0555b664__Alcohol_and_Other_Drug_Issues__Program_Improvement_Plan__PIP_
[State] Maine Among all reasons identified for children coming to the attention of the child welfare agency, substance abuse by parents was cited in 21 (42%) cases. Of the 50 cases reviewed, substance abuse by parent was cited as the primary reason for opening a child welfare agency case in 4 cases (8%). Services to family to protect child(ren) in home and prevent removal was cited as an area needing improvement when reviewers determined that the agency offered services, but they were not adequate to ensure the safety of the children in the home (5 cases). For example, in one case, the agency provided homemaker services, but did not address the parent�s substance abuse problems. In another case, the agency addressed parent�s domestic violence problems, but did not address apparent sexual abuse issues. Services provided to the families included, but were not limited to: sex offender treatment, domestic violence interventions, individual and family therapy, psychological assessments and evaluations, psychosexual evaluations, individual and family counseling, support groups, parenting education classes, parenting capacity evaluations, transportation to facilitate visitation, medical/forensic evaluations, substance abuse treatment, mental health treatment, in-home services, attachment evaluations, homemaker services, day care, and voluntary placements. Stakeholders commenting on foster care re-entries noted that it is rare that children re-enter foster care in the State. Stakeholders attributed this to (1) the fact that children stay in foster care for a long time, and (2) the tendency of social workers to delay returning children to live with parents who have undergone substance abuse treatment until they are sure that the parents will not relapse. The Statewide Assessment notes that the lack of needed services in some areas of the State is an impediment to reunification, particularly substance abuse treatment, domestic violence interventions, and mental health services. The Statewide Assessment indicates that there is agreement from surveyed casework staff that permanency hearings are, for the most part, occurring Statewide. However, the Statewide Assessment also notes that judges and defense attorneys believe that BCFS sometimes moves too slowly, is inadequately prepared for the hearings, or is over-focused on timeframes. Some of these stakeholders noted that the timeframes are unrealistic for families with substance abuse issues. According to the Statewide Assessment, despite the fact that State funds earmarked for the expansion of in-home, reunification, and kinship care initiatives have not been made available, BCFS provides access to a wide array of services and programs. Available services include: home family therapy, time limited reunification services, psychological evaluations, substance abuse evaluations, attachment evaluations, mental health counseling, in-patient and out-patient substance abuse counseling, Al-Anon groups, anger management classes, psychiatric services, family foster care, treatment foster care, residential services, parenting education, family violence programs, sexual abuse treatment teams, sexual assault support groups, batterer�s treatment, non-offenders groups, sexual offender assessment and counseling, interpreter services, transportation, supervised visitation, childcare, homemaker services, Early Head Start, domestic violence and homeless shelters, and case management In addition to these established services and programs, two additional programs are being piloted within the State: (1) a comprehensive family reunification program in conjunction with Casey Family Services, and (2) a Rapid Evaluation Program. Stakeholders identified gaps in critical services, including substance abuse assessments and treatment services, and residential drug treatment facilities that would allow parents and children to stay together (e.g., older mothers and children, fathers and children). The majority of stakeholders expressed great frustration with the prevalence of waiting lists, echoing concerns raised in the Statewide Assessment. Stakeholders emphasized that waiting lists are a major barrier to effective service delivery across the State. They reported that there are long waiting lists for assessments (e.g. psycho-sexual, parental capacity, independent living, home study), and this situation is compounded by the length of time it takes to receive results. Stakeholders also identified numerous waiting lists for contracted services (e.g., individual counseling, visitation, in-home and family preservation services, in-patient substance abuse treatment, community mental health services, and comprehensive evaluations). Stakeholders pointed out that some contracted services are generic in quality, and that greater focus or specialization is needed in certain areas (e.g., the provider may not offer treatment services for a specific type of substance abuse, psychological evaluations with a parenting component, specialized in-home services, etc.). Stakeholders observed that philosophies and approaches differ among agencies and need to be reconciled. For example, the mental health system advocates for the parents and the child welfare system advocates for children, thus creating conflict with child-oriented safety and permanency goals. In addition, stakeholders pointed out that ASFA timelines for achieving permanency for children in foster care are not synchronized with substance abuse treatment timeframes. Substance abuse recovery often takes longer than the 15 months specified in ASFA. Stakeholders commenting on coordinated services expressed the opinion that BCFS is working intensively with other public agencies to coordinate services and benefits (i.e., education, public health, substance abuse, TANF, child care, and Medicaid). Stakeholders noted that formal entities meet regularly to coordinate services.
As part of the BCFS Quality Improvement Review, Maine will assess whether substance abuse services needed and provided.
A Review of Alcohol and Other Drug Issues
Program Improvement Plan (PIP)