St. Vincent Mercy Medical Center
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Transcript of St. Vincent Mercy Medical Center
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St. Vincent Mercy Medical Center
Healthy Connections SEN Project
Celeste Smith, MA, FLE
Program Coordinator, SVMMC Healthy Connections Program
419-251-2459 [email protected]
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Background on CAPTA
• What does CAPTA mean?
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Background on CAPTA
• Keeping Children and Families Safe Act 2003 Child Abuse Prevention and
Treatment Act (CAPTA)
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Healthy Connections SEN Project
• HC Goal: to improve access to and utilization of mental health services for community-based populations of children, adolescents, and their families through integration of primary health care and behavior health care services.
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Healthy Connections SEN Project
Goal: to increase the compliance with CAPTA requirements in order to maximize child and family social,
emotional and developmental outcomes.
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Healthy Connections SEN Project
Demographics
• Suburban/urban county
• Population approx. 455,055 and 313’620 live in the city
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Healthy Connections SEN Project
Racial composition
• White 77.5%
• African American 17.0%
• Native American 0.3%
• Asian 1.2%
• Other 1.9%
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Healthy Connections SEN Project
Racial composition cont
• Hispanic of any race 4.5%
• Hispanic other 2.2%
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Healthy Connections SEN Project
Objectives:1. Collaborate with 10 maternal and child
serving agencies2. Develop procedures for identification and
referral in obstetrics prenatal, Labor and Delivery, and pediatrics
3. 60% of participating infants will receive needed development and social/emotional services
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Healthy Connections SEN Project
Objectives cont.
4. 75% of participating parents will complete Individual Family Service Plan goals.
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Healthy Connections SEN Project
Project Activities
• Development of policies and procedures
• Training of health care professionals and child protective workers
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Healthy Connections SEN Project
Services for substance using parents
• Assessment
• Education
• Case management
• Parenting Classes
• Infant-parent psychotherapy
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Healthy Connections SEN Project
Target population
• Newborns receiving primary care SVMMC FCC
• SVMMC Labor and Delivery
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A Helping Hand: Mother to Mother
The Massachusetts SEN Project
John A. Lippitt, Ph.D.Project Director, Department of Public Health
617-624-6017 [email protected]
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A Helping Hand: Mother to Mother
• VISION: Substance exposed newborns have the opportunity to achieve their full potential through nurturing caregiving
• GOAL: Enhance identification of and services for substance exposed newborns (SENs), their mothers and families
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A Helping Hand: Mother to Mother
• Growing body of evidence that, except for alcohol, the compromised parenting of the post-natal environment has greater impact on the infant than pre-natal exposure
• Nurturing caregiving and continuity of caregiver(s) are essential
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A Helping Hand: Mother to Mother
• Newborn: infant under 90 days old
• Substance exposed newborn (SEN): any illegal use of a substance during pregnancy
• 3 of 29 Dept. of Children and Families (DCF) offices
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A Helping Hand: Mother to Mother
• Voluntary, complementary, enhanced intervention through DCF
• Integrate child welfare, substance use,
child development, mental health, etc.
• Services are individualized, strength-based, and family-centered, as well as gender and culturally appropriate
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A Helping Hand: Mother to Mother
• Coordinated services through cross-agency collaboration
• Monthly Implementation Team meetings to oversee and coordinate local AHH activities
• Statewide Steering Committee meets every other month
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A Helping Hand: Mother to Mother
Key partners• Dept. of Public Health (DPH): Div. of
Perinatal, Early Childhood, & Special Needs
• DCF: Local Offices & State HQ• Substance abuse (SA): local treatment
providers, DPH Bureau of Substance Abuse Services, Institute for Health & Recovery
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A Helping Hand: Mother to Mother
Key partners (continued)• Early Intervention (EI): local
programs• Parent-to-parent support: Federation
for Children with Special Needs• Mental health, domestic violence• Economic support & housing
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A Helping Hand: Mother to Mother
• Family Support Specialist (FSS): a peer, a mother in recovery
• Engage and maintain mother in substance abuse treatment / recovery
• Support nurturing parenting
• Ensure a developmental assessment of the infant and services if indicated through Early Intervention
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A Helping Hand: Mother to Mother
• FSS meets weekly with mother or even more frequently
• Phone contact and work with family
• Coordinates very closely with DCF case worker: in touch weekly
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A Helping Hand: Mother to Mother
Keys to Identification
• Birthing hospitals and other health care and early childhood service providers
• Identify best practices for SEN identification and response
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A Helping Hand: Mother to Mother
• Good data on SENs are hard to get
• SAMHSA: 3.5% of newborns exposed to illegal drugs
• MA: ~3,000 SENs per year
• Under-reported on electronic birth certificates (125) and to DCF
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A Helping Hand: Mother to Mother
Challenges and Lessons Learned
• Postpartum mothers of SENs often feel overwhelmed by the complex issues facing them
• Engaging these mothers requires persistence, patience, creativity, and hope
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A Helping Hand: Mother to Mother
Challenges and Lessons Learned (cont)• Identification of SEN cases at DCF
and referral to AHH• Communication between DCF worker
and FSS, especially when DCF worker changes
• DCF workers may not appreciate / understand the value / role of the FSS
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A Helping Hand: Mother to Mother
Challenges and Lessons Learned (cont)
• Accessing & coordinating the multiple services / supports needed
• Finding the nurturing caregiving for the infant NOW
• Effectiveness of EI with these families
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A Helping Hand: Mother to Mother
Results to-date
• Pilot site #1: 40 SEN cases, 20 offered and accepted AHH since February 2007
• Pilot site #2: 10 cases, 6 have accepted AHH since February 2008
• Pilot site #3: Hiring FSS
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A Helping Hand: Mother to Mother
Results to-date (continued)• Caseload: 14 – 20 for full-time FSS,
with an average six-month duration
• Cost: average cost per client is $1,800–$2,300, fully loaded
• Client comments
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Four Substance Exposed Newborn Demonstration Projects
COLLABORATION
• Collaboration is a commitment to work together to address a problem and achieve a goal that could not be accomplished by the organizations working individually
• Three degrees: Linkage, Coordination, Full integration (Leutz)
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Four Substance Exposed Newborn Demonstration Projects
COLLABORATION (continued)
• Identify a lead facilitator and a liaison at each agency
• Hold regular meetings of the core collaborators
• Build cross-agency knowledge and relationships
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Four Substance Exposed Newborn Demonstration Projects
COLLABORATION (continued)
• Develop shared language; define key terms
• Establish two-way information sharing among the partners
• Share policies and procedures across agencies
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Four Substance Exposed Newborn Demonstration Projects
IDENTIFICATION• Work to identify pre-natally, at birth,
and post-natally in health care• Screen: interview with a standard,
validated instrument• Test: toxicology tests of mother and /
or baby when indicated• Consistent implementation of
identification and response protocol
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Four Substance Exposed Newborn Demonstration Projects
IMPLEMENTATION• Identify or develop a champion at
each agency
• Get buy-in at multiple levels• Work to consistently implement
policies and procedures
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Four Substance Exposed Newborn Demonstration Projects
IMPLEMENTATION (continued)• Ensure that services that mothers,
babies, and families need are available and accessible
• Know and address legal issues in your state
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Four Substance Exposed Newborn Demonstration Projects
IMPLEMENTATION (continued)
• Engagement of these mothers and families is often a challenge
• Peer worker model has important strengths in building relationship and trust
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Four Substance Exposed Newborn Demonstration Projects
• Ambitious and complex projects
• Work to build collaboration among service systems using a variety of approaches
• Goal is enhanced safety and well-being for substance exposed newborns, their mothers and families