Regional Partnership Grant Program Update

AIA/SEN Grantees’ Meeting

Ken DeCerchio, MSW. CAP

Children and Family Futures

A Program of the

Substance Abuse and Mental Health Services AdministrationCenter for Substance Abuse Treatment

and the

Administration on Children, Youth and FamiliesChildren’s Bureau

Office on Child Abuse and Neglect

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Why Partner ?

• Needs of families are more complex and require multiple system responses

• Achieve better outcomes

• Broaden the base of community support

• Maximize existing and generate additional resources

Responding to CFSR: Making the Case for

Partnerships

Percent and Number of Children with Terminated Parental Rightsby Reason for Removal -- 2007

0 10 20 30 40 50 60 70 80 90 100

Reliquishment (n=6,203)

Child Disability (n=7,438)

Child Alcohol or Drug Abuse (n=7,672)

Parent Incarceration (n=9,922)

Child Behavior (n=10,250)

Abandonment (n=10,280)

Sexual Abuse (n=10,764)

Inadequate Housing (n=19,992)

Physical Abuse (n=26,002)

Parent Unable to Cope (n=30,896)

Parent Alcohol or Drug Abuse (n=46,622)

Neglect (n=90,020)

Source: Boles, S. (2010). Data analysis of the 2007 Adoption and Foster Care Analysis and Reporting System (AFCARS) data set. Unpublished data.

The Regional Partnership Grant (RPG) Program

Cross-systems partnerships designed to improve the safety, permanency and

well-being of children affected by parental substance use

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Background of the RPG Program

• Authorized by the Child and Family Services Improvement Act of 2006

• 53 regional partnership grants awarded by ACF in September 2007

• Improve the safety, permanency and well-being of children affected by methamphetamine and other substance abuse

• Address a variety of common systemic and practice challenges that are barriers to optimal child, adult and family outcomes

Regional Partnership Grants

Regional Partnership Grants = 53 Sites

Array of Services - 11

Child Focused – 8

Drug Courts – 10

System-Wide Collaboration – 9

Treatment Focused – 9

Tribal - 6

NCSACW IDTA Sites = 20 Sites

16 States (NE & KY Pending) 3 Tribal Communities

1 County

14 OJJDP Sites

NCSACW In-Depth Technical Assistance Sites Children’s Bureau Regional Partnership Grants

OJJDP Family Drug Courts

US DEPARTMENT OF HEALTH AND HUMAN SERVICESSubstance Abuse and Mental Health Services AdministrationAdministration for Children and Familieswww.samhsa.gov

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Five Broad Program Strategy Areas(and selected examples of specific grantee activities)

• Systems Collaboration and Improvements– Cross-systems training

– Cross-systems information-sharing and data collection

– Intensive coordinated case management

– Family Group Decision Making

• Substance Abuse Treatment Linkages and Services– Improved substance abuse screening and assessment

– Specialized outreach, engagement and retention

– Family-centered treatment for parents with children

• Services for Children and Youth– Early intervention and developmental services

– Trauma and other therapeutic services

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Five Broad Program Strategy Areas(and selected examples of specific grantee activities)

• Clinical and Community Support Services for Children, Parents and Families– Parenting education and family strengthening programs

– Continuing care and recovery support services

– Housing, child care, transportation and other ancillary services

– Mental health and trauma-specific services

• Expanded Capacity to Provide Treatment and Services to Families– Implementation of new and/or expansion and enhancement of

existing Family Treatment Drug Courts (FTDCs)

– Increased number of residential treatment beds for parents

– Co-located and out-stationed staff

SYSTEMS CHANGES

Organizational and Other Strategies

Training

Substance Abuse Training/Education for Foster

Care Parents

Partnership Meetings

Regular Program/

Administrative Meetings

SYSTEMS COLLABORATION

Formal Cross-Systems Policies and ProceduresInformation Sharing and Data Analysis

Increased Service Capacity

Initial Program Activities Program Services/Strategies

Inputs Outputs Outcomes

Family Enters Community

Services

Family Enters AOD Treatment

Family Enters CW System

Family Enters RPG

Family Court

Family DrugCourt

SHORT TERM

C1. Children Remain at Home

C2. Occurrence of Maltreatment

C3. Length of Stay in Foster Care

C7. Prevention of Substance-Exposed Newborns

C9. Child Well-Being

A1. Access to Treatment

A2. Retention in Substance Abuse Treatment

A3. Substance Use

A5. Employment

A6. Criminal Behavior

A7. Mental Health Status

F1. Parenting

F2. Family Relationships/ Functioning

F3. Risk/Protective Factors

R1. Collaborative Capacity

LONG TERM

C3. Length of Stay in Foster Care

C4. Re-entries to Foster Care

C5. Timeliness of Reunification

C6. Timeliness of Permanency

A3. Substance Use

A5. Employment

A6. Criminal Behavior

A7. Mental Health Status

R1. Collaborative Capacity

COMMUNITY SERVICES

Parent Supportive Services:• Primary Medical Care• Dental Care• Mental Health

Services• Child Care• Transportation• Housing• Parenting

Training/Child Development Education

• Domestic Violence• Employment Training• Continuing

Care/Recovery Support

• Alternative Therapies

Child Supportive Services:• Developmental

Services• Mental Health

Services• Primary Pediatric

Care• Substance Abuse

Prevention and Treatment

• Educational Services

ADULT SERVICES

Assessment of Service Needs

Coordinated Case Management Wrap Around

In-Home ServicesSubstance Abuse

Treatment Family-Centered

TreatmentParents Connected to

Support ServicesCognitive/Behavioral/ Therapeutic Strategies

Judicial Oversight

CHILD/YOUTH SERVICES

Assessment of Service Needs

Coordinated Case Management Wrap Around

In-Home ServicesSubstance Abuse

Treatment Family-Centered

TreatmentChildren Connected to

Support Services

RPG SC Data Analysis Logic Model

Tools for Partnerships

The 10 Elements of System Linkages

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10-Element Framework of Systems Linkages

• Method to organize collaborative activities in specific practice and policy areas– Defines key elements of collaboration– Describes components of an initiative

• Provides systematic way to assess effectiveness of collaborative work– Assists in measuring their implementation– Helps assess progress in building stronger cross-

systems linkages and where those linkages are most effective

Outcomes

10. Shared Outcomes and Systems Reforms

System Elements

6. Information Systems 7. Training and System Tools 8. Budget and Sustainability 9. Working with Other Agencies

Children, Family, Tribal, and Community Services2. Screening and

Assessment3. Engagement and

Retention 4. Services for Children 5. Community and Family Support

Mission

1. Underlying Values and Priorities

Elements of System LinkagesThe Ten Key Bridges

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Collaborative Practice and Policy Tools

Ten Element Framework – A method to organize collaborative activities in specific practice and policy areas

Collaborative Values Inventory – An anonymous way to explore values and beliefs to facilitate the development of common principles using web-based data collection

Collaborative Capacity Instrument – An anonymous way to assess the strengths and challenges in each of the areas of system linkages using web-based data collection

Matrix of Progress in System Linkages – A practice-based approach that specifies characteristics of advance collaboration practice in the elements of system linkages

Screening and Assessment for Family Engagement, Retention and Recovery — SAFERR -- A guidebook to develop effective communication across systems while engaging families in services

Early Lessons from the RPG Program

Successes and Challenges of Cross-Systems Collaborations

(Year Two)

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Percentage of RPGs Experiencing Greatest Accomplishments and Challenges in

Key Collaborative Areas in Year 2

Building Community SupportsWorking w/Related AgenciesStaff Training/Development

Budget/SustainabilityJoint Accountability/Shared Outcomes

Info Sharing/Data SystemsChildren's Services

Engagement/RetentionScreening/Assessment

Collaborative Values

0 10 20 30 40 50 60 70

21

23

21

25

32

43

9

43

28

38

43

32

51

25

26

21

28

66

28

62

Accomplishment Challenge

Perc

ent (

N=5

3 gr

ante

es)

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Collaborative Values and Principles – Accomplishments

• Nearly two-thirds (62 percent) identified accomplishments in developing and/or strengthening underlying collaborative values and principles, such as:

– Conducted case file review to understand services provided to families and identify ways to improve coordination between substance abuse treatment providers and child welfare

– Implemented discharge criteria to ensure a more uniform approach across partners to discharging cases

– Developed a cross-systems communication plan to establish consistent language and terminology across systems and a clear message for families

– Developed interagency MOU to prioritize services for families involved in child welfare system due to parental substance abuse

– Changed culture and focus of the systems from looking solely at the deficits of families to identifying their strengths as well

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Collaborative Values and Principles – Challenges

• Yet more than one-third of grantees (38 percent) also experienced challenges in the area of collaborative values and principles, such as:

– Involvement of substance abuse agency, child welfare agency, courts or community providers on a case-by-case basis and only when a referral is necessary

– Lack of understanding of how the RPG program and partnership fit into the bigger systems picture

– Lack of cooperation and involvement of major partners and lack of clear roles and responsibilities among partners

– Limited or ineffective communication between RPG staff and dependency and drug court judges and differing beliefs about whether reunification is in the child’s best interest

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Working with Other Agencies and Building Community Supports – Accomplishments

• 43 percent of grantees noted advancements in building community supports, while 32 percent experienced successes in working with related agencies

– Worked with the housing authority to complete a housing feasibility study that resulted in stronger agency relationships and the provision of Family Unification Program housing vouchers for 100 RPG clients

– Increased collaboration with community agencies that led to RPG representation on several community boards and expanded collaboration with partners in a neighboring county

– Used parents’ digital stories as a social marketing strategy to facilitate greater community awareness, interest, involvement and support

– Established partnerships with local community colleges to provide job training/work readiness programs

Accomplishments in these areas are critical to securing additional core and supportive services that clients need to succeed both while in the

RPG program and when they are discharged or graduate

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Working with Other Agencies and Building Community Supports – Challenges

• Challenges experienced by grantees in working with other agencies and building community supports include:

– The need to clarify and better articulate the RPG program model before trying to engage other systems

– Overcoming community concerns/skepticism regarding hiring of Family/Peer Mentors who have prior history of substance abuse and child welfare involvement

– The RPG lead agency lacking the credibility or recognition needed to engage other State or community agencies

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Collaborative Relationships – Key Themes/Lessons

• Collaboration takes time and is developmental and iterative in nature

• Collaboration needs to occur at multiple levels

– Front-line and larger systems levels

– State and local levels

• Importance of oversight and feedback structures (e.g., advisory boards, steering committees)

– Provide leadership, direction, problem-solving

– Continually review project goals and progress

– Address emerging or specific issues

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Collaborative Relationships – Key Themes/Lessons

Fundamentals of successful collaboration and active engagement of partners include:

• Alignment of project and partner goals

• Communication of concrete benefits to prospective partners

• Ability to integrate the collaborative’s work into existing efforts or infrastructures

• Clarification, understanding and agreement on roles, responsibilities and processes

• Ongoing communication (all levels), reporting and monitoring

– Establishing relationships is an event, maintaining relationships is a process

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Collaborative Relationships – Key Themes/Lessons

Development and strengthening of collaborative relationships is facilitated by:

• Cross-systems communication on client progress (e.g., joint case staffing or case conferences, team decision making)

• Cross-systems training on both:

– The broad array of clinical issues affecting shared clients

– Program and policy issues impacting how each system operates

• Intensive, targeted and multi-faceted community outreach:

– Presentations to partners; convening of community forums

– Involvement on other local advisory boards or steering groups

– Value of routine and regular in-person contact and dedicated person or position to conduct outreach

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Sustainability – Themes and Lessons from the RPG Program

Key Elements of Sustainability include:

• Strong collaborative relationships

• Engaging key stakeholders – in particular, State leadership

• Promoting awareness of the RPG program and communicating its results/outcomes

• Linking and aligning RPG program to CFSR and PIP goals

• Building capacity at the local level (for large-scale, multi-site initiatives)

• Making sustainability an explicit program objective

• Having a designated body or structure (e.g., task force, subcommittee) to focus on sustainability

• DATA

How Do I Access Technical Assistance?

• Visit the NCSACW website for resources and products at http://ncsacw.samhsa.gov

• Email us at ncsacw@cffutures.org

• Ken DeCerchio kdecerchio@cffutures.org