Substance Exposed Newborn Task Force

9-23-14

Agenda

1. Welcome and Introductions 2. Updates from Last Meeting

a) Statewide SEN Task Force Update – Progress Report b) Court Team Model Update c) Haven Recovery – status of services d) Prenatal Care Update

3. Subcommittee Reports a) Pediatrics b) OB c) Post Partum d) Staff Development/Policy

4. Next Steps 5. Adjourn

Baby Court Team Model Update

• State Court Team Events • Pilot Program – Progress • Next Meeting of the IMH Workgroup

– Monday, 9-29-14 @ 3:00 P.M.

• Other

Haven Recovery Center Update

• Haven’s new name is WINWARD • Number of women in treatment • Challenges • Assistance needed from Taskforce • Staff Changes – Sara Ely is no longer the

contact person. Please contact Connie Hickey • Well Family System is now in use for Haven

Clients • Other

WARM (Women Assisting Recovering Mothers) Update

• Capacity – moms & children – waiting list • Medical – Flagler County Health Department • Training

– SF Continuing

• Challenges – medical component • Culinary coordinating to serve at Daytona

Blues Festival • Other Updates?

Training Availability

• Safe Sleep • Neonatal Abstinence

Syndrome • Cultural Diversity • Bereavement • Parent Leadership • Parent Involvement • Strengthening Families

Overview

• Living the Protective Factors

• Futures Without Violence

• ACES and Trauma-Informed Response

• Interconception Education (10 Modules)

• Risk Appropriate Care

Process & Resources - Pregnancy Mother screens at risk

Discuss SEN risk and tx options*

Negotiate consent

Contact WIS

WIS verifies if in HS system • complete BPS – identify if other Children • link to care coordinator • Staff case for tx and care • coordinate for delivery

Mother signs consent & referral form

Mother declines consent

Track during pregnancy

Re-negotiate consent Screen at time of delivery Provide brochure Contact WIS DCF call

Medical detox case by case

Coordinate with SMA or WINWARD with Healthy Start support

Mama Bear

Coordinate Medical for STI and follow-up

Link to Healthy Start

Treatment Options

Residential – WARM – Bunnell infants and

children on site • After detox ONLY

– HAVEN/ NOW WINWARD – infants and children on site

• Will accept opioid managed pregnant women

– SMA – HAVEN/WINWARD – Other – Subutex management

with OB Coordination

Outpatient • HAVEN/WINWARD • SMA • Subutex or other opioid

management with OB Coordination

Pediatric Subcommittee Goal Statement: All caregivers will be trained on handling

an infant diagnosed with NAS before discharge

• Bio-parents, foster parents, relative caregivers, and other caregivers of substance exposed newborns will be trained at the hospital on handling of newborns and the Finnegan Scoring Guide – status report

• CPC placement/foster care resources are trained in special handling - Integration of NAS/signs and symptoms/handling into foster care training

• Substance exposed LBW and VLBW infants will be referred to CMS, Early Steps for follow-up and Child Find activities – CMS Referral form being used, Dr. Thorpe will accept all infants at Keech for coordination

Pediatric Sub-committee (cont’d) • Substance Exposed Newborns will have “early” follow-up with

pediatrician. NOS is actively working with NICU for follow up with Dr. Thorpe on East side. SEN Staffing form updated. Staffings held 3 x weekly at Halifax NICU. Need support for babies at tx sites.

• Explore research regarding sensitivity of toxicology screens used with newborn sensitivity - completed

• Support Court Team Model and training activities for health and human service agencies about maltreatment prevention and response – Circle of Security training available through A Helping Hand and Lisa Benitez

• Provide information to Circuit 7 to assist with updating of Child Abuse Prevention Plan – info to Susan LeBlanc

OB Sub Committee Goal Statement: Develop an effective program that offers prenatal support and

services for the substance exposed pregnant woman regardless of the dependency at hand.

• Standardize Universal Screening tool for OB providers - 4 P’s Plus Screening Instrument recommended – Training plan needs to be developed

• Develop brief power point to educate OB Providers regarding importance of utilizing universal screening in early pregnancy based on AWHONN and ACOG guidelines – Update – Dr. Carbiener has developed. Schedule Grand Rounds.

• Create a resource guide for OB providers when a positive screen is identified – Draft list to reviewed – add DMTC.

• Educate OB providers regarding the universal screening tool and resources available when a positive screen is identified – develop grand rounds schedule – OB Subcommittee convened in June. Discussed key points of entry and physician resource support

Update • Resource Guide updated. • Grant submitted to HRSA notification of non-

award. We were just advised that our award would be reviewed again.

• WVHA grant approved by Community Advisory Committee for a WIS for West side. Need final approval by WVHA. If approved, effective October 1, 2014

• Deltona City Commission preliminarily approved space in Deltona

Post Partum Sub Committee Goal Statement: Ensure mothers have necessary follow

up care upon hospital discharge • Ensure family planning discussed PRIOR to delivery and post

partum. Provide resources to women • Have the Family Planning Waiver signed by patient – NOS • Send a letter to physicians about performing tubal ligation for

patients – Title X - need Health Department letter • Provide training to providers patients, caregivers and the

community about substance exposure. Training Menu • Provide training about NAS, resources, etc. • Provide training about “how to discuss SENS” with patient –

Healthy Start will provide if hospitals/physicians will request – Career Source can assist with payment.

Update

• What tools/activities can Healthy Start assist with to support Post Partum activities?

• MomCare’s ability to follow up is changing. Tubal ligation referral form needed for Title X

• Update on Newborn Nursery Staffing activities • Haven/WINWARD and WARM Updates for

Post Partum. Any needs from partners?

Staff Development Sub Committee Goal Statement: Our service area will have a community workforce trained in

prevention and intervention for women of reproductive age, pregnant women, and their babies.

• Identify target audiences for training considering points of entry of each targeted population - completed

• Identify learning objectives for pre/interconception, prenatal, post partum, and early childhood (pediatrics) – completed

• Identify existing staff development resources and means of communicating them to partners/community – menu available

• Review feedback from subcommittees about training needs/goals. • Identify various local workgroups that are reviewing related

issues/initiatives – CAPP Plan development, CPC, Court Team, Thrive by Five, ELC, LPT

• Transfer of knowledge from workgroup to workforce – recommend quarterly training opportunities

Next Steps • Sub Committees continue to meet to achieve

objectives. • Training objectives to Staff Development

Committee – schedule “grand rounds?” • Coordinate special clinic at Women’s Care

NOW for substance using pregnant women. • Additional Updates on Resource Guide – • Provide information on training activities. • Other next steps needed?

Questions?

Let’s work together to keep them ALL safe, healthy, and happy!

Thank You!