# Presentation: 497916

## Findings from the Retrospective PhaseFamily Drug Treatment CourtNational Cross-Site Evaluation

**Presented at the**
**National Association of Drug Court Professionals**
**4****th**** Annual Juvenile & Family Drug court Training Conference**
**Washington, DC**
**January 10, 2003**

**Nancy K. Young, Ph.D.**
**Children and Family Futures**
**4940 Irvine Boulevard, Suite 202**
**Irvine, CA  92620**
**714.505.3525 Fax 714.505.3626**
**www.cffutures.com**

## The Federal Partners

**Department of Health and Human Services (DHHS)**
**Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (CSAT)**
**Administration on Children, Youth and Families, Children’s Bureau, Office on Child Abuse and Neglect (OCAN)**
**Office of the Assistant Secretary for Planning and Evaluation (ASPE)**
**Department of Justice (DOJ)**
**Drug Court Program Office (DCPO)**
**National Institute of Justice (NIJ)**

## The Contractors - April 2002

**Johnson, Bassin and Shaw**
**Mr. Ray Johnson, Officer in Charge**
**Dr. Kazi Ahmed, Task Order Manager**
**Project coordination**
**Communications among partners**
**Hiring and supervision of Site Research staff**
**Logistics for project meetings**
**Center for Children and Family Futures, Inc.**
**Dr. Nancy Young, Executive Director**
**Dr. Mamie Wong, Senior Research Associate**
**Tina Adkins, Research Associate**
**Shaila Simpson, Assistant Director**
**Development and implementation of the evaluation plan**
**Site selection criteria and implementation**
**Research design and methodology**
**Data analyses **
**Drafting of reports**

## Overall EvaluationConceptual Plan

## Overall Study Questions

**What are the components and active ingredients of family drug treatment courts?**
**How do programs and procedures in the target family drug treatment courts differ from one another?**
**How do the various systems involved with family drug treatment courts work together?**
**Are family drug treatment courts more effective than standard services in achieving the key outcomes of the child welfare, substance abuse treatment and court systems?**
**Are family drug treatment courts cost beneficial?**

## Eight Year Retrospectiveand Prospective Plan

**1998    1999    2000    2001    2002    2003    2004    2005    2006   **

**Retrospective**
**Sample**
**Selection**

**SECONDARY DATA**

**Prospective**
**Sample**
**Selection**

**PRIMARY DATA SECONDARY DATA COSTS**

**SECONDARY DATA COSTS**

## The Retrospective Study Evaluation  Plan

## Retrospective Study Conceptual Model

**System**
**Environment and Context of Partner Agencies**
**Treatment**
**CWS**
**Court**

**Family**
**Strengths & Needs**
**AOD Severity**
**CW Risks**

**FDTC Program**
**Court oversight**
**Intensive case supervision**
**Treatment linkages**
**Systems’ Collaboration**

**Key Outcomes**
**Treatment**
**Access to Treatment**
**Engagement**
**Retention**
**Completion**
**Functional Status**
**Child Welfare Services**
**Safety**
**Permanence**
**Dependency Court**
**Case Resolution**
**Compliance with statutory timelines**
**Nature of Court Hearings**

## The Study Sites

**The FDTC Sites & their comparison cases**
**Jackson County, Missouri & similar cases not enrolled in FDTC**
**Washoe County, Nevada & similar cases not offered FDTC**
**San Diego, California & similar cases entering CWS prior to FDTC implementation**
**Santa Clara, California & similar cases entering CWS prior to FDTC implementation**
**Suffolk County, New York & another court in the same county with standard services**

## County Population

**2.8 M**

**1.6 M**

**1.4 M**

**411 K**

**380 K**

## FDTC Start Date

**1994**

**1995**

**1996**

**1997**

**1998**

**Washoe**
**First in Nation**

**1999**

**Suffolk**
**  ****Pilot          Countywide**

**San Diego**
**1st Court    Countywide**

**Jackson**
**April**

**Santa Clara**
**October**

## Special Features

**Jackson **
**Primary focus on prenatally-exposed infants**

**Santa Clara**
**DADS assessors on-site at courthouse**
**Mentor Moms provide support to parents**

**San Diego**
**Countywide assessment and recovery case management**
**DDC only for those noncompliant with dependency court orders**

## Suffolk
Court Appointed Special Advocates assigned to every child
AOD assessor on-site at courthouse

**Court Appointed Special Advocates assigned to every child**
**AOD assessor on-site at courthouse**

**Washoe**
**Foster Grandparents provide support to families**
**CPS-contracted AOD assessor**

**Special Features**

## Total Number of FDTC Graduates in 2000 and 2001

**San Diego****1**** ****	****	****	****71**
**Suffolk ****	****	****	****67****	****	****154**
**Santa Clara****	****	****	****52****	****	****  98**
**Washoe****	****	****	****52****	****	****  81**
**Jackson****	****	****	****40****	****	****  91**

**1 ****Only 2****nd**** Tier of DDC participants are eligible to graduate**

-   **Parents       Children**

## Interagency Policy & Oversight

**2 FDTCs have strong Steering/Policy level committees that meet regularly**
**1 FDTC has a steering committee that meets on an as-needed basis for reports on current activities**
**2 FDTCs have no specifically-dedicated policy group but have court- or county-wide oversight committees**

## Program Implementation

**Jackson – ****FDTC team meets two times a week to discuss cases heard that day**
**San Diego**** – Special Task Committees address specific topics; SARMS Implementation Team meets one time per month to address issues impeding effort**

## Program Implementation

**Santa Clara** – **Consolidated service plan meeting one day per week; Full FDTC team meeting one day per week prior to court calendar**
**Suffolk**** – FDTC team meeting three days per week prior to each court calendar**
**Washoe ****– FDTC team meets weekly prior to court calendar**

## Eligibility

**Jackson**
**Court ordered**
**Abuse/Neglect and Criminal Endangerment**
**Excludes**
**Individuals with more than 3 substantiated hotline reports for neglect**

**San Diego**
**All parents in dependency court system with substance abuse **
**Voluntary SARMS pre-Juris/Dispo**
**Court ordered SARMS post-Juris/Dispo**
**Individuals must be off Methadone**

## Eligibility

**Santa Clara**
**Voluntary**
**Abuse/Neglect w/ no concurrent criminal cases**
**Excludes**
**Severe mental illness**

**Suffolk**
**Voluntary**
**Neglect only**
**Excludes**
**Severe mental illness**
**High probability of violence**

## Eligibility

**Washoe**
**Voluntary**
**Excludes**
**Severe mental illness**
**High probability of violence**
**Methadone Clients**

**Summary**
**3 Voluntary**
**2 Court ordered**
**Exclusions:**
**1 court excludes more than 3 substantiated reports**
**3 exclude severe mental illness**
**2 exclude clients with a high probability of violence**
**2 Courts exclude Methadone clients**

## Assessment

**Jackson – ****Newborn Crisis Assessment done by DSS; further assessment by treatment provider**
**San Diego – ****SARMS Recovery Specialists**
**Santa Clara – ****DADS assessors on-site at the courthouse**
**Suffolk –**** Psychiatric social worker who is part of the FDTC team; funded by Dept. of Health**
**Washoe –**** CPS contracted assessor**

## Case Management

**Jackson**
**Dedicated DFS case managers housed at court**
**FDTC team provides case management**

**San Diego**
**All social workers carry SARMS cases**
**SARMS Recovery Specialists case manage treatment issues**
**Specialized social worker assigned to DDC**

**Santa Clara**
**Dedicated master’s level social workers**
**FDTC team provides case management**

## Case Management

**Suffolk**
**DSS assigns senior level caseworkers to FDTC whenever possible**
**AOD case managers housed at court**
**FDTC team provides case management**

**Washoe**
**Integrated Services Case Manager assists with employment issues**
**Dedicated social workers assigned to FDTC**
**FDTC team provides case management**

## Services to Children

**Jackson**
**FDTC case manager referrals to day care and developmental assessments**
**Child Development Coordinator at primary treatment provider agency conducts developmental screens**

**San Diego**
**Children’s Services provide developmental assessments and follow up for children under 6 years**
**Specially trained foster parents for AOD exposed children 6 and under**

## Services to Children

**Santa Clara**
**Public health nursing does developmental assessments for children living in THUs**
**Countywide programs: wraparound services; developmental screens; Kid’s Magic & Kids are Special**

**Suffolk**
**CASA workers assigned to every child**
**Public health nursing conducts developmental assessments on children 3 and under**

## Services to Children

**Washoe**
**CPS Children’s Resource Bureau staffed with MH, child development and sexual abuse & violence specialists**
**Bailey Charter School serves at-risk children including those of FDTC participants**

## Research Design

## Research Design

**Comparison group selected from either cases not offered FDTC services for administrative reasons or cases that entered CWS just prior to FDTC implementation**

**Quasi experimental – lacks random assignment of subjects to groups**

**Each FDTC Site **
**Approximately 50 FDTC intakes and comparisons**
**Total for All Sites **
**FDTC = 249; SARMS = 50; Comparison = 240**
**Sample size allows use of simple statistical procedures to determine if there are significant intra- and inter-site differences in outcome**

## Intent to Treat Sampling

**Use of all cases which entered the program within a designated time frame *****whether or not they completed the program*****.**
**Randomly select the desired number of cases from the available sample *****whether or not they completed the program*****.**

## Data Collection

## ON SITE Data Collectors

**Employed by Logicon/R.O.W. Sciences then Johnson, Bassin & Shaw**
**Supervised by JBS, CFF, and the Site**
**Masters Level Employee**
**Experience with major systems**
**Substance Abuse Treatment**
**Child Welfare**
**The Dependency/Juvenile Court**
**In-depth knowledge based on site-specific characteristics (e.g., electronic data access, CWS case file abstraction)**
**Data Abstraction Instrument developed and refined until adequate inter-rater reliability**

## Sample Descriptions

## Parents

**Over 90% were women**
**Average age was 30**
**Half were Caucasian, about 30% African American and 17% Hispanic**
**Approximately one third did not graduate from high school**
**Over 40% had never been married**

## Parents at Intake

## No Significant Differences Between Groups; Both Groups have Substantial Co-Occurring Conditions

**Percent of Parents with Condition Noted in Case Record**

## No Differences Between Groups onPrior CPS or Treatment

## Compared to the Comparison Sample
Fewer FDTC participants were employed (22% vs 37%)
More were receiving welfare 
	(42% vs 32%)
The 540 Parents had just over 1,500 Children; 1,135 were named in the CPS case
Average children per Parent 2.9 and 2.7

**Fewer FDTC participants were employed (22% vs 37%)**
**More were receiving welfare **
**	****(42% vs 32%)**
**The 540 Parents had just over 1,500 Children; 1,135 were named in the CPS case**
**Average children per Parent 2.9 and 2.7**

**Parents**

## 51% were girls
Average age approximately 4.5 years
Over half were under age 6

**Average age approximately 4.5 years**
**Over half were under age 6**

**Child Description**

## Children’s Issues Noted in CPS Case

**Percent of Children with Condition Noted in Record**

## Type of Allegations
Failure to Protect			91.7	        87.3
No Provision for Support*	 9.0	        18.6
Abuse of Sibling*			 5.1            12.1
Severe Neglect*			 1.0              9.1
Physical Abuse/Harm		 6.7              4.2
Prenatal Drug Exposure*	 4.0              2.2
Emotional Abuse/Damage*	 4.3	          1.2
Other					 5.2              4.6		

**Failure to Protect****	****	****	****91.7****	****        87.3**
**No Provision for Support*****	**** 9.0****	****        18.6**
**Abuse of Sibling*****	****	****	**** 5.1            12.1**
**Severe Neglect*****	****	****	**** 1.0              9.1**
**Physical Abuse/Harm****	****	**** 6.7              4.2**
**Prenatal Drug Exposure*****	**** 4.0              2.2**
**Emotional Abuse/Damage*****	**** 4.3****	****          1.2**
**Other****	****	****	****	****	**** 5.2              4.6****	****	**

-   **FDTC       Comparison**

## Primary Outcomes

**Collected in three areas:**
**Timeliness of substance abuse treatment entry and completion rates**
**Child welfare outcomes related to child safety and permanency**
**Court outcomes related to the timeliness of case resolution**** **

## Significantly More FDTC Parents Entered Treatment within18 Months of CPS Case Opening

**FDTC**
**100%**

**Comparison**
**78%**

**SARMS**
**80%**

## FDTC Parents Entered Treatment in Significantly Fewer Days

**Average Days from**
**    ****CPS Case Opening to****	****	****	****394****	****    802**
**    ****Treatment Entry***
**Average Days from FDTC**
**     ****Entry to Treatment Entry****	**** ****	**** 59****	****      **
**Median Days from FDTC**
**     ****Entry to Treatment Entry****	****	**** 19**

-   **FDTC      Comparison**

## Significantly More FDTC ParentsParticipated in More Intensive Levels of Treatment

## On Average, FDTC Parents Stayed in TreatmentLonger than Comparison Parents

**Average Number of Days in Treatment**

## FDTC Parents Successfully Completed 59% of 919 Treatment EpisodesComparison Group Parents Successfully Completed 52% of 467 Treatment Episodes

**Successful Treatment Completion**

- Successful Completion: Completed & Transferred to Another
- Program

## Significantly Less Criminal & CPS Recidivism Among FDTC Parents 

**Percent of Parents**

## On Average, FDTC Children HaveLess Time in Out of Home Care and Reunify Significantly Faster than Comparisons

- Average Number of
-    Days in Out of Home Care	  588	667
- Average Number of Days
-    to Reunification* 			  322	377

-   **FDTC      Comparison**

## On Average, Slightly More FDTC Children Reunified/Remained with a Parent 

**Percent of Children**

## FDTC Children Reach Permanent Placement3 Months SoonerHave Permanent Plan Ordered 5 Months Earlier and CPS Case Closed 4 Months Sooner 

**Number of Months**

## Summary - Sample Description

- FDTC Clients are predominantly women with an average age of 30
- They have a high degree of multiple co-occurring disorders
- Generally have low education attainment
- A large percentage have never been married

## Summary - Sample Description

- FDTC Children are young with the majority under age 6
- They exhibit a range of social, mental and behavioral challenges

## Summary - Treatment Outcomes

- Significantly more FDTC parents enter treatment
- They enter treatment in significantly fewer days
- They participate in significantly more treatment episodes
- They receive more intensive levels of treatment
- On Average, they stay in treatment longer
- They complete nearly 60% of episodes

## Summary - Child Safety

- FDTC parents have significantly less criminal recidivism
- FDTC parents have significantly less CPS recidivism

## Summary - Child Permanencyand Case Resolution

**FDTC Children are reunified in significantly fewer days**
**FDTC Children Reach Permanent Placement 3 Months Faster**
**FDTC Children Have Permanent Plan Ordered 5 Months Earlier**
**Have CPS Case Closed 4 Months Faster**