children and family futures - a national look at the past, present, future … · 2017. 8. 29. ·...

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A National Look at thePast, Present, Future

Nancy K. Young, Ph.D.Executive Director,

Children and Family Futures

of Family Drug Courts

Children and Family Futures

The Past

How did the FDC movement get here? Why the rapid growth? What happened?

The Birth of the FDC Movement

• First FDCs convened in Reno, Nevada and Florida in 1994 -1995

– Judges Charles McGee & John Parnham

– Judges Pach, Edwards, Milliken, Cohen, Ray, Thomas Merrigan and Commissioner Molly Merrigan

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• First FDCs took concepts developed in criminal and then juvenile drug courts applying a collaborative approach to therapeutic jurisprudence

The “study of the role of the law as a therapeutic agent.” It focuses on the law’s impact on emotional life and on the psychological well‐being of the individual – the impact on the “whole person ”

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whole person.

David Wexler – Therapeutic Jurisprudence: An overview. Paper delivered to the National Institute of Mental Health in 1987. Along with Professor Bruce Winick, University of Miami School of Law, who originated the concept with Wexler.

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“The family drug court, although similar to the adult drug court in terms of services and protocols


drug court in terms of services and protocols, usually focuses on the "best interests of the child" … and this focus is the court's paramount consideration in responding to the progress -- or lack thereof -- of the parent.”

Caroline S. Cooper, Coordinator, 1995 SJI National Symposium on the Implementation& Operation of Drug Courts; and Director, OJP Drug Court Clearinghouse andTechnical Assistance Project School of Public Affairs/American UniversityJune 2000


• Focused on early intervention and treatment based on a comprehensive needs assessmentbased on a comprehensive needs assessment and case plan

• Client and system accountability for compliance through frequent court appearances

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January 1994

• “Call Me Tuesday”

Key Initial FDC Concepts

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3

321350

The FDC Movement

# of FDCs

40

153

321

100

150

200

250

300

350

1040

0

50

1999 2001 2005 2010

Common VisionExtraordinary Effort

Three Systems ith lti lwith multiple:

• Mandates• Training • Values• Timing

Drug Treatment

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Timing • Methods

New Partnerships,Creative Approaches

The need for immediate and

efficient intervention became

overwhelming important in the

face of implementing the

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implementing the Adoption and Safe

Families Act

Implications of ASFA (1997)

• Adoption and Safe Families Act, enacted in 1997 sought to address:- Cases lingering in the court system as parents cycled

in and out of treatment- Children left in foster care for months or even years –

(aka foster care drift)• Emphasis on establishing permanency within federally

mandated timeframes

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mandated timeframes• Created a need to find effective responses to substance

abuse and child maltreatment within families

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AFSA Clock

• In general, FDC’s strive to provide safe and stable permanent re nificationpermanent reunification with a parent in recovery within the time frames established by ASFA

• Responses aim to enhance the likelihood that the family can bethat the family can be reunited before the ASFA clock requires an alternative permanent plan for the child

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The Most Important Clock

• The one that’s ticking on us• How long do we have to act if ourHow long do we have to act if our

families have • 24 months to work and • 12 months to reunify?

• Taking this clock seriously meansthat we take aggressive action to reconcile the clocks on children and families

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Blending Perspectives and Building Common Ground

• Report to Congress in response to the Adoption and Safe Families Act (AFSA) 1999

• Five National Goals established

1. Building collaborative relationships

2. Assuring timely access to comprehensive substance abuse treatment services

3 Improving our ability to engage and retain clients in3. Improving our ability to engage and retain clients in care and to support ongoing recovery

4. Enhancing children’s services

5. Filling information gaps

Leadership of Federal Government on Substance Abuse & Child Welfare Issues

1999 Report to Congress: 2000 2001

2002-2007 National Center

2007-2012 Re-funding

Blending Perspectives and Building

Common Ground

2000-2001 Regional State Team Forums

National Center on Substance

Abuse and Child Welfare

National Center on Substance

Abuse and Child Welfare

2007 2012 2000 20142007-2012Regional

Partnership Grants

2000-2014SAMHSA /

CSATCAM Grants

2010-2012OJP / OJJDP FDCP Grants

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Common Ingredients of Family Drug Courts in

2002 Process Evaluation

System of identifying familiesSystem of identifying families

Earlier access to assessment and treatment servicesEarlier access to assessment and treatment services

Increased management of recovery services and complianceIncreased management of recovery services and compliance

Responses to participant behaviors (sanctions & incentives)Responses to participant behaviors (sanctions & incentives)

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Increased judicial oversightIncreased judicial oversight

Common FDC Outcomes

Safety (CWS)

Permanency (Court)

Recovery (AODS)( )

• Reduce re-entry into foster care

• Decrease recurrence of abuse/neglect

( )

• Reduce time to reunification

• Reduce time to permanency

• Reduce days in care

( )

• Increase engagement and retention in treatment

• Increase number of negative UA’s

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g• Increase

number of graduates

The Present

What do we know now? Where are we? What’s being done? What are the needs?

Family Drug Courts - Nationwide

New York - 55

California - 56

Florida - 22

13 States report no FDCs

California, New York, Florida- 40% of all FDCs in USSource:

National Drug Court Institute (NDCI) Survey, 2010

321 FDCs in 27 States

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Family Drug Courts - Nationwide

New York - 55

California - 56

Florida - 22

1-5 6-10 11-19

Zero FDCs reported

20 +Source: National Drug Court Institute (NDCI) Survey, 2010

Federal‐Funded FDC Projects

US DEPARTMENT OF HEALTH AND HUMAN SERVICESSubstance Abuse and Mental Health Services AdministrationAdministration for Children and Familieswww.samhsa.gov

OJJDP Sites, n=14

RPG, Drug Court Cluster, n=10*

RPG w/FDC Component,n=10

*RPG N=29; 4 sites operating multiple FDCSOJJDP, n=22

LEGEND, N=58

IDTA FDC, n=4

CFF FDC Evaluation,N=5

CAM, n=12

Family Drug Court Models • Dependency

matters• Recovery

management

• Dependency matters

• Specialized court services offered

• Dependency mattersRecovery

• Dependency matters

• Recovery g• Same

court, same judicial officer during initial phase

• Non-compliant case transferred to specialized judicial officer

services offered before noncompliance occurs

• Compliance reviews and recovery management heard by specialized court

• Recovery management

• Same court, same judicial officer

management• Same

court, same judicial officer

• Non-compliant case transferred to Presiding Judge or another court

DUAL TRACK PARALLEL

officer

INTEGRATED HOME COURT INTENSIVE

2009-10 OJJDP FDCP Training and Technical Assistance Program

Online Survey• 86 responses

Site Interviews• 14 interviews

Stakeholder Interviews• 9 interviews

Review of FDC TTA Requests

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FDC Needs Assessment Process

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A Snapshot of Challenges and Barriers Faced by Family Drug Courts

FDC Needs AssessmentSite visits data andSite visits, data, and

observation Technical assistance

requests

FDCP Needs Assessment Findings: Challenges and Barriers

Screening - Assessment - Referral Processes• Target population and process for identifying FDC clients• 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 establishedS f

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

Engaging and Retaining Clients• Clients are given phone numbers or list of resources


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

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

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

FDC requirements)• Issues of treatment availability and quality

Comprehensive Programs – Children’s Services• Very little mention of services to children, though


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

• 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.p og a s o you g c d e

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Collaboration Challenges• 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 team• Lack of appropriate community resources• Issues of collaboration among agencies in

understanding and working toward shared outcomes

Performance Measures/Data Collection• Lack of prevalence data demonstrating the extent of


• Lack of prevalence data demonstrating the extent of substance abuse among child welfare population

• No uniform data collection; inability to measure effectiveness of program

• Lack of long-term data on child welfare and recovery outcomes; only while client is enrolled in FDCFDC

Budget and Sustainability• Need for ongoing champions; challenge with


• Need for ongoing champions; challenge with turnover of judges

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

• Inherent limitations on scale and scope in some FDC models

f• 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

Recent Drug Court Evaluations*

• Majority (32 or 67%) of states report lack of recent evaluation*

• 16 or 33% states report having done recent evaluations*:• Alaska and Maine reported specific evaluations of

family dependency courts• 14 other states reported general evaluations such

as process, outcome, and cost-benefit evaluations, juvenile delinquency court evaluations and

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juvenile delinquency court evaluations, and statewide evaluation programs (without specifying for which specialty court)*

*Not Family Drug Court specificSource: National Drug Court Institute (NDCI) Survey, 2010

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Common Factors: Success in Enrollment into FDC

• Strengthening of existing collaborative relationships orcollaborative relationships or establishing new collaborative relationships with new partners or referral sources

• Strong pre-existing collaboration or establishedcollaboration or established presence in the community

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Common Barriers in Enrolling Families into FDC

Most common barriers included:• Getting referrals from Child Welfare Services• Difficulty engaging clients once referred,

retaining clients once enrolled, and tracking client drop-off points

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Larger Contextual/Community Events Impacting FDC Programs

• State, County or other agency budget cuts or l fflayoffs

• Legislative or policy changes • State, County or other agency personnel

changes • Service provider changes or issues

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• New grant or related initiative in community/region

Larger Contextual/Community Events Impacting FDC Programs

community/region• Broader economic climate in target communities

– Unemployment and job-related issues• Changes in child welfare trends/caseloads

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Key Issues & Challenges Facing FDC

Scale and Scope; Project vs. System

Scale and Scope Challenges

Scale: To what extent can FDCs respond to the full range of treatment needs among the child welfare population—as opposed to remaining marginal to the whole system or “boutique courts?”

Scope:

To what extent can FDCs respond to the full range To what extent can FDCs respond to the full range of co-occurring needs among the child welfare population—mental illness, family violence, family income and employment issues, developmental delays?

Current Scale: Do We Know?

• In most states with multiple FDCs, the average size is gunder 30 families per year

• A few larger FDCs may serve as many as 300-400 clients annually in large counties

• The lack of a national data base and in depth data in mostbase and in-depth data in most states on FDC scale means there is no accurate total of FDC clients

The Project vs The System

Some FDCs focus so heavily upon their project that they become isolated from the larger child welfare s stem res lting insystem, resulting in:

• Inability to track impact on the larger system• Inability to develop to large enough scale to

impact larger system

Isolation from the larger child welfare system g yresults in:

• Continued marginalization for families affected by parental substance use

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Drop off PointsDrop off Points

15,029 cases referredfor SA assessment

11 469 i d SA 11,469 received SA assessment 24% drop off = 3,560

Number referred to SA treatment 7,022

Number made it to SA treatment = 2,744

61% drop off

844 successfully completed SA tx*

Payoff41

* This # may increase slightly as some clients are still enrolled in tx & may successfully complete in the future

The Project vs The System

The lack of Integrated or Coordinated Data and Information systems results in:

Insufficient in depth documentation of treatment and• Insufficient in-depth documentation of treatment and child welfare outcomes to enable evaluation of scale issues over time

• Lack of comparison between FDC child welfare outcomes to the entire child welfare caseload

• Lack of accurate data on caseload overlap among hild lf t t t t l h lth hildchild welfare, treatment, mental health, child

development, and other agencies• Inability to determine if FDC results are able to “move

the needle” in the larger child welfare system

Barriers to Going to Scale

• Preference for manageable caseloads and project-level scale

• Time requirements of intensive client case management

• Lukewarm buy-in from child welfare and treatment agencies, resulting in low referrals or screened-out clients due to narrowed eligibility requirements

• Desire to retain fidelity to an FDC model that may not have been developed at scale

• Inability to sustain funding for an FDC model beyond the level of single project

Barriers to Going to Scale

• Lack of resources or ability to redirect resources.

• Historically, lack of national FDC standards and performance standards; few states have FDC standards

• Limited national data on the b f FDC li t d FDCnumber of FDC clients, and FDC

outcomes• Limited technical assistance

available to FDCs

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Barriers to Expanding FDC Scope

• Resistance to engaging with other systems– Work load and effort – The “It’s Just one more Thing” Syndrome

• Other agencies’ resistance to coordination with a caseload defined by child welfare

• Clarity in roles and responsibilities

– Assessment of substance use disorders

– Referral to treatment

– Coordination of services (mental health, housing, vocational training, etc.)

• Gaps in resources

So How Did the Big Ones Get So Big?

• Judicial leadership in convening interagency players and tracking outcomes over time

• Child welfare, treatment agency and parents’ attorney buy-in based on recognition that FDCs could directly improve their own outcomes

• Data systems and case management tracking that focused on both FDC project and larger p j gsystem

• Annual evaluations that included cost offset data powerful enough to convince policy leaders to expand FDCs

ChangingThe System

Getting Better at Getting Along: Four Stages of Collaboration

ChangingThe Rules

The System

Shared DataUniversal ScreeningSh d C Pl

FDC Project

Better Outcomes for Children and

Families

InformationExchange

JointProjects

Sid Gardner, 1996Beyond Collaboration to Results

Shared Case Plans

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• “It doesn’t matter to me if she goes to treatment right away”

“We have a program, but you don’t qualify” – December 2010

– Child’s attorney • “She can’t go to drug court, she’s charged with

child endangerment”– Public Defender

• “She won’t qualify for family drug court becauseShe won t qualify for family drug court because she is was in jail”– CWS Program Manager

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“We have a program, but you don’t qualify” – December 2010

• “She can’t go to family drug court if she goes to residential” – CWS Program Manager

• “She can’t go to the residential women and children’s program that is funded for CWS families because her child will be 6 years old next October and it’s a year program for mothers with children 5 and under”– Residential Treatment Program Director

Focusing on Institutional Change

While many FDCs are able to “collaborate” at the level of FDC “project,” the ingredients for real

h bsystems change may not yet be present:• Shared outcomes• Universal substance abuse screening for all

parents involved with child welfare• Universal child maltreatment screening for g

parents involved in substance abuse treatment• Joint (SA/CW) case planning and monitoring• Shared data systems

ChangingThe System

Getting Better at Getting Along: Four Stages of Collaboration

ChangingThe Rules

The System

We have a program, but you

don’t qualify

Better Outcomes for Children and

Families

InformationExchange

JointProjects

Sid Gardner, 1996Beyond Collaboration to Results

Call Me Tuesday

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Family Drug Courts: Past, Present, and Future -Past, Present, and Future

A Judicial Perspective

Judge Leonard P. Edwards Superior Court, Santa Clara County

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Why Do Judges Like Family Drug Courts?

Why FDCs Need Judicial Leadership and

Support

What Does Judicial Leadership Look Like

• Advocate for systems change• Monitor outcomes across agencies• Engage child welfare director• Engage treatment directly and

through contract process• Support community investment in

systemic change• Speak out in publicSpeak out in public• FDC as the laboratory for change• Make resources available from the

inception and monitor cost savings and offsets

The Future of the FDC Movement

FDCs will continue to grow and flourish

Where are FDCs going? What does the future look like?

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Why Will FDCs Flourish?

• Better treatment engagement, participation, and recovery outcomesrecovery outcomes

• Judicial support• Holistic approach for client and entire family• Benefits children, families, communities• Maximization of collaboration• Community engagement• Personal and professional satisfaction for all

participants


What will they look like?1. They will look more y

and more like treatment courts and less like criminal drug courts.

2. They will have a significant impact on all dependency cases, not just the ones in the treatment court.

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3. There will be more follow-up, more building a


sober community with events and contacts extending for months and years.

4. There will be more support persons (mentors) for clients. This will include mentors/advocates for children.

5. Treatment beds will be available in most communities so that mothers and infants can start over in a protected environment.

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6. There will be greater use of group decision making models


making models7. A wider range of

professionals will become involved

8. Special dockets will be developed docketsdeveloped – dockets that address particular populations such as families with new-borns or teenagers 60

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9. There will be more community involvement


yas community members recognize the importance of supporting families with children.

10. Domestic violence service providers will become a basic part of every treatment court team.61

• Professional satisfaction

Worth the Effort

• FDC will improve the entire dependency process

• Juvenile dependency court the way it should be

• It’s about giving parents a fair g g popportunity to recover and reunify with their children

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Remaining Challenges for Grantees

• Will FDCs define their client mix to include a significant segment of the CW population needing treatment?

• Will FDCs work closely enough with other agencies to provide needed services for co-occurring problems?

• Will the results of FDCs be significant enough to make an impact on national goals for child welfare and treatment outcomes?

- Expanding timely access to effective treatmentExpanding timely access to effective treatment- Reducing out of home care- Ensuring timely decisions about child safety and permanency?

• Will FDCs reduce out of home care costs?

Piecing Lives Back Together

“Some people say this is about mothersis about mothers getting their kids

back. I think it’s more about

kids getting their mothers back.”

Teenager, Santa Clara County Drug Court

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children and family futures - a national look at the past, present, future … · 2017. 8. 29. ·...

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