SUBSTANCE ABUSE AND MENTAL HEALTH

SERVICES ADMINISTRATION

CENTER FOR SUBSTANCE ABUSE PREVENTION

NATIONAL ADVISORY COUNCIL

Tuesday,

August 28, 2007

Sugarloaf Mountain Room

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Rockville, Maryland

IN ATTENDANCE:

[Chairperson]{.underline}

Dennis O. Romero, M.A.

Acting Director

Center for Substance Abuse Prevention

Room 4-1057

1 Choke Cherry Road

Rockville, MD 20857

[Committee Management Specialist]{.underline}

Tia Haynes

Center for Substance Abuse Prevention

Room 4-1066

1 Choke Cherry Road

Rockville, MD 20857

[Members]{.underline}

Karel A. Ares, M.Ed.

Executive Director

Prevention First, Inc.

2800 Montvale Drive

Springfield, IL 62704

Paul J. DeWispelaere

President and CEO

PRIDE Youth Program

4 West Oak Street

Fremont, MI 49412

Sharyn L. Geringer

Substance Abuse Prevention Advocate

190 Preuit Road

Wheatland, WY 82201

Alan H. Shinn, M.S.W.

Executive Director

Coalition for a Drug-Free Hawaii

1130 North Nimitz Highway, Suite A259

Honolulu, HI 96817

Hope R. Taft, D.Ed., D.H.L.

Substance Abuse Prevention Advocate

2811 South Dorchester Road

Columbus, OH 43221

[C O N T E N T S]{.underline}

PAGE

Welcome, Opening Remarks, and Introductions

Dennis O. Romero, M.A.

Acting Director, CSAP 6

Administrator\'s Report

Arne Owens, M.S.S.M.

Senior Advisor to the Administrator

Immediate Office of the Administrator, SAMHSA 12

CSAP Budget Overview

Peggy Thompson

Director

Office of Program Analysis and Coordination, CSAP 22

Discussion 32

Strategic Prevention Framework (SPF) in

Discretionary and Block Grant Programs

Allen Ward

Public Health Advisor

Division of State Programs, CSAP 34

Discussion 45

Underage Drinking

Gwyndolyn Ensley

Senior Public Health Analyst

Division of Systems Development, CSAP 56

Meg Baker, CPP

Program Coordinator

Health Promotion and Substance Abuse Prevention

Drawing the Line on Under 21 Alcohol Use

and

Kathie Durbin

Division Chief

Division of Licensure, Regulation, and Education

Montgomery County Department of Liquor Control 57

Discussion 67

[C O N T E N T S]{.underline}

PAGE

Minority, Vulnerable, and Diverse Subpopulations

Claudia Richards

Branch Chief

HIV Behavioral Health Issues Branch

Division of Community Programs, CSAP 74

Peggy Quigg

Division Director

Division of Community Programs, CSAP 88

Discussion 95

Council Roundtable Discussion 100

Data Strategy

Kevin Mulvey

Acting Director

Division of Systems Development, CSAP 121

Discussion 123

Older Adults

Jennifer Solomon

Public Health Analyst

Division of Systems Development, CSAP 126

Discussion 135

Workforce Development

Nel Nadal

Public Health Analyst

Division of Systems Development, CSAP 138

Discussion 146

[C O N T E N T S]{.underline}

PAGE

Public Comment 151

Closing Remarks

Rose C. Kittrell, M.S.W., M.Div.

Acting Deputy Director, CSAP 162

[P R O C E E D I N G S]{.underline} (9:05 a.m.)

MR. ROMERO: Good morning, folks. Before we get started, I want to
apologize. I was on a conference call since 8 o\'clock this morning and
it was hard to get off that call.

But I would like to officially bring this meeting of the SAMHSA Center
for Substance Abuse Prevention National Advisory Council to order.

First of all, I\'d like to welcome back our members and ask, are there
any questions before we get started of yesterday\'s activities?

(No response.)

MR. ROMERO: I would like to acknowledge at the front end that Ms. Hope
Taft is on her way here from the airport and she should be here maybe
around 9:30 or 10 o\'clock from Ohio.

I would also like to acknowledge that we have two NAC members on
conference call, and I will ask them to also acknowledge and introduce
themselves.

Yesterday we had a full day of information sharing, as well as
overviews, of both the work of CSAP, the work of the Center for
Substance Abuse Treatment, and the work of the Center for Mental Health
Services. We also had the privilege of learning or getting an overview
of the priorities of the Center for Substance Abuse Prevention, which
are underage drinking, older adults, vulnerable populations, and
workforce development.

Today on the agenda is to afford you the opportunity to hear and be
exposed to, in a more realistic fashion, the four priorities as
operationalized in the prevention field.

At this time, I would like to also acknowledge that Ms. Rose Kittrell,
the Acting Center Deputy Director, is on her way down. She was at the
conference call with me, and I asked her to stay just a couple extra
minutes while I scooted out. So she will be here in a few minutes.

For those that are on conference call, Ms. Tia Haynes is present, as
well as other CSAP staff, members of the prevention community, and
certainly our prevention partners are present here as well.

Before we get started, I would like to invite the council members to
introduce themselves. I ask that you give your name, your current
professional position, as well as the expertise that you believe you
bring to the National Advisory Council. And we\'ll start with our newest
member.

MS. ARES: Thank you, Dennis. Good morning, everyone. My name is Karel
Ares. I\'m the Executive Director of Prevention First, which is a
statewide drug prevention, training, and resource center located in
Springfield and Chicago, Illinois. I\'ve been with Prevention First for
17 years and in the field of prevention for 20.

I feel that with this background I bring quite a bit of experience and
knowledge about certainly what\'s worked and what hasn\'t worked in drug
prevention over the past 20 years. I also bring with me a good
understanding of the kinds of training and technical assistance and
support that local communities need in order to implement what we know
are best practices in prevention, and I also have an appreciation for
the challenges of the state and federal bureaucracy in trying to do its
good work and looking at that from a systems approach.

So I\'m very humbled and honored to serve on the advisory council and
look forward to working with my fellow members to help CSAP advance its
agenda. Thank you.

MR. ROMERO: Thank you, Karel.

Sharyn?

MS. GERINGER: Good morning. I\'m Sharyn or more friendly known as Sherry
Geringer.

MR. ROMERO: Sherry. Good. I like that.

MS. GERINGER: I\'m the former First Lady of Wyoming. I was one of the
founding members of the Governors\' spouses\' initiative, Leadership to
Keep Children Alcohol-Free, and then subsequently one of the founders of
the foundation, which is working to support that work of the Governors\'
spouses.

I\'m mostly a volunteer. That\'s what I consider myself professionally
now, having retired from the political arena. As the mother of five and
grandmother of 10, my main area of interest is prevention of underage
drinking.

MR. ROMERO: Thank you, Sherry.

Jay?

MR. DeWISPELAERE: Good morning. My name is Jay DeWispelaere. I\'m the
President and CEO of PRIDE Youth Programs. I have served on the advisory
council now for a while. I have the privilege of working with these
folks and the wonderful staff here at SAMHSA.

My background is in law enforcement. I spent 25 years as an officer
working with young people. I was a volunteer working with peer-to-peer
prevention groups, high school mostly. Now I would say my area of
expertise ‑‑ I have a background in serving the mentally ill as a board
member and state board member. I have a background working with people
in treatment, and of course, my work today is in prevention. So I find a
lot of interest but probably the number one drug of choice is underage
drinking and alcohol, and that\'s probably what I spend the majority of
my time on.

I\'m here to make sure that young people\'s voices are heard across the
country. We support young people that live a drug- and alcohol-free
lifestyle, and I really believe that until which time as we grow as a
council to the point that we add a young person with that background on
the council that I\'ll make sure their voices are heard. Thank you.

MR. ROMERO: Thank you, Jay.

And Alan?

MR. SHINN: Aloha kako, everyone. My name is Alan Shinn, Coalition for a
Drug-Free Hawaii. We\'re a primary prevention agency in Honolulu,
Hawaii, but we serve the entire State of Hawaii. So we have some
interesting challenges in Hawaii because of the physical isolation of
the various islands. We\'re separated by water, of course, and some
distance, but also each island actually has a different culture of its
own in terms of its political and demographic makeup. So we do have some
challenges. But it is paradise, let me tell you. It\'s nice to live
there.

Our agency just celebrated its 20th anniversary, and we had a great fund
raiser and celebration aboard the NCL ship, Pride of America. It\'s one
of two ships the NCL fleet has in Hawaii. So it was a great celebration.
Dennis was there. He was on our 20th anniversary video. The theme was 20
years of excellence in prevention, and I think that the agency really
deserves that celebration and recognition for all the good work that
it\'s done. I just feel very proud to be representing it.

By the way, Allen Ward, how come you weren\'t at our fund raiser? I\'m
just kidding. I\'m kidding, Allen. He\'s out in Hawaii. He\'s our
project officer for our SPF/SIG and state. A great guy.

And John, you weren\'t there either. How come? You weren\'t authorized
to travel.

MR. ROMERO: There may be a conflict of interest when it comes to fund
raising activities, but we won\'t go there now.

MR. SHINN: On a serious note, we still have a serious problem with ice
and crystal meth in the islands, and I believe we\'re either number one
or number two, competing with Oregon State around this issue. I believe
that the solution really lies in agencies like ours pulling people
together, communities to really mobilize and to take action against not
just ice but underage drinking and other drug-related issues in the
islands.

So thank you very much, Dennis.

MR. ROMERO: Thank you, Alan.

I should also acknowledge that we\'re in the process of getting Mr.
Henry Lozano and Mr. Don Coyhis, who will be on conference call in a few
minutes for the remainder of this NAC meeting. Again, Ms. Hope Taft is
on her way from the airport.

Today we will have the opportunity, as I said earlier, to actually bring
some life to the priorities of prevention. My charge to the NAC members
is to listen to the presentations of our four priorities and to really
think critically from your vantage point how this can be further
enhanced and be able to reach to all the communities that are in need of
the prevention presence.

At this time, I have the privilege of introducing Mr. Arne Owens. Arne
Owens is the Senior Advisor to the Administrator in the Immediate Office
of the Administrator, representing today Dr. Terry Cline, our
Administrator, and on behalf of our Deputy Administrator, Rear Admiral
Ric Broderick. Arne?

MR. OWENS: Well, thank you, Dennis. Again, as I mentioned yesterday,
it\'s really a pleasure to be here with all of you and we\'re glad that
you all are here advising us and providing us your input and your
counsel and your advice. That\'s extremely valuable.

Dr. Cline regrets that he cannot be here. He is on travel, along with
Dr. Broderick, on an adventure that began somewhat last minute.
Otherwise, he would have been here.

I will have to depart right after I deliver some comments here because
I\'m also chairing an Executive Leadership Team meeting here at SAMHSA.
So I\'ll need to scoot on up to that. But I did want to take just a
couple of minutes here to hit some key points that I think are very
important.

We do a lot here at SAMHSA. I mentioned yesterday how we are primarily a
resource provider, a provider of funding, and also a provider of
knowledge-based resources, information, evidence-based practices, things
that will help you do your job better, more effectively. So we\'re very
pleased to be doing that. It\'s really the core of what we do. We have
some great people here at SAMHSA that are delivering those services. But
again, as I also mentioned yesterday, we don\'t deliver direct services
to people out of SAMHSA. You all do that and the states and the
communities, community providers actually come into daily contact with
people. But the folks here at SAMHSA care very much about this mission,
and so they like to stay connected to you and it\'s important that we
maintain that connection.

As you know, we have three centers here that provide the resources out
to the states. Of course, in addition to CSAP, we have the Center for
Substance Abuse Treatment and the Center for Mental Health Services.
They provide the resources in their appropriate areas.

We\'d always like to do more, of course. There are some limitations. But
also ‑‑ and I think I mentioned this yesterday ‑‑ when it comes to
prevention, quite frankly, I think prevention is the most important
thing that we do. It\'s the most important mission we have. Yet, at the
same time, it\'s the area ‑‑ well, treatment gets most of the money,
quite frankly. CMHS gets a big chunk of money because they have some
very important resources they need to provide to the mental health
community throughout the country. But in my own mind, prevention is the
most important of the fields, quite frankly. Again, that\'s my
subjective point of view, but I think that\'s true.

But I think we probably also agree that the primary deliverer of
prevention services is not necessarily a government entity at the
federal level or at the state level. It\'s primarily families. It\'s
primarily churches. It\'s communities, community groups and
organizations.

I still remember back to when I was growing up and in my high school
years and was at the point in my life when I could be getting into
trouble. I remember the little town I grew up in. Actually it wasn\'t
quite as ‑‑ well, we had more than 3,500 people. We had about 95,000. So
we were actually a small city I guess. But our local police department
sponsored an Explorer Scout post. They also sponsored a youth band, and
we got to wear the police uniforms. We started identifying with the good
guys. As I look back on that, I realize that in my own life that was a
fairly effective prevention program. Both of those programs were
sponsored by the local community, and that was outside of my family.
Now, I had a very positive family experience, which was really the
ultimate prevention story in my life, and I had a very supportive
church. But all of those things combined kept me on the right track. Not
everyone has that, but that\'s the heart of what we do, to try to
provide that as best as we can in our communities throughout the
country.

How are we doing? Well, it\'s very difficult to measure the prevention
effort. I guess I look at it in terms of the big picture. We do what we
call the Household Survey. We do a national survey of drug use in
American households throughout the country. And it\'s pretty darned good
data. I think it gives us a fairly accurate picture. Some folks say
maybe it under-reports in certain areas. I don\'t know if that\'s true
or not.

But from those surveys, we believe that there are probably 23 million or
so Americans with a substance abuse problem that\'s so serious that they
need some form of treatment. That\'s 23 million. Now, that\'s a lot of
people. And they\'re really our priority. They are our priority of
effort. They are our focus. About 20 million of those, by the way,
don\'t think they need treatment. They do but they just don\'t think
they do. So our challenge is to convince them that they do need some
sort of help. But that\'s the scope of the problem.

Now, I guess the good news is on the flip side of that, there are 270
million Americans out there who don\'t need treatment. So I kind of like
to look at that positive side as well. So the more we can do on the
prevention side, we just encourage and support that 270 million. So I
just really appreciate what you all do in that regard.

As you know, here in CSAP, we\'ve got some major programs, and I\'ve
been involved with at least one of them, Drug-Free Communities. The
Office of National Drug Control Policy will tell you it\'s their
program. It is their money. No question about that. But the people that
actually make it happen and get it down to the communities are the
people right here in the Center for Substance Abuse Prevention. I see
Peggy Quigg back there. She\'s the division chief that makes all of that
work. And we have project officers down there who are connected to
communities and do, in fact, help enormously with that. There are 750
grantees around the country, \$70 million or so per year that goes
toward this effort, maybe more in the future. We\'ll see. But it\'s a
great program.

It\'s coupled with another great program, the Strategic Prevention
Framework. As you know, there are a lot of folks out there that want to
do good. High-functioning families are out there engaging in what we
would call prevention anyway. Communities are doing some good things.
But a lot of times there are disconnects and there\'s no organized
approach. There\'s no integrated approach with community leaders
focusing on what needs to be done within their communities because
communities are different.

In the area where I live right now down in suburban Richmond, Virginia
where my family is located out on what we call the west end of Richmond,
there\'s a problem with underage drinking, and it\'s an issue of
suburban kids being a little rebellious and getting a six-pack and going
out drinking and throwing the beer cans off the side of the road and
that sort of thing. It\'s a problem there.

Other communities have problems with drugs. So it varies based on the
community you\'re in. So we need approaches tailored to those
communities. And that\'s the great thing about the Strategic Prevention
Framework. It provides a whole mechanism on how to achieve that. I\'m
very supportive of it and I\'m glad the folks at CSAP are moving that
forward.

I mentioned underage drinking. We did a roll-out of the Surgeon
General\'s report on underage drinking a month or two back and gave some
attention to that issue, and we\'re helping with roll-outs in states
around the country, again providing an opportunity to deliver a very
positive message of what can be done and to raise the visibility of that
issue because it is an important issue that affects communities that may
not have been the focus of much attention prior to this.

I know in the part of Richmond I live in, the drug problem is probably
minimal. Folks figured, well, there just aren\'t any problems out there
in the suburbs, but there are. There are teenagers out there that are
dealing with two parents working. They may be making a lot of money, but
the kids feel neglected and they can get into trouble. So everything you
do is important in that regard.

I wanted to talk about budget just briefly. Dennis will go into the
details here of the CSAP budget. We\'re in an interesting environment.
For fiscal year \'08, the President has proposed about \$156 million to
go toward prevention. Most of that is within ‑‑ well, that\'s for
SAMHSA. Most of that is in the CSAP area. Not all of it. I guess some of
it is counted as prevention, but some of the programs are in some of our
other centers. That\'s a lot of money but it is a decrease from what we
had had before, and I felt it\'s important for me to place that in
context and explain some of the background for that.

We\'re in a challenging budget environment right now. You need to know
that. I think if you read the papers, you can understand that. The
President has actually announced in February of this year that he wants
to balance the budget by 2012. So he\'s proposing over five years to do
just that. Now, there are a lot of factors that work into that. If the
economy continues to do well, then the revenues received by the federal
government will increase at a higher level than what the Office of
Management and Budget projects, hopefully. So maybe we\'ll achieve that
sooner. Maybe there will be more money to spend. We\'ll have to see. But
that\'s one of his goals, to balance the federal budget.

We\'re doing that at the same time where we\'re fighting a war in Iraq,
and I don\'t need to explain that to anybody. It\'s in the newspapers
every day. It\'s a very important matter, a very important issue. The
President feels very strongly that we need to do what we\'re doing over
there and try to bring some ‑‑ well, a new form of doing business, a new
form of government to that part of the world. Whether you agree or
disagree with that, that\'s the priority that he has set. And folks who
disagree will, of course, have the opportunity to vote on it next year.
All that will take care of itself with time. But that\'s the environment
we\'re in.

In this restrictive environment, however, we feel that we have here at
SAMHSA identified the priorities that we need to follow. We believe we
can do everything that we need to do with this \$156 million and move
forward and continue to advance these great programs. Now, this is \$156
million of discretionary funding for SAMHSA. Now, in addition to that,
of course, 20 percent of the substance abuse prevention and treatment
block grant goes out to the states. It has to be used by the states for
prevention. On top of this \$156 million, of course, we have this
Drug-Free Communities money, this \$70 million or so, which comes from
the Office of National Drug Control Policy. So we believe the resources
are there to do what needs to be done and we want to just press forward
with this mission.

Now, I will also state that the number I just gave you was the budget
number that was sent to the Appropriations Committees on Capitol Hill.
That\'s the budget presented to them by the President. As you know, the
process doesn\'t end there. The Appropriations Committees go to work.
We\'re told that in some of the markups they have done, dollars have
been added to the SAMHSA budget.

But that then begs another question. If they add too much money overall
and the proposed discretionary spending of the federal government
exceeds the target level that the President has established, then we
face the threat of a presidential veto. If that happens, there aren\'t
enough votes to override a presidential veto in the Senate. So that then
leaves us with the possibility that there may be a continuing
resolution, and if that happens, then things continue at the 2007 level.
So that\'s kind of the convoluted process and the environment we work in
here. Nothing is ever settled in this town, it seems like, but those are
the realities that we have to deal with.

Now, here at SAMHSA, we have to consider all these ramifications, and we
have to do our planning based on the environment and the possibilities
that we see occurring. All I can assure you of is this, that we will
take the resources that we\'re provided by the American taxpayer and we
will do our level best to expend those resources wisely, as efficiently
as possible certainly, but as wisely as we possibly can and do
everything that we can to support your efforts as you carry the
prevention message and do the prevention work around the country. That
much I can guarantee you.

Thanks.

MR. ROMERO: Thank you, Arne, for those wonderful remarks.

As you hear from Arne, we truly have both a challenge to try to meet the
needs of the prevention community, attempting to strike a balance with
the resources made available to us, the taxpayers\' dollars. It is my
contention that we need to ensure that every penny that is loaned to us
be used in the most responsible manner as possible. And that is the
charge that is before me, and I truly welcome and challenge the NAC
members to embark on this quest with me to ensure that the
responsibility ‑‑ the public trust and certainly the need to ensure that
all citizens\' hard-earned money is truly put to the best use as
possible.

Now I have the privilege of affording you the opportunity to hear from
Peggy Thompson who is the Director of the Office of Program Analysis and
Coordination in CSAP, also known as our budget office. I\'m not sure why
we have this long-winded name when it really is a budget office, but
someone will have to explain it to me at some point. Peggy will offer
you a brief presentation on the CSAP budget. So, Peggy?

MS. THOMPSON: Well, good morning, and I see all of you made it back from
lunch and from yesterday\'s evening. That\'s the first test. So
congratulations. You passed.

(Laughter.)

MS. THOMPSON: The second test is not going to be on the budget. I
didn\'t realize, when I started preparing my remarks, that budget was
going to be the topic du jour. So as a result, I\'m going to keep my
comments and my briefing very brief. It\'s a brief briefing, but I\'m
available for any kind of questions you might want. I just don\'t want
to pound you to death on the budget because it\'s a topic that can be
detailed, tedious, and important. So let\'s see how fast and how
interesting we can make this.

I wanted to do my presentation in terms of personalizing the budget, not
just SAMHSA-wide but specifically prevention-wide. I\'m going to try
hard not to repeat Mike\'s remarks. A couple of Arne\'s I am going to
repeat, but I\'ll really skim through them quickly for you.

So I wanted to focus the presentation on three aspects: past, present,
and future. So my first slide has to do with where we\'ve been.
Prevention Funding History. Where have we been? This is one of my
favorite slides. Some of you may have seen it before, but it bears
repeating because it keeps things in context. It shows where we\'ve been
and what the general trend in prevention funding has been. It\'s a nice
chart that goes from 1998 to the present and it shows a nice, general,
gentle increase in prevention funding cumulatively across the years. It
does break it down into Drug-Free Communities funding, which is the
little greenish bars; our ever so popular PRNS, or Programs of Regional
and National Significance, funding which is the yellow bars; the block
grant funding, which is that part of the prevention and treatment block
grant, that 20 percent set-side in the black bar; and then the happy red
bar is the total of all of those different funding streams come
together. So you get the picture. It\'s been increasing historically
over time and shows a nice, consistent progression and continued
increase and continued interest.

This is my second-favorite slide, probably your least favorite slide.
It\'s a complicated slide but I\'m going to make it really easy for you.
This is the entire federal budget process. Basically it shows you that
at any given time we are working in three fiscal years. The first
multi-colored line is FY \'07. It could be any year, but for the
purposes of where we are right now, it\'s FY \'07. The second
multi-colored line is FY \'08, and the third would be FY \'09.

Each year, as you can see, is divided into five sections, the first
section being budget planning in which we\'re thinking conceptually
about where are we, where should we be going, what are our interests,
what are the needs of the communities. This is the phase in which the
National Advisory Council can play a really strong role in terms of
helping us to understand from your perspectives where we should be
going, what\'s real, what\'s out there. You are a reality check. You can
give us ideas. You can help guide us as to where we should be going. So
the red bar of each year is particularly important in terms of National
Advisory Council roles and functions.

The second bar, which is the yellow, talks about budget formulation, and
that\'s one in which our office gets very closely involved in that we
prepare plans for the upcoming year. That is, each fiscal year we do
three sets of plans. The first set goes to the Department of Health and
Human Services. The second set goes to OMB. I\'m sure you\'ve heard of
them. And the third set becomes the President\'s budget. So we do those
three different versions for each budget year that we have to go
through.

The third bar, which is purple, is congressional action, and that is the
action in which the House and the Senate make their recommendations and
the combined committees come together and do a final recommendation for
any given year\'s budget.

The green represents budget execution, some people\'s favorite part
because it\'s where we actually get to spend the money. That is when we
actually award our grant and contract programs. So that occupies a lot
of our time and attention.

The last bluish, I guess it is, bar is the audit and review section. We
don\'t have a whole lot to do with that, but what we do is scrutinize by
various folk in the government to make sure that we have spent our funds
appropriately.

So the real question is where the heck are we now. This nice little line
shows where we are. We\'re in August in terms of FY \'07. This is hard
to see upside down, but I\'m trying. In FY \'07, we have spent almost
all of our money. You\'ll notice it bisects the green. We\'re finishing
up our fiscal year. It does end officially the end of September, but
because of the various financial systems that all actions have to go
through, we\'d like to close down the books a little earlier if we
possibly can. In fact, we have to. So we are basically almost through
spending all of our money in \'07.

If you go to the second cross-wise line for \'08, Congress is acting on
the budget proposals that we have submitted. So as you\'ve already
heard, the House and Senate have already made their recommendations for
what kind of funding we should have. It\'s not quite through all the
purple because we haven\'t had final congressional action yet.

If you look at the third cross line for \'09, it\'s in the budget
formulation process. Again, that means that we\'ve thought through where
we would like to be going in \'09. We have made some recommendations to
HHS. We have just now submitted our recommendations to OMB, and we are
still in the process of finalizing what \'09 will look like.

So hopefully that\'s not too much detail, but it gives you the overall
picture about what the process is and where we are right this minute in
each of the three different years.

This slide captures what Arne was just talking about in terms of the
\'08 process, where are we going. It shows, or I tried to make it show,
the historical trends between the different parts of the budget
formulation process. To put that a little bit more simply, it starts
with where we are right now, or how much money we have been
appropriated. The legend didn\'t come out quite right on this one. The
red line is FY \'07. The bluish line is FY \'08. I put them both on
there so that you could get a feeling about normal cycle changes instead
of, oh, my gosh, look at \'08. We\'re going to die, which really isn\'t
the case.

So in \'07, we started with a level that we ended \'06 with. We
submitted the President\'s budget. The House acted on it. You can see
the line went up at that point. The Senate acted on it and it went up
even slightly more. And then we had our final funding level, which ended
up being in \'07 a continuing resolution. That meant that the House and
the Senate did not finalize our spending level. So they did not make any
changes to it, and the fall-back position is that we are allowed to
spend funds this year at the same rate that we spent them last year.
That\'s the really layman\'s definition of a continuing resolution. So
that\'s kind of what happened this year.

In \'08, the blue line, we started again with the \'07 actuals, which is
the current level. The President\'s budget you\'ve heard too much
discussion about already, being \$156 million. But you can see how that
does look pretty dramatic as the line goes down in terms of money
available. But the House and Senate, you may notice, have proposed
higher amounts or differing amounts. And then there is no blue final
because we\'re not there yet. But even though you hear pretty scary
suggestions about where we\'ll be in \'08, what I wanted to leave you
with is that these fluctuations are part of the normal budget process.
They are not necessarily dire predictions of the future.

Indeed, for \'08 we do have recommendations from the House and the
Senate as to what we should be doing, as well as the funding levels. I
wanted to just capture a few of the programmatic highlights or
lowlights, but I think highlights, about where the House and Senate
think we should be going.

Basically the House level continues to support the SPF/SIG at about the
same level that it is now. It also continues to support the HIV grant
program that we have. In fact, it proposes a \$4 million increase over
this year\'s levels. It continues to support the meth grant program that
we currently have available, and it continues to support workplace
programs at about the same level that we have this year.

The new things that the House would like to see us tackle are a \$7
million increase to help support more funding for underage drinking. As
you heard from Mike yesterday, that means \$5 million worth of grants,
\$1 million for the Ad Council, and \$1 million for the ICCPUD. Don\'t
ask me to spell that acronym. I can\'t do it. But it\'s I-C-C-P-U-D.
It\'s the interagency group. So there is definitely an interest in
underage drinking, and it is supported with funds at the House level.
That\'s good news.

And the other good news is that the House has recognized a need to
continue funding the CAPTs technical assistance, Center for Applied
Prevention Technology systems. So those funds were restored in the House
level.

The Senate level looks a whole lot like the House, which is really good
news. It means there are fewer compromises to be worked out and fewer
problems between the two groups. It also continues the SPF/SIG grant
program, but it provides \$7 million more within that program for
funding. It continues the HIV, the meth, and the workplace programs at
about the same funding level. It also wants to see more funds go to
underage drinking, but they have proposed only \$4 million. And it also
restores the CAPT.

So you see huge similarities between the two funding levels, and
basically what that means is although we really don\'t know what the
\'08 final will look like, there really are only two options. Those of
you who were at lunch with us yesterday may appreciate this slide more
than others.

(Laughter.)

MS. THOMPSON: Basically there are two things that may happen for \'08.
One is that the House and Senate subcommittees may come to a compromise.
Because they are already so close, that seems like a strong possibility,
and we\'ll have a final budget that looks approximately like those two
levels.

The other possibility is that they won\'t come to an agreement or the
President won\'t sign it or something horrible will happen that we
can\'t even foresee today, which I\'m not even going to worry about. And
then the worst case scenario that will happen from that is that we will,
once again, be under a continuing resolution, meaning basically that we
will have the same level of funding that we have right now. That\'s not
such a horrible scene either because right now you may recall or may not
that right now we have \$192 million, and the House proposed \$194
million and the Senate \$197 million. So there is a slight difference
between those numbers, but percentage-wise not a huge difference. So no
matter how you look at it, \'08, while there may be a big question in
your mind, does have some stability and a likely direction that we will
be going in.

And \'09. Okay. Why did I say \"back to the future\"? My daughter asked
me that when I told her what I was going to do, and I had a beautiful
explanation. It sounded so good last night.

Today all I can tell you is that we are always projecting in the future
and we\'re always doing it at the current. So there is a circular
relationship between the future and the present, and we cannot tell you
exactly what the future will look like, but we are working on it. We are
planning for it. A lot of things will happen between now and then, as
you may recall from that incredibly complex slide, and we anticipate
building on what we\'ve done, taking your recommendations into account,
and moving forward in \'09.

That\'s it. You\'ve heard enough about budget, but I\'m happy to answer
any specific questions or general questions you may have about the
process or the content of the CSAP budget. You would have let me down if
you hadn\'t said something.

MR. DeWISPELAERE: No, I couldn\'t do that. You know that. I\'m going to
be nice today. So I want to say, Peggy, that you make the budget
process, although sometimes not the most easy thing to understand,
simple and colorful, and that makes it nice. So with that said, thank
you, Peggy.

MS. THOMPSON: Well, thank you.

MS. GERINGER: Peggy, I really appreciate that slide with the process of
the three years because I\'ve not understood how it works at all, and
that at least clarifies some of it. So thank you.

MS. THOMPSON: Great. Thanks.

MR. ROMERO: Peggy, thank you for your presentation. Always good.

What\'s the CAPTs funding level? It said, \"restores CAPTs.\" What would
that funding level be for the House and the Senate, do you know?

MS. THOMPSON: Well, it would be approximately the same as it is
currently. Let\'s see if I can give you a good number. It\'s ‑‑

MR. SHINN: Nine.

MS. THOMPSON: Nine? I was going to say \$7 million to \$9 million,
approximately.

MR. SHINN: No, \$9.2 million.

MS. THOMPSON: The funding for the CAPTs is distributed between two
different budget lines, which you really don\'t need or want to go into
at this point. But the bottom line is about \$9 million.

That\'s too easy, guys. Great. Thank you.

MR. ROMERO: Well, Peggy, thank you very much. You do make this look and
feel like it\'s manageable and attainable. To me, still it\'s a very,
very foreign topic. Trying to translate this information into English
is, in and of itself, a daunting task. So thank you, Peggy.

As you know, the SPF, the Strategic Prevention Framework, is CSAP\'s
major flagship, and it truly affords us the opportunity to challenge the
prevention field to really begin to think strategically about the issues
that confront their community. The SPF is taking hold across the nation
and I am proud to say and report to the council that we are making
tremendous headway across this land. The SPF is, in fact, challenging
folks within the allied health field beyond the walls of prevention and
into other areas of the allied health field.

To that end, this morning we have Allen Ward, the project officer within
the Division of State Programs, who will present on the SPF, or the
Strategic Prevention Framework, program within the discretionary grants
and also give you an overview of some good news as to how the SPF is
permeating across other areas of the substance abuse field. I will
preface this ‑‑ and I don\'t mean to take some of the wind off your
sails, Allen, but this is something that occurred to me not too long ago
to really begin to look at this piece and see better ways to manage and
measure the effectiveness of the Strategic Prevention Framework within
the substance abuse field.

So, Allen, thank you for coming this morning. I should also acknowledge
that Allen is the project officer of the Pacific jurisdictions, which is
an area of tremendous interest and of concern to CSAP and to me as well.
So, Allen, thank you.

MR. WARD: And don\'t forget about Hawaii also, project officer for
Hawaii.

Alan, to answer your question earlier, I didn\'t get the invitation in
time. It was sort of late when I got the invitation from the Lieutenant
Governor. I would have loved to have come. Looking at the big waves on
the north shore is really great. Of course, we get a lot of work done
when we\'re in Hawaii also.

I\'m going to my best impersonation of Mike Lowther because this is
actually Mike\'s presentation. So if I don\'t sound exactly like him and
don\'t get the little movements down exactly right, let me know, and if
I do, don\'t tell Mike.

This is probably going to be a repeat for a lot of people when I start
talking about the SPF process, but I\'m just going to give a slight
overview of the SPF process for some of you here who don\'t understand
exactly what we\'re talking about with the SPF.

The SPF is a five-step process. It\'s really a planning process that we
look at. But underneath the SPF, you have to realize that there has to
be infrastructure in place in order for you to address the SPF. There\'s
a certain infrastructure that a state or community has to have in place
in order to address each one of the steps. So the model itself is a
planning model to help you get from point A to point B and to also
determine whether or not your programs are working. If they are working,
what is causing them to work, and if they\'re not working, why aren\'t
they working and how can we change that?

So the first thing we\'re going to look at is the assessment process.
The assessment, when we look at the SPF/SIG grants, is a totally
different process from when we\'re looking at communities. The SPF/SIG
grant ‑‑ we have in place what we call an Epi Workgroup. The Epi
Workgroup is a group of individuals from different agencies and
organizations throughout the state that have access to data that\'s
going to look at consumption and consequences associated with substance
use. So that can include many different organizations and agencies that
work with families, children and work throughout the community, police
enforcement, and different sorts of agencies. So the assessment part is
to take a snapshot of your state, determine what the problems are around
substance abuse, the consumption patterns of those problems, and also
where they are located throughout the state.

The next part is the capacity part. You want to be able to address those
issues. So you\'ve got to assess your entire system to determine what
capacity do you have to address the needs in your state. You\'re going
to look at things like resources associated with knowledge, skills,
abilities. You\'re going to look at financial resources, human
resources. So there are a lot of different resources you\'re going to
assess when you\'re looking at capacity.

The next thing you\'re going to look at you\'re going to develop a plan.
The plan is going to include addressing the need, but it\'s also
addressing the capacity. How are we going to build that capacity that we
don\'t have. So you\'re going to have goals and objectives around
addressing the need and goals and objectives around addressing the
capacity.

The implementation process is where you\'re going to look at
evidence-based policies, practices, and programs. What do we need to put
in place in order to address the need? So in the implementation process,
you\'re going to look at that, and you\'re going to look at how are we
going to operationalize our policies, practices, and programs. So in the
implementation process, you\'re going to look at the programs you\'re
going to put in place. You\'re going to look at how you\'re going to
operationalize it. Operationalize can be we\'re going to use grants,
contracts, whichever means we have to use to put this particular action
in place.

And evaluation and monitoring is something that\'s going to be inherent
throughout all five steps of the SPF. So you want to evaluate and
monitor. You want to look at process evaluation where you\'re looking at
everything that you put in place. How it\'s done, when it\'s done. In
outcome evaluation, you want to look at what you put in place and how it
affects the overall baseline that you\'re looking at of behaviors,
attitudes and perceptions, norms, so forth.

Inherent within the whole process, in the center you see sustainability
and cultural competence. Throughout the process, you want to determine
how are we going to sustain those outcomes that we\'re trying to
achieve. That has to be thought of at the very beginning. The cultural
competence ‑‑ we want to work with individuals not only just race,
creed. We want to look at all those different subcultures. We want to
look at the cultural aspects that are conducive to using substances
within the community also and how you would address those needs.

So that\'s the quick and dirty overview of the SPF process.

As Dennis said, I work for the Division of State Programs. In the
Division of State Programs, we look at the SPF/SIG grants, which are
discretionary grants that we give out. Right now we funded three cohorts
of SPF/SIG grants and I\'ll talk about how many funded in each cohort.

We also look at the block grant. We work with states who received a 20
percent portion of the block grant. That\'s all 50 states, the District
of Columbia, and we have jurisdictions and territories that receive
those block grants. Six of those jurisdictions are actually the ones
that I work with in the Pacific, but we also have jurisdictions in the
Caribbean with Puerto Rico and the Virgin Islands.

Also I have to mention Synar, too. We work with the Synar Program, and
that\'s another issue that a lot of states don\'t want to hear about,
but it\'s an important part of our job.

The structure of the SPF/SIG, or the Strategic Prevention Framework
State Incentive Grant, first off is a five-year cooperative agreement. A
cooperative agreement is a little bit different from a grant in that we
get an opportunity where we work more closely with the states when it
comes to making decisions. With a grant, we usually just give them the
money and say we want you to achieve these outcomes and basically
monitor their implementation of the grant. With the SPF/SIG process,
we\'re actually a member of the advisory council. So we advise them on
every step of the SPF/SIG. The SPF/SIG is guided by the SPF/SIG advisory
group, which is a group of individual organizations within the state
usually appointed by the Governor. In the case of Hawaii, the Lieutenant
Governor works pretty closely with the SPF/SIG and he is also the chair
of the advisory group.

The other part of that is also the Epi Workgroup. The advisory group has
to work very closely with the Epi Workgroup to make decisions around
what are the priority needs that need to be addressed and the locations
within the state or areas that need to be addressed. Eighty-five percent
of the funds have to go to the community. What we look at is a 15
percent/85 percent split. Fifteen percent of the funds go towards
administration, evaluation, and epi work. We have to do a cross-site
evaluation also. That\'s part of the evaluation piece. But there\'s also
evaluation of the implementation at the state level.

The Epidemiology Workgroup looks at all the data related to consumption
and consequences within the state. When you look up there, you see
state/tribal and we also have jurisdictions. We also forget about the
jurisdictions. There are three jurisdictions that have SPF/SIG grants.
The tribal Epidemiology Workgroup is going to be somewhat of a challenge
to us right now because a lot of them don\'t have the data that the
states have and not even the data that the jurisdictions have. So
that\'s something that we\'re going to have to look very closely at and
work very closely with the tribes. This year we funded five tribes,
which is the first cohort in which we funded tribes.

The SPF/SIG program is made up right now of 42 grantees. Twenty-one were
funded in Cohort I. Five were funded in Cohort II, and we had 16 funded
in Cohort III. Of the 16 funded in Cohort III, five of those were tribal
grantees, and we had one territory which was American Samoa.

If you take a look at the map ‑‑ I believe you have this map in your
handout. I know you can\'t see it very well. But it shows the location
of the different cohorts and where they\'re located throughout the
country. So in fiscal year 2004 and fiscal year 2005 was Cohort II, and
2006 was Cohort III. We haven\'t funded a Cohort IV yet. We\'re not sure
how that\'s going to work out.

The updates for Cohort I and II. Since they\'ve been in the works for a
while, they had an opportunity to do some of the benchmarks that we look
at. One is the epidemiology profile. So they did an epidemiology profile
which actually looked at the consequences and consumption throughout the
state, and they broke it down by not only race, sex, and different
areas, but they also broke it down by different areas of the state where
there are priority needs so they can determine the priority areas of the
states that they need to address.

The second thing that they did ‑‑ once they completed their
prioritization process based upon their epi profile, each state is
required to develop a strategic plan, and that strategic plan is one
that we at CSAP have to review and approve before they can fund the
communities. Most of the states in Cohort I and II ‑‑ in fact, there is
a list of the information that\'s available, some in the handouts. I
will hand those out later. We also have some of the handouts on the
table. The handouts will show you the priority targets that were
selected. This one will show you the priority targets that were
selected. I\'m not sure if everybody has this. If not, I have copies
here.

The first handout will show you the priority targets that each one of
the states have selected so far. What you see in the handout will be
Cohort I and II. Cohort III has not gotten to the point yet where they
have selected a priority target. I think actually that was handout 2. I
need to hand you this one which has the priority targets.

Handout 2 shows you the communities that have been funded, how many have
actually funded their communities.

If you look closely at handout 1, you\'ll see that a lot of the
individuals selected alcohol in some form or fashion as their priority
target. In fact, when you do analysis or actually looking at that ‑‑ and
I was talking to one of the project officers this morning about the
underage drinking. She pointed out that all except one had selected some
form of underage drinking. So underage drinking looks like one of the
priority targets that most states have identified that is a problem
within their state.

The second handout will tell you which states have actually funded the
communities. If you look out to the side, there\'s a number in
parentheses, and that number tells you how many communities that they
actually funded.

So I\'m going to move on and talk a little bit about the block grant
next. The SAPT Block Grant, as you know, is a block grant that gives
funding to prevention and treatment. At least 20 percent goes towards
prevention, addressing primary prevention. Some states target more than
20 percent of the funding, but 20 percent is required.

For fiscal year \'08, which is the fiscal year coming up, states must
report on NOMs in their application. The NOMs are the National Outcome
Measures. The NOMs P1 through P11, which is the first 11 forms ‑‑ most
of that information is pre-populated information which would come from
the National Household Survey. Although states have an opportunity to
substitute that information, there\'s a process that they must go to if
they like that that information does not truly capture what\'s going on
in their state.

Now, on forms P12 through P15, the states are required to report on that
each fiscal year.

States are encouraged by the SPO, which is the state project officer,
and site visits to embrace SPF as their planning mechanism for the block
grant.

If you look at the next slide, we have a breakdown of the number of
states and also we have a handout that has the summary information too.
But we have the breakdown of the number of states that are using the SPF
in some form. According to the information that we have, 48 states are
using the SPF process of assessment in their block grant planning.
Forty-two of the states are using capacity in their planning for the
block grant. The SPF step 3 of planning, 52 states are using that. The
SPF step 4 of implementation, 34 states, and the SPF step 5 of
evaluation, 22 states.

As for the last block grant applications that we got in, all 60
applications for the prevention and treatment portion of the block
grants were approved. What we do each year, each state has to complete
their block grant application. This year the block grant application is
going to be a little bit different because we\'re not requiring states
just to do the six strategies. They\'re given an opportunity to choose
whether or not they want to do the six strategies or look at the
Institute of Medicine model, the IOM model, where they\'re looking at
selected, indicated, and universal programs.

Since January 2007, CSAP has conducted so far ‑‑ when we talk about the
system reviews, we do system reviews with every state to look at their
system. When we look at their system, we also look at the way that they
plan for their block grant. A lot of the information that we got about
the states using the SPF in their block grant process came from the
system reviews. Since January 2007, we have conducted combined
prevention and Synar system reviews. Last year we decided to do Synar
system reviews as part of the normal prevention system reviews. So we
look at their Synar system, as well as their prevention system. So far
this year, calendar year 2007, we did seven states and three
territories.

The block grant is undergoing transition right now. So that\'s where the
opportunity for them to start looking at the IOM model comes into play
this year and also the requirement for them to report on their NOMs
comes into play this year, or the National Outcome Measures.

Finally, the SPF has been integrated into other programs as part of our
Division of Community Programs, which is headed by Peggy Quigg.
Methamphetamine prevention, they\'re looking at the five steps of the
SPF and using the five steps of the SPF. The HIV/AIDS program, they\'re
using the five steps of the SPF, and also Drug-Free Communities Support
Program, they\'re looking at five steps of the SPF. So the five steps of
the SPF are actually being integrated into all of our grants, and we\'re
looking for states to integrate it more and more into their block grant
as they\'re normal operating procedures.

Do you have any questions?

MR. ROMERO: First of all, thank you, Allen, for that wonderful overview
of the SPF.

Before we open up some questions, I\'d like to publicly welcome and
acknowledge Hope Taft, former First Lady of Ohio, and another newest
member of CSAP\'s National Advisory Council. So I\'m glad you were able
to make it here, and great to see you again.

Are there any questions?

MR. DeWISPELAERE: Welcome, Hope. Nice to see you again.

Allen, I want to clarify a couple things that we talked about yesterday.
Sometimes we get confused with the budget, but I get a lot of questions
as I travel in different states as it relates to the SPF/SIG process.
And, Dennis, you might want to chime in here too.

For the \'07-\'08 budget year, how much money do we anticipate will be
available to fund new states or territories, depending on who is on the
list? Do you know that?

MR. ROMERO: I\'m going to ask Peggy to help me out with this question.

MR. DeWISPELAERE: I didn\'t mean to put you on the spot.

MR. ROMERO: No, no, no.

MR. DeWISPELAERE: I just want clarification of that.

MR. ROMERO: It\'s a bit of a quandary. We have to remember a couple of
things. As we are preparing our budget or as we are submitting our
proposed budget to OMB and ultimately to the President for his
authorization, we have to take into consideration not only funding new
efforts but do we have enough money, first of all, to fund the
continuation of the already existing efforts. So that\'s a balancing act
in and of itself.

It is my understanding ‑‑ actually, Peggy, could you just chime in and
provide us with a quick overview of where we are with continuations into
\'07?

MS. THOMPSON: Okay. The answer always depends exactly on how the
question is asked. So do you want to ask it one more time so that I can
give you what you need?

MR. DeWISPELAERE: I sure do because I get confused. I was just taking it
easy on you up there. I was waiting for this one, Peggy.

MS. THOMPSON: Thanks.

MR. DeWISPELAERE: I get confused when I ask about ‑‑ because we talk
about the \'08 budget. Does that start in October of \'08 or does it
start on a continuation from October of \'07?

MS. THOMPSON: The latter. The first day of the FY \'08 budget period
starts October 1st, 2007.

MR. DeWISPELAERE: So my question is, of the monies that we anticipate,
will there, number one, be enough money to continue to support the
current funded SPF/SIGs, and number two, will there be any money to add
any new states or any new territories?

MS. THOMPSON: There\'s limited money depending on which scenario
actually ends up being the case. We talked about the different budget
levels. We talked about the House level, the Senate level, the potential
compromise committee, and potential CR. Each of those pictures has a
slightly different answer, but the general answer to all four is that
there is very limited money for a new SPF/SIG grant, which I think is
your real question, under the Senate mark level and no money for a new
SPF/SIG grant under the House, the continuing resolution, or the
President\'s budget.

MR. DeWISPELAERE: So that answer is there probably in this budget year
won\'t be any new grantees.

MS. THOMPSON: It\'s still a guessing game. That chihuahua isn\'t just a
cutesy little placeholder. It is a real thing. It isn\'t over till it\'s
over.

MR. DeWISPELAERE: Oh, I understand that.

MS. THOMPSON: We do not have a final appropriation, and even when we get
it, the actual funding picture for each specific grant or contract
program does undergo some minor shifting during the development of the
year, as the year goes on. So I can\'t say with absolute finality that
there will be no new SPF/SIGs. All I can tell you is under the currently
proposed scenarios, it\'s not likely.

MR. DeWISPELAERE: Okay, thank you.

The other thing, Allen, is I want to ‑‑ because I do a tremendous amount
of work in the states ‑‑ I work with a number of SPF/SIG states and I
work with a number of people that operate within the block grant. I
think the key word there is cooperative agreement in the places that
I\'ve seen the SPF/SIG working best, the capacity that they\'re building
throughout that state. As I think back, when we voted on starting the
SPF/SIG, that\'s exactly what we were trying to do because we know how
effective that is.

That said, good job on that to you and your shop, but I want to
encourage the states. I know our friend from NASADAD is here, and not to
pick on him either, but I want to encourage that the states take the
same approach. I realize we can\'t require it. The law doesn\'t allow us
to do that, but we can certainly encourage them to look at the states
that are being successful because of their cooperative agreements and
things that they have employed in their states and take that same
approach with the block grant even if that changes systems that have
been in place for years and years and years. Let\'s get all of these
talking together so that the communities can access the most services
that they can.

With that said, thank you for your presentation.

MR. WARD: And I appreciate that comment also because what we tried to do
with the last SPF/SIG meeting ‑‑ I think we did it a little bit too late
‑‑ was we opened it up to the states that didn\'t have a SPF/SIG for
them to come to the meeting and hear some of the good things that the
states are doing that have a SPF/SIG. And we\'re also hoping and we\'re
pushing as project officers the states to look closely at the SPF/SIG
process and use that.

I worked in a state system for 20 years before I came to CSAP. I worked
for the State of Louisiana, and I did work with the block grant program
there. In fact, I oversaw the block grant program. I also was the
legislative liaison for my agency. One thing that I realized in working
in a state system that had something in place for many, many years is
that it\'s a political thing. And a lot of times it\'s hard to uproot
that political structure when you\'re looking at dollars that have been
in place for many, many years, but it can be done. It\'s a process that
takes a while.

MR. ROMERO: Thank you, Jay. Thank you, Allen.

Any other questions?

MR. SHINN: I\'d add a comment. I just want to thank Allen for working
with us in Hawaii. I think he\'s shown a lot of patience with us, but
also he brings a lot of expertise and we appreciate that. He\'s very
calm for some reason. He doesn\'t get upset with us or he doesn\'t get
stressed out. So thank you, Dennis, for sending Allen.

MR. ROMERO: You\'re welcome.

MR. SHINN: I had a question and that was New Mexico keeps getting
brought up as a model. Why is that, Allen? I mean, what\'s going on in
New mexico that we need to know about?

MR. WARD: Actually New Mexico was first. Well, this last SPF/SIG meeting
we tried to involve more states in the process because there are a lot
of good things that are going on in other states. In New Mexico, they
grasped the SPF/SIG process and they moved forward a lot quicker than a
lot of states. It doesn\'t mean that they had anything special or
anything different from a lot of other states, but they did have the
lead and they could show states some of the problems that they
encountered and how to overcome those problems.

And we\'re learning more and more with each cohort. In fact, the last
SPF/SIG meeting, I think we had just about everybody from Cohort I to
present on lessons learned and do a different presentation. In fact, we
had a really good presentation from Guam and Palau, the way that they
addressed the SPF/SIG issue. One of the states made a comment that
instead of having Palau on a panel, next time we should let them go for
the whole 90 minutes because they enjoyed their presentation that much.

MR. ROMERO: And just to reiterate, of the first two cohorts of the
SPF/SIG grants awarded, 25 of the 26 states have received an approval
for their state plans. With one state, we\'re in the draft. This sort of
equates to approximately 305 communities that have already received an
SPF/SIG within 34 states. So the process is starting.

What you heard Allen speak to today is how the SPF as a planning
mechanism is permeating again across other areas of the substance abuse
field and certainly with the block grant. That to me is a real important
sign that we are making headway in beginning to think strategically
about the problems of substance abuse.

Yes, Hope.

DR. TAFT: Is the process being used by any states or any communities to
leverage non-federal dollars, i.e., private money?

The reason I ask is Ohio has developed a system that\'s very similar to
your SIG program, but we have found that the communities are using the
information that they gather from the assessment and the other steps to
really be able to leverage Community Chest, United Way monies,
foundation monies, those kind of things.

MR. WARD: I really want to defer to Alan about that because they did
something in Hawaii where they\'ve gotten state monies dedicated to
prevention. I don\'t know the process that they went through to get that
done.

MR. SHINN: You got me there, Allen. I\'m trying to think of how we did
that or what we did. Maybe it will come to me.

MR. ROMERO: I think, for example, that Nevada did leverage some monies
from the state from other coffers to support prevention efforts.

In my opinion, it goes to the heart of what the SPF is about, which is
sustainability. So long as we are not perpetuating or participating in
an immoral, unethical, or illegal activity, I think sustainability is a
good thing for a community.

It has to involve the leveraging and cooperation and collaboration of
other systems, whether it\'s not-for-profit or for-profit entities that
will contribute to the sustainability. That\'s the only way that it\'s
going to work because if not, then we are creating in my opinion a very
dependent relationship between the federal government and the
communities and the states. So we have to strike a balance.

I would be very curious, Hope, to hear more about what Ohio is doing,
and this may be something that we may want to explore, making sure that
this message gets out to other states as well. So we\'ll work on
something. You bet. Thank you.

MR. WARD: Actually that is our hope, that states will look at sources in
their community, as well as within their state, that they can leverage
and pull in and bring in. That\'s the whole premise behind the advisory
council, is we bring these groups together and we get them on board with
a common vision, common mission, and looking at their resources, to
dedicate their resources towards that goal, that one mission, one
vision.

DR. TAFT: I think the more you can encourage that at the community
level, the more effective the program will be and sustainability will be
long-term.

MR. ROMERO: Thank you, Hope.

Karel?

MS. ARES: That was kind of a nice little lead-in to one of my questions
around what kinds of barriers have you observed with states and their
ability to use this process thus far, recognizing they haven\'t
completed it yet. But what are some of the things that you\'ve seen, and
what is being done then to help them overcome those barriers?

MR. WARD: Well, from the very beginning, some of the first barriers, of
course, is that it\'s a new process to them, and they have to put a
totally different system in place that they\'re normally used to working
with. Many times, if they have a close relationship with the Governor, a
lot of those barriers are easily overcome. In states that they don\'t
have a close relationship with the Governor, they have a lot of problems
getting organization agencies to cooperate and provide data. Data is one
of the first barriers that I\'ve seen that we\'ve run into, trying to
get access to data, trying to go through different processes that are
put in place in order to get that data released. That\'s one of the main
barriers.

The other barrier that I\'ve seen is getting communities to actually
want to look at the data to determine their need because a lot of times
what we\'re used to doing is going straight to planning without actually
looking at a data-driven method for planning. So our planning doesn\'t
tie back to our data. So those are just a few of the things that we see.

MR. ROMERO: Thank you, Allen, again. This is such a vital piece to the
work that we do.

We are running just about 30 minutes late. So I have been given the
order ‑‑ and I follow the order quite well ‑‑ that we need to try and
get back on time. So thank you, Allen.

As a quick point of housekeeping activities, we had scheduled a
10-minute break, and I think we will just do a quick stretch, maybe 2
minutes, if it\'s okay with the council members, and we\'ll then
continue. Thank you, Jay, for your support on that one.

(Laughter.)

MR. ROMERO: I have the privilege now of beginning to present to you
where we are with our four priorities. As I said yesterday and I began
earlier this morning, we have identified four priorities under the
umbrella of CSAP and prevention. The first one that I\'m pleased to
present to you is on youth but particularly on underage drinking, and I
know that there are a couple of members on the council who truly have
their heart in this area of importance.

So Ms. Gwyn Ensley is the Senior Public Health Analyst in the Division
of Systems Development in CSAP. Gwyn will be presenting on underage
drinking activities, and with her, we have two additional guests present
today. First is Meg Baker, Program Coordinator for Health Promotion and
Substance Abuse Prevention, \"Drawing the Line on Under 21 Alcohol
Use,\" and Kathie Durbin, Division Chief Licensure, Regulation and
Education, Montgomery County Department of Liquor Control. Gwyn, we\'ll
start with you.

MS. ENSLEY: Good morning, everyone. It\'s a pleasure to talk with you
and present to you this morning. It\'s been a pleasure because I\'ve
worked with a couple of you, Mrs. Taft, in the past with the Reach Out
Now Program, and I always work with Jay. He\'s been one of our best
community people to work with in helping us get our programs out there
for Reach Out Now and Too Smart to Start.

Dennis has already presented to you our two community leaders. However,
before I get into my presentation, sometimes we can always talk about
how successful we are, but sometimes the proof is in the pudding. We
have people from the community. So today I want you to hear some
individuals who have worked with us and have used our programs and how
they have used our programs to help sustain underage drinking prevention
activities in their community. So I\'m going to let Meg and Kathie
present to you first, and then I\'m going to come back and tell you what
SAMHSA and CSAP are doing around underage drinking.

MR. ROMERO: Thank you.

MS. BAKER: Good morning. My name is Meg, and we thank you very much for
allowing us to present to you. This is really very exciting.

I guess with Drawing the Line on Under 21 Alcohol Use, there\'s a long
history there. It goes way back. Actually it goes way back to 1990 when
the Montgomery County Community Partnership was brought together under a
CSAP grant, and it is now sustained under the Drug-Free Support Grant.

Drawing the Line is a community coalition made up of public and private
agencies that focus on reducing adolescent access to alcohol and also
promoting the message that under 21 alcohol use is illegal, unhealthy,
and unacceptable. And I\'m going to stop here for a minute because
we\'ve made copies of the PowerPoints so you can kind of keep up with
us.

MS. DURBIN: My name is Kathie Durbin, and I\'m the Division Chief for
Licensure, Regulation and Education at the Montgomery County Department
of Liquor Control. We are a controlled jurisdiction here in Montgomery
County which really makes life easy for us when we\'re working on
prevention issues. We have some put in place automatically. There are
liquor stores. We run them. We close them at 10 o\'clock at night. There
are no spirits sold in Montgomery County after 10:00 p.m at night. So
there are things that are already put in place here, and we\'ve never
really talked about it. So we\'re talking about it now.

I actually used to be the coordinator for Drawing the Line on Under 21
Alcohol Use before Meg, and I worked as a prevention specialist for HHS
as well. So it\'s really nice to be able to have this role as regulator
as well. I\'m not really sure who I am. I actually also worked in the
hospitality industry for many years and was Executive Director of the
Montgomery County Restaurant Association in the \'80s. So it\'s been
very exciting for me to work through these processes and to use these
materials to move forward with our community efforts.

MS. BAKER: We have a variety of partners, as you can see: Safe and Drug
Free Schools. I\'m not going to read them. You can read them. Whenever
we\'d develop a project in Montgomery County, we call on our partners,
we develop work groups, and a plan of action follows.

MS. DURBIN: And then also, which I\'m sure Mrs. Taft is very familiar
with, Parents Who Host, Lose the Most Program ‑‑ we took that model on,
I guess, three and a half years ago working with Ohio, and it was very
exciting. We\'re actually moving that program right now into the Adults
Who Host, Lose the Most program. So we\'re starting a new program in
several languages with highway safety funding as well.

With that, we created a SAFE line to use with all of our partners, and
the SAFE line is a call-in line for the community and for the police and
any enforcement agencies that would like to talk about any issues they
see might be arising, whether it\'s an underage drinking party that\'s
coming up and maybe a mom found it in her son\'s backpack or anything.
It\'s really a SAFE line. They can call in and give us any information.
We also offer the brochure and materials on how to have safe events that
are alcohol-free.

MS. BAKER: Actually, let\'s see. What was it? About a year and a half
ago, we accepted the challenge of offering a town hall meeting to our
community. We gathered all our partners together. The packet that you
have shows you our materials, ranging from flyers, as Kathie said, that
were developed in different languages. What we did was we partnered with
public schools. They have five official languages. So those are the
languages that we focused on. You\'ll also see some media release in
there and our agenda.

We also partnered with the local alcohol and other drug advisory
councils.

And we publicized the materials in a variety of ways. In fact, one of
them was the cover of the Department of Liquor Control newsletter. So
that went out to all of their establishments. The PTA inserted a copy of
the flyer into their bulletin that went out. So we tried many, many
different ways to get the information out and to get folks there.

Our evening consisted of not just speakers, but we also involved local
resources. So they had tables of their materials on display and for
handing out. We used the Ad Council\'s PSA that was developed at that
point in time. We decided to have a door prize, and we took some of the
stipend to purchase that. Actually we purchased a cell phone. The winner
was one of the attendees, a Boy Scout in the Boy Scout troop. So it was
really quite appropriate so that he could keep talking. Then we also
gave out certificates to the participants as well.

One of the activities ‑‑ the police department has what\'s called fatal
vision goggles, and they had a display. This demonstrates what limited
abilities take place when you\'re under the influence of alcohol in the
goggles, usually around .08. But it was to make a point, and it did.

We also developed calendar of opportunities when adolescents could have
access to alcohol, and that\'s the single sheet that\'s around there.
Folks were quite surprised that every day of the week, every month,
every year there\'s always an opportunity when youth could have access
to alcohol. Our youngsters that participated came from the State Teen
Advisory Council, and one of our partners, Safe and Drug-Free Schools,
was very influential in getting the teens to participate as well.

MS. DURBIN: We also worked with the police on this event, and Chief
Manger was there to introduce an expansion of our safe line to SAFEnet.
So Keeping it Safe in Montgomery County is really our umbrella, and the
SAFEnet goes out monthly from the Department of Liquor Control, but all
the partners send their information. We send out to PTAs. We send out to
anybody. Anytime we get their email, it\'s sent out to them. it\'s all
information on what\'s happening in prevention, tools and materials they
can get, especially the free materials, anything that we are doing to
educate the businesses as well with underage drinking efforts and
educating the businesses.

MS. BAKER: Our feedback came in the form of the attendees filling out an
evaluation, and then further along, as we were working on other
projects, folks who had attended that event offered community comments
as well. So that\'s the unofficial evaluation.

Montgomery County Public School instructional TV filmed it and then
broadcast it on their local TV stations. The materials were requested.
So we were able to fulfill that. And to help the evening move along, we
also had a few planted questions as well to get group discussion, and we
had good audience participation with that.

I guess one of the challenges was with this material is not getting it
in an early-enough fashion so that this could take place in the month of
March. This is my opinion. If something like this is offered again, the
materials need to be out at least three or four months, way, way in
advance so that it allows communities to find their partners, get them
together, plan, figure out where it\'s going to take place, how
everything is going to take place. Otherwise, the materials were quite
helpful.

MS. DURBIN: The next thing we\'re going to talk about is our teach-in in
Montgomery County. To lead into the teach-in, I\'ll tell you a little
bit about what we\'re doing now.

Right after our town hall meeting, I received a phone call from the
Century Council who we work with for the liquor control, and they said
they were doing an event downtown in D.C., a media event, for their Girl
Talk Program. And I happen to be a troop leader as well. I have three
daughters. So it was perfect for me to bring the girls down by Metro.
They go to school in Rockville, and we just hopped on Metro, 14 girls
and I, with permission of the principal of their school. They were a
little too young to be part of that program, but it was really exciting
for them to see a press event downtown and to be part of it. Not to
mention, there were soccer players and other people that they can really
look up to.

So I kind of found that the girls liked, first of all, T-shirts. They
like gifts. They were really excited about the whole program and they
learned something that day. This is when the young people are really
forming their opinions about alcohol and drugs. So one happens to be my
daughter. I was very happy she could be part of that as well. But we
were really pleased about it, and they talked about it forever and ever
and ever.

So when the teach-in came up, I asked them if they wanted to plan the
teach-in themselves. So Troop 2060 ‑‑ at that time they were in sixth
grade ‑‑ planned the teach-in and they actually helped to create the
agenda. They were speakers as well, and we worked around them and
actually used the materials from the website as well.

What we had to do when we went into the school ‑‑ it\'s a small, private
school. It\'s about 300 students in the school, kindergarten through
eighth. But it took me four years to get a principal to finally say,
working with the archdiocese, yes, we can do something like this. Last
year we really opened it up. So it took a long time. This is not an
overnight process. So you\'re really building relationships with
teachers who don\'t think it\'s their kind of issue that they should be
doing this at some point. They\'re already tapped out. Working with the
school, working with the administrative system, the whole support system
in getting that approval took a while.

But once we did get approved, it was really exciting and we worked
closely with Bill Beard and Meg and I worked together. We produced a
media release and we put it out there, and it was really exciting.

So since we already found out the girls love shirts, we ended up using
some of the money that we had from the troop. I didn\'t realize we had
like \$700 since kindergarten. They\'re in sixth grade now. So we used
money and we purchased T-shirts that said \"Start Talking\" ‑‑

MS. BAKER: No, \"Keep Talking.\"

MS. DURBIN: I\'m sorry. \"Keep Talking Before They Start Drinking.\" We
asked the girls what they wanted, and they kept it as \"Keep Talking.\"
At the end of the day, we were wishing it said \"Stop Talking.\"

(Laughter.)

MS. DURBIN: It was fifth and sixth graders and we took them for pizza
afterwards and they talk a lot.

So it was very exciting. We had Captain Fascinelli, who used to run our
alcohol unit here in Montgomery County, came and spoke, and we worked
some scenarios that we had gotten from the website and used the
scenarios with the kids. As you can see, two of the scouts actually
wrapped up the program for us. The principal couldn\'t be there, so the
vice principal was part of it, which was great because she\'s never,
ever been part of any of this. And we have the principal\'s buy-in
already.

So it ended up at the last minute being fifth and sixth graders. We
thought it was just going to be sixth graders. So it was exciting. We
had a room full of young people, and as you can see, they like the lime
green shirts.

MS. BAKER: We started the morning off by using the alcohol true/false
quiz, and that was a real good place to get started from. Then as Kathie
said, we developed into some of the scenarios that took place.

MS. DURBIN: Right.

I guess the feedback we did get from the teach-in was really exciting
because only a couple of parents came to the event, but we had lots of
emails because the kids were going home telling them exactly what they
learned that day. They were talking about it. They did have a
conversation with their parents about this event, and it was very
exciting for them.

It went through the school. We also had a lot of pictures to put on our
website. We\'ve got a lot of play out of both of these events, and it\'s
been wonderful for us because the parents have really responded in a
positive way.

We\'ve also empowered the youth and they are wanting to play in another
event this year of the same sort. So it\'s very exciting and we\'ll get
them whatever color T-shirts they want because that\'s what they like. I
forgot the T-shirt.

So, anyway, we\'re really excited about doing these programs. We use the
material. I\'m always on the Stop Alcohol Abuse website and we\'re
always pulling off the materials because we don\'t have a lot of money
to spend. So this has been very exciting to not recreate the wheel
again.

MS. BAKER: Right. And also with the SAFE line, our online newsletter,
we\'re able to reach out to the community parents and refer them to the
different websites too so that we don\'t have to recreate a lot of our
material. It\'s been wonderful.

MS. DURBIN: That\'s it. If you have any questions.

(Applause.)

MS. ENSLEY: Thank you. Thank you. Don\'t go away. Have a seat.

MS. GERINGER: I do have a question for you, if I could, Kathie. You
mentioned that your liquor stores in Montgomery County close at 10:00
p.m. Was that done through the county legislative body or how was that
enabled?

MS. DURBIN: No. Actually that was done years ago through the Montgomery
County Department of Liquor Control. It\'s their stores. They run them.
I\'m sure if they wanted to keep them open, then they would have to go
to the county council at this point. When prohibition ceased, we became
a controlled jurisdiction. The State of Maryland went to the counties.
There are 18 other states that are controlled. We actually have three
additional counties in the State of Maryland that are controlled, but
they control spirits only. In Montgomery County, we control beer, wine,
and spirits. So we have the complete control over who gets the alcohol,
when they get it. So it comes really from our agency.

MS. GERINGER: Wow, that\'s terrific.

What about bars? Are they also controlled?

MS. DURBIN: The alcohol they purchase has to be purchased through the
county system, and then that money goes back into a general fund which
goes into substance abuse prevention programs and highways and roads and
such. We transferred \$24 million last year into the general fund. But
it is a state licensing system. So we work through the Comptroller\'s
Office under the state licensing.

So if they have a license that it goes until 2:00 in the morning, if
we\'re seeing issues in Montgomery County, when those businesses are now
up for renewal, we ask them to work with us, and we put restrictions on
their license but they have to agree to it. If they don\'t agree to it,
then we work with them in other ways, whether it\'s enforcement or more
education. So we do have a handle on it.

MS. GERINGER: I see. Thank you very much.

MS. ENSLEY: I want to thank Kathie and Meg for presenting on two of the
programs that we do, and the programs that they talked about is Reach
Out Now and Reach Out Now teach-ins and town halls.

And we want to thank Mrs. Taft who is the one who first started. She did
the very first teach-in when she was the co-chair of the Leadership to
Keep Children Alcohol-Free.

So after that, SAMHSA took the ball from Mrs. Taft. And we have now been
in our sixth year, and hopefully in fiscal year 2008, we are going to do
teach-ins again, along with town hall meetings. We did over 1,500 town
hall meetings in 2006. So it is proposed to do town halls in 2008 based
on the budget, along with Reach Out Now and Reach Out Now teach-ins.

Real quick, because I\'ve been asked to cut it short and move it along,
upcoming, as I just said, we\'re doing the town halls and the teach-ins.
Allen mentioned to you earlier about the SPF/SIGs. We have about 42
SPF/SIGs now. But out of the 25 that we have gotten approved plans, 24
of them have underage drinking as their major target, and about 15 of
them are specifically spending their SPF dollars on underage drinking.
So that\'s a good one for us.

I looked at a report from Texas this morning, and some of the things
that they are doing in terms of working with all the types of different
groups, parents, and communities, well, that gives us hope that the
states now are definitely increasing their focus on underage drinking in
the states because we know that there is a big problem.

SAMHSA/CSAP will be also participating in a DEA museum where we\'ll have
a piece that\'s going to be presented, I believe, in California in
November. So we also have an opportunity to address underage drinking
there, along with the Surgeon General\'s Call to Action. He has visited
some states, and he did one of his roll-outs in Hawaii and, I
understand, has been very successful. He has North Carolina and a couple
more states coming up. He\'s working with the Leadership Foundation to
continue to push this effort. So we have new publications, materials
that are coming out, and we\'re definitely trying to keep underage
drinking sustained within the community.

You heard about what Congress has proposed in terms of their budget with
the STOP Act, which has to do with underage drinking, in terms of the
money for grants and for the Ad Council\'s new PSAs that they\'re
developing for this upcoming year. So we\'re trying to definitely keep
it on target and keep it focused in the communities.

I want to thank Jay and Mrs. Taft for their efforts for definitely
helping us keep this at the forefront.

I hope this was quick and short.

MR. DeWISPELAERE: That was short, wasn\'t it?

MR. ROMERO: Thank you very much, Gwyn, and also Meg and Kathie for your
wonderful story. This is what prevention truly is about, and the more we
can share the promising actions that communities make to really bring
attention to underage drinking ‑‑ to me it\'s a personal charge. I have
two young children. My daughter is 2 years old. My son is 1 year old,
and I want to see a healthier tomorrow for them, certainly a better one
than the one I had. So it really is very personal to me and I know to
the members of this council. We\'re all here not because this gives us
tremendous aspirations but, rather, because this is the right thing to
do. It\'s doing the people\'s work. For that, I thank you very much for
your work, for your continued support for this effort.

Underage drinking remains an important priority for me, as I stated. It
remains a major priority for CSAP and for SAMHSA. Terry Cline and Ric
Broderick are very much aligned with our focus on focusing our attention
on underage drinking. Youth will remain a top priority for prevention in
the years to come as well.

So once again, thank you very much.

Before we break, we are close to back on time. So we will have a
five-minute break, a little stretch. Just two quick points before we
break for five minutes.

Because we had changed the meeting of the NAC, there were some
preexisting meetings that I am unable to change. So I will not be back
after the break. I will be attending some meetings with other HHS and
federal folks. So Rose Kittrell, the center Acting Deputy Director, will
chair the remainder of the meeting. I hope to be back as soon as I can.
I do have to leave a little early because I have a flight out to, I
think, it\'s Michigan, if I remember correctly. The last time I checked
‑‑

MR. DeWISPELAERE: You better check that because I think it might be
somewhere else. You can fly with us to Michigan, though.

(Laughter.)

MR. ROMERO: But let me just, in my minutes here, just say thank you to
the council.

I also need to acknowledge the CSAP staff who are present here today.
Really, there is no better group of people to shoulder yourself with,
folks who are just truly committed to this work from the division
directors, Peggy Quigg, Mike Lowther, Kevin Mulvey, Peggy Thompson, and
certainly the staff of CSAP. But we don\'t do this alone. We have a
wonderful family. We call this family SAMHSA. SAMHSA truly is engaged in
addressing and creating a healthier community. So to the CSAP staff who
are present and certainly to the SAMHSA folks who are also present, I
thank you very much for your attendance at this very important meeting.

So we will break for five minutes and we will resume at that point.
Thank you very much.

(Recess.)

MS. KITTRELL: We\'re going to go ahead and move right along here. We
want to be flexible with our agenda to meet the needs of our council
members and, at the same time, provide all of this information that I
think will help you during your tenure on the council. So what we\'re
going to do is to move right along with the \"Minority, Vulnerable, and
Diverse Subpopulations\" with Claudia Richards, and then we also have
Peggy Quigg, who is the Division Director, and she will talk with you
about the returning veterans initiative. Then Dr. Kevin Mulvey will be
joining us, and he will do a presentation. I\'m sure it\'s the data
strategy. That\'s what he\'s going with us about that, after which we
have a council member that\'s going to need to leave, and there are some
recommendations that she wants to share with us. What we would like to
do at that time is just take recommendations from the council.

I also want you all to be thinking about recommendations for new members
for the council. It\'s about a 9- to 12-month process. So it\'s not too
early to get started on that. So we would like for you to share with us
some of your recommendations and give that information to Tia.

So we\'ll now start with Claudia Richards. She is the Branch Chief, HIV
Behavioral Health Issues Branch.

MS. RICHARDS: It gives me great pleasure to speak to you council members
today with regard to CSAP\'s Minority AIDS Initiative programs and
looking at the Programs of Regional Significance, the Secretary\'s
Emergency Fund for the Minority AIDS Initiative, and last, talk to you a
little bit about the methamphetamine abuse project.

Through several Minority AIDS Initiative grant activities, we at CSAP
are working to prevent and reduce health disparities and substance abuse
and HIV for at-risk minority and disadvantaged populations in all
sectors of the communities. The Minority AIDS Initiative grew out of the
Congressional Black Caucus initiative reflecting their leadership in
creating a framework and providing and securing new federal funding. The
Minority AIDS Initiative is also designed to strengthen organizational
capacity and expand substance abuse and prevention-related HIV services.

The creation of the Minority AIDS Initiative is reflected in a broader
focus on disproportionately affected racial and ethnic minority
communities and also involves efforts taken on by the Congressional
Hispanic Caucus. We pretty much target five racial and ethnic groups
within the Minority AIDS Initiative programs that include African
Americans, Hispanic Latinos, Latin Americans, Native Americans, Asian
Americans, and Pacific Islanders.

First, I just want to make you aware that under the Minority AIDS
Initiative, it began in 1999 when CSAP initiated its first Cohort I. We
currently have six cohorts at this time. So we have been quite
progressive in terms of getting funding out in the communities of color
to address this impact of substance abuse or to prevent or delay the
onset of substance abuse, as well as to prevent HIV infections.

CSAP currently has 148 HIV grants. That would include currently three
cohorts. That would involve Cohort III, Cohort IV, Cohort V, and Cohort
VI. We currently have 22 active grantees in Cohort III. We have 48 in
Cohort IV and 81 in Cohort VI.

At this time, Congress has created this initiation simply because of the
spread of HIV in the minority communities, and as a result, has targeted
appropriated funds within the Department of Health and Human Services.
SAMHSA is one of several federal agencies that receive Minority AIDS
Initiative funds over the course of years. That would include CDC,
Health Resources and Services Administration, Office of Minority Health,
Office of Women\'s Health, and other federal agencies, Indian Health
Service, all receive Minority AIDS funds, as well as each of the centers
within SAMHSA receive appropriated dollars for minority AIDS services.

What we attempt to do is to continue to reinforce the idea with the
President\'s State of the Union address that was made in January of \'06
to continue to fight against HIV and AIDS in America, also to continue
to stop the spread of the disease. This is very important to the field
of prevention. We continue to embrace rapid testing as a mechanism to
continue to identify new HIV-infected individuals.

Looking at the infusion of the Strategic Prevention framework, we have
afforded an opportunity for 81 grantees within Cohort VI that involved
implementation of the SPF. Eighty-one grantees were awarded in fiscal
year 2005 that initiated their first three steps of the SPF, assessment,
capacity, and planning, during fiscal year 2006. These grantees have
been awarded \$254,000 over the course of five years, and they will
continue to implement services starting this year and the remaining
years of their grant.

This map illustrates our current active portfolio within the area of
minority HIV and AIDS grants. As you can see, to the right is a
distribution by our five CAPT regions in terms of how the funding is
being distributed across the states. You can see, in terms of proportion
of the HIV rates and prevalence, it\'s pretty much more predominantly on
the east coast area, as well as across the southern states. Then it goes
across and then it goes to California and up.

In terms of the metropolitan statistical area, primarily these
particular communities of color have been identified to meet the CDC
case rate in terms of 50 cases or greater with a population of 500,000
or 20 cases per or greater with a population of 100,000. Or they may
have been identified to have a case rate of 10 cases per 100,000 that
would include those states and communities.

Next, I\'d just like to give you a brief update in terms of some of our
current demographics of Cohorts IV and V. Currently you can see, in
terms of race and ethnicity, a proportional amount of target population
are African Americans\' followed by Hispanic Latinos; third, American
Indians and Native Americans; and last, Asians and Asian Americans and
Pacific Islanders.

Next is targeted groups by gender. We continue to see serving males more
than females, but preliminary data have shown, in terms of some more
recent information, that this is shifting a little bit in terms of
serving more females. So we want to continue to outreach to both genders
because of the importance of prevention.

Next is the category, age range. You can see we continue to serve
adults. Also we serve adolescents and youth and, more importantly,
children. We also connect these people with their families.

Intervention methods. It\'s very important that our grantees identify
evidence-based intervention models not only for substance abuse
prevention, but also for HIV. We afford the flexibility for them to
identify these intervention methods as they begin implementation of
services. You can see the distribution across the various types of
intervention models that are being used under the Minority AIDS
Initiative.

Next, I\'d like to give you a couple updates of some other special
projects. We have a recipient of two types of funding for this project.
Under the PRNS line, we\'re line-item appropriated. You can see our
funding has been flat consistently. It was good to hear that on the
House side, that we potentially may get an increase, and that really
will be refreshing.

You can see, in terms of 2007, that particular funding amount continued
to support Cohorts IV, V, and VI. IV and V will be in their last years
starting fiscal year \'08 that we\'ll be ending. We will continue to
fund the 81 grantees that are responsible for implementation of the SPF,
which are five-year grants.

The next slide illustrates another source of funding that we receive
from the Department of Health and Human Services. This is called the
Secretary\'s Emergency Fund. This is a departmental fund, approximately
\$50 million, that are available to federal agencies that have been
designated to receive Minority AIDS Initiative funds that I had
mentioned earlier. SAMHSA is one of those agencies. As a result, SAMHSA
submits a request to the Department and CSAP is a recipient of these
funds, looking just at a three-year window from 2005 to 2007. As you can
see, we have received a significant amount of increase for two of our
projects regarding Minority Education Institution and the Drug-Free and
Faith-Based Partners Initiative, which I\'ll speak about briefly.

The first project is the Minority Education Initiative project. This
particular project was initiated with funding in \'05 and started
implementation in \'06. We initially awarded 13 schools in \'05, and in
\'06 we awarded 12. We anticipate adding additional minority
institutions starting this fiscal year. Hopefully, we anticipate making
these awards by the end of the fiscal year.

But the main thing about this project is that it focuses attention on
increasing minority students\' awareness about risk factors associated
with substance abuse. We\'re looking at underage drinking on college
campuses. We\'re also looking at sexual risk behavior associated with
the use of illicit substances or alcohol and just the importance of
using student peer educators as a mechanism to get the information out
to do a lot of reaching out to their students. We have had a lot of
success rate in terms of training our young workforce, if you will, as
well as having the ability to allow them to continue to encourage people
to get tested. A lot of our schools do HIV rapid testing or some kind of
arrangement with a public health entity on campuses to encourage
students to get tested. So we have had a lot of success rate in those
increased numbers.

But more importantly, I\'d like to note that this year with the 12
existing minority education institutions, they\'re currently adopting
the Strategic Prevention Framework, which is a different animal because
it\'s actually being implemented in an academic institution. We do have,
for example, on our discretionary side another academic institution
that\'s currently doing SPF, and we\'re learning a lot about that
project to transfer that knowledge to this project. So we\'ve had a lot
of success rate in terms of schools having the opportunity to not only
work within the walls of their schools, but also to engage the proximity
of their community in terms of looking at those stakeholders that are
key people that would have some influence and some involvement in terms
of their participation in the project.

Also, we look at it from a sustainability standpoint. So we have had
continuously success because, as you know, on college campuses proximity
of the community ‑‑ there are liquor stores. There are drug activities
going on outside of the walls of the schools, and you have to engage the
community. So this is the first opportunity where a lot of schools are
taking that opportunity to actually interface with people outside the
walls of the school.

Next, I\'d like to just mention the other project under the Secretary\'s
Emergency Fund is our Faith-Based Partners Initiative. Again, this
project also started at the same time the Minority Education Institution
project started that I spoke of earlier. It has pretty much a twofold
approach. This particular initiative is underway, which is part of our
2007 funding, to continue to fund or at least establish funding for 12
to 15 new awardees that will receive \$50,000 that have some affiliation
and partnership with a community-based organization such as a drug-free
coalition, partnering with a faith-based organization to address the
needs of the reentry community, partners that come back from the
prisons. Reentry is very important to the faith-based community, and
they\'re doing a lot of work. So we want to engage them, along with the
drug-free coalition partners and to begin that collaboration to address
the needs of minority prisoners who are reentering into the community.

David Wilson is the government project officer on that particular
contract. He\'s not available today, but hopefully we\'ll get a chance
to tell you more about that because he\'s doing a lot of exciting work
with faith-based partners across the country in terms of doing PSAs and
a lot of educational and social marketing.

Next, I\'d just like to shift gears. The other project that our branch
manages is the methamphetamine. Who is using methamphetamine?

Well, in terms of 101, for those council members who may just want to
have just a quick synopsis, methamphetamine is a synthetic stimulant
drug which induces a strong feeling of euphoria and is highly addictive.
Meth, of course, can be eaten, smoked, injected, and snorted.

These are some of the slang terms for meth that you will see, folks.

These are some of the short-term side effects of meth users. These are
other short-term side effects.

This picture depicts a woman who has been using meth for about 1.5
years. In terms of some of the long-term effects on meth users, they are
listed. With regard to rotten teeth, the National Dental Association is
quite interested in looking at ways to work with meth users to address
meth mouths. That\'s what they\'re calling it. So SAMHSA is showing some
leadership in working with the National Dental Association to looking at
meth users across the country as they begin to treat these individuals.

In terms of methamphetamine kills, it causes heart failure. It causes
brain damage. It causes stroke. It exposes children to hazardous
chemicals. Fires and explosions and, more importantly, aggressive and
violent behavior.

In terms of CSAP\'s response to methamphetamine prevention, first of
all, what we have been able to do is partner with a lot of federal
people. We are now partnering with the Centers for Disease Control, the
Indian Health Service, Department of Justice, and also the National
Native Law Enforcement Association.

In terms of some of the history for meth, as you can see in the previous
slide ‑‑ I\'m not going to read it, but in terms of statutory authority,
we continue to address this authority in terms of our grant portfolio
program, and we have a very exciting program because it\'s a different
approach that we\'re using in terms of addressing meth. We\'re
addressing meth in several ways. We\'re addressing it from
infrastructure, also for service delivery.

In terms of the historical funding, you can see the project is maybe on
a smaller scale, but it\'s making major impact in the community. More
importantly, we recently received additional funding of \$588,000 to
award two additional methamphetamine abuse grantees, and they will be
active October 1st. We currently have 10 active grants with a budget of
\$3.3 million. So that\'s our current portfolio. These grants are three
years, and again, they provide infrastructure and service delivery
intervention services.

In terms of the types of expectations, the grantees provide
community-based prevention programming with these funds. They assist
local government entities to conduct appropriate meth prevention
activities. They continue to do workforce development and training and
educating state and local law enforcement officials and other key
community stakeholders. Also, they continue to monitor and evaluate the
meth prevention activities and report and disseminate results to the
public. Again, all of our grantees are reporting on the NOMs measures,
so we anticipate having some additional data to be able to report out
next year.

In terms of our interests in the area of meth, what we are attempting to
do is to build capacity in the community in terms of infrastructure and
also community-level support for interventions. We also want to help
communities to initiate and develop interventions, to design change in
attitudes and norms about meth, particularly young people, and going
into the schools. Again, we want to prevent or delay the use of meth.

The vulnerable populations that we serve and also the diverse
subpopulations that we serve under this initiative require intervention
services. We have very unique programs in terms of a wide spectrum of
array of services that are being carried out under this initiative,
working with meth mothers and their babies, as well as going into the
school systems, the school-aged children, and addressing from a
prevention standpoint. We also look at it from the community standpoint
in terms of infrastructure development. We continue to work with those
individuals in the community to continue to educate and make positive
change.

Some examples of our infrastructure projects. Again, training is very,
very key. Capacity building, workforce development. Also to establish a
prevention referral linkage system is very, very key. Many times a lot
of the individual meth users lack the support in terms of the type of
level of service that they will need in order to sustain or to prevent
themselves from reoccurring any use of meth. So we provide these
wraparound services as needed.

Examples of prevention intervention projects. Again, school-based
programs about the dangers of meth and inhalant abuse. Replicating,
developing, implementing and adopting evidence-based effective
prevention interventions.

This is just a map that illustrates several of CSAP\'s programs, the
SPF/SIGs, overlaid with the methamphetamine grantees, as well as the
Minority AIDS Initiative grantees. As you can see, the overlay is pretty
much targeting communities of need. In my case, my MAI program targeted
minority communities of need because these providers are either
minority-serving organizations or organizations that serve minorities.
So it\'s very good to see the overlay in terms of the geomapping and see
how our funds are distributed across the country, looking at various
aspects of prevention services.

The next slide I\'d like to share is just methamphetamine laboratory
incidence in 2006. As I mentioned, CSAP is partnering with the National
Native Law Enforcement Association, as well as the Indian Health
Service, and we\'re partnering with them in terms of putting on a meth
track along with the Center for Substance Abuse Treatment in November in
Memphis, Tennessee. As you know, Memphis is one of the leading states in
the area of methamphetamine laboratory incidence, as well as meth use.

Last, but not least is my staff. I could not have done all of this
without my staff. And if they are here, could you please stand?

(Applause.)

MS. RICHARDS: I\'d just like to give kudos to my staff every
opportunity.

So it gives me great pleasure to just give you a synopsis of what we\'re
all about in the Behavioral Health Branch, and I will entertain any
questions you may have.

MS. KITTRELL: For the sake of time, if you could hold your questions.

Peggy, because we are operating under a very tight time frame here,
because we do want to get the recommendations from the council members,
if you could hold your presentation to about five or six minutes. Do you
have it available for the notebook? And you all can chat over this at
lunch as well.

MS. QUIGG: Well, thank you, Rose. My presentation is a very short
presentation. We had actually taken this presentation out of your
schedule, but due to the questions that were raised yesterday by, I
believe, you, Sharyn, about what we were doing about veterans, we put it
back in for you. So I\'ll be very brief.

We continue to work as a result of the Returning Veterans National Forum
that was held almost two years ago now by SAMHSA where we brought
together groups from all over the country to look at the emerging issues
around returning veterans. We continue to work with a variety of
agencies, groups to look at this not only from the returning veterans
aspect, but across the spectrum of what are we doing pre-deployment,
during deployment for families, and post-deployment activities across
the board. We know now that this war effort is not a short effort, that
no matter what happens politically, we\'re still going to be involved in
this for the next couple of years, and the numbers just keep expanding
and growing.

I\'ve provided for you the most recent report from Congress looking at
what are the issues. This is the report that was the joint commission by
Elizabeth Dole and ‑‑ I can\'t remember the other person, but it\'s
called the Dole Commission report now. It was released in July as a
draft. It really gives you a quick snapshot of kind of where we are at
current day.

Last week the Pentagon released a second report on suicide rates for
returning veterans. The most significant finding out of that is a fairly
alarming finding I believe, that the suicide rate is almost double that
of the normal population, and the attempt rate is even higher than that.
So suicide has become probably the next major emerging issue that we\'re
looking at, in addition to substance use.

On the National Guard side ‑‑ and, Sherry, I think that\'s probably more
what your comments were asking about yesterday ‑‑ we\'ve been working
nationally with the National Guard Bureau to try to help them build up
some of their own programs internally. They came to CSAP and SAMHSA
asking for us to help them bring evidence-based findings to their
programs, and they also wanted to make a shift in their programs to do
more in-reach into some of their own military families and dependents.
And that\'s not been a typical mission of the National Guard
counter-drug program.

There are three components to the National Guard counter-drug program in
the States. The first is the counter-drug supply reduction, which is the
typical mission they\'ve done forever around helping law enforcement
reduce the supply of drugs in enforcement activities.

The second piece is the drug testing and control program within the
National Guard. It\'s their own monitoring and maintenance system of
their soldiers. That program has been around for a long time, about 15
years, within the Guard. They actually do random drug testing of their
soldiers and drug testing for deployments has become an even higher
need.

In addition to that, because of where we are today and I think because
of the long-term work that the Guard has done in communities, there\'s
an increased awareness now that they needed to expand that program much
more in an area of prevention and not just only limit it to drug testing
and control. So the expansion has been a program they\'ve done through
an interagency agreement with SAMHSA to begin to bring one of our
workplace model programs into the Guard called Team Awareness. They\'ve
adapted that to a program called Team Readiness, and readiness is
certainly the issue that they\'re concerned about most for their
families and soldiers.

So the program is a great program. It\'s been tremendously supported by
workplace environments. It is one of our model programs. It is an
intensive program.

The developer has worked with the National Guard to help break down the
modules so that they can do it however they need to do it to work best
within their training schedules. Normally they would come into a
workplace and do two or three days\' worth of intensive training time.
They don\'t get that luxury with the Guard. So the developer has worked
with them to figure out how they could break it down into one-hour
modules, four-hour modules, how they could do family program pieces
along with it.

They\'re currently in a pilot project with 26 states fielding that
program now, and by the end of the year, they hope to expand that to all
50 states and the territories that the National Guard serves.

The Demand Reduction Program also took a little bit of a change this
year and last year using a model to really look at how can they measure
the work that they\'re doing. They too, like all the rest of us, are
held to accountabilities and outcome measures. The program that they had
was 50-plus different programs all across the country with no good
measures for outcomes. They have good outputs if you\'re talking about
the number of people reached and number of programs done, the number of
volunteer hours, but no good outcomes. And Congress was challenging them
to show outcomes like they\'re challenging the rest of us in prevention.

They worked with us on some recommendations on a prevention curriculum.
They saw a need to do a standardized curriculum. With the turnover rates
that they have in deployments, their Drug Demand Reduction folks now
have less than two years\' experience, and they needed something that
they could give them in a kit to go out and do a viable, evidence-based
service to the communities. That\'s way different than what they\'ve
done in the past.

There are a lot of communities and even a lot of the folks in the Guard
that have not been happy about that transition, but I think given the
current state of affairs, they made a good choice in moving in that
direction for standardization for their own survivability and
sustainability and to get some measurable outcomes going.

They also complement that with a production made by Motivational
Productions called Freedom Calls. So they go into school, show that
piece. It is about motivation and it has two parts. It leads kids to
think about what\'s going on in their heads, what\'s going on in their
hearts, and what do they need to do about it. It is designed to really
target kids that are having some problems not just about substance
abuse, but all of the kid behavior issues, to seek some help, to go find
somebody to talk to about some of these issues, to talk to their
parents, to talk to their teachers, counselors, whoever.

And then they inserted within that production a piece specifically
designed for military kids to heighten both awareness of the school
environment, the counselors, teachers, that, my gosh, you might have
kids here whose family members are deployed through the Guard and
Reserve and also to tap into those kids who may be feeling lonely and
left out and different now that their family members are deployed or the
risk of being deployed. It\'s not a matter of if you get deployed now.
It\'s a matter of when. So there\'s a lot of increased anxiety with
these kids. So this production was designed to help bring some of those
things to light, make the school think about some of their environment
and what they\'re doing and target those kids.

That production and the curriculum is now being fielded in, I think, 46
states across the country. They did a pilot last year with 10 states.
The states had the chance to adopt both programs, and 46 have now gone
on and adopted those not only with the federal resources they get, but
with some additional state resources and making their own state plans
adopt that.

It\'s also about doing community outreach and in-reach for the military
youth, trying to educate communities that these kids who used to be in
our lowest at-risk populations have now become part of the highest
at-risk populations.

Then lastly, there are several ongoing special emphasis work groups and
efforts here at SAMHSA, combined with other federal agencies. I
mentioned the Dole Commission report. The veterans focus groups continue
to work on an ad hoc basis and around certain issues that come together.
Most importantly right now and most intensely right now, Kathryn Power
has been a part of a mental health work group that released an intensive
report about a month ago that also fed into this report as well. As a
result of that initial report, HHS has brought together an intense work
group. One of Claudia\'s team leaders is detailed right now from CSAP
down to work on that work group to make recommendations around mental
health concerns, mental health capacities, and the mental health
response for both returning veterans, as well as their families.

I mentioned the Pentagon Workgroup on Suicide Prevention. We now have on
our SAMHSA website a host of things about veterans initiatives and
linkages to the VA and other sites about veterans issues. So if you want
more information on what we\'re doing, please refer back to that
website. It\'s a fairly intensive group of things that are going on.

So that\'s brief. How was that, Rose?

MS. KITTRELL: You did good, Peggy. Thank you so much.

MR. DeWISPELAERE: Peggy, aren\'t you a veteran too?

MS. QUIGG: Yes, sir, I am.

MR. DeWISPELAERE: I thought so. Thank you for serving.

MS. QUIGG: Thank you.

MS. KITTRELL: All right. Do you have any questions for the last two
presenters?

MR. DeWISPELAERE: Good job.

MS. KITTRELL: Sharyn, did you have any questions?

MS. GERINGER: No. I think my questions were very well answered. Thank
you.

I am concerned about the children of our Guard ‑‑ well, the active duty,
as well as the Guard. And I\'m glad to see that there is some focus on
their needs because when members serve, it\'s not expected that the
children will have a consequence, and yet, we\'re finding that that\'s
happening in some of our communities. So thank you for helping with
those people particularly.

MS. QUIGG: We\'re also working, Sherry, a lot with our Drug-Free
Community coalitions. The coalitions need heightened awareness that they
need to be doing more outreach for those Guard and Reserve families. And
that\'s working. They\'re coming on board with a big interest, that
it\'s more than just collect the boxes and the things to send overseas
and the cards. Those are all important.

MS. GERINGER: Right.

MS. QUIGG: But the coalitions have a lot more to do.

It\'s also been helping the National Guard understand that they need to
let other people come in and bring the communities in to help them. The
military has a pretty strong attitude of it\'s their job to do it for
their own and not real open to that. So we\'ve partnered a lot with
Community Anti-Drug Coalitions of America. A lot of the training that
the National Guard has done has been in conjunction with other CADCA
venues, the Mid-Year Institute, the National Forum, so that we can help
blend that and make them a little more aware that coalitions are
standing ready to do that.

MS. GERINGER: Right. And that\'s a good point.

The other thing is that not all of our National Guard troops are going
to combat, and I think that there is some confusion among our community
members about that as well. So no matter how they feel about war
situations, the Guard members are serving in other venues, as well as on
the battlefield.

MS. QUIGG: Eighteen months away from home is 18 months away from home.

MS. GERINGER: Exactly.

DR. TAFT: Peggy, you probably know about the effort in Ohio where mental
health and alcohol and drugs have combined together to provide support
through the Guard situation. Those single state agencies ‑‑ maybe in
other states are doing that. I don\'t know.

I also have heard of a program. I think it was in Florida where they are
providing so many hours of pro bono service. The President\'s Council on
Service and Civic Participation is having a conference on pro bono
service that you all might want to connect into as a way to heighten
these two professions giving service to families.

MS. QUIGG: Yes. Thank you for that, because I think NPN and NASADAD have
done also some great outreach efforts to help their folks better
understand that they need to be at that table. Ohio Cares has been a
leader. Vermont has had a fabulous program. Those two have presented
nationally at several of the NASADAD and NPN venues to kind of make them
more aware of what\'s going on. Thank you.

DR. TAFT: And then you know about the program in Wyoming that\'s at the
air force base out there. It seems to be getting good results.

MS. QUIGG: Actually we invited Penny Norton to present to the internal
prevention and control work group at their last training last month to
talk about the Warren Air Force Base experience because it did shift the
culture, and we wanted them to see that they can shift the culture as
well. And it was a great experience.

MS. KITTRELL: All right. Thank you so much.

Alan, you had a question?

MR. SHINN: Thank you. Just really brief. Peggy and Claudia, thank you
for the presentations.

I just wondered what the effort was with our military in the Pacific
region because I know we have a lot of Samoan and Micronesian troops out
there. The losses have been heavy disproportionately for their
populations. I wonder if you could address that.

MS. QUIGG: I think we still struggle with the same issues we do to
outreach to that population as a whole. There are probably more efforts
going on within the active duty components because you\'ve got
substantial active duty military components both in Hawaii and Guam and
the build-up activity that\'s going on in Guam.

The active duty always does much better than the Guard and Reserve in
terms of they are their own community. They have all the resources.
That\'s what puts the Guard and Reserve at greater risk.

My previous experience and the work that I continue to do particularly
with the Hawaii National Guard is that they have always tapped in very
well to their active duty components just because of the isolation
factor, whereas that doesn\'t happen so much in the States. In most
states, the military is a unique entity of its own and the bases are
very isolated with the exception of the surrounding communities. Because
of the geographic pieces of the islands, the military base is a huge
part of those islands. So the Guard naturally works very much hand in
glove with those active duty components much better than what we see in
the States.

But I\'ll continue to raise that issue with the Guard.

MS. KITTRELL: Thank you.

All right. We\'ve made these revisions to the agenda, and I hope you all
are okay with it. From 11:40 till about 12:05 or 12:10-ish, around in
there, we will have our roundtable discussion instead of having it this
afternoon. That way you\'ll be able to give your input at that time.

Then from about 12:10 till about 1:05, 1:10, somewhere like that, you
all will have lunch, and we changed the venue for lunch. Tia is working
on that to be able to bring it back here and eat it. Then that way we
can start at 1 o\'clock.

Dr. Kevin Mulvey will return. He\'s agreed to come back after lunch.
Then that way you can have your full time here to be able to do your
roundtable.

Okay. We\'re ready for the roundtable discussion.

Thank you, Peggy and Claudia.

MS. HAYNES: It\'s open to the floor, council members.

MR. DeWISPELAERE: Rose, we\'ve had a lot of discussion the last couple
of days and a lot to absorb and take in. We appreciate what you guys
have done to keep that moving and keep it going.

I want to encourage ‑‑ I didn\'t get a chance to because of the
quickness to turnaround ‑‑ that as an organization we get the Reach Out
Now and the Teach-In and the town hall meeting information out earlier.
Groups are getting that information probably through the contractor too
late, and so we\'re missing out across the country on a lot of
organizations. Planning is essential to what we do. Please understand
I\'m not being critical because I think the program ‑‑ and I\'ve been
involved with Hope and others here to help move that out there. But the
sooner we can get the information out, the better, and I would encourage
that we do that.

MS. KITTRELL: Good. You know, one of the things that Dennis was talking
about is to develop the infrastructure internally to CSAP, the same
thing that we\'re encouraging states and communities to do. We\'re
trying to internalize that process ourselves, and that is, we\'re going
to develop a calendar, a time line, if you will, of events and to build
in it the time that it will take to get the information out to the
communities so that we won\'t be sending you things at the last minute.
I mean, every year we have the same thing. We know when Red Ribbon is
going to occur, FASD, HIV Month, all of these things. Let\'s put it up
on the calendar. Let\'s let everybody know about it ahead of time so
that everybody can build it into their local calendars. So that\'s a
good point.

MS. ARES: While we\'re on that initiative ‑‑ and this, again, may just
be my newness. So please take that into consideration. But I know that
in Illinois we had a lot of town hall meetings and some of the
teach-ins. I would concur with Jay\'s recommendation to get that
information out earlier than in the past.

And even in the presentation this morning, I didn\'t really see if there
is a consistent or standard evaluation process for that initiative. So I
guess I would recommend that we look at developing some kinds of
information or resources or tools or supports that would help grantees
evaluate these initiatives and tie that evaluation to progress toward
NOMs. In Illinois and I know in many other states, these National
Outcome Measures are taken very, very seriously, and the states are
implementing a lot of their directives to their grantees to tie into
NOMs. So when you add an additional initiative that you\'re going to ask
a state to help coordinate or a local community, at least in Illinois,
to implement, the more that we can help them understand how it ties into
the NOMs and give them the resources and tools that they can evaluate
these efforts in relationship to that, I only think that helps present a
bigger, better picture about the work that CSAP is really doing and
progress toward those outcomes.

MS. KITTRELL: So noted.

MR. DeWISPELAERE: An example of that is the PRIDE conference is in
April, and obviously all my staff are tied up for a couple months prior
to that. Then we get the information out in March. We have 500 groups
that would like to participate, but all their focus is on getting to our
national event at that time. I think being more open to the timetables
involved and getting the information out earlier, you will see the
involvement increase dramatically.

MS. KITTRELL: Okay.

DR. TAFT: In regard to the Reach Out Now and Teach-In, some of the
schools tell me that they don\'t get the material in a timely manner
either directly from the supplier/provider or that they don\'t come at
all. So you might want to double check to make sure that they\'re still
going out in a systematic way.

MS. KITTRELL: Okay. I hate Gwyn is not in here because she\'s our guru.

MS. GERINGER: On a different subject, one of my concerns is the size of
our council. As I look at those of us around the table and the number of
people actually listed, I see just from the list that we are four
members short even with our new members listed. That\'s a concern to me
because I think this is a really important thing for people in the
substance abuse prevention community across the country to be part of.
So I understand from what you said, Rose, that it does take a while to
get through the process. We know that. So I guess maybe, hopefully, we
can start earlier so that there aren\'t big gaps like we have right now.

One of the things that I would like to consider, given the four
priorities that Dennis has, I would like to see some sort of a
representative from the aging population be included as a member of the
council. I know we used to have someone from the military or
military/National Guard as a representative. I think that that\'s
important too.

I don\'t know how the invitations are structured in terms of are we
looking for people to represent certain areas of concern that CSAP
addresses or is it just kind of a shotgun approach. But having a youth
representative ‑‑ and I know it\'s hard to define youth, but I guess I
would think that in terms of someone who\'s college age that maybe is
majoring in a field, something along the lines of what we do for our
fellowship program perhaps. And then someone from justice or law
enforcement I think would be appropriate.

I don\'t know what other people would think of in terms of the kinds of
experience that would be useful on the National Advisory Council, but it
seems to me that if we could get representatives from various areas of
interest, it might be helpful for the council.

MS. ARES: I would also like to add that when we\'re looking at
additional council membership, that we look at the diversity of the
group. I\'m not aware of anyone from the African American community
serving. There has been, but I would encourage that kind of diverse
representation in addition to the other areas that Sherry just
mentioned.

MR. DeWISPELAERE: I know that the Administrator is looking into the
youth representation on the councils because he\'s asked if our
organization would send some names forward, and I know he\'s recruiting
other names throughout the country to do that. So we\'ll be providing
them just as quickly as we can. That request was made to me. And I know
he defines ‑‑ Tia, you might know more about that, but he defines youth
I think that he\'s looking for to be hopefully college age, if I
understood that correctly.

MS. HAYNES: Well, I guess 18 to 21. We would have to get more of a
definition of what \"youth\" is defined as. But, yes, Dr. Cline did
express that he wants youth on the council, as you heard from Toian
Vaughn, who you met yesterday at the orientation meeting. So that\'s one
thing that we can look into.

In terms of the balance of the council, it\'s such a long process. We do
have four new members, but they won\'t be on until September the 15th.
So we have four names that are on, but we can\'t announce their names.
It\'s a very long process. So we have four new members. So we\'re
looking for three more. We are only short three members.

In terms of diversity, Marcus Harvey was on the council. He was an
African American male, faith-based. He recently went off. He just went
off.

When you look at diversity, it doesn\'t go by ethnicity. It goes by your
expertise and the state that you\'re in. We try to look at all of it,
including ethnicity, everything. So we are taking that into
consideration.

When you make your recommendations, I think what we need to do is really
focus ‑‑ since we have three slots, we need to look at who is
represented on the council now and the three slots that will be filled,
like who will be recommended because it really doesn\'t help if we get
20 names and then we have to narrow it down. Out of the three slots that
we needed, if we could get 10 strong names that would cover the areas
that we need to cover to make it a balance. I think the areas that we do
want to cover are the four priorities that CSAP wants to focus on.

MS. ARES: So if anyone knows a retired chaplain who\'s African American,
over the age of 65 ‑‑

(Laughter.)

MS. ARES: ‑‑ give their name to Tia. Right? There you go.

MR. DeWISPELAERE: And a male. Right? You did say that?

MS. HAYNES: On a serious note, there will be emails coming from me. We
will be communicating in reference to this because packages take
typically four to six months once a name is submitted. It takes a long
time. They have to be vetted through the White House. You know, it\'s a
long process. So the sooner we get it done, the sooner we can replace
the three slots that are left on the council. We try to keep a smooth
flow.

MR. DeWISPELAERE: Along that line too, I think that as we continue to
look for creative ways in the states to get the good name of SAMHSA out
there, I know as a council member I\'m not the most senior council
member on here in terms of age, Alan. But I\'ve been on the council a
long time and I can tell you that I attend state SPF/SIG meetings. I
attend other state collaborative meetings, and I not only attend in the
occupation that I have, but I attend as a representative of the NAC
council. I\'m often asked about, everywhere I go, what CSAP or SAMHSA is
doing on this issue or that issue or another issue. I think you\'d be
surprised, especially the new members, just how often you are asked what
the direction is and what the priorities are. The more we can get that
information out, I think the better position it puts SAMHSA as a whole.

DR. TAFT: Since I was not here yesterday, can you report the four areas?

MS. KITTRELL: Okay. It\'s youth, older population, vulnerable
populations. I think he had a subset of that. Underage drinking and
workforce development.

DR. TAFT: So it\'s really basically the tabs in the book.

MR. DeWISPELAERE: Right.

In the old days of the council, the Administrator would appoint certain
members to participate in different national events around the country.
Like one would be appointed to CADCA. One would be appointed to
represent at NASADAD\'s meetings and the NPN, of course, meeting. I
think that\'s coming up pretty soon, if I\'m not mistaken.

PARTICIPANT: I\'ll be there.

MR. DeWISPELAERE: The PRIDE conference. Other events like that, they
would appoint members to attend on behalf of the council and actually
cover their cost of travel.

I would recommend, Tia and Rose, that when you go back and discuss with
‑‑ I think it would probably be inappropriate today with Dennis not here
to appoint them ‑‑ that you seek out what these members are interested
in and get back from them their best area of expertise.

MS. KITTRELL: Yes, most definitely.

MS. ARES: One of the things that I guess I would like to hear more about
maybe at a major council meeting is the degree to which CSAP works with
the U.S. Department of Education and the Safe and Drug-Free Schools and
Communities Program or any other type of prevention-related programs
that might fall under its purview. We\'re seeing an increasing interest
and a lot of strong evidence about the value of student assistance.

And given that so many prevention providers do their work in schools or
with schools, it would make a lot of sense to look at models that not
only help meet CSAP\'s priority areas but also help meet schools\'
academic goals. A lot of the things around school violence and mental
health and even the program that Peggy was talking about earlier that
the National Guard is using, these things have value. There\'s
absolutely no doubt. But through some kind of student assistance
framework or collaborative framework, I think schools and communities
need help kind of making sure that they don\'t trip over one another and
that they work together to really provide the full range of support that
students and their families need.

MR. DeWISPELAERE: The Under Secretary would be a good one to invite.
It\'s Deborah ‑‑ maybe you remember, Hope. I can\'t think.

DR. TAFT: Price.

MR. DeWISPELAERE: Deborah Price. To invite to the council and ask her to
come, give us a report. She\'s a great spokesperson and would encourage
more of that. I know that CSAP works with several different government
agencies. I\'ve not seen those folks at our tables in the time that
I\'ve been involved.

DR. TAFT: In fact, there might be some way that you could get everyone
that\'s on the Interagency Coordinating Committee on the Prevention of
Underage Drinking, the ICCPUD group, to come and talk about how they\'re
all trying to mesh their programs together.

MS. KITTRELL: Okay. Did you have something?

MR. SHINN: Yes, I just wanted to bring something up.

MS. KITTRELL: Okay.

MR. SHINN: All good stuff, Jay, especially from you. I\'m impressed.

MR. DeWISPELAERE: You didn\'t think I could do it.

MR. SHINN: No, I didn\'t think you could do it at all, Jay, but you
really impressed me. Thank you.

The issue of problem gambling, I guess, is something that\'s been coming
up a lot. I just don\'t know where it fits. I don\'t want to give CSAP
another issue here, but how it relates to substance abuse I think is
very interesting. I think we need to look at that.

I know in many casinos and card clubs in California ‑‑ it\'s not legal
in Hawaii, but I\'m sure in other states ‑‑ a lot of Asian/Pacific
Islanders frequent those casinos and card clubs. There are projects in
California, NAPAFASA, our national organization, has a contract with the
California State Office of Problem Gambling to do prevention and
outreach not just to Asian/Pacific Islanders but to the general
population.

So I don\'t know if it\'s a cutting edge issue. It\'s been around for a
long time, but I just want to know how we might incorporate that into
our base of knowledge and connect the dots on that issue with substance
abuse because I think there is one.

MR. DeWISPELAERE: I know CMHS does some things with that because we
worked with them last spring on a youth problem gambling track at our
event, and it was a combination of a couple of states and CMHS, as I
remember it.

MS. KITTRELL: What I have done, I have taken your comments and I have
put them into five categories. I want to go back over this with you
because we need to reach consensus. If we\'re going to take something
forward, I need to know this is the consensus of the council.

So the first I pretty much think we\'ve reached consensus on, but I
still want the group to let me know. As it relates to getting to
materials out, Reach Out Now, the teach-ins, town hall meetings and
everything, we have consensus on that. I see the heads. Okay, now, very
good.

There was concern that was expressed by Sharyn concerning the advisory
council, the representation. She had put forth some categories for
consideration. Representation from the aging population. Are we in
agreement that this should go forth? Okay.

Military/National Guard? Jay, are you with us?

MR. DeWISPELAERE: My concern is the statute is very clear about
appointments. My history on this council is that we\'ve always had good
representation from almost every ‑‑ you know, I\'m for it. If it\'s
consensus, I\'ll go along with it. But I want to say that I think SAMHSA
as a whole has done a marvelous job with that over the years, and I just
think that that\'s important to point out here.

MS. ARES: I\'m sorry. Does that mean, Jay, that you would ‑‑ I guess
I\'m asking for clarification ‑‑ that you would recommend that we not
specify particular categories and just let them do what they think is
best in identifying new members?

MR. DeWISPELAERE: I\'m not sure we can. I see the general, as I call her
‑‑

(Laughter.)

MR. DeWISPELAERE: ‑‑ the nicest lady in the world, up at the microphone.
Maybe she can give us some direction there.

MS. VAUGHN: With regard to the military, the councils are to have a
representative from the Veterans Administration and the Department of
Defense. All the councils. We don\'t have them and that\'s on me because
I need to communicate with the assistant secretaries of those agencies
to have them appoint individuals. But dealing with your military issue,
we\'ll move on that.

And I didn\'t hear all of your recommendations. I heard the ethnic and
diversity person that you wanted. You can make the recommendations of
looking at certain types of individuals. The law is very clear on the
expertise that we\'re looking for. What we really would like are names
of individuals and then looking at them within the constraints of the
law and then the departmental policy, looking at diversity, the
geographical issues, the gender, and all those other variables. But we
really need some names that will make the process move faster.

MR. DeWISPELAERE: Toian really isn\'t a general. I just like to call her
that.

DR. TAFT: Is there a way you could communicate with us what your
parameters are for names and then we could submit names to you when we
have our databases with us?

MR. DeWISPELAERE: An email reminder would be wonderful.

MS. VAUGHN: Well, the law states a national leader. What I look for are
people who are serving on national boards, who are leaders of
organizations, associations. Then looking at the law itself in the
behavioral and social science area, the law even talks about lawyers.
But you don\'t have to look for a lawyer, a media person, but people
from the law area, the social science area. But just people that you
interact with that are national leaders in the prevention, treatment,
mental health field that you have encountered through your movement
through this system. You have the charter and you can look at the
charter for those particular expertise, but what you\'re looking for are
people that you feel would best represent the agency and provide advice
to the center director and the Administrator, as well as the Secretary.

MS. KITTRELL: The other areas, Toian, were justice or law enforcement,
college age youth representation. And Jay has already indicated that he
had been approached about providing the names of some youth. So that was
it.

MS. VAUGHN: So justice is in the law. It\'s in the legislative
authority. So that takes care of your parameters, your categories. So
now help the agency find the individuals that meet those criteria.

I\'ve already spoken to Jay and he\'s going to search for some
individuals who are young people. The Administrator is very interested
in having young people on these councils, as well as consumers, who will
self-identify, who are experts in the prevention, treatment, and mental
health fields.

MR. DeWISPELAERE: Oh, man, the young people that we work with in our
organization have 10, 12, 15 years\' experience doing this. They\'re
probably are more experienced than most of us here. And it\'s not just
our organization. It\'s the field. I know Hope knows many. They look to
her leadership. There are just a ton of kids that have a tremendous
amount and can talk data and can talk science-based and can talk all the
strategies that you want to talk.

MS. KITTRELL: Another area ‑‑ and Jay brought this out ‑‑ had to do with
creative ways to get SAMHSA\'s name out, and he was talking about
conferences and meetings wherein the members would identify an interest,
and if it was a meeting that SAMHSA would want them to represent us at,
they would attend at our expense. It seems like Dennis said something
about that maybe at a couple of previous meetings that he does want that
type of representation.

MR. DeWISPELAERE: Right.

MS. KITTRELL: It\'s really incumbent upon you all to identify what
you\'re interested in and then we can get this information in to Tia.

MR. DeWISPELAERE: Can I make a recommendation?

MS. KITTRELL: Yes.

MR. DeWISPELAERE: Could Tia send an email out to the council members on
which events that SAMHSA supports and their location and when they\'re
going to be, which will help you guys get together that national
calendar that you\'re working on, and email that out to us for an area
of interest because I can tell you right now that there are three of us
sitting right here that have a strong interest and a lot of expertise on
underage drinking. And there was just an underage drinking conference in
Florida. Did you get to go? I didn\'t have the opportunity. It didn\'t
work out. But I don\'t know of another member from the NAC council that
got to go to that. Did you get to go, Alan? No. And that\'s just an
example.

I think you\'ll get several interests from members for certain
categories. The chairman appoints who goes to what. Just do it as fair
as you can, and I\'m sure nobody on the council is going to argue.

I think the key to that, though ‑‑ what\'s happened in the past with
those appointments, if Sherry is appointed to the PRIDE conference and
she can\'t make it because of her previous commitments, then that should
come back to Tia for someone else to attend that will certainly
represent the council.

SAMHSA supports some pretty cool initiatives out there, and it\'s neat
to watch that happen.

DR. TAFT: And then, Jay, did they have any official role in the
conference, or did they just kind of wander around with a name badge?

MR. DeWISPELAERE: Well, I could tell you at our event they had official
roles. I can\'t say what happened at others, but I can only imagine that
if council members went to CADCA ‑‑ I think I was one of the appointed
members there ‑‑ General Dean introduced them. And they had a number of
folks come up to them ‑‑ I know I did ‑‑ asking questions about the
council. That\'s another good way to look for people from the field to
help serve on the council down the road.

I know NASADAD has two events, the NPN and the state one, and they\'re
usually always around the same time. Is that correct? I myself would
love to serve on that one, but I think you need to put them out fairly.

DR. TAFT: I\'ll be at the NPN one in Oregon for a short period of time,
if you want to put me down for that one.

MS. KITTRELL: I gather from various ones that you want some more
information about the collaborative work that we\'re doing with the
Department of Education to look at some educational models, perhaps some
of the models that they have, as well as what we have in NREPP. You
wanted to invite someone named Price?

MR. DeWISPELAERE: That\'s Under Secretary Deborah Price, the Safe and
Drug-Free Schools Program.

MS. KITTRELL: And someone from the ICCPUD, underage drinking group. So
we\'ll see if we cannot contact them and see who would be available to
come.

DR. TAFT: Steve Wing is the chair of the ICCPUD group, and it might be
nice for this council to learn all the prevention activities that are
going on throughout the federal government and how they relate to what
CSAP is doing or the overall picture.

MS. KITTRELL: Yes. Steve will be more than willing to come.

And then also more information about problem gambling and a nexus with
substance abuse prevention. You said at CMHS, they have been doing
something in this arena as it relates to mental health. We could
certainly have them to come, and if you have a speaker that you would
want to hear from, you could certainly send that person\'s name in.

MR. SHINN: There was a John Vierras from Illinois who is working on
that, and actually John is from Hawaii. I missed his presentation
because I\'m here. But he was in Hawaii just presenting on that just
last week.

MR. DeWISPELAERE: There\'s a national organization for problem gamblers
right here in the Rockville area that works with a number of the states.
I have that information back in the office. I\'d be glad to send you
that. I just don\'t have it with me.

MS. KITTRELL: Okay.

Did we get consensus on that as well?

MR. DeWISPELAERE: Sure.

MS. KITTRELL: Okay, then. Well, I think I\'ve covered all your issues.

MS. HAYNES: One more thing. One last thing just to clarify something.
This is on the attendance of meetings. What I\'ll do is ‑‑ and let\'s
put this on the table. I can\'t send you a list of things that will come
up. As things come up, I\'ll develop a letter and send it out and ask
you. I know that you\'re interested in this issue if it\'s a meeting on
underage drinking. And in your return, let me know if you\'re interested
in going. The purpose of you attending the meeting is, one, to follow up
on something that Dennis is interested in or the Administrator. So if
you\'d attend, then you would have to report back to the council. So
you\'ll come back and give us a briefing.

Toian, is that clear?

MS. VAUGHN: Yes.

MS. HAYNES: So just to clarify that.

MS. GERINGER: We\'re not going on a vacation. We\'re going there to
work.

MS. HAYNES: Right. So we\'re in agreement to move forward.

MS. KITTRELL: Is there anything else?

(No response.)

MS. KITTRELL: If not, we\'ll go ahead and take a break for lunch and
we\'ll get back at 1 o\'clock. Thank you.

(Whereupon, at 12:18 p.m., the meeting was recessed for lunch, to
reconvene at 1:00 p.m.)

[AFTERNOON SESSION]{.underline} (1:25 p.m.)

MS. KITTRELL: We\'re going to go ahead and get started and we\'re going
to start with the data strategy with Dr. Kevin Mulvey.

MR. MULVEY: Good afternoon.

MS. KITTRELL: Good afternoon.

MR. MULVEY: As you know, data strategy has been an activity in SAMHSA
for a couple of years now, and it was revitalized, if you will, and a
new group got together about six to eight months ago from each of the
centers and pulled all the previous material together. To try to cull it
down into about a 20 to 25-page document was the goal.

You have the data strategy as it currently exists in your notebook. Just
briefly, I\'d just like to say there are essentially three goals the way
the data strategy is laid out: a goal of looking at national information
including incidence and prevalence, a goal of looking at performance
information, and a goal of promoting the electronic health records and
health information technology. The rest of the data strategy essentially
walks you, as you read it, through each of those goals in terms of the
objectives that were set for those goals, current progress having been
made or underway on those goals, and then future activities for those
goals.

It went out for review for a variety of folks, and we\'re currently
reviewing the responses or the comments that we received. In fact, the
comments that I reviewed were all positive. There were some specific
questions about some elements, about whether or not we\'d be collecting
and looking at those elements. Currently what\'s under process is again
that clearance process in SAMHSA to address the comments, create a
document that shows that the document addressed those comments, and then
to create a two-year action plan that would bring to life milestones and
markers based on those activities listed within the document.

So I was asked by Admiral Broderick to thank you all for commenting,
that the comment period is currently closed, that we\'re currently
addressing the comments that were received, and that we will have a
final document, the expectation is I believe, by the end of next month.

The two-year action plan, once developed, will be shared again with each
of the centers. It\'s a very center-driven, office-driven activity.
Hopefully by the time that you all meet again, we\'ll have the cleared
version and we\'ll have the two-year action plan, which you would have
had time to take a look at and provide input.

That\'s the update on where we are with this current version of the data
strategy. It very much is in line with, if you\'ve read it, the
strategic plan of SAMHSA, which is in line with, obviously, the HHS
strategic plan.

DR. TAFT: Judging from the second paragraph under 1.0, I am assuming
that there\'s no statutory mandate to provide national data on mental
health and substance abuse prevention services?

MR. MULVEY: There are statutory requirements to collect depending upon
how the program was funded. So, for example, PRNS activities, Programs
of Regional and National Significance, might have specific data
collection and reporting requirements for prevention activities such as
the MAI program you heard about before lunch, the methamphetamine
program that you heard about. There\'s a report to Congress that\'s due
as a result of that. So there are certain programs that are funded with
certain legislative mandates that prescribe the report to Congress.

DR. TAFT: And this is just for SAMHSA programs. You\'re talking about
the Household Survey or are you talking about other kind of surveys that
you do?

MR. MULVEY: This is in fact for SAMHSA. What we\'re planning to do is
you\'ll notice under the performance measurement activity, which is
where each of the three centers are focusing on right now with GPRA, the
Government Performance and Results Act, and PART, the Program Assessment
Rating Tool ‑‑ under goal 1, we\'re expecting for prevention
specifically to begin looking at developing a prevention survey similar
to the inventory of treatment and mental health services facility survey
and then to create a framework for collecting that information. That was
one of the major outputs that would affect prevention activities.

MR. SHINN: Hi, Kevin.

MR. MULVEY: Hi.

MR. SHINN: How are you?

MR. MULVEY: Good.

MR. SHINN: Again, just about data and the need for disaggregated data
especially among Asian/Pacific Islanders, I know I\'m going down to the
very narrow, but I think within the data sets, there needs to be that
breakout. It\'s not useful for us in the Asian/Pacific Islander
community unless we have some disaggregated data on ethnicity and the
use rates and all for different groups. That would be most helpful.
It\'s not a new issue, as you know. I just want to know how we are doing
on advancing that issue.

MR. MULVEY: What SAMHSA has done is put into place a process whereby
specialized reports get generated or can get generated, and one of those
specialized reports might be looking at subpopulations such as African
Americans or Asian/Pacific Islanders, et cetera, across all the data
sets that we have access to. The Office of Applied Studies, through
Beatrice Rouse, is primarily responsible for the special reports and
those types of publications. So we\'re moving towards the direction of
having subpopulation type reports out.

Thank you. I apologize, but I have to now go to another meeting.

MS. KITTRELL: Thank you so much, Kevin, for your patience.

MR. MULVEY: Sure. You\'re welcome.

MS. KITTRELL: Our next presenter is Ms. Jennifer Solomon, and she\'s a
public health analyst. Jennifer is very passionate about her work.
She\'s going to share with us information on the older adults.

MR. DeWISPELAERE: Madam Chairman, can I make a comment before she
starts?

MS. KITTRELL: Yes.

MR. DeWISPELAERE: The gal leaving, Beatrice, with Kevin\'s shop ‑‑

MS. KITTRELL: She stopped.

MR. DeWISPELAERE: You can go ahead and leave. We\'re just going to talk
about you. You\'ve got another meeting to go to. She\'s the one that
sends us out information. I know I\'ve found that very helpful and I get
a chance in a less rushed atmosphere to read that. We appreciate getting
that information from her on the updates on the data collection. Thank
you.

MS. KITTRELL: Excellent.

Go ahead, Jennifer.

MS. SOLOMON: The presentation objectives for this afternoon are to
discuss the demographic imperative, share CSAP\'s Older Americans
Technical Assistance Center experience using the strengths, weaknesses,
opportunities, and threats assessment with Louisiana and Mississippi
around emergency disaster planning for older adults.

This is about our third meeting. This is the first one we had around
disaster planning. We had with the Asian/Pacific Islands last fall.
We\'ve worked with Ohio, Maryland, and Connecticut, and we\'re working
our way across the country. We\'ve been taking them in groups of twos
and threes.

And we\'re going to discuss the Get Connected! Toolkit, which is here.
I\'ll leave this in the back of the room so if you\'d like to look at it
after. It\'s available in our clearing house, and it\'s free and you can
order multiple kits. But I just wanted to bring this to show you, and
we\'ll also discuss it within the presentation.

The demographic imperative. Thirteen percent of the U.S. population is
65 and older and expected to increase to up to 20 percent by 2030.
Eighty-three million baby boomers born from 1946 to 1964 were counted in
the U.S. Census of 2000, and 78 million baby boomers turned 65 turned in
January 2006. So we\'re really seeing a real increase in the older adult
population. I\'m sure you\'ve been seeing it now, especially on TV in
terms of commercial ads. AARP has also lowered their age range to 50. So
you\'re really starting to see a change in how America is looking at
what we call the graying of the population.

There\'s an enormous pressure on retirement systems, health care
facilities, and other services. What we\'re seeing now in the workforce
is that people are retiring. They\'re coming back. Some are staying
retired. Some are taking part-time jobs. So there\'s a real difference
in people just going out and retiring. Some are getting second careers.
Some are moving into the volunteer area.

Major implications for substance abuse and mental health on prevention
and treatment. So what\'s happening is now as people are getting older,
there are more chronic conditions. People who have been drinking their
whole life went through body changes. You\'re seeing that alcohol ‑‑
especially women are staying intoxicated longer. So what you\'re seeing
is more medications being taken, differences in health conditions, and
more medication and alcohol staying in the body longer.

An estimated 1 in 5 older Americans, 19 percent, may be affected by
combined difficulties with alcohol and medication. The number one abused
substance in older adults is still tobacco. While the rates do go down
now for older adults, the baby boom generation is going to be changing
that. So you\'re going to see what now are lower rates going up.
There\'s also more of an acceptance of marijuana, alcohol, medications
in the baby boom generation versus this cohort of older adults.

MR. DeWISPELAERE: Can you identify the age of which you\'re talking?

MS. SOLOMON: Yes. It depends on who you\'re talking about. Still, it\'s
65. We\'ve dropped it down to 55. AARP is setting new standards now for
50. So you\'re really getting almost like a 30- to 40-year group of
older adults which are being broken out into separate cohorts of 10
years at a time. They dropped it down to 55 to capture the baby boomers.
Sixty-five is still Social Security. That will be changing. It will be
up to 72. The age rate for women is up to the middle 70s. For men to
pass away is in the lower 70s. So you\'re really seeing a change in
those. The laws just have not caught up with the system, but they will
be changing.

In 2004, CSAP created the Substance Abuse and Mental Health Older
Americans Technical Assistance Center. The center is an experimental
center. There is no substance abuse prevention field for older adults.
There is no coordinated effort across the country. This center is set up
to find out what states are doing, to look at information through data,
to find out where the gaps are, where people are making progress. So the
overarching goal is to create sustainable changes in the field of
geriatrics around substance abuse and mental health so that these issues
are recognized and planned for.

There\'s a lot of retrofitting within states. They\'ll come up with a
plan and then they\'ll say, oh, yes, but the older adults. They\'ll try
to retrofit them into a use system.

Older adults have very different needs than younger children. They found
that through the Hanley Center in West Palm Beach. They tried putting
them in the same treatment center, and they had to divide them out.
Older adults in treatment will tend to parent the younger cohort.

Also with prevention, they found out when you give prevention messages
to older adults, they will actually listen and change their behavior. So
prevention really does work for this group.

The Older Americans TA Center priorities. Technical assistance with
respect to prevention and early intervention of substance abuse,
medication misuse and abuse. It\'s not just substance abuse. It\'s
misuse. There\'s a whole lot of misuse going on with older adults. They
can\'t read the medication bottle. They don\'t understand what they\'re
taking. They\'re taking multiple medications that look alike. They
don\'t know what a standardized drink is. Since the drink level goes
down, NIAAA has set out guidelines for what a standard drink is, and
it\'s a neat kind of experiment to do to find out what people think a
standard drink is. It\'s kind of like the Weight Watchers and what a
serving size is. It\'s really interesting to see what people think.

Co-occurring. We do not go into serious mental illness. We only go as
far as anxiety and depression. As I was saying before, it\'s very
interesting. The new Medicare laws do not cover anxiety medication, only
medication for depression. One thing older adults have is anxiety. So
it\'s very interesting to see. It was written into the legislation. So
it\'s not covered.

As I spoke before, state planning with Louisiana and Mississippi.
Louisiana had a state planning meeting in Louisiana on May 17th and May
18th. We partnered with the Center for Mental Health Services and their
Crisis Counseling Peer Program. We took on the second day and a half of
the meeting, and the Older Americans Technical Assistance Center used
the strengths, weaknesses, and opportunities and threats assessment. Are
you aware of ‑‑ basically it states what you have, what you don\'t have,
where do you need to go. We found that tool to be the best tool for
working with this group, especially with state and community and health
and social service providers. It provided a way of getting to
information that we could formulate and give back in a reporting format.

So we gathered the information using conference calls, and we really
wanted people to talk between state and community leaders and the
stakeholders. What we\'re really finding is once people get in a room
and start discussing, they really are starting to pair off. We saw that
in Connecticut and we saw that in Ohio, that they\'re really starting to
pair off and they start working together and they start linking.

We did more than 20 conference calls. We made an integrated report from
the responses, and we reported back on that day. Then we did breakout
groups so they could further discuss what we found in the reports.

What we found from the strengths was the Division of Aging is the
centralized state contact for aging services and the Area Agencies on
Aging, which are run by the Administration on Aging, provide a majority
of the services. In the makeup of the Area Agencies on Aging, they have
44,000 people across the country, health and social service providers
and different types of community providers. So they\'re a real strong
network for us to get the information out.

Project Recovery is in Louisiana and they provide services through 15
individuals who are familiar with older adults\' needs and resources.
What we are finding is that there are teams approaches, especially
Louisiana and Mississippi, especially after Hurricanes Katrina and Rita,
and older adults are one of the best resources. They tend to rally
around each other and they tend to volunteer.

Gaps. Need to conduct more outreach to older adults regarding substance
abuse and mental health issues. Trauma causes increase in medication and
alcohol use. There was a lot of displacement.

Lack of screening tools for substance abuse and mental health for older
adults. There\'s the CAGE and the Michigan Alcohol Screening Test, which
are contained in this kit. But a lot of the screening tools are not
tailored for older adults.

The need for home-delivered meals, transportation, and socialization
services are very important. There\'s a huge isolation factor with older
adults, especially people who are 80 and over, and it\'s even worse now
in places like ‑‑ if you go to New Orleans, they\'re not staffed. Some
have left and there\'s just not a lot of staff and a lot of people have
been displaced and moved around the country.

The need for a statewide needs assessment focusing on state agency
resources for older adults especially around substance abuse and mental
health. They get a good picture in their SWOT assessment when we give
the report back. They end up seeing a really good picture of what their
state looks like.

And there\'s a lack of dedicated full-time staff to address older adult
issues. Also, we checked. Only about 3 percent of medical schools had
any kind of geriatric-specific training program. So there are really a
lot of professionals that do not have any training even like you would
take the extra credit, you know, continuing education credits that
specifically are targeted for older adults.

Opportunities. State agencies have the opportunity to partner on grant
applications. There\'s an environment of mentorship and training exists
due to varying levels of staff experience. They build on stronger
relationships between state agencies and the participation on state work
groups, epidemiology and advisory groups, to provide a platform to
launch an assessment for state agency resources aimed at older adults.

This is the Get Connected! Toolkit. We worked with the National Council
on Aging to develop this toolkit, and it\'s targeted organizations that
provide services to older adults. It provides materials necessary for
training staff who work for older adults.

The Get Connected! Toolkit helps aging services providers learn how to
incorporate substance abuse and mental health issues into their ongoing
health promotion and health education activities.

How to identify and partner with local substance abuse and mental health
organizations. There\'s actually a resource matrix in here that we\'ve
been finding very helpful about connecting with substance abuse and
mental health, what you have, where do you need to go, what type of
professionals you have within your own organization, and who you can
link with, and it\'s contained in the notebook. The notebook is also
contained online. So if you just wanted to download the notebook, you
could go and download just the pieces.

Collaborating with NCOA to provide the Get Connected! Toolkit training.
We held a training in Boston, Washington, D.C., Orlando, Baltimore,
Birmingham, Lexington, and West Palm Beach. We\'ve had a wide range of
audience service providers from mental health and substance abuse, aging
nutritionists ‑‑ actually that\'s a very interesting group to provide
this training to ‑‑ public health officials, and state program
administrators. State program administrators have taken this and
actually have had statewide trainings.

Here\'s one. The State of Washington held a training for 150 clinicians
and paraprofessionals in the fall of 2005 and administrators from mental
health and substance abuse and the aging fields in Seattle and Spokane.
The technical assistance center, along with the National Council on
Aging, did about 75 people per day and a two-pronged training approach
addressing health literacy, which is a very big component of this, and
behavioral health resources.

Then we have a new level on the training called Increasing Provider
Comfort. That\'s actually a training which teaches you and that talks
about doing activities like how much alcohol an older person should
have. It includes how to read labels, what older adults actually see. Do
you know what the labels actually mean? So it\'s a very good partner to
this training.

I guess that would be it.

MR. DeWISPELAERE: Can I ask you a question?

MS. SOLOMON: Sure.

MR. DeWISPELAERE: The Get Connected! thing. Can I get you to send me one
of them?

MS. SOLOMON: Sure.

MR. DeWISPELAERE: I\'d take it today, but ‑‑

MS. SOLOMON: I have extra copies upstairs.

MR. DeWISPELAERE: ‑‑ I would have to haul it on the airplane. I would
appreciate it.

MS. SOLOMON: Yes. I\'ll get your address from Tia and we can put some in
the mail to you.

MR. DeWISPELAERE: A lot of the coalitions that we talk to ‑‑ as a matter
of fact, I\'m serving on a statewide committee and a local committee on
services to older adults.

MS. SOLOMON: Oh, great.

MR. DeWISPELAERE: There\'s very little data in the state that I\'m from
in regards to that, and what I\'m hearing, there\'s very little data ‑‑

MS. SOLOMON: There is.

MR. DeWISPELAERE: ‑‑ across the country. As coalitions struggle to work
on different issues within the community and there\'s a lot of attention
on it, very little is known about it. We appreciate what you\'re doing.

MS. SOLOMON: Thank you.

On the SAMHSA website, if you go down on the left side, there\'s a
section that says \"older Americans\" under the matrix. You can click on
that and there are policy documents on older adults that talk about the
state of the knowledge. So there are different pieces. But we can also
get you some kits as well.

MR. DeWISPELAERE: Good. Appreciate that.

MS. KITTRELL: Tia brought it to my attention that it would be good if we
could have some kits for all of the members.

MS. SOLOMON: Okay.

MS. ARES: I just have one question. To what degree are pharmacists
engaged in this initiative?

MS. SOLOMON: For the Increasing Provider Comfort, pharmacists were
involved in developing the training for the professionals. Actually CVS
was involved in providing labels, what the labels look like. On the side
of the older bottles, you would see those little strips, and they would
have a picture on them. So we involved them in the Increasing Provider
Comfort to make sure that we had gotten the appropriate information to
them that they would understand.

Now, for doctors it\'s a little bit different. We have a scientific
team, Dr. Blow and Dr. Bertells, and they have helped us with more of
the academic side. Not everybody is involved in every piece, but for the
specific audience we\'re trying to target, we\'ve brought in the
appropriate expertise to help us along with that.

MS. KITTRELL: Thank you, Jennifer.

At this time I\'d like to introduce Ms. Nel Nadal. She is a public
health analyst in the Division of Systems Development. She will present
on the workforce development plan that we\'re putting together and talk
about our collaboration with CMHS. Nel?

MS. NADAL: Good afternoon. Glad you all are still here and hanging in.

MR. DeWISPELAERE: Some of us stayed.

MS. NADAL: In our time together, I just want to go ahead and share some
information about SAMHSA\'s workforce development initiative which is a
matrix priority. Then we\'ll go over some of the specific activities
that CSAP is implementing.

The action plan that I think is yet to be posted on the SAMHSA website
‑‑ its basic purpose is that across all of SAMHSA, looking at all the
key issues within both the substance abuse prevention and treatment
fields, as well as mental health, as to what are the things we need to
do in terms of bolstering our workforce and also retention and
recruitment. These are issues that pretty much cut across the entire
country regardless of field.

Also for the SAMHSA action plan, the matrix is actually currently headed
up by the center director for CMHS and the Special Advisor to the
Administrator. So that would be Beverly Watts Davis and Kathryn Power.

The challenges. SAMHSA has identified four major program challenges. The
first one, basically we need more people to do the work that you need to
do in the fields of prevention and treatment, as well as mental health,
and we need to ensure that all areas of the country have the expertise
accessible to them. Obviously, you have the transitions between rural
and urban and even within urban settings, you may not necessarily have
the kinds of resources you need to go ahead and implement those kinds of
activities.

The diversity and cultural expertise. It\'s nothing new. It\'s meeting
people where they are. Do you have the staff that know how to do what
they need to do with the various audiences, whether you\'re talking age,
you\'re talking different kinds of geographic communities, SES, you\'re
talking about working with military populations? Are our folks not
necessarily going to become experts in knowing every kind of culture
there is, but are they good at going ahead and working with the
populations that they\'re working with so that they learn about what it
is to implement things appropriately? Because you can\'t be an expert in
everything, but there are ways that you can talk to everyone and be able
to work with them.

Education and training. Everybody strives to keep their workforce up to
date with the latest research, but all of us here, whether you\'re at
the community level, state level, or whatever, it\'s difficult to go
ahead and keep up. Even if you do keep up, how do you necessarily bring
it to the application side? So these are things that will be ongoing. So
SAMHSA is working on trying to go ahead and strengthen as many of the
channels that we can possibly affect to improve some of those systems.

Then the consistent and high-quality implementation. How do you we know
we\'re doing a good job as prevention folks? It\'s basically what it
comes down to. We know things differ across states. That\'s not
necessarily bad or good, but to the extent that we can go ahead and
bring everybody\'s capabilities up to a higher level in using the things
that we know in terms of the evidence base, that\'s what we\'re shooting
for.

In terms of performance measures, there is a web portal that is under
construction. So one of the things, once that is fully developed, is
having that as a major tool for states to go ahead and use and bring to
all of their planning processes and to the extent too that national
organizations can make use of it or even just individuals in finding
resources for their own continuing education, hopefully that will be
kind of like the one-stop shop.

In terms of other performance measures, the idea is that it\'s not just
the professionals. You have a lot of paraprofessionals. You have a lot
of consumers. How do we go ahead and provide opportunities for training
or whatever level of involvement people want to be involved with
prevention? How can we bring them in and then how do we track that to
the extent we can?

In terms of SAMHSA\'s workforce development activities, the cartoon
there ‑‑ you can\'t really see the team work picture there, but the idea
would be Dr. Cline wants to make sure that all the centers are working
together. It\'s not that the centers don\'t try to do that, but he\'s
emphasized that piece. Pretty much in looking at this particular
picture, we decided that prevention is kind of the foundation. So that
would be the dog on the bottom, that you really build on prevention and
kind of move up from there.

So it\'s a broader focus than what the centers have traditionally done
because there\'s a lot of individual work that each of the centers has
pursued. What we\'re doing through a single contract is working so that
we\'ve got a more comprehensive approach and we don\'t just have
parallel efforts going on. So it\'s beyond just communicating that we
actually struggle through trying to figure out what each of these tasks
are and applying them to each of the centers, but making sure that it
really represents behavioral health.

In terms of those first three activities, it\'s kind of the basics,
what\'s out there in terms of the inventory, what are people doing for
recruitment and retention, dissemination, training, education. What are
different groups doing? How do they tell how their workforce is doing in
terms of strengths, gaps, weaknesses?

And then the behavioral health core competency development. Going across
all the centers, what core competencies currently exist? So in doing a
needs assessment, sort of an environmental scan, the contractor is
collecting on SAMHSA\'s behalf a number of different competency sets.
Then from that compendium, what we hope to do is to have a single set
that would be broad enough to cover all three of the centers.

Then the other activities that are also covered in sort of the global
thing is looking at accreditation and credentialing. So we\'re looking
at all of the different standards that all the different accreditation
and credentialing bodies have, and for prevention, a lot of it is the
ICRC. The idea there is that understanding what from those can we draw
when we do our core competencies and then figure out how do we promote
the adoption and implementation of the standards.

And then as I mentioned before, the website is under development.

In terms of CSAP specifically, workforce development pretty much is
integrated across CSAP whether it\'s called that or not because it\'s
integral to all the work that\'s going on with our discretionary grant
programs and technical assistance and training. The bullets that are up
here really are just highlighted because they\'re more intensive
workforce development efforts. I\'m not entirely sure all the staff are
here, but the folks who have been working on the Learning Communities
are Alaina Harris and Erica Pearson. Erica Pearson actually is going to
be leaving us shortly to go to the Bureau of Health Professions at HRSA.
So we\'ll still have a connection in terms of that cross agency working
together since the training issue is a big deal over there.

Prevention Fellows. Daniel Bailey is the project officer for that, and
Nancy Kennedy is working with him as well. Mary Joyce Pruden is my CSAP
co-lead for workforce development, and so she\'s working with me
initially on our prevention core competencies, as well as the Prevention
Leadership Academy.

Very briefly I will go through kind of what these all are.

The CSAP Learning Communities. It\'s basically CSAP walking the talk.
It\'s like integrating educational experiences across the divisions,
theory and practice. It\'s basically self-directed, self-organized, and
Alaina and Erica have done a really nice job in piloting these different
learning communities around the SPF. So looking at how can we do a
better job of delivering effective TA. So you\'re looking at problem
solving from a systems perspective, examining how do you deliver TA. So
they\'re using case studies and simulations to have staff practice.
It\'s not like everybody knows how to do these different kinds of
things, and it\'s not that it\'s foreign to any of them. But the more
you can interact with your other colleagues, I think you end up being a
little bit stronger in your delivery.

Ultimately too, for those folks that want to pursue it in doing the
learning communities and some of the other continuing education work,
folks would be eligible for prevention certification.

Prevention Fellows Program. It\'s a three-year program basically
promoting the SPF as a mechanism for delivering evidence-based substance
abuse prevention. There are currently 36 fellows. It\'s currently in its
second year. Awards are made of up to \$35,000 being available to each
state. The District of Columbia has a fellow, as well as CADCA and
NASADAD.

MR. DeWISPELAERE: How did they get one and we didn\'t? Go ahead.

MS. NADAL: Another piece that I didn\'t list on this one was the
Prevention Leadership Academy, and Mary Joyce has worked on that. It\'s
an annual event that we do with the state prevention coordinators, and
it really is to emphasize the leadership roles that states have in the
prevention field. And ultimately through that annual event and other
things that go on during the year, it\'s to really sustain a core of
state leaders who can build effective state prevention systems.

The prevention core competencies. There\'s been a lot of work done
within the field, and what we held at the end of June was a meeting of
various state representatives. Alan Moghul from NASADAD was there. The
idea was to come to some consensus at least on an initial set of core
competencies which we\'re then going to go ahead and vet through the
field just to establish some kind of baseline, and from there, we\'ll go
further in terms of working with the field in terms of promotion and
adoption of those.

Kind of that old team work thing. It\'s government. It isn\'t limited to
government. There\'s a lot of times when you\'re working really closely
with folks, and sometimes you can still end up in two different places.
So the whole idea with workforce development is that we\'re not trying
to go there, and I think, because of the integration and the emphasis
that the Administrator has put in doing this particular activity, that
we\'re in pretty good shape.

And it\'s the end of the day. I\'ll give you something positive to look
at.

MS. ARES: I have one question.

MS. NADAL: Yes.

MS. ARES: On the prevention core competencies, I know that you mentioned
earlier ICRC. Have you looked at their competencies? Because I think
they\'ve kind of organized them into a domain.

MS. NADAL: We have.

MS. ARES: They have knowledge, skills and attitude sets under each one
of those things.

MS. NADAL: We have, and basically we were also drawing upon work that\'s
been done by California, Washington State, and we had somebody from ICRC
involved with us, as well as some folks from Drug-Free Community
coalitions. So we\'re not quite at the point where we need to actually
negotiate all of these because part of the challenge is that everybody
looks at it slightly differently and there isn\'t necessarily one answer
for all of this. But we want to come to something that people are
comfortable with, that they can work with, and hopefully then do
whatever they need to do, if they need to develop it further, to make it
match up more so with their state or community.

MS. ARES: Have you seen a great variance across these groups?

MS. NADAL: No. There\'s a lot of similarities.

MS. ARES: Well, that\'s good to hear.

MS. NADAL: And it\'s terminology and it\'s the way that people choose to
define things.

MS. ARES: Wordsmithing.

MS. NADAL: That\'s the big one that has held some of this discussion
ongoing I think. So we\'re going to put something out. Hopefully it\'s
something that folks can work with and kind of let them take it from
there because it won\'t be prescriptive.

MS. ARES: I wish you the best in that endeavor because I know prevention
people love to wordsmith. Or is it wordsmith? I\'ve heard it both ways.

MS. NADAL: See. There you go.

MS. KITTRELL: Are there any other questions or comments? Alan?

MR. SHINN: Aloha, Nel. How are you?

MS. NADAL: Pretty well.

MR. SHINN: I was just wondering do you think CSAP will ever get to the
point where ‑‑ CMHS has actually implemented curriculum training for
language and ethnic minority populations with mental health
professionals. Do you think we\'ll get to that point with our
prevention?

MS. NADAL: I don\'t know. I\'d look to the senior staff in terms of
where our budget planning is. I think it\'s one of those that if it was
an important one for the field and you could make the case for it
because it\'s always going to be an issue of sort of carving out the
dollars for specific groups. If it makes sense, if it\'s something that
we could pursue perhaps with other interagency type arrangements, just
because HRSA has a large amount of money put into that kind of work and
the Congress tends to look to them as the primary delivery system for
training.

So it\'s something that I think SAMHSA leadership has taken a look at
and we\'re not quite sure yet what direction we\'re going to go in terms
of all of the interagency options that they can pursue. But we would
definitely be behind having things that would support additional
resources.

MR. SHINN: The other question is Hawaii ‑‑ you know, we have our
SPF/SIG, and we\'re looking for an epi person. Are you willing to come
to Hawaii?

MS. NADAL: I think we\'ve made sure to go ahead and advertise all those
jobs for you.

MR. SHINN: Can I recruit? No? We\'ll buy you a plate lunch every day.
How\'s that?

MS. KITTRELL: Thank you very much, Nel. Oh, there was another one?

DR. TAFT: I was intrigued by your Prevention Leadership Academy, your
one-day training. Could you go into a little more detail on that?

MS. NADAL: Is Mary Joyce here?

MS. KITTRELL: Yes.

MS. NADAL: Mary Joyce, you have to talk about details for the Prevention
Leadership Academy.

MS. PRUDEN: We started it about three years ago. We\'ve had three annual
events, and we will begin planning the fourth one at the NPN conference.
This is for NPN specifically. Many other people want to come to it, but
this is really to develop our prevention contacts and who we see as a
state prevention person in a state, as the lead prevention person in the
state, so that we can help foster their leadership and hopefully have
some sustainability too with some of the leaders.

We work in partnership with the NPN with the Executive Committee and
also the Workforce Development Committee of the NPN. Last year they
helped to choose ‑‑ they were even on some of our telephone calls when
we interviewed some of the trainers. So they have a huge role in this.

So what are some other things you might want to know about it?

DR. TAFT: What kind of things do you touch on when you\'re with them
that day?

MS. PRUDEN: Okay. Well, each year they decide what they want to do. The
first year we ended up with various people talking about various topics,
and that didn\'t go over as well. They wanted one subject more in depth.
So the second year we decided to look at leadership models, and we had
Cambridge, Harvard University come and present adaptive leadership. So
we got an orientation about that was about. Also, there was a lot of
group process.

When we do this training and we look at this, we look at two things, and
we want to strengthen the NPNs individually for each state. We also look
at the NPN association and try to help them strengthen themselves. We
want to make prevention more visible. You know how we\'re always kind of
the last person that they think about when it comes to budgets, the
first person that they think about when it comes to cuts. So we want to
try to make the value of prevention so people can see that, and that\'s
probably the underlying purpose of one of them.

DR. TAFT: Thank you.

MS. PRUDEN: You\'re welcome.

MS. KITTRELL: Thanks for coming down, Mary Joyce.

Any other comments, questions?

(No response.)

MS. KITTRELL: If not, I will open up the floor for public comment. Do
you we have anyone from the public that wants to make a comment? Okay,
Alan.

DR. MOGHUL: I bring you greetings from my association, which is the
National Association of State Alcohol and Drug Abuse Directors, NASADAD,
as well as its affiliate, National Prevention Network. My name is Alan
Moghul, and I serve as the Chief of Prevention there.

In short, our association is very, very happy to be a partner in many of
these activities that we talked about today. I just want to zero in on
one particular topic that was talked about this morning and basically
just give you accolades from our association.

In the SPF/SIG program, Director O\'Meara was asked earlier will there
be a SPF/SIG in every state, and of course, the answer is we don\'t
know. I mean, if money were endless, sure. But we were able to prevent a
situation of haves and have nots. There are about 30-some SPF/SIG
states, but those that don\'t have the cooperative agreement right now
‑‑ you guys were able to put together epidemiological work groups, and
that proved to be very, very helpful. It leveled the playing field and
allowed states to really do an effective needs assessment and capacity
assessment and so on and start to move ahead on their own strategic
prevention framework outside the actual SPF/SIG. So we just wanted to
say thanks for that.

If the budget does prove to be very, very tight, again, we would hope
that you\'d continue to look into that model. Thank you.

MS. KITTRELL: Thank you, Alan.

Is there anyone else?

MR. BAILEY: I\'m the project officer for the Prevention Fellowship
Program, and Alan actually has a fellow working in your office right
now. So just to give a little bit more visibility ‑‑ and I heard the
question you mentioned earlier. Why doesn\'t my state have a fellow?
Well, your state can have a fellow. We are looking. We\'re going to have
a recruiting process the end of the year, and what we\'re trying to do
is hit a lot of these conventions, letting the states know that this is
free money basically. You don\'t have to pay the salaries of \$35,000 a
year in which you\'re able to use a fellow working in your state
prevention office.

MR. DeWISPELAERE: That\'s more money than I get.

(Laughter.)

MR. BAILEY: Part of the reason why we wanted to have a flat fee of
\$35,000 is because basically, depending on what area it would be and so
forth. But I thought also it would be a great opportunity for you to
recruit because actually what we do is that we actually fund the
\$35,000, but you are the ones who are actually selecting the fellows.
We don\'t actually select the fellows. So it gives you an opportunity to
see ‑‑ if you want someone who has a strong epi background, it allows
you the opportunity to say, well, you can come through this Prevention
Fellowship Program that we have here.

MR. DeWISPELAERE: Sure.

MR. BAILEY: It\'s a three-year program. The first year, they go with the
SPF model and they learn about the different steps, what it entails. So
even with states that don\'t have SPF funding, it\'s a great opportunity
to have a person understand how the system works, and it brings an asset
into your state.

The second year, they go into a more concentrated area depending on what
their interests are. Maybe it would be social marketing or epi work or
substance abuse across the life span. They get to choose what they want,
and then they\'ll get additional training in that area.

Then the third year, we\'re pretty much hands-off. We provide funding
for them to present, write a paper, or to evolve what they\'ve learned
in the program in their state. So we\'re really trying to give back to
the states and say here\'s an asset that you can use in the state and
also work in the state as a future employee.

So we\'re really trying to use this opportunity to get these fellows out
here, give them a chance to work in the field in a strong, supportive
network, and meeting a lot of these goals that Nel talked about in the
workforce development plan. We\'re trying to create resources. As you
know, the federal government and also the field is going to have a brain
drain, and this is very important that we support this program as much
as possible because this is the way we can.

Also, another thing. They\'re all getting ICRC certification, and
hopefully by the end of the three years, you\'ll have not only a person
that worked in your state, but also a person that\'s certified to do the
work and has had training and support in all portions of their
development.

So I just wanted to mention that before you all got a chance to walk
away.

MR. DeWISPELAERE: My question was a little more selfish than that being
that NASADAD and CADCA are national organizations and the organization I
work with is too. That\'s why I asked. But trust me, I\'ll be seeing you
before the meeting is done.

(Laughter.)

MS. KITTRELL: Thank you, Daniel.

You know what I\'d like to do, because we have a little bit more time. I
see CSAP staff. I see some of our interns out there. If you could just
stand up briefly and say who you are and where you\'re working, if
there\'s any special project that you\'re on, just quickly. Daniel told
you the project that he\'s working with, the Prevention Fellows. And you
met Peggy. Andrea?

MS. KAMARGO: I\'m Andrea Kamargo and I work for Peggy Thompson in OPAC.
I work on the RFAs, as well as Healthy People 2010 and soon to be 2020,
and a variety of other ad hoc projects and work groups and committees
and things like that. Nice to meet you all.

MS. KITTRELL: And could you come right on up behind Ron?

MR. ARMSTRONG: I\'m Ron Armstrong from the Division of Workplace
Programs, and I do policy oversight of the federal Drug-Free Workplace
Programs in all the federal agencies. So it\'s about 120 federal
agencies. And along with that, I do a lot of policy work with the Office
of National Drug Control Policy, and we get our legal opinions and a lot
of coordination back and forth with the Department of Justice.

MS. KITTRELL: Thank you.

Nancy?

MS. KENNEDY: Hi. I\'m Nancy Kennedy and I work in the Division of
Systems Development. I\'ve been in behavioral health for 35 years. I\'m
looking forward to retiring in two and a half years, and therefore, I\'m
trying to be in the background and let young people like Daniel and
David Wilson and others step up to the plate as they do so well. Thank
you.

MS. KITTRELL: Deborah?

MS. GALVIN: I\'m Deborah Galvin. I\'m in the Division of Workplace
Programs. I have several interesting programs that I think are
important. One is the Young Adults in the Workplace where we are trying
to figure out the best ways of integrating young people into our
workplace. As Jennifer shared, so many people are leaving, and we have a
great influx of young people now. We\'re not sure our programs in the
workplace work for these young people. So this grant program is looking
at that.

We also have a workplace website, and on that website, we\'re having
very shortly a brand new workplace kit that will be coming out. That
will be for small businesses and large businesses across the country
with how to do a Drug-Free Workplace program.

We\'re also going to parallel that kit and have a health and wellness
kit, and that is for places that may not like terminology like
\"drugs.\" It will be almost the same kit, but its focus is on health
and wellness. What we found out in our Workplace Managed Care Program is
that when you put substance abuse prevention within health and wellness,
you have a very successful substance abuse prevention opportunity, as
well as the health and wellness message still gets across.

In that vein, the last thing I work on is I\'m responsible for our
getfit@samhsa.gov, which is a health and wellness interactive website
that can be adapted by communities, schools, workplaces. You put your
own name in it. You put your own health care plan in it, and it provides
government-oriented health and wellness information that can be counted
on.

Thank you. I\'m sorry I took so much time.

MS. KITTRELL: Thank you. That\'s all right.

Walt?

MR. VOGL: I\'m Walter Vogl in the Division of Workplace Programs.
Primarily we work on what\'s called the National Laboratory
Certification Program. We have currently 45 labs that are certified
around the country, and they do all of the drug testing for federal
agencies, for all of the industries regulated by the Department of
Transportation, Department of Energy, Nuclear Regulatory Commission.
Basically all of the regulated industries have their urine specimens
tested in our certified labs.

I\'m also involved with the website with Deborah. We both work on it
quite extensively to keep it as current as we can. We have all of our
guidelines on there and other records and information that people use to
establish a workplace drug testing program.

It\'s been in existence since \'87, and we really look at it as
prevention. A lot of people look at drug testing as a law enforcement
sort of activity, but we really look at it as prevention. We want to
prevent people from starting to use drugs, and that\'s why we test them
in the workplace, the job applicants for jobs. If they\'re clean,
hopefully they\'ll be convinced to stay that way. So we really look at
it as prevention, not law enforcement.

Thank you.

MS. KITTRELL: Thank you. Come on. Don\'t be shy. Interns, staff on the
other side, come on. Thank you, Costella.

MS. GREEN: My name is Costella Green, and I\'m a Drug-Free Communities
project officer. I have the States of Washington and California and
Illinois. I also work on the PRIDE program with Jay that I love because
it\'s with youth and I used to do direct service. My old supervisor is
here at the table and she knows I love direct service. So I love what I
do working with the coalitions.

MS. KITTRELL: Thank you.

MR. DeWISPELAERE: Good work, all of you.

MS. PRUDEN: Hi, and I\'m Mary Joyce Pruden. I came back because to let
you ‑‑ no, not Hope. Let\'s see. Who else? I guess she left. Right?
Sharyn. Yes, because I\'m the state project officer for Wyoming. I
wanted to make sure she knew that.

But anyway, I have five states. I do many things here, many committees.
I\'m on the Workforce Development Committee with Nel. She and I do a lot
of work together in the Leadership Academy, and we\'re starting our
fourth year on that.

Other states that I have are California, Washington State, Nevada,
Oregon, and Wyoming.

MS. KITTRELL: Thank you, Mary Joyce.

MS. STEINER: Hello. My name is Elizabeth Steiner. I recently finished my
degree and came up here as a summer intern, and as of the last few
weeks, I\'ve transferred over to student appointment. I work in OPAC
with Peggy Thompson. I\'m learning the duties of personnel liaison and
I\'m going to start learning about the conference grants.

MR. DeWISPELAERE: Can I ask a question?

MS. STEINER: Sure.

MR. DeWISPELAERE: What is the difference between summer intern and
student appointment?

MS. STEINER: Student appointment is more permanent. Summer intern, you
leave, you\'re done. Student appointment transfers over into a job,
hopefully.

MR. DeWISPELAERE: Good.

(Laughter.)

MS. STEINER: Hopefully. I look in that direction.

MR. DeWISPELAERE: Hey, that\'s the way we like it. Good job.

MS. HAYNES-BATTLE: Good afternoon, everybody. My name is Josefine
Haynes-Battle. I\'m brand new to SAMHSA. I\'m working directly with Dr.
Mulvey, along with Dr. Kennedy, Daniel, Nel, as well as Dr. McHale. And
I\'m primarily working on a couple of contracts. One deals with fetal
alcohol spectrum disorders, and then the second contract that I\'m
assisting with is the Native American Center of Excellence which we hope
to kick off early next month.

So welcome and have a safe trip back home.

MS. KITTRELL: Thank you, Josefine.

MS. CLARK: Good afternoon. I\'m Jennifer Clark, and I\'m a new project
officer in the Drug-Free Communities Program. I have the States of
California and Nevada.

MR. ROSE: Hi. I\'m Gilbert Rose. I\'m also a new project officer at
CSAP, Drug-Free Communities, and I have Missouri, Kansas, and Louisiana.

MS. KITTRELL: Thank you.

MR. VOKES: Hey, I\'m Kevin Vokes. I\'m a new intern here. I\'m in a
masters program in community counseling. I\'m new here.

MS. KITTRELL: Thank you, Kevin.

MS. RUBIO: Hello. I\'m Cynthia Rubio. I\'m with Drug-Free Communities as
well, and I have the State of Iowa.

MS. McHALE: Hello, everyone. I\'m Carol McHale. I work with Kevin Mulvey
in the Division of Systems Development. I\'m a project officer for the
Northeast CAPT contract, and I have several task leads. I am the task
lead on a fairly new initiative that we launched this year with the
HIV/MAI grantees where the CAPTs did two and a half-day regional
workshops, and they were really very well received. We did them in all
five regions, about 400 participants overall. So that was one major
activity, which I believe will be repeated next year, we hope.

I\'m also the task lead on a unique CSAP initiative called Service to
Science, which is intended to nurture the development of local
innovative, field-grown programs to develop stronger evidence of
effectiveness and to be able to document it well.

I serve as a liaison with SAMHSA on the National Registry of
Evidence-Based Programs and Practices, and I work with the state
division and Mike Lowther on the development of CSAP\'s guidance around
selecting evidence-based programs and practices for the SPF/SIG program.

MS. KITTRELL: Thank you, Carol.

Are there any other comments?

(No response.)

MS. KITTRELL: All right. If not, I want to thank all of you all for
being here, for the CSAP staff, those of you who hung in here with us
for two days, and I wanted to thank the National Advisory Council for
you taking the time out of your busy schedules to be here with us.

As Mike Lowther likes to say, we don\'t deliver services at the federal
level. We don\'t deliver them at the state level. They are delivered
locally in your communities. You bring to us your experiences and you
all become the arms and legs for CSAP for SAMHSA when you go out into
the field, when you attend the meetings, the conferences, when you\'re
representing us because we can\'t be everywhere, but you all can take
the message. You can take our priorities out into the field. The
information that\'s in your new members\' orientation packet ‑‑ you have
that. You have the information that has been shared with you today.
Plus, the recommendations that you all have given to us already we can
begin to act on some of those, and hopefully we\'ll be able to report
some things out to you. Tia will be in contact with you.

I thank you for all that you do, for your expertise, and you all have a
safe journey home.

(Whereupon, at 2:22 p.m., the meeting was adjourned.)