A Prescription for Program Sustainability: The Drug-Free Community Sustainability Model in Practice

ABSTRACT

Context:

The Drug-Free Communities (DFC) Support Program awards federal grants for up to 10 years to community coalitions aimed at reducing youth substance use across the United States. This report describes efforts for program sustainability, shares sustainability examples from DFC-funded coalitions, and describes public health impact of coalition continuity of funding and activities beyond the DFC funding period.

Program:

The overarching DFC program aims to mobilize community leaders to identify and respond to substance use challenges unique to their community, as well as local community environmental factors tied to substance use.

Implementation:

DFC coalitions follow a sustainability framework that addresses community engagement, funding, policy planning strategies, partnerships, and staff retention. Communities are encouraged to use the sustainability checklist and are required to submit a sustainability plan.

Discussion:

Planning for sustainability helps coalitions and their members, partners, and the greater community at large to ensure that substance use prevention efforts are poised to continue the work after DFC funding ends.

Implications for Policy and Practice:

Coalition sustainability is key to maintaining the reach of DFC coalitions as they move beyond the funding period and new communities join the DFC program.

Introduction

Sustainability is crucial for the long-term success and effectiveness of community health initiatives. It is operationalized as “a community's ongoing capacity and resolve to work together to establish, advance, and maintain effective strategies that continuously improve health and quality of life for all.”¹ Since its inception in 1997,² the Drug-Free Communities (DFC) Support Program, or DFC program, has consistently embraced and promoted continuity of efforts by providing multi-year funding to coalitions, building active partnerships through 12 required sectors, requiring dedicated matching funds, implementing policy and environmental strategies, and ensuring that coalitions plan toward sustainability throughout the life of the grant. Research demonstrates that planning for sustainability is correlated with greater evidence-based program sustainability.³ The goal of this report is to explain sustainability within the DFC program context, share coalition examples and successes, and describe the public health impact of coalition continuity of funding and activities beyond the DFC funding period.

Context

The DFC program provides grants to community coalitions to reduce local youth substance use. Community coalitions across the country receive funding up to $125,000 per year to strengthen collaboration among local partners and create an infrastructure that reduces youth substance use.⁴ Funding is provided for a maximum of 10 years annually, including an initial grant period of 5 years, with an option to compete for a second grant period of 5 years. While the combined grant periods provide consistent funding for community coalitions, funded coalitions are required to dedicate matching funds and plan toward program continuity. Starting in Year 1, coalitions must obtain a 100% match of federal funds and that percentage increases in Years 7-8 and 9-10.

The DFC model requires 12 sectors be part of the coalition: youth; parent; business; media; school; youth-serving organization; religious or fraternal organization; law enforcement; civic or volunteer group; healthcare professional; state, local, or tribal government agency with expertise in the field of substance use; and other organization involved in reducing substance use.⁴ The program aims to mobilize these community leaders to identify and respond to the substance use challenges unique to their community and change local community environmental conditions tied to substance use.

The DFC program defines sustainability as “a DFC coalition's capacity to maintain and scale its impact and effectiveness to produce community-level outcomes that reduce youth substance use beyond the 10-year project period.”⁵ This project period allows time for coalitions to assess community readiness and acknowledge that youth substance use prevention is important, plan and implement evidence-based programs, engage youth, develop and strengthen partnerships, and plan for sustainability. Coalitions are encouraged to complete a sustainability checklist and required to submit a sustainability plan at the end of Year 3, implement and revise it in subsequent years, and submit an updated plan at the end of Year 7.

While sustainability is often understood solely in a financial context, the DFC program emphasizes discussions from the onset and focuses on 5 core sustainability elements: community engagement, funding, policy planning strategies, partnerships, and staff retention. DFC also supports cross-knowledge sharing whereby coalitions, especially those who are geographically close or in the same implementation year, are connected to share sustainability challenges, solutions, and practices.

Community Engagement

Community engagement is a core element of DFC program success. It requires actively engaging with the 12 required sector representatives and sustaining their participation over time to ensure shared ownership of prevention decisions and strategies. Sustainability thus becomes organizational and rooted in community norms and values.

Building connections, promoting collective efficacy, and leveraging unique community specific strengths are pivotal in affecting sustainable community-level change.⁶ The adage, “nothing about us without us” is applicable and compelling when advocating for involvement in community action. To date, community-level engagement efforts largely focus on education and raising awareness, promoting positive behaviors (eg, no smoking, no alcohol use, no illegal drug use), and building knowledge or skills for positive community change.^7,8 Research illuminates that empowering communities to act in consort, while prioritizing youth best interests, can be achieved through collective action.⁶ This active participation among community members is essential for sustainability.

Community voice is needed to inform readiness and buy-in.^9,10 Community sectors such as schools and law enforcement, to name a few, are important partners to reach youth and form positive relational experiences.¹¹ The Chester County Empowering Communities for Healthy Outcomes (ECHO) Coalition in Chester County, South Carolina, for example, serves a resource-limited rural community and recognizes the importance of reaching youth and other community partners to sustain its efforts. Since its inception in 2016, ECHO has recruited and maintained an active membership of more than 60 adult partners and youth advisory boards that represent 3 county high schools and more than 60 youth.¹²

DFC also supports engaging the community and ensuring there is continuous feedback to inform identification of local problems and implementing local solutions. For example, the Genesee County Prevention Coalition (GCPC) in Genesee County, Michigan, uses community readiness survey data to guide their approach to issues, aligning with community readiness and maximizing their impact with limited resources.¹³ After analyzing survey data, GCPC found limited community awareness of the existing issues and efforts to address them.¹³ To address this issue, GCPC partnered with a media marketing consultant to develop strategies to promote the GCPC's brand and initiatives across multiple media platforms with dedicated campaigns such as “Talk, They Hear You.”¹³

Funding

Funding is critical to any sustained effort as staff, supplies, and more impose fiscal impact. The DFC program requires that funded coalitions provide matching funds (ie, $125,000 per year) ensuring that youth substance use prevention efforts do not rely on a single funding stream. For example, one commonly cited challenge is “chasing dollars” whereby efforts to secure funding may affect the coalition's mission and goals. Resisting the urge to follow every funding stream to match dollars has helped many coalitions, including former DFC coalition, Schools Together Allowing No Drugs Coalition (STAND), who has operated in Scott County, Tennessee for 20 years.

Another important strategy is braiding and blending funding or strategies by combining multiple funding streams to maximize resources and impact. At a minimum, DFC coalitions must maintain at least 2 sources of funding (ie, federal DFC grant and required matching funds), but many coalitions have multiple funding streams. For example, the ECHO coalition activities are sustained through state and local funding, partner funding for shared program costs, and operational funding from the Hazel Pittman Center. When the ECHO coalition was coming to the end of a federal grant program in 2024, they were able to continue efforts uninterrupted while new funding sources were sought. This infrastructure has allowed the coalition to responsibly manage grants, coordinate staff across funding sources, and maintain continuity in prevention programming.¹²

In addition, the Oyate Prevention Coalition (OPC) in Rapid City, South Dakota, has implemented funding solutions through partnerships to maximize funding and allowable expenses. The OPC co-sponsors prevention events with several area organizations to share costs while continuing to apply for relevant funding support to enhance their state and federal funding.¹⁴

Policy Planning Strategies

Constantly shifting policies may cause difficulties for coalition efforts. For example, GCPC noted that the state legalization of cannabis changed community priorities. GCPC had to pivot prevention strategies to address the new policy environment.¹³ Despite the changing policy landscape at the local, state, and federal levels, policy changes remain an effective way to sustain coalition efforts as youth substance use prevention becomes systematically normalized through community implementation. Effective policy work involves building relationships with legislators, community leaders, and key sectors; sharing the benefits of evidence-based approaches; and considering policies that reduce youth access to substances.¹⁵

For example, the ECHO coalition has an ongoing collaboration with a local school district focused on tobacco-free and substance use policies and their implementation. The coalition also takes part in alcohol and tobacco compliance checks, court-mandated education programs, and ongoing efforts in collaboration with law enforcement to reduce underage access to alcohol and reinforce community norms around underage drinking.¹² These ECHO strategies are embedded into existing community systems that enhance sustainability and normalize substance use prevention as a standard and expected community norm.¹² As substance use prevention-related policies and procedures become integrated within other sectors, these prevention efforts are more likely to be sustained and normalized.

Partnerships

Cross-sectoral partnerships bring together multiple perspectives and share expertise to collaboratively address the complexities of substance use prevention.¹⁶ While all sectors are active by attending meetings and other community events, some sectors may have more time and resources to contribute to coalition efforts than others. Regardless, partnerships remain key to sustainability efforts for coalitions. During times of funding scarcity, the ECHO coalition noted they rely “heavily on coalition partners to share implementation responsibilities,” and specifically noted the importance of partners donating meeting or event space and volunteering.¹²

Sharing responsibilities can occur in many ways. For instance, OPC partners with Delaney Apple (Oglala Sioux), a Lakota community leader and Cultural Director at Oyate Health. His hands-on partnership and leadership resulted in implementation of a program that increases cultural connectedness among American Indian (AI) youth as a protective factor to prevent youth substance use.¹⁴ It also resulted in connecting other leaders to teach youth and community members traditional arts (eg, beading, sewing, and singing) and sharing his experience as a counselor, cultural expert, and with his own healing and recovery journey. This discussion is intended to inspire and motivate young men and women to confront historical and social challenges, creating holistic healing and strengthening youth substance use prevention efforts.¹⁴

Another example of shared partnership responsibilities includes GCPC and its partners who identified a need for a resource directory to increase access to resources and services within Genesee County. GCPC and partners created and launched the Partners in Prevention Portal (PiPP) in 2022, using marketing and community engagement strategies to continuously develop, recruit, promote, and improve the PiPP. Partners list their programs and services, which are shared through quarterly Lunch and Learn events. The directory now has 40 categories, 120 providers, and 163 programs and services. Notably, nearly 6,000 page views are documented in fiscal year 2025, demonstrating how a successful shared partnership reached thousands of community members and connected them to substance use prevention services and programs.¹³

Community voice, represented in the 12 sector DFC model, is a key component to building and strengthening a coalition. Using community voice, GCPC expanded efforts to collaboratively address prevention by focusing on risk and protective factors for youth substance use. These efforts have illuminated co-occurring challenges, such as the importance of youth mental health to the community. GCPC notes, “As we have pushed into new spaces, current partners help identify potential partnerships and other voices needed at the proverbial table to more effectively address prevention across the community. As people see the benefit of working together and supporting one another, the impact grows.”¹³

Strong partnerships may also rely on respecting local practices to strengthen partner engagement. For example, the OPC, who serves all youth with a primary emphasis on AI youth, holds monthly one and one-half hour coalition meetings that average 25 to 30 attendees, many identifying as AI.¹⁴ Using matching state funds, the coalition is able to provide a traditional meal, in keeping with AI culture, in addition to prevention programming and planning.¹⁴ DFC's multi-sector approach brings people together to prevent youth substance use and supports relationship building and partnerships that are critical to maintaining a strong coalition beyond DFC funding.

Staff Retention

DFC program staff are critical to maintain the mission to prevent youth substance use and provide institutional and community knowledge. Key staff tasks often include administrative duties such as maintaining core program documents (eg, logic model, evaluation, sustainability plan), convening meetings, maintaining program and grant files and budgets, compiling reports, and implementing program and evaluation activities. One strategy to tackle staff turnover challenges and promote staff sustainability is to intentionally structure positions so that staff support multiple initiatives and funding sources, rather than relying on a single grant to maintain a specific position.¹² This flexible staffing approach includes cross-training staff and allocating time across grants and programs, which allows prevention services and coalition operations to continue uninterrupted. Thus, in the case of transition or a lapse of funding, staff may be able to maintain programs until new funding is available. Another option may be to embed dedicated volunteers and other in-kind partner support in administrative duties.

The GCPC, after identifying the need for dedicated marketing efforts, received funding in fall 2025 to hire a Health Communications Specialist. The position provides expertise in developing and tailoring messages unique to the needs identified (through survey) in Genesee County and overall focuses on increasing awareness and access to programs and services offered by GCPC and other partners.¹³ For over 10 years, GCPC has followed the Strategic Prevention Framework,¹⁷ a public health approach used to secure initial funding for the coalition to hire staff and establish a multi-year work plan that includes both the internal organizational development and external partnership to sustain long-term strategies for community-level change.¹³

Sustainability Tools and Technical Assistance

Effective sustainability planning should address core elements identified by the DFC framework, including community engagement, funding, policy planning strategies, partnerships, and staff retention, to maintain and scale efforts that reduce youth substance use at the community-level. CDC developed a sustainability checklist and a step-by-step guide to assist coalitions in developing and implementing a sustainability plan that ensures long-term commitment and impact beyond the 10-year grant period. To this end, coalitions are encouraged to use the checklist and all available sustainability resources to guide planning and strengthen organizational capacity.

Sustainability Checklist

The sustainability checklist was created as a foundational guide and self-assessment tool for coalitions to evaluate readiness and progress toward sustainability during their first 2 years of grant funding. Furthermore, the checklist is not exhaustive and may be referred to during any funding year to identify actions or areas of improvement to support coalition sustainability.

The checklist is a series of questions with a 5-point response scale from 1 = not ready, 2 = aware of criteria, 3 = needs are identified, 4 = ready for action, and 5 = implemented. Subscores are summed and converted into a grading scale of A to F (like a school report card) where an A is excellent, B is good, C is satisfactory, D is passing, and F is improvement needed. The checklist's questions are organized across 8 topic areas, and coalitions use the checklist scores to inform their sustainability plans for topic areas that are lowest scoring. The 8 topic areas include:

1. sustaining the ability to meet DFC statutory requirements (3 questions, eg, “The coalition has specific sustainability goals”),

2. coalition operations and infrastructure (10 questions, eg, “The coalition has outlined and documented key administrative duties and operations,” “meetings are held regularly”),

3. staff retention sustainability (5 questions, eg, “Coalition leaders have been identified,” “Leadership has developed succession plans to support position backfill as needed”),

4. community engagement sustainability (11 questions, eg, “New coalition members are actively recruited,” “The coalition shares results and outcomes from implementation of its strategies and activities with partners and the community”),

5. financial sustainability (10 questions, eg, “The coalition independently holds 501(c)3 status and is legally eligible to receive federal funds,” “The coalition promotes efficient use of in-kind and available resources,” “The coalition has identified and is preparing to/has applied to other grant opportunities”),

6. developing sustainable policy practices (3 questions, eg, “The coalition promotes policies that reduce youth substance use”),

7. developing sustainable partnerships (4 questions, eg, “The coalition has a process in place to monitor community priorities”), and

8. developing sustainable evaluation practices (3 questions, eg, “The coalition participates in the DFC National Cross-Site Evaluation,” “The coalition routinely shares findings and data on youth substance use with the community”).

Sustainability Plan

The sustainability plan is crucial to ensure long-term community impacts. The sustainability plan organizes coalition information (ie, coalition vision, mission, and key personnel with contact information), lists existing funding resources and the amount and when funding end, identifies coalition priorities and organizes these by strategy and related actions required to sustain the work, summarizes operational expenses (eg, salaries and wages, consultant costs, equipment, supplies, other costs), and plans future programmatic implementation which are organized by strategy, funding required, potential funding sources, actions to be taken, and action owners. While having a concrete, written plan is a key sustainability milestone, successful plans may be updated and adapted for coalition and community changes. For example, STAND coalition noted that sustainability is “about adaptability” and that the coalition has “stayed open to learning, willing to change course when the data, the community, or our youth told us we needed to.”¹⁸

In 2021, the ECHO coalition identified 6 key outcomes and strategies that needed to be sustained:

1. Continued use of enforcement-based environmental strategies including safety checkpoints and saturation patrols to reduce impaired driving crashes.

2. Increased perception of risk associated with drinking and driving through increased media awareness using local newspapers, billboards, social media, radio, and alternative media strategies.

3. Increased skillset, knowledge, and resources of coalition members regarding evidence-based prevention strategies through the use of trainings, conferences, and continued education concerning alcohol, tobacco, and other drug trends.

4. Increased availability of local substance use prevention services for youth and adults in the targeted population groups.

5. Engaged youth in preventing underage drinking, impaired driving, and other substance use and risk behaviors through community mobilization and capacity building.

6. Reduced availability of alcohol to minors by conducting compliance checks and by providing retailer training to merchants.

The above requires an annual investment of $125,000, including key staff such as a project director, project coordinator, prevention specialist, and evaluator. Other needed resources included training, program support, and media/marketing. While there are many additional strategies and implementation actions noted, the ECHO coalition emphasized the need to maintain their Youth Advisory Board who partner in implementing youth prevention activities in school and continuing partnerships to continue programs (eg, court-mandated classes for alcohol and cannabis education), partner on future funding opportunities, and continue to provide programming and presentations to local leaders and the greater Chester County community.¹⁹

Discussion

Sustainability is complex and not solely related to funding. The DFC program includes 5 sustainability elements: community engagement, funding, policy planning strategies, partnerships, and staff retention. Each of these elements and examples of how they are implemented by coalitions in different community contexts provide important insights into DFC program sustainability practices. From the onset, DFC coalitions are guided toward program continuity through required multi-sector collaborations, matching funds, and sustainability requirements (ie, submission of a sustainability checklist and plan). These elements have additional benefits, such as enhancing a coalition's capacity and collaborative structures.²⁰

Planning for sustainability helps the coalition and its members, partners, and greater community to ensure that substance use prevention efforts may continue beyond the 10 years of DFC funding. The DFC focus on sustainability elements and supporting tools (ie, sustainability checklist and plan) emphasizes the importance of partner and community buy-in, engagement, and feedback. It also emphasizes the importance of diversifying and sharing funding responsibilities, integrating policy and prevention practices, strengthening partnerships, and retaining staff for institutional and community knowledge and continuity of services when in transition or during lapses in funding. Sustainability remains a top priority for all DFC-funded coalitions. These efforts are effective, as showcased by the continued success of DFC coalitions, such as STAND, who have continued prevention activities multiple years after initial funding.¹⁸

Implications for Policy and Practice

• ■ Sustained federal investments paired with sustainability requirements create the conditions for maintaining national prevention reach. The DFC program's multi-year funding model, statutory match requirement, and program reporting requirements promote sustainability from inception. With an estimated 63 million people living in a DFC community in 2024,²¹ continued federal investment supports not only prevention programming but also durable prevention systems. The longevity of coalitions, such as STAND who has operated for more than 20 years, illustrates how structured funding models and shared ownership can translate into sustained community-level impact.

• ■ Evidence-based program sustainability is achievable through early sustainability planning.³ When planning models include financial and alignment planning components, the likelihood of long-term program continuity increases.³ At onset, DFC coalitions are driven toward program continuity through the match funding requirements and required cross-sector collaboration. With these organizational structures and processes in place, research suggests that programs are more likely to be sustained beyond funding periods.³ Coalitions such as ECHO and GCPC show that formal sustainability plans, diversified funding, and integration of the DFC frameworks support coalition continuity during change in staff transitions and funding gaps.

• ■ A strong, resilient, and adaptable coalition distributes responsibility, cultivates shared ownership, and uses sustainability tools. Such coalitions are better positioned to endure beyond the DFC funding period amid shifting funding, emerging substances, and rising community needs. The STAND coalition reflected on their 20+ years of expertise, “In the end, our coalition has lasted because it has never belonged to a single agency, grant, or personality. It belongs to the community and when the community claims ownership, sustainability stops being something you worry about and becomes something you live.”¹⁸

• ■ Coalitions can use sustainability frameworks and tools to guide local planning and decision making within their unique community context. Using the Strategic Prevention Framework¹⁷ and tools like the sustainability checklist and plan template, coalitions can gauge readiness, strengthen organizational capacity, identify areas of programmatic improvement, and track sustainability efforts. Importantly, coalitions can gather data to inform strategic planning, implementation, and evaluation of progress, increasing the likelihood that prevention gains are maintained beyond the DFC funding period.