Substantial Harm: Thinking Critically about Child Welfare Referrals for Parents with SUD
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- Non-Member - $39
- Regular Member - $29
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- Early Career Physician - $29
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- Student - $19
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Substantial Harm: Thinking Critically about Child Welfare Referrals for Parents with SUD
Recorded: Thursday, April 13, 2023 to Sunday, April 16, 2023
On-Demand Session
Overview
This 75-minute on-demand session from the ASAM 54th Annual Conference addresses how the medical system interacts with the child welfare system.
Nearly 9 million children live with at least one parent with a substance use disorder (SUD), and parental substance use is a contributing reason for child removal in more than 1/3 of out-of-home child welfare placements. This session helps mandated reporters understand how healthcare systems interact with child welfare organizations, explores current weaknesses and biases, and presents opportunities for creating healthier interactions for both substance using individuals and their children.
The target audience for this intermediate level session includes physicians, nurse practitioners, physician assistants, other clinicians, researchers, residents, fellows, students, and counselors.
This session addresses the following ACGME Competencies: Medical Knowledge, Professionalism, Systems-based Practice
This session addresses the following IOM Competencies:Provide patient-centered care, Work in interdisciplinary teams, Professionalism
Learning Objectives
Upon completion, learners will be able to:
- Appraise their understanding of how the medical system interacts with the child welfare system, and in particular, compare and contrast their beliefs about this interaction pre- and post- focus session
- Identify areas where implicit bias creates unintended negative outcomes for patients and their families, and examine how their own routine practice patterns might contribute to bias
- Propose changes to practice that can improve outcomes for patients and families
Registration Rates
| Rate Description | Rate |
| ASAM Member | $29 |
| Non-Member | $39 |
| Associate Member | $19 |
| Resident Member* | $19 |
| Student Member* | $19 |
*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.
Membership Question? Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.
Refunds & Cancellations
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Registration Deadline: 05/15/2026
Session Instructions
- Click on the Contents tab to watch the on-demand recording.
- Click Complete Post Test to answer multiple choice questions. Participants will have 10 attempts to pass and must answer 4 out of 5 questions correctly.
- Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
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Lulu Zhao, MD
Assistant Professor of ObGyn, Assistant Professor of Psychiatry
University Hospitals Cleveland Medical Center
Lulu Zhao, MD, FACOG, FASAM is a jointly appointed Assistance Professor in the Departments of Obstetrics & Gynecology and Psychiatry at University Hospitals Cleveland Medical Center. A board certified ObGyn and addiction medicine specalist, she directs the Rainbow Interdisciplinary Substance Exposure (RISE) Moms Clinic, which provides compassionate and integrated care for pregnant and postpartum individuals with substance use disorder.
Aaron Ellington, PhD, LPCC-S, LICDC-CS
Director of Ambulatory Clinical Programming
University Hospitals Cleveland Medical Center
Aaron Thomas Ellington, Ph.D., LPCC-S, LICDC-CS works for University Hospitals’ Department of Psychiatry as the Director of Ambulatory Clinical Programming and Chair of the Diversity, Inclusion, and Equity Committee. Dr. Ellington has a doctorate and master's degree in counseling psychology from Cleveland State University and University of Wisconsin at Madison respectively. He has over 30 years of clinical experience including over 16 years of supervision/management experience. Dr. Ellington also has a license in psychology, independent clinical counseling with supervision designation license, and an independent chemical dependency license with supervision designation. Dr. Ellington is well versed in running groups, individual counseling, assessments (psychosocial, chemical dependency, and some psychological testing), training seminars, research, crisis intervention, case management, teaching master’s level chemical dependency classes and doctoral level counseling psychology classes at Cleveland State University. Dr. Ellington was also honored with Cleveland State University’s Distinguished Alumni Award in 2011. Dr. Ellington currently runs a private practice (Behavioral Health Services of Greater Cleveland) in two locations with his partner David Smith.
Margaret Isquick, PhD, JD
Assistant Public Defender
Cuyahoga County Public Defender Office
Margaret Oshuns Isquick (PEGGY) PhD, JD is a Cuyahoga County Assistant Public Defender who has been practicing in the Cuyahoga County Juvenile Justice Center (CCJJC) since 1993. Ms. Isquick represents both youth and parents who have been diagnosed with a Substance Use Disorder (SUD). She represented all juveniles on the CCJJC Youth Drug Court docket in the past, but is currently only representing the female juveniles. Ms. Isquick has been involved in the CCJJC Family Recovery Court Docket since its inception in 1999. As part of the Family Recovery Court (FRC) team she represents parents who used alcohol and/or other drugs prenatally and are consequently involved with the Cuyahoga County Division Of Children and Family Services (CCDCFS) and the juvenile court. Ms. Isquick, a public defender social worker, CCDCFS' prosecutor, case workers and family adovocates make up the FRC Team who work together to help parents maintain their infants in their home; or reunify them with their children as soon as possiblle. Additionally, Ms. Isquick represents parents who have been diagnosed with mental health issues, developmental delays and dual diagnoses. Besides her recovery court and juvenile drug court representation, she is involved in pilot program funded by the Ohio Supreme Court to help parents and families avoid being involved in the CCJJC stsstem. The program is named FIRST which stands for Family Intervention Representation and Services Team. The program is a collaboration between the Public Defender Office and CCDCFS to identify and support families in need of short-term aid such as housing issues, school issues, or finding SUD treatment. The Public Defender FIRST program maintains a holistic, multidisciplinary approach, utilizing a team of attorneys, social workers and parent advocates, that is solution-focused, community based, and rehabilitative so as to avoid the adversarial, punitive, and traumatizing affects of being court-involved.
Celina Cunanan, MSN, APRN-CNM, FACNM
Chief Diversity, Equity and Belonging Officer
University Hospitals
Celina Cunanan, MSN, APRN-CNM, FACNM is the Chief Diversity, Equity & Belonging Officer at University Hospitals and leads the UH Office of Community Impact, Equity, Diversity and Inclusion (CEDI). University Hospitals is the second largest employer in Northeast Ohio and as their DEI leader, Celina is leading the CEDI office to develop and grow thoughtful, innovative programs to build a culture of Equity and Belonging within the organization, as well as to address social determinants of health in the diverse communities that they serve. These signature programs include the UH Health Scholars pipeline program, the UH Second Look and Satcher Clerkship programs for graduate medical education recruitment, the UH Food For Life Markets to address food insecurity, and the UH LGBQT/Gender Services line. An experienced clinician leader, Celina was the inaugural Division Director for Nurse-Midwifery in the Department of Obstetrics & Gynecology from 2007 through June 2022, and System Chief for Nurse-Midwifery since 2017. Under her leadership, UH Midwifery has grown to be the largest network of midwives in Ohio. In 2010 and in response to Cleveland’s high preterm birth and infant mortality rates, Celina initiatied the Centering Pregnancy model of care, and served as Medical Director. The UH Centering program is recognized as one of the largest and most innovative programs nationwide, and has been designated as Centering Healthcare Institute’s Midwest Regional Leadership Partner since 2018. Celina previously served as president of the Northeast Ohio chapter of the American College of Nurse-Midwives (ACNM) and as an elected member of the ACNM Nominating Committee. For her leadership and expertise in the field of midwifery, Celina was inducted as a Fellow in the American College of Nurse-Midwives in 2019. Celina was appointed to the Ohio Minority Health Commission by Governor Mike DeWine in 2020, and now serves as Board Vice Chair.
Christina Delos Reyes, MD, FASAM
Associate Medical Director
Ohio Physicians Health Program
Christina Delos Reyes, MD, FASAM is the Associate Medical Director at the Ohio Professionals Health Program (OhioPHP) and assists in the oversight of clinical services as well as the monitoring program. She is a 1996 graduate of the BS/MD program at the Northeast Ohio Medical University (NEOMED).
Dr. Delos Reyes has been passionate about physician well-being and recovery since her first year of medical school. She volunteered as an OhioPHP monitor in the 1990s and served on the OhioPHP Board between 2010 and 2020. Before joining OhioPHP, Dr. Delos Reyes practiced addiction psychiatry at University Hospitals Cleveland Medical Center and was the Program Director of the Addiction Psychiatry Fellowship from 2001 until 2022. Dr. Delos Reyes is board-certified in Psychiatry, Addiction Psychiatry, and Addiction Medicine and is a Fellow of the American Society of Addiction Medicine (ASAM). She has lectured extensively on co-occurring mental health and substance use disorders, medications to treat opioid use disorders (MOUD), motivational interviewing (MI), and integrated dual disorders treatment (IDDT). Dr. Delos Reyes has been active in organized medicine for over 25 years and most recently served as President of the Ohio Society of Addiction Medicine from 2020 to 2022. She has been a member of the Motivational Interviewing Network of Trainers (MINT) since 2008 and is certified as an Acupuncture Detoxification Specialist (ADS) since 2019. In 2020, she completed two years of specialized training in Gestalt Therapy and is currently working toward her Gestalt Coaching Certification.
CME, CE, CEU and Other Credit Types
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
NAADAC, the Association for Addiction Professionals
This activity has been approved by the American Society of Addiction Medicine, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #295, ASAM is responsible for all aspects of the programming.
California Association for Drug/Alcohol Educators (CAADE)
This educational program is approved by CAADE: #CP40 999 1225.
California Association of DUI Treatment Centers (CADTP)
This educational program is approved by CADTP: #205.
California Consortium of Addiction Programs and Professionals (CCAPP)
This educational program is approved by CCAPP: #OS-20-330-1224.
Continuing Education Credits (CEUs)
Non-physician participants will receive a certificate of attendance upon completion of the activity and an online evaluation confirming their participation. Participants should submit his/her certificate of attendance to their professional organization/institute.
Maintenance of Certification / Continuing Certification Program
American Board of Preventive Medicine (ABPM)
The American Board of Preventive Medicine (ABPM) has approved this activity for 1.25 credits towards ABPM MOC Part II requirements.
American Board of Anesthesiology (ABA)
This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in Anesthesiology TM (MOCA®) program, known as MOCA 2.0®.
American Board of Pediatrics (ABP)
Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 1.25 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.
American Board of Internal Medicine (ABIM)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credits.
American Board of Surgery (ABS)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and/or Self-Assessment requirements of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
American Board of Psychiatry and Neurology (ABPN)
Successful completion of this CME activity can be used to satisfy the American Board of Psychiatry and Neurology’s (ABPN) CME requirement for Maintenance of Certification program.
American Board of Addiction Medicine (ABAM)
Successful completion of this activity can be used to satisfy the American Board of Addiction Medicine (ABAM) for Tmoc as credits towards ABAM LLSA Part II requirements.
Royal College of Physicians and Surgeons of Canada (RCPSC)
Royal College Fellows can use participation in Accredited Continuing Medical Education to earn Section 3 Credits.
Disclosure Information
In accordance with disclosure policies of ASAM and the ACCME, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all CME/CE activities. These policies include mitigating all possible relevant financial relationships with ineligible companies for the Planning Committees and Presenters. All activity Planning Committee members and Presenters have disclosed relevant financial relationship information. The ASAM CE Committee has reviewed these disclosures and determined that the relationships are not inappropriate in the context of their respective presentations and are not inconsistent with the educational goals and integrity of the activity.
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