Planning for the Development of Comprehensive Community Alcoholism Services: Organizational Approaches

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Abstract
A comprehensive community alcoholism program can become viable regardless of the manner in which it is formed, the agencies that may be involved and the number of different sub-systems of service that need to be developed only if there is an effective cohesion of these elements. In this paper, the third in a series on alcoholism planning (1, 2), the advantages and disadvantages of four different approaches to the organization of “comprehensive” (all necessary services) community-based alcoholism services are presented. The selection of a specific concept of organization will depend upon the kinds of agencies involved, the existing services and their relationships and the particular individuals involved in the planning process. These approaches are as follows 1) the “governmental approach”; 2) the “single community agency approach”; 3) the “consortium model approach”; and 4) the “for profit approach”. Regardless of which approach is chosen, there are certain substantive issues that transcend any and all of these organizational approaches. Without paying attention to them, those involved in planning will undermine their own ability to successfully implement the chosen organizational approach. Substantive underlying issues discussed include community boards, traditional versus non-traditional approaches to the delivery of alcoholism services, pre-program planning, continuity of care and funding. A “comprehensive” community alcoholism program which includes all services necessary for the information of a total treatment system, must become viable regardless of how it is formed or the number of agencies involved. Unless these multiple elements are integrated, service delivery will be inadequate. Consequently, the development of an administrative structure requires clearly defined lines of communication and responsibility between care-giving agencies, institutions and the community. Effective service delivery and continuity of care are directly related to the administrative structure. The specific concept of administrative organization selected will depend upon the kinds of agencies involved, existing services and their relationships and those individuals involved in the planning process.

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