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Home My WebLink AboutMINUTES - 05041999 - C56 6b FHS#32 b TO: BOARD OF SUPERVISORS �,." s ';' CONTRA ;nta COSTA FROM: Family and Human Services Committee N, COUNTY COUTY DATE: May 4, 1999 SUBJECT: Progress Report on Alcohol and drug Treatment Programs for Mouth SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION RECOMMENDATION(S�: I, AUTHORIZE the Chair, Board of Supervisors, to execute letters to the superintendents of schools in Contra Costa County expressing the Boards support for the California healthy Kids Surveys including the resilience Assessment, and request participation in the State survey program. . ACCEPT the attached report on the activities of the Substance Abuse Advisory Board. BACKGROUNDIREASONS FOR RECOMMENDATIONS: On April 26, 1999, the Family and Human Services Committee heard the attached report on alcohol and drug treatment programs for youth. Cr. Bill Walker, health Services Director, introduced the report. Arnalia Gonzales-delValle, Community Substance,Abuse Services manager, and Tom Aswad, Chair of the Substance Abuse Advisory Board, briefed the Committee on the report. They also introduced Melinda Moore, the consultant who was responsible for most of the youth study. CONTINUED ON ATTACHMENT., —YES SIGNATURE: REGd 14�ENBATI£)N OF COUNTY ADMINISTRATOR TOR„®RECOMMENDATION OF BOARD COMMITTEE —APPROVE —OTHER d 41 e SIGNATURE(S): MARK DESAULNIER GAYLE S.U€LK M ACTION OF BOARD ON Ma—4 X99 APPROVED AS RECOMMENDED�OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A XX UNANIMOUS(ASSENT =- - - - TRUE AND CORRECT COPY OF AN AYES, --- -_ NOES: ACTION TAKEN ANLL ENTERED ASSENT: ABSTAIN:— ON MINUTES OF THE BOARD OF SUPERVISORS ON THE[SATE SHOWN. Contact:Sara Hoffman,336-1090 ATTESTED Mqu #L BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND c Y ADMINISTRATOR cc: CAO A .a cores-dda TOM Aswed(via Heafth Sam) BY DEPUTY # � t � s -�# • ' # s# • �a s The Board of SupervisorsPhil Batchelor C Clerk of the Board County Administration Building Costa County Administrator and drab Pine Street, Room 106 {925)335-1900Martinez,California 94555,E-1293 County ft•�Int / John Gula,1st District t� Gayle Ulikerna,2nd District Donna Gerber,3rd D strict Mark DeSaulnier,4th District joe Canclamilla,5th District May 4, 1999 Joseph A. Ovick, Ed.D Contra Costa County Superintendent of Schools Contra Costa County Office of Education 77 Santa Barbara ltd. Pleasant ]Kill, CA 94523 Dea 'cke The Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of Youth Access and Utilization of Alcohol and Other Drug Treatment in Contra Costa County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts participated in .Healthy Kids CHECKS, California Office of Education survey. We would appreciate your support of the efforts of the SAAB by encouraging all School District Superintendents and School Principals to utilize and administer Healthy Kids CHECKS in Fall 1999. SAAB members have made presentations to Safe and Drug Free Schools Community Coordinators to identify strategies and to develop processes that will promote use of Healthy Kids CHECKS. In addition, a meeting has been scheduled with Debbie Supple and Carol Burgon to identify the schools that are planning to use Healthy Kids CHECKS. The Office of Education and the school districts have been valuable partners in our collective efforts to create safe and healthy environments for the children of Contra Costa. Thank you for your continued interest and involvement. Please contact Tom Aswad, SAAB Chair or Fatima Matal Sol, SAAB staff at (925) 313-6311 for further questions or comments. `ncerely, h Canciarnilla, Chair oard of Supervisors cc: SAAB Wit 1ANA B. WAI K!R. M_ Ll CONTRA COSTA COMMUNITY CMICK DiM�k HNIAN Dmi(i-)i, SUBSTANCE CONTRA COSTA ABUSE SEPVICES 597 Center Avenue, Suite 310 H E A L T H SEkVICES Martinez, catJornia 94553 Ph (925) 313-6300 TO: Family and Human Services Committee Fax (925) 313-6390 CC: Dr. William Walker, CCC Health Services Director Chuck Deutschman, CSAS Director FROM: Amalia Gonzalez del Valle, CSAS Manager RE: Status of Tasks Assigned to the Substance Abuse Advisory Board as per Board Order 11/ 1S/9S DATE: April 22, 1999 Accept completed Study of Youth Access and Utilization of AOL? Treatment in Contra Costa County which includes interviews with Mental Health and Child Welfare and report on tasks assigned to the Substance Abuse Advisory Board. 1. Letters of appreciation to Mount Diablo and Acalanes school districts acknowledging their efforts to collect substance abuse prevalence data. Status: Completed 2. Presentation of youth study findings to systems impacted by or serving youth that use or abuse alcohol and drugs. The Division has developed informational and educational materials to disseminate youth study findings. See enclosed Access Cards, Care Cards, Resource Guide, Youth and Family Continuum of Care, Service Maps, Profile of AOD Risk and Need Indicators for Contra Costa County and Alcohol Outlet Maps. Staff has developed schedule of presentations to following groups: School Superintendent's Council; Public Manager's Association; City Councils/Relations Committee; Municipal Advisory Boards; Mayor's Conference; County Commissions; Police and Sheriffs Departments; Probation; School Parent Action Teams and Parent Teacher Associations; Child Welfare, Health and Mental Health Services. Status: Ongoing �merq,,rlyWdcaj cort;a Cost, Enwo'lmortaNe"01 40 cofl!rd Costa Hfza!CICLI,V,1,t�Iyk proqram Cc,lt(a'_Osta M_nl� 02,11'11 - Contra 1,C,,fa PL"N'c i,eal Con.ra .osta Region,3!Md:ci,_enter Cortia Cosa Health Centers 3. Develop standardized screening, assessment, referral and evaluation variables to be used among all systems impacted or serving youth that use or abuse alcohol and drugs to ensure (1] early identification, (2] easy access to services, and [3] tracking of youth outcomes between service delivery systems. Staff assigned to attend joint standing meetings and planning efforts with Mental Health, Public Health, Probation, Child Welfare Safe and Drug Free Schools and Community Coalitions. Refer to description of CSAS Youth and Family Continuum of Care implementation of "Principles of Effectiveness" and "Best Practices" guidelines required by the Center for Substance Abuse Prevention and the California Alcohol and Drug Programs. Status: Ongoing 4. Develop strategies to facilitate standardized use of survey instruments to collect school-based alcohol and other drug prevalence data. Meet with Dr. Ovick and Safe and Drug Free Schools and Communities Coordinators to identify strategies and to develop action plan for implementation of processes that will promote use of California Office of Education recommended survey, the Healthy Fids CHECKS. SAAB members have made a presentation to Safe and Drug Free Schools and Community Coordinators and convened a planning meeting with project directors to identify schools that are planning to use CHECKS next academic year. Refer to enclosed report from Office of Education. Two planning meetings scheduled for May to develop a joint action plan for data collection processes. Status: Ongoing S. Appointment to Proposition 10 Commission. The Substance Abuse Advisory Board elected a representative and an alternate for the Commission. Tom Aswad and Jodi Riley attended a statewide conference in Sacramento and are scheduled to attend another statewide conference in Los Angeles at the end of the month. SAAB representatives met with CSAS program manager responsible for perinatal substance abuse services to scheduled regional focus groups with clients and alumni of programs that serve pregnant and parenting women. Status. Ongoing The Ba of SupervisorsContra Phil Batchelor Clerk W the Board C)Sc` County Admini reand ticr� uiiciir}g County F�rlr nisirator 651 Pine treet,` doorrl 106 ts25;335-19oa Martinez, Ca';#crr' 54-53-1293CounTY John Glola, tst Distr;`wt Gayle Ullkerna 2nd Dt t= Donna Gerber,arc+District y� � Mark DeSaulnier,4th District _ n: a Joe Canciamllla, District ,F May 25, 1999 Mr. Frank Hengel, Superintendent Oakley Union Elementary Sch of District.. P. O. Box 7 Oakley, CA 94561 Dear Superintendent en 1: The Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of Youth Ares and Utilization of Alwhol and Other Drug Treatment in Contra Costa Cmmtv. A Ivey finding was the lark of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board. of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data.. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience.Assessment module. Your leadership on this issue would be very much appreciated. Sincerely l i Joseph c�airtilla, Chair Boar cif Supervisors t cc; AAB jlF !f Board of supervisors Contra Perkhil of the Born Cterk of the£3cerrf IE and CGS^ty t" rrtinistration Building os t County Administrator 6 ' 17int 'Street, Room 106 1925)335-1900 Mjirtine jl calitornia 94553-1293 County d' ,# hn C7ala,1st District iy2erber, kema,2nd District 3rd Oistdct 1 Mark DeSaulnier,4t1h District Joe Canclamills,5th District w+ May 25, 1993 �� r Henry Dors uperintendent Pittsbur reified School District 2000 oad Ave. Pi urg, CA 945£5 E 1�U t `IPS lei 7Ve �e� Dear Superintendent Dorsey: 'Me Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of Youth Access and Utilization of Alcohol and Other Drug Treatment in Contra Costa County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use - among our youth, SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional. Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerely, Joseph Canciamilla, Chair Board of Supervisors CC.* SAAB 1 The Board orI' t ry sors ontr Phil Batchelor}; Clerk of the Board am County Administration But k;Ong ;�` County Administrator 5 nd tl PrCt6 Street, Room 1�3t{3 (925)335-1 Wo sta Martinez, California 9455341293".: County �. John Glola, tst DJ strict f. Gayle Ulikerna,2nd Dist ct -'`ap`• Donna Gerber,urs District i Mark DeSau€vier,4th District ie Joe Gare€arn€lla,5th District May 25, 1999 r Mr. Daniel Srruth, Superintendent Liberty inion High School .District 850 Second St. Brentwood, CA 94513 f Dear Superinterrden Truth: The Board of Supervisors recently received a report from the Substance Abuse Advisory Board. (SAAB) on the Study ofYouth Acess and Utilization rrf A.leohol and Other.drug Treatment in Contra Costa County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and .Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience.Assessment module. Your leadership on this issue would be very much appreciated. Sincerely, Joseph. clamilla, Chair Boar 7Sn upervisors E cc: SAAB The a of Supervisors Contra #phi#Batchelor Clerk at the Board Coup 651 Costa Adrnand ir strati n Building County Administrator Pine tr o , R0,m 05 (925)335-i 900 Martinez, Call f Inia 553-1293 C unT\ ' Jahn Glola.,st '�rrict Gayle Uilkema,2n"", 'act Bonne Gerber,3rd District Mark DeSauinler,4th District Joe Canclarnilla,5th District ' "' May 25, 1999 r_ Dr. Paul Allen, Superintendent Mt. Diablo United School District 1936 Carlotta give Concord, C�A.9 �19 Dear L)r. n: The Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of`Youth A=s and Utilization of Alcohol and Other Drug Treatment in Contra Costa Count,y. A key finding was the lack of standardized survey data that assesses and evaluates uselabuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. We would like to take this opportunity to acknowledge your leadership in initiating use of survey instruments to assess alcohol and drug use/abuse among youth. Your actions have been a model for all other school districts. The data that you shared with us for the 1998 Children's Report Card was invaluable and helps focus public policy attention on the need for increased prevention, early intervention and treatment for youth. We strongly support your continued efforts to survey youth with the new State survey, including the .Resilience .Assessment module. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Again, thank you very much for your continued leadership with children and families. Sincerer Joseph C milla, Chair Board of Supervisors J cc: SAAB Batc elor rTheb !3M of Supervisors Contra ve (of'he Board Costa and County; dmin!�traticn Building �. osta county Administrator €r51 Pln4''Strecl Boom 106 (s25)335-,Sao Martinej� al rnia 94553-1293 County John G1411a,Is!� ;strict Gayle U' amat2nd District DonnaC, 3rd District ! ; Mark DeSaulnier,4th District ni Mese Cartciamiiia,5th District w` May 25, 1999 Dr. James J. Perin, Superintendent Acalanes High School District 1212 Pleasant.Hill Road Lafayette, CA 94549 Dear Ur. os The Boarr ,(if Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of Youth Aaess and Utilization of Alcohol and Other Drug Treatment in Contra Costa County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. We would like to take this opportunity to acknowledge the leadership of the Acalanes High School District last year in assessing alcohol and drug use/abuse among,youth. We strongly support your continued efforts to survey youth using Healthy Kids CHECKS, including the new Resilience Assessment module. SAAB is currently working with the Safe and. Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Again, thank you very-much for your leadership on this issue. Sincerely� F Josep pan " a, Chair Boar of Supervisors s cc: SAAB 7be PfDai Y of Supervisors Contra Y�.t Phil Batchelor 3 of t # Cierk of the Board and County AdOinisUl tion BuildingCosta County Administrator 651 dine w-reet, iiorn #{35 t (925)335-1900 Martinez,�� I afifor#ia 4553-1293 John Gloie�1 St D,I trict Gayle Ullk€` a, 'd District #donna Gerb°e,3rd Cistrict - Mark Cesaulnier,4th Distftt Joe Canclamilfa,5th District 'y May 25, 1999 r �. Mr. Alan Newell, S rintendent Antioch Unifie drool District 524 C Stre5V Antioch, 94509 Dear Superintendent well: The Board of Supervisors recently received a report from the Substance Abuse.Advisory Board (SAAB) on the Study ofYouth Ams and Utilization o,f`Alcohol and tither Drug Treatment in Contra Costa County, A key finding was the lank of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra. Costa school districts administered the new Healthy Kids CHECKS, California ice of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In. addition, the optional Resilience.Assessment module is very important in helping understand why mouth do and do not get involved in alcohol and drugs. We believe this information will, be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerely-, Joseph Canciamilla, Chair Board of Supervisors cc: SAAB } Phil Batchelor The Board of�-slOpervisors Contra Gierk of the Board and County Administration Bu##cog � �LJ � CourryAdministrator 651 Pine Street, Room 1'06``�'; (925)335-1900 Martinez, California 94553-#tt93 , County Johns filo#a,tst District Gayle Ui#kema,2nd District 1' Done Gerber,3rd District Mark DeSauln#er,4th District i Joe Danciami#fa,fit^ District May 25, 1999 Dr. Shalee Cunningham, Superintendent Orinda Union School District 8 Altarind.a Road Orinda, CA 94563 Dear Superintendent Cunningham:. The Beard of Supervisors recently received a report from the Substance Abuse.Advisory Beard (SAAB) on the Stud,} of Youth A=s and Utilization of Alcohol and Other Drug Treatment in Contra Costa Country. A key finding was the lack of standardized survey data that assesses and evaluates useVabuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerely Joseph a, Chair Boar Suervisors t � cc: /SAAB I Supervisors Contra Clerk ol ihe Board to 'and C€�uny Acirt'�tistr�ition Building County Administrator 651 Pine Sfn,iet R��3arn 106 (��y 4szs�s��•hsca Martinez, Ct�`Vorni2�94553-1293 County a ;a> John Glois, 1 s,,� stri4I Gayle Uiikerna,A nd ;itrict ° Donna Gerber, Strict F Mark DeS€ruinier,4th District Joe Cenciemllle,5th District May 25, 1999 Gerhard Grotke Canyon School District P. 0. Box 1.87, Pinehurst Rd. Canyon, CA 94516 Dear Mr. Carotke The Board of Supervisors recently received a report from the Substance Abuse Advisory Board. (SAAB) on the Study v,f'Youth.Access and Utilization q,fAlwhol and Other Drug Treatment in Contra Costa Courtty. A key finding was the lack of standardized survey data that assesses and evaluates use/'abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the neve Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce ,alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience..Assessment module. Your leadership on this issue would be very much appreciated. Wn /Z a, Chair ors r , SAAB I� elor The Board W Supervisors Contra ler o!the oar Clerk a?the Board , Costa �n� County Adtrtlnistra#i an wingCounty Adrnlnistrator 6651 Pine Street, R1 1)m 1 O13 (925;335-1900 Martinez, Cal1fornia;I945541,-1293 County s John G€ola; 1 St€3istri-Q Gayle Ullkerna,2nd Di rEcr j Donna Gerber,3rd[dist Mark DeSau€vier,4th District c Joe Canciarni€€a,5ti5 District May 25, 1999 r Mr. Jon Frank., Superintendent Lafayette School District F. 0. Box 1029 Lafayette, CA 94549 Dear Superintendent Frank: The Board of Supervisors recently received a report from the Substance.Abuse Advisory Board (SAAB) on the Study of Youth Axes and Utilization cof Alcohol and Other Drug Treatment in Contra Costa Gounty. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional. Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincere c Jose , air Bof rvisors / r f� SAAB Spa � Phil Batchelor The �3�,paid U Supervisors (�C`1�C'� Qerk of the Board County AdrAiiistra n Building Costa County Administrator Ii j (925)3335-19'00 651 Pine S'r.�4 �tt�i� 1tt6 C�ur�� Martinez, Cil vforni�'It{''94553-1293 lJ ,Ii is John Giola, ts��}istrW Gayle tlllkema,S rid tract Donna Gerber,3r istdct Mark DeSaulnier,4th District Joe Canclamille,5th District May 25, 1999 Mr. J. Douglas Adams, Superintendent Brentwood Union School District 2.55 Guthrie Lane Brentwood, CA. 94.513 Dear Superintendent The Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of Youth Access and Utilization of Alcohol and Other Drug Treatment in Contra Costa Gountty. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use - among our youth.. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerely, 3 Josep a, Chair Boar off`Supervisors cc:(VSAAB r Is ,� � � Contra Phil BatchelorThe Boan 0 Clerk ofthe Burd ctarc County s�d^?nistra,csn E3 l':9ding cozrty Administrator 651 Pine Street, R{rpo t 14 (925)335-1900 Martinez, Caiiforni l 9455j3-1293 County G a John Gioia, 1st Disttiv Gayle Lillkerna,2nd lk3lstrigl y. 5 Donne Gerber,3rd - Mark DeSaulnier,4th District Joe Canclamills,5th DiStrict _ m 0 May 25, 1999 r Mrs. Vickey Rinehart, Superintendent Knightsen School District P. 0. Box 265, Delta Road Knightsen, CA 94548 Dear Superintenden eh The bard of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of Youth A xess and Utilization of Alcohol and Other Drug Treatment in Contra Costa 0untp. A Ivey finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniforrn administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerely, f` Jo "a.rnilla, Chair Bar 'of upervisors �, SAAB f � ;i Batchelor The Board of Supervisors Contra Clerk CSl@ Board ilind County AdninistYatilirBuilding CostaCouxyAdn;nis.rato r 1551 vine Street, Rcjm 1(i t� 5;a3s- soo Martinez, Cali#orni-1,9450-1293 County �!Jahn Gioia,1st DEstr�dt Gayle Uilkerna,2nd t,istri` ` Donna Gerber,3rd Dis f Mark DeSauinier,4th District n Jae Canciamiiia,5th District May 25, 1999 Mr. Michael Lae Sa, Superintendent Walnut Creek School District 960 Ygnacio Valley load Walnut Creek, CA 94596 Dear Superintendent De Sa: The Board of Supervisors recently received a report from the Substance Abuse Advisory-Board (SAAB) on the Study of Youth A=s and Utilization of Alcohol and Other Drug Treatment in Contra Costa County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this infon-nation will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerer z f Jos lr; am ilia, Chau B and of upervisors ;�cc:. SAAB hil The 136# ,ofSupervisorsContra nt a Cerkoethe Board k and County Adrnini�ltretio�Btuilding Costa County Administrator 661 Pine Street:�i;ia R:Isrict 106 JL`,l (925)335-1900 Martinez, Calftcs63-1293 �,.Jo�,,,#I ! 4`� John Glola, ?st DIi AGayle tliikerna,gniDonna Gerber,3rd Mark DeSaulnier,4th ;strict — Joe Canclarnilla,5th District _ r+�e, May 25, 1999 r .; Mrs. Peggy Green, Superintendent Byron Union School District. Route 1, Box 48 Byron, CA. 945 Dear Superintend ree f The Board of Supervisors recently received a report from the Substance Abuse.Advisory Board (SAAB) on the Study r f Youth Acms and Utilization o,f Alcohol and Cather Drug Treatment in Contra Costa County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Centra Costa school districts administered the new Healthy Kids CHECKS, California Office o Education survey, using the same protocols. SAAB has informed the ]board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional. Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincer ly, Jo4e C , Chair ail of Supervisors �' SAAB tom" The Boar, uperviso '$ Contra Phil Batchelor Clerk of the Board and kaount+y Adri jnistratl 1 B17; inCosta County Admin afra?or $5 I Ere Street, Rot!;i fC}�`, (925}335.1900 Martinez, California st�5 3 '12-93 CounTV Jahn Glola, 's£District '!s Gayle tilikernaE,2nd Dist Donna Gerber,3rd District , tut$rk LyeSsuinier,Ott; District Joe Cenciarnilla,5th District May 25, 1999 Dr. Herbert Cole, Superintendent 'west Contra Costa unified School District 1108 Bissell Ave. Richmond, CA 94802 Dear Dr. Cole: The Board of Supervisors recently received a report from the Substance.Abuse Advisory Board (SAAB) on the Study of Youth Access and Utilization of`Alcohol and Cather Drug Treat hent in Contra Costa Cau my A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra. Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional anti city level. data. In addition, the optional Resilience Assessment module is very important in helping understand why youth:do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAR is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated.. Sincerely, , p Josf i1a, Chair art o Supervisors SAAB V ��€€ Batchelor The 13diart o Supervisors Contra Clerk of the Board Cost erd County Adminis��'at=.cry;dui€ding Countyhdrr"snistrator 651 line Stree Soo! ,106 {925}335.19000 Martinez, Califort" 941' 3-1293Coun1 Johns G€o€e,ist Dist;tct Gayle Ul€kesme,2rt#L''-tr€-"! a Donna Gerber,3rd Disfrict � Mark DeSeu€nler,4th District �_ a Joe Cenc€emilla,Stn District - ri , May 25, 1999 r Mr. Robert Kessler, Superintendent San Ramon Unified School District 699 Old Orchard Road Danville, CA 94526 Dear Superintendent Kessler The Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study a,f Youth.Ams and Utilization rof.�lcehvl and Other Drug Treatment in Contra Costa County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all Contra Costa school districts administered the new Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerely, t � s T epi ` a, Chair oad Supervisors t ce. SAAB The Board o ;S ervisors Contra i I Phil Batchelor C;erk of the Board County Administration Buiic g coca yAdministrator _and 661 Pine Street, Room 106 335.1 sea Martinez, California 94563-1, 3 "- Counly John Glola, ist District Gayle Ulikerna,2n;t District Donna Gerber,3rd District Mark DeSaulnier,4t?. District Joe Canclamllla,5th istrict May 25, 1999 Dr. John Cooley, Superintendent Nloraga, School District P. U. Box 158 Moraga, CA 94556 Dear Dr. Cooley. The Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the study of Youth Access and Utilization of Alwhol and Other Drug Treatment in Contra Crista County. A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all. Contra Costa school districts administered the neve Healthy Kids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition., the optional Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and:drug use among our youth.. SAAB is currently working with. the Safe and Drug Free Schools Community Coordinators to support uniform administration of the survey and to develop grant funding for the optional Resilience Assessment module. Your leadership on this issue would be very much appreciated. Sincerely, clamil a, Chair /ar of Supervisors c: SAAB Phil Batchelor The 0 of upiissue Contra Clerk fthe Board Costa and County Ad.,< Istrati� , Building County 651 PICK Strep Ro�3:1 106 C � t pa (925)335-1900 Martinez, Calito, is 94x53-1293 County 1 John Gioia, 1st Dista Gayle Uiikema,2nd District i t3c>nna Gerber,arc District [dark DeSauinier,4th District Joe Caneiamiiia,5th District �k n May 25, 1999 Lyn Palmer, Interim Superintendent. Joan Swett Unified School District P. O. Box $47 Martinez, CA 94553 Lear Superintendent Palmer: The Board of Supervisors recently recei The Boa�., � ',supervisors Contra Phil Batchelor cork 0-he e Board 3L� Cosh County Administration` iriiE�`t. CountyAa�dm;ristrator 651 Pine Street, Room,Cts aL (925)335-1900 Martinez, California 945 3-12 Coni -TV John Gloia, jst District Gayle Ullkerna,2nd Drs'ict 4� Dorene Gerber,3rd District f � Mark DoSaulnier,4t;1 District ; .toe Canclarnilla,5th District May 25, 1999 r ;° Dr. Scott Brown, Superintendent Martinez. Unified School District 921 Susana St. Martinez, CA 94553 Dear Dr. Brown: The Board of Supervisors recently received a report from the Substance Abuse Advisory Board (SAAB) on the Study of Youth Access and Utilization ofAlcohol rel and tither~Drag Treatment in Contra Costa Countp A key finding was the lack of standardized survey data that assesses and evaluates use/abuse of alcohol and drugs by youth. Such data would be readily available if all. Contra. Costa school districts administered the new Healthy Fids CHECKS, California Office of Education survey, using the same protocols. SAAB has informed the Board of Supervisors that the key is uniform administration of the youth survey. This would allow compilation of countywide, regional and city level data. In addition, the optional. Resilience Assessment module is very important in helping understand why youth do and do not get involved in alcohol and drugs. We believe this information will be very valuable in the County's and the community's efforts to reduce alcohol and drug use among our youth. SAAB is currently working with the Safe and Drug Free Schools Community Coordinators to support, uniform administration of the survey and to develop grant funding for the optional Resilience.Assessment module. Your leadership on this issue would be very much appreciated. Sincerely, jo Bgar f Supervisors � SAAB _. _. C 0-"' N T R A C S I............................................................... ..........................................S . . . . ..... ................................... HEALTH SERVICES O� MUNI Y SUBSTANCE E _ABIs � SERVICES And CCC Substance Abuse Advisory Stud, of Youth Access and Utilization of OD Treatment iu Contra Costa County April 1999 77 77 lr Cont = a The purpose of the youth study was to explore the question "were publicly funded alcohol and drug (AOD) treatment services being under utilized by youth between the ages of 12 and 17 in Contra Costa County?" While the answers to this question are complex, and require an in-depth review of each of the "systems" that tend to confront youth alcohol and drug problems; several important points can be made. Ivey informant interviews, focus groups, and analysis of secondary AODdata were the data collection methods used by the researchers. More than 60 key informant interviews were conducted with individuals representing six primary "systems", the Community Substance Abuse Services Division, Probation/Juvenile Justice, Law Enforcement, Mental Health, Social Services, and Education/Schools. A series of focus groups were also held--including three regional focus groups, and a youth only group. There were a number of findings that emerged from the study, some of which are system specific and others that reach across systems. First, it does appear that youth are under- represented in publicly funded AOD treatment programs, using several different methods for estimating the expected number of youth with serious alcohol and drug problems who require treatment. In 1996/97 only 99 youth were admitted to publicly funded substance abuse treatment in the county, compared to an expected estimate of at least 800 youth. When compared to other California counties, the number and percentage of youth in treatment relative to total treatment clients in Contra Costa County is also low. Finally, among the larger counties (with annual treatment clients exceeding 7,500), Contra Costa County also reports the lowest percentage of youth in treatment. Simply put, only about 1 in 8 of the youth who need publicly funded AOD treatment are receiving it at present. Understanding why this is the case is a more complex problem. First, youth that need help are not being identified in sufficient numbers. Second,once identified,youth are not being referred to treatment in adequate numbers. Third, once referred, these youth are not entering treatment in adequate numbers. Recent news reports suggest that youth use of alcohol and drugs in Contra Costa County is on the increase, yet very few of the young people who are using and abusing alcohol or drugs appear to be receiving the services they need to obtain a drug free lifestyle. Although the following report describes a number of reasons why this is the case, data suggest that one of the most serious problems is that youth are not receiving integrated services, rather, each systems is attempting to salve the problem on its own. Each system tends to perceive the nature of ACED problems among youth differently, and as a result, each system tends to develop and implement its own solutions to these problems in isolation. I CAAmalia'sBocuree tts\System of care\youth\Yot thstudylgewSLlMM.ARY.rtf A number of recommendations emerged from the study. Members of the Substance Abuse Advisory Board then met to review, add to, and prioritize both these recommendations. Results of their work are indicated below. Overall System-wade Recommendations • Increase the numbers of youth with AOD problems that are identified, referred, and provided with treatment by improving the communication and real collaboration across all of the "systems" that are likely to encounter these young people. • Establish the "Antioch .model", a multi-disciplinary youth diversion program, in other cities in the county. By identifying youth earlier in their alcohol or drug using behaviors and before they penetrate deep into the juvenile justice system where it is both more costly and more difficult to address their AOD problems. • Institute a"211" or other type of emergency phone number that young people could call to request help for their (or their family's) drug and alcohol problems without incurring negative consequences. • Make AOD related referral numbers available in front pages of the telephone boob. • Develop and implement a short, standardized alcohol and drug screening tool that would be used to identify youth with AOD problems regardless of what system first identifies the problem. • Move away from an approach that provides services only to the most serious offenders, and instead, finds most efficient ways to identify youth with problems earlier in their AOD use. CSAS Recommendations • Educate the public and along with staff in other related "systems" about the treatment resources that exist for youth in the county, that treatment works, and how best to link referrals and services and to track clients' movement through these systems. • Obtain additional funding to provide treatment to more youth in the county, and provide a more intensive level or"dosage" of treatment services to youth. This would mean increasing the amount of high intensity outpatient, and low and high intensity residential services available to youth in Contra Costa County. II C:%A<matia'sDocumentslSystem of CarelyouthlYouthStudylnewSU.MMARY.rtf _................................................ _...................................................................................._..... .......... ......... ......... ......... ......... ......... ......... ......_..... .... ......... ......... .......... _...... .............. _ _ _ ......._...... Law Enforcement Recommendations s Provide resource list describing adult and youth ACID prevention and treatment services availability, including location, hours, entrance criteria. Develop and disseminate shortened version of the same information on small cards that could flit in officers' pockets so they could easily access information as needed. • Find alternative and more equitable approaches to respond to youth with AOD problems but who do not have the benefit of parental.support. Parent/Family Recommendations • Provide more general education to parents about how to recognize indicators of alcohol and/or drug use in their children, and what to do if they believe their children are using or abusing drugs. • Once or twice a year, invite a well known "star"to come and speak about the impact of alcohol and drugs on youth. Video tape the presentation and make it available free through the schools, libraries, police departments, recreation centers, etc. • Provide support groups for parents of youth who are using who need to learn ways in which they can stop "enabling" the use of alcohol and drugs by their children. Youth Recommendations • Support youth that are in recovery from alcohol and drug use/abuse by making 12-step meetings available at lunchtime, on campus at local high schools. • Parents should learn how to recognize the signs of AOD use among their children, and the treatment resources available to help thein. • Using peer educators, youth now in recovery, to educate other youth about AOD use. Juvenile Justice Recommendations i Provide cross-training opportunities for probation officers and AOD treatment providers to learn about each other's systems and how they might work even more effectively together. Education/Schools Recommendations Increase the number of school-based prevention programs III CAAma1WsDocuments\System of Care\youth\Youthstudyl.,iewSUMMARY.rtf • Make an AOD counselor available to all middle and high schools in the county for a minimum of 1 day per week. • Ensure AOI) education is provided as part of all university teacher-training programs. Require all middle and secondary schools to be drug and alcohol certified. • Promote healthy, sober, alternative activities to youth. Mental Health Recommendations Provide cross-training opportunities for mental health providers and AOD treatment providers to learn about each other's systems and how they might work even more effectively together. Social Service Recommendations • Provide cross-training opportunities for CPS case workers and AOD treatment providers to learn about each other's systems and how they might work even more effectively together. • Identify and refer youth within the CPS system whose parents are substance abusers and as a result are at high risk of becoming substance abusers themselves to high risk prevention groups located on school campuses or at CSAS provider clinics. IV CAAmalia'sDocuments\System of Care\youth\YouthstudylnewSUMMARY.rts` ................. ......................................................................................._.. ................................................................................._........._......__............ ...... ......... ............................. ..............._....... ........ ......._ ........ ......... ......... ......... ........... _...... ......... ......... ......... ......... ....._...... TABLE OF CONTENT Page No. Introduction 1 Methodology and Background Treatment Estimates 2 Contra Costa County Treatment Clients 4 DSAS Prevention and Treatment Services 10 A. Prevention 12 B. Treatment 15 Findings: A Tale of Six Systems 1. How is the problem of AOD use among people perceived 17 and defined? 2. How are youth with AOD problems identified? 21 3. What happens once a youth with AOD problems is identified? 26 4. What barriers exist that tend to prevent youth with AOD problems from receiving appropriate AOD treatment? 37 System Contradictions -or Other Issues 44 Overall System. Recommendations 48 Appendix A: List of]People Interviewed Appendix B: Youth Focus Group Report .............................................. ............................................................................... ............................................................................................................. ....................................................................... ............. ......................................................................................... ....... ............................................................................... .................1.111,111, STUDY OF YOUTH ACCESS AND UTILIZATION OF AOD TREATMENT IN CONTRA COSTA COUNTY INTRODUCTION In the Winter of 1997, members of Contra Costa County's Substance Abuse Advisory Board raised a concern that based on indicator data provided to them by the Community Substance Abuse Services Division, it appeared a relatively small proportion of those receiving subsidized alcohol and other drug (AOD) treatment services in the county in 1996/97 were youth between 12-17 years of age. This assertion seemed in sharp contrast to reports from staff in social services, probation, law enforcement, and schools who suggested that alcohol and drugs were present in the majority of problems faced by young people. Substance Abuse Advisory Board members then brought their concerns to the County Board of Supervisors, who commissioned mer study of this 'issue. M. K. Associates, a public health and social science research firm was hired to complete the study, which was funded by the Community Substance Abuse Services Division (CSAS) of the Contra Costa County Department of Health Services. IMETHODOLOGY M. K. Associates staff worked with members of the Substance Abuse Advisory Board to develop the study design and standardized interview protocols. Data collection methods included key informant interviews with more than £0 people representing law enforcement, probation, public schools, social service, .trental health, and alcohol and drug treatment providers, and analyses of secondary data of the "in-treatment" population. (A complete list of interview subjects may be found in Appendix A.) Once a draft report was completed, a series of three multi-disciplinary and regional focus groups and one youth focus group were convened to test draft recommendations, and to assess the extent to which study findings resonated with personnel from the various systems. The focus groups were facilitated by M. K. Associates staff, Debra Wilson (Substance Abuse Advisory Board), and John Reardon(CSAS). BACKGROUND Adolescence is a complicated, challenging, and often chaotic phase of life, involving efforts to resolve the dependency-independence-counter-dependency struggle with parents, the challenge of integrating an emerging sexuality, and various peer pressures; the challenge of learning, of performing well in high school, of going to college or planning a career. Adolescents are cast into a limbo between the safe reality of childhood, ruled by simple laws of consistency and fairness, and the complete indeterminate reality of adulthood(Baumrind, 1983). 1 CAAmatia'sDocuments\Systern of Care\youth\YouthStudy\newReport.doe One consequence or these adolescent challenges and struggles can be the use and abuse of alcohol and other drugs. But who are adolescent alcohol and drug users? Unfortunately, it is just as difficult to understand alcohol and drug users as it is adolescents in general. Youth who use alcohol and other drugs are not easily characterized. Drug use, like adolescence, is a complex phenomenon. Drugs are readily available to most young people, yet only some become seriously involved. Adolescence is a time of risk-taking, but only a very small percentage will experiment with such drugs as heroin, cocaine, and PCP. It is a time when peer groups become increasingly significant as a socializing influence, yet only some succumb to group pressure to use drugs regularly. Research shows adolescents use drugs for a host of reasons including: 1) drugs are often readily available; 2)they provide a quick, easy, and frequently cheap way to feel good; 3) they offer a means of gaining acceptance in peer relationships, and 4) they may help modify unpleasant feelings, reduce disturbing emotions, alleviate depression, reduce tension, and help cope with life pressures (Beschner and Friendman, 1979). Researchers have found that many individuals use marijuana to alleviate anxiety and stress (Lipton and Marel, 1980; Jalap et al., 1981). For some adolescents, drug use goes well beyond experimental and occasional recreational use and may signal serious adjustment problems. These adolescents are generally compulsive, dedicated users with serious personal problems who rely on drugs as self-medication to cope with their problems, not unlike some adults (Wesson et al., 1977 Kandel, 1982). These adolescents, possibly as many as five percent of youth aged 14 to 18, have serious drug-related problems and need specialized substance abuse treatment. Treatment Estimates In order to answer the question of whether there are too few young people represented among the county's subsidized treatment population, M. K. Associate's staff used three methodological approaches. First, we compared the percentage of youth in treatment in Contra Costa County to youth in all other California counties. Second, in order secure a more precise estimate, the percentage of youth in treatment in Contra Costa County was compared to other large California counties (that is, those with more than 7,500 total annual treatment clients). The last method used was to develop an actual "expected number of youth needing subsidized treatment" in Contra Costa County, using U.S. Census Bureau estimates and 1998 estimates from the California Department of Alcohol and Drugs. Youth treatment admissions comprised only about 1% of the total treatment population in Contra Costa County's publicly funded AOD treatment programs. When that percentage is compared to other California counties, data reveal that only two other counties have similar percentages--Butte and San Joaquin counties. 2 CAAmalia'sDocuments\System of Care\youth\YouthStudy\newReport.doe ................................... .................................................................................._.. .. ......... ......... ......... ......... .............. ........................ ......... ......... ......... ......... ......... .. _...... ......... ..... ......... ......... ......... ........... _.. ......... ......... ......... ........ .... ..... ............._.......... However, a number of counties in which the percentage of youth in treatment, relative to the total in-treatment population, was considerably higher than 1% were small rural counties. In order to find a more comparable measure, investigators looked at treatment admissions among those counties with a total treatment population of 7,500 or more. Out of the 58 counties in California, six counties had total treatment populations of 7,500 or more, including. Contra Costa, Fresno, Los Angeles, San Bernadino, San Francisco, and Santa Clara. Among these six counties, Contra Costa County youth comprised the smallest percentage (1.0%) of total treatment clients, followed by San Francisco (1.4%), Fresno (1.8%), Los Angeles (3.7%), and San Bernadino (3.6%). Among the large counties, youth comprised the largest percentage of total treatment clients in Santa Clara County(7.6%), over seven times higher than the percentage in Contra Costa County. Breakdown of Percentage of Youth in 1996 Treatment Pop. by Counties with TX Pop. Exceeding 7,500 County Youth in Total TX Pop. Contra Costa 99 1.0 Fresno 142 1.8 Los Angeles 1747 3.7 San Bernadino 281 3.6 San.Francisco 229 1.4 Santa Clara 567 7.6 CA Dept.of Alcohol and Drug Programs, :996/97 CADDS data .According to 1996 U.S. Census Bureau population estimates, there are approximately 70,727 children between 12 and 17 years of age in Contra Costa County. Of these, we estimated that 14.1% (9,972) are uninsured and thus most likely to .need subsidized treatment.' Next we estimated the percentage of youth needing treatment by using California:Department of Alcohol and Drug and other researcher's estimates of 5 to 810. .Applying this percentage to the number of uninsured youth in the county, we calculated that between 498 and 797 youth in Contra. Costa County may require subsidized treatment for alcohol and/or drug use or abuse. In 1996/97, the latest year for which we have complete data, 99 youth under 18 years of age received subsidized treatment in the county. Obviously these data are merely estimates and cannot be considered as hard empirical evidence of the county's unmet treatment needs, however, these data do suggest that a gap exists between the number of youth who need treatment and the number actually receiving it. It is important to stress that the number of youth in treatment may be undercounted for a variety of reasons. The central issue is the manner in which alcohol and drug treatment cases are calculated by the state. The State of California has a centralized data collection Derived from U.S.census data on%of uninsured children in California. 3 C:1Arnaiia'sDocuments\System ofCarrelyouthlYouthstudylnewReport.doc system called the California Alcohol and Drug Data System (CADDS). This system collects data on persons specifically receiving alcohol or drug treatment from a publicly- ,funded drug treatment program. Thus,persons who receive treatment in a private facility (e.g., Kaiser Walnut Creek, New Bridge, CPC, etc.) are not included in the system. Moreover, there may well be a number of youth receiving treatment for alcohol and/or drug problems from the mental health system (and these youth are not reported to the state's drug and alcohol database). Similarly, youth in the juvenile justice system may receive treatment from "in-house" professionals (again, these youth are not reported to the state's database). It may also be that some alcohol and drug treatment providers do not adequately complete the relevant state reporting forms. In addition, conflicting definitions of what constitutes "intervention" vs. "treatment" may also contribute to lower counts. For example, according to treatment provider interviews, prior to 1997/94, providers had 30 days to complete the requisite paperwork, including CADDS. If a juvenile were admitted to treatment but did not stay beyond 30 days, often a CADDS would not be completed by the treatment provider and the youth's treatment would thus go uncounted. The next series of tables report on the number of youth and adults in publicly-funded treatment(for whom a CADDS was completed), and their characteristics. Contra Costa County Treatment Clients Between July 1, 1996 and June 30, 1997, a total of 10,199 individuals were admitted to treatment in Contra Costa County, of these, approximately 99 (1%) were under 18 years of age. A total of 75 youth were discharged during the same time period. Of these, 52 were admitted and discharged during 1996/97, and 23 were discharged in 1996/97, but were admitted in 1995/96. In Contra Costa County, providers funded by the Community Substance Abuse Services Division(CSAS) are required to complete a CADDS forme on any client whose treatment is in any way subsidized with public funds. Data in the next tables are derived from analysis of all CADDS forms submitted to the state by Contra Costa County providers between July 1, 1996 and June 30, 1997. As data indicate, two-thirds (66.7%) of all youth in treatment are White, compared to only 45.3% among adult treatment clients. The rates of Asian/PI and Latinos in treatment also decrease among adult treatment clients. In contrast, while African Americans comprise only 4% of youth in treatment, they comprise fidly 42.8% of the adults in treatment. These data imply several possibilities: 1) the onset of drug use among African American youth is delayed compared to other youth--occurring after the age of 14; 2)youth provider staff may not be adequately engaging African American youth; 3) African American youth may manifest their drug and/or alcohol or "acting out" behaviors in such a way that they are more often referred to the juvenile justice system than to the treatment system, or 4) African a Statewide ADP standardized database. 4 C:\Ama1WsDocuments\system of Care\youth\YouthStudy\newReport.doc ............................. .........................................................................................__. ...... ......... ......... ......... ......... _ _ _ ......... .................... ....... ......... ... ......... ......... ......... ..................................... .................................................................................................................................... American youth are more likely to be charged with felony drug use--and thus receive more severe (non-treatment-related) sanctions than do White youth. Ethnic Breakdown of Youth vs.Adults in"Treatment 1996/97--Centra Crista County Under 18 Years 18 and Over No. % No. % White 66 4,577 45.3 African American 4 4.a 4,322 42.8 American Indian a U 48 .5 Asian/PI 1a 10.1 101 1.0 Latino 14 14.1 860 8.4 Other 5 5.1 192 1.9 Total 99100.0 16,100 laa.o The following table breaks down juvenile drug arrests by ethnicity. As data indicate, four out of five youth arrested for felony drug offenses are African American compared to only 20% for all other youth. Whites comprised the greatest proportion of felony dangerous drug arrests (including methamphetamine), and felony marijuana arrests. White youth comprised 100% of all DUI felony arrests. White youth also make up more than three-quarters of misdemeanor marijuana and misdemeanor DUI arrests. Ethnic Breakdown of Felony and Misdemeanor Drug Arrests 1996--Contra Costa County African White Latino Other Total Americans � No. i % No. % No. % i No. = No. % Felony Narcotics 63 80.7 4 5.> 11 14.1 , 0 ; 0.0 78 100.6 Felony dangerous 7 19.4 1 20 55.5 7 19.4 2 € 5.5 36 100.0 drugs i i i Felony marijuana. 23 35.4 i 26 40.0 11 16.9 5 i 7.7 65 100.0 Felony DLII 5 -100.-fl 5 100.0 Misdemeanor 30 13.3 162 71.7 � 28 F 12.3 6 2.6 226 100.0 rnariivana i N isdemeanor ' 2 3.2 49 I 77.7 9 14.3 0 0.0 63 100.0 DUI i Among youth in treatment, marijuana, followed by alcohol and methamphetamines are the primary drugs of choice. Among adult treatment clients, alcohol, heroin, cocaine, and methamphetamines are the most widely used drugs of choice. Alcohol is the primary drug of choice among half of all adults in treatment, and the drug of choice for one in four adolescents. According to law enforcement personnel, alcohol use among youth is the most prevalent and more troublesome, although these trends are not reflected in the 5 erAAma1ia'sDocurnenu\System of care\youl:i\YouthStudy\newReport.doc arrest statistics. This may be due in part to the fact that alcohol use by youth tends to be minimized by parents and other adults, often being seen as a rite of passage, and going unreported. Misdemeanor use of alcohol is also underreported because according to law enforcement personnel, there is little point in arresting youth because charges are seldom filed on youth for misdemeanor use of drugs or alcohol. The exception to these practices seems to be law enforcement jurisdictions with their own diversion programs. Primary Drug Among Youth vs. Adult Drug Users 1996/97--Contra Costa County Primary Drug Under 18 Years 18 and Over No. % No. % Heroin 1 1.01 3,022 29.9 Alcohol 25 25.3 5,164 51.1 Barbiturates 0 0.0 6 .1 Other sedatives 0 0.0 2 ! 0.0 Methamphetamines 20 20.2 814 i 8.1 Other amphetamines 0 0.0 16 1 .2 Other stimulates 0 0.0 1 0.0 Cocaine/Crack 2 2.0 913 9.0 Marijuana 50 50.51 129 1.3 PCP 0 0.0 3 0.0 Other hallucinogens 1 1 1.0 2 0.0 Tranquilizers 0 ' OA 3 0.0 Other Opiates 0 0.0 25 .3 Other 0 0.0 6 .1 Total 99 100-04 10,106 100.0 Among youth in treatment, more than four out of five youth (84.4%) indicated they first used their primary drug of choice under the age of 15, and 100% reported its first use by age 18. (These data suggest that identification of youth with AOD problems, and prevention education for high-risk youth, should begin as early as middle and/or junior high school through 10th grade; and that general prevention education focus on elementary age youth.. In contrast, 31.6% of adults reported first use of their drug of choice under 15 years of age. (This is likely because the presenting drug of choice for adults tended to be "hard drugs" and the initial use of this drug often occurred after the age of 17.) However, like youth currently in treatment in the county, adult use of alcohol and marijuana(gateway drugs) likely also begun at an early age. 6 CAAmai;a'sDocuments\System o:Care\youth\YouthStudy\nowReport.doo ..................................... ..................._................................................_ ......... ......... ......... ......... ...... ......... ......... .................... .... ......... ......... ......... ................................................................................ ................................................................................................................................ Age of First Use--Youth vs. Adults Under 18 Years 18 and Over 3 No. °.' I No. % Under 15 1 81 84.4% 3,169 31.6 15-17 years I 15 15.6% 2,380 23.7 18-20 years 0 0.0 1,691 16.8 21-25 years 0 0.0 1,260 12.6 26-30 years 0 0. 0 702 6.9 31-35 years 0 0.0 448 4.5 Over 35 0 0.0 387 3.9 Total 96 100-0.-L10,437 100.0 Frequency of use helps clinicians determine the acuity of drug use among clients. Close to three-quarters (70%) of all youth in treatment reported minimum use of 1-2 times per week. Slightly more than 40% of youth in treatment reported daily use of their drug of choice, 12.1% reported 3 to 6 times per week, and 30.3% reported using their drug of choice 1-2 times per week. Among the adult treatment population, 77.6% reported daily use. Frequency of Use--Youth vs.Adults Frequency Under 18 Years 18 and Over No use in 30 days 8 8.1 658 6.5 1-3 tunes past month E 8 8.1 ' 469 4.7 1-2 times per week 30 30.3 571 5.7 3-6 times per week 12 12.1 550 5.5 Daily 41 1 41.4 i 7,817 77.6 Total 99 1 100.0 10,164 100.0 Data in the following table show the referral source for both youth and adult treatment clients. Data indicate that young people are far less likely to self refer or be .referred to treatment by a family member than are adults (26.3% vs. 80.0%). One quarter of the youth is referred by the juvenile justice system, schools refer 22.2%, and community referrals constitute about 15.2% of youth referrals to treatment. Among adults, four out of five are self-referred, followed by criminal justice referrals (6.8%), and other community referrals (5.3%). These data demonstrate that youth are more likely to receive a "system" referral to treatment than are adults, and less likely to be referred by self or another individual, e.g., family, friends, etc.' Includes detox ciients. 7 C:\Amalia!sDocuments\System of Care\youth\Youth5tudy\newReport.doc Referral to TX Source--Youth vs. Adults Under 18 Years 18 and Over No. % No. °ego Individual (Self) ? 26 26.3 8063 80.0 Care Program 2 2.0 380 3.8 Other Health Care 7 7.1 369 3.7 School 22 22.2 8 .1 Employer/EAP 1 1.0 13 .1 Court/Justice system 26 26.3 685 6.8 12 Step 0 0.0 18 .2 Other Commun. referral. 15 15.2 538 5.3 Total 99 ` 100.0 10,074 100.0 Of total treatment admissions during 1996/97, more than four out of five youth (86.8°1x) were referred to outpatient treatment, and 12.1% to residential treatment. In contrast, among adult clients, slightly more than half (51.3°1x) were admitted to detox, 25.2% methadone maintenance, 15.4% to outpatient, and 8%to residential treatment of 30 days or longer. However, when detox cases are removed from the analysis, 31.7% of adults were admitted to outpatient treatment, 16.5% to residential treatment (30+ days), and 51.8x/°to methadone programs. Breakdown of Admission Type--Youth vs. Adults Under 18 Years 18 and Over No. % No. i % Detox 0 0.0 5,183 j 51.3 Outpatient 86 86.8 1,560 15.4 Residential 30 days 12 , 12.1 813 8.0 Methadone Maint. 1 i 0.1 2,550 25.2 Total 99100.0 10,106 100.0 As data indicate in the table below,New Connections, Tri-Cities, San Ramon Valley Discovery Center, REACH Project, and Thunder Road were responsible for treating more than 80% of all youth treated in publicly-funded programs. 8 CAAmatiesDocuments\System ofcare\youth\YouthStudy\newReport.doo .................. ................................................................................... .. ........ ......... ......... ......... ........ ....................... _._.._. ......... ......... ......... ......... ............ .......... ......... ......... ......... ......... ......... ........... .... ... . . _..... _....... ........... ................................ .... ............... .... ...... .......... Breakdown of Youth and Adult Admissions by Provider July 1, 1996 -June 30, 1997 Provider 1 Under 18"Years 18 and Over CJTP-Central 81 i 8 CJTP-Vest i 38 1 1.0 CJTP-Bast 63 .6 Neighborhood House 1481 1 14.7 Ozanam Center 86 .9 Shennum.Detox 2661 26.4 Gregory Recovery Ctr, 1 i 1.0 29 .02 Rectory 36 .03 Diablo Valley Ranch 259 2.6 BAART-Richmond 1897 18.8 BAART-Pittsburg 1 10 862 # 8.6 La Casa lijima E 58 .6 Family Recovery5 .04 I;jima West 1 , ; 1.0 93 .9 Tri-Cities 20 20.0 78 .8 San Pablo Discovery 4 4.0 193 2.0 San mon Valley Disc. 14 14.0 32 .3 Wollurn House 44 .4 .Bast County Deto 1137 11.3 Thunder Road 12 12.1 , 0 ! 0.0 New Connections-Pittsburg 7 7.1 3 i 3 New Connections-Central 24 24.2 47 .5 Discovery House 95 .9 REACH Project 13 13,1 84 .8 Sojourne 193 1.9 Born Free-Martinez 1 1.0 74 .7 Born Free-Richmond 92 .9 Barn Free-Pittsburg 84 .8 Ujima East 1 _1.0 59 1 .6 Sunrise House 112 1.1 Total 99 100.0 10,070 3 100.0 Discharge status is one way to monitor treatment effectiveness. In 1995/96, the success rate for youth in outpatient and residential treatment r was 42% compared to 30% for 4 The number of youth in treatment includes both subsidized and non-subsidized treatment clients. Includes only subsidized youth treatment clients. An additional 9 youth clients were private pay. 9 Q\ArnaliesDomments\System of Care\youti\YouthStudy\ evwkeport.doc those 18 years of age or older. VAiile data for the current year are not yet complete, for the first ten months of 1997/98 (July through April), the success rate for youth in treatment is 51.9%, and 52.1% for adults (including detox). Another way to look at treatment success is to calculate the number of people in treatment who require more than one "dose" of treatment. When youth treatment data for the five year period between 1993 and 1997 were reviewed, it was found that of the 703 youth treated by Contra Costa County's subsidized outpatient and residential treatment programs, only 6% received more than one treatment episode in the five year period. Among those receiving outpatient treatment only, 5% received more than one treatment dose; for those receiving only residential treatment, 2% had more than one episode; and for those who received both residential and outpatient treatment over the five year period, 36% received one additional treatment dose(of either residential or outpatient). CSAS Prevention and Treatment Services A variety of prevention and treatment services are available to youth in Contra Costa County through the Contra Costa County Community Substance Abuse Services Division. These are designed to assist communities, families and individuals to reduce and prevent substance abuse; discourage youth access and use of alcohol, tobacco and other drugs; and encourage communities to change conditions that contribute to substance abuse related problems. Decreases in CSAS funding over the past five years have required the Division to increase its focus on program efficiency and efficacy, and to prioritize its service populations. Current service priorities are as follows; • Children and youth whose parents have alcohol or drug addiction, are in treatment or recovery; ■ Families and significant others that suffer the effects of another person's alcohol or drug addiction, abuse or dependency problems; • Populations and groups with special needs such as preschoolers, school dropouts, youth in juvenile detention facilities or juvenile justice system, runaway and homeless children and youth, pregnant and parenting teenagers, children and youth served by social welfare systems; ■ Immigrants, refugees, racial and ethnic minorities, particularly Native Americans, African Americans,Latinos and Asian/Pacific Islanders; ■ Residents of public housing, families and individuals living in communities subsidized by local and/or federal government or defined as enterprise zones; 6 Includes completed as well as those who left TX with satisfactory progress 10 CAAmaHa'sDocumeats\System of Care\youth\YouthStudy\newReport.doe School sites with high levels of truancy or serving children and youth unable to function in regular settings e.g., continuation, community and alternative schools. Portals of Entry County services can be obtained through several "portals" of entry. First, there is a centralized Access Unit designed to handle the majority of calls from county residents seeking information, screening, placement, registration or other or services. Second, clients seely treatment directly from one of the county's funded AOD treatment providers. Other portals of entry include referrals from school staff, representatives from probation or Children's Protective Services, and health services. To address the service priorities described above, formal linkages with Mental Health, Public Health, Foster Care, Group Domes, Homeless Shelters, and other Youth Diversion programs i.e., 'Safe Futures, Juvenile Drug Court, and Independent Diving Skills Programs are being developed. CSAS Principles Regarding Youth Prevention and Treatment Services 1. CSAS recognizes that youth experimentation, use, and abuse of alcohol and other drags is impacted by family and community norms. 2. Given that a large percentage of youth are referred rather than self-referred, the substance abuse problem among youth tends to be ascribed rather than self-defined. 3. Although youth experimentation and use of alcohol and tobacco is illegal, these substances are still accessible and available to young people. Thus, experimentation and use is to an extent perceived by youth to be"a rite of passage into adulthood." 4. Given different levels of"awareness of the substance abuse problem and readiness to change" among youth, CSAS prevention and treatment services include youth identified as "high risk" i.e., children of substance abusers, youth who are experimenting or using alcohol and other drugs. S. Prevention and treatment services are tailored to a variety of cultural and ethnic populations. 6. Services engage (1) youth, (2) parent or caregiver, and (3) the environment in which the youth substance abuse problem is identified e.g.,the family, group or foster home, child welfare, school, criminal Justice system, etc. but are not contingent on parental participation. 11 C:\Ama[iWsDocuments\System of Care\youth\YouthStudy\ncwR.eport doc The Continuum of Youth and Family Services' A. Prevention The goals of prevention services are (1)to reduce alcohol and drug use and availability of those substances in the community; (2) to reduce alcohol and drug use among school- aged youth;and(3)to increase the use of prevention activities that are research-based and outcome driven. CSAS's prevention services are funded by the California Alcohol and Drug Programs Title IV "Safe and Drug Free Schools and Communities" (SDFS) Grant Program, and Title 45 of the United States Code of Federal Regulations (C.F.R. 96.125) which governs the Substance Abuse Prevention and Treatment (SAPT) Block Grant Primary Prevention Set-Aside. Required strategies are listed below: Strategies INFORMATION DISSEMINATION: This strategy provides knowledge and awareness of the nature and extent of alcohol, tobacco and drug use, abuse, and addiction and their effects on individuals, families and communities. It also provides knowledge and awareness of available prevention programs and treatment services. Information dissemination is characterized by one-way communication from the source to the audience with limited contact between the two. EDUCATION: This strategy involves two-way communication and is distinguished from the information Dissemination strategy by the fact that interaction between the educator/facilitator and the participants is the basis of its activities. Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, critical analysis (e.g., of media messages), and systematic judgement abilities. ALTERNATIVES: This strategy provides for the participation of target populations in activities that exclude alcohol, tobacco and other drug use. The assumption is that constructive and healthy activities offset the attraction to,or otherwise meet the needs usually filled by alcohol,tobacco and other drug and would, therefore, minimize or obviate resort to the latter. PROBLEM IDENTIFICATION AND REFERRAL: This strategy aims to identify those who have indulged in illegal/age inappropriate use of tobacco or alcohol and those individuals who have indulged in the first use of illicit drugs in order to assess if their behavior can be reversed See updated version of CSAS Youth and Family Continuum 12 C:\Amalia'sDocuments\System of Care\youth\YouthStudy\newReport.doc .......................... .................................................................................................................................. __ through education. It should be noted, however, that this strategy does not include any activity designed to determine if a person is in need of treatment. COMMUIN'ITY-BASED PROCESS: This strategy aims to enhance the ability of the community to more effectively provide prevention and treatment services for alcohol, tobacco and drug abuse disorders. Activities in this strategy include organizing, planning, and enhancing efficiency and effectiveness of service implementation, interagency collaboration., coalition building, and networking. ENVIRONMENTAL:: 'I his strategy establishes or changes written and unwritten community standards, codes and attitudes, thereby influencing incidence and prevalence of the abuse of alcohol, tobacco, and other drugs used in the general population. This strategy is divided into two sub- categories to permit distinction between activities which center on legal and regulatory initiatives and those, which relate to the service and action- oriented initiatives. To ensure performance and compliance with funding requirements, CA 's prevention services require standardized data collection and measurement of outcomes. To reduce service duplication and to increase cost-effective collaboration and community-wide planning, prevention providers are required to join School District Safe and. Drug Free School and Community Coalitions in their service area as well as local alcohol and drug prevention coalitions. Services Community Partnership - CAS prevention services provide technical assistance, training, and resources to regional substance abuse AOD coalitions and grassroots organizations. The Community Partnership is a bottom up approach to substance abuse prevention based on coalition building, collaboration, and environmental strategies to promote"A Drug and Alcohol Free Contra.Costa County." The Community Partnership initiatives engage these most affected by the AOD problem in the planning, implementation, and evaluation of proposed solutions. For example, • Mini-grants are offered to grassroots groups through a proposal process,which is both a vehicle for skill development and ars effort to recruit community members to join substance abuse coalitions. ■ Citizen development focused on building leadership capacity in the community. The strategy is to recruit and bring out new and emerging leaders to dune. the local prevention agendas in their communities. 13 C:\Amatia'sDocumenus System o.-Care\youtii\'Ycu;hStudy\iewRoport.dac • Pro-active community outreach to constituencies that are not represented in the substance abuse coalitions. The strategy is to use culture-specific outreach that is appropriate to the yet-to-be-reached citizens. • Organizing the community to identify issues, target solutions and pursue goals. The strategy is to encourage collaboration, facilitate problem solving, acknowledge power differentials and build alliances. Partnership Forum - CSAS Administration staffs an alliance of local prevention groups that work with the Substance Abuse Advisory Board (SAAB) to implement the county's Substance Abuse Action Plan. In 1995 SAAB formally included the Partnership Forum in two of its standing committees, the Public Policy and Public Relations Committees. The intent is to bring together SAAB members appointed by the Board of Supervisors and concerned citizens, volunteers, providers and consumers of substance abuse services that form.the Partnership Forum Alliance. Special emphasis has been placed in recruiting youth and people in recovery. The intent, to encourage community residents and appointed members of the Substance Abuse Advisory Board to articulate and evaluate initiatives, recommend policies and advocate for AOD services. Clients' Families —Prevention services are provided at outpatient drug-free treatment programs, in schools, and community centers. To ensure linkages between different service components, outreach to treatment clients,their children and families,is provided on site at outpatient,detox and residential programs. Services include presentations,dissemination of infonnaation and educational materials,education and support groups,problem identification and referrals. General Population 1) The purpose of education strategies is to provide low intensity and high volume AOD information to children, youth, parents and the community at large. The intent is change in knowledge and attitudes. This service requires an AOD curriculum, and pre-post surveys to measure change in knowledge and attitudes. 2) The purpose of alternative activities is to (a) build leadership and planning skills among a core group of youth and(b)create alcohol and drug-free events and activities for youth. Services engage youth from a school, community center, and other neighborhood groups to plan and implement alcohol and drug free activities and events. The intent is to increase AOD awareness and to develop capacity among"core" group members. A shills inventory is required to measure changes in capacity among"core"members. Alternative strategies also require administration of participant evaluation questionnaires to rate satisfaction and AOD awareness. 14 CAArna:ia!sDocuments\System of Care\youthlYou&.Stlsdy\newReport.doc ............... ...................................... . .........................................................................__.. .......................................................... ............................................................_...... ........ .................... ............._................................................. ......................................................................... ...................................................................... .._.......... .._......... High-Risk GrojMs Youth referred to an educational group for the purpose of modifying or changing a problem behavior are identified to be"at risk" for substance abuse addiction because they are members of an identified peer or family group within which other individuals abuse alcohol or drugs, or have a current history of behavioral problems at home, school, or community that are directly related to use of alcohol and drugs. This prevention strategy accommodates youth that are using alcohol or drugs but do not believe this is a problem for them as well as youth that have tested positive or have been found to use alcohol or drugs and are required to attend a program. Standardized screening is required to establish the "problem." in terms of expected behavioral changes. Screening results are used to develop a contractual agreement specific to each youth which includes a plan to (a) change the risk behavior and (b) increase resiliency. high-risk groups educational services are structured in terms of(a) a set number of hours of group sessions; (b) discussion and strategies for behavior change; (c) evaluation of behavior change; and(d)referrals. B. Treatment Assessment A youth referred to a treatment program for assessment fits the same criteria as a youth referred to a "high.-risk" group but the severity of use and behavioral problems have resulted in more serious consequences. Standardized assessment is required to establish the severity of addiction, emotional, psychological, or environmental conditions that contribute to the AOD problem. Results determine treatment placement or appropriate referral to mental health, child protective services, etc. Qutpattient Low lntensi Treatment Outpatient low intensity treatment services are structured in terms of treatment philosophy and(a) number and length of group treatment sessions; (b)number and length of educational groups and topics covered; (c) number and length of individual sessions; (d)number and length of family sessions; (e)criteria for accepting or terminating youth. Standardized assessment and treatment plans are required. Modality includes after care and relapse prevention. Treatment dosage ranges from one to seven hours per week for sixteen to twenty four weeks(4-6 months). Outpatient High lntenkV Treatment (There are no high intensity outpatient services for youth at this time.' 15 C:1AmaIWsDocuments\Systein or Care\youth\YouthStudy\newReport.doc Outpatient high intensity treatment services are structured in terms of treatment philosophy and(a) number and length of group treatment sessions; (b)number and length of educational groups and topics covered; (c) number and length of individual sessions; (d)number and length of family sessions; (e) criteria for accepting or terminating youth. Assessment and treatment plans are required. Modality includes after care and relapse prevention. Treatment dosage ranges from nine to eleven hours per week for sixteen to twenty four weeks(4-6 months). Residential Low Intensity Treatment (There are no residential low intensity services available in Centra Costa County, however currently youth receive services ,from Thunder Road, an adoelscent treatment program in Oakland. Services are provided free of charge if accompanied by a probation referral.) Residential low intensity treatment services are structured in terms of treatment philosophy and (a) number and length of group treatment sessions; (b) number and length of educational groups and topics covered; (c) number and length of individual sessions; (d)number and length of family sessions; (e) criteria for accepting or terminating youth. Assessment and treatment plans are required. Modality includes after care and relapse prevention. Treatment dosage is twenty four hours per day for thirty days (I month). Residential High Intensity Treatment (There are no high intensity residential services available in Centra Costa County at this time; youth are referred to Thunder Road in Oakland:) Residential high intensity treatment services are structured in terms of treatment philosophy and(a)number and length of group treatment sessions; (b) number and length of educational groups and topics covered; (c) number and length of individual sessions; (d) number and length of family sessions; (e)criteria for accepting or terminating youth. Assessment and treatment plans are required. Modality includes after care and relapse prevention. Treatment dosage is twenty four hours per day for sixteen to twenty four weeps (4-6 months). 16 C:\Amalia'sDocuments\Systein of Ca.•e\youth\YouthStudy\newReport.doe ....................._ ............................................................................................................... ....... ......... ......... ......... ......... ......... ......... ......__......... ......... ......... .. _ ...... ......... ......... ......... ......... ....__. _ _....... ............. __ FINDINGS: A TALE OF SIX SYSTEMS The next section of this report focuses on findings from the more than 60 interviews conducted with representatives from law enforcement, probation, school staff, mental health and social service providers, and CSAS funded treatment providers. Interviews with people within the six sought to answer four basic questions: 1) How is the problem of AOD use among young people perceived and defined by the various systems? 2) How are youth with AOD problems identified? 3) What happens to youth with AOD problems once they have been identified? and 4) What barriers exist that prevent youth who need subsidized AOD treatment from receiving it? 1) How is the problem of AOD use among young people perceived and defined? Perhaps the greatest surprise was the apparent lack of awareness of people in one system about how people in the other systems identified or dealt with youth with alcohol or drug problems. Differences in philosophy and mission also seem to affect the ways in which each system regards the other's efforts to resolve the problem of drug and alcohol use by youth in the county, ultimately discouraging cooperation and collaboration. This is not to say that there are not individual instances where cooperation and collaboration among systems is exemplary,or that the work being done by individual systems is not good. These differences in definition of the "problem," in language used to describe the problem, and differences in the understanding of its root causes tend to discourage collaboration among agencies dealing with youth with AOD problems. The differences in mission among the six systems also affect the way alcohol and drug use among 12-17 year olds is perceived. Categorical funding also discourages real collaboration, sometimes preventing any system of treating youth with AOD problems within the context needed to really address the problem fully. The result is often ineffective communication and collaboration among the six systems to the detriment of young people needing help. Schools Many of the school staff interviewed reported that they do not feel sufficiently trained to recognize alcohol or drug problems among their students. In the past, school counselors were present on many school campuses and it was the counselors who would try to intervene with a student whom they perceived might have a problem with alcohol or drugs. At present, where counselors still exist, they have caseloads in the hundreds and are able to provide only academic counseling at best. The line between what constitutes a mental health problem, an alcohol or drug problem, an adolescent development problem, or a combination of any or all of the three is murky at best and also tends to contribute to school staffs' unwillingness to "label" a young person as misusing alcohol and/or drugs. The antecedents for drug and alcohol use and those of delinquency are difficult to distinguish, and often look similar, e.g., a drop in grades, truancy, a change in friends, etc. 17 CAAmaliesDocumentASystem ox-Care\youth\YouthStidv\newRepor,,doc "Normal" teen behavior can be amazingly similar to the signs of youth who are using drugs, at risk of running away, or are suicidal. "You hear drug use in on the increase" said one respondent, "But fewer kids are getting busted for using " .Police liaisons and others are just not seeing it on many campuses. Most of that behavior is occurring offcampus f`campus (where truancy comes in). A number of respondents indicated that they see alcohol and drug use by some young people as a way to relax and escape family or peer problems. Additionally, several school staff interviewed also stated they were reluctant to confront parents with the issue, fearing a backlash from parents who are unable or unwilling to believe their child is using drugs and/or alcohol. Finally, several school staff indicated that it is unfair to expect schools to be"all things to all kids." It is difficult enough these days to try to educate youth without also trying to be parent, social worker, and police officer. Others expressed reluctance to identify students as AOD users, fearing parental wrath, and in some cases legal liability. Law Enforcement For law enforcement officials, the issue is more clear. Alcohol and drug use by minors is a crime and as such police officers are required to arrest any young person they find who is using or selling drugs or alcohol. Law enforcement officials also tend to see AOD use by youth as a family problem or a character flaw rather than a treatable, chronic disease. The perception of the alcohol and drug problems among youth also depends on how "Problem" is defined. In terms of volume--both for the police and the youth--alcohol seems to be more of a problem in most of the county. The average police officer's time is more likely to be spent dealing with alcohol use among youth than with the use of other drugs. Alcohol is also considered a problem because, according to some respondents, it is a "gateway drug," and more likely to produce aggressive and sometimes violent behaviors in young people compared to marijuana use. Harder, or illegal, drugs are also a problem in terms of the crime associated with their acquisition and use. Respondents mentioned that a wide variety of drugs are consumed by youth in the county, although use patterns vary by community. Some respondents felt that powered cocaine is a problem in some of the more affluent areas. Some respondents said that in the past three years, there has been an "explosion" of methamphetamine use. In some parts of the county, according to respondents, rock cocaine use is much more prevalent. Some respondents feel that there is even some degree of heroin use among youth, although most respondents felt that injection drug use is minimal among county youth. 18 CAAma:ia'sDoouments\System of Carelyouth\YouthStudylnewl2eport.doc In some areas of the county (usually in the less affluent areas, according to some respondents), the sate of drugs is a much more significant problem. Drug sales are associated with other crimes, such as violence and gang activity. Probation Probation officials' first concern is public safety. Beyond that, as part of the juvenile justice system, they believe in the rehabilitation of youthful offenders, and make every effort to see that the least restrictive alternative is used to deal with thein. However, resource availability also affects policy directions. Ten years ago, after funding cuts required lay-off of a number of probation officers, out-of-home placements began to increase, and in home placements were reduced because with fewer officers, it was impossible to provide adequate supervision to youthful offenders and ensure the public safety. Over the past few years the number of probation officers has increased, and as a result, there are fewer out-of-home placements, and a greater number of in home placements. However, interviews with probation staff and others throughout the juvenile justice system_ indicate that many view the A©D treatment provided by group homes and county funded AOD treatment providers as virtually identical. When asked about residential ADD treatment options, one probation officer stated "that of the more than 30 group homes in the county,he would only send kids to about four." The Office of Criminal Justice Planning's Safe Futures funding is one of the largest sources of outside funding to address alcohol and drug problems among youthful offenders. Social Services The Department of Social Services (DSS), Child Welfare, estimates that 80% of their cases are impacted by substance abuse, mainly through the neglect of children by their substance-abusing parents. The Department's primary mission is the safety of the child, but CPS workers try to access needed services for the family, as well as the child. If parents' substance abuse is negatively impacting their children (regarding school attendance, basic care, safety, etc.). Child Protective Services makes an effort to remove the child from the home. The process is as follows. If someone suspects a child is at risk of abuse or neglect, they call the centralized screening unit and explain why they believe the child is at risk. The centralized screening unit is located in Martinez, and when calls conte into the unit, staff make a determination as to whether the conditions being reported warrant investigation. If the "screener"determines there is ample information to proceed, a referral is sent to the emergency response unit. Folks in this unit then go out and investigate to see if the child is in fact in danger or is being neglected. If a determination is made that the child is indeed being neglected or endangered, the cases is referred to the court unit. A court unit worker continues investigating the case, and if they decide it is 19 CAAmaiia"sDocuments\System of Cam\youth\YouthStudylnewReport.doe warranted, they file Welfare and Institutions Code 300 petition. The worker then goes to court to try to have the child removed. There are three types of court hearings: detention, jurisdictional, and dispositional. (At the detention hearing a determination is made as to where the child should be placed in the short-term; at the jurisdictional hearing the court decides as to whether sufficient cause is present to make the child a ward of the court, pursuant to WI 300; at the dispositional hearing a plan for the long-team care of the child is made with conditions as to how and under what circumstances the child can be returned to the care of his/her parents/guardians.) After the dispositional hearing the social worker files a psychosocial report describing what is happening with the family and makes recommendations to the court as to what the substance abusing guardian must do before the child can be returned to their care. Then, the case is transferred to what is referred to as the "back end" of the system, which includes family maintenance, family reunification, and permanency planning and adoption. It should be noted however that according to DSS staff, parental substance abuse alone does not mandate a child be taken from the home; it must be accompanied by Clanger or neglect. Recently, DSS staff, in conjunction with representatives from CSAS, developed a substance abuse protocol describing how substance abuse is viewed within the child welfare system, and what actions should be taken with substance abusing CPS clients. Once finalized, the protocol will be widely disseminated to various agencies and organizations including the schools, law enforcement, etc. Women involved in the county's CAL WORKS program are often those women who have been unsuccessful in their family reunification efforts, and whose children are already in foster care. In order to get benefits, these women must participate in the CAL WORKS program, which means attending job club, conducting a job search, etc. If they are unable to participate in these activities because of their ACID addiction, they can inform their worker of the problem and get into treatment without losing benefits. According to one CPS worker,there is no time limit on the length of stay in treatment. In order to facilitate this link between DSS/CPS and CSAS, CSAS staff are now out- stationed at DSS/CPS to screen and assess clients with identified ACID problems. These assessments are paid for with DSS/CPS funds. Mental Health According to the Director of Mental Health (DMH), perhaps as many as 70-80% of the adolescents seen by the department have substance abuse issues. Another amental health supervisor stated that about 40-50% of the youth he sees have chemical dependency issues—that is, they use drugs. This individual also stated that probably 70% of the youth have some sort of"history"of chemical dependency within their family structure that is,parental use,use by other relatives, and/or they,themselves use. "Where is a gigantic need for substance abuse treatment services for youth in the mental health system. " 20 C:1Amaiia'sDocuments\System of Ca:elyouth\YouthStudylnewReport.doe .. . ........................................................................................................___.. ......... ......... ......... ......... ......... .... ..... ....... ..... ......... ......... ......... ..................... ................. ......... ......... ......... ........ .......... .............. ........ _...... ......... ................................... Currently, the Mental Health system handles a large number of youth with substance abuse problems. However, mental health will not accept a youth for services is she or he has only a substance abuse problem--even though substance abuse may be a specific diagnosis in the DSM TV. The Department requires some other mental health diagnosis or the youth cannot be seen by mental health. This appears to be generally construed, including such potentially vague things as depression or seriously emotionally disturbed (SEI ) youth. Mental .Health selects a mental health diagnosis using a 5 axis grid. Axis 1 is called a "primary diagnosis." A youth roust have a primary diagnosis of a mental health.problem. This could include depression or suicidal ideation. The primary diagnosis cannot be substance abuse; rather substance abuse can only be a supplemental or secondary diagnosis. The county's mental health system is very large, and there are many avenues in and out of the system. Mental health has a total budget of about $12 million for youth mental health services (comparable to CSAS's total budget). Mental Health. provides PATCHES' for 50 beds, totally about $2 million per year. This compares to the CSAS PATCH of 6-8 bed totaling about$80,000.9 2. How are youth with AOD problems identified? According to law enforcement personnel, school staff, and youth themselves, the use of alcohol and drugs by Contra Costa youth is more widespread that is at first obvious by reviewing alcohol and drug arrest data, school Substance Abuse Review Board (SARIS) data, AOD treatment statistics, or probation records. Generally, only those youth who cause problems in relation to their use tend to be identified and receive services. Furthermore, according to data on youth in treatment, they are far less likely to be referred to treatment by a parent, family member or self than are adults (26.3% vs. 80.0%). Youth users have more denial about their use of alcohol and drugs, often seeing it as a "rite of passage," rather than indicative of any personal problem. Therefore, the majority of juvenile substance abusers in need of treatment.must rely on the schools, law enforcement, probation, CSAS providers, and in some cases parents to identify when youth are in need of alcohol and drug treatment. Schools According to the County Office of Education, Contra. Costa County receives a total of $800,000 in Safe and drug Free Schools funding from the state, and that amount covers all 19 school districts in the county, and$20,000 for the Office of Education to administer the funds. 'Mental Health subsidizes the asst of 50 resident treatment beds. s The amount allocated by CSAS for youth residential treatment will likely more than double beginning May 1999,as will the number of residential treatment options available. 21 C:\Amaha!sUocaments\System of Care\youthlYouthStudy\newReport.doe While overwhelmingly school staff interviewed indicated that alcohol and drug use constitute a major problem among youth in the county, they also seemed to believe that drug use on campus is a relatively small problem. When asked "to what extent AOD is a problem on campus," some said that, on the surface, AOD-related problems are not as prevalent as problems arising from non-drug-based conflicts and relationships. Others said that while there is no question that substance abuse is an issue for students, not too much is actually visible on campus, or obvious during school hours. However, based on their conversations with students, other respondents said that many more youth have AOD problems and come to school high than are identified or caught. One school counselor observed that "AOD use is hardly ever the major issue" with the students she sees. Most referrals are about youth who are deeply troubled in a variety of ways. AOD issues may surface later, after they've had a chance to talk, but do not present as the problem. The youth she sees have problems that focus more around self- esteem elfesteem and anger. Adolescents struggle to create a lifestyle in which they have self- respect elfrespect and friends. Alcohol and drugs are used to relax and forget about the bad things happening in their lives. Some respondents reported ACID problems are more likely to be faced by young people with little family support. And, that these youth get the "Short end of the Stick," with some seen as "throwaway kids": they run away, and manage to muddle through on their own, in spite of, rather than because of a system-based response. Most go unnoticed, but even those who are identified as having a problem, if their parents are uncooperative, or themselves using, are likely to receive a more punitive response than are youth with familial support. Another respondent said that youth need to feel that they are the issue, not drugs or alcohol, so he was reluctant to pose the problem as an AOD problem, rather than a family problem. All school staff interviewed agreed that suspension data do not reflect the full scope of the alcohol and drug problems on campus, nor describe what is actually happening. Except for"suspicious behavior," on the surface there is little objective evidence of AOD use. Most youth tend to be very "Subtle" about using alcohol and drugs on campus, leaving few clear signs. Alcohol tends to bring out more disruptive, aggressive and confrontational behavior, and of course can be smelled. But few alcohol-related problems are seen on campus. Students tend not to come to school drunk or hung over since it is easier to detect. Alcohol is more of an off-campus problem (i.e., drinking and driving). 'Marijuana has a more low key, mellowing effect, interfering with the ability of students to focus in class,thereby impeding their learning process,but is more difficult to detect. But teachers often don't make that connection. Instead, they see students as tired, sleepy, or uninterested, rather than"high." According to school staff, one indication of AOD problems is absenteeism or truancy when students may cut class to smoke a joint or a cigarette. This can also happen with alcohol, but it's easier and quicker to smoke a joint. Other red flags include poor grades, 22 CAAmalia'sDocuments\System of Care\youtt'\YouthStudy\newReport.doc increased number of disciplinary problems, cutting classes, tardiness, less interaction and interest in class. Generally, by the time a student is identified by the school as having a problem,their grades probably have slipped, attendance has become erratic and they may have already been caught in an AOD-related incident. VvUle school staff appeared to be reluctant to identify youth with AOD problems, it was most likely to occur when there were CSAS prevention/treatment providers on campus and available to deal with youth once identified. Lav Enforcement Virtually all of the law enforcement respondents, from chiefs of police to patrol officers, believe that the use and abuse of alcohol and other drugs constitute a serious problem in Contra Costa County among adults as well as youth. The nature and extent of the problem varies by region and specific community throughout the county. In any event, law enforcement officers identify AOD problems among youth by using two simple and straight forward methods—both related to the traditional mission of law enforcement. First, an officer might respond to a complaint and find a youth in possession of alcohol or other drugs. Second, an officer might encounter a youth under the influence of alcohol or other drugs. Either instance would constitute a crime in the .normal sense of the term.. And the youth could therefore be arrested and taken into custody. Generally speaking, law enforcement agencies do not conduct significant investigations to determine if a particular youth has an"alcohol or drug problem," or if substance abuse is causing the behavior. If the charge for which the youth has been arrested is a drug or alcohol offense, e.g., sales, possession, under the influence, etc., from a law enforcement perspective that young person has an AOD problem. Law enforcement officers see their job as arresting offenders, and in the case of juveniles, to turn over these youth to probation or their families. However, a law enforcement agency typically has files on youth who have been arrested in the past(at least in their own jurisdiction). So if a youth is arrested on multiple occasions for alcohol or drug-related offenses, the agency will have an indication that the youth has an alcohol or drug problem.. Probation The probation department does not conduct a standardize alcohol/drug screening to assess youth for alcohol or drug problems. The screening that takes place is on a more informal (although not necessarily arbitrary) level or scale. Recognition of a young person's alcohol or drug problem relies on the experience of the intake probation officer, and the officer charged with preparing a pre-sentencing report. Therefore, identification of an AOD problem in a youthful offender is likely to occur only when the young person has penetrated further into the juvenile justice system. 23 U\Amaiia'.sDocuments\System of Care\your_$i\YouthStudy\newReport.doc Sometimes drug problems are very obvious to the probation department--the presenting problem. (i.e., the specific offense) is for alcohol or drugs. Other than that, probation officers simply ask relevant questions. They appear to have a very informal and unstructured system.. The intake probation officer will talk to the youth and that probation officer may learn some relevant facts at that point. Many of the youths have also been in the system in the past, so the probation department therefore have files on them. The probation officer will look through the youth's file to see if there is any indication of a drug or alcohol problem--such as multiple arrests in the past for drug- related offenses. Information gathering appears to be done in a cumulative fashion, depending on how far a youth penetrates into the juvenile justice system. The first point of screening is at probation intake, when a youth would first be brought to the probation department by a law enforcement agency. The intake officer (of the probation department) reviews the facts and circumstances of the case (e.g., whether the youth was under the influence, was in possession of drugs, etc.), and the youth's prior record (including possible drug-related offenses). The intake officer also interviews the youth and any other key players (such as the complainant and/or the youth's parents). A compilation of these sources then suggest to the intake probation officer whether the youth has a drug or alcohol problem. The second point of review comes in juvenile court, if the youth is found to have committed the alleged offense. A dispositional hearing is ordered by the juvenile court judge, and a probation officer is assigned to write a dispositional (pre-sentence) report. The main goal of the disposition (and dispositional report) is to determine the main type of sanction that will be imposed. The two main categories are in-home placement and out-of-home placement. The probation officer conducting the dispositional investigation (and preparing the report)will again review the circumstances of the instant case, review the youth's record, interview the youth, and interview all relevant parties--such as the youth's parents. The officer then makes reasonable inferences about the youth's drug problem. If the officer writing the dispositional report has a specific interest in placing the youth in the department's new Diversion Program, an additional level of review takes place. This screening is done by the probation officer and the head of the.Diversion Program. In this instance, the probation officer (PO) and the head of the Diversion Program. meet (somewhat informally) and they go over the case. The PO has already interviewed the youth, so they look at his or her record, etc. Substance abuse is just one of many factors they consider. There is no formal substance abuse screening,per se. If the PO wants to recommend an out-of-home placement, the screening is done by the out-of-home placement unit screening. Again, they are using the term "screening" in a general sense. The youth comes to that screening, and the committee members asks him or her about a wide variety of issues--including substance use and abuse. The screening is thus part of the formal interview process. 24 CAAmaiia'sDocuments\System of Care\youth\YouthStudy\newReport.doe Substance Abuse Treatment Providers CSAS funded prevention/treatment providers are present on many of the county's more than 222 public elementary, middle, junior, and high schools. At schools where prevention/treatment providers are present, school staff often refer youth to these programs for screening and in some cases assessment. if youth are judged to be at risk of using or are beginning to experiment with alcohol or drugs, they are assigned to a high- risk prevention group. In these groups, youth work on behavior change and learn about the consequences of alcohol and drug use. If youth in one of the high-risk groups later reveals habitual use of alcohol and/or rugs, providers work to get these youth into AOD treatment. Most often treatment occurs at the offices of AOD funded providers, although at least one CSAS funded agency (in South County) currently provides on-campus treatment. A number of schools also have other programs on campus to deal with troubled youth (CARE teams, intensive probation officers, staff paid by Safe Futures, etc.) with slightly different purposes; however, it does not appear that there is good communication or collaboration among these programs and between these programs and CSAS funded prevention/treatment providers. Social Services Most children and youth are identified through their substance-abusing parents. Neglected infants are often identified in the hospital when they test drug positive at birth. The schools or a neighbor often identifies older children who are neglected or a relative recognizes that a child is hungry, dirty, unsupervised, etc. According to CPS staff, only about 5-10% of the youth they encounter have substance abuse problems, and these are generally older youth that often run away from foster care and the system in general early on. Meatal Health According to mental health staff, there are many access points into the mental health system, including: • Schools A Probation • Family • Ytearrm in Nest county s Pape crisis • :'dental Health Outreach • Self referral • Homeless programs • CSAS" referrals • Child Protective Service 25 CAAmaha'sDocuments\system of Care\youths\"You;h5tudy\newReport.doc P'arentsl.F'amilies It would seem on the surface that parents would be the first to identify an alcohol or drug problem in their child. However, this is often not the case. Many parents are uneducated about substance abuse and unaware of the signs of use and/or abuse. In other instances parents are unable to determine the difference between an emerging AOD problem and what they might interpret as "normal" adolescent acting out. In other instances they are unwilling to face the fact that their child has an AOD problem because of the stigma attached to substance abuse, and may be reluctant to seek help for their child unless they are able to provide private therapy and thus able to keep the problem a secret. 3. What happens once a youth with AOD problems is identified? Identification of an AOD problem among county youth in only the first step towards receipt of services. The next step is to determine how each system responds once an AOD problem has been identified. Again, each system's response is based on its primary mission with little interaction among systems. Schools Schools respond to a student's use of alcohol or drags in similar ways. What is described below are the policies of six of the county's school districts. In West County USD, a student found in possession of or using alcohol or drugs is cited by school police, taken to the dean's office, and the parents are notified. Students may be suspended and are referred to the CARE team (there is one at each secondary school in the district and is connected with support services for students needing on-site support), which sends them to a five-hour, four-week Saturday CARE class. If kids are caught using drugs/alcohol at school they are referred to the dean or other administrator. If the student is found in possession, he or she is cited by police, brought to dean's office, and referred to an intervention class (five hour class which runs for four Saturdays). According to the DATE Coordinator, about 60% of kids complete the class. There is a CARE team at every secondary school site that gets referrals for students who need to be seen. (This is separate from intervention of treatment.) Parents are informed about the class and a letter also goes to the CARE team leader who encourages students to attend class or refers them to an on-site support group. A police officer is assigned to Richmond High School, and there are probation officers on site at the three high schools. When school staff get referrals from probation for some kind of diversion, students are referred to Saturday class. There are several reasons youth are not in treatment: 1)the student has not been identified as having a problem, 2) the student is not yet failing school; 3) the parents have not been 26 CAAmaha`sIDocuments\system of Care\youth\Youthstudy\newReport.doe _ ........................................._ __._ __........_............................_.._......_........................................................................................................................................................................................... _...... ......... .......... ...... .... .. ..... ......... ......... ................. .... .... ................_...... ....................... .. ........ .............. ...._ ........... .................................... ........ _ _ _ _ __ informed and are unaware there is a problem; 4) no treatment facility in the county is geared to adolescents. According to a Communities in Schools liaison, students caught using, or for suspicion of use, are referred to the Saturday class. Last year, San Pablo Discovery Center provided ongoing "therapy" for students caught for using or for suspicion of using at Richmond High School. However, the county discontinued that service and San Pablo Discovery Center is now closed. The Center for Human Development's NEAT family works with students regarding AOD issues, and Tri Cities comes in and works with students who have anger problems and other behavioral problems that have proven to be antecedents of AOD use and delinquency. Staff at several schools in the district reported that the AOD referral process could definitely be improved. According to these staff, "Many bids have problems that go unrecognized. There are no sanctions for kids who do not follow through'xrth a referral." One CARE Team leader indicated that the original purpose of the CARE team was to decide what to do with students using drugs and alcohol, and make recommendations to their parents. After a while, however, they discovered that many parents would not follow through, and many were using drugs themselves or were otherwise unwilling to come in. She was then asked to run groups. According to one respondent, almost all of the students in her groups use drugs, although they talk about many things in addition to drug use, e.g., family life, school performance, friends, etc. The CARE staff at Kennedy High School reported that she provides group sessions to 60 youth per week--one group per class period. The groups meet weekly and last for the entire school year. The respondent also makes individual appointments because the youth have so many survival issues. As far as she knows, she is the only on-campus resource available to students. "Kids never present with AOD problems alone; it is usually some serious personal problem and the AOD use comes out later. Very few of the problems involving students are AOD related at their core. They are more about self-esteem and anger. .Drugs are used to relax and forget about the bad things that are happening. " Several of the CARE team staff indicated that the schools are .not doing a good job of referring students--i.e., they should be receiving many more referrals from school staff than they do. (In fact the majority of referrals are from other students.) In Mt. Diablo USD, the district has a zero-tolerance, multi-level process dealing with students caught under the influence or in possession of, or selling alcohol or drugs. For a first non-selling offense, the police and parents are notified, the student is suspended, a principal's conference is scheduled and a recommendation for expulsion is considered. If the student is not recommended for expulsion, the student is placed on a behavior contract, the student is refereed to an ACD counselor, and the family is referred to an 27 CAAmalia'sDocuments\System of Care\youth\YouthStudy\newReport.doe AOD workshop. For a second non-selling offense,the same process occurs as in the first, except the student is recommended for expulsion(which is required by district policy), A first offense involving selling involves the same process as in a second non-selling offense,including expulsion,which is required by the Education Code. According to a student survey conducted in Mt. Diablo Unified School District in 1997, about one-half of middle school students and many high school students believe that "alcohol, marijuana, other drugs and tobacco use are a problem at school." According to the Director of Student Services, marijuana is the drug most often used at school,but alcohol is used most overall. However, of 37,000 students in the district, only (.01%)were expelled for drug and alcohol offenses last year. "On the surface, AOD-related problems are not as prevalent as problems arising from non-drug-based conflicts and relationships. Where is, however, a substantial correlation between weapons and drugs. Suspension data probably don't reflect the full scope of the problem, and do not accurately describe what is happening on campus. Student focus groups reveal that students say AOD data are low and underreported " According to California Safe School Assessment Program,which began collecting school crime data in 1995, drug crimes (along with battery, assault, robbery, sex offenses, weapons, and property crimes) must be reported to the state. The 1995196 school data released in 1997 by school district,provides data on rates per 1,000 students. Mt. Diablo was cited in the 1997 report as one of eight districts in California as exemplary in making the district's school safe. According to the report, there was an overall rate of 3.80 drug- related reportable crimes per 1,000 students in the state overall, compared to 3.21 per 1,000 in Contra Costa County, and. 1.84 in Mt. Diablo. There are AOD counselors at each school according to district staff. The counselors see students based on three referral sources: 1) those referred for disciplinary reasons; 2) those referred by parents; and 3) students who self-refer. Counselors at each school generally have full caseloads. Each middle and high school has a substance abuse counselor and access to tobacco information and cessation. Referrals for AOD problems are made to: the Alcohol Council, AA, Alanon/Alateen, Cocaine Hotline, New Connections, Teen Substance Abuse Program(Kaiser) and Thunder Road. Antioch USD also has a zero-tolerance policy for students caught using alcohol or drugs on campus. These are expellable offenses. First offenders go before the Youth Intervention Panel (YIP), composed of police, probation, school representatives, and counseling agency representatives. For a first offense that involves possession, the student would be transferred to another school site, and receive suspension and a police citation, appear before the YIP at the police station, and be referred to counseling. If the 28 CAAma2esDocuments\system of Case\youth\Youth5tudy\newRepo,t.doe incident involves a weapon or drug sales or possession of a large quantity, the student could be expelled. For second offenders, the case is turned over to the probation department. According to the Assistant Superintendent of Educational Services, and the District Head of Child Welfare and Attendance, the"perception of ACT problems is greater than actual disciplinary data bear out." The majority of school suspensions are due to "willful defiance"and physical injury. When a student under the influence of AOD has been identified in Pittsburg USD, the student is escorted by campus security to the school administrator. The student is suspended for a period of time (e.g., five days) and might even be expelled, depending on the circumstances. A report is filed with the police for drugs, alcohol or weapons. The BATE Coordinator and the Assistant Dean for Attendance and Discipline bath report that substance abuse is an issue in the district. They were not sure how many of the problems involving students are AOI.)related. They estimated that maybe 35% are AOD related. The Healthy Kids Survey (which is now being field tested) should provide better information about actual student AOD use. disciplinary referral data indicate that only about 3%are AOD related. According to California Safe Schools Assessment, rates of reported drug crimes showed. Pittsburg `unified with a low rate (1.1 per 1,000 students, compared to the county overall rate of 3.21 and state overall rate of 3.80). Pursuant to district policy regarding students under the influence of AOD (and whether AOD is the underlying or secondary problem), the student is escorted by campus security to the school administrator. The student is suspended for a period of time (five days) and might even be expelled depending upon the circumstances. A report is filed with the police for drugs, alcohol and weapons offenses. The District is just beginning to collect data.on AOD involvement in other offenses. Students with AOD problems are sometimes referred to New Connections or NEAT family support groups. These referrals involve students who have not yet been expelled but there is goad reason to suspect they may have an AOD problem. Agencies on campus everyday include; Neat family, Planned Parenthood, Rape Crisis, Previous Life and a higher education guidance program. School staff estimate that about 50% of students who need AOD intervention either do not get it, or do not get appropriate services. According to school staff there are no treatment programs in East County that are easily accessible to youth. The only program is New Connections which is not always accessible. Transportation is sometimes an issue, or time is too limited and some students cannot attend. Neat Family support groups are accessible and available in two junior highs and the high school. 29 CAA.,-naiia'sDocuments\System of Care\youth\YouL'iStudy\newRepaat.doc The collaboration among systems has 'improved in last two or three years as part of the district's effort to help see that students get the services they need. However, sometimes people in the community are not very cooperative, and community norms support AOD use among youth. For example, Pittsburg has a community norm that young people use alcohol as a rite of passage. This is true for girls as well as boys. However,young people do not show up in treatment programs for a number of reasons: a lack of available programs with space; insufficient support for non residential treatment; some youth are seen as "throwaway kids," etc. Truancy is not always seen as an important issue to other agencies, such as the District Attorney, and action is not taken early enough to really intervene in a young person's downward spiral. A lot of work still needs to be done regarding the various systems that interact with youth and identify youth with AOD problems. The district is presently trying to find ways to better collaborate with the juvenile justice system to get parents involved with students identified as having AOD and other problems. For the first violation, the .Martinez USD contacts parents and police. A five-day suspension can be reduced to three days with parental involvement in the student's drug or alcohol abuse assessment by a state licensed agency. A list of suggested agencies and/or services is provided by the district to the student and/or parent. Verification of parental assessment participation needs to be provided to the school by the agency. The student is restricted from school activities for 30 calendar days. Failure to complete an assessment results in an additional 90 day ineligibility for all school-sponsored activities. In addition, the student could be expelled and referred to a community counseling program. For second and subsequent violations, when intervention efforts fail and the student continues to use or possess alcohol or other drugs at school or any school activity, the student is recommended for expulsion. The Board of Education may suspend the expulsion and assign the student to a school, class or treatment program. With the consent of the parent, a student expelled for offenses involving alcohol or drugs may be required to enroll in a county-sponsored treatment program prior to being readmitted. According to a DATE Coordinator, "after talking with school counselors and police officers,"AOD use among students in the district constitutes only a small (1-3%) portion of the problem. District and school staff collaborate with the law enforcement liaison. The SELPA also works with the district on expulsion hearings, and counsels with parents. School staff cite several reasons the number of youth in subsidized treatment is relatively small. These include: 1) students with AOD problems tend to drop out of high school; 2) students may need treatment but are not identified because they are not causing problems, or no one has intervened with the student; 3) programs are costly if students don't know where to look for help; and 4) many students are still in denial, don't want help, and are adept at hiding their use of alcohol and/or drugs. 30 C.\Amaha'slDocuments\System of Care\youth\YbuthStudy\newReport.doe ............................................................................_._.................................................................................................................................................................................................................... ...........................................................................................................................................................................................................................................................................................................______. _................... .................................. ... . ............. _ .. Alcohol and drug use is not perceived as much of a problem in the Moraga Unified School District, according to the Superintendent. While district staff believe there is some level of experimentation with alcohol and drugs that may be of concern (more with alcohol than with drags), a very small percentage of problems involving youth at school are AOD related. There are virtually no disciplinary referrals each year but staff believe the ones they do have are AOD related. ,According to the Superintendent, the district has a "zero-tolerance policy" regarding students found to be under the influence of alcohol or drugs. However, this policy is rarely invoked. The Superintendent indicated that school staff do make referrals for students with AOD problems, and believes these students would be referred to a psychologist who works for district. The district has no programs for students with ACED problems. The district recently completed an AOD survey of middle and high school students and the Superintendent indicated he would be willing to share the results with CSAS if he received a letter from the Director of CSAS requesting a copy. Law Enforcement The juvenile justice system vests an enormous amount of discretion in the hands of officials--from law enforcement officers to probation officers to judges. Discretion in lazy enforcement is evident at the department level (i.e., differing policies and procedures) and at the individual officer level,where discretionary actions are the noun.. Thus, a wide variety of actions may take place when a youth is identified who has committed an alcohol or drug offense. The variation depends in part on the nature of the offense and in part on the policies of the individual police departments. Some officers may take a youth(particularly Trainor offenders)home, rather than effect an arrest. This practice varies somewhat throughout the county. Some respondents indicated that such a practice is more prevalent in the affluent areas of the county than in the impoverished areas. It would also depend on the circumstances of the incident. If it were some sort of kegger party and. "alcohol is present," then the officers may just try to take intoxicated youth home to their parents. "Arresting" a youth is a very common option. if a law enforcement officer discovers a youth in possession of or under the influence of alcohol or other drugs, the officer could arrest the youth or take the youth into custody. Whether an arrest is made depends in part on how one defines "arrest." If by "arrest," one means to put in handcuffs and take to juvenile hall for booking, then the answer is no, police usually do not west youth for alcohol or minor drug offenses alone. But if one uses the legal definition of arrest--i.e., to take a person into custody in a manner prescribed by law--then law enforcement agencies arrest youth for alcohol and drug offenses with some frequency. Law enforcement agencies commonly take an intoxicated youth into custody, take the youth the to the 31 C:\Ama:ia'sDocumenrs\System of Care\youth\YouGzstudy\newReport.doc police station, and then release the youth to the custody of the parents. Naturally, the police arrest a youth on a serious drug offense, such as selling drugs to minors or the possession of larger amounts of a heavy drug like meth, heroin, or crack. Once a youth is in custody, the law enforcement agency also has a variety of options. The youth might be released directly to the parents. Some departments have what they call an "informal arrest." This is where the youth is taken into custody on a less serious offense, such as being drunk at a party. The youth is then released to the parents without any other official action taken. Another possibility is to issue a citation or refer the youth to the police department's own diversion program--often called a Youth Services Bureau (YSB). (Some police departments have diversion programs and some do not.) The appearance by the youth (usually with the parents) before the YSB is supposed to take place in a short time frame- -typically within one week. At the YSB, an intake and assessment are done. There are in-person interviews with the child and the child's parents. And then a referral is made. Normally, a YSB does not provide a lot of services per se. YSB staff make referrals to a variety of agencies. :Naturally, the nature of the referral depends on the type of case, the motivation of the youth and parents, and the amount of money available to the family (or insurance), and related factors. For example, if the family belongs to Kaiser, the YSB staff may refer to the Kaiser adolescent drug program. Several departments, particularly in mid-county, refer to New Connections. Several other programs are used as referral agencies by those departments that have YSBs. It is important to note that many departments do not have their own diversion programs and do not refer cases to drug treatment programs (or any other type of program). What happens at this point depends in part on the resources of the family and youth. Some families have the motivation and resources to attempt to deal with the drug problem without further governmental (juvenile justice) intervention. As an officer in one affluent city stated, "the parents [in his city] won't allow their kids to go to juvenile hall." This officer contended that there is a lot of political pressure on the part of the parents to handle the cases informally. Part of this is possible because the parents often have the resources to do something about the problem on their own. This respondent also stated that parents send their kids to in-patient drug treatment, and even to out-of-state treatment programs. If that happens, the police may be less concerned about pursuing any legal action. Another option for law enforcement is to issue a citation to the probation department. In this instance, a youth would again probably be released to the parents by the law enforcement agency. .But the citation would require the youth to appear at the probation department to discuss the case with a probation officer. This process is discussed below. A final option for law enforcement is to transport the youth to the probation department (juvenile hall) for possible intake (booking) into the probation system. As will be 32 C:\Amalia'sDocumentslSystem of Carelyouth\Youthstudy\newReport.doo _. ........................................................................................................................................................................................................................................................................................................................ discussed in more detail below, this option is not commonly exercised because the juvenile hall is usually over-crowded and the intake probation officer will refuse to accept any but the most serious juvenile offenders. The intake probation officer will not admit minor drug offenders into the system, so the police do not even attempt to take such cases to juvenile hall. One police department even has police officers call the juvenile hail and discuss the case with the intake officer. If the intake officer indicates that he or she will not accept the youth, then the arresting officer simply issues a citation and releases the youth. Probation As with law enforcement agencies, a wide variety of possible actions may be taken at the probation department level. Generally speaking, the youth may be released immediately by a probation officer, or the youth may penetrate deeper into the juvenile justice system. A police officer could bring a youth to the "intake unit" of the probation department--at juvenile hall. The intake officer has a couple of main choices. The intake officer can release the youth to his parents or some responsible relative or guardian. This, naturally, is done in less serious cases, when the parent or guardian seems relatively responsible, and when it appears that the youth will not get into any further trouble or run away from the jurisdiction. At intake, the probation officer cann decide to handle the case informally. The department has statutory authority to place a youth on "informal probation." This means that the youth will be "on the books" for a period of six months. If the youth behaves properly, the probation department will drop the case and never refer it to the DA. If the youth does not behave, the probation department will refer the case to the DA. ?NTot surprisingly, the youth they handle on informal probation have committed less serious offenses,have a relatively stable family life, and have some sort of hope of staying out of trouble. The intake probation officer may also deckle to detain the youth if it is a serious crime, if there is no one to release the youth to, or if appears that the juvenile will flee justice or commit .new crimes. If the youth is detained, the probation officer determines if the youth is already on probation. If the youth is already on probation, the current supervising probation officer will be notified and he or she will help determine what to do next. If the youth is not currently on probation, the youth is designated as a "new case in court," and the youth will be assigned a new probation officer. This probation officer will then help determine the next steps. The deputy district attorney (DA) is responsible for filing a formal petition (i.e., a criminal complaint) in order to get the case before the court. The DA may decide not file the case. This would usually occur because of"evidence problems"--3.e., a weak case. It does not mean that the DA does not want the youth in court; it is just that the DA does not have a good case, and the case would probably be dismissed by the court. 33 C:\AmaHa`sDocuments\system ofcsre\you h\YoathStudy\newTteport.doe If the case goes to juvenile court and there is a finding of delinquency--that is, the youth is guilty of the offense, several things could happen. The juvenile court may put the youth on probation, or in a diversion unit, or in some sort of residential (out-of-home) placement. The court usually orders"drug treatment" as a condition of probation. What happens to the youth depends in part on the nature of the case. For the less serious cases, the youth will be placed on probation with various terms and conditions. Among the terms and conditions are to seek some sort of drug treatment. This may include, for example, NA or AA. The drug treatment condition will be specified in the court order. Theoretically, the supervising probation officer is supposed to keep track of this, but in reality (because the Probation Department is understaffed), POs on regular caseloads have a difficult time following up on their probationers. If the youth's problem is more serious and requires more intensive supervision, the youth may be placed in the probation department's"diversion"program. This program is called a diversion program., but it is different from traditional diversion programs. In the normal sense of the term, diversion means diverting a youth from entry into the juvenile justice system in the first place. That is,not getting into the probation and the court system. The Contra Costa County Probation Department Diversion Program really means diversion from placement. A youth has to be a ward of the court (a 602 W&I) to be placed in the probation diversion program. The whole idea of the program is to keep youth from going to an out-of-home placement. Thus, the idea is to keep more youth in the community, in part because keeping some youth in the community fosters better rehabilitation, and in part because it saves money. The diversion program has five caseloads, more or less based on geography. Each of the five caseload or units above has about 20 to 25 youth. And each of the caseloads has one full-time certified probation officer and one full time probation counselor (similar to the type of counselor one would find in juvenile hall, except that he or she is out in the field). With this intensive caseload,the two probation staff are able to "hound"the youth well so that he or she stays in school and goes to treatment. The diversion program refers youth to (and makes sure the youth does goes to) a couple of main programs--including drug treatment programs. First is New Connections, the county-run program. Second is Families First, a family therapy program. In the more serious cases, the juvenile court will order some form of residential treatment--that is an out-of-home placement--and perhaps recommend a drag treatment program. That is, if alcohol or drugs are an "overwhelming problem" for the youth, the court will order residential placement. The juvenile court does not mandate a specific drug treatment program in the commitment order. Rather, the juvenile court orders an out-of-home- placement, and refers the case to the Probation Department's (Jut-of-Home Placement Committee,which will mare the specific placement choice. 34 CAAmelra'sDocuments\System of Care\youth\YouthSrady\newReport.doe ......................................................................................................................................................................................................................................................................................................... ........................................................................................................................................................................................................................................................................................................................ ................. .. ...................... ............. ......... The Placement Committee usually has about 15 to 24 youth per month ordered to it by the court. The Placement Committee tries to take all factors into consideration and make the most appropriate placement for each individual youth. The Placement Committee has many factors to consider, such as the youth's specific problems or issues (such as substance abuse, mental health, sexual orientation, and gang affiliation), as well as the willingness and ability of the parents to participate in any specific program, and cost factors. Social Services Youth with AOD problems who remain in the system are referred to appropriate mental health or substance abuse providers, although no standardized protocol to identify and document AOD use by youth is currently used by CPS workers. Furthermore, there is no routine attempt made by CPS staff to refer the children of substance abusing parents to high-risk prevention services available ors many high school and middle school campuses. More likely, referrals are done on an "ad hoc" basis, where it is up to the individual worker to refer these youth to primary prevention or other needed services. According to CPS staff, they are generally too busy to get involved in making CSAS prevention referrals, they are too busy trying find these youth a safe and appropriate living environment. Most of the youth they serve have multiple problems and CPS staff try to see these youth get the services they need, using a case management approach. There seems to be a difference of opinion as to how the department handles substance- abusing parents. One worker indicated that the county never removes children because of parental substance abuse alone. Another worker stated that in the past, there was more emphasis on family maintenance, and if a child were living in a home where adults were abusing alcohol/drugs, but seemed to be providing adequate parenting, they would try to keep the child at home with his or her parents. However, according to this worker, now there is little or no tolerance for drug use in the county, and if a worker finds out that a child's parents are substance abusers,they almost always try to remove the child from the home. Child Protective Services staff work closely with mental health staff because almost all of their clients (children and youth) have mental health issues. Also, in order to secure a level 12-14 placement (which provides a more intensive level of care), CPS staff need to get agreement from mental health, because mental health provides the PATO funding that enables these youth to receive treatment in a more therapeutic setting. Mental Health Once a youth is referred to the mental health system, the person is usually seen at a district or branch office of mental health (e.g., at some sort of clinic). All youth are seen by a clinician. An interview and mental health screening are conducted, and a chart is opened. At that time, a diagnosis is also made. The clinician then tries to place the youth in the most appropriate form of treatment, given the diagnosis. 35 CAAmatia'sDocuments\System of Care\youth\YoutaStudy\newReport.doe For dually diagnosed youth, there are several options, including both residential and day treatment programs. If youth have a serious mental health problem (including a substance abuse problem), they may receive residential treatment. As mentioned earlier, mental health has budgeted for 50 residential treatment beds. In East Contra Costa County, youth with chemical dependency problems are referred to a CSAS provider, New Connections that operates an intensive outpatient after school program. According to one mental health practitioner: "We need more intensive AOD treatment programs for youth in the county. Programs with the needed ftequency and duration. " Mental Health also runs the Summit Program for the Probation Department. The Summit Program is on the grounds of juvenile hall. It is a program for youth (boys only) that have mental health problems—that is, a mental health diagnosis. It is interesting to note that all the probation department staff interviewed characterize the Summit Program as a dual diagnosis facility. However according to mental health staff, that is not technically correct. They said the Summit is a mental health facility. Many, if not most, of the youth there have substance abuse problems and some of the youth are dually diagnosed--but it is not specifically a dual diagnosis facility. This is because first, mental health did not want to be limited to serving only dually diagnosed youth, and second, there are not enough trained staff, particularly with regard to substance abuse treatment for the facility to be deemed a dual diagnosis facility. In fact, respondents said that one of their big needs was to have more training for staff in substance abuse treatment--or hiring more substance abuse treatment specialists. Mental health respondents indicated they are also planning to implement a similar program for girls with mental health problems. They are currently planning a 16-20-bed program for girls, which is estimated to open in the summer of 1999. Treatment for youth in the mental health system has increased dramatically because of a relatively new funding stream called Early Periodic Screening, Diagnosis and Treatment (EPSDT). In the federal Medicaid law, there is some general language regarding payment for providing medical services. States would be eligible for federal payment or reimbursement if the services provided "would improve some existing medical problem." That is, the federal statute was rather general and open to broad interpretation. Many states did in fact interpret the law broadly and included substance abuse treatment in their medical treatment programs—and as a result were eligible to receive reimbursement from the federal government. In contrast, California elected to restrict the definition. The state did not want Medical to apply to substance abuse and other minor mental health services. They were unwilling to provide the necessary "matching funds" in order to get the federal dollars. However, a 36 CAAmafia'sbocuments\System of Care\youth\YouthStudy\newReport.doe couple of years ago someone sued the state of California (and the Medical system) Claiming the state was not in compliance with the federal law and won the lawsuit. As a result, California is now eligible for EPSDT funding for substance abuse and minor mental health problems.'° According to one mental health administrator, they see themselves as the "de facto" substance abuse provider for youth in the county. This is because CSAS has such a small budget---and because of mental health's access to the new EPSDT funding stream. 4. ghat barriers exist that tend to prevent youth with AOD problems from receiving appropriate AOD treatment? Schools Lack cif Awareness is a critical issue. Most young people do not perceive their drug use as a problem, largely because they are early in their drug taking career. For many, drug use is a regular part of their daily lives. Drug use is related to environmental, culture, and adaptational issues of adolescence such as peer pressure and family influence(Jalali et al., 1981). When asked directly if they feel that drug use is a problem or if they want help in reducing their drug use,the majority of young people say no. The lack of insight into the potential consequences of drug use on their lives and the lack of motivation to reduce the extent of their drug use are serious impasses that human service providers must overcome before the drug problem can be addressed. A related issue is denial on the part of adults in the young person's sphere. Parents tend to be in denial, either because they are unable to identify the signs of AOD use and/or abuse in their child, or they are unwilling to see the signs. In some families, youth get drugs or alcohol from their parents. Sometimes the family is unwilling to change. Teachers and staff are often unable or unwilling recognize students' AOD problems, in part because some staff do not believe it is the school's job, and others because they feel there are inadequate resources available to address the problem, once identified. The strong denial systems at work make it difficult for schools to do much, especially because there are so few school counselors anymore. .Identifying young people who are using alcohol and drugs is difficult according to school staff; young people are adept at hiding their use of alcohol or drugs from family and teachers. It can take a while before some of the more serious signs, like failing in school, become apparent. Unwillingness to seek help is a critical issue. Youth do not want to quit, do not want to be in treatment, or are not willing to change their lifestyle. Maybe it is still fun to get high and they haven't reached the point where tine consequences of their behavior have zo CSA.S is currently exploring the feasibility of also accessing EDSDT funding for outpatient treatment. 37 C:\AmaHa'sDocurnents\System of Care\youth\YouthStudy4.zewPeport.doc became serious enough to motivate them to quit. Young people can live a marginal lifestyle for quite a while. Doing drugs is more fun than doing nothing or playing video games. Cast is always an issue. Many parents cannot afford the cost of treatment. Few resources exist for parents who do not have insurance. And, even if resources are available, parents and school staff are often unaware of them. Accessibility often hinders entry into treatment. Lack of transportation can be an issue for youth, or the time of a program is too limited,making it difficult for students to attend. The social stigma attached to being identified as a substance abuser often stands in the way of people seeking help. In some cultures, seeking professional help is frowned upon as a potential betrayal of family privacy. Parents are often reluctant to refer their youngsters to treatment because of the stigma associated with drug use and/or seeking professional help. In making a commitment to treatment, adolescents are frequently confronted with another dilemma--the possibility of giving up or changing their peer relationships. Being ostracized from the peer group--leaving one's drug-using friends behind to join a treatment program--is difficult choice for an adolescent. Beginning in early adolescence, the peer group becomes increasingly significant as youth become less dependent on parents. Adolescent drug abusers are difficult to treat--their problems are multidimensional. They are going through a difficult developmental phase--trying to become independent, initiating interpersonal/sexual relationships, and some problems are beyond their control: emotional upheaval, alienation, insecurity about sex roles and personal identity, and uncertainty about future goals are the norms. Treatment programs offering specialized treatment approach (i.e., unideininsional programs), such as traditional therapeutic community, pose another potential barrier. Many drug treatment programs are organized around particular concepts and philosophies. The adolescent client must adjust to the program; most programs will not adjust to the adolescent client. Distrust by potential clients is a barrier. The treatment approach can limit access to those needing to explore a variety of ways to change and grow. Although many young people are in urgent need of psychiatric, medical and other kinds of help, they are often too distrustful to utilize existing professional services and institutions. 3s CAAmalia`sDocuments\System of Care\youth\YouthStudy\newReport.doc .................................................................................................................................................................................................................._,......................................................................... ....................................................................................................................................................................................................................................................................................................... ......._........................................ _ __ Law Enforcement A variety of issues (or barriers) prevent or deter law enforcement agencies from helping youth get treatment from alcohol or drug problems. These issues can be divided into several categories. First are system issues--that is, problems in the juvenile justice system per se. As alluded to above, the probation department is very selective in the cases it accepts into juvenile hall,thus, many alcohol and drug offenders never make it into the probation system. As a result, police departments rarely take arrested youth to juvenile hall because the hall is dreadfully overcrowded and the intake probation officer will not accept minor cases. The juvenile hall will only accept the most serious cases, such as those involving violence. The police therefore do not even bother taking minor drug or alcohol offenders to the juvenile hall. Thus, the vast majority of drug and alcohol offenders never make it to juvenile hall or into the juvenile probation system. Second, there are legal issues. Only the juvenile court can order (legally mandate and enforce) a youth into drug treatment. Law enforcement does not have that legal authority. Thus, law enforcement officers do not have the "leverage" to get a youth into a drug treatment program. It is possible for youth to get into a treatment program without being under court order. But these voluntary admissions are problematic. For one, they are very expensive--families have to pay themselves if there is no court order. Also, some youth will not want to be there and will run away. Because it is difficult to get youth with drug problems into the probation department or into drug treatment on a voluntary basis, many police officers "give up." They see it as a "revolving door" problem, and they get frustrated and cease making referrals. Third, there is a lack of collaboration among agencies in the juvenile justice system.--and related agencies. To the extent there is any collaboration, it is generally limited to the juvenile probation department and the DA's office. There is not a lot of collaboration with substance abuse treatment programs. Police departments on occasion refer parents and youth to some type of drag program, not on a regular basis. Law enforcement agencies in general do not know much about drug treatment or about the specific drug treatment programs in their community. Fourth, and related to the above, there is a lack of communicationlinarketing on the part of the drug treatment programs (or possibly the county's Community Substance Abuse Services Division). As one police chief stated, "we have a basic lack of communication." That is, he said that he (and other law enforcement officers) had never heard anything about drug treatment programs funded by the county. Most of the law enforcement respondents were never aware that the county sponsored any such treatment programs, particularly one that was not being fully utilized. One distinct possibility for underutilization, according to law enforcement personnel, is the fact that the county does not properly do outreach to police agencies and inform agencies of the existence and 39 CAAmaha'sDocuments\System of Care\youth\You&Study\newReport.doc availability of such a program. If drug treatment programs were better publicized, it was suggested,then officers might make referrals in appropriate cases. Fifth, money and resource limitations are an issue. In a private (or voluntary) referral to Thunder Road, the client has to pay the full amount. The police do not pay for the client's treatment. Unless there is a commitment from the court, the client has to pay. There are not that many families that have the money to pay for such expensive residential treatment. Law enforcement agencies often feel helpless when faced with this situation. Related to this is the variation in money and resources among different communities in the county. Some law enforcement respondents contended that in more affluent communities, youth are not getting into the formal juvenile justice system because their cases are handled informally by the parents. Many parents have the resources to send their .kids to different treatment programs (including Thunder Road), and even out of state. So, proportionately, kids from south county, for example, are more likely to get into some form of private drug treatment programs--and not go through the official juvenile justice system. Probation System problems affect the probation department as well. As mentioned, juvenile hall cannot handle all of the youth police arrest for alcohol and drug offenses. The county's juvenile hall was built many years ago, when the county population was but a fraction of what it is now. There simply is not enough space in juvenile hall. Moreover, there are not enough probation officers to supervise youth who get into trouble for alcohol and drug offenses. In 1992, the probation department had to fire about 58 officers because of budget cut-backs. There has been some improvement--more hiring--but the juvenile hall is still over-crowded. Thus,the probation department cannot take minor drug and alcohol cases into juvenile hall. "Denial" is another significant problem. One probation officer said that a lot of bids are "in denial,"that is, the don't feel that they have problems and therefore do not want to go to treatment. If they go to treatment and do not adjust well,they will simply run away. If they run away or exhibit other behavior problems in the treatment program, they may be terminated from the program. Thus, it is difficult to keep many youth enrolled in their treatment program. Probation officers also contend that parents are often in denial, and therefore do not want their child to go into treatment. Many treatment programs will not accept a youth in the first place if the parents will not participate in the treatment process. One probation officer stated that "youth are very difficult to work with." They have multiple problems--rage, anger, running away--and families often will not work with the department or any program. Thus, it is often difficult to place youth in a good program. As one probation officer stated, "just because you have a lot of kids with drug problems 40 CAAmalla'sDccuments\.System o:Care\youth\YouthStudy\newReport.doc .. ......... ......... ....... ......... ......... ......... ......... ......... ......... ......... ......... ......... _......... ......... ........................ ..... .. ...... ..... .... ..... .................................. ................ ......................... ........ ......... .._.._..... .......... ........_..... ........................................ .... .._... .... does not necessarily mean that you have a lot of good candidates for drug treatment programs." A final issue is the apparent growing need for specialized treatment. Treatment programs often specialize in treating one type of problem--for example, drug problems. Treatment programs often do not have the capacity to treat youth with multiple problems, such as substance abuse combined with mental illness problems, or sexual acting out. Probation officers contend that they are receiving from the juvenile court more youths with multiple problems; as a result, it is .more difficult to find appropriate placements. Regular drug treatment programs might not be appropriate for a person with a dual diagnosis. AOD Treatment Providers The lack of low cost, easily accessible treatment is a barrier. For youth who need residential treatment, there is no subsidized in-county treatment available. Residential treatment at Thunder Road (Oakland) or Walden House (San Francisco) is generally only available to youth who have committed serious enough crimes to be on probation, require out-of-home placement,and therefore who are subsidized by the probation department. Because AOD use among teenagers is often viewed a family problem, most DSAS providers put a heavy emphasis on parental involvement. However, many parents want treatment providers to `°fisc their kids" and to participate only minimally if at all. If parents are unwilling to support their teenager's recovery, it decreases the chances the young persona will enter and remain in treatment, and it negatively affects the outcome. Social Services Substance abuse among youth is a hidden problem. Several staff indicated they felt certain that many youth with problems go unidentified because the adults in their life (either family members or people in the system) don't want to recognize the problem. One worker also indicated that it is difficult for many parents to recognize their child has an AOD problem and they tend to attack the DSS/CPS system for suggesting their child might have an AOD problem. According to several of the staff interviewed there is a lack of available and appropriate treatment for youth in the county. Youth needing residential substance abuse treatment are referred out of the county to Thunder Road, CenterPoint, Walden House, Advent, and McDowell; however without private insurance or a probation referral, it is difficult for youth to access these services. DSS/CPS and CSAS seem to have a good relationship and report working well together to get women into needed AOD treatment. According to DSS staff, Contra Costa County has more women's substance abuse program options than almost any other Bay Area county. However, there are still waiting lists, and DSS and CSAS are working to develop 41 CAAmaHa!sDocuments\System of Care\youth\You*distudy\newRcport.doc pre-treatment groups in order to engage clients needing treatment in the hopes of keeping them connected until a treatment slot opens up. Another barrier faced by the two systems arises from the competing demands for AOD services for populations other than children and families. In part due to the improving information base about what kinds of treatment are most effective for which kinds of clients, demands for AOD support services have multiplied from the criminal justice system, the mental health system, and now, notably, the overlapping welfarelTAL F system. Another major barrier is the difference between the CPS and AOD systems' responses to licit and illicit drugs. CPS workers tend to focus on illegal substances and overlook alcohol abuse and its consequences on the family, despite the much greater overall damage that alcohol poses to children in-utero, during infancy and early developmental stages of childhood. Mental Health According to mental health staff, one of their biggest problems is dealing with youth with substance abuse problems. There are large numbers of youth with AOD problems and very limited services for youth. Mental Health personnel feel there should be more treatment slots available for such youth. They feel that there is a great need for more specialized training in substance abuse treatment for mental health staff. Or, there is a need to hire more substance abuse treatment personnel. Since they perceive themselves as the main youth treatment provider, they wish they had more money, resources and more trained staff to address these needs. Another mental health clinician expressed some dismay that youth must be on probation to access so many of the resources available to youth with mental health and chemical dependency problems. Another barrier is the perception by at least one mental health clinician that probation often avoids placing youth in residential treatment, even when residential treatment is warranted. Specifically, he mentioned that probation avoids placing 17 year olds, evidently because, according to him, they are almost adults and therefore don't constitute a good"investment"of youth treatment dollars. While some of those interviewed within the mental health system thought the amount of collaboration between the two systems was good, others felt there was inadequate communication and partnering between CSAS and the DMH. One individual stated: 42 CAAmalia'sDocuments\System of Care\youth\YouthStudy\newReport.doc "Since there are so many youth with mental health and chemical dependency problems, the two agencies should sit down and plan together. We should try and figure out the funding stream issues so that there is sufficient (and integrated) treatment available to dually diagnosed youth. " Another clinician thought the two departments should be more systematic in their planning and program development. For example, he mentioned that they should map out the entire continuum of care- ftom prevention to residential treatment--and try to determine what specific amental health services and CSAS services are needed (and where). "Mental health and CSAS should work together to carefully determine the deficiencies in treatment services available to youth and work together to fill those voids. " Finally, the complexity of categorical funding impairs the collaboration between the child welfare and alcohol and drug abuse systems. It is often difficult to obtain,reimbursement for many of the treatment needs of parents and adolescents, and there is a tendency by each side to protect its own funding sources and seek allocations from the other. These funding barriers also lead to problems caused by the inability of either child welfare or ACT agencies to control their own resources due to two major external forces: the decisions of courts and the decisions of managed care firms in the behavioral health arena. In both cases, resource decisions are significantly out of the hands of child welfare or AOD agencies, which means that when the two sets of agencies do seek to cooperate, outside mandates often make it more difficult because of a requirement set by the court or a regulatory burden of proof created by a managed care firm that makes it difficult to arrange appropriate treatment for some clients. Parentsl'amilies One might think that parents would be the first to notice alcohol and or drag use among their adolescent children. However, this is often not the case. There are a number of issues that prevent parents from identifying AOD problems in their children, and once identified, from attaining the help needed. These include: 1) they are uneducated about what signs to look for; 2)they often"enable"the youthful user in the mistaken belief they are protecting their children; 3) distrust of the "system" generally; 4) a lack of money/resources to help; 5) fear their child will be "officially" identified as a drug/alcohol abuser and that will affect their life choices; 6) parents condone or are passive about their children's use of alcohol or drug use because they themselves use one or both of these substances and do not believe it to be a problem. 43 CAAmalia'sDoouments\System of Care\youth\YonthStudy\newReport.doe Svstem contradictions--or other issues Schools The school system also has many disadvantages as a source of early intervention. As drug-using youth progress trough the grades, more and more drop out and become immune from school-based programs. The same naivete that haunts parents also can affect school administrators and teaching staff. Signs of significant drug use may be subtle. There is often a similar reluctance to admit a problem. Many school administrators see their domain limited to basic academic education and are reluctant to take on the in loco parentis function they feel is associated with behavioral health problems such as drug abuse. Some school boards have policies against getting involved in the drug use and abuse of their students. Some school principals still deny drug use is occurring in their schools. Law Enforcement Agency or Social Service Agency There is an age-old issue (or contradiction) in the field of law enforcement--and this is particularly true when working with juveniles and particularly true when dealing with drug offenders. That issue (or conflict) is the extent to which a police department should concentrate on law enforcement per se, and to what extent it should be concerned with the personal (medical, drug abuse, mental health, social service) problems of the people the police officers come into contact with. fart of the conflict is related to philosophy (punish or treat) and part to financial resources (that is, some departments do not have enough money to do any more than arrest suspected law violators). This issue (or conflict) plays out in inconsistent handling of juvenile drug offenders by different law enforcement agencies within the county. Some departments, for example, have established Youth Service Bureaus that specialize in working with youth and solving the problems that individual youth face. These departments attempt to deal directly with the youth's underlying problems--including drug problems. Thus, a youth may come to the YSB with a drug problem and YSB the counselor would work it out with the parents to have the youth voluntarily enter a drug treatment program. On the other hand,there are also police departments that stay close to their traditional law enforcement role. Their view is that they should arrest people who break the law {juveniles or adults) and take them to the proper authorities. For juvenile law breakers, no matter what their underlying problem, these departments choose to arrest the youth-- and then either issue a citation to the probation department in minor cases or directly transport the juvenile to juvenile hall in more serious cases. One respondent stated that-- from the police point of view--they have no legal authority (or leverage) to send a youth to such a drug treatment program. Even a YSB cannot commit someone to treatment. Thus, some departments choose not to get involved in drug treatment issues at all. 44 CAAmai:a'sDocuFnents\System of Care\youth\YouthStudy\newReport.doc ......._.................. ....... _.. ......... ..._...... Arrest DatalCrime Statistics Juvenile crime data, and specifically drug arrest data, are very deceptive and inaccurate. There remains a mystery of the low drug arrest statistics in Contra Costa County. All law enforcement respondents said that the official number of drug arrests published by the State Bureau of Criminal Statistics (BCS) for Contra Costa County sounded extremely low. It appears that this anomaly is related to how arrest data are collected and processed. All law enforcement respondents believed that there is a lot more substance muse in Contra Costa County than is reflected in the official crime data. And there are more arrests than are reflected in the official data. To a great extent the issue relates to how law enforcement agencies define and count arrests. The California Penal Code definition of arrest is "taking a person into custody in the manner prescribed by law." Based on that legal definition, police departments throughout the county arrest youth for alcohol and drug offenses with great frequency-- and many of those arrests are never counted in the official statistics. However, most police departments do not call these types of actions arrests. Normally, if a. youth is taken into custody and taken to the police station, the police consider this to be a "detention," not an arrest. As a detention, there is no formal paperwork completed and sent to BCS. There are many such cases,but exact figures are not available. A second factor related to how drug arrests are processed is what is called "the hierarchy rule." This rule of counting crime holds that only the most serious crime will be counted in the statistics--if there are multiple offenses in one incident. Thus, if a youth gets arrested for assault with a deadly weapon (ADW) and possession of meth, only the ADW gets officially recorded. Because of this rule, a lot of drug-related cases are lost or "masked" in the official crime data,because they are recorded as some other crime. .Probation Probation also faces several important issues that are related to substance abuse treatment for juveniles. One is the differing conceptions of treatment among probation officers. Many probation officers think there are enough substance abuse treatment slots in the county to handle all of the youth who need treatment. However, it appears that many probation officers confuse the specifics of substance abuse treatment and with different types of counseling. Substance abuse treatment is thus confused with counseling or other types of therapy. On the other hand, there are very specialized views of treatment based on specialized mental health and substance abuse problems. For example, some probation officers believe that most of the youth who come in for placement have substance abuse issues. However, most are not your goad old fashioned simple substance abuse delinquent--with qc CAAmaiia`sDocuments\System of Care\youth\Youtf Study\newRoport.doe no other problems. Many of the youth who are ordered to the placement committee are not like that. Most have other problems--violence; sex offenders, mental illness, gang affiliation, etc. There are not enough treatment slots for these types of youths. Money is always an issue. There is not enough money to provide all of the specialized treatment that county youth need. Although this remains somewhat unclear, it appears that the probation department has a pot of money--about $7 million--to provide for out- of-home placements. With a finite amount of money,there is always a concern as to how to allocate it. Although there is undoubtedly genuine concern on the part of the probation department to provide high quality treatment for wards of the court, there is also a motivation to spend the money on the probation department's own programs. Those programs include the new diversion program and the Summit program. Related to fiscal concerns is the philosophical conflict over how to handle juvenile drug cases--or any juvenile cases for that matter. There is a general rule in juvenile justice philosophy--employ the "least restrictive alternative" possible while maintaining public safety and taking care of the needs of the child. Thus, there is conflict in whether it would be preferable to provide drug treatment on an out-patient basis, or on an in-patient basis. It is possible that in-patient treatment may be best for the youth, but it is not necessarily the least restrictive alternative. For example, some probation officers contend that Thunder Road may be too long of a program for some youth. If the Thunder Road program is really long (9-12 months), they may be "putting themselves out of business." Even if youth had a substance abuse problem, they would not want to go to a long treatment program, but instead want to go to the camp or boys ranch for a shorter period of time--like six months. Relating it back to the community approach, one probation states that the court wants to use, and that the probation department is successful in implementing, "intermediate" sanctions. These intermediate sanctions, in her mind, include remaining in the home and going to out-patient treatment, going to school, community services, etc., etc.--all combined with good (intensive) supervision by the probation department. It is that supervision that has unproved in recent years. Treatment entry for most drug abusing adolescents often follows some rather dramatic behavioral dysfunction, overdose, delinquency, drug related offense, truancy, family related assaults, intensive family conflict, , emotional breakdowns or severe decrements in performance noted by concerned others. Even in severe drug dependency among young people, completed voluntary self-referral to treatment is unfortunately rare. three primary system sin the network of adolescents influence them to seek help--peers, family, and school. To the extent that referral comes first from other systems e.g. criminal justice system,the problem is even more likely to be severe. Yet public and private school systems have profound advantages for implementing early intervention programs. First and foremost, except for dropouts, they capture youths for a 45 CAAma1WsDocuments\System of Caralyouth\YouthStudylnewReport.doc _..._........_._.__......................................................................................................... ...................................................................................................................................................................................................................................................................................................................... ............... ........................................................................ ........... ......... ......... _.... significant part of their day. They have considerable power within their domain to influence the informational and attitudinal environment surrounding youth. 47 CAA maHa'sDocuments\System of Care\youth\YouliStudy\newReport.doo OVERALL SYSTEM RECOMMENDATIONS • Improve the communication and collaboration across all systems regarding the identification and referral of youth in need of AOD-related services, and encourage joint planning efforts across systems when seeking new program directions, e.g., adolescent drug court, regional screening centers, one-stop service centers, etc. ® Provide opportunities for cross-training of staff in law enforcement, probation, the schools, and AOD treatment providers. Training might include information on addiction medicine, the AOD system of care, probation's continuum of care, location and entrance criteria for AOD programs serving youth, etc. • Develop written Memorandums of Understanding (MOU) between the law enforcement, probation, the schools, and AOD treatment providers describing how youth with AOD problems will be identified, and each systems specific response once youth have been identified, e.g., referral to REACH Project, or N.ew Connections, or CARE Team, etc. • Use empirical data to target youth at risk and develop multi-disciplinary teams comprised of representatives from all four systems to work together to marshal the resources of all four systems to intervene with youth who may be using but who could still benefit from targeted secondary prevention efforts. • Develop a core of standardized variables designed to identify AOD problems among youth, ensure these variables are imbedded in the intake forms in the juvenile justice, social services, mental health, prevention, law enforcement systems. Ideally this information would be routinely entered into an electronic database, but if this was not possible, it would at least be possible to undertake "window studies," looking at data across systems for a given time frame, e.g., two weeks,three months, etc. ® Involve youth in the development of a youth continuum of AOD services within the county's system of care that would focus on engaging and retaining youth. ® In order to reduce the stigma against drug and alcohol treatment and those in recovery, and to encourage those who need help to seek it, undertake a social marketing plan to emphasize that treatment works. : Consider "one-stop-shopping" service model for youth, currently being successfully used in the city of Fairfield and in Alameda County. 48 C.\Aw.a:is'sDoouments\System ofCare\youth\YouthStudy\newReport.doc - .....__._... _ ..__.._.. ......... _._. ......... ......... ......... ......... ......... ................._ ................................................................................................................................................................................................................................................................................................................ ... ............................................................................. ..._..... _..... ........_.... _ _..... • Work with probation, schools, mental health, health services, and substance abuse personnel to find better ways to share information. In order to better serve youth in a more integrated and comprehensive way, these systems need to negotiate ways to share information while still protecting the confidentiality of youth, e.g., use of Qualified Service Agreements or Memoranda of Understanding which specify the ways in which information can and cannot be used, even after informed consent has been obtained. • Move from an approach to youth AOD use that focuses on the most seriously affected to one that is more prevention driven. At the same time find ways to more effectively target and serve high-risk youth. LAW EN ORCEMENT RECOMMENDATIONS • Provide a general resource list describing adult and youth AOD treatment services available in the CSAS system of care (including location, hours, entrance criteria, etc.) to law enforcement agencies. Also provide an abbreviated "care card" that could be carried by all law enforcement personnel, and would include local treatment resources for youth. • Provide more training for law enforcement personnel regarding the nature of addiction and drug-related problems. • Consider "'importing" Antioch's youth diversion model to other areas of the county. The commitment made by the Antioch Police Department ($92,000) is substantial,but worth every cent according to their Chief. • Develop a written "how to" which describes in detail Antioch's Youth Diversion Panel model, including costs, methods and extent of collaboration among systems that are required, etc. : 'Utilize a youth diversion model (like Antioch's) that allows for "courtesy referrals,"that is, a young person can be referred to the Youth Diversion Panel even if no crime has been committed, if it is determined that the young person could benefit from the Panel's services. + Find alternative approaches to respond more effectively to youth with AOD problems that do not have parental support. PRONATION RECOMMENDATIONS + Provide more training for the probation department regarding the nature of addiction and drug-related problems. 49 C:\A maiia'sDccuments\System of Care\youth\YouthStudy\ncwkeport.doc • Provide cross-training opportunities for probation officers and AOD treatment providers to learn how the other works, and how the two systems work can together more productively,etc. • Provide training about the distinction between substance abuse treatment and other types of treatment. • Promote out-patient treatment for youthful substance abusers who remain in the community. SCHOOL-BASED RECOMMENDATIONS • More training for school personnel on how to identify AOD use by students, and what to do once these youth have been identified. These training sessions should include youth educators as well as adult educators. • Increase the number of school-based prevention programs, including support groups, and ensure adequate dispersion throughout the county. • Schools have the best access to youth. However, in most schools there is not an adult on campus with whom a young person could talk about AOD problems without incurring consequences. Put substance abuse counselors at every secondary school. Hire one less teacher and use funds to hire counselors. Teachers could then refer students who may have AOD problems to individuals trained to interview, screen, and assess students if needed. • Institute an elective class, built into the academic schedule, that would allow youth who may themselves be considering AOD use or concerns about the use of alcohol and drugs by others (friends, family, etc.) to learn about ways to deal with these situations without having to self identify, or be labeled as a substance abuser. • Have more prevention education available to students (elementary and middle school) on school sites. A structured curriculum for 6th graders (or younger) is needed and should be part of the regular educational curriculum. • Work with university teacher training programs to encourage inclusion of a curriculum that would better train and prepare teachers (including elementary school teachers) to recognize AOD problems among youth, and to make appropriate referrals. • Focus general prevention education on elementary school age youth. Concentrate more targeted prevention education (peer support groups) for 50 C:\Atnaha`sDocumentslSystem of Care\yo.rth\YouthStudy\newReport.doe ................................................................................................................................................................................................................................................................................................................... _......................................................................................................................................................................................................................................................................................... .... ................. ._......_....._........ youth who are themselves experimenting with alcohol or drugs, or have family members who are using in middle,junior,and high schools. • Measure effectiveness of"Saturday classes" currently being used by schools as a sanction for youth caught high on alcohol or drugs on campus to determine whether it is an effective approach and impacts recidivism. • Conduct anonymous, countywide AOD use prevalence surveys in junior and high schools, asking about AOD use as well as frequency. These studies would allow more accurate assessments of ACID youth services needs. • Institute more alternative activities and community-based resources focused on alternative and necessary small school students who are by definition at higher risk of AOD use. CSAS RECOMMENDATIONS • Improve accuracy of CADDS reporting generally. • Try to secure funding to expand the intensity of youth treatment currently available within the county (including high intensity outpatient services, and possibly low and high intensity residential treatment). • Ensure treatment and prevention providers are accurately reporting on all youth who are receiving treatment services--whether in groups or on individual basis. • AOD treatment providers should spread the word to staff in the other "systems" that treatment works. While client confidentiality guidelines must be adhered to,treatment programs could provide feedback to law enforcement, schools, and probation regarding the impact of their treatment referrals in the aggregate, e.g., probation referred 30 youth to treatment this month, 50% entered and are still in treatment, 25% never showed up, and 25% left before 30 days, etc. MENTAL >EiEALTH RECOMMENDATIONS • Provide more training for the mental health providers regarding the nature of addiction and drug-related problems. • Provide cross-training opportunities for mental health providers and AOD treatment providers to learn how the other works, and how the two systems work can together more productively, etc. 51 C:\AmaHa'sDo,.uments\System of Care\youth\Youths:udy\newRepo t.doo • Work even more closely with CSAS, particularly with regard to clients served by both systems. • Provide training regarding the distinction between substance abuse treatment and mental health treatment. SOCIAL SERVICES RECOMMENDATIONS • Provide more training for DSS/CPS workers regarding the nature of addiction and drag-related problems. • Work even more closely with CSAS, particularly with regard to clients served by both systems. • Provide cross-training opportunities for DSS workers and AOD treatment providers to learn how the other works, and how the two systems work can together more productively, etc. • Provide training about the distinction between substance abuse treatment and other types of treatment. • Promote out-patient treatment for youthful substance abusers who remain in the community. PARENT/FAMILY RECOMMENDATIONS • Provide AOD treatment on school campuses. • Provide more parent education regarding how to identify if their child is using alcohol or drugs, and what to do once identified. These training sessions should include youth educators as well as adult educators. • Provide groups for parents who need support to stop enabling their children's use of alcohol and/or drugs. YOUTH RECOMMENDATIONS • If money and resources are limited, first target youth who experimenting with alcohol and drugs. • Focus general prevention efforts on younger children(below 6th grade). • See focus group report attached. 52 C:\Amaiia'sDocuments\System of Care\youth\YouthStudy\newReport.doc .................................................................................................................................................................................................................................................................................................................... __ _............................... _ _...... ......... ....... ........... ............ __ ........_...... .......................... ... :5WO Appendix A: Lust of People Interviewed Appendix A List of People Interviewed Terry Star,Chief Probation Officer i Dan Douglas,Community and Youth Resource Officer,San Ramon Police Dept. Dean Storm,Group Horne Licensing,State of Randal Dickey,Patrol Officer,Moraga Police Dept. Califoia Richard Birss,Director,Probation Deist.Diversion Joe Brosiino,Supervising Deputy Probation Officer Program. Karen Godfrey,Supervisor,Calif. State Dept.of Laurence Katz,Juvenile Court Referee,Contra Human Services Costa County Randy Snoden,former Admin.at Thunder Road, 6 Tom Gerstel,.Administrator,Thunder Road Adolescent Treatment facility Diane Degrassia,West Contra Costa Co.Unified Jim Becker,Executive Director,Center for Human School Dist.DATE Coordi. Development Linda.Larsen,Martinez Unified School Dist.DATE Craig Chafee,Department of Research,California Coordin. State Department of Drags and Alcohol Ken Durkert,Asst.Dir.of Student Svcs.Mount Jiro Bouquin,Executive Director,New Connections Diablo Unified School Dist. Lynn Straight,Asst. Superint.of Educational Svcs. Marlette Tinker,New Connections Antioch Unified School Dist. I Jim Burcio,Dist.Head of Child Welfare and E Denise Polk,New Connections Attendance,Hearing Officer for Expulsion,Antioch Unified Sch.Dist, Dr.John.Cooley, Superintendent Mickey Marchetti,REACH Project Moraga Unified School District Linda Miller,Pittsburg Unified School Dist.,DATE Shirley Marchetti,REACH Project Coordinator Phil Webb,Asst.Principle for Attendance& Tri Cities,Lead Worker Discipline,Pittsburg Unified Michael Lazar,Probation Dept. Nora Carter,Director Group Horne and Fast Track Programs,Thunder Road Michael Phalen,Chief of Police,Pleasant Cynthia Haven,Supervisor,Placement Unit, Hill Police Department Probation Dept. Chief Nunez,Clayton Police Dept. Carol Nelson,Communities in Schools,Richmond High School Decky Thornton,Head Counselor,Pleasant Hill Ruth Peritz,CARE Team Leader,Kennedy High Police Dept.,Youth Svcs.Bureau School Lt.Ernie Templeton,Policy and Planning Unit, Robert Cockley,Deputy District Attorney,Juvenile Sheriff's Department Court Veronica:Flores,Chief of Records,Pittsburg Police William Landsdowne,Chief of Police,City of Dept. Richmond Juvenile Court Referee,Bruce Sterling Karla Goad,Project Director,NEAT Family,Center for Human Development Mark Morris, Safe.Future Program Chuck Deutschman,Director CSAS Debbie Supple,Contra Costa County Office of Ed. Ruth Ormsby,Dept.of Mental Health Donna Weygand,Dept. of Mental Health Ann Campbell,Child Welfare,Dept.of Social Services Savannah McKenzie,Court Supervisor Dana Flabella,Contra Costa County Dept of Social Dept.of Social Svcs..Child Welfare Services,Director of Children's Services Juvenile Court Referee Sterling Amalia Gonzalez del Valle,Director Prevention Program,CSAS Judge Lois Haight Leslie Bialek,Alternative Defender, Contra Costa County Juvenile Ct. Richard Griegsor.,Chief,Walnut Creek Police 12 youth in treatment Department .... ..................................................................................... . . ... ...................... . ...... .... .......................... .............. ..... ...... ..... . ..... Appendix B: Youth Focus Report YOUTH As part of this study of why youth comprise such a small percentage of Contra Costa County's publicly funded treatment population, a focus group of youth. (mostly in treatment) was held in August, 1998. A total of 14 youth participated, 40% were White, 20% African American, and 40% were Latino. The group was conducted at 595 Center, Martinez, and respondents were paid S 10 for their participation. How many had been in outpatient or residential treatment for alcohol or drug use? Included in the group were fourteen youth, 10 of whom were currently in treatment, and 2 who were not in treatment and did not use alcohol or drugs. Describe the circumstances that caused you to enter treatment. Most of the youth indicated they were out of control with their A©D use prior to entering treatment. Almost all of them described coming to school high on their drug of choice. In virtually all cases,their drag use was discovered by their parents or a probation officer, but was seldom identified by school staff In several cases parents reported their child's drug use to a police officer. In your opinion why did you first start using drugs and/or alcohol.? A number of reasons for using were identified by the group. Most frequent were: 1) to deal with problems at home; 2) to prove myself to my friends; 3) as a way to get closer to an older sibling, and 4)to reduce stress and/or depression. How old were you when you first started using alcohol and/or drugs? Of the 12 youth who report using alcohol/drugs, 3 (25%) reporting first using it by age 7. Another 25% report first using before the age of 10. All 12 (100%) report first using by 13 years of age. What did you use and horn often? Marijuana, alcohol and amphetamines were the drugs of choice for the group as a whole. Virtually all 12 of the youth that reported using,reported using daily or almost daily. When asked what other drugs are used by their friends, youth mentioned: white out, glue, gasoline, formaldehyde, LSD,peyote, angel's trumpet, PSI', and prescription drugs. 1 CAAmalia'sDocumen&System of Care\you,,h\Youthstudy\newyouthfocus.doe How did you acquire your alcohol or drugs? Parents (both having it provided by parents and stealing it from parents), stealing it from Safeway or Payless, older friends, and relatives were the ways most youth described getting their drug of choice (primarily alcohol,marijuana or amphetamines). Who first discovered you were using alcohol and/or drugs? In almost every case, youths' drug taking behaviors were first discovered by parents (33%), older siblings (25%), other relatives (25%), and group home counselor (17%). However, little was done to seek treatment for any of the respondents at the time of first discovery. What did this person do once they found out? Alarmingly, in several instances the discovery of a youth's drug and alcohol use served as an invitation to for that youth to begin using with a parent or a sibling. In a few cases parents actually turned their child in to the police. One young girl reported being sent to Walnut Creek Hospital because her parents thought she was mentally ill--they did not recognize her erratic behavior as amphetamine addiction. (She later entered more appropriate substance abuse treatment.) How many of your friends who use alcohol and/or drugs have been caught using? According to respondents, very few of their friends have been caught for using alcohol or drugs. Even those youth whose friends may have been under the influence at the time they committed another crime report their friends not being confronted with their drug use. What happened to them when they were caught? Those youth that had committed other more serious crimes were sent to Byron's Boys Ranch, others received only minor,if any sanctions. Do you think what happened was fair or right? Most respondents believed that something needed to be done to interfere with their A.OD use (now that they themselves are in treatment)but indicated it would be better for kids to get the help they need to stop using drugs rather than just being punished. If not,what do you think should have happened? (See above) 2 CAAmalsa°sDocumentsl.System of Care\youth\YouthStudylnewyouthfocus.doc :...................................................................................................................................................................................................................................................................................................................... .... .................................................................................. ...... .................................... ................................ .. .._..... ......... ......... .._._....... ... ..... ........... What are the main reasons you believe young people use alcohol and/or drugs? Respondents revealed the following reasons as why people use drugs: stress, boredom., trying to fit in with your friends, weight loss, abuse at home,to feel cool, to not feel or to cover up your feelings, and to be sell-destructive--wanting to die. What drugs do you consider serious drugs? Heroin, cocaine, PSP, and LSD were considered as serious drugs. Alcohol, glue, ecstasy, marijuana and amphetamines were not considered to be serious drugs. What percentage of your friends use alcohol? drugs? tobacco? (Research shows that young people who use drugs often over estimate their use by other youth.) A hong youth respondents 13 (93%) of the 14 youth said their friends use alcohol and/or drugs. They also believe that 75%of all students smoke cigarettes or cigars. What percentage of your friends come to school high on alcohol or drugs? Among the 12 youth who report themselves using alcohol or drug, half believe that 50% of their friends come to school high, one-third believe 75% of their friends cone to school high, and 1 youth indicated that all of her friends (100%)come to school high. What do you think should happen to youth that are caught using alcohol or drugs at school? The majority of youth believe that expelling students or sending there home is an ineffective way to deal with a student's alcohol or drug problem. They believe that most students who are using would happily not come to school,preferring to stay home and get high. They believe there are too many youth that use alcohol and drugs at school to expel all of them frorn school anyway. In-school suspension was mentioned as a"punishment" that makes an impression on youth, but that it is not as effective as a class or providing free treatment that really tried to help these kids stop using. What do you think should happen to youth that are caught by police using alcohol or drugs in public? Respondents generally understood that the police have a job to do and if they are caught under the influence of alcohol and drugs that the police need to act. Some suggested alternative approaches for dealing with these youth including: telling their parents, or giving them a chance to seek treatment for their addiction. If youth do actually get help and stop using alcohol or drugs, the police should just let it go (unless they committed some other crime as well). 3 C.\AmaUsDocuments\System of Care\youth%` outhStudy\newyouthfocus.doc What do you think parents should do if they catch their teenager using alcohol or drugs? Get their kids help. For those of you who have been, or are currently in treatment, are you fearful of returning to school, and the impact it might have on your recovery? Most respondents indicated some nervousness about going back into an environment in which they have used in the past. (Unlike adults, youth often don't have the luxury of moving away to a place where they will not encounter people with whom they formerly used.) Respondents indicated that "just do it one day at a time," "it's hard to get rid of your old friends, but you have to if your serious about staying clean," "go to meetings (12 step,)", and "fill your time with school and work" as possible approaches to support their recovery. In your opinion,is there any support at school for youth in recovery? All respondents stated there are virtually no on-campus services or support available to help youth maintain their recovery. What could be dune to help more youth that need drug and alcohol treatment receive the help they need? More than half of the respondents believe that on-campus 12 step meetings led by other youth or young adults would be helpful. They were not afraid of being labeled as former drug users, and believed that having meetings on-campus would help not only those youth who are in recovery,but provide a non judgmental place for youth who may still be using. Other suggestions included: 1) Give parents more information about what kinds of help are available for their children. 2)Authorities shouldn't lie about drugs. They shouldn't tell you that it's not fun because if you try it and find out that it is fun,you don't believe anything else they tell you--like it can wreck your life,addict you, etc. 3)Have peer speakers that come to the schools to talk about drug/alcohol use. It makes it more believable to hear information from someone "who's been there." 4)Have more treatment options available for youth that don't have money. 4 CAAmaI4a`sDocuments\System of Carelyouth\Y'outhStudy\newyouthfocus.doe ...................................................................................................................................................................................................................................................................................................................... CUNTR.�. COSTA HEALTH SERVICES COMMUNITY SUBSTANCE ABUSE SERVICES ypi1TH AND FAIMILY PREVENTION -TREATMENT - AFTER CARE Apri11999 W PAGE NO. CSAS System of Care 2 CSAS Youth and Family Continuum of Care 2 Service Priorities 2 Portals of Entry 3 Practice Principles 3 Continuum of Services 4 A. Prevention 4 Universal or General Prevention 6 Community Partnership 6 Partnership Forum Initiatives 7 Selective Prevention g Indicated Prevention S B. Treatment 9 Assessment 9 Outpatient Drug-.Free 10 Residential 10 Appendix 1: Service Continuum and Service Flow Chart Appendix 2: Contra Costa County Community Partnership Appendix 3: Indicated Prevention Screening and Behavioral Contract Appendix 4: Treatment Levels and Performance Measures r' ` A—MY CSAS System of Care The Community Substance Abuse Services (CSAS) "puts people first". CSAS advocates for alcohol and drug free communities by promoting individual and family responsibility, hope, and self-sufficiency. CSAS operates and contracts for services through a community-based continuum of care that stresses accountability and outcomes, is culturally competent and client driven. All services comply with California State Standards for Substance Abuse Treatment and Prevention Services, and with federal and local laws, CSAS Youth and Family Continuum of Care Youth and Family services are designed to assist communities, families and individuals to reduce and prevent substance abuse; discourage youth access and use of alcohol, tobacco and other drugs; and encourage communities to change conditions that contribute to substance abuse related problems. Service Priorities • Children and youth whose parents have alcohol or drug addiction, are in treatment or recovery; • Families and significant others that suffer the effects of another person's alcohol or drug addiction, abuse or dependency problems; • Populations and groups with special needs such as preschoolers, school dropouts, youth in juvenile detention facilities or juvenile justice system, runaway and homeless children and youth, pregnant and parenting teenagers, children and youth served by social welfare systems; • Immigrants, refugees, racial and ethnic minorities, particularly Native Americans, African Americans, Latinos and Asian Pacific Islanders; • Residents of public housing, families and individuals living in communities subsidized by local and/or federal government or defined as enterprise zones; • School sites with high level of truancy or serving children and youth unable to function in regular settings e.g., continuation, community and alternative schools. C:\Amalia'sDocuments\System of Care\vouch\services.doc 4/1/99 2 ................. ......................... ............ _.... ......... ......... ......... ....................................................... ....... ......... ......... ......... .... ......... ..................... .............................................................................................. ..... ......... ......... ......... ............................................................. .............................................................................. i JIMY a11M Portals of Entry CSAS System of Care operates and contracts community-based programs that provide prevention, treatment and after care services for youth and their caregivers or family members (Appendix 1: Service Continuum and Service Flow_Chart. 'These local portals of entry are supported by the Access Unit, a centralized management and information system that provides substance abuse information, problem identification and referrals, screening, placement, registration and care coordination services to Contra Costa County residents. Other portals of entry are Schools, Juvenile Justice System, Children's Protective Services; and Health Services. To address service priorities described above, formal linkages have been established with Mental Health, Public Health., Foster Care, Group Homes, Homeless Shelters, and. ether Youth Diversion programs i.e., Safe Futures, Juvenile Drug Court, and. Independent Living Skills Programs. Practice "Principles": 1. CSAS recognizes that youth experimentation, use, and abuse of alcohol and other drugs is impacted by family and community norms. 2. Given that a large percentage of youth are referred rather than self-referred, the substance abuse problem among youth tends to be ascribed rather than. self-defined. 3. Although youth experimentation and use of alcohol and tobacco is illegal, these substances are still accessible and available to young people. Thus, experimentation and use, is to an extent perceived by youth to be "a rite of passage into adulthood". 4. Given different levels of "awareness of the substance abuse problem and readiness to change" among youth, CSAS prevention and treatment services define children of substance abusers and youth that are experimenting or using alcohol and other drugs as "high risk". S. Prevention and treatment services are tailored to a variety of cultural and ethnic populations. 6. Services engage (1) youth, (2) parent or caregiver, and (S) the environment in which the youth substance abuse problem is identified e.g., the family, group or faster home, child welfare, school, criminal justice system, etc. but are not contingent on parental participation. C:\AmalialsDocunents\System of care\youth\services.doc 411/99 3 CCNCMASERVICES AMI Continuum of Services A. Prevention The goals of prevention services are (1) to reduce alcohol and drug use and availability of those substances in the community, (2) to reduce alcohol and drug use among school-aged youth; and (3) to increase the use of prevention activities that are research-based and outcome driven. CSAS Community Partnership prevention approach (Appendix 2; Contra Costa County Community Partnership) is a. public health systems model that addresses environmental factors and risk factors within communities impacted by alcohol and drugs. The approach takes into consideration the physical and social context in which drinking and other drug use occurs, as well as "the laws, regulations, formal and informal rules and understandings that are adopted on a collective basis to guide individual and collective behavior" (Mosher and Jernigan). CSAS's prevention services are funded by the California Alcohol and Drug Programs Title IV "Safe and Drug Free Schools and Communities" (SFDS) Grant Program, and Title 45 of the United States Code of Federal Regulations (C.F.R, 96.125) which governs the Substance Abuse Prevention and Treatment (SAPT) Block grant Primary Prevention Set-Aside required strategies listed below. INFORMATION DISSEMINATION [CODE 12]. Involves dissemination of information to raise knowledge and awareness of the nature and extent of alcohol, tobacco and drug use, abuse, and addiction and their effects on individuals, families and communities. It also provides knowledge and awareness of available prevention programs and treatment services. Information dissemination is characterized by one- way communication from the source to the audience with limited contact between the two. EDUCATION [CODE 13]: Involves two-way communication and is distinguished from the Information Dissemination strategy by the fact that interaction between the educators facilitator and the participants is the basis of its activities. Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, critical analysis (e.g., of media messages), and systematic judgement abilities. Ca\A°aa', ia'sDoct.:.ments\system of Care\youth\services.doc 4/1/93 4 ALTERNATIVES [CODE 14]. Involves the participation of target populations in activities that exclude alcohol, tobacco and other drug use. The assumption is that constructive and healthy activities offset the attraction to, or otherwise meet the needs usually filled by alcohol, tobacco and other drug and would, therefore, minimize or obviate resort to the latter. PROBLEM IDENTIFICATION ANIS REFERRAL [CODE I.5]: This strategy aims to identify those who have indulged in illegal/age inappropriate use of tobacco or alcohol and those individuals who have indulged in the first use of illicit drugs in order to assess if their behavior can be reversed through education. It should be noted, however, that this strategy does not include any activity designed to determine if a person is in need of treatment. CoMmuNITY-BASET! PROCESS [CODE 16]: This strategy aims to enhance the ability of the community to more effectively provide prevention and treatment services for alcohol, tobacco and drug abuse disorders. activities in this strategy include organizing, planning, and enhancing efficiency and effectiveness of service implementation, interagency collaboration, coalition building, and networking. ENVIRONMENTAL [CODE 17]e This strategy establishes or changes written and unwritten community standards, codes and attitudes, thereby influencing incidence and prevalence of the abuse of alcohol, tobacco, and other drugs used in the general population.. This strategy is divided into two sub-categories to permit distinction between activities which center on legal and regulatory initiatives and those, which relate to the service and action-oriented initiatives. As CSAS strives to have more costa-effective, research based prevention programs that can measure alcohol and other drug related outcomes, determining priorities and performance outcomes across systems involved in the delivery of AOD services has become a. significant factor. Equally important is the need to establish best practices" to ensure compliance with principles of effectiveness required as of July 1, 1999 by the Center for Substance Abuse Prevention and the California. Alcohol and Drug Programs. For this purpose, CSAS prevention include universal prevention strategies to serve general populations as well as selective and indicated strategies that target communities, groups and individuals that are known to have specific risks for substance abuse. C:\A alia'sDocuments\system of Care\youth service .doc 4/1199 5 " Sus RMCES Universal or General Prevention) - The purpose of general prevention services is to provide low intensity and high volume AOD information to children, youth, parents and the community at large. The intent is change in knowledge and attitude, increased awareness of risks, resiliency factors and available resources. A significant aspect of these services is the facilitation and support of strategies that promote development of partnerships among schools, churches, local groups and service organizations concerned with substance abuse problems impact on the health and well being of local communities. Services include AOD education curriculum provided in a regular classroom or community setting. This service requires approved curriculum, measurement of knowledge and attitude change using pre-post surveys, and administration of participant satisfaction evaluations. Another service strategy, AOD alternatives, aims to build leadership skills among a core group of individuals involved in planing alcohol and drug free events and activities for others. The intent is to increase AOD awareness and to develop leadership shills among "core" group members. A skills inventory is required to measure changes in AOL} knowledge and increased capacity among "core" members, as well as administration of evaluation questionnaires to rate satisfaction among those that attend alcohol and drug free activities and events. Community Partnership - CSAS Community Partnership services provide technical assistance, training, and resources to regional alcohol and drug abuse prevention coalitions and grassroots organizations. The Community Partnership uses coalition building, collaboration, and environmental strategies to promote "A Drug and Alcohol Free Contra Costa County". The Community Partnership initiatives engage those most affected by the substance abuse problem in the planning, implementation, and evaluation of proposed solutions through the following activities: • Mini-grants are offered to grassroots groups through a proposal process, which is both a vehicle for skill development and an effort to recruit community members to join substance abuse coalitions. • Citizen development focused on building leadership capacity in the community. The strategy is to recruit and bring out new and emerging leaders to define the local prevention agendas in their communities. "...universal measures are directed to general population groups that have not been identired on the basis of risk factors related to substance abuse."in Preventiny,Substance Abuse Among Children and Adolescents:Family- Centered Approaches Reference Guide,DHHS Publication No.{SMA}3223-FY98,"Introduction"page xxii C:\Amalia'sDocuments\System of Care\youth\services.dec 4/1/99 6 4 • Pro-active community outreach to constituencies that are not represented in the substance abuse coalitions. The strategy is to use culture specific outreach that is appropriate to the yet-to-be-reached citizens. • Organizing the community to identify issues, target solutions and pursue goals. The strategy is to encourage collaboration, facilitate problem solving, acknowledge power differentials and build alliances. Partnershii Forum - CSAS Administration staffs an alliance of local prevention groups that work with the Substance Abuse Advisory Board (SAAB) to implement the Contra Costa. County's Substance Abuse Action Plan. In 1995 SAAB formally included the Partnership Forum in two of its standing committees, the Public Policy and Public Relations Committees. The goal, to encourage community residents and appointed members of the Substance Abuse Advisory Board, in particular youth and persons in recovery, to articulate and evaluate initiatives, recommend policies and advocate for ACID services. Some of the current Partnership Forum supported initiatives are listed below: 1. CSAS System of Care - A process to develop, implement and evaluate publicly funded substance abuse services which involves CSAS administration, CSAS county operated and contract providers, and the Substance Abuse Advisory Board; 2. Los Medanos and Pegasus Mentor Projects - A project to increase representation of minority and low income people in healthh care professions and to provide opportunities for high school students to interact informally with adult role models in the employment arena. Los Medanos serves youth residents from a Dousing Project in Bay Point and Pegasus serves Richmond High School students. 3. Las Casitas - A collaborative process to provide technical assistance and training to Housing Project Resident Councils in Contra Costa. County. 4. Partners In Recovery Alliance [PIMA] - A three year project funded by the Center for Substance Abuse Treatment brings together recovery community to (a) advocate for improved AOD treatment services; (b) promote local, regional, and statewide recovery groups; (c) promote empowerment, education, recovery, rehabilitation, and socialization of all persons in recovery. 5. Alcohol/Drug Sensitive Information Planning System/Geographic Information System [ASIPS/GIS] -- A community-based process to collect. C:\Amalia`sDocuments\System of Care\youth\services.dcc 4/1/99 7 BSTMI , �:' AMMY alcohol/drug problem information from local sources, including public agencies and community groups involved in the prevention and reduction of local alcohol and drug problems. The intent is to educate, organize and mobilize communities to pursue strategies aimed to reduce or eliminate high-risk environments of alcohol and drug use and availability. 6. Access and Utilization of Youth AOD Treatment - An attempt to explore why publicly funded AOD treatment services in Contra Costa County are underutilized by youth between the ages of 12 and 17. Concurrent with this study CSAS System of Care planning process proposed a family- centered Youth and Families continuum of care, shifting emphasis on early identification, standardized measurements and linkages between prevention, treatment and after care services e.g., recruiting youth that successfully completed treatment to join youth prevention programs that support recovery. 7. Mapping of Alcohol Retail Outlets and 'Violations in Contra Costa County - An educational and organizational tool to mobilize elected officials, community residents and merchants to establish responsible retail practices, in particular, sales to minors and compliance with the California Alcohol and Beverage Control regulations. Selective Prevention2 -.. The purpose of selective prevention is to ensure that CSAS client's children and family as well as clients from other systems that serve clients that abuse or are addicted to alcohol and drugs are identified and referred to CSAS System of Care. Outreach efforts are directed to CSAS outpatient, residential and detox treatment clients, their children and families, under served communities, Probation, Mental. Health. and Social Service clients. Services include presentations, dissemination of information and educational materials, AOD education and support to "high risk" individuals, families and groups. Indicated Prevention3 - The purpose of indicated prevention is to provide high intensity and low volume AOD services to groups of persons identified as "high risk" for substance use, abuse or addiction. The intent is behavior change by increasing resiliency and decreasing risk behaviors. Services involve an adult referral or a youth self-referral to an educational group for the purpose of 2",..selective measures are directed to families whiz children who do not yet abuse substances but who,as a subgroup,have an above average risk for developing substance abuse problems" in Preventing Substance Abuse Among Children and Adolescents:Family-Centered Approaches_Reference Guide,DHHS Publication No.(SMA) 3223-FY98,"Introduction"page xxiii 3"...indicated measures are directed to specific families whose children are not abusing substances but who have known,identified risk factors for doing so."in Preventing Substance Abuse Among Children and Adolescents_ Family-Centered Approaches Reference Guide,DHHS Publication No.(SMA)3223-FY98,"Introduction"page xxiii C;\Amalia°sDocuments\System of Care\youth\services.doc 4/1/95 8 f at 8,12 Am modifying or changing a problem behavior. For example, a youth is a member of an identified peer or family group within which other individuals abuse alcohol or drugs or, has a current history of behavioral problems at home, school, or community that are directly related to the use of alcohol and drugs. This prevention strategy accommodates youth that are using alcohol or drugs but dei not believe this is a problem for them as well as youth that have tested positive or have been found to use alcohol or drugs and are required to attend a program. Services apply to adults as well. Indicated prevention requires a standardized screening4 (Appendix 3) to establish the "problem" in terms of expected behavioral changes. Screening results are used to develop a contractual agreement specific to each youth or adult, which includes a plan to change or reduce the problem behavior. Services are structured in terms of (a) a set number of hours of group sessions; (b) discussion and strategies for behavior change; (c) evaluation of behavior change; and (d) referrals to a higher or lower level of services e.g., assessment and treatment, or general prevention activities. B. Treatment The goals of treatment services are (1) to provide a continuum of care that is family centered, culturally competent and youth specific; (2) to increase the number of youth needing treatment that are identified and once identified, to increase the number that receive treatment; and (3) to provide comprehensive care coordination for youth to ensure increased length of stay in a continuum of services that supports recovery and promotes resiliency. A fully accredited multi- disciplinary staff of Licensed Social Workers (LCSW), Marriage, Family, Child Counselors (MFCC), and Substance Abuse Counselors provide assessment for addiction severity and dual diagnosis, individual and group counseling, and an array of other services for family and youth who are directly or indirectly affected by substance use or abuse. Assessment - A youth referred to a treatment program for assessment fits the same criteria than a youth referred to an indicated prevention 'high risk" group described above, but the severity of use and behavioral problems have resulted in more serious consequences. A standardized assessments is required to establish the severity of addiction, emotional, psychological., or environmental 'Screening and Assessment of Alcohol and other Drug Abusing Adolescents.Treatment Inivrovement Protocol (TIP)Series No.3,pages 9 through 16—Substance Abuse and Mental Health Services Administration,Center for Substance Abuse Treatment,D HiS Publication No. (STMA)94-2094.Printed 1994. s CSAS staff and providers are meeting to make a final determination as to whether the C-ASI or the CATOR will be used to assess youth clients. Cr\Ar,ialia°sDocuments\System of Care\youth\services.doc 4/1/99 9 conditions that contribute to the AOD problem, Results determine treatment placement level of care or appropriate referral to mental health, children protective services, etc. as well as development and evaluation of individualized treatment pians and client outcomes. OutpatientDru�;_Pree --- CSAS non-residential drug-free youth treatment services are structured in terms of a family centered social model treatment philosophy which includes a set number of required (a) individual, group, family and multi-family treatment sessions; (b) educational and twelve step groups; (c) drug-testing, (d) relapse prevention and after care services; and (e) care coordination to ensure continuity of care between treatment levels and among service modalities. CSAS non-residential drug-free youth treatment consists of three levels of care, one non-intensive and two intensive levels (Appendix 4: Treatment Levels and Performance Measures). Level I Non-Intensive treatment dosage ranges from one to six hours per week for youth and one to three hours for adult caregiver or parent for a period of eight weeks, a total of forty four treatment hours per segment. Level II Intensive treatment dosage requires ten hours of treatment per week for youth and four hours per week for adult caregiver or parent for a period of ten weeks, a total of ninety five treatment hours per segment. Level III Intensive treatment dosage requires twelve hours of treatment per week for youth and four hours per week for adult caregiver or parent for a period of twelve weeks, a total of one hundred and thirty five treatment hours per segment. Care coordination services includes monitoring progress within the different treatment levels and between modalities to ensure continuity of care and support for recovery. Parent or caregiver participation is highly recommended but is not a requirement for services. Residential - Residential programs are 24 hour per day, seven day per week social model environments that require a minimum of 40 hours per week of counseling and/or structured therapeutic activities such as consciousness raising, twelve steps, stress management, poly-drug education, relapse prevention and planning groups. Treatment includes assessment, development and monitoring of individualized treatment and discharge plans, education and required attendance to AA and NA groups. Modality includes after care and relapse prevention. Residential treatment dosage is twenty-four hours per day for forty five days, another forty-five days of Level II or III intensive outpatient at the residential facility with comprehensive care coordination services to link client to a community-based outpatient drug-free treatment program at discharge time. The intent is to provide continuity of care from residential to outpatient treatment levels and then to prevention services to support recovery and to build resiliency. C: \Amalia`sDocuments\System of Care\youth\services.doc 9/1/99 ................. .............................................. ..........................................................................._. ......... ......... ......... ............................................_... ............................................................................................. . . .......................................................................................... . .................................................................................. ..................................................................._............_____.. . ........................................................................................................ .. .................................................................................... ... ........... ... Appendix 1. Service Continuum and Flow Chart / } z r: f ro ^ f � 7 r Rr a + r L f� n R XX i r v Lc i Y ryl . 'YY y a K JO N W 4j r IIN 'nl Li xR i. `f»�;S .Re .r.;_ is f�>•:s cr:,.,a a� ',.z s. - +fsas x.£,�'. flt' �. L,',. y 4�- ak •�'.;iia. • ;a 4 zr f K ea p s x[. :.w y t %i Y ' ' L:r f ff �f'% �{}�%��}�Zf f/cif}'f%.�/�}�` /. • }/}�}ff�� }f } x f{. Appendix 2: Contra Costa County Community Partnership WILLIAM B. WA .KER, M. D, CONTRA COSTA HEALTH SERVICES i"IRcCTOR ,. "''� ' q c-tt�rcD;uzsct N-(MACOMMUNITYCOMMUNITYCIIU �.TOR SUBSTANCE DiR �� T �.A COSTA S �A ABUSE SERVICES C O 597 Center Avenue, Suite 320 HEALTH SE VICES Martinez, California 94553 Pit (925) 313-5300 Fox(925) 313-6390 The Community Substance Abuse Services (CSAS) prevention services or Community Partnership provide comprehensive strategies designed to assist communities, families and individuals to reduce and prevent substance abuse; to discourage youth access and use of alcohol, tobacco and other drugs; and to encourage communities to change conditions that contribute to substance abuse related. problems. The goals of the Community Partnership are (1) to reduce alcohol and drug use and availability of those substances in the community; (2) to reduce alcohol and drug use among school-aged youth; and (S) to increase the use of prevention activities that are research-based and outcome driven. To promote equitable distribution of prevention resources, to ensure accountability and performance outcomes, and to promote culturally relevant services that are specific to community needs CSAS has instituted three initiatives inclusive of community-based providers, volunteers, local residents appointed by the Board of Supervisors to the Substance Abuse Advisory Board and members of the recovery community. CSAS System of Care, Community Partnership and Partners in Recovery Alliance. The System.. of Care, a continuum of treatment, prevention and after care community-based services, operates through an infrastructure of accountability based on cost, quality and measurement of performance outcomes. The Access Unit, its centralized management and information system, provides information and referrals, screening for substance abuse placement, registration, and waiting list management. The Community Partnership provides technical assistance, training and access to resources through an alliance of community- based substance abuse prevention coalitions, task forces and grassroots groups known as the Partnership Forum. The Partnership environmental and community-based strategies promote voiunteer participation, collaborative efforts, in-bind matching of resources and strategic community-wide planning and evaluation among "partners' working towards a Drug and Alcohol Free Contra Costa County. The Partners in Recovery Alliance brings together recovery community in Contra Costa County to advocate for improved substance abuse treatment and prevention services; to promote local, regional and statewide recovery groups; and to promote empowerment, education, recovery, rehabilitation and socialization of all person in recovery. The Alliance operates through a Management Team composed of persons in recovery in partnership with representatives from CSAS Administration and the Substance Abuse Advisory Board.. Contra Costa Cornmunr Suostance Abuse Services Con,ra Costa Smergency NAedical Services e Contra Costa Environmental Health Conva Costa eaith Plan > "° Contra Costa Hazardous Materials Programs •Contra Costa Mental Heai:h Contra Costa Public Health - Contra Costa Regional Medical Center - Contra Costa Health Centers sior A Community Partnerships working towards a drug and alcohol free Contra Costa County Each and every member of the Contra Costa County community will work towards a. safer and healthier environment by the reduction of Alcohol, Tobacco, and Other Drugs (ATODA) use and abuse and their related problems. The Partnership based on a bottom u .approach to pr ration. This principle is practiced through the following actions: Doing with the community rather than doing for them. Creating capacity building opportunities for residents and volunteers. Promoting shared leadership. The Partnership values diversity and respects differences, `hese principles are practiced through the following actions: 0 Ensuring inclusion of all ethnic, cultural, and socio-economic groups in the community. 0 Creating opportunities for dialogue, reflection, and collective action. 0 Implementing a multi-sector community-wide prevention strategy that is representative of the community. 0 Promoting strategic alliances and collaborative efforts between different community 'stakeholders". 0 Developing 4partnerships" that are willing to share risks, resources, responsibilities, and rewards. The Partnership is intentional its commitment m,itment to community empowerment. This principle is practiced through the following actions: 0 Acknowledging differential power status between groups and populations. Developing democratic structures to ensure group representation and relationships that are predicated on responsibility, experience, and skills. Ensuring equal access to resources, opportunities, and choices. Creating a communication system that is open and inclusive. Implementing policies that encourage conflict resolution and problem solving. -\As M iLIKSDOCUtulEN \PAR'I`,N*ERS £IP\PA.RITN HIP.D 3CA%)riI 4. 1999 �F `: + mrd h , . INCLUSION POLICY UMIATMES INITIATIVES )01 A forum to network and exchange substance abuse prevention. information. );0- A catalyst for the creation of a community culture that "de-normalizes" the use and abuse of illegal drugs, alcohol, tobacco, and the violence related to AOD use and abuse. > An alliance of 'partners" that comes together to collaborate with various public and private sectors in the community. > A commitment to work with citizens to build a locally crafted, shared vision of the changes necessary to create a healthy community. > An agreement to broker, mediate, and negotiate the implementation of social policies, programs, and practices the community needs to use to increase protective factors and decrease risk factors in the community. C:\AMALIA' In,7OCUMEi TS\F°ARTN RSHIP\PARTNERSHIP.DOCAoril4. 1999 Appendix 3: Indicated Prevention Screening and Behavioral Contract f E Ou The Screening Process.' Screening is a broad term that may be defined as a range of evaluation procedures and techniques. The screening process, however, is distinguishable from comprehensive assessment procedures in several ways. it is important to understand this distinction so that the limitations of the screening instruments are recognised, thereby increasing- the likelihood that they will be used appropriately and effectively. A screening instrument does not enable a clinical diagnosis to be made, but rather merely indicates whether there is a probability that the condition looked for is present. Screening is a preliminary assessment or evaluation that attempts to measure whether key or critical features of the target problem area are present in an individual. A comprehensive assessment, on the other hand, is a thorough evaluation whose purpose is to establish definitively the presence or absence of a diagnosable disorder or disease. Accomplishing this goal entails evaluating other problems that may be related to the individual's disorder. A screening procedure typically involves a single event. A comprehensive assessment, in contrast, necessarily encompasses multiple procedures and sources of information. In addition to ascertaining the presence of AOD abuse or infectious disease, a comprehensive assessment is also aimed at identifying problems that may be related to the condition being iden tif.ied-information is used to develop a treatment plan and to determine person's need for additional services. The options arising from the results of screening should be limited to the followincs 1. The individual is likely to benefit from a referral for a comprehensive assessment to determine the provision of treatment or referral for treatment and for other specialized assessments; 2. Findings suggest that the individual is engaging in "high risk" AOD behaviors (youth is experimenting or using, behavior problems indicate potential use or abuse, care givers are substance abusers, etc. ) and is likely to benefit from participation in education groups tailored to change identified problem behaviors. FOR DETAILED INFORMATION REFER TO ENCLOSED DOCUMENTS LISTED BELOW: "Chapter 2--Development of the Simple Screening Instrument for ACD Abuse and "Chapter 2-Preliminary Screening of Adolescentsi3 1 "Introduction" in Simnle Screening Instruments for Outreach for Alcohol and Other Drua Abuse and Infectious Diseases. Treatment Improvement Protocol (TIP) Series No.11, page 3 -- Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, DHHS Publication No. (SMA) 95-3058. Printed 1994. 2 ibid,pages 9 through 18 3 Screening and Assessment of Alcohol and Other Drug Abusing Adolescents. Treatment improvement Protocol (TIP) Series No.3, pages 9 through 16-•- Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment,DHHS Publication No.(SMA)94-2094.Printed 1994. C:\Amalia'sDocuments\System of Care\youth\YoutnAssess\screening.doc04/04/99 MGH, . Target Population Youth referred to an educational group for the purpose of modifying or changing a problem behavior are identified to be "at risk" for substance abuse addiction because: (a) they are members of an identified peer or family group within which other individuals abuse alcohol or drugs or, (b) have a current history of behavioral problems at home, school, or community that are directly related to use of alcohol and drugs. Service Strategy Alcohol and Other Drug Education for "at risk" groups is a prevention strategy for youth that are using alcohol or drugs but do not believe this is a problem for them as well as youth that have tested positive or have been found to use alcohol or drugs. The service consists of 8 to 12, one to two hours, weekly or bi-weekly group sessions. The educational process is experiential, it follows guided discussions of AOD topics and strategies to change participants` identified "problem" behaviors. Service Requirements Providers accepting referrals to CSAS Alcohol and Other Drug Education "high risk" groups are expected (a) to gather information about the referral source including their perception of what the problem behavior is; (b) to use a standardized screening instrument to establish the "problem" in terms of expected behavioral changes and severity of AOD problem; (c) to develop a standardized contractual agreement specific to each individual including a plan to change or reduce the problem behavior; (d) to document and evaluate behavioral change progress; (e) to document linkages and referrals to AOD assessment, treatment or prevention activities; (f) to document linkages and referrals to other services such as health care, mental health, social services, probation or school counseling programs. Service Data Tracking participants' progress and referrals includes the use of CSAS System of Care as well as other private pay or publicly funded service resources such as Safe and Drug Free Schools and Communities, Safe Futures, Healthy Start, etc. Service documentation requirements include the following: 1. -Maintaining group files that document attendance and process notes that describe topics, highlights of discussion, etc. 2. Keeping confidential files with screening, behavioral contract, evaluation of individual progress, linkage and referral data. 3. Submitting monthly Prevention Activities Data Systems reports. 4 . Administering Participant Satisfaction Survey when participants complete the program (8-12 sessions) , are terminated or referred. C:\Amalia'sDoc,axnents\System of Care\youth\YouthAssess\highrisk.doc04/04/99 ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ........_. ................................................... ......... .. ........ ....._.... _.................................._......................................................................................................_ _ _ _ .............................................................. ........................... i 14 RV 3f SELF—ADMINISTERED FC3M4 ; f Directions: The questions that follow are about your use of alcohol and other drugs. Your answers will be kept private. Mark the response that best fits for you. Answer the questions in terms of your experiences in the past 6 months. During the last 6 months... 1. Have you used alcohol or other drugs? (Such as wine, beer, hard liquor, pot, coke, heroin or other opiates, uppers, downers, hallucinogens, or inhalants) ? YES-NO f 2. Have you felt that you use too much alcohol and other drugs? YES NO 3. Have you tried to cut down or quit drinking or using alcohol or other drugs? i YES NO f 4 4. Have you gone to anyone for help because of your drinking or drug use? (Such as Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, counselors, or a treatment program) ? 1 3 YES NO 5. Have you had any health problems? For example, have you i Had blackouts or other periods of memory loss? injured your head after drinking or using drugs? € Had convulsions, delirium tremens (DT's) ? Had hepatitis or other liver problems? Felt sick, shaky, or depressed when you stopped? Felt "coke bugs" or a crawling feeling under the skin after you stopped using drugs? € Seen injured after drinking or using? e Used needles to shoot drugs? 6. Has drinking or other drug use caused problems between you and your family or friends? YES NO 7. Has your drinking or other drug use caused problems at school or at f work? YES NO 8. Have you been arrested or had other legal problems? (Such as bouncing bad checks, driving while intoxicated, theft, or drug possession) j( YES NO i 9. Have you lost your temper or gotten into arguments of fights while drinking or using other drugs? YES NO PLEASE TURN PACE TO CONTINUE C:\Ama1ia°sDo.-..mems\System of Care\your i\YouthAssess\screenir3g.doc04/04/99 10. Are you needing to drink or use drugs more and more to get the effect you want? YES NO 11. Do you spend a lot of time thinking about or trying to get alcohol or other drugs? YES NO 12. When drinking or using drugs, are you more likely to do something you wouldn't normally do, such as break rules, break the law, se:,! things € that are important to you, or have unprotected sex with someone? YES NO The next questions are about your lifetime experiences. 13. Have you ever had a drinking or other drug problem? YES NO 3 14. Have any of your family members ever had a drinking or drug problem? YES NO 15. Do you feel that you have a drinking or drug problem now? YES NO Thanks for filling out this questionnaire. i Scoring for the AOD Abuse Screening Instrument i Name/1D No: Date: s Provider Name: 6 Place/Location: j i - Items 1 and 25 are not scored. The following items are scored as m (yes) or a (no) , 2 7 12 3 8 13 4 9 14 3 5 (any items listed) 10 16 i i Total Score M", ,..� Score Range: 0 - 14 3 Preliminary interpretation of responses: Score Degree of Risk for AOD Abuse 0-1 None to low 2-3 Minimal 1 E >4 Moderate to high: possible need for assessment ABOVE RESPONSES ARE PRIVATE AND CONFIDENTIAL. PROVIDER IS REQUIRED TO INFORM RESPONDENT OF THEIR RIGHTS FOR CONFIDENTIALITY, SITUA'T'IONS WHEN PROVIDER RESPONSIBILITY TO DISCLOSE INFORMATION SUPERCEDES CONFIDENTIALITY, CONSENT TO SHARE INFORMATION OR SECURE PARENTAL CONSENT AS NEEDED. C:\Amaha sDocuments\System of Care\youth\YouthAssess\screening.doc04/04/99 .........................................................................................................................._.... . .................................................................................................................................................................................................................................................................................... _ _. ......_...... _............. ......... ......... ......... ......... ......... ............_ .............. Directions: Cover Form filled by Provider/Group Facilitator 1, Who referred youth to "high risk" group? (a) Name Date: (b) Position Program: (c) Site/Location 2, How did referral source define the behavioral problem for which s/he made the referral? (a) (b) (c) 3. Participant information: Name: Age: Sex: Race/Ethnicity: School: Grade: GPA: CPS- Probation: 4. Screening protocol score: Screening date: S. Describe how problem identified by screening protocol corresponds to (a) referral source and (b) youth's perception of problem? 6. Disposition Requires Counselor and Youth (or Adult Participant) description of rationale for any of the choices outlined below: (1) Satisfactory Completion (2) Unsatisfactory (3) Termination (4) request for more sessions _- - (5) referred to AOD assessment (6) Referred to Mental Health (7) Referred to Social Services (8) Referred to Probation (9) Referred to Other Services *Requires approval from CSAS Prevention Manager 7. Evaluation: CAAmaIia`sDocuanents\System of Care\youth\YouthAssess\behaviorcontract.doc04/04/99 it # Directions: Youth and Provider/Facilitator review referral information and screening to jointly develop the contract. As a member of the group sponsored by , I agree to the following points as Part of my participation in the group: 1. T will not attend group while under the influence - EVALUATION + of any illegal substances. 2 3 4 5 2. i will be present each week, be on time, and will remain throughout the entire meeting. Tf unable to attend, 1 will let my counselor know beforehand. 2 3 4 5 3. 1 will put feelings into words, not actions. 1 2 3 4 5 4. 1 will treat all group members with respect. 1 2 3 4 5 5. T will not discuss group meetings with anyone outside the group. 1 2 3 4 5 6. 1 will remain in the group until the issues that brought me to group have been resolved, or until the group ends. 1 2 3 4 5 2 agree to work on changing the following behaviors: (1) 1 2 3 4 5 (2) y 2 3 4 5 (3) 1 2 3 4 5 In order to achieve my goal to change above behaviors and to develop a more positive support system, I need the support of the following people: (1) 1 2 3 4 5 (2) _ 2 3 4 5 (3) 1 2 3 4 5 I feel that I have accomplished my goal by changing the behaviors that resulted in my referral to the group. ® believe that I deserve the following rating: XMIMAMM Participant Signature and Date Counselor Signature and Date C:\Amaiia'sDocuments\System of Care\youth\YouthAssess\hehaviorcontract.doc04/04/99 Appendix 4: Treatment Levels and Performance ?Measures CSAS Youth Family Treatment Levels of Care Treatment Hrs> Staff Iii p i:j::ri'i*i:•::4:4iii:ii::: :r :. •inti.:rSi:,i. ,..:..�•.Wit..;.... n�.�:...:rrr.;.;; 0m,M- W 4:4ir:i,i.i?i'::tO:r};;.iii::.:F::i?i:ri+ youth parent youth parent youth parent one t€rne segment.. rrfent 1.Screening 0.5 0.5 0.5 0.5 9.3 0.5 0.5 d..5 2. 1d 2.0 2.l3 3.Individual Counseling 1.0 1.0 4,Group Counseling 2.0 1,0 1.0 5.Group Education High Risk 2.0 1.0 1.0 1,0 12.0 1"i3 3. 6.PanyA Education High Riese 1.0 1.0 1. 7,Farnfly Counseling 1.5 1.5 1.5 1,5 1.5 1.5 S.Multi-Farnfly Counseling 1.5 1.5 1.5 1.5 g.Twelve Step Group Meeting 3.0 3,0 1,0 10.latter Care 1.0 1.0 1.0 t••toure Per Week 12.0 4. 10.0 A 5.5 2• 1.5 12. 1.0 3.6, 11.drug Testing <>a> €<< 12.Care Oocsrdlneitlrsn ...:, :4nv•>:?>:<•;,.<>;»: kSitj:::>':i�44:•i: { :rt>..,>.i::.n::;'w:Y:::;•:::rr.....i:i:v::•i;;]t+p, .� .� :. .• :.::: : 3 ..: .;;:':';z Youth Parent youth Parent Youth int total w eew total I.Screening 0.5 0,5 0.5 0.5 0.5 0.5 0.5 0.5 V.Individual Counseling 12.0 10.0 0.0 4.Groups Counseling 24.0 10,0 6.0 5.Group Education High Risk 24.0 12.0 12.0 1,0 12.0 1.0 3. 3.Parent Education High ruts 12,0 12.0 12. Farnfly Counseling 40.0 10.0 15,0 16.0 12.0 12.0 L Muffi-l'-smily Counseling 18.0 10.0 15.0 16.0 Twelve Stals Group~ng 36.0 30.0 1.0 A Atm Care 1.0 1.0 1.0 Hours Per Segment 135.0 45. 95"O 412. 44.0 24. 1.5 12.5 1.0 3�F 1.Drug Testing +t 4'.::Yi1.:;::: :•,ir.'....,x,.j v?:;iii..;>t::ii ::f:.:•,G is G::::ri::::; :.t;•::i ..:;:: <Care Coordbuftn t:.hz;:kvn:>•:;<+rxz: .f:yrf::.:it.:t.::: } Wk 10 f �3 `'ixdshrs.xl*VIM 3 g. _. 06 CL! CL CL IL CL r k {EL { r. h• ' 4 i:L A } r. } : .: :. f.. is .r kf } .w } CL 0 603 0 t9' ti }} •s till, r• F r. r: j1{3': : w rj . iy ti c } r:• ewL 'r Mr t'•4 {v. a •Y } tf � : t.3 '• �` '• ... .. ... ...... .. .� .: ._ ;__ ,syr>f Y y , :k CONTRA. COSTA HEALTH SERVICES COMMUNITY SUBSTANCE ABUSE SERVICES Fiscal Year 1998-1999 Treatment and Prevention April 1999 d K E " Purpose The Community Substance Abuse Service Maps depict Fiscal Year 1998- 1999 community, school and clinic based prevention and treatment services displayed within each Supervisorial District. Two other documents are included with the service maps (1) a description of the Community Substance Abuse Services Youth. and Family Continuum of Care and. (2) the California Department of Alcohol and Drug Programs County Profile of ACED Risk and Need Indicators for Contra Costa County. Distribution of these materials is intended to raise awareness about publicly funded alcohol and drug abuse services in Contra Costa as well as to promote collaborative planning and establishment of "best practices" among systems and community "stakeholders" impacted or concerned about alcohol and drag abuse problems. Goal 1. promote Collaboration Across Systems Serving Youth Findings from "Study of Youth Access and Utilization of Alcohol and Drug Treatment Services in Contra Costa County"', a joint project of the Contra Costa County Substance Abuse Advisory Board (SAAB) and the Community Substance Abuse Services (CSAS) Administration, show that youth that are using or abusing alcohol and other drugs (AOD) are not being identified in sufficient numbers, that once identified, youth are not referred to AOD treatment in adequate numbers, and once referred, youth are not entering AOD treatment in adequate numbers. The study interviews with Probation, School, Social Service, Mental Health, Law Enforcement and ACID Providers suggest that one of the most serious barriers to youth access and utilization of ACED treatment services is that each system involved with youth tends to perceive the nature of AOD problems differently, and as a result, each system tends to develop and implement its own solutions to these problems in isolation. Thus, the need for collaboration to ensure standardized tools for early identification, appropriate referrals and measurement of outcomes across systems involved in serving youth that use or abuse alcohol and other drugs. Goal 2; Promote "Principles of Effectiveness" and "Best Practices" Among Systems Serving Youth Identified as Using or ,Abusing Alcohol and Other Drags. The "Study of Youth Access and Utilization of Alcohol and Drug Treatment Services in Contra. Costa County" findings and recommendations go hand 1 Copies of the study available per request. C:\Amalia'sDocu encs\Amalia\maps\svcmaps.doc in hand with Federal and State funding requirements articulated in terms of "Principles of Effectiveness" and "Best Practices". These guidelines emphasize cost-effective, research-based treatment and prevention programs, establishment of performance standards, and outcome evaluations. Compliance requires the following; (1) programs based on need/risk assessment about drug and alcohol problems in the communities intended to be served; (2) assistance of local and regional advisory groups, to prioritize results of the assessments to ensure that the identified needs are culturally sensitive of the community intended to be served; (3) establishment of a set of measurable goals and objectives for each program, as well as a design of the activities proposed by the program to meet goals and objectives that are based on needs identified in the assessment process; (4) program design and implementation based on research or evaluation that provides evidence to support the strategies used to prevent or reduce alcohol and drug use in a culturally relevant manner; (5) ongoing program evaluation to assess program progress toward achieving its goals and objectives as well as use of evaluation findings to refine, improve and strengthen services. CSAS FY 98-99 Service Maps Information is organized into three sets of maps: [1] Treatment and Prevention Providers, [2] School-Based and [3] Community-Based Prevention. Each set of maps is overlayed on census data that shows (a) Percentage of Children in the Population, (b) Percentage of Children Living At or Below the Poverty Level, and (c) Median Household Income by Region. The colored areas of the maps show variations in areas of the county by percentage of children living in the area, percentage of children living in poverty and median household income. It is useful to compare maps depicting where percentage of children in the population is high (lavender areas] with maps that show areas of the county where highest percentage of children in the population live at or below the poverty level [once again lavender areas]. The comparison suggests a greater need for prevention services in areas where the number of children in the population is higher as well as well the need for a more comprehensive approach to indicated prevention services where high concentration of children live at or below the poverty line. The areas with lower median household incomes are colored pink and the areas with high household incomes are colored lavender, once again suggesting the need for approaches to AOD services that are C: \Amalia'sDocumen ss\Ar..al4-a\maws\svcmaps.doc 2 __. ......... ......... ......... ......... .......... .......... . .. .............................................................................................................................................................................................................. . __..... _........_........._... . ......... ......... ......... .. ....... .............. .... _ ....... appropriate to populations with higher or lower levels of income, where corresponding levels of education, percentage of population unemployed and underemployed, percentage of families that have health care insurance coverage, etc. are good indicators of the different need/risk factors in each area of the county. [1] Treatment and Prevention Providers CSAS county-operated and contract providers are identified by name, address, and service area. Data shows the type of service (modality) offered by each program and the type of persons served (special populations). Red circles show prevention services that serve youth and blue circles, treatment services that serve youth. Red triangles indicate prevention services that serve adults and blue triangles, treatment services that serve adults. A red square is used to show prevention services that target both adults and youth and yellow squares are used to show programs that provide both prevention and treatment services that serve adults and youth. [2] School-Based Prevention CSAS school-based prevention, publicly funded substance abuse services which are free of charge for all Contra Costa County residents, depict FY 98-99 service projections by school and by either (1) West and Central or (2) Central and East areas of the county. The spread of services as well as the gaps depicted in these maps suggest (a) the need for collaborative planning between CSAS System of Care youth providers and school districts that are federally funded by Safe and Drug Free Schools and Communities Block Grant to provide alcohol, tobacco and other drug prevention services; and (b) the lack of or limited objective processes used to identify need/risk assessment about drug and alcohol problems in the schools intended to be served that have taken into consideration assistance of local and regional advisory groups, to prioritize needs that can ensure culturally competent services appropriately matched to schools that serve Contra Costa County's diverse socioeconomic and multiethnic student populations. Red circles are used to show 132 schools that have no CSAS prevention services. Blue triangles are used to show (52) schools where one CSAS provider delivers General or Universale prevention services. Blue squares are used to show (10) schools where one CSAS provider delivers High Risk or Indicated 3prevention services. In the same fashion, yellow triangles General or Universal Prevention in CSAS Youth and Famil-y-Continuo, page 6. April 1999 3 high Risk or Indicated Prevention ibid. page 8 C:\Amalia'sDocuments\A,mal-'-a\maps\svcmaps.doc 3 show (9) schools where two CSAS providers deliver General/Universal prevention services and yellow squares show (1) school where two CSAS providers deliver High Risk/Indicated prevention services. The yellow pentagons show (5) schools where two CSAS providers deliver both types of service, General/Universal and High Risk/Indicated prevention. The green pentagons show (12) schools where three or more CSAS providers deliver both types of service, General/Universal and High Risk./Indicated prevention. School-based prevention maps include tables of Contra Costa County (18) school districts with each school identified by name and address, type of school e.g., elementary, middle, junior, high, continuation, and total number of students enrolled in each school as per Contra Costa County Office of Education 1997 Public Schools Directory. Another table shows the number of students in each school projected to be served by a CSAS provider during FY 98-99. The data is displayed by provider name, type of prevention service, number of students projected to be served in each school, and the percentage of students from each school total student population projected to be served by CSAS providers. For explanation of abbreviations used in tables, see bottom of page 16. The table also shows the number of students in each district projected to be served by a CSAS provider, the percentage of the student population in each district projected to be served by a CSAS provider, and the number and percentage of total student population projected to be served by CSAS providers. Table totals also show the number of students projected to be served in each district and the percentage of the total student population in the district that corresponds to the projection of students served by CSAS school-based prevention services. [3] Community-Based Prevention The maps show community sites that correspond to the list of coalitions/task forces/initiatives projected to be served by CSAS providers during FY 98-99. The list shows coalition names, service area, provider name, organization that sponsors or staffs the coalition, and organization address. In some locations, multiple agencies offer services from within the same building, thus, overlapping community site markers have been moved to make them visible. The community sites are displayed in county maps that show [1] Percentage of Children in the Population, [2] Percentage of Children Living At or Below the Poverty Line, and [3] Median Household Income by City Overlay. For the last two years, in an effort to promote collaboration between systems that serve youth that use or abuse alcohol and drugs as well as "stakeholders" impacted or concerned with substance abuse problems in C:\knaila'sDoc:L-:zents\Amai.ia\maps\svcmaps.doc 4 their communities, CSAS has required prevention providers to allocate a percentage of their budget to community-based strategies4, in particular those that provide school-based services. CSAS expected results were: (a) to increase awareness of the AOI) problem and resources among coalitions where CSAS prevention providers are members; (b) to increase the number of collaborative initiatives among systems that serve youth that use or abuse alcohol and drugs 'where CSAS providers are involved; [c] to increase system-wide strategic planning processes to ensure compliance with "Principles of Effectiveness" and equitable allocation of resources that is based on need/risk assessments and performance outcomes; (d) to increase support for community driven efforts to curb youth access to alcohol, reduce density of alcohol outlets, increase compliance of alcohol outlets licensing regulations, and promote responsible retail practices among alcohol merchants$. Expected results so far, are extremely limited in spite of the fact that CSAS providers projected community-based services for FY 98-99 included allocation of prevention funding to almost 60 staff persons and staff participation in 85 different community and school coalitions, task forces, and advisory boards. At the same time, CSAS systems approach to map youth services is the first step of a results-based planning and evaluation process for FY 1999-2000. Ideally, other youth systems will join CSAS effort to be able to develop a comprehensive strategies to serve youth that use or abuse alcohol and drugs. d : n ,�. use to C0Wim* cqn 0=t=ICVSU = ReiServices V ► : SWte:4320 Martinezr ; 944W d lvW3 hsd,.co,00 xtra- osta. a-u 4 Community-eased Process Strategy in CSAS Youth and Family Continuum of Care page 5 April 1999 Mail Alcohol outlets Maps Presentations available upon request. 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ONE co m m i i www oU o � z-1:z`z, c'crC 0-,o , 01 EE i E - iEl a oa 1p ' co cc 0 -E G t OC t tm 4 cu: ca JI co zicI>,> Pro e of SOD ask and Need Indicators Contra Costa Counq Illlill I IIIIIIIIIIII1111111111111111NI11111111HIIIIIl11111111111111111111111111111111111111111111111N 1111111 I IIIIIIIIII1111111111111111111111111111111111111111111HIillllll lllllllllllllllllllllllllllllllil State of Califiomia Department of Alcohol and Drug Program 1700 K Street Sacramento,CA 95814 EMT Group, Inc 771 Oak Avenue Parkway, Suite 2 Fohom, CA 95630 III�II�IIlI) bble of Contents 1� �II �I �I� 11lfllllll� l� llllllllll�ll�I�III11 �� 11111�� introduction ................................................................................ ................ 1-2 CommunityDomain .....................................................................................................3-6 Subscale 1: Social/Economic DeprivatiorvDisplacement...................................3-4 (1) Annual Average Rate of Unemployment..................................3 (2) AFDC Recipients.....................................................................3 (3) Population Croom per Annum, ...............................................4 (4) Legal Foreign Immigration.......................................................4 Subscale2: Availability........................................................................................5 (1) Reil Liquor licenses...............................................................5 Subscale3: Health Status....................................................................................6 (1) Low Birth Weight Infer..........................................................b FamilyDomain ...................................................................................................7-12 Subscale1: Risk Environment.............................................................................7 (1) Percentage of Births to Unmarried Women..............................7 Subscale2: Family Management.....................................................................8-9 (1) Emergency Response Dispositions ...........................................8 (2) Domestic Violence Calls...........................................................8 (3) Children in Foster Care............................................................9 Subscale 3: Adult Alcohol and Drug Use......................................................10-11 (1) Adult Arrests for Drug-Related Offenses................................. 10 (2) Adult Arrests for Driving-Under-the-Influence......................... 10 (3) Adult Arrests for Cather Alcohd-Related Offenses................... If Subscale 4: Family Income................................................................................ 12 (1) Percentage of Students in School Lunch Programs.................. 12 SchoolDomain ...................................................................................................... 13 Subscale1: Commitment to School.................................................................. 13 (1) Percentage of College-Prepared Students............................... 13 (2) Percentage of Students Completing High School..................... 13 IndividualDomain ................................................................................................. 14-17 SubscaleI: Adolescent Risk......................................................................... 14-15 (1) Juvenile taw Enforcement dispositions................................... 14 (2) Juvenile Alcohol and Drug-Related Arrests.............................. 14 (3) Births to Teen Mothers........................................................... 15 Subscale2e Early Nsk ....................................................................................... 16 (1) Alcohol and ©rug Arrests-C7fenders Ages 10-14.................... 16 Subscale 3s Adolescent Alienation..................................................................... 17 (1) Adolescent Suicides................................................................ 17 (2) Reported Runaways............................................................... 17 DataSummary ................................................................................................. 18-19 .............................................. ...... ......... ......... ......... ......... ......... ......... .......... .......... ....... .......... . ......... ..._ ..... ............................... ......... ..................................................... ............ introduction Ander contractwith the California Department of Alcohol and Drug Programs,EMT Group, Inc., began work in 1996 on improving the State's prevention information systems. A primary goal of this effort was to develop a management information system for consistently and uniformly documenting a)levels of need for substance abuse prevention programming throughout the state, b) program efforts in prevention throughout the State, and c) results/outcomes of these efforts. As developed by EMT, the cornerstone for this information system was a series of AOD need and outcome indicators. These indicators represent a prelirri€nary effort in developing a statewide set of prevention indicators that would serve to assist prevention policy snaking at the State level by providing useful, systematic data about prevention needs and related conditions across the state at a reasonable cost. in developing these indicators, EMT built on risk and protective factors by Hawkins and Catalano at the Social Development Research Group (SDRG) at the University of Washington. 'rhe currentconfiguration of indicators represents a preliminary model and may be changed in response to subsequent analysis. Although each individual indicator may be monitored and analyzed separately,EMT has proposed that related indicators be grouped by broad domain and by subscale. A domain is a general area upon which prevention efforts typically may be focused. The proposed indicators correspond to four separate domains: 1. minitr7ity--- including indicators that relate to characteristics of the entire community, such as availability of alcoholic beverages; 2. FAznlly— including indicators that refer to characteristics of families or family members such as child abuse or single-heads of household; 3. School®- including indicators relating to schools, such as drop-out attendance rates; and 4. lndlirldrrol YouthlPeer includes indicators that focus on youth characteristics, such as AOD-related arrests for juveniles and other individual risk or protective factors. Domains are a logical basis for grouping indicators related to differing prevention strategies, but they are not always mutually exclusive. Some individual indicators could easily.fall into more than one domain. Except for the case of the school domain, each domain contains several kinds of indicators, including risk/need, incidence, and outcome indicators. For planning and analytic purposes, it may be useful to group indicators by type, or by some other rationale. introduction (coat.) A fifth domain, Prevention Effort, is not included in the proposed model because EMT has not yet determined which indicators are available and appropriate for inclusion in such a domain. Generally speaking, a Prevention Effort domain would include Prevention Program Indicators -- indicators that measured the extent to which counties allocated funds and other resources to prevention ofATOD problems. Ultimately, this domaln could be used to help evaluate the overall effectiveness of prevention strategies. Each domain is divided into two or more subscales. A subscale is a combination of several conceptually linked individual indicators within a domain. unlike domains,subscales also imply a specific analytic/methodological strategy. EMT has proposed that subscale scores be calculated that are a mathematical combination of each individual prevention indicator that comprises a subscale. This can be achieved by standardizing the score for each county's individual indicators in a scale and averaging these standardized scores. Doing so will simplify the data by providing a single aggregated score for each subscale. The subscales will provide a convenient means of comparing the conditions, behaviors, and outcomes of each county. For each indicator, counties are ranked in ascending order based on an average of their three most current years of data (e.g.a rank of 1St indicates that the county's three-year average rate is lowest among the fifty-eight counties in the state). Rates may .be influenced by a number of contributing variables. For example, the rate of admission to substance abuse treatment reflects the prevalence of substance abuse problems as well as the capacity of the service system to meet treatment needs. In summary,what you have in this report are the preliminary building blocks for a more sophisticated way to assess needs and ultimately the effectiveness of prevention services in the state of California. The indicators in this report present abroad,seven-year picture in a number of different areas. Hbwever, for better and more effective local level prevention planning, additional data for individual communities and population subgrou€pings is desirable. EMT can assist counties interested in pursuing this more detailed level of data collection and analysis. 2 - _ ...................................................... ............................................................................................................................................................................................................................................................................................... ......... ......... . ......... .............................. ..... ...... .... .......... . ..... ........ _..........__....... __ _ ....... . ......... . ._.... ......_.. ... __ Community Domain 1111111 IIIIIIIIIIIIIIIIIIIIIIIIIII Illlllllllllllllillllilllllllllllllllll l lllllllllllllllilllllll 1111111 IIIIIflllllllllllllllllllllllllllllllllllllllllilllllllilllillllllllllllillllllllllllllllllllllll i(illll II�IIIIII��) COMMUNITY DOMAIN SUBSCALE 1: SOCIALIECONOMIC DEPRIVATION/DISPLACEMENT INDICATOR 1„ ANNUAL AVERAGE RATE OF UNEMPLOYMENT 1990 1991 1992 1993 1994 1995 1996 Contra Crista 4 15.4 6.5 6.5 6.25.7 4.9 California 5.8 7.7 i 9.1 9.4 8.6 7.8 7.2 12 TIRES-YEAR AVERAGE(1994-96)5.6 10 STATE RANK(1994-96)6th i � NET CHANGE{1990-96) 1 8 6,5 6.5 6 5.4 5.`7 8.2 Source; 4 4 4.9 California Health and Welfare Agency,Employment 2 Development department, labor Market Information Division 0 1990 1999 1992 1983 1994 1995 1996 INDICATOR 2: AFDC RECIPIENTS AS A PERCENTAGE OF TOTAL POPULATION 1990 1991 1992 1993 1994 1995 1996 Centra Costa 5.1 5.5 5.5 5.6 5.7 5.5 5.2 California 6.7 7.3 7.7 8.2 8.6 8.5 8.2 10 t THREE-YEAR AVERAGE(1994-96)5.5 6 STATE RANK(1994-96)17th E NET CHANGE(11990-96) l 66.5 5.6 _r 5.5 15.1 5.5 5.7 5.2 41 Source. 21 California Health and Welfare Agency,Department of Social Services:Statistical Services Bureau 0 1990 1991 9992 1893 1994 3995 1996 Contra Costa County S ...................................................... .... ......... ......... ......... ......... ......... ......... ......... ................................... ........... ............___..... ...... ............................... ......... ......... . ... ............................... .......................... ....... ........ .................................................. . ... ......_ .._... ......... ........ COMMUNITYDOMAIN SUBSCALE 1: SOCIALIECONOMIC DEPRIVATION/DISPLACEMENT (CONT.) INDICATOR 5: COUNT'S POPULATION GROWTH PER ANNUM 991 1992 1993 1 19541995 1996 Contra Costa , 1.7 2.1 1.5 1 .8 1.2 California 2.07 2.04 1.06 .87 .86 1.0 5 THREE-YEAR 14VERAGE('1994.96)x#.27 4 STATE RANK€1994-963 24th i NET CHANGE('199"1-96)♦ 3 2.1 I Source: California Department of Finance,Demographic Research Unit 1 1 Report E-2:Population Estimates for California Counties 0.8 I 1994 1992 1993 1994 105 1995 INDICATOR A: LEGAL FOREIGN IMMIGRATION RATE PER 100,000 1990 1991 1992 1993 1994 1995 Contra costa 454.8 461.5 501 537 453 408.9 California 604.04 623.01 757.21 780.61 644.91 513.43 700 THFtEte-YEAR AVERAGE€1995.953 466.3 STATE RANK(1593.95)22nd 600 537 NET CHANGE(199€-95)T 501 50€3 461.5 453 454.8 Source: 400 408.8 California Department of Finance,Demographic 3001 Research g.JClEt 200 , 1990 1991 1992 1993 1994 1995 Contra Costa County 4 COMMUNITY DOMAIN SUBSCALE 2:Availability INDICATOR 1: RETAIL LIOUOR OUTLETS PER 100,000 POPULATION AGE 21 AND OVER 1990 -'.991 1992 1993 E 1994 1995 X996 Contra Costa 205.2 202.8 197.7 191.6 186.9 191.1 188.2 California 229.4 223.7 219 214.1 210.5 212.3 :0:: 300 THREE-YEAR AVERAGE('1994-96)188.7 STATE RANK(1994-96)8th 250 NET CHANGE(1990-96)r 205.2 200197.7 202.8 "`" _- ig6 g 188.2 191.6028 .6 191.1 Source: 150 California Alcoholic Beverage Control 100 1990 1991 1992 1993 1994 1995 1996 Contra Costa County 5 ............... ............................................................................................................................................................................................................................................................................................................................ ......................... ....... ............................................ ................. ........... ....... ...... .............................................. .................... COMMUNITY DOMAIN SUBSCALE S: HEALTH STATUS INDICATOR 1: PERCENTAGE OF INFANTS BORN WITH BIRTH WEIGHT UNDER 2500 GRAMS 1950 1991 1992 1993 1994 1995 1996 Contra Cost 6.1 6.2 6.1 6.1 6.5 6 6.3 California 5.8 5.8 5.9 6,0 6.2 6.1 6.1 10 i I THREE-YEAR AVERAGE(1994-96)6.2 I i STATE RANK(1993-96)43rd i 6 MET CHANGE(1990-96)w � 6.2 6.9 6.1 15 6.31 41 i Source: i California Health and Welfare AgencV, Department of 2 � Health Services,Vital Statistics Section I 0 3990 1991 9992 1993 1994 1995 19% Contra Costa County 6 Family Domain IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllllllilllllllllllllllllllllllllllllllllllll 1111111 ...................................................................................................... .................................................................................................................................................................................................................................................... .......................................................................................................... . ............................... ....................... IIIIIIIIIIIIIIIIIIIIIIIIIIilllllllllllllllllllllllilllllllllllllllllllllllllllllillllilllllllllll 1111111 IIIIIIIIIIII FAMILY DOMAIN SUBSCALE 1. RISK ENVIRONMENT INDICATOR 10 PERCENTAGE OF BIRTHS TO UNMARRIED WOMEN 1990 1 1991 1992 1593 1594 1595 1596 Contra Costa25.5 26 26.1 27.5 27.9 26.4 25.8 California 31.433.3 34.2 35.1 35.5 32.1 31.4 50 THREE-YEAR AVERAGE(9994-96)26.7 € STA"T"E RANK(1994-96)23rd 40� s NET CHANCE(1990-96)1 30!� 6 26.1 27.9 25.8 25.5 27.5 26.4 I 20� Source: ! l California Health and Welfare Agency, Department of 10I Health Services,Vital Statistics Section t 03 1990 1991 1692 1863 1694 1995 1996 Contra Costa County 7 FAMILY fl(71 AIN SUBSCALE 2: FAMILY MANAGEMENT INDICATOR 1: EMERGENCY RESPONSE DISPOSITIONS FOR CHILD ABUSE AND NEGLECT PER 1,000 POPULATION UNDER AGE 18 1990 1991 1992 1993 1994 9995 1996 Contra Costa 1 69.1 54.3 66.5 78.5 $1 i 84.2 87.1 California 70.4 70.3 73.4 76.4 74.5 15.1 i 74.8 200 THREE-YEAR AVERAGE(1994-96)84.1 STATE RANK(1994-96)24th 950 NET CHANGE(1990-96)A '30(3 75.5 84.2 69.1 66.5 81 87.1 Source: So 64.3 i California Health and welfare Agency,Department of Social Social Services,Statistical Services Bureau 0I 9900 9991 1992 1993 9994 1995 1995 INDICATOR 2: DOMESTIC VIOLENCE CALLS FOR ASSISTANCE RATE PER 1,000 POPULATION AGES 18-69 1990 1991 1992 1993 1 1994 1995 1996 Contra Costa 9.6 9.3 9.7 90.3 i 10.6 10.6 9.1 Cafifornia 9.7 10 11.7 11.4 11.8 2.6 10 20 THREE-YEAR AVERAGE(1994-96)10.1 STATE RANK('3994-96)29th 15 NET CHANCE(1990-96)♦ ; 10.3 10.6 '30.6 9.3 9.7 9.9 Source: j California Department of Justice.Division of Law Enforcement, Law Enforcement Information Center 0 1990 1991 9992 1993 7994 1995 9998 Contra Costa County B .............................................................. ......... ......... ......... ........... .. .......... .. ...... ...... ......... ......_. .. ................... ........ ............................... ..._.... ............................................................ ...... _ _ _ ............ ......... FAMILY DOMAIN SUBSCALE 2: FAMILY MANAGEMENT(CANT.) INDICATOR S: CHILDREN LIVING IN FOSTER CARS RATS PER 1,000 CHILDREN UNDER 18 1990 1991 1992 1993 1994 1995 1996 Centra Costa 10.2 10.5 1 10.1 9.7 8.5 7.9 7.7 California 7.5 17.66 7.6 7.6 7.7 7.7 20 THREE-YEAR AVERAGE(1994-96)8.0 STATE RANK(1994-96)36th 25 NET CHANGE(19M96)T 10.6 9.71(} 10.2 10.1 7.9 8.6 7.7 Source: 5 California Health and Welfare Agency,Department of Social Services,Statistical Services Bureau 299(3 '1997 1992 1993 1994 1995 19% Conga Costa County 9 FAMILY DOMAIN SUBSCALE 3:ADULT ALCOHOL AND DRUG USE INDICATOR 1: ADULT ARRESTS FOR DRUG-RELATED OFFENSES RACE PER 1,000 POPULATION AGE 18-69 ":990 1991 1 1992 1993 1994 1995 1996 Contra Costa 7 7.1 j 8.3 8 9.3 8.8 8.8 California 12 9.9 10.4 10.0 11.8 11 10.3 20 THREE-YEAR AVERAGE(199496)9.0 STATE RANK(1994-96)21St 15 NET CHANGE(1990-96)A 10 5.3 9.3 8.8 7.1 8.8 33 Source: 5 7 California Department of Justice,Division of Law Enforcement,Law Enforcement information Center 0 1990 1991 1992 1993 1994 1995 19W INDICATOR 2: ADULT ARRESTS FOR DRIVING-UNDER-THE-INFLUENCE RATE PER 1,000 POPULATION AGE 18.69 1990 1991 1992 1993 1994 1995 1996 Contra Costa 13.6 11.2 9.4 7.8 7.5 6.9 7.1 California ! 18.2 15.23 12.5 11.1 9.8 9.3 8.9 20 - THREE-YEAR AVERAGE(1994-96)7.2 � STATE RANK(9994-96)4th 1s 113.6 NET CHANGE(1990-96)V 11.2 10 9.4 701 Source: 5 7.8 7.5 6.9 California Department of Justice,Division:of Law Enforcement, Law Enforcement information Center 0 1990 1991 1992 1993 1994 1995 1895 Contra(Costa County 10 FAMILY DOMAIN SUBSCALE 3: ADULT ALCOHOL AND DRUG USE (CONT.) INDICATOR 3: ADULT ARRESTS FOR OTHER ALCOHOL-RELATED OFFENSES RATE PER 1,000 POPULATION AGE 18.63 i9902 1991 1992 1993 1994 1995 9996 Contra Costa 5.9 6.1 4.9 4.1 3.2 3.6 3.8 California 10.4 8e7 7.3 6.4 5.8 6 6.6 10 THREE-YEAR AVERAGE(1994-96)3.5 STATE RANK(1994-96)2nd 8 6.9 NET CHANCE(1990.96)V 6.1 6 4 4.9 4.1 3.8 Source: 3.2 3.6 California Department of,ustice,Division of Law 2 Enforcement, Law Enforcement Information Center 0 1990 1991 1992 1993 1994 1995 1996 Contra Costa County 11 FAMILY DOMAIN SUBSCALE 4: FAMILY INCOME INDICATOR 1: PERCENTAGE OF STUDENT'S PARTICIPATING IN SCHOOL LUNCH PROGRAMS #990 1991 1992 1 1993 1994 1995 1 1996 Contra Costa 26.6 26.7 27.7 28.7 ! 29.4 29.6 i' 30.3 California 43 43.2 44.2 44.8 45.4 45.8 46 THREE-YEAR AVERAGE(1994-96)29.7 100� STATE RANK(1994-96)8th gp� NET CHANGE(1990-96) 1 1 so� i 40 26.7 28.7 29.6 1 Source: 20 26.6 27.7 29.4 80.8 California State Off#Ce of Education 0 9980 1999 1992 1993 1894 1995 4995 Contra Costa County 12 _................................................................................................................. .......................................................................................................................................................................................................................................................................__.. ...... ........._.. .......... .......................... ........... . ........ ....... ........ __ School Domain Illlllllfllll SCHOOL DOMAIN SUBSCALE 1: COMMITMENT TO SCHOOL INDICATOR 1 PERCENTAGE OF HIGH SCHOOL GRADUATES PREPARED FOR COLLEGE(ENROLLMENT IN A-P CLASSES) 1990 1991 1992 1993 1994 1995 1996 Contra Costa - -- 38 38 37 39 44 California - 33 33 32 35 35 100 --�---� ----�------ THREE-YEAR AVERAGE(1994-96)40 1 STATE RAMC(999496)5th 80` NET CHANGE(1990-96)A -- 60 t 441 40,38 37 38 39 Source. j 20� California State office of Education 01 1992 1993 1994 1995 1996 INDICATOR 2• PERCENTAGE OF STUDENTS COMPLETING HIGH SCHOOL 1990 1991 1992 1993 1994 1995/96 1996/97 Contra Costa -- --- - -- -- 90 93.8 California - - -- 85.3 87.7 120 TWO-YEAR AVERAGE(95/9646/97)91.9 100 93.8 STATE RANK(1995-97)11th 9(3 wI NET CHANGE(95/96-96/97)A so Source: 40 I i California State Office of Education, 20 California High School Performance Report 0 1995196 1996/97 --,Data not reported. contra Costa County 13 .............................................................................................. -- ........ ............ .. . ... ............ .... ........_... _ __ Individual Domain IIIIIIIIIIillllllllllllllllllllllllllllllllllllilllllllllllllilllllllllllll1111111111111111111111 1111111 (IIIIIIIIII) INDIVIDUALIPEER DOMAIN SUBSCALE 1:ADOLESCENT RISK (CONT.) INDICATOR 3: JUVENILE LAW ENFORCEMENT DISPOSITIONS PER 1,000 POPULATION AGE 10-17 E 1990 1991 1992 1993 1994 I 199, 1996 Centra Costa 67.4 168.5 ; 67.1 61.5 58.9 62.1 59 i California76.875.9 74.5 74.7 73.4 68.3 j 73.6 100 THREE-YEAR AVERAGE(1994.96)60.0 �) STATE RANK(1994.96)14th $0 i 68.5 51.562.1 NET CHANGE(1990-96)1► 6()'167.4 67,E 58.9 59 40 Source: California Department of Justice, Division of Lava 20 Enforcement, Law Enforcement Information Center 0 1980 1991 1992 1993 1994 1995 19% INDICATOR 4: JUVENILE ALCOHOL AND DRUG-RELATED ARRESTS PER 1,000 POPULATION AGE 10-17 I i 1990 1991 1992 1993 1994 ! 1995 1996 Contra Costa 7.8 7.3 7 6.5 8.5 9.2 8.2 California 4.4 3.8 3.7 3.84.6 9.4 13.3 25 THREE-YEAR AVERAGE(1994-96)8.6 ' 20 STATE RANK(1994-96)13th P NET CHANGE(1990-96)♦ 151 I 3 9.2 107.8 Source. 5 7'8 6.5 California Department of Justice,Division of Law Enforcement,Law Enforcement Information Center 0 1990 1991 1992 1993 1994 1995 1996 Contra Costa county 14 ._ ...__.........................................................._................. ........ .................................................................................................................................................................................................................. __ _ __ INDIVIDUALIPEER DOMAIN SUBSCALE 1:ADOLESCENT RISK (CONT-) INDICATOR 36 BIRTHS TO TEEN MOTHERS PER 1,000 WOMEN ACRS 15-19 1990 1991 j 1992 1883 1994 1995 1996 Contra Costa 45.4 45.1 ! 39.9 41.4 140.8 40.1 35.2 California 70 72.9 71.7 71.3 70.2 67.2 61.6 100 THREE-YEAR AVERACE(1994-96)40.0 S'TA'TE RANK(1894-96)12t11 80 i Ne r CHANGE(1990-96)r Sol i 45.4 39.9 40.8 39.2 Source: 40 45.9 41.4 40.9 California Health and Welfare Agency,Department 20 Of Health Services,Vital Statistics Section 1990 1991 1992 1998 1994 1995 1996 Contra Costa County 15 INDIVIDUALIPEER DOMAIN SUBSCALE 2:EARLY RISK INDICATOR 1: ALCOHOL AND DRUG ARRESTS AMONG OFFENDERS ACE 10-14 RATE PER 1,000 1990 1991 1992 1993 1994 j 1995 1936 Contra Cosh 1.7 1.9 1.7 2.2 2.9 3.5 2.3 California 1 1.9 1.7 1.8 2.2 2.7 3 3.1 10� THREE-YEAR AVERAGE(1994-96)2.981 i STATE RANK(1994-96)117th f NET CHANGE(1990-96)A g fR I 4 3.5 Source: 2.2 2.9 2 1.9 California Department of.justice,Division of taw 2.3 Enforcement, Larry Enforcement information Center 1.7 1.7 0 1990 1991 1992 1998 1994 1995 1996 Contra Costa County 16 INDIVIDUAL PEER DOMAIN SUBSCALE S:ADOLESCENT ALIENATION INDICATOR 1: ADOLESCENT SUICIDE RATE PER 100,000 POPULATION UNDER AGE 15 €990 ^991 1992 1993 1994 1995 1996 Contra Cosmo 1.47 1.91 2.32 1.81 j 1.77 0.87 0 California 2.08 1.97 1.78 2.05 1.63 ! 1.27 1.18 4 -- THREE-YEAR AVERAGE(1994-96)0.88 j I 3.5 STATE RAMC(1994-96)7th 3 NET CHANGE(1990-96)V ; 2.5 2.32 2 9.91 1.77 1.5 1.81 Source: 1.47 1 03.87 California Health and Welfare Agency, 0epartment of I 0.b Health Services,Vital Statistics Section 01 0 199i? 1991 1992 1898 1994 1995 1996 INDICATOR 2e RUNAWAY RATE PER 1,000 POPULATION UNDER 1S 1990 1+391 1992 1993 1994 1995 1995 Contra Costa - - - - 10.5 11.3 i California -- - --- 13.3 12.7 12.3 20 THREE-YEAR AVERAGE(1994-96)10.9 STATE RANK(1994-96)17th 15' NET CHANCE(1990-96)A 11.8 14{10.5 19 Source 5 � California Department of Justice, Missing and Unidentified I Persons Unit WUPs) I 0 L_ 1994 1995 1996 no data is reported Contra Costa County 17 Data Summary IIIIIIIIIIIII ................................................................................................ ...................................................................................................................................................................................................... ...................................... . ......... ................................................ .......................... ................................................................... ............... ............................ State and County Data Comparisons Contra Costa County Current Data Year Net Change from Rate 1990.1996" 1994-96 Domain/Subscale indicator Average County State County State State Rank Community Domain Annual Average j Unemployment Rate 4.9 7.2 6th AFDC Recipients as a Percentage of County/ � Subscale 1: Population 5.2 8.2 1 A 17th; SOCialf Economic Derivation/Displacement Population Growth per Annum 1.2 1.0 ® V 24th Legal Foreign I Immigration Rate 408.9 513.43 ® ® 22nd i Retail Liquor Licenses per I Subscale 2: Availability 100,000 Population 188.2 205.9 ® V 6th Subscale 3: health Status % LOW Birth Weight 6.3 6.1 43rd ........ ................ ..........................................-........................... Family Domain Subscale 1: %Of Births to Unmarried 25.8 31.4 23rd 1 t Risk Environment Women Emergency Response for 87.1 74.8 A A 24th Child Abuse j Subscale 2: Domestic Violence Calls Family Management for Assistance 9.1 10.0 V ® 29th Children in Faster Care 7.7 7.7 T A 36th Subseale 3: Adult Arrests for Drug- Adult Alcohol and Drug Related Offenses 8.8 10.3 ` 21st Use Adult Arrests for Driving- 7.1 8.9 T V 4th Under-the-Influence Adult Arrests for Other Alcohol-Related Offenses 3.8 6.6 V +r 2nd Subscale 4:Family income %of Students in School 30.3 46 , AL Stn Lunch Programs School Domain Contra Costa county IS Current Data Year Net Change from Rate 1990-1996* 1994-96 Domain/Subscale indicator Average County State County State State Rank Subscale 1: % of High School Committment to School Students Completing A-F 44 35 Still Classes %Of Students 93.8 87.7 11th Completing High School ............................................................................................................................................................................................................................... Individual Domain Juvenile Law Subscale 1:Adolescent Risk Enforcement 59 73.6 V V 14th Dispositions Juvenile Alcohol and Drug-Related Arrests 8.2 10.3 A A 13th Teen Pregnancy 39.2 61.6 V V 12th Subscale 2:Early Risk Alcohol and Drug Arrests- Offenders Ages 10-14 2.3 3.1 A A 17th Subscale 3: Adolescent Suicide 0 1.18 V V 7th Adolescent Alienation Reported Runaways 11 12.3 ♦ V 17th No Change between 1990 and 1996 rates A, Rate has increased between 1990 and 1996 V Rate has decreased between 1990 and 1996 --rates not available if not 1990 rate then first available rate Contra Costa County 19 ... ............................................................ ......................................... ....................... ..................................................... ............... ............................................................................ ................... ........... .. ..................... .............................. ............. .. ...... ..... ................ ............. ........... ........... ................................... ........... ..................... ......................... ........ ................... ....... ..... ................. ...... ... ................... CONTRA. COS....................... ................ .................- ................. TA .......................... .............-- .................. HEALTH SERVICE-....S COMMUNITY SUBSTANCE ABUSE SERV"IDES Retail Alcohol Outlets Maps April 1944 Contra Costa County, Retail Alcohol Outlet Maps The Community Substance Abuse Services Administration Alcohol Outlets Mapping Protect depicts all retail alcohol outlets in Contra Costa County, by type and by city, as well as violations as of October 5, 1998. The maps display Selected Population Statistics for Contra Costa County Cities and Census Designated Places, Number of Active Retail Alcohol Licenses as of October 5, 1998, Number of Alcohol License Violations Occurring Between July 1. 1.997 and October 2, 1.998 and Type of Alcohol License Violations Occurring Between July 1, 1997 and October 2, 1998. The distribution of these maps is intended to raise awareness about the alcohol and drug abuse problem in Contra Costa as well as to provide information about substance abuse prevention resources. The goal is to promote collaborative community development that is based on the recognition of local determination as the foundation for an Alcohol and Drug Free Contra Costa County. Off and On Sale Alcohol Licenses are displayed within each District using per capita density of 5 licenses per 1000 persons superimposed on maps of Contra Costa County that show: (1) Percentage of Children in the Population by City (2) Percentage of Children Living At or Below the Poverty Level by City (3) Median Household Income by Area These maps show the density of both off-sale and on-sale retail alcohol licenses. There are two numbers in the parentheses below each city name. The first number is the off-sale density, the second, the on-sale density. These same numbers are reflected in a visual "pie" where the green portion of the pie shows the proportion of off-sale outlets, the maroon portion the on-sale outlets. The density pies allows comparison between the density of off-sale outlets in one city and the density in another city, taking into account differences in population. The colored areas of the maps show how the areas of the county vary by percentage of children living in the area, the percentage of children living in poverty and median household income. It is useful to compare the retail alcohol license density by areas where the percentage is high (light blue areas) and where the percentage is low (pink areas). C:\A,malia'sDocuments\A,mali-a\alcoholmaps.doc (4) Retail Alcohol Outlets with Currently Active Licenses as of October 5, 1998 Median Household Income by City Overlap [Maps 1-101 This set consists of close-up maps of site specific alcohol license naps for the following areas: Richmond/EI Cerrito/San Pablo/EI Sobra.nte/Pinole Crockett/Rodeo/.Hercules/Pinole/EI Sobrante Martinez/Vine Hill/Pachecho/Pleasant Hill/Concord Walnut Creep/Concord/Pleasant Hill/Lafayette/Alamo/Danville Lafayette/Orinda/Moraga Danville/Blackhawk/San Ramon Fest Pittsburg/Pittsburg/Clayton Antioch/Oakley/Brentwood Oakley/Brentwood/Bethel Island Discovery Bay-Byron This set of maps shows both off-sale sites (maroon circles) and on-sale sites (green circles). Please note change in color key. The licenses are mapped over portions of the county that also show the median household income by area. The areas with lower .median household incomes are colored pink the areas with high household incomes are colored lavender. Compare the density and location of alcohol sites with differences in median household income. A list of Alcohol Retail Outlets sorted out by outlet type [Off-Sale and On-Sale] and by City is included with the set. (5) Percentage of Off-Sales Sites with Violations by City This map shows the off-sale and on-sale violations occurring between ,July 1, 1997 and October 2, 1998. The numbers in the parentheses focus mainly on off-sale violations, including (1) the number of off-sale licenses in the city; (2) the number of off-sale violations in the city; and (8) the percentage of off-sale violation types. This information is overlaid with the percentage of ofd sales sites with violations by city. When the percentage of off-sales sites with violations is low the area is colored lavender, when the percentage of violations relative to the number of outlets is high; the are is colored pink. This allows for comparison between the number of off-sale violations in a city to the total \ramal ia'sDocumencs\Amapa\aicoho mmaps.doc 2 number of off-sales sites. Using the key at the bottom left of the neap one can readily see the areas of the county where there are a low percentage of off-sale sites with violations (gray areas) to those areas with a high percentage (violet). (5) Alcohol License Violation Sites by Type of Violations Occurring Between July 1, 1.997 and October 2, 1998 [Maps 1-161 This set consists of close-up maps of site specific violations for the following areas: Richmond San Pablo/El Sobrante Rodeo/Crockett Martinez/Vine Hill/Pacheco Pleasant Hill/Walnut geek Concord Walnut Creek Danville/San Ramon San Ramon West Pittsburg/Pittsburg Pittsburg Antioch Oakley Brentwood Betldial Island Byron Both on-sale [squares) and off-sale [circles] license violations are plotted on the area maps. By looping at the color of the circle or square one can see what type of violation a site received and exactly where the site is located. The large roman numerals differentiate the five supervisorial districts. This set includes a list of outlets with violations that identify name of outlet or license holder, address, zip code, type of license and type of violation. The list follows the order of map marker numbers. If you need technical assistance or information in hoar to best use these maps to educate and to plan for a healthy community, contact Contra Costa County Health Services Community Substance Abuse Services Administration 597 Center Avenue Suite #320 Martinez, California 94553 Phone: (92 5) 313-6484 or 313-6311 Fax: (925) 313-6390 E-Mail: delvalle{'7a,hsd.co.contra-costa.ca.us C:\Amalia'sDocuments\Amalia\alcoholmaps.doc 3 E �s Fj C; t� l: k k, G. Selected Population Statistics for Contra Costa County Cities and Census Designated Places (CDPs). Narne of City or CDP* Population Median HH Pct. of Children Pct. of Children (see note) Income(ill Living At or Below in the Population f Dollars) I the Poverty Level (Alamo* 13,377 93,089 2.13 20.02 I x Antioch 79,300 40,936 12.48 23.70 Bayview-Montalvin* 3,988 37,528 19.07 24.36 Bethel Island* 2,264 35,731 4.96 11.25 Blackhawk* 6,199 129,135 1.67 22.03 Brentwood 17,000 4I,455 12.27 24.45 C€cyton 10,600 69,710 0.00 22.82 'Concord 113,400 41,675 10.18 19.66 I ;Crockett* 3,228 38,750 5.24 16.09 Danville 39,150 74,472 2.81 20.30 Discovery Bay* 7,000 65,494 2.39 17.27 E. Richmond Hts* 3,266 40,613 12.78 17.40 El Cerrito 23,600 39,538 3.71 13.57 El Sobrante* 9,852 39,496 8.31 18.84 Hercules 19,050 56,098 1.11 23.14 I Kensington* 4,974 61,330 5.35 13.39 i Lafayette 24,000 64,806 4.45 18.43 Martinez 36,100 45,964 8.32 18.65 I Noraga Town 16,550 69,767 2.30 117.57 Oakley* 27,000 46,091 8.26 24.90 �Orinda 17,150 80,968 2.32 18.15 Pacheco* 3,095 33,712 6.99 13.88 ''Pinole 18,350 45,820 6.22 20.08 Pittsburg 52,200 38,532 15.27 23.64 ;;Pleasant Hill 32,500 46,885 3.28 17.00 II,Richmond 92,800 32,165 26.17 20.68 ,Rodeo* 7,589 38,919 12.75 22.92 San Pablo 26,400 25,479 27.47 23.35 San Ramon 43,500 63,607 1.68 21.17 Tara Hills* 4,998 41,678 6.36 1831 Vine Hill* 3,214 37,012 0.67 21.91 Walnut Creek 63,200 45,529 4.37 14.23 West Pittsburg* 19,200 32,322 22.16 23.83 Data Sources: U.B. Census Bureau,CA Department of Finance, Contra Costa County Planning Departement Note: Duplicate and Event Licenses(n=67)not included. i Number of Active Retail Alcohol Licenses as of October 5, 1998 For Contra Costa County Cities and Census Designated Places (CDPs). Name of City or CDP* Number of Number of Number of Number of Licenses per 1,000 Active Retail On-Sale Off-Sale persons Alcohol Licenses ; Licenses Licenses (# of Outlets) N oto N % All On-Sale Off Sale Alamo* 17 (17) 12 70.6 5 ' 29.4 1.27 0.90 0.37 �Antioch 125 (122) 77 61.6 48 38.4 1.58 0.98 0.61 Bayview-Montalvin* 3 (2) 0 0.0 3 100.0 0.75 0.00 0.75 Bethel Island* 25 (23) 16 64.0 9 36.0 11.04 7.07 3.98 Blackhawk* 1 (1) 1 100.0 0 0 0.16 0.16 0.00 Brentwood 38 (34) 20 52.6 18 47.4 2.24 1.18 1.06 r t Clayton 12 (12) 8 66.7 4 33.3 1.13 0.75 0.38 Concord. 235 (232) 154 65.5 1 81 34.5 2.07 1.36 0.71 1 Crockett* 12 (11) 7 58.3 5 41.7 3.72 2.17 1.55 .� Danville 92 (89} 74 ; 80.4 18 j 19.6 2.35 1.89 0.46 s Discovery Bay* 6 (6) 4 66.7 2 1 33.3 0.86 0.57 0.29 E. Richmond Hts. 1 ; (i) 0 0.0 1 100.0 0?1 0.00 0.31 j i'• ;El Cerritto 45 (43) 30 1 66.7 15 ! 33.3 1.91 1.27 0.64 EI Sobrante* 27 (27) 13 48.1 14 51.9 2.74 1.32 1.42 (Hercules 9 (8) 3 33.3 6 66.7 0.47 0.16 0.31 E; Kensington* 7 (7) 5 71.4 2 28.6 1.41 1.01 0.40 Lafayette 47 (45) 34 72.3 13 27.7 1.96 1.42 0.54 1 Martinez 66 (65) 40 60.6 26 39.4 1.83 1.11 0.72 Moraga Town 25 (25) 19 76.0 6 24.0 1.51 1.15 036 s Oakley* 28 (25) 15 53.6 13 46.4 1.04 0.56 0.48 Orinda 25 (25) 20 80.0 5 20.01 1.46 1.17 0.29 Pacheco* 7 (7) 4 57.1 3 42.9 2.26 1.29 097 { Pinole 43 a (42) 29 ; 67.4 14 : 32.6 2.34 1.58 0.76 Pittsburg 74 1 (74) 36 48.6 38I 51.4 1.42 0.69 0.73 s Pleasant Hill 81 (80) 54 66.7 27 ' 33.3 2.49 1.66 0.83 Richmond 147 (145) 761 51.7 71 48.3 1.58 0.82 0.76 r ;Rodeo* 16 (16) 10 62.5 61 37.5 2.11 1.32 0.79 San Pablo 80 (76) 34 42.5 46 57.5 3.03 1.29 1.74 } San Ramon 96 (95) 67 69.8 29 30.2 2.21 1.52 0.67 Nara Hill* 2 (2) 21 100.0 0 0.0 0.40 0.40 0.00 Vine Hill* 10 (10) 3 ' 30.0 7 70.0 3.11 093 2.18 s Walnut Creek 182 (174) 134 73.6 48 26.4 2.88 2.12 0.76 West Pittsburg 27 (2 5) 11 40.7 16 59.3 1.41 0.57 0.84 Unincorporated 19 (19} 16 84.2 3 15.8 n/a n/a n/a Totals 1630 1 1585 1028 63.1 602 36.9 1.81 1.14 0.67 Data Source: CA Alcohol Beverage Control Note: Duplicate and Event Licenses(n=67)not included. i F I( 1; I: N Number of Alcohol License Violations Occurring Between July I, 1997 and Oct. 2, 1998 For Contra Costa County Cities and Census Designated Places (CDPs). 'Name of City or CDP* ' Number of Number of Number of Pct. of All Pct. of Off-Sale Pet. of On-Sale Violations Of On-Site Licenses w/ Licenses w/ Licenses w/ i Violations Violations Violations Violations Violations Alamo* 0 0 0, 0.0 0.0 0.0� Antioch 10 10 0 8.0 20.8 0.0 Bayview-Montalvin* 2 2 0 66.7 66.7 0.0 Bethel island* 2 1 1 8.0 11.1 6.3 # Blackhawk* 0 0 0 0.0 n/a 0.0 Brentwood 4 3 1 10.5 16.7 5.0 Clayton 0 0 0 0.0 0.0 0.0; r Concord 3 3 0 1.3 3.6 0.0� Crockett* I 1 0 9.1 20.0 0 0 11 Danville 1 0 1 1.1 0.0 1 A Discovery Bay* 0 0 0 0.0 0.0 0.0 E. Richmond Hts. 0 0 0 0.0 0.0 0.0 El Cerritto 1 1 0 2.1 5.9 0.0 El Sobrante* 8 7 1 29.6 50.0 7.7 Hercules 0 0 0 0.0 0.0 0.0 Kensington* 0 0 0 0.0 0.0 0.0 I Lafayette 0 0 0 0.0 0.0 0.0 Martinez 3 3 0, 4.5 11.5 0.0 Moraga Town 0 0 0 0.0 0.0 0.0 Oakley* 4 3 1 14.3 23.1 6.7' Orinda 0 0 0 OA 0.0 0.0 ;Pacheco* 2 2 0 25.0 66.7 0.0 Pinole 0 0 0 0.0 0.0 0.0 Pittsburg 8 7 1 10.8 18.4 2.8 Pleasant Hill I 1 0 1.2 3.7 0.0 Richmond 15 13 2 10.4 18.8 2.7 Rodeo* 4 4 0 22.2 66.7 0.0' San Pablo 3 1 2 3.8 2.2 5.9 San Ramon 5 4 1 5.2 13.8 1.5 Tara Hill* 1 0 1 50.0 n/a 50.0 Vine Hi11* 3 3 0 30.0 4.3 J2. � Walnut Creek 4 1 3 2.2 2.1 West Pittsburgh 9 6 3 32.1 37.5 Unincorporated I 1 0 6.7 33.3 Totals 95 77 18 5.8 12.8 Data Source: CA Alcohol Beverage Control Note: Duplicate and Event Licenses(n=67)not included. E; lcohol License Vzolatlons Occurring Between July 1, 1997 and Oct. 2, 1998 For Contra Costa Type of A County Cities and Census Designated Places (CDPs). Naive of City or CDP* Number of _ Type of Violation Violations Sale to Minor Sale to Minor Presence of Presence of ; Other License (Decoy) Slot Machines : Controlled Violations 1 1 _ Substances I % I`1 %� 1� % N % N % Alamo* 0 Antioch 10 8 80.0 1 10.01 i 10.0 Bayview-Montaiyin* 2 11 50.0 1 50.0 Bethel Island* 2 1; 50.0 1 50.01 Blackhawk* 0 Brentwood 4 2 50.0 1 25.0 1; 25.01 Clayton 0 .Concord 3 1 33.3 2 66.7 Crockett* 1 1 100.0 ' Danville 1 j 100.0 Discovery Bay* 0 = E. Richmond Hts. 0 j El Cerritto 1 1 100.0 El Sobrante* 8 7 87.5 1 12.5 Hercules 0 1 Kensington* 0 Lafayette 0 i Martinez 3 1 2 66.7 1 33.3 Moraga Town 0 Oakley* 4 1 25.0 3 75.0 fOrinda 0 t l Pacheco* 2 2 100.0 IlPinole 0 ! ! Pittsburg 8 3, 37.5 21 25.0 21 25,0 1 12.5 Pleasant Hill 1 I 1 100.0 3 Richmond 15 12 80.0 ! 3 20.0! Rodeo* 4 2 50.0 1 25.0 1 25.0 San Pablo 3 2 66.7 o: San Ramon 5 5 100.0 Tara Hill* 1 1 100.0 Vine Hill* 3 2, 66.7 1 33.3 Walnut Creels 4 1 25.0 1 25.0 2 50.0' West Pittsburgh 9 41 44.5 2 22.2 1, 11.1 2 22.2 Unincorporated 1 I 100.0 Totals 95 541 56.81 15_ 15.8 7 7.41 4 4,2 151 15.8 f Data Source: CA Alcohol Beverage Control i r. is l: i k 1:= l is E: County Maps with tiff-Sale &On-Safe Retail Alcohol Licenses s: r 1 s j G i x «� IL UO 0 AP { 4) m A' CO .� 4) � Lo::.; ::• 0 �. x c eri .... ccR >.4 M rig IN 0 , ODOM i l tJr4 f ILA �i 4$ s ` i o CO ei g} .Cs 0 0 -6 rn i tIs >' .... d if°.: co -E© o .. u 0) 0 $ �.° ° a ' ? C)a) o LL U R }}��....� Roo � 6 v 0- rz b y 0 e� � N Iff y� ,C w� s � f si # .t� c 00 � E LO > " at .W <!! `' ` < �y CD �j r �3 al+/ • °}�...+ yam' yA;:;:�.. �` �� %` ;',�" @D CS fl C3 .jw L"• Q� a� Gh ..a Q �y�y 60 y�y J 79 44 >t1.21 � . s� g ` �. CL CL ''` F A: Detailed Maps of Retail Alcohol Outlets with Current Licenses i E; r. 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