In 1999, CFF staff conducted a comprehensive review of AOD services in Fresno County. The purpose of the review was to provide analysis and recommendations to better integrate County substance abuse prevention and treatment services into the recently created Health and Human Service System. Methods used in this study were:

• Interviews with more than one hundred policy leaders, agency officials, front-line staff, and service providers;
• Focus groups conducted with clients of AOD programs, former clients, and staff of service providers
• A survey of service providers;
• A public opinion survey of nearly 500 households to assess attitudes toward key issues in the AOD area;
• Analysis of 36,000 admissions to AOD services in Fresno County during 1994-97, using state data systems;
• Assessment of comparable counties' statistics and organizational structures; and
• Review of the literature on AOD services and service delivery options.

Beyond the issues of service organization and integration, final recommendations also covered:

• Quality Improvement processes.
• A framework for managing provider contracts from an outcomes perspective.
• Information system improvements for performance measurement.

CFF staff participating in the project were Sid Gardner, Victor Kogler, Jorge López and Dr. Nancy Young.