Division of Alcohol and Substance Abuse

1
Division of Alcohol and Substance Abuse

• Pregnant and Parenting Women (PPW) with
• Chemical Dependency Issues
• DASA Services in the Prevention of FASD

2
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.

3
What does 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.

4
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

5
DASA Services

• PPW Residential Chemical Dependency programs
• 10 sites statewide, for a total of 148 beds.
• PPW Housing Support Services programs
• 9 sites statewide, for a total of 143 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.

6

PPW Residential Housing
Support Services DASA Supported Crisis
Nursery ParentChild Assistance Program
Safe Babies Safe Moms (TICM)
PPW Services
Whatcom
Snohomish

King
Kitsap
Spokane
Spokane


Pierce
Grant

Yakima
Benton Franklin



October 2004
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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.

8
Therapeutic Childcare

• Developmental assessment
• Play therapy
• Behavioral modification
• Individual counseling
• Self esteem building
• Family intervention to modify parenting behavior
  and/or the childs environment to
  eliminate/prevent the childs dysfunctional
  behavior
• Parent education and parenting plan

9
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

10
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.

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Other Services

• Parent Child Assistance Program (PCAP)
• Safe Babies Safe Moms (SBSM)
• Parent Trust
• FASDPN
• Iceberg Newsletter
• FASFRI
• CUP
• FASIAWG

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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.

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PCAP Services Include

• Paraprofessional advocacy services for up to the
  target childs 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.

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Safe Babies Safe Moms

• Snohomish, Benton-Franklin, and Whatcom Counties
• 260 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.

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Targeted Intensive Case Management Safe Babies
Safe Moms

• 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/emotiona
  l disorders that prevent them from functioning
  normally in their home, communities, and other
  settings.

16
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.

17
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.

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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.

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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 professionals 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.

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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.

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Fetal Alcohol Syndrome Family Resource Institute
(FASFRI)

• 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.

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FASFRI Activities Include

• Training
• Advocates
• Information and resources
• 1-800-999-3429
• Newsletter publisher (quarterly)
• FAS Times
• Assists with FASD conference planning

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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

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Fetal Alcohol Syndrome Interagency Workgroup
(FASIAWG)

• Established by the Legislature in 1995
• Legislatively mandated state agencies that
  attend
• DSHS (DASA, CA, MA, 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.

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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

26
Additional Information

• Sue Green
• Women/Special Services Lead
• Division of Alcohol and Substance Abuse
• 360-725-3732
• greensr_at_dshs.wa.gov

27
Websites

• DASA http//www1.dshs.wa.gov/DASA/
• DASA Greenbook http//www1.dshs.wa.g
  ov/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/
• FASFRI http//www.fetalalcoholsyndrome.
  org/
• Iceberg Newsletter/FASIS http//www.fasiceberg.o
  rg/
• Parent Trust http//www.parenttrust.org/
• PCAP http//depts.washington.edu/f
  adu/
• Washington State Alcohol/Drug Clearinghouse http/
  /clearinghouse.adhl.org

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PPW Residential Providers
29
PPW Housing Support Services Providers
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CUP Providers

• Grays Harbor Community Hospital/Eastcenter
  Recovery Alcohol and Drug Unit
• [phone]
• Swedish Medical Center/Ballard Community Hospital
  Addiction Recovery Services
• [phone]
• Providence General Medical Center/Providence
  Recovery Program - Behavioral Health Services
• [phone]
• Valley General Hospital/Behavioral Health
  Services
• [phone]
• St. Peter Hospital/St. Peter Chemical Dependency
  Center
• [phone]

31
Acronyms

• ADATSA Alcoholism and Drug Addiction Treatment
  and Support Act
• CA Childrens Administration
• CUP Chemical Using Pregnant
• DASA Division of Alcohol and Substance Abuse
• DDD Division of Developmental Disabilities
• DOC Department of Corrections
• DOH Department of Health
• DSHS Department of Social and Health Services
• FAE Fetal Alcohol Effect
• FAS Fetal Alcohol Syndrome
• FASD Fetal Alcohol Spectrum Disorders
• FASDPN Fetal Alcohol Syndrome Diagnostic and
  Prevention Network
• FASFRI Fetal Alcohol Syndrome Family Resource
  Institute
• FASIAWG Fetal Alcohol Syndrome Interagency
  Workgroup
• FASIS Fetal Alcohol Syndrome Information Services
• JRA Juvenile Rehabilitation Administration
• MA Medical Assistance
• MHD Mental Health Division
• OSPI Office of the Superintendent of Public
  Instruction