Empowering Family Resiliency Program: Iowa Children's and Family Collaborative developing assessment and treatment for families exposed to substances. - Iowa continues to face significant levels of substance use among its child-rearing population, with parental drug and alcohol use identified in nearly half of all foster care removals. This crisis is especially acute in Iowa's rural Third Judicial District in the northwest part of the state, where treatment access is limited, service systems operate in silos, and no formal program exists to address the needs of children affected by prenatal or environmental substance exposure. Building on the success of three existing Empowering Family Resiliency Programs (EFRPs) developed through prior grant funding in central, northeast, and southwest Iowa, this proposal establishes a fourth EFRP in the Third Judicial District, hosted by Siouxland Mental Health Center (SMHC) in Sioux City. The project is led by Iowa Children's Justice (ICJ) on behalf of the Iowa Children and Families Collaborative (ICFC), a multiagency coalition that includes the Iowa Department of Health and Human Services (IDHHS), the University of Iowa, juvenile court judges, and other key stakeholders. The EFRP will serve families with children aged birth to 12 who are at risk of, or in, out-of-home care due to parental substance use disorder. Using a transdisciplinary assessment model, families will receive comprehensive evaluation across medical, developmental, psychological, and social domains. Additionally, families will receive a coordinated treatment plan delivered by a Family Navigator in partnership with SMHC's clinical team and consultation from NTI Upstream. Available services include evidence-based practices, including Child-Parent Psychotherapy, Parent-Child Interaction Therapy, and Medication-Assisted Treatment. A rigorous randomized controlled design, conducted by an independent evaluation team at the University of Iowa School of Social Work, will test two hypotheses: (1) that, as compared to a control group, parents enrolled in the EFRP will demonstrate improved parental functioning, abstinence, and mental health; and (2) that children served will demonstrate improved well-being, permanency, and safety. Recruitment will scale from 10 families in Year 1 to 50 families annually by Year 4, with outcomes tracked through validated instruments and IDHHS administrative data at baseline, 6-, and 12-month follow-up. Sustainability is built into the project design through the creation of a statewide Community of Practice linking all four EFRPs to share clinical knowledge, address Medicaid funding barriers, and continue evidence-based training beyond the grant period. Cost-sharing is provided through in-kind contributions from SMHC, IDHHS, the Iowa Judicial Branch, and other ICFC member agencies. This project advances the goals of the Child and Family Services Improvement Act of 2006 by expanding evidence-based, family-centered services to an underserved rural region, thereby strengthening Iowa's capacity to protect children affected by parental substance use and contributing to the field's broader understanding of best practices for substance-affected families.
