Opioid Crisis Response

The Opioid Public Health Crisis is impacting Missouri families and communities. The Department of Social Services (DSS) is dedicated to fighting this epidemic and is supporting the needs and protecting the health and safety of Missouri children and adults.  Department of Social Services offices will be equipped with Naloxone and trained to use it for emergency treatment of an opioid overdose. Below are brief descriptions of how DSS is combating this health crisis.

Child Welfare

The illegal use of controlled substances may impair a parent or caregiver’s ability to properly care for their child or expose the child to unsafe conditions to the point that the child is abused or neglected.

If the parent or caretaker engages in behavior that constitutes child abuse or neglect according to state law, this information should be reported to the child abuse/neglect hotline. Once a report is received, it will be reviewed and may result in a child abuse/neglect investigation or family assessment conducted by Children's Division staff and in some cases in conjunction with law enforcement.

In situations where parental substance may be leading to abuse or neglect of a child ages birth to 18 years of age, the child abuse and neglect hotline may be contacted by calling (800) 392-3738 or (844) CAN-TELL anytime 24 hours a day/7 days a week.

Newborn Crisis Assessment

A health care provider can request a Newborn Crisis Assessment when they have concerns about the health and safety of newborns typically because of drug exposure or the capacity of a caregiver to meet the needs of the infant. Children’s Division workers assure the child’s safety and discuss the plan for discharge. The assessment includes a recommendation as to whether the infant should be released from the hospital with the mother, father or other familial caretaker. Children’s Division also helps new parents through home visiting and intensive in-home services.

Home Visitation Program

The Children’s Division contracts for in-home services and intervention that can be provided to families at risk or experiencing substance abuse to keep children safe.

Intensive In-home Services

Intensive In-home Services are concentrated, short-term, home based, crisis intervention services to help families remain safely together and avoid placing children out of their family home whenever possible.

Drug Courts

Children’s Division staff work in partnership with drug courts and substance abuse treatment programs to ensure the safety and wellbeing of every child.

Drug Court Commission Member

The Director of the Department of Social Services participates as a member of the Drug Court Commission which is responsible for evaluating, securing and allocating funds for the drug courts.  The Drug Court Commission also impacts drug court policy setting and administration.

Fostering Court Improvement Programs

The Department of Social Services participates in Fostering Court Improvement Programs which are data-driven collaboratives to improve child welfare outcomes in 15 local judicial circuits.

Referral for Services

The Children's Division makes referrals to services for families impacted by substance abuse who are struggling to keep their children safe and ensure they are well cared for.  Referrals may be made to the Department of Mental Health or other state and community resources.

Communities

Community Partnerships/Families and Communities Trust (FACT) Support

The Department of Social Services engages with Families and Communities Trust (FACT) and the 20 Community Partnerships in initiatives working directly with communities and families to improve the lives of children and families in those communities.

MO HealthNet

PREVENTION


Opioid Prescriptions

Management

MO HealthNet Pharmacy authorizations for opioid prescriptions follow Centers for Disease Control and Prevention guidelines, which recommend a 7-day limit on new prescriptions for opiate-naïve participants.

Lock in Program: Referral of Participants and Providers

Missouri Medicaid Audit and Compliance (MMAC) has the authority to "Lock-In" participants to a specific medical and/or pharmacy provider for reasons relating to misuse.  Providers are also subject to provider requirements and MMAC will submit provider referrals to licensure and regulatory boards regarding provider prescribing issues.

Intervention-Providers

MO HealthNet will monitor Medicaid pharmacy claims data to identify and provide guidance to providers regarding opioid prescribing that may be outside of clinically-based best practices.  The interventions will also assist prescribers in identifying participants who may be at risk for harm from opioids, and recommend resources to assist in the management of their patients.

Intervention-Participants

MO HealthNet will utilize pharmacy claims data to identify and provide information to MO HealthNet participants regarding pain management and the safe use of opioids.

Access to Naloxone (Narcan®)

Naloxone, an emergency treatment for opioid overdose, has been proven to save lives. MO HealthNet provides unrestricted access to Intranasal Naloxone for participants, consistent with recent MO State legislations. MO HealthNet will only reimburse pharmacies and other providers, for Naloxone dispensed or used for eligible MO HealthNet participants.

Chronic Pain ECHO

MO HealthNet providers can utilize Show-Me ECHO to improve care for patients with chronic pain.  The University of Missouri’s Extension for Community Healthcare Outcomes (ECHO) uses videoconferencing to connect an interdisciplinary team of specialists with primary care providers.  Providers collaborate in case-based learning sessions to help primary care providers develop advanced skills and best practices to increase the availability and quality of patient care. No cost CME for health care professionals is available. Contact Show-Me ECHO for more information or to register.

Opioid Use Disorder ECHO

MO HealthNet providers can utilize Show-Me ECHO to decrease opioid-related morbidity and mortality by using a medication-first strategy.  The University of Missouri’s Extension for Community Healthcare Outcomes (ECHO) uses videoconferencing to connect interdisciplinary team of experts with primary care providers.  They collaborate in case-based learning sessions to help primary care providers develop advanced skills and best practices to increase the availability and quality of patient care.  No cost CME for health care professionals is available. Contact Show-Me ECHO for more information or to register.


MEDICATION ASSISTED TREATMENT


Telehealth

MO HealthNet participants can participate in telehealth to access behavioral health treatment for mental illness contributing to opioid and substance misuse.  Contact the Missouri Telehealth Network for more information.

Opioid Dependence Treatment Strategies

MO HealthNet is working with Rachel Winograd, Ph.D., Opioid State Targeted Response (STR) Project Director on Medication Assisted Treatment (MAT) for opioid dependence treatment.   The Missouri Opioid STR will help Missourians with opioid use disorder access integrated prevention, treatment, and recovery support services.

Medication Assisted Treatment - Opioid Dependence Agents

MO HealthNet is working closely with the Missouri Opioid State Targeted Response (STR) Project, as it aims to expand access to integrated prevention, treatment, and recovery support services for individuals with opioid use disorder (OUD) throughout the state. The Pharmacy Program provides many options for MO HealthNet participants needing Medication Assisted Treatment (M.A.T.).  MO HealthNet is working to align our policies with the most effective strategies and practices for treatment of OUD.