Division of Behavioral Health Services
Annual Report on Substance Abuse
Treatment Programs
Fiscal Year 2012
Submitted Pursuant to A.R.S. §36-2023

Report Contents

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

Report Highlights

 93.4% of treatment recipients
were adults

 44.7% of treatment recipients
were located within Maricopa
County
 15.6% of treatment recipients
were referred to treatment by
the criminal justice system
 36% 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
 26.2% of treatment recipients
had a co-occurring Serious
Mental Illness

December 31, 2012

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, num-

bers of clients served with their
corresponding demographic information, substance use patterns
and encounters for utilized services. 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.

Four Regional Behavioral Health
Authorities (RBHAs), and three
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 maintain a
comprehensive network
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 respective areas.

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

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Enrollment and Demographics
Table 1: FY 2012 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)

13,805

18.4%

La Paz
Yuma

Cenpatico Behavioral Health of Arizona (GSA 2)

2,442

3.3%

Cochise
Graham
Greenlee
Santa Cruz

Cenpatico Behavioral Health of Arizona (GSA 3)

2,516

3.3%

Gila
Pinal

Cenpatico Behavioral Health of Arizona (GSA 4)

4,024

5.4%

Pima

Community Partnership of Southern Arizona
(CPSA - GSA 5)

16,739

22.3%

Maricopa

Magellan of Arizona (GSA 6)

33,546

44.7%

TRBHA: Gila River Indian Community

822

1.1%

TRBHA: Pascua Yaqui Tribe

594

0.8%

TRBHA: White Mountain Apache Tribe of Arizona

156

0.2%

IGA: Navajo Nation

471

0.6%

Counties

al identifiable factors, such as date of birth, race
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
2012. The sidebar on page 3 also details consumer
demographics for the statewide system.

Enrollment
In Fiscal Year (FY) 2012 there were 75,115 consumers enrolled in Arizona’s public behavioral
health system for substance abuse treatment; the
number of enrolled increased by 10.24 percent between 2011 and 2012. 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 (CBHS), 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—55.9 percent versus 44.1
percent, respectively. Males outnumbered females
in all regions of the State, with the exception of the
Gila River Indian Community, where females made
up 55 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 of the substance abuse
treatment population were adults, ages 18 and
over; 44.3 percent of all adult clients were enrolled
in Magellan, followed by CPSA and NARBHA. Similarly, Magellan accounted for 49 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 sever-

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
2

consumers are often referred to as
being “AHCCCS eligible” because
their services are funded through the
Arizona Health Care Cost Containment System (AHCCCS), the State’s
Medicaid Authority. In FY 2012, 77.2
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).

CBHS 2, 3 and 4 reported a greater
rate of Hispanic/Latino client enrollment than the statewide rate with a
range from 31.5 percent to 49.1 percent.
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 2012, 51.1 percent 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 11.2 percent of consumers
to the system, while 15.6 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 2012 were adults,
with those between the ages of 18
and 40 accounting for 57 percent of
all clients (see sidebar and Figure 1),
and the median age for this group
was 34.4 years. Similar to the previous five fiscal years, approximately Behavioral Health Category
6.6 percent of substance abuse cli- Co-occurring mental health issues
ents were under the age of 18.
such as depression, anxiety and psychotic disorders are commonly noted
with substance abuse. As highlighted
Race and Ethnicity
in the sidebar, 20.1 percent of subThe majority (83.1 percent) of persons who received substance abuse stance abuse clients had a cotreatment services in FY 2012 were occurring General Mental Health Disorder (GMH), while 26.2 percent also
White, 7.8 percent were American
Indian, and 7.1 percent were African had a Serious Mental Illness (SMI),
American. Statewide, 26.5 percent of in addition to a substance use disorparticipants identified themselves as der.
Hispanic/Latino. However, CPSA 5,
Figure 1— FY 2012 Substance Abuse Treatment Age Distribution

Substance Abuse
Client Demographics
(n=75,115)
Gender
Male:

55.9%

Female:

44.1%

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

77.2%
22.8%

Age Distribution
Birth - 5:
6-12
13-17
18-21
22-25
26-30
31-35
36-40
41-45
46-50
51-55
56-60
61-65
65+
Median Age

0.0%
0.1%
6.5%
9.0%
11.0%
14.4%
12.5%
10.1%
10.1%
10.1%
8.4%
5.0%
2.0%
0.8%
34.4 yrs

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

7.8%
0.4%
7.1%
0.3%
83.1%
1.3%

Hispanic:

26.5%

Referral Source

Community Agency:

51.1%
15.6%
11.2%
9.3%
4.5%
3.6%
2.3%

Federal Agency:
Dept. of Education:
Child Prot. Serv.:
RBHA:

0.7%
0.6%
0.6%
0.4%

Self Referred:
Criminal Justice:
Other Providers
Other:
Dept. of Econ. Sec.:
AHCCCS/PCP:

Behavioral Health
Category
Adult—Sub. Abuse
Adult—SMI
Adult—GMH
Child/Adolescent
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47.0%
26.2%
20.1%
6.6%

Program Funding
Table 2—Substance Abuse Treatment Funding Summary—FY 2012
Fund Source

Dollar Amount

Percentage

Medicaid Funding (Title XIX & Proposition 204)

$99,261,365

71.88%

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

$26,660,338

19.31%

State Appropriated

$10,419,313

7.55%

$1,689,871

1.22%

$55,875

0.04%

$138,086,762

100%

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

Total Funding:

During fiscal year 2012, ADHS/DBHS expended
$138,086,762 in service funding for individuals and
families with substance abuse disorders. The single largest source of substance abuse treatment
funding (71.88%) was Medicaid (TXIX & Proposition 204) as reflected in Table 2, followed by the

Federal Substance Abuse Prevention and Treatment (SAPT) Block Grant (19.31%) (nonprevention monies). Additional funding included
State appropriated monies, funds from Maricopa
County for local detoxification services, the City of
Phoenix IGA, and Liquor Services Fees.

Available Services
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).

sure 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 RehaWith respect to substance abuse treatment, ADHS/ bilitation. Table 4 (page 5) details the complete
DBHS works diligently with its contractors to en- array of substance abuse services offered.

Service Utilization
As indicated on page 2, the substance abuse population includes individuals who are under the age
of 18 (children / adolescents), those with a General
Mental Health disorder or a Serious Mental Illness,
as well as individuals diagnosed only with a substance use disorder. However, service utilization
varied significantly between population groups, as
reflected in Table 3, below.

Furthermore, SMI and GMH members were also
more likely to be prescribed medication than those
individuals without a co-occurring mental health
disorder.

Table 3: Utilization by Behavioral Health Category
Group
Adult—Sub. Abuse

Percent of
Population

Annual Cost
Per Client

47%

$2,735.28

Adult—SMI

26.2%

$8,366.37

Adult—GMH

20.1%

$2,288.60

6.6%

$5,180.53

Child / Adolescents

For example, the Division expended an average of
$8,366.37 per co-occurring SMI member, while
members with no co-occurring disorder were
served at an average cost of $2,735.28 per person.
This is primarily due to the added costs incurred
with treating a Serious Mental Illness in conjunction
with a substance use addiction.

The services listed in Table 4 (right) are available
to Arizona’s public behavioral health members and
are delivered based on need per each member’s
individualized treatment plan.
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Table 4: 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
Alcohol remained the most common substance and adults under age 25; alcohol continues to be
used by those in treatment in FY 2012; 36 percent more prevalent amongst adults over age 25.
of all enrollees cited it as their primary substance,
almost a 2 percent decrease from FY 2011. As in Table 5 - Primary Substance Type by Group
past years, patterns in substance preference difSubstance Type
Child
Adults
All Clients
fered greatly between children/adolescents and
Alcohol
16%
37%
36%
adults.
This disparity between child/adolescents and
adults is apparent when comparing substance preference by age group (see Figure 2).Marijuana was
more commonly reported by children, adolescents

Marijuana

77%

23%

27%

Narcotics

2%

16%

15%

Stimulants

2%

21%

20%

Other Substances

3%

3%

3%

Figure 2—Primary Substance Type by Age Band—FY 2012

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Treatment Outcomes and System Performance
Table 6— 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
49.8%
16.6%
94.5%
29.1%
83.3%
16.6%

The Division 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 (SAMHSA) 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
+10.4%
+5.2%
+1.3%
+4.6%
+0.13%
-0.05%

cent while the number of clients reducing or abstaining from alcohol and drug use increased 10.4
percent. Finally, the .05 percent decline in educational participation is largely to be expected, given
that the vast majority of participant are adults who
would be exiting the educational system to enter
the workforce.
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 performance in access to care, coordination of care, service delivery and consumer outcomes, similar to
Table 6.

Table 6, above, shows the most recent status, and
corresponding change, in each of the outcome domains for those receiving treatment for a substance
use disorder during FY 2012. For example, employment for this population increased by 4.6 per-

Goals for the Current Fiscal Year
including racial and ethnic minorities, the LBGTQ
ADHS/DBHS will continue to enhance the quality of
community, and among the different age bands.
substance abuse service delivery, increase the use
of evidence-based practices in treatment, and im-  Continue to integrate Peer and Family Support
prove clinical outcomes and the overall efficiency
Services and self-help participation (AA, NA and
of substance abuse service utilization. The Adult
CA) into treatment planning.
and Children Systems of Care Plans each have  Increase the number of youth identified as having
specific initiatives designed to promote and ena substance use disorder and the overall enrollhance the effectiveness of treatment, while inment for this group.
creasing outreach activities and encouraging more  Collaborate with other state agencies, community
individuals to both seek out, and complete, treatgroups and other stakeholders to improve outment. These initiatives will be in place through
reach and enrollment of adults over the age of 55
2013 and are as follows:
with a diagnosed substance abuse disorder.
 Expand the availability and utilization of Medically-Assisted Treatment (MAT) options through the
increased use of Federal Grant funds.
 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
(NOMs) across the various population subsets,
Data Source: Arizona Department of Health Services, Division of Behavioral Health Services, Bureau of Business Information
Systems. ARS §36-2023 (FY 2011); September 2012.
6