[Federal Register Volume 60, Number 52 (Friday, March 17, 1995)]
[Notices]
[Pages 14441-14442]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-6612]



-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration


Single Source Grant to CODAC Behavioral Health Services of Pima 
County, Inc.

AGENCY: Center for Substance Abuse Treatment, Substance Abuse and 
Mental Health Services Administration (SAMHSA), HHS.

ACTION: Notice of intent to award a single source demonstration grant 
to support a comprehensive outpatient treatment and prevention program 
for substance-abusing mothers and their infants in Pima County, 
Arizona.

-----------------------------------------------------------------------

SUMMARY: The Center for Substance Abuse Treatment (CSAT), SAMHSA, is 
publishing this notice to provide information to the public concerning 
a planned single source grant award to CODAC Behavioral Health Services 
of Pima County, Inc. This is not a formal request for applications. 
Assistance will be provided only to CODAC Behavioral Health Services of 
Pima County, Inc., based on the receipt of a satisfactory application 
that is approved by a peer review group and the CSAT National Advisory 
Council.

Authority/Justification

    The grant will be made under the authority of Section 510(b)(1) of 
the Public Health Service Act, as amended.
    An award is being made on a single source basis because the 
Conference Report to the Treasury/Postal Service and General 
Appropriations Act of 1995, Pub. L. 103-329, provides directive 
language that the appropriation includes $500,000 for CSAT to support 
CODAC Behavioral Health Services of Pima County, Inc., for ``a 
comprehensive treatment and prevention program for substance-abusing 
mothers and their infants.'' Providing assistance through a grant is 
the appropriate mechanism to fund this activity because it is our 
intent to provide support for a public purpose and agency involvement 
in the actual conduct of the activity is not required. The grant is 
subject to review as governed by Executive Order 12372, 
Intergovernmental Review of Federal Programs.

Background

    Scientific evidence indicates that certain individuals are at 
greater risk of disease, dysfunction and death as a consequence of 
alcohol and other drug use and abuse. Women, and in particular, 
pregnant and postpartum women, their infants and children who live at 
or near the poverty line, are among the most vulnerable of these. For 
them, substance use/abuse, chemical dependency, and the biological, 
psychiatric, psychological and socio-economic co-factors of substance 
abuse (herein referred to as ``alcohol and other drug problems'') may 
be severe. Unfortunately, the treatment infrastructure has not kept 
pace with the demand or complexity of need in response to the serious 
problem of [[Page 14442]] maternal alcohol and other drug use/abuse and 
the resulting complications experienced by this population. When women 
do seek treatment they often face strained substance abuse treatment 
agencies that lack the capacity, financial resources, or appropriate 
family-centered approaches to effectively meet the multiple treatment 
needs of women and their children. Few treatment agencies have the 
capability to provide all services required to meet the needs of this 
population, such as treatment for critical health and mental health 
problems and injuries resulting from histories of physical and sexual 
abuse; child care and development; parenting skills development; and 
child abuse and neglect prevention. Both residential and outpatient 
treatment services specifically designed for women are necessary to 
ensure that the full range of services is available. This is necessary 
because the needs and circumstances of clients can vary considerably. 
Some women are unwilling or unable to enter residential treatment; 
outpatient treatment is therefore the most appropriate option for them. 
Some residential programs have a combination of residential and 
outpatient care designed as part of their treatment approach, and for 
some programs, outpatient services are available as part of required or 
voluntary continuing care.
    CODAC has offered substance abuse treatment, prevention and general 
mental health services in Pima County for 25 years, during which time 
it has become a nationally-known center for provision of residential 
and outpatient substance abuse treatment services for women and their 
children. CODAC targets women in the criminal justice system, ethnic 
minority women, and low-income women, all high-risk groups according to 
the Office of National Drug Control Policy. The majority of women 
served by CODAC are between 19 and 24 years of age, approximately 2% 
are African American, 30% Latino, 60% Caucasian, 1% Native American and 
7% other (including multiracial).
    CODAC has also initiated comprehensive residential treatment and 
prevention services to substance abusing mothers and their infants, 
under Section 508 of the Public Health Services Act, CSAT's Services 
Grant Program for Pregnant and Postpartum Women (PPW). The residential 
services are complemented by outpatient case management and treatment 
referral services funded by the Center for Substance Abuse Prevention 
(CSAP) since 1990. The CSAP project (Comprehensive Assistance to 
Mothers & Infants Outpatient Program Expansion--CAMI) comprises a wide 
range of services, including ensuring that the women receive prenatal 
care, education/job development, and housing.
    Funding for CAMI is due to expire April 30, 1995. Among CAMI's 
innovations in outpatient prevention and treatment have been early 
detection and screening of infants and children (and referral for 
services as necessary), parenting training, outreach to difficult to 
reach target populations, and follow-up of clients post-treatment. From 
February 1991 to June 1994, CAMI has served 249 women, 153 infants and 
approximately 200 children. Of the 40 women who had been in treatment 
and are presently involved in 6 month post-treatment reevaluations, 79% 
have abstained from use of all drugs except tobacco (72% continue to 
smoke). Importantly, clients in CAMI have demonstrated a significant 
decrease in drug use during the second trimester of pregnancy. This 
reduces the probability of perinatal effects of drug use and therefore 
the costs of medical and associated care.
    Providing continuing support for CAMI under the CSAT PPW program 
helps to ensure linkage between the residential and follow-up phases of 
treatment and thereby improve the likelihood of sustained recovery for 
the discharged mothers and their children as well as for women to enter 
the outpatient program only. This will, in turn, result in positive, 
wide-ranging impact on the Tucson community.
    This grant will support comprehensive outpatient services to 
mothers and their infants, including:
    (1) Outpatient substance abuse treatment;
    (2) Expanded outreach to women not yet engaged in treatment;
    (3) Coordination of services for women enrolled in the PPW program, 
including continuing care (aftercare) services;
    (4) Expanding treatment, psychological counseling and educational 
groups tailored specifically to the needs of women in treatment;
    (5) Expanding the wellness component and strengthening its linkage 
with the PPW residential program;
    (6) Expanding the mentoring program;
    (7) Provision of child care services for women enrolled only in the 
outpatient program; and
    (8) Expanded prevention services directed toward at-risk 
populations.
    This grant is consistent with the State of Arizona drug abuse 
treatment plan. Providing funding to CODAC under this grant will help 
ensure that the prevention and treatment approaches devised and 
implemented by CODAC can continue to serve as models for programs 
serving women and their children throughout the country.
    The project will be funded for one year in the amount of 
approximately $500,000.
    The Catalog of Federal Domestic Assistance number for this program 
is 93.101.

FOR FURTHER INFORMATION CONTACT: Maggie Wilmore, CSAT/SAMHSA, Rockwall 
II, 7th Floor, 5600 Fishers Lane, Rockville, Maryland 20857. Telephone 
(301) 443-8160.

    Dated: March 13, 1995.
Richard Kopanda,
Acting Executive Officer, Substance Abuse and Mental Health Services 
Administration.
[FR Doc. 95-6612 Filed 3-16-95; 8:45 am]
BILLING CODE 4162-20-P