MassTAPP Meeting for Coordinators of MOAPC, SAPC, & PFS 2015 Initiatives

Wednesday February 15th, 2017

Tower Hill Botanical Garden, Boylston, MA

BSAS Announcements

Fernando Perfas, Assistant Director of Prevention - Billing:

  • We are held to the same high standard and level of detail that you are with billing for prevention. It is getting a lot better, thank you.
  • Majority of earmarks have been approved. For the most part, programs are doing a better job to connect funding requests to the goals in your strategic plan. Descriptions and details you give us help us greatly. Thank you.

Andy Robinson, Contract Manager - Earmarks:

  • Expend by end of fiscal year, it is a different billing process
  • We very pleased and impressed and the nature and thoughtful way in which you responded to requests around the holidays
  • There are 19 MOAPC’s, 11 received your contract packages, packets being processed and money will be sent soon
  • A whole second round of you are still waiting: DPH is working on a system update which will delay your contract packages by 3-4 weeks. 1st or 2nd week of March we don’t have an exact date yet
  • Still able to do the conferences that were proposed; we just have to come up with a creative way.
  • A couple are still finalizing and getting your plan approved. There are some practical delays that we will be working through with you.
  • Your attention to detail and level of responsiveness makes us look great

Updates:

  • The Voluntary Non-Opioid Directive
  • Check out our website please, signed by Gov Baker last March
  • A form each resident can sign and hand to their physician saying that they do not want to be prescribed or offered opioids
  • It’s a huge policy change
  • Alcohol Regulations Taskforce
  • Led by Treasurer’s Office
  • Prevention not at the table for that. Have reached out to our director to get a seat at that table to provide a prevention lens in this conversation.
  • Marijuana
  • Lots of conversations with lots of different bureaus at the table, we voice your concerns at these meetings
  • Taking this issue very seriously to make thoughtful decisions and regulations around this issue
  • We are aware of concerns about data collection for marijuana

‘Alcohol, tobacco, marijuana and other drugs’:

  • Marijuana is now its own legal substance, so the language is changing
  • No longer saying ATOD, Marijuana is its own legal substance, now its ATMOD.

Alison Bauer is our new Director

  • Former Senior Director of Health and Wellness of The Boston Foundation leading efforts to decrease healthcare costs
  • Staff director and chief counsel to legislative committee on substance abuse and mental health, government relations positions
  • Staff attorney at Dept. of Labor, adjunct professor at Boston College
  • She puts prevention up with treatment and this why we are at the table with marijuana and alcohol taskforce.
  • With new Director comes with new priorities for us
  • Today’s meeting format is not a permanent shift
  • All of you value the opportunities for collaboration, and we want to provide other opportunities for that to happen
  • We do want to create more space to network with each other

MIS:

  • MIS and connecting to evaluation and outcomes, how do we quantify what we do?
  • MIS bridge to evaluation and connecting to outcome data
  • Our director wants to see outcome data that demonstrates the impact of what we do. Why are you doing what you are doing?

Questions from audience & BSAS answers

Question or comment:

  • Schools and providers are saying marijuana data use is up and mental health issues are up
  • Students using Marijuana to address anxiety. Schools are most concerned with the mental health issues youth are struggling with and not so much substance use, then the Time magazine cover story
  • From prevention perspective you cannot silo the two things?

BSAS Answer:

  • I am less concerned about the substance people are using rather than why they are using it.
  • We are trying to find a space for that.We are trying to reach middle school youth.How early do we start with primary prevention?
  • It has to be culturally competent and age appropriate. Vast majority of youth are using alcohol so that’s why our focus is there
  • Our hope is by building the Risk & Protective factor framework they are resilient to address the substance use and mental health issues.

Question or comments:

  • How can we think about evidence-based protective factors that relate to substance use that also have the most impact on mental health?
  • Kat Allen recommends looking at the PreVenture programme, which is not on the NREP list
  • Screens kids for four different personality types (anxiety-sensitivity, hopelessness, impulsivity, and sensation-seeking)
  • Identifies kids for whom these traits put them at risk of addiction, and provides them with targeted 90-minute workshops building skills that are particular to their traits
  • The program seems to have very good outcomes in both preventing youth substance use and improving mental health outcomes, with protective effects both among the higher-risk kids who screen in to the workshops and among the lower-risk kids who don’t
  • Youth unfortunately get defined as having behavioral health problems and get channeled to mental health counseling without understanding that there is an underlying substance use problem.
  • A lot of my communities are trying to start Life Skills and SBIRT before these programs are actually mandated
  • Life Skills has DVD’s and activities that are very impactful and powerful for substance use and also mental health – general upstream prevention.
  • They are not diagnosed, they have behavioral issues, kids are directly affected by their parents’ use, living with their grandparents because parents are in treatment.

BSAS answer:

  • We sometimes identify things that are really relevant to substance use prevention, we have to find that space where we are within our scope of work, and our capacitythough
  • The Coordinator is part conductor, there are lots of things I can connect you too, versus fill the space and provide the solution
  • How do you help them think about it? this is the different space. We have to resist being the doers and help others in leadership roles navigate to resources they need. You can help respond but it might not be you directly.

Sustainability:

  • How to bring info to Communities? Creating sustainable solutions, how do you get the people who are going to be implementing it to pick something that they feel is a fit?
  • Hand hold, brought in training and support, paid for things including rolling suitcases. It took a long time.
  • Part of sustainability is showing how this work is impacting in your community
  • Ex) Public hearings across the state for the Alcohol Taskforce, the impact of state alcohol laws on your local communities, the impact of underage drinking on your communities
  • There is a societal cost to some of these economic decisions that prevention practitioners like us bring to the table.

Learning Lab

Fernando:

  • High quality data is better than big numbers
  • Who is being reached by efforts? This info is more useful
  • We have an excellent reputation with SAMHSA (MA) – we are one of the only states with a TA system this comprehensive and large
  • Other states – grantees don’t see funders
  • At the end of the day, we want to make sure that what we are doing is connecting with the right audience and that we are making progress
  • Elected officials may have no idea what we are doing. We want to be able to stand on what, how and why the work is being done
  • BSAS – not politicians. What we hear from you is what we tell higher-ups in state government
  • Restorative rather than retributive. Strengthen system in a way that makes sense
  • When we meet with you it’s because we want to help

Scott Formica- “The Wonderful World of MIS”:

  • MIS operates on the state fiscal year. #s reset to 0 on July 1.
  • Total # reached in each quarter cannot exceed the total # of people in the community
  • The same individuals should not be counted multiple times within the same strategy. For example: media strategy – FB, mailing + billboard – can only reach each person once.
  • Make educated estimates when you can’t directly obtain demographics.
  • We need to do a better job of not lumping people into “unknown”

MIS – Old SAMHSA term for Management Information Systems – reporting on people served through block grants. State has discretion on how to get prevention $$$ out to communities.

  • MOAPC, SAPC and MassTAPP come out of prevention block grant
  • PFS is discretionary funding

Used to be a spreadsheet, now it’s all part of an integrated online system.

What are data used for?

  • State reports to SAMHSA as indicator of activity using block grant funds.
  • SAMHSA reports them to Congress to justify their annual appropriation. These numbers are taken into account to determine eligibility and amounts for discretionary grants.
  • So - funds we received for PFS tied to #s reported under block grant.

Big numbers are not better – consistent and well-informed numbers are better.

Does not look good if the #s and characteristics don’t roughly match the services we proposed to deliver or the populations we proposed to serve.

Questions:

Billboards – company gives estimate of # of people reached. Is this accurate?

  • Yes – would rather see estimate from billboard company instead of total population of community
  • In this case the # can exceed the population of the community (exception to the rule)
  • Yes, some answers are on a case-by-case basis. Provide information to justify – explain how #s were compiled.

How do we get #s for sticker shock? Liquor store #s are unrealistic.

  • Case by case answer – start with # of stickers and try to get a reasonable estimate of how many people saw them. After you figure out a system for estimating (together with contract managers and Scott) be consistent in using this system over time.

Another example: parent campaign – how many parents are there across middle and high school? Go from there – how many of these do you think you actually reached?

Quarterly Report Strategy Section (see chart in ppt):

  • Distinguish strategies from activities – for reporting, we want you up at the strategy level
  • Only count people served by strategy one time
  • You may also want to track #s served/reached per activity, but that is a different number that could be useful to you but not what goes in report
  • Start counting again at the beginning of the fiscal year (everyone is new again) – based on appropriation/funding stream

Numbers Served:

  • Measure of activity within strategies in any given quarter – how many people were served during this quarter (whether or not they were served before)
  • Quarters 2 3 4 – you have to think about whether you already reached these people during this fiscal year
  • If not, count them as new
  • This way we can add up the total # of people served within a given year
  • In 1st quarter we don’t ask the “new” question at all.
  • Total box cannot exceed population of community (with possible exceptions like billboard/media campaigns)
  • Think about how many people you really are trying to reach and start there. Educated guess
  • Call Scott or contract manager with questions!

Is there an educated way to find the “new” numbers?

  • Varies by type of strategy.
  • Classroom curriculum – everyone is new first quarter, future quarters new #s are very small (or could be zero).
  • For something like an ongoing media campaign – assume some amount of mobility. Estimate – 15-20% of people who see this strategy are new.

Fernando: use MIS data as reason for pursing another strategy – no new people being reached. This might lead to decisions about changing logic model, etc.

  • Can only serve each person once per strategy per quarter

Demographics:

  • Need to report demographics for any new people serve.
  • Educated estimates. Sometimes you have to use your knowledge of populations you are trying to reach to get to these numbers.
  • Describe how numbers were reached – this is an important field.

Whoare we reaching?

  • Current reports – very large % unknown
  • “Can’t tell a thing about them”
  • Could make estimates based on community demographics.
  • If you are working in a cluster, you may want to provide communities with total # you are anticipating to reach as a starting point.

Comment: go back to grant proposal and YRBS – breakdown of demographics.

  • If you want to track level of details re: gender, ethnicity etc. Scott can modify categories.

Suggestion: make these changes statewide.

Suggestion: OEND programs do a good job of tracking granular detail of gender and other categories. Take a look at this?

We have a good reputation with SAMHSA – won’t continue to have this if we can’t do this better.

SEE PRO TIPS in ppt

You can be indirectly reaching more people than you directly reach.

Question and answer session about improving the quality of MIS.

Barriers/ Challenges to Collecting MIS demographic data:

  • How about getting that info about people? in closed school setting easier to get the demographic info
  • How do you ask folks about their ethnicity? if they are going to self-disclose that’s one thing. Some folks have been told not ask demographics. Identifying people by sight doesn’t do them justice or cannot tell? You don’t want to make any assumptions about folks’ ethnicity.
  • For example, how to estimate after a training completion how many will actually be served back at the school when those who completed training implement the intervention/strategy?
  • One barrier is how to do we support the member comms in our cluster collect their own demographic data?
  • Top Tier is individual self-report. That is the gold standard.
  • Encourage folks to fill out the form and why it’s important for our funding and future work to identify race, ethnicity.
  • If you can see someone ask them. People like to tell you who they are if you are talking to them one on one, if you have not asked folks to self-identify before and are nervous about doing it.
  • Just ask people why they don’t want to share their info if they don’t.

Successes: What are folks doing already that works for them?

  • Many attendees are using some kind of survey tool already to track attendees at events and training.
  • One community has a voluntary survey which is conducted one on one, we ask folks to participate in it, explains it’s confidential (Revere)
  • Another community’s evaluation survey includes demographic data gathering section such as ‘check your race, age, gender’ and coordinator says there is 100% response rate to the evaluation survey tool (Somerville). However not all people like to fill out forms.
  • Large community forum/auditorium style events, how do you track? have 2 folks counting the head counts in addition to the form, then compare and count evaluations.
  • Partner with another entity, they create a sign-up and go through and go through and ask schools etc. for their demographics information.

Don’t forget to look at your own community’s demographics.

Clicker answer to poll quests, the 84 movement uses that tool well, and free websites with the same texting etc.

What would help to improve the quality of MIS data inputted?

  • Demographic Tracking template
  • More accurate demographics on tracking form (more categories for gender and ethnicity there aren’t enough currently)
  • A demographic handout from MIS to give out at the trainings and community events (without names- not on sign-in)
  • Talking points sheet that explains why we ask these questions? that its related to the funding.
  • Put MIS requirements in the MOU’s with cluster member communities, you invoice when you submit your data
  • Give us the MIS reporting tool at the beginning of the quarter not the end.

Scott and Andy continued:

  • How do we know we did it with this subpopulation if we don’t know who was there?
  • We want meaningful numbers. Who is the defined audience that you are trying to reach?
  • Base your estimate on numbers reached
  • The strategy might benefit everybody but our strategy is to drive a change among an indicated subpopulation
  • You want to evidence that you are reaching that subpopulation
  • Responsible Beverage Service example
  • Did you make a difference with the service providers who work in the store?
  • Where was the change we were trying to make again? with whom?
  • Impact the change with the indicated group/ the people we were intending to impact
  • Social host liability and low perception of risk and harm for parents’ example:
  • Strategic thoughtful way to implement
  • Educate parents first to the perception of risk and harm, parents stop hosting parties

Presenting and interpreting MIS data big picture themes about the grants. See Scott slides.