UCLA Integrated Substance Abuse Programs

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CalOMS Training for Counties

• UCLA Integrated Substance Abuse Programs
• Richard Rawson, Ph.D.
• Rachel Gonzales, Ph.D.
• Funded by California Alcohol and Drug Programs

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Learning Objectives

• Goals of the CA Data System
• Importance of using data to improve treatment
• Basic models for disseminating CalOMS data

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Goals of CA Data System

• Provide a comprehensive data collection and
  management system
• To establish greater accountability of the
  treatment system for providing quality services
• Ensure efforts are in accordance with SAMHSAs
  National Outcome Measurement System
• NOMS essential Indicators used to evaluate the
  quality of substance abuse treatment

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Importance of CalOMS Data

• CalOMS data are standardized same data are
  collected across programs/counties at admission
  (t1) and discharge (t2)
• CalOMS data are comprehensive - allows for
  understanding
• Clients in treatment (Demographic data)
• Treatment patterns (Service data)
• How programs are performing (Performance data)
• Impact of treatment on client outcomes (Outcome
  data)
• CalOMS data helps us keep up to date with
  treatment improvement initiatives Use data to
  improve treatment

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Steps Using CalOMS Data
Step 1 What do you want to know Tx
Priority Step 2 Identify CalOMS Data Needed
(demographic, service, performance,
outcome) Step 3 Request Data/Run Data Report
Step 4 Examine Analyze Results Step 5
Determine, what, if any, changes should be made
to improve service delivery
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Exercise CalOMS Demographic Data

• Whos in treatment?
• Primary substance problem
• (e.g., alcohol, marijuana, cocaine, opiates,
  prescription, meth)
• Special needs Pregnant
• (e.g., injectors, homeless, youth, disabled,
  veterans, criminal offenders, mentally ill)

Apply CalOMS demographic data to treatment
improvement initiatives
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Primary Substance Problem
CalOMS Treatment Admission Report
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Clients with Special Needs

• 6 of admissions were pregnant women
• Meth most commonly reported among pregnant women

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Exercise CalOMS Service Data

• What are treatment trends?
• Service utilization
• (e.g., detox, outpatient, residential, NTP)
• Treatment referral sources
• (e.g., SACPA, Self, DMC)

Apply CalOMS service data to improve treatment
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Service Utilization Referral

• Most admissions are to outpatient programs

• ½ of referrals are from criminal justice system

CalOMS Assessing Services Report
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What is Performance Data?
Performance indicators measure the treatment
process at the program level
Access
Retention/Completion
Continuity of Care
Desired Outcomes
Treatment
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Exercise CalOMS Performance Data

• Access
• Retention
• Continuity of Care

Applying CalOMS performance data to improve
treatment
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• Access
• (Wait time)

Research supports reduced wait time is
associated with improved engagement and retention
in treatment
CalOMS Assessing Services Report
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Access for Priority Populations
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• Retention
• (Length of stay)

Research supports without an adequate amount of
time in treatment, few improvements are observed.
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CalOMS Service Utilization Report
lt30 days
lt90 days
gt90 days
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What do the data indicate?
Outpatient Treatment
lt ½ Optimal Dose
Sub-optimal
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40 not retaining during initial 30 days
lt 1 are staying 365 days or more
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Continuity of Care Measure

• Do individuals who enter treatment proceed
  through appropriate levels of care?
• Per CalOMS matched admission-discharge treatment
  service sets that occur within 30 days of a prior
  discharge (via client unique client ID)

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Treatment Episode
Detox/ Inpatient
Long-term Residential Treatment
Intensive Outpatient/Psychosocial Behavioral
Treatment
Sober Living Residence
Continuing Care/Aftercare Programs
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Continuity of Care Patterns

• Majority of clients only receive 1 service (level
  of care)
• 75 of clients in detox do not go to another
  level of care

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What is Outcome Data?
Outcome indicators measure client status at the
client level
Substance use
Employment/Education
Criminal Activity
Housing Stability
Social Connectedness
Desired Outcomes
Treatment
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Exercise CalOMS Outcome Measures Interested in
treatment impact

• Stopping or Reducing
• Substance use
• Unemployment
• Crime
• Homelessness
• Family conflict

Applying CalOMS Outcome data to improve treatment
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Reductions in Criminal involvement and crime
Changes During Treatment Reports
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Improvements in Client Outcomes
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Step 5 Using Data to Improve Treatment
Desired Program/Policies/Services
What NEEDS to be done
Data
Whats being done
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What To Look At?

• Start at the
• Program and Provider Level
• ACTIVITIES Use of evidence based practices
• FACTORS Staff, license/training, resources, tx
  environment
• PERFORMANCE MEASURES
• Access, retention, continuity of care

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Tx Improvement What changes are needed?

• What program elements can affect performance
  measures?
• Improved screening and placement
• Timeliness rapid response
• Comfortable, friendly environments
• Flexibility
• Case management

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Strategies for Enhancing Service Linkages

• Active referral/transfer
• Case management processes
• Integrating staff at different tx levels
• Creating personal linkages
• Arranging transportation
• Referring to appropriate geographical location

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Illustration NIATX Strategies Improve Access
Retention

• Screening/
• Placement
• Timeliness/
• Rapid Response
• Enhanced Tx
• Response

Contact your ATTC Representative
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Summary Utility of CalOMS Data

• Provides Evidence
• Establish Priorities
• Decision-Making
• Improvement

and
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• .... increase and sustain
• Community Financial Support

For Services Programs
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Data Validity is Essential

• Remember
• Data in a system is only as good as how the data
  is collected
• Data quality efforts are essestial

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Goal Improved Measures

• More work is needed to improve upon CalOMS
  performance and outcome measurement
• Standard data collection of discharge is
  necessary for valid data and assessing treatment
  quality effectiveness

Continued Training is Critical
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Disseminate the Data

• Demonstrates utility
• Gives feedback on services and outcomes
• Increases buy-in engagement
• Improves data collection
• Greater data quality valid data

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Effective Dissemination Models

• Using CalOMS data you can create
• Program Site Reports (report card)
• Brief Treatment Updates
• Fact Sheets on specific topics
• State CalOMS Reports

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Program Site Reports

• Report Style
• Executive Summary
• Highlight Program Performance
• Tables/Graphs with Outcomes
• Engaging

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Treatment Updates

• Specific data topic
• Newsletter Style
• One-page Format
• Graphs/Tables
• Short Summary

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Treatment Updates

• Innovative
• Quick Reference
• Targeted Subject
• Concise

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Fact Sheets

• Comprehensive
• Visual
• Summary of major trends
• Downloadable

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State CalOMS Reports
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CalOMS Resources

• Data Dictionary
• Data Collection Guide
• Reports User Guide Instructions
• Data Quality Standards

• http//www.adp.ca.gov/CalOMS/CalOMSmain.shtml

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Contact Information
Richard Rawson rrawson_at_mednet.ucla.edu Rachel
Gonzales rachelmg_at_ucla.edu www.uclaisap.org