007.25.94 Ark. Code R. 001
Attachment for Item 9
1991 GOALS UPDATE
In FY'91, the Division of Alcohol and Drug Abuse Prevention utilized a planning format that was created in the middle 1970s. The goals were established in the enabling legislation that created the Office of Alcohol and Drug Abuse Prevention (Act 644 of 1977). These six goals, very broads in nature, are as follows:
Each goal and a review of its status are as follows:
This goal was met in pan by two significant events. During 1991, the Division of Alcohol and Drug Abuse Prevention provided leadership in founding The Interagency Coordinating Committee on Drug Abusing Pregnant Women and Drug Affected Infants. This 37 member committee has members from 25 different state and private non-profit agencies and has served as the springboard for joint grant applications and ultimately the establishment of the SSA's three (3) Pregnant and Parenting Women Living Centers. Also, during this same period, the Division presented a legislative package for the 78th Session of the Arkansas General Assembly. Although a great many of the bills were passed, including a $3,593,010 expansion of adolescent and adult treatment services. However, due to the Revenue Stabilization Act, the Acts were placed in lower funding categories that were not implemented.
The Division funded a statewide treatment network of 25 residential and outpatient treatment facilities during FY'91. These geographically located facilities provided treatment services to 13,483 men, women and adolescents throughout the State. Additionally, all treatment providers had to be able to provide comprehensive treatment services to their clients either through direct service provision, by sub-contract, or by referral. The Division, through a combination of funding sources, provided prevention programming through grants to private non-profit agencies. The basic prevention service was delivered through a group of 12 agencies which provided the Early Intervention Program. This skill building/decision making curriculum was available to all Arkansas citizens at no cost. Additionally, the Division funded approximately 21 Prevention Service Program grants with community-based organizations. This is in keeping with the SSA's philosophy that the local community knows best how to solve its own problems.
The Division of Alcohol and Drug Abuse Prevention sub-divided the State into 13 catchment areas for treatment services and eight (8) regions for prevention programming. Funded treatment programs were required to provide services to their entire catchment area, thus providing comprehensive services to all 75 counties in the state. In addition, the Standards for the Accreditation of Alcohol and/or Other Drug Abuse Treatment Programs/Facilities require that treatment program Boards of Directors have representation from all counties in their catchment area, thus assuring that geographic interests were represented. Prevention programming statewide coverage was assured by funding 12 private non-profit agencies to deliver the Early Intervention Program (EIP) in eight (S) regions throughout the state. Each provider of EIP services was mandated to serve the counties in their region or partial region. Additionally, the Division funded two Prevention Service Program (PSP) grants in each of the eight (8) regions and two extra PSPs in the Central Region (largest population concentration area) and three (3) larger PSP grants on an at-large basis.
As mentioned in item three (3) above, the Division of Alcohol and Drug Abuse Prevention has in place an accreditation process for the assurance of quality treatment services for all treatment providers in the State, both publicly funded and for-profit entities. These standards are applied using a peer-review process which includes Division staff as well as peer reviewers. The process is mandated by Act 597 of 1989 and applies to any entity holding itself out to be a provider of alcohol and or other drug treatment services. Additionally each program (treatment and prevention) receives at least one on-site monitoring visit each year and a desk review of monthly and quarterly reports.
The Division of Alcohol and Drug Abuse Prevention has historically allocated treatment program funding on a per capita catchment area basis. Such was the case in FY'91. Any other distribution or re-distribution of treatment funding was based on program utilization. Prevention funding was allocated as described in item three (3) above.
The Division of Alcohol and Drug Abuse Prevention has continued its close association with the Arkansas Department of Health, the Divisions of the Arkansas Department of
Human Services, Arkansas Department of Correction, and other State agencies. As mention in item one (1) above the Division was a leader in establishing the Committee on Drug Abusing Pregnant Women and Drug Affected Infants. Additionally, the Division continued its working relationship with the University of Arkansas for Medical Sciences through its two Division-endowed professorships. The Division again served as a co-sponsor of the Mid-South Summer School on Alcohol and Other Drug Abuse Problems which brought together 768 participants for a week of continuing education in 1991.
The Arkansas Bureau of Alcohol and Drug Abuse Prevention (ADAP) continued to contract a significant portion of the ADMS Block Grants funds to support eleven community-based Early Intervention Programs during the period covered in this narrative. These programs are assigned specific geographical regions within the state to provide services which ensure that a variety of education/prevention/early intervention services are available to the public at no charge.
The EIP's, first funded in 1982, were originally developed as community-based "diversion" programs which were intended to provide Arkansas with effective and less expensive alternatives to treatment for those youth who were experimental, casual recreational and/or moderate substance abusers. The core of each program was a four (4) foci curriculum intended for small, highly interactive group presentations following a skill building, structured learning format, targeting family, youth, parents and the community. The strategies employed through these curricula are designed to address characteristics that correlate positively with reduced risk of alcohol and other drug abuse. Some of the characteristics are as follows:
Strong identification with viable role models which enhance self concept and provide a positive reference group.
High identification with and responsibility for "family" process which provides an identity with things greater than self and involves shared investments and responsibility for achievement of outcomes and accountability to others for behavior.
Strong problem-solving skills which facilitate the ability to work through problems and enhance the belief that through the use of personal resources, solutions may be developed.
Strong interpersonal skills which enable the individual to effectively communicate, negotiate and adapt their interaction with others.
While the life-skills curricula remains at the core of the EIP's, ongoing assessment and evaluation as well as the application of prevention research from other studies has caused the program to change in the following manner:
* it empowers the youth by providing opportunities for meaningful participation and responsibility.
The Early Intervention Programs provide the ADAP's only contracted/directed education/prevention/intervention services. ADMS Block Grant funding accounts for 66% of the funding costs allocated for this effort. Over 72,000 Arkansans were in receipt of these services in state fiscal year 1992. The Early Intervention program would be discontinued in the following fiscal year. These funds will be used to support the creation of Prevention Resource Centers.
Education, training and providing information and referral services to personnel from a variety of disciplines continues to occupy an important role in the attainment of our ADMS Block Grant prevention/early intervention goals. The ADAP continues to support teacher training programs housed at the University of Arkansas - Fayetteville and the University of Central Arkansas to instruct classroom teachers in innovative methods of infusing a holistic health education message into curricula for students in grades K-12. Specific funding is targeted to two local educational agencies (LEA's) to address the needs of those students in an Alternative classroom setting. The ADAP also provides block grant to support a consortium of representatives from the states' 41 campuses of higher education. This constitutes the states sole effort to provide coordinated ATOD prevention programs on these campuses. The Bureau continues to support the Mid-South Summer School on Alcohol and Other Drug Problems which entered its 19th year by providing topical presentations on a variety of ATOD issues to the almost 800 in attendance. Also included in this category is the ongoing support of the Arkansas Substance Abuse Certification Board which ensures quality standards are achieved by the AOD treatment community.
The ADAP also provides funds to twenty-two Chemical Free Living Centers (CFLC's) across the state to assist those individuals that have recently completed a state-certified AOD residential program in maintaining a drug-free lifestyle while they reintegrate into mainstream society. A Substance Abuse Treatment Program (SATP) is also provided to inmates housed at seven units within the State Department of Correction.
The ADAP strives to assess on an ongoing basis those populations, areas and locations in the state with the greatest need for alcohol and other drug abuse prevention/intervention services and to target programs, resources and services accordingly. Most of the progress we have made in addressing these needs have been through the utilization of funds from sources other than the ADMS Block Grant, such as, the Department of Education Drug-Free Schools and Communities Act - Governor's Portion, CYAP Block Grant funds and through collaborative efforts with other state governmental agencies to maximize the tenuous levels of funds available to address these tasks. An inhouse evaluation of the type of services and programs currently supported through the use of ADMS Block Grant funds is underway. It is anticipated that portion of the funding available to certain efforts will be redistribute to further target identified prevention/intervention needs.
UPDATE ON FY 1993 GOALS
The following are the goals listed in last year's application and a progress report on their objectives:
Goal #1 To develop and implement a comprehensive statewide needs assessment process.
Objectives 1 and 2 were based on ADAP being awarded a CSAT Needs Assessment Grant. ADAP did not receive this grant and therefore these objectives were not attained.
Objective 3 was to continue the ADAP process for receiving public input. This was attained.
Comment: Currently, the ADAP is participating in the development of a needs assessment for the entire Department of Health. The most useful component of this needs assessment for the ADAP's purposes will be a mailed survey of the general public. The ADAP has never had this type of information before.
Goal #3 To monitor all prevention and treatment grants and to make any necessary changes to improve their quality and appropriateness.
Objectives 1 and 2 stated the ADAP's system of monitoring programs on-site and at the ADAP office. Both of these objectives were attained.
Comment: Monitoring has been enhanced this past year due to ADAP's move to the Health Department. As part of this process 4 financial personnel were transferred to the ADAP. All 4 staff members are experienced in alcohol and other drug grants and PC skills.
Goal #4 Address the treatment needs of substance abusers in the State.
Objective 1 addressed the need to provide treatment options.
Objective 2 addressed the needs of options for injection drug users. These objectives were attained.
Objective 3 addressed the need for continuous dissemination of current HIV information to treatment providers. This objective was attained.
Comment: In January, 1994 the ADAP and UAMS opened an injection drug users clinic with methadone services. This is the first in the state.
Goal #5 Insure that comprehensive treatment services are available in Arkansas for drug abusing pregnant women and women with small children.
Objective 1 was to award specific grants for residential centers for this client population. This was attained.
Objective 2 was to continue and enhance interagency cooperation for issues involving this client population. This was attained.
Comment: In 1993 the ADAP awarded 3 grants to establish Pregnant and Parenting Women Living Centers. These are comprehensive, residential treatment centers where pregnant women and women with small children may stay for a maximum of 2 years.
Also, in July of 1993 the ADAP sponsored a team to participant in the Community Team Training Institute.
Goal #6 To seek out potential applicants for the Revolving Loan Fund.
Objectives 1 and 2 addressed the promotion and assistance to potential applicants for this fund. These objectives were attained, but the number of applicants has not increased significantly.
Comment: During 1993, ADAP arranged for a volunteer representative of Oxford Houses, Inc. to address various groups within the state.
GENERAL COMMENT: For FFY'91, the base for services to pregnant omen with dependent children, tuberculosis services and for HIV early intervention was S0.0. However, as noted above and in other sections of this application, the ADAP is moving forward on all these requirements in our current fiscal year.
Detailing expenditures on prevention and early intervention (Row 4)
There are six prevention strategies typically funded by principal agencies administering the block grant. Here are definitions of those strategies:
Information - This strategy provides knowledge and increases awareness of the nature and extent of alcohol and other drug use, abuse, and addiction, as well as their effects on individuals, families, and communities. It also provides knowledge and increases awareness of available prevention and treatment programs and services. It is characterized by one-way communication from the source to the audience, with limited contact between the two.
Education - This strategy builds skills through structured learning processes. Critical life and social skills include decision making, peer resistance, coping with stress, problem solving, interpersonal communication, and systematic and judgmental abilities. Tnere is more interaction berween facilitators and participants than in the information strategy..
Community and professional mobilization - This strategy provides ongoing networking activities and technical assistance to community groups or agencies. It encompasses neighborhood-based, grassroots empowerment models using action planning and collaborative systems planning.
Alternatives - This strategy provides participation in activities that exclude alcohol and other drugs. The purpose is to meet the needs tilled by alcohol and other drugs with heaithy activities, and to discourage the use of alcohol and drugs through these activities.
Social policy and environmental change - This strategy establishes or changes written and unwritten community standards, codes, and attitudes, thereby influencing alcohol and other drug use by the general population.
Early intervention - This strategy is designed to come between a substance user and his or her actions in order to modify behavior. It includes a wide spectrum of activities ranging from user education to formal intervention and referral to treatment from a substance abuse professional.
Now refer back to Form 04 and look at all "the entries you made on row 4 (prevention and early intervention). Use the table below to indicate how much funding supported each of the six strategies. Enter in whole dollar amounts.
ENTITY INVENTORY LIST
1. City of North Little Rock
Sherman Park Recreation Ctr. 624 North Beech Street North Little Rock, AR 72114
25. Arkansas Community Cornerstone Foundation P. O. Box 5822
Pine Bluff, AR 71611
26. Community Service, Inc. P. 0. Box 679 Morrilton, AR 72110
27. Ouachita Children1 s Center 339 Charteroak
Hot Springs, AR 71901
28. Youth Bridge P. 0. Box 668 Fayetteville, AR 72702
29. Arkansas College Personnel Association
SAU Box 1364 Magnolia, AR 71753
30. Jonesboro School District 1307 Flint Street Jonesboro, AR 72401
31. Malvern School District 525 East Highland Malvern, AR 72104
32. University of Central AR Department of Health Education P. O. Box 5016
Conway, AR 72035-0001
33. University of Arkansas-Fayetteville
HPER 326-A Fayetteville, AR 72701
34. " University of Arkansas-
Little Rock 2801 University Little Rock, AR 72204
35. Division of Children and Family Services -Youth Services Ctr.
P. O. Box 1437
Little Rock, AR 72203-1437
36. New Futures for Little Rock Youth 209 W. Capitol
2nd Floor Annex
Little Rock, AR 72201-3630
37. Office of the Governor Arkansas Drugs Don't Work State Capitol Building Little Rock, AR 72201
38. Boys, Girls, Adults Community Development Center P. O. Box 1356
Marvel, AR 72366
39. City of Dermott P. O. Box 371 Dermott, AR 71638
40. Massey D. Jordan Youth
Development 1314 S. Cherry Pine Bluff, AR 71601
Tnis is similar to the first item of Section II, except that there are now separate block grants for substance abuse and for mental health. It documents any plans the State might have to transfer funds between these two block grants. Complete the following checklist:
GOALS, OBJECTIVES AND ACTIVITIES
STATE GOAL - The Bureau of Alcohol and Drug Abuse Prevention (ADAP) will continue to monitor closely all SAPT expenditures in order to assure the requirement to expend not less than 35 % of the grant for alcohol treatment and 35 % for other drug treatment.
OBJECTIVES
Comment: Within the last year the ADAP increased its financial staff by four positions. Each of these financial persons has extensive PC skills and experience in alcohol and other drug treatment grants and billing. Therefore, ADAP's monitoring abilities have been enhanced.
STATE GOAL: - Implement and maintain an alcohol, tobacco and other drug (ATOD) education and primary prevention system that maximizes available resources, targets unserved and underserved populations, and empowers communities.
OBJECTIVES:
STATE GOAL - The ADAP will increase by a minimum of 5% the amount of SAPT funds specifically for services to pregnant women and women with dependent children.
OBJECTIVES:
Comment: Last year the ADAP awarded three PPWLC grants. PPWLCs are comprehensive, residential treatment centers for pregnant women and women with small children. Residents may stay for two years.
STATE GOAL: To develop and implement by July 1, 1994 an agreement with providers offering treatment services to IDUs that fulfills the 90% capacity reporting, 14-120 day performance requirement, interim services, outreach activities and monitoring requirements.
OBJECTIVES:
ACTION STEPS:
STATE GOAL: - Continue to provide tuberculosis related services to all clients of funded alcohol and other drug treatment facilities through a memorandum of agreement with the Arkansas Department of Health Tuberculosis Division.
OBJECTIVES:
ACTION STEPS:
STATE GOAL - The ADAP will assure that early intervention services for HIV clients will be provided by all grantees.
OBJECTIVES:
Comment: For several years the ADAP, the AIDS/STD Unit of the Health Department, and the ADAP grantees have been working cooperatively on HIV/AIDS issues. These areas of cooperation include:
- An ADAP policy and procedures
- Training opportunities
- Pre- and post-test counseling
STATE GOAL: - Actively utilize the ADAP Revolving Loan Fund to assist recovering alcoholics and drug addicts in transitioning back into society.
OBJECTIVE:
STATE GOAL - Monitor the implementation and enforcement of State laws that forbid any manufacture, retailer or distributor of tobacco products to sell or distribute any such product to any individual under the age of 18 and subsequently reduce the extent to which tobacco products are made available to individuals under IS.
OBJECTIVES:
STATE GOAL - The Bureau of Alcohol and Drug Abuse Prevention will establish policies and procedures to insure priority services and interim services to pregnant women.
OBJECTIVES:
Comment: Since the ADAP currently has three Pregnant and Parenting Women Living Centers and will have another by July, 1994, the capacity for serving this population has increased and will continue to increase.
STATE GOAL - The Bureau of Alcohol and Drug Abuse Prevention (ADAP) will develop a standardized assessment tool and criteria for standardized placements into the various treatment modalities.
OBJECTIVES:
Comment: This assurance will be a high priority because the ADAP believes that this is a necessary step in the preparation for Health Care Reform.
STATE GOAL: To ensure that each and every prevention training conducted in the state of Arkansas is designed to be outcome oriented, focused on the arena of application, tied to a long range plan, based on an acceptable theoretical framework, planned and executed collaboratively and be designed to build capacity and empower each person to promote and actively demonstrate a healthy lifestyle.
OBJECTIVES:
ACTION STEPS:
STATE GOAL: To provide coordinated ATOD prevention activities and treatment services that are designed to maximize the existing resources available at the local, state and Federal levels.
OBJECTIVE:
STATE GOAL - The Bureau of Alcohol and Drug Abuse Prevention (ADAP) will continue to pursue activities related to a statewide needs assessment targeting specifically treatment catchment areas.
OBJECTIVES
Comment: The ADAP is currently reorganizing and will have a new section which will coordinate all planning, research and data information. This action should facilitate any future attempts at developing needs assessment.
STATE GOAL: - Implement a method to insure that no Block Grant funds are used by funded programs to supply hypodermic needles or syringes to addicts, thus promoting illegal drug use.
OBJECTIVE:
STATE GOAL - Assess and improve, via independent peer review, the quality and appropriateness of treatment services delivered by providers that receive funds from the Block Grant.
OBJECTIVES
STATE GOAL - To enforce the requirements of 42 CFR, Part 2.
OBJECTIVES:
SUBSTATE PLANNING ARKANSAS
Within this item of the application, as well as some of the subsequent items, forms, and attachments, reference is made to estimations of the various client populations needing services. The State of Arkansas has not conducted a comprehensive needs assessment as yet, although FFY94 funds are allocated to do so. Therefore, no estimations are being provided for this application. However, the State has utilized a trial format to test the allocation of funding utilizing population figures for substate planning areas, drug-related crime statistics for those substate planning areas, and drug-related infectious disease rates for those substate planning areas. The trial proved successful and the State will utilize this method of allocating treatment funding beginning July 1. 1994.
The State is planning to develop a comprehensive needs assessment in calendar year 1994. The Single Slate Agency (SSA) for Arkansas was transferred from the Department of Human Services to the Arkansas Department of Health (ADH) as of July 1, 1993. As stated in last year's application, the anticipated close working relationship has occurred and the SSA now has access to the ADH Epidemiology Unit as a sister agency. Furthermore, the ADH is currently conducting a feasibility study of a statewide needs assessment. All bureaus/divisions will be able to participate in the needs assessment, if the decision to proceed is made.
Plans for substance abuse treatment and prevention by ADAP in Arkansas are developed for eight (S) planning regions.
These regions are divided into thirteen (13) catchment areas. We also plan for certain target populations (youth, IDU, women, minorities and the elderly).
We are not responsible for the development of sub-state plans. Since our services are community-based, local providers submit grant applications to ADAP. However, we do have procedures that grant applicants must follow.
Since we do not develop sub-state or local plans, the only plan we are responsible for is the Annual Plan. Since our Annual Plan has served as our state application for federal funds, our timetable of developing it has been dependent upon deadlines and guidelines from the Federal government (those may vary from year to year). However, the process usually takes approximately four calendar months to complete, including gathering and interpreting statistics from providers throughout the State, adding new or updated information to the format, public comment period, rewriting and printing time. As a part of Arkansas' state requirement (Administrative Procedures Act), a legislative hearing is required to approve our Annual Plan and our state's application for funds. In addition, the recent transfer to the Arkansas Department of Health has expanded the public hearing process. The ADH requires a public hearing, separate and apart from the legislative hearing for all funding applications submitted by the ADH.
Data collected consists of treatment admissions/discharge information collected from all accredited treatment providers through the ADAP Alcohol/Drug Abuse Management Information System; State Drug Task Force information on arrests/confiscations; Arkansas Department of Health AIDS/STD incidence and prevalence information; Arkansas State Crime Lab Drug Analysis reports; Arkansas census information. As has been stated previously, Arkansas currently does not have a valid needs assessment process to be able to accurately tract trends, therefore, much of this data is used anecdotally to provide general direction to the ADAP in decision making.
Additionally, the ADAP relies on the Arkansas Alcohol and Drug Abuse Authority as a board of review for policy/program and allocation review. This six (6) member Governor appointed citizen panel meets quarterly to provide input and to approve plamiing related issues.
The twenty-three (23) member Governor appointed (according to Legislative mandate) Arkansas Alcohol and Drug Abuse Coordinating Council serves as a board of review for the Governor's portion of the Drug-Free Schools and Communities Grant funding decisions.
PUBLIC INPUT
The Arkansas Bureau of Alcohol and Drug Abuse Prevention (ADAP) meets with the Arkansas Association of Substance Abuse Treatment Programs (AASATP) and the Arkansas Nonprofit Treatment Providers Association (ANTPA) to discuss and explore substance abuse issues and trends. The ADAP also meets with all funded treatment providers on a quarterly basis for the sharing of information and the solicitation of input. The Annual Plan and Block Grant Application is released to the AASATP, the ANTPA, the Arkansas Association of Alcoholism and Drug Abuse Counselors, the Arkansas Substance Abuse Certification Board, as well as advertised for a 20 day public comment period in the Arkansas Democrat-Gazette statewide newspaper. In compliance with Executive Order 123872, the State A95 Clearinghouse review process is utilized and a legislative committee public hearing is conducted. Additionally, as noted in the previous section (Substate Planning), since transfer to the Arkansas Department of Health on July 1, 1993, the Single State Agency is required to conduct a public hearing, separate and apart from the legislative hearing for all funding applications submitted by the Arkansas Department of Health.
A six member Governor appointed citizen Alcohol and Drug Abuse Authority acts as a board of review in areas of policy and funding allocation, including the Annual Plan and Block Grant Application. In developing this FY94 Block Grant Application, it was the ADAP's expectation to utilize a series of town meetings to gather grass roots input from across the state. This plan was contingent upon the availability of a staff position to coordinate these activities. Since the position has been acquired only in the last two weeks, this was an unrealized expectation. Therefore, it is the intention of the ADAP during FY94 to conduct a series of town meetings across the state to assist the ADAP in the formulation of plans for the development of the 1994 SAPT Block Grant Application.
The State will utilize a series of tools to assure that funded programs serve communities with the highest prevalence and need based on a comprehensive needs assessment process as outlined by Dr. Eric Wish, CSAT Consultant. The ADAP has available several computer-generated monthly reports which measure utilization and slot capacity. This will be paired with another computer generated report which will measure activity of funded programs in serving identified Injection Drug Users. The ADAP also reviews on a monthly basis data generated by the State-funded Drug Task Forces, the drug analysis reports of the State Crime Lab, the quarterly report of the Arkansas Department of Health AIDS/STD unit, as well as the annual progress reports of the funded treatment and Early Intervention Program providers. The ADAP utilizes these desk-review techniques as well as on-site monitoring and accreditation processes.
Use the following checklist to indicate the criteria your State will use in deciding how to allocate FFY 1994 funds. Mark all criteria that apply. Indicate the priority of the criteria by placing numbers in the boxes. For example, if the most important criterion is "incidence and prevalence levels," put a "1" in the box beside that option. If two or more criteria are equal, assign them the same number.
fTl Population levels (Specify formula:_)
Q Incidence and prevalence levels
(xJ Problem levels as estimated by aicohol/drug-related crime statistics ("7! Problem levels as estimated by alcohol/drug-related health statistics O Problem levels as estimated by social indicator data O Problem levels as estimated by expert opinion
0 Resource levels as determined by_(specify method)
1 1 Size of gaps becween resources (as measured by_) and needs
(as estimated by_)
Gl3 Other: prP7Pnf.i nn project's - rpmppM hi ?p(specify) bid
METHODS FOR ESTIMATING THE NUMBER IN NEED OF SUBSTANCE ABUSE TREATMENT SERVICES
In the past the State of Arkansas has used a modified version of the Parker-Marden formula to estimate the numbers of individuals needing treatment services. This formula was first developed for the National Instimte on Drug Abuse in the 1970's, and basically computes the numbers of any given population having a substance abuse problem and therefore potentially needing services at 10%. This is the method that is currently in use and will be so, until the State has a more accurate method of estimating these numbers.
The sources of data used in completing this section are as follows:
TOTAL POPULATION - Obtained from the 1990 Census and broken down into the substate planning areas.
TOTAL POPULATION IN NEED - Modified Parker-Marden formula (described above). THE NUMBER SEEKING TREATMENT computed by taking 10% of the planning area figure.
NUMBER OF IVDUS IN NEED - Number of IDUs reported to the State's Alcohol/Drus Management Information System (ADMIS). The NUMBER SEEKING TREATMENT computed by taking 10% of the planning area figure.
NUMBER OF WOMEN IN NEED - Modified Parker-Marden formula (described above) applied to the number of females in each substate plannina area. The NUMBER SEEKING TREATMENT computed by taking 10% of the planning area figure.
PREVALENCE OF SUBSTANCE-RELATED CRIMINAL ACTIVITY -
Total drug-related arrests as reported by the Arkansas Crime Information Center in its publication Crime In Arkansas 1991 and broken down by substate planning area.
INCIDENCE OF COMMUNICABLE DISEASES - Information provided by the Arkansas Department of Health and broken down by substate planning areas.
The information in Column 6 is used anecdotally in discussions/planning activities with the Alcohol and Drug Abuse Authority, Alcohol and Drug Abuse Coordinating Council, Bureau of Alcohol and Drug Abuse Prevention quarterly planning meetings, and other gatherings with interest in this type of data.
The information in Column 7 was used this past year to guide the Bureau in the placement of a pilot street outreach program in the counties with the highest incidence of AIDS/HIV cases. The tuberculosis index is being used to prioritize the order in which the Department of Health Tuberculosis Unit is conducting training and on-site surveys to determine the number and placement of ultra-violet c lighting in residential treatment facilities.
S. Purchasing services
9. Program performance monitoring
The ourpose of this item is to document how the principal agency of die State will monitor and evaluate the performance of substance abuse service providers that receive State- and/or block urant funds'. "
Use the following checklist to indicate what methods your State uses. Cher.; all that apply.
ATTACHMENT 1: GROUP HOME ENTITIES AND PROGRAMS
The State of Arkansas, Bureau of Alcohol and Drug abuse Prevention has established (9/39) and continues to administer the Revolving Loan Fund for Recovery Homes for Substance Abusers. SAPT Block Grant funds are used as the source to establish the Revolving Loan Fund. There have been no changes from the previous year.
Information is enclosed concerning the Revolving Loan Fund program an the processes involved. The fund conforms to P.L. 100-690 of the Anti-Drug Abuse Act of 1988 or its successor. Through the fund, non-profit corporations may apply for loans of up to S4,000 to house a minimum of six (6) recovering individuals. The loan shall be repaid to the State in 24 equal installments due on the first of each month with a late fee of $25 assessed to each payment received after the 25th of the month. Loan funds may be used for any legitimate cost (as listed in the enclosed information) associated with the establishment of a recovery home. Pre-applications or final applications may be submitted to the Bureau with the required documentation. Applications are reviewed in the order in which they are received and a determination of eligibility is made within 10 working days. Warrants are issued through the State payment system normally within a two to three week period.
The Group Home Revolving Fund is monitored by the Administrative Services Section of the Bureau of Alcohol and Drug Abuse Prevention. At a minimum, records are kept on applicants, disposition of applications, loan amounts, payments, and late fees. No loans were made in FY1991. During FFY93, the Bureau received and processed its first applications. Of the four (4) applications received, three (3) were funded. The fourth application was incomplete and additional information was requested. During the interim, the proposed dwelling was withdrawn by the owner and the application was never completed. The Bureau will report on the status of the three active loans when this information is called for in subsequent SAPT Block Grant applications.
STATE OF ARKANSAS ARKANSAS DEPARTMENT OF HEALTH BUREAU OF ALCOHOL AND DRUG ABUSE PREVENTION
REVOLVING LOAN FUND RECOVERY HOMES FOR SUBSTANCE ABUSERS
PURPOSE
The State of Arkansas Bureau of Alcohol and Drug Abuse Prevention has established a revolving loan fund for the purpose of providing loans to support drug and alcohol free housing for recovering alcoholics and/or addicts. This fund is established in accordance with P. L. 100-690 of the Anti-Drug Abuse Act of 1988.
ELIGIBILITY
REQUIREMENTS AND LIMITATIONS
APPLICATION PROCEDURES
Applicants are encouraged to consider submitting their applications in two stages:
The eligibility determination could take several days or longer if there are problems with documentation. Such delays could cause the applicant to lose property that is being pursued for a lease. Pre-approval would eliminate such delays.
The applicant must submit a loan application to:
ARKANSAS DEPARTMENT OF HEALTH
BUREAU OF ALCOHOL AND DRUG ABUSE PREVENTION
108 East 7th Street
400 Waldon Building
Little Rock, AR 72201
Attn:
A. D., Administrative Services
Applications can be obtained from the Bureau of Alcohol and Drug Abuse Prevention at the above address or by calling the office at 682-6663. The following documentation is required to be submitted with each application:
ATTACHMENT 3: PROGRAMS FOR WOMEN
The Bureau of Alcohol and Drug Abuse Prevention (ADAP) continues to provide treatment services far in excess of the federally mandated amount of SAPT funds for women's services.
Of the funded projects for treatment services for women listed in Form 06, all the grantees will accept pregnant women and continue their alcohol/other drug treatment as long as the pregnant client is able to participant in and benefit from the program.
The ADAP uses no special definition for women in need of services. A desire or need for services is the only eligibility criteria for services for women and for any other client population.
By virtue of our Alcohol and Drug Management Information System (ADMIS), the ADAP was able to monitor the number of women in treatment services and the amount expended for services, thereby assuring compliance with Section 1916 (c) (14).
Other than the above monitoring mechanism, the ADAP, via its accreditation process, case reviews, and services-to-billings audits, monitors the adequacy of our effort to serve women.
In regard to estimation of treatment capacity, see Section III. 4.
The ADAP continued to serve as the lead agency on the "Interagency Coordinating Committee on Services to Drug Abusive Pregnant Women and Drug Affected Infants." This committee shares information, supports each other in funding proposals, and advocates on behalf of this client population.
Beginning in July, 1993 the ADAP began issuing grants for Pregnant and Parenting Women Living Centers (PPWLC). These are comprehensive, residential treatment centers for pregnant women and women with small children. The women and their children may stay at these PPWLCs for up to two years while receiving such services as:
Alcohol/Drug Treatment Prenatal and Postpartum Care Case Management Parenting Skills Job Training Life Skills and other needed services.
There are now 3 PPWLCs which are operational:
Arkansas CARES
4301 W. Markham, Slot 711-1
Little Rock, AR 72205
661-7979
Gateway House 1715 Grand Avenue Fort Smith, AR 72901 783-8849
Quapaw House P.O. Box 6368 115 Market Street Hot Springs, AR 71902 624-3325 or 624-1360
The number of available beds for women under these grants are:
Quapaw House | 6 |
Gateway House | 5 |
Arkansas CARES | 8 |
Total 19 |
The ADAP does not specify in its treatment grants that certain amounts must be spent on women. The ADAP's only specification is in regard to "alcohol" vs. "drug" funding. The following, however, is a listing of treatment grants which serve women, either in a women only facility, or a co-ed facility.
PROVIDER | NDATUS # |
ARKANSAS CARES | D 53000 |
OMART | D 14714 |
DECISION POINT | D 12031 |
CRDC | D 324311 |
ECA-EDC | D 32334 |
DEPARTMENT OF CORRECTION | D 44335 |
HDRS | D 448311 |
CASAP | D 546310 |
ARVAC | D 63813 |
QUAPAW HOUSE | D 64431 |
SARHC | D 71732 |
GATEWAY | D 84112 |
WESTERN ARKANSAS | |
COUNSELING & GUIDANCE | D 80533 |
ATTACHMENT 4: PROGRAMS FOR IVDUs
In the past, the Arkansas Bureau of Alcohol and Drug Abuse Prevention has utilized its network of community based residential and outpatient treatment centers to service the alcohol and drug treatment needs of this population. The ADAP had directed its funded providers to insure that IVDUs receive priority access to treatment services by moving identified IVDUs into the next available treatment slot. In most instances for residential services this means placing them in a priority status on a waiting list. In the event that the length of time to access a residential slot will exceed seven (7) days, providers will place the individual into outpatient status and begin the treatment process. Providers also seek referrals to other treatment centers if the client requests and/or is agreeable to this course of action. The ADAP has also revised its method of identifying and capturing data concerning this population. The ADAP has been very aggressive in accessing training for the treatment provider community. In cooperation with The Center for AIDS and Substance Abuse Training and Westover Consultants, nationally recognized AIDS training courses and presenters have been brought to Arkansas at low or no costs to the State. The Training of Trainers courses has allowed the State to develop a core of NIDA certified AIDS trainers who regularly replicate training for administrators, counselors, and others who receive instruction on risk reduction, human sexuality, counseling issues, gay and lesbian issues, etc. Also, through a cooperative agreement with the AIDS/STD Unit of the Arkansas Department of Health, the ADAP has available an AIDS education course, as well as a course on pre- and post-test counseling. AIDS training is also presented through the Arkansas Substance Abuse Certification Board and through the University of Arkansas at Little Rock Department of Social Work's "Mid-South Summer School on Alcohol and Other Drug Abuse Problems" (both funded in part by grants from the ADAP). The ADAP mandates that each funded treatment program has an AIDS contact person on staff who is responsible for providing staff updated information, an agency AIDS policy, collecting a library of AIDS-related material and resources, and implementing an AIDS education component for the clients of the facility. The ADAP is a member of the Arkansas AIDS Advisory Committee, and works closely with the Arkansas Regional AIDS Interfaith Network (Arkansas RAIN), as well as with the Arkansas AIDS Foundation. Following this narrative is a listing of the community-based treatment facilities that provide treatment services to IVDUs in either an outpatient or a comprehensive residential treatment setting. These treatment centers are not equipped at this time to test for the etiologic agent in the Human Immunodeficiency Virus, and consequently utilize their local Arkansas Department of Health county unit to provide the testing for any client who may request it. Several providers have expressed an interest in receiving training in the drawing of blood to be able to conduct testing-related activities on site. All testing is done with Centers for Disease Control-approved pre- and post-test counseling. AIDS testing is at the option of the client and an individual's AIDS/HIV status cannot be used as a criteria for denying admission to treatment. All test results are communicated by the testing unit directly to the client who has the discretion as to whether or not to disclose his/her status to the treatment facility.
FUNDED TREATMENT CENTERS WHO WILL PROVIDE TREATMENT SERVICES TO IVDUs
Arkansas CARES
4301 W. Markham, Slot 711-1
Little Rock, AR 72205
215 Club, Inc., Dba "Decision Point" P.O. Box 1174 301 Holcomb Springdale, AR 72764
Ozark Mountain Alcohol Residential P.O. Box 308 Highway 62 GassviHe, AR 72635
Ozark Counseling Services #8 Medical Plaza P.O. Drawer J Mountain Home, AR 72653
Northcentral Arkansas Development Council P.O. Box 3349 Batesville, AR 72501
North Arkansas Human Services System, Inc. P.O. Box 2578 Batesville, AR 72501
Black River Area Development Corp. (Brad) 1405 Hospital Drive Pocahontas, AR 72455
Crowley's Ridge Development Council P.O. Box 1497 Jonesboro, AR 72401
Eastcentral Arkansas Economic Development Corporation
P.O. Box 709
Forrest City, AR 72335
Human Development And Research Services, Inc.
P.O. Box 8225
HDRS Building
Pine Bluff, AR 71611
Southeast Arkansas Mental Health Center P.O. Box 1019 2500 Rike Drive Pine Bluff, AR 71613
Counseling Clinic, Inc. 307 East Sevier Street Benton, AR 72015
Detoxification Services Center 6701 Highway 67 Benton, AR 72015-8486
GYST House 4201 Barrow Road LM& Rock, AR 72204
Riverbend Recovery Center
1201 River Road
North Little Rock, AR 72114
Family Service Agency Of Central Arkansas
628 West Broadway
North Little Rock, AR 72115
Serenity Park
2801 W. Roosevelt Road
Little Rock, AR 72204
Twenty-Four Hour Center, Inc. (Men) 2021 Main Street Little Rock, AR 72206
Twenty-Four Hour Center, Inc. (Women) 3900 Affolter Lane Route 5, Box 32A LitdeRock, AR 72212
Freedom House 900 Dike Road P.O. Box 1463 Russellville, AR 72801
Counseling Associates 110 Skyline Drive RussellviUe, AR 72801
Quapaw House
P.O. Box 6368
115 Market Street
Hot Springs, AR 71902
Recovery Center
710 W. Grove
El Dorado, AR 71730
Red River Council On Alcohol And Drug Abuse 222 W. 5th Avenue Texarkana, TX 75501
Harbor House, Inc. 615 North 19th Street P.O. Box 4207 Fort Smith, AR 72914
Gateway House 1715 Grand Avenue Fort Smith, AR 72901
Horizon
3900 N. Armour Street Fort Smith, AR 72904
Sections 1912A and 1915(c) of the Public Health Service Act required that at least 50 percent of the funds expended from any block grant award to combat drug problems be used for treatment programs for individuals whose substances(s) of abuse is/are intravenously administered, with priority given to programs to treat individuals who are HIV infected, for training of drug abuse counselors in these programs, and to carry out related outreach activities.
Any individual who in their drug taking history ever used a needle to inject drugs into their body, whether it be skin popping, intramuscular or intravenous, and present themselves for treatment.
The ADAP has directed its funded providers to insure that IVDUs receive priority access to treatment services by moving known IVDUs into the next available treatment slot and placing them in out-patient services until they can be admitted to the program. The ADAP has been very aggressive in accessing training for the treatment provider staff. In cooperation with the Center For AIDS and Substance Abuse Training and the Westover Consultants, nationally recognized AIDS training courses and presenters have been accessed at either low or no cost to the state. Also, through a cooperative agreement with the AIDS/STD unit of the Arkansas Department of Health, the ADAP has available an AIDS education course, as well as a counseling course on pre and post- test counseling. AIDS training is also presented through the Arkansas Substance Abuse Certification Board and through the University of Arkansas at Little Rock Department of Social Work "Mid-South Summer School on Alcohol and Other Drug Abuse Problems:", (both funded in part by grants from the ADAP). The ADAP mandates that each funded program have AIDS information, an agency AIDS policy, a library of AIDS-related material and resources, and an AIDS education component for the clients of the facility. The ADAP is a member of the Arkansas AIDS Advisory Committee, and works closely with the Arkansas Regional AIDS Interfaith Network (RAIN), as well as the Arkansas AIDS Foundation. All funded providers have at one time or another served IVDUs. In the past there has been no separate discrete funding directiy attributable to the provision of services to IVDUs. the only identifiable funding was the billing record of the individual treatment facilities. However, in January 1994 the ADAP opened an IVDU Clinic in conjunction with the University of Arkansas for Medical Sciences (UAMS).
The clinic provides a comprehensive program of treatment services which utilizes prescription methadone as an adjunct to treatment. The pharmacological intervention stabilizes opiate-addicted individuals, thus allowing them to participate in an enhanced treatment service program of counseling, 12 step meetings, and other ancillary services. Topics to be discussed in individual and group counseling sessions shall consist of, at a minimum, issues concerning family or significant others; living skills; methadone maintenance; peer confrontation; positive drug screens; educational training; employment; vocational training; AIDS education. In addition, patients will receive a full range of health screening, including testing for infectious diseases. Patients will move through treatment phases and will be required to demonstrate a level of stability and progress in treatment prior to being advanced to another phase.
Revised the Alcohol and Drug Management Information System (ADMIS) to better identify IVDUs as of July 1, 1991 and began the implementation of an CSAT approved action plan.
The ADAP had grant assurances signed by the funded providers and did follow-up monitoring visits.
The ADAP did this by desk review of monthly treatment utilization reports by the funded providers and required grant assurances.
The ADAP had directed its funded providers to insure that IVDUs receive priority access to treatment services by moving known IVDUs into the next available treatment slot an placing them in out-patient services until they can be admitted to the program.
The ADAP did implement a pilot comprehensive street outreach program for IVDUs on April 1, 1992 in the three highest areas of HIV-f/AIDS in the State of Arkansas (Fayetteville, Little Rock and Pine Bluff).
ATTACHMENT 5: WAIVERS
The State of Arkansas, Bureau of Alcohol and Drug Abuse Prevention does not plan to apply for any waivers for the FY1994 Substance Abuse Prevention and Treatment Block Grant.
ATTACHMENT 6: TOBACCO SALES TO MINORS AND LAW
ENFORCEMENT
Discussions have begun with the state Alcohol Beverage Control agency to initiate a process of random buys by underage individuals. It is anticipated these enforcement provisions will be in place by October 1, 1994.
ATTACHMENT 7: PROGRAM COMPLIANCE MONITORING
In order to satisfy compliance of monitoring the admission criteria for IDU clients under section 1923, the ADAP uses several methods.
For the special programs for pregnant women, and for HIV and TB services, accreditation visits and case record reviews are the primary methods of compliance monitoring.
ATTACHMENT 8: INDEPENDENT PEER REVIEW
Beginning with the Substance Abuse Prevention and Treatment (SAPT) Block Grant application for FY1995, the Bureau of Alcohol and Drug Abuse Prevention will address compliance of the Independent Peer Review. This section is not applicable for the FY1994 application.
ATTACHMENT 9: CAPACITY MANAGEMENT AND WAITING LIST SYSTEMS
Currently, the ADAP calls each funded treatment program once a month, on the same day of the month to ascertain the following information:
Obviously, this method is not an adequate measurement for monitoring information regarding waiting lists. Therefore, during the current fiscal year the ADAP conducted a survey of how other states monitored their waiting lists and the particular information they gathered. With some modification, the ADAP has developed a system similar to the one established in Colorado. Basically this will involve the following changes:
An on-line ADMIS reporting system is being developed with our treatment provider within the Arkansas Department of Correction. The ADAP will test this ADC pilot system by July 1, 1994, with the final implementation target date of a statewide on-line system being July 1, 1995, thus assuring timely capacity management information.
ATTACHMENT 10: TB AND EARLY INTERVENTION SERVICES FOR HIV TB SERVICES
In the fall of 1992, while still a part of the Department of Human Services, the Single State Agency (SSA) began a dialogue with the Arkansas Department of Health Tuberculosis Division. The ensuing discussions centered upon what pro-active steps could be implemented to assure that the publicly-funded AOD treatment programs in Arkansas did not experience outbreaks of active tuberculosis among its client population. The SSA negotiated a Memorandum of Agreement with the TB Division that called for, among other things, the training of AOD treatment facility staff in the administration and interpreting of TB tests, the mandatory testing of all clients entering residential treatment, a confirmatory x-ray by the local county health unit of all clients having a positive TB skin test, and prophylactic intervention and assignment of a primary physician for those clients in need of such intervention. The Agreement also provided for the TB Division to do an on-site survey of all residential AOD treatment facilities funded by the SSA to determine the appropriateness of placing Ultra Violet-C (UVC) germicidal lights in said facilities to protect both clients and staff. The UVC fixtures and light bulbs were provided through a 50-50 matching grant to those facilities that could accept the placement of the fixtures. The TB Division is providing the installation of the fixtures at no cost to the facilities and SSA staff monitor the cleaning and maintenance of the fixtures during routine site visits for compliance and records reviews. William Stead, M.D., Director of the TB Division, has determined that placement of UVC fixtures in outpatient-only clinics is not indicated at this time. This remains an option if the need arises.
In that the SSA was legislatively-transferred to the Arkansas Department of Health on July 1, 1993, the close working relationship established with the TB Division prior to the transfer, has carried on into this year. The Memorandum of Agreement also calls for joint visits to AOD treatment providers, at least quarterly meetings to discuss relevant issues of mutual concern, and cross training to foster better understanding of AOD and TB programs. A staff member of the TB Division was part of the Arkansas State Team that attended the Legal Action Center's Confidentiality and Health Records training held in Kansas City, Missouri in September, 1993. This resulted in confidentiality training being provided to TB Division staff by an SSA staff member in December, 1993. The SSA also negotiated a model Qualified Service Organization Agreement with the TB Division which each AOD treatment provider has used to establish a QSOA with the TB Division, thus fostering and facilitating a closer working relationship.
FARLY INTERVENTION SERVICES FOR HIV
Beginning with treatment grants effective July 1, 1994, the three current IDU street outreach programs will add an HIV intervention services component to their programs, namely, a physician who will provide all services as defined in § 96.121 of the March 31, 1993 Interim Final Rules. Furthermore, an agreement will be implemented which satisfies all requirements listed in §1923 of the Public Health Services Act concerning the provision of interim services in conjunction with the admission requirements of this Section.
In particular, a physician will be retained at each of the treatment programs of Decision Point in Springdale, CASAP in Little Rock, and HDRS in Pine Bluff. These physicians will perform, at a minimum, the following:
* Will perform on-site HTV anti-body testing, pre-test and post-test counseling, and on-going counseling for HTV clients.
* Will arrange for monitoring of HIV clients' CD4 counts on a regular and as needed basis.
* Will screen for TB and monitor HTV clients who are also positive for TB.
* Will medically treat HIV clients, especially for the opportunistic diseases associated with HIV infection.
* Will contact the local Ryan White consortium to arrange for medications e.g., AZT, ddl, ddC, d4T, etc.
* Will arrange for procurement of nutritional supplements.
* Will make other appropriate referrals for HTV clients.
* Will, in general, perform the tasks of a case manager, in conjunction with the AOD treatment provider, for HIV clients.
In addition to these direct client services, these physicians will provide the staff of their respective treatment centers with in-service training on HTV related issues, will keep staff updated on the statistical trends of HIV in Arkansas, and will assist in the development of policies, procedures, protocols, or other types of guidelines for improving services to HIV clients.
In that the SSA was legislatively-transferred to the Arkansas Department of Health on July 1, 1993, the close working relationship established with the AIDS/STD Division prior to the transfer, has carried on into this year. The Memorandum of Agreement also calls for joint visits to AOD treatment providers, at least quarterly meetings to discuss relevant issues of mutual concern, and cross training to foster better understanding of AOD and AIDS/STD programs. A staff member of the AIDS/STD Division was part of the Arkansas State Team that attended the Legal Action Center's Confidentiality and Health Records training held in Kansas City, Missouri in September, 1993. This has resulted in a better understanding of the confidentiality requirements that AOD treatment providers are subject to. The SSA also negotiated a model Qualified Service Organization Agreement with the AIDS/STD Division which each AOD treatment provider has used to establish a QSOA with the AIDS/STD Division, thus fostering and facilitating a closer working relationship.
007.25.94 Ark. Code R. 001