One hospital near Watts delivered 1,200 drug-exposed babies in 1987 alone. Alarmed by the epidemic and determined to find a solution, Icenhower discovered that many women refused treatment at rehabilitation centers because they knew their children would be sent into the foster care system while they were away.

She created a new model of substance-abuse treatment based on what she considered simple common sense: Keep families together by letting children stay with their mothers at the treatment center and help families address the range of issues connected with substance abuse through family therapy, parenting classes, and other services. In 1991, Icenhower cofounded SHIELDS for Families to implement the program. The results have been stunning. More than 80 percent of SHIELDS’ clients complete their treatment programs — triple the national average. The number of drug-exposed newborns at the South Los Angeles hospital soon dropped to 250 a year, saving the hospital $60 million per year.

Icenhower explains, “We are keeping whole families together. The outcomes — for both society and the individuals involved — are better when we do.”

Under Icenhower’s leadership, SHIELDS now has 30 intervention programs that help families have a healthy and productive future. Programs include family therapy, parenting classes, housing, education, and job training. SHIELDS also owns apartment complexes where clients can live and access services on-site.

Icenhower grew increasingly concerned, however, by the number of local children directed into the foster care system. Icenhower knew that outcomes are significantly better for kids who come from intact families. And she knew 80 to 90 percent of child welfare cases in Los Angeles County involved substance abuse, not child abuse. In these cases, children were routinely removed from homes with the presence of drugs without a fuller assessment conducted to determine other possible options.

We are keeping whole families together. The outcomes – for both society and the individuals involved – are better when we do.

Kathryn Icenhower

“The money is there. It’s all about how the public resources are used,” says Icenhower. In 2004, working with the Los Angeles County Department of Children and Family Services (DCFS), Icenhower designed an initial assessment protocol that, during a child-welfare crisis, looks at the family situation and offers immediate assistance and treatment if necessary. In the first three years, the protocol helped reduce out-of-home placements by 62 percent in the Compton area. It has been so successful in Compton that DCFS adopted it this year as a countywide approach. The estimated savings to Los Angeles County due to the anticipated reduction in foster care placements over five years will be $92 million.

For her insights and effectiveness in keeping families in Los Angeles together and helping children grow up in healthier environments, Kathryn Icenhower is a recipient of a 2009 James Irvine Foundation Leadership Award.