A Regional Partnership for New York City to Improve Well-Being and Child Welfare Outcomes Among Families at Risk of Substance Misuse Through Parenting Education and Enhanced Case Management - Montefiore Medical Center will partner with several state and local governmental agencies and subject matter experts, including those addressing child welfare, substance use, and economic and concrete supports (ECRS), and with several Bronx providers who work closely with families that have child welfare, substance use, and ECRS needs. Our goals are to (i) improve collaboration between substance use disorder (SUD) treatment providers, child welfare providers, and providers of ECRS and (ii) to enhance parent, child, and family outcomes for enrolled families. Given the association between child maltreatment and substance misuse, prior work by Montefiore and others has demonstrated that improving access to SUD treatment, coupled with parenting education and contingency management, has led to many positive child welfare outcomes. Although valuable, this work doesn’t account for the role of sociodemographic factors, or “social determinants of child welfare involvement” in outcomes related to co-occurring substance use and child welfare. Substance use, poverty, and underemployment are significant contributing factors to adverse child welfare outcomes, and a multipronged approach is required to truly ameliorate the problem. Building on the successes of our past Regional Partnership Grants (RPGs), Montefiore will develop collaborations to support families at risk of negative substance use and child welfare outcomes in the Bronx; this borough is overrepresented in terms of child welfare involvement, substance use concerns, and lack of ECRS. Families will be referred from Montefiore’s Family Treatment & Rehabilitation (FTR) preventive child welfare program if caregivers are at-risk of substance use and will be randomly assigned to receive services as usual as part of the comparison group, or to receive enhanced RPG8 services as part of the program group. These enhanced services include: (1) an evidence-based parenting education curriculum; (2) referrals and support with ECRS needs, (3) Enhanced Case Management including Motivational Enhancement and supports in making ECRS and substance use treatment referrals, and (4) Contingency Management to reinforce healthy behaviors, including attendance at services. The project includes an independent evaluation and will include 250 FTR parents randomly assigned to the program or comparison group. Outcomes related to parental well-being (including recovery), child well-being, family functioning, and child safety and permanency, will be evaluated using self-report and administrative data. The partnership will also be evaluated using stakeholder surveys. Findings will be disseminated to all partners, and presented to ECRS, SUD treatment, and child welfare providers in national conferences; these results may also assist in the implementation of similar services in New York City and beyond.
