► Collected data from regular/expected sources:  California Health Kids Survey (CHKS)  California Health Information Survey (CHIS)  CalOMS Pv/CalOMS ► Expanded data collection/search to other local sources  Other Departments/Divisions within the County (mental health, public health, aging)  Other healthcare organizations (local hospital, emergency rooms)  Enforcement of local laws/regulations (social host, compliance checks) ► Missing data  Clearly identified exact data points/sources of information for things that we wanted to know, but were not available  Who would collect this data? What would it look like? What would it tell us?

► Conducted Focus Groups/Key Informant Interviews  Helped to fill in the gaps of some of the missing data  Qualitative information about social norms, perspectives  Occasionally connected to other data sources ► Making Sense of the Data  Pooled the data together  Worked with an evaluator to pull key data points, sections from reports  Created an organized “structure” for the data by source  Looked again at what was “missing” (communities, gender, ethnicity)  Worked with Epidemiology program to probe for strengths/weaknesses of the data

► Reviewed the data  Created committees/workgroups of local providers, partners, County staff  Chance for partners to dig into the data, ask questions, make some initial interpretation  Asked partners to identify data “a-ha’s”  Pooled the highlights – conducted several small group exercises to determine what the “a-ha’s” meant  Looked again at what was “missing”

► Reflecting/Prioritizing  Collected additional data  Reviewed/Prioritized the “a-ha’s”  Creative exercise – what “story” are the “a-ha’s” telling us ► Developed key words/phrases ► Any connection to the other data “a-ha’s” ► Created rough problem statements  Reviewed the problem statements with the larger group  Follow-up – were any from the various committees connected?  Combined/Integrated similar “problem ”issues” ► Resulted in the following draft statements:

Overview: Areas of Focus and Themes Impact Norms and Perceptions Improve System Capacity and Infrastructure Implement Effective Services Substance abuse continues to be viewed primarily as a social problem, rather than as a health condition. There are pervasive high-risk patterns of alcohol, tobacco and other drug use across Marin Youth have easy access to alcohol, tobacco and other drugs from social sources There is a lack of consistent adherence to and implementation of alcohol, tobacco and other drug laws and policies There is a lack of consistent early identification, screening and referral of alcohol, tobacco and other drug problems, which reduces access to appropriate services There is a lack of communication, coordination and collaboration between departments and agencies Data collection in the alcohol, tobacco and other drug system of care is not consistent and does not support a continuum of care model There is a need to leverage alternative resources in order to maximize the provision of comprehensive alcohol, tobacco and other drug services Alcohol, tobacco and other drug services are not consistently tailored to specific client needs and considerations, such as economic, gender, age, language, geographical, racial, cultural and situational issues Alcohol, tobacco and other drug programs and services are not consistently incorporating evidence-based practices The lack of coordination, communication and collaboration across departments and agencies, which is not consistent with a chronic disease and continuum of care model, limits access to and delivery of effective services Alcohol, tobacco and other drug use, abuse and addiction range in intensity from experimentation to severe and life-threatening chronic medical conditions. Therefore, alcohol, tobacco and other drug- related problems can be most effectively prevented, treated and/or managed through providing a continuum of prevention, treatment and recovery support services. Overall Philosophical Approach Strategic Direction Priority Problem Statements