CARBON-MONROE-PIKE DRUG & ALCOHOL COMMISSION, INC. SINGLE COUNTY AUTHORITY (SCA)

Transcription

1 STATE FISCAL YEAR 27-8 ANNUAL REPORT October 3, 28 CARBON-MONROE-PIKE DRUG & ALCOHOL COMMISSION, INC. SINGLE COUNTY AUTHORITY (SCA) 211 RICHARD L. MROCZKA, M.S. EXECUTIVE DIRECTOR PENN SQUARE, 724A PHILLIPS STREET STROUDSBURG, PA 1836 PHONE: (57) FAX: (57) This project made possible through a contract with the PA Department of Health s Bureau of Drug & Alcohol Programs (BDAP). The Department specifically disclaims responsibility for any analysis, interpretations or conclusions herein.

2 THE CARBON-MONROE-PIKE SINGLE COUNTY AUTHORITY (SCA) MISSION STATEMENT: The SCA s primary mission is the assessment of the local drug & alcohol prevention, intervention and treatment service need, as well as the planning for and funding of the local continuum of services for the tri-county community (The 27-8 Treatment Needs Assessment & Treatment Plan in its entirety can be found at the Commission s Website: ). Additional missions the Commission has adopted since its incorporation include HIV/AIDS Prevention and Case Management service provider for both Carbon and Monroe Counties, and for Tobacco Prevention/Cessation services in the tri-county area. The Commission receives its primary funding from the Pennsylvania Department of Health, however additional allocations are received annually from the PA Department of Welfare (DPW), AIDSNET, County funding, local grants and the Wayne County SCA. The Commission also receives funds form third party insurance companies fees, Consumer fees and public donations. BACKGROUND: TYPE OF SCA: The CMP D&A Commission, as currently organized, was initially incorporated in December of l985, as a non-profit charitable and educational institution under the name of Carbon-Monroe-Pike Counties Drug and Alcohol Commission, Inc. The SCA is organized as an Executive Commission, as designated by the publicly elected Commissioners of Carbon, Monroe and Pike Counties OVERSIGHT: The governing body of this SCA is an eleven (11) member independent Board of Directors appointed by the Commissioners of Carbon, Monroe and Pike counties. THE BOARD OF DIRECTORS SFY 27/8: Christine Papson, Chair, Monroe County Sharon Kelly, Vice-Chair, Pike County Theresa Croushore, Secretary, Monroe County Mertice Shane, Treasurer, Monroe County Jack Finnegan, Carbon County Gregory Mousseau, Esq, Carbon County Brian Morgan, Carbon County Vivian Morris, Monroe County Thomas Crowley, Monroe County Mary Stanley, Pike County Robert McLaughlin, Pike County The Board of Directors provide governance to the Commission and is involved in all aspects of the Commission ranging from ATOD needs assessment through the oversight and evaluation of the established service delivery system. Members serve on various sub-committees, including Personnel, Legal & Finance, and Nominating Committees. DESCRIPTION OF IN-HOUSE SCA FUNCTIONS: Since its inception, the Commission has been both an administrative body and direct service provider, hiring its own employees to maintain functional prevention, intervention, case management and outpatient treatment units. All other treatment services within the C-M-P treatment continuum of care are purchased through fee-for-service contracts with various residential hospital/non-hospital detoxification, rehabilitation, halfway house, medication assisted treatment and outpatient treatment providers from across the State. Administration (SCA) Contracted Services: Hospital Detox. & Rehab., Non-Hospital Detox. & Rehab. Halfway House, Methadone Maintenance Outpatient & Intensive Outpatient. PHAST C-M Tobacco Control Program C-M-P Case Management C-M-P AHSP C-M-P Outpatient C-M-P-W Prevention/ Intervention C-M-P Prevention C-M Cessation & Prevention Referral Center C-M-P Intensive Outatient C-M-P-W Education/ Information C-M-P Case Management C-M Assessment C-M-P Partial Hospitalization M SAP C-M-P ICM C-M-P 2

3 Carbon-Monroe-Pike Drug & Alcohol Commission, Inc. Organizational Chart (6/9/8) Carbon-Monroe-Pike D&A Commission Board of Directors Executive Director Asst Administrator Tx Program Mgr Chief Fiscal Officer QA Program Rep DAPS Supervisor Medical Director Fiscal Tech Lead Fiscal Asst C DAPS M Lead DAPS DAPS - Tob DATS Supervisor C Lead DACMS M Lead DACMS DATS Lead M Lead CT II M CT II M DAPS M DACMS M Lead DACMS M Lead DATS C DATS W CT II C/M CT II M CT II M DAPS C DAPS M DAPS P DAPS M Lead HIV CM M DACMS M DACMS M AHSP M DACMS M DATS M DATS M DATS M DATS C DATS C DATST C Clerk 1 C AHSP C DATS W DATST DATS DATS DATS C DATS C CT II SCA INFORMATION: SCA NAME: Carbon-Monroe-Pike Drug & Alcohol Commission, Inc. ADDRESS: 724A Phillips Street, Stroudsburg, PA 1836 TELEPHONE & FAX NUMBER: (57) Fax (57) WEBSITE ADDRESS: ADDRESS: Admin@cmpda.cog.pa.us CHAIRPERSONS OF THE CMP COMMISSIONERS DURING SFY 27-8: o Mr. William O Gurek, Carbon County o Ms. Suzanne F. McCool, Monroe County o Mr. Richard Caridi, Pike County CHAIRPERSON OF THE COMMISSION S BOARD OF DIRECTORS DURING SFY 27-8: o Ms. Christine Papson 3

4 MAJOR ACCOMPLISHMENTS OF THE SCA: ADMINISTRATION The Administrative unit effectively maintained oversight of all aspects of the Commission s business and at the same time was able to maintain administrative costs at 6%. In July of 27, the Commission participated in a Quality Assurance audit of its contract which did not net any findings by the Department of Health. In August of 27 the SCA participated in a successful OMB circular a-133 audit of all of its funds, and a Program Specific Audit required for the Tobacco Control Program, for the SFY There was no material weakness found in any of its program accounts. The SCA and the Carbon-Monroe-Pike MH/MR program, on behalf of the three Boards of County Commissioners, was granted the Right of First Opportunity by the PA Department of Welfare for its participation in the Department s HealthChoices project which began July 27. The agency has now completed a successful year for the provision of services in the HealthChoices Network. In September 27 The Commission created a new position to serve as Quality Manager to the Commission and to the local HealthChoices Department. The SCA continued the data tracking, authorization management system, Client Suite In April of 28 the SCA filed its Provider Monitoring report in the BDAP Service Provider Monitoring Report System. The SCA was actively involved, throughout the fiscal year, in maintaining partnerships throughout the tricounty area. Maintaining an active leadership role in both the Pocono Healthy Communities Alliance and the Carbon County Partners for Progress, which are the local State Health Improvement Plan (SHIP) affiliates, the Commission continued partnership activities with the Carbon County Criminal Justice System,the Pike County Correctional Facility, County ICSP Committees, and HealthChoices Advisory Committees. INTERVENTION Intervention services expanded in the Alcohol Highway Safety Program (AHSP) and the Treatment Intervention Group (TIG). In July of 27 the SCA was informed that, it received United Way funds to support Student Assistance Programming, to include funding for residential rehabilitation services for eligible adolescent patients who meet the ASAM placement criteria for that level of care. CASE MANAGMENT/TREATMENT The SCA during FY 7-8 continued to carve out dollars from its residential treatment program budget to continue a Medication Assisted Treatment project using the agent Buprenorphine (Suboxone) in a public/private partnership with a local Physicians and Pharmacies. A new Buprenorphine Coordinator position was created in September 27 to manage the increased case management needs. As well, in June 28 the Commission was awarded a Community Award for the program by NCAC. In June of 28 the SCA exhausted it residential rehabilitation budget, however it was able to maintain a pool of funds necessary to keep emergency detoxification services available to its patients though the end of the fiscal year. In September 27 The Commission created a new position of Treatment Program Manager to oversee the functional units of the Commission and all contracted treatment providers. In April of 28 the Commission s Outpatient Units participated in the annual four-day licensing review visit conducted by the Department of Health s Division of Program Licensing. All of the Commission s functional units were granted full licenses. Details of the visit and how the Commission did in comparison to other like facilities can be found on the PA Department of Health s Website at: 4

5 SCA CASE MANAGEMENT SERVICES: D&A SCREENING: The Commission s Telephone Referral Center serves as the central point of contact for local residents wishing to access drug & alcohol services and/or HIV/AIDS case management services. This unit conducts a telephone screening interview to rule in-or-out the need for emergent care, and refers the individual for a face-to-face level of care assessment within 24 hrs of their call, if deemed emergent, or within seven days if the call is deemed routine. C-M-P D&A REFERRAL CENTER TOLL FREE: STROUDSBURG AREA: Healthcare Insurance Coverage Status MA 24% 1st Priority 3% Other 8% No Insurance 54% BC/BS 1 D&A LEVEL OF CARE ASSESSMENT A comprehensive assessment is conducted during a 9-minute face-to-face interview, following which, the Pennsylvania Client Placement Criteria (PCPC) or the American Society of Addiction Medicine (ASAM) criteria are utilized to determine the appropriate level of care referral. PRIORITY TREATMENT POPULATION STATEMENT The Commission s Case Managers and treatment provider network are required through its contract with the PA Department of Health to supply priority treatment for: Pregnant Injection Drug Users, Pregnant Substance Abusers and Injection Drug Users. Pregnant Women and Women who have recently given birth are entitled to Preferential Services through the Commission. Individuals in these populations can expect to be given top priority when seeking D&A treatment services and, if by chance treatment waiting lists are being employed, their name will be immediately moved to the top of the list. Each of these individuals will be provided special interim services information should they need to wait for a treatment slot. INTENSIVE CASE MANAGEMENT SERVICE ELIGIBILITY DETERMINATION: The primary goal of the Case Management Unit is to provide ancillary support services for those individuals who are deemed eligible to participate. The CMP assessment tool contains questions designed to correlate with the domains of the Inventory of Support Services (ISS) for adults. When the assessor identifies a need in six or more of the ISS domains the client must be offered a referral to ICM services. 5

6 D&A Screening Call completed by the Referral Center & PCSS Total Patients Assessed for level of care placement Assessed within 7 days of Screening Waited longer than 7 days post Screening for an assessment 1 Total LOC Assessments Recommended for Treatment Patients referred that received type of service recommended Patients referred that didn't receive the type of service Reasons why clients recommended for treatment did not receive the recommended type of service Funding Capacity Issues Provider staffing concerns Proximity Lack of appropriate service Client Choice Other 5 49% 58% 9 9% % % % % % 46% 54% *During SFY 27-8, Due to errors in reporting regarding client choice and staffing concerns, the Case Management Unit was not always offering level of care Assessment within the seven-day time BDAP frame at all contracted providers locations. Admissions by Referral Source 6 56 Percentage of clients referred Self Legal System Family/F riend School Mental Health Referral Source Referral Source Medical C&Y Provider Services 8 Other 6

7 SFY 7-8 SCA Funded Inpatient Services Report Number of Clients 4 3 Males Females Total 2 1 Medically Monitored Detox Medically Managed Detox Medically Monitored Short Term Rehab Medically Managed Inpatient Rehab Medically Monitored Long Term Rehab Males Females Total Inpatient Drug of Cholice Opiates 5 Marijuana 5% Other 5% Alcohol 34% Stimulants 5% 7

8 S F Y 7-8 J u l y t h r u J u n e O u t p a ti e n t A d m i ts, D i s c h a r g e s, a n d C e n s u s N u m b e r o f C l ie n t s A d m its D is c h a r g e s C e n s u s 1 5 C a r b o n M o n r o e P i k e W a y n e A d m it s D i s c h a r g e s C e n s u s SFY 7-8 Carbon County Admits, Discharges, and Census Report Number of Clients 2 Carbon Admits Discharges Census Carbon

9 SFY 7-8 Monroe County Admits, Discharges, and Census Report Number of Clients 25 Monroe Admits Discharges Census Monroe SFY 7-8 Pik e C ou nty Ad m its, D isc ha rge s, a nd C ens us Re port N u m b er o f C lien ts Pike 1 5 Ad m it s D is ch arges C ens us Pik e

10 SFY 7-8 Wayne County Admits, Discharges, and Census Report Number of Clients Wayne 1 5 Admits Discharges Census Wayne SFY 7-8 Type of Discharge Report Percentage of Clients Discharged Carbon Monroe Wayne Pike 1 5 Complete No Use Complete Some Use Relocatio n Noncomplianc e With Facility Advice Against Facility Advice Referred to another facility Carbon Monroe Wayne Pike Jailed Medical Administr ative Deceased Other 1

11 SFY 7-8 July thru June Drug of Choice Report Number of Clients Carbon Monroe Pike Wayne 1 5 Alcohol Cannabis Opiates Stimulants Other Total Carbon Monroe Pike Wayne SFY 7-8 Carbon County Drug of Choice Report Number of Clients 2 Carbon Alcohol Cannabis Opiates Stimulants Other Total Carbon

12 SFY 7-8 Monroe County Drug of Choice Report Number of Clients 25 Monroe Alcohol Cannabis Opiates Stimulants Other Total Monroe SFY 7-8 Pike County Drug of Choice Report Number of Clients Pike 1 5 Alcohol Cannabis Opiates Stimulants Other Total Pike

13 SFY 7-8 Wayne County Drug of Choice Report Number of Clients Wayne 1 5 Alcohol Cannabis Opiates Stimulants Other Total Wayne SFY 7-8 Age Range and Gender Report Number of clients by 18 admission < > Female Male Total Female Male Total 13

14 SFY 7-8 Carbon County Age Range and Gender Report Number of clients by admission Female Male Total < > Female Male Total SFY 7-8 Monroe County Age Range and Gender Report Number of clients by admission Female Male Total < > Female Male Total

15 SFY 7-8 Pike County Age Range and Gender Report Number of clients by admission 3 2 Female Male Total 1 < > Female Male Total SFY 7-8 Race Report by County Number of Clients Carbon Monroe Pike Wayne 1 5 Black Hispanic Native American Not Provided Other White Total Carbon Monroe Pike Wayne

16 SFY 7-8 Carbon County Race Report Number of Clients 2 Carbon Black Hispanic Native American Not Provided Other White Total Carbon SFY 7-8 Monroe County Race Report Number of Clients 25 Monroe Black Hispanic Native American Not Provided Other White Total Monroe

17 SFY 78 Pike County Race Report Number of Clients Pike 1 5 Black Hispanic Native American Not Provided Other White Total Pike SFY 7-8 Wayne County Race Report Number of Clients 1 Wayne 5 Black Hispanic Native American Not Provided Other White Total Wayne

18 SFY 7-8 DUI Statistics CRNS Completed Out of County Referrals to AHSP AHSP Completions Carbon Monroe Pike CRNS Completed Out of County Referrals to AHSP AHSP Completions

19 SFY7-8 Medication Assisted Treatment Report Number of New Admissions in Year Methadone Number of Clients Number of Clients Type of Medication Suboxone Methadone Suboxone Number of Clients 8 66 MAT Report SFY 7-8 As a result of the growth in buprenorphine program a Buprenorphine Coordinator position was created in September 27 to serve as liaison between the physician, pharmacy, counselor and to provide case management services to the clients involved The Commission was granted the Exception from licensing for the Carbon and Monroe County offices The Commission is recognized by Reckitt Benckiser as a model for program implementation The Commission was honored by the NCAC with a Community Award in the Health Category in June 28 The Commission has plans to add a new physician in the Monroe County Office to begin in SFY 8-9 In SFY 7-8 the Commission provided targeted Community Education to the County School Nurses, Retired Teachers, CCBH, Board of County Commissioners, and Wayne County SCA The Commission reallocated funds from the inpatient budget into the buprenorphine program totaling close to $1, which is a significant increase over the prior fiscal year 19

20 SCA PREVENTION: The goal of the Commission's prevention/intervention units is to provide services that are designed to preclude or reduce the negative impact of drug abuse on children, families and the community at large. The Prevention Unit has maintained the BDAP Performance Based Prevention System (PBPS) software, which will be used to measure the effectiveness of our prevention programming in relation to the Unit s established goals and objectives. PBPS Prevention Objectives SFY Achieved Educate 35 youth and Parents with the Strengthening Families Program. 97% * Disseminate 3 pieces of ATOD Literature Yes Educate 1 community members on ATOD awareness issues. Yes Identify 25 families for appropriate support services. 52% ** Attend 25 community coalition groups to reduce ATOD use/ abuse in the community. Yes Provide 1 youth and adults with D&A free alterative activities. Yes Attend 25 SAP core team meetings to identify at-risk youth. Yes Identify & Refer 75 youth to appropriate support services. Yes Conduct 25 SAP team referrals for youth evaluation. Yes Educate 5 youth with the BABES program. Yes Conduct 12 prevention risks/ needs assessments with key community informants. Yes Educate 7 youth with the anger management group. Yes Educate 2 youth with ATOD education group. Yes Educate 5 youth with the Positive Action program. Yes *- Objective was missed by one participant. One subcontractor was unable to provide the program for their county this fiscal year. **- The majorities of referrals were for the individual and did not necessitate a family referral. SCA STUDENT ASSISTANCE PROGRAM (SAP) SERVICES: Student Assistance Programs have become a cardinal component of our local school districts response to student substance abuse/addiction problems. SAP teams, made up of key members of the administrative, faculty and support staff of the districts, convene regular team meetings with various Agency Consultants to develop intervention plans for those identified students who demonstrate some type of problematic behaviors. Currently the PA Department of Education s SAP model endorses the use of expert consultants from the local drug & alcohol, mental health, children & youth and juvenile probation offices. The key to the SAP programs success is the existence of strong K through 12 prevention/education programs and the consistent adherence to a District wide, community supported, alcohol, tobacco and other drug use (ATOD) policy. The Carbon-Monroe-Pike SCA has designated its functional prevention unit as the lead agent for the delivery of services for this very important project. SAP services include a wide array of school based programming including SAP team consultation services, early intervention activities which include D&A screenings/assessments for students referred by the team, early intervention counseling for students in both individual and group formats and primary prevention/education programming for the general student population. Individual Students Seen for Intervention Services (Screening/Assessment) Male Female White Black Hispanic Asian American Indian Other Total Resulting Referral (Intervention/Treatment/Other/None) Intervention Group Treatment Other None School Based Community Based Drug & Alcohol Outpatient Drug & Alcohol Intensive Outpatient Drug & Alcohol Partial Hospitalization Drug & Alcohol Residential Mental Health Other Breakdown by County None # of Assess. # Consult Hrs SAP Referrals Individual Interventions Group Interventions Carbon County Subtotal Monroe County Subtotal Pike County Subtotal Carbon-Monroe-Pike Totals

21 FISCAL INFORMATION SFY 27/8 OPERATING REVENUE DPW Act 152 $234,85 DOH AIDSNET $171,756 Assistance Program Fees $145,85 County DUI Fine Revenue $2,923 DOH BDAP Federal Block Grant $45,587 DOH BDAP State Allocation $569,552 DPW BHSI $442,469 County CSBG $29,9 County Match $63,894 Self-Pay AHSP Fees $272,853 DPW IGT $122,873 DPW Medical Assistance $215,432 DPW MH/MR Fees $29,185 Other Grants $118,967 Other Income $9,219 Outpatient Consumer Fees $233,139 Private Health Insurance Fees $58,974 DOH Tobacco Control Program Grant $332,593 DOH BDAP Wayne SCA Outpatient $124,43 TOTAL $3,629,374. DUI Fine % Federal 12% Fees Charged 2% PA DOH 33% Other Grants & Income 4% County Match 2% PA DPW 29% 21

22 OPERATING EXPENSE BY ACTIVITY Administration $28,87 Assistance Programs $29,776 Case Management - BDAP $476,885 Case Management AIDSNET $137,923 Inpatient-Non Hospital $434,413 Inpatient Hospital $ OP Maintenance $112,223 OP & Intensive OP $1,222,125 Other Intervention Programs $2,11 Prevention $216,23 Tobacco Control Program $332,593 TOTAL $3,632,49. Intervent 14% Prevent 15% Admin 6% Case Mgt 17% Treatment 42% TREATMENT FUNDS UTILIZED Act 152 Revenue $195,88 BDAP Federal Block Grant $334,694 BDAP State Allocation $336,788 BHSI Revenue $43,111 Community Service Block Grant $29,9 County Revenue $23,282 IGT Revenue $122,873 MH/MR Fees $29,185 Other Grants $226,298 Wayne County Outpatient $124,43 TOTAL $1,852,

23 DUI & CRN Fees - $84,615 9% Healthchoices - $4,833 Carbon County Revenue 7-8 $963,284 County DUI Fine - $2,923 % Act $34,483 4% SAP Fees - $33,25 3% Aidsnet Prevention Grant - $19,517 2% IGT - $29,49 3% Tobacco - $43,393 5% Urine Fees - $2,555 2% Youth Forestry Camp - $24,738 3% Outpatient Client Fees - $124,39 13% Bureau of HIV - $1,38 % BHSI - $119,23 12% BDAP Allocation - $45,233 4 County Match - $15,335 2% Carbon County Expense 7-8 $963,284 DUI Program - $73,361 8% SAP - $97,371 Tobacco Admin - $11,423 Aidsnet Prevention - $7,68 Prevention - $45,599 5% Inpatient - $14,452 1 Methadone Maint - $8,328 Admin - $5,129 5% Tobacco Direct - $31,97 3% Case Mgmt - $16,792 1 Outpatient - $358,917 37% Suboxone - $67,262 7% 23

24 Monroe County Revenue 7-8 $2,29,438 DUI & CRN Fees - $188,328 9% Healthchoices - $11,478 SAP Fees - $85,1 4% County Match - $36,42 2% CMP MHMR - $29,185 Aidsnet Case Mgmt - $128,49 6% Monroe C&Y - $19,261 Aidsnet Prev - $23,748 BHSI - $244,13 12% Other Grants - $18,42 OP Client Fees - $335,134 17% Act $154,311 8% BDAP - $447,49 22% MCCF - $33,89 2% IGT - $7,37 3% CSBG - $29,9 Tobacco - $174,584 9% Monroe County Expense 7-8 $2,29,438 DUI Program - $126,651 6% Tobacco Admin - $21,626 Aidsnet Prevention - $38,461 2% Prevention - $9,452 4% Admin - $119,56 6% SAP - $133,598 7% Inpatient - $261,161 13% Methadone Maint - $14,815 Aidsnet Case Mgmt - $137,923 7% Outpatient - $63,941 3% Tobacco Direct - $152,963 8% Case Mgmt - $28,17 14% Suboxone - $21,621 24

25 Pike County Revenue 7-8 $454,497 Tobacco - $114,616 25% Healthchoices - $3,826 SAP Fees - $28, 6% IGT - $23,346 5% HSDF - $1,5 % Act $29,696 7% Urine Fees - $6,738 BHSI - $66,778 15% County Match - $12,14 3% BDAP Allocation - $167,857 37% Pike County Expense 7-8 $454,497 Tobacco Admin - $1,667 2% Prevention - $34,37 7% SAP - $59,87 13% Inpatient - $68,8 15% Admin - $39,685 9% Methadone Maint - $196 % Outpatient - $47,437 Tobacco Direct - $13,945 24% Case Mgmt - $89,923 2% 25