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Kentucky Sobriety Treatment and Recovery Team (START) program for Parents Involved with the Child Welfare System
Physical Health, Child Welfare
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ZERO TO THREE Policy Center state updates
Kentucky is engaged in cross-system collaboration to meet the needs of young children with substance-abusing parents involved with the child welfare system. The Kentucky Sobriety Treatment and Recovery Team (START) program uses an intensive intervention model that integrates addiction services, family preservation, community partnerships, and best practices in child welfare and substance abuse treatment. The program aims to reduce recurrence of child abuse and neglect, improve substance abuse disorder (SUD) treatment rates, build protective parenting capacities, and increase the county’s and state’s capacity to address co-occurring substance abuse and child maltreatment. It was adapted in 2006 from the START model developed in Cleveland, Ohio.
START pairs specially trained child protective service (CPS) workers with family mentors, who have at least three years of sobriety and previous involvement with CPS, to work with families. The program also partners with substance abuse treatment providers to ensure START participants have quick access to intensive treatment. Decision-making is shared among all team members, including the family and court.
START is currently being implemented in two urban and one rural Appalachian site. The program is directed and funded by the state CPS department (the Kentucky Department for Community Based Services) in partnership with the state behavioral health office that oversees contracts with local treatment providers (the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities).Eligibility varies slightly based on the community’s needs: one site serves families with substance-exposed newborns, two serve families with at least one child under three, and one serves families with children under six.
As of April 2013, 322 families with 531 adults and 451 children have been served by START in the state-funded sites. The integrated program has produced twice the rates of sobriety and less than half the rates of placement of children in state custody (20% or less, compared to 41%) than typical practice. Specifically, 66% of women and 40% of men achieved sobriety at closure of their child welfare case, including clean drug tests and progress in both CPS and SUD treatment, compared with a 37% favorable discharge rate overall for CPS-involved clients served in publicly funded SUD treatment programs. A recent cost analysis found that for every $1 spent on START, the state avoids $2.52 in the cost of foster care. START has also been successful in bringing much-needed support services to underserved areas, especially in rural Appalachia.