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Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse
Treatment Improvement Protocol (TIP) Series 9

Appendix B -- Treatment of Patients With Dual Disorders: Sample Cost Data

To provide readers with illustrative data on the costs of running programs for patients with dual disorders, the consensus panel Chair obtained data on actual costs during fiscal year 1991-1992 from three programs in urban areas. One program, on the West Coast, provided day and evening intensive outpatient services. The second, in the Northeast, provided intensive outpatient services during the day. In the third program, in the Northwest, daytime intensive outpatient services, partial hospitalization, and intensive case management were provided.

Included in the tables below are descriptive data for each program, including institutional status (for example, private for-profit or public), payer mix (for example, Medicaid or self-pay patients), number of clients served (at 100 percent capacity), salary ranges of various levels of staff, and other expenses (for example, facility costs). Total expenses and total revenues for each program are listed at the end.

TREATMENT OF PATIENTS WITH DUAL DISORDERS SAMPLE COST DATA

Program 1Program 2Program 3
PROGRAM TYPE
Evening Intensive OutpatientX
Day Intensive OutpatientXXX
Partial Hospitalization X
OtherDay treatment and intensive case management
REGIONWest CoastNortheastNorthwest
LOCALEUrbanUrbanUrban
INSTITUTIONAL STATUS
Private for-profitX
Private nonprofit
PublicXX
Other
PAYER MIX (BY PERCENT)
Insurance/Managed CareX
Medicaid66%30%
MedicareX25%
Self-payX4%
HMO contractX
State grant/purchase of care30%45%
Program 1Program 2Program 3
NUMBER OF PATIENTS SERVED (AT 100 PERCENT CAPACITY)
Daily50+45100
Weekly320225300
SALARY RANGES
Administrators/managers$60,000 to 70,000$38,000 to 50,000$35,000 to 60,000
Physicians$70/Hour to 100/Hour$85,00$70,000 to 90,000
Social workers$30,000 to 50,00$30,000$26,000 to 35,000
Psychologists$50,000 to 60,000n/a$50,000 to 70,000
Support staff$18,000 to 27,000$20,000 to 29,000$22,000 to 28,000
Other Addiction counselors, $23,000 to 35,000Nurses, counselors and recreational therapists, $25,000 to 38,000Addiction mental health specialists, $23,000 to 33,000
Nurses $32,000 to 48,000
Program 1Program 2Program 3
OTHER EXPENSES (BY PERCENT)
Administrative overhead 7.1%24%20%
Personnel (including fringe benefits)80.5%60%70%
Facility costs12.4%16%10%
TOTAL EXPENSES FY 1991-1992TOTAL REVENUES FY 1991-1992
Program 1$482,000$489,000
Program 2$811,052$561,052
Program 3$2,200,000$1,980,000
 



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