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Florida PSEP Status Update

Florida PSEP Status Update. October 2012. Scope of Problem in Florida. 1200% increase in production of Oxycodone from 8.7 tons in 1997 to 105 tons in 2010.(St. Pete Times 10/30/11)

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Florida PSEP Status Update

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  1. Florida PSEP Status Update October 2012

  2. Scope of Problem in Florida • 1200% increase in production of Oxycodone from 8.7 tons in 1997 to 105 tons in 2010.(St. Pete Times 10/30/11) • More Oxycodone is dispensed in Fl. than in the rest of the nation. 4.1 million prescriptions in Fl. compared to 5 million in the 49 states combined. • 98 of the top 100 doctors dispensing Oxycodone nationally are in Fl. • 1355 infants classified as Neonatal Withdrawal Syndrome in 2010 but many more exposed and not diagnosed- a 433% increase from 2005.

  3. +433% Source: Florida Agency for Health Care Administration Emergency Department and Inpatient Hospital Datasets

  4. Team Members • Judi Vitucci, Christine Gibson, Rhonda Brown, Jane Murphy, Patti Kodish, Jane Bambace, Mari Detres, Kay Doughty, Diane Clark, Dixie Morgese, Patricia Armstrong, Brooke Baker, Carol Scoggins, Kris-Tena Albers,LynnMarie Firehammer, Jennifer Highland Biggest challenge: Team member turn-over at the state level

  5. Our Vision Florida will be a state where every child is born substance free and lives in a family that promotes healthy growth and development

  6. Florida PSEP Method of Work • Action Plan developed at first meeting in October 2011 and revised based on input from CityMatch in May 2012 • Leadership responsibilities divided between two co-leads (facilitate/communicate with team & minutes) • The team has met monthly to work on the established strategies in the plan. • We collaborate with 190 colleagues statewide in 9 MOD workgroups to work on various aspects related to the effects of substance exposure during pregnancy • Multiple Florida communities have local SEN workgroups • PSEP resources are shared statewide

  7. PSEP Team & Systems Map for the Prevention of Risky Behavior Crisis Centers Law Enforcement Attorney General 9 FQHCC FASD Center DOH Family Planning 9 Legislature 1 CHD March of Dimes DCF FOGS 10 1=Danielle/Rhonda, 2=Chris, 3=Lori/Patti, 4=Jane, 5=Kay,6=Judi; 7-Dixie,, 9-Mari,10=Jane B,, 11=Jennifer Highland Travelers= RED; Non travel team = green Healthy Start 3 9 DEC 4 School System Drug Rx Centers CSCs Universities 5 CPI 7 6 FADAA CBC Community Drug Coalitions Fed. HS SAMH

  8. Strategy 1: Work with physicians and providers serving on MOD workgroups to develop at least one clinical guideline or protocol for screening and brief interventions for pregnant women and infants.

  9. Strategy 1 Action Steps 1.Literature review of effective screening tools and brief interventions 2. Obtain buy-in from PAMR 3. Pilot screening tools in Pinellas, Alaucha Hillsborough Counties, etc 4 . Engage Healthy Start to implement screening and brief intervention statewide

  10. Strategy 1 Accomplishments • After literature review, 5Ps selected for piloting in Florida • Dixie and Kay offered 5P’s Behavioral Risk Screening training • Jane shared with PAMR and they support our efforts • Dr. Karen Harris (Alachua Co), Dr. Kay Roussos-Ross at UF clinic (Hillsborough Co.) and Bayfront High Risk Clinic (Pinellas Co. )are piloting the 5Ps screening tool • Florida OBGYN(FOGS) survey completed re: screening • Not ready to implement screening and brief intervention statewide yet

  11. Strategy 1: Work with physicians and providers serving on MOD workgroups to develop at least one clinical guideline or protocol for screening and brief interventions for pregnant women and infants by October 20, 2012Pilot of Screening & Brief Intervention • Baseline data collected using standard screening. • Pilot protocol for screening pregnant women, using the 5 Ps tool, initiated in June at Dr. Karen Harris’s OB practice with 8 physicians and 4 midwives. The practice serves 1500-2000 women annually. • Strong Start grant written and includes 5 Ps screening in four county area (Pinellas, Hillsborough, Polk, and Lake)-pending funding decision. If awarded, 2748 women will receive SBIRT in year one and 8502 by year

  12. Strategy 2: Identify and implement guidelines/ protocols for treatment of pregnant women and newborns by clinicians. Raise awareness/train clinicians.

  13. Strategy 2 Action Steps 1. Conduct literature review of effective opioid treatment 2. Reviewed protocols and identified best/promising practices- a. Identify evidence based protocols 3. Create protocols where gaps exist 4. Obtain buy-in from clinical groups to implement the protocols 5. Develop logic model related to clinical protocols

  14. Strategy 2 Accomplishments • Dr. Mark Hudak provided leadership for the American Academy of Pediatrics Committee on Drugs and the Committee on Fetus and Newborn. He was lead author on their guidance for treatment of neonatal drug withdrawal that was published in Pediatrics on January 31, 2012 • Dr. Hudak presented at the Perinatal Quality Conference in April 2012 in Tampa with several hundred health care providers in attendance. • March of Dimes funding obtained for conference on December 14th with multiple sessions to train clinicians planned. • CityMatch offered an educational Webinar for physician leaders with national expert (Dr. Ted Parran) on 4/25/12.

  15. Strategy 3: Design and implement at least two health provider education programs.

  16. Strategy 3 Action Steps 1. Develop logic model pertaining to education 2. Develop and offer educational program for non clinical staff including home visitors and child welfare staff. 3. Develop and offer educational program for clinical staff (nurses/OB offices, treatment, etc) 4. Develop educational program for non clinical staff 5. Find funding for educational programs. a. Apply for MOD funding to support educational component b. Find out what other agencies can provide to support education Develop educational program for CPIs.

  17. Strategy 3 Accomplishments • Logic model developed • Conducted two substance abuse oriented training for 120 home visiting staff entitled, "Motivational Interviewing: Releasing the Power of Change" and "Women and Substance Abuse." Topics included "Current Trends in Pharmaceutical Drug Diversion" and "Substance Abuse Services in Pinellas County • Generation RX Conference held on September 7, 2012 in Tampa with 171 attendees.

  18. Strategy Accomplishments (cont) 1948 individuals were trained statewide by Dixie Morgese • 850 child welfare staff at Dept Children & Families Dependency Summit • 430 child welfare workers • 125 home visitors & direct care providers at Fl. Association of Infant Mental Health Conference on 7/11/12 • 23 nurses and social workers at Daytona State College on 5/3/12 • 200 North Central Healthy Start Community workers on 3/1/12 • 160 community based care workers on 1/20/12 at Community Partnership for Children. • 160 medical providers and direct care providers on 10/28/11 at Bayfront Medical Center

  19. Strategy 3 Accomplishments(cont) • Addicted At Birth” Webinar offered on March 29 with Kay Doughty as one of the panelists. • “An educational program for 45 school system employees & early childhood educators was provided in March 2012. • Prescription Drug Misuse and Effects on Young Children presented to 160 childcare providers in March 2012. • Information about webinars & conferences sponsored by other agencies disseminated to Florida PSEP participants. • Drug Abuse Awareness Webcast presented by Fl. DOH and Fl. Medical Association on 3/21/12. • Grant written and awarded for March of Dimes support of Statewide Conference/Summit on December 14, 2012

  20. Other Accomplishments • Advocated with legislators to add two PSEP team members (representatives of Healthy Start Coalitions & March of Dimes) to a Statewide Prescription Drug Task Force led by the State Attorney General • Home Visiting Program for substance misusing women and their infants initiated in Pinellas Co. (MIECHV funded)

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