RD258 - 2011 Substance Abuse Services Council Response to Code of Virginia § 2.2-2697.B. – Comprehensive Interagency State Plan


Executive Summary:
*This document was replaced in its entirety by the Department of Behavioral Health and Developmental Services on December 21, 2011.

Publicly funded substance abuse treatment services in the Commonwealth of Virginia are provided by the following state agencies: the Department Behavioral Health and Developmental Services (DBHDS); the Department of Juvenile Justice (DJJ); and the Department of Corrections (DOC). Common goals of these programs include abstinence or reduction in alcohol or other drug usage and reduction in criminal behavior.

The 2004 Session of the General Assembly amended the Code of Virginia (§ 2.2-2697) directing the Substance Abuse Services Council to collect information about the impact and cost of substance abuse treatment provided by public agencies in the Commonwealth and to “include the following analysis for each agency-administered substance abuse treatment program: (i) the amount of funding expended under the program for the prior fiscal year; (ii) the number of individuals served by the program using that funding; (iii) the extent to which program objectives have been accomplished as reflected by an evaluation of outcome measures; (iv) identifying the most effective substance abuse treatment, based on a combination of per person costs and success in meeting program objectives; (v) how effectiveness could be improved; (vi) an estimate of the cost effectiveness of these programs; and (vii) recommendations on the funding of programs based on these analyses.

DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES (DBHDS)

DBHDS provides funding and oversight to 40 community services boards which provide publicly funded substance abuse treatment services to specific jurisdictions. The following information reflects these services.

- Treatment services expenditures totaled $147,915,747 for FY 2010.

- This overall expenditure is an approximate sum of the following expenditure components:

Federal: $42,873,676
State: $ 46,678,876
Local: $ 38,310,365
Consumer fees or third party payers (e.g., insurance): $14,105,100
Other: $ 5,947,730

- A total of 38,661 individuals received substance abuse treatment services supported by this funding.

A variety of actions could be undertaken to improve program effectiveness. Because community services boards are limited in the array of services and capacity, consumers of substance abuse treatment services may not have access to the intensity or duration of care that would be the most clinically appropriate, and may receive less intensive care (and thus, less effective). Evidence-based practices are not always available. Addressing these issues would require significant investments in workforce development of current and future professionals working in publicly-funded substance abuse treatment programs.

DEPARTMENT OF JUVENILE JUSTICE (DJJ)

DJJ institutions provide substance abuse treatment services at five of its six juvenile correctional centers (JCCs), excluding the Reception and Diagnostic Center (RDC), to residents meeting appropriate criteria. The following information reflects these services:

JCC Programs:

Substance Abuse Services Expenditures: $1,039,012
Total Division Expenditures: $76,455,205

In FY 2010, 88% of the 608 residents admitted to JCCs had a mandatory or recommended substance abuse treatment need.

DJJ institutions should continue to implement evidence-based programming: Cannabis Youth Treatment (MET/CBT 5 & 7), individualized treatment plans for residents with co-occurring disorders, and Residential Substance Abuse Treatment (RSAT) program (gender-specific treatment programming for female residents). Re-entry systems and collaboration with community resources and families should continue to be strengthened to ensure smooth transition of residents to the community.

DEPARTMENT OF CORRECTIONS (DOC)

DOC provides a tiered substance abuse services approach to address varying offender treatment needs based on the severity of the problem. DOC is organized into two (2) primary operating divisions: Community Corrections (DCC) and Operations (DO). DOC attempts to match the offender to the appropriate treatment services based upon criminogenic factors and risk to recidivate.

The Division of Community Corrections (DCC) encompasses adult probation and parole services, detention and diversion centers. There are approximately 58,000 offenders active under community supervision statewide. The Division of Operations (DOC-DO) has over 38,000 offenders in adult facilities and jails. Recent assessment results indicate that at least 70% of DOC’s offender population may have a need for some level of substance abuse treatment.

DCC contracts for many of its treatment services with community service boards (CSBs) and private vendors. Most probation and parole districts (43), detention centers (3) and diversion centers (4) have a memorandum of agreement with their respective CSBs for substance abuse treatment services.

In 1998, Virginia’s General Assembly passed House Bill 664 and Senate Bill 317 enacting the Drug Offender Screening, Assessment, and Treatment (DSAT) Initiative to reduce substance abuse and criminal behavior among offenders. DSAT attempts to enhance the identification of substance-abusing offenders and their treatment needs and improve the delivery of substance abuse treatment services within the criminal justice system. However, cuts in funding since 2001 have hampered the implementation of DSAT. DOC is re-examining protocols and developing alternative strategies to maximize the use of remaining resources.

The DOC-DCC is engaged in the process of introducing and implementing evidence-based practices (EBPs) in each of the probation Districts and detention/diversion centers. EBPs have been shown to be effective in reducing recidivism through extensive research and meta-analysis. The process for integrating EBPs into a District or Center takes many months. A District and/or Detention/Diversion Center will undergo EBP training in the following areas: Introduction to EBPs, Deportment, Motivational Interviewing (MI), Risk/Needs Assessment, Case Planning, Treatment Referral, and EBP Fidelity. To date 17 P&P Districts, three Diversion Centers and one Detention Center have received the Introduction, Deportment, MI and Case Planning trainings.

As part of EBP integration, the DOC reviewed the Matrix Model (a registered evidence-based substance abuse program) and has chosen the model as its primary outpatient substance abuse intervention. The intervention consists of relapse-prevention groups, education groups, social-support groups, individual counseling, and urine and breath testing delivered over a 16-week period. A review is underway to determine the feasibility of offering the initial phase of treatment in the correctional centers followed by the relapse prevention and family component taking place in the community through probation & parole districts.

As the DOC-DO continues to review substance abuse program for EBP fidelity, there are currently five (5) programming tiers to DOC institution-based substance abuse related treatment and services: Orientation; Psycho-Education (to be eliminated); Substance Abuse Counseling: Support Programs, such as Alcohol Anonymous and Narcotics Anonymous; and the Cognitive Therapeutic Community (CTC) Programs. The CTC program is an evidence-based treatment model designed to address substance addiction, criminal thinking and antisocial behaviors. It is an evidence-based institutional substance abuse treatment program. There are approximately 1,450 CTC beds.