Texas Partnership for Family Recovery

From www.dshs.state.tx.us/sa/txpartnership

In 2003, the Department of State Health Services (DSHS) took the lead in submitting a collaborative application to the National Center on Substance Abuse & Child Welfare (NCSACW) for technical assistance (TA) to integrate judicial, substance abuse and child welfare services. The other participating agencies were: Texas Court Appointed Special Advocates for Children (TX CASA), Department of Family and Protective Services (DFPS), Office of Court Administration (OCA) and the Court Improvement Project (CIP).

Funded by the Administration for Children & Families and the Center for Substance Abuse Treatment, the National Center on Substance Abuse & Child Welfare (www.ncsacw.gov) focuses upon systems integration and service coordination for families with substance abuse problems who are involved with the child welfare system. The NCSACW provided a preparatory year of technical assistance support. The first year is followed by a 15 month period of in-depth technical assistance (IDTA).

The Texas Project is entitled the Texas Partnership for Family Recovery. The three systems – judicial, child protection and substance abuse – are working together to achieve systems integration and coordination for the benefit of children and families.

An Executive Committee comprised of Deputy Commissioner Dave Wanser, DSHS; Assistant Commissioner Joyce James (DFPS), Executive Directors Carl Reynolds (OCA) and Joe Gagan (TX CASA) provides project oversight. A Core Team, which is composed of staff from the participating agencies, is responsible for project organization and coordination.

The Core Team Members provide support to an Advisory Committee of representatives from each of the systems. The first Advisory Committee meeting of the Texas Partnership was held May 1-2, 2006 in Austin. At this meeting the committee created product workgroups and developed the basic plans for the upcoming 15 months of the IDTA. They plan to complete the Funding/Resources Plan by January 31, 2007; the Practice Protocol and the Stakeholder Marketing Plan by March 31, 2007; and the Cross-Systems Training Delivery Plan by April 15, 2007. All documents will be submitted to the partner agency heads for sign off. Initial implementation of each of these plans will begin during the IDTA period which will end July 31, 2007.

The Advisory Committee has defined the Texas Partnership’s priority population as families, defined broadly, affected by alcohol and other drugs (AOD) involved with child protective services. The ultimate goal is to build a sustainable, family focused, integrated behavioral health service system that will strengthen, stabilize and unify families involved with the child welfare system. The Advisory Committee mission is:

To reduce the number of children in out of home placements, shorten time in care, and increase the number of children successfully reunited with families by building and sustaining integrated and coordinated substance abuse and mental health services, policies, protocols and tools for children and families who are involved with the judicial and Child Protective Services (CPS) systems due to substance use/abuse or mental health disorders.

To do so, the Advisory Committee has identified the following major products for completion during the IDTA

• Practice Protocols
• Evaluation, Marketing and Sustainability Plans
• Cross-Systems Training Delivery Plan

The Texas Partnership Advisory Committee is also working with Tarrant and Nueces Counties to support and participate in the development and implementation of a Family Drug Treatment Court. The partnership opportunities these joint efforts provide will help define, refine and define the differing roles of the state agencies, local communities, courts and direct service providers. While the in-depth TA will provide protocols, evaluation and training plans, each community will want and need to adapt the models to their own resources, cultures and goals.

To enhance and support the initiative, the Center for Substance Abuse Treatment (CSATS) is sponsoring a special training opportunity for substance abuse and mental health providers as well as for CPS, TX CASA and the judiciary. The training is on Trauma Informed Services for adults and children. This modality is evidence based and represents the Best Practice in working with mental health and substance abuse. Behavioral health providers and clinicians, CPS managers and staff, TX CASA directors and volunteers along with some judges have been invited to attend the four day workshop. The first two days of the training is designed to inform managers and clinicians on how to establish a trauma informed agency, environment and service. The third and fourth days for clinicians and will provide training in the Seeking Safety treatment model for women and on Skills-Based Intervention for Children Ages 5 to 10 years, in Families with Substance Abuse, Mental Illness, and Trauma. This training will, it is hoped, be a first step towards developing Trauma Informed Behavioral Health Services on a statewide basis.

More about the Texas Partnership for Family Recovery, a collaborative project of the Department of State Heath Services (DSHS), Office of Court Administration (OCA), Department of Family & Protective Services (DFPS), the Court Improvement Project (CIP) and Texas Court Appointed Special Advocates for Children (TX CASA):

Background

The Texas IDTA Project is taking place during a period of major transition that has included the consolidation of mental health, substance abuse and health agencies. The legacy child protection and substance abuse agencies began collaborating to integrate and coordinate the judicial, child protective and substance abuse systems prior to consolidation. The service integration and coordination efforts have been strengthened by agency mergers. These changes provide a strong foundation for the Texas Partnership for Family Recovery initiative, while simultaneously presenting challenges.

Texas has been engaged in major child welfare reform as a result of Senate Bill (SB) 6 passed in 2005. SB 6 mandates outsourcing of all substitute care and case management services, reducing investigated caseloads, reducing the response time for reports of abuse and neglect, a strengthened, forensic-based approach to investigations, establishment of a medical home for children in foster care, increased collaboration with law enforcement and foster care eligibility and services to youth transitioning to independent living. In addition, separate legislation, House Bill (HB) 10, provides additional funds for more investigative caseworkers, specialized professional and support staff, increased funds for prevention and early intervention programs, better training and salaries for investigative workers, and planning and evaluation for outsourcing. Outsourcing will be phased in from FY06 – FY12.

The Department of State Health Services (DSHS) is involved in several related initiatives to further transform service systems in Texas. Specifically, DSHS has an Access to Recovery (ATR) grant that provides families involved with CPS with recovery support services. Other discretionary awards to DSHS include: a Mental Health Transformation Grant, a State Improvement Grant for Co-Occurring Disorders and a Screening, Brief Intervention, Referral and Treatment grant.

The Children’s Justice Court Improvement Project (CIP) brings together substance abuse, the judicial and child welfare systems. The CIP has been central to the State’s ability to address a broad range of issues and systemic obstacles to the investigative, administrative and judicial handling of child abuse cases. CIP is working with the 231 judges in the state who hear child protection cases to promote and support the development of Family Drug Treatment Courts.

Texas CASA has been active in Texas since 1981 and now has 63 local CASA programs. CASA volunteers are advocates for the best interest of abused and neglected children in the court system. CASA will be helping to upgrade and enhance substance abuse training for volunteers working with children whose families need integrated services.

The Office of Court Administration oversees the Child Protection Courts that evolved from the CIP’s Rural Cluster Court Initiative that was originally developed to improve family court services in small and more isolated communities. The OCA is taking the lead in helping the Texas Partnership to work with the Child Protection Court judges to design, develop and implement integrated systems.

Issues and Goals for Technical Assistance

The key issues facing Texas in the provision of this technical assistance are:

• Establishing a systematic approach and protocol for collaboration among child welfare, substance abuse and the legal system
• Establishing communication systems and improving screening and assessment so that retention, impact and outcome information needed by all three systems is collected and shared in a timely manner
• Determining how to establish systems that are family centered and accommodate often inconsistent and/or competing timeframes across systems
• Identifying opportunities for maximizing available resources, including leveraging and combining funds
• Developing an effective statewide cross-training and/or integrated training initiative
• Developing a plan to sustain the effort

Expected Outcomes

As a result of this technical assistance, the State team will be prepared to guide and support efforts at the local level to assure safety, permanency and wellbeing for children in families with alcohol and other drug problems. Specifically:

• The lead State agencies will have a shared understanding of the importance and intended outcome of this work. This shared understanding will be supported by working agreements that delineate who is responsible for what tasks, individually and collectively.
• Protocols will be implemented that reflect a collaborative, integrated approach in support of families to meet their needs most effectively.
• Participating counties and local agencies will receive guidance and training to support the implementation of collaborative strategies to support families and engage them in the most appropriate service available to address their needs, build on their strengths, expedite referrals and deliver services in the most respectful manner.
• Cross-system information-sharing will facilitate collaboration, improve service delivery and opportunities to leverage and share resources.
• A comprehensive inventory and analysis of Federal, State and local funding and other resources will facilitate sustainable funding policies and practices in support of systems integration and the implementation of proven effective programs and practices.

Deliverables and Products

The following three products will be developed over the course of the IDTA effort:

Product 1: Practice Protocol

A Practice Protocol that provides minimum guidelines for statewide implementation that (a) for each system, defines parameters for cross-system collaboration in the best interest of the child’s safety and well-being and (b) is respectful of parents rights. The Protocol will address, but not be limited to, the following:

• Identifies the shared goal/joint outcome for all systems, i.e., reunification, family wellbeing
• Guidance to child welfare providers on criteria to screen out substance use disorders; this will be included on the referral, progress and follow-up form(s)
• Investigative, screening, referral, progress and follow-up forms to include information on in utero ATOD exposure.
• Guidance for substance abuse providers on screening for child safety/risk and how to report child abuse and neglect, with appropriate systems coordination so that such reporting does not jeopardize the client’s recovery.
• Defines the roles and responsibilities of parent attorneys, children’s attorneys, prosecutors, guardian’s ad litem (GAL) and the judiciary in implementing the protocol.
• Coordinated case planning, assessment, referral & engagement processes and tools that look at the entire family.
• Evidence-based AOD prevention, intervention and treatment practices for every member of the family (including all of the children, foster and adoptive placements, relative caregivers) and their individual needs (including medical, developmental, neurological, psychological and emotional).
• Confidentiality guidelines and templates
• Accessing recovery supports and building them into the service planning process, including child care, transportation, housing, employment, parenting education.
• Accessing appropriate services for FASD and other ATOD related developmental delays.
• Evaluation of activities, processes and outcomes.
• A clear communication pathway describing what information needs to be collected and flow to whom, when and for what purpose, through all three systems so as to ensure complete and timely information sharing.
• Includes a glossary of terms.

Product 2: Evaluation, Sustainability and Marketing Plan

Develop a communication and sustainability plan, which will include social marketing strategies, to maximize cross-system communication and participation in support of the Texas Partnership for Family Recovery. Each component of the plan will contain recommendations for policy, improving cross-system coordination, resources and data system implications and needs. The plan will include the following:

• Memorandum of Understanding among the OCA, CIP, DSHS, CASA, DFPS that reflects shared values and guiding principles and defines joint outcomes.
• Overall, providing recommendations as to how to ensure that the Texas Partnership initiative is to be initiated and will be institutionalized in terms of structure, policy and practice. These recommendations will include strategic, long-term recommendations, including the need for capacity assessment and plans for identifying and filling service gaps.
• An evaluation plan that will define what to measure, including both process and product elements.
• A funding/resource collaboration plan and recommendations that address both private and public entities, opportunities for resource sharing, current resources and funding sources/parameters for accessing funding, analysis of overlap, gaps and limitations
• A stakeholder marketing plan addressing various audiences (policy makers, local jurisdictions, legal/judicial groups, fund sources, general public, consumers, taxpayers, system staff, lead agencies, providers) that addresses audience-specific messages and defines the communication mechanism, venues, timeframes and plans.
• Data guidance that identifies gaps and limitations, definitions, elements, processes and defines the implications for what is needed in order to ensure sustainability.
• Collecting and disseminating information about Family Drug Courts in Texas to inform expansion efforts and activities.

Product 3: Cross-system Training Plan

Design strategies to strengthen, enhance and improve legal, judicial, child welfare and substance abuse professional training, as well as training and educational resources provided to families and caregivers, using family focused strategies to enhance content, delivery and participation. Steps in developing these training strategies will include:

• A template for information gathering to assure uniformity, consistency and relevancy.
• Gather information on the required training in each discipline, opportunities for training in each discipline, who sets training requirements, training resources for each (e.g., caseworker training, bar association CLE), and sources of funds for each.
• Analysis of gathered information using a taxonomic method that identifies essential elements/best practices to be included in training, where training already exists and the gaps.
• Recommendations for strategies to meet the goal of strengthening professional/staff training and family training and educational resources
• Develop training and delivery plan – a strategic plan to implement the recommendations, supporting implementation training for the Practice Protocol (Product 1).

For more information on the National Center on Substance Abuse and Child Welfare (NCSACW), visit http://www.ncsacw.samhsa.gov/. The NCSACW offers web based training, service integration models and current research information on families and substance abuse.

Other excellent web based resources:

• Children & Family Futures: http://www.cffutures.com/
• Abandoned Infants Association: http://aia.berkeley.edu
• Child Welfare League of America: http://www.cwla.org/
• National Center on Addiction & Substance Abuse: http://www.casacolumbia.org/absolutenm/templates/Home.aspx