METHAMPHETAMINEMETHAMPHETAMINE AND CHILD WELFARE: AND CHILD WELFARE: National Statistics and Clermont County, Ohio National Statistics and Clermont County, Ohio

ExperienceExperience BackgroundBackground

Will Will MethMeth affect your affect your county?county?

Will Will MethMeth affect your affect your Child Welfare Child Welfare DepartmentDepartment

Explanation of Ohio Explanation of Ohio Boards’ Role and Boards’ Role and FundingFunding

Current Status of Current Status of Substance Abuse Substance Abuse Treatment Services and Treatment Services and Priorities for Services in Priorities for Services in Clermont County, OhioClermont County, Ohio

WHAT IS METHAMPHETAMINE?WHAT IS METHAMPHETAMINE?

Methamphetamine is a Methamphetamine is a powerful central nervous powerful central nervous system stimulant that system stimulant that strongly activates multiple strongly activates multiple systems in the brain.systems in the brain.

Use of Methamphetamine Use of Methamphetamine can lead to psychosis, can lead to psychosis, eating and sleeping eating and sleeping disorders, dental disorders, dental deterioration, and skin deterioration, and skin scratching.scratching.

Methamphetamine is more Methamphetamine is more toxic than other drugs, but toxic than other drugs, but if an addict completes if an addict completes treatment and stays treatment and stays abstinent, brain function abstinent, brain function returns to normal in about returns to normal in about 24 months. 24 months.

BRIEF HISTORY OF BRIEF HISTORY OF METHAMPHETAMINE USEMETHAMPHETAMINE USE

Abundant in West/Southwest Abundant in West/Southwest for decadesfor decades

In 1979, key ingredients In 1979, key ingredients outlawed in U.S.outlawed in U.S.

Ephedrine method simplified Ephedrine method simplified productionproduction

Internet spread the formulaInternet spread the formula Production moved to rural Production moved to rural

areasareas Laws restricting sale of Laws restricting sale of

ephedrine products impacting ephedrine products impacting productionproduction

New supply from MexicoNew supply from Mexico Historically, shooting or Historically, shooting or

snorting only option for snorting only option for ingestion; in early 1990’s, ingestion; in early 1990’s, smoking methamphetamine smoking methamphetamine greatly expanded greatly expanded demographics and increased demographics and increased addiction liabilityaddiction liability

The Faces Of MethThe Faces Of Meth

APPROACHES TO APPROACHES TO METHAMPHETAMINE PROBLEMMETHAMPHETAMINE PROBLEM

Supply interventionSupply intervention Precursor controlPrecursor control TreatmentTreatment Law enforcementLaw enforcement PreventionPrevention

Meth StatsMeth StatsNational StatsNational StatsFrom the NACo SurveyFrom the NACo Survey 40% of all child welfare officials report an increase in out of home 40% of all child welfare officials report an increase in out of home

placements because of meth in the last yearplacements because of meth in the last year 87% of law enforcement agencies report increases in meth related 87% of law enforcement agencies report increases in meth related

arrests (starting three years ago)arrests (starting three years ago) NACo Survey of 500 County law enforcement officials in 44 states NACo Survey of 500 County law enforcement officials in 44 states

consider methamphetamine their primary drug problem.consider methamphetamine their primary drug problem. Recently, there has been a decrease nationally in Recently, there has been a decrease nationally in

methamphetamine lab busts (due to effects of laws restricting methamphetamine lab busts (due to effects of laws restricting access to needed ingredients), but access to drug still high.access to needed ingredients), but access to drug still high.

Ohio StatsOhio StatsAccording to the Ohio Attorney GeneralAccording to the Ohio Attorney General Ohio had 345 meth lab busts in FY 04Ohio had 345 meth lab busts in FY 04 More in FY 05More in FY 05

Where are the Where are the Meth Labs in Meth Labs in

Ohio??Ohio??

How has Meth How has Meth Impacted Clermont Impacted Clermont

County??County??

Clandestine Labs Discovered in Clandestine Labs Discovered in Clermont CountyClermont County

20042004 30 Methamphetamine labs busted30 Methamphetamine labs busted 84 persons arrested on meth related charges84 persons arrested on meth related charges

20052005 42 Methamphetamine labs busted42 Methamphetamine labs busted 88 persons arrested on meth related charges88 persons arrested on meth related charges

2006 (thru June 302006 (thru June 30thth)) 24 Methamphetamine labs busted24 Methamphetamine labs busted 38 persons arrested on meth related charges38 persons arrested on meth related charges

Children Removed From Meth Children Removed From Meth Labs in Clermont CountyLabs in Clermont County

20032003 # of children removed – 30# of children removed – 30 # placed with relatives - 10# placed with relatives - 10 # placed in foster care – 20# placed in foster care – 20 Estimated costEstimated cost - $430,000- $430,000

2004 2004 # of children removed – 40# of children removed – 40 # placed with relatives - 15# placed with relatives - 15 # placed in foster care – 25# placed in foster care – 25 Estimated costEstimated cost - $540,000- $540,000

20052005 # of children removed – 40# of children removed – 40 # placed with relatives - 10# placed with relatives - 10 # placed in foster care – 30# placed in foster care – 30 Estimated costEstimated cost - $613,000- $613,000

Community KillerCommunity Killer

As a direct result of the growing methamphetamine problem in Clermont County more than 100 kids, at a cost of more than a million dollars, entered our system in the last 3 years…

Clermont StatsClermont Stats Clermont County led the state of Ohio in the discovery of meth Clermont County led the state of Ohio in the discovery of meth

labs in 2003, we were second in 2004labs in 2003, we were second in 2004 From January of 2003 to January of 2004 we saw a 37% increase in From January of 2003 to January of 2004 we saw a 37% increase in

the number of children in Foster Care…the increase was due, the number of children in Foster Care…the increase was due, almost exclusively to Methalmost exclusively to Meth

Placement costs in Clermont County went from $ 3.6 million Placement costs in Clermont County went from $ 3.6 million dollars in 2001 to $6.4 million in 2004. Much of the increase can dollars in 2001 to $6.4 million in 2004. Much of the increase can be associated with the increase in drug abusebe associated with the increase in drug abuse

We currently investigate about one meth lab case a weekWe currently investigate about one meth lab case a week We failed in an attempt to pass a Replacement Levy to address We failed in an attempt to pass a Replacement Levy to address

the additional costs – we found that while people were the additional costs – we found that while people were sympathetic to the children they were not sympathetic to the drug sympathetic to the children they were not sympathetic to the drug addicted parents- we subsequently passed a levy in May 2006 addicted parents- we subsequently passed a levy in May 2006 shifting focus away from Methshifting focus away from Meth

A recent survey of registered voters showed 57.2% identified the A recent survey of registered voters showed 57.2% identified the sale and abuse of Meth as a major problem in Clermont County. sale and abuse of Meth as a major problem in Clermont County. Another 26.5% identified it as somewhat of an issue for the Another 26.5% identified it as somewhat of an issue for the county.county.

Other impacts on Children’s Other impacts on Children’s ServicesServices

Clothing vouchers – Clothing vouchers – children can’t take children can’t take anything from a meth lab anything from a meth lab with them to their foster with them to their foster homehome

Medical examinations Medical examinations Staff time – investigator, Staff time – investigator,

ongoing worker, ongoing worker, transportation worker, transportation worker, court personnel, assistant court personnel, assistant prosecutor, public defender prosecutor, public defender

Worker safety (both with Worker safety (both with clients who are using meth clients who are using meth and by being exposed to and by being exposed to the toxic chemicals)the toxic chemicals)

Lack of adequate Lack of adequate treatment programs treatment programs

Who are these Children and Who are these Children and What Happens to them??What Happens to them??

Often the children are forced by their parents to be Often the children are forced by their parents to be INVOLVED in the production of the methamphetaminesINVOLVED in the production of the methamphetamines

Most of the children taken from homes with meth labs are Most of the children taken from homes with meth labs are young-under the age of 8yrs oldyoung-under the age of 8yrs old

Often other relatives are also involved in the “family Often other relatives are also involved in the “family business”…thus when removed many end up in foster carebusiness”…thus when removed many end up in foster care

Many of the parents are unable to kick the addiction to the Many of the parents are unable to kick the addiction to the drug and end up losing permanent custody of their childrendrug and end up losing permanent custody of their children

Depending on the circumstances of the lab, these children Depending on the circumstances of the lab, these children may be affected emotionally, psychologically, and may be affected emotionally, psychologically, and physically…FOR LIFEphysically…FOR LIFE

At this point, the long term effects of exposure to meth for At this point, the long term effects of exposure to meth for children is unknownchildren is unknown

What are we Doing??What are we Doing?? CPS staff working closely with the Sheriff’s Department & community partnersCPS staff working closely with the Sheriff’s Department & community partners Multi-Discipline training for our staff (SWORTC, Sheriff’s Department). Training Multi-Discipline training for our staff (SWORTC, Sheriff’s Department). Training

included staff from CPS, Mental Health, Home visitors, Board of Healthincluded staff from CPS, Mental Health, Home visitors, Board of Health Established a committee to address these issues: Established a committee to address these issues:

Meth kitsMeth kits Protocol for medical treatmentProtocol for medical treatment

Policies for staff safety (ex: no pregnant workers assigned to these cases.) Policies for staff safety (ex: no pregnant workers assigned to these cases.) Look to other states who have had this issue for an extended period of timeLook to other states who have had this issue for an extended period of time Educating the public about this crisisEducating the public about this crisis

Launched “Death2Meth.com” websiteLaunched “Death2Meth.com” website Produced a local documentary on the meth issue in Clermont County – called “Deadly Ice”Produced a local documentary on the meth issue in Clermont County – called “Deadly Ice” Provided testimony to Sub-Committee on Criminal Justice, Drug Policy & Human ResourcesProvided testimony to Sub-Committee on Criminal Justice, Drug Policy & Human Resources Continue to work with the Ohio department of Job & Family Services to develop meth Continue to work with the Ohio department of Job & Family Services to develop meth

awarenessawareness

Commissioner Proud is now a member of NACo’s national “Meth Action Task Force”Commissioner Proud is now a member of NACo’s national “Meth Action Task Force” Task force has established the “PETE-V” philosophy (Prevention, Education, Treatment, Task force has established the “PETE-V” philosophy (Prevention, Education, Treatment,

Enforcement, and Victims)Enforcement, and Victims) Commissioner Proud and Director McCartney members of Ohio’s Advisory Committee Commissioner Proud and Director McCartney members of Ohio’s Advisory Committee

on Methamphetamine on Methamphetamine This group successfully lobbied the general assembly to pass Senate Bill 53 which restricted This group successfully lobbied the general assembly to pass Senate Bill 53 which restricted

the sale of pseudoephedrine in Ohiothe sale of pseudoephedrine in Ohio

There is a growing awareness of the There is a growing awareness of the Impact of MethImpact of Meth

NACo has made Meth a priority NACo has made Meth a priority Meth was featured as the cover story in Meth was featured as the cover story in

Newsweek Magazine (8/8/05) and many other Newsweek Magazine (8/8/05) and many other publicationspublications

Meth was the focus of sub-committee on Criminal Meth was the focus of sub-committee on Criminal Justice, Drug Policy and Human Resources….Justice, Drug Policy and Human Resources….

Locally….we lauched a website… Locally….we lauched a website… www.death2meth.comwww.death2meth.com and Clermont County was and Clermont County was featured on NBC Nightly News…featured on NBC Nightly News…

The Federal Government launched the websiteThe Federal Government launched the websitewww.methresources.govwww.methresources.gov

The WebsiteThe Website

www.death2meth.comwww.death2meth.com

The National NewsThe National News

NBC Nightly NewsNBC Nightly News

The DocumentaryThe Documentary

““Deadly Ice”Deadly Ice”

Clermont County Office of Clermont County Office of Public InformationPublic Information

SummarySummary Will Meth effect your county?Will Meth effect your county?

Yes the extent is up to youYes the extent is up to you Will Meth effect your Children’s ServicesWill Meth effect your Children’s Services

Yes begin the partnerships nowYes begin the partnerships now Meth is a community, state and national Meth is a community, state and national

problemproblem Meth tears at the fabric of our societyMeth tears at the fabric of our society Meth is devastating to the people who Meth is devastating to the people who

make or use it, and the communities that make or use it, and the communities that they do it inthey do it in

We must make it unpopular to use it or We must make it unpopular to use it or make it…make it…

The News is NOT The News is NOT ALL BADALL BAD

MYTH AND REALITY OF TREATMENT FOR MYTH AND REALITY OF TREATMENT FOR METHAMPHETAMINEMETHAMPHETAMINE

MYTH: Clients addicted to methamphetamine MYTH: Clients addicted to methamphetamine do not complete treatment and do not do not complete treatment and do not recover.recover.

REALITY: REALITY: Data show that methamphetamine treatment Data show that methamphetamine treatment

completion rates are not very different than those completion rates are not very different than those for other addictive drugs.for other addictive drugs.

People addicted to methamphetamine can and do People addicted to methamphetamine can and do recover.recover.

If methamphetamine addicts complete treatment, If methamphetamine addicts complete treatment, they are no more or less likely to require re-they are no more or less likely to require re-admission to treatment program, lose their job or admission to treatment program, lose their job or be arrested than those who were treated for other be arrested than those who were treated for other drug use.drug use.““Good news – some of the bad news Good news – some of the bad news about methamphetamine is wrong.”about methamphetamine is wrong.”

Alternative View of Current Alternative View of Current Methamphetamine SituationMethamphetamine Situation

A report released in June by The Sentencing A report released in June by The Sentencing Project, an advocacy group, states that Project, an advocacy group, states that methamphetamine use is dangerous but not methamphetamine use is dangerous but not the national threat portrayed by political and the national threat portrayed by political and law enforcement officials.law enforcement officials. Not an epidemic – “highly localized”, even though Not an epidemic – “highly localized”, even though

more widely used than 10 years ago.more widely used than 10 years ago. Positive outcomes achievable for people with Positive outcomes achievable for people with

primary methamphetamine addiction.primary methamphetamine addiction. ““Mischaracterizing impact of methamphetamine by Mischaracterizing impact of methamphetamine by

exaggerating prevalence and consequences.”exaggerating prevalence and consequences.”

SAMHSA Treatment Episode Data SAMHSA Treatment Episode Data

Number of people admitted to Number of people admitted to addiction treatment programs for addiction treatment programs for methamphetamine use rose 25% methamphetamine use rose 25% between 2002 and 2004.between 2002 and 2004.

Methamphetamine users:Methamphetamine users: 8% of treatment admissions nationally.8% of treatment admissions nationally. 20% or more in Arkansas, California, 20% or more in Arkansas, California,

Hawaii, Idaho, Nevada, Oklahoma Hawaii, Idaho, Nevada, Oklahoma and and Utah.Utah.

Lifetime, Past Year, and Past Month Methamphetamine Use among Persons

Aged 12 or Older: 2002-2004Numbers of Users (in Thousands)

597

12,303

1,315607

1,440583

1,541

12,38311,726

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Lifetime Past Year Past Month

200220032004

a = Significant change 2003 to 2004; b = Significant change 2002 to 2004

Methamphetamine UsersMethamphetamine Users

High rate of use among women and the High rate of use among women and the homosexual community (45% of homosexual community (45% of admissions are women – higher admissions are women – higher percentage of women admissions than for percentage of women admissions than for any drug except tranquilizers).any drug except tranquilizers).

Traditionally considered Caucasian drug – Traditionally considered Caucasian drug – mainly blue collar.mainly blue collar.

Increasing use among Hispanic and Asian Increasing use among Hispanic and Asian population.population.

Use highest among the 25-34 age group.Use highest among the 25-34 age group.

Methamphetamines as Primary Substance by Gender and Pregnancy Status: 1994-2004

0%

3%

5%

8%

10%

13%

15%

18%

20%

23%

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Pregnant Females Non-Preg Females Males

Percent of Total Admissions

Source: Analysis of Treatment Episode Data Set (TEDS) Computer File

IMPACT on CHILDRENIMPACT on CHILDREN Since women more likely caretakers of children, Since women more likely caretakers of children,

more children affected by methamphetamine.more children affected by methamphetamine. 80-90% of children in homes where 80-90% of children in homes where

methamphetamine manufactured test positive for methamphetamine manufactured test positive for drug.drug.

Methamphetamine in children’s systems due to Methamphetamine in children’s systems due to inhaled fumes, direct contact with drug, second inhaled fumes, direct contact with drug, second hand smoke, or direct ingestion.hand smoke, or direct ingestion.

Children uniquely susceptible because of their Children uniquely susceptible because of their natural curiosity (touching, putting things in natural curiosity (touching, putting things in mouth), because their nervous systems and mouth), because their nervous systems and brains are still developing, and because thinner brains are still developing, and because thinner skins absorb chemicals faster than adults. skins absorb chemicals faster than adults.

Impact on Fetal DevelopmentImpact on Fetal Development

Exposure early in pregnancy: fetal Exposure early in pregnancy: fetal death, small size for gestational death, small size for gestational period.period.

Exposure later in pregnancy: learning Exposure later in pregnancy: learning disabilities, poor social adjustment.disabilities, poor social adjustment.

Parents Entering Publicly Funded Parents Entering Publicly Funded Substance Abuse TreatmentSubstance Abuse Treatment

59% had child(ren) under 18.59% had child(ren) under 18. 20% had child(ren) removed by 20% had child(ren) removed by

Children’s Protective Services.Children’s Protective Services. 10% who had child(ren) removed lost 10% who had child(ren) removed lost

their parental rights.their parental rights.

(Based on CSAT TOPPS-II Project)(Based on CSAT TOPPS-II Project)

Various Scenarios of Methamphetamine Various Scenarios of Methamphetamine Use Impacting ChildrenUse Impacting Children

Parent uses or abuses methamphetamine.Parent uses or abuses methamphetamine. Parent dependent on methamphetamine.Parent dependent on methamphetamine. Parent “cooks” small quantities of Parent “cooks” small quantities of

methamphetamine.methamphetamine. Parent involved in trafficking.Parent involved in trafficking. Parent involved in super lab.Parent involved in super lab. Mother uses methamphetamine while pregnant.Mother uses methamphetamine while pregnant.

Each situation poses different risks and requires Each situation poses different risks and requires different responses.different responses.

Child welfare workers and treatment staff need to Child welfare workers and treatment staff need to know the risks and responses. know the risks and responses.

Parent Uses or Abuses Methamphetamine – Risks Parent Uses or Abuses Methamphetamine – Risks to Safety and Well-being of Childrento Safety and Well-being of Children

Parental behavior under the influence: poor Parental behavior under the influence: poor judgment, confusion, irritability, paranoia, judgment, confusion, irritability, paranoia, violence.violence.

Inadequate supervision.Inadequate supervision. Inconsistent parenting.Inconsistent parenting. Chaotic home life.Chaotic home life. Exposure to secondhand smoke.Exposure to secondhand smoke. Accidental ingestion of drug.Accidental ingestion of drug. Possibility of abuse.Possibility of abuse. HIV exposure from needle use by parents.HIV exposure from needle use by parents.

Parent Dependent on MethamphetamineParent Dependent on Methamphetamine

All the risks of parents who use/abuse, but All the risks of parents who use/abuse, but children may be exposed more often and for children may be exposed more often and for longer periods.longer periods.

Chronic neglect is more likely.Chronic neglect is more likely. Household may lack food, water, utilities.Household may lack food, water, utilities. Chaotic home life.Chaotic home life. Children may lack medical care, dental care, Children may lack medical care, dental care,

immunizations.immunizations. Greater risk of abuse.Greater risk of abuse. Greater risk of sexual abuse if parent has multiple Greater risk of sexual abuse if parent has multiple

partners.partners.

Parent Involved in Manufacturing, Parent Involved in Manufacturing, Trafficking, etc.Trafficking, etc.

All the previous risks.All the previous risks. Exposure to the drug.Exposure to the drug. Possible fire or explosion.Possible fire or explosion. Presence of weapons.Presence of weapons. Possibility of violence.Possibility of violence. Possibility of physical or sexual abuse by Possibility of physical or sexual abuse by

persons visiting the household.persons visiting the household. Possibility of parent incarceration and Possibility of parent incarceration and

permanency issues for children.permanency issues for children.

Relationship of Methamphetamine Relationship of Methamphetamine Use and Child WelfareUse and Child Welfare

Not solely use of specific substance Not solely use of specific substance that affects child welfare system – it’s that affects child welfare system – it’s complex relationship between:complex relationship between: Substance use pattern.Substance use pattern. Variations across state and local Variations across state and local

jurisdictions regarding policies and jurisdictions regarding policies and practices.practices.

Knowledge and skill of workers.Knowledge and skill of workers. Access to appropriate health and social Access to appropriate health and social

supports for families.supports for families.

Substance Abuse Treatment ServicesSubstance Abuse Treatment Services

Outpatient Outpatient Individual CounselingIndividual Counseling Group CounselingGroup Counseling

Intensive Outpatient (IOP)Intensive Outpatient (IOP) Day TreatmentDay Treatment Detoxification (outpatient and inpatient)Detoxification (outpatient and inpatient) Residential/InpatientResidential/Inpatient 12 Step Programs (AA, NA)12 Step Programs (AA, NA)

Recommended Treatment ApproachesRecommended Treatment Approaches

Psychosocial TreatmentPsychosocial Treatment Contingency ManagementContingency Management

Technique employing systematic delivery of positive Technique employing systematic delivery of positive reinforcement for desired behaviors (e.g., vouchers or reinforcement for desired behaviors (e.g., vouchers or rewards earned for methamphetamine-free urine sample).rewards earned for methamphetamine-free urine sample).

Relapse PreventionRelapse Prevention Matrix ModelMatrix Model

Manualized, 16 week, non-residential programManualized, 16 week, non-residential program Includes individual counseling, cognitive behavior therapy, Includes individual counseling, cognitive behavior therapy,

motivational interviewing, family education groups, urine motivational interviewing, family education groups, urine testing, and participation in 12 step program.testing, and participation in 12 step program.

Effective Methamphetamine Treatment Effective Methamphetamine Treatment ComponentsComponents

Minimum of 6 months -1 year of Minimum of 6 months -1 year of treatment.treatment.

Structured, intensive and Structured, intensive and comprehensive.comprehensive.

Focus on coping mechanisms.Focus on coping mechanisms. Cognitive and behavioral in nature.Cognitive and behavioral in nature.

Strategies for Working with Strategies for Working with Methamphetamine Abusing ParentsMethamphetamine Abusing Parents

Use of Motivational Interviewing Use of Motivational Interviewing TechniquesTechniques

Role modelingRole modeling AccountabilityAccountability

Obstacles to Client ChangeObstacles to Client Change

Late stage addiction.Late stage addiction. Resistance to the “System”.Resistance to the “System”. Lack of hope.Lack of hope. Methamphetamine addicts often Methamphetamine addicts often

dismissed in dependency cases or dismissed in dependency cases or prejudged.prejudged.

Methamphetamine affects brain Methamphetamine affects brain chemistry, often leading to reduced chemistry, often leading to reduced memory and attention rates.memory and attention rates.

Limitations on Current TreatmentsLimitations on Current Treatments

Training and development of knowledgeable Training and development of knowledgeable clinical personnel are essential elements to clinical personnel are essential elements to successfully address challenges of treating successfully address challenges of treating methamphetamine users.methamphetamine users.

Training alone is insufficient if funding Training alone is insufficient if funding necessary to deliver the recommended necessary to deliver the recommended treatment is not available.treatment is not available.

Treatment funding policies that promote Treatment funding policies that promote short duration or non-intensive outpatient short duration or non-intensive outpatient services are inappropriate for providing services are inappropriate for providing adequate treatment for methamphetamine adequate treatment for methamphetamine users.users.

Models of Improved ServicesModels of Improved Services

Many communities began program models Many communities began program models in the 1990’s.in the 1990’s. Paired counselor and child welfare worker.Paired counselor and child welfare worker. Counselor out-stationed at Child Welfare office.Counselor out-stationed at Child Welfare office. Multidisciplinary teams for joint case planning.Multidisciplinary teams for joint case planning. Persons in recovery act as advocates for Persons in recovery act as advocates for

parents (peer support).parents (peer support). Training and curricula development.Training and curricula development. Family Treatment Courts.Family Treatment Courts.

More Advanced Models of Team EffortsMore Advanced Models of Team Efforts

Workers out-stationed in collaborative settings: at Workers out-stationed in collaborative settings: at courts, at child welfare agencies, at treatment courts, at child welfare agencies, at treatment agencies.agencies.

Increased recovery management and monitoring of Increased recovery management and monitoring of recovery process.recovery process.

New methods and protocols on sharing information.New methods and protocols on sharing information. Increased judicialIncreased judicial oversight and family drug courts.oversight and family drug courts. New priorities for treatment access for child welfare New priorities for treatment access for child welfare

involved families.involved families. New responses to children’s needs.New responses to children’s needs.

Sacramento, California Model of Effective Child Sacramento, California Model of Effective Child Welfare and Substance Abuse ServicesWelfare and Substance Abuse Services

Comprehensive training – to understand substance Comprehensive training – to understand substance abuse and dependence and acquire skills to abuse and dependence and acquire skills to intervene with parents.intervene with parents.

Early Intervention Specialists – social workers Early Intervention Specialists – social workers trained in motivational enhancement therapy trained in motivational enhancement therapy stationed at Family Court to intervene and conduct stationed at Family Court to intervene and conduct preliminary assessments with ALL parents with preliminary assessments with ALL parents with substance abuse allegations at the first court substance abuse allegations at the first court hearing.hearing.

Improvements in Cross-System Information Improvements in Cross-System Information Systems – to ensure that communication across Systems – to ensure that communication across systems and methods to monitor outcomes are in systems and methods to monitor outcomes are in place, as well as management of the County’s place, as well as management of the County’s treatment capacity.treatment capacity.

Sacramento, California Model of Effective Child Sacramento, California Model of Effective Child Welfare and Substance Abuse Services (cont.)Welfare and Substance Abuse Services (cont.)

Prioritization of Families in Child Protective Prioritization of Families in Child Protective Services (CPS) – county-wide policy to ensure Services (CPS) – county-wide policy to ensure priority access to substance abuse treatment priority access to substance abuse treatment services.services.

Specialized Treatment and Recovery Services Specialized Treatment and Recovery Services (STARS) – to provide immediate access to (STARS) – to provide immediate access to substance abuse assessment and engagement substance abuse assessment and engagement strategies conducted by staff trained in strategies conducted by staff trained in motivational enhancement therapy. STARS motivational enhancement therapy. STARS provides intensive management of the recovery provides intensive management of the recovery aspect of the child welfare case plan and routine aspect of the child welfare case plan and routine monitoring and feedback to CPS and the Court.monitoring and feedback to CPS and the Court.

Dependency Drug Court – to provide more Dependency Drug Court – to provide more frequent court appearances for ALL parents with frequent court appearances for ALL parents with allegations of substance abuse.allegations of substance abuse.

RecommendationsRecommendations Improve data systems that help paint a better Improve data systems that help paint a better

picture of addiction and child welfare issues.picture of addiction and child welfare issues. Improve intervention for children.Improve intervention for children. Improve and increase availability of staff Improve and increase availability of staff

training.training. Increase timely access to addiction treatment.Increase timely access to addiction treatment.

(Nancy Young, Ph.D., Testimony before the (Nancy Young, Ph.D., Testimony before the U.S. House of Representatives Government U.S. House of Representatives Government Reform Subcommittee on Criminal Justice, Reform Subcommittee on Criminal Justice, Drug Policy, and Human Resources, July 28, Drug Policy, and Human Resources, July 28, 2005)2005)

Cost Issues re: Increased Substance Abuse Cost Issues re: Increased Substance Abuse and Methamphetamine Treatmentand Methamphetamine Treatment

Policy makers may view cost of providing Policy makers may view cost of providing substance abuse treatment services substance abuse treatment services prohibitively high.prohibitively high.

Estimates state as few as 10% of those Estimates state as few as 10% of those needing substance abuse treatment actually needing substance abuse treatment actually receive treatment – costs of meeting needs receive treatment – costs of meeting needs too high.too high.

Focus on costs savings that balance treatment Focus on costs savings that balance treatment costs when treatment readily available – costs costs when treatment readily available – costs savings due to reduced crime, increased work savings due to reduced crime, increased work productivity, decreased health costs, productivity, decreased health costs, decreased child welfare involvement.decreased child welfare involvement.

Cost Issues re: Increased Substance Abuse Cost Issues re: Increased Substance Abuse and Methamphetamine Treatment (cont.)and Methamphetamine Treatment (cont.)

Research by Ettner et al. confirms previous Research by Ettner et al. confirms previous studies, finding that treatment of substance studies, finding that treatment of substance abuse results in net benefits.abuse results in net benefits.

““Benefit vs. Cost in the California Treatment Benefit vs. Cost in the California Treatment Outcome Project: Does Substance Abuse Outcome Project: Does Substance Abuse Treatment pay for itself?”Treatment pay for itself?”

Every dollar invested in substance abuse Every dollar invested in substance abuse treatment yields $7 worth of economic benefits to treatment yields $7 worth of economic benefits to society.society.

Study looked at effects of treatment on medical Study looked at effects of treatment on medical care, mental health services, criminal activity, care, mental health services, criminal activity, employment earnings, and government payments employment earnings, and government payments (e.g., TANF/welfare).(e.g., TANF/welfare).

Future DirectionsFuture Directions

Family-Based Methamphetamine Family-Based Methamphetamine Treatment Access Act of 2006 – Treatment Access Act of 2006 – providing resources and tools to providing resources and tools to reduce substance abuse among reduce substance abuse among mothers and non-violent offenders.mothers and non-violent offenders.

White House Drug Policy Office – goal White House Drug Policy Office – goal to cut methamphetamine use by to cut methamphetamine use by 15% and increase seizures of 15% and increase seizures of methamphetamine labs by 25%.methamphetamine labs by 25%.

ResourcesResources

NATIONAL CENTER ON SUBSTANCE ABUSE AND NATIONAL CENTER ON SUBSTANCE ABUSE AND CHILD WELFARE (NCSACW)CHILD WELFARE (NCSACW)

A Program of the Substance Abuse and Mental A Program of the Substance Abuse and Mental Health Services Administration, Health Services Administration,

Center for Substance Abuse Treatment,Center for Substance Abuse Treatment,

and theand the

Administration on Children, Youth, and FamiliesAdministration on Children, Youth, and Families

Children’s BureauChildren’s Bureau

Office on Child Abuse and NeglectOffice on Child Abuse and Neglect

www.ncsacw.samhsa.govwww.ncsacw.samhsa.gov

Contact InformationContact Information Bob Proud, Clermont County CommissionerBob Proud, Clermont County Commissioner

bproud@co.clermont.oh.usbproud@co.clermont.oh.us (513) 732-7300(513) 732-7300

Karen Scherra, Executive Director of Karen Scherra, Executive Director of Clermont County Mental Health & Clermont County Mental Health & Recovery BoardRecovery Board kscherra@ccmhrb.orgkscherra@ccmhrb.org (513) 732-5400(513) 732-5400

Tim McCartney, Director, Clermont County Tim McCartney, Director, Clermont County Department of Job & Family ServicesDepartment of Job & Family Services mccart04@odjfs.state.oh.usmccart04@odjfs.state.oh.us (513) 732-7212(513) 732-7212