Division of Behavioral Health Services

Annual Report on Substance Abuse
Treatment Programs
Fiscal Year 2015
Submitted Pursuant to A.R.S. §36-2023

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

Report Highlights

 94.6% of treatment recipients
were adults
 35.7% of treatment recipients
were located within Maricopa
County
 9.3% of treatment recipients
were referred to treatment by
the criminal justice system
 32.8% of all treatment recipients
cited alcohol as their primary
substance type; however, Marijuana was the primary substance abused by 79.7% of children/adolescents in treatment
 29.3% of treatment recipients
had a co-occurring Serious
Mental Illness

December 31, 2015

Introduc on
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, 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 Loca on 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 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 2015 Enrollment Distribution

Counties

Tribal / Regional Behavioral Health Authority
(Geographic Service Area)

No. of Enrolled and Percentage of Statewide
Served Substance
Substance Abuse
Abuse Clients
Population

Apache
Coconino
Mohave
Navajo
Yavapai

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

9,980

18.9%

La Paz
Yuma

Cenpatico Behavioral Health of Arizona (GSA 2)

2,249

4.3%

Cochise
Graham
Greenlee
Santa Cruz

Cenpatico Behavioral Health of Arizona (GSA 3)

2,067

3.9%

Gila
Pinal

Cenpatico Behavioral Health of Arizona (GSA 4)

3,590

6.8%

Pima

Community Partnership of Southern Arizona
(CPSA - GSA 5)

15,449

29.2%

Maricopa

Mercy Maricopa Integrated Care (MMIC - GSA 6)

18,855

35.7%

TRBHA: Gila River Indian Community

325

0.6%

TRBHA: Pascua Yaqui Tribe

90

0.2%

TRBHA: White Mountain Apache Tribe of Arizona

25

0.0%

IGA: Navajo Nation

191

0.4%

Enrolled and Served Demographics
Enrolled and Served

in Arizona’s public behavioral health system and
received at least one substance abuse service. Of
Division policy requires that all behavioral health enrollees, 35.7 percent were enrolled in GSA 6
clients undergo a clinical assessment, adminis- (Maricopa County).
tered by a clinician at the provider level. Among the
information gathered during this process are sever- Table 1 shows enrollment counts throughout the
al identifiable factors, such as date of birth, race State’s various geographic service areas.
and ethnicity, gender, financial status and reasons
for seeking treatment. The following paragraphs Gender
present this information for those clients with a
Substance Use Disorder (SUD) enrolled and The overall behavioral health population is divided
served in Arizona’s behavioral health system dur- nearly evenly between males and females; however, the substance abuse population is comprised of
ing Fiscal Year 2015 (FY 2015).
more men than women—53.3 percent versus 46.7
The sidebar on page 3 also details demographics percent, respectively.
of those who were enrolled and received substance abuse treatment services in the Arizona Financial Status
behavioral health system for FY 2015.
ADHS/DBHS is responsible for providing treatment
and rehabilitation services to those individuals who
In FY 2015, there were 52,821 consumers enrolled 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 2015, 90.8
percent of substance abuse treatment members were eligible for
AHCCCS.
Age

multi-race backgrounds, and 0.8 percent whom were Asian or Pacific
Islander. Statewide, 26.0 percent of
participants identified themselves as
Hispanic/Latino.
Referral Source
Substance abuse members 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 2015, 52.8 percent of
all substance abuse members were
self-referrals, meaning they decided
to enroll on their own, or upon the
recommendation of friends or family.
External behavioral health providers
referred 11.9 percent of members to
the system, while 9.3 percent of individuals enrolled after involvement
with the criminal justice system .

Aggregate review of client age data
indicates the vast majority of substance abuse treatment members in
FY 2015 were adults, with those between the ages of 26 and 45 accounting for about half of all members (48.5 percent). Approximately
5.4 percent of substance abuse
members were under the age of 18.
The highest counts for age distribution occurred for the age group representing the 26 to 30 year olds
(14.2 percent) and the 31 to 35 years Behavioral Health Category
olds (13.7 percent).
Co-occurring mental health issues
such as depression, anxiety and psyRace and Ethnicity
chotic disorders are commonly noted
The majority (83.0 percent) of per- with substance abuse. In FY 2015,
sons who were enrolled and served 19.5 percent of substance abuse
for substance abuse treatment ser- clients had a co-occurring General
vices in FY 2015 were white, 6.0 per- Mental Health Disorder (GMH), while
cent were African American, and 6.8 29.3 percent also had a Serious
percent were American Indian, fol- Mental Illness (SMI), in addition to a
lowed by 1.2 percent whom were of substance use disorder.

Percent of Served Population

12%

10.9%
9.7%

9.3%

10%
8%
5.4%

6%

9.4%

4%
2%
0%

9.7%
6.8%

6.0%

Male:

53.3%

Female:

46.7%

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

90.8%
9.2%

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%
0.0%
5.4%
6.0%
9.3%
14.2%
13.7%
10.9%
9.7%
9.4%
9.7%
6.8%
2.9%
1.8%
38.3

Race and Ethnicity
American Indian:
Asian or Pacific
Islander:
African American:
White:
Multiracial:

6.0%
83.0%
1.2%

Hispanic/Latino:

26.0%

Self Referred:
Other :
Other Providers:
Criminal Justice:
Dept. of Economic
Security:
AHCCCS/PCP:

14.2%
13.7%

14%

Gender

6.8%
0.8%

Referral Source

Figure 1— FY 2015 Substance Abuse Treatment Age Distribution
16%

Substance Abuse
SERVED Member
Demographics
(n=52,821)

2.9%
1.8%

52.8%
12.5%
11.9%
9.3%
5.0%
2.2%

Community Agency:

1.6%

Federal Agency:
RBHA:
Child Protective
Services:
Dept. of Education:

0.7%
0.6%
0.5%
0.5%

Behavioral Health
Category

0.0% 0.0%

Adult—Sub. Abuse
Adult—SMI
Adult—GMH
Child/Adolescent

Age Group
3

45.9%
29.3%
19.5%
5.4%

Program Funding
Table 2—Substance Abuse Treatment Funding Summary—FY 2015
Fund Source

Dollar Amount

Medicaid Funding (Title XIX & Proposition 204)

Percentage

$128,516,274

78.87%

$23,913,267

14.68%

State Appropriated

$8,753,120

5.37%

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

$1,689,871

1.04%

$66,725

0.04%

$162,939,257

100.00%

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

Liquor Fees

Total Funding:

During fiscal year 2015, ADHS/DBHS expended $162,939,256 in service funding for individuals and
families with substance abuse disorders. The single largest source of substance abuse treatment funding (78.87%) was Medicaid (TXIX & Proposition 204) as reflected in Table 2, followed by the Federal
Substance Abuse Block Grant (SABG) (14.68%) (non-prevention 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 3 (below) details the complete arDBHS works diligently with its contractors to en- ray of substance abuse services offered.
Table 3: Service Array
Service Category

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 and medical procedures 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.
4

Service Encounters
The services listed in Table 3 (page 4) are available to Arizona’s public behavioral health members
and are delivered based on need per each member’s individualized treatment plan.

whereas Behavioral Health Day Programs encountered at the least percent (0.6%). Please
note, the number members served in each category varied, as well as the cost of each service,
therefore the percent does not necessarily reflect
the most utilized service by the members.

As indicated in Figure 2 (see below), Support Services encountered at the highest percent (29.6%),

Figure 2— FY 2015 Percent Encountered by Service Category

Statewide Substance Abuse Service Encounters, FY2015
35%
29.6%

30%

Percent

25%
20%
15%

12.6%
10.0%

10.3%

Medical Services

Pharmacy

10%
5%

11.6%

11.5%

8.8%

4.9%
0.6%

0%
Behavioral
Health Day
Programs

Crisis
Intervention
Services

Inpatient
Services

Rehabilitation
Services

Residential Support Services Treatment
Services
Services

Service Category

Treatment Needs Addressed by the Programs
Alcohol remained the most common substance used by those in
treatment in FY 2015; 32.8 percent of all members cited it as
their primary substance, almost a
2 percent increase from FY 2014.
As in past years, patterns in substance preference differed greatly
between children/adolescents and
adults. For example, 17.9 percent of adolescents receiving substance abuse treatment services
cited marijuana as the primary
substance
used, compared to
19.5 percent of adults receiving
substance abuse services.

Table 4 - Primary Substance Type by Group
Substance Type

Child

Adults

All Clients

Alcohol

13.4%

37.8%

32.8%

Marijuana

79.7%

19.5%

22.7%

Methamphetamine

2.5%

17.9%

17.1%

Heroin/Morphine

1.4%

15.4%

14.7%

Other Narcotics/Opiates

0.8%

6.8%

6.5%

Cocaine/Crack

0.5%

4.1%

3.9%

All Other Substances

1.5%

2.1%

2.1%

Other Stimulants

0.3%

0.3%

0.3%

5

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
and adults under age 25; alcohol continues to be more prevalent amongst adults over age 25.
Figure 3—Primary Substance Type by Age Band—FY 2015
100%
90%

Percent of Served Members

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

61-64

65+

Age Group
Alcohol

Crack/ Cocaine

Marijuana

Heroin

Methamphetamine

Other Narcotics

Other Stimulants

Other Substances

Treatment Outcomes and System Performance
Table 5— FY2014 Outcomes
How has participating in the behavioral health
system impacted the lives of our clients?

Outcomes
Our Substance Abuse Clients:

Percent
42.1%

No Alcohol Use

Change
+21.0%

No (Other) Drug Use

38.7%

+24.1%

Participate in Self-Help Programs During Treatment

1.5%

+134.8%

Are Not Homeless

93.4%

+1.1%

Are Competitively Employed Full or Part-Time

22.8%

+6.1%

Have No Recent Involvement with the Criminal Justice System

84.2%

+1.3%

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.

corresponding change in each of the outcome domains for those receiving treatment for a substance
use disorder. For example, the number of clients
reducing or abstaining from alcohol at discharge in
FY2014 was 21 percent greater in relation to those
abstaining from alcohol at admission.

Participation in self-help programs during treatment
at discharge was 134.8 percent greater than at admission. Although this was a large change, there
was a small number of members participating in
self-help programs at admission; this allowed for a
Table 5 (above) shows the most recent status and very large relative change.
6

Programmatic Initiatives for Specific Populations
In the following paragraphs, are highlights of programmatic initiatives in FY 2015 that focused on
specific substance abuse populations:

ing and support services, and an “Older Adult Behavioral Health” program that focuses on providing
an array of services in-clinic.

Pregnant and Parenting Women
The protocol for pregnant females using drugs intravenously continues use in order to ensure medically assisted treatment medications are appropriately prescribed for this population. Collaboration
also continues with Arizona’s Family First Program
to provide substance use treatment services to parents who have involvement with the Department of
Child Safety (DCS) due to abuse of substances.
The Women’s Services Directory, which lists all
treatment providers with treatment services and
programs that are gender specific to women in
Maricopa County, continues to assist providers and
other entities in making appropriate treatment referrals.

Youth
The behavioral health system has been working to
promote youth substance abuse prevention
through stakeholder meetings, school and community-based trainings, public service announcements, media campaigns, and youth leadership
programs. Provider treatment trainings have included components on how to screen for substance
abuse in the adolescent population and the application of effective substance abuse treatment such
as ACRA and other evidence-based practices targeting the adolescent population.
Military, Veterans and Their Families
Our RBHAs have been collaborating in various capacities, including participating in military-centered
coalitions and councils, as well as collaborating on
a Resource Navigator training. Additionally, Rally
Point Tucson continues to help veterans and their
families in Pima County navigate and access various resources. Providers throughout the state have
been engaged in multiple trainings that are specific
to the needs of service members, such as Trauma
Informed Care, PTSD, Traumatic Brain injury, employment assistance, and resource navigation.

Older Adults
RBHAs continue to work with councils, providers,
and community agencies to make appropriate referrals and monitor substance use diagnoses
among the older adult population, as well as attend
educational events. Providers have implemented
programs tailored to the older adult population,
such as a “Senior Peer” program that provides preventative services, resource connections, counsel-

Goals for the Current Fiscal Year
ADHS/DBHS will continue to enhance the quality of  Make data-driven decisions when planning for
substance abuse service delivery, increase the use substance abuse prevention.
of evidence-based practices in prevention and  Increase network of substance abuse prevention
treatment, and improve clinical outcomes and the services providers.
overall efficiency of substance abuse service utili-  Continue to track the availability and utilization of
zation.
Medically-Assisted Treatment (MAT) options
through the increased use of Federal Grant
The Adult and Children Systems of Care Plans funds.
each have specific initiatives designed to promote  Increase outreach, engagement and enrollment
and enhance the effectiveness of treatment, while of members of the military and their families.
increasing outreach activities and encouraging  Promote the Arizona Prescription Drug Misuse
more individuals to both seek out, and complete, and Abuse Initiative.
treatment. These initiatives will be in place through  Promote education on the availability and effec2016 and include the following:
tiveness of Peer and Family Support Services
and self-help participation (AA, NA and CA).
 Increase the utilization of Evidenced-Based Prac-  Continue to provide substance abuse and wrapatices (EBPs) in substance abuse prevention and round services for at risk populations through
treatment.
discretionary grants.
Data Source: Arizona Department of Health Services, Division of Behavioral Health Services, Bureau of Business Information
Systems. ARS §36-2023 (FY 2015); December 2015.
7