During the year, the State Alcoholism Authorities felt the need for an organization to deal collectively with their common problems. Incorporation documents were filed in the District of Columbia and the organization known as the Council of State and Territorial Alcohol Authorities was formed. The Council is currently recruiting for an Executive Director and other personnel. The 1974 alcoholism amendments, P.L. 93-282, which were signed into Law May 14, 1974, include special grants for implementation of the Uniform Alcoholism and Intoxication Treatment Act. States which have enacted the basic provisions of this Act were eligible to receive $100,000 plus 10% of their formula allotment. Work began immediately to develop the regulations and guidelines for this program and it is expected they will be published early in Fiscal Year 1975. DIVISION OF SPECIAL TREATMENT AND REHABILITATION PROGRAMS The Division of Special Treatment and Rehabilitation Programs was engaged in developing and supporting programs to reduce and prevent alcohol-related problems with particular emphasis on the needs of special population groups. Among the collaborative programs established were those providing treatment services designed for alcoholic employees of goverment and industry, staffing and crosspopulations, low-income persons, American Indians, Alaskan natives, Blacks, Spanish-Americans, the criminal justice population, women, youth, migrant farm laborers, chronic drunkenness offenders and drinking drivers. The Division is comprised of an Occupational Alcoholism Branch and a Special Projects Branch. Occupational Alcoholism Branch In accordance with the intent of Congress and the requirements of the Secretary of HEW under the provisions of Title II, Public Law 91-616 and Title V, Public Law 92-129, Section 501, the Occupational Alcoholism Branch has supported on a national scale major efforts to develop and implement program activities designed to meet the alcohol abuse and alcoholism treatment needs of the employed populations and the Armed Forces for whom this Branch provided consultative support in the creation and evaluation of their programs for the treatment of alcoholic members. Commencing in FY 1972, the Occupational Alcoholism Branch, in accordance with its concepts and philosophy, encouraged employers Federal, State, and local governments, private industry, and the Armed Forces to adopt "the troubled employee" approach to identify for treatment purposes those employees whose job performance was being impaired through their use of alcohol. This approach was embraced after study of the problems encountered in the implementation of early industrial alcoholism programs and a survey of existing programs. Support for the troubled employee approach met with resistance from the traditional industrial alcohologists. However, a survey of all state programs clearly revealed that "troubled employee" programs were the type more likely to be advocated by the State Occupational Program Consultants. Additionally, whereas older industrial alcoholism programs tend to be in larger companies, the survey revealed that State Occupational Program Consultants are now dealing with both smaller businesses and with organizations at the local level. The Occupational Alcoholism Program consists of three types of projects: (1) State Occupational Alcoholism Consultant Projects; (2) Programs for Federal Employees; and (3) Industrial Alcoholism Projects. Occupational State and Territorial Consultant Program Grants In FY 1974, State Occupational Grants provided each of 49 States, the District of Columbia, Puerto Rico and the Virgin Islands, with two trained Occupational consultants. They were qualified to create programs of management control systems for business, industry, and State and local government in cooperation with management and employee organizations. In January 1974, an 18-month continuing education program for occupational program consultants employed by the States and sponsored by grant funds from the Institute was concluded. To advance the training of Occupational Consultants at the State, Regional and Local levels, a contract was awarded in April 1974 to an educational institution to support training for personnel now employed in the 52 State and Territorial Programs through June 1975. To determine the impetus generated in the private and public sectors as a result of State Occupational Alcoholism efforts, an updated survey was undertaken. Tentative statistical data on 18 states at the time of this input indicated: 121 new private company programs with substantiated policy statements Programs for Federal Employees While the Civil Service Commission (under Public Law 91-616) is responsible for developing programs in civilian agencies in cooperation with those agencies, NIAAA provided, on request, technical consultative assistance to the Commission and to individual agencies. The Occupational Alcoholism Branch fulfilled its mandate by assisting in the development of programs through providing consultation from a cadre of experts drawn from around the country to Civil Service personnel and to Federal department facilities, wherever located. This responsiveness has extended to components of the Department of Defense. Industrial Program Grants Industrial Alcoholism Project Grants were funded and aimed at the development of services within the industrial environment capable of reaching the employed, problem drinker early in the course of his illness. The program seeked to establish new methods of effective case-finding, referral systems and industry-union-community relationships to facilitate the provision of services to alcoholic employees. During FY 1974, a total of 21 project grants were awarded. In FY 1974, a total of 78 occupational grants, including the 21 industrial program grants, were awarded in the amount of $6,536,193 for 49 States, the District of Columbia, Puerto Rico and the Virgin Islands. Special Projects Branch The Special Projects Branch has two thrusts: (1) the Staffing and CrossPopulation programs, the Poverty Programs, and the Special Population Programs American Indians, Alaskan Natives, Black, Spanish-Americans, Women, Youth, Migrant Farm Laborers; and (2) the Alcohol and Public Safety Programs including the Drinking Drivers, the Criminal Justice and Public Inebriate Programs. Staffing and Cross-Population Programs During FY 1974, staffing grants provided support of program efforts to develop and conduct comprehensive alcoholism treatment and rehabilitation services programs. Funds were made available to support initial salary costs of professional and technical personnel providing alcoholism services. This program is authorized under Part C of the Community Mental Health Centers Act, Public Law 91-211. The NIAAA has been utilizing the comprehensive staffing grant mechanism to provide funding for such programs. However, this funding mechanism required a specific range of services, including inpatient, outpatient, intermediate, and emergency care as well as consultation and education services, regardless of the total needs of service recipients. In addition, the staffing grant mechanism was limited to the provision of funds for the salaries of professional and technical personnel. It did not provide funds for consultation fees, equipment, travel, etc. In an effort to be more responsive to the total human needs of service recipients, the NIAAA discontinued the use of the staffing grant mechanism in funding new projects. The direct project grant, which allows funding support for the full operating cost without specific type of service requirements and limitation on the use of consultants, is now being utilized as the funding mechanism for such programs. The term "Cross-Population Program" was devised as a means of identifying this particular program effort. This term "Cross-Population" is in keeping with the Institute's policy of directing the focus of communities on the needs of alcoholic people rather than the needs of institutions or particular service systems. Cross-Population Projects enable communities, which consist of more than one target population group, to utilize the various guidelines of the Institute that pertain to these special population groups in a flexible manner as determined by the needs of the alcoholic population. The Institute is continuing its commitment to the presently funded Staffing Grant Programs. During FY 1974, a total of 45 comprehensive staffing programs were supported in the amount of $11,839,943. Poverty Program The Community Alcoholism Services Poverty Program is a component of the Special Projects Branch within the Division of Special Treatment and Rehabilitation Programs. This program was initiated officially on May 7, 1972, concurrent with the transfer of the Alcoholism Recovery Projects from the Office of Economic Opportunity to the National Institute on Alcohol Abuse and Alcoholism. The intent of the program is to support special projects that demonstrate how a variety of services can be made available, and be effectively utilized by the poor alcoholic person and his family. In a broader context, it is intended to demonstrate that the poor can be integrated into existing health and social service systems. Additionally, a contract between the National Council on Alcoholism (NCA) and the Office of Economic Opportunity to provide technical assistance and monitoring to the service programs was transferred to NIAAA on July 1, 1972, at a cost of $305,629. This contract has been renegotiated for an additional year. The total cost for FY 1974 was $140,746. During FY 1974, 186 projects were funded at a level of $14,909,705. The American Indian Program The Institute has recognized the special severity of alcoholism problems among American Indians and has made support of alcoholism programs for them one of its top priorities. During FY 1974, NIAAA supported 124 Indian alcoholism grants totalling $12,485,873, in both urban and reservation areas. The primary objective in FY 1974 of the American Indian alcoholism program was to assist in making the best alcoholism treatment and rehabilitation services available at the community level. To accomplish this objective, each program was designed to provide a variety of services which included residential care, including room and board, for problem drinkers who were seeking help--individual counseling, job placement, referral service, group therapy, Indian AA groups, didactic lectures, work therapy, recreation and self-government. Other methods which were utilized to help Indian communities solve their alcohol abuse problems included broad programs of public education, training of Indian people, and development of community services. Since their inception, the Indian alcoholism programs have had a significant impact upon the attitude of Indian people toward drinking--the first vital step in recovery. The communities and Indian tribes living on reservations have gained valuable knowledge about alcohol abuse and are now viewing alcoholism as a major social, cultural, and economic problem. Other alcoholism programs without Federal funds were developed, and community resources have been organized in a concerted effort to meet the needs of Indian people afflicted by alcoholism. The following are examples of the results achieved in FY 1974 by the alcoholism programs supported by NIAAA: 50% of the NIAAA Indian alcoholism program clients recovered and became productive citizens 10% of these became sober 40% changed drinking patterns for the better (family relationships did improve). 15-20% did obtain jobs through the programs this was especially The NIAAA programs did encourage Indian persons in Federal, State and Approximately 100 Indian Alcoholics Anonymous groups have been esta- To assist in carrying out its objectives an Indian Desk was maintained within NIAAA which was staffed by experienced Indian people to monitor, assist, and advise these programs. In addition, the Indian Desk is charged with the responsibility of maintaining close liaison with other Federal agencies involved in health care and social service delivery to Indian people, as well as with national Indian advocate organizations. The NIAAA also employs the American Indian Commission on Alcohol and Drug Abuse (AICADA), a non-profit organization, to provide technical assistance to isolated American Indian communities on and off the reservation. AICADA, located in Arvada, Colorado, has earned the reputation as an organization representative of Indian interests with experience in combating the unique problems associated with alcohol abuse among the American Indians. Alaskan Native Programs To parallel the above efforts of NIAAA, a special "mini-grant" program was launched in FY 1973 to provide $5,000 - 10,000, one year project grants to Alaskan Native communities to assist their people in developing their own alternatives to combat alcoholism among the Alaskan Native people. In FY 1973, the NIAAA funded 44 Alaskan Native mini-grants in the amount of $472,826. During FY 1974, 119 additional new mini-grant programs were funded in the amount of $1,179,398. The overwhelming response of the Alaskan Native people has been to construct, remodel, or rent village centers to serve as focal points for Alaskan Native people in which to engage in a variety of constructive activities such as arts and crafts, youth and adult recreation, repair and sale of small machinery such as snow equipment, employment training, village meetings and AA meetings. The variety of planned activities and equipment is regarded by the Alaskan Native communities as their most urgent need and most effective way to begin helping their people face and overcome their drinking problems. Programs for Special Population Groups Many minority groups in our society have experienced exceptional deprivation. For these disadvantaged citizens, heavy drinking has accentuated or been a response to such hardships as a limited access to job opportunities, unequal housing and schooling, and inadequate medical care. In an effort to be responsive to the needs of such population the Institute has placed heavy emphasis on providing funding support to these target populations. Black Alcoholism Program An initiative to establish an advocacy group to represent the Black alcoholism constituency has been launched by a group of Black alcoholism program people resulting in the formation of the National Black Council on Alcoholism (NBCA). The goals of the NBCA are: to promote the development of policies and programs responsive to the needs of the Black alcoholism constituency and its service providers; to establish a viable communications network for dissemination of relevant information to Black alcoholism workers; to stimulate the development of Black-oriented alcoholism research; and to identify training needs and develop the mechanism for meeting these needs. Spanish-American Programs As a result of the demonstrated need for alcoholism programs to assist this bicultural and bilingual population, the Spanish-American communities organized themselves under the aegis of the National Commission on Spanish-Speaking Alcoholism, Inc. (NCSSA). This group officially incorporated itself on August 30, 1974 in Los Angeles, California, to assist in the establishment, implementation and enhancement of alcoholism programs within the Spanish-Speaking Community. The NCSSA has requested financial and technical assistance from NIAAA in planning a National Alcoholism Conference for Spanish-Speaking in March 1975 in San Francisco. The main purpose of the Conference will be to provide assistance to community-based organizations in the areas of treatment and rehabilitation, training, prevention, research, and technical assistance in order to insure the establishment, implementation, and enhancement of alcoholism programs within the various Spanish-Speaking communities of the United States and Puerto Rico. |