Susan Delle Shaffette

As part of the 21st National Conference on Child Abuse and Neglect (April 24-26, 2019), the Children's Bureau is accepting nominations for the Children's Bureau Champion Awards. Please see the attached for more information. We encourage you to send this information to your networks or submit a nomination. Nominations are due November 12th, 2018. The Children’s Bureau Champion Awards honor those working to improve the overall health and well-being of our nation’s children and families. Awards will be given in the following five areas: preventing child maltreatment; reshaping foster care as a support to families; promoting child and family well-being; building community capacity; and supporting the workforce. More information, including how to submit a nomination, is available on the NCCAN website.  Please let Rosie Gomez, This email address is being protected from spambots. You need JavaScript enabled to view it.  know if you have any questions.

Title: State Practices in Treatment/Therapeutic Foster Care. 
Author(s): Seibert, Julie.;Feinberg, Rose.;Ayub, Asha.;Helburn, Amy.;Gibbs, Deborah. 
Published: 2018 
Available from: Assistant Secretary for Planning and Evaluation (ASPE) 
http://aspe.hhs.gov/ 
Room 415F 
U.S. Department of Health and Human Services 
200 Independence Av, SW 
Washington, DC 20201 

Printable version (PDF): https://aspe.hhs.gov/system/files/pdf/259121/TREATMENTFOSTERCARE.pdf

Abstract: This federally funded report presents findings from an investigation into how therapeutic foster care (TFC) is implemented and supported by States. Information for the report comes from key informant interviews, representing a variety of perspectives on TFC, and a review of relevant literature. The report provides an overview of the key program elements of TFC defined by States and how States differentiate TFC from foster care. The report also provides a description of how States provide adjunct services, such as case management and behavioral health services to children in TFC. Finally, the report includes information on the different funding strategies employed by States to support TFC services. Findings indicate key elements of TFC include highly skilled caregivers (TFC parents) who are part of the child’s treatment team, enhanced case management, and coordinated delivery of behavioral health and other community-based services. The study also found that although TFC may be a cost-effective alternative to residential care, funding challenges limit its use in many States. States typically fund TFC using Medicaid funds for clinical and therapeutic services and Title IV-E funds for daily care of eligible children. TFC may also be supported with funds from state child welfare, juvenile justice and behavioral health agencies, and provider agency fundraising. Finally, the study found States have employed a variety of strategies to increase Medicaid funding for TFC, such as defining TFC as a service in the state Medicaid plan, categorizing TFC as a rehabilitative service, and using waivers authorized by Section 1115 and Titles 1915(b) and (c) of the Social Security Act. The report concludes TFC is successfully utilized by several States as an alternative to congregate care. Appendices include State profiles. 6 references. 

Trauma-informed care integrates an understanding of the prevalence of adverse childhood experiences and their impact on lifelong health. The science of early brain development reveals that the environment in which children develop—family, community, and culture—impacts brain development, health, and genetics. In the medical home, being trauma-informed is important for prevention and amelioration of this impact.

Title: Trauma-Informed Primary Care: Prevention, Recognition, and Promoting Resilience.
Author(s): Earls, Marian F.
Published: 2018
Journal Name: NCMJ (North Carolina Medical Journal)
v. 79, 2, March-April 2018, p. 108-112
Available from: NCMJ (North Carolina Medical Journal)
PDF: http://www.ncmedicaljournal.com/content/79/2/108.full.pdf+html
Abstract: This commentary explains trauma-informed care integrates an understanding of the prevalence of adverse childhood experiences and their impact on lifelong health. It notes the science ...

Five Steps to a Stronger Child Welfare Workforce (Press release)

Annie E. Casey Foundation - September 12, 2018

The five-step process described in this paper comes from On the Frontline, the Annie E. Casey Foundation's three-year effort to measurably improve the leading edge of the child welfare workforce: its child protection staff, including investigations caseworkers and supervisors.

Report: : https://www.aecf.org/m/resourcedoc/aecf-fivestepstoastrongerchildwelfare-2018.pdf

https://youthtoday.org/2018/09/five-steps-to-a-stronger-child-welfare-workforce/

The ABA Center on Children and the Law is seeking proposals to present at our two upcoming conferences:

  • National Conference on Access to Justice for Children and Families (2-day focus for all child law professionals), April 9-10, 2019 Request for Proposals 
  • National Conference on Parent Representation (2-day focus on parent advocacy), April 11-12, 2019 Request for Proposals 

Please view proposal criteria and the online proposal form for each conference at the links above. Proposal deadline: October 9, 2019. For information about past conferences, visit the Center's National Conferences web page.

Children Placed in Foster Care Because of Substance Use Now More Likely to Go to Relatives than Non-relatives, A Report Finds

The recently updated report from Generations United, Raising Children of the Opioid Epidemic: Solutions and Support for Grandfamilies, shows that -- overall -- foster care systems are relying more on grandparents and other relatives to care for children when their parents cannot. The report includes recommendations on how to connect grandfamilies to the same supports and services that traditional unrelated foster families receive. Read the release, then see the updated report

To prevent youth opioid misuse, many states are more effectively regulating prescriptions

SEP 04, 2018
AUTHORS: ANDRA WILKINSON, HANNAH WINSLOW

The majority of people who misuse drugs start before their 18th birthday. Furthermore, the risk of addiction increases when drug use starts in adolescence, making this period a key prevention window. Leftover prescription pills, either from one’s own prescription or those of family or friends, are the dominant source of opioid pain relievers for adolescents who misuse them.[1] By the end of high school, approximately 13 percent of teens will have misused opioid pain relievers (i.e., used them without prescription, in a manner not prescribed, or to get high). Strategies that address adolescent misuse of prescription opioid pain relievers represent a critical component of any successful effort to address the opioid crisis.

A national study of 12th graders found that, among those with no prior history of drug use and strong disapproval of illegal drug use, a prescription for opioids in high school was associated with a threefold increased risk of later opioid misuse. Opioid pain reliever misuse can substantially increase the risk of initiating heroin use. As such, decreasing excessive opioid prescribing and lowering the number of leftover pills are important strategies for preventing opioid pain reliever misuse—and, potentially, later heroin or fentanyl (a more powerful and lethal synthetic opioid) use among youth.

Adolescent outreach and education is necessary but not sufficient for prevention. To prevent adolescent misuse, many states have implemented policies designed to limit unnecessary prescribing. Recent legislative efforts have included the following strategies:

Despite their effectiveness at reducing misuse, policies targeting the supply of prescription opioids have met varying degrees of resistance. In recent years, opioid prescribing has dropped. Teen prescription opioid and heroin use is now at a historic low, fueling concerns that these new policies may not be necessary, and that poorly implemented policies can—and are—harming terminal patients and those with chronic pain. Furthermore, increased regulation of prescription opioids generally correlates with upticks in heroin use. Ohio, the state with the second-highest opioid overdose death rate, has in recent years passed legislation that includes all three of the previously mentioned policy approaches. In subsequent years, the state saw opioid prescribing fall 20 percent, while its overall overdose death rate continued to rise as the proportion of deaths due to heroin and fentanyl increased.

However, the relationship observed between decreasing supplies of prescription opioids and increases in heroin use is complex, and research shows that the overall increase in heroin use began long before efforts to decrease opioid prescribing. For this reason, lawmakers should consider ways to expand treatment while taking careful steps to limit supply, as confirmed by a recent predictive model. Although prescribing has dropped overall, it still varies considerably across states; for example, certain states have prescribing rates more than twice as high as their neighbors. Some researchers also assert that state policies are important for continued declines in prescription opioid use among youth.

Policies regulating access to prescription opioids are certainly not a cure-all, but they do provide an opportunity for policymakers to intervene before youth addiction begins. As prescription pain relievers continue to be one of the most common drugs of choice for first-time users in adolescence, state policy initiatives to reduce excessive prescribing may be a powerful tool for lawmakers. However, to ensure that prescription opioid regulation corresponds with decreases in overdose deaths, policies limiting supply must not harm chronic pain patients and must go hand-in-hand with expanded and comprehensive addiction treatment.

[1] Child Trends analyses of the 2016 National Survey on Drug Use and Health.

[2] State policies related to opioid prescribing change rapidly. For the most up-to-date information, please consult http://www.ncsl.org/research/health/injury-prevention-legislation-database.aspx.

 

A newly revised field manual, Child Protection in Families Experiencing Domestic Violence, is now available. The manual reflects recent practice innovations, the latest research and data, and a greater emphasis on family preservation and in-home services.

The comprehensive user manual informs child protective services (CPS) workers, supervisors, and related professionals on multiple issues related to the co-occurrence of child maltreatment and domestic violence. The newly revised edition reflects the Children's Bureau commitment to a collaborative and community-based approach to child protection and offers guidance on:

  • Ensuring the safety of children in incidents of domestic violence
  • Ensuring domestic violence survivor safety
  • Perpetrator accountability
  • Agency response

The updated manual also addresses the following practice issues:

  • Guidelines for assessing families experiencing domestic violence
  • Perpetrators of domestic violence
  • Adult survivors and child witnesses
  • Complexity of children's issues and trauma-focused approach
  • Safety and wellness for CPS workers
  • Building collaborative responses for families experiencing domestic violence

The revised manual is part of the Children's Bureau Child Abuse and Neglect User Manual Series—last updated in 2003—and serves as a companion piece to Child Protective Services: A Guide for Caseworkers, a second revised manual in the series. The updated manuals from the U.S. Department of Health and Services' Children's Bureau Office on Child Abuse and Neglect are available at https://www.childwelfare.gov/pubs/usermanuals.

For a series of tip sheets on how to respond to families experiencing domestic violence and child maltreatment—including general practice recommendations, suggestions for engaging families, and guidance on documentation, assessment, decision-making, and planning—see the Child Welfare Capacity Building Center for States' Domestic Violence and the Child Welfare Professional Series at https://capacity.childwelfare.gov/states/focus-areas/child-protection/domestic-violence.

Pediatricians Put It Bluntly: Motherhood And Marijuana Don't Mix

Kaiser Health News - August 27, 2018

More and more people consider smoking marijuana harmless or even beneficial, but mounting research suggests women who are pregnant or breastfeeding should avoid it altogether.

https://khn.org/news/pediatricians-put-it-bluntly-motherhood-and-marijuana-dont-mix/

The Opioid Crisis and its Impact on Children

Legal Executive Institute - August 23, 2018

Although the impact on adults is tragic, an increasing number of children are also suffering, especially as opioid addiction reaches crisis levels. From birth on, these children are living with the consequences of their parents' addiction.

http://www.legalexecutiveinstitute.com/opioid-crisis-impact-on-children/

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