0555b664__Alcohol_and_Other_Drug_Issues__Program_Improvement_Plan__PIP_
[State] Ohio Among all reasons identified for children coming to the attention of the child welfare agency, neglect (not including medical neglect) was cited in 29 (58%) cases, and substance abuse by parents was cited in 11 (22%) cases. Primary reasons for opening a child welfare agency case included substance abuse by parent in 2 cases (4%). Recently changes to the staff training curriculum were made in response to a need for more training on alcohol/substance abuse treatment services, sexual abuse treatment, and adoption by foster parents.� The stakeholders also agreed that the State make available specialized training on specific topics when necessary, including training in risk assessment and in substance abuse assessment.� There are 43 county (of 88 counties) or multi-county mental health and alcohol and drug addiction services boards and 7 counties with separate mental health boards and alcohol and drug addiction service boards.� ODJFS has conducted a number of evaluations to assess the availability of services across the State. According to the 1998 Statewide Child Protection Services Needs Assessment study conducted by Hornby-Zeller Associates, Inc., of the more than 60 services examined, there were only nine that were not adequately available statewide. Of these nine services, those with the greatest shortfall in client capacity were intensive family preservation, medical/physical exams, and alcohol and other drug residential treatment. There were, however, particular geographic areas where more services were needed. In the large (and some medium-sized) counties there were inadequate drug and alcohol assessments, psychological and mental health assessments, alcohol and drug treatment, protective day care, and transportation services. In response to the study, $4,000,000 was allocated by the legislature to ODADAS for the prioritization of substance abuse services for families involved in the child welfare system. The Statewide Assessment also discussed the systemic barriers to the provision of mental health and substance abuse services. For example, as pointed out in the Statewide Assessment, although basic mental health and substance abuse services are provided in each county, most counties are not able to maintain a full spectrum of care (e.g., detoxification, outpatient, inpatient, residential treatment, etc.).� Consequently, the PCSAs have to make arrangements for clients to travel significant distances in order to access necessary services.� Activities that are planned or have been implemented as a result of recommendations by the Governor�s Task Force on Investigation and Prosecution of Child Abuse include expedited appeals of TPRs and the establishment of family drug courts for parents who abuse or neglect their children because of substance abuse or addiction. Information in the Statewide Assessment supports statements made by stakeholders regarding the scarcity of mental health and drug and alcohol services in many counties and the negative impact of the lack of these services on the agency�s ability to reunify families in a timely manner. Stakeholders mentioned that lack of access to services, waiting lists for services, and crowded court dockets were key barriers to timely reunifications. These stakeholders also noted that often there are insufficient services available in the community that would permit children to be safely maintained in their homes, particularly services to address mental health and drug and alcohol problems. Stakeholders in the sites included on the onsite review identified a number of service gaps specific to their communities, including housing, placement resources for juvenile sex offenders, mental health services, independent living services, inpatient alcohol/drug treatment, residential treatment for girls, therapeutic foster care, wraparound/community-based services, transitional services for the MRDD population, services for the developmentally delayed, treatment resources for adult and youth sexual abusers, residential facilities, childcare, and transportation.� Array of services was rated as a Strength; according to the Statewide Assessment, the State offers a comprehensive array of services to meet the physical, mental, psychological, substance abuse, behavioral, therapeutic, and environmental needs of the children and families it serves in the child welfare system.� However, stakeholders also noted that there are long waiting lists for many of the services, particularly mentoring, mental health, and substance abuse treatment services for women.� Services accessible to families and children was rated as an Area Needing Improvement because unstable and disparate funding from county to county, and insufficient availability of services such as mental health and substance abuse treatment, negatively affect Ohio�s ability to deliver needed services to children and families. The needs and services of child, parents and foster parents was rated Area Needing Improvement; case reviewers noted that a key problem was that assessments were not sufficiently in-depth to uncover potential underlying problems, such as domestic violence or substance abuse.� ��� Ability to deliver needed services was rated as an Area Needing Improvement because the ability to deliver needed services to children and families is negatively affected by unstable and disparate funding from county to county and extreme variation in the availability of services such as mental health and substance abuse treatment. Stakeholders commenting on the above issue noted that ODJFS is effective in meeting families� needs for hard services, such as housing assistance, but is less effective when service needs are more complex, such as substance abuse treatment.� This problem was attributed to a lack of adequate funding in the community for key services.� Specific problems identified in the case review process were unmet service needs and incomplete assessments, specifically assessments that were not sufficiently comprehensive to identify underlying problems, such as domestic violence or substance abuse. Stakeholders indicated that many caseworkers use the exception that �the services required in the case plan have not been available or provided� to delay filing for TPR, particularly when the service involves substance abuse treatment.� Despite the generally positive perception of the agency�s efforts to coordinate service delivery with other agencies, some stakeholders identified specific barriers to coordination and collaboration including turnover of personnel in leadership positions, variation in available financial resources among agencies, different funding sources (i.e., Medicaid and Title IV-E), and differences in the structure and mandates of child welfare, mental health, and alcohol/drug addiction services.
The Assumptions section of the PIP states that ODJFS had to be mindful that services needed by families and children involved with PCSAs may be provided by other agencies, and the support for systems change needs to be obtained from agencies at the state and county level that provide mental health, alcohol and drug addiction, mental retardation and developmental disabilities, and educational services. It is anticipated ODJFS will present proponent testimony to the Ohio legislature regarding HB 117 no sooner than January 2004.� If the legislation is enacted ODJFS will develop Ohio Administrative Code rules for the implementation of the bill. If the bill fails to be enacted, ODJFS will promulgate rules that require additional training for youth care workers, similar to that which recently went into effect for foster caregivers. The rules will require training of staff on the specific needs of the population served, such as mental health issues, substance abuse and juvenile justice topics. To better meet the special needs of children in the child welfare system whose parents struggle with substance abuse, ODJFS and ODADAS will promote the provision of specialized programming for children of parents who are addicted to alcohol or other drugs.� These efforts include, but are not limited to, meetings with local service providers, prevention coalitions, board associations and provider councils. To promote best clinical practices, ODJFS with work with the Ohio OMHD and ODADAS to disseminate information regarding statewide initiatives and research-based interventions. To maximize financial resources, ODJFS, ODMH and ODADAS will continue to provide further technical assistance to PCSAs and local treatment providers regarding initiatives, best practice methods and funding resources for behavioral health programming. ODJFS will serve in an advisory capacity on program evaluation projects conducted by ODADAS and ODMH to assess the effectiveness of behavioral health care treatment services. ODJFS will support the ODMH-ODE partnership designed to provide assessment, intervention and treatment services with the school system. ODJFS, OCF, Bureau of Family Services and ODADAS will continue to provide training to PCSAs and treatment providers regarding issues associated with federal confidentiality laws. ODJFS and OCF will encourage the establishment of multi-disciplinary teams and other collaborative models for assessment, case planning, and the monitoring of service provision to address issues which require involvement of multiple agencies (e.g., domestic violence, mental health, education, substance abuse, mental retardation/developmental disabilities). ODJFS, OCF, Bureau of Family Services and ODADS will promote the provision of specialized programming for children of parents who are addicted to alcohol or other drugs. In addition, ODJFS and ODADAS will continue to provide technical assistance to local communities to increase utilization of resources and promote effective programming for families in the child welfare system who struggle with substance abuse.
A Review of Alcohol and Other Drug Issues
Program Improvement Plan (PIP)