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Public Sector Workgroup Description

The Washington Sector Public Sector Workgroup was formed by CSAT/SAMHSA in 2004 with a goal of adapting the Washington Circle AOD performance measures that were developed in the commercial sector for use in the public sector. The Workgroup focuses on improvement of delivery of substance abuse treatment services in the public sector, using common measures and methods among states for continuous quality monitoring. The Workgroup currently includes 12 states: Arizona, Connecticut, Delaware, Kansas, Massachusetts, New York, Nevada, North Carolina, Oklahoma, Tennessee, Vermont, and Washington.

SAMHSA has supported the performance measure specification and pilot testing activities through the Brandeis/Harvard National Institute on Drug Abuse (NIDA) Center. Researchers at the Institute for Behavioral Health in The Heller School for Social Policy and Management, Brandeis University have collaborated with other Workgroup members in these activities.

Activities of the Public Sector Workgroup are accomplished through monthly conference call and face-to-face meetings twice a year. The activities that lead up to the 2006 pilot test began with an initial meeting in May of 2005 in Washington, D.C. This meeting included WC Policy members and state agency directors or research directors. The group explored the data availability for calculating the WC measures in each of the participant states.

Issues pertaining to the appropriate denominator for the identification measure and which service codes to allow to quality for the initiation and engagement measures lead to the formation of two committees: denominator committee and HCPCS coding committee. The goal of the identification committees was to explore ways of developing the denominator for the identification measure since the public sector treatment system does not have an enrollment membership as in the commercial sector. The goal of the HCPCS coding committee was to develop a list of HCPCS codes that guide users of the WC measures as to which would qualify for identification, initiation, and engagement.

A second face-to-face meeting took place in December of 2005 which included state agency directors/research directors and technical representative with expert knowledge of the data in participant states. Plans for the pilot test were discussed and the Workgroup came away from this meeting with a clear idea of a specific set of descriptive statistics to calculate that would guide the revision of the specifications for the measures as applied to the public sector. The Workgroup decided to expand the original three WC measures of identification, initiation, and engagement to 10 measures.

In June of 2006, a third meeting of the Workgroup came to consensus on refining the WC measures. Key decisions included separate measures calculated by level of care (e.g., outpatient, residential, detoxification) and finalizing specifications for the 10 measures in preparation for the pilot test.

In the fall of 2006, six states that are members of the Workgroup pilot tested the Washington Circle measures for adults and five states tested the measures for adolescents using specifications that the group had revised for use in public sector. Results of the pilot were presented at a November 2006 meeting, including detailed specifications for calculating the WC measures and a comparison of the measures from the WC and the Network for the Improvement of Addiction Treatment (NIATx). Presentations that resulted from this work are:

Obtaining and Working with Data from Multiple Agencies: What You Need to Know Before Attempting This!

Washington Circle Public Sector Workgroup: Pilot Test for Adolescents

Are Washington Circle Performance Measures Associated with Decreased Criminal Activity Following Treatment?