To identify and address gaps in substance use disorder (SUD) treatment capacity, state and federal policymakers need information on the need and demand for different SUD levels of care. Although there exists some information on SUD treatment capacity by level of care, there is no national database of information on the treatment needs of individuals by level of care.
Patient placement criteria and biopsychosocial assessment tools for SUD have been established to guide providers in matching clients to the appropriate level of care. The results of these placement assessments, if collected centrally by states, can also inform states of the distribution of need for different levels of care. These data can be linked and compared to other information for identifying and addressing SUD treatment gaps.
This project fielded a survey of Single State Agencies for Substance Use Services and Medicaid agencies to every state and the District of Columbia. It collected information on how patient placement criteria are operationalized, and the degree to which data are collected and can be used to determine SUD treatment needs across states.
The project found variability in how the criteria are applied due to differences in training and implementation practices, and also variation in the populations for who the criteria are required and the levels of care for which they are required. Variations in these dimensions can affect the ability to compare data on treatment needs across multiple states.
Despite the variation in these practices, there may be an opportunity to collect aggregate de-identified information from a subset of states that are using a uniform set of patient placement processes. These data may be used to potentially establish a multi-state database of SUD treatment needs by level of care. Among participating states within this database, treatment needs could be compared to treatment availability and utilization by level of care, thus identifying areas where resources can be invested to minimize the treatment gap.
This research was conducted under contract #HHSP233201600021I between HHS/ASPE’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and Research Triangle Institute. Please also visit the ASPE Human Services or Public Health for additional research in this area.
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