# Presentation: 640414

## From Shore to Shore: Michigan FASD Task Force Success 

- Cheryl Lauber, MSN, DPA
- Michigan FASD State Coordinator
- Michigan Department of Community Health

- May 2008 BFSS Meeting

## Slide 2

## Vision

- Coming together to address Fetal Alcohol Spectrum Disorders through
- awareness
- prevention
- access to services

## Mission

- To advocate for statewide prevention and treatment
- The Task Force brings together affected individuals, families and multidisciplinary professionals committed to increasing awareness of FASD and improving service delivery systems.
- Decreasing these preventable disorders and enhancing quality of life for affected individuals and their families will lessen the social and economic impact of FASD in Michigan.

## 5 Year Strategic Plan

- Increase awareness of FASD and gain public and private support for decreasing the number of pregnant women who drink alcohol.
- Expand and improve timely lifelong service access and delivery statewide to individuals who have FASD and their families.

## 5 Year Strategic Plan

- Increase identification and diagnosis of individuals who have FASD.
- Improve the education system’s response to students who have FASD.
- Determine and monitor the incidence and prevalence of FASD in Michigan.

## 5 Year Strategic Plan

- Improve the justice system’s response to individuals who have FASD.
- Expand, increase the diversity of and strengthen the Task Force.

## Task Force Development

- Organization
- Parent Co-chairs
- Staffed by state-paid consultant
- Action groups for each major goal meet regularly
- Participation
- State agency representatives
- Advocacy groups
- Parents
- Meeting goals
- Quarterly in Central location – Lansing
- General session + breakout Action Teams
- Communication
- Email list
- Online chat group

## Awareness

- Pre-screening tool
- Training on its use across the state
- Required to be used by prevention projects in local communities
- Wide variety of trainings across the state
- Head Start conference
- Substance Abuse conference
- Local special education offices

## Wayne County Surveillance 

|   | Michigan |  | Detroit / Wayne |  | Linked to SA Tx |  |
| --- | --- | --- | --- | --- | --- | --- |
| Category | Freq | Rate | Freq | Rate | Freq | R/R |
|   |   |   |   |   |   |   |
|  Small for Gestational Age | 74310 | 113.7 | 13132 | 116.3 | 251 | 206.1 |
|   |   |   |   |   |   |   |
|  Birth Defects | 45895 | 70.2 | 13039 | 115.5 | 330 | 270.9 |
|   |   |   |   |   |   |   |
|  Microcephalus | 510 | 0.8 | 172 | 1.5 | 8 | 6.6 |
|   |   |   |   |   |   |   |
|  FAS | 83 | 0.1 | 21 | 0.2 | 5 | 4.1 |
|   |   |   |   |   |   |   |
|  Deaths (2000 - 2004) | 5640 | 8.6 | 1455 | 12.9 | 34 | 27.9 |
|   |   |   |   |   |   |   |
|  Total Live Births | 653666 |   | 112900 |   | 1218 |   |
|   |   |   |   |   |   |   |
| Rate per 1,000 |  |  |  |  |  |  |

## Prevention

- 9 Local community grants
- CDC funding for field testing Project CHOICES in City of Detroit
- SAMHSA funding for Parent–Child Assistance Program in substance abuse treatment programs in West Michigan

## Access to Services

- Continued state funding for 5 Diagnostic Centers
- Multidisciplinary clinics
- Follow Univ. of Washington diagnostic process
- Working on increasing capacity through faculty/student multidisciplinary clinic arrangements

## Specific Barriers to Services

- Under-diagnosis/ misdiagnosis of FASD and co-occurring disorders
- Lack of understanding by providers that FASD is a disability
- Lack of medical coverage
- Lack of services and treatment facilities
- Restrictions on eligibility for services, such as age or IQ
- Difficulty obtaining birth records and medical history in adoption
- Lack of financial resources for medical, mental, and respite care
- Lack of special education resources

- Little resources for child care when seeking substance abuse treatment
- Failure to recognize FASD variety of symptoms
- Ethnic and racial differences
- Parents in rural areas have geographic barrier
- Lack of transportation make appropriate treatment and care difficult, if not impossible.
- Lack of cohesive interaction among treatment systems
- Inadequate support for foster families or caregivers

## Policy Direction

- Dept. Human Services Foster Care/ Adoption
- In 2005 foster care policy did not reference FASD or treatment.
- There was no required evaluation for FASD prior to release for adoption.

## Success

- Memo issued from DHS in 2007
- FASD definition
- Sources of FASD diagnosis at Diagnostic Centers
- Results of a pre-screening for FAS must be included when requesting a pre-ten waiver for placement of children less than ten years of age in residential or institutional settings.
- Recommended including FASD in all worker trainings

## Policy Direction

- Substance Abuse Services:
- block grant funds support services for women, including pregnant women and women with dependent children.
- specialized services are available for pregnant women and women with dependent children.

## Success

- Technical Advisory on FASD Treatment
- FASD prevention should be a part of all substance abuse treatment programs that serve women.
- Complete the FASD prescreen for children that they interact with during their mother’s treatment episode and refer for FASD diagnosis.

## Policy Direction

- Special Education:
- Add a classification to the Michigan Rules for Special Education that includes programs for Neurologically Impaired children
- Self‐contained classrooms in general education schools and allow the children to be mainstreamed as their abilities dictate
- Teachers would receive training to help them understand how to meet the needs of neurologically challenged children

## Success

- In 2002 and 2003, SAMHSA convened 15 Town Hall meetings on FASD.  A Town Hall meeting was convened in Michigan in August 2002.
- 532 individuals testified including:
- More than 200 parents/caregivers
- 140 professionals
- 30 individuals with FASD
- 20 community leaders
- 2006 MCFARES Family Needs Assessment

## Policy Direction

- Criminal Justice System
- lack of awareness about FASD
- offender reentry program to help inmates prepare for release

## Success

- Michigan Prisoner Reentry Initiative
- Pilot project in Washtenaw County
- May be broadened to include other counties

## Parents Prioritize State Task Force Goals

- Prevention
- Training for professionals working with affected children
- Recognition of FASD as a legitimate diagnosis
- Financial assistance for families & adults with FASD
- Screening for at-risk children
- Housing options for adults with FASD
- Social skills training programs

## Thank you!

- There are still many challenges ahead, but many collaborators are working toward more success.