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1. Statewide reentry services (Horizons-EMPOWER): The EMPOWER is a gender and trauma-responsive post-release model for pregnant, postpartum, and single women with substance use disorder (SUD) or substance use history leaving a jail or state prison in North Carolina. Our primary EMPOWER services prioritize women leaving the three state prisons in North Carolina: North Carolina Correctional Institute for Women (NCCIW), Western Correctional Institute for Women (WI), and Anson Correctional (AI) in North Carolina to reduce substance use-related deaths and injuries upon release and promote access to ongoing SUD treatment. The team consists of care coordinators embedded in the Anson, Buncombe, and Raleigh areas to assist with screening, referrals, transportation, assistance state and federal social service benefits,  access to medication for substance use disorders and psychiatric medications, childcare assistance, housing support, and legal coaching.

2. Co-occurring reentry services (Horizons-GRACE): GRACE provides comprehensive recovery and reentry services for women living with a substance use disorder and mental health diagnosis (co-occurring). This program provides pre and post-release services for incarcerated women at the North Carolina Correctional Institute for Women (NCCIW) in Raleigh, NC. It is an interdisciplinary SUD treatment program that works alongside prenatal and medical providers, peer support coaches, and psychiatry. Women enrolled in the GRACE project can receive therapy, care coordination, transportation, financial assistance with housing, clothing, and prescription medications. The program also offers assistance with vocational training and educational courses. Lastly, the program provides access to legal coaching with a trusted consultation and mediation expert at no cost to participants enrolled.

3. Perinatal and Maternal Substance Use Housing (Horizons-CHERISH): The CHERISH program extends housing services supported by the Wake County Commissioners and ARPA-19 funding. Horizons-CHERISH provides housing for pregnant and parenting women whose lives have been impacted by substance use and incarceration. The program offers fully furnished living arrangements, behavioral health supports, comprehensive behavioral health services, maternal-child interventions, access to prenatal and physical health appointments, and postpartum doula support. The program is staffed seven days a week, and 24/7 staff is available on the weekend to support families.  The program is to help women reconnect with their minor children, avoid a return to use, and reduce recidivism due to untreated substance use disorders.

4. Incarcerated Perinatal Behavioral Health Services: UNC Horizons partners with other UNC General Obstetrics and Gynecology providers to facilitate an integrated perinatal SUD clinic at the women’s prison in Raleigh, NC. Pregnant women experiencing incarceration at a prison can have access to screenings, referrals, assessments, individual therapy, and care coordination before or after their prenatal visits. Individual therapy and counseling sessions focus on identifying coping skills, relapse prevention, psychoeducation on addiction and trauma, community reinforcement approaches, cognitive behavioral therapy, mindfulness-based relapse prevention, and treatment planning post-release. This clinic replicates UNC’s Horizons Specialized Prenatal and Postnatal Clinic.

5. Statewide Perinatal SUD and Incarceration Referral Line: Horizons facilitates a 24/7 referral and peer warm line for clients, families, and providers seeking services and resources for pregnant and recently delivered women leaving prisons and jails in North Carolina. The line is staffed 24/7 with licensed and certified clinicians and recovery coaches. The goal is to connect individuals to medication for their substance use disorder, provide emotional support during the transition home, and provide access to pregnant and parenting women’s residential programs.

6. Integrated Family and Drug Treatment Services (Horizons-RISE): The RISE provides comprehensive SUD treatment services for pregnant and parenting, and single women enrolled in Chatham County and Orange County family drug treatment. The purpose of the program is to expand gender-responsive SUD treatment within the two treatment courts to promote long-term recovery and caregiver-child connectedness, avoid imprisonment, promote birth and infant outcomes, and access to specialized pediatric, prenatal, and postnatal services.

7. Brief Jail-based Perinatal SUD services (Horizons-Justice Core): Justice Core is based out of the Division of General Obstetrics and Gynecology and works with the Horizons’ Division for behavioral health services. Perinatal behavioral health services include screening, referrals, assessments, and pre-release care coordination to pregnant and postpartum women incarcerated at a jail at the time of their screening due to drug-related charges. The behavioral health team works with diversion and pre-trial team members to connect pregnant and parenting women to treatment services. Women enrolled in Justice Core may also be connected to other Horizons’ justice-involved services.

8. DWI Services: Horizons-Wake is a licensed DWI agency site serving in-state DWI/DUI services in NC. DWI services include in-person and telehealth assessments and clinical recommendations. The team also provides DWI group programming available for women enrolled in Horizons’ traditional outpatient services who have required more intensive interventions and are also eligible for outpatient services.

6. Child Welfare and Family Court: UNC Horizons provides comprehensive services and clinical recommendations to promote family preservation and connectedness for women interfacing with the legal and child welfare system due to untreated substance use disorders. Horizons-Wake facilitates comprehensive clinical assessments, social drivers of health assessments for families, treatment planning, and referrals to specialized substance use disorder treatment programs for women and children. These treatment and preventive interventions are focused on keeping women and children, instilling hope, and promoting healing among perinatal women impacted by substance use trauma.