Ob/Gyn: Project CARA

The Hub & Spokes Model

Project CARA of WNC is an outpatient, comprehensive*, and integrated** perinatal substance use disorder treatment program. We utilize a Hub & Spokes model, where our program at the MAHEC Biltmore Campus is the Hub supporting multiple Spokes in the region.

1Project CARA Hub

The Hub is comprised of these integral parts and provides the highest level of access to outpatient care delivery services. Additionally, the Hub collaborates with outside perinatal substance use care delivery teams/the community to improve systems of care. Hubs also provide ongoing consultation and support to Spokes and other providers caring for this population.

Medical Care	Behavioral Health Care
Perinatal Care Outpatient services Inpatient services Maternal-fetal medical consults and support Hepatitis C screening and treatment Substance Use Disorder Care Waivered to, and do, prescribe buprenorphine Trained in addiction medicine Full-spectrum, integrated care with behavioral health specialists	Internal Crisis management, intake, care, relapse prevention planning, 1:1 therapy, basic groups, and referral Psychiatry (medication treatment for OUD waivered) Contingency management External Residential care Medically-assisted withdrawal Inpatient SACOT / IOP
Education & Research	Wraparound Services
Technical assistance and clinical support services Training programs and continuing education for medical providers and community members in management Research on comprehensive perinatal care, with a focus on rural areas	Transitions of care support Psycho-social services Referrals/warm handoffs

2Project CARA Spokes

A Spoke includes some of the most integral pieces of the program model, as well as a relationship with the Hub to provide ongoing support and development for their program. If your organization is interested in learning more about becoming a Spoke, please contact projectcara@mahec.net.

Medical Care	Behavioral Health Care
Perinatal Care Outpatient services Hepatitis C screening and referral to treatment Substance Use Disorder Care Waivered to, and do, prescribe buprenorphine Integration with behavioral health	Internal Crisis management, intake, care, relapse prevention planning, 1:1 therapy, basic groups, and referral External Residential care Medically-assisted withdrawal Inpatient SACOT / IOP
Education & Research	Wraparound Services
Participate in training on evidence-based practice for comprehensive perinatal care Opportunities to participate in development of best-practice Continuing professional development and education	Transitions of care support Psycho-social services Referrals/warm handoffs

Current Spoke Sites

MAHEC Ob/Gyn Specialists at Franklin
Macon

MAHEC Women’s Care at Brevard
Transylvania

Blue Ridge Health - Haywood
Haywood

Blue Ridge Health - Justice Street (Hendersonville Family Health Center)
Henderson

Blue Ridge Health - Polk
Polk

Blue Ridge Health - Jackson (Sylva Health Center)
Jackson

Mission Women's Care - McDowell
McDowell

Advisory Council

Project CARA of WNC also utilizes an Advisory Council for input and guidance on the following components of care:

Delivering hospital
LME / MCO
Department of Social Services
Ob/Gyn care delivery
Residential treatment services
Care management
Pediatric services/care management
Opioid Treatment Program
Inpatient detoxification and rehabilitation services
Harm Reduction

*Comprehensive Care, Definition of. American Academy of Family Physicians. Accessed May 20, 2021. Source
**A Standard Framework for Levels of Integrated Healthcare. Primary Care Collaborative. Accessed May 20, 2021. Source