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Tribal Child Welfare Systems’ Experiences With Prenatal Exposure to Alcohol and Other Drugs: A Case Study

Day, Priscilla.; Geary, Erin.; Ingoldsby, Erin.; Ahonen, Pirkko – 2021

This report presents the findings of a federally funded case study that examined prenatal alcohol and other exposures in child welfare, including in Tribal child welfare systems. For the study, multiple listening sessions were held with diverse Tribal stakeholders across Minnesota in 2018 to understand issues related to prenatal substance exposure (PSE), to develop relationships with Tribes, and to inform the study. In 2019, the research team engaged the Ombimindwaa Gidinawemaaganinaadog Red Lake Family and Children Services agency to co-develop a case study. After Tribal council and IRB approval, in 2020 the Tribal liaison and a team member conducted two data collection efforts: a service process mapping activity, and interviews with nine key informants. Findings from the case study are reported and indicate: currently, no validated assessment or decision-making tools are used by this agency to guide the intake process when there are reports of prenatal alcohol or other drug exposures; participants were less aware of the relevant referral partners and the process to identify children affected by PSE than those processes for serving and supporting pregnant mothers; the two most frequent points of referral for pregnant mothers who are using substances are family preservation services and chemical dependency services for supporting pregnant mothers; challenges included struggles with maintaining and communicating processes consistently across agencies, and because all births currently occur off-reservation, the Tribal programs must follow the lead of external agencies. Themes that emerged from the interviews are also discussed and address the needs and strengths of the Tribal community, services for pregnant mothers and infants with PSE, facilitators to implementing services, challenges to implementing services, and recommendations for improved services. Finally, implications of the findings for Tribal child welfare program and federal agencies are explored. 27 references.