OASAS Statewide Comprehensive Plan 2008-2012 - Co-occurring disorders

In Chapter II of the OASAS Statewide Comprehensive Plan 2008 - 2012, these is a system's overview of various characteristics of the population in treatment in New York State in 2007. Here is a bar chart of the percentage of patients who had co-occuring psychiatric disorders with their substance abuse disorders.

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Interestingly, while the Statewide average percentage outside of New York City appears to be about 37-38 %, at GCASA the percentage of clients with psychiatric disorders was 38% and in Orleans County it was 38.7%. The community residence population in New York State outside of New York City was about 32% while at GCASA's Atwater Community Residence it was only 10.9% and about the same in GCASA's Supportive Living Program. I wonder if the data is accurate.

At any rate, in GCASA's outpatient programs a little more than 1/3 of our clients have had, or have, psychiatric problems.

Video lasts 3:29.

OASAS Statewide Comprehensive Plan reports primary substance of abuse at admission

What do you suppose the biggest substance of abuse is in New York State requiring treatment by OASAS licensed programs?

I'll give you a hint. It's legal.

The OASAS plan doesn't get it right. Because the correct answer is tobacco. However, not until this year has OASAS systematically addressed the problem of nicotine addiction.

So, the OASAS plan reports that the primary substance of abuse at admission is alcohol.

No other drug or substance comes even close. The next closest is opiates, then cannabis, and then cocaine and crack, and then other drugs.

Here is a table that outlines the data.

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GCASA's data is very similar although GCASA has been asked to provide service to increasing numbers of people struggling with dependence on opiates. It is expected that opiate addiction will continue to be a growing problem, and GCASA has developed a new Opiate treament program to specifically help manage the problems which opiates cause for people. (To learn more click on the videos on this blog under Cheryle McCann.)
This is article # 9 in a series on the OASAS Statewide Comprehensive Plan

OASAS Statewide Comprehensive Plan reviews history of services by sex

In Chapter II of the OASAS Statewide Comprehensive Plan 2008-2012 entitled "System Overview" there is a bar chart on page 9 which displays the admissions to OASAS licensed program across New York State by sex. In general about 75% of patients treated for substance abuse problems are male and 25% are female.

In out patient treatment the ratio is 72% male, 28% female, and in residential services it is 77% to 23%.



In 2007, 27% of GCASA's 1,159 admissions were female in its outpatient and residential programs combined which is higher than the state average. I believe the reason for this may be that GCASA has specialized services for women and try to deliver substance abuse services in a gender competent way appreciating the unique differences in needs between males and females.

This is article #8 in a series on the OASAS State Comprehensive Plan 2008 - 2010.

OASAS Statewide Comprehensive Plan provides information on the system overview - People served

In the OASAS Statewide Comprehensive Plan 2008-2012, chapter 2 is entitled "System Overview".

In 2007, approximately 258,000 unique individuals were served in OASAS certified programs with the largest number, 164,818 served in outpatient programs while the rest were served in crisis, Methadone, Inpatient and Residential programs.

Here is a graph which depicts the numbers in a graph.

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In 2007, GCASA had 1,057 unique individuals admitted to its outpatient services in addition to clients already being served. In 2007 at GCASA outpatient clinics and satellites served 2,236 unique people with 27,436 treatment visits.

In addition, in 2007 GCASA admitted 102 people to its Atwater and Supportive Living Programs and provided over 14,000 bed days.

GCASA is very efficient and effective in its operation achieving good outcomes, cost efficiently, with good customer satisfaction. GCASA is proud to be a part of the New York State Office of Alcoholism and Substance Abuse system of care.

OASAS Statewide Comprehensive Plan acknowledges that there are significant concerns about healh insurers denial of claims

In the first part of the OASAS Statewide Comprehensive Plan 2008-2012 there is a section on public input. It is noted on p. 6 of the plan that there were what the plan describes as "significant concerns" about health insurers denying claims for treatment for insured patients. Here is what the plan says:

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It certainly has been the experience at GCASA that "managed benefits" have made it very difficult not only for clients to access care but for counselors to develop and implement a service plan without taking into consideration how the needed services will be paid for. Counselors often spend more time brokering benefits with insurance companies than they do providing clinical services for their clients. This type of micro managing of benefits is extremely costly to the system.

OASAS planning dialogues for Statewide Comprehensive Plan highlight system issues

As part of the needs assessment process which OASAS engaged in to develop its Statewide Comprehensive Plan 2008 - 2012, OASAS held meetings with various providers, county staff people, and constituency groups. 73 people particpated in Albany, NY, and 62 additional people participated in that meeting via video conference from NYC. Another 40 watched the webcast.

The common themes that emerged from these dialogues have been known to the field and to GCASA for years and include topics such as regulatory relief/paperwork reduction, insurance coverage issues, staffing problems and service delivery issues.

It is interesting that a special note is made of low salaries and poor benefits in the field especially when nonprofit salaries are compared to salaries and benefits of county and state employees. GCASA has lost many well qualified and trained staff over the last 5 years on a regular basis to State employment where staff can make much more money and get better benefits.

Here is what it says in part on page 5 of the plan document.

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Provider feedback to OASAS descibed in OASAS Statewide Comprehensive Plan 2008-2012

During the summer of 2007 OASAS staff and consultants contacted all 1,550 OASAS licensed programs in New York State to ask for feedback and input on how the addiction treatment and prevention system could be improved. I (David Markham) was interviewed on the telephone by a consultant and answered her questions as accurately and completely as I was able. Here is a description of that effort in the OASAS Statewide Comprehensive Plan Report 2008 - 2012.

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This is article #4 on the OASAS Statewide Comprehensive Plan 2008-2012

OASAS Statewide Comprehensive Plan 2008 - 2012 affirms importance of collaboration across systems

It is affirming to read that OASAS like GCASA believes in cross systems collaboration. GCASA's mission has been for years "to improve community health, reduce stigma towards people with substance abuse disorders, and to work across systems for positive community change."

The third part of GCASA's mission is celebrated every year at the annual awards dinner in the fall where we publically acknowledge our collorative partners and all those who work to improve the quality of life in our communties of Genesee and Orleans. Throughout the year GCASA staff works collaboratively with community partners to improve the quality of life in the communities we serve.

Over many years, GCASA has developed many important partnerships with the criminal justice system, the school system, the health care system, the public welfare system, the faith based community, community nonprofits, youth serving agencies, civic organizations, business, and government.

It is very validating to finally find a state agency, OASAS, which recognizes and supports these collablorations. For too long bureaucracies have been rigid and funding has been rigidly categorical constraining creative partnerships.

Here is what it says about collaboration in the OASAS comprehensive plan on page 3.

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This is article #3 in a series on the OASAS comprehensive plan

Extent of addiction problem in New York State

In the beginning of the OASAS comprehensive plan, on page 1, there is description of the extent of the addiction problem in New York.

Here's a little pre-test. See how well you do.

1. How many New Yorker's suffer from a substance abuse disorder or problem gambling?

A. 1 in 3
B. 1 in 20
C. 1 in 50
D. 1 in 7

2. What percentage of the adult population in New York State has a gambling problem?

A. 1 1/2 %
B. 5%
C. 10%
D. over 15%

3. Among teenagers 12 - 17 problem gambling affects:

A. 1 in 4
B. 1 in 7
C. 1 in 10
D. 1 in 17

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This is article #2 on OASAS comprehensive plan.

2008 - 2012 OASAS statewide comprehensive plan issued on October 1, 2008

On October 1, 2008, OASAS issued its 2008-2012 Statewide Comprehensive Plan. You can access it by clicking here.

I will be posting a series of articles on GCASA Cares of nuggets of information which I glean from the report.



This is article #1 on the OASAS comprehensive plan.