ALCOHOL & DRUG ABUSE SERVICES, INC.

Annual Report Fiscal Year

July 1, 2018 – June 30, 2019

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12 Church Street, Suite 100Port Allegany, PA 16743

814-642-2910www.adasonline.org

Alcohol and Drug Abuse Services, Inc. is funded in part by the PA Department of Drug and Alcohol Programs and Counties of Cameron, Elk and McKean.

Table of Contents

Introduction 3

Administrative Report 6

Fiscal Report 9

Prevention/Intervention Report 12

Case Management Report 16

Community Based Adolescent Treatment Report 17

Outpatient Treatment Report 18

Inpatient Treatment Report 25

Contracted Services 33

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Introduction

Mission StatementOur mission is to provide quality and compassionate substance use and co-occurring

services, empowering individuals to develop responsible, healthy lifestyles.

PhilosophyAlcohol and Drug Abuse Services, Inc., (ADAS) provides compassionate treatment

for substance using individuals including those with co-occurring disorders.  Recognizing that both these disorders influence other people, ADAS also offers counseling and support for the families of those affected by these disorders.

The program is based upon the understanding that an addiction is a treatable illness – that addiction is the problem, not just a symptom. A recovery program, the lifelong process of total abstinence, begins with an honest assessment of the problem.

At ADAS, the staff provides the finest professional compassionate care and treats addiction for what it is – a life threatening disease affecting the entire family. ADAS staff strives to be sensitive to each individuals needs and understands there may be co-occurring and trauma specific issues which play a significant role in their lives.

Individualized treatment plans are specifically designed for each individual with the goal of restoring the person to a meaningful, productive role in society. The plans are strength based to empower them to want to make healthy lifestyle changes.

BackgroundAlcohol and Drug Abuse Services, Inc. was initiated as a department of the Cameron,

Elk, McKean, and Potter County Mental Health Mental Retardation Joinder in 1972 with seed money from the Law Enforcement Assistance Act (LEAA).  Drug and alcohol prevention services, outpatient counseling and the residential treatment facility, Maple Manor, was established at that time through LEAA grant funding.

In 1987, ADAS separated from the CEMP MH/MR joinder and became incorporated as a separate private non-profit agency. Potter County became its own SCA under the county government. ADAS was contracted by the county commissioners to serve as the Single County Authority (SCA) for Cameron, Elk, and McKean Counties.  ADAS was established as a Private Executive Commission, which is overseen by a Governing Board that is made up of eleven members; three from Cameron County, four from Elk County and four from McKean County.  The appointment of Board Members is approved by the County Commissioners.

Whereas most SCAs act as an administrative entity providing oversight and contracting for services, ADAS was established as a Functional Unit facilitating direct treatment services. ADAS provides prevention, early intervention, case management, recovery support, outpatient treatment, intensive outpatient treatment, community based treatment and adult residential treatment services for residents of Cameron, Elk, McKean and Potter Counties. Additional contracts are in place with surrounding Single County Authorities for services provided at Maple Manor.

Additional contracted services offer choice, specialized services, and expand the continuum of services available to clients. ADAS maintains contracts with other providers for outpatient, intensive outpatient, detoxification, short and long term rehabilitation, halfway house, and partial hospitalization.

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Treatment services are offered on a fee for service basis. ADAS is part of the provider network of most insurance companies. Services are also offered on a sliding scale. As the Single County Authority, ADAS also receives funding to subsidize treatment for low income uninsured individuals residing in Cameron, Elk and McKean Counties. Pregnant women injection drug users, pregnant women substance users, injection drug users, overdose survivors, and veterans are priority populations for treatment.

Agency Goals Assess and monitor community needs in relation to the incidence and prevalence of

alcohol, tobacco and other drug abuse. Provide, or make available through contracted services, a full continuum of drug and

alcohol prevention, treatment and support services to meet community needs. Review and evaluate the effectiveness of drug and alcohol services. Provide training to agency staff and community stakeholders to enhance local

knowledge and skills to address drug and alcohol issues. Engage in collaborative processes with stakeholders and community members to

address substance abuse concerns. Expand awareness of programs and services available to reduce and prevent

substance abuse.

Board of Directors

Chairperson, Ms. Kathy Roche - McKean CountyVice Chairperson, Mr. Brian Harmon - Cameron CountySecretary, Ms. Kathleen Obermeyer - McKean CountyTreasurer, Ms. Kathleen Obermeyer - McKean CountyMs. Jamie Colley - McKean CountyMr. Gene Williams - Elk CountyMr. Scott Atwell – Elk CountyDr. Pamela Allegretto - Diiulio - Elk CountyMs. Kaitlyn Taylor – Elk CountyMr. Joe Fragale - Cameron CountyMr. Rob Aversa – Cameron CountyDr. Richard Melka – McKean County Agency Leadership

Executive Director – Angela EckstromMedical Director – Dr. George CastellanoAdministrative Officer – Tammy ConwayProgram Manager: Prevention – Sheri Larson Program Manager: Case Management, Recovery Support and Community Based – Lisa Cherry Program Manager: Program Development, Clinical Services and Compliance - Jennifer Greenman Inpatient Supervisor – Jessica BloodCommunity Based Supervisor - Sarah CiminoClerical Supervisor - Cassandra Ryder

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ADAS Board of Directors

TABLE OF ORGANIZATIONALCOHOL & DRUG ABUSE SERVICES

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Jennifer GreenmanD&A Treatment Program Manager

Tammy ConwayAdministrative Officer II

Jessica BloodD&A Treatment Supervisor

Inpatient Treatment StaffMaple ManorDavid ShafferTreatment Specialist

Lisa CookTreatment Specialist

Tammy GardnerTreatment Specialist

Case ManagerVACANTCase Management Specialist

Lacey CassidyCase Management SpecialistTrainee

Life Skills WorkerHeather SutherlandResidential Worker

Food Service Michelle FillhartCook 2

Van Driver/Maintenance VACANTVan Driver

Outpatient Treatment StaffBradfordMelissa TuckerTreatment Specialist

Bradford/Port AlleganyChristina MitchellTreatment Specialist

Kane/St MarysRae Nelson Treatment Specialist

St MarysNicole YoungTreatment Specialist

RidgwayVACANTTreatment Specialist

CoudersportDarlene Manning Treatment Specialist

Prevention StaffBradfordGreta BillingsPrevention Specialist

Port AlleganyAshley ElliotPrevention Specialist Trainee

Ridgway/KaneCourtney DunworthPrevention Specialist

St Marys/Emporium Audra ReigelPrevention Specialist Trainee

CoudersportKatie TaylorPrevention Specialist

Administrative Support Staff – Clerical SupervisorCassandra RyderAdministrative Assistant II

Administrative Support StaffKrystal MeadeAdministrative Assistant II

Treatment Support StaffMaple ManorChristina VanCampClerk Typist II

Port Allegany/EmporiumBrooke BoyerClerk/Typist III

Administrative Support Staff/BradfordShimalien Niver

Treatment Support StaffKane/RidgwayCynthia HulingsClerk/Typist II

BradfordJennifer ReesClerk/Typist III

St. MarysJeri ReedClerk/Typist II

Coudersport Barbara BlackClerk/Typist II

Maple Manor-InpatientGwendolyn McKinneyAdministrative Assistant I

Sheri LarsonD&A Prevention Program Manager

Case ManagersBradfordVACANTCase Management Specialist Trainee

Bradford LeadBobbie GuzanCase Management Specialist

Port Allegany/Emproium-LeadCameron HorningCase Management Specialist

St Marys COE-LeadMichelle SkrzypekCase Management Specialist

St Marys/Penn HighlandsRichard SchlimmCase Management SpecialistTrainee

Ridgeway/St MarysMichelle RomanicCase Management SpecialistTrainee

Recovery Support Kane/Port AlleganyJeff RughRecovery Support Specialist

CoudersportAngiline PalmiterRecovery Support Specialist

St Marys/Ridgway Gordon JohnstonRecovery Support Specialist

St Marys/EmporiumLisa ChmelarRecovery Support Specialist

Bradford - FT Teresa HuntRecovery Support Specialist

Port Allegany/EmporiumSarah CiminoD&A Treatment Supervisor

Lisa CherryD&A Treatment Program Manager

Residential Worker SupervisorAdam AndersonResidential Worker Supervisor

Darlene ShoffResidential Worker

Scott WalkerResidential Worker

Stephanie ShatleyResidential Worker

Kristen GodfreyResidential Worker

VACANTResidential Worker

Shelby BakerResidential Worker

Residential WorkersKaren WennerstromResidential Worker

Sarah HowardResidential Worker-PT

Daniel HowardResidential Worker-PT

Angela WhiteResidential Worker-PT

Daniel HughesResidential Worker-PT

Lori CartyResidential Worker-PT

Angela EckstromCounty D&A Administrator II

Administrative Report

Board Development Kathy Roche remained the Board of Directors Chairperson throughout 2018-2019. Scott Atwell completed four, three year terms July 2019. Gene Williams, Elk County, resigned June 2019. Dr. Richard Melka, McKean County, was appointed November 2018.

Staff RecognitionIn 2018-2019, the following staff members and board members were recognized for years of dedicated service to ADAS.

Angela Eckstrom: Executive Director – 25 years Nicole Young: Outpatient Therapist – 5 years Jessica Blood: Inpatient Supervisor - 5 years Jen Rees: Clerical – 5 years Dr. Pamela Allegretto-Diiulio - Board Member – 3 years Joe Fragale - Board Member – 3 years

Staff DevelopmentThe growth of the agency continued in this reporting period, which led for an

increased demand for specialized training of our new staff. To meet the need, the agency purchased Relias, a web-based training system. Many of our residential staff work non-traditional hours and keeping them trained with the latest information of topics such as boundaries and medication management was a challenge prior to Relias. With the addition of the new training system, the staff can complete trainings during their normal work shift.

Trauma, gambling, harassment in the workplace, confidentiality refresher and fraud, waste and abuse trainings were provided to the entire agency this year at our All-Agency meetings that occur three times during the year.

ADAS staff were supported in the participation of a total of 2,417 hours of training this reporting period. This figure is up 252 hours over the total last reporting period. The increase is due to the hiring of more staff and meeting the training requirements of existing staff that work in specialized programs.

On-site we offered 42 hours of Pennsylvania Certification Board and DDAP approved trainings. This total was up 12 hours over last year due to a systems of care grant we received to bring in-house a boundary training.

Our Prevention Department provided 30 hours of Student Assistance Program (SAP) training to all three counties.

Prevention, Case Management, and Administrative staff all attended their respective yearly conferences which offered trainings and information specific to their departments. Many of our staff completed enough hours this year to obtain their certifications in their specialized areas of expertise. ADAS is trauma certified, our staff participated in 158 hours of trainings specific to trauma.

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Inpatient Treatment StaffMaple ManorDavid ShafferTreatment Specialist

Lisa CookTreatment Specialist

Tammy GardnerTreatment Specialist

Case ManagerVACANTCase Management Specialist

Lacey CassidyCase Management SpecialistTrainee

Life Skills WorkerHeather SutherlandResidential Worker

Food Service Michelle FillhartCook 2

Van Driver/Maintenance VACANTVan Driver

Darlene ShoffResidential Worker

Scott WalkerResidential Worker

Stephanie ShatleyResidential Worker

Kristen GodfreyResidential Worker

VACANTResidential Worker

Shelby BakerResidential Worker

Karen WennerstromResidential Worker

Sarah HowardResidential Worker-PT

Daniel HowardResidential Worker-PT

Angela WhiteResidential Worker-PT

Daniel HughesResidential Worker-PT

Lori CartyResidential Worker-PT

Infrastructure Development In February 2019, ADAS added an embedded Case Manager in Penn Highlands

Elk hospital to strengthen our warm hand-off process and provide a seamless transition to treatment for any individual in need who sought care at the hospital.

In February of 2019, ADAS added a Prevention Specialist to the complement to increase service delivery in McKean County.

In March 2019, ADAS added three Case Coordinators and two and one-half Certified Recovery Support Specialists to the complement to increase services in all three counties.

In April 2019, we added an administrative support person to help support the added burden of administrative work and grant management to the agency.

Collaborative Processes The Executive Director is a member of the PA Association of Drug and Alcohol

Administrators (PACDAA) and serves on the Legislative and Policy Committee. The Executive Director is a member of the Central Governing Board of the

Behavioral Health Alliance of Rural Pennsylvania (BHARP). The Executive Director is a member of the McKean County Community

Engagement Veteran Board. The Executive Director is an active member of the Task Force for Community

Intervention. The Task Force is comprised of providers, law enforcement and the Mayor and works to raise awareness of substance use and addiction and provide resources for help.

The Executive Director and the Administrative Officer are Community Benefit Advisors for Cole Memorial.

ADAS is a member of the Northern Tier Community Collaboration and Substance Use Subcommittee.

ADAS participates in McKean County Collaborative Board. ADAS participates in Cameron County Collaborative Board. ADAS participates in the Elk County Family Resource Network. ADAS participates in the Criminal Justice Advisory Board in Cameron, Elk, and

McKean Counties. ADAS, Clearfield/Jefferson SCA and Penn Highlands hospital have formed a

consortium to address Narcan disbursement efforts and warm hand-off initiatives. ADAS is in partnership with Bradford Regional Medical Center to provide the

counseling services for their MAT programs. ADAS partnered with Northern Tier Community Action on a housing grant

process for opioid addicted individuals in need of housing.

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Program Expansion/Enhancements ADAS was awarded a two-year PCCD grant to bring an evidenced based, family

centered program called Strengthening Families to all three counties. ADAS, as part of a consortium with Clearfield Jefferson County SCA and Penn

Highlands Healthcare, was awarded a Health Resources and Services Administration (HRSA) grant. This grant allowed us to hire a Case Manager that is embedded in Penn Highlands Elk Hospital to do warm hand-offs, to make sure individuals with substance use treatment needs in the hospital are referred to appropriate treatment and to train the hospital staff and community on the use of Narcan.

ADAS was awarded a State Opioid Response (SOR) grant that allowed us to hire three Case Coordinators and two and one-half Certified Recovery Support Specialists (CRS). This grant allowed for a Case Manager to do assessments and a Case Coordinator to address all of the ancillary needs, such as Medication Assisted Therapy (MAT) coordination services in all three counties. The addition of two and one-half CRS’s means that all counties have a certified peer to help support the recovery of individuals we serve. All of the added positions help the individuals we serve navigate through the levels of care seamlessly.

ADAS, in partnership with Northern Tier Community Action, was awarded a SOR grant that allows for opioid addicted individuals in Cameron County in need of housing to apply and receive payment-free housing while they are in treatment.

ADAS was awarded additional SOR grant money that allowed our Prevention Department to bring alternative healthy activities to youth and their families in all three counties. The additional funds also provided scholarships for educators to be Student Assistance Program (SAP) trained for free.

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2018-2019 Fiscal Report

This year’s budget reflects a broad range of funding secured through federal, state, county and private sources. Federal legislation provides for block grants distributed through the state, which provides funds for Prevention, Intervention, Inpatient, Outpatient, Intensive Outpatient, Community Based Adolescent Drug and Alcohol, Case Management, Recovery Support, Student Assistance Programs (SAP), Gambling, Opioid State Targeted Response (STR), State Opioid Response (SOR) and services targeted to priority populations (pregnant injection drug users and substance abusers, injection drug users, overdose survivors and veterans). Using the STR and SOR funds, ADAS was able to provide prevention services including additional alternative activities for the communities, continue treatment services to the uninsured or underinsured, and increase case management and recovery support services drastically.

The Commonwealth of PA provides the Base Allocation, Student Assistance Program, Heroin/Opioid Crisis, State Gaming, and Compulsive & Problem Gambling Treatment funding. The Commonwealth also distributes Human Services Development Funds (HSDF) to counties who, in turn, provide ADAS with funding for prevention services provided in the schools, county jails, family centers, and other community locations. Cameron, Elk and McKean Counties also provide matching funds for services in individual counties.

Through the Department of Public Welfare, ACT 152 funds and Behavioral Health Special Initiatives (BHSI) funds continued to be available for treatment across the continuum of care. ACT 152 continues to fund medical assistance eligible individuals needing non-hospital residential treatment prior to being funded through Community Care Behavioral Health. BHSI funded medical assistance non-eligible individuals, due to welfare reform, for all levels of treatment. McKean is a block grant county and allocates ACT 152/BHSI monies to ADAS. These funds are used for treatment, case management, recovery support and prevention services. Elk and Cameron counties continued to be non-block counties in which ADAS. receives funding directly from the Department of Public Welfare.

In addition, ADAS generated fees from clients with health choices, private health insurance, and some local foundations. The programs also obtained funds from First-Time Offenders Programs, McKean County Jail, McKean County Intermediate Punishment, HRSA grant through Penn Highland Elk, Clearfield Jefferson Centers of Excellence, area school districts, and local United Way agencies (Bradford, Port Allegany, St. Marys, and Smethport). Funds were also generated through Potter County on a fee for service basis to provide prevention, outpatient, recovery support, DUI and Drug court, and inpatient services and Warren, Tioga, Armstrong-Indiana-Clarion and Clearfield-Jefferson Counties for inpatient services. Our prevention department administered the Strengthening Families Program in the community using PCCD grant funding. Other local foundations provided funding for more prevention activities through CEM.

ADAS has continued to expand services in Cameron, Elk and McKean Counties within all departments particularly Case Management and Recovery Support Services. We ended the fiscal year with 63 employees/positions on our personnel complement.

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ADAS has increased services and personnel in efforts to continue fighting the national opioid crisis epidemic.

2018-2019 EXPENDITURES

BUDGETED EXPENDED ACTUAL %

INPATIENT$1,522,093.0

0 $1,182,299.00 38.46%

OUTPATIENT $845,298.00 $826,697.00 26.89%

PREVENTION $360,656.00 $359,139.00 11.68%

ADMINISTRATION $130,104.00 $125,035.00 4.07%

CASE MANAGEMENT $365,070.00 $400,814.00 13.04%

RECOVERY SUPPORT $125,352.00 $86,378.00 2.62%

COMMUNITY BASED $82,175.00 $86,378.00 2.81%

INTERVENTION $6,122.00 $6,122.00 0.20%

INTENSIVE OUTPATIENT $7,590.00 $7,590.00

$7,590.00 0.25%

TOTAL EXPENDITURES$3,445,000.00 $3,074,475.00 100.00%

ACTUAL FUNDS USED FOR TREATMENT

FISCAL YEAR 2018-2019

ACT 152 $55,217.00 2%BHSI $35,596.00 1%BLOCK GRANT $84,729.00 3%STATE $262,622.00 11%FEDERAL BLOCK GRANT $246,631.00 10%HSDF $0.00 0%CYS $0.00 0%

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CCBH $1,329,209.00 53%COUNTY MATCH $103,006.00 4%OTHER FUNDS USED $370,108.00 15%

TOTAL $2,487,118.00 100%

2018-2019 TOTAL PROGRAM REVENUES

BUDGETED INCOME ACTUAL %

STATE BASE ALLOCATION $402,454.00 $402,454.00 11.17%

FEDERAL BLOCK GRANT $530,752.00 $530,752.00 14.73%

FEDERAL OPIOID STR & SOR $223,688.00 $252,688.00 7.01%

ACT 152 $57,128.00 $69,128.00 1.92%

BHSI $55,900.00 $55,901.00 1.55%

CLIENT FEES & OTHER $86,000.00 $90,828.00 2.52%

HEALTH CHOICES - CCBH $1,350,500.00 $1,417,125.00 39.33%

HEALTH INSURANCE $85,000.00 $81,535.00 2.26%

COUNTY MATCH $103,006.00 $103,006.00 2.86%

MCKEAN COUNTY JAIL $7,920.00 $7,920.00 0.22%

PREVENTION 3RD PARTY $131,808.00 $136,478.00 3.79%

HSDF $21,960.00 $21,960.00 0.61%

STATE GAMING FUND (ACT 2010) $22,951.00 $22,951.00 0.64%

UNITED WAY $11,587.00 $11,432.00 0.32%

C&P GAMBLING TREATMENT $38,836.00 $38,836.00 1.08%

FEDERAL PAROLE $0.00 $0.00 0.00%

MAPLE MANOR OUT OF

COUNTY $150,000.00 $120,411.00 3.34%

OTHER INCOME $7,560.00 $11,876.00 0.33%

MCKEAN BLOCK GRANT $132,892.00 $132,893.00 3.69%

GRANTS & REINVESTMENT $60,703.00 $61,095.00 1.70%

DUI FUNDS $23,858.00 $23,858.00 0.66%

DONATIONS $10,497.00 $10,209.00 0.28%

TOTAL REVENUE $3,515,000.00 $3,603,336.00 100%

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2018-2019 Prevention and Early Intervention ReportProgram Manager – Sheri Larson

Environmental Strategies: Establish or change written and unwritten community standards, codes, ordinances and attitudes to influence the prevalence of substance abuse in the population. An example of an activity would be providing support and technical assistance to a company or organization related to development of drug-free policies and procedures. ADAS had partnered with the Department of Drug & Alcohol Programs and the Pennsylvania Drug-Free Workplace to provide training and education services to the community and employers in our area. Town Hall meetings regarding the opiate issue in our surrounding area were offered to professionals and community residents. ADAS also participated in the Reality Tour for Elk County to address the alcohol/drug issues in the county.

Services Provided - 43 Individuals Assisted - 617

Community Events: Provide large scale opportunities to increase awareness and are typically undertaken in collaboration with multiple partners. Health Fairs and Screening Events Services Provided – 36 events Individuals Impacted - 3,346 participants

Gambling Awareness Community Events Services Provided - 27 Individuals Impacted – 6,419 participants

Community Prevention Partnerships: Focus on increasing community capacity to provide substance abuse prevention and treatment services. Activities include inter-agency collaboration, coalition building and networking. Prevention staff participated in the following collaborative processes during fiscal year 2018-2019:

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Elk County Family Resource Network McKean County Collaborative Board and Steering Committee McKean County Youth Transition Team Cameron County Collaborative Board and Family Center Cameron County Children and Youth MDIT Advisory Board Cameron County Children and Youth Service Advisory Board Criminal Justice Advisory Boards – Cameron, Elk, McKean Counties PA LINKS Bradford YWCA Elk and McKean County Jails Elk County Area School Districts Charles Cole Memorial Hospital Dickinson Center, Inc. Emporium Foundation Northern Tier Community Action Corporation

Professional Development Training: Prevention Department staff are state approved trainers for Student Assistance Program Training. Staff also provide Children in the Middle facilitator training. The SAP training occurred once during fiscal year 2018-2019.

Services Provided - 1 – (3 day) SAP Training Individuals Impacted - 42 professionals SAP trained

Information Dissemination: Development and distribution of marketing materials such as newspaper articles, brochures, flyers, public service announcements and media campaigns. Some of the materials developed and distributed over the past year included PA STOP brochures, flyers and stickers, and banner displays, dissemination of drug/alcohol brochures during health fairs, prescription take back day flyers, made bags with FASD information and distributed to local OB-GYN offices as well as WIC offices, Red Ribbon Week information distributed, materials and pencils donated during Backpack giveaway, Live Line show advertising Teen Scene, Small Games of Chance Seminar materials, and creation of a gambling article for newspapers and website.

Marketing of prevention and treatment programs available to address substance abuse – 14 meetings – 299 individuals impacted

Information related to Fetal Alcohol Spectrum Disorders – 15 services - 98 pieces distributed

Gambling materials development and dissemination – 1503 pieces distributed

Alternative Activities: Provide constructive and healthy social activities to offset the attraction to, or otherwise meet the needs usually filled by alcohol, tobacco and other drugs. These activities are provided in conjunction with an educational or skill-building activity around substance abuse prevention/education. Examples include hosting drug-free activities on New Year’s Eve, holding an after prom party, or providing after school activities. ADAS provided assistance with after school groups for Cameron County

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students. ADAS also held an Arts Week where students could participate in five days of learning about different forms of art in both Cameron and Elk Counties.

Services provided - 51 Events in Cameron, Elk & McKean Individuals Impacted – 1205 in Cameron County

Educational Presentations: There is typically a one-time speaking engagements that offer specific alcohol, tobacco, and other drug information. This past year, education services were delivered to teachers and administrators of Elk County schools regardingSAP, Anti-Drug Meetings, Stackpole Hall, Dickinson Center, Inc., County Coordination, Port Allegany Health Class, Cameron County Junior Achievement, Teen Scene Presentations, Impaired Drivers Simulation, Racoh Products, Shippen Township, St. Marys, Elk County Catholic, Otto-Eldred and Johnsonburg School Districts, SCI-ForestSt. Marys Adult Day Center, McKean County CYS, Northern Tier Community Action Head Start, CASA, Bradford Senior Center, Opiate/Heroin Awareness presentations, United Way of Bradford, UPB freshmen classes, and parents attending family center playgroups.

Gambling Education Presentations – 35 presentations – 152 individuals Drug and alcohol presentations to businesses, agencies, organizations, and youth -

126 presentations – 1401 individuals

Wanna Bet: This is a gambling prevention curriculum for students in grades 3-8 that is designed to be integrated into existing units in health, math, and life skills, or used in conjunction with an existing prevention program within the schools. Outcomes include improved critical thinking and problem solving skills.

Sessions Provided - 10 Youth Impacted - 63

Too Good for Drugs (TGFD): Too Good for Drugs (TGFD) is an evidence based prevention curriculum for students in Kindergarten through 12th grade that is delivered over a series of 10 sessions in the school setting. Too Good for Drugs is designed to reduce the intention to use alcohol, tobacco, and illegal drugs.

Services were provided to elementary students at Johnsonburg Area School District, St. Boniface Catholic School, Cameron County School District, and Smethport Area School District. Services were provided to middle school students at Ridgway Area Middle School and St. Marys Area School District in Elk County and St. Bernard Parochial School, Fretz Middle School and Kane Area Middle School in McKean County. Services were provided to high school students in Port Allegany School District, Cameron County School District, Johnsonburg Area School District and St. Marys Area School District.

Classroom Services provided – 164 Cameron Co, 789 Elk Co, 105 McKean Co TOTAL: 1,058

Youth Impacted – 366 Cameron Co, 1206 Elk Co, 783 McKean Co

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TOTAL: 2,325

Incredible Years Program: This is an evidence based 11 session group delivered program for parents of youth ages 2-12 designed to promote emotional and social competence and to prevent, reduce, and treat behavioral and emotional problems in young children. This program is facilitated in partnership with the McKean County Family Centers operated by The Guidance Center. During fiscal year 2018-2019, the Incredible Years series was provided once in Bradford and once in Smethport.

Group Series provided - 5 Parents Impacted – 7

Children in the Middle: Children in the Middle is a program that focuses on strengthening co-parenting skills. All McKean County parents/caregivers who are experiencing divorce or engaged in a custody dispute are court ordered to participate. The program is delivered in one day.

Services Provided - 12 Parents impacted – 87

Student Assistance Program: Provides intervention service within the school setting intended to identify and address problems negatively impacting student academic and social growth. Services include assessment, consultation, referral and/or small group education for SAP identified youth. The services are provided by cross-disciplinary staff including substance abuse and mental health professionals. Support programs provided to school students who have been identified as being at risk or using substances.

SAP Meetings Attended by Prevention Staff - 247 Number of youth referred for drug and alcohol prevention services through SAP

- 34 Number of youth referred to drug and alcohol treatment though SAP - 22

First Time Offenders Program – This is an early intervention service used to educate those individuals who have been convicted of a DUI or underage drinking violation but who do not meet the criteria for treatment. The First Time Offenders program provides education and promotes addiction awareness. Services provided – 24 sessions Individuals Impacted – 59

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2018-2019 Case Management and Recovery Support ReportProgram Manager – Lisa Cherry

Service Overview:Case Management staff facilitate client entry into treatment services, determining

appropriate levels of care and ensuring access to appropriate services. Functions include screening and assessment, placement determination, funding eligibility and continued stay reviews. Once a level of care is determined through a thorough assessment of the client’s needs, staff work to ensure that the individual is getting the most effective treatment. When residential placement is indicated, every effort is made to arrange treatment as appropriate and convenient to the individual and their families to ensure that needed support and resources are as close to home as possible. ADAS contracts with a number of out of county providers to provide a wide range of specialized services to residents of Cameron, Elk and McKean Counties.

After the initial assessment, ADAS continues to provide ongoing Case Management services in accordance to the Case Coordination model, which provides flexibility to meet the individual’s needs at any point of their recovery process. The addition of a Case Coordinator in each county this reporting year was made possible by a State Opioid Response (SOR) grant award. The primary goals of the Case Managers are to increase engagement in drug and alcohol treatment, to identify and reduce any barriers to treatment or ancillary services and to facilitate access to services such as primary health care, psychiatric services, housing, positive support networks, vocational training, and employment.

ADAS also provides assessments at the McKean and Elk County jails, as well as the McKean County Courthouse. Clearfield Jefferson SCA, Penn Highlands Elk and ADAS has formed a consortium that was awarded a HRSA grant that allows ADAS to have a Case Manager embedded in Penn Highlands hospital. The Case Manager provides assessments to any individual with substance use concerns, facilitate a seamless warm hand-off process and educate the staff on the use of Narcan and substance use issues.

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Medicated Assisted Treatment (MAT) services are important to the individuals we serve who have been diagnosed with opioid use disorders. ADAS Case Managers have provided 149 individuals with Case Coordination services. ADAS has also partnered with Northern Tier Community Action on a housing grant (SOR) for individuals with an opioid use disorder. To date, there have been eight referrals with five individuals housed as part of the program.

Recovery Support Services are part of the Case Management Department. This service offers additional support provided by a peer who has had a “lived experience” with addiction. Recovery Support Specialists facilitate support group meetings, and provide advocacy and outreach services. The SOR grant award also allowed ADAS to have recovery support services in each county. In addition, our inpatient facility, Maple Manor, has a Certified Recovery Support Specialist working with Bradford Regional Medical Center as part of the overdose/warm hand-off process to provide support and make referrals for treatment.

2018-2019 Highlights: The Case Management Department continues to be a Compass community

provider. This is to better assist clients that are uninsured to sign up for benefits in our main offices.

Recovery Support staff assisted 222 non-duplicated clients by offering assistance in recovery planning, life skills, budgeting, job search and support group meeting encouragement and attendance. They offer both individual and group sessions.

Continued support of Bradford Regional Medical Center's Buprenorphine Medication Assisted Therapy (BMAT) program by providing case coordination services for 11 clients participating in the program.

ADAS provided 1,169 level of care assessments and evaluations this reporting period.

Through Case Management services, ADAS was able to connect all clients determined to meet the need for residential treatment to that level of care regardless of their ability to pay. This was done in large part by the staff assisting the clients in obtaining the insurance benefits they were entitled to as well as utilizing Single County Authority funds to fill the gaps in insurance coverage.

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2018-2019 Community Based Adolescent Treatment ReportProject Manager – Lisa Cherry

Service OverviewDuring fiscal year 2018-2019, ADAS continued to provide Community Based

Adolescent Drug and Alcohol (CBDA) services. This program is targeted for adolescents aged 12-18, whom are experiencing alcohol/drug problems and are at risk for out of home placement or may be returning home after a residential stay. This program is led by a clinical supervisor accompanied by a treatment specialist to deliver the service in the home, school and community settings. The average length of stay is 6-8 months with an average of 3-6 hours of therapy per week, including individual and family sessions.

The CBDA program has been in operation since December 2017. Ten individuals and their families participated in this team delivered service during this reporting period.

Outpatient Treatment Annual Report – 2018/2019Outpatient Program Manager – Jennifer Greenman

The Outpatient Department of ADAS provides a variety of services to the communities throughout the three-county area served. Our goal is to provide effective treatment to individuals and their families. To accomplish this, the individuals and/or families are exposed to a variety of treatment modalities, which may be composed of individual, group, or educational sessions. Other services offered are interventions, assessments, evaluations, and aftercare. We currently provide hospital consultation, legal evaluations and treatment when requested. We also provide assessments and treatment in the jail setting. We network with other agencies to ensure a holistic approach to treatment.

In order to meet the need of the co-occurring population we became a co-occurring competent facility. This fiscal year approximately 60% of the population we served were co-occurring.

Each county offers a gambling certified counselor. They are available to do screening, assessment and treatment.

In September of 2013, we became involved with the Potter County DUI court. Our involvement includes providing outpatient counseling to the individuals involved in the DUI Court as well as consultation two times a month at court hearings and case

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coordination as needed. In June of 2015, Potter County started a Drug Court as well. At the end of this fiscal year, we served 25 clients in outpatient from the Potter County DUI/Drug Court.

In January 2018, ADAS was proud to have three of our offices became a Trauma Informed Designated Site. These are our Bradford, St Marys and Coudersport offices. To obtain this designation outpatient staff participated in a trauma initiative sponsored by Community Care Behavioral Health and Behavioral Health Alliance of Rural PA. In January 2019, we resubmitted our application to continue to be trauma informed sites and obtained exemplary status which has earned us the privilege to not have to reapply for two years.

From July 1, 2018 to June 30, 2019, we provided services through offices in the following communities: McKean County: Bradford, Port Allegany, and Kane; Elk County: St. Marys, Ridgway; Cameron County: Emporium. All offices excluding Emporium maintain a full time staff which provides evening appointments. The Emporium office is by appointment only. As of September 30, 2003 we began providing outpatient services to the Potter County community by establishing an office in Coudersport.

This fiscal year alcohol was the primary substance of choice. Other opiates was secondary. The percentage of those in treatment for alcohol was 36%. The percentage of those in treatment for opiates was 31%. An interesting statistic is that 40% of those in treatment for opiate use disorder were women as opposed to 22% of women in treatment for alcohol use disorder. The percentage of people in treatment for marijuana dependence was 23%. The percentage of individuals in treatment for opiates continues to rise as does the women in treatment. This fiscal year, there were seven outpatient staff members who provided counseling. Outpatient staff carried a caseload of approximately 30-35 clients per full-time counselor. Initially clients are seen once weekly and later in treatment may be seen every two weeks. The outpatient successful completion rate this fiscal year was 54%. This is an increase from last year. The major referral source was county and or state parole/probation and or court with 69% of the referrals coming from these sources.

Outpatient Treatment Report (cont’d.)

The number of client admissions by county and gender are outlined below:

County Male Female 2018/2019Total

Cameron 11 6 17

Elk 101 45 146

McKean 150 73 223

Out of County (Potter) 38 16 54

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TOTAL: 300 140 440

The most significant age range this year was 26-35 with 35% in that category, although a significant number were in the 19-25 age range at 19%. Overall, 73% were from ages 19-45. There were 7% in the age range of 13-18 and only .06% in the 65 and older category.

Outpatient therapists continue to provide treatment to the school districts in the four-county area. Our agency served nineteen 19 different schools which included five (5) in Elk County, seven (7) in McKean County, one (1) in Cameron County. A total of 23 new assessments were completed with a total of 24 students receiving treatment throughout the fiscal year. Approximately 67 hours of treatment were provided in the schools this fiscal year.

The Outpatient Department provides treatment services in the Elk, McKean, and Potter County Jails. We began in the McKean County Jail in March 2007. In McKean County Jail, two one-hour groups per week were contracted for fiscal year 18/19. We provided a total of 66 hours of treatment. There are between four and eight people in each group. We can impact up to 16 McKean County inmates each week.

In the Elk County Jail we are contracted for three one-hour groups three times a month for a total of nine hours per month. There are between four and eight people impacted each visit for fiscal year 18/19. We provided a total of 67.45 hours of group at the Elk County Jail and had the opportunity to impact 24 inmates per scheduled treatment day.

OUTPATIENT DEMOGRAPHICS FORFISCAL YEAR 2018-2019

SEX CAMERON ELK MCKEAN POTTER TOTAL

MALE 11 101 150 38 300 FEMALE 6 45 73 16 140

TOTAL 17 146 223 54 440

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Total Number Discharged 23 173 261 60 517

Total Number Completed 8 92 142 36 278

RACE CAMERON ELK MCKEAN POTTER TOTAL

CAUCASIAN MALE 11 101 147 37 296 FEMALE 6 45 73 16 140

AFRICAN AMERICAN MALE 0 0 3 0 3 FEMALE 0 0 0 0 0

HISPANIC MALE 0 0 3 0 3 FEMALE 0 0 0 0 0

PACIFIC ISLANDER MALE 0 0 0 1 1 FEMALE 0 0 0 0 0

TOTAL 17 146 223 54 440

DRUG OF CHOICE

DRUG OF CHOICE CAMERON ELK MCKEAN POTTER TOTAL

ALCOHOL MALE 4 37 68 17 126 FEMALE 3 8 17 6 34

COCAINE/CRACK MALE 0 0 2 1 3 FEMALE 0 0 4 0 4

MARIJUANA/HASHISH

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MALE 2 20 35 13 70 FEMALE 0 4 21 6 31

OTHER OPIATES MALE 3 37 37 5 82 FEMALE 3 25 21 4 53

AMPHETAMINES MALE 2 4 6 2 14 FEMALE 0 8 9 0 17

SEDATIVES MALE 0 0 1 0 1 FEMALE 0 0 0 0 0

OTHER SUBSTANCES MALE 0 1 0 0 1 FEMALE 0 0 0 0 0

METHAMPHETAMINES MALE 0 1 1 0 2 FEMALE 0 0 0 0 0

ADJUSTMENT DISORDER MALE 0 1 0 0 1 FEMALE 0 1 0 0 1

TOTAL 17 146 223 54 440

REFERRAL SOURCE

REFERRAL SOURCE CAMERON ELK MCKEAN POTTER TOTAL

D & A PROVIDER 0 8 3 0 11SELF 2 20 23 8 53HOSPITAL/PHYSICIAN 1 6 4 1 12COMM.SERV./AGENCY/IND. 0 18 31 4 53FAMILY/FRIEND 0 0 2 0 2SCHOOL 0 4 2 0 6COURT 0 11 4 1 16COUNTY PROBATION 14 68 124 39 245STATE PAROLE 0 11 30 1 42EMPLOYER 0 0 0 0 0

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TOTAL 17 146 223 54 440

AGE BREAKDOWN

AGE CAMERON ELK MCKEAN POTTER TOTAL13-18 0 11 21 0 3219-25 2 35 36 12 8526-35 4 45 84 20 15336-45 5 25 42 10 8246-55 1 20 28 11 6056-65 5 8 11 1 2566-75 0 2 1 0 376-85 0 0 0 0 0

TOTAL 17 146 223 54 440

2018-2019 Outpatient Department Outcomes

The Outpatient Department has three major goals for treatment for fiscal year 18-19. They are as follows:

1) Program effectiveness2) Program efficiency3) Client satisfaction

The objectives we will explore to meet these goals in order of importance are as follows:

EFFECTIVENESS GOAL: 1. Abstinence2. Increase in quality of functioning life

EFFICIENCY GOAL: 3. Treatment availability, accessibility, and appropriateness

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EFFICIENCY GOAL: 4. Treatment completion

SATISFACTION: 5. Client satisfaction 6. Trauma Care satisfaction

We obtained this information through a follow-up survey completed by a mailed survey at 30 & 180-day intervals after discharge from treatment.

The results of this survey are based on the fiscal year 18-19. There were a total of 59 responses returned. This is only 4% of all the surveys sent.

CONCLUSION

The outcomes-based evaluation, from July 1, 2018 through June 30, 2019, identify that the outpatient department has met or exceeded their three major goals which are: program effectiveness, program efficiency, and client satisfaction.

In regard to our goal of Program Efficiency (objectives 3 and 4) we continue to improve. Over 64% were involved in a program of recovery and all that were referred to another program did follow through. This is an increase of 14%.

*These goals and objectives will remain for the 19/20 fiscal year as well as the objective under client satisfaction related to how satisfied they were with how their trauma, if identified was addressed.

Outcomes for 2018-2019

OBJECTIVE MIN GOAL RESULTS

1 60% 70% 90%

2 65% 75% 89%

3 50% 70% 84%

4 75% 85% 95%

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5 (A) 70% 85% 100% (B) 60% 85% 100% (C) 80% 90% 100%

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2018-2019 MAPLE MANOR – INPATIENT TREATMENT REPORTClinical Program Manager – Jennifer Greenman

The Maple Manor program and treatment approach centers on the belief that chemical dependency is a primary, chronic, progressive, and relapsing disease and when left untreated, can be fatal. The treatment approach is primarily based on the 12 -Program of Alcoholics Anonymous and Narcotics Anonymous; however, other approaches and methodologies are utilized. Treatment is provided by experienced professionals who are aware of and adaptable to the unique needs of each individual. Therapists work with each client to develop an individualized treatment plan which includes family involvement. This plan is based on abstinence from all chemicals. We provide a caring and complete treatment experience to anyone affected by alcohol and other drugs, including clients with co-occurring disorders. The program is under the supervision of the Medical Director and utilizes our Case Management Department for meeting special needs and to engage our clients with recovery support services, the Outpatient Department for follow-up outpatient therapy and the Prevention Department to provide education if necessary.

On July 1, 2017, Maple Manor expanded to include eight long-term beds. This in addition to the 16 short-term beds brings the maximum capacity to 24.

The referrals for both long- and short-term treatment primarily came from community service agencies, and hospitals. We received out-of-county referrals from Warren, Potter, Clarion, Tioga, Clearfield/Jefferson, Crawford and Armstrong Indiana Counties, 63% of all long-term referrals were from out-of-county and 52% of all short-term referrals were from out-of-county. Funding sources for inpatient treatment were CCBH, BHSI, ACT 152, Cameron/Elk/McKean SCA Funds, SCA funds from Potter and Forest/Warren Counties, private insurance, client fees (client liabilities), Women with Children Funds, and Intermediate Punishment funds from McKean County.

Maple Manor’s short-term completion rate for 2018-2019 was eighty-three percent (83%). The completion rate for long term was fifty-nine percent (59 %). The occupancy rate for short term was seventy-three percent (73%). The occupancy rate for long-term was eighty-one percent (81%).

Other opiates was the primary drug of choice for long-term treatment. Fifty-seven percent (57%) of our long-term clients identified opiates as their substance of choice. Twenty-four percent (24%) of admissions to long-term were for Methamphetamines. Methamphetamines was the drug of choice for short-term this year with thirty-five percent (35%) of all admissions. Opiates was the second highest in short-term with thirty percent (30%) of all admissions. Alcohol was the third highest admissions for both long- and short-term with ten percent (10%) and twenty-eight percent (28%) respectively.

This fiscal year the population of all inpatient clients was seventy-eight percent (78%) male and twenty-two percent (22%) female. The age breakdown for long-term was seventy-nine percent (79%) of individuals were between the ages of 18-35. In short-term, 69 % were in this age range. For both long- and short-term, the largest percentages were in the 26-35 age range. This is consistent with last fiscal year.

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INPATIENT DEMOGRAPHICS FORFISCAL YEAR 2018-2019

SHORT TERM

SEX CAMERON ELK MCKEA

NPOTTE

ROTHER

*TOTA

L

MALE 5 23 50 13 77 168FEMALE 1 3 19 3 17 43

TOTAL 6 26 69 16 94 211

Total Discharged: 5 22 54 14 80 175

Total Completed: 5 16 51 10 64 146

Total Treatment Days: 138 542 1369 327 1882 4258

Occupancy Rate: 66%Completion Rate: 83%The Completion Rate does not include clients who were carried over into the next fiscal year or were medically transferred within 2 days.

*Other- Warren, Tioga, Clearfield, Jefferson, and Armstrong Counties

RACE CAMERON ELK MCKEA

NPOTTE

ROTHER

*TOTA

L

CAUCASIANMALE 5 23 50 13 76 107FEMALE 1 3 19 3 16 42

AFRICAN AMERICANMALE 0 0 0 0 1 1FEMALE 0 0 0 0 0 0

HISPANIC/LATINOMALE 0 0 0 0 0 0FEMALE 0 0 0 0 1 1

TOTAL 6 26 69 16 94 211

DRUG OF CHOICE

DRUG OF CHOICECAMERO

N ELKMCKEA

NPOTTE

ROTHER

*TOTA

L

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INPATIENT DEMOGRAPHICS FORFISCAL YEAR 2018-2019

LONG TERM

SEX CAMERON ELK MCKEA

NPOTTE

ROTHER

*TOTA

L

MALE 3 9 8 6 24 50FEMALE 2 3 0 2 10 17

TOTAL 5 12 8 8 34 67

Total Completed: 2 9 3 3 13 30

Total Treatment Days: 209 536 237 314 1081 2377

Occupancy Rate: 81%Completion Rate: 59%The Completion Rate does not include clients carried over into the next fiscal year.

*Other- Warren, Clarion, Tioga, Clearfield, Crawford and Jefferson Counties

RACE CAMERON ELK MCKEA

NPOTTE

ROTHER

*TOTA

L

CAUCASIANMALE 3 9 8 6 23 49FEMALE 2 3 0 2 9 16

AFRICAN AMERICANMALE 0 0 0 0 1 1FEMALE 0 0 0 0 0 0

HISPANICMALE 0 0 0 0 0 0FEMALE 0 0 0 0 1 1

TOTAL 5 12 8 8 34 67

DRUG OF CHOICE

DRUG OF CHOICECAMERO

N ELKMCKEA

NPOTTE

ROTHER

*TOTA

L

ALCOHOL MALE 0 1 2 1 3 7 FEMALE 0 0 0 0 0 0

2018-2019 INPATIENT OUTCOME BASED REPORT

The inpatient department has seven (7) primary objectives for the fiscal year 2018-2019.

1) Achieve and maintain total abstinence.2) Maximize employment or other productive roles.3) Minimize legal involvement.4) Maximize completion of treatment program.5) Maximize participation in self-help groups.6) Maximize participation in follow-up outpatient counseling.7) Maximize program satisfaction and effectiveness.

As noted in previous reports, the results obtained cannot always be a reliable standard for determination of the results of outcomes due to a poor return rate. A total of 429 surveys were mailed at 30 and 180 days after discharge, and only 37 were returned. This is only nine percent (9%) of the total that were mailed. This is an increase from last year. This fiscal year we will use data collected from phone calls if possible at 30 days to increase reliability of outcome results.

Objectives Minimum Goal Percent Meeting Objective 1 50% 75% 86%2 50% 75% 90% 3 60% 80% 92%4 70% 80% 97%5 60% 80% 92%6 60% 80% 64%7 60% 80% 95%

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(83% got a job after discharge and only 1 person lost a job)

SCA FUNDED CLIENTS2018-2019

Contracted Programs Number of Clients Sent

Total Number of Service Days

Apline Springs Linesville, LLC 1 17Bradford Regional Medical Center 1 46Conewago-Indiana – Orange Stone’s Co. 1 28Gaudenzia Erie, Inc 7 128Maple Manor 51 469Pyramid Healthcare, Inc. 7 101Turning Point 2 40White Deer Run of Allenwood 5 9White Deer Cove Forage 3 37TOTAL 78 875

The SCA shall be responsible for and agrees to indemnify and hold harmless the Commonwealth of Pennsylvania from all losses, damages, expenses, claims, demands, suits, and actions brought by any party against the Commonwealth of Pennsylvania. The Department of Drug and Alcohol Programs specifically disclaim responsibility for any analysis, interpretations or conclusions herein.

R 9/30/2019

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