Substance Exposed Babies - Potentially, a Lifetime of Public Support*

2 Orange County agencies use 13-year-old prevalence rate data (1992) for planning and allocation of prenatal and permatal resources. The applicability of the prevalence data is now questionable because of changed prevalence rates, changed demographics, and changed substances of choice. Response: Disagrees partially with the finding It is agreed that a major statewide study like the one conducted in 1992 has not been conducted recently and that there may have been significant changes in the past 13 years. However, other useful and more current data are available to the Orange County Health Care Agency (HCA) and other interested organizations to assist in planning and resource allocation. This includes information on the numbers, types and sources of referrals for current service providers; information compiled by the Assessment and Coordination Team (ACT) on the drugs of choice for the program's referred pregnant clients; the birth and death data that are compiled and analyzed annually by HCA Public Health Services; hospitalization data available from the Office of Statewide Health Planning and Development; a 2002 Health Care Agency survey of Alcohol, Tobacco and Other Drug Use Prevalence among adults; and information from the California Alcohol and Drug Data System that identifies the "substance of choice" for individuals, including pregnant women, admitted into publicly funded treatment programs in Orange County. 7.3 The prenatal and perinatal staff and resources are insufficient for current caseloads and referrals. Therefore, many substance-using mothers go unattended. Response: Disagrees with the finding HCA: It is agreed that the current need for perinatal substance abuse services is extremely challenging for the Public Health Nurses of the Assessment and Coordination Team (ACT), as well as the treatment programs coordinated through Exhibit 2 HCA Behavioral Health Alcohol and Drug Abuse Services. Growth in demand for services will require continued assessment of available resources. We do not agree that "many substance using mothers go unattended." The nurses of the ACT program do not refuse any referrals and provide services to anyone requesting assistance. The outpatient perinatal substance abuse treatment programs are able to offer services without a waiting period. Although there are waiting lists for perinatal residential substance abuse treatment programs, which may temporarily delay treatment, interim services are provided immediately to anyone on the waiting list for more than 14 days. These interim services include both counseling and education, and in the case of pregnant women, referral for prenatal care. SSA: SSA social workers currently respond and provide services in accordance with the Welfare and Institution Code (WIC) and State program mandates regarding child protective services. Current resources are sufficiently allocated to address prenatal and perinatal issues associated with children and families referred and served by SSA. 7.4 For its 18 communities, south Orange County has only one county healthcare facility serving substance abusing pregnant women. Compounding the problem, public transportation to north county healthcare providers is lengthy, inconvenient, and tiring. Response: Agrees with