ct keeping infants drug free (k.i.d.) project 5 year ...€¦ · 1 april 2017 ct keeping infants...

1 April 2017

CT Keeping Infants Drug Free (K.I.D.) Project 5 Year Strategic Plan ~ 2016 to 2021

Connecticut’s Keeping Infants Drug Free Program has as its mission to improve the capacity to diagnose, treat and prevent prenatal substance exposure through education, policies and increased coordination of services that engage and support families impacted by substance abuse.

Focus Area: Primary Prevention Through Education

Goal 1: Increase knowledge and expertise among professionals, systems stakeholders, and the community at large about substance use during pregnancy and the effects on infants and children

Area of Concentration: Professional Development

Objective Strategies Action Steps Timeframe Lead Partners Outcome Measures 1: Create a broader understanding of prenatal substance exposure and its effects

Create an operational definition of Substance Exposed Infants to include a broad representation of infants and children

1. Create definition

2. Receive approval from Core Team

Year 1 K.I.D. Early Identification and Screening Work Group

K.I.D. Core Team Definition completed and approved by Core Team

2: Educate target groups/populations about the teratogenic effects of drugs and alcohol during pregnancy

Partner with professional organizations, multiple state agencies and public/private universities to design and provide professional development to target groups/populations including:

community at large

medical providers

social services & treatment providers

schools

higher education programs

child welfare staff

foster/adoptive parents

1. Work with systems partners to research and design CT and target group specific curriculum

2. Provide training to OEC in home services providers, i.e. Nurturing Families, MIECHV Home Visiting Programs and Healthy Starts staff

3. Develop training targeted for teens and young adults; partner with DMHAS Young Adult Services to provide training

4. Partner with DPH SHIP activities to align “messaging” across systems

Year 1 and ongoing

DCF

DMHAS ABH DSS DPH OEC CHCA of CT MothertoBabyCT CT Clearinghouse at Wheeler Clinic CT Women’s Consortium CT Chapters of AAP & ACOG

2 April 2017

Provide professional development across the Child Welfare agency workforce

1. Develop training based on video “Moment to Moment” Pilot test training

Year 1 and ongoing

DCF K.I.D. Training Work Group

# of DCF staff trained

Educate all in-home service programs about SEI and FASD to provide primary prevention through information/education to pregnant and parenting women and fathers; serve as a first line of screening/identification for women and children for further assessment/treatment

1. Attend and provide promotional/educational material at the annual in-home service provider conference: Childhood Conversation Conference

2. Explore use of existing curriculum for adaptation in CT

Year 1 and ongoing

OEC/In Home Services

DCF

# of in home services providers provided with training

3 April 2017

CT Substance Exposed Infants 5 Year Strategic Plan ~ 2016 to 2021

Focus Area: Primary Prevention Through Education

Goal 1: Increase knowledge and expertise among professionals, systems stakeholders, and the community at large about substance use during pregnancy and the effects on infants and children

Area of Concentration: Community Education and Awareness

Objective Strategies Action Steps Timeframe Lead Partners Outcome Measures 1: Increase awareness about "Safe Haven" laws and “Safe Sleep” methods

Leverage existing campaigns and strategies for additional target populations

1. Target Women’s and Children’s Programs, Help Me Grow Statewide Provider Groups

Year 1

K.I.D. Training Work Group

K.I.D. Core Team DCF DPH

2: Raise awareness within the community about the effects of alcohol and drug use before and during pregnancy

Develop a public relations and marketing plan that includes using multiple media sources targeting multiple organizations, i.e. social media, PSAs, newspapers, ads on public transportation, attendances at community events, etc. Ex.: ECHN Network Community Baby Showers, Women’s Expos, Planned Parenthood offices, Spanish language newspapers

1. Explore expansion of the DCF Public Health Campaign

Year 2 DCF K.I.D. Core Team DPH Preconception Health Media Campaign 211/Child Development Infoline

Educate fathers about effects of substance use during pregnancy

1. Partner with “Circle of Security” trained staff to train groups including: DCF; DMHAS staff; OEC trained staff/programs, i.e. Nurturing Families, Child First, Fathers for Life

2. Partner with OEC to provide brief training to their fatherhood groups

Year 2 DCF OEC DSS DOC

Community-based Fatherhood Programs CAFAF

# of fatherhood groups provided with brief training

4 April 2017

Educate youth and young adults in state level and community/school- based programs providing services or treatment to address high risk alcohol and drug use and sexual behaviors

Year 3 K.I.D. Training Work Group

DCF DMHAS State Dept of Education Community/school-based clinics 211/Child Development Infoline CT Strong

5 April 2017


Focus Area: Early Identification / Screening and Assessment

Goal 2: Increase capacity and availability of screening and assessment for substance exposure in infants and children

Area of Concentration: Screening of Infants and Children for Substance Exposure

Objective Strategies Action Steps Timeframe Lead Partners Outcome Measures 1: Build an understanding and consensus about current protocols and practices used to screen infants and children for substance exposure

Create and beta test a survey that includes questions about current hospital and practitioner methods for screening neonates, infants and children

1. Finalize survey

2. Select hospitals and practitioners to beta test survey

3. Explore availability/use of student researcher

4. Develop data collection mechanism

5. Analyze results

Year 1 DCF CT Hospital Assoc. CT Chapters of AAP & ACOG

2: Make the CPS response for newborns testing positive for substance exposure standardized and understandable

1. Include SEI in the DCF policy

being developed for “high risk

infants”

2. Provide a guidance document to hospitals that articulates the CAPTA requirements for reporting drug-affected neonates to CPS, specifies the timeliness of CPS response to a referral for SEI, and engages the hospital as a partner in a plan for discharge and care for mother and newborn

1. Draft and obtain approval for policy

Year 1 DCF CT Hospital Assoc.

3: Ensure early identification of neonates for substance exposure

Develop protocols for hospitals and practitioners that reflect best practices for testing newborns for drug exposure including appropriate consents

Year 1 K.I.D. Early ID & Screening Work Group

CT Hospital Assoc. CT Chapters of AAP & ACOG

6 April 2017

4: Provide support for parents and family members who are parenting children with FASD

Support efforts by a non-profit service provider to reconstitute NOFAS Chapter in CT

Year 1 ABH K.I.D. Core Team

5: Provide support to foster and adoptive families who are parenting children with FASD/NAS

Support efforts by a non-profit service provider to create specialized support groups for foster and adoptive parents

Partner with organizations (CAFAF) already conducting support groups to add specialized support groups

Year 1 ABH CAFAF UCHC Adoption Resource Center

6: Provide greater access to child's medical records, especially for foster and adopted parents, including children adopted through private adoption agencies

Clarify and disseminate DCF policy associated with access to DCF records

Create a one-page fact sheet about laws and regulations for distribution

Year 1 DCF CAFAF Public Act 16-11 grants Bill of Privileges to foster & adoptive parents. March 2017 DCF produced required You Oughta Know: A Caregiver’s Resource Guide to explain rts.

7: Ensure early identification and a continuum of screening of infants, toddlers, children and youth for substance exposure

Encourage screening for substance exposure by pediatricians, family practitioners and community/school-based programs that provide services or treatment

1. Encourage continuation of the use of the Adolescent SBIRT screening tool by DCF

2. Expand use of Adolescent SBIRT across provider communities

Year 1 Pilot program

K.I.D. Early ID & Screening Work Group

DCF DMHAS OEC State Dept of Education Community/School Based Health Clinics

Use existing Child Development Infoline and in-home services as the front line for identification of infants and children with developmental delays that require further assessment


DCF DMHAS OEC/In Home Services, DPH Healthy Starts Program Family Resource Centers Parents as Teachers

8: Increase capacity and availability for assessment and diagnosis of FASD

Explore the use of facial recognition software by additional clinical providers

1. Gather data from other states about use of the software 2. Consult with experts on the research about use of the software with diverse populations

Year 1 DCF MothertoBabyCT MDE Providers

Expert opinions solicited from geneticists in 4 states do not support expanded use of facial recognition software as

7 April 2017

FASD diagnostic tool

Utilize pediatric geneticists to assist with diagnosis of FASD and to provide guidance to concerned caregivers, pediatricians and/or DCF

1. Inform DCF staff of roles and functions of available geneticists and developmental pediatricians using brochures, trainings

2. Inform home visitors of the roles and functions of available geneticists and developmental pediatricians using brochures, training

Year 1 DCF K.I.D. Early ID & Screening Work Group CT Chapters of AAP & ACOG

Promote awareness of existing resources to encourage parents to seek support for developmental delays in their children


DPH “Learn the Signs-Act Early” 211/Child Development Infoline

Teach pediatricians and other family practitioners how to screen for FASD and/or drug exposure

1. Gather data from other states about ways to screen

2. Consult with experts on the research about screening


AAP Guidelines/Strategy for FASD screening

Utilize pediatric geneticists to train teams from the Multidisciplinary Exam provider clinics on how to conduct assessments and develop plans for care with caregivers and others

Year 3 DCF University-based training programs & clinics, Ex.: U of WA FASD Clinic/Dr. Susan Ashtley, Research Triangle/Dr. Erin Telford, Yale Child Study/Dr. Carol Weitzman

Standardized practice within the child welfare population for screening children who enter care for FASD to include record keeping and mining

1. Research existing screening tools

2. Develop and beta test screening tools for use with CW population

Year 3 DCF

MDE Providers

8 April 2017

Expand availability of high-end FASD assessment services through supporting expansion of existing resources or create a pilot program modeled after the University of Washington FASD Clinic; collect data to evaluate concept

Year 5 DCF University-based training programs/clinics, Ex.: University of Washington FASD Clinic/Dr. Susan Astley, Research Triangle/Dr. Erin Telford, Yale Child Study/Dr. Carol Weitzman

Identify age-appropriate treatment methods for children diagnosed with FASD

Gather data and information from other states and programs about “best practices” for providing treatment and services to children diagnosed with FASD

Year 5 K.I.D. Work Groups

OEC DCF DMHAS CAFAF

9 April 2017


Focus Area: Early Identification / Screening and Assessment

Goal 3: Increase capacity and availability of screening for substance abuse with women of child bearing years and pregnant women

Area of Concentration: Screening and testing of Women for Substance Use during Pregnancy

Objective Strategies Action Steps Timeframe Lead Partners Outcome Measures 1: Build an understanding and consensus about current protocols and practices used to screen and test women

Create and beta test a survey that includes questions about current hospital and practitioners methods for screening and testing women

1. Finalize survey

2. Select hospitals and practitioners to beta test survey

3. Explore availability/use of student researcher

4. Develop data collection mechanism

5. Analyze results

Year 1 DCF CT Hospital Assoc. Local Hospitals CT Chapters of AAP & ACOG

2: Ensure early identification of women for substance exposure

Develop trauma-informed, culturally competent and socioeconomically neutral protocols and practices for universal screening to support women’s disclosure of substance use during pregnancy

1. Expand use of SBIRT

2. Provide education on use of the tool and response to women who disclose substance use

3. Align effort with DPH SHIP

Year 2 DHMAS DPH

CT Hospital Assoc. Local Hospitals CT Chapters of AAP & ACOG DMHAS Young Adult Program

Increase the capacity of prenatal care providers and hospitals to conduct substance use testing of pregnant women


CT Hospital Assoc. Local Hospitals DSS DPH

# of women who receive prenatal screening annually

Identify and address gaps in insurance coverage through Medicaid and private providers for appropriate levels of care for pregnant and post partum women

Year 3 DSS

10 April 2017

Use existing in-home services as the front line for screening pregnant women for substance use

Year 3 DCF DMHAS OEC/In Home Services FBR DPH

3: Reduce the negative response by providers to pregnant women’s disclosure of substance use

Educate healthcare providers who care for pregnant women and parenting mothers on psychosocial issues related to perinatal addiction (i.e. trauma, violence, abuse)


DCF DMHAS DPH

Create or utilize existing “health care advocates” to help pregnant women navigate the health care, substance use treatment, and social services systems

Identify existing resources who could serve in the capacity of “health care advocates”, i.e. care coordinators, insurance co. nurse case managers, CT BHP staff


DCF DMHAS DPH

11 April 2017


Focus Area: Access to Services

Goal 4: Ensure that women and their children have access to services/treatment to meet their needs

Area of Concentration: Services for Mothers and Infants

Objective Strategies Action Steps Timeframe Lead Partners Outcome Measures 1: Maximize the use of existing resources available to mothers and their children including: substance use treatment, health care, developmental assessments, and treatment services for children of all ages

1. Use multiple methods to articulate what services are available and how they can be accessed

1. Work with United Way to streamline access to information for pregnant and parenting women

2. Create and distribute a quick card about resources for distribution by health care providers

3. Create and distribute informational packets at women’s prenatal health care services

Year 1 K.I.D. Exec. Implementation Team

DCF DMHAS 211/Child Development Infoline United Way MothertoBabyCT

2. Disseminate referral criteria for Birth to 3 to allow seamless referrals for infants suspected to have been exposed to substances


K.I.D. Core Team OEC Birth to Three

3. Encourage full use of the DPH Birth Defects Registry and Vital Records Registry

Distribute policy memos Year 2 DPH CT Hospital Assoc. CT Chapter of AAP

2: Provide mothers and their babies priority access to supportive parenting and treatment services

Ensure in-home providers can give priority access to pregnant and parenting women and their newborns

Year 1 DCF DMHAS OEC In-home services ADPC – Governor’s Opioid Policy Initiative

12 April 2017

Maximize use of existing substance use treatment resources to ensure priority access to pregnant and parenting women

1. Clarify providers understanding of Medicaid eligible block grant programs

2. Conduct research to better understand private payer system for access to certain levels of care

Year 2 DMHAS DSS DCF OEC ADPC

Support mothers’ engagement in treatment by ensuring quality child care is available where they attend outpatient services, including MAT

Conduct a fiscal assessment on the feasibility of co-locating child care/parenting programs with substance use treatment programs

Year 3 K.I.D. Executive Implementation Team

DCF DMHAS OEC ADPC HeadStart Programs

3: Minimize barriers to health care for pregnant women, mothers and children

Collaborate with other initiatives to ensure that women and their infants/children have quality health care available

Year 2 K.I.D. Core Team

DPH –MICH CHCA of CT

13 April 2017


Focus Area: Using Data to Inform Practice

Goal 5: Gather and use data to understand and plan for the needs of substance exposed infants/children, their mothers and families

Area of Concentration: Data Collection and Analysis

Objective Strategies Action Steps Timeframe Lead Partners Outcome Measures

1: Create a broader understanding of prenatal substance exposure and its effects

Create an operational definition of Substance Exposed Infants to include a broad representation of infants and children

1. Create definition

2. Receive approval from Core Team


K.I.D. Core Team Definition completed and approved by Core Team

Survey hospitals and practitioners about current protocols and practices for collecting and reporting information to: DPH (Birth Records and Birth Defects Registry), DCF (Neonates born Substance Exposed, Children with FASD Diagnosis); and Newborn Screening and Hospital Discharge data


DPH CT Hospital Assoc. CT Chapters of AAP & ACOG

2: Increase hospital reporting to DPH Birth Defect Registry and Birth Registry

Encourage full use of DPH Birth Defects Registry and Vital Records Registry

DPH to inform hospitals and practitioners of their obligations under CT law to submit data

Year 1 DPH CT Hospital Assoc. CT Chapters of AAP & ACOG

3: Create and provide data in a “report card” format using administrative data from multiple venues to better understand the problems associated with SEI, its impact on all affected systems, and how the various systems are responding

1. Identify data currently collected by each agency 2. Collect administrative data from system partners on maternal alcohol and drug use (both illicit and prescription), distinct populations of infants and children (i.e. grouped by ages categories), types of services, and access and use of those services 3. Seek funding for data analysis by a university or other entity

1. Have each agency provide the data they currently collect for a one year timeframe 2. Review data received to build a consensus about what should be reported 3. Use a research-oriented organization to create analysis across systems

Year 2 K.I.D. Data Work Group

DPH DCF DMHAS DSS DDS OEC CT Hospital Assoc.

14 April 2017

4: Create a data sharing agreement across key systems

Convene key stakeholders to determine what data each collects that could be useful, if possible, to share across systems

1. Identify agencies engage in discussion 2. Prepare a draft agreement for review by each agency 3. Finalize the agreement for signature

Year 3 K.I.D. Data Work Group

DPH DCF DMHAS DSS DDS OEC CT Hospital Assoc.

ct keeping infants drug free (k.i.d.) project 5 year ...€¦ · 1 april 2017 ct keeping infants...

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