START
and
SobrietyTreatment RecoveryTeams
Cuyahoga of
County Department Child and Family Services
ExecutiveSummary
The Problem
Child wetfareservicesin CuyahogaCountyhave increasinglybeen~.ged by an influx of
referralsInvolvingparentalsubstanceabuse;drug abuse is a factor in 75% of .1 intakes.a high
percentageinvolvingcrack cocaine.In Septemberand October.1996.26 and 29 infantswere
screening
referredto CCDCFSthroughthe 696-KIDSHotlinewho showeda positivetoxj(X)iogy
for any drug at the time of birth. In 1996.11 infantsborn w;th a positivetoxicologydied while
living at home.No infantsborn with a positivetoxicologydied in foster cafe in 1996.
The STARTUnits are an attemptto meld togetherwhat we know aboutaddictionservices
treatment,good child welfare practiceand family preservationpradice into a modelthat can
work with the specialneedsof thesefamilies.These units have all of the responsibilitythat
regular Intakeand SocialWCX'kers have.They providein-homeservicesand ongoingprotective
services.When indicated,they can take custodyand place children,workingwith the family on
reunificationor developingan alternativepennanencyplan for the children.STARTbegan
operationIn March, 1997.
Tenets and Philosophy
We acknowledge We
that addictionis a di88ale which requiresabstinence. supportthe recovery
philosophyand understandthat relapsemay occur, requiringmodifiedand/orIntensified
services.We believethat the neglectand abuseof childrenis often associatedwith addiction.
The potentialfor ~sing custodyof their child is often the key to bringingthe parentInto
treatment.We understandthat since the other needsof the parentare often rootedin the
addiction,the initialfocus of servicesshou~ be directedtowardassessmentand treatmentof
is
the addiction.We believethat a sober, supportivelivingenvironment critical to the recovery
process.We are awarethat no one agencycontainsall the resourcesand expertiseto respond
adequatelyto the needsof the parentwho is addlded and who has abusedor neglectedtheir
children.We committo modifyingagencypoliciesor procedureswhid1may Impedethe family's
cooperationwith all serviceprovidersand we committo consultingwith both family and other
service providers in all significant decision making. We commit ourselvesto work cooperatively
togetherand to consulton importantdecisionswith each other and with the parents,to develop
I
and implementplansto meet each family member'sindividualneeds.We believethat keeping
the parentsand childrencloselyconnectedis an essentialfactorto enhanceor preservethetr
relationship.We believethat when a chIld must be removedfrom his family for protection,the
child has the right to frequentvisits with the family duringthe parent'streatment.We agreeto
towarda goal of reunification the family and child as quicklyas the child's
work cooperatively of
protectioncan be assured.If the parentdoes not achievesobriety,we agreethe child deserves
will
a safe and permanentho~; therefore,consideration be givento filing for permanent
custody.We believethat boththe family and the child have the right to continuityof healthcare
to
services.We committo creativeapproaches child care, improvingparentingskills, building
family supportsystems,etc. for those who are willing to enter treatment.
Ooals
Our purposes ., "18 'p.~.m are m: 1) keep dMldfen 18fe; 2) develop a ". n~Mg and
stable a livtng I*-tion for them a. r8J*j1y and reepcx18i)ly as poIIibIe; and 3) hetp their parents
overoome their mug 'p.~T... Specific objectives are deYekJpedfor ~ of theae goals. atl of wtMa\ are
besed on a set ~ tenets and values developed and agreed~n as the foundation of the work. Induded
are an ackrJQwl8dyment of the dI8e88e ooncept of addiction. and u.t abuse and negted is often
associated. Drt18Iapfnent of oooperative Waftn and other emergency assistance is
providedas necessary.Other basic needsare also providedfor as needed.
Drug assessmentand treatmentis availablewithin 72 hoursof Intake.The STARTstaff makes
the referral,usingagreed-uponprotocots,and they take the clientto at least the first three
in
treatmentappointments order to help establishthe relationshipbetweenthe client and the
provider.
Case plans address all of the safety needs of the child and family, the treatment needs for the
parent, and the other service needs that will supportthe parenfs ability to succeed In treatment
and be able to keep the child safe. One of our biggest challenges is to leave ourselves the
flexibility to provide what families most need, without setting staff up for unrealistic expectations
and failure. Another of our biggest challenges Is having flexibility 80 that either the advocateor
the sociaJ worker is able to perfonn many tasks, while retaining enough clarity about their roles
that they oon' spend eoormoos amounts of time negotiating or over1apping. At the same time,
we also reoognize that social wori(ers are legally mandated to assume full responsibility for
some tasks, such as case planning and signing complaints. At present, few boundaries have
been set ~ services to be provided by child welfare staff, their partnersIn other systems,
and informal supports.
contactwith the D~ T,
STARTp8'118Ip in ongoW1g ~Provldw et leastweeklyby
phone. and monthly,face to face. The Tr88tmentProvideris expectedto notify the START team
parent milses .,y appolnVnents. The START team Is committed to
immediately If U'1e
.;4.
meeting with the parent witt*' 2. hours. If drug treatment ... there is . face-to-facemeeting.We will
case plan reviewas long 88 the CMe is active.See ~ment
ajso hold 8 slx-nQ111 for
8H8 more
from
detail regardingthe k1diYldualservDs8V8l1able STARTserviceproWtef8.
~
There is a hili May of drugtreatmentsefVDs, indudi1gbut not limitedto, residential o~ treatment,
aftercare,family educationand treatment,parentingand nutritionservices,supportmeetings,
group and individual counseling, sober housing, relapse prevention and treatment,
detoxification, well-baby care, self esteem building, cultural/social activities, and play therapy. In
addition, services include such things a8 child care, transportation, medical
services, crisis services, job SefVtces, concrete services, and child safety-therunber one priority.
Closure of ServICM
Caseclosure a
remains risk ""8~t-b888d d8C8k)n. At thesameti~, ~
tt1ese 8'8 extremely
and
CXJmplex we expectwe will continueto strup to makePeffectdec8; where none may be
to
possible.One of the ways we are addr-a,g U18l88ue18 define"pole.. tt1atwould m8k8decilions
, at, say. six month1n8rvals.The sIuation8at the emme endsof the pole appeer8npIe to
~. Is between
Oura.nent d1alienge to mapoutnae 8C8n8iOI th888 poles, aoo to dewIop
8ddItion8t ~~:~I for
makingguidel.-.es ~ aJ.-x1y of d1IIdren.
temporaryand permanent