DRUG COURTS AND MEDICAID MANAGED BEHAVIORAL HEALTH CARE

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DESCRIPTION: (Applicant's Abstract) Drug courts have increased rapidly in recent years, as have evaluations of their impact on criminal activity. On the other hand, little is known about the substance abuse treatment services provided to drug court participants. As noted in a recent National Institute on Drug Abuse Request for Applications, this lack of information is especially striking since "drug abuse treatment in general is undergoing change related to managed care." While drug court programs facilitate (indeed mandate) access to and participation in treatment services, managed care may restrict (or at least alter) provision of drug abuse treatment services. Little if anything is known about the interaction between drug courts and managed care. This issue is of particular interest to Medicaid clients since most states have adopted or are planning to implement managed care for publicly funded drug abuse treatment programs. This revised longitudinal cohort study (application number R01 DA 13091) will describe substance abuse treatment services for drug court participants and comparison group offenders in Oregon (which has one of the country's oldest drug court programs). Oregon made a dramatic alteration to its public substance abuse treatment programs in 1995 when fee for service Medicaid was replaced by managed care (i.e., capitation). This project will examine cohorts of offenders prior to Medicaid managed care and after managed care had been implemented. Drug court participants will be compared with similar offenders who were eligible for but did not participate in drug court (chiefly due to lack of drug court capacity). Medicaid clients will be compared with non-Medicaid offenders. The chief outcome measure will be re-arrest rates. Process measures will include the modality and extent of drug abuse treatment services (as well as information gleaned from chart review). The results will be important for justice system and Medicaid policy makers.