The Butler County Alcohol and Drug Addiction Services Board

 

Community Plan for SFY 2010-2011

 

May 1, 2009

 

· The Butler County Alcohol and Drug Addiction Services Board ·


Mission Statement

 

The mission of the Butler County Alcohol and Drug Addiction Services Board is to develop, maintain, and continuously strive to improve a system for the provision of, education about, and services to prevent and treat alcohol and drug addiction in Butler County.

 

Vision Statement

 

 

Residents of Butler County who are or who may be directly or indirectly affected by substance abuse will lead healthier, safer, and more productive lives.


Environmental Context for the Community Plan:  Board Area and Clients Served

 

General Characteristics

 

Butler County's overall population increased from April 2001 to July 2007 by 7.6%. White collar workers constitute 61% of the population and the median estimated household income in 2007 was $47,885. Seventeen percent of residents do not have a high school diploma. About 7% are black, and the Hispanic/Latino population constitutes 2.5% of the total population. The county is a mix of rural, sub-rural, suburban and urban areas with six cities and seven villages. The county has an aging population with just over 11% being 65 and older. The poverty rate is 5.4%.

 

Also see document at the end of this narrative “Alcohol and Other Drug Abuse and Addiction in Butler County”.

 

Major Recent Trends and Factors

 

The county's unemployment rate is increasing as major employers such as Miami University and county government itself implement recent layoffs.

 

Characteristics of Clients Receiving Substance Abuse Prevention Services

 

For almost a decade now the Board has chosen to direct the majority of its prevention funding toward school aged children who, through collaborative efforts with all of the public and private schools in the county, are either receiving general prevention education courses or problem identification and referral services at the schools. These services have shifted more into the latter category as schools have lost their Safe and Drug Free Schools funds and have been unable to provide intervention themselves as problems occur. The second largest group to receive prevention services from Board funded programs are high risk young children of women in treatment and low-income junior and senior high school minority children who are involved in their neighborhood community center programming.

 

The Board recently began funding environmental services for the first time in the form of a local coalition coordinator who addresses community and county-wide organizing and community norms around substance abuse issues.

 

The general public benefit from the awareness services the Board funds through an effort called Substance Abuse Awareness Week.


Characteristics of Clients Receiving Substance Abuse Treatment and Recovery Support Services

 

A series of tables from the Board's SFY2008 enrollment and behavioral health data are available upon request that give many specifics regarding treatment client characteristics. Some significant trends have emerged from this data as the Board anticipates program development in the next biennium:

 

Clients Have Fewer Financial Resources -The percentage of clients identifying themselves as unemployed increased by five percent from SFY2007 to SFY2008. As one would also expect the percentage of clients contributing to their treatment costs in the form of a co-payment or identifying their own income as a source of reimbursement decreased as well.

 

Clients Either Have More Severe Concurrent Presenting Problems Or Providers Are Getting More Sophisticated at Identifying Concurrent Presenting Problems -The category of severely mentally disabled increased in one fiscal year by almost 10%. Suicidal clients increased from 3.4% to 7.2%. Almost 53% of clients identify themselves at admission as having a past psychiatric history.

 

Opiates Continue Be Abused by Increasing Numbers of Clients -Clients who are primary opiate users increased as an overall percentage of treatment cases as follows: 14% in SFY06, 15% in SFY07, and 19% in SFY09. This is largely an adult trend but we know from past history that adolescent behaviors follow adult trends and there is some anecdotal evidence that prescription abuse by adolescents is also increasing state-wide.

 

Provider Focus on Effectiveness with Clients Has Paid Off -Case dispositions of "client rejects continuation" or "client did not return" decreased from '07 to '08 from 34.5% to 27%. These two case dispositions are substantially higher in the adult population than they are in the adolescent treat population. Use during the past 30 days at case closure increased from 54.2% to 62.6% overall with adults reporting no use at 64% and adolescents at 52%.

 

Primary Substance is Highly Age Variable -Seventy percent of adolescents reported marijuana as their primary substance whereas about 15% of adults reported this as their primary substance.

 

As Providers Implement Cost Cutting Measures Satellite Offices Suffer -The percentage of clients from the Middletown area has decreased in one year from 31% to 25%.


Capacity to Provide Services/Access to Services

 

Access to Alcohol and Drug Prevention and Treatment Services

 

The biggest problem currently with access to services is waiting lists for major categories of service delivery, especially higher levels of care. Men's residential services currently averages a waiting list of 50 people and women's residential services averages a waiting list of 30 people. There is also a long waiting list for intensive outpatient services, especially at the Middletown office of the Board's primary outpatient provider. Limited detoxification funds and the increasing demand on these funds by opiate users who can benefit from medication assisted treatment led the Board to suspend detoxification admissions nine months into the current fiscal year.

 

Waiting list problems are complicated by federal regulations requiring providers to give precedence to intravenous drug users. The end result of this requirement in times of long waiting list periods results in clients who are not opiate users not getting services for months on end if ever.

 

Strengths regarding access to services include provider contractual requirements and monitoring regarding special populations including deaf and hard of hearing, veterans, and ex-offenders. There have been no reports of difficulty of special populations having problems accessing services during the last community plan period. In addition treatment providers have instituted walk in assessments days that have resulted in no waiting time for assessment services.


Workforce Development and Cultural Competence

 

The local service system does not have sufficient numbers of qualified licensed and credentialed staff although current economic struggles have resulted in less staff turnover and opportunities for the field to promote itself in order to recruit bright, motivated people who are unable to enter higher salary jobs. Major treatment providers report that Chemical Dependency Certified Assistants (CDCAs) require more supervision in the form of co-signature for all billable services that is not feasible or cost effective. Salaries have not been competitive in recent years with the for-profit system resulting in high turnover of the best trained and qualified staff. A typical scenario is that providers hire and train inexperienced staff and once these staff persons have developed both experience and qualifications they are lost to higher paying jobs. Workforce development is inseparable from funding concerns and budgetary approaches. Continued workforce development efforts are needed particularly in the area of best practices and techniques.

 

One approach that both major treatment providers are using is the hiring of area college students working on social work or psychology degrees as short term interns. This approach is commonly used in private sector companies to recruit, train, and "test drive" employees with college degrees. An increased emphasis on hiring college graduates who are licensed social workers has been both cost effective and cost beneficial. The Board for several years has been working with providers not only to keep staff productivity high but also to keep service rates at levels where salaries can be more competitive. This has resulted in more effective treatment but has also contributed to the problem with access to services. In the end the Board has concluded there is little point in spreading low quality services too thinly in an attempt to meet demand but in the end not fulfill the need for effective treatment.

 

Treatment providers have mandatory training schedules for all employees in cultural competency some of which are offered online. Specifically Dr. Edward Nickel offered a day of cultural competency training for chemical dependency workers in SFY2009.

 

The Board's Director of Clinical and Program Development is responsible for working with providers on workforce development which she does in a variety of ways including chart reviews, utilization reviews, training coordination, and grant writing.

 

New staff of the Board's major prevention provider are required to attend a nine month regional prevention class, which also serves as a route to prevention certification. The provider's associate director is one of the coordinators of this program. Staff  persons are required to attend an annual diversity/bias awareness in-service. The provider has also found that they are able to retain qualified experienced staff persons by offering a variety of incentives such as flex-time to employees. Prevention employees also have available to them a budget for attendance to workshops, conferences, and trainings.


Capital Improvements

 

Consistent with the Board's previous plan the Board has established its women's residential facilities located in older buildings as priority for capital improvements. Renovation is needed as well as expansion of space for additional beds.

Second, the current adolescent residential facility's location and condition has been identified as inadequate. A new facility for these services is also needed.

 

Financial Status

 

Impact of reduction in services

 

Any reduction in state funding will in all likelihood result in a decrease in the Board's adolescent outpatient funding. This group currently has minimal to no wait for services and other sources of funding such as Medicaid and state grant funds are more readily available for this population. A reduction in funding for this program will result in waiting lists developing for this service as well as one to two counseling positions would need to be eliminated resulting in a reduction of about 30 to 40 annualized treatment slots for non-Medicaid eligible adolescents.

 

Factors contributing to the costs of services

 

The factor that has most affected costs of services is retaining qualified staff. Salaries and benefits have had to remain highly competitive to decrease staff turnover resulting in increased quality of care and improved outcomes. Larger agencies such as Sojourner that have multiple sites have struggled with increased costs related to rent, insurance, utilities, and ongoing maintenance of buildings.

 

Most large training and technology initiatives have been funded by grants and have not contributed to the ongoing costs of service provision.

 

What cost-saving measures and operational efficiencies have been implemented?

 

The agencies most likely to survive the current state and federal funding reductions are those that have diversified. All of the Board's major providers have some lines of business that are supporting their cash flow and increased costs of their nonprofit publically funded alcohol and other drug programming. New contracts with entities that refer significant numbers into treatment has also been a successful approach. Sojourner, for instance, is on track to bill Children Services of Butler County $500,000 this fiscal year. Agencies have also let vacant positions go unfilled and the Board's providers maintain very high productivity standards for direct service personnel. Programs have been downsized. The county has fewer men's and women's residential beds than it had in prior years. The Board has also put some amount of effort into trying to convince funding entities to relax restrictions so that monies can be utilized where they are most needed locally.

 

Other budgetary planning efforts

 

The Board itself is looking to reduce its administrative budget as much as possible by offering employees opportunities to reduce hours per week, to work at home thus saving on time and parking costs, and by doing work in-house that was previously contracted out such as printing.


Section II: Capacity Development

 

Access to Services

 

Prevention services will be expanded by Board and provider collaborative efforts via the County Coalition. The Coalition has already applied for and received new grant funds for Fetal Alcohol Spectrum Disorder training and is waiting to hear about a recent federal grant application. Continued efforts to expand prevention efforts via diverse funding applications and collaborative efforts will continue as the Coalition picks up momentum and support throughout the county.

 

New sources of funding and maximum use of existing funding will be the Board's main effort in addressing access to inadequate treatment services.

 

Continued emphasis on provider diversification, new contracts with traditional large referral source entities, applying for local, state and federal grant applications will all be completed. With regard to maximum use of existing funding the Board and its providers will be insuring that Medicaid and insurers are billed in every possible circumstance and expanding efforts to secure client co-pays including the possibility of establishing minimum co-pays for all clients will be examined.

 

Workforce Development and Cultural Competence

 

The Board will continue to utilize grant funding and new contracts with large traditional referral sources in order to secure additional funding that will allow for salaries to be increased in order to recruit and retain qualified experienced staff persons and to provide trainings in best practices and techniques for staff. The Board will continue to have on staff its Director of Clinical and Program Development who will be responsible for providing leadership in a variety of ways to provider staff including new program development oversight, and chart audit and utilization review summaries to providers. Staff trainings will be organized for the system as a whole by the Director of Clinical and Program Development. The Board's focus for the SFY2010/2011 plan period will be on promoting, training, and implementing the NIATx model of system change and development. As part of the NIATx model implementation at the provider level the areas of consumer satisfaction will be a major factor in choosing change projects. Already the NIATx model is being utilized by providers to address access to service problems and treatment outcomes in the form of implementing changes to reduce no-shows and increase client engagement and retention thus resulting in better outcomes.

 

We hope to change the basic nature of our able and willing provider system into a cultural environment that promotes continual reassessment and examination of treatment approaches and milieus to make adjustments that result in improved client satisfaction and outcomes.

 

Capacity Development Targets

 

Increase diversity of revenue sources to support Ohio's Alcohol and other drug system (e.g., apply for foundation and SAMHSA discretionary grants).


Section III: Prevention Services

 

Prevention Needs

 

Needs Assessment Methodology

 

With the assistance of a consultant in the field the Board completed a broad prevention planning process three years ago (report issued in April 2006) that identified several opportunities to expand the range of services it funds and potential threats to existing services. This process utilized the expertise of area prevention providers, Center for Substance Abuse Prevention frameworks and guiding principles, and a series of meetings and interviews with large referral sources such as Children Services, school representatives, Family and Children First staff, treatment provider staff, and community leaders. PRIDE survey data, household survey data, census data, Board provider client data, and service data from prevention providers were utilized in the analysis of need.

 

Needs Assessment Findings

 

The major outcome of the above process was the Board's decision to prioritize and commit funding to the development of a county-wide coalition coordinator during its last community plan period. This coordinator has been hired and is assessing community need and community readiness as part of her duties. Of the Board’s existing prevention programming, school-based prevention education and problem identification and referral services are in demand over the current capacity. Other significant gaps in prevention services identified by the prevention planning process include:

 

* Universal ATOD specific prevention education in the schools,

* Prevention targeted at general adult populations,

* Prevention targeted at known high risk populations, such as Children of

Alcoholics/Addicts,

* Prevention efforts targeting environment factors,

* Coordination of prevention efforts at the local community level, as well as county-wide,

* Data collection, coordination and communication.

 

Prevention Priorities

 

Method for Determining Prevention Priorities

 

The process to determine need was also instrumental in determining SFY2010-2011 prevention priorities for the Board and ended in an all day Board retreat with the prevention consultant. As a follow up project to the retreat the Board members themselves undertook a series of interviews with members of the community to gauge how the general public and certain groups of stakeholders perceived community needs. The Board's basic premise was that investing in coalition activities first would maximize the amount of cross-system multi-sector collaborative efforts that would result in increased funding opportunities to implement other needed services.


The Board's prioritization process was quite expansive and included a wide range of systems of needs. Implications to these systems include decreased problems created by substance use in any milieu including communities, schools, families, and other social serving systems. The Board was very cognizant of all of these factors in determining its priorities.   Please see document “Board Priorities” at the end of this narrative.

 

Prevention Investor Targets

 

Please see document, "Butler County ADAS Board Investor Targets" at the end of this narrative.

 

Section IV: Treatment and Recovery Support Services

 

Treatment and Recovery Support Needs

 

Needs Assessment Methodology

 

The driving force behind the Board's determination of treatment needs was current problems with waiting lists for treatment and the input the Board has received from its providers and referral sources about the severe difficulties they face when clients are unable to receive treatment in a timely fashion, especially at higher levels of care. Providers submit monthly waiting lists to the Board that are subject to guidelines established by ODADAS and the Board so data is quite current. In meetings with providers held over the past three months it was clear that their main concern was inadequate treatment slots for core services to the general public such as intensive outpatient and non-Medicaid residential services.

 

Other sources of data considered over the past three months in determining treatment priority needs include:

 

* Referral source survey summaries (fall, 2008)

* PRIDE adolescent use survey summaries (2008 results)

* SFY2008 client data outcomes in the form of 30 day use at closure and case disposition

 

Board and provider staff are members of all committees of the Family and Children First Council (FCFC) and receive input from families receiving services. Also the FCFC provides annual reports to the Board on services and needs as part of its relationship with ABC and FAST funds.

 

The Board has a SA/MI Program that has fidelity reviews and program development meetings that the Board's Director of Clinical and Program Development is involved in. Feedback from this program drives the Board's priorities with regard to the SA/MI population.

 

Information is gathered from clients in the form of contractually mandated consumer satisfaction surveys which are gathered by the Board every quarter. As part of its interviews of community members the Board included persons receiving treatment services.  Please see document “Board Member Tallies” at the end of this narrative.


Treatment and Recovery Support Priorities

 

Method for Determining Treatment Priorities

 

The Board interviewed members of the community, reviewed SFY2008 referral source survey reports, requested the input of its provider system in writing as well as in a series of meetings, reviewed treatment outcomes data generated by its providers and the Behavioral Health Data module for SFY2008. SFY2008 and SFY2009 demand for services based on assessments that take careful consideration of level of care needed as well as treatment outcomes of programs were the most strongly weighted factors in deciding the most important areas in which to invest resources.

 

Grouping of Priorities (High, Medium and Low)

 

See attached document, "ADAS Board Priorities -Worksheet" at the end of this narrative.

 

Implications of Identified Priorities to Other Systems

 

If the Board is unable to address its needs individuals who may have recovered as a result of treatment will go on abusing substances. This may result in loss of wages or suspension/expulsion from school, stress on families, increased traffic accidents, criminal behavior and the subsequent load on the community and courts/probation of this behavior, loss of custody of children, and the onset of mental and physical health problems.

 

As a result, systems set up to address criminal behavior will be overloaded with offenders whose underlying problem is substance abuse but the system has no options for making referrals to address this underlying issue. Systems that monitor child welfare will be forced to take custody of children from their parents. Families will suffer from the loss of income from lost jobs and will be forced to seek assistance. The behavioral and physical health care industries will see increases in clients with serious secondary symptoms related to their alcohol and other drug abuse.

 

Treatment and Recovery Support Investor Targets

 

See document, "Butler County ADAS Board Investor Targets" at the end of this narrative.


Section V: Collaboration

 

Benefits/Results Derived from Collaborative Relationships

 

The Board’s primary collaborative entity is the criminal justice system. One-third of adolescent treatment referrals and just under half of adult referrals come from this arena. The Board has a Common Pleas Drug Court, a Common Pleas SAMI Court, a Juvenile Court Program, and a Family Court Program. These specialized courts result in better integration of the criminal justice and AoD systems goals for clients that hold them more accountable and results in improved treatment outcomes.

 

The Board has a close working relationship with the Health Foundation of Greater

Cincinnati (HFGC). The Board and its providers, thanks to past successes with program development utilizing HFGC grants, received three grants from HFGC in SFY09. The Foundation is not just about awarding grants, it is a planning and training entity that assists local communities in developing expertise and solid planning processes. One current planning grant from HFGC is researching the benefits of alternative health practices for clients which includes a local court system, Children Services, and two physicians. Another current grant is resulting in the development of a new multiple DUI offenders program to work with three area courts. This program will also result in clients who would traditionally add to the waiting lists for outpatient services being redirected into a specialized program that better suits their needs.

 

The ODADAS STAR-SI initiative in conjunction with the NIATx initiative funded by HFGC has been an opportunity for the two major treatment providers to work together to create more seamless step-down from non-medical residential to intensive outpatient care. This has also resulted in the providers paying closer attention to the time individuals are waiting for services for each level of care and to put mechanisms in place to track this data better including the ability to import and query centralized data systems to keep information more current and usable.

 

The new Butler County Community Coalition Initiative has brought the Board into closer and more functional working contact with its major prevention provider. Members of the community are being recruited into the Coalition's projects and a large federal grant proposal has been submitted.

 

The Board has developed a medication assisted treatment program for opiate and alcohol users. Working in collaboration with local psychiatric experts as well as pharmaceutical companies has assisted in paying for some of the program expenses as well as developing expertise in this new area of treatment. This collaboration has resulted in improved retention rates and outcomes for opiate derivative users and one provider's decision to open a for fee methadone clinic.

 

The Board conducts an annual satisfaction survey of its funded providers and includes the providers in meetings, retreats, and planning activities. The provider network has been very stable and successful over the past decade. There is a fundamental mutual trust between them and the Board that helps them feel cooperative and important as the Board undertakes new initiatives and monitors their performance.


Most of the Board’s prevention programming is conducted in collaboration with ten public school districts and one private school in the county. As a provider staff person put it, "Everything we do is collaboration with one or multiple systems." The prevention provider has an ongoing group of drug free school representatives who gather to discuss programming. They also do programming at the juvenile court, and the local Head Start Program. Benefits of these collaborations include sharing of expertise and resources such as manpower and space and the results are increased shared responsibility, ownership, and effective delivery of services.

 

Staff of the Board is involved in various committees of the Family and Children First Council. The FCFC is the Board’s chosen recipient of both its FAST and ABC funds.

 

Clients and consumers of services have three main avenues for participation in the Board’s planning process: Client complaint, client grievance, and client satisfaction surveys. The Board’s associate executive director handles client complaints and grievances on a case-by-case basis according to established policies and procedures. Often, individual complaints and grievances lead to broader system improvement efforts that are initiated and monitored by the Board’s CQI committee. Client satisfaction surveys are administered by the treatment providers and summarized for the Board.

 

Consultation with county commissioners regarding services for individuals involved in the child welfare system

 

C -The Board continues to utilize all of its ODADAS HB 484 funds as well as the

ODADAS Family Drug Court grant to provide services to clients of Children

Services (CS) and will do so into the next plan period. During the SFY08-09 biennium Board staff worked with a broad spectrum of individuals from the social serving system and representatives from the commissioners’ office to develop a federal grant proposal to expand services to clients of Children Services. The proposal was funded and it has resulted in the Board's two major treatment providers as well as its major prevention provider in obtaining contracts for services totaling over $800,000. In order to assist in providing the best coordinated services possible the Board and its provider staff are now part of the CS Multi-Disciplinary Treatment Team. In addition Butler County Children Services now reimburses the Board for the local match portion of Medicaid bills for clients they send to out of county providers.

 

Involvement of customers and the general public in the planning for service provision

 

D -The members of the Board completed a series of interviews with members of the community that are summarized in an attached document. These interviews asked about perceptions of problems, severity of problems, personal experiences, and possible solutions to the problems. In addition the Board's County Coalition Initiative has led to the involvement in discussions about substance abuse members of local communities in towns such as Fairfield and Middletown.


Section VI: Evaluation

 

Board’s Approach to Evaluating the Effectiveness and Efficiency of Services in the Overall System of Care

 

A - The Board examines its providers' service rates in comparison to budget, previous years, and other comparable agency rates. Also the Board monitors provider fiscal solvency through audits and contractually obligated reporting about loans including lines of credit.

 

* The Board examines weekly unit billings and budgeted unit rates to determine productivity of staff.

* The Board conducts regular non-Medicaid claims audits to determine accuracy of billing.

* The Board examines client outcomes at its providers and by sub-groups when needed. Behavioral health data have two outcome elements the Board utilizes: Case disposition and 30 day use at case closure. The Board also provides an opportunity to its providers to submit any additional outcomes studies they have completed. In the past these have included 90 and 180 day follow up interviews, pre-and post-test for prevention programs, as well as milestones tracking and reporting. The Board annually requests its providers to select investor targets from the Board's and report on their success in meeting these targets. In addition providers submit twice a year a report summarizing how they integrated their outcomes data into their quality improvement process (i.e., what did they do in order to respond to the data?)

* The Board examines the following agency management of customers: Waiting list monthly, grievances quarterly, utilization review of charts quarterly, and client satisfaction surveying semi-annually.

* The Board examines providers own internal quality improvement process including a Board level element of intra-system referral quarterly.

* The Board examines on an annuals basis the following provider performance elements: Referral source satisfaction surveys, personnel qualifications and retention, participation in quality improvement both at the Board and agency level, contract compliance, independent peer review summaries, and a broad spectrum of client characteristics taken from enrollment and admission and closure data.

 

Collaboration with the Agencies in Evaluating Services

 

B -The agencies assist the Board in determining both the components of the annual evaluation process and its time frames. The providers are the ones who submit most of the information for evaluation reporting unless it can be obtained from an independent source. Board staff persons assist the providers in anyway possible including interpreting and writing results.


Services or Programs Having the Highest Priority for the Evaluation of Effectiveness and/or Efficiency

 

C -Newly developed programs that target special populations of clients have the heaviest burden of proof of effectiveness or efficiency. These programs often have more than just the Board as an interested funding party and funders are interested in improved outcomes in order to duplicate strategic approaches to treatment or prevention. In Butler County new programs have ongoing development committees that can include one to four members of the Board staff (totaling five) thus oversight can be intense and the reporting requirements are often above and beyond any established ongoing programming. Also in terms of cost effectiveness if a specialized or target program does not result in better outcomes than the programs for the general public then it is unlikely to maintain its funding after a few years as target programming tends to be more expensive.

 

Using the Results from the Evaluation of Programs/Services

 

D -Evaluation results lead directly to funding decisions. If a program is proving itself cost effective the program is much more likely to have stable funding from the Board or the Board is much more likely to apply or make appeals for funding for the program to another source. Evaluation results are also shared with other interest funders and used to decide whether approaches merit duplication in other programs, services, or agencies.

 

Strategies to Evaluate Child & Adolescent Services Versus Adult Services

 

E -Yes. School performance and retention in school leading to graduation are examined for children and adolescents rather than income earning potential, employment, or days worked. Also, family dynamic is a more closely examined and treated problem area as adolescents in order to recover must repair relationships with those responsible for their well-being. For adults one outcome that is often examined is reunification with their children if the children have been placed in custody while the parent is a client of Children Services.


Alcohol and Other Drug Abuse and Addiction

In Butler County, Ohio

 

Butler County Alcohol and Drug Addiction Services Board

November 2008

 

Abuse and Addiction

Some Compelling Facts

 

  • 2.6 million Americans (9.2% of persons aged 12 and older) have alcohol or other drug abuse and addiction problems. (National Survey on Drug Use and Health, 2006)

 

  • One in four Americans will have an alcohol or drug problem at some point in their lives. (National Center on Addiction and Substance Abuse at Columbia University)

 

  • More than half of all adults have a family history of alcoholism or problem drinking. (National Council on Alcoholism and Drug Dependence)

 

  • 25% of Ohio health care costs result from problems arising from abuse and addiction. (Ohio Association of County Behavioral Health Authorities)

 

  • 75-80% of Ohio inmates are in need of substance abuse treatment. (Ohio Association of County Behavioral Health Authorities)

 

  • Over 70% of cases of child abuse and neglect are caused by or exacerbated by substance abuse and addiction. (Ohio Association of County Behavioral Health Authorities, National Center on Addiction and Substance Abuse at Columbia University)

 

  • Fetal alcohol syndrome is the leading cause of mental retardation. (National Council on Alcoholism and Drug Dependence)

 

  • 70% of those with alcohol or other drug abuse or addiction are employed.  One of ten employees suffers from substance abuse. (Ohio Department of Alcohol and Drug Addiction Services)

 

  • The conclusion that addiction treatment is effective is demonstrated in over 600 published scientific papers. (Mid-America Addiction Technology Transfer Center)

 

  • Numerous studies report savings from $4 - $7 for every dollar invested in treatment or prevention of addiction (decreased crime, improved health, increased employment/productivity). (Mid-America Addiction Technology Transfer Center)

Alcohol and Other Drug Use by Butler County Youth

 

BACKGROUND:  The data source for use of alcohol and other drugs by Butler County youth is the Pride Survey conducted biannually by the Coalition for a Drug-Free Greater Cincinnati (CDFGC).  About 10,000 7-12 grade students in Butler County participated in the most recent survey (released in 2008).  The multi-county region surveyed by CDFGC includes Butler, Brown, Clermont, Hamilton, and Warren counties in Ohio, and Boone, Campbell, and Kenton counties in Kentucky.  Regular use is defined as using at least once a month over the previous year.  Regular (at least monthly) use is one of the four core measures required by the federal Drug-Free Communities grant program.  A change of two or more percentage points in the Pride Survey is considered significant.

 

DATA:  Use of alcohol, tobacco, and marijuana by Butler County youth has been markedly declining over the last several years.  However, on some measures, use by Butler County youth exceeds regional and national rates.

 

                                    Butler County 7th to 12th Graders

 

Regular Use by 7th to 12th Graders – Comparisons (2008)

 

 

 

 

 

Butler County

Region

National

Alcohol

23%

20%

21%

Tobacco

18%

15%

16%

Marijuana

12%

10%

10%

 

 

Regular Use by 12th Graders – Comparisons (2008)

 

 

 

 

 

Butler County

Region

National

Alcohol

45%

41%

44%

Tobacco

36%

27%

32%

Marijuana

23%

19%

20%

 

 

Other Core Measures Related to Youth Use of Alcohol and Other Drugs

 

BACKGROUND:  In addition to regular use of alcohol, tobacco, and marijuana, the other core measures of the federal Drug-Free Communities grant program are: perception of risk, peer and parent disapproval, and age of onset.  The data presented for these measures are also from the Pride Survey.  As perception of risk, peer disapproval, and parental disapproval increase, likelihood of use declines.  Early age of onset of use is correlated with greater likelihood of substance abuse and addiction problems in adulthood.

 

DATA SUMMARY FOR THESE CORE MEASURES:   Overall, perception of risk seems to have remained rather constant while peer and parental disapproval have been trending in the preferred direction.  Perception of risk is highest for tobacco, followed by marijuana and then alcohol.  Peer and also parental disapproval are highest for marijuana, followed by tobacco, and then alcohol.  Age of onset of use is trending upwards, the preferred direction.

 

Perception of Risk: The question Do you feel the following drugs are harmful to your health is used to measure this statistic by reporting the percentage of students who report that using the drug is Harmful or Very Harmful to their health.  Perception of risk seems to have remained constant with perception of risk highest for marijuana, followed by tobacco, and then alcohol.

 

 

Perception of Peer Disapproval: The question, Would your friends disapprove of you…is used to measure this statistic by reporting the percentage of students who report that friends would Disapprove or Strongly Disapprove of their using alcohol, tobacco, and marijuana.  Peer disapproval has been increasing with disapproval highest for marijuana, followed by tobacco, and then alcohol.    

 

 

Perception of Parental Disapproval: The question Would your parents disapprove of you is used to measure this statistic by reporting the percentage of students who report that parents would Disapprove or Strongly Disapprove of their using alcohol, tobacco, and marijuana.  Parental disapproval has been increasing with disapproval highest for marijuana, followed by tobacco, and then alcohol. 

         

 

Age of Onset: The question, At what age did you first use…is used to measure this statistic. The possible responses to this question range from 8 or Under to 17 or Older. The table shows the age range that represents the average category score for this question of those students who answered the question with a response other than Never Used.  Age of onset of use is trending upwards, the preferred direction.

 

Alcohol and Other Drug Use, Abuse, and Dependence - Persons 12 and Older

 

BACKGROUND:  The data for this section are drawn from the National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration.  This survey involves interviewing approximately 67,500 persons each year.  Sub-state data are available for Butler County on some measures in some survey years but the small sample size results in a wide margin of error. 

 

DATA:   Estimated use of alcohol, marijuana, and other illicit drugs in Butler County by persons ages 12 and older are very similar to state and national estimates.  The binge drinking rate, however, is higher in Butler County than in the state and national estimates.  According to national estimates, binge drinking peaks in the early twenties. (Binge drinking is defined as 5 or more drinks on one occasion.)  The total estimate for past year dependence or abuse of illicit drugs or alcohol was higher for Butler County (9.6%) than for the state and nation (9.2%).  The estimated total number of persons ages 12 and older in Butler County with past year dependence or abuse of illicit drugs or alcohol is approximately 28,600 people.  

 

 

National Data                

 

Past Month Use – Persons Ages 12 and Older, Comparisons (2006)

 

 

 

 

 

Butler County

Ohio

National

Alcohol

50.5%

51.1%

51.0%

Marijuana

6.1%

6.1%

6.1%

Other Illicit Drugs

3.4%

3.4%

3.7%

Binge Drinking

25.1%

23.8%

22.8%

 

  

Dependence or Abuse of Illicit Drugs or Alcohol – Past Year

Persons Ages 12 and Older (2006)

 

 

Butler County

9.6%                 28,600 people

Ohio

9.2%

National

9.2%

 


Drinking and Driving

 

BACKGROUND:  Driving under the influence of alcohol is a major contributor to traffic accidents and fatalities.  The national statistics on drinking and driving are derived from the National Survey on Drug Use and Health while Butler County statistics on alcohol-related arrests and crashes have been provided by the Butler County DUI Task Force.

 

DATA:  According to national statistics, driving under the influence has been declining in recent years with an estimated 12.4% of persons aged 12 and older reporting driving under the influence in the year prior to the 2006 survey.  Driving under the influence is age related (and peaks in the early twenties) and gender-related with males nearly twice as likely as females to drive under the influence.  For the five year period ending in 2007, Butler County DUI arrests and alcohol-related crashes appear to be declining but remain significant.  No reason has been provided by the DUI Task Force for the lower numbers reported for 2005.  

 

Butler County – Arrests and Crashes

 

 

 

 

 

 

 

2003

2004

2005

2006

2007

 

 

 

 

 

 

Arrests

1667

1548

641

1529

1203

Crashes

511

536

200

421

369

 


Alcohol, Other Drugs and Crime in Butler County

 

BACKGROUND:  The source of data for violent and property crimes in Butler County is the uniform crime report data made available by the Ohio Department of Alcohol and Drug Addiction  Services (ODADAS).  The estimated percentages for alcohol and drug related crimes are also made available by ODADAS.  Information about number of admissions to the Butler County Jail, number of these with drug charges, average length of stay of inmates (19 days), and estimated cost per inmate per day ($55) have been provided by the Butler County Jail.  Estimated total number of inmates with alcohol and other drug problems has been calculated using the estimate provided by ODADAS and OACBHA of 75% of Ohio prison inmates having alcohol and other drug problems.  

 

DATA:  Alcohol and other drugs are major contributors to violent crime and property crime in Butler County.  Close to 4000 persons were admitted to the Butler County Jail in 2007 with drug charges.  Based on state percentage estimates, close to 9000 persons in need of alcohol and other drug treatment were admitted to the county jail in 2007.  The cost to the county for the detention of persons with alcohol and other drug problems is estimated at over $9 million in 2007.

 

Violent Crime in Butler County (2005)

 

Total

Estimated Alcohol-Related

Rape

201

46 (23%)

Robbery

412

12 (3%)

Assault

677

203 (30%)

 

 

Property Crime in Butler County (2005)

 

Total

Estimated Drug-Related

Burglary

2828

848 (30%)

Larceny

10,199

3060 (30%)

Motor Vehicle Theft

919

64 (7%)

 

 

Butler County Jail (2007)

Number of Admissions

11,984

Number with Drug Charges

3,919 (33%)

Estimated Number with Alcohol/Drug Problems

8,988 (75%) (1)

Estimated Cost of Offenders with Alcohol/Drug Problems

$9,392,460 (2)

 

(1) Calculation based on percentage of offenders in Ohio prisons with alcohol and drug problems as estimated by the ODADAS and the Ohio Association of County Behavioral Health Authorities

(2)Calculation based on average length of stay (ALOS) of 19 days and estimated average daily cost of $55


Fetal Alcohol Spectrum Disorder (FASD)

 

BACKGROUND:  FASD is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy.  These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.   FASD includes Fetal Alcohol Syndrome (FAS), the more pronounced disorder, and Fetal Alcohol Effects (FAE).  According to the Lewin Group, the total lifetime cost per person with FAS is $1.4 million to $2 million.  The national incidence of FAS is estimated at 2 births per 1000 while the national incidence of FAE is estimated at 8 births per 1000.  The total incidence of FASD (FAS and FAE) is estimated at 10 births per 1000 or 1 per 100.  

 

DATA:  Based on the number of Butler County births as reported by the Ohio Department of Health and the national incidence rates, it is estimated that there are approximately 50 births per year in Butler County of babies with Fetal Alcohol Spectrum Disorder and that 10 of these have Fetal Alcohol Syndrome. 

 

Estimated Incidence of Fetal Alcohol Spectrum Disorder (FASD) in Butler County

 

Butler County Births

Fetal Alcohol Syndrome (FAS)

Fetal Alcohol Effects (FAE)

Total (FASD)

2002

4566

9

37

46

2003

4768

10

38

48

2004

4800

10

38

48

2005

4901

10

39

49

2006

5125

10

41

51

 


Children Services

 

BACKGROUND:  It has been estimated that approximately 70% of child abuse and neglect cases and related out-of-home placements involve one or more parents with serious alcohol and other drug problems (Ohio Association of County Behavioral Health Authorities; National Center on Addiction and Substance Abuse at Columbia University).  The source for county data is Butler County Children Services.  It should be noted that Children Services recognizes the high prevalence of alcohol and other drug problems among the parents of children in their custody and currently has provider contracts for alcohol and other drug services in excess of $1 million.

 

DATA:  Alcohol and other drug problems are a major factor in out-of-home placements by Children Services.  It is estimated that on any given day, parental alcohol and other drug problems are a significant factor in the out-of-home placements of approximately 243 children in Butler County.  The estimated cost for these placements is over $6 million per year.  (This economic cost for placements is in addition to the personal and social costs impacting individuals and families burdened with addiction.)  It should also be noted that these costs are limited to costs associated with out-of-home placements. 

 

Alcohol and Drug-Related Out-of-Home Placements

by Butler County Children Services

Estimated average out-of-home placements

(# in placement 8/12/08)

347 (1)

Estimated average alcohol/drug-related out-of-home placements

243 (70%)

Average cost per placement per day (2008)

(blended rate for different placements)

$72 (2)

Estimated average cost per day for all alcohol/drug-related out-of-home placements

$17,496

Estimated total cost per year for alcohol/drug-related out-of-home placements

$6,386,040

 

(1)In 2007, average number of children in placement was 379.

(2)Based on 248 network placements @ $90.18 per day and 99 placements in homes @ $26.96 per day.


Butler County Capacity for Addiction Treatment Services

 

Background:   If no service capacity is available at the time of clinical assessment, clients are placed on a waiting list for the service for which they have been deemed to be appropriate.  Waiting list data are seen as an indicator of insufficient capacity to provide treatment services for persons requesting treatment and determined appropriate for treatment.   ADAS Board-funded treatment service providers routinely provide waiting list information to the ADAS Board.

 

Data:  According to waiting list data provided to the ADAS Board by its funded treatment agencies, 781 clients were placed on waiting lists in SFY 2008.  Of these, 433 clients (55%) were eventually admitted to treatment and 348 clients (45%) did not enter treatment.  For those clients eventually admitted from a waiting list, the average waiting period for treatment services was 46 days, ranging from a high of 75 days for men’s residential to 27 days for adult outpatient services.  Since funding has been reduced for adolescent outpatient services, it is expected that there will be a waiting list for these services in SFY 2009. 

 

Waiting List Data Summary (SFY 2008)

Number of Clients Placed on Waiting List

781

Number of Waiting List Clients Admitted

433 (55%)

Average Number of Days Waiting

(Those Eventually Admitted From Waiting List)

46

 

Average Number of Days From Assessment to Treatment

By Program Type (SFY 2008)

Program

Number of Days

Men’s Residential

75

Women’s Residential

55

Adolescent Residential

30

Adult Outpatient

27

Adolescent Outpatient

*

 

*Because of a reduction in funds allocated for this service, it is expected that there will be a waiting list for adolescent outpatient services in SFY 2009.


Summary of Data Highlights

 

1.                 Rates of regular use of alcohol, tobacco, and marijuana by 7th to 12th graders in Butler County have been declining over the past few years but remain higher than regional and national rates.  Close to half of Butler County high school seniors (45%) are regular users of alcohol.

 

2.                 Estimated use of alcohol, marijuana, and other illicit drugs in Butler County by persons ages 12 and older are very similar to state and national rates. 

 

3.                 The rate of binge drinking is higher in Butler County than in state and national estimates.  Close to half (47%) of persons 18 to 25 years old in Butler County engage in binge drinking.

 

4.                 It is estimated that almost 1 in 10 persons (9.6%) in Butler County 12 years of age and older has a substance abuse problem.  This amounts to approximately 26,800 persons. 

 

5.                 Nationally, the rate of driving under the influence has been declining.  Driving under the influence is age-related (and peaks in the early twenties) and is gender-related with males nearly twice as likely as females to engage in this behavior.  In Butler County DUI arrests and alcohol-related crashes seem to be declining but remain significant.

 

6.                 Alcohol and other drug use is a major contributor to crime.  In 2007, it is estimated that the Butler County Jail admitted almost 9000 persons in need of alcohol and other drug treatment.  The cost to the county for the detention of such persons is enormous and estimated at over $9 million in 2007.

 

7.                 It is estimated that there are approximately 50 births per year in Butler County of babies with Fetal Alcohol Spectrum Disorder and that 10 of these have Fetal Alcohol Syndrome.  These preventable disorders exact enormous personal and economic costs.

 

8.                 It is estimated that on any given day in Butler County, approximately 243 children are in out-of-home placements largely because of the alcohol and other drug problems of one or both of their parents at an annual placement cost over $6 million.

 

9.                 Waiting list data reveal that many persons requesting addiction treatment in Butler County are not admitted for treatment and that those who are eventually admitted from waiting lists wait an average of 46 days for admission with a high of 75 days for men’s residential treatment followed by 55 days for women’s residential treatment.


Butler County Alcohol and Drug Addiction Services Board

Community Member Input Form

 

Interviewer:  _________________________                        Date:  _______________

Name of Person Interviewed (Optional):  _________________________

Personal and Family Information:

Age

_2__ 18 – 20

_2__ 21 – 30

13__ 31 – 40

20__ 41 – 50

16__ 51 – 64

_3__ 65 and older

 

Employment Status

__1_ Student

_33_ Employed Full-Time

__4_ Employed Part-Time

__1_ Homemaker Full-Time

__4_ Retired

__8_ Disabled

 

Highest Educational Level

__1_ 8th grade

__3_ Some High School

_13_ High School Graduate

_12_ Some College

_27_ College Graduate

Ethnic Origin

_39_ White

_12_ African American

__2_ Hispanic/Latino

____ Asian/Pacific Islander

____ Native American

__2_ Mixed Origin

Occupation

____ Alcohol/Drug Field

__1_ Mental Health Field

__3_ Social Services Field

__4_ Law Enforcement/Criminal

         Justice Field

____ Faith Community

__5_ Service Industry

____ Retail

__3_ Teacher

__9_ Health Care Field

__6_ Office/Clerical

__2_ Small Business Owner

____ Elected Official

_15_ Other (please specify):

   IT Director

   Attorney

   Scientific/technical

   Sales Manager

   Government Employee

   None

   Auto Mechanic/security & factory worker

   Disabled

   Unemployed computer   engineer

   Janitor

   OWF-foodstamps-medical-pending SSI

   Laborer

   IT

Living Situation

_34_ Own Home

__3_ Rent House

__8_ Rent Apartment

__6_ Live In Other’s Home

____ Residential Center

__5_ Homeless

 

 

Sex

21__ Male

32__ Female

 

Family Income Level

_18_ Under $25,000

__4_ $25,000 - $49,999

__9_ $50,000 - $74,999

__7_ $75,000 - $99,999

__8_ $100,000 and above

 

Check if applicable (optional)

_4__ Currently receiving     

         alcohol/drug treatment

10__ Recovering Person

 

Zip Code of Residence:

         ___45013_(16)

               45044_(13)

               45011_(9)

               45069_(5)

               45042_(4)

               45014_(2)

               45005_(1)

               45067_(1)

 

1.                 Do you think that alcohol and other drugs are a problem in Butler County?   Yes   53   No   1

 

2.                 How serious a problem do you think alcohol and other drugs are in Butler County?

                  __1__ 1.  not a problem at all

                  _____ 2.  a less serious problem

                  _20__ 3.  a moderately serious problem

                  _19__ 4.  a very serious problem

                  _15__ 5.  an extremely serious problem

 

3.                 How would you describe the problem here in Butler County?

¨      Problem is worsening as the county continues to grow

¨      Drug/alcohol abuse is a serious problem among the poorer residents of the county, particularly in Hamilton & Middletown.  It is not such a serious problem in the suburban areas.  The problem is strongest among those with the least economic opportunities.

¨      It is pretty well under control, however there are parts of town that I do not travel in when I’m alone

¨      Eroding family values and destroying lots of lives

¨      Shootings -  leads to violence

¨      Serious

¨      Drugs and alcohol lead to unproductive members of society, which then burdens the community as a whole

¨      Alcohol and drug abuse leads to criminal activity

¨      It is a problem that leads to crime and unnecessary death

¨      Alcohol/DUI too common

¨      Low income/unemployed addiction and dealing

¨      Serious.  I don’t know percentages but I do know that ___wood is a very busy place.  The drugs are going someplace.

¨      Not enough available treatment programs, waiting to get in takes too long

¨      Based on newspapers and news seems like there are a lot of drug-related crimes bogging down court system

¨      Very serious (x4)

¨      Drivers

¨      It seems as a health care professional that I see more and more patients who are or who have been alcohol or drug abusers and their health problems seem to stem from the abuse.

¨      Outrageous

¨      I never knew there was such a large problem until I had the opportunity to be a grand juror.  Every case was drug or alcohol related.

¨      I can only judge by the amount of clients we see, it is bad!

¨      Drug and alcohol use among teens is a big problem

¨      I believe the problem is with educating people with the various levels of drinking.  Many feel moderate drinking is okay when reality is that it isn’t

¨      Too much crack

¨      You always hear talk from others talking about crack and other drugs, how easy it is to get

¨      It’s a shame that kids are killing kids about drugs

¨      It seems like many traffic accidents and crimes involve drugs and alcohol

¨      It seems to be everywhere you look or go

¨      A growing problem that continues to decrease in the age of the user

¨      Problem seems to increase as population increases

¨      Alcohol/drug abuse leads to more serious criminal acts

¨      Drug abuse is widespread involving many teens and adults

¨      Haven’t lived here long enough to know

¨      Bad, see it all the time

¨      Very bad

¨      Very extreme – young children to elderly, either using or selling

¨      Moderate

¨      Very serious and needs immediate attention

¨      It’s a serious problem because there are numbers of people using and not aware they are addicted

 

4.                 Are you especially concerned about the use of any particular substances in Butler County?  (For example, alcohol, club drugs/date rape drugs, cocaine, heroin, inhalants, methamphetamine, steroids, and prescription drugs such as painkillers, uppers, downers)  Please describe your concern:

¨      All of them are a concern. But the worst is oxy, meth & heroin

¨      My experience is that crack is king in the urban areas, but methamphetamines in the rural areas.   Crack is a bigger problem than Meth

¨      All of them

¨      Alcohol – it’s seen as acceptable and its often abused

¨      They are all bad

¨      I feel any substance abuse is a concern

¨      My concern is with the teen substance abuse of all types

¨      Prescription drugs – especially among our youth.  They take pills they don’t know.  Not only is the effect of the drug dangerous, personal reactions are deadly. Inhalants are easily accessible to youth – it’s a quick high and questions usually are not asked since household products are used.

¨      Cocaine and heroin – concern is people on these drugs are mentally and physically ill and handicapped because of this abuse

¨      Alcohol painkillers/prescription drugs – more crime and death

¨      Painkillers

¨      Nothing in particular, I have grandchildren going to school in Butler County and would like everything done that is possible to keep our schools drug free.

¨      Concerned about all of the above

¨      Oxycontin sounds like a problem

¨      All could be problems if used

¨      All of the above

¨      I see it all.  I see a lot of people addicted to vicodin/oxycontin and meth and it seems to go hand in hand also with alcohol abuse. What scares me is that this abuse is at all age levels.

¨      Unemployment tends to be a big factor for any kind of addiction

¨      Alcohol, prescription drugs

¨      Alcohol, because I am on the road with my children and any other drug for the same reason

¨      Prescription drugs – Drs. are too willing to prescribe them to addicts

¨      I don’t know specifics, we see so many clients involved in an alcohol and drug treatment program

¨      My concerns are with the increases in crime that follows the increased usage of prescription drugs

¨      Oxycontin becoming a big problem

¨      I am afraid for the future leaders of the area being influenced by drugs and alcohol

¨      Crack and crystal meth

¨      The drugs are very easy to get

¨      Yes, Percocet, Upjohn, crack, marijuana, crystal meth

¨      MJ, Rx drugs, EJOH

¨      My concern is drug use and the increase crime rate is climbing

¨      Alcohol – D.U.I. related crashes;  Heroin – extremely dangerous – I’ve observed three deaths as a result of heroin abuse

¨      Prescription drug abuse is very much on the rise

¨      No, not really socially aware

¨      Crack ( x2)

¨      They all are a problem

¨      All drugs are a problem in Butler Co.

¨      Prescription drugs, crack, meth

¨      All of the above is a problem. It is seen openly on the street, the sale and use of drugs and alcohol are destroying us

¨      Doesn’t concern me all that much

¨      All illegal drugs

¨      With children its very important to show the pitfalls of drugs of any kind

¨      Any drug that effects our families needs to be focused on

 

5.                 Do you share these same concerns about other communities?         

Yes   40      No 12

            If yes, please describe your concern:  

                  YES:                                                 

¨                              City of Hamilton, Preble County

¨                              Cincinnati, Dayton (Hamilton Co, Montgomery Co)

¨                              The drugs are very easy to get

¨                              I have grandchildren walking to and from school and a stray bullet might hit one or a car hit them

¨                              It’s a nationwide problem

¨                              I see the rise in crime really having no boundaries

¨                              Hamilton County’s problem with drug abuse definitely contributes to our county’s issues

¨                              All communities have their own problems. I am however more concerned about mine.

¨                              Seems nationwide

¨                              No community is exempt

¨                              It is diversity everywhere.  This use to be an inner city problem but not anymore, it’s trickled out to the suburbs and country.

¨                              These problems exist everywhere

¨                              Prevalent nation wide

¨                              It’s a problem everywhere – the news is full of it

¨                              If there is a problem in surrounding communities, it would naturally enter into our community

¨                              The youth are our future

¨                              This is not a community concern, it is societal – differences are the drug of choice within the various communities

¨                              It can be brought into our community

¨                              Prescription medications are too accessible via doctors freely prescribing narcotics and the internet

¨                              Problems filter over into neighboring communities

¨                              These are issues affecting our whole community

¨                              Boston where I’m from; drugs kill everybody and their children

¨                              I concern surrounding communities bring drugs to Butler Co and Butler Co bring it to those communities.

¨                              Drugs are prevalent everywhere

 

6.                 How would you compare alcohol use in Butler County to alcohol use in surrounding counties:

 

                        _45__ 1.  about the same

                        __6__ 2.  greater in Butler County

                        __2__ 3.  greater in surrounding counties              

                          Unsure (2)

 

7.                 How would you compare use of illegal drugs in Butler County to use in surrounding counties:

 

                        _44__ 1.  about the same

                        __4__ 2.  greater in Butler County

                        __5__ 3.  greater in surrounding counties              

                          Unsure (2)

 

8.                 How serious a problem do you think each of the following is in Butler County?  (Please rate each item on a scale of 1 – 5 with 1 being not serious and 5 being very serious.)

           

a.  Alcohol and other drug use by pre-teens

3.47 average

b.  Alcohol and other drug use by teens

3.81 average

c.  Alcohol and other drug use by college age youth and other young adults

4.05 average

d.  Alcohol and other drug use by middle age adults

3.85 average

e.  Alcohol and other drug use by older adults

3.37 average

f.  Alcohol and other drug use by pregnant women

2.98 average

g.  Alcohol and other drug use in the workplace

2.87 average

h.  Misuse of prescription drugs

4.23 average

i.  Traffic accidents related to alcohol and other drug use

3.94 average

j.  Crimes committed by persons with alcohol and other drug problems

4.26 average

k.  Mentally ill persons with alcohol and other drug problems

3.64 average

l.  Homeless persons with alcohol and other drug problems

3.89 average

 

                   Which of the above are you most concerned about and why?

¨      Teens and young adults. Too many lives are irreparably harmed because of seemingly youthful experimentation as they see it.

¨      My experience is that much of the petty crime: shoplifting, theft, burglary, is drug-related

¨      I, J, People who are under the influence do not have control of their actions

¨      Teens – laying the groundwork for how they will parent and their family values

¨      Teens and preteens – because I have children this age and I am concerned about peer pressure and other influences

¨      A,B,C,D,F.  A thru D because it effects families, F because of the health concerns of the baby and mother

¨      Youth… they put their futures at risk without the understanding of the consequences

¨      There is not one more concerning than another.  Each has its own set of problems that when they reach into the community are dangerous

¨      Biggest concern is abuse in the population of young adults because they will be our future leaders of our communities and nation

¨      Pre-teens and teens because it causes them to commit more crimes and overdoses.  The will be our future leaders

¨      I. traffic accidents; L. homeless; C. college students

¨      All are very serious concerns

¨      K; mentally ill

¨      B & C:  There are too many car accidents involving teens/college-age youth

¨      Prescription drugs because you can get them just about anywhere

¨      By teens because I have a teenage daughter that I watch very closely and by the middle age population because it seems to be raging at that age.

¨      Alcohol dug use by teens, best way to stop is not to start (prevention)

¨      H, B

¨      Pre-teens and teens

¨      Among teens

¨      Alcohol and drug abuse by pregnant woman and crimes committed.  I really think there would be a lower crime rate altogether if drugs and alcohol were not such a problem

¨      Personally I don’t have to deal with these problems in my home, it is a problem with the clients we see!

¨      Crimes committed by people needing to feed a habit

¨      Pregnant women. They are destroying unborn kids life

¨      Probably alcohol and drug use by college age youth because I have 2 kids that fit in that category

¨      Use by pre-teens

¨      B,I,J:  B – because teen snot educated about consequences of their actions.  I – because innocent people are affected by impaired drivers.  J – because addictions lead them to escalating types of crime.

¨      Again prescription drugs because of their ease of use and accessibility

¨      K; because I’m ill

¨      Homeless seem to get money to buy drugs or alcohol instead of getting a place or help

¨      E; because I am an older adult and my friends

¨      I have concern for the young children – want better life for them;  “mentally ill” – drugs and alcohol make them worse and dangerous

¨      Young adults and the effect of drugs.  Through their children, homes, schools, etc – on their lives

¨      D & F

¨      Drugs use by children does not allow them to grow into the president of our tomorrows

¨      All of them have an effect on our families

 

Are there any other alcohol/drug problems that you are concerned about and why?        

¨      I believe it should be mandatory for all elected officials and persons who have filed as candidates to run for political office, to have random drug screens.  These positions are only for responsible people

¨      Parent sponsored parties where alcohol is served… very common even though illegal

¨      We have a lot of positive drug screen at work

¨      Not really

¨      Why there are not more treatment centers for these people so they can get immediate help when they need it and not put them on waiting lists or until they can come up with the money to pay for help

¨      No

¨      I am sorry, I only know what I see on the job from clients

¨      Myself – cause I have a long history with drugs

¨      I am concerned about all alcohol/drugs it is a great big problem

¨      The open sale of drugs in our community and the devaluing of the neighborhood and property

¨      Crack cocaine.  Seem to be a big problem for our society as a whole

¨      Misuse of medication as this is legal and can really affect our children’s growth

¨      Any misuse

 

9.                 How effective do you think the following are in addressing alcohol and other drug problems and why?  (Please rate each on a scale of 1 – 5 with 1 being ineffective to 5 being very effective.)

 

a.  Arresting and imprisoning people for alcohol and other drug offenses

2.77 average

b.  Providing education and prevention programs in the schools and community

3.57 average

c.  Having anti-drug messages on television (or other media)

2.65 average

d.  Restricting youth access to alcoholic beverages

3.47 average

e.  Providing treatment services in outpatient clinics and in residential treatment centers        

3.54 average

 

¨      All have some positive impact on addressing the problem but education is probably the most effective in discouraging abuse in the first place

¨      My experience is that an individual must be receptive to drug treatment in order for such treatment to work. You can lead a horse to water but you can’t make him drink. Many people only become receptive after they have hit bottom

¨      Crime will continue if no treatment; children listen to tv

¨      a.) get these people off the streets

b)   educating the youth and adults of the effects of alcohol and drug problems, how to recognize the problem

c)    not effective – too impersonal

d)   youth still will find a way to access alcohol

e)    effective only if people are willing to attend

 

10.            Given the limited availability of financial resources to address alcohol and other drug problems, how would you prioritize the following and why?  (Number 1 is the highest priority; number 2 is the medium priority; number 3 is the lowest priority.)

 

2    1    3     3     1    2_    law enforcement efforts to combat alcohol and other drug problems 

1    3    2     1     2    3_    providing treatment for persons addicted to alcohol or other drugs   

      3    2    1     2     3    1_    investing in preventing alcohol and other drug problems                

    (3)  (2) (14)(20)  (5)  (2)

 

¨      Education (early) is very important in the treatment and prevention of misuse of substances

¨      Law enforcement combats problem directly; prevention programs may reduce before problem start; large amount of repeat offenders

 

11.             Do you know a relative, friend, or personal acquaintance you believe has or had an alcohol problem?          Yes  49       No   5      If yes, how many relatives, friends, or personal acquaintances would you say that you believe have or have had such a problem:

 

                        __4__    one person

                        _17__    two to four persons

                        _19__    five to nine persons

                        __2__    ten to fifteen persons

                        __7__    more than fifteen persons

 

12.            Do you know a relative, friend, or personal acquaintance you believe has or had a problem with drugs other than alcohol?          Yes 43     No  11       If yes, how many relatives, friends, or personal acquaintances would you say that you believe have or have had such a problem:

 

                        __7__    one person

                        _25__    two to four persons

                        __5__    five to nine persons

                        __1__    ten to fifteen persons

                        __4__    more than fifteen persons

 

13.            If you or a loved one had a problem with alcohol or other drugs would you know where to turn for help?          Yes  37       No  16      If yes, where would that be?

 

YES:

¨      Alcohol and drug treatment centers

¨      AA, NA (x3)

¨      Treatment

¨      Pastor first, clinics

¨      Church, Hamilton Christian Center – they have a substance abuse program

¨      Really, it depends on the situation.  AA may be a start for people suffering from alcoholism

¨      I would turn to a treatment program in my community

¨      EAP at work; AA, Horizon Programs

¨      I would ask (a friend that) has been there

¨      Transitional living

¨      God – drug/alcohol treatment center

¨      Al-Anon, AA

¨      Church, Celebrate Recovery, 211, Health & Human Services

¨      Resources within the community. 211 to start for referrals. Health Insurance carrier

¨      A rehab center

¨      Would call county board for referral

¨      AA – have been sober over 20 years            

¨      Horizon

¨      My church, my Lord

¨      TLC

¨      Inpatient/outpatient drug treatment, Sojourner

¨      My God (x2)

¨      NA/AA/ church – focus

¨      Social services, AA and NA

                 

14.            Would you be inclined to support a property tax levy to pay for alcohol and other drug prevention and treatment services?          Yes  27        No   22           Why or why not?

 

YES:

¨      If the treatment services were run correctly and monitored for outcomes

¨      The prevention message needs to be louder, the ‘moderate’ user needs to be reminded how fragile their situation is.

¨      Whatever helps

¨      Because I need help myself

¨      I’d rather see our resources used to discourage and prevent abuse, than simply policing up the results

¨      Maybe – although I’m not sure that spending more money is the way. Maybe parents need to be better educated in becoming more involved in their kids’ lives

¨      It depends on how the money was going to be spent.  I’m in support of taxing the alcohol and tobacco so maybe people would think twice before buying these items.

¨      It is important to have these programs

¨      To improve our community/city

¨      Because its important

¨      Only if the money raised would be used for those programs

¨      Government support is helpful

¨      To help others

¨      Because people need help with this problem

¨      If I was financially capable I would love to help people like people helped me

¨      It is a priority

¨      Its needed

¨      It is always best to try and prevent causes of downfalls

¨      If its helping us with our children to focus

¨      Maybe – would need to see particulars

 

      NO:

¨      I would feel like we are being punished for others who make bad choices.  Homes and taxes are too expensive as it is

¨      It’s a personal choice!

¨      Enough property taxes already

¨      That would be placing the burden on the shoulders of people who are generally successful and who have become that way by being responsible for their own life.  The successful should not be solely financially responsible for those whose choices are irresponsible and lead to their own demise

¨      Those that don’t own property are not participating

¨      I think property owners are taxed enough to support education and other governmental services

¨      I work and think others should pay their own way

¨      Property taxes are already stretched to the limit

¨      I can’t afford it!

¨      I should not have to fund someone else’s drug or alcohol problem

¨      People can’t afford to pay property tax as it is

¨      Its not my problem

¨      Taxes are too high as it is

 

15.            Would you be inclined to support a county tax on alcoholic beverages and cigarettes to pay for alcohol and other drug prevention and treatment services?  Yes   40    No   11   Why or why not?

 

YES:

¨      Yes, would help with prevention – nobody could afford it.  One of the reasons people quit smoking is because of price – however, it could increase crime even more

¨      Tax the ultimate users

¨      It would be practical that the people with addictions pay for education and services

¨      I’d rather see our resources used to discourage and prevent abuse, than simply policing up the results

¨      People who use those substances most likely will be ones needing treatment!

¨      People who drink or smoke are the ones who end up having problems and going to treatment

¨      It is important to have these programs

¨      Would put more revenue for rehab centers and for counselors

¨      It places the burden on those who likely will be using the services

¨      If you’re a responsible adult making purchases, a tax may prevent others (youth, homeless) from making the purchase. However, if it is wanted desperately enough, no amount of tax will prevent the purchase. My question is will there be enough money collected to help combat this generation and others to come.

¨      If a person chooses to drink or smoke, the money made from taxing those luxuries could be used for treatment and prevention programs

¨      Higher taxes would also encourage less use of the substances

¨      Because its important

¨      This is where it is based

¨      Let the problem support itself

¨      These are ‘legal’ drugs sold by companies to make money from addition, force consumer/addicts to wean themselves off by hitting them in the wallet

¨      Government support is helpful

¨      If it would help

¨      To help others

¨      Because people need help with this problem

¨      Its needed

¨      It would help to fund many needed programs in our communities

¨      To add more programs of help, needs our support

 

NO:

¨      I’m not an alcoholic, but I will have a drink on occasion and choose not to pay for that

¨      Too many

¨      Taxes on cigarettes and alcohol are ridiculously high as it is.  Look at Ohio in comparison to Kentucky or Florida, are we so much better off because of these taxes? Is it working?

¨      Tired of taxes!

¨      We have too many taxes now!

¨      Enforce laws we have on books.  Too many parents condone teenage drinking, hosting parties at which teens consume alcohol

¨      It just doesn’t seem to be that effective

 

16.            What can we do to more effectively address alcohol and other drug problems in Butler County?

 

¨      I’m not sure there is much the community can do, other than providing economic opportunities.  So much depends on the individual.

¨      Perhaps have someone (a recovering alcoholic) go into the schools, etc. and give seminars to the students, because he knows first hand what terrible consequences this can cause.  He could stress “this is what happened to me; don’t let it happen to you”

¨      A way to have groups that have means to teach and reach people about good parenting

¨      Raise awareness of addictive behavior to teens and young adults through education. Also make it known to the community where help is available for family, friends and relatives

¨      Reinstate and require programs such as D.A.R.E. from local law enforcement. Make them age appropriate starting @ Elementary School

¨      Reinstitute a work house and stiffer penalties,  more rehab programs

¨      Have stiffer consequences for breaking the laws

¨      Some use as a result of unemployment and lack of meaningful activities.  This may not be solvable, but I believe it is a key element in preventing and treating substance abuse.

¨      Stiffer punishments.  Billboards for drug free schools – maybe rewards for drug free students/no offenses. Ex. Scholarships

¨      Road blocks – police checks other times besides New Year and holidays – random stops

¨      Educate! Educate! Educate!  Then provide easily accessible prompt treatment

¨      Educate youth as much as possible

¨      Educate people about addiction and substance abuse, more treatment programs for more people

¨      Steer people to AA

¨      Education!  Prevention in schools.  Have drug/alcohol addicts speak to our children Fact-of-life way!  Don’t hide and skim content, tell the truth and facts.  Show them the morgues or the psych wards and the effects of substance abuse.  Talk to the families and the effects after they lose someone and the financial problems cause by this.  Education!

¨      Educate early, start with our youths at school and continue at home. Parents’ role is important

¨      Above all:  parental involvement.  Secondly, more educational programs at the elementary level

¨      Stricter laws.  However – prisons are overcrowded so that’s difficult

¨      Education – information – support

¨      Parents need to know who their children are friends with; what they are doing and where they are going. Parents need to talk open and honestly with their children.

¨      Less ‘fear impact’ messages about lock ups and traffic stops, more positive media about help and treatment

¨      Use more preventative measures to help the problem before it becomes an issue

¨      Do the job

¨      Education and prevention/ more accessible treatment (shorter waiting lists)

¨      More aggressive alcohol and drug enforcement

¨      More enforcement of current laws

¨      Provide more services in West Chester

¨      Advertise on T.V., newspapers

¨      Continue to help people

¨      Provide access to treatment instead of waiting 2-6 months

¨      Offer help, place for counseling where people can be safe and get help

¨      I do not

¨      Make more help available

¨      The drug users need to accept the help as long as help is out there

¨      Education

¨      People need help – provide it

¨      Stricter laws and punishments

¨      Educate our children in their schools about the effects it has on them and their family

¨      Support programs that talk about issues effecting our children, our community, our family and friends

 

17.            Any other comments?

¨      We need to help one another, but 1 person can’t help everyone - pray

 

Thank You!


Butler County Alcohol and Drug Addiction Services Board

Priorities for SFY2010-2011

 

I.  Treatment Priorities

 

A.    General Priorities Related to Community Needs (whether met, partially met or unmet)

 

Scale = Low (L), Medium (M), High (H)

 

General Priorities

Rating

1.  Continuum of accessible treatment services for adult men.

H

2.  Continuum of accessible treatment services for adult women.

H

3.  Continuum of accessible treatment services for adolescents.

H

4.  Specialty treatment services for felony drug offenders (non-SAMI).

M

5.  Specialty treatment services for felony drug offenders with both mental health and substance abuse disorders.

M

6.  Continuum of accessible treatment services for parents of CSB children.

M

7.  Services for multi-need adolescents (adolescents with multiple problems such as substance abuse, mental health, juvenile court involvement, CSB involvement, etc.)

M

8.  Services for persons at risk of HIV/AIDS and other infections.

M

 

 

B.    Priorities for Additional Funding (in the event additional funds become available from ODADAS or other sources)

 

Scale = Low (L), Medium (M), High (H)

 

Priorities for Additional Funding

Rating

1.  Increase service capacity for women’s residential services.

H

2.  Increase service capacity for men’s residential services.

H

3.  Increase service capacity for adult outpatient services.

H

4.  Develop case management/community-based services for adult men and women.

H

5.  Increase case management/community-based services for adolescents.

H

6.  Increase family counseling services for adolescents.

M

7.  Increase less intensive counseling services for adolescents (e.g., ABT).

M

8.  Increase dual disorder outpatient services.

H

9.  Develop dual disorder residential/supervised housing services.

M

10.Develop transitional housing/halfway house/assisted living with wraparound and intensive case management services.

M

11.Enhance detoxification services.

M

12.Improve access to methadone maintenance.

L

13.Improve access to medication assisted treatment other than methadone maintenance.

H

 


II.  Prevention Priorities

 

A.  General Priorities Related to Community Needs (whether met, partially met or unmet)

 

Scale = Low (L), Medium (M), High (H)

 

General Priorities

Rating

1.  Services for elementary, middle, and high school youth (for example, school-based services, youth mentoring, other programs targeted to at risk youth).

H

2.  Services for FASD prevention.

H

3.  Services for college students.

M

4.  Services for at risk pre-school children and their parents.

M

5.  Services for young adults, middle-age adults, and older adults.

H

6.  Community coalition activity.

H

 

 

 

B.  Priorities for Additional Funding (in the event additional funds become available from ODADAS or other sources)

 

Scale = Low (L), Medium (M), High (H)

 

Priorities for Additional Funding

Rating

1.  Increase services for at risk school-age youth.

H

2.  Increase services targeting COA’s (children of alcoholics/addicts).

M

3.  Increase services for young adults, middle-age adults, and older adults.

H

4.  Increase community coalition activity.

H

 

 

 

III.  Non-Service Priorities

 

Scale = Low (L), Medium (M), High (H)

 

Priorities for Additional Funding

Rating

1.  Increased professional training

H

2.  IT improvements

H

3.  Make salaries competitive for purposes of employee retention

H


Butler County Alcohol and Drug Addiction Services Board

Investor Targets for SFY2010-2011

 

I.                  Treatment Investor Targets and Programs Contributing to These Targets

 

Investor Target (Source(s) of Verification)

Programs Contributing To This Target

1.  Increase in number of customers who are abstinent at the completion of the program. (behavioral health data “BHD”, utilization review chart audits “URCA”)

Treatment programs for adolescents and adults

2.  Increase in number of customers who incur no new arrests at the completion of the program. (BHD, URCA)

Adult drug court and SAMI drug court programs

3.  Increase in number of customers who live in a safe stable permanent living situation at the completion of the program. (BHD, URCA)

SAMI drug court program (specifically, no crisis psychiatric hospitalizations)

4.  Increase in number of customers who maintain or regain custody of their children. (BHD, URCA, CSB report)

484 funded programs

5.  Increase in number of adult customers whose children are provided residential and/or day care services.  (URCA)

Services for children of adult customers

6.  Increase in number of customers who enter post-detoxification treatment programs.   (URCA, claims data)

Detoxification services

7.  Increase in number of customers who acquire knowledge about the risks of HIV/AIDS, STD, TB, and Hepatitis C infections. (Provider pre/post test records and summaries)

HIV program

 

II.              Prevention Investor Targets and Programs Contributing to These Targets

 

Investor Target (Source(s) of Verification)

Programs Contributing To This Target

1.  Programs that increase the number of customers who avoid ATOD use and perceive non-use as the norm. (Provider pre/post test records and follow up)

Programs for elementary, middle, and high school youth

2.  Programs that increase the number of customers who perceive ATOD use as harmful. (Surveys)

Information dissemination programs

3.  Programs that increase the number of drug dependent pregnant women who deliver a drug-free baby. (Provider records)

Peri-natal program

 

4.  Programs that increase the number of initiatives that demonstrate an impact on community laws and norms. (Surveys, changes in laws)

Community coalitions


I.  Treatment Investor Targets and Suggested Outcome Measures

 

Investor Target

Measures Contributing To This Target

1.  Increase in number of customers who are abstinent at the completion of the program.

Abstinent 30 days prior to discharge. 

2.  Increase in number of customers who incur no new arrests at the completion of the program.

No new arrests 30 days prior to discharge. 

3.  Increase in number of customers who live in a safe stable permanent living situation at the completion of the program.

No new arrests or psychiatric hospitalizations for three months prior to discharge from SAMI program.

4.  Increase in number of customers who maintain or regain custody of their children.

Increase in number of CSB referred customers who maintain/regain custody of their children.

5.  Increase in number of adult customers whose children are provided residential and/or day care services.

Increase in number of adult customers discharged during SFY 2006 whose children were provided residential and/or day care services.

6.  Increase in number of customers who enter post-detoxification treatment programs.

Increase in number of customers receiving detoxification services in SFY 2006 who subsequently entered treatment programs.

7.  Increase in number of customers who acquire knowledge about the risks of HIV/AIDS, STD, TB, and Hepatitis C infections.

Increase in number of customers who acquire knowledge about the risks of HIV/AIDS, STD, TB, and Hepatitis C infections.

 

II. Prevention Investor Targets and Suggested Outcome Measures

 

Investor Target

Measures Contributing To This Target

1.  Programs that increase the number of customers who avoid ATOD use and perceive non-use as the norm.

Increase in number of customers who refrain from ATOD use.  Increase in number of customers who come to perceive non-use as the norm.  Increase in number of trained positive peer leaders.  Increase in number of customers who acquire specified developmental assets/develop specified protective factors in support of healthy drug-free lifestyles. 

2.  Programs that increase the number of customers who perceive ATOD use as harmful.

Increase in number of persons receiving ATOD information.  Increase in number of placements of media messages communicating ATOD awareness messages.

3.  Programs that increase the number of drug dependent pregnant women who deliver a drug-free baby.

Increase in number of drug dependent pregnant women who deliver a drug-free baby, i.e., mother is abstinent from alcohol and illegal drugs for the last trimester of her pregnancy.

4.  Programs that increase the number of initiatives that demonstrate an impact on community laws and norms.

Increase in number of community partners engaged in addressing community laws and norms.  Increase in number of community partner initiatives addressing community laws and norms.