Fwc powerpoint sparc9 5-12


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  • ■ Identified early on that one of our key values was trauma-informed system and this helped get buy-in from the beginning ■ With respect to provider education, we’ve done number of trainings around trauma includes impact of trauma on brain development, understanding what trauma triggers are and how to avoid them ■ Working with Vivian Brown, national trauma expert, regarding assessing our systems for trauma triggers; questionnaire and walkthrough of not just FWC, but all partners in CWS ■ She’s also helping us review our findings and create action plans for addressing concerns ■ Mental Health offers trauma based cognitive behavioral therapy and DADS now requires all providers to offer seeking safety, which is a trauma curriculum ■ Vivian Brown observed Court and said we were The Premier Example of a trauma- informed court ( comings and goings, side conversation )
  • ■ Child welfare drug court, with a focus on meeting the needs of the child, the child focus is the primary distinction between this court and the DDTC ■ Target pop formerly focused on women, wanted family focused model, expanded to include men, significant male engagement and involvement, quite a few on track to get their kids back, even when woman not doing well ■ Goal is to serve 100 families annually, which is subset of those eligible, so ultimate goal is to make this the model used across the dependency system
  • ■ Closely working in partnership, all contributing resources in addition to grant funded and committed to systemic change and letting go of old ways of doing things to improve ■ Common values ■ Collaboration is flexible, changing and responding to request for change quickly; instituted a governance structure that provides for top-down/bottom-up information exchange and decision-making
  • ■ Early access to assessments and treatment and prevention of future substance abuse exposure
  • ■ Child focus ■ Systemic change. Not only taking to scale
  • ■ Couple things about eligibility criteria – it is a little challenging to determine if parents will meet those last two criteria at the time the petition is filed….. goal is to start in FWC ASAP and ■ L ooking at long-term incarceration – how we can serve because so many parents are incarcerated
  • ■ Due to age of child, law requires that they make significant progress within six months for reunification to be considered ■ About 40% have been in child welfare system themselves as children ■ Large percentage have had other children in CWS that they weren’t able to reunify with and have been adopted, are with relatives, etc. ■ Almost all cases have extensive trauma histories, rapes, kidnapping, abandoned in dumpster as infant ■ 66% have annual incomes less than 10,000 ■ Did survey when applying for a housing grant earlier and 65% either homeless or met criteria for substandard housing ■ Meth – nearly all are meth users
  • ■ We’ve expanded our service model significantly as we’ve identified additional needs families have. Grant only covers 2/3’s of direct client service, many partners designating additional unpaid staff to assist ■ Court environment is actually one of most significant parts of our intervention and court environment is critical to our success. Focus group cites the attitude of judge, support ■ Early DADS assessment critical to success – 6 month timeline, previously taking 4 months to get into treatment ■ Recently did a focus group and mentors also cited as significant intervention. Mentors do a lot to support the parents and educate about CW system and how to be successful, but also play a critical role in supporting recovery, ensuring women get sponsors, role models, etc. ■ Most women victims of DV, 80 % cross-over – DV advocate works with women on developing safety plans
  • ■ NCF: Flexible funding to remove barriers to case plan goals can use to help with rent/basic needs, PG&E, work clothes, GED, therapy co-pays, etc ■ Therapeutic services: child therapy, parent therapy and also dyadic therapy in which parent and child work together, PCIT ■ Primary goal is to prevent sub-exposed newborns. If woman does become pregnant, role of home visitor is to ensure linked with early prenatal care ■ Really critical because kids at high risk; we’re catching any issues like developmental delays early when interventions can really make the biggest difference ■ CASA’s for 30% of families; but more importantly, their role has changed to serve and support entire family – bio parents and extended family as well as foster parents
  • ■ Also ensuring women linked to primary care providers so can get other needs met. ■ Parenting workshops: there are many; Celebrating Families which is evidence based parenting program that includes whole family. In-home parenting coaching would be good ■ Home visitors/PHN’s and Friends Outside also work on relationships and bonding ■ Dental care really essential for adults, lot of damage associated with meth; pain can be trigger for relapse; self-esteem ■ Tattoo removal also important (Sherri Galli’s story)
  • ■ Children’s funded by FIRST 5 of Santa Clara County which tobacco tax $; KLEPS Award for collaboration in Family Court ■ Leverage other funding sources (Eligibility worker in courtroom and courthouse) ■ Mental Health services provided through F5 System of Care are funded by County MH Gen fund, Prop 63 (Calif Millionaire Tax) and kids linked with healthcare coverage programs to leverage as well. ■ Services prioritized based on need; home visitation and therapeutic services are reserved for only those children with the greatest risk of poor developmental outcomes
  • ■ Hearings are in addition to and held separate from statutorily- required CW hearings before the same judge ; contested hearings are before a different judge ■ If issues arise between scheduled hearings, a staffing (meeting with service providers) may be set for case planning and/or the family may be scheduled for an earlier hearing. ■ If parent non-compliant, may be asked to come later in the week – or even daily – to bring back documentation of AA meeting, etc. ■ Hearings are an important part of our intervention and the relationship with the judge and team ■ Accountability is important for this population, consequences. Wide range of sanctions, depending on what the issue is: attending extra AA meetings, community service, writing an essay, coming to court more often, etc. Will start Phases and Stages ■ Incentives: Fishbowl, NCF’s, educational toys, children’s books, praise
  • ■ Executive Directors of all of our partner agencies are very committed. Before we knew if we’d get the grant funding, they’d decided to go ahead ■ Lucero discussed shared values and it was critical in building foundation to support our service model among many other things ■ Would not believe the level of commitment and passion among partners, 85 agencies still involved, people saying that this is what they’ve wanted to do all their lives, above and beyond, energy behind ■ Clients with multiple issues and challenges and need to be able to address ■ Flexibility and ongoing assessment
  • Fwc powerpoint sparc9 5-12

    1. 1. SPARC Webinar September 5, 2012Family Wellness Court Judge Erica Yew California Superior Court Santa Clara County 1
    2. 2. Trauma-Informed CourtExtension of Problem-Solving Courts What is it and WHY? Therapeutic alliance  Vivian Brown: 50 to 60% of outcome rests upon a positive therapeutic alliance  Only 1 to 2% is related to the treatment model or methodology used  20 years of adult drug court research indicates that the #1 incentive for people is their relationship with their judge or their probation officer 2
    3. 3. Considerations for a Trauma-Informed Court Taking your time, even if it is an illusion Reduce waiting if possible Noise Setting Listening and validating where possible HONESTY RESPECT HOPE TRANSPARENCY: Clear communications and expectations 3
    4. 4. Trauma-Informed Systems FWC values statement includes trauma- informed system Commitments by Partner Agencies Provider education Continual system assessment and modification – 360 assessment Trauma specific services: DADS Seeking Safety (PTSD and addiction), Mental Health trauma based cognitive behavioral therapy 4
    5. 5. FWC Overview Target population: Pregnant women and parents, with children 0 to 3, whose abuse of methamphetamine and other substances have placed their children in or at risk of out-of-home placement. Ten year experience, repeated subsequent pos-tox births Started with grant in March 2008 5
    6. 6. FWC Primary Partners for Grant US$ 6.3 million over 5 years Superior Court Social Services Agency (SSA), SSA’s Department of Family and Children’s Services (DFCS) and SSA’s County Counsel First 5 Department of Drug and Alcohol Services (DADS) County Mental Health (MH) Legal Advocates for Children and Youth (LACY) – children counsel Dependency Advocacy Center (DAC) – parents counsel 6
    7. 7. Primary FWC Goals (1) Early identification of and intervention for the needs of pregnant women and parents with substance use disorders. Rapid engagement and successful retention in treatment and care Reduction in subsequent pos-tox births 7
    8. 8. Primary FWC Goals (2) Early identification and intervention for developmental delays, disabilities and concerns for children 0-3 whose parents come before the FWC Creation of a comprehensive System of Care across all systems serving children in or at risk of out-of-home placement as a result of parents’ methamphetamine and other substance abuse 8
    9. 9. FWC Eligibility Criteria The parent has given birth to an infant that has been exposed to methamphetamine or other substance abuse during the pregnancy; OR The parent has a child under the age of three that was either born drug exposed or has been raised in a substance abuse afflicted environment with documented abuse and/or neglect; AND The parent does not demonstrate intractable mental health issues as presented in the filed petition; AND The parent is not likely to face long term incarceration 9
    10. 10. FWC Customer Characteristics Fast-track cases History of CWS involvement as children 40% were foster children themselves Prior cases in CWS, many with prior termination of parental rights, 9 prior births, multiple pos-tox births 10
    11. 11. More Customer Characteristics  Extensive trauma history (give examples – multiple deaths, abandonment, kidnapping, prostitution as 8 yo)  80% cross over with DV  90% incarceration history 11
    12. 12. More about Customer Characteristics Methamphetamine primary drug of choice:  national, state and local data indicate that 75-80% of child welfare cases are drug and alcohol related. In Santa Clara County the drug of choice is methamphetamine where preference is around 64-67%. Homeless or living in substandard housing, 65% chronic homelessness Extremely low income, 66% have annual income of less than $10,000  TWD $ 285,000  Average California income US$ 61,017  Average U.S. income US$ 52,029  Federal Poverty Level for parent and 1 child US$ 14,570 12
    13. 13. FWC Services (1) Therapeutic court environment, with regular reviews Early connection to TANF, food stamps, other programs Case management by the court Legal representation Early drug and alcohol assessment and treatment Residential inpatient-treatment for women; and for women with their children Transitional Housing Units (THU) for women, men, children Mentor Parent support Domestic violence advocacy and services Transportation assistance (bus tokens, bus tokens for children, bicycles, car seats) Linkages to shelter and housing 13
    14. 14. FWC Services (2) Limited funding to assist with barriers to case plan completion (books, birth certificates, funeral transportation) Linkages to employment and benefits services, record clearance Coordination with Criminal Court partners, fine conversion Therapeutic services, dyadic and PCIT included Pregnancy prevention education Comprehensive developmental and behavioral screening, assessment and interventions for all children Child appointed special advocates (CASA’s) for many children and parents = an extension of role 14
    15. 15. FWC Services (3) Linkage to health coverage and primary care physicians Linkage to dental and vision care through charitable organizations Access to a wide array of parenting classes Home visitation and Public Health Nurses with regular reporting – transparency Diapers, children’s and adult clothing & shoes, hygiene products, groceries/meals, milk, books, toys, strollers Early care and education services GED assistance Language assistance Budget and nutrition information and workshops Medical and dental health care for children Tattoo removal and MORE…. 15
    16. 16. Children’s Services Overview Funded by FIRST 5 Santa Clara County Medi-Cal/EPSDT (Early Periodic Screening and Diagnosis and Treatment) is leveraged MHSA (Prop 63: Mental Health Services Act – 1% income tax on excess of personal income of $1 million), County General Fund and reimbursement via public children’s insurance programs are also utilized for Mental Health services System of Care: Tiered system based on level of need as determined by screening and assessments utilizing standardized tools and evidence-based practices 16
    17. 17. FWC Multidisciplinary Team/MDT Judge  Social Work Liaison Court Resource  County Counsel Manager  Child’s Attorney DV/Trauma Therapist  Parent Victim Witness  Parent’s Attorney & Advocate♦ Mentor Eligibility Worker  Social Worker Child Advocate  Therapist  Home Visitor DADS rehab counselor  Public Health Nurse Adult MH Coordinator♦  Special Support People First 5 Specialist (SARC, parent advocates) 17
    18. 18. FWC Hearings Hearings may occur daily, weekly, twice a month or once monthly depending on parent progress Staffings are held with the court team prior to the hearing to discuss case progress, concerns and develop joint recommendations – COMPREHENSIVE Incentives or Sanctions may be given Resources given 18
    19. 19. FWC Data Doors Opened March 14, 2008 As of April 2011, data below:  1 to 2+ years of services per family (FR → FM) 290 parents served  3 re-entries (mental health and housing) in 3 years  11-12% re-entry rate in California  1 subsequent pos-tox births in 3 years (despite many births and population that had repeated prior pos-tox births, mothers with 8 children previously removed) 19
    20. 20. More about the Results Santa Clara County Reunifications Rates  2009 = 48%, no separate tracking for Fast Track cases  2010 = 53%, FWC may be improving general outcomes  FWC as of September 2010 for Fast Track cases = 71% 350 children served  100% of children whether parents succeed or not 20
    21. 21. Primary Keys to Success Commitment at highest agency administrative levels Shared values Passion and commitment of involved staff Comprehensive service model Service model that evolves as additional client needs are identified Incorporation of the parents’ voices (through mentors and the actual parents before the court – surveys, court experience) Promoting the parent-baby bond 21