0555b664__Alcohol_and_Other_Drug_Issues__Program_Improvement_Plan__PIP_
[State] Rhode Island Among all reasons identified for children coming to the attention of the child welfare agency, substance abuse by parents was cited in 17 cases (35%). Primary reason for opening a child welfare agency case included substance abuse by parent in 6 cases (12%). Critical gaps in the service array are foster homes, foster parent support services, substance abuse services for both youth and adults, and in-home/post-reunification support services. Stakeholders attributed maltreatment recurrence to a variety of factors including the following: (1) parental substance abuse and a lack of services to address it; (2) the fact that services are rarely provided to families when maltreatment reports are �indicated� but determined to involve a low level of risk (e.g., in these situations families are referred to community-based services rather than assigned for on-going DCYF involvement); (3) delays in providing services following a substantiated report; (4) premature reunifications; (5) lack of post-reunification supports; and (6) premature case-closures. A key concern identified during the CFSR pertained to insufficient assessments of underlying and ongoing risk, particularly risk associated with parental substance abuse, mental illness, or domestic violence. Services provided to the families included, but were not limited to, individual and family counseling and therapy, developmental and behavioral assessments, psychiatric evaluations, substance abuse and mental health assessment and treatment, parent groups, domestic violence counseling and treatment, supervised visitation, in-home parent aide services, parent advocacy and education, home-based early intervention, day care and respite care, therapeutic recreation, intensive wraparound services, transitional and post-reunification services, independent living services, employment services, financial services, housing assistance, transportation services, and visiting nurse services. In several cases, reviewers identified problems in the family that contributed to the risk of harm to the children but that were not addressed by DCYF. These included, but were not limited to, parental substance abuse, parental mental illness, domestic violence, and inappropriate contact between the child and the maltreatment perpetrator. Stakeholders expressed the opinion that the State has a high rate of foster care re-entry. They attributed this in part to the agency and court practice of returning children home �too soon,� without adequate preparation or planning. Stakeholders suggested that this problem is particularly relevant in situations in which parents with substance abuse issues have not made the necessary changes, yet children are returned to their care.
The Rhode Island Department of Children, Youth, and Families has seven major strategies that focus on improving system effectiveness through various means, including policies and procedures to enhance service delivery in our approach to the treatment of substance abuse issues With NHPRI and DHS working collaboratively with DCYF, the Rite Care health plan (Medicaid) is taking an active role in the development of an array of community-based children’s behavioral health services, including substance abuse services. In response to substance abuse treatment capacity issues, MHRH recently re-procured the state’s outpatient substance abuse treatment system of care. Under this new system, funding is allocated to provide a continuum of levels of care – traditional outpatient, intensive outpatient, partial hospitalization, and aftercare services. Funds are also allocated to provide specialized services for pregnant and/or parenting women and an array of case management services for both men and women. There is effective and ongoing collaboration between DCYF, MHRH, DHS and community providers regarding substance abuse prevention, intervention and treatment. Through this program improvement plan, the DCYF will work to identify the need for parent substance abuse evaluations and treatment, and request technical assistance from the National Center on Substance Abuse and Child Welfare to determine best practice approaches to treatment. Subsequently, the Department will work with its sister agencies toward addressing the capacity needs. Action step within PIP includes participation in efforts to ensure sufficient substance abuse services The Comprehensive Family Assessment (CFA) and reassessment was designed to address various areas, including identification of substance abuse issues that the family may face A work group regarding improvement of the assessment process is working on development of a Court Clinic. The Clinic will have broader diagnostic capacity, especially in the forensic and substance abuse realms. The Department requires that experienced social work staff attend a minimum of 20 hours of training per year. The Child Welfare Institute provides training sessions on substance abuse.
A Review of Alcohol and Other Drug Issues
Program Improvement Plan (PIP)