Transcript El Paso County Family Treatment Drug Court A Placement

A Successful Collaboration Among
Systems:
El Paso County Family Treatment Drug Court:
A Program Model
Putting the Pieces Together: 1st National
Conference on Substance Abuse, Child
Welfare and Dependency Court
July 14 – 15, 2004 Baltimore, MD
Julia L. Polland, MA, LPC, CACIII
Savio Child Protection Coordinator
Shirley Rhodus, MSW
EPC DHS Child Protection Administrator
Welcome and Introductions
Who’s In The Room?
Name…
System…
Job Responsibility…
Expectations…
CONFERENCE
LEARNING OBJECTIVES
Participants Will…
• Learn How Three Major Systems Came Together
To Develop an Integrative and Creative Program
With Limited Fiscal Resources
• Learn the Structure of El Paso County’s Family
Treatment Drug Court Including:
– Program Design
– Graduated Sanctions
• Learn How to Manage Child Safety and Risk with
The Substance Abusing Population
• Learn About Developing, Collecting and Using
Outcome Data
• Have the Opportunity to Ask Questions
The Road Map
• El Paso County Recognized a Need For
Specialized Services For Substance Involved
Families
– Many Children Were Entering Foster Care and
Not Returning Home
– Fragmented Response to Cases By All Systems
Involved
• Initial Work Group
– Financial Situation Stopped Meetings
– Brought in Savio Direct Link
– Identified Joint Service Management Partners
• 4th Judicial District, DHS, TANF, Savio and Connect
Care
Reasoning Behind Building The
Partnership
• Why Each System Was Identified and
Brought to the Table
• Each System Was Asked to Bring Resources
–
–
–
–
–
Connect Care – Dedicated a Staff Member
TANF – Assigned a Worker
DHS – Re-Assigned Staff
Savio – Had the Model, Hired and Trained Staff
Court – Dedicated Docket Time
Doing Business Differently…
• Joint Service Management Requires
Different Participation by Each Member
• Traditionally Services are Fragmented
• JSM Partners are Jointly Responsible for….
–
–
–
–
Program Design and Development
Continuous Quality Improvement
Case and Program Outcomes
Collection and Reporting of Data
Making It Work
• Systemic Problems We Addressed Head On
– Some of the JSM Partners were Competitors –
This Was Shift In Their Relationship
– Getting Judicial On Board – Changing Standard
Practice
– Developing Trust and Cooperation Within The
Treatment Team
• Setting a Start Date
– Ready, Start, Aim…
– It’s Important Not To Just Plan Forever –
Nothing Would Ever Start
Entrance Criteria
• Referred Through DHS Intake
• Substance Abuse Primary Concern
• One Child Under the Age of 12
– Focus on EPP Population
• At Least One Parent Willing To Participate
• Violent Offenders EXCLUDED
• Children Would Have Been Placed Were It
Not For This Intervention
Referral Process
• DHS Intake Worker Checks With DHS
Gatekeeper
• Refers to Savio Direct Link
– Intensive In-Home Services Begin Immediately
•
•
•
•
•
•
OCA Flags Case
D&N Filed
FTDC Counsel Appointed at Filing
Waiver Provided To Family
Pre-Trial In Front Of FTDC Magistrate
Family Enters or Returns To Regular Docket
System
Program Capacity
DHS Dedicated 52 Savio Direct Link Slots To
FTDC
• Average Length of Stay 7.5 Months
– Annually Serving 83 Families
• Will Use Outcomes to Promote Program
Sustainability
Treatment Philosophy
Strength Based
with An Emphasis on
Motivational Interviewing*
*William Miller and Stephen
Rollnick (1991). New York: Guilford
Phases of Treatment
• There are Four Phases of Treatment
–
–
–
–
Orientation
Achieving Sobriety
Treatment
After Care Planning and Treatment Completion
• These are Designed to Follow the Treatment
Process
• Behaviorally Anchored to Make Advancement
and Regression Consistent
• All Phases are Tied Into The Treatment
Model
Phase O Orientation
•
•
•
•
•
•
•
•
•
•
•
Two to Four Weeks
Sign Waiver
Begin 3 Times Per Week Drug Screening
Received Sanctions, Rewards & Tx Responses
Provided FGC Information
Has Every Choice You Make Notebook
Has Treatment Team List & Phone Numbers
Began Parenting Skills Enhancement Program
Signed and Following Safety Plan
Attendance At Court
Met With Savio Worker for Required Time
Phase 1 Achieving Sobriety
• Minimum of 30 Days
• Completed Assessment (3 Drug Screens)
• 30 Consecutive Days of:
–
–
–
–
Clean Drug Screens
Attendance At Court
Attendance At Treatment Support
Meeting With Savio Worker for Required Time
• Completed Substance Abuse Treatment Intake and
Began Treatment
• Treatment Plan Developed and Adopted by Court
(Dispositional Hearing)
• CAC Completed
• Attend and Participate in FGC
• Signed IRC (If Applicable)
Phase 2 Treatment
• Four to Six Months
• 90 Consecutive Days of:
–
–
–
–
–
–
Clean Drug Screens
Attendance At Court
Attendance At Treatment Support
Meeting With Savio Worker for Required Time
Compliance with Visitation
Following IRC
• 120 Consecutive Days Attendance at Substance
Abuse Treatment
• Complete 10 of 12 Parenting Classes
• Attendance and Participation in FGC
• Improvement on CAC
Phase 3 After Care
Treatment Completion
• 30 Consecutive Days of:
– Attendance at Court Hearings
– Attendance at Treatment Support
– Meeting with Savio Worker for Required Time
• Successful Completion of Court Ordered
Treatment Plan
• Presentation and Acceptance of Relapse
Prevention/After Care Plan
• Demonstrate Ability to Be Self-Sufficient
• Improvement on CAC (Elimination of Safety
Concerns)
Phase Advancement and
Regression
• Participants Advance When Phase
Advancement Requirements are Met - These
are Behaviorally Anchored
• Participants Regress When They Receive
Three Sanctions in a 60 Day Period - Again
Behaviorally Anchored
Rewards, Sanctions and
Treatment Response
• Each Identified Behavior Will Have A Sanction
Or Reward & Treatment Response
• Rewards Will Occur Regularly Throughout The
Treatment Process (Every Choice You Make
Program) & In Court
• Sanctions Are Given During Each Court Hearing
and on A Graduated Scale
• Sanctionable Offenses are Outlined in The FTDC
Waiver
• Offenses are Cumulative From Acceptance Into
FTDC Through Graduation
• Participants will Receive One Sanction or Reward
Per Court Hearing (Highest Offense)
• The Focus is On Supporting The Change Process
Court Rewards
• Clean, No Missed or Dilute Drug Screening
• Presentation and Acceptance of Relapse
Prevention Plan to Treatment Team
• Successful Completion of Substance Abuse
Treatment
• Phase Completion
• Improvement on Colorado Assessment
Continuum
• More to Come Re: Every Choice You Make
Program
Court Sanctions
Sanctionable Offenses
• Positive Drug Screens
–
–
–
–
Admission Prior to Result
Admission After Result
Denial
Missed or Dilute
• Failure to Appear in Court
• Failure to Meet with Savio Worker
Useful Community Service
• Participants Will Be Sentenced to Useful
Community Service
• They Must Complete The Hours Prior to
Next Court Date (Or Deadline Given in
Court)
• Participants Will Be Given a List of Agencies
Where They Can Complete the Sentence
• If The Participant Chooses Not To Complete
The Community Service - They Will Serve
The Corresponding Number of Days in Jail
Jail Time
• Credit is Given To Participants For Being
Honest About Drug Use
• Jail Time Is Not Given For First Positive
Drug Screen
• Will Be Used For Failure to Attend
Substance Abuse Treatment More Quickly
Than Positive Drug Screen (Emphasis on
Importance of Treatment)
• Will Be Used for Failure to Meet With Savio
Worker
Treatment Focused
Implementation
• The Treatment Team Wants to Acknowledge
The Process of Treatment and Recovery and
Will Only Regress Participants for Having
Three Violations in a 60 Day Period
• The Treatment Team Will Also Take Into
Consideration Confirmable, Reasonable,
Mitigating Circumstance Prior to Imposing A
Sanction
Outcomes?
• What Are Outcomes?
• Why Track Them?
• How Are They Utilized?
• Why Are They Valuable at Every
Level of Service Delivery?
• How Do They Impact Daily
Practice?
Family Treatment Drug Court
2003 Outcomes Summary
• 46 Families Served
– 83 Adults
– 95 Children
• 13 Families Discharge
– 25 Adults
– 31 Children
• Average Length of Stay 7.5 Months
• 87% of Children Were At Home or With Kin
At Discharge
• 13 % Were Non-Relative Adoption
• 100% Were In Permanent Homes At The
Time of Discharge
Creative Funding During Fiscally
Challenging Times
• Need Support of Top Administration
• These Families Are Being Served Somehow
Within The System
• Sometimes Intervention is More Costly UpFront
• Managing Funding Creatively
• Search For Grant Funding
• Develop Collaborative Partnerships With
Equal Investment
Some Resources
• Substance Abuse and Mental Health
Association (SAMHSA)
– www.samhsa.gov
• Bureau of Justice Assistance & Office of
Justice Programs Drug Courts Programs
Office
– www.ojp.usdoj.gov
• National Council of Juvenile and Family Court
Judges
– www.ncjfcj.org
Questions and Answers