Transcript Slide 1

Screening and Assessment for Family
Engagement, Retention and Recovery – SAFERR
Guidance for States and Communities Serving
Families with Substance Use Disorders in Child
Welfare Services and Dependency Courts
Nancy K. Young, Ph.D., Director
Presented at
4940 Irvine Blvd, Ste 202
Putting the Pieces Together for Children and
Irvine, CA 92620
Families: The National Conference on Substance
Phone: 714-505-3525
Abuse, Child Welfare and the Courts
Fax: 714-505-3626
February 1, 2007
Email: www.ncsacw.samhsa.gov
Developing since Summer 2003
 Review and Input from Community Expert
Panel
 Review at NCSACW Researchers’ Forum
 Shared with In-Depth TA State Teams
 Consultant Liaisons and States Provided
Input to Implementation Guide
 Edits and Rewrites
SAFERR is based on the premise that
when parents misuse substances and
maltreat their children, the only way to
make sound decisions is to draw from
the talents and resources of at least
three systems: child welfare, alcohol
and drugs, and the courts.
Principles

The problems of child maltreatment and substance
use disorders demand urgent attention and the
highest possible standards of practice from
everyone working in systems charged with
promoting child safety and family well-being.

Success is possible and feasible. Staff in child
welfare, substance abuse, and court systems have
the desire and potential to change individual lives
and create responsible public policies.

Family members are active partners and
participants in addressing these urgent problems.
Premises
1. The team is the tool, and people, not tools, make
decisions
2. The family is the focus of concern
3. Problems don’t come in discrete packages; they
are jumbled together
4. Assessment is not a one-person responsibility
Premises
5. Information is limited, and there is no researchbased answer
6. There is no time to lose
7. ICWA creates specific guidelines for working with
American Indian populations
8. Developing and sustaining effective
collaborations is hard work
Organization of SAFERR
I.
Building Cross-System Collaboration
 Creating the structure to create and sustain change
II.
Collaboration Within and Across Systems
 What each system needs to know about itself and
its partners
III. Collaboration in Action: Working Together on the
Front Line
 Presents activities that create cross-system practice
changes
Organization of SAFERR
A. Facilitator’s Guide
 Templates and exercises
B. Fact Sheets
 To educate administrators, legislators and
stakeholders about the initiative
C. Understanding the Needs of Children
D. Screening and Assessment Tools for
Substance Use Disorders
Organization of SAFERR Appendices
E. Substance Use, Abuse, Dependence
Continuum, and Principles of Effective
Treatment
F. Safety and Risk Assessments for Use by Child
Welfare Staff
G. Sharing Confidential Information
H. Glossary of Terms
I. Guide to Compliance with the Indian Child
Welfare Act (ICWA)
Assessment is a Process
Assessment happens along a continuum to determine:
 Presence and Immediacy
 Is there an issue present?
 What is the immediacy of the issue?
Assessment is a Process
Assessment happens along a continuum to determine:
 Presence and Immediacy
Is there an issue present?
What is the immediacy of the issue?
 Nature and Extent
 What is the nature of the issue?
 What is the extent of the issue?
Assessment is a Process
Assessment happens along a continuum to determine:
 Presence and Immediacy
Is there an issue present?
What is the immediacy of the issue?
 Nature and Extent
What is the nature of the issue?
What is the extent of the issue?
 Developing & Monitoring Change, Transitions &
Outcomes of Treatment and Case Plans
 What is the response to the issue?
 Are there demonstrable changes in the issue?
 Is the family ready for transition?
 Did the Interventions Work?
Definitions of Terms and Processes
AOD Services
Is there an
issue?
 Screen
CWS Services
 Child Abuse
Report
Court Services
Definitions of Terms and Processes
AOD Services
Is there an
issue?
 Screen
What is the
immediacy
of the
issue?
 Immediate
Need Triage
CWS Services
Court Services
 Child Abuse
Report
 In-Person
Safety
Assessment
 Preliminary
Protective
Hearing
Definitions of Terms and Processes
AOD Services
Is there an
issue?
 Screen
What is the
immediacy
of the
issue?
 Immediate
What is the
nature of
the issue?
Need Triage
 Diagnosis
CWS Services
Court Services
 Child Abuse
Report
 In-Person
Safety
Assessment
 In-Person
Response/
Risk
Assessment
 Preliminary
Protective
Hearing
 Court
Findings
Definitions of Terms and Processes
AOD Services
Is there an
issue?
 Screen
What is the
immediacy
of the
issue?
 Immediate
What is the
nature of
the issue?
What is the
extent of
the issue?
Need Triage
 Diagnosis
 Multi-
Dimensional
Assessment
CWS Services
Court Services
 Child Abuse
Report
 In-Person
Safety
Assessment
 In-Person
Response/
Risk
Assessment
 Family
assessment
 Preliminary
Protective
Hearing
 Court
Findings
 Petition Filed;
Preliminary
Protective
Hearing
AOD Services
What is the
Response?
 Treatment
Plan
CWS Services
 Case Plan
Court Services
 Adjudication/
Dispositional
Hearing;
Court-ordered
Case Plan
AOD Services
What is the
Response?
Is there
demonstrable change?
 Treatment
CWS Services
 Case Plan
Plan
 Treatment
Monitoring
Court Services
 Adjudication/
Dispositional
Hearing;
Court-ordered
Case Plan
 Case Plan
Monitoring
 Court Review
Hearings
AOD Services
What is the
Response?
Is there
demonstrable change?
Is family
ready for
transition?
 Treatment
CWS Services
 Case Plan
Plan
Court Services
 Adjudication/
Dispositional
Hearing;
Court-ordered
Case Plan
 Court Review
Hearings
 Treatment
 Case Plan
Monitoring
 Transition
Planning
Monitoring
 Permanency
 Permanency
Determination Hearing
AOD Services
What is the
Response?
 Treatment
CWS Services
 Case Plan
Plan
Is there
demonstrable change?
 Treatment
Is family
ready for
transition?
 Transition
What is to
happen after
discharge?
 Recovery
Monitoring
Planning
Management
Court Services
 Adjudication/
Dispositional
Hearing;
Court-ordered
Case Plan
 Case Plan
Monitoring
 Permanency
Determination
 Family Well
Being
 Court Review
Hearings
 Permanency
Hearing
 Case Closed
AOD Services
What is the
Response?
 Treatment
CWS Services
 Case Plan
Plan
Is there
demonstrable change?
 Treatment
Is family
ready for
transition?
 Transition
What is to
happen after
discharge?
Did the
intervention
work?
 Recovery
Monitoring
Planning
Management
 Outcome
Monitoring
Court Services
 Adjudication/
Dispositional
Hearing;
Court-ordered
Case Plan
 Case Plan
Monitoring
 Permanency
Determination
 Family Well
 Court Review
Hearings
 Permanency
Hearing
 Case Closed
Being
 Outcome
Monitoring
 Outcome
Monitoring
Assessment Information must be
Communicated
Assessment happens along a continuum to determine:
 Presence and Immediacy
Is there an issue present?
What is the immediacy of the issue?
 Nature and Extent
What is the nature of the issue?
What is the extent of the issue?
 Developing & Monitoring Change, Transitions &
Outcomes of Treatment and Case Plans
 What is the response to the issue?
 Are there demonstrable changes in the issue?
 Is the family ready for transition?
 Did the Interventions Work?
The SAFERR Model
Development
Builds Cross
System
Collaboration
Establishes
Individual
and
Cross System
Roles and
Responsibilities
Identifies
Front-Line
Collaborative
Practice
Establishes and Monitors Individual
and Cross-System Outcomes
The SAFERR Model
Development
Builds Cross
System
Collaboration
Establishes
Individual
and
Cross System
Roles and
Responsibilities
Establishes and Monitors Individual
and Cross-System Outcomes
Identifies
Front-Line
Collaborative
Practice
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight
Committee
 Steering
Committee
 Subcommittees
Most senior officials from all
systems
• Direct staff to give this priority
• Provide overall direction
• Meet 3-4 times a year
• Receive interim reports
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight
Committee
 Steering
Committee
 Subcommittees
Senior managers from
within systems
• Co-chaired or use
facilitator
• Have decision-making
authority
• Receive materials in
advance for discussion
• Make decisions during
meetings
• Report collectively to the
oversight committee
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight
Committee
 Steering
Committee
 Subcommittees
The Charge to the
Steering Committee:
Senior managers from
within systems
• Co-chaired or use
facilitator
• Have decision-making
authority
• Receive materials in
advance for discussion
• Make decisions during
meetings
• Report collectively to the
oversight committee
• Create a mission
statement based on
exploration of values
and principles
• Enhance understanding
of current systems &
barriers to
communication
• Establish goals,
milestone, products &
implement plan to
achieve them
• Create and oversee
subcommittees
• Identify training
curricula and strategies
• Monitor progress and
evaluate outcomes
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight
Committee
 Steering
Committee
 Subcommittees
Establishes Individual and
Cross System Roles and
Responsibilities
The Subcommittee(s)
• Comprised of county front
line and supervisory staff;
• Charged by Steering
Committee to conduct
specific tasks
• Participate in pilot tests of
strategies
• Report to the Steering
Committee
Identifies Front-Line
Collaborative
Practice
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission &
Principles
Shared
Understanding on
Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
Establishes Individual and
Cross System Roles and
Responsibilities
Identifies Front-Line
Collaborative
Practice
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
Identifies Front-Line
Collaborative
Practice
The SAFERR Model
Development
Builds Cross
System
Collaboration
Establishes
Individual
and
Cross System
Roles and
Responsibilities
Identifies
Front-Line
Collaborative
Practice
Establishes and Monitors Individual
and Cross-System Outcomes
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
CWS Understands
 Basics of substance use & how use
affects child development
 How to screen for substance use
 Treatment system & how to help
people stay in treatment
 Implications of tensions between
Treatment Staff and CW timelines
Identifies Front-Line
Collaborative
Practice
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
CWS Understands
 Basics of substance use & how use affects
child development
 How to screen for substance use
 Treatment system & how to help people stay in
treatment
 Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System
Understands
 How substance use puts children at
risk & how CWS must respond
 Child maltreatment reporting
requirements
 How to screen for child safety
Identifies Front-Line
Collaborative
Practice
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
CWS Understands
 Basics of substance use & how use affects
child development
 How to screen for substance use
 Treatment system & how to help people stay in
treatment
 Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
 How substance use puts children at risk & how
CWS must respond
 Child maltreatment reporting requirements
 How to screen for child safety
Court System Understands
 Basics of substance use & child
maltreatment
 Its role in requiring assessments
 The authority to prompt/require
collaboration
Identifies Front-Line
Collaborative
Practice
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees
Establishes Individual and
Cross System Roles and
Responsibilities








TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data






CWS Understands
Basics of substance use & how use affects child
development
How to screen for substance use
Treatment system & how to help people stay in treatment
Implications of tensions between Treatment Staff and CW
timelines
Alcohol and Drug System Understands
How substance use puts children at risk & how CWS must
respond
Child maltreatment reporting requirements
How to screen for child safety
Court System Understands
Basics of substance use & child maltreatment
Its role in requiring assessments
The authority to prompt/require collaboration
Collaboratively all Three Systems
 Establish joint policies/procedures
to share information
 Establish case plans
 Develop shared indicators of
progress
 Monitor progress and evaluate
outcomes
Identifies Front-Line
Collaborative
Practice
The SAFERR Model
Development
Builds Cross
System
Collaboration
Establishes
Individual
and
Cross System
Roles and
Responsibilities
Identifies
Front-Line
Collaborative
Practice
Establishes and Monitors Individual
and Cross-System Outcomes
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
Identifies Front-Line
Collaborative
Practice
CWS Understands
 Basics of substance use & how use affects
child development
 How to screen for substance use
 Treatment system & how to help people stay in
treatment
 Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
 How substance use puts children at risk & how
CWS must respond
 Child maltreatment reporting requirements
 How to screen for child safety
Court System Understands
 Basics of substance use & child maltreatment
 Its role in requiring assessments
 The authority to prompt/require collaboration
Collaboratively all Three Systems
 Establish joint policies/procedures to share
information
 Establish case plans
 Develop shared indicators of progress
 Monitor progress and evaluate outcomes
CWS, SUDS and CS
Have Collaborative
Policies,
Procedures and
Tools to:
 Screen for
substance use and
child maltreatment
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
Identifies Front-Line
Collaborative
Practice
CWS Understands
 Basics of substance use & how use affects
child development
 How to screen for substance use
 Treatment system & how to help people stay in
treatment
 Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
 How substance use puts children at risk & how
CWS must respond
 Child maltreatment reporting requirements
 How to screen for child safety
Court System Understands
 Basics of substance use & child maltreatment
 Its role in requiring assessments
 The authority to prompt/require collaboration
Collaboratively all Three Systems
 Establish joint policies/procedures to share
information
 Establish case plans
 Develop shared indicators of progress
 Monitor progress and evaluate outcomes
CWS, SUDS and CS Have
Collaborative Policies,
Procedures and Tools
to:
 Screen for substance
use and child
maltreatment
 Assess for
substance use and
child maltreatment
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
Identifies Front-Line
Collaborative
Practice
CWS Understands
 Basics of substance use & how use affects
child development
 How to screen for substance use
 Treatment system & how to help people stay in
treatment
 Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
 How substance use puts children at risk & how
CWS must respond
 Child maltreatment reporting requirements
 How to screen for child safety
Court System Understands
 Basics of substance use & child maltreatment
 Its role in requiring assessments
 The authority to prompt/require collaboration
Collaboratively all Three Systems
 Establish joint policies/procedures to share
information
 Establish case plans
 Develop shared indicators of progress
 Monitor progress and evaluate outcomes
CWS, SUDS and CS Have
Collaborative Policies,
Procedures and Tools
to:
 Screen for substance
use and child
maltreatment
 Assess for substance
use and child
maltreatment
 Develop and
implement
collaborative case
plans
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
Identifies Front-Line
Collaborative
Practice
CWS Understands
 Basics of substance use & how use affects
child development
 How to screen for substance use
 Treatment system & how to help people stay in
treatment
 Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
 How substance use puts children at risk & how
CWS must respond
 Child maltreatment reporting requirements
 How to screen for child safety
Court System Understands
 Basics of substance use & child maltreatment
 Its role in requiring assessments
 The authority to prompt/require collaboration
Collaboratively all Three Systems
 Establish joint policies/procedures to share
information
 Establish case plans
 Develop shared indicators of progress
 Monitor progress and evaluate outcomes
CWS, SUDS and CS Have
Collaborative Policies,
Procedures and Tools
to:
 Screen for substance
use and child
maltreatment
 Assess for substance
use and child
maltreatment
 Develop and implement
collaborative case plans
 Monitor progress
and evaluate
results
Builds Cross
System
Collaboration
GOVERNANCE
 Oversight Committee
 Steering Committee
 Subcommittees




TASKS
Mission & Principles
Shared Understanding
on Language &
Processes
Goals, Timetables,
Products
Training
Curricula/Strategy
MONITORING
 Baseline Data
 Progress Reports
 Outcome Data
Establishes Individual and
Cross System Roles and
Responsibilities
Identifies Front-Line
Collaborative
Practice
CWS Understands
 Basics of substance use & how use affects
child development
 How to screen for substance use
 Treatment system & how to help people stay in
treatment
 Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
 How substance use puts children at risk & how
CWS must respond
 Child maltreatment reporting requirements
 How to screen for child safety
Court System Understands
 Basics of substance use & child maltreatment
 Its role in requiring assessments
 The authority to prompt/require collaboration
Collaboratively all Three Systems
 Establish joint policies/procedures to share
information
 Establish case plans
 Develop shared indicators of progress
 Monitor progress and evaluate outcomes
CWS, SUDS and CS Have
Collaborative Policies,
Procedures and Tools
to:
 Screen for substance
use and child
maltreatment
 Assess for substance
use and child
maltreatment
 Develop and implement
collaborative case plans
 Monitor progress and
evaluate results
The SAFERR Model
Development
Builds Cross
System
Collaboration
Establishes
Individual
and
Cross System
Roles and
Responsibilities
Identifies
Front-Line
Collaborative
Practice
Establishes and Monitors Individual
and Cross-System Outcomes
Assessment is a Process
Assessment happens along a continuum to determine:
 Presence and Immediacy
Is there an issue present?
What is the immediacy of the issue?
 Nature and Extent
What is the nature of the issue?
What is the extent of the issue?
 Developing & Monitoring Change, Transitions &
Outcomes of Treatment and Case Plans
 What is the response to the issue?
 Are there demonstrable changes in the issue?
 Is the family ready for transition?
 Did the Interventions Work?
Establishes and Monitors Individual and
Cross-System Outcomes
 Increased identification of substance use disorders among
families reported for child maltreatment
 Increased identification of potential child maltreatment for people
assessed/treated for SUDS
 Increased communication regarding screening and assessment
for SUDS and child maltreatment
 Informed decision making by CWS and CS regarding
reunification, aftercare, terminations
 Reduced duplication and burden with regard to case plan
requirements
 Increased engagement and retention of parents in treatment
 Reduced risk of maltreatment of children
 Increased family stability, reunification and well being