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Project Description

Illinois The FACTS project was a collaborative effort between the CRT, the Illinois Department of Children and Family Services (DCFS), Southern Illinois Healthcare Foundation and Chestnut Health Systems to promote family safety and permanency for children in the western region of Southern Illinois who were affected by prenatal or environmental substance exposure. Partners implemented an integrated and collaborative system of care to identify and address the developmental, behavioral and mental health needs of the affected child and family. This collaborative system of care included:

  • Prenatal screening for substance use; Follow-up screening by the pediatrician; Comprehensive medical, neurodevelopmental and psychological assessments; Specialized child and family clinical programs (i.e., individual and group therapy, trauma specific services, parenting programs and coordinated care management); Substance abuse treatment for parents and caregivers; Extensive community outreach and education regarding the impact of prenatal or environmental substance exposure.

Target Population

FACTS targeted:

FACTS served children from birth to 18 years of age (or 21 if still involved with DCFS or if the caregivers maintained guardianship) living in the western region of Southern Illinois and affected by prenatal or environmental exposure and in one of the following placements:

  • Intact family or out-of-home placement with DCFS including children residing with birth families, in kinship or traditional foster homes, residential and group home placements and independent and transitional living programs; Children in subsidized or legal guardianship placements or adoptive homes; Biological family in which either or both parents are in substance abuse treatment, but with no involvement with DCFS; Biological family in which the pregnant woman had a positive screen for substance use on interview during routine care at Southern Illinois Healthcare Foundation utilizing the 4P’s Plus, but no report to DCFS was made.

Major Project Goals

Integrating Systems – Public and private agencies delivered collaborative services within an integrated system of care; Outreaching to Families – Families were educated on the effects of prenatal and environmental exposure and how to access services for the family; Providing Professional Training – Increase number of professionals in Southern Illinois who demonstrate knowledge about the impact of prenatal and environmental exposure and provide comprehensive assessment and treatment services to children who have been exposed; Coordinating Referrals – DCFS caseworkers and substance abuse treatment providers referred prenatally or environmentally exposed children for a full assessment of cognitive, behavioral, developmental and mental health functioning and specialized therapeutic services; Assessing Clients – The physical and behavioral health status of prenatally or environmentally exposed children in Southern Illinois improved through the delivery of specialized, comprehensive assessment services; Treating Clients – The physical health and behavioral health status of prenatally and environmentally exposed children and families in Southern Illinois will be improved through the delivery of specialized, comprehensive treatment services; Increasing Permanency and Safety – Permanency, safety and stability for children who have been prenatally or environmentally exposed to methamphetamine or other substances will be increased.

Key Major Program Services

Parenting/Family Strengthening

  • Manualized/Evidence-Based Parenting Program-Nurturing Parenting

Mental Health and Trauma Services for Adults

  • Trauma-Informed Services
  • Trauma-Specific Services – Seeking Safety

Children’s Services

  • Developmental Services
  • Mental Health Services for Children/Youth – Dyadic Developmental Psychotherapy
  • Trauma Services for Children/Youth – Trauma-Focused Cognitive Behavioral Therapy, Structured Psychotherapy for Adolescents Responding to Chronic Stress

Screening and Assessment – Child Welfare and Other Children’s Issues

  • Screening and Assessment for Trauma
  • Specialized Screening and Assessment – Pre-natal exposure/risk, Developmental, Behavioral/Socio-Emotional, Psychosocial

Screening and Assessment – Substance Use and Other Adult Issues

  • Specialized Screening and Assessment – Parenting, Mental Health/Co-Occurring Disorders

Specialized Outreach, Engagement and Retention

  • Cognitive Behavioral Strategies – Motivational Interviewing/Motivational Enhancement Therapy
  • Organizational Outreach – NIATx
  • Co-location of Staff

Partner Agencies and Organizations

The FACTS Project includes the following partners:

Child Welfare

  • State Child Welfare
  • Child Welfare Services Provider

Substance Abuse

  • State Substance Abuse Agency
  • Substance Treatment Provider


  • Family Drug Court
  • Juvenile Justice Agency

Criminal Justice, Law Enforcement, Legal and Related Organizations

  • Dependency/Juvenile Courts
  • Criminal Courts
  • County Juvenile Justice Agency
  • Law Enforcement
  • Office of the Attorney General
  • Court Appointed Special Advocates

Mental Health

  • Mental Health Services Provider

Health Services

  • County Public Health/Maternal Child Health
  • Children's Dental
  • Adult Health Services Provider – Federally Qualified Health Center (FQHC)
  • Children’s Health Services Provider (FQHC)


  • County/Regional School District; Individual School(s)

Other Community and Child and Family Services

  • Other Community Stakeholder Group

Other Evaluation and Training

  • Consultant/Training

Performance Indicators


Children Remain at Home: All 31 children who were identified as at risk of removal from their home were able to remain within the custody of their parent or caregiver throughout their involvement in the program.

Adult and Child Well-Being

Parental Stress: Of the parents who completed both baseline and follow-up Parenting Stress Index (PSI) measures, 42.8 percent demonstrated a change from clinical to non-clinical in their level of parental stress.

Developmental Assessments: Of children and youth in the treatment group, 86.9 percent were assessed for developmental needs compared to only 15.5 percent in the comparison group.

Mental Health Assessments: With respect to mental health needs, 93.3 percent of the treatment group was assessed for these needs with 65.2 percent of this group accessing services, as compared to 10.3 percent of the comparison group assessed and only 9.9 percent accessing services.

Sustainability Status

The screening and referral system; Prenatal screening and referral; Pediatric developmental screening; Therapy for children and families are fully sustainable for the project. 

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Project Details

  • Lead Agency:
    Children's Research Triangle (CRT)
  • Geographic Area and Congressional District Served:
    St. Clair County; Congressional District 12
  • Federal Grant:
    $1 million/5 years (2007-2012)
  • Evaluation Design and Comparison Group Type:
    Quasi-experimental, Same-Time and Matched Population-Level
  • Proposed Number Served (5 years):
    Children: 483
    Adults: 550
    Families: 461
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