The San Francisco Treatment on Demand (TOD) initiative was designed to increase the Department of Public Health substance abuse treatment budget over time, and to do so by increasing county government support. The use of these funds was guided by a community planning process in which a range of treatment needs were identified and prioritized for funding. To evaluate how system capacity and utilization changed in response to the TOD initiative, we reviewed county budget documents and substance abuse treatment admission records for four fiscal years (FY 95-99). TOD began in July 1997 therefore this four-year period includes 2 years preceding and 2 years following the onset of TOD. In this period the county budget supporting publicly funded treatment increased from 32 million (FY 95-96) to 45.2 million dollars (FY 98-99), a 42% increase. Most of this increase is directly attributable to an increase in local funding, and reflects a substantial and sustained commitment on the part of local government to increase treatment availability. During the same four-year period, both the number of admissions and the number of persons entering the system increased by 19% and 10%, respectively, in any single year. While the increases in numbers of persons served and number of admissions provided are impressive, they are smaller than the increase in funding, due in part to the time required to translate allocated funds into actual treatment services. This analysis demonstrates both the promise of and the challenges associated with local efforts to dramatically increase substance abuse treatment funding.
Learning Objectives: 1. Identify Treatment on Demand as model to increase publicly funded substance abuse treatment. 2. Assess the relationship between increased public budgetary support and access to care. 3. Discuss the challenges associated with local efforts to increase substance abuse treatment funding
Keywords: Access to Care, Utilization
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.