Reducing the adverse outcomes of perinatal mental illness and substance use disorders for newborns and families.

The Perinatal Behavioral Health Initiative provides funding and technical assistance to allow medical practices that provide prenatal and post-partum care to implement a coordinated, team-based approach that improves outcomes for women with substance use disorders or mental illness. The team-based model of care pairs obstetric providers with a behavioral health clinician (such as a social worker or licensed addictions counselor), and includes strong care coordination and peer support to reduce the adverse outcomes of perinatal mental illness and substance use disorders for newborns and their families. The Montana Healthcare Foundation and the Montana Department of Public Health and Human Services have partnered to develop this initiative.

Substance use and mental illness during and after pregnancy have serious impacts on the health and well-being of mothers, children, and families around Montana: the problem is on the rise, and affected families are not adequately served by Montana’s current health care system and social services. The number of Montana children in foster care more than doubled since 2011; out of more than 3,200 children in foster care in 2016, 64% were removed from the home for reasons related to parental substance abuse. Among Medicaid patients, the percentage of infants with perinatal drug exposure increased from 3.7% in 2010 to 12.3% in 2016. In a 2017 report, we found that only 6% of Montana’s state-licensed substance use disorder treatment programs serve pregnant women or young families.

Based on national evidence and examples from other states, implementing a supportive, team-based approach to prenatal and postpartum care along with better coordination between health care providers and social service agencies offer a powerful way to improve these outcomes.

For more information about this initiative and the funding opportunity, please watch the webinar below. For additional videos on this topic, please visit our Perinatal Behavioral Health Vimeo album

Funding Opportunity

Grant funding of up to $150,000 for 2-year projects is available. MHCF and DPHHS will also provide in-depth training and technical assistance to grantees throughout the project.

Grant funding will be awarded to providers who work closely with pregnant and postpartum mothers experiencing behavioral health issues. Family practitioners, obstetricians, midwives, and rural hospitals are encouraged to apply. Required grant elements include:

  • Clinical Team: Establish a care team that includes prenatal and post-delivery care with care coordination and “warm hand-offs” to a licensed behavioral health clinician.
  • Community-Wide Reach: Develop partnerships and a defined referral pattern among practices in the community so that most prenatal patients are screened for substance use disorders and those that need care are cared for by the clinical team.
  • Multidisciplinary Collaboration: Develop collaborations among the clinical team, child protective services, public health and home visiting programs, criminal justice, and other agencies as appropriate.
  • Unmet Social Needs: Screen for social needs and use care coordination and collaboration with local organizations to address needs such as transportation, housing, and additional intensive treatment.
  • Culture Change and Communications: Develop and promote (both in the hospital and community) a supportive approach that engages women and increases participation in prenatal care and substance use disorder treatment.
  • SBIRT: Implement screening, brief intervention, and referral to treatment for pregnant women.
  • Collaboration with Tribes or Urban Indian Health Centers: Develop a strong collaboration with the appropriate tribal or urban Indian health centers if caring for a substantial number of American Indian families.

To apply, please email MHCF Program Director Tressie White. Grant decisions will be based on the selection criteria below.

Selection Criteria

Invited grant applications for this initiative will be evaluated accourding to the following criteria:

Importance of perinatal behavioral health issues in your community: The volume of prenatal and post-partum care provided in your practice or hospital, and the prevalence of perinatal behavioral health issues in the population you serve.

Need: The grant will fill a need that cannot be met by other resources available in the community(ies) served.

Sustainability: A short-term grant investment will catalyze improvements that endure long after the grant funding runs out. When funding will be used to establish or support new programming, the strongest proposals will demonstrate a clear, feasible plan to sustain the programming through third-party reimbursement or shared savings within the health care system.

Creating partnerships: The proposed project will create or advance new and substantive partnerships that result in more efficient and effective use of resources, and collaboration between organizations that may not typically work together, such as health care providers (hospitals, clinics, behavioral health treatment centers), public health (local or tribal health departments), and other organizations (such as community developers, county sheriffs, or schools). The strongest proposals will include specific plans for the involvement of and collaboration with and among the major health resources in the community.

Focus on at-risk populations and health disparities: The proposed project will serve a region or population of high need, as measured by the existence of health disparities, poor access to health care, health professional staffing shortages, geographic remoteness, or other factors clearly described in the proposal. Health disparities are defined as the higher rates of illness experienced by certain populations, including socially or economically disadvantaged families, racial and ethnic minorities, children, and older adults. In all our initiatives, we seek to decrease health disparities and to improve health and well-being among those at greatest risk.

Solutions exist: Effective, evidence-based interventions exist to address the problem but are not already being implemented.

Workable in Montana and culturally appropriate: Infrastructure, community support, and strong partners exist to implement the intervention; the intervention is tailored to work well within the community(ies) that will be served.

Feasibility and scale: There is a high probability that this MHCF investment will lead to success.  The strongest proposals will also have a high potential for being replicated successfully in other communities. The dollar amount of the proposed project budget is appropriate to the scale and complexity of the project.

Contribution to a diverse grantee portfolio: We seek to support a range of projects across Montana. We recognize that preparing a high-quality grant application may be more difficult for smaller communities that lack staff and resources. We may give preference to proposals based on their contribution to the overall diversity and balance of our portfolio, and to proposals from regions with the greatest demonstrated need.

Involving stakeholders and community members: The proposed project includes a strong plan to ensure that community members and other stakeholders are engaged and included in the work.

Collaboration with tribal leadership: Projects that involve a substantial focus on American Indian populations must demonstrate collaboration with the appropriate tribal health authorities, such as the relevant tribal council(s), the health directors of the relevant tribes, or the relevant urban Indian health centers.

Integrated Behavioral
Health

Substance Use Disorder Prevention and Treatment

Behavioral
Health Leadership

Focus Area: Behavioral
Health

Perinatal Behavioral Health Resources

Our Work in Perinatal Behavioral Health

Perinatal Behavioral Health Grantees

Helena OB/GYN and Associates

Go Mom Go

Project Term: 24 months; 2018-2020
Grant Amount: $150,000

Helena OB/GYN and Associates and community partners organizations will collectively develop a program that supports mothers and mothers-to-be in Lewis and Clark County. The genesis of the program is to provide a proactive, integrated behavioral health and community-based care delivery model for pregnant women and those exposed to perinatal drug use. Community outreach and a marketing plan will also be developed throughout the course of this project. Key partnerships include Saint Peter’s Hospital, Florence Crittendon Home, and Helena Indian Alliance.

Healthy Mothers Healthy Babies

Building Bridges for Better Births

Project Term: 24 months; 2018-2020
Grant Amount: $68,000

For this project, Healthy Mothers Healthy Babies (HMHB) will work with statewide partners to coordinate community coalitions focused on implementing evidence-based integrated behavioral health models to treat perinatal substance use disorders. This work aligns closely with MHCF’s Solving Perinatal Drug and Alcohol Use Initiative, and, as part of this project, HMHB will partner with the foundation to plan for and convene two meetings that will allow for presentation and coordination of statewide efforts to successfully treating perinatal substance use disorders and decrease the number of infants born exposed to drugs in Montana.

Saint James Healthcare Foundation

A Relational Model for Reducing Perinatal Substance Use Disorders in Southwest Montana

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

For this project, Saint James Healthcare (SJH), in partnership with a network of community partners, will work to prevent perinatal substance abuse and improve care and access for pregnant women struggling with substance use in Southwest Montana. The multidisciplinary community team includes SJH, Montana Chemical Dependency Center, Southwest Montana Community Health Center, the Butte-Silver Bow Health Department, the Southwest Region Child & Family Services, and the Butte Community Action Team. This program a relational model of care and education inclusive of behavioral health, consistent prenatal care, and care coordination to address social factors impeding treatment. As a key component, the program engages the father or significant partner within the sphere of care, treatment, and social support. The program seeks to reduce occurrences of substance use in pregnancy and specifically encourages a path to long-term recovery through early detection and intervention, accessible treatment, and increasing community awareness. SJH will create a clinical team consisting of a social worker/care coordinator, a licensed behavioral health provider and family medicine physicians and an obstetric provider. Grant funds will be used primarily to support personnel and facilitate travel.

Providence Montana Health Foundation

A Collaborative Approach to Screening and Treatment of Perinatal Drug Use Disorders

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

For this project, Missoula’s Providence Saint Patrick Hospital (SPH) will implement a collaborative approach to screen for and treat perinatal drug use. The goal of this project is to provide holistic, non-judgmental care empowering women with skills and resources to successfully care for their newborns, especially those with neonatal abstinence syndrome. The hospital’s family maternity center and neurobehavioral health will partner with Western Montana Clinic’s obstetrics and gynecology providers to establish and implement a clinical care team that includes licensed behavioral health clinicians. At the community-level, partnerships will be established with the Missoula City-County Health Department, the neonatal abstinence syndrome workgroup, child protective services, and other appropriate agencies. Providence SPH and Community Medical Center will work collaboratively on educational and outreach efforts for staff and the community-at-large regarding the critical importance of addressing the impact of perinatal drug and alcohol use in Missoula. A central focus is provider education regarding the need for universal drug screening for all pregnant women in Missoula and the surrounding areas to improve health outcomes for mothers and their newborns. Grant funds will be primarily used for personnel including a behavioral health provider and childbirth educator.

Community Medical Center

Improving Screening and Treatment for Perinatal Drug Use in Missoula

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

For this project, Community Medical Center (CMC) will work to improve the quality of care for pregnant women and infants affected by substance use disorders in Missoula County. In collaboration with Partnership Health Center, Saint Patrick’s Hospital, and community groups serving pregnant women, this project’s goal is to reduce the stigma that prevents many women with substance use disorders from seeking help. As a part of the project, obstetric offices will standardize screening and care for women with substance use disorders and partner with community organizations to provide referrals to addiction support services. As a part of the project, CMC’s mother-baby unit will institute a program to engage parents as partners in the treatment of neonatal abstinence syndrome after birth. This approach will train parents to use evidence-based, non-pharmacologic methods to soothe withdrawal symptoms in babies. The goal of this approach is to improve mother-infant bonding, strengthen families, decrease pharmacologic treatment and long hospital stays, and decrease foster care placements in Missoula County. Grant funds will be used for personnel expenses, staff training, and communications and marketing materials.

2018 Call for Proposals

Find out about this year’s available grants.