Project Description
Understanding the Impacts of Funding Volatility on Treatment Services
PI:Patricia Ebener
Funded by:Robert Wood Johnson Foundation
As California’s most recent fiscal crisis began in 2001, advocates for substance abuse treatment once again rallied to defend the already limited public resources for alcohol and other drug treatment services. In addition to periodic cutbacks and increases due largely to federal and state economic conditions, California has experienced other sources of volatility in funding for substance abuse treatment over the past two decades, resulting from policy decisions to prioritize access to treatment for one population or another in the competition for the limited treatment dollar.
The programs that comprise the services infrastructure at the local level throughout California’s 58 counties must adjust to the periodic cutbacks; compete for the unpredictable new resources; and retool quickly to meet the needs of different populations with new or improved access to treatment. How the capacity of the system responds; how much utilization increases for the newly targeted groups and likewise increases or displaces other users; and how the quality of care is affected in the aftermath of these shifts is largely unknown. The County Alcohol and Drug Program Administrators Association of California (CADPAAC) asked RAND’s Drug Policy Research Center (DPRC) to design and conduct a study of the impacts of funding volatility on treatment services. We propose a joint study with the Alcohol and Drug Policy Institute, a research and advocacy partner with CADPAAC, to provide improved information to local and state policymakers facing difficult choices in the present economic crisis in California and to provide forecasting tools to help plan ahead for future changes in treatment resources.
In this project, we will describe the policy and economic influences on treatment funding in California over the time period from 1990-2004. We will inventory all major sources of public funding and link funding levels and changes therein to various indicators of treatment system capacity and utilization, including indicators of quality of treatment services. Multivariate models will shed new light on the complex relationships between funding and services, while qualitative analysis of data collected from five unique counties will assist us in understanding (1) the process of implementing funding shifts at the local level; and (2) the measurement error that might remain in the quantitative models that are estimated.
The proposed project is a collaboration between RAND’s Drug Policy Research Center (DPRC) and CADPAAC/ADPI. Dissemination efforts will include those that RAND traditionally employs to distribute the results of its policy research to academic and policy audiences, but will be supplemented with ADPI’s efforts to bring the research to its constituents throughout California and to advocate for changes in programming suggested by results from the survey. RAND and ADPI each bring valuable experience to this effort, from very different perspectives, making this a well-qualified collaboration. Both organizations share a mission of improving public policy and decision making, and both have successfully mobilized multi-agency partnerships. CADPAAC members in policy making positions in California counties have endorsed our proposal and will provide advice and access to the study team. Moreover, they will carry the findings from the research into the policy making arena in California. Combined, we bring the needed resources to design, conduct and effectively disseminate the results of the study.
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