The URL can be used to link to this page

Home My WebLink AboutMINUTES - 11091993 - 1.34 TO: BOARD OF SUPERVISORS FROM: Mark Finucane, Health Services DirectorContra By: Elizabeth A. Spooner, Contracts Administrator Costa DATE: October 23, 1993 County SUBJECT: Approval of the Fiscal Year 1993-94 Substance Abuse Program Plan and Budget SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: A. Approve the Contra Costa County Substance Abuse Program Plan and Budget for FY 1993-94; B. Authorize the Health Services Director or his designee (Chuck Deutschman) to execute on behalf of the County the Certification page (ADP-7125) in the Plan; and C. Authorize the Health Services Director or his designee to submit said Plan and Budget to the State Department of Alcohol and Drug Abuse Programs. II. FINANCIAL IMPACT: Approval of the Substance Abuse Program Budget will provide third party revenues to the County in the following amounts: $ 5,849,906 FEDERAL 2,335,194 STATE 4.091,610 FEES AND OTHER REVENUE $12,276,710 TOTAL III. REASONS FOR RECOMMENDATIONS/BACKGROUND: During previous years, the Board of Supervisors has approved the Drug Abuse and Alcohol Program Plans and Budgets in response to the substance abuse crisis. This year the State Department of Alcohol and Drug Programs has combined the separate Drug and Alcohol Program Budgets into one Substance Abuse Program Budget. Contra Costa County has provided substance abuse program services for the past twenty-four years and has in that time addressed the prevention, intervention and treatment needs of County residents. The Plan for Fiscal Year 1993-94 shows an- increased and continued commitment to provide drug and alcohol abuse services in the County. Your Board's approval of the Fiscal Year 1993-94 Substance Abuse Program Plan and Budget is required by the Health and Safety Code (Section 11983.1) in order for these County programs to receive State and Federal funds for this fiscal year. The Annual Plan and Budget for FY 1993-94 was reviewed and recommended for approval by the County's Substance Abuse Advisory Board. CONTINUED ON ATTACHMENT: YES SIGNATURE: e RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMIT EE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON fitly 1) 1993 APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Chuck Deutschman (313-6350) NOV 9 CC: Health Services (Contracts) ATTESTED 10 Auditor-Controller (Claims) Phil Batchelor, Clerk of the Board of State Dept. of Alcohol and Drug Programs SlapBtllt)tS�ld �Admit�jsttat M382/7-83 BY - DEPUTY Health Services Department Substance Abuse Services Division THE CONTRA COSTA COUNTY BOARD OF SUPERVISORS Tom Torlakson, Chair District S Tom Powers Jeffrey Smith District 1 District 2 Gayle Bishop Sunne Mc Peak District 3 District 4 THE COUNTY SUBSTANCE ABUSE ADVISORY BOARD Marlene Rebhan, Chair District 1 District 2 District 3 Ruth Grogan Diana Rodger Marianne Eve Clark Constance Stein Indra Huber Rollin Klink District 4 District 5 At Large Peter B. Burnett Michael Burke Eleanora Johnston Lucretia Jones Rev. Curtis Timmons Rachelle Remington Marlene Rebhan David J. Travers Tom Aswad, Alternate Mark Finucane, Director Health Services Department Chuck Deutschman, Director Substance Abuse Services Division Robin Bereny Plan Coordinator October 1993 TABLE OF CONTENTS Paye I. COUNTY ORGANIZATION Health Services Department Organizational Chart . . . . . . . . . . . . . . . . . . . . . . . . . . I - 1 Substance Abuse Services Division Organizational Chart . . . . . . . . . . . . . . . . . . . . I - 2 County Prevention and Treatment Programs Roles and Responsibilities . . . . . . . . . . I - 3 Advisory Board Membership Roster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I - 4 II. GOALS AND OBJECTIVES FOR FY 93/94 AND PROGRESS REPORT FOR THE PRIOR FISCAL YEAR Goals and Objectives For FY 93/94 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . II - 1 Progress Report For the Prior Fiscal Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 - 12 III. SUBSTANCE ABUSE BUDGET Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . III - 1 SupportServices . . . . . . . . . . . . . . . . . . . ,. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . III - 3 Primary Prevention Services . . . . . . . . . . . ,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 - 4 Secondary Prevention Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 - 7 Non-Residential Services . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 - 10 Chemically Assisted Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . III - 16 Residential Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . III - 17 Ancillary Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . III - 21 Drinking Driver Program Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . III - 24 IV PREVENTION STRATEGIES AND PROGRAM DESCRIPTIONS SupportServices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV - 1 Primary Prevention Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV - 4 Secondary Prevention Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV - 26 Non-Residential Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV - 42. Chemically Assisted Treatment . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV - 59 Residential Services . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV- 62 Ancillary Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . — IV - 77 Drinking Driver Program Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV - 89 Characteristics of Persons To Be Served - Prevention . . . . . . . . . . . . . . . . . . . . . . IV - 98 Characteristics of Persons To Be Served - Treatment . . . . . . . . . . . . . . . . . . . . . . IV - 99 V. ASSURANCE AND CERTIFICATIONS Assurances Regarding The No Unlawful Use of Drugs or Alcohol . . . . . . . . . . . . . . V - 1 Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V - 2 a:93-94tc Cf) S4e IL -10 IL g 7 •.•+' N M �S �' y=' • tip s 7� ,�/}_ r 5) •q r O cs • Y' IMP is 3 i s C a •►i � e �S Al p s R � Qo =9 q g =t, a � M m�f m@"� 'a b Z� Gnu g 0 3 O spy-a-2 z �c2-5-a=Sl a 3x So �� m S m ' t ti r • • • o 1 1 rl z zm0N M mA • � Ny z z m b'� A� m � o$D o �o t , yr. 1 P a � •'m '�O t� c 1 deo d�� P �� i, � urn 4) rn mCm o0 3L T ARA m } 'S d � �1 1 1 J 1 � � � X � r 1p CP D W CD 4 y © O m -• 1 ax m i gAmm z g ZT G � m � 1 O � i • Z , N A yo� Q 3 CD i - 2 �a A_ COUNTY ORGANIZATION DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS rYP1:OF SUBMISSION: COUNTY PREVENTION AND TREATMENT PROGRAMS I 1 ALCOHOL X I Original ROLES AND RESPONSIBILITIES 1 1 DRUG I Amended FY 1993-94 Pq ALC/DRUG DATE. October 15, 1993 1. COUNTY NAME: Contra Costa 2. ADMINISTRATORS NAME: 3. TITLE: Chuck Deutschman I Substance Abuse Program Director 4. ADMINISTRATORS ADDRESS: 5. TELEPHONE NUMBER: (510) 313-6350 EXT. x 595 Canter Avenue, Suite #200, Martinez. CA 94553 6. DESIGNATED COUNTY AGENCY Contra Costa Countv Substance Abuse Division 7. DESIGNEE NAME: 8. TITLE: Chuck Deutschman I Substance Abuse Program Director (Person to represent the county at the quarterly Administrator Association rneatin sI 9. ADDRESS: 10. TELEPHONE NUMBER: (510) 313-6350 EXT.# 595 Center Avenue. Suite 4k200. Martinez, CA 94553 ' 11. AMERICANS W/DISABILITIES ACT COORDINATOR NAME: 12. ADDRESS: i Lois Ellison 595 Center Avenue, Suite 200, Martinez. CA 9455 13. TELEPHONE NUMBER: 14. HAVE A CURRENT AND ACTIVE ( I YES (510) 313-6610 EXT.# REFERRAL LIST FOR INDIVIDUALS ( I No WITH DISABILITIES? 15. ALCOHOL/DRUG AIDS COORDINATOR NAME: 16. ADDRESS: I Steve Loveseth 595 Canter Avenue. Suite 200. Martinez, CA 945 17. TELEPHONE NUMBER: 18. (510) 313-6350 E.YT.# 19. ADDITIONAL INSTRUCTIONS: (A) IF DURING THE COURSE OF THE YEAR THERE IS A CHANGE IN ANY OF THE PERSONS NAMED ABO V E, NOTIFY THE DEPARTMENT IN WRITING WITH THE ABOVE INFORMATION. A LETTER FROM THE APPOINTING AUTHORITY MUST ACCOMPANY THE NOTIFICATION. (B) THIS FORM MUST BE ACCOMPANIED BY A COUNTY ORGANIZATION CHART IDENTIFYING THE ALCOHOL AND/OR DRUG OFFICE AND THE CHAIN OF COMMAND WHICH SHOWS THE RELATION— SHIP OF THE COUNTY ALCOHOL AND/OR DRUG PROGRAM ADMINISTRATOR TO OTHER MAJOR HEALTH PROGRAMS IN THE COUNTY AND THE BOARD OF SUPERVISORS. IF NECESSARY A SECOND CHART MAY BE SUBMITTED TO CLEARLY DISTINGUISH THE ADMINISTRATIVE LINES OF AUTHORITY AND STAFF POSITIONS WITHIN THE COUNTY ALCOHOL AND/OR DRUG OFFICE, INCLUDING COUNTY—OPERATED TREATMENT AND PREVENTION FUNCTIONS. [HSC Sections 11800, I181L6(a), 11962,11963(j)l ADP 7226A (3/93) I - 3 k0VISORY BOARD MEMBERSHIP R051 trt DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS ADVISORY BOARD MEMBERSHIP ROSTER Y] Original COUNTY NAME:Conus Cana County ] Amended Fiscal Year 1993/1994 DATE_October 13,1993 (HSC Sections 11805, 11964, 11964-51 AREA OF RACE/ APPOINTMENT END OF MEMBER NAME AND ADDRESS REPRESENTATION ETHNICITY DATE TERM Ruth Grogan 2424 Mira Vista Drive Disctrict I EI Cerrito,CA 94530 Retired White 1990 6x0/94 Diana Rodger c/o Mason McDuffie Realtors Disctrict II 2300 Contra Costa Blvd. P.H.CA,94523 Real Estate White 1987 6/30/96 Constance Stein 29 Canyon View Drive District II Orinda,CA 94563 Business White 1988 6/30/95 Marianne Eve Clark /237 Robyn Drive Districr III Danville, CA 94526 Real Estate White 1992 61-,Oi94 Indra Huber 40484 Terra Alta Drive District III San Ramon,CA 94583 Pharmacist White 1991 6530/95 Rollin Klink 3415 Claridge Drive District III Danville, CA 94526 U.S. Customs White 1992 6/30/96 Peter Burnett 890 Hamilton Drive Disctrict IV Pleasant Hill,CA 94523 Business White 1992 6/30/94 Lucretia Jones 3821 Palmwood Court District IV Concord,CA 94521 Education White 1990 6/30/96 Marlene Rebhan 1537 Maynard Street District IV Concord,CA 94519 Real Estate White 1990 6/30/95 :Michael Burke 2717 Barcelona Circle District V Antioch, CA 94509 Pastor White 1991 650194 Rev. Curtis Timmons P.O. Box 8213 District V Pittsburg,CA 94565 Pastor Black 1992 6530/96 David J.Travers 3900 Brown Road District V Oaklev. CA 94561 Business White 1992 1 6/30/95 ADP 7927 I - 4 ADVISORY BOARD MEMBERSHIP ROSTER DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS ADVISORY BOARD MEMBERSHIP ROSTER ( X I Original COUNTY NAME: Contra Costa County ( J Ameaded Fiscal Year 1993/1994 DATE.—October 13,1993 fHSC Sections 11805. 11964. 11%4.51 AREA OF RACE/ APPOIN7MF_NT END OF MEMBER NAME AND ADDRESS REPRESENTATION ETHNIC= DATE TERM Eleanora Johnston 167 Oakvale Road At Large Member Walnut Creek,CA 94596 Education White 1978 6/30/94 Rachelle Remington 411 Roberta Avenue At Large Member Pleasant Hill,CA 9523 Business White 1993 6/30/95 ADP 7927 I - 5 GOALS AND OBJECTIVES FOR FISCAL YEAR 1993/94 STATE GOAL I: Design, maintain and enhance a comprehensive system of alcohol and other drug prevention,treatment and recovery services in California. Countv Goal I A: Prevention and Earlv Intervention Services: Provide a comprehensive array of primary prevention and early intervention services including: information dissemination; education and refusal skills training; alternative activities which exclude alcohol, tobacco and other drugs; community based networking; and early intervention counseling and support groups. Objectives for Goal I A: 1. Provide information, referral and crisis counseling to approximately 2,000 callers through toll-free telephone numbers in east, west and central county. Distribute informational materials and provide informational outreach services to persons with alcohol or drug abuse problems. 2. Train approximately 275 parents and community volunteers to deliver a prevention program to approximately 6,000 elementary school children in 35 schools through the Parent Educator Program. 3. Provide alternate activities and encourage healthy lifestyle choices for approximately 2,500 junior high school students in a minimum of 15 schools through the Club Live Program. 4. Provide educational support-group services to approximately 2,750 junior high and high school students in 10 - 15 schools and provide educational support services to a minimum of 50 parents of these students through the NEAT Family Project. 5. Through volunteer area coordinators, train 400 - 500 high school students to teach a primary prevention curricula to approximately 5,500middle and junior high school students in approximately 25 schools through the Youth Educator Program. 6. Provide alternate activities and encourage healthy life style choices for approximately 20,000 high school students in 20-25 schools through the Friday Night Live Club Program. 11 - 1 7. Provide substance abuse educational services to approximately 18,500 persons through county operated and contxact outpatient treatment programs. 8. Provide assistance to the North Richmond community in identifying, addressing and linking to appropriate resources specific community problems relating to substance abuse and violence. 9. Continue to implement the prevention, treatment and law enforcement section of the County-Wide Drug and Alcohol Action Plan by networking and building coalitions with community members and providers of these services. 10. Provide support and technical assistance to community task force groups funded by the Center for Substance Abuse Prevention's "Partnership for a Drug-Free Contra Costa" grant. Provide resource information, materials and training and suggest environmental and other prevention strategies including advocacy, ballot initiatives and legislation. 11. Provide outpatient intervention counseling and other intervention activities to approximately 2,500 persons at risk for addiction or alcoholism at all county operated and contract counseling programs. County Goal I B: Outpatient Treatment Services: Provide a comprehensive array of outpatient treatment services including: outpatient counseling; methadone maintenance services; vocational rehabilitation services; and drinking driver (DUI) services. Objectives for Goal I B: 1. Provide outpatient treatment counseling to approximately 1,500 clients at county operated and contract counseling programs. 2. Provide methadone maintenance services to approximately 245 clients at the Richmond and Pittsburg facilities. 3. Provide vocational training and placement services to approximately 150 county alcohol program clients who have 60 continuous days of sobriety. 4. Provide driving under the influence (DUI) services for approximately 3,300 adult first and multiple offenders at county and contract operated programs. 5. Provide driving under the influence (DUI) classes for approximately 50 adolescent first offenders and 300 other youth cited for possession of alcohol or drugs. 11 - 2 County Goal I C: Residential Services: Provide comprehensive residential services including residential recoveryand residential detoxification. Objectives for Goal I C: 1. Provide 8 residential beds and recovery services to approximately 50 adolescent males or females at Thunder Road in Oakland. 2. Provide 23 residential beds and recovery services to approximately 100 adult males or females at Sunrise House's facilities. 3. Provide 79 residential beds and recovery services to approximately 250 adult men at Discovery House, Diablo Valley Ranch and Fauerso New Way Center. 4. Provide 24 residential beds and recovery services to approximately 100 adult women at Ozanam Center and at East County Detoxification Women's Recovery Program. 5. Provide 47 detoxification beds and social model services to approximately 3,000 male or female adults at the Holloman Detoxification Program, East County Detoxification Center and the Shennum Center. STATE GOAL II: Maximize access to alcohol and drug services for unserved and underserved priority populations. Countv Goal H A: Prevention and Earlv Intervention Services: In addition to the primary prevention and early intervention services listed under County Goal I A above, provide additional services to the following unserved and underserved priority populations. Objectives for Goal II A: 0 1. High Risk Youth : a) Train 60 - 80 high school students to teach a primary prevention curricula to approximately 1,500 high-risk middle and junior high school students in approximately 4 schools in the Richmond Unified School District through the Youth Educator Program. 11 - 3 b) Provide early intervention ease management services to approximately 100 west county high-risk youth and their families by linking them with natural support systems in their communities. 2. Afro-Americans : Provide outreach and intervention services to a minimum of 1400 Afro Americans in east county. 3. Spanish Speaking Persons Provide outreach, intervention and referral services to a minimum of 500 Latinos in east county. 4. Persons Carina for Children of Drug Dependent Parents-: Provide educational training and support groups to 200 west county caretakers of children of drug or alcohol dependent parents. 5. Residents of Public Housing a) Provide educational presentations to approximately 1320 residents of public housing developments in North Richmond and Pittsburg. b) Provide outpatient intervention counseling to approximately 265 residents of public housing developments in North Richmond and Pittsburg. C) Provide recreational. services for youth who are residents of the public housing development in North Richmond. 6. Persons At-Risk for HIV Infection : Provide HIV/AIDS education and risk reduction strategies at all county and contract primary prevention and early intervention a programs. County Goal H B: Outpatient Treatment Services: In addition to the outpatient treatment services listed in County Goal I B above, provide additional services to the following unserved and underserved priority populations. II - 4 Objectives for Goal II B: 1. State Prison Parolees a) Provide case management services to approximately 180 state prison parolees. b) Provide outpatient treatment counseling to approximately 50 state prison parolees. 2. Pregnant and/or Parentiniz Women : a) Provide case management services to approximately 175 substance abusing pregnant and/or parenting women in east and west county. b) Provide outpatient treatment counseling to approximately 15 pregnant and/or parenting women in central and west county and to 8 pregnant and/or parenting women at the county jail. Services in Central County include parenting services and child care. c) Provide intensive day treatment services for approximately 60 pregnant and/or parenting women and their children in east and west county. 3. Residents of Public Housin. a) Provide outpatient treatment counseling including acupuncture services to approximately 285 residents of public housing developments in North Richmond and Pittsburg. b) Provide 21 day outpatient opiate detoxification services to El Pueblo public housing development residents who are clients of the El Pueblo treatment program. 4. Persons At Risk for HIV Infection : a) Implement state guidelines regarding the pre-test counseling, testing, and post-test counseling for HIV in all county and contract outpatient treatment programs. b) Provide HIV education and pre and post-test counseling to approximately 750 methadone maintenance clients and their needle- sharing and/or sexual partners and perform 900 antibody tests. County Goal II C: Residential Services: In addition to the residential services listed in County Goal I C above, provide additional services to the following unserved and underserved priority populations. II - 5 Objectives for Goal II C: 1. State Prison Parolees: Provide 15 residential beds and recovery services and 3 sober living beds for state prison parolees. 2. Preinant and/or Parenting Women a) Provide 36 residential beds and recovery services for pregnant and/or parenting women and their children (0-5 years). b) Provide 24 transitional living beds for pregnant and/or parenting women and their children (0-5 years) who have completed a residential program. C) Provide a child care enrichment component into The Rectory's residential treatment program services. 3. Residents of Public Housini Provide 3 residential detoxification beds for public housing residents who are clients of North Richmond's outpatient treatment program. 4. Persons At Risk For HIV Infection Implement state guidelines regarding the pre-test counseling, testing and post- test counseling for HIV in all residential treatment programs. STATE GOAL III: Ensure and increase program quality, accountability and effectiveness. County Goal III: Working together with providers, implement standards of program quality, accountability and effectiveness. Objectives for Goal III: 1. Provide technical assistance to and ongoing monitoring of all county and contract operated prevention and treatment programs. a) Each month, monitor provider's monthly services report to ensure they are rendering an adequate; level of primary prevention, intervention and treatment services and serving an adequate number of clients. 11 - 6 b) Each year, conduct a formal site visit to each program, issuing a report on the programs compliance to the state's standards. Ensure the programs policies, procedures and practices are in compliance with applicable federal, state and local laws. C) Each year, review provider's annual performance report to ensure they have met contractual obligations. 2. Develop client outcome indicators based on methodologies utilized by the Community Partnership Project. 3. Administer and evaluate specially funded projects in terms of quality, accountability and effectiveness. 4. In response to documented service needs, develop, expand and implement a culturally sensitive continuum of substance abuse services consisting of prevention, outpatient and residential services. STATE GOAL N: Maximize all funds available for alcohol and other drug services. County Goal IV: Actively pursue all potential funding sources to increase services to the community. Objectives for Goal IV: 1. Prepare grant applications for funding. 2. Continue to review client fee schedules and monitor fee collection efforts. 3. Assist unlicensed residential programs to meet eligibility requirements for participation in the federal food stamp program. 4. Support the Substance Abuse Advisory Board in its fund-raising efforts. STATE GOAL V: Build a uniform and easily accessible data system that will support policy analysis and program and operational decisions. County Goal V: Implement a user friendly management information system. 11 - 7 Objectives for Goal V: 1. Obtain two additional computers to monitor program's progress in meeting goals and to provide demographic and trend data. 2. Obtain technical assistance and consultation to review and install an appropriate software program. SPECIALLY FUNDED PROGRAMS GOALS AND OBJECTIVES 1. Friday Night Live (FNL) Program These services are supported by federal Drug Free Schools and Communities funds. Goal: Reduce alcohol and drug use among junior high school students by promoting alcohol, tobacco and drug-free activities and lifestyles. Objectives: a) Sponsor a county-wide leadership training. b) Maintain existing chapters and provide schools with intensive training and leadership skills. Each regional coordinator will hold training and reach approximately 50 students per month. C) Organize rallies, assemblies and community presentations to reach an estimated 20,000 students. Provide activity-oriented information to guide students in making alcohol and drug free choices. d) Organize activities and events that promote healthy lifestyles, such as day trips to the beach, water slides, amusements parks, etc. e) Set up a network of youth serving organizations to work together in promoting and providing healthy alternative activities. f) Work with Alameda, Marin and Sacramento counties to provide extensive training and activities for the youth, each county will host one event during the year. 11 - 8 2. Club Live Program These services are supported by federal Drug Free Schools and Communities funds. Goal: Reduce alcohol and drug use among junior high students by promoting alcohol, tobacco and drug-free activities and lifestyles. Objectives: a) Maintain 15 Club Live Chapters at 15 county wide junior high schools that will impact 2,500 students. b) Provide Club Live officers with leadership training through school conferences. C) Establish one community service project at seven junior high schools. d) Organize assembly presentations at ten junior high schools. 3. School Community Primary Prevention Program These services are supported by state School Community Primary Prevention Program funds. Goal: In conjunction with the County Office of Education, implement a school-based primary prevention program throughout the county. Objective: Through volunteer Area Coordinators, train 400 - 500 high school youth to teach a primary prevention curricula to approximately 5,500 middle and junior high school students in approximately 25 schools through the Youth Educator Program. 4. Drug Free Schools and Communities - Hi-Risk Youth These services are supported by federal Drug Free Schools and Communities funds. Goal: In conjunction with the County Office of Education, implement a school-based primary prevention program targeting high-risk youth. Objective• Train 60 - 80 high school students to teach a primary prevention curriculum to approximately 1500 high-risk middle and junior high school students in 4 schools in the Richmond Unified School district through the Youth Educator Program. II - 9 5. High Risk Youth Set Aside Goal. Support high-risk youth who have participated in a school-based prevention program to sustain gains made in this program by utilizing community based support systems. Objectives: a) Continue to identify and describe natural community support systems. b) Through case management servicers, link 100 high-risk youth and their families to these support systems. 6. Perinatal Services Network These services are supported by State Perinatal Expansion Funds, federal SHPT block grant funds, Perinatal Drug/Medi-Cal funds and Perinatal Set-Aside funds. Goal: Increase the availability of treatment services for substance abusing pregnant or parenting women who are impaired in their ability to care for their children. Objectives: a) Provide case management services to approximately 75 women in east county through the Born Free Project and 100 women in West County through the East Bay Perinatal Council. b) Provide outpatient treatment couriseling to approximately 15 women in central and west county and provide treatment counseling to 8 women incarcerated at the county jail through the Born Free Project. C) Provide intensive day treatment services for approximately 60 pregnant and/or parenting women and their children (0 - 5 years) in east and west county. d) Provide 36 residential beds and recovery services at La Casa Ujima in Martinez and The Rectory in Richmond. e) Provide 24 transitional living beds at Tri-County Women's Recovery Services Houses I and II in Richmond and at Wollam House in Pittsburg. f) Provide a child care enrichment component in the Tri-County Women's Recovery Services treatment program . g) Ensure compliance with the suites new Perinatal Services Standards and ensure . implementation of the new funding requirements for programs supported by these funds. 11 - 10 7. Parolee Services These services are supported by state Parolee Services Funds to link parolees who have drug abuse and/or alcohol problems with services immediately upon their release from state prisons. Goal: Improve parolee outcomes as evidenced by fewer drug-related parole revocations/new violations. Objectives: a) Provide case management services to approximately 180 state prison parolees. b) Provide outpatient treatment counseling services to approximately 50 state prison parolees at selected county operated drug and alcohol programs. C) Provide 15 residential beds and recovery services for state prison parolees at the following sites: Ozanam Center; Gregory Center; Sunrise House; Diablo Valley Ranch, and Discovery House. d) Provide 3 sober-free-living beds through a not yet negotiated contract. S. HIV Set Aside Goal: Reduce the incidence and prevalence rates of HIV infection among the substance abusing population. Objectives: a) Implement state guidelines regarding the pre-test counseling, testing, and post- test counseling for HIV in all county and contract outpatient and residential treatment programs. b) Provide HIV education and pre and post-test counseling to approximately 750 methadone maintenance clients and their needle-sharing and/or sexual partners and perform up to 900 antibody tests. 9. Public Housing Residents These services are supported by the Center for Substance Abuse Treatment (CSAT) - Critical Populations grant. Goal: Provide a comprehensive array of health and human services to individuals, their families and significant others to reduce alcohol and drug use. II - 11 Objectives: a) Provide educational presentations to approximately 1,320 residents of public housing developments in North Richmond and Pittsburg. b) Provide outpatient intervention counseling to approximately 265 residents of public housing developments in North Richmond and Pittsburg. C) Provide recreational services for youth who are residents of the public housing development in North Richmond. d) Provide outpatient treatment counseling including acupuncture services to approximately 285 residents of public housing developments in North Richmond and Pittsburg. e) Provide 21 day outpatient opiate detoxification services to El Pueblo public housing development residents who are clients of the El Pueblo treatment program. PROGRESS REPORT FOR PRIOR FISCAL YEAR The Contra Costa County Substance Abuse Division met or exceeded its Goals and Objectives for fiscal year 1992/1993 a:93-94pin.rpr II - 12 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS 6. y 1•g• I of COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL 71..o► .o•w,..,o■. SUMMARY COUNTY NAME: CONTRA COSTA FISCAL YEAR 1993194 COUNTY CODs: or L-awa.- SUSMISSION DATE: 10/29/93 A H C D e r LINE rUNDING SOURCES SUPPORT PRIMARY SECONIMAY RON5UM=EmTIAL RESIDENTIAL PACS TOTAL NS 1 INCLUDZU0 SERVICES PREHSNISION PRSVEIMON SERVICES SERVICES SUDGST D DY 1 -FED CAT / SUDGETED sUDGETED BUDGETED HUDGETED SUDGET"D ?V"ZNG SOURCr 40 kl..00ijDruq Meda-Cal tort ::, _._ .. 0 Fed Cat t $3.778 .�:`.�. �"....:.. .. 110.856 �� 110,856 ao• porloacal - Meda-ca] Oa ted Cat 1 93.775 111:';1:...::?. :::...:.,..�:::..:.:.:.. . :�..:.::::..;1111::::�:::�:::��::.::..::::....:.,1111:::::.::�:::. ai Lu General lands 1 414,020 12.292 72,023 53.278 610,446 1,162.059 iia Perinstal Trtmt. Olpaoaion .... Is Pr9a 36.817 '`` < '> >`< ;' 128,085 203.270 368,172 43 Foc.t4caal sehabi litatioa 2 :1111 �i 4�•�;:.�:.....::i':::::.:..:is is ...•:.:.�:::: ............. ::.::.:::1::111 ...:.:......:.. :v.v.v..:.�:.:.:::.:.�:.:.:: 'v.::::::.::::::.:.iii'•::.:::: :':::'i`ii:: �. ..1111 as PPP - School Commanity .' .... .•• ... .., 111:1..:;:::::::: { Prima Prevention 1.230 47,979 49,209 a wl oL1•oder 1111. 1111 5 S X. r••taint Projectact 0 ..;1,111.;1:11:::•::::::::::::1:. ::..:::::::::::::::.:::.:::::,,.,.,:11::::1:::::1:::.::.::::::.:::: aG arotee 6er.aa•e Pro3•eRa :,e.:..:.>;'.::.;;..,_.:`:.'.`.'..`:: i:i::f: :::>L::';r::::::`:,>; 6 P P 37 60.765 79 1 oar, PNP. PP ,9532 183 377.90 50 APT - 0i•Cr•t1oERry 50 Fed Cat / 93.959 325,928 1,046,495 293.863 685,502 869,407 3,221.195 51 41V set-Acid• 1 red Cat 1 93.959 Q .:.:>::..x:::::.:::.;:...,.:,,.:. ,1::::::::1:11:..�::..........:.. 52 APT-rev P.rin•tal S/A 2 Fed Cat / 93.959 107,656 107,656 Sla •ri"tei Pilot Yrtmt. 7• 4 8 4 1 .Q23 1 4 1 1 Cat 1 19 2 Of 103 ,03 Hd C t 1 9J.959 9 76 5Jn P.rabazal Pilot Caw Mgst. '<:•>::::;:::'•;?2:" _. . . - 3b :1111:..: .. Ted Cat / 93.959 ''��"::;::;:,.i::;;i,�':. .: ..•:"::'1`11':1" .:.� <;:>�..:'::..:.'."` Q 11:11 ... ... .. .. 111:1 1111... .. 1111 111:::::1 54 0101." PY03.00 54 Fed Cat 1 93.959 0 55 lC/Drug-rrse workplace led Cat 1 93.959 0 56 APT special Pro3octs 6 saxomaryoL rued• 0 60 rsc-Rign Risk Youth s/A 0 red Cat / 84.186 110 800 110,800 62 r5C-sCnoo1 Based Pr•v. 2 Fed Cat 1 84.186 891 48,827 14,083 `?:z: 63.801 fa r6C-Otuq KN Halaing a • at 1 8{ '8 Q 66 rSC-rriday Night Live 6 r.d cat / s4.186 15,000 `" . 15,000 6a Esc-clan Live e Fed Cat / 8{.186 15 000 15 .d .000 69 ns match to Club Liv ..:....•...:.. 1111.. ... 9 Fe Cat 20.600 9.305 9 d 1 305 70 SAT-BZV/AIDS Cues. Outran. 70 Fed Cat i 91.949 0 72ritical Populations 2 4 6 Fed tae i 93.90] 35,000 '�� 166.410 37,254 4238.664 7a •sid•nt.-Publin Housing Q • F d 1 Cat 93.902 le.. Juv.nile J sCi 6 / u w 6 • 9 .9 Fed Cat 1 ] 01 78 ria.Jus tiN Non-ISar. 8 Cat 9 11.d 1 9]. O7 11::1:1:::.::::::.:::...:::...... ::::.::.�..:..................... Q s0 nh.r R...bass 30 590.782 52.246 600,952 66.628 1,310,608 81 t.quirad County match 3i 40TZ: -- 50,093 10,557 8,003 20,152 90,412 179,217 82 ouoty nand• - Other 2 189.039 2,829 48.396 86.286 916,670 1,243,220 83 c... Pa.. - 3 0 84 e•e 6,800 20,077 15,831 79.659 260,333 382.700 { 85 n.uraoce 35 86lf{3.25 - so 920 s r1 6 1372.7 - so 921 68,765 68.765 87 ia6l.lf - •tathaa 7 14.995 208,653 223,648 as c••• D D Prot r4 P it/6u us 1 ................. e ............::... :::,.::.:•::..::::.:.......:..:•.� .;:.>. X., 1111 1111 89 unkin9 ri.% : ;;};:: , .>::.:•::::4:1, 1 9Drier tees dein. 6 monitorin ,1111 :..::.:>:;o-::•..:,:a,;::•:.:::.:. 0 1111 1111..: 0 90 OTAL BUDGETED Y SERVSCE CATEWRY 1,304-742 1,887.908 615.245 2,419,968 4.060.926 10 288.789 92 O1LLnLwr 6erv3Ge• 2 NOTE: -- Statham funds being used for Alcohol match gust appear on the Statham line 87. Do NOT REPORT STATHAm AS MATCH ON LINE 81. 9♦ C'rAL ALCOHOL HUDCaTED a Fed C.t t 93.959 258.952 401.051 36.199 517.356 466.643 1.680.2Q1 96 OTAL DRUG BUDGETED 6 r.e C.t 1 97.959 258.952 1 645.444 257,664 596.169 921 434 2.679.663 CONTACT NAME: 1.041..oat DATE RECEIVED: A D 7 2 2 5 A 1 ( a/9 3 ) PRONE /: (510) 370-5048 III - 1 0EPARTMENT OF ALCOHOL AND DRUG PROGRAMS a—a--y Pees z f 2 COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL SUMMARY COUNTY WAAZ9 CONTRA COSTA FISCAL YEAR 1993194 COUNTY CODZ: 07 L---=.- *URKISSZON DATA: 10/20/93 3 T FUNDING SOURCES cxmxcALLr ANCILLARY :>RIVKING DRIVER PAGE TOTAL IN=UDnje ASSISTED TX SOMICES FROG. SERVICES TOTAL B=xMD BY # FID ED CAT sLTDG=M K=ETED 3UT-G ETTD 40 kicorm/Drug MedL-Cal, .......X: 2 f6 . Fed Cat I 93.77e 599,400 599,400 710,256 404, ?*ribatal-Nadi-Cal Oft 0 0 Fad Cat t 93.77a 0 41 tate General Funds ala pri—t.1 I. . ZxpwLLcn 4,049 4,049 1,1.66,108 Is (prrvj 0 368,172 42 Rehabilitation ....... 2 17,042 17,042 17.042 44 p School Ccumun.LLY ...... 0 49,209 14 Prima ry Prevention 45 ams 1e off—der is........... ............... 0 ... ....... ................ re^tmnt Project 0 46 P.—l" s.rvIce. Pro]*=& .... ..... .......... BN, Pp", "p) 1�634 1,634 379,535 so ;APT Discretionary 0 Fad Cat P 93.959 0 3.221,195 51 41v sat-Aside Fed Cat t 93.959 310.884 :p ...... 310,884 310.884 52 5APT-Neu Perinatal S/A 52 Fed Cat f 93.959 0 107,656 53" Pevtnatal Pilot 7rtmt. Fad Cat # 93.959 0 1,031,013 53b perinataa Pilot CA" mgmt. 53b .......... Fed cat * 93.959 • 329,198 329,198 329,198 54 4wl.4. project ." 54 X Ped Cat # -9.7.939 0 0 55 c/Drug-Free workplace Fed Cat # 93.959 0 0 56 3APT special Projects �X, 56 5=w.ry of Funds 42.262 42,262 42,262 60 :,FSC-Hiqb Risk youth 5/A ......... ....... 0 ....... .. Tod Cat f 84.146 0 110.300 62 )P'Sc-school Based Prev, ...... ........-....... ........ 2 Fed Cat 1 84.146 0 63.801 ....... S4 0 64 Drsc-Drug r� Housing ......... Fed cat f 84.146 0 66 Drsc-Fridy Night Live red G,- 84.1136 0 15,000 68 )Fsc-.Cl= t.Lva Fed Cat s $4.106 .. .... 0 15,000 )TS match to Club Live 9 F ed Cat * 20.600 9,305 0 70 f"T-alwAIDcaccow. Outroh. 70 Ped t # 93.949 0 0 72 ritiul P.P.I.AtIODS 72 ... .:.....:•..... Fed Cat 1 93.902 .............. 0 238,664 711 lesidente-Public Housing 74 0 .d cat 93.902 .. ....... 0 76 kdolee./Juvenile Justice ...... 76 X. X.. . . ....... Fed Cat 1 93.902 0 0 79 rim.Justir Non-Incir, ....... 78 Fed Cat 3 93-903 0 0 so )tber Revenues 74,207 74,207 1,384,815 al kequired County Match 31 2,343 90TE: 2,343 181,560 82 ounty Funds other 12 83 nu:es. Fees 0 1,243,220 3 0 0 8a see 4 480,832 480,832 863,532 85 meta ran<:e S0 36 IC 1463.25 - Sa 920 tS 11372.7 - SB 921 0 68,765 87 -C 1463.16 - Statham 7 0 223,648 .... ......... a* Dws— DOF Profit/Surplus ....... ... 0 -%-king Driver Fees 4 n. c . .... . . . ... ... .. .... . .... mu=�— ii55 10 FICTAL allDGXTED I�0.850 0 bY SERVICE CATEGORY 1.122.494 739,357 1.550.850 3.412.701 13,701.490 92orluntser Services ............. 2 40`T'M: Statham being used !or Alcohol maten must appear on the Statham 14.n. 17. ZO :Kir RESORT STATHAM AS MATCH ON LINE 81. 94ALCQHOL BUDGETED4 ...... . . ge rL rd cat § 93.959 253.026 253,026 1.933.227 fOTAL DRUG SUDGETED 41 ?ad cat A 53.959 . 42.2621 387.056 429.3181 3.108.981 CONTACT NAME: PW4T ..00K A 0 P 7 2 2 5 B ( 4/9 3 7 PHONE 1 (510) 370—5048 111 - 2 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS . . COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL SUPPORT SERVICES Coos:: MASS* cearra —:a TT.e or suss=aetor, FISCAL YEAR 1993194 �/�/ eovsrT cons: of svaazsazor ears: Io/:e/es L— G Q F A B 1 O1 ROVTDER HAAS COUNTY 'AL RESEARCH .. 05 PROV=ER CODE (;07 0799 C 07 0798 "' '':" 10 £RVICE COOS 00 04 r�C 0 90 OTAL BUDGETED 1 269 742 35.000 1 304 742 FUNDING SOURCES i.MJ 1 41 tat% General ?undo 414.020 414.020 1a 41a erinatal Srtmt. Expansion 36$17 36 817 . PTEY} r 4 44 CPPD - School C.Msunity 1 230 1 230 ma Pri : Prevention 1,230 46 arolee Servicer Projects37,953 7 37,553 (RASA. PPNP, PPP) 0 So APT - 0_cratiooary 325928 325,928 , Fed Cat # 93.959 I 51 IV $et-Aside 0 Fed Cat # 93.959 52 52 AFT--Hav Perinatal S/A 0 .*ed Cat # 93.959 n 3. aa 534 arital Pilot Trtmt. 19176 191 976 Fed Cat # 93.959 4 54 omeless Project 0 Fad Cat # 93.959 55 55 lc/Druq-Free Workplace 0 Fed Cat # 93.959 6 56 3APT Special Projects 0 Summar of Funds so 60 FSC-High Risk Youth S/A 0 Fed Cat # 84.186 S2 62 FSC-School Based ?rev. 891 891 Fed Cat # 84.1864 64 FSC-Druq Free Housing 0 Fed Cat # 84.186 56 66 FSC-Friday Night Live 0 Fad Cat # 84.1868 68 FSC-Club Liva 0 Fed Cat # 84.186 0 70 70 SAT•HIV/AIDS COMM- Outrch. gad Cat # 93.949 2 72 1=ritical Populations 35 V/x,00 35,000 rad Cat 1 93.902 dJ LIV 4 7i esidents-Public Rousing 0 Fed Cat # 93.902 76 76 dol"./Juvenile Justice 0 Fed Cat # 93.9028 78 ria.Justice tion-Incar. 0 Fed Cat # 93.903 10 80 then Revenues 0 1 81 squired County Hatch 56 093 50.093 oTEt •• 2 82 ounty Fund* - Other 189,039 189.039 3 81 excess Fees 0 4 Ia ser 6 800 6 800 5 Bs nsurance 0 6 86 PC 1463.25 - Sa 920 0 5 11372.7 - 48 921 37 87 C 1463.16 - Statba 14,995 14,995 9 89 riakiaq Driver Feee 4 0 dmin. x Honitorin �jc nnrt 0 90 OTAL BUDGETED 1 •i9 742 35.Q00 0 0 0 1 304.742 Y S$RVTCE CATEGORY 2 92 olunteer Servxcee NOTE: •• Stathaa funds beiaq used for Alcobol matCh must appear on the Statham line 81. DO HOS REPORT STATHAN AS MATCH ON LINK 81. 4 94 OTAL ALCOHOL BUDGETED 258,952 Fad Cat i 93.959 258952 6 96 OTAL DRUGBUDGETED 258.952 Fed Cat 1 93.959 258.052 AD7225C1 (4/93) OATS RECEIVED: III - 3 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL TTVI OF SUSNISSIQMI PRIMARY PREVENTION SERVICES COUNTY NAME: CDUTRA COSTA 'oa141 NAL FISCAL YEAR 1993/94 COUNTY CODE: ol SUBMISSION DATE: C D z 01 IROVIDEX NAME RUUNUL& LJHLU L$Uyb&-U-[RL.� COUNCIL AIRS CENTRAL AIRS EAST AIRS WEST_ CLUB 05 'ROVrDER CODE f F )s A 07 0070 A 07 0001 A 117 0003 A 07 0002 D 07 0764 10 ;ERVICE CODE 10 10 10 10 10LQ 90 !OTAL BUDGETED j 0 1 1 7 141.308 1 59.575 24.497 26,629 1 83-9181 335.927 FUNDING SOURCES 41 state General tunas 1 12.292 12,292 4 44 CPPP - School Community 44 Primary Prevention 0 50 iAPT - Discretionary So — Fed Cat # 9].959 39.808 59,575 24,497 26,629 83,918 234,427 54 4omoless Project 4 Fed Cat 0 93.959 0 55 PLlc/Drug-Fres workplace 5 F. Cat 0 93.959 0 56 5APT SPeci.lPr:j* summer 7 , z 6 Funds 0 60 DFSC-High Risk Youth S/A so Fed Cat J $4.186 0 62r -Snboo 1 Based Prev. 2 FSC Fed Cat # 84.186 0 64 FSC-Drug Free Housing 1 4 F Cat # 84.18 0 66 rFSC-Friday Night Live 6 Fed Cat # 84.186 15.000 15,000 68 rrsC-Club Live 8 Fed Cat # 84.184 15,000 15.000 69 rTS Match to C 9 Fed Catlu20.600 b Live 9.305 9,305 80 rth.r Revenu aso 2.504 21504 S 81 squired County Match 'l TE: .. 1.366 1,366 82 rounty Funds - Other 0 32 83 cess fee 3 0 84 Fees 34 20,077 20,077 as Insurance 35 0 86 PC 1463.25 - SB 920 36 JIS 11372.7 - SB 921 25,956 25,956 87 C 1463.16 - Statham 7 0 So OTAL BUDGETED '0 Y SERVICE CATEGORY 141.308 59.575 24,497 26.629 83,918 335-9271, 92 j*l1nt-1 Service, 1 �2 NOTE: -- Statham funds being used for Alcohol matco must appear on the Statham line 87. 1>0 NOT REPORT STATHAM AS MATCH ON LIVE 81. 94 rOTAL ALCOHOL BUDGETED ' Fed Cat # 93.959 39.8081 59.575 1-_ 24,4791 26,6291 150.491 r 1 96 rOTAL DRU BUDGETED red Cat # 93.959 83.918 83.918 r I AD7225131 (4/93) 111 - 4 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL TT1a Or SOSMIsslow, PRIMARY PREVENTION SERVICES COUNTY NAME, C007e. COs:. M 0R1GINa1. FISCAL YEAR 1993/94 COUNTY cons, a7 �MEND40 SUBMISSION DATE, 1e/2e/93 A B C D L F 01 ROVIDER NAME C 1 CHD CONNECTIONS REACH SAN PABLO VALLEY DISC. 0S ROVIDER CODE � ,•.ay...��i:?:; 5 A 07 0754 D 07 0745 D 07 0753 D 07 0732 0 07 0733 10 ERVICE CODs %./f>:::;?s<.e a..:>::;:: 0 90 OTAL BUDGETED 0 487.245 71.363 36,469 101.406 15.191 711.674 FUNDING SOURCES 41 State General Funds 1 0 44 CPPP - School Community 4 7rimary Prevention 47,979 47,979 50 SAPT - Discretionary 50 red Cat $ 93.959 389,166 69,137 36,469 101,406 15,191 611,369 54 omele a Project 4 Fed Cat f 93.959 0 55 lc/Drug-rree workplace 55 Fed Cat # 93.959 0 56 SJL2T Special Projects 56 Summary of Funds 0 60 rSC-High Risk Youth S/A 0 Fed Cat t 84.186 0 62 FSC-School Based Prov. 2 Fad Cat t 84.186 34,743 34,743 64 FSC-Drug free Housiaq 54 Fed Cat 6 84.186 0 66 rSC-Friday Night Lava 56 Fed Cat 84.186 0 68 FSC-Club Lave 58 Fed Cat t 84.186 0 69 3TS Hatch to Club Lave 9 Fed Cat 1 20.600 0 80 Dther Revenues 30 6,166 2,226 8,392 el Required County Match 31 ora: 9,191 9,191 82 ounty Funds - Other 2 0 83 excess Fees 3 0 84 Fees 34 85 Znsurance 35 0 84 C 1463.25 - SB 920 6 S 11372.7 - SB 921 0 87 C 1463.16 - Statham 7 0 90 OTAL BUDGETED 0 Y SERVICE CATEGORY 487,245 71.363 36,469 101,406 15.191 711,674 492 ,1.nteer S.—z..e 2 NOTE: •• Statham funds being used for Alcohol match must appear on the Statham line 87. DO NOS REPORT STATHAM AS MATCH ON LINE 81. 94 OTAL ALCOHOL BUDGETED 4 Fed Cat 1 93.959 250.560 1 1 250,560 96 OTAL DRUG BUDGETED 6 Fed Cat i 93.959 138.606 69.137 36.469 101,406 15,191 360.809 AD7225D2 (4/93) III - 5 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL. TYPO or &O.MIsi Z*.t PRIMARY PREVENTION SERVICES COUNTY NAMZz CONWA COSTA FISCAL YEAR 1993194 COUNTY cons: 02 j xxDa10ZMLL SUHNIS&ZON DATES 10/30/93 �Al10MD00 g CD Z t A I C O1 ROVIDER NAME SO-10URNE PREVENTION TRI—CITIES YSB FREE C.C. OS ROVIDER CODE 't� •..tS:•: ::%:'•t .�:ji 5 O 07 0761 2-070798 O 07 0731 O 07 0765 C 07 079$ .. :N`:> ;> :: :D ERvzcE cons 10 10 10 10 10 0 90 OTAL BUDGETED 94,015 45.638 81,683 43.771 575 200 840.307 tUNDING SOURCES 2 al tats General Funds Q 4 as CPAP ^ School Co—unity 0 Primary Prevention �•fn CA 0 50 APT - Discreti-4ry 81 683 2S QQ1 200,6`9 Fed Cat ! 93.959 94,015 4 [60 *.also. Project Q Fed Cat i 93.959 5 vzkplace Q Fed Cat ! 93.959 rrt� 6 APT Special Projects 6Su..ar ofFunds 0 FSC-High Risk Youth $/A 0 Fed Cat 9 84.186 2 62 FSC-School aao*d Pr.- 14,084 14.084 Fed cat 1 84.186 S4 6a FSC-Div9 Fre* Housing 0 Fed Cat f 84.186 66 66 FSC-friday Night Liv* 0 Fed Cat # 84.186 58 6d FSC-Club Liv. 0 Fed Cat J 84.1869 69 TS Mateh to Club Liv* Q Fed cat i 20.600 0 C pp 0 80 they Revenues 4 6$6 575 294 579.886 3 81 squired Couaty match Q TE: p�1A 2 82 Oanty Funds - Other 2 tG]3 O my 2,829 GG77 3 83 xces. Fess 0 1 84 sea 0 5 as neuranc. 0 6 86 C 1463.25 - SH 920 42,809 42,809 S 11372.7 - SH 921 7 87 C 1463.16 - Stathaw 0 0 90 OTAL BUDGET= 45.638 81 683 43.771 575.200 840.307 Y SERVICE CATEGORY 94.015 2 92 Olunteer S*rvic** NOTE: — Statham funds using used for Alcohol retch must appear On cbs *Pathos lin. d7. DO NOT REPORT NOTE: A$ MATCH ON LIVE dl. a 94 OTAL ALCOHOL aUDGE£ZD 0 ted cat 9 93.959 6 96 OTAL DRUG BUDGETED 81,6831 25.001 200,699 Fed Cat 9 93.959 94.015 AD7225D3 (4/93) III - 6 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL Tyre or sDaaas IO., SECONDARY PREVENTION SERVICES COUNTY NAMat eo.aa eros?& XX OaIDt.AL FISCAL YEAR 1993/94 COUNTY CODE. a? 'asnoaD SUBMISSION DATEt 10/Z9/93 A B C D O1 ROVIDER NAME - C 1 U I ALO IRS CENTRAL AIRS EAST AIRS WEST CLUB NEW CONNE IONS os ROVIDER CODA A 07 0001 A 07 0003 A 07 0002 D 07 0764 D 07 0745r >':s; < ';' to ERVLCE coca 18 18 18 18 18 <r + ` Igo OTAL BUDGETED 15.693 8 404 12,1021 11,1631 43,7111 91.073[ rUNDTNG SOURCES 41 State General Fund■ 1 10,047 10.047 44 SCPPP - School Comvunity 44 Prima?y, Prevention 0 50 3APT - Discretionary so red Cat ! 91.959 15.693 8,404 12,102 31,255 67,454 S4 omeles. Project 54 red Cat i 93.959 0 55lc/Drug-rre• Workplae• 5 Fed Cat 1 93.959 0 56 APT Special Projects 56 suvem.ry of Funds 0 60 FSC-Higb Risk Youth $/A so Fed Cat 084.186 0 62 FSC-School Based Prev. 52 Fed Cat t 84.186 0 64 FSC-Drug Free Housing 54 red Cat i 84.186 0 66 rsc-Friday Night Live 56 Fed Cat 84.186 0 68 FSC-Club Live, 58 Fed Cat f 84.186 0 69 DTS Hatch to Club Live 9 Fed Cat # 20.600 0 80 tber Revenues 0 10,000 10.000 81 Required County Hatch 1 11OTE. — 1,116 1,116 82 zounty Fund. - Other2 0 81 Excess Fee. 3 0 84 ... 34 2,456 2,456 85 0 neuranca 5 0 86 C 1463.25 - SB 920 6 S 11372.7 - SS 921 0 87 C 1463.16 - Statham 37 90 OTAL BUDGETED 0 Y SERVTCE CATEGORY 15.693 8,404 12,102 11,163 43.711 91.073 92 olunteer Servlc.• 2 TOTE: •• Statham funds being used Eos Alcohol match must appear on the Statbaa line 87. DO NOT REPORT STATHAM AS HATCH ON LINE 81. 94 OTAL ALCOHOL BUDGETED 4 Ted Cat # 93.959 15.693 8.404 12,102 36.199 96 OTAL DRUG BUDGETED - 6 Fed Cat 4 93.959 31.255 31.255 AD7225H1 (4/93) 111 - 7 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL r,.a of aoas.aalo.. SECONDARY PREVENTION SERVICES COUNTY NAMES COeaA C05TA ...... FISCAL YEAR 19513/94 coots:: CODE: eI Asaaeao SUBMISSION DATZ1 1e/2e/e3 A B C D L. 01 ROVIDER NAME PERSPECTIVES REACH DISCOVERY VALLEY DISC. SOJOURNE c 1 05 IROVIDER CODE C 07 0720 D 07 0753 D 07 0732 D 07 0733 D 07 0761 :0 £RVICa CODA ..nw;::.:: :.ti::; 0 18 18 18 18 18 ., 90 7OTAL BUDGETED 0 124.8831 57.0021 60,8431 101,7081 56,409 400.845 FUNDING SOURCES 4: State General rands 28,574 28,574 1 44 CPPD - School Community 4 Primary Prevention 0 50 SAPT - Discretionary So Fed Cat 1 91.959 57,002 60,843 56,409 174,254 54 qomele.s Project 4 Fed Cat 0 91.959 0 55 lc/Drug-Free Workplace 5 Fed Cat / 93.959 0 56 SAPT Special Project* 56 Summary of Funds 0 60 rSC-High Risk Youth S/A so red Cat 4 84.186 110,800 110,800 62 FSC-School Based Prev, 52 Fed Cat / 84.186 14,083 14,083 64 FSC-Drug tree Housing 54 Fed Cat i 84.186 0 66 FSC-rriday. Hight Live 56 Fed Cat t 84.186 0 68 FSC-Club Live 58 red Cat i 84.186 0 63 DTS Hatch to Club Live 59 red Cat t 20.600 0 80 Dther Revenues 0 42,246 42,246 81 Required County Match 1 '40TE! •• 3,175 3,175 82 zounty Funds - Othez2 14,338 14,338 81 Excess Fee e 3 0 84 ees 34 13,375 13,375 85 Insurance 5 0 86 PC 1463.25 - SB 920 96 S 11172.7 - SB 921 0 87 C 1463.16 - Statham 7 0 90 OTAL BUDGETED 0 Y SERVICE CATEGORY 124,883 57.002 60.843 101,708 56.409 400.845 92 olunteer Services 2 :TOTE: •• Statham funds being used for Alcohol match must appear on the Stathas line 87. DO NOT REPORT STATHAM AS MATCH ON LINA 81. 94 OTAL ALCOHOL BUDGETED4 red Cat a 93.959 0 96 [OTAL DRUG BUDGETED 6 red Cat 4 93.959 57.002 60.843 56.409 174.254 LJ (4/93) 111 - 8 DEPARTMENT OF ALUUMUL ANI.7 DRUG F'HUGHAMJ COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL n■ or sosstastos, SECONDARY PREVENTION SERVICES COUNTY NAME: .0.1NA CoarA _Dai0Ima4 FISCAL YEAR 1993194 COUNTY CODs: 67 waso■s SUSMI36I0N DATA: to/2e/93 A 8 C D £ 31 IROVIDER NAXX TRI—CITIES DETENTION EAST COUNTY D OX 1 )5 ROVIDER CODS :.:?.... :.urAr>:.::s::;:;::•:•.:: D 07 0731 A 07 0010 C 07 0738 .f:"• ,s.//�'•./�::'i:#tz>>a�:_ s 70 ERVICE CODE �,•:y.' /i";::;;:;'+,:;;,;\�: 0 18 19 19 00 OTAL BUDGETED c::..........: ..:... ,.. 0 52,155 1 8.175 62,997 L 123.327 rUNDrNG SOURCES 11 State General Funds 1 7,357 26,045 33,402 14 5CPPP - School Coa nity 44 Primary Prevention 0 i0 APT - Discretionary so Fed Cat_# 93.959 52.155 52,155 i4 0Oe1ees Project 4 Fed Cat t 93.959 0 i5 lc/Drug-Free Workplace 5 Fed Cat t 93.959 0 i6 3APT Special Projects 56 Summary of Funds 0 ;0 FSC-High Risk Youth S/A so Fed Cat t 84.186 0 ;2 FSC-School Based Prev. 52 Fed Cat ► 84.186 0 !4 FSC-Drug Free Housing 54 Fed Cat t 84.186 0 ;6 rSC-Friday Night Live i6 Fed Cat t 84.186 0 ;a FSC-Club Live 58 Fed Cat t 84.186 0 19 3TS Match to Club Live S9 Fed Cat t 20.600 0 ;0 Dth.r Revenues 30 0 ;1 Required County Match 1 OTE: •• 818 2,894 3.712 :2 ounty Funds - Other2 34,058 34,058 3 Excess Fees a3 0 v ream, 34 0 5 ro.uranc. 35 0 6 C 1463.25 - SS 920 - 6 8 11372.7 - SS 921 0 7 C 1463.16 - Statham 7 0 0 OTAL BUDGETED 0 Y SERVICE CATEGORY 52.155 8,175 62997 0 0 123.327 2 oluntesr Services 2 ,TE: -- Statham funds being used for Alcohol match must appear on the Statham line 87. DO NOT REPORT STATHAM AS MATCH ON LINE 81. 4 OTAL ALCOHOL BUDGETED4 Fed Cat t 93.959 0 6 [OTAL DRUG BUDGETED bf red Cat t 93.959 52.155 52.1551 1 AD7225113 (4/93) III - 9 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL NONRESIDENTIAL SERVICES TT►. or S.ft ...2o.. FISCAL YEAR 199./94 COUNTY NAME: cosTRA COSTA oa:cle•L COUNTY CODE: 07 ...... SUEMZSSION DATE: 10/to/f) A B C D E 0 1 RAVIDER NAMEC 1 1 AIRS CENTRAL AIRS EAST AIRS WEST BORN FREE BORN FREE 05 ROVIDER CODE A 07 0001 A 07 0003 A 07 0002 C 07 0770 C 07 0773 "' c,\ r.:tis.:..:. 10 ERV ICE CODE ;v .:.'f".>v:`°•>.::�� 0 31 31 31 31 31 90 TAL BUDGET .......:.........: 9Da �e�te 217.890 72 599 139 755 281 427 0 422141 1.133.812 2,451 822 1923 800 1560 91 :oat Per Unit of Service 1 88.90 88.32 72.68 351.78 270.60 150.05 F"DING SOURCES 40 iconoi/Drug Heal-Cal ° Fed Cat 1 93.778 30,000 30,000 40a PerInatal - Nadi-Cal 40. Fed Cat } 93.778 0 41 5tate General funds 1 Fed Cat / 93.778 25,910 25,910 41a •rinatal TrtmC. Exp an&ioa la PTEP 1 51,234 76,851 128.085 45ems Is offender 5 eatment Project 0 46 Parolee Service. Projects M �n 6 20 BASN, PPNP, PPP) .255 20 255 40,510 50 5A2T - Discretionary 50 fed Cat i 93.959 188,286 17,032 98,027 303,345 51 irV set-Asia• 1 Fed Cat 1 93.959 0 52 APT-Ner Perinatal S/A 2 Fed Cat "3.959 0 53a *rinatal Pilot Trtmt. 53a Fed Cat 0 93.959 0 54 inmates. Project 54 Fed Cat t 93.959 0 56 APT Special Projects 56 Summery of Fund& - 0 70 AT-HIV/AIDS Comm. Outrch. 70 Fed Cat 1 93.949 0 72 ritical Populations 72 Fed Cat ! 93.902 0 74 evidence-Publia Housing 74 Fed Cat 1 93.902 0 76 oleo./Juvenil* Justice 76 fed Cat 6 93.902 0 78 -1m,Juetice Non-Incar. 78 fed Cat i 93.903 0 80 hes Revenues 0 224,500 336,751 561,251 81 equired County Hatch 31 2,879 5,693 8 539 17,111 62 ounty Funds - Other 5,260 5 260 2 81 tees Fe•& 3 0 84 sae4 9,349 5,312 7,679 22,340 85 neuranc• 35 0 86 C 1463.25 - SB 920 6 8 11372.7 - SS 921 0 87 C 1463.16 - Statham 7 0 90 TAL BUDGETED ° Y SERV ICE CATEGORY 217.890 72,599 139.755 281,427 422141 1.133.812 92 oiuntesr Services 2 NOTE: — Statbam funds being used for Aloobol maecb must appear on the Statham line 87. DO NOT REPORT STATHAM A8 HATCH ON LINE 81. 94 TAL ALCOHOL BUDGETED 4 Fed Cat ) 93.959 188.286 17.032 98,027 303.345 96 TAL DRUG BUDGETED 6 Fed rat ) 93.959 0 AD7225E1 (4/93) DATE RECEIVED: III - 10 UL--t-ARTIVIEN I Ur /AUUr1UL ANU Umuu r-r1v-)UM~Z) COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL NONRESIDENTIAL SERVICES ...... FISCAL YEAR 1993194 COUNTY MAXat COe A COSTA F 5Y0.102—L COUNTY CODES of SUBMISSION VATSt E r 01 IROVIDER NAME bUTb&k-aitlLb OUTZ)&UiHLZ> NtVV CLUB CLUB NHNR CONNECTION REACH 05 'ROVIDOt CODE D 07 0764 D 07 0740 D 07 0741 D 07 0745 D 07 0753 10 - ;ZRVICZ CODE 31 31 31 31 11: 90 OTXL BUDGETED 31 1 68.1541 33.0141 53.8661 172,222 53.7921 -181.048 90. 1.1ta 96=0 6001 601 3,632 700 6,493 91 oat Per unit of service 70.991 55e02f 89.631 47.42 7685 58.69 FUNDING SOURCES 40 klcohol/Drug Medi.-Cal 40 Fed Cat $ 93.778 0 40. P.rinatAl - Medi-Cal 40. Fed Cat # 93.778 41 ;tate General Funds41 — red Cat 093.778 0 — 41. ?0rinatol Trtmt. Expansion 41. (PTEP) 0 45 Faisal. Offender 45 rreatment Project 0 46 Parolee Services Projects 46 (BASN, PPM1P, PPP) 0 50 ;APT - Discretionary 50 ?.,i Cat 1 93.959 66,414 100,331 53,792 220,537 51 IV Set-Aside 5.1 Fed Cat # 93-959 0 52 APT-Nev Perinatal S/A 52 1 Fed Cat 8 93.959 0 53A Perinatal Pilot Trtmt. i3a Fed cat 1 53.9159 0 54 iont.l.a. Project 4 Fed Cat 0 93.959 0 56 APT Special Projects 56 Summary of Funds 0 70 SAT-HIV/AIDS Comas. O.Itrcb. 70 Fed Car. # 93.949 0 72 :ritical Populations 72 Fed Cat 1 93.902 33.014 53,866 86,880 74 le.idents-Public Housing 74 Fed Cat 6 93.902 0 76 kdoles./Juvenil. Justice 76 Fed Cat $ 93.902 0 78 :rim.Justic. NCO-10MAr. 78 Fed Cat # 93.903 0 80 Dth.r Revenues 0 1,740 26,847 28,587 81 squired County Match 31 OTE: — 0 82 --ounty Funds - Other 32 0 83 .-xc... Fee* 33 0 84 r... 4 45,044 45,044 85 Cn.uranc* 35 0 86 ?C 1463.25 - SB 520 56 iS 11372.7 - SS 921 d7 1C 1463.16 - Statham 37 0 90 'OTAL BUDGETED 0 1 py SERVICE CATEGORY 68.154 33.014 53.866 172.222 53,792 381,048 1,12_r lunteer services, I I I I I I 12 :TOTE: — Statham funds being used for Alcohol match must Appear on the Statham, line 87. DO NOT REPORT STATHAM A8 MATCR ON LINE 81. 94 rOTAL ALCOHOL BUDGETED 0 r4 Fed cat # 93.959 96 rOTAL DRUG BUDGETED Fed Cat I 93.959 66,414 100,331 53,7921 220-537 AD7225E2 (4/93) DATE RECEIVED! III - I 1 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL NONRESIDENTIAL SERVICES rt►. or ssaarsatos, FISCAL YEAR 1993/94 COUNTY NAMEt CONTRA COSTA =)(X-...-Al. COUNTY coos: 67 L____:_ND/D SUHMISSZON DATEt toi:ois3 A B C D E F Ol 4WVIDER NAME — I DISCOVERY VALLEY DISC. SO,IOURNE TRI—CITIES WOMEN—EAST 05 ROVIDER CODE ,,;v 1, . 5 D 07 0732 0 07 0733 D 07 0761 0070731 C 07 0775 10 ERV ICE CODE 31 31 31 31 30 �........ 90 IOTAL BUDGETED 0 107.982 27.036 1 174.476 88.061 2Z7.754 625 309 90. leiCs 1,976 471 1 897 1,257 5,423 11 024 Ga 91 ost Pe! Unit of Service 1 54.65 57.40 91.97 70.06 42.00 56.72 •'UNDING SOURCES 40 1conol/Drug Medi-Cal 40 red Cat 6 93.778 80,856 80,856 40a erinatal - Hedi-Cal 40. Ped Cat ► 91.778 0 41 irate General Funds 41 Fed Cat t 93.778 14,159 13,209 27,368 41a erinatal Trtmt. Expansion 41. PTEP) 0 45 esa le Offender 45 zeatment Project 0 46 Rarolee Services Projeete 46 BAs N, PPNP, PPP i 20,255 20,255 50 IART - Discretionary so Ped Cat t 93.959 72.468 30,315 58.837 161,620 51 1111 S.t-Abid. 1 Fed Cat i 93.959 0 52 APT-New Perinatal $/A 52 Fed Cat f 93.359 0 53a erinatal Pilot Tztmt. 53. Ped Cat / 93.359 2Z7,754 227,754 54 iomel.e. Project 54 Ped Cat t 93.959 0 56 APT Special Projects 56 Summary of Funds 0 70 AT-HIV/AIDS Coss. Outrch. 70 Fed Cat i 93.949 0 72 ritical Populations2 Fed Cat 1 93.902 0 74 esidents-Public Housing 4 Fed Cat4 93.902 0 76 ole../Juvenile Justice 76 Fed Cat f 93.902 0 78 r=.Justics Non-Incar. 78 Fed Cat 1 93.903 0 80 her Revenues 30 11,114 11 114 81 kequired County Match 31 rE: •• 1,573 1,468 3,041 82 Zounty Funds - Other2 19,782 41,944 19,300 81,026 81 cess Pees 33 0 84 e.. 4 1,245 1,106 9,924 12,275 85 to.urance 85 0 861463.25 - SS 920 6 S 11372.7 - SS 921 0 87 C 1463.16 - Statbam7 0 90 TAL BUDGETED 0 Y SERV ICt CATEGORY 27.0361 G/.036 174 476 1 88,0611 227,754 625,309 92 olusteer Services 2 NOTE: — Statham funds being used for Aloobol match most appear on the Statham line 87. DO NOT REPORT STATHAM As MATca On LINE 81. 94 rOTAL ALCOHOL BUDGETED 113 8T!/7 113,877 4 Pad Cat f 93.959 96 rOTAL DRUG BUDGETED 6 Fed Cat s 93.959 72,4681 30 315 58.837 113,8771 275.497 AA7225E3 (4/93) DATE RECEIVED: III - 12 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL NONRESIDENTIAL SERVICES r�TP/9y o7 SO"1561G., FISCAL YEAR 1993/94 COUNTY NAME: Co■�e.a cosy► 5My,O.1G:■AL COUNTY CODEC a7 �jMa■ses SUBMISSION DATE: 10/20/93 A B C D E sr O1 IROVIDER -AME — OMEN—WEST l OS IROVIDER CODE 0 07 0713 i.�� z:'>'••:•h; s :.jv JiQi 10 ERVICE CODE ,,,,r; 2:: 0 90 TAL BUDGETED 200.269 200.269 90• 11.1ts 4,768 4,768 Da X91 :O.t Per Unit of Service 1 42.00 ERR ERR ERR ERRIJ 42.00 FUNDING SOURCES 40 k1conoliDruq Medi-Cal 4o Fed Cat t 93.778 0 404 erinatal - Medi-Cal 4o. Fed Cat 1 93.778 O al State General Funds 41 Fed Cat 1 93.778 0 414 erinatal Trtmt. Expansion1a YTEPI O 45 emale Offender 5 reatment Project 0 46 arolee Services Projects 46 BASH, PPNP, PPPI 0 50 APT - Discretionary 5o Fed Cat 1 93.959 0 51 IIV Set-"id* 51 Fed Cat 1 93.959 0 53 APT-Ser Perinatal S/A 2 Fed Cat 1 93.959 0 53A erinatal Pilot Trtmt. 3. Fed Cat t 93.959 200.269 200,269 54 iomaleas Project 4 Fed Cat i 93.959 0 56 APT special Projects 6 summa of Funds 0 70 SAT-HIV/AIDS Coag. Outrcb. 0 Fed Cat 1 93.969 0 72 ritical Populations 72 Fed Cat / 93.902 0 74 esidents-Public Housinq 74 Fed Cat / 93.902 0 76 oles./Juvenile Justice i6 Fed Cat 1 93.902 0 78 rim.Justice Non-Incar. 78 Fed Cat / 93.903 0 80 her Revenues 30 0 el loquired County Match 31 TE: 0 82 ounty Funds - Other2 0 83 cess Fees a.3 0 84 see 14 0 85 Insurance as 0 86 IC 1463.25 - SB 920 6 6 11372.7 - 58 921 0 87 IC 1463.16 - Statham 37 0 90 TAL BUDGETED �n ncn M nC 0 Y SERV ICE cATEGORY 200.267 0 0 0 0 200.269 92 olunte.r Servic.a 2 NOTE: — Statham funds being used for Alcohol match mat appear on the Statbam line 87. DO NOT RESORT STATHAM AS MATCH ON LINE 81. 94TAL ALCOHOL BUDGETED ?4 Fed Cat 1 93.959 100,134 100.134 96 JTAL DRUG BUDGETED 6 Fed Cat 1 93.959 100,135 100.135 AD7225E4 (4/93) DATE RECEIVED: III - 13 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL NONRESIDENTIAL SERVICES Type or SUSHISSION. FISCAL YEAR 1993/94 COUNTY NAME: CONTRA COSTA COUNTY CODES 07 Awaseae SUBMISSION DATE: C 01 rROVIDE311 NAME ihLZ� U I ALI), 1 CLUB NHNR 05 ROVTDER CODE Q 07 0740 G 07 0740 5 10 ;ERVICZ CODE 10 10 0 90 1*0TAL BUDGET= l 28.610 1 ----15.926 1 44,536 0 90a iazt. —0 0. 191 [... Per "nit of Service ERR FUNDING SOURCES 40 iconol/Drugt y-Cal40 Fed Cat # 93.778 0 1 40a rerynatal - Kdi-Cal 40. Fed Cat 0 93.778 41 tLace General Fund 8 41 Fed Cat-# 93.778 0 414 rerinatal Trtm 41. (;T,,ransion 0 45 teem le Offender is Tests. t . .t 0 46 azo lee Services Projects 46 HASH,_PPNP, PM 0 50 5ATT - Discretionary io Fad Cat 93.959 0 51 -[IV set-Aside 51 Fed Cat 1 93.959 0 52 5APT-Nev Perinatal S/A 52 Fed Cat # 93.959 0 53& ?erynatal Pilot Trtimt. 53. Fed Cat 191.959 0 54 ...less Project 54 Fed C. * 93.959 0 56 [ART Specialje 6 'U S 's'a4r:f Zda 0 70 [SAT-HIV/AIDS Com. Outrch. 70 Fed Cat_# 93.949 0 72 rriticAl Populations 72 Fed Cat # 93.902 28,610 15,926 44,536 74 ;Lesi dents-PUbli c HoUsimq 74 Fed Cat # 93.902 0 76 %doles./juv*nile Justice, 6 Fed Cat # 93.902 0 73 ::rim.justice No=-Incax. 78 Fed Cat # 93.103 0 80 ther Revenues 30 0 81 ttsquired County Match 11 '80TE: 0 82 -ounty Funds - other2 0 3 83 c... F... 33 0 84 re.6 4 1 0 85 tneuranc. 0 35 86 tC 1463.25 - SH 920 0 36 S 11372.7 - SH 921 87 rC 1463.16 - Statham7 0 3 90 TAL BUDGETED Y SERVICE CATEGORY 28.610 15.9261 01 0 0 44.536 o 92 lunte*r services ::OTE: .. StAth" funds boyng used for Alockjol match =at appear on the Statham line 87- DO NOT REPORT STATHAM AS MATCH 09 LINE 81. 94 rOTAL ALCOHOL BUDGETED [4 !led Cat # 93.959 96 rOTAL DRUG BUDGETED 6 F,d Cat * 93.959 0 r AD7225E5 (4/93) DATE RECEIVED: 111 - 14 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL NONRESIDENTIAL SERVICES �T7�T(a�[a�. S.es:a4:0a- FISCAL YEAR 1993/94 COUNTY NAME: CONTRA c"TA ! XX vela.... COUNTY CODE: 67 �aMs.oso SUBMISSION DATE2 10/20/91 A 8 C D E T O1 ROVIDIR NAME bUTZ�6L CLUB NHNR 1 OS ROv2Dam CODE K_., •}:::::::.�••:.. G 07 0740 G 07 0740 .v? y. °a»?::;:>s< ;:: S :'f•:: .KJ. 10 ERVICE CODE p p `>::a.^`:'i;.>:;\@::::::::::;..;;,�.�. 0 90 IOTAL BUDGETED ..................:. .99d 22.481 12513 0 90• 1—ta 0a 0 91 st Par Unit of Service 1 ERR FUNDING SOURCES 40 icohol/Drug Msdi-Cai 4o Fed Cat ! 93.778 0 40a erinatal - Medi-Cal 4o. Fed Cat ! 93.778 0 41 tats General Funds 41 Fad Cat t 93.7780 41a erinatal Trtmt. la PTEPCxpansion 0 45 seals offender 5 reatment Project 0 46 Parolee Services Projects 46 SASH, PPNP, PPP) 0 50 3APT - Discretionary so Fed Cat ! 93.959 0 51 4xv Sec-Acids S1 Fed Cat ! 93.959 0 52 APT-Nev ?erinatal S/A 52 Fed Cat t 93.959 0 51a Perinatal Pilot Trtmt. 53. Fed Cat ! 93.959 0 54 Aomele.s Project 54 Fed Cat ! 93.959 0 56 APT Special Projects 56 Su=mary of Funds 0 70 SAT-HIV/AIDS Com. Outrch. 0 Fed Cat ! 93.949 0 72 ritical Populations 72 Fed Cat f 93.902 22.481 12,513 34,994 74 ..idents-Public Housing 74 Fed Cat ! 93.902 0 76 ole../Juvenile Justice 76 FedCat i 93.902 0 78 rim.Justics Non-Incar. 78 Fed Cat ! 93.903 0 80 then Raven .6 30 0 al Required County Match 1 rE: 0 82 zounty Funds - Other2 0 81 Cees Fees 33 0 84 ea. 34 0 85 Cneurance 35 0 86 IC 1463.25 - 58 920 6 S 11372.7 - SB 921 0 87 IC 1463.16 - Statham 0 7 90 TAL BUDGETED 0 Y SERVICE CATEGORY 22,4811 12,5131 01 01 01 34.994 92 oluntesr Services 2 NOTE: •- stathaa.funds bel.nq used for Alcohol match Rist appear on the Stathan line 87. DO NOT REPORT STATHAM AS MATCH ON LIRE 81. 114TAL ALCOHOL BUDGETED 4 Fed Cat ! 93.959 0 TAL DRUG BUDGETED 6 Fad Cat 4 93.959 0 AD7225E6 (4/93) DATE RECEIVED: III - 15 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGR/1MS BUDGET DETAIL CHEMICALLY ASSISTED TREATMENT xr►eor suswl S.1oe. FISCAL YEAR 1993/94 COUNTY NAMES COPMA Ceara XX M WIGIsAL COUNTY CODE: 47 �kwa4oao 3UBMZSSION DATE: le/M/al A B C a a 01 PROVZDER NAME PITTSBURG RICHMOND 1 05 OVIDER CODE .a.•. 0070709 007 0708w,:„ 10 ERVICL CODS40 40 90 roTAL BU wmv 0 509.918 612,576 1 122 ago 906 iaite 61,362 73,715 135,077 Io. 91 oat Per unit of Service 1 8.31 8.31 8,31 FUNDING SOURCES ' 40 lcohol/D=q Medi-Cal 40 Fed Cat 0 93.778 299,700 299.700 599,400 406 erinatal - Medi-Cal oa Fed Cat t 93.778 0 41 it.t. General Funds 91 Fed Cat } 93.778 0 416 Perinstal Trtnt. Expaaeioa Ila PTEP 0 44 CPPP - School Coam��.ty 4 Prins Prev®tioa 0 45ems Is Offenoor 5 reatment Prosect 0 46 ?♦role* Services Projects 16 HASH, PPNP PDP 0 48 Perinatal :rtmt. Expansion 18 PTEP 0 50 iART - Discretionary 50 Fed Cat 1 93.959 0 51 4ZV Set-Aaide 1 Fed Cat 1 93.959 0 52 APT-Now Perinatal S/A 2 Fed Cat 8 93.959 0 53n Porinatal Pilot Trtmt. 53a Fed Cat t 93.959 0 54 omelees Project 54 Fed Cat 0 93.959 0 56 APT Special Projeote 56 Sunumery of Funds 42.262 42.262 70 SAT-HIV/AIDS Com. Outrch. 10 Fed Cat i 93.949 0 72 ritical Populaticas 72 Fed Cat # 93.902 0 74 esidents-Public Houainq 74 Fed Cat i 93.902 0 76 oleo./Juvenile Justice 76 Fed Cat 1 93.902 0 78 rim.Juetice Non-Incar. 78 Fed Cat ! 93.903 0 80 they Revenues 30 0 81 laquired County Match 31 OTE: • 0 82 ounty Funds - Other 32 0 83 case Feea 3 0 84 r..8 a4 210,218 270,614 480,832 85 nsurancs 35 0 86 C 1463.25 - SB 920 6 S 11372.7 - S8_921 0 87 r 1463.16 - StathaAl 17 0 90 OTAL HUDGLTED - 0 Y SERVTCZ CATEGORY 509.918 612,576 0 0 0 1,122,494 92 oluateer Services 2 NOTE: •• Starhan funcr being used far Alcohol =tea must appear on tb* Stath— line 87. DO NOT REPORT STATHAM AS MATCH ON LINE 81. 94 rOTAL ALCOHOL BUDGETED 4 Fed Cat # 93.9S9 0 96 OTAL DRUG BUDGETED 6 Fed Cat 4 93.959 42,2621 4'L 262 AD722541 (4/93 ) DATE RECEIVED: III - 16 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL RESIDENTIAL SERVICES TV- ar £.eels...W. FISCAL YEAR 19=94 COUNTY NAME: CONTMA =614 XX oa talsar. COUNTY CODES 67 wRaoao SUBMISSION DATES 10/26197 A H C p E F 01 IROVIDEX HANE - ( C 1 SFiENNEM DETOX NHNR C.'EMTER RANCH 05 ROVIDER CODE A 07 0020 A 07 0738 A 07 0004 0010735 A 07 0060 " ^*'< r>.:... .......... 10 ERV SCE CODE \:: o 50 50 50 51 51 90 rat BUDGETED 479.6751 183.219 1 321.589 1 68.1241 640,368 1,692.975 a 904 el Days 7.833 3.645 5.426 334 18.694 35,932 �` 91 ort Per unit of Service 1 61.24 50.27 59.27 203.96 34.26 47.12 FUNDING SOURCES 40a erinatal - Heli-Cal 40. 0 41 tate General Funds 41 54.089 76.366 121,641 48,503 143,191 443,790 41a erinatal Trtmt. Expansion 41. (PTEP) 0 45 Ift.10 Offender 45 reatment Project 0 46 larolse Services Projects 4 6 (HASN, PPNP, PPP) 113,472 113,472 50 AAT - Discretionary 50 Fed Cat t 93,959 15.859 131,522 147,381 51 ZV set-Aside 51 Fed Cat 1 93,959 0 52 AAT-Nev Perinatal S/A 52 Fed Cat 1 93,959 0 53a Derinatal Pilot Trtmt. 53. Fed Cat 1 93,959 0 54 omelass Project a Fed Cat 1 93,959 0 56 A?T Special Projects 56 Su=m.ry of Funds 0 70 SAT-HIV/AIDS Comma. Outrch. 70 Fed Cat 1 93,949 0 72 ritical Populations 72 Fed Cat 1 93,902 0 74 eoidente-Public Housing 74 Fed Cat 1 93,902 0 76 O1 es./Juvenile Justice 76 Fed Cat 1 93,902 0 78 lm.Justice Non-Incar. 78 Fed Cat 1 93,903 ry� M 0 80 her Revenues '0 7,000 20 000 27 000 81 1equired County Match 31 rE: •• 6,010 8,485 13,516 5,389 15,910 49,310 BI ounty Funds - Other 2 181,064 95,368 183,958 14,232 150,881 625 503 83 mess 'ass 83 0 e4 see 4 7,000 3,000 2,474 65,392 77,866 85 naur-e 3S 0 86 PC 1463.25 - SB 920 36 5 11372.7 - SH 921 0 87 C 1463.16 - Statb" 7 208.653 208.653 90 TAL BUDGETED 0 Y SERVICE CATEGORY 479.675 183.219 321,589 68,124 640.368 1.692.975 92 olunteer Services 2 NOTE: •• Statham funds being used for Alcobol match must appear on the Stathaa line 87. DO NOT REPORT STATHAM A6 MATCH ON LINE 81. 94 TAL ALCOHOL BUDGETED Fad Cat 1 93,959 15.859 131 522 147.381 96 [TAL DRUG BUDGETED 6 Fed Cat / 93,959 0 NOTE: ONES 40a AND 41 ARE FOR PERINATAL PROGRAMS ONLY. AD7225FI (4/93) DATE RECEIVED: III - 17 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL RESIDENTIAL SERVICES t-6 of s..a:aa:e.. FISCAL YEAR 1993/94 COVtlT! NAME: tow9Ra tos:, moa tciN,L COUNTY CODE: 07 �,aaa0es SUBMISSION DATE: 10/20/93 A B C D E F 01 ROVIDER NAME t5l— 'REGURY GENT OZANUM HOUSE DETUX NHNR OS RDVZDZR CODE ..•. C 07 0030 0070010 C 070750 A 07 0738 A 07 0004 s 10 ERV ICE CODE ......yi;:':::;;:y;;.: 51 51 51 51 51 ,moi'•'`" o 90 IOTAL BUDGETED 0 13,060 276,458, 401.846 1 99 464 203.031 1 993 859 90a ad Days Oa 388 7.015 5,737 2.110 6.179 21,429 91 ost ter Unit of Service I. 33.66 39.41 70.04 47.14 32.86 46.38 FUNDING SOURCES 40a eu natal - Hed1.-Cal0e 0 41 3tats General Funds 41 22,289 68.646 90,935 41a erinatal Trtmt. Enpe,sion 41. (PTEP) O 45 ems is Offender 65 reatment Project 0 46 &role• Services Proje=s 6 BASH, PPNP, ?"1 13,060 26,492 56,517 96,069 50 APT - Discretionary 0 Fad Cat t 93.959 189,243 260,869 4,000 454,112 51 41V Set-Aside 51 Fed Cat t 93.959 0 52 APT-Nev Perinatal S/A 52 Fed Cat t 93.959 0 Sia erinatal Pilot Trtmt. 53. Fed Cat i 93.959 0 S{ omelesa Project 4 Fad Cat 1 93.959 0 S6 iA.PT Special ?rojeets 6 Sum of Funds 0 70 :SAT-HIV/KIDS Comm. Outrch. 70 Fed Cat / 93.949 0 72 ritical Populations 72 Fed Cat t 93.902 37,254 37,254 74 esid.nte-Public Housing 74 Fed Cat { 93.902 0 76 ole../Juvenile Juatice 76 Ped Cat i 93.902 0 78 rim.Juetice Non-Incar. 78 Fed Cat 1 93.903 0 80 that Revenues so 4,413 4,413 81 loquirod County Match al tpoTm: •• 2,477 7,6Z7 10,104 82 runty Funds - other 2 42,310 18,560 67,698 74,912 203,480 83 cess Fees 3 0 84 sea 14,000 71,234 7,000 10,592 102,826 4 85 n.urance - 5 0 86 C 1463.25 - SB 920 36 S 11372.7 - SH 921 0 87 C 1463.16 - Stathu7 0 90 TAL BUDGETED 0 Y SERVICE CATEGORY 13.060 276.458 407,180 99.464 203.031 999.193 91 olunteer Services 2 ^JOTL: •- Statham funds being used for Alcohol match auat appeal on the Stathe� line B7. DO NOT REPORT STATHAM AS MATCH ON LINE 81. 94 POTAL ALCOHOL BUDGETED s Fad Cat i 93.959 109.755 4.000 113.755 96 rOTAL DRUG BUDGETED 6 Fed Cat f 93.959 79.488 260.869 340.357 NOTE: LINES 40a AND 41 ARE FOR PERINATAL PROGRAMS ONLY. AD7225F2 (4/93) DATE RECEIVED: III - 18 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL RESIDENTIAL SERVICES IS or s0ew:5910N1 FISCAL YEAR 1993/94 COUNTY NAME: CONTRA COSTA _DRIGIMAL COUNTY CODE: 07 swoe0 SUBMISSION DATE: to/20/f1 A B C D E F 1 IROVIDER NAME SUNRISE HOUSE RE(r'TORY LA CASA DE7OX WOMEN 1 S IROVIDER CODE D 07 0797 C,07 0040 0070712 C 07 0738 .0 ERVICE CODE 51 51 51 56 56 ° ................:.... '0 rOTAL BUDGETED O 436.6091 221.7401 446,2291 1101921 115.4631 1,330, 433 Oa 3,wa Days 8.238 6.308 5.966 3,285 3,3851 27,182 Oa '1 O.t Per Unit of service 1 53.00 35.15 74.80 33.60 34.11 48,95 FUNDING SOURCES 104 Par.Lnatai - Medi-Cal 40. 0 11 itato Gene rel Funds 1 75,721 75,721 Ila erinatal Trtmt. Expansion la (PTEP) 99,353 103,917 203,270 IS reml. Offender 65 reatment Project 0 16 Parolee Services Projects 6 BASH, PPNP, PPP) 31.317 31,317 50 iA.PT - Discretionary so Fed Cat-$ 93.959 186.021 81,893 267,914 51 iry Set-Aside 51 Fed Cat 1 93.959 0 52 APT-Nev Perinatal S/A 52 Fed Cat { 93.959 107,656 107,656 534 Perinatal Pilot Trtmt. 3. Fed Cat i 91.959 411,014 411,014 54 omelees Project 54 Fed Cat t 93.959 0 56 APT Special Projects 6 slum. of Pltads 0 70 SAT-HIV/AZDS Comm. Outrch. 70 Fed Cat / 93.949 0 72 ritical Populations 2 Fed Cat ► 93.902 0 74 esidents-Public Housing 74 Fed Cat i 93.902 0 76 oles./Juvenile Justice 76 Fed Cat t 93.902 0 78 rim.Justice NON-ZAOar. 8 Fed Cat / 93.903 0 80 Les Revenues BO 35,215 35,215 81 tequired County Match 51 8,413 11,039 11,546 30,998 82 County Funds - Other2 87,687 87,687 83 cess Fees 33 0 ea re.6 47,450 32,191 79 641 a 85 neurance 5 0 86 C 1663.25 - 58 920 36 S 11372.7 - 56 921 0 87 C 1463.16 - Statham 37 0 90 TAL BUDGETED 0 Y SERVICE CATEGORY 436.609 221.740 446.229 110 392 115.463 1.330.433 92 olunreer Services 2 iO=: — Statham funds being used for Alcohol match must appear on the Statham line 87. DO HOT REPORT STATHAM AS MATCH ON LZNE BUDGETED81- 9a TAL ALCOHOL BUDGET a Fed Cat f 93.959 205.507 205.507 96 TAL DRUG BUDGESEp 6 Fed Cat 0 93.939 186.021 189.549 205,507 581,077 VOTE: LINES 40a AND 41 ARE FOR PERINATAL PROGRAMS ONLY. AD7225F3 (4/93) DATE RECEIVED: III - 19 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL RESIDENTIIALSE(R]V�IC�.ES TT►t Or su—Iaslo.. FISCAL YEAR 1993/94 COUNTS NAME: CONTRA COSTA oRtctRAL COUNTY CODE: 07 �AstsOsa SUBMISSION DATE: to/2e/fl A B C D E r Ol IROVIDER 4A43C ) 1 TBA OS IROVIDER CODE •• 10 =vrcLr CODA56 :.>�""..' 0 90 TAL BUDGETED 0 38.3251 1 38.3251 90a aed Days Oa 1.0951 11.095 91 Cost Per U"t of Service 1 35.00 1 35.00 FUNDING SOURCES 40. erinatai - Msdl-Cal 0a 0 42 State General Funds 41 0 41a erinatal 'rtmt. Eupaasion 41. (PTEP) 0 45 remale Offender as reatment Project 0 &roles Service. Projects 6 (BASH, ?PNP, 7") 38.325 38,325 50 APT - Discretionary O 46Fed Cat i 93.959 0 d51 IV Set-Aalds 51 Fed Cat '! 93.959 0- 52 APT-New Perinatal S/A 52 Fed Cat A 93.959 0 53. erinatai Pilot Trtmt. 34 Fad Cat ! 93.959 0 54 iomoleas Project 54 Fed Cat t 93.959 0 56 5APT Special Project. 56 Summary of Funds 0 70 SAT-HIV/AIDS Comm. Oatrch. 70 Fed Cat # 93.949 0 72 ritical 70pulationa2 Fed Cat ! 93.902 0 74 esidenes-Public HOn.ing 74 Fed Cat i 93.902 0 76 oles./Juvenile Justice 76 Fed Cat i 93.902 0 78 :rx—Ju.".. Noa-Incas. 78 Fad Cat >) 93.903 0 80 the. Revenues 10 0 81 Required County Hatch 1 TE: 0 82 ounty Funds - Other ' 2 0 83 Excess Fees 33 0 84 ess 34 0 a5 Insurance 35 0 86 C 1463.25 - SB 9206 S 11372.7 - SB 921 0 JC1s71463.16 - Statham 07 TAL BUDGETEDSERVICE CATEGORY 38.325 0 0 0 0 38.325 lune Aar S."Ice. 2 NOTE: — Stataam funds being used for Alcohol matcn mast appear on the Statham line 87. DO NOT REPORT STATHAM AS MATCH ON LINE 81. 94 rOTAL ALCOHOL BUDGETED 4 Fed rat 3 93.959 0 96 rGTAL DRUG BUDGETED 6 Feed Cat f 93.959 0 NOTE: LINES 40a AND 41 ARE FOR PERINATAL PROGRAMS ONLY. AD7225F4 (4/93) DATE RECEIVED: 111 - 20 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL ANCILLARY SERVICES / '7Ia 0r SUBMISSION, FISCAL YEAR 1993/94 COUNTY NAME: COWTRA COST& XX ORttINAL COUNTY CODEI 07 _JAraeDss SU8MZ38ZON DATE: 10/20/93 A H C D E F O1 IROVIDER NAME OAAM I 0AAN II U i1 VOC REHAB AIRS CENTRAL AIRS EAST PITTSBURG RICHMOND 05 ROVIDER CODE :e£•,.:::y..?.;;:�i;;: A 07 0100 A 07 0001 A 07 0003 0070709 A 07 0708 :<> : 10 ERVICE CODE "tin y'yi ?rr:.•:;i'.`:.::?:;:3:to 64 65 65 65 65 ...................:.....:.,...... 90 'OTAL BUDGETED 0 97,641 44.214 1 44.214 22,800 22.800 231.669 90. ieite 114 497 500 2,743 2,746 6,600 pa 91 oat Par Unit Of Service 1 856.50 88.96 88.43 8.31 8.30 35.10 rUNDING SOURCES 41 3tate General Funds 1 4,049 4,049 41• Perinatal Trtmt. Expansion 41. PTEP) 0 42 location.1 Rehabilitation 42 17,042 17,042 45 -mate Offender 45 reatment Project 0 46 azole* Services Projects 46 (BASH, PPNP, PPP) 0 50 APT - Discretionary 50 Fed Cat i 93.959 0 5: i1v Set-Asid• 51 Fed cat / 93.959 44,214 44,214 22,800 22,800 134,028 52 APT-New Perinatal S/A 2 Fed Cat i 93.959 0 53• erinatal Pilot Trtmt. 3a Fed Cat 1 93.959 0 53b R.rin.tal Pilot Case Mgmt. 3b Fed Cat 1 93.959 0 54 omnis.. Project 54 Fed Cat i 93.959 0 56 5APT Spscial Proj*ets 6 Summary c£ Funds 0 70 SAT-HIV/AIDS Comm. Outrch. 70 Fed Cat t 93.949 0 80 then Revenues 0 74,207 74,207 31 Required county match 31 TE: -- 2.343 2.343 82 ounty Funds - Other2 0 83 x..se Fees 33 0 84 see 84 0 85 neaten-• 5 0 86 C 1463.25 - SH 920 36 S 11372.7 - 58 921 0 87 C 1463.16 - stacb 17 0 90 OTAL BUDGETED 0 Y SERVICE CATEGORY 97.641 44.214 44,2141 22,800 22,800 231.669 92 7lunteer Services 2 OTE: — Statham funds being used for Alcohol match must appear on the Statham line 87. DO NOT REPORT STATHAM AS MATCH ON LINE 81. 94 OTAL ALCOHOL BUDGETED 4 Fed cat a 93.959 44.214 44.214 88.428 96 OTAL DRUG BUDGETED 6 Fed cat ! 93.959 22,8001 22,8001 45.600 AD7225I1 (4/93) DATE RECEIVED: 111 - 21 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL ANCILLARY SERVICES FISCAL YEAR 1993194 COUNTY BAIZE: co.x.a cosra �'xx►a or $06W.S.O.. COUNTY eons: os FN/- exwaL SUHNISSION DATE: xe/xe/fx awBeat* E r A R C D 1 01 Rov1aER Nwl4a I-fOUSIr 70) 70731220 JOURNS TRI—C1TtES 80RNFREE C 07 0770 47 4761 D070731 C 07 0750H:: < <: Q 1Q ERVICE CODE 65 65 0 90 OT AL BUDGETED 44,214 44.214 44.214 44.214 128.447 345.303 Oa 808 480 631 1 476 4 026 9Qa 1.ita 631 1 91 net per unit of s.zoxcs 92.11 74.47 $7.42 75.83 74.07 54.72 L 'tYN DLNG SOURCES 4 41 tat. General Funds 1a 0 41a erinatal Trtmt. Lxpaasian 2 (pTEP1 4 42 acation al Rehabilitation 5 4 a5 emala J££eader 6 r.. mant ?reject 4 46 arolae services Projects 0 BASH, ?PNP. PPP} 4 50 APT - Diacretionarp 51 Fed :at 1 93.959 44 214 176,856 51 IV set-Asid. 44,214 44.214 44,214 2 red Cat t 93.954 0 52 v ?erinatal 53. red Fed Cat 1 93.959 4 SSa erinatal pilot Trtmt- 53b red Cat f 93.959 128,447 128.447 53b erinatal Pilot Caee Hgmt• 4 red Cat f 93.959 4 Si amel a.. 2roject 6 Fed Cat f 93.959 4 1705AT-HIWAIDS PT Special Projects 0 summary of Funds 4 Cams. Oatrch• 0 Fed CaC f 93.949 4 hat Reve::ues 4 quirsd County Hatch 2 4 82 ounty Funds Other 3 0 83xceae Fees q 0 S 94 sea 0 85 neusancs 6 0 86 C 1463.25 - $H 920 7 - S 11372.7 - SH 921 4 87 C 1463.16 -- Statham 0 44.214 44.214 128.447 305,303 90 O?AL BUDGETED t 44.214 2 Y SERVtCt CATEGORY 92 oluntaer Seraiear NOTE: *'� StaLSam £ands being u6etl for wlcohol match must appear oa the Stath&M line 87. Du NOT REPORT STA2Hw14 AS MATCH ON LIRE 8 4 64.223 64.223 194±,O,T,,,COHOLL ALBUDGETED 6ed Cat ! 93.959 64.224 241.4849UG BUDGETED 44,214 44.214 44.214'ed Cat f 93.959 44'214 DATE RECEIVED: AD7225I2 (4193) 111 - 22 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PREVENTION AND TREATMENT PROGRAMS BUDGET DETAIL ANCILLARY SERVICES :..• or SUBMISSION. FISCAL YEAR 1993/94 eoowrY NAME: co.a, COSTA Xx ORIGINAL COUNTY CODE: 07 ,MS■se. SUBMISSION DATE: Lo/29/13 A B C D £ r of IROVIDER C 1 U I AL.11 31 PERINATAL ABUSE 05 IROVIDER CODE C 07 0771 C 07 0798r::;�>::�;::;;:::; 10 E3tVICE CODA ,, 0 90 TAL BUDGETED 0 200,751 1 1.634 202'Inc; 90a ysyta 110 110 Da 91 oat Per Unit of Service 1 1.825.01 1.839.86 FUNDING SOURCES 41 State General Fund■ 1 0 41a erinatal Trtmt. Expansion 41. (PTEP) 0 42 o..ti—.l Rehabilitation2 0 45 I.Stal. Offender is reatment Project 0 46 &roles Services Projects LO BASH, PPNP, PYP) 1,634 1,634 50 APT - DiacretiOMAXY Fed Cat 1 93.959 0 51 IIV Set-Aside 1 Fed Cat 1 93.959 0 52 APT-Nev Perinatal S/A 52 Fed Cat 1 91.959 0 53. erynatal Pilot Trtmt. - 3a Fed Cat 1 93.959 0 53b Pwrinatal Pilot Case Mgmt. 53b red Cat 1 93.959 200,751 200,751 54 40meless Project 4 Fed Cat t 93.959 0 56 3A.YT Spacial Projects 56 Summary of Funds 0 70 SAT-HIV/AIDS Comm. Outrch. 70 Fed Cat f 93.949 0 80 Dtber Revenues 30 0 81 Required County Match 31 TE: - 0 82 ounty Funds - Other 32 0 83 Excess r..• 33 0 84 rose 34 0 85 Insurance 5 0 d9286 C 1463.25 - SB 920 6 S 11372.7 - SH 921 0 87 C 1463.16 - Stathu 0 7 90 OTAL BUDGETED 0 F SERVICE CATEGORY 200.751 1.634 0 0 0 202.385 Olunteer Services I I I I 1 1 2 'OTX: ^ Statham funds beynq used for Alcohol match must appear on the Statbam line 87. DO NOT REPORT STATHAM AS MATCH ON LINE 81. 54 rOTAL ALCOHOL BUDGETEDa red Cat 1 93-959 100,375 100.375 Me 96 rOTAI, DRUG BUDGETED 6 Fed Cat L 93.959 100.376 100.376 AD722513 (4/93) DATE RECEIVED: 111 - 23 DEPARTMENT OF ALCOHOLAND DRUG PROGRAMS COUNTY PROGRAMS BUDGET DETAIL DRINKING DRIVER PROGRAM SERVICES TYPE Or SUBKISSION: BY PROVIDER COUNTY NAME: CONTRA COSTA zz Origin.l FISCAL YEAR 1993/94 COUNTY CODE: 07 A:ended SUBMISSION DATE: 10/20/93 A 9 C D E F 01 ROVIDER "ME 1 COUNCIL AIRS CENTRAL AIRS EAST AIRS WEST BI—BETT OS ROVIDER CODE A 07 0070 A 07 0001 A 07 0003 A 07 0002 A 07 0010 5 10 EAVICE CODE 90 90 90 90 90 D 90 OTAL BUDGETED 90 91.430 583.764 243.943 348,743 53.560 1,321.440 90anits of Service I 1 Oa Participant Visite 400 36,485 21,194 )9,9 9 909 192 88,180 91 oat Per Unit of service 1 228.58 16.00 11.51 11.66 278.96 14.99 FURDIRG SOURCES 41 state General Funds 41 0 80 Dther Revenues so 0 82 Zounty Funds - Other 32 0 85 asuranc• 5 0 87 PC 1463.16 St.thaN 7 0 88 SXceas DDP Profit/Sarplu■ e 0 89 )rinking Driver 39 _Participant Fees 91,4301 583,764 243,943 348,743 53,560 1,321,440 89a DP Fees to County for 39. Admin. 6 monitorin 0 90 OTAL BUDGETED 0 T sERVICE CATEGORY 91.430 583.764 243.943 348 743 53.560 1.321.440 -Counties with a population under 20,000 may use State General funds if they have a waiver approved by the Dept. DDP Section. AD7225XI (4/93) DATE RECEIVED: 111 - 24 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ ]Alcohol I X I Original [ I Drug i I Amended [ I Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: None Center for Substance Abuse Prevention 4. PRIMARY SERVICE Contra Costa Federal Grant CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Amalia Gonzales del Valle (510)313-6389 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: ( ] Confidential 595 Center Avenue,Suite#200 Martinez.CA 94553 Same 19. [ ] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 110. [ X I NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION j SCHOOL BASED ALTERNATIVES i X COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS 03 10 09 08 03 ! 5000 i ENVIRONMENT EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL X I MOBILITY f I PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ j NEW - PROJECTED START DATE: [X j EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) The CSAP funded"partnership for a Drug Free Contra Costa"works to build alliances among public and private organizations, agencies and institutions for the planning and coordination of long—range,comprehensive programs,policies and activities to reduce the illegal use and abuse of alcohol and othe drugs. Five regional partnerships have been established each with a fiscal manager. These managing organizations are: The Organization for Youth Services TOYS(Acalanes/Lamorinda area); Center for Human Development(Central County); Delta 2000( East County); San Ramon Valley Community Services Group(South County);and Opportunity West(West County). 22. SPECIAL SERVICES BREAKDOWN [ ] FRIDAY NIGHT LIVE ( ] HRYSA [ J SCPPP [ ] CLUB LIVE [ ] DRUG FREE HOUSING [ ] ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. *Early Intervention cannot be used to meet the 20% Block Grant Prevention Requirement. TV - 25 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: >ubmission Type FY 1993-94 ( 1 Alcohol X I Original (X I Drug J Amended [ I Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: D070765 4. PRIMARY SERVICE Contra Costa West Contra Costa Youth Service Bureau #409 CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Taalia Hasan (510)237-9503 ext # 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 1300 Amador Street#18 San Pablo.CA 94806 Same 9. (X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 110. [X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One) PROGRAM NAME: 1! 777 ..........-......... INFORMATION DISSEMINATION EDUCATION I 01 15 07,08 02,08 02 500 ( 1SCHOOL BASED I � ALTERNATIVES t X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL I 1130TH COMMUNITY—BASED PROCESS j ENVIRONMENT EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL If"yes"or'by referral' indicate type by placing either an A or R in the box: [ ( HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20_ PROGRAM STATUS: [ J NEW — PROJECTED START DATE: (X I EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) New Attitudes: Provides educational and support groups to persons caring for children of drug dependent parents. 22_ SPECIAL SERVICES BREAKDOWN ( i FRIDAY NIGHT LIVE ( ] HRYSA ( J SCPPP ( J CLUB LIVE ( J DRUG FREE HOUSING ( J ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 24 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ 1 Alcohol I X]Original [XI Drug I ]Amended [ I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070731 4. PRIMARY SERVICE Contra Costa Tri—Cities Discovery Center CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Linda Schaefer (510)222-9838 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 2586 Appian Way Pinole,CA 94564 Same 9. ( ] IN COUNTY CONTRACT PROVIDER (X] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT I I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION 03 14 03,04 08 03 630 1SCHOOL BASED ALTERNATIVES X COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL (BOTH COMMUNITY-BASED PROCESS ENVIRONMENT j EARLY INTERVENTION' 19. DISABILITY ACCESS: [X) YES [ ] NO [ ) BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING ( ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY 20. PROGRAM STATUS: ( ] NEW — PROJECTED START DATE: [X I EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services to the community. 22. SPECIAL SERVICES BREAKDOWN ( J FRIDAY NIGHT LIVE ( ] HRYSA [ ] SCPPP [ I CLUB LIVE [ ] DRUG FREE HOUSING ( j ALCOHOL- AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 23 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGR.A.M DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Dubmission Type FY 1993-94 [X ]Alcohol X]Original [ I Drug I Amended ( I Combined 1. COUNTY NAME: .PROVIDER'S NAME: . PROVIDER CODE: A070799 4. PRIMARY SERVICE Contra Costa Substance Abuse Administration — Prevention CODE: 10 5. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Kathv Padro (510)313-6399 ext# 7. MAILING ADDRESS: 18.FACILITY ADDRESS: [ ] Confidential 595 Center Avenue,Suite 200 Martinez,CA 94553 Same 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT I f I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION i ISCHOOL BASED ALTERNATIVES I I X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL I I IBOTH COMMUNITY—BASED PROCESS 03 10 09 08 03 , 5.000 I ENVIRONMENT I I EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If'yes" or"by referral' indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL [ j DEVELOPMENTAL (XI MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: (X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Prevention Specialist: Provides guidance and support to community coalitions in implementing the County—Wide Drug and Alcohol Action Plan. 22. SPECIAL SERVICES BREAKDOWN ( I FRIDAY NIGHT LIVE ( ) HRYSA [ J SCPPP [ ) CLUB LIVE [ j DRUG FREE HOUSING [ ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 22 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 ( ]Alcohol X I Original [X j Drug [ I Amended ( I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3.PROVIDER CODE: D070761 4.PRIMARY SERVICE Contra Costa ornmunity Cou selinq Center CODE: 10 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Kirk Brocks (510)374-3813 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS. [ ] Confidential 3029 MacDonald Avenue Richmond,CA 94804 Same 9. [ ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT I I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RAGE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: ( . INFORMATION DISSEMINATION EDUCATION 03 14 03,04 02.08 03 490 SCHOOL BASED ALTERNATIVES XI COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or'by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL [X I MOBILITY [ ] PHYSICAL [ ] OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: I X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the community. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE ( j HRYSA [ ] SCPPP ( ] CLUB LIVE ( ] DRUG FREE HOUSING ( ] ALCOHOL- AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 21 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 ( ]Alcohol X I Original [X] Drug ]Amended [ ]Combined 1. COUNTY NAME: .PROVIDER'S NAME: . PROVIDER CODE: D070733 . PRIMARY SERVICE Contra Costa San Ramon ValleV DiscoverV Center#535 CODE: 10 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Diana Li—Re ac.Ph.D (510)837-0505 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: [ ] Confidential 530 La Gonda Way,Suite A Danville,CA 94526 Same 9. [X] IN COUNTY CONTRACT PROVIDER ( ] COUNTY OPERATED 110. [ X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION - AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION i EDUCATION 03 14 03,04 08 03 i 1,660 1SCHOOL BASED t ALTERNATIVES ]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL I XIBOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes" or"by referral"indicate type by placing either an A or R in the box: ( ] HEARING ( ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL [X] MOBILITY ( ] PHYSICAL ( ] OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: (X J EXISTING ( ] EXPANSION OF SERVICES [ ] ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the schools and in the community. 22. SPECIAL SERVICES BREAKDOWN ( J FRIDAY NIGHT LIVE ( ] HRYSA [ J SCPPP ( ) CLUB LIVE [ j DRUG FREE HOUSING [ J ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for eactf service code. IV - 20 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 ( j Alcohol [X I Original (X I Drug [ j Amended I I Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: D070732 4. PRIMARY SERVICE Contra Costa San Pablo Discovery Center CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Henry (510)374-3332 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 2523 EI Portal Drive,Suite 102 San Pablo.CA 94806 Same 9. [ ] IN COUNTY CONTRACT PROVIDER [ X] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. 12. 13. 14. 15. 16, 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION 03 + 14 03,04 08 03 3,500 1 ]$CHOOL BASED ALTERNATIVES X]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED (PROCESS ENVIRONMENT EARLY INTERVENTION' 19. DISABILITY ACCESS: [X J YES [ ] NO ( ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL ( j MENTAL ( ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW PROJECTED START DATE: [X I EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21_ PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the community. 22. SPECIAL SERVICES BREAKDOWN ( J FRIDAY NIGHT LIVE [ j HRYSA ( J SCPPP ( j CLUB LIVE ( j DRUG FREE HOUSING ( j ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 19 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 1 I Alcohol X I Original [X I Drug I Amended I I Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: D070753 4. PRIMARY SERVICE Contra Costa REACH Project fnc. #243 CODE: 10 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Shir:ev Marchetti 510 754-3673 ext 7. MAILING ADDRESS: 8. FACILITY ADDRESS: [ ] Confidential 1915 D Street Antioch.CA 94509 Same 9. [X] IN COUNTY CONTRACT PROVIDER ( ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I F I PROFIT 11. 12. 13. 14. 15. 16. 117. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: I I .. .. } i INFORMATION DISSEMINATION EDUCATION 03 I 14 03,04 08 03 4,500 1SCHOOL BASED ALTERNATIVES I ]COMMUNITYBASED PROBLEM IDENTIFICATION f AND REFERRAL J XIBOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' I I 19. DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL ff"yes"or"by referral' indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL [ ) DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: (X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the schools and in the community. 22_ SPECIAL SERVICES BREAKDOWN [ ] FRIDAY NIGHT LIVE [ ] HRYSA ( ] SCPPP [ ( CLUB LIVE ( I DRUG FREE HOUSING ( J ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 18 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ ]Alcohol [X]Original [X]Drug ( ]Amended ( I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070741 _ 4. PRIMARY SERVICE Contra Costa Nei hborhood House of North Richmond#576 CODE: 10 5. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Steve Mitchell (510)237-3090 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ) Confidential 305 Chesley Avenue 208 23rd Street Richmond CA 94801 Richmond.CA 94801 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X J NONPROFIT OUT OF COUNTY CONTRACT F I PROFIT 11. 12. 13. 14. 15. 16. 17. 18, TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One) PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION 01 19' 09 02.08 03 660 ]SCHOOL BASED ALTERNATIVES [X]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL [ ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION* 19. DISABILITY ACCESS: [X] YES [ ] NO [ J BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING ( ] VISUAL ( j MENTAL [ ] DEVELOPMENTAL [Xj MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [X 1 NEW — PROJECTED START DATE:_10/1/93_ [ ] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Las Deltas Housing Development: Provides primary prevention educational presentations to residents of this public housing development. 'Housing Development Residents 22. SPECIAL SERVICES BREAKDOWN [ J FRIDAY NIGHT LIVE ( ] HRYSA ( J SCPPP [ ] CLUB LIVE [ ] DRUG FREE HOUSING [ ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 17 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ 1 Alcohol [X I Original I X1 Drug [ I Amended I I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070745 4. PRIMARY SERVICE Contra Costa New Connections#513 CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Beth Schecter (510)676-1601 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: [ ] Confidential 1760 Clayton Road Concord.CA 94520 Same 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 110. [X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 1S. 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One .. PROGRAM NAME: ._.. INFORMATION DISSEMINATION i EDUCATION 03 14 03.04 08 03 3.500 1SCHOOL BASED ALTERNATIVES [ ]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL j XIBOTH COMMUNITY-BASED PROCESS ENVIRONMENT I I EARLY INTERVENTION* I 19. DISABILITY ACCESS: [X] YES ( J NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ J HEARING [ ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL [XI MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: ( j NEW - PROJECTED START DATE: (Xj EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the schools and in the community. 22. SPECIAL SERVICES BREAKDOWN ( J FRIDAY NIGHT LIVE [ J HRYSA ( ] SCPPP ( ] CLUB LIVE [ ] DRUG FREE HOUSING ( I ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 16 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [X]Alcohol [X I Original (X I Drug ( I Amended [ I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: A070754 D070754 4. PRIMARY SERVICE Contra Costa Center for Human Develo ment#711 CODE: 10 5. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Ian Falk (510)687-8844 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: ( ] Confidential 391 Taylor Blvd.,Suite 120 Pleasant Hill.CA 94523 Same 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION ]SCHOOL BASED ALTERNATIVES ]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS 01 10 09 02,08 03 500 ENVIRONMENT EARLY INTERVENTION` 19. DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL If'yes"or"by referral"indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL ( ] MENTAL ( j DEVELOPMENTAL X 1 MOBILITY PHYSICAL OTHER(SPECIFY) 20_ PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: [X] EXISTING EXPANSION OF SERVICES I I ENHANCED SERVICES 21_ PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) North Richmond Community Initiative: Provides assistance in identifying,addressing and linking to resource community problems relating to substance abuse and violence. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE [ ( HRYSA j ] SCPPP [ ] CLUB LIVE [ ( DRUG FREE HOUSING ( J ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 15 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: submission Type FY 1993-94 [X]Alcohol X]Original I X]Drug ]Amended [ ]Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: D076754 A070754 . PRIMARY SERVICE Contra Costa Centerfor Human Develo ment#711 CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Jan Fall: (510)687-8844 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 391 Taylor Blvd.,Suite 120 Pleasant Hill.CA 94523 Same 9.[X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X ] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14, 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION 03 14 03.04 08 03 6.400 X j SCHOOL BASED ALTERNATIVES )CCMMUNIT-(BASED PROBLEM IDENTIFICATION AND REFERRAL I I ]BOTH COMMUNITY-BASED PROCESS I ENVIRONMENT EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL [X] MOBILITY ( ] PHYSICAL ( ] OTHER(SPECIFY) 20. PROGRAM STATUS: [ j NEW — PROJECTED START DATE: (X] EXISTING ] EXPANSION OF SERVICES [ I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Parent Educator Program: Trains parents and community volunteers to deliver a primary prevention program to elementary school children. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE [ ] HRYSA ( J SCPPP ( ] CLUB LIVE [ ] DRUG FREE HOUSING ( ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 14 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ J Alcohol i X J Original [X I Drug i I Amended [ I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070754 4. PRIMARY SERVICE Contra Costa Center for Human Develo ment#301 CODE: 10 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Jan Falk (510)687-8844 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 391 Taylor Blvd,Suite 120 Pleasant Hill. CA 94523 Same 9. [X ] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT 11. 12. 13. 14, 15, 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: z. ....... . INFORMATION DISSEMINATION i i EDUCATION 03 14 I 03 08 03 7,580 N SCHOOL BASED ALTERNATIVES ]CCMMUNITY BPSED PROELEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY-BASED PROCESS I i i ENVIRONMENT i I EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL If"yes"or"by referral' indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL ( ] MENTAL ( ] DEVELOPMENTAL (X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: [X] EXISTING EXPANSION OF SERVICES ) ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Youth Educator State Program: Through volunteer Area Coordinators,high school students are trained to deliver a primary prevention curriculum to the target population 5,.500 middle and junior high school students in 25 schools throughout the county. The ethnic breakdown of the target group is 70%white, 13% African—American,9% Latino,2% Filipino,6% Asian,and.5% Native American. This program is funded by the state School—Community Primary Prevention Program. Youth Educator Federal Program: In addiction to the standard Youth Educator curriculum,a special component was added to meet the needs of 1,500 high—risk middle and high school junior students in the Richmond Unified School District. Federal criteria define a"high—risk youth"as a person under 21 years of age who is at risk of becoming or has been a drug or alcohol abuser and who is economically disadvantaged. As 40% of the students in the Richmond Unified School District are living in households receiving AFDC.40% of these students have been designated as high—risk vouth. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE [ I HRYSA [XI SCPPP ( ) CLUB LIVE [ ] DRUG FREE HOUSING ( J ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 13 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: ubmission Type FY 1993-94 [X]Alcohol KI OriginalX [ ]Drug I Amended ( I Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070754 D070754 . PRIMARY SERVICE Contra Costa Center for Human Develo ment#259 CODE: 10 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Jan Falk S]0 687-8844 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: ( ] Confidential 391 Taylor blvd,Suite 120 Pleasant Hill,CA 94523 Same 9. [X] IN COUNTY CONTRACT PROVIDER ( ] COUNTY OPERATED 110. [X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13, 14, 15. 16. 17. 18, TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT ` TYPE ETHNICITY SERVED Check One t PROGRAM NAME: ` INFORMATION DISSEMINATION I EDUCATION 03 14 03.04 08 03 2.800 SCHOOL BASED ALTERNATIVES 1 j COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL jBOTH COMMUNITY-BASED PROCESS I ENVIRONMENT EARLY INTERVENTION- 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING ( J VISUAL [ ] MENTAL [ ) DEVELOPMENTAL [XI MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: ( ] NEW — PROJECTED START DATE: [X I EXISTING EXPANSION OF SERVICES I I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) NEAT Family Project: Provides educational support group services to junior high and high school students and to parents of these students. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE ( J HRYSA ( ] SCPPP ( J CLUB LIVE [ ] DRUG FREE HOUSING [ ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 12 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ I Alcohol [X] Original [X] Drug I ]Amended , ( ]Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070740 4. PRIMARY SERVICE Contra Costa Bo 's & Girls Club of East ountv #577 CODE: 10 S. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Tem Basile (510)439-8035 site 427-3120 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: ( ] Confidential P.O.Box 1087 85 Treatro Avenue#283 Pittsbure.CA 94565 Pittsburg.CA 94565 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11_ 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RAC EJ SIX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION 01 19' 10 02,08 03 660 ]SCHOOL BASED ALTERNATIVES 01 19 03 02,08 03 30 COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION` 19. DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL X I MOBILITY f I PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [X j NEW — PROJECTED START DATE:-10/1/93— ( j EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) EI Pueblo Housing Development: Provides primary prevention educational presentations to residents of this public housing development. Also provides recreational activities for youth. Housing Development Residents 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE ( j HRYSA [ j SCPPP ( ] CLUB LIVE ( 1 DRUG FREE HOUSING ( ] ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 11 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: ubmission Type FY 1993-94 ( 1 Alcohol (I Original (X]Drug I Amended [ I Combined t. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070764 4. PRIMARY SERVICE Contra Costa Boy's & Guts Club of East ountV #473 CODE: 10 i. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Tem Basile (510)439—8035 ext# I. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential P.O.Box 1087 335 East Leland Pittsburg,CA 94565 Pittsbure.CA 94565 �. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X I NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT I1. 12. 13, 14, 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED (Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION 03 14 03,04 08 03 3,000 1 1SCHOOL BASED ALTERNATIVES ]CCMt.7UNl iY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES [ J NO ( ] BY REFERRAL If"yes"or"by referral' indicate type by placing either an A or R in the box: [ I HEARING ( ] VISUAL ( ] MENTAL [ ] DEVELOPMENTAL [X) MOBILITY ( ) PHYSICAL [ ) OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: IX I EXISTING I ]EXPANSION OF SERVICES [ I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Drug and Alcohol Prevention Project: Provides primary prevention educational services in the community. ?. S' ECIAL SERVICES BREAKDOWN V •.Y NIGHT LIVE [ I HRYSA 1 I SCPPP CL _IVE [ I DRUG FREE HOUSING ( J ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 10 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 1 X I Alcohol (X I Original I ]Drug ( I Amended I ]Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070002 4. PRIMARY SERVICE Contra Costa 11cohol Intervention & Recovery Services AIRS -West CODE: 10 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Henry (510)374-3036 ext# 7. MAILING ADDRESS: S. FACILITY ADDRESS: [ ] Confidential 3043 Research Drive,Suite 100 Richmond.CA 94806 Same 9. [ ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT IF I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY ( SERVED Check One 1 PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION 03 10 09 08 03 ( 300 1SCHOOL BASED ALTERNATIVES CCnAMUNIIY BASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY—BASED PROCESS I ENVIRONMENT I EARLY INTERVENTION` 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL ( ] MENTAL [ ) DEVELOPMENTAL [Xl MOBILITY f I PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ J NEW — PROJECTED START DATE: [X I EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the community_ 22. SPECIAL SERVICES BREAKDOWN [ ] FRIDAY NIGHT LIVE [ J HRYSA ( J SCPPP [ ] CLUB LIVE [ j DRUG FREE HOUSING [ ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 9 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 (X]Alcohol [X J Original [ I Drug ( ]Amended ( I Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070003 4.PRIMARY SERVICE Contra Costa 11cohol Intervention & Recovery Services AIRS —East CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Henry (510)427-8630 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: ( ] Confidential 2400 Sycamore Drive,Suite 36 Antioch.CA 94509 Same 9. [ ) IN COUNTY CONTRACT PROVIDER [X) COUNTY OPERATED 10. [X) NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: _. INFORMATION DISSEMINATION EDUCATION 03 10 09 08 03 300 1SCHOOL BASED ALTERNATIVES X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY-BASED PROCESS { ENVIRONMENT EARLY INTERVENTION* 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral' indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL f X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ J NEW — PROJECTED START DATE: (X J EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the community. 22. SPECIAL SERVICES BREAKDOWN [ ] FRIDAY NIGHT LIVE [ ] HRYSA ( ] SCPPP [ ( CLUB LIVE ( J DRUG FREE HOUSING ( J ALCOHOL- AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 8 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 f X]Alcohol (X]Original ( ]Drug I ]Amended ( J Combined 1. COUNTY NAME: PROVIDER'S NAME: 3.PROVIDER CODE: A070001 4.PRIMARY SERVICE Contra Costa 11cohol Intervention & Recovery Services AIRS —Central CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Hen (510)313-1050 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: ( ] Confidential 10 Douglas Drive,Suite 130 Martinez.CA 94553 Same 9. [ j IN COUNTY CONTRACT PROVIDER [ X] COUNTY OPERATED 10.IX ] NONPROFIT OUT OF COUNTY CONTRACT I f I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY l SERVED Check One PROGRAM NAME: I I I INFORMATION DISSEMINATION i EDUCATION 03 I 10 09 08 03 400 1 1SCHOOL BASED I ALTERNATIVES I I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL I ]BOTH COMMUNITY-BASED I j PROCESS I ENVIRONMENT I j EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral"indicate type by placing either an A or R in the box: [ ] HEARING ( ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: (X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides primary prevention educational services in the community. 22. SPECIAL SERVICES BREAKDOWN [ J FRIDAY NIGHT LIVE [ J HRYSA ( J SCPPP [ ] CLUB LIVE [ J DRUG FREE HOUSING ( J ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 7 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: submission Type FY 1993-94 1 X I Alcohol X]Original [ ]Drug ]Amended [ I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: A070070 4. PRIMARY SERVICE Contra Costa Alcohol and Drug Abuse Council #754 CODE: 10 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Michael Kin (510)932-8100 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: [ ] Confidential 171 Mayhew Way,Suite 210 Pleasant Hill CA 94523 Same 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT I f I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION ]SCHOOL BASED ALTERNATIVES 03 14 04 08 03 20.000 1 ]COMMUNITYBASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION` 19. DISABILITY ACCESS: [ X] YES ( ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL (X] MOBILITY [ ] PHYSICAL [ ] OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: [X] EXISTING [ ] EXPANSION OF SERVICES I ] ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Friday Night Live: Provides alternate social activities for high school students that exclude alcohol,tobacco and drug use and promote Healthy lifestyle choices. 22. SPECIAL SERVICES BREAKDOWN [X) FRIDAY NIGHT LIVE [ ] HRYSA ( J SCPPP [ J CLUB LIVE [ J DRUG FREE HOUSING ( J ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 6 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [XI Alcohol [X J Original [ J Drug ( I Amended ( J Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070070 4. PRIMARY SERVICE Contra Costa Alcohol and Druq Abuse Council #754 CODE: 10 5. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Michael Kin (510)932-8100 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: ( ] Confidential 171 Mayhew Way,Suite 210 Pleasant Hill.CA 94523 Same 9. [X I IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 110. [X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13, 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: i INFORMATION DISSEMINATION EDUCATION j X ]SCHOOL BASED ALTERNATIVES 03 14 03 08 03 j 2500 ]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL I i )BOTH COMMUNITY-BASED PROCESS ENVIRONMENT i EARLY INTERVENTION' 19. DISABILITY ACCESS: [X] YES ( ] NO ( ] BY REFERRAL If"yes"or"by referral' indicate type by placing either an A or R in the box: [ I HEARING [ ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: [X I.EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Club Live: Provides alternate social activities for junior and middle high school students that exclude alcohol,tobacco and drug use and promote healthy lifestyle choices. 22. SPECIAL SERVICES BREAKDOWN ( I FRIDAY NIGHT LIVE ( I HRYSA ( I SCPPP [XI CLUB LIVE ( I DRUG FREE HOUSING [ j ALCOHOL- AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 5 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: lubmission Type FY 1993-94 I X]Alcohol X I Original I ]Drug ]Amended [ ]Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070070 _ 4. PRIMARY SERVICE Contra Costa Alcohol and Drua Abuse Council #754 CODE: 10 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Michael Kin q (510)932-8100 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: [ ] Confidential 171 Mayhew Way,Suite 210 Pleasant Hill.CA 94523 same 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X I NONPROFIT OUT OF COUNTY CONTRACT I f I PROFIT 11. 12. 13, 14, 15. 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT f TYPE I ETHNICITY SERVED Check One PROGRAM NAME: I { ... INFORMATION DISSEMINATION 03 10 09 I 08 03 2000 EDUCATION I I SCHOOL BASED ALTERNATIVES COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY-BASED PRCCcSS ENVIRONMENT EARLY INTERVENTION* 19. DISABILITY ACCESS: [X] YES [ j NO [ ] BY REFERRAL If'yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL [X] MOBILITY ( ] PHYSICAL ( ] OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: (X] EXISTING [ ] EXPANSION OF SERVICES [ ) ENHANCED SERVICES 21_ PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Information & Referral: Provides information and referral services throughout the county through toll free telephone lines and distribution of informational materials. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE [ ] HRYSA [ ] SCPPP ( [ CLUB LIVE [ ] DRUG FREE HOUSING [ ] ALCOHOL- AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 4 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X ] DRUG X] Original BUDGET DETAIL ( ] COMBINED ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Contra Costa Center for Applied Local Research D070798 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)970-7520 Tom Foster Ext.# 04 7. MAILING ADDRESS 8.FACILITY ADDRESS [ J Confidential 183 Broadway [ ] Intermittent Richmond,CA 94804 Same 9.[X j IN COUNTY CONTRACT PROVIDER [ J COUNTY OPERATED 10.[X J NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS (X] GENERAL POPULATION [X) GENERAL POPULATION ( j DISABLED [ ) MEN [ ] WHITE(NOT HISPANIC) f J GAY/LESBIAN [ J WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN f J HOMELESS [ ] PERINATAL (NOT HISPANIC) f ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ J HISPANIC [ ]RURAL/ISOLATED [ ] ELDERLY [ )AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ] FAMILIES ( ] ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN ( ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ J NATIVE HAWAIIAN [ ]CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC N/A PROGRAM DURATION N/A 13. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides evaluation of the CSAT— Critical Populations grant activities and is funded by this grant. 15. SPECIAL SERVICES BREAKDOWN PERI NATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ I BASN f ] TB SERVICES [ ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE ( ] PPN [ ] HIVSET—ASIDE ( J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 3 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X ] DRUG K J Original BUDGET DETAIL ( ] COMBINED ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ j PAROLEE SVS. L. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Substance Abuse Administration D070798 1. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)313-6350 Chuck Deutschman Ext.# 00 1. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 595 Center Avenue,Suite 200 [ ] Intermittent Martinez CA 94553 Same IN COUNTY CONTRACT PROVIDER [X ]COUNTY OPERATED 10.(X J NONPROFIT OUT OF COUNTY CONTRACT I PROFIT _ 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION ( ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ J HOMELESS [ J PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT [ j HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ] FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC N/A PROGRAM DURATION N/A 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING [ ] EXPANSION OF SERVICES ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced orspecial services provided.. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides coordination and administrative support for the OTI — Critical Populations Grant which provides services for residents of public housing developments. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES ( ] PERINATAL PILOT ( j ClW ( J IDU INTERIM SERVICES f ] PERINATALSET—ASIDE [ ] PPN ( J HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 2 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS (X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS (X] DRUG [ X] Original BUDGET DETAIL [X] COMBINED [ ] Amended PROGRAM DESCRIPTION [X] PERINATAL FY 1993/94 [X] PAROLEE SV: 1. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: A070799,C070799 Contra Costa Substance Abuse Administration D070799 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6.SERVICE CODE: (510)313-6350 Chuck Deutschman Ext.# 00 7. MAILING ADDRESS S.FACILITY ADDRESS ( ] Confidential 595 Center Avenue,Suite #200 [ ] Intermittent Martinez,CA 94553 Same 9.( I IN COUNTY CONTRACT PROVIDER (X]COUNTY OPERATED 10.(X]NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X J GENERAL POPULATION [X J GENERAL POPULATION [ J DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY ( J BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ J YOUTH/ADOLESCENT [ ] HISPANIC ( ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY ( i FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER_ PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ]NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER E 12. CAPACITY: STATIC N/A PROGRAM DURATION N/A _ 13. PROGRAM STATUS: ( J NEW — PROJECTED START DATE [X J EXISTING [ ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES_ 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides administrative staffing for the Drug and Alcohol Programs to manage county operated programs; monitor contract programs;and provide general oversight and administrative support for grants and specially funded programs such as the Perinatal Services Network,HIV Set Aside Funds and the Parolee Services Project. Also supports the preparation of new proposals and grant applications. I 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( I OPTIONS PROGRAM [X I BASN ( I TB SERVICES (X1 PERINATAL PILOT I I CIW [ ] IDU INTERIM SERVICES [X1 PERINATAL SET—ASIDE [ I PPN [X] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES ( I PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229. (4/93) IV - 1 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS COUNTY PROGRAMS BUDGET-DETAIL DRINKING DRIVER PROGRAM SERVICES !PE or SUBMISSION: BY PROVIDER COUNTY RAMS: CONTRA COSTA zz original FISCAL YEAR 1993/94 coosTY CODE: 07 Amend ea SUBMISSION DATE: 10/20/93 • e C D E r 1 PftOVXbEA NAME - PAGE TOTALS 1 AST CO. DETO NHNR OCC.HEALTH SUNRISE S PROVMER CODE 5 A 07 0738 A 07 0004 A 07 0140 A 07 0797 0 ERVTCE CODE 90 90 90 90 O TOTAL BUDGETED Ju • 78,750 30.960 104 720 14,980 229,410 Oa nit. of service717 -(Participant visits 304 260 440 42 1,G46 1 oat Per unit of Service N N 1 259.05 119.08 238.00 356.67 ERR 219.32 FUI7DIRG SOURCES 1 3tare General Funds 41 0 0 Dther Revenues 30 0 2 ounty Funds - Other 32 0 s asuranw 5 0 _ :7 C 1463.16 Statham 0 a Cosa DDD Profit/Surplus 0 38 9 ziaking Driver a rtitipant F..a 78,750 30,960 104,720 14,980 229,410 19a Dp Pees to County for 39 dmin, s xonitorin 0 i0 OTAL BUDGETED T SERVICE CATEGORY 78,750 1 30.960 1 104,7201 14.980 0 229.410 ,Counties with a population under 20,000 may us. Stat. General funds if they have a waiver approved by the Dept. DDP Section. AD722SE2 (4/93) DATE RECEIVED: : 111 - 25 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 1 X]Alcohol X J Original [ ]Drug I Amended ( J Combined 1. COUNTY NAME: PROVIDER'S NAME: . PROVIDER CODE: A070001 4. PRIMARY SERVICE Contra Costa :[,PROVIDER'S Intervention & Recovery Services AIRS -Central CODE: 18 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Henry (510)313-1050 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: ( ] Confidential 10 Douglas Drive,Suite 130 Martinez.CA 94553 Same 9. [ ] IN COUNTY CONTRACT PROVIDER [X ] COUNTY OPERATED 110. [ X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14, 15. 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: ' ... I . INFORMATION DISSEMINATION EDUCATION i ]SCHOOL BASED I I ALTERNATIVES X]COMMUNITY BASED PROELEM IDENTIFICATION I AND REFERRAL ! )BOTH COMMUNITY-BASED 1 PROCESS I ENVIRONMENT EARLY INTERVENTION' I 03 ( 10 1 09 08 I 03 250 19_ DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL If'ye s'or"by referral" indicate type by placing either an A or R in the box: ( ] HEARING [ ] VISUAL ( ] MENTAL [ ] DEVELOPMENTAL [X ] MOBILITY ( ] PHYSICAL ( ] OTHER(SPECIFY) 20. PROGRAM STATUS: ( ] NEW - PROJECTED START DATE: I X J EXISTING ( ] EXPANSION OF SERVICES [ J ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals,families and groups who are at risk of becoming alcohol dependent. 22. SPECIAL SERVICES BREAKDOWN [ J FRIDAY NIGHT LIVE [ J HRYSA [ ] SCPPP ( ] CLUB LIVE [ ] DRUG FREE HOUSING ( ] ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 26 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 1 X]Alcohol (X j Original ( j Drug ( j Amended ( ]Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070003 4. PRIMARY SERVICE Contra Costa Icohol Intervention & Recovery Services AIRS —East CODE: 18 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Henry (510)427-8630 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: ( ] Confidential 2400 Sycamore Drive,Suite 36 Antioch CA 94509 Same 9. [ ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 110. [X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE! SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION I SCHOOL BASED ALTERNATIVES X]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY—BASED i PROCESS I ENVIRONMENT j EARLY INTERVENTION' 03 10 09 08 03 I 150 19. DISABILITY ACCESS: [X ] YES ( ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ j MENTAL [ ] DEVELOPMENTAL [XI MO$ILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ I NEW — PROJECTED START DATE: (X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals,families and groups who are at risk of becoming alcohol dependent. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE ( ( HRYSA [ ] SCPPP f I CLUB LIVE [ ] DRUG FREE HOUSING [ ] ALCOHOL— AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 27 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 (X I Alcohol X I Original [ I Drug I Amended ( I Combined 1. COUNTY NAME: PROVIDER'S NAME: 3,PROVIDER CODE: A070002 4. PRIMARY SERVICE Contra Costa Icohol Intervention & Recovery Services (AIRS)—West CODE: 18 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Henry 510 374-3036 ext 7. MAILING ADDRESS: 8. FACILITY ADDRESS: [ ] Confidential 3043 Research Drive,Suite 100 Richmond CA 94806 Same 9. [ ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 10.[X ] NONPROFIT OUT OF COUNTY CONTRACT I t I PROFIT 11. 12. 13. 14. 15_ 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION I )SCHOOL BASED I ALTERNATIVES X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL + I, )BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 03 10 09 08 03 150 19. DISABILITY ACCESS: [ X] YES [ ] NO [ ] BY REFERRAL If"yes" or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL [X] MOBILITY [ ] PHYSICAL [ OTHER(SPECIFY) 20_ PROGRAM STATUS: ( ] NEW - PROJECTED START DATE: [X I EXISTING [ ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals,families and groups who are at risk of becoming alcohol dependent. 22. SPECIAL SERVICES BREAKDOWN [ I FRIDAY NIGHT LIVE [ J HRYSA [ j SCPPP [ j CLUB LIVE ( ) DRUG FREE HOUSING ( j ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 28 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 1 ]Alcohol [X I Original (X I Drug [ I Amended [ I Combined 1.COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070764 4. PRIMARY SERVICE Contra Costa Boy's &Girls Club of East ountv #473 CODE: 18 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Terry Basile (510)439-8035 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ J Confidential P.O.Box 1087 335 East Leland Pittsburg,CA 94565 Pittsbur .CA 94565 9. [X J IN COUNTY CONTRACT PROVIDER [ J COUNTY OPERATED 110.[ X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED (Check One) PROGRAM NAME: { INFORMATION DISSEMINATION I EDUCATION ]SCtiCOI_BASED ALTERNATIVES X]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 03 I 14 03.04 08 03 85 19. DISABILITY ACCESS: [X J YES [ ) NO [ J BY REFERRAL If"yes" or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING ( J VISUAL [ ] MENTAL [ ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ j NEW — PROJECTED START DATE: (X I EXISTING [ J EXPANSION OF SERVICES ( I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Drug&Alcohol Prevention Project: Provides intervention counseling to individuals,families and groups who ar at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN [ j FRIDAY NIGHT LIVE [ j HRYSA ( ] SCPPP ( ] CLUB LIVE [ j DRUG FREE HOUSING ( J ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION IV - 29 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ ]Alcohol I X I Original [X]Drug I I Amended [ )Combined 1. COUNTY NAME: PROVIDER'S NAME: 3.PROVIDER CODE: D070740 . PRIMARY SERVICE Contra Costa Bo 's & Girls Club of East CountV #577 CODE: 18 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Terry Basile (510)439-8035 site 427-3120 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential P.O.Box 1087 85 Treatro Avenue#283 Pittsburg,CA 94565 Pittsburg.CA 94565 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: f `( .. INFORMATION DISSEMINATION EDUCATION I SCHOOL BASED ALTERNATIVES X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY—BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 01 19* 10 I 02,08 03 135 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( J DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: (X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Drug& Alcohol Prevention Program — El Pueblo Housing Development: Provides intervention counseling to residents of this housing development who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE [ J HRYSA ( J SCPPP [ J CLUB LIVE [ J DRUG FREE HOUSING [ J ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 30 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 ( t Alcohol [X]Original [X J Drug I ]Amended [ I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3.PROVIDER CODE: D070741 4. PRIMARY SERVICE Contra Costa Nei hborhood House of North Richmond#576 CODE: 18 S. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Steve Mitchell (510)237-3090 ext# 7. MAILING ADDRESS: S.FACILITY ADDRESS: ( ] Confidential 305 Chesley Avenue 208 23rd Street Richmond.CA 94801 Richmond.CA 94801 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION JSCHOOL BASED ALTERNATIVES X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION* 01 19* 09 02,08 03 135 19. DISABILITY ACCESS: [XI YES [ ) NO [ ] BY REFERRAL If'yes"or"by referral'indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( j DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ J NEW - PROJECTED START DATE: [X I EXISTING EXPANSION OF SERVICES [ ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Las Deltas Housing Development: Provides intervention counseling to residents of this public housing development who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN [ j FRIDAY NIGHT LIVE [ ] HRYSA ( j SCPPP [ ] CLUB LIVE [ j DRUG FREE HOUSING [ [ ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 31 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ 1 Alcohol 'X I Original (X I Drug I Amended [ I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070745 4. PRIMARY SERVICE Contra Costa New Connections#513 CODE: 18 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Beth Schecter 510 676-1601 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 1760 Clayton Road Concord.CA 94520 Same 9. [X ] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [ X] NONPROFIT OUT OF COUNTY CONTRACT I I PROFIT 11. 12. 13. 14, 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION ECUCATION ISCHOOL BASED ALTERNATIVES I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL X]BOTH COMMUNITY-BASED PROCESS I ENVIRONMENT i EARLY INTERVENTION* 03 10 1 09 08 03 I 123 19. DISABILITY ACCESS: [X] YES [ ] NO, [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ I MENTAL DEVELOPMENTAL [X] MOBILITY [ ] PHYSICAL [ ] OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: [X] EXISTING ( J EXPANSION OF SERVICES I ] ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals, families and groups who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN [ ] FRIDAY NIGHT LIVE ( J HRYSA ( J SCPPP [ ] CLUB LIVE [ ] DRUG FREE HOUSING ( ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 32 0 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 ( ]Alcohol I X I Original ( I Drug ( ]Amended [X I Combined 1. COUNTY NAME: PROVIDER'S NAME: PROVIDER CODE: C070720 PRIMARY SERVICE Contra Costa New Perspectives #619 CODE: 18 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Sam Piha (510)223-9270 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ j Confidential 375 Doherty Drive 4197 Lakeside Drive,Suite#190 Larkspur,CA 94939 Richmond CA 94806 9. [ X] IN COUNTY CONTRACT PROVIDER ( ] COUNTY OPERATED 10. [ X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One) PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION ( I SCHOOL BASED i ALTERNATIVES ' X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION` ( 01 I 14 03,04 08 1 03 100 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral' indicate type by placing either an A or R in the box: [ I HEARING [ ] VISUAL [ J MENTAL [ ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: ( ] NEW - PROJECTED START DATE: [X ] EXISTING [ EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Gateway Project: Provides case management services to high—risk youth and their families in West County. 22. SPECIAL SERVICES BREAKDOWN [ J FRIDAY NIGHT LIVE fX J HRYSA [ I SCPPP [ ] CLUB LIVE ( ] DRUG FREE HOUSING ( ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 33 0 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 ( j Alcohol I X I Original [X] Drug ( I Amended ( j Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070753 4. PRIMARY SERVICE Contra Costa REACH Proiect Inc. #243 CODE: 18 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Shirlev Marchetti (510)754-3673 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 1915 D Street Antioch.CA 94509 Same 9. [ X I IN COUNTY CONTRACT PROVIDER ( ] COUNTY OPERATED 110. [X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15' 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION ]SCHOOL BASED ALTERNATIVES I I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL XIBOTH COMMUNITY-BASED PROCESS I ENVIRONMENT i EARLY INTERVENTION` 02 10 03 04 09 08 03 450 19. DISABILITY ACCESS: (X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral' indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL [ ] DEVELOPMENTAL X 1 MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: ( j NEW - PROJECTED START DATE: [X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals,families and groups who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN [ I FRIDAY NIGHT LIVE [ I HRYSA [ I SCPPP ( J CLUB LIVE ( j DRUG FREE HOUSING ( ] ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 34 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ I Alcohol [X]Original (X I Drug [ ]Amended ( ]Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070732 4. PRIMARY SERVICE Contra Costa San Pablo Discovery Center CODE: 18 S. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Adanna Henry (510)374-3332 ext# 7. MAILING ADDRESS: 8. FACILITY ADDRESS: [ ] Confidential 2523 EI Portal Drive,Suite 102 San Pablo.CA 94806 Same 9.[ ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION I SCHOOL BASED ALTERNATIVES X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 03 10 09 08 03 150 19. DISABILITY ACCESS: [X] YES ( ] NO [ ] BY REFERRAL If"yes"or"by referral' indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL X 1 MOBILITY PHYSICAL OTHER(SPECIFY 20. PROGRAM STATUS: ( ] NEW — PROJECTED START DATE: JXJ EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals,families and groups who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE ( ] HRYSA [ ] SCPPP ( ] CLUB LIVE [ I DRUG FREE HOUSING ( ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 35 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ 1 Alcohol (X I Original [X I Drug ( I Amended ( I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070733 4. PRIMARY SERVICE Contra Costa San Ramon ValleV Discovery Center#535 CODE: 18 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Diana Li-Re ac Ph.D (510)837-0505 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: ( ] Confidential 530 La Gonda Way,Suite A Danville,CA 94526 Same 1I9. [X J IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 110.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RAC EJ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED (Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION I ]SCHOOL BASED ALTERNATIVES I X]COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT I EARLY INTERVENTION* 03 10 09 08 03 ! 185 19. DISABILITY ACCESS: [X] YES [ ) NO [ J BY REFERRAL If"yes"or"by referral"indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ J MENTAL ( ] DEVELOPMENTAL fXj MOBILITY f I PHYSICAL f I OTHER(SPECIFY) 20. PROGRAM STATUS: ( ] NEW — PROJECTED START DATE: (X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals,families and groups who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN [ J FRIDAY NIGHT LIVE ( ] HRYSA ( ) SCPPP ( ) CLUB LIVE [ ] DRUG FREE HOUSING ( ] ALCOHOL— AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 36 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [ J Alcohol I X I Original [X I Drug [ I Amended [ I Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070761 4. PRIMARY SERVICE Contra Costa SojourneCommunitVCounselin Center CODE: 18 S. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Kirk Brocks (510)374-3813 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ ] Confidential 3029 MacDonald Avenue Richmond.CA 94804 Same 9. ( ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. 12. 13. 14. 15' 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE . RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: ... .. INFORMATION DISSEMINATION EDUCATION I j SCHOOL BASED ALTERNATIVES X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 03 10 09 02,08 03 350 0 19. DISABILITY ACCESS: [X] YES [ ] NO [ J BY REFERRAL If"yes" or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL [ j DEVELOPMENTAL X I MOBILITY f I PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ) NEW - PROJECTED START DATE: [X) EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling for individuals,families and groups who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE ( J HRYSA [ J SCPPP [ j CLUB LIVE ( J DRUG FREE HOUSING [ J ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 37 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: :submission Type FY 1993-94 [ ]Alcohol X I Original [X I Drug ]Amended ( ]Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: D070731 . PRIMARY SERVICE Contra Costa Tri—Cities Discovery Center CODE: 18 5. CONTACT PERSON'S NAME: 6.PHONE NUMBER: Linda Schacfer (510)222-9838 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: ( ] Confidential 2586 Appian Way Pinole CA 94564 Same 9. [ ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One) PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION I SCHOOL BASED ALTERNATIVES X ICOMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION' 03 10 09 08 03 1$0 19. DISABILITY ACCESS: [X] YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ j MENTAL ( ] DEVELOPMENTAL [X] MOBILITY [ ] PHYSICAL [ OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: [X] EXISTING [ ] EXPANSION OF SERVICES [ I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Provides intervention counseling to individuals, families and groups who are at risk for drug dependency. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE [ ] HRYSA [ ] SCPPP ( ] CLUB LIVE [ ] DRUG FREE HOUSING [ ] ALCOHOL—AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 38 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [X ]Alcohol (X]Original I ]Drug [ ]Amended I ]Combined 1. COUNTY NAME: .PROVIDER'S NAME: 3. PROVIDER CODE: A070010 . PRIMARY SERVICE Contra Costa Bi—Belt Corporation #722 CODE: 19 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Pat Walters (510)798-7250 site 676-2580 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ J Confidential 2090 Commerce Avenue 1000 Ward Street Concord,CA 94520 Martinez.CA 94553 9. [X J IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. (X J NONPROFIT OUT OF COUNTY CONTRACT I f I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: 77: ............ . ...... INFORMATION DISSEMINATION EDUCATION I SCHOOL 8 ASED ALTERNATIVES X I CCMMUNITYBASED PROBLEM IDENTIFICATION AND REFERRAL IBOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION` 03 13 09 08 03 1,000 19. DISABILITY ACCESS: [X J YES ( J NO [ J BY REFERRAL If"yes" or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING ( ] VISUAL ( ] MENTAL ( ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: [X J EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) County Jail Outreach: Provides outreach services to persons incarcerated in the county jail. This contract was terminated in August 1993. 22. SPECIAL SERVICES BREAKDOWN [ ] FRIDAY NIGHT LIVE [ J HRYSA ( J SCPPP ( ] CLUB LIVE [ ] DRUG FREE HOUSING [ J ALCOHOL- AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 39 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCfZIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 [X]Alcohol (X 1 Original [ j Drug ( J Amended [ j Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070738 4. PRIMARY SERVICE Contra Costa East County Detoxification Center#743 CODE: 19 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Kav uinn (510)458-1616 ext# 7. MAILING ADDRESS: 18.FACILITY ADDRESS: [ ] Confidential 500 School Street Pittsburg,CA 94565 Same 9. [X j IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT 11. 12. 13. 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON- POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: .. . INFORMATION DISSEMINATION EDUCATION ]SCHOOL BASED ALTERNATIVES XI COMMUNITY BASED PROBLEM IDENTIFICATION �r,taD REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLY INTERVENTION` 03 10 09 02 03 1,400 19. DISABILITY ACCESS: [X) YES [ ] NO [ ] BY REFERRAL If"yes"or"by referral" indicate type by placing either an A or R in the box: [ ] HEARING [ ] VISUAL [ ] MENTAL ( ] DEVELOPMENTAL X I MOBILITY I PHYSICAL f I OTHER(SPECIFY 20. PROGRAM STATUS: [ ] NEW - PROJECTED START DATE: [X I EXISTING EXPANSION OF SERVICES ( ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Afro—American Outreach: Provides outreach and intervention services to Afro—Americans in East County. 22. SPECIAL SERVICES BREAKDOWN ( ] FRIDAY NIGHT LIVE [ ] HRYSA [ J SCPPP [ ] CLUB LIVE [ J DRUG FREE HOUSING [ ] ALCOHOL-AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 40 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS PROGRAM DESCRIPTION PREVENTION STRATEGY REPORT Provider Type: Submission Type FY 1993-94 f X I Alcohol I X I Original I ]Drug [ J Amended I ]Combined 1. COUNTY NAME: PROVIDER'S NAME: 3. PROVIDER CODE: A070738 4. PRIMARY SERVICE Contra Costa East County Detoxification Center#743 CODE: 19 5. CONTACT PERSON'S NAME: 6. PHONE NUMBER: Kav Quinn (510)458-1616 ext# 7. MAILING ADDRESS: 8.FACILITY ADDRESS: [ j Confidential 500 School Street 723 Third Street Pittsburg,CA 94565 Brentwood.CA 94513 9. [X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. 12. 13, 14. 15. 16. 17. 18. TARGET STRATEGY ENVIRON— POPULATION AGE RACE/ SEX NUMBER SETTING MENT TYPE ETHNICITY SERVED Check One PROGRAM NAME: INFORMATION DISSEMINATION EDUCATION ]SCHOOL BASED ALTERNATIVES I X I COMMUNITY BASED PROBLEM IDENTIFICATION AND REFERRAL ]BOTH COMMUNITY-BASED PROCESS ENVIRONMENT EARLYINTERVENTION• 04 10 09 03 03 1.450 19. DISABILITY ACCESS: (X] YES ( ] NO [ ] BY REFERRAL If"yes" or"by referral" indicate type by placing either an A or R in the box: ( ] HEARING [ J VISUAL [ ] MENTAL [ ] DEVELOPMENTAL X I MOBILITY PHYSICAL OTHER(SPECIFY) 20. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE: JX I EXISTING EXPANSION OF SERVICES I I ENHANCED SERVICES 21. PROGRAM DESCRIPTION: (Describe activities and any enhanced or special services provided.) Spanish Information &Referral: Provides outreach,intervention and referral to Spanish speaking persons in East County. Program is located in the Delta Community Center in Brentwood. 22. SPECIAL SERVICES BREAKDOWN [ J FRIDAY NIGHT LIVE ( ] HRYSA ( I SCPPP ( j CLUB LIVE [ ] DRUG FREE HOUSING ( I ALCOHOL— AND DRUG FREE WORKPLACE RECOGNITION NOTE: Complete one ADP 7235 for each service code. IV - 41 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( ] DRUG [X] Original BUDGET DETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION (X j PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Tri—County Women's Recovery Services,Inc.#617 Contra Costa [rima East C070775 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)236-3139 site(510)427-9100 Albione Becnel Ext.# 30 7. MAILING ADDRESS S.FACILITY ADDRESS [ ] Confidential 1901 Church Lane 369 East Leland [ ] Intermittent San Pablo,CA 94806 1 Pittsburg,CA 94565 9.[X] IN COUNTY CONTRACT PROVIDER ( ]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT _ 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION (X] GENERAL POPULATION [ ] DISABLED [ ]MEN ( ]WHITE(NOT HISPANIC) ( ] GAY/LESBIAN [ ] WOMEN ONLY ( ]BLACK/AFRICAN—AMERICAN [ ] HOMELESS (X J PERINATAL (NOT HISPANIC) ( j MULTIPLE DIAGNOSIS [ J YOUTH/ADOLESCENT [ J HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ J URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [,] OTHER 12. CAPACITY: STATIC_15 Women/15 Children PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES [ ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Intensive day treatment services for alcohol and drug dependent women and children(0-5). Ujima East is open Monday through Friday from 9:00 a.m.to 1:30 p.m. Treatment includes,didactic drug and alcohol education groups,child birth preparation and parenting classes, 12—Step meetings, recovery support groups and counseling which specializes in both recovery and re—entre, and also in special issues of women. Transportation is facilitated for clients. Child enrichment services are provided on site. IIS 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ ] BASN ( j TB SERVICES [X J PERINATAL PILOT ( ] CIW [ j IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE [ ] PPN ( j HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 42 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ j ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [ X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [X] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Tri—County Women's Recovery Services,Inc.#617 Contra Costa Ujima West 0070713 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)236-3139 site(510)215-2280 Albione Becnel Ext.# 30 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 1901 Church Lane 3939 Bissell Avenue [ j Intermittent San Pablo,CA 94806 Richmond,CA 94805 9.(X] IN COUNTY CONTRACT PROVIDER ( ]COUNTY OPERATED 10.[X I NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [x] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ J MEN ( ]WHITE(NOT HISPANIC) [ J GAY/LESBIAN [ ] WOMEN ONLY ( ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS (X) PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ J YOUTH/ADOLESCENT [ ] HISPANIC ( ] RURAL/ISOLATED [ ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ] ASIAN/ASIAN—AMERICAN/ [ ) SUBURBAN [ ] OTHER PACIFIC ISLANDER ( J PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 15 Women/15 Children_ PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X ]EXISTING EXPANSION OF SERVICES f I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Intensive day treatment services for alcohol and drug dependent women and children(0-5). Ujima West is open Monday through through Friday from 9:00 a.m.to 1:30 p.m. Treatment includes,didactic drug and alcohol education groups,child birth preparation and parenting classes, 12—Step meetings, recovery support groups and counseling which specializes in both recovery and re—entry and also in special issues of women. Transportation is facilitated for clients. Child enrichment services are provided on site. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM" ( ] BASN ( J TB SERVICES [X ] PERINATAL PILOT [ J C1W [ ] IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE [ ] PPN [ [ HIV SET—ASIDE ( ] PERINATAL 1NTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 43 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( ] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [X] PAROLEE SVS 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention&Recovery Services A070001 Contra Costa AIRS — Central C070001 4. CONTACT PERSON'S NAME: S.PHONE NUMBER: 6. SERVICE CODE: (510)313-1050 Adanna HenryExt.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 10 Douglas Drive,Suite 130 [ ] Intermittent Martinez,CA 94553 Same 9.[ ] IN COUNTY CONTRACT PROVIDER [X] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X ] GENERAL POPULATION [X] GENERAL POPULATION ( ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ j BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT ( ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( ] AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES ( ] ASIAN/ASIAN—AMERICAN/ ( ] SUBURBAN [ ] OTHER PACIFICISLANDER ( ] PUBLIC INEBRIATES NATIVE HAWAIIAN [XICRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 80 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: [ J NEW— PROJECTED START DATE ( ] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services including evaluation,education,intervention,and group process for alcoholics and persons with alcohol problems. Also provides services to state prison parolees upon discharge from prison through the Parolee Services BASN Project. I t I 15. SPECIAL SERVICES BREAKDOWN ' PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ j OPTIONS PROGRAM [X] BASN [ ] TB SERVICES [ ] PERINATAL PILOT ( ] CIW [ ] IDU INTERIM SERVICES [ ) PERINATAL SET—ASIDE ( ] PPN [ ] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 44 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TRZATMEN:' PROGRAMS [ ] DRUG [X ] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 (X] PAROLEE SV: 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention&Recovery Services Contra Costa AIRS — East A070003 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6. SERVICE CODE: (510)427—8630 Adanna HenryExt.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 2400 Sycamore Drive,Suite#36 [ ] Intermittent Antioch,CA 94509 Same 9.( ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION (X] GENERAL POPULATION [ ] DISABLED [ ] MEN ( ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS ( ] PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT ( ] HISPANIC [ ] RURAL/ISOLATED [ ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN ( ] OTHER PACIFICISLANDER ( ]PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [X] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 60 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE (X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. .PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services including evaluation,education,intervention,and group process for alcoholics and persons with alcohol problems. Also provides services to state prison parolees upon discharge from prison through the Parolee Services BASN Project. This program is partially funded by federal Medi—Cal funds. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [X] BASN [ ] TB SERVICES [ ] PERINATAL PILOT ( ] CIW ( ] IDU INTERIM SERVICES [ J PERINATAL SET—ASIDE [ J PPN ( J HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 45 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ X J ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ J Amended PROGRAM DESCRIPTION [ j PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention&Recovery Services Contra Costa AIRS — West A070002 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)374—3036 Adanna HenryExt.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 3043 Research Drive,Suite#100 [ ] Intermittent Richmond,CA 94806 Same 9.[ ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X ] GENERAL POPULATION [ ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) ( ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ I PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 60 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE [X I EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services.provided. A pamphlet maybe stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services including evaluation,education,intervention and group process for alcoholics and persons with alcohol problems. i I 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( j OPTIONS PROGRAM ( ] BASN [ ] TB SERVICES ( ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE ( ] PPN [ ] HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 46 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ j ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG ( X] Original BUDGET DETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION [X] PERINATAL FY 1993/94 ( ] PAROLEE SVS. 1.COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Contra Costa Born Free Project C070770 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)646-1165 site(510)374-8085 Leslie Lieberman Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 111 Allen Street [ ] Intermittent Martinez CA 94553 Same 9.[X]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.(X]NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ]GENERAL POPULATION [X]GENERAL POPULATION [ ]DISABLED [ ]MEN [ ] WHITE(NOT HISPANIC) ( ] GAYILESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [X ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ] ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [ J PUBLIC INEBRIATES [ j NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_15 Women& Children PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE (X J EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides drug and alcohol counseling to pregnant and parenting women incarcerated at the Martinez Jail. Services include group/individual counseling,assessment,education,and referrals_ Under a subcontract to the Born Free Project,the Family Stress Center provides parenting services and child care to 1_S women and their children involved in the Born Free treatment program in central county. Services include assessment,individual counseling,group education,parent/child groups, and child care. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( ] BASN [ J TB SERVICES [ ] PERINATAL PILOT [ ] CIW [ ) IDU INTERIM SERVICES [X] PERINATAL SET—ASIDE ( J PPN [ ] HIVSET—ASIDE j ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 47 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS ( ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( ] DRUG X j Original BUDGET DETAIL [ ] COMBINED ] Amended PROGRAM DESCRIPTION [X] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Born Free Proiect C070773 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6. SERVICE CODE: (510)646—1165 Leslie Lieberman Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 111 Allen Street 100 —38th Street ( ] Intermittent Martinez CA 94553 Richmond CA 94804 9.[ ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT f 1 PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION [ ]GENERAL POPULATION [ ] DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [X]BLACK/AFRICAN—AMERICAN ( ] HOMELESS [X] PERINATAL (NOT HISPANIC) ( J MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [ ] CRIMINALJUSTICE ( ] OTHER 12. CAPACITY: STATIC 8 PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient drug and alcohol counseling to women in west county at the pre—natal clinic at the County Health Center. Services include individual/group counseling,urine testing,parenting education and child care. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ j BASN [ ] TB SERVICES ( ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [X] PERINATAL SET—ASIDE ( ] PPN [ J HIV SET—ASIDE ( ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 48 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Bo 's&Girls Club of East County#473 D070764 4. CONTACT PERSON'S NAME: S.PHONE NUMBER: 6.SERVICE CODE: (510)439-8035 Terry Basile Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential P.O.Box 1087 335 East Leland [ ] Intermittent Pittsburg,CA 94565 Pittsburg,CA 94565 9.(X ] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.(X ] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS (X] GENERAL POPULATION [X] GENERAL POPULATION ( ] DISABLED ( J MEN [ ] WHITE(NOT HISPANIC) [ j GAY/LESBIAN ( ] WOMEN ONLY [ ].BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE ( ] OTHER 12. CAPACITY: STATIC 250 PROGRAM DURATION 6 Months 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE (X] EXISTING EXPANSION OF SERVICES 1 ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services to drug dependent individuals,families and groups. Initially, clients are seen individually one or two times a week; thereafter they are referred to group services and receive individual counseling once every other week. One counselor is based in Riverview Middle School and will provide short term counseling — 3 months. If needed,the client will be referred to an appropriate agency for longer—term counseling. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ ] BASN [ ] TB SERVICES [ ] PERINATAL PILOT [ j CIW [ J IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE [ ] PPN [ ] 141V SET—ASIDE [ J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 49 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG [ X] Original BUDGET DETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [ ] PAROLEE SVS, 1. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Boy's&Girls Club of East County#577 Contra Costa EI Pueblo Housing Develo ment D070740 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)439-8035 site(510)427-3120 Terry Basile Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential P.O.Box 1087 85 Treatro Avenue,#283 [ ] Intermittent Pittsburg,CA 94565 Pittsburg,CA 94565 9.[X] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ J GENERAL POPULATION [ ] GENERAL POPULATION [ J DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) ( ]GAY/LESBIAN ( ] WOMEN ONLY [X]BLACK/AFRICAN—AMERICAN ( J HOMELESS [ ]PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT ( ] HISPANIC [ J RURAL/ISOLATED ( ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [X ] OTHER — Residents of Public Housing PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 85 PROGRAM DURATION 12-24 Weeks 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X]EXISTING EXPANSION OF SERVICES f I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services for drug dependent residents of the EI Pueblo Housing Development in Pittsburg. Clients receive at least two hours of individual and group counseling a week. This contract is funded by the'Taking Back our Community" CSAT — Critical Populations Grant. i 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ ] BASN [ ] TB SERVICES ( ] PERINATAL PILOT [ } CIW ( ] IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE [ ] PPN ( ] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 50 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG [ X] Original BUDGET DETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 ( ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Neighborhood House of North Richmond#576 Contra Costa Las Deltas Housing Develo went D070741 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6.SERVICE CODE: (510)237-3090_ Steve Mitchell Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 305 Chesley Avenue 1744 4th Street [ ] Intermittent Richmond.CA 94801 Richmond CA 94801 9.[X ] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT f 1 PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION (X] GENERAL POPULATION ( ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN ( ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ J HOMELESS [ ] PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT ( ] HISPANIC ( ] RURAL/ISOLATED [ ] ELDERLY ( ] AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN-AMERICAN/ [ ]SUBURBAN [X] OTHER — Residents of Public Housing PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 200 PROGRAM DURATION 12 Weeks 13. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE [X] EXISTING X I EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services to residents of the Las Deltas Housing Development at the North Star Treatment Center. The facility is open from 9:00 a.m.to 9:00 p.m.,Tuesday through Saturdays. Counseling services are provided on a one—to—one or group basis. This contract is funded by the"Taking Back our Community" CSAT — Critical Populations Grant. I 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ j OPTIONS PROGRAM [ ] BASN [ ] TB SERVICES [ ] PERINATAL PILOT [ J CIW ( J IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE [ ] PPN [ j HIV SET—ASIDE f J PERINATAL INTERM SERVICES [ J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 51 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG X] Original BUDGET DETAIL [ ] COMBINED ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: i Contra Costa New Connections#513 D070745 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)676-1601 Beth Schecter Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 1760 Clayton Road ( ] Intermittent Concord,CA 94520 Same 9.[X] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X]NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ ] MEN ( ] WHITE(NOT HISPANIC) [ ]GAY/LESBIAN [ j WOMEN ONLY ( ] BLACK/AFRICAN—AMERICAN [ J HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [X J YOUTH/ADOLESCENT [ ] HISPANIC [ ]RURAL/ISOLATED [ ] ELDERLY [ J AMERICAN INDIAN OR ALASKAN NATIVE [ J URBAN — INNER CITY (X] FAMILIES ( ] ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN ( ] OTHER PACIFIC ISLANDER ( I PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 90 PROGRAM DURATION_6 Months 13. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( ]ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling for drug dependent adolescents,their families and adults. The Youth/Family Program provides school—based services in Northwest county at Willow School,Carquinz Middle School,John Swett High School and the Boy's and Girls Club. Less intensive counseling services are available in Central County at the office. Clients receive on average 1-2 counseling hours per week. A Youth Recovery Program offers individual and group counseling. The Chemical Dependency Treatment Program is for adults and is based on the neurobehavioral model. Clients receive intensive services on the average S-6 counseling hours per week. Nineteen individual/family slots are county funded. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( ] BASN [ j TB SERVICES [ ] PERINATAL PILOT [ ] CIW ( J IDU INTERIM SERVICES [ J PERINATAL SET—ASIDE [ ] PPN ( j HIV SET—ASIDE ( ] PERINATAL INTERM SERVICES ( j PPP NOTE: Complete one ADP 7229 for each service code. kDP 7229 (4/93) IV - 52 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS ( J ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS (X I DRUG [X] Original BUDGET DETAIL [ J COMBINED ( I Amended PROGRAM DESCRIPTION [ J PERINATAL FY 1993/94 ( ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa REACH Project Inc.#243 D070753 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)754—3673 Shirley Marchetti Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 1915 D Street [ ] Intermittent Antioch,CA 94509 Same 9.(X ] IN COUNTY CONTRACT PROVIDER ( ]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I f I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X ] GENERAL POPULATION [X] GENERAL POPULATION [ j DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ J GAY/LESBIAN [ ) WOMEN ONLY ( )BLACK/AFRICAN—AMERICAN ( j HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT ( ] HISPANIC ( ] RURAL/ISOLATED [ ] ELDERLY [ ] AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES ( ] ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 120 PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE (X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling for drug dependent youth,families and adults. Two counselors are assigned to the REACH Center and work with the general Antioch population and referrals from the Antioch Police Department. One counselor is stationed in Brentwood and provides individual/family counseling for the population of Far East County, Liberty and La Paloma Highs. The programs are funded by receiving equal match to the county contract from the City of Antioch and the Antioch School District. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ) BASN [ J TB SERVICES [ ) PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES ( ] PERINATALSET—ASIDE ( ) PPN [ ] HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 53 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa San Pablo Discovery Center D070732 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6.SERVICE CODE: (510)374—3332_ Adanna HenryExt.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 2523 EI Portal Drive,Suite 102 [ ] Intermittent San Pablo CA 94806 Same 9.[ ] IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ]GAY/LESBIAN [ J WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ J HOMELESS [ ) PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( j FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ J PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ J CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 60 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE (X]EXISTING ( j EXPANSION OF SERVICES ( j ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services to drug dependent individuals,families and groups with an emphasis on lifestyle changes. Services are provided on an one—to—one or group basis. On average,clients receive three hours of counseling a week. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ J BASN [ ] TB SERVICES [ J PERINATAL PILOT ( ] C1W [ j IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE [ ] PPN [ J HIV SET—ASIDE [ J PERINATAL INTERM SERVICES f J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 54 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X J DRUG [ X] Original BUDGET DETAIL [ ] COMBINED [ J Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa San Ramon Valley Discovery Center#535 D070733 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)837-0505_ Diana Li—Re ac Ph.D Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 530 La Gonda Way,Suite A [ ] Intermittent Danville,CA 94526 1 Same 9.(X] IN COUNTY CONTRACT PROVIDER [ J COUNTY OPERATED 10.(XJ NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS (X ]GENERAL POPULATION f X j GENERAL POPULATION ( j DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ )BLACK/AFRICAN—AMERICAN ( ]HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC ( ] RURAL/ISOLATED [ ] ELDERLY [ J AMERICAN INDIAN OR ALASKAN NATIVE [ ) URBAN — INNER CITY [ ]FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER ( J PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 63 PROGRAM DURATION 3 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X]EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services to drug dependent youth,families and adults. Services are provided on an individual,couple or family basis. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ j OPTIONS PROGRAM [ ] BASH [ ] TB SERVICES [ ] PERINATAL PILOT ( ) CIW ( J IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE ( ] PPN [ J HIV SET—ASIDE ( ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 55 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG X] Original BUDGET DETAIL [ ) COMBINED ]Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [X] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa So'ourne Community Counsdin Center D070761 C070761 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)374-3813 Kirk Brocks Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 3029 MacDonald Avenue [ ] Intermittent Richmond,CA 94804 1 Same 9.[ j IN COUNTY CONTRACT PROVIDER [X j COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION ( ]DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) ( ] GAY/LESBIAN [ ] WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN ( ] HOMELESS ( ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT ( J HISPANIC [ ] RURALASOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN (X] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 80 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES [ ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling to drug dependent individuals,familes and adults. Also provides services to state prison parolees upon discharge from prison through the Parolee Services BASN Project. Services include individual,family and group counseling,various educational and process groups,acupuncture,Spanish speaking groups,and aftercare. This program is partially funded by federal Medi—Cal funds. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( J OPTIONS PROGRAM (XI BASN [ j TB SERVICES [ ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ j PPN [ ] HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. kDP 7229 (4/93) IV - 56 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMT?NT PROGRAMS (X] DRUG [ X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2-PROVIDER'S NAME: 3.PROVIDER'S CODE: Contra Costa Tri—Cities Discovery Center D070731 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)222-9838_ Linda Schaefer Ext.# 31 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 2586 Appian Way [ ] Intermittent Pinole CA 94564 1 Same 9.[ ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS j X J GENERAL POPULATION [X J GENERAL POPULATION [ J DISABLED [ ] MEN ( ]WHITE(NOT HISPANIC) ( ] GAY/LESBIAN [ ] WOMEN ONLY [ J BLACK/AFRICAN—AMERICAN [ ] HOMELESS ( J PERINATAL (NOT HISPANIC) ( ]MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ] ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFICISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ) CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 60 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient treatment counseling services to drug dependent youth,families and adults. Services are provided on a one—to—one or group basis. There are separate Teen Recovery and Adult Recovery Programs. On average,clients receive three hours of counseling a week. i I 15. SPECIAL SERVICES BREAKDOWN r PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ J OPTIONS PROGRAM [ ] BASN [ ] TB SERVICES ( j PERINATAL PILOT [ J CIW ( ( IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE [ ] PPN [ J HIV SET—ASIDE ( J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 57 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS ( ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X I Original BUDGET DETAIL f ] COMBINED [ ) Amended PROGRAM DESCRIPTION [ ) PERINATAL FY 1993/94 ( ] PAROLEE SVS. I.COUNTY NAME: 2.PROVIDE R'S NAME: 3. PROVIDER'S CODE: Center for Substance Abuse Prevention Contra Costa Federal Grant None 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6. SERVICE CODE: (510)646-1165 Hope Ewing,MD Ext.# 3t 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 111 Allen Street [ I Intermittent Martinez,CA 94553 Same 9.[ ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X ]NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( J GENERAL POPULATION [X I GENERAL POPULATION [ ] DISABLED ( ] MEN ( ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN ( ] WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ ]HOMELESS [X I PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ )FAMILIES j ]ASIAN/ASIAN—AMERICAN/ [ ) SUBURBAN [ ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC PROGRAM DURATION 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING f ] EXPANSION OF SERVICES [ I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced orspecial services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program.modality. The Born Free Project promotes family recovery from the addictions to alcohol and other drugs. Services include outpatient treatment counseling at the three largest prenatal clinics in the county as well as in the labor and delivery unit at the county hospital. it 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ j BASN [ J TB SERVICES [ ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ ] PPN [ J HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 58 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X J DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ J Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ]PAROLEE SVS 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa BAART#469 — Pittsb rg D070709 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)427-2285 Stephen Sooter Ext.# 40 7. MAILING ADDRESS 8. FACILITY ADDRESS [ ] Confidential 45 Civic Drive [ ] Intermittent Pittsburg, CA 94565 Same 9. [X]IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X]NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X ] GENERAL POPULATION [X ] GENERAL POPULATION ( J DISABLED ( ]MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN ( ]WOMEN ONLY [ I BLACK/AFRICAN—AMERICAN f ] HOMELESS [ ]PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ ]YOUTH/ADOLESCENT [ ]HISPANIC [ J RURAL/ISOLATED ( ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE[ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN ( ]OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ]NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 110 PROGRAM DURATION_1 year 13. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE [X]EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient methadone maintenance services to Medi—Cal eligible and medically indigent clients. This service is partially funded by federal Medi—Cal funds. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ ] BASN [ J TB SERVICES [ ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE [ ] PPN [ J HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 59 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X ] DRUG X] Original BUDGET DETAIL. [ ] COMBINED ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa BAART#469 — Richmond D070708 CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)232-0874_ Phillip MacFarland Ext.# 40 '. MAILING ADDRESS S. FACILITY ADDRESS [ ] Confidential 2910 Cutting Blvd. [ ] Intermittent Richmond CA 94804 Same _ [X]IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10. [X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT .1. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS (X] GENERAL POPULATION [X]GENERAL POPULATION [ J DISABLED [ ]MEN [ ] WHITE(NOT HISPANIC) ( ] GAY/LESBIAN [ ]WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ ]PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ]YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE ( ) URBAN — INNER CITY ( ]FAMILIES [ ]AS IAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE ( ]OTHER .2. CAPACITY: STATIC 135 PROGRAM DURATION 1 Year 3. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE [X] EXISTING f ] EXPANSION OF SERVICES ( i ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides outpatient methadone maintenance service to Medi—Cal eligible and medically indigent clients. This service is partially funded by federal Medi—Cat funds. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( J BASN [ J TB SERVICES ( ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE ( ] PPN [ ] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ,DP 7229 (4/93) IV - 60 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ j ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X ] DRUG [X ] Original BUDGET DETAIL [ ] COMBINED [ ) Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Contra Costa BAART#596— Richmond D070708 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6. SERVICE CODE. (510)232-0874 Phillip MacFarland Ext.# 40 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 2910 Cutting Blvd. ( ] Intermittent Richmond,CA 94804 Same 9.(X j IN COUNTY CONTRACT PROVIDER ( ]COUNTY OPERATED 10.(X j NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X ] GENERAL POPULATION [X ] GENERAL POPULATION [ ] DISABLED ( ] MEN [ ] WHITE(NOT HISPANIC) [ j GAY/LESBIAN ( ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED ( ] ELDERLY ( j AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ ]FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ ( ] SUBURBAN ( ] OTHER PACIFICISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE ( ) OTHER 12. CAPACITY: STATIC-66 slots PROGRAM DURATION 1 Year 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X]EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provision of outpatient methadone maintenance services to county individuals served through Waiting Period Reduction funds.. This contract terminated September 30,1993. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ j BASN [ ] TB SERVICES [ ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES [ j PERINATALSET—ASIDE ( ] PPN ( ) HIVSET—ASIDE ( ] PERINATAL INTERM SERVICES ( ) PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV 61 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( ] DRUG X.] Original BUDGET DETAIL [ ] COMBINED ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Bi—Bett Corporation#722 Contra Costa Shennum Center A070020 4.CONTACT PERSON'S NAME: S. PHONE NUMBER: 6.SERVICE CODE: (510)676-2580 Pat Walters Ext.# 50 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 2090 Commerce Avenue ( ] Intermittent Concord CA 94520 f Same 9.[X ]IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X ] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY .RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION (X] GENERAL POPULATION ( ] DISABLED [ ] MEN ( ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ ] PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ]HISPANIC ( ] RURAL/ISOLATED [ ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ] FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ ( ] SUBURBAN [ ] OTHER PACIFICISLANDER ( ] PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE ( ] OTHER 12. CAPACITY: STATIC 20 Beds PROGRAM DURATION 3-5 Days 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE [X ] EXISTING ( � EXPANSION OF SERVICES [ J ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 20 detoxification beds for alcohol dependent adults. Program is a social model detox dually licensed and certified by the Department of Alcohol and Drug Programs. Services include information and referral,family counseling,NA,AA,self help meetings. This service is partially supported by State AB2086(Statham) funds. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES [ ] PERINATAL PILOT [ ] CIW [ J IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE ( ] PPN O HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES [ J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 62 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG ( X J Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 11. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: iEast County Community Detoxification Contra Costa Center Inc.#743 A070738 14. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)458-1616 i Kay Quinn Ext.# 50 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential i 500 School Street [ ] Intermittent Pittsburg,CA 94565 Same 9.[X ] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X)GENERAL POPULATION [ ) DISABLED ( ] MEN [ j WHITE(NOT HISPANIC) [ ] GAY/LESBIAN ( J WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ J HOMELESS [ ) PERINATAL (NOT HISPANIC) j ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ )AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFICISLANDER [ J PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 112. CAPACITY: STATIC 10 Beds PROGRAM DURATION 3-5 Days 113. PROGRAM STATUS: [ j NEW— PROJECTED START DATE (X] EXISTING [ ] EXPANSION OF SERVICES f ] ENHANCED SERVICES 114. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. jProvides 10 detoxification beds for alcohol dependent adults. Program is a social model detox for ambulatory clients. Services include information and referral. i I i I 1S_ SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ) OPTIONS PROGRAM [ ] BASN ( J TB SERVICES [ ] PERINATAL PILOT [ ) CIW [ J IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ ] PPN [ ] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 63 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG [ X] Original BUDGET DETAIL [ J COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Neighborhood House of North Richmond#723&576 Contra Costa Hollomon Detox A070004 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)235-9780 site(510)233-1270 Steve Mitchell Ext.# 50 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 304 Chesley Avenue 208 —23rd Street [ ] Intermittent Richmond,CA 94801 Richmond,CA 94804 9.[X] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION ( ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN ( ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ]PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( ] AMERICAN INDIAN OR ALASKAN NATIVE f ] URBAN — INNER CITY [ ]FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [X] OTHER Residents of Public Housing PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 17 Alcohol&2-3 Drug Beds PROGRAM DURATION 3-5 Days 13. PROGRAM STATUS: [ j NEW — PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 17 detoxification beds to alcoholdependent adults. Also provides 2-3 detoxification beds to residents of the Las Deltas Housing development who are clients of North Star's Treatment Program,(funded by the CSAT Critical Populations grant). Program is a social model(non—medical)residential program. Services include information and referrals to appropriate services and informal one—to—one counseling. Tape and discussion meetings and rap sessions are provided daily. Alcoholics Anonymous meetings are held at the center three times weekly. Medical assistance is available on a referral basis,as needed. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OT14ER SERVICES ( ] OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES [ ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE [ ] PPN ( j HIV SGT—ASIDE ( ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 64 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X I ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X I DRUG [X I Original BUDGET DETAIL [ ] COMBINED [ ] Ameaded PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ J PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Adolescent Treatment Center#443&444 A010735 Contra Costa ThunderRoad D010735 4. CONTACT PERSON'S NAME: S.PHONE NUMBER: 6. SERVICE CODE: (510)653—5040 Rand Snowden Ext.# 51 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 390 40th Street [ ] Intermittent Oakland CA 94609 Same 9.[ I IN COUNTY CONTRACT PROVIDER ( ] COUNTY OPERATED 10.(X I NONPROFIT [.XLOUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( ] GENERAL POPULATION [X I GENERAL POPULATION ( I DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) [ I GAY/LESBIAN j [ ] WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ I HOMELESS [ I PERINATAL (NOT HISPANIC) [ I MULTIPLE DIAGNOSIS i (X] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( j AMERICAN INDIAN OR ALASKAN NATIVE ( I URBAN — INNER CITY i f )FAMILIES j ]ASIAN/ASIAN—AMERICAN/ [ ) SUBURBAN [ ] OTHER PACIFICISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ]OTHER 1 12. CAPACITY: STATIC_4 Alcohol&4 Drug Beds_ PROGRAM DURATION 3 Months 13. PROGRAM STATUS: ( I NEW— PROJECTED START DATE [X] EXISTING ( I EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 4 residential beds and recovery services for drug dependent adolescents and 4 residential beds and recovery services for alcohol dependent adolescents. Services include individual,group and family counseling,chemical dependency education, 12—Step recovery groups, recreational therapy,and a school program operated by the Alameda County Office of Education. i 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( j OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES [ J PERINATAL PILOT ( ] CIW [ ] IDU INTERIM SERVICES [ ) PERINATAL SET—ASIDE [ ] PPN [ ] HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each servicc code. ADP 7229 (4/93) IV - 65 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG (X] Original BUDGET DETAIL ( ] COMBINED ( ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [X] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Bi—Bert Corporation#722&640 Contra Costa Diablo Valley Ranch A070060 C070060 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)672-5656 Marcia Stover Ext.# 51 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential P.O.Box 5487 11540 Marsh Creek Road [ ] Intermittent Concord CA 94524 Clayton,CA 94517 9.[X J IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X ] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION [X) GENERAL POPULATION ( ] DISABLED [X] MEN [ ] WHITE(NOT HISPANIC) ( J GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ J HISPANIC [ J RURAL/ISOLATED [ ] ELDERLY ( )AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY ( ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ ( ]SUBURBAN ( ] OTHER PACIFIC ISLANDER ( J PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [X ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_43 Alcohol&8 Parolee Beds PROGRAM DURATION 90 Days 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE (X] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 43 social model residential beds and recovery services for adult alcohol dependent men. Also provides 8 residential beds and recovery services to state prison parolees upon discharge.from prison(funded by Parolee Services BASN Project). Services include alcohol and other drugs education,individual and group process,relationships and family groups,relapse prevention groups,literacy skill training,job development,chef school,AIDS education,alumni groups,social and recreational events,etc. A minimum of 30 days stay is required. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM (X j BASN ( J TB SERVICES ( ] PERINATAL PILOT [ J CIW O IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ ] PPN ( ] HIVSET—ASIDE ( ] PERINATAL INTERM SERVICES ( J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 66 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X J Original BUDGET DETAIL ( J COMBINED [ ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [X] PAROLEE SV. I. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Bi—Betz Corporation#642 Contra Costa Gre o Recovery Center C070030 4.CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)798-0908 Dale Sweetland Ext.# 51 7.MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential P.O.Box 5487 1311 Aberdeen Court [ ] Intermittent Concord CA 94524 Concord,CA 94518 9.[X ] IN COUNTY CONTRACT PROVIDER ( j COUNTY OPERATED 10.j X]NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( ] GENERAL POPULATION (X] GENERAL POPULATION [ ]DISABLED [X] MEN ( ] WHITE(NOT HISPANIC) [ ] GAYILESBIAN ( ] WOMEN ONLY ( ]BLACK/AFRICAN—AMERICAN f ]HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ]RURAL/ISOLATED [ ] ELDERLY ( ] AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ ( ] SUBURBAN ( ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [X J CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC—1 Bed PROGRAM DURATION 90 Days 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 1 social model residential bed and recovery services to working male state prison parolees upon discharge from prison (funded by Parolee Services BASN Project). Services include recovery groups Sunday through Thursday evenings. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [X] BASN { J TB SERVICES [ ] PERINATAL PILOT [ J CIW ( J IDU INTERIM SERVICES [ j PERINATALSET—ASIDE ( j PPN [ J HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES f ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 67 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS (X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ X J DRUG X] Original BUDGET DETAIL [ ] COMBINED j Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [X J PAROLEE SV: 1. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Bi—Sett Corporation#7.22,#582,#641 A070010,D070010 Contra Costa Ozanam Center C070010 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: .SERVICE CODE: (510)676-4840 Jonah Powell Ext.# 51 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 2931 Prospect St. ( ] Intermittent Concord,CA 94518 Same 9.[X I IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( ] GENERAL POPULATION (X] GENERAL POPULATION [ ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [X] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN. [ ] HOMELESS [ ) PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT ( J HISPANIC O RURAL/ISOLATED ( ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN ( ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE ( ] OTHER 12. CAPACITY: STATIC 13 Alcohol,6 Drug,2 Parolee Beds PROGRAM DURATION 80 Days 13. PROGRAM STATUS: [ J NEW— PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 13 social model residential beds and recovery services for adult alcohol dependent women. Also provides 6 beds for adult drug dependent women,and 2 beds for state prisonparolees upon discharge from prison(funded by Parolee Services BASN Project). Services include alcohol and other drug education,individual and group process,parenting skills training, relapse prevention physical exercise program,job skills development,alumna groups, 12 step self help groups. AIDS education,etc. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM (X j BASN ( ] TB SERVICES ( ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [ ) PERINATAL SET—ASIDE O PPN [ ] HIV SET—ASIDE ( ) PERINATAL INTERM SERVICES ( J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 68 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [XI DRUG [X] Original BUDGET DETAIL [ j COMBINED [ ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [X] PAROLEE SVS. 1. COUNTY NAME: 2-PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Discovery House D070750 C070750 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)229—4212 Adriane Bento Ext.# 51 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 4639 Pacheco Blvd. ( ] Intermittent Martinez CA 94553 Same 9.[ ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION [X] GENERAL POPULATION [ ]DISABLED [X] MEN [ J WHITE(NOT HISPANIC) f ] GAYILESBIAN [ ]WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN ( ]OTHER PACIFIC ISLANDER ( J PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [ J CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 22 Drug&2 Parolee Beds PROGRAM DURATION 3 Months 13_ PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES f I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 22 social model residential beds and recovery services for adult drug dependent men. Also provides 2 beds and recovery services to state prison parolees upon discharge from prison(funded by Parolee Services BASN Project). Services include drug education,individual and group therapy, 12—Step groups,vocational assessment and counseling, and job finding skill groups. I 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM IX ] BASN I I TB SERVICES [ ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES ( ] PERINATALSET—ASIDE [ ] PPN [ J HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES f ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 69 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X I Original BUDGET DETAIL [ ] COMBINED ] Amended PROGRAM DESCRIPTION [ ],PERINATAL FY 1993/94 [ ] PAROLEE SVS. I. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: East County Detoxification#743 Contra Costa Women's Recovery Prozram A070738 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)458-1616 Kay Quinn Ext.# 51 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 500 School Street [ ] Intermittent Pittsburg,CA 94565 Same 9.[X ] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION [X ]GENERAL POPULATION [ ]DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [X ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC ( J RURAL/ISOLATED [ ] ELDERLY [ ] AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ ] FAMILIES [ ] ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 5 Beds PROGRAM DURATION 3 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X J EXISTING [ ] EXPANSION OF SERVICES [ i ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 5 residential beds and recovery services to alcohol dependent women. Services include education and individual and group counseling with emphasis on wellness. 15. SP V SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM ( ] BASN ( ] TB SERVICES [ ] PERINATAL PILOT ( ] CIW ( ] IDU INTERIM SERVICES ( J PERINATAL SET—ASIDE ( ] PPN ( ] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES ( J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 70 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( J DRUG [X] Original BUDGET DETAIL [ j COMBINED [ j Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 ( ] PAROLEE SVS. 1. COUNTY NAME: 2-PROVIDER'S NAME: 3. PROVIDER'S CODE: Neighborhood House of North Richmond#723 Contra Costa Fauerso New Way Center A070004 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)235-9780 site(510)233-1270 Steve Mitchell Ext.# 51 7. MAILING ADDRESS S.FACILITY ADDRESS [ j Confidential 305 Chesley Avenue 208 —23rd Street [ ] Intermittent Richmond CA 94801 Richmond,CA 94804 9.1 X) IN COUNTY CONTRACT PROVIDER j ]COUNTY OPERATED 10.[X j NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION (X] GENERAL POPULATION [ ]DISABLED [X] MEN [ ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN ( ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ j MULTIPLE DIAGNOSIS ( J YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ] AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ )FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ ( ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [X] PUBLIC INEBRIATES [ ) NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 14 Beds PROGRAM DURATION 90 Days 13. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE (X J EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 14 social model residential beds and recovery services for alcohol dependent men between the ages 18-65 years. Services include: recovery education and information;life management skill assistance; health referrals;court and probation assistance; family linkages; alumni contact follow—up and fellowship; and A.A referrals in—house and in the community. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ J BASN ( ] TB SERVICES [ ] PERINATAL PILOT ( ] CIW ( J IDU INTERIM SERVICES [ j PERINATALSET—ASIDE [ J PPN ( [ HIVSET—ASfDE [ ] PERINATAL INTERM SERVICES [ J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 71 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG X] Original BUDGET DETAIL [ J COMBINED ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ X] PAROLEE SV: 1_ COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: A070797,C070797 Contra Costa Sunrise Hose#736,#578 #637 D070797 4. CONTACT PERSON'S NAME: S.PHONE NUMBER: 6. SERVICE CODE: (510)825-7049 Donald Travins or Terri WhitneyExt.# 51 7. MAILING ADDRESS 8. FACILITY ADDRESS [ ] Confidential 135 Mason Circle,Unit M ( J Intermittent Concord CA 94520 Same 9.[X ] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED. _ 10.[X]NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS (X] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ ] MEN ( ] WHITE(NOT HISPANIC) [ ] GAYILESBIAN [ ] WOMEN ONLY ( ] BLACK/AFRICAN-AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN - INNER CITY ( ] FAMILIES ( ]ASIAN/ASEAN-AMERICAN/ ( ]SUBURBAN ( ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC-11 Alcohol,12 Drug&2 Parolee Beds PROGRAM DURATION 90 Days 13. PROGRAM STATUS: [ ] NEW- PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 11 social model residential beds and recovery services for adult men and women dependent on alcohol and 12 beds and recovery services for drug dependent men&women. Also provides 2 beds and recovery services to state prison parolees upon discharge from prison(funded by Parolee Services BASN Project). Services include; group(educational and life-skill as well as process),one-to-one recovery counseling, AA and NA meetings,study groups,recreation and aftercare. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [X] BASN ( J TB SERVICES ( ] PERINATAL PILOT f ] CIW ( ] IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE [ ] PPN ( ] HIV SET—ASIDE ( ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. -,DP 7229 (4/93) IV - 72 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [X] PERINATAL FY 1993/94 [ ] PAROLEE SVS_ I. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Tri—County Women's Recovery Services#429 Contra Costa The Rectory A070040 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)236-3139 Albione Becnel Ext.# 51 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 1901 Church Lane [ ] Intermittent San Pablo CA 94806 Same 9.[X ] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X ] NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( ] GENERAL POPULATION [X ] GENERAL POPULATION [ ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ]WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS (X J PERINATAL (NOT HISPANIC) [ j MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT ( ] HISPANIC ( ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN ( ] OTHER PACIFICISLANDER [ ] PUBLIC INEBRIATES [ J NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 15 Beds PROGRAM DURATION 90 Days 13. PROGRAM STATUS: [ ] NEW — PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides,15 social model residential beds and recovery services for pregnant and/or parenting substance abusing women and their children. Services include 24 hour guidance, individual or group recovery,alcohol/drug education,growth groups,women's group, recreation activities,recovery and exit planning,family education,parenting program,children's activities,and case management. 1S. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES [ ] PERINATAL PILOT ( ] CIW ( ] IDU INTERIM SERVICE=S [X] PERINATALSET—ASIDE ( ] PPN ( ] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 73 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X] Original BUDGET DETAIL [ ] COMBINED J Amended PROGRAM DESCRIPTION [X] PERINATAL FY 1993/94 [ J PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Tri—County Women's Recovery Services,Inc.#617 Contra Costa La Casa Ujima C070712 4. CONTACT PERSON'S NAME: 5. PHONE-NUMBER: 6. SERVICE CODE: (510)236-3139 site(510)229-0230 Albione Becnel Ext.# 51 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 1901 Church Lane 904 Mellus Street ( ] Intermittent San Pablo,CA 94806 Martinez,CA 945553 9.[X] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( ) GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED ( ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS (X] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC ( ] RURAL/ISOLATED ( ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ] FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ ( ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES ( j NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 21 Beds PROGRAM DURATION 6 Months 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE (X] EXISTING ( ]EXPANSION OF SERVICES [ ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 21 residential beds and recovery services for alcohol and/or drug dependent women and their children. Program offers social model recovery and includes individual treatment planning,individual and group counseling, family counseling, 12—Step meetings,education,and recreation. The family care component also provides child enrichment activities,groups and childcare. Parents receive parenting skills training. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( ] BASN [ J TB SERVICES (X j PERINATAL PILOT ( ] CIW ( ] IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ ] PPN ( ] HIVSET—ASIDE ( ] PERINATAL INTERM SERVICES O PPP NOTE: Complete one ADP 7229 for each service code. IDP 7229 (4/93) IV 74 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( ] DRUG [X] Original BUDGET DETAIL [ J COMBINED j ] Amended PROGRAM DESCRIPTION (X) PERINATAL FY 1993/94 ( J PAROLEE SVS. I. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: East County Community Detoxification Center#630 Contra Costa Wollam House C070738 4. CONTACT PERSON'S NAME: S.PHONE NUMBER: 6.SERVICE CODE: (510)458-1616 Ka Quinn Ext.# 56 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 500 School Street 510 Wollam [ ] Intermittent Pittsburg,CA 94565 Pittsburg,CA 94565 9.[X ] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X ]NONPROFIT OUT OF COUNTY CONTRACT t PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED ( ] MEN ( ] WHITE(NOT HISPANIC) [ ]GAY/LESBIAN [ ] WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ ] HOMELESS (X] PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ J RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ) CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_6 Women,6 Children Beds PROGRAM DURATION 6 Months 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced orspecial services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 12 transitional living residential beds for alcohol and drug dependent women and their children. Services include recovery support groups,recreation and 12—Step meetings. The family program includes access to children's activities and groups, family groups and parenting skills training. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN [ J TB SERVICES [ ] PERINATAL PILOT [ J CIW [ ] IDU INTERIM SERV(CES [X] PERINATAL SET—ASIDE [ ] PPN ( ] HIV SET—ASIDE ( ) PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 75 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X J Original BUDGET DETAIL ( ] COMBINED ] Amended PROGRAM DESCRIPTION [X ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Contra Costa Tri—County Women's Recovery Services,Inc.#623 C070040 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6. SERVICE CODE: (510)236-3139 Albione Becnel Ext.# 56 7. MAILING ADDRESS 8. FACILITY ADDRESS [ ] Confidential 1901 Church Lane 1515 24th Street ( ] Intermittent San Pablo,CA 94806 Richmond, CA 94804 9.[X] IN COUNTY CONTRACT PROVIDER [ )COUNTY OPERATED 10.(X]NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( ] GENERAL POPULATION [X)GENERAL POPULATION ( ] DISABLED ( ] MEN [ ] WHITE(NOT HISPANIC) ( ] GAY/LESBIAN ( ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [X ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT [ J HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ ( ]SUBURBAN ( ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ J CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC-6 Women/6 Children Beds_ PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING [ ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides 12 transitional residential beds to alcohol and/or drug dependent women and their children. Services include recovery support groups,recreation and 12—Step meetings. The family care component also assists women residing in treatment with their children by providing children's actvities and groups, family groups,and parenting skills training. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( ] BASN [ ] TB SERVICES [ J PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [X] PERINATAL SET—ASIDE [ ) PPN [ j HIV SET—ASIDE ( ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 76 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X J ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X] Original BUDGET DETAIL [ ] COMBINED ] Acucudcd PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 ( ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa State Department of Rehabilitation A070100 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)689-3010 Chuck Murphy Ext.# 64 7. MAILING ADDRESS S.FACILITY ADDRESS [ J Confidential 830 K Street 2285 Morello Avenue ( ] Intermittent Sacramento,CA 95814 Pleasant Hill,CA 94523 9.1 )IN COUNTY CONTRACT PROVIDER ( ] COUNTY OPERATED 10.[X)NONPROFIT X.1 OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X ] GENERAL POPULATION [X] GENERAL POPULATION j ] DISABLED ( ] MEN [ ]WHITE(NOT HISPANIC) ( ]GAY/LESBIAN [ ] WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ ]HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED . [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN ( ] OTHER PACIFIC ISLANDER [ J PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 150 Year PROGRAM DURATION varies 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X ] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 114. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. I nclude the program modality. Provides employment rehabilitation services and training for recovering alcoholics in County alcohol programs. Eligibility requirements include 60 continous days of sobriety and active participation in a treatment program. 1S. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ J BASN [ ] TB SERVICES ( ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ ] PPN [ J HIVSET—ASIDE f J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV 77 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X] Original BUDGET DETAIL (X] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention and Recovery Services Contra Costa AIRS Central C070001 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)313-1050 Adanna HenryExt.# 65 7. MAILING ADDRESS 8.FACILITY ADDRESS ( J Confidential 10 Douglas Drive,Suite 130 [ ] Intermittent Martinez CA 94553 Same 9.[ J IN COUNTY CONTRACT PROVIDER (X]COUNTY OPERATED 10.f X] NONPROFIT OUT OF COUNTY CONTRACT f I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY ( ]BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ J AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ ]FAMILIES [ )ASIAN/ASIAN—AMERICAN/ ( ] SUBURBAN ( ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ]NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 80 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides clients with HIV education, risk reduction strategies and referrals to HIV testing. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM ( ] BASN [ j TB SERVICES [ ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [ J PERINATAL SET—ASIDE ( ] PPN [X ] HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES [ j PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV 78 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [ X] Original BUDGET DETAIL [XJ COMBINED ( ]Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. I. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention and Recovery Services Contra Costa AIRS East C070003 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)427-8630 Adanna HenryExt.# 65 7. MAILING ADDRESS 8. FACILITY ADDRESS [ ] Confidential 2400 Sycamore Drive,Suite 36 [ ] Intermittent Antioch CA 94509 Same 9.( ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION [ j DISABLED [ j MEN ( ] WHITE(NOT HISPANIC) ( ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ J HOMELESS ( ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC ( ] RURAL/ISOLATED [ ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ ] FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ ( ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ) PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ J CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 60 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES f I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provide clients with HIV education,risk reduction strategies and referrals to HIV testing. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN [ ] TB SERVICES [ J PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE [ I PPN IX ] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 79 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 ( ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa BAART#515— PittsburgD070709 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6.SERVICE CODE: (510)427—2285 Stephen Sooter Ext.# 65 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 45 Civic Drive ( ] Intermittent Pittsburg,CA 94565 1 Same 9.[X ] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION (X] GENERAL POPULATION [ ] DISABLED [ ] MEN ( ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS ( ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 375 PROGRAM DURATION 1 Year 13. PROGRAM STATUS: [X ] NEW — PROJECTED START DATE 10/1/93 [ ] EXISTING f ] EXPANSION OF SERVICES f ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides HIV education and pre and post HIV test counseling to methadone clients and their needle—sharing and/or sexual partners. Blood samples are drawn at the clinic and sent to the county's Public Health Laboratory where the blood is tested. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN [ ] TB SERVICES ( ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE [ ] PPN (X] HIV SET—ASIDE [ ] PERINATAL INTERM SERVICES ( I PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 80 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [X] DRUG [ X] Original BUDGET DETAIL [ ] COMBINED [ I Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1.COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa BAART#515— Richmond D070709 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)232-0874 Phillip MacFarland Ext.# 65 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 2910 Cutting Blvd. [ ] Intermittent Richmond CA 94804 Same 9.(X J IN COUNTY CONTRACT PROVIDER [ J COUNTY OPERATED T10.(X ] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X I GENERAL POPULATION (X] GENERAL POPULATION ( ] DISABLED ( ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ J WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS ( J PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ j AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( J FAMILIES [ ] ASIAN/ASIAN—AMERICAN/ ( ) SUBURBAN ( ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE ( ]OTHER 12. CAPACITY: STATIC 375 PROGRAM DURATION 1 Year 13. PROGRAM STATUS: [X] NEW — PROJECTED START DATE 10/1/93 [ ] EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides HIV education and pre and post HIV test counseling to methadone clients and their needle—sharing and/or sexual partners. Blood samples are drawn at the clinic and sent to the county's Public Health Laboratory where the blood is tested. i 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ ] BASN [ TB SERVICES [ J PERINATAL PILOT ( ] CIW [ ] IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE [ I PPN JXJ HIV SET—ASIDE ( J PERINATAL INTERM SERVICES [ J PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV 81 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TRFATMENT PROGRAMS [ ] DRUG X] Original BUDGET DETAIL [X] COMBINED Amended PROGRAM DESCRIPTION [ ) PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Discovery House C070750 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6.SERVICE CODE: (510)229-4212 Adriane Bento Ext.# 65 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 4639 Pacheco Blvd. [ ] Intermittent Martinez,CA 94553 Same 9.[ ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X J NONPROFIT Ll OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION [X J GENERAL POPULATION [ ] DISABLED [X J MEN [ J WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS " [ J YOUTH/ADOLESCENT [ ] HISPANIC [ ]RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES j ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES j ] NATIVE HAWAIIAN [ J CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 24 Beds PROGRAM DURATION 3 Months 13. PROGRAM STATUS: [ J NEW— PROJECTED START DATE [X J EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides clients with HIV education,risk reduction strategies and referrals to HIV testing. I 15, SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES [ J PERINATAL PILOT [ ] CIW [ J IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ ] PPN [X ] HIVSET—ASIDE [ J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. AQP 7229 (4/93) IV - 82 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( J DRUG [ X J Original BUDGET DETAIL [X] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 ( J PAROLEE SVS. 1. COUNTY NAME: 2-PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa San Pablo Discovery Center C070732 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)374—3332 Adanna HenryExt.# 65 7. MAILING ADDRESS 8. FACILITY ADDRESS ( ] Confidential 2523 El Portal Drive,Suite 102 [ j Intermittent San Pablo,CA 94806 Same 9.( J IN COUNTY CONTRACT PROVIDER [X J COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X ] GENERAL POPULATION [ ] DISABLED ( J MEN ( ] WHITE(NOT HISPANIC) ( J GAYILESBIAN f ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ J PERINATAL (NOT HISPANIC) f ] MULTIPLE DIAGNOSIS j ] YOUTH/ADOLESCENT ( ] HISPANIC ( J RURAL/ISOLATED ( J ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( J FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER ( ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER i 12. CAPACITY: STATIC 60 PROGRAM DURATION 6-9 Months 113. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X J EXISTING ( ] EXPANSION OF SERVICES f I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides clients with HIV education,risk reduction strategies,and referrals to HIV testing. i i 15_ SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( ] BASN [ J TB SERVICES [ ] PERINATAL PILOT [ J CIW [ j IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE [ ] PPN [X J HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES [ J PPP ,I NOTE: Complete one ADE'7229 for each service code. ADP 7229 (4/93) IV - 83 \ DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X] Original BUDGET DETAIL [X] COMBINED ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2-PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Soiourne Community Cou seling Center C070761 4. CONTACT PERSON'S NAME: S.PHONE NUMBER: 6. SERVICE CODE: (510)374-3813 Kirk Brocks Ext.# 65 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ) Confidential 3029 MacDonald Avenue ( ] Intermittent Richmond CA 94804 Same 9.( ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X j NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X j GENERAL POPULATION [X I GENERAL POPULATION [ j DISABLED ( ] MEN ( ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY ( ]BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT [ ] HISPANIC ( J RURAL/ISOLATED [ ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ I FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ [ ) SUBURBAN ( ] OTHER PACIFIC ISLANDER [ ) PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 80 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE (X] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special.services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides clients with HIV education,risk reduction strategies,and referrals to HIV testing. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ I OPTIONS PROGRAM ( ] BASN [ ] TB SERVICES [ ] PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE ( ] PPN [XI HIV SET—ASIDE ( ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 84 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ ] ALCOHOL COUNTY PREVENTION AND TREATMENT ?ROGRAMS [ j DRUG [ X] Original BUDGET DETAIL (X] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3.PROVIDER'S CODE: Contra Costa Tri—Cities Discovery Center o C070731 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)222-9838 Linda Schaefer Ext.# 65 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 2586 Appian Way [ J Intermittent Pinole,CA 94564 Same 9.[ J IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.(X ] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION (X]GENERAL POPULATION ( ]DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) [ ]GAY/LESBIAN [ ]WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ]PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT [ ]HISPANIC [ ] RURAL/ISOLATED [ ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY ( ]FAMILIES ( ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN ( ] OTHER PACIFIC ISLANDER [ J PUBLIC INEBRIATES [ ]NATIVE HAWAIIAN [ J CRIMINAL JUSTICE [ ]OTHER L 112. CAPACITY: STATIC 60 PROGRAM DURATION 6-9 Months 13. PROGRAM STATUS: j j NEW— PROJECTED START DATE j X j EXISTING ( EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. I Provides clients with HIV education, risk reduction strategies,and referrals to HIV testing. i 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( ] BASN ( [ TS SERVICES [ ] PERINATAL PILOT ( ] CIW ( J IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE [ I PPN [X] HIV SET—ASIDE ( J PERINATAL INTERM SERVICES j ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 85 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS j ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X] Original BUDGETDETAIL [ ] COMBINED ] Amended PROGRAM DESCRIPTION [X ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Born Free Project 0070080 4. CONTACT PERSON'S NAME: S.PHONE NUMBER: 6. SERVICE CODE: (510)646-1165 site(510)374-8085 Leslie Lieberman Ext.# 68 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 111 Allen Street 327 East Leland Road [ ] Intermittent Martinez,CA 94553 1 Pittsburg,CA 94565 9.[ ] IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X I NONPROFIT ( 1 OUT OF COUNTY CONTRACT ( ]PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [ ] GENERAL POPULATION (X] GENERAL POPULATION [ ] DISABLED [ ] MEN ( ]WHITE(NOT HISPANIC) ( j GAY/LESBIAN [ ] WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN ( ] HOMELESS [X]PERINATAL (NOT HISPANIC) [ I MULTIPLE DIAGNOSIS f ] YOUTH/ADOLESCENT [ ] HISPANIC ( ] RURAL/ISOLATED ( ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES ( ] ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN ( ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 75 PROGRAM DURATION 2 Years 13. PROGRAM STATUS: [ J NEW— PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides comprehensive case management services to pregnant and/or parenting women in East County. Services include outreach coordination,referrals to drug and alcohol services,medical services,legal and foster care, mental health,education and vocational services,financial,housing and emergency needs. These services are accomplished by assessment,referrals,and individual service plans with specialized follow—up in cooperation with client's treatment program. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ I OPTIONS PROGRAM [ ] BASN [ J TB SERVICES [X] PERINATAL PILOT ( ] CIW [ J IDU INTERIM SERVICES [ j PERINATAL SET—ASIDE [ ] PPN ( ] HIV SET—ASIDE ( ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 86 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ J ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG (X] Original BUDGET DETAIL ( ] COMBINED ( ]Amended PROGRAM DESCRIPTION (X ] PERINATAL FY 1993/94 f ] PAROLEE SVS. 1. COUNTY NAME: 2-PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa East Bay Perinatal Council#618 C070771 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)452-3441 Denise Peebles Ext.# 68 7. MAILING ADDRESS 8. FACILITY ADDRESS [ ] Confidential 654 13th Street 3838 MacDonald Avenue j ] Intermittent Oakland,CA 94612 Richmond,CA 94804 9.[X] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X J NONPROFIT OUT OF COUNTY CONTRACT I PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS ( ] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ J MEN [ ] WHITE(NOT HISPANIC) ( ]GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN { ] HOMELESS [X] PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC ( ] RURAL/ISOLATED [ ] ELDERLY j ]AMERICAN INDIAN OR ALASKAN NATIVE j )URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN ( ] OTHER PACIFIC ISLANDER [ J PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( J CRIMINAL JUSTICE ( ] OTHER 12. CAPACITY: STATIC 100 Women PROGRAM DURATION 2 Years 13_ PROGRAM STATUS: [ J NEW— PROJECTED START DATE [X J EXISTING EXPANSION OF SERVICES ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides comprehensive case management services to pregnant and/or parenting women in West County. Services include outreach coordination,referrals to drug and alcohol services,medical services,legal and foster care, mental health,education and vocational services,financial,housing and emergency needs. These services are accomplished by assessment,referrals and individual service plans with specialized follow—up in cooperation with client's treatment program. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM ( ] BASN ( ) TB SERVICES [X J PERINATAL PILOT ( ] CIW j J IDU INTERIM SERVICL'•S O PERINATALSET—ASIDE [ J PPN ( J HIVSET—ASIDE ( ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 87 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS ( ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( ] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 (X] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Substance Abuse Administration — Parolee Contra Costa Case Management 0070798 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)313-6386 Adanna HenryExt.# 68 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 595 Center Avenue,Suite#200 [ ] Intermittent Martinez,CA 94553 Same 9.( ]IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X]NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION ( ] DISABLED [ ] MEN f J WHITE(NOT HISPANIC) [ ] GAY/LESBIAN j [ ] WOMEN ONLY ( J BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ ] PERINATAL (NOT HISPANIC) ( j MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ]HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ ( ]SUBURBAN ( ] OTHER PACIFIC ISLANDER ( j PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [X] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 60 PROGRAM DURATION N/A 13, PROGRAM STATUS: ( ] NEW— PROJECTED START DATE [X j EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to.this area that describes the services provided. Include the program modality. Provides case management services to parolees who are at risk of discontinuing substance abuse treatment services. This activity is supported by Parolee Services Funds— the Bay Area Services Network. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ j OPTIONS PROGRAM [X ] BASN f J TB SERVICES ( J PERINATAL PILOT [ ] CIW [ J IDU INTERIM SERVICE'S [ J PERINATALSET—ASIDE ( ] PPN ( J HIVSET—ASIDE [ ] PERINATAL INTERM SERVICES ( ] PPP NOTE: Complete one ADI'7229 for each service code. ADP 7229 (4/93) IV - 88 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS (X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROCRAMS ( ] DRUG ( X] Original BUDGET DETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 ( ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa -ug Abuse Council DUI Program A070070 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6. SERVICE CODE: (510)932-8100_ Michael R.King Ext.# 90 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 171 Mayhew Way,Suite 210 [ ] Intermittent Pleasant Hill,CA 94523 Same 9.[X] IN COUNTY CONTRACT PROVIDER [ ] COUNTY OPERATED 1 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS (X] GENERAL POPULATION [X J GENERAL POPULATION [ ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) ( ] GAYILESBIAN [ ] WOMEN ONLY [ ]BLACK/AFRICAN—AMERICAN ( ] HOMELESS [ J PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS (X] YOUTH/ADOLESCENT ( ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY f ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES ( )ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ) PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN ( ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_350 Year Adult,350 Youth PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ) NEW— PROJECTED START DATE (X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced orspeciai services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides Level 1 Driving under the Influence(DUI)classes for first offender adults. Services include education about the dangers of drinking and driving and promoting awareness about substance abuse,addiction,and recovery. The Alcohol Offense Program is for youth cited for the possession of alcohol or drugs and minors arrested for drinking and driving (DUI). Teens are referred by probation or diverted by the courts,police orschools. Two Saturday classed are required. Services j include education on addiction,recovery,and available resources. I 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ j OPTIONS PROGRAM [ ] BASN ( J TB SERVICES ( ] PERINATAL PILOT [ ] CIW [ J IDU INTERIM SERVICES [ ] PERINATALSET—ASIDE f ] PPN O HIV SET—ASIDE [ J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 89 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [ X J ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X] Original BUDGET DETAIL ( ] COMBINED ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention&Recovery Services Contra Costa AIRS Central — DUI Program A070001 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)313-1050 Steve Loveseth Ext. # 90 7. MAILING ADDRESS 8.FACILITY ADDRESS ( ] Confidential 10 Douglas Drive,Suite 130 [ ] Intermittent Martinez,CA 94553 Same 9.( J IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.(X] NONPROFIT [ ] OUT OF COUNTY CONTRACT I ( ]PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ j WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ J HOMELESS [ ] PERINATAL (NOT HISPANIC) [ J MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT ( ] HISPANIC [ J RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN ( J OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_700 Year PROGRAM DURATION_First Offender—limos,Multiple Offender-18mos 13. PROGRAM STATUS: ( J NEW— PROJECTED START DATE [X] EXISTING ( J EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided_ A pamphlet may be stapled to this area that describes the services provided. I nclude the program modality. The First Offender Drinking Driver Program provides services to adults with first DUI conviction or convictions treated as first offense. Services include group counseling and for persons with blood alcohol content.20 or above,individual counseling. The Post—Conviction Drinking Driver Program provides services to persons with two or more drinking driver convictions. Services include weekly individual and group counseling and alcohol education for 18 months. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM [ ] BASN [ ] TB SERVICES ( ] PERINATAL PILOT [ ] CIW ( j IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE ( ] PPN ( ( HIV SET—ASIDE [ J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 90 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X] Original BUDGET DETAIL ( J COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 [ J PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention&Recovery Services Contra Costa AIRS East—DUI Program A070003 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)427-8630 Steve Loveseth Ext.# 90 7. MAILING ADDRESS 8. FACILITY ADDRESS ( ] Confidential 2400 Sycamore Drive,Suite#36 [ ] Intermittent Antioch,CA 94509 Same 9.[ ] IN COUNTY CONTRACT PROVIDER [X]COUNTY OPERATED 10.[X J NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED ( ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY ( ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS ( ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT ( ]HISPANIC [ ) RURAL/ISOLATED [ ] ELDERLY [ ] AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ]FAMILIES [ J ASIAN/ASIAN—AMERICAN/ ( ] SUBURBAN [ ] OTHER PACIFICISLANDER ( ] PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN ( ] CR IMINAL JUSTICE [ ] OTHER 12. CAPACIT STATIC 400 PROGRAM DURATION—First Offender-6 mos,Multiple Offender— 18 mos _ 13. PROGRAM STATUS: ( J NEW— PROJECTED START DATE [X ] EXISTING EXPANSION OF SERVICES I I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced orspecial services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. The First Offender Drinking Driver Program provides services to adults with first DUI conviction or convictions treated as first offense. Services include group counseling and for persons with blood alcohol content.20 above,individual counseling. The Post—Conviction Drinking Driver Program provides services to adults with two or more drinking convictions. Services include weekly individual and group counseling and alcohol education for 18 months. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN [ j TB SERVICES ( ] PERINATAL PILOT [ ] CIW [ ] IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE ( ) PPN [ ] HIV SET—ASIDE [ J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 91 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS (X] ALCO140L COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X j Original BUDGETDETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ j PERINATAL FY 1993/94 [ J PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Alcohol Intervention&Recovery Services Contra Costa AIRS West — DUI Pro am A070002 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6.SERVICE CODE: (510)374—3036 Steve Loveseth Ext.# 90 7. MAILING ADDRESS 8. FACILITY ADDRESS [ ] Confidential 3043 Research Drive,Suite 100 [ ] Intermittent Richmond,CA 94806 Same 9.[ ] IN COUNTY CONTRACT PROVIDER (X]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11_ MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X I GENERAL POPULATION [X]GENERAL POPULATION ( ] DISABLED ( ] MEN [ ] WHITE(NOT HISPANIC) [ ] GAY/LESBIAN ( ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( ] AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES ( ] ASIAN/ASIAN—AMERICAN/ [ ]SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ J NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_400 Year PROGRAM DURATION First Offender-6 mos,Multiple Offender-1S mos. 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING ( EXPANSION OF SERVICES ( ] ENHANCED SERVICES _ 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. The First Offender Drinking Driver Program provides services to adults with first DUI conviction or convictions treated as first offense. Services include group counseling and for persons with blood content.20,individual counseling. The Post—Conviction Drinking Driver Program provides services to adults with two or more drinking driver convictions. Services include weekly individual and group counseling and alcohol education for 18 months. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES ( J PERINATAL PILOT [ ] CIW ( ] IDU INTERIM SERVICES ( ] PERINATAL SET—ASIDE ( ] PPN [ ] HIVSET—ASIDE [ J PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for tach service code. ADI' 7229 (4/93) IV - 92 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS ( ] DRUG [X] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2-PROVIDER'S NAME: 3. PROVIDER'S CODE: Bi—Bett Corporation Contra Costa First Offender Drinking Driver Program A079010 4. CONTACT PERSON'S NAME: S. PHONE NUMBER: 6.SERVICE CODE: (510)937—5713_ Kit Mount Ext.# 90 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 3748 Buskirk Avenue,Suite 1032 [ ] Intermittent Concord,CA 94523 Same 9.[X] IN COUNTY CONTRACT PROVIDER ( ]COUNTY OPERATED 10.[X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION (X] GENERAL POPULATION [ ] DISABLED [ ] MEN ( ] WHITE(NOT HISPANIC) ( ] GAY/LESBIAN ( ] WOMEN ONLY ( ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_358 Year PROGRAM DURATION_6 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE (X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14_ PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides Level 1 Driving Under the Influence(DUI)classes for first offender adults. Services include education about the dangers of drinking and driving and promoting awareness about substance abuse,addiction,and recovery. Classes in the Spanish language are also provided. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( ] OPTIONS PROGRAM ( ] BASN ( J TB SERVICES ( ] PERINATAL PILOT ( ( CIW ( J IDU INTERIM SERVICES [ ] PERINATAL SET—ASIDE ( ] PPN [ ] HIV SET—ASIDE [ j PERINATAL INTERM SERVICES f ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 93 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG [X] Original BUDGET DETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1.COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: East County Detoxification Center Contra Costa First Offender Drinking Driver Program A070738 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)458-1616_ Kay Quinn Ext.# 90 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidential 500 School Street ( I Intermittent Pittsburg,CA 94565 Same 9.[X] IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.[X] NONPROFIT f j OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE, PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [Xj GENERAL POPULATION [ ] DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ J WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) ( ] MULTIPLE DIAGNOSIS [ j YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ] ELDERLY [ j AMERICAN INDIAN OR ALASKAN NATIVE ( ] URBAN — INNER CITY [ ]FAMILIES [ )ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES ( ] NATIVE HAWAIIAN [ J CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 365 Year PROGRAM DURATION 6 Months 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE (X] EXISTING ( j EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides Level 1 Driving Under the Influence(DUI)classes for first offender adults. Services include education about the dangers of drinking and driving and promoting awareness about substance abuse,addiction,and recovery. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ J OPTIONS PROGRAM [ ] BASN ( ] TB SERVICES [ J PERINATAL PILOT ( [ CIW ( J IDU INTERIM SERVICES [ j PERINATALSET—ASIDE [ ] PPN ( J HIVSET—ASIDE ( ] PERINATAL INTERM SERVICES [ j PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 94 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [XJ ALCOHOL COUNTY PREVENTION AND TREATMENT PRCGRAMS [ ] DRUG IX] Original BUDGET DETAIL [ ] COMBINED [ ] Amended PROGRAM DESCRIPTION [ ] PERINATAL FY 1993/94 j ) PAROLEE SVS. 1.COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Neighborhood House of North Richmond A070004 4.CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6.SERVICE CODE: (5 10)235—9780,(510)233—1270 Steve Mitchell Ext.# 90 7. MAILING ADDRESS 8.FACILITY ADDRESS [ J Confidential 305 Chesley Avenue 208 —23rd Street [ ] Intermittent Richmond,CA 94801 Richmond,CA 94801 9.[XJ IN COUNTY CONTRACT PROVIDER [ ]COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS (X] GENERAL POPULATION [XJ GENERAL POPULATION [ ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ J GAYILESBIAN [ J WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ]HOMELESS [ ] PERINATAL (NOT HISPANIC) ( J MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLF_S CENT [ ) HISPANIC [ J RURAL/ISOLATED [ ] ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY [ ]FAMILIES [ ] ASIAN/ASIAN—AMERICAN/ f )SUBURBAN [ ] OTHER PACIFIC ISLANDER [ J PUBLIC INEBRIATES [ J NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC_105 Week PROGRAM DURATION o Months 13. PROGRAM STATUS: ( ] NEW— PROJECTED START DATE [X] EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides Level 1 Driving Under the Influence(DUI)classes for first offender adults. Services include education about the dangers of drinking and driving and promoting awareness about substance abuse,addiction,and recovery. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN [ J TB SERVICES [ ] PERINATAL PILOT ( ] CIW [ ] IDU INTERIM SERVICES [ ) PERINATAL SET—ASIDE ( J PPN ( J HIV SET—ASIDE ( ] PERINATAL 1NTERM SERVICES NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 95 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X ] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ ] DRUG X] Original BUDGET DETAIL [ ] COMBINED ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 [ ] PAROLEE SVS. 1. COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Occupational Health Services A070140 4. CONTACT PERSON'S NAME: 5.PHONE NUMBER: 6. SERVICE CODE: (510)798—8936 James O'Donnell Ext.# 90 7. MAILING ADDRESS 8.FACILITY ADDRESS [ ] Confidcniial 2401 Stanwell Drive [ ] Intermittent Concord,CA 94520 Same 9.[X ] IN COUNTY CONTRACT PROVIDER [ J COUNTY OPERATED 10.(X] NONPROFIT ( I OUT OF COUNTY CONTRACT ( ( PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION [ ] DISABLED [ ] MEN [ ]WHITE(NOT HISPANIC) [ ] GAY/LESBIAN [ ] WOMEN ONLY j ] BLACK/AFRICAN—AMERICAN [ ] HOMELESS [ ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS [ ] YOUTH/ADOLESCENT [ ] HISPANIC [ ) RURAL/ISOLATED [ ] ELDERLY ( ]AMERICAN INDIAN OR ALASKAN NATIVE [ ] URBAN — INNER CITY ( ] FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ ( ) SUBURBAN ( ] OTHER PACIFIC ISLANDER ( ) PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ) CRIMINAL JUSTICE ( ] OTHER 12. CAPACITY: STATIC 400 Year PROGRAM DURATION 6 Months 13. PROGRAM STATUS: [ ] NEW— PROJECTED START DATE [X] EXISTING ( ] EXPANSION OF SERVICES ( ] ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides Level 1 Driving Under the Influence(DUI)classes for first offender adults. Services include education about the dangers of drinking and driving and promoting awareness about substance abuse,addiction,and recovery. 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PAROLEE SERVICES OTHER SERVICES ( J OPTIONS PROGRAM ( ] BASN [ J TB SERVICES O PERINATAL PILOT [ ) CIW [ ) IDU INTERIM SERVICES [ ) PERINATALSET—ASIDE ( ] PPN ( ] HIVSET—ASIDE O PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. DP 29 (4/93) IV - 96 DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [X] ALCOHOL COUNTY PREVENTION AND TREATMENT PROGRAMS [ J DRUG [X] Original BUDGET DETAIL ( ] COMBINED [ ] Amended PROGRAM DESCRIPTION ( ] PERINATAL FY 1993/94 , [ ] PAROLEE SVS. 1.COUNTY NAME: 2.PROVIDER'S NAME: 3. PROVIDER'S CODE: Contra Costa Sunrise House A070797 4. CONTACT PERSON'S NAME: 5. PHONE NUMBER: 6. SERVICE CODE: (510)825-7049 Donald Travins or Jenny Pawlisa Ext.# 90 7. MAILING ADDRESS 8. FACILITY ADDRESS [ ] Confidential 135 Mason Circle,Unit M [ ] Intermittent Concord,CA 94520 Same 9.[X]IN COUNTY CONTRACT PROVIDER [ j COUNTY OPERATED 10.(X] NONPROFIT OUT OF COUNTY CONTRACT PROFIT 11. MAJOR FOCUS OF SERVICE: PRIMARY RACE/ETHNICITY OTHER POPULATIONS [X] GENERAL POPULATION [X] GENERAL POPULATION ( ] DISABLED [ ] MEN [ ] WHITE(NOT HISPANIC) [ j GAY/LESBIAN [ ] WOMEN ONLY [ ] BLACK/AFRICAN—AMERICAN ( ] HOMELESS ( ] PERINATAL (NOT HISPANIC) [ ] MULTIPLE DIAGNOSIS ( ] YOUTH/ADOLESCENT [ ] HISPANIC [ ] RURAL/ISOLATED [ ]ELDERLY [ ]AMERICAN INDIAN OR ALASKAN NATIVE [ ) URBAN — INNER CITY [ ]FAMILIES [ ]ASIAN/ASIAN—AMERICAN/ [ ] SUBURBAN [ ] OTHER PACIFIC ISLANDER [ ] PUBLIC INEBRIATES [ ] NATIVE HAWAIIAN [ ] CRIMINAL JUSTICE [ ] OTHER 12. CAPACITY: STATIC 237 Year PROGRAM DURATION 6 Months 13. PROGRAM STATUS: ( ] NEW — PROJECTED START DATE [X) EXISTING EXPANSION OF SERVICES I ENHANCED SERVICES 14. PROGRAM DESCRIPTION: (Describe the program design,activities and any enhanced or special services provided. A pamphlet may be stapled to this area that describes the services provided. Include the program modality. Provides Level 1 Driving Under the Influence(DUI)classes for first offender adults. Services include education about the dangers of drinking and driving and promoting awareness about substance abuse,addiction,and recovery. I 15. SPECIAL SERVICES BREAKDOWN PERINATAL SERVICES PA120LEE SERVICES OTHER SERVICES [ ] OPTIONS PROGRAM [ ] BASN ( J TB SERVICES [ j PERINATAL PILOT [ ] CIW ( IDU INTERIM SERVICES [ ) PERWATALSET—ASIDE O PPN [ ] HIVSET—ASIDE ( ] PERINATAL INTERM SERVICES [ ] PPP NOTE: Complete one ADP 7229 for each service code. ADP 7229 (4/93) IV - 97 E n) ! n LL I - I I O O "1 1 O — O O O o C E I I LL I I ]"I O 0 O O N O Q I l:-I o m i n v v V N n rv� N ry n i o0 (n v/ O/^�� W < 1n o L � N z O < L N N V N N O 2!x FIT! I IO o � -I"IL w = II W h O I C -I aCi IN -I V N N O WI Im m 11 I I N CD Lu U OI NI i 7 O O N N N O 0 0 O� I I I L C R! r� nl vl V m V V e1�N N)Ni cn N W v _ _ ! I O E N I N N P O v n _ N _ � I _ o LL th I o V nl I N N P O v t1 _• � V p OI O G :I oil O O O O O O O O O TIO OI I � I{ w I 1 0 0 I W c I cd P N o w > } U O o ~ Y n � Y Q C U a p • ,4 B uBa ; (z < " IV 98 dj O . a N O OO v rl ^ h O h N N N S I h � N N LL I I m f ~ O � C E W w O U a o O f• w E I f W Q Z W I o WCL 0 U- 15.01L LU < a. o .o N co P r r r f I o r• z — Z - E f W i Lu P c N _ EU G I I l� I I I i I ° i I w V P ^ !t M O ^ O 0 0 h ( I O rr C7 0 C < p - Z ¢ LL � N X O O m o I . C w o ~ a cl H m ^ U ° w N0 z E c U o c E o a w ¢l c m c o w w Na (n - C O - D C K C C O U c m }U o c ¢ c.�.� m — m �.. N m o.aY m I-' O ° ¢ vi N C.�'C U.:m....',',.C:`�:W C O N C 2_ S N V Ip .2.. N:O !tl.-:;m C C t0 E < N C U J N Z = m oYLY �B:m � �.� m.q..0' � � < IV 99 m. S m o m n ° 3'0 o c x c c c F' n. o w o r m c.E.v, m'L =.°'�o �.o m .m m > >- - O o U � d 3m � < ¢ ¢UULLC7x �YJN> O �Ua00 ►- < ASSURANCES REGARDING THE NO UNLAWFUL USE OF DRUGS OR ALCOHOL Consistent with the requirements of California Health and Safety Code, Division 10.5, Sections 11999 through 11999.3 (SB 1377) , Statutes of 1989. Chapter 1429) , and on behalf of Contra Costa County Substance Abuse (official program name) the undersigned person does hereby assure that: Division I. He or she understands the requirements of Section 11999.2 which states: (a) Notwithstanding any other provision of law, commencing July 1, 1990, no state funds shall be encumbered by a state agency for allocation to any entity, whether public or private, for a drug- or alcohol-related program, unless the drug- or alcohol-related program contains a component that clearly explains in written materials that there shall be no unlawful use of drugs or alcohol . No aspect of a drug- or alcohol-related program shall include any message on the responsible use, if the use is unlawful of drugs or alcohol . (b) All aspects of a drug- or alcohol-related program shall be consistent with the "no unlawful use" message. including, but not limited to. program standards. curricula, materials, and teachings. These materials and programs may include information regarding the health hazards of use of illegal drugs and alcohol , concepts promoting the well-being of the whole person, risk reduction, the addictive personality. development of positive concepts consistent with the "no unlawful use" of drugs and alcohol message. (c) The "no unlawful use" of drugs and alcohol message contained in drug- or alcohol-related programs shall apply to the use of drugs and alcohol prohibited by law. (d) This section does not apply to any programs funded by the state that provides education and prevention outreach to intravenous drug users with AIDS or AIDS-related conditions, or persons at risk of HIV-infection through intravenous drug use. 2. He or she has reviewed those aspects of the program to which Section 11999.2 applies, and 3. Those aspects of the program to which Section 11999.2 applies meet the requirements of Section 11999.2. PrintedName* Chuck Deutschman Substance Abuse Program Director 10/19/93 Original Signature* Title Date *NOTE: This form must be signed by the person responsible for operating a drug- or alcohol-related program. ADP 7290 (4/92) V-1 V' DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS ALCOHOL AND DRUG PROGRAMS CERTIFICATION Contra Costa County. pursuant to Section 11810.6(8) Article 4: Chapter 4, Part 2, Division 10.5 and Section 11983.2(b) , Chapter 4, Part 3. Division 10.5. of the Health and Safety Code certifies the following: 1. The county conducted a public hearing on the proposed use and distribution of funds and any changes were made public within the county on a timely basis and in a manner which facilitated comments from interested persons. 2. The county shall administer the county alcohol or drug program in accordance with Division 10.5 of the Health and Safety Code and all other applicable state and federal requirements. including civil rights. Further the county shall assure that contractors are aware of and are in compliance with the federal requirements for audits and all other applicable state and federal laws and regulations, including civil rights. The county shall also comply with those provisions outlined in Section XIII, Certification and Assurances, of the plan guidelines. 3. The planning process of the program plan was reviewed by the county alcohol or drug advisory board and approved by the board of supervisors. 4. The county will monitor all services and programs receiving state or federal funds or funds administered through the county alcohol or drug plan. 5. The county agrees to any additional assurances which may be necessary as a result of changes in laws or regulations. COUNTY ALCOHOL/DRUG PROGRAM ADMINISTRATOR DATE (Original signature required) [X] COMBINED j ] ALCOHOL [ ] . DRUG AOP 7125 (4/92) V-2