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Lifeline Connections proposes to provide comprehensive and expanded treatment for pregnant and postpartum women and their children and extended families. The purpose of the proposed project is to expand treatment and recovery services for pregnant and postpartum women and their children who are involved in residential substance use treatment services. The project will include comprehensive services for family members, including those not involved in residential components of programming (i.e., spouses, partners, older children, grandparents). Finally, the project will include prevention services and activities geared toward all program participants and extended family members. GOALS: The goals of the project are to: • Decrease the misuse of alcohol, drugs, tobacco and other illicit substances among pregnant and postpartum women and their families; • Increase the number of safe and healthy pregnancies among program participants; • Improve birth outcomes for infants of program participants; • Improve the mental and physical health of women and children involved in the program; • Improve parenting skills, family functioning, economic stability, and quality of life for program participants; • Decrease out-of-home placements for children of program participants; • Reduce perinatal and environmentally related effects of maternal and/or paternal drug abuse on infants and children; • Decrease involvement in and exposure to crime, violence and neglect among pregnant and postpartum women, their families and children; • Decrease physical, emotional, and sexual abuse for all family members; and • Reduce the stigma of seeking help for substance use disorders, and increase access, engagement and participation among communities of color. MEASURABLE OBJECTIVES: We expect to achieve the following outcomes as a result of this project: • Improved quality of life as measured by improvement in areas such as housing and employment; • Increased number of women in treatment and the number of children with whom they were reunified in the treatment facility, and the number reunited who remained in external care; • Increased number of fathers reunited with their children while they resided in the residential facility with their mothers and number of children with whom the father was reunited while they remained in external care; • Increased number of individualized/family service plans that include engagement and active involvement of fathers of the children, partners of the women, and other family members of the women and children; • Improved child functioning in terms of social, emotional, cognitive, and physical development measured according to developmental level wellbeing.

The Center for Health Care Services seeks to expand the residential treatment components of its Neonatal Abstinence Syndrome (NAS) Program. The Programs provides specialized, gender-specific and trauma-informed treatment, including Medication Assisted Therapy using suboxone or methadone, integrated with parenting support, consistent case management and navigation assistance to ensure connection to all available resources. Project Name: Neonatal Abstinence Syndrome (NAS) Residential Treatment Program Population to Be Served: The population of focus consists of young, low-income pregnant or post-partum women with Opioid Use Disorder (OUD) and their newborn children. Demographic characteristics are estimated to be: 85% Hispanic, 10% White, 5% African American, 100% female, 90% heterosexual, 10% homosexual, < 5% transgender, 18-35 years of age, and 100% will fall below the federal poverty guidelines. For 80% of participants, the substance of choice will be heroin, with 20% addicted to prescription painkillers. Strategies/Interventions: The NAS Program seeks to expand the availability of specialized residential treatment (60-90 days) services for the population of focus. In addition, the program will: care for infants of participating women after they have been released from the NICU; provide trauma-informed counseling to address the drug-use triggers associated with histories of domestic violence; provide parenting education to assist mothers in becoming a nurturing influence in their children’s lives; provide case management to support participants’ transition back into the community, including education, employment and housing assistance; and deliver continuous recovery supports to ensure she and her children are safe and healthy. Counseling and substance use education will be offered to supportive family members. Goal: To re-organize the existing NAS Program facility and increase the availability of gender-specific, trauma-focused, family-centered and culturally relevant OUD treatment and supportive services for low-income women and children. Objectives: A: Assess for OUD, trauma histories, alcohol misuse, tobacco use, co-occurring disorders and unmet personal and family needs of 72 women per year who are referred to the NAS Program. B: Provide substance abuse treatment in correspondence to assessed needs. C: Integrate mental health treatment for women assessed as having co-occurring disorders. D: Provide trauma-focused group counseling with all participants to address the impact of past traumatic experiences on their risk behaviors. E: Provide obstetric, pediatric and primary care to 72 women and 24 children per year. F: Provide recovery supports to all participants. G: Provide counseling, parenting education and connections to peer support as needed to help participants build or rebuild their families and foster long-term recovery assets. Number to Be Served: The NAS Program will care for 72 women and 24 children in both Year 1 and in Year 2. In Years 3, 4 and 5, the Program will care for 138 women and 42 children each year, for a project total of 558 women and 174 children over five years.

Samaritan Daytop Village (“Samaritan” or “SDV”) proposes the Maximizing Opportunities for Mothers’ Success (MOMS) Program, to expand and enhance trauma-informed, culturally competent, outreach, residential treatment and comprehensive wraparound services for pregnant/ postpartum women (PPW); primarily African American women and Latinas, who have substance use disorders or co-occurring substance abuse and mental disorders (SUD/COD). The population of focus (POF) will be low-income, pregnant and postpartum women (up to 12 months after child-birth), and their minor children. The MOMS Program will focus on serving PPW who are women of color (with SUD/COD) and their minor children because they experience elevated rates of trauma, morbidity and mortality, and are disproportionately impacted by New York City Administration for Children’s Services intervention and forensic involvement. The MOMS Program will assess 415 pregnant/postpartum women with SUD/COD in order to expand and enhance culturally-competent residential treatment for 350 unique POF members over the five-year project period (59 in Yr. 1; 72 in Yrs. 2-3; 84 in Yr. 4; 63 in Yr. 5). The MOMS Program will provide residential SUD/COD treatment, including integrated trauma treatment and comprehensive wraparound peer recovery coaching to POF members and their children up to age 1, plus non-residential children, the fathers of their children, partners, and other family members as indicated. The MOMS Program will expand and enhance services of SDV’s existing Young Mothers’ Program (YMP; which serves 36 PPW with SUD/COD and up to 30 of their young children age 0-3 at any given time). SDV will expand services for PPW with SUD/COD by fully creating a trauma-informed system of care and integrating trauma treatment into existing services; by adding a therapeutic nursery to fill a serious gap in YMP services to address and/or prevent developmental delays, mental health issues or behavioral issues of the infants and toddlers living on-site; as well as, adding or enhancing delivery of evidence-based practices (Attachment and Biobehavioral Catch-up, Nurturing Parents Program, Seeking Safety, Cultural Congruence, Medication Assisted Treatment, Motivational Incentives, Recovery Coaching and Skills Training in Affective and Interpersonal Regulation), within a network of 16 providers committed via MOAs to provide quality health, behavioral health, and supportive services to MOMS clients. The MOMS Program has five overarching goals/objectives: 1) Create, implement and evaluate the efficacy of a comprehensive, culturally competent, residential SUD/COD treatment model for the POF that includes integrated trauma treatment, peer recovery coaching and; 2) decreasing substance use among PPW; 3) increase the safety and health for the POF during pregnancy, improve birth outcomes and reduce the impact of perinatal and parental drug use; 4) improve the health/behavioral health of clients and children and enhance attachment between mom/child and dad/child (and preventing mental emotional and behavioral disorders among them); and 5) increase the capacity of the YPM by at least 16.6%, to serve more POF members. From the “crack babies” of the 1980s, to the “meth[amphetamine] babies) of the early 21st century (Lewis, 2005), the drugs changed, but not the soul-crushing patterns of stigma that reinforces fear of treatment and loss of a child to ACS and/or imprisonment. Research dating back to 1992 found that five percent of pregnant women used illicit drugs. Given the extended benefits of treating substance use disorders and co-occurring substance abuse and mental illness (SUD/COD), it is sadly ironic that adequate funding for that substance abuse treatment can be so elusive. There is no good time to abuse drugs or suffer from distress related to mental illness or trauma, but it seems apparent that pregnancy and early motherhood are particularly inauspicious.

Meta House’s (MH) Families in Recovery, Stronger Together (FIRST) program will provide residential family treatment for pregnant and postpartum women (PPW) with substance use disorders (SUDs) and their children, and provide supportive and preventative services for their non-resident children, partners/children’s fathers, and other family members. Over the five years of the program, FIRST will serve 122 women, 166 children, 81 women’s partners/children’s fathers, and 158 extended family members. The goals of the FIRST program are closely aligned with the goals of the PPW FOA: 1) Decrease barriers to accessing treatment; 2) Improve quality of life for women and their families; 3) Increase collaboration between MH and partner agencies by establishing formal agreements and cross-system training; 4) Increase the use of and participation in evidence-based practices (EBPs); 5) Increase the number of mothers reunited/reunified with their children; 6) Increase the number of fathers reunited/reunified with their children; 7) Increase the number of individualized service plans that include child interventions; 8) Increase the number of individualized services plans that include involvement of partners/fathers and other family members, 9) Increase the coordination/integration of services and systems of care; 10) Improve child functioning in terms of social, emotional, cognitive, and physical development; 11) Improve mother-child relationship/attachment; 12) Improve father-child relationship/attachment; and 13) Improve family functioning and well-being. To achieve these goals, FIRST incorporates five EBPs: 1) Filial Therapy, 2) Celebrating Families!, 3)The Nurturing Program (including the Nurturing Program for Families in Substance Abuse Treatment and Recovery and Nurturing Fathers), 4)Motivational Interviewing/Stages of Change, and 5) Seeking Safety. FIRST will implement these EBPs in the context of MH’s into MH’s gender-responsive, trauma-informed, culturally-competent residential family treatment program. The program will also provide onsite nursing and psychiatric care to support the health of the PPW in the program, in addition to a variety of preventative and supportive services to the women, children, fathers/partners, and other family members, either provided on-site or through referral to one of the 37 participating community partners with whom MH has established MOAs. These services include screening and assessment for substance/tobacco use, co-occurring disorders, trauma symptoms, FASD, and developmental needs; treatment and prevention for SUDs and for mental health/trauma symptoms; coordinating care for medical, educational, career, legal, and housing needs; and providing a wide array of other supportive services. The performance assessment for FIRST will be conducted by an external evaluator with more than 20 years of experience evaluating SAMHSA grants. The performance assessment will use findings from intake and 12 month follow-up evaluation interviews, as well as qualitative and process data, to examine the extent to which FIRST meets the goals listed above. For over 50 years, MH has provided gender-responsive, trauma-informed, culturally-competent substance abuse and mental health treatment for families. The FIRST program will allow MH to provide the intensive, comprehensive, integrated treatment, prevention, and recovery support services required to effectively serve PPW with SUDs and their families. The FIRST program is designed to help families see long-term change in their substance use, trauma symptoms, mental health, parenting challenges, and quality of life and aims to effect long-term change in the system of care so that there are fewer barriers to treatment; a better quality of trauma-informed, family-centered, culturally-competent care for these families; and less racial disparity in treatment, infant/child health, and family functioning.

Chrysalis House located in Lexington, KY, requests $524,000 in year one from SAMHSA for Residential Treatment for Pregnant and Postpartum Women. The purpose of the project, Residential Treatment Program for Pregnant and Postpartum Women and Their Children, is to provide comprehensive residential substance abuse treatment to women who are pregnant, postpartum and their minor children who would normally have limited access to such intensive, holistic treatment. The target population for the proposed project is low-income (as defined by Federal poverty definitions) minority women, age 18 and over, with substance abuse disorder (focusing on opioid use disorder), who are pregnant, postpartum (the period after childbirth up to 12 months), and their minor children, age 17 and under, and who have limited access to quality health services. Services will be extended, when appropriate, to non-residential family members, such as fathers of the children, partners of the women, and other extended family members and children in residential treatment. The project will expand and enhance the existing comprehensive continuum of care offered to pregnant and postpartum women by Chrysalis House. Using effective trauma-informed substance abuse practices Chrysalis House will implement a holistic, state-of-the art clinical and service delivery approaches that are gender-specific and culturally appropriate for women and their minor children and other family members. This family-based treatment approach is comprehensive, and addresses the biological, psychological, and social aspects of women and their families by incorporating a variety of effective practices. The project will provide treatment to 50 pregnant and postpartum women, their infants, and other children annually. Over the 5 year project period, the project will serve 250 women and 250 infants and children, outpatient services to 60 additional children, and targeted outreach to 2,340 women and extended family members. To ensure that the project is comprehensive in scope, Chrysalis House has formal MOA’s with more than 50 community service providers, assuring that either it or community partners will provide the full range of PPW services. Goals are: 1) to facilitate and ensure continuous quality improvement; 2) to provide residential treatment for pregnant and postpartum women; 3) to decrease the use and/or abuse of drugs, alcohol, and tobacco among women; 4) to increase safe and healthy pregnancies and improve birth outcomes; 5) to improve the mental and physical health of the women and children; 6) to improve parenting skills, family functioning, economic stability, and quality of life; and, 7) decrease involvement in and exposure to crime, violence, neglect, and abuse for the family.

Center Point, Inc. (CPI) is requesting $ 495,864 per year for up to five years from the SAMHSA Center for Substance Abuse Treatment to expand comprehensive treatment, prevention, and recovery support services for women and their children. These funds will support the CPI’s Pregnant and Postpartum Women’s Project (LifeLink) located in San Rafael, Marin County and serves families from throughout the Bay Area. LifeLink, if funded, will enhance CPI’s integration of primary health, substance use and mental health disorder treatment for women and their children, further positioning the Agency to sustain services beyond the funding period. LifeLink is a component of The Village, a DHCS licensed/certified program (DHCS designated ASAM Level of Care 3.1 and 3.5) and DMC Certified provider. The Mission of CPI is to “provide comprehensive, affordable support services by offering education, training, health care and counseling support so that clients can claim self-worth and dignity and engage in pro-social lifestyles.” The aims of the LifeLink project are to increase the capacity to serve pregnant and postpartum women, and to expand and enhance the availability of comprehensive, residential substance abuse treatment support services for pregnant and postpartum women and their minor children, including services for non-residential family members of both the women and children. The populations of focus are low-income women, age 18 and over, who are pregnant or postpartum (the period after childbirth to 12 months), and their minor children, age 17 and under. The women and children served will be a culturally, ethnically, and socio-economically diverse group. CPI will serve 15 women and a minimum of 15 children during the first year of the grant. If funded for the continuation periods, CPI will serve up to 20 women and a minimum of 20 children in each of Years Two through Five for a total of 95 women and their children throughout the lifetime of the project. The project goals are to decrease the use and abuse of illicit substances among pregnant and post-partum women; increase safe and healthy pregnancies and improve birth outcomes; improve parenting skills, family functioning, economic stability, and quality of life and; decrease involvement and exposure to crime. Additionally, LifeLink will help prevent mental, emotional, and behavioral disorders among children and decrease the physical, emotional, and sexual abuse within the target population. CPI conducts extensive screening and assessments to determine the presence of substance use disorders, depression, anxiety, and other mental health disorders, as well as trauma; LifeLink further assesses parenting skills and stress and a full range of children’s developmental and mental health scales. LifeLink will utilize a number of evidence-based practices and strategies, including providing integrated services (through a co-located FQHC) so that substance abuse, mental health disorders, primary health and psychiatric services, and trauma can be treated effectively. Utilizing a multi-disciplinary staff CPI approaches service delivery, as does CSAT, from a family-centered perspective, meets the multiple and complex needs of the pregnant and postpartum women and their family members, and considers the physical and mental health and well-being and the substance abuse of family members within the context of their families and other important relationships.

CLARE Foundation: SAMHSA PPW Program Abstract CLARE Foundation, Inc. (CLARE) will expand comprehensive treatment, prevention, and recovery support services by 30 residential beds for pregnant and postpartum women (PPW) and their children up to age 17 in Los Angeles County. The project will be homed with in two treatment facilities owned by CLARE in the high-prevalence homeless area of Santa Monica, CA, and where African Americans comprise the largest group of the homeless. Called Bay Street Beach, this PPW program will serve African American families and is named in memory of the historic Black beach in our Pico neighborhood. As L.A. County is a diverse community, no ethnicity will be refused services. The project seeks to reduce the human and financial costs of substance abuse and trauma for PPW, their children, and family members. The goal is improved birth outcomes and maternal, child, and family health and well-being. CLARE will use a Comprehensive Family-Centered Treatment model with culturally- and linguistically-appropriate evidence-based practices normed for our service group. During the five-year project period, CLARE Foundation will serve 250 PPW (50 annually) and 125 residential children (25 annually) in a four-to-six-month treatment program at a cost of $6,986.67 annually for each woman/child. The project will additionally serve 500 family members of PPW (100 annually). Santa Monica is known as “The Homeless Capital of America,” and CLARE is the only behavioral health organization in the local continuum of care for the homeless and 90,000 residents. We were established in 1970 to provide food, blankets, and counseling to homeless ""flower children"" getting high on Santa Monica beaches. Today, CLARE Foundation is a state-licensed and certified, multi-site behavioral health agency offering ten nonprofit programs that deliver trauma-informed, evidence-based, client-centered treatment in culturally-congruent residential, outpatient, and school-based programs. Alcohol, drug, and tobacco use among pregnant and parenting women is an urgent concern in L.A. County. One in 10 babies here is born to a mother who uses illegal drugs during pregnancy, and in 2015 women comprised 37% of 47,000+ L.A. County treatment admissions. A study of L.A. County mothers who had infant custody removed at birth revealed that alcohol/drug-using women were more frequently homeless than non-users, had more mental health disorders, 25% had a criminal record, and 22% gave birth to another drug-exposed infant within 18 months of their last child. With less adequate housing, financial resources, medical care, and higher cumulative stress, women of color and their families have increased susceptibility to substance use disorders and health problems. The literature is especially replete with abysmal healthcare outcomes for pregnant African American women and their newborns. Without intervention, PPW substance users face medical, mental health, legal, and social adversities that threaten their health, shorten their lives, and endanger their family members. CLARE’s PPW program will deliver specialized treatment using evidence-based practices to which disadvantaged PPW in L.A. County may otherwise have little access. Services will include clinical treatment, clinical support, and community support delivered in the context of cultural competence, gender-specific care, and developmental appropriateness.

Through Preferred Family Healthcare, Inc., the PPWS project will expand trauma-informed, evidence-based, gender-focused, family-centered residential prevention, treatment and recovery services PPWS will collaborate with community stakeholders to enhance comprehensive services and supports in the economically disadvantaged and federally designated Health Provider Shortage Area comprised of Barry, Lawrence, Stone and Taney Counties in Southwest Missouri. The overarching purposes of PPW are to 1).Expand service capacity for Pregnant/ Post-Partum Women’s treatment services through education and coordination with service providers, and 2). Enhance services for Pregnant/ Post-Partum Women’s, their children, and family members. The program will serve 140 pregnant and postpartum women with substance use disorders and/or co-occurring disorders, their children, fathers and other family members, for a service total of 440 people over five years. PPWS Goals include: decrease the use and/or abuse of substances, including prescription drugs, alcohol, tobacco, illicit, and other harmful drugs among pregnant and postpartum women; Increase safe and healthy pregnancies, improve birth outcomes, and reduce related effects of maternal drug abuse on infants and children; Improve the mental and physical health of women and children; improve family functioning, economic stability, and quality of life. PPW will participate in residential treatment and recovery support, focused on tobacco cessation and abstinence in order to decrease Fetal Alcohol Syndrome Disorder (FASD), increase family functioning; decrease criminal charge frequency; increase employment and financial stability; prevent abuse and out of home placements and encourage early reunification of placed children. PPW and family members will receive evidence-based case management using the P-CAP model, peer-mentoring support, medication assisted treatment (MAT), Nurturing Parenting education, Individualized Placement Support (IPS) Services, Doula, and Promotora support, evidence-based and designed to prepare and support pregnant/postpartum women and their families with resources and skills to maintain recovery and a healthy lifestyle. Children will have access to comprehensive medical care and social supports aimed at promoting healthy developmental and social emotional functioning. Through the provision of evidence based, family-centered services, individually tailored to maximize outcomes, it is anticipated that substance use can be reduced, behavioral health symptoms can be improved, and increased resilience and positive parenting skills expected can be learned and strengthened.

Project THRIVE will provide residential substance abuse treatment and other services at Volunteers of America Texas San Antonio Living in Good Healthy Treatment (LIGHT) program location. THRIVE will provide a trauma-informed, family-centered, culturally-competent continuum of services to aid pregnant and postpartum women in attaining long-term recovery while reuniting and strengthening their families. THRIVE will expand the substance abuse, parenting, and recovery services available to substance-using pregnant and postpartum women through the incorporation of new community-based partners and by expanding services to meet the needs of family members of the women in treatment. Special emphasis will be placed on serving the fathers of the children of the women in treatment. The project will integrate a number of evidence-based practices and programs including Motivational Interviewing, Strengths-based Case Management, Seeking Safety, Understanding Dad™, Thinking for a Change, Nurturing Fathers, Celebrating Families!™, and the Nurturing Program for Families in Substance Abuse Treatment and Recovery (NPFSATR). Services will also be provided to children, the children’s fathers and other family members of the participating women, such as screenings and referrals for physical and mental health needs, including substance abuse treatment. Comprehensive, strength-based case management will guide all project clients through their services and link them to outside resources. To date, nine partners have signed on to this project and have provided letters of commitment/MOUs to support the achievement of the Service Delivery goals and objectives as well as the Outcome goals and objectives. The proposed interventions support SAMHSA’s goals of reducing substance use; increasing safe, healthy pregnancies; improving mental and physical of women and children; improving family functioning; and decreasing crime, violence, abuse, and neglect. 300 adult, primarily Hispanic, low-income, pregnant and postpartum (PPW) women, and an estimated 80 of their children, 30 fathers and 35 family members in San Antonio and/or Bexar County, Texas will be served over the life of the project. As required by SAMHSA, participants will complete a 6-month follow-up assessment. Wilder Research will serve as the Lead Evaluator for the project. VOATX has been operating the LIGHT residential treatment programs for over 13 years which offers organized substance use disorder treatment services for women and their minor children, and features a planned regimen of care in a safe 24-hour residential setting with staff supervision. Project THRIVE will approach service delivery from a family-centered perspective, to meet the multiple individual needs of the population of focus, and consider the health and well-being of the family members; and, the needs of all the minor children of the mothers in the program. The minor children and other family members who do not reside in the treatment facility are to receive the required services and interventions, and the appropriate staffing structure will ensure that the children, the fathers of the children and other family members are actively engaged in the treatment process. To ensure that the goals of the individual and family treatment plan are met, any services that are provided off-site will be well-coordinated. The key staff are the Project Director, Case Manager (Women’s Coordinator), Father/Family Coordinator, and Lead Evaluator.

JWCH Mini House(MH)proposed program ""Residential Treatment Services for Pregnant and Postpartum Women (PPW)"" will provide 45 women annually and 245 over the course of the 5 year program (685 women, children and family members total)with residential substance abuse treatment and/or supportive services. The program will target low income minority women, in particular African American and Latina homeless women. The project will facilitate full recovery from SA through treatment, recovery, peer recovery support services, and direct linkage to primary care, mental health, social and housing services. The following outcomes are expected annually: 1) A minimum of 45 women, at pregnancy or post-partum will complete the combined Seeking Safety and Matrix SA treatment interventions;2) A minimum of 35 of the women’s children will complete mental health counseling and case management services 3)A minimum of 85% of women participants identified as needing Residential Medical Detoxification treatment and children/family members needing intensive treatment will be linked to Residential Medical Detoxification treatment (provided by BHS through existing partnership). 4) A minimum of 30% of the women’s family members will be linked to outpatient SA treatment, primary care, mental health and ancillary services; 5)A minimum of 45 persons will complete Intensive CM (ICM) services; 6)A minimum of 45 women will receive peer recovery support services; 7)A minimum of 90% of pregnant/post-partum women in the program will be provided with perinatal and primary care services (provided by JWCH and partner agencies). MH provides 31 beds in a home-like setting for women to receive therapeutic mental health services, substance abuse treatment and case management. MH provides residential care for women, pregnant women and those with small children 24 hours a day, 7 days a week, in 365 days a year. MH, together with Special Services for Groups (SSG), a nonprofit providing services to children and families that address mental health, substance abuse treatment, and homelessness, will develop services aimed at pregnant and postpartum women,their children and family members. This will be achieved through enhancement of a residential SA treatment program using: Matrix combined with Seeking Safety (SS), Intensive Case Management (ICM), and Peer Recovery Support Services (peer support). In addition to child and family services provided to participants by SSG, MH staff will provide the Evidence Based Program Nurturing Parenting Program intervention with topics that address the unique needs of families in substance abuse recovery and childcare services.

Tarzana Treatment Centers, Inc. (TTC) will implement the Growing Miracles Project to provide Residential Substance Use Disorder (SUD) treatment and other related services to pregnant and postpartum women in the Antelope Valley of Los Angeles County (LAC). TTC will target low income African American and Latina women who disproportionately are affected by high rates of preterm birth, infant mortality, and SUD. These women often lack the social supports to cope effectively with childrearing and other stresses in their lives. TTC will provide space in the facility for women to bring their minor children and comprehensive treatment services that include interventions to improve the mother-child bond and support family preservation and reunification. Treatment planning will be family-based and include the mother’s minor children, fathers of the children, mother’s partners, and extended family members. All children will be assessed at intake or within two weeks of intake for children not residing in TTC’s facility with the mother. TTC will tailor treatment plans to include family preservation or reunification plans and will work with relevant agencies to ensure that clients are progressing through treatment successfully and meeting the necessary requirements. The goals of the program are to: Decrease the misuse of prescription drugs, alcohol, tobacco, illicit and other harmful drugs (e.g. inhalants) among pregnant and postpartum women; Increase safe and healthy pregnancies; Improve birth outcomes; Reduce perinatal and environmental related effects of maternal and/or paternal drug abuse on infants and children; Improve the mental and physical health of the women and children; Prevent mental, emotional, and behavioral disorders among the children; Improve parenting skills, family functioning, economic stability, and quality of life; Decrease involvement in and exposure to crime, violence, and neglect; and Decrease physical, emotional, and sexual abuse for all family members. The proposed project will integrate trauma-informed treatment strategies through all treatment encounters. The project will use Beyond Trauma: A Healing Journey for Women and ACTIVE Parenting as its primary Evidence-Based Prevention Interventions. The proposed project will be fully embedded in TTC’s existing service delivery system. Under this program TTC intends to serve” 1) 40 women per year for a total of 200 unduplicated women over the course of the five-year program; 2) 80 children per year for a total of 400 unduplicated children over the course of the five-year program; and 3) 60 family members per year for a total of 300 unduplicated family members over the course of the five-year program.

The Boston Public Health Commission, the city’s health department, proposes the Entre Familia PPW Wellness Project. Its purpose is enhance and expand comprehensive treatment, prevention and recovery support services for PPW Latinas and their children in residential substance use treatment facilities, including services for non-residential family members of both the women and children. It will provide cost effective, comprehensive and sustainable services that address the needs of the Latino families we serve, preserve and support the family unit and provide a healthy and safe environment for women and their children. The project has the following goals: (1) Decrease the misuse of prescription drugs, alcohol, tobacco, illicit and other harmful drugs for 180 Latina pregnant and postpartum women (PPW). (2) Increase safe and healthy pregnancies among Latina PPW; improve birth outcomes; and reduce perinatal and environmentally related effects of maternal and/or paternal drug abuse on Latino infants and children. (3) Improve the mental and physical health of the Latina PPW women and their children; prevent mental, emotional, and behavioral disorders among their children. (4) Improve parenting skills, family functioning, economic stability, and quality of life among PPW Latinas and their families. (5) Decrease involvement in and exposure to crime; violence; neglect; and physical, emotional and sexual abuse for all family members. The project will provide a series of enhancements to an existing residential treatment program that offers comprehensive treatment, recovery and prevention services to Latinas and their children, located in Boston and serving women and children across Massachusetts. It will employ two main evidence-based practices: The Boston Consortium Model: Trauma-Informed Substance Abuse Treatment for Women, and the Nurturing Program for Families in Substance Abuse Treatment and Recovery. The proposed project will be designed, implemented and supported by a diverse team of staff and expert consultants with extensive experience providing substance abuse treatment and recovery services to individuals from communities of color. We also propose a robust evaluation effort, led by Angela Robertson Bazzi, PhD, MPH from the Boston University School of Public Health, designed to identify significant program outcomes, better understand the processes by which these outcomes have been achieved and apply lessons learned to this and future programs.

Circle Park Behavioral Health Services, will implement Chrysalis 2.0, a project to expand, extend and enhance the current residential services for pregnant and postpartum women at the Chrysalis Center. While the geographic focus of the project will be the eight bordering counties of the Pee Dee region of South Carolina, pregnant and postpartum women statewide will be eligible for the services. Service enhancements will include medication assisted treatment for opiate disorders, increased health care availability, extended days of residential stays, inclusion of peer support specialist, the implementation of the evidenced based Triple P program and the utilization of telehealth as a recovery resource and tool. These initiatives will serve to not only lower the rates of substance abuse disorders with pregnant and postpartum women but increase successful recoveries and the reunification of families This effort will include a wide range of collaborative partners such as the Behavioral Health Services of South Carolina the Florence County Coalition for Alcohol and other Drug Prevention and a cadre of local health service, medical and community group entities. Our objectives are many but will directly address one of the most critical and underserved populations in our community while improving the overall quality of life for the women, children and families of South Carolina.

House of Healing, Gaudenzia Erie, Inc. will provide comprehensive, integrated medically assisted evidence-based residential treatment, prevention and recovery support services for 150 high risk pregnant and postpartum women in rural Pennsylvania with a substance use and/or co-occurring mental health disorder (COD), 300 of their children in residence or non-residential and 300 family members of both the women and children. Population of Focus: The POF are 150 low-income pregnant and up to 12-months postpartum women, age 18 and over, including women with CODs, women from the criminal justice system (CJS), and women with, or at high risk for HIV/AIDS and hepatitis and 300 of their minor children, age 17 and under. With maternal opioid use in the US increasing disproportionately in rural counties, we will prioritize women living in rural and/or health professional shortage counties who have limited access to quality health services. We will also reach out to under served racial and ethnic minority women, who are often isolated in rural areas of PA. When deemed appropriate, services will be provided to 300 fathers of the children, partners of the women, and other family members of the women and children who do not reside in the residential treatment facility. Target Area: The House of Healing is located in Erie, PA and accepts admissions from: Clearfield; Crawford; Forest; Jefferson; Potter; Venango; and Warren counties. Strategies/Interventions: The House of Healing staff will provide residential treatment that integrates a full range of substance use (SUD) and mental health disorder (MH) treatment; adult and pediatric medical care/psychiatric services; SUD prevention; trauma informed care; wrap-around and recovery support services. Services include case management; childcare; parenting; vocational and employment services, life skill building; aftercare planning and follow-up, family education, counseling, and referral services; and supportive transitional and permanent housing. We will provide age appropriate services for children and services to families and significant others (SOs). Goals: The overall goal is to address the individual needs of the PPW, her children while providing a pathway to recovery with healthy children and positive relationships. 1. Decrease the use/abuse of prescription and illicit drugs, alcohol, tobacco by 90%; 2. Increase safe and healthy pregnancies; and improve birth outcomes for 100%; 3. Reduce negative effects of parental drug abuse on infants and children by 90%; 4. Improve the mental and physical health of the women and children by 80%; 5. Prevent mental, emotional, and behavioral disorders among the children; 6. Improve parenting skills/family functioning/economic stability/quality of life by 80%; 7. Decrease involvement in and exposure to crime, violence, and neglect by 75%; and 8. Decrease physical, emotional, and sexual abuse for all family members by 90%.

Pregnant Postpartum Women (PPW) Residential and Therapeutic Nursery (TN) Services in Hawaii Problem Statement: PPW with substance use disorders continue to be a serious problem in the United States (Armstrong et. al., 2003; Goler et. al., 2008) and poorer birth outcomes are likely (Howell et. al., 1999; Forrester & Merz, 2007; Smith et.al, 2003). Compounding factors of mental health diagnoses, lack of housing and other resources, domestic violence or trauma, and/or involvement with the legal system, create hurdles for pregnant/parenting women to overcome when gaining access to care that will assist in decreasing the risk of pregnancy complications, premature births, birth defects, infant mortality, and child abuse. The Salvation Army Family Treatment Services (FTS) (Oahu) and Malama Family Recovery Center (MFRC) (Maui), the sole providers of residential substance abuse treatment services for PPW in Hawaii, will provide expanded residential service capacity and enhanced TN services to meet the needs of this population in Hawaii. Methods: PPW will receive all continuum services including but not limited to outreach/case management support, screening/assessment, family centered individualized health and wellness planning, and a full continuum of residential substance abuse treatment services as well as ongoing case management so that pre/perinatal and pediatric appointments are kept and ongoing family reunification efforts continue. All evidence based services provided to PPW and their children/extended family are provided in a specific culturally competent manner, in alignment with the local Hawaiian culture, is trauma informed, and is integrated into the treatment approach for both FTS and MFRC. Increased professional services at FTS and MFRC will include a dedicated project coordinator, master’s level counselors, an infant mental health coach, care givers, and an early learning center coordinator. Expected Results: There will be overall increased numbers of PPW clients/families served. Additional staff positions will positively affect the identified target outcomes. These outcomes are related to PPW achieving abstinence, decreasing tobacco/nicotine use, receiving prenatal care, substance free births, infants/children screenings for developmental delays, screenings for physical and mental health issues, providing parenting skills and increasing scores on the AAPI-2, reducing exposure to crime/violence/neglect/abuse, meeting goals and Family Plans, increasing skills and demonstrating skills in attachment through play groups, children exhibiting secure attachment behaviors at discharge, and increasing of overall knowledge and skills in secure attachment as a result of TN interventions. Conclusions/implications: Higher EBP fidelity and effectiveness in service delivery to meet needs. Increased system linkages for PPW services statewide with increased access, capacity, for quality PPW Residential and TN services. There will be increased linkages to courts, corrections, and other community partners. Therefore providing improved continuity and linkage with community program partners. With increased numbers of those reunified, mother and child(ren) in treatment, there will be increased number of fathers reunited with mother and child(ren) while women/children are residing in residential treatment. There will be an increased number of family-centered service plans to include child health promotion, prevention, and treatment services. Family-centered service plans will include active engagement of fathers, partners, and extended family. There will be improvements of developmentally appropriate social, emotional, cognitive, and physical development of child. There will be improved relationships in attachment between mother/child, father/child, and improved family functioning.

PAMPERRS (Pregnant and Mothers Postpartum Enhanced Recovery-oriented Residential Services) expands and enhances specialized residential substance use disorder (SUD) treatment, prevention and recovery support for high-risk pregnant/postpartum women, their children and families from Houston, Harris County, Texas and 12 surrounding counties through gender-responsive, trauma-informed and integrated services strengthened through a comprehensive, coordinated, targeted family systems approach. Baylor College of Medicine (applicant) is proposing an expanded and enhanced residential program with services to be provided as part of its existing and separately funded specialized residential treatment program for women and women with children at Santa Maria Hostel. Services will be provided primarily onsite at Santa Maria's TDSHS-licensed residential treatment center to increase integration and coordination for improved access to treatment and supplemental services for a population who have limited access to quality health services. Baylor College of Medicine will oversee the project, provide critical medical and mental health services and serve as project evaluator. PAMPERRS will offer required supplemental services for the women, their children and family members. PAMPERRS will serve high-risk pregnant/postpartum women, age 18 and over, who are medically stable and meet DSM criteria for SUD diagnoses. The target women are expected to be single; unemployed; homeless or without a permanent or stable living situation; not graduated high school/obtained a GED; had prior criminal justice involvement; have an active CPS case; experienced domestic violence or have trauma histories, present with a co-occurring disorder, and be at or below 100% of federal poverty level. In addition, the women will be primarily African American (41%), Caucasian (41%), Hispanic (16%) and 2% other, with 24% ages 18-26 and 52% ages 27-45. Majority will be referred from Harris County CPS, Harris County Community Supervision and Corrections Department and collaborating drug/family courts. PAMPERRS will serve 310 women (50 Y1, 65 Y2-Y5); 360 children (60 Y1, 75 Y2-Y5); and 350 adult family members (50 Y1, 75 Y2-Y5). The goals of PAMPERRS include: 1) Decrease use and/or misuse of prescription, alcohol, tobacco, illicit and other harmful drugs among pregnant/postpartum women; 2) Increase safe and healthy pregnancies, improve birth outcomes, and reduce related effects of maternal SUD on infants and children; 3) Improve mental and physical health of women and children; 4) Improve family functioning, economic stability, and quality of life; and 5) Decrease involvement in/exposure to crime, violence, sexual and physical abuse, and child abuse/neglect. Client outcomes include improvements in: 1) use and/or misuse of prescription drugs, alcohol, tobacco and illicit drugs; 2) prenatal/birth outcomes; 3) family/living conditions; 4) employment; 5) social connectedness; 6) parenting and family functioning; 7) criminal justice status; 8) child development gains; 9) improvements in mental health status; and 10) access to treatment.

The purpose of the HFP is to provide gender-focused, family-centered comprehensive and collaborative residential prevention, treatment and recovery support services to pregnant and postpartum women (PPW) who have substance use disorders (SUD) and/or co-occurring disorders (COD), their children, and families, including fathers. The first of its kind, bi-state collaboration will provide residential PPW services to women from Missouri and Illinois living in the Saint Louis Metropolitan Statistical Area (STLMSA). The goal of the HFP is two-fold; 1. Expand service provider capacity for PPW treatment services, and 2. Enhance services for PPW, their children, and family members. This purpose will be accomplished through residential trauma-informed prevention, treatment and recovery support services aimed to: 1) reduce substance use and mental health symptoms, 2) improve daily living, 3) increase parenting knowledge and healthy parenting behaviors, 4) increase substance-free births, 5) increase/maintain developmental milestones for children, 6) increase/ maintain social emotional functioning in children, and 7) increase family functioning. Through the provision of gender-specific, family-centered services which are individually tailored to maximize outcomes it is hoped substance use can be reduced and other behavioral health symptoms can be improved. In order to create sustainable change, culturally sensitive services and evidenced based practices will be offered to PPW with SUD/COD, their children and non-residential family members. The Healthy Families Program (HFP) goals and measurable objectives are focused on PPW with SUD/COD, their children and families. The goal of the project is to prepare and support PPW, children, and families with resources and skills to maintain recovery and a healthy lifestyle. Annually, 60 PPW will be recruited in the HFP and 44 PPW will participate in residential prevention, treatment, and recovery support services offered at QOPC to include; parenting education, doula services, medication-assisted treatment (MAT)/Detox, and targeted case management. Additionally, 20 children will have access to participate in residential evidence based treatment services aimed at promoting health developmental and social emotional functioning and 20 non-residential family members will have access to family therapy and parenting education services.

Project name: Fresh Start Recovery Center Expansion and Enhancement Population to be served: VOAIN’s PPW project will target the Indianapolis metropolitan statistical area. Fresh Start Recovery Center (Fresh Start) expects to serve pregnant women and mothers and their children up to age 5 through residential treatment and services, and non-resident family members including dependent children age 5 and older. VOAIN estimates that 75% will be female. All will be low-income (living at or below the federal poverty level and/or eligible for Medicaid). We project that 78% of participants will be white, 15% Black/African-American, 6.2% Hispanic/Latino, and 8% other or multiracial. VOAIN estimates 4.2% of people will be LGBT, which is 7 people annually or 35 during the project period. Project goals and measurable objectives: Expand the program to serve 112 mothers and children annually; Build staff capacity to offer evidence-based treatment and services such as gender-responsive care, Motivational Interviewing, Relapse Prevention Therapy, Trauma-Informed Care, Mind-Body Bridging Substance Abuse Program, the Nurturing Parenting curriculum, and Look Up and Hope program model; Increase the number of mothers who achieve and sustain recovery goals to 60% of pregnant women and 65% for mothers with children; Increase the number of infants and children who are healthy and strong; and Strengthen family bonds and increase stability. The number of people to be served annually and throughout the lifetime of the project: 182 people annually (except approximately 100 people during year 1 to account for the start-up and pilot phase) or 830 people during the project period October 1, 2017-September 30, 2022. Summary: Volunteers of America of Indiana (VOAIN) proposes to use FY 2017 HHS SAMHSA Services Grant Program for Residential Treatment for Pregnant and Postpartum Women (PPW) funds to enhance and expand our Fresh Start Recovery Center (Fresh Start), a fifteen-unit residential addictions treatment program at VOAIN’s Theodora House facility in Indianapolis. The purpose of the project is to increase the availability of accessible alcohol and substance use disorder treatment for pregnant and post-partum women and their families using evidence-based programs and services. Our team approach to case management will offer wrap-around services to meet families’ holistic needs, equipping them with the support they need to be healthy and self-sufficient well beyond treatment. VOAIN seeks PPW funding to expand Fresh Start Recovery Center to an additional fifteen units for women and their children. VOAIN will use SAMHSA funding to support an additional 15 units which will serve approximately 182 people annually (56 mothers, 56 infants and children ages 5 and under, and 70 other family members including dependent children over 5). The SAMHSA-funded program will extend the treatment period from 11 to 14 weeks, with the option to reside at Theodora House up to six months.

Through Serenity House, Mountain Comprehensive Care Center will provide comprehensive residential SUD treatment, prevention, and recovery support services for rural, low-income adult women who are pregnant or postpartum who have SUD or COD and their minor children who have limited access to quality health services. Services will be extended, when deemed appropriate, to fathers of the children, partners of the women, and other family members of the women and children who do not reside in the residential treatment facility. Population: The project will target rural, low-income women, ages 18 and over, who are pregnant or postpartum and have a SUD or COD, their minor children (ages 17 and under) and family members who choose to participate in treatment. The project will include all of Kentucky's 120 counties with an emphasis on serving the 54 rural counties within the Central Appalachian region. Participants have a primary addiction of pharmaceutical opioids along with issues such as co-occurring anxiety, depression, and a history of traumatic experiences. Strategies/Interventions: The project will utilize the evidence-based practices of Motivational Interviewing, Comprehensive Opioid Response with Twelve Steps, Seeking Safety and Living in Balance. All interventions will be conducted through a trauma-informed care approach. Treatment will be integrated with mental health care, victim services, health care, case management, peer and recovery-oriented supportive services, and child and family services. Goals & Objectives: MCCC will serve 16 PPW, 6 children and 6 family members in Year 1, and 24 PPW, 11 children and 11 family members annually in Years 2-5 for a total of 112 PPW, 50 children, and 50 family members. Goals include: 1) Increase access to and use of residential SUD treatment, mental health care, and primary health care for low-income PPW; 2 & 3) Improve access to and use of comprehensive, coordinated, integrated and evidence-based services for children of PPW; and non-residential family members; 4) Increase resources to strengthen individual and family functioning, parenting skills, and recovery support systems; and 5) Ensure that project implementation and evaluation adhere to targeted goals, objectives and outcomes and facilitate CQI. Expected outcomes by the end of the project period include: 1) Decreased misuse of prescription drug, alcohol, illicit and other harmful drugs; 2) Increased incidents of safe and healthy pregnancies; 3) Improved birth outcomes; 4) Reduced perinatal and environmentally related effects of maternal and/or paternal drug abuse; 5) Improved mental and physical health of women and children; 6) Prevention of mental, emotional, and behavioral disorders among children; 7) Decreased physical, emotional, and sexual abuse among family members; 8) Improved parenting skills, family functioning, economic stability, and quality of life; 9) Decreased involvement in and exposure to crime, violence and neglect; and 10) Maintenance of the operational integrity of the program. The University of KY will conduct an independent project evaluation to determine achievement of goals, objectives, outcomes.