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Maternal Opioid Misuse (MOM) Model Funding Opportunity March 6, 2019
Maternal Opioid Misuse (MOM)
Model Funding Opportunity
March 6, 2019
• Introductions
• Overview of Target Population
• Current State Service Landscape
• DHHS Priorities
• Maternal Opioid Misuse (MOM) Model
• Care-Delivery Partner Next Steps
• Timeline
• Integrated Care for Kids Opportunity
• Questions/Discussion
Agenda
2Maine Department of Health and Human Services
Pregnancy is an opportune time to reach women with substance use
disorders (SUD), as women may have more regular interactions with
the healthcare system and may be more engaged in their own care.
• 2010: MaineCare paid for 63% of all births in Maine (6th highest
rate in the country)
• 2015: MaineCare covered a total of 6,910 births
Overview of Population
3Maine Department of Health and Human Services
Overview of Population
4Maine Department of Health and Human Services
Between October-December 2018, 6% of pregnant women in MaineCare had an OUD
Pregnant MaineCare
Members
N= 4,446
w/ OUD
diagnosis
n = 269
6%
OUD Treatment AccessedMethadone
+ Other14%
Non- MAT ONLY11%
No treatment
11%
Buprenorphine ONLY
4%Buprenorphine +
Provider Type Service60%
Overview of Population
5Maine Department of Health and Human Services
Number of drug-affected baby reports
statewide per 10,000 residents, by Public
Health District: 2013-2017
Overview of Population
6Maine Department of Health and Human Services
Rate of infants born with Neonatal Abstinence Syndrome
statewide per 1,000 hospital births, 2008-2015
The Office of Substance Abuse and Mental Health Services funds evidence-
based treatment and support services for the uninsured. Women who are
pregnant and/or with dependent children are a priority population.
Current State Service Landscape: SAMHS
7Maine Department of Health and Human Services
SAMHS-Funded Services for Parenting and Pregnant Women - SFY 2018
The Maine CDC has led efforts to reduce substance exposed infants in
Maine in collaboration with other state offices and agencies. Examples
include:
• Substance Exposed Infants State Steering Committee
• Substance Exposed Infants Community Taskforce
• The Maine Maternal, Fetal, and Infant Mortality Review Panel
(MFIMR)
• Public Health Nursing
• Educating and screening women of childbearing age
• Workforce development opportunities
Current State Service Landscape: Maine CDC
8Maine Department of Health and Human Services
The Office of Child and Family Services (OCFS) oversees the Maine
Enhanced Parenting Partnership, combining the evidence-based Triple P
Parenting and Matrix model IOP to:
• Reduce substance use in the home
• Increase parental capacity
• Keep families together
OCFS also prioritizes:
• Development of a Plan of Safe Care during the assessment phase of child
welfare for families with substance exposed newborns or drug affected
babies.
• Access to inpatient residential substance abuse treatment services, as
appropriate, when SUD is identified as a need and part of the
reunification plan.
Current State Service Landscape: OCFS
9Maine Department of Health and Human Services
The Mills Administration is committed to preventing and treating SUD in Maine.
• Executive Order “Implement Immediate Response to Maine’s Opioid Epidemic”
– Focus on identifying non tax-based resources to further state goals
– Expand treatment recovery efforts
– Support connections to timely care and supports
• For the MOM initiative, the Department seeks to partner with health systems and
community-based organizations to:
– Expand access to services
– Seek changes in how we pay for health care to prioritize outcomes, quality,
and coordinated care
– Improve service-delivery
– Integrate and/or coordinate health and health-related social needs
– Improve quality of care and health outcomes for mother and infant
DHHS Priorities & the MOM Initiative
10Maine Department of Health and Human Services
• A cooperative agreement with the Center for Medicare and
Medicaid Innovation (CMMI).
• Testing payment and care-delivery innovation to improve
outcomes and reduce costs for pregnant and post-partum
Medicaid beneficiaries with OUD and their infants.
• May be statewide or in a sub-state region.
• Five year model period: January 2020 - December 2024.
• States are expected to sustain strategies after model end.
MOM Model: Basics
11Maine Department of Health and Human Services
MOM Model: Basics
12Maine Department of Health and Human Services
Edited image from the MOM model factsheet: Center for Medicare and Medicaid Innovation. Accessed: https://www.cms.gov/sites/drupal/files/2019-02/02-08-2018%20Fact%20Sheet%20--%20Maternal%20Opioid%20Misuse%20%28MOM%29%20Model_NOFO%20updates%20%28FINAL%29.pdf
MOM Model: Model Timeline
13Maine Department of Health and Human Services
Transition - CMMI may pay for the
intake, assessment, treatment planning
and coordination, engagement, and
referral activities not otherwise covered
by Medicaid or another source.
All services included in the care-delivery model
are expected to be covered through the state
Medicaid program during these years. State may
be eligible for additional performance-based
“Milestone” payments.
Develop and
prepare model
Applicants are encouraged to propose use of model funding to
extend and strengthen the impact of current programs and activities.
Model funds may not pay for Medicaid covered services and may not
supplant or duplicate existing efforts (including federal, state, local,
grants, etc.).
MOM Model: Funding Timeline
14Maine Department of Health and Human Services
Implementation Funding is available throughout the five-year model.
This may fund, but is not limited to, activities to:
• Increase provider capacity to effectively serve model population
• Establish data reporting or sharing infrastructure
• Strengthen collaborative relationships between providers
• Develop telemedicine resources
• Conduct outreach to model population
• Provide patient engagement incentives, as permitted by law
MOM Model: Implementation Funding
15Maine Department of Health and Human Services
In Year 2, CMMI may pay for the intake, assessment, treatment planning and
coordination, engagement, and referral activities not otherwise covered by
Medicaid or another source.
Current related MaineCare-covered services for the model population include:
• Section 13, Targeted Case Management: Adults with SUD
• Section 91, Health Home Services
• Section 93, Opioid Health Home Services
• Section 97, Appendix B, Private-Non Medical Institutions
If you include one of the above services in your proposal, you would not be able to
use model funding during the Transition Period (Year 2) to cover activities provided
as part of these services.
You may be able to receive transition funding to support these activities as they
relate to other services not listed above.
MOM Model: Transition Funding (Year 2)
16Maine Department of Health and Human Services
The State Medicaid Agency must partner with one or more care-delivery
partners to design and implement an intervention that coordinates and
delivers physical and behavioral healthcare services – along with
appropriate coordination, beneficiary engagement, and referrals to
community or other support services for the model population.
A care-delivery partner must be a health system or payor that is
associated with a clinical delivery site.
MOM Model: Care-delivery Partners
17Maine Department of Health and Human Services
MOM Model: Other Potential Partners
18Maine Department of Health and Human Services
The Department expects that this will be a community effort, extending
beyond clinic walls. Recommended partners from the Notice of Funding
Opportunity include:
Local public health department Professional organizations
Justice system Advocacy organizations
Civil legal aid organizations Home visiting programs
Quality collaboratives Early intervention services
Local government Area hospitals
Academic institutions State agencies
Homeless and temporary shelters Early care and education programs
WIC programs Public health nursing
We look forward to seeing what you envision for your
community!
Care-Delivery Partner Next Steps
19Maine Department of Health and Human Services
Organizations interested in becoming a Care-Delivery Partner
must submit a 2-3 page concept paper by March 13.
The Concept Paper Submission Form includes:
• Geographic scope of your organization & model (if different)
• List of planned partners
• Relevant background and experience
• Proposal
Care-Delivery Partner Next Steps
20Maine Department of Health and Human Services
What we’re looking for:
• Promising partnerships
• Builds off existing programs or experience
• Avoids duplication of services
• Includes a multidisciplinary team
• Incorporates evidence-based care
Care-Delivery Partner Next Steps
21Maine Department of Health and Human Services
Timeline
22Maine Department of Health and Human Services
Date Activity/Event
March 6 Stakeholder meeting
March 13 Concept papers due to OMS
March 14-20 DHHS review of concept papers
Week of March
25
Discussion with short-list of care-delivery partner(s)
Month of April Bi-weekly MaineCare and care-delivery partner(s) meetings
and virtual application writing
May 6 Applications due!
November 6 Anticipated notice(s) of award from CMMI
January 2020 Anticipated model start date
A cooperative agreement with CMMI, to develop state specific alternative
payment models that incorporate provider accountability and focus on
meaningful improvements in care quality and health outcomes for children
with health concerns (behavioral health, substance use, and physical health
needs).
• May not be statewide and must have in-state comparison group.
• Seven year model period: January 2020 - December 2026.
• A partnership between the State Medicaid Agency and a Lead
Organization (HIPAA covered entity).
Are any attendees considering applying for this award?
Integrated Care for Kids Opportunity Overview
23Maine Department of Health and Human Services
Olivia Alford
Acting Director, Value-Based Purchasing
24Maine Department of Health and Human Services
Questions?
