1. Emerging Issues about FASD in Michigan Cheryl Lauber, DPA, MSN Michigan Department of Community Health E-MCH Audio-conference Sept. 2006

2. Prevalence Estimates for FASD 0.5 to 3 per 1000 live births with FAS (US) 70-400 births/year in Michigan 1% of births are alcohol affected (US) 1,300 births/year in Michigan

3. Current FASD Services $200,000 MCH Block Grant annually 6 Diagnostic Centers Piloted a screening project w/foster care 7 Community Prevention Projects Pilot Horse-back Riding Therapy Project 2 Consultants provide technical assistance State FASD Coordinator in Dept. of Community Health Local Parent Support Groups State FASD Task Force Program Advisory Group

4. Screening/Diagnosis/Services Local Health Department Protective Services Foster Care/ Adoption Commun Mental Health Schools Parents Women in Treatment Criminal Justice System Medical/Health System Doctors/Nurses Indicators: Small head circumference Height/weight (10% or below) Behavioral indicators Facial features Maternal alcohol history during pregnancy RN/Coordinator Parent Advocate Educational Psychologist Speech Therapist MSW or Counselor Occupational Therapist Physician particularly: Dysmorphologist or Developmental or Behavioral Pediatrician or Geneticist Advocacy Maternal/Infant Support Family Planning Early On Individual Educ Plan Comm Mental Health Substance Abuse Tx Family Support Group Insurance Assistance Respite Referral Sources ScreeningDiagnostic Team Support Services Michigan FASD Program

5. Michigan FASD Task Force Vision: Coming together to address Fetal Alcohol Spectrum Disorders (FASD) through awareness, prevention and access to services.

6. Michigan FASD Task Force Mission: T he mission of the Michigan FASD Task Force is to advocate for statewide prevention and treatment. T he Task Force brings together affected individuals, families and professionals in many disciplines committed to increasing awareness of FASD and improving service delivery systems. D ecreasing these preventable disorders and enhancing quality of life for affected individuals and their families will lessen the social and economic impact of FASD in Michigan.

7. Five Year Goals A. Decrease the number of women who drink alcohol during pregnancy B. Increase awareness of FASD and gain public support C. Expand and improve timely lifelong service access and delivery statewide to individuals who have FASD and their families D. Increase identification and diagnosis of individuals who have FASD E. Improve the education system’s response to students who have FASD F. Determine and monitor the incidence and prevalence of FASD in Michigan G. Improve the justice system’s response to individuals who have FASD H. Expand, increase the diversity of and strengthen the Task Force

8. Detroit FAS Prevention Project $450,000 CDC Prevention Grant for each of 5 years 9/30/03 through 9/29/08. Field test prevention strategies with women Link families with services for children Test a surveillance model for determining prevalence of FAS

9. Identifying Children Exposed to Alcohol during Pregnancy In Detroit and Wayne county, 10,225 women ages 14-54 were admitted to substance abuse treatment programs between 2000 and 2004. 1,680 women were matched using the Social Security Number with 2,144 births from 2000-2003.

10. Demographic Profile of Women in Substance Abuse Treatment 66% African American, 30% White 53% age 30-44, 44% age 21-29 50% with education 12+ years 77% never-been married 74% unemployed 58% with 1+ dependents 12% pregnant at the time of admission

11. Birth File Match 2,144 births to 1,680 women in substance abuse treatment 88% born in Detroit and Wayne county 49% males, 51% females 48% matched to women who listed alcohol as the substance of abuse <8% reported alcohol use during pregnancy on the birth certificate

12. Birth Defects Registry Match 562 out of 2,144 births found in MBDR 49% matched to women who listed alcohol as the substance of abuse 8 out of 562 had FAS diagnostic code of 760.71 (3.7 – 7.8 per 1,000 births) 7 more had the diagnostic code of 742.1 (7.0 – 14.5 per 1,000 births) 291 out of 562 (52%) had other maternal exposure affecting the fetus

13. Summary Michigan has considerable work to do to understand the prevalence of FASD in the state. The state has stable minimum funding for service delivery but will need other resources to expand services, particularly prevention. There is impressive support among state service agencies, parents and advocacy groups for implementing the FASD State Plan. The CDC grant has made it possible to test prevention and surveillance strategies that can be expanded to other parts of the state.

14. Thank You! For questions or comments, please contact: Cheryl Lauber, DPA, MSN Michigan Department of Community Health 109 W. Michigan, PO Box 30195 Lansing, MI 48909 Phone (517) 335-9483; Fax (517) 335-8822 LauberC@michigan.gov