Transcript SACRAMENTO COUNTY DEPENDENCY DRUG COURT …

Research Findings from the Sacramento
County Dependency Drug Court: Systems
Changes and its Impact on Permanency
Sharon M. Boles, Ph.D.
Nancy K. Young, Ph.D.
Children and Family Futures
February 1, 2007
Anaheim, CA
Children and Family Futures
4940 Irvine Boulevard, Suite 202
Irvine, CA 92620
714.505.3525 Fax 714.505.3626
www.cffutures.com
Sacramento County Statistics
 Sacramento County population: 1.5 million
 In 2004, there were approximately 7,000
substantiated child abuse/neglect referrals, in
Sacramento.1
 Approximately 60% of child welfare cases in
Sacramento involve families affected by substance
use
1. Needell, B., Webster, D., Armijo, M., Lee, S., Cuccaro-Alamin, S., Shaw, T., Dawson, W., Piccus,
W., Magruder, J., Exel, M., Conley, A., Smith, J., Dunn, A., Frerer, K., Putnam Hornstein, E., &
Kaczorowski, M.R., (2006). Child Welfare Services Reports for California. Retrieved May 1, 2006,
from University of California at Berkeley Center for Social Services Research website. URL:
<http://cssr.berkeley.edu/CWSCMSreports/>
Sacramento County’s Comprehensive
Reform
Five Components of Reform
1.
2.
3.
4.
5.
Comprehensive cross-system joint training
Substance Abuse Treatment System of Care
Early Intervention Specialists
Recovery Management Specialists (STARS)
Dependency Drug Court
Reforms have been implemented over the past eleven
years
Five Components of Sacramento County’s
Comprehensive Reform
1. Comprehensive cross-system joint training
 Three Levels of Training
 AOD basics for all staff – 4 days required
 AOD screening, brief intervention, motivational
enhancement and AOD treatment – 4 days
required of all case carrying workers
 Group intervention skills – 4 days required of all
ADS staff and voluntary for any CPS division staff
Five Components of Sacramento County’s
Comprehensive Reform
2. Substance abuse treatment system of care
 Child welfare clients have priority access to
treatment
 Immediate access to substance abuse services
 Group services expansion and implementation of
pre-treatment groups
Five Components of Sacramento County’s
Comprehensive Reform
3. Early Intervention Specialists
 Review of every court petition to determine if
substance use disorders may be present
 Immediate access to intervention and assessment
at court hearings
 Immediate authorization of publicly-funded
treatment services
Five Components of Sacramento County’s
Comprehensive Reform
4. Recovery Management Specialists (STARS)
 Motivational enhancement
 Gender-specific services
 Immediate access to recovery management and
treatment services
 Provider orientation of providing hope and
accountability
 Compliance monitoring—twice monthlies
Five Components of Sacramento County’s
Comprehensive Reform
5. Dependency Drug Court
Parallel system to dependency petition
Non-adversarial approach
30, 60 and 90-day compliance hearings
Structured incentives for compliance and sanctions
for non-compliance
 Voluntary participation in on-going services
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

Models of Family Drug Treatment Courts
The Sacramento Initiative added a third primary model of family drug
courts to the two previously described in the literature. The three models
are:
 Integrated (e.g., Santa Clara, Reno, Suffolk)
 Both dependency matters and recovery management conducted in the same court
with the same judicial officer
 Dual Track (e.g., San Diego)
 Dependency matters and recovery management conducted in same court with same
judicial officer during initial phase
 If parent is noncompliant with court orders, parent may be offered DDC participation
and case may be transferred to a specialized judicial officer who increases monitoring
of compliance and manages only the recovery aspects of the case
 Parallel (e.g., Sacramento)
 Dependency matters are heard on a regular family court docket
 Specialized court services offered before noncompliance occurs
 Compliance reviews and recovery management heard by a specialized court officer
Sacramento County
Dependency Drug
Court Model
Level 1
DDC
Hearings
Level 3
Monthly Hearings
30
Days
60
Days
90
Days
180 Days
Graduation
Level 2
Child in
Custody
Detention
Hearing
Jurisdiction
& Disposition
Hearings
Early Intervention Specialist
(EIS) Assessment &
Referral to STARS
STARS
Voluntary
Participation
Weekly or Bi-Weekly
Hearings
Court Ordered to
STARS & 90 Days of DDC
STARS
Court Ordered
Participation
Sacramento County Prior to
Dependency Drug Court
 18.5% reunification rate
 Parents unable to access AOD treatment
 Social workers, attorneys, courts often uninformed on
parent progress
 Drug testing not uniform and results often delayed
Evaluation Conceptual Model
System
• Environment and
Context of
Partner Agencies
– Treatment
– CWS
– Court
Family
• Strengths &
Needs
• AOD Severity
• CW Risks
Key Outcomes
• Treatment
–
DDC Program
• Court
oversight
• Intensive
case
supervision
• Treatment
linkages
• Systems’
Collaboration
–
–
–
–
•
Child Welfare
Services
–
–
•
Access to
Treatment
Engagement
Retention
Completion
Functional Status
Safety
Permanence
Dependency Court
–
–
–
Case Resolution
Compliance with
statutory timelines
Nature of Court
Hearings
Multiple Data Sources
1. Child Protective Services Division






Child demographics
Parent demographics
Child placements
Child reunifications
Subsequent referrals
Court orders
 3. Juvenile and Dependency Court
 Monthly system statistics
2. Alcohol and Drug Services
Division
EIS system statistics
Preliminary Assessments
STARS intake log
STARS twice monthlies
California Alcohol & Drug Data
System (CADDS)-now CalOMS
 CADDS supplemental data
 DDC court hearings


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
Participant Groups
Parents
Children
Comparison
111
173
Year 1 DDC
324
432
Year 2 DDC
249
429
Year 3 DDC
274
485
Year 4 DDC
449
741
Year 5 DDC
442
731
Parents and Children in the Evaluation
1000
900
800
700
600
500
400
300
200
100
0
24
Mos
24
Mos
24
Mos
24
Mos
12
Mos
741
485
432
429
324
249
173
449
731
442
274
111
Comparison
DDC YR 1
DDC YR 2
Parents
DDC YR 3
Children
DDC YR 4
DDC YR 5
Child Demographic Characteristics
 2991 children: 173 comparison, 2818 DDC
 Overall, 51.4% were girls and 48.6% were boys





46.7% Caucasian
27.9% African American
20.4% Hispanic
3.2% Asian/Pacific Islander
1.8 % American Indian/Alaskan Native
 There were no cohort differences in terms of gender
 There were significantly more American Indian/Alaskan
Native children in the comparison group (4.6%) than the
DDC group (1.6%)
Parent Demographic Characteristics
 1849 participants: 111 comparison, 1738 DDC
 Overall, 70.0% of the participants were women,
approximately 32 years of age






52.0% Caucasian
20.2% Hispanic
20.0% African American
3.0% American Indian/Alaskan Native
3.0% Asian/Pacific Islander
1.7% “other”
 There were no cohort differences in terms of gender
or race/ethnicity
Parent Baseline Characteristics
84.2% were unemployed,
46.0% had less than a high school education
22.0% were pregnant at treatment admission
30.9% reported a disability impairment
30.7% reported being diagnosed with chronic mental
illness
 41.1% were homeless at treatment admission
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
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 50.8% reported methamphetamine as their primary drug
problem, 18.0% marijuana, 16.3% alcohol, 9.5%
cocaine/crack, 2.5% heroin
 There were no cohort differences in any of these variables
 Gender differences were found with all of the baseline
characteristics
Baseline Characteristics with Significant
Gender Differences
100
Percent
80
87.8
74.4
60
48.4
44.4
39.6
40
38.1
34.1
32.3
22.0
20
0
12.7
Unemployed*** Less than a High
Disability
School
Impairment***
Education**
**p<.01; ***p<.001
Men (n=414)
Chronic Mental
Illness***
Women (n=1118)
Homeless***
Primary Drug Problem by Gender
80
Percent
60
52.4
46.4
40
22.2
20
21.0 16.9
14.0
2.4
6.0
2.5
10.7
0
Heroin
Alcohol***
Methamphetamine*
Men (n=414)
*p<.05; **p<.01, ***p<.001
Cocaine**
Women (n=1118)
Marijuana
Treatment Admission Rates***
84.8
100
80
Percent
53.2
60
40
20
0
Comparison (n=111)
***p<.001
DDC (n=1738)
Gender Differences in Treatment Admission
Rates***
86.7
100
73.9
Percent
80
60
40
20
0
Men (n=560)
***p<.001
Women (n=1289)
Mean Number of Treatment Admissions***
2.9
3
Number
2.5
2
1.4
1.5
1
0.5
0
Comparison (n=59)
***p<.001
DDC (n=1738)
Gender Differences in Mean Number of Treatment
Admissions**
2.8
3
Number
2.5
2
1.5
1.5
1
0.5
0
Men (n=414)
**p<.01
Women (n=1118)
Treatment Modality***
100
80
72.2
Percent
57.1
60
42.9
27.8
40
20
0
Outpatient
Comparison (n=158)
Residential
DDC (n=4177)
***p<.001; no gender differences were found in terms of treatment
modality
Average Days Per Treatment Episode*
150
114.5
85.0
Days
100
50
0
Comparison (n=59)
* p<.05
DDC (n=1333)
Average Days Per Treatment Episode by
Gender***
150
99.2
81.9
Days
100
50
0
Men (n=352)
*** p<.001
Women (n=1040)
Treatment Discharge Status*
100
80
65.1
Percent
56.8
60
43.2
34.9
40
20
0
Satisfactory
Comparison (n=146)
Unsatisfactory
DDC (n=3725)
* p<.05; no gender differences were found in terms of discharge status
Treatment Discharge Status by Primary
Drug Problem***
80
71.3
66.1
60.2
Percent
60
61.9
50.3
49.7
39.8
40
28.7
33.9
20
0
Satisfactory
Heroin (n=181)
Methamphetamine (n=2039)
Marijuana (n=465)
***p<.001
Unsatisfactory
Alcohol (n=623)
Cocaine/Crack (n=465)
38.1
12-Month Child Placement Outcomes
50
35.3
Percent
40
30.6
30
18.5
24.9
21.1
20
19.7
13.3
10
9.8
3.1
3.4
0
Reunification***
Adoption**
Guardianship***
Continued
Reunification
Services***
Comparison (n=173) DDC (n=2087)
**p<.01; ***p<.001
Long-Term
Placement***
Time to Reunification at 12 Months
250
210.8
193.6
Days
200
150
100
50
0
Comparison (n=32)
n.s.
DDC (n=736)
24-Month Child Placement Outcomes
80
Percent
60
43.6
40
27.2
31.8
22.6
14.0
13.3
20
4.5
1.7
18.5
3.3
0
Reunification***
**p<.01; ***p<.001
Adoption**
Guardianship***
Continued
Reunification
Services***
Comparison (n=173) DDC (n=1346)
Long-Term
Placement***
Time to Reunification at 24 Months
350
300.7
280.8
300
Days
250
200
150
100
50
0
Comparison (n=47)
n.s.
DDC (n=587)
24-Month Child Placement Outcomes
by Parent Primary Drug Problem
80
Percent
60
40
20
0
Reunification*
Adoption***
Heroin (n=39)
Cocaine/crack (n=177)
*p<.05 ***p<.001
Guardianship
Alcohol (n=232)
Marijuana (n=246)
Continued
Reunification
Services*
Long-Term
Placement*
Methamphetamine (n=763)
24-Month Child Placement Outcomes
by Race/Ethnicity of the Child
48.5
50
42.8
40
Percent
33.2
30
24.8 24.9
23.1
20
14.2
10
6.0
7.1
13.8
6.5
7.1
4.6
5.4
3.2
0
Reunification***
Adoption
African American (n=416)
**p<.01; ***p<.001
Guardianship
Continued
Reunification
Services**
Hispanic (n=309)
Long-Term
Placement
Caucasian (n=739)
Percent
Recidivism Rates
10
9
8
7
6
5
4
3
2
1
0
6.1
1.1
0.0
Comparison
Court Ordered
National
Standard
24-Month Cost Savings Due to
Increased Reunification Rates
Preliminary Findings
 Takes into account the reunification rates, time of out-of-home
care, time to reunification, and cost per month
 27.2% - Reunification rate for comparison group children
 43.6% - Reunification rate for court-ordered DDC group children
 221 Additional DDC children reunified
 33.1 – Average months in out-of-home care for comparison group
children
 9.4 - Average months to reunification for court-ordered DDC
children
 23.7 month differential
 $10,049,036 Estimated Savings in Out-of-Home care costs