.... 

\ 

CRACK BABIES: 

SELECTED MODEL PRACTICBS


'YIClS 

OFFICE OF INSPECTOR GENER1 

OFFICE OF EVALUATION AND INSPECTIONS 

JUNE 1990 
. _, 

. . . .

OFFICE OF INSPECTOR GENERAL


Il1issionoftheOffc ofIr1 pe9tor(3eJ1era(OIG) is to promoteeffci ncy. effectiveness, 

and integrty of pmgr~inth Vnite, States Depan ntof lIeaIthand Humarrvces 

(HS). lt does thS by ' yeloping tlb9s () detec Ard prevent!rud. waste. and abus 

Crea YStatutein' 7 6. tary andthe' Congrss lJSptor neralkeeps '.JJththe 

fll11Yandcllntly infof1ed l?utprogror management problems and reoIIends 

tiveaction. 'IeOIqJt1iormjtsrnssion by COJ1dllCtig aU l$, investigations and 

irspedions with approxi elyl.300 sta strategicaly loca 'around the countr. 

OFFICE OF EVALUATION AND INSPECTIONS 

Thine.ponis prouced by the Qfce ofEvaluarlon and Inspetions (OEI), one of th major 

offce withinthe()IG,'The Other tWo mthePfceof Audit Servces (OAS) and the Office 

oflnyestigations (QI). TbeOElconducts ins tions whichartyicallysbon-term stUdies 

designed to detennne progr .effectiven ss. effciency and wlnerabiltyto frud and abuse. 

1Qrepon is descrbes selected IDodel practices which maybe effective in assisting 

clg posebabies dtheirfaries These modls were encountere durg an insption 

tpghoW crack abies ect thech d welf sys Thefmdigs from the Crack 

" Bab $ijspetiol1arcor1 edi. a separte repon, OEI-03-89-01540. 

Thestudyy.as prepar Wlderthe dition of Joy Quil, Regiona Insptor Genera. Ofce 

of Ev uationand Inspetions, RegioIlID. Parcipatig in thsproject wer thefoUowig peple: 

PhiiadelphlaReglon Washington. D. 

JosephG. White. Project Leader Alan Levine 

Lois C Lehmarn 

Lida M. Ragone 

Isbelle Buonocore 

Cyth R. Hasford 

San Francisco 

Cythia A. Lemesh . 

Mahal Schff 

TriciBanniter 

For mor inoration on ths stdy. conta Joseph G. Whte at (215) 596-17. 
, 

CRACK BABIES:


SELECTED MODEL PRACTICES


Richard P. Kusrow 

INSPECTOR GENERAL 

OEI..3-89-01542 JUNE 1990

INTRODUCTION 

PURPOSE 

This repon descrbes selected model pratices which may be effective in assisting 

drg~xpose babies and their famies. 

These modls were encountere durng an inspetion examng how crk babies afect the 

child welfar system. The findigs frm the Crk Babies inspetion ar contaed in 

separte repon.


BACKGROUND 

Durg the Crk Babies inspection. we found that public and private agencies ar strgglig 

to cope with the incrased volume of drg-expose inants and the multiple servce need of 

their famlies. Servces ar provide to fames considere to be at ' high-risk." Some 

indicators of high-risk famy cirumtaces ar poveny. substace abuse. famly disruption. 

and abuse or neglect. 

Agencies identied may servce prblems. Some agencies have prblems providig early 

intervention servces. comprehensive cas maagement, and casworker trg. Study 

respndents ar also concerned about the spe educational nee of these chidrn and the 

lack of interagency coordation. 

In ths repon, we descbe pratices being use by public and prvate agencies. and State and 

local governnts to adss some of these problems. 

The Crak Babies insption found that the problems cause by crk ar inseparble frm the 

larger issue of prenata exposur to other drgs includig alohol. Accordgly. progr and 

procedurs descbe in ths repo ar not lite to those dealg with crk or cocaie 

exposur. 

METHODOLOGY 

We collecte inormtion in 12 metrpolita ar durg the lat qua of 1989. 

Respondents include chid welfar adistrto and cawor, hospita soal servces 

sta. prvate agency reprsentatives. foste parnts, Sta and local offals. and national 

expert. These respndents idntied prgr and prurs which they considere 

effective in assistig drg~xpose babies and their fames. Whe al prgr cite in ths 

repo were contate and most were visite we did not atmpt to assess their effectiveness. 
CATEGORIES OF MODEL PRACTICES 

This repon is a selection of model practices which may be effective in assisting drg~xposed 

babies and their famlies. 

Practices are presented in eight categories: 

COMMUNIT OUTREACH AND EARLY INTERVENTION 

II. COMPREHENSIVE SERVICES IN ONE LOCATION 

II. EDUCATION FOR DRUG-EXPOSED CHILDREN 

IV. CASE MANAGEMENT 

PROFESSIONAL TRAINING 

VI. MANAGEMENT PRACTICES 

VII. INTERAGENCY COORDINATION 

VIII. PRIVATE INmATIES 

More inormtion on these pratices can be obtaed frm contatS liste in the appendi. 
I ' 

I. COMMUNITY OUTREACt: AND EARLY INTERVENTION 

Communty outrach involves going into neighborhoo to find drg abusing women and 

their childrn. The next step is to encourge them to use avaiable medical and socal services, 

Aggressive outrach getS women and childrn to servces they would not othexwise receive. 

Early intervention means identifyig problems in their early stages and providig appropriate 

services in ordr to prevent serious problems. 

The followig four progr provide outrach and/or eary intervention to fames in their 

communities. 

MaternitY Outeach Mobile (MOM) Proiect The is adistere by the Deparent of Human

Servces (DHS). Commssion on Public Health, Offce of Marn and Chid Health. in the 

Disaict of Columbia. The MOM Project conducts early identication and trattent of 

high-risk populations thugh scning. referr. and follow-up. The project i!ta response to 

the high inant mortty rates in the Distrt. 

The MOM tagets pregnant women. parnting women, and inants in high-risk aras. The van 

canvasses neighborhoo, par. and shopping aras lookig for mothers and inants. It also 

taes referr fr DHS and a varety of other soures. 

Outrach workers in the van tr to enrll high-risk women and inantS intO the MOM project. 

The workers then refer women for car to the nearst health center or health car provider. 

The MOM van sta also ta women to appoinnnnts and follow-up to be sur women ar 

using the servces. 

St. Luks/Roosevelt HosDital Center New Yor City. ha tWo prgr with its Community 

Servces for Chidrn and Fames: the Prvention Unit and the FU't Step Unit. Since the 

unitS ar afate with the hospita, their clints have acss to the wide rage of servces offere by the hospita 

The New Yor City Ch Welfar Admtrtion (CWA) contrts with bOth unts and 

provides a lae porton of their fudig. The Firt Step Unit also reeives 2S percent of its 

budget frm prvate sours and foundations. 

The Prvention Unit sees muti-prblem fames, most of whom ar referr by CWA. At 

least 6 of thir 42 fams must be "bor baby" prevention referrs. The unt is stafed by 

soial worer, psychologits, and vo unter home visito. 

The Prvention Unit seks to prvent foste car placment, deas the incidence of child 

abuse and neglect, imve the parnts' abilty to deal with psycho-soc crses. and promote 

the persnal development of parnts and chidrn. The sta assumes cas maagement and 

clical respnsibilty for th famy with personalze coordation strtegies. ,The coo seces includ counselig, crsis intervention, home visits, and parnt hild 

intetion therpy. 
,. ;

The Firt Step Unit serves 24 pregnant teenagers and teenage mothers with infants. Staed by


social worker and volunteer home visitors. the unit seeks to improve parntig skils. reduce 

psycho-soial strss, foster personal development. increas self-estem. and reuce potential 

foster car placement. The home visitors help incras the mother s knowledge of the 

physical and emotional needs of her baby. The sta suppons the mother in "dealing with 

conflct and strsS, and motivate her to consider the choices for her futu. 

The Harbor/UCLA Medical Center in Torrce. Caorna has a Substance AbusinR Mothers

(SAM) Clinic The SAM Clinic provides suppon and car to pregnant women adcted to 

illicit drgs. Eighty percent of the infants born to women attndig the clinic have ben drgfr at bin. The infants have a reuced incidence of prematuty and low-bin weight, 

shoner neonata stays. fewer perinata deaths. and deas nee for foster car as 

compar to other babies born to adcte women not in ths prgr 

Sta include a clic coordnator, periatologist, developmenta psychologit, psychitrt, 

dietician, and nur educator. as well as petrcians. OB-GYN house sta, and certed nure 

midwives. The servces prvide ar prenata car. peatrc car, soal servc. case 

maagement, chemical dependency tratmnt, parnt education. suppo grups. indiviual 

and grup counselig. community outrach. and famy plag. The fundig for these 

servces comes from the county Drg Abuse Prgr and State funds set aside for hospita in 

tagete counties. 

There is also a clinic for childrn of substace-abusing mother th dos developmenta 

testig and assessment. Babies ar followed at 4-month inteal durg their fit year and 

6-month interval thereafte. 

Center for Famly Likin Broklyn, New Yor is a multi-sece agency servg the The 

Sunset Park communty of Broklyn, a por neighbooo of some 98.00 people. 

While its pri focus is to susta chidrn in eir own homes thugh a varety of 

supportve servces. it reently develope a pilot foster famy prgr in which foster 

fames ar matched with natu fams with the sa neighbooo when placement is 

necessar. Suppo by a contrt with the New Yor Chid Welfar A strtion. the 

progr pur is to reuce the trum of separon for chidrn who have to be removed 

to keep siblip together, and to offer mor intensive ses ai towar famy 

reuncation. Af chin ar retued to their parnts, th famy is encourged to rema 

connecte with the Cente for ongoing suppo and risk reucton. The Cente has found 

neighborhoo foste famy homes for 64 chidrn and ha retued 33 to their parnts. 

The Cente's famy servces include individua grup, and famy counlig; psychological 

and psychiatrc assessments; an inant/oder/parnt progr foste grdparnts; 

employmnt servces and job plaement; emergency foo an advocac cliic; and extensive 

school-bas acvities. The lattr include school-age chid car seces at tWo schools, as 

well as tWo ten cente and sum day camp prgr. 
The Center for Famy Life has develope servces that ditly meet the nee of its 

neighborhoo clients. It is involved in developing the community as well as with individual 

and famly clients. This commtment is reflecte in the Center s policy of being available to 

the neighborhoo 7 days and evenings a week. 

II. COMPREHENSIVE SERVICES IN ONE LOCATION 

Central locations offerig comprehensive servces ar a preferr approach for reaching and 

servng drg-addcted women and their famies. Servce nee include medcal car, 

counseling, and social servces. The facilties provide servces dite at the 

multi-diensional nee of drg-afecte famlies. The avaibilty of a varety of services at 

one location maes it easy and convenient for fames to accept seces. 

Descptions of th facilties which provide comprehensive servces to drg-adcte women 

and their childrn follow. 

Marrn LUlher Kinll ir. Hospital in Los Angeles, Caornia is a county facilty where four 

progr ar avaiable for drg-expose babies and their fames. These progr ar pan of 

an umbrell progr caled Shield for Fames. 

The flIt progr Prject Support provides prenata car and outpatient drg tratment 

clients referr priy by the hospita The Caorn Deparnt of Chdrn s Servces 

(DeS) can madate individua parcipation in the prgr by me of a coun orr. The 

county Drg Abuse Prgr provides fu4ig. 

The seond progr High-Risk Inant Follow-up, is a clic th prvides medcal car for 

inants and ensurs they reeive necessar serces. It is for chidrn from 0 to 5 year of age 

who have developmenta nee or ar at high-risk. Chdrn ar referr frm other Shield for 

Fames prgr as well as by DeS, hospitas, and other foste car agencies. The progr 

is fude by the county Deparnt of Health Servces. 

The th progr is Assitace and Relief to Ki (AR), a chid abuse p ject for high-rik 

women funde by the Sta. Upon reommendation frm OC, the coUt ca ordr mothers 

to attnd the prgr The AR progr reives its fundig frm a State-adistere 

Fedra grt for mol progr dealg with chid abuse. 

The foun prgr Edn Inant, aid and Famy Development Cente, consists of early 

developmenta assistace for drg-expose newbos and their fams with spial needs. 

The progr fudig comes frm the Unite Way, DC, and the county Drg Abuse Prgr Edn offer center and home-bas prgr focusg on parnta ski 

development. Mother parcipate in both for a tota of 1 ye. 

The center-bas prgr includes parntig clases, counlig, psychological evaluations, and Cocaie Anonymus metigs. Edn s home-bas prgr includs fuer counseling, 

implementaon of new parntig sk, and application of new maagement skills. It also 

includes famy assessment with an indiviualze tratnt pla develope with famy input. 
Family Health Center in Mi , Florida is a tratment community for female substace 

abusers which allows mothers to keep their childrn with them while attending the program 

The Center offers comprehensive prima car and adction services which include 

outpatient services, day tratment, and residential components. Curntly there are 15 

residential beds, with 25 more being planned. 

The Center receives fundig from the U. S. Depanent of Health and Human Services and the 

Florida Depannt of Health and Rehabiltative Servces. The residential progr lasts 6 to 

9 months, is self-paced and employs a token system. The token system allows patients to ear 

points nee to move though tratment phass. 

The residential progr s goal is cognitive grwt. In adtion to drg tratment, enrollees 

receive vocational trning, tutoring for high school equivalency diploma, parnting and 

nutrtion classes, psychological counseling, AIDS prevention trning, trsitional housing, 

child car, and health car. Women attend physical fimess and an clases, along with 

communty soial events and Narotics and Alcoholics Anonymus metings. 

To gruate, a woma must be employed for 90 days, have $500 saved possess 

facilty-approved housing, and have or be workg towar her high school diploma. After 

graduation, parcipation is reuir in an outpatient program which includes radom drg 

testing. Center sta conduct follow-up if the women do not attnd. 

The Women s Anne in Tacoma Washigton provides trsitional housing for women (and

their childrn) recovering frm drg and alcohol abuse. To live in the Anex, women must 

have attnde or be attnding drg tratmnt and be in school or workg. The Annex 

consists of seven houses with a resident maager and cas maager on-site at al times. The 

sta assist women in seurg servces and resoures they nee to stay drg-fr. 

The houses ar designed to offer a suppove home envinmnt for women and their 

childrn. Servces includ chid car, trspon, reation, and workshops. Women also 

have access to employmnt and education reso and referr inormtion. The women may 

stay as long as necessar to mata drg-fr sobriety and wor towar ,independence. 

More inormtion on Women s Anex is provide in Section vm, Prvate Intiatives. 

II. EDUCATION FOR DRUG-EXPOSED CHILDREN 

Serious conce exist about the futu impact of drg-e~pose babies on school systems. 

Drg~xpose babies ar considere liely to have developmenta, behaviora, psycho-soial 

and learg problems which school systems and prschool prgr wi face. With early 

intervention, may professionals believe these chidrn can be masttam Both progr 

descbe below prvide a strctu educational prgr for preschool chidrn. 

The Los Anieles UniJW School Distrct has a pilot reseh prgr for drg-expose 

chidrn whih uses speal local and State education funds. Since its inception in 1987, 

childrn between the ages of 3 and 6 have parcipate 
The progr tagetS marginal childrn, I.e., those who may ultimately be integrted into 

regular classroms. Childrn ar referr to the progr by the Deparnt of Childrn 

Services, foster parntS, and relatives. Upon referral, the sta perform an initial child 

assessment to detennne if the program is appropriate. The program s initial goals ar to 

develop strategies for teaching regular teachers about the unique nee of drg~xposed 

childrn, and determne if there ar similar characteristics among drg-expose childrn. 

stated in the program manual, "There is no tyical profie of a drg~xposed child, and as 

such, each child must be educate as an individual with parcula strngths and 

vulnerabilties. .. 

Three other program ai are: 

to identi preschool childrn at risk for behaviora and developmenta learing 

problems due to prenata drg and/or alcohol e~posUJ; 

to develop effective strtegies and provide strctu learg experiences to promote 

cogrtive, communicative, psycho-soial and moto development of chidrn prenatay 

exposed and


to faciltate the successful trsition of prenatay expose chidrn to a regular 

education settg or to the least restrctive speial education prgr 

The progr provides morng classes that last 3 hour and 20 miutes for preschool-age 

childrn and full-day classes for chidrn year and olde. The sta include a soial worker, 

psychologist, doctor, and th teachers. Each teacher handles 6 to 8 chin, providig 

consistency and reliabilty thugh day routies. Th approh strngtens a child' 

self-contrl and builds a sense of matery over the envinmnt. 

The chid's home lie is also considere an essenti pan of the curulum; home visits and 

parnt education classes ar conducte When nee the famy is offere menta health 

servces. Parnta confdence and competency ar incras thugh intervention strtegies 

which strngten the positive interation betWeen chid and famy. 

Head Sta is a chi development progr for preschool chidrn frm low,.income famies. 

It is funde by the U.S. Deparnt of Health and Hum Servs, Ofce of Hum 

Development Seces. Prjects ar adtere at the loc leveL 

In reent yea, Head Sta prgr arund the countr re thy ar seg incrasing 

numbers of dysfuctional fames, may with drg abuse prblems. Hea Sta famies may 

have spal nee and experience diculty coping with as of day livig. A number of 

Head Sta progr have crate unque local parerships with menta heath centers and 

chid welfar agencies to adss these problems. A surey of prblems and mol progrs 

is contaed in the November 1989 OIG repon, Dysftina Ftllus in tM Head Stan 

Program: Meeting the Chalenge, (OAI-09-89-0100). 
_

IV. CASE MANAGEMENT

Quality cas maagement can htlp ensur that drg-adcte mothers and their childrn 

receive essential servces. Cas management means guidig fames to servces including 

health car, counseling, physical therapy, drg rehabiltation, parnting classes, and vocational 

trning. 

Two progr which provide both case management and dit servces to drg-adcted 

mothers and their babies ar descrbe below. 

The Center for the Vulnerable Child (CVC) in Oakand, Caorn provides cas maagement 

to high-risk chidrn. Two evc goal ar to "met the heath car, developmenta and socia 

nee of vulnerable chidrn" and to "coordate servces to provide comprehensive car. 

The evc servces ar funde primay thugh money frm private foundations. 

The Chemical Addction Recovery Effons (CARE) Cl is one evc progr The clic 

serves chemicaly dependent women and their drg-expose inants. A peatrcian, nur, 

and therapist/cas maager with specia chemical dependency expertse sta the clic. 

The CAR Clic provides both medical and counselig servces. Medcal servces include 

pediatrc car, developmenta assessment, and parnt trg. Sta spalsts visit homes to 

teach fames about the reovery proess and their inant s development Mothers alo gai 

suppon thugh individual counselig, grup metigs, and famy therpy. 

The cas maager s role adjusts to clint nee. The cas maager may see "as problem 

solver, role modl, advocate, broker, assessor, planer, sece monitor, reord keeper, 

therapist, collabotor, and detective." Furer, the cas maager consults with speiasts and 

communty providers to offer mother and chid a varty of seces. 

The Perinata OUteach Project in Washigtn, D.C. prvis in-home skied nuring, socia 

servces, and prfessional therutic seces to prna an potpar patients and at-risk 

newbos. The Prject seed approxitely 800 clints in 1989. An estite 80 percent of 

the babies served wer frm drg-afecte fames.- The prje is maaged by Chldrn 

Home Health Ca Servces with fudig frm the D.C. Commssion of Public Health, Offce 

of Mate an Chid Heth. Clnts ar referr by local hospita and the Deparent of 

Hum Ser.


Outrach sta rrk mother and child to ensur they ar gettg aduate mecal car. The 

Prject also helps prvent duplication ,and frgmntation of seces to ths high-risk 

population. Sta nurs conduct an average of th to five in-home viits pe month. Durg 

these viits, they teh wOlDn about prenata and potpar car and chid reg. 

The sta counsel individual about educational, fianci so sece, and employmnt 

nee, and assist fames in acssing mecal and foo supplement prgr. They also 

identi progr and ma appropr refeIr bas on individua famy nee. 

T".--
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V. PROFESSIONAL TRAINING 

;f . 

Prfessionals who work with drg-adcted women and drg-exposed childrn have specific 

trning nee. The trning components cited below include recognizing substace abuse and 

identiying the medical and social servces nee of drg-expose babies and their famlies. 

The National Association for Perinaral Addiction Research and Education (NAPARE) has 

develope and disseminated trning curcula for soial servce and health car professionals. 

They have offere to shar this curcula with child welfar agencies and physicians 

associations. Recognizig that professionals often tae inaduate substace-abuse histories, 

NAPARE emphasizs the nee to tae comprehensive substace-abuse and lifestyle histories. 

The curcula includes guidelines for reognzing, assessing, and tratig substace-abuse 

cases. It is designed for physicians, social servce and drg and alohol casworkers, and 

famly cour judges and attorneys. 

The University of Caorn at Los Angeles develope Proiect TEAS (TraininR, Eduation 

and ManaRemenr Skills) to trn workers to deal with the special nee of drg~xpose babies 

placed with foster parnts and relative cargivers. The TES "curculum supprt a 

servce delivery mol which is interdsciplinar in pratice, integency in focus, and holitic 

in its approach towards infant, famy, and cargiver nee. 

Prject TES was funde by the National Cente on Chd Abuse and Neglcct frm Apri 

1986 thugh May 1988. The project has since ben c~pande to include biological parnts 

and is suppone by the Los Angeles County Boar of Supervsors and the Deparent of 

Childrn s Servces. Prject TEAM also has a contrt with thc county to tr physicians 

about issues concerng drg~xpose babies. 

Curntly, thc U.S. Deparnt of Education s Hadicappe Chdrn s Ealy Education

Prgr is fudig an expansion of the prgr to prvi trg and tehncal assistace 

to public and private agencies workg with chemicaly dependent fames in communities 

thughout Caorn The progr crates skied interdscpli team of chid protective 

scrvces workers and public health nurs. These team, tu, help cargivers crate 

healthy, nurg envinmnts for their drg-cxpo inants. 

Traning for th chid proteve worrs and public health nurs lasts 6 months. The fit 

phasc of inuuon concerns the effects of substacc-abuse on the developing fetus, inant, 

child, parntS an cnti famy. Th phas also involves establishig gudelies for 

assessmen intecntion, and interagency collraon. 

The seond phas is a clical component consitig of cas maagcment, individual 

consultaons, and monthy sma-grup consultaons. Tea conduct home viits with 

inants and cargiver. Thc trees alo atnd grup metigs to diuss issues relatig to 

thesc babies an their foste parnts. 

W. ? . :7'" 
,. 

VI. MANAGEMENT PRACTICES 

Severa States and local governments have established maagement practices to improve 

trcking and supervsion of child welfar cases involving drg exposur. These pratices 

include automated centr registres, special drg baby units, and fast trking of the legal 

process. Although severa States and cities have these pratices, only" one example of each is . 

cited. 

Many States have centr registres where child abuse and neglect cases are reponed In 

Florida these cases ar referr to the Deparnt of Health and Rehabiltative Servces 

Florida Abuse ReRisrr was established by Deparnta ditive in October (HS). The 


1988 to provide a single statewide 800 toll-fr number for reportng all suspeted child abuse 

and neglect cass. The HRS regulations reuir centrize reportg of all newborns "who 

ar born to mothers who ar adcte or have abuse drgs durg the chidbearng period" 

The Deparent also reuirs that drg-afecte famlies and substace-abusing pregnant 

women "be given the highest prority in servce prvision. 

The DelJarenl of Childen s Services (DCS) in Los Angeles ha established tWo high-risk 

drg bab untS. The units perform th functions: emergency responsc, custody 

investigations, and famy matenance. They opera on a vercal cas mol, where each 

casworker perform al th fuctions in ord to ensur consistency in case maagement. 

When an inant is fIrt referr DCS intae evaluatOrs usc a spal high-risk intae form. 

When informtion obtaed mets selecte crteri the baby is referr to the high-risk unit 

for asscssment. 

In the unt, soial worker use a speial risk asscssment gude for inants prenatay expose to 

drgs. The gude, along with persnal intervews, aids in determg the inant s placement. 

If the inant canot be saely released to the mother, a custoy petition is fied in coon If the 

chid is alowed to go home with the mother, a famy matenance plan is develope 

A legal pross known as 'fast tracking has ben imlemente in Dad County, Florida 

The proess helps expete the less complex dependency cass thugh the coon system by 

prscbing spc ti slots for chi welfar cass. This results in quicker placement 

deisions. FUt trkig is a cooate effon among Florida' Deparnt of Health and 

Rehabiltave Seces, the Juvenie Justice System. and the Sta Attey Genera's Ofce. 
, 

. ; 

VII. INTERAGENCY COORDINATION

Interagency coordiation is necessar to ensure that services to famlies ar available, 

accessible, and not duplicated. Lack of coordnation among service providers is a major 

problem cas managers face in offering multiple servces to drg-affected famlies. The 

following two program ar using interagency coordiation to adss the issues and 

consequences of drg use in their communities. 

Illnois Model is an innovative interagency coordiate effon to adss the needs of The 

cocaine and other drg-exposed infants. The agencies pancipating in and funding the project 

are the Illnois Depanent of Childrn and Famy Servces, the ilinois Deparnt of 

Alcoholism and Substace Abuse, and the National Association for Periata Addction 

Researh and Education (NAPARE). The th agencies use an education, prevention, 

referr, and coordiated intervention strtegy. 

The Ilinois Modl has "reuced systems barers to integrted servces and ma available a 

full complement of servces to high-risk famlies." The Modl has provide integrted 

medical substace-abuse, and soial servces to over 40 mothers and inants since 1986. 

One of the modl's components is a conf1dntial, tOll-fr "Coaie Baby" Helpline. The 

helpline provides inonntion and referr to individual in five midwestern states. The 

toll-fr number is staed by a peatrcian and peatrc nur pratitioner who refer 

women to clics and physicians for medcal car and drg traannt. 

The agencies have co-sponsore th national trg conferences and develope a national 

newslettr to provide an educational forum about cocaie use and pregnancy. The N APARE 

has also develope curcula to trn medical. soal servce, and substace..abuse 

professionals to reogn, refer, and trat cocaie-afecte inants. 

The Governor s Commsion for a Drull Free Indna was establihed by cxecutivc ordr in

May 1989 to exame Indiana s overa drg prblcm with speia emphasis on local issues 

such as crk abuse. Commssion members have divers backgrunds in youth servces, law 

enforcement, business, education, chid welfar and pro tion servces, medcinc, drg and 

alcohol abus and tratmnt, and othcr soal servces. 

The commsion servcs as an umbrella organzation to suppon local coordation and 

initiativcs in 1b war agait drgs. It trks local fuds. inorm the Governor of local nee, 

and advis locties of Sta legislanvc intiatvcs. 

Fundig is drwn frm a varcty of Fedra and State prgr includig thc Alcohol, Drg 

Abuse, and Menta Health block grt, Cral Justice block grt, Natona Highway Safety 

funds, and Indian s Drg Fre Communties grt prgr 

7"-
.. .

VII. PRIVATE INITIATIVES

Severa progr visited durg the Crack Babies inspection were initiated with private funds. 

These progrs were private sector responses to curnt soial problems. Two of the the 

progrs described now receive some public funding. 

The Women s Annex (previously descrbe) was funde by a local attrney who acquir 

seven houses and renovated them into housing for women reoverig from drg adction. 

Severa of the houses were formrly crk houses. The servces ar funde thugh private 

conttbutions and the Washingtn State Division of Alcohol and Substace Abuse. 

The Children s Home SoCietY of Miam, Florida offers a varety of servces for infants and

childrn to age 18. They provide pregnancy counselig, adption servces, residential foster 

car, foster homes for childrn with AIS, emergency shelters for inantS and childrn, soial 

servces for developmentaly delayed childrn, and grup homes for tens. Their servces 

now under contrt with the Florida Deparent of Health and Rehabiltative Servces. 

In 1986, Burger King, with help frm other local businesses, buit the facty contang their 

adnistrtive offces and an emergency shelter. Funds to constrct the inant center were 

donated by a local foundation. A signcant porton of the Socty s operational costS ar pai 

for with Unite Way funds and private conttbutions. 

The fornia Medical Center in Los Angeles rus a progr caled Rebirth for substaceabusing mothers and their inantS. The progr provides education on maternal drg abuse to 

mothers in hospitas. Rebin also trs cargiver on the spial nee of the 

drg-withdrwig inant A nur conductS follow-up home visitS to check the inant and 

answer any questions. The prgr which reives no publi money, is fude by the 

Caorna Communty Foundation and private donaons. 

. __0" 
. 

/

APPENDIX


CONTACTS: 

I. COMMUNITY OUTREACH AND EARLY INTERVENTION 

Maternity Outreach Mobile Project 

Paaicia Thompkis 

Office of Maternal and Child Health 

Commssion of Public Health 

Deparent of Human Servces 

166 L Stret, NW 

Washington, DC 20036 

(202) 673-4551 

St. LukeslRoosevelt Hospita Center 

Joane Johnson-Hershm 

West 114th Strt and Amterda Avenue 

New York City, NY 10025 

(212) 523-2122 

HaborlUa. Medcal Center -

Substace Abusing Mothers Clic 

M. Lynn Yoneku MD. 

1000 West Caon Strt 

Torrce, CA 90509


(213) 533-3565 

Center for Famy Ute 

Siste Ma Paul DSW 

345 43rd Strt 

Broklyn, NY 11232 

(718) 788-3500 

II. COMPREHENSIVE SERVICES IN ONE LOCATION 

Ma Luther Kig Jr. Hospita 

Xylia Bean, MD. 

12021 South WWngtn Avenue 

Los Angeles, CA 9059 

(213) 603-457 

A- ' VI 
. .. 

Famly Health Center 

Toni Shamplai 

5361 NW 22nd Avenue 

Miam, FL 33142


(305) 637-6400 

Women s Annex 

Jacquelyn Nonnan 

2024 South J Stret


Tacoma WA 98405 

(206) 383-0104 

II. EDUCATION OF DRUG-EXPOSED CHILDREN 

Los Angeles Unified School Distrct


Dr. Phillip Callison 

Assistat Superintendent


Division of Special Education 

450 Nonh Grad 

Los Angeles, CA 9051 

(213) 625-6701 

Head Sta 

Oennie Murhy, Jr. 

Head Sta Burau Associate Commsioner 

O. Box 1182

330 C Strt, 


Washigton, DC 20013 

(202) 245-0572 

IV. CASE MANAGEMENT

Center for the Vulerble Chd 

Neil Haon, MD., M..H

s Hospita Mecal Center 

747 52nd Strt 

Oakan CA 946 

(415) 428-3783 

Perinat Outrach Prgr Lida Mauro 

n ' s Home Health Ca Sers 

111 Mihigan Avenue, 

Washigtn, DC 20010


(202) 939-4917 

n & -, "'-

V. PROFESSIONAL TRAINING ;f . 

National Association for 

Perinata Addiction Research and Education 

Judy Burison 

11 East Hubbar Street 

Suite 200 

Chicago, IT 60611 

(312) 329-2512 

Prject T.


Judy Howar, M. 

UCLA Deparent of Pediatrcs 

Intervention Prgram 

1000 Vetera Avenue 

23- 10 Rehabiltation Center 

Los Angeles, CA 9024-0797 

(213) 825-4821 

VI. MANAGEMENT PRACTICES

Florida Abuse Registr 

Judy Rosenbaum 

Senior Management Analyst 

Health and Rehabiltative Servces 

401 NW 2nd Avenue 

10t Floor, South Wmg 

Miam, FL 33128 

(305) 377-5301 

Los Angeles Drg Baby UnitS 

Gerhar Moland


Chidrn s Servces AdmsU'ator 

Deparnt of Chidrn s Servces 

Exposition Pa Ofce 

3965 Vent Avenue 

Los Angeles, CA 9037 

(213) 730342 

Florida Past Trakig 

Charles Edlstein 

Consultat to the Chef Judge 

Juvenie Justice Center 

330 N.W. 27th Avenue 

Miam, FL 33142


(305) 638-6185 

. . F A- A._- .. i". . - .

:\.

VII. INTERAGENCY COORplNATION

Ilinois \1odel 

nionJ. Association for 

rinJrJ. Addiction Research and Education 

J llJ Y B urison 

11 Elsr Hubbard Street 

Suire 200 

Chicago, II 60611


(12) 329-2512 

Governor s Commssion for a Drg Free Indiana 

Joseph Mils 

150 West Market Stret


Suite 703 

Indianapolis, IN 46204 

(317) 232- 1142 

VIII. PRIVATE INITIATIVES

Women s Annex 

Jacquelyn Nonnan 

2024 South J Stret


Tacoma, WA 98405 

(206) 383-0104 

Children s Home Society 

Mar Louise Cole, Ph. 

Executive Director 

800 NW 15th Street 

Nfan, FL 33136- 1495 

(305) 324- 1262 

California Medcal Center 

Nfnda Ofiano


1401 South Grad Avenue 

Los Angeles, CA 90 15 

(213) 748-2411