F.E.A.T Substance Exposed Newborn Resources Oregon Hospital/Agency
Policies and Procedures Oregon and Federal Legislation State Workgroup Lane County Workgroup


State Workgroup - Meeting Minutes

February 26rd, 2008

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Participants : Alan Garland, Lesa Dixon-Gray, Cyndi Durham, Kris Funk, Diane Lia, Tedra Mandell, Bob Nickel, Teri Schultz, Liz Twombly, Jay Wurscher

  • Updates on Lane County Workgroups
    • Hospital Policy (Bob Nickel)
      • This workgroup's most recent hospital risk assessment and algorithm will be posted on the FEAT website. The workgroup hopes to begin piloting these new procedures this spring.
      • The question arose of whether each hospital has a nurse from DHS to help with planning for children. Terry Schultz says this is a unique role with a separate contract for DHS assessments. Babies are discharged so frequently from hospitals that it is often difficult to get a nurse there in time. The service is inconsistent across the state; some hospitals have this service and others do not. The presence of the service depends on whether the local area will use service, and whether they have nurse who apply for the position. The service is used frequently in Portland , for example.
    • Prenatal Pilot (Kris Funk)
      • This workgroup is focused on creating materials for a pilot in screening and brief intervention at Lane County prenatal practice.
      • Diane mentioned new study on link between poverty/stress and developing fetus. Tedra also mentioned link between first trimester trauma and schizophrenia. Diane also mentioned link between alpha waves and ability to deal with stress. Alcoholic men showed no alpha waves. When they could impact this, relapse rate went way down.
    • SEN Team/Postnatal Supports (Liz Twombly)
      • SEN Team: This workgroup meets at hospital when SEN identified at birth and consists of Hospital Social Workers, DHS Staff, Treatment Staff, Medical Staff, etc. The purpose of this group is to gather as much information as possible and makes decisions in SEN's best interest. A new, monthly SEN Team Review process is in place to look at how the process is going and make changes to the process as necessary.
      • Postnatal Supports: The postnatal support workgroup is looking at compiling information on the variety of postnatal supports that are currently in place for caregivers of SEN, and how to enhance/increase access to those supports.
      • Liz explained that one issue has been an inability to access nursing services for SEN being placed in foster care. Cyndi said that conversations are happening at higher levels about the need for Public Health nurses.
      • Diane said that ITRS monies are available for women who are addicted and have no OHP, have lost their children and thus their OHP. The Oregon legislature gave $3 million for residential and $7 million for outpatient treatment for these women. Some children have been lost to foster care, others are with mom. AMH is controlling this money, giving fudning to counties who then work with CAF counterparts to create a plan for allocating monies to treatment providers and wrap-around services. Generally, this money is directed more towards the mom. However, in Clatsop County , some of the money is going to Circle of Security projects. To access this funding, talk to the County Mental Health Provider in Lane County -the director should be able to tell us how to get the money and who's using it. Sandy Moses would know who the CMHP is.
    • Collaboration with HBHC
      • FEAT hosted a joint community meeting with the Healthy Babies, Healthy Communities initiative (HBHC-the Lane County fetal-infant mortality project) in January and plans to host another in May. This joint meeting structure enables both groups to reach a broader community audience. FEAT is also collaborating with HBHC in developing community education strategies and defining and developing community resources for impacted families.
    • FEAT Grant Years 4 and 5 :
      • Liz briefly reviewed plans. FEAT plans to spend Year 4 of our grant disseminating is work in Lane County and Year 5 disseminating across the state.
    • FEAT meeting with Rob Bovett.
      • Bob Nickel updated on recent meeting between FEAT staff and Rob Bovett, president of the Oregon Alliance for Drug-Endangered Children. OADEC, a 401C3, emerged out of the Governor's Task Force on Meth and the edcuation this group did across the state around the issues of meth labs. Rob suggested OADEC may be able to serve as an umbrella for future SEN-related grant-funded efforts.
  • Agency Updates
    • Diane Lia announced an upcoming national gathering to discuss about women's treatment standards.
  • Potential Policy Issues
    • The group discussed potential policy issues and considerations, as listed below:
      • Focus on changes that would become stable over time-such as policy changes, staffing changes, etc. so that training follows that change.
      • Find an advocacy group to provide support needed for legislative change-such as group of doctors etc.
      • Include any agency that will be impacted so that they're not blindsided by any changes.
      • Focus on surveillance/data collection so that we can approach the legislature with prevalence statistics. Training and intervention are important priorities, but monitoring is very important. (Liz asked Lisa and Cyndi to pinpoint what we'd be looking for in terms of things we'd like to monitor or "report on.")
      • Consider how to sell any proposed legislation to state (e.g. provide studies that show how much money is spent or saved by prevention).
      • Highlight the issue across the spectrum. Look at prevention with kids across the age spectrum.
      • Rick Caddy-new prevention manager for AMH.
      • Alan is still working on getting CAPTA referrals in place. In terms of monitoring referrals from CPS and hospitals, we might be looking at reporting issues. There is currently no mandate in IDEA for screening, so if child screens out, don't necessarily get screened again in timely way.
      • DHS Child Welfare scores went down on the recent federal review and they now have to complete the PIP (Performance Implementation Plan). Pieces of our priority list fit with the PIP. Jay will get the PIP to us so that we can look at overlaps. The interface between DHS and Part C is a particular area of overlap.
      • Also, at end of May DHS will be bringing together all providers with dependent beds. FEAT should present to that group. Focus in on those in agencies who work with kids. Jay is contact person for this as well.
      • Diane -AMH is looking at screening and brief intervention with all populations, across the spectrum. Especially emphasizing physicians and screening.
  • 4 Statewide Meth Grants
    • Jay Wurscher provided information about the four existing Oregon Methamphetamine grants awarded to collaborative efforts in the following areas:
      • Multnomah County : This project is focusing on intervening with parents through the court process. Parents are offered drug & alcohol services before going to court. The project includes parent mentors (recovering folks who have lost kids and got them back) outreach workers, drug & alcohol screening, and efforts to provide treatment more quickly. The grant amount was $3.7 million
      • Jackson County : Funding for this project went to On Track, an existing treatment program for men, women and families. On Track plans to use part of their funding for construction.
      • Klamath Tribes : uncertain
      • Baker City : Project funding will be directed toward treatment expansion, intensive outpatient treatment, and parent mentors.
  • Next meetings
    • The 2nd week of May appeared to be the best time for most people. FEAT Staff will send out an email planning for the next meeting.

October 23rd, 2007

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Present : Kristin Funk (FEAT), Sid Gardner (NCSACW, by phone), Diane Lia (DHS, Addictions and Mental Health), Bob Nickel (CDRC/FEAT, by phone), Stephanie Stafford (CAPTA Grants Coordinator), Liz Twombly (FEAT), Karen Van Tassel (Healthy Start), Jay Wurscher (DHS Child Welfare)

  • Introductions/Announcements
    • FEAT's Lane County workgroup received a community award from Lane County Commission on Children and Families. FEAT Staff received the award at the Western Oregon Women's Conference in Eugene last week.
    • Diane Lia reported that the Office of Family Health chose not to apply for the Northup Grummon grant for FASD related monies due to complications with the grant requirements.
    • 4 Oregon counties (Multnomah, Baker, On Track ( Medford ) and Klamath Tribes) were awarded federal Methamphetamine Partnership Grants. It will be important for FEAT to touch base with these groups when they convene. Sid suggested finding out whether any of the groups will be focusing on SEN-related issues. Sid's group (NCSACW) will be providing technical assistance for these grants.
  • Update on Lane County Workgroup
    • Kris, Liz and Bob reviewed the Lane County workgroups work and proposed system plan (Lane County SEN systems map). The three major components of this plan are as follows.
      • Birth hospital pilot: FEAT hopes to implement a pilot at Sacred Heart Hospital and potentially McKenzie-Willamette in January. This pilot will include a standard risk assessment and consistent guidelines around urine testing for both mother and baby.
      • Prenatal pilot: FEAT hopes to implement a pilot with Peacehealth OBs in Eugene that involves universal and comprehensive prenatal screening, education and referral for pregnant women.
      • SEN Team (SEN Scenarios)
    • Diane Lia asked about the 4Ps Plus and FEAT's reasons for considering this tool. She is participating in the Women's Commission on Alcohol and Drugs. One of the topics that Diane would like to propose to the Commission is t posting recommended screening tools online.
      • Sid Gardner said that that the 4 Ps Plus was researched on 79,000 women.
      • Sid also said that while urine tests identified 2% of using women, verbal interview identified 20%.
    • A question was raised about whether CPS alerts hospitals and prenatal providers when they are aware of pregnant women who are using.
      • Jay Wurscher reported that when CPS receives a report of a pregnant women who is using, they can't open a case, but do send alert letters to area hospitals that a woman who is using will be delivering in a certain timeframe and that CPS wishes to be alerted when the woman delivers.
      • Jay also said that this does not interfere with HIPPA, because HIPPA states that following HIPPA guidelines must not interfere in any way with appropriate referring of child abuse.
    • SBIRT: Diane Lia referred to the SBIRT (Screening, Brief Intervention, Referral and Treatment) that is being implemented in WA state. With the SBIRT, onsite Certified Alcohol and Drug (CADC) counselors conduct substance abuse screening with all people coming to the ER. The counselors are hired by the hospital and are part of the hospital staff. Although the transition to this model took time, Diane reports that doctors love the counselors and that they are very effective with the women as well.
      • Workgroup participants raised concern for Hospital Pilot of whether women will be screened while they are in for labor and delivery, as this is a chaotic time for women and stressed the importance of training personnel who will be screening women.
    • Safe Care Plan: The group discussed necessary components of safe care planning for SEN and families
      • Jay Wurscher will set up a meeting in Eugene with Stacy Daeschner, Kelli Augustadt and FEAT staff to discuss the possibility of contractualizing the ART (Addiction and Recovery) Team's work with the SEN Team, as well as other DHS-related issues, such as the need for new coding for SEN-related referrals.
      • Sid reminded group that under CAPTA a safe care plan should include referral to Part C services. Stephanie reported that in OR Child Welfare workers are at 21% compliance with referrals to Part C. Lane County was one of the better counties in this regard.
      • Cocoon and Babies First are potential home visiting resources for these infants and families
      • Sid suggested looking at what NJ is doing in terms of follow-up and referral. FEAT Staff will follow up.
      • Recent legislation has allocated funding for CAF (Children, Adults and Families) clients who are at risk or already involved with the child welfare system due to addiction. Some of these clients will be admitted to alcohol and drug treatment even though they they have lost their OHP card because they have a child in CPS custody. This money will be used to provide intensive and residential treatment.. CPS and treatment providers are required to have case management and recovery mentors for these women.Intensive Treatment and Recovery Services is the name of the program.
  • Review Priorities identified by State Workgroup
    • Group briefly reviewed priorities from last meeting (FEAT State Workgroup Priorities draft)
      • Sid suggested adapting Priority #6 to read "Identify gaps in programs for children of substance-abusing parents targeted on the special developmental needs of these children." (Originally read "Develop range of programs.") This will be a more manageable priority.
      • Sid also suggested adding hospital referrals to Priority 8, so that we will monitor both referrals from Child Protective Services and from hospitals.
      • Sid also reaffirmed the need to draft a narrative that gives an overview of the problem, a summary of our matrix of available programs and services and that outlines our priorities and the legislative issues we are surfacing. FEAT Staff will draft this narrative.
    • Group began looking at state agencies responsible for priority areas. DHS, ODE, Hospital, OMA and OHSU may all be involved in Priority #7: "Monitor all children aged 0-2 referred by Child Protective Services and hospitals under the provisions of the 2003 amendment to IDEA and CAPTA."
    • Stephanie Stafford will email FEAT Staff information about the 14 areas of CAPTA funding. The CAPTA funding is very small and a lot of it is dedicated to internal DHS projects.  There is a new process where our advisory committee reviews the recommendations for this funding source which is then passed on to our CAF Assistant Director.  It's possible that we may be able to submit a request  for  SEN/FEAT-related projects, however the request may not be included on a list for final approval.  There is no guarantee that it will be funded.
  • Future Alliances
    • Group briefly discussed possibilities for FEAT State Workgroup to partner or merge with other existing state level workgroups or task forces.
    • Diane Lia suggested that we consider writing a policy-option package for whatever area we want to focus on. One possibility is for funding to implement Dr. Chasnoff's prenatal screening program statewide. One option is to partner with another group within DHS in writing a policy option package, though outside groups sometimes have a better chance of getting bills passed. The deadline for submissions is in February.
      • Diane will find out from Karen Wheeler the procedures for policy option submissions. FEAT Staff will follow up with this.
    • Diane Lia mentioned the Governor's Task Force on Alcohol and Other Drugs as a possible partner for FEAT
    • Karen Van Tassel spoke about Partners for Children and Families as another possible partner for writing a policy option package. This state workgroup is mandated to collaborate and includes administrators of many of the agencies that FEAT is attempting to collaborate with as well. The Early Childhood Counsel is a subgroup of the Partners for Children and Families. Karen suggested that FEAT present to this group as avenue toward partnering with the Partners for Children and Families.
      FEAT Staff will contact Karen to get list of people involved in these groups.
  • Dates for upcoming Meetings
    • FEAT Staff will email workgroup participants to set future meeting dates.

July 10, 2007

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Participants: Stacy Daeschner (DHS CW), Jay Wurscher (DHS CW), Diane Lia (DHS Addiction and Mental Health), Stephanie Stafford (DHS CAPTA grants coordinator), Liz Twombly (FEAT), Sid Gardner (NCSACW), Kris Funk (FEAT), Jane Squires (Project FEAT), Bob Nickel (CDRC Pediatrician), Project FEAT), Lesa Dixon-Gray (DHS Office of Family Health), Joan Baccus (Project Director, NARA NW), Hannah Jordan (Mental Health Provider, NARA NW), Teri Shultz (DHS Foster parenting program)

  • Announcements / Updates
    • FEAT Staff shared highlights from SEN/AIA Grantees Conference in Berkeley . The conference was helpful in providing information about forming and sustaining collaborations, as well as giving FEAT Staff a sense of what the three other grant-funded SEN projects (in MA, OH and CO) are doing. The projects in CO and OH are focused primarily on providing supportive services to pregnant women and their families, while the Denver , CO project, like FEAT, is focused on more system-wide changes in policy and procedures.
    • Diane Lia attended a women's treatment conference in Vermont in June. Women's treatment standards will be created across the county and will include national outcome standards.
    • Joan Baccus, Project Director for Raising our Seventh Generation, NARA NW provided an overview of NARA NW. NARA NW is a treatment program that serves Native American families with substance use issues. The program incorporates culturally appropriate services such as "Sweats" in their treatment programs for native families.
  • Data Matrix.
    • FEAT staff have been continuing to input data into the "SEN 5-point data matrix " Liz provided a brief update on some of those additions. To view the matrix to date, please go to: (SEN 5-point data matrix)" Following are a few of the additions:
      • 1st point of intervention.
        • Independent Learning Program contractors help educate ILP students-preventative program
        • Oregon Department of Education-schools encouraged to use evidence based curriculum that includes effects of substance exposure on children
        • CARES Northwest-active outreach prevention program out of Portland
      • 2nd point of intervention-in prenatal period,
        • providers report concerns to DHS, bulletins sent to area hospitals as a "heads-up"-state policy
        • WIC-screens during pregnancy but difficult to extract data
      • In addition, the following was discussed in relation to the SEN 5 point-data matrix.
        • Lesa Dixon-Grey mentioned an Intensive Case Management System that is operated through DHS Office of Family Health (we should find out the details of this and add to the data matrix).
        • Teri Shultz mentioned a new, state-wide program (?) operating through DHS child protective services where babies who are in state custody can receive an assessment by a nurse while in the hospital (prior to placement). (we should find out the details of this and add to the data matrix).
        • Teri Shultz also mentioned that the state will be working toward providing guidance to CPS foster care programs (such as requirements for training, etc)...but that other issues are pressing at this point.
        • There was a discussion regarding how to get real numbers regarding prevalence of the SEN problem. Sid Gardner shared that California did a double blind study on babies to determine the extent of the problem.
  • Oregon Laws.
    • Lesa Dixon Grey recently forwarded FEAT staff a document created by the Women's Law Project outlining state's legislative responses to the issue of substance use during pregnancy. This document was reviewed by the group. (Oregon SEN Legislation)
    • Sid Gardner commented that he was struck by how many laws are currently on the books in Oregon . Some of these laws are being more fully implemented than others (e.g., Treatment programs in Oregon do prioritize pregnant women). Other legislation, particularly those with no $ behind them may be less implemented.
    • Lesa Dixon-Grey questioned when these laws were enacted.some may have been in the early 1990s.there may have been some efforts begun, and then discontinued.
    • Diane Lia said she would talk to Karen Wheeler about the legislative requirement to form a committee within DHS to study the issue of substance use during pregnancy. (See section in Oregon SEN Legislation document regarding Oversight Committees, Task Forces, Research)
    • Sid Gardner commented that there may be a need for a legislative oversight committee. As a group, we may want to identify a legislative champion who could go to the Appropriations committee and ask for a progress report on the status of this legislation.
  • Collaboration Surveys and Prioritization Process
    • FEAT staff compiled Collaborative Capacity Instruments received from state workgroup participants over the past few months . 8 people completed the Collaborative Capacity Instrument; 7 responses were tallied. Kris shared the compiled results of this survey. (Oregon Collaborative Capacity Instrument summary)
    • Kris also reviewed a draft of potential state priorities that FEAT staff compiled based upon initial survey results.
    • Sid Gardner provided a brief history of the Collaborative Capacity Instrument evolved from a general tool that measured the status of collaboratives, to how state collaboratives are operating as it pertains to substance exposed newborns.
    • Sid Gardner commented that it was important to look at categories where participants responded "nothing yet," as well as where they indicated important efforts or identified priority areas. "Nothing Yets" may be areas of potential priority as well
    • FEAT Staff provided summary of Lane County workgroup efforts in terms of screening and changes to hospital policy.
  • State workgroup priorities.
    • After a brief discussion of the initial priority areas presented by FEAT Staff, workgroup participants agreed to the following draft list of priorities for the state workgroup:
      • Develop a statement of shared principles among the key state agencies working with the problem of SEN.
        • Joan Baccus commented that she hoped we would not take too long on this priority (and not get to other work).
        • Jay Wurscher stated that developing this statement is a key first step for buy-in and important for engaging higher level administrators and ensuring their commitment
      • Agencies involved with the SEI issues identify the major policy areas of consensus and disagreement created by our different mandates and perspectives on the problems of AOD use, prenatal exposure, parenting, and child safety.
      • Continue to view prenatal exposure to alcohol as being as important as prenatal exposure to illegal drugs.
      • Develop a statewide protocol for prenatal screening that is accepted by hospitals, maternal and child health providers, private practitioners, and child welfare agencies.
        • See Oregon Legislation related to SEN handout. This protocol, as well as training is addressed already. Need to follow-up on where this is at.
        • Lane Co. workgroup working on this issue. Should have a pilot project in the next year.
        • Jackson County working with Ira Chasnoff on a grant to implement a study related to this as well.
      • Develop a statewide protocol to ID substance use @ hospital level
        • Bob Nickel shared work from Lane County workgroup on a protocol that will be implemented at Sacred Heart in Eugene in the next year.
      • Define substance use for Oregon (Should we use Oregon legislation's definition, that states that "within Oregon's set of statutes dealing with the treatment of pregnant drug users, "substance" has the meaning of "controlled substance" as defined in Oregon, but also includes "alcoholic beverages or other substances with abuse potential." )
      • Develop a range of programs for children of substance-abusing parents that are targeted on the special developmental needs of these children.
      • Become familiar with national models of prevention and intervention for SEI-affected children.
      • Monitor all children aged 0-2 who are referred from child protective services agencies under the provisions of the 2003 amendments to IDEA and CAPTA.
      • Require Community-wide accountability systems or "report cards" are used to monitor SEI issues with specific indicators measuring progress for public review.
    • At future meetings group will refine draft of priorities and give consideration to low-cost actions as well as to steps that can be easily completed by individual agencies without workgroup participation.
  • Exposure, future alliances, next steps for project.
    • There needs to be a process in place to bring more exposure to our FEAT state group
    • The project is beginning to develop some impressive written work, including the State wide data matrix, Priorities, etc.
    • Sid Gardner suggested that putting this together, with potentially a 2 page summary of FEAT project, direction etc. would be then good to share.
    • Who needs to see our compiled information?
      • DHS cabinet-Bob Nikkel, Ramona Foley, Bruce Goldberg
      • Meth Task Force
      • Oregon Meetings: DEC, Substance Abuse
      • Legislators?
  • Next FEAT State Workgroup Meeting
    • October 23 rd , 2007.

April 17, 2007

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Participants:

  • Sudge Budden ( Emmanuel Hospital , Oregon Pediatric Society)
  • Stacey Daschner (DHS Child Welfare)
  • Lesa Dixon-Gray (DHS Office of Family Health-FAS Project)
  • Cyndi Durham (DHS Office of Family Health)
  • Kris Funk (FEAT Project)
  • Sid Gardner (National Center on Substance Abuse and Child Welfare)
  • Jim Ledbetter (OHSU, Child Development and Rehabilitation Clinic)
  • Diane Lia (DHS Addictions and Mental Health Division)
  • Catherine Luby (U.S. Department of Health and Human Services, Children's Bureau)
  • Tedra Mandell (Oregon Commission on Children and Families/Healthy Start)
  • Marina Merrill (Oregon Department of Education, Part B and C)
  • Bob Nickel (FEAT, OHSU, Child Development and Rehabilitation Clinic)
  • Jane Squires (FEAT, University of Oregon Early Intervention Program)
  • Theodora Tsongas (DHS Public Health)
  • Liz Twombly(FEAT, University of Oregon Early Intervention Program)
  • Karen Van Tassel (Oregon Commission on Children and Families/Healthy Start)
  • Jay Wurscher (DHS Child Welfare)

  • Introductions
    • Participants introduced themselves to group. Diane Lia of DHS Addictions and Mental Health Services and Marina Merrill of the Oregon Department of Education are new to the FEAT State Workgroup. Sid Gardner from the NCSACW was present to facilitate parts of this meeting. He will be providing technical assistance to FEAT staff and will assist in facilitating the ongoing FEAT state planning process.
    • Jane Squires gave a brief introduction to the FEAT project for newcomers (Powerpoint presentation)
  • Overview of Oregon Data and Programs
    • Liz Twombly reviewed matrix compiled by FEAT staff with contributions from State Workgroup participants of Oregon Programs and available data at Five Levels of Intervention, along with recent trends data and local county data.
    • Participants provided additional information and raised relevant questions. This information has been inserted into the working draft matrix.
      • Additions are in green font.
      • Questions or missing data is in red font.
      • Assignments of data to be collected is in blue .
    • Bob Nickel said that there is a methamphetamine research project at OHSU involving memory deficits associated with methamphetamine exposure in 9 to 11 year-old children. Diane Lia said that the DHS office of Addiction and Mental Health has also been working with the researcher on this project.
    • The issue was raised about whether doctors should be able to make CPS reports prenatally, when a pregnant woman is using drugs but before a child is born. Participants raised concern about whether this would inhibit women from accessing prenatal care. Sid suggested that we create a discussion item around the possibility of changing CPS policy. He suggested that we look at the body of national literature about whether screening practices would actually drive women away, suggesting that in actuality this is not the case.
    • Diane Lia reported that there is a good chance that current law that absolves insurance companies of responsibility in cases involving alcohol will be rescinded. She will send more information on this. She also suggested that is it likely that the state will be passing new substance screening measures in trauma centers.
    • Diane also suggested that it is important that define what a data year is (calendar vs. fiscal) so that we are all tracking data in the same way.
  • Overview of National Legislative and Policy Choices
    • Sid Gardner from the National Center on Substance Abuse and Child Welfare (NCSACW) gave a review of activities across multiple states.
      • He talked about the 5 Level of Intervention. These intervention points are supposed to fit together. From before a baby is born into adulthood, we're accountable for all of those points as a system. The five points help to frame the discussion about substance-exposed newborns. We are ahead of most states simply through our attempts to look at the whole picture.
      • State are currently doing partial, pilot-oriented things:
        • A few states are moving toward universal prenatal screening
        • Very few are talking about universal hospital screening
        • Some states are looking at the college population
      • The CAPTA requirement for referral for developmental assessment is not being taken seriously in most places.
        • How much has hospital referrals to CPS increased?
        • How much has referrals from CPS to Part C increased?
      • There is new money for CPS for meth and regional partnerships. Over $40 million is available in individual grants of $500,000 to $1 million per year.
  • Discussion of data and feasible policy choices
    • Sid suggested that we consider the following questions/input as we consider feasible policy choices:
      • What do we agree about as a group? What are the priority areas we want to address? We should think in terms of
        • No-cost changes
        • Low-cost changes
        • Serious cost changes
      • A collaboration without shared outcomes will have no payoff. We need a unified "score card."
      • We have to continue our conversation about prevalence. Legislators want to know numbers. We can extrapolate from national numbers when necessary. 10-12% is a defensible rate in terms of substance, though the number can jump to 15-18% with really good screening. The data we have right now is so awful that even slightly better data is a leap into the future. Don't let the perfect be the enemy of the good .
      • How do we define SEN? This question was raised by Lesa Dixon-Gray and it is something for us discuss. Are we including alcohol and tobacco in our definitions of substance exposure?
      • We need to develop a budget that costs out what is being spent on state programs. This information will speak to legislators.
      • We need to set 4 to 5 priorities. Lists won't do anything. A list of 35 priorities will just sit there.
      • Questions to consider:
        • Do we agree on the size of the problem?
        • Should we do a self-assessment?
        • Do we agree on the effectiveness of the ongoing programs and how we will measure their effectiveness?
        • Do we agree on priorities (no-cost, low-cost and significant cost)?
      • Sid said that low dosage programs don't work. It's better to do high dosage programs with fewer clients, even though this isn't popular with legislators.
    • Group Discussion
      • Diane Lia is the Coordinator for Women's Treatment for DHS-AMH. She is going to the National Meeting soon and would like information on state legislation from Sid to bring to the meeting
      • The Governor's Task Force on Underage Drinking and the Governor's Task Force on Methamphetamine were suggested as possible participants in this process.
      • The Governor's Task Force on Underage Drinking and the Governor's Task Force on Methamphetamine were suggested as possible participants in this process.
      • Jay Wurscher suggested that we need to get upper administration buy-in.
      • Sid said that we should not be afraid to point out how long substance-exposed kids stay in the system. A lot of budgets are impacted by these issues: highway patrol, Early Intervention, etc.
      • The group discussed our plan from here and how and when we should invite upper administration involvement. Sid suggested that we:
        • Complete the matrix , remembering that it will never fully be complete. We should attempt to get as much information as we can at this point in time.
        • Engage in a prioritization process. We could begin this process before the next meeting by sending something out to all participatns.
        • Once we know our priorities, we can then bring additional players into the process . These players may add information or tweak our priorities, but it's important to have them established first.
      • Sid also suggested utilizing a Collaborative Capacity Instrument, created by NCSACW to assess statewide interagency collaboration around the issue of substance-exposed newborns. Sid will forward this document to FEAT staff.
  • Next FEAT State Workgroup Meeting
    • FEAT staff proposed Tuesday, July 10 th for our next State FEAT meeting.
    • The group discussed the merits and challenges of using a video-conference format for the next meeting. There were advocates both for trying the video-conference format and for gathering for another face-to face meeting. FEAT staff will explore the options and report back to the group.

January 23, 2007

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Polycom Participants:

  • Portland: Sudge Budden, Bob Nickel (FEAT), Sig-Linda Jacobsen, Theodora Tsongas, Cyndi Durham, Jim Ledbetter
  • Medford: Jim Shames (Medical Director, Jackson and Josephine Counties), Lillian Koppleman (Health Care Coalition of Southern Oregon), Judy Willingham (On-Track Home Program), Barbara Northrup (On Track Home and Dads Programs), Wendy Sharp (On Track)
  • Eugene : Kris Funk, Karen Lawrence, Jane Squires, Liz Twombly, Misti Waddell (all from FEAT)
  • Salem : Jay Wurscher (DHS Child Welfare), Stacey Daschner (DHS Child Welfare), Tedra Mandell ( Oregon Commission on Children and Families/Healthy Start)
  • Irvine , CA : Nancy Young and Sid Gardner (SAMHSA)

  • Introductions/Updates
    • Bob and others gave introduction to Polycom technology. Salem site had technical difficulties and connected by phone. Nancy and Sid also called in from Irvine by phone.
    • Nancy Young and Sid Gardner of NCSACW ( National Center for Substance Abuse and Child Welfare) will be providing Technical Assistance to the state FEAT workgroup. They have provided assistance to other states who are working with issues related to substance-exposed newborns and have interviewed.
    • Sudge Budden commented that there has been very little difference in alcohol and drug use from 1999 to the present, which she finds very discouraging given the money that is being spent in this realm.
  • FEAT Project
    • Bob Nickel gave a brief history of FEAT State Workgroup and its focus (powerpoint presentation) including an update on activities of FEAT Staff and Lane County Workgroup
      • Lane County Planning Group
      • Meeting with Governor's staff
      • Meeting with Office of Family Health
      • Meeting with Governor's Meth Task Force: Bob Nickel has met with the Governor's Meth Task Force, and they are very interested in forming a formal partnership with FEAT. The Task Force historically has had more of a criminal/law enforcement focus, but is now beginning to focus on drug use in general and on the needs of children and families. They will be introducing new legislation in 2009, at which point the FEAT project could be prepared to provide guidance into how that legislation is presented.
      • Cyndi Durham discussed how we may be able to learn from the drug endangered child (DEC) protocol process-which successfully developed protocols across the state related to DEC-Jay Wurscher mentioned that there was financial incentive behind the development of these protocols (always helpful!)-however, if the state group moves forward in developing protocols related to SEN, it would be a good idea to connect with the DEC group for guidance related to statewide protocol development.
    • FEAT Recommendation for quarterly state meetings
      • Discussion of dates and times. Proposed date for next meeting: April 17 th
      • Discussion of State Workgroup goals and format
        • Discuss recommendations for small workgroups: Data, Protocols, Training, Policy, Other?
  • Data presentation/discussion (Sid Gardner)
    • Sid stressed that it's importance for
  • Jackson County Perinatal Task Force Presentation (Lillian Koppelman and Dr. Jim Shames of Southern Oregon)
    • Perinatal task force started in 1989. In 1999 expanded and brought together broad range of individuals interested in perinatal issues. Consists of Obs, Pediatricians, Neonatologists, Nurses and representatives from community agencies. They engage in a very broad range of issues related to perinatal period. They are looking critical issues regarding substance-exposed newborns: how do we identify women who are at risk for substance use during pregnancy, how to do we decide upon/create an adequate screening protocol.
    • The On-Track program does interevention Because On-Track ( Medford ) has a nice residential program, they have the capacity to put the pieces together from identification to treatment.
  • Announcements
    • Ira Chasnoff will be in Roseburg , May 11 th , 2007. FEAT Staff will post additional information on the FEAT website.
    • 16th National Conference on Child Abuse and Neglect: Protecting Children, Promoting Healthy Families, and Preserving Communities Portland , April 16 th -21 st
    • Substance Use and Brain Development: Impacts and Interventions , Eugene , March 22-24, Lane County Public Health
  • Next FEAT State Workgroup Meeting
    • Liz will send out several possible dates to the larger workgroup, along with an agenda for the next meeting. FEAT Staff will make phone calls to encourage participation.

October 17, 2006

Printable version (opens new window)

Present :
Cyndi Durham, Kris Funk, Tedra Mandell (Healthy Start), Liz Twombly, Jay Wurscher

  • Announcements / Updates
    • Liz gave brief update on Oregon Pediatric Society (OPS) panel: A Focus on Meth. Liz, Jay Wurscher, Jim Lace, Grant Beardsley and Carol Chervenak provider overview for OPS of issues related to SEN.
    • Kris and Tedra gave an update on Ira Chasnoff's Workshop: Impact of Prenatal Substance Exposure on Infants, Children and Families which took place in Medford last week.
      • Dr. Chasnoff provided participants with several research articles. FEAT staff will seek permission to post these articles on the FEAT website or otherwise make them available for those who are interested.
      • Dr. Chasnoff's research suggests that many of the screening tools commonly used by prenatal providers have not been proven effective with pregnant woman. His own copyrighted tool, the 4 P's Plus, has been shown to be affective. He is willing to work with states to implement systems related to Screening, Assessment, Referral and Treatment. FEAT Staff is following up with him about potentially working with the Lane County Workgroup
      • Dr. Chasnoff stressed importance of setting up community referral and treatment system prior to implementing a screening plan and suggested that having a central referral number is most effective.
        • The group discussed the status of Oregon 's 211 info-line and whether this service is adequate. FEAT Staff will investigate further.
      • Tedra reported Dr. Chasnoff's assertion that paraprofessionals are most effective at screening and suggested that Healthy Start home visitors might be good
    • Jay raised questions about the proposed tax on beer and wine that will for substance abuse treatment. The group discussed whether it is appropriate for the FEAT Project to support this legislation, given our federally funded status and if so, how. FEAT Staff will look into this issue.
  • AIA Noteworthy Policies and Practices related to SEN
  • Update on Lane County workgroup: Kris and Liz gave brief update on the Lane County Workgroup and the areas they are currently working on. Refer to FEAT website for details of workgroup progress
    • Liz reported that a FEAT Lane County sub-workgroup hopes to establish a multi-disciplinary SEN-Team that will help make decisions about recently identified SEN. Group hopes that SEN caregivers will receive medical record/notebook that will travel with the child and provide information about medical history, treatment etc.
      • Cyndi Durham reported on a similar program mandated in WA. The Passport program mandates that medical records become part of the CPS record. Cyndi also has heard of a group in Oregon that is seeking grant funding to develop a similar medical record program. Cyndi will find out more information about this and pass it on to FEAT Staff.
    • Kris talked about a FEAT Lane County sub-workgroup that hopes to conduct focus groups with moms at Willamette Family Treatment Center in Eugene to glean information about their experience of prenatal care, hospital care and CPS. Jay said that he also could identify additional parents to survey for this purpose.
    • Kris also mentioned an interest in doing a public education campaign related to substance us in pregnancy. Cyndi said that Lisa Dixon Grey of the Fetal Alcohol Syndrome Surveillance Project is currently working on a Public Education Campaign regarding alcohol and pregnancy. Cyndi will provide FEAT staff with Lisa's contact information.
  • FEAT website update
    • Liz alerted group to FEAT website updates and asked them to look at the website and to alert FEAT Staff to any SEN-related resources that are not already listed. http://eip.uoregon.edu/projects/feat/
  • State meeting Format / Participants
    • Group discussed current meeting format and structure. There seemed to be agreement that the State Workgroup needs to further define its focus and goals. The group discussed focusing more on developing and proposing SEN-related legislation, potentially starting with effective models from other states.
      • Group mentioned a legislative focus on funding for treatment or on screening guidelines/recommendations for prenatal providers.
      • Jay recommended Rob Bovett an attorney and the head of Narcotics Enforcement Legislation. Rob is skilled at writing legislation and may be a good resource to the FEAT Project. Jay will contact Rob to ask him if he is willing to speak to or work with FEAT.
    • Group discussed importance of making legislators and others aware of the FEAT Project.
      • Jay also suggested that FEAT be in contact with Governor's Task Force on Meth. He provided a list of Task Force Members to the FEAT Staff. Jay will find out more information about how a connection between FEAT and this task force should happen, and whether FEAT staff should attend a task force meeting.
      • Group discussed inviting Senator Floyd Prozanski to a FEAT Workgroup. FEAT Staff will follow up on this.
    • FEAT Staff will explore best formats and develop a plan for future state meetings.
  • Next FEAT State Workgroup Meeting
    • Liz will send out several possible dates to the larger workgroup, along with an agenda for the next meeting. FEAT Staff will make phone calls to encourage participation.

July 18, 2006

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Present :
Sudge Budden (OPS Emanuel/OHSY Prov), Carol Chervanak (ABC House), Kris Funk (U of O), Sandra McIlhenry (PSU Child Welfare Partnership), Paula Michaud (FEAT CPS Liaison), Bob Nickel (CDRC/OHSU), Ruth Stroemple (Medical Foster Care Providers Trainer), Theodora Tsongas (DHS-Public Health Division), Liz Twombly (U of O), Karen Van Tassell (Oregon Commission on Children and Families), Karen Wheeler (DHS-OMHAS)

  • Introductions
  • Announcements
    • The Marion County Sheriff's Office is sponsoring a 2-day seminar on the Physiological Impacts of Methamphetamine. The conference will take place on August 14 & 15 at Chemeketa Community College . For more information, contact Nicki Prather @ 503-588-8557 or nprather@co.marion.or.us
    • The Oregon Pediatric Society will be conducting a panel on SEN and FEAT on September 29 th at Eagle Crest. Bob Nickel, Jim Ledbetter, Carol Chervenak, Jay Wurscher and Liz Twombly will sit on this panel.
      • Jim Lace suggested that Kim Vesco (Ob-Gyn) might be a good person to include on this panel.
      • What do we want the working pediatrician (nurse, PA etc.) to take home with her/him?
        • Can't be all medical information
        • identification of SEN
        • testing issues
        • What happens when a child goes to Child Welfare
        • What resources are available in ongoing working groups
        • How to support foster parents with the care of these difficult children
        • Address ongoing developmental/behavioral issues of these children, including the impact of emotional neglect
        Have resource table with information about SEN, effects of drug use etc.
  • Overview of FEAT Project:
    • Liz gave a brief overview of FEAT for newcomers.
  • Update on Lane County Workgroup/discussion
    • Workgroups : Kris and Liz updated on Lane County Workgroup history and the aim statements that have been created by the smaller workgroups. More information on those aims can be found on the FEAT Website
    • Care Notebooks : Carol attended a recent meeting where folks talked about the importance of having a Nurse Care Manager at the hospital level to complete a Care Notebook for SEN who are released from the hospital, someone individually knowledgeable. Notebook could include information for foster parents/parents on how to make appointments etc. This coincides with work being done by the FEAT Communication and Leadership Workgroup in Lane County .
    • Foster Care : Possibility suggested of identifying specific foster parents to take care of SEN
      • Currently, a DHS workgroup is looking at training foster parents to meet needs of these children
      • DHS has a Methamphetamine Response Team which is currently creating a status report on how meth affects DHS services. Foster care is a particularly important piece of this data. Karen Wheeler will bring a draft of this report to the next FEAT meeting.
    • Attachment Issues: Could State workgroup address the issue of attachment by advocating that CPS only take child as a last resort?
  • Data : Discussed importance of compiling all available data sources in order to see what's happening in the area regarding substance use and SEN.
    • Hospital/DHS data: Things are only coded if they're written in hospital records. Data is only as good as medical records. The same is true for DHS records. Important to looks at sources of data around the state and to talk to social service staff who have better information that hospitals and doctors.
      • We looked at 2004-2005 statewide hospital data reporting SEN births. Numbers are surprisingly low.
      • One reason for this may be that insurance companies are not obligated to pay for substance-related services, and thus SEN births are not being coded as such.
    • Survey: we discussed the possibility of creating a survey to collect information on available state-wide SEN-related data.
      • Karen Wheeler suggested including a formal survey re: policies and procedures; suggested that a goal of this FEAT Workgroup could be to have a statewide recommendation about how hospitals, DHS and other agencies keep SEN-related data.
      • We need to get a sense of what is really happening with meth: levels of addiction, number of SEN etc.
  • State Community Resource Mapping: Workgroup reported on SEN-related resources of which they are aware:
    • Available resources
      • DHS
        • Training for foster parents on working with substance-exposed children in toddler years
        • Ongoing foster care training for foster parents, adoptive parents and relative foster parents
        • Training on meth-exposed children
        • Information on foster parent training can be found at www.cupsalem.pdx.edu/foster/
      • Partners for Children and Families State Implementation Team for State bIl555
        • Initiative for social and emotional well-being of children.
        • Motivational interviewing (Healthy Start)
        • Thinking of working with TANF Population
      • Charles Martinez (OSLC) is doing research on substance abuse and child attachment
      • Cyndi Durham informed us of Caring For Babies with Prenatal Substance Exposure , a resource available to Public Health Nurses via a CaCoon sponsored web page that was created in Canada . Liz will forward a link to this resource to all FEAT meeting participants and will put a link on the FEAT website.
      • Karen Wheeler mentioned the following projects of the DHS Office of Mental Health and Addiction Services:
        • Starting Early Starting Smart
        • Residential Treatment for moms and babies
      • Karen Van Tassell provided copies of family stress factor screening tools used with families in Healthy Start.
      • Ira Chasnoff, M.D. and Richard F. MCGourty, Ph.D. have written I Am Concerned: A Brief Intervention for the Primary Prenatal Care Setting. This manual for prenatal providers gives guidelines for a brief, nonthreatening, inexpensive and beneficial substance use and abuse intervention for women in prenatal care. Liz has a copy of the manual and accompanying video. They can be purchased from
    • Needs :
      • Need training for parents on alcohol spectrum disorder and how to work with these children.
      • Website for folks to access different categories of resources/what's happening statewide re: SEN
      • Bob suggested conducting a statewide resource survey in the following areas:
        • Training
        • Data Sources
        • Websites (resources)
        • Task Groups
        • Legislation (DEC)
        Policy
    • Additional Resources : Please send any additional resources related to SEN to FEAT Staff ( ltwombly@uoregon.edu or kristinf@uoregon.edu )
  • Next Meeting
    • Tuesday, September 19, 12-2

April 4, 2006

Printable version (opens new window)

Present :
Stacey Daeschner (DHS/Child Welfare-Policy), Cyndi Durham (Public Health-Babies 1 st ), Liz Twombly (U of O), Kris Funk (U of O), Bob Nickel ( Eugene CDRC), Laura Spivak ( Oregon Poison Center , Dept of Emergency Medicine, OHSU), Paula Michaud (FEAT CPS Liaison), Anna Cox (DHS Data Manager), Kent Johnson (MetroLab)

  • Introductions
  • Overview of FEAT Project:
    • Liz gave a brief overview of FEAT for newcomers
    • Bob suggested asking Sudge to recommend someone to serve in her stead while she's out of the country.
  • Update on Lane County Workgroup
    • Kris and Liz updated on Lane County Workgroup history and what happened at last meeting (see March meeting minutes from Lane County Workgroup)
    • Cyndi suggested contacting HMOs to access Ob-Gyns and Midwives of OHP clients for participation in FEAT.
    • Cyndi stressed the importance of focusing on Best Practices in Lane County Workgroups rather than setting goals and priorities based upon personal passions.
  • Medical Testing/Laboratories
    • Bob's report
      • Bob has discovered that the tests used/ordered by hospitals are not consistent across hospitals.
      • Peacehealth routinely orders a specific level of test
      • Question is whether doctors are currently ordering what is most helpful.
      • If FEAT advocates for change or increased consistency in testing, we could also create an educational component to help facilitate this change.
    • Kent Johnson (MetroLab): Kent had a lot of information for us; following are some of the highlights
      • Urine screens can be inaccurate and should always be confirmed
        • Kent told story of situation in London to illustrate this: THC (marijuana) was consistently showing up in newborn urine screens at a particular hospital. When 40 positive screens were sent to the lab, only 1 had confirmed THC; the rest showed no sign of THC. It turned out that the hospital was using Johnson's Baby Wash on the baby after birth. This product was creating a positive result for THC after the baby was bagged. The lab involved did not disclose this information. Legacy is currently informing hospitals not to wash an infant's peri-anal area with Johnson's Baby Wash before bagging the baby. Kent also emphasized the educational responsibility of the lab.
        • DHS does get confirmations on positive UAs; Legacy does this in most parts of the state. DHS will request a testing level of 20 for children who are coming out of an environment where meth is being used. DHS is trying to increase statewide consistency in terms of the test levels ordered by worker. Workers know they need to order down to 20 if the lab will to it, and that they need to order a test as soon as possible.
        • Bob ideally would like the screen to over-identify and then allow lab confirmation to rule out rather than the opposite.
      • Testing
        • Meconium Testing: Legacy is currently preparing to be able to test meconium. Meconium is easy to get, but it takes longer to obtain test results, usually 24-48 hours or up to 72 hours for a positive. This can be an issue for hospitals who need the results before the SEN is released. Legacy is working on efficiency and hoping to reduce the window to 48 hours.
        • Legacy needs to know from hospitals what drugs are most important to screen for/monitor. Are they interested only in the major drugs of abuse, or in others as well?
        • Currently the two major Lane County hospitals will only to meconium testing on a negative screen if they suspect the mom is using meth.
        • Peacehealth is also not using GCMS screening; Legacy is asked for this only about 10% of the time.
        • Liz raised the question of who needs to get this information about lab testing? Hospitals? The Legislature? The Governor?
    • Laura Spivak's Survey of Labs:
      • Laura is about to begin surveying labs across the state regarding their process of testing children for meth exposure. She will begin her survey in the next month, pending IRB approval from OHSY. The survey questions she plans to ask are as follows:
        • What is your cut-off for pediatric testing?
        • What instrument are you using for testing?
      • Laura is willing to add questions to her survey for FEAT. She will ask about other major drugs as well.
      • The surveys should not take much time to conduct, and Laura will forward the information to the group as soon as she gets it.
      • Laura would like to write this research up in some way, perhaps doing something in collaboration with FEAT.
  • State Data Reports:
    • Anna Cox (DHS)
      • The DHS database is a case management system; much information is in narrative form and there is some lack of detail regarding the information tracked as data.
      • Currently DHS has an injury code for "drug-exposed child" (dec) which is considered a form of physical neglect. Any child exposed to a substance that poses a threat of harm to his/her safety is included in this category. This does not include only illegal drugs and does include such things as driving with a child under an unlawful level of influence of alcohol.
      • Only when child abuse/neglect is founded is it tracked in the DHS database. In FY '05, DHS tracked 302 drug-exposed children, 289 of whom were under 27 days old.
      • DHS does track medical referrals; however don't identify these children as data elements until abuse is founded. If children go immediately into relative care, for example, they will not be tracked.
    • OHSU Database: Bob Nickel
      • May be able to search for newborn with diagnosis of prenatal substance exposure or for mother with prenatal drug use code.
      • In the past, the injury group may have accessed this information already. Bob and Cyndi will investigate this.
  • Miscellaneous Tasks
    • We need a representative from Oregon Mental Health and Addiction Services (OMHAS). Bob will contact Karen Wheeler's boss, Bob Nickel, to ask if she can attend.
    • Cyndi is looking at the MN Prevention resource that Liz passed on to her. She will investigate what Oregon Public Health is currently doing or putting out re: SEN and prevention resources
  • Next Meeting
    • Friday, June 9 th , 12-2
    • Focus on the vision and mission of this state workgroup.

Februray 21, 2006

Present :
Stacey Daeschner (DHS/Child Welfare-Policy), Cyndi Durham (Public Health-Babies 1 st ), Jay Wurscher (DHS/Child Welfare-Drug and Alcohol), Liz Twombly (U of O), Kris Funk (U of O), Bob Nickel (Eugene CDRC), James Ledbetter (Director, Center for Children with Special Health Needs, OHSU), Laura Spivak (Oregon Poison Center, Dept of Emergency Medicine, OHSU), Karen Van Tassell (Director, Oregon Healthy Start), Kay Halverson (Department of Education, EI/ECSE), Ruth Stroemple, (Trainer, Medical foster Care Providers), Sudge Budden (Pediatrician, Emmanual Hospital), Sandra McIlhenry (PSU-Child Welfare Partnership), Paula Michaud (FEAT CPS Liaison)

  • Introductions
  • Power Point Presentation
    • FEAT staff gave an overview of the FEAT project's origins and aims. (download)
  • Discussion:
    • What is currently in place, or in development?
      • Laura Spivak talked about her work on developing a methamphetamine treatment protocol for use in the OHSU emergency department; she is also currently doing a survey on labs in Oregon testing for meth. Karen Phifer of CARES NW gave Laura this idea and has been helpful in providing her with information.
      • Carol Chervanak, Laura Spivak and Karen Pheiffer are currently working with Legacy, OHSU and Kaiser hospitals to develop protocol related to drug screening.
      • James Ledbetter discussed his role as director of the Center for Children with Special Health Needs, and that part of the mission of that group is infrastructure building, and that that mission complements FEAT's goals.
      • Hospitals in Jackson County and Josephine County currently using Merconium Testing
      • Legacy hospital (Kent Johnson?) moving to Merconium testing
    • What areas would this group like to focus on? We had a brief discussion about the role of the State FEAT Workgroup and began to identify some possible areas of focus. We will narrow our focus at future meetings as it becomes clear what role this group will have in relationship to the Lane County Workgroup. Some possible focus areas mentioned were:
      • Setting a goal of identifying more drug-exposed kids
      • Focus on lack of treatment options for adults and create plans for changing this. The state group could make a formal recommendation to the legislature about creating / supporting more drug/alcohol treatment options for parents. Jay felt it would be particularly powerful to have doctors participate in making this statement.
      • Ruth Stroemple discussed the need for written continuum of care plans that move with children (between caregivers, social-workers etc.). Verbal communication is not sufficient.
      • James Ledbetter discussed the need for people to see addiction issues as a disease. In the same way you would penalize a mother with a genetic condition she may pass to her child, you should not penalize a mother with an addiction she may pass to her child.
      • Collaborate with Laura Spivak on her project to survey medical labs to determine types of testing is being done and what types of cutoffs are used. The workgroup might participate in developing surveys and FEAT staff could assist with interview process and evaluation.
      • Focus on creating/accessing mental health services for parents
        • explore impact of having her child removed from her care on a mom's mental health and recovery process
        • explore options for maintaining mom's relationship with baby/attachment.
      • Focus on Prevention, particularly at the high school level. FEAT staff will contact Kay Halverson about contact person at the Department of Ed who works will high school prevention.
      • Overseeing the development of CPS policies that are consistent across the state.
      • Address lack of OB/GYN participation in FEAT project and desire to bring them into this process. It was brought up that during pregnancy there is a lack of services available to refer pregnant women too (or a lack of awareness about what is available), so doctors reluctant to start conversations.
  • Additional workgroup participation/committee's to collaborate with
    • Someone should be invited from OMAHAS . (Can Jay invite?)
    • Karen Wheeler (Jay will invite)
    • Ob/Gyn's?
    • Governor's Task Force on Methamphetamines
    • Governor's Council on Alcohol and Drug Abuse (Ann Uhler, Chair-- Jay recommended)
    • Oregon Alliance for Drug Endangered Children
    • Oregon Poison Center
    • Legacy Metro Lab
    • Department of Education (Teen ed programs, Kay Halvorson can find appropriate person through dept. of ed)
    • DHS Self-Sufficiency Program (Stephanie Jurganstadt)
    • Law enforcement (Rob Bourette-Jay recommended)
    • OMA Task Group
  • Future Meetings
    • We talked briefly about how often to meet-monthly, bi-monthly, quarterly. We will discuss this further at our next meeting, once we have more information about the direction of the Lane County Workgroup.
    • Next Meeting: Tuesday, April 4th, 12:00-2:00 , DHS building, Room 137C, Salem

December 12, 2005

Present :
Stacey Daeschner (DHS/Child Welfare-Policy),
Cyndi Durham (Public Health-Babies 1 st ),
Jay Wurscher (DHS/Child Welfare-Drug and Alcohol),
Liz Twombly (U of O),
Kris Funk (U of O)

  • Power Point Presentation - FEAT staff gave an overview of the FEAT project's origins and aims.
  • Changes to Oregon Mandatory Reporting Law :
    • Stacey talked about changes to state definition of child abuse to include
      • "Unlawful exposure to a controlled substance . that subjects a child to a substantial risk of harm to the child's health or safety."
      • DHS policy proposal has been made that incoporates these changes to state law. Substance exposure was listed under physical abuse in DHS policy, but DHS staff indicated that it more appropriately should be included under neglect, as it does not constitute purposeful abuse to the child by the mother. Additionally, in the proposed changes to DHS policy, the threat to the child's health must be confirmed by a medical doctor. Attorney General will approve a temporary rule re: DHS policy on working with SEND by January 1 st .
  • Workgroup participation : Group discussed other people who might be appropriate members of this workgroup
    • Jay suggested inviting a couple of recovering parents to participate in our local workgroup.
      • Liz will contact the Relief Nursery to find parents who might be appropriate
    • Jay suggested the following other people
      • Karen Wheeler, Office of Mental Health and Addictive Services
      • Dr. Tsongas, Epidemiologist who traces all children who are poisoned.
      • Liz will contact these people
    • Cyndi suggested Laura Spivak from OHSU. She will contact her.
    • Jay suggested inviting doctors on opposing sides of screening/testing issues to workgroups so that participants can get a clear sense of the different persepctives
  • Participant suggestions for the state FEAT project workgroup
    • Have physicians communication with physicians
    • Collect CPS data on how often a child is sent home with a mother and how often a child goes to foster care
    • Educate/Train medical staff on what happens for a child after a report is made to CPS and the potential benefits for a family who is referred to CPS.
      • This could alleviate medical staff concerns about referring children
      • Jay has video of drug and alcohol clients talking positively about their experiences of CPS that might be helpful in educating medical staff; he passed this on to FEAT staff
    • Research/solicit funding for SEN related projects
    • Provide assistance / data to local/county groups as needed
      • Jay can request data from Anna Cox of DHS. It's best to come to her with several (5-6) data questions at once in order to best use her time
  • Next Meeting: Tuesday, January 24, 12:00-2:00, DHS building, Salem
© 2006 Early Intervention Program, University of Oregon College of Education. All rights reserved.
Project funded by: Children's Bureau, of Health and Human Services. Grant # 90-CB-0154
Disclaimer: Any views or opinions presented by this website are solely those of the project members do not necessarily represent those of the funding agency.