Presentation on theme: "Findings from the Illinois IV-E AODA Waiver"— Presentation transcript:
1Findings from the Illinois IV-E AODA Waiver Children and FamilyResearch CenterFindings from the Illinois IV-E AODA WaiverState Liaison Officers’ Grantee MeetingPortland, ORApril 17, 2007Presenter:Ms. Rosie Gianforte, LCSWIllinois Department of Children and Family Services
2Illinois IV-E AODA Waiver Demonstration The Illinois Department of Children and Family Services received approval from the U.S. Department of Health and Human Services (HHS) beginning in April 2000 to waive certain restrictions on the use of federal IV-B and IV-E funds to facilitate the demonstration of new approaches to the delivery of child welfare services.The waiver allows the Department to provide enhanced alcohol and other drug abuse services to DCFS involved placement families in the Cook County catchment area.
3Impact of AODA on DCFS Court Cases GAO Report 1998 74% of Cook County DCFS cases had 1 or more parent required to get AOD treatment82% of mothers AOD histories greater than 5 years (41% > 10 years)> 80% were primary heroin or cocaine abusersChild welfare agencies had limited familiarity with AODA resources making admissions lowJudges reported permanency decisions delayed due to lack of information on treatment progress
4Foundations of the Waiver Project – Built on Existing Relationships Existing DASA/DCFS Initiative Services, 1995Full range of treatment servicesExpedited assessment and admissionRemoval of barriers to treatment, I.e. childcare and transportationJuvenile Court Assessment Project, 1999On site assessment services at Juvenile CourtStandardized assessment (DSM IV-R & ASAM)Same day referral to treatmentProvide courts assessment results
5Illinois IV-E AODA Waiver Project Goals Increase the number of AODA impacted foster care children that are safely reunifiedDecrease the length of time it takes for safe reunification of AODA foster care casesIncrease the number of cases and the speed at which AODA impacted cases are moved to a permanency decisionIncrease the number of DCFS involved individuals referred to AODA that remain in treatment for at least 90 daysReduce the number of subsequent oral reports (SOR) of child abuse and neglect
6Eligibility and Random Assignment Just extended the number of days for eligibility to 180 days from TCRandom assignment conducted based on the agency/team servicing the parent.
7Recovery Coach Role Contracted through an independent agency (TASC) Recovery Coaches:Assist the parent(s) in obtaining AODA treatment services and negotiating departmental and judicial requirements associated with AODA recovery and permanency planningWork in collaboration with the Child Welfare worker, AODA treatment provider and extended family members to bridge service gapsProvide specialized outreach, intensive AODA case management & support services throughout the life of the case, before, during, and after treatment & reunification
8Specific Recovery Coach Interventions Coordinate AOD planning efforts, arrange staffings, participate in family meetingsProvide ongoing assertive outreach and re-engagement efforts, i.e.…transportation to initial intake appointmentAssist in removing any barriers in engaging, retaining and re-engaging parents who have discontinued treatmentProvide ongoing assessments to evaluate the need for mental health, parenting, housing, domestic violence and family support servicesUrinalysis testingStandardized, regular (monthly) reporting to worker & the courts
10The Recovery Coach Profile Recovery Coach Credentials:Certified Alcohol & Drug Counselors (CADC)Certified Assessment & Referral Specialists (CARS)Some experience in Child WelfareBachelor Level Degree – Human Services FieldSupervised by Master Level Degree with Child Welfare & Substance Abuse ExperienceCaseloads: Average clients
11Evaluation of the Demonstration Eligibility: (1) foster care cases opened after April 2000, and (2) parents must be assessed at the Juvenile Court Assessment Program (JCAP) within 90 days of the temporary custody hearingAssignment: Substance abusing caregivers were randomly assigned to either the control (regular services) or demonstration groupTreatment: Parents in the demonstration group received regular services plus intensive case management in the form of a Recovery Coach
12Evaluation of the Demonstration Research QuestionsAre parents in the demonstration group more likely to access AODA treatment services compared with parents in the control group?Do parents in the demonstration group access AODA treatment services more quickly compared with parents in the control group?Are families in the demonstration group more likely to achieve family reunification and/or permanence compared with families in the control group?Are families in the demonstration group less likely to be associated with subsequent reports of maltreatment?Is the waiver demonstration cost neutral?
13Evaluation of the Demonstration Parent Characteristics As of June 30, 2006, 496 parents in control group (790 children) and 1,347 parents in the demonstration group (1,894 children).Parent CharacteristicsDemoControlAfrican American83%80%White11%14%Unemployed75%72%Previous Substance Exposed Infant66%64%Age of Youngest Parent3536Primary Drug Cocaine36%35%Primary Drug Heroin24%Primary Drug Alcohol18%19%
14Treatment Participation Control = 52% Demonstration = 71% Data from three sources: caseworkers, AODA treatment providers and recovery coaches
16Family Reunification & Permanence Group Assignment by Permanency Status (child level) as of June 2005Living Arrangement TypeControlDemonstrationHome of Parent105 (13%)298 (17%)Home of Adoptive Parent131 (17%)309 (16%)Subsidized Guardianship61 (7.2%)132 (7%)Permanency Totals297 (37%)739 (40%)The difference between the proportion of children returning home isstatistically significant
18Subsequent Reports of Maltreatment Group Assignment Subsequent Reports totalsNo YesControl 255 (70%) 111 (30%) 366Demonstration 706 (75%) 237 (25%) 943Totals 961 (73%) 348 (27%) 1309 (100%)The difference between the proportion of subsequent reports between the Control and Demo groups is statistically significant.As of June 200514% vs. 19% if we included all subsequent SEIs…..ones that occur only days after entering the demonstration waiver.
19Subsequent Substance Exposed Infants (SEI) Group Assignment Subsequent SEI totalsNo YesControl 210 (80%) 51 (20%) 261Demonstration 579 (86%) 91 (14%) 670Totals 789 (85%) 142 (15%) 931 (100%)The difference between the proportion of subsequent SEI births between the Control and Demo groups is statistically significant.As of June 200514% vs. 19% if we included all subsequent SEIs…..ones that occur only days after entering the demonstration waiver.
21Additional Findings of Interest Domestic Violence 30%Mental Health 40%Housing 56%ReunificationSubstance AbuseTreatmentRecovery Coach
22Problems indicated by Caseworker Enter page title here!Co-occurring Problems and ReunificationThe Problems and the Progress are ImportantProblems indicated by CaseworkerNot ReunifiedReunifiedTotalsSubstance abuse only79%21%8%One additional problem89%11%30%Two additional problems88%12%35%Three additional problems27%100%
23Co-occurring Problems and Reunification The Problems and the Progress are ImportantProblem Area% progressNot ReunifiedReunifiedSubstance AbuseComplete18%74%26%Substantial24%87%13%Reasonable effort15%91%9%Unsatisfactory43%93%7%Domestic Violence75%25%76%90%10%58%95%5%
24Co-occurring Problems and Reunification The Problems and the Progress are ImportantProblem Area% progressNot ReunifiedReunifiedHousingComplete10%69%31%Substantial13%83%17%Reasonable effort22%88%12%Unsatisfactory55%93%7%Mental Health5%58%42%18%20%92%8%56%
25Findings from Multivariate Models Families unable to make sufficient progress in SA are 42% less likely to achieve reunificationFamilies unable to make sufficient progress in DV are 53% less likely to achieve reunificationFamilies unable to make sufficient progress in MH are 39% less likely to achieve reunificationNo significant effect associate with housing
26Conclusions:Families involved with the AODA waiver report a variety of co-occurring problems.These problems decrease the likelihood of reunification.Yet – when progress is achieved – the likelihood of achieving family reunification is significantly increased – especially with regard to MH and DV.IV-E Extension: Integrated service model designed to increase treatment access and reunification targeting services to specific problem areas such as Domestic Violence, Mental Health and Housing.
27Lessons Learned Outreach and early engagement are critical Data systems and data collection aren’t exciting but they can be invaluableThe job of project awareness is never doneSeemingly unimportant factors can kill the project
28Lessons Learned (continued) Juvenile Court Assessment Program (JCAP) – the project’s “secret weapon”Evolution of Recovery Coaches from generalists to more specialized rolesImportance of Recovery Coach’s independenceStability through the processAlly for the parentDriving force for system collaboration
29Project Extension-Cook County Focus on co-occurring problemsHousing – provide housing resources and advocates to assist in securing safe homes.Mental health – Implement a MH screen to assist in securing necessary services to address needs.Domestic violence – collaborate with case worker to identify needs and secure appropriate services.Stabilize families in drug free housingTransition to subsidized and independentEducation/vocational supports to recovery
30Project Extension-Downstate Expansion to 2 downstate countiesAssessment & Recovery Coach services to less urban less centralized settingIntegrate drug court model into processConfront methamphetamine abuse and production in rural populations