Preserving Families Through Partnerships (PFTP) flexibly, creatively and with collaborative expertise builds on PFH's previous RPG project, entitled Strengths, Needs, Abilities and Preferences (SNAP), and uses a trauma-informed and responsive, evidence-based, family and community-centered process to preserve families and enhance family and child well-being in six southwest Missouri counties (Greene, Barry, Lawrence, Stone, Christian and Taney). Need: Collectively, the target counties have 1,425 children currently in out of home placements, 10.7% of Missouri's total. The 8,155 child abuse/neglect referrals to Missouri's Children Division received in 2017 frequently include parental substance abuseas a significant factor at least 40% of the time. 302 adults died in the six PFTP target counties from opioid overdose in 2013-2016. It is observed, based on internal reports, that as many as one-third of parents with SUD meet the criteria for PTSD diagnosis in the service area. Faced with barriers to obtaining basic resources, families impacted by substance use disorders (SUD) are at greater risk of experiencing severe health and emotional problems, family violence, and lack socialsupport. Approach: PFTP enhances the community's collaborative capacity to improve SUD recovery, family safety and stability, which promote long-term family and child well-being. PFTP uses the Signs of Safety Child Protection PracticeFramework currently being implemented by the Missouri Children's Division in all target counties. This framework, which is the foundation for PFTP's family assessment and service plan, melds effectively with the PFH trauma-informed,recovery-oriented, strengths-based models of service delivery. Core services will be provided to all participant families and include: 1) enhanced case management that incorporates the use of three evidence-based practices (EBP): a. modifiedHomebuilders crisis intervention; b. Parent-Child
Assistance Program (P-CAP) long-term family support services; and c. Child and Adolescent Support Services Program (CASSP) supporting severe and persistent mental health needs with connections to long-term community mental health support. 2) Peer Recovery Mentors providing recovery support and guidance. 3) Access to community SUD treatment with in-home, evidence-based SUD treatment, as needed in rural areas. 4) Access to primary and basic behavioral health care through partnering with a regional FQHC or other community health providers, including screening for substance-related neonatal disorders and FASD. Population: PFTP will support 288 families (36, 72, 72, 72 and 36) over the five years of the project. Each participating family will receive basic core services. As core service enhancements, each family will have access to supported employment and kinship caregivers/foster parents will have access to specialized behavior management training: Nurturing Program and Together Facing the Challenge. Comparison groups: the 288 families will be randomly assigned to four groups, totaling 72 families per group. Three groupswill receive in-home EBP: Living in Balance, Seeking Safety or both; while the fourth group, being a control group, will receive only the aforementioned core services.