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Climbing Mountains to Increase Diagnostic Capacity in State Systems – Florida’s Experience. Kathryn Shea, LCSW COO, Fl Center for Child and Family Development Sarasota, FL kathryn.shea@thefloridacenter.org www.thefloridacenter.org. Building State FASD Diagnostic Capacity.

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climbing mountains to increase diagnostic capacity in state systems florida s experience

Climbing Mountains to Increase Diagnostic Capacity in State Systems – Florida’s Experience

Kathryn Shea, LCSW

COO, Fl Center for Child and Family Development

Sarasota, FL

kathryn.shea@thefloridacenter.org

www.thefloridacenter.org

building state fasd diagnostic capacity
Building State FASD Diagnostic Capacity
  • Laying the Foundation
  • State FASD Inter-agency Action Group developed in Fall 2000
  • Co-Founders
    • DOH, Maternal and Child Health Office
    • DCF, Substance Abuse Program Office &Family Safety Program Office
  • Holds regularly scheduled meetings
  • Membership includes representation from families effected by FASD and various stakeholder agencies.
building state fasd diagnostic capacity3
Building State FASD Diagnostic Capacity
  • Florida’s FASD State Strategic Plan
  • Level 1: Prevention
  • Level 2: Diagnosis and Assessment
  • Level 3: Intervention
  • Level 4: Life Support/Extended Services
building state fasd diagnostic capacity4
Building State FASD Diagnostic Capacity
  • 2002 - FASD Center for Excellence Town Hall Meeting held in Clearwater, FL
  • January, 2004 - Presented before Gov.’s Drug Policy Council – Dir. of Gov’s Office on Drug Control Policy became a huge supporter
  • May, 2004 - Invited to speak at Florida Drug Summit
    • Governor and Cabinet were present
    • Showed slide of brain with FAS vs. normal
    • Showed video of Seth – (Value of personal story)
building state fasd diagnostic capacity5
Building State FASD Diagnostic Capacity
  • The Florida Center funded a team of five interdisciplinary staff to attend a 2 day training in Seattle, WA on the FASD 4 Digit Diagnostic Code developed by University of Washington FAS –DPN (Diagnostic & Prevention Network) staff
  • Wrote Community Budget Issue Request (CBIR) October, 2004 for $280,000 to develop Florida’s first statewide FASD Diagnostic & Intervention Clinic in Sarasota
building state fasd diagnostic capacity6
Building State FASD Diagnostic Capacity
  • CBIR sponsored in Senate by Sen. Bennett and in House by Rep. Reagan (get local legislators involved and educated on the issue)
  • Endorsed/supported by Sarasota County Community Alliance and Board of County Commissioners (get local community involved and educated on the issue)
building state fasd diagnostic capacity7
Building State FASD Diagnostic Capacity
  • CBIR fully funded by House & Senate and supported by Governor Bush – non-recurring state funds
  • Contract developed with DOH and signed August 1, 2005
  • Gov. Bush recommended in his 06/07 budget an increase to $380,000 of base funding and that it be recurring funds. Senate/House approved. Also approved $75,000 non-recurring to start FASD clinic in Jacksonville, FL. Jacksonville Clinic just awarded FASD Center for Excellence sub-contract.
building state fasd diagnostic capacity8
Building State FASD Diagnostic Capacity
  • Surviving Tough Economic Times
    • This session initially proposed a cut of 50% in base funding of $190,000; with the $75,000 non-recurring eliminated
    • Initiated a huge response to key legislators; activated the Miami community (site of next clinic)
    • $190,000 has been fully restored
    • Additional $260,000 added as a line item
    • Advocacy efforts now aimed at the Governor’s Office
building state fasd diagnostic capacity10
Building State FASD Diagnostic Capacity
  • Leverage Additional Funding
    • Demonstrates sustainability efforts to State Government also “shares the load” between federal, state, local, private investment)
  • Fl Center 07/08 FASD Budget
    • $380,000 DOH funding (recurring)
    • $100,000 Ounce of Prevention Fund of Fl (3 Years)
    • $80,000 All Star Children’s Foundation (Sarasota)-3 grants
    • $75,000 Non-recurring funds from state legislature through another CBIR in FY 07/08
    • $30,000 Sarasota County Government FY 07/08
    • Total FL Center FASD budget for FY 07/08 $655,000
building state fasd diagnostic capacity11
Building State FASD Diagnostic Capacity
  • Goals of FASD Project:
    • All connected/linked to FASD state Strategic Plan
    • To increase statewide diagnosis/identification of young children ages birth through eight with FASD, as early identification and intervention has been determined to be a universal protective factor
    • To provide statewide training to parents and professionals to increase education/awareness of FASD
building state fasd diagnostic capacity12
Building State FASD Diagnostic Capacity
  • Goals of FASD Project
    • To provide intensive intervention services to children with FASD and their families residing in Sarasota County.
    • To seek additional local, state, and federal funding to expand FASD clinics statewide
    • To explore how we might leverage federal dollars through Medicaid and other funding sources
building state fasd diagnostic capacity the vision
Building State FASD Diagnostic Capacity – The Vision
  • Replication of Diagnostic/Intervention Centers in 3 other key areas of state (Jacksonville, Miami,

Panhandle (Panama City/Pensacola)

  • Major public awareness/media campaign funded in part by alcohol industry
building state fasd diagnostic capacity14
Building State FASD Diagnostic Capacity
  • Intensive cross-discipline training focusing on health, juvenile justice, mental health, education, developmental disabilities
  • Evaluation Component to measure outcomes/success of project
  • Approximate budget: $4,620,000
building state fasd diagnostic capacity15
Building State FASD Diagnostic Capacity
  • Diagnostic Process:
    • Using 4 Digit Code (Univ. of WA)
    • Core Team of OT, Speech Pathologist, Mental Health Therapist, Psychologist, Developmental Pediatrician, Child Psychiatrist (on consult)
    • Assessment takes 4 hours
    • Currently conducting 6 clinics a month
    • Diagnostic Assessments scheduled thru July
building state fasd diagnostic capacity16
Building State FASD Diagnostic Capacity
  • Diagnostic Assessments completed in

FY 05/06 = Target 35; Performed 37

  • Diagnostic Assessments completed in

FY 06/07 – Target 70; Performed 73

  • Diagnostic Assessments Target for

FY 07/08 = 84 - Will reach or exceed target

building state fasd diagnostic capacity23
Building State FASD Diagnostic Capacity
  • Intervention Services/Strategies/Protocols:
    • Referrals for additional evaluations if deemed necessary per assessment
    • Interventions/services individualized per child/family needs
    • 89% of children assessed referred for MH services
    • 76% of children assessed referred for OT services
building state fasd diagnostic capacity24
Building State FASD Diagnostic Capacity
  • Intervention Services/Strategies/Protocols
    • 51% of children referred for Speech services
    • 66% referred for neurological evaluation
    • 23% referred to Children’s Medical Services
    • 14% referred for genetic testing/counseling
    • 33% referred for Special Education services
building state fasd diagnostic capacity25
Building State FASD Diagnostic Capacity
  • Intervention Services/Strategies/Protocols
  • 37 children/families received intensive intervention services through FL Center FASD clinic FY 06/07
  • Core Services include:
    • Parent advocacy/support/case management
    • Mental Health services (2 to 3 hours a week)
    • Psychiatry Services (med management)
building state fasd diagnostic capacity26
Building State FASD Diagnostic Capacity
  • Intervention Services/Strategies/Protocols
  • Core Services include:
    • Occupational Therapy Services (2 to 3 times a week)
    • Respite services (3-4 hours a week)
    • Behavioral support in home and pre/school or school (4 to 6 hours a week)
    • Other services as needed
building state fasd diagnostic capacity27
Building State FASD Diagnostic Capacity
  • Intervention Strategies in Progress of Development
    • Specific Parent Skills Training
    • Intensive Behavioral Consultation to pre-schools and schools specific to needs of children with FASD
    • Social skills/problem solving child groups (focusing on pragmatic language, sensory processing, and social/emotional development). Facilitated by OT, Speech, MH practitioners.
building state fasd diagnostic capacity28
Building State FASD Diagnostic Capacity
  • Outcomes to Date for Intervention Protocol: N=37
    • Improved development in areas of social/emotional, adaptive functioning, language, and behavior. Tools used: DAYC, Eyeberg Child Behavior Inventory, OT and Speech assessments (looking at additional tools)
    • Decrease in parent stress. Tool used: Parent Stress Index (Short Form)
    • Parent Satisfaction: 92% of parents reported satisfied/very satisfied with services.
    • 86% of children involved in treatment maintained home or school placements
building state fasd diagnostic capacity29
Building State FASD Diagnostic Capacity
  • Summary
    • Start small – Think Big!
    • Make a personal connection to people in high places. Parent/child stories or real life connections are critical.
    • Educate, educate, educate. Use cost/benefit data to show long term state costs to care for long-term.
    • Have a clear plan of what you want to do and how you want to measure.
    • Involve parents in all steps of planning and implementation.
    • Use multiple funding opportunities.
    • GOOD LUCK!! DON’T GIVE UP!!!