Project Director Theodora Binion-Taylor
DHS Contract Mgr Peggy Alexander
Annual Grant $ $325,000
Evaluator Name & Contact Info

Richard E. Sherman, Ph.D.

Richard.Sherman@illinois.gov

Annual eval. $ $28,000
Funding Source SAMHSA/CSAT
Eval Period 9/30/06 through 9/29/09

Project Summary

Strengthening Treatment Access and Retention State Implementation Grant or STAR-SI grant funded by the Center for Substance Abuse Treatment is designed to improve the rates of client access to and retention in publicly funded substance abuse outpatient treatment programs in Illinois. Specifically, STAR-SI focuses on four goals:

  • Reduction in waiting time for treatment;
  • Reduction in client no-shows;
  • Increased admissions; and
  • Increased continuation in treatment.

The project model is quality driven, customer centered, and outcome focused. The project has two provider networks, one in Chicago and one serving rural clients.

Summary of Key Findings

The purpose of the evaluation of the Illinois STAR-SI project funded is to assess the project's ability to improve access to and retention in outpatient treatment. The evaluation focused on two of the project's major goals:

  1. Identification of strategies and process improvements that will increase rates of access and retention in Illinois outpatient substance abuse treatment programs; and,
  2. Increase substance abuse outpatient treatment program efficiency in Illinois.

Objectives associated with the first of these goals included the formation of two networks of outpatient treatment provider organizations, one in urban Cook County (Cohort 2) and the other in southern Illinois (Cohort 1). Year 1 of the project focused on the establishment and support of a peer learning network of five substance abuse treatment organizations in southern Illinois (Cohort 1). Additional objectives under the first project goal pertained to the development of a collaboration with the Network for the Improvement of Addiction Treatment (NIATx), local strategic planning and training activities, and the identification of process improvement strategies to be implemented within each established network.

The second Illinois STAR-SI Project goal concerned the achievement of the following system outcomes:

  1. Reduction in no-shows or failure to keep outpatient treatment appointment rates;
  2. Increased client retention rates and length of stay; and,
  3. Increased outpatient treatment admissions.

The CSAT Cooperative Agreement required that all STAR-SI grantees collect and report the following data at baseline and periodic intervals throughout the course of the project. This data is derived from the Government Performance and Results Act (GPRA) data elements that IDHS/DASA submit to CSAT on a routine basis.

  • Number of treatment providers participating in STAR-SI implementation;
  • Number of unique (unduplicated) client admissions;
  • Length of Client stay (defined as duration between dates of admission and last service); and,
  • Number of units of service provided between intake and discharge.

Project Year 1 Illinois STAR-SI project services and activities began in collaboration with the following five IDHS/DASA treatment provider organizations located in southern Illinois (Cohort 1).

  • Community Resource Center
  • Egyptian Public and Mental Health Department
  • Franklin-Williamson Human Services, Inc.
  • Heartland Human Services
  • Southeastern Illinois Counseling Centers

Midway through Year 1, Heartland Human Services elected to cease participation in Illinois STAR-SI. This provider organization was experiencing work stoppage problems from the beginning of Year 1. This organization's reduced staffing level made it difficult for them to actively participate in the project. Also, they were experiencing problems in meeting the minimum 150 client admissions/year criteria for participation. The other four Year 1 providers remained active in the project. At the start of Year 2, Illinois STAR-SI project services and activities were expanded to include collaboration with the following five IDHS/DASA Cook County treatment provider organizations (Cohort 2).

  • Breaking Free
  • Healthcare Alternative Systems, Inc.
  • Human Resource Development Institute
  • Pilsen-Little Village Community Mental Health Center
  • South Suburban Council on Alcoholism and Substance Abuse

Updated A&R Measure Summary Tables for the Illinois Cohort 1 and Cohort 2 providers are included with this report. These tables include monthly levels for each provider specific to the two measures reported for each STAR-SI state, and the three additional measures on which Illinois has elected to report. These updated A&R tables were circulated in early March 2009. The two most recent months on these spreadsheets are November and December 2008. The data for each of these months is partial in nature. The Illinois A&R Summary Table format includes data not requested in the template distributed by NIATx. One of the additional pieces of data provided is the number of clients represented in each month's calculations.

Some of the measures, such as average duration from admission to first session, place restrictions on those clients admitted during the particular month who are eligible for inclusion in the measure's calculation. For example, only clients who actually received a first session following admission are included in the measure's calculation. Without this data, it would not be possible to appropriately combine data across months. Converting the number of clients in such monthly calculations into the percentage of clients admitted during the month who met the measure's criteria can provide an additional useful index. That is, it may be useful to consider the percentage of admitted clients who actually received a first session. For example, a decrease in average duration from admission to first session for those clients who received a first session might indicate improvement. However, if at the same time there was a substantial decrease in the percentage of admitted clients who actually received a first session, a broader look at the data might indicate a possible retention problem.

The tables below are among the pages in the Cohort 1 and Cohort 2 A&R Summary Table Excel workbooks. These tables summarize individual provider and overall Cohort progress toward achieving STAR-SI measure targets over the indicated time periods. Following these tables are summary dot points based on the data in these tables.

Cohort 1 Providers

llinois STAR-SI Project - Year 1 Cohort Average Level I Admissions/Month State Target - 10% Increase from Baseline 08/2007 - 07/2008

Provider Baseline Target Monthly Average Net Change Percent Change
CRC 28.0 31.0 27.9 -0.1 -0.4%
EPMHC 19.0 21.0 21.5 2.5 13.2%
FWHS 39.0 43.0 46.8 7.8 20.0%
SECC 62.0 68.0 72.8 10.8 17.4%
Year 1 Cohort 148.0 163.0 168.9 20.9 14.1%

CRC - Community Resource Center (Monthly Average N=335)

EPMHC - Egyptian Public and Mental Health Center (Monthly Average N=258)

FWHS - Franklin/Williamson Human Services (Monthly Average N=561)

SECC - Southeastern Illinois Counseling Centers (Monthly Average N=873)

Illinois STAR-SI Project - Year 1 Cohort Average # of Service Sessions/First 30 Days State Target - 10% Increase from Baseline 08/2007 - 07/2008

Provider Baseline Target Monthly Avg. Net Change Percent Change
CRC 2.3 2.5 2.6 0.3 13.0%
EPMHC 2.8 3.1 3.4 0.6 21.4%
FWHS 1.6 1.8 2.4 0.8 50.0%
SECC 1.8 2.0 1.6 -0.2 -11.1%
Year 1 Cohort 2.0 2.2 2.2 0.2 10.0%

CRC - Community Resource Center (Monthly Average N=335)

EPMHC - Egyptian Public and Mental Health Center (Monthly Average N=258)

FWHS - Franklin/Williamson Human Services (Monthly Average N=561)

SECC - Southeastern Illinois Counseling Centers (Monthly Average N=873)

Illinois STAR-SI Project - Year 1 Cohort Avg. Duration (Days) from Admission to First Clinical Session State Target - 10% Reduction from Baseline 08/2007 - 07/2008

Provider Baseline Target Monthly Avg. Net Change Percent Change
CRC (Unit 73) 29.5 26.6 13.4 -16.1 -54.6%
EPMHC (Unit 74) 19.1 17.2 15.5 -3.6 -18.8%
FWHS (Unit 71) 46.7 42.0 18.8 -27.9 -59.7%
SECC (Unit 71) 23.0 20.7 38.9 15.9 69.1%
Year 1 Cohort 34.6 31.1 22.2 -12.4 -35.8%

CRC - Community Resource Center (Monthly Average N=42)

EPMHC - Egyptian Public and Mental Health Center (Monthly Average N=85)

FWHS - Franklin/Williamson Human Services (Monthly Average N=383)

SECC - Southeastern Illinois Counseling Centers (Monthly Average N=135)

Illinois STAR-SI Project - Year 1 Cohort Avg. Duration (Days) from First to Second Clinical Session State Target - 10% Reduction from Baseline 08/2007 - 07/2008

Provider Baseline Target Monthly Avg. Net Change Percent Change
CRC (Unit 73) 25.7 23.1 13.0 -12.7 -49.4%
EPMHC (Unit 74) 20.5 18.5 14.8 -5.7 -27.8%
FWHS (Unit 71) 12.1 10.9 14.6 2.5 20.7%
SECC (Unit 71) 24.3 21.9 39.2 14.9 61.3%
Year 1 Cohort 17.8 16.0 19.3 1.5 8.4%

CRC - Community Resource Center (Monthly Average N=38)

EPMHC - Egyptian Public and Mental Health Center (Monthly Average N=80)

FWHS - Franklin/Williamson Human Services (Monthly Average N=330)

SECC - Southeastern Illinois Counseling Centers (Monthly Average N=106)

Illinois STAR-SI Project - Year 1 Cohort % of Admitted Level I Clients/At Least 4 Sessions/First 30 Days State Target - 10% Increase from Baseline 08/2007 - 07/2008

Provider Baseline Target Monthly Avg. Net Change  Percent Change
CRC 9.4% 10.3% 20.0% 10.6% 112.8%
EPMHC 29.8% 32.8% 63.7% 33.9% 113.8%
FWHS 5.2% 5.7% 23.3% 18.1% 348.1%
SECC 5.4% 5.9% 4.4% -1.0% -18.5%
Year 1 Cohort 9.2% 10.1% 17.5% 8.3% 90.2%

CRC - Community Resource Center (Monthly Average N=335)

EPMHC - Egyptian Public and Mental Health Center (Monthly Average N=258)

FWHS - Franklin/Williamson Human Services (Monthly Average N=561)

SECC - Southeastern Illinois Counseling Centers (Monthly Average N=873)

  • The four Cohort 1 providers had a combined average of 168.9 client admissions per month, which was a 14.1% increase over the baseline of 148 admissions per month. Three of the four providers had increases that exceeded the target 10% increase over baseline.
  • The four Cohort 1 providers had a combined monthly average of 2.2 service sessions provided to admitted clients during the first 30 days, which was a 10.0% increase from the baseline of an average of 2.0 sessions during the first 30 days. Three of the four providers had a monthly average that exceeded the target 10% increase over baseline.
  • The four Cohort 1 providers had a combined average duration from opening to first service of 22.2 days, which was a 35.8% decrease from the baseline of 34.6 days. Three of the four providers had decreases that exceeded the target 10% decrease from baseline.
  • The four Cohort 1 providers had a combined average duration from first to second service of 19.3 days, which was a 8.4% decrease from the baseline of 17.8 days. Two of the four providers had decreases that exceeded the target 10% decrease from baseline.
  • The four Cohort 1 providers had a combined average percentage of 17.5% of admitted clients who had at least four sessions during the first 30 days following opening, which was a 90.2% increase from the baseline of 9.2% of admitted clients. Three of the four providers had increases in percentage of admitted clients with at least four sessions in the first 30 days that exceeded the target 10% increase from baseline.

Cohort 2 Providers

Illinois STAR-SI Project - Year 2 Cohort Average Level I Admissions/Month State Target - 10% Increase from Baseline 02/2008 - 07/2008

Provider Baseline Target Monthly Avg. Net Change PercentChange
Breaking Free 48.0 53.0 48.2 0.2 0.4%
HAS 72.0 79.0 77.5 5.5 7.6%
HRDI 47.0 52.0 45.8 -1.2 -2.6%
Pilsen Little Village 22.0 24.0 30.5 8.5 38.6%
South Suburban 35.0 39.0 37.3 2.3 6.6%
Year 2 Cohort 224.0 247.0 239.3 15.3 6.8%

Breaking Free (Monthly Average N=289)

HAS - Healthcare Alternative Systems (Monthly Average N=465)

HRDI - Human Resources Development Institute (Monthly Average N=275)

Pilsen-Little Village (Monthly Average N=183)

South Suburban (Monthly Average N=224)

Illinois STAR-SI Project - Year 2 Cohort Average # of Service Sessions/First 30 Days State Target - 10% Increase from Baseline 02/2008 - 07/2008

Provider Baseline Target Monthly Avg. Net Change Percent Change
Breaking Free 2.9 3.2 2.8 -0.1 -3.4%
HAS 1.9 2.1 2.7 0.8 42.1%
HRDI 3.6 4.0 3.7 0.1 2.8%
Pilsen-Little Village 5.2 5.7 5.3 0.1 1.9%
South Suburban 2.7 3.0 3.0 0.3 11.1%
Year 2 Cohort 2.9 3.2 3.3 0.4 13.8%

Breaking Free (Monthly Average N=289)

HAS - Healthcare Alternative Systems (Monthly Average N=465)

HRDI - Human Resources Development Institute (Monthly Average N=275)

Pilsen-Little Village (Monthly Average N=183)

South Suburban (Monthly Average N=224)

Illinois STAR-SI Project - Year 2 Cohort Avg. Duration (Days) from Admission to First Clinical Session State Target - 10%  Reduction from Baseline 02/2008 - 07/2008

Provider Baseline Target Monthly Avg. Net Change Percent Change
Breaking Free (Unit 62) 18.2 16.4 16.7 -1.5 -8.2%
HAS (Unit 10) 26.9 24.2 19.1 -7.8 -29.0%
HRDI (Unit 01) 0.6 0.5 1.8 1.2 200.0%
Pilsen-Little Village CMHC 10.0 9.0 8.6 -1.4 -14.0%
South Suburban Council 16.9 15.2 16.2 -0.7 -4.1%
Year 2 Cohort 12.9 11.6 12.1 -0.8 -6.2%

Breaking Free (Monthly Average N=166)

HAS - Healthcare Alternative Systems (Monthly Average N=102)

HRDI - Human Resources Development Institute (Monthly Average N=140)

Pilsen-Little Village CMHC (Monthly Average N=154)

South Suburban Council (Monthly Average N=124)

Illinois STAR-SI Project - Year 2 Cohort Avg. Duration (Days) from First to Second Clinical Session State Target - 10% Reduction from Baseline 02/2008 - 07/2008

Provider Baseline Target Monthly Avg. Net Change Percent Change
Breaking Free 38.3% 42.1% 34.7% -3.6% -9.4%
HAS 18.8% 20.7% 33.1% 14.3% 76.1%
HRDI 48.5% 53.4% 52.0% 3.5% 7.2%
Pilsen-Little Village 62.7% 63.3% 59.6% -3.1% -4.9%
South Suburban Council 28.8% 31.7% 32.6% 3.8% 13.2%
Year 2 Cohort 35.1% 38.6% 40.2% 5.1% 14.5%

Breaking Free (Monthly Average N=289)

HAS - Healthcare Alternative Systems (Monthly Average N=465)

HRDI - Human Resources Development Institute (Monthly Average N=275)

Pilsen-Little Village (Monthly Average N=183)

South Suburban (Monthly Average N=224)

  • The five Cohort 2 providers had a combined average of 239.1 client admissions per month, which was a 6.8% increase over the baseline of 224 admissions per month. One of the five providers had an increase that exceeded the target 10% increase over baseline.
  • The five Cohort 2 providers had a combined monthly average of 3.3 service sessions provided to admitted clients during the first 30 days, which was a 13.8% increase from the baseline of an average of 2.9 sessions during the first 30 days. Two of the five providers had a monthly average that exceeded the target 10% increase over baseline.
  • The five Cohort 2 providers had a combined average duration from opening to first service of 12.1 days, which was a 6.2% decrease from the baseline of 12.9 days. Two of the five providers had decreases that exceeded the target 10% decrease from baseline.
  • The five Cohort 2 providers had a combined average duration from first to second service of 7.4 days, which was a 5.1% decrease from the baseline of 7.8 days. Three of the five providers had decreases that exceeded the target 10% decrease from baseline.
  • The five Cohort 2 providers had a combined average percentage of 40.2% of admitted clients who had at least four sessions during the first 30 days following opening, which was a 14.5% increase from the baseline of 35.1% of admitted clients. Two of the five providers had increases in percentage of admitted clients with at least four sessions in the first 30 days that exceeded the target 10% increase from baseline.

Illinois Strengthening Treatment Access and Retention - State Implementation (STAR-SI)

Evaluation Design Richard E. Sherman, Ph.D. , Evaluator

Indicators / Measures Tools / Instruments / Data Sources Other Deliverables / Comments

The Illinois STAR-SI project will collaborate with five treatment provider organizations in southern Illinois.

All STAR-SI states are required to report the baseline and periodic status of the following service and retention measures.

  • Average Units of Service Provided to Admitted Outpatients will measure the average level of treatment participation among admitted outpatients.
  • Average Length of Stay--average number of days that clients remain open in outpatient services.

Illinois has decided to additionally report on the following service access and retention measures.

  • Average Time to Assessment Appointment-from date client first contacts the agency.
  • Average Time from Assessment to First Outpatient Session.
  • Average Time from First to Second Outpatient Session.
  • Early Client Engagement Rate will measure the successful completion of four group or individual sessions within thirty days of admission.
DARTS Not Applicable at this time.