Drug Endangered Child Program (DEC) A Proposal for a Multi-Disciplinary Integrated Response System Contents Overview Purpose Mission and Values Partnerships/Roles Training Protocols/Continuum of Care Evaluation References Overview Nationally: Drugs, $, and weapons are typical seizures by LE agents during “controlled buys” or clandestine lab raids; Growing phenomenon of children exposed to the production, sale, and use of illicit drugs Overview 500% increase in cases where Methamphetamine is drug of choice in TX programs (Manning, 1999) San Diego – Methamphetamine Capital Production: multi-level, organized criminal enterprise & “mom & pop shops” Every state, county, and city now faced with the need to respond CY2004: 82/129 CHIPS Petitions - SLC CY2001-04: SLC Sheriff -29 meth labs Overview Methamphetamine (Meth) Man made, extremely addictive, CNS stimulant. It is extremely powerful Known as: crank, ice, crystal, glass, speed, mud, or chalk, etc Smoked, snorted, orally ingested, or injected Overview Effects on Users Intense, pleasurable “high” last several hours; Followed by an equally intense “crash” Addicts: extreme paranoia, anxiety, confusion, hallucinations, violence, depression, insomnia; Health: increased BP & heart rate, dopamine depletion, kidney & liver Before and After Before and After Overview Methamphetamine Production Drug Cartels – Organized Crime Local Labs – Urbane, Rural Private Homes/Apartments Hotels/Motels Storage Facilities Hunting Shacks/Cabins Ice House, etc Meth Lab in a Home Mobile Lab in a Vehicle Ice House Lab Meth Lab in a Cabin Meth Labs - Dangers Fires Explosions Toxic Waste Sites Inhalation and exposure to toxic fumes and chemicals Accidental ingestion of chemicals and contaminated foods Chaos & poor supervision Adults involved in criminal behavior Meth Labs/Homes - Hazards Drugs and drug paraphernalia Booby traps Guns & weapons Exposed wiring Chemicals in refrigerators Strangers Dangers of Meth Labs Chemical hazards from cooking process Solvents Corrosives Toxics Reactives Meth Lab Waste METH WASTE– BABBITT, MN Meth Lab Dump Site Overview Dangers For Children Individuals involved in the production, sale, and use of Methamphetamine exhibit chaotic lifestyles; Their children are at significant risk of physical abuse, sexual abuse, neglect, and drug-related violence by family members and the array of strangers who enter the home to buy or use drugs (Harris, 2004) Purpose Community Responses to “Big Problems” 1980’s – Domestic Violence & DAIP 1990’s – Child Sexual Abuse & 1st Witness 2000’s – Drugs and Drug Endangered Child Programs Purpose Ensure children exposed to the production, use, and sale of illicit drugs receive community specific service delivery that meets their unique needs; Facilitate the identification and collaboration of various disciplines Build coalitions; Meth Task Force Jointly develop discipline-specific protocols (review, revise, finalize, & publish) Purpose Coordinate a multi-disciplinary integrated response to children Team meetings, cross training, goals Provide direct service to children Organize neighborhoods & communities Participate in the development and implementation of creative community support programming; Shared Family Care Program Search for funding Evaluate Mission To Protect, Promote, and Improve the health and quality of life in St. Louis County Values Safety Permanency Well Being Collaboration Dedication Partnerships Law Enforcement Assume investigatory duties at the site of the production, sale, or use of illicit drugs State Municipal Tribal County Partnerships Fire, EMT, HAZMAT Team Assist in the management of environmental hazards from production Testing Clean-up Partnerships Medical Develop protocols Conduct medical evaluations & screenings to ensure the child’s physical and mental health needs are met Partnerships Justice County Attorney’s Office, in conjunction with municipalities and Tribal authorities, would be responsible for litigation of criminal drug cases and juvenile child protection (CHIPS) cases; Public defenders and victim’s advocacy would be a positive addition Partnerships Public and Tribal Social Services Intake workers will provide for immediate protection and safety; gather forensic data; transport for evaluation and address placement need DEC social worker will initiate the development of the DEC program; assume co-coordination with public health Identify team members, build coalitions, develop protocols, coordinate responses, facilitate team meetings, etc. Partnerships Public & Tribal Social Services DEC worker will conduct adjunctive home visitations with families and children in concert with pubic and tribal case managers to ensure safety and well-being (Kitzmann, 1997) DEC worker will assist in the recruitment, initial training, and continuing education of Shared Family Care Providers (Barth, 1994) Partnerships Public Health Public Health Nurse (PHN) will initiate development of the DEC program; assume co-coordination with social services; Identify team members, build coalitions, develop protocols, coordinate responses, facilitate team meetings, etc PHN will conduct adjunctive home visitation; track safety, well-being and progress Foster Care Service Shared Family Care (SFC) Dual – Adult & Child Licensed Foster Home Services to parent with chemical health issues and their child(ren) Provide assistance, mentoring, parent skill training, independent living skills training Keep family intact; and prepare them for independence (Barth, 1994, 1999; Barth & Price, 2005) Foster Care Services Shared Family Care (SFC) Human Services Roles Provide dual licensed foster homes Access to chemical health treatment and support Provide initial training; continuing education for foster homes Assistance and support services which facilitates transition to independence within the community Foster Care Services Shared Family Care (SFC) Public Health Role Pre/Post natal care monitoring Child development education to parent and provider Child development monitoring/on-going testing Child immunizations Assist with initial training and continuing education of providers Assist parent(s) with community transition Training for DEC Teams Specialized training related to drug cases and child maltreatment – forensic data collection Drug environments – exposures Develop specific skill sets Develop curriculum and training modules for SFC providers/mentors UMD – CW Spring Conference Protocols Develop a response matrix for each discipline or core agency Identify important responses or action steps as it relates to: Team member Their location Procedure Timeline Documentation/reporting Protocols Law Enforcement Assess condition of the child Place child into protective custody Collect physical evidence Protocols Fire – EMT – HAZMET Coordination with on-site law enforcement Stabilization – respond to trauma Field Assessments samples Decontaminations Protocols Public and Tribal Social Services Accept transfer of child & notify DEC Team (SW/PHN) Arrange for any decontamination of the child; medical evaluations; screenings; etc Protocols Public & Tribal Social Services Conduct initial interviews Network with foster care workers/providers Provide community support services Conduct home visitation Organize /communities Provide education/awareness Protocols Public Health Collaborate with law enforcement and child protection services/DEC social worker Network with the clinical/medical community Conduct home visitation Organize neighborhoods/communities Provide public education/awareness Protocols Medical Emergency Immediate Treatment Non-Emergency Medical Exam Screenings Urine/Blood Samples Protocols - Medical Protocols Justice Review Evidence Criminal Charges No Criminal Charges Juvenile Court CHIPS Protocols Foster Care – SFC Recruit Train Referral Process Screen placements Provide regular/periodic staffing for team related to the placement of mother and child in SFC Provide early and continuing mentorship for parent in care Evaluation - Outcomes Creation of a DEC program Participation of core community agencies Train team members Review, rewrite, publish protocols Regular & periodic DEC program team meetings Community outreach & education Evaluation - Outcomes Children will have safe environments Children will receive appropriate screenings and evaluations Children will receive appropriate education SFC participants will remain together Parents will continue treatment and recovery efforts Evaluation - Outcomes Children placed in alternative care will be reunited with parents or achieve alternative permanency References Barth, R.P. (1994). Shared Family Care: Child Protection and Family Preservation. Social Work, 79, 515-525. Barth, R.P (1999). Shared Family Care: Providing Services to Parents and Children Placed Together. Child Welfare, 78, 8898. Barth, R.P. & Price, A. (2005) Shared Family Care: Evidence from Implementing an Innovative Child Protection and Family Preservation Program. Forthcoming In J. Scott & H. Ward (Eds). Promoting the Well Being of Vulnerable Children. Harris, J. (2004). Drug Endangered Children – Police Practice. The FBI Law Enforcement Bulletin, February. References Manning, T. (1999). Drug Labs and Endangered Children – Children of Methamphetamine Makers. The FBI Law Enforcement Bulleting, July. Kitzman, H., Olds, D.L., & Henderson, C.R. (1997). Long- Term Effects of Home Visitation On Maternal Life Course and Child Abuse and Neglect; Fifteen Year Follow-up of a Randomized Trial. Journal of American Medical Association, 278, 637-643. References Photos Kurtz, David. (2004) Northwest Toxicology, Salt Lake City, Utah. Presentation at the 2nd Annual Idaho Drug Endangered Child Conference. Mendoza, E. (2004). Los Angeles County Department of Children and Family Services, Bureau of Child Protection. Presentation at the 2nd Annual Idaho Drug Endangered Children Conference. Poppenberg, B. (2004) St. Louis County Public Health and Human Services. Presentation at the St. Louis County Human Service Confernece. Websites http://www.nationaldec.org/index.asp http://www.azag.gov/DEC/ http://www.colodec.org/index.asp http://dec.co.riverside.ca.us/ http://www.whitehousedrugpolicy.gov/ http://www.practicenotes.org/vol10_n2/ref_v10n 2.htm http://www.isp.state.id.us/DEC_Conference/mat erials.html http://www.health.state.mn.us/divs/eh/meth/lab/ children.html