Thursday, November 21, 2024
11/21/2024
Texas Medicaid and its care-delivery partner, Harris Health System (the county hospital system for Harris County, Texas), propose to create a multidisciplinary program for pregnant women with opioid use disorder (OUD) in Houston, which will include hospital and community outreach, expanded partnerships in Houston, and a centralized multidisciplinary integrated substance use disorder (SUD) clinic. The project will create a “hub and spoke model,” with Ben Taub hospital in Houston being the primary site or “hub” for program development, implementation, and evaluation of model components. Collaborative and multidisciplinary outreach by the core care teams will form “spokes” to other hospitals, prenatal clinics, and federally qualified health centers throughout Houston (which extends beyond Harris County). The goals of the project are consistent with Alliance for Innovation on Maternal Health (AIM) patient safety bundle Obstetric Care for Women with Opioid Use Disorder. These include: engaging appropriate partners to assist patients and families in development of a plan of safe care for the mother and her baby, providing education on neonatal abstinence syndrome (NAS) and newborn care, providing staff-wide education on substance use disorder, establishing specific clinical pathways for women with OUD that incorporate care coordination, developing pain control protocols to decrease opioid prescriptions and that account for increased pain sensitivity in women with OUD, and knowing state reporting guidelines regarding the use of opioid pharmacotherapy and identification of SUD during pregnancy. Harris Health and Baylor College of Medicine will update hospital protocols to reflect best practices for care of patients with OUD across the Harris Health System. Protocol updates include: standardized screening, brief intervention, and referral to treatment for SUD; establishing a system of pre-delivery anesthesia consults for development of a pain plan and implementing enhanced recovery after surgery (ERAS) for cesarean deliveries to decrease narcotic usage and narcotic prescription dispensing; establishing lactation training and planning for pregnant women with OUD; and standardizing inpatient care for infants with NAS and planning for transition to outpatient care. Ben Taub will create a SUD in Pregnancy Clinic, which will integrate obstetrics, addiction medicine, and behavioral health. The multidisciplinary team will include maternal and fetal medicine, obstetric anesthesiology, neonatology, addiction medicine psychiatry, social work, case management, psychology, and peer support. This multi-disciplinary structure will allow coordinated care for mental health and substance use needs and create an environment that promotes health of mother and baby up to and following delivery. Clinic physicians will have waivers allowed by the Drug Addiction Treatment Act 2000 (DATA) to treat OUD. Harris Health will expand its relationship with the Patient Care Intervention Center (PCIC), a nonprofit organization that leverages technology and health data sharing to identify patients’ use of medical and community resources. This allows extensive coordination of care and promotion of retention in care across medical systems and organizations in Harris County, including housing and transportation, income and employment status, hunger and access to nutritious foods, literacy and language, behavioral health, and social integration. Harris Health will also coordinate with Santa Maria, a licensed SUD treatment provider, Medicaid managed care organizations, case management providers, and others. MOM Model funds will support developing training, policy, and protocols; educating Harris Health clinic and hospital staff on new protocols; and gathering and reporting data. MOM Model funds will also support outreach to women in need of treatment and efforts to engage them and keep them in care. HHSC is requesting $3,100,000 for implementation.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
