What's Your Strategy? Examining Types and Intensity of Interagency Collaboration Between Child Welfare and Drug and Alcohol Service Providers

Background: The co-occurrence of child maltreatment and caregiver substance use disorders (SUD) is a pervasive problem, with an estimated two thirds of child welfare systems’ (CWS) cases involving SUDs. Caregiver SUDs have been linked to adverse outcomes for children, including higher rates of re-report for maltreatment and a heightened risk of later substance misuse among maltreated children. As such, practices that increase the availability of SUD services and support caregivers’ connection to SUD treatment services are crucial. The organizational-level practice of interagency collaboration between CWS and drug and alcohol service (DAS) providers shows promise in improving connections to and delivery of SUD services. However, limited research has examined organizational factors related to engagement in interagency collaboration between CWS and DAS providers. Addressing this gap, this study presents research on national trends in interagency collaboration between CWS and DAS providers and examines organizational factors that influence engagement in both types and intensity of collaboration between these two entities.

Methods: This study uses baseline data from the National Study of Child and Adolescent Well-being (NSCAW II), a nationally representative study of CWS-investigated children, caseworkers, and local CWS agency directors. Local CWS agency directors (N=87) answered Yes/No to engaging in the following collaborative practices: (1) memorandum of understanding (MOU) for collaboration, (2) cross training of staff, (3) joint budgeting or resource allocation, and (4) co-location of staff. Type of collaboration was conceptualized as either policy (collaboration through a MOU) or practice-related (cross-training of staff, joint budgeting or resource allocation, and colocation of staff). Intensity of collaboration was measured by a count variable consisting of the number of collaboration strategies used (range 0 to 4). Organizational factors included director characteristics, agency staffing, and county characteristics. Using sampling weights, multinomial logistic and negative binomial regression models tested the relationship between organizational factors and types and intensity of collaboration, respectively.

Results: Results indicate that almost 35 percent of CWS organizations engaged only in MOU, 28 percent engaged only in practices, and 38 percent engaged in both policy and practices types of collaboration with DAS providers. No significant relationship was found between organizational factors and engagement in types of collaboration. However, collaboration intensity/count increased for CWS organization that reported increased caseloads (IRR= 1.48, 95% CI 1.02-2.16) and where the agency director had a masters degree or higher (IRR= 1.77, 95% CI 1.02-3.09). Additionally, collaboration intensity decreased for CWS organizations where agency director reported shorter job tenure (IRR= 0.53, 95% CI 0.35-0.80).

Conclusions: Given that engagement in interagency collaboration between CWS and DAS providers is an innovative organizational-level intervention that has potential to support service-connection activities for CWS-involved caregivers, it is worthwhile to investigate organizational factors that may impede or support collaboration. As study findings suggest that agency staffing and directors' educational background affect CWS' engagement in interagency collaboration, CWS agencies and stakeholders should take these factors into account when implementing interagency collaboration practices with DAS providers.