An initial complication from the elaborate web of relationships included delays in decision- making regarding changes in forms and data collection instruments at the beginning of the project. The interconnectedness among the substance abuse treatment provider who hired and supervised the SALs, IDHW who housed the grant, and the Substance Abuse Office within IDHW who contributed funding to SALs created billing and allocation of time challenges that needed periodic attention. Since SALs were hired by local substance abuse agencies and only half-time for the PTP, they sometimes experienced competing loyalties and pressures over how to allocate their time. The understanding of the grant requirements and procedures by the hiring substance abuse agencies varied; some were well-informed, others were not.
Building Relationships. One of the principle anticipated challenges for SALs was the devel- opment of positive relationships with the CPS and local substance abuse treatment provid- ers. Relationships with CPS have been greatly enhanced by co-location in the same office. Informal and formal contacts now are occurring – not just about referrals to SALs, but about questions social workers have about substance abuse issues. The SAL in Region I had an of- fice at a local substance abuse treatment provider office, and an office at the CFS office, where she attended many meetings and staffings. In addition, the SAL provided initial training to the staff on the scope and purpose of the grant, and consulted informally on case situations.
Having a consistent and reliable “go-between” on CPS cases to screen and assess DOA prob- lems and “shepherd” the paperwork through the BPA approval process enhanced relationships with substance abuse treatment providers in each region. SALs also provided pre-treatment services that enabled participants to stay in a holding pattern until substance abuse treatment providers had openings. Relationships to the local providers became so positive that, in many cases, SALs’ clients received preferential treatment and access to treatment. This positive development is believed to have contributed to the decreased waiting list time for child protec- tive clients.
Client Recruitment. Approaches and activities to recruit families to the PTP were to orientate CPS social workers and caseworkers in each region about the program, the referral form, and SALs. Orientation took place formally through staff meetings and individual meetings with the SAL and informally through the everyday interaction of SALs with the CPS staff.
An unanticipated initial challenge was the lack of open IDHW cases in which children re- mained at home instead of in foster care. To include more families, the criteria for eligible referrals expanded to children who already were in out-of-home placement when they entered the PTP, provided this was a recent development (i.e., they were temporarily out-of-home while professionals completed the assessment, or the assessment of the case was just com- pleted and they had been placed out-of-home with a goal of reunification).
As shown in subsequent data, the number of children out-of-home greatly outnumbered the children in-home at the time of referral. This may reflect the seriousness of the cases that were referred to the program or of policy decisions by law enforcement or CPS regarding removal of children when substance abuse is a concern.
Idaho Pre-Treatment Program