DHMH Website Reveals Function of DAAC

Diana Broomell <diana.broomell@gmail.com>	12/19/13
to John, Ken

Ken and John,

Walt had shared with me that at the last meeting there was confusion on what the by laws were for the The Drug and Alcohol Abuse Council and who appoints the members. I didn't find by laws but did locate the Initial Plan:

Vision: A community free from substance abuse and dependence.

Mission: To reduce substance abuse and dependence and related consequences through development and implementation of a plan, strategies and priorities for meeting the identified needs of the general public, and the criminal justice system for alcohol and drug evaluation, prevention and treatment services.

Goal 1: Establish an integrated continuum of adult substance abuse treatment services that will be accessible to the residents of Cecil County.

Objective A: Extend residential treatment services (20 additional beds) for individuals with substance abuse disorders.

Measure: Reduce the number of clients on the waiting list at the A.F. Whitsitt Center for Inpatient Care by 50%.

Objective B: Restore funding for Purchase of Care Program for detoxification services.

Measure: Restore the 20% of funding for Purchase of Care Program that was eliminated in the FY 2006 allocation.

Objective C: Expand transitional housing services for individuals in need of ongoing long-term substance abuse care to include services for women and women with children.

Measure: Establish additional transitional housing services.

Objective D: Enhance existing outpatient substance abuse treatment to allow for increased intensity and contact with clients referred through the criminal justice system.

Measure: Expand staffing, space and related resources (at the Cecil County Health Department, Cecil County Detention Center and Community Adult Rehabilitation Center Unit) for the provision of substance abuse services

Objective E: Establish non-hospital crisis intervention services for individuals experiencing mental health crises with or without coexisting substance abuse concerns.

Measure: Complete a feasibility study for non-hospital crisis intervention services.

Performance Target: Improve access for Cecil County residents to integrated treatment services.

Goal 2: Establish and enhance resources and programs to address the substance abuse concerns among individuals referred by the criminal justice system.

Objective A: Explore the feasibility of a Drug Court through the Cecil County Circuit Court.

Measure: Complete feasibility study for a Circuit Court Drug Court.

Objective B: Maintain jail-based treatment services at the Cecil County Detention Center and Community Adult Rehabilitation Center Units.

Measure: Maintain 45 treatment slots at the Cecil County Detention Center and Community Adult Rehabilitation Center Units.

Objective C: Explore the feasibility of a Re-Entry Drug Court for offenders serving sentences at the Cecil County Detention Center and Community Adult Rehabilitation Center Units.

Measure: Complete feasibility study for a Re-Entry Drug Court.

Performance Target: Improved substance abuse related resources for individuals involved with the criminal justice system.

Goal 3: Establish an integrated continuum of substance abuse prevention, intervention and treatment services that will be accessible to the adolescents and families of Cecil County.

Objective A: Extend residential treatment services (10 additional beds or 10% of adolescents in treatment) for individuals with substance abuse disorders.

Measure: Reduce the number of adolescents referred outside of the county for inpatient treatment.

Objective B: Establish education and counseling services in the county including case management for the families of substance abusing adolescents.

Measure: Establish services for the families of adolescents in substance abuse treatment.

Objective C: Use appropriate evidenced-based prevention programs in all settings.

Measure: Reduce the prevalence of substance abuse among adolescents as evidenced by the Maryland Adolescent Survey, Department of Juvenile Justice referrals and school suspensions related to substance abuse.

Objective D: Establish non-hospital crisis intervention services for individuals experiencing mental health crises with or without coexisting substance abuse concerns.

Measure: Complete a feasibility study for non-hospital crisis intervention services.

Performance Target: Improve access for Cecil County adolescents and their families to integrated prevention, intervention and treatment services.

Goal 4: Educate and assist families in Cecil County to live healthy and drug free lives.

Objective A: Increase awareness among healthcare providers as to the importance of screening their patients for substance abuse as well as resources for treatment and intervention in the community.

Measure: Increase the percentage (to 100%) of healthcare providers who routinely screen and refer patients experiencing substance abuse concerns.

Objective B: Utilize environmental strategies to change individual and community norms.

Measure: Reduce the prevalence of high risk substance abusing behaviors among residents as indicated the Cecil County Community Health Survey and Maryland Adolescent Survey.

Performance Target: Increased awareness of substance abuse related concerns among Cecil County residents.

___________________________

According to the information below, I don't believe County Ex. Moore has more than one appt. to the Council.  The local council is supposed to be composed of different agencies.  

Local Drug and Alcohol Abuse Council

The state legislature enacted regulations that require that each of the 24 jurisdictions in Maryland establish a local drug and alcohol abuse council. Each council’s membership is composed of local government officials, members of the judiciary, prevention and treatment providers, and other key stakeholders. Councils are responsible for preparing a two year strategic plan that includes strategies and priorities of the jurisdiction for meeting the identified needs of the general public and the criminal justice system for alcohol and drug abuse evaluation, prevention and treatment services. Councils are also required to submit reports every 6 months to the Alcohol and Drug Administration on their progress in implementing the plan.

The statement above was found on this link to the DHMH website:  http://adaa.dhmh.maryland.gov/SDAAC/SitePages/SDAAC_Information.aspx

I noticed that there were certain expectations required from the local drug councils including 6 month reports and the 2 year strategic plan.  At this point I believe we should be having meetings every month, the council should be collectively contributing to these reports and we should be following through on initiatives including in the reports and providing performance measures on current programs.  I believe the Council should have an appointment to the Council as well as the Co. Ex.  If I am that appt., I would also be interested in serving as co chair. 

Just my thoughts,

Emails exchanged with John Bennett

Dottiejobennett@aol.com	12/19/13
to stephanie.garr., me, ken.collins

Good evening Diana,

  By coincidence, I wrote to Ken and Stephanie this morning suggesting that the DAAC may want to shift from a "advice giving" mode to a "supportive and consensus building" mode for the initiatives contained in the County Executive's letter to the Governor dated November 22, 2013.  Of course, any activities under the "supportive" mode would need to be approved by Stephanie as Health Officer to make sure we do not conflict with whatever message is being delivered by her office.

  I had suggested a list of groups and individuals could be contacted, both at the State and local level, to build support first for these initiatives being included in the Governor's budget, and second that once included, they are approved by the General Assembly.  For example, I believe Ken has said that the Recovery High School initiative has met with some enthusiastic support from some State employees who will need to "sign off" on these initiatives.  If that is true, it certainly would be helpful to have a letter of support from the Cecil County Board of Education.  I indicate I would be happy to reach out to Dr. Devine and the Board members to see if such a letter could be obtained.

  Since State employees may not "lobby" (but they can "educate"), the DAAC in the past has not taken any kind of formal vote on consensus building initiatives.  Those of us who are not employed by the State have contacted State and local officials on behalf of Council, but again such contacts have been approved in advance by the Health Officer.  I will let you know when Stephanie decides how she wants to use DAAC in this role, if at all.

  Regarding the language you cite regarding the strategic plan:

"ouncils are responsible for preparing a two year strategic plan that includes strategies and priorities of the jurisdiction for meeting the identified needs of the general public and the criminal justice system for alcohol and drug abuse evaluation, prevention and treatment services. Councils are also required to submit reports every 6 months to the Alcohol and Drug Administration on their progress in implementing the plan."

I am pleased to report that the Cecil County DAAC has met every deadline as required under this statute.  Ken has spent hours each year submitting the updates and the 2 year plan.  Over the years, many community members have suggested additions (unfortunately, not many deletions).  As I noted to Ken in August, I was thusly very disappointed that the Governor appeared unaware of Cecil's plan, and also disappointed that no one thought to share it with him.  However, that's "water over the dam" now.

Thank you for your thoughts, and Merry Christmas!  John

Diana Broomell <diana.broomell@gmail.com>	12/28/13
to Diana

John,

I was wondering why you replied to my last email as if you had already addressed what the intended function of DAAC was.  I didn't see this reply until I went searching for my email to you.  

My question still is, where are you getting the guidelines on how the DAAC is supposed to function. You say that the DAAC is only advisory but why would that be limiting. I thought the 2 year plan and 6 month reports were compiled from the direction of the DAAC. Until we see the Rules of Procedure, how can you say what authority Stephanie Garrity has in using the DAAC?    

Also, can you provide a copy of the Attorney General Opinion you are referring to on advisory councils?  

Another question, did the DAAC approve or review the 6 month reports and the 2 year strategic plan submitted by Ken Collins? I would have thought the plan and reports were compiled using data from the DAAC meetings.  Also, can you provide the 6 month reports and strategic plans for the last 6 years?

I expressed a concern on the Recovery High School at the last DHMH Meeting.  Where did this initiative originate?  Is there a model they are copying that has been successful?  Isn't the High Roads School already providing this service?  In fact, we requested that Ken bring Louis Guertin (Director of High Roads School) in to discuss further the Recovery High School.  By the way, we still need the DHMH Meeting to be scheduled because they were going to explain the State Stat findings on our specific questions regarding the effectiveness of Methadone Maintenance Programs.

My biggest concern is that we could be wasting a lot of money and time by supporting initiatives that sound good on paper but have not had the scrutiny or review to be vetted properly.  I'm guessing that the whole purpose of the DAAC's was to first identify the top goals in a County and then back that up with action.  The 6 month reports are supposed to show how we are supporting the Strategic Plan.  

After I read the Initial Plan, it answered a lot of questions on why Cecil County has been spinning its wheels for so long: The first goal had never been addressed!  Increased access to intensive inpatient detox for Whittsit.  Why did I have to hear about this for the first time at the Governor's Round Table?  And now I see it has always been our #1 goal but what has DAAC done to meet that goal?

There is no doubt that you and Ken Collins are enthusiastically in support of Tari Moore's initiatives. But if we allow our feelings to determine how to best invest our resources in attacking drug abuse, we will end up looking foolish.  Let's base our choices on facts and research.  I was pleased County Ex. Moore agreed with my request to make expanding Intensive Inpatient Care at Whittsit our top goal - which was previously vetted and supported by many County Departments, included in our strategic plan and our highest overdose rate coincides with the increased 6 week waiting list when the 1/2 the beds were no longer available.  However, I'm concerned that no funding amount has been assigned to that request.  After speaking with representatives at Whittsit, they did provide the funding amounts necessary for what was requested and I believe it was about $700,000.  

As I had mentioned to Ken Collins, I am very concerned with the County Executive's #2 request that we expand residential access to detox.  Where is the research to support that program will work.  From my initial inquiry, in the majority of cases it usually doesn't because the patient is still located in the environment that triggers their addiction.  The most successful detox program is when the patient is removed from their existing environment to detox and are then provided the tools and support system to continue fighting addiction in the future.    

I would request that a DAAC meeting be scheduled as soon as possible to have a sobering discussion on what initiatives we as a Council will formerly support.  

December 2006 Progress Report

Cecil County Alcohol and Drug Council

Progress Report – December, 2006

Vision: A community free from substance abuse and dependence. Mission: To reduce substance abuse and dependence and related consequences through development and implementation of a plan, strategies and priorities for meeting the identified needs of the general public, and the criminal justice system for alcohol and drug evaluation, prevention and treatment services. The Cecil County Alcohol and Drug Council meets each month at the Cecil County Health Department. Organizationally, the council has a chair and co-chairperson and a secretary as established by bylaws instituted by the membership. A list of members and contact information is enclosed with this report. Maintaining steady attendance at monthly meetings has been a challenge as funding to support the strategic plan for the council has been delayed and, therefore, progress has been slower than hoped when the council was initially established. The strategic plan remains as it was initially formatted but will be reviewed and updated as needed. The council has, and will continue to, develop work groups as special projects are undertaken. The following is a summary of activities and accomplishments of the Cecil County Alcohol and Drug Council through the end of December, 2006. Accomplishments are highlighted in red. Goal 1: Establish an integrated continuum of adult substance abuse treatment services that will be accessible to the residents of Cecil County. Goal 1- This area was the priority focus identified in the strategic plan. Council has allocated funding received from ADAA in the amount of $19,266 for the purchase of bed time from approved providers. The process and providers are already in place via the purchase of care program via Cigarette Restitution funding. This has permitted some expansion of available treatment interventions and progress toward this goal, specifically under Objective A. Objective A: Extend residential treatment services (20 additional beds) for individuals with substance abuse disorders. Some progress had been made toward this objective. With additional funds in the amount of $19,266, clients who have been referred for detoxification services (under the previously existing purchase of care program) have been able to benefit from an extension of bed days beyond the 5 days generally allotted for detox. This has provided a greater foundation for the client’s recovery. Measure: Reduce the number of clients on the waiting list at the A.F. Whitsitt Center for Inpatient Care by 50%. Objective B: Restore funding for Purchase of Care Program for detoxification services. Objective B was previously accomplished and additional funding was allocated from the Cecil County Health Department due to vacancies and increased collections through the Alcohol and Drug Center. This was reported in the June, 2006 report on progress. Measure: Restore the 20% of funding for Purchase of Care Program that was eliminated in the FY 2006 allocation. Objective C: Expand transitional housing services for individuals in need of ongoing long-term substance abuse care to include services for women and women with children. Additional funding is needed in order to accomplish this goal. Measure: Establish additional transitional housing services. Objective D: Enhance existing outpatient substance abuse treatment to allow for increased intensity and contact with clients referred through the criminal justice system. Additional funding is needed in order to accomplish this goal. Measure: Expand staffing, space and related resources (at the Cecil County Health Department, Cecil County Detention Center and Community Adult Rehabilitation Center Unit) for the provision of substance abuse services Objective E: Establish non-hospital crisis intervention services for individuals experiencing mental health crises with or without coexisting substance abuse concerns. Additional funding is needed in order to accomplish this goal. Measure: Complete a feasibility study for non-hospital crisis intervention services. Performance Target: Improve access for Cecil County residents to integrated treatment services. Goal 2: Establish and enhance resources and programs to address the substance abuse concerns among individuals referred by the criminal justice system. Objective A: Explore the feasibility of a Drug Court through the Cecil County Circuit Court. Objective A has been completed as Adult Treatment Drug Court has been operational since late May. At this time, there are 8 clients enrolled in the program. Measure: Complete feasibility study for a Circuit Court Drug Court. Objective B: Maintain jail-based treatment services at the Cecil County Detention Center and Community Adult Rehabilitation Center Units. Objective B has been accomplished as jail-based treatment services are continuing. Measure: Maintain 45 treatment slots at the Cecil County Detention Center and Community Adult Rehabilitation Center Units. Objective C: Explore the feasibility of a Re-Entry Drug Court for offenders serving sentences at the Cecil County Detention Center and Community Adult Rehabilitation Center Units. Additional funding is needed in order to accomplish this goal. Measure: Complete feasibility study for a Re-Entry Drug Court. Performance Target: Improved substance abuse related resources for individuals involved with the criminal justice system. Goal 3: Establish an integrated continuum of substance abuse prevention, intervention and treatment services that will be accessible to the adolescents and families of Cecil County. Objective A: Extend residential treatment services (10 additional beds or 10% of adolescents in treatment) for individuals with substance abuse disorders. Additional funding is needed in order to accomplish this goal. Measure: Reduce the number of adolescents referred outside of the county for inpatient treatment. Objective B: Establish education and counseling services in the county including case management for the families of substance abusing adolescents. Additional funding is needed in order to accomplish this goal. Measure: Establish services for the families of adolescents in substance abuse treatment. Objective C: Use appropriate evidenced-based prevention programs in all settings. Evidenced-based prevention services are in place through the Cecil County Health Department’s Prevention Program as well as through the public schools for children grades K-12. Measure: Reduce the prevalence of substance abuse among adolescents as evidenced by the Maryland Adolescent Survey, Department of Juvenile Justice referrals and school suspensions related to substance abuse. Objective D: Establish non-hospital crisis intervention services for individuals experiencing mental health crises with or without coexisting substance abuse concerns. Additional funding is needed in order to accomplish this goal. Measure: Complete a feasibility study for non-hospital crisis intervention services. Performance Target: Improve access for Cecil County adolescents and their families to integrated prevention, intervention and treatment services. Goal 4: Educate and assist families in Cecil County to live healthy and drug free lives. Objective A: Increase awareness among healthcare providers as to the importance of screening their patients for substance abuse as well as resources for treatment and intervention in the community. Measure: Increase the percentage (to 100%) of healthcare providers who routinely screen and refer patients experiencing substance abuse concerns. Objective B: Utilize environmental strategies to change individual and community norms. Council partnered with Union-LEAD program to explore needs of employers regarding substance abuse intervention in the workplace so that we could improve outreach and services but we have not yet had a full report on the project. Measure: Reduce the prevalence of high risk substance abusing behaviors among residents as indicated the Cecil County Community Health Survey and Maryland Adolescent Survey. Performance Target: Increased awareness of substance abuse related concerns among Cecil County residents. .

Bennett Email 8-14-14

Untitled
To: kelly.frost@comcast.net, stephanie.garrity@maryland.gov, ken.collins@maryland.gov
From: Dottiejobennett@aol.com
Date: 08/14/2014 02:29PM
Cc: TMoore@ccgov.org, amccarthy@ccgov.org, jbowlsbey@ccgov.org, mdunn@ccgov.org,
dbroomell@ccgov.org, rhodge@ccgov.org, laurie.humphries@maryland.gov
Subject: Re: Official Members of the Cecil County Drug and Alcohol Abuse Drug Council]...

Good afternoon Kelly,

As long as I am the Chair, the DAAC will not be spending time discussing the finances of the
Health Department related to substance abuse or investigating how the Health Department
spends its money. As I have discussed with Councilor Broomell several times, it is my opinion
that the DAAC is not an oversight or investigatory body. It is an advisory body, much like the
local Forestry Board, Ag Advisory Board, or the Sheriff's advisory board for CARC operations.
In my opinion, if you want the DAAC to function as an oversight Board, then you need to talk
with the Cecil County Delegation about changing the legislation that created the LDAACs to
specify the functions you want to see occur.

Consequently I will repeat my statement that a continued discussion of the Cecil Plan will not
be on the agenda for September. However, in December, we are required by statute to
discuss a 6 month update. However, I do not intend at that time to spend 1.5 hours discussing
the plan--only those issues that have seen progress over the 6 months.
I am also not going to engage in an extended dialogue with you over this issue. I assume
you will not be pleased with my response, and I suggest that you contact the County
Executive, as she is the appointing authority for citizen members, such as me and you.
John