PATCH-NC: Perinatal Access to Care and Health in North Carolina
Site Selection and Implementation Readiness Assessment Application– 2026

About This Application


Thank you for your interest in participating in the PATCH-NC (Perinatal Access to Care and Health in North Carolina) initiative.

The North Carolina Community Health Center Association leads this project in partnership with Nurture NC and with funding support from The Leon Levine Foundation, managing the initiative's implementation in 10 rural counties designated as maternal care deserts or low-access counties.

This application is designed to assess your organization's readiness to implement a family physician-led shared maternity care model. The application includes 20 questions organized into four sections:

• Current Maternity Care Capacity and Shared Care Partnerships (Questions 1–15)
• Implementation Readiness and Performance Reporting (Question 16)
• Leadership Commitment and Sustainability (Questions 17-20)
• Supporting organizational information, including identification of key implementation sponsors and delivery partners

The application is intended to be completed collaboratively by organizational leaders, such as the Chief Executive Officer/Executive Director, Medical Director or Family Medicine Clinical Leader, Operations Leader, Quality Improvement Leader, and other staff involved in maternity care, care coordination, or data reporting, as appropriate. One application per organization will be accepted.

Most questions are multiple choice or select-all-that-apply. Organizations should expect to complete this application in approximately 20–30 minutes. The submittal deadline is September 4th, 2026. If you have questions, you may contact us at communications@ncchca.org.



Site Selection Principles

PATCH-NC is a statewide initiative designed to expand access to high-quality maternity care in rural North Carolina by supporting community health centers (FQHCS and look-alikes), rural health centers, and local health departments in developing coordinated prenatal and postpartum care models close to home. To review the selected site support menu, including direct financial supports and additional high-value supports, please refer to the appendix at the end of the application.

The PATCH-NC site selection process will prioritize organizations that demonstrate the following:

1. Family Physician-Led Maternity Care Expansion

The core intervention of PATCH-NC is enabling family physicians and their teams to provide prenatal and postpartum care locally at the full scope of their training, with or without obstetric delivery. Selected sites must demonstrate readiness to support family physicians as primary maternity care providers within their communities.

Sites should identify:

• Current family physicians and their teams providing maternity care.
• Family physicians and their teams prepared to expand maternity care services with training and support.
• Clinical leaders committed to sustaining shared maternity care after initial funding.

2. Commitment to Serving Communities with Maternity Access Challenges

Priority will be given to organizations serving communities with significant maternity care access challenges, including:

• Maternity care desert counties
• Low-access maternity counties

Please note: Qualified applicants must have an existing access point within the county identified as a desert or low-access county.


3. Established or Developing Shared Care Partnerships

Successful PATCH-NC sites must have the ability to establish a coordinated maternity care pathway with a specific delivery partner. Family physicians and their teams will need to work collaboratively with OB/GYNs and maternal-fetal medicine specialists in their region who provide consultation, high-risk care support, and delivery services.

Applicants should identify:

• The hospital where patients are anticipated to deliver.
• The OB/GYN group or clinicians supporting deliveries for the community.
• Existing relationships with above partners.
• Any existing processes for consultation, escalation, and transfer of care.

4. Organizational Leadership Commitment and Readiness for Practice Transformation

PATCH-NC requires organizational transformation, including changes to workforce models, clinical workflows, care coordination, and financial operations.

Selected sites must demonstrate:

• Executive leadership commitment for implementation.
• Clinical leadership engagement.
• Willingness to redesign workflows and integrate maternity care into routine operations.
• Identification of a project champion.

Selected sites will commit to participating in:

• Clinical education, CME, and ECHO-based learning.
• Quality improvement coaching.
• EHR and workflow optimization.
• Participation in a streamlined implementation assessment using routinely collected clinical and operational data.
• Coordination with evaluation partners.
• Testing innovative models of care.

Organizational Readiness for Performance Reporting

PATCH-NC is designed to minimize reporting burden by using data routinely available through participating organizations' electronic health records (EHRs), scheduling systems, staffing records, referral systems, and learning management systems. Selected sites will submit data on implementation progress using the reporting schedule below. Please note: the measure set below and reporting cadence is currently in draft form.

(The following would not be the responsibility of PATCH sites: Long-term maternal, infant outcomes, and other population-level indicators. Such data will be evaluated through statewide administrative data, birth records, Medicaid claims, and other available population-level data whenever feasible rather than through routine reporting by participating sites.)

Proposed Measure	Proposed Frequency
Number of pregnant patients enrolled in Shared Maternity Care (current and cumulative)	Monthly
Number of completed prenatal visits monthly (current and cumulative)	Monthly
Percentage of scheduled prenatal visits completed	Monthly
Percentage of patients initiating prenatal care during the first trimester	Quarterly
Percentage of patients completing a postpartum visit within 12 weeks	Quarterly
Number of clinician FTE providing Shared Maternity Care	Quarterly
Provider completion of PATCH-NC CME/ECHO education (yes/no)	Quarterly
Percentage of patients with a documented referral and completed handoff to the delivery hospital/OB partner	Quarterly
Telehealth visits conducted as part of Shared Maternity Care (when applicable, yes/no)	Quarterly
Clinician satisfaction with the Shared Maternity Care model	Semi-annually
Burnout score of clinicians and staff	Baseline & Annually
Tracking of incentives to patients	Quarterly

Appendix

Selected Site Support Menu: Selected sites will have access to both direct financial supports, along with other high-value supports, to cover opportunity costs for expanding services to offer shared maternity care. Selected sites will be eligible for the resources listed below, with exact amounts to be guided by proposed interventions, capacity, and other implementation and sustainability factors.

Direct financial supports up to:

• $27,500 to support staff/clinical time to launch model (time away from practice for CME, planning time, decreased productivity)
• $25,000 Direct Patient Care incentives for achieving key milestones (purchased and distributed on site)
• ~$15,500 EHR modifications, quality reporting, telehealth equipment upgrades
• ~$10K telehealth/Remote Patient Monitoring/equipment upgrades in year 2
• ~$110K to fund postpartum and hard-to-reach population innovations across grant (pending model approval)

Additional high-value supports:

• CME bundle (25 hours) for participating providers ($1K/each value)
• CME ECHO Model for participating teams with expert clinical support
• Billing and Coding Guide to ensure sustainability of model
• Dopplers (1-3/site), Non Stress Test Equipment ($2.5k value)
• Promotional materials to support community awareness of new scope ($5K/site)
• Pipeline investments for recruitment of new graduate family physicians
• Formal evaluation of model and publication