research updates on family treatment courts · steering . committee. management level. monthly or ....

Research Updates on Family Treatment Courts: Overview of Best Practices – Part 2

Phil Breitenbucher, Children and Family Futures 1

This presentation is supported by:

The Office of Juvenile Justice and Delinquency Prevention Office of Justice Programs

(2013-DC-BX-K002)

Points of view or opinions expressed in this presentation are those ofthe presenter(s) and do not necessarily represent the official positionor policies of OJJDP or the U.S. Department of Justice.

Acknowledgement

A permanent shift in doing business that relies on relationships across systems and within the community to secure needed resources to

achieve better results and outcomes for all children

and families

Systems Change

3RsRelationshipsResourcesResults

Outcomes5Rs for more families

Values – Why Are We Doing This?

A Framework for Systems ChangeRecoveryRemain in homeReunificationRecidivismRe-entry

FDC Common

Ingredients –What works…

Structural Supports1. Relationships2. Resources3. Results

Leadership at all levels

Inclusion of stakeholders

Sustainability based on outcomes and

results

Shared information about institutional

barriers

Key Components of Meaningful Systems Change

Oversight/ExecutiveCommittee

Director Level

Quarterly

Ensure long-term sustainability and final approval of practice and policy changes

Steering Committee

Management Level

Monthly or Bi-Weekly

Remove barriers to ensure program

success and achieve project’s goals

FDC Team

Front-line staff

Weekly

Staff cases; ensuring client success

Membership

Meets

Primary Functions:

The Collaborative Structure for Leading Change

Mobilizing Resources

Building Relationships

Prioritizing Results

Information flow is the lifeblood, the fuel of an effective collaborative.

Leadership consists of encouraging that flow, analyzing its meaning, and framing decisions

that the team needs to make together.

Information flow

FDC Team

Membership Primary FunctionFrequency

FDC Coordinator vs. FDC Case Manager

Key FDC Case Management Functions

Assessment

Planning

Linkage

Monitoring

Advocacy

Provide case management

Garnering community support

Prepare and manage FDC docket

Oversee budget and resources

Contract management

Grant Writing

FDC Coordinator Roles & Functions

Maintain individual client files

The FDC Coordinator - The Realities• Often work under limited direction of a manager• Responsibility-YES; Authority –MAYBE• No choice in team members• Dynamics constantly changing due to new staff, politics, funding• May involve frequent and relatively independent working relationships• May assume leadership at various points of development process or life

span of FDC • Oftentimes grant-funded positions and are cut due to budgetary issues• Partners’ resource limitations• May oversee other collaborative court programs

One person expecting to be all things to all people

Oversight/ExecutiveCommittee

Director Level

Quarterly

Ensure long-term sustainability and final approval of practice and policy changes

Steering Committee

Management Level

Monthly or Bi-Weekly

Remove barriers to ensure program

success and achieve project’s goals

FDC Team

Front-line staff

Weekly

Staff cases; ensuring client success

Membership

Meets

Primary Functions:

The Collaborative Structure for Leading Change

Information Flow

Steering Committee

Membership Primary FunctionFrequency

Effective Steering Committees is more than reporting about what agencies did last month—it’s about whether clients are doing better.

Busting barriers for improved outcomes

Effective leaders approach barrier-busting as a norm; they don’t take barriers for granted

They know the difference between barriers and excuses

- Confidentiality won’t let us share information- Other agencies don’t understand our clients- Our funders won’t let us do it- We don’t have the funding to take our efforts to scale

Barrier Busters

Innovative

@ the table means:- More than signing an MOU- Key agencies are not just “sending

somebody;” they are actively engaged- Involved in policy and operation

decisions- Knows where the money is going

Who’s Missing @ the Table

Effective leaders invest and help build capacity of each partner, particular missing partners, to better serve families.

Remember - you are only as strong as your weakest link

Builds Up Weakest Links

Collaborative

Beware!

Marginalized Collaborative

Ahead!

Warning Signs of Powerless Partnerships

Warning Signs of Powerless Partnerships• Monthly BOGSATs* reporting only on activities, not results

‒ Reporting on what agencies are doing, not whether clients are doing better

• No buy-in at policy levels, only mid-level staff involved• No buy-in at front-line levels: all supervisors without staff who have

regular contact with families• Missing players, too-dominant conveners, absent handoff agencies,

over-reliance on a “coordinator”• Undue focus on one set of links—training, referrals, info systems—

without looking at the whole system

*Bunch of guys sitting around a table

Develop Interagency Partnerships#2

Key Component 1: Integrate treatment services with justice system case processing Key Component 2: Using a collaborative approachKey Component 10: Forging partnerships

FDCs bring together the legal framework of court, child welfare system and treatment services in a collaborative relationship with a common goal: to restore families. To best achieve this goal, however, they must collaborate with other agencies to provide the range of services and support required to ensure family stability, recovery of parents, and the permanent placement, safety and well-being of children. These partners should include mental health, domestic violence, primary health care, child development and other agencies.

Develop Interagency Partnerships

Routinely Assess for Rates ofReferrals, Completions & Barriers

Somewhat Agree

Agree

Responses (n = 26)

Disagree

Don’t Know:26.9%

Drug Courts That Required All Team Members to Attend Staffings

Had 50% Greater Reductions in Recidivism and 20% Greater Savings

0%

10%

20%

30%

40%

50%

All team members attend staffingsN=31

All team does NOT attend staffingsN=28

42%

28%

Perc

ent r

educ

tion

in re

cidi

vism

Note 1: Difference is significant at p<.05Note 2: “Team Members” = Judge, Both Attorneys, Treatment Provider, Coordinator

Note: Difference is significant at p<.10

Drug Courts Where a Representative from Treatment Attends Court Sessions

Had 81% Higher Cost Savings

Yes (N=55) No (N=9)

29%

16%

A Representative from Treatment Attends Court Sessions%

incr

ease

in c

ost s

avin

g

0%

10%

20%

30%

Defense attorney attends staffingsN=59

Defense Attorney does NOT attend staffingsN=11

29%

15%

Perc

ent I

ncre

ase

in C

ost S

avin

gs

Drug Courts Where the Defense Attorney Attends Drug Court Team Meetings (Staffings) had

a 93% Higher Cost Savings

Note: Difference is significant at p<.0528

WHO needs to know WHAT,

WHEN?

http://www.ncsacw.samhsa.gov/files/SAFERR.pdf

Resource: Screening and Assessment for Family Engagement, Retention, and

Recovery (SAFERR)

To download a copy, please visit:

Create Effective Communication Protocols for Information Sharing#3

Key Component 1: Integrate treatment services with justice system case processing Key Component 2: Using a collaborative approachKey Component 6: Responses to behaviorKey Component 7: Judicial Interaction

Effective, timely and efficient communication is required tomonitor cases, gauge FDC effectiveness, ensure jointaccountability, promote child safety and engage and retainparents in recovery.

Create Effective Communication Protocols for Sharing Information

0%

10%

20%

30%

40%

50%

60%

70%

Agree Somewhat Agree Disagree Not Sure

Responses (n = 26)

The FTC has developed the capacityto automate data about theoutcomes of the participants

compared to the larger systems

The FTC utilizes community-wideaccountability systems to monitor childwelfare issues with specific indicators

Somewhat Agree

Agree

Responses (n = 26)

Disagree

Don’t Know:34.6 %

Create Effective Communication Protocols for Sharing Information

Don’t Know:53.9 %

0%

10%

20%

30%

40%

Program usespaper files

N=8

Program haselectronic 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

Note: Difference is significant at p<.05

Drug Courts where all team members attended staffings had 50% greater reductions in recidivism

0%

10%

20%

30%

40%

50%

All team members attend staffingsN=31

All team does NOT attend staffingsN=28

42%

28%

Perc

ent r

educ

tion

in re

cidi

vism

Note: Difference is significant at p<.10

Drug Courts Where Treatment Communicates withthe Court via Email had

119% greater reductions in recidivism

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

0.45

0.5

YesN=31

NoN=14

0.46

0.21

% re

duct

ion

in #

of r

earr

ests

Treatment communicates with court via email

Note: Difference is significant at p<.05

0%

10%

20%

30%

40%

Drug tests are back within48 hours

N=21

Drug testsare back in

LONGER THAN48 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

Ensure Cross-Systems Knowledge

Ongoing cross‐training of FDC team members andstakeholders at all levels is essential for ensuringcollaboration and consistent, effective practice.

#4

Key Component 9: Continuing interdisciplinary education

Note: Difference is significant at p<.05

Drug Courts That Provided Formal Training for ALL New Team Members

Had 54% Greater Reductions in Recidivism

0%

10%

20%

30%

40%

50%

All new teammembers have formal training

N=30

All team membersNOT formally trained

N=17

40%

26%

Note: Difference is significant at p<.05

Drug Courts That Received Training Prior to Implementation Had Almost

3.5 Times Higher Cost Savings

0%

10%

20%

30%

40%

Team trained BEFORE implementationN=12

Team members NOT trained beforeimplementation

N=5

27%

8%

Perc

ent i

ncre

ase

in c

ost s

avin

gs

Cross-Systems Knowledge –Training on Operations

10091

0102030405060708090

100

Training on RPG OperationsFDC Cohort (N=20) All Other RPGs (N=35)

Perc

ent

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

Oversight/ExecutiveCommittee

Director Level

Quarterly

Ensure long-term sustainability and final approval of practice and policy changes

Steering Committee

Management Level

Monthly or Bi-Weekly

Remove barriers to ensure program

success and achieve project’s goals

FDC Team

Front-line staff

Weekly

Staff cases; ensuring client success

Membership

Meets

Primary Functions:

The Collaborative Structure for Leading Change

Information Flow

Oversight|ExecutiveCommittee

Membership Primary FunctionFrequency

Implement Funding & Sustainability Strategies#9

Key Component 9: Continuing interdisciplinary education

Key Component 10: Forging partnerships

Sustainability planning must address financial needs as well as support from a broad range of stakeholders. FDCs must have access to the full range of funding, staffing and community resources required to sustain its innovative approaches over the long term. FDCs need a governance structure that ensures ongoing commitment from policy makers, managers, community partners and operational staff members.

Budget and Sustainability – Barriers and Challenges• Need for ongoing champions; challenge with turnover of

judges• Some FDTCs operate as “projects” or “boutique courts” (on

top or on the side)• Inherent limitations on scale and scope in some FDC 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

Implement Funding and Sustainability Strategies

0%

10%

20%

30%

40%

50%

Agree Somewhat Agree Disagree Not Sure

Responses (n = 26)

Funding and Sustainability Efforts

The FTC has a community outreach andeducation plan to further sustainability

efforts

The FTC's partners are able and willing toshare information about their budget and

staffing

Somewhat Agree

Agree

Responses (n = 26)

Disagree

Don’t Know: 42.3 %

Don’t Know:30.7 %

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:

Redirection of Resources Already Here

Substance Abuse

TANF

Domestic Violence

HospitalsSchools

Police

Medicaid

Housing

MentalHealth

Courts

Families

FDCs

Pilots, Demos and Grant-funded Projects

The “Real” Resources

in the Community

Potential Funding for Expansion

Federal 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)

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

Collaborative Practice Implications

What do substance abuse and mental health treatment practitioners need from child welfare staff to more effectively assess and treat parents and children?

What do child welfare staff need from substance abuse and mental health treatment practitioners to more effectively make decisions about the safety, permanence and well-being of children they are charged to protect?

Effective leaders have wide-lens radar: • See external policy context;

parallel/competing initiatives• Know they’re not the only

game in townWide-Lens View

Systems-Focused

Distributive

Effective leaders sell the results of collaboration to other leaders

Demand the data to make the sale

Outcome-focused

Characteristics of collaborative leadership IILeaders know that nothing collaborates like cash—but it takes more than resources to make it real and to take it to scale

Limits of Cash

Garner Community Support

FDCs collaborate with community‐based organizations tosupport the multiple needs of parents, children andfamilies during FDC participation, and to provide ongoing support for continued success after family members have completed their FDC services.

#8

Key Component 10: Forging partnerships

To develop marketing documents, consider these elements in building your case:

• Prevalence of the problem

• Outcomes

• Case savings

• Intergenerational impact

• Early intervention and developmental effects on children

Making the Case in the Community

• How does parental substance use and child maltreatment effect other, high-priority issues?

• Are we clear on the benefits of your FDC?

• Have we done an inventory of potential funders? Have we begun a dialogue with those funders?

• Have we packaged the strongest possible case for our FDC? Do we use both stories and numbers to make the case?

• Have we documented how we’ve already changed the system and changed the rules?

• Who’s going to tell our story: who’s singing our song?

Making the Case in the Community

• What type of strategies have been developed to recruit broad community participation in addressing the needs of participant families?

• Do participant families have an active role in planning, developing, implementing and monitoring services?

• Do you include community stakeholders in planning and program development?

• Have you conducted a needs-assessment of FDC participants?

• How do you identify and link families with support services they need?

• Do you keep the community aware of your efforts and outcomes?

• Which policy leaders and stakeholders agree that funding is a priority in the midst of all the competing options for use of scarce resources?

Garnering Community Support

Note: Difference is significant as a trend at p<.15

Drug Courts That Had Formal Partnerships with Community Organizations Had

More Than Twice the Savings

0%

10%

20%

30%

40%

Drug court has formal partnerships in communityN=15

Drug court doees NOT have formal partnershipsN=5

35%

15%

Collaborative Practice ImplicationsWhat system changes need to occur to support local, cross-system collaborative practices? • Priority and timely access to treatment• Address confidentiality• Abstinence vs. Harm Reduction • Systems’ response to relapse• Enhanced acceptability of MAT• Cross-Systems Training• Engagement of Court and Attorneys

Evaluate Shared Outcomes to Ensure Accountability

FDCs must demonstrate that they have achieved desiredresults as defined across partner agencies by agreeing ongoals and establishing performance measures with theirpartners to ensure joint accountability. FDCs developand measure outcomes and use evaluation results to guidetheir work. FDCs must continually evaluate their outcomes and modify their programs accordingly toensure continued success.

#10

Key Component 8: Monitoring and Evaluation

Oversight/ExecutiveCommittee

Director Level

Quarterly

Ensure long-term sustainability and final approval of practice and policy changes

Steering Committee

Management Level

Monthly or Bi-Weekly

Remove barriers to ensure program

success and achieve project’s goals

FDC Team

Front-line staff

Weekly

Staff cases; ensuring client

success

The Collaborative Structure for Leading Change

Primary Functions:

Meets

Membership

Information Flow

The Community

Collaboration =

Shared results =

Accountability =

Trust that PromotesSustainability

Evaluate for Shared Outcomes and Accountability

The FTC has an ongoing plan forevaluation

Somewhat Agree Agree

Responses (n = 26)

Disagree

Don’t Know:30.77 %

Note: Difference is significant at p<.05

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

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

Court Operations had a 131% Increase in Cost Savings

Note: Difference is significant at p<.05

0%

10%

20%

30%

40%

50%

Used evaluation to make modifications toprogram

N=18

Did NOT use evaluation to make modificationsN=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

Five Diagnostic Questions about Collaboration1. Do we agree on the mission?2. Do we agree on how we are going to measure whether we are

achieving the mission—do we have a way of tracking progress (i.e. data dashboard)

3. When front-line staff raise issues about barriers they run into—do we ignore it or go to work as a team to reduce or remove the barriers?

4. Do we share enough information across agencies to be able to use our results to get more resources for what is working?

5. Do we have an agenda for scaling up—or are we stuck in projectitis?

Q&A and Discussion

Building on our Success

TEAM ACTION PLANNING Building Structure to Implement and Sustain Your Program

71

Resources

http://www.ncsacw.samhsa.gov/files/SAFERR.pdf

Resource: Screening and Assessment for Family Engagement, Retention, and

Recovery (SAFERR)

To download a copy, please visit:

FDC Guidelines

http://www.cffutures.org/files/publications/FDC-Guidelines.pdf

To download a copy today visit our website:

FDC Discipline Specific Orientation Materials

Child Welfare | AOD Treatment | Judges | Attorneys

Please visit: www.cffutures.org/fdc/

Resources

FAMILY DRUG COURTPEER LEARNING COURT

PROGRAM

King County, WA

Baltimore City, MDJackson County, MO

Chatham County, GAPima County, AZ

Wapello County, IA

Miami-Dade, FL

Jefferson County, AL

Dunklin County, MO

CONTACT US FOR MORE INFORMATION: fdc@cffutures.org

• FDC Peer Learning Court

• FDC Podcasts

• Leadership Resources

• FDC Video features

• Webinar registration information

FDC Learning Academy BlogLeading Change

www.familydrugcourts.blogspot.com

2016

1. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers

2. Understanding Child Welfare and the Dependency Court: A Guide for Substance Abuse Treatment Professionals

3. Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Legal Professionals

Please visit: http://www.ncsacw.samhsa.gov/

NCSACW Online Tutorials

Resources

Family Drug Court Online Tutorial

FDC 101 – will cover basic knowledge of the FDC model and operations

Contact InformationPhil Breitenbucher, MSW FDC TTA Program DirectorChildren and Family Futures(714) 505-3525pbreitenbucher@cffutures.org