Lorain’s PRIDECommemorative

Journal

“Partners Realistically Integrating Durable Empowerment”

Slogans

Working Together For A Healthier LorainPeople Helping People Through Programs and Services

For Help Through Tough Times, Call Lorain’s PRIDE

AuthorsElaine Georgas

Christine Robinson Brenda Taylor-Hines

Nancy Toth Visobe Welch

Commemorative Journal

2

Acknowledgments

Lorain’s PRIDE wishes to thank the individuals, businesses, members of the

faith community and organizations for their involvement in making this initiative

successful. The Commemorative Journal chronicles activities and includes data on

the impact on the Lorain’s PRIDE Initiative. Numerous people were involved in the

initiative and the development of this commemorative journal (See Appendix).

DISCLAIMER

This journal was developed (in part) under Grant Number SM60312 from the Substance Abuse Mental Health

Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies

and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.

ELECTRONIC ACCESS AND COPIES OF PUBLICATION

This publication can be accessed electronically through the

Alcohol and Drug Addiction Services Board of Lorain County website: www.lorainadas.org.

3

TABLE OF CONTENTSSection 1: Purpose, History & Goals

Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Target Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Lorain’s PRIDE Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Activities Necessary for Program Implementation . . . . . . . . . . . . . 12

Collaborating Partners, Steering Committee, Screeners Meeting and Tier II Committee Representative Agencies . . . . . . . . . . . . . . . . . . . 13

Section 2: Community Awareness & Social Marketing

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Community Canvassing Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Faith Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Vendors at Faith Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

PRIDE Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

PRIDE Brochures & Other Advertisements . . . . . . . . . . . . . . . . . . . . 23

PRIDE Billboard Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

PRIDE Presentations & Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Section 3: Evidence Based Programs & Services

Level II - Evidenced Based Prevention . . . . . . . . . . . . . . . . . . . . . . . 30

Level III (a .) Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Level III (b .) Interventions, Brief Treatments . . . . . . . . . . . . . . . . . . 33

RX For Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Medical Vouchers Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Transportation Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Community Impact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Testimonials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Section 4: Highlights

Accomplishments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Lessons Learned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Challenges and Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Press Conference 2013 Photos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Section 5: Appendix

Author’s Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

4

Purpose of the Journal• To chronicle activities and events that resulted in the achievement of Lorain’s PRIDE goals and objectives.

• To showcase the effectiveness of media and communication strategies.

• To demonstrate the effectiveness of Patient Tools as a screening and referral device.

• To identify programs of interest to City of Lorain residents.

• To increase involvement from the faith and business community.

• To recruit and engage participants in volunteer activities.

Purpose of Lorain’s PRIDE GrantThe purpose of the grant was to create rapid access to tailored services through a “no wrong door” approach for Lorain’s City’s residents impacted by recent economic downturn and are experiencing depression anxiety, problematic substance use and who may be suicidal or in extreme psychological distress.

The grant components included community awareness, evidence-based prevention, screening, brief intervention and treatment, screening, referrals and crisis intervention and involved the project’s partners who worked together with participants to 1) reduce symptoms of anxiety, depression and substance use; 2) prevent the onset of substance use and 3) restore a sense of pride and hope for City of Lorain’s resident.

A total of 13 formal partners, 52 informal partners, 65 volunteers, 5 consultants and 6 project staff were involved in implementing Lorain’s PRIDE during the three year time period.

A total of 2,547 adult Lorain City residents were screened for services in addition to 943 youth for a total of 3,490 (5.4% of Lorain City’s population was screened).

PURPOSEPURPOSE

5

History

May of 2010The ADAS Board of Lorain County submitted a Federal Grand Proposal on behalf of the City of Lorain locally referred to as “Partners Realistically Integrating Durable Empowerment” or P.R.I.D.E.

October 2010The City of Lorain received the Notice of Award for $1.4 million a year x 4 years (One of three in the Nation).

6

October 2010Lorain received Notice of Award:

$5.6M over 4 years

The Substance Abuse and Mental Health Administration (SAMHSA) proudly announces the winners of the CRRI grant.

And the winners are:

The City of Lorain, OhioThe City of Fall River, MAThe City of Union City, NJ

Congratulations and Good Luck!

7

• The extreme economic conditions in the city including high unemployment, high rates

of mortgage foreclosure, discouraged workers, loss of manufacturing, ship yards,

closing of the Ford Plant and local steel mills.

• The city’s unemployment rate was 7.3% in December of 2007 and 12.5% in

February of 2009.

• Strong partners with a history of collaboration. “Our partners are committed in

bringing healthy activities, develop new employment skills, strengthening family

connections, and provide options to those who seek help when needed from health

professionals, “ cited Mayor Tony Krasienko. (Mayor 2010).

• A resource rich community. “This project brings together city leadership, service

providers and the community to help our city’s residents get through the tough

times that we’ve experienced and bring a sense of hope back for their families and

ultimately a sense of renewal in our city,” Elaine Georgas, Executive Director of the

Alcohol and Drug Addiction Services Board of Lorain County.

• The grant goals were consistent with the mission of the Mayor’s Office – “to

enhance the quality of life for Lorain’s citizens by providing a clear vision, strong

leadership and quality services”.

The criteria for the selection of Lorain, Ohio included:

8

• PRIDE served the entire city;

• PRIDE was designed for all ages;

• Services were available to Lorain City residents

regardless of their ability to pay;

• The City of Lorain has a highly diverse racial and

ethnic makeup.

Lorain’s PRIDE Enrollment Data - February 1, 2011 – September 30, 2013

• More males (56%) than females (44%) took advantage of

PRIDE programs.

• However, regarding race/ethnicity, program enrollment

mirrored the City’s diverse population, 46% were

white, 34% were African American and 26% were

Hispanic or Latino.

• When age is considered, about two-thirds of program

participants were under the age of 45.

Target Population

9

Program enrollment mirrors the City of Lorain demographics

Target Population

10

LORAIN’S PRIDE GOALS

Overall GoalTo improve the behavioral

health outcomes in communities

experiencing hardships from the

recent economic downturn.

1Increase community

awareness of resources available to assisting in tempering difficult

financial/emotional time. 2Reduce depression, anxiety and problematic alcohol use through outreach, screening, brief treatment and referral to a host of evidence based

practices embedded w/in the community.

3A community approach will be used for crisis

interventions for those at risk for suicide or in extreme psychological

distress.

4Delay the onset of substance abuse

through identification and referral of youth 0 – 17 to evidence based

prevention services.

5Reduce teen depression and

suicide through evidence based and coordinated screening and referral

between the school system and service providers.

Working Together For A Healthier Lorain

11

Crisis Intervention

Brief Treatment & Referrals to Treatment

Screening & Outreach

Evidence Based

Programs

Community Awareness

& Social Marketing

Brief Interventions

People Helping People Through Programs and Services

Activities Necessary

for Program Implementation

12

City of Lorain (Grantee) Mayor Tony Krasienko (2010) Mayor Chase Ritenauer (2011-Present)

Implementing Agency Alcohol and Drug Addiction Services (ADAS) Board of Lorain County: Elaine Georgas, Executive Director John Ellis, Director of Program Services (2010-2012) Christine Robinson, Director of Program Services (2012-Present)

Pride Initiative Staff Brenda Taylor-Hines, MSW Project Director Dalila “Dee” Vargas, GPRA Specialist/Translator

Steering Committee Members Cathy Gabe, Communities That Care Cecilia Henderson, Student Charles Neff, Mental Health Board of Lorain County Derek Feuerstein, Mayor’s Chief of Staff City of Lorain Dina Ferrer, Lorain County Community College Joe Thayer, AFL CIO Mark Ballard, Committee Chair Robert Gilchrist , Seville Builders, Inc. Sascha Chatman, Mercy Regional Medical Center

SAMHSA Project Officers Ekaterina Zoubak Dr. Nainan Thomas

Collaborating Partners, Steering Committee, Screeners Meeting and Tier II Committee Representative Agencies

TIER II COMMITTEE REPRESENTATIVE AGENCIES Alcohol And Drug Addiction Services (ADAS) Board Of Lorain County Bellefaire Jcb Communities That Care Of Lorain County (CTC) El Centro De Servicios Sociales Lorain City Health Department Lorain City Schools Lorain County Alcohol And Drug Abuse Services (LCADA) Lorain County Board Of Mental Health Lorain County Community College, Public Service Institute (PSI)

Lorain County Health & Dentistry (LCH&D) The Nord Center Urban Minority Alcoholism And Drug Abuse Outreach Program (UMADAOP)

Contractors Alicia Nicely, Graphic Designer Aurora Mercado, Admin. Assistant David Brown, Website Manager Debra Simpson, Program Ambassador Lolita Darlese Swain, Videographer Melissa Figueroa, Administrative Assistant Richard Romero, Media Consultant Stacy Corbin, Administrative Assistant

13

“ The PRIDE Initiative allowed the services that have been siloed to come together in partnership and wrap our arms around our community.”

- Kathy Loughrie, Nursing Supervisor Lorain City Health Department

“ People have been able to meet their obligations, overcome the alcohol and drug addictions and address other issues in their life.”

- Chris Robinson Drug Counselor LCADA

14

Informal Partners

50 additional partners (informal) were involved in the successful implementation of Lorain’s PRIDE.

15

Community Awareness and Social Marketing

Lorain’s PRIDE Initiative participated in a wide variety of community awareness events during its two and one half years of servicing Lorain City residents .

Community members were advised of events via advertising campaigns using radio, television, newspaper and social media . Billboards were used to remind citizens that screening for programs and services was just a phone call away, and permanent displays were set up at strategic locations to give residents easy access to PRIDE screening and program information .

PRIDE staff designed brochures and flyers in an effort to educate residents about the programs and services available as well as to describe the screening tool and screening process . Posters were created for business windows and quick reference cards were given to partners to assist them in spreading the word about PRIDE . A monthly E-Newsletter was created to keep partners and clients apprised of new information or upcoming events, and YouTube was also utilized to post information about PRIDE . PRIDE staffers even came up with a PRIDE Placemat for restaurants and social service agencies who serve food, and a number of awareness items such as pens, magnets, nail files, first-aid kits and chip clips were routinely handed out to residents attending community events .

16

Community Canvassing EventsDuring PRIDE’s first year, over 12,000 post cards were direct-mailed to all eight wards in Lorain . Once the mass mailing was complete, Lorain PRIDE Initiative volunteers and staff participated in several door-to-door canvassing events in a follow-up effort to spread the word about PRIDE screening and referral services . Canvassing also covered all eight wards of the city of Lorain, but it was strategically focused in zip codes where screening numbers were lowest .

17

PRIDE Faith Events

18

The PRIDE Initiative Faith Events provided opportunities to inform, educate and create awareness about how to access programs and services . Members of the faith community were encouraged to host screenings, participate in programs and services . Faith Events were held quarterly .

19

PRIDE Faith Events

20

Vendors at Faith Events

21

PRIDE Displays

22

PRIDE Brochures & Other Advertisements

23

PRIDE Billboard Displays

24

PRIDE Presentations & Events

25

PRIDE Presentations & Events

26

27

PRIDE Presentations & Events

28

29

Evidence Based Programs & Services

Level II - Evidenced Based Prevention

#of Referrals=947/# Enrolled & Served=52

2. Coping and Support Training (CAST)

Coping and Support Training is a high school based suicide prevention program targeting youth 14 to 19 years old. CAST delivers life-skills training and social support in a small-group format). CAST’s

skills training sessions target three overall goals: increased mood management (depression and anger), improved school

performance, and decreased drug involvement. Group sessions incorporate key concepts, objectives, and skills that inform a

group-generated implementation plan for the CAST leader. Sessions focus on group support, goal setting and monitoring, self-esteem,

decision-making skills, better management of anger and depression, “school smarts,” control of drug use with relapse prevention, and self-recognition of progress through the program. Each session

helps youth apply newly acquired skills and increase support from family and other trusted adults. Detailed lesson plans specify the type of motivational preparation, teaching, skills practice,

and coaching activities appropriate for at-risk youth. Every session ends with “Lifework” assignments that call

for the youth to practice the session’s skills with a specific person in their school, home, or

peer-group environment.

#of Referrals =288/# Enrolled & Served=24/# Completed=8

30

Level III (a.) Screening

Evidence Based Programs & Services

31

Level III (a.) Screening

Evidence Based Programs & Services

32

Level III (b.) Interventions, Brief Treatments

Evidence Based Programs & Services

1. Cognitive Behavior Therapy for Youth DepressionThis is a structured 12 to 16 session program where the therapist actively involves the child in setting realistic goals and taking responsibility for action and thought . The child learns how to develop new ideas and ways of thinking in order to develop a positive outlook on himself/herself, his/her experiences and the surrounding environment . #of Referrals=60/# Enrolled & Served=28/ #Completed=4

2. Cognitive Behavior Therapy for DepressionCognitive Behavior Therapy (CBT) for Depression is a structured program where the therapist actively involves the client in setting realistic goals and taking responsibility for action and thought . By learning to change thought and perception, the client can change behavior and emotional response . The client learns how to develop new ideas and ways of thinking in order to develop a positive outlook on himself/herself, his/her experiences and the surrounding environment . #of Referrals=320/# Enrolled & Served =30/# Completed=2

3. Twelve Step FacilitationThe Twelve Step Facilitation (TSF) is a brief and structured program which uses a workbook to assist the client in early recovery from alcohol abuse, alcoholism and other drug abuse or addiction problems . Clients attend 12 to 15 private sessions . TSF helps the client address urges and triggers while transitioning into other existing self-help networks . Therapy focuses on achieving two main goals: First, acceptance of the need for abstinence from alcohol and other drug use; second, surrender or willingness to actively participate in 12-step fellowships as a means of sustaining sobriety . #of Referrals=718/# Enrolled & Served=188/# Completed=82

33

Level III (b.) Interventions, Brief Treatments

Evidence Based Programs & Services

4. Brief Couples TherapyAt one time or another, every couple has trouble in their relationship . Problems in a relationship have many causes . Some problems originate outside the relationship, such as job loss, illness or conflict in the family . Others stem from personality factors within the partners . Still other difficulties may be related to natural stages in the growth of the relationship . Couples therapy takes place over eight sessions and is a means of resolving problems and conflicts that couples have not been able to handle effectively on their own . #of Referrals=397/#Enrolled & Served=46/#Completed=7

5. JOBS ProgramThe JOBS program is intended to prevent and reduce the negative effects on mental health associated with unemployment and job- seeking stresses, while promoting high quality re-employment . Structured as a JOBS seminar, the program teaches participants (ranging from 17-65) effective strategies for finding and obtaining suitable employment as well as strategies for anticipating and dealing with the inevitable setbacks they will encounter while remaining motivated with enhanced self-esteem . #of Referrals=1199/# Enrolled & Served=296/# Completed=269

6. Medication Assisted TherapyMedication Assisted Therapy (MAT) is a program offered for opioid dependency . Individuals receiving referral to this program based on their initial screening and were provided an assessment to ensure that they were appropriate for the program . Participants in MAT received addiction treatment combined with buprenorphine (Suboxone) medication to assist them in the recovery process . #Enrolled & Served=31/# Completed=1

34

Evidence Based Programs & Services

RX For Change

Lorain City residents wishing to use Lorain PRIDE

Initiative’s new smoking cessation program can get a free, confidential

screening at one of five screening sites conveniently located throughout the city. Once

referred to the no cost program, clients can receive counseling services.

1 to 2 individual counseling sessions are provided for people thinking about quitting, and up to an

additional six sessions for those clients trying to quit. Sessions can be conducted face-to-face or by telephone. Face-to-face sessions can be

provided in either our Lorain office or in a convenient location within your community.

#of Referrals=171/#of Enrolled & Served=38/# Completed=4

35

Medical Vouchers Services

Evidence Based Programs & Services

# of Screened Referrals = 2,547; # Qualified to Enroll

in Medical Vouchers = 300

Enrollees = 100%

Client without a regular doctor may

qualify for a set number of medical or dental visits through

the PRIDE Initiative voucher Program. *Clients must complete one

other PRIDE program before qualifying for the Medical Voucher program.

This completion could be any one of the following programs of PRIDE:

JOBS, 12-Step, Rx for Change, Couples Therapy and more.

36

Evidence Based Programs & Services

Transportation Services

Some transportation needs to and from

certain services may be met through Lorain’s PRIDE project.

Transportation may be provided to Adolescent Counseling at Bellefaire, Couples Therapy at Nord, Depression

Counseling at Nord, 12 step Facilitation at LCADA (West Park Office), Medical

Services at Health and Dentistry, and the JOBS project.

Pegasus Transit LLC provided transportation services

for the following programs: Youth Adolescent Depression Counseling,

Brief Couples Therapy, Adult Depression Counseling, Medical Vouchers and post-JOBS related employment and

education connections.

Lorain County Alcohol & Drug Abuse Services, INC. (LCADA) provides the 12-step

facilitation program services of Lorain’s PRIDE Initiative. In addition, they have also included transport services for the

newly enrolled JOBS Workshop Program participants.

LCADA provided a total of 10 rides for each 296 enrolled participants.

37

Lorain City Community Survey SummaryDuring the project, two community surveys were conducted in December 2011 and 2012. The purpose of the survey was to gather information about the health status of Lorain City residents and then to monitor this overtime. But as might be expected, due to the short time frame, survey results show little change between 2011 and 2012. Following are highlights from the 2012 community survey:

• 45% of Lorain residents heard about PRIDE (44% the previous year).

• Overall, a little more than 40% of Lorain City residents described their health status as excellent or very good.

• 91% of Lorain City residents had some type of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, Medicaid, VA or Indian Health Services. Racial and ethnic minorities were less likely to have health care coverage than White. The unemployed were less likely to have health care coverage than retirees, homemakers, or those who were employed.

* African Americans were less likely to have health care coverage than White, 83% and 93%, respectively.

* Similarly, only 74 percent of Hispanic respondents had any type of health care coverage.

* 20% of respondents who were out of work for less than one year did not have any type of health care coverage.

Community Impact

38

• 8% percent of Lorain City residents did not have a primary medical care provider. Racial and ethnic minorities were less likely to have a primary care provider than White residents.

* 74% Hispanics and 90% of African Americans had a primary care provider, compared to 94% of Whites.

• 22% of Lorain City residents in 2012 indicated that they were currently using cigarettes. The 2011 Lorain County Health Assessment Report also suggested that 22 percent of Lorain County adults were smokers.

• Overall, 80% of Lorain City residents felt safe in their neighborhood.

• 92% of Lorain City residents reported that they had friends or relatives who would help them if they experienced psychological problems such as depression or anger.

• Overall, 93% of Lorain City residents reported that they knew where to get assistance for themselves or loved ones to help with depression, anxiety or emotional problems.

• Most Lorain City residents (97%) believed that they could quickly recover after they faced financial and emotional difficulties at home or at work.

• Respondents were asked a series of questions regarding alcohol consumption. In general, highest rates of alcohol use were found among the newly unemployed who were out of work for less than one year.

* 50% of the newly unemployed who were out of work for less than one year used any alcohol in the past 30 days, compared to 30% of all Lorain City residents.

* Similarly, 30% of individuals who were out of work for less than one year engaged in binge drinking (5 or more drinks on one occasion) in the past 30 days, compared to only 8 percent of all Lorain City residents.

• Respondents were asked a series of questions about their mental and behavioral problems. Generally, unemployed people, especially those who were out of work for more than 1 year, reported higher rates of those problems than the general population.

* 57% of people who were out of work for more than 1 year experienced serious depression in the past 30 days, compared to only 23% of all Lorain City residents.

* Similarly, two-thirds (67%) of those who were out of work for more than 1 year suffered from serious anxiety in the past 30 days, compared to only one-third (34 %) of all Lorain City residents.

* Also, those who were unemployed for more than 1 year tended to suffer more frequently from other problems such as hallucination, violent behavior, and taking prescribed medication.

• Similar to the previous year (79%), about eight out of ten Lorain City residents (78 percent) in 2012 indicated that they always or almost always received the emotional support they needed.

• Most Lorain City residents (91%) reported that, in general, they were very or somewhat satisfied with their life.

* Respondents’ overall satisfaction with quality of life was significantly related to their employment status. Employed people were more likely to be satisfied with their life than unemployed people. For example, 96% of the employed were very or somewhat satisfied with their life, compared to only 72% of those who were out of work for more than 1 year and 80% of those who were out of work for less than 1 year.

39

PRIDE Awards

40

Prior to treatment would isolate herself in her apartment

with little human interaction. Today, she has improved

her socialization skills. She participates in self-help

community events at least twice a week, reports

celebrating her birthday with friends and attending an out

of state family function to celebrate the holidays. She is

celebrating over 1 year of sobriety.

Client successfully completed after 3 treatment episodes

with LCADA. He gained employment, home group and

sponsor. He has rebuilt his relationship with his mother,

and helped his uncle get into day treatment at LCADA. His

attitude has totally changed. He shared that his hardest

stumbling block was changing friends and with the help

of the recovery community he was able to do that. He has

the goal of going to college and earning a degree in art.

Client spoke and shared his story at the Gallup event on

11/9/11.

Client, a Hispanic male, is very active in treatment,

attending 3 self help meetings a week, has a home group,

2 sponsors, is very proud that he can pass a drug screen

and is starting to interview with success for employment.

Client attributes this to his hard work, the JOBS project

and the Twelve Step Facilitation program. He is celebrating

5 months of sobriety.

TestimonialsPRIDE participants describe

the impact on their lives.

“The PRIDE Jobs program has given me much hope

for a better future. I have suffered an 8 year period of

unemployment and under employment. PRIDE Jobs has

helped to repackage myself for today’s new economy.

the continuing services offered through JOBS makes job

retention considerably more likely and not only land a job

in the field I am enjoying but continue to show up. I have

identified skills I never knew I had!”

“We were worried about transportation because we

didn’t have any...they actually gave me rides to enroll in

school, for job interviews, and for my first week and half

when I started a new job. This was a blessing.”

“This experience has helped me to learn communication

skills outside of being judgmental/critical of my spouse

and enabled me to be an active participant in resolving

family issues. Thank you for making me part of the

solution and strengthening our bond.”

“I had just about given up on my life period…was so

depressed i didn’t want to move on…i really can’t say

what would be if PRIDE wasn’t here to give supportive

services… this program needs to be everywhere…”

41

Debra Simpson, Lorain’s PRIDE AmbassadorSylvia Duvall, Secretary

Negro for Business & Professional Women of Lorain County

TestimonialsPRIDE participants describe

the impact on their lives.

“PRIDE really offered me a new vision on the

job search I went to the program looking for an

opportunity to learn new things. I enjoyed the time I

spent in the workshop because the people in charge

of running the program in lorain socialize well with

us, treated us with respect and gave us their time.

“They communicated their experience and their

knowledge making me realize many errors I was

doing in the job search. PRIDE helps you, especially

after the workshop ended. Personally I’ve been

offer to volunteer and they are always there to

guide you. The transportation is very reliable too;

they pick you up and get you through the whole

process freely. There are a lot of worried people

not having transportation so, this is something that

will definitely help you and carry you so you can

be successful. There’s free help at no cost. All the

personnel can be reach easily. Also, they find you

job applications when possible and when they find

any openings they let you know. PRIDE would be

the perfect program for those who are depressed

and those who are without a job and looking to be

successful in the workforce who are affected by

economy.” – Christian l. Ocasio

42

“I began participating in the 12-step program back in

august of 2012. I since then completed the program by

first week of april of 2013 and doing really well. I brought

my son in to be screened for services, especially the jobs

program and other services too he needed. I thought if the

program can help me, it can also help my son”

“The MAT program has assisted in affording me the

ability to work on my issues that in the past hindered

my recovery. Without the use of suboxone, i would have

been focused more on the cravings than on the issues

that continue to lead me back to using”

“When I heard about Lorain’s PRIDE and the wrap

around services, I knew I wanted everyone in the

community to know about the services.“ – Sylvia

Duvall, Secretary Negro for Business & Professional

Women Of Lorain County.

43

GREATJOB!

Accomplishments

PRIDE

Year 2013

Year 2012

Year 2011

• Lorain’s PRIDE Initiative received a Community Service Award in April as well as a Community Outreach Award from the Negro Business and Professional Women – Lorain, Ohio Chapter.

• PRIDE’s Health Talk articles were printed in the Lorain Morning Journal covering a range of health and mental health related topics. The Journal estimates viewership at 21,589.

• About 150,600 people have been exposed to PRIDE and its programs through the billboards strategically

located around the City of Lorain. All these activities seem to be getting the message out.

• The Teen Screen Program, a nationally recognized prevention program that is highly effective in identifying signs of possible mental illness and risk of suicide in youth is now a school program, not a PRIDE Program.

• PRIDE was viewed positively by participants according to the client satisfaction survey. All (100%) participants so far say they are satisfied with services and would recommend others to services.

• The January Press Conference at Lorain City Hall announcing the start of Lorain’s PRIDE became the lead story in two local newspapers.

• Excluding Billboards “Eyes on Data,” materials or messaging has gotten to an estimated 196,768 end users. This equates to three PRIDE related messages to every man, woman and child in the City of Lorain.

• The Mental Health Liaison in Lorain City Schools

became certified to facilitate TeenScreen.

• El Centro Servicios de Sociales became the fifth screening site in South Lorain which is home to the Hispanic community.

• Screening sites were expanded to include the municipal court, churches, health fairs and community events.

• The Nord Center served 57 Lorain City residents at no cost to Lorain’s PRIDE. The cost was covered by the Lorain County Mental Health Board.

• A total of 2,547 adult Lorain City residents were screened for services in addition to 943 youth for a total of 3,490 (5.4% of Lorain City’s population was screened).

• The highest demand programs were the JOBS with 296 enrolled and the 12 Step Facilitation with 188 enrolled.

• A total of 67 volunteers were involved in Lorain’s PRIDE working to support community events, JOBS, 12 Step, case managers, direct mail campaigns, logistics, canvassing, focus group members, storm clean-up, clothing drive and

• Two young men, brothers were screened in 2011. Neither had completed high school and both completed the JOBS Workshop. Almost 18 months later, they obtained their GEDs and are attending a local community college

44

GREATJOB!

“People who share a common direction and sense of community can get where they are going more quickly and

easily because they are traveling on the thrust of one another.”(Reprinted from The Goose Story by Dr. Harry Clarke Noyes, from materials provided by Bonnie J. Collins, EdM, LCSW-R)

45

• Volunteer Recruitment was a necessary function because it extended the reach and depth of the program. A total of 67 volunteers helped perform awareness and program activities.

• Bonding provided the motivation for participants to complete their programs. By proving participants with meaningful opportunities to learn new skills, network and recognition for their efforts created a connection with the service provider. Participants received Burger King gift cards and certificates for completing programs.

• Embraced technology that allows diverse groups to learn more about the impact of the program. Lorain’s PRIDE had over 406 Facebook friends. The Patient Tools was used for screening at many sites and community events. A total of 2,547 adult were

screened for services. In addition, 943 youth were screened for a total of 3,490.

• Participación y Reconocimiento: El reconocimiento por el programa es acogido por la diversa población hispana. Participación en diferentes programas, el aprender nuevas habilidades, sensibilizar a la comunidad en general sigue teniendo su efecto. Las asociaciones se estableció correctamente.

• Participation & Appreciation: The appreciation for the program was embraced by the diverse Hispanic population. Participation in different programs, learning new skills, bringing awareness to the community in general continues to have its effect. Partnerships continue to be established successfully.

• Collaboration is a good thing but you have to hold people accountable. A Memorandum of Agreement (MOA) was an important tool.

• People can and do recover as the testimonials indicated. Service providers obtained testimonials about the program’s impact on participant’s lives.

• Communicate frequently using various media. A monthly E-PRIDE Newsletter, Email Blasts, website, Facebook, Screener’s Meeting, Tier II Meeting, letters, flyers, conference calls, webinars, Steering Committee Meetings and Team Meetings were regularly scheduled for information sharing and problem solving.

• This is not a 9 to 5 job as evident by the number of community events and evening activities. Staff and volunteers participated in over 35 events annually.

• En Las Obras: La colaboración y la comunicación es evidente en la diversa población hispana. El deseo de participar en los eventos, voluntariado y testimonios fueron en aumento.

• In The Works: Collaboration and communication was evident in the diverse Hispanic Community. The desire to participate in events, volunteering and testimonials were on the rise.

• Value diversity and included those views in your work products and environment. Differences do not mean deficit.

• Value data and its usefulness in making programmatic changes.

• Lorain’s PRIDE restored hope. Many in the community lost hope because of the economy. The challenge was to help people find it again first through our messaging and then through our programs and services.

• Introducción a “ORGULLO” a la Comunidad Hispana: fue un éxito una vez que nuestro reto fue entendido por la diversa población hispana que estábamos aquí para hacer una diferencia en su vida, y no aquí para impugnar su propio orgullo de quién son o aquello en lo qué se creía.

• Introduction of PRIDE to the Hispanic Community: It was a successful challenge once our diverse Hispanic population understood we were here to make a difference in their lives and not here to challenge their own pride for who or what they believed in.

Lessons Learned

2013

2012

2011

46

Challenges and Solutions 2011

1. Challenge: Tracking program activities was a common challenge at all program levels.

Solution: A spreadsheet for Level One activities that included locations, material and type(s) of event was created to capture data.

2. Challenge: Participants referred for medical vouchers (co-pay assistance) were initially seen first without enrollment to other programs and services. Solution: As a result of s SAMHSA site visit, the policy was modified effective Octotober1 , 2011 to increase enrollment into other Evidence Based Programs and Services.

3. Challenge: During the first year, Lorain’s PRIDE Communications Plan established a more general framework of awareness and education regarding the relationship between behavioral health issues and the economic downturn effects. Solution: In consultation with Gallup Communications, the second year Communication Plan was revised to be more focused in messages and action oriented in a variety of platforms: newspaper, radio, magazine, TV, video, Website, town hall venues, health fairs, and community events.

4. Challenge: The first year’s screening results indicated that two primary service gaps: Brief Treatment for Tobacco and Depression programming for those between the ages of 18-49 years old. Solution: Provided brief treatments called RX for Change for participants with tobacco issues and added an Adult Depression Program

20121. Challenge: The screening team was challenged to develop a plan to move screening into the community.

Solution: A combination of fixed sites and mobile sites in the community allowed for greater access to screeners and increase referrals to programs and services. Screeners were able to partner with agencies and increase the number of screenings and referrals to programs.

2. Challenge: The JOBS participants needed additional supportive services. Solution: Identified agencies to provide clothing, job training, stipends, food and other resources to ensure successful completion of JOBS.

3. Challenge: Finding volunteers to augment staffing for Community Awareness and Social Marketing and Evidence Based Programs. Solution: Created a volunteer program to assist with implementation activities for Community Awareness, Social Marketing and Evidence Based Programs.

4. Challenge: Translating PRIDE into messages that resonate with residents. Solution: Use focus groups and Gallup Technical Assistance to develop and test messages and slogans.

20131. Challenge: Several staff left the PRIDE Program for other positions and this impacted screening and GPRA follow-up.

Solution: Staff was re-aligned to cover their tasks and ADAS became a screening site.

2. Challenge: Screening staff was reduced. Solution: The remaining screeners developed a schedule of Community Screenings.

3. Challenge: Assisting Hispanic/Latinos PRIDE participants get to resources in the community that do not have bi-lingual staff. Solution: Bilingual PRIDE staff initiated contact with providers and assisted participants in getting services.

4. Challenge: Getting the word out about PRIDE’s transition (closing) and who to call for assistance. Solution: The health educator prepared PSAs, flyers, updates on Facebook and the website about upcoming changes. Billboards were strategically placed throughout the community with the message “For Help Through Tough Times call 211.” The Resource Guide was updated and included the United Way of Lorain County logo.

47

Lorain’s PRIDE Press Conference 2013

48

Lorain’s PRIDE Press Conference 2013

49

Author’s Acknowledgements Lorain’s PRIDE wishes to thank the City of Lorain, our partners, Steering Committee members, contractors, speakers, local businesses, members of the faith community, our project officers, volunteers and Tier II members for their involvement in making this initiative successful. The Commemorative Journal chronicles activities and includes data on the impact on the Lorain’s PRIDE Initiative. Numerous people were involved in the initiative and the development of this commemorative journal (See Appendix).

Disclaimer This journal was developed (in part) under Grant Number SM60312 from the Substance Abuse Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.

Electronic Access and Copies of Publication This publication can be accessed electronically through the Alcohol and Drug Addiction Services Board of Lorain County website www.lorainadas.org.

City of Lorain (Grantee) Mayor Tony Krasienko (2010) Mayor Chase Ritenauer (2011-Present)

Implementing Agency Alcohol and Drug Addiction Services (ADAS) Board of Lorain County: Elaine Georgas, Executive Director John Ellis, Director of Program Services (2010-2012) Christine Robinson, Director of Program Services (2012-Present)

Pride Initiative Staff Brenda Taylor-Hines, MSW Project Director Dalila “Dee” Vargas, GPRA Specialist/Translator

Contractors Alicia Nicely, Graphic Designer Aurora Mercado, Admin. Assistant David Brown, Website Manager Debra Simpson, Program Ambassador Lolita Darlese Swain, Videographer Melissa Figueroa, Administrativa Assistant Richard Romero, Media Consultant Stacy Corbin, Administrative Assistant

Steering Committee Members Cathy Gabe, Communities That Care Cecilia Henderson, Student Charles Neff, Mental Health Board of Lorain County Derek Feuerstein, Mayor’s Chief of Staff City of Lorain Dina Ferrer, Lorain County Community College Joe Thayer, AFL CIO Mark Ballard, Committee Chair Robert Gilchrist , Seville Builders, Inc. Sascha Chatman, Mercy Regional Medical Center

SAMHSA Project Officers Ekaterina Zoubak Dr. Nainan Thomas

Speakers Bureau: Will Castro Mark Provenza Marilyn Parker-Jeffries Dennis Waite Gloria Mantini Barbara Mingee Ed Chavez Sr. Connie Williams Ron Bakalar Dr. Mary Hillaire-Tavvener Joanne Moon Jim Deppert Joseph Wolf Marge Walker

50

Thank you!

TIER II COMMITTEE REPRESENTATIVE AGENCIES Alcohol And Drug Addiction Services (ADAS) Board Of Lorain County Bellefaire Jcb Communities That Care Of Lorain County (CTC) El Centro De Servicios Sociales Lorain City Health Department Lorain City Schools Lorain County Alcohol And Drug Abuse Services (LCADA) Lorain County Board Of Mental Health Lorain County Health & Dentistry (LCH&D) Lorain County Community College, Public Service Institute (PSI) The Nord Center Urban Minority Alcoholism And Drug Abuse Outreach Program (UMADAOP)

PROGRAM SERVICES & STAFF Bellefaire JCB

Adolescent CBT Depression Tamara Iwaszkiw MSSA, LISW-S—Director of Programs Rebecca Urig, LISW-S—Intake Specialist Katie Young MSSA, LISW-S— CBT Therapist

El Centro de Servicios Sociales Victor Leandry , Executive Director Malixa Morales, Screener

JOBS Workshop Brenda Taylor-Hines, MSW Project Director/Facilitator

Lorain City Health Department Sheryl Corbin, GPRA Data Entry Clerk Kathy Loughrie—Director of Public Health Nursing Nancy Toth, BS—Health Educator Gloria M. Gonzalez—Public Health Nurse Yvonne Sproule—Public Health Nurse

Lorain City Schools Cast

Dr. David Hall, Director of Student Services Jay Nimene, Coordinator Micah Gibbs, Facilitator Jeremy Wilt, Facilitator Colin Irish, Facilitator

Teen Screen Dr. David Hall, Director of Student Services Jay Nimene, Coordinator Patty Kalo Cheryl Holmes, Coordinator, Parent Engagement Emily Roll Anna Picchionet

Lorain County Community College Public Services Institute (PSI)

Visobe Welch, Evaluator Jeff Lange, Evaluator Assistance

Lorain County Health & Dentistry The Medical Voucher Stephanie Wiersma, CEO Lisa Hemker, CFO Cheryl Newman, Systems/Facilities Manager Elizabeth Detres, Billing Associate

51

PROGRAM SERVICES & STAFF Lorain County Alcohol and Drug Abuse Services (LCADA)

Tom Stuber, CEO/PresidentMedication Assisted Therapy (MAT) Program Deborah Broaddus, LPCC-S Suboxone Coordinator Timothy Smith, LSW Student Intern Rx for Change Program Charles Mead, Director of Prevention Services Orville Dean, MA, LICDC, Program Facilitator

The 12-Step Program Leesa Clark—Director of Men’s Treatment Services Karyn Tremento, LCDC II Program Facilitator Christopher Robinson, LCDC II Program Facilitator/Screener Peggy Brewer, CDCA Program Facilitator

Lorain Urban Minority Alcoholism and Drug Addiction Outreach Program (UMADAOP)

Strengthening Families Program Ruth Williams-Clark, MSW, OCPS II Executive Director Judy Lozano, Spanish Facilitator Jennifer Day, Facilitator Andre Taylor, Facilitator

The Nord Center Amy Denger, Executive DirectorAdult CBT Depression Carol Redding, Therapist Brigid O.Brien-Demyan, Therapist Brief Couples Therapy Michael Carr, LSW Clinical Services Coordinator John Vesel, Therapist Dina Petrella, Therapist Crisis Intervention ESS Debbie McCormick, LISW-S Director of NORD ESS Emergency Stabilization Staff 24/7 Ligia Darby — Screener and Follow-up Specialist

Transportation Services

LCADA DRIVERS: Dan Haight, Supervisor Jose Santana Sam Crowell Hank Sell Dennis Ortner

PEGASUS Teresa Yuzon, Supervisor Daryl Davis, Driver Kathy Henderson, Driver

Informal Partners (50) Alicia Nicely DesignLorain County Labor Agency Blessing House Lorain County Urban League Boys and Girls Clubs of Lorain County Lorain Growth Corporation Cathedral of Praise Lorain Lighthouse Church Catholic Charities Lorain Port Authority Christian Temple Disciples of Christ Lorain Public Library Church of The Nazarene Mercy Regional Medical Center Church of The Redeemer City Center - Lorain, Ltd Digital Image Communications Faithfully Fitness Group Center Neighborhood Alliance/The Haven First Congressional Baptist Church New Creation Baptist Church Gathering Hope House Northern Ohio Recovery Association Genesis House Shelter Goodwill Industries Red Cross of Lorain County Greater Victory Christian Ministries Reserves Network Harrison Cultural Community Center Sacred Heart Church Home Heritage Presbyterian Salvation Army Italian American Veterans Post #1 Second Baptist Church LCCC - Learning Center at St Joe’s Comm. Center Sprenger Health Care Centers Legacy Staffing The Employment Network Lorain Cooperative Ministries Teen Institute of Lorain County Lorain County Community Action Agency The Key Women’s Treatment Program Lorain County Metro Housing Authority (LMHA) United Way of Lorain County Lorain County Community Development We Care We Share Ministries Lorain County Detention Home YAADA Coalition Lorain County Job and Family Services YMCA Lorain

52

About the Authors and References

Elaine Georgas is the Executive Director of the Alcohol and Drug Addiction Services Board (ADAS Board) of Lorain County, implementing agent for the PRIDE Initiative. A lifelong resident of Lorain, Ohio, Elaine graduated from Admiral King High School in 1980 and from Cleveland State University in 1985 with a Bachelor in Business Administration, finance major.

Christine Robinson, LISW-S is a graduate of Case Western Reserve University, Mandel School of Applied Social Sciences. She has been working in the addiction field for over 10 years and loves to see the miracles that occur through recovery and the resiliency of the human spirit. Christine came to the ADAS Board in 2012, after Lorain’s PRIDE began programs and services in the community.

Brenda Taylor-Hines, MSW is a graduate of Case Western Reserve University, Mandel School of Applied Social Science. She has been working in diverse communities for over 30 years assisting in the implementation of evidence-based programs and services designed to improve the quality of life and health outcomes for residents. Ms. Taylor-Hines has worked as a program consultant and trainer for national organizations including CADCA, America’s Promise, Channing-Bete, Hazelden, The BEST Foundation and the DSG, Inc.

Nancy Toth is a Health Educator for the City of Lorain Health Department. She assisted with public outreach, awareness and education activities for Lorain’s PRIDE Initiative. Nancy is a graduate of the Ohio State University with a degree in Biomedical Communications and has over 30 years of experience in training and education for all age groups.

Visobe Welch is a full-time Evaluation Specialist in the Public Services Institute (PSI) at Lorain County Community College. She holds a BA in Business Management from the University of Zambia, an MBA from Eastern University in Pennsylvania, and an MPA in Public Administration and Urban Studies from the University of Akron. In addition to management of primary data collection efforts involving multiple research approaches for PSI clientele, Ms. Welch has expertise in outcome-based program evaluation.

About the Authors

ReferencesThe following documents were the sources of information for details within this journal. The documents can be found on the following website www.lorainadas.org

CRRI FY13 3RD Qtr. Aggregate Report , CRRI FY13 2nd Qtr. Aggregate Report , CRRI FY13 1st Qtr. Aggregate Report

Annual Evaluation Report FFY12, CRRI FY12 4th Qtr. Aggregate Report, CRRI FY12 3rd Qtr. Aggregate Report, CRRI FY12 2nd Qtr. Aggregate Report, CRRI FY12 1st Qtr. Aggregate Report

Annual Evaluation Report FFY11, CRRI FY11 4TH Qtr. Aggregate Report, CRRI FY11 3rd Qtr. Aggregate Report, CRRI FY11 2ND Qtr. Aggregate Report, CRRI FY11 1ST Qtr. Aggregate Report

53

“Partners Realistically Integrating Durable Empowerment”