Los Angeles County Evaluation System

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Los Angeles County Evaluation System

• Accomplishments and Next Steps toward Outcomes
  and Performance Measurement of Treatment Services
  in LA County
• 2008

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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.

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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.

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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.

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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.

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LACES Accomplishments, contd.

• 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.

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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.

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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.

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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.

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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.

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Performance Measurement and Outcomes Monitoring
in the US A Two Day Meeting

• Sacramento, California
• November 15, 16 2007

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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.

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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?

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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?

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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.

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Summit Using Performance and Outcomes Measures
to Improve Treatment

• Los Angeles Sheraton
• March 20, 21, 2008

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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.

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The End