Transcript COSA - Florida Alcohol and Drug Abuse Association

Interventions for
Substance Exposed Children
PROGRAMS FOR SUCCESS
Presenters
 Kay M. Doughty, MA, CAP, CPP
 VP, Family and Community Services
 Jackie S. Griffin, MS
 Vice President of Development
 Executive Director or LiveFree!
 Mark A. Vargo, Ph.D.
 Vice President of Research and Evaluation
Workshop Content





Overview
Substance Exposed Data
Development of a Logic Model
Comprehensive Program Development
Program Descriptions/ Evidence Based Practices
 Motivating New Moms
 COSA Substance Abuse Treatment
 Development Center Services
 Parenting Prevention
 Outcomes
Drug Use Trends
Drug Use and Gender Differences
Source: Hal Johnson, MPH, Florida Department of Children and Families, eFORCE Data.
Drug Use and Gender Differences
Source: Hal Johnson, MPH, Florida Department of Children and Families, eForcse Data
Rate of Fetal Substance Exposure
Rate of Diagnosis of Selected Fetal Substance
Exposure per 1,000 Live Births, 2005-2011
10
9.4
Fetus affected by narcotics (760.72)
Neonatal Abstinence Syndrome (779.5)
Either Diagnosis
8
7.8
6
4
2
0
2.0
1.7
1.1
0.7
2005
2006
2007
2008
2009
Source: Hal Johnson, MPH, Florida Department of Children and Families.
2010
2011
Counties With Largest Incidence
County
CY 2007
CY 2008 CY 2009
CY 2010
CY 2011
Total
Florida
536
694
1019
1336
1563
5148
Duval
80
62
118
153
154
567
Pinellas
43
67
92
107
155
464
Orange
36
61
66
100
129
392
Hillsborough
24
41
61
90
124
340
Brevard
27
56
53
78
86
300
Alachua
21
32
63
87
96
299
Hernando
34
39
59
79
74
285
Escambia
51
52
61
52
61
277
Lee
22
26
56
69
75
248
Broward
29
35
48
73
55
240
Selected County Rates of Fetal
Substance Exposure
Number of Births By County
180
160
140
Duval
Number
120
Pinellas
100
80
Orange
60
Hillsborough
40
Brevard
20
0
CY 2007
CY 2008
CY 2009
CY 2010
CY 2011
Source: Statewide Task Force on Prescription Drug Abuse and Newborns, February, 2013 Final Report
Demographics of Fetal Substance
Exposure
NAS Diagnosed Newborns by Race
Black/African
American
6%
White
88%
Other
4%
Unknown
2%
Demographics of Fetal Substance
Exposure
NAS Diagnosed Newborns by Ethnicity
Non-Hispanic
or Latino
92%
Other or
Unknown
4%
Hispanic or
Latino
4%
Post-Partum Care
Disposition of Newborns at Discharge
Home, Self Care
9%
1%
0%
89%
1%
Other Medical Facility
Home Health Care Organization
Court/Law Enforcement (Only
for 2011)
Other
Consequences: Economic Costs
Year
Monthly
Total # of
Average of
children
Children
removed
Removed
# of
children
removed
due to RX
abuse
Monthly
# of
Average of
children
Children
placed in
Removed
licensed
Due to Rx
foster care
Abuse
Monthly
Average
Average Cost
% of
of
Average Cost of
of placement in removals
Children
placement in
licensed foster
due to
placed in licensed foster
care for 12
Prescripti
licensed care per month
months
on Drugs
foster
care
2010*
259
64.8
110
27.5
33
8.3
$13,819
$165,825
42%
2011
888
74.0
265
22.1
96
8.0
$13,420
$161,040
29.8%
2012
1021
85.1
295
24.6
175
14.6
$24,062
$288,750
28.9%
2013*
538
89.7
152
25.3
128
21.3
$42,240
$506,880
31.8%
*2010 data includes only the months of September through December for Pinellas County
*2013 data includes through June for Pinellas County
Source: Eckerd Community Alternatives and LiveFree! Coalition
Consequences:
Neonatal Complications
 Prematurity
 Low Birth Weight
 Infections Diseases
 SIDS
 IUGR
 Failure to Thrive
 Apnea
 Stroke
 CNS Disorders (e.g. spinal infarctions)
 Heart Attack
Signs of Substance Exposure
in Infants
 Withdrawal Symptoms (tremors,
seizures, digestive issues, vomiting,
diarrhea, poor feeding, difficulty
sleeping , high pitched cry, and
inconsolability)
 Easily overstimulated
 Difficulty in self-regulation
 Frequent hiccups, yawning, sneezing
 Myoclonic Jerking and Twitching
 Tight fists, rigid body, stiffening of
arms and legs
Signs of Substance Exposure
in Older Children
 Social Withdrawal
 Aggressiveness
 Impulsiveness
 Language Delays
 Attention Problems
 Anxiety, Depression
 Overfriendliness
 Mental Retardation
The Problem
Many parents in Pinellas County are
using and abusing alcohol, drugs,
and other mood altering substances,
leaving them unable to provide
proper care and supervision for their
children, and in turn results in high
reports of abuse/neglect and children
placed out of the home
The Plan
Goal
To assist
substance
abusing parents
and parents at
risk of substance
abuse in
obtaining
sobriety and
utilizing age
appropriate
parenting skills,
so that their
children receive
appropriate care
Barriers
Strategies
•Parents involved
with Child Welfare
System and Criminal
Justice System
•Treatment
program linked
with Child Welfare
•Mother delivers an
NAS infant
•NICU linkage with
referral to
treatment
•Parents have
inadequate
parenting skills
•Developmental
Services for
Children
•Parents lack
knowledge of
developmental
stages
•Parent
Interaction to
learn age
appropriate
behaviors
•Parents are victims
of trauma
•Effective
Parenting
programs
The Goal
Short Term Outcomes
Long Term Outcomes
Increased level of healthy coping
skills, drug refusal skills,
employment and parenting skills
Verified reports of abuse
and neglect will decrease
Ability to demonstrate improved
parenting skills
Stable Recovery Support System
Children have completed a
Developmental Services Plan
More Pinellas children live
in a stable and nurturing
home environment.
Hospital
Child
Welfare
CPI
Access
Center
Community
FIS (MSS)
MnM
MET/CBT
Seeking Safety
Living in Balance
COSA
COSA
COSA
Parenting
Treatment Developmental Center
ASQ
HELP
Living in
Balance Parent
Parenting Wisely
Strengthening
Families
Nurturing
Parenting
Motivating New Moms
 Motivating New Moms is a program
designed to engage pregnant or
post partum prescription using
mother into services with a
Behavioral Health Consultant with
the ultimate goal of engaging the
mother in substance abuse services
and the completion of in-home
parenting classes
Motivating New Moms




 COMPONENTS
Referrals from Hospitals, High Risk
Pregnancy Centers, Child Welfare,
and Substance Abuse Treatment
Facilities.
In home/hospital visits for
engagement
Nurturing Parenting Curriculum
Referrals to community based
programs
Nurturing Parenting
 The Nurturing Parenting Program
 family-centered initiative
 builds nurturing parenting skills to replace abusive and
neglecting parenting
 The program activities:
 foster positive parenting skills and self-nurturing,
 Provide home practice exercises and family nurturing time,
 activities that promote positive brain development
 Targets all families at risk for abuse and neglect with
children birth to 18 years old.
PAR COSA
 COSA (Cornerstone of Successful Achievement) program
serves substance abusing pregnant and parenting women
and fathers whose infants and preschool children are often
developmentally delayed.
 Day treatment
 outpatient treatment,
 case management
 COMPONENTS
Early intervention
group
continuing care
COSA integrates therapeutic child development into its
treatment model developed from evidence-based studies.
COSA
Substance Abuse Treatment
 Assessment and Admission
 Individualized Treatment Planning
 Group Counseling
 MET/CBT Substance Abuse
 Seeking Safety: Trauma and Substance Abuse
 Living in Balance: Designed for Co-Occurring Disorder
 Individual Counseling
 Parenting Engagement
 Parenting
 Continual assessment for proper treatment level of care
PAR COSA
 PHILOSOPHY
 Holistic approach integrating relationship building
between parent and child.
 Strengthen parent/child bonds
 Acquire effective parenting skills
 Understand the basic principles of child development
 Participate daily in their child's educational activities.
PAR COSA
Program goals:
 Adults will reduce their drug use;
 Adults will demonstrate satisfactory
parent/child interaction
 Children in the Child Development
Center will satisfactorily complete at
least two educational goals on their
Individual Development Plans.
COSA Child Development and
Family Guidance Center
 Priority: Children from birth to 5 years of age with
Parent:
 Receiving services at Operation PAR or
 Has a Child Welfare case plan
 Service Delivery
 After thirty days of admission, ASQ-3 developmental screening is
done to provide a base line measure of skills.
 An education plan is drawn up based on the results of ASQ- 3
Screening
Child Development and
Family Guidance Center
 Service Delivery
 The educational plans are used as a guide for lesson planning to
assure skill practice in areas of deficit.
 Children 0 – 2 years receive the ASQ-3 every 4 months afterward with
children 2- 5 yrs. receiving them every 6 months as a measure of
continued development.
COSA Development Center:
Family Services Worker
 New Parent Orientation
 Monthly Newsletter
 Family Literacy Program
 Commitment To Character
Charge Up
 Family Involvement Hour
 Family to School Liaison
Parenting Wisely
 Presented to parents only for
all age children
 Uses:
 Interactive group dynamics,
 Videos and
 Hands on mock case studies
associated with parenting.
Parenting Wisely
 May also be offered individually
 Intent: Improve parenting skills and
reduce negative behaviors.
Strengthening Families
 Designed for both parent and
youth
 Includes education and
interaction.
 Has separate curricula for
Families with children from
ages six through eleven or
teenagers from ages twelve
through sixteen
Strengthening Families
 Purpose:
 Improve family interaction
 Youth’s self-expression, self-esteem and behavior
Components
1) Separate Parent and Youth Sessions
2) Family Activity Sessions
3) Family Dinner
4) Four In-home Parent Sessions.
Prevention System of Care Discussion
Questions and Answers
Contact Information
Kay M. Doughty
(727)545-7564, ext. 274
[email protected]
Jackie S. Griffin
(727) 545-7268
[email protected]
Mark A. Vargo
(727) 499-7240, ext 204
[email protected]