ADP

 

 

In This Issue

 

 

 






DIRECTOR'S CORNER

For the last several years, I have attended the California Women’s Conference and at the close of each one I would say to myself, “It can’t get any better than this.” Yet somehow it always did. This fall I attended my fourth conference at the Long Beach Convention Center and I was inspired by the long list of exceptional people First Lady Maria Shriver had gathered. The speakers and workshops were superb.  What was once a local conference in 2002 has become an international conference with more than 33,000 women attending from around the world.

This year’s theme—It’s Time—focused on changing the world, encouraging the participants to be the “architects of change” in their communities and in the world. This prompted me to ask myself: What is it time for me to do? What changes can I bring about in my world? 

One answer came quickly. I want to put my energy into getting a counselor certification and licensure bill approved by our legislature and signed by our governor. It is time to prepare our counselors and providers for the changes that health care reform will bring to our field. It is time to train our workforce in the additional skills that will be required for us to be part of integrated care.  

What is it time for you to do?  What changes can you bring about in your life and your community?  

The end of the calendar year is traditionally a time to rethink and redirect energies and actions for the coming year. There were some profound, yet simple, suggestions for personal change presented at the Women’s Conference that I want to share with you. Consider these ideas from some of the conference speakers:

  • Clean out the warehouse – In business, business people take inventory regularly. Apply that same entrepreneurial practice to your personal life by taking stock of what isn’t working anymore. Be brutally honest with yourself. Make a list of five practices that are no longer serving you. Then make a plan to phase them out today.
  • Stumble toward success – “I think it’s about the journey,” Paula Deen says. “It’s about lookin’ over your shoulder and learnin’ from your mistakes.” Write down a sentence describing your last big mistake. Underneath it, make a list of everything you’ve learned from the experience.
  • Coulda, woulda, shoulda – Been telling yourself “I can’t” a lot lately? It’s time to get real. What you really mean is, “I won’t.” Right? You won’t make time for your priorities. You won’t take the class that offers the skills you need. Write down three ways you will take action today. Then put down the pen and do one of them.
  • Brain power – Experts say your brain is like a muscle; the more you work it, the stronger it gets. Take time today to read a book, work a puzzle, take a class or otherwise stretch your mental muscle.

We have had many challenges this year. I don’t need to reiterate them here because we have all gone through most of them together. I’m looking forward to continuing our work to enhance our field and improve the lives of those we serve in the new year. I wish all of you safe and happy holidays!


 


FEATURED ARTICLES

Health Care Reform

The federal comprehensive health care reform law was enacted in two parts in March 2010:  The Patient Protection and Affordable Care Act was signed into law on March 23 and was amended by the Health Care and Education Reconciliation Act on March 30.  The term “Affordable Care Act” (ACA) is used to refer to the final amended version of the law.  http://www.healthcare.ca.gov

The federal government is implementing health care reform in stages.  As of September 23, 2010, new reforms under the ACA apply to all new health plans and many existing health plans as they are renewed.  The law includes health-related provisions to take effect over a four-year period that will…

  • expand Medicaid eligibility
  • subsidize insurance premiums
  • provide incentives for businesses to provide health care benefits
  • prohibit denial of coverage claims based on pre-existing conditions
  • establish health insurance exchanges/Health Information Technology
  • support medical research. 

 

A message from California’s Health and Human Services
Secretary Kim Belshé:

“On October 1, 2010, Governor Schwarzenegger launched a new health care reform implementation website, www.healthcare.ca.gov.  The site is a dynamic, one-stop-shop to learn about the implementation of the federal Patient Protection and Affordable Care Act in California. It features information regarding the Governor's Task Force and priorities for implementation, time line for the major changes contained in the new law and resources to help Californians with their health coverage options.

At the Governor’s direction, we have assembled a Health Reform Implementation Task Force comprised of leaders of state agencies and departments with expertise in insurance regulation, Medi-Cal, health coverage purchasing, public health, financing, health information technology and health care workforce development – the people who will play a significant role in implementing the requirements of the new federal law. 

I’m pleased to have the opportunity to chair this Task Force and work with my Administration colleagues to lay a responsible foundation for the implementation of reform in our state in collaboration with the Legislature, community partners, and stakeholders.
The decisions the state, providers, community leaders and others make in 2010 and the groundwork laid will provide an important foundation upon which the broader 2014 reforms can be built.  In many respects, 2014 is tomorrow.

We encourage our stakeholder partners and others to check out the new health reform website.”

KIM BELSHÉ
Secretary

 


ADP Training Conference Earns Praise and Applause

Enthusiasm and passion ran deep among the more than 500 people who attended the 2010 ADP Training Conference Oct. 12-14 in Sacramento. More than a hundred speakers—from White House representatives to recovering heroin addicts—presented 55 workshops over the 2-1/2-day conference and left most attendees with new information and skills and a renewed commitment to their jobs while being reminded of the impact of their work.

Ample offerings perked the interests of those who attended, whether they work in the AOD or problem gambling fields in the areas of prevention, treatment, and recovery. All of the speakers’ PowerPoint presentations can be viewed online.

This year’s conference presented five highly-respected professionals in the field as keynote presenters. Dennis D. Embry, CEO of PAXIS Institute in Arizona presented a plenary session and workshop on evidence-based prevention results; Judge Rogelio R. Flores, a Superior Court judge from North Santa Barbara County Municipal Court presented a plenary session on the importance of prevailing in difficult times, followed by a workshop on engaging clients from the bench; Dr. Thomas McLellan, former deputy director with the White House Office of National Drug Control Policy, who has participated in past ADP conferences, gave an empowering plenary presentation on the future of substance abuse policy; David K. Mineta, Deputy Director of Demand Reduction at the White House Office of National Drug Control Policy, provided an overview of the national drug control strategy and health care reform; and Constance M. Weisner with Kaiser Permanente Division of Research and University of California, San Francisco, spoke on the implications of health care reform for alcohol and other drug treatments and the approaches to continuing care.

All of the workshop and keynote presenters were engaging, thought provoking and brought new energy and perspectives to the event.  We thank them for their dedication to the field and their commitment to the success of our conference.

This year’s planning committee included more than 40 members who worked for over a year to ensure that the conference offered the very best workshops and keynote presenters balanced with sufficient time for networking opportunities. Conference evaluations reflected the committee’s hard work and successful strategic planning. In their evaluations, participants rated both the overall conference program and the presenters as “excellent,” noting that the variety of educational topics, the affordability of the conference, and the well-informed speakers were the most appealing aspects of the conference.  A significant percentage of participants submitted evaluation forms at the end of each day of the conference applauding valuable programs and making suggestions for the next conference.

The biennial conference also gives ADP an opportunity to honor outstanding leaders in the fields of substance abuse prevention, treatment, research and recovery. Director Renée Zito presented the 2010 Director’s Awards at a luncheon the second day of the conference, recognizing the following individuals and organizations for their valuable contributions:

  • Dr. James Kooler, leader of the California Friday Night Live Partnership, received the 2010 Director’s Award for State Leader in the Field. Kooler piloted the FNL program in Contra Costa County in 1984 as a way to reduce the number of deaths and injuries caused by teen motorists driving under the influence of alcohol and other drugs. The success rate was so great that in 1988 a statewide FNL office was opened. By 1990, the number of counties with the FNL program increased 300 percent and the main focus of the program shifted to promoting healthy lifestyles—free of alcohol, tobacco, or other substance abuse—among youth. Dr. Kooler has been an inspiration and role model for hundreds of thousands of youth in California, as well as others working in the field.
  • Tony Santilena and the Los Angeles County Friday Night Live Partnership received the 2010 Director’s Award for Innovative and Effective Prevention Approaches for LA County’s FNL “Prevention and Youth Action Research Leaders Project.” This program teaches young people the connection between research and policies that directly affect their lives. The program engages youth in “action research” on societal issues involving alcohol, drugs, tobacco and violence prevention. Project Coordinator Tony Santilena taught young people the Photovoice research method, which involves using a camera to define, document and communicate an issue, and, ultimately, to use the finished film product as a catalyst for change in their communities. The project incorporated digital photography with one-on-one interviews with community members.
  • Dr. Gregory A. Austin, director of WestEd’s Health and Human Development Programs, received the 2010 Director’s Award for Innovative and Effective Research Approaches. Austin has contributed significantly to the understanding of adolescent substance abuse and dependency throughout California. He has conducted research and overseen the California Student Survey for more than 20 years and the California Healthy Kids Survey for more than 13 years. The two biennial surveys helped create the first comprehensive picture of adolescent alcohol and other drug use and they remain the most respected assessments of youth in this regard.
  • Warren Daniels III, CEO of Community Recovery Resources in Grass Valley, received the 2010 Director’s Award for Innovative and Effective Treatment Approaches. Daniels spearheaded the revamping of an addiction services delivery system that combines addiction services—prevention, detoxification, residential, outpatient, transitional, and aftercare—within a central community campus. In this model, services are delivered by a multi-disciplinary team of addiction-focused professionals. Daniels’ first “campus” is expected to open in Grass Valley by 2012.
  • James L. O’Connell, CEO of Los Angeles-based Social Model Recovery Systems, Inc., received the 2010 Director’s Award for Innovative and Effective Recovery Approaches. O’Connell was recognized for his strategic expansion of his treatment center to offer day treatment, community-based housing, outpatient services, the Wellness Center, and Proposition 36 programs at four locations in Los Angeles and Orange Counties. O’Connell integrates his expertise in the fields of recovery, treatment and environmental prevention with his business acumen to develop innovative approaches to help those whose lives have become unmanageable due to alcohol and other drug use.
  • Santa Clara County-based Prevention Partnership International and its ¡Celebrando Familias! substance abuse prevention program received the 2010 Director’s Award for Cultural Diversity. ¡Celebrando Familias!, an evidence-based prevention program for Latino families, has been shown to strengthen recovery, improve family reunification, and increase healthy living skills for family members impacted by substance use disorders. The program is the only program listed on the National Registry of Effective Programs and Practices engaging all family members (ages three to adult). First piloted in 2009, ¡Celebrando Familias! will be available for national and international distribution from the National Association for Children of Alcoholics in January 2011. Accepting the Cultural Diversity Award at the ADP Conference (pictured at left) were Mary Gardner, Prevention Partnership International Project Director, and Toni Welch Torres, EMQ-Families First Addiction Prevention Services, manager of the team piloting the Spanish version of Celebrating Families.

Congratulations to all the award recipients!

 


ADP’s Budget Summary: SFY 2010-2011

After a record-breaking number of days without a budget, the California legislature passed—and the Governor signed—California’s Budget Actfor state fiscal fear (FY) 2010-2011in early October.  The following is a summary of the Budget Act as it affects the Department of Alcohol and Drug Programs (ADP):

  • ADP’s budget for FY 2010-11 is $606.1 million, which includes $186.1 million from the State General Fund (GF). The previous year’s budget in FY 2009-10 was $661 million of which $189.5 million was General Fund.
  • 92.6% of ADP’s budgeted funds in FY 2010-11 will be distributed to local communities; the remaining 7.4% will be used for State Support activities.
  • The FY 2010-11 Budget Act, when compared to the FY 2009-10 Budget Act, represents a funding decrease of $54.9 million ($3.4 million GF) as a result of the following changes:        
    • $18 million GF decrease due to the elimination of the Substance Abuse Offender Treatment Program.
    • $663,000 GF decrease due to the loss of funding for one of the nine residential perinatal treatment programs affiliated with Women and Children’s Resident Treatment Services.
    • $45 million decrease due to the loss of one-time reimbursement funds from the California Emergency Management Agency to provide substance abuse treatment for criminal offenders convicted of non-violent drug offenses.
    • $14.7 million total increase ($15.3 million GF) due to Drug Medi-Cal (DMC) caseload, rate, and FMAP changes. The FY 2010-11 DMC budget reflects the recent federal approval of a phased down extension of the enhanced federal FMAP percentage under the American Recovery and Reinvestment Act. The federally approved FMAP percentages for FY 2010-11 are as follows:
      • 61.59% for July 2010 – December 2010.
      • 58.59% for January 2011—March 2011
      • 56.59% for April 2011—June 2011.
    • $5.9 million decrease in excess federal and reimbursement authority and other miscellaneous budget adjustments.

 


ADP Serves as a Model for Iraq


In October, the Department of Alcohol and Drug Programs hosted a team of behavioral health practitioners from Iraq who were part of a delegation visiting the United States to gather insight, ideas, and skills to implement treatment services in their country. During the meetings the ADP contingent discussed California’s treatment protocol for addiction as well as what is anticipated for the future.

The Iraqi delegation was in the United States as part of a six-year partnership between the Iraqi government and the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) to rebuild and expand Iraq’s mental health services capacity and improve services to special populations in the United States.

California was chosen to serve as a model because the population is relatively the same as Iraq’s. The group also spent time at UCLA learning about the school’s Integrated Substance Abuse Program, which is renowned for its expertise in training treatment providers. Dr. Tom Freese from UCLA’s Integrated Substance Abuse Programs (ISAP) said that Iraq’s interest in implementing treatment services is an indication that word is spreading—addiction is a disease and a treatable condition.



After meeting with ISAP and ADP representatives, and attending the ADP Training Conference, the delegates were very pleased with the information they collected, Freese said. “They went away with a road map for where they need to go to continue developing their treatment programs.”

The group that visited ADP included: Maria Hadjiyane, Counseling Director, Inova Fairfax Hospital Comprehensive Addictions Treatment, Washington D.C. Metro Area; Dr. Nsaif Jasim Mhaimeed Al-Hemiary, Consultant Psychiatrist and Lecturer, Baghdad University, Baghdad, Iraq; Dr. Tom Freese, ATTC and Director of Training, UCLA Integrated Substance Abuse Programs; Dr. Mohammed Abduljabbar Bardi, Psychiatrist, Saudi Arabia; Dr. Mushtaq Talib Hashim, Specialist Psychiatrist Baghdad Teaching Hospital, Baghdad, Iraq; Iman Ali Hussein Al-Nasrawi, Psychiatric Nurse, Baghdad, Iraq; and Dr. Maha Wasfi Mobasher, Psychiatrist, Cairo, Egypt.


 


Alcohol Energy Drinks: A Major Issue Across the Nation

Manufacturers of energy drinks that contain alcohol—alcoholic energy drinks (AEDs)—are under fire by state and federal lawmakers in the wake of nine college students in Washington who were hospitalized after drinking Four Loko—one of the most popular AEDs—that left them with a blood alcohol content four times the legal limit.

The states of Michigan and Washington were the first states to issue emergency rulings prohibiting the sale of alcoholic energy drinks, claiming the packaging is misleading, directly targets youth, and that the marketing campaigns encourage excessive consumption. The U.S. Food and Drug Administration (FDA) issued warnings to the manufacturers, saying that it was unsafe to put caffeine in alcoholic beverages. Within a week of the FDA warning, a total of 25 states had taken some form of action banning or restricting the sale of AEDs.

On Nov. 17, the California Department of Public Health sent a letter to beer distributors saying it is illegal to manufacture, distribute or sell AEDs under California law because they are considered “adulterated food products”— meaning that the caffeine added to an alcoholic beverage is considered an “unsafe food additive.” The Department’s Food and Drug Branch will be initiating investigations to ensure that manufacturers and distributors are complying. Violators are subject to civil and criminal fines, including up to one year in jail and $1,000 fine for each violation.

The City of San Francisco followed suit and sent letters to all retailers in the city urging them to stop selling the beverages and remove existing products from their shelves.

“The popularity of alcohol energy drinks among college students and underage drinkers is growing at an alarming rate,” said ADP Director Renée Zito. “The recent action by DPH was imperative to prevent tragedies that are bound to result from excessive drinking of alcohol energy drinks.”

A typical alcoholic energy drink is 24 ounces and has 12 percent alcohol content, compared to a 12 ounce can of beer, which normally has an alcohol content ranging from 4 to 5 percent. AEDs have 3 to 4 times the alcohol content of a 12-ounce beer, come in flashy containers that resemble the packaging of non-alcoholic energy drinks, and offer tempting flavors such as lemonade, grape and fruit punch. In addition to having the same amount of alcohol as three or four 12-ounce beers, one AED also has the same amount of caffeine as a cup of Starbucks coffee and costs about $2 to $5 per can.

Caffeine masks the effects of alcohol and puts users in a state of "wide-awake drunk," which leads them to believe they can keep drinking when they are actually well past the point of being drunk. A study out of the University of Florida shows those who drink alcoholic energy drinks — because they are fueled by a feeling of being both wide awake and drunk — are four times as likely to drive while intoxicated as those who drink only alcohol.

Nine Central Washington University students were hospitalized in October after drinking Four Loko. Law enforcement officers reported the students had blood alcohol levels ranging from 0.12 to 0.35 percent, more than four times the legal limit. A blood alcohol content of 0.3 percent is considered potentially lethal.

 


California Food Stamp Program Gets Name Makeover

The new name of the Food Stamp Program in California, “CalFresh—Better Food for Better Living,” was rolled out in October at “The Modern House Call” event at California State University at Long Beach. The event was sponsored by First Lady Maria Shriver to provide information on free medical and financial services to women in the Long Beach area.

The Department of Social Services will send a letter to all counties with instructions on how to incorporate the new name into the program. Expecting the transition process to be slow, DSS will roll out changes to forms, documents, and outreach materials over time.  In addition, the department will work with the consortia to update systems as changes that affect the Food Stamp/CalFresh program are implemented. 

Changes to the website, www.calfresh.ca.gov, are in process.  For more information, contact Christine Webb-Curtis of the Welfare-to-Work Division at Chris.Webb-Curtis@dss.ca.gov or call her at 916-651-8047.

 


Teens Using Marijuana at Younger Ages

In a recent press release from the White House Office of National Drug Control Policy, Director Gil Kerlikowske alerted parents to the heightened dangers of marijuana use that has risen sharply in recent years with kids starting to use the drug at a younger age.

According to data from the National Survey on Drug Use and Health (NSDUH) released by the Substance Abuse and Mental Health Services Administration (SAMHSA), there were 2.4 million new past-year users of marijuana in 2009 and the average age of initiation—that is, first-time use of the drug—dropped from 17.8 years of age in 2008 to 17 years in 2009. The survey also reported a nine percent increase (from 6.7% to 7.3%) in current users of marijuana age 12 to 17 between 2008 and 2009.

Marijuana use is associated with dependence, respiratory and mental illness, poor motor performance, and cognitive impairment, among other negative effects. Although using drugs at any age can lead to addiction, research shows the earlier a person begins to use drugs, the more likely he or she is to progress to more serious abuse and addiction and suffer harmful, long-term effects on the brain. Research suggests the human brain is still maturing during adolescence, with significant changes continuing into the early 20s.

"Marijuana use is increasing, teens are starting to use the drug at younger ages, and attitudes about the dangers of drug use are eroding," said Kerlikowske. "We recognize American families are facing many challenges today, but failing to adequately prevent young people from using drugs now can lead to a lifetime of devastating consequences."

A renewed focus on drug prevention is a major component of the Obama Administration's effort to implement a public health approach to reducing drug abuse and its consequences. President Obama's FY 2011 Budget request includes an increase of more than $203 million in prevention funding – a 13 percent increase.

Director Kerlikowske cited three steps parents can take to protect young people from illegal drug use, including talking to kids about drugs, learning to spot risk factors, and going through medicine cabinets to remove expired, un-needed, or unused prescription drugs. For more tips and parenting resources, visit: www.TheAntiDrug.com.

 


ADP DIVISION UPDATES

Information Management Services

Health Care Reform
In preparation for the first stages of the new health care reform law and its mandate to establish a universal system for exchanging health information, ADP has set up a Health Care Reform Information Technology (HCR IT) committee to address changes in technology that are anticipated as a result of the new law. The committee is comprised of representatives from ADP, the Departments of Mental Health and Health Care Services, Office of Systems Integration, Office of Health Information Integrity, the University of California at Los Angeles, counties, and providers. Primary goals of the committee include:

  • Engaging with California E-Connect (Cal eConnect), a nonprofit that works with key stakeholders in the healthcare industry and guides the private and secure exchange of electronic health information.
  • Understanding the implications of the term “Meaningful Use” as it relates to substance abuse in the new law.
  • Considering the implications for existing information systems.
  • Defining Electronic Health Records (EHR) Standards at a generic level.
  • Addressing security, privacy, and confidentiality issues.

Cal eConnect has also established four advisory groups (Business, Engagement, Policy, and Technology) and a Lab Services Task Group.  For more information about the advisory groups or to get involved, go to the Cal eConnect website.

Health Information Technology (HIT) required by the health care reform law dramatically changes the way IT systems function—from a system that administers claims payments to one that will allow, and eventually require, providers to manage the health of their clients through Electronic Health Records.  The HIT initiative requires providers from a wide range of disciplines to access and share patient information with the common goal of providing better client care. The following are some provisions in health care reform that potentially will impact health information technology:

  • Public and private health providers will need to update data systems to comply with increasingly rigorous reporting requirements and mandates for electronic health records.
  • We will see increased demand for access to performance and financial information for management and accountability purposes.
  • Expectations for qualitative data will become universal.
  • Draft certification criteria will increase requirements for use of quality data.  For more information go to http://www.cchit.org/.
  • Federal health care reform makes tax credits and subsidies available in 2014.

Treatment for problem gambling and substance abuse is considered specialty care under HCR.  As a field, problem gambling service providers will work with groups representing other treatment fields to negotiate the implementation of HIT in California.
 
CalOMS Reports
Changes in the CalOMS system now allows substance abuse treatment providers to access their own CalOMS data and monitor their outcomes and performance. If you are a provider and want to access your CalOMS data, please contact Debra Connick at 916-327-6724 or dconnick@adp.ca.gov.

CalOMS Tx Enhancements
In response to a recommendation from the Lesbian, Gay, Bisexual, and Transgender (LGBT) Constituent Committee of the Director’s Advisory Council, ADP will add a sexual orientation field in the California Outcomes Management System for Treatment (CalOMS Tx).  Completing the field that asks for sexual orientation is optional, but was added to capture data on the health status and health needs of LGBT Californians.  Watch this publication for additional details on the values to be used in this field and when it will be available.

Drug Medi-Cal HIPAA EDI Standard 5010
The Centers for Medicare and Medicaid Services (CMS) will be changing the way Drug Medi-Cal providers access information regarding eligibility of patients for DMC-funded services. This is a result of CMS adopting the X12, Health Insurance Portability and Accountability Act (HIPAA) 270/271 Electronic Data Interchange (EDI) standard, version 5010, for the HIPAA Eligibility Transaction System (HETS) 270/271 application starting in 2011.

ADP is working with the Departments of Health Care Services and Mental Health to remediate the DMC Claims System to comply with the revised standard.  The three departments will engage the trading partners—those providers that have contracts with a county or ADP to provide treatment services funded through the Drug Medi-Cal (DMC) program—in remediation efforts to ensure that trading partners’ needs are met and adequate time is allowed for understanding the changes, for making necessary changes to business processes and IT systems, and for adequate testing.

Information Security
Many of us are dependent on Personal Computers (PC) in our personal lives and at work. Your working relationship with ADP requires you to provide and receive increasing amounts of private and confidential business information via your PC.

The following links are websites that provide useful information on ways to keep your PC and its contents safe and secure. We also encourage you to work with your program’s information security officer or consultant to secure your data and systems.

 


Office of Legislative and External Affairs

End of the Year Wrap-Up
The mid-term elections in November marked the official end of the political season in California.  Several new legislators will be stepping in to fill the shoes of those who have been termed out or were voted out.  California also lost two senior legislators this year, Senator Dave Cox and Senator Jenny Oropeza, who died while in office.  

While a number of propositions were on the ballot, Proposition 19 was of particular interest to ADP. The measure that would have legalized the recreational use of marijuana was rejected by California voters 54 to 46 percent.  Backers of Prop 19, ranging from unions to special interest groups, have vowed to bring the issue back to the ballot box in 2012 with a better organized strategy. Some legislators, including Assemblyman Tom Ammiano, also have indicated that they will continue to work toward legalizing marijuana through legislative efforts.

As previously reported, the Administration sponsored ADP’s legislation to create a new alcohol and drug counselor certification and licensing program, but it failed to pass.  ADP will work with sponsors and legislators next year to redraft AOD counselor legislation.

In December, the Office of Legislative and External Affairs (OLEA) will conduct ADP site visits for select agency and legislative staff to educate them on the importance of the services that ADP provides in California communities and the positive impacts that these services have on families and communities.

ADP’s Cultural Competence Quality Improvement (CCQI) Strategic Plan
California is one of the largest states in the nation covering 163,696 square miles in land mass and 840 miles of coastline.  Its diversity lies not only in its geography, which ranges from oceans, rivers and lakes to deserts and mountain ranges, but also in the many cultures and people that populate the state.  This diversity contributes greatly to the richness of this state. Those of us fortunate enough to call California home know it to be one of the most culturally and geographically spectacular places in our country. 

The diversity of California’s population also contributes to the challenges healthcare providers face in addressing the needs of consumers. A one-size-fits-all approach in addressing the healthcare needs of a diverse consumer population invariably results in inequitable and/or ineffective treatment.  Remaining aware of its current and potential consumer population, and cognizant of how to provide culturally and linguistically appropriate services to that population, is an ever present challenge for healthcare agencies seeking to provide effective services.

In 2001, the U.S. Office of Minority Health (OMH) released the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care as a proposed means to correct inequities that exist in the provision of health services.  Committed to improving the cultural and linguistic competency of its business functions and to leading the alcohol and drug and problem gambling fields in implementing a culturally and linguistically competent prevention, treatment and recovery continuum of care, ADP adopted the OMH CLAS standards in 2008 as its guide in developing a Cultural Competency Quality Improvement Plan (CCQI).  ADP’s CCQI Strategic Plan provides a foundation that will guide our understanding of cultural competence and will help ADP to ensure its ongoing growth and progress in the area of cultural competence in the years to come. 

OLEA staff recently updated ADP’s CCQI Strategic Plan, which can be viewed at http://www.adp.ca.gov/pdf/CCQI Strategic_Plan_2010-12.pdf .  ADP’s CCQI steering committee meets monthly to discuss implementation of priorities in the CCQI Strategic Plan.  OLEA and other ADP staff will be working with stakeholders to determine how best to support the availability of culturally competent AOD and problem gambling services throughout the state. 

We will provide status updates on ADP’s implementation of its CCQI strategies in future issues of FOCUS.

 


Communications Office

Daily News Clips
The ADP Communications Office is updating its list of recipients for ADP’s Daily News Clips. In case you have never subscribed, Daily News Clips is a compilation of news articles gathered by Communications staff from media outlets throughout the state on topics of concern.  We search for articles on illicit as well as prescription drug use and abuse, alcohol abuse, underage drinking, problem gambling, California’s budget issues and healthcare reform, among others. If you would like to receive these important daily news updates, send a quick email to Hailey Simons at hsimons@adp.ca.gov  and ask that your name be added to the email subscription list.  You may unsubscribe at any time by indicating your choice on any current issue.

 


Office of Problem Gambling

New multicultural website!
The Office of Problem Gambling (OPG) unveiled its new website www.problemgambling.ca.gov in October with a state-of-the-art feature that allows users to access the site in one of seven languages—English, Spanish, Chinese, Korean, Vietnamese, Tagalog, and Hmong.

Over the past year, OPG and its contractor, California Council on Problem Gambling, developed the much improved, multi-cultural website with a goal of reaching a broader group of problem and pathological gamblers, their families and friends.  Not only is the information presented in different languages, the website also includes self-assessments; links to resources for gamblers; help for families, friends, youth and communities affected by problem/pathological gambling; information for treatment providers; insight about the gambling industry and betting odds. Other resources offered on the website provide information on upcoming events, training sessions, funding opportunities, and scholarships. 

OPG is also piloting the introduction of social networking and viral marketing sites such as Facebook, MySpace, Twitter, LinkedIn, and YouTube on its web pages.

 


Program Services Division: Prevention

Office of Women and Perinatal Services
The Department of Alcohol and Drug Programs’ Office of Women and Perinatal Services recently completed a project targeted at manufacturers of at-home pregnancy tests.  The branch staff mailed packets of information to manufacturers to encourage them to include labels on pregnancy test kits warning prospective users of their products about the dangers of alcohol use during pregnancy. Staff prepared and mailed packets containing sample warning labels and signed letters from ADP, the Department of Public Health, and the National Association of State Alcohol and Drug Abuse Directors, Inc.

ADP staff also sent packets to stakeholders all over the state encouraging them to add their voices to the effort by contacting manufacturers to request warning labels be included in all packaging.  The louder the voice, the more chance of being heard and helping to prevent Fetal Alcohol Spectrum Disorder (FASD) in California’s babies.

Fetal Alcohol Spectrum Disorder occurs in approximately 10 out of every 1,000 live births or 40,000 babies per year. FASD lasts a lifetime, but is entirely preventable by avoiding alcohol during pregnancy. Fetal Alcohol Syndrome (FAS), the most serious and recognizable condition in the spectrum, is estimated to occur in 0.5 to 2 of every 1,000 live births. An FAS baby requires an average lifetime health cost of $2 million, although it could be higher. Children do not outgrow FAS and its serious consequences.

In 2005 the U.S. Surgeon General stated, in part, that “A pregnant woman should not drink alcohol. A pregnant woman who has already used alcohol during her pregnancy should stop right away. A woman who is thinking about getting pregnant should stop using alcohol. Nearly half of all births in the United States are unplanned; therefore, any woman who could become pregnant should talk to her doctor and take steps to lower the chance of exposing her baby to alcohol.”

FASD is 100% preventable. A warning label affixed to or inserted in an obvious and prominent location in the packaging of at-home pregnancy test kits will be an important step toward educating women of child-bearing age about FASD.

SAMHSA Service To Science Award
ADP Prevention Branch sends hearty congratulations to Riverside County for receiving a Service To Science (STS) Award and for being published in the Journal of Psychoactive Drugs for its Individual Prevention Service (IPS) Program.

The IPS program was developed to fill the gap between substance abuse prevention and treatment services.  It is utilized by Riverside County to deliver the Brief Risk Reduction Interview and Intervention Model (BRRIIM) to individuals that are at highest risk for developing substance abuse related problems.  The BRRIIM screening, a three-stage motivational interview process, takes about 90 minutes. At the end of the process, the individual is referred to a substance abuse treatment professional or other mental health professional for further diagnostic assessment, or continues through the IPS process.  For individuals that continue through the IPS process, a Prevention Service Agreement is developed along with a brief intervention through education.  

The STS Award, a national initiative supported by the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention (SAMHSA, CSAP), is dedicated to enhancing the evaluation capacity of innovative programs and practices that aim to prevent substance abuse.  Ultimately, the initiative supports state prevention efforts by increasing the number of local programs that meet evidence-based standards.

Both the STS Award and the journal article, written by Will Harris and Jan Ryan, will further Riverside County’s efforts toward getting the IPS Program listed as a nationally recognized evidence-based program.

ADP Awarded Strategic Prevention Framework State Incentive Grant
In October ADP was awarded the Strategic Prevention Framework (SPF) State Incentive Grant (SIG) by the Substance Abuse and Mental Health Services Administration’s (SAMHSA).  California will receive $1.94 million for five years.  The SPF SIG is one of SAMHSA’s infrastructure and service delivery grant programs designed to build a foundation for delivering and sustaining effective substance abuse prevention services. 

The goal of the California SPF SIG is to expand ADP’s current SPF activities, increase local capacity to implement SPF, and fund four community prevention projects.  With the SPF SIG, ADP will be able to:

  • identify statewide prevention needs based on data
  • communicate priorities to local communities and assist those communities in identifying populations of greatest need through data
  • implement appropriate prevention strategies
  • and evaluate the effectiveness of the programs 

The next nine to twelve months will be devoted to statewide planning and capacity development.  We will determine priorities and choose sub-recipient communities after completing initial activities.  For additional information, contact Jane Williams at ADP (916) 445-7174 or email:  jwilliams@adp.ca.gov

 


Program Services Division: Treatment

California Access to Recovery Effort (CARE)
After a competitive application process, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded ADP a third Access to Recovery (ATR) grant to continue and expand the California Access to Recovery Effort (CARE) program through the Program Services Treatment Division.

ADP will receive $13,119,440 over the four-year grant period with the new CARE program (CARE 3) rolling out January 1, 2011.  Services will be available in five counties (Butte, Los Angeles, Sacramento, Shasta, and Tehama) to provide vouchers for treatment and recovery support services to youth ages 12 through 17.  In addition, voucher services in those same counties will be available to young military service members and veterans up through age 25.

A condition of the grant funding is that CARE 3 serve at least 11,560 individuals, almost 600 more per year than in the previous grant.  To accomplish this, some changes to the program are necessary, which may include reduction or elimination of certain services based on utilization and costs. ADP will solicit input on the proposed changes from stakeholders as we move forward.

According to SAMSHA, more than 22 million people—8.9 percent of the U.S. population—had a diagnosable substance abuse problem last year. The ATR grants, totaling $379 million over the next four years, were awarded to 24 states and six tribal governments to help people with drug and alcohol use problems pay for needed treatment and recovery support services.

Suicide among Veterans:  A Major Concern
Eye-opening data concerning the significant role that substance use plays in suicide and criminal activity in the Army is revealed in the U.S. Army’s recently released Health Promotion - Risk Reduction - Suicide Prevention Report 2010.
In 2009, there were 239 suicide deaths in the Army (including Reserves), 160 of which were active duty servicemen.  There were 146 active duty deaths related to high-risk behavior, including 74 drug overdoses.  Some form of high-risk behavior—self harm, illicit drug use, binge drinking, criminal activity—was a factor in nearly all of the deaths. This report captures the Army’s campaign to promote wellness, risk reduction and suicide prevention with a holistic, multi-disciplinary approach.  Read more on the report.
According to General Peter W. Chiarelli, who wrote an introductory letter to the report, “…approximately 106,000 soldiers are prescribed some form of pain, depression or anxiety medications. The potential for abuse is obvious.”  Gen. Chiarelli emphasizes that the Army “…must increase health care access, reduce the stigma associated with help-seeking behavior and implement the Army’s Pain Management Plan to increase the health of the force.” 
Suicide is such a major issue in the military that the commanding general of the California Army National Guard recently issued a bulletin ordering immediate suicide prevention training for all of his troops.  An analysis of death certificates published by the Bay Citizen (http://www.baycitizen.org) showed that more than 1,000 California veterans under the age of 35 had died between 2005 and 2008, three times the number who died in Iraq and Afghanistan combined.
The data showed that veterans of Iraq and Afghanistan were two-and-a-half times as likely to commit suicide as Californians of the same age with no military service. They were twice as likely to die in a vehicle accident and five-and-a-half times as likely to die in a motorcycle accident. 
Depression and substance use disorders are treatable for everyone.  If you notice any of the following signs in someone, there is a risk of suicide:

  • Talking about wanting to hurt or kill oneself
  • Trying to get pills, guns or other ways to harm oneself
  • Talking or writing about death, dying, or suicide
  • Hopelessness
  • Rage, uncontrolled anger, seeking revenge
  • Acting in a reckless or risky way
  • Excessive drinking or illicit drug use
  • Feeling trapped, like there’s no way out
  • Saying or feeling there’s no reason to live.

There are many resources available to learn more about suicide, prevention and risk reduction.  Visit www.suicidepreventionlifeline.org or call 1-800-273-TALK, press #1 for veterans.

 


PROFILE IN RECOVERY

Tianna's Story

Editor’s note: The following story is the first of a series of profiles in recovery to be featured periodically in FOCUS.

The first part of Tianna’s story is all too familiar to tens of thousands of young people affected by substance abuse in California. But it is the current chapter of her life that makes all the difference—Tianna is a shining example of how treatment works.  She credits the determined efforts of her probation officer, Sacramento County’s drug court, the Substance Abuse and Crime Prevention Act (aka Prop. 36), and the loving support of family and friends for getting her to where she is today. 

Tianna told her story at a recent drug court graduation celebration in Sacramento County that included alumnae like her. She admitted to the audience that it is still hard for her to believe how much her life has changed in the last eight years.

If there was ever someone in need of help, she says, it was her.

“At age 11, I began using marijuana daily and tried methamphetamine for the first time when I was 12.  You would think by hearing this that I was a trouble maker who came from a home that condoned this behavior.  That couldn’t be further from the truth.  I was a straight-A student taking college prep classes in high school surrounded by family who surely weren’t perfect, but loved me.  However, at age 16 my recreational use of methamphetamine turned into addiction and I began using every day. Meth became my life, nothing else mattered, not my family, friends or even my dreams,” she says.

Tianna was amazed at how quickly her life changed.  Within two short years—by age 18—she was living on the streets, completely immersed in the drug-addicted lifestyle.  She says she embraced it fully; her meth use turned into intravenous use supported by criminal activity.  “There was always a part of me that knew I was meant to be better than what I was,” she explains.  “I would have moments of determination and I would go to the county for drug treatment.  But with nothing really holding me there, I failed every time despite my once whole-hearted conviction to change.”

Each time Tianna was sent to jail she would write classic letters home, promising her family that things would be different. “Trust me,” she says, “I wanted to change so much it would physically hurt.  But, I lacked the tools to do anything different.”

In 2002 at age 21, she was sentenced under Proposition 36 after her seventh time in jail.  She was haggard and weighed less than 100 pounds. Meth had severely damaged her physically and she looked it. Worse than her appearance, however, was the hollow look in her eyes that mirrored the loss of hope in her soul.

“My probation officer actually got angry at me and I will never forget what he said.  He looked at me and told me that I was better than this.  His words cut deep because I knew that it was true.”

That year she was sent to her third residential program, this time to River City Recovery.  “I want to stress that it was my third time because sometimes people think that if you don’t get it the first time you will never change.  Well, I am living proof that the third time really was a charm.  Why was it different?  This time, my probation officer made it clear that he would hunt me down if I left.  The fear of going to prison overcame my urge to leave.  And since I didn’t leave that time, a miracle happened.”

Tianna says she “woke up” at River City Recovery.  Light and life flowed back into her body and spirit and she began to picture a different life for herself.

“After treatment, the day I was recognized in court and shook the hand of the judge and everyone else involved in my case—those who said they were proud of me, who gave me the confidence to challenge myself to go to the next level in my life—I knew life would be different.  I went back to school and took pride in becoming certified as a drug and alcohol counselor.  I went to work for that same program that saved my life during the first three years of my recovery,” she continues. 

On her two-year sobriety birthday, Tianna gave birth to her first child, a daughter.  She says that God gave her and her daughter the same “birthday” so that she would always remember. Now she is a mother, a wife, a taxpayer, a friend and a counselor.  She says she is still driven to challenge herself, to improve herself.  “I wasted six years of my life on daily meth use and promised myself that since I had been given this chance, I would continue to strive to do and to be more, for my sake and my family’s sake.”

Tianna Rowe now works for Bridges, where she directs two residential homes, an outpatient program, and the STARS program. As Supervisor/Human Resources and Early Intervention Family Drug Court Coordinator, she travels the country and speaks on behalf of courts that are unlike any others.  Two years ago, she was put in charge of a project called Celebrating Families, whichis a parenting program that focuses on the entire family and is available to families involved in child protective services.  “The impact of Celebrating Families on the lives of children is profound,” she points out. “Parents are given the tools to break the cycle of addiction in their families.”

Last year Sacramento County recognized Celebrating Families with a Heroes of Human Services award. And the program has been awarded a federal grant to continue for another four years in Sacramento County.

Life has changed dramatically for Tianna and she is now living up to the potential she always possessed.  In addition to her daily responsibilities, she also teaches workshops on codependency that help entire families.  She is back in school—an honor student maintaining a 3.7 GPA.  She is working on skills to be a grant writer and learning all aspects of human resource management.

In October of this year, Tianna gave birth to her second child and her family is complete, she says.  “My 6-year-old daughter has a new brother and my husband and I purchased our first home.  A homeowner!  Talk about blessed!  I want to shout it from the rooftops that my life has been transformed. Divine intervention and Proposition 36 gave me the chance to turn my life around eight and a half years ago.  Drug court and caring people took me out of a desperate pit of despair and offered me a better life based on love.  Now I need to give it back.  There are so many people out there suffering, desperately wanting to change.  That is why I work in this field.  I believe people can change.  I thank God for drug court and Proposition 36 for the opportunity to change. I will continue to pay it forward in gratitude for the rest of my life.”

 


NEWS FROM THE FIELD

Has your organization been honored for its achievements or received a significant grant for innovative programs or projects?  Have members of your staff been recognized for outstanding work that could be instructional for others?  We would like to hear about it! 

In coming issues of FOCUS, we will feature short news items about prevention, treatment and recovery providers, county programs, and individuals who have made the news.

Send your “news from the field”—national or international honors or awards or major grants—to ADP’s Communications Office c/o Suzi Rupp (srupp@adp.ca.gov).

 


ON THE ROAD WITH DIRECTOR ZITO

Community Social Model Advocates, Inc.
The Rose Julia Tranquility Village
Atwater, CA

This fall Director Zito traveled to Atwater to meet with Lori Newman, Program Manager for The Rose Julia Tranquility Village, a women’s residential program of Community Social Model Advocates, Inc. (CSMA). The group of single-family homes that comprise the Village on a pleasant cul-de-sac lives up to the name—tranquility—for the women and children who live there. 

CSMA was established in 1989. The Atwater program started with six beds, but now can accommodate 56  women for 30-, 60-, or 90-day treatment.  The Village offers a safe, home-like environment with an evidence-based curriculum and gender responsive approach. Lori runs the well maintained  facility on a shoe-string budget, but has been a life-saver for the women who have stayed there.  Her passion and commitment to her work are evident in the success she has had with her clients.

Joining Director Zito on a tour of the facility were Manual Jiménez, Jr.,, Director of Merced County’s Department of Mental Health; Christina Kraushar, Assistant Director of Mental Health Services for Merced County, and Merced City Councilman John Carlisle.

 




From left: Lori Newman, Program Manager at The Rose Julia Riordan Tranquility Village, Community Social Model Advocates, Inc. in Atwater, CA and Renée Zito, Director of the California Department of Alcohol and Drug Programs.



From left: Manuel J. Jiménez, Jr., Director, Merced County Department of Mental Health; Renée Zito, Director of the California Department of Alcohol and Drug Programs; Christina Kraushar, RN, Assistant Director of Mental Health Services for the Merced County Department of Mental Health, and Lori Newman, Program Manager at The Rose Julia Riordan Tranquility Village, Community Social Model Advocates, Inc. in Atwater, CA.




From left: John Carlisle, Merced City Councilman; Renée Zito, Director of the California Department of Alcohol and Drug Programs, and Lori Newman, Program Manager at The Rose Julia Riordan Tranquility Village, Community Social Model Advocates, Inc. in Atwater, CA.