A Successful Collaboration A Successful Collaboration Among SystemsAmong Systems::

El Paso County Family Treatment Drug El Paso County Family Treatment Drug Court:Court:

A Program Model A Program Model

Putting the Pieces Together: 1st National Conference on Substance Abuse, Child

Welfare and Dependency CourtJuly 14 – 15, 2004 Baltimore, MD

Julia L. Polland, MA, LPC, CACIIISavio Child Protection Coordinator

Shirley Rhodus, MSWEPC DHS Child Protection Administrator

Welcome and Introductions

Who’s In The Room?Name…

System…Job Responsibility…

Expectations…

CONFERENCE CONFERENCE LEARNING OBJECTIVESLEARNING OBJECTIVES

Participants Will…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

• 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

Doing Business Differently…

Making It WorkMaking 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 CriteriaEntrance 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 CapacityProgram 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

*William Miller and Stephen Rollnick (1991). New York: Guilford Press

Treatment PhilosophyTreatment Philosophy

Strength Based with An Emphasis on

Motivational Interviewing*

Phases of TreatmentPhases 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 - Phase O - OrientationOrientation

• 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 - Phase 1 - Achieving SobrietyAchieving 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 - Phase 2 - TreatmentTreatment

• 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 - Phase 3 - After CareAfter Care

Treatment CompletionTreatment 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 Phase Advancement and RegressionRegression

• 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 Rewards, Sanctions and Treatment and Treatment

ResponseResponse

• 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 RewardsCourt 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 SanctionsCourt SanctionsSanctionable OffensesSanctionable 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 ServiceUseful 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 TimeJail 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 Treatment Focused ImplementationImplementation

• 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 Court2003 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

Up-Front• Managing Funding Creatively• Search For Grant Funding• Develop Collaborative Partnerships With

Equal Investment

Some ResourcesSome 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 AnswersQuestions and Answers