1. 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

2. 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:

3. Five Components of Reform 1.Comprehensive cross-system joint training 2.Substance Abuse Treatment System of Care 3.Early Intervention Specialists 4.Recovery Management Specialists (STARS) 5.Dependency Drug Court Reforms have been implemented over the past eleven years Sacramento County’s Comprehensive Reform

4. Five Components of Sacramento County’s Comprehensive Reform  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 1. Comprehensive cross-system joint training

5. 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

6. 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

7. 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

8. 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 Five Components of Sacramento County’s Comprehensive Reform

9. 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

10. Jurisdiction & Disposition Hearings Detention Hearing Child in Custody STARS Voluntary Participation STARS Court Ordered Participation Sacramento County Dependency Drug Court Model Level 1 DDC Hearings 30 Days 60 Days 90 Days Level 3 Monthly Hearings Level 2 Weekly or Bi-Weekly Hearings 180 Days Graduation Early Intervention Specialist (EIS) Assessment & Referral to STARS Court Ordered to STARS & 90 Days of DDC

11. 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

13. 1. Child Protective Services Division 2. Alcohol and Drug Services Division Child demographics Child demographics Parent demographics Parent demographics Child placements Child placements Child reunifications Child reunifications Subsequent referrals Subsequent referrals Court orders Court orders EIS system statistics EIS system statistics Preliminary Assessments Preliminary Assessments STARS intake log STARS intake log STARS twice monthlies STARS twice monthlies California Alcohol & Drug Data System (CADDS)-now CalOMS California Alcohol & Drug Data System (CADDS)-now CalOMS CADDS supplemental data CADDS supplemental data DDC court hearings DDC court hearings Multiple Data Sources  3. Juvenile and Dependency Court  Monthly system statistics

15. Participant Groups ParentsChildren Comparison111173 Year 1 DDC 324432 Year 2 DDC 249429 Year 3 DDC 274485 Year 4 DDC 449741 Year 5 DDC 442731

16. Parents and Children in the Evaluation 24Mos12Mos24Mos24Mos24Mos

17. 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%)

18. 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

19. 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  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

20. Baseline Characteristics with Significant Gender Differences **p<.01; ***p<.001

21. Primary Drug Problem by Gender *p<.05; **p<.01, ***p<.001

22. Treatment Admission Rates*** ***p<.001

23. Gender Differences in Treatment Admission Rates*** ***p<.001

24. Mean Number of Treatment Admissions*** ***p<.001

25. Gender Differences in Mean Number of Treatment Admissions** **p<.01

26. Treatment Modality*** ***p<.001; no gender differences were found in terms of treatment modality

27. Average Days Per Treatment Episode* * p<.05

28. Average Days Per Treatment Episode by Gender*** *** p<.001

29. Treatment Discharge Status* * p<.05 ; no gender differences were found in terms of discharge status

30. Treatment Discharge Status by Primary Drug Problem*** ***p<.001

31. 12-Month Child Placement Outcomes **p<.01; ***p<.001

32. Time to Reunification at 12 Months n.s.

33. 24-Month Child Placement Outcomes **p<.01; ***p<.001

34. Time to Reunification at 24 Months n.s.

35. 24-Month Child Placement Outcomes by Parent Primary Drug Problem *p<.05 ***p<.001

36. 24-Month Child Placement Outcomes by Race/Ethnicity of the Child **p<.01; ***p<.001

37. Recidivism Rates

38. 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

39. Summary – Sample Description Sacramento DDC clients are predominantly women with an average age of 32 Sacramento DDC clients are predominantly women with an average age of 32 More than half reported methamphetamine as their primary drug problem More than half reported methamphetamine as their primary drug problem Generally have low education attainment and are largely unemployed Generally have low education attainment and are largely unemployed Almost 32% reported a disability at treatment entry and almost 31% reported a history of chronic mental illness Almost 32% reported a disability at treatment entry and almost 31% reported a history of chronic mental illness Gender differences were found in regard to all baseline characteristics Gender differences were found in regard to all baseline characteristics

40. Summary – Treatment Outcomes  Significantly more court-ordered parents entered treatment  They had significantly more treatment admissions  They averaged less time per treatment episode  They received more intensive levels of treatment  They completed more treatment episodes than the comparison group  Gender differences were observed in all of the above areas except in regard to treatment modality (intensity of treatment) and discharge status  Differences in discharge status were observed in regard to the parent’s primary drug problem

41. Summary – Case Resolution  Court-ordered children were more likely to reunify than comparison children  Comparison group children were more likely to be in adoption, guardianship or long-term placement and less likely to be in continued reunification services at 12 and 24 months than the court-ordered children.  There were no cohort differences in time to reunification at 12 or 24 months  Child placement outcomes varied by the parent’s primary drug problem and the child’s race/ethnicity  Rates of recidivism for both groups were extremely low

42. Summary – Cost Savings  The drug court created considerable savings and cost offsets of foster care funds