Priority: Women’s mental health
Cesarean deliveries
Update on PM targets:
NPM 2: Percent of cesarean deliveries among low-risk first births was 21.6%. The target for reporting year 2018 was 20.0%. The target was not met.
ESM 2.2: Number of Colorado birthing hospitals with NTSV c-section rates exceeding the HP 2020 and Colorado-specific target of 23.9% implementing at least one strategy from the California Maternal Quality Care Collaborative toolkit was 3. The target for reporting year 2018 was 3. The target was met.
For this reporting period, MCH Block Grant dollars funded staff from the Maternal Wellness and Early Childhood team at CDPHE to serve on the Executive Committee and Board of Directors for the Colorado Perinatal Care Quality Collaborative (CPCQC). CPCQC leads implementation efforts for this priority funded through a five-year grant from the Centers for Disease Control and Prevention (CDC)’s state-based perinatal quality collaborative grant. The grant provides needed resources to adequately support the organizational capacity of the Collaborative and fund quality improvement implementation efforts. The strategies and associated outcomes for this priority are summarized below.
This NPM is reported in the women’s mental health priority section since research suggests that women who experience an unplanned cesarean may be at increased risk for postpartum depression. During this reporting period, the CPCQC continued to advance the implementation of evidence-based quality improvement strategies from the California Maternal Quality Care Collaborative toolkit to reduce the percent of nulliparous, term, singleton, vertex (NTSV) cesarean deliveries. The initiative is known as SOAR (SuppOrting vAginal births for low Risk mothers) and represents the Collaborative’s first formal perinatal quality improvement initiative.
After receiving the CDC grant in July 2017, the Executive Committee of the CPCQC established a more formal organization and staffing infrastructure for the Collaborative. Staff from CDPHE, a CPCQC Executive Committee member and a volunteer Medical Consultant attended the CDC grantee kick-off meeting in November 2017. By January 2018, the CPCQC was fully staffed with an Executive Director, Quality Improvement Specialist, Medical Consultant and Program Assistant. The Collaborative also established mentoring relationships with the Ohio and the Massachusetts Perinatal Quality Collaboratives. The CPCQC completed a logo rebranding process and launched a new website in the summer of 2018. In July 2018, the CPCQC Executive Committee held a retreat to identify next steps to establish a formal policy board for the non-profit organization rather than continuing to meet as an Executive Committee. In the fall of 2018, the CPCQC Executive Director worked closely with the Chair of the Executive Committee to develop board roles, board recruitment strategies and drafted formal articles of incorporation in anticipation of establishing a new board in early 2019. In addition to strengthening the infrastructure of the Collaborative, the CPCQC continued to hold quarterly meetings throughout the year. In August 2018, CDPHE hosted the quarterly meeting, which provided an opportunity to highlight MCH efforts to address substance misuse among pregnant and postpartum women and Colorado’s Maternal Mortality Review Committee process and findings.
To guide implementation of the Collaborative’s first quality improvement initiative, the SOAR Advisory Committee was formed as a sub-group of the CPCQC, which met regularly throughout the year. This multidisciplinary committee includes the Collaborative’s Executive Director, SOAR MD Consultant, a labor and delivery nurse representative, an obstetric physician representative, a neonatology physician representative, a nurse midwife representative, a March of Dimes representative, CDPHE’s Maternal Health Clinical Consultant, the Director of Clinical Research in Maternal Fetal Medicine at the University of Colorado, and the SOAR Quality Improvement Specialist. Early in 2018, the Advisory Committee approved the SOAR project charter, key driver diagram and data management plan for the project. The Advisory Committee reviewed data coming in from the participating hospitals to determine opportunities for improvement and address challenges to implementation of the quality improvement intervention. The Committee also began to conceptualize how to incorporate the experience of women and families having cesarean deliveries into the SOAR initiative, which will continue in 2019. CDPHE staff also provided data analyst support for the SOAR initiative through CDPHE’s Vital Statistics Office in the Center for Health and Environmental Data.
In December 2017, hospital recruitment efforts to participate in the SOAR initiative to reduce NTSV cesarean deliveries began. The initial goal was to recruit three hospitals in the first cohort, but when more requested to join, the CPCQC Executive Committee accepted additional hospitals for a total of six. Three of the six hospitals met the target recruitment criteria of NTSV cesarean rates ≥23.9%. Summits were held in May and September 2018 with representatives from each of the six hospitals participating. The first summit focused on shared learning about initial implementation steps and the second summit focused on implementation challenges related to the safety bundles to reduce cesarean deliveries. The SOAR MD Consultant presented a review of recent literature and led a discussion on strategies to respond to provider and patient inquiries about these recent findings, as well as how the research impacts the SOAR initiative. Monthly web-based seminars provided opportunities for participating hospitals to learn, collaborate and discuss challenges and barriers in implementation across hospitals on an ongoing basis. Data were collected and analyzed on a monthly basis as part of the quality improvement process. In its first year, the SOAR initiative achieved a 9% reduction in the NTSV cesarean rate for the six pilot hospitals for post-implementation period compared to baseline. Individual hospital reductions range from 7% to 52%.
Pregnancy-related depression
Update on PM targets:
SPM 1: Percent of mothers that report a doctor, nurse, or other health care worker talked with them about what to do if they felt depressed during pregnancy or after delivery was 74.2%. This data trend is statistically flat and relatively unchanged. The target for reporting year 2018 was 81.9%. The target was not met.
For this reporting period, MCH Block Grant dollars funded staff on the Maternal Wellness and Early Childhood team at CDPHE, implementation of the strategies outlined in the state action plan, and contracts with local public health agencies to implement local action plans for this priority. MCH aligned with and leveraged funding from the Colorado-based Zoma Foundation, as well as a Project LAUNCH grant from Substance Abuse and Mental Health Services Administration to advance the strategies outlined in the MCH pregnancy-related action plan. The funded strategies and associated outcomes are summarized below.
Depression is the most common complication of pregnancy, affecting nearly one in ten Colorado mothers. The pregnant and postpartum period is a critical time to identify and address maternal mental health problems, for both mother and child. However, even when women are screened and referred for treatment, many women still do not seek out needed mental health treatment. Research suggests that stigma associated with mental health is a primary reason many women do not seek treatment.
As part of a multi-pronged approach to addressing this stigma, CDPHE continued implementation of a bilingual public awareness campaign. The goals were to 1) improve the awareness and knowledge of pregnancy-related depression and anxiety among pregnant and postpartum women and their support networks, and 2) improve women’s perceptions and attitudes toward seeking help. Social media and digital advertising were the primary delivery mechanisms for the campaign’s messages and images. The campaign’s call-to-action directs people to visit the campaign landing page in English or Spanish or to call the Postpartum Support International 24/7 helpline.
The transcreated Spanish-language public awareness campaign launched in January 2018. Transcreation is the process of adapting a message from one language to another, while maintaining its intent, style, tone and context. Developed in conjunction with the CDPHE-convened Spanish Task Force, the Spanish-language campaign included an entirely new set of print materials (posters, flyers, business cards, and fact sheets), social media content (including paid advertising on Twitter, Facebook, Instagram, and Pandora, as well as content for partners to share via their own channels), radio and television interviews and ad campaigns, blog posts, press releases, and new Colorado-specific Spanish-language resources in collaboration with Postpartum Support International. The English and Spanish campaigns were primarily implemented in communities with local public health agency staff dedicated to assisting with the promotion activities. Using additional MCH funds and local partner resources, the campaign achieved its highest reach and impact in Spring 2018 with a statewide paid media drive. Visits to the English landing page during the three-month statewide drive made up more than half of the total visits for 2018 (about 26,000 page views in March through May compared to about 45,000 page views total for 2018). The Spanish landing page had more than 13,000 page views during the three-month period out of about 33,000 for 2018.
In addition to stigma, gaps in services, referral inconsistencies, limited access (especially in rural areas), and limited training for providers are all identified barriers to women receiving treatment. CDPHE worked to strengthen the referral network to ensure women who ask for help have access to appropriate support services. As part of CDPHE’s ongoing collaboration with the Colorado Chapter of Postpartum Support International, state MCH staff assisted them in the development and dissemination of a statewide maternal mental health provider directory. Colorado Crisis Services is a statewide mental health services and emotional crisis help center. To expand understanding specific to maternal mental health and available referral resources among staff at Colorado Crisis Services, a series of training modules on pregnancy-related depression was developed and disseminated. Local MCH staff also worked at the community level to identify and provide support services for expectant and new moms including new parent support groups in both English and Spanish.
To improve workforce capacity to accept referrals, state MCH staff promoted Postpartum Support International’s 2-day Perinatal Mood and Anxiety Disorders Certificate training in October 2017, hosted by Larimer County Health Department in northern Colorado and attended by approximately 75 participants. State MCH staff also coordinated a second session of the training in Denver in August 2018, with more than 130 participants. The second training included, for the first time, the development of a Spanish-language module to enhance the capacity of Spanish-speaking providers to support their clients. The Denver training also included an advanced module for experienced providers who had completed a prior Perinatal Mood and Anxiety Disorders Certificate training.
Prior qualitative findings of focus group discussions, funded by MCH, highlighted the faith community as a frequent source of support for women, especially among African-American women. State MCH staff conducted key informant interviews with members of the faith community to learn and understand how women might access support. State MCH staff also worked with local public health agency partners and the Center for African American Health to identify opportunities for collaboration and support. Outreach to faith-based partners requires a careful cultivation of relationships, to ensure meaningful partnership and community involvement and engagement. Thoughtful and intentional outreach has made for stronger partnerships and improved strategies around community engagement more broadly.
Another way to reach people who may be impacted by pregnancy-related depression is through the workplace. State MCH staff participated on CDPHE’s Mental Health in the Workplace internal committee to identify ways maternal mental health can be supported among CDPHE employees and inform strategies for use in other workplace settings. As a result, CDPHE sponsored a two-part lunch and learn series for employees focused on maternal mental health and early childhood social emotional development in the fall of 2017 and spring of 2018. Staff also recruited the program manager at the Colorado State Employee Assistance Program to attend the Postpartum Services International 2-Day Certificate training to build their capacity to address mental health among state employees who are new parents.
State MCH staff coordinated and presented at a number of additional trainings related to the integration of maternal and early childhood mental health including: 1) a local panel discussion in partnership with the Colorado Office of Early Childhood and Project LAUNCH (Linking Actions for Unmet Needs in Children's Health) as part of the live-streamed 2020 Mom annual conference in February 2018; 2) a training to more than 50 home visiting staff at the annual Parent Possible Home Visiting Conference in April 2018 (part of this training was also conducted in Spanish); and 3) a national webinar hosted by AMCHP and the Substance Abuse and Mental Health Services Administration, highlighting Colorado efforts to leverage MCH work and resources to effectively promote early childhood and maternal mental health.
In recent years, the topic of maternal mental health has gained momentum in Colorado, and as a result, the Zoma Foundation convened a Maternal Mental Health Steering Committee starting in Spring 2017. The Committee is comprised of stakeholders from academia, medicine, mental health, state and local public health, funders, insurers, and family representatives with personal experiences. State MCH staff actively participated in this group and were a key part of developing and launching a statewide Maternal Mental Health Framework for Colorado, released in July 2018.
The pregnancy-related depression State Advisory Committee continued to meet each quarter to inform outreach and training to community and faith-based organizations, review and comment on the Maternal Mental Health Framework, and give input on the public awareness campaign.
State MCH staff also leveraged CDPHE’s Maternal Mortality Review Committee efforts. Nearly one-third of pregnancy-associated deaths in Colorado are attributed to suicide and accidental drug overdose, which may have maternal mental health as a root cause. The Centers for Disease Control and Prevention included data and findings from Colorado’s MMRC as one of nine states in their second national report on maternal mortality. CDPHE also published its first comprehensive report on maternal mortality in Colorado in October 2017, which analyzed all maternal deaths from 2008 to 2013.
State MCH staff also maintained and expanded a resource portal (www.prdresourcehub.com) for stakeholders to improve technical assistance. The portal is a web-based knowledge management tool that provides a centralized hub where all relevant pregnancy-related depression materials (e.g., toolkits, training opportunities, professional guidance, and data) are housed. Between June 2018 and September 2018 there were 125 unique visitors and 297 page views, with the majority of visits from Colorado.
During this reporting period, state MCH staff provided technical assistance to 13 local public health agencies who elected to address this MCH priority in their community. Technical assistance included help with the development and implementation of local action plans and local quality improvement projects.
Priority: Substance misuse reduction (tobacco, marijuana and prescription drugs) among pregnant and postpartum women
Tobacco
Update on PM targets:
NPM 14A: Percent of women who smoke during pregnancy was 6.1%. The target for reporting year 2018 was 6.0%. The target was not quite met.
NPM 14B: Percent of children who live in households where someone smokes was 14.2%. The target for reporting year 2018 was 13.9%. The target was not met.
ESM 14.1: Percent of women who report that a doctor, nurse, or other health care worked talked with them about how smoking could affect their baby was 61.3%. The target for reporting year 2018 was 69.0%. The target was not met.
ESM 14.2: Percent of women who report that a doctor, nurse, or other health care worker advised them during pregnancy and postpartum about the harms of their child’s exposure to secondhand smoke was 32.0%. The target for reporting year 2018 was 35.7%. The target was not met.
ESM 14.3: Percent of children whose parents report that their child’s health care provider talked to them about their child’s exposure to secondhand smoke was 33.6%. The target for reporting year 2018 was 30.3%. The target was met.
During this reporting period, MCH Block Grant dollars for this priority supported a portion of the Tobacco Cessation Specialist position to lead implementation of the state action plan for this priority. MCH Block Grant funding continued to be braided with revenue from Colorado’s tobacco excise tax and funding from the Centers for Disease Control and Prevention to address tobacco use amongst the MCH population. Leveraging these funds enabled CDPHE’s Tobacco Education, Prevention and Cessation Grant Program to extend the reach of implementation efforts to help reduce the maternal smoking rate and the percent of Colorado children who are exposed to secondhand smoke. The funded strategies and associated outcomes are summarized below.
In 2018, the BABY & ME - Tobacco Free™ program was delivered by a total of 35 contracted local public health, human services, and health care agencies in 57 sites, covering 54 counties across Colorado. BABY & ME - Tobacco Free™ is a smoking cessation program created to reduce the burden of tobacco use among socioeconomically disadvantaged pregnant and postpartum populations. The program provides up to four prenatal and 12 monthly postpartum counseling sessions with carbon monoxide testing used as validation of abstinence at each visit. As an incentive, women who remain smoke-free are provided a $25 diaper voucher for each smoke-free visit. Between July 2017 and June 2018, the BABY and ME Tobacco Free™ program provided pre and postnatal smoking cessation to 700 low-income women in Colorado. In 2018, for the second consecutive year, women who completed the program gave birth, on average, to the same percentage of healthy weight babies as non-smokers. To ensure continued success and quality improvement, Rocky Mountain Health Foundation, the organization that oversees the BABY & ME - Tobacco Free™ program in Colorado, worked with the University of Colorado Cancer Center to evaluate program effectiveness.
An independent evaluator from the University of Colorado Cancer Center completed a report detailing the BABY & ME - Tobacco Free™ program’s impact on maternal and child health. They found that participation in the program was associated with lower risk of low birth weight, preterm birth and neonatal intensive care unit admission compared to both birth certificate and Pregnancy Risk Assessment Monitoring System (PRAMS) reference populations, corresponding to a return on investment of between $2.79 and $7.73 for each dollar spent on BABY & ME - Tobacco Free™ programming and an individual cost savings of between $2,182 and $6,040 for birth related medical costs. This report is pending approval for publication in a prominent peer-reviewed public health journal. Its findings are further evidence for the effectiveness and cost-effectiveness of the BABY & ME - Tobacco Free™ program.
CDPHE continued to work closely with the state Medicaid agency to ensure that comprehensive cessation coverage for members was available, accessible, and promoted. Smoking during pregnancy by Medicaid members continued to drop, and the disparity between the general population and the Medicaid population continued to narrow. The maternal smoking rate among women on Medicaid dropped from 13.2 percent in 2013 to 10 percent in 2017. The overall percentage of women smoking during pregnancy was the lowest ever recorded in Colorado at 5.2 percent, but the change was statistically insignificant from the previous year.
Since 2010, the Colorado QuitLine has operated a smoking cessation program tailored for pregnant and postpartum populations, which features dedicated coaches and incentives for participation. In 2018, the QuitLine served a total of 194 pregnant women across the state. Of those women, 133 were either on Medicaid or uninsured. The high proportion of enrolled clients with Medicaid or no insurance coverage is evidence that the QuitLine continues to reach Colorado’s most vulnerable pregnant population. In 2017-18, CDPHE partnered with the QuitLine to relaunch the Colorado Quitline website. The new online program is mobile-optimized for use on smartphones and tablets and features simple sign-up, web chat, e-coaching, text messaging and web-based nicotine replacement therapy. These improvements reduce barriers to access and engagement for pregnant and postpartum women who cannot access phone services or who prefer web-based support.
Public Housing Authorities had until July 2018 to be fully compliant with the U.S. Department of Housing and Urban Development (HUD) rule requiring all public housing properties to be smoke-free. In 2018, 65 housing authorities had no-smoking policies, up from 41 housing authorities in 2017. CDPHE funded Denver Health and Hospital Authority to provide technical assistance to housing authorities across Colorado to encourage them to make their entire housing portfolios smoke-free, not just those affected by the HUD rule. As a result, the number of units covered by a smoke-free policy was nearly three times that of the goal set 2017 and now approximately 80% of all buildings and units owned by Colorado housing authorities have a no-smoking or smoke-free policy (2,686 buildings with 19,062 units out of an estimated 3,303 buildings with 23,903 units).
In 2018, CDPHE funded the ONE Step program at the American Lung Association of Colorado and Children’s Hospital Colorado. ONE Step is a program designed to reduce children’s exposure to secondhand smoke and support parent and caregiver cessation by training childcare providers and early childhood educators to advise caregivers to smoke away from their children. At the American Lung Association, they expanded their reach and made training more accessible by creating a new, online learning module where childcare providers and early childhood educators can become trained and certified in the ONE Step program for free from anywhere in the state.
In addition to the work outlined in the MCH state action plan for this priority, CDPHE also used state tobacco excise tax dollars to support systems change projects at hospitals, federally qualified health centers, behavioral health sites, a dental clinic, and school based health clinics to make tobacco screening, treatment, and intervention an integral part of all healthcare visits.
MCH Block Grant dollars supported contracts with local public health agencies to implement local action plans for this priority. MCH Block Grant funds continued to be braided with state cash funds and Centers for Disease Control and Prevention (CDC) funding to implement the state action plan for this priority. Leveraging these funds enabled CDPHE’s Mental Health Promotion-Violence and Injury Prevention Branch to extend the reach of implementation efforts to the MCH population. The funded strategies and associated outcomes are summarized below.
Marijuana
Update on PM targets:
SPM 3: Percent of women who report using marijuana at any time during their pregnancy was 7.2%. The target for reporting year 2018 was 7.5%. The target was met.
To meet Colorado’s goal of decreasing the percent of women ages 15-44 in Colorado who used marijuana during the past 30 days from 15.3% to 14.5% by 2019, CDPHE continued to work with partners to inform and disseminate mass-reach health education campaigns that target pregnant and postpartum women with marijuana prevention messages. In July 2017, CDPHE began contracting with a new media partner. This partner reviewed the evaluation data from the previous Good To Know Pregnancy and Breastfeeding public awareness campaign that ended in June 2017 and developed new creative content and a tactical plan. Based on evaluation data from the original campaign, the new campaign is focused specifically on young moms, ages 15-19, which is the population that reported the lowest perception of risk of daily or near daily use of marijuana during pregnancy. The updated campaign launched in August 2018. Once the campaign launched, CDPHE worked with state and local partners to coordinate messaging and outreach efforts with statewide partner organizations to promote health education campaign materials with marijuana prevention messaging. CDPHE aimed to decrease the percentage of women ages 15-44 who perceive daily or near daily use of marijuana as "no risk" in Colorado from 20.4% to 18.4% by September 2019. In July 2018, CDPHE selected a new university evaluation partner, who was responsible for evaluating the new pregnancy and breastfeeding campaigns. Additionally, CDPHE continued to promote the online course for health care providers focused on the health effects and risks of marijuana use for pregnant or postpartum women. The course was developed to ensure that all providers who work with pregnant and breastfeeding women and their families have information readily available and contains pertinent health effect information, demographic information to inform provider outreach, screening best practices and access to print-ready materials to guide conversations with patients. All provider materials are free to order or download.
Opioids
Update on PMs:
SPM 4: Rate of prescription opioid-related emergency department visits per 100,000 females ages 15-44 in Colorado was 25.7. The target for reporting year 2018 was 19.5. The target was not met.
SPM 5: Rate of prescription opioid-related hospitalizations per 100,000 females ages 15-44 in Colorado was 12.7. The target for reporting year 2018 was 13.0. The target was met.
CDPHE’s Opioid Overdose Prevention Program leveraged resources from Colorado’s Prescription Drug Overdose Prevention for States grant from the Centers for Disease Control and Prevention to decrease fatal and non-fatal opioid overdoses among women of reproductive age. Colorado aims to decrease the percent of women ages 15-44 in Colorado who reported non-medical use of prescription drugs during the past 30 days from 15.3% in 2016 to 14.5% in 2020. In order to achieve this, the Opioid Overdose Prevention Program continued to collaborate with state and local members of the Colorado Consortium for Prescription Drug Abuse Prevention, housed at the University of Colorado Denver School of Pharmacy. Public awareness, safe disposal, provider education, and public health surveillance strategies, are outlined in the MCH state action plan.
CDPHE worked with partners to inform and disseminate materials from the Consortium’s Take Meds Seriously campaign, which focuses on raising public awareness among Colorado citizens regarding the problem of prescription drug abuse and promoting the safe use, storage, and disposal of prescription medications. In the spring of 2018, the Consortium’s Public Awareness Work Group released a community prevention reference guide for local coalitions that contains information about public awareness campaigns, resources from Consortium work groups, and materials such as brochures and guidelines. Additionally, the Office of Behavioral Health at the Colorado Department of Human Services released a new anti-stigma campaign to increase the number of people who seek treatment from opioid addiction. CDPHE promoted these resources and ensured MCH staff in local public health agencies were aware of the materials available to their communities. CDPHE also worked to address Colorado’s opioid epidemic by increasing access to safe disposal sites for controlled substances. As of September 2018, 58 of Colorado’s 64 counties (or 91%) had permanent prescription drug disposal sites.
A large part of CDPHE’s work to combat the opioid epidemic continued to involve healthcare provider education on safe prescribing practices and training materials on the effects and risk from prescription drug misuse. The Opioid Overdose Prevention Program also maintained contracts with 14 community-based agencies to educate providers about safe opioid prescribing practices. Opioid Overdose Prevention Program staff provided technical assistance to local grantees and partners with the Consortium’s Provider Education Work Group to promote trainings, clinical guidance documents, and webinars for health care providers on talking points, health effects, and risks of prescription drug misuse. As of September 2018, 30 CME trainings were held in conjunction with the Consortium. Additionally, CDPHE’s Opioid Overdose Prevention Program evaluators developed and began implementing a survey tool to measure the impact of prescription drug education trainings. Aggregate impact data will be available November 2019.
CDPHE hopes to decrease the percentage of women of reproductive age (ages 15-44) in Colorado who receive a high dose of opioid prescriptions (>90 medical morphine equivalents) from 5.7% in 2016 to 4.0% by October 2019. To achieve that, CDPHE implemented a number of interventions to promote the use of the Prescription Drug Monitoring Program (PDMP), housed by the Colorado Department of Regulatory Agencies. For example, CDPHE worked with the Consortium’s PDMP Work Group and clinical partners to integrate the PDMP with Colorado’s two health information exchanges and with the electronic health record system in eight outpatient clinics. Additionally, CDPHE partnered with the Denver Health and Hospital Authority to pilot a platform called OpiSafe, which integrates PDMP data with electronic health records and measures providers’ adherence to CDC prescribing guidelines. CDPHE also analyzed PDMP data for women ages 15-44 and/or prescribers who provide care to pregnant and postpartum women. In July 2018, CDPHE updated the MCH opioid fact sheets and disseminated findings to raise awareness among prescribers of the risks of opioid misuse among women of reproductive age. Additionally, in February 2018, CDPHE partnered with the Colorado Department of Regulatory Agencies to begin sending prescriber reports to controlled substance prescribers that compare each provider’s opioid prescribing habits to other providers in their same specialty, including primary care and OB/GYN providers.
To expand data collection and surveillance to deepen the understanding of the scope of prescription drug misuse, particularly for pregnant and postpartum women, CDPHE added questions to CDPHE’s new Health eMoms panel survey. Questions focus on the types of prescription, illicit and/or over-the-counter drugs that pregnant and postpartum women have used and how they accessed them. The first cohort of data will be available in the fall of 2019.
CDPHE staff continued to serve as members of the Substance Exposed Newborn Committee of the Substance Abuse Trend and Response Taskforce. In early 2018, CDPHE staff participated on a workgroup that focused on developing recommendations for improving data systems related to maternal substance abuse. As a result, the Opioid Overdose Prevention Program implemented selected recommendations, including linking PDMP data to maternal mortality review data. CDPHE staff also participated on the Substance Exposed Newborn Committee’s provider education workgroup that focuses on the impact of substance misuse on the maternal and child health population. CDPHE funded Illuminate Colorado, which serves as the backbone organization for the Substance Exposed Newborns Committee, to create an inventory of existing resources for perinatal providers, with the long term goal of creating an online platform to facilitate access to the resources.
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