Women’s Treatment and Resources Christine K. Scalise, MA, LPC, LCADC Office of Treatment and Recovery Supports Manager, Special Populations Unit

Overview - DAS Single State Agency for substance abuse in New Jersey, and as such, plans, licenses, monitors and regulates New Jersey substance abuse treatment and prevention efforts Provides funding for services through both Federal and State funding streams, with primary funding source being the Substance Abuse Prevention and Treatment Block Grant, which totals approximately $47 million annually Total budget of $162 million for SFY 2011

Substance Abuse - Treatment Need and Demand 6,589,930 Million Adult NJ Residents No need for treatment – 5,772,779 Need for treatment – 817,151 (12.3%) Demand treatment – 86,866 (10.6%) Met demand – 53,586 (62%) Unmet demand – 33,280 (38%)

Parent / pregnant women Primary Drug Using Cocaine 13% Alcohol 29% Heroin/Other Opiates 41% Marijuana 77% 23% Non Smoke Smoke

Level of Care Distribution PPW

Women and Substance Abuse Substance Abuse and Mental Health Services Administration (SAMHSA) Office of Applied Studies: 5.5% of women ages 18 – 49 who have one or more children living with them are substance abusers 70% of women entering treatment report having children 30% of the more than 13,000 treatment programs in the USA offer specialty programs for women; 14% offer programs for pregnant women

Federal Block Grant Women’s Set Aside Requirements Primary medical care while in treatment includes prenatal and child care Primary pediatric care including immunizations Gender specific substance abuse treatment & other therapeutic interventions that may address relationship issues, sexual and physical abuse and parenting & child care while women are receiving these services Therapeutic interventions for children in custody of women in treatment which may address their developmental needs, issues of sexual and physical abuse & neglect Case management and transportation services

Treatment Providers Priority Services for Pregnant and Parenting Women Provide support during a women’s recovery process Priority access for pregnant client Awareness of funding sources Resources/information on available services Linking, coordination and collaboration with Social Services DYFS Federally Qualified Health Care (FQHC) Perinatal Addiction Coordinators/Specialists

NJ Treatment Providers Block Grant Requirements When treatment facility is full – referral must be made to another facility or make interim services available (not later than 48 hours i.e., counseling and education about HIV and TB, risks of needle sharing, transmission, perinatal addiction, referrals for prenatal care, to outpatient programs in area until admitted to an appropriate level of care If all facilities are full, facility will refer to the contracted State hotline and/or County Drug and Alcohol Coordinator, who assists in referring to a treatment facility with the capacity to provide treatment services.

DAS Funding for Pregnant and Parenting Women $6 million funding through Federal Block Grant Women’s Set Aside for pregnant and parenting women $12 million State funding women with children under DYFS supervision (Child Welfare) Funding supports a statewide network of 48 licensed substance abuse treatment providers for all modalities of care (IOP, IOP with Housing, Methadone IOP, LTR, HH) Pregnant women have priority admission

Parenting Women - Barriers to Treatment PERSONAL BARRIERS: Fear of Reprisal from Significant Others or Family Members Confidentiality concerns Linguistic or Cultural Barriers Social Stigma Fear of Child Protection Involvement (DYFS) Financial (lack of money, insurance)

Barriers to Treatment (cont) SYSTEMS BARRIERS: Lack of money or insurance Waiting lists Lack of treatment for pregnant women Childcare Employment Housing Need for time to address demands of other systems i.e., DYFS, TANF, Courts

NJ - Women’s Treatment Program Requirements Gender specific therapies Assessment and treatment for co-occurring disorders Family centered treatment approach Individual and family counseling sessions Trauma Informed/Trauma Specific treatment using “Seeking Safety Program” Strengthening Families Program Group and educational counseling sessions Case management services Physical examination/medical assessment including TB testing as required Acknowledgment of HIV counseling and testing; must offer women on-site HIV counseling and testing

NJ Women’s Treatment Program Requirements (Cont) Childcare – while women are in treatment to focus on developmental needs and age appropriate activities Children referred for medical (including immunization and/or psychological care as needed) Primary medical care including referral and linking woman to prenatal care Evidence based Parenting Skills Curriculum Life Skills Training (budgeting, nutrition, household, child safety) Linkages, Recovery Management and supports Housing support and assistance, helping women with children access permanent housing Transportation

SAMHSA/CSAT “Guidance to the States” Document outlines specific recommendations for women in criminal justice system, women and children and pregnant women 25 service elements emphasize Best Practice Looks at full continuum of treatment needs for women throughout their lifespan Help States develop women’s treatment standards to build on capabilities and strengths in State system

“Guidance to the States” (Cont) Family Centered Treatment Approach - addresses full range of women’s needs with an array of: Clinical Treatment Services – core services addresses medical/bio-psychosocial issues of addiction; Clinical Support Services –assist clients to maintain recovery i.e., life skills, linkages, coordinate services with collateral agencies, child development, employment readiness, housing support (includes primary health care often provided at start) Community Support Services – services/resources outside treatment but within the community that is support system for recovering woman and her family

In-Depth Technical Assistance National Center of Substance Abuse and Child Welfare through SAMHSA/CSAT and ACF Improve outcomes for substance abusing families involved with child welfare and courts Joint Initiative – DYFS, DAS and AOC Develop cross system partnerships & practice changes Data integration Best Practice Models across 3 systems Professional Training & Staff Development Recovery Support Specialists

Contact Information Christine K. Scalise, MA, LPC, LCADC Department of Human Services Division of Addiction Services PO Box 362 120 South Stockton Street Trenton, NJ 08625 Christine.scalise@dhs.state.nj.us