Evaluation of the Summit County STARS Program

The STARS program

To help address substance use disorders in the child welfare population, a group of government and local agencies in Summit County have collaborated to provide a coordinated system of care for families. Collaborators include Children Services, the Health Department, the Juvenile Court, the Addictions and Mental Health Board, and several local community agencies.

Through STARS, families are offered

• An expedited in-home alcohol and drug (AoD) assessment by a Health Department AoD specialist
• Trauma assessment and, as needed, trauma-informed counseling for children aged 3 and older
• Coordinated program services (a Health Department STARS coordinator partners with caseworkers to coordinate such services as an evidence-based parenting program)
• Access to and support from trained peer support specialists
• Access to other community services (a Health Department outreach worker connects families to services based on a needs assessment)

A subset of STARS participants are also enrolled in a family drug court that functions as an extra service for some STARS families.

Working closely with the partnering agencies, we’re conducting a process study and an outcomes study. For the process study, we’ve been seeking out the perspectives of staff and families through interviews, focus groups and surveys. For the outcomes study, we use information derived from standardized instruments and data extracted from administrative databases.   

Expedited in-home assessment

Core to the STARS program is the rapid in-home AoD assessment. Designed to quickly identify substance use disorders by streamlining access to assessment, STARS’ expedited assessment resulted in substantially reduced wait times compared to assessments occurring in the local community. We also found that 72% of the 483 parents assessed were identified as having a substance use disorder. 

Staff buy-in and changes in systems infrastructure

One caseworker from each child welfare unit volunteered to receive ongoing intensive training in substance use disorders. These workers, called Subject Matter Experts, act as additional knowledge resources for other unit workers, and have helped other staff see the value of the STARS program. In addition, certain Health Department staff have been relocated from the Health Department offices to Children Services, resulting in a 5-fold increase in communication between Health Department staff and caseworkers and a 6-fold increase in the number of contacts with, or on behalf of, families by Health Department outreach staff.

Evidence-based programs and promising practices

Evidence-Based Parenting classes ensure that parents in substance treatment or recovery have the skills necessary for successful parenting by focusing on changing the patterns of parenting that are related to a child’s neglect or abuse. Attendance rose substantially after STARS instituted a new evidence-based parenting class program: parents completed an average of 75% of program sessions in 2016, compared to 57% in 2015.    

Peer Mentors undertake an intensive week-long training and must have a full 2 years of sobriety. Currently five agencies across Summit County are contracted to provide peer mentors. Many of the mentors are also prior child welfare clients. STARS parents describe several benefits to having a peer mentor. These include encouragement and empathy as well as the incentive of being held ‘accountable’ by a peer for their actions.

Visitation

Most recently, the STARS partners identified that some parents were finding it challenging to maintain consistent visits with their children placed in out-of-home care. At the request of Summit County Children Services, and based on interviews with parents who have been successfully reunified with their children, we developed a series of Visitation Profiles. These are designed to stimulate discussions between parents and staff around reasons for failing to maintain regular visits and ways to overcome these challenges.

Family Reunification through Recovery Court (FFRC)

FRRC aims to provide additional support for some STARS families through a 3-phase step-down family drug court. During Phase I parents attend court weekly. As progress is made they are required to attend with lessening frequency through Phases II and III. Prior to each court hearing the ‘treatment team’ convenes to discuss each family’s successes and troubleshoot any challenges the family may be facing in their recovery. With a capacity of approximately 25 families per year since 2014, 64% of those parents whose case has closed have successfully completed the program.

Results

We present findings formally and informally on an ongoing basis across the span of the evaluation during monthly calls and in-person collaborative planning meetings. This stimulates regular discussion among agency directors and staff. These discussions provide us with important study insights and create opportunities for agencies to learn from the evaluation and one another—and to make program adjustments as needed.

Outcomes related to child and family wellbeing, safety and permanency are currently underway. Propensity scores are being used as a mechanism to adjust for observed background differences between STARS families, STARS + FRRC families, and comparison families.