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CHoSEN Hospital Spotlight: Valley View Hospital

7/8/2022

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Valley View Hospital
is a true champion of improving the care of Colorado families impacted by substance use and pregnancy.

One of the ways they demons
trate this is through their participation in many of our state’s relevant initiatives, including CHoSEN QIC (Colorado Hospital Substance Exposed Newborns Quality Improvement Collaborative), our state’s AIM SUD (Alliance for Innovation on Maternal Health Substance Use Disorder) Learning Collaborative, and the IMPACT (IMprove Perinatal Access, Coordination & Treatment) Behavioral Health project.
​

We connected with the Director of Family Birthplace at Valley View Hospital, Michele ‘Mic’ Zywiec, RN, MSN, to learn more about Valley View’s participation across these initiatives.
What led/motivates the team at Valley View Hospital to participate in these initiatives?
“I am a member of the Maternal Mortality Review Committee for the state of Colorado. [Two of my colleagues at Valley View], Bonnie Sihler, CNM and Dr. Katie Mang-Smith are also on the review committee. After seeing that the leading cause of maternal mortality is suicide and overdose, it brought awareness to how we approach these topics at our institution. We were involved in the CHoSEN initiative and joining in on the AIM Substance Use Disorder initiative seemed like what we needed to do for our clients to help them navigate care and obtain the resources they need.”
What does Valley View Hospital’s participation in each initiative look like and how do you see them all fitting together and complementing each other?
“CHoSEN treats infants born to mothers using substances. This helps us keep our babies and mothers together and support the baby that has withdrawal symptoms. We then also try to set up resources for follow up with these families.  The AIM SUD Learning Collaborative starts screening early in pregnancy and makes referrals early on to help families navigate the pregnancy and postpartum period with the support they need to decrease substance use or have a medication-assisted treatment (MAT) provider prescribe different, safer medications during pregnancy and hopefully try to reduce the use of substances. We will also screen for mental health conditions and make referrals for these individuals as well. Our goal is always to keep families together and to give them the support and resources they need."
What have been the biggest impacts of participating in these initiatives- on Valley View Hospital’s work and/or on the families you work with?
“We have seen shorter lengths of stay for the newborns with substance exposure. We have been able to get more of a support system in place for those working with social services by pairing them with a peer support person who helps families through the process based on the expertise of their own lived experience. All of our staff members have completed SBIRT (Screening, Brief Intervention, and Referral to Treatment) training so that we can screen patients and then make referrals as needed. This has brought awareness to our staff.  Through the trainings, we have had many educational opportunities for staff and providers to learn more about resources around the state and programs we can use. Recently, the Colorado Naloxone Project presented to our provider/staff group about giving out naloxone to high-risk patients. They gave suggestions on how to help the patient feel comfortable accepting the medication without shaming them. We have had the Naloxone Project active in our unit, but this will help us with better rates of dispensing this life-saving medication.”
<< Want to learn more about Colorado Naloxone Project? Watch the presentation they gave during the May 2022 CHoSEN Forum. >>
Finally, Michelle had these words of advice to share with others
who are considering participating in these or similar initiatives:
​
“Start small with small acts of change in your hospital and clinics.”
  • ​Meet with your clinics to see where everyone is and what support and screenings you all offer.  
  • Have a book of resources in your patient care areas so you can access resources when a patient needs them. 
  • Know your community partners and have meetings once a year or more to keep in contact and know your resources. It is worth the energy and time to help patients in crisis. 
  • The free monthly educational resources from CPCQC provided during the AIM SUD Learning Collaborative’s monthly coaching calls are invaluable and so insightful. No matter what the topic, we always have something to take away. The best part is they are recorded so if you cannot join the meeting live, you can watch it later and have the same education. I am able to educate the entire staff by sharing the recording with them. The Colorado Perinatal Quality Care Collaborative has made it easy to make change. The resources are given to you and the other hospitals share freely the resources they have developed. ​
"I encourage every hospital or clinic to join what they can
​and get the education to the providers that need it.”
We are so inspired by the Valley View Hospital team’s dedication to and participation in so many efforts to improve their support of families impacted by substance use during pregnancy. Have questions or want to learn more about any of these initiatives? Reach out to us at info@chosencollaborative.org!
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Legislation Passed During the 2022 Colorado Session Related to Pregnancy, Substance Use, and Families

7/8/2022

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Colorado’s 2022 legislative session wrapped up in May, and it included the passage of many new pieces of legislation that will impact individuals with the capacity to become pregnant, children, and families.  

We’ve put together a summary of what passed this session that is relevant to substance use and families, including topics across behavioral health, reproductive and perinatal medical care, early childhood, economic security, and more.
Support for families impacted by behavioral health
  • House Bill 22-1278 Behavioral Health Administration establishes the behavioral health administration (BHA) in the department of human services in pursuit of creating a coordinated, cohesive, and effective behavioral health system in the state.
  • House Bill 22-1214 Behavioral Health Crisis Response System requires crisis system facilities and programs, including crisis walk-in centers and mobile crisis programs, to meet minimum standards to provide mental health and substance use disorder services and clarifies that crisis system facilities and programs shall provide behavioral health services to individuals experiencing a substance use disorder crisis.
  • House Bill 22-1302 Health-care Practice Transformation creates the primary care and behavioral health statewide integration grant program in the department of health care policy and financing to provide grants to primary care clinics for implementation of evidence-based clinical integration care models.
  • House Bill 22-1303 Increase Residential Behavioral Health Beds requires the department of human services (department) to renovate a building at the mental health institute at Fort Logan to create at least 16 additional inpatient civil beds for persons in need of residential behavioral health treatment. It also directs the department and the department of health care policy and financing to create, develop, or contract to add at least 125 additional beds at mental health residential treatment facilities (mental health facilities) throughout the state for adults in need of ongoing supportive services.
  • House Bill 22-1326 Fentanyl Accountability And Prevention establishes many measures focused on addressing synthetic opiates. Some highlights include:
    • Enabling hospitals and ERs to dispense take home buprenorphine 
    • Requiring that individuals arrested for possession receive evaluations for treatment
    • Development of a fentanyl prevention and education campaign
  • Senate Bill 22-021 Treatment Behavioral Health Disorders Justice System updates provisions of existing statue concerning the treatment of persons with mental health disorders in the criminal and juvenile justice systems.
  • Senate Bill 22-021Treatment Behavioral Health Disorders Justice System updates provisions of existing statue concerning the treatment of persons with mental health disorders in the criminal and juvenile justice systems. 
  • House Bill 22-1295 Department Early Childhood And Universal Preschool Program, which establishes duties of the new Department of Early Childhood, creates Colorado’s universal preschool program and provides continued investment in Illuminating Child Care—a program that provides an innovative approach to increasing access to child care for parents and caregivers navigating complex life situations-- through 2028. 
  • House Bill 22-1369 Children’s Mental Health Programs directs the department of early childhood to contract with a Colorado-based nonprofit entity to provide children's mental health programs.
  • Senate Bill 22-147 Behavioral Health Care Services for Children provides funding for schools to increase the number of health professionals, allowing more schools and districts to provide behavioral health services for all students.
Access to reproductive and perinatal medical care
  • House Bill 22-1289 Health Benefits For Colorado Children and Pregnant Persons provides full health care coverage for people who are pregnant or up to 12 months postpartum and children who would otherwise be eligible for Medicaid and CHP+ if not for their immigration status. It also makes other critical investments in perinatal services across the state, including making breast pumps a covered benefit for all Coloradans who use Medicaid and CHP+ and creating a Special Enrollment Period for pregnancy, which will allow people to sign up for individual market insurance coverage as soon as they find out they are pregnant.
  • House Bill 22-1279 Reproductive Health Equity Act declares that every individual has a fundamental right to use or refuse contraception; every pregnant individual has a fundamental right to continue the pregnancy and give birth or to have an abortion; and a fertilized egg, embryo, or fetus does not have independent or derivative rights under the laws of the state.
  • House Bill 22-1329 2022-23 Long Bill (the FY 2022-23 state budget) includes protection for the quality prenatal and postpartum care in Colorado’s Medicaid program and provides funding for stakeholder engagement, including through the Maternity Advisory Council.
Family financial security
  • House Bill 22-1259 Modifications To Colorado Works Program makes critical improvements to the Colorado Works program (our state’s Temporary Assistance for Needy Families (TANF) program), including increasing the amount of Basic Cash Assistance (BCA) provided to families, establishing a cost of living adjustment to the BCA, and improving the way the program works for families. 
  • ​​House Bill 22-1055 Sales Tax Exemption Essential Hygiene Products creates a state sales tax exemption commencing January 1, 2023, for all sales, storage, use, and consumption of menstrual products, diapers, and incontinence products.
Paid family and medical leave policies
  • House Bill 22-1133 Family and Medical Leave Insurance Fund is one of the next steps in the implementation of Colorado’s paid family leave program. It helps to establish funding mechanisms for state employee coverage that the state is required to pay under the new program. 
  • ​House Bill 22-1305 Paid Family Medical Leave Premium Reduction reduces the premium paid by employers for the state's paid family and medical leave program, starting January 1, 2023, through June 30, 2023, from nine-tenths of 1% of wages per employee to eighty-one hundredths of 1% of wages per employee, and requires the state treasurer to transfer $57.5 million from the general fund to the family and medical leave insurance fund.
Mandatory reporting
  • ​​House Bill 22-1240 Mandatory Reporters establishes a Mandatory Reporter Task Force charged with analyzing best practices and recommending changes to training requirements and reporting procedures and analyzing the effectiveness of mandatory reporting and its relationship with systemic issues, including the disproportionate impact of mandatory reporting on under-resourced communities, communities of color, and persons with disabilities.
Looking ahead and to the federal level: While this year’s state legislative session is over, we will need to continue to pay attention to the following related to reproductive health, substance use, and families: 
  • Stakeholder opportunities as part of implementation of bills that passed this session, especially: 
    • The stakeholder process required by House Bill 22-1289 Health Benefits For Colorado Children and Pregnant Persons to determine priorities for drawing down federal funds to improve perinatal and postpartum support
    • The Mandatory Reporting Task Force established by House Bill 22-1240 Mandatory Reporters to analyzing best practices and recommending changes to training requirements and reporting procedures and analyzing the effectiveness of mandatory reporting and its relationship with systemic issues
  • Progress of the FASD Respect Act, legislation that has been proposed at the federal level that would reauthorize funding for Fetal Alcohol Spectrum Disorder (FASD) research, prevention, and services. 
  • Continued efforts to support family economic security–especially access to housing, food, Temporary Assistance for Needy Families (TANF), Child Care Assistance Program (CCAP), tax credits, and family-friendly work policies

Have questions about any of this recently passed legislation or want to get involved in advocating for the FASD Respect Act or other next steps? 
​
Reach out to Illuminate Colorado’s strategic initiatives manager, Cassie Davis, at cdavis@illuminatecolorado.org.
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