Needs Assessment Methodologies in Determining Treatment Capacity for Substance Use Disorders: Environmental Scan Final Report. APPENDIX E: DATA EXTRACTION FORM

09/16/2019

ASPE Network Capacity for Substance Use Disorder Needs Assessment Data Extraction Form

Coder:

Date Completed:

Module A: Coding of Content

Section A: Document Information

  1. Document Title: (e.g., Report Title or Article Title)
  2. Source Title: (e.g., Journal title or Book Title)
  3. Document Publication Year:
  4. Contractor(s) Conducting Needs Assessment:
  5. Funder(s) of Needs Assessment:

Purpose/Focus of Report: (include a short description)

NOTES:

Section A: Questions/Issues Explored

  1. What topics are explored in the questions/issues? (Check all that are applicable) Note: Should include only items that are included in the assessment of the current system, not things that are discussed in a general way, such as in the background section. For example, "Research has demonstrated significant health disparities for individuals with mental illness and substance use and there is growing evidence of shortened lifespans" we would not check "disparities" unless disparities were assessed in the current system.

    ___Prevalence/frequency related to: (Check all that are applicable)

    ___General substance use

    ___Alcohol

    ___Opioids

    ___Heroin

    ___Methamphetamine

    ___Marijuana

    ___Cocaine

    ___Depression

    ___Suicide

    ___Overdose

    ___Co-Occurring Disorders (CODs)

    ___Medical Co-morbidity

    ___Other prevalence/frequency, describe:

    ___Other prevalence/frequency, describe:

    ___Unmet need (other than prevalence)

    ___Utilization/Penetration

    ___Demand (services likely to be requested)

    ___Referrals

    ___Means of Obtainment (how drugs are obtained)

    ___Risk Factors

    ___Expenditures/costs/cost benefit

    ___Funding sources

    ___Workforce supply

    ___Workforce competency/training

    ___Workforce licensing/certification

    ___Peer involvement

    ___Provider organization supply/capacity

    ___Collaboration

    ___Law enforcement

    ___Leadership

    ___Special populations

    ___Disparities

    ___Diagnostic group differences

    ___Regional variation

    ___Demographic trends

    ___Cultural competency

    ___Benchmarks for future progress

    ___Behavioral health integration

    ___High utilizers

    ___Quality (Check all that are applicable)

    ___Access (capacity, wait-times, etc.)

    ___Availability/Network adequacy (existence of services)

    ___Outpatient follow-up

    ___Outcomes

    ___Treatment completion/adherence

    ___Satisfaction/perception of care

    ___Other quality describe:

    ___Other quality describe:

    ___Evidence-Based Practices (EBPs)

    ___Stigma

    ___Transitions by functional level

    ___Benefit design/coverage

    ___Policy changes

    ___Technology (Check all that are applicable)

    ___Data systems

    ___Use of HIT

    ___Use of EMRs

    ___Use of Telehealth

    ___Use of e-prescribing

    ___Interoperability among provider organizations

    ___Interoperability among public agencies

    ___Privacy/confidentiality issues

    ___Other technology issue describe:

    ___Other technology issue describe:

    ___Barriers/limitations (Check all that are applicable)

    ___Policies

    ___MH/SUD bifurcation

    ___Other agency silos

    ___Decentralized (e.g., county) systems

    ___Service locations

    ___Service costs

    ___Lack of access, NOS

    ___Qualified workforce

    ___Provider reimbursement limitations

    ___Stigma

    ___Other barriers/limitations, describe:

    ___Other barriers/limitations, describe:

    ___Quality/performance measurement systems

    ___System assets/strengths

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

Section B: Location

  1. What is the geographical boundary? (Choose only one)

    ___United States (U.S.)

    ___County/countries outside of U.S. (If yes, specify):

    ___Region(s) (If yes, specify):

    ___State(s) (If yes, specify):

    ___County(ies) within state(s) (If yes, specify):

    ___City(ies) (If yes, specify):

    ___Zip Code(s) (If yes, specify):

    ___Tribe(s)/Tribal Community(ies) (If yes, specify):

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

  2. Is there a focus on a specific type of region? (Choose only one)

    ___Urban

    ___Suburban

    ___Rural

    ___Frontier

    ___No specific regional focus (e.g., focused on a county or state)

    ___Not specified/identified

    NOTES:

Section C: Data Sources/Methods

  1. What data sources/methods were utilized? (Check all that are applicable)

    ___SAMHSA National Directory of Drug and Alcohol Abuse Treatment Facilities

    ___SAMHSA NSDUH

    ___BRFSS

    ___Youth Risk Behavior Surveillance System (YRBSS)

    ___SAMHSA TEDS

    ___SAMHSA Behavioral Health Barometer

    ___SAMHSA Buprenorphine Treatment Practitioner Locator

    ___SAMHSA N-SSATS

    ___SAMHSA N-MHSS

    ___SAMHSA Emergency Department Data

    ___U.S. Census Data

    ___Bureau of Labor Statistics (BLS)

    ___Centers for Disease Control and Prevention (CDC) Data

    ___State Management Information System (MIS)

    ___State health database (including Medicaid enrollment)

    ___Licensing boards

    ___Healthy People 2020

    ___County/City MIS

    ___County/City Health database

    ___Provider MIS

    ___Medical Record/EHR

    ___Medicaid claims

    ___Medicare claims

    ___Existing reports/studies

    ___Surveys with: (Check all that are applicable)

    ___State/local agency leadership/staff

    ___Legislators

    ___Provider organization leadership

    ___Practitioner/workers

    ___Peer organizations

    ___Advocacy organizations

    ___Consumers/patients

    ___Family members

    ___General Public

    ___Other surveys with, describe:

    ___Other surveys with, describe:

    ___Focus groups with: (Check all that are applicable)

    ___State/local agency leadership/staff

    ___Legislators

    ___Provider organization leadership

    ___Practitioner/workers

    ___Peer organizations

    ___Advocacy organizations

    ___Consumers/patients

    ___Family members

    ___Other focus groups with, describe:

    ___Other focus groups with, describe:

    ___Key informant interviews with: (Check all that are applicable)

    ___State/local agency leadership/staff

    ___Legislators

    ___Provider organization leadership

    ___Practitioner/workers

    ___Peer organizations

    ___Advocacy organizations

    ___Consumers/patients

    ___Family members

    ___Other key informant interviews with, describe:

    ___Other key informant interviews with, describe:

    ___Meetings

    ___Community/public

    ___State/local agency leadership/staff

    ___Legislators

    ___Provider organization leadership

    ___Practitioner/workers

    ___Peer organizations

    ___Advocacy organizations

    ___Consumers/patients

    ___Family members

    ___Steering committee

    ___State/local agency leadership/staff

    ___Legislators

    ___Provider organization leadership

    ___Practitioner/workers

    ___Peer organizations

    ___Advocacy organizations

    ___Consumers/patients

    ___Family members

    ___Other steering committee members, describe:

    ___Other steering committee members, describe:

    ___Document review

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

Section D: Data Limitations Noted

  1. What data limitations were noted? (Check all that are applicable)

    ___Claims: Emergency Department Utilization by non-Medicaid

    ___Other claims limitations

    ___Omitted persons not residing in households (e.g., unsheltered homeless)

    ___State system lack integration/common identifiers

    ___Providers reimbursed by multiple payers

    ___Non-billing services (drop in centers, warm lines, etc.)

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

Section E: Populations/Groups

  1. What are the populations/groups of focus? (Check all that are addressed)

    ___Substance use disorder (SUD) (Please specify)

    ___Substance use unspecified

    ___Alcohol

    ___Poly drug use

    ___Needle use

    ___Opioids

    ___Prescription drugs

    ___Heroin

    ___Methamphetamines

    ___Marijuana

    ___Cocaine

    ___Hallucinogens

    ___Other substance use disorder, specify:

    ___Other substance use disorder, specify:

    ___Mental health

    ___Co-occurring disorders (CODs) (mental illness and substance use disorders)

    ___HIV/AIDS

    ___Children/adolescents

    ___Transition-age youth

    ___Adults

    ___Older adults

    ___Racial/ethnic groups (If yes, specify groups):

    ___Lesbian, gay, bisexual, or transgender individuals, questioning and allies (LGBT/LGBTQA)

    ___Gender

    ___Income

    ___Marital Status

    ___Homeless

    ___Veterans

    ___Adults criminal justice system

    ___Youth juvenile justice system

    ___Child/youth child welfare

    ___Other (specify):

    ___Other (specify):

    ___Not described/specified

    NOTES:

Section F: Workforce Characteristics and Supply

  1. What are the workforce categories of focus? (Check all that are addressed)

    ___Psychiatrists (Check all that apply)

    ___Addiction

    ___Other psychiatrists, describe:

    ___Physicians (non-psychiatrist)

    ___Licensed buprenorphine physicians

    ___Other physicians, describe:

    ___Nurses (Check all that apply)

    ___Licensed Practical Nurses/Licensed Vocational Nurses

    ___Registered Nurse (Diploma, Associate's, and Baccalaureate)

    ___Psychiatric and Mental Health Nurses

    ___Advanced Practice Registered Nurses (Master's and Doctoral)

    ___Nurse Practitioner

    ___Other nurses, describe:

    ___Physician Assistant

    ___Psychologists

    ___Social Workers (Check all that apply)

    ___Associate's and Baccalaureate

    ___Masters

    ___Clinical

    ___Counselors (Check all that apply)

    ___Rehabilitation Counseling

    ___Addiction Counseling

    ___Clinical Mental Health Counseling

    ___Other counselors, describe:

    ___Peers

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

  2. Are workforce pay sources specified? (Check all that are addressed)

    ___Medicaid

    ___Medicare

    ___Private insurance

    ___State funds

    ___Charity/free care

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

  3. Is the geographic distribution of the workforce reported?

    ___By state

    ___By county across the state

    ___By urban/rural

    ___Other geographical classification describe:

    ___Not reported

    NOTES:

  4. What workforce characteristics are reported?

    ___Racial/ethnic composition

    ___Competencies/training

    ___Certification

    ___Licensing

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

Section G: Provider Organization and Service Type

  1. What types of facilities or organization types are addressed? (Check all that are addressed)

    ___Community Health Centers (CHC)

    ___Federally Qualified Health Centers (FQHC)

    ___Community Mental Health Center (CMHC)

    ___Health Care for the Homeless agency

    ___Hospital or Medical Center

    ___Private psychiatric hospital inpatient

    ___Private psychiatric hospital outpatient

    ___Public psychiatric hospital (acute care)

    ___Public psychiatric hospital (long term care)

    ___Academic Medical Center

    ___Substance use (only) agency

    ___Opioid Treatment Program (OTP)

    ___Mental health/substance use agency

    ___Veteran Administration (VA) agency or facility

    ___Accountable Care Organizations (ACO)

    ___Health Homes

    ___Primary care clinics

    ___Drug/mental health courts

    ___Social service agency

    ___Consumer-run agency

    ___Shelter or temporary housing resources (e.g., Sober Living, Halfway Homes, etc.).

    ___Other housing agencies

    ___Jail/Prison

    ___Private practice

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

  2. What types of service settings are addressed? (Check all that are addressed)

    ___Hospital (Check all that are addressed)

    ___General hospital

    ___Emergency room

    ___Veteran Administration (VA) hospital

    ___Hospital detoxification

    ___Psychiatric hospital

    ___Psychiatric unit within a general hospital

    ___Hospital outpatient

    ___Other hospital, describe:

    ___Outpatient (Check all that are addressed)

    ___Outpatient detoxification

    ___Outpatient SUD treatment

    ___Outpatient methadone/buprenorphine or naltrexone treatment

    ___Outpatient MH treatment

    ___Outpatient day treatment or partial hospitalization

    ___Intensive outpatient treatment

    ___Outpatient VA

    ___Other outpatient, describe:

    ___Residential

    ___Residential detoxification

    ___Residential SUD treatment

    ___Residential MH treatment

    ___Other residential, describe:

    ___Inpatient

    ___Inpatient detoxification

    ___Inpatient SUD treatment

    ___Inpatient MH treatment

    ___Other inpatient, describe:

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

Section H: Services/Level of Care

  1. Are ASAM levels specifically addressed?

    ___Yes

    ___No (skip to 3)

    NOTES:

  2. If yes, what ASAM Level are addressed? (Check all that are addressed)

    ___Level of Care 0.5: Early Intervention for Adults and Adolescents

    ___Level of Care 1: Outpatient Services for Adolescents and Adults

    ___Level of Care 2: Intensive Outpatient/Partial Hospitalization Services

    ___Level of Care 2.1: Intensive Outpatient Services for Adolescents and Adults

    ___Level of Care 2.5: Partial Hospitalizations for Adolescents and Adults

    ___Level of Care 3.1: Clinically Managed Low-Intensity Residential Services for Adolescents and Adults

    ___Level of Care 3.3: Clinically Managed Population-Specific High-Intensity Residential Services for Adults

    ___Level of Care 3.5: Clinically Managed Medium-Intensity Residential Services for Adolescents and Clinically Managed High-Intensity Residential Services for Adults

    ___Level of Care 3.7: Medically Monitored High-Intensity Inpatient Services for Adolescents and Medically Monitored Intensive Inpatient Services Withdrawal Management for Adults

    ___Level of Care 4: Medically Managed Intensive Inpatient Services for Adolescents and Adults

    NOTES:

  3. What services/treatment modalities are addressed? (Check all that are addressed)

    ___Substance abuse treatment services (Check all that apply)

    ___Inpatient treatment

    ___Outpatient treatment

    ___Individual treatment

    ___Group treatment

    ___Family treatment

    ___Residential treatment

    ___Day treatment

    ___Crisis/emergency services

    ___Support services

    ___Education/risk reduction/screening

    ___Prevention

    ___Medication-assisted treatment (e.g., methadone, buprenorphine, etc.)

    ___Detoxification

    ___Rehabilitation

    ___Intensive home based treatment (SAMHSA Good and modern)

    ___Consultation to caregivers (SAMHSA Good and modern)

    ___Outreach/engagement SAMHSA Good and modern)

    ___Aftercare (hospital, residential, outpatient, etc.)

    ___Self-help/faith-based 

    ___Other substance abuse treatment services, describe:

    ___Mental health treatment services--check all that apply

    ___Psychotherapy/counseling

    ___Medication management

    ___Peer support/consumer operated services

    ___Psychosocial (e.g., supported employment, case management)

    ___School-based services

    ___General health services

    ___Housing

    ___Financial

    ___Transportation

    ___Legal

    ___Testing (e.g., Hep C, HIV, STD)

    ___Needle exchange

    ___Condoms

    ___Other, describe:

    ___Other, describe:

    ___Not specified/identified

    NOTES:

Section I: Funding

  1. What payor sources were included in the needs assessment? (Check all that are applicable)

    ___Medicaid

    ___Medicare

    ___Dually Eligible

    ___State financed insurance (other than Medicaid)

    ___Community Mental Health Service Block Grant (MHBG) Funds

    ___Substance Abuse Prevention or Treatment Block Grant (SAPTBG) Funds

    ___State Mental Health Agency (or Equivalent) Funds

    ___State Substance Abuse Agency (or Equivalent) Funds

    ___County or Local Government Funds

    ___Access to Recovery (ATR) vouchers

    ___Private Insurance/Fee for Pay

    ___Private Insurance/HMO

    ___Military Insurance (VA, TRICARE)

    ___Indian Health Services

    ___Uninsured

    ___Cash or self-payment

    ___Other, describe:

    ___Other, describe:

    ___None specified/included

    NOTES:

Module B: Coding for Quality

  1. Are the questions (purposes) of the needs assessment clearly specified? (Research Question 4 and 9)

    ___Yes

    ___Partial

    ___No

    NOTES:

  2. Are the methods for defining the population described? (Research Question 2a)

    ___Yes

    ___Partial

    ___No

    NOTES:

  3. Are the selection criteria for workers specified? (Research Question 2b)

    ___Yes

    ___Partial

    ___No

    NOTES:

  4. Is the setting (geographical area, service area) well defined for the purpose? (Research Question 2c)

    ___Yes

    ___Partial

    ___No

    NOTES:

  5. Are the levels of care identified in the utilization assessment? (Research Question 2d)

    ___Yes

    ___Partial

    ___No

    NOTES:

  6. [If surveys were conducted] Was random sampling used?

    ___Yes

    ___No

    ___Unknown/unclear

    NOTES:

  7. [If surveys were conducted] Is the instrument reliability and validity reported?

    ___Yes

    ___No

    NOTES:

  8. [If surveys were conducted] Is pilot testing of the instrument reported?

    ___Yes

    ___No

    NOTES:

  9. Were statistical methods described?

    ___Yes

    ___No

    ___Unknown/unclear

    NOTES:

  10. Are limitations due to data unavailability or quality reported? (Research Question 12)

    ___Yes

    ___No

    NOTES:

  11. Is validation of the methodology reported? (Research Question 13)

    ___Yes

    ___No

    NOTES:

  12. Does the report include a model system for gap comparison ("what should be")?

    ___Yes

    ___No

    NOTES:

  13. Does the report include recommendations?

    ___Yes

    ___No

    NOTES:

  14. Are recommendation feasibility, priorities or strategies discussed?

    ___Yes

    ___No

    ___Not Applicable (no recommendations offered)

    NOTES:

  15. Were ethical issues addressed in the needs assessment?

    ___Yes

    ___No

    NOTES:

  16. Was the needs assessment approved by an IRB?

    ___Yes

    ___No

    ___Unknown/unclear

  17. How was capacity measured?

    ___Inventory (number of providers, beds, slots, etc.)

    ___Utilization data

    ___Consumer Self-report (access, availability)

    ___Key informants

    ___Unknown/unclear

    NOTES:

  18. Was stratification used in the analysis?

    ___Yes

    ___No

    ___Unknown/unclear

    NOTES:

  19. Is an operational definition of "need" provided?

    ___Yes Prevalence-unmeet need gap

    ___Yes-Other Describe:

    ___No

    ___Partial

    NOTES:

Best Practices Notes:

Write notes on anything that looks good from the report.