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Department of Health and Human Services |
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Research, Demonstration, and Evaluation Activities
FY 2003 Plan and Budget
February 2002 |
RESEARCH AND DEMONSTRATIONS
(by HHS Strategic Plan Objective)
REDUCE THE ABUSE AND ILLICIT USE OF DRUGS (OBJECTIVE 1.5)
Table V
(Dollars in thousands) |
PROGRAM |
FY 2001 Actual |
FY 2002 Appropriation |
FY 2003 Presidents Budget Request |
Health Services Research
(NIH) |
$90,240 |
$102,000 |
$111,000 |
Substance Abuse Prevention (SAMHSA) |
$71,422 |
$87,584 |
$40,915 |
Substance Abuse Treatment (SAMHSA) |
$95,208 |
$98,259 |
$53,331 |
Total |
$256,870 |
$287,843 |
$205,246 |
FY 2003 Priorities
HEALTH SERVICES RESEARCH (NIH)
Research: In FY 2003, NIH funds will be used to support programs that
expand existing knowledge of drug abuse treatment and prevention and translate
this knowledge into practice through the provision of proven, effective, and
cost-effective services for drug abusers. FY 2003 priorities include:
The National Institute on Drug Abuse (NIDA) will support research on:
- improving the effectiveness and efficacy of drug abuse treatment and
prevention interventions.
- examining different models of managed care and their effects on access
to services, quality of care, and treatment outcomes.
- decision and management processes in adopting new business and
therapeutic processes (i.e., new technology and treatments) and practices.
- looking at contextual and environmental factors that affect the
quality, availability, or utilization of drug abuse treatment and prevention
services.
NIDA research also will examine what services are needed for a given
problem set or specific population, and how these needs can best be met. The
priorities in this area are:
- studies on integrating drug abuse treatment with mental health and
primary care systems.
- studies of treatment for criminal justice-involved drug users, which
integrate drug abuse treatment with legal oversight and sanctions.
- studies about the different patterns of use of services by various
populations (adolescents, minorities, women, homeless, mentally ill,
HIV-infected drug abusers), and research to improve drug abuse treatment and
prevention services for these special populations.
- studies that measure the prevalence of drug use and the extent of
co-existing drug abuse and mental disorders, and determine variations in rates
among various subpopulations.
- research on health disparities resulting from challenges of access,
utilization, or effectiveness of prevention or treatment interventions.
Since cost is a fundamental issue in the field of health services, NIDA
will support research on:
- the cost-effectiveness and cost benefits of drug abuse treatment and
prevention services.
- alternative payment systems, public and private financing systems, and
the design of insurance.
- the development of an economic methodology for estimating the costs of
drug abuse and drug treatment and for valuing the benefits of various
intervention strategies.
NIDA will continue to support research on effective drug abuse
prevention and interventions, including:
- developing strategies that communities can use to better determine
their own local needs and readiness for intervention.
- examining the organization, management, financing, and delivery of
prevention services.
- assessing the impact of provider characteristics on service delivery
and outcomes.
- examining approaches for matching patients to providers and to
institutional settings and assessing the impact of matching on outcomes.
- examining how to determine the type and intensity of services
necessary for substance abuse treatment.
SUBSTANCE ABUSE PREVENTION (SAMHSA)
Research: The Center for Substance Abuse Prevention (CSAP) program will
continue to support the development and dissemination of knowledge toward
curbing alcohol and drug abuse and bring about effective prevention programs to
every community. Priorities include:
- supporting the development of new practice knowledge for the
prevention of substance abuse in diverse populations in real life environments.
Special focus areas will be on ecstacy use among students, steroid
use among young males, and underage alcohol use to determine what prevention
efforts work, for whom, and under what circumstances.
- identify effective, science-based models, and disseminate
science-based intervention information in areas such as fetal alcohol syndrom,
early childhood substance abuse prevention interventions, and programs focused
on prevention in high risk youths.
- identify best practices in 20 new model substance abuse prevention
programs.
- developing and applying new knowledge to support Targeted
Capacity Expansion projects, which also address alcohol abuse.
Evaluation:
- SAMHSA will conduct a cross-site evaluation of the State Incentive
Grant program to determine whether it has had an impact on youth substance
abuse, and how SIG States differ in their impact on youth substance abuse.
(This evaluation also contributes to objectives 1.1 and 1.4.) This evaluation
will also examine the impact on reducing drugs and other substance abuse,
whether States attained the SIG Programs two main goals of coordinated
funding streams and revitalized comprehensive prevention stratSAMHSA will
conduct a cross-site evaluatio
- The Methamphetamine Treatment Program (MTP) is an ongoing assessment
and multi- site investigation addressing the treatment needs of methamphetamine
abusers, and strategies to integrate research into the real world of drug abuse
treatment. An evaluation will assess the long-term outcome and functioning of
individuals who previously participated in treatment for methamphetamine
dependence. Economic Analysis will evaluate the cost effectiveness of both the
Matrix and Treatment-as-Usual treatment conditions.The Methamphetamine
Treatment Program (MTP) is an ongoing assessment and multi- site investigation
addressing the treatment needs of methamphetamine abusers, and strategies to
integrate research into the real world of drug abuse treatment. An evaluation
will assess the long-term outcome and functioning of individuals who previously
participated in treatment for methamphetamine dependence. Economic Analysis
will eval
- Conduct evaluation of SAMHSAs crosscut programs such as the
Addiction Technology Transfer Centers and the Centers for the Application of
Prevention Technologies.
- Monitor Performance in refining Government Performance and Results Act
performance measures and formats for reporting progress. For example, we will
conduct an evaluation to identify which measures are most appropriate for use
in Performance Based Budgeting for application in the next budget cycle, and
will assess the effectiveness of SAMHSAs performance measures for
Congressional Black Caucus programs and other HIV-related activities.
- Evaluate major administrative and management processes to ensure
optimal effectiveness and efficiency in accomplishing the Agency mission of
reducing drug abuse. For example, (1) continue to conduct evaluation on grants
review to develop information for implementing improvements, and (2) conduct an
overall assessment of the results of SAMHSA's Knowledge Development and
Knowledge Application programs initiated from FY 1993 through FY 1998, and
identify the implications of these findings for future research activity.
SUBSTANCE ABUSE TREATMENT (SAMHSA)
Research: The Center for Substance Abuse Treatment (CSAT) is
prioritizing the design and testing of innovative treatment approaches for
those diagnosed with the most severe drug addition. Priorities include:
- understanding ways to close the substance abuse treatment
gap through services targeted for diverse communities, to help implement
the Presidents Initiative to Close the Treatment Gap.
- developing knowledge of addiction that is sensitive and responsive to
the cultural and treatment needs of population groups across the United States.
- developing knowledge of substance abuse treatment services for
children and adolescents.
- developing and disseminating best practices, such as those found in
integrative Adolescent Treatment Models and Comprehensive Community
Treatment programs, tailored to the developmental and social needs of
adolescents.
- examining questions of appropriateness of treatment, feasability,
cost-effectiveness, and quality in the delivery of drug treatment service
programs for a variety of populations.
Evaluation: More than 38 Treatment Improvement Protocols (TIPs) have
been distributed to the public since 1993. The purpose of TIPs is to transfer
protocols and guidelines for the treatment of alcohol and other drug (AOD)
abuse from acknowledged clinical, evaluation, and administrative experts to the
nation's AOD treatment field. The overall objective of proposed evaluation work
is to learn the impact of TIPs on the substance abuse treatment field.
Evaluation priorities include:
- assessing the extent to which target audiences realize, read, and
implement TIPs.
- learning ways to strengthen the development, formatting, marketing,
dissemination, use, and evaluation of TIPs to ensure effective use of future
Federal resources devoted to TIPs.
- The National Treatment Improvement Evaluation Study (NTIES) will
explore how drug and alcohol abuse treatment outcomes are affected by different
amounts and components of treatment. Evaluating current treatment practices is
fundamentally important to improving treatment in the future. We will examine
the relationships among treatment components, client-level factors, and
treatment outcomes and how these relationships vary by treatment modality.
(This evaluation work also contributes to objectives 1.1 and 1.5.)
- The Center for Substance Abuse Treatment (CSAT) and other federal
agencies are developing a regulatory framework for opioid substitution therapy
that will change the current regulatory system for monitoring opioid treatment
programs (OTPs) to an accreditation/regulatory approach. Over a five year
period, CSAT will conduct and evaluate a phase-in program to obtain information
that will aid in the full implementation of the new system. The evaluation will
provide information to guide the national implementaThe Center for Substance
Abuse Treatment (CSAT) and other federal agencies are developing a regulatory
framework for opioid substitution therapy that will change the current
regulatory system for monitoring
- Persistent Effects of Treatment Studies (PETS) The purpose of PETS is
to evaluate the long-term effectiveness (up to thirty-six months) of substance
abuse treatment services provided through a series of CSAT grants and
cooperative agreements, and to conduct a number of special studies and policy
analyses that address specific drugs subject to abuse, methods of treatment,
populations, or policy issues. The primary follow-up studies will involve
obtaining information at selected follow-up periods for personsPersistent
Effects of Treatment Studies (PETS) The purpose of PETS is to evaluate the
long-term effectiveness (up to thirty
- State Substance Abuse Managed Care Evaluation Program The State
Substance Abuse Managed Care Evaluation Project will evaluate the effects of
managed care on substance abuse services in five States. Each of these five
State studies will inform future behavioral health care policy.