Coalitions are formed in communities throughout the United States when local institutions, policymakers and residents join together in a voluntary alliance to identify problems such as underage drinking or prescription and over-the-counter medicine abuse. After a careful analysis of root causes and local conditions, members develop and collectively carry out comprehensive strategies to help remedy the identified problem.
Coalitions generally utilize a public health approach rather than provide direct support to a limited number of individuals. They employ advocacy strategies and create political will. Coalitions organize and mobilize locally but frequently join with other likeminded groups to bring about change on the state or national level. Recently, many local coalitions mobilized to support the substance abuse and mental health parity bill, which was signed into law on October 3, 2008.
Improving the way services are financed is a tactic employed by coalitions to help reduce an identified problem. Decisions regarding financing strategies are made strategically based on the larger aim of the coalition. For example, if the coalition’s aim is to identify substance use disorders early and reduce the need for costly, late-stage treatment, they might organize influential community members to convince the local hospital board to require screening, brief intervention and referral for treatment (SBIRT) in the emergency room.
There are five principal ways that coalitions employ financing strategies to reduce the substance use in their communities.
Expand funding: Funding to expand or enhance coalition supported activities is sought from external sources such as local, state or federal sources. For example, coalitions have spearheaded the creation and institutionalization of juvenile drug court programs through federal grants and local matching funding from the justice system. And, they have convinced local policy makers to provide funding to continue the program once it has demonstrated success.
Better utilization of existing funds: By identifying underutilized or misdirected programs or activities, coalitions have helped to channel resources into more productive areas. For example, coalitions have successfully argued that local asset forfeiture funding dedicated to drug supply reduction should be spent on both prevention and enforcement activities.
Improved coordination of funding streams: Coalitions reduce duplication and fragmentation; promote efficiencies and coordinate functions across agencies. Many coalitions have, for example, identified all the local funding spent for substance abuse prevention through the schools, health departments, local faith and community based organizations and substance abuse agencies. These groups then worked together to create a community substance abuse prevention funding system to maximize the impact of their efforts by streamlining and consolidating funding streams.
Increasing non government funding and in-kind support: Coalitions specialize in tapping into community support by mobilizing residents, businesses, faith and civic partners to contribute time and talent to develop and carry out the coalition’s strategic plan. Local universities contribute staff and students for data collection and create evaluation systems, the business community donates materials and political capital, and residents, parents, and young people are involved as volunteer coalition leaders and change agents.
Moving funding “upstream”: Only a small percentage of public funding is allocated for prevention and early intervention efforts. Coalitions recognize the need to ensure that adequate funding is available to reduce the problems that illegal or excessive use of substances creates for the larger community. Creative funding strategies currently employed include obtaining waivers to spend a portion of state foster care dollars to provide substance abuse treatment to parents to reduce the need for costly foster care placements.
Creative financing solutions devised by coalitions have contributed to the significant expansion of prevention efforts. And, coalitions are frequently the “first responders” to ensure that financing strategies promoted by state and national are adopted to address funding gaps in local communities. By employing a “systems” approach to addressing local substance abuse problems, coalitions have made important contributions to reducing substance abuse in their communities.
