Assessing the Context of Permanency and Reunification in the Foster Care System: Mothers Making a Change Program . 2. Mothers Making A Change Program


Within the context of the Cobb County child welfare service system, MMAC is a program that provides comprehensive substance abuse services to women in the community. The MMAC program is operated under the Cobb and Douglas Counties Community Services Boards, a public agency established by law under the Georgia State Department of Human Resources, that primarily provides mental health, substance abuse, and mental retardation services in the community (i.e., adolescent counseling, family preventive services, men's substance abuse treatment) to the community. The Community Service Board is considered part of the state's mental health system and not within the CPS organizational arm of DHR.

MMAC was established in the early 1990s in response to an increase in the number of women delivering crack cocaine-addicted infants. There was a scarcity of substance abuse services in the area for women; in particular, there were limited services for women abusing substances and few places to house women with high-risk problems. The area lacked residential programs for substance abuse services, especially programs willing to take the risk of serving a pregnant woman and provide the additional maternal health services needed. At about the same time, there was a highly publicized court case in Cobb County involving the prosecution of a woman who delivered a cocaine-positive baby. The woman, in her defense, claimed there were no substance abuse treatment services for her and other women who were pregnant and had a drug addiction. As a result, Cobb County set up a Task Force, under the auspices of the Department of Public Health (DPH), to study the problem. The Task Force discovered that the DPH, DFCS, and CPS were serving the same families and addressing the same substance abuse problems. Focus groups were set up in the county to address the problems of women with substance abuse problems. It was determined that the county's "traditional" model used by child welfare and public health services to serve substance abusers was ineffective in addressing women's substance abuse problems, particularly for those women who were pregnant. In the end, it was decided that DPH and DFCS would collaborate to form services to address women's substance abuse in the county. In the summer of 1992, the idea for women's services was developed. By November 1992, the specific needs of both Cobb and Douglas counties were identified and MMAC was established.

Services were initiated in January 1993, and the program has evolved through a number of changes. Services originally included substance abuse services, counseling, and assessment. The focus was to deliver healthy babies to women at risk of substance abuse by providing street outreach and substance abuse treatment targeted to pregnant women and mothers who were at risk. The program worked closely with the Cobb DFCS Parent Education and Training program (PET), assisting the program with substance-abusing women having high dropout rates and incidents of child abuse and neglect. MMAC worked closely with PET and came onsite to provide substance abuse services for PET consumers. MMAC, co-located with DFCS PET program, also provided parent training and educational services to county clients.

In 1994, MMAC began focusing more attention and efforts on CPS cases. The program expanded services and began providing day treatment services to CPS clients. Women and their children received 6 hours of service per day including treatment for substance abuse, domestic abuse, women's issues, low self-esteem, anger management, rape issues, parenting, education, and child support. The program encountered confounding issues along the way, and changes in the program developed based on those issues. For example, when MMAC administrators realized that almost three-quarters of the women they served were homeless, and client homelessness was a major problem interfering with reunification, the program developed a residential component to the program so women and their children could live together while the mother received substance abuse treatment.

Today, MMAC is a comprehensive program that includes community outreach, early intervention, family preservation and support services, comprehensive outpatient treatment services, and residential services for women with substance abuse problems in Cobb and Douglas counties. The goal of the program has expanded from its inception in 1994 and includes providing comprehensive treatment for pregnant and postpartum substance abusing or chemically dependent women with young children, with a main focus to promote a drug-free environment and family stability.

MMAC's services are based on a non-threatening treatment model that is family centered, community based, and encompasses a holistic approach to treatment. MMAC recognizes that substance abuse is one of multiple family problems and addresses the addiction, as well as the education, health access, housing, and employment needs in a holistic fashion. Moreover, the program recognizes that to keep a parent and child together requires resolving the problems of the parent. Therefore, services are mother and family focused rather than child focused.

In addition to providing direct services to women, MMAC provides extended services to other public agencies and the courts. The program provides liaison services to DFCS including drug assessments, toxicology screening, panel review hearings, case reviews, as well as case plan consultation and recommendations on CPS cases. In addition, MMAC provides similar services to TANF offices. MMAC staff also provide liaison services to the Juvenile Court by appearing at hearings and making recommendations regarding child placement and service interventions and participates in staffings for high-risk clients at the county hospital. Evident from their many links to social service agencies and the juvenile courts, MMAC staff are perceived as experts among their peer agencies and have an excellent working relationship within the social agency and court communities.

Communication and collaboration between MMAC and DFCS staff run smoothly. This is supported by having a MMAC staff member stationed at the Cobb County DFCS division office for consultation and liaison services and a CPS staff member stationed at MMAC to work collaboratively on cases. Likewise, judges seem to have a good working relationship with MMAC and reported using the program frequently because they believe it works. In fact, despite our best efforts to find any antagonistic feelings in peer agencies and the community, we failed to find anyone less than impressed by MMAC staff and services.