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September 2007Vol. 8, No. 8Addressing Substance Abuse and Child Maltreatment: The RMQIC

First in a series of articles on the Children's Bureau's Quality Improvement Centers

How can child welfare agencies and substance abuse treatment programs coordinate their services to achieve better outcomes for children and families? This was the issue that American Humane Association's Rocky Mountain Quality Improvement Center (RMQIC) began to tackle in 2001 when the Children's Bureau awarded a 5-year grant to the regional research and demonstration project. As part of the process, the RMQIC awarded subgrants and provided technical assistance to four projects in the western region of the United States.

Program-level evaluations show a number of positive outcomes for each project, including a decrease in the recurrence of child maltreatment, an increase in children returning to or remaining in their homes, and an increase in child and family well-being. Cross-site evaluation data demonstrate that the following program and process characteristics are associated with positive outcomes:

  • Integrated systems for service delivery
  • Use of a central case coordinator/manager/substance abuse liaison
  • Immediate availability of the case coordinator
  • Skilled, knowledgeable, relationship-focused staff
  • User-friendly referral and engagement process
  • Service planning and delivery process that is mindful of the cognitive impairments caused by substance abuse
  • Respectful but open flow of client information across systems
  • Environment that supports open dialog across systems
  • Streamlined access to a variety of affordable services
  • Integrated funding

According to Carol Harper, who served as RMQIC's Project Director:

"We found that with the right combinations of supports and services, substance-abusing parents can have their children safely remain at home or returned to their care.”

RMQIC Projects

  • The Recovering Together Program in Cortez, CO, served substance-abusing mothers and their children in rural Colorado. The support and services included gender-specific substance abuse treatment, support groups for mothers, child and youth educational groups, family skills classes, family advocacy services, and vocational assistance.
  • The Pretreatment Education and Support Program provided services in three regions of Idaho to parents referred to child protective services and on a waiting list for substance abuse treatment. The focus was on family engagement, which was maintained through group meetings, individual visits, and calls with substance abuse liaisons who were co-located in the Department of Health and Welfare.
  • The Family Violence Court Project in Ada County, ID, was a collaborative effort between the Ada County Family Violence Court and the Idaho Department of Health and Welfare Children and Family Services. Families who were already involved in the court system due to domestic violence issues and had co-existing child maltreatment and substance abuse received streamlined case planning and services via an intensive case coordination approach.
  • The Denver Indian Family Resource Center provided culturally appropriate services to American Indian families in the greater Denver metro area. Services provided to parents included family advocacy, substance abuse pretreatment, parenting classes, and cultural strengthening activities.

RMQIC Resources

The RMQIC is in the process of posting a number of program replication guides and manuals, curricula, and evaluation reports on its website, including:

  • How to Effectively Serve Urban American Indians
  • Case Coordinator Manual for the Family Violence Court
  • Curricula for Motivational Interviewing, a 16-week Mother’s Treatment Program, and a separate 16-week Children’s Educational Program
  • Program Replication Manuals and Program Evaluation and Research Reports for each of the RMQIC projects

Please visit American Humane’s website to read more about the RMQIC and the individual projects.

In addition, American Humane's Protecting Children journal features findings from the RMQIC projects in Protecting Children, Vol. 21(3): Crossing Systems and Sharing Responsibilities on Behalf of Families Struggling With Substance Abuse. (2.87 MB)

For more information on the RMQIC, visit the website, or contact Joanna Reynolds at