Family Treatment Drug Courts: Innovations with Impact from the - - PowerPoint PPT Presentation

Family Treatment Drug Courts: Innovations with Impact from the Regional Partnership Grants

National Conference on Juvenile and Family Law March 17, 2010

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Nancy K. Young, Ph.D., M.S.W. Director, National Center on Substance Abuse and Child Welfare Catherine E. Luby, M.S.W. Child Welfare Program Specialist, Office of Child Abuse and Neglect, Children’s Bureau, Administration on Children Youth and Families

Regional Partnership Grants (RPGs)

• Authorized by the Child and Family Services

Improvement Act of 2006

• 53 regional partnership grants awarded in

September, 2007

• Improve the safety, permanency, and well-being of

children affected by methamphetamine and other substance abuse

• The grants address a variety of common systemic

and practice challenges that are barriers to optimal family outcomes

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Background

• Through legislation, Congress required DHHS to

develop:

• A set of performance indicators through broad

consultation with the field and grantees

• Partnerships with child welfare and substance

abuse treatment providers

• An annual report on the “services provided and

activities conducted… performance indicators established…and the progress that has been made addressing the needs of families…”

• PL 109-89, section 4, (8), (9)

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Frequently Cited Barriers Between Systems



Differences in values and perceptions of primary client



Timing differences in service systems



Knowledge gaps among staff working in the systems



Lack of tools for effective engagement in services



Intervention and prevention needs of children



Lack of effective communication



Data and information gaps



Categorical and rigid funding streams as well as services and treatment gaps

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Grantees were awarded funds based on review criteria which included:

• Select a set of performance indicators
• Provide justification for their selection
• Relate them to the conceptual framework in the

program announcement

• Demonstrate your capacity to collect and report on

selected indicators

• Justify any additional indicators planned
• Demonstrated collaboration between child welfare

and substance abuse treatment providers

Background

5

Suggested Strategies to Improve Practice



Develop principles for working together



Create ongoing dialogues and efficient communication



Develop cross-training opportunities



Improve screening, assessment and monitoring practice and protocols



Develop funding strategies to improve timely treatment access



Expand prevention services to children



Develop improved cross-system data collection

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Background

• Under an ACF support contract, the Center for

Children and Family Futures (CCFF) was tasked with:

• Refining and developing final set of RPG performance

indicators

• Developing a RPG data collection and reporting

system

• Providing TA to grantees on evaluation, data collection

and reporting, other performance measurement matters and programmatic issues

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A Program of the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment and the Administration on Children, Youth and Families Children’s Bureau Office on Child Abuse and Neglect

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Regional Partnership Grants = 53 Sites

Array of Services - 11 Child Focused – 8 Drug Courts – 10 System-Wide Collaboration – 9 Treatment Focused – 9 Tribal - 6

Regional Partnership Grants

Created 7/28/09

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Regional Partnership Grants = 53 Sites

Array of Services - 11 Child Focused – 8 Drug Courts – 10 System-Wide Collaboration – 9 Treatment Focused – 9 Tribal - 6

NCSACW IDTA Sites = 17 Sites

12 States Round 5: 2 States and 1 Tribal Community 2 Tribal Communities 1 County

Created 7/28/09

Children’s Bureau Regional Partnership Grants and NCSACW In-Depth Technical Assistance Sites

NCSACW IDTA Sites = 20 Sites

16 States (NE & KY Pending) 3 Tribal Communities 1 County

14 OJJDP Sites

NCSACW In-Depth Technical Assistance Sites Children’s Bureau Regional Partnership Grants OJJDP Family Drug Courts

US DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Administration for Children and Families www.samhsa.gov

Cluster Groups

• Purpose and Description

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Tribal Drug Court Child-Focused System-Wide Collaboration Treatment Focused Array of Services

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• Omaha Nation Community Response Team, NE
• Klamath Tribes , OR
• Apsaalooke Nation Housing Authority, MT
• Cook Inlet Tribal Council, Inc., AL
• Choctaw Nation of Oklahoma, OK
• White Earth Band of Chippewa, MN

Tribal N=6

FPO: Miguel Vieyra & Rosie Gomez PML: Paulette Running Wolf

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Drug Court N=10

FPO: Catherine Luby & Emily Cooke PML: Robyn Ristau

• Idaho Department of Health and

Welfare, ID

• County of Lucas, OH
• Sacramento County Department of

Health and Human Services, CA

• North Carolina Department of Health

and Human Services, NC

• Judicial Branch State of Iowa, IA
• Connect Care, Inc., CO
• Mendocino County

Health and Human Service Agency, CA

• Multnomah County, OR
• Supreme Court of

Georgia, GA

• County of Santa Cruz

Health Services Agency, CA

Child-Focused N=8

FPO: Melissa Lim Brodowski & Rosie Gomez PML: Theresa Lemus & Linda Carpenter

• County of Santa Clara, Social

Services Agency, CA

• Child and Family

Tennessee, TN

• University of Rochester, NY
• Oklahoma Department of

Mental Health and Substance Abuse Services, OK

• WestCare

California, Inc., CA

• Houston Council on

Alcoholism and Drug Abuse, TX

• Center Point, Inc., CA
• WestChester County, NY

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System-Wide Collaboration N=9

FPO: Irene Bocella PML: Linda Carpenter

• Denver Department of Human

Services, CO

• Children's Research

Triangle, IL

• Kentucky River Community

Care, Inc., KY

• Butte County Department of

Employment and Social Services, CA

• Wisconsin Department of

Health and Family Services, WI

• Travis County, TX
• Baker County, OR
• Upper Des Moines

Opportunity, Inc., IA

• Kid's Hope United-Hudelson

Region, MO

16

17

Treatment Focused N=9

FPO: Irene Bocella & Pat Campiglia PML: Theresa Lemus

• Island Grove Regional

Treatment Center, Inc., CO

• SHIELDS for Families, Inc., CA
• County of San Diego, Health

and Human Services Agency, CA

• OnTrack, Inc., OR
• Pierce County

Alliance, WA

• State of Arizona, AZ
• Children's Friend and

Service, RI

• State of Nevada, NV
• Juvenile Justice Fund, GA

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Array of Services n=11

FPO: Elaine Stedt & Jean Nussbaum PML: Nancy Hansen

• Massachusetts Department of

Public Health, MA

• Department of Community Based

Services, KY

• Clarity Counseling P.C., CO
• St. Patrick Center, MO
• Tennessee Department of Mental

Health and Developmental Disabilities, TN

• Hillsborough County Board of

County Commissioners, FL

• Kansas Department of

Social and Rehabilitation Services, KS

• Aliviane, Inc., TX
• Butler County Children

Services Road, OH

• Lund Family Center, VT
• The Family Tree Center-

Billings Exchange Clubs' CAP-Center, MT

Drug Court N=10* RPG w/Drug Court Component N=10*

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* Four sites operate multiple Family Drug Court sites; total N=29.

Geographic Areas Served by the 53 Regional Partnership Grantees

(Percentage serving given geographic area) 5.7 47.2 43.4 3.8 20 40 60 80 City (n=3) County (n=25) Region (n=23) State (n=2)

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Lead Agencies for the 53 Grantees

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1.9 3.8 3.8 5.7 13.2 3.8 11.3 1.9 5.7 3.8 11.3 3.8 13.2 17.0 20 40 60 80

School personnel (n=1) Tribe/Tribal Consortium (n=2) Judge/Court (n=2) Community Mental Health Provider (n=3) Other Child/Family Services Entity (n=7) Joint Child Welfare/Substance Abuse Agency (n=2) Substance Abuse Treatment Provider (n=6) Tribal Substance Abuse Agency (n=1) County Substance Abuse Agency (n=3) State Substance Abuse Agency (n=2) Child Welfare Services Provider (n=6) Tribal Child Welfare Agency (n=2) State Child Welfare Agency (n=7) County Child Welfare Agency (n=9)

Partner Member Agencies Representing Child Welfare, Substance Abuse, Courts and Tribes

(Percentage Grantees Indicating Given Member is a Partner)

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7.5 5.7 11.3 13.2 58.5 13.2 58.5 9.4 28.3 28.3 26.4 11.3 54.7 60.4

20 40 60 80

Court Appointed Special Advocates (n=4) Other Criminal Justice* (n=3) Local Law Enforcement (n=6) Juvenile Justice (n=7) Judges/Courts (n=31) Tribe/Tribal Consortium (n=7) Substance Abuse Treatment Provider (n=31) Tribal Substance Abuse Agency (n=5) County Substance Abuse Agency (n=15) State Substance Abuse Agency (n=15) Child Welfare Services Provider (n=14) Tribal Child Welfare Agency (n=6) County Child Welfare Agency (n=29) State Child Welfare Agency (n=32) * Other criminal justice (e.g.,. attorneys general, probation)

Partner Member Agencies Representing Other Service Systems and Community Organizations

(Percentage Grantees Indicating Given Member is a Partner)

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15.1 5.7 7.5 11.3 11.3 35.8 15.1 20.8 34.0 26.4 49.1 32.1

20 40 60 80

Other Partners** (n=8) Faith-Based Org (n=3) Schools/Education (n=4) Community Stakeholder Group/Org (n=6) DEC/Drug Control Task Force/Related Org (n=6) University/Evaluator* (n=19) Housing Services Agency/Provider (n=8) Employment Services Agency/Provider (n=11) Other Child/Family Services Provider (n=18) Health Services (n=14) Mental Health Services Provider (n=26) State/County Mental Health Agency (n=17)

* University partners are typically the evaluators ** Other includes other types of non-profit service providers (e.g., legal services or client advocacy), peer/parent mentor groups, consultant/training organizations, community development districts or other advisory groups or committees.

Target Population

(Percentage Focusing on Children in In-Home and/or Out-of-Home Care)

73.0 6.0 21.0 20 40 60 80 Both In-Home & Out-of-Home Out-of-home In-home

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Percentage with Focus on Methamphetamine

All Grantees and by Cluster

36.4 88.9 77.8 62.5 90.0 66.7 69.8 20 40 60 80 100 Array of Services Cluster (N=11) System-Wide Collaboration Cluster (N=9) Treatment Focused Cluster (N=9) Child Focused Cluster (N=8) Drug Court Cluster (N=10) Tribal Cluster (N=6) All Grantees (N=53)

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Five Broad Program Areas

• Systems Collaboration and Improvements
• Substance Abuse Treatment Linkages and Services
• Services for Children and Youth
• Support Services for Parents and Families
• Expanded Capacity to Provide Treatment and Services to

Families

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In an effort to provide truly comprehensive services, grantees did not limit their initiatives to only 1 of the 5 program areas

• 74% of grantees’ approaches include activities in all 5

program areas

• 25% of grantees’ approaches includes activities in 4 of 5

areas*

* 1 grantee’s approach includes activities in 3 of 5 areas.

Program Models, Evaluation and Performance Measures

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Initial Program Activities Program Services/Strategies

Inputs Outputs Outcomes

SHORT TERM

• C1. Children Remain at

Home

• C2. Occurrence of

Maltreatment

• C3. Length of Stay in

Foster Care

• C7. Prevention of

Substance-Exposed Newborns

• C9. Child Well-Being
• A2. Retention in

Substance Abuse Treatment

• A3. Substance Use
• A5. Employment
• A6. Criminal Behavior
• A7. Mental Health

Status

• F1. Parenting
• F2. Family

Relationships/ Functioning

• F3. Risk/Protective

Factors

• R1. Collaborative

Capacity LONG TERM

• C3. Length of Stay in

Foster Care

• C4. Re-entries to

Foster Care

• C5. Timeliness of

Reunification

• C6. Timeliness of

Permanency

• A3. Substance Use
• A5. Employment
• A6. Criminal Behavior
• A7. Mental Health

Status

• R1. Collaborative

Capacity COMMUNITY SERVICES Parent Supportive Services:

• Primary Medical Care
• Dental Care
• Mental Health

Services

• Child Care
• Transportation
• Housing
• Parenting

Training/Child Development Education

• Domestic Violence
• Employment Training
• Continuing

Care/Recovery Support

• Alternative Therapies

Child Supportive Services:

• Developmental

Services

• Mental Health

Services

• Primary Pediatric

Care

• Substance Abuse

Prevention and Treatment

• Educational Services

ADULT SERVICES Assessment of Service Needs Coordinated Case Management Wrap Around In-Home Services Substance Abuse Treatment Family-Centered Treatment Parents Connected to Support Services Cognitive/Behavioral/ Therapeutic Strategies Judicial Oversight CHILD/YOUTH SERVICES Assessment of Service Needs Coordinated Case Management Wrap Around In-Home Services Substance Abuse Treatment Family-Centered Treatment Children Connected to Support Services SYSTEMS CHANGES Organizational and Other Strategies Training Substance Abuse Training/Education for Foster Care Parents Partnership Meetings Regular Program/ Administrative Meetings SYSTEMS COLLABORATION Formal Cross-Systems Policies and Procedures Information Sharing and Data Analysis Increased Service Capacity Family Enters Community Services Family Enters AOD Treatment Family Enters CW System Family Enters RPG Family Court Family Drug Court

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Program Strategy Confirmations

• Purpose: To determine which grantees are using

similar program strategies and evaluation methods (e.g., quasi-experimental with matched comparison group)

• Importance: Will enable us to combine subgroups
• f grantees’ data for more sophisticated analyses

Individual grantees will not be identified in reporting

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Broad Program Strategy Categories

• Case management
• Screening and assessment
• Substance abuse treatment
• Children’s services
• Parenting/Family therapy
• Mental health and trauma services
• Collaborative clinical practice activities
• Collaborative program and policy activities

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RPGs in Other Clusters with a FDC Component

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* Formerly known as Island Grove Grantee State Cluster Butler County Ohio Array of Services Family Tree Center Montana Array of Services Hillsborough Florida Array of Services North Range Behavioral Health* Colorado Treatment Focused Juvenile Justice Fund Georgia Treatment Focused Pierce County Alliance Washington Treatment Focused Santa Clara County California Child Focused

• St. Patrick Center

Missouri Array of Services State of Nevada Nevada Treatment Focused Travis County Texas System-Wide

RPGs Implementing Family Drug Court (FDC)

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Grantee State Connect Care Colorado Supreme Court of Georgia Georgia Idaho Department of Health & Welfare Idaho Iowa Judicial Branch Iowa Lucas County Ohio Mendocino County Health & Human Services Administration California Multnomah County Oregon North Carolina Department of Health & Human Services North Carolina Sacramento Department of Health & Human Services California Santa Cruz County California

Regional Partnership Grants/ Family Drug Courts-Continued

 Of the 20 RPG/FDC Sites, 4 are operating more than one

FDC, for a total of 29 FDCs:

 Supreme Court of Georgia (2)  Idaho Department of Health and Welfare (3)  Judicial Branch State of Iowa (6)  North Range Behavioral Health* (2)

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* Formerly known as Island Grove

Program Strategies

34

 The 20 RPG/FDC sites are expected to serve a total of

approximately:

• 8,760 children
• 9,000 adults
• 7,700 families

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Program Strategies

Case Management, Case Conferencing and Wraparound/In-Home Strategies

95 80 75 86 49 63

10 20 30 40 50 60 70 80 90 100

Intensive/Coordinated Case Mgt Family Group Decision Making Wraparound/In-Home Services

FDC cohort (N=20) All Other RPGs (N=35)

Percent Note: The total N does not add to 53 as two grantees have both a FTDC program and a non-FTDC intervention; their non-FTDC program is included in “All Other RPGs” count.

Screening and Assessment (Children and Adults)

100 75 95 75 91 80 91 71

10 20 30 40 50 60 70 80 90 100

Child Welfare Issues Other Children's Issues* Adult Substance Abuse Other Adult Issues*

FDC Cohort (N=20) All Other RPGs (N=35)

Percent

*Other includes screening/assessment for issues such as: developmental, behavioral, mental health, family functioning and parenting.

Substance Abuse Treatment for Adults

100 75 90 85 95 60 91 49 80 74 91 34

10 20 30 40 50 60 70 80 90 100

Specialized Outreach Residential Outpatient* Aftercare Family-Centered Tx Continuum of Care**

FDC Cohort (N=20) All Other RPGs (N=35)

Percent ** Continuum of Care captures grantees doing all of the following: Specialized Outreach + Residential + Outpatient + Aftercare * Outpatient includes: partial hospitalization, intensive outpatient and/or non-intensive outpatient.

Substance Abuse Prevention

20 40 20 20 30 15 49 34 34 14 29 20 10 20 30 40 50 60 70 80 90 100

Information Dissemination Prevention Education Alternative Activities Problem ID & Referral Community-Based Process Environmental Approaches

FDC Cohort (N=20) All Other RPGs (N=35) 45% percent of the FDC cohort is engaged in any type of prevention activities, compared to 69% of the other RPGs

Percent

Services for Children/Youth

50 45 50 45 35 5 54 54 60 37 29 26 10 20 30 40 50 60 70 80 90 100

Early Intervention Developmental Therapeutic Trauma Academic Supports Substance Abuse Tx

FDC Cohort (N=20) All Other RPGs (N=35)

Percent

Parenting* and Family Therapy/Counseling

35 50 70 65 40 40 69 69 10 20 30 40 50 60 70 80 90 100

Standard Parenting Enhanced Parenting Manualized/EBP Family Therapy/Counseling

FDC Cohort (N=20) All Other RPGs (N=35)

Percent *Parenting strategies are not mutually exclusive; grantees may be doing more than one type of parenting

Mental Health and Trauma

85 70 80 57 37 69 10 20 30 40 50 60 70 80 90 100

Mental Health Services Psychiatric Care Trauma Informed/Specific Services

FDC Cohort (N=20) All Other RPGs (N=35)

Percent

Cross-Systems Collaboration – Clinical-Related Activities

90 100 75 55 97 80 71 57 10 20 30 40 50 60 70 80 90 100

Training on SA/CW Clinical Issues Joint Case Staffings Formal Policies & Procedures Co-located Staff

FDC Cohort (N=20) All Other RPGs (N=35)

Percent

45% of the FDC cohort and 37% of all other RPGs are doing all 4 of these activities.

Cross-Systems Collaboration – Program- and Policy-Related Activities

100 100 90 91 94 94 10 20 30 40 50 60 70 80 90 100

Training on RPG Operations Regular Partnership Meetings* Info Sharing/Data Analysis

FDC Cohort (N=20) All Other RPGs (N=35)

Percent * Includes meetings to discuss program and policy and/or management or administrative issues

Performance Indicators

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Performance Indicators

• Child/Youth
• Adult
• Family/Relationship
• Regional Partnership/Service Capacity

46

Child/Youth Indicators

(Percentage grantees selecting indicator)

77 89 29 46 71 71 63 97 89 50 80 50 80 85 85 90 100 80

20 40 60 80 100

• C9. Improved child well-being
• C8. Children connected to support services
• C7. Prevention of substance-exposed newborns
• C6. Timeliness of permanency
• C5. Timeliness of reunification
• C4. Re-entries to foster care
• C3. Length of stay in foster care
• C2. Occurrence of maltreatment
• C1. Children remain at home

FDC Cohort (N=20) All Other RPGs (N=35)

Note: The total N does not add to 53 as two grantees have both a FTDC program and a non-FTDC intervention; their non-FTDC program is included in “All Other RPGs” count.

Adult Indicators

(Percentage grantees selecting indicator)

74 63 74 83 86 94 83 45 75 85 95 100 100 100

20 40 60 80 100

• A7. Mental health
• A6. Criminal behavior
• A5. Employment
• A4. Connected to support services
• A3. Substance use
• A2. Treatment retention
• A1. Access to treatment

FDC Cohort (N=20) All Other RPGs (N=35)

Family/Relationship Indicators

(Percentage grantees selecting indicator)

24.0 77.0 86.0 89.0 94.0 15.0 75.0 65.0 65.0 80.0

20 40 60 80 100

• F5. Substance abuse education/training

for foster parents

• F4. Coordinated case management
• F3. Risk/protective factors
• F2. Family functioning/relationships
• F1. Parenting

FDC Cohort (N=20) All Other RPGs (N=35)

Regional Partnership/Service Capacity Indicators

• R1. Collaborative capacity
• 100% of all grantees will report on this indicator
• R2. Capacity to serve families
• 90% of the FDC cohort and 77% of all other grantees

will report on this indicator

50

Preliminary Findings from RPG/FDC Sites

51

Number of Children and Adults in Data Set

52

Treatment Group Control Group Comparison Group Total Children 4,645 302 662 5,609 Adults 3,017 220 439 3,676

Gender of Children

Preliminary Data

50.1 49.9 49.3 50.7 20 40 60 80 100 Girls Boys Percent

FDC Cohort (n=4245) All Other RPGs (n=5222)

53

Not significant

Age of Children

Preliminary Data

54

***p<.001

27.6 24.5 11.5 13.2 12.2 11.0 21.7 17.0 12.2 15.8 14.4 12.0

20 40 60 80 100

< 1 year 1-3 yrs 4-5 yrs 6-8 yrs 9-12 yrs 13-18 yrs

Percent

FDC Cohort (n=4645) All Other RPGs (n=5459)

Race/Ethnicity of Children

Preliminary Data

55

AI/AN = American Indian/Alaskan Native

**p<.01; ***p<.001

53.5 37.6 13.1 11.5 7.9 0.3 63.3 14.3 24.8 14.6 0.9 0.1

20 40 60 80 100

Caucasian*** African American*** Hispanic Origin*** AI/AN*** Asian*** Native Hawaiian/PI**

Percent

FDC Cohort All Other RPGs

Child Removed from Home

Preliminary Data

56

***p<.001

57.4 42.6 20 40 60 80 100 FDC Cohort (n=4645) All Other RPGs (n=5459) Percent

Gender of RPG Adults

Preliminary Data

26.4 73.6 25.6 74.4 20 40 60 80 100 Male Female Percent

FDC Cohort (n=3006) All Other RPGs (n=659)

57

Not significant

Race/Ethnicity of Adults

Preliminary Data

58

AI/AN = American Indian/Alaskan Native

**p<.01; ***p<.001

63.0 21.1 11.4 7.2 1.5 0.6 69.6 10.0 18.2 13.4 0.8 0.1

20 40 60 80 100

Caucasian*** African American*** Hispanic Origin*** AI/AN*** Asian** Native Hawaiian/PI***

Percent

FDC Cohort All Other RPGs

Adult Baseline Characteristics

Preliminary Data

59

**p<.01; ***p<.001 22.7 8.0 34.8 40.5 27.9 6.7 31.0 37.8

10 20 30 40 50

Employed*** Pregnant Meth as Contributing Factor** Prior Perpetrator

Percent

FDC Cohort All Other RPGs

Primary Substance at Treatment Admission

Preliminary Data

60

***p<.001

31.2 19.4 20.1 14.5 12.9 1.9 32.8 17.9 21.2 9.8 14.2 4.0

10 20 30 40

Meth Alcohol Marijuana Cocaine/Crack*** Heroin/Other Opiates Other***

Percent

FDC Cohort (n=2017) All Other RPGs (n=1910)

Major Factors Related to Success or Challenges in Enrolling Families into FDC

Most common reasons for success included:

 Strengthening of existing collaborative relationships or

establishing new collaborative relationships with new partners or referral sources (7 grantees)

 Strong pre-existing collaboration or established presence

in the community (5 grantees)

Most common barriers included:

 Problems getting referrals to the RPG program

(5 grantees)

• In addition, 2 grantees had difficulty engaging clients once referred,

retaining clients once enrolled and tracking client drop-off points

61

Reflects insights gleaned from grantees’ Semi-Annual Progress Reports

Larger Contextual/Community Events Impacting RPG/FDC Programs

 State, County or other agency budget cuts or layoffs

(14 grantees)

 Legislative or policy changes (7 grantees)  State, County or other agency (not RPG) personnel

changes (6 grantees)

 Service provider change or issue (4 grantees)  New grant or related initiative in community/region

(4 grantees)

 Broader economic climate in target communities

(7 grantees)

 Unemployment and job-related issues (6 grantees)

 Changes in child welfare trends/caseloads (4 grantees)

62

Reflects insights gleaned from grantees’ Semi-Annual Progress Reports

Percentage Grantees Identified as Experiencing Greatest Accomplishments in Key Collaborative Areas in Year 2

30 25 55 15 30 15 30 35 25 35 82 30 73 36 15 33 21 61 36 49 10 20 30 40 50 60 70 80 90 100 FDC Cohort (N=20) All Other RPGs (N=33)

Percent

Percentage Grantees Identified as Experiencing Greatest Challenges in Key Collaborative Areas in Year 2

25 15 55 5 30 20 35 20 25 10 46 36 36 12 52 39 18 21 21 27 10 20 30 40 50 60 70 80 90 100 FDC Cohort (N=20) All Other RPGs (N=33)

Percent

Summary

65

Strategies Most Likely to be Selected by RPG/FDCs

 Case Management, Case Conferencing, and

Wraparound/In-Home Strategies

 Family Group Decision Making (80% FDC vs 49% Other)

 Substance Abuse Treatment for Adults

 Residential (75% FDC vs 49% Other)  Continuum of Care (60% FDC vs 34% Other)

 Parenting and Family Therapy/Counseling

 Enhanced Parenting (50% FDC vs 40% Other)

66

Strategies Most Likely to be Selected by RPG/FDCs-Continued

 Mental Health & Trauma

 Mental Health Services (85% FDC vs 57% Other)  Psychiatric Care (70% FDC vs 37% Other)

 Cross-Systems Collaboration-Clinical

 Joint Case Staffings (100% FDC vs 80% Other)

67

Strategies Least Likely to be Selected by RPG/FDCs

 Substance Abuse Prevention

 Information Dissemination (20% FDC vs 49% Other)  Alternative Activities (20% FDC vs 34% Other)

 Services for Children/Youth

 Therapeutic (50% FDC vs 60% Other)

68

Indicators Most Likely to be Selected by RPG/FDCs

 Length of stay in foster care

(90% FDC vs 63% Others)

 Re-entries to foster care

(85% FDC vs 71% Others)

 Timeliness of permanency

(80% FDC vs 46% Others)

 Prevention of substance-exposed newborns

(50% FDC vs 29% Others)

69

Indicators Least Likely to be Selected by RPG/FDCs

 Improved child well-being

(50% FDC vs 77% Others)

70

Highlights from Preliminary Findings

 Higher percentage of African American and Asian

children served by FDC sites

 Caucasian (53.5% FDC vs 63.3% Others)  African American (37.6% FDC vs 14.3% Others)  Hispanic Origin (13.1% FDC vs 24.8% Others)  American Indian/Alaskan Native

• (11.5% FDC vs 14.6% Others)

 Asian (7.9% FDC vs. 0.9% Others)

 Children serve by FDC sites more likely to have

been removed from the home

 57.4% FDC vs 42.6% Others

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Highlights from Preliminary Findings- Continued

 FDC sites reported greatest accomplishments in

Information Sharing/Data Systems (30% FDC vs 15% Others)

 FDC sites reported greatest challenges in:

 Engagement/Retention (55% FDC vs 36% Others)  Budget/Sustainability (35% FDC vs 18%)

72

A reminder…

73

74

Number of Children in Out of Home Care and with Terminated Parental Rights by Year

400,000 500,000 600,000

0,000 50,000 100,000 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Number of Children

Children Whose Parental Rights Have Been Terminated Children in Care

600,000 500,000 400,000

Source: Adoption and Foster Care Analysis and Reporting System (AFCARS).

75

Percent and Number of Children with Terminated Parental Rights by Reason for Removal -- 2007

10 20 30 40 50 60 70 80 90 100

Reliquishment (n=6,203) Child Disability (n=7,438) Child Alcohol or Drug Abuse (n=7,672) Parent Incarceration (n=9,922) Child Behavior (n=10,250) Abandonment (n=10,280) Sexual Abuse (n=10,764) Inadequate Housing (n=19,992) Physical Abuse (n=26,002) Parent Unable to Cope (n=30,896) Parent Alcohol or Drug Abuse (n=46,622) Neglect (n=90,020)

Source: Boles, S. (2010). Data analysis of the 2007 Adoption and Foster Care Analysis and Reporting System (AFCARS) data set. Unpublished data.

Parental Substance Use Cited as Factor in Child Welfare Case

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CFSR Round 1 Review 2001-2004** (N=50 Cases*) CFSR Round 2 Review 2007-2010 (N=65 Cases*) 2007 AFCARS Data Parental Alcohol or Drug Abuse (N=190,900 Cases*) State Percent Percent Percent Alabama 12 15 14.4 Alaska 8 31 51.0 Arizona ** 17 18.8 Arkansas** 11 26.5 California 16 20 4.4 Colorado 10 14 30.6 Connecticut 12 14 30.0 Delaware 16 5.8 D.C.** 15 18.3 Florida ** 26 42.0

*This chart depicts 10 of 52 states. **In Round1, these data were not included in the first cohort of states reviewed; it was an added item in subsequent states.

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QUESTIONS QUESTIONS ?

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CONTACT INFORMATION

Contact: Larisa Owen, M.B.A. Director of Technical Assistance Services 4940 Irvine Boulevard, Suite 202 Irvine, CA 92620 Toll-free: 866.493.2753 Website: www.ncsacw.samhsa.gov Email: ncsacw@cffutures.org