ARIZONA FAMILIES F.I.R.S.T. PROGRAM
Annual Evaluation Report
State Fiscal Year 2010

Prepared for
Arizona Department of Economic Security
Division of Children, Youth and Families
Phoenix, Arizona
Contract No.: DES060718-001

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

© 2010 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 DES060718-001 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., Stephen James, Charles Davis, Richard Rivera, Julie Sauvageot, Babu
Kumaran, Harsha Undapalli, and Sunil Mukkavilli all contributed to this year’s report.
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.
Finally, the authors wish to express appreciation to the staff and directors of the nine contracted
AFF provider agencies throughout the state. Their cooperation in providing evaluation staff
access to their data, staff, and participants is critical to the development of this report. Their
insights and recommendations of strategies for improving the utility and quality of the evaluation
are appreciated. Most notably, their dedication to the families and children served through the
AFF program is recognized and honored.
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. (2010). Arizona Families F.I.R.S.T.
Program: Annual Evaluation Report for the Period July 1, 2009 – March 31, 2010.
Tempe, AZ. Arizona State University.

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TABLE OF CONTENTS
Acknowledgements .......................................................................................................................... i
Table of Contents .............................................................................................................................1
Executive Summary .........................................................................................................................2
Section 1: Introduction ....................................................................................................................3
Section 2: Evaluation Framework and Data Sources ......................................................................6
Section 3: Arizona Families F.I.R.S.T. Clients and Services Received .........................................7
Section 4: AFF Program Outcomes ..............................................................................................12
Section 5: Summary ......................................................................................................................15

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Executive Summary
Now in its ninth year of operation, the Arizona Families F.I.R.S.T. program provides a statewide,
locally coordinated, and efficacious effort to intervene at the intersection of child maltreatment
and parent substance abuse. This year’s annual evaluation report is restricted primarily to the
first nine months of the state fiscal year, in order to provide more accurate and more detailed
analysis. As a result of the AFF program, more than 2,500 families in SFY 2010 received
substance abuse treatment and support services that are based on evidence-supported and best
practices. As a result of the provision of these treatment and support services, participating
parents who had drug tests were found to be drug free 92% of the time throughout their program
participation. Further, for 85% of the child victims of maltreatment, no subsequent maltreatment
was reported during the time period assessed by this report.
Increases in Timeliness, Availability, and Accessibility of Services. During SFY 2010, these
families received outreach, assessment, engagement, and treatment services in a timely manner.
On average, AFF providers made initial contact with families within 1.4 days upon receipt of a
referral from CPS. These providers cut in half the average time it took for clients to accept AFF
services, down to 5 days compared to last year’s reported rate of 11 days. Consequently, a
significant increase in the timeliness of services was observed this year. During SFY 2010,
clients receiving services did so with funding provided exclusively by DES or in concert with
services funded by the RBHAs. As such, the AFF program continues in its tradition of
facilitating access to, and availability of, a full range of complimentary treatment and support
services designed to reduce parental abuse of alcohol and drugs.
Recovery from Alcohol and Drug Problems. The results of drug tests conducted with AFF
clients indicate that 92% of these tests were drug free, indicating no drug use. Therefore, the
AFF program continues to result in the reduction and abstinence of parental alcohol and drug
use.
Child Safety and Reduction of Child Abuse and Neglect. Nearly all families served by the
AFF program had a substantiated or unsubstantiated report of child maltreatment before
enrolling in the program. Most AFF clients (85%) had no subsequent report filed during this
reporting period. As such, the AFF program continues to provide services that have a
documented impact in reducing the exposure to neglect and abuse of children and reducing the
risk of these events re-occurring in the future.
Permanency and Reunification. Nearly 900 children who had been placed in out of home care
achieved permanency this year. The overwhelming majority of these children (n=811) were
reunified with their parents due in part to parental receipt of AFF treatment and support services.
The AFF program continues to promote safe and healthy families, particularly for those families
impacted by parental substance abuse.
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.
During SFY 2010, only one individual was referred to an AFF provider from the Jobs program.

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SECTION 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 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, an annual evaluation of the Arizona
Families F.I.R.S.T. (AFF) program is required. This 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.
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. Clients for the program are referred
by Child Protective Services and by the Jobs program. 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 Arizona
Department of Economic Security, Division of Children, Youth and Families (ADES/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, genderspecific treatment, motivational enhancement strategies, and collaboration with child service
providers to assist the entire family in its recovery, are incorporated into service delivery.
The diagram on the following page shows the flow of clients through various stages of the AFF
program.

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Exhibit 1
Overview of the AFF Program Model
CPS
Case Managers

JOBS
Case Managers

Referred to AFF Provider
Conduct Outreach
Engage Client in Services
Determine AHCCCS Eligibility

AHCCCS
Eligible?

No
DES/DCYF
DES Funded Services
Continue with AFF Provider
Conduct Core Assessment
Develop Service Plan
Begin Services

Yes

Continuous
Review of
Title XIX Status

ADHS/DBHS
RBHA Funded Services
Connect to RBHA Provider
Conduct Core Assessment
Develop Service Plan
Begin Services

AFF Funded
Supportive Services
Child Care, Transportation, Housing, Job Training, etc.

Access AFF Aftercare Services

Close Case

Center for Applied Behavioral Health Policy  Arizona State University

Close Case

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Exhibit 2 summarizes the county, DES provider agency, and associated RBHA within each of
the 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
County
District
I
Maricopa
II

Pima
Coconino

III

Yavapai
Apache and
Navajo
Yuma

IV

La Paz

DES Provider Agency
TERROS
Community Partnership of
Southern Arizona (CPSA)
Arizona Partnership for
Children (AzPaC-Coconino)
Arizona Partnership for
Children (AzPaC-Yavapai)
Old Concho Community
Assistance Center
Arizona Partnership for
Children (AzPaC-Yuma)
WestCare Arizona

Mohave

WestCare Arizona

V

Gila and Pinal

Horizon Human Services

VI

Cochise, Graham,
Greenlee, and
Santa Cruz

Southern Arizona
Behavioral Health Services
(SEABHS)

Regional Behavioral
Health Authority
Magellan
Community Partnership of
Southern Arizona (CPSA)
Northern Arizona Regional
Behavioral Health Authority
(NARBHA)

Cenpatico Behavioral Health of
Arizona, Inc.
Northern Arizona Regional
Behavioral Health Authority
(NARBHA)
Cenpatico Behavioral Health of
Arizona, Inc.
Community Partnership of
Southern Arizona (CPSA)

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SECTION 2
EVALUATION FRAMEWORK AND DATA SOURCES
This evaluation report responds to the legislatively-mandated performance indicators of the AFF
program. The data provided within this report are drawn primarily from administrative data
submitted to the evaluation team directly, or obtained from administrative information files
maintained by DES and DBHS. These data, like those reported in previous reports, include:
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 (ADHS/DBHS) for services
provided through the local RBHA network;
DES CHILDS data, which provides child welfare information including information
of allegations of child maltreatment, child foster care placement, and reunification;
and
DES JAS/AZTEC data, which provides employment services information.
DES providers use a common data reporting format, revised by CABHP in November 2008.
These data are either entered directly 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 submit 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/RBHA, 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,
as specified in the Arizona Department of Health Services’ Covered Behavioral Health Services
Guide and Client Information System File Layouts and Specifications Manual, a common
services taxonomy is used to organize the services funded both by DBHS and DES.

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SECTION 3
ARIZONA FAMILIES F.I.R.S.T. CLIENTS
AND SERVICES RECEIVED
This year, the Annual Report has been restricted primarily to the indicators of service
performance that were reported for the period of July 1, 2009 – March 31, 2010. Restricting
these analyses to 9 months, rather than 12, was a mutual agreement by DES and CABHP in
recognition of the short time frame, during which the data are available for receipt and analysis
by the evaluation team, and the deadline for submission of the report. The next two sections
present data for all 12 months of SFY 2010; all subsequent sections will be restricted to data for
the first 9 months of SFY 2010.
3.1

AFF Program Referrals

A total of 4,308 unique individuals
were referred to AFF during all four
quarters of SFY 2010, averaging 1,077
referrals per quarter. The total number
of unduplicated individuals referred to
the AFF program for SFY 2010
increased by 9.2% as compared to SFY
2009; reversing the sharp declines in
referrals observed during the last two
quarters of SFY 2009.
3.2

Exhibit 3
Statewide AFF Referrals
SFY 2009 SFY 2010 % change
Jul-Sep
1256
878
-30.1%
Oct-Dec
1208
957
-20.8%
Jan-Mar
863
1238
43.5%
Apr-Jun
627
1308
108.6%
Total Referrals
3954
4381
10.8%
Unique Referrals
3944
4308
9.2%

Client Outreach and Engagement
Exhibit 4
Disposition of Cases Referred to the AFF Program
SFY 2009
n
%
# unique referrals 3944 99.7
# individuals with record of outreach attempt 3616 91.5
# of referred individuals accepting services1 2473 62.5
# of referred individuals refusing services 30
0.8

SFY 2010
n
%
4308 98.3
3645 83.2
2373 54.2
36
0.8

Exhibit 4 provides a comparison of client outreach and referral patterns for all four quarters of
SFY 2010 and all four quarters of SFY 2009. Approximately 83% of all individuals referred to
the AFF program this year received outreach services, and slightly more than one half (54%) of
all clients referred to AFF this year accepted services and became clients (i.e. they received
treatment services).
All further analyses to be reported are in reference to the first 3 quarters of SFY 2010.

1

Not all clients had a record of accepting or refusing services; therefore, these data do not sum to 100 percent.

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3.3

Annual Case Processing

The average duration from referral to first contact during the first three quarters of SFY 20102
was 1.4 days, which is shorter than last year (mean=2 days). Slightly more than three quarters
(76.4%) of all referred individuals received an outreach contact from their AFF provider within
one day of their referral. The average number of days from referral to client acceptance of AFF
services was 5 days, which has improved significantly from SFY 2009 (mean=10.7 days). On
average, clients were referred to the RBHAs within 15.4 days, slightly quicker than last year
(mean=17 days).

n
Median # Days
Mean # Days
SD
Minimum # Days
Maximum # Days

3.4

Exhibit 5
Duration from AFF Referral to Selected Events
(Number of Unique Client Referrals; N = 3,035)
First
Individual
Outreach
Accepting
Referral Sent
Contact
AFF Services
to RBHA
2731 (90%)
1833(60.4%)
1061 (35%)
1
1.4
2.4
0
25

2
5.0
8.6
0
57

13
15.4
15.2
0
58

Individual
Refusing
AFF Services
28 (0.9%)
6
6.6
6.0
0
19

DES Provider Assessments and DBHS Enrollments

A total of 2,0323 individuals (67% of all individuals
Exhibit 6
referred to AFF) were assessed during the first three
Assessments Statewide
quarters of SFY 2010. Assessments were conducted
SFY 2010
by a contracted DES provider and/or a RBHA
n
%
contracted provider, depending on the referred
Total Assessments
2032
100.0
individual’s eligibility status for RBHA services.
DES only
880
43.3
4
Assessment data were compiled from two sources:
DES & RBHA
569
28.0
DES provider data and RBHA enrollment data. As
RBHA only
583
28.7
depicted in Exhibit 6, a significant proportion of
individuals were assessed by DES providers and less commonly by a RBHA provider.

2

Throughout this report, reference will be made to SFY2010. These references will be to the first three quarters of
the SFY, unless noted otherwise.
3
This figure includes individuals who had been referred to the AFF program in SFY 2009, but not assessed until
SFY 2010 (n=368), along with clients who were referred and assessed during SFY 2010 (n=1,664).
4
This figure may not accurately represent two separate assessments; there are many different reasons for duplicate
assessments, including the same assessment being erroneously entered twice.

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3.5

Substance Use Among Individuals at Time of AFF Assessment

Individuals who are assessed
Exhibit 7
complete a self-report of
Substances Used by AFF Clients
their substance use patterns
30 Days Prior to Enrollment
during the immediately
Total Assessed Clients: 2,032
preceding 30-day period. As
Primary
All Substance
part of the assessment,
Substance
Use Reports
clients are asked to report all
Use Reports
substances used, and to
n
%
n
%
identify substances that are
Clients Reporting Use
1807
88.9
1888
92.9
used most frequently.
Alcohol
689
33.9
970
47.7
Exhibit 7 provides a
Methamphetamine
673
33.1
788
38.8
summary of primary
Marijuana
459
22.6
841
41.4
substance use and all
Cocaine/Crack
131
6.4
217
10.7
substance use reported by
Other Narcotics
89
4.4
123
6.1
these clients at the time of
Heroin/Opioids
48
2.4
60
3.0
their initial assessment. The
Other Drugs
19
0.9
29
1.4
majority of individuals
Hallucinogens
27
1.3
40
2.0
reported alcohol (33.9%) and
Benzodiazepines
31
1.5
43
2.1
methamphetamine (33.1%)
Other Sedatives
28
1.4
42
2.1
as the primary substance
Other Stimulants
15
0.7
20
1.0
used. Of the individuals
Inhalants
3
0.1
5
0.2
reporting any substance use
(and not just primary), alcohol (47.7%), marijuana (41.4%) and methamphetamine (38.8%) were
the more frequently reported substances used.
3.6

Clients Treated by Funding Source

During the first three quarters of
Exhibit 8
the SFY 2010 reporting period, a
SFY 2010 Clients Served and Funding Source
total of 2,760 individuals
Total Clients Served in SFY 2010: 2,760
received AFF services in SFY
SFY 2010
2010. Approximately 30%
n
%
(n=781) of the clients had been
New and Continuing Clients
served in SFY 2009 and
SFY 2010 New AFF Clients
1979
71.7
continued to receive services
SFY 2009 Continuing AFF Clients
781
28.3
during the current reporting
Service Funding Source
period. As evidenced in Exhibit
DES only Funded Clients
1067
38.6
8, nearly equitable proportions of
Shared Funding Clients
750
27.2
clients received AFF treatment
RBHA only Funded Clients
943
34.2
services funded exclusively by
DES or by a RBHA, or with a combination of DES and RBHA funding.

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3.7

Service Access by Service Domain

Exhibit 9 provides a summary of the number of clients who were provided at least one unit of
service in one or more service domains during the first three quarters of SFY 2010. Support
services and treatment services were the more commonly provided services, regardless of the
source of funding for these services.
Exhibit 9
Statewide Patterns of Service Access

Service Domain
Treatment Services
Rehabilitation Services
Medical Services
Support Services
Crisis Intervention
Services Services
Inpatient
Residential Services
Behavioral Health Day
Programs
3.8

DES only funded
services
n = 1,067
#
%
937
87.8
114
10.7
241
22.6
970
90.9
0
0
0
0
12
1.1
0

DES & RBHA funded
services
n = 750
#
%
706
94.1
132
17.6
232
30.9
745
99.3
50
6.7
3
0.4
32
4.3

0

27

3.6

RBHA only funded
services
n = 943
#
%
827
87.7
231
24.5
274
29.1
867
91.9
128
13.6
14
1.5
71
7.5
34

3.6

Service Closure and Treatment Duration

During the first three quarters of SFY 2010, 1,847 client cases (representing 67% of all clients
served) were closed by the DES provider, the RBHA provider, or both (for those clients
accessing services from both systems simultaneously). Of these, 1,259 client cases were closed
by a DES/AFF provider.
As reflected in Exhibit 10, clients who completed their treatment program represented the
majority (48%) of the AFF clients who were closed by their DES/AFF provider. Among those
clients closed by their AFF provider and identified as completing their service plan, the average
length of treatment (LOT) was 127 days, with a median LOT of 90 days.

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Exhibit 10
Statewide Patterns of DES/AFF Closure and Length of Treatment
Clients who received services and were subsequently closed
n = 1,259
Closure Reason
#
%
Clients Completing Service Plan
609
48.37
Client Discontinued Participation
182
14.46
Client Refused Services
4
0.32
Provider Terminated Services
1
0.07
5
All Other Reasons for Closure
463
36.78
6
Length of Treatment
Mean (SD)
Median
Clients Completing Service Plan
127 (119)
90
Clients Discontinuing Participation 123 (104)
98
Client Refused Services
31 (40)
21
Provider Terminated Services
30
30
All Other Reasons for Closure
127 (85)
104

5

Other reasons for closure are unclear at this time; they are currently under investigation.
Length of treatment (LOT) is defined as the number of days between the first treatment service date following
assessment and the last treatment service date prior to closure by the DES/AFF Provider. LOT is not calculated
when the first and last service dates are the same.
6

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SECTION 4
AFF PROGRAM OUTCOMES
This section highlights the outcomes achieved by families who have participated in the AFF
program in the following key dimensions that were articulated in the enabling legislation of the
AFF program: child safety, family stability and permanency, recovery from alcohol and drug
abuse, and self-sufficiency as reflected in employment.
4.1

Child Safety: Recurrence of Child Maltreatment

Of the 2,760 clients in the AFF program, 2,532 (92%) had at least one allegation of child
maltreatment immediately prior to their referral to the AFF program. Among those clients with a
maltreatment allegation at intake, the majority of the allegations were for neglect (64%), with
physical (29%) and sexual abuse (7%) less frequently identified. These findings are consistent
with other studies that have reported that substance abusing caregivers tend to be linked with
neglect referrals rather than with sexual or physical abuse referrals.
Exhibit 11
Summary of Pre- and Post-Referral Report Findings7
Pre-Referral Finding
Post-Referral Finding
Totals
Substantiated
Unsubstantiated
Pending/Other
No Report
Total

#
%
612 22.2
1596 57.8
324 11.7
228 8.3
2760 100

Substantiated Unsubstantiated Pending/Other
#
7
20
0
1
28

%
1.1
1.3
0.0
0.4
1.0

#
62
227
6
11
306

%
10.1
14.2
1.9
4.8
11.1

#
21
59
9
3
92

%
3.4
3.7
2.9
1.3
3.3

No Report
#
522
1290
309
213
2334

%
85.3
80.8
95.4
93.4
84.6

Of the families with a maltreatment report (substantiated or unsubstantiated) at the time of their
referral to the AFF program, 14% had a recurrence8 (as indicated by a substantiated or
unsubstantiated report at post-referral). Using a conservative definition of recurrence, subsequent
substantiated report following an initial substantiated report, a rate of 1% was observed,
compared to last year’s 0.5%. Caution should be taken when reviewing these findings, since the
short duration between pre- and post-referral only allows for a minimally adequate follow up
window in which to monitor recurrence (e.g. 6 months).

7

Pre-referral findings were extracted from the last CPS report initiated prior to the client’s referral to the AFF
program. Post-referral findings were extracted from the first CPS report following the client’s referral to the AFF
program.
8
This figure was calculated by summing all substantiated and unsubstantiated post-referral findings that had an
initial substantiated or unsubstantiated pre-referral finding (n=316) and dividing this by the sum of the total
substantiated and unsubstantiated pre-referral findings (n=2208).

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4.2

Permanency Achieved by Children of Parents in AFF

A total of 3,303 children, whose parents (1,585) were AFF clients in the first three quarters of
SFY 2010, were in CPS out of home placement at some point during the reporting period. As
depicted in Exhibit 12, 72% (2,371) of these children were still in out of home placements at the
end of the reporting period. By comparison, in SFY 2009, 60% of children of parents in AFF
were still in care at year’s end. More than one quarter of the total number of children in care at
any point during the year (27%) achieved permanency during the first three quarters of SFY
2010. As documented in Exhibit 12, reunification occurred, on average, within 210 days.

Total Children
Still in Care
Other
Achieved Permanency
Reunification
Guardianship
Adoption
Relatives
Aged Out
4.3

Exhibit 12
Permanency Achieved by
Children of Parents in AFF
n
%
3,303
100.0
2,371
71.8
Days in Out of Home Care Among
37
1.1
Children Achieving Permanency
Average Days
Median Days
895
27.1
187
210
811
90.6
404
425
58
6.5
791
811
10
1.1
14
37
8
0.9
313
343
8
0.9

Recovery from Substance Abuse

Drug tests are
Exhibit 13
conducted on AFF
Statewide Summary of AFF Client Drug Test Data
clients throughout their
Reported by DES/AFF Providers
participation in the
Average # of
n
%
AFF program. These
tests per month (SD)
tests provide a good
Total Clients
2760 100
means for monitoring
Clients with a record of at least
1791 64.9
1.5 (2.2)
parental abstinence
one drug test in SFY 2010
from substance use and Drug Free Ratio
N/A9 91.6
can be used
therapeutically to celebrate parental sobriety, as well as to detect and provide an opportunity for
intervention when parental relapse occurs. According to AFF guidelines, all AFF clients are
supposed to be tested for drug use at least twice per month for each month of AFF program
participation. Beginning in November 2009, AFF providers were required to report drug test
results regardless of whether these tests were conducted by the AFF provider directly, or
conducted by a collateral agency or system providing treatment or supervision to the AFF client.
9

Since the drug free ratio represents the number of negative drug tests divided by the number of all drug tests, it is
only applicable to present information as a percent, and not as a number.

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Drug test results were reported for 1,791 clients (65%), representing a significant improvement
from the 51.4% of clients reported in last year’s report.10 AFF clients with reported drug tests
were tested, on average, 1.5 times per month. This performance level is higher than in SFY
2009, when 1.24 drug tests per month were observed among those AFF clients with reported
drug tests. Nearly all (91.6%) reported drug tests were negative, reflecting no drug use.
4.4

Employment Outcomes For Jobs-Referred AFF Clients

During the first three quarters of SFY 2010, only one individual was referred to an AFF provider
from the Jobs program. This client’s case was closed by their provider 70 days later;
employment status for this individual is unknown. Five additional individuals, who were referred
to AFF providers in SFY 2009, continued to receive AFF services during SFY 2010. Two of
these individuals were subsequently closed with their employment status listed as employed.
Three additional clients referred in SFY 2009 remained open in SFY 2010.

10

Drug test data for 347 clients (12.6%) were excluded from this year’s analyses, since they occurred outside the
specified SFY 2010 timeframe.

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SECTION 5
SUMMARY
This report summarizes the key processes and outcomes of the Arizona Families F.I.R.S.T.
program, now in its ninth year of operation. The continued commitment of the legislature to
critically examine the processes and outcomes of this innovative program has afforded the
opportunity to study the development and operations of a program unique in its scope and focus.
The performance of the AFF program, in relation to each of the five goals articulated by the
legislature, was addressed by utilizing information from a variety of sources, including
administrative data and service utilization records.
A constant focus of attention for this evaluation is the relative integrity and accuracy of the
information utilized in this report. Due to the short time frame from the evaluation team’s
receipt of these data and the deadline for report transmittal, validation of data remains an area of
continuing concern. The performance indicators analyzed in this report are as accurate as the
information provided to the evaluation team, largely absent of any independent verification.
Limitations associated with this information include missing data (most notably for referrals,
assessments, and drug testing), unreliable data (e.g. information that has been entered
incorrectly), and unmatchable data (e.g. to DES or DBHS records). To complicate issues, some
providers use varying data and service definitions. Strong efforts were made this year to
improve data integrity and validation procedures in future reports. To improve processes in the
upcoming years, emphasis will be placed on complete and accurate data entry and data matching;
this will be accomplished, in part, by using automated web-based reports to improve quality
control, and by using automated data validation checks. In spite of these limitations, this
evaluation provides a consistent analysis of the performance and outcomes of this highly
innovative program.
Increases in Timeliness, Availability, and Accessibility of Services
In the first three quarters of SFY 2010, 2,760 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 Latina(o). Nearly three quarters of the
clients were unemployed and slightly less than half reported their highest educational level to be
a high school diploma or equivalent. Nearly all of these individuals were under investigation for
child maltreatment. Most 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 2010, these families received outreach,
assessment, engagement, and treatment services in a timely manner. On average, AFF providers
made initial contact with families within 1.4 days upon receipt of a referral from CPS. These
providers also cut in half the average time it took for clients to accept AFF services, down to 5
days compared to last year’s reported rate of 11 days.

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Those families who 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. The proportion of individuals referred to
AFF providers in SFY 2010 that were subsequently referred to the local RBHA (35%) remained
constant with last year’s (SFY 2009) observed rate of 37% of all referrals. During the first three
quarters of SFY 2010, 61% of those AFF clients that received AFF services did so with funding
provided in part, or in whole, from a RBHA.
Recovery from Alcohol and Drug Problems
The results of reported drug tests conducted with AFF clients to detect continued substance use
indicate that 92% of these tests were drug free, indicating no drug use. AFF clients with reported
drug tests were tested on average 1.5 times per month, which is slightly below the DES specified
policy that requires clients to be tested at least twice per service month. However, this
performance level has improved from last year, when 1.24 drug tests per month were observed.
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. Most
families served by the AFF program had a substantiated or unsubstantiated report of child
maltreatment before enrolling in the program. A majority of the reported maltreatment
investigations were for charges of neglect, with physical or sexual abuse accounting for 36% of
all maltreatment allegations at the time clients were referred to the AFF program. Most AFF
clients (85%) had no subsequent report filed during this reporting period. Among those families
with a substantiated report at the time of their referral to the AFF program, only 1% had a
subsequent filing of a substantiated report during the first three quarters of the state fiscal year.
Permanency for Children through Reunification
At the end of this year’s reporting period, 72% of children whose parents were AFF clients
remained in CPS out of home placements. More than one quarter of the total number of children
in care (27%) achieved permanency during the first three quarters of SFY 2010. The majority of
these children (91%) were reunified with their parents; reunification occurred, on average, within
210 days.
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. During the first three quarters of SFY 2010, only one
individual was referred to an AFF provider from the Jobs program. This client’s case was closed
by their provider 70 days later; employment status for this individual is unknown. 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  Arizona State University

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