Transcript DCHS Substance Use Disorders Statewide Conference August

DCHS Substance Use Disorders
Statewide Conference
August 11-13, 2014
Hilton Orange County Costa Mesa
Al
California DUI Treatment System
History / Services / Costs
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Your Presenters
Bob Dorris
Retired, The High Road Program
CADTP Board of Directors
CADTP Counselor Certification Board
[email protected]
Barbara Aday-Garcia
OHS San Marcos
CADTP Board of Directors
[email protected]
Craig French
Twin Palms Recovery Center
CADTP Board of Directors
[email protected]
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History of DUI Treatment Services
Pre-Conviction Era

Prior to 1978 there was no formal DUI treatment system in California.

DUI program services were provided by a number of courts throughout the
State.

Individuals were referred by the court to the programs on a pre-conviction
basis.

Successful completion of the program (as developed by the provider) resulted
in the dismissal of the charge by the Court.

While these program services were for the most part very successful, There
was no uniformity of services.
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History [continued]

In 1978 the California Legislature mandated development of programs that would be designed to
reduce the high level of recidivism of individuals arrested and convicted of driving-under-theinfluence [DUI], endangering public safety by individuals consuming alcohol and drugs and driving
on California streets and highways.

The legislature passed Senate Bill 38 creating a post-conviction program and assigned the
Department of Alcohol and Drug Programs responsibility for developing regulations based on state
law, i.e. §11836 – §11837 of the California Health and Safety Code, and §23161 – §23181 of the
California Vehicle Code.

The initial focus of the legislature was on alcohol related offenses. Over the past thirty-six (36)
years, program services have evolved to focus on any type of DUI offense, i.e. alcohol, licit
[prescription] and/or illegal drugs.
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History [continued]

For over 25 years the California Department of Motor
Vehicles [DMV] has conducted annual outcome studies
on the effectiveness of the California DUI treatment
system in reducing recidivism.

The 2012 report from the DMV states that recidivism has
declined by 44.7% for 1st offenders and 46.4% for 2nd
offenders over the last 20 years.
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The DUI System Today

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
DUI programs are licensed by the Department of Health Care Services to
provide a less intensive level of outpatient alcohol and other drug treatment
services focused on improving public health and safety by reducing and/or
eliminating additional DUI offenses.
These services consist of education classes (prevention); individual and group
counseling sessions (intervention); and in some counties individual client
involvement in self-help programs to facilitate ongoing recovery from the
abuse of alcohol and drugs.
Consistent with state regulations DUI treatment is provided by alcohol and
other drug counselors certified under Chapter 8, Division 4, Title 9,
California Code of Regulations.
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The DUI System Today

DUI treatment programs collaborate with the Courts and the Department of
Motor Vehicles to ensure compliance with their summary or formal
probation requirements and prepare clients to regain their to drivers license
by successfully completing their DUI treatment program.

While program services are focused on refraining from operating an
automobile [or any mode of transportation] while under-the-influence, DUI
services also provide clients with a new understanding of their individual
responsibility to themselves, their families, and their community, and a
healthy new approach to their use of alcohol and drugs.
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Myth vs. Fact
Myth:
“DUI program providers are allowed to charge exorbitant fees and make
huge profits”.
Fact:
DUI program fees are approved and controlled by the
Department of Health Care Services and by law are
limited to earning a maximum 10% profit/surplus of
total DUI revenue
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Fee Structure
DUI treatment program fees are regulated under §9878 – Chapter 3, Division 4,
Title 9, California Code of Regulations. In part these regulations state:

The licensee shall charge only the program fee and any additional fees that have been
approved by the Department pursuant to this section of regulation. The licensee shall
not increase program fees unless a request has been submitted to the county alcohol
and drug program administrator and approved by the Department.

The program shall establish and use a standardized payment schedule, approved by the
Department in accordance with this subsection, to determine each participant's
assessed program fee and schedule for payment of fees.
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Myth vs. Fact
Myth:
“There is little or no oversight of DUI program providers and the statewide DUI
treatment system”.
Fact:
The California Department of Health Care Services licenses all DUI
treatment programs and regulates the delivery of services as
prescribed in Chapter 3, Division 4, Title 9, California Code of
Regulations, and provides analysts who conduct on-sight
compliance visits bi-annually. In addition, the County Alcohol and
Drug Administration of each county has responsibility to monitor
compliance of the DUI treatment programs within their county on a
consistent basis throughout any given year.
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Myth vs. Fact
Myth
“DUI treatment service providers receive state and/or county funding to provide
services to clients.”
Fact
California’s DUI treatment system is one hundred percent (100%) selffunded by program fees paid by the client.
From inception of the system in 1978, the State Legislature made it
mandatory that the system would be self-funded. That remains true today
… there is no tax-payer money funding the system and its services.
The DUI Programs collect participant fees for providing program services
plus fees to reimburse the State and County for their monitoring and
compliance auditing services as required by state law.
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Fee Structure

Clients pay as services are delivered.

Provisions are made in fees based on the client’s income and ability to pay.
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The regulations provide for clients who are unemployed and who are on county general relief
receive a substantially reduced fee.

Program profit or surplus shall not exceed

The program fee shall be set at a level sufficient to cover the cost of program services,
including each participant's share of personnel and operating expenses incurred by the
program in providing program services.
10% of gross revenue from fees per annum.
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Myth vs. Fact
Myth
“DUI Program Services are costly and a financial burden to the client.”
Fact
The actual cost of treatment services statewide ranges from a
low of $15.00/hour to $27.00 /hour of service, depending on the
level of program the client needs to complete, (shown below).
Program fees vary between counties, but all counties are within
fee ranges stated above.
Wet Reckless Program
3-Month Program
6-Month Program
9-Month Program
18-Month Program
30-Month Program
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DUI Program Services
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DUI Program Services

The DUI programs primary goal is to assist
participants to explore their relationships with
alcohol/drugs and the inherent risks involved

The desired result is modified drinking and/or drug
use in high-risk situations such as driving

Our programs provide counseling and education to
assist in reducing the recidivism rate of DUI offenders
Myth
Fact
DUI Programs are
Education not
Counseling
DUI Program Services
DUI Programs take a proactive stance in helping those with alcohol and/or
drug dependency problems make life-affirming changes.
DUI Programs recognize that substance use behavior exists along a
continuum, ranging from non pathological use at one end, to problematic or
substance abuse in the middle to chronic substance dependence on the other.
DUI services are designed to address this continuum of use through the
education, group and individual case management sessions.
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All AOD Treatment Programs have an
Educational Component and so do
DUI Treatment Programs

Orientation to DUI laws, Alcohol & Drug Impairment and the DUI
Program

Patterns Of Consumption, Chemical Dependency And Assessment

Medical Aspects Of Alcohol And Other Drugs

Social Aspects Of Alcohol And Other Drugs

Addiction And The Family

Recovery, Resources And Options For Change
Instructors are certified counselors who must
have 2 years of experience providing Alcohol and
Other Drugs Education.
DUI Program Levels
Wet Reckless Program:
Blood Alcohol Content under .08
 12 hours of education
3-month First Offender Program - 37.5 % education, 62.5% counseling
Blood Alcohol Content .08 and above




12 hours of education
10 hours of group counseling
3 individual sessions (face to face)
Eight additional hours of program services,
consisting of educational sessions, group
counseling sessions, or a combination of the two
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DUI Program Levels
6-month First Offender Program 26.7% education, 73.3% counseling
Blood Alcohol Content .15 - .19
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12 hours of education
28 hours of group counseling
Minimum of 4 individual sessions
Four additional hours of program services, consisting of
educational sessions, group counseling sessions, face-to-face
interviews or a combination of the three
9-month First Offender Program 19.1% education, 80.9% counseling
Blood Alcohol Content .20 and above
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12 hours of education
44 hours of group
Minimum of 5 individual sessions
Four additional hours of program services, consisting
of educational sessions, group counseling sessions,
face-to-face interviews or a combination of the three
DUI Program Levels
18-month Multiple Offender Program 15.4% education, 84.6% counseling
2 or more DUI’s in a 10 year period
 The first 12 months of the 18 month program
 12 hours of education,
 52 hours of group counseling
 1 individual session every other week.
 The last 6 months of the 18-month program includes up to
6 hours of services.
 Each program and/or county determines how to
structure the last 6 months of service
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DUI Program Levels
30-Month Multiple Offender Program 7.9% education, 92.1% counseling
3 or more DUI Offenses in a 10 year period
 1st 18 months = 12 hours of education, 78 hours of group counseling and
one face to face session every other week
 Last 12 months – DUI Program must continue to monitor compendium
of evidence, can credit some time towards last 12 months for residential
or in-patient AOD Treatment with court approval
Client must show a compendium of evidence, on a tri-monthly basis, of performance of
voluntary community service for one-half of the time served (not less than 120 hours and
not more than 300 hours, as determined by the court) demonstrating:
1. The prevention of driving-under-the-influence, promotion of safe driving,
and responsible attitude toward the use of chemicals of any kind.
2. Significant improvement in occupational performance (including efforts to
obtain gainful employment), physical and mental health, family relations,
and financial affairs and economic stability.
* Not available in all Counties in California
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Fact
Myth
DUI Counselors are not
Certified Alcohol &
Other Drug Counselors
Title 9 California Code of Regulations Staff Qualifications
DUI program staff who conduct educational sessions shall have a minimum of two
years of experience in providing alcohol and/or drug education and information to
persons with alcohol and/or other drug problems in a classroom setting or meet the
staff qualifications required in Section 9846(c) or Section 9846(f).
All DUI program staff who provide counseling services (as defined in Section
13005(a)(4)) shall be licensed, certified, or registered to obtain certification
pursuant to Chapter 8 (commencing with Section 13000) or meet the
qualifications required in subdivision (f).
DUI program staff who provide counseling services (as defined in Section
13005(a)(4)) shall comply with the code of conduct, pursuant to Section 13060,
developed by the organization by which they were certified or registered
Myth
Fact
DUI Programs Do Not
Provide Treatment
Individual Counseling Sessions
Face to face sessions address the following questions,
1. “Discuss and identify problems which may be barriers to program completion,
including progress in group and other counseling sessions.”
2. “Evaluate the client’s need for referral to ancillary services.”
3. “Discuss and encourage client attendance in educational and counseling
sessions.”
4. “Monitor payment of fees.”
A formal substance abuse assessment is conducted within 60 days from
enrollment, discussed with the client and appropriate referrals are provided and
documented.
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Objectives of individual and group counseling
1. To assist clients in recognizing and eliminating high risk behavior
associated with alcohol and drug use i.e. drinking and driving.
2. To provide clients with assessment and referral services to address
life management issues that impact healthy functioning and wellbeing.
3. To facilitate the reduction or elimination of alcohol or drug use as
appropriate.
4. To stimulate positive behavioral change resulting in increased wellbeing and functioning in major life areas.
Problem recognition
Taking responsibility
Self-regulation
Harm reduction
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The DUI Client
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A Preventable Tragedy
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WHO IS THE “TYPICAL" DUI CLIENT?
 The California DUI client is as unique and diverse as the State’s
population
 The California DUI client runs the full spectrum of cultural, ethnic, and
educational background.
 The DUI offenses occur with no respect to age or gender
 California DUI clients are from every walk of life and income level, i.e.,
students, blue collar workers, white collar workers, agricultural
businesses , small business, manufacturing, unemployed, health care
professionals, retirees and politicians
 The DUI clients participating in our program mirror the communities
we live in
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CALIFORNIA DEPARTMENT OF MOTOR VEHICLES ANNUAL REPORT OF
THE CALIFORNIA DUI MANAGEMENT INFORMATION SYSTEM 2013
2011 DUI ARRESTS
180,212
Race/Ethnicity
Number
Percentage
% California
Population
White
71,817
39.9%
39%
Hispanic
77,257
45.9%
38.4%
Black
15,076
8.4%
6.6%
Other
16,062
8.95%
15.8%
California Population 2013 = 38,332,521
DUI Arrests 180,212 = .0047% of population
1 out of approximately 212.70 people are
arrested for DUI
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2011 DUI ARRESTS
180,212
Gender
Male
Female
Number of
arrests
137,866
Percentage
of arrests
76.5%
% California
Population
49.7%
42,346
23.5%
50.3%
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2011 DUI ARRESTS
180,212
Male
Female
Average Age
33.7 years
33 years
White
Hispanic
Black
Other
35.6 years
31.5 years
35.7 years
31.9 years
Average age is 34 years
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All DUI Clients are Alcoholics
or Addicts
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What we know as providers of DUI services is that our
clientele run the full spectrum regarding use/abuse of
alcohol and drugs.
Some clients do not have a substance use disorder and
others may require additional services to address
addictive behaviors.
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DUI Providers have a
Singular Mission to Provide
DUI Services Only
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DUI Programs are mandated by Regulations to “Evaluate
the client’s need for referral to ancillary services”
The referral to ancillary services are based upon the
clients assessed needs. i.e. an appropriate level of AOD
Treatment, medical issues, food bank, financial
assistance, etc.
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How Clients Fit into DHCS’S
Continuum of Care
DUI Programs are:
Prevention, Assessment , Early Intervention, and Treatment
Approximately 150,000 court ordered DUI participants per year are provided
support for positive changes in life style to facilitate reduction or elimination
of alcohol/drug problems by the DUI Program Providers.
This is accomplished through the AOD education, group and individual
counseling session , the assessment of their substance use/abuse and the
evaluation of the participant’s need for referral to ancillary services.
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Napa
Referrals to Ancillary Services
FY 11-12
#
Services
# referrals
%
1 Napa County Alcohol and Drugs Services
12
12%
2 Tobacco cessation (Take charge)
30
30%
3 AA/NA (12 Step Programs
4 Clinic Ole- Behavioral services
25
25%
6
6%
5 HHS Mental health Services
6 Residential Treatment programs
5
5%
9
9%
7 Dental Services (Clinic Ole)
1
1%
8 Other*
11
11%
99
100%
Total Referrals
Napa
Referrals to Ancillary Services
Fiscal Year 12-13
* Job Connection,ParentCan, Goodwill, Meals on Wheels, CMSP, FS, IHSS,
#
Services
Total
%
1 Napa County ADP
10
8%
2 Tobacco cessation
30
24%
3 AA/NA (12 Step Programs
30
24%
4 CO- Behavioral services
5
4%
5 HHS Mental health Services
3
2%
6 Treatment programs
10
8%
7 Centro Legal la raza
20
16%
8 Carecen
15
12%
9 CO-Dental Services
1
1%
#
3
2%
127
100%
Other*
Total Referrals
*Other: Divorce lawyer, Domestic Violence Program, Care giver support
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Summary of DUI Services

Alcohol and drug outpatient treatment and education services

1st stage treatment program – primary gate keeper

Prevention specialists, education, assessment

Intervention

Continuum of care

Totally self-funded

Effective at reducing recidivism

Protect public safety
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A Successful Client
=
A Safer Community
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