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New England Practice & Policy

Webinar #2

December9,20141:00‐2:30PM(Eastern)

“MeetingtheNeedsofFamiliesintheChildWelfareSystem AffectedbySubstanceUseDisorders"

Screening and Assessment for Family Engagement

and Retention

NancyK.Young,PhDExecutiveDirector

NationalCenteronSubstanceAbuseandChildWelfare

SaraJ.Becker,PhDNewEnglandAddiction

TechnologyTransferCenterBrownUniversity

Welcome & Opening Remarks

• Establishedin2002• Anationalresourcecenter

providinginformation,expertconsultation,trainingandtechnicalassistancetochildwelfare,dependencycourtandsubstanceabusetreatmentprofessionalstoimprovethesafety,permanency,well‐beingandrecoveryoutcomesforchildren,parentsandfamilies

National Center on Substance Abuse and Child Welfare

NE ATTC Mission

• Establishedin1993bySAMHSA• Nationalnetworkcomprisedof10regionalcenters,4nationalfocusareacenters,andacoordinatingoffice.

• Networkmissionisto:raiseawarenessandskillsoftheworkforcethatservesindividualsaffectedbysubstanceusedisorders;acceleratetheadoptionandimplementationofevidence‐basedpractices;andfosterregionalandnationalalliances amongdiverseclinicians,researchers,policymakers,fundersandtherecoverycommunity.

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In your region, what are the top three general areas of greatest training need? Please select three responses. (N=63)

Collaboration across systems(e.g. CWS, AOD,

Courts) Evidence-based interventions for families affected

by SUDs

Retention and engagement of

families in treatment

67.2%65.6% 63.9%

Budgeting for and sustaining new initiatives

32.8% (20)

Substance use screening and assessment

32.8% (20)

Tracking and measuring family outcomes

26.3% (15)

Other 3.3% (2)(N=41)

(N=40)

(N=39) Assessing impact of parental substance abuse on children, especially infants and those under 5 throughout involvement. Budgeting for sufficient staff and services to respond to increased need. Cross training of DCF and providers.

All of those, truly!

• A National Perspective Screening and Assessment for Family Engagement and Retention

• A Case Example: Connecticut’s Recovery Specialist Voluntary Program Collaborative Model

• National Resources and Tools• The next webinar in the series• Discussion

Today’s Webinar Agenda

LindaCarpenter,MEdProgramDirector

NationalCenteronSubstanceAbuseandChildWelfare

A National Perspective

Screening and Assessment for Family

Engagement and Retention

Improvingtheoutcomesofchildrenandfamiliesaffectedbyparentalsubstanceuse requiresacoordinatedresponsewhichdrawfromthetalentsandresourcesofatleastthreesystems:• ChildWelfare• SubstanceAbuse

Treatment• Courts

Better together

No Single Agency Can Do This Alone

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Mission and Underlying Values

Howdoesyourmissionimpactscreening,assessment,engagementandretention?

• Whomdoyouserve?• Differenceinperceptionoftheprimaryclient:theparent,the

child,thefamily.• Differenceinperceptionofthetargetpopulation• Differenceinperceptionofaddiction,recoveryandparenting• Differenceinunderstandingandperceptionofterms(e.g.

screening,assessment,successfulcompletion,etc)

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EarlyScreeningandIdentificationofparentalsubstanceuseinchildwelfarecasesiscritical.

• 61%— thepercentageofconfirmeddrugoralcoholdependenceamongsubstantiatedabuseorneglectcasesmissedbyfrontlineCWSsocialworkers(Gibbons,Barth,Martin,2005)

• Anecdotalreportsfromchildwelfarestaffclaimparentalsubstanceabuseasafactorintheircasestobeashighas85%.

Current Screening Practices

• Currentlynostatehasauniversalscreeningforallchildwelfarecases

• Somescreenatinvestigativestage• Someonlywithsubstantiatedcases• Somethroughoutthelifeofthecase

• Somestatesandlocalitiesreportmuchhigherratesofsubstanceabusewhenthereis

• Workertraining—togainabetterunderstandingofaddictionandrecovery,engagementandtrauma

• Agreementonwho,how,whatandwhyofscreening• Interagencyagreementsonwhatwillhappenasaresultofapositivescreen

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Questions to Consider with a Screening Protocol?

• Whoisyourtargetpopulation?• UniversalorSpecificSegment• ScreeningInvs.ScreeningOut

• Doesyourprogramaddressotherissuesthatfamiliesareexperiencing?• Whathappenswithpositivescreen?• Howarereferralsmadeforfurtherassessment?• Howisinformationcommunicatedwithparents?Withtreatmentproviders?Areappropriateconsentsinplaceandconsistentlysigned?• Doprovidersacceptthescreeningresults?• Whatfollow‐upexistswithparents?Withtreatmentproviders?• Doyouscreenonlywhenchildsafetyisanissue?• Aresome“substances”agreaterconcernthanothers?• Whattrainingandsupportdostaffwhoareconductingthescreeningneedtofeelcomfortable/confidentaskingthesequestions?

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Timely engagement and access to assessment and

treatment matters.

Questions to Consider with an Assessment Protocol?

• Howistheindividualreferredforassessment?• Onanaveragehowlongdoesittaketogofromreferraltoassessment?• Whoconductstheassessmentandwhattoolsareused?• Whatadditionalinformationfromchildwelfareandotherpartnerswouldbehelpfulinunderstandingtheneedsoftheparent,childandfamily?

• Howisinformationcommunicatedtotheparent?Tothechildwelfarestaff?Tothecourts?Aretheappropriateconsentsinplaceandconsistentlysigned?

• Whathappensiftheparentdoesn’tshowforassessment?• Whatarethenextstepsiftreatmentisindicated?Iftreatmentisnotindicated?• Ifthepersons/systems/agenciesconductingtheassessmentsarenotthesameastheonesprovidingtreatment,isthereawarmhand‐off?

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Assessment is an On-Going Process

Assessmenthappensalongacontinuumtodetermine:PresenceandImmediacy

• Isthereanissuepresent?

• Whatistheimmediacyoftheissue?

NatureandExtent• Whatisthenatureoftheissue?

• Whatistheextentoftheissue?

Developing&MonitoringChange,TransitionsandOutcomesofTreatmentandCasePlans

Whatistheresponsetotheissue?

Aretheredemonstrablechangesintheissue?

Isthefamilyreadyfortransition?

DidtheInterventionswork?

Rethinking Engagement

Will they come?

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PrinciplesofEffectiveEngagement

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Eliminates barriers

Collaborative

Enhances motivation

Family-focused

BarrierstoEngagementandRetention

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• - Accessibility -Appropriateness and Quality of services• - Duplication - Consumer Satisfaction• - Availability • - Requirements (multiple, conflicting)

Organizational

• - Gender - Motivation• - Culture, values - Client-staff relationships• - Mental health/Trauma - Involuntary• - Attitude of workers - Development

Interpersonal

• - Housing - Legal issues• - Employment - Safety, physical environment• - Childcare - Transportation / Distance• - Health - Isolation, no supportsEnvironmental

StrategiestoImproveEngagementandRetention

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Organizational

Interpersonal

EnvironmentalCoordinated Case managementRecovery specialistCommunity Supports/Aftercare Location of services; physical environment

Client-centered, family-focused practiceMatching client needs w/appropriate LOCMotivational InterviewingPeer SupportsRecovery Specialist

Cross-system joint agreementsClient HandbookCross-training for staffCo-locationWalk-though (ie NIAtx)

Rethinking Treatment Readiness

Addiction as an elevatorRe-thinking “rock bottom”

“Raising the bottom”

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Rethinking Treatment Readiness

Re-thinking “Rock Bottom”

“Raising the bottom”

• “Tough love” - in the hopes that they will hit rock bottom and wanting to change their life.

• Collective knowledge in the community is to “cut them off, kick them out, or stop talking to them.”

• Addiction as a disease of isolation

• Getting off on an earlier floor• Has realistic expectations and

understands both the neuro-chemical effects on people with substance related and addiction disorders and difficulties and challenges of early recovery

• Readiness • Recovery occurring in the context of

relationships

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Drop‐offAnalysis221 cases referred for SA assessment

(assuming all caregivers receive an assessment)

169 received SA assessment (144 assessed, 25 in treatment but no assessment date)

(24% drop off = 52)

Number referred to SA treatment = 166

Number made it to SA treatment = 162

(2% drop off)

85 successfully completed SA tx*

Payoff22

*This#mayincreaseslightlyassomeclientsarestillenrolledintreatmentandmaysuccessfullycompleteinthefuture

• PairedCounselorandChildWelfareWorker• CounselorOut‐StationedatChildWelfare• OfficeorCourt• ParentMentorsandRecoverySpecialists• SubstanceAbuseSpecialists• MultidisciplinaryJointCasePlanningTeams• FamilyTreatmentDrugCourt

Effective Models of Collaborative Practice Connecticut: A Case Example

Listen for the key premises and principles

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Taming the Many Headed Dragon:Recovery Specialist Voluntary 

ProgramCollaborative Model

Marilou Giovannucci, Manager, (CIP Director) Judicial Branch Christine Lau, Regional Administrator, Department of Children and Families (DCF)

Janet Storey, Behavioral Health Program Manager, Department of Mental Health and Addiction Services (DHMAS)

Jane Ungemack, Assistant Professor, University of Connecticut School of Medicine (UCHC)

Recovery Specialist Voluntary Program(RSVP)

Both a policy and a practice model  Voluntary program offered to parent/caregiver whose child or children are removed by court order as a result of alleged abuse or neglect and substance abuse is a factor in the removal RSVP introduced to parent/caregiver by court staff (Court Services Officer) at the first court hearing on the Order of Temporary Custody (OTC) Removal Parent signs an agreement to participate that includes adherence to a court standing order

RSVP is a collaborative program of:  Department of Children and Families (DCF) Department of Mental Health and Addiction Services (DMHAS) Judicial Branch ‐ Court Operations

Along with: Advanced Behavioral Health, Inc. (ABH), an administrative services organizationOffice of the Chief Public Defender, Juvenile Delinquency and Child Protection UnitOffice of the Attorney General

Began as an IDTA project with the NCSACW27

Funding, Data Sharing and Communication 

• Financing the initiatives: • Re‐purposed existing  Project Safe recovery case management dollars;• Developed braided funding among partners, including CIP dollars for training and evaluation;• Re‐deployed savings (hair test reductions) to expand the program;• Leverage competitive federal grant dollars to test new models

• Began organically• Survived administration and staffing changes and expanded

• Communication and Confidentiality on the client level:• Developed an MOA and Standing Order governing communication/confidentiality and data sharing;

• Data Sharing to Inform Practice and to Evaluate Outcomes:• Developed a Data Use/Sharing Agreement

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Connecticut does not have family drug courts

1 in 3 OTC cases in Connecticut are substance‐

involved

Only 1 in 3 parents/caregivers referred by DCF for evaluation and treatment for a substance abuse problem enter 

treatment

Parental substance abuse is associated with longer out‐of‐home placements for 

children

Barriers for Substance Abusing Families in the Child Welfare System

Parents have difficulty navigating the three major systems: Child Welfare Substance Abuse Treatment Court system

Lack of communication between systems Insufficient knowledge and understanding of addiction and recovery in the child welfare and court systems

Different perspectives and goals among stakeholders, especially in the court community

Limited ability and/or willingness to share information due to confidentiality and privacy laws and concerns

Competing timeframes: time to treatment vs. ASFA timelines

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Project SAFE

Statewide Substance Abuse Family Evaluation program co‐funded by DCF and DMHAS, administered by ABH

Provides priority access for substance abuse evaluations to parents/caregivers involved with the child welfare system

Provides outpatient treatment, if recommended, through a statewide network of approximately 50 community providers

Is a payer of last resort for parents/caregivers without health insurance Legislatively mandated

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Screening of child welfare clients for substance abuse

DCF had been using the GAIN SS for several years.  

Considerable investment in training Social Work staff including the clinicians

SW’s were required to complete the GAIN before a referral to ABH for Project SAFE evaluation. 

CPS staff did not like the GAIN.  Had to be administered in a specific fashion, could not deviate. Staff felt that families were not truthful in the substance abuse section. Screen did not giving a true picture substance use and was not engaging to use with families. 

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Screening of child welfare clients for substance abuse

In 2011,  DCF began work to implement a new Practice Model with a strong emphasis on family engagement;

Implementation of Differential Response System (DRS) in 2012.

With the implementation of DRS, the GAIN was dropped as an expectation for Family Assessment Response (FAR) staff.  

GAIN was believed to not be useful and a barrier in family engagement given the nature of the tool. 

Investigation staff felt they should not use it either and was later dropped as an expectation for them.

Instead FAR and Investigation staff use a set of guiding questions to assess factors and indicators that would point to substance abuse and a referral to ABH for Project SAFE evaluation 

DCF Assessment Process

History of using the GAIN Short Screen to assess parental substance problems  Reduce reliance on screening tools to assess families strengths and needs; Partner with the family at every step of the child welfare case; Use motivational interviewing to engage families; Examine behaviors and supports systems to inform child welfare decision‐making.

Goals of RSVP

Help parents navigate the DCF, Court and substance abuse treatment systems Establish a shared definition of substance abuse treatment and recovery Help the systems talk to each other Do it fast!

Shared Mission

Improve child well‐being, safety and permanency when parental substance abuse has been identified as a significant issue resulting in children being removed from their homes.

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Goals of RSVP Collaboration

Increase system capacity to better serve families impacted by substance use disorders:  Implement a recovery‐oriented integrated system of care for families  Improve access to evaluation and treatment services and collateral recovery supports

Facilitate collaborative problem resolution for concerns and issues raised by the parties involved

Bridge multi‐system policies, procedures and practices  Improve communication and information exchange among state agencies, practitioners, communities, consumers and families

Engage and educate the court community including judges, agency and parent/child attorneys and court staff

Structure and Processes of RSVP 

Operates under a Memorandum of Understanding/Data Use Agreement Oversight by Agency Commissioners and Chief Administrative Judge Shared decision‐making and leadership by DCF, DMHAS, and Judicial through the Core Management Team Substance Abuse Managed Service System (SAMSS) meeting in each area office Solicits stakeholder input Develop  and jointly provide multidisciplinary training that promotes cross‐agency understanding of: Addiction and recovery  Evidence‐based interventions Children’s mental health Child development and well‐being Impact of substance abuse/dependency on parenting Culturally and gender‐appropriate service delivery

RSVP Program Components

Three phases lasting approximately 3 months each at different levels of intensity and frequency of meetings with the Recovery Specialist and random alcohol/drug tests Engagement in substance abuse treatment Attendance at self‐help support groups Participation in case conferences

RSVP Recovery Specialist

ABH staff, Supervised by ABH Program Manager Trained to use motivational interviewing with clients Identify needs and Assist parent/caregiver in accessing and engaging in 

substance abuse treatment and other support services Advocates for parent/caregiver Conducts reliable random drug screens Tool to support recovery, Not punitive

Provides regular compliance monitoring to DCF, courts, and attorneys Supports parent/caregiver in increasing building recovery capital and self 

advocacy skills through recovery coaching

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Substance Abuse Managed Service System(SAMSS) Meetings

Unique feature not found in drug court models Developed organically on the local level, expanded and supported by leadership Solution‐focused Facilitated by DCF  Held weekly or biweekly Case overview presented by DCF Social Worker Active participation from DMHAS, ABH and local treatment providers

SAMSS Supports Recovery Capital

SAMSS is viewed as an systems intervention: Review evaluation findings and recommendations for individual parent/caregiver Develop a plan of action through collaborative problem solving and resource identification to eliminate barriers to recovery Close collaboration and communication among providers, DCF and clients provides opportunities for engagement and treatment to take place Discussions highlight system issues that create barriers to treatment Having decision makers participate assists in addressing systems issues in a timely manner

Court Case Status Conferences

Facilitated by Court Services Officer; The purpose is to discuss compliance with RSVP, engage and encouragethe parent in her/his recovery efforts, 

Reinforce the impact of recovery on their court case;  Allow the parent to share any barriers or challenges that s/he is experiencing; and 

Engage in collective case problem‐solving.  

Data for the Evaluation

DCF Child-centered Numbers and characteristics of OTC cases Family reunification, child permanency and re-entry Family strengths/needs and safety assessments

DMHAS Adult client-centered Number and characteristics of substance abuse treatment clients

Judicial Child-centered Time to disposition and disposition status

ABHNumber and characteristics of clients served by RSVPTimeliness of treatment entryMonthly functional assessmentsProgram participation and discharge status

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Co-occurring Problems among RSVP Clients: 2009 – 2012

(n=208)

Ever arrested 72%

Current criminal justice involvement 51%

History of domestic violence 42%

History of trauma 24%

History of mental health problems 51%

Unemployed 79%

Never married or divorced/separated/widowed 74%

Problem Substances among RSVP Clients in Treatment: 2009 – 2012

24%

16%

29%

8%

15%

42% 44%

34%

18%

39%

ALCOHOL COCAINE/CRACK HEROIN OTHER OPIATES MARIJUANAPrimary Problem Any Problem

Substance Abuse Treatment Outcomes for RSVP Clients

97% of OTC enrollees referred to RSVP were evaluated to need treatment84% of RSVP clients enrolled in substance abuse treatment68% within 30 days

61% had a prior history of substance abuse treatmentLevel of care: 6% Detoxification only15% Methadone maintenance30% Outpatient28% Intensive outpatient/partial hospitalization21% Residential

Median length of stay was 88 days75% of RSVP clients had a successful discharge from their RSVP-related treatment

admission compared to 43% of substance abuse clients statewide

Percent of Child Exits Reaching Permanent Placement within 12 Months: RSVP vs. Statewide*

0

20

40

60

80

RSVP Statewide

74%

49%

* 76% of RSVP children were reunified with their parent/caregiver

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Summary of Findings

Substance‐abusing parents in need of treatment are being identified and enrolled Participants who comply with RSVP are more likely to be successfully reunited with their 

children and in a more timely manner RSVP clients present with multiple and complex problems that require intensive 

intervention and coordination across service systems Some challenges remain:  1‐in‐4 eligible OTCs are not referred to RSVP Statewide expansion Obtaining access to other needed services Housing Mental health services Trauma services Employment/vocational training

Sustaining the Efforts

• Sustaining your efforts:• Report utilization and outcomes monthly, quarterly and annually to leadership and stakeholders;

• Examining economic impact;• Celebrate success with program participants.• Exploring creative funding sources for expansion. (Pay for Success, Social Impact Bonds)

Parting Words

“Together we embrace safety, permanency and well‐being, and substance abuse recovery. Our ultimate goal is to achieve positive

results for a family that will last a lifetime.” 

NCSACWWrap-up,Resources and

Tools

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Guiding Principles

• Improvingtheoutcomesofchildrenandfamiliesaffectedbyparentalsubstanceusedemandsurgentattentionandthehighestpossiblestandardsofpracticefromeveryoneworkinginsystemschargedwithpromotingchildsafetyandfamilywell‐being.

• Since 85% of all children with substantiated abuse and neglect cases stay home or return home to their parents, child  and family well‐being requires services for both children and families. 

• Successispossibleandfeasible.Staffinchildwelfare,substanceabuse,andcourtsystemshavethedesireandpotentialtochangeindividuallivesandcreateeffectivepracticesandresponsiblepublicpolicies.

Guiding Principles

• Thefamilyisthefocusofconcern• Theteamisthetool,andpeople,nottools,makedecisions

• Problemsdon’tcomeindiscretepackages;theyarejumbledtogether

• Ongoingassessmentisasharedresponsibility• Developingandsustainingeffectivecollaborationsishard—butessentialwork

• Sharedmissionandvision‐ agreementandunderstandingoftargetpopulationandexpectedoutcomes

• Clearandconsistentreferralprocess—preferablywarmhand‐off

• Coordinatedcaseplanning,informationsharing,• timelyandongoingcommunicationandfollow‐up• Understandingofandattentiontocompeting“clocks”—timeframes–recognizingthattimeisoftheessence!

Essential Elements Cross-System Collaboration Includescollaborativepracticesandtoolsforlinkingsubstanceabuse,childwelfare,andfamilycourts.

• CollaborativePracticeModel• MatrixofProgress• CollaborativeValuesInventory

• CollaborativeCapacityInstrument

Pleasevisitourresourcepage:https://www.ncsacw.samhsa.gov/collaboration/default.aspx

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Collaborative Practice

• SAFERR• CollaborativePracticeModel

• Cross‐SystemsCollaborationPrimer

• Cross‐SystemsDataPrimer

Pleasevisitourresourcepage:http://www.ncsacw.samhsa.gov/resources

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1. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers

2. 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

National Center on Substance Abuse and Child WelfareOnline Tutorials

Please visit: www.ncsacw.samhsa.gov

Client Screening,

Assessment, Engagement &

Retention

Pleasevisitourresourcepage:https://www.ncsacw.samhsa.gov/resources/daily‐practice‐client.aspx

Resource: Substance Abuse Specialist in Child Welfare Agencies

and Dependency Courts

6 State Case Studies

Todownloadacopy,pleasevisit:http://www.ncsacw.samhsa.gov/files/SubstanceAbuseSpecialists.pdf

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Resource: Drug Testing in Child Welfare: Practice and

Policy Considerations

http://www.ncsacw.samhsa.gov/files/DrugTestinginChildWelfare.pdf

Todownloadacopy,pleasevisit:http://www.ncsacw.samhsa.gov/files/SAFERR.pdf

Resource: Screening and Assessment for Family Engagement, and Recovery

(SAFERR)

Todownloadacopy,pleasevisit:

Just Released !

Todownloadacopy,visit:http://store.samhsa.gov/shin/content//SMA14‐4816/SMA14‐4816.pdf

• Assistsbehavioralhealthprofessionalsinunderstandingtheimpactandconsequencesforthosewhoexperiencetrauma

• Discussespatientassessment,treatmentplanningstrategiesthatsupportrecovery,andbuildingatrauma‐informedcareworkforce

NationalCollaborativeonWorkforceandDisabilityPolicyBrief‐ http://www.ncwd‐youth.info/policy‐brief‐02

SAMHSATIPs:TIP31ScreeningandAssessingAdolescentsforSubstanceUseDisordersandTIP32TreatmentofAdolescentsWithSubstanceUseDisordershttp://store.samhsa.gov/shin/content/SMA01‐3596/SMA01‐3596.pdf

The ATTC and the National Institute on Drug Abuse jointly created a suite of blending products: http://www.attcnetwork.org/explore/priorityareas/science/blendinginitiative/

NewEnglandResources:RhodeIsland‐ AdolescentHealthCareTransitionProgram‐ OfficeofSpecialHealthcareNeedsattheDept.ofHealth:http://www.health.ri.gov/programs/adolescenthealthcaretransition/

Massachusetts ‐ DepartmentofMentalHealthTransitionAgeYouth(TAY)Initiativehttp://www.mass.gov/eohhs/gov/departments/dmh/transitional‐age‐youth‐initiative.html

Connecticut ‐ Dept.ofMentalHealth&AddictionsServices‐ YoungAdultServicesDivisionhttp://www.ct.gov/dmhas/cwp/view.asp?q=334784

Vermont‐ VermontFamilyNetwork‐ resourceguidefortransitionageyouthwithmentalhealthorsubstanceuseissues: http://www.vermontfamilynetwork.org/wp‐content/uploads/2012/12/Resource‐Guide‐for‐Parents‐of‐Transition.pdf

Maine ‐ MaineYouthTransitionCollaborativewebsite‐ http://maine‐ytc.org/

NewHampshire‐ Dept.ofHealthandHumanServices‐ YoungAdultResourceGuide:http://www.dhhs.state.nh.us/dcyf/documents/youngadult.pdf

Resources - Youth

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Next in theWebinar Series…

In your region, what are the top three special topic areas of greatest training need? Please select three responses. (N=63)

Trauma-informed approaches to

careOpioid abuse and

medication-assisted

treatmentTransition-age

youth; aging out of the system70.5%

59.0%52.5%

Substance-exposed newborns 37.7% (23)

Prescription drug abuse 26.2% (16)

Minority and underserved populations

17.5% (10)

Parental custody rights 13.1% (8)

Medicaid/ACA implementation 9.8% (6)

Other 8.2% (5)(N=43)

(N=36)

(N=32)

How to assess child safety related to substance abuse/reunification

Training and support for foster parents who are asked to care for children impacted by parental substance abuse.

CBT skills training for providers

Diagnosis

Screening and treatment for adolescents

The Webinar SeriesSeptember 30, 2014Kick‐OffWebinar

December 9, 2014ScreeningandAssessmentforFamilyEngagementand

Retention

March 2015ConductingTrauma‐InformedSystems

AssessmentQ&AandDiscussion

12/9/2014

18

Contact InformationNancyK.Young,PhDExecutiveDirectorNationalCenteron

SubstanceAbuseandChildWelfarencsacw@cffutures.org

(714)505‐3525

SaraJ.Becker,PhDNewEnglandAddiction

TechnologyTransferCenterBrownUniversity

sara_becker@brown.edu(401)863‐6604