By Caroline Halsted, Research Analyst, National Association of State Alcohol and Drug Abuse Directors and Jessica Simon, Program Manager, Association of Maternal & Child Health Programs (AMCHP)
The federal Substance Abuse Prevention and Treatment Block Grant (SABG) and the Title V Maternal and Child Health (MCH) Block Grant provide critical funding that states can use to tailor services based on the specific needs of their populations. Although these funding streams are aligned in their commitment to improving the health of women and their families, few states have leveraged these block grants collectively to address the needs of pregnant and parenting women who have or are at risk of developing a substance use disorder. This article explores a successful state collaboration that leverages these block grants to meet the needs of this population.
The Substance Abuse Prevention and Treatment Block Grant
Created in 1993, the SABG is administered by the Substance Abuse and Mental Health Service Administration. SAPG block grant funding supports substance use disorder prevention, treatment, and related services. The funding is used to plan, implement, and evaluate activities that prevent and treat substance use disorders. To receive block grant funds, states are required to complete a needs assessment and develop an action plan biannually. States must spend at least 5 percent of their SABG on services for pregnant and parenting women. These services include prenatal care and well-child care; gender-specific substance use disorder treatment; therapeutic interventions for children with mothers in treatment; and family support services such as case management, transportation, and day care.
Leveraging Block Grant Resources: The Nevada Experience
Nevada braids SABG and Title V MCH Block Grant funding to enhance state programming for pregnant and parenting women who use substances. In response to a statewide gap analysis of women’s substance use disorder treatment services, Nevada’s Substance Abuse Prevention and Treatment Agency (SAPTA) and the state’s Title V MCH program worked together to raise awareness about the impact of substance use on pregnant people, health care providers, and women of childbearing age and their families.
Nevada’s SAPTA and Title V MCH program collaborated to develop Nevada’s Sober Moms, Healthy Babies, a website offering resources on how to prevent and treat substance use disorders. The website includes information on how to get priority access to SAPTA-funded treatment facilities (available at no cost to all pregnant people with substance use disorders in the state); the Nevada 211 referral line; and plans of safe care, among other resources. Joint block grant funding was used to support the cost of developing, maintaining, and promoting the website through television, radio, and social media.
SAPTA and the Title V MCH program share the goal of expanding the use of Screening, Brief Intervention, and Referral to Treatment (SBIRT) with pregnant people who use substances. Funding from both block grants supports a statewide provider training program on SBIRT implementation and helped the state develop the Reference Guide for Reproductive Health Complicated by Substance Use, a toolkit for training providers on the SBIRT model. Beginning in 2022, the state will require annual SBIRT training for physicians, osteopaths, physician assistants, and nurse practitioners.
Nevada’s SAPTA and the Title V MCH agency are both committed to expanding access to medication-assisted treatment (MAT). After conducting the state’s gap analysis of women’s substance use disorder treatment, SAPTA used block grant funds to expand its network of community-based providers licensed to prescribe MAT for opioid use disorders. Title V block grant funds support efforts to promote community awareness about MAT access. The sharp increase in perinatal cannabis use resulting from the legalization of recreational use of cannabis also has invigorated both agencies to leverage their block grants to support public health messaging on the dangers of cannabis use during the perinatal period.
Nevada has successfully braided block grant funding to serve the needs of pregnant people with substance use disorders. Nevada can be seen as a model for other states on how to collaborate on mutual goals and collectively use the SABG and Title V MCH Block Grant funds. In so doing, Nevada has expanded the reach of MCH and behavioral health agencies and has strengthened prevention efforts and public awareness about substance use disorder prevention and treatment, provider training, direct care, and other services. By leveraging their block grant funding, Nevada’s agencies have made strategic investments to improve the health outcomes of women who use substances and their families.