Project Description

OklahomaThe Oklahoma Partnership Initiative Phase-2 (OPI-2) proposed to increase the well-being and improve the permanency outcomes for children affected by substance abuse. The OPI-2 has implemented and is evaluating a multifaceted approach to address the presence of alcohol and other drug abuse (AOD) within the context of Oklahoma's child welfare system. The overall goal of this project is to build on Oklahoma's collaborative infrastructure to meet the needs of families involved with both substance abuse treatment and the child welfare system. The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) is the lead agency on this project and collaborates with the Oklahoma Department of Human Services (OKDHS) and substance abuse treatment providers statewide to implement two evidence-based early intervention and prevention initiatives, Strengthening Families Program (SFP) and Solution-Focused Brief Therapy (SFBT). The project has assured the full integration of the UNCOPE Drug Screening Tool. The OPI-2 has anchored itself in the four objectives listed below. These affect participants at distinct points in the life of the child welfare case, and represent multiple types of service interventions.

Key objectives:

(a) Increase the well-being of substance affected children and families;
(b) Expedite permanency for children from substance affected families;
(c) Ensure safety of children from substance affected families; and,
(d) Increase the state's capacity to deliver collaborative and integrated services.

Strategies focus on early identification and timely referral for services to improve child well-being, enhance safety, and increase permanency and family stability.  The OPI-2 implemented evidence-based strategies designed to increase child, adult, and family functioning.

Target Population

OPI-2 targeted:

General: There are three distinct target populations:

  • For the UNCOPE objective, the target population is parents statewide with child welfare involvement whose children have been removed from the home
  • For SFP, the target population is families statewide screened for inclusion into the program as needing SFP. As of the time of this profile, the grantee has implemented SFP in three counties; Oklahoma, Tulsa, and Canadian
  • For SFBT, the target population is substance-affected families in Oklahoma's two largest counties, Oklahoma and Tulsa.  The grantee utilizes SFBT as an enhancement to primary substance abuse treatment services for child welfare involved parents in outpatient treatment for substance use disorders. As of the time of this profile, one substance use treatment provider is implementing in Tulsa County

Adult Exclusion Criteria: Non-substance abusing, parents not involved in the Oklahoma child welfare system.

In-home/Out-of-home Focus: Both in and out-of-home with a focus on placement in kinship care if child welfare removed the child.

Serving Voluntary Families: Yes

Major Program Goals

Goal 1: A partnership of ten state and local agencies will deliver and evaluate a three-pronged approach to addressing the presence of alcohol and other drug abuse within the context of the child welfare system. The Collaborative Practice Model guides this initiative. The four main objectives of the OPI-2 are to improve child and parent well-being, increase permanency, ensure safety, and increase systems collaboration

Obj 1.1: Continued utilization of UNCOPE Universal Drug and Alcohol Screening tool by the OKDHS for OPI-2 parents whose children are at imminent risk of removal due to abuse or neglect and service linkage for children and adults will enhance safety for children from substance affected families, and increase the state's capacity to deliver collaborative and integrated services.

Obj 1.2: Statewide implementation of two evidence-based early intervention and prevention services for substance involved child welfare families will increase the well-being of children and families from substance affected families, and expedite permanency for children from substance affected families.

Major Program Services

Substance Abuse and Mental Health Treatment Services

  • Universal Screening- UNCOPE
  • Intensive Outpatient
  • Case Management
  • Family and Individual Therapy – Short Term
  • Trauma Screening, Assessment & Treatment

Parenting

  • Strengthening Families Program (SFP)

Cross-System Collaboration/Training

  • Training to providers and referral sources on UNCOPE, SFP and SFBT

Evidence-Based Practices

  • Strengthening Families Program (SFP)
  • Solution-Focused Brief Therapy Training (SFBT)
  • Universal Screening-UNCOPE

Key Partner Agencies

The Regional Partnership Grants encouraged service providers to develop and/or strengthen cross-system linkages between substance abuse treatment, child welfare, dependency court, and other service systems. The following partners are included:

Treatment Services for Substance Use and Mental Health Disorder

  • ODMHSAS- Lead Agency
  • Substance Use Treatment Services Community-Based Providers 
    • RedRock Behavioral Health Services
    • Center for Therapeutic Interventions
    • Latino Community Development Agency

Child Welfare

  • OKDHS – State and Regional Child Welfare Agency

University

  • University of Kansas - School of Social Welfare - Evaluation
  • University of Denver - Graduate School of Social Work - SFBT, Evaluation

Dissemination Activities

Dissemination occurs on a regular basis and includes sharing data, outcomes and project reports with partners and stakeholders. The project team and evaluator share lessons learned and program outcomes via presentations, workshops, panels, and publish in journals when appropriate. The team continues to prepare presentations and publications related to the project.

Sustainability Strategies and Activities

Involvement of Partners: ODMHSAS staff from the OPI-2 serves as a member of the Oklahoma State Health Department's Maternal, Infant, and Early Childhood Home Visiting grant’s sustainability implementation committee.

Sustainability Approach: The federal funding has been a catalyst to establish a foundation for a long-term strategy. The OPI-2 activities have enhanced data-driven infrastructures and ensured protocols and processes will be in place to continue when grant funding has expired.

Additional Funding: The partners have researched state Medicaid billing options and have confirmed treatment provider's ability to bill Medicaid for evidence-based interventions. The project evaluator's outcomes evaluation will include a cost-benefit analysis to support the sustainability conversation. The ODMHSAS plans to utilize the most applicable model to analyze the cost-effectiveness of the OPI-2 project when compared to child welfare services treatment as usual.

Evaluation

The ODMHSAS is evaluating each of its RPG programs. The grantee used a comparison group design to study SFP and a randomized controlled trial to study SFBT. The evaluation has also collected information about the process of implementing SFP and utilization of the UNCOPE tool.

In the SFP evaluation, families in the program group receive SFP while the comparison group receives the traditional parenting program mandated by the OKDHS for families with a child in out-of-home placement. The sample size for the SFP evaluation is 60 families per year, to include an estimated total of 140 children and 80 adults per year.

In the SFBT evaluation, families in the program group receive SFBT, a strengths-based counseling intervention to support recovery from substance abuse, while families in the control group receive substance abuse treatment, typically treatment-as-usual, which consists of research-supported treatments (e.g., cognitive-behavioral therapy, motivational therapy). The sample size for the SFBT evaluation is 80 families per year, for an estimated total sample size of 320, split evenly between SFBT program and control groups.

Outcome Study Designs: Families eligible for SFP choose whether to participate in SFP or in the traditional parenting class. To form a comparison group, the SFP evaluation uses propensity score matching to identify families who are similar to those receiving SFP from the State’s child welfare administrative database. The evaluator will use variables including: time in placement, child’s birthday, gender, and race or ethnicity, to identify comparison families. For the SFBT study, the evaluation team randomly assigned participants to receive either SFBT counseling or treatment-as-usual.

The OPI-2 is assessing SFP outcomes related to child permanency, child safety, adult recovery, family functioning (including parenting skills), and child social skills. The evaluation will measure SFBT outcomes in these domains as well.  The evaluation team collects data related to client emotions for both the SFBT and comparison groups prior to beginning the program and at program exit. The evaluation team measures outcomes for both SFP and SFBT at program exit. Program staff collect primary child well-being, family functioning, and adult recovery data, while the evaluator uses child welfare administrative records to track permanency and safety outcomes.

Additional Evaluation Components: The evaluation measures fidelity to the SFP model in the areas of environmental context, population served, program components, staff qualities and qualifications, and curriculum fidelity, including benchmarks of output measures, modifications, and linguistic adaptations. The evaluation for the SFBT study also assesses fidelity to the SFBT model by using counselor rated SFBT fidelity measure and external SFBT session observation forms.

RPG National Cross-Site Evaluation Participation: In addition to its local evaluation, the OPI-2 is participating in the RPG national cross-site evaluation studies of family outcomes, program implementation, and RPG partnerships across all 17 RPG Round II grantees. As part of the cross-site evaluation, the OPI-2 is participating in a sub-study of the impact of RPG programs on families and children that includes a subset of grantees.

Administrative Structure

The lead agency for the grant is ODMHSAS. ODMHSAS is the Single State Authority for publicly funded substance abuse and mental health prevention and treatment in the State of Oklahoma. The ODMHSAS Project Director, Elicia Berryhill, is responsible for the oversight of the project, including executing contracts, federal reporting, convening Steering Committee meetings, monitoring grant activities, and ensuring achievement of goals and objectives. The OKDHS is the Single State Authority responsible for child welfare services and administration of the State Plan under Title IV-B and IV-E of the Social Security Act in the State of Oklahoma. The OKDHS provides oversight for the increased utilization and improved fidelity of the UNCOPE Drug Screening Tool, and serves as the primary referral source for the projects early intervention and prevention initiatives. The OKDHS and ODMHSAS established agreements ensuring a solid management plan to implement the project and achieve its proposed goals and objectives. Jody Brook, Ph.D. serves as the evaluator. Dr. Brook works at the University of Kansas, School of Social Welfare and brings considerable experience and expertise to this project. Johnny Kim, Ph.D., serves as the lead for the SFBT study implementation and evaluation. Dr. Kim is an Associate Professor at the University of Denver, Graduate School of Social Work and is an expert in SFBT and intervention research.

A separate Steering Committee meets quarterly, at minimum, to address policy-related issues, review outcomes of the services and address sustainability.

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Project Details

  • Lead Agency:
    Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS)
  • Location:
    Oklahoma City, OK
    Program Funding:
    ?$650,000/Year; $535,282/Federal; $114,718/Match
  • Geographic Area and Congressional District Served:
    Statewide Implementation, OK-005
  • Number Served:
    Children: 200/year; Adults: 160/year; Families: 140/year
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