The Center of Warren and Clinton Counties hired a project director and a support staff person to implement the planning process and maintain communication with the key stakeholders in the 3,402 square-mile rural area, covering seven counties. Highlights of the results of this planning project follow.

The project team included a diverse group of stakeholders to ensure optimal service development.

A project team of 20 individuals from the seven counties met three times to guide the needs assessment and strategic planning activities. Key stakeholders from treatment and prevention, juvenile justice, child protection, and schools completed over 300 surveys. The Kettering Foundation consulted on the project and completed interviews with 32 teens in the community and in local detention centers regarding the nature of adolescent substance abuse in the region. After these interviews, the Kettering Foundation created a booklet to share the teens' opinions and advice with adult community members and stakeholders. A key statement from this booklet is the following: "Stress is the unmanageable subject in (teens') lives, and teens don't know or have alternatives for dealing with it. They'll blow up, get depressed, or hurt others--substance abuse provides escape."

The project team completed a needs assessment and developed a region-wide strategic plan.

The needs assessment revealed that:

• The teen pregnancy rate in four of the seven counties is higher than the Ohio average of 33.2 per 1,000.
  
• Approximately 6,800 children in the region are uninsured.
  
• The five treatment agencies in the seven counties serve 350 adolescents, approximately 10% of the estimated number of those who need treatment.
  
• The juvenile justice system referred 52% of those receiving services.
  
• The treatment offered to teens predominantly built on adult models of care and does not adequately address family issues or aftercare needs.
  
• Child-serving agencies gather data to meet state requirements but rarely use these data for local decision-making.
  

Both Boards endorsed the strategic plan, which included six objectives:

• All adolescent outpatient treatment programs are supported with a minimum of one year of community-based aftercare.
  
• A common, comprehensive assessment tool is developed and used to identify individualized treatment needs.
  
• Adolescent substance abuse treatment is provided by well-trained and supported staff in a continuum of services based upon best practice.
  
• Suspension, assessment, and treatment intervention policies are coordinated to more effectively identify and address adolescent substance abuse and behavioral issues.
  
• Asset-based, comprehensive strategies to enhance adolescent, family, and community health are adopted and promoted across the region.
  
• Prevention activities are coordinated at the community level to reduce duplication and ensure age appropriateness.
  

The first four of the objectives of the strategic plan were included in a business plan for adolescent substance abuse treatment system change covering the seven counties (see the Mental Health and Recovery Services of Warren and Clinton Counties grant entitled "Adolescent Treatment Program" for more information).

The facilitators of the planning project included:

• a budget that allowed for both a project director and an administrative assistant;
  
• a strategy that allowed issues to be reported in general terms so that no particular agency was singled out;
  
• a comprehensive collaborative approach that brought numerous systems to the table; and
  
• the Board being the grantee, which gave authority to the process.
  

The barriers to the planning project included:

• the difficulty of obtaining detailed budget, program, and client demographic data;
  
• the lack of consistent terminology between systems; and
  
• lack of "self-evaluation" by the local substance abuse treatment system.