Models of care in New York State Medicaid substance abuse clinics - Range of services and linkages to medical care

Purpose: to explore the range of health care services in substance abuse cl inics. Methods: sun ey of directors of a stratified random sample of 125 su bstance abuse treatment clinics offering methadone, drug-free therapy, or b ath, representing 344 clinics participating in the New York State (NYS) Med icaid program. Survey asked about clinic services and referral patterns. We defined five categories of linkage of substance abuse to medical care rang ing from unlinked (e.g. referral to distant sites) to highly linked (e.g. o n site), To estimate the number of patients sewed, State data on licensed p atient capacity for each clinic were used, Results: This sample represented 344 clinics statewide serving an estimated 60,914 patients. For patients w ith acute, chronic, or HIV-related medical conditions, weighted analyses sh owed highly linked care in 54 of the 344 (16%) clinics statewide, setting a n estimated 13,741 patients. Unlinked care for all these medical conditions was found for 28% of statewide clinics, sewing an estimated 8866 patients, Clinics offering both methadone and drug-free therapy were generally more likely to have medically related sen ices on site. Implications: The extent of medical care services available at substance abuse clinics varies widel y. Over one-quarter of clinics offered only loosely connected medical and s ubstance abuse care. (C) 2001 Elsevier Science inc. All rights reserved.