Sunday, February 28, 2010

Low wage earners in Western New York live on the edge

The University at Buffalo Regional Institute has released a policy brief in February, 2010, which describes the plight of low wage earners in Western New York.

Here is part of what the press release says about the report:

From cashiers to child care workers, low-wage jobs are filling a growing segment of the Western New York economy, placing more and more Western New Yorkers on the brink of poverty, according to a policy brief released today by the UB Regional Institute.

Between 2004 and 2008, jobs in low-paying occupations, with average annual wages below $30,000, increased 17 percent, while middle-wage jobs ($30,000-$70,000) declined 10 percent. In 2009, one in four jobs was in an occupation with median annual wages below $22,000, the federal poverty line for a family of four.

A little further the report says:

The brief presents a range of measures of poverty and low-wage work. For example, a full-time job at minimum wage garners just over $15,000 a year. The federal poverty line sets $14,570 as the threshold for a two-person family, well below the $36,000 "living wage" to meet basic needs for a single parent and child, as estimated by Penn State's Living Wage Calculator.

A full time worker making minimum wage of $7.25/hr makes $15,080.00 per year.

The poverty level for one person is $10,830.00
The poverty level for two people is $14,570.00
The poverty level for three people is $18,310.00
The poverty level for four people is $22,050.
The poverty level for five people is $25,790.00

Only 10 of GCASA's 89 employees make over $40,000.00 per year. The remaining 79 employees average $26,5000.00 The median wage for jobs in Western New York in 2009 was $31,810.00.

Many of GCASA's employees are living at or below the poverty level. This has huge implications for workers and their families, for the communities in which they live, for government which contracts for GCASA's services, and for civic organizations which must provide a safety net and support services for families struggling.

You can access the report by clicking here.

Saturday, February 27, 2010

State Trooper George Cameron wins award for DWI arrests in Madison County

From the Oneida Daily Dispatch on 02/24/10:

Of the 365 driving while intoxicated arrested made in Madison County last year, New York State Trooper George Cameron was responsible for making 30.

For the second year in a row, Cameron, stationed out of the Sullivan Troopers office, was awarded the Karl Taylor Award at the 22nd annual Law Enforcement Day Luncheon.

The award is handed out each year to the law enforcement officer with the most DWI arrests in honor of former Madison County Deputy Sheriff Karl Taylor, who handled more than 950 DWI arrests in his 21 years of service.

The good work of our law enforcement officers have made New York State the safest state in the United States to drive in as far as DWI fatalities are concerned.

Thanks to Trooper Cameron and all the other police officers who do a great job every day keeping our roads safe.

Friday, February 26, 2010

The seven Cs for Children of Substance Abusers

While there have been articles before on this blog about Adult Children of Alcoholics and Substance Abusers, we have been derelict in not mentioning that the Children of Alcoholics Week was on February 14 - 20th.

Almost 50% of GCASA's 1050 admissions in 2009 identified themselves as having been children of substance abusers. We know that there is a 4 to 5 times greater chance that children of substance abusers will become substance abusers themselves.

It is valid to describe substance abuse as a family disease. The substance abuse not only affects the person who is abusing substances but all the people that that person has relationships with and the more intense and involved those relationships the greater the negative consequences.

One of the prevention models to help children who are growing up with substance abusing parents is to teach them the 7 Cs:

You didn't cause it,
You can't control it,
You can't cure it,
Take care of yourself,
Communicate your feelings
Make healthy choices
Celebrate yourself.

The first three are especially important.

Check out the National Association of Children Of Alcoholics by clicking here.

GCASA has many services for children of alcoholics. For more information contact Maryann Bowman, the Director of Prevention, at 585-815-1877

Thursday, February 25, 2010

The tragedy of DWI ripples out from the scene of the crime

From the McClatchy News Service on 02/23/10:

As a bailiff carted 24-year-old Jennifer Cowgill off to prison, Gracie Smith asked if she could give Cowgill, her brother's killer, a hug.

Cowgill never got that hug, but she wiped away tears with shackled hands as family members of 51-year-old Irvin Tefertiller stood and offered her their forgiveness.

Cowgill was sentenced Monday to 15 years in prison for hitting Tefertiller while driving her sport utility vehicle with marijuana and alcohol in her system, then fleeing barefoot from the crash in east Modesto last May.

Honey, you didn't leave victims on one side of the room. You left them all over," Smith said, as Cowgill's 5-year-old son bounced on the laps of her family and friends in the courtroom.

Wednesday, February 24, 2010

DWIs in New York State carry increasingly harsh penalties

This comes from the New York Lawyers and Attorneys web site:

The penalties for a DUI in New York have become severe because the statistics show just how dangerous drinking and driving can be. For instance, 1/3 of all New York fatalities involve not only impaired drivers, but impaired pedestrians too! The statistics also show that, as a person’s blood alcohol concentration (BAC) level rises, so, too, do their rate of car accidents. Consider the facts that a driver with a .08 BAC is 4 times as likely to cause an accident, and a driver with a .16 BAC is 25 times as likely to cause an accident when compared to sober drivers. Therefore, in an effort to protect all drivers, New York has implemented some very harsh dui fines and dui penalties.

Your 1st drunk driving conviction brings a jail term of up to 1 year, fines from $500 to $1,000, plus a mandatory surcharge, and a 6-month minimum driver’s license suspension. In addition, alcohol screening and/or an alcohol evaluation will be mandatory. Depending on your particular circumstances, you may be required to install an ignition interlock device (IID) in your car, and you may need to undergo a driver responsibility assessment. And if there was a passenger under the age of 16 in your vehicle at the time of your New York DUI, you will be in violation of Leandra’s Law, which passed the New York State Senate on November 17, 2009, and states you will be charged with a Class “E” felony, be fined up to $5,000, and/or be jailed up to 4 years.

To read the whole article click here.

Tuesday, February 23, 2010

GCASA's staff numbers

After GCASA's downsizing GCASA is left with 89 staff.

61 work full time.

28 work part time.

12 staff members are 65 and older. Of these 5 work full time and 7 work part time.

Only 10 staff members make over $40,000.00 per year. The remaining 79 make an average of $26,500.00.

Monday, February 22, 2010

NIDA issues new report on Co-Occurence Of Drug Abuse and Other Mental Disorders

NIDA (National Institute On Drug Abuse) has issued a new report which discusses the Co-Occurrence of Drug Abuse and Other Mental Disorders.

You can read about it and access it by clicking here.

Sunday, February 21, 2010

College kids drink more than their age-related non-college peers

Volume 22, Number 6 of the NIDA notes has an article which discusses studies which appeared in the Archives of General Psychiatry and the Journal Of Adolescent Health which found that college students abuse alcohol more often than their same age non-college peers but that non-college peers were more likely to use drugs, smoke cigarettes, not use condoms, engage in casual sex, and reported high risk sex.

The article goes on to say that these differences seem more related to sociodemographic factors rather than education. It also found that non-college kids with substance abuse problems were twice as likely to use treatment resources than college students.

It seems that binge drinking is more a part of the college culture than among kids who don't go to college, but non-college kids engage in other risk behaviors at higher rates than their college peers.

This is article #2 on Underage Drinking.

Saturday, February 20, 2010

Quarterly recovery management check-ups help substance abusing patients with co-occurring psychiatric disorders

Quarterly Recovery Management Checkups seem to help patients who have co-occuring disorders of substance abuse and psychiatric stay on track according to an article in Volume 22, Number 6 issue of NIDA Notes. Here is what it says in part:

Recovery management checkups (RMC) aim to identify and alleviate client problems before they derail recovery and to facilitate rapid readmission to treatment when recovery falters. Quarterly appointments form the core of RMC.

New York State Office Of Alcoholism and Substance Abuse is supposedly looking at chronic care models for substance abusers. Current regulations make chronic care difficult to provide. It is interesting that chronic care seems to help substance abusing patients who also have psychiatric disorders.

Friday, February 19, 2010

Underage drinking in Genesee County has dropped over the last 5 years

Prevention efforts to decrease teen age drinking in Genesee County are working.

Genesee/Orleans Council on Alcoholism and Substance Abuse (GCASA) began administering the Prevention Needs Assessment (PNA) Survey every two years to 6th-12th grade students in Genesee and Orleans Counties in 2000.

We have been successful implementing strategies to reduce underage and binge drinking over the last four to five years.

In Genesee County, the rate for 30-day use of alcohol has decreased from 26.7% in 2004 to 23.2% in 2008.

Binge drinking rates have decreased from 16.2% in 2004 to 13.8% in 2008.

What is making the difference?

The Genesee County Drug Free Communities Coaltion is having an impact. We see progress. There is still a ways to go.

This is article #1 in series on Underage Drinking.

Thursday, February 18, 2010

Employment rates among GCASA's 2009 admissions

It is interesting that one of the indicators which OASAS (New York State Office Of Alcoholism and Substance Abuse) measures on its program Score Card is employment of people under treatment in OASAS licensed programs.

The rationale seems to be that if people deal with their substance issues they will be capable of maintaining or improving their employment. In the current economy and for many other reasons this is a dubious assumption, but nonetheless, it is one of the indicators which OASAS has chosen to track.

Of the 606 admissions to the Genesee County Clinic in 2009, 223 were employed either full time or part time. That's 37%.

Of the 341 admissions to the Orleans County Clinic in 2009, 118 were employed either full or part time which is 35%.

The other 2/3rds were involved in child care, disabled, retired, students, or looking for work. 25% of people admitted in Genesee County, and 30% of people admitted in Orleans County said they were unemployed and looking for work.

What does are this mean?

1. Most people don't have employer sponsored health insurance to pay for their care. The percentage is only about 17%. Most of the people getting care at GCASA are on Medicaid for a variety of reasons: they are poor, disabled, or caring for children.

2. A quarter to a a third of GCASA's patients indicate that they would like to work if they could find work. Many of GCASA's patients are poorly educated, involved with the criminal justice system, and have poor work histories due to their substance abuse disorders, and are not perceived as reliable and desirable employees making it very difficult for them to find employment.

3. GCASA counselors are being held accountable for producing a social benefit which they have little if no control over, the employability of their patients, which seems to be an inappropriate expectation.

4. While substance abuse disorders cut across all social classes, it hits the lower classes the hardest because they have so few resources to cope with the disease. When Lindsey Lohan, Brittany Spears, Robert Downey, Jr., Rush Limbaugh, Betty Ford, and other members of the elite run into trouble with substance abuse, they not only can pay for their expensive rehabs, but they have the income to tide them over their illness. Poor people suffer much worse and occasionally die.

5. Many people who have problems with alcohol and other subtances are referred to as "functional alcoholics" and many patients use their employment as a denial for the severity of their illness. "I go to work every day!" is a common rebuttal when they are questioned about their substance abuse. Indeed, going to work hung over or in withdrawal may be admirable and reduces absentism for the employer, but a substance abuser while even making it to work is more likely to have workplace errors, accidents, and interpersonal problems.

This is article #7 in a series on 2009 GCASA Admissions Data.

Wednesday, February 17, 2010

Organizational values matter

In the last issue of Resources, Vol. 9, No. 1 issue on Addiction Treatment and The Criminal Justice System, an article which is a transcript with Martin Horn the Retired Commissioner of Corrections and Probation for New York City had some interesting things to say which are worthy of broader circulation.

Mr. Horn points out that criminal justice staff often are ambivalent about alcohol and drug addiction themselves. These staff have difficulty modeling the behavior that they want inmates to follow. Here is part of what Mr. Horn says:

Click on image to enlarge for easier reading.

GCASA does not hire employees who are dependent on any substance including tobacco. GCASA was a pioneer in the field having this policy since 1999. Unfortunately, many addiction professionals still smoke which has created problems for GCASA when OASAS sends program analysts, and people providing technical assistance, to the agency to review addiction programs. When these reviewers are addicted themselves and reviewing programs in which they would not be eligible to be employed due to their addiction, it seems very dysfucntional.

OASAS adopted tobacco free regulations which were to be implemented in July of 2008 in all OASAS licensed facilities. GCASA applauds this step forward. However,OASAS seems to have the same problem which Mr. Horn describes when he describes staff ambivalence toward drugs and alcohol themselves and they model behaviors which other staff are working to help clients change.

It makes one wonder about State and County government hiring people to work in jobs where their behaviors are a trigger for the very inmates, clients, patients they are attempting to help. It is incumbent upon human resource management, supervisors, and administration to deal with these contradictions in an honest and constructive way. GCASA did it 11 years ago and we continue to address it as it poses an impediment to a safe and healthy environment for communal living and working.

As Mr. Horn says a little further, organizational values matter.

"There are many things in this business that we don't talk about. We don't talk about sobriety and drug use, alcohol use; we don't talk about issues of gender and gender boundaries. We don't talk about issues of race. In my experience, if the leaders of the organization don't talk about it, then nobody will talk about it, So it is incumbent upon leaders to make this part of everything. Whenever they speak, they have to speak about the values of the organization, and the organization has to have a value orientation."

I appreciate Mr. Horn's candidness. When GCASA asked OASAS not to send addicted staff to review its programs, the Executive Director was told he has "balls as big as an elephant" to make this request. Being the Executive Director I can assure the reader that I do not have "balls the size of an elephant" but I am charged to exemplify GCASA's values and to teach, model, and hold accountable GCASA's collaborative partners to respect them if possible. I appreciate OASAS respecting GCASA's request so far.

Are you braver than you think

Doing the right thing often takes faith and courage. It takes bravery to stand up for what you think is right, just, true. People will often retaliate by giving you a hard time. You probably are braver than you think.

Raising the drinking age to 21 has saved 864 lives of kids 20 and younger every year

There has been some talk, especially among college presidents, of lowering the drinking age to 18 again.

These folks don't want the responsibility of policing the binge drinking on their campuses which results in deaths, rapes, assaults, property damage, and disorderly conduct.

However, the public health research has demonstrated that raising the drinking age to 21 and enforcing strictly underage drinking and driving laws saves 864 lives of people 20 and under in the United States every year. That's a lot of kids.

There was an interesting article in the Winter, 2009 issue of the newsletter from the Erie County Council for the Prevention of Alcohol and Substance Abuse which describes these findings.

Click on image to enlarge for easier reading.

Tuesday, February 16, 2010

The future of the addictions professional field

The latest issue of Resource Links, Vol.9, #1, on Addiction Treatment and the Criminal Justice System has an interesting article by New York State Office Of Alcohol and Substance Abuse Commissioner, Karen Carpenter-Palumbo entitled "New York's Drug Law Reform Highlights: Critical Need For Addictions Professionals.

Here is part of what she writes:

Click on image to enlarge for easier reading.

What the Commissioner doesn't mention is that Substance Abuse Counselor is #13 on CNN Money's list of most stressful and worst paid jobs in America. Social Work, by the way, is #1 and many Social Workers work in the Substance Abuse field.

Salaries for CASACs and other substance abuse staff are very poor and are not likely to attract many people into the field who aren't highly motivated by altruistic concerns. Most not-for-profit agencies don't pay much beyond poverty wages and provide very poor benefits.

While it is true that substance abuse staff who work in State and County agencies make a decent wage with decent benefits, those who work in community based not-for-profits make half what state employees make. There are many reasons for this.

While I share the Commissioner's optimism for the need for and the growth of addictions professionals, attention needs to be paid to reimbursement schemes for not-for-profit agencies that provide the bulk of substance abuse services in New York State. These jobs are very stressful, poorly paid, and provide poor benefits. It is hard to see how the system will prosper when its human resource management leaves a lot to be desired. With the Governor's Budget Deficit Reduction plan, there is little hope that increased funding will find its way to the substance abuse work force. Already, New York State has canceled its promise for a 2010 COLA (Cost of Living Increase) and a high placed OASAS official has told GCASA staff that OASAS would look unfavorably on a 2% raise for GCASA's already underpaid staff.

I wish I could share the Commissioner's optimism and I hope she is right, but down here on the front lines, in the trenches, I am not feeling it while wages and benefits for hard working and skilled addictions professionals are so low.

"Sin taxes" may be New York State's way out of its deficits

New York State is hurting for tax revenue right?

Soft drinks, loaded with sugar and few to no nutrients, contribute to obesity and other health problems, right?

Alcoholic beverages also contribute to many social problems from DWI deaths to rape, assault, property damage, etc.

Why not tax them to help cover the social costs which these substances incur to taxpayers in our health care and criminal justice systems?

Legalizing and taxing marijuana is a good idea too.

And while we're at it, let's increase the taxes on gambling.

If you want to play, you have to pay. Pay for the negative social consequences which such indulgences has on your fellow citizens.

Here is a neat advertisement which appeared in the Winter, 2009, issue of the Erie County Council For Prevention of Alcohol and Substance Abuse Newsletter.

Click on image to enlarge for easier reading.

Monday, February 15, 2010

Drugs - What's your choice?

Video lasts 5:14

Sunday, February 14, 2010

1/3 of GCASA's admissions have not achieved high school graduation

335 out of 1050 admissions to GCASA's treatment programs in 2009 did not finish high school or have a GED. That's 32%, 1/3 of GCASA's admissions.

Only 28 out of the 1050 or 3% had a Bachelor's degree or better.

What does this mean?

1. A significant number of GCASA's clients are functionally illiterate. They probably cannot read well enough to understand the paperwork they are signing on admission. Their ability to read and comprehend written materials is probably compromised in some way.

2. The ability of GCASA's clients to be employable is limited not only by their substance abuse histories, but by their relatively low levels of academic achievement.

3. GCASA is serving a population of poorly educated folks who will not do well in our current economy or participate positively in a democratic society which requires an educated and aware electorate.

4. What is the association of poor academic achievement and substance abuse? Did the poor academic achievement constitute a risk factor for the substance abuse disorder or did the substance abuse disorder constitute a risk factor for poor academic achievement? It is hard to know this for sure, but we do know that children with learning disabilities, Attention Deficit Disorder, and Behavioral Problems which contribute to poor school performance are at higher risk for the development of substancea abuse disorders.

5. How can GCASA's treatment services take into account the fact that 1/3 of its clients are poorly educated? These folks need a tremendous amount of help negotiating the more complex systems and bureaucracies that constitute our current world whether it be social services, health care, criminal justice, employment, etc. Many of GCASA's clients are badly in need of case management services because their skills in self sufficiency are limited and these folks need a lot of assistance. Unfortunately, these case mananagment services are what is called an "indirect service" that is not "medically necessary" and therefore is usually not a reimbursable service. Looking closely at the demographic characteristics of GCASA's admissions, clearly leaves the impression that GCASA is serving people whose social functioning is at the bottom level of the social strata. As such, these are the folks that need taxpayers help the most and GCASA is serving the people whom the agency is intended to serve, the folks who are at risk of all kinds of social problems without the resources, financial, psychological, social, to cope.

6. The populaton which GCASA serves is highly stigmatized in our society and this stigma often flows over onto the people who would attempt to serve them. The people that GCASA serves are often poorly educated, impoverished, involved in the criminal justice system, have poor health, and have difficulty in developing and maintaining constructive social relationships.

This is article #6 in a series on 2009 GCASA admission data.

Saturday, February 13, 2010

Jim Collins in his book, Good To Great, points out that exceptional executive leadership, is composed of the paradoxical blend of personal humility and professional will.

My old boss, Susan Costa, used to say, "We take our work seriously, but never ourselves."

Another supervisor, Dr. Susan McDaniel, said to me one time after observing a family interview I was conducting from behind a one way mirror. "It was a very good interview, Dave, very business like, very professional."

I said, "Good, great, thank you. What can I improve on?"

She said, "Well you were too professional, too business like."

I said, "Too professional? Too business like? What are you talking about?"

She said, "Dave I know you. You are warm, irreverant, have a good sense of humor. You were too serious in there. If you aren't having fun, you are not doing it right."

Her words lit me up like a light bulb. I had an epiphany. That was 30 years ago. And now, every time I feel stressed, anxious, frustrated, like I'm trying to hard, that this is too much work, I hear Susan McDaniel's words "Dave, if you're not having fun, you're not doing it right", and I lighten up, I look for the incongruity, the absurdiy, the humor in the situation. I catch myself taking myself too seriously, and this is always a mistake.

Lighten up!

This is aricle #6 in a series on Lessons In Management.

Friday, February 12, 2010

2/3rds of GCASA's admissions are involved in the criminal justice system

Of the 606 patients admitted to GCASA's Batavia Clinic in 2009 only 31.3% had no involvement in the criminal justice system. That means that 68% or 2/3rds did.

In the Orleans County clinic of the 341 patients admitted in 2009 only 33.9% had no involvement in the criminal justice system which means that 64% did.

The same percentages also occured in the Atwater Community Residence and even higher Criminal justice involvement, 75%, occured in Supportive Living.

What does this mean?

1. Increasingly, treatment is being used concurrently with other criminal justice programs. Is this a good thing? Probably. It costs over $35,000.00 per year to keep a person in State Prison and the person incarcerated cannot work, pay taxes, be available for their children, etc.

2. A great deal of staff time is spent on case coordination and producing documents for criminal justice agencies. This kind of collaborative programming gets good outcomes, but substance abuse agencies, in general, are not reimbursed for this kind of indirect service. This creates a huge burden on substance agencies and counselors. Perhaps GCASA's counselors should bill out their time at $125.00 like the criminal defense attorneys do.

3. GCASA is serving the people whom New York State and the counties are expecting us to serve. As I jokingly tell people, GCASA is not the Betty Ford Clinic. We are not set up to provide celebrity rehab to the Lindsey Lohan's and Brittany Spears and Robert Downey, Jr.s of the world. GCASA is set up to serve your family members, neighbors, co-workers when they get their DWIs, are arrested for possession, and family life turns into a distressful, dysfunctional nightmare.

4. The people whom GCASA serves come with many problems: substance abuse, legal, financial, employment, family, mental health, and health problems. The criminal justice systen is the last stop in our society for people who are socially downwardly mobile and whose functioning requires external supervision. These folks have messed up their lives to the extent that their behavior has become problematic and criminal for other people. GCASA becomes the agency to which these folks turn to put the pieces back together again, and/or get things on a more positive track. As you can imagine, this is a very challenging project. It is not a small thing for 2/3rds of GCASA's patients.

5. The medical model, upon which substance abuse service reimbursement is based, may not be the best way to pay for services which often have a very heavy psychosocial component. The Managed Care Organizations make it clear that they only want to pay for services that are "medically necessary". So many of the services which substance abusers need do not fit neatly into this category. Good substance abuse treatment often goes far beyond problems that could be described as "medically necessary" in the strict sense of the word. The expectations from various stakeholders from various perspectives for substance abuse services often leave counselors in a very conflicted and contradictory position having to respond to multiple agendas often which are working at cross purposes. Is it any wonder that CNN money listed substance abuse counselor as the 13th worst job out of 50 in the United States today?

This is article #5 in a series on 2009 GCASA Admission Data.

Thursday, February 11, 2010

GCASA's employees earn credentials

GCASA is very proud of three of its employees.

Laura Lynch and Charlene Grimm were notified last Friday, 02/05/10, that they have earned their CASAC credential, Credentialed Alcoholism and Substance Abuse Counselor.

Sherri Bensley earned her CPS credential, Credentialed Prevention Specialist.

Ms. Lynch,CASAC, and Ms. Grimm, CASAC, work in GCASA's Batavia Clinic, and Ms. Bensley, CPS, works in the Orleans County Prevention Program plus has designed and is the lead trainer for GCASA's server training program.

GCASA is proud of its high quality services provided by well educated, trained, and credentialed staff. GCASA works hard to support OASAS designed Credentialing programs and its employees in attaining credentials which attest to their high levels of knowledge and skill pertaining to dealing with substance abuse problems.

Wednesday, February 10, 2010

Bearing witness is a way to keep from going insane

I have been complaining a lot lately to OASAS officials, the Directors of Community Services in Genesee and Orleans Counties, our elected officials, etc.

Other staff at GCASA have expressed concerns that my complaining not only will do no good, and fall on deaf ears, but may even engender retaliation. I am surprised at the number of people who are afraid to express their opinions and to "call a spade a spade".

I ran across this story which captures my experience the last few months.

Once upon a time an old Buddhist monk went to the town square every day to cry out for peace and justice and for an end to hostility and anger. His cries went unheeded and unheard and had absolutely no effect on his country's war making or his own neighbor's hatred and selfish lives. After a while even his own monks wree embarrassed for him and sent a delegation pleading with him to stop, saying that he was having no effect and that people thought him senile or crazy. They did not want to be associated with him anymore. They begged, pleased, and rationalized with him to stop. They told him, "No one cares what you say. They don't even listen to you anymore. Everyone in the country has gone insane with fear and war, selfishness, greed, and killing. Why go on?" His answer was given directly, looking his own monks right in the eye: "I go out for peace and justice so that I will not go insane."

And that my friends is why I speak up against the injustice, the dysfunction, the arrogance, the condescension, the snark that is nothing but hurtful.

Will anybody listen?

No, I doubt it.

Will there be retaliation?


So why do it?

To keep from going insane.

Sometimes the only thing we can do, but the most important, is bear witness.

Tuesday, February 9, 2010

GCASA and the OASAS Scorecard

The New York State Office of Alcoholism and Substance Abuse (OASAS) has developed a new scorecard which provides measurements on 13 indicators. The only information individual agencies have on how agencies score is their own scores and the state average.

So how did GCASA do compared to the state averages?

GCASA had four programs rated:

The Batavia Clinic
The Orleans Clinic
The Atwater Community Residence
The Supportive Living program.

On almost all indicators GCASA performed as well, and usually, better than the state average.

For example on the indicator % of discontinued use which is the indicator most people ask about first as in "How many people quit drinking and drugging because of treatment at GCASA?"

In the Batavia Clinic program 90% of patients discontinue use as compared to the state average of 70%.

In the Orleans Clinic it was 91%.

On the indicator of maintaining or improving employment the Batavia Clinic had 51% as compared to 49% statewide, and the Orleans Clinic had 54%.

On the indicator of reduction in 6 month arrests, in Batavia the reduction was 48% compared to the state rating of 41%, and in Orleans County it was 68% compared to 41%.

GCASA is proud of its patients, its staff, its community partners who all work together for superior treatment results.

Monday, February 8, 2010

Patient access to counseling when costs are imposed

Reuters Health Day reported on 02/03/10 an interesting study which found that when counseling is free more people will access it to make health improving changes in their lives. However, when a cost is attached, it often becomes a barrier not only to patients accessing the service, but to health care providers referring to the service.

We have noticed this dynamic at play at GCASA. Patient's are often resistant to getting the help that they need even when required to by criminal justice agencies. The cost of the service is often raised as a primary reason for patient objection. Patient's will often gladly pay thousands of dollars in attorney fees, fines, and court costs, rather than much less for treatment which can significantly change the quality of their lives.

For some people, maybe most of us, change is very hard and we resist it. When we have to pay for services to facilitate the change, our objections become even more strenuous.

Whether response to counseling programs on obesity and smoking is positive depends on whether the programs are free, a new study has found.

And the cost of the counseling makes a difference not just to people who might participate but also to the doctors or health-care providers who refer them to the programs, according to the study.

"Our quantitative and qualitative data underscore that clinicians, not just patients, are influenced by costs," the researchers, from Virginia Commonwealth University in Richmond, concluded.

People responded well to free counseling programs on weight loss or smoking cessation, the study found, but participation fell dramatically when services were no longer free.

The findings are reported in the March issue of the American Journal of Preventive Medicine.

The researchers examined a program that used an electronic database system to suggest health-care counseling for adults with unhealthy behaviors. When counseling was free, 1,860 of 5,679 people who were evaluated were determined to have at least one unhealthy habit, and 407 of them were given referrals for intensive counseling, the study reported.

But after the funding ceased, 729 of 2,510 people who were evaluated were determined to have unhealthy habits and just five were referred for counseling -- a 97 percent decrease in the referral rate, according to the study.

Even when clinicians did offer a referral, 81 percent fewer patients followed through and got counseling when the counseling was not free.

"This study indicates that policymakers and payers should support clinical-community partnerships and eliminate cost as a barrier to intensive smoking-cessation and weight-loss counseling," the researchers wrote. "Modifying health behaviors is daunting enough for patients and clinicians -- cost can be the tipping point in their decision to forego the effort."

SOURCE: Elsevier Health Sciences, news release, Feb. 2, 2010


Sunday, February 7, 2010

Medical Marijuana now legal in 14 states - Can New York be far behind?

14 states now have legalized "medical" marijuana the such state being New Jersey. NPR's show Planet Money distributed an interesting show on this topic on 01/27/10. Here is the blurb from the Planet Money web site:

Fourteen states have adopted medical marijuana laws. We talk to Harvard economist, Jeffrey Miron, about what happens when drugs move from the black market to the open market. Do they get 100 times cheaper? Or instead, more expensive? Miron talks about the economics of prohibition, and reveals his drug of choice (which is legal) and one he would like to try (which is not).

You can access the show by clicking here.

Saturday, February 6, 2010

"I'm not buying it."

From Trench Warfare posted on 01/22/10.



I know you're telling me you had "maybe half a shot of whiskey" but I'm just not buying it.

Know why?

'Cause your blood alcohol level is .240. ->

Friday, February 5, 2010

Lessons in management - Use of power

"It is what it is until those in power say how it's to be."

History gets written by the winners.

Money talks and baloney walks.

When someone tells you its not the money, it's the principle of the thing, you can bet your last buck, it's the money.

During Watergate investigation the two Washington Post reporters, Bob Woodward and Carl Berstein, were advised by deep throat to "follow the money."

Power corrupts and absolute power corrupts absolutely. I have observed this in every organization I have worked in and every church I have been a member of.

It is hard for an honest person who would lead a virtuous life to rise in politics or business. The two are contradictory given what it takes to be successful in politics and business. The name of the game is to equivocate, lie, cheat, maybe steal, and play along with the corruption that is rampant at all high levels. Even the Roman Catholic Bishops, the Shepherds of the Church, the Apostles and Jesus' representative on earth supposedly lied and conspired to hide criminal activity for fear of their position and credibility.

So here's the moral of the story - "Question authority!" The better their story and the more adamant they sound, probably the more corrupt they are. True leaders are humble, and honest, and compassionate. By these three criteria you will discern the true leader from the false. I am 64 years old and haven't met too many. The higher you go usually the worse they are.

How are organizations like septic tanks?

The big chunks rise to the top the quickest.

This is article #5 in a series on Lessons In Management.

Community approach to preventing drug abuse

NIDA Town Hall Meeting summary on preventing drug abuse.

GCASA was acknowledged as having the best Drug Free Communities Coalition in the nation in 2006 by CADCA. We are proud that we are one of the best in the country.

Video lasts 6:19

Thursday, February 4, 2010

2009 GCASA Admissions Data - Who is your neighbor?

In rude comments left on articles in the Daily News about GCASA's operations, accusations fly that GCASA brings in drunks and druggies from other counties to prey on the good citizens of Genesee County.

How about some facts for the Xenophobes?

Out of the 606 2009 admissions to the GCASA clinic 552 or 91.1% were homegrown, came from right here in Genesee County. Okay, 17 out of the 606 or 2.8% came from Erie County, and 16 out of 606 or 2.6% came from Wyoming County, and 10 or 1.7% came from Orleans County, but the great majority or 9 out of 10 came from right here.

Most social agencies who deal with stigmatized populations have to deal with prejudiced people who play the MIMBY game (Not In My Back Yard). But what happens when the stigmatized people are already in you backyard? Hell, they are probably living in your house, or in your neighborhood, or going to your church, or working at your work place?

The GCASA treatment clinic and satelittes in Batavia, Indian Falls, and LeRoy are serving just who they are intended to serve, our family, friends, and neighbors. Once in a while we also serve the stranger, but isn't that what good people do?

So, I would hope that the Xenophobes would reconsider their attitudes, and certainly recognize that GCASA serves it community with pride, humility, and dedication. You should be happy that there is place to turn when the person suffering from a substance abuse disorder is your child, your parent, your spouse, your niece, your nephew, your cousin, aunt or uncle, or best friend.

My favorite buttons reads, "Reality is when it happens to you."

This is article #4 in a series on 2009 GCASA admissions data.

Wednesday, February 3, 2010

2009 GCASA Admissions Data - Growing up with substance abuse

We know from research that people who come from families where substance abuse is a problem have a 40% greater chance of having a substance abuse problem as an adult as someone who doesn't have that family history.

At GCASA the data is even stronger. In 2009, 48%, or 507/1050 admissions reported growing up in families where substance abuse was an issue. In 2008, 47% or 518/1094 reported being children of substance abusers.

Take aways:

1. Is substance abuse a family disease? Most definitely.

2. Are the children of substance abusing parents likely to have substance abusing kids when they grow up? There is a 50/50 chance.

3. Is it worthwhile to provide preventive services to these high risk kids? Absolutely! Supposing heart disease or cancer or other life threatening illnesses ran an almost 50% chance of being transmitted to the subsequent generation, wouldn't you want to do every thing you could to inform the at risk kids of the factors which influence the contracting of their familial disease? Absolutely!

4. When the risk and trends are so apparent, why doesn't our society do more to warn people about the dangers? There is tremendous shame involved, social stigma, and the breweries and distilleries have an opposite agenda of selling their products to make money rather than caring about the people who are harmed. The norms and attitudes towards substance abuse in our society are slowing changing in a more positive direction, but as a society we still have a long way to go.

This is article #3 in a series on 2009 GCASA Admissions Data

Tuesday, February 2, 2010

Gambling Awareness Luncheon in Batavia on March 9, 2010

There will be a Gambling Awareness Luncheon and program on Tuesday, March 9,2009 from 11:30 A.M. - 3:00 P.M. at Terry Hills Banquet Facility on Clinton Street Rd. (Rt.33), in Batavia, NY. After lunch Michelle Hadden from the New York Council on Problems Gambling will be speaking along with Dr. John Welte from the Buffal Research Addiction Institute, and Joyce Barrett, a New York Council Gambling Treatment Counselor.

For more information, call Jamie Beedham at 585-815-1879 or email Jamie at

Click on image to enlarge for easier reading.

2009 GCASA Admission Data - What about the kids?

We know from research that families that have a substance abuse problem have a high prevalence of child maltreatment.

At GCASA 17 of the 341 admissions in 2009 had active child maltreatment cases open at the time of admission, while 23 of 606 admissions in 2009 in Genesee County had active child maltreatment cases open. There were also 5 open child maltreatment cases out of 103 in residential services clients.

Over all there were 45 people with active child maltreatment cases open admitted to GCASA in 2009 out of the 1050 admissions or 4% of cases. Last year, 2008, 6%, or 66 of 1094 admissions were involved in Child Protective Services.

3% or 31 out of 1050 of GCASA's 2009 admissions were parents whose children were in foster care. These parents had 58 kids in foster care. This is a huge expense for the counties responsible. Getting their parents sober and into recovery so that they can parent their own children would be a big relief to the foster care system and save enormous amounts of tax dollars. Unfortunately, re-unification is always possible or even desirable, and there are no resources for family oriented services to facilitate this re-unification. GCASA sees the need for and would very much like to do this kind of work, but there are no funding sorces to pay for these services.

What do these statistics mean?

1. It is clear that substance abuse is a family disease and affects far more people than the addict.

2. The societal costs of substance abuse are significant with an overlap of services from the child welfare, family court, and substance abuse system.

3. Substance abuse counselors at GCASA must be skilled in dealing with much more than just addiction when you consider the negative consequences of addictions on parents, their children, and other family members.

4. Is the reduction in percentage of admissions with involvement in child protective services significant, and if so of what?

5. Innovative programs run by the State Department of Social Services and the Office of Alcoholism and Substance Abuse services to team up substance abuse counselors and child protective workers were run on a demonstration project basis in 2008 and 2009 in Genesee and Livingston Counties. GCASA was chosen by the Genesee Department of Social Services and the Livingston County Department of Social Services to create was was dubbed the "co-location program" meaning that child protective workers and substance abuse counselors would be co-located. The program was very successful but when State government hit on financially hard times it cut the funding for these programs. Rather than provide services to prevent foster care placement our State government has decided it is better to just pay for foster care. I do not have the data to show which approach is cheaper and more effective but I strongly suspect that the co-location strategy is not only more effective and humane in the long run but cheaper for the taxpayers as well.

When you see the beer commercials on Super Sunday which promote good family times with super bowl parties of which tailgating and drinking have become such a part of our American sports experience, remember the kids.

The kids damaged from parental drinking and drugging are pretty much hidden away quietly in our society where shame leads to all kinds of avoidance, denial, and secret keeping, but we here at GCASA know because we see it in approximately 1 out of 20 people who walk through our door for help.

A parent who becomes sober and gets into recovery not only benefits him/herself, but their children too, and grandparents, and teachers, etc.

This is article #2 in a series on 2009 GCASA Admissions Data.

Monday, February 1, 2010

Lessons in management: Mission vs. money

Years ago I consulted with a group of therapists in an agency suffering from severe financial problems. The therapists told me that the administration of the agency told them that there would have to be a lot of changes which would curtain their ability to carry out the agency's mission. When the therapists complained they were told by the administrators "without the money, there is no mission."

I said, "Golly, that turns you all in prostitutes, into whores. You are willing to sell you soul for money. With those values not only will this agency fail, but it probably should fail."

A year later the agency went bankrupt and was closed.

Joseph Campbell, the great mythologist said that people often have to choose between the money and their bliss. His advice was "always follow your bliss."

I ask teenagers, "If you could have a job that paid $50,000.00 a year that you hated or a job that paid $35,000.00 a year that you loved, which job would you choose?" Most, 80%, say the $50,000.00 a year job.

Teens are young. They don't know yet what matters in life, but agency administrators and managers should. They should have the experience, the wisdom, the maturity to know that an agency/organization which sells out its mission for money is doomed. Keeping faith with an agency's mission is protecting its soul, its spirit. Without an authentic, significant mission, and a staff who have faith and commitment to it, an agency/organization not only will fail, but probably should fail.

When you have to choose between the mission and the money, stay true to the mission, otherwise you have sold your organizational soul to the devil for a few bucks.

This is article #4 in a series on Lessons In Management.