WICOMICO COUNTY, MARYLAND STRATEGIC PLAN FOR ALCOHOL AND DRUG ABUSE January 15, 2008

Vision: A safe, drug and alcohol free Wicomico County

Mission: The Wicomico County Drug Council will provide a forum to identify existing and prioritize needed drug and alcohol prevention, intervention and treatment programs and strategies to promote healthful behaviors, decisions and environments that will reduce or eliminate the problematic use of alcohol, prescription, and over-the-counter drugs, and any use of illegal drugs (and tobacco products).

Data driven analysis of jurisdictional needs:

The 2000 and 2005 Tri-County Community Health Assessment, modeled on the APEX- PH (Assessment Protocol for Excellence in Public Health), a sample of 800 adults living in Wicomico, Somerset and Worcester Counties provided statistically significant information, for each jurisdiction, on a wide range of health/health related characteristics/issues. Wicomico County residents responded that they felt, “Drugs and Alcohol” was the number one social problem affecting the community, which was five times more likely to be chosen than the second ranked response of racism. Wicomico County residents also felt that the number-one health issue affecting adolescents in the community was Alcohol/Drugs/Tobacco, which was selected over two and a half times more frequently than the second place mention of obesity. This problem was also ranked as the number one social and adolescent problem in a similar survey conducted in 2000

The Wicomico County Drug and Alcohol Council Treatment Committee distributed a survey during December 2006 requesting all Substance Abuse Treatment agencies to provided feedback on what they felt were gaps in services. The survey asked each facility to identify what services they currently offer and how many slots they are able to provide. The providers were also asked to provide what services were lacking in Wicomico County. The analysis of the local continuum of care reveals a lack of service in several areas, most notably in detoxification, inpatient care for clients with co- occurring disorders, inpatient care for adolescents and halfway housing for clients who are new in recovery, particularly for those who are court involved. Since there are many services lacking for the Wicomico County residents, it is very important that what is currently in place is maintained.

According to FY 2004 data from ADAA, 4,824 adults and 493 adolescents are in need of substance abuse treatment. During the fiscal year of 2005 Wicomico County only 2,834 adults and 104 adolescents received treatment through funded agencies. For the first quarter of FY07 53% of the detoxification referrals made to Hudson Health Services were from Wicomico County.

1 Wicomico County is above the state average for beer/wine/wine coolers in 6th, 8th, 10th, and 12th grade for every year, but one, since the inception of the MAS. Wicomico County is also above the state average for liquor except in 6th and 12th grades. For five or more drinks on one occasion as well as any form of alcohol, Wicomico County is above the state average in all grades. Beer/Wine/Wine Coolers and Liquor are increasing among 8th and 12th graders. Five or more servings of alcohol on the same occasion are increasing among 6th and 12th graders. The use of any form of alcohol is increasing among 8th and 12th graders. The use of any drug other than alcohol or tobacco is increasing among 6th graders.

Marijuana usage is above the state average in all grades. There is a slight increase in marijuana use among our 6th graders and an increase as well among our 12th graders. An increase among 6th graders demonstrates the likelihood of them moving on to other illicit drugs. Drug use in Wicomico County generally declines when students reach twelfth grade yet marijuana use is increasing among this age range.

Goal 1: Educate and assist families of Wicomico County to live healthy and drug free lives

Objective 1: Implement Second Step Programming to elementary students, Strengthening Families (10-14) to parents attending a certified treatment program, and programming like “Parents Who Host, Lose the Most”, Sticker Shock, etc., during prom and graduation. Statewide media campaign will be implemented in the new fiscal year.

Action Plan:

Steps for Goal 1, Objective 1:

. Review present evidence-based programs. - Make sure that all programs are model programs or have peer reviewed journal articles supporting the strategy, etc. (Need to do more research)

. Second Step Programming - Determine where and what age group will receive Second Step programming in 2008. (East Salisbury Family Center 4th and 5th graders) - Site will complete surveys on targeted students.(Pre- Observation Surveys were completed prior to start of program). - Program will begin in late September and run through April 2008. (Program began September 27, 2007)

. Strengthening Families

2 - Write Position Description for Coordinator of Special Programs. (Completed) - Work with Personnel in advertising for the Coordinator of Special Programs position. (Completed) - Locate potential sites for training in the community. (Completed) - Determine interest in part-time positions. (Completed) - Write interview questions. (Completed) - Schedule interviews for Coordinator of Special Programs. - Etc. (Completed)

. Implement Parents Who Host Lose the Most and/or Sticker Shock – Drug Free Communities Grant. (Will begin work on this after the New Year) - Work with Distributors and Liquor Licensees to implement Sticker Shock or something similar. - Educate parents about the law in relation to providing or giving alcohol to minors.

. Implement statewide media campaign. - Statewide Prevention meeting on February 1, 2008 to determine focus for statewide media campaign. - Determine statewide time period for implementing campaign. - Develop statewide media campaign. - Determine what pieces can be implemented in Wicomico County.

Intended Measurable Outputs:

. 10-20 students will participate in Second Step programming during FY 08 (Presently, 15 + students have participated in Second Step)

. Strengthening Families will serve 13 families three times a year (13 parents and 13 youth x 3 = 78). (Plan to begin on January 16, 2008)

. A minimum of 100+ adults will be reached through Parents Who Host Lose the Most, or Sticker Shock, or a variation of Sticker Shock in FY 2008/Drug Free Communities Grant. (Work on this will begin after the New Year)

. A minimum of 200 people will be reached through the media campaign in Wicomico County (dependant on media sources

3 utilized, etc.). The campaign will not begin until the new fiscal year.

Actual Impact on Performance Target:

Second Step programming began on September 27, 2007 at East Salisbury Elementary After School Program. This year the program is targeting 4th and 5th graders. At this time, 15+ students have participated in Second Step. Pre-observation forms have been completed on every student.

A Strengthening Families Coordinator has been hired and working since the end of October 2007. There have been numerous plans to begin programming with a number of set backs which include staffing. Most staff have been determined and submitted to Personnel as contractual staff. The start date will be January 16, 2008.

The local distributor who implemented programming to educate purchasers about selling or purchasing alcohol to minors last year are interested in participating again this year. Work on Parents Who Host Lose the Most will begin after the New Year.

The statewide Prevention Network is planning on implementing a statewide media campaign during the new fiscal year. We plan to determine the focus of the media campaign at the February 1, 2008 statewide prevention meeting. Other meetings will be held to develop the campaign.

Objective 2: Increase the effectiveness of prevention activities by targeting direct interventions to children who have risk factors for ATOD use.

Action Plan:

Steps for Goal 1, Objective 2:

. Review populations being served by prevention programming for risk factors (Completed). . Continue to provide prevention programming to summer camps, after school programs, and alternative to suspension programs located in CSAFE regions.

- Determine programming based on number of students and student turnover.

4 - Implement short-term programming that will address skill building. - Locate peer reviewed journal articles that support the use of skill building/team building.

Intended Measurable Outputs:

. A minimum of 25 middle school students will receive 3-5 days of skill building programming at New Day during FY 2008. (At this time, I have served 52 different students in New Day)

. A minimum of 25 elementary/middle school students will receive skill building programming at summer camps during FY 2008. (During the summer, 58 students received services)

Actual Impact on Performance Target:

New Day students are middle school students who have been suspended from school for 3-5 days. Due to the shortness of their stay, model programming cannot be utilized with this population. Most of the students are there due to problems with peers and/or problems with teachers. Ninety eight percent of the students at New Day are African American. They do not have the appropriate skills needed when students or school staff are confrontational. For that reason, we work on cooperation, communication, problem solving, trust, thinking and conflict resolution. At this time, we have served over 52 middle school students.

Summer programming is short as well which does not provide enough time for model programming. For that reason, cooperation, communication, problem solving, trust, thinking and conflict resolution skills are taught to students through the use of games. Fifty eight students participated in summer programming.

Objective 3: Utilize evidence-based environmental strategies to change individual and community norms.

Action Plan:

Steps for Goal 1, Objective 3:

- Determine potential drug related legislation to support for FY 08 – Drug Free Communities Grant (Appears that Alcohol Tax Legislation will be reintroduced) - Research legislation and get support from local Drug Council – Drug Free Communities Grant. (Met with Legislator to educate on Alcohol Tax; Drug Council supported legislation)

5 - Mobilize community members around legislation – Drug Free Communities Grant. (Asked for support from Prevention Professionals on alcohol tax)

. Revise liquor licensee sanctions so that it deters liquor licensee behavior. - Prevention Sub-Committee will recommend revising liquor licensee sanctions – Drug Free Communities Grant. (Revised sanctions and presented to Liquor License staff who then presented sanctions to Board) - Present suggestions to Wicomico County Council. (This is not needed since we presented to the Liquor License Office) - Gain support for sanctions – Drug Free Communities Grant. (Board has reviewed sanctions and is considering support of some sanctions).

. Research alcohol policies in Wicomico County. - Prevention Sub-Committee will select a policy that we can work toward changing – Drug Free Communities Grant. (This was done by working with Liquor License staff. We plan to look at other potential alcohol policy changes that are needed in the community) - Select strategies to work toward changing the policy. (Recommended stronger sanctions and longer suspension of liquor licenses)

. Coalition building/Drug Free Communities Grant. - Make sure Drug Council reflects community diversity (race, sex, etc.) or consider potential community members for another coalition. (Plan to work on in New Year) - Begin the dialog on starting an Asset Building Coalition. (Sent e-mail to Local Management Board to determine how we can work together on this) - Locate potential stakeholders for the Asset Building Coalition that includes informal leaders in a cross section of the community. - Begin dialog on the need for a Youth Coalition. -

. Encourage Enforcement Agencies to continue to issue underage alcohol and tobacco citations/ Drug Free Communities Grant. (Work on this begins after the New Year)

6 - Plan Awards Luncheon for 2007 (citations given from January 1, 2007 through December 31, 2007. - Contact Enforcement Agencies to get the numbers of alcohol and tobacco citations given out during 2007. - Send out invitations to award winners, their guests and supervisors, community leaders, etc. - Reward officers who give out the most underage alcohol and tobacco citations yearly.

Intended Measurable Outputs:

. # of people involved in supporting legislation . County Council support for liquor licensee sanctions; completed tasks for policy change, completed tasks for coalition building . # of underage alcohol and tobacco award winners, # of underage alcohol and tobacco citations.

Actual Outputs: The Prevention Sub-Committee met with our County Council representative and local Liquor License Department about recommended policy/sanction changes. The Liquor License Board has tried to stiffen the sanctions with liquor licensees who fail compliance checks. The businesses who pass compliance checks are listed in the local newspaper.

The Prevention Sub-Committee met with Delegate Norm Conaway to educate him on the need for an alcohol tax. State wide support was requested as well as local Drug Council support. Due to the state deficit, both alcohol tax bills died. There are plans to address this issue again in the next legislative session.

We received a Drug Free Communities grant (effective October 1, 2007) to continue our work on coalition building. We are looking at present Prevention Sub-Committee members and are looking at ways to include more members representative of the community. We plan to begin dialog on starting an Asset Building Coalition and a Youth Coalition. Discussion has begun with our Local Management Board in relation to these two ideas/needs.

Information has been requested from all of the enforcement agencies on the number of alcohol and tobacco citations given out in 2007. That information is utilized to determine who will receive awards this year at the Awards Luncheon.

7 Budget:

Goal 1 Current Funding Current Amount of Source(s) of Funding Anticipated Increase Objectives 1, 2, 3 Amount Source of Funding Needed to accomplish in # of Slots and # to Funding Increase priority be Served Needed Implement Second Step A total of $3,274 ADAA Additional Additional funding - programming to for objectives 1, Drug Free funding would be beneficial for elementary students, 2, and 3 for all Communities would be statewide media Strengthening Families prevention Grant beneficial campaign.. (10-14) to parents programming for statewide attending a certified media treatment program, and campaign. programming like “Parents Who Host, Lose the Most”, Sticker Shock, etc., during prom and graduation. Implement statewide media campaign. Increase the Same as above. ADAA N/A No funding needed at - effectiveness of Drug Free this time unless new prevention activities by Communities programming was targeting direct Grant considered interventions to children who have risk factors for ATOD use. Utilize evidence-based Same as above ADAA N/A No funding needed at - environmental Drug Free this time unless new strategies to change Communities programming was individual and Grant considered community norms.

Goal 2: To identify, develop and maintain alcohol and drug intervention and treatment services provided or to be provided in Wicomico County which will promote abstinence and recovery management.

Objective 1: Develop protocols for standard screening, assessment and referral for all public human services and law enforcement agencies.

Action Plan:

Completed

Intended Measurable Outputs:

. 70% of Addiction Treatment providers will utilize universal referral, screening, and assessment tools. . Drug Court, PRMC, Wicomico County Detention Center and Parole and Probation will only utilize the universal referral form.

8 Actual Outputs:

Goal 2/Obj. 1 Performance Targets: Increase the number of agencies utilizing the standard protocols

Goal 2/Obj. 1 Measure: The number of agencies using protocols

Some agencies (30%) agreed that they could continue to use the Initial Contact Form, but were not able to use a universal intake or assessment tools.

Actual Impact on Performance Target: . Members of the Treatment Committee voiced concerned about the redundancy of information obtained by each treatment provider in regards to screening and assessing clients for treatment. . The Treatment Committee invited all Certified Addiction Treatment Providers, Law Enforcement, Corrections, Parole and Probation, Peninsula Regional Medical Center, and other community agencies, to attend the meeting. . Community agencies discussed how they could participate in the process of developing and implementing a universal referral, screening, and assessment tool. . Law Enforcement identified that they would not be able to assist in the process due to particular regulations and laws. . Treatment, Parole and Probation, and Corrections agreed that they could move forward in developing universal protocols and forms. . The Treatment Committee developed an Initial Contact Form to be used as a quick screening and referral form. . The Initial Contact Form was mailed to all providers, asking them to use for a certain time period. . A survey was sent to each provider requesting feedback at 30 and 60 day intervals. . Survey results were reviewed by the treatment committee. Follow up surveys were conducted by phone and paper to capture the majority of providers in Wicomico County. . The results indicated that many providers would not be in favor of continuing to use universal forms. . 30% of providers responded that they would be able to continue the use of the Initial Contact form, but not the intake or assessment tool. . The committee agreed that they could no longer go forward with this objective.

9 Budget: Objective could not be completely met.

Priority Action Area: Current Current Amount of Source(s) of Anticipated Increase in Completed Funding Source of Funding Increase Funding Needed # of Slots and # to be Amount Funding Needed to accomplish Served priority Develop protocols for standard None NA N/A N/A 70% of Wicomico Co. screening, assessment and Certified Treatment referral for all public human Providers will utilize all services and law enforcement universal tools. agencies.

Objective 2: Identify the gaps in services in Wicomico County

Action Plan:

Steps for Goal 2 Objective 2:

. At a minimum maintain levels of services that are currently available to Wicomico County Residents. . Continue to monitor the gaps in service for Wicomico County

Intended Measurable Outputs:

To assist the residents of Wicomico County to receive full continuum of care.

Actual Outputs:

Goal 2/Obj. 2 Performance Target: Increase the number of programs to refer for services.

Goal 2/Obj. 2 Measure: Increased Treatment Slots for identified gaps in services.

Actual Impact on Performance Target: . Drug Council members voiced concern regarding lack of treatment services in Wicomico County and funding for the gaps in services. . Treatment Committee, develop and implemented a survey for local providers to help identify specific gaps in services. . The survey was mailed to all Certified Addiction Providers located in Wicomico County. . Follow-up surveys were conducted by paper and phone calls. . Treatment Committee reviewed the results of the survey. . Determined the following are gaps in services for Wicomico County: Adolescent Inpatient Treatment, Halfway Housing, Detoxification and Residential Treatment for Adults.

10 . A survey was developed and conducted over the phone to help provide a cost analysis of the above services through out the state of Maryland. . Once the survey was completed the results are as follows: - There are only three adolescent inpatient treatment facilities in the state of Maryland. None are located on the Eastern Shore. The average per diem rate is $260.00 - None of the agencies that were surveyed provide specific case management services, so we were not able to develop a per diem rate. To have estimate information was obtained from Mental Health Case management services. - There are only two facilities on the Easter Shore that will accept State referrals and they are Whitsitt Center and Hudson Health Services. A 28 day per diem rate averaged at $150.00. Whitsitt could assist with psychiatric services if needed, but Hudson Health could not include those services at their state per diem rate. - Average per diem rate for state patients was $235.00. Both Hudson Health and Whitsitt provide these services. - Ambulatory Detox was only offered at three facilities with an average per diem rate of $200.00 - Only three facilities provided half way housing. Two were for men and one was for women. The average per diem rate was $74.00 - The majority of the facilities accepted managed care and self pay patients. . Services have been identified. The objective has been completed.

Objective 3: Identify means of fulfilling gaps in services.

Action Plan:

Steps for Goal 2 Objective 3:

. Identify the service that is most needed for Wicomico County Residents. . Obtain recommendations and information from ADAA regarding processes and provide suggestions to help further guide the committee. . Invite different agencies to discuss options regarding location for services. . Investigate and discuss how to develop the services. . Identify funding resources.

11 . Develop a plan to implement services. . September 2007 all local agencies, law enforcement and an ADAA representative were invited to attend the Treatment Sub-Committee meeting to discuss Adolescent Inpatient Treatment. All members agreed that the biggest gap in service is the lack of local Residential Adolescent Treatment Facility. . The representative from ADAA provided feedback to the committee regarding steps that needed to be accomplished to further pursue Residential Treatment for Adolescents. . Private providers were encouraged to help look for resources since funding is limited through the state.

Intended Measurable Outputs:

To assist the residents of Wicomico County to those services that are currently unavailable or difficult to access.

Actual Outputs:

Goal 2/Obj. 3 Performance Target: Increasing the number of treatment slots available within the community.

Goal 2/Obj. 3 Measure: Increased Treatment Slots for identified gaps in services.

Actual Impact on Performance Target:

Pending

Budget:

Goal 2 Current Current Amount of Source(s) of Anticipated Increase in # Objectives 2: Funding Source(s) Funding Increase Funding Needed to of Slots and # to be Gaps in Services for Amount of funding Needed accomplish priority Served Wicomico County Residential Adolescent 0 N/A $218,400 ADAA/Ins./Self 30 Individuals/ 6,000 Pay bed days

Goal 3: A full continuum of care will be available to all Wicomico County residents.

Objective 1: Increase local and regional capacity for treatment for individuals with co-occurring disorders, women and children, and adolescents. TBD - Deferred

Objective 2: Develop a capacity for case management services. TBD - Deferred

12 Objective 3: Increase local and regional capacity for detoxification services and long term treatment. Action Plan:

Steps for Goal 3 Objective 3

. Identify further funding resources to help expand detox services to Wicomico County Residents. . At a minimum maintain levels of services that are currently available to Wicomico County Residents.

Intended Measurable Outcome:

. Provide detoxification services to 18 residents of Wicomico County that met ASAM Criteria for FY07. . Continue to identify Long Term Treatment for the indigent population.

Actual Outputs: As of June 30, 2007, 18 Wicomico County Residents were referred for detoxification services at Hudson Health Services.

Goal 3 Performance Target: Increase quality of life of individuals in treatment and recovery in Wicomico County.

Goal 3 Measure: Decrease in the number of arrests, homelessness, use of substances and an increase in employment.

Actual Impact on Performance Target: . Council Identified the main priority is to help Wicomico County residents to access funds for detoxification. . The funds were utilized by the Wicomico County Health Department for indigent patients. . These patients were referred to Hudson Health Services for detoxification and remained for 28 days of Residential Treatment.

Objective 4: Utilize buprenorphine to help increase medication management for the opiate addicted population in Wicomico County. Action Plan:

Steps for Goal 3 Objective 4

. Evaluate the regulations for developing a buprenorphine program. . Identify and develop policies and procedures . Identify costs to provide services. . Identify funding resources.

13 . Identify resources that are available to provide a location for the medication management. . Locate a provider/doctor that is certified to prescribe the medication. . Provide training to local agencies to educate the community regarding buprenorphine. . Implement the program.

Intended Measurable Outcome:

Expand buprenorphine services to indigent residents who are addicted to opiates in Wicomico County.

Actual Outputs:

Goal 3/Obj 4: Performance Target: Increase the quality of life to residents of Wicomico County

Goal 3/Obj 4 Measure: Decrease in the number of arrests, homelessness, use of substances, increase in employment and re-engage with family.

Actual Impact on Performance Target:

The Lower shore Directors have been meeting to discuss the Buprenorphine initiative that will be provided through ADAA. Regional money would be distributed to each county to manage individually. Each county would also develop their own plan for burpenorphine since the prescribing doctors want to focus on different populations. We are in the process of developing the policies and procedures for buprenorphine treatment. The plan from the Lower shore Directors will be submitted to ADAA by the end of January 2008.

Budget:

Goal 3 Current Current Amount of Source(s) of Anticipated Increase in # Objectives 4: Funding Source(s) Funding Increase Funding Needed to of Slots and # to be Buprenorphine Treatment Amount of funding Needed accomplish priority Served

Buprenorphine 0 N/A $90,000 ADAA/Self 30 Individuals Pay/PAC/Med Bank

14 Objective 5: Expand the availability of Drug Court in Wicomico County.

Action Plan:

Steps for Goal 3 Objective 5

Wicomico County Adult District Drug Court

. The budget was approved, and they will proceed to hire a Drug Court Coordinator to help develop and implement the Wicomico County Adult District Drug Court. . Planning sessions will resume in February 2008 and begin screening participants for the program by March 2008. . Identify further funding solutions for a Certified Drug and Alcohol Counselor. . Begin the hiring process for a Drug Court Coordinator. . Define the roles of each team member and how the Judge would like them to participate in the Drug Court Process. . Identify criteria to admit a participant into Drug Court. . Write the Policy and Procedures for the Drug Court. . Set a date for the first court session.

Wicomico County Adult Circuit Drug Court . The Adult Circuit Drug Court for Wicomico County has been actively accepting and treating clients since September 2005. . The steering committee for the Circuit Court Adult Drug Court continues to meet to implement and update policies and procedures.

Intended Measurable Outcome:

. Decrease in recidivism of the addicted population within the legal system.

. Increase quality of life for participants, their families, and the citizens of Wicomico County.

Actual Outputs:

The budget has been approved for the Adult District Drug Court. Preliminary meetings were held to discuss possible criteria for a person to become involved with the Drug Court. The budget was developed, submitted, and approved by the Office of Problem Solving Courts. The meetings will resume in February 2008.

Participants involved with Wicomico County Adult Circuit Court are being Treated and meet Level II care. There is a current census of 34 participants. Funding only provides for one certified addiction counselor salary.

15 Two certified addictions counselors are providing treatment to the drug court participants. Once District Drug Court begins, the number of counselors providing addictions treatment to this population will increase to four.

Goal 3/Obj. 5: Performance Target: Increase quality of life of individuals in treatment and recovery in Wicomico County.

Goal 3/Obj 5: Measure: Decrease in the number of arrests, homelessness, use of substances and an increase in employment.

Actual Impact on Performance Target:

Wicomico County District Drug Court . Wicomico County District Court identified a need to better help reduce the recidivism rate for those who are convicted of a crime related to drugs and alcohol. . The District Court began having planning sessions to make a determination if they had support from other community agencies to pursue the implementation of an Adult Drug Court for District Court. . The States Attorney’s Office, Public Defenders Office, Parole and Probation, Local Law Enforcement, Wicomico County Detention Center, and Wicomico County Health Department all agreed to support the development and implementation for the Drug Court. . Each agency reviewed funding amounts that would be necessary for them to participate. . The Drug Court Coordinator developed and submitted a budget to the Offices of the Problem Solving Courts. Further funding for addictions counselors and Public Defenders could not be placed in the budget for FY08. . The new Drug Court Coordinator for Wicomico County District Drug Court is to begin January 2, 2008. . Planning sessions are to resume in February 2008.

Wicomico County Circuit Drug Court . The census continues to increase with referrals from Parole and Probation, Public Defenders office and private attorneys. . 68% of the participants are employed or participating in volunteer programs. . 26% of the participants have maintained sobriety for a year or longer. . May and September 2007, the Circuit Drug Court held two graduation ceremonies for 4 participants. . Another ceremony is pending for March 2008.

16 Budget:

Goal 3 Current Current Source(s) of Amount of Source(s) of Anticipated Objectives, 4 Funding funding Funding Funding Needed to Increase in # of Amount Increase accomplish priority Slots and # to Needed be Served District Drug Court 0 N/A 34,870 ADAA 30 (FY09) Circuit Drug Court 46,278 ADDA 34,870 ADAA 20 (FY08) (FY09)

Goal 4: Develop the infrastructure to sustain an efficient and effective system.

Objective 1: Improve the overall compensation and benefit package for administrative and clinical staff. TBD – Deferred

Objective 2: Improve staff development through technical assistance and training. TBD - Deferred

Objective 3: Increase the pool of qualified certified addictions counselors, trainees and supervisors through working with the Board of Professional Counselors and local secondary educational facilities. TBD - Deferred

Objective 4: Increase training opportunities to improve clinicians’ use and skill level related to computers and computer programs. TBD - Deferred

17