The document discusses Alabama's Substance Abuse Systems Improvement Initiative which aims to better serve Alabamians impacted by substance abuse. It outlines the initiative's goals of improving access to treatment and prevention services across the state through standardized screening, assessment and data collection procedures, expanded service options, enhanced human resources, and improved technical assistance and training. The initiative also seeks to enhance revenue and claims processing to improve cash flow for providers.

1. Alabama Substance AbuseAlabama Substance Abuse
Systems ImprovementSystems Improvement
InitiativeInitiative
Presentation to Conference ofPresentation to Conference of
Community Mental Health BoardsCommunity Mental Health Boards
August 24, 2006August 24, 2006

2. PanelistsPanelists
►Kent Hunt, Associate Commissioner forKent Hunt, Associate Commissioner for
Substance Abuse ServicesSubstance Abuse Services
►Sarah Harkless, Executive Assistant to theSarah Harkless, Executive Assistant to the
Associate Commissioner for SubstanceAssociate Commissioner for Substance
Abuse ServicesAbuse Services
►Bob Wynn, Director of Treatment ServicesBob Wynn, Director of Treatment Services
for Substance Abusefor Substance Abuse
►Kristopher Vilamaa, Director of InformationKristopher Vilamaa, Director of Information
Services for Substance AbuseServices for Substance Abuse

3. SummarySummary
► HistoryHistory
► PreventionPrevention
► TreatmentTreatment
 StandardsStandards
 Screening and EnrollmentScreening and Enrollment
 Standardized AssessmentStandardized Assessment
 Waiting List ManagementWaiting List Management
► Claims and Revenue EnhancementsClaims and Revenue Enhancements
► Data Collection and ReportingData Collection and Reporting

4. HistoryHistory

5. HistoryHistory
►Prevention:Prevention:
 Children’s Policy Council surveysChildren’s Policy Council surveys
 Alabama specific youth surveysAlabama specific youth surveys
 Majority of prevention activities are not focusedMajority of prevention activities are not focused
on priority populationson priority populations
 All areas of Alabama are under fundedAll areas of Alabama are under funded
 No formal collaboration in many areasNo formal collaboration in many areas

6. HistoryHistory
►TreatmentTreatment
 Alabama Treatment Needs AssessmentAlabama Treatment Needs Assessment
 National Survey of Drug Use and HealthNational Survey of Drug Use and Health
 Gap between those needing treatment andGap between those needing treatment and
those getting treatmentthose getting treatment
 DemandDemand
 Waiting listsWaiting lists

7. HistoryHistory
►Treatment continued:Treatment continued:
 Assessment and placementAssessment and placement
 CollaborationCollaboration
 Inadequate fundingInadequate funding
 Clinical monitoringClinical monitoring
 Fiscal monitoringFiscal monitoring
 Length of treatmentLength of treatment

8. HistoryHistory
►General:General:
 Priority populationsPriority populations
 Science and evidenced based practicesScience and evidenced based practices
 Capacity managementCapacity management
 Core servicesCore services
 Advocacy supportAdvocacy support
 Outcome measurementOutcome measurement
 Maximization of fiscal resourcesMaximization of fiscal resources

9. HistoryHistory
►Why do we need a Systems ImprovementWhy do we need a Systems Improvement
Initiative?Initiative?
 Alabama citizens deserve the best system theAlabama citizens deserve the best system the
resources will provideresources will provide
 It is our responsibility to meet this expectationIt is our responsibility to meet this expectation

10. TreatmentTreatment
►Revised StandardsRevised Standards
►Contract ReviewersContract Reviewers
►New StaffNew Staff
►Co-Occurring DisordersCo-Occurring Disorders

11. PreventionPrevention
►Revision of StandardsRevision of Standards
►New Rate StructureNew Rate Structure
 Emphasis on Community-Based Process andEmphasis on Community-Based Process and
Environmental StrategiesEnvironmental Strategies
►Focus on Targeted InterventionsFocus on Targeted Interventions

12. Alabama Substance AbuseAlabama Substance Abuse
Information System (ASAIS)Information System (ASAIS)
► Meets all federal reporting requirements, whichMeets all federal reporting requirements, which
are not being met todayare not being met today
 Unique Identifier for all clientsUnique Identifier for all clients
 All required admission and discharge elements collectedAll required admission and discharge elements collected
► Allows for active management of waiting lists andAllows for active management of waiting lists and
access to care information across the stateaccess to care information across the state
► Timely processing of claims will help improve cashTimely processing of claims will help improve cash
flowflow

13. Screening and EnrollmentScreening and Enrollment
►All clients, across the system, will goAll clients, across the system, will go
through a brief screening process and athrough a brief screening process and a
unique identifier will be assigned, orunique identifier will be assigned, or
reported if the number already existsreported if the number already exists
►The screening information will be availableThe screening information will be available
to any future service provider working withto any future service provider working with
that clientthat client

14. Standardized AssessmentStandardized Assessment
►All clients will have minimum informationAll clients will have minimum information
reported and collected from theirreported and collected from their
standardized assessmentstandardized assessment
 SASD is still exploring options to allow providersSASD is still exploring options to allow providers
to share the full assessment through ASAISto share the full assessment through ASAIS
►The assessment information will beThe assessment information will be
available to any future service provideravailable to any future service provider
working with that clientworking with that client

15. Waiting List ManagementWaiting List Management
►Referrals will be sent through ASAIS toReferrals will be sent through ASAIS to
other locationsother locations
►Information on waiting lists for all providersInformation on waiting lists for all providers
will be available in ASAISwill be available in ASAIS

16. Claims and Revenue EnhancementsClaims and Revenue Enhancements
►All enrolled clients will be checked forAll enrolled clients will be checked for
Medicaid eligibility on a monthly basisMedicaid eligibility on a monthly basis
►Claims that have a Medicaid eligible serviceClaims that have a Medicaid eligible service
paired with a Medicaid eligible client will bepaired with a Medicaid eligible client will be
sent to Medicaid for paymentsent to Medicaid for payment
►There will be either a Medicaid or BlockThere will be either a Medicaid or Block
Grant/State Funds check-write every weekGrant/State Funds check-write every week
after go live – providers can receiveafter go live – providers can receive
payments weekly, if desiredpayments weekly, if desired

17. Our GoalOur Goal
To serve Alabamians impacted by substanceTo serve Alabamians impacted by substance
abuse…betterabuse…better

18. To Serve…To Serve…
►To work for…To work for…
►To be of assistance to…To be of assistance to…
►To promote the interest of…To promote the interest of…

19. AlabamiansAlabamians
►50% of all admissions to SASD funded50% of all admissions to SASD funded
programs live in 5 Alabama countiesprograms live in 5 Alabama counties
►Nearly one-third of Alabama’s counties haveNearly one-third of Alabama’s counties have
no substance abuse treatment servicesno substance abuse treatment services
►Pregnant women account for less than 3%Pregnant women account for less than 3%
of admissions to SASD funded treatmentof admissions to SASD funded treatment
programsprograms
►The community impact of SASD fundedThe community impact of SASD funded
prevention services is unknownprevention services is unknown

20. Alabamians…Alabamians…
All who are impacted by Substance AbuseAll who are impacted by Substance Abuse

21. Better…Better…
►Not bestNot best
►A continuous processA continuous process
►Each day providing a new opportunity toEach day providing a new opportunity to
exceed the one beforeexceed the one before

22. Better…Better…
► Access to CareAccess to Care
 Treatment and Prevention Services in Every CountyTreatment and Prevention Services in Every County
 Easy access to information and referralEasy access to information and referral
 Specialized services to meet targeted needsSpecialized services to meet targeted needs
► Detox ServicesDetox Services
► Medication Assisted TreatmentMedication Assisted Treatment
► Adolescent ServicesAdolescent Services
► Low Intensity Housing ServicesLow Intensity Housing Services
► Vision, language, and hearing accommodations routineVision, language, and hearing accommodations routine
► Children’s ServicesChildren’s Services

23. Better…Better…
► ServicesServices
 Expanded treatment modalities that match the ASAMExpanded treatment modalities that match the ASAM
levels of carelevels of care
 A variety of services to aid in treatment planningA variety of services to aid in treatment planning
available under each level of careavailable under each level of care
 All treatment programs co-occurring capable, manyAll treatment programs co-occurring capable, many
enhancedenhanced
 Treatment services based upon ongoing assessment ofTreatment services based upon ongoing assessment of
client needsclient needs
 Prevention services based upon ongoing assessment ofPrevention services based upon ongoing assessment of
community needscommunity needs
 Evidence-based treatment and prevention servicesEvidence-based treatment and prevention services
 Reimbursement processes for services providedReimbursement processes for services provided

24. Better…Better…
►Human ResourcesHuman Resources
 Improved organization to enhance customerImproved organization to enhance customer
serviceservice

25. Better…Better…
►Technical Assistance and TrainingTechnical Assistance and Training
 Based upon assessment of the needs of ourBased upon assessment of the needs of our
customerscustomers
 Full access to our in-house resources as well asFull access to our in-house resources as well as
TA and training available through our State andTA and training available through our State and
Federal PartnersFederal Partners
 Routine program monitoring in addition toRoutine program monitoring in addition to
certification site visitscertification site visits

26. Better…Better…
► CollaborationCollaboration
 Clients and their familiesClients and their families
 Contract ProvidersContract Providers
 Certified ProvidersCertified Providers
 Other Divisions within DMH/MROther Divisions within DMH/MR
 Other state agenciesOther state agencies
 Community agenciesCommunity agencies
 The Alabama State LegislatureThe Alabama State Legislature
 The Governor’s OfficeThe Governor’s Office
 Federal and State funding sourcesFederal and State funding sources
 Medical CommunityMedical Community
 Private IndustryPrivate Industry
 Etc. Etc.Etc. Etc.

27. Better…Better…
►DataData
 ASAISASAIS
 Alabama Epi Work GroupAlabama Epi Work Group

28. Better…Better…
Outcomes:Outcomes:
Individuals getting wellIndividuals getting well
Families reunitingFamilies reuniting
Communities stopping the devastation ofCommunities stopping the devastation of
substance abusesubstance abuse

29. Alabama Department of MentalAlabama Department of Mental
Health and Mental RetardationHealth and Mental Retardation
Substance Abuse Services DivisionSubstance Abuse Services Division
http://www.mh.alabama.govhttp://www.mh.alabama.gov