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Children's Voice Article, March/April 2003

Courts That Heal

By Norah Lovato and Kelly Mack

Alcohol and other drug (AOD) abuse destroys the lives of children, families, and communities. Every year, nearly one million children are victims of child abuse or neglect; parental AOD abuse is a contributing factor in an estimated 80% of dependency court cases. These cases overwhelm our court, child welfare, and AOD treatment systems, making it difficult to provide critical services to protect children. The Adoption and Safe Families Act (ASFA) brings a new sense of urgency, because it significantly decreases the time available to achieve permanency for children.

One successful, cost-effective innovation in working with families involved in the child welfare system that have AOD issues is family drug courts (FDCs), which provide timely, coordinated access to treatment and support services for families. Through FDCs, the courts, social service agencies, AOD treatment providers, and other stakeholders work together to provide wraparound services to the entire family. This coordination reduces the trauma families experience when faced with multiple systems, policies, and competing timelines.

FDCs are an alternative for parents who have committed non-violent drug-related offenses. Many FDCs have general jurisdictional powers, allowing a parent's drug felony charge to be transferred to an FDC and handled under a "one family, one judge" theory. A lifeline for many families in the child welfare system, these courts have helped families and entire communities begin healing recovery.

A New Kind of Court

When Judge Nicolette Pach began hearing child abuse and neglect cases in Suffolk County, New York, she soon observed that most cases involved AOD abuse. She was aware of criminal drug court programs and thought that applying a similar model to her cases might be effective. Her efforts, and the team she organized, have developed a remarkable program.

"Very few parents don't graduate, and most of the kids are reunited with their parents," Pach says. "You actually know people's names, and everyone on the team cares about the outcome of the case, as opposed to another faceless number going through the system." The program has been a win-win for everyone, and the city has seen a significant a decrease in the length of time children are in foster care--from 2.5 years to 16 months--since its family treatment court began in 1997.

FDCs are organized and managed by a team of professionals led by a judge or court commissioner. District Court Judge Charles McGee, who helped establish the first FDC in Washoe County (Reno), Nevada, in 1994, says the team must be dynamic and fluid, able to put aside differences and keep the best interests of the children at the forefront. Washoe County Deputy Public Defender Cynthia Lu agrees: "The hardest part of forming a drug court team is establishing the roles of each player. Giving up control can be difficult." Establishing inter-agency rapport and letting go of the natural adversarial stance is essential, Lu says.

Drug court teams vary by jurisdiction but typically include judges and court officials, attorneys, social service agencies, AOD treatment providers, and representatives from law enforcement and probation and parole offices. Parents actively participate in the team and have a voice they may not have had in other courts. This team approach helps ensure that services and supports are available, compliance issues are addressed, and the case plan is realistic and on track.

The Court Process

Although their frameworks are consistent, each FDC designs its program to meet the unique needs of its own community. The drug court team establishes protocols and agreements for exchanging information to ensure client confidentiality. Each court may implement a different method of screening and assessing participants to find the best candidates for the program.

Pach's court flags petitions at the mention of parental substance abuse. The program is voluntary, and Pach emphasizes early on the need for accountability and the impact of one's actions on family, friends, and the community. McGee relies on his first meeting with the parent and looks for a connection between parent and child.

The team develops a case plan with clear goals and time frames. The parent receives AOD treatment and partners with team members to arrange safe care for the child and to access other support services, including referrals for housing, job training, or counseling. Participants, most of whom are single mothers, attend frequent court hearings, undergo drug testing, and are monitored regularly. Sanctions--such as additional AOD treatment, community service, or even jail time--are determined for noncompliance. The program also rewards positive behavior with incentives such as reducing program requirements or gift certificates to local merchants.

"The most important aspect of developing sanctions is to ensure the sanction is appropriate for the behavior," says Jackson County Drug Court Administrator Penny Howell, Kansas City, Missouri. Early on, she says, their program restricted parental visitation for noncompliance but found this was not in the best interests of the children, so they stopped using it in most cases.

Usually, family involvement is a major asset to FDCs. Many families want to be informed about a parent's progress and, when children are involved, want to be closely connected to the case. And families can be a critical resource not found elsewhere, providing ongoing monitoring, for example, when formal systems are no longer required, and serving as a source of information to help team members identify past barriers that have hindered a parent's recovery.

Successful Innovations

Some FDCs have added services to help ensure clients' success. McGee relies heavily on the foster grandparent program in Reno and Washoe County, calling it "one of the keys--maybe the essential key" to his program's success. Foster grandparents volunteer and provide support to families in the program. "Families need aftercare options when the program is over and it's difficult for a court to stay involved with the family," he says. "This relationship fills some of that void, and [the bonds] can go on forever."

In Suffolk County, New York, an alumni group provides peer support for program graduates and mentors current participants. (See "A Life-Saving Choice," page 20.) Pach explains how powerful it is for parents to connect with alumni who have turned their lives around.

In Reno, Lu describes how trauma recovery services have made affected her caseload. "Every client struggles with co-occurring mental health and substance abuse disorders.

If these issues aren't treated, [the client] won't make it." Most who have relapsed entered the program before it had trauma services, she says. Washoe County has an integrated services case manager who provides services that social workers may not have time to address, such as helping parents find job training or completing paperwork to return to school or secure housing. This allows social workers to focus on permanency plans.

Overcoming Challenges

Although each FDC is unique to the population it serves, they often encounter similar difficulties in their implementation. One of the greatest barriers to comprehensive, holistic programs is the enormous amount of resources necessary to provide a diverse array of services. This is particularly challenging for participants with special needs, such as co-occurring mental health and substance abuse disorders, developmental disabilities, or limited access to local services and supports in rural areas.

Resources are especially strained with recent budget crises. Federal and state funding and private grants often are restricted to first-year start-up costs and don't cover support services such as housing assistance or transportation costs. Many courts have better luck persuading state and local legislatures to give support, and many have established nonprofit agencies for fundraising. Others have found ways to streamline resources--Pach's court arranged for AOD screening by a health department employee who was relocated to the court.

Another challenge is the many policy issues involved in working with multiple systems, such as confidentiality and information exchange. Particularly important are the consequences of violating or disregarding the rules, and the impact on family case plans. The drug court team can manage these issues if it initiates communication and teamwork from the program's outset.

McGee cites the challenge of securing housing vouchers for parents who must undergo criminal background checks. He sees the background checks as a reasonable request, but the time it takes to complete--often as long as nine months--is difficult for families who only have 12 months to get back on their feet under ASFA. He is rallying key stakeholders to work with the federal government to streamline the background check process.

Healing Old Wounds

Initial findings from local program evaluations show increased reunification rates, a reduction in the number of children placed in foster care, and decreases in AOD use, recidivism, domestic violence, and criminal activity after being in the program.

Another key benefit: immediate savings in such areas as foster care and incarceration. The average stay in foster care for a child in New York City is approximately four years, at an annual cost of $15,200 per child. But the average stay in foster care for a child whose parent successfully completes the FDC program is only 11 months, saving New York City as much as $45,000 per child.

McGee points out that housing an adult in jail costs his county an estimated $27,000 per year, but moving a parent through the FDC program costs only a few thousand dollars. "The cost savings are there," he says, "and the program prevents problems in a number of areas, such as juvenile justice, education, and health."

Other, less obvious and less quantifiable savings from successful treatment include fewer adoptions, fewer drug-addicted newborns, and, in the long-run, overall reductions in educational, social welfare, and other costs that can accrue when children grow up in intact, supportive families.

But more rigorous evaluations are needed before drawing major conclusions about the long-term outcomes of the FDC model. The U.S. Departments of Health and Human Services and Justice are conducting the first national cross-site evaluation of FDCs, exploring similarities and differences among programs and procedures, multisystem collaboration strategies, cost benefits, and outcomes for the child welfare, AOD treatment, and court systems.

The first phase of this national evaluation is revealing a clearer, more comprehensive picture of the components and benefits of successful FDCs. Access to AOD treatment and parent engagement are improved, and reunification rates are higher than for families not eligible for the program. But the length of time to achieve reunification is not meeting ASFA guidelines, and case closures are not happening as quickly as expected. One explanation could be that many judges are finding compelling reasons to postpone termination of parental rights if a parent is making progress in an FDC. The FDC model has grown tremendously since its genesis.

As of October 2002, 25 states and the District of Columbia were operating or planning FDCs. Affecting this growth is the training and technical assistance provided by organizations such as the National Council of Juvenile and Family Court Judges (NCJFCJ) and the National Association of Drug Court Professionals. Mary Mentaberry, NCJFCJ Director of Permanency Planning for Children, explains that judges interested in starting FDCs may not have experience with dependency and permanency issues. "When we approach training for new FDCs, we not only give [judges] information on the key elements, but also educate them on best practices in handling dependency cases." This essential component helps resolve the conflict between ASFA timelines and the demands of AOD treatment and recovery.

FDCs have helped hundreds of parents begin recovery and granted children and families new opportunities to begin healing. Wary parents entering an FDC quickly discover the program's supports, resources, and mission are beneficial to themselves and responsive to their children's permanency needs. "Parents finally see the system is working with them and supporting them, not trying to trick them into losing their children," Pach says. "It changes their perspective on what's happening. When you go to a graduation, and the parent who had their kids taken away personally thanks you, that's pretty good stuff."

A Life-Saving Choice

"Marcy's"* husband knew where to find her, she just wouldn't come home. For two years, she lived on the streets as an addict, floating in and out of her family's life. Finally, out of desperation, her husband reported her to child protective services, called the police, and had them drag her into court. There, she had to make one of the most important decisions of her life: Would she participate in the new family drug court (FDC) program?

After four years of sobriety, Marcy says she owes her life to FDC and is an active advocate of the program for parents struggling with substance abuse: "Without that opportunity, I would be dead today."

It wasn't easy. Marcy entered FDC voluntarily, but she wasn't committed to her recovery. She relapsed three times before committing to the rigors of drug court, realizing that fooling her husband, her child, and the court wouldn't get her anywhere but back on the streets. After Marcy's third relapse and testing positive for drugs at a court hearing, the judge incarcerated her, warning her, "You're either going to do this right, or you're going to get your child taken away from you, or you're not going to be allowed to live in the house." The court then arranged for Marcy to enter inpatient treatment, where she began the long process of recovery.

Marcy was lucky because her husband was able to take care of their child while she was in treatment court. Many parents who enter drug court programs have their children removed, at least temporarily, while they complete the program. Permanency planning is at the core of FDC, either by preparing the individual to be a better parent or by working with parents to develop a plan for their children. If Marcy had refused to enter FDC, she likely would have entered criminal court and faced separation from her child.

In treatment, Marcy made a breakthrough and began working on issues in her past--her mother's death from a drug overdose when Marcy was 10, sexual abuse, and issues of anger--that had contributed to her addiction and downward spiral. She and her husband worry about the child they are raising, a nephew placed in their care after his father was incarcerated for substance abuse. "Every day, he has the odds stacked against him." Marcy tries to set a strong example, using her experiences to teach him about dangers of substance abuse.

FDC provided Marcy with a life-saving choice, one that let her reunite with her family and rebuild her life. The judge, caseworker, program director, and drug court staff listened to and worked with her to find the help she needed.

Now that she has been in successful recovery for several years, Marcy serves as a mentor with other drug court clients, sharing her knowledge and experiences. She also participates in an alumni support group, where she gives and receives support from other former FDC clients. She reminds those struggling to stay sober that their children need them and that drugs only make their problems worse.

"A lot of people should take advantage of what they're offering you…It's offering to keep your family together."

Norah Lovato is Program Manager of Behavioral Health Services, and Kelly Mack is an Associate Editor, at CWLA.

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