Oklahoma uniform application : Substance Abuse Prevention and Treatment Block Grant 2011 |
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Oklahoma UNIFORM APPLICATION FY2011 SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT 42 U.S.C.300x-21 through 300x-66 OMB - Approved 07/20/2010 - Expires 07/31/2013 (generated on 10/1/2010 12:07:53 PM) Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Center for Substance Abuse Prevention OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 1 of 311 Introduction: The Substance Abuse Prevention and Treatment Block Grant represents a significant Federal contribution to the States’ substance abuse prevention and treatment service budgets. The Public Health Service Act [42 USC 300x-21 through 300x-66] authorizes the Substance Abuse Prevention and Treatment Block Grant and specifies requirements attached to the use of these funds. The SAPT Block Grant funds are annually authorized under separate appropriation by Congress. The Public Health Service Act designates the Center for Substance Abuse Treatment and the Center for Substance Abuse Prevention as the entities responsible for administering the SAPT Block Grant program. The SAPT Block Grant application format provides the means for States to comply with the reporting provisions of the Public Health Service Act (42 USC 300x-21-66), as implemented by the Interim Final Rule (45 CFR Part 96, part XI). With regard to the requirements for Goal 8, the Annual Synar Report format provides the means for States to comply with the reporting provisions of the Synar Amendment (Section 1926 of the Public Health Service Act), as implemented by the Tobacco Regulation for the SAPT Block Grant (45 CFR Part 96, part IV). Public reporting burden for this collection of information is estimated to average 454 hours per respondent for Sections I-III, 40 hours per respondent for Section IV-A and 42.75 hours per respondent for Section IV-B, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to SAMHSA Reports Clearance Officer; Paperwork Reduction Project (OMB No. 0930-0080), 1 Choke Cherry Road, Room 7-1042, Rockville, Maryland 20857. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is OMB No. 0930-0080. The Web Block Grant Application System (Web BGAS) has been developed to facilitate States’ completion, submission and revision of their Block Grant application. The Web BGAS can be accessed via the World Wide Web at http://bgas.samhsa.gov. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 2 of 311 Form 1 DUNS Number: 933662934- Uniform Application for FY 2011-13 Substance Abuse Prevention and Treatment Block Grant I. State Agency to be the Grantee for the Block Grant: Agency Name: Oklahoma Department of Mental Health and Substance Abuse Services Organizational Unit: Substance Abuse Services Mailing Address: P. O. Box 53277 City: Oklahoma City, OK Zip Code: 73152-3277 II. Contact Person for the Grantee of the Block Grant: Name: Terri White, MSW, Commissioner and Secretary of Health Agency Name: Oklahoma Department of Mental Health and Substance Abuse Services Mailing Address: P. O. Box 53277 City: Oklahoma City, OK Code: 73152-3277 Telephone: (405) 522-3877 FAX: (405) 522-0637 Email Address: tlwhite@odmhsas.org III. State Expenditure Period: From: 7/1/2009 To: 6/30/2010 IV. Date Submitted: Date: Original: Revision: V. Contact Person Responsible for Application Submission: Name: Mary Hagerty Telephone: (405) 522-3859 Email Address: mhagerty@odmhsas.org FAX: (405) 522-3767 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 3 of 311 Form 2 (Table of Contents) Form 1 pg.3 Form 2 pg.4 Form 3 pg.5 1. Planning pg.15 Planning Checklist pg.34 Form 4 (formerly Form 8) pg.35 Form 5 (formerly Form 9) pg.37 How your State determined the estimates for Form 4 and Form 5 (formerly Forms 8 and 9) pg.38 Form 6 (formerly Form 11) pg.42 Form 6ab (formerly Form 11ab) pg.43 Form 6c (formerly Form 11c) pg.44 Purchasing Services pg.45 PPM Checklist pg.46 Form 7 pg.47 Goal #1:Improving access to prevention and treatment services pg.48 Goal #2: Providing Primary Prevention services pg.65 Goal #3: Providing specialized services for pregnant women and women with dependent children pg.88 Programs for Pregnant Women and Women with Dependent Children (formerly Attachment B) pg.94 Goal #4: Services to intravenous drug abusers pg.102 Programs for Intravenous Drug Users (IVDUs) ( formerly Attachment C) pg.109 Program Compliance Monitoring (formerly Attachment D) pg.113 Goal #5: TB Services pg.116 Goal #6: HIV Services pg.120 Tuberculosis (TB) and Early Intervention Services for HIV (formerly Attachment E) pg.124 Goal #7: Development of Group Homes pg.128 Group Home Entities and Programs (formerly Attachment F) pg.133 Goal #8: Tobacco Products pg.138 Goal #9: Pregnant Women Preferences pg.140 Capacity Management and Waiting List Systems (formerly Attachment G) pg.147 Goal #10: Process for Referring pg.151 Goal #11: Continuing Education pg.158 Goal #12: Coordinate Services pg.165 Goal #13: Assessment of Need pg.175 Goal #14: Hypodermic Needle Program pg.189 Charitable Choice (formerly Attachment I) pg.215 Waivers (formerly Attachment J) pg.217 Waivers pg.218 Form 8 (formerly Form 4) pg.221 Form 8ab (formerly Form 4ab) pg.222 Form 8c (formerly Form 4c) pg.223 Form 9 (formerly Form 6) pg.224 Provider Address Table pg.231 Form 9a (formerly Form 6a) pg.235 Form 10a (formerly Form 7a) pg.244 Form 10b (formerly Form 7b) pg.245 Description of Calculations pg.246 SSA (MOE Table I) pg.249 TB (MOE Table II) pg.251 HIV (MOE Table III) pg.253 Womens (MOE TABLE IV) pg.255 Form T1 pg.256 Form T2 pg.258 Form T3 pg.260 Form T4 pg.262 Form T5 pg.267 Form T6 pg.272 Form T7 pg.274 Treatment Performance Measures (Overall Narrative) pg.276 Corrective Action Plan for Treatment NOMS pg.281 Form P1 pg.283 Form P2 pg.284 Form P3 pg.285 Form P4 pg.286 Form P5 pg.287 Form P6 pg.288 Form P7 pg.289 Form P8 pg.290 Form P9 pg.291 Form P10 pg.292 Form P11 pg.293 P-Forms 12a- P-15 – Reporting Period pg.294 Form P12a pg.295 Form P12b pg.297 Form P13 (Optional) pg.298 Form P14 pg.299 Form P15 pg.300 Corrective Action Plan for Prevention NOMS pg.301 Prevention Attachments A, B, and C (optional) pg.303 Prevention Attachment D (optional) pg.304 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 4 of 311 Goal #15: Independent Peer Review pg.193 Independent Peer Review (formerly Attachment H) pg.201 Goal #16: Disclosure of Patient Records pg.205 Goal #17: Charitable Choice pg.210 Prevention Attachment D (optional) pg.304 Description of Supplemental Data pg.306 Attachment A, Goal 2 pg.308 Addendum - Additional Supporting Documents (Optional) pg.310 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 5 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 FORM 3: UNIFORM APPLICATION FOR FY 2011 SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT Funding Agreements/Certifications as required by Title XIX, Part B, Subpart II and Subpart III of the Public Health Service (PHS) Act c Title XIX, Part B, Subpart II and Subpart III of the PHS Act, as amended, requires the chief executive officer (or an authorized designee) of the applicant organization to certify that the State will comply with the following specific citations as summarized and set forth below, and with any regulations or guidelines issued in conjunction with this Subpart except as exempt by statute. SAMHSA will accept a signature on this form as certification of agreement to comply with the cited provisions of the PHS Act. If signed by a designee, a copy of the designation must be attached. I. Formula Grants to States, Section 1921 Grant funds will be expended “only for the purpose of planning, carrying out, and evaluating activities to prevent and treat substance abuse and for related activities” as authorized. II. Certain Allocations, Section 1922 Allocations Regarding Primary Prevention Programs, Section 1922(a) Allocations Regarding Women, Section 1922(b) III. Intravenous Drug Abuse, Section 1923 Capacity of Treatment Programs, Section 1923(a) Outreach Regarding Intravenous Substance Abuse, Section 1923(b) IV. Requirements Regarding Tuberculosis and Human Immunodeficiency Virus, Section 1924 V. Group Homes for Recovering Substance Abusers, Section 1925 Optional beginning FY 2001 and subsequent fiscal years. Territories as described in Section 1925(c) are exempt. The State “has established, and is providing for the ongoing operation of a revolving fund” in accordance with Section 1925 of the PHS Act, as amended. This requirement is now optional. VI. State Law Regarding Sale of Tobacco Products to Individuals Under Age of 18, Section 1926 The State has a law in effect making it illegal to sell or distribute tobacco products to minors as provided in Section 1926 (a)(1). The State will enforce such law in a manner that can reasonably be expected to reduce the extent to which tobacco products are available to individuals under the age of 18 as provided in Section 1926 (b)(1). The State will conduct annual, random unannounced inspections as prescribed in Section 1926 (b)(2). VII. Treatment Services for Pregnant Women, Section 1927 The State “…will ensure that each pregnant woman in the State who seeks or is referred for and would benefit from such services is given preference in admission to treatment facilities receiving funds pursuant to the grant.” VIII. Additional Agreements, Section 1928 Improvement of Process for Appropriate Referrals for Treatment, Section 1928(a) Continuing Education, Section 1928(b) Coordination of Various Activities and Services, Section 1928(c) Waiver of Requirement, Section 1928(d) generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 6 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 FORM 3: UNIFORM APPLICATION FOR FY 2011 SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT Funding Agreements/Certifications As required by Title XIX , Part B, Subpart II and Subpart III of the PHS Act (continued) IX. Submission to Secretary of Statewide Assessment of Needs, Section 1929 X. Maintenance of Effort Regarding State Expenditures, Section 1930 With respect to the principal agency of a State, the State “will maintain aggregate State expenditures for authorized activities at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant.” XI. Restrictions on Expenditure of Grant, Section 1931 XII. Application for Grant; Approval of State Plan, Section 1932 XIII. Opportunity for Public Comment on State Plans, Section 1941 The plan required under Section 1932 will be made “public in such a manner as to facilitate comment from any person (including any Federal person or any other public agency) during the development of the plan (including any revisions) and after the submission of the plan to the Secretary.” XIV. Requirement of Reports and Audits by States, Section 1942 XV. Additional Requirements, Section 1943 XVI. Prohibitions Regarding Receipt of Funds, Section 1946 XVII. Nondiscrimination, Section 1947 XVIII. Services Provided By Nongovernmental Organizations, Section 1955 I hereby certify that the State or Territory will comply with Title XIX, Part B, Subpart II and Subpart III of the Public Health Service Act, as amended, as summarized above, except for those Sections in the Act that do not apply or for which a waiver has been granted or may be granted by the Secretary for the period covered by this agreement. State: Name of Chief Executive Officer or Designee: Signature of CEO or Designee: Title: Date Signed: If signed by a designee, a copy of the designation must be attached Oklahoma Terri White, MSW Commissioner and Secretary of Health generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 7 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION The undersigned (authorized official signing for the applicant organization) certifies to the best of his or her knowledge and belief, that the applicant, defined as the primary participant in accordance with 45 C.F.R. Part 76, and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal Department or agency; (b) have not within a 3-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and (d) have not within a 3-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. Should the applicant not be able to provide this certification, an explanation as to why should be placed after the assurances page in the application package. The applicant agrees by submitting this proposal that it will include, without modification, the clause titled "Certification Regarding Debarment, Suspension, In eligibility, and Voluntary Exclusion – Lower Tier Covered Transactions" in all lower tier covered transactions (i.e., transactions with sub-grantees and/or contractors) and in all solicitations for lower tier covered transactions in accordance with 45 C.F.R. Part 76. 2. CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS The undersigned (authorized official signing for the applicant organization) certifies that the applicant will, or will continue to, provide a drug-free work-place in accordance with 45 C.F.R. Part 76 by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee’s workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an ongoing drug-free awareness program to inform employees about – (1) The dangers of drug abuse in the workplace; (2) The grantee’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a) above; (d) Notifying the employee in the statement required by paragraph (a), above, that, as a condition of employment under the grant, the employee will – (1) Abide by the terms of the statement; and (2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; (e) Notifying the agency in writing within ten calendar days after receiving notice under paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 8 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 (f) Taking one of the following actions, within 30 calendar days of receiving notice under paragraph (d) (2), with respect to any employee who is so convicted – (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). For purposes of paragraph (e) regarding agency notification of criminal drug convictions, the DHHS has designated the following central point for receipt of such notices: Office of Grants and Acquisition Management Office of Grants Management Office of the Assistant Secretary for Management and Budget Department of Health and Human Services 200 Independence Avenue, S.W., Room 517-D Washington, D.C. 20201 3. CERTIFICATION REGARDING LOBBYING Title 31, United States Code, Section 1352, entitled "Limitation on use of appropriated funds to influence certain Federal contracting and financial transactions," generally prohibits recipients of Federal grants and cooperative agreements from using Federal (appropriated) funds for lobbying the Executive or Legislative Branches of the Federal Government in connection with a SPECIFIC grant or cooperative agreement. Section 1352 also requires that each person who requests or receives a Federal grant or cooperative agreement must disclose lobbying undertaken with non-Federal (non-appropriated) funds. These requirements apply to grants and cooperative agreements EXCEEDING $100,000 in total costs (45 C.F.R. Part 93). The undersigned (authorized official signing for the applicant organization) certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the under signed, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities, "in accordance with its instructions. (If needed, Standard Form-LLL, "Disclosure of Lobbying Activities," its instructions, and continuation sheet are included at the end of this application form.) (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 4. CERTIFICATION REGARDING PROGRAM FRAUD CIVIL REMEDIES ACT (PFCRA) The undersigned (authorized official signing for the applicant organization) certifies that the statements herein are true, complete, and accurate to the best of generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 9 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 his or her knowledge, and that he or she is aware that any false, fictitious, or fraudulent statements or claims may subject him or her to criminal, civil, or administrative penalties. The undersigned agrees that the applicant organization will comply with the Public Health Service terms and conditions of award if a grant is awarded as a result of this application. 5. CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103-227, also known as the Pro- Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children’s services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children’s services provided in private residence, portions of facilities used for inpatient drug or alcohol treatment, service providers whose sole source of applicable Federal funds is Medicare or Medicaid, or facilities where WIC coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing the certification, the undersigned certifies that the applicant organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The applicant organization agrees that it will require that the language of this certification be included in any subawards which contain provisions for children’s services and that all subrecipients shall certify accordingly. The Public Health Service strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of tobacco products. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED Commissioner and Secretary of Health Oklahoma Department of Mental Health and Substance Abuse Services generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 10 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action 3. Report Type: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance a. bid/offer/application b. initial award c. post-award a. initial filing b. material change For Material Change Only: Year Quarter date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier , if known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Entity (if individual, last name, first name, MI): b. Individuals Performing Services (including address if different from No. 10a.) (last name, first name, MI): 11. Information requested through this form is authorized by title 31 U.S.C. Section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature: Print Name: Title: Telephone No.: Date: Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97) generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 11 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 DISCLOSURE OF LOBBYING ACTIVITIES CONTINUATION SHEET Reporting Entity: Page of generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 12 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks “subawardee”, then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 [e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency]. Include prefixes, e.g., ‘‘RFP-DE- 90-001.’’ 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No.0348- 0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503. generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 13 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 ASSURANCES – NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standard or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM’s Standard for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L.88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681- 1683, and 1685- 1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §§794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to non- discrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Title II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply with the provisions of the Hatch Act (5 U.S.C. §��1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333), regarding labor standards for federally assisted construction subagreements. generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 14 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetland pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§ 469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED Commissioner and Secretary of Health Oklahoma Department of Mental Health and Substance Abuse Services generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 15 of 311 1. Planning THREE YEAR PLAN, ANNUAL REPORT, and PROGRESS REPORT: PLAN FOR FY 2011-FY 2013 PROGRAM ACTIVITIES This section documents the States plan to use the FY 2011 through FY 2013 Federal Substance Abuse Prevention and Treatment (SAPT) Block Grant. For each SAPT Block Grant award, the funds are available for obligation and expenditure for a 2-year period beginning on October 1 of the Federal Fiscal Year (FY) for which an award is made. States are encouraged to incorporate information on needs assessment, resource availability and States priorities in their plan to use these funds over the next three fiscal years. In the interim years (FY 2012 and FY 2013), updates to this 3-year plan are required; however, if the plan remains unchanged, additional narrative is not necessary. This section requires completion of needs assessment forms, services utilization forms and a narrative description of the States planning processes. 1. Planning This section provides an opportunity to describe the State’s planning processes and requires completion of needs assessment data forms, utilization information and a description of the State’s priorities. In addition, this section provides the State the opportunity to complete a three year intended use plan for the periods of FY 2011-FY 2013. Finally this section requires completion of planning narratives and a checklist. These items address compliance with the following statutory requirements: • 42 U.S.C. §300x-29, 45 C.F. R. §96.133 and 45 C.F.R. §96.122(g)(13) require the State to submit a Statewide assessment of need for both treatment and prevention. The State is to develop a 3-year plan which covers the three (3) fiscal years from FFY 2011-FY 2013. In a narrative of up to five pages, describe: • How your State carries out sub-State area planning and determines which areas have the highest incidence, prevalence, and greatest need. • Include a definition of your State’s sub-State planning areas (SPA). • Identify what data is collected, how it is collected and how it is used in making these decisions. • If there is a State, regional or local advisory council, describe their composition and their role in the planning process. • Describe the monitoring process the State will use to assure that funded programs serve communities with the highest prevalence and need. • Those States that have a State Epidemiological Outcomes Workgroup (SEOW) must describe its composition and contribution to the planning process for primary prevention and treatment planning. States are encouraged to utilize the epidemiological analyses and profiles to establish substance abuse prevention and treatment goals at the State level. Describe how your State evaluates activities related to ongoing substance abuse prevention and treatment efforts, such as performance data, programs, policies and practices, and how this data is produced, synthesized and used for planning. A general narrative describing the States planned approach to using State and Federal resources should be included. For the prevention assessment, States should focus on the SEOW process. Describe State priorities and activities as they relate to addressing State and Federal priorities and requirements. • 42 U.S.C. §300x-51 and 45 C.F. R. §96.123(a)(13) require the State to make the State plan public in OK / SAPT FY2011 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 16 of 311 such a manner as to facilitate public comment from any person during the development of the plan. In a narrative of up to two pages, describe the process your State used to facilitate public comment in developing the State’s plan and its FY 2011-FY 2013 application for SAPT Block Grant funds. For FY 2012 and FY 2013, only updates to the 3-year plan will be required. In the Section addressing the Federal Goals, the States will still need to provide Annual and Progress reports. Fiscal reporting requirements and performance data reporting will also be required annually. The Prevention component of your Three Year Plan Should Include the Following: Problem Assessment (Epidemiological Profile) Using an array of appropriate data and information, describe the substance abuse-related problems in your State that you intend to address under Goal 2. Describe the criteria and rationale for establishing primary prevention priorities. (See 45 C.F.R §96.133(a) (1)) Prevention System Assessment (Capacity and Infrastructure) Describe the substance abuse prevention infrastructure in place at the State, sub-State, and local levels. Include in this description current capacity to collect, analyze, report, and use data to inform decision making; the number and nature of multi-sector partnerships at all levels, including broad-based community coalitions. In addition, describe the mechanisms the SSA has in place to support sub-recipients and community coalitions in implementing data-driven and evidence-based preventive interventions. If the State sets benchmarks, performance targets, or quantified objectives, describe the methods used by the State to establish these. Prevention System Capacity Development Describe planned changes to enhance the SSA’s ability to develop, implement, and support—at all levels —processes for performance management to include: assessment, mobilization, and partnership development; implementation of evidence-based strategies; and evaluation. Describe the challenges associated with these changes, and the key resources the State will use to address these challenges. Provide an overview of key contextual and cultural conditions that impact the State’s prevention capacity and functioning. Implementation of a Data-Driven Prevention System Describe the mechanism by which funding decisions are made and funds will be allocated. Explain how these mechanisms link funds to intended State outcomes. Provide an overview of any strategic prevention plans that exist at the State level, or which will be required at the sub-State or sub-recipient level, including goals, objectives, and/or outcomes. Indicate whether sub-recipients will be required to use evidence based programs and strategies. Describe the data collection and reporting requirements the State will use to monitor sub-recipient activities. Evaluation of Primary Prevention Outcomes Discuss the surveillance, monitoring, and evaluation activities the State will use to assess progress toward achieving its capacity development and substance abuse prevention performance targets. Describe the way in which evaluation results will be used to inform decision making processes and to modify implementation plans, including allocation decisions and performance targets. OK / SAPT FY2011 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 17 of 311 1. Planning The state is to develop a 3-year plan which covers the three (3) fiscal years from FFY 2011-FY 2013. In a narrative of up to five pages, describe: • How your state carries out sub-state area planning and determines which areas have the highest incidence, prevalence, and greatest need. • Include a definition of your state’s sub-state planning areas (SPA). • Identify what data is collected, how it is collected and how it is used in making these decisions. • If there is a state, regional or local advisory council, describe their composition and their role in the planning process. • Describe the monitoring process the state will use to assure that funded programs serve communities with the highest prevalence and need. • Those states that have a State Epidemiological Outcomes Workgroup (SEOW) must describe its composition and contribution to the planning process for primary prevention and treatment planning. States are encouraged to utilize the epidemiological analyses and profiles to establish substance abuse prevention and treatment goals at the state level. Describe how your state evaluates activities related to ongoing substance abuse prevention and treatment efforts, such as performance data, programs, policies and practices, and how this data is produced, synthesized and used for planning. A general narrative describing the states’ planned approach to using state and federal resources should be included. For the prevention assessment, states should focus on the SEOW process. Describe state priorities and activities as they relate to addressing state and federal priorities and requirements. • 42 U.S.C. §300x-51 and 45 C.F. R. §96.123(a)(13) require the state to make the state plan public in such a manner as to facilitate public comment from any person during the development of the plan. In a narrative of up to two pages, describe the process your state used to facilitate public comment in developing the state’s plan and its FY 2011-FY 2013 application for SAPT Block Grant funds. For FY 2012 and FY 2013, only updates to the 3-year plan will be required. In the Section addressing the Federal Goals, the states will still need to provide Annual and Progress reports. Fiscal reporting requirements and performance data reporting will also be required annually. The Prevention component of your Three Year Plan Should Include the Following: Problem Assessment (Epidemiological Profile) Using an array of appropriate data and information, describe the substance abuse-related problems in your state that you intend to address under Goal 2. Describe the criteria and rationale for establishing primary prevention priorities. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 18 of 311 (See 45 C.F.R §96.133(a) (1)) Prevention System Assessment (Capacity and Infrastructure) Describe the substance abuse prevention infrastructure in place at the state, sub-state, and local levels. Include in this description current capacity to collect, analyze, report, and use data to inform decision making; the number and nature of multi-sector partnerships at all levels, including broad-based community coalitions. In addition, describe the mechanisms the SSA has in place to support sub-recipients and community coalitions in implementing data-driven and evidence-based preventive interventions. If the state sets benchmarks, performance targets, or quantified objectives, describe the methods used by the state to establish these. Prevention System Capacity Development Describe planned changes to enhance the SSA’s ability to develop, implement, and support—at all levels—processes for performance management to include: assessment, mobilization, and partnership development; implementation of evidence-based strategies; and evaluation. Describe the challenges associated with these changes, and the key resources the state will use to address these challenges. Provide an overview of key contextual and cultural conditions that impact the state’s prevention capacity and functioning. Implementation of a Data-Driven Prevention System Describe the mechanism by which funding decisions are made and funds will be allocated. Explain how these mechanisms link funds to intended state outcomes. Provide an overview of any strategic prevention plans that exist at the state level, or which will be required at the sub-state or sub-recipient level, including goals, objectives, and/or outcomes. Indicate whether sub-recipients will be required to use evidence based programs and strategies. Describe the data collection and reporting requirements the state will use to monitor sub-recipient activities. Evaluation of Primary Prevention Outcomes Discuss the surveillance, monitoring, and evaluation activities the state will use to assess progress toward achieving its capacity development and substance abuse prevention performance targets. Describe the way in which evaluation results will be used to inform decision making processes and to modify implementation plans, including allocation decisions and performance targets. PLANNING Describe how your state carries out sub-state area planning and determines which areas have the highest incidence, prevalence and greatest need. Include a definition of your OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 19 of 311 state’s sub-state planning areas. Identify what data is collected, how it is collected, and how it is used in making these decisions: The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) utilizes needs assessment data developed through the Department’s Decision Support Services Division and the Oklahoma State Epidemiological Outcomes Workgroup (SEOW) for state and sub-state planning. In addition, sub-state and statewide data from other agencies and federal sources are reviewed along with information from providers, consumers, and stakeholders. The internal assessment of the need for treatment was previously supported by the Oklahoma Substance Abuse Needs Assessment Project (STNAP) contracts and grants with the federal Center for Substance Abuse Treatment (CSAT) in Rockville, Maryland. All phases of the needs assessment were completed with the third phase completed in FFY2004. Since the estimates from the above referenced studies are dated, the ODMHSAS began using the Office of Applied Studies National Survey on Drug Use and Health prevalence estimates for Oklahoma in FFY2005. The data collected is by sub-state planning regions and includes information on incidence, prevalence and need. The Provider Performance Management Report (PPMR) for Substance Abuse Agencies utilizes information from the Integrated Client Information System (ICIS), a database of provider services, to develop a quarterly agency report of performance indicators. This provides facilities and Department program staff with up-to-date performance information. The provider information is also reviewed for planning and gaps in services in each sub-state area. In late April 2006, the weekly census/waiting list report to the Department’s Decision Support Services (DSS) to comply with the 90% capacity reporting requirement was replaced with a daily reporting system to a designated substance abuse services staff person. Daily reporting by residential and halfway house programs has provided the ODMHSAS with a more timely account of the percentage of capacity and which agencies have available beds. The number of individuals waiting for treatment is also reported through this Residential/Halfway House Capacity Report providing valuable information on the needs within the state. Outpatient programs are able to admit clients as soon as appointments can be made so waiting lists are not needed for those programs. The ODMHSAS has now developed a secure online capacity report and staff are in the process of moving providers onto that system. Waiting list data is captured through the use of unique identifiers. Information from providers reporting to the online system is collected in a database which will provide valuable information including capacity of providers, bed availability, waiting lists information for each agency, an unduplicated count of individuals waiting for treatment, priority populations waiting time, and interim services data. The ODMHSAS website www.odmhsas.org includes an informative ad hoc query system, the Health Information Integrated Query System which includes prevalence and needs data by sub-state regions. Users can create a personalized query to produce OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 20 of 311 specific ODMHSAS data. These reports, too, are simple to use. They are generated through the ‘Basic Query’ and the ‘Advanced Query’ functions and provide demographic and count data for admitted clients for the last six years. The query system accesses over 1,500,000 records to produce results. The Oklahoma Prevention Needs Assessment Survey (OPNA) was provided to volunteering schools throughout Oklahoma in the spring of 2010. It is a risk and protective factor survey that was developed and offered to schools in Oklahoma to give them a snapshot of the communities in which they live. Participating schools throughout the state surveyed sixth, eighth, tenth, and twelfth grade students. Each school receives an analysis of the data from their school’s surveys and are encouraged to use the data for resource development, prevention planning, and community education. In addition, statewide and regional data are generated. This information is available to the Area Prevention Resource Centers (APRCs), community coalitions, and the general public. APRCs receive regular training on how to interpret and utilize OPNA data in their prevention planning and strategy development. This local Oklahoma data will be invaluable as schools, prevention programs, and local coalitions develop goals and objectives and plan prevention services in their communities based on the Strategic Prevention Framework (SPF). The OPNA is offered to schools every other year. The prior survey was completed in the spring of 2008 and the next survey will take place in 2012. The Oklahoma State Epidemiological Outcomes Workgroup (SEOW) was created August 3, 2006 and modeled after the National Institute on Drug Abuse (NIDA) community epidemiological work group. The SEOW is housed in the Oklahoma Department of Mental Health & Substance Abuse Services (ODMHSAS) and is funded through a federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (CSAP). The mission of Oklahoma SEOW is to improve prevention assessment, planning, implementation, and monitoring efforts through the application of systematic, analytical thinking about the causes and consequences of substance abuse. Oklahoma’s SEOW will continue to compile and update data annually or as new data becomes available. In fiscal year 2011, the ODMHSAS intends to make significant improvements to the state’s prevention data system in three proposed ways: 1) creation of a web-based epidemiological data query system as a common, real-time place to access data, analyze data, and produce reports/graphs/charts/maps; 2) identification of methods to address identified data gaps that exist at the state and local levels to effectively make data-driven decisions and evaluate efforts; and 3) creation of a web-based prevention service data reporting and tracking system that meets the evolving needs of federal funders, ODMHSAS, and local-level providers. The Oklahoma SEOW will also examine opportunities to expand its scope to meet the needs of other state agencies and to collect/analyze data on other health-related issues. Sources for the comprehensive epidemiological profile currently include: • Arrestee Drug Abuse Monitoring Program • Behavioral Risk Factor Surveillance Survey OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 21 of 311 • Center for Disease Control and Prevention • Ensuring Solutions to Alcohol Problems • Fatality Analysis Reporting System • National Institute on Alcohol Abuse and Alcoholism • National Survey on Drug Use and Health • National Vital Statistics System • Oklahoma Bureau of Narcotics and Dangerous Drugs • Oklahoma Department of Mental Health and Substance Abuse Services • Oklahoma Highway Safety Office • Oklahoma State Bureau of Investigation • Oklahoma State Department of Health • Oklahoma Tax Commission • Oklahoma Violent Death Reporting System • Oklahoma Youth Tobacco Survey • Pacific Institute for Research and Evaluation • Pregnancy Risk Assessment Monitoring System • Smoking Attributable Mortality, Morbidity and Economic Costs • Substance Abuse and Mental Health Services Administration • United States Census Bureau • Youth Risk Behavior Survey The ODMHSAS regional planning system divides Oklahoma into eight sub-state planning regions. Those regions include: 1. Central – Canadian, Cleveland, Grady, and McClain counties 2. East Central – Adair, Cherokee, Creek, Lincoln, McIntosh, Muskogee, Okfuskee, Okmulgee, Sequoyah, and Wagoner counties 3. Northeast – Craig, Delaware, Kay, Mayes, Noble, Nowata, Osage, Ottawa, Pawnee, Payne, Rogers, and Washington counties 4. Northwest - Alfalfa, Beaver, Cimarron, Ellis, Garfield, Grant, Harper, Kingfisher, Logan, Major, Texas, Woods, and Woodward counties 5. Oklahoma County 6. Southeast – Atoka, Bryan, Carter, Choctaw, Coal, Garvin, Haskell, Hughes, Johnston, Latimer, LeFlore, Love, Marshall, McCurtain, Murray, Pittsburg, Pontotoc, Pottawatomie, Pushmataha, and Seminole counties 7. Southwest – Beckham, Blaine, Caddo, Comanche, Cotton, Custer, Dewey, Greer, Harmon, Jackson, Jefferson, Kiowa, Roger Mills, Stephens, Tillman, and Washita counties 8. Tulsa County Of the eight sub-state areas, the Oklahoma County and Tulsa County regions are urban. The Central region is a suburban area close to Oklahoma City, housing the University of Oklahoma in Cleveland County. All other regions are rural. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 22 of 311 Oklahoma utilizes these eight sub-state areas for all substance abuse planning and needs assessment data and information, including the data collected through the Decision Support Services Division for TEDS and other needs assessment reporting. If there is a state, regional, or local advisory council, describe their composition and their role in the planning process. Oklahoma works closely with the Oklahoma State Department of Health (OSDH) in many areas including tobacco prevention, reduction of acute diseases including TB, HIV/AIDS, and Hepatitis C, and coalition development to promote wellness in local communities. Oklahoma does not have a substance abuse advisory council but most of the prevention programs and several treatment providers participate with the local OSDH coalitions. With this in mind, the ODMHSAS has joined forces with the Oklahoma State Department of Health to participate in their Turning Point coalitions. Although there is no formal advisory capacity, many of the ODMHSAS partners, prevention and treatment programs, state and community agencies participate and suggestions or ideas are passed on to the ODMHSAS leadership as needed. In addition, the ODMHSAS Prevention staff participate with the State Turning Point Advisory Council. The Area Prevention Resource Centers (APRCs) partner with community coalitions, including those in the Turning Point network, at the local levels within each service region. Each APRC in partnership with their associated community coalitions conduct local level needs assessments to identify priority issues (alcohol, tobacco, and other drug consumption/consequences) and intervening variables/causal factors that contribute to the identified priorities. Strategic plans are developed utilizing the needs assessments findings. The ODMHSAS prevention staff collaborate with the Oklahoma State Departments of Education and Health, the Governor’s Office, the Oklahoma Commission on Children and Youth, and other agencies, task forces, work groups, planning and community groups throughout Oklahoma. Examples of this include the Governor’s Task Force on the Prevention of Underage Drinking, the Oklahoma Prevention Leadership Collaborative, Oklahoma Crystal Darkness Collaborative, the SEOW, the Oklahoma Health Improvement Plan flagship workgroups, and the Oklahoma Partnership Initiative Steering Committee. The Department will continue to actively contribute to the Oklahoma Prevention Leadership Collaborative to help influence other prevention leadership bodies in the state to utilize the principles of the Strategic Prevention Framework and advocate for the coordination of prevention services and resources. The Collaborative was developed in 2010 to promote coordinated planning, implementation, and evaluation of quality prevention services for children, youth, and families at the state and local levels with a particular focus on the prevention of mental, emotional, and behavioral health disorders, related problems (i.e. alcohol and other drug use), and contributing risk factors. Oklahoma was awarded the Transformation State Incentive Grant (TSIG) in FFY 2005. While the grant is directed at transformation of mental health systems, the ODMHSAS is also responsible for providing substance abuse services and since the management of OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 23 of 311 mental health and substance abuse disorders share many common approaches, Oklahoma determined that transformation activities should include both the mental health and substance abuse service systems. Because people with mental health and substance abuse problems receive services from a number of state agencies and to ensure the participation of all other state agencies that may impact this population, in December 2005, Governor Brad Henry issued an Executive Order establishing the Governor’s Transformation Advisory Board (GTAB) to guide transformation activities. The 28-member panel includes the heads of eleven state agencies, representatives from the State Senate and House of Representatives, the law enforcement community, the state’s Indian Nations, the Indian Health Services, the chair of the Mental Health Planning and Advisory Council, eight representatives of consumer, youth and family advocacy organizations, and representatives from private industry and the philanthropic community. The GTAB Board continues to aid Oklahoma’s planning and transformation efforts. The Department’s Governing Board has three members who represent substance abuse issues specifically. The Department’s executive staff work closely with board members. The ODMHSAS governing board is a strong partner in the planning process. Additional organizations with which the ODMHSAS maintains open communication and which work with the Department throughout the year, providing advice and counsel to the Department include: The Oklahoma Substance Abuse Services Alliance (OSASA), a statewide organization, composed primarily of public and non-profit prevention and treatment providers. This organization serves as an advocate for substance abuse services, as well as for prevention and treatment programs. The Oklahoma Citizen Advocates for Recovery and Treatment Association (OCARTA) is a statewide recovery organization dedicated to empowering recovering people and their families, reducing the stigma associated with addiction, and advocating for the recovery community. The Oklahoma Prevention Policy Alliance (OPPA), a statewide advocacy organization composed of state and community prevention professionals. The ODMHSAS is committed to developing and supporting statewide prevention and recovery advocacy group(s) comprised of concerned or recovering citizens dedicated to reducing the stigma of addiction, advocating for prevention and treatment services and publicizing the fact that treatment works. It is the desire of the Department to be affiliated with prevention and recovery groups which will be able to contribute to the planning process through their recommendations as independent advocacy organizations. The Department encourages advice from many different sources, keeping an open door to all. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 24 of 311 Describe the monitoring process the state will use to assure that funded programs serve communities with the highest prevalence and need. The Integrated Client Information System (ICIS), a public online ad-hoc query system called the Health Information Integrated Query System (HI-IQs), along with preformatted reports and the Provider Performance Management Report (PPMR) provide information on prevention and consumer services throughout the sub-state regional areas of Oklahoma. This data allows for the monitoring of services to assure that communities with the greatest need are the communities receiving services. Beginning July 1, 2010, treatment providers began utilizing the Consolidated Claims Process (CCP), a combined service database and fee-for-service payment system developed through a partnership with the Oklahoma Health Care Authority, the state Medicaid agency. The CCP collects service, outcome and demographic data and will greatly enhance providers’ ability to work with Medicaid. The Department expects more consumers to be treated, and additional Medicaid dollars to pay for behavioral health services as a result. Data on substance abuse services through either the Medicaid or the ODMHSAS system will be reported into the CCP system. Individual-level data include consumer demographics, presenting problems, benefits information, Addiction Severity Index scores, drugs of choice, frequencies of use, routes of administration, and ages of first use. Information is also gathered on all services provided to consumers, the duration of those services, and identifying information of staff members providing the services. Using a unique client identifier, services can be linked to the client characteristics, and tracked across agencies and over time. Annual reports and ad-hoc queries will continue to be available through the ODMHSAS website at www.odmhsas.org. The Provider Performance Management Report will utilize information from the CCP database to develop a quarterly agency report providing facilities and Department program staff with up-to-date performance information. This information is available throughout the year for planning and identification of gaps in services in each sub-state area. All of the above information, in addition to Needs Assessment information, provider and consumer input, and various other sources, is utilized to provide quality services to consumers in need of such services. As indicators show an area to have a higher prevalence of need and as funding becomes available, every effort is made to increase services in that area. Describe the state’s Epidemiological Outcomes Workgroup’s composition and contribution to the planning process for primary prevention and treatment planning. States are encouraged to utilize the epidemiological analyses and profiles to establish substance abuse prevention and treatment goals at the state level. Describe how your state evaluates activities related to ongoing substance abuse prevention efforts, such as programs, policies and practices, and how this data is used for planning. For the OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 25 of 311 prevention assessment, states should focus on the SEOW process. Provide a summary of how data/data indicators were chosen, as well as, key data construct and indicators for understanding state-level substance use patterns and related consequences and mechanisms for tracking data and reporting significant changes should be outlined. The Oklahoma State Epidemiological Outcomes Workgroup (SEOW) is a multidisciplinary workgroup whose members are connected to key decision-making and resource allocation bodies in the state. This workgroup, funded through a Federal grant from SAMHSA/CSAP, was established by ODMHSAS in 2006 and is patterned after the National Institute on Drug Abuse (NIDA) community epidemiological workgroup. Oklahoma’s SEOW is charged with improving prevention assessment, planning, implementation, and monitoring efforts through data collection and analysis that accurately assesses the causes and consequences of the use of alcohol, tobacco, and other drugs and drives decisions concerning the effective and efficient use of prevention resources throughout the state. The Oklahoma State Epidemiological Outcomes Workgroup (SEOW) was convened to collect and report on substance abuse consumption and consequence data to help identify and monitor state priorities for ODMHSAS and other agencies. The SEOW is tasked with analyzing the state epidemiological data to determine problem or emerging alcohol, tobacco, and other drug consumption and consequence patterns. Using CSAP recommendations, data indicators for each substance are chosen based on the following criteria. 1) National source. The measure must be available from a centralized, national data source. 2) Availability at state level. The measure must be available in disaggregated form at the state (or lower geographic) level. 3) Validity. There must be research-based evidence that the data accurately measure the specific construct and yield a true snapshot of the phenomenon at the time of assessment. These criteria are used to eliminate measures that look at face value as if they assess a particular construct, but are in fact poor or unproven proxy measures and thus do not accurately reflect the construct. 4) Trend. The measure should be available for the past 3 to 5 years, preferably on an annual basis, but no less than a biennial basis. This enables the state to determine not only the level of an indicator but also its trends. 5) Consistency. The measure must be consistent (i.e., the method or means of collecting and organizing data should be relatively unchanged over time, such that the method of measurement is the same from time i to time i+1). Alternatively, if the method of measurement has changed, sound studies or data should exist that determine and allow adjustment for differences resulting from data collection changes. 6) Sensitivity. For monitoring, the measure must be sufficiently sensitive to detect change over time. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 26 of 311 This data focus—collection, analysis, and use—is entrenched in each step of the Strategic Prevention Framework, which is utilized in block grant funded prevention service delivery. Epi data continually informs the process. The formal assessment of contextual conditions, needs, resources, readiness, and capacity is used to identify priority issues in Step 1. In Step 2, data are shared to generate awareness, spur mobilization, and leverage resources. In Step 3, assessment data are used to drive the development of a strategic plan and guide the selection of evidence-based strategies. Data are used in Step 4 to inform (and, if necessary, revise) the implementation plan. And finally, data are collected to monitor progress toward outcomes, and findings are used to make adjustments and develop sustainable prevention efforts. Oklahoma will begin contracting for evaluation services on the prevention block grant in fiscal year 2011. The contractor, the University of Oklahoma College of Public Health, will develop an improved framework for tracking data and reporting significant changes. Currently, Oklahoma collects and reports on National Outcome Measures and the additional SEOW indicators outlined below. To study the nature and extent of the problem of alcohol, tobacco, and other drug use in Oklahoma, the state’s SEOW utilized the CSAP model for consequence and consumption indicators. The following represents Oklahoma’s latest SEOW profile for 2010. Table 1. Alcohol, Tobacco, Illicit Drugs, and Prescription Drug Consumption and Consequence Indicators Alcohol Tobacco Illicit Drugs Prescription Drugs Consumption • Current use •Current use • Current use • Age of initial use •Lifetime use •Age of initial use • Drinking and driving Consequence •Alcohol‐related mortality • Alcohol‐related Crime •Dependence or abuse •Total cigarette use consumption per capita • Apparent per capita alcohol • Alcohol‐related motor vehicle crashes •Tobacco‐related mortality •Illicit drug‐related mortality •Ilicit drug‐related crime •Dependence or abuse •Prescription opiate��related mortality • Current use • Heavy drinking • Age of initial use • Current binge drinking • Alcohol use during pregnancy •Tobacco use during pregnancy Alcohol Consumption According to Oklahoma’s Youth Risk Behavior Survey (YRBS), in 2009, 39.0 percent of students in grades 9–12 reported current alcohol consumption. That percentage is consistent with data collected by the National Survey on Drug Use and Health (NSDUH) for the population aged 12 and older, which showed 42.5 percent of respondents were current drinkers in 2007. NSDUH and YRBS data also showed between 21 and 28 percent of adolescents were binge drinkers at the time of the surveys. Although youth binge drinking is on the decline, with the exception of 2009, Oklahoma has been consistently above the national average for this behavior according to the YRBS. NSDUH data from 2007 indicated 37.4 percent of 18- to 25-year-olds and 9.0 percent of 12- to 17-year-olds were binge drinkers. The 2009 YRBS showed 19.4 percent of OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 27 of 311 Oklahoma students in grades 9–12 reported early initiation of alcohol; a continued indication of a steady decline in that behavior since the 2003 YRBS report of 26.8 percent. While adolescent drinking and driving is trending downward, Oklahoma continues to have percentages higher than the national average. In 2003, Oklahoma’s percentage of adolescent drunk driving was 17.5 percent, which was 45 percent higher than the national average. This dropped to 11.0 percent in 2009, which was 13 percent higher than the national average of 9.7 percent. Indicators from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) show Oklahoma is lower than the national average in current alcohol consumption, heavy consumption, and binge drinking among adults. In 2009, 42.6 percent of Oklahoma adults reported current alcohol consumption, which was 27 percent lower than the national average of 54.3 percent. Although lower than the national average, NSDUH data indicates Oklahoma’s percentage of binge drinking among persons 12 and older has increased from 2003-2007. The percentage was 19.01 in 2003 and 21.2 in 2007. Data from the Pregnancy Risk Assessment Monitoring Survey (PRAMS) show that alcohol use among pregnant women has been climbing in Oklahoma since 2003, when 2.5 percent of pregnant women had consumed alcohol during the last 3 months of their pregnancy. In 2007, the percentage had increased to 4.8 percent of pregnant women. Alcohol Consequences Oklahoma is consistently above the national average in alcohol-related mortality. Long-term alcohol consumption is associated with chronic liver disease. The relationship between alcohol use and suicide is also well documented, according to CSAP. Both chronic liver deaths and suicide deaths have been on the rise in Oklahoma since 2003. According to the Uniform Crime Reports (UCR), Oklahoma has also been consistently above the national average in crimes related to alcohol use which include aggravated assaults, sexual assaults, and robberies. Since 2003, there has been an 18.1 percent increase. Fatality Analysis Reporting System (FARS) data show that Oklahoma has maintained a steady rate of fatal crashes involving an alcohol-impaired driver. In 2003, Oklahoma’s alcohol-impaired driver fatality rate was 31.3 percent, and in 2008, that figure remained relatively stable at 31.6 percent. National percentages for those years were 30.3 and 31.4, respectively. Tobacco Consumption According to the 2007 NSDUH, 30.6 percent of Oklahomans aged 12 and older were current cigarette smokers, which was above the national average of 24.2 percent. Data OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 28 of 311 from the 2009 BRFSS also showed Oklahomans’ daily cigarette smoking exceeding that of the United States population as a whole, at 25.4 percent vs. 17.9 percent, respectively. The YRBS shows indicators in tobacco use among adolescents have been falling in Oklahoma since 2003, with students who smoked their first cigarette before the age of 13 decreasing by half since that year. Smoking among pregnant women is climbing in Oklahoma according to PRAMS. In 2003, 16.2 percent of pregnant women reported they had smoked during the last 3 months of their pregnancy; in 2007, the most recent PRAMS for which data are currently available, the percentage of pregnant women who smoked during the last 3 months of pregnancy had jumped to 21.3. Tobacco Consequences National Vital Statistics System (NVSS) data show deaths from both chronic obstructive pulmonary disease (COPD) and emphysema for Oklahoma are above the national average. Illicit Drug Consumption The YRBS shows daily marijuana use for high school students in grades 9–12 is decreasing; 22.0 percent were daily users in 2003, while just 15.9 percent reported this behavior in 2007. According to NSDUH, Oklahoma has been consistently above the national average among persons aged 12 and older reporting the use of any illicit drug other than marijuana. The percentages were 4.1 in 2004 and 4.6 in 2007. The national percentages for those same years were 3.4 and 3.7, respectively. Although still above the national average, youth methamphetamine use continues to decline in Oklahoma according to the YRBS. Since 2003, the percentage of youth methamphetamine users has dropped by half. The YRBS also shows Oklahoma exceeds the national average in cocaine, ecstasy, steroid, and inhalant use. Although above the national average, cocaine use in Oklahoma has dropped from 9.2 percent in 2003 to 7.4 percent in 2009. Although initially below the national average in years 2003–2007, adolescent use of inhalants is on a steady ascent. In 2009, 12.7 percent of Oklahoma adolescents reported inhalant use, surpassing the national average of 11.7 percent. Illicit Drug Consequences The latest NVSS data show that Oklahoma exceeds the nation in number of deaths due to drug-related behavior. In 2006, the rate per 100,000 was 17.3 for Oklahoma and 12.8 for the United States as a whole. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 29 of 311 The number of drug-related crimes (larceny, burglary, motor vehicle theft) in Oklahoma also outstrips that of the nation; in 2008, Oklahoma reported 3,442.4 per 100,000 compared to the national rate of 3,212.5 per 100,000. However, Oklahoma’s 2008 rate does represent a decline for the state, which reported drug-related crimes of 4042.0 per 100,000 in 2005. Prescription Drug Consumption According to data from the 2007 NSDUH, Oklahomans aged 12 and older exceeded the national average for the consumption of painkillers for nonmedical use by 232 percent. This is a 22 percent increase since 2004. Prescription Drug Consequences Although hospital inpatient discharge data were not indicators used in scoring, they were presented to the State Epidemiological Outcomes Workgroup (SEOW) due to the paucity of indicators regarding prescription drugs. Oklahoma hospital data associated with opiates have shown a 91 percent increase since 2003. Although this is a general category for opiates, for all practical purposes, heroin is the only illicit opiate taken into account. NVSS data show there has been a 328 percent increase in opiate-related deaths in Oklahoma since 1999. In 2006, Oklahoma ranked 4th in the nation for opiate overdose deaths, exceeding the national average by 123 percent. American Indian In 2000, the American Indian and Alaska Native (AI/AN) population in Oklahoma was 266,801, comprising 8 percent of the state’s total population and ranking Oklahoma second among all states for AI/AN population. Alcohol and tobacco consumption is a significant problem in this population. According to data from the 2009 BRFSS, 14.2 percent of AI/AN adults reported binge drinking, and 4.0 percent reported heavy drinking; both percentages exceed those reported by any other race. Smoking consumption was also highest among this group according to the BRFSS. In 2009, 31.9 percent AI/ANs reported current smoking compared to all other races (25.0 percent). Data from the Oklahoma State Bureau of Investigation (OSBI) show Oklahoma’s AI/AN population had substantially greater alcohol-related arrests (i.e., driving under the influence, liquor law violations and drunkenness) at 44 percent; lower drug law violation arrests (i.e., all drug arrests reported as sale/manufacturing and possession) at 8 percent; and lower index crime arrests (i.e., murder, rape, robbery, aggravated assault, burglary, larceny, and motor vehicle theft) at 10 percent, compared to all races combined (29 percent, 14 percent, and 13 percent, respectively). From fiscal years (FYs) 2001–2008, Oklahoma’s AI/AN population had consistently high rates of persons served in substance abuse treatment facilities compared to Whites and people of all races combined. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 30 of 311 Older Adults Older Oklahomans, aged 65 and above, are the fastest growing segment of the state’s population. In 2006, Oklahoma had the 19th-highest number of persons aged 65 and over, with 475,637 individuals falling into this category (U.S. Census Bureau, 2006). The population ages 60 and older increased by 18.2 percent from 1980 to 2000. This is substantially higher than the national average of 12.4 percent. In 2000, Oklahoma ranked 13th in terms of the percentage of the total population 60 years and older. This high growth rate among senior citizens outpaced Oklahoma’s overall growth rate of 14 percent for the same period. The very old (85 years and older) experienced the most notable growth rate of 61 percent from 1980 to 2000. It is estimated that while Oklahoma’s total population will grow at a relatively slow pace (10.2 percent), those 65 years and over will increase by over 60 percent between 2007 and 2030. Further, the state’s population ages 85 years and older is expected to increase by 50 percent during the same time period (U.S. Census Bureau, 2006). According to Oklahoma’s 2009 BRFSS, 78.8 percent of persons aged 65–74 said that they always or usually received support. This was down from 2005, when the percent was 83.1. Conversely, this among persons aged 75 and older, 77.6 percent always or usually received support in 2005 and 78.4 percent did in 2009. Another significant characteristic within the state’s older populations is grandparents raising grandchildren. Approximately 43,000 older Oklahomans are responsible for their grandchildren; of these, 16,200 have been responsible for the care of their grandchildren 5 years or longer. Grandparents living with grandchildren under 18 years of age for the population 30 years and over households are shown in the following table. Household types United States Oklahoma Total households 30+ years 158,881,037 1,915,455 Grandparents living with grandchildren under 18 5,771,671 67,194 Grandparents responsible for their grandchildren 2,426,730 39,279 Grandparents responsible for their grandchildren 5 years or more 933,408 14,714 Source: U.S. Census 2000 Veterans and Military Families In Oklahoma, 12.5 percent (333,358) of the state’s citizens are veterans, with 20.7 percent having served in the Gulf War, 35.1 percent having served in Vietnam Conflict, 12.7 percent having served in the Korean War, and 13 percent having served in World War II. The American Forces News Services reports that over 47,000 individuals based in Oklahoma are active in military operations and 24,500 have been deployed since American troops entered Afghanistan (www.usmilitary.about.com. 2008). In addition to OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 31 of 311 other mental health disorders, 20 percent of returning veterans suffer posttraumatic stress disorder.1 According to the OVDRS, 23 percent of suicide deaths between 2004 and 2007 were veterans, which represented 76 percent of all violent deaths among veterans. In addition, a comparison of mortality between Operation Enduring Freedom/Operation Iraqi Freedom veterans and the general U.S. population (adjusted for age, sex, race, and calendar year) showed evidence of a 21 percent excess of suicides among veterans through 2007. Although the evidence is preliminary, it suggests decreased suicide rates since 2006 among veterans of both sexes aged 18–29 who have used Veterans Health Administration (VHA) health care services relative to veterans in the same age group who have not. This decrease in rates translates to approximately 250 lives per year. Finally, more than 60 percent of suicides among users of VHA services include patients with a known diagnosis of a mental health condition. Incarcerated Women According to the Oklahoma Department of Corrections (ODOC), Oklahoma leads the nation in the rate of female offender incarceration at 131 per 100,000 population, a significant departure from the national average of 69 per 100,000 population. As of 2006, 2,213 women were incarcerated in the state of Oklahoma, and the state’s female inmate population is growing more rapidly than its male inmate population. Analogous to this rise in incarcerated females is a rise in incarcerated female drug use (i.e., both personal use and drug-related crimes). From 2001 to 2007, the number of female prison admissions per year increased by 136 (12 percent). Of the total female prison admissions during this time, 5,308 (61 percent) were White; 2,141 (24 percent) were Black; 998 (11 percent) were American Indian or Alaska Native; and 274 (3 percent) were Hispanic. According to the Bureau of Justice Statistics (2002), 52 percent of the nation’s female inmates were dependent on drugs or alcohol. Of all the offenses listed for incarcerated women between 2001 and 2007 in Oklahoma, approximately 70 percent were associated with a controlled substance (i.e., a drug or chemical substance whose possession and use are controlled by law), alcohol, or both. Describe state priorities and activities as they relate to addressing state and federal priorities and requirements: State and federal priorities are closely linked. State priorities focus on the well-being of Oklahomans just as our federal partners focus on the well-being of individuals throughout the nation. Many of the same issues face us all. Oklahoma has been working with the Oklahoma Healthcare Authority, which is the state Medicaid agency, to develop the Consolidated Claims Process, a system that will be a rich source of consumer data for both systems. 1 Edmond Sun, August 13, edmondsun.com, “Veterans face mental health risks.” OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 32 of 311 Oklahoma has been developing a statewide telehealth network to improve access to services for consumers in rural areas. Oklahoma is delivering behavioral healthcare to rural Oklahomans via a telehealth network. This network consists of 131 endpoints at 81 sites throughout Oklahoma. The current reimbursable services that are being delivered are a) medication clinics (psychopharmacological management), b) individual therapy sessions, c) consultations, and d) assessments (both routine and emergency). Along with the reimbursable services delivered, the Department is also using this technology for administrative meetings, trainings (for both CEU’s and CME’s), and court proceedings (commitment hearings, etc). This service delivery approach increases access to information and services for rural Oklahomans who, without this technology, would continue to be at a significant disadvantage as compared to their metro counterparts. It reduces the cost of seeking services for the consumer, as well as the cost of providing services for the clinician. Evidence-based programs are being utilized by prevention and treatment agencies to provide quality and effective services. Training on evidence-based models and treatment approaches, such as motivational interviewing, cognitive behavioral therapy, the strategic prevention framework and others will be presented at various sites throughout the state and at appropriate conferences to enhance the quality of services for consumers. Oklahoma will continue to work with providers to increase the use of these programs. The ODMHSAS models and promotes cultural competency through monthly cultural events at the administrative offices. To advance cultural information, providers are contractually required to participate in cultural competency training each year. In addition, Oklahoma received technical assistance through training in cultural competency in SFY 2010 through the Center for Substance Abuse Treatment for the Field Services Coordinators (FSCs). This information will help FSCs assist providers in providing culturally competent services for consumers. To support all its cultural competency initiatives, the ODMHSAS has purchased access to the Culture Vision web service, which has been made available to all ODMHSAS funded providers in the state. Culture Vision provides information about history, culture, customs, and beliefs of many countries, religions, and cultural groups and is available on-line for easy access. Culture Vision is a readily available resource of cultural information for our treatment provider network. Many ODMHSAS consumers have faced multiple traumas during their use of alcohol and other substances. To help with recovery, Oklahoma strives to create a system that understands the impact of trauma, and consequently provides trauma sensitive services to all Oklahomans. Many substance abusers and mentally ill individuals face the loss of their incomes and homes, finding themselves without a place to live and without resources. Oklahoma is working with the Coalition for the Needy and street outreach programs to provide services and resources for homeless individuals, encouraging them to participate in treatment services and assisting with recovery resources. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 33 of 311 Oklahoma’s drug court programs provide a highly-structured alternative to incarceration for eligible offenders in the criminal justice system. With oversight from the ODMHSAS, multidisciplinary teams work together to increase participant accountability through intensive substance abuse and judicial supervision, focusing on recovery and improvement in all areas of life. Presently, 53 drug courts are in operation, comprised of 41 adult drug courts, 8 juvenile drug courts, and 4 family courts. In addition, 10 mental health courts have been implemented. Drug courts are a smart investment. The average annual cost of incarceration in the Oklahoma Department of Corrections is $19,000 per person, compared with the average annual per person cost for drug court participation of $5,000. The ODMHSAS Prevention Services has been awarded the Strategic Prevention Framework (SPF) State Incentive Grant. Prevention has been focusing on educating communities in the SPF. Local coalitions develop action plans for the prevention needs in their areas. The SPF SIG funding will afford the opportunity to increase the development of prevention capable communities. Many of Oklahoma’s priorities reflect SAMHSA’s 10 Strategic Initiatives. As noted above, Oklahoma faces many of the same issues that are felt nationally. Describe the process your state used to facilitate public comment in developing the state’s plan and its FFY 2010 application for SAPT Block Grant funds. The ODMHSAS website provides access to multiple types of information for the public. It has become an invaluable communication tool. After the SAPT Block Grant Application is drafted and has been through a first review, a copy is posted on the website at www.odmhsas.org. A news release inviting comments is issued and picked up by multiple newspapers throughout the state. The news release is also emailed to providers. For the 2011 SAPT Block Grant Application, providers and the general public have approximately three weeks to review the application and provide comments, ask questions, or suggest changes by contacting a designated ODMHSAS staff member. Comments are submitted to the substance abuse services management team and the Deputy Commissioner of Substance Abuse Services for review. Final revisions are made to the application and it is then submitted to SAMHSA by the October 1 deadline. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 34 of 311 Planning Checklist Criteria for Allocating Funds Use the following checklist to indicate the criteria your State will use how to allocate FY 2011-2013 Block Grant funds. Mark all criteria that apply. Indicate the priority of the criteria by placing numbers in the boxes. For example, if the most important criterion is 'incidence and prevalence levels', put a '1' in the box beside that option. If two or more criteria are equal, assign them the same number. 2 Population levels, Specify formula: Underserved Populations 2 Incidence and prevalence levels Problem levels as estimated by alcohol/drug-related crime statistics 1 Problem levels as estimated by alcohol/drug-related health statistics 2 Problem levels as estimated by social indicator data 1 Problem levels as estimated by expert opinion Resource levels as determined by (specify method) 1 Size of gaps between resources (as measured by) State and Federal Resources and needs (as estimated by) Waiting Lists Other (specify method) OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 35 of 311 Form 4 (formerly Form 8) Treatment Needs Assessment Summary Matrix 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Central 439,074 30,823 1,849 1,317 79 15,440 926 1,812 1,843 2,264 3.19 3.42 1.82 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 East Central 391,386 27,475 1,649 1,174 70 13,987 839 2,319 1,860 2,876 3.32 0 2.04 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Northeast 472,552 33,173 1,990 1,418 85 16,674 1,000 2,378 2,129 2,963 3.39 1.90 2.96 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Northwest 194,314 13,641 818 583 35 6,808 409 850 882 1,056 2.57 0 5.15 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. B. A. B. A. B. A. B. C. Other: A. B. C. generated on 9/27/2010 10:18:57 AM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 36 of 311 Needing treatment services That would seek treatment Needing treatment services That would seek treatment Needing treatment services That would seek treatment Number of DWI arrests Number of drug-related arrests Drunkenness Hepatitis B /100,000 AIDS/ 100,000 Tuberculosis /100,000 Oklahoma County 819,177 57,506 3,450 2,458 147 29,475 1,769 3,866 5,043 4,784 2.56 4.76 2.81 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Southeast 437,873 30,739 1,844 1,314 79 15,548 933 3,562 3,504 4,393 3.20 0.69 4.11 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Southwest 330,713 23,216 1,393 992 60 11,429 686 1,618 1,598 1,999 3.63 0 2.12 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Tulsa County 601,961 42,258 2,535 1,806 108 21,568 1,294 3,118 3,770 3,853 4.49 5.81 2.33 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 State Total 3,687,050 258,831 15,530 11,061 664 130,928 7,856 19,523 20,629 24,188 3.31 2.74 2.77 generated on 9/27/2010 10:18:57 AM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 37 of 311 Form 5 (formerly Form 9) Treatment Needs by Age, Sex, and Race/ Ethnicity AGE GROUP A. Total B. White C. Black or African American D. Native Hawaiian / Other Pacific Islander E. Asian F. American Indian / Alaska Native G. More than one race reported H. Unknown I. Not Hispanic Or Latino J. Hispanic Or Latino M F M F M F M F M F M F M F M F M F 17 Years Old and Under 27,090 10,178 9,793 1,323 1,267 13 12 216 201 1,322 1,284 763 718 0 0 12,318 11,680 1,496 1,596 18 - 24 Years Old 78,814 29,848 28,443 4,211 3,691 42 34 912 763 3,733 3,657 1,768 1,712 0 0 37,064 34,245 3,450 4,055 25 - 44 Years Old 61,549 23,800 24,397 2,589 2,499 42 30 671 675 2,448 2,478 949 971 0 0 27,904 27,671 2,596 3,379 45 - 64 Years Old 59,700 23,972 25,314 1,829 2,054 17 16 366 481 1,871 2,094 794 892 0 0 27,618 29,455 1,232 1,396 65 and Over 31,892 11,936 15,850 568 841 6 6 104 166 669 909 352 485 0 0 13,269 17,941 365 315 Total 259,045 99,734103,79710,52010,352 120 982,2692,28610,04310,422 4,626 4,778 0 0 118,173120,992 9,13910,741 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 38 of 311 How your State determined the estimates for Form 4 and Form 5 (formerly Form 8 and Form 9) How your State determined the estimates for Form 4 and Form 5 (formerly Form 8 and Form 9) Under 42 U.S.C. §300x-29 and 45 C.F.R. §96.133, States are required to submit annually a needs assessment. This requirement is not contingent on the receipt of Federal needs assessment resources. States are required to use the best available data. Using up to three pages, explain what methods your State used to estimate the numbers of people in need of substance abuse treatment services, the biases of the data, and how the State intends to improve the reliability and validity of the data. Also indicate the sources and dates or timeframes for the data used in making these estimates reported in both Forms 4 and 5. This discussion should briefly describe how needs assessment data and performance data is used in prioritization of State service needs and informs the planning process to address such needs. The specific priorities that the State has established should be reported in Form 7. State priorities should include, but are not limited to the set of Federal program goals specified in the Public Health Service Act. In addition, provide any necessary explanation of the way your State records data or interprets the indices in columns 6 and 7, Form 4. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 39 of 311 FORM 8 AND FORM 9 ESTIMATION METHODOLOGY Estimates for treatment need in Oklahoma have been derived primarily through the latest National Surveys on Drug Use and Health data for Oklahoma. 1. Data from the ODMHSAS Integrated Client Information System (ICIS) were used to estimate the number in need of treatment among persons 11 years of age or younger. 2. SAMHSA’s State Estimates of Substance Use from the 2006-2007 National Surveys on Drug Use and Health (NSDUH) report (http://www.oas.samhsa.gov/2k8state/stateTabs.htm) was used as a data source to estimate treatment needs among persons 12 years of age or older. 3. The number that would seek treatment was estimated to be six percent of those in need of treatment but not currently being served based on a news release from the U.S. DHHS, September 5, 2003 “22 Million in U.S. Suffer from Substance Dependence or Abuse,” (http://www.samhsa.gov/news/newsreleases/030905nrNSDUH.htm). 4. The number of injection drug users in need of treatment (0.3%) was estimated using SAMHSA’s 2002-2003 National Surveys on Drug Use and Health (http://www.oas.samhsa.gov/2k5/ivdrug/ivdrug.cfm). 5. Statistics from the Oklahoma State Bureau of Investigation’s (OSBI) Uniform Crime Report (2008) were used to report substance-related criminal activity. 6. Statistics collected in 2009, at the Oklahoma State Department of Health (OSDH) Surveillance and Analysis Program HIV/STD Service and Acute Disease Service were used to report the incidence of communicable diseases. FORM 8 – TREATMENT NEEDS ASSESSMENT SUMMARY MATRIX TOTAL POPULATION IN NEED: Needing Treatment Services: For youth age 11 and younger, no data were available from the NSDUH. Estimates for those youth were derived using 2009 treatment data in ICIS. All clients, 11 years old or younger, served under an ODMHSAS substance abuse funding source in 2009, who did not have a presenting problem as a dependent child of a substance abuse client or co-dependent of a substance abuser, were considered to be seeking treatment. It was assumed that the 4 youth who received publicly-funded substance abuse treatment in 2008 represented the six percent of those in need of treatment. Therefore, an estimated 0.008 percent of youth in Oklahoma, 11 years of age or younger were in need of treatment. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 40 of 311 Estimates of past year alcohol or illicit drug dependence or abuse (NSDUH, 2007) were used to calculate the number of persons 12 years of age or older in need of treatment in Oklahoma. The estimates specific to each age group were applied to the 2009 Oklahoma population estimates (12 to 17, 7.32%; 18 to 25, 19.35%; 26 or Older, 6.53%). Those estimates were allocated to sub-state regions, and sex, race and origin categories. That Would Seek Treatment: It is estimated that over 94 percent of people with substance use disorders who did not receive treatment did not believe they needed treatment (see source above). Therefore, it was estimated that six percent of people in need of treatment would seek treatment. NUMBER OF IDUs IN NEED Needing Treatment Services: A national estimate of injection drug users from the NSDUH, 2003, was used to estimate the number of IDUs in need of treatment. The estimate (0.3%) was allocated to each of the eight sub-state planning areas. That Would Seek Treatment: Using the source previously described, it was estimated that six percent of intravenous drug users would seek treatment. NUMBER OF WOMEN IN NEED Needing Treatment Services: Estimates for the number of women in need of treatment were derived in the same manner as described above for the total population in need. That Would Seek Treatment: Estimates for the number of women who would seek treatment were derived in the same manner as described above for the total population. PREVALENCE OF SUBSTANCE-RELATED CRIMINAL ACTIVITY Data for substance-related criminal activity were obtained from the Oklahoma State Bureau of Investigation’s (OSBI) 2008 Uniform Crime Report. Number of DWI Arrests: The number of arrests for “driving under the influence” in Oklahoma during 2008 is reported in lieu of “driving while intoxicated.” “Driving under the influence” is defined as driving or operating any motor vehicle while drunk or under the influence of liquor or drugs. Number of Drug-Related Arrests: The number of arrests in Oklahoma during 2008 for “possession, distribution, sale or manufacture of illegal drugs” is reported. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 41 of 311 Other: Drunkenness: The OSBI normally classified “Alcohol-related Arrests” as arrests for driving under the influence, liquor law violations, and drunkenness (drunk and disorderly). Since DUI arrests are presented elsewhere and liquor law violations do not necessarily represent treatment-related issues, drunkenness has been included as a separate category in this report. INCIDENCE OF COMMUNICABLE DISEASES The rates per 100,000 population were generated for the state and each sub-state region from data provided by the Oklahoma State Department of Health. The number of new acute Hepatitis B, reported AIDS and new Tuberculosis cases during calendar year 2009 are utilized. FORM 9 – TREATMENT NEEDS BY AGE, SEX, AND RACE/ETHNICITY The methodology employed to complete this report is reported above under Form 8. EVALUATION OF METHODOLOGY The estimates of need and demand obtained through the methodology described have a number of potential failings. The NSDUH data are probably not representative of Oklahoma at the sub-state level for state specific data or for each sex, race and origin category reported on Form 9. Consequently, estimates based on those data will be biased toward conformance with estimates at the state level. Estimates for IDUs were based on national estimates and are therefore not representative of state rates. Estimates for persons under 12 years old suffer from a complete lack of data. Publicly-funded treatment delivery data are poor substitutes for measures of statewide treatment need. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 42 of 311 Form 6 (formerly Form 11) INTENDED USE PLAN (Include ONLY Funds to be spent by the agency administering the block grant. Estimated data are acceptable on this form) SOURCE OF FUNDS (24 Month Projections) Activity A.SAPT Block Grant FY 2011 Award B.Medicaid (Federal, State and Local) C.Other Federal Funds (e.g., Medicare, other public welfare) D.State Funds E.Local Funds (excluding local Medicaid) F.Other Substance Abuse Prevention* and Treatment $ 13,285,655 $ 1,352,746 $ 17,641,826 $ 73,656,242 $ $ Primary Prevention $ 3,542,841 $ 3,440,072 $ 1,767,576 $ $ Tuberculosis Services $ 0 $ $ $ $ $ HIV Early Intervention Services $ 0 $ $ $ $ $ Administration: (Excluding Program/Provider Lvl) $ 885,710 $ $ 8,318,198 $ $ Column Total $17,714,206 $1,352,746 $21,081,898 $83,742,016 $0 $0 *Prevention other than Primary Prevention OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 43 of 311 Activity Block Grant FY 2011 Other Federal State Funds Local Funds Other Information Dissemination $ 637,711 $ 619,213 $ 318,164 $ $ Education $ 106,285 $ 103,202 $ 53,028 $ $ Alternatives $ 53,142 $ 51,601 $ 26,513 $ $ Problem Identification & Referral $ 17,714 $ 17,200 $ 8,837 $ $ Community Based Process $ 2,207,420 $ 2,201,647 $ 1,131,249 $ $ Environmental $ 460,569 $ 447,209 $ 229,785 $ $ Other $ 0 $ 0 $ 0 $ $ Section 1926 - Tobacco $ 60,000 $ 0 $ 0 $ $ Column Total $3,542,841 $3,440,072 $1,767,576 $0 $0 Activity Block Grant FY 2011 Other Federal State Funds Local Funds Other Universal Direct $ 743,997 $ 722,415 $ 371,191 $ $ Universal Indirect $ 2,798,844 $ 2,717,657 $ 1,396,385 $ $ Selective $ 0 $ $ $ $ Indicated $ 0 $ $ $ $ Column Total $3,542,841 $3,440,072 $1,767,576 $0 $0 Form 6ab (formerly Form 11ab) Form 6a. Primary Prevention Planned Expenditures Checklist Form 6b. Primary Prevention Planned Expenditures Checklist OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 44 of 311 Form 6c (formerly Form 11c) Resource Development Planned Expenditure Checklist Did your State plan to fund resource development activities with FY 2011 funds? Yes No Activity Treatment Prevention Additional Combined Total Planning, Coordination and Needs Assessment $ 320,000 $ 80,000 $ 0 $ 400,000 Quality Assurance $ 250,000 $ 65,000 $ 0 $ 315,000 Training (post-employment) $ 265,000 $ 65,000 $ 0 $ 330,000 Education (pre-employment) $ 0 $ 0 $ 0 $ 0 Program Development $ 0 $ 0 $ 0 $ 0 Research and Evaluation $ 0 $ 0 $ 0 $ 0 Information Systems $ 25,000 $ 0 $ 0 $ 25,000 Column Total $860,000 $210,000 $0 $1,070,000 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 45 of 311 Purchasing Services This item requires completing two checklists. Methods for Purchasing There are many methods the State can use to purchase substance abuse services. Use the following checklist to describe how your State will purchase services with the FY 2011 block grant award. Indicate the proportion of funding that is expended through the applicable procurement mechanism. Competitive grants Percent of Expense: % Competitive contracts Percent of Expense: 20 % Non-competitive grants Percent of Expense: % Non-competitive contracts Percent of Expense: 80 % Statutory or regulatory allocation to governmental agencies serving as umbrella agencies that purchase or directly operate services Percent of Expense: % Other Percent of Expense: % (The total for the above categories should equal 100 percent.) According to county or regional priorities Percent of Expense: % Methods for Determining Prices There are also alternative ways a State can decide how much it will pay for services. Use the following checklist to describe how your State pays for services. Complete any that apply. I n addressing a State's allocation of resources through various payment methods, a State may choose to report either the proportion of expenditures or proportion of clients served through these payment methods. Estimated proportions are acceptable. Line item program budget Percent of Clients Served: % Percent of Expenditures: 20 % Price per slot Percent of Clients Served: % Percent of Expenditures: % Rate: $ Type of slot: Rate: $ Type of slot: Rate: $ Type of slot: Price per unit of service Percent of Clients Served: % Percent of Expenditures: 80 % Unit: OP/group couns/15 min Rate: $ 9.28 Unit: Res/adult/per day Rate: $ 74 Unit: Res/WWC/per day Rate: $ 95 Per capita allocation (Formula: ) Percent of Clients Served: % Percent of Expenditures: % Price per episode of care Percent of Clients Served: % Percent of Expenditures: % Rate: $ Diagnostic Group: Rate: $ Diagnostic Group: Rate: $ Diagnostic Group: OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 46 of 311 Program Performance Monitoring On-site inspections Frequency for treatment: ANNUALLY Frequency for prevention: ANNUALLY Activity Reports Frequency for treatment: NONE SELECTED Frequency for prevention: NONE SELECTED Management Information System Patient/participant data reporting system Frequency for treatment: NONE SELECTED Frequency for prevention: NONE SELECTED Performance Contracts Cost reports Independent Peer Review Licensure standards - programs and facilities Frequency for treatment: OTHER Every three years or sooner as needed Frequency for prevention: NOT APPLICABLE Licensure standards - personnel Frequency for treatment: OTHER Ongoing Frequency for prevention: OTHER Ongoing Other: Specify: OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 47 of 311 Form 7 State Priorities State Priorities 1 Promote the well-being of Oklahomans by encouraging prevention specialists and consumer services providers to actively participate in the primary healthcare delivery system through health information technology. 2 Create prevention capable communities utilizing the Stratregic Prevention Framework where individuals, families, schools, workplaces, and communities have the capacity and infrastructure to prevent and reduce substance abuse across the lifespan. 3 Prevent the onset and prevent/reduce the problems associated with the use of alcohol, tobacco and other drugs across the lifespan as identified and measured using epidemiological data. 4 Increase the use of prevention and treatment services that are evidence-based, implemented with fidelity and evaluated for effectiveness. 5 Expand the capacity of prevention and treatment providers to meet the behavioral health needs of diverse individuals and communities in a timely, culturally competent, trauma-informed manner that promotes recovery and an improved quality of life. 6 Develop systematic processes for analyzing data and establishing data-driven policy decision methods to effectively utilize prevention and treatment reseources, improving the quality of services and outcomes for individuals, families and communities. 7 Actively seek opportunities to collaborate and coordinate efforts with community stakeholders within the state to address homelessness. 8 Divert individuals with substance abuse and mental health disorders from criminal and juvenile justice systems into trauma-informed treatment and recovery. 9 Enhance support systems for Oklahoma military families, connecting service members and families to supportive and knowledgeable peers, and providing appropriate referrals for behavioral health systems. 10 Actively promote health insurance reform for the prevention and treatment of substance abuse disorders to reduce current disparities. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 48 of 311 Goal #1: Improving access to Prevention and Treatment Services The State shall expend block grant funds to maintain a continuum of substance abuse prevention and treatment services that meet these needs for the services identified by the State. Describe the continuum of block grant-funded prevention (with the exception of primary prevention; see Goal # 2 below) and treatment services available in the State (See 42 U.S.C. §300x-21(b) and 45 C.F.R. §96.122(f)(g)). Note: In addressing this narrative the State may want to discuss activities or initiatives related to: Providing comprehensive services; Using funds to purchase specialty program(s); Developing/maintaining contracts with providers; Providing local appropriations; Conducting training and/or technical assistance; Developing needs assessment information; Convening advisory groups, work groups, councils, or boards; Providing informational forum(s); and/or Conducting provider audits. FY 2011- FY 2013 (Intended Use/Plan): FY 2008 (Annual Report/Compliance): FY 2010 (Progress): OK / SAPT FY2011 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 49 of 311 GOAL # 1. Improving access to prevention and treatment services: The State shall expend block grant funds to maintain a continuum of substance abuse prevention and treatment services that meet these needs for the services identified by the State. Describe the continuum of block grant-funded prevention (with the exception of primary prevention: see goal #2 below) and treatment services available in the State (See 42 U.S.C. §300x-21(b) and 45 C.F.R. §96.122(f)(g)). FY 2011-FY2013 (Intended Use/Plan): The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) will utilize block grant funding, grants and contracts, and state appropriations to maintain a continuum of substance abuse treatment services within the State. Oklahoma will spend approximately 75% of the FFY 2011 block grant award on alcohol and drug treatment services. The ODMHSAS will continue to contract with private, non-profit and for-profit, certified agencies to provide detoxification, residential, halfway house, outpatient, intensive outpatient, and early intervention services with substance abuse block grant funds and state appropriations. These agencies include substance abuse treatment facilities, community mental health centers, community action agencies, youth and family services agencies, and Native American programs. Services will be offered in facilities which serve males and/or females, women with children, and adolescents. Three ODMHSAS-operated agencies will continue to provide residential services. In addition, other public agencies will continue to provide contracted services including the University of Oklahoma Health Sciences Center which provides screening, assessment, and treatment planning for children with Fetal Alcohol Spectrum (FAS). Substance abuse treatment programs are expected to treat approximately 22,000 consumers during this fiscal year. The Department will continue to provide early intervention services through public schools. Services will include working with school personnel and parents to develop drug free strategies with high-risk or substance using students, educational programs, screening and assistance with therapeutic linkages as needed. These programs will be funded through state and federal treatment monies. In addition, a pilot program has been initiated involving three Charter Schools and three contract adolescent substance abuse providers to provide an evidence-based early intervention curriculum within the school setting and communities utilizing state funds. This is an effort to expand services to an at-risk and underserved population, within their communities. The ODMHSAS will strive to sustain funding for programs and to continue to collect outcomes and determine how these programs could be replicated. Oklahoma is invested in expanding the practice of case management within the substance abuse field by providing continual training and technical assistance. Standards have been revised to require anyone providing case management to be a Certified Behavioral Health Case Manager. Integrated, strength-based, person-centered case management plays an FY 2011 - FY 2013 (INTENDED USE/PLAN) OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 50 of 311 important role in treatment programs by linking consumers to needed services such as employment, education, vocational skill development, child care, and health care. The ODMHSAS case management staff will continue to explore ways to increase the knowledge base and skill level for Certified Behavioral Health Case Managers through training opportunities. Oklahoma will continue to require standardized consumer evaluations, an individualized approach to treating the consumer, family involvement if appropriate, case management, the use of evidence-based practices, relapse prevention and connecting the consumer to community self-help groups. Oklahoma will continue monitoring provider programs by assigning each state-operated and contract treatment program to a Field Services Coordinator (FSC). The FSC will continue to be the primary contact for their assigned providers and responsible for linking them with other appropriate ODMHSAS staff as needed, visiting the agency, conducting site reviews, developing plans of correction and technical assistance needs for each agency, as well as reviewing provider staffing, services and performance reports. Technical assistance will be provided by the FSC or other Department staff, or through workshops at meeting/conferences, as needed per the findings of the site review or as requested by the provider. This monitoring approach allows the FSC to develop a partnership with their providers and facilitates opportunities for discussions and additional technical assistance to improve the quality of care provided for consumers. Continued collaboration with the Oklahoma Department of Human Services (OKDHS) TANF program will benefit both agencies’ consumers. OKDHS will provide TANF funding to the ODMHSAS to subcontract with certified treatment agencies. Contracted agencies will provide screening, assessment, and outpatient substance abuse services to consumers receiving or making application for Temporary Assistance to Needy Families (TANF) and individuals who have Child Welfare (CW) involvement. These services provide valuable early intervention in many cases that will allow families to stay together. The ODMHSAS will provide training, technical assistance, and program monitoring. Immediate Access and other initiatives with TANF or Child Welfare participants will continue to be pursued as a means of providing substance abuse services to more individuals in need of treatment. The ODMHSAS will continue to collaborate with the Oklahoma Health Care Authority (OHCA), the state’s Medicaid agency, to access Medicaid funding for substance abuse services. The Consolidated Claims Process (CCP) will allow service providers to submit both ODMHSAS service invoices and Medicaid claims into one system. The system will determin
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Title | Oklahoma uniform application : Substance Abuse Prevention and Treatment Block Grant 2011 |
OkDocs Class# | M1400.3 S941a 2010/11 |
Digital Format | PDF, Adobe Reader required |
ODL electronic copy | Downloaded from agency website: www.ok.gov/.../Oklahoma_(10-1-2010_12%2007%2052_PM)_-_BLOCK_GRANT_APPLICATION_-_2011.pdf |
Rights and Permissions | This Oklahoma state government publication is provided for educational purposes under U.S. copyright law. Other usage requires permission of copyright holders. |
Language | English |
Full text | Oklahoma UNIFORM APPLICATION FY2011 SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT 42 U.S.C.300x-21 through 300x-66 OMB - Approved 07/20/2010 - Expires 07/31/2013 (generated on 10/1/2010 12:07:53 PM) Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Center for Substance Abuse Prevention OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 1 of 311 Introduction: The Substance Abuse Prevention and Treatment Block Grant represents a significant Federal contribution to the States’ substance abuse prevention and treatment service budgets. The Public Health Service Act [42 USC 300x-21 through 300x-66] authorizes the Substance Abuse Prevention and Treatment Block Grant and specifies requirements attached to the use of these funds. The SAPT Block Grant funds are annually authorized under separate appropriation by Congress. The Public Health Service Act designates the Center for Substance Abuse Treatment and the Center for Substance Abuse Prevention as the entities responsible for administering the SAPT Block Grant program. The SAPT Block Grant application format provides the means for States to comply with the reporting provisions of the Public Health Service Act (42 USC 300x-21-66), as implemented by the Interim Final Rule (45 CFR Part 96, part XI). With regard to the requirements for Goal 8, the Annual Synar Report format provides the means for States to comply with the reporting provisions of the Synar Amendment (Section 1926 of the Public Health Service Act), as implemented by the Tobacco Regulation for the SAPT Block Grant (45 CFR Part 96, part IV). Public reporting burden for this collection of information is estimated to average 454 hours per respondent for Sections I-III, 40 hours per respondent for Section IV-A and 42.75 hours per respondent for Section IV-B, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to SAMHSA Reports Clearance Officer; Paperwork Reduction Project (OMB No. 0930-0080), 1 Choke Cherry Road, Room 7-1042, Rockville, Maryland 20857. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is OMB No. 0930-0080. The Web Block Grant Application System (Web BGAS) has been developed to facilitate States’ completion, submission and revision of their Block Grant application. The Web BGAS can be accessed via the World Wide Web at http://bgas.samhsa.gov. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 2 of 311 Form 1 DUNS Number: 933662934- Uniform Application for FY 2011-13 Substance Abuse Prevention and Treatment Block Grant I. State Agency to be the Grantee for the Block Grant: Agency Name: Oklahoma Department of Mental Health and Substance Abuse Services Organizational Unit: Substance Abuse Services Mailing Address: P. O. Box 53277 City: Oklahoma City, OK Zip Code: 73152-3277 II. Contact Person for the Grantee of the Block Grant: Name: Terri White, MSW, Commissioner and Secretary of Health Agency Name: Oklahoma Department of Mental Health and Substance Abuse Services Mailing Address: P. O. Box 53277 City: Oklahoma City, OK Code: 73152-3277 Telephone: (405) 522-3877 FAX: (405) 522-0637 Email Address: tlwhite@odmhsas.org III. State Expenditure Period: From: 7/1/2009 To: 6/30/2010 IV. Date Submitted: Date: Original: Revision: V. Contact Person Responsible for Application Submission: Name: Mary Hagerty Telephone: (405) 522-3859 Email Address: mhagerty@odmhsas.org FAX: (405) 522-3767 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 3 of 311 Form 2 (Table of Contents) Form 1 pg.3 Form 2 pg.4 Form 3 pg.5 1. Planning pg.15 Planning Checklist pg.34 Form 4 (formerly Form 8) pg.35 Form 5 (formerly Form 9) pg.37 How your State determined the estimates for Form 4 and Form 5 (formerly Forms 8 and 9) pg.38 Form 6 (formerly Form 11) pg.42 Form 6ab (formerly Form 11ab) pg.43 Form 6c (formerly Form 11c) pg.44 Purchasing Services pg.45 PPM Checklist pg.46 Form 7 pg.47 Goal #1:Improving access to prevention and treatment services pg.48 Goal #2: Providing Primary Prevention services pg.65 Goal #3: Providing specialized services for pregnant women and women with dependent children pg.88 Programs for Pregnant Women and Women with Dependent Children (formerly Attachment B) pg.94 Goal #4: Services to intravenous drug abusers pg.102 Programs for Intravenous Drug Users (IVDUs) ( formerly Attachment C) pg.109 Program Compliance Monitoring (formerly Attachment D) pg.113 Goal #5: TB Services pg.116 Goal #6: HIV Services pg.120 Tuberculosis (TB) and Early Intervention Services for HIV (formerly Attachment E) pg.124 Goal #7: Development of Group Homes pg.128 Group Home Entities and Programs (formerly Attachment F) pg.133 Goal #8: Tobacco Products pg.138 Goal #9: Pregnant Women Preferences pg.140 Capacity Management and Waiting List Systems (formerly Attachment G) pg.147 Goal #10: Process for Referring pg.151 Goal #11: Continuing Education pg.158 Goal #12: Coordinate Services pg.165 Goal #13: Assessment of Need pg.175 Goal #14: Hypodermic Needle Program pg.189 Charitable Choice (formerly Attachment I) pg.215 Waivers (formerly Attachment J) pg.217 Waivers pg.218 Form 8 (formerly Form 4) pg.221 Form 8ab (formerly Form 4ab) pg.222 Form 8c (formerly Form 4c) pg.223 Form 9 (formerly Form 6) pg.224 Provider Address Table pg.231 Form 9a (formerly Form 6a) pg.235 Form 10a (formerly Form 7a) pg.244 Form 10b (formerly Form 7b) pg.245 Description of Calculations pg.246 SSA (MOE Table I) pg.249 TB (MOE Table II) pg.251 HIV (MOE Table III) pg.253 Womens (MOE TABLE IV) pg.255 Form T1 pg.256 Form T2 pg.258 Form T3 pg.260 Form T4 pg.262 Form T5 pg.267 Form T6 pg.272 Form T7 pg.274 Treatment Performance Measures (Overall Narrative) pg.276 Corrective Action Plan for Treatment NOMS pg.281 Form P1 pg.283 Form P2 pg.284 Form P3 pg.285 Form P4 pg.286 Form P5 pg.287 Form P6 pg.288 Form P7 pg.289 Form P8 pg.290 Form P9 pg.291 Form P10 pg.292 Form P11 pg.293 P-Forms 12a- P-15 – Reporting Period pg.294 Form P12a pg.295 Form P12b pg.297 Form P13 (Optional) pg.298 Form P14 pg.299 Form P15 pg.300 Corrective Action Plan for Prevention NOMS pg.301 Prevention Attachments A, B, and C (optional) pg.303 Prevention Attachment D (optional) pg.304 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 4 of 311 Goal #15: Independent Peer Review pg.193 Independent Peer Review (formerly Attachment H) pg.201 Goal #16: Disclosure of Patient Records pg.205 Goal #17: Charitable Choice pg.210 Prevention Attachment D (optional) pg.304 Description of Supplemental Data pg.306 Attachment A, Goal 2 pg.308 Addendum - Additional Supporting Documents (Optional) pg.310 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 5 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 FORM 3: UNIFORM APPLICATION FOR FY 2011 SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT Funding Agreements/Certifications as required by Title XIX, Part B, Subpart II and Subpart III of the Public Health Service (PHS) Act c Title XIX, Part B, Subpart II and Subpart III of the PHS Act, as amended, requires the chief executive officer (or an authorized designee) of the applicant organization to certify that the State will comply with the following specific citations as summarized and set forth below, and with any regulations or guidelines issued in conjunction with this Subpart except as exempt by statute. SAMHSA will accept a signature on this form as certification of agreement to comply with the cited provisions of the PHS Act. If signed by a designee, a copy of the designation must be attached. I. Formula Grants to States, Section 1921 Grant funds will be expended “only for the purpose of planning, carrying out, and evaluating activities to prevent and treat substance abuse and for related activities” as authorized. II. Certain Allocations, Section 1922 Allocations Regarding Primary Prevention Programs, Section 1922(a) Allocations Regarding Women, Section 1922(b) III. Intravenous Drug Abuse, Section 1923 Capacity of Treatment Programs, Section 1923(a) Outreach Regarding Intravenous Substance Abuse, Section 1923(b) IV. Requirements Regarding Tuberculosis and Human Immunodeficiency Virus, Section 1924 V. Group Homes for Recovering Substance Abusers, Section 1925 Optional beginning FY 2001 and subsequent fiscal years. Territories as described in Section 1925(c) are exempt. The State “has established, and is providing for the ongoing operation of a revolving fund” in accordance with Section 1925 of the PHS Act, as amended. This requirement is now optional. VI. State Law Regarding Sale of Tobacco Products to Individuals Under Age of 18, Section 1926 The State has a law in effect making it illegal to sell or distribute tobacco products to minors as provided in Section 1926 (a)(1). The State will enforce such law in a manner that can reasonably be expected to reduce the extent to which tobacco products are available to individuals under the age of 18 as provided in Section 1926 (b)(1). The State will conduct annual, random unannounced inspections as prescribed in Section 1926 (b)(2). VII. Treatment Services for Pregnant Women, Section 1927 The State “…will ensure that each pregnant woman in the State who seeks or is referred for and would benefit from such services is given preference in admission to treatment facilities receiving funds pursuant to the grant.” VIII. Additional Agreements, Section 1928 Improvement of Process for Appropriate Referrals for Treatment, Section 1928(a) Continuing Education, Section 1928(b) Coordination of Various Activities and Services, Section 1928(c) Waiver of Requirement, Section 1928(d) generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 6 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 FORM 3: UNIFORM APPLICATION FOR FY 2011 SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT Funding Agreements/Certifications As required by Title XIX , Part B, Subpart II and Subpart III of the PHS Act (continued) IX. Submission to Secretary of Statewide Assessment of Needs, Section 1929 X. Maintenance of Effort Regarding State Expenditures, Section 1930 With respect to the principal agency of a State, the State “will maintain aggregate State expenditures for authorized activities at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant.” XI. Restrictions on Expenditure of Grant, Section 1931 XII. Application for Grant; Approval of State Plan, Section 1932 XIII. Opportunity for Public Comment on State Plans, Section 1941 The plan required under Section 1932 will be made “public in such a manner as to facilitate comment from any person (including any Federal person or any other public agency) during the development of the plan (including any revisions) and after the submission of the plan to the Secretary.” XIV. Requirement of Reports and Audits by States, Section 1942 XV. Additional Requirements, Section 1943 XVI. Prohibitions Regarding Receipt of Funds, Section 1946 XVII. Nondiscrimination, Section 1947 XVIII. Services Provided By Nongovernmental Organizations, Section 1955 I hereby certify that the State or Territory will comply with Title XIX, Part B, Subpart II and Subpart III of the Public Health Service Act, as amended, as summarized above, except for those Sections in the Act that do not apply or for which a waiver has been granted or may be granted by the Secretary for the period covered by this agreement. State: Name of Chief Executive Officer or Designee: Signature of CEO or Designee: Title: Date Signed: If signed by a designee, a copy of the designation must be attached Oklahoma Terri White, MSW Commissioner and Secretary of Health generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 7 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION The undersigned (authorized official signing for the applicant organization) certifies to the best of his or her knowledge and belief, that the applicant, defined as the primary participant in accordance with 45 C.F.R. Part 76, and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal Department or agency; (b) have not within a 3-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and (d) have not within a 3-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. Should the applicant not be able to provide this certification, an explanation as to why should be placed after the assurances page in the application package. The applicant agrees by submitting this proposal that it will include, without modification, the clause titled "Certification Regarding Debarment, Suspension, In eligibility, and Voluntary Exclusion – Lower Tier Covered Transactions" in all lower tier covered transactions (i.e., transactions with sub-grantees and/or contractors) and in all solicitations for lower tier covered transactions in accordance with 45 C.F.R. Part 76. 2. CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS The undersigned (authorized official signing for the applicant organization) certifies that the applicant will, or will continue to, provide a drug-free work-place in accordance with 45 C.F.R. Part 76 by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee’s workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an ongoing drug-free awareness program to inform employees about – (1) The dangers of drug abuse in the workplace; (2) The grantee’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a) above; (d) Notifying the employee in the statement required by paragraph (a), above, that, as a condition of employment under the grant, the employee will – (1) Abide by the terms of the statement; and (2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; (e) Notifying the agency in writing within ten calendar days after receiving notice under paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 8 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 (f) Taking one of the following actions, within 30 calendar days of receiving notice under paragraph (d) (2), with respect to any employee who is so convicted – (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). For purposes of paragraph (e) regarding agency notification of criminal drug convictions, the DHHS has designated the following central point for receipt of such notices: Office of Grants and Acquisition Management Office of Grants Management Office of the Assistant Secretary for Management and Budget Department of Health and Human Services 200 Independence Avenue, S.W., Room 517-D Washington, D.C. 20201 3. CERTIFICATION REGARDING LOBBYING Title 31, United States Code, Section 1352, entitled "Limitation on use of appropriated funds to influence certain Federal contracting and financial transactions," generally prohibits recipients of Federal grants and cooperative agreements from using Federal (appropriated) funds for lobbying the Executive or Legislative Branches of the Federal Government in connection with a SPECIFIC grant or cooperative agreement. Section 1352 also requires that each person who requests or receives a Federal grant or cooperative agreement must disclose lobbying undertaken with non-Federal (non-appropriated) funds. These requirements apply to grants and cooperative agreements EXCEEDING $100,000 in total costs (45 C.F.R. Part 93). The undersigned (authorized official signing for the applicant organization) certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the under signed, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities, "in accordance with its instructions. (If needed, Standard Form-LLL, "Disclosure of Lobbying Activities," its instructions, and continuation sheet are included at the end of this application form.) (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 4. CERTIFICATION REGARDING PROGRAM FRAUD CIVIL REMEDIES ACT (PFCRA) The undersigned (authorized official signing for the applicant organization) certifies that the statements herein are true, complete, and accurate to the best of generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 9 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 his or her knowledge, and that he or she is aware that any false, fictitious, or fraudulent statements or claims may subject him or her to criminal, civil, or administrative penalties. The undersigned agrees that the applicant organization will comply with the Public Health Service terms and conditions of award if a grant is awarded as a result of this application. 5. CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103-227, also known as the Pro- Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children’s services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children’s services provided in private residence, portions of facilities used for inpatient drug or alcohol treatment, service providers whose sole source of applicable Federal funds is Medicare or Medicaid, or facilities where WIC coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing the certification, the undersigned certifies that the applicant organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The applicant organization agrees that it will require that the language of this certification be included in any subawards which contain provisions for children’s services and that all subrecipients shall certify accordingly. The Public Health Service strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of tobacco products. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED Commissioner and Secretary of Health Oklahoma Department of Mental Health and Substance Abuse Services generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 10 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action 3. Report Type: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance a. bid/offer/application b. initial award c. post-award a. initial filing b. material change For Material Change Only: Year Quarter date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier , if known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Entity (if individual, last name, first name, MI): b. Individuals Performing Services (including address if different from No. 10a.) (last name, first name, MI): 11. Information requested through this form is authorized by title 31 U.S.C. Section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature: Print Name: Title: Telephone No.: Date: Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97) generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 11 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 DISCLOSURE OF LOBBYING ACTIVITIES CONTINUATION SHEET Reporting Entity: Page of generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 12 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks “subawardee”, then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 [e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency]. Include prefixes, e.g., ‘‘RFP-DE- 90-001.’’ 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No.0348- 0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503. generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 13 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 ASSURANCES – NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standard or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM’s Standard for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L.88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681- 1683, and 1685- 1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §§794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to non- discrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Title II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply with the provisions of the Hatch Act (5 U.S.C. §��1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333), regarding labor standards for federally assisted construction subagreements. generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 14 of 311 OMB No. 0930-0080 Approval Expires 07/31/2013 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetland pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§ 469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED Commissioner and Secretary of Health Oklahoma Department of Mental Health and Substance Abuse Services generated on 9/16/2010 2:48:55 PM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 15 of 311 1. Planning THREE YEAR PLAN, ANNUAL REPORT, and PROGRESS REPORT: PLAN FOR FY 2011-FY 2013 PROGRAM ACTIVITIES This section documents the States plan to use the FY 2011 through FY 2013 Federal Substance Abuse Prevention and Treatment (SAPT) Block Grant. For each SAPT Block Grant award, the funds are available for obligation and expenditure for a 2-year period beginning on October 1 of the Federal Fiscal Year (FY) for which an award is made. States are encouraged to incorporate information on needs assessment, resource availability and States priorities in their plan to use these funds over the next three fiscal years. In the interim years (FY 2012 and FY 2013), updates to this 3-year plan are required; however, if the plan remains unchanged, additional narrative is not necessary. This section requires completion of needs assessment forms, services utilization forms and a narrative description of the States planning processes. 1. Planning This section provides an opportunity to describe the State’s planning processes and requires completion of needs assessment data forms, utilization information and a description of the State’s priorities. In addition, this section provides the State the opportunity to complete a three year intended use plan for the periods of FY 2011-FY 2013. Finally this section requires completion of planning narratives and a checklist. These items address compliance with the following statutory requirements: • 42 U.S.C. §300x-29, 45 C.F. R. §96.133 and 45 C.F.R. §96.122(g)(13) require the State to submit a Statewide assessment of need for both treatment and prevention. The State is to develop a 3-year plan which covers the three (3) fiscal years from FFY 2011-FY 2013. In a narrative of up to five pages, describe: • How your State carries out sub-State area planning and determines which areas have the highest incidence, prevalence, and greatest need. • Include a definition of your State’s sub-State planning areas (SPA). • Identify what data is collected, how it is collected and how it is used in making these decisions. • If there is a State, regional or local advisory council, describe their composition and their role in the planning process. • Describe the monitoring process the State will use to assure that funded programs serve communities with the highest prevalence and need. • Those States that have a State Epidemiological Outcomes Workgroup (SEOW) must describe its composition and contribution to the planning process for primary prevention and treatment planning. States are encouraged to utilize the epidemiological analyses and profiles to establish substance abuse prevention and treatment goals at the State level. Describe how your State evaluates activities related to ongoing substance abuse prevention and treatment efforts, such as performance data, programs, policies and practices, and how this data is produced, synthesized and used for planning. A general narrative describing the States planned approach to using State and Federal resources should be included. For the prevention assessment, States should focus on the SEOW process. Describe State priorities and activities as they relate to addressing State and Federal priorities and requirements. • 42 U.S.C. §300x-51 and 45 C.F. R. §96.123(a)(13) require the State to make the State plan public in OK / SAPT FY2011 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 16 of 311 such a manner as to facilitate public comment from any person during the development of the plan. In a narrative of up to two pages, describe the process your State used to facilitate public comment in developing the State’s plan and its FY 2011-FY 2013 application for SAPT Block Grant funds. For FY 2012 and FY 2013, only updates to the 3-year plan will be required. In the Section addressing the Federal Goals, the States will still need to provide Annual and Progress reports. Fiscal reporting requirements and performance data reporting will also be required annually. The Prevention component of your Three Year Plan Should Include the Following: Problem Assessment (Epidemiological Profile) Using an array of appropriate data and information, describe the substance abuse-related problems in your State that you intend to address under Goal 2. Describe the criteria and rationale for establishing primary prevention priorities. (See 45 C.F.R §96.133(a) (1)) Prevention System Assessment (Capacity and Infrastructure) Describe the substance abuse prevention infrastructure in place at the State, sub-State, and local levels. Include in this description current capacity to collect, analyze, report, and use data to inform decision making; the number and nature of multi-sector partnerships at all levels, including broad-based community coalitions. In addition, describe the mechanisms the SSA has in place to support sub-recipients and community coalitions in implementing data-driven and evidence-based preventive interventions. If the State sets benchmarks, performance targets, or quantified objectives, describe the methods used by the State to establish these. Prevention System Capacity Development Describe planned changes to enhance the SSA’s ability to develop, implement, and support—at all levels —processes for performance management to include: assessment, mobilization, and partnership development; implementation of evidence-based strategies; and evaluation. Describe the challenges associated with these changes, and the key resources the State will use to address these challenges. Provide an overview of key contextual and cultural conditions that impact the State’s prevention capacity and functioning. Implementation of a Data-Driven Prevention System Describe the mechanism by which funding decisions are made and funds will be allocated. Explain how these mechanisms link funds to intended State outcomes. Provide an overview of any strategic prevention plans that exist at the State level, or which will be required at the sub-State or sub-recipient level, including goals, objectives, and/or outcomes. Indicate whether sub-recipients will be required to use evidence based programs and strategies. Describe the data collection and reporting requirements the State will use to monitor sub-recipient activities. Evaluation of Primary Prevention Outcomes Discuss the surveillance, monitoring, and evaluation activities the State will use to assess progress toward achieving its capacity development and substance abuse prevention performance targets. Describe the way in which evaluation results will be used to inform decision making processes and to modify implementation plans, including allocation decisions and performance targets. OK / SAPT FY2011 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 17 of 311 1. Planning The state is to develop a 3-year plan which covers the three (3) fiscal years from FFY 2011-FY 2013. In a narrative of up to five pages, describe: • How your state carries out sub-state area planning and determines which areas have the highest incidence, prevalence, and greatest need. • Include a definition of your state’s sub-state planning areas (SPA). • Identify what data is collected, how it is collected and how it is used in making these decisions. • If there is a state, regional or local advisory council, describe their composition and their role in the planning process. • Describe the monitoring process the state will use to assure that funded programs serve communities with the highest prevalence and need. • Those states that have a State Epidemiological Outcomes Workgroup (SEOW) must describe its composition and contribution to the planning process for primary prevention and treatment planning. States are encouraged to utilize the epidemiological analyses and profiles to establish substance abuse prevention and treatment goals at the state level. Describe how your state evaluates activities related to ongoing substance abuse prevention and treatment efforts, such as performance data, programs, policies and practices, and how this data is produced, synthesized and used for planning. A general narrative describing the states’ planned approach to using state and federal resources should be included. For the prevention assessment, states should focus on the SEOW process. Describe state priorities and activities as they relate to addressing state and federal priorities and requirements. • 42 U.S.C. §300x-51 and 45 C.F. R. §96.123(a)(13) require the state to make the state plan public in such a manner as to facilitate public comment from any person during the development of the plan. In a narrative of up to two pages, describe the process your state used to facilitate public comment in developing the state’s plan and its FY 2011-FY 2013 application for SAPT Block Grant funds. For FY 2012 and FY 2013, only updates to the 3-year plan will be required. In the Section addressing the Federal Goals, the states will still need to provide Annual and Progress reports. Fiscal reporting requirements and performance data reporting will also be required annually. The Prevention component of your Three Year Plan Should Include the Following: Problem Assessment (Epidemiological Profile) Using an array of appropriate data and information, describe the substance abuse-related problems in your state that you intend to address under Goal 2. Describe the criteria and rationale for establishing primary prevention priorities. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 18 of 311 (See 45 C.F.R §96.133(a) (1)) Prevention System Assessment (Capacity and Infrastructure) Describe the substance abuse prevention infrastructure in place at the state, sub-state, and local levels. Include in this description current capacity to collect, analyze, report, and use data to inform decision making; the number and nature of multi-sector partnerships at all levels, including broad-based community coalitions. In addition, describe the mechanisms the SSA has in place to support sub-recipients and community coalitions in implementing data-driven and evidence-based preventive interventions. If the state sets benchmarks, performance targets, or quantified objectives, describe the methods used by the state to establish these. Prevention System Capacity Development Describe planned changes to enhance the SSA’s ability to develop, implement, and support—at all levels—processes for performance management to include: assessment, mobilization, and partnership development; implementation of evidence-based strategies; and evaluation. Describe the challenges associated with these changes, and the key resources the state will use to address these challenges. Provide an overview of key contextual and cultural conditions that impact the state’s prevention capacity and functioning. Implementation of a Data-Driven Prevention System Describe the mechanism by which funding decisions are made and funds will be allocated. Explain how these mechanisms link funds to intended state outcomes. Provide an overview of any strategic prevention plans that exist at the state level, or which will be required at the sub-state or sub-recipient level, including goals, objectives, and/or outcomes. Indicate whether sub-recipients will be required to use evidence based programs and strategies. Describe the data collection and reporting requirements the state will use to monitor sub-recipient activities. Evaluation of Primary Prevention Outcomes Discuss the surveillance, monitoring, and evaluation activities the state will use to assess progress toward achieving its capacity development and substance abuse prevention performance targets. Describe the way in which evaluation results will be used to inform decision making processes and to modify implementation plans, including allocation decisions and performance targets. PLANNING Describe how your state carries out sub-state area planning and determines which areas have the highest incidence, prevalence and greatest need. Include a definition of your OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 19 of 311 state’s sub-state planning areas. Identify what data is collected, how it is collected, and how it is used in making these decisions: The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) utilizes needs assessment data developed through the Department’s Decision Support Services Division and the Oklahoma State Epidemiological Outcomes Workgroup (SEOW) for state and sub-state planning. In addition, sub-state and statewide data from other agencies and federal sources are reviewed along with information from providers, consumers, and stakeholders. The internal assessment of the need for treatment was previously supported by the Oklahoma Substance Abuse Needs Assessment Project (STNAP) contracts and grants with the federal Center for Substance Abuse Treatment (CSAT) in Rockville, Maryland. All phases of the needs assessment were completed with the third phase completed in FFY2004. Since the estimates from the above referenced studies are dated, the ODMHSAS began using the Office of Applied Studies National Survey on Drug Use and Health prevalence estimates for Oklahoma in FFY2005. The data collected is by sub-state planning regions and includes information on incidence, prevalence and need. The Provider Performance Management Report (PPMR) for Substance Abuse Agencies utilizes information from the Integrated Client Information System (ICIS), a database of provider services, to develop a quarterly agency report of performance indicators. This provides facilities and Department program staff with up-to-date performance information. The provider information is also reviewed for planning and gaps in services in each sub-state area. In late April 2006, the weekly census/waiting list report to the Department’s Decision Support Services (DSS) to comply with the 90% capacity reporting requirement was replaced with a daily reporting system to a designated substance abuse services staff person. Daily reporting by residential and halfway house programs has provided the ODMHSAS with a more timely account of the percentage of capacity and which agencies have available beds. The number of individuals waiting for treatment is also reported through this Residential/Halfway House Capacity Report providing valuable information on the needs within the state. Outpatient programs are able to admit clients as soon as appointments can be made so waiting lists are not needed for those programs. The ODMHSAS has now developed a secure online capacity report and staff are in the process of moving providers onto that system. Waiting list data is captured through the use of unique identifiers. Information from providers reporting to the online system is collected in a database which will provide valuable information including capacity of providers, bed availability, waiting lists information for each agency, an unduplicated count of individuals waiting for treatment, priority populations waiting time, and interim services data. The ODMHSAS website www.odmhsas.org includes an informative ad hoc query system, the Health Information Integrated Query System which includes prevalence and needs data by sub-state regions. Users can create a personalized query to produce OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 20 of 311 specific ODMHSAS data. These reports, too, are simple to use. They are generated through the ‘Basic Query’ and the ‘Advanced Query’ functions and provide demographic and count data for admitted clients for the last six years. The query system accesses over 1,500,000 records to produce results. The Oklahoma Prevention Needs Assessment Survey (OPNA) was provided to volunteering schools throughout Oklahoma in the spring of 2010. It is a risk and protective factor survey that was developed and offered to schools in Oklahoma to give them a snapshot of the communities in which they live. Participating schools throughout the state surveyed sixth, eighth, tenth, and twelfth grade students. Each school receives an analysis of the data from their school’s surveys and are encouraged to use the data for resource development, prevention planning, and community education. In addition, statewide and regional data are generated. This information is available to the Area Prevention Resource Centers (APRCs), community coalitions, and the general public. APRCs receive regular training on how to interpret and utilize OPNA data in their prevention planning and strategy development. This local Oklahoma data will be invaluable as schools, prevention programs, and local coalitions develop goals and objectives and plan prevention services in their communities based on the Strategic Prevention Framework (SPF). The OPNA is offered to schools every other year. The prior survey was completed in the spring of 2008 and the next survey will take place in 2012. The Oklahoma State Epidemiological Outcomes Workgroup (SEOW) was created August 3, 2006 and modeled after the National Institute on Drug Abuse (NIDA) community epidemiological work group. The SEOW is housed in the Oklahoma Department of Mental Health & Substance Abuse Services (ODMHSAS) and is funded through a federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (CSAP). The mission of Oklahoma SEOW is to improve prevention assessment, planning, implementation, and monitoring efforts through the application of systematic, analytical thinking about the causes and consequences of substance abuse. Oklahoma’s SEOW will continue to compile and update data annually or as new data becomes available. In fiscal year 2011, the ODMHSAS intends to make significant improvements to the state’s prevention data system in three proposed ways: 1) creation of a web-based epidemiological data query system as a common, real-time place to access data, analyze data, and produce reports/graphs/charts/maps; 2) identification of methods to address identified data gaps that exist at the state and local levels to effectively make data-driven decisions and evaluate efforts; and 3) creation of a web-based prevention service data reporting and tracking system that meets the evolving needs of federal funders, ODMHSAS, and local-level providers. The Oklahoma SEOW will also examine opportunities to expand its scope to meet the needs of other state agencies and to collect/analyze data on other health-related issues. Sources for the comprehensive epidemiological profile currently include: • Arrestee Drug Abuse Monitoring Program • Behavioral Risk Factor Surveillance Survey OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 21 of 311 • Center for Disease Control and Prevention • Ensuring Solutions to Alcohol Problems • Fatality Analysis Reporting System • National Institute on Alcohol Abuse and Alcoholism • National Survey on Drug Use and Health • National Vital Statistics System • Oklahoma Bureau of Narcotics and Dangerous Drugs • Oklahoma Department of Mental Health and Substance Abuse Services • Oklahoma Highway Safety Office • Oklahoma State Bureau of Investigation • Oklahoma State Department of Health • Oklahoma Tax Commission • Oklahoma Violent Death Reporting System • Oklahoma Youth Tobacco Survey • Pacific Institute for Research and Evaluation • Pregnancy Risk Assessment Monitoring System • Smoking Attributable Mortality, Morbidity and Economic Costs • Substance Abuse and Mental Health Services Administration • United States Census Bureau • Youth Risk Behavior Survey The ODMHSAS regional planning system divides Oklahoma into eight sub-state planning regions. Those regions include: 1. Central – Canadian, Cleveland, Grady, and McClain counties 2. East Central – Adair, Cherokee, Creek, Lincoln, McIntosh, Muskogee, Okfuskee, Okmulgee, Sequoyah, and Wagoner counties 3. Northeast – Craig, Delaware, Kay, Mayes, Noble, Nowata, Osage, Ottawa, Pawnee, Payne, Rogers, and Washington counties 4. Northwest - Alfalfa, Beaver, Cimarron, Ellis, Garfield, Grant, Harper, Kingfisher, Logan, Major, Texas, Woods, and Woodward counties 5. Oklahoma County 6. Southeast – Atoka, Bryan, Carter, Choctaw, Coal, Garvin, Haskell, Hughes, Johnston, Latimer, LeFlore, Love, Marshall, McCurtain, Murray, Pittsburg, Pontotoc, Pottawatomie, Pushmataha, and Seminole counties 7. Southwest – Beckham, Blaine, Caddo, Comanche, Cotton, Custer, Dewey, Greer, Harmon, Jackson, Jefferson, Kiowa, Roger Mills, Stephens, Tillman, and Washita counties 8. Tulsa County Of the eight sub-state areas, the Oklahoma County and Tulsa County regions are urban. The Central region is a suburban area close to Oklahoma City, housing the University of Oklahoma in Cleveland County. All other regions are rural. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 22 of 311 Oklahoma utilizes these eight sub-state areas for all substance abuse planning and needs assessment data and information, including the data collected through the Decision Support Services Division for TEDS and other needs assessment reporting. If there is a state, regional, or local advisory council, describe their composition and their role in the planning process. Oklahoma works closely with the Oklahoma State Department of Health (OSDH) in many areas including tobacco prevention, reduction of acute diseases including TB, HIV/AIDS, and Hepatitis C, and coalition development to promote wellness in local communities. Oklahoma does not have a substance abuse advisory council but most of the prevention programs and several treatment providers participate with the local OSDH coalitions. With this in mind, the ODMHSAS has joined forces with the Oklahoma State Department of Health to participate in their Turning Point coalitions. Although there is no formal advisory capacity, many of the ODMHSAS partners, prevention and treatment programs, state and community agencies participate and suggestions or ideas are passed on to the ODMHSAS leadership as needed. In addition, the ODMHSAS Prevention staff participate with the State Turning Point Advisory Council. The Area Prevention Resource Centers (APRCs) partner with community coalitions, including those in the Turning Point network, at the local levels within each service region. Each APRC in partnership with their associated community coalitions conduct local level needs assessments to identify priority issues (alcohol, tobacco, and other drug consumption/consequences) and intervening variables/causal factors that contribute to the identified priorities. Strategic plans are developed utilizing the needs assessments findings. The ODMHSAS prevention staff collaborate with the Oklahoma State Departments of Education and Health, the Governor’s Office, the Oklahoma Commission on Children and Youth, and other agencies, task forces, work groups, planning and community groups throughout Oklahoma. Examples of this include the Governor’s Task Force on the Prevention of Underage Drinking, the Oklahoma Prevention Leadership Collaborative, Oklahoma Crystal Darkness Collaborative, the SEOW, the Oklahoma Health Improvement Plan flagship workgroups, and the Oklahoma Partnership Initiative Steering Committee. The Department will continue to actively contribute to the Oklahoma Prevention Leadership Collaborative to help influence other prevention leadership bodies in the state to utilize the principles of the Strategic Prevention Framework and advocate for the coordination of prevention services and resources. The Collaborative was developed in 2010 to promote coordinated planning, implementation, and evaluation of quality prevention services for children, youth, and families at the state and local levels with a particular focus on the prevention of mental, emotional, and behavioral health disorders, related problems (i.e. alcohol and other drug use), and contributing risk factors. Oklahoma was awarded the Transformation State Incentive Grant (TSIG) in FFY 2005. While the grant is directed at transformation of mental health systems, the ODMHSAS is also responsible for providing substance abuse services and since the management of OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 23 of 311 mental health and substance abuse disorders share many common approaches, Oklahoma determined that transformation activities should include both the mental health and substance abuse service systems. Because people with mental health and substance abuse problems receive services from a number of state agencies and to ensure the participation of all other state agencies that may impact this population, in December 2005, Governor Brad Henry issued an Executive Order establishing the Governor’s Transformation Advisory Board (GTAB) to guide transformation activities. The 28-member panel includes the heads of eleven state agencies, representatives from the State Senate and House of Representatives, the law enforcement community, the state’s Indian Nations, the Indian Health Services, the chair of the Mental Health Planning and Advisory Council, eight representatives of consumer, youth and family advocacy organizations, and representatives from private industry and the philanthropic community. The GTAB Board continues to aid Oklahoma’s planning and transformation efforts. The Department’s Governing Board has three members who represent substance abuse issues specifically. The Department’s executive staff work closely with board members. The ODMHSAS governing board is a strong partner in the planning process. Additional organizations with which the ODMHSAS maintains open communication and which work with the Department throughout the year, providing advice and counsel to the Department include: The Oklahoma Substance Abuse Services Alliance (OSASA), a statewide organization, composed primarily of public and non-profit prevention and treatment providers. This organization serves as an advocate for substance abuse services, as well as for prevention and treatment programs. The Oklahoma Citizen Advocates for Recovery and Treatment Association (OCARTA) is a statewide recovery organization dedicated to empowering recovering people and their families, reducing the stigma associated with addiction, and advocating for the recovery community. The Oklahoma Prevention Policy Alliance (OPPA), a statewide advocacy organization composed of state and community prevention professionals. The ODMHSAS is committed to developing and supporting statewide prevention and recovery advocacy group(s) comprised of concerned or recovering citizens dedicated to reducing the stigma of addiction, advocating for prevention and treatment services and publicizing the fact that treatment works. It is the desire of the Department to be affiliated with prevention and recovery groups which will be able to contribute to the planning process through their recommendations as independent advocacy organizations. The Department encourages advice from many different sources, keeping an open door to all. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 24 of 311 Describe the monitoring process the state will use to assure that funded programs serve communities with the highest prevalence and need. The Integrated Client Information System (ICIS), a public online ad-hoc query system called the Health Information Integrated Query System (HI-IQs), along with preformatted reports and the Provider Performance Management Report (PPMR) provide information on prevention and consumer services throughout the sub-state regional areas of Oklahoma. This data allows for the monitoring of services to assure that communities with the greatest need are the communities receiving services. Beginning July 1, 2010, treatment providers began utilizing the Consolidated Claims Process (CCP), a combined service database and fee-for-service payment system developed through a partnership with the Oklahoma Health Care Authority, the state Medicaid agency. The CCP collects service, outcome and demographic data and will greatly enhance providers’ ability to work with Medicaid. The Department expects more consumers to be treated, and additional Medicaid dollars to pay for behavioral health services as a result. Data on substance abuse services through either the Medicaid or the ODMHSAS system will be reported into the CCP system. Individual-level data include consumer demographics, presenting problems, benefits information, Addiction Severity Index scores, drugs of choice, frequencies of use, routes of administration, and ages of first use. Information is also gathered on all services provided to consumers, the duration of those services, and identifying information of staff members providing the services. Using a unique client identifier, services can be linked to the client characteristics, and tracked across agencies and over time. Annual reports and ad-hoc queries will continue to be available through the ODMHSAS website at www.odmhsas.org. The Provider Performance Management Report will utilize information from the CCP database to develop a quarterly agency report providing facilities and Department program staff with up-to-date performance information. This information is available throughout the year for planning and identification of gaps in services in each sub-state area. All of the above information, in addition to Needs Assessment information, provider and consumer input, and various other sources, is utilized to provide quality services to consumers in need of such services. As indicators show an area to have a higher prevalence of need and as funding becomes available, every effort is made to increase services in that area. Describe the state’s Epidemiological Outcomes Workgroup’s composition and contribution to the planning process for primary prevention and treatment planning. States are encouraged to utilize the epidemiological analyses and profiles to establish substance abuse prevention and treatment goals at the state level. Describe how your state evaluates activities related to ongoing substance abuse prevention efforts, such as programs, policies and practices, and how this data is used for planning. For the OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 25 of 311 prevention assessment, states should focus on the SEOW process. Provide a summary of how data/data indicators were chosen, as well as, key data construct and indicators for understanding state-level substance use patterns and related consequences and mechanisms for tracking data and reporting significant changes should be outlined. The Oklahoma State Epidemiological Outcomes Workgroup (SEOW) is a multidisciplinary workgroup whose members are connected to key decision-making and resource allocation bodies in the state. This workgroup, funded through a Federal grant from SAMHSA/CSAP, was established by ODMHSAS in 2006 and is patterned after the National Institute on Drug Abuse (NIDA) community epidemiological workgroup. Oklahoma’s SEOW is charged with improving prevention assessment, planning, implementation, and monitoring efforts through data collection and analysis that accurately assesses the causes and consequences of the use of alcohol, tobacco, and other drugs and drives decisions concerning the effective and efficient use of prevention resources throughout the state. The Oklahoma State Epidemiological Outcomes Workgroup (SEOW) was convened to collect and report on substance abuse consumption and consequence data to help identify and monitor state priorities for ODMHSAS and other agencies. The SEOW is tasked with analyzing the state epidemiological data to determine problem or emerging alcohol, tobacco, and other drug consumption and consequence patterns. Using CSAP recommendations, data indicators for each substance are chosen based on the following criteria. 1) National source. The measure must be available from a centralized, national data source. 2) Availability at state level. The measure must be available in disaggregated form at the state (or lower geographic) level. 3) Validity. There must be research-based evidence that the data accurately measure the specific construct and yield a true snapshot of the phenomenon at the time of assessment. These criteria are used to eliminate measures that look at face value as if they assess a particular construct, but are in fact poor or unproven proxy measures and thus do not accurately reflect the construct. 4) Trend. The measure should be available for the past 3 to 5 years, preferably on an annual basis, but no less than a biennial basis. This enables the state to determine not only the level of an indicator but also its trends. 5) Consistency. The measure must be consistent (i.e., the method or means of collecting and organizing data should be relatively unchanged over time, such that the method of measurement is the same from time i to time i+1). Alternatively, if the method of measurement has changed, sound studies or data should exist that determine and allow adjustment for differences resulting from data collection changes. 6) Sensitivity. For monitoring, the measure must be sufficiently sensitive to detect change over time. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 26 of 311 This data focus—collection, analysis, and use—is entrenched in each step of the Strategic Prevention Framework, which is utilized in block grant funded prevention service delivery. Epi data continually informs the process. The formal assessment of contextual conditions, needs, resources, readiness, and capacity is used to identify priority issues in Step 1. In Step 2, data are shared to generate awareness, spur mobilization, and leverage resources. In Step 3, assessment data are used to drive the development of a strategic plan and guide the selection of evidence-based strategies. Data are used in Step 4 to inform (and, if necessary, revise) the implementation plan. And finally, data are collected to monitor progress toward outcomes, and findings are used to make adjustments and develop sustainable prevention efforts. Oklahoma will begin contracting for evaluation services on the prevention block grant in fiscal year 2011. The contractor, the University of Oklahoma College of Public Health, will develop an improved framework for tracking data and reporting significant changes. Currently, Oklahoma collects and reports on National Outcome Measures and the additional SEOW indicators outlined below. To study the nature and extent of the problem of alcohol, tobacco, and other drug use in Oklahoma, the state’s SEOW utilized the CSAP model for consequence and consumption indicators. The following represents Oklahoma’s latest SEOW profile for 2010. Table 1. Alcohol, Tobacco, Illicit Drugs, and Prescription Drug Consumption and Consequence Indicators Alcohol Tobacco Illicit Drugs Prescription Drugs Consumption • Current use •Current use • Current use • Age of initial use •Lifetime use •Age of initial use • Drinking and driving Consequence •Alcohol‐related mortality • Alcohol‐related Crime •Dependence or abuse •Total cigarette use consumption per capita • Apparent per capita alcohol • Alcohol‐related motor vehicle crashes •Tobacco‐related mortality •Illicit drug‐related mortality •Ilicit drug‐related crime •Dependence or abuse •Prescription opiate��related mortality • Current use • Heavy drinking • Age of initial use • Current binge drinking • Alcohol use during pregnancy •Tobacco use during pregnancy Alcohol Consumption According to Oklahoma’s Youth Risk Behavior Survey (YRBS), in 2009, 39.0 percent of students in grades 9–12 reported current alcohol consumption. That percentage is consistent with data collected by the National Survey on Drug Use and Health (NSDUH) for the population aged 12 and older, which showed 42.5 percent of respondents were current drinkers in 2007. NSDUH and YRBS data also showed between 21 and 28 percent of adolescents were binge drinkers at the time of the surveys. Although youth binge drinking is on the decline, with the exception of 2009, Oklahoma has been consistently above the national average for this behavior according to the YRBS. NSDUH data from 2007 indicated 37.4 percent of 18- to 25-year-olds and 9.0 percent of 12- to 17-year-olds were binge drinkers. The 2009 YRBS showed 19.4 percent of OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 27 of 311 Oklahoma students in grades 9–12 reported early initiation of alcohol; a continued indication of a steady decline in that behavior since the 2003 YRBS report of 26.8 percent. While adolescent drinking and driving is trending downward, Oklahoma continues to have percentages higher than the national average. In 2003, Oklahoma’s percentage of adolescent drunk driving was 17.5 percent, which was 45 percent higher than the national average. This dropped to 11.0 percent in 2009, which was 13 percent higher than the national average of 9.7 percent. Indicators from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) show Oklahoma is lower than the national average in current alcohol consumption, heavy consumption, and binge drinking among adults. In 2009, 42.6 percent of Oklahoma adults reported current alcohol consumption, which was 27 percent lower than the national average of 54.3 percent. Although lower than the national average, NSDUH data indicates Oklahoma’s percentage of binge drinking among persons 12 and older has increased from 2003-2007. The percentage was 19.01 in 2003 and 21.2 in 2007. Data from the Pregnancy Risk Assessment Monitoring Survey (PRAMS) show that alcohol use among pregnant women has been climbing in Oklahoma since 2003, when 2.5 percent of pregnant women had consumed alcohol during the last 3 months of their pregnancy. In 2007, the percentage had increased to 4.8 percent of pregnant women. Alcohol Consequences Oklahoma is consistently above the national average in alcohol-related mortality. Long-term alcohol consumption is associated with chronic liver disease. The relationship between alcohol use and suicide is also well documented, according to CSAP. Both chronic liver deaths and suicide deaths have been on the rise in Oklahoma since 2003. According to the Uniform Crime Reports (UCR), Oklahoma has also been consistently above the national average in crimes related to alcohol use which include aggravated assaults, sexual assaults, and robberies. Since 2003, there has been an 18.1 percent increase. Fatality Analysis Reporting System (FARS) data show that Oklahoma has maintained a steady rate of fatal crashes involving an alcohol-impaired driver. In 2003, Oklahoma’s alcohol-impaired driver fatality rate was 31.3 percent, and in 2008, that figure remained relatively stable at 31.6 percent. National percentages for those years were 30.3 and 31.4, respectively. Tobacco Consumption According to the 2007 NSDUH, 30.6 percent of Oklahomans aged 12 and older were current cigarette smokers, which was above the national average of 24.2 percent. Data OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 28 of 311 from the 2009 BRFSS also showed Oklahomans’ daily cigarette smoking exceeding that of the United States population as a whole, at 25.4 percent vs. 17.9 percent, respectively. The YRBS shows indicators in tobacco use among adolescents have been falling in Oklahoma since 2003, with students who smoked their first cigarette before the age of 13 decreasing by half since that year. Smoking among pregnant women is climbing in Oklahoma according to PRAMS. In 2003, 16.2 percent of pregnant women reported they had smoked during the last 3 months of their pregnancy; in 2007, the most recent PRAMS for which data are currently available, the percentage of pregnant women who smoked during the last 3 months of pregnancy had jumped to 21.3. Tobacco Consequences National Vital Statistics System (NVSS) data show deaths from both chronic obstructive pulmonary disease (COPD) and emphysema for Oklahoma are above the national average. Illicit Drug Consumption The YRBS shows daily marijuana use for high school students in grades 9–12 is decreasing; 22.0 percent were daily users in 2003, while just 15.9 percent reported this behavior in 2007. According to NSDUH, Oklahoma has been consistently above the national average among persons aged 12 and older reporting the use of any illicit drug other than marijuana. The percentages were 4.1 in 2004 and 4.6 in 2007. The national percentages for those same years were 3.4 and 3.7, respectively. Although still above the national average, youth methamphetamine use continues to decline in Oklahoma according to the YRBS. Since 2003, the percentage of youth methamphetamine users has dropped by half. The YRBS also shows Oklahoma exceeds the national average in cocaine, ecstasy, steroid, and inhalant use. Although above the national average, cocaine use in Oklahoma has dropped from 9.2 percent in 2003 to 7.4 percent in 2009. Although initially below the national average in years 2003–2007, adolescent use of inhalants is on a steady ascent. In 2009, 12.7 percent of Oklahoma adolescents reported inhalant use, surpassing the national average of 11.7 percent. Illicit Drug Consequences The latest NVSS data show that Oklahoma exceeds the nation in number of deaths due to drug-related behavior. In 2006, the rate per 100,000 was 17.3 for Oklahoma and 12.8 for the United States as a whole. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 29 of 311 The number of drug-related crimes (larceny, burglary, motor vehicle theft) in Oklahoma also outstrips that of the nation; in 2008, Oklahoma reported 3,442.4 per 100,000 compared to the national rate of 3,212.5 per 100,000. However, Oklahoma’s 2008 rate does represent a decline for the state, which reported drug-related crimes of 4042.0 per 100,000 in 2005. Prescription Drug Consumption According to data from the 2007 NSDUH, Oklahomans aged 12 and older exceeded the national average for the consumption of painkillers for nonmedical use by 232 percent. This is a 22 percent increase since 2004. Prescription Drug Consequences Although hospital inpatient discharge data were not indicators used in scoring, they were presented to the State Epidemiological Outcomes Workgroup (SEOW) due to the paucity of indicators regarding prescription drugs. Oklahoma hospital data associated with opiates have shown a 91 percent increase since 2003. Although this is a general category for opiates, for all practical purposes, heroin is the only illicit opiate taken into account. NVSS data show there has been a 328 percent increase in opiate-related deaths in Oklahoma since 1999. In 2006, Oklahoma ranked 4th in the nation for opiate overdose deaths, exceeding the national average by 123 percent. American Indian In 2000, the American Indian and Alaska Native (AI/AN) population in Oklahoma was 266,801, comprising 8 percent of the state’s total population and ranking Oklahoma second among all states for AI/AN population. Alcohol and tobacco consumption is a significant problem in this population. According to data from the 2009 BRFSS, 14.2 percent of AI/AN adults reported binge drinking, and 4.0 percent reported heavy drinking; both percentages exceed those reported by any other race. Smoking consumption was also highest among this group according to the BRFSS. In 2009, 31.9 percent AI/ANs reported current smoking compared to all other races (25.0 percent). Data from the Oklahoma State Bureau of Investigation (OSBI) show Oklahoma’s AI/AN population had substantially greater alcohol-related arrests (i.e., driving under the influence, liquor law violations and drunkenness) at 44 percent; lower drug law violation arrests (i.e., all drug arrests reported as sale/manufacturing and possession) at 8 percent; and lower index crime arrests (i.e., murder, rape, robbery, aggravated assault, burglary, larceny, and motor vehicle theft) at 10 percent, compared to all races combined (29 percent, 14 percent, and 13 percent, respectively). From fiscal years (FYs) 2001–2008, Oklahoma’s AI/AN population had consistently high rates of persons served in substance abuse treatment facilities compared to Whites and people of all races combined. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 30 of 311 Older Adults Older Oklahomans, aged 65 and above, are the fastest growing segment of the state’s population. In 2006, Oklahoma had the 19th-highest number of persons aged 65 and over, with 475,637 individuals falling into this category (U.S. Census Bureau, 2006). The population ages 60 and older increased by 18.2 percent from 1980 to 2000. This is substantially higher than the national average of 12.4 percent. In 2000, Oklahoma ranked 13th in terms of the percentage of the total population 60 years and older. This high growth rate among senior citizens outpaced Oklahoma’s overall growth rate of 14 percent for the same period. The very old (85 years and older) experienced the most notable growth rate of 61 percent from 1980 to 2000. It is estimated that while Oklahoma’s total population will grow at a relatively slow pace (10.2 percent), those 65 years and over will increase by over 60 percent between 2007 and 2030. Further, the state’s population ages 85 years and older is expected to increase by 50 percent during the same time period (U.S. Census Bureau, 2006). According to Oklahoma’s 2009 BRFSS, 78.8 percent of persons aged 65–74 said that they always or usually received support. This was down from 2005, when the percent was 83.1. Conversely, this among persons aged 75 and older, 77.6 percent always or usually received support in 2005 and 78.4 percent did in 2009. Another significant characteristic within the state’s older populations is grandparents raising grandchildren. Approximately 43,000 older Oklahomans are responsible for their grandchildren; of these, 16,200 have been responsible for the care of their grandchildren 5 years or longer. Grandparents living with grandchildren under 18 years of age for the population 30 years and over households are shown in the following table. Household types United States Oklahoma Total households 30+ years 158,881,037 1,915,455 Grandparents living with grandchildren under 18 5,771,671 67,194 Grandparents responsible for their grandchildren 2,426,730 39,279 Grandparents responsible for their grandchildren 5 years or more 933,408 14,714 Source: U.S. Census 2000 Veterans and Military Families In Oklahoma, 12.5 percent (333,358) of the state’s citizens are veterans, with 20.7 percent having served in the Gulf War, 35.1 percent having served in Vietnam Conflict, 12.7 percent having served in the Korean War, and 13 percent having served in World War II. The American Forces News Services reports that over 47,000 individuals based in Oklahoma are active in military operations and 24,500 have been deployed since American troops entered Afghanistan (www.usmilitary.about.com. 2008). In addition to OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 31 of 311 other mental health disorders, 20 percent of returning veterans suffer posttraumatic stress disorder.1 According to the OVDRS, 23 percent of suicide deaths between 2004 and 2007 were veterans, which represented 76 percent of all violent deaths among veterans. In addition, a comparison of mortality between Operation Enduring Freedom/Operation Iraqi Freedom veterans and the general U.S. population (adjusted for age, sex, race, and calendar year) showed evidence of a 21 percent excess of suicides among veterans through 2007. Although the evidence is preliminary, it suggests decreased suicide rates since 2006 among veterans of both sexes aged 18–29 who have used Veterans Health Administration (VHA) health care services relative to veterans in the same age group who have not. This decrease in rates translates to approximately 250 lives per year. Finally, more than 60 percent of suicides among users of VHA services include patients with a known diagnosis of a mental health condition. Incarcerated Women According to the Oklahoma Department of Corrections (ODOC), Oklahoma leads the nation in the rate of female offender incarceration at 131 per 100,000 population, a significant departure from the national average of 69 per 100,000 population. As of 2006, 2,213 women were incarcerated in the state of Oklahoma, and the state’s female inmate population is growing more rapidly than its male inmate population. Analogous to this rise in incarcerated females is a rise in incarcerated female drug use (i.e., both personal use and drug-related crimes). From 2001 to 2007, the number of female prison admissions per year increased by 136 (12 percent). Of the total female prison admissions during this time, 5,308 (61 percent) were White; 2,141 (24 percent) were Black; 998 (11 percent) were American Indian or Alaska Native; and 274 (3 percent) were Hispanic. According to the Bureau of Justice Statistics (2002), 52 percent of the nation’s female inmates were dependent on drugs or alcohol. Of all the offenses listed for incarcerated women between 2001 and 2007 in Oklahoma, approximately 70 percent were associated with a controlled substance (i.e., a drug or chemical substance whose possession and use are controlled by law), alcohol, or both. Describe state priorities and activities as they relate to addressing state and federal priorities and requirements: State and federal priorities are closely linked. State priorities focus on the well-being of Oklahomans just as our federal partners focus on the well-being of individuals throughout the nation. Many of the same issues face us all. Oklahoma has been working with the Oklahoma Healthcare Authority, which is the state Medicaid agency, to develop the Consolidated Claims Process, a system that will be a rich source of consumer data for both systems. 1 Edmond Sun, August 13, edmondsun.com, “Veterans face mental health risks.” OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 32 of 311 Oklahoma has been developing a statewide telehealth network to improve access to services for consumers in rural areas. Oklahoma is delivering behavioral healthcare to rural Oklahomans via a telehealth network. This network consists of 131 endpoints at 81 sites throughout Oklahoma. The current reimbursable services that are being delivered are a) medication clinics (psychopharmacological management), b) individual therapy sessions, c) consultations, and d) assessments (both routine and emergency). Along with the reimbursable services delivered, the Department is also using this technology for administrative meetings, trainings (for both CEU’s and CME’s), and court proceedings (commitment hearings, etc). This service delivery approach increases access to information and services for rural Oklahomans who, without this technology, would continue to be at a significant disadvantage as compared to their metro counterparts. It reduces the cost of seeking services for the consumer, as well as the cost of providing services for the clinician. Evidence-based programs are being utilized by prevention and treatment agencies to provide quality and effective services. Training on evidence-based models and treatment approaches, such as motivational interviewing, cognitive behavioral therapy, the strategic prevention framework and others will be presented at various sites throughout the state and at appropriate conferences to enhance the quality of services for consumers. Oklahoma will continue to work with providers to increase the use of these programs. The ODMHSAS models and promotes cultural competency through monthly cultural events at the administrative offices. To advance cultural information, providers are contractually required to participate in cultural competency training each year. In addition, Oklahoma received technical assistance through training in cultural competency in SFY 2010 through the Center for Substance Abuse Treatment for the Field Services Coordinators (FSCs). This information will help FSCs assist providers in providing culturally competent services for consumers. To support all its cultural competency initiatives, the ODMHSAS has purchased access to the Culture Vision web service, which has been made available to all ODMHSAS funded providers in the state. Culture Vision provides information about history, culture, customs, and beliefs of many countries, religions, and cultural groups and is available on-line for easy access. Culture Vision is a readily available resource of cultural information for our treatment provider network. Many ODMHSAS consumers have faced multiple traumas during their use of alcohol and other substances. To help with recovery, Oklahoma strives to create a system that understands the impact of trauma, and consequently provides trauma sensitive services to all Oklahomans. Many substance abusers and mentally ill individuals face the loss of their incomes and homes, finding themselves without a place to live and without resources. Oklahoma is working with the Coalition for the Needy and street outreach programs to provide services and resources for homeless individuals, encouraging them to participate in treatment services and assisting with recovery resources. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 33 of 311 Oklahoma’s drug court programs provide a highly-structured alternative to incarceration for eligible offenders in the criminal justice system. With oversight from the ODMHSAS, multidisciplinary teams work together to increase participant accountability through intensive substance abuse and judicial supervision, focusing on recovery and improvement in all areas of life. Presently, 53 drug courts are in operation, comprised of 41 adult drug courts, 8 juvenile drug courts, and 4 family courts. In addition, 10 mental health courts have been implemented. Drug courts are a smart investment. The average annual cost of incarceration in the Oklahoma Department of Corrections is $19,000 per person, compared with the average annual per person cost for drug court participation of $5,000. The ODMHSAS Prevention Services has been awarded the Strategic Prevention Framework (SPF) State Incentive Grant. Prevention has been focusing on educating communities in the SPF. Local coalitions develop action plans for the prevention needs in their areas. The SPF SIG funding will afford the opportunity to increase the development of prevention capable communities. Many of Oklahoma’s priorities reflect SAMHSA’s 10 Strategic Initiatives. As noted above, Oklahoma faces many of the same issues that are felt nationally. Describe the process your state used to facilitate public comment in developing the state’s plan and its FFY 2010 application for SAPT Block Grant funds. The ODMHSAS website provides access to multiple types of information for the public. It has become an invaluable communication tool. After the SAPT Block Grant Application is drafted and has been through a first review, a copy is posted on the website at www.odmhsas.org. A news release inviting comments is issued and picked up by multiple newspapers throughout the state. The news release is also emailed to providers. For the 2011 SAPT Block Grant Application, providers and the general public have approximately three weeks to review the application and provide comments, ask questions, or suggest changes by contacting a designated ODMHSAS staff member. Comments are submitted to the substance abuse services management team and the Deputy Commissioner of Substance Abuse Services for review. Final revisions are made to the application and it is then submitted to SAMHSA by the October 1 deadline. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 34 of 311 Planning Checklist Criteria for Allocating Funds Use the following checklist to indicate the criteria your State will use how to allocate FY 2011-2013 Block Grant funds. Mark all criteria that apply. Indicate the priority of the criteria by placing numbers in the boxes. For example, if the most important criterion is 'incidence and prevalence levels', put a '1' in the box beside that option. If two or more criteria are equal, assign them the same number. 2 Population levels, Specify formula: Underserved Populations 2 Incidence and prevalence levels Problem levels as estimated by alcohol/drug-related crime statistics 1 Problem levels as estimated by alcohol/drug-related health statistics 2 Problem levels as estimated by social indicator data 1 Problem levels as estimated by expert opinion Resource levels as determined by (specify method) 1 Size of gaps between resources (as measured by) State and Federal Resources and needs (as estimated by) Waiting Lists Other (specify method) OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 35 of 311 Form 4 (formerly Form 8) Treatment Needs Assessment Summary Matrix 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Central 439,074 30,823 1,849 1,317 79 15,440 926 1,812 1,843 2,264 3.19 3.42 1.82 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 East Central 391,386 27,475 1,649 1,174 70 13,987 839 2,319 1,860 2,876 3.32 0 2.04 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Northeast 472,552 33,173 1,990 1,418 85 16,674 1,000 2,378 2,129 2,963 3.39 1.90 2.96 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Northwest 194,314 13,641 818 583 35 6,808 409 850 882 1,056 2.57 0 5.15 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. B. A. B. A. B. A. B. C. Other: A. B. C. generated on 9/27/2010 10:18:57 AM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 36 of 311 Needing treatment services That would seek treatment Needing treatment services That would seek treatment Needing treatment services That would seek treatment Number of DWI arrests Number of drug-related arrests Drunkenness Hepatitis B /100,000 AIDS/ 100,000 Tuberculosis /100,000 Oklahoma County 819,177 57,506 3,450 2,458 147 29,475 1,769 3,866 5,043 4,784 2.56 4.76 2.81 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Southeast 437,873 30,739 1,844 1,314 79 15,548 933 3,562 3,504 4,393 3.20 0.69 4.11 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Southwest 330,713 23,216 1,393 992 60 11,429 686 1,618 1,598 1,999 3.63 0 2.12 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 Tulsa County 601,961 42,258 2,535 1,806 108 21,568 1,294 3,118 3,770 3,853 4.49 5.81 2.33 1. Substate Planning Area 2. Total Population 3. Total Population in need 4. Number of IVDUs in need 5. Number of women in need Calendar Year: 2008 6. Prevalence of substance-related criminal activity 7. Incidence of communicable diseases A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Needing treatment services B. That would seek treatment A. Number of DWI arrests B. Number of drug-related arrests C. Other: Drunkenness A. Hepatitis B /100,000 B. AIDS/ 100,000 C. Tuberculosis /100,000 State Total 3,687,050 258,831 15,530 11,061 664 130,928 7,856 19,523 20,629 24,188 3.31 2.74 2.77 generated on 9/27/2010 10:18:57 AM OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 37 of 311 Form 5 (formerly Form 9) Treatment Needs by Age, Sex, and Race/ Ethnicity AGE GROUP A. Total B. White C. Black or African American D. Native Hawaiian / Other Pacific Islander E. Asian F. American Indian / Alaska Native G. More than one race reported H. Unknown I. Not Hispanic Or Latino J. Hispanic Or Latino M F M F M F M F M F M F M F M F M F 17 Years Old and Under 27,090 10,178 9,793 1,323 1,267 13 12 216 201 1,322 1,284 763 718 0 0 12,318 11,680 1,496 1,596 18 - 24 Years Old 78,814 29,848 28,443 4,211 3,691 42 34 912 763 3,733 3,657 1,768 1,712 0 0 37,064 34,245 3,450 4,055 25 - 44 Years Old 61,549 23,800 24,397 2,589 2,499 42 30 671 675 2,448 2,478 949 971 0 0 27,904 27,671 2,596 3,379 45 - 64 Years Old 59,700 23,972 25,314 1,829 2,054 17 16 366 481 1,871 2,094 794 892 0 0 27,618 29,455 1,232 1,396 65 and Over 31,892 11,936 15,850 568 841 6 6 104 166 669 909 352 485 0 0 13,269 17,941 365 315 Total 259,045 99,734103,79710,52010,352 120 982,2692,28610,04310,422 4,626 4,778 0 0 118,173120,992 9,13910,741 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 38 of 311 How your State determined the estimates for Form 4 and Form 5 (formerly Form 8 and Form 9) How your State determined the estimates for Form 4 and Form 5 (formerly Form 8 and Form 9) Under 42 U.S.C. §300x-29 and 45 C.F.R. §96.133, States are required to submit annually a needs assessment. This requirement is not contingent on the receipt of Federal needs assessment resources. States are required to use the best available data. Using up to three pages, explain what methods your State used to estimate the numbers of people in need of substance abuse treatment services, the biases of the data, and how the State intends to improve the reliability and validity of the data. Also indicate the sources and dates or timeframes for the data used in making these estimates reported in both Forms 4 and 5. This discussion should briefly describe how needs assessment data and performance data is used in prioritization of State service needs and informs the planning process to address such needs. The specific priorities that the State has established should be reported in Form 7. State priorities should include, but are not limited to the set of Federal program goals specified in the Public Health Service Act. In addition, provide any necessary explanation of the way your State records data or interprets the indices in columns 6 and 7, Form 4. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 39 of 311 FORM 8 AND FORM 9 ESTIMATION METHODOLOGY Estimates for treatment need in Oklahoma have been derived primarily through the latest National Surveys on Drug Use and Health data for Oklahoma. 1. Data from the ODMHSAS Integrated Client Information System (ICIS) were used to estimate the number in need of treatment among persons 11 years of age or younger. 2. SAMHSA’s State Estimates of Substance Use from the 2006-2007 National Surveys on Drug Use and Health (NSDUH) report (http://www.oas.samhsa.gov/2k8state/stateTabs.htm) was used as a data source to estimate treatment needs among persons 12 years of age or older. 3. The number that would seek treatment was estimated to be six percent of those in need of treatment but not currently being served based on a news release from the U.S. DHHS, September 5, 2003 “22 Million in U.S. Suffer from Substance Dependence or Abuse,” (http://www.samhsa.gov/news/newsreleases/030905nrNSDUH.htm). 4. The number of injection drug users in need of treatment (0.3%) was estimated using SAMHSA’s 2002-2003 National Surveys on Drug Use and Health (http://www.oas.samhsa.gov/2k5/ivdrug/ivdrug.cfm). 5. Statistics from the Oklahoma State Bureau of Investigation’s (OSBI) Uniform Crime Report (2008) were used to report substance-related criminal activity. 6. Statistics collected in 2009, at the Oklahoma State Department of Health (OSDH) Surveillance and Analysis Program HIV/STD Service and Acute Disease Service were used to report the incidence of communicable diseases. FORM 8 – TREATMENT NEEDS ASSESSMENT SUMMARY MATRIX TOTAL POPULATION IN NEED: Needing Treatment Services: For youth age 11 and younger, no data were available from the NSDUH. Estimates for those youth were derived using 2009 treatment data in ICIS. All clients, 11 years old or younger, served under an ODMHSAS substance abuse funding source in 2009, who did not have a presenting problem as a dependent child of a substance abuse client or co-dependent of a substance abuser, were considered to be seeking treatment. It was assumed that the 4 youth who received publicly-funded substance abuse treatment in 2008 represented the six percent of those in need of treatment. Therefore, an estimated 0.008 percent of youth in Oklahoma, 11 years of age or younger were in need of treatment. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 40 of 311 Estimates of past year alcohol or illicit drug dependence or abuse (NSDUH, 2007) were used to calculate the number of persons 12 years of age or older in need of treatment in Oklahoma. The estimates specific to each age group were applied to the 2009 Oklahoma population estimates (12 to 17, 7.32%; 18 to 25, 19.35%; 26 or Older, 6.53%). Those estimates were allocated to sub-state regions, and sex, race and origin categories. That Would Seek Treatment: It is estimated that over 94 percent of people with substance use disorders who did not receive treatment did not believe they needed treatment (see source above). Therefore, it was estimated that six percent of people in need of treatment would seek treatment. NUMBER OF IDUs IN NEED Needing Treatment Services: A national estimate of injection drug users from the NSDUH, 2003, was used to estimate the number of IDUs in need of treatment. The estimate (0.3%) was allocated to each of the eight sub-state planning areas. That Would Seek Treatment: Using the source previously described, it was estimated that six percent of intravenous drug users would seek treatment. NUMBER OF WOMEN IN NEED Needing Treatment Services: Estimates for the number of women in need of treatment were derived in the same manner as described above for the total population in need. That Would Seek Treatment: Estimates for the number of women who would seek treatment were derived in the same manner as described above for the total population. PREVALENCE OF SUBSTANCE-RELATED CRIMINAL ACTIVITY Data for substance-related criminal activity were obtained from the Oklahoma State Bureau of Investigation’s (OSBI) 2008 Uniform Crime Report. Number of DWI Arrests: The number of arrests for “driving under the influence” in Oklahoma during 2008 is reported in lieu of “driving while intoxicated.” “Driving under the influence” is defined as driving or operating any motor vehicle while drunk or under the influence of liquor or drugs. Number of Drug-Related Arrests: The number of arrests in Oklahoma during 2008 for “possession, distribution, sale or manufacture of illegal drugs” is reported. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 41 of 311 Other: Drunkenness: The OSBI normally classified “Alcohol-related Arrests” as arrests for driving under the influence, liquor law violations, and drunkenness (drunk and disorderly). Since DUI arrests are presented elsewhere and liquor law violations do not necessarily represent treatment-related issues, drunkenness has been included as a separate category in this report. INCIDENCE OF COMMUNICABLE DISEASES The rates per 100,000 population were generated for the state and each sub-state region from data provided by the Oklahoma State Department of Health. The number of new acute Hepatitis B, reported AIDS and new Tuberculosis cases during calendar year 2009 are utilized. FORM 9 – TREATMENT NEEDS BY AGE, SEX, AND RACE/ETHNICITY The methodology employed to complete this report is reported above under Form 8. EVALUATION OF METHODOLOGY The estimates of need and demand obtained through the methodology described have a number of potential failings. The NSDUH data are probably not representative of Oklahoma at the sub-state level for state specific data or for each sex, race and origin category reported on Form 9. Consequently, estimates based on those data will be biased toward conformance with estimates at the state level. Estimates for IDUs were based on national estimates and are therefore not representative of state rates. Estimates for persons under 12 years old suffer from a complete lack of data. Publicly-funded treatment delivery data are poor substitutes for measures of statewide treatment need. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 42 of 311 Form 6 (formerly Form 11) INTENDED USE PLAN (Include ONLY Funds to be spent by the agency administering the block grant. Estimated data are acceptable on this form) SOURCE OF FUNDS (24 Month Projections) Activity A.SAPT Block Grant FY 2011 Award B.Medicaid (Federal, State and Local) C.Other Federal Funds (e.g., Medicare, other public welfare) D.State Funds E.Local Funds (excluding local Medicaid) F.Other Substance Abuse Prevention* and Treatment $ 13,285,655 $ 1,352,746 $ 17,641,826 $ 73,656,242 $ $ Primary Prevention $ 3,542,841 $ 3,440,072 $ 1,767,576 $ $ Tuberculosis Services $ 0 $ $ $ $ $ HIV Early Intervention Services $ 0 $ $ $ $ $ Administration: (Excluding Program/Provider Lvl) $ 885,710 $ $ 8,318,198 $ $ Column Total $17,714,206 $1,352,746 $21,081,898 $83,742,016 $0 $0 *Prevention other than Primary Prevention OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 43 of 311 Activity Block Grant FY 2011 Other Federal State Funds Local Funds Other Information Dissemination $ 637,711 $ 619,213 $ 318,164 $ $ Education $ 106,285 $ 103,202 $ 53,028 $ $ Alternatives $ 53,142 $ 51,601 $ 26,513 $ $ Problem Identification & Referral $ 17,714 $ 17,200 $ 8,837 $ $ Community Based Process $ 2,207,420 $ 2,201,647 $ 1,131,249 $ $ Environmental $ 460,569 $ 447,209 $ 229,785 $ $ Other $ 0 $ 0 $ 0 $ $ Section 1926 - Tobacco $ 60,000 $ 0 $ 0 $ $ Column Total $3,542,841 $3,440,072 $1,767,576 $0 $0 Activity Block Grant FY 2011 Other Federal State Funds Local Funds Other Universal Direct $ 743,997 $ 722,415 $ 371,191 $ $ Universal Indirect $ 2,798,844 $ 2,717,657 $ 1,396,385 $ $ Selective $ 0 $ $ $ $ Indicated $ 0 $ $ $ $ Column Total $3,542,841 $3,440,072 $1,767,576 $0 $0 Form 6ab (formerly Form 11ab) Form 6a. Primary Prevention Planned Expenditures Checklist Form 6b. Primary Prevention Planned Expenditures Checklist OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 44 of 311 Form 6c (formerly Form 11c) Resource Development Planned Expenditure Checklist Did your State plan to fund resource development activities with FY 2011 funds? Yes No Activity Treatment Prevention Additional Combined Total Planning, Coordination and Needs Assessment $ 320,000 $ 80,000 $ 0 $ 400,000 Quality Assurance $ 250,000 $ 65,000 $ 0 $ 315,000 Training (post-employment) $ 265,000 $ 65,000 $ 0 $ 330,000 Education (pre-employment) $ 0 $ 0 $ 0 $ 0 Program Development $ 0 $ 0 $ 0 $ 0 Research and Evaluation $ 0 $ 0 $ 0 $ 0 Information Systems $ 25,000 $ 0 $ 0 $ 25,000 Column Total $860,000 $210,000 $0 $1,070,000 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 45 of 311 Purchasing Services This item requires completing two checklists. Methods for Purchasing There are many methods the State can use to purchase substance abuse services. Use the following checklist to describe how your State will purchase services with the FY 2011 block grant award. Indicate the proportion of funding that is expended through the applicable procurement mechanism. Competitive grants Percent of Expense: % Competitive contracts Percent of Expense: 20 % Non-competitive grants Percent of Expense: % Non-competitive contracts Percent of Expense: 80 % Statutory or regulatory allocation to governmental agencies serving as umbrella agencies that purchase or directly operate services Percent of Expense: % Other Percent of Expense: % (The total for the above categories should equal 100 percent.) According to county or regional priorities Percent of Expense: % Methods for Determining Prices There are also alternative ways a State can decide how much it will pay for services. Use the following checklist to describe how your State pays for services. Complete any that apply. I n addressing a State's allocation of resources through various payment methods, a State may choose to report either the proportion of expenditures or proportion of clients served through these payment methods. Estimated proportions are acceptable. Line item program budget Percent of Clients Served: % Percent of Expenditures: 20 % Price per slot Percent of Clients Served: % Percent of Expenditures: % Rate: $ Type of slot: Rate: $ Type of slot: Rate: $ Type of slot: Price per unit of service Percent of Clients Served: % Percent of Expenditures: 80 % Unit: OP/group couns/15 min Rate: $ 9.28 Unit: Res/adult/per day Rate: $ 74 Unit: Res/WWC/per day Rate: $ 95 Per capita allocation (Formula: ) Percent of Clients Served: % Percent of Expenditures: % Price per episode of care Percent of Clients Served: % Percent of Expenditures: % Rate: $ Diagnostic Group: Rate: $ Diagnostic Group: Rate: $ Diagnostic Group: OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 46 of 311 Program Performance Monitoring On-site inspections Frequency for treatment: ANNUALLY Frequency for prevention: ANNUALLY Activity Reports Frequency for treatment: NONE SELECTED Frequency for prevention: NONE SELECTED Management Information System Patient/participant data reporting system Frequency for treatment: NONE SELECTED Frequency for prevention: NONE SELECTED Performance Contracts Cost reports Independent Peer Review Licensure standards - programs and facilities Frequency for treatment: OTHER Every three years or sooner as needed Frequency for prevention: NOT APPLICABLE Licensure standards - personnel Frequency for treatment: OTHER Ongoing Frequency for prevention: OTHER Ongoing Other: Specify: OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 47 of 311 Form 7 State Priorities State Priorities 1 Promote the well-being of Oklahomans by encouraging prevention specialists and consumer services providers to actively participate in the primary healthcare delivery system through health information technology. 2 Create prevention capable communities utilizing the Stratregic Prevention Framework where individuals, families, schools, workplaces, and communities have the capacity and infrastructure to prevent and reduce substance abuse across the lifespan. 3 Prevent the onset and prevent/reduce the problems associated with the use of alcohol, tobacco and other drugs across the lifespan as identified and measured using epidemiological data. 4 Increase the use of prevention and treatment services that are evidence-based, implemented with fidelity and evaluated for effectiveness. 5 Expand the capacity of prevention and treatment providers to meet the behavioral health needs of diverse individuals and communities in a timely, culturally competent, trauma-informed manner that promotes recovery and an improved quality of life. 6 Develop systematic processes for analyzing data and establishing data-driven policy decision methods to effectively utilize prevention and treatment reseources, improving the quality of services and outcomes for individuals, families and communities. 7 Actively seek opportunities to collaborate and coordinate efforts with community stakeholders within the state to address homelessness. 8 Divert individuals with substance abuse and mental health disorders from criminal and juvenile justice systems into trauma-informed treatment and recovery. 9 Enhance support systems for Oklahoma military families, connecting service members and families to supportive and knowledgeable peers, and providing appropriate referrals for behavioral health systems. 10 Actively promote health insurance reform for the prevention and treatment of substance abuse disorders to reduce current disparities. OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 48 of 311 Goal #1: Improving access to Prevention and Treatment Services The State shall expend block grant funds to maintain a continuum of substance abuse prevention and treatment services that meet these needs for the services identified by the State. Describe the continuum of block grant-funded prevention (with the exception of primary prevention; see Goal # 2 below) and treatment services available in the State (See 42 U.S.C. §300x-21(b) and 45 C.F.R. §96.122(f)(g)). Note: In addressing this narrative the State may want to discuss activities or initiatives related to: Providing comprehensive services; Using funds to purchase specialty program(s); Developing/maintaining contracts with providers; Providing local appropriations; Conducting training and/or technical assistance; Developing needs assessment information; Convening advisory groups, work groups, councils, or boards; Providing informational forum(s); and/or Conducting provider audits. FY 2011- FY 2013 (Intended Use/Plan): FY 2008 (Annual Report/Compliance): FY 2010 (Progress): OK / SAPT FY2011 OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 49 of 311 GOAL # 1. Improving access to prevention and treatment services: The State shall expend block grant funds to maintain a continuum of substance abuse prevention and treatment services that meet these needs for the services identified by the State. Describe the continuum of block grant-funded prevention (with the exception of primary prevention: see goal #2 below) and treatment services available in the State (See 42 U.S.C. §300x-21(b) and 45 C.F.R. §96.122(f)(g)). FY 2011-FY2013 (Intended Use/Plan): The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) will utilize block grant funding, grants and contracts, and state appropriations to maintain a continuum of substance abuse treatment services within the State. Oklahoma will spend approximately 75% of the FFY 2011 block grant award on alcohol and drug treatment services. The ODMHSAS will continue to contract with private, non-profit and for-profit, certified agencies to provide detoxification, residential, halfway house, outpatient, intensive outpatient, and early intervention services with substance abuse block grant funds and state appropriations. These agencies include substance abuse treatment facilities, community mental health centers, community action agencies, youth and family services agencies, and Native American programs. Services will be offered in facilities which serve males and/or females, women with children, and adolescents. Three ODMHSAS-operated agencies will continue to provide residential services. In addition, other public agencies will continue to provide contracted services including the University of Oklahoma Health Sciences Center which provides screening, assessment, and treatment planning for children with Fetal Alcohol Spectrum (FAS). Substance abuse treatment programs are expected to treat approximately 22,000 consumers during this fiscal year. The Department will continue to provide early intervention services through public schools. Services will include working with school personnel and parents to develop drug free strategies with high-risk or substance using students, educational programs, screening and assistance with therapeutic linkages as needed. These programs will be funded through state and federal treatment monies. In addition, a pilot program has been initiated involving three Charter Schools and three contract adolescent substance abuse providers to provide an evidence-based early intervention curriculum within the school setting and communities utilizing state funds. This is an effort to expand services to an at-risk and underserved population, within their communities. The ODMHSAS will strive to sustain funding for programs and to continue to collect outcomes and determine how these programs could be replicated. Oklahoma is invested in expanding the practice of case management within the substance abuse field by providing continual training and technical assistance. Standards have been revised to require anyone providing case management to be a Certified Behavioral Health Case Manager. Integrated, strength-based, person-centered case management plays an FY 2011 - FY 2013 (INTENDED USE/PLAN) OMB No. 0930-0080 Approved: 07/20/2010 Expires: 07/31/2013 Page 50 of 311 important role in treatment programs by linking consumers to needed services such as employment, education, vocational skill development, child care, and health care. The ODMHSAS case management staff will continue to explore ways to increase the knowledge base and skill level for Certified Behavioral Health Case Managers through training opportunities. Oklahoma will continue to require standardized consumer evaluations, an individualized approach to treating the consumer, family involvement if appropriate, case management, the use of evidence-based practices, relapse prevention and connecting the consumer to community self-help groups. Oklahoma will continue monitoring provider programs by assigning each state-operated and contract treatment program to a Field Services Coordinator (FSC). The FSC will continue to be the primary contact for their assigned providers and responsible for linking them with other appropriate ODMHSAS staff as needed, visiting the agency, conducting site reviews, developing plans of correction and technical assistance needs for each agency, as well as reviewing provider staffing, services and performance reports. Technical assistance will be provided by the FSC or other Department staff, or through workshops at meeting/conferences, as needed per the findings of the site review or as requested by the provider. This monitoring approach allows the FSC to develop a partnership with their providers and facilitates opportunities for discussions and additional technical assistance to improve the quality of care provided for consumers. Continued collaboration with the Oklahoma Department of Human Services (OKDHS) TANF program will benefit both agencies’ consumers. OKDHS will provide TANF funding to the ODMHSAS to subcontract with certified treatment agencies. Contracted agencies will provide screening, assessment, and outpatient substance abuse services to consumers receiving or making application for Temporary Assistance to Needy Families (TANF) and individuals who have Child Welfare (CW) involvement. These services provide valuable early intervention in many cases that will allow families to stay together. The ODMHSAS will provide training, technical assistance, and program monitoring. Immediate Access and other initiatives with TANF or Child Welfare participants will continue to be pursued as a means of providing substance abuse services to more individuals in need of treatment. The ODMHSAS will continue to collaborate with the Oklahoma Health Care Authority (OHCA), the state’s Medicaid agency, to access Medicaid funding for substance abuse services. The Consolidated Claims Process (CCP) will allow service providers to submit both ODMHSAS service invoices and Medicaid claims into one system. The system will determin |
Date created | 2011-07-27 |
Date modified | 2011-10-27 |
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