• Implemented 7/1/96.
• Substance abuse counselors co-located with CPS staff to identify families to link to treatment and other services.
• Substance abuse counselors accompanied CPS workers on initial visits.
• Substance abuse counselors arranged for substance abuse treatment and provided case management services.

Title IV-E eligible and non-IV-E eligible children in out-of-home care or likely to enter out-of-home care due to parental substance abuse.

Implemented statewide.

• Final evaluation report received 3/27/02.
• Comparison group design.
• As of 02/02, 530 families in the experimental group (55% of original expected sample) and 530 in the comparison group.
• Barriers to implementation: (1) problems identifying eligible families; (2) higher than expected caseloads; (3) lack of appropriate external treatment programs and resources; (4) lack of insurance or restrictions placed on treatment by managed care; (5) lack of training for child welfare caseworkers in identifying and responding to substance abuse problems; and (6) philosophical differences between caseworkers and substance abuse counselors (e.g., counselors emphasized abstinence whereas caseworkers emphasized child safety).
• On average, children in experimental group spent 204 days in out-of-home care compared to 294 days for children in comparison group.
• Proportion of cases with children entering out-of-home care was lower in the experimental group (33%) than in control group (40%).
• No statistically significant differences found between experimental and comparison groups in permanency rates.

• Implemented 4/28/00.
• Parents in substance-affected families are referred to Juvenile Court Assessment Program (JCAP) at time of Temporary Custody hearing or at any time within 90 days of hearing.
• JCAP staff conducts assessment of families referred for treatment.
• Experimental group participants receive Recovery Coach services in addition to traditional child welfare and substance abuse treatment services.
• Recovery Coaches assist families early in treatment process and provide support to families during and after treatment to prevent relapse and facilitate reunification.

Substance-abusing custodial parents with a child in out-of-home care; includes custodial parents who deliver drug-exposed infants.

Participating children may be title IV-E eligible or non-IV-E eligible.

Implemented in Cook County, Illinois.

• Final evaluation report expected 12/05.
• Two-stage random assignment process: (1) agencies and caseworker teams are randomly assigned to experimental or control groups; (2) cases are then randomly assigned to agencies in the control group or experimental group.
• As of 6/30/04, 1,320 eligible parents had been assigned to the demonstration, with 366 in the control group and 954 in the experimental group.
• Parents in experimental group access substance abuse treatment at a significantly higher rate than parents in the control group: 50 percent of caregivers in the experimental group accessed services within 40 days of their assessment, whereas 100 days elapsed before 50 percent of control group caregivers accessed substance abuse services.
• As of 6/30/04, 73 percent of experimental group parents (697) had participated in treatment at some point in time compared with only 50 percent (182) of control group parents.
• Although children in the experimental group are no more likely to achieve reunification than children in the control group, they tend to spend less time in foster care. On average, children in the experimental group spent 142 fewer days in care prior to reunification, a statistically significant difference.
• As of 6/30/04, a smaller proportion of experimental group caretakers had a maltreatment allegation following assignment to the demonstration (11.2 percent) compared with control group caretakers (15.3 percent). This difference is statistically significant.

• Implemented 10/1/01.
• Family Support Services Teams (FSST) comprised of chemical addiction counselors, local child welfare agency staff, treatment providers, parent aides, and mentors.
• Three treatment options offered: (1) inpatient treatment for parents and their children; (2) intermediate care; and (3) intensive outpatient treatment.
• Services included: case management; individual, group, and family therapy; housing, employment, child care, and transportation assistance; and health care and family planning.

Mothers or other female primary caregivers with a child in out-of-home care or at risk of placement due to substance abuse.

Participating children were both title IV-E eligible and non-IV-E-eligible.

Implemented in Baltimore City and Prince George’s and Baltimore Counties.

• Interim evaluation report received 3/31/04.
• Random assignment design. Initial plan to assign 100 women to experimental group and 100 to control group.
• Demonstration terminated early (December 2002) due to:
  • Lack of enrollment. As of 9/02 the demonstration had only 9 women in the experimental group and 9 women in the control group;
  • Client ineligibility and/or confusion regarding eligibility requirements;
  • Underreporting of substance abuse at intake;
  • Caseworkers’ lack of training to identify substance abuse issues;
  • Caseworkers being overburdened with existing child protection issues;
  • Resistance by caseworkers to random assignment;
  • Confusion over responsibility for recruiting eligible parents.
• Changes to address barriers included: (1) more training for intake workers in identifying and confronting substance abuse; (2) extended project enrollment periods; and (3) expanded eligibility criteria.
• Changes in training and recruitment did not significantly affect program enrollment.
• No outcome findings were reported.

• Implemented 11/15/99. Currently operating under a short-term extension through 11/30/05.
• Licensed Alcohol and Drug Abuse Counselors (LADCs) work with child protection workers in an advisory and supportive capacity, using their clinical skills to provide training, assessment, treatment, and case management services.

As appropriate, LADCs:

• refer parents to counseling and treatment;
• assist with case planning;
• collaborate with State and county corrections departments;
• provide intensive substance abuse case management; and help link caregivers and children to supportive resources.

Families involved in child protection services with caretaker substance abuse as a major referral reason.

Participating children may be title IV-E eligible or non-IV-E eligible.

Implemented in 2 child protection district offices (Nashua & Manchester).

• Interim evaluation report submitted 9/12/03. Final evaluation report expected 7/31/05.
• Random assignment design.
• 435 families enrolled in the demonstration as of 4/03: 222 families in experimental group and 213 families in control group.
• Substance abuse assessment completed for 58% of family members as of 9/03.
• Barriers to implementation: (1) clients’ reluctance to give informed consent; (2) clients’ lack of readiness to acknowledge substance abuse problems; (3) high CPS caseloads; (4) staff turnover; (5) confusion regarding roles and responsibilities of caseworkers and substance abuse specialists; and (6) problems with tracking client data.
• No statistically significant differences to date between experimental and control groups in placement rates, placement duration, placement stability, or maltreatment recurrence.
• Although not statistically significant, available findings on child and parent well-being point in a positive direction:
  • Interviews conducted using the Child Behavior Checklist (CBCL) indicated greater declines in problem behaviors in 7 of 8 categories for children in the experimental group compared to children in the control group.
  • Experimental group parents are less likely to be receiving TANF at follow-up, more likely to be enrolled in an educational program, and more likely to be employed full-time than parents in the control group.