Armstrong-Indiana-Clarion Drug and Alcohol Commission
Annual Report
Fiscal Year 2012/13
Introduction
The Armstrong-Indiana-Clarion Drug and Alcohol Commission (AICDAC) is the
Single County Authority (SCA) for Armstrong, Indiana, and Clarion Counties. In this
role, the Commission is responsible for facilitating the provision of a comprehensive and
balanced system of quality substance abuse prevention, intervention, treatment, and
case management services for the three-county area.
The mission of the Armstrong-Indiana-Clarion Drug and Alcohol Commission is
to address the abuse and destructive effects of alcohol, tobacco, and other drugs
through prevention, intervention, treatment, and case management. The vision of the
Armstrong-Indiana-Clarion Drug and Alcohol Commission is to maximize resources that
empower change to improve the quality of life for individuals, families, and the
community impacted by the abuse and destructive effects of alcohol, tobacco, and other
drugs.
The Commission is a 501(c)(3) non-profit corporation and is classified as an
Independent Executive Commission that contracts directly with the PA Department of
Drug and Alcohol Programs. The Commission is also responsible for assessing
substance abuse needs, planning, developing, and coordinating programming to meet
service needs, and then monitoring and reviewing the outcomes. Administrative staff
responsible for insuring contractual compliance, reporting and fiscal operations include
the Executive Director (Kami Anderson), Chief Fiscal Officer (Amanda Schroeder),
Fiscal Assistant (Tracy Stross), part-time Fiscal Officer (currently vacant), and the
Administrative Assistant (Ashley Callihan) for the Clarion satellite office.
In early 2012, the Commission conducted a three-county-wide Needs
Assessment under the direction of the Department of Drug and Alcohol Services
(formerly the Bureau of Drug and Alcohol Services under the Department of Health).
This document is available by calling the SCA Administrative Office at 724-354-2746 or
email at kanderson@aidac.org.
The Commission has a functional Case Management Unit responsible for the
provision of case management services which include: screening, assessment,
placement, level of care determination and case coordination services. The Case
Management Supervisor (Nicole Salvo) oversees a total of seven Case Managers for
the three Counties.
The Case Management Department made significant structural changes at the
end of the fiscal year 2012/13 in order to increase the availability of our Case Managers
to our clients. Two Case Managers are now located in the main population centers of
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each County. For Armstrong County, two Case Managers (Barbara Miklos and Amanda
Cochran) are located in the Commission’s office at 354 Vine Street, Kittanning, PA. For
Indiana County, two Case Managers (Steven Olish and Susan Graham) are located in
the outpatient provider office, The Open Door, at the Atrium, 665 Philadelphia Street,
Indiana, PA. For Clarion County, two Case Managers (Corrin Cochran and Meredith
Karg) are located in the Commission’s Clarion Office at 1250 East Main Street, Clarion,
PA.
Armstrong and Indiana County share a Criminal Justice Case Manager (Lisa
Lloyd), who works primarily with Level 3 and 4 offenders who have been diverted to
treatment or Drug Court Program through a Restrictive Intermediate Punishment grant
funded by the Pennsylvania Commission on Crime and Delinquency (PCCD).
Armstrong County operates an Intensive Supervision and Treatment Program funded
through PCCD, and Indiana County operates a Drug Treatment Court with PCCD funds.
For Clarion County, one of the Case Managers (Corrin Cochran) is employed at
.5 FTE as a Criminal Justice Case Manager that works primarily with Level 3 and 4
offenders enrolled in the Clarion County Drug Court program. The other .5 FTE is
spent providing Case Coordination services to the general population.
One of the Case Managers in each County also serves as the drug and alcohol
liaison (at .5 FTE) for the SAP teams in their County, providing consultation and on-site
assessments for students referred by the 33 teams and other school personnel.
The Commission added a Recovery Support Services (RSS) department in 2010.
Four full-time Certified Recovery Specialists (CRS) are employed by the SCA. The
CRS Supervisor (Michael Krafick) and three CRS staff (Lea Bevick, Brandon Houston,
and Paul Oresick) provide recovery support services to any client requesting those
services. A recovery plan is developed with the client and progress is evaluated
periodically. The CRS staff members provide recovery support in person or over the
phone. All of the CRS staff are trained in the Criminal Justice population and are
involved in the County Jail and Drug Court programs.
In the FY 2012/13, the Commission began providing Prevention services directly.
The Commission employs six full-time Prevention Specialists (Matthew Antis, Courtney
Hankinson, Michele Simpson, Sarah Muth, Jessica Snyder, and Rita Woodard) to
provide Prevention Services in the three Counties. The Deputy Director (Carrie Bence)
is responsible for the oversight of all Prevention Services in all three Counties.
The Commission is responsible for the Tobacco Prevention Education and
Cessation Program in Armstrong, Indiana, Clarion, Clearfield and Jefferson Counties.
The Deputy Director is responsible for the oversight of the project, including the
coordination of all tobacco compliance checks, cessation programs, health fairs, and
coalition activities. All Tobacco Services are provided by two Tobacco Coordinators
(Kolaya Horne and Betsee Brunier).
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The Deputy Director also oversees the Drug-Free Communities Coalition, which
was created in 2003 as the Drug Awareness Prevention Partnership (DAPP), and
provides oversight of the prevention grant programs. The name of the Coalition was
changed in 2008 as a response to the new grant awarded to the Commission,
SAMHSA’s Drug-Free Communities (DFC) federal grant. A Prevention Specialist
(Jennifer McCroskey) acts as the Community Mobilizer for the Coaltion. The
Commission is proud to announce that it was awarded the second five-year Drug Free
Communities grant that will run from October 2013 through September 2018.
During the FY 2012/13, the Commission was also awarded the SAMHSA STOP
ACT Grant, which is a three year grant that focuses on the prevention of underage
drinking in Armstrong and Indiana Counties. Through this grant, the Commission
collaborates with the Sheriff’s Department to provide an Alcohol and Driving curriculum
class to all 9th or 10th graders in both counties. The Alcohol and Driving curriculum was
also presented to all schools in Clarion County through a grant from the PA Liquor
Control Board. The grants also provide funding for social norms campaigns in the
schools and for increased Underage Drinking Enforcement activities.
The Commission was again awarded the Problem Gambling grant for the fiscal
years 2013/14 and 2014/15 through the Department of Drug and Alcohol Programs
(DDAP) for the three counties. Problem gambling education and prevention services
are provided by the Commission prevention staff.
The Commission is governed by a thirteen member volunteer board of directors.
Five members represent our largest County of Indiana. Four members represent each
Armstrong and Clarion Counties. The officers for FY 2013/2014 are: President, Marie
Dillon-Griffith; Vice President, Jodi Beers; and Secretary-Treasurer, Robert Rout. Other
board members are: Commissioner Patricia Evanko (Indiana), Commissioner Richard
Fink (Armstrong), Commissioner Wayne Brosius (Clarion), Dennis Demangone, Erin
Eisenman, Dr. Mary Swinker, Dr. Greg Clary, Sheriff Rex Munsee, Thomas Curry.
There is currently one vacant position for Indiana County. Board meetings are open to
the public and held the third Tuesday of each month.
The Service Provider’s Advisory Task Force consists of management staff of the
local sub-contractors and meets on a monthly basis with management staff from the
Commission. The role of the Task Force is to discuss service planning, current ATOD
trends, and any SCA/provider issues that need addressed. Staff training is a major
focus of the meeting, as well as contract requirements, service delivery, and fiscal
concerns. The President of the Task Force is Vincent Mercuri, Executive Director of the
Open Door.
An organizational chart for the Commission by job title is included on the
following page (4).
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Armstrong-Indiana-Clarion Drug & Alcohol Commission
Organization Chart
FY 2012/2013
Board of Directors
13 Member Volunteer Board
County D/A Administrator II
K003-L0152-0001
Kami Anderson
DD, BH, A, HC, T, G
County Fiscal Officer II
K003-L0316-0001
Amanda Schroeder
DD, BH, A, HC, T, D, G
Fiscal Assistant
K003-L0360-0001
eder
Tracy Stross
DD, BH, A, HC, T, P, G, S
Part-time
Fiscal Assistant
K003-L0360-0002
Vacant
DD, BH, A, HC, T, D, G
Funding
Streams:
DD = DDAP
BH = BHSI
A = ACT 152
HC = Health
Choices
T = Tobacco
P = PCCD
D = DFC
G = Gambling
H = HRSA
L = PLCB
S = STOP Act
(Clarion) Administrative
Assistant I
K003-L0031-0001
Ashley Callihan
DD, BH, A, G
D/A Prevention
Specialist
K003-L0681-9901
Jennifer
McCroskey
D, G, S
D/A Prev Specialist
Betsee Beunier
K003-L0681-9903
T
(Clarion) D/A Prev Specialist
K003-L0681-0001
Rita Woodard
DD, G, L
(Clarion)D/A Prev Specialist
K003-L0681-9902
Kolaya Horne
T
D/A Case Management Supervisor
K003-L0687-0001
Nicole Salvo
HC, DD, BH, P
County D/A Program
Assistant Administrator
K003-L0150-0001
Carrie Bence
DD, T, D, G, L, S
D/A Prev Specialist
Courtney Hankinson
K003-L0681-0002
DD, G, S
D/A Prev Specialist Trainee
K003-L0680-0001
Matthew Antis
DD, G, S
D/A Prev Specialist Trainee
K003-L0680-0002
Michelle Simpson
DD, G, S
(Clarion) D/A Prev
Specialist Trainee
K003-L0680-0003
Jessica Snyder
DD, G, L
D/A Prev Specialist Trainee
K003-L0680-0004
Sarah Muth
DD, G, S
Drug Free Communities
Coalitions
Recovery Support Specialist Supervisor
K003-L0675-0001
Mike Krafick
HC, H
Recovery Support Specialist
K003-L0675-0002
Brandon Houston
P
Recovery Support Specialist
K003-L0675-0003
LeAnn Bevak
HC, H
(Clarion) Recovery Support Specialist
K003-L0675-0004
Paul Oresick
HC
(Clarion) D/A Case Mgmt Specialist
K003-L0686-0005
Corrin Reffner
DD, BH, P, HC
D/A Case Management Specialist
K003-L0686-0002
Steve Olish
DD, BH, P
D/A Case Management Specialist
K003-L0686-0001
Barb Miklos
DD, BH, P
D/A Case Management Specialist
K003-L0686-9901
Lisa Lloyd
P
D/A Case Management Specialist
K003-L0686-9902
Susan Graham
HC
D/A Case Management Specialist
K003-L0686-0003
Amanda Cochran
DD
(Clarion) D/A Case Mgmt Specialist
K0003-L0686-0004
Meredith Karg
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DD, BH, HC
The SCA has offices at the following locations:
Armstrong/Indiana (Administrative Office):
10829 U.S. Route 422
P.O. Box 238
Shelocta, PA 15774
724-354-2746
Armstrong County:
354 Vine Street
Kittanning, PA 16201
724-545-1614
Clarion County:
1350 East Main Street, Suite 30
Clarion, PA
814-226-6350
Indiana County:
665 Philadelphia Street
Indiana, PA 15701
724-463-7860
The Commission has contracts with the following local treatment providers for the
following services:
OUTPATIENT TREATMENT:
ARC Manor
200 Oak Avenue
Kittanning, PA 16201
724-548-7607
Cindy McCrea, Executive Director
The Open Door
665 Philadelphia Street
Indiana, PA 15701
724-465-2605
Vincent Mercuri, Executive Director
ARC Manor Satellite Offices:
116 Main Street
Leechburg, PA 15686
30 Pinnacle Drive, 2nd Floor
Clarion, PA 16214
INTENSIVE OUTPATIENT and
ENHANCED MAT INTENSIVE OUTPATIENT:
ARC Manor
200 Oak Avenue
Kittanning, PA 16201
724-548-7607
Cindy McCrea, Executive Director
The Open Door
665 Philadelphia Street
Indiana, PA 15701
724-465-2605
Vincent Mercuri, Executive Director
30 Pinnacle Drive, 2nd Floor
Clarion, PA 16214
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PARTIAL HOSPITALIZATION and
ENHANCED MAT PARTIAL HOSPITALIZATION:
ARC Manor
200 Oak Avenue
Kittanning, PA 16201
724-548-7607
Cindy McCrea, Executive Director
The Open Door
665 Philadelphia Street
Indiana, PA 15701
724-465-2605
Vincent Mercuri, Executive Director
30 Pinnacle Drive, 2nd Floor
Clarion, PA 16214
ADULT RESIDENTIAL:
ARC Manor
200 Oak Avenue
Kittanning, PA 16201
724-548-7607
Cindy McCrea, Executive Director
In addition, the Commission contracted with the following out-of-county
treatment providers:
HOSPITAL-BASED DETOX AND REHABILITATION:
Stepping Stones – Meadville Medical Center
NON-HOSPITAL DETOX:
Conewago-Pottsville
Cove Forge Behavioral Health System
Gateway Rehab Center
Gaudenzia Erie-Crossroads
Greenbriar Treatment Center
Pyramid HealthCare
Roxbury
Transitions at Wilkinsburg
Turning Point - Franklin
Twin Lakes Recovery Center
White Deer Run - Allenwood
White Deer Run - Lancaster
White Deer Run – New Perspectives
NON-HOSPITAL RESIDENTIAL REHABILITATION:
Conewago-Indiana
Pyramid HealthCare - Belleville
Cove Forge Behavioral Health
Renewal Inc.
Freedom Center
Roxbury
Gaiser Addiction Center
Transitions - Wilkinsburg
Gateway Erie
Turning Point – Franklin
Gateway Rehab Center
Twin Lakes Recovery Center
Greenbriar Treatment Center
White Deer Run - Allenwood
Gaudenzia Erie- Crossroads
White Deer Run - Lancaster
Pyramid HealthCare
White Deer Run – New Perspectives
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ADOLESCENT NON-HOSPITAL RESIDENTIAL REHABILITATION:
Gateway Rehab Center
Pyramid Ridgeview Adolescent Center
White Deer Run
WOMEN W/CHILDREN NON-HOSPITAL RESIDENTIAL REHABILITATION:
Family Links
Samara House of CYWA
Gaudenzia
NON-HOSPITAL DUAL DIAGNOSIS RESIDENTIAL REHABILITATION:
Cove Forge
Pyramid HealthCare
Gaudenzia Erie
Transitions at Wilkinsburg
Greenbriar Treatment Center
White Deer Run
HALFWAY HOUSE:
Abstinent Living at the Turning Point
Highland House
of Washington
Lighthouse for Women
Another Way
Lighthouse for Men
Clem-Mar House (Male and Female Programs) Moffett House
Cove Forge Renewal Center
New Directions @ Cove Forge
Davis Archway House
Pyramid HealthCare
Gaudenzia Erie (Male and Female Programs) Pyramid-Gratitude House & Pine Ridge
Halfway Home of Lehigh Valley
Tom Rutter House
OUTPATIENT METHADONE MAINTENANCE:
RHJ Medical
Med-Tech Rehab
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Administration
The Commission continued to be active in the fiscal year 2012/13 on a statewide
basis through the Executive Director’s (Kami Anderson) participation as an Officer in the
PA Association of County Drug and Alcohol Administrators (PACDAA), and the Deputy
Director’s (Carrie Bence) participation in the PA Commonwealth Prevention Alliance,
Southwestern PA Tobacco Free Coalition, and the Western PA Regional Prevention
Workgroup. The Commission’s Executive Director (Kami Anderson) currently holds the
following Board positions:
Treasurer, PA Association of County Drug and Alcohol Administrators (PACDAA)
Treasurer, Southwest Behavioral Health Management Corporation (SBHM)
Executive Committee, Behavioral Health Alliance of Rural PA (BHARP)
The Commission staff was active on the local level with membership and
participation in the following:
Armstrong/Indiana/Clarion Service Providers Advisory Task Force
Armstrong and Indiana County Criminal Justice Advisory Boards
Armstrong/Indiana/Clarion County Human Service/Resource Councils
Armstrong/Indiana/Clarion County Chambers of Commerce
Armstrong and Indiana County Family Group Decision Making
Indiana County LINK
Indiana County Multi-Disciplinary Team (MDT)
Indiana County Children’s Advisory Council (CAC)
Indiana/Clarion County Child Death Review Team
Clarion County Family Net
Clarion County Jail Treatment Team
Clarion County Disaster Crisis Response Team
Clarion County Shelter Task Force
Clarion University Of PA Rehabilitation Sciences Advisory Board
SAP District Council
SAP Coordination Teams
Training
Training was made available to staff of the SCA and the SCA’s contracted
providers in the three county drug and alcohol service delivery system via workshops
and seminars sponsored solely by the Commission or in partnership with the Service
Providers Advisory Task Force. The training programs included Confidentiality, Ethics,
PA Client Placement Criteria (PCPC), Fetal Alcohol Spectrum Disorders (FASD),
Screening and Assessment, and Addictions 101.
Training needs identified by the SCA and the contracted providers include the
DDAP-required Prevention trainings for new staff; Common Behavioral Health
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Medications trainings; Practical Applications of Confidentiality and PCPC; Recovery
Coaching; Affordable Care Act informational trainings and how it will affect drug and
alcohol services; and Fraud, Waste, and Abuse Compliance trainings.
Prevention Services
Armstrong, Indiana, and Clarion Counties
The Commission spent $257,552 in funding for Prevention Services for
Armstrong, Indiana, and Clarion counties during the Fiscal Year 2012/13. The
prevention plan for FY 2012/13 focused on the prevention of youth usage of alcohol,
tobacco, marijuana, and prescription drugs. The target communities of focus were
Kittanning in Armstrong County, Blairsville in Indiana County, and Knox in Clarion
County.
The Commission implemented over 2,360 direct service hours on prevention
efforts concentrating in the areas of education, information dissemination, alternative
activities, problem identification and referral, community-based process, and
environmental activities.
Over 1,035 direct service hours and were provided in education and training in
the areas of critical life and social skills such as decision-making, refusal skills, critical
analysis of media messages, and the effects of ATOD usage. Presentations were
made through Act 211 ATOD education using the evidence based and innovative
programs; such as, Too Good For Drugs (TGFD), Too Good For Drugs and Violence,
BABES, Alcohol and Driving Course, alternative school programs, after school skills
groups, Underage Users’ group, minority youth groups, school personnel presentations,
worksite presentations and Teen Leadership training. The TGFD program was
presented to a total of 2,527 youth, the Alcohol and Driving program was presented to
1,344 youth, the Class Action curriculum was presented to 65 students, and the BABES
program was presented to 481 children.
During the FY 2012/13, 883 staff hours were spent on information dissemination
activities that provide awareness and knowledge of the nature and extent of ATOD use,
abuse, and addiction and their effects on individuals, families, and communities.
Contacts were made through community health fairs and presentations, media
campaigns, public service announcements, phone contacts, pamphlets, brochures, and
video distribution to approximately 41,137 youth and adults.
Prevention staff spent 48 hours coordinating alternative activities that excluded
alcohol, tobacco, and other drug use for youth. Over 500 youth and adults benefited
from alternative activities sponsored by the Commission in the FY 2012/13.
Problem identification and referral services were provided during the FY 2012/13.
This strategy aims at identifying those who have indulged in illegal and/or age
inappropriate use of tobacco and alcohol and those individuals who have indulged in the
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first use of illicit drugs in order to assess if their behavior can be reversed through
education. 181 direct service hours were provided through the Underage Users’ group
and various community/parental requests for information and training. 231 youth
received services through the problem identification and referral process.
Community-based services aimed at enhancing the ability of the community to
more effectively provide and participate in prevention services were provided to area
residents. Local community-based coalition meetings, church and civic group
presentations, staff training at housing authorities, domestic violence shelters, and WIC
are examples of community-based services that were provided through 157 direct
service hours that reached 149 individuals.
Environmental activities attempt to establish or change written and unwritten
community standards, codes, and attitudes to influence incidence and prevalence of the
abuse of alcohol, tobacco, and other drugs used in the general population. Prevention
staff spent 60 direct service hours and reached 659 individuals participating in various
committees and coalitions and contacting local legislatures, school superintendents,
and public officials.
The Armstrong-Indiana-Clarion Drug and Alcohol Commission Prevention
Department educated the communities of Armstrong, Indiana, and Clarion counties on
Fetal Alcohol Spectrum Disorders Awareness (FASD) by distributing approximately
2,000 table tents to alcohol licensees and the community with an awareness message
that “there is No safe time, No safe amount and No safe alcohol use during pregnancy.”
Tobacco Prevention and Cessation Program
Armstrong and Indiana Counties
The Commission was awarded a grant to be a sub-contractor for Washington
County Health Partners to provide tobacco prevention, cessation and exposure
activities in Armstrong and Indiana Counties. This grant is a result of the Master
Settlement Agreement funding awarded through the Pennsylvania Department of
Health. The grant is carried out through three program areas.
The Tobacco Free program focuses on three goal areas: prevent the initiation
of tobacco use among young people, promote quitting among adults and young
people, and eliminate nonsmokers’ exposure to secondhand smoke. This includes
school programs, tobacco free schools training, tobacco policy, work with community
business organizations, and the Synar survey. Highlights for these program areas are
provided below by each county.
Armstrong County
 20 programs in schools and community locations reached 1,942 children with
tobacco prevention and cessation education.
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



The average yearly compliance rate of tobacco retailers not selling tobacco
products to minors was 100%.
16 tobacco users participated in local cessation classes, made 11 quit attempts,
and had an impressive 31% quit rate. Group cessation rates are typically
between 11.6% and 16.1%.
2,484 “Quit for Me” stickers, 3 Tobacco Stop signs, and 5 Young Lungs at Play
signs were distributed.
27 Fax to Quit referrals forms were distributed
Indiana County
 31 programs in schools and community locations reached 3,010 children with
tobacco prevention and cessation education.
 The average yearly compliance rate of tobacco retailers not selling tobacco
products to minors was 86%.
 16 tobacco users participated in local cessation classes, made 14 quit attempts,
and had an impressive 54% quit rate. Group cessation rates are typically
between 11.6% and 16.1%.
 4,019 “Quit for Me” stickers and 7 Tobacco Stop signs were distributed
 6 Fax to Quit referrals forms were distributed
During the FY 2012/13, 373 teens from Armstrong and Indiana Counties
participated in five tobacco prevention events, including the Great American Smoke out,
Kick Butts Day, and World No Tobacco Day.
In support of a Tobacco Free SWPA regional coalition initiative, the “What’s
in Your Child’s Backpack—can you tell the difference?” educational presentation
was made to 126 people. The goal of this program is to inform government
officials, community organizations and school personnel about the new products
tobacco companies are making which appeal to younger users and delivers three
key messages relating to how new products containing tobacco and nicotine
appeal to youth by:
1) looking, smelling and tasting like candy;
2) being easy to disguise their use; and
3) having a cheap price and cool packaging.
The Tobacco Free Coalition is a subcommittee of the Armstrong-Indiana Drug
Free Communities Coalition, whose goal is to raise awareness in the communities
concerning tobacco prevention, education, and cessation. The subcommittee members
participated in several health fairs in the community to raise awareness and provide
information on second hand smoke and the dangers of smoking during pregnancy.
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Tobacco Prevention and Cessation Program
Clarion, Clearfield, and Jefferson Counties
In February 2011, the Commission was awarded a grant to be a sub-contractor
for the Northwest PA Region through Erie County Department of Health to provide
tobacco prevention, cessation and exposure activities in Clarion, Clearfield, and
Jefferson Counties. This grant is a result of the Master Settlement Agreement funding
awarded through the Pennsylvania Department of Health.
The Tobacco Free program focuses on three goal areas: prevent the initiation
of tobacco use among young people, promote quitting among adults and young
people, and eliminate nonsmokers’ exposure to secondhand smoke. This includes
school programs, tobacco free schools training, tobacco policy, work with community
business organizations, and the Synar survey. Highlights for these program areas are
provided below by each county.
Clarion County
 13 Synar tobacco checks were completed
 21 Tobacco presentations reached 2,113 youth
 A total of 35 Young Lungs at Play signs were distributed to 8 agencies
 Tobacco Quitline and prevention information was distributed at 11 Community
Events
 7 Fax to Quit clipboards were distributed
 A total of 6 people participated in Cessation programming and 3 quit using
tobacco
Clearfield County
 5 Tobacco presentations reached 589 youth
 A total of 17 Young Lungs at Play signs were distributed to 2 agencies
 Tobacco Quitline and prevention information was distributed at 2 Community
Events
 7 Fax to Quit clipboards were distributed
 A total of 9 people participated in Cessation programming and 4 quit using
tobacco
Jefferson County
 9 Tobacco presentations reached 283 youth
 A total of 20 Young Lungs at Play signs were distributed to 4 agencies
 Tobacco Quitline and prevention information was distributed at 2 Community
Events
 4 Fax to Quit clipboards were distributed
 A total of 3 people participated in Cessation programming and none were able to
stay quit from using tobacco
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Drug Free Communities Coalition
Armstrong and Indiana Counties
In September 2008, the Commission was awarded a five-year Drug Free
Communities Grant through the Office of National Drug Control Policy (ONDCP) and
Substance Abuse and Mental Health Services Administration (SAMHSA). The goal of
this grant is to reduce the use/abuse of alcohol, tobacco, marijuana, and prescription
drugs by adolescents and young adults through environmental approaches. The
Commission is proud to announce that it was awarded the second five-year Drug Free
Communities grant that will run from October 2013 through September 2018.
The Armstrong-Indiana Drug Free Communities Coalition (DFCC) is the leading
organization bringing together all the community sectors in the two-county area to
create a safe, healthy, and drug free environment for our youth and families.
A project of the Armstrong-Indiana-Clarion Drug and Alcohol Commission, the
Coalition is an important part of making the picture of a drug-free community come to
life. The Coalition meets the first Wednesday of each month at the Commission’s office
in Shelocta. The DFCC is led by a cross-section of community stakeholders. At the
table you will find individuals representing education, healthcare, drug and alcohol
prevention, human services, law enforcement, government, parents, and concerned
citizens.
The DFCC is working on multiple fronts to tackle the substance abuse issue with
a comprehensive approach including many strategies.
• Informative and up-to-date website
• Distribution of educational brochures
• Drug and alcohol-free alternative activities
• Bi-annual Adolescent problem surveys (PAYS)
• Trainings and seminars
• Community meetings
• Alcohol and tobacco compliance checks
• Legislative advocacy
• Public awareness campaigns
• Public service announcements
In the fiscal year 2012/13, the DFCC conducted a total of eleven prescription
drug take-back events in Armstrong and Indiana Counties and collected over 311
pounds of prescription drugs. A total of seven Teen Scene presentations were
conducted with 281 participants teaching parents and community members about
current drug trends, where kids may be hiding their drugs, and everyday items that kids
use to get high.
Also in the FY 2012/13, the Coalition collaborated with the Indiana County
District Attorney’s Office to form a drug information panel in Indiana County and
conducted three Town Hall meetings in the towns of Homer City, Blairsville, and
Saltsburg. The Coalition also supported Town Hall meetings at West Shamokin, North
Apollo, and Freeport in Armstrong County. All meetings were well attended with
approximately 20 to 30 people at each meeting.
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The Drug Free Communities Coalition partnered with the Indiana University of
Pennsylvania’s MARTI Conference (Mid-Atlantic Research and Training Institute) to
conduct a town hall meeting for attendees. The panel of speakers consisted of Deputy
Director David Minetta, Office of National Drug Control Policy, Secretary Gary Tennis,
PA Department of Drug and Alcohol Programs, Patrick Dougherty, Indiana County
District Attorney, Kami Anderson, Executive Director AICDAC, Michael Krafick, Certified
Recovery Specialist Supervisor, and Courtney Hankinson, Prevention Specialist.
Approximately 100 people attended 2 sessions and received information about work
being done at the federal, state, and local level concerning alcohol, tobacco and other
drug abuse. They also received information about drug trends, signs, symptoms, and
recovery. At the request of IUP, the Commission’s Teen Scene was on display daily at
the MARTI Conference.
Sober Truth On Preventing (STOP)
Underage Drinking Act Grant
In October 2012, the Armstrong-Indiana Drug Free Communities Coalition and
the Armstrong-Indiana-Clarion Drug and Alcohol Commission were awarded a STOP
Act Grant to increase enforcement of underage drinking laws in Armstrong and Indiana
Counties, to increase the number of schools receiving the Alcohol and Driving Program,
and to implement a social norms campaign in the schools. In the fiscal year 2012/13,
the Alcohol and Driving underage drinking prevention program was presented to 1,018
students in Armstrong and Indiana counties. In February 2013, Courtney Hankinson,
AICDAC Prevention Specialist, was chosen to present the Alcohol and Driving
curriculum during a workshop at the Community Anti-Drug Coalitions of America 23rd
National Leadership Forum in Washington D.C. and at the National Prevention Network
Conference in Oklahoma in August 2013.
The STOP Act grant has allowed the current Underage Drinking Task Force to
expand by including additional law enforcement agencies in the program to include the
Bureau of Liquor Control Enforcement, the State Police, the Armstrong County Sheriff’s
Department, the Kittanning Police, Leechburg Police, and the Ford City Police.
A social norms campaign was implemented in the high schools in Armstrong and
Indiana Counties using the 2011 Pennsylvania Youth Survey data. In Indiana County
posters were created that state: “In the past 30 days 77% of Indiana County students
have not used alcohol.” In Armstrong County posters read, “In the past 30 days, 9 out
of 10 Armstrong County students have not used alcohol.”
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Drug Free Coalition
Clarion County
In August 2010, the Clarion Drug Free Coalition (CDFC) was established. The
coalition consists of 56 members from 12 sectors in the community. The Coalition has
met bi-monthly and discusses issues pertaining to drug and alcohol use, abuse,
treatment, and prevention. There are six subcommittees of the coalition that target
specific areas of interest to the Coalition, including membership, parents, evaluation,
media, youth, and action.
The Coalition’s vision is that every child and young adult in the communities of
Clarion County will have the knowledge, opportunity, and support to make the choice to
grow up drug and alcohol free. The mission of the Clarion Drug Free Coalition is to
prevent and reduce substance abuse and addiction among our youth and young adults
by empowering and encouraging parents, youth, young adults, government and
community through education, resources and awareness. The priorities of the Coalition
are to: Decrease Substance Abuse in Clarion County; Increase Tobacco, Alcohol, and
Drug Education; and Increase Parental Involvement
The Coalition has responded to change drug and alcohol issues in the county in
multiple ways through the collaboration of local law enforcement officers and magisterial
district judges to improve communication, prosecution, and enforcement of alcohol laws
in the county, through community town hall meetings, project sticker shock campaigns,
and prescription drug take back initiatives.
Coalition meetings have provided an opportunity for school districts to educate
themselves regarding the use and availability of alcohol and drug use/abuse among
youth through Coalition presentations that outline drug and alcohol trends in Clarion
County (highlighting information found in the PAYS data). Schools also utilize the
collective expertise and advice of the Coalition to aid in the development of
comprehensive school policies regarding legal and illegal substances that are abused
and identified as concerns.
The Coalition participated in 2 prescription drug take back programs collecting
over 100 pounds of prescription drugs. The Coalition has also participated in several
town hall meetings throughout the county educating the public on drug trends in their
local area and where to go for help. The Coalition has also sponsored Responsible
Alcohol Management Program (RAMP) training for local licensees in Clarion County
and has worked with the Pennsylvania Liquor Control Board to host owner/manager
trainings.
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PA Liquor Control Board Prevention Grant
Clarion County
In July 2012, the Armstrong-Indiana-Clarion Drug and Alcohol Commission was
awarded a grant for $15,000 from the Pennsylvania Liquor Control Board (PLCB) to
reduce underage and dangerous drinking. The funding was used to increase the
implementation of the Alcohol and Driving program to 9th or 10th grade students in all
school districts in Clarion County. A total of 326 students received the Alcohol and
Driving program in all seven school districts. Collaboration with local law enforcement
was key to the program’s success in the schools. The program is conducted over a 3day period and one day is dedicated to law enforcement instruction and a question and
answer series. Clarion County received participation from the local State Police
Barracks, the Sheriff's Department and Clarion Borough Police.
PLCB funding was also used to conduct a Social Norms Campaign. An
underage drinking social norms campaign was implemented in April 2013 and involved
the Commission and the Clarion County high schools. Clarion County youth
participated in the campaign about alcohol use in their schools showing students that
not all youth are using alcohol. The message they used was, "in the past 30 days 74%
of Clarion County Students have not used alcohol.” This campaign helped the students
to better understand their Pennsylvania Youth Survey data and send the message that
not everyone is using alcohol. This message was also used on posters that were
distributed in the schools.
Reality Tour
The Reality Tour is an interactive reality-based educational concept for drug
awareness and prevention meant to be attended by parents and their children to show,
rather than tell, the pitfalls of using drugs and emphasizes the fact that anyone can
become addicted to drugs. At the end of the tour, attendees also are given the
opportunity for a question and answer session with law enforcement, treatment
providers, and addicts in recovery. It takes 25-28 volunteers to operate the Reality Tour
each month.
In Armstrong County, the Reality Tour program is operated by ARC Manor. In
Indiana and Clarion Counties, the Reality Tour program is conducted by the
Commission.
From July 2012 to June 2013, a total of 114 people attended the program in
Clarion County and a total of 72 people attended the program in Indiana County. The
Clarion County Reality Tour received a grant from the Attorney General’s Office for
$2,500 to help support the cost of the tour. The Indiana County Reality Tour is funded
through the Drug Free Communities grant.
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Problem Gambling Grant
Armstrong, Indiana, and Clarion Counties
The Armstrong-Indiana-Clarion Drug and Alcohol Commission received a grant
for $128,708 to implement and conduct gambling prevention and education in all three
counties for the fiscal year 2012/13. In Armstrong County, the three groups identified
most at risk for problem gambling behaviors are 10th graders, 12th graders, and senior
citizens. In Indiana County, the three groups most at risk are 8th and 10th grade
students, post-secondary students (Indiana University of PA and Wyotech), and senior
citizens. In Clarion County, the three groups most at risk are 12th grade students,
college students (Clarion University of PA), and low income residents with a special
emphasis on the senior population.
In all three counties, senior citizens were identified as a target population. In the
fiscal year 2012/13 the Commission completed a total of 9 Gambling Away the Golden
Years programs reaching 141 senior citizens.
To address the problem gambling needs of college students, the Commission
implemented gambling speaking engagements, gambling information dissemination and
gambling alternative activities in all three counties. A total of 5,654 youth and adults
were reached with gambling prevention and education information and materials.
Also, in the FY 2012/13 the Commission addressed small games of chance
gambling education by conducting workshops with the Pennsylvania State Police
Bureau of Liquor Control Enforcement and the County Treasurer Offices. A total of 6
trainings were conducted reaching 534 residents with the new laws and policies
pertaining to the Small Games of Chance license.
Intervention
In the fiscal year 2012/13, HealthChoices began funding the crisis hotline
telephone and walk-in services for Armstrong and Indiana Counties provided by the
Open Door. The Open Door’s 24-hour crisis hotline service responded to the needs of
the residents of Indiana County. Paid staff and Crisis Intervention Specialists are
available on a 24-hour basis.
ARC Manor also operates a 24-hour drug and alcohol hotline in Armstrong
County that has both a local exchange and a toll-free number that serves residents of
Armstrong and Clarion Counties. The hotline responds to crisis/emergency calls and
information/referral calls. The hotline was staffed by paid employees of ARC Manor,
which included specially trained therapists, resident managers, and clerical support
staff. The Commission provided hotline funding for Clarion County residents in the
amount of $5,000.
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Safe Driving Schools were provided in both counties for DUI offenders. ARC
Manor operated the Safe Driving School in Armstrong County and The Open Door
provided the service in Indiana County. Clarion County’s Safe Driving School services
are provided by the Clarion County Probation Department.
Case Management
The SCA offers and/or is involved with the following programs to individuals
suffering the effects of substance abuse/dependence:
Level of Care Assessment (LOC)
Case Coordination
Restrictive Intermediate Punishment Program (RIP)
Indiana County Drug Treatment Court Program (DTC)
Armstrong County Intense Supervision and Treatment Program (IST)
Clarion County Treatment Court (CTC)
Student Assistance Program (SAP)
Intensive Case Management for CYFS Referrals
Certified Recovery Specialist (CRS) Support Services
All of these programs experience overwhelming demand. Level of Care
functions include screening, assessment, placement, and continued stay utilization
review. In addition, there are routine crisis calls from individuals, family members and
friends in need of information. Case Managers often travel to meet clients at schools,
hospitals, jails, and other agencies.
The Case Management Unit completed 665 assessments for residential
treatment (127 of those within County Jails) during the fiscay year 2012/13. ARC Manor
completed 128 assessments in Armstrong County and 64 assessments in Clarion
County for outpatient levels of treatment. The Open Door, located in Indiana County,
completed 421 assessments for outpatient levels of treatment. ARC Manor and the
Open Door also completed 1,309 additional non-SCA assessments (funded through
independent insurance carriers, managed care, grants, self-pay, etc.). In total, the SCA
and its providers completed 2,587 level of care assessments during the FY 2012/13.
Individuals are screened by the providers and those appearing to be in need of
outpatient services are scheduled for an assessment. Each individual is assessed in
the areas of medical, abuse, legal, family/social, education, employment, gambling,
military, mental health, spiritual, and drug and alcohol. The outpatient providers gather
information, apply the PCPC or ASAM, and offer clients an option of appropriate
treatment agencies. During the assessment process, each client is offered Case
Coordination (CC) services and re-offered CC services during the treatment episode.
The Case Managers of the Armstrong-Indiana-Clarion Drug and Alcohol
Commission have offices located at the SCA’s satellite offices in Armstrong and Clarion
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Counties, and The Open Door in Indiana County. The SCA maintains a close
relationship with our providers to ensure that clients receive the most appropriate level
of care in a very timely manner. The key to this successful relationship between the
Case Managers and the local providers has been the understanding of each other’s
function, face to face communication, and most importantly, working together on the
goal of meeting the needs of the client.
The Case Coordination (CC) programs have been a very important part of our
client’s lives. The CC programs are voluntary for individuals who have been affected by
drugs and/or alcohol. In addition to the substance abuse concerns, drug & alcohol
clients experience a variety of specialized needs. Some of these needs include
housing, transportation, childcare, budgeting skills, and assistance with employment
and education. During the FY 2012/13, a total of 716 unique clients received Case
Coordination services in the three-county area.
Many individuals were assisted with transportation arrangements, resume
building skills, prescription medication co-payments, housing supports and support
when scheduling GED training. Simple resources helped each client to make
necessary changes in their lives. These changes have led to improved self-sufficiency
on the way to sustained recovery.
In July 2011, the Commission added a full-time Medication-Assisted Treatment
Case Management (MAT-CM) position. MAT Case Management services are offered to
a target population of individuals seeking or receiving prescribed
buprenorphine/suboxone or methadone. The primary objective is to ensure that their
medication-assisted treatment is facilitated in a coordinated manner between the
member, the treating physician, the pharmacy, and the treatment community that is
supporting the person. This includes assuring that co-morbid issues are addressed,
individuals are linked to other necessary services and supports and that the person
remains engaged in their recovery plan. The MAT Case Manager offered all the
standard case management functions, as well as to help prevent relapse; promote
timely re-entry into treatment if relapse occurs; promote sustained recovery and assist
the person to achieve an enhanced quality of life through the use of
buprenorphine/suboxone or methadone. The MAT–CM position was funded through
HealthChoices Reinvestment funding through June 2013. With the re-structuring of the
Case Management Department in July of 2013, MAT-CM services are now being
offered by all of the Case Managers.
Restrictive Intermediate Punishment Program
On July 1, 2012, the Commission was re-awarded a grant from the Pennsylvania
Commission on Crime and Delinquency (PCCD) for the Restrictive Intermediate
Punishment Program. This program focuses on Level 3 and Level 4 offenders who, due
to the presence of a substance abuse problem, are sentenced to the program in lieu of
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jail. The Commission also provides funding for Level 2 clients that are appropriate for
the program. The goals of the program are to assist in the reduction of jail overcrowding and reduce the incidence of relapse while ensuring appropriate treatment and
access to support services.
Since January 1, 2007, as a part of the Pennsylvania Commission on Crime and
Delinquency (PCCD) grant, the Indiana County Drug Treatment Court (DTC) has been
the primary program in Indiana County for Level 3 and Level 4 offenders. This program
combines the authority and sanctioning power of the court with the clinical expertise of
treatment professionals. The Drug Treatment Court Team is composed of the President
Judge, the District Attorney, the Probation Chief, the Criminal Justice Case Manager
from the Armstrong-Indiana-Clarion Drug and Alcohol Commission, the DTC Probation
Officer, and a Defense Advocate. Intensive Judicial supervision is involved, requiring
the client to appear regularly in court before the Judge. Graduated incentives and
sanctions are used to reward progress and require accountability of the client. On July
1, 2012, there were 17 clients active in the program. During the fiscal year 2012/13, 9
new clients were accepted into the program. Of those 26 total participants, there have
been 10 clients who have successfully completed the program and 6 clients who were
discharged unsuccessful, leaving 10 clients currently active.
On January 1, 2009, also as part of the Pennsylvania Commission on Crime and
Delinquency (PCCD) grant, Armstrong County implemented the Intensive Supervision
and Treatment (IST) Program. This program combines intensive supervision by a
Probation Officer designated solely for this program with intensive drug and alcohol
treatment and case management services. The IST team consists of the dedicated
Probation Officer, Probation Chief, ARC Manor Treatment Specialist, Criminal Justice
Case Manager, and Lead Case Manager from the Armstrong-Indiana-Clarion Drug and
Alcohol Commission. The client is required to meet regularly with the IST team to review
progress. Rewards and sanctions are used to acknowledge progress and require
accountability of the client. Progress reports are provided to the Judge on a regular
basis. As of July 1, 2012, there were 7 clients active in the program. During the fiscal
year 2012/13, 3 new clients were accepted into the program. Of those 10 clients, there
have been 2 clients who have successfully completed the program and 2 clients were
discharged unsuccessful, leaving 6 clients currently active.
The Commission also operates a traditional Restrictive Intermediate Punishment
program in both Armstrong and Indiana Counties. As of July 1, 2012, there was 1 client
active in the program. Through June 30, 2013, 4 new clients were accepted into the
program. Of those 5 clients, 2 clients successfully completed the program and 1 client
was discharged unsuccessful, leaving 2 clients currently active.
In total, since the Commission was awarded the first Armstrong-Indiana PCCD
grant (includes Indiana Drug Treatment Court, Intensive Supervision and Treatment
Program, and a few clients in the traditional RIP program), there have been two
hundred fifty-four (254) offenders who were diverted from jail to the Restrictive
Intermediate Punishment program. Clients participated in inpatient treatment, halfway
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house, partial hospitalization, intensive outpatient counseling, group and individual
counseling. During treatment and after discharge, case management continues to
assist clients in achieving their goals. Of the 264 clients that were admitted into these
programs, one hundred forty-five (145) successfully completed, one hundred and one
(101) were discharged from the program unsuccessful, and eighteen (18) clients are still
active in these programs.
The Commission completed a proposal during the FY 2009/10 for an
ARRA/Stimulus grant through PCCD for the Armstrong County IST program. AICDAC
was awarded a grant of $279,861 for the period from April 1, 2010 through March 31,
2012. The Commission submitted a Project Modification and was approved to extend
this grant until June 30, 2013. The grant helped to fund the Intensive Supervision and
Treatment Probation Officer and added a Certified Recovery Specialist to provide
recovery support services to the IST clients and inmates at the Armstrong County Jail.
In July 2012, the Commission took over administration of the PCCD grant that
funds the Clarion County Treatment Court Program. Similar to our Restrictive
Intermediate Punishment Program in Armstrong and Indiana Counties, this program
focuses on Level 3 and Level 4 offenders who, due to the presence of a substance
abuse problem, are sentenced to the program in lieu of jail. The goals of the program
are to assist in the reduction of jail overcrowding and reduce the incidence of relapse
while ensuring appropriate treatment and access to support services. As of July 1,
2012, there were 19 clients in the Clarion County Treatment Court Program. During FY
2012/13, 7 clients were added to the program. Of the total 26 clients in the program
during FY 2012/13, 7 clients graduated successfully and 3 clients were discharged
unsuccessfully, and sixteen (16) are still active in the program.
The Commission has been involved with the Clarion County Treatment Court
Program for a total of three fiscal years. In those three years, there have been forty-five
(45) offenders who were diverted from jail to the Clarion County Treatment Court
Program. Clients participated in inpatient treatment, halfway house, partial
hospitalization, intensive outpatient counseling, group and individual counseling. During
treatment and after discharge, case management continues to assist clients in
achieving their goals. Of the 45 clients that were admitted to the program, seventeen
(17) successfully completed, eleven (11) were discharged from the program
unsuccessful, and 1 relocated out of county (transferred to another county Drug Court
Program as well), and sixteen (16) clients are still active in the program.
Student Assistance Program (SAP)
The Armstrong-Indiana-Clarion Drug and Alcohol Commission’s Student
Assistance Program (SAP) was established in 1986 and employs a Case Manager who
serves as the SAP Liaison core team member for 25 SAP Teams in Armstrong and
Indiana Counties. During the 2012/13 school year, the SAP Liaison provided 256 hours
of consultative services to the 25 Core Teams within the two counties. In 2012/13, 75
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students were referred for drug and alcohol assessments. Of the 75 students referred,
1 was referred to residential treatment, none were referred to adolescent intensive
outpatient treatment, 28 were referred to outpatient treatment, 16 were referred to early
intervention educational services, 4 were referred to or currently involved with the
mental health system, 1 was not referred to treatment due to no identified drug and or
alcohol problem, and 25 received DDAP/SAP screenings only as a full assessment was
not warranted.
The Commission also employs a Case Manager in their Clarion office who
serves as a SAP Liaison (.5 FTE) core team member for 8 SAP Teams in Clarion
County. During the 2012/13 school year, the SAP Liaison provided 137.50 hours of
consultative services to 8 Core Teams within the county. In the FY 2012/13, 28 students
received referrals for drug and alcohol assessments. Of the 28 students referred, 2
were referred to residential treatment, 1 was referred to adolescent intensive outpatient,
5 were referred to adolescent outpatient, 4 were referred to early intervention
educational services, 2 were not referred to treatment due to no identified drug or
alcohol problem, 1 refused to meet with the CM and 13 received DDAP/SAP screenings
only as a full assessment was not warranted.
In March 2013, the SAP program and the Drug Free Communities Coalition
sponsored a Spring training day on Youth Mental Health Issues, Crisis, and Youth
Problem Gambling. The trainers were Dr. Ralph May- Chief Clinical Officer, Community
Guidance Center; Craig Faish- Crisis Hotline Coordinator, The Open Door; and Sgt.
Jamie Jones- Pennsylvania State Police, Bureau of Liquor Control Enforcement. This
training included information on common adolescent mental health issues, crisis hotline
services and youth problem gambling in Pennsylvania. There were approximately 45
participants at the training.
During the 2012/13 school year, the SAP Liaisons provided informational packets
to the SAP Core Teams in all three counties. The informational packets provide the
district SAP Core Teams with drug and alcohol related information. The Commission
plans to provide the informational packets once again for the 2013/14 school year.
The primary focus of the SAP Liaisons is to provide support and comprehensive
SAP services to the students, their families, and the school districts of Armstrong,
Indiana, and Clarion Counties. The Armstrong-Indiana-Clarion Drug and Alcohol
Commission will continually strive to provide the most up-to-date and comprehensive
SAP services to the students, families and school districts in the three county area. The
Commission’s Prevention staff will also make themselves available to provide education
and information to the SAP teams.
Recovery Support Services
The Armstrong-Indiana-Clarion Drug and Alcohol Commission (AICDAC) began
providing Recovery Support Services in March of 2010, within the Case Management
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Department. Recovery Support Services enhance clients’ recovery through
coordination of care, casework activities and aftercare. Recovery Support Services at
the Armstrong-Indiana-Clarion Drug and Alcohol Commission include, but are not
limited to: recovery planning, assistance transitioning from residential treatment to a
client’s home community, self-help meeting introduction, assistance with sponsor
searches, accessing community resources, interview and resume coaching, connection
with Case Managers to access treatment services and providing support groups. During
the FY 2012/13, a total of 181 unique clients engaged in various types of Recovery
Support Services. Of those 181 individuals, 39.2% were referred by the Criminal
Justice System and 60.8% were referred by other sources (D&A Case Managers, D&A
Providers, Human Service Agencies, self-referrals.) The Certified Recovery Specialists
(CRS) also started four Medication Assisted Recovery (MAR) Support Groups in the
three counties we serve (1 in Armstrong, 2 in Indiana and 1 in Clarion) due to concerns
expressed by SCA clients and community contacts that local self-help groups don’t
accept individuals on recovery-related medications into their groups and/or limit their
ability to fully participate in the group when permitted to attend. During the Fiscal Year
2012/13, 138 unique individuals participated in MAR Support Groups run by CRS staff.
CRS Staff facilitated a Recovery Life Skills Group in the Armstrong County Jail and 21
unique clients attended. CRS Staff worked with the Nurse Navigator Program and cofacilitated a Hepatitis C Education/Support Group that was attended by 42 unique
clients.
During the FY 2012/13, the Commission employed a full-time CRS Supervisor, a
full-time Forensic CRS through the federal ARRA Stimulus grant (that provided
Recovery Support Services to IST clients and inmates in the Armstrong County Jail), a
full-time female CRS (funded through HealthChoices Reinvestment funds), and a fulltime CRS for Clarion County (funded through HealthChoices Reinvestment funds).
The Commission has been moving steadily toward a Recovery Oriented System
of Care (ROSC) over the past few years. The Commission has been active in
establishing Recovery Advocacy groups and has sponsored activities promoting the
groups. The Advocacy Group (TAG) of Armstrong County identified Recovery Housing
as a need in their county and the SCA was able to assist the group with establishing an
Oxford Recovery House for males in Kittanning, PA. It has been open for six years and
continues to take new residents. The Commission worked with TAG to open an Oxford
Recovery House for women with children in Armstrong County in July 2010. The
Commission was also successful in acquiring HealthChoices Reinvestment funds to
establish two male Oxford Recovery Houses in Indiana County during the fiscal year
2011/12. The Commission also acquired HealthChoices reinvestment funds to open a
male and a female Oxford Recovery House in Clarion County during the fiscal year
2012/13.
The Commission has established a Recovery Oriented System of Care (ROSC)
Committee and meets quarterly. The Committee has established a ROSC Action Plan
with goals and objectives for the three-county area and are making progress on all of
their goals, including establishing more Oxford Recovery houses, additional ROSC
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trainings for human services and criminal justice staff, and plans for a Recovery Center
in the future.
The Commission has also worked with SBHM and seven Southwestern PA
counties to provide Peer-Based Recovery Support Services. Training is provided
annually for the Certified Recovery Specialist (CRS) certification for participants from
Armstrong, Indiana, and Clarion counties. In the FY 2012/13, a total of eight residents
were trained in the CRS Certification classes for the three Counties. ARC Manor
requires all of their Resident Assistants to have the CRS certification.
The Commission and seven other Western PA counties collaborated to develop
a supplemental service for HealthChoices that allows for the reimbursement of various
peer provided CRS services.
The Commission offered a new training opportunity for Certified Recovery
Specialists in the FY 2012/13. The CCAR Recovery Coach Academy is a 5 day training
that is designed to provide additional training for CRSs. The Case Management
Supervisor and CRS Supervisor are CCAR certified Recovery Coaches and Recovery
Coach Trainers. SBHM has sponsored 2 CCAR Recovery Coach Academies to date.
The Commission worked with the BHARP to provide technical assistance for
providers and SCAs in the 23 county BHARP Zone that were interested in and/or
beginning to provide Recovery Support Services. The Case Management Supervisor
and CRS Supervisor worked together to assist new Recovery Support Services
providers to establish policies and procedures, forms, support groups facilitated by CRS
Staff, and in person job shadowing.
In FY 2012/13, the Commission was active in supporting the first annual CRS
Recovery Conference in Bolivar, PA. The CRS Supervisor was on the planning
committee. Both the Case Management Supervisor and CRS Supervisor provided
training. The Commission sponsored 6 people from our counties to attend the
conference.
The Commission partnered with seven counties to contract with IRETA/Northeast
ATTC to provide technical assistance in the development of a recovery-orientation to
the provision of methadone maintenance services from the SCAs, and eventually
through HealthChoices. The Best Practices for Recovery Oriented Methadone (ROM)
have been completed and ROM went into effect in all of the nine counties on March 1,
2012. Case Management, Recovery Support, and Tobacco Cessation Services have
been offered by the SCA to area Methadone providers as part of the ROM during the
fiscal year 2012/13.
The Commission has established a Family Education and Support Group in
Armstrong and Indiana Counties that was funded through the HealthChoices
reinvestment funds. This free program is conducted in each county as an eight week
program for 90 minutes per week. A treatment therapist provides 45 minute sessions
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each week to family members on addiction subjects, such as Addiction 101, relapse,
enabling, local support services, etc. and the other 45 minutes of the session is in a
support group format. This program expanded to Clarion County in December 2012.
The Commission’s ROSC Committee has identified the following Recovery
Support Service Goals and Objectives for the development of a Recovery Oriented
System of Care (ROSC) in the three-county area:
Goal 1) Enhance county-wide knowledge and awareness of ROSC:
Objective 1) Educate all Armstrong/Indiana/Clarion SCA staff and board
members regarding the ROSC concept.
Objective 2) Educate all Armstrong/Indiana/Clarion contracted substance
abuse providers, staff, and board members.
Objective 3) Promote awareness and knowledge of the addiction
treatment/prevention systems and the ROSC model to
organizations and community leaders.
Goal 2) Implement, enhance, and sustain the ROSC model in Armstrong,
Indiana, and Clarion Counties
Objective 1) Promote and increase the use of the ROSC values and
model with treatment and prevention providers.
Objective 2) Increase individual and family participation in all phases of
treatment and recovery planning.
Objective 3) Enhance the pre-recovery and engagement stages of
recovery.
Objective 4) Promote and support the recovery community in efforts that
enhance ROSC values and model.
Objective 5) Obtain sustainable funding for Recovery Support Services.
Goal 3) Provide and support safe and sober housing and activities for individuals
in recovery
Objective 1) Expand and support the network of Oxford Houses in the
three-county area.
Objective 2) Establish and support recovery oriented community
center(s).
Objective 3) Promote and support recovery oriented community activities.
The ROSC Committee will continue to meet and progress with the action plan into fiscal
year 2013/14.
HealthChoices
The SCA Administrator works in cooperation with the Mental Health
Administrator from each County in collaboration to oversee the HealthChoices program
in each of the three Counties. Armstrong and Indiana Counties are part of the
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Southwest Six County consortium, comprised of Armstrong, Butler, Indiana, Lawrence,
Washington, and Westmoreland Counties and oversight is provided by the Southwest
Behavioral Health Management (SBHM) Program. The Managed Care Organization
(MCO) for Armstrong and Indiana Counties is Value Behavioral Health of Pennsylvania
(VBH-PA), a subsidiary of Value Options. Kami Anderson, Executive Director, serves
as the Secretary/Treasurer of SBHM’s Board of Directors and Chairs the SBHM
Finance Committee.
Clarion County is part of the North Central 23 County Region and the SCA
Administrator serves as an executive board member of the oversight corporation,
Behavioral Health Alliance of Rural Pennsylvania (BHARP). The Managed Care
Organization for Clarion County is Community Care Behavioral Health Organization
(CCBHO).
Reinvestment funds have been utilized in all three Counties by both the MH
program and the SCA to expand and start new treatment programs, such as Partial
programs, Halfway House, Medication Assisted Treatment, Recovery Support Services,
Recovery Housing, Family Education and Support programs, Adolescent O/P Therapy
in the schools and pediatrician offices, integrated PH/BH Nurse Navigator services, and
a proposed detox program and expanded residential treatment program in Armstrong
County.
Nurse Navigator Outreach Program
The Nurse Navigator and Recovery Specialist Outreach program is a
collaboration between the Armstrong-Indiana-Clarion Drug and Alcohol Commission,
ARC Manor, and the Armstrong County Memorial Hospital. The program is intended to
enhance rural service delivery of physical and behavioral health services. The
objectives of the Nurse Navigator and Recovery Specialist Outreach program are to:
 Improve our clients’ perception of their overall health and wellness;
 Improve clients’ coping strategies and symptom management;
 Improve communication with their physicians and treatment providers; and
 Reduce the number of emergency room visits and hospitalizations.
The program began initially as a reinvestment program to create a behavioral
health/physical health navigator for clients in Clarion County. Kami Anderson,
Executive Director, and Cindy McCrea, ARC Manor’s Executive Director, collaborated to
write a proposal for a Health Resources and Services Administration (HRSA) grant to
expand the program into the other two counties, add the outreach component, and
sustain the program. The Commission was awarded the grant on May 1, 2012, and will
continue for a three year period.
Certified Recovery Specialists provide recovery support services and outreach
services to the community regarding the program. The Nurse Navigator works with
individuals to: promote health and wellness; increase education on the benefits of
proper nutrition; bridge the gap between physical, mental, and substance abuse
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providers; lose or gain weight through proper diet and exercise; education on
prescription medication management; education on communications with physician;
promote routine screenings and physicals; stress management and co-occurring
groups; advocacy; and promote awareness about alternative practices available.
Treatment
The Armstrong-Indiana-Clarion Drug and Alcohol Commission contracts with
every level of care available to clients. These include outpatient, intensive outpatient,
partial hospitalization, halfway house, non-hospital based residential treatment and
detoxification, methadone maintenance, enhanced treatment to include medication
assistance (such as buprenorphine) and hospital based residential treatment and
detoxification. There are currently no issues with waiting lists or access to services,
other than at times during the year, there may be a shortage of detox beds available.
Targeted populations include adolescents, pregnant females, women with
children, intravenous drug users and those with co-occurring disorders. The
Commission assisted agencies in designing services for these individuals as well as
contracted with programs that specialize in these populations.
Co-occurring clients (those with Mental Health and Substance Abuse issues)
have the option to be referred to outpatient, intensive outpatient, partial hospitalization,
halfway house, and non-hospital residential. ARC Manor and The Open Door, local
outpatient providers continue to expand the programs that they offer to co-occurring
consumers.
During the FY 2012/13, the SCA and the Mental Health Administrators continued
to co-chair the Armstrong-Indiana Co-Occurring Disorders Committee that includes staff
of all of the Substance Abuse and Mental Health provider agencies in the two-County
area. The Committee meets bi-monthly to discuss the delivery of Co-Occurring
Disorder services, specific complex cases, and methods of improving the system. A
series of trainings was held during the FY 2012/13 for staff of the area D & A and MH
agencies on topics including MH and Addiction 101, Motivational Interviewing,
Medication Series to include Common Psychiatric Medications, Medication Assisted
Treatment 101, and Prescribing Mental Health Medications and Addiction Issues.
Through a Staunton Farm Foundation grant acquired by the SCA in 2012,
providers in the two counties purchased video conference equipment that is used to
conduct tele-conference staffings between the mental health and substance abuse
agencies to discuss common clients. Plans are being made to include the clients in
future meetings, as well as social service agencies and physical health providers with
which the client may be involved.
27
Through the state-wide Act 152/HUB program, the Commission was able to draw
down an additional $100,000 in Act 152 treatment funds for the residents of the three
Counties.
Preferred Provider Program
Since 2003, the SCA has operated a preferred provider program that allows
treatment providers to earn financial incentives based upon performance. The pay for
performance standards include: earning funding from various other sources, meeting
levels of direct service hours for treatment staff, follow-up contact with discharged
clients, licensing status, contract/fiscal/case management monitoring results, fiscal and
budget projections, and expedited appointment numbers. No providers earned
Preferred Provider status in the FY 2012/13.
Medical Assistance
Jail Pilot Program
The Armstrong-Indiana-Clarion Drug and Alcohol Commission asked by the PA
Department of Drug and Alcohol Programs and the Department of Public Welfare to
begin a Medical Assistance Jail Pilot program that would provide an opportunity for
County Jail inmates that need residential drug and alcohol treatment to apply for
Medical Assistance through the COMPASS program while incarcerated and have their
HealthChoices eligibility in place on the date of their release to a residential treatment
facility.
The Medical Assistance County Jail Pilot began in Armstrong and Clarion
Counties on December 1, 2012 and expanded to Indiana County on May 1, 2013. The
model in Armstrong, Clarion, and Indiana Counties operates as follows:
The County Probation Office identifies an inmate that is likely to need residential
drug and alcohol treatment and notifies the local Single County Authority (SCA) office
 The SCA sends one of their Case Managers to the County Jail to perform a drug
and alcohol assessment on the inmate
 If the inmate’s assessment indicates a need for residential treatment, the SCA
will send a Certified Recovery Specialist (CRS) to the County Jail within seven
days of the inmate’s release date to assist the inmate with completing an on-line
COMPASS application for Medical Assistance
 The inmate is requested to sign a release to the SCA so that if the County
Assistance Office needs further information for the application, a notice is sent
directly to the SCA and to the inmate
 The County Assistance Office then processes the application prior to the
inmate’s release date. If the inmate is eligible for Medical Assistance, the County
Assistance Office activates the inmate’s eligibility for Medical Assistance and
HealthChoices on the date of release.
28

The SCA secures an inpatient admission for the inmate’s date of release,
allowing the inmate to go directly from the County Jail to the residential treatment
facility. Transportation is provided by the treatment facility.
As of August 31, 2013, 85 clients have been referred to the program. Of those
85 referrals, 52 clients have been eligible to participate in the program and have been
deemed eligible for Medical Assistance. Eleven (11) referrals were pending on August
31st. Approximate savings to the Single County Authority for the cost of treatment in
the first nine months of the pilot is $203,168.00.
Barriers
A major challenge that the Commission has faced in the Fiscal Year 2012/13 is
the 10% decrease in funding of Act 152 and BHSI funding. Due to the funding
reduction, the Commission needed to make some very difficult decisions regarding the
continuation of its programs. Instead of eliminating any treatment programs or levels of
care, the Commission voted to discontinue subcontracting its Prevention services to
three different Prevention providers and bring Prevention services in-house and provide
the services directly. This restructuring of the Prevention Department saved the SCA
over $150,000 in funding and allowed the SCA to continue treatment services at its prior
levels and meet the increasing demand for treatment.
Another challenge in relation to the Prevention restructuring was the need to hire
new staff, have them trained, and develop new contacts and relationships with the
schools to schedule and provide the curriculum. Four new Prevention Specialists and
one Tobacco Specialist were hired in the first quarter of the FY 2012/13 for the
Armstrong and Indiana County areas. Relationships were developed with the school
districts and some type of prevention programming was provided to almost every school
in the three-county area.
Another major struggle that the SCA and its treatment providers faced during the
FY 2012/13 was the implementation of the STAR data system and the difficulties
experienced by the staff required to input or upload data into the new system. The SCA
decided to continue dual entry and keep its current Fiscal and Client Tracing System
(FACTS). The subcontract providers have also made the decision to do dual entry,
which causes an administrative burden for each agency.
Trends/Emerging Needs
The Commission continued to experience an increased demand for treatment by
opiate users, specifically heroin, over the past fiscal year. Two methadone providers,
Med-Tech Resources and RHJ Medical are conveniently located for residents of our
three counties.
29
The Commission has continued with the use of Buprenorphine in an office-based
treatment program with an increase of clients who have chosen this option. The
Commission currently contracts with two providers, ARC Manor and the Open Door for
these services in Armstrong and Indiana Counties. During the FY 2012/13, a total of 89
unique individuals were funded for Medication Assisted Treatment (MAT) by the
Commission. With the increase in heroin and other opiate use, the buprenorphine
program gives our clients another option when requesting treatment for opiate addiction.
Many clients still opt for drug-free residential treatment with the hope of attaining
abstinence. More physicians are needed in the tri-county area to work with ARC Manor
and the Open Door to meet the demand for buprenorphine services in our area.
The Commission also recognizes that there is an ongoing concern of the abuse
of prescription drugs by adolescents and adults in our tri-county area. Prevention and
education efforts to inform residents of this issue have been made. The SCA takes an
active role with the District Attorney’s office in each County to participate in the
Prescription Drug Take Back and Town Hall Meeting events.
The Commission continued to experience an unusually high demand for
detoxification services, more than the amount spent in the previous fiscal year and over
twice the amount that was spent in the fiscal year 2006/07. In response to the
increased demand, the SCA worked with Value Behavioral Health and Southwest
Behavioral Health Management to develop a Request for Proposals (RFP) for
detoxification services in Armstrong County. Reinvestment funds will be used to add a
10-bed detox facility in Armstrong County. ARC Manor was awarded the contract for
the addition of a detox unit to their facility.
Finally, there has been a general overall increase in demand for treatment. The
capacity in our rural counties is being tested. Outpatient satellite offices continue to
operate in two of the three counties in an effort to reach out to clients in their community
thus eliminating the transportation barrier. While effective and successful, this has also
been a drain on the SCA’s limited financial resources. This increased demand for
treatment has continued in this fiscal year. The trend is expected to continue.
30
CLIENT DEMOGRAPHICS
The Armstrong-Indiana-Clarion Drug and Alcohol Commission (AICDAC) served a total of 987
unduplicated Armstrong-Indiana County clients and 149 unduplicated Clarion County clients in
the fiscal year 2012/13. The breakdown by age, race and sex, is as follows:
Armstrong-Indiana County
Clarion County
Black
Under 15
15-17
18-24
25-34
35-44
45-54
Over 54
TOTALS
Male
0
0
3
3
0
1
0
7
Female
0
0
0
0
1
0
0
1
Male
0
0
2
1
0
0
0
3
Female
0
0
0
0
0
1
0
1
Hispanic:
Under 15
15-17
18-24
25-34
35-44
45-54
Over 54
TOTALS
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
White:
Under 15
15-17
18-24
25-34
35-44
45-54
Over 54
TOTALS
0
9
197
285
109
84
30
714
1
9
88
96
39
28
4
265
0
3
34
30
15
11
4
97
0
1
14
16
6
11
0
48
Other:
Under 15
15-17
18-24
25-34
35-44
45-54
Over 54
TOTALS
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
GRAND TOTALS
721
266
100
49
31
The primary drug of choice for the clients served by AICDAC are as follows for fiscal year
2012/13:
Armstrong-Indiana County
Alcohol
Amphetamines
Barbiturates
Child of Alcoholic
Co-Dependency
Cocaine/Crack
Hallucinogens
Heroin
Inhalants
Marijuana
Methamphetamine
Opiates
Other
Over the Counter Meds
Poly Drug
Prescribed Medication
Sedatives
Tobacco
Clarion County
492
0
1
0
0
28
1
230
3
131
3
22
2
74
0
0
0
0
91
1
0
0
0
3
0
23
0
11
0
10
1
8
1
0
0
0
The referral sources for clients served by AICDAC are as follows for fiscal year 2012/13:
Armstrong-Indiana County
Attorney
County Parole
County Probation
Community Service Agency
Court
CYS
D&A Provider
Diversion Program
Doctor
Employer
Family/Friend
Federal Parole
Hospital
Other
School
Self
State Parole
State Probation
Clarion County
0
4
481
15
75
1
70
0
1
1
10
1
25
5
8
278
11
1
0
1
42
3
18
0
24
0
0
2
1
0
3
21
0
32
2
0
32
SCA Treatment Services
Fiscal Year 2012/13
Type of Service
Inpatient (Non Hospital)
Adolescent Residential
Detox
Dual Diagnosis Residential
Halfway House
Long-Term Residential
Adult Residential
Clarion Inpatient (Non Hospital)
Adolescent Residential
Detox
Dual Diagnosis Residential
Halfway House
Adult Residential
Outpatient
Assessments
Buprenorphine Doctor Visits
Buprenorphine Medication
Buprenorphine Drug Tests
Drug Tests
IOP (Group, Individual)
Med Checks
Methadone
Outpatient (Group, Individual)
Partial (Group, Individual)
Psych Evaluations
Emergency/Recovery Housing
Clarion Outpatient
Assessments
Drug Tests
IOP (Group, Individual)
Outpatient (Group, Individual)
Partial (Group, Individual)
Emergency/Recovery Housing
PCCD
Detox
IOP (Group, Individual)
Adult Residential (Non Hospital)
# of Clients
# of Days/Hrs
1
141
34
11
2
158
12 days
502 days
393 days
188 days
66 days
1,656 days
1
16
1
4
28
25 days
69 days
4 days
110 days
311 days
506
84
84
79
153
447
15
5
801
99
8
15
993.5 hrs
437 visits
4,659 pills
360 tests
415 tests
8,868 hrs
17 checks
34 weeks
5,928 hrs
1,537.5 hrs
8 evals
16 months
60
41
45
94
2
5
96 hrs
83 tests
460.5 hrs
503.5 hrs
43.5 hrs
6 months
1
2
3
4 days
7 hrs
19 days
33
Indiana Drug Court
Drug Tests
Halfway House
IOP (Group, Individual)
Outpatient (Group, Individual)
Adult Residential (Non Hospital)
Long-Term Residential (Non Hospital)
Intensive Supervision & Treatment
Drug Tests
Halfway House
IOP (Group, Individual)
Outpatient (Group, Individual)
Partial (Group, Individual)
Emergency/Recovery Housing
Psych Evaluations
Clarion Treatment Court
Assessments
Drug Tests
Halfway House
IOP (Group, Individual)
Outpatient (Group, Individual)
Emergency/Recovery Housing
Adult Residential (Non Hospital)
1
1
3
6
4
1
2 tests
24 days
29 hrs
49.5 hrs
84 days
27 days
1
1
4
2
2
1
1
4 tests
28 days
81.5 hrs
31 hrs
75 hrs
1 month
1 eval
5
10
2
6
22
3
2
7.5 hrs
25 tests
136 days
150 hrs
298.5 hrs
3 months
63 days
34
SCA Revenue/Income
Fiscal Year 2012/13
(unaudited)
Funding Category
State Base
Federal Block Grant - Drug
Federal Block Grant - Alcohol
Strategic Prevention Framwork State Incentive Grant (SPF-SIG)
State Compulsive & Problem Gambling Treatment
State Act 2010-01
BHSI Funds
Act 152 Funds
HealthChoices
DUI and Human Services Development Funds (HSDF)
PCCD RIP Grant
ARRA/Byrne Justice Assistance Grant
Clarion County PCCD RIP Grant
Drug Free Communites Grant (DFC)
STOP Act Grant
Tobacco Settlement Funds
Rural Health Care Services Outreach Grant
PA Liquor Control Board Grant
Miscellaneous Income
Total
Amount
593,284
352,998
315,480
2,919
128,708
45,927
413,909
254,758
630,679
123,529
129,504
81,656
116,886
148,323
15,341
194,393
107,665
15,166
58,140
3,729,265
35
Expenses by Category
Fiscal Year 2012/13
(unaudited)
Activity Code
51
53
61
62
63
64
65
66
67
72
82A
82B
82C
85
86A1
86A2
86B
87A
87B
88A&B
88C
Activity Description
Amount
Administration
Administration
Evaluation and Research
Total Administration
552,003
6,075
Prevention
Information Dissemination
Education
Alternative Activites
Problem ID and Referral
Community Based Process
Environmental
Other - Prevention Services
Total Prevention
387,027
189,271
61,640
66,635
16,273
64,396
160
Intervention
Intervention
Total Intervention
140,952
Treatment
Inpatient Non-Hospital Detox
Inpatient Non-Hospital Rehab
Inpatient Non-Hospital Halfway
House
Partial Hospitalization
Outpatient Drug-Free
Pharmacotherapy
Intensive Outpatient
Emergency Housing
Recovery Housing
Total Treatment
Case Management
Case Management
Recovery Support Services
Total Case Management
Total Expenses
558,078
785,402
140,952
325,974
486,729
47,272
69,366
296,484
3,060
246,681
1,898
16,541
1,494,005
583,035
142,775
725,810
3,704,247
36
SCA Expenses by Category
Fiscal Year 2012/13
(unaudited)
Activity
Code
51
53
61
62
63
64
65
66
67
72
82A
82B
82C
85
86A1
86A2
86B
87A
87B
88A&B
88C
Comp &
HC Admin,
State Federal Federal
Prob State Act
Clinical,
Base Drug Alcohol SPF-SIG Gambling 2010-01 BHSI/IGT Act 152 Reinvestment
189,485
3,634
16,263
41,516 19,310
84,087
1,500
600
30,055 28,126 25,468
52,779
53,101 48,614 43,869
12,058
1,658 2,117 1,995
46,283
50,595 6,423 6,241
1,653
6,277 4,387 3,766
725
1,760 1,747 1,596
Activity Description
Administration
Evaluation and Research
Information Dissemination
Education
Alternative Activities
Problem ID & Referral
Community Based Process
Environmental
Other Prevention Services
Intervention
5,555
Inpatient Non-Hospital Detox
29,499
Inpatient Non-Hospital Rehab
84,809
Inpatient Non-Hospital Halfway House
Partial Hospitalization
Outpatient Drug-Free
15,912
Pharmacotherapy
1,260
Intensive Outpatient
27,732
Emergency Housing
1,898
Recovery Housing
3,461
Case Management
83,684
Recovery Support Services
6,543
Total Expenses
593,284
3,000
2,000
9,385
33,058
2,724
34,465 65,106
7,727 2,795
77,752 65,001
94,064 64,309
44,576 33,334
352,998 315,480
26,337 56,643
66,760 160,493
8,400 18,312
48,037
47,501
1,800
53,611
760 119,947
5,134
128,708
45,927 413,909 254,758
DUI
Fines
and PCCD RIP ARRA
HSDF
Grant
Grant
16,949
35,541 41,969
Clarion
PCCD
RIP
Grant
21,771
4,834
8,167
463
494
318
10,762 37,737
203,206
11,048
3,390 5,234
50,476 1,052
904
20,938
2,088
15,471
903
1,790 10,000
197,484
77,831
630,679 96,296
Rural
Tobacco Health
STOP
Settlement Care PLCB Act
DFC
Grant
Grant Grant Grant Misc
2,991
30,616
1,949 2,573 43,349
3,750
225
108,866
130,776
5,284
839
7,933 10,182 5,347
8,954
170
1,723
624
23,762
32,841
2,361
11
160
81,898
10,052
2,436 13,312
2,183
1,416 21,903
2,279
3,783
450
840
1,106 45,225
29,817
129,504 81,656 116,886 148,323
53,659
Total
552,003
6,075
387,027
189,271
61,640
66,635
16,273
64,396
160
140,952
325,974
486,729
47,272
69,366
296,484
3,060
246,681
1,898
16,541
3,260 583,035
25,767
2,817 142,775
194,393 107,665 15,166 15,341 58,140 3,704,247
37