Overview of Best Practices Part 2 Phil Breitenbucher, Children and Family Futures

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1 Research Updates on Family Treatment Courts: Overview of Best Practices Part 2 Phil Breitenbucher, Children and Family Futures 1

Acknowledgement This presentation is supported by: The Office of Juvenile Justice and Delinquency Prevention Office of Justice Programs (2013-DC-BX-K002) Points of view or

2 Acknowledgement This presentation is supported by: The Office of Juvenile Justice and Delinquency Prevention Office of Justice Programs (2013-DC-BX-K002) Points of view or opinions expressed in this presentation are those of the presenter(s) and do not necessarily represent the official position or policies of OJJDP or the U.S. Department of Justice.

4 Systems Change A permanent shift in doing business that relies on relationships across systems and within the community to secure needed resources to achieve better results and outcomes for all children and families

5 3Rs Relationships Resources Results

6 A Framework for Systems Change Recovery Outcomes 5Rs for more families Structural Supports 1. Relationships 2. Resources 3. Results FDC Common Ingredients What works Values Why Are We Doing This? Remain in home Reunification Recidivism Re-entry

7 Key Components of Meaningful Systems Change Leadership at all levels Inclusion of stakeholders Shared information about institutional barriers Sustainability based on outcomes and results

8 The Collaborative Structure for Leading Change Oversight/Executive Committee Steering Committee FDC Team Membership Director Level Management Level Front-line staff Meets Quarterly Monthly or Bi-Weekly Weekly Primary Functions: Ensure long-term sustainability and final approval of practice and policy changes Remove barriers to ensure program success and achieve project s goals Staff cases; ensuring client success

9 Prioritizing Results Information flow Mobilizing Resources Information flow is the lifeblood, the fuel of an effective collaborative. Leadership consists of encouraging that flow, analyzing its meaning, and framing decisions that the team needs to make together. Building Relationships

10 Frequency Membership Primary Function FDC Team

11 FDC Coordinator vs. FDC Case Manager

12 Key FDC Case Management Functions Assessment Monitoring Planning Linkage Advocacy

13 FDC Coordinator Roles & Functions Contract management Grant Writing Oversee budget and resources Prepare and manage FDC docket Maintain individual client files Garnering community support Provide case management

14 The FDC Coordinator - The Realities Often work under limited direction of a manager Responsibility-YES; Authority MAYBE No choice in team members Dynamics constantly changing due to new staff, politics, funding May involve frequent and relatively independent working relationships May assume leadership at various points of development process or life span of FDC Oftentimes grant-funded positions and are cut due to budgetary issues Partners resource limitations May oversee other collaborative court programs

15 One person expecting to be all things to all people

16 The Collaborative Structure for Leading Change Membership Oversight/Executive Committee Director Level Steering Committee Management Level FDC Team Information Flow Front-line staff Meets Quarterly Monthly or Bi-Weekly Weekly Primary Functions: Ensure long-term sustainability and final approval of practice and policy changes Remove barriers to ensure program success and achieve project s goals Staff cases; ensuring client success

17 Frequency Membership Primary Function Steering Committee

18 Effective Steering Committees is more than reporting about what agencies did last month it s about whether clients are doing better. Busting barriers for improved outcomes

19 Effective leaders approach barrierbusting as a norm; they don t take barriers for granted Innovative Barrier Busters They know the difference between barriers and excuses - Confidentiality won t let us share information - Other agencies don t understand our clients - Our funders won t let us do it - We don t have the funding to take our efforts to scale

20 @ the table means: - More than signing an MOU - Key agencies are not just sending somebody; they are actively engaged - Involved in policy and operation decisions - Knows where the money is going Who s the Table

21 Collaborative Effective leaders invest and help build capacity of each partner, particular missing partners, to better serve families. Remember - you are only as strong as your weakest link Builds Up Weakest Links

22 Beware! Marginalized Collaborative Ahead! Warning Signs of Powerless Partnerships

23 Warning Signs of Powerless Partnerships Monthly BOGSATs* reporting only on activities, not results Reporting on what agencies are doing, not whether clients are doing better No buy-in at policy levels, only mid-level staff involved No buy-in at front-line levels: all supervisors without staff who have regular contact with families Missing players, too-dominant conveners, absent handoff agencies, over-reliance on a coordinator Undue focus on one set of links training, referrals, info systems without looking at the whole system *Bunch of guys sitting around a table

24 #2 Develop Interagency Partnerships FDCs bring together the legal framework of court, child welfare system and treatment services in a collaborative relationship with a common goal: to restore families. To best achieve this goal, however, they must collaborate with other agencies to provide the range of services and support required to ensure family stability, recovery of parents, and the permanent placement, safety and well-being of children. These partners should include mental health, domestic violence, primary health care, child development and other agencies. Key Component 1: Integrate treatment services with justice system case processing Key Component 2: Using a collaborative approach Key Component 10: Forging partnerships

25 Develop Interagency Partnerships Routinely Assess for Rates of Referrals, Completions & Barriers Don t Know: 26.9% Disagree Somewhat Agree Agree Responses (n = 26)

26 Drug Courts That Required All Team Members to Attend Staffings Had 50% Greater Reductions in Recidivism and 20% Greater Savings Percent reduction in recidivism 50% 40% 30% 20% 10% 42% 28% 0% All team members attend staffings N=31 All team does NOT attend staffings N=28 Note 1: Difference is significant at p<.05 Note 2: Team Members = Judge, Both Attorneys, Treatment Provider, Coordinator

27 Drug Courts Where a Representative from Treatment Attends Court Sessions Had 81% Higher Cost Savings A Representative from Treatment Attends Court Sessions % increase in cost saving 29% 16% Yes (N=55) Note: Difference is significant at p<.10 No (N=9)

28 Drug Courts Where the Defense Attorney Attends Drug Court Team Meetings (Staffings) had a 93% Higher Cost Savings Percent Increase in Cost Savings 30% 20% 10% 29% 15% 0% Defense attorney attends staffings N=59 Defense Attorney does NOT attend staffings N=11 Note: Difference is significant at p<.05 28

29 WHO needs to know WHAT, WHEN?

31 Resource: Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR) To download a copy, please visit:

32 #3 Create Effective Communication Protocols for Information Sharing Effective, timely and efficient communication is required to monitor cases, gauge FDC effectiveness, ensure joint accountability, promote child safety and engage and retain parents in recovery. Key Component 1: Integrate treatment services with justice system case processing Key Component 2: Using a collaborative approach Key Component 6: Responses to behavior Key Component 7: Judicial Interaction

33 Create Effective Communication Protocols for Sharing Information 70% 60% Responses (n = 26) 50% 40% 30% 20% 10% 0% Agree Somewhat Agree Disagree Not Sure

34 Create Effective Communication Protocols for Sharing Information The FTC utilizes community-wide accountability systems to monitor child welfare issues with specific indicators Don t Know: 34.6 % The FTC has developed the capacity to automate data about the outcomes of the participants compared to the larger systems Don t Know: 53.9 % Responses (n = 26) Disagree Somewhat Agree Agree

35 Drug Courts That Used Paper Files Rather Than Electronic Databases Had 65% LESS Savings 40% Percent increase in cost savings 30% 20% 10% 20% 33% 0% Program uses paper files N=8 Program has electronic database N=3 Note: Difference is significant at p<.05

36 Drug Courts where all team members attended staffings had 50% greater reductions in recidivism 50% Percent reduction in recidivism 40% 30% 20% 10% 42% 28% 0% All team members attend staffings N=31 All team does NOT attend staffings N=28 Note: Difference is significant at p<.05

Drug Courts Where Treatment Communicates with the Court via Email had 119% greater reductions in recidivism Treatment communicates with court via

37 Drug Courts Where Treatment Communicates with the Court via had 119% greater reductions in recidivism Treatment communicates with court via 0.5 % reduction in # of rearrests Yes N=31 No N=14 Note: Difference is significant at p<.10

38 Drug Courts Where Drug Test Results are Back in 48 Hours or Less had 68% Higher Cost Savings 40% Percent increase in cost savings 30% 20% 10% 0% 32% Drug tests are back within 48 hours N=21 Note: Difference is significant at p<.05 19% Drug tests are back in LONGER THAN 48 hours N=16

39 #4 Ensure Cross-Systems Knowledge Ongoing cross training of FDC team members and stakeholders at all levels is essential for ensuring collaboration and consistent, effective practice. Key Component 9: Continuing interdisciplinary education

40 Drug Courts That Provided Formal Training for ALL New Team Members Had 54% Greater Reductions in Recidivism 50% 40% 40% 30% 26% 20% 10% 0% All new team members have formal training N=30 All team members NOT formally trained N=17 Note: Difference is significant at p<.05

41 Drug Courts That Received Training Prior to Implementation Had Almost 3.5 Times Higher Cost Savings 40% Percent increase in cost savings 30% 20% 10% 0% 27% Team trained BEFORE implementation N=12 8% Team members NOT trained before implementation N=5 Note: Difference is significant at p<.05

Cross-Systems Knowledge Training on Operations Percent 100 90 80 70 60 50 40 30 20 10 0 100 91 Training on RPG Operations FDC

42 Cross-Systems Knowledge Training on Operations Percent Training on RPG Operations FDC Cohort (N=20) All Other RPGs (N=35) * Includes meetings to discuss program and policy and/or management or administrative issues

43 The Collaborative Structure for Leading Change Oversight/Executive Committee Steering Committee FDC Team Membership Director Level Management Level Information Flow Front-line staff Meets Quarterly Monthly or Bi-Weekly Weekly Primary Functions: Ensure long-term sustainability and final approval of practice and policy changes Remove barriers to ensure program success and achieve project s goals Staff cases; ensuring client success

44 Frequency Membership Primary Function Oversight Executive Committee

45 #9 Implement Funding & Sustainability Strategies Sustainability planning must address financial needs as well as support from a broad range of stakeholders. FDCs must have access to the full range of funding, staffing and community resources required to sustain its innovative approaches over the long term. FDCs need a governance structure that ensures ongoing commitment from policy makers, managers, community partners and operational staff members. Key Component 9: Continuing interdisciplinary education Key Component 10: Forging partnerships

46 Budget and Sustainability Barriers and Challenges Need for ongoing champions; challenge with turnover of judges Some FDTCs operate as projects or boutique courts (on top or on the side) Inherent limitations on scale and scope in some FDC models No standardized cost analysis of total program cost or cost savings Lack of sufficient data on program effectiveness Resource problems worsened by State and local fiscal crises

47 Implement Funding and Sustainability Strategies 50% Responses (n = 26) 40% 30% 20% 10% 0% Agree Somewhat Agree Disagree Not Sure

48 Funding and Sustainability Efforts The FTC's partners are able and willing to share information about their budget and staffing Don t Know: 30.7 % The FTC has a community outreach and education plan to further sustainability efforts Don t Know: 42.3 % Disagree Somewhat Agree Agree Responses (n = 26)

49 Sustainability Results 73.2 % of the major services and activities provided as part of the grant were sustained 33.3 % sustained their project in its current form or model beyond their grant period Of the 44 regional partnerships whose grants were not extended: 53.3 % sustained specific components or a scaled down or modified version of their program model 11.1% were not able to sustain any of their program

50 Redirection of Resources Already Here Pilots, Demos and Grant-funded Projects FDCs The Real Resources in the Community TANF Domestic Violence Courts Medicaid Police Housing Mental Health Hospitals Families Schools Substance Abuse

51 Potential Funding for Expansion Federal Direct Funding (FY 2012): $22.6 million $13.6 billion Primarily Title IV-E, TANF, SSBG, Medicaid, IV-B $350 billion Children s Programs - (Urban Institute, 2012)

52 Successful Financing Strategies Widening the definition of available or potential resources Changing the business as usual practices to incorporate RPG innovations Integrating with other child welfare systems improvements Negotiating third party payments for what the grant had initiated Connecting with other related grants or initiatives Incorporating RPG efforts within their own agency Transitioning services and staff to other partner organizations Joining with larger health care reform and care coordination efforts Institutionalizing RPG practices into Third-party billing, Medi-caid existing systems of care Redirecting existing, currently funded resources to adopt new case management and client engagement strategies

53 Collaborative Practice Implications What do child welfare staff need from substance abuse and mental health treatment practitioners to more effectively make decisions about the safety, permanence and well-being of children they are charged to protect? What do substance abuse and mental health treatment practitioners need from child welfare staff to more effectively assess and treat parents and children?

54 Distributive Systems- Focused Wide-Lens View Effective leaders have wide-lens radar: See external policy context; parallel/competing initiatives Know they re not the only game in town

55 Effective leaders sell the results of collaboration to other leaders Outcomefocused Demand the data to make the sale

56 Leaders know that nothing Characteristics of collaborative leadership II collaborates like cash but it takes more than resources to make it real and to take it to scale Limits of Cash

57 #8 Garner Community Support FDCs collaborate with community based organizations to support the multiple needs of parents, children and families during FDC participation, and to provide ongoing support for continued success after family members have completed their FDC services. Key Component 10: Forging partnerships

58 Making the Case in the Community To develop marketing documents, consider these elements in building your case: Prevalence of the problem Outcomes Case savings Intergenerational impact Early intervention and developmental effects on children

59 Making the Case in the Community How does parental substance use and child maltreatment effect other, highpriority issues? Are we clear on the benefits of your FDC? Have we done an inventory of potential funders? Have we begun a dialogue with those funders? Have we packaged the strongest possible case for our FDC? Do we use both stories and numbers to make the case? Have we documented how we ve already changed the system and changed the rules? Who s going to tell our story: who s singing our song?

60 Garnering Community Support What type of strategies have been developed to recruit broad community participation in addressing the needs of participant families? Do participant families have an active role in planning, developing, implementing and monitoring services? Do you include community stakeholders in planning and program development? Have you conducted a needs-assessment of FDC participants? How do you identify and link families with support services they need? Do you keep the community aware of your efforts and outcomes? Which policy leaders and stakeholders agree that funding is a priority in the midst of all the competing options for use of scarce resources?

61 Drug Courts That Had Formal Partnerships with Community Organizations Had More Than Twice the Savings 40% 30% 35% 20% 15% 10% 0% Drug court has formal partnerships in community N=15 Drug court doees NOT have formal partnerships N=5 Note: Difference is significant as a trend at p<.15

62 Collaborative Practice Implications What system changes need to occur to support local, crosssystem collaborative practices? Priority and timely access to treatment Address confidentiality Abstinence vs. Harm Reduction Systems response to relapse Enhanced acceptability of MAT Cross-Systems Training Engagement of Court and Attorneys

63 #10 Evaluate Shared Outcomes to Ensure Accountability FDCs must demonstrate that they have achieved desired results as defined across partner agencies by agreeing on goals and establishing performance measures with their partners to ensure joint accountability. FDCs develop and measure outcomes and use evaluation results to guide their work. FDCs must continually evaluate their outcomes and modify their programs accordingly to ensure continued success. Key Component 8: Monitoring and Evaluation

The Collaborative Structure for Leading Change Information Flow Oversight/Executive Committee Steering Committee FDC Team Membership Director Level Management Level Front-line staff Meets Quarterly

64 The Collaborative Structure for Leading Change Information Flow Oversight/Executive Committee Steering Committee FDC Team Membership Director Level Management Level Front-line staff Meets Quarterly Monthly or Bi-Weekly Weekly The Community Primary Functions: Ensure long-term sustainability and final approval of practice and policy changes Remove barriers to ensure program success and achieve project s goals Staff cases; ensuring client success

65 Collaboration = Shared results = Accountability = Trust that Promotes Sustainability

66 Evaluate for Shared Outcomes and Accountability The FTC has an ongoing plan for evaluation Don t Know: % Disagree Somewhat Agree Agree Responses (n = 26)

67 Percent increase in cost savings Drug Courts Where Review of The Data and Stats Has Led to Modifications in Drug Court Operations had a 131% Increase in Cost Savings 37% 16% Program reviews their own stats N=20 Program does NOT review stats N=15 Note: Difference is significant at p<.05

68 50% #2 Drug Courts Where the Results of Program Evaluations Have Led to Modifications in Drug Court Operations Had a 100% Increase in Cost Savings Percent increase in cost savings 40% 30% 20% 10% 0% 36% Used evaluation to make modifications to program N=18 18% Did NOT use evaluation to make modifications N=13 Note: Difference is significant at p<.05

69 Five Diagnostic Questions about Collaboration 1. Do we agree on the mission? 2. Do we agree on how we are going to measure whether we are achieving the mission do we have a way of tracking progress (i.e. data dashboard) 3. When front-line staff raise issues about barriers they run into do we ignore it or go to work as a team to reduce or remove the barriers? 4. Do we share enough information across agencies to be able to use our results to get more resources for what is working? 5. Do we have an agenda for scaling up or are we stuck in projectitis?

70 Building on our Success Q&A and Discussion

71 TEAM ACTION PLANNING Building Structure to Implement and Sustain Your Program 71

72 Resources

73 Resource: Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR) To download a copy, please visit:

74 FDC Guidelines To download a copy today visit our website:

75 Resources FDC Discipline Specific Orientation Materials Child Welfare AOD Treatment Judges Attorneys Please visit:

76 King County, WA Wapello County, IA Jackson County, MO Baltimore City, MD Dunklin County, MO Pima County, AZ Jefferson County, AL Chatham County, GA FAMILY DRUG COURT PEER LEARNING COURT PROGRAM CONTACT US FOR MORE INFORMATION: Miami-Dade, FL

77 FDC Learning Leading Change Academy Blog 2016 FDC Peer Learning Court FDC Podcasts Leadership Resources FDC Video features Webinar registration information

78 Resources NCSACW Online Tutorials 1. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers 2. Understanding Child Welfare and the Dependency Court: A Guide for Substance Abuse Treatment Professionals 3. Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Legal Professionals Please visit:

79 Family Drug Court Online Tutorial FDC 101 will cover basic knowledge of the FDC model and operations

80 Contact Information Phil Breitenbucher, MSW FDC TTA Program Director Children and Family Futures (714)

Continuous Quality Improvement Project

Continuous Quality Improvement Project Kentucky Interview with Vincent Geremia, State CQI Coordinator, Kentucky Department for Community Based Services Vincent.Geremia@ky.gov 606-920-2007 January 20, 2012