DRUG COURTS AND MEDICAID MANAGED BEHAVIORAL HEALTH CARE

描述：（申请人摘要） 近年来，毒品法庭迅速增加，对毒品的评估也是如此。 对犯罪活动的影响。另一方面，人们对 向毒品法庭参与者提供药物滥用治疗服务。作为 国家药物滥用研究所最近的一项申请中指出， 这种信息的缺乏尤其令人震惊，因为“ 一般正在经历与管理式护理有关的变革。“毒品法庭 项目促进（实际上是强制）获得和参与治疗 服务，管理式护理可能会限制（或至少改变）药物滥用的提供 治疗服务。我们对它们之间的相互作用知之甚少 毒品法庭和管理式医疗这个问题是特别感兴趣的医疗补助 客户，因为大多数国家已经或正在计划实施管理 关注公共资助的药物滥用治疗计划。 这项修订后的纵向队列研究（申请编号R01 DA 13091）将 描述为毒品法庭参与者提供的药物滥用治疗服务， 比较组罪犯在俄勒冈州（其中有一个国家的最古老的 毒品法庭（Drug Court）俄勒冈州对它的公共内容做了一个戏剧性的改变 1995年，当医疗补助服务费被取代时， 管理式护理（即，按人头收费）。该项目将研究罪犯群体 在医疗补助管理式护理之前和实施管理式护理之后。 毒品法庭的参与者将与类似的罪犯进行比较， 有资格但没有参加毒品法庭（主要是由于缺乏毒品 法院能力）。医疗补助客户将与非医疗补助罪犯进行比较。 主要的结果指标将是再逮捕率。过程措施将 包括药物滥用治疗服务的方式和范围（以及 从图表审查中收集的信息）。结果将是重要的， 司法系统和医疗补助政策制定者。

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.