ARIZONA FAMILIES F.I.R.S.T. PROGRAM
Annual Evaluation Report
State Fiscal Year 2009
July 1, 2008 – June 30, 2009

Prepared for
Arizona Department of Economic Security
Division of Children, Youth and Families
Phoenix, Arizona
Contract No.: DES060718

Prepared by
Center for Applied Behavioral Health Policy
College of Public Programs
Arizona State University

© 2009 by the Arizona Board of Regents for and on behalf of
Arizona State University and its Center for Applied Behavioral Health Policy
Center for Applied Behavioral Health Policy
500 N. Third Street, Suite 200
Phoenix, AZ 85004
email: cabhp@asu.edu
website: http://www.cabhp.asu.edu

This document may be copied and transmitted freely. No deletions, additions or alterations of contents are permitted
without the expressed, written consent of the Center for Applied Behavioral Health Policy.

Acknowledgements
This report was prepared by the Center for Applied Behavioral Health Policy (CABHP), College
of Public Programs, Arizona State University, under contract number DES060718-1 with the
Arizona Department of Economic Security, Division of Children, Youth and Families
(ADES/DCYF), in partnership with the Arizona Department of Health Services, Division of
Behavioral Health Services (ADHS/DBHS) through the Joint Substance Abuse Treatment Fund.
Michael S. Shafer, Ph.D. and Brian Arthur are responsible for the content and writing of the
report. Appreciation is given to Charles Davis, Lisa Moen, Richard Rivera, and Julie Sauvageot
for contributing to the report’s analyses, review, and production.
The authors wish to thank staff of the ADES/DCYF and the ADHS/DBHS for their ongoing
cooperation and assistance with the evaluation. In particular, Susan Blackburn, Karen Bulkeley,
Cathy Hasenberg and Mark Klym of ADES, and Jennie Lagunas and Steve Lazere of ADHS
have been very helpful throughout the course of the evaluation.
Points of view represented in this report are those of the authors, and do not necessarily represent
the official position or policies of either the ADES or the ADHS.
Suggested citation:
Center for Applied Behavioral Health Policy. (2009). Arizona Families F.I.R.S.T.
Program: Annual Evaluation Report for the Period July 1, 2008 – June 30, 2009. Tempe,
AZ. Arizona State University.

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TABLE OF CONTENTS
Acknowledgements .......................................................................................................................... i
Table of Contents.............................................................................................................................1
Executive Summary .........................................................................................................................2
Chapter 1: Introduction ...................................................................................................................5
Chapter 2: Evaluation Framework and Data Sources .....................................................................9
Chapter 3: Arizona Families F.I.R.S.T. Clients and Services Received.......................................10
Chapter 4: AFF Program Outcomes .............................................................................................23
Chapter 5: Summary and Conclusions ..........................................................................................27
Appendix A ...................................................................................................................................30

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

EXECUTIVE SUMMARY
Arizona Families F.I.R.S.T. Program Model
Arizona Families F.I.R.S.T. (Families in Recovery Succeeding Together – AFF) was established
as a community substance abuse prevention and treatment program by ARS 8-881. AFF is a
program that provides family-centered substance abuse and recovery support services to parents
or caregivers whose substance abuse is a significant barrier to maintaining or reunifying the
family or achieving self-sufficiency. The program provides an array of structured interventions
to reduce or eliminate abuse of and dependence on alcohol and other drugs, and to address other
adverse conditions related to substance abuse. Interventions are provided through the Department
of Economic Security, Division of Children, Youth and Families (DES/DCYF) contracted
community providers in outpatient and residential settings, or through the Regional Behavioral
Health Authority (RBHA) provider network under the supervision of the Department of Health
Services, Division of Behavioral Health Services (DBHS). AFF emphasizes face-to-face
outreach and engagement at the beginning of treatment, concrete supportive services,
transportation, housing, and aftercare services to manage relapse occurrences. The service
delivery model incorporates essential elements based on family and community needs, such as
culturally responsive services, gender-specific treatment, services for children, and motivational
enhancement strategies to assist the entire family in its recovery.
The evaluation of AFF, required by ARS 8-884, focuses on the fidelity of program
implementation of the AFF model, performance of service providers, factors that contribute to
client success, and the extent to which the legislative outcome goals were met:
•
•
•
•
•

Increases in timeliness, availability and accessibility of services
Recovery from alcohol and drug problems
Child safety and reduction of child abuse and neglect
Permanency for children through reunification
Achievement of self-sufficiency through employment

This year’s evaluation continues the focus on the documentation of program implementation
through the analysis and reporting of client-level service data from DES providers and DBHS,
qualitative data gathered from AFF program directors, and selected substance abuse treatment
and child welfare outcomes for the period July 1, 2008 through June 30, 2009. Key findings for
state fiscal year (SFY) 2009, categorized by the aforementioned legislative outcome goals are as
follows:
Increases in Timeliness, Availability and Accessibility of Services
• A total of 3,954 referrals (representing 3,944 unduplicated individuals1) were received by
DES providers during SFY 2009, averaging 988 referrals per quarter. Overall, unique

1

Each referral is valid for a six-month period. If an individual does not engage in services within six months of the
initial referral, a new referral may be sent to the AFF provider.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

•
•
•
•
•
•

individuals referred to the AFF program for SFY 2009 declined by 15.9% compared to
SFY 2008.
Nearly all clients referred to the AFF program (91%) received at least one or more
recorded outreach efforts on or after the referral date by the DES provider within their
community.
Outreach efforts occurred in a timely manner, averaging 2.1 days, slightly longer than the
1.8 average days recorded in SFY 2008.
The observed rate at which new clients were referred to RBHAs was 79% higher than the
rate of RBHA referrals observed in SFY 2008 (17% of referrals).
A total of 3,1472 individuals (representing 80% of individuals referred to the AFF
program) were assessed3 during SFY 2009.
36% of individuals assessed have records from a DES assessment and a DBHS
enrollment, 34% were unique assessments provided by DES providers, and 30% were
unique assessments reported from DBHS enrollment data.
The total clients served increased between 2007 and 2009, from 4,471 clients to 4,845
clients.

Recovery from Alcohol and Drug Problems
• Based on the initial assessment information collected on 3,147 AFF clients assessed in
SFY 2009, about 85% reported they had used alcohol or one or more illicit substances in
the 30 days immediately prior to their assessment. Alcohol (46%), methamphetamine
(40%), and marijuana (40%) continue to be the more commonly reported substances.
• Based on drug screens reported through the AFF web-based data entry portal, 2,492
clients (51.4% of all clients served) had reported drug screens during their AFF program
participation. On average these clients were tested 1.24 times per month.
• Among those clients with reported drug screens, 67% of the clients tested negative,
indicating no drug use, on all of their drug screens during their AFF program
participation.
Child Safety and Reduction of Child Abuse and Neglect
• Nearly all families (91%) served by the AFF program had at least one report of suspected
child maltreatment prior to entering AFF. While there were no reports received from DES
for the remaining 9% of clients, this is likely due to data matching issues, such as
incomplete SSN, CHILDS person ID, etc.
• Nearly all (97%) had no subsequent report filed during this reporting period.
• Among those families with a substantiated report at intake, only .5% and 2.2% had a
subsequent filing of a substantiated or unsubstantiated report, respectively.
Permanency for Children through Reunification
• A total of 2,443 children whose parents were AFF clients in SFY 2009 were in Child
Protective Services (CPS) out of home placement at some point during the reporting
2

Note: This figure includes individuals that had been referred to the AFF program in SFY 2008, but not assessed
until SFY 2009, along with clients who were referred and assessed during SFY 2009.
3
The term “assessed” is defined as individuals having completed the DBHS initial “Core Assessment.”

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

period. Slightly more than one-third of these children (39%) achieved permanency
during SFY 2009. Of those who were discharged from CPS out of home placement and
achieved permanency (n=948), the majority (84%) were reunified with their families.
Achievement of Self-Sufficiency through Employment
• Employment activity is reported only for those clients referred to the AFF program who
were already enrolled in the Jobs program. Among those clients who were referred to the
AFF program and completed AFF services this year (n=3), one client was reported
employed at the time of AFF program completion.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

CHAPTER 1
INTRODUCTION
Arizona Families F.I.R.S.T. (Families in Recovery Succeeding Together) was established as a
community substance use disorder prevention and treatment program by ARS 8-881 (Senate Bill
1280, which passed in the 2000 legislative session). Under the requirements of the Joint
Substance Abuse Treatment fund that was established under the legislation, Section 8-884
requires an annual evaluation of the Arizona Families F.I.R.S.T. (AFF) program. The evaluation
of AFF examines the implementation and outcomes of community substance use disorder
treatment services delivered by DES-contracted providers and the Regional Behavioral Health
Authorities (RBHA) network.
1.1

Brief Description of the AFF Program and Client Flow

The legislation which created AFF is based on the recognition that substance abuse disorder in
families is a major problem contributing to child abuse and neglect, and that substance abuse can
present significant barriers for those attempting to reenter the job market or maintain
employment. In addition, federal priorities under the 1997 Adoption and Safe Families Act
(ASFA) that address child welfare outcomes (such as permanency and shorter time frames for
reunification) coupled with time limits established under the TANF block grant were factors
behind the legislation. However, the timeframes for substance abuse recovery currently viewed
as a chronic recurring illness4 sometimes conflict with the requirements of ASFA and Arizona
Juvenile Court guidelines. Currently, states must file a petition to terminate parental rights and
concurrently identify, recruit, process, and approve a qualified adoptive family on behalf of any
child, regardless of age, that has been in foster care for 15 out of the most recent 22 months.
AFF is a program that provides contracted family-centered, strengths-based, substance abuse
treatment and recovery support services to parents or caregivers whose substance abuse is a
significant barrier to maintaining or reunifying the family. The goal of the program is to reduce
or eliminate abuse of and dependence on alcohol and other drugs, and to address other adverse
conditions related to substance abuse. Interventions are provided through the Department of
Economic Security, Division of Children, Youth and Families (DCYF) contracted community
providers in outpatient and residential settings or through the RBHA provider network. In
addition to traditional services, AFF includes an emphasis on: face-to-face outreach and
engagement at the beginning of treatment; concrete supportive services, such as, transportation
and housing; and an aftercare phase to manage relapse occurrences. Essential elements based on
family and community needs, such as culturally responsive services, gender-specific treatment,
services for children, and motivational enhancement strategies to assist the entire family in its
recovery, are incorporated into the service delivery.
The diagram on the following page shows the flow of clients through various stages of the AFF
program.

4

Lesher, A. (2001). Addiction is a brain disease. Issues in Science and Technology.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 1
Overview of the AFF Program Model
CPS
Case workers

Jobs
Case workers

Referred to AFF Provider
• Conduct Outreach
• Engage client in services
• Determine AHCCCS eligibility

No

AHCCCS
eligible?

Yes

DES/DCYF
DES-funded Services

•
•
•
•

Continue with AFF provider
Conduct core assessment
Develop service plan
Begin services
9 Substance abuse education
9 Outpatient
9 Intensive outpatient
9 Residential treatment

ADHS/DBHS
RBHA Funded Services

•
•
•
•
•
AFF Funded
Supportive Services
Child care
Transportation
Housing
Job training, etc.

Connect to RBHA provider
Conduct RBHA enrollment
Conduct core assessment
Develop Service plan
Begin services
9 Outpatient
9 Intensive Outpatient
9 Residential Treatment

Access AFF Aftercare Services

Close Case

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Close Case

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 2 summarizes the county, DES provider agency, and associated RBHA within each of six
regional DES districts. DES-contracted agencies in bold italics also participate in the RBHA
network as either a RBHA or a RBHA network provider.
Exhibit 2
List of DES Districts, Counties, DES Providers, and RBHAs
DES
District

Regional Behavioral
Health Authority

DES Provider Agency

I

Maricopa

TERROS

Magellan

II

Pima

Community Partnership of
Southern Arizona (CPSA)

Community Partnership of
Southern Arizona (CPSA)

Coconino

Arizona Partnership for Children
(AzPaC-Coconino)

Yavapai

Arizona Partnership for Children
(AzPaC-Yavapai)

Apache and
Navajo

Old Concho Community Assistance
Center

Yuma

Arizona Partnership for Children
(AzPaC-Yuma)

III

Northern Arizona Regional
Behavioral Health Authority
(NARBHA)

Cenpatico Behavioral Health
of Arizona, Inc.

La Paz

WestCare Arizona

Mohave

WestCare Arizona

Northern Arizona Regional
Behavioral Health Authority
(NARBHA)

V

Gila and Pinal

Horizon Human Services

Cenpatico Behavioral Health
of Arizona, Inc

VI

Cochise, Graham,
Greenlee, and
Santa Cruz

Southern Arizona Behavioral
Health Services (SEABHS)

Community Partnership of
Southern Arizona (CPSA)

IV

1.2

County

Statewide Context of AFF Program and Substance Use and Treatment

In 2008, an estimated 22.2 million persons nationwide (8.9 percent of the U.S. population aged
12 or older) were classified with substance dependence or abuse in the past year based on criteria
specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).
Of these, 3.1 million were classified with dependence on or abuse of both alcohol and illicit

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

drugs, 3.9 million were dependent on or abused illicit drugs but not alcohol, and 15.2 million
were dependent on or abused alcohol but not illicit drugs.5
The recent data available on substance use in Arizona6 indicate that 9.2% of Arizonans were
classified with alcohol or illicit drug dependence or abuse in the past year, slightly higher than
the national average. Twenty-one percent of Arizonans 18-25 years of age and 7% of Arizonans
26 years of age or older used illicit drugs during the past month. Further, past-month binge
alcohol abuse was reported by 38% and 22% of individuals within these two age groups
respectively. Finally, in a recent report on substance use in the 15 largest metropolitan areas,7
7.6% of persons living in the Phoenix metropolitan area aged 12 or older reported using illicit
drugs in the past month, and 24.6% of persons living within the Phoenix metropolitan area
reported past-month binge alcohol use, significantly higher than the national average.
Abuse and neglect of children is generally believed to be associated with substance abuse. In
reports on this issue,8,9,10 data were presented showing that parents who abuse drugs and alcohol
generally do not attend to children’s emotional cues, are poor role models, and discipline their
children less effectively than other parents. It is within this context that the AFF program is
meant to intervene and break the cycle of substance abuse, and the abuse and neglect of children.
The significant event affecting the AFF program in State Fiscal Year (SFY) 2009 has been the
declining economy. In late January 2009, the Arizona State Legislature was called into special
session to address an anticipated $1.6 billion state budget shortfall projected by the Joint
Legislative Budget Committee for FY 2008 - 2009. The First Special Session made statutory and
session law changes necessary to resolve the projected $1.6 billion shortfall, and SFY 2008-2009
appropriations were reduced.
On January 31 2009, the Arizona Legislature passed and Governor Brewer signed a revised
budget for SFY 2009. As a result of reductions, fund transfers and internal shortfalls, DES had to
reduce its budget by $153 million by the end of SFY 2009 (June 30, 2009). The Arizona
Families F.I.R.S.T program was not immune to these cuts – approximately $762,500
(representing 11% of the AFF program services budget) was cut from the program during this
5

Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on
Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-36, HHS Publication No.
SMA 09-4434). Rockville, MD.
6
Substance Abuse and Mental Health Services Administration. (2008). 2007 State Estimates of Substance Use and
Mental Health: Arizona. Office of Applied Studies. Rockville, MD. Retrieved September 15, 2009, from
http://www.oas.samhsa.gov/2k7state/arizona.htm
7
Substance Abuse and Mental Health Services Administration. (2007). The NSDUH Report. Office of Applied
Studies. Rockville, MD. Retrieved September 15, 2009 from http://www.oas.samhsa.gov/2k7/metro/metro.pdf
8
U.S. Department of Health and Human Services (1999). Blending Perspectives and Building Common Ground: A
Report to Congress on Substance Abuse and Child Protection. Washington, DC: US Department of Health and
Human Services.
9
U.S. General Accounting Office (1994). Foster Care: Parental Drug Abuse Has Alarming Impact on Young
Children. GAO/HEHS-94-89.
10
DePanfilis, D. (2006). Child Neglect: A Guide for Prevention, Assessment, and Intervention. Washington, DC: US
Department of Health and Human Services, Administration on Children, Youth and Families, Children’s Bureau.
Retrieved September 15, 2009, from http://www.childwelfare.gov/pubs/usermanuals/neglect/neglect.pdf

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

period. Similarly, the Arizona Department of Health Services/Division of Behavioral Health
Services was also cut. In response to the Legislative and Governor-approved actions, ADHS
announced cuts of $11,624,500 to program services, of which $3,125,000 were directed toward
non-SMI adults, including but not exclusively AFF program recipients. Collectively, these midyear budget reductions to both DES and DBHS resulted in reductions in AFF services as are
noted throughout this report.
In addition to the reduction in funding for service provision from DES and DBHS, the contract
for the evaluation of the AFF program was reduced by 27%. This reduction has resulted in
significant modifications to this evaluation report that will be apparent to readers of previous
annual evaluation reports. Most notably, in many instances DES provider and/or DES district
level comparisons have been eliminated and replaced with overall, statewide performance
reporting. Likewise, onsite visits to each of the DES programs have been eliminated, along with
any in-person interviewing of program staff or clients. The onsite visits have been replaced by
semi-structured telephonic interviews conducted with DES provider agency management
personnel and program supervisors.
The following chapters summarize the methods and findings of the AFF program evaluation for
State Fiscal Year 2009 (July 1, 2008 – June 30, 2009).

CHAPTER 2
EVALUATION FRAMEWORK AND DATA SOURCES
The evaluation design developed for the AFF program focuses on program implementation to
determine whether DES provider agencies implemented the services in a manner consistent with
their scope of work. The design also addresses whether the AFF outcome goals and performance
measures, as well as other outcomes in the areas of substance abuse recovery, family stability,
safety, permanency, and self-sufficiency were achieved. The evaluation design is not a
longitudinal study of AFF clients using data collected from individual client interviews, nor does
it use any comparison group. Rather, the design uses primarily administrative data covering
points in time.
This year’s report again draws upon information from multiple data sources. Data sets included:
• Service utilization data obtained directly from the nine DES providers;
• Enrollment and encounter data provided by the Arizona Department of Health
Services, Division of Behavioral Health Services (DBHS) for services provided
through the local RBHA network;
• DES CHILDS information system, which provides child welfare information, and the
DES JAS/AZTEC information system, providing employment services information;
and
• Qualitative information obtained from DES provider agency management personnel
and program supervisors. Comments or findings from program managers are
provided throughout the report in “text box” format. These comments are from
qualitative semi-structured interviews in August and September of 2009.
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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

DES providers use a common data reporting format, revised by CABHP in November 2008.
These data are either directly entered into the AFF web-based data entry portal or uploaded by
the provider to the portal. The data entered through the AFF web-portal include information
regarding outreach efforts, assessment information, drug testing results, and service provision,
using a service matrix that emulates the categories of service utilized by DES for payment to
their providers. Providers are required to report service data through the AFF web-portal only
for client services that are funded by DES.
For those client services that are funded through DBHS, enrollment and service encounter data
are provided by DBHS. These data are derived from the DBHS Client Information System
(CIS). Using the service domain and levels structure and service definitions, specified in the
Arizona Department of Health Services’ Covered Behavioral Health Services Guide and Client
Information System File Layouts and Specifications Manual12, a common services taxonomy is
used to organize the services funded both by DBHS and DES.
Three additional data sets used for this evaluation include: the ADES CHILDS information
system which provides child welfare information; the ADES JAS/AZTEC information system
providing employment services information; and data from the Temporary Assistance for Needy
Families (TANF) information systems.
The third source of data used for the analysis of the AFF program is the nine DES providers’
agency management personnel and program supervisors. These individuals were interviewed by
telephone in September 2009 to gain perspectives on programmatic successes, changes in
program implementation, updates on collaborative partnerships, perceived barriers and
facilitators to program implementation, changes in contextual issues, and other events that may
have influenced service delivery.

CHAPTER 3
ARIZONA FAMILIES F.I.R.S.T. CLIENTS
AND SERVICES RECEIVED
During the SFY 2009 reporting period, a total of 4,845 individuals were served by the Arizona
Families F.I.R.S.T. program, representing a 15% decrease over the previous year (5,722 clients)
but an 8% increase over SFY 2007. This figure includes clients who were referred, assessed, and
received treatment in SFY 2009 (n = 2,936) and clients who were referred and assessed in SFY
2008 and continued to receive services in SFY 2009 (n = 1,909).

12

For more information on how these services are derived, consult http://www.azdhs.gov/bhs/bhs_gde.pdf and
http://www.azdhs.gov/bhs/cis.pdf

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 3
SFY 2009 Referrals and Client Participation
Reported Unique Individuals Referred to AFF
n = 3,944

Reported Referral Outreach
n = 3,616
Reported Individuals Accepting Services13
n = 2,473

Reported Individuals Assessed
n = 3,147
2,790 new referrals + 357 referred in SFY 2008
but assessed in SFY 2009
SFY 2009 New AFF Clients14
n = 2,936

SFY 2008 Continuing AFF
Clients
n = 1,909

+

Total AFF Clients, SFY 2009
N = 4,845
DES only Funded
Clients
n = 1,305 (26.9%)
933
372 clients
clients
continuing
closed
to receive
from
services
services

DES & RBHA jointly Funded Clients
n = 1,685 (34.8%)
624
clients
closed in
both
systems

516 closed
by DES,
continuing
to receive
services
from
RBHA

158 clients
closed by
RBHA,
continuing
to receive
services
from DES

387
clients
continuing
to receive
services
from both
systems

RBHA only Funded
Clients
n = 1,855 (38.3%)
952 clients
903 clients
closed from
continuing
services
to receive
services

13

The term “accepting services” is defined as an individual who has been referred to the AFF program, who has
been reported through the web-based portal as expressing a willingness to receive AFF services. The number of
individuals noted as accepting services (2,473) is less than the number of new referrals assessed (2,790) because no
report of accepting services was detected for 317 individuals even though these individuals were subsequently
reported as being assessed.
14
Two hundred – eleven (211) individuals assessed in SFY 2009 did not have any services recorded after the
assessment date; consequently, they are not included in the count of Total AFF Clients, SFY 2009.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

3.1
Referrals to the AFF Program
A total of 3,954 referrals (representing 3,944 unduplicated individuals15) were received by DES
providers during SFY 2009, averaging 988 referrals per quarter. Nearly all referrals to the AFF
program (99%) were provided by CPS caseworkers, a trend that has been consistent since the
inception of the program. Only five referrals came from the Jobs program during the reporting
period ending June 30, 2009. There were nine referrals for which the referral source was from
another department within DES (n = 4) or unspecified (n = 5) by the DES provider.
Overall, the total number of unique individuals referred to the AFF program for SFY 2009
declined by 15.9% compared to SFY 2008, continuing a declining trend in referrals, but
exacerbated during the current reporting period. This decline was accelerated during the second
half of the state fiscal year (January through June) during which time a 40% decline, relative to
the same period in SFY 2008, was observed. These reductions in referrals occurred concomitant
with the mid-year budget reductions previously described.
Exhibit 4
Statewide AFF Referrals

Jul‐Sep 2008
Oct‐Dec 2008
Jan‐Mar 2009
Apr‐Jun 2009
Total Referrals
Unique Clients

3.2

SFY 2008
1260
1047
1260
1233
4800
4691

SFY 2009
1256
1208
863
627
3954
3944

%
change
‐0.3%
15.4%
‐31.5%
‐49.1%
‐17.6%
‐15.9%

Client Outreach and Engagement

Nearly all clients referred to the AFF program (91%) received at least one or more recorded
outreach efforts on or after the referral date. Outreach efforts occurred in a timely manner,
averaging 2.1 days, slightly longer than the 1.8 average days recorded in SFY 2008. It should be
noted that a few outreach dates (n = 20) submitted by providers were 30 days earlier than the
referral date. DES providers reported that in these instances they had been informally notified by
CPS of an impending referral and contacted the client immediately rather than waiting for the
formal referral.

15

Each referral is valid for a six-month period. If an individual does not engage in services within six months of the
initial referral, a new referral may be sent to the AFF provider.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 5
Disposition of Cases Referred to the AFF Program
SFY 2008
SFY 2009
n
%
n
%
4800
100%
3954
100%
# of referrals
# unduplicated referrals16
4691
97.7%
3944
99%
# outreached
4365
93.1%
3616
91%
3639
77.6%
2473
62%
# of referred clients accepting services17
# referred to RBHA
836
17.8%
1497
36%
# of referred clients refusing services
49
1%
30
1%

Among referred clients, 2,473 (62%) accepted AFF services, down from the 78% acceptance rate
observed in SFY 2008. The average number of days from referral to acceptance was 10.73 days
(SD = 28.1) slightly longer than the average time reported for service acceptance in SFY 2008
(mean = 7.8 days; SD = 37.5).
Slightly more than one-third of referred individuals were referred to the local RBHA for
treatment services because they were Medicaid (Title XIX) eligible. The observed rate of RBHA
referral was 79% higher than the rate of RBHA referrals observed in SFY 2008 (17% of
referrals). On average, clients were referred to the RBHAs within three weeks of their AFF
program referral.
Exhibit 6
Duration from AFF Referral to Selected Events
(Number of Days; N = 3954)

First Outreach
Contact
3616 (91.4%)

Client Accepting
AFF Services
2473 (62.5%)

Referral Sent
to RBHA
1497 (37.9%)

Client Refusing
AFF Services
30 (0.7%)

Median # Days

1.00

2.00

11.00

5.00

Mean # of Days

2.04

10.73

16.98

17.17

SD

6.6

28.07

19.83

31.93

n

16

The term “referrals” is defined as the receipt of an AFF referral form from DES by a provider. The referral
identifies the name of an individual referred for AFF services.
17
The term “accepting services” is defined as a referred individual indicating their willingness to accept AFF
services upon outreach by a DES provider.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report
Exhibit 7 Disposition of Cases Referred to the AFF Program18
Total Individuals
Referred
3,954
100%
Outreach
Attempted
3,616
91%

Outreach
Attempted
Case Closed
300
8%

Outreach
Attempted
In process
177
4%
Outreach
Completed
Refused Services
6
<1%
Outreach
Attempted
Referred to
RBHA
443
11%

No Outreach
Attempted
338
9%

Outreach
Completed
Accepted
Referral to
Services
2,373
60%

No Outreach
Attempted
Accepted
Referral to
Services
100
3%

Total Accepted
Referrals to Services
And Assessed
2473
62%

No Outreach
Information
206
5%

Case
Closed
32
1%

Note: 987 (25%) referred to RBHA

Outreach
Completed
No Acceptance
Documented
317
8%

New AFF Clients Assessed
2790
71%

18

3,954 referrals were received, representing 3,944 unique clients. At least one and not more than 10 clients had
been referred more than once to the AFF program during the fiscal year.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

3.3

DES Provider Assessments and DBHS Enrollments

A total of 3,14719 individuals (representing 80% of individuals referred to the AFF program)
were assessed during SFY 2009. Assessments were conducted by a contracted DES provider
and/or a DBHS/RBHA contracted provider, depending on the referred individual’s eligibility
status for RBHA services. Assessment data were compiled from two sources: DES provider data
and DBHS enrollment data. As depicted in Exhibit 8, 36% of individuals assessed have records
from a DES assessment and a DBHS enrollment, 34% were unique assessments provided by
DES providers, and 30% were unique assessments reported from DBHS enrollment data.

Total Assessments
RBHA only
DES & RBHA
DES only

Exhibit 8
Assessments Statewide
SFY 2008
SFY 2009
n
%
n
%
4381
100%
3147
100.0%
2003
45.7%
954
30.3%
1154
26.3%
1134
36.0%
1224
27.9%
1059
33.7%

As these data reflect, variations are evidenced when compared to SFY 2008. Most noticeably,
these data reflect a significant decline in the proportion of individuals assessed by the RBHA
only, concomitant with sharp increases in those clients with both DES provider and RBHA
assessments (up 10% ) and those cases assessed by DES providers only (up 6%).
Among clients assessed in 2009, the average number of days from referral to assessment was 36
days (SD = 41.7) with half of the clients assessed within 23 days.
3.4

Substance Use Among Clients at Time of DES Assessment or RBHA Assessment

Individuals that are assessed by a DES or RBHA provider complete a self-report of their
substance use patterns during the immediately preceding 30-day period. Exhibit 9 provides a
summary of the substances used by these clients at the time of their initial assessment. About
85% of these clients reported they had used alcohol or one or more illicit substances in the 30
days immediately prior to their assessment. Alcohol (46%), methamphetamine (40%), and
marijuana (40%) continue to be the more commonly reported substances. Polysubstance use
continues to be the norm with most clients.

19

Note: This figure includes individuals that had been referred to the AFF program in SFY 2008, but not assessed
until SFY 2009, along with clients who were referred and assessed during SFY 2009.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 9
Substances Used by AFF Clients
30 Days Prior to Enrollment
Total Assessed Clients: 3,147
n
2,665
Clients Reporting Use
Alcohol 1441
Methamphetamine
1266
Marijuana
1260
Cocaine/crack
460
Other Narcotics
157
Heroin/Morphine
91
Other drugs
82
Hallucinogens
49
Benzodiazepines
44
Other sedatives
27
Other Stimulants
13
Inhalants
7

%
84.5%
45.8%
40.2%
40.0%
14.6%
5.0%
2.9%
2.6%
1.5%
1.4%
0.8%
0.4%
0.2%

Exhibit 10
Multiple Substance Use
Among AFF Clients whose
Clients also used….
Primary Substance Use is……
Alcohol
48% also use Marijuana
(n = 1441)
39% also use Methamphetamine
26% also use other illegal substances
56% also use alcohol
Marijuana
(n=1260)
44% also use methamphetamine
24% also use other illegal substances
Methamphetamine
44% also use marijuana
(n= 1266)
46% also use alcohol
18% also use other illegal substances

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

3.5

Service Access by Service Domain

Nearly all clients that were served in the AFF program during the past year received services
within the support services domain and the treatment domain. Support services encompass such
things as case management and transportation assistance. Treatment services include, for
example, counseling (individual, group, family) and outpatient services. Approximately 72% of
clients received services within the medical domain, while 19% or fewer of all AFF clients
received services within the Rehabilitation, Crisis Intervention, Inpatient, Residential, or
Behavioral Health Day Program domains (see Appendix A for service patterns by DES district).
Exhibit 11: Statewide
Patterns of Service Access
Service Domain
Treatment Services
Rehabilitation Services
Medical Services
Support Services
Crisis Intervention Services
Inpatient Services
Residential Services
Behavioral Health Day
Programs

3.6

DES only funded
services
n = 3156
#
%
2499
79.2
201
6.4
2511
79.6
2824
89.5
1
0
0
0
32
1
0
0

DBHS only funded
services
n = 3660
#
%
2942
80.1
762
20.8
1378
37.7
3501
95.7
439
12.0
73
2.0
283
7.7
208
5.7

DES & DBHS funded
services
n = 4845
#
%
4058
83.8
936
19.3
3465
71.5
4580
94.5
439
9.1
73
1.5
303
6.3
208
4.3

Service Closure and Service Duration

During SFY 2009, 3,183 client cases (representing 66% of all clients served) were closed20 by
either the DES provider and/or the RBHA provider.

20

Although 3,183 clients were closed in SFY 2009, only 1,662 cases had usable data to calculate a client’s length of
stay in the program.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 12
Summary of AFF Case Closures

Length of stay (LOS) is computed by counting the number of calendar days from the date of a
client assessment to the date of case closure. LOS has become an increasingly important
indicator of treatment success and correlates with long term sobriety.21 Overall, clients receiving
services only from DES providers spent nearly five months in the AFF program (mean = 143.0
days), compared with 11 months (mean = 330.4 days) for those receiving services exclusively
through the RBHA providers. Not surprisingly, continuing clients experienced longer LOS
(mean = 357.0 days) compared to new clients in 2009 (mean = 111.4 days).
3.7
Summary of Interviews with AFF Provider Agency Management and Program
Supervisors
Semi-structured interviews involving a total of 12 AFF provider agency management personnel
and program supervisors (respondents), representing all 9 AFF provider agencies were conducted
during the month of September 2009. These audio taped telephone interviews sought to solicit
information from AFF provider agency management personnel and program supervisors
regarding their perceptions of the relative strengths, areas for improvement, and impacts that the
recent budget crises and corresponding funding reductions have had upon the availability,
timeliness, and accessibility of substance abuse treatment services.
As in previous years, these individuals were asked to identify barriers and compensatory
strategies their agencies have experienced with regard to providing timely outreach and
21

United Nations-Office on Drugs and Crime. (2002). Contemporary Drug Abuse Treatment: A Review of the
Evidence Base (Electronic Version) Retrieved from www.unodc.org/pdf/report_2002-11-30_1.pdf

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

engagement, completion of client assessments, treatment plans, and client treatment engagement.
Additionally, these individuals were questioned about unmet client treatment needs, changes in
other services in their communities, and the quality of communication and collaboration with CPS
case workers, the RBHAs, and other agencies in their communities. Finally, information was
solicited regarding distinguishing program characteristics, areas of weakness and improvement,
training needs, and recommendations to DES. These telephone surveys involved informed
consent, following a protocol approved by the Arizona State University’s Institutional Review
Board. The comments summarized below are frequently specific to individual providers, or
specific DES districts and do not necessarily reflect upon all providers and/or Districts.
Strengths and Qualities of AFF Programs across Arizona
Each of the individuals interviewed identified particular strengths and unique aspects of their
programs locally. Exhibit 13 highlights the more commonly identified and/or unique strengths of
their programs.
Exhibit 13
Identified Program Strengths
• Community Resources and Community • Partnership with Drug Court
Collaboration in the Face of Resource
Reductions
• Program Staff
• Home‐based services, sober living facilities, and
thrift store
• Program motivation to keep clients engaged
• Smaller caseloads

Of particular note was the consistency with which respondents identified the collaboration and
resource sharing among and between community based agencies. Particularly in light of the
budget reductions, the degree of collaboration noted was significant and spoke to the shared
sense of camaraderie in the face of tribulation that many community based organizations are
experiencing during this budget crisis.
Weaknesses and Areas of Improvement of the AFF Programs
These individuals identified a variety of areas for improvement and strengthening of their local
program. Ranging from data base enhancements to more consistent procedures for closing cases,
these noted areas for program improvement tended to focus on operational and infrastructure
needs along with clinical enhancements. Training and information for staff on substance abuse
and addictive disorders, methods for detecting and treating prescription drug abuse, and
evidence-based substance abuse family-treatment models (such as Community Reinforcement &
Family Therapy, Brief Strategic Family Therapy, and Multi-Dimensional Family Therapy) were
also identified as areas for program improvement and program strengthening.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

•

•

•
•

Exhibit 14
Identified Program Weaknesses/Areas for Growth
Improve communications between CPS [case
• Data base enhancements and better billing,
workers] and DBHS [RBHA provider staff],
documentation, and reporting procedures
providing clarity of roles and responsibilities
Strengthening case closure procedures
• Staff training with specific attention to
intergenerational substance use, prescription
drug abuse, and evidence‐based family
treatment models
Life skills/living skills training
• More employment support services
Incorporating evidence‐based family treatment
• Broader base of peer support specialist services
strategies and family support groups

While the issue of improved communications with CPS case workers and DBHS/RBHA provider
staff was identified as a program need, it is important to note that all respondents indicated that
communication with CPS staff has improved significantly this year. Respondents noted that
these improved communications occurred in spite of staff cutbacks within CPS and in a few
instances, office closures. Likewise, most respondents spoke positively with regard to their
relationships with their RBHAs, although not with the same overwhelmingly positive tone. One
respondent noted that the relationship with the RBHA in their community has gotten worse,
noting added bureaucratic and paperwork demands from the RBHA.
Significant Program Changes in Treatment Services and Community Collaborative Partnerships
The individuals interviewed identified a variety of resources or services that have been reduced
during the final four months of the fiscal year. The most significant change cited by all
respondents was the cut in program funds and the subsequent measures taken to stabilize their
programs. In addition to identification of reductions in a wide range of supports and supportive
services, many of those interviewed noted the reduction of transportation assistance (bus
vouchers, cab fare, etc.) for their clients and higher CPS caseloads and/or reduced responsiveness
from CPS case managers due to budgetary cutbacks at CPS.
Exhibit 15
Service Impacts Resulting from Budget Cutbacks
• Loss of transportation assistance cited repeatedly
• Reductions in CPS staff and CPS office consolidations
• Reductions in services in general; specific examples including food boxes, parenting classes, parent
aides for supervised visitation, utility assistance, etc.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Barriers and Improvements
Respondents were asked to discuss specific barriers and strategies they had found to be effective
in resolving these barriers in three key performance areas of outreach, assessment and treatment
planning, and engagement in treatment services.
Exhibit 16
Barriers and Improvements in Key Performance Areas
Outreach Barriers
• Delays in receiving client information from the RBHA when clients transfer
Assessment and Treatment Plan Barriers
• Limited certified staff or loss of certified staff
• Clients not coming back to complete assessments they started
• The lack of transportation, especially in the rural communities, but now coupled with the
downturn in the economy has reduced the availability of lower skilled positions, typically taken
by AFF clients. As transportation resources have dried up and unemployment has risen, these
families find themselves without the means to get to AFF services, nor the means to pay for
vehicle fuel and/or cab/bus fare
Engagement in Treatment Services Barriers
• CPS closing cases “…when CPS is not involved, the families sometimes won’t stay engaged
because they no longer have CPS to motivate them.”
• Lack of Flexibility from DES contract requirement: “There is no flexibility for individuals who are
no longer in need of high intensity services. Even though a client is progressing along with
treatment and they don’t need all three hours of service each week, the only way we get paid is
if the client received three hours of service per week. It is both an unfair burden for the agency
and for the client. The lack of flexibility of the requirements for three hours of treatment services
is a barrier for clients who are [fully engaged] in treatment.”
Outreach Improvement Strategies
• Attend TDMs, CFTs and court hearings whenever possible in order to make contact and engage
clients
• Continue to engage clients while paperwork is catching up with them and/or while they are in
jail
• Making repeated visits to clients’ residence to connect with them in person to get them to
engage in services

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Engagement in Treatment Services Improvement Strategies
• Adaptation of the Recovery Team Treatment Model
• In order to keep clients engaged when there is limited IOP and SOP group capacity due to
budget reductions, one DES provider is enrolling clients in education groups: “We will get clients
into education groups to engage them. They are learning things in a non‐threatening
environment. Clients have stated that the education group has helped to prepare them for
treatment and has helped them to understand the impact of substance abuse in the family.”

Meeting Client Needs
The provider agency management personnel and program supervisors indicated that treatment
specific services, including inpatient and outpatient treatment services continue to be readily
available without too much difficulty. Supportive services, however, such as employment
support services, housing, and transportation are becoming much more problematic to access.
Respondents stated that while residential treatment is available, new barriers and challenges have
emerged most notably related to the cost and obtaining authorization for payment. Clients with
acute or unstable medical problems may not be admitted because of the guidelines of residential
care facilities. In the accompanying table are direct quotes from program coordinators regarding
AFF client needs.
Exhibit 17
Provider Agency Management Personnel and Program Supervisor Comments
“We have clients who are doing very well in treatment and they just can’t get a stable home or they
can’t find stable employment, and that is what is holding them back. They are stressed, they get
triggered and they might relapse. We refer them to county and city housing, but the lists are so long.
As far as employment, we print out lists of job openings almost weekly and provide them to our clients
in our front lobby. We help them fill out applications – anything to help them get their foot in the door.
If a client wants us to help them with resume preparation, we definitely will help them.” District IV,
Yuma
“The lack of employment opportunities, the lack of affordable housing, and the lack of childcare
needed for the time period that they are engaged in services and treatment activities are real issues
and barriers to treatment. Our clients are having issues with keeping their phones in service.” District
III, Flagstaff
“We don’t get a lot of requests or demands; however, we help them however we can and we are
flexible. We have, for the most part, eliminated support services from our menu of services we offer
clients because of our budget.” District II, CPSA
“There is no domestic violence shelter in Apache County. If a client is in crisis, I have no place to put
them.” District III, Winslow
“The biggest gap really comes down to vocational training‐whether it is pre‐vocational training, job
coaching, or job placement.” District VI, SEABHS
“Clients need assistance with utilities and other essentials, like food boxes and household supplies.”
District IV, WestCare

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

“They need transportation. Employment is very difficult, if not impossible, if there is no public
transportation. How can you keep a job if you have to walk five miles in the heat of the desert to a job?
There were people living in their cars this summer.” District V, Horizon
“Clients desire to have better communication with CPS. At times they have difficulty making contact with
the CPS worker. Sometimes the process is not explained to them in a way they can understand, especially
if the parents have any type of developmental issue or learning problem which makes it difficult for them
to understand. We try to explain the process to them in a way they can understand.” District III,
Prescott

CHAPTER 4
AFF PROGRAM OUTCOMES
This chapter highlights the outcomes experienced by families that have participated in the AFF
program. Outcome information is presented on the following key dimensions articulated in the
enabling legislation establishing the AFF program: child safety, family stability and permanency,
self-sufficiency as reflected in employment, and recovery from alcohol and drug problems.
4.1

Child Safety: Recurrence of Child Maltreatment

Of the total of 4,845 clients in the AFF program, 4,398 (91%) had at least one report of
suspected child maltreatment prior to entering AFF22. Among the 4,398 clients with a report at
intake, 1,107 (23%) clients had reports that had been substantiated23; 3,233 (67%) clients had
reports that were unsubstantiated, while 58 (1%) clients had reports whose status was pending.
During the reporting period, 75% of substantiated cases consisted of neglect, 7% were physical
abuse, and 1% sexual abuse. Similarly, last year the vast majority of substantiated maltreatment
cases were also for neglect (84%), and the remainder for physical (12%) or sexual abuse (3%).
These findings are consistent with other studies that showed substance abusing caregivers tend to
be linked with neglect referrals rather than with sexual or physical abuse referrals.24

22

While there were no reports received from DES for the remaining 447 clients, this is due probably to data
matching issues, such as incomplete SSN, CHILDS person ID, etc.
23
A substantiated finding is one in which the facts of a report provide a reasonable ground, i.e., some credible
evidence, to believe that abuse or neglect occurred (Arizona Department of Economic Security, Division of
Children, Youth and Families. Children’s Services Manual. Retrieved from www.azdes.gov/dcyf/cmdps
/cps/Policy/ServiceManual.htm on February 3, 2009).
24
Sun, A., Shillington, A.M., Hohman, M., & Jones, L. (2001). Caregiver AOD Use, Case Substantiation, and AOD
Treatment: Studies Based on Two Southwestern Counties. Child Welfare, 80(2), 151-177.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 18
Summary of Pre and Post Assessment Report Findings
Pre‐Assessment Finding
Post Assessment Finding
Totals
Substantiated Unsubstantiated Pending/Other
#
%2
#
%2
#
%1
#
%2
Substantiated 1107 22.9%
5
0.5%
24
2.2%
0
0.0%
Unsubstantiated 3233 66.7% 19
0.6%
99
3.1%
3
0.1%
Pending/Other 58
1.2%
0
0.0%
3
5.2%
1
1.7%
No Report21 447 9.2%
1
0.2%
17
3.8%
0
0.0%
Total 4845 100% 25
0.5%
143
3.0%
4
0.1%
1

No Report
#
%2
1078 97.4%
3112 96.3%
54 93.1%
429 96.0%
4673 96.4%

Percentages total vertically; 2Percentages total horizontally

Exhibit 18 also provides information on child maltreatment recurrence statewide. Of the families
with a report (substantiated or unsubstantiated) at pre-assessment, only 7% had a recurrence.
Using the more conservative definition of recurrence used by NCANDS (subsequent
substantiated reports following an initial substantiated report), a recurrence rate of 0.5%, lower
than last year’s 2.4%, was observed. For informational purposes, the federal standard for absence
of maltreatment recurrence within six months is 94.6% (allowing, therefore, recurrence of 5.4%).
Thus, for SFY 2009 among AFF families, recurrence was significantly lower (better) than this
national standard.25
4.2 Permanency Achieved by Children of Parents in AFF
A total of 2,443 children whose parents (1,268) were AFF clients in SFY 2009 were in CPS outof-home placement at some point during the reporting period. As depicted in Exhibit 19, 60%
(1,464) of these children were still in out of home placements at the end of the reporting period.26
By comparison, in SFY 2008, 54% of children of parents in AFF were still in care at year’s end.
Exhibit 19
Permanency Achieved by
Children of Parents in AFF
Total Children
2443 100.0%
Still in Care
1464
59.9%
Other
31
1.3%
Achieved Permanency
948
38.8%
Reunification
Guardianship
Adoption
Relatives
Emancipated
1

794
64
27
39
24

83.8%1
6.8%1
2.8%1
4.1%1
2.5%1

Percentage is based on those achieving permanency

25

U.S. Department of Health and Human Services, Administration on Children, Youth and Families. Child
Maltreatment 2006 (Washington, D.C.: U.S. Government Printing Office, 2008).
26
Included in this group are children who are participating in trial visits with relatives, guardians, or potential
adoptive families.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

More than one-third of the total number of children in care at any point during the year (39%)
achieved permanency during SFY 2009. Of those who were discharged from care and achieved
permanency, the vast majority (84%) were reunified with their families, up slightly from 83% in
SFY 2008. Others found permanent homes with relatives (n=39, 4%), through adoption (n=27,
3%), emancipation (n=24, 3%) or guardianship (n=64, 7%).
Among the children who achieved permanency the median number of days27 in out-of-home care
for children subsequently living with relatives was 11 days, followed by 153 days for children
reunified with birth families, 354 days for children where guardianship was arranged, and 776
for children who were adopted.
Exhibit 20
Days in Out of Home Care Among Children Achieving
Permanency
N = 948
n
Median
Average
Reunification
794
153
216.2
Guardianship
64
354
374.6
Relatives
39
11
76.1
Adoption
27
776
835.2
Emancipated
24
560.5
654.4

4.3

Recovery from Substance Abuse

Drug Screens. Drug screen results were analyzed only for those clients whose drug screens
were entered directly into the AFF web-based data entry portal or uploaded by the DES provider
into the data portal. Clients who were also enrolled with a RBHA provider may have been drug
tested as well; however, the data from DBHS is less complete and does not provide the result of
the drug screen. Consequently, this section of the report only discusses the results of the drug
screen data available from the AFF web-based data entry portal.
Drug screen results were reported in the AFF web-based data entry portal for 2,492 clients, more
than half (51.4%) of all AFF clients, and slightly higher than the percentage reported last year
(49%). Among clients whose drug screens were reported in the AFF web-based data entry portal,
the average number of screens reported was 5 drug screens in SFY 2009 (higher than the 4.6
drug screens in SFY 2008), while more than half of the clients had reports of three or more drug
screenings. The maximum number of drug screens reported for any client for the year was70.

27

The mid-point wherein half the children spent less time in care and half spent more time in care.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Exhibit 21
Statewide Summary of AFF Client Drug Screens
Reported in AFF Web Portal
Avg drug screens
n
%
per month (SD)
Total Clients
4845
100%
Drug Screens Reported
2492
51.4%
1.24 (1.68)
in Web Portal
No Drug Screens
2353
48.6%
Reported in Web Portal

DES providers are required by contract to conduct or collect a minimum of two (2) drug
screenings per client per month. Among clients with screens reported through the AFF webbased data entry portal, the average was 1.68 screens per 30 days (less than the 2.09 drug screens
per month observed in SFY 2008).
For all drug screens that were reported through the AFF web-based portal, 83% were negative,
reflecting no drug use. This rate is down from the 90% rate of negative drug screens reported in
SFY 2008. Among those clients that were tested in SFY 2009 and reported through the AFF
web-based data entry portal, 67% had all negative drug screens indicating no drug use, while the
remaining 33% with drug screens had at least one positive drug screen.
Self-Report. Previous annual reports contained information on self-report substance use at
completion of services. These data reflect only a partial sample of all clients, i.e., those DBHS
clients exiting services from the local RBHA. Issues about the integrity of the self-report data at
closure were raised in last year’s annual report. Since that time, the Arizona Office of the
Auditor General identified a variety of problems in the ADHS reporting system28 that calls into
question the usefulness and integrity of the self-report substance use data at program closure.
Consequently, we have removed those data and discussion from this year’s report.
4.4

Employment Outcomes For Jobs-Referred AFF Clients

As stated in the enabling legislation for the AFF program, services are provided to recipients of
Temporary Assistance for Needy Families (TANF) whose substance abuse is a significant barrier
to maintaining or obtaining employment. These individuals are referred to the DES providers
through the Department’s Jobs program.
Five individuals referred by the Jobs program were AFF clients during 2009 (three new clients in
2009 and two continuing clients from 2008). Among these five clients, all were unemployed at
the time of their intake assessment. Three clients exited the program in 2009 and one of these
clients was reported as employed at the time of their closure.

28

Arizona Office of the Auditor General (July 2009). Report No 09-07: Performance Audit, Department of Health
Services, Division of Behavioral Health Services – Substance Abuse Treatment Programs. Phoenix: Author.

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Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

CHAPTER 5
SUMMARY AND CONCLUSIONS
This report summarizes the key processes and outcomes of the Arizona Families F.I.R.S.T.
program, now in its eighth year of operation. The continued commitment of the legislature to
critically examine the processes and outcomes of this highly innovative program has afforded the
opportunity to study the development and operations of a program unique in its scope and focus.
The utilization of information gathered from a variety of sources, including administrative data,
focus groups, key informant interviews, and service utilization records provide diverse
perspectives to address the performance of the AFF program in relation to each of the five goals
articulated by the legislature.
Increases in Timeliness, Availability and Accessibility of Services
In SFY 2009, 4,845 individuals were served by the AFF program statewide. These individuals
and their families continue to be characterized by mothers, slightly more than half of whom
reported they were single and had never been married. Slightly more than one fourth of these
clients identify themselves to be Latino. Nearly three quarters of the clients were unemployed
and slightly less than half report their highest educational level to be a high school diploma or
equivalent. All but five of these families were known to CPS. Nearly 85% of these individuals
self-reported at the time of their assessment that they abused alcohol or other illicit substances,
with alcohol, marijuana, and methamphetamine continuing to be the more commonly reported
substances.
For these families, the AFF program continues to provide services in a manner consistent with
which the program was designed. During SFY 2009, these families received outreach,
assessment, and treatment engagement services in a timely manner; most families were contacted
by a local DES provider within two days of their referral with these same families accepting AFF
services in less than two weeks of their referral.
Those families that are engaged in treatment services typically find themselves receiving services
from their local DES provider and/or a RBHA contracted treatment provider in their community,
depending upon their program eligibility. This year witnessed a sharp increase in the rate at
which these families were referred to a RBHA, up nearly 80% relative to SFY 2008. The
referrals to, and joint service delivery with, the RBHAs reflect the integrated and complementary
nature of the AFF program design.
Interviews conducted with the DES provider agency management personnel and program
supervisors indicate the high degree of inter-agency collaboration that occurs locally among and
between DES providers, the RBHAs, and other state and local agencies. Notably this year, DES
provider agency management personnel and program supervisors reported on significantly
improved communications and coordination with CPS field offices and CPS program managers.
As such, the AFF program continues to exhibit a pattern of early and timely engagement into
substance abuse treatment, which has been a hallmark of this program.
Center for Applied Behavioral Health Policy y Arizona State University

27

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Recovery from Alcohol and Drug Problems
Data collected this year are consistent with that reported in past years: the overwhelming
majority of parents entering the AFF program self-report patterns of substance use with alcohol,
marijuana, and methamphetamine predominating. The results of drug screens or urine testing
conducted with AFF clients to detect continued drug use and reported through the AFF webbased data entry portal indicate that two thirds (67%) of the AFF clients tested clean (no
detection of continued substance use) on all occasions that they were tested, a rate consistent
with that observed in past years. Among the rest of these clients, the patterns of drug testing
results are uneven, suggesting periodic relapse among these individuals as they proceed on a path
toward recovery and sobriety. While these results are encouraging, it should be noted that drug
screen results submitted through the AFF web-based data entry portal were available for only
51% of the participating clients, up from the 49% of clients that were reported tested in SFY
2008.
Child Safety and Reduction of Child Abuse and Neglect
Among those families served in the AFF program, the rates of recurrence of child maltreatment
following AFF program enrollment continues, as in past years, to be exceedingly low. Nearly all
families (91%) served by the AFF program had a substantiated or unsubstantiated report of child
maltreatment before enrolling in the program and nearly all (97%) had no subsequent report filed
during this reporting period. Among those families with a substantiated report at intake, only
.5% and 2.2% had a subsequent filing of a substantiated or unsubstantiated report, respectively.
As such, these data suggest that the AFF program continues its tradition of enhancing child
safety and avoiding the recurrence in child maltreatment as a result of parental substance abuse
treatment.
Permanency for Children Through Reunification
An increase in the rate of children still in out of home care at the end of this reporting period was
evidenced for 60% of all children placed into out of home care, as compared to 54% of all out of
home placed children as reported for SFY 2008. This rate of continuing out of home placement
is still well below the 75% rate that was observed in SFY 2007. Concomitant with the increase
in continuing out of home placement was a corresponding decrease in the proportion of youth
achieving permanency, observed among 39% of AFF client children and down from the 45%
observed in SFY 2008. This drop, like the corresponding increase in continuing out of home
placement is relatively small and statistically insignificant. For those youth that did achieve
permanency, the overwhelming majority (84%) were reunified with their family, up slightly from
the 83% rate observed in SFY 2008. As such, these data suggest that the families and children
involved in the AFF program continue to experience rates of permanency planning and
reunification that meet or exceed existing program performance patterns and/or national or state
trends.

Center for Applied Behavioral Health Policy y Arizona State University

28

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Achievement of Self-Sufficiency through Employment
Employment activity is reported only for those clients referred to the AFF program who were
already enrolled in the Jobs program. Among those five clients who were referred to the AFF
program and completed AFF services this year (n=3), one client was reported employed at the
time of AFF program completion. As such, due to the low number of AFF clients referred by the
Jobs program, no determination can be made regarding the AFF program’s performance on this
goal.

Center for Applied Behavioral Health Policy y Arizona State University

29

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

APPENDIX A
DES Districts
Services
Treatment Services (A)
Family Counseling
Individual Counseling
Group Counseling
Assess., Eval. & and Screening
Other Treatment by Profess
Intensive Outpatient Services
Outpatient Services
Rehabilitation Services (B)
Skills Training and Development
BH Prevention/Promotion
Psycho educational
Medical Services (C)
Medication
Laboratory
Medical Management
Pharmacy
Support Services (D)
Case Management
Personal Care
Home Care Training Family
Self-Help/Peer
Unskilled Respite Care
Supported Housing
Sign Language
Flex Fund
Transportation
Child Care
After Care
Other Support

I
#
1591
7
1488
0
1231
0
0
0
197
113
39
114
606
74
138
495
485
1851
1816
23
42
184
0
0
0
0
751
0
0
0

Source: DBHS Encounter Data
II

%

#
690
0
493
1
579
0
0
0
274
126

0.4%
93.5%
0.0%
77.4%
0.0%
0.0%
0.0%
57.4%
19.8%
57.9%
12.2%
22.8%
81.7%
80.0%
98.1%
1.2%
2.3%
9.9%
0.0%
0.0%
0.0%
0.0%
40.6%
0.0%
0.0%
0.0%

196

28
408
47
106
324
343
809
778
16
4
252
1
0
0
0
197
0
0
0

III
%
0.0%
71.4%
0.1%
83.9%
0.0%
0.0%
0.0%
46.0%
71.5%
10.2%
11.5%
26.0%
79.4%
84.1%
96.2%
2.0%
0.5%
31.1%
0.1%
0.0%
0.0%
0.0%
24.4%
0.0%
0.0%
0.0%

#
254
0
201
1
179
0
0
0
100
69
51
6
157
5
20
130
130
341
339
11
5
15
0
0
0
0
144
0
0
0

IV
%
0.0%
79.1%
0.4%
70.5%
0.0%
0.0%
0.0%
69.0%
51.0%
6.0%
3.2%
12.7%
82.8%
82.8%
99.4%
3.2%
1.5%
4.4%
0.0%
0.0%
0.0%
0.0%
42.2%
0.0%
0.0%
0.0%

Center for Applied Behavioral Health Policy y Arizona State University

#
139
0
79
0
110
0
0
0
53
48
11
5
64
4
23
53
51
175
171
3
7
31
1
0
0
0
51
0
0
0

V
%
0.0%
56.8%
0.0%
79.1%
0.0%
0.0%
0.0%
90.6%
20.8%
9.4%
6.3%
35.9%
82.8%
79.7%
97.7%
1.7%
4.0%
17.7%
0.6%
0.0%
0.0%
0.0%
29.1%
0.0%
0.0%
0.0%

#
107
0
100
0
79
0
0
0
38
18
23
12
61
2
19
42
46
139
137
8
3
16
2
0
0
0
65
0
0
0

30

VI
%
0.0%
93.5%
0.0%
73.8%
0.0%
0.0%
0.0%
47.4%
60.5%
31.6%
3.3% 6
31.1%
68.9%
75.4%
98.6%
5.8%
2.2%
11.5%
1.4%
0.0%
0.0%
0.0%
46.8%
0.0%
0.0%
0.0%

#
161
0
134
0
132
0
0
0
100
83
39
82
0
9
60
65
186
184
5
12
63
3
0
0
0
91
0
0
0

Statewide
%
0.0%
83.2%
0.0%
82.0%
0.0%
0.0%
0.0%
83.0%
39.0%
6.0%
0.0%
11.0%
73.2%
79.3%
98.9%
2.7%
6.5%
33.9%
1.6%
0.0%
0.0%
0.0%
48.9%
0.0%
0.0%
0.0%

#
2942
7
2495
2
2310
0
0
0
762
457
359
171
1378
132
315
1104
1120
3501
3425
66
73
561
7
0
0
0
1299
0
0
0

%
0.2%
84.8%
0.1%
78.5%
0.0%
0.0%
0.0%
60.0%
47.1%
22.4%
9.6%
22.9%
80.1%
81.3%
97.8%
1.9%
2.1%
16.0%
0.2%
0.0%
0.0%
0.0%
37.1%
0.0%
0.0%
0.0%

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Source: DBHS Encounter Data
DES Districts
Services
Crisis Intervention Services (E)
Crisis
Crisis Mobile
Crisis Stabilization
Inpatient Services (F)
Inpatient Professional
Residential Services (G)
Residential Level II
Residential Level III
Child Residential w/Parent
Behavioral Health Day
Programs (H)
Supervised BH Treatment
Therapeutic BH Services
Community Psych.

I
#
235
1
111
177
22
22
128
128
0
0
177
7
171
0

II
%
0.4%
47.2%
75.3%
100.0%
100.0%
0.0%
0.0%

#
132
0
10
126
22
22
102
102
0
0
18

4.0%
96.6%
0.0%0

18
0

III
%
0.0%
7.6%
95.5%
100.0%
100.0%
0.0%
0.0%
0

0.0%
100.0%
0.0%

#
15
0
11
4
14
14
23
23
0

11
0
11
0

IV
%

#
13

0.0%
73.3%
26.7%0
11
100.0%
100.0%
0.0%
0.0%
0
0.0%
100.0%
0.0%

4
2
2
6
6
0
0
0
0

V
%
0.0%
84.6%
30.8%

100.0%
100.0%
0.0%
0.0%

#
16
0
14
5
3
3
6
6
0
0

%
0.0%
87.5%
31.3%
100.0%5
100.0%
0.0%
0.0%

0
0.0%
0.0%
0.0%0

0
0

0.0%
0.0%
0.0%

0

1
1

0

Center for Applied Behavioral Health Policy y Arizona State University

VI

31

#
28
0
24
10
10
18
18
0

2
0

Statewide
%

100.0%
0.0%
0.0%

#
439
1
181
321
73
73
283
283
0
0

100.0%
0.0%
0.0%

0.0%
50.0%
50.0%

208
7
201
1

3.4%
96.6%
0.5%

0.0%
85.7%
17.9%
100.0%

%
0.2%
41.2%
73.1%
100.0%

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Source: Services In AFF Webportal
DES Districts
Services
Treatment Services (A)
Family Counseling
Individual Counseling
Group Counseling
Assess., Eval. & and Screening
Other Treatment by Profess
Intensive Outpatient Services
Outpatient Services
Rehabilitation Services (B)
Skills Training and Development
BH Prevention/Promotion
Psycho educational
Medical Services (C)
Medication
Laboratory
Medical Management
Pharmacy
Support Services (D)
Case Management
Personal Care
Home Care Training Family
Self-Help/Peer
Unskilled Respite Care
Supported Housing
Sign Language
Flex Fund
Transportation
Child Care
After Care
Other Support

I
#
1969
13
1647
1035
1675
0
175
656
132
5
127
0
1908
0
1897
0
87
2331
2328
0
0
0
0
0
0
0
7
0
81
182

II
%
0.7%
83.6%
52.6%
85.1%
0.0%
8.9%
33.3%0
3.8%
96.2%
0.0%

#
136
0
0
0
135
0
68
0
0

0
0 109
0.0%
0
99.4% 109
0.0%
0
4.6%
0
60
99.9%
60
0.0%
0
0.0%
0
0.0%
0.0%
0
0.0%0
0
0.0%
0.0%
0
0.3%0
0
0.0%
0
3.5%
0
7.8%
0

III
%

0.0%
0.0%
0.0%
99.3%
0.0%
0.0%
50.0%0
0.0%
0.0%
0.0%

#
120
3
0
0
106
21
26
16
6
11
0
189
0

0.0%
100.0%
0.0% 189 0
0.0%
0
186
100.0% 163
0.0%
0
0.0%
3
0
0.0%
0.0%
0
0.0%
16
0.0%
0
0.0%
0.0%
37
0.0%6
1
0.0%
28
0.0%
57

Center for Applied Behavioral Health Policy y Arizona State University

IV
%

#
139
0

2.5%
0.0%
0.0%
6
88.3%7 117
0.0%
17.5%
21.7%0 34
0 44
37.5%
2
68.8%
42
0.0%
170
0.0%0
0
100.0%
0.0% 170 0
0.0%
0
155
87.6%
0.0%
0
95
1.6%
0.0%
0
0.0%14 0
8.6%
0.0%
0
3.2%2
0
19.9%
0.5%
6
15.1%3
30.6% 128
28

V
%

0.0%
5.0%
4.3%
84.2%
0.0%
0.0%
24.5%
0
4.5%
95.5%
0.0%1

#
40
8
12
16
32
0
6
6
5
0
49
0

0.0%
100.0%
0.0% 49 0
0
0.0%
13
61.3%
0
0.0%
9
9.0%
0
0.0%
0.0%0 0
1.3%
0
0.0%
0
0.0%
0
1.9%
3.9%
0
18.1%2
82.6%
2
1

32

VI
%

#
95

20.0%
30.0%
0
40.0%
0
80.0%
0
0.0% 86
0.0%
15.0%0 25
0 3
16.7%
83.3%
0
0.0%
3
86
0.0%0
100.0%
0.0%086
0.0%
3 79
2
69.2% 22
0.0%
0.0%
0.0%0
0.0%0
0.0%0
0.0%0
0.0%0
15.4%0 0
0.0%0
7.7%
12
15.4%0
67

Statewide
%

#
2499
24
1666
1057
2151
0

0.0%
0.0%
0.0%
90.5%
0.0%
0.0%
26.3%
196 201
815
0.0%
14
100.0% 188
0.0%
0
2511
0.0%
0
100.0% 2500
3.5%
3
2.3%
89
2824
27.8% 2677
0.0%
0
0.0%
17
0.0%
0
0.0%
0
0.0%
18
0.0%
0
0.0%
6
0.0%
49
0.0%
7
15.2%
150
84.8%
436

%
1.0%
66.7%
42.3%
86.1%
0.0%
7.8%
32.6%
7.0%
93.5%
0.0%
0.0%
99.6%
0.1%
3.5%
94.8%
0.0%
0.6%
0.0%
0.0%
0.6%
0.0%
0.2%
1.7%
0.2%
5.3%
15.4%

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Source: Services In AFF Webportal
DES Districts
Services
Crisis Intervention Services (E)
Crisis
Crisis Mobile
Crisis Stabilization
Inpatient Services (F)
Inpatient Professional
Residential Services (G)
Residential Level II
Residential Level III
Child Residential w/Parent
Behavioral Health Day Programs (H)
Supervised BH Treatment
Therapeutic BH Services
Community Psych.

I
#
1
0
0
1
0
0
21
21
0
0
0
0
0
0

II
%

0.0%
0.0%
100.0%
0.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
0
0
0
0
0
0
7
7
0
0
0
0
0
0

III
%
0.0%
0.0%
0.0%
0.0%

100.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
0
0
0
0
0
0
2
2
0
0
0
0
0
0

Center for Applied Behavioral Health Policy y Arizona State University

IV
%

0.0%
0.0%
0.0%
0.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
0
0
0
0
0
0
0
0
0
0
0
0
0
0

V
%

0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
0
0
0
0
0
0
0
0
0
0
0
0
0
0

33

VI
%

0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
0
0
0
0
0
0
2
2
0
0
0
0
0
0

%
0.0%
0.0%
0.0%
0.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
1
0
0
1
0
0
32
32
0
0
0
0
0
0

Statewide
%
0.0%
0.0%
100.0%
0.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0%

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Source: Services In AFF Webportal and DBHS Encounter Data
DES Districts
Services
Treatment Services (A)
Family Counseling
Individual Counseling
Group Counseling
Assess., Eval. & and Screening
Other Treatment by Profess
Intensive Outpatient Services
Outpatient Services
Rehabilitation Services (B)
Skills Training and Development
BH Prevention/Promotion
Psycho educational
Medical Services (C)
Medication
Laboratory
Medical Management
Pharmacy
Support Services (D)
Case Management
Personal Care
Home Care Training Family
Self-Help/Peer
Unskilled Respite Care
Supported Housing
Sign Language
Flex Fund
Transportation
Child Care
After Care
Other Support

I

II

#
%
#
2444
792
0
0.8%
20
2198
42.3%493 1
103589.9%
2086 85.4% 683
0.0%
0
0
7.2%
175
0
68
26.8%
656
325
274
115
35.4% 126
166
51.1% 196
114
35.1%
28
2235
508
47
74
2000
3.3%
22.1%212324
495 89.5%
22.9% 343
511
2775
840
2751
0.8% 810 16
23 99.1%
4
1.5%
42
6.6%
184
0.0%252 1
0
0
0.0%
0
0.0%
0
0
0.0%
0
27.3%0 197
757
0
0.0%
0
0
2.9%
81
182

6.6%

0

III
%

0.0%
62.2%
0.1%
86.2%
0.0%
0.0%
0
8.6%
0.0%
0.0%
0.0%
9.3%
41.7%
63.8%
67.5%

#
303
3
201
1
229
21
26
108
74
60
6
286
5
200
130
130
387

96.4%
1.9% 380 11
8
0.5%
30.0%
0.1% 15 0
16
0.0%
0
0.0%
6
0.0%
23.5% 166
1
0.0%
28
0.0%
0.0%

57

Center for Applied Behavioral Health Policy y Arizona State University

IV
%

1.0%
66.3%
0.3%0
75.6%
0.0%
6.9%
0
8.6%
68.5%
55.6%
5.6%

#
206
84
6
173
0
34
86
49
51
5
205

1.7%
69.9% 182
45.5%4
45.5%53 51
238
98.2%
2.8% 219 3
21
2.1%
31
3.9%
1
0.0%
4.1%
0
0.0%
2
0
1.6%
53
42.9%
6
0.3%
28
7.2%
14.7%

128

V
%

0.0%
40.8%
2.9%
84.0%
0.0%
0.0%
16.5%

#
125
8
102
16
96
0
0
6
42

57.0%
59.3%18 27
5.8%
12
95
2.0%
2
88.8%
63
25.9%
42
24.9%
46
145
92.0% 142
8
1.3%
3
8.8%
16
13.0%
2
0.4%
0
0.8%
0.0%
0
0.0%
22.3%0 67
0
2.5%
1
11.8%
53.8%

34

2

VI
%

#
188
0
134
0

6.4%
81.6%
12.8%
76.8%
0.0% 159 0
0.0%
4.8%
0 101
25
42.9%
83
64.3%
41
28.6%
6
136
2.1%
0
66.3%
44.2%88
48.4%62
67 195
97.9% 190
5
5.5%
12
2.1%
11.0%
1.4% 63 3
0
0.0%
0
0.0%
0.0%
46.2%
0.0%091
0.7%
0
1.4%12 67

Statewide
%

0.0%
71.3%
31
0.0%
84.6%
0.0%
0.0%
13.3%

#
4058
3212
1059
3426
0
196
815
936
465

%
0.8%
79.2%
26.1%
84.4%
0.0%
4.8%
20.1%

82.2%
40.6%
5.9% 541
3465
171
0.0%
132
64.7% 2745
45.6% 1106
49.3% 1148
4580
97.4% 4492
2.6%
90
6.2%
66
32.3%
1.5% 561 7
0.0%
0
0.0%
18
6
0.0%
46.7% 1331
7
0.0%
6.2%

49.7%
57.8%
18.3%

98.1%
1.4%
2.0%
12.2%
0.2%
0.4%
0.0%
0.1%
29.1%
0.2%
3.3%

34.4%150 436

9.5%

3.8%
79.2%
31.9%
33.1%

Arizona Families F.I.R.S.T. Program 2009 Annual Evaluation Report

Source: Services In AFF Webportal and DBHS Encounter Data
DES Districts
Services
Crisis Intervention Services (E)
Crisis
Crisis Mobile
**Crisis Stabilization 31
Inpatient Services (F)
Inpatient Professional
Residential Services (G)
Residential Level II
Residential Level III
**Child Residential w/Parent 32
Behavioral Health Day Programs (H)
Supervised BH Treatment
Therapeutic BH Services
Community Psych.

31
32

I
#
235
1
111
178
22
22
144
144
0
0
177
7
171
0

II
%
0.4%
47.2%
75.7%

100.0%
100.0%
0.0%
0.0%
4.0%
96.6%
0.0%

#
132
0
10
126
22
22
105
105
0
0
18
0
18
0

III
%

0.0%
7.6%
95.5%
100.0%
100.0%
0.0%
0.0%
0.0%
100.0%
0.0%

#
15
0
11
4
14
14
23
23
0
0
11
0
11
0

IV
%

0.0%
73.3%
26.7%
100.0%
100.0%
0.0%
0.0%
0.0%
100.0%
0.0%

#
13
0
11
4
2
2
6
6
0
0
0
0
0
0

V
%

0.0%
84.6%
30.8%
100.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
16
0
14
5
3
3
6
6
0
0
0
0
0
0

Can include medical detoxification.
Child can be placed with a parent in a Level II facility.

Center for Applied Behavioral Health Policy y Arizona State University

35

VI
%

0.0%
87.5%
31.3%
100.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0%

#
28
0
24
5
10
10
19
19
0
0
2
0
1
1

Statewide
%

0.0%
85.7%
17.9%
100.0%
100.0%
0.0%
0.0%
0.0%
50.0%
50.0%

#
439
1
181
322
73
73
303
303
0
0
208
7
201
1

%
0.2%
41.2%
73.3%
100.0%
100.0%
0.0%
0.0%
3.4%
96.6%
0.5%