$1.46 million in HPC funding supported coordinated, bias-free care for 200+ caregivers with substance use disorders and their infants
BOSTON — The Massachusetts Health Policy Commission (HPC) convened the cohort of Cost-Effective, Coordinated Care for Caregivers and Substance Exposed Newborns (C4SEN) awardee hospital teams at the College of the Holy Cross in Worcester, Massachusetts, and presented findings from the program’s evaluation. The HPC was honored to be joined by State Representative Lindsay Sabadosa (1st Hampshire District), a member of the Joint Committee on Health Care Financing, teams from four C4SEN awardee hospitals, and community stakeholders to discuss the program’s impact on patients and in each of their communities.
Launched in 2021, C4SEN supported innovative initiatives aimed at improving the quality of care for caregivers with substance use disorder and their infants, from pregnancy through postpartum and into early childhood. Through C4SEN, the HPC dispersed close to $1.5 million to five awardee hospitals: Baystate Franklin Medical Center, Berkshire Medical Center, Mercy Medical Center, Southcoast Health, and South Shore Hospital.
C4SEN was founded on the belief that providing culturally competent care, free of stigma and bias -- and coordinated across medical, behavioral health care, and social services providers -- can improve outcomes and help mitigate future health care costs. The program also enabled access to cost-effective treatments and care options for patients, including Early Intervention services and medication for opioid use disorder.
“C4SEN recognizes that successfully supporting caregivers with substance use disorders and their children requires acknowledging the inequities these caregivers face, which exist because of stigma and other structural forces,” said Dr. Matilde Castiel, HPC Commissioner. “We are grateful for the creativity and resiliency of the program teams, who understand the importance of a holistic approach of meeting caregivers’ needs beyond traditional medical parameters.”
Across the five awardee programs active from 2021-2023, C4SEN enrolled 221 caregivers and 212 infants. These programs supported caregivers on medication for opioid use disorder and initiated treatment for some caregivers during their program enrollment. Each program strived to support every caregiver holistically, without stigma or bias, addressing individual needs and personal experiences. These needs often extended beyond medical or behavioral health care, including supporting childcare, transportation, legal services, and providing tangible goods such as infant car seats and clothes.
“I would not be here today if I weren't for [the program team]. I know ultimately it was my choice to turn my life around and show up for myself and my kids. But without the support of them and the encouragement and having them in my life, I really don't think I would be where I'm at today,” said a C4SEN program participant during an interview.
An evaluation of caregivers’ experience of the C4SEN program showed high levels of program satisfaction and positive reports of non-judgmental staff. Many participants noted that support around connection to resources, program flexibility, and access to telehealth were all helpful program elements.
Caregivers also shared that they felt supported through their perinatal period within the program, and this was especially true for participants who had few other social supports.
“The HPC’s C4SEN investment program has demonstrated the effectiveness of providing comprehensive, compassionate care to caregivers with substance use disorder and their children," said Representative Lindsay Sabadosa. “I am supportive of this critical work and pleased that the Massachusetts House of Representatives took long overdue steps to support birthing people in opioid legislation passed yesterday. It is time for us to adapt our supports for this vulnerable population, and the C4SEN program has set an excellent model for the Commonwealth to follow.”
“We thank the legislature for acknowledging that caregivers with substance use disorder and their children require innovative, community-centered approaches to care, and for entrusting the HPC and these awardee programs to help carry out this critical work,” said David Seltz, HPC Executive Director. “These programs have helped to set the standard and serve as a model for what caring for this population and centering their needs can look like, and we are thrilled to be able to bring this cohort of awardee hospital teams together today.”
The C4SEN Investment Program was developed by the HPC in response to a legislative mandate in Chapter 208 of the Acts of 2018. Three of the C4SEN awardee programs will continue beyond the HPC’s funding period, ensuring that more birthing people and their families have access to the supports they need and deserve.
Find more information about C4SEN and the awardee programs as well as the HPC’s other investment programs on the HPC’s website.
