York County Strategic Plan 
York County Prevention Collaborative
Prepared by:  Scott M. Gagnon, MPP  
SPEP Project Coordinator for York County

Vision

	To create, foster, and continue a county-wide initiative that incorporates voices of all ages and from all reaches of the York County community to work towards a common goal of healthy and drug-free youth.

Introduction

	This report is the result of a concerted and collective effort on behalf of the substance abuse prevention community in York County.  Since September of 2006, much energy and effort has gone into collecting existing data, identifying knowledge gaps, collecting new data to address those gaps, and put together a comprehensive strategic plan.  It was the goal of this project to construct a viable strategic plan that can make real strides to address some of the underlying intervening variables and contributing factors that influence substance consumption and consequences.  A secondary goal in this process, though equally vital, was to foster a strong and unified energy within York County to address substance abuse.  
	There was a desire and need to not only strengthen already existing ties and linkages, but to create new ones and to branch out to other communities and partners and invite them to the table for the process that was carried out under this grant.  The York County Prevention Collaborative and Day One were the driving forces behind the needs assessment and strategic planning effort.  Together they were able to tap substantial resources of knowledge, expertise, and support.  

Description of Geographic Areas Covered in the Strategic Plan and Collaborating Partners

	At the beginning of this grant, the Planning Team had identified geographical areas in York County that hadn’t been represented on the York County Prevention Collaborative and the York County collective substance abuse prevention efforts.  Those towns were Cornish, Limington, Bar Mills, and Parsonsfield.  So, essentially we were missing the western and northern sections of York County.  However, through the needs assessment and strategic planning process we did garner some initial collaboration and partnership in these areas.  

	One of the biggest successes was collaborating with the respective school districts that served these towns.  These school districts would be SAD 6 and SAD 55.  Both schools agreed to partner with us and gave us access to their school-level MYDAUS data.  This data was very important in our analysis of substance abuse consumption and related factors amongst York County youth.  It is the aim of the York County Prevention Collaborative and those implementing the Strategic Plan to build upon this collaboration and to further engage these areas in the county-wide substance abuse prevention efforts.

	There were several collaborating partners in the needs assessment and strategic planning process.  All of these collaborating partners played crucial and vital roles in data gathering, decision making, advising, and strategic planning.  Several are members of the York County Prevention Collaborative while others were participating attendees to the Strategic Planning Summit.  The following is a list of people and/or organizations that were represented in this process:

•	Alliance for Healthy Families
•	Caring Unlimited
•	Child Abuse Prevention Council
•	Coastal Healthy Communities Coalition
•	University of New England
•	Community Wellness
•	KEYS Coalition
•	Counseling Services, Inc.
•	Day One
•	Northern New England Poison Center
•	Parent Resource Center
•	Partners for Healthier Communities
•	Goodall Hospital
•	Pediatric Evaluations for Developmental Solutions Clinic
•	Southern Maine Medical Center
•	Project AWARE
•	Sexual Assault Response Services of Southern Maine
•	Towns of Kennebunk-Kennebunkport Youth Services
•	University of Maine Cooperative Extension
•	United Way of York County
•	Saco Police Department
•	Maine State Police
•	District Attorney’s Office
•	York County Recovery Associates
•	York County Shelter, Inc.
•	Sanford-Springvale YMCA
•	York Hospital

Description of Planning Team and Process (including data and information used)

	Within the larger York County Prevention Collaborative, a subcommittee was established to govern the day-to-day work of the SPEP grant.  This subcommittee was dubbed the OSA Grant Work Group or Work Group as it was commonly called.  The Work Group was the primary decision-making body for the SPEP Grant.  The Work Group was facilitated by the York County SPEP Project Coordinator, Scott M. Gagnon of Day One.  It was the duty of the Project Coordinator to facilitate the meetings and to be the primary data gatherer and analyst.  The Project Coordinator also set up and co-facilitated focus groups and wrote the key informant survey that was administered to gather additional information.  It was also the duties of the Project Coordinator to file the quarterly and final reports to the Office of Substance Abuse.

	The Work Group also had six members from the York County Prevention Collaborative.  Their roles were to advise the Project Coordinator in the areas of data gathering, focus group and survey implementation, and Strategic Planning Summit planning.  Also, various members of the Work Group aided in co-facilitating focus groups and key informant survey distribution.  The Work Group members served as a strong and vital knowledge base and networking component for the grant work. 

	The following people made up the Work Group.  Margaret Jones is the Director of Prevention Services at Day One.  She served as the direct supervisor for the Project Coordinator who was based in the Day One offices.  Barbara Wentworth is the Director for Community Building at the United Way of York County.  Her organization also provided office space for the Project Coordinator.  Cyndi Amato is the Executive Director of the Sexual Assault Response Services of Southern Maine.  Emily Rines is the Director of the Coastal Healthy Communities Coalition and also a representative of the University of New England.  Kendra Lychwala is an Assistant District Attorney for York County.  Lauren Edstrom is a member of the Maine State Police based in Alfred, in York County.  

	In addition to the direct reporting to the Work Group, the Project Coordinator also reported work progress to the larger York County Prevention Collaborative at its monthly meetings.  Members of this organization, who are listed in an earlier section, also provided valuable knowledge, expertise, and networking to the Project Coordinator and the Work Group.   The YCPC also provided some decision making during the process.  The primary focus of the YCPC was in planning the Strategic Planning Summit.  The YCPC is co-chaired by Mari Jo Allen, Executive Director of the Pediatric Evaluations for Developmental Solutions Clinic at SMMC, and by Rachel Phipps, a Youth Services Coordinator for the towns of Kennebunk and Kennebunkport.  

Processes Used to Interpret Information and Make Decisions

	One of the important jobs of the Project Coordinator was to gather existing data on substance abuse consumption and consequences from various sources.  Some of this data was provided in a County Profile developed by Hornby Zeller Associates.  Additional information was gathered from various sources such as the Office of Substance Abuse, Uniform Crime Reporting, Fatality Analysis Reporting System, the CDC, SAMHSA, Maine State Planning Office, area Hospitals, the Northern New England Poison Center, and others.  

	The data was gathered, collated, and analyzed as appropriate.  As data was compiled it was presented to the Work Group during its monthly meetings.  Trend data in substance consumption amongst the various subpopulations were analyzed as was trend data for consequences such as treatment admissions, crime data, traffic fatalities, etc.  Initially data was gathered from a wide spectrum of age subpopulations.  However, as time went on, the priorities, age-wise, were narrowed.  This decision was made based upon the amount of information available.  In addition, York County had to consider future funding for any strategic planning, and thus the county had to consider what priorities the State was developing.  

	By spring, after additional data was gathered through focus groups and a key informant survey, the Work Group and the YCPC designated the priority areas for York County.  This was done through synthesizing the data presented by the Project Coordinator and Work Group and using that information to determine how to best focus the upcoming Strategic Planning sessions.  All decisions by the YCPC, as a body, are carried out by a voting process.  This same process was utilized for all appropriate decisions regarding the SPEP Grant work.   

	There was another level or scenario of decision making when it came to crafting the strategic plan.  After all of the data was gathered and prepared for the needs assessment, the YCPC held a Strategic Planning Summit.  There were 48 attendees at the summit which included a wide variety of substance abuse prevention professionals as well as some students and citizens.  At this summit, the Project Coordinator presented all of the collected data and outlined the priority areas that had emerged, as was agreed upon by the Work Group.  The Summit was facilitated by Steve Ridini who did a presentation and guided the participants through the Strategic Prevention Framework model.  At the conclusion of this presentation, the Summit attendees were divided into the various priority areas.  For example, there was a group that dealt with underage drinking, another who considered non-medical prescription drug use amongst youth, and so on.  Within each priority area, intervening variables were identified.  This was all put together into logic models for each priority area and blown up on newsprint.  Each group was charged with coming up with strategies that would address specific intervening variables within their priority area.  The suggestions were written down on stick-on notes.  
	
	After the Summit was held, the logic models with the strategies were taken back to the Day One offices and the information was collated into a master strategy document.  It was from this master list that the Work Group then narrowed down the strategies that would go into the final Strategic Plan to be submitted at the end of June.  Along with the strategies, was included capacity building measures and some initial benchmarks to use to evaluate progress made on the strategic plan.  

Prioritization of Goals and Objectives (What are the priorities and why?)

	After we gathered our additional data from focus groups and the key informant survey, we combined it with the collected existing information to form a corpus or body of data.  The data was presented to the Work Group which subsequently implemented a prioritization session.  In this process the Work Group considered the priority consumption and consequence areas to address and then the connected intervening variables.  The four priority areas that emerged, in terms of consumption and consequences, were underage drinking, high risk drinking amongst young adults, non-medical prescription drug use amongst youth and young adults, and marijuana consumption among youth and young adults.  

	The next step was to take these priority areas and to then prioritize the related intervening variables for each category of substance abuse.  The process of the intervening variable prioritization considered two factors.  Those two factors were importance and changeability.  Each intervening variable was examined and assessed to how high of importance the intervening variable was and how likely strategies were to make any change or impact on the consumption and consequences.  

	The priorities in terms of consumption and consequences emerged from the patterns in the data.  In both MYDAUS data and survey data for young adults, we saw high rates of consumption amongst the young populations for alcohol, marijuana, and prescription drugs.  In addition, the information we gathered in our focus groups confirmed these three substances being the most consumed and with the greatest widespread availability to York County young people.  Our key informant surveys that were administered to 30 York County professionals in the substance abuse field also indicated these to be the top three substance of choice for the younger populations.  

	The prioritization of objectives, or intervening variables, was driven by the data.  The objectives that made it to our strategic plan were those that emerged as priorities as we examined trends and correlations and listened to what participants in the focus groups were telling us.  For example, with underage drinking it became clear that parental monitoring, enforcement, access, and knowledge of health risks were key influential elements in the consumption and consequence patterns.  The themes were evident in multiple data sources that were gathered.

York County SPEP Strategic Plan

Problem Statement: High incidence of under age drinking, binge drinking and negative consequences from alcohol use for 12-17 year olds.  
Goal:  Reduce high risk drinking among youth 12-17 years old

Objective/Intervening Variable	Strategy	Capacity Building Actions	Benchmarks	
Parental Monitoring	1. Parent education on laws and liability.
2. Underage drinking task force	-Coalition building and collaborating especially for #2.	Formation of underage drinking task force.
Obtaining task force grant(s).	
Knowledge of Health Risks	1. School based substance abuse counselors.
2. Alcohol education—early intervention for students	-Collaborate with OSA and State regarding substance abuse counselors.	Compile and review information and/or resources	
Access to alcohol	1. Parent education on laws and liability.  With elements of media literacy and brain research woven in.
2. Educating older siblings on laws and liability.
3. Sticker Shock Program	-Collaboration with school districts.
-Collaboration with OSA and others in regards to procuring or creating materials.	Distribute materials and/or hold information sessions with parents and older siblings from every school district in York county.	
Enforcement	1. Parent education on laws and liability—emphasis on parent enabling behaviors.
2. Educate law makers; need to be on same page as law enforcement.
3. Sticker Shock Program	-Relationship building with lawmakers and enforcement officials.	Making contact and establishing a communication channel with York County lawmaker(s).	

Problem Statement: High incidence of high risk drinking, binge drinking and negative consequences from alcohol use for 18 to 25 year olds.  
Goal:  Reduce high risk drinking among young adults aged 18 to 25.

Objective/Intervening Variable	Strategy	Capacity Building Actions	Benchmarks	
Knowledge of Health Risks	1. Alcohol education—early intervention for students.
2. Outreach to business community about alcohol abuse and impact on companies.	-Building and establishing relationships with business community.

-Find materials to distribute to schools.	1. Workshop(s) to employees and/or employers on health risks of substance abuse.	
Promotion 	1. Developing collaboration around marketing and promotion
2. CMCA (this is being funded and implemented by HMPs)	-Partner and collaborate with colleges in York County.
-Partner and collaborate with HMPs.
	Establishing connection(s) with colleges such as UNE, YCCC.	
Family	1.  Colleges reaching out to parents about ability to impact behavior and informing them on campus policies (if they aren’t already doing so)	-Outreach to York County colleges.	Connecting with college representatives and reviewing current outreach to parents.	
Retail Sales/Over-service	1. Educate bar owners about relationship between consumption & sexual assaults & violence.
2. Accountability to bar owners for over-service and resulting injuries and death.  Server training on server practices.	-Outreach to bar owners and retailers.	Establishing communication and/or partnership with bar owners and retailers.	

Problem Statement: High incidence of non-medical prescription drug use amongst youth and young adults.
Goal:  Reduce non-medical prescription drug use amongst youth and young adults.

Objective/Intervening Variable	Strategy	Capacity Building Actions	Benchmarks	
Access and Availability	1. Public education to physicians and community.
2. Promoting the Prescription Monitoring Program to physicians in York County.  Work with State and OSA to raise visibility and utility of PMP.	-Outreach to physicians and medical community.
-Work with the State and OSA to develop strategy to raise awareness of PMP.	1. Recruiting a physician(s) to YCPC
2. Establishing a Lock it up campaign
3. Increased usage and awareness of PMP.	
Knowledge of Health Risks	1. School based substance abuse counselors.
2. Early education/early intervention 	-Collaborate with OSA and State regarding SA counselors.  
-Collaborate with Project AWARE	Compile and review information and/or resources	
Enforcement	1. Capacity building/collaboration with Law Enforcement
2. YCPC outreach/activities to raise awareness of enforcement issues.	-Collaboration with law enforcement	1. More law enforcement representation or perspective on YCPC.
	
Parental Monitoring	1. Review current parent model programs and see where prescription drugs can be worked in.
2. Programs for Parents of teenagers
3. Youth driven strategies	-Review current model programs.
-Partner with HMPs in their efforts to impact non-medical Rx drug use.
-Collaborate with Project AWARE	Identify current model programs with potential to integrate prescription drug education.	

Problem Statement: High incidence of marijuana consumption amongst youth and young adults.
Goal:  Reduce marijuana consumption amongst youth and young adults.  

Objective/Intervening Variable	Strategy	Capacity Building Actions	Benchmarks	
Knowledge of Health Risks	1.  Peer support networks
2. School based substance abuse counselors.
3. Educate school personnel; drug affects, change school culture.	-Collaboration and relationship building with schools.  

-Collaboration with OSA and State regarding substance abuse counselors.	Compile and review information and/or resources	
Parental Monitoring	1. Parent education
2. Collaboration between parents and schools.	-Collaboration with schools and parents.	Establishing communication between parents and schools (e.g. school sponsored/hosted forum for parents)	

Capacity Building Priorities

There are some capacity-building measures that will be undertaken in the process of putting the strategic plan into action.  One of the important areas for capacity building will be further strengthening the internal county linkages.  When this grant was started there were some communities in York County that were identified as being missing at the table.  These communities were Cornish, Limington, Bar Mills and Parsonsfield.  This will begin to be remedied by reaching out to the school community for participation in the strategic plan and to garner partnership in the form of sharing school-level MYDAUS data.

	Another area to address will be cultural competence.  There are some refugee immigrant populations in a few York County communities including the Biddeford area.  It will be important to make sure their voices are heard in this process and to look for ways to engage them in the implementation process.  For the purposes of this grant, materials and information from the SPF SIG Cultural Subpopulation study on Sudanese and Cambodian refugee immigrants will be incorporated.  

	Finally, the area of sustainability will require continuous capacity building.  Through the Healthy Maine Partnerships there will be some funding that will fuel prevention efforts in the areas of high risk drinking and prescription drug misuse.  However, this will not address all of the priority areas and intervening variables identified in the needs assessment.  It will be important for York County to continue to look for sources and avenues to support the strategies it has identified.

Action Plan

	In terms of action planning, the Healthy Maine Partnerships will be addressing some of the intervening variables and objectives that were identified in the SPEP Assessment Process.  Indeed, it was the SPEP Needs Assessment that was a main data and information conduit for the recent HMP RFP process.  As such, many of the Year One activities will be undertaken by the three Healthy Maine Partnerships that operate in York County.  The York County Prevention Collaborative will play support roles in these activities wherever possible and appropriate.

	Beyond the activities initiated by the Healthy Maine Partnerships, there will be objectives that are not addressed by their efforts that were identified in the SPEP Needs Assessment.  For example, the priority area of marijuana abuse is not a part of the OSA funded objectives in the RFP.  The York County Prevention Collaborative will continue to go forward with those objectives and strategies outlined in the Strategic Plan that are not addressed by the Healthy Maine Partnerships.  The first step in this process will be to hold additional summits or work sessions with those who attended the Strategic Planning Summit.  Indeed plans are already underway to convene another summit or work session later this summer.  In this next gathering, more specific conversations around the objectives, not being funded by OSA in the HMP r.f.p. process, will be held.  

Here are the activities being undertaken in year one:
Objectives	Prevention Activities and Capacity Building Activities	Timeline	Who is Responsible	
Increase effectiveness of local underage drinking law enforcement policies & practices	Implementation of CMCA model. 
– Assess law enforcement policies and practices.
– Develop a plan to address policies and practice issues.
– Capacity building measures by recruiting for task forces.	Varies by HMP	HMPs	
Increase use of recommended parental monitoring practices for underage drinking	Under the CMCA model, create parental monitoring taskforce.
– Assess best practice parental monitoring component to deliver through community education channels.
– Identify budget and resources needed. Create timeline and decide what indicators will be used to measure success.

	Varies by HMP	HMPs
OSA manger (lead)
Day One
Coalition Director
Prevention Specialists	
Increase effectiveness of retailers policies and practices that restrict access to alcohol by underage youth,	Under the CMCA model, work with Prevention Specialists and teen groups in community (e.g. Natural Helpers, Captains club, etc.)
– Assess what stores should be targeted, which have liquor violations, which are located close to schools and other areas where youth congregate.
– Develop team and community driven plan to implement sticker shock. Identify resources needed. Create timeline
– Implement and advertise Sticker Shock activities.	Varies by HMP	HMPs
OSA Staff (Lead)
Coalition Director
Prevention Specialist	
Reduce appeal of high risk drinking by increasing knowledge of the health risks	Under the CMCA model, work with natural helpers and other peer education organizations
– Assess what schools have natural helper programs and what schools are interested in starting new programs where one doesn’t exist. Assess what schools Project Aware performs at.
– Develop a plan including a timeline and resources needed. Select indicators of success to track.	Varies by HMP	HMPs	
Decrease promotions and pricing that encourage high risk drinking among young adults	Under the CMCA model, create 18 – 25 year old task force
– Assess best practice strategies to decrease promotions and pricing that encourage high risk drinking among young adults.
– Develop a plan to implement to-be-selected best practice program (Year one & two).
– Work with local bars and establishments to adopt policies related to visibility of marketing and promotions.	May 2008	HMPs	
Increase effectiveness of school substance abuse policies	Work with underage drinking taskforce, prevention steering committee and comprehensive substance abuse prevention plans.
– assess what policies contain, and what they need to address.
– develop a plan to change the policies, including a time line and recruitment of local school key players.	On-going	HMPs	
Reduce availability of prescription drugs for purposes other than prescribed, by increasing prescribers and dispensers awareness of and use of the Prescription Monitoring Program based on assessment-based local substance abuse prevention priorities	Identify key stakeholders.  Outreach to local Physicians
– Recruit a physician to the York County Prevention Collaborative

Assess what local practices are currently using the Prescription Drug Monitoring Program (if any) and to what extent.  

Develop a plan to increase awareness of the PMP program.
	TBD	HMPs
YCPC	
Reduce appeal of misuse of prescription drugs by increasing knowledge of health risks	Look for ways to use CMCA model to educate parents on ways to keep children away form prescription drugs.

Present Project AWARE production “Falling” and look for best ways to utilize this resource.  	Fall 2007	YCPC
HMP
Project AWARE	
Increase the number of employers with a substance abuse priority population workforce who use the HMP Worksite Health Framework to address underage/high risk drinking and misuse of prescription drugs	Work with Action Team and CMCA subcommittee to identify key worksite stakeholders. 
– Assess what worksites may be working on Drug Free Workplace Policies
– Develop an Action Plan to increase the number of worksites that know about Drug Free Work Policies.
	January 2008	HMPs	

Sustainability

	There will be two important keys to the sustainability of the strategic plan that has emerged from the SPEP grant.  Those keys are further communication/collaboration and funding resources.  Both of these elements will be necessary to keep the momentum and energy that have been created and to ensure that the priority areas and objectives for York County are being addressed in the time to come.
	
	There are already plans and mechanisms in place to sustain the communication and collaboration piece of the strategic plan.  When the Strategic Planning Summit was held in May, a database of attendees and participants was created, complete with e-mail addresses and phone numbers.  This will be an important tool in keeping the lines of communication open throughout York County.  Utilizing this database, the York County Prevention Collaborative is in the process of planning a follow up meeting of the Summit attendees.  It will be more of a work session where the aim will be to hammer out more specifics as far as the implementation of the strategies that have been outlined in this plan.  There will be discussions of timelines, responsibilities, and the researching of funding sources to initiate strategies that will not be implemented by the Healthy Maine Partnerships’ OSA funding.  In the next few weeks the Work Group and the York County Prevention Collaborative will be finalizing plans to hold this meeting and then subsequently discuss further opportunities to have this larger group of prevention professionals meet, collaborate and continue with the implementation of the identified strategies.  

	The York County Prevention Collaborative, itself, will also continue to hold its monthly meetings.  While the Collaborative does specialize in multiple areas of prevention, the substance abuse component will be a primary focus and it will continue to devote time and energy to the objectives in the strategic plan.  It will collaborate where appropriate with the Healthy Maine Partnerships as they implement their OSA-funded strategies.  Between the YCPC and the larger group of the Strategic Plan collaborators a significant energy has been created to carry out these strategies to reduce substance consumption amongst the young and young adults in York County.  

	The other key element in sustainability will be funding.  As mentioned earlier, some of the strategies and objectives that have been identified in the SPEP Needs Assessment process will be taken on by the three Healthy Maine Partnerships in York County.  This will be done through the OSA funding that was braided into their funding stream.  The three Healthy Maine Partnerships in York County will be using this funding to implement strategies that will target under age drinking, high risk drinking, and non-medical prescription drug use amongst youth and young adults.  However, the SPEP project itself identified more objectives and priorities than will be addressed by the HMPs.  As such, it will be necessary to seek out funding sources for those strategies that are not under the HMP umbrellas.  

	Part of the first steps for the strategic plan will be to research and find potential funding sources for some of these strategies.  This will be one point of business in the future meetings of the larger group of Strategic Plan collaborators.  The York County Prevention Collaborative, and its member organizations such as Day One, will continue to keep an eye on emerging funding possibilities and identify those which will best address the objectives and strategies identified in this strategic plan.  
	
	While no specific funding sources have been identified at this time, the YCPC and its member organizations are aware of different avenues to find potential funding sources for the strategic plan.  A couple of examples are the Robert Wood Johnson Foundation and Healthy Communities – Healthy Youth.  The YCPC will focus on potential funding sources such as these who have interests in aiding coalitions in prevention efforts.  The fact that the York County Prevention Collaborative has a broad scope of prevention efforts gives it a variety of approaches to take when it comes to finding funding.  In addition many of the YCPC member organizations are part of the Statewide Prevention listserv, which posts new funding sources as they become available.  As potential funding sources are identified, and deemed appropriate to the strategic plan, they will be brought to the YCPC and the larger strategic plan collaborators for consideration.  

Appendices: (being sent as separate attachments):

Assessment Plan

Summary of Key Findings Data

Signed Memorandum Of Understanding by the York County Prevention Collaborative Co-chair.  Agreed to by unanimous consent by the YCPC