Background: In February of 2008, a group of concerned Delta area residents began meeting to discuss ways to address the community’s behavioral health needs. The school, law enforcement, the military, city government, and local citizens in attendance all agreed that the first step was to develop a plan for attracting and implementing integrated behavioral and physical health services. The ad hoc group, naming itself the Delta Junction Health and Social Services Coalition (Coalition), agreed that they needed to find a mechanism for financing the development and early implementation of the plan. One member, Deborah Hayes of Northwest Resource Associates (NWRA), agreed to ask her parent agency to apply for start-up funding through their Fairbanks-based non-profit organization, Alaska Center for Resource Families (ACRF). The grant application was filed in March of 2008, and in July of 2008, the Alaska State Division of Behavior Health awarded NWRA a grant for a Deltana Community Human Services Partnership project (DCHSP).
The Deltana region consists of people who live in Delta Junction, Big Delta, the Tanana river area, Fort Greely, and residents along the Alaska Highway. The Coalition had its first official meeting under the DCHSP grant on July 21, 2008, and set to the task of defining itself and its mission. They adopted the following mission statement: To develop and implement a 10-year plan that will address a broad scope of behavioral health needs in order to insure individual, family and community health for all ages in the Deltana region. The Coalition decided to maintain the broad perspective of behavioral health, so that their scope would include primary care issues (e.g. counseling, medication, related health issues), as well as factors that contribute to problematic behaviors and those that promote good behavioral health. The goal is to supplement classic behavioral health services by generating activities and services designed to strengthen individuals and families, and diminish stressors.
Data Gathering: In September 2008, the Coalition began to gather information about what services actually exist, how they are being utilized, and what residents see as the current unmet needs. This was accomplished by surveying the community, gathering information from the school district, and obtaining data from agencies that could provide needed services.
It is important to note that this is only the first, high-level cycle of data gathering. It provided general, community-wide information to begin planning. Each workgroup (see Methodology) will gather specific data of what is needed within each scope of service. It will provide the information necessary to determine specific needed services, and the capacities needed for each.
Community Survey: The DCHSP Survey asked each person to: a) add any available community services that had not been included in a list of known services, in order to develop a complete catalog of available community services b) evaluate the need level in each service category, and c) list other specific human services needs. In order to accommodate the large Slavic population, the survey was available in English and Russian.
The Coalition distributed the survey as an insert in the community newspaper and various church bulletins, through human services agencies, and at the supermarket. The survey could also be completed online through the ACRF website. The Coalition advertised the survey process and ballot locations through several articles and paid ads in the newspaper, the two online bulletin boards commonly used by residents, and through several public services announcements on the local radio station. Additionally, Coalition members conducted live surveys at the IGA supermarket. A total of 101 surveys were completed, 16 of which were in Russian.
On November 8, 2008 the Coalition members gathered for a summit meeting, which provided training in community human services development and established the method for sorting out the data from our information gathering. The group reviewed articles about and discussed Asset-Base Community Develop (ABCD) theory, and some of the successful projects and methodology. This model was chosen by the consultant, Ted Sponsel, as it would likely be most advantageous in such as community setting, and it also is in harmony with DBH’s charge to “advocate the ‘blending, braiding and pooling’ of resources and programming concepts…..We want communities to have the freedom to connect these issues, to partner and collaborate with community members working on connected issues, and to focus on what it will take to develop overall community health and wellness.” With a theoretical foundation and the available data in hand, the group turned to sorting through the data.
Through the analysis of the data, interaction with the consultant and in subsequent Coalition meetings, the Coalition established a 10-year priority plan. The following are the priorities for the first three years (for full data and all priorities, see the DCSH Plan Analysis):
Methodology: Each service need will require a core of community individuals who will focus on that given need. Workgroups will be formed during the first implementation year and continue through the implementation of their service area. Each workgroup will decipher the actual need for that service, seek out and develop community assets, cultivate Fairbanks and Anchorage services were applicable, and find funding to implement the needed service. The workgroups will determine what specific projects are needed, determine the community readiness for each project, and develop personnel and financial resources to support each project.
Once established as a non-profit agency, the DCSP board of directors will coordinate workgroup efforts and serve as the formal body to make contracts and working agreements with other service agencies, government entities, and private businesses. They will maintain oversight responsibilities and coordinate fiscal matters. Funding requests will come through the board of directors and be coordinated with other workgroups.
These priorities reflect DBH’s theory that “Community efforts are most effective when combinations of strategies are used, together.” They also respond to all of the six CASP prevention strategies:
1. Dissemination of Information: Each component service will not only serve as an information center for its own program related information, but also for other community programs and their benefits. The elder clearinghouse is a priority because there is an urgent need for information and referral.
2. Education: Virtually every service has an education component. For example, the teen center will be developed as a learning model, combined with recreation.
3. Alternative (meaningful) Activities: The community clearly stated that it needed alternative activities that promote healthy lifestyles for youth and families. Recreation, teen center, health care, and after school programs speak to this strategy.
4. Community-based processes: All activities are community-based in that 1) they were determined by the community itself, and 2) they will be organized and maintained by mostly volunteer community members. Although many specific practitioners my work on an itinerant basis from other communities (usually Fairbanks or Anchorage), all services are planned and implemented by the community itself.
5. Environmental approaches: Community change will occur on three levels – lifestyle, agency coordination and governmental. Lifestyle changes will occur as community members become increasingly involved in the services provided by this project. This is the ultimate objective for the project. Agency coordination will begin with the DCSP board of directors, as they will serve as a program coordination body for the Deltana region. The DCSP board will stay informed about all human services and related programs in the region and strive to coordinate efforts, program development, and referrals. Already, all human service agencies in the region participate in the DCSP. Governmental involvement in this project has occurred from the beginning with the participation of the Delta City Council, the Delta Greely School District, law enforcement, the court system, churches, and the military. We have had several meetings with the mayor, the city council and the school board president in order to apprise them of the DCHSP’s intentions and progress. Our intention is that this project will provide a new and coordinated planning tool for these government or school entities.
6. Identification, support and referral: This is an integral part of each component service within the project, and will culminate in a community referral system.
Progress Summary Regarding the Strategic Prevention Framework
As with most community development projects that incorporate all segments of a community, events did not progress precisely as predicted. All of the components were accomplished, but some meetings were combined (e.g. training with strategy meetings), and other aspects moved faster than expected (e.g. incorporation of a non-profit organization). Nevertheless, the project as a whole is on schedule according to the timeline in the proposal.
Step 1: Assessment: In addition to the data gathered outlined in the previous sections, we gathered information from several other sources. The Public Health Nurses provided epidemiological information for the region. The State Troopers and Magistrate provided information about arrests and the most common criminal activities. Unfortunately state health and court records include a far larger area of Alaska than the Deltana region, and we were not able to get area specific statistics for Deltana. The statistics of the larger region are only somewhat helpful. We gathered information from the Ft. Greely substance abuse program and the Morale, Welfare and Recreation (MWR) department. Interviews with four prominent church pastors provided information about existing faith-based social programs. The Catholic Social Services Immigration Services provided information and liaison with the Slavic community. The City Council provided information about current projects and community concerns.
Step 2: Capacity: This project has made an effort to be all-inclusive, and to build a broad stakeholder base. It has included government (City council, Senator Therriault, meetings at city hall), law enforcement (Alaska State Troopers, Magistrate), school (Delta Greely School District board president and middle school principal, high school radio for PSAs), state and non-profit agencies (Public Health, OCS, Big Brothers/Big Sisters, Adult Learning Programs of Alaska, Alpha Omega Life Care, Catholic Social Services Immigration Services), faith-based organizations (We have been in contact with five primary church leaders, and the Slavic congregations through Catholic Social Services), and a service organization (Kiwanis). The Coalition members are the stakeholders, and represent the full gamut of ages, from college students to seniors in their 80s, and a full range of race, employment, and economic standing.
Training for the Coalition member has been informal and formal. The consultant and the Director of Alaska Center for Resource Families have provided guidance regarding the process of program development. The day-long training at the summit meeting was provided by Dr. Ted Sponsel. The curriculum consisted of 1) Understanding needs and resources, 2) Identifying relevant resources, 3) Developing an organization plan utilizing ABCD theory, 4) Sequencing the plan, and 5) Implementation of the plan.
The newly appointed DCSP Board President, Barbara Flynn traveled to Anchorage with project director Deborah Hayes, for training in capacity building delivered by the State of Alaska, Department of Behavioral Health during January 2009. Additionally, Deborah Hayes participated a legislative workshop on obtaining funding for capital improvements. The DCSP Vice President Joseph Brokus and the Treasurer, Katie Charlie attended training on Creating Business Plans presented by the Foraker Group on January 28, 2009. In February 2009 we plan to attend a Rasmuson Foundation funding training.
Step 3: Planning: The plan is currently being developed, but will follow the needs established by the data we have gathered (see Survey and Methodology). The FY 2010 Business Plan will outline specific services to be delivered by this grant and detail implementation strategies.