Summary Regional Demographics Data Needs identified in one or more communities across the region

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1 Community Partnership Regional Support Center Community Needs Assessment FY2013 Summary A community needs assessment was completed for the 21-county region served by the Community Partnership Regional Support Center (RSC). Community Partnership Regional Support Center has held the ADA contract for 20 years. This region includes the Missouri Division of Alcohol and Drug Abuse (ADA) Service Areas 9, 10 and 18. This assessment was based on county level data for each of the 21 counties, as well as more detailed data for the communities/areas served by the 23 active ADA-registered coalitions in this region. Registered coalition s existence ranges from one to 20 years. The Regional Support Center is involved with several other organizations and nonregistered ADA coalitions in which data is not included. Regional Demographics Data According to the 2011 census data, the region s estimated population is 946,952. While this 21-county region includes Missouri s 3 rd and 14 th most populated cities (Springfield and Joplin), the majority of the region is rural. Aside from Springfield and Joplin, the average population of the communities where ADA-registered coalitions are located is 5,100. The region s racial makeup is 95.2% Caucasian (92.3% Caucasian, not Hispanic), 3.4% Latino, 1.9% two or more races, 1.1% Native American, 1% African American and <1% other. While the overwhelming majority is Caucasian, there has been a dramatic increase in the Latino population over the past decade resulting in some communities with over 50% of the population being Latinos. According to 2011 census data, the region is slightly higher than state s rate with 24.1% (23.5% Mo) of the population being under 18 years of age, and the percentage of persons over 65 in the region is 17.5%(14.2% Mo). Needs identified in one or more communities across the region Please highlight any needs that apply to your coalitions if not already highlighted by someone else. Too many youth are consuming alcohol Too many college students are engaging in underage and risky drinking Too many youth are abusing prescription and over-the-counter (Rx/OTC) drugs Too many youth are using synthetic drugs Too many adults and youth use tobacco Too many people are exposed to environmental tobacco smoke Too many youth are using marijuana Too many problems associate with meth use and manufacturing Too many incidents of domestic violence and child abuse and neglect Too many college students involved in interpersonal violence and/or being taken sexually advantaged of at Springfield colleges and universities Too many youth have experienced interpersonal violence Too many youth are involved with a gang 1

2 Data to Support Identified Community Needs Barry County - 3 coalitions (identified needs - underage tobacco use, environmental tobacco smoke, underage drinking, teen Rx/OTC drug abuse, bullying and suicide) 26% of Barry County residents smoke (Missouri rate 23.2%) - MFH Missouri County Level Survey (MCLS) 64% of youth have a family member using tobacco - Barry County School Tobacco Use Survey 33.5% of Southwest students surveyed reported using tobacco in the past 30 days, as compared to only 16% of youth in Barry County as a whole. Missouri School Survey (MSS) % of Barry County youth reported using alcohol in the past 30 days Behavioral Health Profile, May 2012 In Barry County, 58.7% of youth believe that it would be easy to get cigarettes and 48.4% have friends who smoke Behavioral Health Profile, May % of Barry County students reported alcohol would be easy to obtain - Behavioral Health Profile, May % of Barry County youth report using Rx medications for non-medical purposes in the last 30 days Behavioral Health Profile, May % of all Barry County students surveyed reported abusing Rx/OTC drugs in their lifetime MSS 2010 School administrators and resource officers report increases in incidents of teen prescription and OTC drug abuse among students Christian County 3 coalitions (identified need - environmental tobacco smoke, teen Rx/ OTC drug abuse, and suicide) 20% of Christian County adult residents smoke Behavioral Risk Factor Surveillance System (BRFSS) In the last year Christian County has seen smoking among pregnant women increase from 12.7% to 14.2% - Behavioral Health Profile (BHP) Christian County There has been an increase since 2003 in the number of people who think smoking should not be allowed at all in restaurants and would support a smokefree restaurant MCLS % of youth in Christian County believe that it would be easy to get cigarettes and 39.7% have friends who smoke BHP Christian County 5.26% of youth report abusing Rx drugs and 4.86% of youth reported abusing OTC medications MSS 2010 Nixa had 4 teen fatalities related to Rx drug overdoses, three of those within a 5- month period Nixa Police Department Christian County had 9 reported suicides in 2009 and individuals reporting serious psychological distress is higher than the state average BHP Christian County 402 residents received treatment for serious mental illness at publicly-funded facilities in 2011 BHP Christian County 2

3 Dade County 1 coalition (identified needs underage drinking, teen Rx/OTC drug abuse, methamphetamine, and drug endangered children) 13.91% of youth reported binge drinking in the last 30 days, which is higher that the state average of 11.40% MSS 2010 Schools have reported hospitalization of student for Rx/OTC abuse, an attempted suicide with Rx/OTC, and multiple incidents of confiscation for distribution and abuse 7.3% of Dade County youth considered suicide in the past year, 6% made a plan, and 1.4% actually attempted 8% of youth reported abusing Rx drugs, compare to the state average of 6.7% - MSS methamphetamine labs were seized in 2011, down from 7 in 2009 BHP Dade County In 2010, Dade County had 27 DWI arrests and 49 drug-related arrests 34% of children under the age of 18 live in poverty, much higher than the state average of 21% and almost triple the national benchmark of 13% - County Health Rankings 2012 Douglas County 2 coalitions (identified needs underage drinking, underage tobacco use, environmental tobacco smoke, and teen Rx/OTC drug abuse) 22.11% of youth reported using alcohol in the last 30 days and 12.79% have participated in binge drinking, both higher than the state average. MSS % of Ava youth reported smoking cigarettes in the last 30 days, which is higher than the state average of 13.7% MSS % of youth reported using chewing tobacco in the past 30 days, more than double the state average of 6.1% - MSS % of youth believe that it would be easy to get cigarettes and 54.1% have friends who smoke (Behavioral Health Profile, May 2012) 23.6% of Douglas County adult residents smoke - MICA There was in increase in pregnancies in which the mother reported smoking in the last year from 25.7% to 28.5% (Behavioral Health Profile, May 2012) 6.76% of youth reported abusing Rx drugs and 5.05% reported abusing OTC medications, both higher than the state average MSS % of arrests are directly related to drugs and alcohol, an increase of 3% from 2010 Missouri Statistical Analysis Center (MO SAC) 2011 Greene County - 7 coalitions (identified needs - environmental tobacco smoke, teen Rx/ OTC drug abuse, underage drinking, interpersonal violence, domestic violence, child abuse and neglect, gang involvement, and suicide) Smoking attributable deaths are the 3 rd leading cause of death in the county MCLS % of youth report that it would be easy to get cigarettes MSS % of youth report abusing Rx drugs and 5.76% report abusing OTC medications, both above the state average MSS

4 Greene County had 3,190 reported incidents of domestic violence and 88 arrests for sexual offenses in 2011 MO SAC 2011 Over 1,100 domestic violence hotline calls were answered and 30,000 safe & secure bed nights were provided to women and children Harmony House % of child abuse and neglect referrals in Greene County were primarily for parental substance abuse problems - Greene County Juvenile Report 2011 Greene County rated 109 out of 115 Missouri counties for incidents of child abuse and neglect (3,371) in 2010; the Greene County child abuse and neglect rate is nearly double the state rate (57.7% per 1,000 vs. 31.9% per 1,000) Kids Count 2011 The average age of first use of alcohol by youth is 12.63, 72.6% of youth surveyed report people have moderate to great risk of harming themselves if they drink any type of alcohol, 13.8% report past 30-day use of alcohol, and 81.9% report that their parents would feel it is wrong or very wrong for them [the child surveyed] to drink any type of alcohol MSS 2012 (Springfield Public Schools) In 2011 in Greene County, there were 584 MIP s and 10 fake or false ID tickets issued to minors, up from 723 MIP s and 22 fake or false ID tickets issued in 2010 Greene County Prosecutor s Office Greene County had 38 reported suicides in 2009 and the suicide rate for Southwest Missouri is higher than the state rate. BHP Greene County Youth in Greene County reported higher rates than the state average for feeling very sad, feeling hopeless about the future, and seriously considered attempting suicide MSS 2010 Jasper County 3 coalitions (identified needs - underage drinking, teen Rx/OTC drug abuse, environmental tobacco smoke, domestic violence, child abuse and neglect) 52.16% of youth believe that it would be easy to get alcohol and 51.12% have friends who drink alcohol MSS 2010 Jasper County has been identified by the Office of the National Drug Control Policy as a HIDTA, or High Intensity Drug-Trafficking Area, due to the high rate of illegal drug use, manufacturing and movement in the area 6.54% of youth reported abusing Rx drugs and 4.86% reported OTC medication abuse MSS 2010 Most Jasper County communities have no environmental tobacco smoke restrictions beyond state law Jasper County continues to experience significant substance abuse related consequences following the tornado from May 2011 A ballot measure restricting smoking to designated areas was passed in one Jasper County community, but was quickly overturned by city council Jasper County had 1,112 incidents of domestic violence reported in 2011 MO SAC Jasper County rated 67 out of 115 Missouri counties for child abuse and neglect (1,191), higher than the state rate (39.3/1,000 vs. 31.9/1,000); out of home placement was over double the state rate (10.8/1,000 vs. 4.4/1,000) Missouri Kids Count

5 Newton County 1 coalition (identified needs - underage drinking, teen Rx/OTC drug abuse, methamphetamine and synthetic drug use) In 2010, Newton County had 326 DUI arrests, 54 liquor law violations, and 68 alcohol-related crashes BHP Newton County In state fiscal year 2011, 354 Newton County residents were admitted to substance abuse treatment. Of this number, 159 had alcohol listed as their primary substance of abuse while 81 listed marijuana BHP Newton County Neosho School District administrators report increases in incidents of both teen Rx/ OTC drug and synthetic drugs abuse among students 5.16% of youth reported abusing Rx drugs and 5.06% reported abusing OTC medications MSS 2010 Neosho Police reported that 41 of their 131 drug violations were meth-related cases Neosho Police Department 2010 Year End Report There were 36 meth lab seizures in BHP Newton County Polk County 1 coalition (identified needs - underage drinking, teen Rx/OTC drug abuse, suicide, youth violence/bullying, child abuse and neglect; lack of safe places for youth to access) From , there were 32 deaths and 129 hospitalizations in Polk County due to unintentional poisoning for drugs/alcohol (both over the state rate) MICA 49.3% of youth reported having a drink of alcohol sometime in the past year MSS % of youth reported abusing Rx drugs in the past year and 6.4% reported abusing OTC medications MSS 2010 In the past year, 9.5% of youth considered suicide, 6.4% planned suicide, and 4.6% attempted suicide MSS % of youth reported being bullied on school property and 13% of youth reported they did not feel safe at school MSS % of youth reported making fun of someone, 32% reported having spread rumors about other students, and 22% were involved in physical fights in the past year MSS % of all out-of-home placements were due to parental drug use and over 900 juvenile court referrals were made for child abuse and neglect Polk County Family Support Division 2011 From January 2012-August 2012: 11 domestic disturbances, 9 domestic assaults, 6 endangering welfare of a child; 1 sexual assault Bolivar Police Department In 2011, 15 youth died with 7 of them being due to high risky behaviors Polk County House of Hope Stone County 1 coalition (identified needs underage drinking and substance abuse, including prescription/over-the-counter drugs) Based on assessments completed by the juvenile office during a 10 month period, 55 youth were identified with moderate to severe alcohol/drug problems 30% of arrests are directly related to drugs and alcohol, and of those arrests 17% were minors under 18 years old MO SAC

6 Arrests of minors resulted in 16 for sales of illegal substances, double the number in 2009, and 22 for liquor law violations or MIP MO SAC % of youth reported ever having a family member with a severe drug or alcohol problem MSS % of high school youth have abused prescription drugs and 11% have abused over the counter drugs MSS % of high school youth have consumed alcohol MSS 2010 Taney County 1 coalition (identified need - underage drinking, environmental tobacco smoke, and Rx/ OTC drug abuse) 2010 Missouri School Survey (MSS) Data from Taney County indicates that 78% of students believing drinking 1-2 alcohol drinks per day is dangerous Branson s alcohol outlet density is 6.6 times greater than Missouri s outlet density (1 per 68 residents vs. 1 per 451 residents) Hospital records indicate the drug and alcohol overdoses/poisoning rate for local teens ages is higher compared to Missouri s rate (6.55/1,000 vs. 3.62/1,000) 19% of teens surveyed reported riding in a car in the past 30 days with someone who had been drinking alcohol (2010 MSS), down from 27.5% reporting this on the 2008 MSS The Branson Chief of Police reported in an interview that 50% of all service calls to Branson Police Department in 2009 were alcohol related, including crimes like assaults, with approximately 10% of those crimes committed by youth 38% of youth reported trying alcohol in their lifetime (2010 MSS), down from 46.76% in % of youth reported that alcohol was sort of easy or very easy to obtain (2010 MSS), down from 70% in 2008 Approximately 75% of alcohol retailers checked passed their compliance checks in 2011 Taney County has the highest smoking rate in Missouri 12% of youth reported lifetime abuse of Rx drugs and 7% reported lifetime abuse of OTC medications, while 6% of youth reported past 30 day abuse of Rx drugs and 4% reported past 30 day abuse OTC medications 2010 MSS Webster County 1 coalition (identified needs underage drinking, teen Rx/OTC drug abuse, child abuse and neglect) 32% of arrests are drug/alcohol/violence offenses MO SAC 2010 For youth ages 15-18, there were 9 arrests for DUI, 21 arrests for liquor law violations, and 1 arrest for drunkenness MO SAC % of youth report that it would be easy to get alcohol MSS % of youth reported abusing Rx drugs and 6.4% reported abusing OTC medications, both above the state rate MSS arrests were made for offenses against family and children MO SAC in 4 high school students have consumed alcohol in the last 30 days. 73% of high school students reports that their peers drink alcohol 6

7 Wright County 1 coalition (underage drinking, Rx/OTC drug abuse) 17.22% of youth report drinking alcohol and 10.55% report binge drinking in the last 30 days MSS % of youth report abusing Rx drugs and 5.10% report abusing OTC medication, both above the state rate MSS 2010 Risk and Protective Factors Identified Please highlight any needs that apply to your coalitions if not already highlighted by someone else. 1. Decrease community laws and norms favorable towards: Underage drinking Underage tobacco use Teen Rx/OTC drug abuse Environmental tobacco smoke Domestic violence / sexual assault Child abuse and neglect Gang activity Methamphetamine Marijuana Synthetic drugs 2. Decrease availability of: Alcohol to minors Tobacco to minors Rx/OTC drugs to teens Synthetic Drugs Environmental tobacco smoke in the community 3. Decrease attitudes favorable towards: Underage alcohol use Underage tobacco use Teen Rx/OTC drug abuse Synthetic Drugs Bullying among youth Tobacco smoke exposure 4. Increase communities readiness for change to address substance abuse problems and their related consequences. 5. Increase coalitions capacities to utilize the Strategic Prevention Framework (SPF) to reduce community substance abuse problems and their related consequences. 7

8 6. Increase youth s resistance skills and provide youth with meaningful opportunities, skills and recognition for prosocial involvement. Capacity of Resources in the Community Communities across the region have a variety of resources that can be utilized to assist prevention efforts of each coalition. Key community resources are identified below. Ava Douglas County Health Department has received a second MFH tobacco grant and Wal-Mart and Community Foundation of the Ozark grants for cessation aids A community wellness center was completed in June 2010 and the coalition is working with another group to bring a playground to the community The Douglas County Health Department has dedicated staff to assist with prevention of underage tobacco use and environmental tobacco smoke Coalition activities are regularly highlighted in the local newspaper and recently had a member of the media join the coalition Several segments of the Community Wheel model were mentioned in last year s assessment as needing representation, including local law enforcement and city government. Within the past fiscal year, both the Sheriff of Douglas County and the County Treasurer have joined the coalition and become active and vocal members. The coalition has begun changing its focus to address issues brought to their attention by law enforcement Ava, the only incorporated city in Douglas County, has established designated tobacco use areas in its local park area The coalition has established strong relationships with local and state legislators serving Douglas County. At the request of legislators, the coalition now hosts quarterly legislative lunches with speakers from the community to increase knowledge of local events and issues. Barry County Cassville High School has an active SADD that has presented before the school board in support a 100% tobacco free school policy 4 of the 7 county school districts have implemented tobacco-free campus policies in the past two years Media outlets are as active members on multiple coalitions and support local prevention efforts assisting with community Law enforcement act in the capacity of both coalition leaders and/or members on two Barry County coalitions Local healthcare providers; Cox Health, Mercy and a local public clinic are active and supportive of coalition YMCA s exist in both Monett and Cassville and have become more involved with coalition efforts and reaching youth and parents Barry County schools implement prevention activities throughout the year, such as Red Ribbon Week, DARE, Save a Life Tour, Safe and Sober Prom, and Project Graduation 8

9 Bolivar The Polk County Health Department has an MFH grant for tobacco prevention The Bolivar YMCA has an after school program as well as many child care facilities and school clubs that offer after school activities and tutoring Bolivar implements multiple evidence-based programs including the Developmental Assets model, Too Good For Drugs, Mental Health First Aid, QPR Suicide Prevention, Love & Logic, Strengthening Families, and WreckEd in the classrooms of the high school Bolivar law enforcement conducts regular alcohol compliance checks and utilize the Pathways to Selling Alcohol Safely training kit with local alcohol retailers Bolivar law enforcement collaborated last year with the coalition to host Rx/OTC Take Back Events as well as to host a permanent Rx/OTC drug drop box available to the community Bolivar has a long standing coalition (nearly 20 years) with a large volunteer base that partner with many local organizations to accomplish its goals. The coalition recently completed a Kaizen assessment to evaluate the functioning of the coalition and how different elements can improve. Carthage The Carthage coalition was awarded a continuation Drug Free Communities grant and employs a project coordinator and part-time coordinator The Carthage coalition has involvement from all segments of the Community Wheel The Carthage School District is one of five school districts in Missouri implementing the ADA SPIRIT program and implements the following substance abuse prevention Best Practice programs: PeaceBuilders and Too Good For Drugs The high school has two substance abuse prevention clubs, Smokebusters and Carthage In Action that are active coalition members and volunteers The coalition implements multiple programs including Project Sticker Shock, compliance checks, and Child Parent Relationship Training Christian County MSU s Ozarks Public Health Institute provides a staff person to coordinate the breathe easy Christian County (BECC) coalition Christian County Health Department offers tobacco cessation classes Christian County communities have implemented partial smoking bans over the last five years in both Nixa and Ozark The Christian County RxTACC coalition has active leadership and involvement from local law enforcement, city officials, and Nixa school personnel 9

10 Nixa was one of 10 sites in Missouri awarded a Rx/OTC drop box through MYAA in 2011 Dade County The Dade County Health Department provides the county s health educator as the coalition s team leader Dade County is made up of very small communities, yet multiple youth programs are available through local churches, Boys Scouts, and 4H Law enforcement and county officials are members of the coalition and actively support prevention strategies School administration and faculty are actively engaged and supportive of coalition efforts Greene County The City of Springfield passed a second ballot initiative to continue implementation of city ordinance prohibiting smoking in all businesses City and County law enforcement conduct regular alcohol compliance checks Republic and Springfield coalitions were awarded ADA mini-grants Greene County has a successful Drug Court and several specialty courts, including a DWI Court that has been recognized as a national model and training DWI Court Community Partnership coordinates Mandated Reporter training in Greene County Springfield has a Caring Communities contract from the Department of Social Services VFF is a member of the Missouri Coalition Against Sexual and Domestic Violence The Victim Center, Harmony House, and Child Advocacy Center are located in Springfield Springfield is home to two major hospital networks (St. Johns and Cox) UDTF has a federal STOP grant UDTF, VFF and GTF have involvement from the majority of segments from the Community Wheel Law enforcement and city officials are active members and supporters of all Greene County coalitions Multiple substance abuse and mental health treatment facilities are located in Greene County, servicing Southwest Missouri 10

11 Jasper County A Children s Trust Fund grant was awarded in Joplin to build community capacity to reduce child abuse and neglect and improve access to services for these children Joplin area law enforcement collaborated last year with the coalition to host Rx/OTC Take Back events in multiple locations in and around Joplin and currently host permanent Rx/OTC drop boxes in seven locations across Jasper County The Joplin coalition has significant representation from the local school district and Division of Youth Services in support of prevention efforts Joplin has a Caring Communities contract from the Department of Social Services which provides part-time staff for coalition coordination and support Joplin has multiple hospitals and substance abuse and mental health treatment centers serving the far Southwest Missouri counties Joplin implements Stewards of Children, a child sexual abuse community awareness program Many new resources are now available to Joplin and Jasper County following the tornado of 2011, including a current SERG grant ending in September and continued trauma-related funding from SAMHSA for four years Marshfield Marshfield High School has both a substance abuse prevention club and a peer mediation group Webster County Sheriff s Department and Marshfield Police Department collaborated with the coalition to host Rx/OTC Take Back events Law enforcement have volunteered for after-school mentoring program and acted as a mentor for one youth Marshfield has MELD, a after school teen parenting support program Coalition hosts community events, including annual Father-Daughter Dance and a Health and Safety Fair for all residents to receive vital information and screenings Coalition member created a smoke-free dining guide for all of Webster County and it is distributed at multiple sites to the community Neosho Neosho was a 2012 Drug Free Communities Grant Recipient and has one full time and one part time staff allocated to prevention efforts Local treatment providers and recovery support group are engaged in providing support for prevention efforts The YMCA and Neosho Youth Board are actively involved with the coalition and volunteer for alternative activities in the community and host three alternative activities for youth each year 11

12 Local law enforcement and the school resource officer are actively involved in on the coalition Over that past year the coalition has established a relationship with their local representative to the State of Missouri Stone County The coalition is strongly supported by city and law enforcement agencies. Members include the local judge overseeing Drug Court and Juvenile Drug Court, a local lawyer, juvenile officers, and is chaired by the Drug Court Administrator Stone County has multiple specialty courts including Drug Court, Juvenile Drug Court, and a DWI Court Stone County acquired two permanent Rx/OTC drug drop boxes that are available to the community, housed by local law enforcement Taney County Taney County s coalition has strong community support, especially from local government and city officials, the Taney County Health Department, school districts, substance abuse treatment providers, local newspapers, alcohol retailers and other businesses The City of Branson passed an enhanced alcohol ordinance that significantly strengthened its alcohol laws. Highlights from this ordinance include the creation of a liquor control specialist position, mandatory responsible beverage service training for all employees of alcohol establishments, prohibition of alcohol vaporizers, limitations on drink specials, no alcohol advertising in windows of bars and restaurants, no minors in alcohol-serving bars and restaurants after midnight, and restrictions on alcohol outlet density The city and county prosecutor s adopted a new policy to aggressively prosecute persons using/attempting to use fake ID s The Taney County ADAPT coalition was the CADCA Got Outcomes Coalition of Excellence national award winner in 2010 Branson High School has a drug free club that collaborates with the Branson coalition regularly Branson Police Department conducts alcohol compliance checks at least two times a year Taney County ADAPT was awarded an ADA mini-grant Wright County The coalition has support from the Juvenile Probation Units serving Wright, Texas, Douglas, and Howell Counties 12

13 The community collaborative - Together Everyone Achieves More and Wright County Resource Team are support of prevention efforts and provide volunteer resources for events and host presentations on ATODV prevention Gaps in Community Resources Each community in the region has gaps in resources that, if improved, could enhance the community s ability to reduce substance abuse and related consequences in the community. Key gaps in community resources are identified below. Ava Ozark Action and Department of Social Services (DSS) both had drastic cuts in the fiscal year. Ozark Action has reduced the amount of services available to families and children and DSS closed their Ava office There are only seven primary care physicians in the county and no mental health providers other than one social worker at the Ava Medical Clinic that now splits her time with a facility in Wright County For the past four years, Ava has had a very active Smokebusters Club in the high school who worked closely with the coalition, both as active coalition members and volunteers; however the funding for the program ended in August The youth are maintaining their affiliation with the coalition and grant funds have been applied for to maintain their prevention activities within the community. Barry County The Barry County Connections coalition lacks membership from local school administration, the American Cancer Society, and American Lung Association Commitment is needed from the three remaining school districts to implement 100% tobacco-free campuses Due to funding cuts among multiple agencies, sustaining prevention efforts has been difficult While the Southwest COED coalition strives to serve both Washburn and Seligman, the coalition has not been successful in facilitating effective communication between community leaders/members of the two communities The area served by the Southwest COED coalition is very rural and has very few opportunities for youth to become involved in healthy alternative activities The coalitions have not established strong relationships with state legislators serving Barry County People seeking substance abuse treatment services have to travel outside the county to Joplin, Springfield, or Branson Bolivar Bolivar has had a number of recent suicides but has few mental health treatment options, and agencies are experiencing high turnover rates among staff After school prevention education is being conducted by the same few people 13

14 The coalition has not established strong relationships with state legislators serving Bolivar Most opportunities for youth are provided by the schools, whose buildings close by 6pm, leaving a gap of positive activities for youth to engage in during the evening/weekends Lack of transportation for teens, especially in rural areas, limit youth on becoming involved in positive activities There is a lack of adequate funding to meet all the prevention needs of the community It is difficult for coalition members to make meetings, resulting in a lull of collaborative efforts outside of /phone calls Branson The Branson coalition was formed in mid-2007, so some coalition members lack significant prevention experience and training to effectively implement the SPF model in the community The City of Branson has had difficulty enforcing some components of the alcohol ordinance that went into effect in % of retailers participating in alcohol compliance checks failed the checks and are at risk for consequences from both the City of Branson and State Division of Alcohol and Tobacco Control Members of Branson s youth substance abuse prevention clubs have not been able to regularly attend coalition meetings, as they have most often been held during the school day There is a lack of adequate funding to meet all the prevention needs of the community Carthage Carthage has had a sudden increase in population after the Joplin tornado, resulting in an increase in needed services from this population Lack of bilingual service providers and school staff causes difficulty for some Latinos to successfully integrate into the community Many of the prevention strategies of the Carthage coalition are implemented by a few coalition members, and the need for more active involvement in program implementation from additional members is needed There are few substance abuse treatment beds available in the area for teens The coalition has not established relationships with all state legislators serving Carthage The coalition needs to increase the youth members involvement in assessing and planning strategies to address prevention efforts Christian County breathe easy Christian County (becc) continues to struggle with recruiting local community members to the coalition 14

15 The Christian County RxTACC coalition is a new coalition that lacks many representatives from the Community Wheel, as well as members with SPF knowledge The coalition has not established relationships with state legislators serving Christian County There is a lack of adequate funding to meet all the prevention needs of the county Dade County The Dade County coalition lacks membership from the business, faith-based, youth, senior citizens, service organizations, and parent segment of the Community Wheel Dade County is very rural with a county population of only 7,925, has no hospital or urgent care center, and has few law enforcement personnel for the entire county The coalition has not established relationships with state legislators serving Dade County There is a lack of adequate funding to meet all the prevention needs of the county Greene County Sustainable funding is needed to support annual projects Coalitions have not established strong relationships with all state legislators serving Greene County A number of Community Wheel segments are lacking from active participation on VFF and GTF Jasper County Financial and ATODV needs assessments are still impacted by the May 2011 tornado Hospitals, treatment, and mental health services are still rebuilding after the tornado, yet they are seeing increases in service needs Coalitions do not have strong relationships with their state legislators serving the Joplin and Jasper County area Both the Joplin Area Coalition (JAC) and Zero Violence coalitions lack a number of segments from the Community Wheel as active members of the coalitions. Marshfield There is a lack of adequate funding to meet all the prevention needs of the community The coalition s boundaries extend countywide, however the coalition has had little success in incorporating the other communities outside of Marshfield in prevention activities The same volunteers and local funding sources are utilized by many organizations in the community The coalition has not established relationships with state legislators serving Marshfield 15

16 The community of Webster County/Marshfield is often difficult to engage in events and activities Neosho The coalition struggles with its connection to the local governmental representative and the business community While possessing a broad base of support for the coalition from the community, the coalition does need technical assistance for engaging membership and implementation of practices Substance abuse treatment and mental health services are limited in the county The coalition lacks a number of segments from the Community Wheel model including senior citizens, parents, social services, law enforcement, and government Stone County Transportation is the main barrier for residents seeking substance treatment or mental health services often located outside the county in Branson or Springfield All communities in the county are small and lack alternative activities for youth during the evenings and weekends There is a lack of adequate funding to meet prevention needs in all communities in the county Wright County The coalition has not established relationships with state legislators serving Wright County Coalition has little substance abuse prevention experience and knowledge of how to integrate the SPF model into its community efforts There is a lack of adequate funding to meet all the prevention needs of the county Great distance exists between communities in the county, making access to services difficult No public transportation is available Substance abuse treatment and mental health services are limited in the county Coalition Assessment Data The needs identified above are based on empirical data collected from the 2008 and 2010 Missouri School Surveys, Missouri Statistical Analysis Center, local law enforcement reports, County Health Ranking & Roadmaps, Missouri Kids Count, Missouri Department of Health and Senior Services county health departments, Missouri Foundation for Health - Missouri County Level Survey, Behavioral Risk Factor Surveillance System, Missouri Information for Community Assessment, Behavioral Health Profiles, Greene County Juvenile Report, Family Violence Center 2011 Report, Neosho Police Department 2010Year End Report, and United States Census Bureau. In addition, needs assessment data was gathered from youth and adult focus groups, key informant interviews, and coalition needs surveys collected for each ADA-registered coalition in the region. 16