1. Parental Substance Abuse and Child Welfare: Promising Programs for Early Intervention and Permanency Claire Houston S.J.D. Candidate, Harvard Law School

2. Objectives Discuss entry issues related to parental substance abuse Focus: referral requirement under Child Abuse Prevention and Treatment Act (CAPTA) (2003 and 2010 amendments) Secondary focus: Family Drug Treatment Courts targeting substance-exposed infants

3. Parental Substance Abuse and Child Maltreatment Significant problem for child welfare system Prevalence: Related to 60% of abuse and neglect 50-79% of children taken into foster care Poor outcomes for children: Enter care at a younger age Stay in foster care system longer Lower rates of reunification More likely to re-enter child welfare system following reunification Substance-exposed infants fare worse

4. Substance-Abusing Parents Have Multiple Problems Co-occurring problems: poverty, mental health issues/past trauma, domestic violence, low educational achievement Access to treatment issues Difficulties with treatment enrollment and retention Relapse common

5. Reports to Child Welfare  Allegation of abuse or neglect  Substance-exposed infants (SEI’s) CAPTA: required referral for any infant, “identified as being affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure or Fetal Alcohol Spectrum Disorder”

6. Reporting Substance- Exposed Infants (CAPTA) Rationale: “identify infants at risk of child abuse and neglect so appropriate services can be delivered to the infant and mother to provide for the safety of the child” Tool for early intervention – prevent maltreatment

7. Problems with CAPTA  Alcohol provision limited  Does not establish definition of child abuse Limits CPS involvement At least 15 states define prenatal substance exposure as abuse or neglect  “Identification” issue

8. Under-reporting and Biased Reporting (CAPTA) Inadequacies in screening Risk of under-reporting Inconsistencies in testing (among hospitals, within hospitals) Risk of biased reporting Risk of under-reporting of non-minority infants Best option: legally mandated, universal testing

9. Family Drug Treatment Courts (FDTC’s) Aims:  Get parent off drugs, deal with co-occurring problems Collaboration with treatment providers Monitor compliance  Promote faster permanency for children

10. FDTC’s as a Tool of Early Intervention? Traditional FDTC Intervene once maltreatment has occurred FDTC’s geared at substance-exposed infants Intervene prior to maltreatment Work with hospitals, CPS – reporting key Problems with CAPTA may limit the ability of these courts to prevent maltreatment

11. Questions or comments can be directed to: Claire Houston chouston@sjd.law.harvard.edu