New York s Statewide FASD Prevention Initiative Presentation

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New Yorks Statewide FASD Prevention Initiative

• Presentation to BFSS Conference
• May 10, 2006
• Margo B. Singer, MPA
• NYS Office of Alcoholism and Substance Abuse
  Services

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New York was one of ten states funded by
Northrop Grumman IT-Health Solutions in November
2004

• Overall Project Goal
• Reduce the number of cases of FASD by
  eliminating alcohol consumption by
  pregnant women

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The Initiative has Two Phases

• PHASE I November 2004 -- August 2005
• Convene a Statewide Task Force
• Conduct a Needs Assessment
• Develop a Strategic Plan, including an
  Implementation an Evaluation Plan
• Funded at 145,000

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PHASE II September 2005 -- August 2009

• Subcontractors will
• Implement plans
• Collect Evaluation data
• Document the Implementation process
• Funding of up to 325,000 for each of four years
  is available

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NYS FASD Project Team

• Located within the NYS OASAS Division of
  Prevention Treatment Services, Bureau of
  Systems Development Public Education
• Margo B. Singer
• Dr. Pat Perry
• Dianne OConnor

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Required Scope of Work

• Five required elements
• Create state-level administrative focus
• Provide for long-term or sustained funding of
  FASD services/activities
• Develop FASD policies procedures
• Integrate FASD Services into service delivery
  system (s)
• Organize ongoing surveillance and evaluation

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The Original OASAS Proposal

• Prevent and reduce FASD Births in NYS by
• Increased outreach, identification referral
• of at-risk pregnant women and women of
  child-bearing years
• Training on FASD for health care professionals
  working with at-risk women and
• Increased awareness by women of childbearing
  years about the dangers of alcohol consumption
  during pregnancy

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Our Identified Target Audience

• Women of childbearing years
• Pregnant Women
• Women at risk for an alcohol problem

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State Rates of Female At Risk Drinking Females
age 18-44 years, Past Month Binge or Heavy
Drinking
Estimated from 2002 BRFSS U.S. average was
14.9, or 8.4 million females
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PIES -- New Yorks 4-Pronged Approach

• Policy
• Intervention
• Education
• Surveillance

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POLICY Statewide FASD Task Force

• Representatives from
• Five State agencies
• Statewide Addictions, Maternal Health and
  Prevention/Treatment Organizations
• Three Intervention Sites (added in Phase II)
• FASD Experts
• Consumers/family members
• Quarterly Meetings in Albany
• Advisory role
• Policy Information-sharing

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Task Force Development of 15-point Program
Policy Action Plan

• Public Awareness
• OASAS-Systems Collaboration
• Surveillance
• Education Training

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INTERVENTION Possible Service Delivery Systems
identified in initial proposal

• AOD prevention treatment system
• Family Planning services
• Community Health services
• Medical services (e.g. OB/GYN services)
• Perinatal Health Networks
• WIC services
• Healthy Families NY Home Visiting Program
• Native American communities

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Task Force Selection of Three Pilot Sites for
FASD Interventions

• OASAS treatment system (Kingsboro Addiction
  Treatment Center)
• Family planning clinic (Planned Parenthood of
  South Central NY)
• Healthy Families NY Home Visiting Program
  (Buffalo Prenatal Network)
• Each site has a different target population that
  varies by level of risk for alcohol consumption
  and effective use of contraception.

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Our Interventions to Prevent Alcohol-
Exposed Pregnancies in NYS

• Motivational Interviewing (based on Project
  Choices)
• Alcohol Screening Brief Interventions (NIAAA)
• Referral to Family Planning for More Effective
  Contraceptive Methods
• Sites are providing FASD educational
  materials to all consumers men and women who
  access their services

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Kingsboro Addiction Treatment Center (KATC),
Brooklyn

• Inpatient 28-day Chemical Dependence treatment
  program
• Also houses a discrete 20 bed womens treatment
  program and a 22 bed womens residence
• Funded by NYS OASAS
• Target population Women in treatment
• 13 state-operated Addiction Treatment Centers
• Intervention strategies Up to four MI sessions
  to reduce alcohol consumption and enhance the
  effective use of family planning (adaptation of
  Project Choices)
• Male patients to watch the Recovering Hope FASD
  and have FASD education session

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Kingsboro Addiction Treatment Center, (KATC)
Brooklyn

• Outcomes to-date
• FASD Training conducted for all clinic staff
• Motivational Interviewing training conducted for
  all clinic staff (by Linda Sobell)
• Patients served between January - March 2006
• Screened 69
• Received Intervention 15
• Received FASD Education 69

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Buffalo-Prenatal-Perinatal Network, Buffalo

• System Healthy Families NY home visiting
  programs
• Funded by NYS Office of Children Family
  Services
• Target population Women at risk for child
  abuse/neglect --program promotes positive
  parenting and healthy childhood outcomes
• 29 program sites (HF is also a national program
  model)
• Intervention strategies Family Support workers
  will use T-ACE screening and MI techniques to
  reduce alcohol consumption (for non-pregnant
  women) and eliminate alcohol consumption (for
  pregnant woman), and enhance the use of effective
  family planning services

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Buffalo-Prenatal-Perinatal Network, Healthy
Families NY Home Visiting Program, Buffalo

• Outcomes to-date
• FASD Training conducted for all program staff
• Motivational Interviewing training conducted for
  all clinic staff (by Linda Sobell) plus
  refresher training
• Patients served between January and March 2006
• Screened 110
• Received Intervention 14
• Received FASD Education 55

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Planned Parenthood of South Central New York,
Inc. Binghamton

• System Reproductive health providers
• Funded by NYS Department of Health
• 59 family planning service sites at 110 locations
• Target population Women of Childbearing Age
• Intervention strategies Alcohol Screening and
  Brief intervention for all women having an
  initial or annual examination referral to
  alcohol treatment if indicated
• CEO wants to implement interventions at all 6
  clinic locations

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Planned Parenthood of South Central New York,
Binghamton

• Outcomes to-date
• FASD Training conducted for all clinic staff
• Alcohol Screening/Brief Interventions training
  conducted for all clinic staff
• Patients served between January - March 2006
• Screened 259
• Received Intervention 64
• Received FASD Education 259

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Initial findings from the Pilot Sites

• Motivational Interviewing techniques fits well
  with a strength-based approach to working with
  families in many problem areas
• Use of Motivational Interviewing can be a
  challenge for traditional addiction treatment
  counselors
• Men and non-child bearing women are also
  interested in FASD information
• Clinicians will become more comfortable with
  interventions over time
• Some women were surprised that their drinking
  placed them at-risk

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EDUCATION Current Efforts

• NACASA American Indian Regional FASD Trainings
• Ten tribal Nations and urban populations
• Any prevention programming targeting Native
  communities must be consistent with their
  culture, beliefs and values
• Subcontractor Native American Council on
  Alcoholism Substance Abuse Inc.
  www.nacasa.org
• FASD Training to WIC Provider Staff
• System managed by the NYS Department of
  Health 110 agency sites serving 100,000 women
  annually

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SURVEILLANCE

• Goal Organize ongoing FASD surveillance and
  evaluation and make recommendations for
  improvement
• Task Force Workgroup Convened in Phase II to
  examine existing surveillance systems
• CMR - Birth Defects Registry
• Statewide surveys to identify Alcohol Consumption
  among Women of Childbearing Age
• Statewide surveys to identify Alcohol Consumption
  among Pregnant Women
• Recommendations to be presented to the Task Force
  in June

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OVERALL Project Challenges

• Oversight of three pilot projects
  simultaneously
• Staff training issues staff turnover, staff
  resistance, etc.
• Integrating a 'best practice' into a clinical
  setting as a non-research project
• Forging new ground e.g.. evaluating what is
  effective contraception
• Working within state government/political
  environment
• Managing Statewide Task Force with very busy
  people!
• Project sustainability/long-term funding

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• Any questions? Contact me
• Margo B. Singer
• NYS OASAS
• Division of Prevention Treatment Services
• Bureau of Systems Development Public Education
• 518 - 457 6206
• 518 - 485 2147 FAX
• Email margosinger_at_oasas.state.ny.us