Renewing Arizona Family Traditions RAFT 2005 Annual Report Version I Arizona Supreme Court Administrative Office of the Courts Juvenile Justice Services Division FY 2005 Table of Contents I. Introduction........................................................................................................................1 II. Provider Agencies and Geographic Service Responsibilities.........................................3 III. Service Descriptions ...........................................................................................................4 IV. Direct and Indirect Hours .................................................................................................5 V. RAFT Emerge ncy Funds ................................................................................................ 7 VI. Demographic Information............................................................................................ 7 VII. Intakes...............................................................................................................................10 VIII. Discharge and Outcome Criteria....................................................................................12 Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division i RAFT 2005 Annual Report I. Introduction The Renewing Arizona Family Traditions (RAFT) program has completed another fiscal year, 2005, responding to the needs of Arizona=s youth and families by providing intensive, family-oriented services to court referred youth. In this, the sixth annual report for the RAFT program, the AOC reviews the successes as well as the opportunities for growth within the RAFT program. Adolescents with serious behavioral issues are traditionally one of the most difficult populations to treat successfully. In response to this d ifficulty, approaches to working with such populations have evolved from removing adolescents from the home toward treating the youth and family within the family unit. This movement toward family preservation using a multisystems approach was first introduced to the Arizona Juvenile Courts by the Administrative Office of the Courts (AOC) in January of 1994 as the Renewing Arizona Family Traditions (RAFT) program. The RAFT concept is based on the Homebuilder=s model, developed in 1974 by Doctors Jill Kinney and David Haapala to help families who were not successful in community-based programs. RAFT is an intensive inhome, therapeutic, case management and skills-oriented model of intervention. RAFT provider intent deliver timely and intense interventions, which involve diffusing immediate crises, therapeutically engaging the family, developing goals with the family, teaching skills to family members, and providing case management. The ultimate goal is eliminating or reducing the amount of court involvement with the juvenile. RAFT is not a preventative program for low-risk offenders. RAFT is intended to intervene in high risk situations with multi- need families. The child or adolescent may be at risk of being removed from the family or family violence may threaten the stability of the family. RAFT is designed to intervene and respond immediately in a wide variety of areas beyond the scope of many other intervention programs. Therapists employed to deliver RAFT services are required to possess at least a master’s degree with training and/or experience in counseling or social work. The program model uses a single therapist to deliver the intensive services. The RAFT program supports the philosophy that the most effective therapeutic work occurs when the therapist is involved in doing concrete tasks with the family rather than doing traditional “talk therapy.” Services follow the client (home, school, and neighborhood) rather than the client and family coming to the service. RAFT preservationists are available 24 hours a day, seven days a week. Therapists work closely and intensively with the youth and family, often having daily contact when necessary. Perhaps most importantly for families in crisis, RAFT preservationists focus on immediate, maximum effort by the staff, youth and family to attain goals which de-escalate the crisis and create stability. These differences between RAFT and traditional approaches have been identified as the very elements which attribute to the program=s effectiveness. The responsivene ss to the youth’s and family=s needs, the flexibility of services, the setting where services occur, and the length and intensity of services are noted as major contributors to the success of the RAFT model. The RAFT program has evolved in response to several programmatic issues that have materialized Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 1 RAFT 2005 Annual Report since its inception in 1994. The original model was a crisis oriented, short term (four to six weeks long), therapeutic program without case management. RAFT providers had difficulty identifying community-based, lower intensity follow-up services within the original four to six week time frame. Additionally, the availability of follow up services in rural areas remains a problem. In response to these issues, the RAFT program was changed in February 1999 to include case management as well as therapeutic and skill development services. The RAFT model also changed from purely a short term crisis intervention orientation to a goal-based performance model. Referrals now include intensive family reunification and social reintegration services to juveniles transitioning from detention, shelter or out of home placement who are in need of stabilization and support. The revised RAFT program has responded to other issues as well. Geographic coverage under the initial RAFT model was often limited, especially in rural areas. The number of families and clients, which could be served, was also highly limited. Under the revised model, the AOC has been able to expand both geographic coverage and the capacity of the service by giving the contracted providers the administrative authority to use therapists for services other than RAFT, as long as staff availability for RAFT services is maintained. RAFT contracts are performance-based and the contractors are provided financial incentives to produce positive outcomes through a stepped case rate reimbursement payment process. Contractors are paid in “increments” as they deliver the services to the clients and meet established performance goals. For example, the contracts pay a higher rate for an intake completed within 24 hours of referral than one that is completed within 7 days. The contractor who successfully discharges a client according to established criteria is paid a significant incentive. Conversely, the contractor does not receive an incentive for a client who is not successfully discharged. Finally, the contractor receives an additional significant incentive payment for clients who meet established outcome criteria 180 days post discharge. In this way, contractors are encouraged to develop treatment plans and deliver services in ways that promote long term success. This report outlines the RAFT program through a presentation of data collected by the AOC through its contract providers and other sources. The data is recorded by provider agencies and their respective regions and includes intake and discharge/outcome information. The data cited covers the period from July 2004 through June 2005. Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 2 RAFT 2005 Annual Report II. Provider Agencies and Geographic Services Responsibilities As fiscal year 2004/05 began, RAFT Services continued to be available in every county of Arizona with the exception of Maricopa and Mohave Counties. Several years ago, Mohave County Probation opted to utilize a modified home based counseling program for their service model instead of RAFT. This model is titled Mohave County Building Up Families Servic es (MCBUFS). In 2004/05, Mohave County Probation continued to utilize this program. In all other counties of Arizona, the provision of RAFT services continued in fiscal year 2004/05 in the same regional divisions as in the past fiscal year. The counties other than Mohave are contained within one of four specific regions for service provision and a designated provider agency is assigned to each region. Counties, other than Mohave and Maricopa, are assigned to regions in the following schematic. Region Counties Arizona’s Children Association Arizona’s Children Association Arizona’s Children Association Arizona Baptist Children’s Services Coconino Mohave Coconino, Yavapai, Navajo, Apache Gila, Pinal, Graham, Greenlee Pima, Cochise, Santa Cruz Yuma, LaPaz Apache Navajo Region I Region II Region III Region IV Provider Yavapai La Paz Gila Greenlee Mar icopa Pinal Yuma Graham Pima Cochise Santa Cruz Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 3 RAFT 2005 Annual Report III. Service Descriptions RAFT providers throughout the state offer a wide variety of services to meet the needs of the youth and families with whom they work. The ultimate goal of RAFT services is to reduce recidivism. This goal is achieved using a variety of techniques and interventions which fall into three main categories of service: Case Mana gement, Psycho-educational services and Therapeutic interventions. A description of each service is provided below. Case Management Services RAFT therapists take an active role in securing community and faith-based supports for their clients and families. These services include locating assistance for families in paying bills, identifying interim housing, or applying for temporary financial assistance. School support is another important aspect of case management services. The therapist works with school administrators, teachers and school counselors to put plans in place to support youth in school. When formal schooling is not an option, alternative education may be recommended for the client. It may also be an option for the client=s parent(s) who are interested in pursuing their education. If mental health issues are identified for the client or family, RAFT therapists assist in accessing needed services through the Regional Behavioral Health Authority (RBHA). The RAFT therapist is responsible for coordinating RAFT services with other mental or behavioral health treatment services delivered through the RBHA. Clients and families frequently require general health care. When such needs are identified, the therapist works with the family to obtain medical coverage for youth, siblings and parents through plans such as AHCCCS. RAFT therapists work with families to take advantage of community-based resources such as the Joint Training Partnership Act, and with support programs such as the Boys and Girls Clubs. As one RAFT therapist expressed, “You have to be imaginative and do whatever it takes to meet the child=s needs.” Psycho-educational Services RAFT therapists provide a great deal of issue-related education to their clients. For example, therapists may work with parents to help them understand the dynamics of their child=s substance abuse. They may strive to help the family break dysfunctional patterns by providing all of the family members with information about their role in these patterns and by encouraging new ways of relating to one another. Developing/improving parenting skills is often an area of need for the parents with whom RAFT providers work. RAFT providers may address this need by intervening directly to de-escalate situations between parents and youth, modeling and coaching preferred behaviors or even referring parents to parenting skills classes. RAFT therapists teach parents to provide structure, set boundaries, develop and enforce rules, deliver appropriate discipline and discover their own strengths as a parent. Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 4 RAFT 2005 Annual Report Therapeutic Services RAFT therapists typically deliver intensive counseling services, working individually directly with clients or with youth and family members together. Often, therapists have to work hard just to rebuild family unity prior to beginning any client specific interventions. According to a RAFT therapist, “Parents get so tired of their child=s disruptive behavior, they may feel ready to give up. We work to help parents get back in control.” Therapists may have to work separately with the parent and child until they are ready to be brought together. RAFT therapists occasionally find that parents and other family members are very motivated to support changes in the youth, but have difficulties making changes themselves. In most cases, this can be overcome and improvement in both the client and family occur, but sometimes a RAFT therapist must assist the youth in developing other support systems in addition to the immediate family. In addition to the variety of case management, psycho-educational and therapeutic services, RAFT therapists may assume the role of mentor with the individual youth they counsel. They may meet with the youth once or twice a week in this revised role to talk about school, sports, or friends. The RAFT therapist typically serves in this mentoring role to help transition the youth and family to other, more long-term community based support systems. IV. Direct and Indirect Hours RAFT service hours are classified as either direct or indirect. Direct hours include therapeutic sessions with the youth and family, skill development with the youth and family, crisis intervention, and case management activities requiring direct involvement with the client. Indirect hours include such activities as advocating for the client with his/her school and other community providers, accessing community resources for the client, accessing economic and social support systems on the client=s behalf, and progress note and report writing. Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 5 RAFT 2005 Annual Report RAFT 2005 Annual Report All Counties - Direct and Indirect Hours 6,000 5,279 5,000 Hours 4,000 3,485 3,000 1,794 2,000 1,000 0 Direct Service Hours Indirect Service Hours Total RAFT 2005 Annual Report By Region - Direct and Indirect Hours 3485 3500 3000 2903 2500 2000 Hours 1794 1500 985 1000 800 556 500 9 26 0 Region I Region III Direct Hours Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division Region IV Total Indirect Hours 6 RAFT 2005 Annual Report V. RAFT Emergency Funds Emergency fund monies are available for providing emergency services to referred client families. RAFT emergency fund use is not to exceed $400 per family. Each provider must develop a written policy and procedure for their RAFT emergency fund, and all disbursements or use of emergency funds must be in accordance with AOC approved policy and procedure. RAFT emergency funds are required to be kept in a separate account and are to be available for AOC review. VI. Demographic Information RAFT providers collect and report demographic information on the clients served. Information collected includes the clients’ ethnicity and gender. In order to respond the needs of the cultural and ethnic diverse population of youth in Arizona’s juvenile justice system, all RAFT providers receive training through their agency to develop cultural competency. Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 7 RAFT 2005 Annual Report RAFT 2005 Annual Report All Counties - Clients By Gender Total = 109 37 Female Male 72 RAFT 2005 Annual ReportGender by Region 80 72 70 60 Number of Youth 50 42 40 30 37 Male Female 29 22 20 14 10 1 1 0 Region I Region III Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division Region IV 8 Total* RAFT 2005 Annual Report RAFT 2005 Annual ReportAll Counties - Ethnicity 120 109 100 Caucasian Hispanic Number of Youth 80 60 African American 60 Native American 38 40 Other Total 20 7 3 1 0 ic an sp i H ian as uc a C n ica Afr tal To r he Ot n ca eri m A tive Na n ca eri Am RAFT 2005 Annual Report Ethnicity All Counties By Region 109 Caucasian Hispanic African American Native American Other/ Unknown Total 64 60 43 38 31 28 9 28 7 0 2 Region I 1 1 0 Region III Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 1 1 0 0 0 2 7 3 Region IV 1 TOTAL 9 RAFT 2005 Annual Report VII. Intakes Of the 79 youth referred for RAFT service statewide, 100% were accepted. RAFT providers must accept youth who meet the following intake criteria: A. Incorrigibility/ Delinquency: Youth who present with incorrigible or delinquent behaviors which threaten the stability and unity of the family, and whose family is willing to learn how to improve parenting skills and positively impact their youth=s behaviors. B. Substance Abuse: The youth and perhaps other family members present with substance abuse problems, but are willing to invest efforts into education, treatment and other skill development and improvement. C. Family Violence: Documented evidence exists that physical violence has existed in the family with a high likelihood that renewed or escalated violence will occur. Family members must express a commitment to learn new ways of expressing anger in non- violent ways. D. Behavioral Health: The youth or family member presents with a serious behavioral health problem negatively impacting family stability, but which may be addressed through a combination of medication, treatment and skill development. E. Sexual Behavior: The youth is engaging in promiscuous sexual behaviors in or outside of the home and/or the family=s sexual boundaries are contributing to inappropriate sexual behaviors. RAFT providers may deny or terminate services according to the following criteria: A. The family=s location is unknown. B. The therapist cannot gain access to or contact the family after multiple documented attempts. C. The youth or family presents a risk which is highly dangerous or life threatening. D. The youth or family adamantly refuses services and will not cooperate. Once the RAFT provider receives the referral from the juvenile court, the AOC prefers that the provider make face-to-face contact with the client and completes a written assessment of the family within 24 hours of receipt of the referral. If the referral is designated by the county probation department as a crisis referral, the intake and assessment must be completed within 24 hours of the provider=s receipt of the referral. For all referrals, if face-to- face contact within 24 hours is not possible, telephone contact is required and must be documented. If the referral is not designated as a crisis referral, the provider then has seven days to make face-to- face contact with the youth and family and complete the initial assessment form. Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 10 RAFT 2005 Annual Report RAFT 2005 Annual Report – Referrals/Intakes By County Yuma 1 Yavapai 14 Pima 30 Navajo 7 Coconino 2 Cochise 15 Apache 9 0 5 10 15 20 25 30 35 By Region 58% 1% 41% Region I Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division Region III 11 Region IV RAFT 2005 Annual Report VIII. Discharge and Outcome Criteria The AOC contracts with each of the RAFT provider agencies by providing incentive based case rates. The provider is paid an intake rate with an incentive for completing the intake within 24 hours of referral, a set rate for acceptance of a case, an incentive for a case that is successfully discharged, and a final incentive payment for a successful outcome 180 days after discharge. A successful discharge in the RAFT program is measured by all of the following criteria having been met: A. The problem behaviors for which the client was referred have been eliminated or diminished and the family is stable as may be evidenced by documented achievement of service plan goals. B. The youth remains in the home or has been successfully transitioned from an out-ofhome environment to the home or other appropriate environment. C. The youth is actively attending school and achieving passing grades or is actively pursuing alternative education and/or is employed or seeking employment. D. The youth is compliant with the terms of probation The target performance goals of RAFT are that at least 80% of RAFT referrals accepted into service will be successfully discharged, and at least 80 % of RAFT clients will have remained in home during the six month period following discharge. Successful outcome is measured by all of the following criteria having been met: A. The client remains in the home with no removal for out-of- home placement. B. The client has not been transferred to detention on a new charge or had a probation violation for longer then 72 hours, had no runaway for longer than 7 days, had no commitment to the Department of Juvenile Corrections, was not transferred to adult court and placed on probation or was not sentenced to the Department of Corrections. C. The client is meeting the terms of probation and has not received any new referrals excluding status offenses. D. The client is attending school and achieving passing grades, or, if not in school, is actively pursuing alternative education and/or is employed. Clients who are not successfully discharged due to their lack of compliance with one or more of the program=s discharge criteria may still be tracked to determine whether they meet the criteria for a successful outcome. The provider agencies may then report and bill the AOC for a successful outcome, if the client meets the successful outcome criteria six months after discharge, even if the original discharge was unsuccessful. Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division 12 RAFT 2005 Annual Report RAFT 2005 Annual Report All Counties - Discharges and Outcomes 68 70 60 Number of Youth 50 46 40 36 30 24 22 20 12 10 To tal Un su cc es sfu l Su cc es sfu l To tal Un su cce ssf ul Su cc es sfu l 0 Discharges Outcomes RAFT 2005 Annual Report By Region - Discharges 70 68 60 Number of Youth 50 46 40 37 31 29 30 22 20 15 14 10 6 2 0 2 0 Successful Unsuccessful Region I Arizona Supreme Court . Administrative Office of the Courts Juvenile Justice Services Division Region III 13 Region IV Total Discharges Total RAFT 2005 Annual Report