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Screening and Assessment for Family Engagement, Retention and Recovery – SAFERR
Guidance for States and Communities Serving Families with Substance Use Disorders in Child
Welfare Services and Dependency Courts
Presented atPutting the Pieces Together for Children and
Families: The National Conference on Substance Abuse, Child Welfare and the Courts
February 1, 2007
Nancy K. Young, Ph.D., Director4940 Irvine Blvd, Ste 202Irvine, CA 92620Phone: 714-505-3525Fax: 714-505-3626Email: www.ncsacw.samhsa.gov
Developing since Summer 2003
Review and Input from Community Expert Panel Review at NCSACW Researchers’ Forum Shared with In-Depth TA State Teams Consultant Liaisons and States Provided
Input to Implementation Guide Edits and Rewrites
SAFERR is based on the premise that when parents misuse substances and maltreat their children, the only way to make sound decisions is to draw from the talents and resources of at least three systems: child welfare, alcohol and drugs, and the courts.
Principles The problems of child maltreatment and substance
use disorders demand urgent attention and the highest possible standards of practice from everyone working in systems charged with promoting child safety and family well-being.
Success is possible and feasible. Staff in child welfare, substance abuse, and court systems have the desire and potential to change individual lives and create responsible public policies.
Family members are active partners and participants in addressing these urgent problems.
Premises
1. The team is the tool, and people, not tools, make decisions
2. The family is the focus of concern
3. Problems don’t come in discrete packages; they are jumbled together
4. Assessment is not a one-person responsibility
Premises
5. Information is limited, and there is no research-based answer
6. There is no time to lose
7. ICWA creates specific guidelines for working with American Indian populations
8. Developing and sustaining effective collaborations is hard work
Organization of SAFERR
I. Building Cross-System Collaboration Creating the structure to create and sustain change
II. Collaboration Within and Across Systems What each system needs to know about itself and
its partners
III. Collaboration in Action: Working Together on the Front Line Presents activities that create cross-system practice
changes
Organization of SAFERR
A. Facilitator’s Guide Templates and exercises
B. Fact Sheets To educate administrators, legislators and
stakeholders about the initiativeC. Understanding the Needs of ChildrenD. Screening and Assessment Tools for
Substance Use Disorders
Organization of SAFERR Appendices
E. Substance Use, Abuse, Dependence Continuum, and Principles of Effective Treatment
F. Safety and Risk Assessments for Use by Child Welfare Staff
G. Sharing Confidential InformationH. Glossary of TermsI. Guide to Compliance with the Indian Child
Welfare Act (ICWA)
Assessment is a ProcessAssessment happens along a continuum to determine: Presence and Immediacy Is there an issue present? What is the immediacy of the issue?
Assessment is a ProcessAssessment happens along a continuum to determine: Presence and Immediacy
Is there an issue present?What is the immediacy of the issue?
Nature and Extent What is the nature of the issue? What is the extent of the issue?
Assessment is a ProcessAssessment happens along a continuum to determine: Presence and Immediacy
Is there an issue present?What is the immediacy of the issue?
Nature and ExtentWhat is the nature of the issue?What is the extent of the issue?
Developing & Monitoring Change, Transitions & Outcomes of Treatment and Case Plans What is the response to the issue? Are there demonstrable changes in the issue? Is the family ready for transition? Did the Interventions Work?
Definitions of Terms and Processes
Screen Child Abuse Report
AOD Services CWS Services Court Services
Is there an issue?
Definitions of Terms and Processes
Screen Child Abuse Report
Immediate Need Triage
In-Person Safety Assessment
Preliminary Protective Hearing
AOD Services CWS Services Court Services
Is there an issue?
What is the immediacy of the issue?
Definitions of Terms and Processes
Screen Child Abuse Report
Immediate Need Triage
In-Person Safety Assessment
Preliminary Protective Hearing
Diagnosis In-Person Response/ Risk Assessment
Court Findings
AOD Services CWS Services Court Services
Is there an issue?
What is the immediacy of the issue?
What is the nature of the issue?
Definitions of Terms and Processes
Screen Child Abuse Report
Immediate Need Triage
In-Person Safety Assessment
Preliminary Protective Hearing
Diagnosis In-Person Response/ Risk Assessment
Court Findings
Multi-Dimensional Assessment
Family assessment
Petition Filed; Preliminary Protective Hearing
AOD Services CWS Services Court Services
Is there an issue?
What is the immediacy of the issue?
What is the nature of the issue?
What is the extent of the issue?
Treatment Plan
Case Plan Adjudication/Dispositional Hearing; Court-ordered Case Plan
AOD Services CWS Services Court Services
What is the Response?
Treatment Plan
Case Plan Adjudication/Dispositional Hearing; Court-ordered Case Plan
Treatment Monitoring
Case Plan Monitoring
Court Review Hearings
AOD Services CWS Services Court Services
What is the Response?
Is there demonstra-ble change?
Treatment Plan
Case Plan Adjudication/Dispositional Hearing; Court-ordered Case Plan
Treatment Monitoring
Case Plan Monitoring
Court Review Hearings
Transition Planning
Permanency Determination
Permanency Hearing
AOD Services CWS Services Court Services
What is the Response?
Is there demonstra-ble change?
Is family ready for transition?
Treatment Plan
Case Plan Adjudication/Dispositional Hearing; Court-ordered Case Plan
Treatment Monitoring
Case Plan Monitoring
Court Review Hearings
Transition Planning
Permanency Determination
Permanency Hearing
Recovery Management
Family Well Being
Case Closed
AOD Services CWS Services Court Services
What is the Response?
Is there demonstra-ble change?
Is family ready for transition?What is to happen after discharge?
Treatment Plan
Case Plan Adjudication/Dispositional Hearing; Court-ordered Case Plan
Treatment Monitoring
Case Plan Monitoring
Court Review Hearings
Transition Planning
Permanency Determination
Permanency Hearing
Recovery Management
Family Well Being
Case Closed
Outcome Monitoring
Outcome Monitoring
Outcome Monitoring
AOD Services CWS Services Court Services
What is the Response?
Is there demonstra-ble change?
Is family ready for transition?What is to happen after discharge?Did the intervention work?
Assessment Information must be Communicated
Assessment happens along a continuum to determine: Presence and Immediacy
Is there an issue present?What is the immediacy of the issue?
Nature and ExtentWhat is the nature of the issue?What is the extent of the issue?
Developing & Monitoring Change, Transitions & Outcomes of Treatment and Case Plans What is the response to the issue? Are there demonstrable changes in the issue? Is the family ready for transition? Did the Interventions Work?
The SAFERR ModelDevelopment
Builds CrossSystem
Collaboration
Establishes Individual
and Cross System
Roles and Responsibilities
Identifies Front-Line
Collaborative Practice
Establishes and Monitors Individual and Cross-System Outcomes
The SAFERR ModelDevelopment
Builds CrossSystem
Collaboration
Establishes Individual
and Cross System
Roles and Responsibilities
Identifies Front-Line
Collaborative Practice
Establishes and Monitors Individual and Cross-System Outcomes
GOVERNANCE Oversight
Committee Steering
Committee Subcommittees
Builds CrossSystem
Collaboration
Most senior officials from all systems
• Direct staff to give this priority• Provide overall direction• Meet 3-4 times a year• Receive interim reports
GOVERNANCE Oversight
Committee Steering
Committee Subcommittees
Builds CrossSystem
Collaboration
Senior managers from within systems
• Co-chaired or use facilitator
• Have decision-making authority
• Receive materials in advance for discussion
• Make decisions during meetings
• Report collectively to the oversight committee
GOVERNANCE Oversight
Committee Steering
Committee Subcommittees
Builds CrossSystem
Collaboration
Senior managers from within systems
• Co-chaired or use facilitator
• Have decision-making authority
• Receive materials in advance for discussion
• Make decisions during meetings
• Report collectively to the oversight committee
The Charge to the Steering Committee:
• Create a mission statement based on exploration of values and principles
• Enhance understanding of current systems & barriers to communication
• Establish goals, milestone, products & implement plan to achieve them
• Create and oversee subcommittees
• Identify training curricula and strategies
• Monitor progress and evaluate outcomes
GOVERNANCE Oversight
Committee Steering
Committee Subcommittees
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
The Subcommittee(s)
• Comprised of county front line and supervisory staff;
• Charged by Steering Committee to conduct specific tasks
• Participate in pilot tests of strategies
• Report to the Steering Committee
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission &
Principles Shared
Understanding on Language & Processes Goals, Timetables,
Products Training
Curricula/Strategy
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
The SAFERR ModelDevelopment
Builds CrossSystem
Collaboration
Establishes Individual
and Cross System
Roles and Responsibilities
Identifies Front-Line
Collaborative Practice
Establishes and Monitors Individual and Cross-System Outcomes
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS UnderstandsBasics of substance use & how use affects child developmentHow to screen for substance useTreatment system & how to help people stay in treatment Implications of tensions between Treatment Staff and CW timelines
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects
child development How to screen for substance use Treatment system & how to help people stay in
treatment Implications of tensions between Treatment
Staff and CW timelines
Alcohol and Drug System Understands
How substance use puts children at risk & how CWS must respondChild maltreatment reporting requirementsHow to screen for child safety
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects
child development How to screen for substance use Treatment system & how to help people stay in
treatment Implications of tensions between Treatment
Staff and CW timelinesAlcohol and Drug System Understands
How substance use puts children at risk & how CWS must respond Child maltreatment reporting requirements How to screen for child safety
Court System UnderstandsBasics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects child
development How to screen for substance use Treatment system & how to help people stay in treatment Implications of tensions between Treatment Staff and CW
timelinesAlcohol and Drug System Understands
How substance use puts children at risk & how CWS must respond
Child maltreatment reporting requirements How to screen for child safety
Court System Understands Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration
Collaboratively all Three SystemsEstablish joint policies/procedures to share informationEstablish case plansDevelop shared indicators of progressMonitor progress and evaluate outcomes
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
The SAFERR ModelDevelopment
Builds CrossSystem
Collaboration
Establishes Individual
and Cross System
Roles and Responsibilities
Identifies Front-Line
Collaborative Practice
Establishes and Monitors Individual and Cross-System Outcomes
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects
child development How to screen for substance use Treatment system & how to help people stay in
treatment Implications of tensions between Treatment
Staff and CW timelinesAlcohol and Drug System Understands
How substance use puts children at risk & how CWS must respond Child maltreatment reporting requirements How to screen for child safety
Court System Understands Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration
Collaboratively all Three Systems Establish joint policies/procedures to share
information Establish case plans Develop shared indicators of progress Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
Screen for substance use and child maltreatment
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects
child development How to screen for substance use Treatment system & how to help people stay in
treatment Implications of tensions between Treatment
Staff and CW timelinesAlcohol and Drug System Understands
How substance use puts children at risk & how CWS must respond Child maltreatment reporting requirements How to screen for child safety
Court System Understands Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration
Collaboratively all Three Systems Establish joint policies/procedures to share
information Establish case plans Develop shared indicators of progress Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
Screen for substance use and child maltreatment
Assess for substance use and child maltreatment
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects
child development How to screen for substance use Treatment system & how to help people stay in
treatment Implications of tensions between Treatment
Staff and CW timelinesAlcohol and Drug System Understands
How substance use puts children at risk & how CWS must respond Child maltreatment reporting requirements How to screen for child safety
Court System Understands Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration
Collaboratively all Three Systems Establish joint policies/procedures to share
information Establish case plans Develop shared indicators of progress Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
Screen for substance use and child maltreatment
Assess for substance use and child maltreatment
Develop and implement collaborative case plans
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects
child development How to screen for substance use Treatment system & how to help people stay in
treatment Implications of tensions between Treatment
Staff and CW timelinesAlcohol and Drug System Understands
How substance use puts children at risk & how CWS must respond Child maltreatment reporting requirements How to screen for child safety
Court System Understands Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration
Collaboratively all Three Systems Establish joint policies/procedures to share
information Establish case plans Develop shared indicators of progress Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
Screen for substance use and child maltreatment
Assess for substance use and child maltreatment
Develop and implement collaborative case plans
Monitor progress and evaluate results
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
GOVERNANCE Oversight Committee Steering Committee Subcommittees
TASKS Mission & Principles Shared Understanding
on Language & Processes
Goals, Timetables, Products
Training Curricula/Strategy
MONITORING Baseline Data Progress Reports Outcome Data
CWS Understands Basics of substance use & how use affects
child development How to screen for substance use Treatment system & how to help people stay in
treatment Implications of tensions between Treatment
Staff and CW timelinesAlcohol and Drug System Understands
How substance use puts children at risk & how CWS must respond Child maltreatment reporting requirements How to screen for child safety
Court System Understands Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration
Collaboratively all Three Systems Establish joint policies/procedures to share
information Establish case plans Develop shared indicators of progress Monitor progress and evaluate outcomes
CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:
Screen for substance use and child maltreatment
Assess for substance use and child maltreatment
Develop and implement collaborative case plans
Monitor progress andevaluate results
Builds CrossSystem
Collaboration
Establishes Individual and Cross System Roles and
Responsibilities
Identifies Front-LineCollaborative
Practice
The SAFERR ModelDevelopment
Builds CrossSystem
Collaboration
Establishes Individual
and Cross System
Roles and Responsibilities
Identifies Front-Line
Collaborative Practice
Establishes and Monitors Individual and Cross-System Outcomes
Establishes and Monitors Individual and Cross-System Outcomes
Increased identification of substance use disorders among families reported for child maltreatment
Increased identification of potential child maltreatment for people assessed/treated for SUDS
Increased communication regarding screening and assessment for SUDS and child maltreatment
Informed decision making by CWS and CS regarding reunification, aftercare, terminations
Reduced duplication and burden with regard to case plan requirements
Increased engagement and retention of parents in treatment
Reduced risk of maltreatment of children
Increased family stability, reunification and well being