- Associated Press - Sunday, December 4, 2016

NASHVILLE, Tenn. (AP) - Melanie McCarter is about to start a job doing what she loves: helping women find the right resources to get, and stay, clean so they can have a healthy life.

McCarter, a mom of a 15-month-old son, will start next month at 180 Health Partners - a new company focused on providing collaborative, multidisciplinary care for pregnant women who are addicted to opioids that is attracting high-profile investors and board members.

She’ll be a peer advocate, someone who understands where the mom-to-be is at in life, and help them get connected to the resources and motivation they need.

For McCarter, it’s a chance to be part of the support structure that people need - a peer who understands what it’s like to be pregnant and addicted. She lost a baby when she was nine months pregnant several years ago while fighting an opioid addiction.

“Basically that I’ve been where they are at, and I came out of the other side clean,” McCarter said. “I had family to push me in the right direction, and not everyone has that.”

Babies can be born drug dependent with a withdrawal syndrome called neonatal abstinence syndrome, or NAS, when they are exposed to opioids, such as oxycodone or heroin, while in the womb.

There were at least 1,063 babies treated for NAS in Tennessee in 2014 because that’s how many were treated by TennCare that year. Justin Lanning, CEO of 180 Health, expects the number is closer to 2,000 to 2,500.

Tennessee is dealing with a rising number of overdose deaths amid a struggle with opioid abuse and misuse that health officials dub an epidemic. Alongside the rising overdose death rate is an increase in the number of babies treated for NAS under TennCare. In 2008, the agency treated 264 newborns.

180 Health, based in Brentwood, will start working in January with some of the companies that administer TennCare to identify women who are at risk for having babies with NAS, and getting them connected with either detox or tapering and other community resources.

180 Health’s goal is to reduce the number of babies born dependent, and help the women stay clean after giving birth so they and their family can have healthier lives.

The company will work with obstetricians under TennCare to identify addicted women and assist them with getting into detox or tapering programs to get them off opioids before the baby is born. Dr. Mary Jane England, a psychiatrist and professor at the Boston University School of Public Health, said this could save the baby from undue harm.

“We have science now” that shows that detox and tapering programs are not harmful to the fetus, said England, a 180 Health board member. Dr. Craig Towers, an obstetrician and professor at the University of Tennessee Medical Center in Knoxville, did a five-year study on the effects of detox and is chairman of 180 Health’s clinical advisory board.

The process is difficult, but England said pregnancy is a moment to catch women when they are focused on the health of their baby.

“If you ask a mom what she’ll do for her baby, she’ll do a lot for her unborn baby,” England said.

The company will send people, including peer advocates like McCarter, social workers and nurse educators, into the women’s homes or accompany them to doctor’s visits. Transportation and missing work are often barriers to getting treatment or staying in recovery programs so 180 Health wants to fill in those gaps, Lanning said.

It also will help the woman connect into resources in her community to ensure she has a recovery and support system as she adjusts to being a mom under the added pressure of staying clean. 180 Health will stay in touch with the woman for a year after she delivers.

Reducing the number of NAS babies and helping women get successfully into recovery carry financial and social benefits.

TennCare spent $48,854 per NAS baby in 2014 versus $4,951 for non-low birth weight babies. A baby born with NAS spent an average of 24 days in the hospital, compared with two days for a healthy baby.

Even with the cost of treating a pregnant woman, roughly $10,000 to $12,000, the early intervention is a less expensive option that has the potential to save treatment down the road, Lanning said.

With a five-year 50 percent uptick in the number of people losing their parental rights due to addiction across the state, it could help keep families together.

The company’s mission and approach have attracted board members who have worked with Medicaid or managed-care organization entities in the past. Darin Gordon, who left as TennCare’s director in June for the private sector, is chairman of the board.

Addressing opioid addiction and its ripple impacts at a time when women are already engaging with the health care system by bringing in behavioral health and community recovery resources will bring a holistic approach to treating addiction, without stigma, said Dr. Bill Frist, an investor in 180 Health. Frist, a former U.S. senator, also backs Aspire Health, which sends palliative care clinicians to people’s homes.

The company plans to be working with 500 to 600 women by the end of the year, and deepen its relationships with providers who may have been hesitant in the past to send women into treatment out of concern they would be prosecuted, Lanning said. The company will get paid by the MCOs as it makes inroads in reducing the number of babies born with NAS.

“We focus on a too often stigmatized, frequently disenfranchised population who at a special time in their lives, around the birth of their child, today at best receive fragmented care that lacks continuity and chances of long-term success for mother and child,” Frist said. “We are the first company in the opioid crisis to take to scale this comprehensive, holistic, dedicated approach to empowering moms with healthy babies.”

McCarter’s job officially starts Dec. 1, exactly a week before she celebrates being four years clean.

“The cool thing is I’m in on the ground level so I’m getting to help them come up with different ideas and different ways to help women - what’s going to be support or enabling,” she said. “I have a passion for this. There are so many women . I just hope we can reach more people so they can get help. More healthy babies and more healthy women.”

___

Information from: The Tennessean, https://www.tennessean.com


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