Part 11: Bureau of Alcohol and Drug Services State Plan

BUREAU OF ALCOHOL AND DRUG ADDICTION SERVICES FY 2022 –2023 STATE PLAN Prevention Works ~ Treatment is Effective ~ People Recover Department of Mental Health Bureau of Alcohol and Drug Addiction Services STATE PLAN FY 2022-2023 Presented by: Felita Bell, MSL, Program Administrator Mallory Malkin, PhD Chief Clinical Officer Misty Bell, EdS, LCPC, CRC, CMHT, CPM Division Director Substance Use Disorders Treatment Services Chuck Oliphant, M.Ed., CMHT, CADC Division Director Wellness and Recovery Opioid Treatment Prevention Works ~ Treatment is Effective ~ People Recover Table of Contents Bureau of Alcohol and Drug Addiction Services Advisory Council 4-5 Governor’s Letter of Support Mission and Vision of MS Department of Mental Health Mission and Vision of the Bureau of Alcohol and Drug Addiction Services Core Values Community Mental Health System Substance Use Disorder Programs Prevention Services Population Served State-Wide Plan for Substance Use Prevention, Treatment and Support Priority Areas Budget Summary Prevention Works ~ Treatment is Effective ~ People Recover Bureau of Alcohol and Drug Addiction Services Advisory Council Members Contact Information 1. Kennan B. Lesure Hanging Moss Road Church of Christ/Retired Board of Pharmacy 510 Hathaway Drive Clinton, MS 39056 (601) 316-8120 kblesure@gmail.com 2. Angela L. Shine, LMSW Radical, Inc., CEO Mental Health Coordinator/NBCUSA Certified Mental Health First Aid USA Instructor P.O. Box 221 Columbus, MS 39703 (662)-368-2210 Radical1@tds.net 3. Mark Chaney Retired 7070 Hwy 80 Vicksburg, MS 39180 (601) 638-4784 katchaney@bellsouth.net 4. Dr. Nelson Atehortua De la Pena, MD, PhD, MPH, MS Jackson State University P.O. Box 17038 Jackson, MS 39213 (270)-438-3827 nelson.atehortua@jsums.edu 5. Dr. Shawn Clark, Vice-Chair Veterans Administration 5234 Parkway Drive Jackson, MS 39211 (601) 957-6746 (601) 362-4471 (6192) shawn.clark@va.gov 6. Dwight Owens Motivational Speaker Americans with Disabilities Act Consultant P.O. Box 114 Taylorsville, MS 39168 (601)-498-2332 owensdwight@yahoo.com 7. Martha Lynn Johnson, South Panola Community Coalition 1058 Good Hope Road Batesville, MS 38606 (662) 563-9250 (662) 934-0687 mljohnson445@icloud.com 8. Jordan Hillhouse, M.Ed. Prevention Services 829 Wilson Drive, Suite C Ridgeland, MS 39157 (601) 421-9892 jhillhouse@hotmail.com 9. Toniya Lay, MSCE, Ed.S., LPC, NCC Choctaw Behavioral Health 210 Hospital Circle Philadelphia, MS 39350 601-389-6291 toniya.lay@choctae.org 10. Ronney Henderson Peer Support Specialist, VA 211 Samuels Dr. Madison, MS 39110 Ronney.henderson@va.gov 11. Paul Matens Retired 219 Cambridge Drive Madison, MS 39910 (601) 201-2982 paulmatens7@gmail.com 12. Kevin Freeman, Ph.D UMMC Psychiatry & Human Behavior 2500 N State Street Jackson, MS 39216 (601) 815-5622 kfreeman@umc.edu Prevention Works ~ Treatment is Effective ~ People Recover 13. Sandra Moffett Retired, MS Office of Public Safety P. O. Box 1606 Jackson, 39236 (601) 540-8252 smoffett@dps.ms.gov 14. Dawn Wisdon, M. Ed. Outreach Coordinator Pax Behavioral Health 4918 William Arnold Road (480) 356-1511 dawn.wisdom@paxbehavioralhealth.com 15. Curtis Oliver, MPA Faces and Voices of Recovery Mississippi 610 South Washington Street Brookhaven, MS 39601 (601) 455-7488 curtis@favorms.com 16. DeGarrette Tureaud MS Dept. of Health, Off. of Tobacco Control 805 S. Wheatley Street Ridgeland, MS 39157 (601) 991-6050 Degarrette.tureaud@msdh.state.ms.us 17. Joe Grist, President North MS State Hospital 1937 Briar Ridge Road Tupelo, MS 38804 (662) 690-4200 (662) 321-0059 joe_grist@nmsh.state.ms.us 18. James Moore Behavioral Health Advocate 406 Crestmont Avenue Hattiesburg, MS 39401 (601) 549 -2392 mooresbikes@gmail.com 19. Tamritha Dean Office of Disability Determination Services P. O. Box 1271 Jackson, MS 39215-1271 tamritha.dean@ssa.gov (601)-566-2701 20. Carol Elrod MS Depart. of Voc. Rehab PO Box 1698 1281 Hwy 51 North Madison, MS 39110 celrod@mdrs.ms.gov 21. Terry James Session 112 Saint Anthony St. Greenville, MS 38701 662-347-5465 tjsession1@gmail.com 22. Julie Powell, MS Brentwood Behavioral Health 121 Sweetgum Road Brandon, MS (601) 278-4445 juliep444@gmail.com 23. Pamela S. Holmes Director of Problem-Solving Courts Supreme Court of Mississippi P.O. Box 117 Jackson, MS 39205 (601)-576-4631 pholmes@courts.ms.gov 24. Natalie Webster, President A Nod to Veterans 2436 South Lennox Mesa, Arizona 85209 (601)-941-4436 nwebster@anodtoveterans.com Prevention Works ~ Treatment is Effective ~ People Recover State of Mississippi TATE REEVES Governor August 16, 2021 Odessa F. Crocker Formula Grants Branch Chief Division of Grants Management, Office of Financial Resources Substance Abuse and Mental Health Services Administration 5600 Fishers Lane, 17E22 Rockville, MD 20857 Dear Ms. Crocker: I designate the Mississippi Department of Mental Health as the state agency to administer the Substance Abuse and Mental Health Services Administration's (SAMHSA) Community Mental Health Block Grant (MHBG) and the Substance Abuse Prevention and Treatment Block Grant (SABG) in Mississippi. I designate the Executive Director of the Mississippi Department of Mental Health, Wendy Bailey, to apply for the block grant and to sign all assurances and submit all information required by Federal law and the application guidelines. These designations are effective throughout the remainder of my term as Governor. If you have any questions, please contact Ms. Bailey or Jake Hutchins, Deputy Executive Director Community Operations, at (601) 359-1288 or email jake.hutchins@dmh.ms.gov. Post Office Box 139, Jackson, Mississippi 39205 • Phone (601)359-3150 • Fax (601) 359-3741 Prevention Works ~ Treatment is Effective ~ People Recover Mississippi Department of Mental Health MISSION STATEMENT Supporting a better tomorrow by making a difference in the lives of Mississippians with mental illness, substance use problems and/or intellectual/developmental disabilities one person at a time. MISSISSIPPI DEPARTMENT OF MENTAL HEALTH VISION STATEMENT We envision a better tomorrow where the lives of Mississippians are enriched through a public mental health system that promotes excellence in the provision of services and supports. A better tomorrow exists when… ▪ All Mississippians have equal access to quality mental health care, services, and supports in their communities. ▪ People actively participate in designing services. ▪ The stigma surrounding mental illness, intellectual/developmental disabilities, substance use, and dementia has disappeared. ▪ Research, outcome measures, and technology are routinely utilized to enhance prevention, care, services and supports. Prevention Works ~ Treatment is Effective ~ People Recover Bureau of Alcohol and Drug Addiction Services Mission Statement The mission of the Bureau of Alcohol and Drug Addiction Services is to provide quality care within a continuum of accessible community-based services including prevention, treatment, and recovery support in an effort to improve the health and well-being of all Mississippi citizens. Vision Statement In support of the mission, the Bureau of Alcohol and Drug Addiction Services will promote the highest standards of practice and the continuing development of substance use disorder programs and services related to current community needs. Prevention Works ~ Treatment is Effective ~ People Recover Core Values and Guiding Principles of the Department of Mental Health People: We believe people are the focus of the public mental health system. We respect the dignity of each person and value their participation in the design, choice, and provision of services to meet their unique needs. Community: We believe the community-based service and support options should be available and easily accessible in the communities where people live. We believe that services and support options should be designed to meet the particular needs of the person. Commitment: We believe in the people we serve, our vision and mission, our workforce, and the community-at-large. We are committed to assisting people in improving their mental health, quality of life, and their acceptance and participation in the community. Excellence: We believe services and supports must be provided in an ethical manner, meet established outcome measures, and be based on clinical research and best practices. We also emphasize the continued education and development of our workforce to provide the best care possible. Accountability: We believe it is our responsibility to be good stewards in the efficient and effective use of all human, fiscal, and material resources. We are dedicated to the continuous evaluation and improvement of the public mental health system. Collaboration: We believe that services and supports are the shared responsibility of state and local governments, communities, families, and service providers. Through open communication, we continuously build relationships. Integrity: We believe the public mental health system should act in an ethical and trustworthy manner on a daily basis. We are responsible for providing services based on principles in legislation, safeguards, and professional codes of conduct. Awareness: We believe awareness, education, prevention and early intervention strategies will minimize the behavioral health needs of Mississippians. We also encourage community education and awareness to promote an understanding and acceptance of people with behavioral health needs. Innovation: We believe it is important to embrace new ideas and change in order to improve the public mental health system. We seek dynamic and innovative ways to provide evidence-based services/supports and strive to find creative solutions to inspire hope and help people obtain their goals. Respect: We believe in respecting the culture and values of the people and families we serve. We emphasize and promote diversity in our ideas, our workforce, and the services/supports provided through the mental health system. Prevention Works ~ Treatment is Effective ~ People Recover Overview of the State Mental Health System The State Public Mental Health Service System is administered by the Mississippi Department of Mental Health (DMH), which was created in 1974 by an act of the Mississippi Legislature, Regular Session. The creation, organization, and duties of the DMH are defined in the annotated Mississippi Code of 1972 under Sections 41-4-1 through 41-4-23. The Service Delivery System is comprised of 3 major components: 1) state-operated programs and community services programs, 2) regional community mental health centers, and 3) other nonprofit/profit service agencies/organizations. The Board of Mental Health governs the DMH. The Board’s nine members are appointed by the Governor of Mississippi and confirmed by the State Senate. By statute, the Board is composed of a physician, a psychiatrist, a clinical psychologist, a social worker with experience in the field of mental health, and one citizen representative from each of Mississippi's five congressional districts (as existed in 1974). Members' 7-year terms are staggered to ensure continuity of quality care and professional oversight of services. The Department of Mental Health Central Office is responsible for the overall state-wide administrative functions and is located in Jackson, Mississippi. The Central Office is headed by an Executive Director and consists of bureaus. The Bureau of Administration works in concert with all bureaus to administer and support development and administration of mental health services in the state. The Bureau oversees the accounting/payroll, auditing, and grants management functions of the agency. Information Systems is also a part of this Bureau. The Bureau of Behavioral Health Services is responsible for the administration of state and federal funds utilized to develop, implement and expand a comprehensive continuum of services for adults and children/youth experiencing serious mental illness, serious emotional disturbances, and substance use disorders. The Bureau of Behavioral Health Services is currently comprised of five divisions: The Division of Adult Community Mental Health Services; The Division of Children and Youth Mental Health Services; The Division of Prevention; The Division of Treatment; The Division of Recovery and Peer Support. The Division of Adult Community Mental Health Services and The Division of Children and Youth Mental Health Services comprise the Community Mental Health Services component of the Bureau of Behavioral Health Services. These Divisions are tasked with administration of state and federal funds utilized to develop, implement, and expand community related services to emphasize the importance of individuals living successfully at home and in their community, including crisis stabilization services. The Division of Prevention, The Division of Treatment and The Division of Recovery and Peer Support comprise the substance use and alcohol services team members. These Divisions are tasked with development, implementation, and supervision of services and supports for adults and children/youth with substance use disorders. The Bureau of State Operated Programs is responsible for the planning, development and supervision of an array of services for individuals served at the state operated behavioral health programs, which include services for individuals with mental illness, alcohol/drug services and nursing homes. Prevention Works ~ Treatment is Effective ~ People Recover The Bureau of Intellectual and Developmental Disabilities is responsible for planning, development and supervision of an array of services for people in the state with intellectual and developmental disabilities. The service delivery system is comprised of the ID/DD Waiver program, the IDD Community Support Program, and five state-operated comprehensive IDD programs located in communities throughout the state. The ID/DD Waiver and Community Support Programs provide support to assist people to live successfully at home and in the community. These services are provided by community mental health centers and other community service providers. The Branch of Coordinated Care is responsible for the agency’s strategic planning process including the DMH Strategic Plan and the Legislative Budget Office Five Year Plan. The Bureau also oversees all outreach efforts including internal and external communications, public awareness campaigns, trainings, statewide suicide prevention, and special projects. The Bureau of Certification and Quality Outcomes is responsible for ensuring the safe provision of high-quality services from qualified individuals in programs certified by the Mississippi Department of Mental Health. The Bureau includes three divisions: Certification, Incident Management, and Professional Licensure and Certification (PLACE). The Bureau of Human Resources is responsible for the employment and workforce development. Such matters include all aspects of human core capital processing, recruitment, retention, benefits, worker’s compensation, job performance monitoring, and discipline. The Bureau also oversees the Contract Management of the agency’s contract workers and independent contractors assuring compliance with state rules and regulations. Functions of the Mississippi Department of Mental Health State Level Administration of Community-Based Mental Health Services: The major responsibilities of the state are to plan and develop community mental health services, to set Operational Standards for the services it funds, and to monitor compliance with those Operational Standards. Provision of community mental health services is accomplished by contracting to support community services provided by regional commissions and/or by other community public or private nonprofit agencies. State Certification and Program Monitoring: Through an ongoing certification and review process, the DMH ensures implementation of services which meet the established Operational Standards. State Role in Funding Community-Based Services: The DMH’s funding authority was established by the Mississippi Legislature in the Mississippi Code, 1972, Annotated, Section 41-45. Except for a 3% state tax set-aside for alcohol services, the DMH is a general state tax fund agency. Agencies or organizations submit to DMH for review proposals to address needs in their local communities. The decision-making process for selection of proposals to be funded are based on the applicant's fulfillment of the requirements set forth in the RFP, funds available for existing programs, funds available for new programs, funding priorities set by state and/or federal funding sources or regulations, and the State Board of Mental Health. Services/Supports Overview: The DMH provides and/or financially supports a network of services for people with mental illness, intellectual/developmental disabilities, substance use problems, and Alzheimer’s disease and/or dementia. It is our goal to improve the lives of Mississippians by supporting a better tomorrow…today. The success of the current service delivery system is due to the strong, sustained advocacy of the Governor, the State Legislature, the Board of Mental Health, the Department's Prevention Works ~ Treatment is Effective ~ People Recover employees, consumers and their family members, and other supportive individuals. Their collective concerns have been invaluable in promoting appropriate residential and community service options. Service Delivery System: The mental health service delivery system is comprised of three major components: 1) state operated programs and community services programs, 2) regional community mental health centers, and 3) other nonprofit/profit service agencies/organizations. State-Operated Programs: DMH administers and operates state behavioral health programs, a mental health community living program, a specialized behavioral health program for youth, regional programs for persons with intellectual and developmental disabilities, and a specialized program for adolescents with intellectual and developmental disabilities. These programs serve designated counties or service areas and offer community living and/or community services. The behavioral health programs provide inpatient services for people (adults and children) with serious mental illness (SMI) and substance use disorders. These programs include: Mississippi State Hospital and its satellite program Specialized Treatment Facility; East Mississippi State Hospital and its satellite programs- North Mississippi State Hospital, South Mississippi State Hospital and Central Mississippi Residential Center. Nursing home services are also located on the grounds of Mississippi State Hospital and East Mississippi State Hospital. In addition to the inpatient services mentioned, East Mississippi State Hospital provides transitional, community-based care. The programs for persons with intellectual and developmental disabilities provide residential services. The programs also provide licensed homes for community living. These programs include: Boswell Regional Center and its satellite programs Mississippi Adolescent Center, Ellisville State School, Hudspeth Regional Center, North Mississippi Regional Center, and South Mississippi Regional Center. Regional Community Mental Health Centers (CMHCs): The CMHCs operate under the supervision of regional commissions appointed by county boards of supervisors comprising their respective service areas. The 13 CMHCs make available a range of community-based mental health, substance use, and in some regions, intellectual/developmental disabilities services. CMHC governing authorities are considered regional and not state level entities. The DMH is responsible for certifying, monitoring, and assisting CMHCs. Other Nonprofit/Profit Service Agencies/Organizations: These agencies and organizations make up a smaller part of the service system. They are certified by the DMH and may also receive funding to provide community-based services. Many of these nonprofit agencies may also receive additional funding from other sources. Services currently provided through these nonprofit agencies include community-based alcohol and drug services, community services for persons with intellectual/developmental disabilities, and community services for children with mental illness or emotional problems. Prevention Works ~ Treatment is Effective ~ People Recover MISSISSIPPI DEPARTMENT OF MENTAL HEALTH COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTERS Region 1: Coahoma, Quitman, Tallahatchie, Tunica Region One Mental Health Center Karen Corley, Interim Executive Director 1742 Cheryl Street P. O. Box 1046 Clarksdale, MS 38614 (662) 627-7267 Region 2: Calhoun, Lafayette, Marshall, Panola, Tate, Yalobusha Communicare Sandy Rogers, Ph.D., Executive Director 152 Highway 7 South Oxford, MS 38655 (662) 234-7521 Region 3: Benton, Chickasaw, Itawamba, Lee, Monroe, Pontotoc, Union LIFECORE Health Group Raquel Rosamond, Executive Director 2434 South Eason Boulevard Tupelo, MS 38801 (662) 640-4595 Region 4: Alcorn, Prentiss, Tippah, Tishomingo, DeSoto Timber Hills Mental Health Services Jason Ramey, Interim Director 303 N. Madison Street P. O. Box 839 Corinth, MS 38835-0839 (662) 286-9883 Prevention Works ~ Treatment is Effective ~ People Recover Region 6: Attala, Bolivar, Carroll, Grenada, Holmes, Humphreys, Issaquena, Leflore, Montgomery, Sharkey, Sunflower, Washington Life Help Phaedre Cole, Executive Director 2504 Browning Road P. O. Box 1505 Greenwood, MS 38935-1505 (662) 453-6211 Region 7: Choctaw, Clay, Lowndes, Noxubee, Oktibbeha, Webster, Winston Community Counseling Services Richard Duggin, Executive Director 1011 Main Street Columbus, MS 39701 (662) 327-7916 Region 8: Copiah, Madison, Rankin, Simpson, Lincoln Region 8 Mental Health Services Dave Van, Executive Director 613 Marquette Road P. O. Box 88 Brandon, MS 39043 (601) 825-8800 (Service); (601) 824-0342 (Admin.) Region 9: Hinds Hinds Behavioral Health Kathy Crockett, Ph.D., Executive Director 3450 Highway 80 West P.O. Box 7777 Jackson, MS 39209 (601) 321-2400 Prevention Works ~ Treatment is Effective ~ People Recover Region 10: Clarke, Jasper, Kemper, Lauderdale, Leake, Neshoba, Newton, Scott, Smith Weems Community Mental Health Center Russ Andreacchio, Executive Director 1415 College Road P. O. Box 2868 Meridian, MS 39302 (601) 483-4821 Region 11: Adams, Amite, Claiborne, Franklin, Jefferson, Lawrence, Pike, Walthall, Wilkinson Southwest MS Mental Health Complex Sherlene Vince, Executive Director 1701 White Street P. O. Box 768 McComb, MS 39649-0768 (601) 684-2173 Region 12: Covington, Forrest, Greene, Jefferson Davis, Jones, Lamar, Marion, Perry, Wayne, Hancock, Harrison, Pearl River, Stone Pine Belt Mental Healthcare Resources Mona Gauthier, Executive Director 103 South 19th Avenue P. O. Box 18679 Hattiesburg, MS 39404-86879 (601) 544-4641 Region 14: George, Jackson Singing River Services Sherman Blackwell, II, Executive Director 3407 Shamrock Court Gautier, MS 39553 (228) 497-0690 Prevention Works ~ Treatment is Effective ~ People Recover Region 15: Warren, Yazoo Warren-Yazoo Mental Health Services Bobby Barton, Executive Director 3444 Wisconsin Avenue P. O. Box 820691 Vicksburg, MS 39182 (601) 638-0031 Available Services and Supports Both facility and community‐based services and supports are available through DMH service system. The type of services provided depends on the location and provider. Behavioral Health Services The types of services offered through the regional behavioral health programs vary according to location but include: Acute Psychiatric Care Nursing Home Service Intermediate Psychiatric Care Medical/Surgical Hospital Services Continued Treatment Services Forensic Services Adolescent Services Substance Use Disorder Services Community Service Programs The types of services offered through the programs for individuals with intellectual/ developmental disabilities vary according to location but statewide include: ICF/IDD Residential Services Special Education Psychological Services Recreation Social Services Speech/Occupational/Physical Therapy Medical/Nursing Services Vocational Training/Employment Diagnostic and Evaluation Services Community Services Programs Prevention Works ~ Treatment is Effective ~ People Recover Community Services A variety of community services and supports are available. Services are provided to adults with mental illness, children and youth with serious emotional disturbance, children and adults with intellectual/ developmental disabilities, individuals with a substance use disorder/mental illness, and persons with Alzheimer’s disease or other dementia. Services for Adults with Mental Illness Psychosocial Rehabilitation Halfway House Services Consultation and Education Services Group Home Inpatient Referral Services Elderly Psychosocial Rehabilitation Services Co-Occurring Disorder Services Partial Hospitalization Intensive Residential Treatment Outpatient Therapy Supervised Housing Consumer Support Services Physician/Psychiatric Services Day Support SMI Homeless Services Drop‐In Centers Mental Illness Management Services Crisis Stabilization Programs Individual Therapeutic Support Individual/Family Education and Support Crisis Emergency Mental Health Services Pre‐Evaluation Screening/Civil Commitment Exams Services for Children and Youth with Serious Emotional Disturbance Therapeutic Group Homes Day Treatment Therapeutic Foster Care Outpatient Therapy Mobile Crisis Response Services School Based Services Intensive Crisis Intervention Services Mental Illness Management Services Prevention/Early Intervention Services Physician/Psychiatric Services Crisis/Emergency Mental Health Services MAP (Making A Plan) Team Consumer Support Services Individual Therapeutic Support Family Education and Support Acute Partial Hospitalization Prevention Works ~ Treatment is Effective ~ People Recover Services for People with Alzheimer’s disease and Other Dementia Adult Day Centers Caregiver Training Services for People with Intellectual/Developmental Disabilities Early Intervention Community Living Programs Work Activity Services Supported Employment Services Day Support HCBS Attendant Care HCBS Behavioral Support/Intervention HCBS Community Respite HCBS In‐home Nursing Respite HCBS ICF/IDD Respite HCBS Day Habilitation HCBS Support Coordination HCBS Occupational, Physical, and Speech/Languages Therapies Services for Individuals with Substance Use Disorders Withdrawal Management DUI Diagnostic Assessment Services General Outpatient Services Intensive Outpatient Services Prevention Services Primary Residential Services Recovery Support Services Recovery Housing Services Opioid Treatment Services Transitional Residential Services Co‐Occurring Disorder Services Prevention Works ~ Treatment is Effective ~ People Recover SUBSTANCE USE DISORDER SERVICES Contact Information Alcohol Services Center http://www.alcoholservicesms.org Alcohol Services Center Sheba Borden 950 N. West Street Jackson, MS 39202 601-948-6220 Catholic Charities http://www.catholiccharitiesjackson.org Born Free/New Beginnings Kellie Leo, Director 7100 Midway Roas Raymond, MS 39154 601-922-0026 Center for Independent Learning http://www.thefriendshipconnectionjackson.com The Friendship Connection Terri Micou-Smith, Director 1480 Raymond Road Jackson, MS 39206 601-373-1533 Harbor House Chemical Dependency Services http://www.hhjackson.org Harbor House Chemical Dependency Services Jacqueline Lampley, Assistant Director 5354 I-55 Frontage Road Jackson, MS 39272 601-371-7335 Region I: Coahoma, Quitman, Tallahatchie, and Tunica http://www.regionone.org Community Mental Health Center Amber Jones, Director, Alcohol & Drug Services 1742 Cheryl Street P.O. Box 1046 Clarksdale, MS 38614 (662) 624‐4905 or 624‐2152 Prevention Works ~ Treatment is Effective ~ People Recover Region II: Calhoun, Lafayette, Marshall, Panola, Tate, and Yalobusha http://www.communicarems.org/index.html Communicare Melody Madaris, Director, Alcohol & Drug Services 152 Highway 7 South Oxford, MS 38655 (662) 234‐7521 Region III: Benton, Chickasaw, Itawamba, Lee, Monroe, Pontotoc, and Union http://famecreative.com/lifecore Lifecore Health Group Clint Crawford, Director, Alcohol & Drug Services 2434 Eason Blvd. Tupelo, MS 38801 (662) 844-1717 Region IV: Alcorn, DeSoto, Prentiss, Tippah, and Tishomingo http://www.regionivmhs.com Region IV Mental Health Services Adrian Owens, Director, Alcohol & Drug Services 303 North Madison Street P.O. Box 839 Corinth, MS 38835‐0839 (662) 286‐9883 Region VI: Attala, Bolivar, Carroll, Grenada, Holmes, Humphreys, Issaquena, Leflore, Montgomery, Sharkey, Sunflower, and Washington http://www.region6‐lifehelp.org Life Help Jonathan Grantham, Director, Alcohol & Drug Services 254 Browning Road P.O. Box 1505 Greenwood, MS 38935‐1505 (662)453‐6211 Region VII: Choctaw, Clay, Lowndes, Noxubee, Oktibbeha, Webster, and Winston http://www.ccsms.org Community Counseling Services Keenyn Wald, Director, Alcohol & Drug Services 1001 Main Street Columbus, MS 39701 (662) 326‐7916 Prevention Works ~ Treatment is Effective ~ People Recover Region VIII: Copiah, Lincoln, Madison, Rankin, and Simpson http://www.region8mhs.org Region VIII Mental Health Services Ann Rodio, Director, Alcohol & Drug Services 613 Marquette Road, Box 88 Brandon, MS 39043 (601) 591‐5553 Region IX: Hinds http://www.hbhs9.com Hinds Behavioral Health Services Kimbria Thorne Coordinator, Alcohol & Drug Services 3450 Highway 80 West P.O. Box 7777 Jackson, MS 39284 (601) 321‐2400 Region X: Clarke, Jasper, Kemper, Lauderdale, Leake, Neshoba, Newton, Scott, and Smith http://www.weemsmh.com Weems Community Mental Health Center Wynter Ward, Director, Alcohol & Drug Services 1415 College Drive, Box 4378 Meridian, MS 39325 (601) 483‐4821 Region XI: Adams, Amite, Claiborne, Franklin, Jefferson, Lawrence, Pike, Walthall, Wilkinson http://www.swmmhc.org Southwest MS Mental Health Complex Maria Riggins, Director, Alcohol & Drug Services 1701 White Street, Box 768 McComb, MS 39649 (601) 684‐2173 Region XII: Covington, Forrest, Greene, Jeff Davis, Jones, Lamar, Marion, Perry, Wayne http://pbmhr.com Pine Belt Mental Healthcare Resources Ester Faye Clay, Director, Alcohol & Drug Services 103 S. 19th Ave., Box 18678 Hattiesburg, MS 39403 (601) 594‐1499 Prevention Works ~ Treatment is Effective ~ People Recover Region XIV: George and Jackson http://www.singingriverservices.com Singing River Services Christina Fingerle, Director, Alcohol & Drug Services 3407 Shamrock Ct. Gautier, MS 39553 (228) 497‐0690 X2005 (866) 497‐0690 Region XV: Warren and Yazoo http://www.warren‐yazoo.org Warren‐Yazoo Mental Health Services Warner Buxton, Director, Alcohol & Drug Services 3444 Wisconsin Ave. Vicksburg, MS 39180 (601) 634‐0181 Prevention Works ~ Treatment is Effective ~ People Recover Prevention Works ~ Treatment is Effective ~ People Recover Regional Community-Based Residential Substance Use Disorder – Adult Programs Location Program Agency Bed Capacity Tutwiler Fairland Center Region I: Community Mental Health Center 24- Male 28-Female Hazlehurst Female Residential Region VIII: Mental Health Services Treatment Center 13-Female Mendenhall Male Residential Region VIII: Mental Health Services Treatment Center 21- Male Meridian Weems Life Care Region X: Weems Community Mental Health Center 16- Male 16-Female 1-Handicap 2-Overflow Moselle Clearview Recovery Region XII: Pine Belt Healthcare Resources 28-Male 28-Female Gulfport Crossroads Recovery Center Region XIII: Gulf Coast Mental Health 28 Male 14-Female Total Bed Capacity: 219 Prevention Works ~ Treatment is Effective ~ People Recover Regional Community-Based Primary Residential Substance Use Disorder – Adult Programs Location Program Agency Bed Capacity Oxford Haven House Region II: Communicare 20-Male 10-Female Tupelo Region III: CDC Region III: Lifecore As needed Corinth Region IV: CDC Region IV: Timber Hills Mental Health Services 16- Male 8-Female Greenwood Denton House CDC Region VI: Life Help 32- Male 12-Female Columbus Cady Hill, The Pines & Recovery House Region VII: Community Counseling Services 18- Male 10-Female Hazlehurst Female Residential Region VIII: Mental Health Services Treatment Center 11-Female Pascagoula Stevens Center Region XIV: Singing River Services 6- Male 12-Female Vicksburg Warren-Yazoo CDC Region XV: Warren Yazoo Mental Health 15- Male 6-Female Total Bed Capacity: 216 Prevention Works ~ Treatment is Effective ~ People Recover Free Standing Primary Residential Substance Use Disorder – Adult Programs Location Program Agency Bed Capacity Jackson Born Free Catholic Charities 12-Female Jackson Harbor House Harbor House of Jackson 42-Male 20-Female Jackson The Friendship Connection Center for Independent Learning 12-Female Total Bed Capacity: 86 Community-Based Transitional Residential Substance Use Disorder – Adult Programs Location Program Agency Bed Capacity Oxford Haven House Region II: Communicare 16-Male 2-Female Tupelo Region III CDC Region III: Life Core As Needed Corinth Region IV CDC Region IV: MH/MR 8-Female 4- Male Greenville Gloria Darden Center Region VI: Life Help 24- Male 12-Female Columbus Cady Hill & Recovery House Region VII: Community Counseling Services 10-Male Prevention Works ~ Treatment is Effective ~ People Recover 6-Female Pascagoula Stevens Center Region XIV: Singing River Services 2-Male 2-Female Vicksburg Warren Yazoo CD Region XV: Warren Yazoo Mental Health 4-Male 0-Female Total Bed Capacity: 95 Free-Standing Transitional Residential Substance Use Disorder – Adult Programs Location Program Agency Bed Capacity Jackson New Beginnings Catholic Charities 12-Female Jackson Friendship Connection Center for Independent Learning 12-Female Total Bed Capacity: 24 Prevention Works ~ Treatment is Effective ~ People Recover Community-Based Primary Residential Substance Use Disorders – Adolescent Programs Location Program Agency Bed Capacity Clarksdale Sunflower Landing Region 1: CMHC 16- Male 16-Female Total Bed Capacity: 32 *Bed capacity may have been altered (decreased) due to the COVID-19 Pandemic. Prevention Works ~ Treatment is Effective ~ People Recover PREVENTION SERVICES Prevention is an awareness process that involves interacting with people, communities, and systems to promote the programs aimed at substantially offsetting the risks associated with alcohol, tobacco, and other problematic drug use. Based on identified risk and protective factors, these activities must be carried out in an intentional, comprehensive, and systematic way to impact large numbers of people. Most substance use disorder prevention programs today are targeted at youth; however, the prevalence of substance use indicates that all age groups are at risk. Since adults serve as role models, their behavior and attitudes toward substance use disorders determine, to a large extent, the environment in which choices will be made about use by children and adolescents. Therefore, the Bureau of Behavioral Health/Addictive Services supports prevention services that target adults as well as young people. The etiology of substance use disorders is both complex and multi‐dimensional. According to research, factors that play a role in the development of drug dependency can include genetics, environment, as well as deficiencies in knowledge, skills, values, or spirituality. Also, social norms, public policies, and social media often promote or convey acceptance of drug use behaviors. These factors must be addressed in prevention programming. Equally important is the willingness of prevention professionals to remain aware of new research and to be prepared to expand or modify their programs, as needed, to address any new causes. A variety of strategies must be employed to successfully reduce problems associated with substance use. Prevention strategies have been categorized in several ways. The Bureau of Behavioral Health/Addictive Services requires that each funded program use no less than three of the six strategies promoted by the Substance Abuse Mental Health Services Administration (SAMHSA)/Center for Substance Abuse Prevention (CSAP). The six strategies are information dissemination, education, alternative activities, problem identification and referral, community‐based process, and environmental strategies. (The definition of each strategy may be found at http://oregonpgs.org/wp-content/uploads/2016/07/6csap-strategies). Through the Bureau of Behavioral Health/Addictive Services, Mississippi has made great strides in improving the prevention delivery service system during the past five years. The Bureau of Behavioral Health/Addictive Services has instituted many new policies for sub‐grantees funded by the 20 percent prevention set aside of the SABG. Two examples include: (1) the designation of an individual to coordinate prevention services, and (2) the requirement that each program implement at least one evidence-based program. The Strategic Prevention Framework-State Incentive Grant (SPF-SIG), awarded to the Bureau of Behavioral Health/Addictive Services in 2001, allowed the Bureau of Behavioral Health/Addictive Services to fund additional programs utilizing evidence‐based programs and more than doubling the number of individuals and families served. In October 2006, the Bureau of Behavioral Health/Addictive Services received a Substance Abuse and Mental Health Services Administration (SAMHSA) five‐year incentive grant. Other grants were subsequently received, including recently completed Partnerships for Success 2015 (PFS 2015) program. Such grants have permitted our team to meet the following federal goals: (1) Build prevention capacity and infrastructure at state and community levels; (2) Prevent the onset and reduce the progression of substance use, including childhood and underage drinking; and (3) Reduce substance use‐related problems in communities. In 2012, the Bureau of Behavioral Prevention Works ~ Treatment is Effective ~ People Recover Health/Addictive Services was awarded the Partnership for Success (PFS) II grant from SAMHSA/CSAP followed by the PFS 2015 grant, both of which permitted the continued effort to combat underage drinking and related consequences but also target the reduction of prescription drug abuse rates and consequences for youth and young adults. The DMH staff continues to participate with Partners to End Homelessness CoC to help plan for and coordinate services for individuals with mental illness who may be experiencing homelessness. Staff attends the MS United to End Homelessness (MUTEH) CoC meetings as well as the Open Doors CoC meetings. The DMH continues to receive technical assistance in the implementation of the SSI/SSDI Outreach, Access, and Recovery (SOAR) Program in Mississippi as provided by SAMHSA. The purpose of SOAR is to help states increase access to mainstream benefits for individuals who are homeless or at risk for homelessness through specialized training, technical assistance, and strategic planning for staff that provide services to these individuals. Mississippi is also participating in SOAR data collection as part of the national SOAR evaluation process. The DMH provides information and oversight regarding the online training. There is an online SOAR data collection system that SOAR processors in the state are encouraged to use to report the results of the SSI/SSDI applications that are submitted using SOAR. POPULATION SERVED BY THE SYSTEM Mississippi has the 32nd largest population among US states and territories. The U.S. Census Bureau figures estimated Mississippi’s 2016 population at 2,988,726. Mississippi has 82 counties and 297 incorporated cities, towns, and villages. Statistics reveal that over 50.1% of the state’s population lives in rural areas since many of these incorporated are nevertheless rural. The Census reveals that Mississippi’s population is 59.3% Caucasian and 37.7% African American, 0.6% American Indian, 1.1% Asian, 0.1% Native Hawaiian, and 3.1% Hispanics. The percentage of population under the age of 5 is reported at 6.3%, and the percentage of population under the age of 18 is 24.1%, and 15.1% over the age of 65. Approximately 76% of Mississippians are 18 years or older. Mississippi has one American Indian tribe that the federal government acknowledges, the Mississippi Band of Choctaw Indians. It has over 10,000 tribal members and half of their population is under the age of 25. The majority of Mississippians speak English primarily, 96.1%. Spanish is primarily the language used by 2.4% of Mississippians and the remaining 1.5% of Mississippians use other languages. The Bureau of Behavioral Health/Addictive Services targets adolescents (17 and under), young adults (18-25), and adults (26 and older) by providing prevention and treatment intervention to combat the increase in licit and illicit substance use. Prevention Works ~ Treatment is Effective ~ People Recover Age of Mississippians in 2016 Age group Number of Mississippians Percentage of MS Population Under 18 721,288 24.1% 18 to 24 295,917 9.9% 25 to 44 759,788 25.4% 45 to 64 760,792 25.5% 65 to 84 399,977 13.4% 85 & older 50,964 1.7% Table 1: The number of Mississippians per age group and the percentage of the Mississippi population each age group represents are displayed (American Community Survey, 2016). The U.S. Census Bureau indicated that in 2015, 22% of Mississippi families lived below the poverty level and the median household income was estimated at $39,665 compared to $53,889 nationally. Eight out of ten Mississippians have health insurance and over half of those insured have private health insurance. The number of Mississippians uninsured, 15.8%, is nearly double that of the national uninsured rate, 8.6%. High school graduates account for 82.3% of the population in the state while 20.7% hold a bachelor’s degree or higher. Mississippi is one of the best states in the U.S. to do business. In fact, Mississippi has a diverse economy with a growing footprint in industries. Small business remains the backbone of the economy. The MS Development Authority (MDA) makes it a priority to help small business owners compete successfully in the marketplace. Industrial, commercial and consumer goods are all produced in our state. Mississippi made products are shipped to other countries regularly. Mississippi has 3,484 same-sex couples and 58% of these couples are women in relationships. LGBTQ Mississippians are six years younger than their heterosexual counterparts; individuals between the ages of 30 and 49 are the highest proportion of same-sex couples, at 54%, followed by 64 year-olds with 29%. The majority of same-sex couples are Caucasians, 68.7%, and one in four same-sex couples are African American, followed by Latinos at 4.5%. Nearly one third of same-sex Mississippians are caregivers to minors in their homes and 63% of those minors are biological children. One-third of same-sex couples that are raising minors are in a minority racial/ethnic group and approximately one in four are white. The median income of same-sex couples is $66,775, which is lower than that for heterosexual married couples. Service Population In general, activities to estimate/determine and monitor needs for substance use disorders services can be divided into two categories: (1) estimation of the number of persons with alcohol and/or drug problems and at risk of needing services; and (2) estimation or determination of needs for specific services among persons with alcohol and/or drug problems and among subgroups of the population. To gather comprehensive information about the prevalence of substance use disorder problems among the general population and among subgroups of the population, as well as more detailed information on service needs and demand, the Bureau of Behavioral Health/Addictive Services has collected data from multiple sources. Prevention Works ~ Treatment is Effective ~ People Recover Substance Use Disorder Data Collection There is a sizeable number of individuals in Mississippi at any given time which needs substance use disorder treatment services. The Division of Information Systems collects data regarding admissions, discharges, types of services provided, and the number of individuals served. DataGadget DataGadget is an online data portal that permits the state of Mississippi to track processes and outcomes associated with state‐funded substance use disorders prevention and treatment programs. Through DataGadget, programs are required to report data on types of prevention services provided and clients served, the duration of service programs and outcomes associated with prevention. DataGadget is also utilized to track outcomes associated with substance use disorders treatment programs implemented throughout Mississippi. DataGadget facilitates the centralized tracking of activities and outcomes associated with Mississippi’s funding of prevention and treatment programs. DataGadget enhances accountability between the state and regional programs and allows the Bureau of Behavioral Health/Addictive Services to engage in data‐driven planning and promote and increase evidence‐based programming. Mississippi Department of Education and Mississippi Private Schools The Mississippi Department of Education reported that 482,446 youth attended public schools in 2016‐2017 and according to surveillance data on private schools in Mississippi, 57,114 youth attended private schools. These numbers do not include youth who are home‐schooled, in detention centers, treatment centers, or hospitals. Many of these youths are at risk for substance use/abuse and in need of treatment due to peer pressure, easy access to drugs, and an increase in the advertising industry. The Mississippi Department of Education is instrumental in conducting the Youth Risk Behavior Survey to gather data on middle and high school students. Youth Risk Behavior Surveillance Survey (YRBS) The Mississippi YRBS survey measures the prevalence of behaviors that contribute to the leading causes of mortality and morbidity among youth. The YRBS is part of a larger effort to help communities promote the “resiliency” of young people by reducing high risk behaviors and increasing health behaviors. The Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health developed the survey. The CDC provides technical assistance to the MS State Department of Health (MSDH) to administer the survey. The MSDH collaborates with the MS Department of Education to administer the survey in schools. The MSDH is responsible for all analyses associated with the survey. The YRBS was completed by students in high school, grades 9‐12 during the spring of 2015. The YRBS is conducted every two years. Mississippi YRBS data limitations have been confronted since 2015, leading to less valid estimates that, for this reason, are not featured here. The National Survey on Drug Use and Health (NSDUH) Adolescent and young adults have faced elevated drug use risks. Data from the National Survey on Drug Use and Health (NSDUH) reveal that past 30-day alcohol use for Mississippi young adults steadily declined over time from 2014-2015 to 2017-2018, with a slight curvilinear (decreasing then increasing) pattern observed for adolescents (Figure 1). The steady and robust decline for young adults Prevention Works ~ Treatment is Effective ~ People Recover is desirable while the slight curvilinear pattern for adolescents is not. The already low rates of use for adolescents might be subject to floor effects (difficult to reduce further). Similar trends consisting of a desirable decline for young adults and mixed results (decreasing then increasing) for adolescents are observed for past 30-day binge alcohol use (Figure 2). Illicit drug use in NSDUH includes prescription drug misuse. Figure 3 reveals a slight curvilinear (fluctuating) trend for both Mississippi young adults and adolescents across the three data years. The desirable portion of this trend is evident from the midpoint (2016-2017) to the endpoint (2017-2018). Mixed success is therefore evident on this measure. 46.93 46.68 44.24 41.93 8.78 7.69 7.65 8.71 2014-15 2015-16 2016-17 2017-18 Percentage Year Figure 1. Past 30-day Alcohol Use (Percentages based on annual averages: NSDUH) Age 18-25 Age 12-17 27.1 25.76 25.25 4.11 3.73 4.41 2015-16 2016-17 2017-18 Percentage Year Figure 2. Past 30-day Binge Alcohol Use (Percentages based on annual averages: NSDUH) Age 18-25 Age 12-17 Prevention Works ~ Treatment is Effective ~ People Recover Over the past several years, the perceived risk of harm associated with binge alcohol use has declined among young adult Mississippians while having increased noticeably for adolescents (Figure 4). These trends indicate mixed success, with an undesirable trend for young adults coupled with a desirable trend for adolescents. However, it is worth mentioning that the perceived risk of harm remains relatively high for young adults at endpoint, with 45% perceiving harm for the stated risk behavior of binge drinking. Surveillance Data Several surveillance data points are also tracked, though data made available to state data analysts are commonly limited and not age-specific. Mississippi’s alcohol-impaired (BAC=.08+ g/dL) vehicular traffic fatalities declined early in the trend period featured in Figure 5, but then steadily increased in subsequent years. This U-shape pattern is a mixed result at best. 17.78 18.85 18.13 6.83 7.02 6.45 2015-16 2016-17 2017-18 Percentage Year Figure 3. Past 30-day Illicit Drug Use including Prescription Drug Misuse (Percentages based on annual averages: NSDUH) Age 18-25 Age 12-17 44.02 43.59 45.2 48.42 47.23 2015-16 2016-17 2017-18 Percentage Year Figure 4. Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week (Percentages based on annual averages: NSDUH) Age 18-25 Age 12-17 Prevention Works ~ Treatment is Effective ~ People Recover Drug overdose mortality rates in the state have trended downward, with a sharp decline in 2018 (Figure 6). The efforts made possible by various Mississippi opioid grants is worth noting. SmartTrack The SmartTrack Survey is a web‐based data collection tool which provides needs assessment data related to the Center for Substance Abuse Prevention core measures. It collects data on severity of substance use, risk and protective factors and identification of the most pressing prevention issues. The data is collected from schools in communities throughout the state with the goal being to establish baseline data on prevalence and severity of substance use, as well as related behaviors and attitudes. A survey of 81,393 6th‐11th grade public school students conducted during the 2015‐2016 school term reveals the following protective factors among MS youth. (Due to logistical challenges followed the pandemic-related schooling fallout, more recent SmartTrack data is not available.) Approximately Percentage Year Figure 5. Alcohol-Impaired (BAC=.08+ g/dL) Vehicular Fatalities (Source: National Highway Traffic Safety Administration) 11.46 11.73 11.66 10.62 10.2 10.4 10.6 10.8 11.2 11.4 11.6 11.8 Rate Year Figure 6. Drug Overdose Mortality Rates per 100,000 Population (Mississippi State Department of Health) Prevention Works ~ Treatment is Effective ~ People Recover 49% of students indicated that smoking marijuana regularly posed a great or moderate risk. Additionally, 56% of students stated that consuming four to five alcoholic beverages per day posed a great or moderate risk. Approximately 30% of surveyed students felt that they belonged to their school; 35% strongly felt that they belonged to their school compared to 8% that strongly disagreed. Approximately 54% of students stated that they never have major fights or arguments with their parent/guardian(s), while 81% indicated that they could ask their parents for help in dealing with a personal problem. Finally, 79% of students indicated that their parents always or frequently enforce rules at home. Alcohol According to the SmartTrack Survey, the percentage of students who had at least one alcoholic beverage in the past 30 days decreased from 19% in 2013 to 13.8% in 2016. The percentage of students who reported having at least one drink of beer in the past 30 days decreased from 12.9% in 2013 to 9.2% in 2016. The percentage of students who reported having at least one drink of a wine cooler in the past 30 days decreased from 7.4% in 2013 to 5.3% in 2016. The percentage of students who reported having at least one drink of other alcohol (liquor, wine, mixed drink, etc.) in the past 30 days decreased from 13.8% in 2013 to 9.9% in 2016. The percentage of students who engaged in binge drinking within the past 30 days decreased from 12.1% in 2013 to 7.4% in 2016. The percentage of students who reported drinking alcohol before the age of 13 was 7.3% in 2016; the national average was 17.2%. (YRBS, 2015). Figure 1: An illustration of past 30-day alcohol consumption among students that participated in the 2016 SmartTrack Survey, grouped by types of alcoholic beverages consumed. Tobacco Use The percentage of students who reported cigarette use in the past 30 days was 15.2% in 2015; the national average was 10.8%. (YRBS, 2015). Estimates from the 2016 SmartTrack Survey showed that about 5.9% of 6th-11th grade students used cigarettes in the past month. The percentage of students who have used chewing tobacco or snuff during the past 30 days decreased from 6% in 2013 to 3.8% in 2016 (SmartTrack, 2013 and 2016). Students reported using e-cigarettes more than any other tobacco product, at 6.6%. The percentage who smoked a whole cigarette before age 13 was 7.3% in 2016; the national average was 6.6%. (YRBS, 2015). 5.3% 9.2% 9.9% Wine Coolers Beer Other Alcohol Past 30 Day Alcohol Consumption Among MS Adolescents in 2016 Prevention Works ~ Treatment is Effective ~ People Recover Figure 2: An illustration of past 30-day tobacco use among students that participated in the 2016 SmartTrack Survey, grouped by different tobacco products consumed. Other Drug Use The percentage of students who used any form of cocaine including powder, crack, or freebase one or more times in the past 30 days was 1.7% in 2016. The percentage of students who use heroin one or more times in the past 30 days was 1.4% in 2016. The percentage of students who sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high one or more times in the past 30 days was 2.2% in 2016. In 2016, estimated 3.4% of 6 th‐11 th grade students reported non‐medical use of prescription drugs at least once in the past month. The percentage of students who used marijuana one or more times during the past 30 days increased from 6.7% in 2013 to 6.9% in 2016. The percentage of students who tried marijuana for the first time before age 13 years was 4.4% in 2016 down from 8.6% in 2011; the national average was 7.5%. (YRBS, 2015). T h e percentage of students that have used prescription drugs one or more times without a doctor's prescription (such as Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax, during their life) in the past 12 months was 6.2%; the national average reported for ever using prescription drugs was 16.8%. (YRBS, 2015). 3.2% 3.8% 5.9% 6.6% Cigars Smokeless Tobacco Cigarettes E-Cigarettes Past 30 Day Tobacco Use Among MS Adolescents in 2016 Prevention Works ~ Treatment is Effective ~ People Recover Figure 3: A display of drug use reported in the past 30 days by Mississippi students that participated in the 2016 SmartTrack Survey. Kids Count Mississippi had an estimated population of 2,988,726 in 2016. The state is predominantly rural, with an estimated 22% of its population reported to be living in poverty, which is the highest rate in the nation (US Census Bureau, 2016); this translates to about one in five Mississippians living below the poverty line. Approximately 31.5% of Mississippi children under the age of 18 live below the federal poverty level, while 26% of all families and 46% of families with a female householder and no husband present also have incomes below the poverty level. Economically, the lack of a viable non‐ agriculture‐based economy has resulted in stagnant incomes and low‐skilled jobs. The link between poverty, mental health, and substance use disorders is undisputable. Furthermore, the challenges associated with living in a rural state often present barrier to the prevention and treatment of substance use disorders and mental health disorders. According to The Annie E. Casey Foundation’s 2017 KIDS COUNT Data Book, the following conditions exist for children in MS today. 1.4% 1.5% 1.6% 1.6% 1.6% 1.7% 1.7% 1.9% 2.0% 2.2% 3.4% 6.9% 10.9% 13.8% Heroin Hallucinogens Methamphetamine Designer Drugs Spice Cocaine Downers Uppers Steroids Inhalants Prescription Drugs Marijuana Tobacco Alcohol 2016 Substance Use in the Past 30 days Among Adolescents in MS Prevention Works ~ Treatment is Effective ~ People Recover CHILD WELL‐BEING INDICATORS STATISTICS Change From Previous RANK National Average MS Percent of children in poverty (2015) 21% 31% increased 50th Teen birth rate (Births per 1,000 females ages 15‐19) (2015) decreased 46th Infant mortality rate (Death per 1,000 live births) (2015) 5.9 9.3 increased 50th Percent of children in single‐parent families (2015) 35% 48% increased 50th Percent of teens not attending school and not working (2015) 7% 10% unchanged 47th Percent of teens who are high school dropouts (Ages 16‐19) (2015) 4% 5% unchanged 30th Child death rate (Deaths per 100,000 Children Ages 1‐14) (2015) increased 45th Teen death rate (Deaths per 100,000 teens ages 15‐19) (2015) decreased 45th Table 2: The comparison of 2015 child health outcomes in MS compared to national estimates and directional changes that occurred in the previous year is displayed (Kids Count, 2017). *The HIV/AIDS statistical sections below are in the process of being updated. Mississippi HIV/AIDS Data Progress in the prevention of Human Immunodeficiency Virus (HIV), which can lead to Acquired Immunodeficiency Syndrome (AIDS), has been uneven. Black and Latino Americans continue to be infected at rates much higher than White Americans — eight times and four times as high, respectively. And in Mississippi, new diagnoses have remained high year after year, between 424 and 509 each year from 2014 to 2019. The state has the sixth-highest rate of HIV in the country, and Jackson remains inundated with new cases. Mendenhall, Mississippi, about 30 miles from Jackson, has one of the highest rates of HIV in the country. (Jahi Chikwendiu/The Washington Post) Sarah Fowler, May 27, 2021. In 2018 there were 476 individuals diagnosed with HIV. Out of the 82 counties in MS, the top 8 counties in 2018 with the highest rate of persons living with HIV were Coahoma (939), Forrest (626), Greene (774), Hinds (1171), Leflore (585), Sunflower (813), Tunica (782), and Washington (580) (AIDVu.org, 2018). The rate of new HIV diagnosis in 2018 was 16 per 100,000 Mississippians, which represents a 12% increase from the 2017 rate. About 78% of people diagnosed with HIV were men, 58% were less than 35 years old, and 74% were Black. Among individuals diagnosed with HIV in 2018, approximately 32% were linked to HIV care within 7 days and 64% were linked to HIV care in 30 days. There were 10,325 individuals living with HIV in Mississippi in 2018, which equates to a prevalence of 346 people living with HIV per 100,000 Mississippians. About 71% of these individuals Prevention Works ~ Treatment is Effective ~ People Recover were male, 77% were over 35 years old, 73% were Black, and 62% resided in an urban area. Among individuals living with HIV, only 64% received medical care in 2018 and only 44% were virally suppressed. In 2018, 190 individuals living with HIV in Mississippi representing a mortality rate of 1,828 deaths per 100,000 people living with HIV in 2018. This is a 23% decline in the mortality rate since 2014. Notable Trends in Mississippi’s HIV Epidemic in 2018 There is a disproportionate burden of HIV on Black individuals. 74% of new HIV diagnoses in 2018 were among Black individuals, who represent 39% of the population in Mississippi. Black individuals have a 6-fold higher rate of new HIV diagnosis compared to White individuals, and the prevalence of HIV is 5.5-fold higher among Black individuals compared to White individuals. Men who have sex with men (MSM), particularly young Black MSM, are at high risk of HIV. The rate of HIV among MSM in Mississippi is 83-fold higher than the rate of HIV among the general population of Mississippians. Overall, 18% of all new HIV diagnoses in Mississippi were among Black MSM less than 25 years old, who represent <1% greater population in Mississippi. Women are often diagnosed with HIV late and women living with HIV have a high mortality rate. Approximately 37% of women were diagnosed with AIDS within one year of their HIV diagnosis (i.e., were considered “late” HIV diagnoses) compared to 26% of men. Women living with HIV died at a rate that was 3.7- times higher than the general population of women in Mississippi, after adjusting for age. Young people and people who reside in rural communities are being linked to HIV care more slowly than other populations. Only 24% of individuals less than 35 years of age who were newly diagnosed with HIV were linked to care within 7 days, compared to 44% of those 35 years and older. Among people who reside in rural counties, only 49% were linked to care within 30 days compared to 80% of individuals who reside in urban counties (2018 MSDH HIV/AIDS Epidemiologic Profile). There are disparities in viral suppression by race and ethnicity. In 2018, viral suppression was lower among Hispanic people living with HIV (35%), but relatively similar between Black people living with HIV (44%) and White people living with HIV (43%). However, among individuals who had a viral load measured in 2018, viral suppression was lower among both Black (80%) and Hispanic (78%) compared to White people living with HIV (88%). (2018 MSDH HIV/AIDS Epidemiologic Profile). Ending the HIV Epidemic Many cities, counties, and states are developing and implementing plans to end the HIV epidemic in their jurisdictions. Complementing these local efforts is a ten-year national initiative known as Ending the HIV Epidemic: A Plan for America, which has brought a new wave of attention, commitment, and resources to achieve the goal of ending the HIV epidemic in the U.S. by 2030. In an effort to achieve the nationwide goal, we are proud to have launched Mississippi’s new statewide awareness campaign, “Put Your Foot Down, Mississippi” to inspire Mississippians to join renewed efforts to end the HIV/AIDS epidemic within the state. Through a partnership with the Mississippi State Department of Health (MSDH) and Mississippi Department of Mental Health (DMH), this campaign is a call to all Mississippians to take steps toward ending the misconceptions surrounding HIV/AIDS by educating themselves, getting tested in order to know their status, protecting themselves proactively against HIV, and doing their part to stop the spread. It is our hope to increase public awareness of rapid HIV testing, including where to locate and how to access needed services, such as those available through Prevention Works ~ Treatment is Effective ~ People Recover county health departments. To learn more or to find a testing site, please visit the Put Your Foot Down, Mississippi website at www.putyourfootdownms.com. “Ending the Epidemic” (EtE) plans across the United States bring together coalitions of local stakeholders to establish shared goals and strategies for ending the HIV epidemic in a city, county, state, or other jurisdiction. EtE plans are tailored to the context, needs, and resources of a particular jurisdiction and tend to take a broad, holistic view of the drivers of the local HIV epidemic. The development of these plans is usually informed by extensive community consultation. The national plan, Ending the HIV Epidemic: A Plan for America (EHE), is a ten-year federal initiative from the United States Department of Health & Human Services (HHS) with the goal of reducing new HIV prevention. Figure 4: A display of Mississippians living with HIV, by county, in 2018. Counties are color coded by rate of existing cases of HIV per 100,000 (AIDSVu.org, 2018). Prevention Works ~ Treatment is Effective ~ People Recover Statewide Plan for Substance Use Disorder Prevention, Treatment and Recovery Support The DMH, Bureau of Alcohol and Drug Addiction Services, administers the public system of substance use disorder assessment, referral, prevention, treatment, and recovery support services for the individuals it is charged to serve. It is also responsible for establishing, maintaining, and evaluating the network of service providers which include state‐operated behavioral health programs, regional community mental health centers, and other nonprofit community‐based programs. The Bureau of Alcohol and Drug Addiction Services strives to achieve and/or maintain high standards through the service delivery systems across the state. Therefore, the bureau is mandated to establish standards for the state’s alcohol/drug prevention, treatment, and recovery support programs; assure compliance with these standards; effectively administer the use of available resources; advocate for and manage financial resources; develop the state’s human resources by providing training opportunities; and develop an alcohol/drug data collection system. In order to address the issues of substance use disorders, the bureau believes a successful program is based on the following philosophical tenets: • Substance use disorders are illnesses which are treatable and preventable. • Effective prevention services reduce, delay, and prevent substance abuse. It decreases the need for treatment and provides for a better quality of life. • Substance use disorders are prevalent in all culturally diverse subgroups and socioeconomic categories. • Services should be delivered in a community setting, if appropriate. • Continuity of care is essential to an effective substance use disorder treatment program. • Vocational rehabilitation is an integral part of the recovery process. • Effective treatment and recovery include delivery of services to the individual and his/her family. • Individuals in recovery from a substance use disorder can return to a productive role within their community. The network of services comprising the public substance use disorder treatment system is provided through the following avenues: Prevention Works ~ Treatment is Effective ~ People Recover Regional Community Mental Health Centers The community mental health centers (CMHCs) with whom DMH contracts are the foundation and primary service providers of the public substance use disorders services delivery system. Each CMHC serves a designated number of Mississippi counties. There are sixty‐seven community‐based satellite centers throughout the state which allow greater access to services by the area’s residents. The goal is for each Community Mental Health Center to have a full range of treatment options available for citizens in its region. Substance use disorders services usually include: (1) alcohol, tobacco, and other drug prevention services; (2) general outpatient treatment including individual, group, and family counseling; (3) recovery support (continuing care) planning and implementation services; (4) primary residential treatment services (including withdrawal management); (5) transitional residential treatment services; (6) vocational counseling and employment seeking assistance; (7) emergency services (including a 24‐ hour hotline); (8) educational programs targeting recovery from substance use disorders which include understanding the disease, the recovery process, relapse prevention, and anger management; (9) recreational and social activities presenting alternatives to continued substance use and emphasizing the positive aspects of recovery; (10) 10‐15 week intensive outpatient treatment programs for individuals who are in need of treatment but are still able to maintain job or school responsibilities; (11) community‐based residential substance use disorders treatment for adolescents; (12) specialized women's services; (13) priority treatment for pregnant/parenting women; 14) services for individuals with a co‐occurring disorder of substance use disorder and serious mental illness; and, (15) employee assistance programs. Other Nonprofit Service Agencies/Organizations Other Nonprofit Service Agencies/Organizations, which make up a smaller part of the service system, also receive funding through the Department of Mental Health to provide community‐based services. Many of these free‐standing nonprofit organizations receive additional funding from other sources such as grants from other state agencies, community service agencies, donations, etc. PROCESS FOR FUNDING COMMUNITY‐BASED SERVICES Within the Department of Mental Health, the Bureau of Alcohol and Drug Addiction Services is responsible for administering the fiscal resources for substance use disorder services. The authority for funding programs to provide services to persons in Mississippi with substance use disorder issues was established through state statute. Funding is provided to community service providers by the Department of Mental Health through purchase Proposals and Application of Services (POS) or grant mechanisms. Funds are allocated by the Department through a Request for Review Process. Requests for Proposals (RFPs) and/or Funding Continuation Applications (FCAs) are disseminated among service providers through the Department's Grants Management office and detail all requirements necessary for a provider to be considered for funding. The RFP/FCA may also address any special requirements mandated by the funding source, as well as Department of Mental Health requirements for programs providing substance use disorders services. Agencies or organizations submit proposals which address needs of prevention and treatment services in their local communities to DMH for their review. Applications for funding of prevention or Prevention Works ~ Treatment is Effective ~ People Recover treatment programs are reviewed by DMH Bureau of Alcohol and Drug Addiction Services staff, with decisions for approval based on (1) the applicant's success in meeting all requirements set forth in the RFP/FCA, (2) the applicant's provision of services’ compatibility with established priorities, and (3) availability of resources. SOURCES OF FUNDING Sources of funding for substance use disorders prevention and treatment services are provided by both state and federal resources. Federal Sources Substance Abuse Mental Health Services Administration The Substance Abuse Block Grant (SABG), is applied for annually by the Bureau of Alcohol and Drug Addiction Services. Detailed goals and objectives for addressing specific federal requirements included in the SABG program are included in this State Plan. The Substance Abuse Block Grant is the primary funding source for DMH to administer substance use disorders prevention and treatment services in Mississippi. The Bureau allocates these awarded funds to its programs statewide. Funds are used to provide the following services: (1) general outpatient treatment; (2) intensive outpatient treatment; (3) primary residential treatment; (4) transitional residential treatment; (5) peer recovery support services; (6) prevention services; (7) community‐based residential substance use disorders treatment for adolescents; (8) special women’s services which include day treatment and residential treatment with priority on recovery support activities and programs for pregnant women and women with dependent children; (9) DUI assessment, opioid treatment services, and withdrawal management services for individuals with a co‐occurring disorder. In administering SABG funds, the DMH Bureau of Alcohol and Drug Addiction Services maintains minimum required expenditure levels (set aside) for substance use disorders services in accordance with federal regulations and guidelines. State Sources Alcohol Tax In 1977, the Mississippi Legislature levied a three percent tax on alcoholic beverages, excluding beer, for the purpose of using these tax collections to match federal funding, as deemed necessary, in order to fund alcohol treatment and rehabilitation programs. The earmarked alcohol tax is tied directly to the volume of alcoholic beverages sold in the state. Funds from the three percent alcohol tax are used to provide treatment for alcohol use disorders at DMH operated behavioral health programs and community-based programs. The components of the substance use disorders prevention and treatment service system are aligned with the Department of Mental Health’s Strategic Plan. The components encompass the strategic plan’s nine (9) themes which include accountability, person‐centeredness, access, community, outcomes, prevention awareness, partnerships, workforce training, and information management. REHABILITATION/TREATMENT SERVICES Treatment Modalities The Bureau of Alcohol and Drug Addiction Services encourages “Best Practices” that aim to investigate the potential problem of substance use disorders and motivate the individual to do Prevention Works ~ Treatment is Effective ~ People Recover something about it either by natural, client‐directed means or by seeking additional treatment. This can be done by utilizing brief interventions in an outpatient setting, which is the most common modality of treatment. If the individual needs a more intense level of treatment, a residential setting is recommended. Some evidence‐based practices currently being utilized in treatment are brief interventions, group‐based approaches to therapy, Cognitive‐Behavioral Therapy, Dialectical Behavioral Therapy, Motivational Interviewing, Applied Suicide Intervention Skills Training, Trauma Focused‐Cognitive Behavioral Therapy, and 12 Step Facilitation. Family Support For many individuals with substance use disorders, interaction with their family is vital to the recovery process. The family has a vital role to play in the treatment of the individual. They can assist by both participating in the development of the treatment plan and family therapy. Where family support is active, the user relies on the strengths of every family member as a source of healing. Several ways the providers encourage and help elicit family support is through the distribution of printed materials, education, internet access, and knowledge of the referral and placement process. Access to Community‐Based Primary Residential Services Level 3 Residential Programs are twenty‐four hour, seven days a week on‐site residential programs for adult males and females who have substance use disorders. This type of treatment is prescribed for those who lack sufficient motivation and/or social support to remain abstinent in a setting less restrictive. Predetermined minimum lengths of stay or overall program lengths of stay that must be achieved in order for a patient to “complete treatment” or “graduate” is inconsistent with an individualized and outcomes-driven system of care. The duration of treatment in Level 3 Residential levels of care always depends on an individual’s progress in acquiring basic living skills. Level 3.3 Clinically Managed Population-Specific High Intensity Residential Services offers 24-hour support setting to meet the needs of people with cognitive difficulties, who need specialized individualized treatment services (who need a slower pace and could not otherwise make use of the more intensive Level 3.5 milieu). This level of care is not a step-down residential level. It is qualitatively different from other residential levels of care. The cognitive impairments manifested in individuals most appropriately treated in Level 3.3 services can be due to aging, traumatic brain injury, acute but lasting injury, or due to illness. Level 3.5 (Adult) Clinically Managed High-Intensity Residential Services is designed to serve individuals who, because of specific functional limitations, need safe and stable living environments in order to develop and/or demonstrate sufficient recovery skills so they do not immediately relapse or continue to use in an imminently dangerous manner upon transfer to a less intensive level of care. This level of care offers organized treatment services that feature a planned and structured regimen of care in a 24-hour residential setting. 24-hour care with trained counselors to stabilize multidimensional imminent danger and prepare for outpatient treatment. Able to tolerate and use full active milieu or therapeutic community. Additionally, this level of care is based on the patient’s severity of illness, level of function, and progress in treatment. Predetermined minimum lengths of stay or overall program lengths of stay that must be achieved in order for a patient to “complete treatment” or “graduate” is inconsistent with an individualized and outcomes-driven system of care. The duration of treatment in this level of care always depends on an individual’s progress in acquiring basic living skills. Prevention Works ~ Treatment is Effective ~ People Recover Level 3.7 (Adult) Medically Monitored Intensive Inpatient Services offers 24-hour nursing care with physician availability for significant problems in Dimension's 1, 2, or 3 with a 16/hour/day counselor ability. Additionally, this level of care is based on the patient’s severity of illness, level of function, and progress in treatment. The duration of treatment in this level of care always depends on an individual’s progress in acquiring basic living skills. Although all substance use disorders treatment programs are accessible to pregnant women, there are three specifically designed for this population. Additionally, there are primary residential treatment programs tailored for adolescents and for persons in the criminal justice system. The Bureau of Alcohol and Drug Addiction Services supports specialized services for the following populations: Specialized Primary Residential Services for Pregnant Women and Women with Dependent Children: In addition to traditional treatment modalities described above, these programs provide pre/post‐natal care to pregnant women throughout the treatment process and afford infants/young children the opportunity to remain with their mothers. The treatment program also focuses on parenting skills education, nutrition, medical and other needed services. SABG-funded Providers are required to respond within 48 hours of a pregnant injecting drug user, a pregnant substance user/abuser, parenting male or female injecting drug users, parenting male or female substance user/abuser, and uninsured/under insured pregnant or parenting men and women (PPMW) seeking treatment. Therefore SABG-funded providers must, if no treatment facility has the capacity to admit the pregnant woman, make available interim services, including a referral for prenatal care, available, to the pregnant woman no later than 48 hours after the pregnant woman seeks treatment services. Level 3.5 Clinically Managed Medium-Intensity Residential Services (Adolescents) Residential Services is the highest community-based level of care for the treatment of substance use/addictive disorders. This level of treatment provides a safe and stable group living environment where the individual can develop, practice, and demonstrate necessary recovery skills. Residential Services provides residential care and comprehensive treatment services for adolescents whose problems are so severe or are such that they cannot be cared for at home or in foster care and need the specialized services provided by specialized facilities. Comprehensive services and activities may include diagnosis and psychological evaluation; alcohol and drug withdrawal management (detoxification) services; individual, family, and group therapy/counseling; remedial education and GED preparation, vocational or pre-vocational training; training on activities of daily living; supervised recreational and social activities; case management; transportation; and referral to utilization of other services. While providing many of the same therapeutic, informational/educational, and social/recreational services as adult programs, the content is modified to accommodate the substance using adolescent population. Adolescent treatment programs are generally longer in duration than adult primary residential programs. Some allow the client to remain from six months to a year, depending on several factors that may include the program’s recommendations, parental participation, and the client’s progress and adaptability. Also, all programs provide regularly scheduled academic classes individually designed for each client following a MS Department of Education approved curriculum by an MDE certified teacher. Specialized Services for Persons in the Criminal Justice System: Substance use disorders screening and a primary treatment unit are provided for the inmates at the Mississippi Correctional Facility. Prevention Works ~ Treatment is Effective ~ People Recover Access to Community‐Based Transitional Residential Services Level 3.1 (Transitional) Clinically Managed Low-Intensity Residential Services Program is a less intensive program for adult males and females, who typically remain from two to six months depending on the individual needs of the client. Level 3.1 (Transitional) Clinically Managed Low- Intensity Residential Services provide a safe and stable group living environment which promotes recovery while encouraging the pursuit of vocational correlated opportunities. Level 3.1 Residential Services are staffed 24 hours a day (with available trained personnel). This level of care requires a minimum a five (5) hours of treatment per week. The length of stay is based on the individual's severity of illness, level of function, and progress in treatment. The duration of treatment in this level of care always depends on an individual’s progress in acquiring basic living skills. Intended to be an intermediate stage between primary treatment and independent re‐entry into the community, the treatment focuses on the enhancement of coping skills needed to lead a productive and fulfilling life, free of chemical dependency. A primary objective of this type of treatment is to encourage and aid in the pursuit and acquisition of vocational, employment, and/or related activities. Although all substance use disorder treatment programs are accessible to pregnant women, there are two specifically designed for this population. There are also programs that provide services for female ex‐offenders and adult males who have been diagnosed with a co‐occurring disorder. Specialized Transitional Residential Services for Female Ex‐offenders: This program provides immediate support for women leaving primary treatment programs in correctional facilities. Access to Community‐Based Outpatient Services Each program providing substance use disorder outpatient services must provide multiple treatment modalities, techniques, and strategies which include individual, group, and family counseling. Program staff must include professionals representing multiple disciplines who have clinical training and experience specifically pertaining to the provision of substance use disorders. General Outpatient: Level 1 Outpatient programs are appropriate for individuals whose clinical condition or environmental circumstances do not require an intensive level of care. The duration of treatment is tailored to individual needs and may vary from a few weeks to several months. Services are less than nine (9) hours a week (adults); less than six (6) hours a week (adolescents) for recovery or motivational enhancement therapy and strategies. Level 2.1 Intensive Outpatient Program (IOP) for Adults: This program provides an alternative to traditional residential or hospital settings. It is directed to persons whose substance use problems are of a severity that require treatment services of a more intensive level than general outpatient but less severe than those typically addressed in residential or inpatient treatment programs. The IOP allows the client to continue to fulfill his/her obligations to family, job, and community while obtaining treatment. Typically, the IOP provides 3‐hour group therapy sessions, which are conducted at least three times per week for a minimum of nine (9) or more hours a week to treat multidimensional instability. Individual therapy sessions are also provided to each individual at least once per week. Specialized Intensive Outpatient Services for Adolescents: These programs operate in the same manner as those described above but focuses on the special needs of adolescents. The program allows the young person to maintain responsibilities related to education, family, employment and community while receiving treatment. Typically, the A-IOP provides 3‐hour group therapy sessions, which are conducted at least two (2) times per week for a minimum of six (6) or more hours a week to Prevention Works ~ Treatment is Effective ~ People Recover treat multidimensional instability. Individual therapy sessions are also provided to each individual at least once per week. Access to Hospital‐Based Inpatient Chemical Dependency Unit Services Inpatient or hospital‐based programs offer treatment and rehabilitation services for individuals whose substance use problems require a medically monitored environment. These may include: (a) patients with drug overdoses that cannot be safely treated in an outpatient or emergency room setting; (b) patients in withdrawal and who are at risk for a severe or complicated withdrawal syndrome; (c) those with an acute or chronic medical condition; (d) those who do not benefit from less intensive treatment; and/or (e) clients who may be a danger to themselves or others. In addition to medical services, treatment usually includes withdrawal management, assessment and evaluation, intervention counseling, aftercare, a family support program, and referral services. Inpatient services also provide treatment for individuals with a co‐occurring disorder of mental illness and substance use. The program is designed to break the cycle of being frequently hospitalized by treating the substance use simultaneously with the mental illness. SUPPORT SERVICES Access to Recovery Support Services A key component to a Person-Centered Recovery Oriented System of Care is Recovery Support Services and Peer Recovery Support Services. Recovery Support Services and Peer Recovery Support Services can effectively extend the reach of treatment beyond the clinical setting into the everyday environment of those seeking to achieve or sustain recovery. These services include social support, linkage to and coordination among allied service providers, and a full range of human services that facilitate recovery and wellness contributing to an improved quality of life. These services can be flexibly staged and may be provided prior to, during, and after treatment. Recovery Support Services and Peer Recovery Support Services may be provided in conjunction with treatment and/or separate and distinct services to individuals and families who desire and need them. Recovery Support Services and Peer Recovery Support Services may be delivered by peers, professionals, faith- based and community-based groups, and others designated to help individuals stabilize and sustain their recovery. They also may provide structured support and assistance to the client in making referrals to secure additional needed services from community mental health centers or from other health or human services providers while maintaining contact and involvement with the client’s family. Research indicates that strong social supports assist recovery and recovery outcomes. Since many of these services are delivered by peers who have been successful in the recovery process, they embody a powerful message of hope, as well as a wealth of experiential knowledge. Access to Services for the Older Adult Services are provided to the older adult with substance use disorder issues and/or their families by providing information and access to needed treatment. Alcohol and prescription drug misuse and abuse are prevalent among older adults due to the aging process of their mind and body. Many older adults also suffer from dementia as well and may require intensive treatment. Substance dependence are directly correlated with other potential causes of cognitive impairment. Coupled with drug Prevention Works ~ Treatment is Effective ~ People Recover addiction and cognitive impairment, they should be encouraged to seek appropriate treatment. Counselors often use the opportunity to educate the older adult and to help them to acknowledge their addiction. Patient understanding and cooperation for the older adult are essential in eliciting accurate information in order to carry out the appropriate type of treatment. Depending on the individual’s particular situation, the person’s needs may change over time and require different levels and intensities of rehabilitation. DUI Diagnostic Assessment Services Diagnostic Assessment Services are for individuals who have been convicted of two or more DUI violations which have resulted in the suspension of their driver’s license. The DUI (Driving Under the Influence) Diagnostic Assessment is a process by which the diagnostic assessment, Substance Abuse Subtle Screening Inventory (SASSI) is administered and the result is combined with other required information to determine the offender’s appropriate treatment environment for second and subsequent offenders. The diagnostic assessment process ensures the following steps are taken. First, an approved DMH diagnostic assessment instrument is administered. Second, the results of the initial assessment along with the DMH Substance Abuse Specific Assessment are evaluated. Third, the Blood Alcohol Content (BAC) and the motor vehicle report are reviewed. And last, collateral contacts along with other clinical observations, if appropriate, are recorded. After this process is completed, the DUI offender is placed or referred to the appropriate treatment environment for services. The Bureau of Alcohol and Drug Addiction Services will monitor the numbers of offenders seeking services by reviewing the Certification of DUI In‐Depth Diagnostic Assessment and Treatment Program Completion Forms, DUI Data System, and the Central Data Repository (CDR). Mississippi Drug Courts Mississippi currently has 40 drug courts covering all 82 counties. There are 22 adult felony programs, 3 adult misdemeanor programs, 12 juvenile programs, and 3 family programs. The mission of the drug court is to establish a system with judicial requirements which will effectively reduce crime by positively impacting the lives of substance users and their families. The target population of the program is for anyone whose criminal behaviors are rooted in their substance use. An evaluation process determines whether or not an offender is eligible for the program. Currently, the Bureau of Alcohol and Drug Addiction Services allocates funding to support a private, non‐profit, free standing community‐based program, IQOL (Improving Quality of Life) to implement the ICMS’s (Intensive Case Management Services) phase of the Drug Court Program. The case managers work closely with the court system to assist the client in meeting the judicial requirements administered by the court. Clients are offered the incentive of a chance to remain out of jail and the sanction of a jail sentence if they fail to remain drug‐free and noncompliant. The BADAS, Director of Prevention Services, serves on the State Drug Court Advisory Committee. Vocational Rehabilitation Services Each primary residential treatment program provides vocational counseling to individuals while they are in the treatment program. In transitional treatment, the primary focus is assisting the client in securing employment and/or maintaining employment. The Department of Rehabilitation Services, Office of Vocational Rehabilitation, partners with the Bureau of Alcohol and Drug Addiction Services Prevention Works ~ Treatment is Effective ~ People Recover in providing some monetary support for eligible individuals in the transitional residential treatment programs. Tuberculosis and HIV/AIDS Assessment/Educational Services All individuals receiving substance use disorder treatment services are assessed for the risk of tuberculosis and HIV/AIDS. If the results of the assessment indicate the individual to be at high risk for infection, testing is made available. Individuals also receive educational information regarding HIV/AIDS, STDs, TB, and Hepatitis either in individual or group sessions during the course of treatment. Referral Services For many years the Bureau of Alcohol and Drug Addiction Services has published the Mississippi Alcohol and Drug Prevention and Treatment Resources Directory for the public to access substance use disorder services. The directory is comprised of all DMH certified substance use treatment and prevention programs as well as other recognized programs across the state of Mississippi. It is revised, updated and redistributed by the Bureau of Alcohol and Drug Addiction Services every three years. The 2017‐2019 publication was distributed in August of 2017 to treatment facilities, human services organizations, and a wide variety of other interested parties statewide. The manual is extensively used for a variety of referral purposes. Approximately 5,000 copies have been distributed throughout the United States over the past few years. In addition, individuals seeking referral information through the Department of Mental Health may do so by contacting a toll‐free help line, operated by the DMH Office of Consumer Support. Priority Areas and Annual Performance Indicators Statutory Criterion for Substance Abuse Prevention and Treatment Block Grant 1. Responding to the Opioid Crisis 2. Pregnant Women and Women with Dependent Children 3. IV Drug Users 4. HIV/AIDS, STDs, Hepatitis, and Tuberculosis 5. Recovery Support 6. Trauma 7. Co-Occurring Disorders 8. Prescription Drugs 9. Adolescents and Prescription Drug Use 10. Adolescents and Alcohol Use Prevention Works ~ Treatment is Effective ~ People Recover Criterion #1: Responding to the Opioid Crisis Goal: To implement or expand clinically appropriate evidence-based treatment service options and availability, and promotions. Objectives: Increase the number of community providers that offer evidence-based, FDA approved MAT. Strategies to attain the objectives: 1. Implement and expand access to and utilize evidence-based, FDA approved medication assisted testament (MAT), in combination with psychosocial interventions. 2. Identify and treat Opioid Substance Use Disorder (OSUD) during pregnancy. Indicator #1: Implement or expand clinically appropriate evidence-based treatment service options and availability. Baseline Measurement: There are currently 4 certified OTP’s in the state. 1st year target/outcome measurement: Two (2) additional providers will be certified in the state. 2nd year target/outcome measurement: An additional two (2) providers will become certified in the state. Certification Database. 3rd year target/outcome measurement Add an additional (2) provider certifications by collaboration with other state and private OSUD providers around the state. Data Source: Certification Database Description of Data: The Certification Database contains all certified providers and their certifications. Indicator #2: Identify and treat opioid abuse during pregnancy. Baseline Measurement: Partner with the Division of Medicaid, state, and private providers to examine the feasibility of implementing and sustaining a state MS OSUD website for immediate MAT and psychosocial treatment access for pregnant females. 1st year target/outcome measurement: Conduct at least two (2) planning meetings between Medicaid and DMH- BADAS on developing a voucher system for pregnant women in treatment. 2nd year target/outcome measurement: Implement a voucher system for pregnant women supporting MAT and psychosocial treatment access for pregnant females. 3rd year target/outcome measurement Work with other state agencies to further develop OSUD process to include an OSUD statewide website. Data Source: Combined data from the state agencies in a month of OSUD data collection Description of Data: Agendas of SEOW meetings, as well as other joint meetings stating the scope of planning and work to be accomplished. Prevention Works ~ Treatment is Effective ~ People Recover CRITERION 2: Pregnant Women and Women with Dependent Children Goal: To ensure the delivery of quality specialized services to pregnant women and women with dependent children. Objectives: 1. Educate obstetrician, pediatric and family medicine providers to recognize and appropriately treat and refer women of child-bearing age with OUDs. 2. Educate the substance abuse disorders workforce on treatment of pregnant women, to include MAT. Strategies to attain the objectives: The Department of Mental Health’s (DMH) Bureau of Alcohol and Drug Addiction Services (BADAS) will continue to certify and provide funding to support fourteen (14) community- based primary residential treatment programs for adult females and males. While all of the programs serve pregnant women, there are two specialized programs that are equipped to provide services for the duration of the pregnancy. Six (6) free-standing programs are certified by the DMH, making available a total of twenty (20) primary residential substance abuse treatment programs located throughout the 14 community mental health regions. In addition to the substance use disorder treatment, these specialized primary residential programs will provide the following services: 1) primary medical care including prenatal care and childcare; 2) primary pediatric care for their children including immunization; 3) gender specific substance abuse treatment and other therapeutic interventions for women that may address issues of relationships, sexual and physical abuse, parenting, and child care while the women are receiving these services; 4) therapeutic interventions for children in custody of women in treatment which may, among other things address their developmental needs and issues of sexual and physical abuse and neglect; 5) sufficient case management and transportation services to ensure that women and their children have access to the services provided in (1) through (4). The DMH Operational Standards require that all substance abuse programs must document and follow written policies and procedures that ensure: • Pregnant women are given priority for admission; • Pregnant women may not be placed on a waiting list. Pregnant women must be admitted into a substance abuse treatment program within forty-eight (48) hours; • If a program is unable to admit a pregnant woman due to being at capacity; the program must assess, refer, and place the individual in another certified DMH certified program within 48 hours; • If a program is unable to admit a pregnant woman, the woman must be referred to a local health provider for prenatal care until an appropriate placement is made; • If a program is at capacity and a referral must be made, the pregnant woman must be offered an immediate face to face assessment at the agency or another DMH certified provider. If offered at another DMH certified program, the referring program must facilitate the appointment at the alternate DMH certified program. The referring provider Prevention Works ~ Treatment is Effective ~ People Recover must follow up with the certified provider and program to ensure the individual was placed within forty-eight (48) hours. Indicator #1: The percentage of women served who successfully completed treatment. Baseline Measurement: Implementation began in January 1, 2018. There was a significant decrease in numbers during FY 20 due to COVID-19. 1st year target/outcome measurement: Increase by 1% the number of pregnant women who successfully complete treatment during 2021-2022. 2nd year target/outcome measurement: Increase by 2% the number of pregnant women who successfully complete treatment during 2022-2023. Data Source: Annual Monitoring visits, Central Data Repository, and Programs will provide policy and procedures ensuring priority is given to pregnant women. Data from the Addictive Services Point of Service Spreadsheet will also be utilized. Description of Data: BADAS will conduct monitoring visits annually to ensure programs are giving priority to pregnant women. Treatment episode data sets will be used to determine the number of pregnant women who successfully complete treatment each year. Indicator #2: The percentage of pregnant women served who utilize Medication Assisted Treatment (MAT) during treatment and successfully complete treatment. Baseline Measurement: Implementation l began on January 1, 2018. There was a significant decrease in numbers during FY 20 due to COVID-19. 1st year target/outcome measurement: Increase by 30% the number of pregnant women that have access to MAT during FY 2019-2020. 2nd year target/outcome measurement: Increase by 35% the number of pregnant women that have access to MAT during FY 2020-2021. Data Source: Annual monitoring visits. Description of Data: BADAS will conduct monitoring visits annually to ensure programs are giving priority to pregnant women. Treatment episode data sets will be used to determine the number of pregnant women who utilized MAT during treatment and successfully complete treatment each year. Data Issues/caveats that affect the outcome measures: Many MAT clinics only accept cash, which may cause a significant hardship. Funding issues could affect the availability of services; however, MS DMH has sought and received funding through the 21st Century Cures grant and State Opioid Response grant to increase the number of certified MAT facilities and defer costs for pregnant women. Finding physicians who have adapted to the medical practice of MAT. Finding physicians who are knowledgeable of how to appropriately code/bill Medicaid for MAT. Prevention Works ~ Treatment is Effective ~ People Recover CRITERION 3: Interventions Drug (IV) Users Goal: The proportion of IV Drug Users who were admitted into treatment and who successfully completed treatment. Objectives: Continue delivering specialized treatment services to injecting drug users throughout the state. Strategies to attain the objectives: All DMH certified substance abuse programs must document and follow written policies and procedures that ensure: • Individuals who use IV drugs are provided priority admission over non‐IV drug users. Individuals who use IV drugs are placed in the treatment program identified as the best modality by the assessment within forty‐eight (48) hours. • If a program is unable to admit an individual who uses IV drugs due to being at capacity, the program must assess, refer and place the individual in another certified DMH program within forty‐eight (48) hours. • If unable to complete the entire process as outlined in sectioned C., DMH Office of Consumer Support must be notified immediately by fax or email using standardized forms provided by DMH. The time frame for notifying DMH of inability to place an individual who uses IV drugs cannot exceed forty-eight (48) hours from the initial request for treatment from the individual. • If a program is at capacity and a referral must be made, the referring provider is responsible for assuring the establishment of alternate placement at another certified DMH program within forty‐eight (48) hours. • The referring provider is responsible for ensuring the individual was placed within forty‐ eight (48) hours. • In the case there is an IV drug user that is unable to be admitted because of insufficient capacity, the following interim services will be provided: o Counseling and education regarding HIV, Hepatitis, and TB, the risks of sharing needles, the risk of transmission to sex partners and infants, and the steps to prevent HIV transmission; o Referrals for HIV, Hepatitis, and TB services made when necessary. Indicator #1: The percentage of IV drug users successfully completed treatment. Baseline Measurement: Implementation began on January 1, 2018. There was a significant decrease in numbers during FY 20 due to COVID-19. Prevention Works ~ Treatment is Effective ~ People Recover 1st year target/outcome measurement: Increase by 1% the number of IV Drug Users who successfully complete treatment after admission. 2nd year target/outcome measurement: Increase by 2% the number of IV Drug Users who successfully complete treatment after admission. Data Source: Annual Monitoring visits. Programs will provide policy and procedures ensuring priority is given to IV drug users. Description of Data: BADAS will conduct monitoring visits annually to ensure programs are giving priority to IV drug users. Treatment episode data sets will be used to determine the number of IV drug users who successfully complete treatment each year. CRITERION 4: HIV/AIDS, STDs, Hepatitis, and Tuberculosis Goal: Increase access to individuals determined to be at high risk for HIV to HIV Rapid Testing & Education services. Objectives: All individuals receiving treatment for a substance use disorder at any program certified by the DMH will receive a risk assessment for HIV, tuberculosis, hepatitis, and STDs at the time of intake and receive referrals for testing and treatment services if determined to be at high‐ risk. Strategies to attain the objectives: All individuals receiving treatment for a substance use disorder at any program certified by the DMH in collaboration with the Mississippi State Department of Health will receive a risk assessment for HIV, tuberculosis, hepatitis, and STDs at the time of intake and receive referrals for testing and treatment services if determined to be at high‐risk. For individuals in a primary residential setting determined to be at high‐risk for tuberculosis, transportation is provided to the location where the assessment will be conducted. If an individual is determined to be at high‐risk for HIV, testing options to that individual are determined by their level of care. Individuals in a primary residential setting will be offered HIV Rapid Testing Services onsite or must be transported to a testing site in the community only until Rapid Testing Program can be implemented. Individuals at high‐risk for HIV in outpatient services will be offered HIV Rapid Testing Services or informed of available HIV testing resources available within the community. Individuals at high‐risk for HIV in Transitional Residential and Recovery Support Services will be offered HIV Rapid Testing unless the program can provide documentation that the individual received the risk assessment and was offered testing during primary substance abuse treatment. If HIV Rapid Testing is not immediately available, then testing will be offered to the individual or the individual will be informed of available HIV testing resources available within the community. It is planned to routinely make available tuberculosis assessment, treatment (if applicable) and educational services to each individual receiving treatment for substance abuse. Prevention Works ~ Treatment is Effective ~ People Recover Additionally, individuals will continue to receive educational information and materials concerning HIV, tuberculosis, hepatitis, and STDs, either in an individual or group session during the course of treatment. Individuals’ records will continue to be monitored routinely for documentation of these activities by Bureau of Alcohol and Drug Addiction Services staff through routine monitoring visits. Indicator #1: Increase access to individuals determined to be at high risk for HIV to HIV Rapid Testing & Education services. Baseline Measurement: Implementation began January 1, 2019. 1st year target/outcome measurement: Increase by 1% the number of at-risk individuals that will receive rapid testing for HIV and Hepatitis during 2019-2020 2nd year target/outcome measurement: Increase by 3% the number of at-risk individuals that will receive rapid testing for HIV and Hepatitis during 2022-2023 Data Source: Monitoring visits and Annual SABG progress report Description of Data: In accordance to the Grant Agreement established between the DMH and the Mississippi Department of Health (MSDH), the MSDH will oversee data collection regarding HIV services. MSDH will collect and report HIV data to the DMH annually or upon request. BADAS will continue to conduct monitoring visits to ensure the completion of this goal. During these monitoring visits individual's records at the 13 community mental health centers will be monitored routinely for documentation of these activities on the DMH Educational/Assessment Forms. Programs will also annually submit a SABG progress report to Mississippi Department of Mental health reporting progress on each of the block grant goals. Data Issues/caveats that affect the outcome measures: Training time needed for HIV and Hepatitis rapid testing and the cost could pose an issue for this goal. Unfortunately, one of the community mental health regions has combined due to limited resources. Now, instead of 14 community mental health centers there are only 13. Also, a lack of staff due to the Delta variant, and an increased number of individuals in substance use disorder programs has presented an accumulation of risk factors and adverse consequences in providing services. CRITERION 5: HIV/AIDS – Resources Goal of the priority area: To provide each substance use disorder treatment center with current HIV materials and accessible educational resources. Objective: 1. Maintain current HIV materials 2. Provide areas to locate resources for HIV 3. Broaden the scope of HIV education Prevention Works ~ Treatment is Effective ~ People Recover Strategies to attain the objectives: Provide, substance use disorder providers educational resources to obtain the latest perspectives on best practices in continuum of HIV services. Indicator 1: Individuals receiving substance use disorder services will receive best practices for HIV care and how it can be made more relevant in all age groups. Baseline Measurement: Starting out to increase by fifty percent (50%) 1st year target/outcome measurement: Fifty percent (50%) of individuals in all substance use disorder treatment centers will receive current HIV materials and accessible educational resources to obtain the latest perspectives on best practices in continuum of HIV services, beginning January 1, 2022. 2nd year target/outcome measurement: Fifty percent (50%) of individuals in all substance use disorder treatment centers will receive current HIV materials and accessible educational resources to obtain the latest perspectives on best practices in continuum of HIV services by January 2023. Data Source: MS Department of Mental Health, Bureau of Alcohol and Drug Addiction Services, and MS Department of Health. Description of Data: Quarterly Reports from MS Department of Health Data Issues/caveats that affect the outcome measures: Limited resources may pose a challenge to provide materials to all substance use disorder providers for this fiscal year. CRITERION 6: Recovery Support (Peer Support) Services Goal: Increase workforce awareness and understanding of the DMH Operational Standards on Recovery Peer Support Services. Utilize individuals with lived experience of mental illness and/or substance use and parent/caregivers to provide varying supports to assist others in their journey to recovery and resiliency. Objectives: Promote recovery, resiliency, and community integration throughout the state. Increase the number of Certified Peer Support Specialists (CPSSs) employed by DMH certified providers Strategies to attain the objectives: Prevention Works ~ Treatment is Effective ~ People Recover To increase workforce awareness and utilize individuals with lived experiences, BADAS will: • Conduct outreach to stakeholders to increase the number of CPSS and the role of CPSSs; • Provide training and technical assistance to service providers on the Recovery Model, Person Centered Planning, and System of Care principles; • Provide training to CPSS Supervisors on recruitment, retention, and supervision of CPSSs. Indicator #1: Increase the number of CPSSs employed by DMH certified providers. Baseline Measurement: A total of 287 CPSSs were trained and employed by DMH certified providers in FY 2021. 1st year target/outcome measurement: Increase the number of CPSSs by 3%. 2nd year target/outcome measurement: Increase the number of CPSSs by 3%. Data Source: DMH Division of Professional Licensure and Certification (PLACE); Division of Recovery and Resiliency Description of Data: Division of PLACE and Division of Recovery and Resiliency monitor and maintain an active list of all CPSSs employed by DMH certified providers. This list is updated monthly (except for December and June) by Division of PLACE and quarterly (or as needed) by Division of Recovery and Resiliency. Goal: Enhance the transition process of individuals to a less restrictive environment. Improve the transition process from inpatient care to community-based level care while significantly decreasing the need for readmission. Objectives: Successfully implement Peer Bridger Program and employ trained Peer Bridgers at four behavioral health programs and all thirteen community mental health centers (CMHCs) statewide utilizing WRAP. Strategies to attain the objectives: To enhance the transition process of individuals in need of Recovery Peer Support Services to a less restrictive environment, BADAS will utilize trained Peer Bridgers at four behavioral health programs and all thirteen community mental health centers (CMHCs) statewide utilizing WRAP. Indicator #1: Increase the number of trained Peer Bridgers. Baseline Measurement: Currently, there are 6 trained Peer Bridgers employed in the state. 1st year target/outcome measurement: Increase the number of trained Peer Bridgers by 3%. Prevention Works ~ Treatment is Effective ~ People Recover 2nd year target/outcome measurement: Increase the number of trained Peer Bridgers by 3%. Data Source: Monthly and yearly Peer Bridger Reports; Workforce development training database Description of Data: Monthly and yearly Peer Bridger Reports are submitted to the Department of Mental Health by all providers implementing Peer Bridger Programs. This report requires the provider to indicate the number of Peer Bridgers currently employed as well as employed throughout the fiscal year. Workforce development training database will also be managed and updated by Division of Recovery and Resiliency. CRITERION 7: Trauma Goal: Increase the proportion of SUD workforce workers trained on Trauma Informed Care throughout the state every year. Objectives: Provide education and intervention techniques to SUD providers that serve victims of trauma. Strategies to attain the objectives: The Mississippi Department of Mental Health, Bureau of Community Services and the Bureau of Alcohol and Drug Addiction Services are working collaboratively to provide training intended to address the effects of trauma. These trainings will be particularly helpful for adult and child survivors of abuse, disaster, crime, shelter populations, and others. It will be aimed at promoting relationships rather than focusing on the traumatic events in their lives. The trainings can also be utilized by first providers, frontline service providers and agency staff. Indicator #1: Infuse trauma history questionnaires within the clinical assessment phase of intake. Baseline Measurement: Implementation will begin by January 1, 2022. 1st year target/outcome measurement: At least 10 individuals will utilize the Trauma questionnaire. 2nd year target/outcome measurement: At least 10 additional individuals will utilize the Trauma questionnaire. Data Source: Training or TA logs from trauma trainings. Tracking and feedback reports from Division of Certification. Description of Data: Number of trainings, sign-in sheets, agendas. Tracking and feedback reports from Division of Certification. Prevention Works ~ Treatment is Effective ~ People Recover CRITERION 8: Co-Occurring Goal: Broaden the knowledge base of the Community Mental Health Centers (CMHCs) to their specific co-occurring conditions and capacities. Objectives: Assess the co-occurring conditions of all thirteen (13) CMHCs to determine whether they are Co-Occurring Capable and Co-Occurring Enhanced. Strategies to attain the objectives: In an attempt to improve the co-occurring disorders (mental health, MH, and substance use disorder, SUD) treatment services in Mississippi, the Bureau of Alcohol and Drug Addiction Services (BADAS) has developed the Co-Occurring Capabilities of Mississippi project. The BADAS have come to the realization that before changes can be made to its current treatment structure, an accurate and multi-dimensional picture of services offered, statewide, is fundamental. In fiscal year 2017-2018, the BADAS conducted a thorough assessment of the CMHCs and have selected the Dual Diagnosis Capability in Mental Health Treatment (DDCMHT) assessment tool to obtain objective information on the co-occurring conditions of the providers with whom it contracts with for MH and SUD treatment services. The DDCMHT assessment tool will allow the BADAS to properly categorize each treatment program into one (1) of two (2) primary categories based upon the agency’s existing co- occurring conditions: Co-Occurring Capable (COC) or Co-Occurring Enhanced (COE). Indicator #1: Determine the co-occurring level of the Community Mental Health Centers (CMHCs) by way of a DDCMHT assessment. (Co-occurring Level will either be Co-Occurring Capable or Co-Occurring Enhanced). Baseline Measurement: In grant year 2018-2019, 50% of the CMHCs Co-Occurring Conditions was identified. In grant year 2019-2020, the remaining 50% of the CMHCs Co- Occurring Conditions was identified. For the upcoming two grant years, 2021- 2023, 5% of SUD Treatment providers will be assessed annually. 1st year target/outcome measurement: Maintain the number of SUD Treatment programs assessed (DDCMHT) at 5% by the end of grant year 2021. 2nd year target/outcome measurement: Maintain the number of SUD Treatment programs assessed (DDCMHT) at 5% by the end of grant year 2022. Data Source: DDCMHT Scoring Results Description of Data: DDCMHT Scoring Results Data Issues/caveats that affect the outcome measures: Obtaining the by-in from the CMHCs during the assessment process. Willingness of the provider to embrace the changes needed as a result of the DDCMHT assessment. Prevention Works ~ Treatment is Effective ~ People Recover CRITERION 9: Prescription Drugs Goal: To reduce prescription drug abuse to protect the health, safety, and quality of life for Mississippi adolescents and young adults. Objectives: To reduce the number of opioids being prescribed by healthcare professionals. To reduce past year and past 30-day non-medical use of prescription drugs. Strategies to attain the objectives: Provide education through media campaigns, town hall meetings, and healthcare policy and practice changes. BADAS prevention providers will continue to increase efforts to inform their communities on the dangers of prescription drug abuse. BADAS will continue to work with both state and community level drug taskforce coalitions in implementing programs aimed at educating individuals on prescription drug take back initiatives. BADAS prevention providers will continue to focus available resources on media campaigns and PSAs to assist in education the general public. Programs will have implemented evidence-based programs, policies, and practices within their communities. Indicator #1: Partner with professional associations and medical teaching institutions to educate dentists, osteopaths, nurses, physician assistants, and podiatrists on current opioid prescribing guidelines. Baseline Measurement: From January 2018 to June 2018, there were 1,402,296 dosage units distributed in Mississippi. 1st year target/outcome measurement: Reduce the number of dosage units by 5% 2nd year target/outcome measurement: Reduce the number of dosage units by 5% Data Source: Mississippi Prescription Monitoring Program Description of Data: All pharmacies input opioid data into the PMP. Data will be collected and analyzed regarding the prescribing changes. Indicator #2: Reduce past 30 day use of non-medical uses of prescription drugs Baseline Measurement: 3.82% of 6-11th graders report using prescription drugs that were not prescribed to them by a doctor in the past 30 days (2018-2019). Prevention Works ~ Treatment is Effective ~ People Recover 1st year target/outcome measurement: Reduce rate by .5 % in year one and two (rate of reduction estimated Covid-19 Pandemic restrictions of access) (rate of reduction estimated Covid-19 Pandemic restrictions of access) 2nd year target/outcome measurement: Reduce rate by .5% in year two (rate of reduction estimated Covid-19 Pandemic restrictions of access) (rate of reduction estimated Covid-19 Pandemic restrictions of access) Data Source: Smarttrack Description of Data: Smarttrack Description: The MS Department of Mental Health (DMH), Bureau of Alcohol and Drug Addiction Services began collaborating with the MS Department of Education, Office of Healthy Schools in 2001 to implement a statewide youth survey (SmartTrack) that measures youth consumption and consequence patterns of alcohol and drug use in MS. It also measures other risk and protective factors including drug-related disapproval attitudes and perceived risk of harm, suicide ideation and attempts, health, nutrition, family influences, school safety and bullying, and social engagement. Data Issues/caveats that affect the outcome measures: We are continuing to strive towards the development of new forms of data collection. We and entered into data sharing collaborative with independent contractors and several other State agencies and will receive technical assistance in this area from additional outside consultants. Indicator #3: To reduce past year non-medical use of prescription drugs. Baseline Measurement: In 2019, 5% of Mississippi youths in grades 6-12 reported having used prescription drugs in a way other than how they were prescribed. 3.82% of 6- 11th graders report using prescription drugs that were not prescribed to them by a doctor in the past 30 days (2018-2019) (rate of reduction estimated Covid-19 Pandemic restrictions of access) 1st year target/outcome measurement: Decrease the percentage of youth in grades 6-12 that reported having used prescription drugs in a way other than how they were prescribed. by .5%. 2nd year target/outcome measurement: Decrease the percentage of youth in grades 6-12 that reported having used prescription drugs in a way other than how they were prescribed by .5%. Data Source: Smarttrack Description of Data: Smarttrack Description: The MS Department of Mental Health (DMH), Bureau of Alcohol and Drug Addiction Services began collaborating with the MS Department of Education, Office of Healthy Schools in 2001 to implement a statewide youth survey (SmartTrack) that measures youth consumption and consequence patterns of alcohol and drug use in MS. It also measures other risk and protective factors including drug-related disapproval attitudes and perceived risk of harm, suicide ideation and attempts, health, nutrition, family influences, school safety and bullying, and social engagement. Indicator #4: Statewide media campaign targeting adolescents on opioid use and misuse. Baseline Measurement: 6.84% of adolescents 12-17 years of age reported using pain relievers nonmedically in MS, 2018-2019 NSDUHs; or 4% of adolescents in 6th-11th grades reported the illicit use of prescription drugs in the past 30 days, 2019 Mississippi Student Survey Prevention Works ~ Treatment is Effective ~ People Recover 1st year target/outcome measurement: By December 31, 2022, reduce the percentage of youth ages 12-17 years, reporting the use of non-medical prescription type drugs. 2nd year target/outcome measurement: By December 31, 2023, reduce the percentage of youth ages 12-17 years, reporting the use of non-medical prescription type drugs. Data Source: Smarttrack Description of Data: Smarttrack Description: The MS Department of Mental Health (DMH), Bureau of Alcohol and Drug Addiction Services began collaborating with the MS Department of Education, Office of Healthy Schools in 2001 to implement a statewide youth survey (SmartTrack) that measures youth consumption and consequence patterns of alcohol and drug use in MS. It also measures other risk and protective factors including drug-related disapproval attitudes and perceived risk of harm, suicide ideation and attempts, health, nutrition, family influences, school safety and bullying, and social engagement. CRITERION 10: Adolescents Goal: To reduce prescription drug abuse to protect the health, safety, and quality of life for Mississippi adolescents and young adults Objectives: To reduce past year and past 30-day non-medical use of prescription drugs. Indicator #2: Reduce past 30 day use of non-medical uses of prescription drugs Baseline Measurement: 3.82% of 6-11th graders report using prescription drugs that were not prescribed to them by a doctor in the past 30 days (2017-2018). 1st year target/outcome measurement: Reduce rate by 1% in year one 2nd year target/outcome measurement: Reduce rate by 1% in year two Data Source: Smarttrack Description of Data: Smarttrack Description: The MS Department of Mental Health (DMH), Bureau of Alcohol and Drug Addiction Services began collaborating with the MS Department of Education, Office of Healthy Schools in 2001 to implement a statewide youth survey (SmartTrack) that measures youth consumption and consequence patterns of alcohol and drug use in MS. It also measures other risk and protective factors including drug-related disapproval attitudes and perceived risk of harm, suicide ideation and attempts, health, nutrition, family influences, school safety and bullying, and social engagement. Data Issues/caveats that affect the outcome measures: We are currently investigating new forms of data collection. We will request technical assistance in this area. Prevention Works ~ Treatment is Effective ~ People Recover Strategies to attain the objectives: BADAS prevention providers will continue to increase efforts to inform their communities on the dangers of prescription drug abuse. Indicator #1: Statewide media campaign targeting adolescents on opioid use and misuse. Baseline Measurement: 5.32% of adolescents 12-17 years of age reported using pain relievers nonmedically in MS, 2017-2018 NSDUHs; or 4% of adolescents in 6th-11th grades reported the illicit use of prescription drugs in the past 30 days, 2017 Mississippi Student Survey. 1st year target/outcome measurement: By December 31, 2022, reduce the percentage of youth ages 12-17 years, reporting the use of non-medical prescription type drugs. 2nd year target/outcome measurement: By December 31, 2023, reduce the percentage of youth ages 12-17 years, reporting the use of non-medical prescription type drugs. Data Source: National Survey of Drug Use and Health (primary) Mississippi Student Survey (secondary: if NSDUH is unavailable due to changes in the methodology for this question in 2015). Description of Data: The National Survey on Drug Use and Health (NSDUH) is the primary source of information on the prevalence, patterns, and consequences of alcohol, tobacco, and illegal drug use and abuse and mental disorders in the U.S. civilian, non- institutionalized population, age 12 and older. The Mississippi Student Survey is the primary source of information on the prevalence, patterns, and consequences of alcohol, tobacco, and other illicit drug use among 6th-11th grade Mississippi students that can examine what is happening on the community level by county and school district. Data Issues/caveats that affect the outcome measures: 2015 NSDUH Redesign Changes and Impact: The NSDUH questionnaire underwent a partial redesign in 2015. The prescription drug questions for pain relievers, tranquilizers, stimulants, and sedatives were redesigned to shift the focus from lifetime misuse to past year misuse. Additionally, questions were added about any past year prescription drug use, rather than just misuse. A separate section with methamphetamine questions was added, replacing the methamphetamine questions that were previously asked within the context of prescription stimulants. Substantial changes were also made to questions about smokeless tobacco, binge alcohol use, inhalants, and hallucinogens. These changes led to potential breaks in the comparability of 2017 compiled with the restriction place on our infrastructure to implement strategies and effectively collect and analyze data in 2019 we feel that fidelity may be somewhat inadequate for estimates from prior years. Consequently, these estimates potentially affected overall summary measures, such as any illicit drug use, and other measures, such as initiation, SUDs, and substance use treatment. Additionally, demographic items were affected, as a result, systems having shut down during a portion of the time period in question. Education questions have been updated, and new questions were added on disability, English-language proficiency, sexual orientation of adults, and military families. Prevention Works ~ Treatment is Effective ~ People Recover Due to the limitation posed by the Covid-19 Pandemic and limitation on the workforce, many estimates from prior years cause our most recent estimates appear low. These include measures of overall illicit drug use, use of illicit drugs other than marijuana, use of hallucinogens, inhalants, and methamphetamine, misuse of psychotherapeutics, binge and heavy alcohol use overall and among females, smokeless tobacco, and substance use treatment. Additionally, estimates by education and current employment have been noted as not Comparable. There are new tables for 2019 pertaining to any past year prescription drug use. Within these tables, corresponding estimates from prior years are noted as unavailable. The newly defined any use of prescription drugs includes both use as directed by a doctor as well as misuse. Misuse includes use in any way not directed by a doctor, including use without a prescription of one's own, use in greater amounts, more often or longer than told to take a drug, or use in any way not directed by a doctor. The detailed tables no longer use the term "nonmedical use" and instead use the term "misuse. To evaluate the effects of the pandemic and shut down we have recently received approval for an additional data analyst along with a recently hired epidemiologist. The SSA will also set aside a percentage of the Covid-19 Supplemental funds for consultations from independent contractors to assist in as aspects of data collection and management. It is anticipated that such efforts will offset potential infidelities moving forward. Already in practice, analyses were conducted on a subset of variables associated with the detailed tables to check for potential trend breaks, including the risk and availability measures. After significant differences between 2017 and previous years were found for 18 of 19 raw risk and availability variables during an initial analysis, logistic regression models were run on dichotomous recodes. All of the perceived risk of harm associated with substance use measures yielded a significant increase in 2017 compared with previous years. Extreme weights and missing rates were investigated to ensure these were not the cause of the difference. As more data become available, trends over time will be further analyzed to determine comparability. Currently, estimates for these measures in the detailed tables for years prior to 2017 have been noted as not reported due to measurement issues. CRITERION 11: Adolescents Alcohol Use Goal: Reduce alcohol use and substance abuse to protect the health, safety, and quality of life for Mississippi adolescents and young adults. Objectives: Reduce past 30 day use and binge drinking among 12-25-year olds. Prevention Works ~ Treatment is Effective ~ People Recover Strategies to attain the objectives: BADAS prevention programs will provide information to communities about the increased risk associated with early exposure to alcohol and its potential negative consequences. BADAS prevention programs will work with local community coalitions to implement local policies that will lower alcohol consumption among youth. BADAS prevention programs will continue to implement evidence-based practices, programs, and strategies aimed at reducing underage drinking and alcohol abuse. Indicator #1: Adolescent past 30-day use Baseline Measurement: 13. 2% (29,000) of youth ages 12-17 reported Alcohol use in the past month 1st year target/outcome measurement: Reduce by 1% in year one. 2nd year target/outcome measurement: Reduce by 1% in year two. Data Source: Smarttrack NSDUH Description of Data: Smarttrack Description: The MS Department of Mental Health (DMH), Bureau of Alcohol and Drug Addiction Services began collaborating with the MS Department of Education, Office of Healthy Schools in 2001 to implement a statewide youth survey (SmartTrack) that measures youth consumption and consequence patterns of alcohol and drug use in MS. It also measures other risk and protective factors including drug-related disapproval attitudes and perceived risk of harm, suicide ideation and attempts, health, nutrition, family influences, school safety and bullying, and social engagement. NSDUH Description: The National Survey on Drug Use and Health (NSDUH) provides national and state-level data on the use of tobacco, alcohol, illicit drugs (including non-medical use of prescription drugs) and mental health in the United States. NSDUH is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Public Health Service in the U.S. Department of Health and Human Services (DHHS). CRITERION 12: Adolescents Marijuana Use Goal: Reduce marijuana use to protect the health, safety, and quality of life for Mississippi adolescents. Objectives: Reduce past 30 days use among 12-17-year olds. Prevention Works ~ Treatment is Effective ~ People Recover Strategies to attain the objectives: BADAS will continue to raise population level change on social norms pertaining to marijuana use among youth. BADAS will continue to raise and increase awareness of the developmental risk associated with early exposure to marijuana use and its potential immediate and long-term side effects. BADAS will continue to educate the public across diverse social groups (gender, race-ethnicity, educational levels, and sub-state regions) on the dangers of marijuana use through evidence- based strategies. Indicator #1: Past 30-day use Baseline Measurement: 7.9% (13,000) of youth ages 12-17 reported marijuana use in the past 30 days 1st year target/outcome measurement: Reduce rate by 1% in year one. (rate of reduction estimated Covid-19 Pandemic restrictions of access) 2nd year target/outcome measurement: Reduce rate by 1% in year two. (rate of reduction estimated Covid-19 Pandemic restrictions of access) Data