Forget, for the moment, the debate over whether the state should pay to hand out free pregnancy tests and/or condoms. Give away both, then think bigger.
Every baby born with fetal alcohol syndrome costs the public $1 million to $4 million in lifetime medical and social services bills. Bar bathroom give-aways aside, experts say plenty more can be done to reduce FASD in Alaska and improve the lives of those with the disability.
Here are just three ideas other states and countries are trying:
1. Teach at-risk women about FASD before pregnancy
Studies funded by the Centers for Disease Control and Prevention found that when doctors and OB-GYNs screen women in their practices for heavy drinking -- and then talk to them about the danger of alcohol during pregnancy -- the would-be mothers use birth control more and drink less.
One intervention method, called "Project CHOICES," involves identifying women who are at-risk to have an FASD child before they are pregnant and teaching them about the disability in a series of counseling sessions and "motivational interviews." The women learn about effective and long-term birth control at a follow-up appointment.
It sounds simple, but don't assume that every Alaska midwife and doctor is already warning patients about fetal alcohol syndrome. A 2006 state survey found that Alaska OB-GYNs held more permissive views toward pregnant women using alcohol than teachers, social workers or even prison employees.
The Department of Corrections, with funding from the Alaska Mental Health Trust Authority, plans to hire an FASD expert this year to develop plans for teaching inmates at Hiland Mountain women's prison about the disability.
"While we have them, literally as captive audience, that would be a good time to address some FASD prevention education," said Laura Brooks, health care administrator for the department.
2. House adults and families, with oversight
On the North Slope, where fetal alcohol syndrome rates are highest, Native Village of Barrow social service employees are looking for ways to help mothers who have the disability retain custody of their children while still getting the help they need to live independently. One solution they recommend: Housing complexes where multiple families could live under some form of oversight or with a live-in guardian.
Adults with FASD also are more likely to wind up in prison. Many need a safe, structured place to live when they get out.
"It doesn't really achieve much to put them back on the streets where they got into trouble in the first place," said Doug Caldwell, spokesman for the Yukon Housing Corp. in Whitehorse.
FASD advocates in that Yukon city created a non-profit to provide housing for people with the disability.
The group, Options for Independence Society, opened a 14-unit apartment building in February for tenants with fetal alcohol syndrome and FASD. The Canadian federal government provided more than $1 million to build the apartments while the Yukon territorial government gave $2 million in construction and mortgage financing The city waived fees and property taxes.
As a partnership of non-profits, local and federal governments and First Nations governments, the project could be duplicated anywhere, said society president Sharon Hickey.
Two staff members oversee the building around the clock, while tenants pay rent to live there, Hickey said. The nonprofit views the housing as a form of crime prevention that might save the public money over time.
"You pay, one way or the other," Hickey said. "When people have a stable place to live, not only does the quality of their life go up, but they don't get up to as much mischief."
3. Facial analysis software works. Use it.
Facial analysis software created by the University of Washington is nearly 100 percent accurate in predicting which children and adults have full fetal alcohol syndrome.
The screening tool is already used in Alaska by FASD diagnostic teams, but could also be employed by the Department of Corrections and the Office of Children's Services.
Brooks, the corrections administrator, said the prison system plans to hire an FASD expert this year to develop better screening for new inmates. That could include use of the software, she said.
Behavioral problems that seem FASD-related might instead spring from childhood trauma or other causes, making the disability hard to diagnose. The added, low-cost step of photographing an inmate and applying the University of Washington software could quickly flag those who might have the trademark features that signal full FAS.
The same is true for foster children, who might be eligible for federal disability assistance with a diagnosis.
Story by KYLE HOPKINS | Photos by MARC LESTER