Health: Alcohol and Other Drug Services (6170P)


Program Outcome Statement

Prevent and treat substance use/abuse, and support clients’ recovery.

Program Services

  • Prevention
  • Treatment
  • Case Management
  • Recovery

Overview

As part of the Behavioral Health and Recovery Services Division (BHRS), Alcohol and Other Drug Services (AOD) provides substance use prevention, treatment, case management, and recovery services to individual clients and their families. AOD will provide treatment to an estimated 2,800 individuals each year.
There continues to be some uncertainty associated with this estimate due to both the impact of improved coverage and substance use disorder benefits for formerly uninsured people through the Affordable Care Act, and the challenge people with addictions will have navigating and becoming enrolled in the new programs. Based on the state and national prevalence rates, AOD will serve approximately 12 percent of individuals needing services in San Mateo County. Treatment services are provided by a network of 14 community-based providers that deliver outpatient, detoxification, day treatment, residential treatment, and narcotic replacement therapy under contract and oversight by AOD.
AOD ensures clients receive high quality services by promoting the use of evidence-based practices by all providers. AOD supports a “continuing care and support” model which reflects research that addiction is a chronic relapsing disease. AOD staff ensures regulatory compliance, contract oversight and accountability, quality assurance, and best practice implementation.
To reduce the use, abuse, and impact of alcohol and drug related problems in our communities through coordinated prevention efforts, AOD supports community partnerships. Five communities in San Mateo County have prevention partnerships aimed at reducing the impacts of alcohol and drug use. Prevention partnerships build community capacity and improve safety in neighborhoods, enhance social cohesion, foster prosperity, and reduce the stigma of substance abuse. Treatment and case management services enable clients to attain sobriety and recovery, achieve stable employment and housing, and engage in positive relationships. The percent of clients completing treatment services is expected to continue to exceed the statewide benchmark.
The last two fiscal years have seen a major expansion of substance use disorder treatment services to the population newly eligible through the Affordable Care Act Medi-Cal expansion and coordination with the Health Plan of San Mateo and Primary Care to improve overall health and wellness; expansion of the certified Drug Medi-Cal provider network to ensure a full continuum of quality services are available to beneficiaries; enhancement of treatment and recovery supports for Criminal Justice Realignment eligible clients and high risk individuals discharged from jail; implementation of a new Strategic Prevention Framework; and significant success in the Medication Assisted Treatment Program (iMAT) that has made a huge difference in the lives of those living with alcoholism. During fiscal year 2017-18, we expanded services with the expansion of iMAT into the treatment of opiate addiction.


Percent of Clients Treated within 24 Hours of Making a Request for Methadone Treatment Under Target

Percent of Participants in Drug Court who Commit a New Crime is Under Target


Percent of Clients Successfully Completing Treatment Meeting - Data Not Available

FY 2018-19 Mid-Year Story Behind Performance

Percent of Clients Treated within 24 Hours of Making Request for Methadone Treatment

The service provider has continued to experience significant staff turnover this year, including the loss of the clinic physician and nurses who prescribe medications to clients. This is attributed in part to the high cost of living in the Bay Area. Staff attrition was also a result of the provider being acquired by Bay Mark, a national health care provider. Staff attrition has created significant service delivery challenges for the provider and clients. Still, the provider prioritizes timely access to this service for new clients as those who are in withdrawal from opioids risk overdose or even death without access to needed medications and treatment.


Percent of Participants in Drug Court who Commit a New Crime

The major innovation of the San Mateo County Drug Court revolves around the team's ability to adopt and incorporate on a regular basis the newest "best practices" in addition to recovery, probation conditions and sentencing order to defendants in our criminal justice system. The team continues to offer a higher level of case management, services, oversight, randomized alcohol and drug testing and frequent court appearances. Oversight meetings of the agencies and departments involved in the Drug Court Program are held monthly or every two months to assess the effectiveness, procedures, and to determine ways to improve the program and address any problems or concerns.


Percent of Clients Successfully Completing Treatment

Data is provided by State and has been unavailable since fiscal year 2017-18.  We are exploring other options to obtain data or may change the measure for the fiscal year 2019-21 cycle.





Future Priorities

  • Implement requirements of the Drug Medi-Cal Waiver authorizing a new substance use disorder benefit and organized delivery system. The changes in the delivery system will result in changes to our procurement/contracting processes, provider certification, quality management, claiming and fiscal reporting.
  • Expand the Integrated Medication Assisted Treatment program to include opiate addiction treatment.
  • Prepare BHRS AOD staff for new state audits and upcoming reviews of the new Drug Medi-Cal Program.

Author: Gina Wilson; Chief Financial Officer, Health System     Contact Email: gwilson@smcgov.org     Last Updated: 1-23-2019