1. Integrating Substance Abuse Competency Within A Child Welfare System Kim Bishop-Stevens LICSW Loretta Butehorn PhD Jan-Feb 2007

2. Child Abuse and Neglect and Substance Abuse 8.3. million children with substance abusing parent 50% of cases in care substance impaired 52% out of home placement due to substance abuse -2001 Child Welfare League of America

3. Why we’re here

4. Massachusetts Child Welfare System State run system 6 Regional Offices with 29 Area Offices 3,500 Staff Yearly Budget $700 Million Serving 23,000 Families 75,000 Total Consumers 40,000 Children

5. 1998 Project on Addressing Substance Abuse DSS-MA Charge to build a system wide capacity to respond Via -Substance Abuse Unit -Standardized screening -Monthly case consultation -Increased training -Urine testing protocol -Cross systems collaboration

6. Substance Abuse Unit 2000 - 1 person 2001 - 2 people 2005 Central Office Unit and 1 person per 6 Regions of State

7. Structural and Staffing Choices Central and Regional hiring and supervision Hired seasoned substance abuse professionals Cross trained them in child welfare

8. Unit members Skill set Paradigm Shift from Clinical to Systemic Perspective Group Process

9. Goals 1.Assess current capacity 2.Build capacity a. Knowledge base b. Identify key collaborators within system c. Develop strong relationship with community partners

10. Stage of Development of Unit Process Team building Group process Content Integrating child welfare perspective into a clinical substance abuse treatment perspective Single/double loop learning

11. Clinical Development Child welfare expertise Skill development in training Consultation skill set Collaboration with internal and external peers Systemic sophistication

12. When does substance use=child abuse/neglect? When Does Substance Use=Abuse/neglect Of children AOD Impairment Special Needs Of child Bonding of parent and child Support system Poverty MH/DV Needs Of Parent Strengths of Parents Hx of Rx Stage of change Age of child Level of parent l insight into risk factors Harm reduction strategies

13. Theoretical model How long does it take to think it though Capacity building: where is work coming from, what info is not overwhelming Stages of change with service planning Does change happen in supervision, case conference, training, language use

14. Initial goals: enter system and form relationships Internal goals: building competence External goals: building collaboratives Substance Abuse Unit

15. System Shifts 2000 Substance Abuse Unit formed 2001 Commissioner initiates Core Values 2002 Family Networks Planning 2002 Child Welfare Institute 2003 Program Improvement Plan Developed 2003 Continuous Quality Improvement 2004 Teaming Pilots Initiated 2004 Division of Policy and Planning

16. System Shifts 2004 Working with Families Right from the Start 2005 Family Recovery Collaborative 2005 Substance Abuse Unit Expanded-1 person per region 2006 Family Networks Implemented 2007 Co-Directors of Integrated Practice

17. CORE VALUES Family Networks Substance Abuse Unit Formed WWFRFS Family Collaborative

18. Core Values Child Driven Family Centered Community Focused Strength Based Committed to Diversity/Cultural Competence Committed to Continuous Learning

19. Family Recovery Collaborative NCSACW Technical Assistance Partnership between State Agencies, Courts and Tribe Products Memorandum of Understanding Shared Principles and Values Draft Communication Protocol Development of Engagement Model

20. Integrated Practice Mental Health Issues Domestic Violence Substance Abuse

21. PRACTICE POINT Family Networks Child Welfare Institute Family Engagement And Teaming CQI CORE VALUES DISPROPORTIONALITY ADOLESCENT PERMANENCY

22. The future