Memo

Los Angeles County Evaluation System (LACES)

BACKGROUND:
The Los Angeles County Alcohol and Drug Program Administration (ADPA) selected the UCLA Integrated Substance Abuse Programs (ISAP) to design and implement an ongoing evaluation program to assess the following:

• The overall effectiveness of services provided by ADPA-funded alcohol and drug service providers,
• The effectiveness of specific service modalities,
• Participant outcomes,
• Service components, and
• Program costs.

This evaluation effort was named the Los Angeles County Evaluation System: An Outcomes Reporting Program (LACES).

Consistent with this evaluation effort, ADPA has also contractually required that all funded alcohol and drug treatment/recovery programs participate in and support this effort.

STAFF:
Principal Investigator: Richard Rawson, Ph.D.
Project Director: Desirée Crèvecoeur, M.A.
Trainer/Program Liaison: Derrick Brown
Information Technologies Specialist: Ed Trejo

GOALS:

• To develop and implement an ongoing, self-sustaining evaluation system.
• To provide data to LA County ADPA regarding its alcohol and other drug treatment programs.
• To assess the overall effectiveness of the alcohol and drug services treatment/recovery systems.
• To assess the effectiveness of specific service modalities and service components.

IMPLEMENTATION:
The evaluation mainly uses information already being collected by treatment programs. We have restricted the quantity of new information being collected so as to limit the burden placed on providers.

MAIN TASKS:

• Training and technical assistance
• Collecting and organizing information into reports
• Disseminating information in reports, presentations, and articles

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LEVELS of the EVALUATION:

Level 1: Client Level
Assess all treatment participants at admission and discharge. A sample of participants is also selected to participate in a follow-up study.

Level 2: Program, Agency, and System Level
Information gathered from alcohol and other drug (AOD) treatment staff (such as counselor training and education, number of years in the AOD treatment field, drug testing policy, and the quantity of treatment – counseling sessions/treatment days) is compiled along with additional information from the client level of the evaluation in order to give us a more complete picture of AOD treatment in LA County.

Level 3: Community Level
This level involves looking to outside sources for additional information concerning the impact of alcohol and drugs. For example, data may be compiled from national or state sources and then compared to LA County to ascertain where we stand when compared to larger populations. An example of this is the trend reports.

Level 4: Cross-Systems Linkage
A little more difficult to accomplish, given the HIPAA (Health Insurance Portability and Accountability Act) privacy regulations, entails gathering information from other LA County health service related organizations such as the Department of Mental Health, the Employment Development Department, the Department of Social Services, etc., in order to track the utilization of these services by the treatment population. This will serve to provide additional information concerning the ancillary treatment needs of the group we serve.

Substance Abuse and Crime Prevention Act (SACPA, aka Proposition [or Prop.] 36)
LACES has also been given the task of completing a county-wide evaluation of the Prop. 36 activities that is above and beyond what is being completed by the statewide evaluation – which is also being handled by UCLA.

PREVIOUS ACTIVITIES:

• Training over 1,000 individuals on a scientifically valid intake assessment instrument (the Addiction Severity Index).
• Conducting over 500 technical assistance calls and appointments.
• Collecting information on approximately 150 participants at a one-year follow-up.
• Completing Level I of LACES – implementation of the evaluation at the client level – and beginning work for Level 3 of the evaluation.

PLANNED ACTIVITIES (LEVEL-BASED):

1. Continue with Level 1 of LACES (client evaluation)

• Assist in the training activities for the revised Los Angeles County Participant Reporting System (LACPRS) admission/discharge questions.
• Construct reports based on the LACPRS information.
• Collect one-year follow-up information from participants to asses their long-term progress post treatment.

2. Commence with the Program, Agency, and System Level of LACES (Level 2)

• Collect information on the training, education, and background of counselors in the substance abuse field.
• Determine the treatment dosage for participants (i.e., number of days spent in Residential Treatment, number of counseling sessions for Outpatient Programs, number of medication dosages for Narcotic Treatment Programs).
• Assess the number and type of ancillary services offered in order to ascertain if this impacts treatment retention and completion.
• Examine billing documents to determine program costs.
• Examine policies and procedures regarding drug screening (where applicable).

3. Continue with the Community Level (Level 3)

• Locate additional sources of state and national drug use/abuse data.
• Determine ways to improve the validity, reliability, and usefulness of current alcohol and drug abuse indicators.
• Develop additional indicators within Los Angeles County.

ADDITIONAL ACTIVITIES:

• Collection of additional information for the LA County SACPA evaluation.
• Composition of the year-end report.

In conclusion, this evaluation will evaluate the outcomes and benefits of alcohol and other drug treatment. LACES will provide a wealth of data on participants, participant outcomes, AOD treatment services, program effectiveness, as well as information regarding what constitutes good treatment practices for ADPA-contracted programs in Los Angeles County. LACES evaluation findings and related-information will be used to improve and support the growth of the overall Los Angeles County Alcohol and Drug Treatment Program and each of its contracted providers.

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