Strategic program area review. Substance Abuse. Debt and Third Party Financing.

              Strategic Program Area Review
Substance Abuse
Debt and Third Party Financing
Governor’s Office of Strategic Planning and Budgeting
and
Joint Legislative Budget Committee
STATE OF ARIZONA
December 2007
1
2008 ARIZONA STRATEGIC PROGRAM AREA REVIEW ( SPAR)
EXECUTIVE SUMMARY
A. R. S. § 41- 1275 establishes the Strategic Program Area Review ( SPAR) process. The
SPARs provide an opportunity for the Governor and the Legislature to evaluate the
effectiveness and efficiency of programs crossing state agency lines. Pursuant to statute,
the Joint Legislative Budget Committee selected program areas for review during the
2008 legislative session: Substance Abuse and Debt and Third Party Financing. The
President of the Senate and the Speaker of the House of Representatives are required to
assign these SPARs to the Appropriations Committees and may additionally assign the
SPARs to an appropriate standing committee. The assigned standing committees or the
Appropriations Committees shall hold at least one public hearing to receive public input
and to develop recommendations whether to retain, eliminate, or modify the program
subject to the SPAR process.
Substance Abuse
In FY 2007, 12 agencies received public finding for substance abuse programs, and the
state spent an estimated $ 172.0 million on substance abuse efforts. Of this amount, $ 58.4
million ( 34%) came from the state General Fund and $ 84.9 million ( 49%) came from
federal monies.
JLBC Staff Findings – The JLBC Staff made 4 findings regarding Arizona’s current
substance abuse efforts:
• The framework for coordination has improved in the past decade due to the receipt of
a federal grant and the formation of Arizona Substance Abuse Partnership ( ASAP).
Anecdotal information suggests that actual coordination efforts may have improved,
but it remains difficult to quantify these efforts.
• There is no set of “ best practices” available for state substance abuse coordination
efforts.
• Additional measures establishing the effectiveness of substance abuse programs are
still needed, but progress has been made since the last program review in 1998.
• The Drug and Gang Prevention Resource Center should be responsible for compiling
an ongoing annual report which includes substance use- related data, resources, and
strategies for both substance abuse prevention and treatment.
OSPB Findings – The OSPB Staff made the following findings regarding Arizona’s
current substance abuse efforts:
• The Department of Economic Security’s Arizona Families F. I. R. S. T. program is very
effective at reducing the incidence of substance abuse treatment in participating
families; continue to expand the program in the future, as funds are available.
• The Arizona Criminal Justice Commission’s Residential Substance Abuse Treatment
program is effective at increasing the number of inmates who remain drug- free after
being released.
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• While the Courts’ drug program is successful in helping participants stay substance
use free during their participation, overall the program has not graduated that many
people.
• The Department of Corrections, Department of Juvenile Corrections, and Drug and
Gang Prevention Resource Center programs should be continued.
• The Department of Health Services successfully provides and participates in
programs that measure the performance and effectiveness of substance abuse
treatment services; however, improvement is still needed in the area of measuring the
effectiveness of prevention programs.
Debt and Third Party Financing
In total, 8 state agencies and bonding authorities issue state debt. According to the
Arizona Department of Revenue’s most recent annual Report of Indebtedness, state
agencies’ level of debt was $ 5.2 billion in FY 2006. Beyond these obligations,
outstanding debt associated with state authorities that can issue debt on behalf of local
governments or other entities was $ 3 billion in FY 2006.
OSPB Findings – The OSPB Staff made 3 findings regarding state debt and third party
financing:
• Department of Revenue Report of Indebtedness is effective, but could be improved.
• Allow the Housing and Finance Authority to retain interest earnings through a new
fund for administrative costs.
• State Funds should be utilized to finance debt service for the School Facilities Board
as opposed to providing a cash outlay at the beginning of a project.
JLBC Staff Findings – The JLBC Staff made 2 findings regarding state debt and third
party financing:
• The state could benefit from having a third party review debt- related financial
transactions that come before the Joint Committee on Capital Review.
• The Legislature may wish to consider requiring a Debt Affordability Report ( DAR).
STRATEGIC PROGRAM AREA REVIEW
2008 Legislative Session
TABLE OF CONTENTS
Page No.
Introduction................................................................................................................ i
Substance Abuse
JLBC/ OSPB Joint SPAR Report ............................................................................... A - 1
Agency Responses ..................................................................................................... A - 27
Debt and Third Party Financing
JLBC/ OSPB Joint SPAR Report ............................................................................... B - 1
Agency Responses ..................................................................................................... B - 11
i
INTRODUCTION
Overview - A. R. S. 41- 1275 establishes the Strategic Program Area Review ( SPAR)
process, which is intended to review issues that often involve multiple agencies and
evaluate the efficiency, effectiveness, and necessity of selected program areas. This
process was established by Laws 1999, Chapter 148 and replaced the Program
Authorization Review ( PAR) process established by Laws 1995, Chapter 283. The two
program areas and associated agencies are identified in Table 1.
Table 1
SPAR Programs/ Agencies
Substance Abuse Debt and Third Party Financing
Department of Corrections Arizona Department of Administration
Administrative Office of the Courts Department of Commerce
Arizona Criminal Justice Commission Greater Arizona Development Authority
Drug and Gang Prevention Resource Center Arizona Health Facilities Authority
Department of Economic Security Arizona Department of Housing
Department of Education Arizona Housing Finance Authority
Governor’s Office Arizona School Facilities Board
Department of Health Services Arizona Department of Transportation
Department of Juvenile Corrections Arizona Board of Regents
Arizona Medical Board Arizona State University
Arizona State Board of Pharmacy Northern Arizona University
Department of Public Safety University of Arizona
Water Infrastructure Finance Authority
The Joint Legislative Budget Committee ( JLBC) Staff and the Governor’s Office of
Strategic Planning and Budgeting ( OSPB) have jointly published a composite report.
This composite report includes all of JLBC/ OSPB’s SPAR reports for the two programs.
The SPAR reports are also available on the websites for JLBC Staff
( http:// www. azleg. gov/ jlbc. htm) and OSPB ( http:// www. ospb. state. az. us/). Following is
a more complete description of the SPAR process and attached reports.
SPAR Process - The SPAR process consists of three phases:
• Agency Authored Self- Assessment - The first phase requires each of the agencies
responsible for a program subject to SPAR to conduct a Self- Assessment of its
program. This assessment answers specific questions relating to background
information, program performance and program management. Pursuant to statute,
agency Self- Assessments were due to OSPB and JLBC Staff by June 1. In addition to
answering standard questions in the Self- Assessment, most participating agencies
were asked additional questions specific to their SPAR subject. These questions were
answered after June 1.
• JLBC/ OSPB Review and Report - In the second phase of the SPAR process, JLBC
Staff and OSPB reviewed the agency materials and gathered additional information,
as appropriate, to validate the agency’s submission. We then prepared reports of our
ii
findings and recommendations for each of the program areas. Both offices agreed to
the contents of the “ Program Background” sections of each SPAR. The “ Findings
and Recommendations” sections were written separately by each office. Each agency
was given a chance to review and comment on the reports during mid- November and
December. The final agency responses are included in the published reports. As
required by law, the JLBC Staff and OSPB are publishing the final joint SPAR
reports by January 1, 2008.
• Legislative Review - In the third phase, the Speaker of the House of Representatives
and the President of the Senate assign SPARs to Appropriations Committees. They
may also assign the SPARs to a standing committee. These committees are to hold at
least one public hearing for the purpose of receiving public input and recommending
whether to retain, eliminate, or modify funding and related statutory references for the
strategic program areas under review. If standing committees hold the public hearing,
their recommendations shall be made to the Appropriations Committees.
SPAR Composite Report Organization - The SPAR report includes, after this
Introduction, each JLBC/ OSPB SPAR report and an Agency Response section.
1. JLBC/ OSPB SPAR Report ( on lavender paper). This narrative includes the
background section and each of the two offices’ findings and recommendations on the
program based upon the agency Self- Assessment. The “ Program Background”
section includes a brief description of the program along with a program funding
summary. The “ Findings and Recommendations” sections provide each office’s
findings regarding the program area and/ or recommendations for the area. These
findings appear in bold.
2. Agency Response to the JLBC/ OSPB SPAR Report ( on white paper). Each agency
involved in the SPAR process was invited to submit an agency response.
Further Information - Copies of the individual SPAR reports are available through the
websites for JLBC Staff ( http:// www. azleg. gov/ jlbc. htm) and OSPB
( http:// www. ospb. state. az. us/). Copies of this report may also be obtained by contacting
Stefan Shepherd at the JLBC Staff office ( 602- 926- 5491) or Bill Greeney at the OSPB
office ( 602- 542- 5381). These two persons can respond to general questions about the
SPAR process. For additional information about the specific program subject to SPAR,
readers may want to contact the appropriate person from JLBC Staff or OSPB. These
contacts are listed in Table 2.
Table 2
SPAR Contacts
SPAR JLBC Analyst OSPB Analyst
Substance Abuse Amy Upston Chris Hall
Debt and Third Party Financing Leah Ruggieri Patrick Makin
2008 Strategic Program Area Review Substance Abuse A - 1
Substance Abuse Strategic Program Area Review
Program Description ― The state’s substance abuse programs fall into 2 broad categories:
treatment and prevention. Approximately 84,300 people received substance abuse treatment
services from the state in FY 2006. The Department of Health Services ( DHS) treats the
majority of these people through the Division of Behavioral Health Services. This is primarily
funded through Federal Title XIX and Title XXI funds and matching General Fund monies for
persons eligible under the Arizona Health Care Cost Containment System ( AHCCCS). The
Department of Economic Security ( DES) serves a similar population with treatment monies
provided through the General Fund and the Temporary Assistance for Needy Families ( TANF)
Block Grant. The State Department of Corrections ( DOC) and the Department of Juvenile
Corrections ( DJC) treat incarcerated persons, while the Administrative Office of the Courts
assists probationers and the Medical Board and Board of Pharmacy maintain programs serving
licensees. The Arizona Criminal Justice Commission administers monies for treatment services
that are passed through to DOC, DJC, and the Maricopa County Sheriff’s Office.
In addition to the treatment services outlined above, prevention services are provided by DHS,
the Department of Education ( ADE), the Governor’s Office, the Arizona Drug and Gang
Prevention Resource Center, DOC, and the Department of Public Safety. ADE and DHS oversee
most local programs, which have a broad range of goals and methods. Some, such as those
administered by ADE, also incorporate crime and violence prevention into their efforts. Many
also tailor their approach to target specific, at- risk populations, such as youth. The Joint
Legislative Budget Committee staff is currently unaware of a reliable estimate of the number of
individuals receiving prevention services.
The Arizona Substance Abuse Partnership ( ASAP) is the state’s current means of coordinating
the efforts of these programs. ASAP was formed by Executive Order 2007- 12 on June 13, 2007
in response to recommendations put forth by the Governor’s Methamphetamine Task Force to
empower a single statewide coordinating council to coordinate resources and strategies across
the state, identify best practices, and recommend specific policies based on its findings. When
the Executive Order was signed, the existing advisory council for the federal Strategic
Prevention Framework State Incentive Grant became ASAP. It is composed of state agency
directors and deputy directors involved in substance abuse treatment and prevention, as well as
representatives of relevant community organizations and federal entities. Its standing
subcommittees include the Co- Occurring Policy Advisory Team, the Epidemiology Workgroup,
the Emerging Issues Subcommittee, the Underage Drinking Committee, the Methamphetamine
Task Force, and the Workforce Development Committee.
In 1998, the Joint Legislative Budget Committee ( JLBC) and Governor’s Office of Strategic
Planning and Budgeting ( OSPB) completed a Program Authorization Review ( PAR) of state
substance abuse programs, primarily focusing on the 2 largest recipients of substance abuse
monies: DHS and ADE. This PAR process was the predecessor to the SPAR process, and it led
to a number of findings. Two of these addressed the substance abuse system as a whole:
• The system is very complex and uncoordinated, with a large number of funding sources
managed by 13 different entities and a very large number of contracted providers.
2008 Strategic Program Area Review Substance Abuse A - 2
• Despite expending $ 59.9 million for substance abuse services statewide, data demonstrating
the impact of these individual programs are not systematically collected or evaluated.
Additional findings specific to DHS included a lack of performance data related specifically to
Arizona and inadequate performance measures incorporated into the Regional Behavioral Health
Authority ( RBHA) contracts. The ADE findings included a lack of clarity for ADE’s “ Chemical
Abuse” program, the absence of documentation of strategies being used in school districts, and
the absence of evaluation of school district programs. However, the findings did acknowledge
that many of the aspects of the programs are federally mandated and, therefore, out of the state’s
control. A complete list of findings can be found in Appendix A.
Program Funding ― According to participating agencies, the state spent an estimated $ 172.0
million on substance abuse treatment and prevention in FY 2007. Of this amount, $ 58.4 million
( 34%) came from the state General Fund and $ 84.9 million ( 49%) came from federal monies.
Figure 1 shows the breakdown of FY 2007 funding by agency, and Figure 2 depicts each
agency’s share of total FY 2007 funds. Treatment programs are expected to have cost $ 135.4
million, while prevention efforts cost $ 36.6 million. This equates to 79% and 21% of total
spending, respectively. DHS programs expended 68% of total funding and ADE 12%. The
funds spent by DHS go primarily to treatment services, while ADE exclusively funds prevention
programs. Table 1 lists expenditures by agency more fully.
Table 1
Substance Abuse Expenditures FY 1996 and FY 2007
All Funding Sources
Year
Agency
FY 1996
Expenditures
( Actual)
FY 2007
Expenditures
( Estimated)
FY 2006
Number Served
( Treatment)
Dept. of Health Services $ 36,208,700 $ 117,136,200 60,105
Dept. of Education 10,495,900 20,336,100 -
Administrative Office of the Courts 3,701,400 8,862,900 14,976
Dept. of Juvenile Corrections 1,518,500 8,161,000 970
Dept. of Economic Security 665,200 7,224,500 4,727
Governor’s Office 1,925,900 6,208,400 -
Dept. of Corrections 2,657,200 3,115,800 2,600
Drug & Gang Prevention Resource Center -- 435,500 -
Medical Board -- 200,400 100
Dept. of Public Safety 356,100 130,000 -
AZ Criminal Justice Commission 250,600 116,000 796
Board of Pharmacy -- 106,500 42
Other 2,101,100 -- -
Total $ 59,880,600 $ 172,033,200 84,316
2008 Strategic Program Area Review Substance Abuse A - 3
In FY 1996, expenditures from all sources totaled $ 59.9 million. From FY 1996 to FY 2007, the
population in Arizona grew by 45% 1/ and inflation by 32% 2/. Had FY 1996 funding been
adjusted only for inflation and population growth, total expenditures would have been
approximately $ 112.8 million. Total FY 2007 spending is estimated at $ 172.0 million, an
increase of 52% above the amount adjusted for inflation and population growth. This increase
over the inflation- adjusted FY 1996 expenditures is due primarily to the expansion of publicly
funded treatment services through the provisions of Proposition 204 passed in 2000. Medicaid
funding constituted only 12% of DHS substance abuse funding in FY 1996. In FY 2007, it
increased to 60% of DHS funds and 42% of total substance abuse funds. Figure 3 illustrates the
growth over the past 10 years.
FY 2007 Funding of $ 172.0 Million by Source
Appropriated Funds,
$ 7.9 million, 5%
Non- Appropriated
Funds,
$ 20.9 million, 12%
Federal Funds,
$ 84.9 million, 49%
General Fund,
$ 58.4 million, 34%
Figure 1
1/ According to the U. S. Census Bureau, the July 1, 1996 population estimate for Arizona was 4,432,308. The Department of Economic Security
estimates the July 1, 2007 Arizona population at 6,432,007.
2/ Inflation was derived using the Consumer Price Index.
2008 Strategic Program Area Review Substance Abuse A - 4
FY 2007 Total Substance Abuse Expenditure by Agency
Dept. of Health
Services
Dept. of Economic
Security
Dept. of Corrections
Governor’s Office
Dept. of Juvenile
Corrections
Drug & Gang
Prevention Resource
Center
Medical Board
Dept. of Public Safety
AZ Criminal Justice
Commission
Board of Pharmacy
Administrative Office
of the Courts
Dept. of Education
Figure 2
Total Substance Abuse Expenditures Grew
From $ 58.9 M in FY 1996 to $ 172.0 M in FY 2007
0
20,000,000
40,000,000
60,000,000
80,000,000
100,000,000
120,000,000
Dept. of Health
Services
Dept. of
Education
Admin. Office of
the Courts
Dept. of
Economic
Security
Dept. of
Corrections
All Other
Figure 3
2008 Strategic Program Area Review Substance Abuse A - 5
Coordination Efforts ― Since 1990, 2 official statewide efforts have attempted to bring state
agencies together to improve the efficiency and effectiveness of substance abuse efforts. In
1990, the Legislature formed the Drug and Gang Policy Council, composed of the director or
representatives from state agencies which receive federal or state monies for substance abuse
prevention and treatment. The Council’s objective was to foster cooperation among state and
local entities, neighborhood groups, community organizations, and private groups to ensure the
optimal delivery of substance abuse treatment and prevention programs. It was tasked with
recommending the basis for effective coordination of all state programs, conducting an annual
inventory of publicly supported prevention and treatment programs, evaluating the results
achieved by publicly supported substance abuse programs, and overseeing the Drug and Gang
Prevention Resource Center. The statutory language detailing the membership and role of the
Council can be found in Appendix B. The Council and its statutory authority sunset on July 1,
2005, but the Center continued and is described in more detail in the next section.
Less than a year before the Council sunset, the Governor’s office received the Strategic
Prevention Framework State Incentive Grant. This federal grant provides $ 11.75 million over a
5- year period. The purpose of the grant is to build a comprehensive system to target substance
abuse problems throughout the state and to focus efforts where they will have the greatest
impact. The grant required that the state form an advisory council and many members of the
Drug and Gang Policy Council became members of this council.
In addition to establishing an advisory council, the grant required a state- level needs assessment
to be conducted. An epidemiology workgroup was formed to work on this project, and the
results were published in 2005. After compiling this data, the workgroup determined that the
grant should focus on 2 substance abuse areas: problematic drinking and youth illicit drug use.
Funds would be distributed through an open competitive bidding process. During this time,
additional workgroups were formed and began working on other significant issues such as
methamphetamine and underage drinking.
In June 2007, the advisory group was formalized as the Arizona Substance Abuse Partnership
( ASAP) as a result of Executive Order 2007- 12. The existing subcommittees under the Advisory
Council and other outside committees were pulled under this umbrella organization, and new
ones were created. ASAP includes the directors or deputy directors of state agencies which
receive public substance abuse funding, along with representatives from relevant community
organizations. Its responsibilities are similar to those of the Drug and Gang Policy Council;
ASAP’s mission, however, does not specifically include gang prevention, and they are not
charged with overseeing the Drug and Gang Prevention Resource Center. A complete listing of
required members of ASAP and its duties can be found in Appendix C. Presently, there are 5
subcommittees underneath ASAP: the Co- Occurring Policy Advisory Team, the Emerging Issues
Subcommittee, the Underage Drinking Committee, the Methamphetamine Task Force, and the
Workforce Development Committee.
Agency Descriptions ― In FY 2007, 12 agencies were involved with the delivery of substance
abuse prevention and/ or treatment. Following is a listing of these agencies, a description of the
services they provide, their statutory requirement, the number of persons served, and the amount
of funding they receive. Funding is delineated by General Fund monies ( GF), Other
Appropriated Funds ( OF), Non- Appropriated Funds ( NA), and Federal Funds ( FF).
2008 Strategic Program Area Review Substance Abuse A - 6
Administrative Office of the Courts
FY 2007 Estimated Expenditures: $ 6,570,543 for treatment, $ 2,292,389 for prevention;
FY 2007 Funding Sources: $ 3.1 million ( 35%) GF, $ 447,500 ( 5%) OF, $ 4.6 million ( 52%) NA,
$ 690,100 ( 8%) FF;
Direct Treatment Population ( FY 2006): 12,712 adult offenders and 2,264 youths.
Four substance abuse- related treatment programs are administered through the Juvenile Justice
Services and Adult Probation Services Divisions of the Arizona Supreme Court.
• A. R. S. § 8- 322 authorizes the establishment of the Juvenile Probation Services Fund which is
used, in part, to provide residential treatment; full or half day intensive care; group, family,
and home- based counseling; and cognitive substance abuse for juveniles.
• A. R. S. § 12- 299 establishes the Community Punishment Program to provide increased
conditions of probation and community- based programs through halfway houses,
detoxification centers, inpatient treatment, psychological, medical, and vocational services,
as well as diagnostic evaluations, counseling, and urine screening. The program served
3,840 individuals in FY 2005 and 1,805 in FY 2006. Monies are dispensed to the counties,
which are responsible for evaluating the program.
• A. R. S. § 13- 3422 authorizes the drug court program for the purpose of prosecuting,
adjudicating, and treating drug dependent persons. Drug court participants sentenced under
A. R. S. § 13- 901.01 for drug abuse offenses are mandated to attend treatment. Additional
participants are required to attend treatment by order of the drug court judge. While some of
the drug courts were initially established with federal funds, General Fund support was first
added in FY 2007; the agency is still in the process of developing performance measures.
The Drug and Gang Enforcement Account, established by A. R. S. § 41- 2402, provides adult
probationers with a variety of services, including court case processing, drug testing, and
funding of staff for adult drug courts. During the first half of FY 2007, participating drug
courts served 1,610 persons.
• A. R. S. § 13- 901.02 establishes the Drug Treatment and Education Fund ( DTEF). DTEF
monies are distributed to 15 Superior Court adult probation departments to help fund drug
education and treatment programs. In FY 2006, 5,150 probationers received residential or
outpatient treatment, 940 received drug education, and 2,480 were assessed or provided other
services.
Department of Corrections
FY 2007 Estimated Expenditures: $ 2,880,844 for treatment, $ 234,909 for re- entry initiative;
FY 2007 Funding Sources: $ 1.6 million ( 50%) GF, $ 984,200 ( 32%) OF, $ 409,600 ( 13%) NA,
$ 163,400 ( 5%) FF;
Direct Treatment Population ( FY 2006): 1,960 inmates in moderate treatment and 640 in
intensive treatment.
2008 Strategic Program Area Review Substance Abuse A - 7
A. R. S. § 41- 1602 authorizes the DOC to provide rehabilitation for all adult offenders, which
enables the department to offer substance abuse treatment and education while offenders are in
prison. Inmates may also be eligible for aftercare while on community supervision. Guidelines
for the transition program are found in A. R. S. § 31- 281. Education and treatment for DWI/ DUI
offenses are mandated by A. R. S. § 31- 255, with a curriculum approved by the Department of
Health Services.
DOC also coordinates with the Department of Health Services ( DHS) for the Correctional
Officer/ Offender Liaison ( COOL) program. The COOL program provides substance abuse and
behavioral health services to high- risk offenders who remain on parole upon leaving prison and
expedites the eligibility screening for offenders to receive DHS- provided services. To avoid
double counting, funding for this program is displayed with DHS.
Four private prisons house DOC inmates and all 10 state correctional facilities provide substance
abuse services. However, substance abuse costs and number treated within the 4 private prison
facilities was not available. As a result, the department's spending may not accurately reflect the
magnitude of substance abuse treatment efforts.
DOC identifies 90% of incoming offenders as requiring some intervention or treatment. Of this
identified population, 19% are classified as low- need and 81% are moderate or high- need.
Programming is established commensurate with risk and need level and takes place near the end
of sentences. In FY 2006, 1,960 moderate- need offenders participated in the 6- month group
therapy program, while 640 high- risk, high- need offenders participated in the 12- month therapy
program.
To help gain a better understanding of the effectiveness of the program, the department measures
the percentage of individuals who pass randomly- administered urine analysis tests. In FY 2006,
96% of all inmates and 99% of those in a formal treatment program at the time of testing were
drug free. Additionally, the department measures the percentage of individuals who graduate
from treatment programs. In FY 2006, 87% of those who entered treatment completed the
treatment curriculum.
Recidivism is defined as a new felony conviction within 3 years of release from Department.
The department regularly reports recidivism rates every 10 years. Its most recent study of
releases between 1990 and 2000 established a recidivism rate of 36% for substance abusers. In
comparison, the recidivism rate for non- substance abusers was 22.7%. A follow up study
determined there was a noted reduction in recidivism from 36% to 28.2% over a 2- year period
when inmates who were substance abusers received and completed substance abuse
programming.
Arizona Criminal Justice Commission
FY 2007 Estimated Expenditures: $ 115,979 for treatment;
FY 2007 Funding Sources: $ 29,000 ( 25%) GF, $ 87,000 ( 75%) FF;
Direct Treatment Population ( FY 2006): 796 jail inmates in Maricopa County.
A. R. S. § 41- 2405 allows the Arizona Criminal Justice Commission ( ACJC) to evaluate and
gather information concerning programs designed to effect community crime prevention through
2008 Strategic Program Area Review Substance Abuse A - 8
citizen participation and disseminate that information to the public, political subdivisions, law
enforcement agencies and the legislature. The Governor has designated the ACJC as the agency
responsible for allocating several U. S. Department of Justice federal grant programs, including
the Residential Substance Abuse Treatment ( RSAT) program.
The RSAT program was designed to address the high rates of substance abuse among inmates
incarcerated in state and county facilities. Offenders must enter the program voluntarily and are
isolated from the general correctional population to avoid relapse. Participants are involved with
group therapy and may be eligible for aftercare services. Substance abuse treatment services are
not legally mandated for this population, but the federal government provides a 3: 1 match for the
RSAT program.
RSAT funds passed onto DOC and DJC are reflected in that department’s expenditures. The
expenditures and population served listed above are solely for the Maricopa County Sheriff’s
Office Jail’s Alpha program. Inmates in this program receive a one- on- one psychological
interview, as well as group counseling sessions.
ACJC uses several performance measures in evaluating this program including the amount of
services provided, number of offenders entering treatment, cost of treatment, recidivism and drug
use, and the number entering the aftercare program and their success rate. In Federal Fiscal Year
( FFY) 2006, 78.5% RSAT participants who completed the program remained drug- free during
the aftercare program. Recidivism rates are included among the factors which determine grant
contract renewals.
Arizona Drug and Gang Prevention Resource Center
FY 2007 Estimated Expenditures: $ 435,500 for education;
FY 2007 Funding Sources: $ 295,900 ( 68%) OF, $ 139,600 ( 32%) FF.
Direct Treatment Population ( FY 2006): None.
The Arizona Drug and Gang Prevention Resource Center is a statutorily independent entity,
which acts as a statewide clearinghouse for drug and gang prevention and substance abuse
prevention information. Staff members provide information, technical assistance, and grant-writing
help for those interested in prevention programs. Additionally, they collaborate with a
wide variety of organizations to encourage prevention programs with effective strategies.
Members of their staff serve on several of the ASAP subcommittees.
Initially, the Center was overseen by the Arizona Drug and Gang Policy Council, which was
established in 1990 through A. R. S. § 41- 617. The Council was allowed to sunset on July 1,
2005. Prior to its sunset, the Council was statutorily required to compile an annual inventory of
publicly supported education, prevention, and treatment programs related to substance abuse and
criminal street gangs in Arizona. The Council had delegated this task to the Center.
The Center’s performance measures include service requests completed, pieces of materials
disseminated, library items checked out, and grant proposals which they help write.
Additionally, they attempt to determine the number of individuals who are directly or indirectly
impacted by their services, the value of the grants which are received due to their assistance, and
customer satisfaction rating.
2008 Strategic Program Area Review Substance Abuse A - 9
Department of Economic Security
FY 2007 Estimated Expenditures: $ 7,224,500 for treatment;
FY 2007 Funding Sources: $ 5.2 million ( 72%) GF, $ 2 million ( 28%) FF;
Direct Treatment Population ( FY 2006): 4,727 individuals.
A. R. S. § 8- 881 et seq. authorizes the Joint Substance Abuse Treatment Fund to provide a
statewide treatment program, known as Arizona Families FIRST ( AFF), for substance abusing
families who take part in the child welfare system or receive TANF Cash Assistance. The
purpose of AFF is to develop government and community partnerships to assist families heavily
involved in substance abuse. These services are delivered through DHS’ Regional Behavioral
Health Authorities, domestic violence agencies, social service agencies and faith- based
organizations. Statute requires provision of the following: substance abuse screening and
assessment, treatment referral, treatment services, aftercare, and service coordination.
A. R. S. § 8- 812 establishes the Child Protective Services Expedited Substance Abuse Treatment
Fund for DES to provide substance abuse treatment services to non- Title XIX eligible parents.
Expedited treatment funds are now integrated into AFF.
DES measures program effectiveness through: 1) abstinence from illicit drugs, 2) substantiated
Child Protective Services ( CPS) reports of abuse and neglect, and 3) reunification of children to
their parents after engaging in the program. The 2006 annual evaluation of the program reported
that 60% of persons were free of drugs while on the program ( as verified by drug screening
tests), there were fewer cases of abuse and neglect compared to state averages, and 25% of all
children of AFF clients achieved permanency in 2006 ( an increase of 9% over 2005).
Department of Education
FY 2007 Estimated Expenditures: $ 20,336,073 for prevention;
FY 2007 Funding Sources: $ 7.4 million ( 36%) GF, $ 8.5 ( 42%) NA, $ 4.4 million ( 22%) FF;
Direct Treatment Population ( FY 2006): None, but public school students and employees
receive prevention services.
A. R. S. § 15- 345 allows local school districts to create and adopt policies regarding substance
abuse prevention programs with the assistance of students, district personnel, and the community
at large. Funding and criteria for substance abuse prevention instruction is detailed in A. R. S.
§ 15- 712, which places emphasis on conveying the harmful effects of dangerous drugs. The
Chemical Abuse Program was created in 1943 to provide instruction about alcohol and narcotics
and their effects on the human body. As of 1995, substance abuse education is no longer
mandated by the state, although school districts still have the option of providing substance
abuse education in their course of study.
A. R. S. § 15- 154 establishes the School Safety program with the purpose of providing funding for
full- time school resource or juvenile probation officers. Because these officers are not primarily
focused on substance abuse prevention, the $ 14.2 million in General Fund and proposition 301
monies for this program only indirectly go towards prevention efforts.
2008 Strategic Program Area Review Substance Abuse A - 10
All programs, strategies, and activities are approved in a combined Chemical Abuse/ Title IV
application, and schools are allocated funds on a formula basis. In compliance with the Safe and
Drug- Free Schools and Communities Act ( Title IV), all applications must follow the U. S.
Department of Education’s Principles of Effectiveness. Each district is responsible for assessing
its own needs and then either developing a program that meets expectations or choosing a
“ proven- effective” prevention program.
Governor’s Office
FY 2007 Estimated Expenditures: $ 6,208,407 for prevention;
FY 2007 Funding Sources: $ 2.7 million ( 43%) OF, $ 3.5 million ( 57%) FF;
Direct Treatment Population ( FY 2006): None.
Two divisions within the Governor’s Office allocate resources for substance abuse prevention.
The Division of Substance Abuse Policy, a component of the Governor’s Division for Children,
Youth and Families, staffs a number of prevention efforts. It oversees the distribution of state
money allocated to the Arizona Parents Commission, which is funded by the Drug Treatment
and Education Fund. It also administers the federal Strategic Prevention Framework State
Incentive Grant and the federal Co- Occurring Disorder State Incentive Grant. The Division
staffs the Parents Commission on Drug Education and Prevention, the Arizona Substance Abuse
Partnership, the Underage Drinking Prevention Committee, the Prisoner Re- Entry Task Force,
and the Methamphetamine Task Force. The 3 largest efforts are discussed in more detail below:
• The Arizona Parents Commission on Drug Education and Prevention Fund was established
by the passage of Proposition 200 in 1996 to increase and enhance parental involvement and
increase education about the health problems caused by the abuse of alcohol and controlled
substances. The Commission is comprised of Arizona citizens who are chosen by the
Governor to serve 2- year terms. The Governor’s Division assists the Commission in
developing education, prevention, and parental involvement strategies. Approximately $ 12
million is set aside annually from alcohol taxes. Of this $ 12 million, approximately one- third
is distributed to each of the following: The Parents Commission, the Administrative Office
of the Courts, and Arizona Department of Corrections. The commission is responsible for
distributing funds to programs which increase parental involvement and provide educational
and prevention efforts.
• The Governor’s Office also oversees the distribution of the 5- year Strategic Prevention
Framework State Incentive Grant which is designed to help the state develop a
comprehensive system to target substance abuse problems. This grant led to the formation of
the Arizona Substance Abuse Partnership and other subcommittees involving intrastate
coordination. This grant is described in greater detail in the previous section.
• On September 20, 2007, the Governor’s Office announced that it was awarded an $ 8.3
million federal Access to Recovery grant, to be distributed over the next 3 years, to support
the expansion of methamphetamine treatment and recovery services through drug courts.
In addition to the Office of Substance Abuse expenditures, the Governor's Office of Highway
Safety provides federal funds for the prevention and education on substance abuse as it relates to
2008 Strategic Program Area Review Substance Abuse A - 11
highway/ traffic safety and youth alcohol issues. These funds are distributed only after the
projects and programs are approved by the National Highway Traffic Safety Administration and
the U. S. Department of Justice ( these are the 2 federal agencies from which the Office of
Highway Safety currently receives funding).
There are no state dollars in the Governor's Office of Highway Safety that are specifically
earmarked for substance abuse programs. However, in FY 2007, the Office of Highway Safety
passed through $ 1.7 million in federal monies to non- profit, local, and state agencies, as well as
expending some of these funds on substance abuse education projects.
Department of Health Services
FY 2007 Estimated Expenditures: $ 110,127,717 for treatment, $ 7,008,, 505 for prevention;
FY 2007 Funding Sources: $ 34.3 million ( 29%) GF, $ 2.5 million ( 2%) OF, $ 7.2 million ( 6%)
NA, $ 73.1 million ( 62%) FF;
Direct Treatment Population ( FY 2006): 60,105 individuals.
The Department of Health Services ( DHS) is the largest recipient of substance abuse monies,
accounting for approximately 68% of total funds. Its primary role, as established by A. R. S.
§ 36- 2001, is the administration and oversight of state funded substance abuse treatment. DHS
contracts with 4 Regional Behavioral Health Authorities ( RBHAs) and 5 Tribal Contractors to
provide substance abuse treatment, along with all other aspects of behavioral health, in 6
geographic areas and 5 reservations.
State coverage of substance abuse treatment, as well as funding, has increased substantially in
the past 15 years. In 1995, substance abuse treatment became a covered service under the state’s
Title XIX ( Medicaid) program. Over the next decade, several programs began which further
expanded the number of persons eligible for substance abuse treatment. During 1998, the
Legislature enacted KidsCare, also known as the Children’s Health Insurance Program ( CHIP),
to allow uninsured children up to 200% of the Federal Poverty Level to qualify for government
assisted health care, including substance abuse treatment. In 2000, Arizona voters passed
Proposition 204 which provides health care coverage to most uninsured adults who earn up to
100% of the Federal Poverty Level. Coverage for parents was expanded even further in FY 2003
when KidsCare Parents was enacted, adding coverage to parents who are uninsured and made
between 100% and 200% of the Federal Poverty Level.
Although the oversight of Title XIX and Proposition 204 monies is the department’s primary
role, DHS also receives federal funding through the Substance Abuse Prevention and Treatment
Block Grant. Although these monies are distributed to DHS, it has contracted with the RBHAs
to provide the prevention and treatment services. The RBHAs, in turn, either provide services
directly or contract with local non- profit agencies.
DHS also assists with some programs run primarily by other agencies, specifically the
Correctional Officer/ Offender Liaison ( COOL) program and Arizona Families FIRST program.
( For more information on these programs, see the description for the Department of Corrections
and Department of Economic Security.)
2008 Strategic Program Area Review Substance Abuse A - 12
To measure the effectiveness of the programs, DHS tracks the following performance measures:
access to care, symptomatic and functional improvement, overall satisfaction with services,
coordination of care with AHCCCS plans, cultural competency, and member/ family involvement
in treatment. DHS participates in the federal National Outcome Measures database, which
collects data on alcohol use, drug use, employment, criminal justice activity, and stable housing.
These items are measured both before and after treatment.
In FY 2005, DHS saw an increase of 2.7% in employment, an increase of 6.9% in abstinence
from alcohol, and an 8.9% increase in drug abstinence. Homelessness and arrests both declined
during that year at a rate of ( 0.3)% and ( 6.6)%, respectively. Substance abuse prevention
programs are required to evaluate programs annually, and the RBHAs are required to report
outcomes to DHS annually. In FY 2006, 83% of prevention programs reported outcomes. DHS
estimates that approximately 212,473 individuals received prevention services in FY 2006.
Department of Juvenile Corrections
FY 2007 Estimated Expenditures: $ 8,160,960 for treatment;
FY 2007 Funding Sources: $ 6.7 million ( 82%) GF, $ 685,300 ( 8%) OF, $ 763,400 FF ( 10%);
Population Served ( FY 2006): 970 youths.
A. R. S. § 41- 2816 authorizes the Department of Juvenile Corrections ( DJC) to provide
rehabilitative services to committed youth. This is to be accomplished through an individual
treatment plan based on a diagnostic psychological evaluation and educational assessment, as
detailed in A. R. S. § 41- 2815. Substance abuse problems are assessed for each youth when they
arrive at DJC. As of July 31, 2007, the department has assessed 1,062 of the 1,088 currently
committed youth. Of these, 91% have been diagnosed with a substance abuse disorder.
The majority of these youth are treated through the New Freedom program. For those with
severe abuse issues, DJC also has 4 specialty substance abuse units funded partially through the
Residential Substance Abuse Treatment ( RSAT) program. Per the RSAT grant requirements,
this program must separate participants from the general correctional populace and focus
primarily on the substance abuse problems of the inmate. In FY 2006, 690 youth completed
treatment plans addressing substance abuse and 135 were admitted to the RSAT program.
A number of objectives are tracked to help DJC evaluate the effectiveness of their program: 1)
the percentage of youth promoted to the next level of behavior management each month; 2) the
number of incident reports each month; 3) the percentage of youth completing treatment work
assigned; 4) the percentage of youth having a negative urine analysis; and 5) the percentage of
youth who articulate their plan for handling high risk situations for relapse in their monthly
meeting. Juveniles released in 2005 had a 12- month recidivism rate of 36%. Those released in
2003 had a 36- month recidivism rate of 48%. DJC is in the process of working with a national
expert to make program improvements.
Arizona Medical Board
FY 2007 Actual Expenditures: $ 200,412 for treatment;
FY 2007 Funding Sources: $ 200,400 ( 100%) OF;
Population Served ( FY 2007): 108 physicians and physician assistants.
2008 Strategic Program Area Review Substance Abuse A - 13
A. R. S. § 32- 1452 allows the Arizona Medical Board to establish a confidential program for the
treatment and rehabilitation of physicians and physician assistants who are impaired by drug or
alcohol abuse. The program shall include education, intervention, therapeutic treatment, and
post- treatment monitoring and support. The Monitored Aftercare Program ( MAP) typically
provides follow- up care for a period of 5 years. This care includes services such as weekly
relapse prevention programs, facilitation of attendance at 12- step programs, regular face- to- face
interviews with participants to evaluate the recovery process, and random biological fluid or
other drug testing.
A private firm is contracted by the Board to administer the program. They are required by
contract to facilitate relapse prevention groups in at least Maricopa, Pima, and Coconino
Counties and to select a drug testing laboratory to collect specimen samples throughout Arizona.
The Board dedicates one staff person to oversight of the contract.
The Board’s performance measures include participant success rate, relapse rate, and recidivism.
Because Arizona’s self- report rate was substantially lower than nationwide, in FY 2007, the
Board implemented a strategy to encourage physicians to self report their substance abuse
problems. In FY 2006, all performance measures were met, with the exception of the MAP
participant relapse rate, which fell short by 1%. The relapse rate in FY 2006 was 6%.
Arizona State Board of Pharmacy
FY 2007 Estimated Expenditures: $ 106,450 for treatment;
FY 2007 Funding Sources: $ 106,500 ( 100%) OF;
Population Served ( FY 2006): 42 pharmacists and pharmacy technicians.
A. R. S. § 32- 1931.01 allows the Arizona State Board of Pharmacy to establish a confidential
program for the treatment and rehabilitation of pharmacists who are impaired by drug or alcohol
abuse. The program shall include education, intervention, therapeutic treatment, and post-treatment
monitoring and support. The statute further stipulates that the Board may allocate up
to $ 20 for each biennial license renewal to help subsidize the program. Currently, the per
renewal contribution to the program is $ 12.42.
The Pharmacists Assisting Pharmacists in Arizona program provides treatment to impaired
pharmacists and pharmacy interns. The Board contracts service delivery to a private firm. The
firm is tasked with identifying and incorporating “ best practices” and evaluating the
effectiveness of the program. The firm reports a recidivism rate of 20% for the program. The
Board does not receive any other information regarding the effectiveness of the program.
The program also provides continuing education programs to professionals and the general
public at least twice a year, and sponsors 2 $ 1,000 scholarships to students who wish to attend
the Utah School on Alcoholism and Other Drug Dependencies.
Department of Public Safety
FY 2007 Estimated Expenditures: $ 130,000 for prevention;
FY 2007 Funding Sources: $ 130,000 ( 100%) NA;
Population Served: None, but 13,090 youths receive prevention services.
2008 Strategic Program Area Review Substance Abuse A - 14
A. R. S. § 13- 2314.01( E) and A. R. S. § 13- 2314.03( E) permit law enforcement agencies to use
anti- racketeering monies for substance abuse prevention and education programs. The use of
asset forfeiture monies to fund substance abuse programs is intended to put criminal proceeds to
productive use by reducing the demand for illegal drugs and to improve the health and safety of
local communities. DPS focuses its funding efforts on youth substance abuse prevention and
education programs.
These programs are administered by non- profit organizations. Of the funding passed through to
these non- profits, 90%, or $ 442,500, has been given to the Boys and Girls Club Smart Moves
program. After DPS funding of this program was implemented, participation increased by 4,436
youth. In FY 2006, the Smart Moves program served a total of 13,090 youth. DPS chose the
Smart Moves program, in part, because it is identified as one of the “ best practice” programs by
the U. S. Department of Justice. The remaining 10% goes to a variety of other prevention
programs targeted at youth.
National Comparison ― Since 1971, the federal government has collected data on the use of
illegal drugs by the U. S. population through an interviewing process3/. Table 2 shows the most
recent results of this survey, including the following:
• Compared to other states, Arizona residents had a lower drug use rate for all age groups, but
a higher use rate for those aged 12- 17. Rates of dependence on either illicit drugs or alcohol
are higher in Arizona than nationally.
• Arizona had the second highest rate of residents 25 years or older who needed, but did not
receive treatment for alcohol, and the second highest rate of 12- 17 year olds who needed, but
did not receive treatment for illicit drugs.
Table 2
Selected Arizona Illicit Drug and Alcohol Use Rates, 2005
Category
Arizona
( Percentage)
National
Average
Arizona
Ranking
Illicit Drug Use in Past Month ( All Ages) 7.33 8.02 36
Illicit Drug Use in Past Month ( 12- 17) 11.16 10.25 14
Dependence on Drugs or Alcohol In Past Year ( All Ages) 10.31 9.25 9
Dependence on Drugs or Alcohol in Past Year ( 12- 17) 10.51 8.44 7
Needing, but not receiving treatment for drugs ( All Ages) 2.67 2.67 25
Needing, but not receiving treatment for drugs ( 12- 17) 6.3 4.69 2
Needing, but not receiving treatment for alcohol ( All Ages) 8.58 7.35 8
Needing, but not receiving treatment for alcohol ( 12- 17) 6.83 5.51 9
Needing, but not receiving treatment for alcohol ( 25+) 7.17 5.93 2
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. State Estimates of Substance Use
from the 2004- 2005 National Surveys on Drug Use and Health. < http:// www. oas. samhsa. gov/ 2k5State/ AppB. htm>.
In addition, 2005 data showed that 932 people per 100,000 in Arizona were admitted into
substance abuse treatment programs, 198 more than the national rate of admission4/. If adjusted
for race, ethnicity and gender, the state’s admissions would be 1,001 per 100,000 Arizona
residents, 339 more than the national rate.
3/ Substance Abuse and Mental Health Services Administration, Office of Applied Studies. State Estimates of Substance Use from the 2004- 2005
National Surveys on Drug Use and Health. < http:// www. oas. samhsa. gov/ 2k5State/ Ch1. htm>
4/ US Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set ( TEDS): 1995- 2005.
< http:// wwwdasis. samhsa. gov/ teds05/ TEDSAd2k5Tbl4.6a. htm>
2008 Strategic Program Area Review Substance Abuse A - 15
There is little data on total substance abuse spending across states; however, the Office of
National Drug Control Policy ( ONDCP) collects data on the spending of single state authorities,
as designated for the purposes of the Substance Abuse Block Grant. Their most recent inventory
details expenditures from 20035/. The Department of Health Services’ Division of Behavioral
Health Services ( DHS/ DBHS) serves as Arizona’s single state authority for substance abuse.
While this data does not perfectly capture substance abuse spending, DHS/ DBHS oversaw 68%
of Arizona’s total substance abuse funds in FY 2007.
Based on data provided by the ONDCP, Arizona was ranked 20th for the highest amount of
substance abuse expenditures per capita. DHS spent $ 14.10 on substance abuse per capita,
compared to the national per capita amount of $ 13.50. State funds made up 19% of the total
expenditures, compared to 42% nationally. Prevention made up 7.9% of DHS’ total
expenditures, while on average other single state authorities spent 13.7% of their budget on
prevention. Administration costs constituted 1.2% of total expenditures, instead of the national
average of 4%. The average cost of treatment per patient was $ 1,243, 20% less than the average
cost of delivery in other states.
Findings and Recommendations – JLBC Staff
The framework for coordination has improved in the past decade due to the receipt of a
federal grant and the formation of the Arizona Substance Abuse Partnership. Anecdotal
information suggests that actual coordination efforts may have improved, but it remains
difficult to quantify these efforts.
The 1998 Substance Abuse Program Authorization Review ( PAR) found that “ the system is very
complex and uncoordinated with a large number of funding sources managed by 13 different
entities and a very large number of contracted providers.” A decade later, there are 12 agencies
involved in this complex system. Several changes have occurred, however, leading to a better
framework for coordination and the possibility of collaboration. The largest change resulted
from the receipt of the federal Strategic Prevention Framework Incentive Grant, which led to the
formation of the Arizona Substance Abuse Partnership ( ASAP). With the exception of the
Arizona Medical Board and the Arizona State Board of Pharmacy, all state agencies that receive
public substance abuse funding are currently active in ASAP. One of ASAP’s collaborative
efforts includes the compilation of a statewide epidemiology report and needs assessment.
Another outcome is the 2007 strategy for reducing methamphetamine use entitled “ A Plan for
Action: Addressing the Methamphetamine Crisis in Arizona.”
Other coordination efforts since 1998 include the Correctional Officer/ Offender Liaison ( COOL)
program and the Arizona Families FIRST program. The COOL program began in 1998 and is a
collaboration between the Department of Health Services ( DHS) and the Department of
Corrections. COOL provides substance abuse and behavioral health services to high- risk
offenders who remain on parole upon leaving prison and expedites the eligibility screening for
offenders to receive DHS- provided services. The Arizona Families FIRST program, established
in FY 2001, is a partnership between DHS and the Department of Economic Security ( DES) that
addresses substance abuse in families participating in the child welfare system or receiving cash
5/ Office of National Drug Control Policy. Inventory of State Substance Abuse Prevention and Treatment Activities and Expenditures ( 2006).
< http:// www. whitehousedrugpolicy. gov/ publications/ inventory/>
2008 Strategic Program Area Review Substance Abuse A - 16
aid. DES clients receive services through DHS, and DES pays for services not reimbursed by
DHS.
Despite the progress, collaboration gaps still exist, particularly with prevention efforts where
multiple agencies serve potentially overlapping clientele. Adolescents, for example, may receive
substance abuse education at school with funds from the Department of Education or through the
Boys and Girls Clubs funded by either the Department of Public Safety or DHS. Because each
agency determines separately how to utilize prevention monies, and a statewide strategic plan
has not been developed, prevention efforts may overlap or miss populations altogether. On the
other hand, treatment programs serve specifically defined groups, diminishing the likelihood of
overlap with treatment.
Agencies may also find it beneficial to share performance measures and consider collecting
uniform measures for similar treatment and prevention programs. Such coordination activities
would allow for comparison of similar programs.
There is no set of “ best practices” available for state substance abuse coordination efforts.
States use a variety of collaborative methods to improve the effectiveness of substance abuse
treatment and prevention services, and many states have only recently begun collaborative
efforts. New Mexico and Washington State are 2 examples of collaboration efforts in other
states.
In 2005, New Mexico began managing mental health and substance abuse services provided by
state agencies through a single statewide entity. The statewide entity provides many of the same
services as each Arizona Regional Behavioral Health Authority ( RBHA), but its role goes
considerably beyond that of a RBHA; it oversees the services that are provided by or funded by
12 separate state agencies.
Unlike New Mexico, which has focused its efforts on service coordination, Washington State’s
efforts have focused on data coordination. All agencies that receive publicly funded monies for
alcohol and drug treatment must provide information to their “ Target” substance abuse database.
The data is then used to demonstrate costs savings in other areas including emergency room
visits, medical costs, arrests, and convictions.
Additional measures establishing the effectiveness of substance abuse programs are still
needed, but progress has been made since the last program review in 1998.
All agencies should collect and report information on prevention and treatment programs. The
1998 Substance Abuse PAR found that “ despite expending $ 59.9 million for substance abuse
services statewide, data demonstrating the impact of these individual programs are not
systematically collected or evaluated.” Although many agencies have improved in this area,
some gaps continue to exist.
One example is in the Department of Education ( ADE) prevention programs. The 1998 PAR
found an absence of documentation on both drug prevention strategies and the effectiveness of
each strategy for these programs. The PAR further concluded that the performance measures did
not measure the effectiveness of the program. For the most part, these 1998 findings remain the
2008 Strategic Program Area Review Substance Abuse A - 17
same. One aspect that has improved, however, is that schools are now required to use best
practice programs.
Another gap occurs with the Administrative Office of the Courts, which only receives
information on the number of clients served in its Drug Court Program, Juvenile Justice Services
Division, and the Drug Treatment and Education Fund program. The agency does not collect
data on recidivism or other outcome measures. Additionally, no internal or external evaluations
have recently been performed.
The Arizona State Board of Pharmacy’s program is also difficult to evaluate. The Board
contracts with a private entity to administer the program. The private entity is responsible for
identifying “ best practices” and adopting these methods, creating strategic plan goals, and
evaluating its program. With the exception of the number of participants in the program, the
board does not receive information that can help them adequately assess the effectiveness of the
program and help determine whether to renew the private program’s contract.
The Department of Health Services ( DHS) has made some progress with program evaluation
since 1998. Regional Behavioral Health Authorities ( RBHAs) are now required to submit data
annually on prevention programs to DHS. Only 83% of prevention programs submitted this
information for FY 2006. The relevance of this data could be further improved if similar
prevention programs used the same performance measures, thus allowing for comparison
between the programs.
DHS has also made advancements with measuring treatment efforts. Additional performance
measures have been added regarding employment, criminal activity, and drug and alcohol
abstinence. RBHAs do not provide information to DHS, however, on recidivism. Tracking
recidivism rates would allow DHS to compare each RBHA’s performance. It could provide
further insight into the most cost efficient practices if it was tracked along with the type of
treatment one receives ( inpatient, outpatient, etc.) and the cost of that treatment.
The Drug and Gang Prevention Resource Center should be responsible for compiling an
ongoing annual report which includes substance use- related data, resources, and strategies
for both substance abuse prevention and treatment.
In addition to improving the collection of agency- specific information, Arizona should have a
mechanism for collecting information across all agencies in order to gain a “ big picture”
understanding of substance abuse prevention and treatment programs and funding. Information
could include descriptions of all programs, spending by each agency, and performance measures.
Prior to FY 2006, that the Drug and Gang Prevention Resource Center was required to compile
an annual inventory of publicly funded substance abuse programs. The sunset of the Drug and
Gang Policy Council eliminated this responsibility. Consequently, this information was not
compiled in 2006. In 2007, the Center’s inventory was included in the Arizona Statewide
Substance Abuse Epidemiology Report, but ASAP members decided that the Center’s inventory
should be limited to prevention efforts. The epidemiology report was the result of Executive
Order 2007- 12 which required ASAP to “ conduct an annual analysis and report of all substance
use- related data, resources, and strategies at the state level to identify gaps in service and
delineate effective resource allocation.”
2008 Strategic Program Area Review Substance Abuse A - 18
Continuation of the annual inventory beyond the expiration of the federal Strategic Prevention
Framework Incentive Grant would provide beneficial information that could be used to improve
Arizona’s substance abuse system. The collection of additional information would enhance the
inventory’s usefulness. These enhancements could include the addition of treatment programs,
more through explanations of funded programs, system- wide strategies for prevention and
treatment efforts, and information on how agencies are coordinating their efforts. Because of
their past experience of compiling these substance abuse surveys, the Drug and Gang Prevention
Resource Center could complete the annual report as part of its formal responsibilities.
Findings and Recommendations – OSPB Staff
Department of Economic Security
Findings:
Overall, the Arizona Families F. I. R. S. T. program is very effective at reducing the incidence of
substance abuse treatment in participating families. Families that have left the program are easy
to re- engage, and the program has proven that long- term treatment is preferable to one- time
treatment. Furthermore, children that had once been removed from their homes are likely to be
reunited with their families more quickly than those who do not participate with the program.
Recommendations:
Continue to expand the JSAT program in the future, as funds are available, in order to include
more families. The average total one- time cost per family is $ 1,100, which is minimal when
compared to the expense of caring for a child that has been removed from the home. Those costs
can range as high as $ 6,000 per child, per month.
Arizona Criminal Justice Commission
Findings:
The RSAT program is effective at increasing the number of inmates who remain drug- free after
being released. The program focuses on treatment of the participants’ substance abuse problems
and provides them with vocation training and the tools to avoid relapse. As a result,
approximately 79% of participants remain drug- free after their release and go on to obtain
employment or attend school.
Recommendations:
Continue the RSAT program. The average cost for the RSAT program per participant across all
institutions is $ 938. Since approximately 85% of participants remain arrest- free after being
released, the cost of the program is lower than if those individuals were released without
treatment and then were re- arrested.
Administrative Office of the Courts
Findings:
The Drug Court program focuses on preventing continued substance use/ abuse by providing
individual and group therapy sessions and educational programs. During the first half of FY
2007, 98% of the drug tests administered to program participants came back negative.
2008 Strategic Program Area Review Substance Abuse A - 19
Unemployment among participants also fell, as 60% of drug court participants were employed
during the program.
Recommendations:
Modify the drug court program. While the program is successful in helping participants stay
substance use free during their participation, overall the program has not graduated that many
people. Since the program’s inception through 12/ 31/ 06, only 23% of program participants have
graduated from the drug court program. During the first half of FY 2007, only 6% of drug court
participants graduated from the program, while 12% were terminated from the program due to
revocation/ violation of probation.
Department of Corrections
Findings:
The Department offers a variety of programs for the treatment and prevention of substance abuse
to its inmates. In addition to the statutorily mandated DWI/ DUI curriculum approved by the
Department of Health Services the Department provides education, treatment, and 12- step
programs. For offenders on Community Corrections the Department provides other programs to
ease the transition into the community, ensure they continue to be substance free and additional
prevention resources. Inmates who participated in the Women in Recovery or Men in Recovery
programs in FY 2006 had a 94% negative urine analysis test rate 90 days following their release
into the community.
Recommendations:
The Department’s efforts so far have generated positive results. Inmates who have participated
in any of the substance abuse programs are staying substance free at a greater rate then those
who do not participate. The Department should continue substance abuse treatment and
prevention programs to the extent possible.
Department of Juvenile Corrections
Findings:
The Department offers primarily two different treatment programs. One, funded partially
through the RSAT grant provides a specific housing unit for those individuals who are substance
dependent and for those that do not meet the RSAT eligibility requirements the New Freedom
program. The RSAT Recovery program and the New Freedom program have produced 100%
negative tests results for their participants in 2006.
Recommendations:
The programs offered by the Department have had success in treating their substance using
population. As the Department has such a good success rate with their RSAT Recovery and
New Freedom Programs they should continue to the extent possible.
2008 Strategic Program Area Review Substance Abuse A - 20
Arizona Drug and Gang Prevention Center
Findings:
The Center acts as a community resource and not as a substance abuse treatment provider. They
have a comprehensive inventory of various treatment programs and prevention materials relating
to both drugs and gangs.
Recommendations:
The Center is a valuable resource for the community and should be continued to the degree
possible.
Department of Health Services
Findings:
The Arizona Department of Health Services successfully provides and participates in programs
that measure the performance and effectiveness of substance abuse treatment services; however,
improvement is still needed in the area of measuring the effectiveness of prevention programs.
The products provided by programs that measure the performance of treatment services include
reports on the medical care provided, outcomes of targeted performance improvement projects,
and results of satisfaction surveys. The Department also monitors specific incentive- linked
performance measures, which included access to care, cultural competency, and member/ family
involvement in treatment. Moreover, the Department participates in the National Outcome
Measures, which are administered by the U. S. Department of Health and Human Services and
provide real- world outcomes on the effectiveness of treatment and prevention services.
To measure the performance of prevention programs, the Department allows programs to submit
individualized evaluations, unless the program serves community coalitions, parents or
adolescents. In these cases, the programs must use one or more of a set of five standard
evaluation instruments. Due to a lack of an adequate database, which is in development, the
Department has not been able to collect the data from each prevention site for statewide analysis.
Recommendations:
To better measure the performance and effectiveness of substance abuse prevention programs,
the Arizona Department of Health Services should continue to develop and implement a database
that will allow a statewide analysis of the evaluations submitted by the several programs.
Moreover, the department should ensure that each program reports as required. Finally, it is
recommended that the department require all prevention programs to submit comparable
evaluations.
2008 Strategic Program Area Review Substance Abuse A - 21
Appendix A: Findings from the 1998 PAR
Overall Substance Abuse Services
• The system is very complex and uncoordinated with a large number of funding sources
managed by 13 different entities and a very large number of contracted providers.
• Despite expending $ 59.9 million for substance abuse services statewide, data demonstrating
the impact of these individual programs are not systematically collected or evaluated.
Department of Health Services
• The Substance Abuse Services program’s statutory responsibility to provide statewide
coordination overlaps the statutory responsibility of the Arizona Drug and Gang Policy
Council.
• Substance Abuse Services has been in existence for 24 years, yet the program’s effectiveness
cannot be established due to the lack of performance data related specifically to Arizona.
• The contracts with the RBHAs do not include adequate program performance or service
quality measures as contract compliance criteria.
• Studies in other states have shown that substance abuse treatment results in cost savings in
other areas such as crime reduction.
Department of Education
• The focus of the “ Chemical Abuse” program is unclear, since it also incorporates both drug
and violence prevention activities funded by the Safe & Drug- free Schools and Communities
Act ( Title IV), while excluding the State School Safety Program.
• There is no documentation on the various drug prevention strategies being used by Arizona
schools and the effectiveness of each strategy. The department provides technical assistance
to school districts in implementing a comprehensive health program that includes chemical
abuse prevention, but does not document and evaluate different prevention strategies.
• The department’s performance measures have improved over the years, but the current
performance measures still do not measure the effectiveness of the program.
• Many aspects of the program are federally mandated and thus out of the state’s control.
More importantly, local school districts are subject to a maintenance- of- effort requirement in
order to be eligible for Title IV funding.
2008 Strategic Program Area Review Substance Abuse A - 22
Appendix B: Statutory Language for the Arizona Drug and Gang Policy Council
( Repealed)
A. R. S. § 41- 617. Arizona drug and gang policy council; duties
A. An Arizona drug and gang policy council is established which shall consist of members as
follows:
1. The Governor, who shall serve as Chairman.
2. The Attorney General.
3. The Director of the Department of Public Safety.
4. The Director of Health Services.
5. The Director of the Department of Economic Security.
6. The Director of the State Department of Corrections.
7. The state Superintendent of Public Instruction.
8. A representative from the Board of Regents appointed by its President.
9. A representative from the Arizona Board of Regents appointed by its President.
10. A member of the Criminal Justice Commission appointed by its Chairman.
11. A representative from the business community appointed by the Governor.
12. A representative from the League of Arizona Cities and Towns appointed by the
Governor.
13. The Administrative Director of the Courts.
14. The Director of the Arizona Health Care Cost Containment System Administration.
15. The Director of the Department of Juvenile Corrections.
16. A representative, appointed by the Governor, from a local community group or
neighborhood group that is actively involved in community substance abuse issues.
B. The council shall meet and organize by electing from among its members such other officers
as are deemed necessary or advisable. The council shall meet at least once during each
calendar quarter and additionally as the Chairman deems necessary. Staff and support
services needed for the administration of the council’s activities will be supplied from those
state agencies represented on the council at the direction of the Governor.
C. The objective of the council is to foster cooperation among all state and local government
entities, neighborhood groups, community organizations and private groups to ensure the
optimal delivery of educational, treatment and prevention programs that will reduce the
incidence of substance abuse or participation in criminal street gangs as defined in A. R. S. §
13- 105 by children, youth and families.
D. The Arizona drug and gang policy council shall:
1. Recommend the basis for effective coordination of all state programs and expenditures,
including federal monies, for education, prevention and treatment relating to alcohol and
drug abuse and participation in criminal street gangs as defined in A. R. S. § 13- 105.
2. Provide a liaison to community groups and private sector programs involved in substance
abuse gang education, prevention, and treatment.
3. Conduct an annual inventory of publicly supported education, prevention, and treatment
programs related to substance abuse and participation in criminal street gangs in
operation in this state to be submitted by October 31 of each year to the Governor, the
President of the Senate and the Speaker of the House of Representatives to be made
available to the general public through the Arizona Drug and Gang Prevention Resource
Center. The report shall include:
i. The name, the location, and a description of each program.
2008 Strategic Program Area Review Substance Abuse A - 23
ii. The amount of sources of funding for each program.
iii. The agency that administers each program.
iv. The type of substance abuse or gang activity addressed by each program.
v. The gender of clientele served by each program and whether the program serves
children or adults, or both.
4. Evaluate the results achieved by publicly supported education, treatment and prevention
programs and make recommendations to the Governor and the Legislature for revisiting
programs or redirecting expenditures to achieve better use of public resources.
5. Evaluate the results achieved by publicly supported education, prevention and treatment
programs that are related to drug related gang activity in this state and make
recommendations to the Governor and the Legislature for revisiting programs or
redirecting expenditures to achieve better use of public resources.
6. Oversee the operation of the Arizona Drug and Gang Prevention Resource Center which
shall be established and maintained at the direction of the Arizona Drug and Gang Policy
Council for collection, storage, and distribution of information relating to substance
abuse prevention and treatment programs, gang education and prevention and treatment
programs and which shall serve as a referral agency for law enforcement activities.
7. Communicate regularly with the statewide Chemical Abuse Prevention Interagency
Committee to collect statewide lay and professional recommendations for prevention,
education, and treatment programs.
8. Communicate regularly with the Arizona Criminal Justice Commission so that programs
for education, treatment and prevention are coordinated with enforcement and related
efforts undertaken within the criminal justice system.
E. The Arizona Drug and Gang Prevention Resource Center shall be operated with full
cooperation of all agencies and entities involved in the organization and maintenance of
publicly supported education, prevention and treatment programs related to substance abuse
and gangs.
2008 Strategic Program Area Review Substance Abuse A - 24
Appendix C: Members and Duties of the Arizona Substance Abuse Partnership
Excerpt from Executive Order 2007- 12: Establishing the Arizona Substance Abuse Partnership.
NOW THEREFORE, I, Janet Napolitano, Governor of the State of Arizona, by virtue of the
authority vested in me by the constitution and laws of the state hereby order and direct the
following:
1. There is hereby established the Arizona Substance Abuse Partnership (“ ASAP”).
2. The membership of ASAP shall be comprised of no fewer than 19 and no more than 25
members who shall be appointed by, and serve at the pleasure of, the Governor. To the
extent practical, they shall include the following:
a. The Governor or a designee to serve as chair.
b. One representative from each of the following community organizations or
federal entities:
i. Business Leaders
ii. Substance Abuse Coalition
iii. Tribal government in Arizona
iv. Substance Abuse Treatment Service Provider
v. Recovery Community ( individuals who have completed substance abuse
treatment)
vi. Local Law Enforcement
vii. Drug Enforcement Administration, residing in Arizona
c. The Director of the following government entities:
i. Attorney General’s Office
ii. Governor’s Office for Children, Youth and Families
iii. Department of Corrections
iv. Department of Juvenile Corrections
v. Department of Education
vi. Administrative Office of the Courts
vii. Department of Economic Security
viii. Department of Health Services
ix. Arizona Health Care Cost Containment System
x. Department of Liquor License Control
xi. Department of Public Safety
d. The Governor may appoint ex- officio members as deemed necessary or
appropriate, which may include representation from the Substance Abuse and
Mental Health Services Administration.
3. Members of ASAP may, with the Governor’s permission, send designees to serve on
ASAP; provided, however, that such designees shall have been delegated by the member
with full authority to vote and otherwise act on behalf of the member.
4. With the approval of the Governor, ASAP may form:
a. A Community Advisory Board to provide ASAP with perspective on community-specific
issues throughout Arizona. The board will focus primarily on rural
communities and seek input from each of the fifteen counties and tribes.
b. An epidemiological workgroup subcommittee to collect and report substance-related
data and resource information.
c. Additional substance- specific or issue- specific subcommittees as necessary.
5. ASAP shall have duties and responsibilities, including but not limited to, the following:
2008 Strategic Program Area Review Substance Abuse A - 25
a. Conduct an annual analysis and report of all substance use- related data, resources,
and strategies at the state level to identify gaps in service and delineate effective
resource allocation;
b. Develop and utilize a shared planning process that encourages state and local
partnerships to maximize existing resources and build capacity of local
communities to meet identified needs;
c. Identify effective practices to integrate strategies across systems that will leverage
existing funding and increase access to services at the community level;
d. Recommend specific drug- and alcohol- related legislation and budget line items
for consideration by the Arizona Legislature;
e. Analyze current state and federal laws and programs governing substance use
prevention, treatment, and enforcement and recommend any changes that would
enhance the effectiveness of these laws or programs;
f. Review evaluation and research reports to ensure the most effective and evidence-based
program, policies, and practices are being utilized across the state and make
recommendations for modifications as needed.
2008 Strategic Program Area Review Debt and Third Party Financing B - 1
Debt and Third Party Financing Strategic Program Area Review
Overview ― In the state of Arizona, several state agencies and authorities issue debt as a means
to pay for a variety of capital projects such as highway construction and design, new schools and
university buildings, infrastructure improvements, and health care facilities. In contrast to pay-as-
you- go financing, which requires state agencies to pay the entire cost of a capital project up
front, the use of debt financing allows state agencies to spread payments over a longer period of
time. The primary issuers of debt are the Universities, the Arizona Department of
Administration ( ADOA), the School Facilities Board ( SFB), and the Arizona Department of
Transportation ( ADOT). The authorities that may issue debt on behalf of local governments or
other entities include the Water Infrastructure Finance Authority ( WIFA), the Arizona Health
Facilities Authority ( AHFA), the Arizona Housing Finance Authority ( AzHFA), and the Greater
Arizona Development Authority ( GADA). In addition, the Arizona Department of Commerce
( ADOC) administers the state’s Private Activity Bond program.
Universities
The state universities issue system revenue bonds and Certificates of Participation ( COPs) to
finance various academic and student related buildings and facilities. Statute requires the
universities’ issuance of bonds or COPs to be reviewed by the Joint Committee on Capital
Review ( JCCR). Under revenue bond financing, the statutes define the revenues that are
required to be pledged as security for the bonds, which generally include tuition, registration fees
and other student related fees. Under COP financing, which is a form of lease- purchase
financing, the repayment is based on the commitment of the university to make the scheduled
payments, generally either from university funds or from State appropriated monies. In addition,
the COPs are secured by the asset being financed. If default on the payments occurs, holders of
the COPs take possession of the asset and any unspent proceeds from the issuance.
A. R. S. § 15- 1683 allows each state university to incur a projected annual debt service for bonds
and COPs of up to 8.00% of each institution’s total projected annual expenditures. This
calculation is known as the debt ratio. The current debt ratios for Arizona State University
( ASU), the University of Arizona ( UA), and Northern Arizona University ( NAU) are 5.46%,
5.44%, and 6.27% respectively.
The universities also enter into capital leases, in which ownership of the property may revert to
the universities at the end of the lease term. For example, in 2003 ASU entered into a 30- year
lease agreement with Arizona State University Foundation, LLC, a non- profit organization and
component unit of the university, for four floors in the Fulton Center and related parking
structure. At the end of the lease for the four floors and termination of the underlying ground
lease, the entire property will revert to the ownership of ASU.
In addition to these traditional debt financing methods, the universities have, in the last 7 years,
used indirect debt or third party financing for several capital projects. ( See discussion on pages
6- 7.) This approach is similar to the third- party, lease- to- own financings that the Arizona
Department of Administration and other state agencies have used for state office facilities.
2008 Strategic Program Area Review Debt and Third Party Financing B - 2
School Facilities Board
From FY 2003 to FY 2005, the SFB issued COPs to provide K- 12 school districts with funds for
new schools facilities, including land acquisition, related infrastructure, fixtures, furnishings, and
equipment. The bonds are paid for by General Fund appropriations for debt service. These COP
issuances required JCCR review. In addition, SFB issued revenue bonds to correct deficiencies
in existing schools prior to FY 2007. The bonds are paid by pledged revenues from the 0.6%
increase in the transaction privilege tax ( TPT) approved under Proposition 301 in the 2000
general election and proceeds from the leasing or sale of state trust lands.
Arizona Department of Transportation
ADOT issues Highway User Revenue Fund ( HURF) bonds to design and construct highways,
and to meet the costs of acquiring right of way for highways. The revenue source for these
bonds are several transportation related licenses, taxes, fees, and penalties. ADOT also
administers the Highway Expansion and Extension Loan Program ( HELP) to provide loans and
financial assistance for eligible highway projects in Arizona. For this same purpose, ADOT’s
State Transportation Board can issue nonnegotiable Board Funding Obligations ( BFOs) for
purchase by the Arizona State Treasurer. Lastly, ADOT issues Grant Anticipation Notes
( GANs) that pay the federal share of projects in advance of the actual receipt of federal highway
funding.
Arizona Department of Administration
ADOA has engaged in privatized lease- to- own ( PLTO) and COP arrangements to purchase
property and construct buildings that house state departments. As with capital leases, PLTO
agreements entail a lease for a set number of years, at the end of which the lessee ( the state) has
the option to own the leased facility. PLTO arrangements are not considered to be state debt.
ADOA has also used COP financing to pay for the Human Resources and Payroll System
( HRIS) and third- party financing for the more than $ 150 million Business Reengineering-
Integrated Tax System ( BRITS).
Greater Arizona Development Authority
GADA issues Infrastructure Revenue Bonds on behalf of local governments to allow them to
finance public infrastructure development. Borrowers secure these bonds through the use of
excise taxes, user revenue streams, general obligation pledges, and other types of pledges not
including state monies. In the event of non- payment, GADA is held liable, but can intercept the
borrower’s state shared revenue funds to fulfill the bond obligation. Pursuant to A. R. S. § 41-
1554.08, the bonds do not constitute a legal debt of this state and are not enforceable against this
state. GADA generally purchases bond insurance to achieve an AAA rating, allowing borrowers
to access lower rates than otherwise available to them.
2008 Strategic Program Area Review Debt and Third Party Financing B - 3
Water Infrastructure Finance Authority
WIFA issues Water Quality Bonds to fund low interest loans for the construction of drinking
water and wastewater ( clean water) facilities and related projects. Bond proceeds also
supplement the 20% state match dollars for the federal drinking and clean water capitalization
grants that WIFA receives each year from EPA.
Arizona Housing Finance Authority
AzHFA uses its share of the Private Activity Bond ( PAB) allocation to help promote home
ownership and multi- family residential development in rural Arizona. ( See discussion of PAB
program below.) PABs are tax- exempt, allowing borrowers to secure lower rates of interest.
AzHFA acts as a conduit between borrower and lender and is not liable for any debt resulting
from the transactions. As of the beginning of FY 2007, total outstanding principal was $ 69.7
million.
Arizona Health Facilities Authority
AHFA issues qualified 501 ( c)( 3) bonds for projects that improve health infrastructure and
facilities in Arizona. The bonds issued by AHFA are not subject to the Private Activity Bond
allocation. AHFA acts as a conduit issuer between borrower and lender and neither AHFA nor
the state is liable for the debt. As of the beginning of FY 2007, total outstanding principal was
$ 2.1 billion.
Department of Commerce – Private Activity Bond Program
Private Activity Bonds ( previously referred to as industrial development bonds) can be issued to
finance manufacturing or industrial projects, mortgages, residential rental housing units, student
loans, or for other private projects that provide a public benefit. The bonds are exempt from
federal income tax, and the federal government annually determines each state’s overall PAB
limit based on state population. Industrial development authorities, AzHFA, and student loan
organization are the issuing entities. The private sector recipient of the funds, however, is the
party legally responsible for paying off the bonds.
The Department of Commerce is charged with administering Arizona’s allocation of PAB’s from
the federal government. In 2006, the federal government granted $ 475 million in PAB authority
to Arizona, all of which was allocated. The allocation process is accomplished following the
procedures outlined in A. R. S. § 35- 901 through 35- 913. Allocations made from the statutorily
designated subcategories, or pools, of the overall state bond allocation are made on a first come,
first serve basis pursuant to state statute. According to the Department of Commerce, the
allocation included:
• Mortgage Revenue Bonds or Mortgage Credit Certificate Programs – $ 94 million
• Student Loans – $ 95 million
• Residential Rental Projects – $ 79 million
• Manufacturing and Other Projects – $ 208 million
2008 Strategic Program Area Review Debt and Third Party Financing B - 4
Existing Debt and Structure ― The table on the following page includes information on
outstanding debt by state agency and authority, as reported by the Arizona Department of
Revenue in its annual Report of Indebtedness. According to the most recent report, state
agencies’ level of debt was $ 5.2 billion in FY 2006. This amount is $ 2 billion higher than the
FY 2002 level of debt.
The increase in outstanding debt from FY 2002 to FY 2006 was largely due to new SFB and
University issuances supported by state General Fund appropriations. From FY 2003 through
FY 2005, SFB received $ 900 million in cash from COP agreements to fund the costs of K- 12
new school construction. In addition, since 2001 the agency issued about $ 1.1 billion in revenue
bonds, consisting of $ 854.8 million in School Improvement Revenue Bonds and $ 247.4 million
in State Land Trust Revenue Bonds, to finance the cost of correcting existing deficiencies in
schools. The Universities issued approximately $ 480 million for research infrastructure projects,
as authorized by Laws 2003, Chapter 267, as well as certain other debt authorized by the
Legislature which is fully funded from state appropriations and Proposition 301 monies.
The $ 5.2 billion amount represents outstanding obligations that must be repaid by the state.
Beyond these obligations, there are certain state authorities that can issue debt on behalf of local
governments or other entities. In these instances, the local government or other entity, not the
state, is the party responsible for making the debt service payments. In FY 2006, the outstanding
debt associated with these state authorities was $ 3 billion, which was a $ 2.1 billion increase from
FY 2002. The primary cause of increase was a substantial amount of debt incurred by AHFA.
Outstanding Debt: State Agencies and Authorities
($ in millions)
Outstanding Debt
State Agency FY 2002 FY 2006 $ Change
ADOA $ 212.8 $ 192.6 $ ( 20.2)
SFB 439.1 1,703.6 1,264.5
ADOT 1,519.3 1,548.9 29.6
Universities 1,000.8 1,725.5 724.7
Total: State Agencies $ 3,172.0 $ 5,170.6 $ 1,998.6
State Authorities
GADA $ 35.1 $ 291.5 $ 256.4
AHFA 617.6 2,098.5 1,480.9
AzHFA 0 69.7 69.7
WIFA 241.9 577.0 335.1
Total: State Authorities $ 894.6 $ 3,036.7 $ 2,142.1
Additional information important for an understanding of debt structure in Arizona includes
measures of state debt relative to other factors. For instance, state debt as a percentage of
personal income is a measure sometimes used by ratings agencies for their analysis of debt
issuance. Two of those measures as of the latest available data include:
2008 Strategic Program Area Review Debt and Third Party Financing B - 5
State Debt as a % of Total Debt 22.8%
State Debt as a % of Personal Income 4.54%
Arizona Debt Ranking ― The following table displays Arizona’s debt position relative to other
states. The data was taken from the U. S. Census Bureau, and reflects the rankings as of FY
2004. ( Census data is not comparable to the earlier table as the Census Bureau uses a different
methodology to measure debt. Census data is included as it is the only available source for state
by state comparisons.) Higher rankings indicate more debt.
Category Amount Rank
Total State Debt $ 6.8 Billion 26th
Total State and Local Debt $ 29.8 Billion 20th
State Debt Per Capita $ 1,179 46th
State and Local Debt Per Capita $ 5,196 30th
State and Local Debt as a % of Personal Income 19.9% 23rd
As shown by the table, Arizona tends to rank comparatively lower to other states if only state
debt is being measured, but increases its ranking when both state and local government debt is
included.
Debt Affordability Reports ― Some states use a Debt Affordability Report ( DAR) to track
their total debt burden and the potential fiscal impact. DARs are an instrument for reporting and
forecasting debt that enables states to better coordinate the authorization and retirement of debt.
The DAR typically only addresses bonds supported by tax- derived revenues, or bonds that are
paid from the General Fund. The applicable debt is usually categorized by agency, division of
principal and interest, and duration.
DARs incorporate forecasts of debt authorization and issuance based on statute and a review of
prior year debt issuances and payments. These trends are used in conjunction with revenue
forecasts to clarify the feasibility of approving various amounts of debt. To give the report a
greater degree of explanatory power, most states incorporate debt ratio measures that compare
General Fund revenues to debt service, debt to personal income, and debt per capita.
Arizona does not produce a DAR. Statute instead requires the Department of Revenue ( DOR) to
annually publish a Report of Indebtedness. The DOR report includes information on all state
agencies, cities, counties, school districts, community college districts, special districts ( such as
flood control or fire districts), and “ other” jurisdictions ( such as the Salt River Project). For each
of these entities the report details:
• total outstanding debt as of the beginning of the fiscal year;
• the amount of principal paid off over the last year;
• the debt limit of the jurisdiction ( if applicable), and how much of the limit is being used;
• the amount of new debt issued over the past year; and
• for certain political subdivisions, their per capita debt level.
2008 Strategic Program Area Review Debt and Third Party Financing B - 6
As opposed to a DAR, the DOR Report of Indebtedness only includes a picture of existing debt
levels. The DOR report does not include a projection of future revenue collections or debt
issuances, nor does it attempt to estimate the ability of the state to enter into new debt
obligations.
Credit Ratings ― Another way to assess a state or an agency’s capacity to issue additional debt
is to look at its credit rating. In the bond market, credit ratings are designed to measure the
likelihood that a government entity will repay a debt it incurs. The ratings are not required by
law, but are standard for all financings undertaken by state agencies.
There are three nationally recognized ratings agencies ( Standard and Poor’s, Moody’s, and
Fitch), each with its own ratings system. The ratings categories for each agency are shown
below. The ratings are displayed from highest to lowest, with AAA ( or Aaa) being the highest
achievable rating and C the lowest rating.
Debt issuances in the top four categories reflect the opinion of the rating agency that the issuer
has sufficient capacity to meet its obligation. In addition to the above ratings, if payments are
not made by the due date and the issuer is in default, the issuance can be assigned a D rating.
A rating can be modified to give a further indication of the issuance’s standing. For example,
Standard and Poor’s ( S& P) and Fitch may append a plus or minus sign to the rating, while
Moody’s will add a 1, 2, or 3 ( 1 indicating a higher ranking). In addition, the potential for a
change to the rating over the short to medium term is assessed. A positive outlook indicates that
the rating may be raised in the future; a negative outlook indicates the rating may be lowered. A
stable outlook indicates the rating is unlikely to change.
Based on the most recent SFB lease- purchase issuance, Moody’s has assigned Arizona an A1
rating with a stable outlook for lease- purchase debt, while S& P has assigned Arizona a AA- with
a stable outlook. Since the debt service payments for SFB lease- purchase issuances are made
from a General Fund appropriation, the ratings serve as an overall assessment of Arizona’s
ability to meet its debt obligations that are subject to annual appropriation and paid from the
General Fund. According to their own classification systems, both S& P and Moody’s have
characterized Arizona’s capacity to meet these types of debt obligations as “ strong.” The pledge
of a revenue stream and the associated legal structure of a revenue bond versus a COP finance
arrangement are factors that will be expected to, but not necessarily, result in a higher credit
rating for state agency debt issuance.
The criteria used to assign a rating for lease- purchase and General Obligation ( GO) bond
issuances are similar across all three ratings agencies. In addition to providing information on
the risk associated with a particular security, the rating can also serve as an assessment of the
Table 2
Adequate Below Average
S& P AAA, AA, A, BBB BB, B, CCC, CC, C
Moody's Aaa, Aa, A, Baa Ba, B, Caa, Ca, C
Fitch AAA, AA, A, BBB BB, B, CCC, CC, C
2008 Strategic Program Area Review Debt and Third Party Financing B - 7
general financial health of the governmental entity. The ratings are generally based on an
assessment of the following:
• Performance of the local and national economies;
• Financial performance of the issuing entity;
• Existing debt levels; and
• Management or organizational strength of the issuing entity.
The above criteria apply to lease- purchase, GO bond debt issuances and revenue bond issuances.
Whereas the debt payments for lease- purchase or GO bond debt are typically paid from general
government receipts, a specific revenue stream is pledged as security for repayment of the
revenue bond debt. The credit rating assigned to a revenue bond, therefore, depends to a greater
extent on the capacity of the selected revenue stream.
Indirect and Third Party Financing ― Beyond the traditional means of issuing bonds
discussed above, the universities, ADOA and other state agencies have in more recent years used
indirect debt or third party financing in several of their capital projects. State statutes define
indirect debt as ones in which a private developer or non- profit organization ( which may include
a component unit of the university) executes bonds or lease- purchase agreements for a capital
project on university property or that houses any university activities. Projects financed with
indirect or third party financing do not count against the universities’ statutory debt ratio. The
rating agencies do, however, consider any indirect debt in determining the rating for the state or
any of its agencies.
Accounting rules defines components units as entities whose relationship with ABOR or a
university is significant enough that the exclusion of that entity from ABOR or university
financial statements would be misleading or incomplete. For example, the University of Arizona
Alumni Association is a legally separate, tax- exempt, nonprofit corporation governed by an
independent Board of Directors, but it is still listed as a component unit in the University’s
annual financial statement because its economic resources are almost entirely for the direct
benefit of the University.
The universities have increased the use of indirect and third party financing over the past 7 years
as a means to address capital infrastructure needs due to student enrollment growth, maintenance
needs for existing capital assets, and capital requirements associated with a research mission. As
a result, Laws 2006, Chapter 352 and Laws 2007, Chapter 265 required indirect or third party
financed projects meeting specified criteria receive JCCR review. ADOA and other state
agencies have also increased their use of this financing approach over the same period, subject to
legislative authorization.
In the past 7 years, the university system as a whole has engaged in 15 indirect or third party
financing projects:
• 7 self- supporting residence halls;
• 3 energy delivery or management type projects developed and managed by a specialty
energy firm;
2008 Strategic Program Area Review Debt and Third Party Financing B - 8
• 2 real estate investment projects by the ASU Foundation;
• 1 specialized research facility;
• 1 medical facility, also known as the UA- Medical School Phoenix;
• 1 conference center and parking structure.
While the use of indirect or third party financing agreements allowed the universities, ADOA
and other state agencies to transfer upfront construction or renovation costs to a third party, the
annual operating and maintenance costs may be the responsibility of either the state or the third
party. For example, the University of Arizona formed a third party financing agreement with
DESCO, a private development corporation, to convert the former Phoenix Union High School
building into the new joint UA- ASU Phoenix Medical Campus. The University, however,
operates the facility. In some cases, the third party will actually operate the project. The Barrett
College and South Campus Academic Village student residence developments at the ASU
Tempe campus, for instance, will be constructed and operated by the private developer American
Campus Communities ( ACC). ASU’s agreement with ACC includes minimum standards for
operations and the ability to comment on proposed student rental rates.
In some of the indirect financing arrangements in which the third party actually operates the
project, the university’s agreement with the third party involves revenue sharing from the project
and minimum performance standards. In 2007, for example, ASU entered into a third party
agreement with American Campus Communities ( ACC) to construct and operate a new dorm for
students at the Downtown Phoenix Campus. According to the agreement, ACC will retain dorm
fee revenues and meet minimum performance standards for the operation.
The state could benefit from having a third party review debt- related financial transactions
that come before the Joint Committee on Capital Review.
A third party review of debt- related financial transactions would be similar in concept to the
Legislature’s previous decision to contract with actuarial firms in FY 2006 to conduct
independent reviews of state- contracted actuarial services.
A third party evaluation of state debt issuances would provide greater clarity as to the feasibility
of proposed debt and the reliability of the intended revenue streams. In some cases, annual bond
payments fluctuate from year to year, and it is unclear if the structure of the bond repayment
period is optimal for minimizing interest costs and accounting for fluctuations in a bond’s
dedicated revenue source. Furthermore, a third party may provide greater insight into the
feasibility of the use of indirect debt or third party financing for capital projects, as these
proposals are often complex financial transactions.
The third party opinion may not change the way the agency structures a debt issuance. In
addition, a third party evaluation may need to be conducted quickly as agencies may be looking
to go to market with their debt issuance as soon as possible so as to capitalize on the current
interest rate conditions.
Findings and Recommendations – JLBC Staff
2008 Strategic Program Area Review Debt and Third Party Financing B - 9
The Legislature may wish to consider requiring a Debt Affordability Report ( DAR).
A DAR allows for a centralized analysis of the debt burdens of state agencies. This data is given
further context by including revenue forecasts to better predict and control the course of state
debt burdens and the feasibility of subsequent capital projects.
Florida, Texas, and North Carolina already produce a DAR. These documents typically include
a revenue, debt service, and an economic forecast that allow the reader to see how current or
future debt loads will impact an agency or state’s ability to meet mandatory spending targets or
discretionary spending goals. Most DARs also outline the impact of the state’s credit rating on
debt service and use debt ratios as a means of comparison against other states.
Currently, the Department of Revenue annually produces a debt report for all state and local
government agencies. While this is a useful tool for determining outstanding debt per agency, it
does not include interest payment information. Therefore, the full impact of the state’s
outstanding debt is not reflected. In addition, the report might provide legislators with a clearer
understanding of the debt situation if it were to include the potential impact of economic
conditions, proposed legislation, forecasted debt issuance, and estimated revenue streams. This
would allow legislators to better guide the infrastructure development within Arizona and
oversee the feasibility of projects based on the forecasted fiscal conditions.
Additionally, for those agencies issuing debt that are not required to come before JCCR for
review, the Legislature may wish to require them to provide information relating to their credit
rating so as to provide a clearer picture of the state’s debt burden.
Department of Revenue Report of Indebtedness is effective, but could be improved.
The Report of Indebtedness currently issued by the Department of Revenue provides a
reasonably accurate snapshot of debt levels statewide. This report compiles information received
from political subdivisions and special taxing districts that issue debt. However, each year a
number of jurisdictions fail to report debt issuance pursuant to A. R. S. § 35- 501 & 35- 502. A, thus
hindering the report’s overall accuracy. Currently potential repercussions to political
subdivisions that violate these statutory reporting requirements include: jurisdictions in question
can be prohibited from issuing new debt; individuals knowingly committing such failure- to-report
offenses could face Class 2 misdemeanors charges.
It is crucial that the Department receive accurate and timely information of new debt issuance in
order to provide political decision makers the highest quality product. This effort would be
assisted if statutory authority were provided to the Department to issue fines against political
subdivisions and special taxing districts up to $ 5,000 per annum for violations of A. R. S. § 35-
501 & 35- 502. A. Additional language may be required to clarify annual reporting requirements
Findings and Recommendations – OSPB Staff
2008 Strategic Program Area Review Debt and Third Party Financing B - 10
of political subdivisions. Statute requires the Department to compile information for their annual
Report of Indebtedness but is not clear with respect to the requirements of state agencies and
political subdivisions. Language should be explicit in statute with respect to reporting
requirements of such agencies and subdivisions for the annual report.
The alternative debt reporting instrument used by a small number of states, the debt affordability
report, forecasts debt issuance and debt capacity, particularly of the General Fund, into the
future. This is inappropriate for states such as Arizona where the majority of debt is outside the
direct political control of the state but rather is instead controlled by political subdivisions or
special taxing districts. Additionally, relative to the economic and demographic data compilation
and forecasting often included in debt affordability reports, such information is already compiled
and reported elsewhere in state government. Compilations and forecasts of this type are created
by ratings agencies in direct correlation with debt issuance. In addition, JLBC and OSPB
compile economic and demographic forecasts from outside private experts, university
economists, and state agencies as part of the standard budgeting process.
Allow the Housing and Finance Authority to retain interest earnings through a new fund
for administrative costs.
When the Housing Finance Authority ( HFA) was created, the state neglected to set up a fund for
it to administer its programs. The HFA must be self- sufficient, per statute, and cannot receive
General Fund monies to offset its costs. The HFA is basically a Board of Directors and has no
personnel to administer its programs. Because of this, the HFA contracts with the Department of
Housing for program administration. An ISA Fund is used to transfer funds between the two
separate entities and all monies currently reside in that fund.
When the HFA issues bonds, monies are placed in the ISA Fund. Interest generated from this
fund is reverted to the General Fund, instead of the HFA for administration costs.
The establishment of a new fund that would allow interest income to remain with the HFA would
address this issue. The fiscal impact to the General Fund would be between $ 85,000 and
$ 200,000; depending on the fund balance and interest rates. This will allow the Housing Finance
Authority to be reimbursed for the administrative costs of managing the bonds.
State Funds should be utilized to finance debt service for the School Facilities Board as
opposed to providing a cash outlay at the beginning of a project.
Public policy is advanced when the cash outlays for infrastructure such as schools and roads
match as nearly as possible the expected benefits of those projects. This requires linking the
payments with the expected lifespan of the project. Whereas cash outlay at the initiation of a
project to pay the entire cost places the financing burden on current taxpayers while the benefits
will accrue across generations, debt financing is a more effective alternative. With debt
financing for school construction, the cash outlay, and thus the burden to taxpayers, can be
equitably spread out across time. Bond debt service is paid by current and future users of the
facilities financed. State funds should therefore provide for debt servicing costs rather than cash
outlay at initiation of school capital projects.