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(90CB0134): Abandoned Infants Assistance • • • • • • • • • Project Milagro (90CB0134) • Abandoned Infants Assistance • Final Report • • Grant Period: • October 1, 2004 . September 30, 2008 • Submitted to • U.S. Department ofHealth and Human Services • Administration for Children and Families, • Children~ Bureau • By • Lourdes Carranza, M.S., Project Manager • Martha Cristo, PhD., Evaluator • December 2008 • • o alOd • Blenvenl OS • • Acknowledgments Contents • We appreciate the longstanding support and Executive Summary encouragement from Pat Campiglia, AlA Project Officer • Introduction during the past 17 years. We are thankful for her interest • in our work and in Latino families living in the East Los MAJOR ACTIVITIES AND ACCOMPLISHMENTS • Angeles community. Further, services offered by Project DURING THIS PERIOD • Milagro would not have been possible without the grant support from the Administration for Children and Families Program Model • and Children's Bureau. We also extend appreciation to Approach: Cultural Theoretical Framework • the National Abandoned Infants Assistance Resource Family Systems • Center for providing numerous resources during the past Home-based Comprehensive Madel decade and for their understanding of the challenges Long Term and Intense Services • faced by Latinas and their children. • Project Milogro Families Characteristics ofFamilies Served • We further thank the Project Milagro staff for dedicating tireless hours in working with families and their efforts to Recruitment Strategies • support children impacted by substance abuse and HIVI Retention • AIDS. Families Living with Substance Abuse Families Living with HIV/AIDS • In final. we dedicate this report to the Latinas and their Vulnerable Children Living with HIV/AIDS • families who are living and struggling with substance and Substance Abuse Parents • abuse, HIV or AIDS. We express our deepest gratitude for Permanency Planning their participation in this program and for sharing their • stories. Evaluation • Discussion • ............................................. Lessons Learned • References • APPENDICES • Appendix A Improving Child Well-Being in Latina-Headed Families Faced with Substance Abuse and • HIV/AIDS: Moving Theory into Practice • with Outcomes • Appendix B Thank You Letters from AlA Participants • Appendix C Praject Milagro Trainings and Presentations Appendix 0 Project Milagro Replication Manual • • • • Bienvenidos 316 West 2nd Street • 8th Floor • Los Angeles CA 90012 • 213 7855906 • www.bienvenidos.org • • • • Executive Summary Under the Abandoned Infants Assistance Program, Bienvenidos 1 • implemented an innovated home-based model to prevent • Bienvenidos Children's Center is a private nonprofit the abandonment ofchildren and secure their safety by organization located in Los Angeles, California and has provided meeting the multiple needs offamilies impacted by substance • services to families in the East Los Angeles and Southeast abuse and/or HIV/AIDS. The amalgamation ofsociocultural, • areas by applying culturally responsive comprehensive socioeconomic and epidemiological factors defined the • models that target children, adolescents, teen mothers and program's framework and the past decade of services to high • parents. The agency's family home-based model funded by risk families. This project successfully provided culturally • the Abandoned Infants Assistance Program was implemented specific services and interventions aimed at mediating the in 1992. During the years, the AlA Project Milagro model detrimental effects of substance abuse and/or HIVIAIDS • has evolved from serving Latinas and children to providing experienced by Latina women and their children. The multi- • substance abuse outpatient treatment through establishing level service tracks involved family assessment and family • the Institute for Women's Health (funded by SAMSHA). Child­ support, case management and advocacy, child assessment • focused interventions and family support models provided the and parenting, health education and medical access, child • AlA program to target Latinas and children impacted by HIVI reunification and permanency planning, and alcohol/drug and AIDS and substance abuse. Bienvenidos developed alliances mental health counseling. The efficacy ofa multidisciplinary • and collaborations with over 25 local organizations focused bilingual/bicultural service team comprised of a case manager, • on HIVIAIDS services and has been recognized for providing parent educator, drug counselor, family support worker, health • culturally sensitive services to Latinas living with HIV/AIDS. The educator, group facilitators, and clinicians proved critical in • program's outcomes provided a framework for working with HIV assessing and meeting the economic, social, cultural, legal, • families by delineating the differing and multitude of problems health, and psychological needs offamilies. The program • impacting these families. AlA Project Milagro Latinas impacted model was expanded to Latinas from Mexico, Central and by substance abuse were more acculturated, more likely to South America, immigrant women and their partners, primary • speak and read English, had generational substance abuse and caregivers and extended family members. • the majority were single parents. These women were more • likely second and third generation Mexican American, faced • with similar challenges as other women ofcolor in this country. • These women were poorly educated, lacked job skills and have Introduction dealt with the limited job training resources often found in • low-income communities. In addition, they represented second Bienvenidos Children's Center implemented the Abandoned Infants Assistance Program from 1992 to 2008. During the • or third generation alcohol/drug using families with histories • ofchild abuse and domestic violence. Many were challenged past 16 years, the AlA Project Milagro has chronicled relevant • with the limited substance abuse programs in the East Los factors that improve the safety, permanency and well being of Angeles area and that served women with children. In contrast, children living with Latina mothers, primarily of Mexican origin, • whom are coping with HIVIAIDS or Substance Abuse. Equally women affected by HIV/AIDS were minimally acculturated to important, historical pathways to understanding the social • the United States and many were recent immigrants. They were and familial dynamics that impede positive outcomes among • monolingual Spanish-speaking, and adhered to Latino cultural latinas have been clearly delineated by this longstanding AlA • practices and beliefs. Women affected by HIV/AIDS were less program. The gaps in knowledge for providing program polices • educated and as new comers to this country, they experienced stress associated with acculturation, discrimination and poverty, and service designs that target the complexities of needs for • latinas and their children have led to an array of innovative and they were often isolated from their extended families that • AlA programs that are perceptible in the interiors of poor and remained in their country oforigin. HIVIAIDS women tended to • be married, and ascribed to traditional sex-roles in the Latino disenfranchised communities. In general, AlA programs have collectively worked towards providing services to the "least of • culture. Project Milagro has actively provided prevention • strategies to reduce the risk of HIV exposure among Latinas, these"communities, families and children. Thus, these programs particularly since the majority of Project Milagro HIV women continue to contribute to improving our knowledge base by • developing strategies to meet the unique needs of families contacted the virus through heterosexual exposure. • coping with HIV/AIDS and Substance Abuse. • • 2 Project Milagro provided comprehensive services to Mexican Program Model • and Mexican American mothers and their children residing in • the East and Southeast Los Angeles area who were identified Cultural Theoretical Framework • as high-risk for abandoning their infants and young children Project Milagro over the course offour years implemented a due to HIVIAIDS or chronic substance abuse. The project's • model that was effective in promoting safety, permanence, and target service area has a large concentration of Latinas living • well-being ofchildren impacted by HIVIAIDS and substance with HIV or AIDS and has been identified as a priority group by abuse. Located in Los Angeles, California, Project Milagro • the Los Angeles County HIV Prevention Plan (2008). Multiple concentrated its efforts towards understanding the needs of • co-factors have been attributed to the disparities of HIVIAIDS families and children in the context of their culture. Beyond • among Latinas. More importantly, such co-factors continue to providing linguistically appropriate (Spanish translations) add to the vulnerabilities of Latinas for newly diagnosed HIV • information and education, the program provided services infections, living with AIDS and limited prevention strategies • that were culturally relevant and sensitive to Latinas. for acquiring HIV. The incidence rates in the United States for • Interventions applied by the program staffwere respectful of women living with AIDS and women at risk for HIV infection cultural beliefs and practices (folkloric concepts and healing, • or transmission has led to re-examining emerging patterns celebrations, family hierarchies, and worldviews, etc.). Such • ofthe epidemiological nature of HIVIAIDS (HIV
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