Project Overview

Through the Mother & Baby Substance Exposure Initiative (MBSEI), Health Management Associates (HMA) provided consultative services, coaching and other technical assistance (TA), on behalf of the California Department of Health Care Services (DHCS), to increase access to MAT using the three FDA-approved medications for the treatment of opioid use disorder (OUD). The goal of the initiative was to reduce unmet treatment needs and reduce opioid overdose related deaths through the provision of prevention, treatment and recovery activities for OUD. Additionally, the initiative aimed to decrease neonatal abstinence syndrome (NAS) severity and length of stay in the hospital, and to increase the number of mothers in long-term recovery.

The grant period was January 2019 to December 2020. During this time, HMA worked hand-in-hand with the California Maternal Quality Care Collaborative (CMQCC) and the California Perinatal Quality Care Collaborative (CPQCC) to deliver state-of-the-art treatment from the prenatal phase to the post-delivery phase. The outcomes include:

• synthesis of information so that all programs and community-based service providers have access to the same information;
• elimination of delays between treatment requests and medication starts;
• standardized and improved addiction, pain management and related services available during delivery and the post-part period;
• standardized and improved hospital-based approaches to the management of NAS including preserving the mom-baby dyad in the postpartum period;
• standardized and improved post-discharge pediatric services available to affected infants including reduction in punitive engagement with child protective services;
• improved access to and help from Addiction Specialty care;
• accurate information consumed by the public;
• partners with large scale skill improvement and stigma abatement;
• high fidelity and predictable practice methods with sustainable delivery;
• information repository available for non-grantee locations; and
• live dissemination of relevant information.

Throughout the website, the terms mother or maternal or she or her are used in reference to the birthing person. We recognize not all birthing people identify as mothers or women. We believe all birthing people are equally deserving of patient-centered care that helps them attain their full potential and live authentic, healthy lives.

Goals

• Decrease NAS length of stay by decreasing NAS severity
• Increase the number of moms identified
• Decrease the number of Child Protective Service referrals
• Increase the number of moms in long term recovery
• Increase ability to identify and treat 50% of predicted individuals in the partners catchment area

Outcomes Achieved

• Developed an outreach and implementation plan to build on the framework of existing treatment access points
• Developed or build upon existing protocols, guidelines, safety bundles, and toolkits (NAS Toolkit)
• Distributed OUD patient education materials
• Coordinated learning collaboratives
• Provided technical assistance
• Developed a resource library