ERIC ED476052: Safe & Sound: Models for Collaboration between the Child Welfare & Addiction Treatment Systems.

45 Pages·2003·0.58 MB·English

by  ERIC

DOCUMENT RESUME
ED 476 052
CG 032 333
Rubenstein, Gwen
AUTHOR
Safe & Sound: Models for Collaboration between the Child
TITLE
Welfare & Addiction Treatment Systems.
Annie E. Casey Foundation, Baltimore, MD.
SPONS AGENCY
2003-00-00
PUB DATE
43p.; Produced by the Legal Action Center, Arthur Liman
NOTE
Policy Institute.
AVAILABLE FROM
Legal Action Center, Arthur Liman Policy Institute, 153
Waverly Fa., 8th Floor, New York, NY 10014.
Information Analyses (070) -- Reports
PUB TYPE
Descriptive (141)
EDRS Price MF01/PCO2 Plus Postage.
EDRS PRICE
DESCRIPTORS
*Addiction; *Agency Cooperation; *Child Welfare; *Drug
Rehabilitation; Models; Parent Child Relationship; Substance
Abuse; *Welfare Services
Adoption and Safe Families Act 1997
IDENTIFIERS
ABSTRACT
An estimated 11 percent of American children live with at
least one parent who abuses or is addicted to alcohol and/or drugs. Parental
addiction is a significant factor in child abuse and neglect, with studies
suggesting that 40 to 80 percent of families in the child welfare systems are
affected by it. With appropriate treatment, many of these parents would be
able to achieve recovery and take care of their children physically,
emotionally, and financially. But treatment services--especially services
that allow women to take their children into treatment with them--are
relatively scarce. The Adoption and Safe Families Act of 1997 (ASFA) created
new challenges for these families and for the systems serving them. ASFA's
time limits on reunification services for families and an accelerated
permanency planning process have increased the challenges facing families and
the child welfare and treatment systems. The purpose of this report is to
examine policy and practice issues affecting these systems and their clients.
Specifically, this report: provides background on the problem of addiction in
the child welfare system; discusses ASFA and its implications for families at
risk for involvement or involved in the child welfare system because of
parental addiction; presents case studies of how two localities are
addressing addiction in their child welfare systems; and presents a model for
addressing addiction among families involved in the child welfare system
based on these case study findings. (Contains 32 references.)
(GCP)
Reproductions supplied by EDRS are the best that can be made
from the original document
Arthur Liman
Policy Institute
Catherine H. O'Neill
SAFE &SOUND:
Director
Gwen Rubinstein
Deputy Director
Board of Directors
Daniel K. Mayers
Chairman
Elizabeth Bartholet
Models for Collaboration
Vice Chair
Eric D. Balber
Pamela S. Brier
Patrick R. Cowlishaw
Suzanne B. Cusack
Harlon L. Dalton
Between the Child Welfare &
Edward J. Davis
Michael K. Deaver
Dennis DeLe6n
Jason Flom
Diana R. Gordon
Addiction Treatment Systems
Alan J. Hruska
Peter Barton Hutt
Alan Jenkins
Brad S. Karp
Richard C. Lee
Doug Liman
Michael Meltsner
Mark C. Morrill
Allan Rosenfield
Ian Schrager
Afshin Taber
Jane Velez
Stephen A. Wamke
U.S. DEPARTMENT OF EDUCATION
PERMISSION TO REPRODUCE AND
Founding Chairman
Office of Educational Research and Improvement
DISSEMINATE THIS MATERIAL HAS
EDUCATIONAL RESOURCES INFORMATION
Arthur L. Liman
BEEN GRANTED BY
CENTER (ERIC)
From 1972 to 1997
This document has been reproduced as
received from the person or organization
originating it.
Executive Staff
Minor changes have been made to
Paul N. Samuels
improve reproduction quality.
Director and President
TO THE EDUCATIONAL RESOURCES
Catherine H. O'Neill
Points of view or opinions stated in this
INFORMATION CENTER (ERIC)
Senior Vice President
document do not necessarily represent
1
official OERI position or policy.
Thomas Facciolo
Vice President
2
AVAILABLE
EST COPY
A PUBLICATION OF THE ARTHUR LIMAN POLICY INSTITUTE
OF THE LEGAL ACTION CENTER
The Legal Action Center is the only nonprofit law and policy organization in
the United States whose sole mission is to fight discrimination against people with
histories of alcohol and drug dependence, AIDS, or criminal records, and to
advocate for sound policies in these areas.
The Arthur Liman Policy Institute enables the Center to expand its public policy work in
the areas of addiction, HIV/AIDS, and criminal justice through a program of
research, publication, and education.
2003 Legal Action Center. All Rights Reserved.
Copyright
First Edition 2003
3
Acknowledgments
This paper was written by Gwen Rubinstein, director of policy research of the Legal Action
Center. This paper owes much to the vision and work of Sue Jacobs, formerly a senior staff
attorney at the Center, who created and nurtured the Center's work on child welfare issues
and ASFA implementation.
Funding to support this work came from the Annie E. Casey Foundation.
335
17 COPY AVAIDLABEE
4
,Table of Contents
Introduction
6
Addiction Among Families
6
The Treatment System - Resources and Effectiveness
7
Adoption and Safe Families Act
8
Methodology
12
Model for Addressing the Needs of Addicted Parents
Involved in the Child Welfare System
13
Case Study: Cuyahoga County, Ohio
14
23
Case Study: Cook County, Illinois
31
Endnotes
33
Bibliography
Appendix A Annotated Model for Addressing the
Needs of Addicted Parents Involved in the
36
Child Welfare System
Appendix B Cross-Site Questionnaire
39
JSJEST COPY AVA.11ILAIEL3
5
SAFE &SOUND:
Models for Collaboration Between
the Child Welfare &
Addiction Treatment Systems
April 2003
BEST COPY MAILABLE
6
Introduction
An estimated 11 percent of American
Discusses ASFA and its implications for
children (8.3 million) live with at
families at risk for involvement or
least one parent who abuses or is
involved in the child welfare system
addicted to alcohol and/or drugs.' Parental
because of parental addiction;
addiction is a significant factor in child
abuse and neglect, with studies suggesting
Presents case studies of how two locali-
that 40 to 80 percent of families in the child
Cook County, Illinois (state-
ties
welfare system are affected by it.2
administered), and Cuyahoga County,
Ohio (county-administered)
are
With appropriate treatment, many of these
addressing addiction in their child wel-
parents would be able to achieve recovery
fare systems; and
and take care of their children physically,
emotionally, and financially. But treatment
Presents a model for addressing addic-
especially services that allow
services
tion among families involved in the
women to take their children into treatment
child welfare system based on these
with them
are relatively scarce. Between
case study findings.
13 and 16 million Americans need treat-
ment for alcoholism and/or drug depend-
Addiction Among Families
ence in any given year, but only 3 million
receive care.3 The measured treatment gap
Alcoholism and drug dependence are seri-
for women is even larger.4
ous public health problems with large social
and economic costs to families, communi-
The Adoption and Safe Families Act of
ties, government, and society as a whole.
19975 (ASFA) created new challenges for
these families and for the systems serving
Addiction cost the United States an esti-
them. ASFA's time limits on reunification
mated $246 billion in 1992, including
services for families and accelerated perma-
$28.75 billion in healthcare costs, $176.4
nency planning process (emphasizing faster
billion in lost productivity, and $40.5 bil-
adoption for children in foster care) have
lion in other costs (such as crime, welfare,
increased the challenges facing families and
and motor vehicle crashes).6 These costs are
the child welfare and treatment systems.
borne primarily by the individuals affected
and their families (44.7 percent) and the
The purpose of this report is to examine
government (41.6 percent).7
policy and practice issues affecting these
systems and their clients. Specifically, this
An estimated 16.6 million Americans over
report:
the age of 12 were abusing or dependent on
alcohol or drugs, representing 7.3 percent of
Provides background on the prob-
the population in 2001.8 The prevalence of
lem of addiction in the child welfare
alcohol and drug problems among parents is
system;
generally lower than for comparable adults
6
Resources and
The Treatment System
without children.9 Still, an estimated 11 per-
cent of American children (8.3 million) live
Effectiveness
with at least one parent who is addicted to
Treatment System for Families Involved in
alcohol, drugs, or both.1°
the Child Welfare System
The effects of parental addiction on
Many families involved in the child welfare
children can be wide-ranging. The two main
research findings are that children of
system have very low incomes14 and do not
have private health insurance. They need
parents with alcohol and drug problems
have poorer developmental outcomes access to the publicly funded treatment
system, whether through Medicaid or other
(physical, intellectual, social, and emo-
tional) and are at higher risk for alcohol and federal and state programs.
drug problems than other children."
The publicly funded treatment system can-
not provide services to all who need it. Ac-
Parental addiction is one of the most com-
cording to the Substance Abuse and Mental
mon reasons for entrance into the child
Health Services Administration (SAMHSA)
welfare system. Most studies have
and Institute of Medicine (IOM), between
estimated that parental addiction is a
13 and 16 million Americans need treat-
contributing problem for 40 to 80 percent
of families involved in the child welfare ment for alcoholism and/or drug depend-
ence in any given year, but only 3 million
system.12
receive care.15 A 1997 study found that
These parents face significant personal child welfare agencies could provide treat-
ment to less than one-third of parents who
barriers to recovery and stability. For exam-
ple, many women with alcohol and drug
needed it.16
problems also have histories of physical or
Effectiveness of Alcohol and Drug Treat-
sexual abuse, mental illness, and
ment for Families Involved in the Child
co-occurring physical illness, such as HIV/
Welfare System
AIDS.
Numerous studies have demonstrated that
Systems barriers to success also exist.
These barriers include different philosophi- alcohol and drug treatment is effective and
cost-effective, despite limitations in the
cal orientations of the addiction treatment
availability of services. Treatment has been
and child welfare systems about expecta-
tions of outcomes, timetables, and relapse, shown to reduce alcohol and drug use and
as well as conflicting federal and state pol-
lower health-care costs,17 as well as in-
icy goals, overburdened child welfare agen- crease family functioning.'8
cies, and inadequate treatment availability
(particularly for women with children)." In
Studies have also shown that treatment is
addition, legal and policy environments in effective for families involved with the
these two systems may have an important
child welfare system:
effect on their ability to collaborate.
8
welfare policy by firmly limiting the time
In Illinois, Project SAFE partici-
allotted for reunification efforts and
pants had a rate of recidivism (a
dictating that children's health and safety
new abuse or neglect complaint)
were "the paramount concern" in place-
of 6.3 percent, compared to a 21.4
ment decisions.
percent recidivism rate among
child welfare clients without an
Three provisions of ASFA have the most
alcohol and drug problem and a
significant implications for parents with
52.3 percent recidivism rate
alcohol and drug problems who are or
among clients with an alcohol and
may become involved with the child
drug problem who did not receive
welfare system.
treatment.I9
Reasonable efforts. ASFA clarifies that
The National Treatment Improve-
when making "reasonable efforts" to pre-
ment Evaluation Study (NTIES)
serve families before foster care place-
found that the number of custodial
ment and to reunify families, the child's
parents who were afraid of losing
"health and safety shall be the paramount
custody of their children because
concern. "23 States are not required to
of an alcohol or drug problem
make reasonable efforts when a court has
declined by 63 percent after treat-
determined that the parent has:
ment.20
Subjected the child to aggravated
An Oregon study found that child
circumstances (as defined by state
welfare involvement dropped 50
law and including abandonment,
percent (from 7.8 percent to 3.9)
sexual abuse, and chronic abuse);
for individuals who completed
treatment.2I
Committed murder, voluntarily
manslaughter, or aided or abetted
Among women served at PAR
crimes such as murder/
Village, a treatment program in St.
manslaughter;
Petersburg, Florida, nearly three-
quarters regained custody of their
Committed a felony assault result-
children after treatment.22
ing in serious bodily injury to the
child or another child of the par-
Adoption and Safe Families Act
ent; or
(ASFA)
Had parental rights to a sibling
ASFA was created to address growing
involuntarily terminated.
concern among policy makers about the
size of the foster care population and the
Some states have also created exceptions
amount of time children were spending in
to reasonable efforts when rights to
foster care by moving children into
another sibling have been terminated.
permanent homes more quickly. ASFA
represented a considerable shift in child
9
Suspending "reasonable efforts" in the case
Will return to the parent;
of previous involuntary termination of
parental rights to a sibling will affect many
Should be placed for adoption and
parents with alcohol and drug problems.
the state will file a petition for
Because many parents struggle with addic-
termination of parental rights;
tion problems for years before entering
treatment, they may have lost their parental
Should be referred for legal guardi-
rights to other children.
anship; or
Later, they might become involved with the
Should be placed elsewhere.
child welfare system when they are able to
engage in treatment, or when they are
ASFA changed the timing of permanency
finally matched with an appropriate treat-
hearings:
ment program. Under ASFA, however, the
child welfare agency will not have to make
If the court determines that reason-
efforts to provide them treatment because of
able efforts to reunite the child with
the earlier termination. These parents risk
his or her family are not required, a
both losing their child and their stability in
permanency hearing must be held
recovery.
within 30 days of the finding. At the
hearing, the court may direct the
In states that provide the opportunity to
foster care agency to file a termina-
challenge the use of an earlier termination
tion of parental rights petition
as a basis for a current termination, parents
immediately.
and their advocates could enlist treatment
staff in providing information to the court to
In all other cases, a permanency
show that provision of treatment services
hearing must occur within 12
are in the best interests of the child and
months after the date the child
family.
entered care.
The reasonable efforts decision can be a
For families not afforded reasonable efforts
crucial one because if reasonable efforts are
to reunify, the permanency hearing may
not made as a result of a determination by a
occur before they have been able to engage
court, then a permanency hearing must be
in treatment and/or had much time in treat-
held within 30 days after the determination
ment. Nonetheless, if they want to reunify
that could result in the child being placed
with their child, they must submit whatever
elsewhere.24
information they can about their treatment
plans and progress. In addition, they might
Permanency hearings. A permanency hear-
consider what alternative permanency plans
ing is a court hearing to determine the plan
would be acceptable to them while they
for where and with whom the child will
continue treatment, such as placement with
live. At the permanency hearing, the foster
a relative or guardianship by a close friend.
care or child welfare agency presents a plan
about whether and when the child:
When the permanency hearing occurs 12
months after placement, parents who are in
10