SUBSTANCE ABUSE SERVICES

PROGRAM MISSION:To improve the biological, psychological and social functioning and prevent the continued deterioration and adverse social, legal, and medical consequences to individuals and the community resulting from alcohol and drug dependency.

This is accomplished by serving those most in need (individuals with severe problems who lack resources for services elsewhere), providing a continuum of care and services to meet client needs, and utilizing private, nonprofit agencies in the delivery of services. The following services are provided:

• Outpatient Substance Abuse Services seek to eliminate clients' alcohol and/or drug use in order to improve functioning, increase self-sufficiency and prevent continued legal, social and medical consequences. These services include: assessment, individual and group therapy, alcohol and drug education courses, relapse prevention services, psychological evaluations, urinalysis, and introduction to community-based support groups. Substance abuse clients are referred primarily from the criminal justice system (Probation and Parole, Alcohol Safety Action Program, Juvenile and Domestic Relations Court) and from other programs in the Department of Human Services. A contract with the Alexandria Community Services Board provides for methadone treatment services for a limited number of narcotic-using adults.

• Case Management and Contractual Substance Abuse Treatment Services prevent the detrimental consequences of alcohol and drug dependency on individuals and society. They promote self-sufficiency through the elimination of drug use and improvement in functioning of seriously impaired chemically dependent individuals. Adults are evaluated by case management staff and placed in the appropriate level of treatment, provided by the nonprofit sector. The continuum of contractual treatment services includes social or medical detoxification, residential treatment (from two to nine months with varying levels of intensity), as well as transitional living placements to facilitate recovery from chemical dependency. Case management staff monitor client services at contract agencies and the individual's progress, referring for ancillary services as needed. The primary recipients of residential services are Arlington residents with severe and chronic substance abuse problems, who require more intensive treatment than is available in an outpatient setting and who do not have the financial resources to pay for residential treatment. Pregnant women, intravenous drug users, and HIV positive individuals are priority populations in programs receiving federal Substance Abuse Prevention and Treatment Block Grant funds.

• Detention Facility Jail Based Services provide assessment, early intervention, prevention, treatment, and case management services to program participants while they are incarcerated to prevent the continuation of bio-psychosocial deterioration and the criminal activities that accompany it. Consolidated Jail-based services include the ACT Program which serves to prevent further biopsychosocial deterioration and prepare individuals for recovery from alcohol and drug dependency. The Mental Health Jail Treatment Unit serves to prevent suicide, and facilitate psychiatric and behavioral stabilization for inmates who have mental retardation or experience mental health or adjustment difficulties while incarcerated. These programs also facilitate appropriate placement in outpatient or residential aftercare settings upon the release of clients from the Detention Facility.

SIGNIFICANT BUDGET HIGHLIGHTS:

• Nonprofit funding increases due to allocation of Nuevo Dia funding that will provide residential treatment services for Hispanic clients ($46,611), and salary and other expense increases for service providers (75,442).

• Increase in interdepartmental credit is due to elimination of the budget for credit for turnover for positions that are reimbursed by the Sheriff's Office.

• Decrease in fees is due to elimination of fees for Alcohol Safety Action Program (ASAP) referred clients during FY 2004 ($23,006).

• Increase in state share is due to new Nuevo Dia funding for residential treatment services ($46,611), LPACAP funding associated with the position transferred from Client Services Entry, and an increase in the state allocation ($29,720).

• Decrease in FTEs (0.4) due to the net effect of reallocating 1.0 FTE from Client Services Entry for the Discharge Assistance Planner in the Jail, and reallocating 1.4 FTEs to Administration for Community Outreach and Education (1.0 FTE), and centralized "front door" services (0.4 FTE).

PERFORMANCE MEASURES:

Adult Outpatient Services

• Alcohol and Drug Education services are offered only to clients enrolled in concurrent treatment services.

• Workload and outcome measures include specialized services provided to dually diagnosed clients (concurrent substance abuse and mental illness disorders) by substance abuse and mental health staff.

Contractual Substance Abuse Detoxification Services

• Of the 273 unduplicated consumers discharged in FY 2004 from the Residential Program Center (RPC) Detox unit nearly all were provided substance abuse case management services; 59 consumers went on to residential substance abuse treatment; 59 persons participated in outpatient substance abuse treatment; 19 persons participated in treatment with the Dual Diagnosis unit; and 12 participated in varied mental health treatment services.

Case Management and Contractual Substance Abuse Services

• In FY 2004, nearly all adults in need of and requesting residential treatment, excluding detoxification, were placed in programs. There were a number of adults with psychiatric problems too severe to be treated in the existing treatment settings or individuals that initially requested services but failed to follow through with the placement.

• Completion rates reflect clients who have achieved most or all of the goals of their treatment plan. The figures shown reflect outcome measures for clients who completed their treatment programs and are a subset of the number of clients in treatment. Overall, 70% of the clients placed in residential treatment successfully completed the program. Completion rates for Demeter House reflect the discharge of women; children are not included in completion statistics.

• In FY 2004, forty-three percent of the clients who completed residential treatment moved into a transitional, supportive living environment and 97% of the clients who completed a residential treatment program went on to participate in ongoing outpatient aftercare treatment. The longer a person is engaged in treatment, the better the long-term recovery outcome.

Detention Facility Jail-based Services – ACT UNIT

• Inmates are surveyed on their views of the Act Unit twice each year because of population turnover. The survey is a Likert scale with a 5 representing the highest rating.

• The completion rate for the ACT Unit is the ratio of the number of individuals who had the opportunity to complete (i.e., the number of admissions less those who withdrew immediately from treatment, or were released/transferred prior to the end of treatment) or continue in treatment.

• The Act Unit measure for follow-up treatment placement reflects the number of Arlington residents who received additional treatment services in Arlington after discharge from the program. Arlington residents comprise an estimated 40% of the total jail population.

Detention Facility Jail-based Services – Mental Health (MH) Unit

• Mental Health Program measures are projections based on current staffing and integration of new program design.