view this resource direct link to Knowledge Center

Document Sample
view this resource direct link to Knowledge Center Powered By Docstoc
					                 Klickitat County
       Intervention  Treatment  Aftercare



                Six-Year Strategic Plan

                           2007-2013



                              First Revision
                              June 1, 2007




                                Developed by
            The Klickitat County Substance Abuse Advisory Board
                             In Partnership with
Klickitat County Health Department, Skamania Klickitat Community Network,
                  And committed citizens of Klickitat County

           To meet Strategic Planning requirements set forth by
               The Division of Alcohol and Substance Abuse

                                                                            1
                       Table of Contents


Strategic Plan Overview                                          3
Klickitat County P-I-T-A Goals                                   4
Initial Networking and Community Assessment                      6
Mobilization and Capacity Building to Address the Needs 10
Klickitat County Intervention, Treatment, and Aftercare          11
Goals and Strategies
Strategic Plan Evaluation                                        25
Annual Activity Timelines
    2007-8 Annual Activity Timeline                              26
    2008-9 Annual Activity Timeline                              27
    2009-11 Biannual Activity Timeline                           28
    2011-13 Biannual Activity Timeline                           29
Supporting Data
    Prevention and Intervention                                  30
    Treatment                                                    35
Treatment Expansion Section                                      47
Criminal Justice Section                                         51
Exhibit
    Exhibit A: SAAB Logic Model                                  60
    Exhibit B: PITA Community Questionnaire                      61
    Exhibit C: PITA Community Questionnaire Dissemination Plan   63
    Exhibit D: PITA Community Questionnaire Results and          65
    Responses




                                                                      2
                           Strategic Plan Overview

Efforts to develop a six-year strategic plan for prevention, intervention, treatment,
and aftercare services in Klickitat County were initiated by strategic planning
requirements set forth by the Division of Alcohol and Substance Abuse (DASA) in
cooperation with Community Mobilization Against Substance Abuse (CMASA). The
strategic plan is necessary to meet RCW 70.96A.320 and RCW 70.96A.350.

In addition to meeting these state and federal funding requirements, the six-year
strategic plan provides a structured format for discussing the long term service
needs and goals of Klickitat County in the areas of substance abuse prevention,
intervention, treatment and aftercare. Planning efforts were led in partnership by
Deidre Duffy, the county’s Prevention Coordinator and staff person to the county’s
CMASA Board, and Lindsay Miller, County Coordinator for Chemical Dependency
Programs and staff person to the Substance Abuse Advisory Board (SAAB). Various
factions of the community, including several advisory and governing boards,
community groups, and unaffiliated community members were included in the
strategic planning process between June, 2006 and June, 2007.

The Skamania Klickitat Community Network (SKCN) worked to develop the goals
and strategies outlined in the prevention portion of the strategic plan. This is a
combined membership board constituting members from both Family Policy Council
and CMASA Boards. Members meet monthly to discuss prevention issues including
topics around parenting supports, after school programs, violence prevention, and
community bonding. The SKCN board meetings held in December, 2006 and
March, 2007 were dedicated solely to strategic planning efforts for prevention
services.

The Substance Abuse Advisory Board (SAAB) played a key role in development of
the intervention, treatment, and aftercare portions of the strategic plan. The SAAB
is comprised of ten Board Members representing public health and healthcare,
corrections, social services, the recovery community, parents, and the faith
community, among other interests. Their mission is to “assist in the development,
implementation, and evaluation of Klickitat County chemical dependency programs”
(Exhibit A).

The resultant six-year strategic plan illustrates the collaborative planning efforts of
committed individuals in Klickitat County. It identifies specific needs in the areas of
intervention, treatment, and aftercare for substance abuse issues in the county,
and outlines supporting data demonstrating the significance of the identified needs.
In addition, the plan outlines targeted goals, outcomes, strategies, and evaluation
indicators for providing high quality chemical dependency services in Klickitat
County over the next six years.

The Klickitat County PITA Strategic Plan is intended to be a working document, one
that is periodically updated to accurately reflect the service needs and goals of our

                                                                                        3
community. Through the strategic planning process, four goals for prevention and
fourteen goals for intervention, treatment, and aftercare services were identified as
priority.


                       Klickitat County P-I-T-A Goals

Prevention Goals (please see the Prevention Section for details):
   1.   Increase community awareness about substance abuse in order to reduce
        community laws and norms favorable to substance abuse.
   2.   Increase communication between parents, community, schools and church
        in order to improve neighborhood attachment.
   3.   Increase opportunities for pro-social involvement for youth to improve
        bonding to school.
   4.   Increase opportunities for youth to bond with their families while increasing
        family management skills.
Intervention Goals
   1.   Build collaborative relationships between schools, intervention programs,
        treatment providers, and community based services.
   2.   Develop additional intervention services across the county to complete the
        service array.
Treatment Goals
   3.   Change the community perception that treatment is not affordable.
   4.   Reduce transportation related barriers to treatment.
   5.   Increase access to timely chemical dependency assessments.
   6.   Develop and implement a family component to county-funded chemical
        dependency treatment.
   7.   Improve coordination and availability of chemical dependency related crisis
        services for people in our county.
   8.   Support positive workforce development in the chemical dependency field
        both locally and statewide
Youth Specific Treatment Goals
   9.   Increase youth treatment completion rate to a rate consistent with the
        statewide average.
Treatment Expansion Goals
   10. Increase outreach and engagement for aged, blind, disabled, people
       receiving TANF, SSI, GUA, or GAX assistance and are in need of chemical
       dependency treatment.




                                                                                        4
Criminal Justice Treatment Goals
  11. Improve access to treatment for criminal justice involved clients.
Aftercare Goals
  12. Decrease community acceptance of substance abuse in our community.
  13. Increase community resources to help people in recovery develop supportive
      social networks.
  14. Develop clean and sober housing in our community.




                                                                              5
           Initial Networking and Community Assessment

To start the planning process, a service assessment across the prevention,
intervention, treatment and aftercare continuum was initiated through the
development and dissemination of a community survey by the Substance Abuse
Advisory Board in September, 2006. This community survey, called the PITA
Community Questionnaire, was developed through a series of meetings by the
Substance Abuse Advisory Board. The purpose of the questionnaire (Exhibit B) was
to gather a wide range of community perspectives to determine the greatest needs
in each of the four service categories (prevention, intervention, treatment, and
aftercare). From a list of possible risk factors, barriers, and unmet needs, survey
respondents were asked to identify which factors most contribute to substance
abuse in Klickitat County. Questions specific to the needs of youth, parents,
persons with disabilities, and the elderly were included in the questionnaire. The
questionnaire was translated into Spanish, developed to accommodate a fifth grade
reading level, and was available both on the web and in paper format.

To circulate the questionnaire, the SAAB developed a dissemination plan (Exhibit C)
that utilized the community connections of each Board member. Target audiences
identified in the DASA strategic planning guidelines were assigned to Board
members depending on their community ties, and over 350 paper copies of the
questionnaire were circulated. Members of the Community Mobilization Against
Substance Abuse (CMASA) and Family Policy (FPC) council boards were also
involved in distributing the survey. Articles about the survey were printed in the
two local newspapers. They included contact information and a link to the online
survey website. Email list serves also distributed the link to the survey. In
addition, surveys were left in a wide variety of public locations, such as the Health
Department and WorkSource offices. Some service providers, such as probation
officers and chemical dependency professionals, also included the surveys in their
client’s required paperwork.

A total of 281 surveys were completed, either online or by hand, representing the
opinions and input of nearly every targeted group. The results were lacking
respondents in the categories of gay/lesbian/bisexual/bi-gendered and pregnant
women. Approximately 68% of the respondents were female, and about 66% were
between the ages of 36 and 65. About 18% of the respondents were between the
ages of 21 and 35, about 5% were under 21, and 11% were over 65. The reported
zip codes of the questionnaire respondents ranged across the entire county.

Out of about 50 possible risk factors included in the survey, 11 priority needs were
identified (Exhibit D) and served as the basis for the strategic plan. The
questionnaire results showed that, under the Prevention heading, respondents felt
the following risk factors contributed most to substance abuse:
    Drugs and alcohol are easy for youth to get (77.7%)
    Our families lack parenting skills (68.7%)
    Parents are not involved in their child’s schooling (73.7%)

                                                                                       6
      Our youth experiment with drugs and alcohol at a young age (75.4%)

Under the Intervention heading, the survey showed that:
   A lack of affordable counseling for youth, individuals, and families (48.1%)
     and
   The lack of mentoring programs for youth (47.4%)
most contributed to substance abuse.

With respect to Treatment barriers, respondents felt that:
    People can’t afford to pay for treatment (53.2%) and
    A lack of transportation makes it hard for people to attend treatment
      (49.8%).

Under the Aftercare heading, the greatest factors contributing to substance abuse in
this county were:
    There is high acceptance of substance abuse in our county (48.7%)
    It is hard for people in recovery to make new friends who don’t use (48.7%)
    We lack clean and sober housing resources in our county (449%)

In addition, the survey results drew over 150 individually written responses to the
question “What do you think the County should do about substance abuse?” The
responses ranged in content and opinion from
       Provide residential treatment and aftercare programs right here in Klickitat
       County. Provide early education to our children. Make the community more
       aware & enlist their help towards prevention activities - Provide more alcohol
       and drug-free activities for our children
to “Education!” to “Just keep trying to reach the people that need and want help.”
For a complete list of the survey responses, please see Exhibit D.
The PITA Community Questionnaire results were analyzed and used as the basis for
the PITA Strategic Planning efforts. Targeted goals were drawn from the top risk
factors in each category, and anecdotal data were taken into consideration when
identifying needs.

In addition to the information gathered on the PITA Community Questionnaire,
community information was also solicited through various community meetings:

Youth Advisory Boards
The prevention specialist/CM coordinator, tobacco prevention specialist, and a CM
board member conducted a series of focus groups with youth advisory boards in
two high schools (White Salmon and Lyle) in order to get more youth input. Over
35 students participated. They came from a variety of social circles. Identified
Needs—The students involved discussed many contributors to substance abuse and
strategies to eliminate the problems. The youth identified the following as
contributors to substance abuse: pain due to relationship (family and peer)
problems, lack of low cost, community-based (non-school) activities, lack of
transportation to activities, poor school spirit, not enough parental involvement, too

                                                                                        7
few school counselors and poor communication about opportunities. They also
discussed parental acceptance of substance abuse as a problem. Identified
Resources—One school’s youth felt that they had received a lot of information
about drugs in school. The sports programs were seen as an asset for those who
are interested in sports. Teachers who cared about kids were also identified as a
resource. Some said that the internet, especially myspace, was a valuable tool for
communication.

The Network Café
In order to get the perspective of parents and their needs, the Skamania Klickitat
Community Network (SKCN) hosted a network café discussion meeting. The SKCN
is a coalition of CMASA board members, Family Policy Council members and anyone
interested in substance abuse prevention. This coalition is being mentored through
support of a Drug Free Community Mentoring grant. 32 people attended the hour
and a half discussion circle about how to best support parents. Many concerns
about lack of parenting skills and involvement had been expressed in other surveys
and planning retreats. We had four circles (school focused, community focused,
spiritual community focused, and agency focused). We asked: what should we
keep doing? stop doing? and start doing? Parents were recruited from the recovery,
low income, and Hispanic communities. We also recruited parents of younger
children. Personal interviews were conducted with parents of special needs
children. Identified Needs—The need for better communication was identified as
a need for parents. Schools, agencies, churches, and the community at large all
need to work towards communicating more clearly with parents and each other.
There is a need for a greater amount of respect and acceptance of parents and
youth of all types. Stereotyping needs to lessen. The need for more parenting
classes was also identified. Identified Resources—School newsletters, parent-
teacher conferences, mandatory parental involvement in disciplinary actions, after-
school programs, community councils, faith based youth groups, art shows,
prevention information, community resources directory, gorgekids.net, and
interagency connections were all seen as community resources.

Horizon - poverty reduction discussion circles
Five communities in Klickitat County (White Salmon, Glenwood, Trout Lake,
Klickitat, and Goldendale) held a series of discussion circles as part of the Horizon
poverty reduction project. 290 people participated in five 2 hour facilitated
meetings in which belief systems about poverty, community needs and resources
and ideas about action plans was discussed. According the 2000 census Klickitat
County has a 17% poverty level. People in poverty and minority groups were
strongly recruited to be part of the discussion circles. The results of these
discussions were included in our assessment. Identified Needs—All five
communities identified poor communication between the community and
government/agencies/schools and lack of community bonding as major contributors
to the continuation of poverty. Some communities expressed the need for
affordable housing, transportation, and skilled leadership. Identified Resources—
People who care, the natural beauty of our area, schools, libraries, the mix of
newcomers and old-timers and living in a small town were all seen as resources.

                                                                                     8
2005 Service Provider survey
51 service providers responded to a needs assessment survey conducted in 2005.
When asked “what is the most significant social/public health problem or issue
affecting citizens in our community?” an overwhelming majority rated substance
abuse as the biggest problem. Community attachment/social isolation, child abuse
and neglect, domestic violence, and low commitment to school followed significantly
behind. Youth violence was the least concern. Poverty and unemployment were
seen as key contributors to problems. Mental health services, parenting classes and
support groups, and after-school programs were seen as the biggest need. Lack of
funding was seen as the biggest barrier to offering services to meet these needs.
Lack of awareness and fear were seen as the biggest barriers to people accessing
services. Domestic violence, substance abuse, and parenting programs were
identified as resources as well as bilingual services and increased program funding.
However, all of these were identified as insufficient.




                                                                                  9
     Mobilization and Capacity Building to Address the Needs

The strategic planning process for intervention, treatment, and aftercare services
took place over several community meetings between February and May, 2007.
The Substance Abuse Advisory Board provided a forum for strategic planning, and
regular SAAB meetings during this time were devoted to the strategic planning
process. The Board has representation from parents, community members, and
professionals dedicated to improving treatment services. Its members reflect the
perspectives of the healthcare, social service, criminal justice, faith based, and
recovery communities. The Board has representatives from two minority groups,
and over half of its members are people in recovery.
In addition to the regularly scheduled SAAB meetings, strategic planning activities
occurred in dedicated community meetings. The SAAB hosted a Strategic Planning
Retreat in February, 2007 and invitations were sent out to a variety of community
participants to elicit feedback to the strategic plan. The meeting was advertised in
the local papers, and notices were sent out by email to county employees and
community list serves. In addition, formal invitations were mailed to each of the
County Commissioners, the Prosecuting Attorney, the Sheriff’s office, Prevention
Intervention specialists, school counselors and administrators, the supervisor of the
Children’s Administration office, representatives from the Police Action League,
representatives from the Hispanic community, and selected healthcare
professionals. A group of ten people attended the full day planning retreat,
analyzed pertinent data, and developed goals and strategies for the treatment
portion of the strategic plan.
In May, we held a second meeting dedicated to strategic planning for intervention
services. In an effort to include the input from school staff, a special invitation was
made to school counselors and prevention specialists working. The two hour
meeting provided time to identify current intervention resources, gaps in services,
and specific goals for the intervention portion of our local service array.
The first version of the strategic plan will be submitted for review by DASA officials,
County officials, and the Substance Abuse Advisory Board. Additions and revisions
to the plan will be made biennially at a minimum, and should accurately reflect the
continuously changing needs of our community.




                                                                                     10
         Klickitat County Intervention, Treatment, and Aftercare Goals and Strategies
INTERVENTION: GOAL #1
Build collaborative relationships between schools, intervention programs, treatment providers, and
community based services.
OBJECTIVE: School staff, Prevention Specialists, and CD treatment providers work in coordination to
provide a seamless continuum of care for youth at risk for substance abuse.
                                                     Available
Problem Statement      Strategy                                             Who/By When               Target Indicator
                                                     Resources
Our current prevention, Treatment provider will      DHS staff currently    DHS staff to provide in- Community utilization of
intervention, and       offer regular                offers onsite          service or onsite trainings intervention and treatment
treatment services for communication and             outreach to schools,   and presentations to at services evidenced by an
youth could be better outreach to schools,           CA and CSO offices     least 4 community           increase in school and
coordinated. Referrals counselors, teachers, and                            partners per year           community-based referrals
across systems are rare community agencies           Positive               beginning October, 2007 to treatment and
and communication       (onsite consultation, in-    relationships with                                 intervention services.
between agencies is     service trainings on         schools in
sometimes lacking.      chemical dependency and      Goldendale
                        the services available)
                        Develop an informational     DHS resources for   Treatment provider with      School personnel working
Target Population       brochure and presentation    printing            county assistance as         knowledge of treatment
                        outlining intervention and                       needed by beginning of       resources and referral
                        treatment services           County support with 2007 school year.            process.
Prevention,             available to distribute to   layout and material
intervention, and       community partners and       development                                Presentations made to
treatment providers     school personnel.                                                       schools and community
School staff members                                                                            partners
                      Build personal relationships Youth Treatment    County to facilitate      Quarterly meetings held
Indicators of Success between treatment,           specialist attends quarterly meetings with beginning September,
Health Youth Survey   prevention, and              JAG meetings       provider, PIs and school 2007.
data                  intervention providers       regularly.         personnel for feedback
Increase in number of through regular meetings                        and ideas on ways to
school and community- and interaction.                                improve services.
based referrals to    Offer youth treatment        Currently offering Provider to determine     If deemed appropriate, on-
treatment             services on-site at schools on-site assessments need for on-site services site services are made
                      as appropriate.              as requested.      through communication available beginning
                                                                      with school and           September, 2008.
                                                                      intervention staff
                                                                                                                                11
INTERVENTION: GOAL #2
Develop additional intervention services across the county to complete the service array.
OBJECTIVE: Intervention service array effectively meets the community’s needs and offers a wide variety
of useful services.
Problem Statement        Strategy                      Available Resources Who/By When                           Target Indicator
When analyzing            Use prevention and           Girls’ Circle training,   Prevention Specialist,          Boys’ Groups offered in
available intervention    intervention funds to        knowledge, and            County Coordinator to work      at least 4
services, several gaps    develop and support a        successful                with Intervention staff and     schools/communities by
were identified,          boys social group            implementation            treatment provider as           Fall 2008
especially mentoring      program modeled after                                  needed to develop program
programs and social       the Girls’ Circle training                             by 2008.
groups for boys.          currently implemented in
                          the county.
                          Enhance existing and/or      Community                 Prevention Specialist,          Effective mentoring
Target Population         develop new resources        motivation around         County Coordinator to           resources and system
                          for mentorship programs      developing mentoring      collaborate with appropriate    in place by Spring 2009
Prevention,               in the county through        resources.                community partners to
intervention, and         partnerships with school     Possible mentor           develop mentoring
treatment providers       and prevention staff and     resources through         resources. Collaborative
School staff              other community              Americorps                meetings to begin process
County officials, general resources such as            Existing Big Brother      should start in the spring of
public                    Americorps.                  Big Sisters program       2008.
                          Continue efforts to          Current DISEY             County to facilitate ongoing    Regular DISEY classes
Indicators of Success provide effective                program in place          discussion and adjustment       are offered and well
Resource analysis         alternative to suspension    Well utilized by          to program to best fit the      utilized by the
demonstrates a well       program for youth in         treatment and JJ          needs of the community.         community.
developed intervention Klickitat County.               Partnership between
service array.                                         DHS and tobacco
                                                       prevention
                         Develop youth support         Strong Families           Begin discussions of possible Youth Support Groups
                         groups county wide for        resources available       partnerships and resources up and running by
                         children of addicts           Family member             through community             January 2009.
                                                       support of the idea       meetings to be held in 2008.
                                                       Existing Youth
                                                       Advisory Board

                                                                                                                                      12
TREATMENT: GOAL #3
Change the community perception that treatment is not affordable.
OBJECTIVE: The community is aware of financial resources available to pay for treatment.
Problem Statement         Strategy                 Available Resources Who/By When                  Target Indicator
People perceive that      Develop and implement a SAAB, SKCN, DV task      Education committee        Community Education Plan
outpatient treatment in   community education         force, CMASA         headed by county staff to developed by January
the community is not      plan promoting              MAT, Local media     include representatives 2008 and implemented by
affordable.               “Treatment is               County resources     from county                March 2008
                          affordable!” to include all Faith community      departments, SAAB, faith
                          available modes of media                         community, treatment
                          and presentation.                                provider, media, and
                                                                           other community groups
                          Ensure that County       County treatment        Treatment provider to      Implementation reports by
Target Population         treatment provider       provider                ensure message is          provider
                          promotes “Treatment is   Available funding for   delivered starting July 07
                          affordable!” message     treatment               SAAB to provide feedback Independent verification
                          beginning with initial   Change process          and additional monitoring
                          client contact and all   participation           as necessary
General public
                          communications
People in need of tx
Agency referrants         Develop and administer   Survey experience    SAAB to develop             Completed survey report
                          community perception                          perception survey in        at least every two years
                          survey                   Web based collection August 2007 and
                                                   mode                 implement perception
                                                                        survey by October 2007
Indicators of Success
                                                   SAAB
# of people in
treatment.
Community perception
survey




                                                                                                                               13
TREATMENT: GOAL #4
Reduce transportation related barriers to treatment
OBJECTIVE: Transportation is not a barrier to receiving treatment
Problem Statement        Strategy                    Available Resources Who/By When                    Target Indicator
Community perceives      Assess the need of         DHS                   DHS to track transport        Needs reported to SAAB
lack of transportation   transportation assistance. TARGET data           needs of clients in treatment by December 2007
as a barrier to                                                           at time of assessment and
treatment                                                                 report to SAAB December
                                                                          2007
                         Communicate with Mt         Mt Adams Transport   County Coordinator to         Status reports to SAAB
                         Adams to coordinate         SAAB                 arrange meeting with Mt       on collaborative
Target Population        group times and/or          Funding for          Adams Transport and/or        transport solutions April
                         capacity building through   transportation       SAAB in January 2008          2008
General public
                         additional contracts/
People in treatment
                         grant writing, especially
Organizations
                         for youth to attend
                         groups
                         Advocate at a county        Mt Adams Transport   SAAB to write letters to     Letters written by SAAB
                         level for a fixed route     SAAB                 appropriate recipients twice twice yearly beginning
                         public transportation       Funding for          yearly                       November 2007
                         system to be developed      transportation


                      Explore the possibility of     Law enforcement      County Coordinator to         Status report to SAAB
Indicators of Success alternate and/or mobile        resources            collaborate with existing     on possible mobile
                      treatment locations in         Funding for          transport providers,          treatment solutions by
Community Perception
                      response to treatment          transportation       treatment providers, and      September, 2008
survey
                      need in rural                  Willing treatment    other community partners
Client barriers to
                      communities                    provider             through meetings beginning
treatment
                                                                          July 2008
                         Dependency Health          Funding               DHS to develop handout or First contact survey for
                         Services to regularly      DHS staff             monitoring tool to ensure     DHS clients
                         inform clients of existing Mt Adams              that all clients receive
                         transportation resources                         transport related information
                         and assistance available                         by July 2007


                                                                                                                              14
TREATMENT: GOAL #5
Increase access to timely assessments.
OBJECTIVE: Average wait time for completed assessment less than 2 weeks
Problem Statement         Strategy                     Available Resources Who/By When               Target Indicator
Currently experiencing    Track average wait time      TARGET and intake    DHS staff to provide wait Status report to SAAB by
six week wait time for    for assessments and          data                 time report by August,    August 2007
assessment                report data back to          County Coordinator   2007
appointments.             SAAB.


                          Facilitate discussion with   DHS                  DHS and County           Implementation plan to
Target Population         Dependency Health            SAAB                 Coordinator to develop   address assessment wait
                          Services and/or initiate     County Coordinator   assessment wait time     time in place by December
Dependency Health
                          contractual language         Youth Treatment      action place as needed   2007 if deemed necessary
Services, referring
                          additions to address         Coordination Grant
agencies
                          assessment wait time
                          issues if deemed
                          necessary by wait time
                          report.



Indicators of Success
Client wait time
between first contact
and completed
assessment is less than
two weeks




                                                                                                                                 15
TREATMENT: GOAL #6
Develop and implement a family component to county-funded chemical dependency treatment.
OBJECTIVE: Youth, parents, and family members of those participating in treatment will be involved in
family support and treatment groups to strengthen recovery skills.
Problem Statement        Strategy                    Available Resources Who/By When                Target Indicator
There currently exists   Complete an                 EBPs for family       DHS staff to work with   Plan developed
no family component to   implementation plan to      component programs    County Coordinator to
CD treatment in our      include research of         Successful projects   develop plan by June
county.                  existing evidence based     through CWCMH in      2008
                         family programs,            Yakima
                         documented local need,      Willing DHS staff
                         projected costs and
Target Population        utilization, possible
Dependency Health        community partners to
Services, County         include in program, and
officials, families      action plans for
participating in         implementation and
treatment                monitoring
                         Secure funding for family   DASA funds            County Coordinator to    Funding proposal complete
                         component programs          County funds          develop funding proposal by June, 2008
Indicators of Success                                                      based on submitted
                                                                           implementation plan
Family treatment
component is available   Implement family      DHS staff and               DHS to implement new Program up and running
and well utilized as     component programming community partners          program by July 1, 2008 by July 1, 2008.
evidenced in the         according to plan
TARGET reporting
system                   Provide family support   DHS staff and/or         DHS, county, and/or      Support groups up and
                         groups for parents,      community partners       community partners       running by July, 2009
Increase in treatment
completion for youth     grandparents, and family                          develop curriculum and
and parents in           members of addicts to                             guidelines for support
treatment                follow family component                           groups by June, 2009
                         of treatment




                                                                                                                            16
TREATMENT: GOAL #7
Improve coordination and availability of chemical dependency related crisis services in our county.
OBJECTIVE: Chemical dependency related crises in our county are responded to in a coordinated,
collaborative, and effective manner.
Problem Statement       Strategy                   Available Resources Who/By When                  Target Indicator
Crisis response services Encourage collaborative Existing Behavioral       County Coordinator to      Crisis coordination plan
for CD related calls are discussions and planning Health Crisis            work with other            developed by July, 2009.
often disjointed, under- across all crisis response Coordination grant     community partners
funded, or nonexistent. systems to include law      through Klickitat      invested in crisis service Plan implementation by
                         enforcement, health care, Valley Health Services improvement, schedule January, 2010
                         CD treatment, and          began discussion       community meetings,
                         transportation to develop process.                and help develop
Target Population        a county wide crisis                              coordination plan by July,
Law enforcement          response plan for                                 2009.
Health services          behavioral health crises.
CD treatment providers
County officials         Secure adequate funding Services are currently County Coordinator to         Funding to be secured for
Transportation           to support after hours CD available, but are      work with provider and 07-09 biennium.
providers                on call crisis services in funded using mental DASA to develop feasible
Clients at risk for ER   Klickitat County           health dollars.        funding plan for 07-09
involvement                                         Estimated 80% of       biennium.
                                                    crisis calls to MH
Indicators of Success
                                                    center are CD related.
Reduction in number of
chemical dependency
related crisis events in
the county as measured
by Health Provider and
law enforcement data
and DASA TA
documented ER visits.




                                                                                                                              17
TREATMENT: GOAL #8
Support positive workforce development in the chemical dependency field both locally and
statewide.
OBJECTIVE: Qualified chemical dependency professionals are available and committed to providing
quality services in our county and across the state.
Problem Statement       Strategy                  Available Resources Who/By When                      Target Indicator
In Klickitat County and Advocate for the fair      SAAB has local          SAAB to write a letter or   Letters and/or activities
across the state we find compensation of qualified advisory power          participate in other        completed annually or in
a shortage of qualified CDPs across the state                              advocacy activities to      response to legislative
CDPs. Certification      and locally by writing                            build support for           developments
requirements are         letters, participating in                         increased compensation
lengthy, and             lobbying activities, and                          to CDPs locally and
compensation following spreading awareness                                 statewide
certification is low in  throughout the
comparison to other      community.
professions.
                         Develop a funding         Creative minds, local   CC to develop proposal      Proposal developed and
                         proposal to include grant support for workforce   by May 2008                 submitted to appropriate
Target Population        or county dollars to      development                                         reviewers
County officials,        support local citizens in
treatment providers,     obtaining their CDP
state leaders and        certification
legislators


Indicators of Success
Decrease in local CDP
attrition rates

Increase in CDP wages




                                                                                                                                   18
YOUTH TREATMENT: GOAL #9
Increase the youth treatment completion rate to a rate consistent with the statewide average.
OBJECTIVE: Youth treatment completion rate will increase from 26% to 45% over the next six years .
Problem Statement         Strategy                   Available Resources Who/By When                   Target Indicator
Our county’s current      Provide Youth Treatment    DHS staff committed DHS staff to select two       Biannual youth treatment
youth treatment           Specialists will attend    to providing quality   youth specific trainings   specific trainings attended
completion rate of 26%    additional trainings       youth services         per year for targeted      by targeted DHS staff
is well below the state   specific to providing      County funding and     staff                      beginning in 07-09
average of 42%.           effective youth services   community priority for County Coordinator to      biennium.
                                                     youth treatment        allocate adequate funding
                                                                            to pay for these trainings
Target Population
Dependency Health
Services, youth and   Incorporate family                                                               Increased youth treatment
families in treatment component into youth                                                             completion rate
Indicators of Success treatment model (see
                      Treatment Goal #4)
Youth treatment
completion rate
reported in DASA
Treatment Analyzer    Develop and implement          DHS staff committed DHS to develop proposal Support groups up and
                      an aftercare or relapse        to providing quality   and implementation plan running by July, 2008.
Monitor incremental   prevention support group       youth services         by April, 2008
improvement, with an for youth completing            County funding and
expected increase in  treatment.                     community priority for
completion rate of 5-                                youth treatment
7% per biennium.




                                                                                                                                 19
TREATMENT EXPANSION: GOAL #10
Increase outreach and engagement for aged, blind, disabled, people receiving TANF, SSI, GAU,
and/or GAX assistance in need of CD treatment.
OBJECTIVE: People qualifying for Treatment Expansion funding are aware of financial resources and
know how to access chemical dependency treatment.
Problem Statement        Strategy                    Available Resources Who/By When                      Target Indicator
We need to increase      Increase collaboration      Funding for position   Collaboration between       Improved utilization of
outreach and             and effectiveness of        available              Coordinator, treatment      outstationed staff person’s
engagement of            outstationed counselor      Desire to maintain     provider, and DSHS staff to time and staff perception
Treatment Expansion      positions at DSHS offices   and improve            brainstorm and implement of the position
clients.                 in Goldendale and White     position               position improvements by
                         Salmon                      Successful CA          September ‘07
                                                     outstation
                         Increase collaboration      ESD 112 and county     County staff, treatment       Collaboration plan
                         with KC Developmental       willing to partner     provider staff, ESD 112       developed by December,
                         Disabilities provider (ESD                         staff to meet by Dec ’08 to   2008
                         112)                                               develop collaboration plan
                         Increase collaboration     DV staff, county        DV staff, county staff,       Collaboration plan
Target Population        with domestic violence     staff, treatment        treatment provider to meet    developed by January,
People who qualify for   resources (DVR)            provider                and develop collab. plan      2008
Treatment Expansion    Increase outreach,        Behavioral Health          Treatment provider staff    Collaboration plan
funds                  collaboration and         Crisis Coord. Grant,       and County Coordinator to developed by March, 2008
Referral agencies      communication to ER and KVHS, Skyline                facilitate collaborative
                       Health Services,          hospital, treatment        discussions with
Indicators of Success especially detox services provider staff              appropriate healthcare
Increase in numbers of in East end of the county                            providers beginning Feb ‘08
Treatment Expansion    to facilitate smooth
clients served         referrals and treatment
                       admissions
                       Provide training and      Large network of in        County Coordinator,           Trainings and information
                       referral information to   home care                  treatment provider staff,     provided to in home care
                       Senior Services In Home providers, strong            Senior Services staff to      providers
                       Care Providers            senior services            meet July ‘07



                                                                                                                                   20
CRIMINAL JUSTICE TREATMENT: GOAL #11
Improve access to treatment for criminal justice involved clients.
OBJECTIVE: People involved in the criminal justice system have access to chemical dependency
treatment.
Problem Statement         Strategy                  Available Resources Who/By When                    Target Indicator
We need to increase       Encourage faith based,    Existing faith based     County Coordinator will   Groups available in jail for
access to treatment for   12-step, and other        groups (SAFE,            invite group reps to a    people who want to
Criminal Justice          support group presence    Freedom Now)             SAAB meeting & ask how    participate by January
involved clients          in local jail.            Supportive law           we can support them       2008.
                                                    enforcement              November, 2007
                                                    AA/NA contacts
                      Facilitate collaboration      DHS                      Set up necessary          Resource plan in place by
Target Population between Sheriff’s                 Supportive law           meetings to develop       January, 2008
                      Department, jail, and         enforcement              treatment resource plan
Criminal Justice
                      Chemical Dependency           Crisis coordination      for jail services by      Jail services as needed in
involved clients
                      treatment provider to         grant                    September, 2007           place by July, 2008
                      assess unmet inmate
                      needs and develop a plan
                      as needed
                      Request additional CJTA State funds available          County Coordinator        Additional funds awarded
                      funds for 07-09 and                                                              for 07-09 biennium
Indicators of Success subsequent biennia
More criminal justice
involved clients
entering treatment        Continue participation in Program is up and        CC to allocate funds,     Adequate utilization of
                          the regional CJTA          running and was well    renew contracts, audit    service by Klickitat County
                          Innovative project for the utilized by Klickitat   facilities, and monitor   clients.
                          Pathways Co-occurring      County in the 05-07     services on an ongoing
                          mental health and          biennium.               basis.
                          chemical dependency
                          inpatient program in
                          Sunnyside.




                                                                                                                                 21
AFTERCARE: GOAL #12
Decrease community acceptance of substance abuse in our community.
OBJECTIVE: Substance abuse is not an accepted norm in our community.
Problem Statement     Strategy                    Available Resources Who/By When                    Target Indicator
Substance abuse is    Develop and implement a SAAB                  SAAB/Beginning of 07/09 Survey developed by April,
accepted in our       community wide survey SKCN                    biennium                2008
community             to measure the level of Prevention strategies                         Survey disseminated and
                      community acceptance of for measurement                               results analyzed by June,
                      substance abuse.        Survey expert                                 2008

                      Provide positive drug and   Existing resources       Create plan for county    County supported activity
                      alcohol free community      (transitional housing,   supported activities by   plan developed by March,
                      events for youth and        community events,        March 2008                2008
                      families                    community ed, parks      Support biannual
                                                  and rec., SKCN, etc)     community events        Drug and alcohol free
                                                  Schools                  beginning June 2008     events take place on a
                                                                                                   biannual basis beginning
                                                                                                   June 2008
                      Develop and disseminate     SAAB, Prevention         SAAB to lead campaign Social marketing/campaign
Target Population     a media/word of mouth       staff, materials, and    efforts following       plan developed January
General public        campaign built upon the     knowledge, SKCN          completion of community 2009
People in need of tx  results of the survey.      Local media,             survey
Businesses            Use questions,              Community groups         SAAB to develop media Social marketing campaign
Youth and Families    community discussions,      Faith based groups,      campaign by January     plan implemented
                      and individual              Schools                  2009                    February 2009-February
                      connections to develop                                                       2011
                      community relationships
Indicators of Success Utilize AA and Meth         MAT has hired,           SAAB to get the word out Community speakers are
Community perception Action Team public           qualified speakers in    to the public that         being utilized at least
survey                speakers to present at      recovery                 speakers are available     quarterly at engagements
                      community events, to        AA has community         and facilitate connections throughout the county by
                      groups, schools, etc.       relations coord and                                 February 2008
                                                  volunteer speakers




                                                                                                                             22
AFTERCARE: GOAL #13
Increase community resources to help people in recovery develop supportive social networks.
OBJECTIVE: People in recovery have resources to help them build a clean and sober social network.
Problem Statement      Strategy                      Available Resources        Who/By When          Target Indicator
It is hard for people in Provide positive drug and
recovery to find friends alcohol free community
who don’t use.           events for youth and
                         families (see related
                         strategy for Aftercare Goal
                         #1)
                         Help with the development Gorge Family Resource        County Coordinator   Communication system is
                         of a coordinated            Guide, SKCN Parent         to partner with      in place and the community
                         communication system to Coordinator, Klick Co          prevention,          knows about it by January,
                         disseminate information     website, Klickmeth         parenting, and       2010
Target Population        on community events,        website                    partner staff
General public           services and resources
People in recovery     Develop peer to peer                              Partnership between Peer to peer services added
                                                     Peer to peer model for
Referral agencies      coaching resources for                            county and provider to the local service array by
                                                     mental health services,
Treatment providers    people in recovery                                staff Services should July 2009
                                                     Liquor tax funds, best
Corrections, DSHS                                    practice peer modelsbe available July
                                                                         2009
                      Develop recovery resource Bunny Nadler and MAT MAT, SAAB, County Resource rooms exist in
                      center in each major      already looking into     staff                 each community by June
Indicators of Success county community          logistics for starting   Resource room in GD 2010
                                                resource room in GD.     by Sept ’08. Other
# of new recovery
                                                Liquor Tax dollars might communities by June
support resources
                                                supplement efforts.      2010
                       Ensure utilization of local   Strong and active AA       Adult probation,    % of clients in treatment
                       AA resources, community       community locally          prosecutor, judges, who participate in 12-step
                       events, and hotline by        Adult probation and        treatment provider, program
                       requiring participation for   treatment provider         ongoing and already
                       Criminal Justice and CD       support participation in   in place
                       treatment clients             AA




                                                                                                                             23
AFTERCARE: GOAL #14
Develop clean and sober housing in our community.
OBJECTIVE: Clean and sober housing resources exist for people in recovery in Klickitat County..
Problem Statement       Strategy                     Available Resources Who/By When              Target Indicator
We lack clean and       Increase collaboration       Work already done on SAAB, Continuum of Care Housing plan in place to
sober housing           and support for the          long term housing      housing group         include specific housing
resources in our        Continuum of Care            plan, bid in to the                          resources for people in
community.              housing group working to     state to receive                             recovery per housing
                        develop homeless and         housing funds, strong                        committee’s timelines for
                        transitional housing         community support                            plan completion and
                        resources in the county.     for efforts, treatment                       implementation
                        The group hopes to be        representative on
                        awarded housing funds        housing committee
Target Population       directly from the state to
General public          continue efforts to
People in recovery      develop housing
Community               resources.
organizations
County Officials




Indicators of Success
# of clean housing
resources




                                                                                                                          24
                             Strategic Plan Evaluation


The Klickitat County six-year strategic plan will be evaluated and revised at least
biannually, with the first revision to occur before June 1, 2009. In addition to the
required biannual updates, we will revise the plan as needed to accommodate the
shifting priorities and needs of our communities.

To monitor progress made on the plan, we will use the following Activity Timelines to
track strategies that have been completed over the next six year. These Activity
Timelines are intended to be used as a tool for holding our community accountable to
the goals that have been set forth in this plan. As goals and strategies contained in
the strategic plan change, as they are expected to do over the next six years, the
corresponding Activity Timeline will be updated. The Activity Timelines will be tracked
on a quarterly basis by our Substance Abuse Advisory Board to monitor the progress
made with respect to each strategy and goal.

In addition, each goal set forth in the strategic plan has corresponding “Indicators of
Success” identified for qualitative monitoring of each goal. Each strategy, in turn, is
associated with an intermediate target indicator to monitor both the effectiveness of
the strategy, and whether or not each strategy has been completed. Strategies
include clear timelines and identify people responsible for the follow through of each
strategy.




                                                                                       25
26
27
28
29
                 Supporting Data: Prevention and Intervention


Are OUR children using alcohol?

…recently?                                               …while driving?
                                                                     Percent of students who report drinking and
     Percent of students who report having a drink              driving OR riding with a driver who had been drinking
                   in the past month

                                                              driving                          26%                 25%
                                                                           24%
                                                              riding

                                                                                                           16%
                                42%
                                              34%                9%                      8%
                   23%
       9%


    Grade 6      Grade 8      Grade 10     Grade 12               Grade 8                Grade 10          Grade 12



 …frequently?                                                How do students who drank during
      Percent of students who report drinking on
                                                              the past month get their alcohol?
          3 or more days in the past month



                                                                                           I got it at a
                                                                                              party
                                                                                              19%
                                                                  I got it at
                                                                 home with
                                                                 permission
                                               19%                   13%                                         I got it some
                                 15%                                                                               other way
                   10%
      2%                                                                                                              17%

                                                          I took it from
   Grade 6       Grade 8      Grade 10      Grade 12      home without
                                                           permission                                               I bought it
                                                               9%                                                 from a store
                                                                                                                        2%
…heavily?
                                                                                                           I got it from
                                                                       I gave money                           friends
                                                                        to someone                              16%
                                                                         to get it for
                                                                             me
                                                                            24%
                                               23%
                                 19%
                   14%
      0%

    Grade 6       Grade 8      Grade 10      Grade 12
                                                        Survey results are generated from
                                                        student responses to the statewide
   Percent of students who report drinking heavily      2004 Healthy Youth Survey. To find
      (5 or more drinks in a row) at least once         out more about the Healthy Youth
                in the past two weeks                   Survey, please visit
                                                        http://www3.doh.wa.gov/HYS




                                                                                                                              30
How strong are the barriers to drinking in our community?
     Percent of students who feel that their                 Percent of students who think they
   parents* think it is only "a little bit wrong" or         will get caught by parents* or police
 "not wrong at all" for their teen to drink alcohol                    if they drink alcohol
                      regularly
                                                                                               parents
                                                                    59%
                                                                                               police
                                                             50%                 49%
                                                                                             37%
                                                                          28%
                                23%          25%
                                                                                       13%           13%
                   14%
       2%                                               0%

    Grade 6      Grade 8     Grade 10     Grade 12      Grade 6      Grade 8    Grade 10     Grade 12




     Percent of students who think it is easy to
           get alcohol when they want




                                66%          73%

                   39%
      30%


    Grade 6      Grade 8     Grade 10     Grade 12




 *Questions about parental attitudes were included at the discretion of the
 school districts. Results may not reflect a representative sample of all
 students in the community.
       Is there real harm in underage drinking?
 Alcohol use among youth is strongly correlated with:

               Violence
               Sexual activity
               School failure
               Illicit drug use
               Driving safety
 "What parents may not realize is that children say that parental
 disapproval of underage drinking is the key reason they have chosen not
 to drink."
                                              Charles Curie, SAMHSA Administrator
                                             U.S. Dept. of Health & Human Services                         31
 Are our children using illegal drugs?
 Percent of students who report using an illegal        Percent of students who report being drunk or
             drug in the past month                            high at school in the past year




                                                                                    18%          19%
                  5%           6%          6%                           8%
                                                            0%
      0%

    Grade 6     Grade 8     Grade 10    Grade 12         Grade 6      Grade 8     Grade 10    Grade 12



    Percent of students who report that it is sort       Percent of students who report it would be
       of easy or very easy to get marijuana               sort of easy or easy to get hard drugs




                              54%         52%

                 30%
                                                                                    23%          24%
     11%                                                                12%
                                                            8%


   Grade 6     Grade 8     Grade 10     Grade 12         Grade 6      Grade 8     Grade 10    Grade 12



Percent of students who report that kids smoking     Percent of students who report that their parents would
                                                      think it was wrong or very wrong to smoke marijuana
    marijuana would be caught by the police




                                                                        89%         90%          91%
     62%
                 38%
                              29%
                                          21%
                                                            0%

   Grade 6     Grade 8     Grade 10     Grade 12         Grade 6      Grade 8     Grade 10     Grade 12




                                                                                                               32
33
34
                                    Supporting Data: Treatment



                                     Is Treatment Affordable?
53% of respondents on the PITA Community Questionnaire felt that “People can’t afford
to pay for treatment”
This was the highest rated barrier to treatment
Related comments include:
      “We need more $ for providing treatment for people with low income.”
      “If they could make what they have more affordable and have more groups or
      classes it would help.”
      “I have known people who have gotten some help, but not enough because they
      couldn’t afford it. It also made them struggle to pay their bills.”

            Monthly Household Income for Admissions 7/05-12/06
               % Clients Admitted




                                         Monthly Household Income


  Who currently qualifies for funding assistance in our county?
   Pregnant and Parenting women                                 Any youth who needs treatment
   IV drug users                                                People receiving assistance
   People on a state medical coupon                             through SSI or TANF
   People over the age of 62                                    People who are unemployed due to
   People who have a mental or                                  a disability
   physical disability                                          People who have used in the last
   Parent who meet income guidelines                            90 days and have no income
   through DSHS                                                 People in the criminal justice
   Youth in foster care                                         system




                                                                                           35
                         Transportation in Klickitat County
  50% of respondents to the PITA Community Questionnaire felt that “Transportation makes it
  hard for people to attend treatment.”
  This was the second highest rated barrier to treatment
  Related comments include:
        “Have outpatient treatment available in rural areas because of the lack of
        transportation for most families.”

                 Available Transportation Resources in Klickitat County
                      Provides free priority transportation for seniors and other people who
                      have a medical coupon across Klickitat County
                      People who don’t have a medical coupon can also be transported for a
                      small fare
                      They have 4 buses in White Salmon and 3 in Goldendale
                      Reservations should be made 48+ hours in advance, and sometimes
                      they fill up 5-6 days ahead of time
                      White Salmon services complete an average of 60-70 pickups each day
                      Example fares for non-Medicaid riders:
  Mt. Adams
                         Wishram to Goldendale: $5.00 round trip
Transportation           In town destination (Goldendale or White Salmon): $1.00
                         White Salmon to Dallesport: $6.00 round trip
                         White Salmon to Lyle: $3.00 round trip
                         Goldendale to White Salmon: $10.00 round trip
                         Just out of town (2-3 miles) pickups: $2.00
                      Weekly trips to The Dalles and Hood River are offered
                      Daily local route with additional pickups/drop-offs as needed
                      Volunteer drivers available when vans are full

                      Available in the White Salmon area only
                      Example fares for one way trip:
                         Lyle to White Salmon: $18.00
 Taxi Service            Goldendale to White Salmon: $50.00
                         In town destination White Salmon: $7.00


Other considerations when assessing transportation needs:
  Average gas price in Washington is $3.31
  Average car gets about 18 miles/gallon
  That’s about 18 cents/mile
  According to admissions data for adults entering treatment between July 2005 and December
  2006:
        53% of clients do NOT have a valid driver’s license
        45% of clients do NOT have access to a vehicle




                                                                                           36
                                       Past Year Changes and State and County Comparisons



                                                                                                                                Past Year Change2
                                                       3
                        Trends in Outpatient Admissions                                                             County                              State
                        Overall Admissions                                                                                        25.60%                              5.80%
                        Youth4                                                                                                  300.00%                               2.55%
                        Female                                                                                                      5.88%                             9.42%
                        Pregnant and Parenting Women5                                                                      undefinedXX                                5.86%
                                                      6
                        Parents with Children                                                                                     33.33%                              4.28%
                        Gay, Lesbian, Transgender7                                                                         undefinedXX                              25.40%
                        IV Drug Use (Ever)8                                                                                         7.69%                             6.88%
                        IV Drug Use (past 30 days)9                                                                              -66.66%                              0.49%
                                                           10
                        CJTA-funded Admission                                                                                    -84.21%                            13.44%
                        CJ Referrals11                                                                                            40.00%                             -1.03%
                        Opiate Substitution Admission                                                                                   n/a                          -8.68%
                        Primary Drug
                        Alcohol                                                                                                     5.00%                             4.57%
                        Cocaine                                                                                            undefinedXX                               -1.97%
                        Heroin                                                                                             undefinedXX                                2.11%
                        Methamphetamine                                                                                           14.28%                            12.49%
                        Marijuana                                                                                                 73.68%                              3.50%
                        Trends in Detox Admissions
                        Detox Admissions                                                                                                n/a                          -5.43%
                        Percent Completed                                                                                               n/a                         65.95%
                        Past year completion, not a change in score




                                                                                                                  PROGRESS TOWARD GOAL IN 2006
                        Treatment Expansion: Progress Toward Goals                                                     County                              State
                        All Adults                                                                                         103.41%                            81.03%
                        Aged                                                                                                  0.00%                           65.61%
                        Blind/Disabled                                                                                     114.34%                            70.33%
                        TANF                                                                                                 96.43%                           86.26%
                        GA-U                                                                                               103.80%                           114.37%
                        Youth                                                                                              179.10%                            91.25%




1
   Defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Admissions whose contract type is DOC-Community are included.
2
   [(Admissions: Jan-June 06-Admissions Jan-June 05)/Admissions Jan-June 05]* 100.
3
   Includes Intensive Outpatient, Outpatient, MICA Outpatient.
 4
   Under 18 years of age at admission.
 5
   Identified using the contract type field in TARGET. Value of Pregnant/Parenting.
 6
   Identified using two fields from TARGET. The first field indicates the client’s children (under 18) that are living with them and the second indicates other children living with the client. If the
client has either their own or other children living with them they are counted as parents with children for this analysis.
 7
   Identified using the sexual orientation field in TARGET.
 8
   Identified using the needle use field in TARGET.
 9
   Identified using the used needle recently field or the method_ID field in TARGET.
 10
    Identified using the contract type field in TARGET. Values of 1) Criminal Justice or 2) Criminal Justice - Innovations.
 11
    Identified using the entry referral field in TARGET. Values of 1) Court/Probation, 2) Department of Corrections, 3) Diversion, 4) Police or 5) JRA.
 12
    Expansion subpopulations were identified using several fields from the TARGET database, including Public Assistance Type, Contract Type and Disability.




                                                                                                                                                                                                          37
                                                                        Outpatient2 Admissions by Primary Drug3

                            70



                            60
                                               
                                                                                                                                                                                                                     

                            50


                                                                                                                                                                                                                                  
A d m issio n s




                                                                                                                                                                                                    
                                                                                                                                                                                                                     
                            40
                                                                
                                                                                                                                                                                     
                                                                                                                                                                                                                                 
                            30


                                                                                              
                                                                                                                                                
                                                                                                                                                                                                                                 
                            20                                                                                                                                                                   
                                                                                                                                                                                                  
                                                                                                                                                              
                                                                                                                                                                                    
                                                                                                
                                                                                                                                
                                                                                                                                                
                                                                                                                                                                                    
                            10
                                                                                                                                                                                                                   
                                  
                                  
                                              
                                                               
                                                                                 
                                                                                               
                                                                                                                 
                                                                                                                                
                                                                                                                                 
                                                                                                                                 
                                                                                                                                                
                                                                                                                                                                  
                                                                                                                                                                   
                                                                                                                                                                   
                                                                                                                                                                                     
                                                                                                                                                                                                                     
                                                                                                                                                                                                                                   
                                                                                                                                                                                                                                   
                              0                                
                                                                                
                                                                                                                              
                                                                                                                                                                                   
                                                                                                                                                                                                   
                                                                                                                                                                                                                                 
                              J a n-J un    J ul-D ec      J a n-J un        J ul-D ec      J a n-J un       J ul-D ec      J a n-J un       J ul-D ec          J a n-J un        J ul-D ec     J a n-J un         J ul-D ec    J a n-J un
                                2000          2000           2001              2001           2002             2002           2003             2003               2004              2004          2005               2005         2006


                                                                     A lc o h o l                                              C o c a in e                                                    H ero in
                                                                     M a riju a n a                                            M eth                                                           O th er




                      Comparison of Admissions Over Time
                                                                                                                  Primary Drug
                       Jan-Jun 2006                                                                                                                                                                             Change in
                      Compared to...4                Alcohol                Cocaine                 Heroin               Methamphetamine                  Marijuana                    Other                 All Admissions

                          Jan-Jun 2005                                     undefinedXX          undefinedXX
                                                        5.00%                                                                      14.28%                  73.68%                    50.00%                          25.60%
                          Jan-Jun 2003                                     undefinedXX                                                                                              undefinedXX
                                                   250.00%                                          0.00%                        500.00%                  560.00%                                                   368.18%
                          Jan-Jun 2000               -23.63%              -100.00%                  0.00%                        200.00%                   94.11%                   200.00%                          22.61%



                  Admissions by Primary Drug
                                                   Alcohol                        Cocaine                      Heroin                     Marijuana                               Meth                           Other
                                            Admits           %            Admits            %            Admits            %         Admits               %            Admits             %         Admits                %        Total

                  Jan 2000-Jun 2000             55        65.5%                   2      2.4%                 1           1.2%           17         20.2%                     8          9.5%                1           1.2%          84
                  Jul 2000-Dec 2000             58        58.0%                   0      0.0%                 1           1.0%           17         17.0%                    22        22.0%                 2           2.0%        100
                  Jan 2001-Jun 2001             38        48.1%                   0      0.0%                 0           0.0%           16         20.3%                    24        30.4%                 1           1.3%          79
                  Jul 2001-Dec 2001             33        70.2%                   0      0.0%                 0           0.0%              3            6.4%                 9        19.1%                 2           4.3%          47
                  Jan 2002-Jun 2002             25        44.6%                   1      1.8%                 0           0.0%           13         23.2%                    16        28.6%                 1           1.8%          56
                  Jul 2002-Dec 2002             21        48.8%                   0      0.0%                 2           4.7%           11         25.6%                     7        16.3%                 2           4.7%          43
                  Jan 2003-Jun 2003             12        54.5%                   0      0.0%                 1           4.5%              5       22.7%                     4        18.2%                 0           0.0%          22
                  Jul 2003-Dec 2003             23        34.3%                   0      0.0%                 4           6.0%           15         22.4%                    24        35.8%                 1           1.5%          67
                  Jan 2004-Jun 2004             41        50.6%                   2      2.5%                 2           2.5%           17         21.0%                    17        21.0%                 2           2.5%          81
                  Jul 2004-Dec 2004             36        50.0%                   0      0.0%                 0           0.0%           17         23.6%                    14        19.4%                 5           6.9%          72
                  Jan 2005-Jun 2005             40        48.8%                   0      0.0%                 0           0.0%           19         23.2%                    21        25.6%                 2           2.4%          82
                  Jul 2005-Dec 2005             56        41.8%                   1      0.7%                 0           0.0%           33         24.6%                    38        28.4%                 6           4.5%        134
                  Jan 2006-Jun 2006             42        40.8%                   0      0.0%                 1           1.0%           33         32.0%                    24        23.3%                 3           2.9%        103

                  1
                    County is defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                  2
                    Includes Intensive Outpatient, Outpatient, MICA Outpatient
                  3
                    Identified using the Substance_ID variable in TARGET
                  4
                    [(Admissions:Jan-Jun 06 – Admissions: Previous Period)/Admissions: Previous Period] * 100.




                                                                                                                                                                                                                                       38
                                                                                 Overall Outpatient2 Admissions

                      15 0




                      12 5




                      10 0
A d m issio n s




                       75




                       50




                       25




                        0

                        J a n-J un   J ul-D ec      J a n-J un    J ul-D ec      J a n-J un    J ul-D ec     J a n-J un      J ul-D ec    J a n-J un    J ul-D ec   J a n-J un   J ul-D ec   J a n-J un
                          2000         2000           2001          2001           2002          2002          2003            2003         2004          2004        2005         2005        2006




                                                                 Comparison of Admissions Over Time
                                                                         Jan-Jun 2006                                   Change in
                                                                         Compared to...                              All Admissions5

                                                                              Jan-Jun 2005
                                                                                                                                 25.60%
                                                                              Jan-Jun 2003
                                                                                                                                368.18%
                                                                              Jan-Jun 2000
                                                                                                                                 22.61%


                                                                                                                          Admissions4
                                                                                   Jan 2000-Jun 2000                                 84
                                                                                   Jul 2000-Dec 2000                                100
                                                                                   Jan 2001-Jun 2001                                 79
                                                                                   Jul 2001-Dec 2001                                 47
                                                                                   Jan 2002-Jun 2002                                 56
                                                                                   Jul 2002-Dec 2002                                 43
                                                                                   Jan 2003-Jun 2003                                 22
                                                                                   Jul 2003-Dec 2003                                 67
                                                                                   Jan 2004-Jun 2004                                 81
                                                                                   Jul 2004-Dec 2004                                 72
                                                                                   Jan 2005-Jun 2005                                 82
                                                                                   Jul 2005-Dec 2005                                134
                                                                                   Jan 2006-Jun 2006                                103




                  1
                    Defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                  2
                    Includes Intensive Outpatient, Outpatient, MICA Outpatient.
                  3
                    [(Admissions:Jan-Jun06 – Admissions:Previous Period)/Admissions:Previous Period)] * 100.
                  4
                    Counts of admissions for a six month period.




                                                                                                                                                                                                   39
                                                                                      Youth2 Outpatient3 Admissions

                         15                                                                                                                                                                                                      15 .0 %




                         13                                                                                                                                                                                                      12 .5 %




                         10                                                                                                                                                                                                      10 .0 %




                                                                                                                                                                                                         % o f A d m issio n s
A d m issio n s




                           8                                                                                                                                                                                                      7 .5 %




                           5                                                                                                                                                                                                      5 .0 %




                           3                                                                                                                                                                                                      2 .5 %



                                                     Y o u th A d m its                                                                            % o f A ll A d m its (4)
                           0                                                                                                                                                                                                      0 .0 %

                           J a n-J un    J ul-D ec       J a n-J un       J ul-D ec   J a n-J un       J ul-D ec    J a n-J un   J ul-D ec     J a n-J un    J ul-D ec        J a n-J un     J ul-D ec      J a n-J un
                             2000          2000            2001             2001        2002             2002         2003         2003          2004          2004             2005           2005           2006




                                                          Comparison of Admissions Over Time
                                                                      Jan-Jun 2006                           Change in Youth                               Change in
                                                                      Compared to...                          Admissions5                               All Admissions5

                                                                        Jan-Jun 2005
                                                                                                                   300.00%                                    25.60%
                                                                        Jan-Jun 2003
                                                                                                                   500.00%                                  368.18%
                                                                        Jan-Jun 2000
                                                                                                                   140.00%                                    22.61%



                                           Youth
                                                                                                         Yes                                         No
                                                                                         Admits                     %6                 Admits                   %                          Total

                                           Jan 2000-Jun 2000                                       5               6.0%                      79               94.0%                         84
                                           Jul 2000-Dec 2000                                       7               7.0%                      93               93.0%                        100
                                           Jan 2001-Jun 2001                                       6               7.6%                      73               92.4%                         79
                                           Jul 2001-Dec 2001                                       2               4.3%                      45               95.7%                         47
                                           Jan 2002-Jun 2002                                       2               3.6%                      54               96.4%                         56
                                           Jul 2002-Dec 2002                                       4               9.3%                      39               90.7%                         43
                                           Jan 2003-Jun 2003                                       2               9.1%                      20               90.9%                         22
                                           Jul 2003-Dec 2003                                       7               10.4%                     60               89.6%                         67
                                           Jan 2004-Jun 2004                                       8               9.9%                      73               90.1%                         81
                                           Jul 2004-Dec 2004                                       4               5.6%                      68               94.4%                         72
                                           Jan 2005-Jun 2005                                       3               3.7%                      79               96.3%                         82
                                           Jul 2005-Dec 2005                                   10                  7.5%                      124              92.5%                        134
                                           Jan 2006-Jun 2006                                   12                  11.7%                     91               88.3%                        103


                  1
                     County is defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                  2
                     Under 18 years of age at admission.
                  3
                     Includes Intensive Outpatient, Outpatient, MICA Outpatient.
                   4
                     (Number of Admissions to Youth/Total Outpatient Admissions) * 100. This line shows the trend in Youth admissions relative to overall admissions. It is included on the graph because of the
                  additional information it provides. For example, it is possible for the total number of Youth admissions to be falling over time and still represent an increasing percentage of overall admissions.
                   5
                     [(Admissions:Jan-Jun 06 – Admissions: Previous Period)/Admissions: Previous Period] * 100.
                   6
                     (N/Total)*100. Figures in this column represent the percent of all admissions for youth during a given period of time.




                                                                                                                                                                                                                                       40
41
                                                                             Parent with Kids2 Outpatient3 Admissions

                              60                                                                                                                                                                                                       8 0 .0 %



                                                                                                                                                                                                                                       7 0 .0 %
                              50

                                                                                                                                                                                                                                       6 0 .0 %

                              40
                                                                                                                                                                                                                                       5 0 .0 %




                                                                                                                                                                                                               % o f A d m issio n s
A d m issio n s




                              30                                                                                                                                                                                                       40 .0 %



                                                                                                                                                                                                                                       3 0 .0 %
                              20

                                                                                                                                                                                                                                       2 0 .0 %

                              10
                                                                                                                                                                                                                                       10 .0 %


                                                          P a ren t w ith K id s A d m its                                                               % o f A ll A d m its (4)
                               0                                                                                                                                                                                                        0 .0 %

                               J a n-J un     J ul-D ec      J a n-J un      J ul-D ec    J a n-J un       J ul-D ec    J a n-J un    J ul-D ec      J a n-J un     J ul-D ec       J a n-J un     J ul-D ec   J a n-J un
                                 2000           2000           2001            2001         2002             2002         2003          2003           2004           2004            2005           2005        2006




                                                              Comparison of Admissions Over Time
                                                                          Jan-Jun 2006                     Change in Parent with Kids                            Change in
                                                                          Compared to...                         Admissions5                                  All Admissions5

                                                                            Jan-Jun 2005
                                                                                                                        33.33%                                      25.60%
                                                                            Jan-Jun 2003
                                                                                                                       633.33%                                     368.18%
                                                                            Jan-Jun 2000                               -16.98%                                      22.61%



                                                Parent with Kids
                                                                                                             Yes                                           No
                                                                                              Admits                    %6                   Admits                    %                         Total

                                                Jan 2000-Jun 2000                                  53                  63.1%                      31                36.9%                         84
                                                Jul 2000-Dec 2000                                  56                  56.0%                      44                44.0%                        100
                                                Jan 2001-Jun 2001                                  44                  55.7%                      35                44.3%                         79
                                                Jul 2001-Dec 2001                                  21                  44.7%                      26                55.3%                         47
                                                Jan 2002-Jun 2002                                  27                  48.2%                      29                51.8%                         56
                                                Jul 2002-Dec 2002                                  18                  41.9%                      25                58.1%                         43
                                                Jan 2003-Jun 2003                                      6               27.3%                      16                72.7%                         22
                                                Jul 2003-Dec 2003                                  35                  52.2%                      32                47.8%                         67
                                                Jan 2004-Jun 2004                                  42                  51.9%                      39                48.1%                         81
                                                Jul 2004-Dec 2004                                  30                  41.7%                      42                58.3%                         72
                                                Jan 2005-Jun 2005                                  33                  40.2%                      49                59.8%                         82
                                                Jul 2005-Dec 2005                                  51                  38.1%                      83                61.9%                        134
                                                Jan 2006-Jun 2006                                  44                  42.7%                      59                57.3%                        103


                  1
                     County is defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                   2
                     Identified using two fields from TARGET. The first field indicates the client’s children (under 18) that are living with them and the second indicates other children living with the client. If the client has either their
                  own or other children living with them they are counted as parents with children for this analysis.
                   3
                     Includes Intensive Outpatient, Outpatient, MICA Outpatient.
                   4
                     (Number of Admissions to Parents with children/Total Outpatient Admissions) * 100. This line shows the trend in admissions for parents with children relative to overall admissions. It is included on the graph
                  because of the additional information it provides. For example, it is possible for the total number of PPW admissions to be falling over time and still represent an increasing percentage of overall admissions.
                   5
                     [(Admissions:Jan-Jun 06 – Admissions: Previous Period)/Admissions: Previous Period] * 100.
                   6
                     (N/Total)*100. Figures in this column represent the percent of all admissions for parents with children in the home during a given period of time.




                                                                                                                                                                                                                                              42
                                                          Gay, Lesbian or Transgender2 Outpatient3 Admissions

                              1                                                                                                                                                                                                                     1.8 %



                                                                                                                                                                                                                                                    1.5 %
                              1

                                                                                                                                                                                                                                                    1.3 %




                                                                                                                                                                                                               % o f A d m issio n s
                              1
A d m issio n s




                                                                                                                                                                                                                                                    1.0 %



                                                                                                                                                                                                                                                    0 .8 %
                              1


                                                                                                                                                                                                                                                    0 .5 %

                              0
                                                                                                                                                                                                                                                    0 .3 %


                                                         G a y , L esbia n o r T ra n sg en d er A d m its                                           % o f A ll A d m its (4)
                              0                                                                                                                                                                                                                     0 .0 %

                              J a n-J un    J ul-D ec     J a n-J un      J ul-D ec    J a n-J un       J ul-D ec    J a n-J un   J ul-D ec         J a n-J un    J ul-D ec     J a n-J un         J ul-D ec                           J a n-J un
                                2000          2000          2001            2001         2002             2002         2003         2003              2004          2004          2005               2005                                2006




                                                            Comparison of Admissions Over Time
                                                                                                        Change in Gay, Lesbian or
                                                                       Jan-Jun 2006                          Transgender                                       Change in
                                                                       Compared to...                        Admissions5                                    All Admissions5

                                                                         Jan-Jun 2005                               undefinedXX
                                                                                                                                                                  25.60%
                                                                         Jan-Jun 2003                               undefinedXX
                                                                                                                                                                 368.18%
                                                                         Jan-Jun 2000                               undefinedXX
                                                                                                                                                                  22.61%



                                               Gay, Lesbian or Transgender
                                                                                                         Yes                                             No
                                                                                           Admits                    %6                Admits                      %                         Total

                                               Jan 2000-Jun 2000                                    0               0.0%                      84                 100.0%                       84
                                               Jul 2000-Dec 2000                                    0               0.0%                      100                100.0%                      100
                                               Jan 2001-Jun 2001                                    0               0.0%                      79                 100.0%                       79
                                               Jul 2001-Dec 2001                                    0               0.0%                      47                 100.0%                       47
                                               Jan 2002-Jun 2002                                    0               0.0%                      56                 100.0%                       56
                                               Jul 2002-Dec 2002                                    0               0.0%                      43                 100.0%                       43
                                               Jan 2003-Jun 2003                                    0               0.0%                      22                 100.0%                       22
                                               Jul 2003-Dec 2003                                    1               1.5%                      66                  98.5%                       67
                                               Jan 2004-Jun 2004                                    1               1.2%                      80                  98.8%                       81
                                               Jul 2004-Dec 2004                                    0               0.0%                      72                 100.0%                       72
                                               Jan 2005-Jun 2005                                    0               0.0%                      82                 100.0%                       82
                                               Jul 2005-Dec 2005                                    0               0.0%                      134                100.0%                      134
                                               Jan 2006-Jun 2006                                    1               1.0%                      102                 99.0%                      103

                  1
                     County is defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                  2
                     Identified using the sexual orientation field in TARGET.
                  3
                     Includes Intensive Outpatient, Outpatient, MICA Outpatient.
                   4
                     (Number of Admissions to gay, lesbian and transgender clients/Total Outpatient Admissions) * 100. This line shows the trend in gay, lesbian and transgender admissions relative to overall admissions.
                  It is included on the graph because of the additional information it provides. For example, it is possible for the total number of gay, lesbian and transgender admissions to be falling over time and still
                  represent an increasing percentage of overall admissions.
                   5
                     [(Admissions:Jan-Jun 06 – Admissions: Previous Period)/Admissions: Previous Period] * 100.
                   6
                     (N/Total)*100. Figures in this column represent the percent of all admissions for gay, lesbian and transgender clients during a given period of time.




                                                                                                                                                                                                                                                         43
                                                                         IV Drug User (Ever)2 Outpatient3 Admissions

                             45                                                                                                                                                                                                  40 .0 %


                             40                                                                                                                                                                                                  3 5 .0 %


                             35
                                                                                                                                                                                                                                 3 0 .0 %

                             30
                                                                                                                                                                                                                                 2 5 .0 %




                                                                                                                                                                                                         % o f A d m issio n s
A d m issio n s




                             25
                                                                                                                                                                                                                                 2 0 .0 %
                             20

                                                                                                                                                                                                                                 15 .0 %
                             15

                                                                                                                                                                                                                                 10 .0 %
                             10


                                                                                                                                                                                                                                  5 .0 %
                               5

                                                         IV D ru g U ser (E v er) A d m its                                                        % o f A ll A d m its (4)
                               0                                                                                                                                                                                                  0 .0 %

                               J a n-J un    J ul-D ec    J a n-J un      J ul-D ec   J a n-J un        J ul-D ec    J a n-J un   J ul-D ec    J a n-J un    J ul-D ec        J a n-J un     J ul-D ec      J a n-J un
                                 2000          2000         2001            2001        2002              2002         2003         2003         2004          2004             2005           2005           2006




                                                           Comparison of Admissions Over Time
                                                                       Jan-Jun 2006                    Change in IV Drug User (Ever)                       Change in
                                                                       Compared to...                          Admissions5                              All Admissions5

                                                                         Jan-Jun 2005
                                                                                                                      7.69%                                   25.60%
                                                                         Jan-Jun 2003
                                                                                                                    366.66%                                 368.18%
                                                                         Jan-Jun 2000
                                                                                                                     16.66%                                   22.61%



                                              IV Drug User (Ever)
                                                                                                          Yes                                        No
                                                                                         Admits                      %6                 Admits                  %                          Total

                                              Jan 2000-Jun 2000                                12                   14.3%                     72             85.7%                          84
                                              Jul 2000-Dec 2000                                25                   25.0%                     75             75.0%                         100
                                              Jan 2001-Jun 2001                                23                   29.1%                     56             70.9%                          79
                                              Jul 2001-Dec 2001                                11                   23.4%                     36             76.6%                          47
                                              Jan 2002-Jun 2002                                16                   28.6%                     40             71.4%                          56
                                              Jul 2002-Dec 2002                                12                   27.9%                     31             72.1%                          43
                                              Jan 2003-Jun 2003                                    3                13.6%                     19             86.4%                          22
                                              Jul 2003-Dec 2003                                14                   20.9%                     53             79.1%                          67
                                              Jan 2004-Jun 2004                                29                   35.8%                     52             64.2%                          81
                                              Jul 2004-Dec 2004                                16                   22.2%                     56             77.8%                          72
                                              Jan 2005-Jun 2005                                13                   15.9%                     69             84.1%                          82
                                              Jul 2005-Dec 2005                                40                   29.9%                     94             70.1%                         134
                                              Jan 2006-Jun 2006                                14                   13.6%                     89             86.4%                         103


                  1
                     County is defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                  2
                     Identified using the needle use field in TARGET.
                  3
                     Includes Intensive Outpatient, Outpatient, MICA Outpatient.
                   4
                     (Number of Admissions to IV Drug Users/Total Outpatient Admissions) * 100. This line shows the trend in IV Drug Use admissions relative to overall admissions. It is included on the graph because
                  of the additional information it provides. For example, it is possible for the total number of IV Drug Use admissions to be falling over time and still represent an increasing percentage of overall
                  admissions.
                   5
                     [(Admissions:Jan-Jun 06 – Admissions: Previous Period)/Admissions: Previous Period] * 100.
                   6
                     (N/Total)*100. Figures in this column represent the percent of all admissions for clients that every used needles to inject drugs.




                                                                                                                                                                                                                                        44
                                                                  IV Drug User (30 days)2 Outpatient3 Admissions

                             30                                                                                                                                                                                                  3 5 .0 %



                                                                                                                                                                                                                                 3 0 .0 %
                             25



                                                                                                                                                                                                                                 2 5 .0 %
                             20




                                                                                                                                                                                                         % o f A d m issio n s
A d m issio n s




                                                                                                                                                                                                                                 2 0 .0 %

                             15

                                                                                                                                                                                                                                 15 .0 %


                             10
                                                                                                                                                                                                                                 10 .0 %



                               5
                                                                                                                                                                                                                                  5 .0 %


                                                         IV D ru g U ser (3 0 d a y s) A d m its                                                   % o f A ll A d m its (4)
                               0                                                                                                                                                                                                  0 .0 %

                               J a n-J un    J ul-D ec    J a n-J un      J ul-D ec   J a n-J un       J ul-D ec    J a n-J un   J ul-D ec     J a n-J un    J ul-D ec        J a n-J un     J ul-D ec      J a n-J un
                                 2000          2000         2001            2001        2002             2002         2003         2003          2004          2004             2005           2005           2006




                                                           Comparison of Admissions Over Time
                                                                                                       Change in IV Drug User (30
                                                                       Jan-Jun 2006                              days)                                     Change in
                                                                       Compared to...                        Admissions5                                All Admissions5

                                                                         Jan-Jun 2005                              -66.66%                                    25.60%
                                                                         Jan-Jun 2003                              undefinedXX
                                                                                                                                                            368.18%
                                                                         Jan-Jun 2000                              -91.66%                                    22.61%



                                              IV Drug User (30 days)
                                                                                                         Yes                                         No
                                                                                         Admits                     %6                 Admits                   %                          Total

                                              Jan 2000-Jun 2000                                12                  14.3%                     72              85.7%                          84
                                              Jul 2000-Dec 2000                                25                  25.0%                     75              75.0%                         100
                                              Jan 2001-Jun 2001                                23                  29.1%                     56              70.9%                          79
                                              Jul 2001-Dec 2001                                    5               10.6%                     42              89.4%                          47
                                              Jan 2002-Jun 2002                                    2               3.6%                      54              96.4%                          56
                                              Jul 2002-Dec 2002                                    2               4.7%                      41              95.3%                          43
                                              Jan 2003-Jun 2003                                    0               0.0%                      22             100.0%                          22
                                              Jul 2003-Dec 2003                                    1               1.5%                      66              98.5%                          67
                                              Jan 2004-Jun 2004                                    3               3.7%                      78              96.3%                          81
                                              Jul 2004-Dec 2004                                    3               4.2%                      69              95.8%                          72
                                              Jan 2005-Jun 2005                                    3               3.7%                      79              96.3%                          82
                                              Jul 2005-Dec 2005                                    6               4.5%                      128             95.5%                         134
                                              Jan 2006-Jun 2006                                    1               1.0%                      102             99.0%                         103


                  1
                     County is defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                  2
                     Identified using the used needle recently field or the method_ID field in TARGET.
                  3
                     Includes Intensive Outpatient, Outpatient, MICA Outpatient.
                   4
                     (Number of Admissions to IV Drug Users/Total Outpatient Admissions) * 100. This line shows the trend in IV Drug Use admissions relative to overall admissions. It is included on the graph because
                  of the additional information it provides. For example, it is possible for the total number of IV Drug Use admissions to be falling over time and still represent an increasing percentage of overall
                  admissions.
                   5
                     [(Admissions:Jan-Jun 06 – Admissions: Previous Period)/Admissions: Previous Period] * 100.
                   6
                     (N/Total)*100. Figures in this column represent the percent of all admissions for recent IV drug users during a given period of time.




                                                                                                                                                                                                                                        45
                                              DASA-TA
                                  Percent of Treatment Admissions
                                                Outpatient Admissions

                                Month of Admission between July 2005 and April 2007

                                                     By ER Visits




Footnote: Based on records where the following conditions are met:
- Governing County is Equal to Klickitat - AND -
- DOC and private pay included
- Note: Data in the system is updated monthly and numbers for the most recent months may change slightly over time.

Run Date: 05/30/2007
TARGET data available through 4/2007




                                                                                                                      46
                            Treatment Expansion Section


Initial Networking and Community Assessment:
     During the networking and assessment phase of the strategic planning process, efforts
     were made to specifically identify the needs of Treatment Expansion eligible clients.
     Target populations including the elderly, disabled, low income, unemployed, and youth
     were asked to complete the PITA Community Questionnaire to provide specific feedback
     on the needs for these populations. Over 30 seniors completed the questionnaire, along
     with several representatives from the other target populations. In addition, discussions
     surrounding the service needs of Treatment Expansion clients were had at the Strategic
     Planning Retreat and subsequent Substance Abuse Advisory Meetings. During the
     meetings, planning participants reviewed Treatment Expansion data, and developed
     strategies accordingly.
     Through the assessment process, we noted that Treatment Expansion efforts in our
     County have been very successful. We have consistently met or exceeded the target
     number of Treatment Clients to be served throughout the 2005-2007 biennium, and
     continue to serve additional clients using Treatment Expansion dollars. Specific efforts
     made include the designation of a Youth Specialist CDPT to provide services to youth in
     the community, at schools, and at the office. This strategy has been immensely effective
     to increase our services to youth over the last two years. In addition, outreach efforts
     have been successfully made in the Children’s Administration offices in both White Salmon
     and Goldendale, where outstationed CDPs are utilized to provide consultation, outreach
     and referral services, and assessments in urgent cases.


Strategic Planning Narrative:
     Please see the following Treatment Expansion Goal #1 and Youth Treatment Goal #1 in
     table format for details describing our County’s plan to expand services to clients who
     qualify for Treatment Expansion.




                                                                                               47
YOUTH TREATMENT: GOAL #9
Increase the youth treatment completion rate to a rate consistent with the statewide average.
OBJECTIVE: Youth treatment completion rate will increase from 26% to 45% over the next six years .
Problem Statement         Strategy                   Available Resources Who/By When                   Target Indicator
Our county’s current      Provide Youth Treatment    DHS staff committed DHS staff to select two       Biannual youth treatment
youth treatment           Specialists will attend    to providing quality   youth specific trainings   specific trainings attended
completion rate of 26%    additional trainings       youth services         per year for targeted      by targeted DHS staff
is well below the state   specific to providing      County funding and     staff                      beginning in 07-09
average of 42%.           effective youth services   community priority for County Coordinator to      biennium.
                                                     youth treatment        allocate adequate funding
                                                                            to pay for these trainings
Target Population
Dependency Health
Services, youth and   Incorporate family                                                               Increased youth treatment
families in treatment component into youth                                                             completion rate
Indicators of Success treatment model (see
                      Treatment Goal #4)
Youth treatment
completion rate
reported in DASA
Treatment Analyzer    Develop and implement          DHS staff committed DHS to develop proposal Support groups up and
                      an aftercare or relapse        to providing quality   and implementation plan running by July, 2008.
Monitor incremental   prevention support group       youth services         by April, 2008
improvement, with an for youth completing            County funding and
expected increase in  treatment.                     community priority for
completion rate of 5-                                youth treatment
7% per biennium.




                                                                                                                                 48
TREATMENT EXPANSION: GOAL #10
Increase outreach and engagement for aged, blind, disabled, people receiving TANF, SSI, GAU,
and/or GAX assistance in need of CD treatment.
OBJECTIVE: People qualifying for Treatment Expansion funding are aware of financial resources and
know how to access chemical dependency treatment.
Problem Statement        Strategy                    Available Resources Who/By When                      Target Indicator
We need to increase      Increase collaboration      Funding for position   Collaboration between       Improved utilization of
outreach and             and effectiveness of        available              Coordinator, treatment      outstationed staff person’s
engagement of            outstationed counselor      Desire to maintain     provider, and DSHS staff to time and staff perception
Treatment Expansion      positions at DSHS offices   and improve            brainstorm and implement of the position
clients.                 in Goldendale and White     position               position improvements by
                         Salmon                      Successful CA          September ‘07
                                                     outstation
                         Increase collaboration      ESD 112 and county     County staff, treatment       Collaboration plan
                         with KC Developmental       willing to partner     provider staff, ESD 112       developed by December,
                         Disabilities provider (ESD                         staff to meet by Dec ’08 to   2008
                         112)                                               develop collaboration plan
                         Increase collaboration     DV staff, county        DV staff, county staff,       Collaboration plan
Target Population        with domestic violence     staff, treatment        treatment provider to meet    developed by January,
People who qualify for   resources (DVR)            provider                and develop collab. plan      2008
Treatment Expansion    Increase outreach,        Behavioral Health          Treatment provider staff    Collaboration plan
funds                  collaboration and         Crisis Coord. Grant,       and County Coordinator to developed by March, 2008
Referral agencies      communication to ER and KVHS, Skyline                facilitate collaborative
                       Health Services,          hospital, treatment        discussions with
Indicators of Success especially detox services provider staff              appropriate healthcare
Increase in numbers of in East end of the county                            providers beginning Feb ‘08
Treatment Expansion    to facilitate smooth
clients served         referrals and treatment
                       admissions
                       Provide training and      Large network of in        County Coordinator,           Trainings and information
                       referral information to   home care                  treatment provider staff,     provided to in home care
                       Senior Services In Home providers, strong            Senior Services staff to      providers
                       Care Providers            senior services            meet July ‘07



                                                                                                                                   49
  Supporting Data: Treatment Expansion



Treatment Expansion Adult Clients: Klickitat County




Treatment Expansion Youth Clients: Klickitat County




                                                      50
                                Criminal Justice Section


Initial Networking and Community Assessment:
     During the networking and assessment phase of the strategic planning process, efforts
     were made to specifically identify the needs of clients involved in the criminal justice
     system. A very active member of our Substance Abuse Advisory Board is also the director
     of Adult Probation Services. During the collection of the PITA Community Questionnaires,
     the survey was included in the paper work required by offenders to ensure that the
     criminal justice involved client’s perspective was voiced. While service needs specific to
     the criminal justice population were included in the PITA Community Questionnaire, these
     needs were not identified as priority by the survey results. However, a significant portion
     of the additional comments collected on the survey discussed the need for improved
     coordination with law enforcement and chemical dependency treatment services.
     Through the assessment process, we noted that Criminal Justice Treatment Account
     (CJTA) funding has been extremely well utilized in our county. In year one of the current
     biennium, the annual allocation of CJTA funds awarded for outpatient treatment was
     expended in only six months. We increased county services to court involved clients
     significantly over the past biennium. According to reports generated using DASA
     Treatment Analyzer, criminal justice involved clients admitted increased by 66% between
     2004 (54 admits involved with court or probation) and 2005 (90 admits involved with
     court or probation), and by 76% between 2004 and 2007 (estimated 95 admits involved
     with court or probation). This increase in services to criminal justice clients can be
     attributed to the increase in CJTA funding, as well as the excellent collaborative
     relationship between our Adult Probation office and the county’s chemical dependency
     treatment provider.


Mobilization and Capacity Building to Address the Needs:
     Efforts were made to include the County prosecutor, County sheriff, County superior court
     and the chemical dependency treatment provider in planning activities for the criminal
     justice section of the plan. Personalized invitations were mailed out to the Substance
     Abuse Advisory Board’s Strategic Planning Retreat held in February, and we did have
     representatives from the Sheriff’s department (including the newly elected Sheriff
     himself), Adult Probation, and the Police Action League attend the full day planning
     retreat.
     Additionally, collaborative discussions began through a small Behavioral Health Crisis
     Coordination Grant awarded to the Klickitat Valley Health Services, which brought the
     County Alcohol and Drug Coordinator together with representatives from the healthcare
     facility, Sheriff’s department, city police, county jail, chemical dependency treatment
     provider and secured transport providers.


Comprehensive Strategic Plan:
     Please see the Criminal Justice Treatment Goal #11 below for detailed strategies and
     desired outcomes for our criminal justice involved clients. Criminal Justice Treatment
     Account dollars in the coming biennia will be used to provide outpatient treatment to
     individuals in Klickitat County who are involved with the criminal justice system.
     Assessments, both in the clinic as well as in the jail, individual, and group outpatient


                                                                                                51
     treatment have proved to be well utilized services, and we hope to continue offering these
     valuable services using the CJTA funds.

     In July 2005, participating counties developed an integrated residential co-occurring
     disorder program for women by wrapping best practice chemical dependency treatment
     models combined with existing mental health residential treatment services. This project
     will continue indefinitely. The project meets three project types:
          Regional – Yakima, Benton, Franklin, Walla Walla, Klickitat and Whitman Counties
            will participate.
          Best Practice – Integrated co-occurring disorders treatment provided by an
            interdisciplinary team that includes mental health case managers, chemical
            dependency professionals, psychiatric, and nursing staff. Comprehensive
            integrated COD treatment is recognized by SAMHSA as an EBP for persons with co-
            occurring disorders. In addition the program will be modeled on the very successful
            Pathways program that has served males with co-occurring disorders for several
            years.
          Innovation – No residential treatment for women with co-occurring disorders
            presently exists in the state. A fully residential program for men no longer exists in
            Eastern Washington.
     The program will continue to occupy a portion of the existing Sunnyside Adult Residential
     Rehabilitation Center (ARRC) operated by Central Washington Comprehensive Mental
     Health (CWCMH). CWCMH is dually licensed by both the DSHS – Mental Health Division
     and DSHS – DASA. The Sunnyside ARRC is licensed by the Department of Health and the
     Mental Health Division. CWCMH is JCAHO accredited.

     In August 2006, the program began serving both men and women with serious and
     persistent mental illnesses and a co-occurring chemical dependency. Initially the program
     was only open to women. Due to limited referrals for CJTA eligible women with co-
     occurring disorders it was been difficult to maintain a full census in the six designated
     beds. Adding men allowed an increase of enrollments. Women will still be given priority
     when identifying individuals for admission. A distinct integrated co-occurring track of
     treatment is provided to the participants. While the residents of the ARTF share basic
     functions such as dining, the treatment tracks are entirely separate.
     Additional services provided include:
         Chemical dependency treatment
         Increased nursing monitoring for physical concerns and medication adjustment
         Increase staffing level to increase program intensity
         Increased psychiatric staffing for medication dose adjustment
         A physical fitness component

     The program is designed for a total of six residents. With co-gender services, it is
     expected that average daily occupancy will continue to be maintained at approximately
     5.5, and will serve 70 residents per year.

Evaluation:

     The program will conduct outcome evaluations at six month intervals during the life of the
     project. The following outcome measures will be utilized:
         Treatment completion – goal: 75%
         Treatment Outcome Package – goal: demonstrate improved standard scores on
           measures of chemical dependency, psychosis, depression, suicide ideation and
           interpersonal skills
                                                                                               52
Follow-up studies will also be completed through contacts with the client and/or the
client’s MH and CD providers. The follow-up will compare treatment compliance, criminal
activity and psychiatric hospitalization with pre-treatment information gathered at
admission. Services will be provided under both a drug-court and non-drug court model.




                                                                                     53
CRIMINAL JUSTICE TREATMENT: GOAL #11
Improve access to treatment for criminal justice involved clients.
OBJECTIVE: People involved in the criminal justice system have access to chemical dependency
treatment.
Problem Statement         Strategy                  Available Resources Who/By When                    Target Indicator
We need to increase       Encourage faith based,    Existing faith based     County Coordinator will   Groups available in jail for
access to treatment for   12-step, and other        groups (SAFE,            invite group reps to a    people who want to
Criminal Justice          support group presence    Freedom Now)             SAAB meeting & ask how    participate by January
involved clients          in local jail.            Supportive law           we can support them       2008.
                                                    enforcement              November, 2007
                                                    AA/NA contacts
                      Facilitate collaboration      DHS                      Set up necessary          Resource plan in place by
Target Population between Sheriff’s                 Supportive law           meetings to develop       January, 2008
                      Department, jail, and         enforcement              treatment resource plan
Criminal Justice
                      Chemical Dependency           Crisis coordination      for jail services by      Jail services as needed in
involved clients
                      treatment provider to         grant                    September, 2007           place by July, 2008
                      assess unmet inmate
                      needs and develop a plan
                      as needed
                      Request additional CJTA State funds available          County Coordinator        Additional funds awarded
                      funds for 07-09 and                                                              for 07-09 biennium
Indicators of Success subsequent biennia
More criminal justice
involved clients
entering treatment        Continue participation in Program is up and        CC to allocate funds,     Adequate utilization of
                          the regional CJTA          running and was well    renew contracts, audit    service by Klickitat County
                          Innovative project for the utilized by Klickitat   facilities, and monitor   clients.
                          Pathways Co-occurring      County in the 05-07     services on an ongoing
                          mental health and          biennium.               basis.
                          chemical dependency
                          inpatient program in
                          Sunnyside.




                                                                                                                                 54
                              Supporting Data: Criminal Justice



  About 30% of respondents to the PITA Community Questionnaire felt that “People in the
  criminal justice system need more help getting treatment.”
  Related comments from the PITA Survey include:
        “The courts need to require more treatment.”
        “Legal services should mandate a series of counseling, activities, housing, faith based
        involvement, and work source to reinforce the skills needed to make lifestyle changes.”
        “Throw all known drug users, manufacturers, and dealers in jail!”



        Criminal Justice Involvement for Admissions made between 7/05-12/06
         % Clients Admitted




                                     Criminal Justice Program


Other considerations when assessing criminal justice client needs:
  About half of the clients admitted to Outpatient services are on probation or parole
  Adult Probation Services conservatively estimates that 74% of their cases are Chemical
  Dependency related. Of 456 total cases:
     297 cases (65%) are for drug related charges
     40 cases (9%) are for assault charges involving substance use
  6% of clients admitted to outpatient treatment have had previous violent crime charges



                                                                                            55
56
The following graphs were taken from the Washington State Department of Health and
Human Services – Data and Research Division Website and are specific to Klickitat
County.




                                                                                 57
58
                                                                         Criminal Justice Admission2 Outpatient3 Admissions

                            40                                                                                                                                                                                                         3 0 .0 %



                            35
                                                                                                                                                                                                                                       2 5 .0 %

                            30

                                                                                                                                                                                                                                       2 0 .0 %
                            25




                                                                                                                                                                                                               % o f A d m issio n s
A d m issio n s




                            20                                                                                                                                                                                                         15 .0 %



                            15
                                                                                                                                                                                                                                       10 .0 %

                            10

                                                                                                                                                                                                                                        5 .0 %
                              5


                                                        C rim in a l J u stic e A d m issio n A d m its                                                 % o f A ll A d m its (4)
                              0                                                                                                                                                                                                         0 .0 %

                              J a n-J un    J ul-D ec     J a n-J un      J ul-D ec    J a n-J un       J ul-D ec    J a n-J un   J ul-D ec         J a n-J un    J ul-D ec        J a n-J un      J ul-D ec      J a n-J un
                                2000          2000          2001            2001         2002             2002         2003         2003              2004          2004             2005            2005           2006




                                                           Comparison of Admissions Over Time
                                                                                                        Change in Criminal Justice
                                                                       Jan-Jun 2006                            Admission                                        Change in
                                                                       Compared to...                         Admissions5                                    All Admissions5

                                                                         Jan-Jun 2005                                -84.21%                                       25.60%
                                                                         Jan-Jun 2003                               undefinedXX
                                                                                                                                                                 368.18%
                                                                         Jan-Jun 2000                               undefinedXX
                                                                                                                                                                   22.61%



                                             Criminal Justice Admission
                                                                                                          Yes                                            No
                                                                                          Admits                     %6                Admits                        %                          Total

                                             Jan 2000-Jun 2000                                      0               0.0%                      84                 100.0%                          84
                                             Jul 2000-Dec 2000                                      0               0.0%                      100                100.0%                         100
                                             Jan 2001-Jun 2001                                      0               0.0%                      79                 100.0%                          79
                                             Jul 2001-Dec 2001                                      0               0.0%                      47                 100.0%                          47
                                             Jan 2002-Jun 2002                                      0               0.0%                      56                 100.0%                          56
                                             Jul 2002-Dec 2002                                      0               0.0%                      43                 100.0%                          43
                                             Jan 2003-Jun 2003                                      0               0.0%                      22                 100.0%                          22
                                             Jul 2003-Dec 2003                                      3               4.5%                      64                  95.5%                          67
                                             Jan 2004-Jun 2004                                 16                   19.8%                     65                  80.2%                          81
                                             Jul 2004-Dec 2004                                 18                   25.0%                     54                  75.0%                          72
                                             Jan 2005-Jun 2005                                 19                   23.2%                     63                  76.8%                          82
                                             Jul 2005-Dec 2005                                 35                   26.1%                     99                  73.9%                         134
                                             Jan 2006-Jun 2006                                      3               2.9%                      100                 97.1%                         103




                  1 County is defined using the Facility County field in TARGET. Private pay funded admissions are excluded. Contract type = ‘DOC-Community’ are included.
                  2 Identified using the contract type field in TARGET. Values of 1) Criminal Justice or 2) Criminal Justice - Innovations.
                  3 Includes Intensive Outpatient, Outpatient, MICA Outpatient.
                  4 (Number of CJTA Admissions/Total Outpatient Admissions) * 100. This line shows the trend in CJTA admissions relative to overall admissions. It is included on the graph because of the additional
                  information it provides. For example, it is possible for the total number of CJTA admissions to be falling over time and still represent an increasing percentage of overall admissions.
                  5 [(Admissions:Jan-Jun 06 – Admissions: Previous Period)/Admissions: Previous Period] * 100.
                  6 (N/Total)*100. Figures in this column represent the percent of all admissions funded by the CJTA during a given period of time.




                                                                                                                                                                                                                                              59
Exhibit A: SAAB Logic Model

                                   FAITH                                         SOCIAL
                                                                                  HEALTH
DASA
                    SCHOOLS
                              DSHS BASED            AA/ COUNTY MAT SERVICES SKCN SERVICES
                                                    NA
                       COMMUNITY STRENGTHS: *Strong and committed community and faith-based




                                                                                                       COLLABORATION
COMMUNICATION




                       groups with similar missions work throughout the county. *NA and AA community




                                                                                                        PARTNERING
                          leaders facilitate regular meetings. *Good communication and involvement
    INPUT




                         between law enforcement, SAAB, and our treatment provider. *Historically we
                                   have strong community support for the needs of children.
                           Chemical dependency negatively impacts our entire community by
                        increasing crime and abuse, costing the county money, and decreasing
                           the quality of life and sense of community connection in our area.


 KLICKITAT COUNTY SUBSTANCE ABUSE ADVISORY BOARD
OUR MISSION: To assist in the development, implementation, and evaluation of
             Klickitat County chemical dependency programs.
               We are made up of community members, people in recovery, and agency
                representatives.
               We meet monthly to promote the awareness and effective treatment of chemical
                dependency issues in our county.
               We believe that addiction is a disease that can be overcome. It is a symptom of a
                deeper problem that can affect anyone. With community support and personal desire,
                people are able to heal in mind, body, and spirit.

                    SUBSTANCE ABUSE ADVISORY BOARD ACTIVIES:
                    Monthly public meetings                       Lead P-I-T-A six-year Strategic
                    Review monthly fiscal reports                  Planning process
                    Provide community input regarding             Conduct community needs assessment
                     chemical dependency needs                     Collaborate with community partners in
                    Advise the county on quality of                county planning
                     services, fiscal decisions, and service       Raise awareness of chemical
                     needs                                          dependency issues in the county

                    SUBSTANCE ABUSE ADVISORY BOARD PRODUCTS:
           Comprehensive six-year strategic plan for prevention, intervention, treatment and
            aftercare (P-I-T-A) services within the county
           Service needs assessment and quality improvement plan
           Local awareness campaign highlighting chemical dependency related issues



                                            DESIRED OUTCOMES:
           Increase public awareness of chemical dependency in our community.
           Decrease public acceptance of substance abuse in our community.
           Increase public knowledge and understanding of available resources.
           Increase number of people accessing treatment in our county.
           Ensure fiscal and social support for County chemical dependency programs.
           Improve community collaboration with respect to referrals and accessing services.

                                                                                                              60
Exhibit B: PITA Community Questionnaire
   Which of the following items do you think contribute most to substance abuse in Klickitat
                      County? Please check as many items as you’d like!
Substance abuse includes: underage drinking, any harmful drinking by people over 21, any use of tobacco or
  illegal drugs, misuse of prescription medicines or other substances like aerosols, and use of any harmful
                                        substance by pregnant women.

               Prevention: Supporting the community to make healthy life choices
In our community…
     Drugs and alcohol are easy for youth to get
     There is too much acceptance of drug use and underage drinking
     People are unaware of substance abuse problems
     There is little or no feeling of neighborhood or community
     Poverty and unemployment is too high
     Other ___________________________________________


Our families…
    Lack parenting skills
    Are too accepting of substance abuse and underage drinking
    Experience a lot of family conflict
    Other ___________________________________________


At school…
     Many kids struggle academically
     Many kids do not feel connected
     Parents are not involved
     Other ___________________________________________


Our youth…
    Experiment with alcohol and drugs at a young age
    Lack skills to find enjoyment without using drugs or alcohol
    Have a history of abuse (sexual, emotional, and/or physical)
    Want more excitement in their lives
    Do not understand the problems caused by alcohol and drug use
    Don’t have enough alcohol/drug-free activities to participate in
    Other ___________________________________________


               Intervention: Supporting youth and adults at risk of substance abuse
Our community…
    Lacks school-based intervention services for educating and assessing youth at risk of substance use
      and connecting youth with treatment when needed
    Doesn’t have mentoring programs that link youth with caring adults
    Lacks affordable and available counseling for children, families and individuals
    Lacks agency assistance for individuals struggling with substance abuse issues
    Doesn’t support individuals struggling with chemical dependency or other abuse issues
    Professionals ignore the symptoms of substance abuse and/or do not refer people for help
    Professionals and community members don’t know who to contact for help
    Other ___________________________________________
    I don’t have experience in this area/am not sure about our community’s needs




                                                                                                           61
       Treatment: Supporting the healing of people suffering from chemical dependency
      Treatment is not available
      Treatment is available, but people don’t know about it
      People can’t afford to pay for treatment
      The quality of treatment in Klickitat County is poor
      People in the criminal justice system need more help getting treatment
      The community doesn’t think that treatment works
      It’s difficult for other agencies to refer people to treatment
      Transportation makes it hard for people to attend treatment
      People have to be sent out of the county for residential services
      I/people I know get drug and alcohol services outside of Klickitat County
      Other ___________________________________________
      I don’t have experience in this area/am not sure about our community’s needs

Aftercare: Supporting the successful recovery of people with chemical dependency
      Our community lacks clean and sober housing
      Our community lacks recovery support groups (ex. Alcoholics Anonymous)
      Recovery supports exist, but people don’t know about them
      Recovery support groups exist, but are not helpful
      There is high acceptance of drug and alcohol use in the community
      We don’t have enough clean and sober activities
      It’s too hard for people to find new friends who don’t use
      People need more professional support after they have completed treatment
      Other ___________________________________________
      I don’t have experience in this area/am not sure about our community’s needs

What do you think the county should do about substance abuse?
_____________________________________________________________________________________________
_____________________________________________________________
Other comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________

 Your Age:                   Gender:                  Ethnicity:                      Zip Code:
     Under 13                  Male                   White
     14-20                     Female                 Native American
     21-35                                             Hispanic                     GROUP:
     36-49                   Are you disabled?         African American
     50-65                      YES                   Other
     Over 65                    NO


Thanks for taking the time to complete this survey! Your anonymous responses will be used to identify the
needs of our county and will help us create a six-year plan for addressing substance abuse in the area.
Questionnaires may be identified by completing group for data analysis purposes.




                                                                                                        62
Exhibit C: PITA Community Questionnaire Dissemination Plan
                     Substance Abuse Advisory Board July 6th, 2006
Group# TARGET AUDIENCE (281)       COMMUNITY GROUP/EVENT            CONTACT PERSON
        Agency Staff (29)        WGAP                              Linda Schneider
                                   KCHD                                     Lindsay Miller
  2                                Courts                                   Larry Barker
                                   CPS/DSHS                                 Deidre Duffy
                                   CHR/JOM                                  Kathy Schwartz
        Businesses (24)            Rotary                                   Linda Schneider
                                   Goldendale Chamber                       Jeff Teal
  3                                White Salmon Chamber                     Deidre Duffy
                                   Soroptimist                              Chris Connolly
        Community members (64)     Family Planning/STD programs             Terry Rundell
                                   Community Days                           Linda Schneider
  1                                Community Council                        Chris Connolly
                                   Friends/Family/People we know            Everyone
        Criminal Offenders (9)     Corrections                              Larry Barker
  4                                Juvenile offenders                       Larry Barker
                                   Parents of juvenile offenders            Larry Barker
        Disabled (16)              Children with Special Healthcare needs   Lindsay Miller
                                   Early Childhood program                  Lindsay Miller
  5                                Mental Health clients                    Becky Twohy
                                   New Hope Farm                            Jeff Teal
  6     Elderly (30)               Senior Services                          Lindsay Miller
        Faith Based (21)           Churches                                 Terry Rundell
  7                                                                         Rene Smith
  8     Gay/lesbian/bisexual (0)   ?                                        Jeff Teal will research
        Grandparent caregivers     Kinship Support Group                    Deidre Duffy
  9     (3)
  10    Health Care Staff (5)      Klickitat Valley Health                  Jeff Teal
        Homeless (11)              Homeless shelter                         Linda Schneider
  11                               Transitional housing                     Linda Schneider
  12    IV Drug Users (3)          Dependency Health Services               Becky Twohy
  13    Low Income (6)             Food Bank                                Linda Scheider
  14    Native American (6)        Tribal connections                       Kathy Schwartz
  15    Parents (7)                Parenting class in Goldendale            Terry Rundell
        People in Recovery (16)    AA                                       Roy Goff
                                                                            Gil Randall
  16                               NA                                       Kathy Schwartz
                                   Dependency Health Services               Becky Twohy
  17    People in Treatment (2)    Dependency Health Services               Becky Twohy
        Pregnant Women (0)         Maternity Support Services               Terry Rundell
  18                               WIC                                      Joni Zolp
  19    Relatives of Addicts (2)   Dependency Health Services               Becky Twohy
        School Staff (6)           Goldendale School Staff                  Chris Twohy
  20                               Superintendent Group                     Deidre Duffy

  21    Spanish Speaking (9)       KCHD clients                             Joni Zolp


                                                                                                      63
Group# TARGET AUDIENCE (281)        COMMUNITY GROUP/EVENT    CONTACT PERSON
                                 Via Victor Benevidas       Lindsay Miller
                                 Via Maria Sanchez          Lindsay Miller
                                 Via Kathy’s sister         Kathy Schwartz
 22    Transitioning Youth (4)   Via Youth Pastor           Rene Smith
 23    Unemployed (4)            Work Source                Deidre Duffy
       Youth in school (8)       Goldendale Youth           Chris Twohy
 24                              Youth Center               Linda Schneider




                                                                              64
Exhibit D: PITA Community Questionnaire Results and Responses

PREVENTION: Which of the following items do you think contributes most to substance
abuse in Klickitat County? Please check as many items as you’d like:
                                                                               Response      Response
In our community…
                                                                                  %            Total
Drugs and alcohol are easy for youth to get                                     77.7%          213
There is too much acceptance of drug use and underage drinking                  61.3%           168
People are unaware of substance abuse problems                                  37.6%           103
There is little or no feeling of neighborhood or community                      26.3%           72
Poverty and unemployment is too high                                            58.4%           160
Other (please specify)                                                          16.1%           44
                                                                       Total Respondents:       274
                                                                   Skipped this questions:       7

                                                                               Response      Response
Our families…
                                                                                  %            Total
Lack parenting skills                                                           68.7%          178
Are too accepting of substance abuse and underage drinking                      59.8%           155
Experience a lot of family conflict                                             61.8%           160
Other (please specify)                                                          18.5%           48
                                                                       Total Respondents:      259
                                                                   Skipped this questions:      22

                                                                               Response      Response
At school…
                                                                                  %            Total
Many kids struggle academically                                                 46.9%           123
Many kids do not feel connected                                                 63.7%           167
Parents are not involved                                                        73.7%          193
Other (please specify)                                                          19.8%           52
                                                                       Total Respondents:      262
                                                                   Skipped this questions:      19

                                                                              Response       Response
Our youth…
                                                                                 %             Total
Experiment with alcohol and drugs at a young age                                75.4%          205
Lack skills to find enjoyment without using drugs or alcohol                    49.3%          134
Have a history of abuse (sexual, emotional, and/or physical)                    45.6%          124
Want more excitement in their lives                                             56.6%          154
Do not understand the problems caused by alcohol and drug use                   59.2%          161
Don't have enough alcohol/drug-free activities to participate in                58.8%          160
Other (please specify)                                                          13.6%           37
                                                                       Total Respondents:      272
                                                                   Skipped this questions:      9


                                                                                                      65
INTERVENTION: Which of the following items do you think contributes most to
substance abuse in Klickitat County? Please check as many items as you’d like:
                                                                                Response      Response
Our community…                                                                     %            Total
Lacks school-based intervention services for educating and assessing youth
                                                                                   41%          110
at risk of substance use and connecting youth with treatment when needed
Doesn't have mentoring programs that link youth with caring adults               47.4%          127
Lacks affordable and available counseling for children, families, and
                                                                                  48.1%         129
individuals
Lacks agency assistance for individuals struggling with chemical
                                                                                  32.8%         88
dependency or other abuse issues
Doesn't support individuals struggling with chemical dependency or other
                                                                                  32.5%         87
abuse issues
Professionals ignore the symptoms of substance abuse and/or do not refer
                                                                                  20.5%         55
people for help
Professionals and community members don't know who to contact for help            29.5%         79
I don't have experience in this area/am not sure about our community's
                                                                                   28%          75
needs
Other (please specify)                                                            18.3%         49
                                                                         Total Respondents:     268
                                                                    Skipped this questions:     13


TREATMENT: Which of the following items do you think contributes most to substance
abuse in Klickitat County? Please check as many items as you’d like:
                                                                                Response      Response
                                                                                   %            Total
Treatment is not available                                                        12.7%         34
Treatment is available, but people don't know about it                            31.5%         84
People can't afford to pay for treatment                                          53.2%         142
The quality of treatment in Klickitat County is poor                              28.5%         76
People in the criminal justice system need more help getting treatment            30.3%         81
The community doesn't think that treatment works                                  25.8%         69
It's difficult for other agencies to refer people to treatment                    14.2%         38
Transportation makes it hard for people to attend treatment                      49.8%          133
People have to be sent out of the county for residential services                  39%          104
I/people I know get drug and alcohol services outside of Klickitat County         14.2%         38
I don't have experience in this area/am not sure about our community's
                                                                                   27%          72
needs
Other (please specify)                                                            16.9%         45
                                                                         Total Respondents:     267
                                                                    Skipped this questions:     14




                                                                                                      66
AFTERCARE: Which of the following items do you think contributes most to substance
abuse in Klickitat County? Please check as many items as you’d like:
                                                                              Response      Response
                                                                                 %            Total
Our community lacks clean and sober housing                                    44.9%          119
Our community lacks recovery support groups (ex. Alcoholics Anonymous)         16.2%          43
Recovery supports exist, but people don't know about them                      21.9%          58
Recovery support groups exist, but are not helpful                              7.5%          20
There is high acceptance of drug and alcohol use in the community              48.7%          129
We don't have enough clean and sober activities                                42.6%          113
It's too hard for people to find new friends who don't use                     48.7%          129
People need more professional support after they have completed
                                                                                43%           114
treatment
I don't have experience in this area/am not sure of our community's needs      22.6%          60
Other (please specify)                                                         10.2%          27
                                                                      Total Respondents:      265
                                                                  Skipped this questions:     16




                                                                                                    67
What do you think we should do about substance abuse in our County?
  1. Need special community project

  2. Quit shaming people and care - more spiritual care and love needed for Spiritual malady

  3. More treatment Better Law Enforcement Judges that give a darn

  4. If more people become more involved with community there may be less abuse.

  5. I believe our county could have more professional help in this area

  6. Have more ways for interactive entertainment for the young.

  7. Concentrate on healthy activities for youth and parenting/family support

  8. Provide residential treatment and aftercare programs right here in Klickitat County. Provide early
     education to our children. Make the community more aware & enlist their help towards
     prevention activities - Provide more non-alcohol or drug activities for our children

  9. Put more resources into prevention and treatment

 10. Forums, public meetings, classes, advertising about subs. abuse use & treatment options. More
     mentoring for youth/adults.. Work more closely w/agencies that can help; provide a residential
     treatment center (local); schools need to begin educating youth @ subs. abuse issues by 3rd
     grade and continue on a yearly basis; more $ for educating and providing treatment for people
     w/low income; time&$ needed to help in criminal justice system

 11. There needs to be more activity for our youth. There needs to be more employment. Keeping
     people busy gives less time for substance abuse and domestic violence.

 12. If they could make what they have more affordable and have more groups or classes would help

 13. throw all the known drug users, manufacturers, dealers in jail

 14. support and encourage instead of label addicts (even when recovery is

 15. Have much more harsh penalties and have judges be not so lenient

 16. Try to give help to the people who want and need it. I know you can't make people do rehab if
     they don't want to. Make people more aware of the help available

 17. fund more after school programs - more recreational activities, more prevention activities & ed

 18. If the schools are not dealing with it they need an education plan and support groups.

 19. Fair but working hard to improve things

 20. This is a high national problem. We need a more productive congress and administration.

 21. Don’t wait until their addicted before doing something

 22. Get more funding and personnel that work!

 23. I think kids should be tested in schools. I think people should randomly tested in the work place
     - especially health care workers.

 24. Working with parent who have children Changing acceptance of drugs and alcohol

 25. more treatment center that include methadone clinics & treatment

 26. try to let people know that there is HOPE and pray a lot

 27. Help parents

 28. get tougher enforce on drug dealers

 29. Just continue to work toward sharing information


                                                                                                          68
30. Education!
31. work with the youth, your parents & get programs that are on-going long term for
    youth

32. After school programs, create programs that provide something other than raise awareness *
     make referrals that already exists.

33. First time = Treatment Repeat offenders = jail
34. more education on effects of drugs and alcohol
35. Have more opportunities for youth to gain confidence, help the community and work on their
     strengths and talents

36. 1) the courts need to require more treatment 2) the community needs to develop and maintain
     clean and sober activities 3) increase prevention work with children at age 8 and up

37. Focus on strengthening each community so that neighbor can help neighbors on a lot of levels.
38. Reach out to young parents - educate - support
39. Educate youth, parents and general public about programs.
40. 1) Substance abuse education 2) Provide drug-free alternative activities for youth
41. Put kids to work. Make them work for things
42. Focus on the kids
43. good questions
44. Do more with the schools to talk with children concerning this topic, even at elementary age.
     Awareness at young age.

45. get groups of kids from school and talk about it!
46. The police effort is not successful the authorities are not authoritative. I personally know several
     officers that themselves or their family members are users. That does not reassure me of any
     solution. Those are things that should truley be focused on.

47. crack down on the meth labs outside of town - if there isn’t little fish, there is the bigger fish to
     get

48. Take it more seriously and provide more treatment. Make more arrests of those selling.
49. Parents could see to their kids and not believe everything they say
50. Enforce the law
51. Work on getting punishment more severe.
52. Keep doing what you are doing - you need increased funding and awareness of what takes place
     stiffer penalties

53. Get more help from county government
54. Increase Law Enforcement!
55. Clean up drug houses & more seriously pursue people selling drugs
56. Have more arrests
57. ?


                                                                                                            69
58. Educate

59. Be more aggressive in processing complaints

60. we need to offer more support for teens before the turn into there parents

61. Officers be more involved in middle school, high school kids Do community dances for all ages

62. more support, help find more affordable activities for kids like YMCA. Stricter punishments for
    violators.

63. Teach our youth in school daily the dangers, consequences of what drugs do to the body, your
    life, and family.

64. Provide more treatment programs that include fun activities

65. Justice system needs to crack down

66. Help, Help & Help

67. I am not real sure

68. I am not sure

69. Allocate more funding for kids prevention programs regarding drugs and alcohol and widen the
    effort to get adults off drugs instead of just treating them like criminals.

70. Do a town sweep get them off the streets Everybody knows who uses and doesn’t (Officers do)
    I'm speaking about meth.

71. be more tolerant of those who want to change but are struggling keep what counselors and user
    say in private

72. I think the Co. should have more meeting regarding the subject

73. Just keep trying to reach the people that need and want help

74. Continue AA Classes and NA and add more meetings

75. Youth programs, Alateen, Lectures, Videos, information available - free counseling

76. More NA - More ex-addict involvement - more faith based involvement - less finger pointing @
    addict

77. Make treatment easily available.

78. Get rid of drug dealers

79. Educate the community, schools and teachers.

80. Have more activities for youth

81. I don't know

82. Look after people

83. make store's have cameras to see if selling to minors. by checking the tapes

84. Just help people who are dependent.

85. Legalize it. Most kids start substance abuse BECAUSE it's illegal. Therefore, legalizing it WOULD
    NOT solve the problem but help it dramatically.

86. I think that more organizations should be formed in supporting substance abusers.

87. keep going as is



                                                                                                        70
 88. make it a bigger study information subject for the kids

 89. just continue to fight the availability of drugs and to stay progressive in other phases of chemical
     dependency

 90. educate more about the treatment and recovery process

 91. Well first I think that the county officials should stop using it themselves and set an example and
     push the issue. Actually make people responsible for their actions and stop wasting people's time
     with petty arguments. Then they should get into people's lives and let them know that they care
     about them and that they have something to live for.

 92. The county should join forces with the churches to help youth get the mentoring that they need.
     The problem is not necessarily 'that' they use drugs, but rather 'why' they use, therefore the
     problem is not just a physical, chemical problem. It is a spiritual problem.

 93. I believe that part of the real problem with substance abuse is a spiritual problem and until we
     are willing to deal with the spiritual aspects of every living soul we are only attempting to put
     band aids on a very serious wound to spirit, soul and body.

 94. for the repeat offender, they need a 60 day in your face treatment center, relocation assistance,
     after services, mandatory family alanon meetings.

 95. Continue the work the Sheriff's office is doing on drug busts. Get the community more informed
     as to what exactly is going on with the drug culture.

 96. Can a residential treatment center sustain itself? It has been my understanding that out-patient
     treatment isn't as helpful - I may be wrong. It would certainly make the issues and the
     treatment more visible to the communities.

 97. The problem is bigger than any one entity and there are no simple answers that any one of them
     might do such and such and thereby fix it; however, the county (in addition to investing in
     prevention efforts) also needs to continue to aggressively pursue living wage jobs. People
     without hope to better their lot and that of their children tend to become disenfranchised and
     take their kids down the same path!

 98. Help in any way possible to develop a feeling of community, neighbors who care, and activities
     to draw people together for clean and sober fun.

 99. Get some good quality professional help in here and get these people the resources they need to
     succeed in the treatment facilities. After care is as much a part of this as anything. Even if they
     go to treatment they come back doing just fine and they are left behind to go it on their own and
     fall down 90% of the time. Lets put the money where it needs to be and get GOOD QUALITY
     PROFESSIONALS. Look at the stats of the people who have completed treatment and how many
     have stayed clean and sober.

100. The laws should be stiffer with the punishment, recommend treatment for repeat offenders. Jail
     time instead of a slap on the hand. All these might have an impact on the younger people who
     are experimenting with Drugs/Alcohol.

101. I feel more treatment opportunities need to be available. I also feel that any drug/alcohol
     violation should be dealt with very strictly, adult or youth. No more slap on the hands and let go!
     Also, the schools may attempt to teach children the effects of drugs, but many parents don't
     know the warning signs. It may be helpful to offer free workshops to parents.

102. talk to each other. The Church, Community hall, police, hospital, schools, need to talk and listen
     to each other. No institution can stand alone in a community. The parts are like a body when
     one is taken away the whole body is not healthy.

103. funds, other than from the feds/state/, should be a part of county budget planning.




                                                                                                            71
104. Those dealing in illegal and controlled substance abuse should be punished accordingly. The
     abuse of alcohol is another issue. It is difficult to help people who either don’t want help, or
     don’t realize they need help. I believe there should be harsher laws about DWI. First offense =
     steep fine, mandatory jail time and confiscate vehicle! (My cousin had a beautiful 3 year old
     daughter whose neck was broken in a head-on collision with a drunk who was driving the wrong
     way on I-84, so I have no tolerance for drunk driving.)

105. early diagnosis and treatment

106. County would need to make large expenditures to allow local access to treatment–this would
     include recruiting competent, well trained people at a good wage. Since this is unlikely to
     happen due to the very large sense of denial among ‘established’ community members, surveys
     such as this are really a moot question. Until citizens and elected officials are willing to devote
     real money to this issue, it is not going to go away.

107. actively pursue criminals that use, sell, and manufacture illegal drugs, and continue to operate
     drug and alcohol rehab programs with support groups.

108. more education of the youth and adults.. get the newspaper, mayor, every school, every
     business, every church, every ONE to listen, learn, talk, share, help, fight as though it was world
     war IV, because it is...we have become desensitized to the problem around us.. look at the
     children.. it is so very real and ugly to them.. everything worth having is worth fighting for and
     the children of tomorrow are worth fighting for today......no one person can win this war, we all
     need to pull together, even if it is slow in going we need an army, whole communities, one by
     one, don’t let anyone forget, keep beating the drum, over and over, again and again and again
     and again.. together

109. Revamp treatment and mental health services. Have therapists in a variety of settings, not just
     the mental health clinic. Fight poverty!

110. Encourage the communities to support halfway houses for the folks coming out of jail.

111. Provide more family oriented activities. Support for a COMMUNITY center where all can feel
     welcome to attend healthy activities. These could include fitness, cooking, parenting, mental
     health, recovery, life-skill training, there is so much that could be offered. County departments
     lack training facilities this could be the place to use.

112. Legal services should mandate a series of counseling, activities, housing, faith based
     involvement, and work source involvement to reinforce the skills needed to make the lifestyle
     changes these folks must make.

113. Pay attention, sometimes individuals have to accept some responsibility themselves to find out
     where help is.

114. Help make young kids aware what substance abuse can do to you as you age. Start young and
     hope that they will use the knowledge and choose not to use.

115. toughen penalties

116. Have monies available for treatment. Most families cannot afford treatment. Have out patient
     treatment available in rural areas because of the lack of transportation for most families.

117. Prevention Education Law Enforcement

118. Provide better wages for good counselors. Need more counselors to provide ongoing support
     services – stay with the client. People are let go too soon. Longer term outpatient services. Must
     make the 12 Step support groups mandatory.




                                                                                                           72
119. Attempt to promote programs that do not accept drug or alcohol use as okay. Put a stigma on
     use. Do not promote use by acceptance.

120. The county should have more after school programs that involves the whole family and that it is
     all inclusive. In Klickitat, my impression is that the whole community works around activities in
     the school. If there are drug issues it seems that are relegated to a few marginalized parents.
     The hope would be to foster a culture where the youth now being involved in these healthy
     programs will be the moms and dads of the next ten years.

121. I’m not sure what the answer to this serious problem is, but this assessment is probably the
     place to start. Having more for at risk youth to do with their time, as many appear to not have
     the parental supervision they need during their formative years seems to me to be critical.

122. I think the county needs to ask, in a non-threatening and nonjudgmental manner, each
     individual why he or she abuses substances. This asking should not be done in a questionnaire,
     but one-on-one, by trained personnel. Unless you’re a user, you can only speculate on why
     someone uses. The answer will be different for each person, but perhaps a pattern will emerge.
     This information will be very helpful in addressing the cause and not the symptoms of the
     problem.

123. It would be great to have healthy places and activities for teens to do on weekends that are
     affordable. It seems to them (I have one) that if you don’t go to party’s there is nothing else to
     do.

124. There needs to be more open and honest education about the effects – and short term – in
     schools, starting at a young age. I think one of the biggest reasons for adult substance is the
     lack of family-wage jobs. They can’t afford to move, and then can’t support their family on the
     available mostly service-oriented jobs. I would imagine that being numb is then more bearable
     than having to deal with reality.

125. Increase support for law enforcement, our communities need more jobs and less welfare.

126. Provide more training to educators on identifying and helping kids with substance abuse issues –
     caring for the kids Follow through on sentencing that includes substance abuse treatment that is
     appropriate for the substance used

127. Continue to financially and otherwise support the Meth Action Team, and the SKCN. Recruit
     more community support. Provide education and skills training to MAT and SKCN to maximize
     the efforts and benefits of the volunteers, to avoid burning out the volunteer. Also, an indirect
     approach to the problem, by funding other activities and recreation events like the guitar
     building class, the free trips to the pool, etc. Increase community-building efforts.

128. Enforce the laws that we currently have, have a zero tolerance for drugs in the schools and on
     the streets. Provide stiffer penalties for those who repeatedly offend Drug laws.

129. More funding for programs and also activities that are pro-active to engage youth so that they
     don’t need to turn to drugs/alcohol. Also need more groups for teens

130. It would be helpful for the county (in cooperation with other agencies – state or private) to have
     a local (within 50 miles) residential treatment facility, particularly for youth. Barring that (and its
     expense), I think the county should consider aftercare facilities (group homes, follow up
     counseling, expanded outpatient care).

131. Put more money into Law Enforcement to help with the drugs in our county. People right now
     know that they can get away with drug crimes. With the ability to aid the people doing drug
     crimes we can then get them the help they need.

132. Upgrade the priority of planning and programs aimed at this multi-phased problem. Enlist church
     and para-church professionals in cooperative treatment, remediation, and support ventures for
     all ages.

133. Encourage ESDs to provide intervention counselors in schools Insist on Truancy services/court
     for those students who skip school.
                                                                                                               73
134. Have more forums, more public announcements, newspaper and radio announcements, etc

135. I do appreciate what the county is trying to do with its limited resources. Good people are doing
     the best that they can. I believe that more publicity, such as flyers, for the services that are
     available would be helpful.

136. I think so much of this has to do with finding adults who are selling to kids -- or giving alcohol to
     kids. The abuse substances are too readily available.

137. They are doing good

138. Mentoring programs for 5-8th graders to show them that there are non-substance abuse
     activities that they can learn (i.e., hiking, rock climbing, fishing, boating, etc.) Increased
     economic development to increase employment opportunities for local citizens. Parenting Skills
     programs Increased pro-active prosecution for violators of substance abuse related crimes -
     including alcohol related matters (MIP/DUI/Furnishing Alcohol to Minors, etc.)

139. The county should provide more in-patient treatment services instead of sending them out of the
     county.

140. Keep trying to educate people and cut down on the availability of drugs/alcohol.

141. More busts of dealers/makers. More severe consequences for manufacturing 'crank'. More
     motivation of those who use to seek treatment. Less enabling like welfare, subsidized housing,
     etc.. Take it away if they use!

142. Start busting the people that are "known" dealers and/or "known" users!

143. Enforcement of the law and jail time rather than probation or suspended sentences and minimal
     fines

144. Educate the public. Bring the issue to the surface. Honestly inform the public about how common
     drugs affect the user/community with attention given to the fact that all "drugs" are not created
     equal and some are more noxious than others. Do not resort to scare tactics as a method of
     informing. Children should be taught facts just like adults -- not propaganda.

145. Start with the kids when they are young ie primary school; and continue throughout their
     education with special reminders in high school. Also we need to educate the parents, especially
     those who abuse drugs. It is hard for a child to know better when their parents are doing drugs
     or excessive alcohol

146. I think that there should be more activities to allow kids to stay off drugs and keep them busy
     with community activities.

147. Involve more people who have successfully recovered from SA in program planning efforts.
     Crack down on and prosecute underage drinking, providing alcohol to minors, etc. Conduct
     random drug screening of public employees. Monitor activities at suspicious residences, get
     search warrants and conduct searches often. Just driving around Goldendale, it is easy to spot
     suspicious activity, especially at night.

148. We should have community centers in all of our communities, with lots of drug and alcohol free
     activities. We should have adequate transportation, so that we can connect with other
     communities. We should be encouraged to talk openly about the risks without labeling those who
     slip as bad people, but people who need support and help.

149. Work on funding for treatment services accessible to addicts (i.e., affordable, in town). an in-
     patient facility would be helpful. Job placement assistance - even if it is out-of-county.

150. Intervene at younger age. Hold parents accountable for children's abuse.




                                                                                                             74
151. If I had an answer and a cure we wouldn't have a problem. Drug addiction is like traveling a
     straight road and taking the wrong turn down a dark and narrow path and losing all sense of
     direction. It happens by accident. You don’t wake up one morning and decide your going to
     become a drug addict. A person needs direction and guidance and the tools to help them find
     away out. Some are more needy then others. In most cases the person has got to want to quit.

152. Work to get more integrated programs in place in the schools that would address prevention and
     treatment needs in a location that's easy for kids to get to (schools).

153. The county needs to come together and work as a community. All human services agencies need
     to develop strong connections with one another and focus on helping community members most
     at need/risk. The county should provide more funds to help support drug/alcohol prevention and
     treatment programs. More creative ways of obtaining funds for these services should be
     reviewed.


Please write any other comments you have:
   1. God is good. He’ll send help in many ways.

   2. Join groups in community – church – dance – social – museum – school – etc

   3. [In the age question this person checked “Over 65” and then noted “88 in fact”]

   4. This community needs to pull together to help stop the crime rate and drug/alcohol abuse.

   5. I have known people who gotten some help but not enough because they couldn’t afford it. It
      also made them struggle to pay bills to get help at what they could

   6. Our police dept seems to be a revolving door. They don’t punish the drug addicts enough!

   7. CPS should keep reporting of abuse confidential. They didn’t when I reported and now I don’t
      report.

   8. Thank you!

   9. Provide community support groups for abusers and family members.

 10. Husband is an alcohol/substance abuse counselor. I’m afraid my attitudes are       hagged.

 11. Usually kids use drugs or use alcohol because they have family problems & they really don’t care
     what they are doing!

 12. I feel that the community is not aware of how to help with these issues and that under age
     drinking is to be expected.

 13. Check in teachers! Teachers (some) use substance abuse. Some teachers doesn’t care about kids
     education or don’t try to keep them out of drugs.

 14. I am very glad to see another group concerned about the community!!! Thank you

 15. The community needs to just stop and restart with an actual goal and solution. Quit chasing the
     obvious and look into things with out stereotyping and prejudice.

 16. The county lacks activities for teenagers to do, to many people are set in their ways and don’t
     want any change

 17. The youth in Klickitat (town) do have anything to do. No youth center or any entertainment. So
     they search out their own and are influenced by older persons and supplied drugs and alcohol.
     Too much boredom.

 18. People know that there is help but don’t seem to think they have a problem.



                                                                                                       75
19. need more for the young adults to do - other than "cig" parties.

20. Rx Drugs should NOT be so available from our doctors. They give out to much. "Everyone knows
    which doctors to go to, to get pain pills." Everyone should be on pain contracts.

21. The county should encourage more business so more people have jobs thus less time to engage
    in illegal activity.

22. there is nothing for kids to do but be disrespectful and get into trouble

23. Do fun activities, make and keep sports affordable

24. The support in Goldendale for youth/adults is not a good one. lack of interest from the
    community

25. I heard a lot of kids say there’s nothing to do so they drink to get high when they get bored or to
    hang out with others. Teach law to Jr High consequence of actions when they choose to engage in
    crimes like stealing for dope, hate crimes etc., instead of Home etc. or in detention hour.
    Goldendale & other towns need a scared straight program for our youth who are headed the
    wrong way.

26. I see unemployed people all over this community high or drunk they walk around probably
    breaking the law to support their habit what about their children

27. There should be a clause when paperwork is completed, a client has to go to treatment. Most
    places will not take a client, if the client decides not to go. If the client carries on his or her
    previous bad habits, it is mandatory to receive treatment again; repeat, repeat, until maybe the
    client will finally see the light. And see someone cares!

28. Since a great deal of professionals identify drug/alcohol abuse as a disease, the community and
    youth ought to treat it as a disease. We don't throw cancer patients, diabetics and others with
    medical problems in jail do we?

29. keep the people that are there to help to quite being control freaks

30. we need more alcohol treatment center in our Co.

31. I have been attending several different AA meetings and its been a lot of help

32. Under group - survey participant stated they were an "ex addict"

33. Same as above "Look after people"

34. I have not ever done any type of substance abuse, but have had friends who have, so I know and
    understand the problem from a teen's point of view.

35. have more counselors in our area, not everyone responds the same to the same counselor, more
    structured treatment, and more informed process to treatment, more support

36. If you want to get rid of a weed you don't cut it off at the tip you go to the root. This is the only
    way to kill it. If we find the root and become proactive in killing it then we will see a significant
    change in our county. One person can help the world and those that are in it. We know this
    because Christ, one person, saved all who choose to receive Him and He has empowered us to
    walk in His authority.

37. The false premise of separation of church and state (it is not in the constitution-check it out) has
    caused the government to leave out the only real hope for what’s missing in man's inner being.
    It's more than just being spiritual according to a persons whim, it requires us being submitted to
    the one who has made us in the beginning.

38. My brother had to ask for help, he got it and has done great since. his friends who have gone to
    treatment haven't been as strong. coming back to the same town and friends is a big mistake! we
    as a family went to support meetings and have tried not to enable him in all areas of his life! this
    has helped him and us!! When treatment is offered it has to include the whole family!


                                                                                                            76
39. This country needs to accept the fact that all children don't learn in the same fashion and that
    some need to proceed on a vocational track instead of through a system wherein they're doomed
    to failure. If any one thing might be identified to give the country (it's a national problem) the
    biggest bang for the buck, it would be preventing 1/4 of it's high school students from dropping
    out -- leaving them and their offspring no hope for economic survival in the modern world!

40. People need to feel they have a chance to contribute to the good of the community without
    spending a lot of money. Get more adults involved in the schools; in adopting families or old-
    people, in being physically fit.

41. I would like to see our county take the bull by the horns and stop the weekend parties the kids
    are having. There are weekly drag races, and lots of speeding. There needs to be more activities
    for kids and they need to be monitored activities. Where can we as a community put our funding
    that would be of better use than into the kids who in all essence the future of our great
    communities.

42. Let’s take back our community.

43. good luck

44. I know for a fact that people who receive Food Stamps trade their benefits for cash, then use that
    cash to buy drugs/alcohol. The state is being an enabler! Why couldn't they receive a check like
    WIC? I know from personal experience with family members who've had drug/alcohol problems,
    that abusers have a low self esteem. They don't have pride in their culture, family or self. I think
    that is very important to any individual.

45. Counselors and teachers must be more positive about a vision for the future of these young
    people. Its the job of the school to prepare them for a working environment. Counselors who
    assist them with summer employment, job skill improvement and job shadowing are a must.
    Putting down youth is not helpful. Forceful discipline acted upon quickly will be beneficial.

46. I don't actually live in Klickitat County, however I have worked with a lot of people that do, and
    answered these questions based on that.

47. I have lived with alcohol and drug addiction in my family and know that the addicted person must
    take responsibility for their actions. Those of us who don't use must not enable others to use.
    Parents need to set boundaries for there children early in life.

48. Any movement, activities and culture that will seek to marginalized few users and that is inclusive
    of everyone in the community will have a positive impact. It will not be perceivable immediately,
    but it will be beneficial in the long run.

49. If I had to guess, I would speculate that the main reasons people abuse substances are: 1)
    boredom and 2) depression. Other things, like peer pressure and /or acceptance of alcohol/drug
    use are contributing factors but in my mind they are not CAUSES. The causes of substance abuse
    come from some deep lack or pain within. If we can address those, maybe we can diminish the
    problem.

50. Thanks for the opportunity to comment. Hope it's useful information.

51. If CPS would start taking the kids out of these drug homes and keeping them exposed to the
    lifestyles of druggies we might have an opportunity with breaking the cycle.

52. I appreciate all you do in our community to help combat drug/alcohol activity.

53. From some of the cases I have seen, I think that putting the youth in jail is wrong --- the parent
    needs to go. Too many parents don't seem to care about what might be happening with their
    children.




                                                                                                         77
54. Community Pride and involvement needs to be a priority throughout the county. Depressed
    community values (lack of jobs, lack of decent housing, no pride in local schools, etc) leads to a
    decreased social status community wide and can lead to increased substance abuse. Why work
    when I can sell drugs? Why play sports for a town who don't care whether we win or lose? I can
    go out and party instead. Why drive an hour to watch a movie? Welfare (or disability) will take
    care of me, so why work? I can stay home and get drunk instead. Take care of the social status
    of the communities, clean up the towns, provide jobs, better education, and develop pride in
    children at a young age.

55. There are plenty of people who care and are willing to help. There are too few who are motivated
    to change their use because there are too many 'safety nets' available to them so they don't have
    to change.

56. I know that there are some parents in the community that take control of their children and
    watch what they do but I am sure there are a lot of people who do not care what their children
    are up to. If more parents were involved in the daily lives of their kids instead of sending them
    outside and ignoring what they are doing I think a lot of the drug and alcoholic problems would
    be solved. I have always believed that Parents are the number one person a child should look up
    to and for a lot of the adults in Klickitat County are either on drugs or have been in substance
    abuse programs and for a child this would be hard.

57. This is an important issue! SA disrupts generations of families and places a tremendous burden
    on society. SA seems more evident in Goldendale than any place else I have lived.

58. People with drug dependency problems should always have the option of treatment over jail. To
    give someone a felony for drugs means that for a long time after leaving prison/treatment they
    have an extremely hard time finding housing and employment...putting more stress on them and
    making it harder for them to succeed.

59. kids simply do not believe what they hear about addiction - they don't think it will happen to
    them. they need early intervention and people who've made the wrong choice to explain that
    they can and likely will get in trouble - and it isn't just a matter of criminal charges, it affects
    friendships, family relationships, job performance, etc.

60. I believe more kindness should be addressed to those with substance abuse. It is not just under
    privileged children that have this problem but the more privileged children as well. I think that
    children with less or below average grades in school get push to the side by teachers. Which in
    turn causes low self esteem to our children. Parents are afraid to discipline there children because
    of the laws today. Substance abuse has been and on going issue for as long as I can remember.
    The Meth epidemic is almost like the 60's LSD epidemic.

61. I don't know how much knowledge community members have in regards to the substance abuse
    issue in Klickitat County? They may hear how bad the Meth problem is, but do they know all of
    the facts about substance abuse (i.e. what services are available, what are the biggest needs in
    our county, what can community members do to help this problem...etc...) More community
    members who do not work in the social services/human services field need to be educated about
    the details of substance abuse. Including substance abuse needs, prevention, treatment, county
    facts...etc...




                                                                                                           78
79

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:2
posted:7/2/2012
language:
pages:79