Thursday, November 21, 2024
11/21/2024
The opioid crisis has grown in complexity and scope over the last two decades, affecting communities across the United States and nearly every segment of the population - including pregnant women and their infants. As opioid complications in the general population grew, so did the rates of pregnant women with opioid use disorder and infants diagnosed with opioid withdrawal. In 2014 alone, one infant was born every 15 minutes on average nationwide with opioid withdrawal, accounting for nearly $500 million in hospital costs to state Medicaid programs. Nationwide, most pregnant women opioid use disorder fail to receive evidence-based treatments including opioid agonist therapies, infants receive variable care for opioid withdrawal. Further, medical care and public programs for pregnant women mother and opioid-exposed infants siloed leading to inefficient resource utilization and suboptimal outcomes for the maternal-infant dyad. Tennessee, a state disproportionately affected by the opioid crisis, proposes to build a program to address the unique needs of pregnant women and infants affected by the opioid crisis to address these critical public issues, through a unique partnership between TennCare, all state Medicaid Managed Care Organization and a large hospital system. Focused on 26 rural and urban counties in middle Tennessee, we will create a unique model to improve outcomes for women with opioid use disorder and their infants beginning in pregnancy and extending to one year postpartum. Grounded in evidence, pregnant women in the program will be treated with a combination of medications for opioid use disorder and enhanced behavioral services. Inpatient services will be enhanced from both the mother and infant ensuring the dyad is not separated during the hospital stay, breastfeeding is promoted, and risk-appropriate care is provided. After birth, care for the dyad will be coordinated, minimizing disruptions including a unified clinic process where both mother and infant care receive care in a single visit. Lastly, partnerships with multiple public systems including early intervention, child welfare will be enhanced to ensure an optimal outcome. Throughout the continuum of care, families will be supported by patient navigators and peer supports. In this model, our primary objectives are to 1) retain women with opioid use disorder in treatment from pregnancy through one-year post-partum, 2) maximize periods of maternal abstinence from illicit substances using evidence-based therapies, 3) optimize the number of days an infant is with their biologic mother by reducing infant hospital stays (birth, readmission, emergency department visits) and 4) to ensure connection to early intervention services for infants.
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).
