Over the last three years, CSAT has negotiated with states to create measures for the Performance Partnership Grant (PPG) program. The PPG will replace the current block grant system for channeling federal money for substance abuse treatment and prevention to states. The major change is that states will be required to report annually on agreed measures of the effect of the state’s treatment and prevention programs.
During deliberations over the measures to be used for the PPG, it became clear to negotiators that states lacked the necessary information technology infrastructure to collect and report these new measures. CSAT commissioned two reports from the National Association of State Alcohol and Drug Abuse Directors (NASADAD) to evaluate alternatives for meeting these new reporting needs (as well as current requirements) and assess states’ capabilities and plans for information collection and reporting.
During the same period of time, new rules were published implementing the Health Insurance Portability and Accountability Act (HIPAA). These rules would require substantial changes in existing state substance abuse administrative data systems. Modifying 54 state and territorial systems to meet both HIPAA and PPG requirements would likely far exceed the resources of the states and CSAT, costing in aggregate hundreds of millions of dollars.
CSAT determined that the best hope for states to meet HIPAA and PPG was to develop or identify core technologies that could be replicated from state to state, sharply reducing the cost of replacing legacy systems. Based on the earlier NASADAD work, CSAT desired core technologies that met the following criteria:
- Web-based architecture.
- Flexible and extensible implementation to meet differing state functional requirements, standardized platforms and development tools, and program scale.
- High data validity and reliability.
CSAT retained Westat as its contractor for this Task Order. Initial work made clear that no existing system adequately met CSAT’s criteria. However, new technologies (e.g., XML, Web Services, rules engines, style sheets) promised to meet CSAT goals in ways that earlier technologies could not feasibly achieve. CSAT decided to undertake the development of an information technology infrastructure that states could choose to use, modify and implement to replace current administrative data systems with new Web-based systems that are HIPAA and PPG compliant. This infrastructure is currently under development, and has been named the Web Infrastructure for Treatment Services (WITS).
