Evaluation of MCCC Services for Substance Using Caregivers [Communities of Hope Program]

Overview: Mountain Comprehensive Care Center (MCCC), a community mental health center offering substance abuse treatment, mental health care, trauma-informed care, victim services and health care for individuals and families of all ages, is proposing to implement the Communities of Hope Program in Johnson, Martin and Floyd Counties in Kentucky, situated in Eastern Kentucky and the Central Appalachian region. Needs to be addressed: The targeted service area faces significant poverty and is designated as "distressed" and in the nation's top 10% for the highest unemployment, poverty and lowest per capita income. Substance use has reached epidemic levels in KY with the region among the state's highest rates of drug use and Pharmaceutical Opioids driving this epidemic. Over one-third of Central Appalachians in KY reported friends or family who had experienced problems as a result of abusing prescription pain relievers - higher than any other area of the state. As a result of such abuse, KY ranks 3rd in the nation for the most drug overdose deaths per capita along with the targeted counties among the state's highest rates for overdose hospitalization involving all drugs with Pharmaceutical Opioids the most predominant. From 2013-2015, the targeted counties had high rates of children in out-of-home care with Johnson highest at 72.2 per 1,000 children followed by Martin at 66.5 and Floyd at 34.1 compared to KY at 39.2. From 2012 to 2015, the percentage of removals of children from their homes that cited parental substance use as a contributing factor increased 13% which was the largest percentage increase of all factors. KY has also reported an increase in children entering foster care faster than they are leaving with this rate increasing annually for Martin and Floyd Counties while dipping slightly for Johnson County - although rates here still remain significantly higher than most areas of the state. Proposed services: MCCC is proposing a project to increase the well-being of, and to improve the permanency outcomes and safety of children affected by substance abuse by developing an Intensive Outpatient Treatment Program to address the needs of parents/caretakers with substance abuse disorders. The project consists of an initial Orientation, 3 phases of care moving from intensive substance abuse treatment to early recovery services, and maintenance (with integrated mental health care, trauma-informed care, case management, peer/recovery supports, and parenting and life skills training) then on to continuing care. In addition to the parent/caregiver, children are screened and assessed with connections to a wide array of existing age and developmentally-appropriate mental health, trauma-informed and substance abuse treatment programs (including First Steps for children birth to age 3) and comprehensive family planning, services, counseling and case management to integrate not only each family member's needs but the collective needs of the family to move towards greater functioning and stability. Population to be served: The targeted population will be adults in Johnson, Martin and Floyd Counties in Kentucky who have a child, birth to age 17, in out-of-home care or who have a child at risk of being placed in out-of-home care due to the parent's or caregiver's substance abuse. The project will serve 40 participant families (adult and at least 1 child) in Year 1 moving to 70 annually in Years 2-5 for a total of 320 participant families served over the 5 year project.