Post on 06-Oct-2020
4/10/2012
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National Family Drug Court Technical Assistance and Training Program
Taking Your Problem Solving Court to Scale:g
Increasing and Expanding
the Families Served
April 10, 2012
P t d b
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This project is supported by Award No. 2009-DC-BX-K069 awarded by the Office of Juvenile Justice and Delinquency
Prevention, Office of Justice Programs
Presented byPhil Breitenbucher, MSW
Children and Family FuturesThe Mission – to improve the lives of children and families,
particularly those affected by substance use disorders.
C l i h i d i id
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• Consults with government agencies and service providers to ensure that effective services are provided to families
• Advises Federal, State, and local government and community-based agencies, and conducts research on the best ways to prevent and address the problem
• Provides comprehensive and innovative solutions to policy makers and practitioners
National Center for Substance Abuse and
Child Welfare
National Center for Substance Abuse and
Child Welfare
Children In-depth
Children and Family
Futures
Affected by Meth
Technical Assistance
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FuturesOffice of Juvenile
Justice and Delinquency Prevention
Office of Juvenile
Justice and Delinquency Prevention
Regional Partnership
Grants
Regional Partnership
Grants
TitleNCSACW In-Depth Technical Assistance Sites (IDTA)Children Affected by Methamphetamine Sites (CAM)
Children’s Bureau Regional Partnership Grants (RPG)OJJDP Family Drug Courts (OJJDP)
NCSACW IDTA(20 Sites)
NCSACW CAM (12 Sites )OJJDP Grantees
(30 Sites)
Array of Services (11)
Child Focused (8)
Drug Courts (10)
System-Wide Collaboration (9)
Treatment Focused (9)
Tribal (6)
RPG Sites (53 Sites)
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The Past
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How did the FDC movement get here? Why the rapid growth? What happened?
The Birth of the FDTC Movement
• First FDTCs convened in Reno, Nevada and Florida in 1994 1995Florida in 1994 -1995– Judges Charles McGee (NV) & John Parnham (FL)
– Judges Pach (NY), Edwards (CA), Milliken (CA), Cohen (FL), Ray (OH), Thomas Merrigan (MA) and Commissioner Molly Merrigan (MO)
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The Birth of the FDTC Movement
• First FDCs took concepts developed in criminal and then juvenile drug courtscriminal and then juvenile drug courts applying a collaborative approach to therapeutic jurisprudenceThe “study of the role of the law as a therapeutic agent.” It focuses on the law’s impact on emotional life and on the psychological well-being of the individual – the impact on the “whole person.”
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David Wexler – Therapeutic Jurisprudence: An overview. Paper delivered to the National Institute of Mental Health in 1987. Along with Professor Bruce Winick, University of Miami School of Law, who originated the concept with Wexler.
The Birth of the FDTC Movement
“The family drug court although similar to theThe family drug court, although similar to the adult drug court in terms of services and protocols, usually focuses on the "best interests of the child”…and this focus is the court's paramount consideration in responding to the progress -- or lack thereof -- of the p gparent.”
Caroline S. Cooper, Coordinator, 1995 SJI National Symposium on the Implementation & Operation of Drug Courts; and Director, OJP Drug Court Clearinghouse and Technical Assistance Project School of Public Affairs/American University June 2000 8
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The Birth of the FDTC Movement
• Focused on early intervention and treatment based on a comprehensive needsbased on a comprehensive needs assessment and case plan
• Client and system accountability for compliance through frequent court appearances
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The FDTC Movement
# of FDCs
153
321
150
200
250
300
350
1040
0
50
100
1999 2001 2005 2010
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Family Drug Courts ‐ NationwideNew York ‐ 55
California ‐ 56
Florida ‐ 22
1‐5 6‐10 11‐19
Zero DDCs reported
20 +Source: National Drug Court Institute (NDCI) Survey, 2010
Total – 322 FDCs
Common VisionExtraordinary Effort
Three SystemsThree Systems with multiple:• Mandates• Training • Values• Timing
Drug Treatment
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Timing • Methods
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New Partnerships, Creative Approaches
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The need for immediate and efficient intervention became overwhelming important in the face of implementing the Adoption and Safe Families Act
Implications of ASFA (1997)
• Adoption and Safe Families Act, enacted in 1997 sought to address:1997 sought to address:- Cases lingering in the court system as
parents cycled in and out of treatment- Children left in foster care for months or
even years – (aka foster care drift)E h i t bli hi ithi• Emphasis on establishing permanency within federally mandated timeframes
• Created a need to find effective responses to substance abuse and child maltreatment within families 14
Blending Perspectives and Building Common Ground
• Report to Congress in response to the Adoption and Safe Families Act (AFSA) 1999Adoption and Safe Families Act (AFSA) 1999
• Five National Goals established1. Building collaborative relationships2. Assuring timely access to comprehensive
substance abuse treatment servicesI i bilit t d t i3. Improving our ability to engage and retain clients in care and to support ongoing recovery
4. Enhancing children’s services5. Filling information gaps
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Five National Reports
1. Responding to Alcohol and Other Drug Problems in Child Welfare: Weaving Together Practice and Policy (Child Welfare League of America,1998)America,1998)
2. Foster Care: Agencies Face Challenges Securing Stable Homes for Children of Substance Abusers (U.S. General Accounting Office, September 1998)
3. No Safe Haven: Children of Substance-Abusing Parents (The National Center on Addiction and Substance Abuse at Columbia University, 1999)
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y, )4. Healing the Whole Family: A Look at Family
Care Programs (Children’s Defense Fund, 1998)5. Blending Perspectives and Building Common
Ground: A Report to Congress on Substance Abuse and Child Protection (Dept. of Health and Human Services, 1999.)
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Common Ingredients of FDTCs in 2002 Process Evaluation
System of identifying familiesSystem of identifying familiesy y gy y g
Earlier access to assessment and treatment servicesEarlier access to assessment and treatment services
Increased management of recovery services and complianceIncreased management of recovery services and compliance
Responses to participant behaviors (sanctions & incentives)Responses to participant behaviors (sanctions & incentives)
Increased judicial oversightIncreased judicial oversight
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What is Success in FDC?Key Outcomes
Safety (CWS)
Permanency (Court)
Recovery (AODS)( )
• Reduce re-entry into foster care
• Decrease recurrence of abuse/neglect
( )• Reduce time to
reunification• Reduce time to
permanency• Reduce days in
care
( )• Increase
engagement and retention in treatment
• Increase number of clean UA’s
• Increase number of graduates
• Decrease Recidivism
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The Present
What do we know now? Where are we? What’s being done? What are the needs?
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Family Drug Court Outcomes
P
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• Parents enter treatment sooner• Parents stay in treatment longer• Parents complete treatment more often• More reunifications• Fewer incidents of non-compliance• Cost Savings
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FDC Local Evaluations
Jackson County OR (N=329 340)
Marion County, OR (N=39, 49)
Maine (3) (N=49, 38*)
Jackson County, OR (N=329, 340)
Washoe, NV (N=84,127)
Santa Clara, CA (N=100, 370)
Sacramento, CA (N=4,858, 111)Baltimore, MD (N=200, 200)
San Diego, CA (N=438, 388)
Suffolk, NY (N=117, 239)
London, England (N=55, 31)
Pima County AZ (N=33 45)
Data complied by CFF; references provided on Slide #
Pima County, AZ (N=33, 45)
11 FDC Sites(N= FDC, Comparison)
*Maine = only 1 of 2 comparison groups are reported in this presentation
Regional Partnership GrantsFamily Drug Courts
24 Grantee Sites
RPG FDC• 5,200 children• 8,000 adults
40
60
80
pletion Ra
te
Treatment Completions
Up to 20-30% higher 40
60
80
100
FR Rates
Reunification Rates
Up to 20-40% higher
0
20
Com
0
20
F
FDC vs ComparisonDays in Foster Care New CPS Petition after FR
Data complied by CFF; references provided on Slide #
0
200
400
600
800
# of Days
Several Fewer Months
0
5
10
15
20
25
New
Petition
Infrequent, In all conditions
FDC Outcomes - Summary
• Higher treatment completion rates• Shorter time in foster care• Higher family reunification rates• Higher family reunification rates• Lower termination of parental rights• Fewer new CPS petitions after
reunification• Cost savings per family
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Cost Savings Per Family
$5,022 Baltimore, MD$5,593 Jackson County, OR$13,104 Marion County, OR
Burrus, et al, 2011
Carey , et al, 2010
Carey , et al, 2010
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73
62 66 69
5561 64
5557 57607080
Treatment Completion Rates
31
48
33
4437
3240
3123
32 36
01020304050
FDC Comparison*p <.05**p <.01
***p <.001+p value not reported
80
91
7670
83
63708090
100
Reunification Rates
5145
56
21
57
394045 45
27
44 45
25
5545
21
0102030405060
FDC Comparison*p <.05**p <.01
***p <.001+p value not reported
477
589
466504 477
688
502.6500
600
700
800
Days in Foster Care
307 301352
437477
312252
327407
466
369
477
310346
0
100
200
300
400
500
0
FDC Comparison*p <.05**p <.01
***p <.001+p value not reported
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17
23
20
25
New CPS Petitions after Family Reunification
2
17
2
7 75
12
2
69
7
0
13
0
5
10
15
FDC Comparison
*p <.05**p <.01
***p <.001+p value not reported
80
70
80
90
Children Remain Home
61.1
20
30
40
50
60
70
0
10
RPG FDC Comparison **p < .001
28
25
30
Access to Treatment
ion
20
5
10
15
20
25
an #
of d
ays
to a
dmis
s
0
5
RPG FDC Comparison
**p < .001
Med
i
122.6140
Length of Stay in Treatment
97.2
40
60
80
100
120
Med
ian
# of
day
s
0
20
RPG FDC Comparison***p <.001
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• Ashford, J. (2004). Treating substance abusing parents: A study of the Pima County Family Drug Court approach. Juvenile & Family Court Journal, 55, 27-37.
• Boles, S., & Young, N. K. (2010, July). Sacramento County Dependency
References
Drug Court year seven outcome and process evaluation findings. Irvine, CA: Children and Family Futures.
• Boles, S., & Carpenter, L. (December 16, 2011). “Regional Partnership Grant Program: Improving Outcomes for Families Affected by Substance Abuse. 2011 Beyond the Bench Conference. California Administrative Office of the Courts.
• Burrus, S. W. M., Mackin, J. R., & Finigan, M. W. (Summer 2011). Show Me the Money: Child Welfare Cost Savings of a Family Drug CourtMe the Money: Child Welfare Cost Savings of a Family Drug Court. Juvenile and Family Court Journal, 62 (3), 1-14.
• Burrus, S. W. M., Mackin, J. R., & Aborn, J. A. (Aug. 2008). Baltimore City Family Recovery Program (FRC) independent evaluation: Outcome and cost report. Portland, OR: NPC Research.
• Carey, S. M., Sanders, M. B., Waller, M. S., Burrus, S. W. M., & Aborn, J. A. (March 2010). Jackson County Community Family Court – Outcome and Cost Evaluation: Final Report. Submitted to the Oregon Criminal Justice Commission. Portland, OR: NPC Research
• Carey S M Sanders M B Waller M S Burrus S W M & Aborn J
References
• Carey, S. M., Sanders, M. B., Waller, M. S., Burrus, S. W. M., & Aborn, J. A. (March 2010). Marion County Fostering Attachment Treatment Court – Process, Outcome and Cost Evaluation: Final Report.Submitted to the Oregon Criminal Justice Commission. Portland, OR: NPC Research
• Harwin, J., Ryan, M., Tunnard, J., Pokhrel, S., Alrouh, B., Matias, C., & Momenian-Shneider, S. (2011, May). The Family Drug and Alcohol Court (FDAC) evaluation project final report. London: Brunel University. y
• Worcel, S. D., Green, B. L., Furrer, C. J., Burrus, S. W. M., Finigan, M. W. (March 2007). Family Treatment Drug Court Evaluation: Final Report.NPC Research: Portland, OR.
• Zeller, D., Hornby, H., & Ferguson, A. (2007, Jan.). Evaluation of Maine’s Family Treatment Drug Courts: A preliminary analysis of short and long-term outcomes. Portland, ME: Hornby Zeller Associates.
How are these outcomes being achieved?
Strategies Most Likely to Be Selected by RPG/FDCs
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Strategies Most Likely to Be Selected by RPG/FDCs
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Strategies Least Likely to be Selected by RPG/FDCs
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Common Challenges and Barriers for FDCs
• Collaboration challenges• Screening and assessment – referral
processes• Engaging and retaining clients• Comprehensive programs – children’s
servicesservices• Performance measures/data collection• Budget/sustainability – scale and scope
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Collaboration Challenges –Defining Your FDC
• Dependency matters
• Recovery
• Dependency matters
• Specialized court • Dependency matters
• Dependency matters• Recovery
management• Same court,
same judicial officer during initial phase
• Non-compliant case transferred to specialized judicial officer
pservices offered before noncompliance occurs
• Compliance reviews and recovery management heard by
i li d t
matters• Recovery
management• Same court, same
judicial officer
a e s• Recovery
management• Same court,
same judicial officer
• Non-compliant case transferred to Presiding Judge or another
DUAL TRACK
j
PARALLEL
specialized court officer
INTEGRATED HOME COURT INTENSIVE
court
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ASAM Definition of Addiction
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing
d d/ li f b b
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reward and/or relief by substance use and other behaviors.”
Adopted by the ASAM Board of Directors 4/12/2011
ASAM Definition of Addiction
• Addiction is characterized by inability to consistently abstain, impairment in behavioral
t l i di i i h d iti fcontrol, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response
• Like other chronic diseases, addiction often involves cycles of relapse and remission
42Adopted by the ASAM Board of Directors 4/12/2011
• Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death
Collaboration Challenges –Policies and Procedures
• Lack of or inconsistent participation or buy-in from one or more critical partners: child welfare, substanceone or more critical partners: child welfare, substance abuse treatment, judges, attorneys
• Confidentiality issues not resolved; information and data sharing problems
• Competing timeframes, lack of coordinated case planningTime to meet as team• Time to meet as team
• Lack of appropriate community resources• Issues of collaboration among agencies in
understanding and working toward shared outcomes
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Screening and Assessment –Referral Processes
• Target population and process for identifying FDC clients is often unclear or inconsistentlyFDC clients is often unclear or inconsistently applied
• No standardized screening for substance use disorders prior to referral to FDC
• Sites are not at capacity and/or it is unclear how capacity rates have been establishedhow capacity rates have been established
• Sites have exclusion criteria for serious mental health issues, felonies, and domestic violence; others deal with these as co-occurring issues 44
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What percentage of families with substance abuse issues are currently
served in the FDTC? Most FDTCs typically
serve 5-10% of the t Th l t
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3
2
0
0
10-20%
20-40%
40-60%
60-80%
80-100%parents. The largest FDTCs serve up to
30-35% parents.
2
0 2 4 6 8 10 12 14 16 18
0-10%
Responses (n=23)
*Based on estimated child entries to out of home care45
What is the ideal percentage of families with substance abuse issues served in
the FDTC?
60% would be approximately
2
5
8
4
4
10-20%
20-40%
40-60%
60-80%
80-100%2,813 parents per
year
0 1 2 3 4 5 6 7 8 9
10 20%
Responses (n=23)
* Divided by 11 (the number of FDCs in Colorado) this would be an average of 256 parents served a year in each FDC.
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Defining the Scale of Your FDC
Defining The Scale of Your FDTC
# of children with substantiated allegations: 11,166
# of children entering foster care: 2,275
# of children of substance users: 1,365 (60% estimate)
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# of potential children
served in FDCYour defined
target population
* Numbers based on Colorado state child welfare data
Engaging and Retaining Clients
• Clients are given phone numbers or list of resources and instructed to call for assessmentand instructed to call for assessment
• Clients report lack of understanding with FDC requirements and expectations - especially in the beginning
• Lack of consistency in responses to client behavior• No clear incentives for client participation
f (• Time of groups; competing priorities (e.g. work vs. FDC requirements)
• Issues of treatment availability and quality
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Defining Your Drop off Points
4,689 cases referredfor SA assessment
3,563 received SA assessment 24% drop off = 1,126
Number referred to SA treatment 80% =2,850
Number made it to SA treatment = 1 425treatment = 1,425
50% drop off
427 successfully completed SA tx*
Payoff49
* 30% completed
Comprehensive Programs –Children’s Services
• Very little mention of services to children, though serving the family is one of primary differencesserving the family is one of primary differences between adult and family drug courts
• A few sites focus on 0-3, 0-5 and Substance Exposed Newborns with partnerships that focus on parent/child interaction and developmental/health programs for young children
• Utilizing CAPTA and Part C partners• Utilizing CAPTA and Part C partners
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Performance Measures and Data Collection
• Lack of prevalence data demonstrating the extent of substance abuse among child welfare populationsubstance abuse among child welfare population
• No uniform data collection; inability to measure effectiveness of program
• Lack of long-term data on child welfare and recovery outcomes; only while client is enrolled in DDC
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Budget and Sustainability
• Need for ongoing champions; challenge with turnover of judgesof judges
• Some FDTCs operate as “projects” or “boutique courts”
• Inherent limitations on scale and scope in some FDTC models
• No standardized cost analysis of total program cost or cost savingsor cost savings
• Lack of sufficient data on program effectiveness• Resource problems worsened by State and local
fiscal crises
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Are FDC results able to “move the needle” in the larger child welfare system?
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“We do thirty families—that’s all we do, and that’s all we want to do”
Changing the Larger System
But given the size of the problem…….54
Why do the Small FDCs Stay Small?
Lack of referrals Exclusionary criteria Limited partnerships;
limited services Lack of recovery case
management Non-standardized
communication protocol
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communication protocol Non-specialized docket
So How Did the Big Ones Get so Big?• Judicial leadership in convening
interagency players and tracking t tioutcomes over time
• Child welfare and treatment agency buy-in based on recognition that FDCs could directly improve their own outcomes
• Data systems and case management tracking that focused g gon both FDC project and larger system
• Annual evaluations that included cost offset data powerful enough to convince policy leaders to expand FDCs 56
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Getting Better at Getting Along: Four Stages of Collaboration
ChangingThe System
ChangingThe Rules
y
Universal Screening
Shared Case Plans
FDC Project
Better Outcomes for Children and
Families
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InformationExchange
JointProjects
Sid Gardner, 1996Beyond Collaboration to Results
Shared Case PlansShared Data
Focusing on Institutional Change
While many FDCs are able to “collaborate” at the level of FDC “project,” the ingredients for real systemsof FDC project, the ingredients for real systems change may not yet be present:
• Universal substance abuse screening for all parents involved with child welfare
• Universal child maltreatment screening for parents involved in substance abuse treatmentJoint (SA/CW) case planning and monitoring• Joint (SA/CW) case planning and monitoring
• Shared data systems• Shared outcomes
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Negotiate with Stakeholders“What would they buy?”
Outcomes• Document effectivenessC f i i
Resources• Inventory of staff, volunteers and
• Cost of innovation• Collect and share stories
redirected funding
current funds• Identify potential sources for future funding
• Select priority options for new funding
• Select priority options for redirected funding
Institutionalize innovation through practice and policy changes 59
Marketing to stakeholders and community
Checkpoints
An annual review of outcomes and dropouts?
Resources for a serious evaluation of agency performance?
Resources shifted from least to most effective programs?
In-depth assessment of children’s needs?
Missing partners brought to the table?
Results measured against the entire community’s needs—or just the project? 60
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Questions & Discussion
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RResourcesChildren and Family Futures, National Center on Substance Abuse and Child
Welfare, & Office of Juvenile Justice and Delinquency Prevention
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FDC Learning Academy 2010-2011
15 webinars
30 hours of content
15 expert presenters
1048 attendees
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43 states
Thank you for your participation!
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Selected Peer Learning Courts will host visiting FDC professionals to view their FDC in action, receive national recognition for their program and receive travel scholarships to the 2012 National FDC Symposium.
T o part application (1) formal application s bmission (2) onsite re ie
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FOR MORE INFORMATION :Visit: http://www.cffutures.org/projects/family-drug-courtsEmail: PeerLearningCourts@cffutures.org
Two-part application: (1) formal application submission; (2) onsite review
Applications due: April 30th
September 5 – 7, 2012 Anaheim Marriot in Anaheim, CA
Family Drug Courts A National Symposium to Improve
Family Recovery, Safety and Stability
For more information please visit:
Presented by SAMHSA in collaboration with OJJD
For more information, please visit: http://www.cffutures.org/fdc_symposium
Presented by SAMHSA in collaboration with OJJDP
Visit the FDC Learning
Academy Blog
• Webinar updates• Presenter info• Learning resources
www.familydrugcourts.blogspot.com
Learning resources• Post a follow-up questionAsk our presenters!
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Training and Staff Development
NCSACW Online Tutorials1. Understanding Substance Abuse and Facilitating Recovery: A
Guide for Child Welfare Workers
2 U d t di Child W lf d th D d C t A2. Understanding Child Welfare and the Dependency Court: A Guide for Substance Abuse Treatment Professionals
3. Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Legal Professionals
Please visit: http://www.ncsacw.samhsa.gov/68
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Phil Breitenbucher, MSWFDC TTA Program Director
Children and Family Futures9 0 S 202
Contact Information
4940 Irvine Blvd., Suite 202Irvine, CA 92620(714) 505-3525
pbreitenbucher@cffutures.org
RESOURCES
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RESOURCESPlease visit our website:
http://www.cffutures.org/projects/ family-drug-courts