Substance abuse prevention and control strategic plan - county of los angeles department of public health
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
county of los angeles department of public health
substance abuse prevention
and control strategic plan
2011-2016
February 2011
county of los angeles department of public health
substance abuse prevention
and control strategic plan
February 2011
Prepared by
message from the director Dear Community Members: The County of Los Angeles Department of Public Health–Substance Abuse Prevention and Control is tasked with implementing policies and strategies to prevent substance use disorders and treat those who are directly or indirectly affected by alcohol and other drug misuse. Substance use disorders affect individuals, families and communities in a variety of ways. Individuals with substance use disorders can suffer from permanent health and social consequences as a result of dependence or abuse. The field of substance use disorders continues to change as funding shifts and the breadth of knowledge about prevention and treatment grows. Recent changes to legislation like the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) will substantially alter the way in which we do business and will affect the way services are delivered in the community. We are working hard to identify and address the underlying social and familial factors that affect individuals and communities in their efforts to limit the unlawful use and abuse of alcohol and other drugs. This plan will guide the Department in facing emerging challenges and will ensure that we are working effectively, efficiently and using our human and financial resources in the best way possible. This plan is a preliminary platform from which we will work to enhance prevention, treatment and recovery efforts for the people of Los Angeles County. We will not work in isolation in this endeavor. We look forward to building new and innovative partnerships to meet our vision, mission and goals. Together, we can and will ensure that all people and communities in Los Angeles County have the opportunity to pursue their dreams and to fulfill their promise without the burden of alcohol or drug abuse and addiction. Sincerely, John Viernes, Jr. Director
ACKNOWLEDGMENTS The County of Los Angeles Department of Public Health–Substance Abuse Prevention and Control (SAPC) wishes to acknowledge the leadership and contributions of various SAPC staff members in developing a strategic plan that will guide the delivery of prevention, treatment and recovery services over the next three to five years. The department also wishes to extend appreciation to the Board of Supervisors, the various county partners and contracted service providers who offered support and expertise necessary to advance substance abuse issues in the County of Los Angeles. The SAPC would also like to thank the many individuals who participated in Key Informant Interviews, Focus Groups and the Stakeholder Forum. SAPC also appreciates the many individuals who responded to survey requests and provided thoughtful responses. Participants in the focus groups included youth and adults in recovery, participants currently engaged in treatment, persons employed by SAPC, contracted service providers, SAPC staff members, staff from partnering County departments, judicial officers, criminal justice experts and other key community stakeholders. We would also like to recognize the skill and expertise of Mark Sillings, Carolyn Verheyen and Andi Nelson of MIG, Inc.
table of contents 1. introduction 7 2. overview of substance abuse prevention and control 9 SAPC Organizational Structure.............................................................................10 SAPC Programs and Partners................................................................................12 Trends and Issues Reshaping the Alcohol and Other Drugs Field and the SAPC Operating Environment................................... 15 3. strategic planning process 19 Phase One–Reviewing and Assessing the Context...............................................19 Phase Two–Defining the Direction...................................................................... 20 Phase Three–Developing the Plan of Action . ..................................................... 20 4. strategic plan framework 23 Introduction and Overview................................................................................... 23 Plan Framework Diagram..................................................................................... 24 Values.....................................................................................................................25 Vision . ...................................................................................................................25 Mission...................................................................................................................25 Goals.......................................................................................................................25 Enterprise Metrics................................................................................................ 26 Relationship to the County of Los Angeles Department of Public Health Strategic Plan..................................................................................27 5. strategic goals, objectives and strategies 29 System of Care...................................................................................................... 30 Prevention and Promotion................................................................................... 36 Preparedness......................................................................................................... 40 Organizational Effectiveness................................................................................ 46 Workforce Excellence............................................................................................52 Fiscal Accountability............................................................................................. 58 Integration of Strategies Across Goals................................................................. 62 6. strategic plan implementation 65 Relationship of SAPC Strategic Plan, Budget and Annual Workplan..................65 Aligning the Budget with the Strategic Plan........................................................ 66 SAPC Strategic Planning Cycle............................................................................. 66 Decision Making Criteria...................................................................................... 66
one: introduction
1 introduction
SUBSTANCE ABUSE PREVENTION AND Concurrent with the new agency name,
CONTROL (SAPC) , a division of the Los leadership in the County of Los Angeles and
Angeles County Department of Public Health SAPC management initiated the strategic
(DPH), developed this Strategic Plan to planning process. Although SAPC has been
successfully navigate through a period of engaged in the AOD field for almost 30 years,
unprecedented changes in the alcohol and this is the first Strategic Plan ever prepared
other drugs (AOD) prevention, treatment and by its staff. Given this long history, the
recovery fields. The convergence of several leadership recognized that to effectively adapt
factors, not least of which involves Health to the coming changes, the organization could
Care Reform (HCR), underlies a wave of no longer rely on unexamined assumptions
change that will in the next few years move and existing institutional practices that may
through and transform the institutional have worked well in the past but which might
and financial environments in which public not be well suited for the rapidly advancing
agencies like SAPC must operate. future. Given an urgent need to plan for these
changes, SAPC staff developed the Strategic
In anticipation of these coming changes, the
Plan to help chart a course through a
primary local agency charged with reducing
landscape that will be fundamentally altered
the community and individual effects of
by HCR and other forces for change. The
AOD use and abuse in Los Angeles County
ultimate benefit of this new Strategic Plan is
has taken on a new name. Until 2010, the
to position SAPC to take full advantage of this
agency was known as the Alcohol and Drug
new environment and so greatly enhance its
Program Administration (ADPA). The name
capacity to reduce AOD use and abuse within
was changed to Substance Abuse Prevention
the communities of Los Angeles County.
and Control to better describe the public
health role it would play in an AOD field that
has been fundamentally transformed.
Substance Abuse Prevention and Control Strategic Plan | 7two: overview of substance abuse prevention and control
2 overview of substance abuse
prevention and control
PROBLEMS ASSOCIATED WITH ALCOHOL billion.2 At the same time, drug overdose is
AND DRUG USE adversely affect an estimated the fourth leading cause of premature death
23 million people throughout the United and the 17th leading cause of death overall.3
States. Although substance use disorders Drug offenses account for the highest
are both preventable and treatable, the vast percentage of overall felony arrests.
majority of those with this chronic condition
go untreated. The impact of this disease In the 2009-10 fiscal year, over 60,000 Los
extends far beyond these individuals and Angeles County residents were admitted to
their families by imposing enormous costs publicly funded AOD treatment programs.4
on local communities and society at large. These programs are funded through the
Nationally, each year alcohol abuse alone SAPC program which has the primary
generates an estimated $185 billion in responsibility in the County for dealing
costs stemming from a myriad of inflictions with this public health problem. With an
including unnecessary illnesses, vehicle annual budget of more than $200 million
crashes, lost productivity and criminal and nearly 200 employees, SAPC provides
activity. Drug abuse contributes another an array of alcohol and drug prevention,
$143 billion to this terrible toll.1 treatment and recovery programs and
services for County residents through
As elsewhere in the nation, the economic
2 The Annual Catastrophe of Alcohol in California:
and social impact in Los Angeles County Los Angeles County. Marin Institute, July 2008.
of untreated substance abuse is enormous. http://www.marininstitute.org/site/images/stories/
pdfs/coststudylafinal.pdf
The annual estimated economic cost in the 3 Mortality in Los Angeles County 2007: Death and
County for alcohol use alone is nearly $11 Premature Death with Trends for 1998-2007, County of
Los Angeles Department of Public Health.
4 Fact Sheet: Drug Use and Misuse in Los Angeles
1 Briefing on Substance Use Treatment and Recovery County. County of Los Angeles Department of Public
in the United States. http://pfr.samhsa.gov/docs/ Health, Substance Abuse Prevention and Control.
Briefing_Substance_Use_Treatment.pdf September 2010.
Substance Abuse Prevention and Control Strategic Plan | 9two: overview of substance abuse prevention and control
contracts with over 150 community-based Evaluation System (LACES) outcomes
organizations. In addition to providing project in partnership with the University of
funding for this provider network, SAPC California, Los Angeles Integrated Substance
directly operates the Antelope Valley Abuse Programs.
Rehabilitation Center (AVRC). The primary
Community Program Services (CPS)
recipients of these County-funded and
Division: oversees management and
operated alcohol and drug prevention,
coordination of an array of programs and
treatment, and recovery services are Los
partner relationships, encompassing:
Angeles County residents, particularly those
who are uninsured or underinsured. • Several federal- and State-funded proj-
ects including the Los Angeles County
To effectively manage its services SAPC is
network of Narcotic Treatment Programs
organized into ten operational divisions, (NTPs) and the network of Community
including AVRC mentioned above. It also Assessment Service Centers (CASCs).
participates in multiple partnerships with
• Treatment and recovery supportive
other agencies and organizations to better
services offered to the Department of
focus on the specific needs of different
Public Social Services’ General Relief
subgroups within the AOD client population.
(GR) and California Work Opportunity
and Responsibility to Kids (CalWORKs)
program participants.
SAPC ORGANIZATIONAL
STRUCTURE • The Department of Children and Fam-
Listed here alphabetically, the ten divisions/ ily Services’ Providing Safe and Stable
Families-Time Limited Family Reunifica-
units of SAPC encompass:
tion (DCFS PSSF-TLFR) program.
Antelope Valley Rehabilitation Centers • HIV and AIDS training and services for
(AVRCs): are comprised of two programs. SAPC’s network of treatment and preven-
The residential program, located on 135 tion agencies.
acres in the mountain setting of the Acton
• Ensuring that persons convicted of Driv-
Rehabilitation Center, provides services to
ing Under the Influence at six court loca-
adult men and women. Acton Rehabilitation tions comply with the conditions of their
Center can accommodate over 300 probation.
participants. High Desert Recovery Services
• Individual and community-based
(HDRS), the outpatient branch of the
prevention services to reduce availability
AVRCs located in Lancaster, is a low-cost,
and accessibility, and change the social
comprehensive, adult outpatient substance
norms and conditions that contribute to
use disorder treatment program. alcohol and drug use.
Community Planning and Program • Criminal justice and drug and specialty
Evaluation: coordinates strategic planning court programs provided by numerous
activities, policy development, and special State and County criminal justice agen-
projects, including the Los Angeles County cies, such as the Offender Treatment
10 | county of los angeles department of public healthtwo: overview of substance abuse prevention and control
Program (OTP), Adult Drug Courts, The Chief Deputy Director manages SAPC
Family Dependency Drug Courts, and daily operations and advances science-
Co-Occurring Disorders Courts (CODCs). based treatment improvement initiatives
• Collaborates with Public Safety agencies and collaborative agreements with SAPC
in the implementation of the Los Angeles partners. The Chief Deputy Director also
Screening, Brief Intervention, Referral, oversees SAPC Strategic Planning, ongoing
and Treatment (SBIRT) program for the community planning processes, and
delivery of early intervention and treat- legislative and policy analyses.
ment services for short-term detainees.
The Chief of Staff coordinates executive
• Administers several Parolee re-entry
assignments, provides AOD commission
programs, including the Parolee Services
support, coordinates facility management,
Network, Female Offender Treatment
and conducts special projects.
Programs, Second-Chance Women’s
Re-entry Program, and Probation Day The Public Information Officer (PIO)
Reporting Center’s substance abuse
oversees SAPC’s media relations and
treatment services.
external communications and liaises with
• Outpatient and residential treatment DPH’s and the State’s Public Information
services tailored to the specific needs of Officers. In addition, the PIO coordinates
youth. special community projects, events, and
• Collaborations with the Department of professional trainings.
Children and Family Services and the
The Medical Director consults with program
Probation Department to provide preven-
tion and treatment services for system- directors on treatment improvement
involved youth. initiatives and protocols and oversees the
expansion of medication-assisted treatment.
Contract Development and Processing
Division (CDPD): is responsible for the The Special Assistant’s Office supports the
administration of the DPH SAPC contract Director in SAPC’s day-to-day operations,
program; manages Requests for Proposals including reviewing all internal and
and other competitive selection processes; external documents and assignments;
and is responsible for maintaining SAPC representing the Director at internal and
program office records of contracts and external meetings; and completing SAPC
updating contract information. and DPH Executive-level assignments,
in collaboration with other DPH staff
Executive Office: The Director of SAPC if necessary. The Special Assistant also
oversees the work of the Chief Deputy oversees the Research and Epidemiology
Director, Chief of Staff, Public Information (R&E) Unit and serves as a Co-Chair on
Officer, Medical Director, Special Assistant, SAPC’s Data and Information Committee.
the Commission on Alcohol and Other
Drugs, Information Systems and The Commission on Alcohol and Other
Personnel Services. Drugs advises and makes recommendations
Substance Abuse Prevention and Control Strategic Plan | 11two: overview of substance abuse prevention and control
to the Board on alcohol and drug issues. use disorder residential treatment servic-
The goal of the Commission is to reduce es for Medi-Cal eligible County residents.
problems related to substance use disorders Services are available for pregnant and
and the negative impact on the quality of life postpartum women. Youth under the
for individuals and their families residing in age of 21 may obtain services through the
Minor Consent Program. DMC programs
Los Angeles County.
comply with Title 22 of the California
Financial and Administrative Services Code of Regulations.
Division: is responsible for the financial
Research and Epidemiology (R&E) Unit:
management and contracting functions
collaborates both internally with other
for SAPC.
SAPC staff and externally with staff from
Information Systems Division: is other DPH programs and outside agencies
responsible for design, development, regarding substance abuse data, research,
and implementation of SAPC’s network and epidemiology issues. R&E staff
operations, information technology support, monitors, analyzes, and interprets local and
and electronic data collection systems national AOD-related data for subsequent
between SAPC and contract agencies to use in local planning, evaluation, and
comply with State and federal funding prevention efforts.
sources. This Division also co-chairs the
SAPC Data and Information Committee.
SAPC PROGRAMS
Personnel Services Division: handles all The SAPC maintains a variety of public and
personnel and payroll-related matters. private partnerships which are intended
to provide a continuum of prevention,
Program Compliance and Quality
treatment and recovery services to persons
Assurance Division: is responsible for a
of any age. The partnerships are manifested
number of core functions, including:
in various programs throughout the county.
• Compliance monitoring of all SAPC
programs; Community Assessment Service Centers
(CASC): serve as entry points for adults
• Evaluation and development of opera-
seeking alcohol and drug treatment and
tional systems and procedures to ensure
recovery services. At each CASC site, a
the effective implementation of programs
person is provided with a standardized
by SAPC contracted providers;
assessment. The results are then used to
• Provision of technical assistance to these refer an individual to the appropriate level
providers on contract compliance and
of treatment. There are currently 19 Service
program standards; and
Center sites located throughout Los Angeles
• Oversight of Drug/Medi-Cal program in County.
Los Angeles County.
• The DMC program offers outpatient, nar- Youth and Family Programs
cotic treatment, and limited substance Youth System of Services: is composed
12 | county of los angeles department of public healthtwo: overview of substance abuse prevention and control
of seventeen community-based programs disorder.
(thirteen outpatient and four residential)
California Work Opportunity and
that provide substance abuse prevention,
Responsibility to Kids (CalWORKs)
treatment, and recovery services tailored to
Program: is a collaboration of SAPC,
the specific needs of youth.
the Department of Public Social Services
Dependent Youth Substance Abuse (DPSS), and the Department of Mental
Treatment Protocol: is a collaborative Health (DMH) designed to address the
project of the Los Angeles County issue of substance abuse and its impact
Dependency Court, the Department of on families in Los Angeles County. This
Children and Family Services (DCFS), SAPC program focuses on helping welfare
and its Youth Services Contractors. The recipients move from public assistance
goal of the project is to identify dependent to employment or from welfare-to-
youth 12 years of age and older with possible work (WtW). Participants meeting WtW
substance abuse issues and to provide them requirements may receive treatment
with the services they need to reduce their for substance abuse, mental health, and
chances of coming into contact with the domestic violence.
juvenile delinquency system.
General Relief (GR): is a program that
Providing Safe and Stable Families—Time assists applicants/recipients with substance
Limited Family Reunification (PSSF-TLFR) abuse problems to recover from their
Program: is a collaborative program, which chemical dependency.
serves families where one or more children
have been removed from parental custody Youth and Family Criminal
for fifteen months or less due to suspected Justice Programs
child abuse or neglect, and addresses the The Juvenile Justice Crime Prevention Act
impact of substance abuse on families in (JJCPA): established funding in California
Los Angeles County. The program requires for services proven to reduce crime among
parents and/or caretakers to enter alcohol at-risk youth and juvenile probationers.
and other drug treatment services as a part Through this collaborative project with the
of their family reunification plan. Probation Department, SAPC Youth Services
Contractors provide substance abuse
Prevention Services: are a network of
treatment services for probation involved
community-based programs throughout the
youth.
County. The programs engage youth and
other community residents in conducting Dependency Drug Court Program: is a
activities to reduce the availability and collaboration between the Los Angeles
accessibility and change the social norms Countywide Criminal Justice Coordination
and conditions that facilitate AOD use and Committee (CCJCC), Superior Court, DCFS,
the related problems. Prevention services County Counsel, SAPC, and attorneys for
target community-level issues and do both the parent and children. The program
not require treatment of a substance use addresses the needs of substance-abusing
Substance Abuse Prevention and Control Strategic Plan | 13two: overview of substance abuse prevention and control
parents while efforts are being made to abuse treatment, drug testing, graduated
foster family reunification. The program sanctions, and rewards. Upon successful
requires a minimum of twelve months of completion of the program, offenders’ guilty
treatment. pleas are vacated and their cases dismissed.
Sentenced Offender Drug Court (SODC)
Adult Criminal Justice and
Program: is an intensive program for
Probation Programs
convicted, non-violent felony offenders who
Parolee Services Network (PSN)
face state prison due to their criminal records
Program: is a collaborative between the
and history of drug addiction. These higher risk
California Department of Corrections and
offenders have medium to high levels of drug
Rehabilitation (CDCR) and the California
addiction and are offered the SODC program
Department of Alcohol and Drug Programs
with formal probation as an alternative to state
(ADP), and provides community-based
prison. SODC integrates in-custody and post-
alcohol and drug abuse treatment for
release treatment components.
eligible parolees. The purpose of the PSN
project is to provide prison parolees with Proposition 36, also known as the Substance
a full array of treatment and recovery Abuse and Crime Prevention Act (SACPA):
services to promote long-term sobriety, is a probation and drug treatment program
support community reentry, and reduce (provided in lieu of incarceration) for
criminal recidivism. Funded by the CDCR, probationers and parolees with drug-
the Los Angeles County PSN project was related probation or parole violations
implemented in 1991. SAPC oversees local and for persons convicted of possession,
community treatment providers that provide use, transportation for personal use, or
PSN services throughout the County. being under the influence of a controlled
substance. It applies only to non-violent
Co-Occurring Disorders Court (CODC): is
drug possession/use offenses by individuals
a pilot court program created to supervise
with no prior violent felony convictions; and
criminal defendants diagnosed with both
provides up to six months of community-
a mental illness and a substance abuse
based substance abuse treatment for eligible
disorder. The project involves an 18-month
participants. In Fiscal Year 2009-10,
program that integrates mental health and
funding for Proposition 36 under SACPA
substance abuse treatment services.
was eliminated, but the mandate for the
CCJCC, Superior Court, District Attorney, provision of Proposition 36 drug treatment
Public Defender, Sheriff, Probation services continues indefinitely.
Department, and SAPC worked together
CCJCC, Superior Court, Sheriff, District
to develop the Drug Court Probation
Attorney, Public Defender, Probation
Program for drug-using offenders. While
Department, University of California,
on probation and subject to the rules of the
Los Angeles Integrated Substance Abuse
Probation Department, drug-using offenders
Programs, and SAPC joined together to
participate in intensive judicial supervision,
establish the Second Chance Women’s Re-
case management, mandatory substance
14 | county of los angeles department of public healthtwo: overview of substance abuse prevention and control
Entry Court Program to provide services for services through a network of community-
25 female offenders who are legal residents based providers and numerous partnerships
of Los Angeles County and are: 1) paroled with other public agencies in Los Angeles
from a CDCR institution under jurisdiction County and at the State and federal
of the Los Angeles Superior Court and levels. These existing inter-organizational
facing a new, non-violent, non-serious relationships for the delivery of AOD
felony charge; 2) concurrently on parole and services and the supporting federal and State
probation; or 3) on felony probation with a funding system have evolved over several
high risk of being sentenced to State prison. decades. This establishment is now on the
Eligible clients are required to complete a verge of a significant transition to new and
treatment plan with incentives and sanctions different institutional arrangements driven
that includes stabilization, orientation, by policy changes at the federal level and
assessment, intensive treatment, transition, related trends within the AOD field. Among
and enhancement services. these change factors are the following:
Screening, Brief Intervention, Referral, • Through Health Care Reform, scheduled
and Treatment (SBIRT) program: is a to be fully in effect by 2014, some rev-
demonstration project funded by the federal enue streams for many AOD prevention
Substance Abuse Mental Health Services and treatment services are likely to shift
away from federal block grants to private
Administration and the State of California
insurance and Medi-Cal.
ADP. This project provides a public health
intervention for short-term detainees to • As a result of the Mental Health Parity
assist them in reducing or eliminating their and Addiction Equity Act of 2008, group
tobacco, alcohol, and/or other psychoactive health plans and insurance can no longer
substance use and abuse. The SBIRT apply more restrictions on the benefits
offered for mental health or substance
Demonstration Project is a collaborative
use disorder than they do for medical/
effort between SAPC-designated treatment
surgical coverage.
agencies, the Sheriff’s Department, and the
Los Angeles Police Department, to increase • The AOD prevention and treatment field
offender access to community support is undergoing a significant increase in
services, reduce alcohol and/or other drug rigor through the adoption of evidence-
based practices designed to increase both
prevalence, decrease recidivism, and reduce
control and accountability by funders
jail overcrowding.
while also moving the field more toward
the medical model and away from the
social model for AOD treatment and
TRENDS AND ISSUES
recovery.
RESHAPING THE ALCOHOL AND
OTHER DRUGS FIELD AND THE • In addition to prevention, the AOD field
SAPC OPERATING ENVIRONMENT is adopting a public health approach
As outlined in the preceding section, SAPC to treatment and recovery that places
facilitates the delivery of a complex array of greater emphasis on prevention of AOD
alcohol and other drug (AOD) programs and through the systematic application of the
Substance Abuse Prevention and Control Strategic Plan | 15two: overview of substance abuse prevention and control
Institute of Medicine (IOM) continuum Key Strategic Issues
of care. The following has been extrapolated from
more detailed information to create profiles
In view of these and other developments in the
of SAPC, and the existing provider network,
AOD field, the current and future role of SAPC
and to identify significant trends that are
was assessed through input provided by the
affecting the AOD field. All of these were
SAPC stakeholder community as a part of the
used as a starting point for the development
strategic planning process. Highlights from
of the SAPC Strategic Plan.
this assessment include the following:
The road map resulting from the Strategic
• There are conflicting views on the pri-
Plan is required to address a number of
mary role and function of SAPC. Many
believe it exists primarily to distribute unresolved questions and issues concerning
funding and administer contracts for the impact of HCR on the existing
AOD services. Others believe it needs AOD prevention and treatment system.
to be more directly engaged in reducing Specifically, the following issues will need to
substance use and its impacts. be considered and resolved, when possible:
• Some argued that SAPC needs to bring
a systems perspective to a set of services The Present—Emerging Trends
that evolved incrementally over time by and Issues to Consider:
asking how it now can best rationalize • The way in which the existing system of
systems and processes to ensure delivery AOD prevention and treatment contract
of high quality substance abuse preven- providers interface with the primary
tion and treatment services in Los Ange- health care system will need to be deter-
les County. mined.
• Many believe that SAPC needs to do • It is not clear how many of the existing
more to prepare for the impact of health AOD contract providers will be able to
care reform by playing a more visible successfully adapt to the new health care
leadership role and engaging in a col- funding system, and to what extent it will
laborative planning process to develop a be the responsibility of SAPC to preserve
comprehensive and clear road map for the existing network.
the coming transition.
• The number of newly insured individuals
• A number of contracted service provid- seeking AOD treatment may dramatically
ers share concerns about how HCR will increase at the same time the supply of
change the way in which consumers seek qualified personnel available to provide
and ultimately obtain treatment. They treatment is reduced because they lack
are also concerned about the way in the necessary educational and profes-
which providers will obtain clients and be sional training now required in the new
reimbursed for services rendered. There system.
is a great deal of discussion about how
• The social model used by many of the
SAPC can function as a bridge in facilitat-
non-profit community-based-organiza-
ing this process.
tions may be at risk in the new funding
and institutional environment.
16 | county of los angeles department of public healthtwo: overview of substance abuse prevention and control
The Future—Providing AOD services • Ensuring contract monitoring is focused
under HCR on both prevention and the treatment
A picture is beginning to emerge of what the process and outcomes.
new AOD prevention and treatment system • Improving the level of performance
may potentially look like in the near future. among AOD service providers.
• The current move toward evidence-based • Updating reimbursement rates to ensure
practices as a foundation for perfor- they cover actual costs for providing AOD
mance management and performance- services and to provide more consis-
based contracting will be even stronger tency between providers. This is being
than it is now. addressed through a Rate Study that is
scheduled to be completed by Spring
• Most clients needing AOD treatment 2011.
will first go to a primary care physician.
Severe cases will be referred to AOD • Exploring the possibility of establishing
treatment specialists, possibly many that a master contract for all AOD services
are now SAPC-contracted providers. so providers can manage one contract
instead of multiple separate contracts for
• There will be greater integration of men- essentially the same services.
tal health and AOD treatment systems
and populations served, although this • Using the current contract rebidding
will require coordination and strength- process to reinforce a fair and competi-
ened efforts to integrate SUD treatment tive selection process for all AOD provid-
and primary care and mental health ers. The contract rebidding process will
services. also enable SAPC to fund innovative and
evidence-based programs and move for-
• SAPC and the contract provider network ward in its pursuit to improve participant
may still need to provide AOD treatment outcomes.
services for populations not covered by
HCR such as some indigent persons and • Finding sustainable ways to continue to
those in the criminal justice system. serve those in the criminal justice popu-
lation seeking AOD treatment through
Proposition 36, the Drug Courts and
Administrative Issues
other successful programs despite signifi-
The transition to a new system for the
cantly diminished funding.
prevention, treatment and recovery of
substance use disorders will provide SAPC
with an opportunity to effectively address
administrative issues:
Substance Abuse Prevention and Control Strategic Plan | 17three: strategic planning process
3 strategic planning process
SAPC DEVELOPED THE STRATEGIC PLAN groups and on-line surveys for both staff and
in three phases over a seven month external stakeholders.
period beginning in the summer of 2010.
SAPC staff selected sixteen stakeholders
Although facilitated by strategic planning
to participate in one-on-one telephone
consultants from MIG, Inc., the planning
interviews conducted by MIG consultants.
process was designed to directly engage
These individual stakeholders represented
SAPC management staff in developing the
a wide spectrum of perspectives concerning
core elements of the strategic plan. This
the current and future role of SAPC and
leadership team of twenty-five SAPC staffers
included contract providers, representatives
representing all divisions of the agency met
from other Los Angeles County agencies,
on a periodic basis to provide input, review
and experts in the AOD field. Results from
findings, and to shape the content of the
these interviews helped to gain information
strategic plan, as well as the future direction
that was subsequently enhanced via other
of the work to prevent and control substance
related outreach activities, including the
abuse.
focus groups and surveys.
During this same time period, the MIG
PHASE I—REVIEWING AND
consultants facilitated five focus groups at
ASSESSING THE CONTEXT
SAPC headquarters. Individuals in each
During the first phase, the MIG consultants,
of these focus groups participated in lively
in close collaboration with SAPC staff,
discussions that provided an opportunity
implemented a series of outreach activities
for in depth exploration of key issues facing
to scan both the internal and external
SAPC and the AOD field. Each focus group
environments of SAPC. These activities
of five to ten people represented a different
included stakeholder interviews, focus
stakeholder category, which encompassed:
Substance Abuse Prevention and Control Strategic Plan | 19three: strategic planning process
• SAPC staff PHASE III—DEVELOPING THE
• Los Angeles County Agencies that part-
PLAN OF ACTION
ner with SAPC SAPC staff held a forum at the beginning of
the third phase during which approximately
• SAPC Contracted Service Providers
100 stakeholders representing contract
• Adult Consumers of AOD services providers and other members of the AOD
• Youth Consumers of AOD services community had another opportunity to
participate in the strategic planning process.
The outreach process also included two During this event, stakeholders heard results
concurrent on-line surveys: an internal from the phase one outreach activities and
survey of SAPC staff and a second survey saw the initial version of the draft strategic
of external stakeholders. The survey was plan framework that was crafted, in part,
available during a two-week period. Both from those findings. Most important,
surveys extended the outreach process far stakeholders were tasked with identifying
beyond the number of interested individuals projects, programs, services and other
that could be reached through only the strategies they believed SAPC would need to
stakeholder interviews and focus groups. undertake to achieve the mission and goals
There were 181 individuals who completed of the emerging strategic plan.
the external stakeholder survey, most of
whom were contract providers. Another 137 In the weeks following the stakeholder
surveys were submitted by SAPC staff. forum, SAPC staff used these ideas as well as
their own deliberations to develop detailed
strategic action plans for each goal in the
PHASE II—DEFINING THE strategic plan. Each strategic action plan
DIRECTION provides more specific information on how
SAPC staff in collaboration with the MIG each goal will be achieved, including a set
consultants used findings from the first of objectives, strategies for achieving the
phase to help define a clear path forward for objectives, a projected timeline and assigned
SAPC in its efforts to meet the challenges lead and support responsibilities. SAPC staff
and opportunities created by HCR and the concluded the strategic planning process
other factors reshaping the AOD field. The with the identification and development of
primary product during this second phase performance measures to track progress
was the development of the Strategic Plan toward the achievement of each goal and its
Framework, consisting of values, vision, set of objectives.
mission and goals, which is presented in the
next chapter. The following chapters present the strategic
plan elements, which will be actively used to
guide SAPC over the next five years.
20 | county of los angeles department of public healththree: strategic planning process
PHASE I: PHASE II: PHASE III:
Reviewing and Defining the Developing the Plan
Assessing the Context Direction of Action
PROJECT LEADERSHIP
SAPC SAPC SAPC SAPC SAPC
Leadership Team Leadership Team Leadership Team Leadership Team Leadership Team
Meeting #1 Meeting #2 Meeting #3 Meeting #4 Meeting #5
COMMUNICATIONS
OUTREACH AND
Online Surveys
Stakeholder Stakeholder
Interviews Forum
Focus Groups
PRODUCTS
Document Asset Draft Action Draft Final Final
Review/ Memorandum Strategic Plans Strategic Draft Plan
Data Plan Plan Plan
Research Framework
JUL AUG SEP OCT NOV DEC FEB
Substance Abuse Prevention and Control Strategic Plan | 21four: strategic plan framework
4 strategic plan framework
THE 2011 SAPC STRATEGIC PLAN DEFINES The Plan Framework consists of the follow-
the future direction and priorities of the ing elements:
agency. The SAPC Strategic Plan will help
• Values express the beliefs and principles
guide decision-making, while facilitating
that guide SAPC and are the basis from
ongoing planning and implementation
which each staff member operates.
within the organization for years to come.
• The Vision describes the ideal future
SAPC is striving to create.
INTRODUCTION AND OVERVIEW • The Mission summarizes the purpose of
The core elements of the Strategic Plan and SAPC and the role it plays in achieving
the relationships between them are pre- the vision.
sented in the Strategic Plan Framework.
• Goals are broad statements of general
The one-page diagram on the following page
direction leading toward a desired end
is a graphic display of this Strategic Plan
state.
Framework, which offers a visual, high-level
overview of the SAPC Strategic Plan.
Substance Abuse Prevention and Control Strategic Plan | 23four: strategic plan framework
Substance Abuse Prevention and Control
Strategic Plan Framework
values
Leadership Integrity Expertise Excellence in Accountability
We share an inspiring We are dedicated, We have the Customer Service We share a
vision and clear honest, transparent knowledge, insight We are respectful, responsibility to each
priorities, we and trustworthy in and expertise to do culturally relevant, other, to the County,
anticipate future all that we do. what we do with and effective, and most essentially,
challenges, we take utmost quality and delivering excellent to those we serve,
action that affects professional rigor, service with dignity to realize results that
positive change and the commitment and compassion. make a profound
in the lives of to continually grow difference for people
individuals and their and improve. and the communities
communities, and in which they live.
in the County
as a whole.
vision mission
All people and communities in Los Angeles SAPC leads and facilitates the delivery of a full
County have a chance to pursue their dreams spectrum of prevention, treatment and
and to fulfill their promise without the burden recovery support services proven to reduce the
of alcohol or drug abuse and addiction. impact of substance abuse and addiction.
GOAL 1: System of Care
goals GOAL 4: Organizational Effectiveness
Implement a coordinated, accessible and Enhance operational capabilities and responsiveness
comprehensive system of evidence-based services through streamlined business processes, synergistic
for substance abuse disorders. teamwork and effective collaboration.
GOAL 2: Prevention and Promotion GOAL 5: Workforce Excellence
Inform, educate and empower communities to change Attract, develop and retain a high quality, adaptable
the social norms and community conditions that workforce that can provide leadership and enhanced
facilitate alcohol and drug use. productivity during changing conditions.
GOAL 3: Preparedness GOAL 6: Fiscal Accountability
Increase preparedness and readiness for health care Employ fiscal strategies and controls to ensure the
reform and for the identification and response to other most effective use of financial resources.
emergent issues.
24 | county of los angeles department of public healthfour: strategic plan framework
VALUES the priorities and values of the staff and its
The Values describe the basic behaviors, stakeholders.
attributes, principles and beliefs that guide
All people and communities in Los Angeles
all SAPC staff. The Values are the bedrock of
County have a chance to pursue their
SAPC staff attitudes toward their work, their
dreams and to fulfill their promise without
mission and their working relationships.
the burden of alcohol or drug abuse and
addiction.
Leadership
We share an inspiring vision and clear
priorities, we anticipate future challenges, MISSION
we take action that affects positive The Mission describes the main functions
change in the lives of individuals and their of SAPC and its role in achieving the Vision.
communities, and in the County as a whole. The Mission gives the overall charge and
purpose of the organization. All SAPC
Integrity activities relate to one or more aspects of the
We are dedicated, honest, transparent and mission statement.
trustworthy in all that we do.
SAPC leads and facilitates the delivery of
a full spectrum of prevention, treatment
Expertise
and recovery support services proven to
We have the knowledge, insight and
reduce the impact of substance abuse and
expertise to do what we do with utmost
addiction.
quality and professional rigor, and the
commitment to continually grow and
improve.
GOALS
A Goal is a statement of general direction,
Excellence in Customer Service
leading towards a desired end state; a “path
We are respectful, culturally relevant, and
of travel.” Each goal helps to answers the
effective, delivering excellent service with
two key questions: What do we want to
dignity and compassion.
achieve? How do we put our mission and
values into action?
Accountability
We share a responsibility to each other, to
System of Care
the County, and most essentially, to those
Implement a coordinated, accessible and
we serve, to realize results that make a
comprehensive system of evidence-based
profound difference for people and the
services for substance abuse disorders.
communities in which they live.
Prevention and Promotion
VISION Inform, educate and empower communities
to change the social norms and community
The Vision describes the ideal future that
conditions that facilitate alcohol and drug use.
SAPC is striving to create. The Vision reflects
Substance Abuse Prevention and Control Strategic Plan | 25four: strategic plan framework
Preparedness
Increase preparedness and readiness for Enterprise Metrics
health care reform and for the identification Alcohol related vehicle fatalities
and response to other emergent issues.
Emergency room submissions of
Organizational Effectiveness reported drug overdoses
Enhance operational capabilities and
responsiveness through streamlined Death rate from alcohol poisoning or
business processes, synergistic teamwork drug overdoses
and effective collaboration.
Percent of persons engaging in binge
drinking of alcoholic beverages
Workforce Excellence
Attract, develop and retain a high quality,
Percent of persons engaging in heavy
adaptable workforce that can provide drinking of alcoholic beverages
leadership and enhanced productivity
during changing conditions. Percent of strategies implemented
by 2016
Fiscal Accountability
Employ fiscal strategies and controls to ensure Unlike these goal-oriented metrics,
the most effective use of financial resources. achieving overall progress toward the
mission and vision of the organization
requires success across all these goals.
ENTERPRISE METRICS
Admittedly, enterprise metrics are also
All the core elements of the SAPC Strategic
attempting to encompass and assess
Plan are designed to work together to
progress in a complex public realm where
achieve the desired outcomes portrayed in
innumerable forces are at play, including
the Vision and Mission. Progress toward the
those beyond the reach of the organization
achievement of these system-wide beneficial
seeking to make a positive impact in this
results is best captured by a select number of
arena.
high-level performance measures referred to
as Enterprise Metrics. The enterprise metrics identified for the
SAPC Strategic Plan reflect key indicators
These agency-wide metrics are similar
of health tracked by DPH and other similar
in function to the performance measures
sources. These metrics will rise or fall in
associated with specific goals and objectives
response to multiple risk and protective
presented in the next chapter. The goal-
factors, many of which are outside the
oriented performance measures described
control of SAPC. Through its program and
in chapter five are designed to provide
services, however, SAPC is in a position
SAPC staff with the feedback they require
to influence these factors, which is an
to determine the extent to which progress
organizational responsibility it has accepted
toward each specific goal and its associated
as reflected by its vision and mission.
objectives is being made.
26 | county of los angeles department of public healthfour: strategic plan framework
RELATIONSHIP TO THE in the SAPC Strategic Plan complement and
COUNTY OF LOS ANGELES reinforce those elements within the DPH
DEPARTMENT OF PUBLIC Strategic Plan. These tables demonstrate
HEALTH STRATEGIC PLAN the alignment between the SAPC Plan
As an operating unit within DPH, the Framework and the vision, mission and
values, vision, mission and goals set forth strategic priorities of DPH.
TABLE 4A: Relationship of DPH Plan to SAPC Plan
DPH Strategic Plan SAPC Strategic Plan
Vision
Healthy People in Healthy All people and communities in Los Angeles County have a
Communities chance to pursue their dreams and to fulfill their promise
without the burden of alcohol or drug abuse and addiction.
Mission
To protect health, prevent SAPC leads and facilitates the delivery of a full spectrum of
diseases, and promote prevention, treatment and recovery support services proven
health and well-being. to reduce the impact of substance abuse and addiction.
TABLE 4B: Plan Strategic Priorities and Goals
DPH Strategic Priorities SAPC Goals
Strategic Priority 1: Goal 1: System of Care
Health Improvement Goal 2: Prevention and Promotion
Strategic Priority 3: Goal 3: Preparedness
Preparedness
Strategic Priority 4: Goal 4: Organizational Effectiveness
Organizational
Effectiveness
Strategic Priority 5: Goal 5: Workforce Excellence
Workforce Excellence
Strategic Priority 6: Goal 6: Fiscal Accountability
Fiscal Accountability
Substance Abuse Prevention and Control Strategic Plan | 27five: strategic plan goals, objectives and strategies
5 strategic plan goals, objectives
and strategies
THE PAGES IN THIS CHAPTER DESCRIBE Performance Measures define the category
THE BROAD, OVERALL DIRECTIONS SAPC or outcome that is monitored to assess
intends to follow to carry out its Mission progress toward the Objectives and the
and achieve the desired future described in overall Goal. They are the indicators SAPC
its Vision. These organizational priorities will rely upon to gauge the extent to which
are defined by six Goals as well as the issues it is achieving what the agency has set out to
and opportunities they address. In turn, accomplish.
the nature and scope of each Goal is further
defined and supported by the following Strategies describe how SAPC will
elements: accomplish these goals and objectives,
i.e., the methods, resources, processes, or
Objectives represent expected results or systems it will carry out or utilize to achieve
measurable targets that SAPC will need to success.
achieve in order to make progress toward
each Goal.
Substance Abuse Prevention and Control Strategic Plan | 29five: strategic plan goals, objectives and strategies
Goal 1 | System of Care
Implement a coordinated, accessible and comprehensive system of
evidence-based services for substance use disorders.
The development of a more integrated
system of care for prevention and treatment OBJECTIVE 1.1 By June 30, 2013, the
health and wellness of Los Angeles
issues is an overarching strategic goal that
County residents will be improved by
touches upon all the others. Over the past establishing a system of care that is
several decades the current AOD system anchored in the community and improves
in Los Angeles County grew organically accessibility of substance use prevention,
treatment and recovery maintenance
in response to each new federal and state
services.
funding initiative. During this period the
opportunity to design and develop a more OBJECTIVE 1.2 By June 30, 2015, the
Los Angeles County system of care will
coherent system for the delivery of AOD
be improved to provide comprehensive
services did not arise. services that supports recovery across
the lifespan, is person-centered,
Health care reform changes all that. A and culturally, linguistically, and age-
whole new way of delivering AOD treatment appropriate; addressing the needs of
services will emerge under HCR. This is unique populations, including persons
who are monolingual, youth, hearing
creating a rare opportunity to re-think
impaired or otherwise disabled, dually
and re-design the existing system of care. diagnosed, homeless, and diagnosed with
Although precise details remain uncertain, HIV/AIDS.
in the near future the existing network of
OBJECTIVE 1.3 By June 30, 2014,
AOD contract providers will interface with efficiency and effectiveness of substance
the primary health care system to a much use prevention, treatment and recovery
greater degree than now. SAPC will strive to maintenance services will be improved
through the use of practices and
build a bridge between the two systems. It
approaches that are based in research and
will facilitate the transition of the contract address emerging trends in the field.
providers to a network of care that offers
OBJECTIVE 1.4 By June 30, 2015,
clients a full array of medical services, while
Los Angeles County’s system of care
ensuring that a continuum of care for the will increase integration of services,
prevention, treatment and recovery of AOD connecting existing substance use service
remains firmly in place both during and delivery with mental health, primary care,
housing and private agencies to ensure
after the transition.
limited resources are available for indigent
persons.
30 | county of los angeles department of public healthfive: strategic plan goals, objectives and strategies
Objectives and Strategies for Goal 1: System of Care
OBJECTIVE 1.1 By June 30, 2013, the health and wellness of Los Angeles County residents will be improved
by establishing a system of care that is anchored in the community and improves accessibility of substance use
prevention, treatment and recovery maintenance services.
TABLE 5A: Objective 1.1 Strategies
Strategy Timeline Lead Support Partners
Strategy 1.1a Develop a protocol to update and 01/01/11 to CDP IS & PIO
maintain a community resource directory that lists 12/31/12
prevention, treatment and recovery services avail-
able throughout the County (see Strategy 4.2b
below).
Strategy 1.1b Identify and secure new funding Ongoing CPPE EO, CPS & PCQA
sources where possible and feasible.
Strategy 1.1c Ensure that treatment capacity and 07/01/11 to IS CPS & PCQA
availability countywide is incorporated into the 06/30/13
SAPC automated system identified in Strategy 4.1.
Strategy 1.1d Establish an independent gatekeep- 07/01/11 to CPS PCQA & CDP
er system that is responsible for patient movement 06/30/12
throughout the continuum of care.
Strategy 1.1e Establish a mechanism that assesses 09/01/12 to CPPE PCQA, CPS & IS
the capacity and geographic accessibility of services. 06/30/13
KEY: D – SAPC Director LACES – Los Angeles County
Evaluation System
AVRC – Antelope Valley Rehabilitation DPHF – Department of Public Health
Centers Finance ODT – Office of Organizational
Development and Training
CDD – Chief Deputy Director DPHHR – Department of Public Health
Human Resources PCQA – Program Compliance and
CDP – Contract Development and Quality Assurance Division
Processing Division EO – Executive Office
PIO – Public Information Officer
CEO-SIB – Chief Executive Officer ES – Executive Staff/Division Directors
Service Integrated Branch PS – Personnel Services Division
FAS – Financial and Administrative
CS – Chief of Staff Services Division PYS – Prevention and Youth Services
CP – Contracted Providers HCR WG – Health Care Reform RE – Research and Epidemiology Unit
Working Group
CPS – Community Program Services SP – Special Assistant
IS – Information Services Division
CPPE – Community Planning and
Program Evaluation
Substance Abuse Prevention and Control Strategic Plan | 31You can also read
