EVALUATION IN SOCIAL AND HEALTH CARE PROGRAMS THAT RESULT IN MEANINGFUL CHANGES IN EFFICIENCY AND EFFECTIVENESS CAN BE COMPLEX, AND PROGRAM EVALUATION CANNOT BE EXPECTED TO SOLVE ALL PROBLEMS WITHIN GOVERNMENT. IT IS ESTIMATED THAT ALCOHOLISM AND ALCOHOL ABUSE DIRECTLY AFFECT 1 IN 16 PERSONS IN SAN DIEGO COUNTY. ALCOHOLISM, BOTH A HEALTH PROBLEM AND A SOCIAL PROBLEM, IS A TREATABLE DISEASE FROM WHICH AS MANY AS TWO-THIRDS OF ITS VICTIMS CAN RECOVER. AN APPROXIMATE LOSS TO THE COUNTY OF OVER $15 MILLION RESULTED FROM COMMUNITY ALCOHOL ABUSE IN 1971. ABOUT 51 PERCENT OF $2,333,217 SPENT BY THE COUNTY IN 1975-1976 FOR PROGRAMS DESIGNED TO LIMIT ALCOHOL ABUSE PROBLEMS WAS DIRECTED TOWARD THE DIRECT CARE AND TREATMENT OF ALCOHOLICS AND ALCOHOL ABUSERS. THE THREE PROGRAMS EVALUATED IN THE REPORT ARE AN ALCOHOL TREATMENT CENTER (COUNTY-OPERATED OUTPATIENT FACILITY), AN ALCOHOL COUNSELING AND EDUCATION CENTER (COUNTRY-CONTRACTED REFERRAL, OUTPATIENT, AND COMMUNITY EDUCATION SERVICE), AND A FELLOWSHIP CENTER (COUNTY-CONTRACTED MALE RESIDENTIAL ALCOHOL RECOVERY HOME AND COMMUNITY EDUCATION SERVICE). BECAUSE NONE OF THE PROGRAMS HAD STATED OBJECTIVES OR MAINTAINED ADEQUATE RECORDS ON TREATMENT OUTCOMES, PROGRAM EVALUATION FOCUSED ON ANAYSIS OF LEVEL OF CLIENT SERVICE, EVALUATION OF EFFICIENCY, AND PERFORMANCE IN TERMS OF CONTRACTUAL OBLIGATIONS. IN ALL THREE PROGRAMS, THERE WAS NO SYSTEMATIC FOLLOWUP METHOD TO ASCERTAIN WHAT HAPPENS TO PEOPLE WHO HAD BEEN TREATED. A SYSTEMATIC FOLLOWUP EVALUATION PROCEDURE TO PROVIDE THIS TYPE OF INFORMATION FOR FURTHER PROGRAM MANAGEMENT AND EVALUATION IS RECOMMENDED. ADDITIONALLY, SURROGATE EFFECTIVENESS MEASURES SUCH AS PATIENT PROFILES, DURATION OF TREATMENT, TYPES OF SERVICE, AND POPULATION SERVED ARE RECOMMENDED FOR ANALYSIS SO THAT AN UNDERSTANDING OF EACH PROGRAM IS POSSIBLE AND COMPARISONS WITH THE LITERATURE AND OTHER PROGRAMS CAN BE MADE. ECONOMIC COSTS OF THE PROGRAMS ARE ASSESSED. (DEP)