Learning Objectives Research Outcomes · 2019-05-08 · 2. Explore FDC outcomes from local evaluation studies including best practices and guidelines to support child welfare outcomes.

Research Outcomes from Dependency Drug Courts Across the U.S

Beyond the Bench Conference – December 2015

Alexis Balkey, BA, RAS Children and Family FuturesRuss Bermejo, MSW Chldren and Family Futures

1.. Gain understanding of current direction of national CWS reforms with attention to possible legal implications that enhance the use of Family Dependency Drug Courts as a response to child neglect.

2. Explore FDC outcomes from local evaluation studies including best practices and guidelines to support child welfare outcomes.

3. Explore implications for both judicial and legal professionals working in collaborative courts.

4. Explore the opportunities and challenges ahead for FDCs as a national CWS reform strategy.

Learning Objectives

Evolution and History of FDCs Overview of RPG & CAM Outcomes (The 5Rs)FDC Practice ImprovementsScale and Prevalence DataSystems Change FrameworkFDC Funding Streams & StrategiesOpportunities for Systems ChangeQ & A Discussion

Session OverviewChildren and Family Futures

To improve safety, permanency, well-being and recovery outcomes for children, parents and families affected by trauma, substance use and mental health disorders.

Our Mission

Office of Juvenile Justice and

Delinquency Prevention Children and

Family Futures

Research and

Evaluation

National Center on Substance Abuse and

Child Welfare

In-depth Technical Assistance

Regional Partnership Grants I-3

Prevention and Family Recovery

(PFR)

FDC Training and TA

Program

Statewide System Reform ProgramProgram

Substance Exposed

Infants IDTA

Adoption and Safe Families Act11997

39 Family Drug Courts

Source – NADCP, 2014

346 FDCs nationwide

Important Practices of FDCs•System of identifying families

•Timely access to assessment and treatment services

• Increased management of recovery services and compliance with treatment

• Systematic response for participants – contingency management• Increased judicial oversight

Sources: 2002 Process Evaluation and Findings from 2015 CAM Evaluation

•Collaborative non-adversarial approach grounded in efficient communication across service systems and court

• Improved family-centered services and parent-child relationships

Importa•

•• Increas

with tr

• Increased ju• Improved fa

77

5Rs

How Collaborative Policy and Practice Impacts

Recovery

Remain at home

Reunification

Recidivism

Re-entry

FDC Local Evaluations

Jackson County, OR (N=329, 340)

Washoe, NV (N=84,127)

Santa Clara, CA (N=100, 370)

Sacramento, CA (N=4,858, 111)

Marion County, OR (N=39, 49)

Baltimore, MD (N=200, 200)

(Source: Marlowe & Carey, May 2012)

Maine (3) (N=49, 38*)

San Diego, CA (N=438, 388)

Suffolk, NY (N=117, 239)

C M 2012)

London, England (N=55, 31)

Pima County, AZ (N=33, 45)

11 FDC Sites (N= FDC, Comparison)

* Maine -only 1 of 2 comparison groups are reported in this presentation

12

24 Grantee SitesRPG FDC• 5,200 children• 8,000 adults

Regional Partnership GrantsFamily Drug Courts

13

22010 Children Affected by Methamphetamine Grant 22014

5Rs

How Collaborative Policy and Practice Impacts

Recovery

Remain at home

Reunification

Recidivism

Re-entry

0

22.0

45.5

CAM RPG FDC* RPG Comparison*

Access to Treatment

Med

ian

# of

day

s to

adm

issi

on

Median of 0.0 days indicating that it was most common for adults to access care the same day they entered CAM services

* This analysis is based on 6 RPG Grantees who implemented an FDC and submitted comparison group data

n = 1359 n = 324n = 2646

310356

422

-25

25

75

125

175

225

275

325

375

425

475


Days in Out-of-Home CareMedian length of stay (days) in out-of-home care


n = 1355 n = 513n = 1419

84.9%73.1%

54.4%

0

10

20

30

40

50

60

70

80

90


Reunification RatesPercentage of reunification within 12 months


n = 1351 n = 509n = 1232

Remained in Home

91.5% 85.1%71.1%

0

10

20

30

40

50

60

70

80

90

100


Percentage of children who remained at home throughout program participation


n = 1652 n = 695n = 1999

2.3%

3.4%

4.9%5.8%

0

1

2

3

4

5

6

7

CAM Children RPG Children - FDC RPG Children - No FDC RPG - 25 State ContextualSubgroup

Recurrence of Child MaltreatmentPercentage of children who had substantiated/indicated maltreatment within 6 months

n = 4776Total RPG Children = 22,558

5.0% 5.1%

13.1%

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

CAM Children RPG - Children RPG - 25 StateContextual Subgroup

Re-entries into Out-of-Home CarePercentage of children re-entered into foster care within 12 months

n = 1232 n = 3,575

Cost Savings Per Family

$ 5,022 Baltimore, MD$ 5,593 Jackson County, OR$ 13,104 Marion County, OR

Burrus, et al, 2011

Carey, et al, 2010

Carey, et al, 2010 Source: Children and Family Futures, 2015

Cost Savings Per Child

$ 12,254 Sacramento, CA (Early Intervention FDC–In Home)$ 11,439 Sacramento (Dependency Drug Court–Out of Home)$ 8,088 Riverside County, CA (Pre-File, In-Home)$ 4,171 Riverside County, CA (Out-of-Home)$ 4,035 Mendocino County, CA (per case)

Cost Avoidance

Costs Offset net Program Cost

Sacramento County, CAM Project, Children in Focus (CIF)

Parent-child parenting intervention

FDC

CIF

Connections to community supports

Improved outcomes

Across all FDC programs, Sacramento is getting ready to admit its 5,000th parent!

• Dependency Drug Court (DDC) - Post-File • Early Intervention

Family Drug Court (EIFDC) - Pre-File


49.2

64.3

4453.7

0

10

20

30

40

50

60

70

80

90

100Treatment Completion Rates

64.364 353.753 7

DDC EIFDCCIF CIF


41.8

64.4

34

50.3

0

10

20

30

40

50

60

70

80

90

100Rate of Positive Court Discharge/Graduate

DDC EIFDCCIF

50.3

CIF


89.9

95.1

84

86

88

90

92

94

96

98

100

Remained at Home

EIFDCCIF


87.897

85.194.9

53.1

0

10

20

30

40

50

60

70

80

90

100

Reunification Rates

COUNTY

SAC

DDC CIF EIFDC CIF

SacramentoCounty, CAM Project, Children in Focus (CIF)

90.2

97.995.7 95.6

88.7

82

84

86

88

90

92

94

96

98

100

No Recurrence of Maltreatment at 12 Months

COUNTY

SAC

DDC CIF EIFDC CIF


89.691.8

100 100

87.7

80

82

84

86

88

90

92

94

96

98

100

No Re-Entry at 12 Months

87.7

COUNTY

SAC

DDC CIF EIFDC CIF

NORTH CAROLINA FAMILY ASSESSMENT SCALE (NCFAS) INTAKE RESULTS

67.3%

45.4%

40.5%

27.1%

23.2%

32.7%

54.6%

59.5%

72.9%

76.8%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Readiness for Reunification (n=156)

Parental Capabilities (n=163)

Family Interactions (n=173)

Caregiver/Child Ambivalence* (n=155)

Child Well-Being (n=168)

Adequate/Strength Mild-Moderate-Serious Problem

*This domain is for reunification cases only and addresses both the child’s and caregiver’s desire to reunite and the nature of their relationship with one another.

Percentage of families by rating category (overall domain item)

2012

FDC Guidelines

A FRAMEWORK: BUILT ON A FOUNDATION OF SHARED MISSION AND VISION, SUPPORTED BY CLIENT SERVICES AND AGENCY COLLABORATION, ACHIEVED BY SHARED OUTCOMES

A Collaborative Framework

What?

• CFF with support from OJJDP, in partnership with Federal and State stakeholders

• Crafted guidance document to States for developing FDC guidelines

• Based on research, previous publications, practice-based evidence, expert advisers and existing State standards

• Resource tool for States to clarify FDC principles and develop State guidelines reflecting local and unique needs

FDC GuidelinesTEN RECOMMENDATIONS

• Description• Research findings• Effective strategies

Shared Outcomes

• Interagency Partnerships• Information Sharing•Cross System Knowledge•Funding & Sustainability

•Early Identification & Assessment•Needs of Adults•Needs of Children•Community Support

FDC Recommendations

Agency Collaboration

Shared Mission & Vision

Client Services

Common Challenges and Barriers for FDCs

• Collaboration challenges• Screening and assessment – referral

processes• Engaging and retaining clients• Comprehensive programs – children’s

services• Performance measures/data collection• Budget/sustainability – scale and scope

Collaboration Challenges – Policies and Procedures

• Lack of or inconsistent participation or buy-in from one or more critical partners: child welfare, substance abuse treatment, judges, attorneys

• Confidentiality issues not resolved; information and data sharing problems

• Competing timeframes, lack of coordinated case planning

• Time to meet as a team• Lack of appropriate community resources• Issues of collaboration among agencies in

understanding and working toward shared outcomes

Create a Shared Mission and Vision FDC partners must have a shared mission and vision to define their joint work. Agreement on values and common principles is an essentialfoundation for collaborative FDC relationships.

Key Component 1: Integrate treatment services with justice system case processing

Key Component 2: Using a non-adversarial approach

h d d

#1 Recommendation

Drug Treatment

Court Child Welfare 3

Systems with multiple:•Mandates•Training •Values

•Timing •Methods

Family Drug Courts Values - Why are We here? Why are You Here?

JusticeEqual Protection

RescueProtection

HopeRecovery

CWS Court SA-MH

Screening and Assessment – Referral Processes

• Target population and process for identifying FDC clients is often unclear or inconsistently applied

• No standardized screening for substance use disorders prior to referral to FDC

• Sites are not at capacity and/or it is unclear how capacity rates have been established

• Sites have exclusion criteria for serious mental health issues, felonies, and domestic violence; others deal with these as co-occurring issues

Defining the Scale of Your FDC

44

Defining The Scale of Your FDC

# of children with substantiated allegations: 19,976

# of children entering foster care: 5,466

# of potential children

served in FDC

# of pch

sserves

# of children of substance users: 3,280 (60% estimate)

Your defined target

population* Numbers based on Georgia state child welfare data

Adult Baseline CharacteristicsPreliminary Data

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

22.7

8.0

34.840.5

27.9

6.7

31.0

37.8

0

10

20

30

40

50

Employed*** Pregnant Meth asContributing

Factor**

Prior Perpetrator

Perc

ent

FDC CohortAll Other RPGs

Note 1: Difference is significant at p<.05

Drug Courts That Accepted Participants With Non-Drug Charges Had Nearly Twice

the Reductions in Recidivism and 30% higher cost savings

Note 2: Non-drug charges include property, prostitution, violence, etc.

0%

10%

20%

30%

40%

50%

DRUG COURT ACCEPTS NON-DRUG CHARGES

N=42

DRUG COURT DOES NOT ACCEPT NON-DRUG CHARGES

N=24

41%

21%

Perc

ent r

educ

tions

in re

cidi

vism

How many children in the child welfare system have a parent in need of treatment?

Statement of the Problem

• Between 60–80% of substantiated child abuse and neglect cases involve substance use by a custodial parent or guardian (Young, et al, 2007)

• 61% of infants, 41% of older children who are in out-of-home care (Wulczyn, Ernst and Fisher, 2011)

• 87% of families in foster care with one parent in need; 67% with two (Smith, Johnson, Pears, Fisher, DeGarmo, 2007)

The Need – Missed and Invisible

61% - the percentage of confirmed drug or alcohol dependence among substantiated abuse or neglect cases missed by front line CWS social workers (Gibbons, Barth, Martin, 2005)

86.5% - rate of misdiagnosis and missed diagnoses of FASD among population of foster and adopted youth (Chasnoff, 2015)

9.4%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

AL (N

=7,4

43)

AK (N

=2,8

42)

AZ (N

=23,

854)

AR (N

=7,4

11)

CA (N

=85,

114)

CO (N

=10,

542)

CT (N

=5,8

03)

DE (N

=1,1

60)

DC (N

=1,9

31)

FL (N

=33,

270)

GA

(N=1

3,54

2)H

I (N

=2,0

54)

ID (N

=2,4

38)

IL (N

=21,

957)

IN (N

=18,

695)

IA (N

=10,

570)

KS (N

=9,8

45)

KY (N

=12,

173)

LA (N

=7,3

84)

ME

(N=2

,441

)M

D (N

=7,0

61)

MA

(N=1

3,63

9)M

I (N

=22,

261)

MN

(N=1

1,11

4)M

S (N

=6,0

72)

MO

(N=1

6,18

6)M

T (N

=3,3

97)

NE

(N=7

,742

)N

V (N

=8,0

28)

NH

(N=1

,282

)N

J (N

=12,

082)

NM

(N=3

,746

)N

Y (N

=30,

981)

NC

(N=1

3,40

1)N

D (N

=1,9

23)

OH

(N=2

1,43

5)O

K (N

=15,

096)

OR

(N=1

2,22

6)PA

(N=2

2,93

8)RI

(N=2

,902

)SC

(N=5

,989

)SD

(N=2

,296

)TN

(N=1

4,39

1)TX

(N=4

6,28

6)U

T (N

=4,8

77)

VT (N

=1,6

05)

VA (N

=7,1

83)

WA

(N=1

5,22

2)W

V (N

=7,9

06)

WI (

N =

10,8

52)

WY

(N=1

,890

)PR

(N=4

,836

)

Perc

enta

ge o

f chi

ld re

mov

als

Source: AFCARS, 2013 5

Parental AOD Abuse as Reason for Removal, 2013

15.818.5 19.6

21.6 22.7 23.4 24.9 26.1 26.3 25.8 26.128.4 29.3 30.5 31

4.1 4.9 4.9 4.7 4.3 4.1 4.1 4.1 4.3 4.4 4.8 5.9 7.7 9.1 9.4

0

10

20

30

40

50

60

70

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

PERC

ENT

Source: AFCARS Data Files

= National Data= California Data

PARENTAL AOD AS REASON FOR REMOVAL IN THE UNITED STATES 1998-2013

No state is able to track all CWS clients into treatment and determine their total recovery and reunification outcomes annually

Source: AFCARS 2013

1.0%

1.6%

2.8%

4.3%

5.1%

5.9%

6.1%

7.2%

14.8%

16.2%

21.0%

37.5%

66.3%

Parent Death (n=1,149)

Relinquishment (n=1,863)

Child Alcohol or Drug Abuse (n=3,320)

Child Disability (n=5,031)

Sexual Abuse (n=5,967)

Child Behavior (n=6,901)

Abandonment (n=7,200)

Parent Incarceration (n=8,424)

Inadequate Housing (n=17,443)

Physical Abuse (n=19,072)

Parent Unable to Cope (n=24,775)

Parent Alcohol or Drug Abuse (n=44,153)

Neglect (n=78,033)

Parent and Number of Children with Terminated Parental Rights by Reason for Removal - 2013

Source: AFCARS 20130.3%

0.5%

0.7%

1.1%

1.9%

2.2%

2.9%

3.9%

4.2%

7.8%

15.8%

31.3%

76.8%

Child Disability (n=36)

Parent Death (n=64)

Relinquishment (n=88)

Abandonment (n=125)

Child Behavior (n=228)

Sexual Abuse (n=265)

Parent Incarceration (n=340)

Child Alcohol or Drug Abuse (n=468)

Inadequate Housing (n=503)

Physical Abuse (n=928)

Parent Alcohol or Drug Abuse (n=1,884)

Parent Unable to Cope (n=3,724)

Neglect (n=9,141)

Parent and Number of Children with Terminated Parental Rights by Reason for Removal in California - 2013

Develop an Early Identification and Assessment ProcessFDCs identify participants early in the dependency case process, use screeningand assessment to determine the needs and strengths of parents, childrenand families and identify the most appropriate treatments and other servicesbased on these needs and strengths.

Key Component 3: Early identification and immediate placement

#5 Recommendation

Engaging and Retaining Clients

• Clients are given phone numbers or lists of resources and instructed to call for assessment

• Clients report lack of understanding with FDC requirements and expectations -especially in the beginning

• Lack of consistency in responses to client behavior

• No clear incentives for client participation• Time of groups; competing priorities (e.g.

work vs. FDC requirements)• Issues of treatment availability and quality

Address the Needs of ParentsFDC partner agencies encourage parents to complete the recovery process andhelp parents meet treatment goals and child welfare and court requirements.Judges respond to parents in a way that supports continued engagement inrecovery. By working toward permanency and using active client engagement,accountability and behavior change strategies, the entire FDC team makessure that each parent that the FDC serves has access to a broad scope of services.Key Component 2: Using a non-adversarial approachKey Component 4: Access to a continuum of treatment servicesKey Component 5: Drug testing

Address the Needs of Parents

#6 Recommendation

Case Management, Case Conferencing And Wraparound/In-home Strategies

95

8075

86

49

63

0102030405060708090

100

Intensive/Coordinated CaseMgt

Family Group Decision Making Wraparound/In-HomeServices

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

Perc

ent

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.

102

130151

200

0

50

100

150

200

250

No Parent Support Strategy Intensive Case ManagementOnly

Intensive Case Managementand Peer/ Parent Mentors

Intensive Case Managementand Recovery Coaches

Median in Days

Median Length of Stay in Most Recent Episode of Substance Abuse Treatment after RPG Entry by Grantee Parent Support Strategy Combinations

46% 46%

56%

63%

0%

10%

20%

30%

40%

50%

60%

70%

No Parent SupportStrategy

Intensive CaseManagement Only

Intensive CaseManagement and

Peer/ Parent Mentors

Intensive CaseManagement andRecovery Coaches

Median in Days

Substance Abuse Treatment Completion Rate by Parent Support Strategies

Substance Abuse Treatment for Adults

100

75

9085

95

60

91

49

8074

91

34

0

10

20

30

40

50

60

70

80

90

100

SpecializedOutreach

Residential Outpatient* Aftercare Family-CenteredTx

Continuum ofCare**

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

Per

cent

** 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.

Mental Health and Trauma

85

7080

57

37

69

0

10

20

30

40

50

60

70

80

90

100

Mental Health Services Psychiatric Care Trauma Informed/SpecificServices


Per

cent

Defining Your Drop off Points (Example)218 Substantiated cases of neglect and/or abuse due to

substance use disorders (555 parents)

164 Potential participants assessed for treatment (Tx)25% drop off

Number of participants referred to the FIT Court50% drop off= 82

Number admitted to FDC = 4048% drop off

16 successfully completed Tx

- 60% drop off

Payoff

• Substantiated cases with D&N filing based on Jefferson County data template

• Drop off percentages estimated based on previous drop off reports

• To be used only as an example

Address the Needs of Children

FDCs must address the physical, developmental, social, emotionaland cognitive needs of the children they serve through prevention,intervention and treatment programs. FDCs must implement aholistic and trauma-informed perspective to ensure that childrenreceive effective, coordinated and appropriate services.Key Component 2: Using a non-adversarial approach

Key Component 4: Access to a continuum of treatment services

Address the Needs of Children

#7 Recommendation

• Very little mention of services to children, though serving the family is one of primary differences between adult and family drug courts

• A few sites focus on 0-3, 0-5 and Substance Exposed Newborns with partnerships that focus on parent/child interaction and developmental/health programs for young children

• Utilizing CAPTA and Part C partners

Comprehensive Programs – Children’s Services

90.4%

9.6%

Children Remain At Home

RemainedIn-Home

Removedfrom Home

•Nearly all children in-home at CAM entry remained in the home• Those who were out-of-home

were reunified more quickly

Preliminary Findings: Children Remaining in Home

3.1

6.0

1

2

3

4

5

6

7

Percentage of Children who had Substantiated/Indicated Maltreatment within

Six Months after CAM Program Enrollment

CAM Participant Contextual State Data

Preliminary Findings: Safety

• No substance-exposed births after CAM entry

• Lower occurrence of maltreatment within six months compared to the average among the six states where CAM grantees are located

Preliminary Findings: Family Functioning

3.3 3.6 3.4 3.43.1

3.43.7

2.93.2

3.9

2.6 2.7 2.62.3 2.4

2.7 3.02.4

2.73.0

0.00

1.00

2.00

3.00

4.00

Overall Mean NCFAS Scored for Each Domain(lower is better)

Intake Closure

Create Effective Communication Protocols for Information Sharing

Effective, timely and efficient communication is required to monitorcases, gauge FDC effectiveness, ensure joint accountability, promotechild safety and engage and retain parents in recovery.

Key Component 2: Using a non-adversarial approachKey Component 4: Access to a continuum of treatment servicesKey Component 6: Responses to behaviorKey Component 7: Judicial interaction

e Effective Communication Protocols for ff f

#3 Recommendation

Why do Systems Need to Communicate and Coordinate?

• To improve and enhance the collective systems’ response to meeting families’ needs

• To more effectively identify, engage and retain families

• To establish agreement on and shared accountability among system partners for improving families’ outcomes

• To provide formal processes for assessing the collaborative’sprogress and addressing policy and practice challenges as they arise

• To help leverage and maximize the use all available resources

• To develop and sustain an integrated, coordinated approach to serving the whole family

Barriers to Effective Cross-Systems Communication

• Discipline-specific training

• Legal mandates and administrative codes

• Lack of trust between the systems

• Competing timelines

• Caseload volume

• Confidentiality provisions

Key Steps to Building an Effective Communication Infrastructure

• Establish individual and cross-system roles and responsibilities

• Establish joint policies for information sharing

• Develop integrated case plans• Develop shared indicators of progress• Monitor progress and evaluate

outcomes

Building Cross-System Collaboration: Developing the Structure to Create and Sustain Change

Oversight/Advisory

Committee

Director Level

Quarterly

Program Funder:Ensure long-term

sustainability

Steering Committee

Management Level

Monthly or Bi-Weekly

Policy-Maker:Remove barriers

to ensure program success

FDC Treatment Team

Front-line Staff

Weekly

Staff Cases: Ensure client

success

Membership

Meets

Primary Function: Information Sharing and

Data Systems

FDC STRUCTURE

Partners need an in-depth understanding of each other’s systems and how they impact each other

– Who does what? When? Why? And How?

– How does that affect the families you serve?

In developing this understanding, partners:

– Raise awareness about unknown processes

– Clarify misunderstood processes

– Develop a shared, common language

– Identify opportunities for improvements

Understanding Current Operations Information Needed by Child Welfare Workers and Court Professionals

• Level of involvement of parents in a treatment program

• Barriers to treatment• Support systems being developed around the

parent and family• When parents are experiencing relapse or

have left treatment• The continuing care plan of the parents, if

they are in residential treatment

Information Needed by Substance Abuse Professionals

• If the child is in the home or has been removed• If some children were removed while others not• If it is a voluntary case or is court mandated• The permanency goal for the child• If reunification is a goal• If there are concurrent plans for both foster care

and adoption• Specific case plan goals requiring treatment

professional involvementCourt requirements and deadlines for specific hearings and achieving necessary outcomes

Changes that might create stress for parents or affect participation in treatment:• Increased visitation or unmonitored visits with

children• Meetings scheduled with social workers• The family's case is being transferred to a new

child welfare worker or to a different unit• Unanticipated changes in any services in the

case plans• Schedule of court hearings or in the court

calendar

Information Needed by Substance Abuse Professionals, Continued…

Systems Walk-Through –A Tool to Increase Understanding

What is it?• A virtual or actual client walk-through of current systems processes to capture all actions,

tools, decisions and data points from referral to case closure to follow up

Why do it?• To identify any problems with, for example, referrals, treatment access, service gaps, client

retention, follow-up support, communication• To generate recommendations to improve system processes and increase coordination• To prioritize issues and develop a scope of work

Collaborative Case Planning1. Incorporate objectives in the child welfare case plan

related to a parent’s treatment and recovery.2. Ensure that child welfare case plans and treatment

plans do not conflict.3. Joint reviews of case plans with treatment staff and

family.4. Share case plans with treatment providers.5. Regularly review a parent’s progress to meet goals in

the case plan, especially after critical events.6. Identify indicators of a parent’s capacity to meet the

needs of their children and outcomes of the case plans.7. Regularly monitor progress and share it with treatment

staff.

Confidentiality Procedures for Sharing Information

Treatment professionals, child welfare workersand attorneys require parent permission to share information with other agencies/providers.

Treatment consent forms must address key treatment requirements and conform to Federal Government regulations: • 42 CFR, Part 2• Health Insurance Portability and

Accountability Act of 1996 (HIPAA) Privacy Rules

Drug Courts That Held Status Hearings Every 2 Weeks During Phase 1 Had

50% Greater Reductions in Recidivism

Note: Difference is significant at p<.1

0%

10%

20%

30%

40%

50%

DRUG COURT HAS REVIEW HEARINGS EVERY TWO WEEKS

N=14

DRUG COURT HAS REVIEW HEARINGS

MORE OR LESS OFTENN=35

46%

31%

Perc

ent R

educ

tion

in R

ecid

ivis

m


0%

10%

20%

30%

40%

DRUG TESTS ARE BACK WITHIN 48 HOURS

N=21

DRUG TESTS ARE BACK IN

LONGER THAN 48 HOURS

N=16

32%

19%

Perc

ent i

ncre

ase

in c

ost s

avin

gs

Drug Courts Where Drug Test Results are Back in 48 Hours or Less had

68% Higher Cost Savings

Cross-Systems Communication

1009094 94

0102030405060708090

100

Regular Partnership Meetings* Info Sharing/Data Analysis


Per

cent

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

Evaluate Shared Outcomes to Ensure Accountability

FDCs must demonstrate that they have achieved desired results as definedacross partner agencies by agreeing on goals and establishing performancemeasures with their partners to ensure joint accountability. FDCs developand measure outcomes and use evaluation results to guide their work.FDCs must continually evaluate their outcomes and modify their programsaccordingly to ensure continued success.

Key Component 8: Monitoring and evaluation

te Shared Outcomes to Ensure Accountability

#10 Recommendation


PROGRAM REVIEWS THEIR OWN STATSN=20

PROGRAM DOES NOT REVIEW STATSN=15

37%

16%

Perc

ent i

ncre

ase

in c

ost s

avin

gs

#1 Drug Courts Where Review of The Data and Stats Has Led to Modifications in Drug Court

Operations had a 131% Increase in Cost Savings


0%

10%

20%

30%

40%

50%

USED EVALUATION TO MAKE MODIFICATIONS TO PROGRAM

N=18

DID NOT USE EVALUATION TO MAKE MODIFICATIONS

N=13

36%

18%

Perc

ent i

ncre

ase

in c

ost s

avin

gs

#2 Drug Courts Where the Results of Program Evaluations Have Led to Modifications in Drug Court Operations Had a 100% Increase in Cost

Savings

0%

10%

20%

30%

40%

PROGRAM USES PAPER FILES

N=8

PROGRAM HAS ELECTRONIC DATABASE

N=3

20%

33%

Perc

ent i

ncre

ase

in c

ost s

avin

gs

Drug Courts That Used Paper Files Rather Than Electronic Databases Had 65% LESS

Savings

Note: Difference is significant at p<.05

Implement Funding and Sustainability StrategiesSustainability planning must address financial needs as well as supportfrom a broad range of stakeholders. FDCs must have access to the fullrange of funding, staffing and community resources required to sustain itsinnovative approaches over the long term. FDCs need a governancestructure that ensures ongoing commitment from policy makers, managers,community partners and operational staff members.

Key Component 9: Continuing interdisciplinary education

Key Component 10: Forging partnerships

ent Funding and Sustainability Strategies

#9 RecommendationBudget and Sustainability

• Need for ongoing champions; challenge with turnover of judges

• Some FDTCs operate as “projects” or “boutique courts”

• Inherent limitations on scale and scope in some FDTC models

• No standardized cost analysis of total program cost or cost savings

• Lack of sufficient data on program effectiveness

• Resource problems worsened by State and local fiscal crises

Sustainability Results

73.2 % of the major services and

activities provided as part of the grant were sustained

53.3 % sustainedspecific components or a scaled down or modified version of their program

model

33.3 %sustained their project in its

current form or modelbeyond their grant period

11.1% were not able

to sustain any of their program

Of the 44 regional partnerships whose

grants were not extended:

Successful Financing StrategiesWidening the definition of available or potential resources

Connecting with other related grants or initiatives

Changing the business as usual practices to incorporate RPG innovations

Incorporating RPG efforts within their own agency

Integrating with other child welfare systems improvements

Transitioning services and staff to other partner organizations

Negotiating third party payments for what the grant had initiated

Joining with larger health care reform and care coordination efforts

Institutionalizing RPG practices into existing systems of care

Third-party billing, Medi-caid

Redirecting existing, currently funded resources to adopt new case management and client engagement strategies

• Insert text here

Potential Funding for Expansion

• InInInInInInInInI seseseeseesesertrtrtrrtrtrtrt tttttttexexeeeexeee tt hehheehehehererrrrrrrrFFederal Direct Funding (FY 2012): $22.6 million

$13.6 billionPrimarily Title IV-E, TANF, SSBG, Medicaid, IV-B

$350 billionChildren’s Programs - (Urban Institute, 2012) Q&A and Discussion

Contact Information

Alexis Balkey, BA, RASProgram [email protected]

Russ Bermejo, MSWSenior Program [email protected]

Children and Family Futures25371 Commercentre Drive, Suite 140Lake Forest, CA 92630Phone: 714-505-3525www.cffutures.org

Learning Objectives Research Outcomes · 2019-05-08 · 2. Explore FDC outcomes from local evaluation studies including best practices and guidelines to support child welfare outcomes.

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