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APHA Scientific Session and Event Listing

Elspeth M. Slayter, PhD, MSW, School of Social Work, Salem State College, 352 Lafayette Street, Academic Building, Salem, MA 01970, 617-686-6594, eslayter@comcast.net

Since the de-institutionalization era, people with mental retardation (MR) have experienced increasing levels of participation in community life, including access to alcohol and other drugs. Several decades into this social experiment, little is known about access to substance abuse (SA) treatment for this population, although most research suggests that males with MR are more likely to experience SA. Using a cross-sectional design, prevalence and SA treatment utilization (access, initiation, dropout, engagement) were examined by analyzing administrative claims for Medicaid beneficiaries aged 12-99 with and without MR. Using performance measures developed by the Washington Circle and further adapted by the National Committee on Quality Assurance for inclusion in HEDIS, 599,658 people with SA were identified. 24.5% of people with MR initiated treatment and 52.6% engaged in treatment, both of which were statistically lower rates than for people without MR. Regardless of MR status, females were less likely to access treatment. Predictors of access, initiation dropout and engagement derived from multivariate logistic regression analysis are presented. Medicaid, a major source of health coverage for people with MR, also pays for up to 20% of SA specialty treatment nationwide. Increased levels of SA treatment initiation and engagement are predictive of treatment retention, which is in turn linked to better recovery outcomes, indicating an areas for improvement with service provision to women with and without MR. Implications relate to how existing systems provide SA-related care to women and areas in which improvements in access to and quality of SA treatment are needed.

Learning Objectives:

• To assess the prevalence of substance abuse among female Medicaid beneficiaries with and without mental retardation across the lifespan
• To apply a set of substance abuse performance measures to females with and without mental retardation through their application to Medicaid administrative claims data
• To identify predictors of substance abuse treatment access, dropout, initiation and engagement among female Medicaid beneficiaries with and without mental retardation across the lifespan

Keywords: Access and Services, Substance Abuse Treatment

Presenting author's disclosure statement:

Not Answered