Prevention Programs

PURPOSE: This rule identifies the expected outcomes, strategies, and operational requirements for prevention programs. (1) Program Description. A prevention program offers a planned, organized set of activities designed to reduce the risk of and incidence of illegal or age-inappropriate use of alcohol, tobacco, and other drugs. (A) Prevention activities and services are provided to an identified target population within a designated geographic area. (B) The target population may include individuals, groups, organizations, communities, and the general public. The target population may include individuals or groups considered to be at-risk or high-risk in their potential for substance use; however, prevention activities are not specifically or primarily directed to persons who need treatment for a substance use disorder. (C) A prevention program provides services that are comprehensive, research based, and culturally sensitive and relevant. (D) A prevention program serves all age groups and populations where the need is evident, including special populations. (2) Use of Risk Reduction Strategies. A prevention program implements strategies which reduce the risk of and the incidence of illegal or age-inappropriate use of alcohol, tobacco, and other drugs. The program shall implement the following risk reduction strategies in accordance with the type of prevention services and programming it offers: (A) Increase awareness of the nature and extent of such substance use and their effects on individuals, families, and communities; (B) Inform others about available prevention and treatment services; (C) Develop social and life skills which reduce the potential for such substance use; (D) Identify and address risk and protective factors associated with substance use; (E) Provide and assist with constructive and healthy activities to offset the attraction of such substance use or to meet needs which otherwise may be fulfilled by these substances; (F) Identify persons who may have become involved in the initial, inappropriate, or illegal use of alcohol, tobacco, and/ or other drugs and then arrange support and other referrals, as needed; (G) Assess community needs and assist in the development of community planning and action; (H) Establish or change community attitudes, norms, and policies known to influence the incidence of such substance use; (I) Actively intervene with individuals and populations who have multiple risk factors for such substance use; and (J) Organize, coordinate, train, and assist other community groups and organizations in their efforts to reduce such substance use. (3) Types of Certified Programs. An agency may be certified to provide one (1) or more of the following types of prevention programs: (A) Primary Prevention Program; (B) Targeted Prevention Program; or (C) Statewide Prevention Resource Center. (4) Requirements for Certification. A prevention program shall comply with rules and standards listed under 9 CSR 30-3.032. (A) Requirements under 9 CSR 10-7.120 are applicable based on the type of services provided by the prevention program and whether services are offered to individuals and groups at the program site. (B) The following rules and standards are waived for prevention programs, unless the department determines that a specific requirement is applicable due to the unique circumstances and service delivery methods of a program: 1. 9 CSR 10-7.010; 2. 9 CSR 10-7.020; 3. 9 CSR 10-7.030; 4. 9 CSR 10-7.060; 5. 9 CSR 10-7.070; 6. 9 CSR 10-7.080; 7. 9 CSR 30-3.100; and 8. 9 CSR 30-3.110. (5) Qualifications of Staff. Services shall be provided by a qualified prevention specialist who demonstrates substantial skill by being— (A) A graduate of an accredited college or university with a bachelor’s degree in community development, education, public administration, public health, psychology, sociology, social work, or closely related field and have one (1) year or more of full-time equivalent professional experience in education, public health, mental health, human services, or a closely related area. Additional years of experience may be substituted on a year-for-year basis for the education requirement; or (B) A prevention professional that is credentialed by the Missouri Credentialing Board to provide prevention services. (6) Documentation of Resources and Services. All prevention programs shall maintain— (A) A current listing of resources within the geographic area in order to readily identify available substance use disorder treatment and prevention resources, as well as other resources applicable to the target population; (B) Informational and technical materials that are current, relevant, and appropriate to the program’s goals, content, and target population. 1. Materials and their use shall accommodate persons with special needs, or the materials can be readily adapted to meet those needs. 2. Materials shall be periodically reviewed by staff and advisory board to ensure relevance to the target population and consistency with current prevention research. The advisory board shall include members of the target population and a broad range of representatives from other community groups and organizations; and (C) A record of all service activities. The record shall— 1. Identify the presenter and participants; 2. Describe the service activity; 3. State how the activity meets the specific needs of the individual, group, or community organization served; 4. Include consents for participation or releases of information, as applicable; and 5. Include or summarize participant evaluations, as applicable. (7) Primary Prevention Program. A Primary Prevention Program shall offer comprehensive services and activities to a specified target population(s) in its effort to reduce the risk of and incidence of illegal or age-inappropriate use or misuse of alcohol, tobacco, and other drugs. (A) A primary prevention program shall offer all of the following types of prevention services: information, education, alternatives, problem identification and referral, communitybased process, and environmental services. 1. Unless otherwise indicated, the target population for information, education, alternatives, and problem identification and referral services shall include, but is not limited to, one (1) or more of the following: persons who are at risk for a substance use disorder; families or friends, or both, of persons at risk for a substance use disorder; school officials or employers of persons at risk for a substance use disorder; caretakers and families of elderly or populations with other special needs. 2. Unless otherwise indicated, the target population for community-based process and environmental services shall include, but is not limited to, persons at risk for a substance use disorder; community groups mobilizing to combat inappropriate substance use including civic and volunteer organizations; church; schools; business; healthcare facilities and retirement communities; state and municipal governments; and other related community organizations. (B) Information services shall increase awareness of the nature, extent, and effects of such substance use. 1. Information services are characterized by one- (1-) way communication from the presenter to the target population. 2. In addition to the target populations listed in subsection (7)(A), the target population information services may include the general public. 3. Examples of information service activities include: distributing written materials such as brochures, pamphlets, newsletters, resources directories, and other relevant materials; distributing audiovisual materials such as films, tapes, public service announcements, and other relevant materials; functioning as information resource center or clearinghouse; arranging speakers and presentations; and operating as a designated access point for computerized information networks. (C) Education services shall develop social and life skills, such as conflict resolution, decision-making, leadership, peer resistance, and refusal skills. 1. Education services are characterized by interaction between the facilitator and the participants to promote certain skills and behaviors. 2. Examples of education service activities include classroom or small group sessions for person of any age, peer leader and helper programs, and parenting and family management classes. (D) Alternatives shall provide healthy and constructive activities to offset the attraction of such substance use or to meet needs which otherwise may be fulfilled by these substances. 1. Alternative services engage the target population in recreational and other activities that exclude such substance use. 2. Examples of alternative service activities include developing and supporting community service activities, teen institutes and other leadership training and activities for youth, adults, parents, school faculty, or others. (E) Problem identification and referral services shall assist in arranging support, education, and other referrals, as needed, for persons who have become involved in the initial, inappropriate, or illegal use of alcohol, tobacco, and drugs. 1. This service does not include a professional or comprehensive assessment and determination of the need for substance use disorder treatment. 2. Examples of specific problem identification and referral activities include training and consultation to student assistance programs, employee assistance programs, medication support programs for the elderly, and other programs and organizations that may intervene with persons in the target population. (F) Community-based process shall involve the assessment of community needs and the promotion of community planning and action in order to enhance other prevention and treatment services and to reduce the incidence of such substance use. 1. The target population shall include community coalitions. A community coalition must have broad-based community representation and participation, such as civic organizations, neighborhood groups, churches, schools, law enforcement, healthcare and substance treatment facilities, businesses, and governmental organizations. 2. Examples of community-based process activities include assessing community needs and risk factors and recruiting, training, and consulting with community coalitions. (G) Environmental services shall positively effect community policies, attitudes, and norms known to influence the incidence of such substance use. 1. Environmental services may address legal/regulatory initiatives, service/action initiatives, or both. 2. Examples of environmental services include maintaining current information regarding environmental strategies; training and consulting with community coalitions in the development and implementation of such strategies; serving as a resource to school, businesses, and other community organizations in the development of policies; and providing information regarding alcohol and tobacco availability, advertising and pricing strategies. (8) Targeted Prevention Program. A Targeted Prevention Program shall actively intervene with individuals and populations that have multiple risk factors for the illegal or age-inappropriate use or misuse of alcohol, tobacco, and other drugs. The program shall reduce risk factors and reduce the likelihood of such substance use and include effective prevention strategies that are based on research findings. (A) The target population shall include: 1. Persons at risk of developing a substance use disorder, such as out-of-school youth, youth dropouts, or persons prone to violence; and 2. Individuals and groups that influence those persons at risk for a substance use disorder, such as parents; teachers, families and caretakers of elderly, or populations with other special needs; and school based and community groups, including civic and volunteer organizations, churches, and other related community organizations. (B) The program may be located in school or other community settings. (C) The program shall provide and promote social and emotional support, skill development, counseling, and other preventive services for persons and populations with multiple risk factors. (D) Examples of specific services and activities include early identification and intervention; efforts to prevent dropping out of school; after-school recreational and educational activities; development of social and life skills such as conflict resolution, decision making, leadership, peer resistance, and refusal skills; group counseling or individual counseling, or both; parent training and consultation with school staff or other community organizations. (9) Statewide Prevention Resource Center. A statewide prevention resource center shall organize, coordinate, train, assist, and recognize community, regional, and state resources in their efforts to reduce the illegal or age-inappropriate use or misuse of alcohol, tobacco, and other drugs. (A) The target population shall include community coalitions and other community organizations including primary prevention programs; and other community and state resources. (B) Examples of specific activities include: 1. Conducting statewide and regional workshops and conferences; 2. Where applicable, distributing a state-wide newsletter that contains current information about prevention activities and issues; 3. Providing information and technical assistance regarding effective prevention strategies that are based on research findings; 4. Recognizing accomplishments by community coalitions and sponsoring recognition events; 5. Coordinating prevention activities and resources development with other state level organizations and state agencies; and 6. Expanding and strengthening the network of community and state organizations involved in prevention activities. (10) All prevention programs shall participate in program evaluation activities as required by the department. AUTHORITY: section 630.655, RSMo 2016.* This rule was originally filed as 9 CSR 30-3.630. Original rule filed May 13, 1983, effective Sept. 13, 1983. Rescinded and readopted: Filed June 27, 1995, effective Dec. 30, 1995. Moved to 9 CSR 30-3.300 and amended: Filed Feb. 28, 2001, effective Oct. 30, 2001. Amended: Filed Oct. 15, 2001, effective April 30, 2002. Amended: Filed March 9, 2018, effective Oct. 30, 2018. *Original authority: 630.655, RSMo 1980.