Washington State Division of Alcohol and Substance Abuse Pregnant and Parenting Women (PPW) with Chemical Dependency Issues DASA Services in the Prevention of FASD What is FASD? Fetal Alcohol Spectrum Disorders: the umbrella term for: -Fetal Alcohol Syndrome (FAS) -Fetal Alcohol Effect (FAE) -Alcohol Related Neurological Disorders (ARND) -other prenatal alcohol exposure related effects These effects may include physical, mental, behavioral, developmental and/or learning disabilities with possible lifelong implications. FASD are 100% preventable and occur when a pregnant woman drinks alcohol during pregnancy. There is no safe amount of alcohol consumption during pregnancy. What does the Division of Alcohol and Substance Abuse (DASA) offer? Chemical dependency treatment for women that includes the families, especially the babies and toddlers. Intervention on a pregnant chemically dependent woman, which may prevent a drug or alcohol exposed baby. Intervention on a chemically dependent woman may prevent an unintended pregnancy, which could lead to a baby that is drug or alcohol exposed. Priority access into outpatient and residential chemical dependency treatment services. With Prevention and Treatment Funding: Maternal drinking during the last 3 months of pregnancy was significantly reduced between 1993 and 1998 in Washington State. (PRAMS data) 93 94 95 96 97 98 14.6% 7.8% 8.2% 8.3% 6.2% 3.9% Of the children placed in foster care (King County specific) from 1993 to 1998, there was significant reduction in the number of children being born and diagnosed with Fetal Alcohol Syndrome. 93 94 95 96 97 98 6.7% 4.8% 0% 0% 2.2% 0% Source: Fetal Alcohol Syndrome Diagnostic and Prevention Network DASA Services PPW Residential Chemical Dependency programs 10 sites statewide, for a total of 150 beds. PPW Housing Support Services programs 11 sites statewide, for a total of 149 support services slots. Outpatient chemical dependency treatment services, many specific to the needs of PPW, that include on-site or off-site childcare. Crisis Nurseries in Yakima and King Counties. ® PPW Residential PPW Services Housing Support Services Parent Child Assistance Program DASA Supported Crisis Nursery Safe Babies Safe Moms (TICM) Whatcom Snohomish ® Spokane Kitsap King ® ® Grant Pierce ® Yakima Benton-Franklin ® ® ® October 2004 PPW Residential Chemical dependency treatment services for pregnant, postpartum, and parenting women. Addresses the issues specific to women in relation to chemical dependency and their children. Service provision and length of stay is variable and is determined by the needs of the woman. Maximum length of stay is six months. Therapeutic Childcare Developmental assessment Play therapy Behavioral modification Individual counseling Self esteem building Family intervention to modify parenting behavior and/or the child’s environment to eliminate/prevent the child’s dysfunctional behavior Parent education and parenting plan PPW Housing Support Services Up to 18 months of housing support services for women who are pregnant, postpartum or parenting and for their children who reside in drug and alcohol free residences. These services are classified as support services, rather than treatment services. Eligibility: PPW at the time they enter housing; and Currently in treatment for chemical dependency or have completed treatment in the last 12 months; and At or below 185% of the Federal Poverty Level at the time they enter housing; and Are not actively involved in using alcohol or other drugs Crisis Nurseries Crisis nursery services to children of parents with chemical dependency issues. Care for children birth through six years of age, while their parents participate in chemical dependency services. Includes both day childcare and respite care. Other Services Parent Child Assistance Program (PCAP) Safe Babies Safe Moms (SBSM) Parent Trust FASDPN Iceberg Newsletter FAS*FRI CUP FASIAWG Parent Child Assistance Program (PCAP) King, Pierce, Yakima, Cowlitz, Spokane, and Grant Counties 90 slots at each site, for a total of 450 statewide (Spokane and Grant are considered one site) For the highest risk women who abuse alcohol and/or drugs during pregnancy. These women are not successful or effectively engaged with community service providers. PCAP Services Include: Paraprofessional advocacy services for up to the target child’s third birthday. Identification and prioritization of realistic goals, steps to meet goals, and evaluation of progress towards goals. Referral to chemical dependency treatment, recovery, and follow-up, to include residential and outpatient treatment. Support for utilization of local resources. Provision of funds for food, unmet health needs, other necessities, and incentives as needed. Safe Babies Safe Moms Snohomish, Benton-Franklin, and Whatcom Counties 270 slots statewide For the highest risk women who abuse alcohol and/or drugs during pregnancy. Comprehensive program that includes: PPW Residential and Outpatient Chemical Dependency Treatment PPW Housing Support Services Targeted Intensive Case Management (TICM) up to three years. Targeted Intensive Case Management – Safe Babies Safe Moms (SBSM) Intensive case management and behavior rehabilitative services for pregnant and parenting alcohol and drug abusing women. For women who have a history of multiple system involvement and need services of longer duration and greater intensity than women enrolled in or served by other resources. Children of these women may suffer from developmental disabilities and behavioral/emotional disorders that prevent them from functioning normally in their home, communities, and other settings. TICM Services Include: Milieu Therapy Activities with children to normalize their psychosocial development, promote safety, and stabilize their environment. Crisis Counseling Immediate short term intervention to assist the mother/child in responding to the crisis and/or stabilizing the situation until problems can be addressed in regularly scheduled counseling or therapy sessions. Regularly Scheduled Counseling and Therapy Work on specific dysfunctions identified in a continually updated formal service/treatment plan. Therapy may be individual or group setting and directed toward the mother, child, or family. SBSM Key Findings The low birth weight rate for infants born after program entry decreased by 66%. The rate of accepted CPS referrals during the first year of life decreased by 35%. SBSM Key Findings (Continued) Criminal justice involvement of SBSM clients is extensive, with an average of 1.5 arrests per woman in the two years before program entry. A decrease of more than 50% in the arrest rate was observed for clients with chemical dependency treatment. Two-thirds of SBSM clients (67.5%) received at least one Medicaid-paid family planning method in the year after enrollment. At the one-year follow-up, onethird (34%) received non-reversible or more effective methods. Source: Research and Date Analysis, Washington State Department of Social and Health Services, January 2004 Parent Trust Family support groups for families recovering from chemical dependency. Using a family support philosophy and creating community networks with family support agencies in participating communities. Develop and maintain Families in Recovery groups, which provide family support and skills development with specific focus on the parenting and family issues of recovering families. Available in most of the PPW residential chemical dependency treatment programs. Fetal Alcohol Syndrome Diagnostic and Prevention Network (FASDPN) Community and Professional Training – University of Washington Regional Network Site Training (Spokane, Yakima, Pullman, and Everett) Trainings include: Fetal alcohol related diagnosis; The roles in providing complex intervention needs for individuals diagnosed as fetal alcohol related; How to identify birth mothers of children diagnosed with prenatal alcohol damage and assist them in avoiding subsequent fetal alcohol exposed births by referral to existing alcohol treatment and/or family planning programs. FASDPN Trainees Will Learn: What FAS and alcohol related brain damage is and how it is diagnosed. What services the FASDPN provides and how to utilize them. What each professional’s role is in the referral, diagnostic, and service provision process. What information is needed to conduct a diagnostic evaluation. Who benefits from a diagnostic evaluation. How to link birth mothers to community intervention services. Iceberg Newsletter Iceberg is a quarterly international educational newsletter on FASD (Fetal Alcohol Spectrum Disorders) published by the Fetal Alcohol Syndrome Information Services (FASIS), a parent/professional partnership. “Because the problems we readily see are only the tip of the iceberg.” Fetal Alcohol Syndrome Family Resource Institute (FAS*FRI) This service provides the citizens of the State of Washington a service dedicated to improving the lives of children and families impacted by fetal alcohol exposure. This service is provided from the viewpoint of parents who have been directly affected by fetal alcohol exposure, whether they are birth, adoptive, foster, grand, or step parents. FAS*FRI Activities Include: Training Advocates Information and resources 1-800-999-3429 Newsletter publisher (quarterly) FAS Times Assists with FASD conference planning Chemical Using Pregnant (CUP) Detoxification DSHS funded inpatient hospital program for acute detoxification and medical stabilization of pregnant chemically dependent women and their fetus. Provides both medical and drug/alcohol treatment services at pre-approved hospitals statewide. Available at: Grays Harbor Community Hospital/Aberdeen Swedish Medical Center/Ballard Providence Medical Center/Everett Valley General Hospital/Monroe St. Peter Hospital/Lacey Chemical Dependency Professionals Co-Located in the Child Protective Service Offices In 2005, the Washington State Legislature passed funding for 22 FTE’s to be co-located in CPS offices statewide. The CDP provides: screening, referral, case consultation, CPS staff training, client engagement support Chemical Dependency Professionals Co-Located in the Community Service Offices Since 1998, CDP’s have been co-located in Community Service Offices statewide. The CDP provides: screening, referral, case consultation, CSO staff training, client engagement support Fetal Alcohol Syndrome Interagency Workgroup (FASIAWG) Established by the Legislature in 1995 Legislatively mandated state agencies that attend: DSHS (DASA, CA, MAA, JRA, DDD, MHD) DOC OSPI DOH The state agencies listed above executed an interagency agreement to ensure the coordination of identification, prevention, and intervention programs for children who have fetal alcohol exposure, and for women who are at high risk of having children with fetal alcohol exposure. A process for community advocacy groups to participate in the review and development of identification, prevention, and intervention programs administered or contracted for by the agencies executing the agreement. How to Access Services Direct admission into PPW Residential or CUP sites Can access through an ADATSA Assessment Entity PPW Resource Guide 24 Hour Alcohol/Drug Helpline 1-800-562-1240 Additional Information Sue Green Women/Special Services Lead Division of Alcohol and Substance Abuse 360-725-3732 [email protected] Websites DASA http://www1.dshs.wa.gov/DASA/ DASA Greenbook http://www1.dshs.wa.gov/DASA/services/certification/GB.shtml (directory of all DASA certified programs statewide) FASDPN http://depts.washington.edu/fasdpn/ FASD Center for Excellence http://www.fascenter.samhsa.gov/ FAS*FRI http://www.fetalalcoholsyndrome.org/ Iceberg Newsletter/FASIS http://www.fasiceberg.org/ Parent Trust http://www.parenttrust.org/ PCAP http://depts.washington.edu/fadu/ Washington State Alcohol/Drug Clearinghouse http://clearinghouse.adhl.org Washington State Fetal Alcohol Spectrum Disorders (includes FASIAWG) http://www.fasdwa.org PPW Residential Providers Evergreen Manor – Unit 1 (Everett) Contact: Linda Grant Triumph Treatment Services: Services: Casita del Rio (Kennewick) Contact: Beth Dannhardt (425) 258258-2407 [email protected] (509) 248248-1800 [email protected] Evergreen Manor – Unit 2 (Everett) Contact: Linda Grant Triumph Treatment Services: Services: Riel House (Yakima) Contact: Beth Dannhardt (425) 258258-2407 [email protected] (509) 248248-1800 [email protected] Perinatal Treatment Services (Tacoma) Contact: Vicky Stark Perinatal Treatment Services (Seattle) Contact: Kay Seim (253) 471471-2782 [email protected] (206) 223223-1300 [email protected] Genesis House (Seattle) Contact: Jeff Bott Drug Abuse Prevention Center (Longview) Contact: Gus Nolte (206) 328328-0881 [email protected] (360) 425425-9210 [email protected] Sundown M Ranch (Selah) Contact: Scott Munson New Horizon Care Centers: Isabella House (Spokane) Contact: Fariba Nikdel (509) 457457-0990 [email protected] (509) 624624-1244 [email protected] PPW Housing Support Services Providers Evergreen Manor (Everett) Contact: Linda Grant Triumph Treatment Services: Services: Casita del Rio (Kennewick) Contact: Beth Dannhardt (425) 258258-2407 [email protected] (509) 248248-1800 [email protected] Agape (Bremerton) Contact: Robin LundLund-Kolp Triumph Treatment Services: Services: Sage House (Yakima) Contact: Beth Dannhardt (360) 373373-1529 [email protected] (509) 248248-1800 [email protected] New Horizon Care Centers (Spokane) Contact: Fariba Nikdel Triumph Treatment Services: Services: Parkway Place (Yakima) Contact: Beth Dannhardt (509) 624624-1244 [email protected] (509) 248248-1800 [email protected] Recovery Centers of King County (Seattle) Contact: Darlene Battles Catholic Community Services (Everett) Contact: Marcia Glendenning (206) 568568-8231 (425) 258258-5277 [email protected] Action Associations: Another Chance for Women (Tacoma) Contact: Tommie Cebrun Drug Abuse Prevention Center (Longview) Contact: Gus Nolte (253) 572572-8170 [email protected] (360) 425425-9210 [email protected] CUP Providers Grays Harbor Community Hospital/Eastcenter Recovery Alcohol and Drug Unit (360) 533-8500 Swedish Medical Center/Ballard Community Hospital Addiction Recovery Services (206) 781-6350 Providence General Medical Center/Providence Recovery Program Behavioral Health Services (425) 258-7390 Valley General Hospital/Behavioral Health Services (360) 794-1405 St. Peter Hospital/St. Peter Chemical Dependency Center (360) 456-7575 Acronyms ADATSA CA CUP DASA DDD DOC DOH DSHS FAE FAS FASD FASDPN FAS*FRI FASIAWG FASIS JRA MAA MHD OSPI PCAP PPW SBSM TICM Alcoholism and Drug Addiction Treatment and Support Act Children’s Administration Chemical Using Pregnant Division of Alcohol and Substance Abuse Division of Developmental Disabilities Department of Corrections Department of Health Department of Social and Health Services Fetal Alcohol Effect Fetal Alcohol Syndrome Fetal Alcohol Spectrum Disorders Fetal Alcohol Syndrome Diagnostic and Prevention Network Fetal Alcohol Syndrome Family Resource Institute Fetal Alcohol Syndrome Interagency Workgroup Fetal Alcohol Syndrome Information Services Juvenile Rehabilitation Administration Medical Assistance Administration Mental Health Division Office of the Superintendent of Public Instruction Parent Child Assistance Program Pregnant and Parenting Women Safe Babies Safe Moms Targeted Intensive Case Management