Taking ACTION in California: Adopting Changes in Addiction Treatment

Five multi-county ACTION Campaign/NIATx Learning Collaboratives have been established in California as part of the “Adopting Changes in Addiction Treatment” project. 

The one-year project, funded by the California Endowment, includes 173 agencies or programs providing substance abuse and behavioral health treatment services in 49 of the state’s 58 counties.

Beth Rutkowski, Associate Director of Training and Epidemiologist for UCLA Integrated Substance Abuse Programs/Pacific Southwest Addiction Technology Transfer Center, led the project. Partners included NIATx and the County Alcohol and Drug Program Administrators’ Association of California (CADPAAC). CADPAAC is a non-profit organization comprised of the designated county alcohol and drug program administrators for all California counties.

“Initially, we hoped to recruit at least one treatment program from 20 counties,” says Beth. “However, the response was so positive that we did not want to turn anyone away.”

A county alcohol and drug program administrator in each of the five regions assisted Beth in recruiting counties and individual agencies for the collaborativies. “They served as intermediaries between the project team and the counties, helping to recruit providers and organize the project’s meetings.”

Each collaborative launched with a free day-long NIATx training for providers. With two free meals and continuing education credit, the workshops were very attractive to organizations facing shrinking training budgets.

ACTION Campaign Director Kim Johnson joined Beth to facilitate kick-off meetings in three regions, while NIATx coach Don Holloway assisted with the kick-off meetings in the remaining two regions.

Six months of coaching calls followed each kick-off meeting. “We discussed the Promising Practices that the NIATx Provider Toolkit recommends. The calls provided a forum for agencies to share their experiences and success stories,” comments Beth. “It was a great opportunity for providers to learn from each other.”

As an example she cites San Luis Obispo County Drug and Alcohol Services. Their walk-through exercise helped them identify problems with the intake process: requiring clients to read and sign multiple pages made for a lengthy intake. “They completely revamped their intake packet to include a single signature page,” explains Beth.

That change saved a significant amount of time. After hearing about the change on a conference call, several other agencies wanted to try it as well.

The result, notes, Beth, is that the collaboratives are creating a set of promising practices unique to the state, “since what works in other states may not work in California.”

Another positive outcome of the project was the business case for process improvement. The results of a recent online evaluation survey of the Adopting Changes in Addiction Treatment project shows that 67 percent of the respondents reported improved services and increased agency revenue by making the changes the ACTION Campaign II recommends.

Notes Beth, “Many of the agencies focused on client engagement and tested promising practices such as reminder calls. With increased admissions leading to increased billing, these agencies were able to save money and continue to improve customer services, even in the midst of California's budget crisis."

While the project ended on October 31, 2009, the regional collaboratives remain an active component of the NIATx ACTION Campaign II. And, beginning in January 2010, the Pacific Southwest ATTC will offer two monthly regional learning collaborative interest calls for participants wishing to report on their progress and receive ongoing coaching support. For more information, please contact Beth Rutkowski at brutkowski@mednet.ucla.edu.