0555b664__Alcohol_and_Other_Drug_Issues__Program_Improvement_Plan__PIP_
[State] Massachusetts In 35 (71%) of the applicable cases, workers did attend to the children�s health needs.� In some of these cases, the workers ensured that the children received specialized services for conditions such as Fetal Alcohol Syndrome, �lazy eye� and speech problems. There were two cases reviewed in which maltreatment recurred during the period under review. In one of these cases, there was early (perhaps, premature) reunification with a family in which substance abuse was the key issue Stakeholders cited the training and consultation available for cases involving domestic violence and substance abuse as promoting increased safety for children who remain in their homes. According to some stakeholders, there are still differences of opinion among the Department, the providers, and the Courts concerning how much time to allow parents to successfully complete their rehabilitation before making the decision to file a TPR petition. This is a particularly difficult question when substance abuse is the primary issue in the case. Adequate service assessments were completed, but the services provided were not appropriate for the assessed needs, e.g. cases in which domestic violence or substance abuse needs were assessed, but services for these problems were not provided and there were waitlists for both mental health and substance abuse services. According to State policies and procedures, when mental health service needs are identified for a child, the DSS social worker arranges for the required service by contacting a provider approved by MassHealth�s mental health vendor, the Massachusetts Behavioral Health Partnership (MBHP). The Partnership provides in-patient mental health and substance abuse services, diversionary services, emergency services and outpatient day programs. The following training needs were identified: making better assessments and engaging families in case planning; family-centered and culturally sensitive services to diverse families; addressing mental health and substance abuse issues; and effectively working with and providing services to adolescents with behavioral issues. Multidisciplinary Assessment Teams (MDATs) have been established in each Area Office to provide a comprehensive clinical assessment of a family�s needs leading to the appropriate level and type of service provision. Family involvement in the MDAT meetings is encouraged. Services funded by the MDATs include mental health/trauma, domestic violence, and substance abuse evaluations; counseling; parent education and support; and summer camp memberships. Two new programs have been developed jointly with the Department of Mental Health for children with assaultive behavior. Mental health and substance abuse professionals provide evaluation, diagnostic and treatment services for children and their parents. Safe Recovery, the first of three programs funded by DSS, prioritizes admittance into their six to twelve month residential treatment program to mothers who have lost custody of their children or who are at risk of losing their children. At the end of FY 2000, Safe Recovery completed its third year of operation with encouraging results: while only 35% of women entered the program with custody of their children, 60% of children were reunified (a total of 17 children) with their mothers after participation. In Pittsfield, stakeholders noted effective coordination between the Department staff and law enforcement. They also spoke about attempts to strengthen the quality of substance abuse evaluations and to work collaboratively with programs such as AA. Reviewers identified needs that were not met, and in particular, noted the lack of available/accessible mental health services and alcohol/drug in-patient treatment services. In addition, stakeholders identified a shortage of placement resources across the continuum of care. Especially noted was the need for specialized foster homes for children with attachment issues; placement options for adolescents, including placement resources for run-aways, particularly girls; residential care (substance abuse and behavioral treatment programs, in particular); and independent living arrangements. Stakeholders provided a comprehensive list of services needed to support and to assist the rehabilitation of families involved with the Department. These include: affordable housing; services for fathers; more culturally responsive service and bilingual treatment providers, including Creole and Spanish translation; services and placement resources to meet the needs of Tribal children; substance abuse evaluations, drug testing and in-patient treatment for adolescents; outpatient mental health services and mental health services for targeted populations Reviewers at all three sites noted access issues with a number of services. While the extent of the problem appears to be worse in some areas than others, primary among these needs were accessing mental health services, special education services, and substance abuse assessment and treatment services � especially for adolescents. The Department is also engaged in collaborative efforts including coordination of Substance Abuse Programming with the Department of Public Health
Complete a substance abuse needs assessment in the remaining Areas Offices in the Western, Northeast, Central & Boston Regions. Connect the above Area Offices to local substance abuse treatment providers by establishing necessary protocols to facilitate client access to treatment. Increase substance abuse resources for DSS families. Implement statewide urine drug testing across all DSS Regions by selecting a drug testing vendor and implementing drug testing system statewide. Provide training and technical assistance to DSS Area Offices on the new drug testing system. Provide each DSS Area Office with training on the impact of substance abuse on child welfare families. Participate in CORE, Investigations and In-Service Training sessions. Provide substance abuse case consultation to DSS Area Office staff; two pilot models are currently in use that bring substance abuse providers into DSS offices for the consultation. The DSS Substance Abuse Unit staff provide consultation to other offices. Ensure access and provide coordinated care to families residing in the women and children�s substance abuse residential programs. Identify a substance abuse continuum of care for adolescents in collaboration with other state agencies, as part of an interagency group. Identify appropriate substance abuse service models for child welfare clients with the assistance of the new National resource Center. Continue cross-system collaboration with key stakeholders, focusing on treatment needs of DSS clients and resource needs for adolescents.
A Review of Alcohol and Other Drug Issues
Program Improvement Plan (PIP)