SLIDE 1 Today’s Agenda
National Center on Substance Abuse and Child Welfare’s model of SAFERR, Screening and Assessment for Family Engagement, Retention and Recovery Questions and Answers Washington State’s pilot testing of the UNCOPE Questions and Answers Washington State’s transition to cross-system implementation of the GAIN SS Questions and Answers Wrap up
1
SLIDE 2 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
4940 Irvine Blvd., Suite 202 714.505.3525 Irvine, CA 92620 www.ncsacw.samhsa.gov ncsacw@cffutures.org
SLIDE 3 NCSACW Online Training
Understanding Child Welfare and the Dependency Court: A Guide for Substance Abuse Treatment Professionals Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Child Welfare Professionals Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Legal Professionals (Fall 2007)
3
SLIDE 4
Screening and Assessment for Family Engagement, Retention and Recovery – SAFERR Guidance for States and Communities Serving Families with Substance Use Disorders in Child Welfare Services and Dependency Courts
SLIDE 5
SAFERR is based on the premise that when parents misuse substances and maltreat their children, the only way to make sound decisions is to draw from the talents and resources of at least three systems: child welfare, alcohol and drugs, and the courts.
SLIDE 6 Principles
- The problems of child maltreatment and substance
use disorders demand urgent attention and the highest possible standards of practice from everyone working in systems charged with promoting child safety and family well-being.
- Success is possible and feasible. Staff in child
welfare, substance abuse, and court systems have the desire and potential to change individual lives and create responsible public policies.
- Family members are active partners and
participants in addressing these urgent problems.
SLIDE 7 Principles
- The problems of child maltreatment and substance
use disorders demand urgent attention and the highest possible standards of practice from everyone working in systems charged with promoting child safety and family well-being.
- Success is possible and feasible. Staff in child
welfare, substance abuse, and court systems have the desire and potential to change individual lives and create responsible public policies.
- Family members are active partners and
participants in addressing these urgent problems.
SLIDE 8
Premises
1. The team is the tool, and people, not tools, make decisions 2. The family is the focus of concern 3. Problems don’t come in discrete packages; they are jumbled together 4. Assessment is not a one-person responsibility
SLIDE 9
Premises
5. Information is limited, and there is no research- based answer 6. There is no time to lose 7. ICWA creates specific guidelines for working with American Indian populations 8. Developing and sustaining effective collaborations is hard work
SLIDE 10 Organization of SAFERR
I. Building Cross-System Collaboration
- Creating the structure to create and sustain change
II. Collaboration Within and Across Systems
- What each system needs to know about itself and
its partners
- III. Collaboration in Action: Working Together on the
Front Line
- Presents activities that create cross-system practice
changes
SLIDE 11 Organization of SAFERR
A.
Facilitator’s Guide
- Templates and exercises
- B. Fact Sheets
- To educate administrators, legislators and
stakeholders about the initiative
C.
Understanding the Needs of Children
D.
Screening and Assessment Tools for Substance Use Disorders
SLIDE 12 Organization of SAFERR Appendices
E.
Substance Use, Abuse, Dependence Continuum, and Principles of Effective Treatment
F.
Safety and Risk Assessments for Use by Child Welfare Staff
- G. Sharing Confidential Information
H.
Glossary of Terms
I.
Guide to Compliance with the Indian Child Welfare Act (ICWA)
SLIDE 13 Assessment is a Process
Assessment happens along a continuum to determine:
- Presence and Immediacy
- Is there an issue present?
- What is the immediacy of the issue?
SLIDE 14 Assessment is a Process
Assessment happens along a continuum to determine:
Is there an issue present? What is the immediacy of the issue?
- Nature and Extent
- What is the nature of the issue?
- What is the extent of the issue?
SLIDE 15 Assessment is a Process
Assessment happens along a continuum to determine:
Is there an issue present? What is the immediacy of the issue?
What is the nature of the issue? What is the extent of the issue?
- Developing & Monitoring Change, Transitions &
Outcomes of Treatment and Case Plans
- What is the response to the issue?
- Are there demonstrable changes in the issue?
- Is the family ready for transition?
- Did the Interventions Work?
SLIDE 16 Definitions of Terms and Processes
Report
AOD Services CWS Services Court Services
Is there an issue?
SLIDE 17 Definitions of Terms and Processes
Report
Need Triage
Safety Assessment
Protective Hearing
AOD Services CWS Services Court Services
Is there an issue? What is the immediacy
issue?
SLIDE 18 Definitions of Terms and Processes
Report
Need Triage
Safety Assessment
Protective Hearing
Response/ Risk Assessment
Findings
AOD Services CWS Services Court Services
Is there an issue? What is the immediacy
issue? What is the nature of the issue?
SLIDE 19 Definitions of Terms and Processes
Report
Need Triage
Safety Assessment
Protective Hearing
Response/ Risk Assessment
Findings
Dimensional Assessment
assessment
Preliminary Protective Hearing
AOD Services CWS Services Court Services
Is there an issue? What is the immediacy
issue? What is the nature of the issue? What is the extent of the issue?
SLIDE 20
Plan
Dispositional Hearing; Court-ordered Case Plan
AOD Services CWS Services Court Services
What is the Response?
SLIDE 21
Plan
Dispositional Hearing; Court-ordered Case Plan
Monitoring
Monitoring
Hearings
AOD Services CWS Services Court Services
What is the Response? Is there demonstra- ble change?
SLIDE 22
Plan
Dispositional Hearing; Court-ordered Case Plan
Monitoring
Monitoring
Hearings
Planning
Determination
Hearing
AOD Services CWS Services Court Services
What is the Response? Is there demonstra- ble change? Is family ready for transition?
SLIDE 23
Plan
Dispositional Hearing; Court-ordered Case Plan
Monitoring
Monitoring
Hearings
Planning
Determination
Hearing
Management
Being
AOD Services CWS Services Court Services
What is the Response? Is there demonstra- ble change? Is family ready for transition? What is to happen after discharge?
SLIDE 24
Plan
Dispositional Hearing; Court-ordered Case Plan
Monitoring
Monitoring
Hearings
Planning
Determination
Hearing
Management
Being
Monitoring
Monitoring
Monitoring
AOD Services CWS Services Court Services
What is the Response? Is there demonstra- ble change? Is family ready for transition? What is to happen after discharge? Did the intervention work?
SLIDE 25 Assessment Information must be Communicated
Assessment happens along a continuum to determine:
Is there an issue present? What is the immediacy of the issue?
What is the nature of the issue? What is the extent of the issue?
- Developing & Monitoring Change, Transitions &
Outcomes of Treatment and Case Plans
- What is the response to the issue?
- Are there demonstrable changes in the issue?
- Is the family ready for transition?
- Did the Interventions Work?
SLIDE 26
The SAFERR Model Development
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice Establishes and Monitors Individual and Cross-System Outcomes
SLIDE 27
The SAFERR Model Development
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice Establishes and Monitors Individual and Cross-System Outcomes
SLIDE 28 GOVERNANCE
Committee
Committee
Builds Cross System Collaboration Most senior officials from all systems
- Direct staff to give this priority
- Provide overall direction
- Meet 3-4 times a year
- Receive interim reports
SLIDE 29 GOVERNANCE
Committee
Committee
Builds Cross System Collaboration Senior managers from within systems
facilitator
authority
advance for discussion
meetings
- Report collectively to the
- versight committee
SLIDE 30 GOVERNANCE
Committee
Committee
Builds Cross System Collaboration Senior managers from within systems
facilitator
authority
advance for discussion
meetings
- Report collectively to the
- versight committee
The Charge to the Steering Committee:
statement based on exploration of values and principles
- Enhance understanding
- f current systems &
barriers to communication
milestone, products & implement plan to achieve them
subcommittees
curricula and strategies
evaluate outcomes
SLIDE 31 GOVERNANCE
Committee
Committee
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice The Subcommittee(s)
- Comprised of county front
line and supervisory staff;
Committee to conduct specific tasks
- Participate in pilot tests of
strategies
Committee
SLIDE 32 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
Principles
Understanding on Language & Processes
Products
Curricula/Strategy Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 33 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy
MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 34
The SAFERR Model Development
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice Establishes and Monitors Individual and Cross-System Outcomes
SLIDE 35 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use
affects child development
- How to screen for substance use
- Treatment system & how to help
people stay in treatment
- Implications of tensions between
Treatment Staff and CW timelines Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 36 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects
child development
- How to screen for substance use
- Treatment system & how to help people stay in
treatment
- Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
- How substance use puts children at
risk & how CWS must respond
- Child maltreatment reporting
requirements
- How to screen for child safety
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 37 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects
child development
- How to screen for substance use
- Treatment system & how to help people stay in
treatment
- Implications of tensions between Treatment
Staff and CW timelines Alcohol and Drug System Understands
- How substance use puts children at risk & how
CWS must respond
- Child maltreatment reporting requirements
- How to screen for child safety
Court System Understands
- Basics of substance use & child
maltreatment
- Its role in requiring assessments
- The authority to prompt/require
collaboration Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 38 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects child
development
- How to screen for substance use
- Treatment system & how to help people stay in treatment
- Implications of tensions between Treatment Staff and CW
timelines Alcohol and Drug System Understands
- How substance use puts children at risk & how CWS must
respond
- Child maltreatment reporting requirements
- How to screen for child safety
Court System Understands
- Basics of substance use & child maltreatment
- Its role in requiring assessments
- The authority to prompt/require collaboration
Collaboratively all Three Systems
- Establish joint policies/procedures
to share information
- Establish case plans
- Develop shared indicators of
progress
- Monitor progress and evaluate
- utcomes
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 39
The SAFERR Model Development
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice Establishes and Monitors Individual and Cross-System Outcomes
SLIDE 40 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects
child development
- How to screen for substance use
- Treatment system & how to help people stay in
treatment
- Implications of tensions between Treatment
Staff and CW timelines Alcohol and Drug System Understands
- How substance use puts children at risk & how
CWS must respond
- Child maltreatment reporting requirements
- How to screen for child safety
Court System Understands
- Basics of substance use & child maltreatment
- Its role in requiring assessments
- The authority to prompt/require collaboration
Collaboratively all Three Systems
- Establish joint policies/procedures to share
information
- Establish case plans
- Develop shared indicators of progress
- Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
substance use and child maltreatment Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 41 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects
child development
- How to screen for substance use
- Treatment system & how to help people stay in
treatment
- Implications of tensions between Treatment
Staff and CW timelines Alcohol and Drug System Understands
- How substance use puts children at risk & how
CWS must respond
- Child maltreatment reporting requirements
- How to screen for child safety
Court System Understands
- Basics of substance use & child maltreatment
- Its role in requiring assessments
- The authority to prompt/require collaboration
Collaboratively all Three Systems
- Establish joint policies/procedures to share
information
- Establish case plans
- Develop shared indicators of progress
- Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
use and child maltreatment
substance use and child maltreatment Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 42 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects
child development
- How to screen for substance use
- Treatment system & how to help people stay in
treatment
- Implications of tensions between Treatment
Staff and CW timelines Alcohol and Drug System Understands
- How substance use puts children at risk & how
CWS must respond
- Child maltreatment reporting requirements
- How to screen for child safety
Court System Understands
- Basics of substance use & child maltreatment
- Its role in requiring assessments
- The authority to prompt/require collaboration
Collaboratively all Three Systems
- Establish joint policies/procedures to share
information
- Establish case plans
- Develop shared indicators of progress
- Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
use and child maltreatment
use and child maltreatment
implement collaborative case plans Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 43 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects
child development
- How to screen for substance use
- Treatment system & how to help people stay in
treatment
- Implications of tensions between Treatment
Staff and CW timelines Alcohol and Drug System Understands
- How substance use puts children at risk & how
CWS must respond
- Child maltreatment reporting requirements
- How to screen for child safety
Court System Understands
- Basics of substance use & child maltreatment
- Its role in requiring assessments
- The authority to prompt/require collaboration
Collaboratively all Three Systems
- Establish joint policies/procedures to share
information
- Establish case plans
- Develop shared indicators of progress
- Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
use and child maltreatment
use and child maltreatment
collaborative case plans
and evaluate results Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 44 GOVERNANCE
- Oversight Committee
- Steering Committee
- Subcommittees
TASKS
- Mission & Principles
- Shared Understanding
- n Language &
Processes
Products
Curricula/Strategy MONITORING
- Baseline Data
- Progress Reports
- Outcome Data
CWS Understands
- Basics of substance use & how use affects
child development
- How to screen for substance use
- Treatment system & how to help people stay in
treatment
- Implications of tensions between Treatment
Staff and CW timelines Alcohol and Drug System Understands
- How substance use puts children at risk & how
CWS must respond
- Child maltreatment reporting requirements
- How to screen for child safety
Court System Understands
- Basics of substance use & child maltreatment
- Its role in requiring assessments
- The authority to prompt/require collaboration
Collaboratively all Three Systems
- Establish joint policies/procedures to share
information
- Establish case plans
- Develop shared indicators of progress
- Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
use and child maltreatment
use and child maltreatment
collaborative case plans
evaluate results
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice
SLIDE 45
The SAFERR Model Development
Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice Establishes and Monitors Individual and Cross-System Outcomes
SLIDE 46 Establishes and Monitors Individual and Cross-System Outcomes
- Increased identification of substance use disorders among
families reported for child maltreatment
- Increased identification of potential child maltreatment for people
assessed/treated for SUDS
- Increased communication regarding screening and assessment
for SUDS and child maltreatment
- Informed decision making by CWS and CS regarding
reunification, aftercare, terminations
- Reduced duplication and burden with regard to case plan
requirements
- Increased engagement and retention of parents in treatment
- Reduced risk of maltreatment of children
- Increased family stability, reunification and well being
SLIDE 47
SLIDE 48
SLIDE 49
SLIDE 50
SLIDE 51 Screening and Assessment for Family Engagement, Retention and Recovery – SAFERR Guidance for States and Communities Serving Families with Substance Use Disorders in Child Welfare Services and Dependency Courts
Nancy K. Young, Ph.D., Director 4940 Irvine Blvd, Ste 202 Irvine, CA 92620 Phone: 714-505-3525 Fax: 714-505-3626 www.ncsacw.samhsa.gov
SLIDE 52 52 52
Implementation of Statewide Screening for Co-occurring Disorders
Washington State Department
& Health Services
Presentation for National Center on Substance Abuse and Child Welfare July 17, 2007
- David Brenna, Sr. Policy Analyst
Mental Health Transformation Grant
- Glenn Baldwin, Planning and Policy Specialist
Division of Alcohol and Substance Abuse
- David de la Fuente, Program Manager
Children’s Administration WASHINGTON STATE DEPARTMENT OF SOCIAL AND HEALTH SERVICES
SLIDE 53 53
Washington State Department of Social & Health Services
Part 1: Early Efforts - Developing Partnerships Part 2: Mental and Substance Abuse Disorders Act
Part 3: Children’s Administration Implementation of Global Appraisal of Individual Needs-Short Screener GAIN-SS
Presentation Outline
SLIDE 54 54
Washington State Department of Social & Health Services
Six Regional Offices 44 Local offices
SLIDE 55 5 5
Washington State Department of Social & Health Services
Part 1: Early Efforts - Developing Partnerships
January 2004
- Discussions between Children’s Administration (CA) and
the Division of Alcohol and Substance Abuse (DASA) May 2004
- Substance Abuse Services Initiative
October 2004
- Memorandum Of Understanding
April 2005
- UNCOPE Pilot
- Chemical Dependency Professional program
SLIDE 56 5 6
Washington State Department of Social & Health Services
- Multi-disciplinary oversight team established, including social
workers, screening experts, treatment providers and administrators
- Local pilot site selected based on existing presence of a
Chemical Dependency Professional and diverse demographics
- UNCOPE tool initially selected for its usability and statistical
validity
- Training provided to local CA staff on UNCOPE and specific
substance abuse issues
- Pilot implementation on April 1, 2004
UNCOPE and Chemical Dependency Professional Pilots
SLIDE 57 5 7
Washington State Department of Social & Health Services
CDPs provide social workers with co-located chemical dependency “liaisons” who:
- Assist social workers to coordinate services for Children’s
Administration clients impacted by substance abuse issues
- Make referrals for assessment and treatment as indicated by
the results screening tool
- Provide expert support to social workers in order to meet the
additional case management needs of clients with substance abuse and co-occurring disorders
Chemical Dependency Professionals (CDP)
SLIDE 58 5 8
Washington State Department of Social & Health Services
- The UNCOPE was not effective when used at initial
contact with client
- The UNCOPE was effective when used later in the
Child Protective Services investigative process
- Several key factors led to the eventual success of the
pilot including:
- Availability of Chemical Dependency Professionals
- Social worker confidence about the tool and process
- Level of client engagement
- Social worker training
Early Efforts: Lessons Learned
SLIDE 59 5 9
Washington State Department of Social & Health Services
Part 2: Mental & Substance Abuse Disorders Act of 2005
- Senate Bill 5763
- Created the Mental and Substance Abuse Disorders Act of
2005
- Required DSHS to use a “universal” tool to screen for co-
- ccurring substance abuse and mental health disorders
- WA State Law
- (RCW 71.05.027 and 70.96C.010)
- Integrated Comprehensive Screening and Assessment of
Chemical Dependency and Mental Disorders
- Development of a state plan and an integrated screening
and assessment process
SLIDE 60 6 0
Washington State Department of Social & Health Services
Membership from:
- Division of Alcohol and Substance (co-lead)
- Mental Health Division (co-lead)
- Children’s Administration
- Juvenile Rehabilitation Administration
- Department of Corrections
- Washington Institute for Mental Illness Research and Training
Legislative Workgroup
SLIDE 61 6 1
Washington State Department of Social & Health Services
Tasks
- Develop selection criteria for screening tool
- Identify a “universal” screening tool
- Develop a flexible PROCESS to provide an
appropriate degree of assessment yet allow for expansion
Legislative Workgroup
SLIDE 62 6 2
Washington State Department of Social & Health Services
Selection Criteria for Screening Tool
Identified Requirements for the “Universal” Screening Tool
- Statistically valid and sensitive
- Brief
- Fiscally practical to license and use
- Easy to implement with minimal training
- Applicable to a wide range of people
- Include a question about suicide
SLIDE 63 6 3
Washington State Department of Social & Health Services
Selection of “Universal” Screening Tool
Global Assessment of Individual Needs Short- Screener (GAIN-SS)
- Review of Literature
- Consultation with national experts
- Consultation from preexisting co-occurring disorder team
- Stakeholder meetings and feedback
- Match to legislative requirements and intent
SLIDE 64 6 4
Washington State Department of Social & Health Services
Legislation: Lessons Learned
- Data collection is very challenging across multiple systems
- High numbers of “false-negative” screens are likely if the screen
is administered before client engagement occurs
- Identifying large numbers of people as potentially needing
services is only part of the battle
- Capacity to provide comprehensive services is also needed
SLIDE 65 6 5
Washington State Department of Social & Health Services
Part 3: Children’s Administration Implementation of GAIN-SS
Three month pilot, 95 screens:
- 13% positive screens for co-occurring
- 4% positive screens for substance abuse only
- Results reinforced the need for workers to refer
regardless of screen results
SLIDE 66 6 6
Washington State Department of Social & Health Services
Expansion of Chemical Dependency Professional Program
- 26 Chemical Dependency Professionals statewide
- Appropriate funding in order to hire and attract the
most qualified professionals in the Chemical Dependency field
- Coordination of Chemical Dependency Professionals
and the social workers is crucial
SLIDE 67 6 7
Washington State Department of Social & Health Services
Global Appraisal of Individual Needs –Short Screener (GAIN-SS):
Key Policy Elements
- The GAIN-SS tool is used with parents, guardians, legal
custodians, and youth age 13 and over
- A screen is not required for clients already engaged in
services
- Social workers may use their own judgment to make a referral
for services regardless of screen results
- Two or more “yes” answers in any of the three sections
generates an automatic referral for assessment
- Client chooses to participate in screening process
SLIDE 68 6 8
Washington State Department of Social & Health Services
GAIN-SS Continued
Child Protective Services (within 45 days)
- Adults identified as the subject on a referral
- High standard investigation only cases
Family Voluntary Services and Child Welfare Services
- Adults and youth
- Cases transferred from Child Protective Services
Family Reconciliation Services
- Adults and youth identified for intervention
SLIDE 69 6 9
Washington State Department of Social & Health Services
GAIN-SS Screening Form
Screening questions were not altered so that results would be valid
- The screen is validated based on the exact wording of the
questions Referral information was added to the top of the form so that social workers only had one form to fill out
- The goal is to make the screen as simple as possible for
the social workers to use Referral data can be easily collected
- Key data elements are collected from all completed
screens and compiled statewide
SLIDE 70 7 0
Washington State Department of Social & Health Services
GAIN-SS Training Continued
- Developed training curriculum with input from
screening experts, statewide implementation team, and social workers
- Regional trainers identified and trained for
statewide effort
- All social workers (over 1,100) trained in a
three month period and in time for statewide implementation on (1/1/07)
SLIDE 71 7 1
Washington State Department of Social & Health Services
- The pilot was essential in informing policy
- Clarified where and when to administer the screen
- Staff training, client engagement and social worker judgment are
critical
- Availability of Chemical Dependency Professional program
- Provide expertise and case management
- Early indications that referrals for services are
increasing
- The simpler you make the screening process and policy the more
likely it will be used
- Ongoing discussions regarding capacity for services are necessary
CA GAIN-SS Implementation: Lessons Learned
