Health System: 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 will further 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 Exceeded Target

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


Percent of Clients Successfully Completing Treatment Meeting Target

FY 2017-18 Mid-Year Story Behind Performance

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

Timely access to care is critical when an individual seeks treatment for an opioid addiction. Failure to provide access will likely result in relapse, and possibly either overdose or death. The County's opioid treatment provider puts prompt admission to treatment with 24 hours of request as a top priority. Retention of qualified staff has allowed the County to exceed the performance target over the past two years.

However, fiscal year 2017-18 results are not available yet.  Currently, the state's reporting system (CalOMS), which is the data source for this performance measure, is not accurately reporting all cases correctly.  The majority of cases are missing from the data.  In addition,  CalOMS does not recognize data elements for the new Drug Medi-Cal Organized Delivery System that we are participating in, which is creating other data errors.  In the event these issues are not resolved by the end of fiscal year 2017-18, we will use an alternative method to report year-end results. 


Percent of Participants in Drug Court who Commit a New Crime

The major innovation of the San Mateo County Drug Court revolves around the Drug Court 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 high 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

To date, San Mateo County has significantly outperformed the state related to successful treatment completion. Successful completion of treatment is achieved when the individual meets his/her treatment goals. BHRS has achieved these results by engaging clients in treatment, establishing an individualized treatment plan and using evidence based approaches to treatment.

However, fiscal year 2017-18 results are not available yet. Currently, the state's reporting system (CalOMS), which is the data source for this performance measure, is not accurately reporting all cases correctly.  The majority of cases are missing from the data.  In addition, CalOMS does not recognize data elements for the new Drug Medi-Cal Organized Delivery System that we are participating in, which is creating other data errors.  In the event these issues are not resolved by the end of fiscal year 2017-18, we will use an alternative method to report year-end results. 

Future Priorities

  • Strengthen the clinical expertise of the new Drug Medi-Cal contractors, by improving their data collection and record keeping, implementing quality management, and strengthening the clinical oversight capabilities of the BHRS AOD Unit.
  • Expand the Integrated Medication Assisted Treatment program to include opiate addiction treatment.
  • Work towards improving long-term treatment options for youth.
  • 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: 02-08-2018