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.

SCO Family of Services, an experienced provider of comprehensive family unification and foster care, behavioral health treatment, shelter, health home, and preventive services proposes the Comprehensive Support Program, an enhanced trauma-informed residential treatment and transitional recovery support program for women with co-occurring disorders, traumatic stress, and histories of victimization, and their children and partners. Women and children from 0 to 3 will enter the Morning Star residential program at SCO?s Madonna Heights campus in Dix Hills, NY?the only behavioral health treatment facility for mothers with children on Long Island. There is an escalating crisis of opioid dependence and a severe treatment bed shortage for women in this area of 7.8 million people. Thirty PPW, 33 children, and 15 spouses/partners will be served per program year, with a total of 355 unduplicated persons served over 5 years. An estimated 50% of mothers will be white, 25% African-American, 20% Latina, and 5% will identify as mixed race. From 10% to 15% of women will identify as lesbian or bisexual. The racial and ethnic makeup of adults and children in the community will roughly parallel that of the PPW. Approximately 90% of the population will be English speaking, 10% will have languages other than English as a 1st language, and 95% will be Medicaid eligible. Forty-five per cent of women will abuse heroin as the primary drug of choice, 70% of women will have at least one child, and 70% of women will have active CPS cases. The goals of the project will be to decrease SUD and the impact of co-occurring disorders and trauma, and to improve birth outcomes and promote healthy child development and improved family functioning for PPW and their families. The objectives will be: 1) Provide comprehensive clinical service coordination blending EBPs for substance abuse, co-occurring disorders , trauma, and health issues into a seamless system of care for PPW women, minor children, and partners; 2) Provide ongoing integrated family services for PPW, partners, and children to strengthen parenting, family unification and family wellness, and to promote age appropriate child development; 3) Implement transition recovery case management, linkage, and ?warm-handoffs? to community support services for PPW and family members; 4) Provide preventive services [to non-CPS involved families] in home and community settings to reduce risks to PPW families and children associated with parental substance abuse, trauma, and family disruption; and 5) Provide health home care management for all eligible children of PPW in the community. The project team consists of a Project Director, Project Coordinator, Women?s Coordinator, Children?s Coordinator, Nurse, two Family Peer Advocates, and a Family Parenting Specialist. Evidence-based strategies include MET, Helping Women Recover/Beyond Trauma, Seeking Safety, The Incredible Years, Celebrating Families!, the Sanctuary Model, and TF-CBT. A Project Evaluator experienced working with PPW will monitor project performance and provide regular feedback to the project team. A total of $2,410,816 is requested over the life of the project.

SAMHSA TI-17-007 Pregnant and Postpartum Women To address the rise in opiate abuse and addiction among pregnant and postpartum (having had children within the past 12 months) women (PPW) residing in the greater Cleveland Metropolitan Ohio counties of Lorain and Medina. The Lorain County Alcohol & Drug Abuse - Way (LCADA-WAY) will re-tool, expand and enhance its Residential Treatment Center and recovery support services. The project Providing Access to Treatment for Indigent Pregnant and Postpartum Addicted Women–II (PATIPPAW-II) which address co-occurring substance abuse and mental health disorders. The KEY program specifically targets the high-risk populations of indigent pregnant and postpartum women, as well as their minor children, affected by maternal substance use and abuse. LCADA began providing residential treatment to women and children in 2004 and in 2009 received a CSAT PPW grant that targeted alcohol dependent women PATIPPAW-II and their minor children. The one-hundred women and their minor children to be served by the residential program are Caucasian (70%); and will be between 18 and 35 years of age. Data from the current Program indicates that this population is at special risk for substance use problems and co-occurring disorders, and has a variety of barriers to perinatal and postpartum care, and to family health and well-being. An estimated 50% of the women to be served will have less than a high school education and 80% will live below the federal poverty level. More than 60% are expected to have co-occurring mental health disorders. These indicators have prompted LCADA to enhance its cultural competence and responsiveness in order to most effectively address specific issues that may be perceived as barriers to the recovery process. The purpose of the Program expansion is to increase access to treatment and recovery support services for women in the greater-Cleveland area (Lorain and Medina Counties) who are pregnant or postpartum, their children, and their partners and families. Project Goals include to decrease barriers to accessing substance abuse treatment for women in first trimester of their pregnancy, resulting in early entry into evidence-based treatment and recovery support, to reduce substance use and severity of co-occurring disorders among pregnant and postpartum women, and to increase the coordination of services and enhance long-term recovery supports for pregnant and postpartum women in new recovery, their children and families.

The SWC-FamU Program aims to reduce the perinatal and environmentally related effects of maternal and/or other family member drug use on infants and children through 17 years of age and through the following four enhanced mother and child services: Parenting Safety Pediatric Centering, Mindfulness Based Family Support, Mindfulness Based Parenting, and Mindfulness Based Centering Prenatal Care. Project Name: Supporting Women and Children in Substance Abuse Recovery - A Family Unit Approach (SWC-Famu) Population served: The target population will be low income pregnant or postpartum women 18 years or older who are underserved and have unmet needs due to disparities of race, class, ethnicity or religion. Services for family members of both the women and children will be targeted in this innovative programmatic adaptation. Strategies/interventions: The four interventions proposed in this program include: Practicing Safety Pediatric Centering, Mindfulness Based Family Support, Mindfulness Based Parenting, and Mindfulness Based Centering Prenatal Care. We will engage children of women in treatment up to age 17 in age specific care by improving their access to pediatric care (Practicing Safety Pediatric Centering). We will also extend services to children who do not reside in the residential treatment center, as well as fathers, partners, and other family members of the women, when deemed safe and appropriate, within our Mindfulness Based Family Support program. The SWC-FamU program will also include Mindfulness Based Parenting, and evidence-based trauma-informed parenting model. Additionally, we intend to increase safe and healthy pregnancies through Mindfulness Based Centering Prenatal Care to improve birth outcomes. Lastly, a distinguishing feature of our program is outreach campaign throughout the city to identify traditionally underserved populations, especially racial and ethnic minority women. Project goals and measurable objectives: The overall purpose of the project, along with the associated goals and objectives, will be to implement an integrated model of health and social service care to stabilize, strengthen, preserve, and reunite families, for the women, their minor children, fathers of the children, partners of the women, and the extended family members of the women and children, as appropriate. Number of people served annually and throughout lifetime of project: The unduplicated number of women we intend to serve each year is 34-170 total for all years of the grant; 2) the estimated number of children yearly is expected to be between 75 and 100 and we intend to serve 340-375 for the entire grant; and 3) the estimated number of other family members we propose to serve annually will be between 34 and 136 and over the project period 170.

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.

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.

DACCO?s Women?s Residential Treatment in Tampa Florida will expand its current residential substance abuse treatment, prevention, and recovery services through the proposed Family Treatment Services to 150 pregnant and postpartum women and 250 children (20 pregnant and postpartum women and their 30 children and 10 pregnant and postpartum women and 20 children involved in dependency court who do not have their children with them but are working toward reunification annually). The unique duplex setting on-site with 8 bedrooms in 2 duplexes is groundwork for a unique treatment program outside of the in-house 78 bed dorm-like therapeutic community. Grouping women with like struggles and their children will enhance the recovery environment, camaraderie and very much simulate living in an apartment after discharge. The program will also provide trauma-informed services to stabilize, strengthen, preserve, and reunite families for the women, minor children, fathers of the children, partners of the women, and extended family members. Through the use of evidenced-based strategies DACCO will accomplish its goals of (a) decrease the use and/or abuse of prescription, alcohol, tobacco, illicit and other harmful drugs among pregnant and postpartum women; (b) increase safe and healthy pregnancies; (c) improve birth outcomes; (d) reduce related effects of maternal and /or paternal drug use on infants and children; (e) improve the mental and physical health of the women and children; (f) prevent mental, emotional, and behavioral disorders among the children; (g) improve parenting skills, family functioning, economic stability, and quality of life for families; (h) decrease involvement and exposure to crime; violence; neglect; and (i) decrease physical, emotional, and sexual abuse for all family members. DACCO will provide residential treatment services to pregnant and postpartum women and their minor children, as well as an array of services for non-residential family members of both the women and children delivered on-site at DACCO?s main campus or in-home. Other components will include follow-up care after families leave the residential setting by continuing the individual and family wellness and recovery plans in the home, and adding parenting and workshops to enhance family functioning and mitigate re-lapse. DACCO will include culturally competent, trauma-informed services designed to meet the specific needs of PPW and their children. The application builds on the strong 44-year service record of DACCO. DACCO has successfully received and implemented substance abuse prevention, treatment, and recovery grants from local, state, and federal sources. In addition, DACCO was awarded the Substance Abuse and Mental Health Services Administration (SAMHSA) 2013 Science and Service Award and the 2013 iAward for Innovation in Behavioral Health Services national awards for Comprehensive Coordinated Care for opiate-addicted pregnant women.

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.

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.

Mary Hall Freedom House, Inc. (MHFH) is pleased to submit this proposal to the Substance Abuse and Mental Health Services Administration (SAMHSA), in response to FOA No. TI-17-007, titled ?Services Grant Program for Residential Treatment for Pregnant and Postpartum Women (PPW). SAMHSA?s continued commitment to serving women with very complicated life issues compounded by substance-use is empowering for diverse stakeholders seeking to collaborate to serve this hard to reach and retain population of women grappling with substance abuse and co-occurring disorders. MHFH will contribute to the process of changing the lives of PPWs and their children, and we are requesting $2,567,066 to serve 125 pregnant and postpartum women, their minor children, and families over a five-year period. Funds will be utilized to expand and enhance our residential substance abuse treatment and related behavioral health and wrap-around services to more effectively reach, retain, and positively impact PPWs and their families.

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.

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.

The Richmond Behavioral Health Authority (RBHA) seeks funding to transform its residential treatment services for pregnant and postpartum women by expanding the availability of evidence-based services, providing family-centered wrap-around supports and continuing care services, thus positively impacting the lives of the children, their fathers, and family members. By providing more comprehensive treatment services, recovery supports, and family services than what currently exist in our community, we will effectively respond to the needs of women and their children, as well as fathers and family members. The five primary goals of the CARE (Creating Access through Recovery & Engagement) Project include: (1) Increase the provision of pre- and post-natal care for pregnant and postpartum women with substance use disorders (SUDs) and/or with SUDs and co-occurring mental health disorders; (2) decrease the incidence of alcohol, tobacco and other drug use among pregnant and postpartum women through the provision of assertive outreach efforts and comprehensive treatment services; (3) improve family outcomes by providing child and family services in the areas of enhanced residential treatment, comprehensive healthcare, and continuing care; (4) decrease involvement in and exposure to crime, trauma, and child abuse and neglect; and 5) evaluate the effectiveness of the project in achieving the defined goals and objectives. The target population is adult pregnant and postpartum (up to 12 months) women who have been diagnosed with SUDs, and with SUDs and co-occurring mental health disorders who reside in the Richmond metropolitan area. The racial demographics of the target population include: 94% African-American, 5% Caucasian, and 1% Hispanic. 100% indicate English as their primary language. The primary drug of addiction is opioids (61%); followed by cocaine (16%); marijuana (18%); and alcohol (5%). It is estimated that 60% of the target population will be diagnosed with co-occurring mental health disorders, the most prevalent of which will be Mood Disorder (50%). Histories or current experiences of trauma are present in approximately 90% of current participants; domestic violence is present in approximately 70% of these cases. The target population has had substantial involvement with the criminal justice and social service systems. Additional problems associated with this target population include a limited or nonexistent employment history, under-education, and a lifestyle of economic dependence on others and/or public assistance. The CARE Project aims to serve 135 women and 375 children over the course of the five-year grant period. Partners of this project include: RBHA; SAARA (Substance Abuse & Addiction Recovery Alliance); Virginia Commonwealth University (VCU) High-Risk Obstetrics Clinic; Richmond Department of Social Services; Virginia Department of Aging & Rehabilitative Services; Stop Child Abuse Now (SCAN); and Friends of Prevention Coalition.

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.

LifeStream Behavioral Center, Inc., a comprehensive mental health and substance abuse treatment facility located in Central Florida, proposes to increase residential treatment services for low income, substance misusing women, age 18 and over, who are pregnant or postpartum and their minor children (age 17 and under) in Central Florida. The population of focus will be traditionally underserved populations, especially racial and ethnic minority women. Due to the high morbidity and mortality rates of pregnant women and their infants among African Americans, focused outreach efforts towards this population will be included in the program design. The requested 524,000 per year will purchase an additional 9 residential treatment beds to treat 18 women and their minor children each year of the grant. Over the life of the project, LifeStream proposes to serve 90 women, 180 children and 180 family members. In the targeted area that LifeStream serves, access to specialized residential treatment services is severely limited due to inadequate capacity and the lack of specialized gender specific care. Women are faced with long wait lists to be accepted into residential treatment. In addition, all residential treatment programs in the area that serve the target population have age restrictions on the children that can reside with their mothers or limit the services to infants and/or toddlers. In most cases, pregnant and postpartum women are placed into a less restrictive modality that cannot accommodate their needs, or not placed into appropriate treatment resulting in continued use and unnecessary societal costs. It is critical to secure this funding to better serve the women and their children in Central Florida.By providing a comprehensive array of culturally sensitive and gender specific services to meet the multiple needs of this population, LifeStream’s existing Anthony House Pregnant and Post-Partum Women’s Program will decrease the incidence and prevalence of substance use among women, provide a safe and stable environment for both the mother and child/ren, provide linkages to needed medical services, and provide housing placements, thus, in turn, reducing the likelihood of return episodes. The program will also enhance the healthy development of children. The goals of the program include: 1) Expand the community’s capacity to provide a comprehensive array of culturally appropriate, gender specific treatment services for the pregnant and/or postpartum substance abusing women and their children; 2) Decrease unstable environments among women and their children by providing housing, employment and other critical service linkages; and 3) Improve the overall behavioral and physical health. The following outcomes have been identified: 1) decrease use and/or abuse of prescription drugs, alcohol, tobacco, illicit and other harmful drugs; 2) increase safe and healthy pregnancies; improve birth outcomes and reduce related effects of maternal drug abuse on infants and children; 3) improve mental and physical health of women and children; and 4) improve family functioning, economic stability and quality of life.

SStarbirth, through PPW funding, will enhance an already comprehensive residential treatment program for pregnant and postpartum women and children utilizing evidence based programming to improve treatment outcomes for both women and children. The program has 12 beds and will focus on a flexible length of stay for up to six months, integrated treatment services for the women, children, and identified family members, and coordinated aftercare services. SStarbirth currently provides on-site treatment for substance use disorders, psychiatric evaluations and medication management, case management services, and a licensed daycare. Community partners provide on-site HIV risk education, domestic violence awareness and education, nutrition information, Healthy Families and early intervention services. Community partners provide off site health screening and treatment, GED and job readiness classes. The program philosophy is based on the relational model of treatment, offering a more supportive and nurturing treatment approach than traditional treatment. A primary objective of this project will be to provide integrated assessments for substance abuse, mental health, and trauma issues. Counseling approaches will embrace a best practice approach through training in Motivational Interviewing and use of a structured cognitive-behavioral manualized treatment. Treatment will also include Najavits? ?Seeking Safety? trauma treatment model, and Covington?s ?Helping Women Recover?. Staff will also be trained to further facilitate cultural competency. Further interventions and treatment will include the ARISE intervention model, as well as the ?Nurturing Families Affected by Substance Abuse, Mental Illness and Trauma? and the ?Attachment, Self-Regulation, and Competency? (ARC) treatment model to enhance parenting skills and the parent/child bond will include. Peer Recovery Specialists will be integrated into treatment services to improved client engagement and improve coordination of wrap-around services, thereby improving overall treatment goals and outcomes. SStarbirth staff, with the Program Evaluator, has a well-established protocol for the collection of data. This will include the collection of GPRA data ? a follow-up rate of over 80 percent has been achieved at 6 and 12 month follow-up intervals in the past projects. SSTAR will utilize the NIATx process improvement model to continually improve access and retention. We will work from program onset to gather the evidence needed and create relationships with key stakeholders to secure funding through a variety of mechanisms for all grant services.

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.

The ?Comprehensive Substance-abuse prevention, treatment and support services for pregnant and post-partum women (Latina and Native American), children and families in high risk U.S.-Mexico Border Communities.? project (09/2017- 08/2022) will reach about 500 pregnant and postpartum women (PPW), 500 children, 100 fathers, and 500 of the PPW?s non-residential family members (N=1600) through expansion of comprehensive treatment, prevention and recovery support services for women and their children in residential substance use treatment facilities and their non-residential family members in El Paso TX, including four underserved local U.S.-Mexico border communities in El Paso County, TX. The purpose of this project, is to reduce the disastrous and continuous impact of violence (structural, domestic & sexual), trauma, and resulting substance use and co-occurring mental disorders for low income minority (Latina and Native American) Pregnant and post-partum (PPW) women, their children (birth ? 17 years), the fathers of the children, the partners of the PPW and non-residential family members in underserved high-risk US-Mexico border communities by providing/expanding comprehensive family-centered residential substance use disorder treatment, prevention and recovery services. The goals of this project which uses a Trauma Informed Approach, are: (i) To decrease misuse of substances (alcohol, tobacco, prescription drugs, illicit and other) among PPW, adolescent and older children, fathers of the children, partners of women and non-residential family members in priority communities; (ii)To address impact of violence and trauma on priority communities? PPW?s, children?s (0-17 years) and families? on the risk for physical, emotional and sexual abuse, involvement in crime and substance use through regionally and culturally appropriate family-centered trauma-informed approaches; and (iii) To sustain Evidence Based Practices (EBP) and case management outcomes related to direct and supplemental prevention, treatment and recovery services through design and use of population and sub-group (children, parents, family) specific social media and marketing in priority communities.

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.

East Bay Community Recovery Project in West Oakland, California, is proposing to enhance and expand its service offered at Project Pride, its residential treatment program for women with co-occurring substance use and mental health diagnoses and their children. Project Pride serves a diverse population of low-income women and their children in Oakland, primarily African American and Latinas. The women tend to arrive in crisis due to arrest and incarceration, homelessness, loss of custody of their child(ren) due to abuse or neglect, an overdose, or other trauma. Project Pride provides stability, treatment for co-occurring disorders, parenting education and workforce development services. Family services at Project Pride are delivered through the Protective Factors framework to strengthen the mother?s resiliency and protect against further trauma for the mother and child. The proposal is designed to help these vulnerable families to thrive by offering expanded and/or enhanced services to residents at Project Pride, their children, and their partners and extended family members, to continue the transition of services at Project Pride from a client-centered to a family-centered approach. Newly expanded services to be provided through this effort include: screening and assessment for co-occurring disorders (expanded to serve family members), screening for FASD (new service to be added to programming for women and adult family members), case management and benefits linkages (enhanced for women, and expanded to serve family members), expanded clinical services for family members including short-term individual counseling, a men?s group, and couples and family counseling. Additionally, there will be workforce development assistance and referrals for family members and services for children not in residence with their mothers. Parenting education will be made available to partners and family members and will be enhanced with the addition of the Nurturing Families Program, an evidence-based program that is deeply aligned with the Project Pride family and children?s program design, based in the Protective Factors model. The project proposes to serve a total of 475 individuals over the course of the five years, 95 each year, as follows: 30 residents of the program, 30 family members, 20 children in residence and 15 children not in residence with their mothers. The project will employ a total of 4.25 FTE of staff, including 3 new full-time staff members.

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%.

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.

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.

The purpose of this project is to enhance the service delivery system at Odyssey House, Inc. (OH) by developing the Healthy Mothers Healthy Families 2 (HMHF2) program to address the unique life circumstances and needs of pregnant and postpartum women and their children in residential substance abuse treatment. HMHF2 will attend to trauma, parenting, and reunification and reconciliation with family members in conjunction with intense chemical dependency treatment to develop a family system model of care that will incorporate the whole family unit, and not just the individual, as the focus of care. We will implement a full continuum of existing best-practice interventions for two targeted substance abusing populations which often encounter barriers preventing access to care: pregnant and postpartum women (defined as having given birth in the previous twelve months). The targeted geographic areas the program proposes to serve are New York City communities located in Northern Manhattan and the South Bronx. The goal of HMHF2 is to strengthen the instrumental and social functioning of Project participants by enhancing current services provided with evidenced-based practices of Strengthening Families Program (SFP), Motivational Interviewing (MI), as well as Peer Mentoring and in-kind Seeking Safety (SS) therapy, Nurturing Parent Programming and Case Management. Retention support delivered via peer mentors will maximize our menu of wrap-around services, while the proposed evidence-based practices delivered within a trauma-informed context by licensed social Workers address issues key to engaging the targeted women in long-term recovery. Goals to be achieved through the HMHF include: (1) decrease the misuse of prescription drugs, alcohol, tobacco, illicit and other harmful drugs among pregnant and postpartum women; (2) increase safe and healthy pregnancies and improve birth outcomes; (3) reduce perinatal and environmentally related effects of maternal and/or paternal drug abuse on infants; and children; (4) prevent mental, emotional, and behavioral disorders among the children; (5) improve the mental and physical health of the women and children; (6) improve parenting skills, family functioning, economic stability, and quality of life; and (7) to decrease involvement in an exposure to crime, violence, sexual and physical abuse, and child abuse and neglect. We plan to provide the following in-kind services and service enhancements within our existing New York State Office of Alcoholism and Substance Abuse Services (licensed) residential treatment program to the number of individuals indicated below during the 5-year project: Outreach and Screening for chemical dependency and co-occurring mental health disorders for 400 individuals; referral to appropriate chemical dependency and/or mental health services for 267 individuals; placement in residential chemical dependency treatment services for 200 individuals; case management for 267 individuals; a trauma-informed curriculum for 200 individuals and family therapy for 300 dependent children and family members of individuals not admitted to residential chemical dependency treatment.

Public Health Management Corporation (PHMC) is a nonprofit health and social services organization in Philadelphia, PA. Interim House West (IHW) is a residential treatment program of PHMC that was established in 1993 to serve the needs of substance-using women and their children. When a woman and her child(ren) are discharged from treatment, the adjustment period is a challenge in and of itself, and without the support of family members and significant individuals in her life, it can cause a host of negative outcomes, including relapse and inability to sufficiently parent. Currently, Interim House West is provided with funding to serve women and children (aged 12 and under) residing in the facility. Many women have children 13 and over who do not receive services. Additionally, IHW participants? parents, grandparents, and significant others play a large role in the mother?s recovery process. PHMC would like to address this gap and obtain the resources to holistically engage and provide support and services to these individuals while the mother and children are in treatment in order to increase the level of success during and after discharge from treatment. IHW is proposing the implementation of the Family Resilience Project (FRP) to enhance recovery support services to pregnant and postpartum women and their families in the Philadelphia County catchment area. More specifically, the FRP will allow IHW to expand existing services to include children that live outside the facility as well as other family members. Family will be defined by each woman and can include partners, boyfriends, spouses as well as grandparents, godparents, extended family members and ?like family? individuals to be engaged in recovery as a family unit. Over the five-year project period, wraparound recovery family services will be provided to over 1,200 participants by a team of highly qualified staff that will utilize a variety of evidence-based practices including Family Behavior Therapy (FBT). The Project Director, Family Services and Children?s Coordinator, Case Manager, Therapist, Women?s Coordinator, and other key IHW staff will work together to provide critically needed support services to pregnant and postpartum women and their families including but not limited to: mental health and substance use screenings; trauma screenings; health screenings, developmental screenings for children and family therapy. A myriad of case management services will also be provided to ensure linkages to appropriate care in order to meet the identified needs of the family service plans. Case management services will be offered 6 months post discharge and FBT will be offered 3 months post discharge to facilitate positive outcomes for families. Services provided by the FRP will help to bridge the gap of services needed to fully support pregnant and postpartum women and their families in recovery. Furthermore, services provided by the FRP will likely generate lasting outcomes for women and their families including but not limited to: increasing retention of women in treatment; reducing or eliminating clients? use of drugs and alcohol; improving parenting skills; increasing healthcare utilization; increasing life skills reducing recidivism and involvement in the criminal justice system; improving family communication; and improving family functioning.

ABSTRACT River Region Human Services, Inc. Women, Children, and Family Treatment (WCFT) River Region Human Services, Inc. (RRHS) has designed a residential substance use disorder treatment program for pregnant and postpartum women (PPW) known as the Women, Children, and Family Treatment (WCFT) program. This treatment program uses a family-model approach to treatment and behavioral health services in a drug-free, home-like environment; allowing substance addicted PPW clients to remain unified with their children during their treatment stay. RRHS is seeking funding through SAMHSA?s PPW funding announcement to reestablish its WCFT program and to expand existing PPW services currently funded by the state. As a licensed, non-profit provider for treatment, prevention, intervention and outreach for substance use and mental health disorders, homelessness and HIV/AIDS, RRHS has extensive experience in providing residential treatment to PPW clients that dates back to 2008. RRHS is keenly aware that pregnant women who give birth while in residential treatment facilities typically could not return to complete treatment because of the lack of suitable housing for mothers and newborns. RRHS is also aware that postpartum women in need of intensive substance use disorder treatment are hesitant to seek residential treatment because of the necessity to separate from their children. The WCFT program provides a full continuum of treatment needs for PPW clients, and a safe, drug-free, home-like environment for their infants and children, making it possible for the family to remain unified. In addition, WCFT uses a Family Disease Model approach to treatment by addressing the needs of the children, their fathers, and significant others and immediate family members in the women?s support system. The target population will include unemployed, low-income pregnant and postpartum women ages 18 and over and their children age 17 and under, who have limited access to quality health services. Women who reside in the city?s urban core will be targeted due to high infant mortality rates and other disparities. Funding will also enable RRHS to provide in-home counseling to children who may not be housed with the mother in the facility as well as significant others. In addition, WCFT will provide trauma specific services that create a collaborative and healing environment that improves efficacy in traumatized individuals while including cognitive, behavioral, inter-personal, case management, and supportive services. The range of services include outreach to detoxification, residential substance abuse, outpatient, mental health treatment, case management, parenting and Triple-P, smoking cessation classes, family strengthening and reunification, substance abuse prevention (for children), aftercare, housing assistance, family reunification services, and community re-entry. RRHS anticipates serving 40 women annually (200 lifetime), 50 infants/children annually (250 lifetime) and 30 family members annually (150 lifetime). WCFT?s goal is the successful completion of residential treatment by the targeted population with the objectives of reducing illicit substance use, increasing healthy pregnancies, improving mental and physical health of women and children, and enriching parenting skills.

Santa Fe Recovery Center is a public, non-profit, CARF-accredited (Commission for the Accreditation of Rehabilitation Facilities) substance use disorder (SUD) program based in Santa Fe, New Mexico. We propose to provide 3 months of residential SUD treatment, followed by up to 6 months of intensive outpatient treatment, for low-income pregnant and postpartum women and their young children in northern New Mexico. The need for these services is great. NM has one of the highest burdens of SUD in the country, and no facilities in the entire state that provide residential SUD services for women and their children. ? In 2015, NM ranked 8th in the nation for rate of drug overdose deaths. ? NM has had the highest alcohol-related death rate in the United States since 1997, which is now twice the national rate. ? NM has the 3rd highest rate of poverty in the United States and the 2nd highest rate of children living in poverty. Santa Fe Recovery Center will provide the following services on-site to residential clients: 1-to-1 and group therapy sessions; art therapy with PhD or Master?s level art therapists; psycho-educational classes including grief/trauma, stigma, and relapse prevention; overdose prevention/Naloxone distribution for opioid users and family members; parenting classes; case management services; family therapy and education groups; children?s play therapy; and buprenorphine treatment for opioid SUD. Additional services provided offsite or by collaborating community-based organizations include prenatal, obstetric and infant/child medical care; AA and NA meetings; counseling and advocacy for clients who are survivors of sexual assault or domestic violence; family support and advocacy services; and supportive housing services, including rental and utility assistance. Our intensive outpatient programs are offered in both Santa Fe (Santa Fe County) and Espanola (Rio Arriba County), and we will provide services to non-residential family members through these programs, including an outpatient buprenorphine program for family members with opioid SUD. Santa Fe Recovery Center proposes to serve a minimum of 233 women through residential treatment, 174 children (ages birth to 3 years in years 1-2 and up to age 6 in years 3-5 of the grant), and 466 non-residential family members during the grant cycle. Our project will provide a safe and therapeutic environment for women with SUD to begin the recovery process and to promote healthy attachment and bonding between mother and child(ren) in an effort to cease trauma and addiction across multiple generations of New Mexican families.

The purpose of this project is to enhance the service delivery system at Isaiah House, Inc. (IH) by developing our existing Community Creche Project to address the unique life circumstances and needs of pregnant and postpartum women and their children in residential substance abuse treatment. The Community Creche Expansion Project will attend to trauma, parenting, as well as reunification and reconciliation with family members in conjunction with intense chemical dependency treatment, to develop a family system model of care that will incorporate the whole family unit, and not just the individual, as the focus of care. We will implement a full continuum of existing best-practice interventions for two targeted substance abusing populations, which often encounter barriers preventing access to care: pregnant and postpartum women (defined as having given birth in the previous twelve months). The targeted geographic areas the we propose to serve are New Jersey communities located in Essex County. The goal of CCEP is to strengthen the instrumental and social functioning of Project participants by enhancing current services provided with evidenced-based practices of Family Behavioral Therapy (FBT), and Seeking Safety (SS) group therapy, Motivational Enhancement Therapy (MET) and Case Management. Facilitated access and retention support delivered via peer mentors will maximize our tailored menu of wraparound services, while the proposed evidence-based practices delivered within a trauma-informed context will address issues key to retaining the targeted women in treatment. Goals to be achieved through the CCEP include: (1) decrease the misuse of prescription drugs, alcohol, tobacco, illicit and other harmful drugs among pregnant and postpartum women; (2) increase safe and healthy pregnancies and improve birth outcomes; (3) reduce perinatal and environmentally related effects of maternal and/or paternal drug abuse on infants; and children; (4) prevent mental, emotional, and behavioral disorders among the children; (5) improve the mental and physical health of the women and children; (6) improve parenting skills, family functioning, economic stability, and quality of life; and (7) decrease involvement in and exposure to crime, violence, sexual and physical abuse, and child abuse and neglect. In partnership with Urban Life Wellness and Counseling Center (a New Jersey licensed treatment facility), we plan to provide in-kind services and service enhancements within our existing New Jersey State Residential Child Care Facility (licensed) to serve 200 individuals over the life of the 5-year project.

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 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.

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.

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.

The proposed PPW Enhanced Parenting Program (EPP) will expand comprehensive treatment, prevention and recovery support services for children of parents in two residential substance use treatment programs including services for non-residential parents, partners and natural supports. The Enhanced Parenting Project (EPP) will increase the capacity of our established Women?s Specialty Services Programs to enhance youth treatment and prevention services to 360 residential and nonresidential children and allow for an estimated 200 nonresidential co-parents and partners to receive screening, assessment, brief treatment, Parenting Education, tobacco use counseling and recovery support services (e.g., child care, vocational, educational, and transportation services). Fathers, co-parents, partners other extended family services will be coordinated by a team of specialized recovery coaches under the supervision of the Director of Women?s Specialty Services. Parenting Advocates will act as case managers and service navigators ensuring each individual participant?s access to community based ancillary services as indicated by an individualized assessment completed by a licensed professional. The Enhanced Parenting Program will engage with family courts, health centers and hospitals over a twenty five county area in central Michigan with specific attention to the urban areas of Flint and Saginaw and rural areas with a professional shortage to identify pregnant women, mothers, fathers, partners and families in need of services towards promoting economic stabilization and improved co-parenting relationships. This proposal will enhance our joint efforts in strengthening families and disrupting the inter-generational connection of Substance Use, Trauma Related Mental Disorders, and Domestic Violence with the Economic instability experienced by residents of Flint and Saginaw Michigan and the surrounding rural communities. A local impact evaluation to be completed by C. Debra Furr-Holden, Ph.D., C.S. Mott Foundation Endowed Professor of Public Health, Division of Public Health, Professor, Department of Epidemiology and Biostatistics; Director, Flint Center of Health Equity Solutions; Michigan State University Co-Director, Healthy Flint Research Coordinating Center; Michigan State University College of Human Medicine. The Outcome Goals are to: 1. Decrease barriers to accessing treatment, resulting in early entry into treatment during the first trimester of pregnancy, 2. Improve quality of life as measured by improvement in areas such as housing, education, and employment. 3. Increase the 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. 4. Improve mother-child relationship/attachment 5. Improve father-child relationship/attachment. 6. Improve family functioning and wellbeing.

En Junto will address a gap in available services to pregnant, postpartum, and parenting women who require treatment for substance use disorders (SUD), particularly low-income and Latina women in Santa Cruz County. Janus of Santa Cruz is the sole provider of residential perinatal alcohol and drug treatment in Santa Cruz County, and has developed a strong multifaceted program in its 25 years of operation. In recent years, several events have converged to create a pressing need for the En Junto program: 1) there is a significant number of Latinas of child-bearing age who are misusing substances, particularly methamphetamine and opiates; 2) Janus Perinatal Residential treatment program is the only perinatal residential treatment program in the county; and 3) needs assessments based on community, client and staff input demonstrate an increased need for perinatal services that include children and family members, trauma-informed services, treatment for co-occurring disorders; and culturally competent services. En Junto will build on the successful Janus Para Madres model with the following enhancements: 1) renewing its Promotora model for outreach and engagement of pregnant and postpartum Latinas to help them overcome barriers to residential treatment and increasing the array and quality of evidence-based practices and other specialized services for women and their families; 2) expanding the depth of its trauma-informed care model with advanced training and clinical supervision for Seeking Safety, training and implementation of Trauma-focused Cognitive Behavioral Therapy (TF-CBT) among staff therapists, and implementation of the TEND Academy?s organizational health model designed for trauma-exposed environments; and 3) adding individualized parenting skill development components (Brazelton Touchpoints, Newborn Observation Assessments, and Keys to Interactive Parenting Scale) alongside implementation of the group-based Celebrating Families! curriculum.In addition to these practices, under En Junto Janus will provide several important enhancements to its already-strong SUD treatment program: 1) additional access to a licensed mental health therapist will be provided to assess and treat co-occurring disorders; 2) case management will expand to include meetings with fathers/partners and other family members to identify any treatment or support services (e.g., behavioral health, child development, housing, employment support) that may be beneficial to the family and to provide warm referrals; 3) clients? access to treatment activities will be increased by expanding child care availability; and 4) existing health education and advocacy services will expand to include tobacco, nutrition, and doula support. Over the course of the grant, En Junto will serve 122 women, 60 children, and 122 other family members including fathers/partners. An annual program review will evaluate the outreach goals of En Junto, as well as quantitative outcomes related to substance use, trauma symptoms, and parenting skills among other measures and will use this information as part of ongoing quality improvement efforts.

Marshall Recovery Center for Families (MRCFF) is a residential treatment facility with 18 two- and three-bedroom apartments that will provide culturally sensitive, evidenced based, trauma informed, and family-centered treatment services to a total of 140 pregnant and postpartum women with substance use disorders (SUD) and co-occurring disorders, and services for their minor children and families in Huntington, West Virginia (WV). The facility will also serve women in surrounding Appalachian communities, including those in the southern part of the state. These families have limited access to quality treatment and health services due to barriers related to geographic isolation, stigma, and poverty. The major goals of MRCFF are as follows: Goal 1: Decrease misuse of substances among pregnant and postpartum women. Goal 2: Increase safe and healthy pregnancies to improve birth outcomes. Goal 3: Reduce perinatal and environmental effects of maternal drug abuse on children. Goal 4: Improve the mental health, physical health and wellbeing of participant families. Goal 5: Prevent mental, emotional, and behavioral problems among children of participants. Goal 6: Improve parenting skills, family functioning, economic stability, and quality of life. Goal 7: Reduce involvement in and exposure to crime, violence, and neglect. Goal 8: Decrease physical, emotional, and sexual abuse for all family members. MRCFF will support the successful, long-term recovery of our clients and their families by building and strengthening their skills through education, support, and counseling through culturally- sensitive, family-centered treatment. This program will address a pressing need in the catchment area by increasing access to care for pregnant and postpartum women and their families, a population that is underserved and increasingly at risk.

Minnesota Residential Treatment for Pregnant and Postpartum Women (PPW) and Substance Use Disorders Grant Application Abstract: The Minnesota (MN) Department of Human Services (DHS) and its Alcohol and Drug Abuse Division/Single State Authority (ADAD/SSA) proposes to expand and enhance women?s pregnant and postpartum substance use disorder (SUD) services across our continuum of care (prevention, treatment and recovery) for women, children and families who receive treatment for SUDs through our grant application titled; MN Pregnant and Postpartum Women (PPW). The MN PPW target population will be Pregnant and Postpartum Women that are low-income women, age 18 and over, who are pregnant or postpartum, and their minor children, age 17 and under, who have limited access to quality health services including traditionally underserved populations, especially racial and ethnic minority women. In Minnesota, these underserved and populations with the largest disparities include American Indian Women, African American Women and Women Receiving Treatment services in rural areas. Through MN census data, Drug Abuse and Normative Evaluation Systems (DAANES) data, MN has shared the rates and numbers of our populations impacted and the increasing need for expanded and enhanced services. Minnesota is proposing to fund (through a request for proposals (RFP)two additional grantees with this PPW funding, to continue our state targeted response dollar services where the target population and services fit the MN PPW requirements, and to create/strengthen/sustain expanded and/or new and/or enhanced programming within all of these new or existing services. The MN PPW grant will require that RFP funded sub-recipients are capable of meeting the cultural and gender specific needs of the populations to be served. Responders to our competitive RFP will be selected based on state level and local level data that shares the needs in Minnesota where substance use disorders and related harms are most prevalent. Each grant recipient selected will need to plan for and address within their response, the distinct needs of their program service area, identify populations served and the projected demographics for who are currently being served, including addressing the needs of American Indians, African Americans and Women in rural areas. Recipients will then design programming to implement specific strategies (per SAMHSA Evidence Based Practices (EBP) requirements), specific to those assessed needs and will serve 100 women and 200 children per grant year, or 500 women and 1000 children over the entire five year grant period. The MN PPW will support evidence-based parenting and treatment models, including trauma-specific services in a trauma-informed context. New and existing grants, through curricula and treatment program services, collaborations and required PPW evaluation will measure outcomes specific to the identified target populations in their response to our RFP and to identified MN populations with the highest disparities in our state.

The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) in partnership with residential substance use treatment providers, Jordan?s Crossing, Inc. and The Oaks Rehabilitative Services Center will create the Oklahoma Program for Pregnant and Postpartum Women (OPPW) project to expand comprehensive treatment, prevention and recovery support services for women, their children, and other involved family members. The OPPW project will work with the identified treatment providers and local partners to achieve the following goals: (1) expand the available evidenced based practices and services available to the women, children, and involved caregivers through a comprehensive, trauma-informed approach that is both individualized and family centered; (2) implement family focused programming to reduce the impact of substance use on infants and children and improve parenting skills, family functioning and the overall quality of life, and (3) utilize a coordinated wraparound recovery support approach to best identify and meet the presenting mental and physical health needs of pregnant and postpartum women, their children, and involved family members. The Oaks and Jordan?s Crossing are two of only four residential treatment providers in Oklahoma that provide the opportunity for women to receive substance abuse services with their children on site. Jordan?s Crossing located in Oklahoma County; the most population dense area of the state serves the greatest number of African American families. The Oaks, located in Pittsburg County is the only residential facility located in a rural area. The two identified providers provide services to prioritized populations and are both poised to enhance their family programs to improve treatment outcomes for the women, children, and additional family members served. Both providers employ a diverse team of professionals with experience, expertise and a unified philosophy necessary to meet the complex needs of the families. The OPPW target population includes the women who are pregnant or postpartum, their minor children, fathers of the children, and other involved family members receiving treatment at a state funded residential setting. The proposed evidenced-based interventions include: Circle of Security, Seeking Safety, the Celebrating Families Program, the Community Reinforcement Approach, and Cognitive Processing Therapy. This comprehensive and integrated approach will improve positive outcomes in the areas of individual and family functioning. Anticipated outcomes include improved child/parent relationship/ attachment, improved family functioning and well-being, increased number of father and other family members served in tandem with mother and child(ren), and increased capacity for providers to address child?s needs through targeted interventions. The OPPW project will serve 70 women and their children in the first year and increase the number served by 15% each year of the grant. In addition, the family centered efforts will increase the number of fathers or other family supports participating in family services by 10% in the first year, and by 25% by the end of the grant period.

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.