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On October 20, 2022, multi-sector professionals who work with perinatal individuals impacted by substance use convened for a Colorado Hospital Substance Exposed Newborns (CHoSEN) Forum that included an in-person attendance option for the first time in over two years.  Colorado Attorney General Phil Weiser provided opening remarks for the momentous occasion, reflecting on the fact that, with the opioid crisis- “the amount of trauma and impact [...] is one that and that - given increased levels of public awareness, the financial settlements with pharmaceutical companies, and the ever-growing amount of need- “we are at a moment of opportunity- with funding, urgency, and creative  Attorney General Weiser asserted that, in order to seize these opportunities to their fullest, we must build “interdisciplinary relationships, outside of our silos, to give us the breadth of vision, including from people with lived experience”. Attendees at the CHoSEN Forum had the opportunity to learn from the insight and experiences of Diane Smith, SuPPoRT Colorado Family Advisory Board Chair and DPALS Peer Navigator Specialist, who shared about her own lived experience and her experience supporting others impacted by substance use during pregnancy. The day’s keynote presentations included the perspectives of a physician who is engaged in similar work in Massachusetts and a Colorado-based expert on Early Intervention. Dr. Davida Schiff presented on special considerations for utilizing toxicology testing with birthing people, including considerations related to consent and racial disproportionality in testing and child welfare referrals, asking attendees, “How do we create systems of support rather than surveillance?” and offering that “Multidisciplinary teams coming together, discussing challenging cases and listening to diverse perspectives, is required for true systems change.” Lenita Hartman presented on Early Intervention (EI), a program that provides support and services to children with developmental delays or disabilities and their families until the child’s third birthday and is an appropriate support service for some children impacted by prenatal substance exposure. Lenita, who is the Associate Director of Early Intervention Colorado Part C, shared updates on the current state of EI in Colorado and ongoing and forthcoming changes related to the intake and referral process, evaluations, and program eligibility. Attendees also heard from the three organizations that support the CHoSEN Collaborative, receiving updates about data on CHoSEN’s key drivers through the 3rd quarter of 2022 from Dr. Susan Hwang, hearing about current perinatal behavioral health related funding and projects from CPCQC’s Katie Breen, and learning about the systems changes in progress from Illuminate Colorado’s Jade Woodard. Information and updates on projects happening within the CHoSEN Collaborative related to the current state and next steps for the care of substance-exposed newborns at University of Colorado Hospital, the CHoSEN Perinatal Navigator Program, and efforts to engage pregnant women impacted by substance use through “passive” recruitment efforts were presented by Lyle Holmes, Dr. Kathi Wells, and Dr. Laurie Halmo. To round out the hybrid portion of the day, Dr. Hwang shared next steps and ways to be involved with CHoSEN and related efforts. With the return of an in-person option came a return to offering attendees a chance to connect in smaller groups and dive deeper into a particular topic by engaging in facilitated breakout discussions on the topics of family engagement, hospital-based naloxone distribution, breastfeeding, and plans of safe care. We were so excited to have so many multi-sector individuals engage in this hybrid event, and we look forward to the next one on April 18, 2023! Missed the event or looking to refresh your memory of the day? Find the materials, recordings, and opportunities to engage below. Event Materials and Recordings: Opportunities to Engage
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Twice a year, the CHoSEN Collaborative hosts the CHoSEN Forum. These forums are special times for those who participate or are interested in CHoSEN’s hospital-based quality improvement efforts and those who work across a variety of relevant sectors to come together to hear updates on the impacts of the efforts, engage in shared learning through presentations from expert speakers, and hear successes and challenges from colleagues who are leading innovative work within the Collaborative.  Colorado Attorney General, Phil Weiser The upcoming CHoSEN Forum being hosted on Thursday, October 20th is particularly momentous, as it will be the first one that includes an in-person option in over two years and will include opening remarks by Colorado Attorney General Phil Weiser. Read on to learn more about the exciting speakers and presentations in store, and DON’T WAIT TO REGISTER! October 13th is the last day to register to attend in-person. Lived Experience Expert Presentation  Meet Diane Smith, proud mother of 3 children, DPALS Peer Navigator Specialist, and SuPPoRT Colorado Family Advisory Board Chair, Not long ago, she had an open case in the child welfare system. Her message is one of empowerment, encouragement, and perseverance. As one of the pioneers of the Denver Parent Advocates Lending Support (DPALS) program, she is very active in the community as panelist, presenter, and helping parents navigate through the child welfare system. Diane is among the many DPALS that share a passion for helping to advocate for parents, just as she needed the same support herself. Diane and her husband James Smith are Co-founders of the DPALS program and longtime advocates for parents and families who have also experienced the system. Ms. Diane Smith is also involved with Illuminate Colorado as she was awarded the Community Leadership Award in 2021 for her accomplishments and support working with families for openly sharing their time and experience to further change and strengthen families in Colorado. Keynote Presentations "Toxicology Testing in the Peripartum Setting: The Unique Social and Legal Consequences for Birthing People" Davida Schiff, MD, MSc Director, Perinatal and Family-Based Substance Use Disorder (SUD) Care MGH SUDs Initiative | Division of Newborn Medicine | General Academic Pediatrics "What's Happening in Early Intervention?" Lenita Ashley Hartman, M.A. Associate Director of Early Intervention Colorado Part C Colorado Department of Early Childhood Innovative Efforts Presentations "UCH SEN Care: Progress and Plans" K. Lyle Holmes, MSN, RN, CPNP-AC/PC “Update on the CHoSEN Perinatal Navigator Project” Kathryn (Kathi) Wells, MD, FAAP | Pronouns: she/her/hers Executive Director, Kempe Center for the Prevention and Treatment of Child Abuse & Neglect Associate Professor and Section Head for Child Abuse and Neglect, University of Colorado Anschutz Medical Campus Department of Pediatrics “The Power of Passivity: Passive Strategies to Engage Pregnant Women with Substance Use” Laurie Seidel Halmo, MD, FAAP Assistant Professor of Pediatrics and Medical Toxicologist Section of Hospital Medicine University of Colorado School of Medicine Volunteer Faculty, Rocky Mountain Poison and Drug Safety Breakout Sessions
 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 demonstrate 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.”
"I encourage every hospital or clinic to join what they can 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!
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
Access to reproductive and perinatal medical care
Family financial security
Paid family and medical leave policies
Mandatory reporting
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:
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. Multidisciplinary professionals who are engaged in the Colorado Hospital Substance Exposed Newborns (CHoSEN) Collaborative’s efforts to increase consistency in implementation of best practice in the identification of and response to newborns prenatally exposed to substances convened virtually on May 24, 2022 to engage in shared learning and receive updates on work happening across the collaborative. As part of the CHoSEN Collaborative’s efforts to improve the experiences and outcomes of pregnant and newly parenting individuals impacted by substance use beyond the birth hospitalization, the day focused on support and harm reduction during the prenatal and post-discharge periods. A panel of individuals with an active role in the Denver Health/CHoSEN Perinatal Navigator Program answered questions about the program’s efforts to begin supporting impacted individuals as early as possible during the prenatal period, and Dr. Don Stader with the Colorado Naloxone Project (CNP) spoke about the importance of sending families home with naloxone and CNP’s efforts to ensure that birthing facilities are able to do so. Speaking to why it is so important to ensure that facilities give families naloxone directly rather than just a prescription for it, Dr. Stader shared: "People often don't fill the naloxone you prescribe because of stigma," and "when you send a patient home with naloxone, you not only keep that patient safer; you keep the community around the patient safer." Keeping with the theme of improved care of families beyond the birth hospitalization, Dr. Leslie Caldarelli, medical director of the NICU at Prentice Women’s Hospital and neonatal co-lead of the Illinois Perinatal Quality Collaborative (ILPQC) gave a keynote presentation on ILPQC’s efforts to optimize coordinated discharge for opioid-exposed newborns, including their process and outcome measures, quality improvement strategies, and the tools and resources utilized. To help attendees understand the legal requirements for addressing the needs of infants and families impacted by prenatal substance use, Dr. Kathi Wells of the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect and Jade Woodard of Illuminate Colorado shared information about the history, current state, and ongoing reauthorization process of the Plans of Safe Care element of the Child Abuse Prevention & Treatment Act (CAPTA). To round out the day, CHoSEN Collaborative participants shared updates on the SCL Health Systemwide SUD AIM/Maternal Mental Health Rollout and the Recovery Nurse Advocate Program at Intermountain Healthcare-Lutheran Hospital, and Dr. Susan Hwang shared the most recent data on several of the CHoSEN Collaborative’s key drivers and information about next steps and ways to be involved with CHoSEN and related efforts. Missed the event or looking to refresh your memory of the day? Find the materials, recordings, and opportunities to engage below. Materials and Recordings: Opportunities to Engage: If you are interested in getting more involved in CHoSEN, need a presentation for your stakeholders, have specific data needs, or would like to schedule a virtual site visit, please reach out to Susan Hwang at Sunah.Hwang@childrenscolorado.org. For any questions or to get involved in any of the perinatal behavioral health related funding projects below, contact info@cpcqc.org.  For any questions or to get involved in the implementation of the 2021-2022 SuPPoRT Colorado priority areas, contact Kelli Sutton at ksutton@illuminatecolorado.org.  Every pregnant and postpartum individual and infant deserves safe, equitable, and quality care, which includes ensuring their behavioral healthcare needs are met. Exacerbated by COVID-19, Colorado is in the midst of a perinatal mental health crisis where suicide and accidental overdose are the leading causes of maternal mortality during pregnancy and through the first year postpartum. Nearly 80% of the state’s maternal deaths are preventable. (1) The Colorado Department of Human Services Office of Behavioral Health has identified a need to bridge gaps in perinatal behavioral healthcare for pregnant and postpartum people by embedding health care delivery system quality improvement initiatives within the meaningful connective tissue of a care coordination model that is fluid enough to meet the perinatal dyad wherever they are in the perinatal continuum of care. “When left untreated, behavioral health conditions and toxic stressors experienced by pregnant and postpartum people have devastating consequences for infants and children, for parents, and for society. There are many contributing factors that lead to poor maternal or child health outcomes, and while some of those factors are a mystery, or outside of our control- many more are known, preventable, treatable, and are things we can and should do something about. This is why OBH believes the IMPACT BH Program is so important- continuity of and access to pregnancy and postpartum behavioral health care is something every pregnant and birthing person in Colorado should have access to. We're not there yet, but IMPACT BH is a step in the right direction.” -Kallen Thornton, MSSW, LCSW Manager of Gender Responsive Services- Office of Behavioral Health  The IMPACT (IMprove Perinatal Access, Coordination & Treatment) Behavioral Health program will establish an integrated perinatal behavioral health care network which spans prenatal, hospital, and postpartum care and improves screening, diagnosis, and treatment of perinatal behavioral health needs through community-derived strategies, including care navigation and increased social and peer support. For individuals experiencing substance use disorder, IMPACT Behavioral Health will expand and integrate medication-assisted treatment programs into perinatal care. With nearly $1 million in funding committed to this program and the recognition that Colorado’s rural birthing population is in dire need of behavioral health support and resources, IMPACT Behavioral Health will launch in Colorado’s western rural mountain region which has been severely impacted by the opioid epidemic and experienced a significant increase in Neonatal Abstinence Syndrome over the past few years. Beginning with a pilot in Garfield County with plans for subsequent rollout in other counties in Health Services Region 12, the program will support behavioral health through the development and implementation of a perinatal behavioral health framework and associated set of coordinated, cross-sector behavioral health services, supports and information-sharing practices. The framework and associated set of services will be developed and implemented collaboratively by local partners with leadership and support from Colorado Perinatal Care Quality Collaborative (CPCQC), Illuminate Colorado, Colorado Hospital Association, and the CU Practice Innovation Program. By 2023, IMPACT Behavioral Health will establish a standard of care, expanding across the state to additional regions identified as having gaps in perinatal behavioral health services, with the potential to positively impact the state’s nearly 60,000 new maternal-infant dyads each year. Want to learn more? Contact the CPCQC team at info@cpcqc.org. (1) Colorado Department of Public Health and Environment (2020). Colorado Maternal Mortality Prevention Program Legislative Report 2014–2016. “We regularly hear from our colleagues that they recognize the importance of taking a trauma-informed approach to patient care, but very few have had the opportunity to receive formal training on trauma-informed care and communication,” said Dr. Laurie Halmo, pediatrician and toxicologist at Children’s Hospital Colorado and co-chair of the Colorado Substance Exposed Newborns Steering Committee work group focused on expanding healthcare provider education resources related to substance use and pregnancy with an emphasis on family leadership and addressing implicit bias. Designed by Healthcare Providers, for Healthcare ProvidersNow, thanks to Colorado Substance Exposed Newborns Steering Committee Provider Education Work Group and the Colorado Perinatal Care Quality Collaborative, a NEW Trauma-Informed Communication and Care Provider Educational Series designed by healthcare providers, for healthcare providers, is available beginning next Monday. Each session is grounded in the perspective of someone with lived experience related to substance use and pregnancy underscores just why this topic is so important. Anyone who interacts with perinatal patients and their families in a clinical setting, from gynecologists, obstetricians, neonatologists, and pediatricians, to mental/behavioral healthcare providers and social workers, are encouraged to attend. Clinical professionals will walk away with the knowledge and tools to care for individuals in the perinatal period and those who are impacted by substance use in a trauma-informed way that leads to better experiences and outcomes for all. The educational series includes:
CHoSEN Collaborative has been published again! We reached out to Blair Weikel, lead author of “Ethnic Disparities in the Care of Opioid-Exposed Newborns in Colorado Birthing Hospitals", to understand more about why this research is important, what was most surprising, and what she would like to see for Colorado’s efforts to improve care of families impacted by substance use in the future.
From your perspective, why was it so important to do this research? “So often we assess data in aggregate and report success when overall average outcomes improve. However, we all know that health is not equitably distributed, a phenomenon that is masked unless we disaggregate data by the social constructs that predict disparate healthcare experiences and health outcomes. It is critical that researchers of all populations, but especially highly sensitive ones such as the SEN population and their families, consider the ways that discrimination can intensify the difficulties these families may face.” As you were analyzing the data, what most surprised you? “In theory, CHoSEN QIC's interventions were rolled out in a hospital at a single time, meaning they should have been implemented for all patients at one time. However, the trend in the data in a delay for improvement for Hispanic families was pretty clear and initially surprising. In retrospect, it makes sense that certain families would have barriers to being engaged in the interventions, such as language or schedules that do not allow for visitation during normal business hours and that it would take hospital teams more time to determine how to best support them - which the data shows they ultimately did.” How can hospitals who participate in the CHoSEN Collaborative support the ability to do more of this kind of research in the future? “Assessment and publication of this work could not be done without the hard work and dedication of CHoSEN QIC hospital teams. To continue to share our statewide progress and struggles, hospitals can continue to enter data reflecting their work.” Thinking about these kinds of data analysis efforts, where do you hope to see Colorado go next? “I would love to see all hospital systems in Colorado engaged with the CHoSEN collaborative, especially as we work to expand our focus from opioid-exposed newborns to infants exposed to any substance during pregnancy. Having a statewide consistent approach to the treatment of these infants and support of their families will likely lead to improved and more equitable outcomes.” Read the full publication, “Ethnic Disparities in the Care of Opioid-Exposed Newborns in Colorado Birthing Hospitals" here, and reach out to Blair Weikel with any questions! Multidisciplinary professionals already engaged in or hoping to learn more about Colorado Hospital Substance Exposed Newborns (CHoSEN) Collaborative’s efforts to increase consistency in implementation of best practice in the identification of and response to newborns prenatally exposed to substances convened virtually on October 19, 2021 to engage in shared learning and receive updates on work happening across the collaborative. Dr. Susan Hwang kicked the day off by rooting in data on Colorado’s overdose-related mortality over the last 20 years, the international increase in perinatal mental health challenges during the pandemic, challenges in accessing substance use treatment experienced by Coloradans who need it, and the disparities that exist within this data. Reflecting on data around the spike in substance use and maternal mortality that occurs during the first year postpartum, Dr. Hwang invited the multidisciplinary professionals on the call to ask themselves: “What are we doing to support mothers, children, and families after birth? And why is it that substance use rates increase astronomically, and moreover, why is it that maternal mortality increases, not immediately after birth, but into the first year postpartum?” -Dr. Susan Hwang This question set the tone for participants, who all care for families impacted by substance use, to reflect on all of the work that needs to be done to better support families and to address the barriers to receiving the support that they deserve. The day included vulnerable and inspiring stories about personal experiences with addiction and recovery from Colorado Public Radio’s Vic Vela and Dr. Robert Dietz. Vic Vela, Colorado Public Radio news host and host of the recovery podcast, “Back from Broken”, openly shared his experiences and set the tone for the event with a message of hope: “There’s a reason I’m here and able to talk to you about very painful things. It’s because I got help. [...] Don’t give up on yourself. Imagine the impossible. But it’s not as impossible as you might think.” -Vic Vela, Colorado Public Radio news host Dr. Robert Dietz shed light on his own experiences and shared words of wisdom about addiction and recovery through his perspective as a physician, offering guidance on what healthcare professionals can do if they or a colleague they know is struggling with substance use. In addition to these moving stories of personal experiences with substance use, the CHoSEN Collaborative was honored to be joined by Dr. Elizabeth Krans, Assistant Professor of Obstetrics, Gynecology and Reproductive Medicine at the University of Pittsburgh and Director of the Pregnancy and Women’s Recovery Center at Magee-Womens Hospital, for the day’s clinical keynote presentation. Dr. Krans’ presentation included valuable information on the importance of using evidence-based practices in the care of pregnant individuals with substance use disorders and concrete examples of how to use them for a variety of topics, including substance use screening, medications for opioid use disorder, and sexual and reproductive health. Updates on work happening within the CHoSEN Collaborative itself included: Data, Funding and Policy/Multisystems Updates:
Missed the event or looking to refresh your memory of the day? Find the materials, recordings, and related opportunities to engage below. Materials and Recordings: Opportunities to Engage: If you are interested in getting more involved in CHoSEN, need a presentation for your stakeholders, have specific data needs, or would like to schedule a virtual site visit, please reach out to Susan Hwang at Sunah.Hwang@childrenscolorado.org.  To learn more about or get involved in any of these perinatal behavioral health related funding projects shared during the Data, Funding, and Policy/Multisystems update, reach out to info@cpcqc.org.  To learn more about or get involved in any of this systems/policy work shared during the Data, Funding, and Policy/Multisystems update, or the implementation of the 2021-2022 Colorado SEN Steering Committee priority areas, contact Cassie Davis at cdavis@illuminatecolorado.org. Since its inception, the Colorado Hospitals Substance Exposed Newborns (CHoSEN) Collaborative has focused on and has made great strides in improvements to the birth hospitalization experience and outcomes of families impacted by perinatal substance use. With this ongoing work well underway, CHoSEN’s leadership decided to explore how they could begin proactively supporting families during the prenatal period and approached the Kempe Center to help develop a Perinatal Navigator Program that would take a collaborative approach to empowering and supporting families, beginning in the perinatal period. We reached out to Jenny Koch-Zapfel, program manager at the Kempe Center, to learn more about the program and hear about successes and lessons learned so far: What is the CHoSEN QIC Perinatal Navigator Program? The Colorado Hospitals Substance Exposed Newborns Quality Improvement Collaborative (CHoSEN QIC) Perinatal Navigator Program is a program partnering the University of Colorado and Denver Health to improve the care and outcomes of families impacted by substance use. Believing that collaboration between systems serving affected infants and their families is best practice, the CHoSEN QIC Perinatal Navigator Program is focused on keeping families together by empowering them to identify and achieve personal goals, preparing them for the arrival of a new baby, and supporting them in accessing community resources. The Perinatal Navigator provides comprehensive and strength-based, client-centered navigation of goal setting, family education, and coordination of services. Learn more about each of the program’s elements here! What have been some of the program’s greatest successes so far? I think our greatest success has been the diversity and collaboration among our workgroup and other programs serving our target population. I think our program and our workflow represents the voices of each of our workgroup members. The collaboration has led to the creation of an informational flyer for providers and an implementation manual that is helping to track our workflow. What have been some of the challenges you have experienced so far, and how have you approached them? Identifying someone to fill the navigator role has been very challenging. At this time, the goal is for the navigator program to reside within the Nurse Family Wellness Program; however, staff availability is limited because the Nurse Educators are funded through the Denver Department of Human Services. We’ve been creative in thinking about how to staff this position given that the program is still in its pilot stage. Not knowing how it may grow and change, hiring staff is not feasible. In thinking about the scope of services we’d like to provide, as well as the experience we think would be most valuable, we’ve considered utilizing MSW students. However, due to the timing of the project and COVID restrictions on clinical time, student interest and availability has been limited. Currently, we’re piecing the navigator role together using one of the Nurse Educators within the Nurse Family Wellness Program, a social worker on the Mom/Baby unit at Denver Health, and the pilot’s Program Manager. Although each of these individuals has a wealth of knowledge and experience, they have other full-time clinical and administrative responsibilities, so we are continuing to brainstorm ideas for filling this role on a more permanent basis. We have identified a process within the Denver Health electronic medical record system for notifying our temporary navigators of referrals. However, we anticipate that providers may forget to offer our program or may feel limited in discussing the program due to time constraints. We’ve approached this challenge by trying to anticipate what providers might consider barriers to the referral process and attempting to ease this burden. By creating an informational sheet with talking points for providers, we aim to educate them about the program, giving them confidence to discuss our program with patients and make referrals. Understanding that the time providers have in prenatal visits is limited, we are also working to educate the staff of Denver Health’s Integrated Behavioral Health program. This is a service which embeds mental health specialists within Denver Health’s clinics, providing additional support beyond the basic prenatal visits. We hope that knowledge of and familiarity with our navigator program amongst prenatal care providers, as well as the mental health specialists, will increase the chances that pregnant individuals may be offered a referral. I think we are heading in the right direction in terms of referrals. We haven’t had a chance to test out our method yet, but [we] hope to soon.” What lessons would you share with others based on your experience? Partnerships are key! We continue to reach out to other programs with similar aims in hopes of improving our processes and learning from what has and hasn’t worked for them. It’s also been invaluable to have a multi-disciplinary group working on the development of this program. Having perspectives of inpatient and outpatient pediatric providers, clinical and non-clinical social workers, non-profit program coordinators, nurse educators, and representatives from DDHS has fostered great relationships and rich discussions. We are thrilled to see the work of CHoSEN expand beyond the birth hospitalization to begin supporting families prenatally! Please share information about this program with your colleagues, and if you have any questions or feedback about the program or ideas about filling the navigator role, please reach out to Jenny Koch-Zapfel at JENNIFER.KOCH-ZAPFEL@cuanschutz.edu.
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