Taking a Toll: State Program Aims to Ease Burden on DCYF Caseworkers

Sep 18, 2018

Credit Department of Human Health and Services

Morning Edition is taking a look at how the opioid epidemic is affecting children - and the people and programs who support them -  in New Hampshire. It's part of NHPR's Crossroad series, examining the impacts of addiction in New Hampshire.

The Division of Children, Youth and Families, or DCYF, is the state office in charge of child welfare.  It's long been overworked and understaffed.

Erica Ungarelli, with the state's Division of Behavioral Health, is currently working with DCYF on a program to improve some of its services around opioids, specifically, she's helping caseworkers connect children and parents who are struggling with addiction to services.  It's called the Strength to Succeed program.

(Editor's note: this transcript has been edited lightly for clarity.)

We worked with DCYF who said that they needed assistance. They needed assistance with these cases because the numbers are on the rise, and the amount of work that the DCYF workers have to go through to get services in place for these cases takes a lot of time, and a lot of effort and a lot of phone calls to try and enlist all of the different services that the parents and the children need.

How do you feel that this program is going to kind of fill a gap that hasn't been filled before?

So we designed this to do three main things. First, to treat the parent with the substance use disorder. So getting them into treatment rapidly is a key component, and offering them peer support. [It's] not just peer support in the sense of substance use issues, but also peer support from parents who've gone through the DCYF system already, and who also may have a substance use issue, who can support that parent in their work in working towards recovery and working towards keeping their family together or bringing their children back into their home if they've been removed.

For the children it provides support and services in the home where they're staying, if not at their parents’ home, through home visiting. And we're also working in prevention messaging for these kids. These kids are at higher risk of developing a substance use disorder later on in life. So gearing age appropriate prevention messaging and curriculum is important. And then for the caregiver, if the parents are not able to care give their children while in treatment, we have caregiver support. These are grandparents. These are aunts and uncles, or foster parents.

We've heard so much in recent years that DCYF is stretched thin -- lack of staff, just not enough people. How does this program, or having another program, how does it address that need and the need for staffing?

It doesn't address the need for staffing. But one of the issues that I wanted to pay particular attention to with this programming is to ensure that the DCYF staff have one number to call to enact all of these components. So it's not addressing the number of staff but it's addressing what the staff have to do to get all of these components in place. And it was really important for us to develop this program in a way that they only had one number to call to enact all of these things.

Let me ask you how things have been handled, and give me an example of how that might change under this program.

Okay, so typically when a family presents itself with an open DCYF case that has substance use issues, it can be very complex. All of the needs of the family and meeting those needs are very complex. You have the treatment needs of the parent that you have to attend to. You have the support and well-being of the child that you have to attend to. And then the caregiver who may be caring for that child while the parent is in treatment has his or her own set of needs that needs to attend to. And that takes a lot of time to engage with all of the family members, understand what each of those needs are and then find the right providers to meet those needs.

And so that can take an extraordinary amount of time, not just working with each of the family, but also them making calls and knowing what's available in the community. Who has available space to provide those services? There may be waitlists to get parents into treatment and so workers can call around to various different providers trying to get that parent into treatment as quickly as possible. So what we hope with this program is through the one vendor in each area the worker can make one phone call, and then the vendor will then ensure that all of these components are in place for all of the folks participating – the child, the parent and then the caregiver.

By one vendor, you mean one agency, one provider? What do you mean by that?

So we have two agencies that are working with the state around this program. Each agency covers a number of different offices within the state. So if I'm a worker working in the Littleton district office for DCYF, I have one number to call to that provider to enlist all of these components of this programming, and same for each office. They have one number, one provider to call that then coordinates all of these components of this program.

And there are resources on that end of that phone call?

Yes, I think so. Both vendors are working very well with their communities to be able to ensure that the resources are there. It's in the beginning stages. They are implementing. They are hiring staff right now, but in the end I think there will be a good response on the other end of the phone call.