and Bay Point. CONTINUED ON ATTACHMENT: 4,--YI!*t SIATURE. RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE($): ACTION OF BOARD ON December 16, 2003 APPROVE AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE x _ UNANIMOUS (ABSENT Nana ) AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: ATTESTED December 16, 2003 JOHN SWEETEN,CLERK OF THE BOARD OF Contact Person: SUPERVISORS AND COUNTY ADMINISTRATOR CC: Dorothy Sansoe(5-1009) r Heafth Services AOD �r f BY: •4f f, DEPUTY The California's Alcohol and Drug Programs data system defines discharge status in terms of completion, leaving with or without satisfactory progress, termination based on fee, non-compliance, administrative reasons, client episode open without services, client went to jail, was referred or transferred out. Although these are crude measures of client outcomes they provide some insight into the program's ability to appropriately design outpatient treatment services tailored to the needs of county clients, in particular children, youth and families at risk (See Appendix #1). Primary Prevention: Best Practices The total allocation for Youth, Family & Community prevention services of $1,294,955 was used to implement four "best practices" (Project Success, Youth Development, Creating Lasting Connections and Dare To Be You) and one "promising practice (Strengthening Youth & Families). Table IV shows distribution of by provider. Table V Prevention Service allocation by Provider ................... ................ -- flP #rsvta� kOi4r ; Ht : iw'1` Discovery Counseling Central Education Creating Lasting 2,024 749 1,190 $41.99 $84,988 Center of San Ramon County connections Valley Family Stress Center Central Education Dare to be You 2,545 339 3,720 $55.01 $140,000 County Asian Pacific west County Education Project Success 1,200 1,100 790 $50.00 $60,000 Psychological Services New Connections Central Education Project Success 1,212 1,212 762 $53.77 $65,169 County New Connections East County Education Project Success 1,212 1,212 891 $53.77 $65,169 Center for Human East County Education SDFSC - Bay 2,590 1,025 155 $48.26 $125,002 Development Point Bay Area Community west county Education SDFSC- Rodeo 2,590 586 317 $48.26 $124,993 Resources Gateway Project Center for Human Countywide Education Strengthening 4,855 2,956 52 $54.79 $266,005 Development Youth& Families REACH Project,Inc. East County Education Strengthening 5,300 2,300 1,500 $33.96 $179,988 Youth & Families Say Area Community west County Alternatives Youth 2,072 227 72 $40.37 $83,647 Resources Gateway Development Project Center for Human Countywide Alternatives Youth 1,700 52.5 112 $58.82 $99,994 . . Development. Development TIAL: r313L3 12,23i3f3�-. >$4 > 31r � 5 : Created by A.DelValle fnsnovl0 12/3/03 12 Other prevention services not included above: (1) SDFSC Bay Point and Rodeo grants; (2) Environmental Prevention and support to the deemed Approved Ordinance; (3) Sojourne and Tri-Cities (County Operated Programs) also provided indicated prevention services in several West County alternative 'schools and one best practice in Chris Adams and Summit Center; (4) the Community Partnership provided technical assistance for coalition building, coordinated countywide campaigns, and disseminated a monthly AOD informative package,,etc. State Alcohol and Drug Programs Safe and drug Free Schools and Communities are fully funded for three years, two annual awards of $178,399 dollars per site to be implemented in the Bay Point and Rodeo communities. The partners involved in the project are the Housing Authority, the Bay Point Health Clinic, the Resident Council, the local school districts, community coalitions and youth groups. The best practices selected for the project are Creating Lasting Family Connections and Youth Development. The goal is to delay the onset of alcohol and other drugs use, reduce frequency of use of alcohol and other drugs, and improve the school, home and community environments. The most recent Prevention Activities Data System (PADS) report submitted to the Alcohol and Drug Programs (ACIP) for the period of July 1, 2002 through June 30, 2003 shows a total of 17,853 individuals served through multiple prevention strategies. Table below show totals per ethnicity and age. Table VI Prevention Service Allocation by Provider �el>�thliclty Twat Black 2,910 Under 5 193 White 7,996 6-9 113 Latino 3,136 10-12 1,124 Asian Pacific Islander 3,001 13-15 1,805 Native 256 16-18 3,575 Mixed 553 19-25 1,334 Total 17,853 26-54 8,539 55+ 1,165 Total 17,853 Under the education strategy 13,257 Contra Costa residents received services, 3,293 individuals participated in alternative activities, and 1272 'units of service were provided for community-based processes. As explainedto the State, the total Created by A.DeiVaiie fhsnovlo 12/3/03 13 ......... ......... ......... ... _ _ ....... ......_..... ......... ._....... ......... _ ......_.. ......_.. ......... ......... ................................................................................. number of education units is a conservative figure that exclusively captures service activities pre-established under this strategy. However, with the implementation of Best Practices, a combination of several prevention strategies are provided simultaneously that Involve community based, environmental, information, etc. Capacity Building As part of the RFP process the Board of Supervisors directed the ADDS Division to include a Capacity Building component. The following activities have been completed a) Each provider received training and technical assistance from the Best Practice Model Author. Curriculum materials required by each model such as workbooks, posters, puppets, lesson plans, etc. were purchased and supplied in-kindby the division to support program start-up as needed. b) During the year service plans were often revised to support providers in areas that had not been contemplated prior to contract negotiation. For instance, the attendance of youth and youth advisors to statewide conferences had not been budgeted in the contract. The Division was able to obtain scholarships from a State organization to supplement the contract and allow youth and staff to participate at the TeenWorks conference. c) Each contract provider met with the State's Technical Assistance- Prevention Outcomes Measurements {TA-POM} consultant to review program evaluation tools and establish expected outcomes appropriate to each target population. The technical support through TA-POM has continued regularly up to date. d) Convened BI-monthly line staff network meetings have occurred consistently for the past two years. The meetings provide a forum for staff to discuss, assess, monitor and revise progress of each model. Technical assistance has also been provided by clustering similar models to evaluate specific issues and discuss potential adaptations particular to Contra Costa's populations, with the author's consent and maintaining a high level of fidelity. e) Conducted three Training Institutes to enhance skills as well as to foster cross-fertilization, coaching, increase proficiency in service delivery utilizing the wealth of experience within the Youth, Family and Community System of Care staff. Prevention Best Practice Implementation The degree of success accomplished this year varies per agency and community. At the countywide level, however, providers' knowledge and expertise has placed them on a competitive edge to attract additional resources as other systems begin to attach funding requirements to best practices and outcome measurements. The ownership of a best practice model has resulted in increased loyalty to the model as Created by A.Delvalle fhsnovl0 12/3/03 14 opposed to the promotion of an agency program. Proficiency in service delivery has also resulted in cost savings and expanded capacity to continue providing services during the summer, particularly for school based programs. Some providers have been extremely successful to market themselves by establishing new partnerships in their local community. Building Resiliency in Children The focus of prevention has shifted to adequately respond to research findings that recommend prevention services to start at an earlier age; a case example is the successful implementation of Clare To Be You for children under 5 and their parents in strong partnership with the County Head Start Programs. Additionally, the majority of prevention services have been placed in middle schools considered feeders for High Schools with high-risk indicators. According to need indicators, the level of prevention services has been increased in some instances, by pairing best practices such as: Project Success and Youth Development to allow youth to benefit from two programs. RECOMMENDATION: ADDS INTERDEPARTMENTAL COLLABORATION MODEL The Alcohol and Other Drugs Services Division hereby proposes a collaborative model for your consideration and endorsement. At a time when accountability is essential for publicly funded services but fiscal resources are limited it is crucial to have a model of inter-departmental collaboration that goes beyond coordination, avoids the pitfalls of integration and ensures a ""seamless" system of care. The overarching goal of the proposed model is to increase delivery of cast effective and comprehensive substance abuse services to children, youth and families. The ADDS Division by the nature of its mandate and existing technical management and evaluation systems can broker purchase of AOD services from a multi- departmental revenue pool. In collaboration with contributing departments, basic service parameters can be established, service objectives and performance measures refined and competitive RPP processes used to select providers. The ADDS Division added value to this proposal is its ability to provide: • A wide range of prevention and treatment services that are client focused, outcome driven and designed around objectives of quality and cost effective standards of care; • The mechanisms to document and track measurable outcomes in order to establish benchmarks and performance indicators based on cost, quality and client/consumer satisfaction; Created by A.Delvalle fhsnoviO 12/3/03 15 ..........I.......I....................... ..............................I.......I................................................................. • The effective use of the Health Department and the Division's Management Information Systems to track services, measure performance and develop program and client outcomes. This model can address the inequities of youth treatment services as well as comply with the Board of Supervisor's call to enhance use of existing funds such as Drug Medical and Healthy Families. The Division has provided Drug Medical training and technical assistant to all the AODS System of Care programs and conducted a study of client eligibility status among last fiscal year's caseload that shows potential for generating fees, which in turn can release existing funds to expand capacity to serve adolescents. In collaboration with the Alcohol and Other Drugs Advisory Board the underutilization of Healthy Families benefits brought to the attention of Assemblyman Tom Torlakson and local elected officials resulted in an agreement with the University of California Alcohol Policy Research Group to conduct an Access and Utilization Study. At their annual retreat last Saturday the Alcohol and Other Drugs Advisory Board proposed solutions to the inequities of youth services and recommended the Division's inter-department collaboration model as a strategy to ensure the most return on investment through competitive provider selection, a reconfiguration and reprioritization of the AODS system of care to better balance youth and adult services, and the development of a single point of entry for adolescents served by Health Services, Children/Family Services and Probation Departments. 5"Opportunities for Addressing Youth Health Disparities"Alcohol and Other Drugs Advisory Board Retreat,November 8,2003 Created by A.DelValle fhsnovlO 12/3/03 16 WILLIAM B. WALKER, M.D. CONTRA COSTA HEALTH SERd3CE5 DIRECTOR ALCOHOL AND AaANNA HENRY OTHER DRUGS SERVICES INTEaiM DIRECTOR 597 Center Ave, Suite 320 CONTRA COSTA _ Martinez, CA 94553 Ph (925) 313-6300 HEALTH SERVICES Fax (925) 313-6390 TO: CCC Board of Supervisors FROM: Health Services Alcohol & Other Drugs Services Division RE: ADDS Youth, Family & Community System of Care DATE: December 3"d 2003 RECOMMENDATIONS: 1. ACCEPT this report from the Health Services Department Alcohol and Other Drugs Services Director for FY 02-03 Youth, Family and Community System of Care describing service distribution and fiscal allocation of primary prevention and youth treatment services, the CCC Juvenile Drug Court program and the Safe and Drug Free Schools and Communities Grants for Rodeo and Bay Point. Z+ ACKNOWLEDGE the Division's compliance with SAMHSA's Performance Partnership'; results from Fast year's prevention RFA and its inter-departmental collaboration programs e.g., Proposition 36, Proposition 10, CalWorks and East County Juvenile Drug Court, examples of"well managed alcohol and drug treatment programs that are a cost effective, socially responsible, humane solution to addiction and its impact on children and families"". 3. RECOGNIZE the disparity between youth and adult treatment funding that restricts youth access and utilization; the significant growthrate of youth population in this county which is projected to increase the most among ethnically diverse youth populations; the disproportionate number of minority youth and the high percentage of substance abuse problems among youth treatment clients involved in the Juvenile justice system; the implications of above trends on youth health disparities and treatment practices required to serve culturally diverse adolescent populations. 4. DIRECT the Health Services Director to address the disparity of funding and the overrepresentation of juvenile probation clients in the ADDS treatment system through the ACIDS Division's inter-departmental collaboration management and evaluation systems already in place, implementation of adolescent treatment best practices, expansion of outpatient treatment capacity financed by Medl-Cal and Healthy Families, and the use of a Request for Proposals process to reconfigure and reprioritize the ADDS system of care to achieve a better balance between youth and adult services. i SAMHSA's Substance Abuse Prevention and Treatment Performance Outcomes in Federal Register Notice,July 9,2003 2 For Our Health and Safety:Joining;Farces to Defeat Addiction Little Hoover Commission Study of Substance Abuse in California March 2003 Nate:These documents are included in the FHS Report •Contra Costa Alcohol and Other Drugs Services+Contra Costa Emergency Medical Services+Contra Costa Environmental Health+Contra Costa Health Plan+ 0 Contra Costa Hazardous Materials•Contra Costa Mental Health+Contra Costa Public Health+Contra Costa Regional Medical Center+Contra Costa Health Centers+ FY 02-03 UPDATES Youth Treatment Disparities: Funding & Service Priorities The combined State and Federal budget for California Alcohol and Drug Programs allocates 2% of the budget to youth treatment although statewide the number of youth ages 12 to 17 in need of substance abuse services is estimated to be 220,000. In a similar fashion the ADDS Division's largest source of funding, the Substance Abuse Prevention and Treatment Block Grant (SAPT), only dedicates 27% of its resources to youth as compared to 73% to adults. Figure x FY 02-03 Alcohol and Other Drugs Services Division Funding Sources COUNTY GEN FUND DRUG MED!-CAL 12% 14% ENSD-SOCIAL SERVICES STATE GEN FUND 2% 5% CALWORKS 8% ...4,,. .... PRO P 10 3% FEDERAL FUNDS PROP 3 36°h 6 10% atal, a): Sources: DUI 2?,375,0()o FEES&FINES_/ 8% 2% Created by A.aelValle fhsnovio 12/3/03 2 Figure II FY 02-03 Alcohol and Other Drugs Services Division Expenditures NARCOTICS 13th* RESIDENTIAL 29% :. ... .................. ................ ...... NONRESIDENTIAL ta /o ANCILLARY 10°k SECONDARY PREV 3% DUI-COUNTY 9°10 ? Total,all expenditures: PRIMARY PREV `'� , _ADMIN/SUPPORT $21,375,000 8% 9°10 The unequal distribution of funds by modality also speaks to a set of priorities that benefit adult rather than youth services. For example, 29% of the division's budget funds residential treatment but only 8% is dedicated to primary prevention and 3% to secondary prevention although these are the most effective strategies to serve at risk children, youth and families. although 17% of the county population is 12-18 years of age last year the Division's overall treatment expenditures for this age group was less than 3% and only 9% of the treatment caseload was 12-18 years of age. Created by A.DeiVaNe fhsnovlO 12/3/03 3 Table I Comparison of Youth vs. Adult Treatment Funding se ... ...... Ancilla Services {3 $2,154,380 Da Treatment 344 658 509 765 $854,423 Methadone Maintenance 0 $2,664,145 664 145 Outpatient Counseling $349,907 $2,146,058 $2,495,965 Residential Detoxification 10 __1990,65 990 658 Residential Treatment $102,150 8 465 090 8 S6Z240 Total $796,715 $1§1930,096 117,726,811 Figure III Contra Costa County Population by Age Groups 0-11, 155,608 55+, 229,551 12-1 s 96,463 3 0-11 12-18 ® 19-54 0 55+ 19-54, 481,803 Created by A.DelValle fhsnovl0 12/3/03 4 The impact of above distribution of services and the lack of age and gender specific treatment programs is significant in lieu of census data' that suggests a 28% growth increase in adolescent population in this county with the largest increase among Latino (40%), Asian Pacific Islander (37%) and African American (22%) youth populations. Figure IV below depicts cumulative growth of youth and adult populations in Contra Costa County. Figure IV Contra Costa County Population Growth Rate by Age Groups 3096 ...._.__—...� 25% — 2046 15% 1096 5% 046 - 1993 1998 2003 - --Youth-+--Ad.ft 3 Produced by the Public Health institute and UCSF's National Adolescent Health Information Center for the California Adolescent Health Collaborative—Based on 1990 census data found in the California Department of Finance"Race/Ethnic Papulation with Age and Sex Detail, 1970-2040"and 2000 census data found in the California Department of Finance Report"Population by Gender,Age and Race' Created by A.DelValle fhsnovl0 12/3/03 5 . ................................................................................................ Youth Treatment: A Carve Out of Probation The division's inter-departmental collaborative model evolved from the successful implementation of recommendations from the "Youth Study" that changed prevention activities into best practices tailored to at risk groups and shifted service delivery to high-risk environments e.g. alternative and community schools, detention facilities, drug court programs and homeless shelters. The 1998 the study of "Access and Utilization of Youth Treatment Services in Contra Costa County„ found that only 101 unduplicated youth treatment clients were served in the ADDS System of Care; since then the youth caseload has steadily increased. Figure V Unduplicated Youth Clients Admitted to Treatment 700 60 Soo 400 i i 30 20a 10G FY 98-99 FY 99-00 FY 97-98 FY 00-01 FY 01-02 FY 02-03 FY 03-04 Est. 101 299 345 482 605 502 456 Created by A.DelVa€le fhsnovl0 12/3/03 6 Given the inadequate funds earmarked for adolescent treatment ($368,000) every year the division has shifted a small percentage of non-categorical SAPT funds from adult outpatient treatment programs to expand youth treatment capacity. The amounts are so small that with few exceptions, providers don't have separate budgets for youth treatment in their service plans. One of the consequences of the Youth Study recommendations -to serve high risk groups, increase early identification and youth referrals to treatment- is the disproportionate number of clients referred by the juvenile justice system (65%) and the high percentage of youth treatment clients on probation (64%). Figures VI and VII show the distribution of treatment referrals and the increased ratio of juvenile justice system referrals by year. Figure VI Sources of Referral for Youth School, 3% Mental Health, 1°10 other, 57% Social Service, 6°l° Community Agency, 7°l0 Self& Family/Friends, 14% Juvenile Justice System, 65/0 Created by A.delValle fhsnovl0 12/3/03 7 FIGURE VII Ratio of Juvenile Justice to Other Referral Sources i 70% � 60°/n - - — - i50°1° _ ---------- - ----- - - _- _-- 40% -------- ----- i 30°!0 --- - - ---- - ------ - -- i i i 20°1n -- ---- - - 10°1a - --- — ----- 0°Jn 98-99 99-00 00-01 01-02 02-03 03-04 Est. Juvenile Justice 32% 39% 59% 61% 66% 73% �•AllOthe.s 68% 61% 41% ' 39% 34% 27% The Juvenile Drug Court - As a result of the leadership provided by Superior Court Judge Lois Haight, and the availability of Drug Court grants, in April 2000, Contra Costa County opened its first Juvenile Drug Court in West County. The drug court annual budget $743,774 is funded by Probation's Juvenile Accountability ,Incentive Block Grant (JAIBG), the California's Alcohol and Drug Program Comprehensive Drug Court Implementation grant (CDCI), the California Collaborative Justice Courts Project for Juvenile Delinquency Drug Courts AOC Mini Grants, the Office of Drug Programs Enhancement Grant, Short Doyle Medical E.P.S.D.T fees and in-kind salaries of two Probation Officers. This ;figure does not include the District Attorney, Public Defender and Court Commissioner's percentage of salary dedicated to the program Of the Health Services match requirements. Oversight for the drug court program is providedby a Steering Committee representative of each region with membership drawn from Probation, Health Services, Court, Public Defender, District Attorney, Alcohol and Other Drugs Created by A.DelValle fhsnOviO 12/'3/03 8 Advisory Board, local law enforcement, school districts, and treatment providers selected through an RFP process. The Juvenile Drug Court Project Supervisor coordinates clinical care, screens potential clients, staffs the Steering Committees and the Court Clinical Teams. New Connections in West County and Reach in East County were selected to provide the drug court outpatient treatment. Drug court clients that are not able to maintain sobriety have been placed in Thunder Road for short term residential (45 days) or referred to the Juvenile Probation Placement Unit for long term residential (9 to 12 months). Probation's MOU - Three years ago the Division developed a Memorandum of Understanding with Probation, the Office of Education and Mental Health to establish AO©S services at Orin Allen, Edgar Center, Chris Adams and Summit Center. The agreement included allocation of a full time Substance Abuse Counselor position funded by the Division to be assigned to Orin Allen to provide treatment services, staff the ART Board and upon the youth release, broker continuing care in one of the AOS community-based outpatient treatment programs. The MOU directed the Division's prevention contract with New Connections to place a full time prevention specialist at the Orin Allen and Edgar Center facilities to deliver Project Success, a prevention best practice focused on juvenile offenders. Fifty percent of another Substance Abuse Counselor position funded by the Division was also assigned to deliver Project Success at the Chris Adams and Summit Centers, and provide on site support for program activities, wraparound and Smart teams. The cost of New Connections prevention contract and the 1.5 FT's county civil service counselors assigned to probation sites is $150,000 per year. Other Probation Clients - Probation's "carve out" is obvious in the Division's treatment caseload and expenditures for last fiscal year. The AODS System of Care served a total of 10,492 treatment clients, 31% were referred by the criminal justice system and 35% upon admission reported being on probation or parole status. Among youth treatment clients the percentages were higher than in the adult caseload: 65% youth clients were referred by the juvenile justice system as compared to 33% in the adult caseload, and upon admission 64% of youth clients reported probation, parole or diversion status as compared to 37% in the adult caseload. Among the 502 unduplicated youth treatment clients served last year, 332 reported probation status, of these, 117 clients were served at Orin Allen and 21 were served by the Division's System of Care outpatient treatment providers at a cost of $293,859. The other 32 clients admitted to the drug court were served by Achieve in East County (17) and Choices in West County (15), the two drug court treatment providers. Five drug court clients completed short-term residential treatment at Thunder Road at a cost of $41,850 before returning to their respective drug court outpatient treatment programs. Created by A.DelValle fhsnovlo 12/3103 9 Client Characteristics, Treatment levels and Cost Differences - Client data comparing drug court and other probation clients suggest that differences between expenditures incurred in serving 34 unduplicated drug court clients at a cost of $295,021 and serving 138 probation youth at a cost of $293,859 is more a function of access to treatment and funding priorities than client's drug use pattern or level of acuity. The same discrepancy between levels of treatment, which of course are reflected in expenditures, applies to non-probation clients. Table II 3uvenile ©rug Court Treatment Program Cost Comparison if € Curt Prov[d�eir Cost Cit�iniii > C Clliert Project Achieve 100211 17 .15,895 Choices 152 960 17 $8,998 Thunder Road* $41,850 5 $%370 Totai $295,021 39 $7,555 *Thunder Road clients include drug court FY 02-03 unduplicated clients Table III Probation Client Characteristics haClri :.:< CII 'ra.l #?char>Rfieia ..in ......... ..... .... ........ ......... The characteristics of probation clients are very different from the rest of the caseload. For example, probation youth is more likely to be male, Black and Latino; the primary drug of use is Marijuana and they are less likely to have a problem with Methamphetamine; also, they have had one or more arrests in the two years prior to admission. The juvenile justice system path to treatment appears to select Created by A.Deivalle fhsnovlo 12!3/03 10 ......... ......... ... .__.. .........._.. ......_.... _._..._.. _...... ......... ......... _.. ....... _........ ......... ........_...._. .................................................................. clients of color whose AOD use may be secondary to criminal activity. The concern is not that Probation referrals have any less need for treatment than other clients; the issue is access to other youth at risk. Performance Indicators SAMHSA's proposal to transform the Substance Abuse Prevention and Treatment (SAPT) dock Grant is an acknowledgement of problems inherent in the field. For example, in response to a congressional mandate from the Children's Health Act of 2000, SAMHSA is working to increase flexibility and accountability, shifting from eligibility requirements toward performance measures. The focus is on achievement of outcomes such as improving retention in treatment rather than describing the processes that take place during a treatment episode, measures that require data driven evaluations, rates of drug use, treatment completion rates, length of stay, etc.¢ Table IV Length of Stay and Treatment Visits t?Utpat' jei k T`teafiOMt Days:ir3 Tr atment Treat11 ment Visits Provider Name Median Me Medlan Mean New Connections Central 47 9.0 36.2 4.0 15.6 New Connections East 17 37.0 45.5 11.0 15.5 Reach - East 119 66.0 68.5 27.0 32.2 Reach - Far East 49 56.0 69.5 25.0 30.6 Sojourne - Richmond 47 31.0 40.4 5.0 5.3 Tri-Citles - Pinole &County 176 48.0 53.0 7.0 9.2 TOTAL 455 41.2 52.2 13.2 18.1 Tri-Cities served 117 Orin Allen treatment clients on site and placed themin continuing care after release. data counts undu ;licated clients only from Jul 02 through June 03 C3 itpaikia» T>i lift + in : Days in Tree MA. nt Treat ent vv>sits Provider Name M,adian Maarr Media Mein New Connections Central 348 16.0 35.1 4.0 12.9 New Connections East 200 15.0 35.2 10.0 23.7 Reach - East 183 22.0 53.4 5.0 26.6 Reach - Far East 84 25.5 51.6 7.0 11.4 Sojourne - Richmond 223 24.0 52.8 5.0 10.0 Tri-Citles - Pinole 94 45.5 60.9 11.0 14.1 TOTAL 1,132 24.7 48.2 7.0 16.4 The Median rather than the Mean gives a more balance view of client's length of stay and treatment visits because of extreme outlier values that skew data display' 4 Little Hoover Commission "Setting Priorities"p.43 in For Our Health&c Safety:Joining:Farces to Defeat Addiction(3/2003) Created by A.DelVaiie fhsnovla 12/3/03 ii