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Through collaborative use of improvement science methods, reduce preterm births & improve perinatal and preterm newborn outcomes in Ohio as quickly as possible. MOMS Plus Project February Action Period Call Ohio Perinatal Quality Collaborative February 21, 2020

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Page 1: PowerPoint Presentationopqc.net/sites/bmidrupalpopqc.chmcres.cchmc.org...Title: PowerPoint Presentation Author: CCHMC Created Date: 2/21/2020 2:24:56 PM

Through collaborative use of improvement science methods, reduce preterm births & improve perinatal and preterm newborn outcomes in Ohio as quickly as possible.

MOMS Plus ProjectFebruary Action Period Call

Ohio Perinatal Quality Collaborative February 21, 2020

Page 2: PowerPoint Presentationopqc.net/sites/bmidrupalpopqc.chmcres.cchmc.org...Title: PowerPoint Presentation Author: CCHMC Created Date: 2/21/2020 2:24:56 PM

Today’s Facilitators

Susan Ford, MSNOPQC QIC

Rachel Staley, MPA OPQC Project Specialist

Cole Jackson, MSOPQC Project Specialist

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Agenda

Time Topic Presenter

12:00 pm Welcome & Agenda Review Susan Ford, MSN, RN

12:05 pm Data Review Susan Ford

12:15 pm Recovery Housing for the mom with OUD

• OMHAS- Housing & Homelessness Programs

• Miami Valley Hospital - Promise to Hope

Roma Barickman, MA, MSSA, LISW-S

Maura Klein, MS

Sarah Zinn, LISW-S

All Teach ~ All Learn

Team sharing regarding Recovery Housing options

All participants

12:50 pm Next steps/Wrap up Susan Ford

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SMART Aim

Key Drivers Interventions

By June 30, 2020 we will:

Optimize maternity medical home to

improve outcomes for pregnant

women with opioid use disorder

(OUD) as measured by:

• Increased identification of

pregnant women with OUD

• Increased % of women with OUD

during pregnancy who receive

prenatal care (PNC), Medication

Assisted Treatment (MAT) and

Behavioral Health (BH)

counseling each month

• Decreased % of full-term infants

with Neonatal Abstinence

Syndrome (NAS) requiring

pharmacological treatment

• Increased % of babies who go

home with mother

Project Leader: Carole Lannon (PI)

Optimize the health and well-being of

pregnant women with opioid use

disorder and their infants

Global Aim

Pregnant women with

opioid use disorder

Population

Revision Date: 8/30/2019

MOMS+ Project

Key Driver Diagram (KDD)

Compassionate care/

culture change

Identification of

pregnant women

with OUD

Supportive care

and tracking during

pregnancy

Connection to

postpartum support

• Provide training in trauma informed care and addiction as chronic disease

for clinical practitioners

• Ongoing support for practice culture change

• Identify a care coordinator to provide ongoing support and assist with referrals

and ongoing communication among the multi-disciplinary care team.

• Use tracking system to monitor care of pregnant women with OUD diagnosis

(e.g.. Database, spreadsheet)

• Use standardized checklist for maternity care of the pregnant patient with OUD

• Coordinate care among OB, BH, MAT, care navigator by regularly reviewing

shared patients (e.g. multi-disciplinary care conference, huddle).

• Tailor counseling and support for healthy behaviors based on

patient-specific situation/need during pregnancy (sobriety,

smoking cessation, stable housing and future contraception

plan) with referral to community resources as needed to

augment medical resources.

• Selection and use of a standardized screening tool for all OB patients to

identify pregnant women with OUD (e.g. 5 P’s, NIDA Quick Screen).

• At time of identification, assess need to prevent acute opiate withdrawal

by initiating or referring to MAT

• Establish connections for coordinated referral to maternity care from BH

and MAT providers, drug courts, prisons, homeless shelters, and ERs.

• Ensure mom and baby have a Patient Centered Medical Home (post-

delivery)

• Provide a warm handoff to pediatric care provider for infant post discharge

• Provide lactation consultation (if applicable), post partum depression

screening and contraceptive counseling; and ”normalization” of

postpartum transition (overwhelmed)

• Facilitate continuation of OUD treatment and services post-delivery occur

• Coordinate with Department of Job & Family Services/Child Protective

Services regarding reporting requirements and infant plan of safe care

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Polling Question #1

Pregnant patients with OUD have options for Recovery Housing in our region.

□ Yes□ No What is Recovery Housing?

Recovery housing is a safe and healthy living environment that promotes abstinence from alcohol and other drugs with peer support and accountability, relapse prevention, case management and employment skills training and other assistance to transition to living independently and productively in the community. Length of stay is not limited to a specific duration.

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Polling Question #2

Moms with OUD and their NEWBORN have options for Recovery Housing in our region.

□ Yes□ No

What is Recovery Housing?Recovery housing is a safe and healthy living environment that promotes abstinence from alcohol and other drugs with peer support and accountability, relapse prevention, case management and employment skills training and other assistance to transition to living independently and productively in the community. Length of stay is not limited to a specific duration.

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Recovery Housing

Roma Barickman & Maura KleinOhio Department of Mental Health and Addiction ServicesHousing & Homelessness Program and Policy Team

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OhioMHASGuiding Principles for Housing

OhioMHAS has aligned its principles and values to the following tenets of Quality Housing Criteria and envisions that all housing settings should:

• Be safe and affordable;

• Ensure access to natural supports and allow visitors of an individual’s choice where one is living in accordance with a legally enforceable lease or resident agreement;

• Be integrated in and have full access to the greater community;

• Be selected by the individual from a variety of housing options;

• Ensure individual rights of privacy, dignity and respect, and freedom from coercion and restraint;

• Include trauma-informed best practices and cultural competence for all staff and residents;

• Optimize autonomy and independence in making life choices;

• Provide access to available services and supports within the community in coordination with individual choice; and,

• Provide for special accommodations or have policies and procedures in place to provide housing for individuals that require special accommodations (such as individuals with physical or mental disabilities, hearing or speaking disabilities, or those with limited English proficiency).

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Recovery housing means housing for individuals recovering from alcoholism or

drug addiction that providesan alcohol and drug-free living

environment, peer support, assistance with obtaining alcohol and drug

addiction services, and other alcoholism and recovery assistance (ORC 340.01)

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What we mean when we say “Recovery House”

Recovery Housing vs.

Sober House

Oxford House

Halfway House

¾ House

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Recovery Housing is NOTTreatment

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Alcohol and Drug

Free

Person Driven LOS

Community of Recovery

Recovery Housing

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Ohio Recovery Housing

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How do I find quality recovery housing?

•https://find.ohiorecoveryhousing.org/

•https://findtreatment.gov/

•Be sure to research your options!

•Use Ohio Recovery Housing ‘5 Questions to Ask a Recovery Housing Operator’ questionnaire.

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5 Questions to Ask a Recovery Housing Operator

1. Do I get a written and signed resident agreement? You should receive a written resident agreement before you move in or pay any fees or deposits. This agreement should tell you what fees are due and when. It should also explain what code of conduct or other behavior guidelines you must follow in order to stay at the house. You should know under what circumstances you may be asked to leave the house. The operator should be able to answer any questions you may have before requiring you to sign the agreement or make a payment. You should not be asked to waive your individual or fair housing rights.

2. How do you ensure that the environment is free from alcohol or illicit drug use? The operator should have a comprehensive strategy for ensuring that the environment is free from alcohol and illicit drugs. This strategy can vary from house to house-but the operator should be able to explain to you how they ensure a recovery environment. As a resident, you will likely have to follow a specific code of conduct that helps the house ensures the maintenance of the recovery environment.

3. What supports are available to help me live in recovery? The recovery house should engage with you in developing positive relationships with others in the house and with your community. This is usually done through both formal recovery oriented activities such as house meetings, assisting you with finding a sponsor, mentor or other mutual aid supporter, or other recovery supports. The house also should engage in recreational and informal activities that are designed to help you develop positive relationships, live in the house as a family, and build community.

4. Does this house feel like a home? The recovery house should look and feel like a home. You should have access to common areas of the house, be able to buy, store and prepare your own meals and snacks, and be able to have personal items and belongings. You should have access to basic utilities, hot water and working appliances. Furniture should be in good condition and used appropriately.

5. How do you ensure resident safety? The recovery house should be following all local building and fire codes designed to keep residents safe. Residents should not be overcrowded. Residents should also have emergency contact information available in case of an emergency. The bedrooms should have appropriate egresses and the house should have smoke alarms, fire extinguishers and other safety equipment.

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Sarah ZinnMiami Valley Hospital - Promise to Hope

Recovery Housing

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Page 18: PowerPoint Presentationopqc.net/sites/bmidrupalpopqc.chmcres.cchmc.org...Title: PowerPoint Presentation Author: CCHMC Created Date: 2/21/2020 2:24:56 PM

Promise to Hope Recovery Housing

• Our site's greatest 2019 accomplishment was the opening of maternal recovery housing in our community.

• Through partnership with our local ADAMHS board, a local recovery housing provider (Joshua Recovery Ministries) and Promise to Hope, we have been able to open the first and only housing of this type in the Miami Valley.

• Pregnant women are eligible to live in the program for a year postpartum, allowing time to establish a solid recovery foundation and then transition toward self-sufficiency.

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Promise to Hope

Maternal Recovery Housing

From Need to Action

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Need Identified, What action should we take?

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The Work Timeline:

Local ADAMHS

applies for OHMHAS Capital Project

Fall 2016

Buildings are

successfully purchased

Summer 2017

First resident

moves in!

Summer 2019

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Onsite recovery supports include:

Weekly 1:1 sessions with site director

7AM-11PM onsite Peer

Recovery Staff

Faith-based recovery

group sessions

Care coordination

Living skills courses

Family education programs

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Page 23: PowerPoint Presentationopqc.net/sites/bmidrupalpopqc.chmcres.cchmc.org...Title: PowerPoint Presentation Author: CCHMC Created Date: 2/21/2020 2:24:56 PM

All Teach ~ All Learn

To submit a question to the presenters, type your question or comments into the CHAT box and hit send.

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You can also come off of group mute by pressing *6

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Next steps

Teams:- The next MOMS+ Action Period Call will be Friday, March 20th at 12N

Suggested PDSA: Test the one of the shared hyperlinks for Recovery Housing options in your region and plan outreach from your team to one site to learn more.

Key Contacts: Review/submit Monthly Progress Report; the February MPR will be sent out next week: Wednesday 2/26/2020

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It takes a village…

The MOMS Plus project is funded by the Medicaid Technical Assistance and Policy Program (MEDTAPP) and administered by the Ohio Colleges of Medicine Government Resource Center. The views expressed in this meeting are solely those of the authors and do not represent the views of state or federal Medicaid programs.