Hoosier Children Caught in the Opioid Crisis: Programs, Policy, Progress Indiana Department of Child Services David Reed, MSW, LCSW, CSAYC Deputy Director of Child Welfare Services Family First Prevention Services Act New federal legislation signed into law on Feb. 9, 2018, that will dramatically change national child welfare practice. Intentional and clear focus on working with children further upstream. Opens federal Title IV E funding for prevention services, focused on keeping families together whenever possible. Why? 1
Impact of removal on ACEs Adverse Childhood Experiences study begun by Kaiser Permanente in 1995, now being continued by the CDC. Study on the impact of childhood trauma, including: Physical abuse Sexual abuse Neglect Serious illness or injury Witnessing domestic violence Witnessing other types of violence Separation from caregivers Grief and loss Results of ACE study Life long consequences, including: Addiction issues Unwanted/early pregnancy Poor educational outcomes Employment problems Mood problems Marital problems Legal problems Early death And it s critical to note that it is a DOSE RESPONSE. The more ACEs someone has, the more likely these negative outcomes are. It s the number of ACEs that predicts the outcomes 2
How DCS is using this research Removing children adds to their ACE score, and, again, it s a dose response. Must be thoughtful about removals and look at both protective factors and risk factors within families. Children should be better off from having met us. FFPSA allows: States to use IV E funds to pay for services to prevent removal of children, provided those services address: In home parent skill based programs (education) Mental health services Substance abuse prevention and treatment services 3
Provided that the services are Evidence based, including: Promising Practice (Created from an independently reviewed study that uses a control group and shows statistically significant results) Supported Practice (Uses a random controlled trial or rigorous quasiexperimental design with sustained success for at least six months posttreatment) Well supported Practice (shows success beyond a year after treatment) Indiana and START Sobriety Treatment and Recovery Teams Evidence based Promising Practice Child welfare and substance use co occurring. Focuses on keeping families together and improving both treatment outcomes and child well being. 4
START Core Concepts Collaboration among child welfare, SUD treatment and courts Early identification of families needing SUD treatment Timely access to assessment and quality SUD treatment services Enhanced management of recovery services Family centered treatment services Intensive administrative/judicial oversight and intervention Cross system responsiveness Indiana START Challenges Staffing. The model calls for Family Mentors, who are individuals in recovery for more than 3 years and have their own CPS history. Readiness on both ends DCS and service providers. Mutual trust and true collaboration. Treatment access, particularly in rural communities. Need to have an available support community. Access to best practice treatments from the treatment community (MAT, relapse understanding, dealing with inconsistent clients, etc.) 5
Family Recovery Courts Based on the Drug Court Model: Family drug courts bring together child welfare services, substance use disorder treatment agencies, and other community service providers to meet the diverse needs of these families. Family drug courts seek to provide safe environments for children and intensive judicial monitoring and interventions to treat parents substance use disorders and other co occurring risk factors. Children and Family Futures (https://www.cffutures.org/family drug courts focus/) Family Recovery Courts Effective Strategies for the implementation of a Family Recovery Court: Create shared mission and vision Develop inter agency partnerships Create effective communication protocols for sharing information Ensure interdisciplinary knowledge Develop protocols for early identification and assessment Address the needs of parents Address the needs of children Garner community support Implement funding and sustainability strategies Evaluate for shared outcomes and accountability Office of Juvenile Justice and Delinquency Prevention: Guidance to States: Recommendations for Developing Family Drug Court Guidelines 6
Family Recovery Courts Current Family Recovery Court Sites: Bartholomew County Clark County Grant County Marion County Noble County Wabash County Vanderburgh County Pending Family Recovery Court Sites: Allen County Delaware County Howard County Vigo County 7