Organizational capacity for service integration in community-based addiction health services

Abstract

Objectives: We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs.

Methods: We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program.

Results: Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing.

Conclusions: These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.

FIGURE 1—

Conceptual model of the effects of program and client characteristics on coordination of mental health, public health, and HIV testing services: Los Angeles County, CA, 2010–2011. Note. TJC = the Joint Commission.