Project for Rural Access to Substance Abuse Treatment

Topics	Substance and alcohol abuse
States served	California
Description	The Mendocino County Department of Public Health's Division of Alcohol and Other Drug Programs (AODP), in collaboration with two health clinics and several community-based organizations, developed the Program for Rural Access to Substance Abuse Treatment (PRASAT) to provide substance abuse treatment, primary medical care, childcare, and transportation assistance to residents in rural areas of the county. PRASAT had three goals: (1) to prevent and reduce substance abuse by providing treatment in selected rural areas to people who cannot afford to pay; (2) to improve client health by addressing medical problems associated with substance abuse among those unable to pay for their medical treatment; and (3) to improve clients' economic standing by providing referrals to vocational preparation and job placement assistance.
Services offered	Clients were referred to alcohol and other drug (AOD) treatment by clinic physicians, emergency rooms, family members, public health nurses, social workers, probation and the courts, and through community outreach and self-referrals. Treatment began with a medical, chemical, psychological, and social assessment. Using the Development Treatment Model, counselors developed a comprehensive treatment plan that included goals and action steps geared toward the client's life and cultural issues and addiction. The provision of the medical examination and treatment at no cost to the client was one of the most innovative features of the program and was an effective incentive for clients to seek and begin substance abuse treatment. Each patient received an initial health assessment that addressed routine primary health care needs followed by treatment progress monitoring through chemical testing for substance abuse. Clients also received assistance in accessing medical benefits including the State-funded California Medical Service or Medi-Cal.
Results	Significant challenges to the program went unsolved. Despite efforts by consortium members to recruit a bilingual, Spanish-speaking substance abuse counselor at one site, no qualified applicant was found for the position. Data collection also posed a challenge. Because each site served a unique clientele in a unique community, it was difficult to standardize collection of program data. A revised monthly reporting format was scheduled to begin in July 2000; however, counselors were still not using it uniformly. During the no-cost extension year of the grant, PRASAT will work to solve these issues.
Replication	PRASAT meets a need for substance abuse and medical treatment in isolated rural communities where treatment is not available, and could be replicated in other rural areas in the United States. An important component of replicating this program is the ability to network with community health centers so that health services can be offered along with substance abuse treatment. Engaging clients and helping them to better understand their addiction and how it affects their physical health is more effectively achieved when the program partners and providers in the network understand the program model. Therefore, it is essential that the consortium establish protocols for the medical component of the program at the outset and that all partners are uniformly informed. Clinics that are new to providing substance abuse treatment services will need a standardized system to measure and report clients' treatment progress.
Source	Outreach Sourcebook, Vol. 9, 1999-2002, Office of Rural Health Policy
Contact person	Judith Tauber, Program Coordinator Department of Public Health, Division of Alcohol and Other Drug Programs 1120 South Dora Street Ukiah, CA 95482 Phone: (707) 472-2606 Fax: (707) 472-2658

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