RD265 - 2012 Substance Abuse Services Council Response to Code of Virginia § 2.2-2697


Executive Summary:
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.”

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 report provides the statistical information for each agency for the state fiscal year that ended June 30, 2011 (the most recent year for which data are available) required by § 2.2-2697.

DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES

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

- Treatment services expenditures totaled $145,680,168 for FY 2011.

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

Federal: $42,707,043
State: $46,679,700
Local: $37,550,461
Consumer fees or third party payers (e.g., insurance): $13,849,259
Other: $4,893,705

- A total of 36,769 individuals received substance abuse treatment services supported by this funding.

Last year DBHDS, working with over 200 persons from state and local agencies, families, consumers, and advocates, completed a strategic plan for behavioral health and developmental services called “Creating Opportunities.” The portion of the DBHDS plan dealing with substance abuse services was broadened and formalized as an interagency plan, in collaboration with the other state agencies listed in this report. (See Creating Opportunities for People in Need of Substance Abuse Services: An Interagency Approach to Strategic Resource Development at http://www.dbhds.virginia.gov/documents/omh-sa-InteragencySAReport.pdf.) That report summarized the strengths and needs of Virginia’s substance abuse treatment system, particularly that portion of it provided by community services boards (CSBs).

Based on this statewide assessment, additional investment of resources is needed in the following types of treatment:

– medication assisted treatment
– detoxification services
– uniform screening and assessment for substance abuse
– intensive outpatient services
– substance abuse case management
– community diversion services for young non-violent offenders
– peer support services
– DRS employment counselors
– intensive coordinated care for pregnant and postpartum women
– supportive living capability
– residential services for pregnant women and women with children
• Workforce development and training, especially to increase understanding and use of evidence-based assessment and treatment practices at all community and state-level agencies.

DEPARTMENT OF CORRECTIONS

The Department of Corrections (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 areas of field operations: Community Corrections and Institutions. DOC attempts to match the offender to appropriate treatment services based upon criminogenic factors and risk of recidivating.

Treatment services expenditures totaled $5,230,468 for FY 2011:

Community Corrections: $1,838,468
Institutions: $3,392,000

As of June 30, 2012, there were approximately 57,069 offenders under active supervision in the community and an active institution population of 29,729. Screenings conducted on all offenders entering DOC indicate that approximately 70% of the offender population may have a need for some level of substance abuse treatment.

DOC continues to face a number of issues related to substance abuse services:

• Limited resources for clinical supervision to ensure program fidelity, provide technical assistance, and enhance outcomes;

• Limited staff resources for programming as well as assessment and data collection activities;
• Limited availability of evidence-based treatment services in Community Corrections for offenders with substance abuse problems;
• Limited special resources for offenders with co-occurring mental disorders;
• Limited evaluation resources; and
• Sometimes a lack of optimal programming space in prisons.

An increase in resources would increase the number of offenders that could be provided with treatment as well as enhance the quality of the programs to provide better outcomes.

In general terms, successful outcomes of substance abuse treatment programs include a reduction in drug and alcohol use which can produce a decrease in criminal activities and, thereby, an increase in public safety. The Department-wide per capita cost of housing offenders was $24,380 in FY 2011. The cost avoidance and benefits to society that are achieved from offenders not returning or not coming into prison offsets treatment costs.

DEPARTMENT OF JUVENILE JUSTICE

The Department of Juvenile Justice provides substance abuse treatment services at all five of its juvenile correctional centers (JCCs) as well as the Reception and Diagnostic Center (RDC) for residents meeting appropriate criteria. The following information reflects these services:

JCC Programs:

Substance Abuse Services Expenditures: $1,120,958
Total Division Expenditures: $78,850,399

In FY 2011, 88% of the 569 residents admitted to JCCs had a mandatory or recommended substance abuse treatment need.

In order to maintain and improve effectiveness, 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.