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Many managed care plans may need to modify their coverage to address substance abusers' multidimensional physical, mental, and social problems. Such adjustments are particularly important for public sector clients whose addiction-related problems are typically more severe than those of private sector patients. Data from a sample of 161 medical emergency, primary care, mental health, and substance abuse treatment programs in Dade County, Florida, reveal highly varied perceptions of managed care. They illustrate that the relevance of provider organization ownership, type of services, and populations served for behavioral managed care analysis. Further implications are the need to provide "wrap-around" or enabling services and to coordinate care for substance abusers to avoid displacement of responsibility for critical aspects of their care onto overwhelmed "safety net" agencies.

Increases in recent years in both violent crime and substance use among United States youth necessitate the development of more efficient and clinically effective approaches to intervention with juvenile offenders. One such approach calls for development and implementation of Juvenile Assessment Centers (JACs) to centralize the screening of juveniles who have been placed in some form of police custody and better coordinate justice and human service system activities. This article presents a summary of data from interviews and surveys conducted at five JACs in three states. It discusses the findings in the context of an "ideal model" specifically designed to better address substance use among justice-involved juveniles.

Juvenile Assessment Centers (JACs) or community assessment centers are essentially screening and classification programs that assess the nature and extent of risks to and from arrested juveniles. This article presents a brief account of the Hillsborough County (Tampa, Florida) JAC, a model for JACs that is currently being implemented throughout Florida and is suggested as a prototype for communities throughout the nation. Identifying, assessing, referring, and ensuring that services for juveniles are delivered and received is extremely important given current levels and recent increases in both violent crime and drug use among U.S. youth.

Objective. We examine volunteering to support the relief effort after the bombing of the Murrah Federal Building. We address two issues: (1) how widespread was volunteering and what forms did it take, and (2) does Wilson and Musick's (1997a) "integrated theory of volunteer work" help to explain variation in volunteering in this disaster situation? Methods. We use data from the 1996 Oklahoma City Survey (OKC Survey). The 1996 OKC Survey is based on a random sample of the adult population of Oklahoma City and was administered 10 months after the bombing. Results. Nearly 75 percent of the sample respondents volunteered to support the relief effort in at least one way; giving money and donating nonprofessional goods or services were the two most prevalent volunteer activities. Socioeconomic status, knowing someone killed or injured in the bombing, belonging to voluntary organizations before the bombing, and being affiliated with a religious denomination were predictors of volunteering, depending on the type of volunteer activity considered. Conclusions. The magnitude of volunteering after the Murrah Building bombing was in line with volunteer efforts after other disasters. The integrated theory of volunteer work is a useful framework for studying volunteering after disasters.

Objective. Local government officials closed the Central Methadone Clinic (CMT) in Miami, FL on 31 May 1997. This study examined the economic consequences & related costs of closing this long-established substance abuse treatment program. Methods. Economic consequences were determined through a comparative analysis of patient status at baseline & one year following treatment cessation for Miami clients, relative to a comparison group in Jacksonville, FL that had continued access to a publicly funded methadone treatment clinic. Outcome measures included health-care utilization, addiction treatment, employment income, & crime. Bivariate & multivariate analyses were conducted to estimate differences in consequences & related costs. Results. Total cost as well as the cost for each category (except for addiction treatment) were statistically similar for both groups. Conclusions. Clients at the CMT did not generate significant economic consequences/costs for taxpayers or society in general during the year following closure relative to clients at a comparison clinic. 4 Tables, 48 References. Adapted from the source document.