Parent-Child Assistance Program: Raising mothers from trouble

Program shows return on investment

The Parent-Child Assistance Program costs Washington about $5,000 per mother per year. Its outcomes suggest the following savings for the state, according to the University of Washington:

o Children of mothers enrolled in PCAP who were in out-of-home care and reunified at program exit had a shorter stay (3.8 months) than Washington’s statewide average (20.4 months). Reunification could save an estimated $21,200 per child.

o Only 12 percent of mothers enrolled in PCAP had a subsequent alcohol- or drug-exposed infant within three years, compared with 21 percent of similar mothers over the same period who received typical substance abuse treatment without intensive case management.

o From 2007 to 2012, Temporary Assistance for Needy Families was the main source of income for 61 percent of women entering PCAP compared to 31 percent at exit.

o From 2007 to 2012, employment was the main source of income for 3 percent of women entering PCAP compared with 27 percent at exit.

o From 1998 to 2004, PCAP clients completed 26 years of higher education during enrollment. Each additional year of schooling translates into a 10 percent increase in earnings. Clients also completed about 96 years of high school equivalency education.

TO LEARN MORE

For more information on the local Parent-Child Assistance Program, contact Clark County program supervisor Amy Morrison at 360-771-7902 or amorrison@csnw.org.

Rachael was addicted to heroin when she learned she was 2½ months pregnant.

The Cowlitz County woman got on methadone to help her kick her heroin habit. It worked, for a while. But when Rachael’s daughter was born in March 2009, she tested positive for both heroin and methadone.

In the hospital, Rachael learned about the Parent-Child Assistance Program, a state-funded program that serves high-risk mothers who abuse alcohol and drugs during pregnancy. The goal of the home-visit intervention program is to prevent future alcohol- and drug-exposed births among the women enrolled in the program.

Rachael enrolled in the program and entered inpatient treatment. In June 2012, after a relapse and associated setbacks, Rachael completed the program. She is now sober, works two jobs and has a place to live with her daughter, now 5 years old.

Rachael, who asked that her last name not be published, attributes her success to the Parent-Child Assistance Program, or PCAP.

“I absolutely love PCAP. I’m passionate about it,” Rachael said. “They saved my life.”

PCAP has been operating in Cowlitz County since 2005. This year, the state program arrived in Clark County, overseen by Vancouver-based Community Services Northwest.

“Having it as a resource for the women who need the program is a huge benefit, not only for the women who utilize it, but the community as a whole,” said Amy Morrison, the Clark County PCAP program supervisor.

PCAP employs trained and supervised case managers, all of whom have bachelor’s degrees and some personal experience or background with the population the program serves, such as substance abuse, homelessness or domestic violence, Morrison said.

In addition to preventing future drug- and alcohol-exposed births, the program aims to help mothers obtain treatment and stay in recovery, ensure the children are in safe homes and link mothers to community resources.

Advocates work with each mother and her family for three years, beginning during pregnancy or the first six months after a child’s birth.

The program is tailored to each woman’s needs. Advocates work with each woman to identify person goals and the steps needed to achieve those goals. If a woman needs help obtaining prenatal care or getting into chemical dependency treatment, the advocate can be that help. Advocates can also help clients get enrolled in school or seek employment.

“Eventually, the women will be able to become self-sufficient,” Morrison said.

The Clark County program enrolled its first client in March and now has four advocates serving about 50 clients. At capacity, the program will have six advocates and 95 clients.

“We’ve just sort of blown up since we started enrolling clients,” Morrison said.

‘Huge need’

PCAP began as a federal research project at the University of Washington in 1991. Based on its success, the program began to expand in 1997 and is now available in 12 counties across the state. The program is still coordinated by the University of Washington Alcohol and Drug Abuse Institute but is now funded by the Washington State Department of Social and Health Services.

The University of Washington estimates the program costs $5,000 per mother per year but has the potential for significant cost savings by reducing the number of children with fetal alcohol syndrome, reducing dependence on public assistance, reducing the amount of time children are in out-of-home care, increasing employment and increasing education levels.

Clark County has a “huge need” for this type of program, said Colleen Castleberry, a licensed clinical social worker at Legacy Salmon Creek Medical Center. Castleberry has referred women to the Cowlitz County program and is now referring women to the local program.

“The bigger benefit is, as we can meet these moms’ needs, they’re better able to meet the needs of their children,” Castleberry said.

Clark County has very few home-visitation programs for pregnant women. Even fewer serve pregnant women who are abusing substances, she said.

Women enrolled in PCAP are not kicked out of the program if they use drugs or alcohol. Instead, the advocates continue to stay in contact with the client and wait until they’re ready to seek help, Morrison said. During that time, the advocates can also ensure the children’s needs are still being met and encourage the mother to get into treatment, she said.

That was the case for Rachael.

When Rachael relapsed, her advocate stayed in contact during the nine months Rachael abused drugs.

“As much as I didn’t want anything to do with them because I was busy being a drug addict, they were persistent,” she said. “When things got bad enough, they were the first ones there.”

In March 2011, Rachael’s advocate helped get her into an inpatient treatment program. Rachael rebuilt her relationship with her sister, who was caring for her daughter, and began seeing her daughter regularly. About a month later, Rachael brought her daughter to live with her at the treatment center.

When Rachael graduated from inpatient treatment in August 2011, her advocate was there to help her get her driver’s license back, provide transportation to parenting classes and help her apply for housing.

Rachael finished the three-year PCAP program in June 2012. She got a job working as an office assistant at PCAP in Kelso, as well as another job. Rachael hopes to go back to school to fulfill her ultimate career goal: to become a PCAP advocate.

“They’re great,” Rachael said. “They saved my life.”