1

SPARC WebinarSeptember 5, 2012

Family Wellness CourtFamily Wellness Court

Judge Erica YewJudge Erica YewCalifornia Superior CourtCalifornia Superior Court

Santa Clara CountySanta Clara County

2

Trauma-Informed CourtExtension of Problem-Solving Courts

What is it and WHY? Therapeutic alliance

Vivian Brown: 50 to 60% of outcome rests upon a positive therapeutic alliance

Only 1 to 2% is related to the treatment model or methodology used

20 years of adult drug court research indicates that the #1 incentive for people is their relationship with their judge or their probation officer

3

Considerations for a Trauma-Informed Court

Taking your time, even if it is an illusion Reduce waiting if possible Noise Setting Listening and validating where possible HONESTY RESPECT HOPE TRANSPARENCY: Clear communications and

expectations

4

Trauma-Informed Systems

FWC values statement includes trauma-informed system

Commitments by Partner Agencies Provider education Continual system assessment and

modification – 360 assessment Trauma specific services: DADS Seeking

Safety (PTSD and addiction), Mental Health trauma based cognitive behavioral therapy

5

FWC Overview

Target population: Pregnant women and Target population: Pregnant women and parents, with children 0 to 3, whose parents, with children 0 to 3, whose abuse of methamphetamine and other abuse of methamphetamine and other substances have placed their children in substances have placed their children in or at risk of out-of-home placement.or at risk of out-of-home placement.

Ten year experience, repeated Ten year experience, repeated subsequent pos-tox birthssubsequent pos-tox births

Started with grant in March 2008Started with grant in March 2008

6

FWC Primary Partners for GrantUS$ 6.3 million over 5 years

Superior CourtSuperior Court Social Services Agency (SSA), SSA’s Department of Social Services Agency (SSA), SSA’s Department of

Family and Children’s Services (DFCS) and SSA’s Family and Children’s Services (DFCS) and SSA’s County CounselCounty Counsel

First 5First 5 Department of Drug and Alcohol Services (DADS)Department of Drug and Alcohol Services (DADS) County Mental Health (MH)County Mental Health (MH) Legal Advocates for Children and Youth (LACY) – Legal Advocates for Children and Youth (LACY) –

children counselchildren counsel Dependency Advocacy Center (DAC) – parents counselDependency Advocacy Center (DAC) – parents counsel

7

Primary FWC Goals (1)

Early identification of and intervention Early identification of and intervention for the needs of pregnant women and for the needs of pregnant women and parents with substance use disorders.parents with substance use disorders.

Rapid engagement and successful Rapid engagement and successful retention in treatment and careretention in treatment and care

Reduction in subsequent pos-tox births Reduction in subsequent pos-tox births

8

Primary FWC Goals (2)

Early identification and intervention for developmental delays, disabilities and concerns for children 0-3 whose parents come before the FWC

Creation of a comprehensive System of Care across all systems serving children in or at risk of out-of-home placement as a result of parents’ methamphetamine and other substance abuse

9

FWC Eligibility Criteria

The parent has given birth to an infant that has been exposed to methamphetamine or other substance abuse during the pregnancy; OR

The parent has a child under the age of three that was either born drug exposed or has been raised in a substance abuse afflicted environment with documented abuse and/or neglect; AND

The parent does not demonstrate intractable mental health issues as presented in the filed petition; AND

The parent is not likely to face long term incarceration

10

FWC Customer Characteristics Fast-track cases History of CWS

involvement as children

40% were foster children themselves

Prior cases in CWS, many with prior termination of parental rights, 9 prior births, multiple pos-tox births

11

More Customer Characteristics

Extensive trauma history (give examples – multiple deaths, abandonment, kidnapping, prostitution as 8 yo)

80% cross over with DV 90% incarceration

history

12

More about Customer Characteristics

Methamphetamine primary drug of choice: national, state and local data indicate that 75-80% of child

welfare cases are drug and alcohol related. In Santa Clara County the drug of choice is methamphetamine where preference is around 64-67%.

Homeless or living in substandard housing, 65% chronic homelessness

Extremely low income, 66% have annual income of less than $10,000 TWD $ 285,000 Average California income US$ 61,017 Average U.S. income US$ 52,029 Federal Poverty Level for parent and 1 child US$ 14,570

13

FWC Services (1)

Therapeutic court environment, with regular reviews Early connection to TANF, food stamps, other programs Case management by the court Legal representation Early drug and alcohol assessment and treatment Residential inpatient-treatment for women; and for

women with their children Transitional Housing Units (THU) for women, men,

children Mentor Parent support Domestic violence advocacy and services Transportation assistance (bus tokens, bus tokens for

children, bicycles, car seats) Linkages to shelter and housing

14

FWC Services (2)

Limited funding to assist with barriers to case plan completion (books, birth certificates, funeral transportation)

Linkages to employment and benefits services, record clearance

Coordination with Criminal Court partners, fine conversion

Therapeutic services, dyadic and PCIT included Pregnancy prevention education Comprehensive developmental and behavioral

screening, assessment and interventions for all children

Child appointed special advocates (CASA’s) for many children and parents = an extension of role

15

FWC Services (3)

Linkage to health coverage and primary care physicians

Linkage to dental and vision care through charitable organizations

Access to a wide array of parenting classes Home visitation and Public Health Nurses with regular

reporting – transparency Diapers, children’s and adult clothing & shoes,

hygiene products, groceries/meals, milk, books, toys, strollers

Early care and education services GED assistance Language assistance Budget and nutrition information and workshops Medical and dental health care for children Tattoo removal and MORE….

16

Children’s Services Overview

Funded by FIRST 5 Santa Clara CountyFunded by FIRST 5 Santa Clara County Medi-Cal/EPSDT (Early Periodic Screening and Medi-Cal/EPSDT (Early Periodic Screening and

Diagnosis and Treatment) is leveragedDiagnosis and Treatment) is leveraged MHSA (Prop 63: Mental Health Services Act – 1% MHSA (Prop 63: Mental Health Services Act – 1%

income tax on excess of personal income of $1 million),income tax on excess of personal income of $1 million), County General Fund and reimbursement via public County General Fund and reimbursement via public

children’s insurance programs are also utilized for Mental children’s insurance programs are also utilized for Mental Health servicesHealth services

System of Care: Tiered system based on level of need System of Care: Tiered system based on level of need as determined by screening and assessments utilizing as determined by screening and assessments utilizing standardized tools and evidence-based practicesstandardized tools and evidence-based practices

17

FWC Multidisciplinary Team/MDT

Judge Court Resource

Manager DV/Trauma Therapist Victim Witness

Advocate♦ Eligibility Worker Child Advocate DADS rehab counselor Adult MH Coordinator♦ First 5 Specialist

Social Work Liaison County Counsel Child’s Attorney Parent Parent’s Attorney &

Mentor Social Worker Therapist Home Visitor Public Health Nurse Special Support People

(SARC, parent advocates)

18

FWC Hearings

Hearings may occur daily, weekly, twice a month or once monthly depending on parent progress

Staffings are held with the court team prior to the hearing to discuss case progress, concerns and develop joint recommendations – COMPREHENSIVE

Incentives or Sanctions may be given Resources given

19

FWC Data

Doors Opened March 14, 2008Doors Opened March 14, 2008 As of April 2011, data below:As of April 2011, data below:

1 to 2+ years of services per family (FR → FM)1 to 2+ years of services per family (FR → FM)

290 parents served290 parents served 3 re-entries (mental health and housing) in 3 years3 re-entries (mental health and housing) in 3 years 11-12% re-entry rate in California11-12% re-entry rate in California 1 subsequent pos-tox births in 3 years (despite 1 subsequent pos-tox births in 3 years (despite

many births and population that had repeated prior many births and population that had repeated prior pos-tox births, mothers with 8 children previously pos-tox births, mothers with 8 children previously removed)removed)

20

More about the Results

Santa Clara County Reunifications RatesSanta Clara County Reunifications Rates 2009 = 48%2009 = 48%,, no separate tracking for Fast no separate tracking for Fast

Track casesTrack cases 2010 = 53%2010 = 53%,, FWC may be improving general FWC may be improving general

outcomesoutcomes FWC as of September 2010 for Fast Track cases FWC as of September 2010 for Fast Track cases

= 71%= 71% 350 children served350 children served

100% of children whether parents succeed or not

21

Primary Keys to Success

Commitment at highest agency administrative levels

Shared values Passion and commitment of involved staff Comprehensive service model Service model that evolves as additional client

needs are identified Incorporation of the parents’ voices (through

mentors and the actual parents before the court – surveys, court experience)

Promoting the parent-baby bond