Grants Dashboard

Overall, the number of opioid overdose deaths in Massachusetts rose 450% between 2000 (338 deaths) and 2015 (1526 deaths). In 2016, approximately 27% of opioid deaths in Massachusetts were women. A review of Massachusetts Department of Public Health, Bureau of Substance Abuse Services (BSAS) data specific to women of child-bearing age (15–44) shows the number of opioid related deaths (all intents) in Massachusetts increased from 9.6 deaths per 100,000 females in 2012, to 174 for a rate of 12.8 deaths per 100,000 in 2013. The state’s child welfare agency, the Department of Children and Families (DCF) reports an increase in allegations of a substance exposed newborn (SEN) over the last two fiscal years, from 2,326 in FY 2015 to 2,642 in FY 2016. The agency saw a 10.4% increase in intakes involving SEN during FY 2016 compared to the previous year. The rate of reported prenatal exposure in Massachusetts rose from 2.6 per 1,000 hospital births in 2004 to 14.7 in 2013, an increase of more than 500%. Led by the Massachusetts Department of Public Health (MDPH), Bureau of Substance Abuse Services, we propose to implement Project Promise, a pilot outpatient day treatment program based in the city of Boston that will serve 150 women and their families, including approximately 300 minor children, across the three-year project period. Project Promise’s purpose and goals are to: a) support family-based services for PPW with a primary diagnosis of a SUD; b) pilot a PPW-specific day treatment program to improve services provided to these women and their children in nonresidential-based settings, and c) use what we learn to improve service delivery and develop more effective policies for PPW across the statewide system. Specifically, we seek to: 1) better integrate Medication Assisted Treatment with prenatal and postpartum care; 2) expand an array of family-specific services into the postpartum period; and 3) pilot key elements of an outpatient program specifically designed to address the needs of PPW and their minor children. In addition, through the project’s infrastructure components, we will enhance system capacity to improve service delivery statewide, and develop policy and practice to strengthen the statewide system for family-based treatment and recovery services for PPW and their children, including developing new reimbursement rates for day treatment. We will also use data from the pilot to define the key components and develop an appropriate rate for an outpatient PPW service delivery model. Through the work of this grant, we anticipate our activities will improve, expand and enhance access to treatment, support sustained recovery, and prevent substance misuse, abuse and overdose to achieve life-saving results.

Project PrOMISE (Pregnant or Mothers with Infants Substance Exposed) focuses on pregnant and postpartum women with substance use disorders, including but not limited to opioid use disorders. This target population includes family as defined by the woman. We focus on women in two locations across New York State: the city of Syracuse, in Onondaga County, and the city of New Rochelle, in Westchester County. If awarded, NYS OASAS will select and fund a third provider in New York City. Recognizing the vulnerability and unique needs of the target population of pregnant and postpartum women and their substance exposed newborns, Project PrOMISE will provide family-centered, gender-responsive, and trauma-informed care. Project PrOMISE seeks to enhance and expand the provider capacity to treat women in several ways. First, NYS OASAS will develop state infrastructure and develop an operating certificate endorsement for women and children’s programs, with an initial focus on community based outpatient and residential services. This will identify programs that offer gender-specific/family-centered services, and create a specific set of standards for those services. Second, NYS OASAS will provide training based on the SAMHSA Training Tool Box for Addressing the Gender-Specific Service Needs of Women, and we will support that training with the 2011 SAMHSA guidance document, Addressing the Needs of Women and Girls: Developing Core Competencies for Mental Health and Substance Abuse Professionals as well as the 2007 SAMHSA Guidance document, Family-Centered Treatment for Women with Substance Use Disorders – History, Key Elements, and Challenges. Third, we require our selected providers to offer evidence-based programming, including medication assisted treatment (MAT) on site or through a formalized relationship with another provider. Fourth, we require our providers increase outreach and engagement with local services, including family planning clinics, ob-gyn offices, local departments of social services, and local housing support services

The Virginia Department of Behavioral Health and Developmental Services will implement Project LINK to provide substance use disorder treatment for pregnant and parenting women. It will enhance efforts in nine existing sites and add two new sites for this purpose. The women served are in targeted underserved rural and urban areas in southwestern, eastern, northwest and central Virginia. Many of these areas are experiencing significant numbers of opioid overdoses. Goal 1: Reduce abuse of alcohol and other drugs - Objective 1) Educate at least five medical, child welfare and other providers in each project area in year one about the unique biopsychosocial needs of women who use substances. Objective 2) Increase the number of medical providers conducting screening and referral services to women of child bearing age in each project area in year one. Objective 3) 100% of project LINK staff will utilize ASAM criteria to identify and refer women to the appropriate level of care. Objective 4) Provide trauma-informed and trauma-specific services at 100% of Project LINK programs throughout the funding period. Goal 2: Increase engagement in treatment services - Objective 1) All Project LINK sites will create at least one formal or informal MOU with providers to refer PPW to the CSB for treatment services. Objective 2) All referred PPW who consent will be enrolled in treatment within 48 hours or sooner Goal 3: Increase retention in the appropriate level and duration of treatment - Objective 1) All Project LINK staff will work with medical, child welfare, and opiate treatment providers to develop and implement multidisciplinary Plans of Safe Care for SEI throughout the project period. Objective 2) Utilizing a trauma-informed approach with all clients, Project LINK staff will provide outreach, home visiting, recovery support services, and other support services to facilitate retention in services throughout the project period. Goal 4: Ensure that opiate-dependent women have access to both methadone and buprenorphine and receive appropriate support services. -Objective 1) Project LINK staff will develop an ongoing collaborative relationship with at least one local OTP programs and community buprenorphine provider throughout the project period. Objective 2) Project LINK staff will provide training each year to at least one social service agency and one medical provider to reduce stigma and misinformation regarding PPW’s use of MAT. Goal 5: Enhance parenting and family functioning -Objective 1) Educate at least 80% mothers in Project LINK services regarding the impact of in-utero substance exposure on infants, the importance of bonding and enhance their ability to read their baby’s cues. Objective 2) Educate at least 80% of mothers in Project LINK services regarding their children’s physical, developmental, and emotional needs. Objective 3) Educate at least 80% of mothers in Project LINK services on the effects of trauma and toxic stress on their own lives and the related impact on their children.