Just All Hands On DECK for Drug Endangered Youth

Introduction [00:00:01] RTI International's justice practice area presents Just Science. Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about public health, innovative technology, current research, and actionable strategies to improve the criminal justice system. In episode seven of our Community based Solutions for Substance Use Challenges season. Just Science sits down with Cristi Cain, local public health section director at the Kansas Department of Health and Environment, and Sally Wright, the all hands on DECK for drug endangered children, Kansas program manager for the Kansas Department of Health and Environment to discuss their COSSUP funded all Hands on DECK program, which helps support drug endangered youth and families across the state of Kansas, in Kansas and across the country, many children and infants are living in an environment where a caretaker uses substances, or where they are born, exposed to substances. In response, the Kansas Department of Health and Environment supports 18 local jurisdictions who are implementing a range of activities to support drug endangered youth, including providing family care bags, administering community and school based drug awareness trainings, distributing naloxone, and more. Listen, long as Sally and Cristi discuss some of the catalysts for creating a youth focused program in their state. How each local site is identified and addressing unique needs within their community, and some of the challenges and successes the DECK program has experienced so far. This season is supported in part by RTI Award number 15PNIJ-21-GK-02192-MUMU awarded by the National Institute of Justice and by award number 15PBJA-23-GK-02250-COAP awarded by the Bureau of Justice Assistance. Both are agencies within the Office of Justice Programs, U.S. Department of Justice. Here's your host, Doctor Lawrence Mullen.

Lawrence Mullen [00:01:57] Hello and welcome to Just Science. I'm your host, Lawrence Mullen, with the Forensic Technology Center of Excellence, a program of the National Institute of Justice in order to reduce overdose deaths, promote public safety, and support access to services. This season is in collaboration with the Comprehensive Opioid Stimulant and Substance Use program, COSSUP. State based grantees are those that have applied on behalf of at least six localities or areas within the state, and provide collaboration and support for local sub recipients. The grantees coordination work ensures that its projects are executed successfully throughout planning, implementation, and evaluation. We are here today to talk with our state based COSSUP grantee, the Kansas Department of Health and Environment, who was awarded a COSSUP grant in 2022 to implement their statewide All Hands on DECK program to support drug endangered children in Kansas. Here to help us with the discussion from the state of Kansas is Sally Wright and Cristi Cain.

Cristi Cain [00:02:54] Thank you. It's great to be here today.

Sally Wright [00:02:56] We're really excited to share what is happening with Drug Endangered Children program in Kansas.

Lawrence Mullen [00:03:01] All right. So just to kind of bridge this into our conversation for today, let's just start with some background. Can you each tell the listeners about what led you to your current position and involvement in the coastal program? Cristi, can we start with you?

Cristi Cain [00:03:13] Sure. That would be great. So way back in 2002, I worked for a local nonprofit in Topeka, Kansas called Prevention Recovery Services, and we were

working on a large federal grant focused on addressing methamphetamine. And I went to a conference that was the first time I had been exposed to drug, endangered children. It was put on by a new organization called the National Alliance for Drug Endangered Children. And just when I became aware of the plight of children living in homes where substances are being manufactured, used, cultivated or sold, I became really passionate about it and have been working on it ever since then.

Lawrence Mullen [00:04:05] Awesome. Thank you for sharing that. Sally, would you mind kind of given us of your background?

Sally Wright [00:04:09] My background is a little bit more foot on the ground. I've worked with families for over 20 years, and I most recently worked with families within Casa, within the court system, in Topeka, Kansas. And I got really involved with what was going on within the court system. And a lot of it involved the reason that the children were being removed from the homes is because they were in drug endangered environments, and kind of tore at my heartstrings a lot. And I've been in this position for one year now, and it's been very interesting to see the growth and be involved on the back end of things and see what's happening with drug endangered children within the state.

Lawrence Mullen [00:04:47] I really appreciate and admire both of your journeys and pathways to get to this space. It seems like it's, you know, something that's a little bit more not necessarily personal, but it means something to you. And I really appreciate and admire that. Let's get more into the meat of the topic here. So you all were awarded a COSSUP grant in 2022 to launch the All Hands on DECK program. Can you give an overview of what that program is?

Sally Wright [00:05:10] The overall heart of the program is currently have 18 all hands on deck grantees within state. So it's all statewide. They all do certain parts of the grant to make their program a success. And they all had to start by implementing a logic model, which we work with Wichita State University, and they design that. And all of the grantees had to submit a logic model at the very beginning of the grant. And we have a monthly community practice meeting where we have different topics of what is going on within the drug endangered children world. And then we have now been having them. The different grantees report out about what they are doing so they can start working on collaborating on their own programs or learn from each other what's going on within their programs.
They do have to do quarterly reporting within their grant. We're learning together along the way to make the grant successful. So.

Lawrence Mullen [00:06:07] Cristi, did you have anything to add?

Cristi Cain [00:06:08] I'll just go to the basics. As far as we have three goals. One is to improve the identification of and the response to drug endangered children in Kansas, because we know that these kids come in contact with a multitude of different professionals or different sectors of the community, but they may not be recognized that there is an issue there. And so it's really creating that awareness about what is a drug endangered child and then what can be done to effectively respond to them. So that's something we're really focused on. And then we want to increase awareness of drug endangered children in Kansas just across communities throughout the state. The general public to professional practitioners, and then we want to build the capacity of the different partners on the project to become more involved in drug endangered children efforts as well. So it's really about collaboration and working across, different sectors of the community and different professions so that we can be sure to have the best response possible for these children.

Lawrence Mullen [00:07:24] Well, that makes perfect sense. Kind of in parallel with that. How did you identify the need for a program like this in the state of Kansas?

Cristi Cain [00:07:31] So I mentioned that we started back in 2002, and then Kansas had a significant problem with methamphetamine usage and manufacture. And one of the things that we noticed was that the law enforcement partners we worked with were encountering children on a large number of arrests and different situations that they were involved in. We also had our hospital partners saying that they were encountering kids who had ingested meth, or who had been burned in a manufacturing incident, and then our child welfare partners were also similarly saying that they were seeing an increase in foster care placements and other indicators that there was a huge problem. And actually in Shawnee County, where Topeka is located. We started efforts at the community level after the death of an infant who was born exposed to meth, and he went home with his parents with a lot of voluntary services in place, and ended up dying, a short time later after he had been sent home. And after that happened, we really came together as community partners and didn't want anything like that tragedy to happen again. And so what could we do to prevent it? And so that's really kept our community efforts going for over 20 years. And then our statewide partners, there had been multiple tragedies across the state that involve children in drug environments. And so again, our statewide partners don't want that happening in our state. And so what can we do to prevent it?

Lawrence Mullen [00:09:22] Thank you for sharing it. One other question kind of in the setup or launch of this particular program, what are the overall goals of the program?

Cristi Cain [00:09:30] So we want to improve identification of and response to drug endangered children in Kansas. That's our first. And I think the most important goal, our second goal is to increase awareness of drug endangered children in Kansas. And our third goal is to build the capacity of our collaborative partners to implement drug endangered children efforts across the state.

Lawrence Mullen [00:09:55] All right, Sally, did you have anything that you wanted to add?

Sally Wright [00:09:58] I was just going to mention that actually, in the state of Kansas, approximately 140,860 Kansas children are live in environments where a parent or caregiver uses substances. And an estimated 5155 Kansas infants are born exposed to substances every year. And nationally, 1 in 8 children live in households with one parent who has a substance abuse disorder. And then nationally, every 25 minutes, a baby is born suffering from opioid withdrawal. So it's, you know, just a very high statistic that we'd like to get that down to zero. So whatever can be done to to make that effort. I feel like this is a great way to get the ball rolling towards making that happen.

Lawrence Mullen [00:10:42] I couldn't agree more. How have partnerships and community buy in impacted your program?

Sally Wright [00:10:48] We have a lot of great partners. We're working with National Drug endagered Children Program. We're working with DECK, we're working with Wichita State University, the Kansas Department of Health and Environment, and the Mid-American Prevention Technology Transfer Center. So we feel like we have a lot of forces to back us

up with the partnerships. And then they've done a lot to help and with us to make arrangements and make things happen for the grantees that we are working with.

Lawrence Mullen [00:11:15] What does DECK stand for again?

Cristi Cain [00:11:16] It doesn't stand for anything, but it is a nonprofit organization that focuses on substance use disorder prevention.

Lawrence Mullen [00:11:25] Thank you for sharing it. The next question will talk about barriers that you all have had, whereas that are link to local and state. Did you want to add something as far as the partnerships go with local versus state level?

Sally Wright [00:11:37] I feel like at the local level, they're more the feet on the ground part of the program, and they're doing a lot of great work. One of our main focus of our grant is to build alliances across the state so that we can have partners from all areas, like Cristi had talked about about the police, the hospitals, schools, the CPS, whoever can be involved locally that works for children that are in the drug endangered child environment. So we really are trying to focus on getting DECK alliances built across the state. And at this point we now have 14, which has built up from this previous year. They do provide care backs to different drug endangered children within their communities. There are two books that are very popular for to give to families that are dealing with substance abuse disorders, and Tim B Talks and there's lamby learns. So a lot of the programs are disseminating those books. There's a lot of community drug awareness trainings, naloxone trainings. Actually, part of our grant is providing naloxone, distribution. And then, there's a lot of drug awareness curriculum within the schools that is being implemented with the DECK program.

Lawrence Mullen [00:12:48] Does seem like really great resources. So I'm moving into a two part question here. What have been some of the barriers in building this program. And you can kind of divide this one up into local versus state. So just kind of looking at those barriers that may have impacted you at the local versus the state level.

Cristi Cain [00:13:04] So I would just say one of the major barriers we encountered. So we had drug endangered children efforts going strong in communities across the state, I would say around 2008, 2009. And then the methamphetamine problem really changed. It went from where people were manufacturing in their own homes to where they were importing from Mexico because of the restrictions placed on the precursor chemicals used in meth manufacture. And all of that is a good thing. However, then funding really changed and so we weren't able to continue to fund our efforts. And so our drug endangered children efforts were really tied to our meth prevention efforts. And so we went for over a ten year period with no funding available for our efforts. And so we maintain with volunteers. But then during that time, our community level efforts really dwindled because there was no central hub to provide them resources and keep them going. And so now I would say that we are building back up that progress that we lost during that time where we didn't have funding. And so I would say we're very grateful that we have this funding opportunity. And so the lack of funding has definitely been a barrier in the past. And just kind of catching up from that lack of funding for those communities, I would say, was one key barrier we encountered.

Lawrence Mullen [00:14:44] Sally, did you have any perspective?

Sally Wright [00:14:46] I think some other barriers that we might have is sometimes people don't know what to do when there's a drug endangered child. So we're wanting to get the word out to key professionals that work with these children on what they can do to help these children to get out of the type of environment they're living in, or to work with the family so that children can stay with them so they can get the help that they need so they can get out of the environment that they're in. And one of the big key factors that I see also is that this is a stigma. It's something that keeps going within a family. And so what we'd like to do is to, you know, get it taken care of when they're children. This is not the type of environment that they should live in, and that you can get the help that you need so that they can not live in substance abuse type of household. And also another issue was during the pandemic, obviously increased social isolation. At that point, there was a lot of lack of community supports at that time, which involved more anxiety and depression within families. That made a lot of families turn to substance abuse at that time, so we'd really like to see the families get help that they need to to get out of that type of environment that they're living in. So and also, Kansas is a rural state, so it's harder to get help in a rural, you know, frontier type area. We're trying to make sure that these grantees are in different areas of the state so that families can get the help that they need.

Lawrence Mullen [00:16:08] Thank you for that. So how have you been able to see any positive impact of the program thus far? Are you all doing any kind of like measurements or data collection of any sort?

Sally Wright [00:16:18] We definitely do data collection. They have to do reporting on quarterly reports. Wichita State University is doing our statistics and doing it compiling our reporting together. So we're definitely working on that. And of course, then we have to give our information back to COSSUP to show the the work that we're doing. But I feel like one thing that has happened within this grant that's been exciting is once we got started was, which is when right when I began, we were provided additional money. So we're able to move forward and we're going to release that. We're adding some new grantees to the program. So we're super excited about that. And they're going to be new programs and they can get all the DECK information. We're looking forward to that.

Cristi Cain [00:16:59] If I can just add, I think some of the important outcomes are the number of counties that start alliances or that continue alliances, the numbers of key partnerships involved. And then we do a lot of training. That is one of our key strategies to increase the awareness of drug endangered children and for people, especially professionals, to be able to recognize drug endangered children and then know what to do. And so we do a lot of measurements around those trainings, such as did awareness increase, and do they feel like they're more capable of recognizing drug ebdangered children now than before they took the training, things like that. So I would say that those are some of our key measures. And with that being said to also, every community is different. So every community that's involved is doing a different type of, you know, program within their own community, what fits their needs. So it's really interesting to see the different things that outreach that they're doing in different ways. I think that's the most effective use of the dollars is, you know, let them decide how to use the money within their community.

Lawrence Mullen [00:18:14] It's a good point as far as successes go, I know you guys have kind of shared with some of the outcomes are do you have any examples of local success stories?

Sally Wright [00:18:23] They're doing a lot of family events locally. They'll have people come and do like movie night or but then the focus is the drug endangered children program so that they know that that's what this is for, to help bring families together. Or there was one program that did a big bear that was very well attended, and the community came out and they had all kinds of fliers and signs, and they even had a drug endangered walk where they have silhouettes of children that were along the pathway. And then, you know, a lot of them were doing like drug endangered t shirts and outreach throughout their communities.

Lawrence Mullen [00:18:59] Cristi, did you have any examples of any success stories that you wanted to share?

Cristi Cain [00:19:03] I think that one of our success stories every year we have Drug Endangered Children Awareness Day.

Sally Wright [00:19:10] Which is April 24th.

Cristi Cain [00:19:12] And it actually started in Kansas many years ago, really an effort to get the word out and increase awareness as much as we can. And so numerous counties this year had press conferences and other events that helped bring attention. So I think that that is really showing that the message is spreading across the state. And so that's exciting.

Lawrence Mullen [00:19:37] As far as positive impact goes, would anyone be able to share any positive impact from the state perspective?

Cristi Cain [00:19:43] I would just say that we have brought together partners that haven't worked together before. And so just increasing those partnerships. And so we have a Kansas Alliance for Drug Endangered Children that has been a volunteer board. Different sectors of communities across the state represented. So we have law enforcement and we have child welfare and prosecutors. And so just having that collaboration I think is extremely valuable. And then being able to tie in those different sectors. So people from the court sector can ensure that we do training for those sectors. And the people from law enforcement can make sure that training is occurring for law enforcement. So really filtering out so we reach as many professionals in Kansas as we can, who are the ones who are going to encounter these children in these environments. And so I would say that's something that I'm most excited about at the state level, is just the great partnerships that have been created and that leading to us being able to reach many more people.

Sally Wright [00:21:01] We have a statewide drug endangered children conference, and so we really want to expand that. It was a one day conference, and this year we want to make it a bigger conference than it has been.

Lawrence Mullen [00:21:11] So shifting gears one more time here, what advice would you give to other agencies who want to implement a youth and family focused program similar to this one?
Cristi Cain [00:21:20] I would say that partnerships are key, which I feel like I'm repeating myself, but that's definitely one of the most important components is that we can't do this work by ourselves. And so there are strength in numbers and strength in having so many different sectors of the community or the state represented. And so I would say just schedule a meeting and invite different partners and have a brainstorming session about

what you want to do. Look at. What is going on in your community, what the needs are. Have you had a tragedy where you're trying to help your community address that situation, or are you trying to prevent a tragedy that's happened in a nearby community from happening in your community? Are you working on reducing opioid use, for example, and just looking at what are the resources or the assets in our community and who can we pull together that we already have here? And then what are we missing? What do we need to add in order to get additional assistance? And so then that would be bringing in statewide partners, for example, just looking at what resources you have available and then listening to what the partners wants and needs are and seeing how you can make it work for everybody. And it's it's definitely a delicate balance, but the work is so rewarding. And, and we know that developing partnerships and that collaboration is really key to addressing substance use issues in communities.

Lawrence Mullen [00:23:06] And Sally, did you have anything to add?

Sally Wright [00:23:08] I just totally agree with everything that Cristi shared with you. And just to give a few examples of that with us kind of moving forward with that, there's been a lot of interest in implementing a statewide handle with care program. And also there's been a dramatic increase in maternal opioid use. So maybe finding a way to we're exploring ways to work with programs statewide to help with maternal opioid substance use. So those are two instances that I feel have gotten some a lot of traction when we've started working with this grant.

Lawrence Mullen [00:23:41] Thank you both for that insight. All right. So we're taking a little time here to kind of conclude. First question what is next for this program?

Sally Wright [00:23:49] Well, we've really got some exciting things coming up. Like I just mentioned, we're adding more grantees to the program, which is super exciting. And we're very excited to start working with the National Drug Endangered Children program. And starting soon, we are going to be doing a statewide training that anybody can attend. It doesn't have to be a grantee. We want all stakeholders that are working with drug endangered children to be part of that training that is going to be offered. And then with the national DECK program, they also have a great app called Check DECK. You can download that Check DECK app and look for assistance. If you're looking for help in any way, in whatever community you're in. So those are some things that we're really excited about.

Lawrence Mullen [00:24:30] And Cristi, did you have anything to add as far as things, that you're looking forward to for the program?

Cristi Cain [00:24:35] I would just echo, I'm really excited about we are adding several new grantees were able to give out an additional $1 million to communities across the state. And so just being able to work with more communities and get this message out further and get professionals trained in more communities and and being able to expand our annual conference, like Sally mentioned. So being able to reach so many more professionals than we have been able to to date is really exciting.

Lawrence Mullen [00:25:11] All right. So we're running near the end of our time together. Are there any final thoughts you'd like to share with our listeners today?
Sally Wright [00:25:17] I guess for me, I just I feel like the momentum is building. The ball is rolling, like we're getting a lot of excitement about the Drug Endangered Children

program within the state. And I just would like to, you know, see that it ends up that there's no drug endangered children, that it's 100% gone. So I am excited about everything that's going on, and I feel like it's making it a big impact within the state. And it's exciting to see the stakeholders and the grantees and and the children being helped through this funding.

Cristi Cain [00:25:50] And I would just like to add that the importance of the work is so massive as far as we've had multiple tragedies in the community where I live with children who were in drug endangered environments. And so if we can do work that help other communities, prevent them from having to go through that, I think it's really valuable. And just looking at what a difference that professionals who have had this training can make in the lives of kids, or even someone from the general public, just interrupting that trajectory in some way, which can can occur in a multitude of different ways. But it's so important because we know that kids who are in environments where drugs are involved are much more likely to be physically abused and much more likely to be neglected, and this has a lifetime impact. And so the work we're doing really. Is life changing for so many kids, and the more people we can get to understand what the issues are and to be involved, the better. And so I just am really appreciative of your time and and including us and this podcast and, and enabling us to help get the word out to more people in other states. And so I'd like to thank you for that.

Lawrence Mullen [00:27:22] Awesome. I just have one quick follow up question. Are there other programs that are similar to this in other states that you may have awareness of, like how do they compare or contrast to your own programs?

Cristi Cain [00:27:35] There are other statewide alliances across the state. So I would say that that was really an impetus back in the early 2000s for states to start alliances. And so many of those have kept going over these last 20 or so years. The National Alliance for Drug Endangered Children helps support those statewide alliances. And I would say they're similar in concept, but they include different components. And so I, I don't know that a lot of states provide funding to local communities to really work on community engagement and developing those county level alliances. I know that some have in the past, but I'm not sure how many are able to do that right now. And so that's one thing that I'm excited about Kansas doing. But there are lots of resources across the country. And so I would encourage anyone who is interested, after hearing this podcast, to reach out to the National Alliance for Drug Endangered Children and get some resources. And they have great resources available.

Sally Wright [00:28:49] And they also have a great website. The National DEC Alliance has a great website with great resources on it.

Lawrence Mullen [00:28:55] I'd like to thank our guest today for sitting down with Just Science to discuss the COSSUP funded, all hands on deck program in the state of Kansas. Thank you so much, Cristi and Sally.

Cristi Cain [00:29:04] Thank you so much for this opportunity. It was great to be here.
Sally Wright [00:29:08] Yes, we we love sharing what's going on in Kansas with the DECK program. So we're really excited to be here today.
Lawrence Mullen [00:29:15] If you've enjoyed today's conversation, be sure to like and follow Just Science on your podcast platform of choice. For more information on today's topic and resources in the forensic field, visit forensicCOE.org to request training and technical assistance or learn about additional resources from the COSSUP TTA collaborative visit COSSUP.org. I'm Doctor Lawrence Mullen and this has been another episode of Just Science.