Division of Behavioral Health Services
Annual Report on Substance Abuse
Treatment Programs
Fiscal Year 2011
Submitted Pursuant to A.R.S. §36-2023

Report Contents

 Program Names and Locations
 Client Demographics
 Program Funding
 Summary of Available Services
 Problems Addressed
 Treatment Outcomes
 Goals for the Current Fiscal
Year
Report Highlights

 93.4% of treatment recipients
were adults

 44.6% of treatment recipients
were located within Maricopa
County
 16% of treatment recipients
were referred to treatment by
the criminal justice system
 38% of all treatment recipients
cited alcohol as their primary
substance type; however, Marijuana was the primary substance abused by 77% of children/adolescents in treatment
 19% of treatment recipients had
a co-occurring Serious Mental
illness

December 31, 2011

Introduction
The Arizona Department of Health
Services, Division of Behavioral
Health Services (ADHS/DBHS)
has conducted an assessment of
its substance abuse treatment
programs in accordance with the
requisites outlined in Arizona Revised Statutes (A.R.S) §36-2023
(C)(6). This report includes information related to service types
and geographic locations, funding

sources and expenditures, numbers of clients served with their
corresponding demographic information and substance use patterns. A review of treatment outcomes, including changes in employment, educational participation, criminal activity, homelessness, and substance use is also
included, along with programmatic
goals for the current fiscal year.

Name and Location of Each Program
ADHS/DBHS serves as the Single
State Authority on substance
abuse, providing oversight, coordination, planning, administration,
regulation and monitoring of all
facets of the public behavioral
health system in Arizona.

Tribal Regional Behavioral Health
Authorities (TRBHAs), are contracted to operate as managed
care organizations in six distinct
geographic service areas (GSAs)
throughout the State (see map).

The T/RBHAs are required to
Four Regional Behavioral Health maintain a comprehensive netAuthorities (RBHAs), and three work of behavioral health providers to deliver prevention, intervention, treatment and rehabilitative
services to individuals
enrolled in the public
behavioral health system.
This structure allows
communities to provide
services in a manner
appropriate to meet the
unique needs of individuals and families
residing within their
local areas.

Arizona Department of Health Services
Division of Behavioral Health Services
150 N 18th Avenue, Suite 200
Phoenix, AZ 85007

1

Enrollment and Demographics
Table 1: FY 2011 Enrollment Distribution
Tribal / Regional Behavioral Health Authority
(Geographic Service Area)

Number of Enrolled
Substance Abuse
Clients

Percentage of Statewide
Substance Abuse
Population

Apache
Coconino
Mohave
Navajo
Yavapai

Northern Arizona Regional Behavioral Health Authority
(NARBHA - GSA 1)

11,467

16.8%

La Paz
Yuma

Cenpatico Behavioral Health of Arizona (GSA 2)

2,078

3%

Cochise
Graham
Greenlee
Santa Cruz

Cenpatico Behavioral Health of Arizona (GSA 3)

2,291

3.4%

Gila
Pinal

Cenpatico Behavioral Health of Arizona (GSA 4)

3,310

4.9%

Pima

Community Partnership of Southern Arizona
(CPSA - GSA 5)

15,633

22.9%

Maricopa

Magellan of Arizona (GSA 6)

30,417

44.6%

TRBHA: Gila River Indian Community

624

0.9%

TRBHA: Pascua Yaqui Tribe

636

0.9%

TRBHA: White Mountain Apache Tribe of Arizona

190

0.3%

1,489

2.2%

Counties

IGA: Navajo Nation

and ethnicity, gender, financial status and reasons
for seeking treatment. The following paragraphs
present this information for those clients with a
Substance Use Disorder (SUD) enrolled in Arizona’s behavioral health system during Fiscal Year
2011. The sidebar on page 3 also details consumer demographics for the statewide system.

Enrollment
In Fiscal Year (FY) 2011 there were 68,135 consumers enrolled in Arizona’s public behavioral
health system for substance abuse treatment; the
number of enrolled decreased by 2.9 percent between 2010 and 2011. Table 1 shows enrollment
counts throughout the State’s various service areas
of Magellan, the Community Partnership of Southern Arizona (CPSA), the Northern Arizona Regional Behavioral Health Authority (NARBHA), and
Cenpatico Behavioral Health Services, as well as
the Gila River Indian Community, the Navajo Nation, Pascua Yaqui, and White Mountain Apache.

Gender
Whereas the overall behavioral health population is
divided nearly evenly between males and females,
the substance abuse population is comprised of
more men than women—56.4 percent versus 43.6
percent, respectively. Males outnumbered females
in all regions of the State, with the exception of the
Gila River Indian Community, where females made
up 54.8 percent of those in substance abuse treatment. This was attributed to the focus Gila River
has placed on gender specific services for female
methamphetamine users at their Center of Excellence, and their increased outreach to these individuals in need of services.

Approximately 93 percent (63,674) of the substance abuse treatment population were adults,
ages 18 and over; 43 percent of all adult clients
were enrolled in Magellan, followed by CPSA and
NARBHA. Similarly, Magellan accounted for 46
percent of the children/adolescents in substance
abuse treatment.
Demographics
Division policy requires that all behavioral health
clients undergo a clinical assessment, administered by a clinician at the provider level. Among the
information gathered during this process are several identifiable factors, such as date of birth, race

Financial Status
ADHS/DBHS is responsible for providing treatment
and rehabilitation services to those individuals who
qualify for Title XIX or Title XXI benefits—these
consumers are often referred to as being
2

“AHCCCS eligible” because their
services are funded through the Arizona Health Care Cost Containment
System (AHCCCS), the State’s
Medicaid Authority. In FY 2011, 86
percent of enrolled substance abuse
treatment consumers were eligible
for AHCCCS. The remaining clients
were funded through other means,
including Federal Block Grant and
State General Fund monies (see
Table 2, page 4).

Cenpatico 3 reported a higher prevalence of Hispanic/Latino clients in
comparison to the statewide rate
(49.2 and 42.5 percent, respectively).
Referral Source
Substance abuse consumers enter
the behavioral health system through
a variety of means and ADHS/DBHS
works with the T/RBHAs to reduce
barriers and promote efficient access
to care. In FY 2011, more than half
of all substance abuse consumers
were self-referrals, meaning they
decided to enroll on their own, or
upon the recommendation of friends
or family. External behavioral health
providers referred 11.4 percent of
consumers to the system, while 16
percent of consumers enrolled after
involvement with the criminal justice
system.

Age
Aggregate review of client age data
indicates the vast majority of individuals receiving substance abuse
treatment in FY 2011 were adults,
with those between the ages of 18
and 40 accounting for 56.2 percent
of all clients (see sidebar and Figure
1), and the median age for this group
was 34.9 years. Similar to the previous five fiscal years, approximately
6.5 percent of substance abuse cli- Behavioral Health Category
Co-occurring mental health issues
ents were under the age of 18.
such as depression, anxiety and psyRace and Ethnicity
chotic disorders are commonly noted
The majority (81.6 percent) of per- with substance abuse. As highlighted
sons who received substance abuse in the sidebar, more than 28 percent
treatment services in FY 2011 were of substance abuse clients had a coWhite. Approximately 9 percent were occurring General Mental Health DisAmerican Indian, and 7 percent order (GMH), while 19 percent also
were African American. Overall, 25.1 had a Serious Mental Illness (SMI),
percent of participants identified in addition to a substance use disorthemselves as Hispanic/Latino. How- der.
ever, areas such as Cenpatico 2 and
Figure 1— FY 2011 Substance Abuse Treatment Age Distribution

Percent of Enrolled Population

16%

10.9%

10%

10.4%

10.6% 10.7%
8.4%

8.6%

8%

6.5%

6%

4.9%

4%
2%

1.9%
0.8%

0.0% 0.1%

0%

56.4%

Female:

43.6%

Financial Eligibility
Title XIX/XXI
Non-Title XIX/XXI

Age Distribution
Birth - 5:
6-12
13-17
18-21
22-25
26-30
31-35

<0.0%
0.1%
6.5%
8.6%
10.9%
14.2%
12.1%

36-40
41-45
46-50
51-55
56-60
61-65
65+

10.4%
10.6%
10.7%
8.4%
4.9%
1.9%
0.8%

Race and Ethnicity
American Indian:
Asian:
African American:
Native Hawaiian:
White:
Multiracial:

9.1%
0.3%
7.1%
0.4%
81.6%
1.4%

Hispanic:

25.1%

Community Agency:

50.1%
11.4%
0.8%
0.2%
3.4%
0.6%
2.5%

Dept. of Econ. Sec.:
Dept. of Education:
Criminal Justice:
Other:

3.7%
0.8%
16.0%
10.7%

Behavioral Health
Category
Adult—Sub. Abuse
Adult—SMI
Adult—GMH
Child/Adolescent

Age Group
3

85.9%
14.1%

Referral Source

12.1%

12%

Gender
Male:

Self Referred:
Other Providers:
Federal Agency:
RBHA:
AHCCCS / PCP:
Child Prot. Serv.

14.2%

14%

Substance Abuse
Client Demographics
(n=68,135)

45.9%
19.0%
28.5%
6.5%

Program Funding
Table 2—Substance Abuse Treatment Funding Summary—FY 2011
Fund Source

Dollar Amount

Percentage

Medicaid Funding (Title XIX & Proposition 204)

$99,718,976

75.5%

Federal: Substance Abuse Prevention and Treatment Block Grant (SAPT)

$25,699,471

19.5%

State Appropriated

$4,986,103

3.8%

Intergovernmental Agreements: Maricopa County; City of Phoenix Local
Alcohol Reception Center (LARC)

$1,689,871

1.3%

$57,700

0.04%

$132,152,121

100%

Liquor Fees

Total Funding:

During fiscal year 2011, ADHS/DBHS expended
$132,152,121 in service funding for individuals and
families with substance use disorders. The single
largest source of substance abuse treatment funding (75.5%) was Medicaid (Title XIX & Proposition
204), as reflected in Table 2, followed by the Federal Substance Abuse Prevention and Treatment

(SAPT) Block Grant (19.5%) (non-prevention monies). Additional funding included State appropriated
monies, funds from Maricopa County for local detoxification services, and the City of Phoenix Local
Alcohol Reception Center (LARC).

Available Services and Programmatic Initiatives
ADHS/DBHS maintains a comprehensive service
delivery network providing primary prevention,
treatment and rehabilitation programs to Children
and Adolescents, as well as Adults with General
Mental Health Disorders (GMH), Serious Mental
Illnesses (SMI) and/or Substance Use Disorders
(SA/SUD).

Medically-Assisted Treatment
ADHS/DBHS has made a concerted effort to effectively monitor and increase the utilization of Medically-Assisted Treatment (MAT) services for individuals with a substance use disorder/dependence.
The most recent review of this information, which
includes all service provision during Calendar Year
2010, indicates that 9.3 percent of all individuals
with a substance use disorder underwent some
form of MAT as part of their individualized treatment plan, including the use of Naltrexone or Campral for an alcohol dependence, and Buprenorphine, Suboxone or Methadone for an Opioid addiction. These medications, in conjunction with
counseling and other forms of support, have been
effective in helping clients abstain from substance
use and prevent instances of relapse.

With respect to substance abuse treatment, ADHS/
DBHS works diligently with its contractors to ensure the service delivery network presents individuals with a choice of multiple, highly-qualified providers, each offering varying levels of care spanning
multiple treatment modalities. Generally speaking,
services can be grouped into seven categories:
Crisis, Support, Inpatient, Outpatient, Medical/
Pharmacy, Residential and Rehabilitation. Table 3
(page 5) details the complete array of substance
ASAM-PPC
abuse services offered.
In 2010 ADHS/DBHS began statewide implemenMethamphetamine Centers of Excellence (COE)
tation of the American Society of Addiction MediIn an effort to combat an increasing trend in cine’s Placement Patient Criteria (ASAM-PPC).
methamphetamine use among the substance Once adopted, this process will serve as the uniabusing population, three COEs were established form criteria for assessing a client’s addiction sein 2006 and designed to serve individuals with a verity and determining the most appropriate level of
primary diagnosis of methamphetamine abuse or care to effectively meet their clinical need. During
dependence through an evidenced-based Intensive FY 2011, the T/RBHAs and service providers were
Outpatient treatment approach. Since their crea- trained as necessary to ensure their staff are capation, these facilities have helped individuals reduce ble of using ASAM-PPC proficiently. It is anticior completely abstain from substance use, find pated that ASAM-PPC will be uniformly utilized
gainful employment or pursue educational opportu- statewide by early FY 2013.
nities and become active members of their local
communities.
4

Table 3: Service Array
Service Domain

Description

Treatment Services

Individual and group counseling, therapy, assessment, evaluation, screening, and other professional
services.

Rehabilitation Services

Living skills training, cognitive rehabilitation, health promotion, and ongoing support to maintain employment.

Medical and Pharmacy

Medications which relieve symptoms of addiction and/or promote or enhance recovery from addiction

Support Services

Case management, self-help/peer support services and transportation.

Crisis Intervention

Stabilization services provided in the community, hospitals and residential treatment facilities.

Inpatient Services

Inpatient detoxification and treatment services delivered in hospitals and sub-acute facilities, including
Level I residential treatment centers that provide 24-hour supervision, an intensive treatment program,
and on-site medical services.

Residential Services

Residential treatment with 24-hour supervision in Level II and III Facilities.

Behavioral Health Day
Programs

Skills training and ongoing support to improve the individual’s ability to function within the community.
Specialized outpatient substance abuse programs provided to a person, group of persons and/or families in a variety of settings.

Client Problems Addressed by the Programs
As in past years, alcohol remained the most com- adults—those under age 25; meanwhile, alcohol
mon substance used by those in treatment in FY was more prevalent amongst adults over age 25.
2011, as 38 percent of all enrollees cited it as their
primary substance. However, patterns in substance Table 4—Primary Substance Type by Group
preference differ greatly between children/
Substance Type
Child
Adults
All Clients
adolescents and adults.
When comparing substance type preference by
age group, as displayed in Figure 2, the disparity
between child/adolescents and adults is apparent.
Specifically, marijuana was the most common substance used by children, adolescents and younger

Alcohol

17%

39%

38%

Marijuana

77%

22%

26%

Narcotics

2%

16%

15%

Stimulants

2%

20%

19%

Figure 2—Primary Substance Type by Age Band—FY 2011

90%

Percent of Individuals

80%
70%
60%
50%
40%
30%
20%
10%
0%
6‐12

13‐17 18‐21 22‐25 26‐30 31‐35 36‐40 41‐45 46‐50 51‐55 56‐60 61‐65

Age Group
Alcohol

Crack / Cocaine

Marijuana

Heroin

Methamphetamine

Other Substances

5

66+

Treatment Outcomes and System Performance
Table 5— Outcomes Dashboard
How has participating in the behavioral health
system impacted the lives of our clients?

Outcomes
Our Substance Abuse Clients:
Show Reduced or No Substance Use
Participate in Self-Help Programs During Treatment
Are Not Homeless
Are Competitively Employed Full or Part-Time
Have No Recent Involvement with the Criminal Justice System
Attend School or a Vocational Educational Program

Percent
42.4%
14.7%
94.9%
26.4%
84.4%
15.9%

ADHS/DBHS employs a variety of mechanisms to
measure the effectiveness of treatment, including
assessing the change in numerous functional outcome indicators for persons receiving behavioral
health services. The Substance Abuse and Mental
Health Services Administration has established a
set of National Outcome Measures (NOMs) to capture an individual’s improvement in the areas of
employment, educational participation, abstinence
from alcohol or other drugs, criminal activity, and
homelessness.

Change
+12.6%
+3.9%
+2.1%
+2.0%
+0.9%
+0.5%

to demonstrate positive changes in each of these
outcome domains. For example, employment for
this population increased by 2 percent while the
number of clients reducing or abstaining from alcohol and drug use increased 12.6 percent.

When performance falls below acceptable benchmarks, corrective action is taken to drive system
improvement. In January, 2011, ADHS/DBHS
launched the Outcomes Dashboard on its website
at www.azdhs.gov/bhs. This dashboard is updated
quarterly and reflects statewide and RBHA perTable 5, above, shows the most recent status, and formance in access to care, coordination of care,
corresponding change, in each of the outcome do- service delivery and consumer outcomes, similar to
mains for those receiving treatment for a substance Table 5.
use disorder during FY 2011. ADHS/DBHS is able

Goals for the Current Fiscal Year
ADHS/DBHS will continue to enhance the quality of
(NOMs) across the various population subsets,
substance abuse service delivery, increase the use
including racial and ethnic minorities, the LBGTQ
of evidence-based practices in treatment, and imcommunity, and among the different age bands.
prove clinical outcomes and the overall efficiency  Continue to integrate Peer and Family Support
of substance abuse service utilization. The Adult
Services and self-help participation (AA, NA and
and Children Systems of Care Plans each have
CA) into treatment planning.
specific initiatives designed to promote and en-  Increase the number of youth identified as having
hance the effectiveness of treatment, while ina substance use disorder and the overall enrollcreasing outreach activities and encouraging more
ment for this group.
individuals to both seek out, and complete, treat-  Collaborate with other state agencies, community
ment. These initiatives will be in place through
groups and other stakeholders to improve out2013 and are as follows:
reach and enrollment of adults over the age of 55
 Continue to integrate the American Society of
with a diagnosed substance abuse disorder.
Addiction Medicine’s Patient Placement Criteria
(ASAM-PPC 2R) into the treatment delivery system.
 Expand the availability and utilization of Medically-Assisted Treatment (MAT) options.
 Increase outreach, engagement and enrollment
of members of the military and their families
through improved collaborations with Veteran’s
Affairs.
 Decrease disparities in treatment outcomes
Data Source: Arizona Department of Health Services, Division of Behavioral Health Services, Bureau of Business Information
Systems. ARS §36-2023 (FY 2011); September 2011.
6