Supporting Substance-Using Caregivers in Pueblo, Colorado

Impact Highlight: With support from the GPL, the Pueblo County Department of Human Services created a “Best for Babies” program and referral pathway from the local Pueblo hospital to supportive community resources. Since 2023, the initiative has served 38 pregnant and newly parenting substance-using caregivers to help reduce contact with the child welfare system.

Project Context:

• In 2021, roughly 15% of all babies born in Pueblo, Colorado, were born exposed to substances. Parental substance use can often be a precursor to a family’s involvement with Child Protective Services (CPS). However, Colorado CPS does not screen in families for prenatal substance use alone. There must also be a clear concern for the infant’s safety.
• For families that became involved in child welfare, the Pueblo County Department of Human Services (PCDHS) offered a Safe Baby Court to help parents safely maintain custody of their children. However, PCDHS wanted to do more to support pregnant families earlier in their recovery journey, to improve health outcomes for infants, and reduce possible involvement with child welfare.
• Pueblo DHS applied and was selected to be a part of the GPL Children and Families accelerator to test ways to reach people using substances during pregnancy and connect them to supports, especially substance use treatment and cash assistance.

How the GPL Supported:

• Analyzed baseline child welfare and other publicly available data to learn more about the demographics of the infants who were removed from their parents between 2019-2022. This allowed leaders to disaggregate by race and child welfare involvement of the parents.
• Supported PCDHS and its sister agency, Public Health and the Environment, as they started a new initiative called Best for Babies, to better support pregnant and newly parenting substance-using caregivers. Through Best for Babies, PCDHS tested two distinct approaches:
  1. Use a Request for Proposal (RFP) to procure for a community navigator program to engage and support pregnant people using substances and connect them to voluntary services.
  2. Dedicate a TANF case manager position to serve families already enrolled in TANF Basic Cash Assistance (BCA) and help them connect to substance-treatment and other recovery services.
• Developed multiple resources including:
  • A slide deck and meeting plans to help explain the challenge and opportunity facing pregnant and newly parenting families using substances in Pueblo. DHS used the GPL-developed materials to engage potential referral partners: the local birthing hospital and local service and housing providers.
  • A tracker to assist the community navigator and TANF case managers in tracking the clients served through the Best for Babies program.
  • A referral toolkit to guide medical and social service agency staff in referring substance-using pregnant and newly parenting caregivers to the Best for Babies program.
  • A script for case aides and DHS hotline supervisors to prompt them to ask hotline callers for their contact information. This would allow staff to follow-up with callers to brainstorm other ways to offer the pregnant person in question resources if they did not answer the phone.

Results

• The community-based referral pathway to Best for Babies has served 38 pregnant and newly parenting individuals (including fathers) since 2023.
  • These individuals have been referred from the local birthing hospital, the local inpatient substance use treatment center, the local Nurse-Family Partnership program, and a large number by word of mouth.
• Pueblo contracted with a nonprofit organization who hired a peer to do the community-based navigator work of reaching out to substance-using caregivers and helping them connect to whatever services they needed.
• Pueblo also dedicated a TANF case manager position to help families already enrolled in TANF Basic Cash Assistance (BCA) connect to additional supports.