1. Los Angeles County Evaluation System Accomplishments and Next Steps toward Outcomes and Performance Measurement of Treatment Services in LA County 2008

2. Why was LACES Implemented? • LA County Commissions on Alcoholism and Narcotics and Dangerous Drugs recommended to ADPA that a system for measuring the effectiveness of LA County AOD Treatment services should be developed. • This sentiment was reinforced by the LA County Board of Supervisors and LACES was funded and initiated. • SAMHSA instituted the NOMS • California instituted CalOMS • Data required to support SACPA and NORA • LA Board of Supervisors Resolution to require health services in LA County to move provider contracts to a performance based platform.

3. Overview of LA County Evaluation System: LACES • LACES is an eight year collaborative partnership between ADPA, contracted providers, UCLA/ISAP and other county and state representatives. • The purpose of LACES is to design, implement, and conduct an evaluation of the adult alcohol and other drug treatment/recovery system in Los Angeles County.

4. Goals of LACES • Gather information on the alcohol and other drug treatment system • Obtain additional insight into the clients who receive treatment at ADPA contracted sites. • Develop a system-wide data collection system to evaluate the outcomes for individuals in treatment in AOD LA County and to assess performance of LA AOD treatment service agencies. • Use data to influence the future development of the AOD system.

5. Accomplishments of LACES To date LACES has: • Laid the foundation and developed many of the fundamentals of the ongoing evaluation system. • Designed and implemented evidence-based, standardized evaluation procedures. • Collects client data at admission and discharge. • Demonstrates treatment benefits to individuals who receive treatment. • Reported findings in LACES Status Report.

6. LACES Accomplishments, cont’d. • Led the efforts to review and improve existing treatment forms and instrument. • Revisions were required to bring LA County compliant with the federal mandates (NOMS/PPG). • Revisions adopted by California (CalOMS). • Conducted extensive training of treatment/recovery staff. • Provided instruction to staff to improve validity and reliability of LACPRS information. • Instructed over 1500 staff in various trainings.

7. Additional Accomplishments • Designed and implemented LACES reports. • LACES Clinical Narrative Report. • Encourages and builds off of accurate completion of admission information by treatment/recovery staff. • A summary of clinical related information. • LACES Discharge Outcome Report • Admission & discharge information on a single individual. • Useful report treatment outcomes to others. • LACES Site Report.

8. What is a Site Report? • Brief – Six pages • Provides demographic, client outcome, and program performance measures. • Information is gathered from the admission & discharge forms. • Includes site specific information as well as information from other sites of the same type. • Reports provided to all programs on an annual basis and to those programs with high admissions every quarter.

9. What is the Purpose of the Site Report? • To provide information concerning how participants are benefiting from treatment. • To provide information concerning areas of program functioning and short-term (admission to discharge) treatment outcome. • To identify provider performance strengths and areas needing improvement.

10. Program Functioning & Treatment Outcomes Areas included in the Site Reports include: • Program Performance • Number of admissions and discharges. • Percent of cases with complete discharge information collected. • Participants who completed treatment. • Treatment Outcomes • Retention in treatment (average days). • Changes in alcohol and other drug use. • Changes in other areas including health problems, employment, and social support.

11. Performance Measurement and Outcomes Monitoring in the US A Two Day Meeting Sacramento, California November 15, 16 2007

12. Objective 1: Major Activities • Develop a set of performance and outcome measures using CalOMS data to improve accountability and treatment quality and meet national standards. • Review and synthesize literature on performance measurement and outcomes monitoring. • Bottom line: Develop some models to define and measure program performance.

13. What do we want to accomplish? • Some specific issues for discussion • Which CalOMS data elements, alone and in combination, provide meaningful performance and outcomes measures? • Are there data elements that need to be added to CalOMS data set to optimally measure performance and outcomes? • Is it possible to operationally define “treatment success” and how can this issue be communicated to the public and policy makers?

14. What do we want to accomplish? • Determine how to adequately measure access to care? • Determine how feedback from clients can be used to improve program performance and treatment outcomes (e.g., satisfaction surveys)? • What is the role of “Evidence-based Practices” in improving performance and outcomes? • How are these defined? How is their implementation measured?

15. Objective 2: Activities • A 2-day meeting in Spring of 2008 with experts and stakeholders to understand promising performance improvement strategies. • Provide trainings for county administrators and treatment providers on how to use CalOMS data for performance and outcome improvement. • Develop CalOMS updates to facilitate communication between State and counties.

16. Summit: Using Performance and Outcomes Measures to Improve Treatment Los Angeles Sheraton March 20, 21, 2008

17. LACES Next Steps • Provide input to shape the way performance is measured in LA County • Refine data collection procedures • Advise on technical assistance support activities needed • Provide input into models for improving program performance with data.

18. The End