Services for Women with Opioid Exposed Pregnancies in North Carolina

Types of Service:
Care Coordination for Children (CC4C)
CC4C is a public health program that serves children from birth to 5 years of age who meet certain risk criteria, including opioid exposed pregnancy. The main goals of the program are to improve health outcomes working with families. The CC4C Program is a partnership between Community Care of North Carolina (CCNC), the NC Division of Public Health (DPH) and the NC Division of Health Benefits (DHB).
Gender Responsive/Perinatal Treatment Programs
Substance use disorder services that are designed for women, including those who are pregnant, parenting or seeking reunification with their children. These programs are available to women regardless of income or county of residence. Services range from outpatient care to long-term residential programs. These are cross area service programs, meaning that women living in any county are eligible to go to a program in any other county if she meets treatment criteria. The programs include or arrange for these components: substance-use disorder treatment, case management, life skills training, parenting education, child care services, and transportation services.
Home Visitors
Home visiting programs for pregnant women and families with young children offers information, guidance, risk assessment, and parenting support at home.The programs are evidence-based models that are designed to improve child health and development, pregnancy outcomes, and parenting skills. There are four evidence-based home visiting models offered in NC:

  1. Nurse Family Partnership
  2. Healthy Families America
  3. Parents as Teachers
  4. Early Head Start/Home-Based
Labor & Delivery Hospital
The hospital birth setting offers a safe environment with access to a range of physicians and medical staff, and medical technology when needed.

This indicates that the hospital has a team that has paid special attention the needs of opioid exposed pregnancies. The Perinatal Quality Collaborative of North Carolina’s Neonatal Abstinence Syndrome (NAS) Initiative has worked with hospital-based teams across NC, to improve services and outcomes for mothers, babies and families, when opioid exposed pregnancies have occurred.

Pregnancy Medical Home
The goal of the Pregnancy Medical Home model is to improve birth outcomes through coordinated, evidence based prenatal care management with a focus on quality improvement for pregnant women insured with Medicaid. Prenatal practices that have signed on to become a ‘Pregnancy Medical Home’ receive coordination support from Community Care of North Carolina’s physician champions and nurse coordinators.
Pregnancy Care Management
Pregnancy Care Managers are registered nurses or social workers who will work with women and their prenatal care providers to ensure they receive the best possible care while pregnant and after delivery. Pregnancy Care Management services are available to pregnant women enrolled in North Carolina Medicaid statewide, and to a limited number of low-income, uninsured pregnant women in some counties.
Prenatal Care
Prenatal care, including physical health check-ups, monitoring of pregnancy progress and health indicators, contribute to healthier birth outcomes. Prenatal care providers listed here provide care for women insured with Medicaid or who are uninsured. They may also provide care for privately insured women which insurance provider should be able to confirm.
Opioid Treatment
Opioid treatment programs offer medication assisted treatment (MAT) for opioid use disorders. Methadone and/or Buprenorphine are listed, indicating what medication the program offers as part of their treatment services. Medication assisted treatment during pregnancy for women struggling with an opioid use disorder has been shown to have better birth outcomes, including full term birth and good birth weight, versus quitting or tapering opioids. Medication assisted treatment is most effective when it is part of comprehensive substance use disorder treatment services (see Gender Responsive/Perinatal Treatment Programs).