Transcript Developing Cross-Systems Training Plans

The Family Wellness Court
for Infants and Toddlers
Judge Erica Yew
Santa Clara County Superior Court
In partnership with Cynthia Ambar, MPA, Project Director
Santa Clara County Social Services Agency
And First 5 of Santa Clara County
FWC Overview
 An expansion and enhancement of
existing child welfare dependency drug
court with a child focus
 Target population: Pregnant women and
parents, with children 0 to 3, whose
abuse of methamphetamine and other
substances have placed their children in
or at risk of out-of-home placement.
FWC Primary Partners
 Social Services Agency (SSA), SSA’s Department of
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Family and Children’s Services and SSA’s County
Counsel
Superior Court
LACY (children’s attorneys)
Dependency Advocacy Center (parent ‘s attorneys)
Department of Drug and Alcohol Services
County Mental Health
FIRST 5 Santa Clara County
Primary FWC Goals (1)
 Early identification of and intervention
for the needs of pregnant women and
parents with substance use disorders.
 Rapid engagement and successful
retention in treatment and care
 Reduction in subsequent positive tox
births
Primary FWC Goals (2)
 Early identification and intervention for
developmental delays, disabilities and
concerns for children 0-3 whose parents come
before the FWC
 Creation of a comprehensive System of Care
across all systems serving children in or at risk
of out-of-home placement as a result of
parents’ methamphetamine and other
substance abuse
FWC Eligibility Criteria
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The parent has given birth to an infant that has
been exposed to methamphetamine or other
substance abuse during the pregnancy; OR
The parent has a child under the age of three
that was either born drug exposed or has been
raised in a substance abuse afflicted
environment with documented abuse and/or
neglect; AND
The parent does not demonstrate intractable
mental health issues as presented in the filed
petition; AND
The parent is not likely to face long term
incarceration
Rationale for Child Focus
 Substance exposed high risk for
developmental and behavioral concerns
 Effectiveness of early intervention
 Improvements in overall family functioning
and relationships
 CAPTA requirements for early intervention
services, such as screening for substance
abuse
FWC Customer Characteristics
 “Fast-track” cases
 History of child welfare system involvement as
children
 Prior cases in CWS, many with prior termination
of parental rights
 Extensive trauma history
 Extremely low income
 Homeless or living in substandard housing
 Methamphetamine primary drug of choice
FWC Services (1)
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Therapeutic court environment, with regular reviews
Case management
Legal representation
Early drug and alcohol assessment and treatment
Residential inpatient-treatment for women; and for
women with their children
Mentor Parent support
Domestic violence advocacy and services
Transportation assistance (bus tokens, bus passes for
their children, bicycles, cab vouchers, gas money, out of
county bus passes, car seats)
Linkages to shelter and housing
FWC Services (2)
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Limited funding to assist with barriers to
case plan completion
Linkages to employment and benefits
services, record clearance
Coordination with Criminal Court partners
Therapeutic services, dyadic and PCIT
included
Pregnancy prevention education
Comprehensive developmental and
behavioral screening, assessment and
interventions for all children
Child appointed special advocates (CASA’s)
for many children
FWC Services (3)
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Linkage to health coverage and primary care
physicians
Access to a wide array of parenting
workshops
Home visitation and Public Health Nurses
Early care and education services
GED assistance
Language assistance
Oral health care for children and some
limited dental services for adults
Tattoo removal and MORE….
Children’s Services Overview
 Funded by FIRST 5 Santa Clara County
 Medi-Cal/EPSDT is leveraged
 MHSA (Prop 63), County General Fund and
reimbursement via public children’s insurance
programs are also utilized for Mental Health
services
 System of Care: Tiered system based on level of
need as determined by screening and
assessments utilizing standardized tools and
evidence-based practices
Assessing For and Addressing
Developmental and Behavioral Concerns
 ASQ/ASQ-SE
(Social Emotional)
screening
 Level 1 assessment
(based on concerns identified
 Level 2 assessment
(based on concerns identified
by ASQ/ASQ-SE)
by ASQ/ASQ-SE)
 MDT
meeting to discuss
results, make recommendations
 Referrals for community interventions
as indicated
(Multi-Disciplinary Team)
Promoting Bonding and
Attachment
 Parenting curriculums that include
children and parent/child interactions
 Home visitation
 Supervised visitation
 Dr. T. Berry Brazelton’s Touchpoints
 Child Appointed Special Advocates in a
new role
Addressing Mental Health
Needs
 Early Childhood Mental Health Specialist on
FWC court team
 Therapeutic services that include:
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Parent-Child Interactive Therapy (PCIT)
Cognitive Behavioral Therapy (CBT)
Trauma-focused cognitive behavioral therapy (TF
CBT)
Trauma-Focused Play Therapy
Dyadic (Child/Parent Psychotherapy)
The Incredible Years
Duration of Services
 Services initiated at dependency hearing
 Services continue until child welfare case closed
 Aftercare program in development, continued
mentor involvement, recovery mentors, stepped
down recovery support, alumni events,
continuation of CASA services, continued mental
health counseling for parent and child, in-home
support services, parenting classes
 Customized aftercare packet upon dismissal
ceremony with Solidarity bracelet, phone card,
FWC Team and community resources, photo with
team in engraved frame, motivational card
FWC Hearings (1)
 Hearings may occur daily, weekly, twice a
month or once monthly depending on
parent progress
 Staffings are held with the court team
prior to the hearing to discuss case
progress, concerns and develop joint
recommendations
 Incentives or Sanctions may be given
FWC Hearings (2)
 Strength-based therapeutic court
environment
 Parents are given positive feedback on
progress and areas of non-compliance
are addressed
 Providers problem solve with client to
identify and address needs
FWC Hearings (3)
 “When I went to court, I always had a
voice. I didn’t just sit and get talked
about, I wasn’t just talked about from
different views. I actually was given a
choice, ‘Do you have any concerns?
Anything that you need?’ I was given a
chance, so I should to speak up and not
be over looked and talked about among
everybody.”
Family Team Meetings
 Purpose is to develop the child welfare
case plan in a strength-based environment
with input from family and friends, SW
and FWC Team
 Scheduled between jurisdiction and
disposition hearings
 Ultimate goals are to enable children to
remain at home with extra support and to
give the family an active role in
developing their case plan
Engaging Fathers
 Equal focus on parents
 Court environment
 Men’s treatment counselors
 Mentor Father
 Male THU in which fathers and their
children can remain together
Working with Trauma
 FWC values statement includes trauma-
informed system
 Commitments by Partner Agencies
 Provider education
 Continual system assessment and
modification
 Trauma specific services-DADS seeking
safety, Mental Health trauma based
cognitive behavioral therapy
FWC Funding (1)
 Awarded $3.7 million over five years
 $6.3 million total with First 5 match
 Grant funds Project Director, mentors,
AOD assessor and counselor, mental
health child specialist, court coordinator
and training, onsite drug monitoring,
short-term strategic planning and
evaluation
 Evaluation >10% of project budget
FWC Funding (2)
 Enhanced model required an additional
annual contribution of more than
$500,000 for direct client services,
many provided by one-time funding
 Additional positions include parent
therapist, mentor father, part-time
psychiatrist, men’s treatment
counselors and eligibility worker
Implementation
 March 14, 2008
 105 Families, 141 parents (with 90 being actively
engaged) and 179 children served as of August 2009.
 14 cases dismissed, 11 reunifications and three TPR
(78%) successful. Two of the three TPR’s had open
cases prior to FWC enrollment. (State 37%, County
44%, DDTC 76% with non-fast track cases)
 Target population expanded to include fathers,
regardless of maternal involvement
 No subsequent pos-tox births (despite many births)
Sustainability (1)
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Inventory existing funding streams
Identify gaps in funding or capacity issues in
the service array
Identifying opportunities for systems
integration/coordination, maximization of
current leverage funding streams, and
identification of funding steams that could be
easily accessed to maintain the existing
program
Implementation of governance structure that
provides for top-down/bottom-up
information exchange and decision-making
Sustainability (2)
 Identifying potential long term means
to fund the program such as legislative
initiatives, grant applications and
seeking philanthropic support
 Ensuring families are linked to all
benefits for which they qualify, in
particular CalWORKS
 Cost analysis to demonstrate long-term
cost savings
Sustainability (3)
 Making children in care a local funding priority
 Reprioritization of drug treatment slots
 Judicial advocacy for restoration of treatment
services
 Sharing resources among County depts
 Convening and partnering with service providers
with needed resources
Primary Keys to Success
 Commitment at highest agency administrative
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levels
Shared values
Passion and commitment of involved staff
Comprehensive service model
Service model that evolves as additional client
needs are identified
Incorporation of the parents’ voices (through
mentors and the actual parents before the
court)
Promoting the parent-baby bond
Primary Challenges
 Sustainability of enhanced model in an
environment of budget cuts
 Multiple and complex needs of clients,
in particular housing and selfsufficiency, such as employment
 Information sharing and data collection
without a centralized database
 Assessor funding years 3-5
Why Problem Solving Courts Work
 “What was beneficial for me was the
encouragement that they [FWC] give you. They
give you so much encouragement and
acknowledge every good thing you do. I got teary
eyed every time they would acknowledge me for
all the good that I’ve done, you know, the hard
work. I overcame the hard stuff in my life. Now
it’s getting easier and easier. They acknowledge
every single thing, too. And that’s what makes
me want to go on more. It encouraged me to do
good things, because I’m getting acknowledged
by these people in the court.”
Why Problem Solving Courts Work
 People want to do better, but don’t believe
they can
 The human spirit is strong
 Genuine, constant positive regard penetrates
pain and builds trust
 Don’t discount “bribery” or the power of
incentives
 People love their children
QUESTIONS?
 Please contact Melanie Daraio, Community
Progam Manager, FIRST 5 of Santa Clara
County
 Email address: [email protected]
 Website: www.first5kids.org