Selected Projects: Policy Development

Performance Based Purchasing in the Delaware Substance Abuse Treatment System:
Deni Carise, Ph.D.
A performance based purchasing system for substance abuse treatment services was developed by the State of Delaware with assistance from TRI investigators. Team members helped State officials and treatment providers introduce a performance-based contracting system rewarding providers able to increase capacity utilization and rates of retention in treatment. (See follow-up project under Research and Evaluation, below.)

Reducing Paperwork Burdens of Outpatient Treatment Providers in Delaware:
Deni Carise, Ph.D.
As part of a NIDA-funded grant to expand Delaware’s performance monitoring/contracting procedures over four phases (see study description under Research & Evaluation, below) TRI completed a systematic evaluation of the multiple competing data collection demands placed upon state-funded outpatient treatment providers. TRI’s recommendations were adopted and resulted in decreases in paperwork burden at admission, during ongoing treatment and at discharge. The group is now in the process of evaluating the amount and nature of time saved as well as any changes in care as a result of the modifications.

Selected Projects: Research and Evaluation

Concurrent Recovery Monitoring in Delaware: Deni Carise, Ph.D.
In this NIDA R21 Exploratory Grant, Dr. Carise is collaborating with Delaware agency staff and outpatient treatment providers to extend the performance-based contracting system already in place. During the two-year pilot project the team: 1) completed a systematic evaluation of the “paperwork burden” in each treatment program with the goal of removing unnecessary and burdensome requirements and consolidating others; 2) selected a small number of additional performance indicators for regular collection within the existing outpatient performance monitoring/contracting system; 3) will pilot test the data collection, recording and reporting procedures for these additional CRM measures to assess their feasibility and their usefulness to the treatment programs; and 4) will use the results of this work to submit further proposals to evaluate evidence-based practices and to further develop the statewide CRM system.

Betty Ford: Focused Continuing Care; Deni Carise, Ph.D.
An existing extended care model, “Focused Continuing Care” or “FCC” has been standardized to simplify training and improve client engagement. The frequency of post-discharge telephone contact was increased with more emphasis on follow-up contact rates. Other changes engage clients and their families in the recovery process by providing graphic reports illustrating clinical progress and “next steps” toward recovery. Development of a data collection/reporting infrastructure allowing Betty Ford counselors to assess results of future FCC changes is underway.

Computer Assisted System for Patient Assessment and Referral (CASPAR): Bucks, Delaware and Montgomery Counties: Deni Carise, Ph.D.
This NIDA-funded study is a replication of a previous study in Philadelphia that found that with brief training on CASPAR, 1) counselors developed treatment plans that were better matched to patient needs; 2) patients received more and better matched services, and 3) patients stayed in treatment longer and were more likely to complete the full course of treatment. The five-year study, now in itss second year, seeks to enroll 20 treatment programs, at least 40 counselors and 400 patients into the two Phases of the study. More on CASPAR. In Phase I, approximately 40 counselors drawn from all adult, abstinence-oriented outpatient treatment programs will be trained to administer the ASI. TRI will review ASIs and completed treatment plans for five clients from each recruited counselor. In Phase II, counselors will receive either a three-hour CASPAR training or a three-hour ASI Booster Training. TRI will follow all clients from Phases I and II at 2, 4, 8 and 12 weeks post admission using the Treatment Services Review to measure the number and types of services received. At six months post admission, TRI will administer the ASI and TSR, along with the Helping Alliance Questionnaire, saliva drug screen, and breathalyzer. Data from clients will be compared between counselor groups to assess replication of previous study findings and to assess the effects of CASPAR training compared to ASI training only.

Computer Assisted System for Patient Assessment and Referral (CASPAR): South Jersey: Deni Carise, Ph.D.
A replication study similar in methodology to the Bucks, Montgomery and Delaware Counties study is funded by NIAAA to evaluate the CASPAR training and resource guide in South Jersey, with primarily alcohol dependent clients.