Performance-Based Pilot Project Workgroup

PURPOSE: The purpose of the Performance-Based Pilot Project (PBPP) is to review existing performance and outcome treatment data and to identify additional performance and outcome data necessary to evaluate and improve Los Angeles County alcohol and other drug treatment programs.  In addition, the pilot project will be used to determine procedures to improve performance areas.  Finally, the pilot project will provide the opportunity to develop contract language, data and billing systems, and performance standards that will support performance-based program management and contracting.

 

SUBJECTS: Pilot project participants will be selected from volunteer providers.  Each participating provider will collect and submit encounter data (process, service, billing, performance, etc.) from one facility site that provides either outpatient counseling or narcotic treatment (methadone maintenance treatment).  The funding sources for these treatment services may be federal, State General, or other County department funds.

 

DATA REQUIRED: The data elements required will include:

 

• the name of the agency;
• site location;
• participant identification number;
• participant date of admission;
• participant date of discharge, when available;
• individual counseling sessions, identified by the date they were conducted and the type of session (e.g., assessment, treatment planning, or counseling);
• group counseling sessions, identified by the date;
• the date the initial treatment plan was completed; and
• urine testing, identified by the date of the test.

PROCEDURE: There will be three parts to the pilot project: pre-pilot data analysis, baseline data collection, and the implementation phase.

 

Pre-Pilot Data Analysis (May 2008 – August 2008)
The pilot project will commence with the pre-pilot data analysis where SAPC and UCLA will collect and analyze preliminary encounter data to determine what data are currently available and what data are still needed.  In addition, the providers who express interest in participating in the pilot project will submit a brief application detailing the program location, contact person, and performance/outcome areas that are of interest.  The determination of who should participate in the pilot project will be determined after review of the applications and that site’s annual site report.

 

Baseline Data Collection (September 2008 – December 2008)
Once the sites are selected and the appropriate SAPC PBPP Reporting Information System is installed, baseline data collection will begin.  Submission and processing of baseline data will be monitored for three to four months.  SAPC and providers will focus on designated performance areas. 

These performance areas include:

 

• Individual sessions in first 30 days (assessment and treatment planning)
• Client engagement - the percent of participants who remain in treatment for at least 30 days and those with a minimum of eight sessions in the first 30 days (at least two of which are individual sessions);
• Urine testing
• Treatment plan completion
• Timely submission of admission and discharge questionnaires.
• Retention – the total number of days between treatment admission and discharge, a designated minimum number of treatment sessions may also be included as a requirement;
• Percent of completed exit interviews which must include the completion of the discharge questionnaire; and
• Reduction in homeless.

These elements are described in greater detail in the Next Steps (see attached).  In addition UCLA and SAPC may decide to examine client outcome areas including client abstinence at discharge; reduction in primary substance use; change in stability of housing from admission to discharge; involvement with criminal justice system (number of arrests, jail days, and prison days); and social productivity (employment and education).

UCLA will work with SAPC information systems staff to analyze the data and assist SAPC in developing automated provider performance reports.  These reports will be made available to providers through Los Angeles County Participant Reporting System.  The performance-based reports may be integrated into the current site report or they may require an entirely new report format.

UCLA and the consultants from the Treatment Research Institute (TRI) will also work with SAPC to make any necessary modification to the data collection system as needed.  TRI may also be consulted to help SAPC develop the appropriate contract language for implementation of an SAPC performance-based contracting system.

Implementation Phase (January 2009 – May 2009)
Once the baseline data collection is completed, data will be analyzed and performance standards will be developed. The implementation phase of the pilot project will commence and the resulting levels and standards of performance will be shared and discussed with the pilot project providers.  Through provider discussions, suggestions will be entertained regarding strategies to improve performance.  Providers will use science-based methods they deem appropriate to increase their performance to the standard set by SAPC.

To keep providers informed of their standing, monthly reports will be made available through the SAPC information reporting system.  The report will be used to identify and establish acceptable and unacceptable levels of provider performance.  These reports will also be used to develop hypothetical reimbursement contingencies.

At the conclusion of the pilot project (May 2009) SAPC, UCLA, and providers will meet to discuss and prepare a brief report which includes pilot project findings and recommendations for further performance management and future performance-based contracting.

 

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