Pediatric Medical Home and Wrap Around Care for Infants and Families 

The American Academy of Pediatrics (AAP) is gathering a digital library of different ways that clinics and practices around the country are serving women in recovery and infants with a history of neonatal opioid withdrawal syndrome (NOWS) or neonatal abstinence syndrome (NAS). The field of maternal-infant care through the child's first three years of life is new, and interventions have not been structurally integrated into many practices. However, pediatricians, nurses and the other members of the clinical care team have embraced both medical home and patient-family-centered care principles to support families affected by parental substance use.

Please consider completing this form if you, and your clinic/practice would like to share the work you are doing to support mothers and infants. Members of the AAP Maternal-Infant Health and Opioid Use core planning team will review the submissions. Selection of clinics/practices for inclusion in the digital library will be based on their adoption of medical home principles, commitment to public health approaches related to opioid use and pregnancy, and integration of family support methodologies.

Submissions selected by the core planning team will be invited to participate in a 1-hour interview. The information shared during the interview will be used to develop a written summary of the clinic/practice, and will be posted on AAP.org/NOWS webpage. The clinic/practice name, city and state will be featured. The Academy will provide the clinic/practice with a Model Practice Excellence Award and a letter of recognition that can be shared as the clinic/practice sees fit with a health system administration, payors, AAP chapters or districts, or even local media.


This project is supported by the Centers for Disease Control and Prevention (CDC) of the U.U. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $500,000 with 100 percent funded by the CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by the American Academy of Pediatrics, CDC/HHS, or the U.S. Government.

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* 1. Please provide the following information about your clinic/practice.

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* 2. Which of the following best describes your clinic/practice?

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* 3. Please include a short description of how your clinic/practice provides coordinated care to the infants with NAS/NOWS and their mothers, in which the family, the physician, and other community service providers work together as an organized team. In your description, please consider including the following:
- Goals/objectives for advancing this approach to care
- The length of time of the clinic/practices has been serving this patient population
- Main setting of activities

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* 4. Please list and describe how you use these community resources in your practice. In your description, please consider including any of the following: 
- Home visiting programs
- WIC
- Transportation assistance
- Medication-assisted treatment providers/referrals
- Mental health and behavioral treatment services
- Peer support groups
- Faith-based organizations support, etc.

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* 5. Please provide the names and contact information for 1-2 staff members familiar with all aspects of your practice, including the types of services offered, financial sustainability, etc. The named staff will be invited to participate in a 1-hour long interview discussion with the AAP technical writer.

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