**The Governor's Initiative to Build a Healthy Louisiana**

**Strategic Plan**

**For Substance Abuse Prevention**

**2006-2010**

![](media/image1.png){width="2.81875in" height="2.8402777777777777in"}

*To recognize that alcohol, tobacco and other drug abuse is a serious
social and public health issue that when addressed will create a climate
of healthiness and community wellness for all of Louisiana.*

July 13, 2006

![](media/image2.jpeg){width="1.8298611111111112in"
height="0.5715277777777777in"}

[Preface 3](#preface)

[Foreword 4](#foreword)

[Introduction 7](#introduction)

[I. Assessment 9](#i.-assessment)

[*Assessing the Problem (Epidemiological Profile)*
10](#assessing-the-problem-epidemiological-profile)

[*Description of SPF-SIG Priorities*
11](#description-of-spf-sig-priorities)

[*Priority Substances* 12](#priority-substances)

[*Priority Population* 12](#priority-population)

[*Alcohol* 12](#alcohol)

[*Tobacco* 12](#tobacco)

[*Illicit Drugs* 13](#illicit-drugs)

[*Criteria and Rationale for SPF Priorities*
13](#criteria-and-rationale-for-spf-priorities)

[*Alcohol Use Consequence Indicators*
14](#alcohol-use-consequence-indicators)

[*Alcohol Consumption Indicators* 14](#alcohol-consumption-indicators)

[*Tobacco Use Consequence Indicators* 15](#__RefHeading___Toc151282288)

[*Tobacco Consumption* 16](#tobacco-consumption)

[*Other Drug Consequence Indicators*
16](#other-drug-consequence-indicators)

[*Illicit Drug Consumption* 17](#illicit-drug-consumption)

[*Procedures of the Subcommittee to Guide Prioritization of Parishes*
17](#procedures-of-the-subcommittee-to-guide-prioritization-of-parishes)

[*Parishes with Rates above the State Average in 2 or More Indicators of
Substance Use*
18](#parishes-with-rates-above-the-state-average-in-2-or-more-indicators-of-substance-use)

[*Alcohol* 18](#alcohol-1)

[*Tobacco (30 Day Tobacco Use Only*)
19](#tobacco-30-day-tobacco-use-only)

[*Illicit Drugs* 19](#illicit-drugs-1)

[*Summary of State Priorities* 19](#summary-of-state-priorities)

[*Needs Assessment Challenges, Data Gaps and Implications*
19](#__RefHeading___Toc151282298)

[*Louisiana Population Shift Resulting from Hurricanes Katrina and Rita*
20](#louisiana-population-shift-resulting-from-hurricanes-katrina-and-rita)

[*Problem Statement: Data Integration*
22](#problem-statement-data-integration)

[*Goal 1A* 23](#goal-1a)

[*Goal 1B* 23](#goal-1b)

[*Long-Term Outcome* 23](#long-term-outcome)

[*Immediate Outcomes (FY 2007)* 24](#immediate-outcomes-fy-2007)

[*Intermediate Outcomes (FY 2008)* 24](#intermediate-outcomes-fy-2008)

[II. Assessing the Systems: Capacity and Infrastructure
24](#ii.-assessing-the-systems-capacity-and-infrastructure)

[*Systems Capacity for Service -- Resource Assessment*
25](#systems-capacity-for-service-resource-assessment)

[*Systems Capacity to Address and Sustain the Intended Prevention
Outcomes*
26](#systems-capacity-to-address-and-sustain-the-intended-prevention-outcomes)

[*Internal Capacity* 26](#internal-capacity)

[*State Capacity and Role of the State Advisory System*
26](#state-capacity-and-role-of-the-state-advisory-system)

[*Louisiana Drug Policy Board* 26](#louisiana-drug-policy-board)

[*Prevention Systems Committee* 28](#prevention-systems-committee)

[*State Epidemiological Workgroup* 31](#state-epidemiological-workgroup)

[*External Capacity: Bridging State and Parish Activities*
32](#external-capacity-bridging-state-and-parish-activities)

[*Technical Assistance Network* 32](#technical-assistance-network)

[*Function and Role* 32](#function-and-role)

[*Needs Assessment Capacity* 33](#needs-assessment-capacity)

[*Technical Assistance Support Capacity*
34](#technical-assistance-support-capacity)

[*Technical Assistance Network to Increase State-Parish
Communication/Collaboration*
34](#technical-assistance-network-to-increase-state-parish-communicationcollaboration)

[*Resource Assessment* 34](#resource-assessment)

[*Leadership Capacity to Address the Intended Prevention Outcomes*
34](#leadership-capacity-to-address-the-intended-prevention-outcomes)

[*Problem Statement: Systems Capacity/Infrastructure*
37](#problem-statement-systems-capacityinfrastructure)

[*State* 37](#state)

[*Community* 38](#community)

[*Goal 2A* 38](#goal-2a)

[*Goal 2B* 38](#goal-2b)

[*Long-Term Outcome* 38](#long-term-outcome-1)

[*Immediate Outcomes (FY 2007)* 39](#immediate-outcomes-fy-2007-1)

[*Intermediate Outcomes (FY 2008)* 39](#intermediate-outcomes-fy-2008-1)

[III. On Going Planning Activities
39](#iii.-on-going-planning-activities)

[*State Planning Model* 40](#state-planning-model)

[*Logic Model of Major SPF SIG Activities and Evaluation Issues to be
Examined*
41](#logic-model-of-major-spf-sig-activities-and-evaluation-issues-to-be-examined)

[*Community Based Activities* 42](#community-based-activities)

[*Allocation Approach* 43](#allocation-approach)

[*Implications of Allocation Approach*
43](#implications-of-allocation-approach)

[*Problem Statement: Alcohol* 44](#problem-statement-alcohol)

[*Goal 3* 45](#goal-3)

[*Long-Term Outcomes* 45](#long-term-outcomes)

[*Immediate Outcomes (FY 2007)* 45](#immediate-outcomes-fy-2007-2)

[*Intermediate Outcomes (FY 2008)* 45](#intermediate-outcomes-fy-2008-2)

[*Problem Statement: Tobacco* 46](#problem-statement-tobacco)

[*Goal 4* 46](#goal-4)

[*Long-Term Outcomes* 46](#long-term-outcomes-1)

[*Immediate Outcomes (FY 2007)* 47](#immediate-outcomes-fy-2007-3)

[*Intermediate Outcomes (FY 2008)* 47](#intermediate-outcomes-fy-2008-3)

[*Problem Statement: Illicit Drugs*
47](#problem-statement-illicit-drugs)

[*Goal 5* 48](#goal-5)

[*Long-Term Outcomes* 49](#long-term-outcomes-2)

[*Intermediate Outcomes (FY 2008)* 49](#intermediate-outcomes-fy-2008-4)

[IV. Implementation 49](#iv.-implementation)

[*State Level Capacity, Infrastructure, and Activities*
49](#state-level-capacity-infrastructure-and-activities)

[*Prevention Systems Committee* 50](#prevention-systems-committee-1)

[*State Epidemiological Workgroup*
50](#state-epidemiological-workgroup-1)

[*Parish Level Capacity, Infrastructure, and Activities*
50](#parish-level-capacity-infrastructure-and-activities)

[V. State-Level Surveillance, Monitoring and Evaluation Activities
52](#v.-state-level-surveillance-monitoring-and-evaluation-activities)

[*SPF-SIG Expected Changes and Tracking at State and Sub-recipient
Levels*
52](#spf-sig-expected-changes-and-tracking-at-state-and-sub-recipient-levels)

[*State-Level Capacity Changes* 53](#state-level-capacity-changes)

[*Community-Level Capacity Changes*
53](#community-level-capacity-changes)

[*Substance Use, Consequences, and Intervening Variables*
53](#substance-use-consequences-and-intervening-variables)

[*Collection of SAMHSA/CSAP NOMS Data at State and Sub-recipient Levels*
54](#collection-of-samhsacsap-noms-data-at-state-and-sub-recipient-levels)

[VI. Cross Cutting Issues 55](#vi.-cross-cutting-issues)

[*Sustainability* 55](#sustainability)

[*Cultural Competency* 56](#cultural-competency)

[*Underage Drinking* 57](#underage-drinking)

[*Service Disruption* 58](#service-disruption)

[Conclusion 59](#conclusion)

[Timeline 60](#timeline)

**The Governor's Initiative to Build a Healthy Louisiana**

**Strategic Plan**

**for**

**Substance Abuse Prevention**

**2006-2010**

*To recognize that alcohol, tobacco and other drug abuse is a serious
social and public health issue that when addressed will create a climate
of healthiness and community wellness for all of Louisiana. *

# Preface

The State of Louisiana suffered unprecedented consequences from two
hurricanes in 2005. On August 29, 2005, Hurricane Katrina made landfall
in Southeastern Louisiana and is now classified as the most destructive
natural disaster in U.S. history. Hurricane Katrina's winds and a storm
surge that crested up to twenty-seven feet high dealt a ferocious blow
to homes, businesses, and property on the coast and for many miles
inland. This storm surge overwhelmed levees all along the lowest reaches
of the Mississippi River and the edges of Lake Pontchartrain. And beyond
New Orleans, Katrina's span of destruction was widespread. Indeed, one
of the gravest challenges presented by this particular disaster was the
vast geographic distribution of the damage. Towns and cities, small and
large, were destroyed or heavily damaged up and down the Gulf Coast and
miles inland. From Morgan City, Louisiana, to Biloxi, Mississippi, to
Mobile, Alabama, Hurricane Katrina's wind, rain, and storm surge
demolished homes and businesses. Large parts of the coastal areas of
these States were devastated. The consequences for New Orleans, which
sits mostly below sea level, were dire. Significant levee failures
occurred on the 17th Street Canal, the Industrial Canal, and the London
Avenue Canal. Nearly 80 percent of the city was flooded; destroying New
Orleans, the Nation's thirty-fifth largest city. Around 770,000 people
were displaced---the largest number since the Dust Bowl migration from
the southern Great Plains region in the 1930s. Most of the New Orleans
population evacuated prior to landfall, but the failure of the levee
system resulted in the evacuation becoming a long-term displacement.

On September 24, 2005, Hurricane Rita, the fourth most intense Atlantic
hurricane ever recorded, made landfall in southwestern Louisiana. The
storm surge caused extensive damage in Louisiana completely destroying
coastal communities in Cameron Parish. The communities of Hackberry,
Cameron, Creole, Grand Chenier, Holly Beach, and Johnson's Bayou were
heavily damaged or entirely destroyed. Hurricane Rita caused the New
Orleans levees to fail once again.

The two storms caused in excess of \$75 billion in damage and more than
1,400 deaths. The parish of Orleans was essentially depopulated
following Katrina and the residents have not yet returned to pre-Katrina
levels and, perhaps, never will. Similarly, the parish of Cameron
remains significantly depopulated as a result of Hurricane Rita.

In the wake of a disaster, concerns about substance use and abuse may
seem minor in relation to the immediate devastation and the task of
rebuilding. However, it is during times of extreme stress such as those
following a disaster that substance use and abuse tends to increase.
Focused disaster management activities are critical in dealing with
disasters.

Disaster management activities can be viewed in three phases:
preparedness, response, and recovery. Phase 1 encompasses all
pre-disaster activities that lessen its effects and lay the groundwork
for response and recovery. Phase 2 includes the first 3 weeks
immediately following the disaster. Emergency assistance is provided
during this phase. Phase 3, the Recovery Phase, runs from 2 weeks to
years after the disaster. This phase begins after basic needs are met
and focus shifts to returning things to normal.

Available statistics and reports from professionals working in the field
indicate that the extreme stress tied to disasters can lead to: misuse
of alcohol and other drugs; increase in problems associated with
substance abuse; breakdown of normal controls that prevent substance
abuse and its related problems; increased difficulties for people in
recovery; and increased initiation by children and youth or abuse the
elderly. Substance abuse prevention professionals must remember "that
all services that address mental health issues are potentially substance
abuse prevention services, since they address the environmental factors
that can give rise to increased alcohol and drug use and other
maladaptive behaviors" (Center for Substance Abuse Prevention \[CSAP\],
1997). Because of the devastation resulting from the storms and the
effort of those who have returned to rebuild homes, the development of
the Technical Assistance Network is critical so that when the devastated
communities are ready to address substance abuse prevention issues,
technical assistance and support will be available to those communities.

# Foreword

Louisiana has a rich and vibrant history. No other state has a more
varied or colorful past than Louisiana. The state has been governed
under ten different flags, beginning in 1541 with Hernando de Soto\'s
claim of the region for Spain. La Salle later claimed it for Bourbon
France and over the years Louisiana was at one time or another subject
to the Union Jack of Great Britain, the Tricolor of Napoleon, the Lone
Star flag of the Republic of West Florida, and the fifteen stars and
stripes of the United States. To this day, Louisiana remains among the
most curious regions of the nation. Though the state shares many of the
characteristics common to her sister states of the South, from the
colonial period to the present Louisiana has been identified more by her
departures from the norm rather than her similarities. Located in the
center of the Gulf Coast environs and home to the mouth of the nation's
greatest river, Louisiana occupied a critical strategic location for the
first European adventurers to the New World. Not only would the
Mississippi River serve as the primary artery of commerce for the
central portion of the nation, but the rich soil deposited in its delta
would bless Louisiana with some of the highest agricultural productivity
found in North America.

Louisiana's location and rich agricultural environment brought many
people to the state with the hope of better lives. The southern area of
the state is unique with deep Mediterranean-African roots that are more
akin to societies in the Spanish and French West Indies than the
American South. The rural part of South Central Louisiana is dominated
by Acadians, or Cajuns, who came from what is now Nova Scotia in the
late eighteenth century. Over time, the Cajuns have absorbed and been
affected by a wide array of cultures in the area: Spanish, German,
Italian, Anglo, Native American, and Slovenian. But some groups retain
greater degrees of independence from Cajun culture. For example,
Spanish-speaking Isleños of St. Bernard Parish are descended from Canary
Islanders who arrived at the same time as the Acadians. American Indians
inhabited the state before all others. The Coushatta and Chitimacha have
maintained separation from the Cajun culture, but the Houma tribe
conserves 19^th^ century French folk culture. Nineteenth and twentieth
century immigration to southern Louisiana included Croatian fisherman
from the Dalmatian coast of Yugoslavia, who settled in lower Plaquemines
Parish, where they introduced the oyster industry. Italians arrived
during the same era, many as sharecroppers on plantations.

The mingling of cultures in South Louisiana is called "creolization".
Creole, from the Portuguese crioulo (native to a region), originally
referred to the European French/Spanish colonial population in south
Louisiana and the Caribbean region. Prior to the Civil War, the word
came to refer to the gens libres de couleur (free people of color) in
Louisiana, those who were of African European descent.

In contrast to South Louisiana, Protestant North Louisiana is culturally
part of the upland and more part of the American South. North
Louisiana's mainly rural folk landscape was shaped by contact between
Indians, Anglo and African Americans, in pioneer, plantation,
sharecropping, and farmstead settings among the river bottom lands,
piney woods, and hills of the region. While the cultural groups in this
region are less overlapped than in the southern part of the state,
cultural contrasts do exist in the region. Creoles of color live in the
Cane River area below Natchitoches; Spanish-speaking people of Choctaw
descent live on the Texas-Louisiana border; and there are Italians,
Hungarians, Czechs, Greeks, and others throughout northern Louisiana and
the southeastern Florida parishes.

The blessings created by her strategic location would also create
challenges. By the time American control was firmly established and a
semblance of stability had descended on the state in the early twentieth
century, fully ten different flags had flown over the Bayou State.
Initially, France, Spain and Britain all vied for control of the
territory. Shifting political loyalties and generous, yet often
competing land claims, contributed to a turbulent colonial period
characterized by frequent wars and an enduring frontier mentality. While
France and later Spain secured a measure of stability in the central
portion of the state, on the margins of the territory specifically the
region in the "toe" of the state, between the Pearl and Mississippi
rivers (known as the Florida Parishes), and in the disputed "neutral
strip" area in the west along the Sabine River, varying degrees of
social and political chaos remained the norm. In each of these regions
suspicion of government, if not outright resistance to it, characterized
the attitude of inhabitants. Before the state was formally incorporated,
the residents of the Florida Parishes would rise in an armed
insurrection against the Spanish government in 1810, and create the
Independent Republic of West Florida before being forcibly annexed by
the United States.

The ill-defined political circumstances, conflicting land claims, and
divided loyalties that characterized the colonial period contributed to
the emergence of resentment toward assertive government. Instead, a
fierce spirit of independence emerged among the people that included a
rejection of governmental assertiveness into the private affairs of
individuals. In his introductory remarks preceding the *Seventh Census*
of the United States in 1850, New Orleans editor and promoter J. D. B.
DeBow lamented that in 1840 in many parishes of the state objections
loomed so strong to the searching nature of the census questions that
several parishes refused peremptorily to answer them. DeBow noted that
though fewer such problems occurred in 1850, in several cases "it was
necessary to call in the services of the district attorney to enforce
the requisitions of the law."

The prevailing spirit of independence was complimented by the residents'
fierce attachment to *honor* as the guiding principle of their society.
As in other regions of the South, in Louisiana honor required a family
to conceal perceived weaknesses from public scrutiny and respond to any
perceived insult to personal or familial integrity violently. Scores of
duels were fought among the elite while even more "eye gougings"
occurred among the common folk who believed they had been insulted or a
family member defamed. Committed to the perspective of General Andrew
Jackson who asserted "a murderer takes only life, a slanderer takes your
honor," thousands of Louisiana's common folk responded to the call of
the planter elite, supported secession, and filled the ranks of the
Confederate Army due less to a desire to defend slavery and more to the
belief that northern insults against the South demanded an aggressive
response.

The Civil War proved an unmitigated catastrophe for Louisiana. Raids by
Union forces left devastated swaths across the state, while thousands
died in the fighting. Flush with victory, the Federal government proved
in no mood to rebuild the land of cotton - destitute farmers who had
lost virtually everything to the War competed for the scraps from the
proverbial table with newly freed slaves who, despite repeated promises
from the victors, were offered little if any land to sustain themselves.
Sharecropping and the crop lien system consumed the poor, both black and
white, in an ever widening cycle of privation and despair. In the late
nineteenth century formerly proud and independent white farmers and
desperate landless blacks vented their frustration in mounting rates of
violence that ultimately permeated all aspects of society. Though less
publicized than in other regions, by the 1890s, Louisiana maintained
some of the highest rural homicide rates recorded in American history -
an ominous distinction that would endure.

Sadly, violence has become ensconced in the culture of the state. Data
on criminal statistics released by the Federal Bureau of Investigation
in 1996 reveals that the homicide rate for the nation as a whole that
year was 7.4 deaths by violence per 100,000 mortalities. The same data
demonstrates that the homicide rate for the entire South stood at 9.0
while Louisiana led the nation with a startling rate of 17.5 per
100,000.

Rampant violence, economic despair, and political uncertainty continued
to characterize the Bayou State through the twentieth century. Even the
reforms offered by Huey Long and other activist political leaders
revealed another aspect of life in Louisiana that has contributed to the
oft evident despair - political corruption. Nurtured in the belief of
their French and Spanish founders that an elective office served as the
holder's property - and one has the right to make money off their
property - many Louisianans have come to assume that government is
inherently corrupt.

In a state that possesses some of the nation's richest oil holdings, a
marginal economic existence and life among people notoriously prone to
violence where government is widely perceived as corrupt, it is no
wonder that many Louisianans' find refuge from reality in alcohol and
drugs. Abuses of the welfare system and more recently, the discovery of
abuses through the waterfall of funds available in the wake of
hurricanes Katrina and Rita, reveal that among some Louisianans
reluctance to receive handouts from government may be on the wane. Pride
nonetheless remains a powerful force in the state. Whether willingness
to embrace offers of assistance from a government long held suspect will
extend beyond those accustomed to a marginal existence to those clinging
to the vestiges of honor, will undoubtedly be revealed by the rapidly
changing circumstances of the state as she advances from the natural
catastrophes of 2005.

# 

# Introduction 

The Louisiana Drug Policy Board, which has statutory authority in
Louisiana to coordinate all substance abuse efforts, including
prevention, treatment and interdiction, accepted the responsibility
presented by the Strategic Prevention Framework-State Incentive Grant
(SPF-SIG) offered by the Center for Substance Abuse Prevention (CSAP),
an office of the Substance Abuse and Mental Health Services
Administration (SAMHSA). The effort was named "The Governor's Initiative
to Build a Healthy Louisiana." In the spring of 2006, two
sub-committees, the State Epidemiological Workgroup (SEW) and the
Prevention Systems Committee (PSC) were created. In 2006, the PSC was
served by the creation of the Core Team, a multi-agency team working
extensive hours to develop the strategic plan.

As a first step in creating the response to the opportunity presented by
the SPF-SIG, the Louisiana Office of the Governor, in July of 2005,
working closely with the Office for Addictive Disorders (OAD), the
single state agency for substance prevention and treatment, developed a
timeframe for embedding the SPF-SIG process. With the assistance of 16
key agencies and organizations from across the state and various
disciplines under the banner "Core Team," a shared vision and mission
statement was created:

*To recognize that alcohol, tobacco and other drug abuse is a serious
social and public health issue that when addressed will create a climate
of healthiness and community wellness for all of Louisiana. *

This Core Team worked to pursue its agreed to mission of providing a
framework for statewide substance abuse prevention that:

-   Acknowledges and builds on what has been accomplished in the past,
    and increases value for what is yet to be accomplished;

-   Changes perceptions about the substance abuse prevention system and
    increase its effectiveness;

-   Coordinates agency efforts to build an inter-agency community;

-   Develops a stronger infrastructure for substance abuse prevention;

-   Drives the creation of a model statewide strategic substance abuse
    prevention plan;

-   Encourages standards for program, policy, and practice selection as
    well as substance abuse prevention workforce development;

-   Guides the integration of data into one accessible system to
    facilitate planning and decision making;

-   Looks at the broad spectrum of related issues;

-   Proactively uses data to educate communities, policy makers,
    legislators, and private industry;

-   Provides a common message about substance abuse prevention;

-   Supports a standardized substance abuse prevention process that
    connects planning, funding and evaluation of substance abuse
    prevention between state, regional, parish and local efforts;

-   Targets the reduction of duplicative substance abuse prevention
    services and promotes increased continuity of effort;

-   Promotes thinking, planning, and acting strategically.

Despite the hurricane disruption, OAD staff, Governor's Office staff,
and the Southwest Center for the Application of Prevention Technologies
(SWCAPT) Liaison continued to meet in October, November and December
prior to the weeklong January meeting of the full Core Team. The
outcomes of these sessions include:

-   Crafted wording for a Memorandum of Understanding (MOU) to be used
    with all partner agencies in the strategic planning process;

-   Developed initial benchmarks and expectations of coalitions;

-   Discussed possible barriers to implementing the resource assessment
    tools and possible solutions;

-   Identified additional agencies critical to the strategic planning
    process and developed a plan for engaging these agencies;

-   Renewed a sense of opportunity about the ability to accomplish
    SPF-SIG;

-   Solidified the next steps for PSC and SEW;

-   Rephrased the vision statement;

-   Increased knowledge about the *Applied* Pathways tools for strategic
    planning, focusing on needs assessment and resource assessment and
    how they connect to evidence-based strategic planning to change
    community problems;

-   Targeted initial agencies to participate in a "face-to-face"
    conversation to collect resource information and present process
    during the immersion (week long *Applied* Pathways training);

-   Clarified overall intent of the SPF steps; and

-   Clarified structure, roles, and membership of Core Team, SEW, and
    PSC (Advisory System).

In January of 2006, the Core Team was expanded to 30 members, comprised
not only of state agencies and statewide organizations, but also the
university system, sub-state coalitions, and service providers. The Core
Team considered consumption and consequence data, reviewed the use of
present resources in the State, analyzed leadership's ability to guide
this effort towards the outcomes stated in the vision and created this
strategic plan. The plan is driven by the intent to develop a system
that coordinates planning, funding, and evaluation for substance abuse
prevention at all levels, from service providers to state agencies, in
order to support the implementation of evidence-based, culturally
appropriate, and cost effective prevention services in all Louisiana
parishes.

The plan has been developed to follow the five steps of the SPF-SIG:
Assessment, Capacity, Planning, Implementation, and Evaluation. The
objectives for each are attached in a chart found on page 60. The three
overarching dynamics: cultural competency, sustainability, and underage
drinking are highlighted in the final section, along with a service
disruption plan.

# I. Assessment 

Louisiana is one of the most culturally, economically, and ecologically
diverse states in the nation. Although only the twenty-second most
populated state in the nation, Louisiana has a population of 4.5 million
people. 32.5% are of African-American descent (*Census* *Bureau, 2002*),
ranking Louisiana 2^nd^ in percentage of African-Americans who comprise
the total population among the states (*Ibid.*). In addition to English
and the increasing use of Spanish, a significant minority of Louisianans
continues to speak French-Cajun and Louisiana Creole French
*(Ethnologue: Languages of the World, 14^th^ Edition, 2004).* More than
two-thirds of the population is located in eight metropolitan areas.
Louisiana's diverse economy includes a strong agricultural sector,
petroleum and natural gas reserves, and prior to Hurricanes Katrina and
Rita, a thriving fishing industry, expanding tourism, and a strategic
location at the mouth of the Mississippi River, gateway to the nation's
vast inland waterway system. Ecologically, the state's landscape varies
dramatically from its famous remote, marshy bayous in the south, to lush
pine forests in the north.

Louisiana also has an extensive workforce of substance abuse prevention
service providers. Key substance abuse prevention agencies are
represented on the Drug Policy Board. Although the Office for Addictive
Disorders receives the largest share of federal funds from the Substance
Abuse Mental Health Services Administration, the Governor's Office of
Safe and Drug Free Schools, the Office of Public Health, the Department
of Education, the National Guard, the Drug Enforcement Agency, the
Office of Elderly Affairs, the Office of Indian Affairs, the Department
of Social Services, and the Office of Mental Health are all actively
engaged in the development and implementation of the strategic plan.

The plan is based on a thorough assessment of available data that
provides information about substance abuse consumption and the related
consequences collected by the State Epidemiological Workgroup (SEW).
This baseline needs assessment includes identification of the substances
that are most threatening to Louisiana's population at all ages, the
specific consequences of use and abuse of these substances, and the
levels of readiness and capacity at state and parish levels. After a
year of gathering data and study the SEW presented their report to the
Core Team in February of 2006. A copy is attached to this strategic
plan.

#### *Assessing the Problem (Epidemiological Profile)*

In April 2005, after meeting for three months, the SPF-SIG SEW
recommended and the Drug Policy Board adopted the following policy:

Through agreements among its members, the substance abuse-related
Louisiana agencies and entities represented by the board, established a
substance abuse prevention planning infrastructure to:

-   Harvest all archival census, crime, education, enforcement, health,
    and social service, etc. data related to substance abuse that is
    presently collected;

-   Summarize available archival data from 1995 to the present using
    common attributes (e.g., gender, race, age range, parish, etc.);

-   House data within a system that allows agency staff and the public
    access to data via the internet to use for planning;

-   Provide analytical tools that cross tabulate the data sets for up to
    ten years and report using graphic images (e.g., bar, GIS, pie, and
    trend line); and

-   Publish the link to the data system on an accessible website.

In August 2005, the SEW completed a review of data related to
consumption and consequences of substance abuse. The data evaluated were
from the following sources:

-   State Epidemiological Data System set (SEDS);

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-   35 social indicators as proxies for the measures of youth risk and
    protection recommended by Dr. David Hawkins and Dr. Richard Catalano
    through the National Institute on Drug Abuse (NIDA) funded six state
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-   Selected data from the Communities That Care/Caring Communities
    Youth Survey (CCYS).

In January 2006, additional data were considered by the SEW for
inclusion in the SEW report to the Drug Policy Board and Core Team:

-   College Alcohol Study, Louisiana State University results;

-   Mortality data from the Office of Public Health;

-   Motor Vehicle Crash and Fatality Data (Fatal Alcohol Reporting
    System - FARS);

-   Department of Education Population Shift Data; and

-   Crime statistics (LA Commission on Law Enforcement).

In February of 2006 the SEW presented to Core Team its initial report.
This report provided the following conclusions.

When leading causes of death by age group are observed, the importance
of substance related mortality is apparent. From ages 15 to 24, the
leading causes of death are unintentional injury (includes traffic
fatalities), homicide, and suicide. All three are associated with
substance use, particularly alcohol. From 25 to 34 years of age,
unintentional injury and homicide are 1st and 2^nd^ as the leading
causes of mortality. In older age groups, chronic causes of death
replace more proximal acute causes as the leading determinants of
mortality. At age 35 and over, at least two substance use related causes
of mortality are ranked in the top three causes of death: heart disease
(tobacco related), malignant neoplasms (some cancers are associated with
tobacco use), and cerebrovascular disease (tobacco related) are common
chronic causes of mortality.

More proximal causes of death (mortality consequences following
substance use or abuse more closely in time) are more evident in younger
age groups in Louisiana. Death rates from homicide are highest in 18 to
34 year olds. The highest number of homicides occurs in the 21 to 29
year old group. Suicide rates and rates of death from illicit drugs
remain fairly constant from age 18 and older. The highest suicide and
illicit drug death rates are seen in the 65 and older group and the
highest number of suicides and illicit drug deaths is seen in the 35 to
54 year old group. Nevertheless, the proportion of deaths from these two
causes in older age groups is reduced due to large numbers of deaths
from chronic causes. The data also revealed:

-   27% of Louisiana students report drinking alcohol by the 6th grade,
    with the average age of initiation at 12.4 years of age. By 8th
    grade this number doubles, as 55% of all 8th graders report drinking
    alcohol at least once in the past 30 days.

-   30% of all 12th graders report binge drinking (more than 5 drinks in
    a sitting) which exceeds the national average.

-   The rate of property and violent crime was higher in Louisiana than
    the national rate between 2000-2002 (LA rate of 44 reported property
    crime and 6.5 reported violent crimes per 1000 population).

-   The homicide rate in Louisiana was homicide rate was double the
    national rate crime from 1999-2001 (LA rate of .12 per 1000
    population).

-   In all years between 1990-2003, the percentage of fatal car crashes
    involving alcohol was higher in Louisiana compared to the US.

-   Despite the fact that the percentage of Louisianans 18-29 reporting
    having drank alcohol at least once during the past 30 days and
    reporting binge drinking during the past 30 days was similar to the
    percentages for the nation, there was a greater percentage of
    Louisianans in this age range who reported drinking and driving than
    for the nation.

-   Tobacco use in Louisiana is higher than the national average, with
    26.2% of young adults using tobacco. This number increases to 30.5%
    for those between the ages of 35-54.

-   Louisiana's death rate due to illicit drug use was greater than
    twice the national average between 1999-2001 (LA rate of .02 per
    1000 population).

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-   Research suggests that approximately 30% of all burglaries and other
    property crime can be attributed to drug use.

-   There is currently no coordinated method of collecting and reporting
    data to guide substance abuse prevention planning.

#### *Description of SPF-SIG Priorities*

The Core Team members reviewed the data in the SEW draft report. The 27
members assessed the report by asking the following questions:

#### *Priority Substances*

1.  *What are the consumption patterns and consequences of alcohol,
    tobacco, and other drug use in Louisiana for which epidemiological
    data is available for all 64 parishes?*

2.  *How close is the relationship between the consumption behavior and
    the consequence?*

3.  *How does Louisiana compare to national rates of both consequences
    and consumption?*

4.  *What is the state rate, percentage, and number of cases for each
    consequence and related consumption behavior?*

The Core Team determined that alcohol, tobacco and illicit drugs are to
be addressed in the comprehensive state plan.[^1] The final decision
made on May 18, 2006, after an extensive two month review of the state
system's ability to support the initial embedding of the SPF process, is
to provide SPF-SIG funding to parishes with the highest rates in order
to support the alcohol outcomes. The plan, however, includes all three
priorities so that they may be addressed by other funding as this is a
*comprehensive* plan, intended for all prevention funding streams.

#### *Priority Population*

Using the State SEW Report, Core Team members addressed the following
questions:

1)  *Which groups are most affected? and,*

2)  *How malleable is the indicator?*

With these questions in mind, the group used consequences and related
consumption behaviors specific to each substance to prioritize the age
populations to be targeted by this comprehensive plan.

#### *Alcohol*

The data showed those most affected by, or who participate in the abuse
of alcohol, are those between the ages of 12 to 29. The most malleable
indicators are alcohol related motor vehicle injuries, death, and
violent crime for 18 to 29; and age of initiation and binge drinking for
those 12 to 17.

#### *Tobacco*

The data showed those most affected by, or who participate in tobacco
use are those 35 and older. The most malleable indicators are lung
cancer and cardiovascular disease. Neither of these are short term
measures of consequences.

#### *Illicit Drugs*

The data showed those with the highest level of participation in illicit
drug use, particularly marijuana use, are those between the ages of 12
to 29. The most malleable indicators are property crimes related to
consumption of illicit drugs, death related to overdose, and treatment
records.

The conclusion of the Core Team, based on consideration of the groups
most affected by the problems, is that the population age group targeted
for change in consequences and/or consumption should be 12 to 29 years.

#### *Criteria and Rationale for SPF Priorities*

***Priority Indicators***

The final selection of the SPF SIG Project priorities occurred at the
March, 2006 meeting of a subcommittee of the Core Team and was later
approved by the Core Team. The subcommittee first considered data common
to all 64 parishes, looking at a range of consumption and consequence
indicators within each category. A list of these indicators and the
attributes considered in selecting priorities are provided in the tables
on pages 14 - 17. The subcommittee selected two indicators that were
determined to be those most tractable (malleable) and most proximal to
actual substance use, when possible, for each prioritized substance. An
exception to this principal was inclusion of the indicator *lung cancer
mortality* for tobacco use. Although *lung cancer mortality* is not
proximal to the actual behavior, the absence of other parish-wide
indicators and the strong association of lung cancer to smoking (80% of
all cases are associated with smoking), led to its choice as a one of
the two indicators.

The indicators chosen were:

1.  Alcohol: *Alcohol related crash injuries* and *Reported violent
    crime*

2.  Illicit Drugs: *Reported property crimes* and *30 day marijuana use*

3.  Tobacco: *Lung cancer mortality* and *30 day tobacco use*

#### *Alcohol Use Consequence Indicators*

+----+-------------+-------+---------+-------+------+-------+-------+
|    | **          | **Av  | **      | **Rel | *    | **Pr  | *     |
|    | Indicator** | erage | Average | ative | *Tre | oximi | *Trac |
|    |             | Ann   | Rate    | Rate  | nd** | ty/** | tabil |
|    |             | ual** | per     | Ra    |      |       | ity** |
|    |             |       | 1000    | tio** |      | **    |       |
|    |             | **N   | Popul   |       |      | Relat |       |
|    |             | umber | ation** | **to  |      | ion-s |       |
|    |             | of    |         | U     |      | hip** |       |
|    |             | Ca    |         | .S.** |      |       |       |
|    |             | ses** |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
| >  | **Alcohol   | 381   | .09     | 1.58  | Sl   | High/ | Hi    |
|  * | Related     |       |         |       | ight | High  |       |
| *M | Motor       |       |         |       | Dec  |       |       |
| or | Vehicle     |       |         |       | line |       |       |
| ta | Crash       |       |         |       |      |       |       |
| li | F           |       |         |       |      |       |       |
| ty | atalities** |       |         |       |      |       |       |
| ** |             |       |         |       |      |       |       |
|    | **(2        |       |         |       |      |       |       |
|    | 001-2003)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **          | 537   | .12     | 2.01  | Sl   | High/ | ?     |
|    | Homicides** |       |         |       | ight | M     |       |
|    |             |       |         |       | Incr | edium |       |
|    | **(1        |       |         |       | ease |       |       |
|    | 999-2001)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | *           | 493   | .11     | 1.04  | St   | High/ | Lo    |
|    | *Suicides** |       |         |       | able | M     |       |
|    |             |       |         |       |      | edium |       |
|    | **(1        |       |         |       |      |       |       |
|    | 999-2001)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | *           | 140   | .03     | Un    | Unk  | High/ | ?     |
|    | *Accidental |       |         | known | nown | M     |       |
|    | Falls**     |       |         |       |      | edium |       |
|    |             |       |         |       |      |       |       |
|    | **(1        |       |         |       |      |       |       |
|    | 999-2004)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | *           | 91    | .02     | Un    | Unk  | High/ | ?     |
|    | *Accidental |       |         | known | nown | M     |       |
|    | Drowning**  |       |         |       |      | edium |       |
|    |             |       |         |       |      |       |       |
|    | **(1        |       |         |       |      |       |       |
|    | 999-2004)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **Chronic   | 362   | .08     | .85   | Sl   | Low/  | Med   |
|    | Liver       |       |         |       | ight | High  |       |
|    | Disease**   |       |         |       | Dec  |       |       |
|    |             |       |         |       | line |       |       |
|    | **(1        |       |         |       |      |       |       |
|    | 999-2001)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
| >  | **Alcohol   | 5133  | 1.09    | Un    | Sl   | High  | Hi    |
|  * | Related     |       |         | known | ight | /High |       |
| *M | Motor       |       |         |       | Decr |       |       |
| or | Vehicle     |       |         |       | ease |       |       |
| bi | Injury      |       |         |       |      |       |       |
| di | Crashes**   |       |         |       |      |       |       |
| ty |             |       |         |       |      |       |       |
| ** | **(2        |       |         |       |      |       |       |
|    | 001-2003)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **Reported  | 2     | 6.35    | 1.33  | St   | High/ | ?     |
|    | Violent     | 8,387 |         |       | able | M     |       |
|    | Crimes**    |       |         |       |      | edium |       |
|    |             |       |         |       |      |       |       |
|    | **          |       |         |       |      |       |       |
|    | (2000-02)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
| >  | **Alcohol   | *Es   | *Estim  | *Es   | Unk  | M     | Med   |
|  * | Dependence  | timat | ated\** | timat | nown | edium |       |
| *O | or Abuse**  | ed\** |         | ed\** |      | /High |       |
| th |             |       | 79.3    |       |      |       |       |
| er | **(2002)**  | 29    |         | 1.04  |      |       |       |
| >  |             | 3,564 |         |       |      |       |       |
| Co |             |       |         |       |      |       |       |
| ns |             |       |         |       |      |       |       |
| eq |             |       |         |       |      |       |       |
| ue |             |       |         |       |      |       |       |
| nc |             |       |         |       |      |       |       |
| es |             |       |         |       |      |       |       |
| ** |             |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+

\*Estimated from NSDUH percent of respondents 12 and over classified as
dependent on alcohol.

#### *Alcohol Consumption Indicators* 

(Percent Indicating Use)

+------------+--------+--------+--------+---------+--------+---------+
|            | **30   |        | *      |         | **C    |         |
|            | Day    |        | *Binge |         | hronic |         |
|            | Use**  |        | Drinki |         | Heavy  |         |
|            |        |        | ng\^** |         | Use**  |         |
+============+========+========+========+=========+========+=========+
|            | *      | **     | *      | *       | *      | *       |
|            | *Louis | United | *Louis | *United | *Louis | *United |
|            | iana** | St     | iana** | S       | iana** | S       |
|            |        | ates** |        | tates** |        | tates** |
+------------+--------+--------+--------+---------+--------+---------+
| **Youth    | 7.7%   | N/A    | 5.8%   | N/A     | N/A    | N/A     |
| Grade      |        |        |        |         |        |         |
| 6\***      |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2004)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Youth    | 22.7%  | 16.6%  | 13.3%  | 11.4%   | N/A    | N/A     |
| Grade      |        |        |        |         |        |         |
| 8\***      |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2004)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Youth    | 37.2%  | 35.4%  | 21.7%  | 22%     | N/A    | N/A     |
| Grade      |        |        |        |         |        |         |
| 10\***     |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2004)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Youth    | 48%    | 48%    | 30.2%  | 29.2%   | N/A    | N/A     |
| Grade      |        |        |        |         |        |         |
| 12\***     |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2004)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **College  | 59.9%  | 60.1%  | 31.8%  | 31.8%   | 8.9%   | 10.5%   |
| Age Adults |        |        |        |         |        |         |
| 1          |        |        |        |         |        |         |
| 8-24\*\*** |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2003)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Adults   | 59.1%  | 64%    | 22.3%  | 24.1%   | 7.1%   | 5.9%    |
| 2          |        |        |        |         |        |         |
| 5-34\*\*** |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2003)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Adults   | 51.4%  | 63.2%  | 19.6%  | 18.2%   | 7.3%   | 5.4%    |
| 3          |        |        |        |         |        |         |
| 5-44\*\*** |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2003)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Adults   | 48.4%  | 60.3%  | 12.2%  | 12.6%   | 5.4%   | 5.2%    |
| 4          |        |        |        |         |        |         |
| 5-54\*\*** |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2003)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Adults   | 38.9%  | 54.7%  | 8.4%   | 8.3%    | 4.8%   | 4.6%    |
| 5          |        |        |        |         |        |         |
| 5-64\*\*** |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2003)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+
| **Adults   | 26.1%  | 41.5%  | 3.1%   | 3%      | 2.5%   | 2.9%    |
| 65+\*\***  |        |        |        |         |        |         |
|            |        |        |        |         |        |         |
| **(2003)** |        |        |        |         |        |         |
+------------+--------+--------+--------+---------+--------+---------+

\^Binge Drinking: For youth -- "5 or more drinks in a row" during past 2
weeks; For Adults -- "5 or more drinks" during past 30 days

\*LA data from CCYS -- US Data from Monitoring the Future

\*\*Data from CDC BRFSS Website -- United States percentages reflect
median percentage of all states

[]{#__RefHeading___Toc151282288 .anchor}***Tobacco Use Consequence
Indicators***

+----+-------------+-------+---------+-------+------+-------+-------+
|    | **          | **Av  | **      | **Rel | *    | **Pr  | *     |
|    | Indicator** | erage | Average | ative | *Tre | oximi | *Trac |
|    |             | Ann   | Rate    | Rate  | nd** | ty/** | tabil |
|    |             | ual** | per     | Ra    |      |       | ity** |
|    |             |       | 1000    | tio** |      | **    |       |
|    |             | **N   | Popul   |       |      | Relat |       |
|    |             | umber | ation** | **to  |      | ion-s |       |
|    |             | of    |         | U     |      | hip** |       |
|    |             | Ca    |         | .S.** |      |       |       |
|    |             | ses** |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
| >  | **Other     | 4,096 | .92     | 1.31  | St   | Low   | High  |
|  * | Car         |       |         |       | able | /High |       |
| *M | diovascular |       |         |       |      |       |       |
| or | Disease**   |       |         |       |      |       |       |
| ta |             |       |         |       |      |       |       |
| li | **(1        |       |         |       |      |       |       |
| ty | 999-2001)** |       |         |       |      |       |       |
| ** |             |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **Lung      | 2,798 | .63     | 1.14  | Sl   | Low   | High  |
|    | Cancer**    |       |         |       | ight | /High |       |
|    |             |       |         |       | Incr |       |       |
|    | **(1        |       |         |       | ease |       |       |
|    | 999-2001)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **Ischemic- | 1     | 2.29    | .94   | St   | Low   | High  |
|    | Cere        | 0,225 |         |       | able | /High |       |
|    | brovascular |       |         |       |      |       |       |
|    | Disease**   |       |         |       |      |       |       |
|    |             |       |         |       |      |       |       |
|    | **(1        |       |         |       |      |       |       |
|    | 999-2001)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **Lung      | 1,613 | .36     | .86   | Sl   | Low   | High  |
|    | Disease**   |       |         |       | ight | /High |       |
|    |             |       |         |       | Incr |       |       |
|    | **(1        |       |         |       | ease |       |       |
|    | 999-2001)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | *           | 95    | .02     | Un    | Unk  | H     | Med   |
|    | *Accidental |       |         | known | nown | igh/M |       |
|    | Deaths due  |       |         |       |      | edium |       |
|    | to Fires**  |       |         |       |      |       |       |
|    |             |       |         |       |      |       |       |
|    | **(1        |       |         |       |      |       |       |
|    | 999-2004)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+

#### *Tobacco Consumption*

(Percent Indicating Use)

+--------------------+-----------+-----------+-----------+-----------+
|                    | **30 Day  |           | **Chronic |           |
|                    | Smoking** |           | Heavy     |           |
|                    |           |           | Sm        |           |
|                    |           |           | oking\^** |           |
+====================+===========+===========+===========+===========+
|                    | **Lo      | **United  | **Lo      | **United  |
|                    | uisiana** | States**  | uisiana** | States**  |
+--------------------+-----------+-----------+-----------+-----------+
| **Youth Grade      | 4.3%      | N/A       | .7%       | N/A       |
| 6\***              |           |           |           |           |
|                    |           |           |           |           |
| **(2004)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Youth Grade      | 12.4%     | 9.2%      | 2.3%      | 1.7%      |
| 8\***              |           |           |           |           |
|                    |           |           |           |           |
| **(2004)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Youth Grade      | 17.5%     | 16%       | 4.2%      | 3.3%      |
| 10\***             |           |           |           |           |
|                    |           |           |           |           |
| **(2004)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Youth Grade      | 23.8%     | 25%       | 7.5%      | 8%        |
| 12\***             |           |           |           |           |
|                    |           |           |           |           |
| **(2004)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **College Age      | 31.2%     | 28.9%     | 22.4%     | 19.5%     |
| Adults**           |           |           |           |           |
|                    |           |           |           |           |
| **18-24\*\***      |           |           |           |           |
|                    |           |           |           |           |
| **(2003)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Adults           | 30.9%     | 25.2%     | 22.8%     | 18.4%     |
| 25-34\*\***        |           |           |           |           |
|                    |           |           |           |           |
| **(2003)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Adults           | 33.4%     | 25.5%     | 26%       | 20.2%     |
| 35-44\*\***        |           |           |           |           |
|                    |           |           |           |           |
| **(2003)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Adults           | 26.9%     | 24.1%     | 22.1%     | 18.8%     |
| 45-54\*\***        |           |           |           |           |
|                    |           |           |           |           |
| **(2003)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Adults           | 23.4%     | 19.4%     | 18.2%     | 15.8%     |
| 55-64\*\***        |           |           |           |           |
|                    |           |           |           |           |
| **(2003)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+
| **Adults 65+\*\*** | 11%       | 9.2%      | 8.5%      | 7.5%      |
|                    |           |           |           |           |
| **(2003)**         |           |           |           |           |
+--------------------+-----------+-----------+-----------+-----------+

\^Chronic Heavy Smoking: Youth -- ½ Pack or more per day; Adult -- Daily
Cigarette Use

\*LA data from CCYS -- US Data from Monitoring the Future

\*\*Data from CDC BRFSS Website -- United States percentages reflect
median percentage of all states

#### *Other Drug Consequence Indicators*

+----+-------------+-------+---------+-------+------+-------+-------+
|    | **          | **Av  | **      | **Rel | *    | **Pr  | *     |
|    | Indicator** | erage | Average | ative | *Tre | oximi | *Trac |
|    |             | Ann   | Rate    | Rate  | nd** | ty/** | tabil |
|    |             | ual** | per     | Ra    |      |       | ity** |
|    |             |       | 1000    | tio** |      | **    |       |
|    |             | **N   | Popul   |       |      | Relat |       |
|    |             | umber | ation** | **to  |      | ion-s |       |
|    |             | of    |         | U     |      | hip** |       |
|    |             | Ca    |         | .S.** |      |       |       |
|    |             | ses** |         |       |      |       |       |
+====+=============+=======+=========+=======+======+=======+=======+
| >  | **Illicit   | 85    | .02     | 2.17  | Sl   | High/ | ?     |
|  * | Drug        |       |         |       | ight |       |       |
| *M | Deaths**    |       |         |       | Incr | High  |       |
| or |             |       |         |       | ease |       |       |
| ta | **(1        |       |         |       |      |       |       |
| li | 999-2001)** |       |         |       |      |       |       |
| ty |             |       |         |       |      |       |       |
| ** |             |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **          | 537   | .12     | 2.01  | Sl   | High/ | ?     |
|    | Homicides** |       |         |       | ight |       |       |
|    |             |       |         |       | Incr | Low   |       |
|    | **(1        |       |         |       | ease |       |       |
|    | 999-2001)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
| >  | **Drug      | *Es   | *Estim  | *Es   | Unk  | Me    | ?     |
|  * | Dependence  | timat | ated\** | timat | nown | dium/ |       |
| *M | or Abuse    | ed\** |         | ed\** |      |       |       |
| or | (2002)**    |       | 33.3    |       |      | High  |       |
| bi |             | 12    |         | 1.13  |      |       |       |
| di |             | 3,274 |         |       |      |       |       |
| ty |             |       |         |       |      |       |       |
| ** |             |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
|    | **State     | 3     | 6.92    | N/A   | St   | Me    | ?     |
|    | Substance   | 1,193 |         |       | able | dium/ |       |
|    | Use         |       |         |       |      |       |       |
|    | Treatment   |       |         |       |      | High  |       |
|    | Admissions  |       |         |       |      |       |       |
|    | (2003-05)** |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+
| >  | **Reported  | 19    | 44.19   | 1.28  | St   | High/ | ?     |
|  * | Property    | 7,526 |         |       | able |       |       |
| *O | Crimes**    |       |         |       |      | M     |       |
| th |             |       |         |       |      | edium |       |
| er | **          |       |         |       |      |       |       |
| >  | (2000-02)** |       |         |       |      |       |       |
| Co |             |       |         |       |      |       |       |
| ns |             |       |         |       |      |       |       |
| eq |             |       |         |       |      |       |       |
| ue |             |       |         |       |      |       |       |
| nc |             |       |         |       |      |       |       |
| es |             |       |         |       |      |       |       |
| ** |             |       |         |       |      |       |       |
+----+-------------+-------+---------+-------+------+-------+-------+

\*Estimated from NSDUH percent of respondents 12 and over classified as
dependent on drugs.

#### *Illicit Drug Consumption*

(Percent Indicating Use)

+------------+---------+--------+---------+--------+--------+--------+
|            | **I     |        | **Ma    |        | **I    |        |
|            | nhalant |        | rijuana |        | llicit |        |
|            | Use in  |        | Use in  |        | Drug   |        |
|            | Past 30 |        | Past 30 |        | Use    |        |
|            | days**  |        | Days**  |        | (other |        |
|            |         |        |         |        | than   |        |
|            |         |        |         |        | Mari   |        |
|            |         |        |         |        | juana) |        |
|            |         |        |         |        | Past   |        |
|            |         |        |         |        | 30     |        |
|            |         |        |         |        | Days** |        |
+------------+---------+--------+---------+--------+--------+--------+
|            | **Loui  | **     | **Loui  | **     | *      | **     |
|            | siana** | United | siana** | United | *Louis | United |
|            |         | St     |         | St     | iana** | St     |
|            |         | ates** |         | ates** |        | ates** |
+------------+---------+--------+---------+--------+--------+--------+
| **Youth    | 5%      | N/A    | 1.1%    | N/A    | 3.3%   | N/A    |
| Grade      |         |        |         |        |        |        |
| 6\***      |         |        |         |        |        |        |
|            |         |        |         |        |        |        |
| **(2004)** |         |        |         |        |        |        |
+------------+---------+--------+---------+--------+--------+--------+
| **Youth    | 6.3%    | 4.5%   | 5.5%    | 6.4%   | 6.2%   | 4.1%   |
| Grade      |         |        |         |        |        |        |
| 8\***      |         |        |         |        |        |        |
|            |         |        |         |        |        |        |
| **(2004)** |         |        |         |        |        |        |
+------------+---------+--------+---------+--------+--------+--------+
| **Youth    | 3.3%    | 2.4%   | 9.9%    | 15.9%  | 8.8%   | 6.9%   |
| Grade      |         |        |         |        |        |        |
| 10\***     |         |        |         |        |        |        |
|            |         |        |         |        |        |        |
| **(2004)** |         |        |         |        |        |        |
+------------+---------+--------+---------+--------+--------+--------+
| **Youth    | 1.8%    | 1.5%   | 13.5%   | 19.9%  | 10.2%  | 10.8%  |
| Grade      |         |        |         |        |        |        |
| 12\***     |         |        |         |        |        |        |
|            |         |        |         |        |        |        |
| **(2004)** |         |        |         |        |        |        |
+------------+---------+--------+---------+--------+--------+--------+
| **College  | N/A     | N/A    | 19.3%   | 17.2%  | 9.5%   | 8.2%   |
| Age        |         |        |         |        |        |        |
| Adults**   |         |        |         |        |        |        |
|            |         |        |         |        |        |        |
| **1        |         |        |         |        |        |        |
| 8-25\*\*** |         |        |         |        |        |        |
|            |         |        |         |        |        |        |
| **(2002)** |         |        |         |        |        |        |
+------------+---------+--------+---------+--------+--------+--------+
| **Adults   | N/A     | N/A    | 3.7%    | 4%     | 3.1%   | 2.7%   |
| 26+\*\***  |         |        |         |        |        |        |
|            |         |        |         |        |        |        |
| **(2003)** |         |        |         |        |        |        |
+------------+---------+--------+---------+--------+--------+--------+

\*LA data from CCYS -- US Data from Monitoring the Future

\*\*Data from NSDUH (SEDS)

#### *Procedures of the Subcommittee to Guide Prioritization of Parishes* 

The Core Team subcommittee next determined which parishes represented
hot spots within the state for the prioritized problems within each
substance category. Through the process described below, a list of
priority parishes was developed for alcohol, tobacco, and illicit drugs.

I. A list of parishes that exhibited at least one of the two indicators
whose value was above the state value was then created. Parishes with
both chosen indicators above the state average were highlighted.

II\. A list of parishes that experienced levels of both selected
indicators above state levels for two or three of the substances
(alcohol and illicit drugs, alcohol and tobacco, illicit drugs and
tobacco, or all three) were listed as the highest priority parishes.

III\. A second level of priority parishes was determined by listing each
parish not already included in the highest priority parishes, which
experienced rates or percentages for any of the selected indicators that
were in the top five (5) among state parishes. These second level
priority parishes were categorized by the particular substance involved.

IV\. A third level of priority parishes was determined by an assessment
of parish leadership and the state's capacity to assist those parishes
in implementing the SPF-SIG model.

V. Based on data from the State Epidemiological Workgroup report and on
strong encouragement from CSAP to address alcohol (because of the
ability to show population changes in this substance) the focus of
SPF-SIG funding will be the consumption and consequences of alcohol
among 12 to 29 year olds.

By this process SPF-SIG prioritized parishes were determined to be:

#### *Parishes with Rates above the State Average in 2 or More Indicators of Substance Use*

-   Orleans (Alcohol and Illicit Drugs)

-   Terrebonne (Tobacco, Alcohol, and Illicit Drugs)

-   Lafayette (Alcohol and Illicit Drugs)

-   St. Landry (Alcohol and Tobacco)

-   Jefferson Davis (Alcohol and Tobacco)

-   Calcasieu (Alcohol and Illicit Drugs)

#### *Alcohol*

-   St. James

-   Evangeline

-   Cameron

-   West Baton Rouge

-   Tangipahoa

-   St. Mary

In addition, this process determined the following Comprehensive Plan
parish priorities:

#### *Tobacco (30 Day Tobacco Use Only*)

-   Cameron

-   Union

-   Caldwell

-   Avoyelles

#### *Illicit Drugs*

-   East Baton Rouge

-   Caddo

-   Rapides

-   West Baton Rouge

-   Caldwell

-   St. Charles

-   Franklin

#### *Summary of State Priorities*

In summary, the substance abuse prevention priorities developed by the
Core Team and the SEW from 2006-2010 are:

SPF-SIG Priorities:

-   Reduce alcohol related motor vehicle crashes, injuries and
    fatalities by reducing alcohol consumption among 16 to 29 year olds
    and delaying the age of onset of alcohol consumption;

-   Reduce the incidence of violent crime by reducing alcohol
    consumption among 12 to 29 year olds and delaying the age of onset
    of alcohol consumption;

Comprehensive Plan Priorities:

-   Reduce the incidence of tobacco related disease by reducing the
    prevalence of tobacco use and delaying the age of onset of tobacco
    consumption, especially smoking; and

-   Reduce the incidence of property crime by reducing consumption of
    marijuana (and other illicit drugs such as methamphetamine.)

#### *Needs Assessment Challenges, Data Gaps and Implications*

The State Epidemiological Workgroup (SEW) investigated several sources
of consumption and consequence data from different agencies and
organizations throughout the state and nation. Despite the success of
the SEW and the Core Team in setting prevention priorities for the state
strategic plan through the examination of consumption and consequence
data, there were significant obstacles and challenges that presented
themselves during the process. First, population shifts resulting from
the devastation of Hurricanes Katrina and Rita presented a difficult
challenge for understanding the substance use consumption and
consequences in regions of the state affected by these storms. Second,
the examination of data available to the SEW revealed important gaps in
the data relevant to substance abuse consumption and consequence that
the SEW would like to address. Finally, the SEW recognizes the need for
a data management system that will make substance abuse prevention
related data available to prevention professionals across the state.

#### *Louisiana Population Shift Resulting from Hurricanes Katrina and Rita*

The devastation of Hurricanes Katrina and Rita presented a unique
challenge to the SEW as large population shifts occurred in regions of
the state affected by the storms. These events required SEW members to
re-examine existing and future data collection methods. At present,
there is no consumption and consequence data available on the displaced
population; however, we have collected census data on the school
population. The map below (Population shift from October to December
2005) shows that most of the affected parishes have re-gained some
population and the areas from which people evacuated lost population.
Since these maps are based on school enrollment, we have a fair amount
of confidence that we are seeing real population movement. Parents do
not readily enroll or withdraw children in school unless they have truly
moved or plan on moving.

![](media/image4.png){width="5.490972222222222in" height="4.76875in"}

The population shift data seem to indicate that where data related to
the SEW are being considered, the most important information regarding
the re-distribution of population is two-fold. First, the closer to the
epicenter of the affected areas, the more similar the evacuee population
is to the pre-Katrina population demographically. This may imply that
where consequence and consumption data are related to ethnic, gender,
socio-economic or other demographic information, rates may simply be
scaled to account for the new population levels. This assumption is
independent of the effects of the disaster on substance abuse, which the
following section addresses.

The second factor is the continuing movement of the affected population.
While there was a large initial displacement of residents, there have
been significant numbers returning to the area. The current (ca. January
2006) population in the affected areas is still significantly less than
the pre-Katrina population. In order to insure that the proper resources
are available in the proper areas at the proper time, ongoing population
estimates will be required. The dynamics of the Louisiana population
will require that the state be flexible and agile in responding to the
changing needs and location of their citizens. As such, the SEW will
continue to attempt to understand on-going changes in the populations of
the hurricane affected regions of the state and address this issue in
future SEW reports.

***Data Gaps***

The SEW analysis of the data resulted in discussions about the validity,
precision, and plausibility of each of the data sets. Several SEW
members also scrutinized data sources from their own organizations
and/or agencies and identified problems with accuracy, timeliness,
sample number, etc. One result of the process was the identification of
a multitude of data gaps, or complete absences of data, that in the
opinion of the SEW are worthy of working to develop in the future.

This encouragement and advocacy of new and/or improved data source
development will be one of the primary roles of the SEW in the coming
years. The consensus of the group is that the membership will continue
to seek new sources individually and together as a group, and to work
within the members' respective agencies/organizations to accomplish the
goals initially stated in the SPF-SIG.

Examples of data sources, data gaps, and related challenges that the SEW
plans to address include:

-   State/parish drug-related emergency room reporting

    -   No statewide system of emergency room reporting exists in
        Louisiana, although some hospitals report "complaint"
        information. No emergency room discharge or diagnostic reporting
        is required.

    -   Emergency departments are often reluctant to release data due to
        proprietary concerns.

    -   Reporting of emergency department diagnoses

        -   Reporting of multiple diagnoses or subgroup diagnoses is
            also desirable.

    -   Reporting of alcohol poisoning.

-   State/parish drug/alcohol related arrests (including those involving
    drugs and/or alcohol but without obvious possession of such
    substances).

    -   Improvement of crime related data indicating possession or
        presence of alcohol and other non-controlled substances.

    -   Reporting of drug and alcohol related homicide data.

    -   Consistent collection of arrest data across all jurisdictions.

    -   Timely collection of arrest data in all jurisdictions.

-   State/parish drug related suicides (adults).

    -   Data on alcohol and drug related suicides.

    -   Coroner reporting of substance related suicides.

    -   Toxicological analysis of all suicide victims.

-   Improvement of or creation of data sources dealing with alcohol or
    drug associated traffic accidents or other accidents.

    -   Uniform consistent drug and alcohol testing of all victims.

    -   More detailed reporting of non-traffic accidents (falls,
        industrial accidents, recreational accidents).

-   State/campus college population's consumption/consequence data
    collection.

-   Age 18 and older consumption/consequence data.

-   Data reported in consistent age cohorts or individuals years across
    most indicators.

    -   Calculation of disability adjusted life years (DALYs) and/or
        years of potential life lost (YPLL) for mortality and morbidity
        data.

-   Parish level tobacco sales.

    -   Include data pertaining to citations given for sales to minors.

-   Parish level alcohol and tobacco sales.

    -   Include data pertaining to citations given for sales to minors.

-   Improved substance related data collection on risk questionnaires
    (HIV/AIDS, STDs, hepatitis C).

-   Non-mortality accident data (injury data).

-   Child Welfare Populations:

    -   Limited and inconsistent methods of identifying and recording
        substance use/abuse in relation to validated complaints of child
        maltreatment.

    -   No data fields available in data system for capturing
        information learned about substance abuse in families following
        a validated complaint of maltreatment when there is continued
        agency involvement with the family.

    -   No data fields available for recording alcohol or other
        substance abuse by youth who are served in the foster care
        system.

#### *Problem Statement: Data Integration*

####  {#section-1 .Problem/Solution}

A comprehensive array of prevention resources must be guided by
community data that measures the rates of substance use behaviors,
delineates factors demonstrated to influence the prioritized substance
use behaviors, and provides focus toward the problems related to
substance misuse and abuse. Without such data, it is impossible for
local collaborators to focus limited resources on priority problems, or
determine whether or not their efforts are changing substance use rates
within these targeted populations.

Louisiana has identified a number of data gaps. While numerous state
level data sets are available, there is limited parish or community
level data. For example, there are state level youth data available for
6^th^ 8^th^, 10^th^, and 12^th^ grade students measuring substance
consumption and some consequences, but there are also gaps in some of
the parish level data indicators available to the state, making it
difficult to compare or rank parish data across the state. Indicators of
consumption by college students, college-age adults not in college, and
older adult data are significant gaps. Another problem is the lack of a
centralized data system to house state data. There is a need to make the
data accessible at state, regional, parish, and community levels for
strategic planning. Developing a system (e.g. GIS mapping) to make data
readily understood for lawmaking, planning, and resource allocation is
needed. Other gaps include emergency room reports of substance related
injuries, arrest data on substance related crime, specific data on
substance related suicides, information on alcohol and tobacco sales,
and data concerning child maltreatment related to substance abuse.

It is intuitive that the creation and improvement of these types of data
sources involve cooperation of many different entities and will require
significant effort. The Drug Policy Board has mandated an annual SEW
report and has agreed to request data from state agencies on an annual
basis.

#### *Goal 1A*

By 2009, the Louisiana substance abuse prevention system will be served
by a coordinated, multi-agency data collection and reporting system that
provides the most current information about populations, needs,
resources and system readiness that is used by state agencies and
organizations to guide the work of the Louisiana substance abuse
prevention system.

#### *Goal 1B*

By 2009, all Louisiana parishes will have access to and regularly
utilize a coordinated, multi-agency data collection and reporting system
that provides the most current information about population needs and
guides the substance abuse prevention efforts of local prevention
coalitions, community agencies, and organizations.

#### *Long-Term Outcome* 

By 2009, Louisiana will have a coordinated data collection, warehousing,
and reporting system that measures substance abuse and consequence rates
as well as intervening variables at the state, regional and local levels
as measured by:

-   Annually updated needs assessment, including measures of substance
    abuse consequences and intervening variables,

-   Annually updated assessment of local substance abuse prevention
    resources,

-   Easily accessible data bank that contains a variety of prevention
    data including needs and resource assessment, readiness assessment,
    and evaluation.

#### *Immediate Outcomes (FY 2007)*

By 2007, the State will collect valid and reliable indicators of
environmental conditions which influence the demand for and supply of
substances, the availability of substances, enforcement of policies to
regulate substance sales, use and access, and the consequences of
substance use/abuse among youth, young adults, adults, and special
populations as measured by the completion of State and parish data
reports.

By 2007, each SPF targeted community will complete an assessment of
community readiness to address substance abuse issues. Readiness will be
measured by the implementation of an augmented version of NIDA's
community readiness instrument with opinion leaders in each parish
targeted with SPF-SIG funding.

By 2007, each SPF targeted parish will have a thorough assessment of
local resources that identifies all funds that support substance abuse
prevention efforts, their use and reach in each parish as measured by
completion and submission of the resource assessment instrument.

#### *Intermediate Outcomes (FY 2008)*

By 2008, Louisiana will collect valid, reliable youth survey data and
surveys of college campus populations that assess the incidence and
prevalence of substance use behaviors (especially alcohol, tobacco,
methamphetamines, and other targeted substances) and risk and protective
factors which have been demonstrated to influence substance use
behaviors from a representative group of youth in each community,
parish, region, and the State overall, as well as archival indicators as
measured by biannual publication of state, parish, and school/college
campus survey data and archival indicator reports.

By 2008, Louisiana will establish a collection of valid and reliable
measures of substance use/abuse behaviors and factors that influence
use/abuse among adults as measured by the publication of state and
parish and local needs and resource assessment reports incorporating
assessments of high risk and/or special populations.

# II. Assessing the Systems: Capacity and Infrastructure

Several steps were taken to assess the capacity of the state and of the
20 initial prioritized parishes to be able to embed the SPF-SIG process
and produce the targeted outcomes. The first step for the Core Team was
completion of a resource assessment for all parishes based on all known
funding that targets changes in consumption of either alcohol, tobacco
or other drugs among 12 to 29 year olds. The second step for the Team
was to assess their individual agency's capacity as well as the state
system's capacity to embed the SPF-SIG process throughout Louisiana. And
third, the Team assessed the leadership capacity of each of the 20
initial prioritized parishes to begin this process.

#### *Systems Capacity for Service -- Resource Assessment*

Louisiana receives twenty-six million dollars from federal sources and
nearly eleven million dollars from state sources annually to address
substance abuse and its related consequences. However, these funding
streams are generally separate and distinct from one another. More times
than not, even when the separate funding streams are administered within
the same agency or department, the funds and more importantly their
scopes of work are kept distinct. This separation of effort leaves the
state resource poor in terms of personal and prevention outcomes. The
continual high rates of alcohol consumption and consequences, despite
the years of efforts by many state agencies, are testament to the
inadequacies of the present system design.

State agencies that receive substance abuse prevention resources and
funds or provide prevention related services were asked to complete a
resource scan detailing the substance abuse prevention related
activities funded within the 20 initial prioritized parishes. The
resource scan, implemented by the Core Team through the *Applied*
Pathways process, captured information about prevention activities
including the population and geographic area targeted, the targeted
outcome (e.g. consequence, drug, intervening variable) the types of
strategies employed, whether or not the policy, program or practice was
evidence-based, what kind of evaluation data is collected to assess and
document effectiveness, the amount of funding allocated for the policy,
program or practice, and the skills and other resources needed to
effectively implement the strategy.

This assessment revealed the following conclusions regarding *state
systems implementation*:

-   Coalition partnerships must be transparent to build relationships
    and trust to set aside personal and/or agency agendas in order to
    work together toward a common goal;

-   Different agencies have different regional alignments which
    complicates coordinated effort;

-   Important to assess available infrastructure needed to support
    intended scope of work;

-   Lack of depth in resource information;

-   Limited resources to reach identified problems;

-   May be spending prevention dollars on programs that may not be
    connected to prevention;

-   Multiple agencies funding the same programs, with the same outcomes,
    in the same parish through the same sub-state agent;

-   Resource assessment process is important but needs to be well
    understood to eliminate inaccuracies among varying definitions of
    terms and language; and

-   Resources may serve a region but not serve every parish in that
    region.

This assessment revealed the following conclusions regarding *parish
service delivery:*

-   Duplication of effort in some parishes and nothing implemented in
    other parishes;

-   Funded programs do not necessarily address substance abuse issues
    specifically;

-   Huge gaps in targeted services (especially young adult) appeared in
    our greatest problem areas;

-   Areas identified as hot spots (prioritized parishes) that have
    significant funding do not consistently have those funds applied to
    address the identified problem;

-   Increased level of imprecision with targeted outcomes and selected
    intervention;

-   Limited reach of programs; and

-   Substance abuse prevention funds not always targeting substance
    abuse prevention outcomes.

#### *Systems Capacity to Address and Sustain the Intended Prevention Outcomes*

#### *Internal Capacity*

Internal agency capacity is the ability to build, support, and
strengthen infrastructure to ensure an adaptive system that is receptive
to change. Louisiana will build, support, and strengthen its
infrastructure through the Drug Policy Board with support of the two
standing committees, the Prevention Systems Committee and the State
Epidemiological Workgroup.

#### *State Capacity and Role of the State Advisory System*

#### *Louisiana Drug Policy Board*

The Louisiana Drug Policy Board advises the Governor's Office on
substance abuse issues. The Drug Policy Board is created by statute and
has 14 members whom are appointed by the Governor and are subject to
confirmation of the Senate.

+---------------------------------------------+------------------------+
| **Louisiana Drug Policy Board**             |                        |
+=============================================+========================+
| Secretary of Department of Health and       | Michael Duffy,         |
| Hospitals or if he designates, the Director |                        |
| of the Office for Addictive Disorders       | Assistant Secretary    |
|                                             |                        |
|                                             | Office for Addictive   |
|                                             | Disorders              |
+---------------------------------------------+------------------------+
| Secretary of the Department of Public       | Richard Stalder        |
| Safety and Corrections                      |                        |
+---------------------------------------------+------------------------+
| Superintendent of State Police              | Col. Henry Whitehorn   |
+---------------------------------------------+------------------------+
| Secretary of the Department of Social       | Ann Williamson,        |
| Services                                    | Secretary              |
|                                             |                        |
|                                             | Joel McLain, Designee  |
+---------------------------------------------+------------------------+
| Director of the Louisiana Commission on Law | Michael Ranatza        |
| Enforcement                                 |                        |
|                                             | Debbie Maggio, Proxy   |
+---------------------------------------------+------------------------+
| Superintendent of Education                 | Cecil Picard           |
|                                             |                        |
|                                             | Felecia Johnson,       |
|                                             | Designee               |
+---------------------------------------------+------------------------+
| Commander in Chief of the National Guard    | Major Bennett          |
|                                             | Landreneau             |
+---------------------------------------------+------------------------+
| Representative of a Private Organization    | Melanie Stockstill     |
| involved in Substance Abuse Prevention, to  |                        |
| be selected by the Governor                 |                        |
+---------------------------------------------+------------------------+
| Representative of the President of the      | C. Brent Coreil        |
| District Attorney's Association             |                        |
+---------------------------------------------+------------------------+
| Representative of a Federal Agency with     | George Cazenavette, IV |
| Responsibilities in Alcohol and Drug Abuse  |                        |
| Education, Treatment, or Prevention         | Drug Enforcement       |
|                                             | Administration         |
+---------------------------------------------+------------------------+
| Attorney General                            | Attorney General       |
|                                             | Charles C. Foti, Jr.   |
|                                             |                        |
|                                             | Nicholas Gachassin,    |
|                                             | Jr., First Assistant   |
|                                             | Attorney General,      |
|                                             | Designee               |
+---------------------------------------------+------------------------+
| Representative of or the President of the   | Sheriff Richard        |
| Louisiana Sheriff's Association             | Edwards                |
+---------------------------------------------+------------------------+
| Chairman of the Louisiana Commission on     | Kathy Hayward          |
| Alcohol and Drug Abuse                      |                        |
+---------------------------------------------+------------------------+
| Representative of the Indigent Defender     | Michael Mitchell       |
| System                                      |                        |
+---------------------------------------------+------------------------+

Because of its status as a permanent board of Louisiana state
government, the Drug Policy Board is well positioned to increase state
capacity and to collaborate across state agencies to ensure data driven
outcome based planning for substance abuse prevention. The board is
mandated to:

-   Identify, examine, select or develop, recommend or implement, drug
    control policies and strategies to more effectively combat illicit
    drugs and alcohol abuse;

-   Stress a coordinated approach emphasizing application, or needed
    revisions, of enforcement capabilities targeting drug use, sale, and
    supply;

-   Identify, examine, select or develop, recommend or implement, demand
    reduction measures such as education, prevention, treatment,
    rehabilitation, and public awareness;

-   Receive reports of the allocations and expenditures of all federal
    anti-drug abuse funds earmarked for education, treatment,
    rehabilitation, and law enforcement;

-   Evaluate how anti-drug monies, both state and federal, are utilized
    in implementing anti-drug programs at the state and local agencies;

-   Evaluate changes in the methods or priorities of the allocation of
    funds to state and local agencies;

-   Identify and evaluate the effectiveness of state and local public
    awareness and drug prevention programs in both the public and
    private sectors, in order to develop a series of recommendations for
    improving the effectiveness of such programs;

-   Evaluate specific problem areas relating to the enforcement of drug
    laws and make recommendations in order to improve the impact of
    those laws through legislative refinement or executive order;

-   Assess the roles and interaction of federal, state, and local law
    enforcement agencies and operations in combating drug abuse and
    trafficking, with recommendations for improving the effectiveness of
    multi-jurisdictional operations throughout the state;

-   Provide an interim report to the governor regarding findings,
    activities and recommendations by July 1, 1991 and thereafter at
    least on a quarterly basis or more often if deemed necessary by the
    governor or the board;

-   Develop long and/or short range plans or strategies that prioritize
    areas of need or otherwise organize the use of resources;

-   Seek assistance or support from any state agency or private sector
    entity which may be helpful in diminishing or eradicating drug and
    alcohol abuse; and

-   Adopt and promulgate rules as may be necessary to implement this
    part.

In April of 2005, the Drug Policy Board affirmed the creation of the
State Epidemiological Workgroup and the Prevention Systems Committee.

#### *Prevention Systems Committee*

The Prevention Systems Committee will provide policy recommendations
that assure implementation of the Strategic Plan. The Core Team will be
consolidated into the Prevention Systems Committee, assuring that the
capacity to utilize the SPF-SIG process begins at the state level and is
mirrored at the regional and community level. This committee will model
the work expected of the parish coalitions. Accountability is expected
at all levels of implementation: state, regional, and community.

The committee includes the following:

+----------------------------------+-----------------------------------+
| **Prevention Systems Committee** |                                   |
+----------------------------------+-----------------------------------+
| **Agency**                       | **Members**                       |
+----------------------------------+-----------------------------------+
| **At Large**                     |                                   |
+----------------------------------+-----------------------------------+
| LA Office of Youth Development   | Melba Oubre                       |
+----------------------------------+-----------------------------------+
| LA Dept. of Health & Hospitals   | Bernetta Hebert                   |
|                                  |                                   |
| Office for Addictive Disorders   |                                   |
+----------------------------------+-----------------------------------+
| LA DHH-Office for Addictive      | Bob Sawyer                        |
| Disorders                        |                                   |
|                                  |                                   |
| Regulatory Authority             |                                   |
+----------------------------------+-----------------------------------+
| Attorney General                 | Cathy Childers                    |
+----------------------------------+-----------------------------------+
| Governor's Office of Community   | Charles Tate                      |
| Programs                         |                                   |
+----------------------------------+-----------------------------------+
| Louisiana National Guard         | Donna Jones                       |
+----------------------------------+-----------------------------------+
| LA Office of Mental Health       | Dr. Brandon Romano                |
+----------------------------------+-----------------------------------+
| Southern University Psychology   | Dr. Murelle Harrison              |
| Department                       |                                   |
+----------------------------------+-----------------------------------+
| LSU School of Human Resource     | Dr. Reid Bates                    |
| Education and Workforce          |                                   |
| Development                      |                                   |
+----------------------------------+-----------------------------------+
| LA Dept. of Education            | Felicia Johnson                   |
+----------------------------------+-----------------------------------+
| Jefferson Parish District        | Freddie Landry                    |
| Attorney                         |                                   |
+----------------------------------+-----------------------------------+
| LA Commission on Law Enforcement | Freddia Dunn                      |
+----------------------------------+-----------------------------------+
| Drug Enforcement Administration  | George Cazenavette                |
+----------------------------------+-----------------------------------+
| Governor's Drug Policy Board     | Jan Devillier/Seton Jenkins       |
+----------------------------------+-----------------------------------+
| LA Students Against Destructive  | Janice Williams/DC Sills          |
| Decisions                        |                                   |
+----------------------------------+-----------------------------------+
| ULL-Center for Child Development | John LaCour                       |
+----------------------------------+-----------------------------------+
| Center for Substance Abuse       | Jon Dunbar Cooper                 |
| Prevention                       |                                   |
+----------------------------------+-----------------------------------+
| LA Office of Public Health       | Jorli Wales                       |
+----------------------------------+-----------------------------------+
| LA Commission on Addictive       | Kathy Hayward                     |
| Disorders                        |                                   |
+----------------------------------+-----------------------------------+
| Mothers Against Drunk Driving    | Kimberlie Kelly                   |
+----------------------------------+-----------------------------------+
| LA Dept. of Social Services      | Lynn Farris                       |
+----------------------------------+-----------------------------------+
| LSUHSC Juvenile Justice Program  | Stephen Phillipi                  |
+----------------------------------+-----------------------------------+
| Drug Court Program Director,     | Scott Griffith/Jamie Pena         |
| Louisiana Supreme Court          |                                   |
+----------------------------------+-----------------------------------+
| **Of Counsel**                   |                                   |
+----------------------------------+-----------------------------------+
| LA Dept. of Public Safety &      | Bob Thompson                      |
| Corrections-Commission on        |                                   |
| Highway Safety                   |                                   |
+----------------------------------+-----------------------------------+
| LSU Ag Center                    | Dr. Deborah Tootle                |
+----------------------------------+-----------------------------------+
| LA TECH, Health and Exercise     | Dr. Tommy Grafton                 |
| Science                          |                                   |
+----------------------------------+-----------------------------------+
| LA Association of Non-Profit     | Melissa Flournoy                  |
| Organizations                    |                                   |
+----------------------------------+-----------------------------------+
| Region VII Office for Addictive  | Trudie Abner                      |
| Disorders                        |                                   |
+----------------------------------+-----------------------------------+

The significant outcomes for this merged body will be to:

-   Achieve and mobilize for greater advocacy;

-   Expand services (comprehensiveness, reach, duration, dosage);

-   Expedite the work of members;

-   Collaboratively identify and fill gaps;

-   Reduce duplication; and

-   Share what is known about needs of those served (interagency
    communication).

The function of this merged body will be to continue the following
efforts:

-   Agreements in place concerning data collection;

-   Agreements in place through action plans for each agency's part of
    the strategic plan;

-   An implementation plan to assure sustainability of the plan and
    movement toward its outcomes;

-   Ascertain from evaluation reports whether targeted outcomes are
    being achieved by funding;

-   Assist in the development of common procedures across funding
    streams;

-   Consider how HIPPA hinders/assists collection of data;

-   Consider what steps can be taken to align regional boundaries;

-   Examine current state level practices that assure
    assessment/evaluation of parish level resource information;

-   Create policies that facilitate collection of evaluation data;

-   Develop procedures to assure implementation fidelity of services
    supported by all funds in the state;

-   Reactivate/create single point of access for funds that come into
    the state; and

-   Review policies/procedures in place to assist and facilitate SEW and
    local coalitions with collection of sub-state data.

Analysis of internal capacity reveals a number of barriers that may
impede full participation by all agencies and organizations in
development of the state's prevention system. These barriers are:

-   Dynamic between messenger and listener breaks down because of a
    failure to tailor the message to audience and/or previous
    relationship between parties;

-   Insecurity and personal lack of understanding roles;

-   No intentional agency plan or process to think through the effort
    and how its work connects with other efforts;

-   Lack of understanding or misunderstanding of the use of
    data/information/ resources

-   Personal loss of control/turf/influence; and

-   See little return on previous investments of resources in substance
    abuse prevention and/or coalition work.

#### *State Epidemiological Workgroup*

The third aspect of the advisory process is the State Epidemiological
Workgroup. The SEW, along with the Prevention Systems Committee, will
remain permanent committees of the Louisiana Drug Policy Board as
approved by the Board in April, 2005. Each committee meets regularly to
expand and update the impact of the State's work to reduce the
consumption and consequences of alcohol, tobacco and other drug misuse
and abuse. This legislated body will assure continuation of this effort
and design long after the SPF-SIG funds have ended. Members of the
present SEW are listed below:

  ----------------------------------- -----------------------------------
  **State Epidemiological Workgroup** 

  **Agency**                          **Members**

  Drug Enforcement Administration     George Cazenavette

  Attorney General                    Cathy Childers

  Southern University Psychology      Dr. Murelle Harrison
  Department                          

  Office of Public Health             Dr. Gary Balsamo

  Louisiana Supreme Court             Chris Andrieu

  ULL-Center for Child Development    Dr. Gary Asmus

  DSS-OCS                             Frank Broussard

  Office of Motor Vehicles            Gloria Jones

  I/T-DHH-OAD                         Jacques Kado

  Office of Alcohol and Tobacco       Ronald Kinchen
  Control                             

  DOTD                                Dan Magri

  LSU Campus Community Coalition for  Dr. Nancy Mathews
  Change                              

  DOA-Office of Electronic Services   Joan McGee

  LCLE                                Robert Mehrtens

  LSUHSC School of Medicine           Dr. Steve Nelson

  DOA-Office of Electronic Services   Karen Paterson

  Dept. of Education, Title IV        Monique Preau

  Drug Enforcement Administration     Henry Richardson

  LSU ISDS Research Group for Highway Dr. Helmut Schneider
  Safety                              

  DHH-OPH-Vital Statistics            Robert Starszak

  LSU School of Public Health,        Dr. Katherine Theall
  Epidemiology                        

  Louisiana Highway Safety Commission Bob Thompson

  DSS-OFS-Program Policy              Nancy Wright

  ULL-Center for Child Development    Ray Biggar

  Capital Area Human Services         Vivian Gettys
  District                            
  ----------------------------------- -----------------------------------

#### *External Capacity: Bridging State and Parish Activities* 

External systems capacity is needed to assure the long-term viability
and integration of new or refined processes, practices, and policies
within a community and between organizations. A significant effort of
the state's strategic plan is to embed the SPF-SIG process within the
SPF targeted parishes initially, and to extend to other parishes as the
long term goal. The intended result will be the development of a
centralized management system with decentralized execution to carry out
the mission to achieve parish and eventually statewide outcomes. To do
this, all key state systems must work together through an enhanced
technical assistance network. To guide the development of this network
that will support the work with the parishes, the members of the Core
Team developed a rubric to determine what areas of technical assistance
should be provided over the initial life of the effort, as well as which
state system or systems should lead in coordinating this effort.

#### *Technical Assistance Network* 

#### *Function and Role*

The Technical Assistance Network will be developed to support the
integration of the SPF-SIG process in parishes and support development
and implementation of the coalition strategic plans. Technical
Assistance Network members will be recruited from different agencies
and/or organizations to provide technical assistance and support to the
community effort. The intent is to connect the wide array of resources
and support in order to sustain the intended outcomes and reduce
substance abuse in Louisiana. The Network will remain fluid as to
identification of geographic divisions of network service areas, and
timeline for development of service area. Integration of technical
assistance to service areas throughout the state will be developed
during the implementation plan process.

The Technical Assistance Network must:

-   Be trained and skilled at implementing the *Applied* Pathways
    resource assessment and leadership assessment tools to assure
    reliability of the collected information,

-   Be connected to the community coalitions to assure cultural
    competency in the work,

-   Be comprised of multi-sector participants who have varied skill sets
    with an emphasis on having representation within its membership from
    parishes that are not targeted for SPF funding to assure
    sustainability of the process, and

-   To enhance coordination of technical assistance expertise across the
    state by the elimination of specific agency regional configurations
    and funding commitments.

*Financial, Human and Technical Skill Set Needed*

The Technical Assistance Network must be sustainable in order to support
a coalition system and provide appropriate technical assistance to
communities based on identified needs, including but not limited to:

-   Leadership;

-   Readiness: community and agency;

-   Data-driven decision-making (increase understanding of the value of
    data);

-   Data system development (collection and utilization);

-   Needs assessment;

-   Resource assessment;

-   Strategic planning;

-   Evidence-based practice, policies, and procedures;

-   Leveraging resources;

-   Coalition building;

-   Mobilization;

-   Financial/business model.

The members of the Core Team agreed that one agency should serve to
coordinate this effort, but that the technical support to the parishes
may be provided by various agencies depending upon interest, capacity,
and resources. Regardless of which agency provides technical assistance
the required capacities are:

-   Adequate staff resources and time available;

-   Formal commitment;

-   Geographical location in order to meet local needs.

The Technical Assistance Network should be:

-   Actively involved in on-going training to keep skills and knowledge
    current;

-   Diverse in power (capabilities and backgrounds), politics
    (leadership), position (willingness to embrace the effort);

-   Conduit of knowledge from federal and state levels to the
    community-level;

-   Objective.

Although the centralized management will continue to be led by the
Governor's Office, four possible systems were discussed to lead the
technical assistance effort: Tobacco Free Living, Office for Addictive
Disorders, Office of Public Health, and the Louisiana Association of
Nonprofit Organizations. All four will be considered for participation
in some manner but the lead partner for developing the technical
assistance system will be the Management Team.[^2]

This long-range system enhancement is intended to lead to the following:

#### *Needs Assessment Capacity*

-   Assist local communities to understand how data can lead to
    identification of problems;

-   Develop local structure, with the SEW, to generate consistent
    objective data; and

-   Support parishes to identify what is and is not working (data) in
    the parishes.

#### *Technical Assistance Support Capacity*

-   Achieve the outcome of reduction of alcohol abuse;

-   Ability to build and strengthen local coalitions;

-   Connect communities to present resources to increase awareness of
    available funds;

-   Create an alignment between support provided by state and local
    needs;

-   Help local members address local turf battles and eliminate
    duplication; and

-   Through the *Applied* Pathways process build a support system to
    solve local problems.

#### *Technical Assistance Network to Increase State-Parish Communication/Collaboration*

-   Increase communication/collaboration between state and appropriate
    local agencies to identify local problems and support local problem
    solving; and

-   Increase local understanding of and opportunity provided by the
    revised system.

#### *Resource Assessment*

#### *Leadership Capacity to Address the Intended Prevention Outcomes*

The resource assessment revealed two unanswered questions:

-   Does the absence of resources mean that the parish needs SPF-SIG and
    therefore goes to the top of the priority list, or rather that the
    system is in such disarray that the parish is not at a level of
    readiness for the SPF-SIG?

-   Does having significant, although perhaps misdirected, resources
    mean that the community is ready for the change SPF-SIG requires or
    instead will fight the SPF-SIG change process at every turn?

The internal capacity assessment left a lingering question as well:

-   What is the timeframe and the expectation for the state to make the
    changes needed within the state systems?[^3]

The external capacity assessment left two questions unanswered as well:

-   How many parishes does the State have the ability to provide direct
    assistance to in their parish implementation of the SPF-SIG?

-   Who should lead this effort at the local level?

To begin to address the lingering questions from the resource assessment
and the external capacity assessment, the Core Team implemented the
*Applied* Pathways Leadership Assessment Tool[^4]. This process,
although initially limited in scope, provided a preliminary indication
of the readiness of the parishes to recognize that the issue of
substance abuse is a top priority for action, accept their role in
creating a sustainable and effective response, and allow necessary
changes in approach to occur within the parish.

Based on the prioritized problem areas and identified hot spots
(prioritized parishes), the Core Team assessed the leadership capacity
of three systems with the greatest stake in substance use prevention
outcomes in the state. These systems are the Office for Addictive
Disorders, the Office of Public Health and the Safe and Drug Free
Schools and Communities Programs. Committed leadership within these
systems is considered critical to the successful attainment of
SPF-SIG/strategic plan outcomes in each targeted parish.

Each key leader interviewed was asked the same set of questions in the
same order with the intent to assess the extent to which the 20 initial
prioritized parish communities view substance use as a problem. Key
leader interviews were attempted by phone with parish representatives
when possible, with the use of regional representatives when no parish
representative existed. In all, 47 interviews were conducted with a
maximum of 3 and a minimum of 1 interview for each of the 20 initial
prioritized parishes.

Initial conclusions:

-   Lack of readiness of the state system to simultaneously support the
    integration of the SPF-SIG model in all 20 initial prioritized
    parishes which are spread out across the state;

-   Little apparent connection between a leader's willingness to address
    substance abuse and the level of resources presently available in
    the parish;

-   No consistent agreement as to the agency or organization most
    essential to achieve outcomes of reduced substance abuse and
    therefore should be left to a parish level decision;

-   Some individuals may not fully understand the necessary connections
    across systems that can assist to provide an objective assessment of
    the present use of substance abuse resources; and

-   The parishes demonstrating the greatest level of readiness to begin
    the process were: Avoyelles, Evangeline, Jefferson Davis, Lafayette,
    St. Charles, St. Mary, Terrebonne, Calcasieu, Franklin, and Rapides.

Therefore, the Core Team concluded that a smaller number of parishes
should be targeted for SPF-SIG implementation in order to have the level
of support necessary to adequately begin the SPF-SIG model. Parishes
that do not make the final selection will be targeted for support
through the Office for Addictive Disorders and will benefit from the OAD
regional staff's initial training in the *Applied* Pathways Process, the
annual report provided by the SEW, and the TAN as their work is extended
beyond the initial SPF targeted parishes.

The initial parishes confirmed for SPF-SIG funding are those that have
percentages of substance abuse higher than the state in at least two of
the three prioritized categories. These parishes are targeted for
SPF-SIG support regardless of their level of readiness: Calcasieu,
Jefferson Davis, Lafayette, Orleans, St. Landry, and Terrebonne.

Second, all these parishes have alcohol as one of the two substances
that is used at levels higher than the state average. In addition, the
first priority set by the Core Team, based on the initial assessment of
the SEW report in February, is alcohol. Alcohol use in Louisiana by
underage youth contributes to a variety of problems including alcohol
related motor vehicle injuries and deaths, as well as violent crime such
as rape, battery, and homicide. The Louisiana Caring Communities Youth
Survey (CCYS) is a survey of 6^th^, 8^th^, 10^th^, and 12^th^ grade
students designed to identify adolescent substance use, antisocial
behavior, and risk and protective factors related to these behaviors.
The survey was conducted in the spring of 2001, the fall of 2002, and
the fall of 2004. For 8^th^ and 10^th^ graders, the percentage of
respondents indicating recent alcohol use was above the national average
for all three years. For 12^th^ graders, the percentages were higher
than the national average in 2001, but in 2002 and 2003 were nearly
identical to national averages. The percentages of adults reporting
driving after drinking in the year prior to completion of the Behavioral
Risk Factor Surveillance Survey (BRFSS 1999 and 2002) was above the
national average in all age groups in the 1999 survey. In the 2002
survey, the percentages of adults reporting driving after drinking was
well above the national average in 18 to 29 years of age. This led to
the decision to target all parishes high in alcohol consumption and
consequences for SPF funding.

The selected parishes for initial SPF-SIG support as shown in the map on
the following page are:

1.  Orleans

2.  Terrebone

3.  Lafayette

4.  St. Landry

5.  Jefferson Davis

6.  Calcasieu

7.  St. James

8.  Evangeline

9.  Cameron

10. West Baton Rouge

11. Tangipahoa

12. St. Mary

![](media/image5.png){width="7.218055555555556in"
height="5.9430555555555555in"}

Red parishes determined to be above the state average in 2 or more
indicators of substance use.

Blue parishes determined to be above the state average in alcohol
consumption and consequences.

#### *Problem Statement: Systems Capacity/Infrastructure*

#### *State*

Currently infrastructure and collaborative capacity are limited across
the state of Louisiana. While state agencies are in place to support
programs and initiatives throughout Louisiana, they lack a coordinated,
systematic approach to address substance abuse and the consequences that
result from substance use and abuse.

In order to reduce the consequences that result from substance use and
abuse for all Louisiana citizens, a greater capacity and coordination at
the state and parish level are required to implement and sustain
evidence-based programs, policies, and practices that are data driven
and outcome based.

#### *Community* 

At the present time local communities are not postured to effectively
address the consequences of substance abuse and use. Most Louisiana
parishes lack organizational structure, skills, and capacity needed to
assess needs and resources and mobilize capacity to effectively address
community substance abuse consumption and consequences. A technical
assistance system is critical to assist parishes in assessing resources
and capacity in order maximize and leverage resources, as well as
expertise to implement evidence-based policies, programs, and practices
that are data driven and outcome based. Community coalitions with
organizational capacity to assess, mobilize, leverage, and direct
available resources are needed to develop and ensure the implementation
of a strategy to reduce targeted substance use behaviors and related
consequences.

#### *Goal 2A*

By 2009, the state of Louisiana will have a coordinated, culturally
competent substance abuse prevention system that elicits, motivates and
coordinates the best efforts, ideas and resources of all state
organizations, agencies, entities, and individuals who volunteer or can
be conscripted to support the prevention of substance abuse issues
across the state.

#### *Goal 2B*

By 2009, Louisiana SPF-SIG parishes will have a certified coalition that
has the skills and capacity to assess local needs and resources and is
guided by a strategic plan that coordinates local resources to address
prioritized alcohol, tobacco, and other drug consumption problems and
consequences.

#### *Long-Term Outcome* 

By 2009, Louisiana will have a coordinated substance abuse prevention
system guided by a common vision and comprehensive strategic plan that
relies on data to identify priorities that will lead to funding of local
community strategic prevention plans that include culturally
appropriate, comprehensive evidence-based strategies that will change
local population substance abuse and consequence rates as measured by:

-   Formalized documents that include comprehensive strategic plan,

-   Interagency agreements that support coordinated efforts,

-   On-going updating of the needs and resource assessment,

-   Utilization of data to determine funding decisions,

-   Increased evidence-based strategies,

-   Reduced duplication of services,

-   Evaluation of prevention efforts, and

-   Decreased substance abuse and consequence rates in targeted
    populations.

#### *Immediate Outcomes (FY 2007)*

By 2007, SPF targeted communities will have a formalized coalition with
multi-sectoral representation, which will have adopted a shared vision
of preventing the incidence and reducing the prevalence of substance use
and sustaining effective coordinated, comprehensive prevention
strategies to achieve outcomes as measured by:

-   A strategic plan,

-   Formalized by-laws,

-   A conflict resolution policy, and

-   Meeting summary notes.

#### *Intermediate Outcomes (FY 2008)*

By 2008, each community coalition will collect and use local youth
survey and archival data to assess substance abuse prevention needs,
identify gaps in prevention services, focus local efforts on prioritized
needs, mobilize resources, and evaluate changes in targeted risk and
protective factors and substance using behaviors as measured by:

-   An ongoing, updated needs assessment that relies on local, regional,
    and state data,

-   A local substance abuse prevention resource assessment,

-   A gaps analysis, and

-   An implementation plan that aligns with the State strategic plan.

By 2008, each community coalition will demonstrate sustained
multi-sectoral coordination of planning and evaluation of substance
abuse prevention efforts across the parish as measured by:

-   Reduced duplication of services and increased comprehensiveness of
    prevention strategies to address prioritized needs,

-   Interagency agreements to braid funding for prevention efforts,

-   Meeting summary notes indicating all efforts are evaluated, and
    evaluation results are shared, discussed, and used by the coalition
    for future decision-making.

# III. On Going Planning Activities

The 2006-2010 Louisiana Strategic Plan for Substance Abuse Prevention is
comprehensive, an essential step in the five phase SPF-SIG model. The
plan sets the stage for work required by steps 4 and 5 (implementation
and evaluation). Once completed, the intent of the Louisiana Drug Policy
Board is for the SPF model to be implemented in all 64 parishes. This
will include the production of an annual implementation plan by the
state system that responds to the emerging evaluation and assessment of
outcomes, need, and capacity. This will include the integration of the
model, through the implementation of the *Applied* Pathways process
first in the 12 SPF targeted coalitions and thereafter across the state.
Finally, Louisiana utilized a hybrid planning model, targeting 12
parishes with the highest incidence of alcohol related consequences
and/or consumption for funding while also building capacity among
parishes throughout the state to implement the SPF process in order to
reduce consequences of tobacco and other drug use.

#### *State Planning Model*

This plan and SPF-SIG model will put into place a coordinated mechanism
for funding, planning, and evaluation at the state and emerging at the
parish community. State agencies will realign data collection and
reporting, funding and planning mechanisms to assist coalitions and
their providers as well as the work of the SPF-SIG. This realignment
will shift funding allocations from separate funding streams to
comprehensive braiding of effort that targets the needs of the
particular communities the agencies serve. A process will be in place to
expand the reach of the SPF-SIG to more coalitions with the intent that
all 64 parishes will eventually be served by coalitions that are trained
in the *Applied* Pathways process and have developed a strategic plan
and sustainability plan that addresses use of alcohol and other drugs.

The state planning follows the SPF-SIG model using the *Applied*
Pathways process. This process enables the system to debate ideas,
deliberate action steps, and decide difficult issues. The process
encourages agencies and organizations represented on the Drug Policy
Board, the Prevention Systems Committee/Core Team, and the State
Epidemiological Workgroup to strengthen the State's prevention system.
The purpose of the process is to coordinate and braid resources
necessary to create a system that is inclusive of perceptions and
perspectives, diverse in backgrounds and experiences, and effective to
measure change with the use of valid and reliable data in order to take
actions that strategically target prioritized outcomes that move the
systems towards the State vision and possesses the leadership that is
accountable to itself and others, and most importantly, the citizens of
Louisiana.

The system, comprised of the Drug Policy Board and its two permanent
committees, the SEW and PSC/Core Team, will complete the SPF-SIG model
with the creation of a sustainability plan that will not only propel the
model across all 64 parishes but integrate it within the state
decision-making and funding allocation processes. Agencies involved in
substance abuse prevention efforts (e.g. agency members of PSC and SEW)
will each create an agency plan to implement the shared standards and
state strategic plan. Each agency will provide quarterly progress
updates to the members of the Drug Policy Board.

#### 

#### *Logic Model of Major SPF SIG Activities and Evaluation Issues to be Examined*

The logic model below provides a brief summary of the major SPF SIG
activities and associated evaluation issues. Implementation of the SPF
SIG will take place at two primary levels: state and community.
Implementation of the SPF at the state level will lead to clear state
level needs assessment prioritization, capacity building through greater
inter-agency collaboration and the development/coordination of the
Technical Assistance Network, and the development of state level
sustainability road map which will include the creation of an
implementation, communication and action(s) plans. The immediate goals
described in the logic model associated with SPF implementation are
focused on the increased external (cross agency) capacity including the
development of a Technical Assistance Network that will serve the 12 SPF
targeted communities initially, and eventually be available to
communities throughout Louisiana.

At the community level, immediate goals also focus on capacity building.
The Technical Assistance Network will provide the necessary technical
assistance to community coalitions to facilitate the implementation of
the SPF. As a result of SPF implementation, communities should expect to
impact targeted intervening/causal variables contributing to alcohol use
identified during the assessment phase, and in turn decrease alcohol
consumption patterns in the specified population and the consequences of
alcohol use identified as priorities in the state strategic plan.

+--------------+-----------------+-----------------+-----------------+
| SPF-SIG      | Immediate       | Intermediate    | Long-Term       |
| Process      | Outcomes        | Outcomes        | Outcomes        |
+==============+=================+=================+=================+
| Im           | #######         | ######## Sust   | Strengthen      |
| plementation | # Increased int | ained internal  | established     |
| of 5 SPF     | ernal (agency a | and external ca | connectors      |
| Steps at     | nd organization | pacity enhancem | between state   |
| State Level  | al) and externa | ents of the Sta | and community   |
|              | l (cross agency | tewide Substanc | prevention      |
|              | ) capacity of t | e Abuse Prevent | systems:        |
|              | he Statewide Su | ion System in t |                 |
|              | bstance Abuse P | he areas of sys | -On-going       |
|              | revention Syste | tem alignment,  | prioritization  |
|              | m in the areas  | capacity and br | of substance    |
|              | of system align | oader support:  | abuse outcomes  |
|              | ment, capacity  |                 | and target      |
|              | and broader sup | -Sharing of     | populations     |
|              | port, as eviden | information     |                 |
|              | ced in the foll |                 | -On-going       |
|              | owing outcomes: | -Cross-agency   | assessment of   |
|              |                 | data-driven     | needs and       |
|              | -Increased      | planning        | capacity to     |
|              | sharing of      |                 | address         |
|              | information     | -Funding of     | priorities      |
|              |                 | evidence based  |                 |
|              | ########        | prevention      | -On-going       |
|              | -Increased cros | practices       | communication   |
|              | s-agency data-d |                 | and sharing of  |
|              | riven planning  | -Cross-agency   | data            |
|              |                 | accountability  | assessments and |
|              | ###             | and joint       | evaluation for  |
|              | ### -Increased  | capacity        | planning        |
|              | commitment to f | building        |                 |
|              | unding of evide |                 | -On-going       |
|              | nce based preve | -Leadership     | implementation  |
|              | ntion practices | commitment for  | of culturally   |
|              |                 | use of outcome  | appropriate     |
|              | -Increased      | ba              | interventions   |
|              | cross-agency    | sed/data-driven | that lead to    |
|              | accountability  | planning        | sustainable     |
|              |                 |                 | outcomes        |
|              | -Increased      | ######## Addi   |                 |
|              | joint capacity  | tional capacity | -Shared         |
|              | building        |  enhancements i | responsibility  |
|              |                 | n the areas of: | for on-going    |
|              | -Increased      |                 | evaluation      |
|              | leadership      | -Increased      | needs           |
|              | commitment      | cross-agency    |                 |
|              | (among state    | funding         | -On-going       |
|              | system leaders  |                 | updating and    |
|              | and agency      | -Increased      | revision of the |
|              | heads) for use  | support for     | state strategic |
|              | of outcome      | substance abuse | plan through a  |
|              | ba              | prevention      | transparent     |
|              | sed/data-driven | outside of SA   | process that    |
|              | planning        | prevention      | sustains past   |
|              |                 | agencies        | priorities      |
|              |                 |                 | (substance use  |
|              |                 |                 | and             |
|              |                 |                 | consequences    |
|              |                 |                 | outcomes) and   |
|              |                 |                 | addresses       |
|              |                 |                 | emerging areas  |
|              |                 |                 | of need         |
+--------------+-----------------+-----------------+-----------------+
|              | Create          | Capacity to     | Capacity to     |
|              | accessible,     | provide         | provide         |
|              | multi-agency    | technical       | technical       |
|              | technical       | assistance on   | assistance to   |
|              | assistance      | SPF process to  | coalitions &    |
|              | network skilled | 12 SPF targeted |                 |
|              | in SPF process  | coalitions      | prevention      |
|              | through the     |                 | providers       |
|              | development of  |                 | across all 64   |
|              | the Technical   |                 | parishes        |
|              | Assistance      |                 |                 |
|              | Network         |                 |                 |
+--------------+-----------------+-----------------+-----------------+
| Im           | Technical       | Impact targeted | Reduce alcohol  |
| plementation | Assistance      | intervening     | consumption     |
| of 5 SPF     | Network         | variables       | among 12-29     |
| Steps at     | provides        | (Decrease risk  | years old       |
| Community    | support to      | and increase    |                 |
| Level        | Communities to  | protective      | Reduce          |
|              | enhance parish  | factors) that   | consequences of |
|              | level substance | influence       | alcohol use and |
|              | abuse           | alcohol use     | abuse:          |
|              | prevention      | among 12 to 29  |                 |
|              | capacity:       | year olds       | -Impaired       |
|              |                 |                 | Driving         |
|              | -Increased use  |                 |                 |
|              | of outcomes     |                 | -Injuries       |
|              | ba              |                 | because of      |
|              | sed/data-driven |                 | vehicle crashes |
|              | planning        |                 | due to alcohol  |
|              | process         |                 | use             |
|              |                 |                 |                 |
|              | -Increased data |                 | -Reduced        |
|              | availability,   |                 | criminal        |
|              | accessibility   |                 | justice system  |
|              | and use         |                 | involvement     |
|              |                 |                 |                 |
|              | -Increased      |                 |                 |
|              | internal        |                 |                 |
|              | organizational  |                 |                 |
|              | (coalition)     |                 |                 |
|              | capacity        |                 |                 |
|              |                 |                 |                 |
|              | -Increased      |                 |                 |
|              | cross agency    |                 |                 |
|              | capacity at     |                 |                 |
|              | community level |                 |                 |
|              |                 |                 |                 |
|              | -Increased      |                 |                 |
|              | leadership      |                 |                 |
|              | commitment at   |                 |                 |
|              | community level |                 |                 |
|              |                 |                 |                 |
|              | -Increased      |                 |                 |
|              | support for     |                 |                 |
|              | substance abuse |                 |                 |
|              | prevention      |                 |                 |
|              | outside of SA   |                 |                 |
|              | prevention      |                 |                 |
|              | agencies at     |                 |                 |
|              | community level |                 |                 |
|              |                 |                 |                 |
|              | ####            |                 |                 |
|              | ## -Increased u |                 |                 |
|              | se of evidence  |                 |                 |
|              | based preventio |                 |                 |
|              | n practices at  |                 |                 |
|              | community level |                 |                 |
+--------------+-----------------+-----------------+-----------------+

#### *Community Based Activities*

SPF-SIG funding will support the development of comprehensive community
strategic plans for each of the 12 alcohol target parishes that will
incorporate the most appropriate evidence-based programs, policies, and
practices for seamless service delivery. The SPF targeted parishes will
receive the support of the newly developed Technical Assistance Network
that will serve to embed the SPF-SIG model in each parish through the
implementation of the *Applied* Pathways process. This process will lead
the parishes in assessing their needs and resources, building on
information already compiled by the state, as well as assessing their
leadership capacities with the outcome of creating a highly functioning
community coalition that will implement and evaluate the effort within
the parish or parishes served.

Upon assessment of data provided by the State Epidemiological Workgroup,
the Core Team identified 12 alcohol target parishes: Orleans, Terrebone,
Lafayette, St. Landry, Jefferson Davis, Calcasieu, St. James,
Evangeline, Cameron, West Baton Rouge, Tangipahoa, and St. Mary. These
parishes comprise 29% of the State's population (based on 2005 US Census
data). Upon assessment of the State's capacity to manage and support the
implementation of the SPF process, the Core Team decided to address only
one priority substance with SPF-SIG funding, alcohol. The data collected
through evaluation and work of the State Epidemiological Workgroup will
influence these on-going actions and future policy development
concerning other substance abuse related problems.

The State system (and process) will be mirrored at the community level
through the establishment of certified community coalitions in all SPF
targeted parishes. The SPF coalitions will receive real time support
through development of the Technical Assistance Network.

#### *Allocation Approach*

The SPF targeted parishes will be invited to participate in the SPF-SIG
process and funding. The application for funding will include the
execution of a Memorandum of Understanding entered into by a coalition
on behalf of the parish. This memorandum will assure partnership between
the parish and state and that each will work together to address the
outcomes of the strategic plan, collect national outcome measure data
(NOMS), (including the implementation of a youth and college population
survey, where applicable), and meet fiduciary accountability and other
administrative requirements. The SPF-SIG Management Team, in
collaboration with the Prevention Systems Committee/Core Team, will
develop other specifics concerning funding expectations. No less than
\$50,000.00 of SPF-SIG funds will be allocated to each identified
parish. Additional funds will be disbursed considering the following:
population, capacity, level of risk in comparison to other parishes,
consequence and consumption, and perception of use.

#### *Implications of Allocation Approach* 

The allocation approach described above will ensure that SPF-SIG
resources will be effectively used. The allocation process balances need
with the ability of the state to set up the Technical Assistance Network
within a smaller geographic subset focused on one substance (alcohol)
and a smaller population base (12 to 29 year olds) and therefore move
those SPF targeted parish populations to the outcomes of reduction in
consumption and consequences while establishing a process that will be
replicated throughout all 64 parishes.

Two of the SPF targeted parishes were devastated by Hurricanes Katrina
and Rita. Population displacement in these areas and lack of adequate
infrastructure makes implementation of this process inherently complex.
The initial work will be assessment of capacity to be followed with
consideration and determination of the need for capacity building.

The prioritized (hot spot) parishes identified by SEW data as having
substantial tobacco or illicit consumption and consequence issues are
targeted by the tobacco and illicit drug reduction goals of the state
comprehensive plan and are not targeted for SPF funding. Although not
directly receiving SPF-SIG resources, each of these parishes will be
provided with access to and benefits from the work of the State
Epidemiological Workgroup and the Prevention Systems Committee. The
parishes with illicit drug and/or tobacco related problems, but not
alcohol are: Caddo, Caldwell, East Baton Rouge, Franklin and Rapides.
The parishes for tobacco related problems are Avoyelles and Union. Other
state prevention funding sources will focus on building capacity and
braiding of funds to target and reduce illicit drug use and tobacco
related problems in these parishes. Additionally, as the Technical
Assistance Network is developed and sustained, the Network will be
available to provide technical assistance and support to non-SPF funded
parishes.

The SEW will assist to assure that the data collection instrument and
collection process at the parish/coalition level is conducted in such a
manner as to ensure accountability and reliability. An assessment model
should be in place for local communities to either duplicate or compare
to ensure methods are in line with state requirements. This assessment
model anticipates participation of staff epidemiologists from each of
Office of Public Health's regional offices.

#### *Problem Statement: Alcohol*

Alcohol use in Louisiana is a major problem beginning at an early age.
In terms of consumption, 27% of students report drinking by the 6^th^
grade with the average age of initiation at 12.4 years of age (CCYS
Survey, 2002). By the 8^th^ grade, 53% of students have used alcohol
with 77% of 12^th^ graders indicating alcohol use. Binge drinking for
this age group exceeds the national average beginning in 6^th^ grade,
with 5.8% reporting this behavior. By the 12^th^ grade, 30% report binge
drinking, which is in excess of the national percentages. Binge drinking
continues to be a significant issue with the targeted age group with
31.8% of college age students (age 18-24) reporting binge drinking,
mirroring the national average. By ages 25-34, 22.3% of respondents
report binge drinking, slightly below the national average (CCYS-US Data
from Monitoring the Future, 2003). In the 2002 NSDUH, the percentages of
12-17 year olds and respondents 26 and older dependent/abusing alcohol
was above national levels. Louisiana was above the national average in
the composite of all age groups.

An area of behavior that is particularly concerning is the percentage of
adults reporting driving after drinking (BRFSS survey 1999 and 2002). In
1999, this percentage was above the national average in all age groups.
In 2002, the percentages of adults reporting driving after drinking were
well above the national average among the 18 to 29 age group.

Consequences of behaviors related to underage drinking and abuse of
alcohol include car crashes, car crash fatalities and injuries,
homicides, and violent crimes. Alcohol related traffic fatalities are
the 7^th^ leading cause of death related to substance use in Louisiana
and one of the three leading causes of alcohol related death. Almost
half of all fatal car crashes in Louisiana somehow involve alcohol. The
percentage of fatal car crashes in Louisiana during the years 1999-2003
was higher than the percentage nationwide. In Louisiana, the death rates
from motor vehicle alcohol-related accidents exceed the national rate.
The age group with the highest number of fatalities per 100,000 licensed
drivers is the 21 to 24 groups. Alcohol is also the drug most frequently
associated with violence: domestic violence, assault, and homicide and a
key factor in up to 68% of manslaughters, 62% of assaults, 54% of
murders/attempted murders, and 48% of robberies.

#### *Goal 3*

By 2009, there will be a reduction in the prevalence of alcohol use by
youth and underage college students and misuse and abuse of alcohol by
adults, as well as a reduction of alcohol use consequences in SPF
targeted communities.

#### *Long-Term Outcomes*

*Behav*io*ral targets for change in consumption among 12 to 29 year
olds:*

By 2009, there will be a reduction in past month alcohol use, binge
drinking, and drinking and driving as measured by self-reported items on
a valid, reliable survey implemented in SPF targeted communities.

*Behavioral targets for change in consequences of consumption among 12
to 29 year olds:*

By 2009, there will be a reduction in alcohol related motor vehicle
crashes, injuries and fatalities, and measurable violent crime
(violence - domestic violence, assault, homicide, robberies) as measured
by local agency data in targeted communities.

#### *Immediate Outcomes (FY 2007)*

By 2007, the State will fund evidence-based interventions that match
identified needs related to alcohol and community readiness to address
alcohol as measured by:

-   Fundable community strategic plans,

-   Drug Policy Board and local coalition meeting summary notes, and

-   State agency and local provider budgets indicating choices to
    reallocate limited funds toward more effective alcohol programs,
    policies, and practices.

#### *Intermediate Outcomes (FY 2008)*

By 2008, there will be an increase in the creation of state and/or local
policies that reduce youth alcohol use and adult abuse as measured by
policy documents.

By 2008, there will be an increase in the implementation of state and/or
local procedures and practices that reduce youth alcohol use and adult
abuse as measured by state and local agency records.

By 2008, there will be a decrease in population rates of targeted
intervening variables that influence youth alcohol use and adult abuse
as measured by longitudinal data.

#### *Problem Statement: Tobacco*

Tobacco use in Louisiana is higher than national rates for all ages. The
targeted age group for addressing the alcohol problem is 12 to 29.
Although the state average is 16.1% of students in grades 6^th^, 8^th^,
10^th^, and 12^th^ grades who report smoking in the past 30 days, 1 in 5
students report smoking in the past 30 days in 10 parishes with a high
of 1 in 4 students in the 2 parishes with the highest use rates (CCYS
survey, 2002). The percentage of Orleans Parish adult respondents
reporting current use was 30.1%. The highest Louisiana adult respondents
reporting current cigarette use were in the 21 to 29 year old group
(34.3%), although very high percentages were reported in the 18 to 20
(26.2%), 30-34 (28.8%), and 35-54 (30.5%) year old groups.

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about how often, if ever, they used
a variety of drugs, including cigarettes. Results indicate that the
overall cigarette use rate in the past 30 days ranged between 25% to 34%
and the overall cigarette use rate in the past year ranged between 36%
to 42%. Rates of use in the past year and in the past 30 days were at
some of the highest levels in 2002.

Consequences related to tobacco use include cancer, emphysema, lung
diseases, asthma, respiratory diseases, and strokes. Louisiana's average
of 0.6 per 1000 population lung cancer deaths exceeds the national rate
for 1999-2001 (NVSS). In addition, chronic lung disease (0.35 per 1000
population) results in almost 1400 annual deaths in the 65 and over
population. Death from heart attack and stroke is a problem primarily in
Louisiana residents age 65 and over (6 per 1000 population), although
there are also a significant number of deaths in those aged 55 to 64 (1
per 1000 population).

This goal is part of the state comprehensive plan, not targeted for SPF
funding.

#### *Goal 4*

By 2009, there will be reductions in the prevalence of tobacco use and
its consequences in tobacco prioritized communities.

#### *Long-Term Outcomes*

*Behavioral targets for change in tobacco use among 12 to 29 year olds:*

By 2009, there will be a reduction in past month cigarette and smokeless
tobacco use as measured by self-reported items on a valid, reliable
survey implemented in tobacco targeted communities.

*Behavioral targets for change in consequences of tobacco use:*

By 2009, there will be a reduction in the incidence of cancer,
emphysema, lung disease, asthma, respiratory disease and strokes as
measured by local agency data in targeted communities.

#### *Immediate Outcomes (FY 2007)*

By 2007, the State will fund evidence-based interventions that match
identified needs related to tobacco and community readiness to address
tobacco as measured by:

-   Fundable community strategic plans,

-   Drug Policy Board and local coalition meeting summary notes, and

-   State agency and local provider budgets indicating choices to
    reallocate limited funds toward more effective tobacco programs,
    policies, and practices.

#### *Intermediate Outcomes (FY 2008)*

By 2008, there will be an increase in the creation of state and/or local
policies that reduce tobacco use as measured by policy documents.

By 2008, there will be an increase in the implementation of state and/or
local procedures and practices that reduce tobacco use as measured by
state and local agency records.

By 2008, there will be a decrease in population rates of targeted
intervening variables that influence tobacco use as measured by
longitudinal data.

####  {#section-3 .Problem/Solution}

#### *Problem Statement: Illicit Drugs*

####  {#section-4 .Problem/Solution}

The illicit drug threat in Louisiana is the widespread availability and
abuse of major drugs such as cocaine, crack cocaine, and heroin, along
with its homegrown marijuana and the increasing danger of local
manufacture of methamphetamine and designer drugs. Conventional drugs
such as cocaine, methamphetamine and marijuana comprise the bulk of
drugs shipped through and arriving in Louisiana. Overland transportation
utilizing private and commercial vehicles continues to be the most
commonly encountered smuggling method in Louisiana. Elevated security
due to the September 11th tragedy has deterred transportation of most
drugs via commercial air travel. Colombian, Mexican, and Caribbean
traffickers traveling to and from Miami, Houston, or the southwest
border via I-10, I-12, I-20 (East / West routes) and I-55 (North /South
route) are largely responsible for the transportation and distribution
of cocaine, crack, methamphetamine, and marijuana into Louisiana.
Additionally, regional and local drug trafficking organizations (DTOs)
ensure widespread availability throughout the state. Regional DTOs have
also made significant inroads into the distribution of imported designer
drugs such as MDMA and GHB, particularly near larger metropolitan areas
of Louisiana where college populations are heavy. Various
pharmaceuticals such as OxyContin® have penetrated the illicit drug
market at an alarming rate and in some areas accounts for more deaths
than any other pharmaceutical drug.

Marijuana is the most widely available illicit drug in Louisiana. Most
marijuana available in Louisiana is produced in Mexico; however,
marijuana produced locally and in neighboring states is also readily
available. The availability of high-grade, domestically produced
marijuana has increased due to modern techniques of indoor cultivation
(i.e., the use of cloning and hydroponics to increase the potency). In
many regions of Louisiana, the price of marijuana has been decreasing
due to the availability of marijuana produced in Mexico and transported
from hub cities in Texas (i.e., Houston, Dallas, San Antonio,
Brownsville, and El Paso, Texas). A common practice among distributors
is to \"bulk up\" domestic marijuana with less expensive, lower quality
Mexico-produced marijuana to increase profits. Mexican DTOs clearly
dominate the greatest portion of wholesale distribution through Texas
into Louisiana. Local independent dealers, street gangs, and some small
ethnic drug groups dominate domestic marijuana retail distribution.

Data provided by the Louisiana State Epidemiological Work Group
indicates that Louisiana's death rate due to illicit use per one
thousand individuals was greater than twice the national average for
1999 -- 2001. Likewise the rate of property crime per one thousand in
Louisiana was higher than the national average for 2000 -- 2002.
Property crimes such as burglary, larceny, and motor vehicle theft, are
often committed to obtain money for the purchase of illicit drugs.
Approximately 30% of burglaries can be attributed to drug use.

A brief look at consumption data from the Epidemiological Work Group
report indicates that according to SEDS data for 2002, current marijuana
use by age group placed use among 12 to 17 year olds below the national
average, 18 to 25 year olds above the national average, and the 26 and
over age group slightly below the national average, with the total being
slightly above the national average. Additionally, 2002 SEDS data for
other illicit drug use by age group indicates that Louisiana is above
the national average. In both categories, 18 to 25 year olds saw the
highest percentage of use. CCYS data for *2004 Youth 30 Day Marijuana
Use* painted a brighter picture for Louisiana, with use being below the
national average for 8^th^, 10^th^ and 12^th^ graders (national numbers
were not available for 6^th^ graders). Although numbers were below the
national average, use rose consistently from 6^th^ grade to 12^th^
grade.

The following parishes were identified as having a higher than the state
percentage of youth reporting use of marijuana in the past thirty days
and property crime rates above the state average:

Orleans Caddo

Rapides Caldwell

St. Charles Franklin

Terrebonne Lafayette

Calcasieu East Baton Rouge

West Baton Rouge

In these identified parishes, resource assessments indicate that
sufficient effort across all domains and age groups is not present.

This goal is part of the state comprehensive plan, not targeted for SPF
funding.

#### *Goal 5*

By 2009, there will be reductions in illicit drug, particularly
marijuana, usage rates in illicit drug prioritized communities.

#### *Long-Term Outcomes*

*Behavioral targets for change in illicit drug use among 12 to 29 year
olds:*

By 2009, there will be a reduction in past month illegal drug use as
measured by self-reported items on a valid, reliable survey implemented
in targeted communities.

*Behavioral targets for change in consequences of illicit drug use:*

By 2009, there will be a reduction in the incidence of property crime as
measured by local agency data in targeted communities.

#### *Intermediate Outcomes (FY 2008)*

By 2008, there will be an increase in the creation of state and/or local
policies that reduce illicit drug use as measured by policy documents.

By 2008, there will be an increase in the implementation of state and/or
local procedures and practices that reduce illicit drug use as measured
by state and local agency records.

By 2008, there will be a decrease in population rates of targeted
intervening variables that influence illicit drug use as measured by
longitudinal data.

# IV. Implementation

The Louisiana prevention system's decision making structures (Drug
Policy Board, Prevention Systems Committee, and State Epidemiological
Workgroup) will ensure the state strategic plan is implemented, as well
as the process for how strategies are selected and provided to
communities throughout the state of Louisiana. The intent is to both
strengthen the accountability of the substance abuse prevention
infrastructure and assure that parishes employ effective evidence-based
strategies that rely on best practices to address targeted problems.
This requires careful planning and decision making procedures that fit
the community culture and lead to the selection of policies, programs,
and practices that can be implemented with fidelity and minimum
adaptation and allow for ongoing monitoring and feedback.

# 

#### *State Level Capacity, Infrastructure, and Activities*

The Governor's Office, through its support of the statutorily
established Drug Policy Board, will seek to ensure that the Board
carries out its charge to actively participate in the development and
maintenance of a comprehensive, cross-agency alcohol, and substance
abuse prevention system. The Governor's Office is committed that this
State Prevention Framework will include needs assessment, capacity
building of state and parish infrastructure, coordinated planning,
funding, implementation, and evaluation of alcohol and substance abuse
programs, policies, and practices in order to decrease duplication and
increase effectiveness.

#### *Prevention Systems Committee*

The Prevention Systems Committee (PSC) is the policy developer for the
state's prevention system and is responsible for decisions regarding the
distribution of the SPF-SIG investment funds, in particular. The PSC
will create a framework to develop the capacity to mobilize state and
community systems in order to address needs identified by data and
implement evidence-based strategies to reduce substance abuse and its
related consequences. This framework will require policy changes that
support increased capacity in workforce development, volunteerism,
criteria for coalition certification, identification and selection of
evidence-based and culturally appropriate interventions, and the
criteria and standards for SPF-SIG investment. The PSC will also develop
a communications plan to increase awareness and engagement of targeted
audiences and stakeholders. The plan will also promote interagency
agreements and collaboration among key prevention agencies, compile and
communicate information regarding prevention resources through the
publication of an annual resource catalogue, and support the assessment
of community readiness to address substance related problems.

# 

#### *State Epidemiological Workgroup*

The SEW functions as the data gatherer and interpreter for the State's
prevention system. The SEW will submit an annual report that monitors
progress toward targeted benchmarks, makes recommendations regarding
improvements for agency data collection, continuously works toward
filling data gaps in order to improve the quality, sufficiency and
integrity of the data, and provides guidance on state and community
level data collection interpretation and use. The SEW will also
recommend system design features, including policy changes and
technology needed to support sharing and utilizing data across state
systems, organizations, and communities. The SEW will continuously
coordinate with the Evaluation Team and support the creation of
regionally based epidemiological efforts to support local level data
driven decision-making.

#### *Parish Level Capacity, Infrastructure, and Activities*

The Office of the Governor and the Office for Addictive Disorders
(collectively known as the Management Team) will collaboratively manage
the SPF-SIG funded communities through multi-year contracts. The
Technical Assistance Network will provide technical assistance and
support to the funded communities. These multiyear contracts will
include specific benchmarks including but not limited to, the
development of a needs assessment, resource assessment, strategic plan,
implementation plan, and evaluation plan.

To assure that the parish level planning process is deliberate and
thorough, the SPF-SIG funds will be allocated to SPF targeted parishes
in a phased process according to the five-step strategic prevention
model using performance based outcome criteria. This process provides an
incentive for the contractor to control cost and perform effectively.
The Department of Health and Hospitals Office for Addictive Disorders
(which was selected by the Core Team to contract with each targeted
local coalition) recommends fixed price contracts be used to support
coalition planning efforts and strategy implementation. Performance
based payments will be based upon completion of designated tasks
outlined to accomplish targeted outcomes. Within the scope of the
performance based outcome model, a multi-year contract (3 years) will be
developed to assure consistency of effort from the local staff and
coalition partners. The multi-year contracts will define in detail the
manner in which funds will be disbursed.

The local fiscal agent for administration of SPF-SIG funds for community
planning and implementation of strategies will be determined by the
parish government in conversation with the parish coalition and with the
approval of the Management Team. Parishes must establish a parish based
coalition, if one is not already organized, and develop a parish
strategic plan that braids and leverages existing prevention funding in
order to target state and/or parish identified prevention priorities. A
new coalition need not be developed if a parish has a viable and
effective coalition, such as those funded by CSAP through the Drug Free
Community Support Program. The Core Team, through the *Applied* Pathways
process, identified the standards of effective coalitions. These
standards include adoption of a clear, common vision and mission
statement that establishes the coalition as a community problem solving
and decision-making body with established operational by-laws, conflict
resolution policy, and operations plan. Coalition meeting agendas and
meetings should be well defined and focused. Members should demonstrate
a willingness to share ideas and discuss issues. The membership list
validates the process by revealing a diverse group with varied
backgrounds who regularly attend and are fully engaged in
decision-making.

The development of the SPF-SIG model in the SPF targeted parishes will
be supported through the development of the Technical Assistance Network
(TAN). The Network will also provide support and technical assistance to
non-SPF-SIG parishes. The Network will also serve as a central point for
dissemination of the SPF model, providing support to established and
newly developed coalitions to mobilize and implement a data driven needs
and resource assessment and to develop a local strategic plan that
identifies and targets local conditions that contribute to consumption
and targeted consequences. The Network will also serve as a conduit for
two-way communication between the state system and parish communities.
The Network will draw on expertise across agencies: public health,
education, criminal justice, behavioral/mental health and the lead
agency on underage drinking with a commitment to consistency in message,
relationship, and support.

The Technical Assistance Network will be trained to work with SPF
targeted parishes to ensure that strategies selected for reducing
consumption and consequences among the parish population have evidence
(documented through evaluation or theorized logical connection) of
influencing underlying conditions thought to be most causally related to
the consumption behavior. Logic models will be developed for each parish
based on local data to ensure that strategies (policies, programs, and
practices) selected are logically connected to the long-term reduction
of the substance related consequence.

The following procedures will ensure essential training is successfully
provided to communities through the Technical Assistance Network:

-   Financial Support: contracting mechanisms in place to a coalition
    (if 501c3) or community agency acting as the fiscal agent for the
    community

-   Champions/Culturally Competent: provide orientation process for new
    members and extensive training of the Network staff

-   Technology: website as an on line resource, newsletter

-   Shared network of resources: aligned with all substance abuse
    prevention resources

-   Sustainable -- multi-agency support lead through the Drug Policy
    Board which provides technical assistance to support development of
    infrastructure and operational capacity at the community level.

-   Empowerment - bearing in mind state outcome priorities, communities
    will determine what their needs are and how to achieve reductions in
    priority problems

# V. State-Level Surveillance, Monitoring and Evaluation Activities

Evaluation staff will track state-level SPF-SIG activities and outcomes
through a variety of both qualitative and quantitative means. A snapshot
of the pre-SPF-SIG prevention system (focusing most heavily on the OAD
and Governor's Office's Drug Free Schools program) will be completed
through interviews with key informants, and analyses of resource
assessment data collected during the assessment phase of the SPF.
Progress towards achieving the prevention system capacity enhancements
outlined in the state strategic plan will be monitored through direct
observation of major SPF-SIG committees (PSC and SEW), participation in
SPF-SIG management team meetings, examination of meeting minutes,
SPF-SIG key informant interviews, assessment phase data collected during
the final year of the SPF-SIG project, and examination of other products
developed by SPF-SIG committees and the management team (e.g., SEW
report, web based data system, training materials for community level
planning, SPF-SIG sub-recipient application materials, utilization of
Technical Assistance Network by SPF-SIG sub-recipients and non-recipient
parishes, etc.).

For community level evaluation activities, the evaluation team will work
closely with each SPF-SIG sub-recipient coalition to ensure that
sub-recipients have the capacity to carry out a successful evaluation of
their SPF-SIG interventions. Evaluation staff will collaborate with each
sub-recipient to develop an evaluation plan tailored to the
intervention(s) chosen. Based on the evaluation plan, evaluation staff
will identify or develop evaluation instruments that will allow
examination of intervention outcomes. Finally, evaluation staff will
analyze data collected and report outcome results to state and local
prevention staff. Additionally, the evaluation of local level SPF-SIG
activities will focus on issues such as: examining changes to local
prevention planning and implementation that result from the SPF-SIG,
examining reactions to the SPF-SIG planning process, and documenting
reactions to trainings and technical assistance provided by state level
staff.

#### *SPF-SIG Expected Changes and Tracking at State and Sub-recipient Levels*

The evaluation will focus on multiple variables at the state, regional
and community levels based on the goals and objectives identified by the
SPF-SIG Core Team. Below, the major domains of expected change are
identified and methods for tracking, monitoring, and documenting the
extent of change are discussed.

#### *State-Level Capacity Changes* 

An important set of goals of the SPF-SIG project revolve around the
enhancement of the state prevention system capacity. One of these goals
is increased utilization of the SPF as a guiding process for prevention
planning at both the state and local levels. The use and impact of the 5
steps of the SPF at the state level will be assessed by examining
increases in interagency prevention system alignment (increased sharing
of information and data, use of data driven planning process across
major prevention agencies, increases in collaboration across agencies
\[shared funding and projects\], and increased commitment to
evidence-based programs, policies, and practices across agencies).
Another capacity related goal of SPF-SIG is development of the Technical
Assistance Network that will provide training and TA initially to
SPF-SIG sub-recipients and eventually to all parishes across the state.
Evaluation staff will monitor the development of the TA Network through
observation and participation in SPF-SIG committee meetings and will
document training and TA products developed by the network.

#### *Community-Level Capacity Changes*

In addition to the state-level capacity changes expected through
SPF-SIG, the strategic plan targets capacity change at the community
level as well. Although training and TA is to be made available to all
communities throughout the state, the impact of the SPF-SIG project at
the community level is expected to be most visible within SPF-SIG
sub-recipient communities. As such, the evaluation team will look
closely at SPF-SIG sub-recipient communities to understand and document
prevention planning procedures and protocols in these communities both
prior to and after the implementation of the SPF-SIG. Expected changes
at the community level are similar to those at the state level:
increased collaboration across local prevention agencies, increased use
of the 5 steps of the SPF, increases in the use of data in prevention
planning, greater value associated with data collection (needs
assessment, resource assessment and evaluation data), and increased
knowledge/selection of evidence-based programs, policies, and practices.
Evaluation staff will monitor these variables through key informant
(local prevention staff) interviews, examination of resource data both
prior to and at the conclusion of SPF-SIG, and examination of coalition
meeting minutes.

#### *Substance Use, Consequences, and Intervening Variables*

The primary substance use and consequence priority identified by the
Core Team to be addressed by the Louisiana SPF-SIG project is alcohol
use and its consequences in individuals age 12 to 29. As such, alcohol
use rates among age groups in this population are expected to decrease
over the course of the grant period. Alcohol use data for youth ages 12
to18 will be collected through the Caring Communities Youth Survey
(CCYS), which measures lifetime use, 30-day use and binge drinking. OAD
currently collects statewide youth data down to the parish level on a
bi-annual basis making this data convenient to obtain by local and state
prevention staff as well as the evaluation team. Alcohol use among the
young adult population 18 to 29 will be collected by the BRFSS, and
where available, through college prevention needs assessment surveys
being initiated and administered by OAD.

The Core Team identified violent crimes and alcohol related motor
vehicle crashes as the primary indicators of alcohol related
consequences of interest. As such, these indicators will be monitored as
part of the evaluation of the SPF-SIG Project. The evaluation team will
obtain these data through collaboration with the SEW. Both indicators
are readily available through the SEDS database (CSAP), and through
state agencies represented on the SEW on an annual basis.

In addition to the primary substance and substance related consequence
data specified above, other alcohol use and consequence variables, as
well as intervening variables specific to community level planning
efforts will be monitored as part of the evaluation. Sub-recipient
planning efforts will utilize community level data that will provide
greater insight regarding the intervening variables that contribute to
alcohol use and it's consequences in a particular community.
Additionally, analyses of alcohol use and consequence data at the
community level may shed light on other highly related use patterns
and/or consequences (e.g., high levels of youth reporting riding with a
drunk driver, as a proxy for motor vehicle crash injuries). The efforts
of sub-recipients to identify community level variables that contribute
to the problems in their community will provide evaluation staff with
additional opportunities to examine the impact of community level
prevention efforts funded by SPF-SIG. Much of these additional data will
be available through the CCYS and the SEW dataset. Evaluation staff will
work with SPF-SIG funded coalitions to obtain local data that is not
available through these state-level avenues.

#### *Collection of SAMHSA/CSAP NOMS Data at State and Sub-recipient Levels*

Collection of the required SAMHSA/CSAP NOMS (National Outcome Measures)
data at the state level will be managed through the collaborative
efforts of the SPF-SIG management team, SEW, and evaluation team. Most
of the state level NOMS are currently available to the SEW through the
SEW dataset. These include measures of abstinence (available through
CCYS and National Survey NSDUH), crime and criminal justice (NSDUH and
archival data currently included in SEW dataset), social connectedness
(NSDUH), access/capacity (resource assessment scans), and cost
effectiveness (OAD Prevention Management Information System \[PMIS\]).
Other NOMS have been under development and have recently been specified
by CSAP. Specifically, NOMS in the employment/education domain have only
recently been defined. The SEW will identify and collect data acceptable
to these new data definitions.

The Technical Assistance Network and the evaluation staff will
facilitate sub-recipient collection of the NOMS data. NOMS data will be
collected at the sub-recipient level as it is determined to be both
relevant to the community level strategic plan, and feasible to collect
at the sub-recipient level. Many of the NOMS are available to the
evaluation team and the SEW as a matter of course. For example, NOMS in
the abstinence domain are available at the parish level through the
bi-annual statewide CCYS administration. Additionally, archival data,
such as the number of alcohol related car crashes and alcohol/drug
related arrests, are available to the SEW at the parish level, and the
number of persons served by prevention programs and the number of
evidence-based practices within each sub-recipient geography will be
available through the OAD PMIS and through resource assessment scans
that will be required of all SPF-SIG sub-recipients on an annual basis.
Several of the NOMS are to be collected through the NSDUH at the
state-level through the annual NSDUH administration, and may not be
readily available at the community level. Where these measures are
relevant to sub-recipient's SPF-SIG Strategic Plan and the interventions
they have chosen to implement, the evaluation team will work with the
sub-recipient to determine the feasibility of collecting these NOMS at
the community level. Feasibility considerations include, method of data
collection, costs involved with generating a representative sample, and
the amount of SPF-SIG funding available to the sub-recipient.

# VI. Cross Cutting Issues

#### *Sustainability*

Within the Louisiana state prevention system, sustainability is
considered to be the process of ensuring the existence of an adaptive,
effective system that achieves and maintains desired long-term results
that ultimately maintain positive outcomes in the community. In order to
achieve and sustain desired community outcomes, each community substance
abuse prevention system, comprised of the community coalition, the
agencies, institutions, and organizations, along with supportive
community leaders, stakeholders, and members, must have the capacity to:

-   Plan strategically,

-   Carry out and maintain effective prevention interventions, and

-   Achieve targeted reductions in consequences and consumption.

Louisiana recognizes that there are three aspects, or areas of
relationships, that must be stabilized and empowered in order to sustain
desired outcomes.

First, there must be an alignment of all services and work that targets
prevention outcomes that can assure an effective relationship wherein
there is mutual accountability and responsibility. This alignment can be
documented through the creation of an implementation plan shared by all
organizations targeting the shared outcomes.

Second, the organizations involved must have the ability to support the
community prevention system and its outcomes. This ability can be
documented through the creation of organizational action plans that
detail resources the organization will bring and products the
organization will produce to assure the overall success of the shared
outcomes.

Third, the organizations must cultivate community support for the shared
outcomes. This cultivation occurs when the system speaks with one
message using many voices connected to the plan and based on the
evaluation results. The creation of a communications plan is essential
to assure a commitment to expanding the circle of support beyond those
who are members of the substance abuse prevention system.

Louisiana challenges its public and private partners, state and
community agencies, and organizations, and all Louisianans to commit to
this process now and beyond this initial infusion of resources. To
sustain this effort, all Louisianans must be willing to commit their
individual and professional power to make a difference to address the
causes of our substance abuse problems. All Louisianans are called to
braid their human, technical, and financial resources in order to
provide the critical mass needed to diminish the causes of substance
abuse problems. This braiding of resources will allow Louisiana to be in
a position to prevent and/or reduce substance abuse and its consequences
on a long-term basis.

Efforts to sustain outcomes require:

-   Long-term partnerships,

-   Commitment by lead agencies to utilize the planning model to fund
    future programs/projects,

-   On-going evaluation (timely) with time to make adjustments/changes,

-   Establishment of the Technical Assistance Networks.

#### *Cultural Competency*

Louisiana is one of the most culturally, economically, and ecologically
diverse states in the nation. Although, only the twenty-second most
populated state in the nation with a population of 4.5 million people,
of which 32.5% are of African-American descent (*Census* *Bureau, 2002*)
Louisiana ranks 2^nd^ in percentage African-Americans who comprise the
total population among the states (*Ibid.*). In addition to English and
the increasing use of Spanish, a significant minority of Louisianans
continues to speak French-Cajun and Louisiana Creole French
*(Ethnologue: Languages of the World, 14^th^ Edition, 2004).* More than
two-thirds of the population is located in eight metropolitan areas.
Louisiana's diverse economy includes a strong agricultural sector,
petroleum and natural gas reserves, a thriving fishing industry,
expanding tourism and a strategic location at the mouth of the
Mississippi River, gateway to the nations vast inland waterway system.
Ecologically, the state's landscape varies dramatically from its famous
remote, marshy bayous in the south, to lush pine forests in the north.

This cultural diversity has long been recognized and the public
prevention services continue to strive to be culturally sensitive and
culturally competent. Thus, another priority of the *Governor's
Initiative to Build a Healthy Louisiana* is the development of a process
for assuring the selection and implementation of culturally competent
and appropriate policies, programs, and practices by communities.

Cultural competency has always been a core value of the state's alcohol
and other drug prevention system and is currently emphasized through
program planning and development, trainings, and meetings. Louisiana
intends to build on this foundation to imbed within its state decision
making process, services supported, and personnel involved in an
atmosphere of respect. Policies, procedures, and practices should
encourage appreciation of others' perspectives and realities, acceptance
of others' perspectives and realities with no need to change or approve
them, and establishment of an environment that encourages and allows
participants to hear, not just listen, to the diversity of thought. A
commitment to cultural competency includes respecting the unique needs
and complexities of multiple cultures, responding to evolving diversity,
and changing how people think about their own culture and how they
communicate with other cultures.

As SPF-SIG is embedded in the parishes it must take into account the
unique needs of service providers and the people of Louisiana. These
relations are effected by cultural norms (e.g. community attitudes
toward adult abuse and underage alcohol use) and community realities
(e.g. community skill set, community resources and community's access to
skills and resources). Through the Technical Assistance Network,
Louisiana will provide ongoing training and technical assistance to
educate providers in the areas of cultural competencies and ethical
practices to ensure that coalitions and service providers have adequate
means of assessing cultural needs and access to programs that are
culturally appropriate to address them. This will help to ensure that:

-   The assessment process will take into account health disparities
    across racial and ethnic and other cultural groups,

-   The capacity building process will ensure that all coalitions are
    both inclusive of perspective and diverse in background,

-   The planning process will embed the focus of respect as outlined in
    the state plan into the community plan,

-   The implementation process will assure that the strategies
    implemented are respectful of the unique needs and complexities of
    the culture of the targeted population, and

-   The evaluation process will provide feedback both to the state and
    parish on cultural appropriateness and effects of each selected
    strategy.

#### *Underage Drinking* 

Alcohol is also a major concern: from the Louisiana highways, where 43%
of fatal traffic crashes were alcohol-related (Louisiana Highway Safety
Commission traffic records, 2003), to the Louisiana classroom where
(27%) of students report drinking alcohol by the 6^th^ grade. Further,
alcohol is the most commonly used substance by Louisiana students
(53.6%) with the average age of initiation at 12.4 years of age (CTC
Survey, 2002). This comprehensive youth survey, available at the state,
parish, and community level, is repeated bi-annually, providing the
state with longitudinal trend data on the substance use and related risk
and protective factors about the same group of students.

The social impact of alcohol can be found in statistics concerning
co-occurring behaviors across the state: 7.8% of high school students
drop out of school (Louisiana State Education Progress Report,
2001-2002); 25.2% of the adult population has less than a high school
degree (Census Bureau, 2002); 9^th^ highest live births to teens in the
nation (Louisiana State Education Progress Report, 2001-2002); ranks
only above Mississippi in 4^th^ grade reading performance and is below
all states in 8^th^ grade reading performance (*Ibid.*). The social cost
of alcohol and drug abuse falls on state and parish government. In 1998,
the state spent \$1.06 billion dollars on substance abuse treatment and
other associated problems, which was 9.9% of the state budget. Health
care spending, loss of productivity, and high rate of crime associated
with alcohol demands a shift in public policy that addresses the impact
of alcohol on our communities.

Furthermore, institutions of higher education in Louisiana have also
become alarmed at the use of alcohol by underage students and have begun
to develop a plan to address this problem. For Louisiana to continue to
grow economically, it must have a well-educated population who is not
alcohol and drug dependant. This highlights why both alcohol and the
target population is between 12 to 29. Louisiana must have a solid
workforce that is well educated.

#### *Service Disruption*

In the wake of a disaster, concerns about substance use and abuse may
seem minor in relation to the immediate devastation and the task of
rebuilding. However, it is during times of extreme stress such as those
following a disaster that substance use and abuse tends to increase.
Focused disaster management activities are critical in dealing with
disasters.

A service disruption plan is needed for the entire state and perhaps
even more so for the SPF-SIG process because more than half the parishes
targeted border on the Gulf of Mexico and others are contiguous to these
parishes. Although a more detailed implementation plan will be crafted
in the first year of this strategic plan, the following overarching
benchmarks need to be addressed:

-   Ensuring that regions have a point of contact at state level ,

-   Capturing what services are being provided following the disaster
    and what current needs are in the regions due to the disaster,

-   Ensuring that at least one trained (certified) substance prevention
    individual can be dispatched to the affected region without the need
    for budget or contract modifications in each region,

-   Ensuring this trained (certified) substance prevention individual
    can provide training to the regions and community partners on
    disaster response skills:

    -   Coping skills

    -   PTSD

    -   Cultural competence

    -   Stress management

    -   Assessment and referral

-   Maintaining up to date documentation of disaster response skills
    among prevention workforce,

-   Assessing human and financial capacity at regional and community
    levels, and

-   Regional boundaries do not apply during the 48 hours prior to the
    disruption and up to 90 days after the event.

In the event of a hurricane or natural disaster, each state agency will
have a plan in place, and language embedded in all contracts that
provide for the following:

-   Services not provided during the time of the disaster and recovery,
    and no funds spent, will be extended beyond the initial life of the
    contract to make up for time lost in the program,

-   Include a communications plan to keep track of displaced employees
    and credentialed professionals and plan for reporting for duty
    wherever relocated,

-   Maintain and secure data and records and make portable for services
    being provided,

-   Put a system in place to assess needs and make appropriate services
    available to displaced service recipients and track services
    provided,

-   Ability to modify the scope of service of the contract if the
    population served drastically changes due to displacement and the
    services contracted to be provided are not culturally appropriate or
    best practices for the new population or substance of concern,

-   A one page, fast method to sign off on any immediate changes
    necessary in the contract, and

-   Linkage to state disaster response plan.

# *Conclusion*

The excitement and commitment from the members of the Drug Policy Board,
the State Epidemiological Workgroup, and the Prevention Systems
Committee has been invaluable. The guidance by the Management Team
comprised of staff both at the Office of the Governor and the Office for
Addictive Disorders, along with their consultants and contractors, has
kept the process on task. However, without the energy, enthusiasm, and
resources provided by those who participated during the initial SPF-SIG
process as members of the Core Team the level of assessment, debate,
deliberation, and the plan itself would not exist.

Much appreciation and gratitude is owed to all committee members, as
well as the leadership of the Office of the Governor and the Office for
Addictive Disorders. Thanks also to our prevention colleagues across the
Southwest who have offered words of support and encouragement and who
join hands with us to improve the health of our state by focusing effort
and attention to the plague of substance abuse. And heartfelt
appreciation to friends and family who've made contributions in time,
effort, and most of all, patience.

# 

# 

# 

# 

# 

# 

# 

# *Timeline*

1\. Profile population needs, resources, and readiness to address the
problems and gaps in service delivery

+-----------------------------------------------------------------------+
| **Year 1 (2006- 2007)**                                               |
+-----------------------------------------------------------------------+
| **Objective 1.1.1:** The State Epidemiological Workgroup, in          |
| conjunction with the Evaluator, will create a statewide system for    |
| collecting, housing, publishing, utilizing, and updating state and    |
| community epidemiological data, including measures of risk and        |
| protection as identified by Hawkins and Catalano (1982), alcohol and  |
| other substance use, and other relevant indicators of social          |
| conditions related to substance use, juvenile delinquency, violence,  |
| school failure and other adverse mental health outcomes for youth and |
| adults, for ongoing substance abuse prevention needs assessment and   |
| strategic planning by state agencies and community-based coalitions.  |
|                                                                       |
| **Objective 1.1.2:** The Prevention Systems Committee will develop a  |
| process to identify prevention infrastructure and evidence-based      |
| programs, policies, and practices at the state and community levels   |
| needed to address state and local prevention priorities as determined |
| by epidemiological needs assessment data.                             |
|                                                                       |
| **Objective 1.1.3**: The Prevention Systems Committee will conduct a  |
| resources assessment that will assess the funds and other resources   |
| presently addressing substance abuse prevention, building on the      |
| foundation of the SIG initiative.                                     |
|                                                                       |
| **Objective 1.1.4:** The Prevention Systems Committee will develop    |
| common benchmarks for coalitions, which will include membership       |
| composition requirements, organizational functions and processes and  |
| will become Louisiana's model for coalitions for state agencies that  |
| fund coalitions as affirmed by the Louisiana Drug Policy Board.       |
|                                                                       |
| **Objective 1.1.5:** The Prevention Systems Committee will develop a  |
| staffing structure to support the creation of a Technical Assistance  |
| Network that will build on the field networks of various state and    |
| private agencies.                                                     |
|                                                                       |
| **Objective 1.1.9:** The Technical Assistance Network, will be        |
| trained in the *Applied* Pathways process and serve as a cadre of     |
| full-time training and technical assistance providers dedicated to    |
| building the capacity of targeted community coalitions to locally     |
| implement the *Applied* Pathways process.                             |
|                                                                       |
| **Objective 1.1.10:** The Louisiana Drug Policy Board through its     |
| Prevention Systems Committee will develop a process for assessing and |
| certifying readiness and capacity of community coalitions to          |
| implement the *Applied* Pathways process.                             |
+-----------------------------------------------------------------------+
| **Year 2 (2007-2008)**                                                |
+-----------------------------------------------------------------------+
| **Objective 1.2.1:** The Louisiana Drug Policy Board will review and  |
| affirm the assessment of the Prevention Systems Committee regarding   |
| the readiness of state agencies to use this proposed data collection  |
| system.                                                               |
|                                                                       |
| **Objective 1.2.2:** The State agencies will develop a plan to modify |
| their systems in order to be able to interface with the new data      |
| collection system.                                                    |
|                                                                       |
| **Objective 1.2.3:** The Louisiana Drug Policy Board through the PSC  |
| and SEW will identify opportunities to leverage funding to develop    |
| capacity among state agencies that fund efforts to reduce underage    |
| drinking and other substance use and abuse across the state to        |
| collect, report and utilize epidemiological needs assessment data to  |
| make funding decisions for their agency and for the prevention        |
| system.                                                               |
|                                                                       |
| **Objective 1.2.4:** The Louisiana Drug Policy Board through policy,  |
| executive order, or legislation will recommend that all funds that    |
| pass through state agencies for substance abuse prevention will be    |
| expended using the data standards recommended by the Louisiana Drug   |
| Policy Board and measured by the agreed to outcomes.                  |
|                                                                       |
| **Objective 1.2.5:** The Louisiana Drug Policy Board through its      |
| Prevention Systems Committee will review and assess the readiness of  |
| all coalitions and certify those that have demonstrated readiness and |
| capacity to implement the *Applied* Pathways process and be           |
| successful in the SPF-SIG process.                                    |
|                                                                       |
| **Objective 1.2.6:** The Technical Assistance Network will assist the |
| selected coalitions in using the *Applied* Pathways process to        |
| collect local substance abuse prevention needs and resource           |
| assessment data, prioritize prevention needs, and identify gaps in    |
| infrastructure/capacity and evidence-based policies, programs, and    |
| practices in preparation for coalition certification.                 |
|                                                                       |
| **Objective 1.2.7:** The Community Coalitions will convene or enhance |
| existing partnerships or groups of concerned citizens within each     |
| parish to conduct a local needs assessment, accurately assess         |
| substance abuse related problems, and identify the magnitude of the   |
| problem and where it is the greatest.                                 |
|                                                                       |
| **Objective 1.2.8:** The Prevention Systems Committee will assure     |
| that a process is in place to work with those parishes that do not    |
| have coalitions participating in the first cohort of coalitions so    |
| that all parishes by 2010 will be participating in the SPF-SIG        |
| process.                                                              |
|                                                                       |
| **Objective 1.2.9:** The Technical Assistance Network will provide    |
| subsequent rounds of technical assistance across the state to raise   |
| awareness and knowledge among existing coalitions about the *Applied* |
| Pathways process and the process for becoming a certified coalition.  |
+-----------------------------------------------------------------------+
| **Year 3 (2008-2009)**                                                |
+-----------------------------------------------------------------------+
| **Objective 1.3.1:** The state agencies will begin to use the data    |
| collection process and begin reporting to the Prevention Systems      |
| Committee the data about needs and resources.                         |
|                                                                       |
| **Objective 1.3.2:** The Prevention Systems Committee will assess the |
| gaps between needs and services and report their recommendations and  |
| findings to the Louisiana Drug Policy Board.                          |
|                                                                       |
| **Objective 1.3.3:** The community coalitions will align their data   |
| and resource collection process with the data and resource collection |
| process used by the state and affirmed by the Louisiana Drug Policy   |
| Board.                                                                |
+-----------------------------------------------------------------------+
| **Year 4 (2009-2010)**                                                |
+-----------------------------------------------------------------------+
| **Objective 1.4.1:** The Louisiana Drug Policy Board will serve as    |
| the forum for issues of coordinating, planning, funding, and          |
| evaluation among all state agencies that receive any federal, state,  |
| or private funds to reduce underage drinking and other substance use  |
| and abuse and assure that these decisions are based on current        |
| prevention needs assessment data.                                     |
|                                                                       |
| **Objective 1.4.2:** The Louisiana Drug Policy Board will work with   |
| the Governor's Press Office to publish a uniform report card/profile  |
| of the parish, region, and state substance abuse use and risk and     |
| protective factors.                                                   |
|                                                                       |
| **Objective 1.4.3:** All parishes will through their certified        |
| coalitions use the *Applied* Pathways process to collect local        |
| substance abuse prevention needs and resource assessment data,        |
| prioritize prevention needs, and identify gaps in                     |
| infrastructure/capacity and evidence-based policies, programs, and    |
| practices.                                                            |
+-----------------------------------------------------------------------+

***2*. *Mobilize and/or build capacity to address needs***

+-----------------------------------------------------------------------+
| **Year 1 (2006-2007)**                                                |
+-----------------------------------------------------------------------+
| **Objective 2.1.1:** The Louisiana Drug Policy Board, through its     |
| Prevention Systems Committee, will work with the University system    |
| regarding underage use of alcohol. This work will continue throughout |
| the remaining years of the SPF-SIG and beyond.                        |
|                                                                       |
| **Objective 2.1.2:** The Prevention Systems Committee will mobilize   |
| key prevention stakeholders across the state, including prevention    |
| funders, state and local elected officials, statewide organizations,  |
| existing community coalitions, and prevention service providers in    |
| order to build their knowledge of, capacity to use, and support for   |
| the *Applied* Pathways process to identify, plan for, and address     |
| substance abuse prevention priorities through evidence-based          |
| programs, policies, and practices.                                    |
|                                                                       |
| **Objective 2.1.3:** The Prevention Systems Committee and State       |
| Epidemiological Workgroup will leverage in-state and out-of-state     |
| expertise to address state and local capacity needs identified in the |
| state and local infrastructure and resource gaps analysis.            |
|                                                                       |
| **Objective 2.1.4:** The Prevention Systems Committee, through the    |
| Technical Assistance Network, will build readiness and capacity to    |
| utilize the *Applied* Pathways process for local data-driven          |
| strategic planning among a target group of community coalitions that  |
| have completed an assessment of local needs and resources and         |
| mobilized key local stakeholders and local recipients of state,       |
| federal, or other funding streams for substance abuse prevention.     |
|                                                                       |
| **Objective 2.1.5:** A target group of community coalitions will have |
| completed an assessment of local needs and resources, and mobilized   |
| key local stakeholders and local recipients of state, federal or      |
| other funding streams for substance abuse prevention, and have        |
| completed the coalition certification process demonstrating readiness |
| to elicit, motivate, and coordinate the best efforts and ideas of all |
| local organizations, agencies, entities, and individuals who          |
| volunteer or can be conscripted to participate in local strategic     |
| planning to address needs identified.                                 |
+-----------------------------------------------------------------------+
| **Year 2 (2007-2008)**                                                |
+-----------------------------------------------------------------------+
| **Objective 2.2.1:** The Prevention Systems Committee and the State   |
| Epidemiological Workgroup will identify and plan for the development  |
| and sustainability of infrastructure and other resources needed to    |
| advance and support state and local data-driven strategic planning,   |
| the implementation of evidence-based, culturally appropriate          |
| prevention approaches to meet identified needs, the collection,       |
| analysis and reporting of evaluation data, and the utilization of     |
| data for continuous quality improvement in prevention service         |
| delivery and sustained outcomes.                                      |
|                                                                       |
| **Objective 2.2.2:** The Prevention Systems Committee will work with  |
| State Universities that provide some level of substance abuse         |
| prevention course work to assess present curriculum and develop a     |
| degree in substance abuse prevention science to address the shortage  |
| in the workforce in this area.                                        |
|                                                                       |
| **Objective 2.2.3:** The certified local coalitions, that have        |
| completed the *Applied* Pathways process and with the SPF-SIG funds   |
| begin to fund substance abuse prevention evidence- based programs,    |
| policies, and practices and will work with the Louisiana Drug Policy  |
| Board and its PSC to communicate the work of the coalitions and       |
| vision for a substance abuse free Louisiana to other community        |
| stakeholders.                                                         |
+-----------------------------------------------------------------------+
| **Year 3 (2008-2009)**                                                |
+-----------------------------------------------------------------------+
| **Objective 2.3.1:** The Prevention Systems Committee, through the    |
| Technical Assistance Network, will provide ongoing assistance to new  |
| cohorts of coalitions in order to build their readiness and capacity  |
| to become certified coalitions and utilize the *Applied* Pathways     |
| process for needs assessment, data-driven strategic planning to       |
| address underage drinking and other prioritized substance use         |
| behaviors, and evaluate outcomes.                                     |
|                                                                       |
| **Objective 2.3.2:** The Technical Assistance Network will serve as   |
| the network for real time diffusion of state recommendations to the   |
| prevention field, build capacity of community coalitions to use the   |
| *Applied* Pathways process, and provide information to the Louisiana  |
| Drug Policy Board regarding engagement by communities in needs and    |
| resource assessment, strategic planning, program selection,           |
| evaluation, and sustainability.                                       |
+-----------------------------------------------------------------------+
| **Year 4 (2009-2010)**                                                |
+-----------------------------------------------------------------------+
| **Objective 2.5.1:** Courses in the area of substance abuse           |
| prevention science will be established in at least two of the state's |
| universities, one of which will be at one of the historically black   |
| universities.                                                         |
|                                                                       |
| **Objective 2.5.2:** Legislation is in place to maintain the renewed  |
| system in substance abuse prevention so that these changes are        |
| sustained past the life of the SPF-SIG.                               |
|                                                                       |
| **Objective 2.5.3:** Each of the 64 parishes in Louisiana will be     |
| served by a certified community coalition for substance abuse         |
| prevention that is empowered to elicit, motivate, and coordinate all  |
| funded local organizations, agencies, entities, and individual        |
| volunteers in ongoing needs assessment using epidemiological data to  |
| identify priorities, strategic planning to address prioritized needs  |
| with evidence-based prevention policies, programs, and practices, and |
| evaluation to assess effectiveness.                                   |
+-----------------------------------------------------------------------+

3\. Develop a comprehensive strategic plan

+-----------------------------------------------------------------------+
| **Year 1 (2006-2007)**                                                |
+-----------------------------------------------------------------------+
| **Objective 3.1.1:** The Technical Assistance Network will be         |
| familiar with the state strategic plan, once it is approved by        |
| SAMHSA/CSAP and will address state prioritized outcomes.              |
|                                                                       |
| **Objective 3.1.2:** The Louisiana Drug Policy Board will adopt a     |
| plan for the development and sustainability of infrastructure,        |
| policies, and other resources needed to advance and support state and |
| local data-driven strategic planning for substance abuse prevention,  |
| the implementation of evidence-based, culturally appropriate          |
| prevention approaches to meet identified needs, the collection,       |
| analysis, and reporting of evaluation data to demonstrate             |
| accountability to national, state and locally established outcomes    |
| and performance measures, including CSAP's National Outcome Measures  |
| and the utilization of data for continuous quality improvement in     |
| prevention service delivery.                                          |
+-----------------------------------------------------------------------+
| **Year 2 (2007-2008)**                                                |
+-----------------------------------------------------------------------+
| **Objective 3.2.1:** Certified Community Coalitions will develop      |
| local strategic plans funded in whole or in part by SPF-SIG funds     |
| that establish goals, objectives, milestones, and measurable outcomes |
| which are aligned with the state strategic plan to address priority   |
| risk and protective factors through culturally appropriate,           |
| evidence-based programs, policies, and practices in order to reduce   |
| underage drinking and other drug use and address other national,      |
| state, and locally prioritized substance abuse-related problems.      |
|                                                                       |
| **Objective 3.2.2**[:]{.underline} The Prevention Systems Committee   |
| will create a mechanism to coordinate funding for additional cohorts  |
| of Certified Community Coalitions, not funded initially with SPF-SIG, |
| funding whose strategic plans demonstrate a logical connection        |
| between proposed evidence-based programs, policies, and practices and |
| reductions in underage drinking and other state and local prioritized |
| prevention outcomes and who sign an assurance to participate in       |
| process and outcome evaluation.                                       |
|                                                                       |
| **Objective 3.2.3:** The Technical Assistance Network will provide    |
| training and technical assistance on strategic planning to a target   |
| group of Certified Coalitions.                                        |
+-----------------------------------------------------------------------+
| **Year 3 (2008-2009)**                                                |
+-----------------------------------------------------------------------+
| **Objective 3.3.1:** Certified Community Coalitions will develop      |
| plans to sustain local strategic plans and the process for            |
| identifying culturally appropriate, evidence-based programs,          |
| policies, and practices that address priority risk and protective     |
| factors in order to reduce underage drinking and other drug use and   |
| address other national, state and local substance abuse-related       |
| behaviors.                                                            |
|                                                                       |
| **Objective 3.3.2:** The State Epidemiological Workgroup, Prevention  |
| Systems Committee and the Technical Assistance Network will develop   |
| policies that support seamless connections and reduce duplications    |
| among funders and providers of substance abuse services.              |
|                                                                       |
| **Objective 3.3.3:** Louisiana prevention system will utilize ongoing |
| epidemiological needs assessment data, evaluation data and other      |
| performance measures to reassess priorities and adjust its            |
| comprehensive state strategic prevention plan in order to achieve and |
| sustain desired outcomes.                                             |
+-----------------------------------------------------------------------+
| **Year 4 (2009-2010)**                                                |
+-----------------------------------------------------------------------+
| **Objective 3.4.1:** The Prevention Systems Committee will create a   |
| mechanism to coordinate funding for additional cohorts of Certified   |
| Community Coalitions across Louisiana with redirected, braided or new |
| non-SPF-SIG funding whose strategic plan implementation demonstrate a |
| continued effort to sustain a logical connection between proposed     |
| evidence-based programs, policies, and practices and reductions in    |
| underage drinking and other state and local prioritized prevention    |
| outcomes and who sign an assurance to participate in process and      |
| outcome evaluation.                                                   |
|                                                                       |
| **Objective 3.4.2:** The Louisiana Drug Policy Board will oversee the |
| process to reassess priorities developed and the vision articulated   |
| based on the result of the initial mobilization process of the state  |
| and community, and affirm key milestones and outcomes that effect all |
| substance abuse prevention funding across systems.                    |
|                                                                       |
| **Objective 3.4.3:** Certified Community Coalitions who were funded   |
| after the first year will develop plans to sustain local strategic    |
| plans and the process for identifying culturally appropriate,         |
| evidence-based programs, policies, and practices that address         |
| priority risk and protective factors in order to reduce underage      |
| drinking and other drug use and address other national, state and     |
| local substance abuse-related behaviors.                              |
|                                                                       |
| **Objective 3.4.4:** The Louisiana Drug Policy Board, through its     |
| Prevention Systems Committee and Epidemiological work group will      |
| continue to reassess its strategic and sustainability plans and make  |
| modifications where necessary.                                        |
|                                                                       |
| **Objective 3.4.5:** Certified Community Coalitions funded for a year |
| or more will submit revised annual implementation plans based on the  |
| findings from on-going evaluation and monitoring.                     |
+-----------------------------------------------------------------------+

4\. Implement evidence-based prevention programs, policies, and
practices and infrastructure development activities

+-----------------------------------------------------------------------+
| **Year 1 (2006-2007)**                                                |
+-----------------------------------------------------------------------+
| **Objective 4.1.1:** The Louisiana Drug Policy Board, with            |
| recommendations from the Prevention Systems Committee and State       |
| Epidemiological Workgroup, will develop infrastructure and adopt      |
| policies needed to support the selection and implementation of        |
| culturally appropriate, evidence-based programs, policies, and        |
| practices by Certified Community Coalitions that receive SPF-SIG and  |
| other federal and state funding to address underage access to and use |
| of alcohol and other local, state, and national substance abuse       |
| prevention priorities.                                                |
|                                                                       |
| **Objective 4.1.2:** The PSC will develop an implementation plan that |
| supports the State's strategic plan and oversees agency action plans  |
| for particular scopes of work                                         |
|                                                                       |
| **Objective 4.1.3:** The Drug Policy Board through the PSC and SEW    |
| will create a communication plan that speaks with one message and     |
| many voices.                                                          |
+-----------------------------------------------------------------------+
| **Year 2 (2007-2008)**                                                |
+-----------------------------------------------------------------------+
| **Objective 4.2.1:** Certified Community Coalitions receiving SPF-SIG |
| funds will establish policies to support selection of evidence-based  |
| programs, policies, and practices and implementation fidelity with    |
| adaptations needed to ensure cultural competence without sacrificing  |
| core program elements.                                                |
|                                                                       |
| **Objective 4.2.2:** The State Epidemiological Workgroup will guide   |
| the local coalitions and providers in the selection of culturally     |
| appropriate evidence-based strategies that meet the unique needs of   |
| their communities.                                                    |
|                                                                       |
| **Objective 4.2.3:** Local providers, with the support of the         |
| Certified Community Coalition, will begin to implement selected       |
| programs, policies, and practices that carry out the local strategic  |
| plan, with a particular emphasis on alcohol.                          |
+-----------------------------------------------------------------------+
| **Year 3 (2008-2009)**                                                |
+-----------------------------------------------------------------------+
| **Objective 4.3.1:** Local providers, with the support of the         |
| Certified Community Coalition, will continue to implement selected    |
| evidence-based programs, policies, and practices that carry out the   |
| local strategic plan with a particular emphasis on alcohol based on   |
| the completed needs assessment.                                       |
|                                                                       |
| **Objective 4.3.2:** All Certified Community Coalitions who receive   |
| federal or state funds for substance abuse prevention will establish  |
| and enforce policies to support the selection of evidence-based       |
| programs, policies, and practices, to assure implementation fidelity  |
| with adaptations needed to ensure cultural competence without         |
| sacrificing core program elements, and to assure implementation staff |
| is trained and culturally competent for the program selected and the  |
| population served.                                                    |
+-----------------------------------------------------------------------+
| **Year 4 (2209-2010)**                                                |
+-----------------------------------------------------------------------+
| **Objective 4.4.1:** Local providers, with the support of the         |
| Certified Community Coalition, will continue to implement selected    |
| evidence-based programs, policies, and practices that carry out the   |
| local strategic plan, with a particular emphasis on alcohol and       |
| related problems, based on a completed needs assessment.              |
+-----------------------------------------------------------------------+

5\. Monitor process, evaluate effectiveness, sustain effective
programs/activities, and improve or replace those that fail

+-----------------------------------------------------------------------+
| **Year 1 (2006-2007)**                                                |
+-----------------------------------------------------------------------+
| **Objective 5.1.1:** The Louisiana Drug Policy Board will affirm as   |
| advised by the Prevention Systems Committee the performance measures  |
| of partner agencies and incorporate the process and outcome measures  |
| into the SEW data system.                                             |
|                                                                       |
| **Objective 5.1.2:** The State Epidemiological Workgroup in           |
| conjunction with the Technical Assistance Network will provide        |
| evaluation training and technical assistance regarding collection and |
| utilization of evaluation and performance measurement.                |
+-----------------------------------------------------------------------+
| **Year 2 (2007-2008)**                                                |
+-----------------------------------------------------------------------+
| **Objective 5.2.1:** The Louisiana Drug Policy Board through its      |
| Prevention Systems Committee and State Epidemiological Workgroup will |
| adopt a common framework for use by all agencies that fund substance  |
| abuse prevention to assess implementation quality, cost-benefit       |
| ratio, and outcomes of evidence-based programs, policies, and         |
| practices, changes in risk and protective factors, and impacts on     |
| underage alcohol and other substance use and related behaviors.       |
|                                                                       |
| **Objective 5.2.2:** The Prevention Systems Committee and State       |
| Epidemiological Workgroup will develop infrastructure needed to       |
| collect, house, and report data used to assess implementation         |
| quality, cost-benefit ratio, and outcomes of evidence-based programs, |
| policies, and practices, changes in risk and protective factors, and  |
| impacts on underage alcohol and other substance use and related       |
| behaviors by all state agencies that fund substance abuse prevention  |
| efforts across the state of Louisiana.                                |
|                                                                       |
| **Objective 5.2.3:** The State Epidemiological Workgroup, in          |
| partnership with the state's SPF-SIG evaluator, will begin to         |
| evaluate the implementation and effectiveness of the Technical        |
| Assistance Network's training and technical assistance regarding the  |
| *Applied* Pathways process.                                           |
+-----------------------------------------------------------------------+
| **Year 3 (2008-2009)**                                                |
+-----------------------------------------------------------------------+
| **Objective 5.3.1:** The Louisiana Drug Policy Board will affirm the  |
| plan recommended by the Prevention Systems Committee and the State    |
| Epidemiological Workgroup to sustain infrastructure and desired       |
| outcomes at the state and community levels.                           |
|                                                                       |
| **Objective 5.3.2:** The local implementers of evidence-based         |
| programs, policies, and practices will carry out the elements of the  |
| community/partnership strategic plan providing on going reports of    |
| the progress made in reducing underage access to and use of alcohol   |
| and other drugs.                                                      |
|                                                                       |
| **Objective 5.3.3:** The State Epidemiological Workgroup, in          |
| partnership with the state's SPF-SIG evaluator, will report to the    |
| Louisiana Drug Policy Board the initial process and outcome           |
| evaluation results of locally implemented evidence-based programs,    |
| policies, and practices supported by SPF-SIG funded Certified         |
| Community Coalitions, communicate identified successes to key         |
| stakeholders across the state, and encourage needed improvements by   |
| funded coalitions and local service providers.                        |
|                                                                       |
| **Objective 5.3.4:** The Certified Coalitions will begin to assess    |
| the work of providers of program, policies, and practices.            |
+-----------------------------------------------------------------------+
| **Year 4 (2009-2010)**                                                |
+-----------------------------------------------------------------------+
| **Objective 5.4.1:** The Louisiana Drug Policy Board will work with   |
| the Governor's Press Office to present the evaluation findings to the |
| Legislature and the media.                                            |
|                                                                       |
| **Objective 5.4.2:** The Technical Assistance Network will work with  |
| the Certified Community Coalitions to adjust implementation plans     |
| based on monitoring and evaluation findings.                          |
|                                                                       |
| **Objective 5.4.3:** The Louisiana Drug Policy Board and its          |
| Prevention Systems Committee and State Epidemiological Workgroup will |
| modify the state strategic and sustainability plans infused with the  |
| knowledge of the evaluation report.                                   |
|                                                                       |
| **Objective 5.4.4:** Local coalitions will assess the data collected  |
| to date regarding the effects of the selected evidence-based          |
| programs, practices, and policies and make adjustments as needed.     |
+-----------------------------------------------------------------------+

[^1]: This process was a culmination of a year long effort by the SEW
    and an assessment of all available data sources to guide the state
    effort.

[^2]: Members of the Management Team include staff from the following:
    Governor's Office, Office for Addictive Disorders, Department of
    Education, Office of Mental Health, University of Louisiana at
    Lafayette, Southwest Center for the Application of Prevention
    Technologies, and Louisiana National Guard.

[^3]: This question will be addressed during the creation of the state
    strategic implementation plan in autumn, 2006.

[^4]: The implementation of the tool, because of time constraints, was
    conducted in a manner that only provided a glimpse of the reality in
    each parish and will be expanded with the assistance of the selected
    parishes.