► Collected data from regular/expected sources: Collected data from regular/expected sources: California Health Kids Survey (CHKS)California Health Kids Survey (CHKS) California Health Information Survey (CHIS)California Health Information Survey (CHIS) CalOMS Pv/CalOMSCalOMS Pv/CalOMS

► Expanded data collection/search to other local Expanded data collection/search to other local sourcessources

Other Departments/Divisions within the County (mental Other Departments/Divisions within the County (mental health, public health, aging)health, public health, aging)

Other healthcare organizations (local hospital, emergency Other healthcare organizations (local hospital, emergency rooms)rooms)

Enforcement of local laws/regulations (social host, Enforcement of local laws/regulations (social host, compliance checks)compliance checks)

► Missing dataMissing data Clearly identified exact data points/sources of information for Clearly identified exact data points/sources of information for

things that we wanted to know, but were not availablethings that we wanted to know, but were not available Who would collect this data? What would it look like? What Who would collect this data? What would it look like? What

would it tell us?would it tell us?

► Conducted Focus Groups/Key Informant Conducted Focus Groups/Key Informant InterviewsInterviews

Helped to fill in the gaps of some of the missing Helped to fill in the gaps of some of the missing datadata

Qualitative information about social norms, Qualitative information about social norms, perspectivesperspectives

Occasionally connected to other data sourcesOccasionally connected to other data sources

► Making Sense of the DataMaking Sense of the Data Pooled the data togetherPooled the data together Worked with an evaluator to pull key data Worked with an evaluator to pull key data

points, sections from reports points, sections from reports Created an organized “structure” for the data Created an organized “structure” for the data

by sourceby source Looked again at what was “missing” Looked again at what was “missing”

(communities, gender, ethnicity)(communities, gender, ethnicity) Worked with Epidemiology program to probe Worked with Epidemiology program to probe

for strengths/weaknesses of the datafor strengths/weaknesses of the data

►Reviewed the dataReviewed the data Created committees/workgroups of local Created committees/workgroups of local

providers, partners, County staffproviders, partners, County staff Chance for partners to dig into the data, Chance for partners to dig into the data,

ask questions, make some initial ask questions, make some initial interpretationinterpretation

Asked partners to identify data “a-ha’s”Asked partners to identify data “a-ha’s” Pooled the highlights – conducted several Pooled the highlights – conducted several

small group exercises to determine what small group exercises to determine what the “a-ha’s” meantthe “a-ha’s” meant

Looked again at what was “missing”Looked again at what was “missing”

► Reflecting/PrioritizingReflecting/Prioritizing Collected additional dataCollected additional data Reviewed/Prioritized the “a-ha’s”Reviewed/Prioritized the “a-ha’s” Creative exercise – what “story” are the “a-Creative exercise – what “story” are the “a-

ha’s” telling usha’s” telling us► Developed key words/phrasesDeveloped key words/phrases► Any connection to the other data “a-ha’s”Any connection to the other data “a-ha’s”► Created rough problem statementsCreated rough problem statements

Reviewed the problem statements with the Reviewed the problem statements with the larger grouplarger group

Follow-up – were any from the various Follow-up – were any from the various committees connected?committees connected?

Combined/Integrated similar “problem ”issues”Combined/Integrated similar “problem ”issues”

► Resulted in the following Resulted in the following draftdraft statements: statements:

Overview: Areas of Focus and ThemesOverview: Areas of Focus and Themes

Impact Norms and Perceptions

Improve System Capacity and Infrastructure

Implement Effective Services

• Substance abuse continues to be viewed primarily as a social problem, rather than as a health condition.

• There are pervasive high-risk patterns of alcohol, tobacco and other drug use across Marin

• Youth have easy access to alcohol, tobacco and other drugs from social sources

• There is a lack of consistent adherence to and implementation of alcohol, tobacco and other drug laws and policies

• There is a lack of consistent early identification, screening and referral of alcohol, tobacco and other drug problems, which reduces access to appropriate services

• There is a lack of communication, coordination and collaboration between departments and agencies

• Data collection in the alcohol, tobacco and other drug system of care is not consistent and does not support a continuum of care model

• There is a need to leverage alternative resources in order to maximize the provision of comprehensive alcohol, tobacco and other drug services

• Alcohol, tobacco and other drug services are not consistently tailored to specific client needs and considerations, such as economic, gender, age, language, geographical, racial, cultural and situational issues

• Alcohol, tobacco and other drug programs and services are not consistently incorporating evidence-based practices

• The lack of coordination, communication and collaboration across departments and agencies, which is not consistent with a chronic disease and continuum of care model, limits access to and delivery of effective services

Alcohol, tobacco and other drug use, abuse and addiction range in intensity from experimentation to severe and life-threatening chronic medical conditions. Therefore, alcohol, tobacco and other drug-related problems can be most

effectively prevented, treated and/or managed through providing a continuum of prevention, treatment and recovery support services.

Overall Philosophical

Approach

Strategic Direction

Priority Problem Statements