Centers of Excellence for Perinatal Substance Use

An updated and revised Center of Excellence application (PDF) launched on November 1, 2024. Please review the criteria carefully as you prepare your application. If you have any questions, or concerns, please email centersofexcellence@doh.wa.gov

How to Become Certified

1. Review the application (PDF)

2. Ensure your hospital can meet the criteria listed in the application

3. Submit your application 

Note: Your responses are saved if you need to exit out of the application before it's submitted. However, we highly recommend completing the application in one sitting.

Contact us if you have questions or need guidance.

Ten Criteria and Resources to Meet These Criteria

These criteria guidelines, established by a consortium of experts, reflect best practices in perinatal substance use treatment and care. These resources may also be helpful if you are not a birthing hospital but want to support people with a substance use disorder who give birth.

In addition to the resources below, we suggest you utilize the free resources found in the Perinatal Substance Use Disorder Learning Collaborative online toolkit and the Washington State Perinatal Collaborative provider resources.

General Resources

Criterion 1: Verbally screen every pregnant or postpartum person for substance use disorder with a validated screening tool. This screening should occur during delivery admission, at a minimum.

Screening Tools

  • 5Ps (Recommended Tool):

Sample 5Ps Screening Tool with verbal prompts and recommended actions. Includes directions on a Brief Negotiated Interview.

A validated screening tool during pregnancy, includes violence and depression screening. Copyrighted instrument available at a cost and with training.

Other Resources

Education

  • Training video using 5Ps and Brief Interview with Dr. Jim Walsh and Tiffani Buck, 11 minutes:
  • Training video using Screening, Brief Intervention, and Referral to Treatment (SBRIT):

Criterion 2: Screen every pregnant or postpartum person for Perinatal Mood and Anxiety Disorders (PMADs) with a validated screening tool. This screening should occur during delivery admission, at a minimum (Note: This screening should be in addition to any hospital-wide mandatory mental health screenings and be validated for the perinatal population)  

Screening Tools

Resources for Clinicians

Resources for Patients

Education

Criterion 3: Have a provider on-site or on-call that can and will initiate and adjust (titrate) medications that treatment opioid use disorder during pregnancy, labor and delivery, and postpartum.

OR

If the hospital does not have an on-site/on-call provider, there is a procedure in place to consult with a provider to initiate or adjust medications to treat opioid use disorder during pregnancy, labor and delivery, and postpartum when needed.

Example Practice Documents

Policy and Process Implementation

  • ScalaNW: Helping hospitals expand to hospital-wide policy and processes for MOUD, including immediate scheduling for lower resource settings

Consultation

Education

Patient-facing Education

  • Patient Video Series: How to prepare for ESC, including medications for OUD and support. In this patient-facing series of 3 short videos, the 3rd video reviews perinatal substance use, recovery, treatment, MOUD, and support. It includes a patient story.

Criterion 4: Allows the birthing person and infant to room together unless the birthing person is in the ICU or there are medical reasons outside of Neonatal Abstinence Syndrome (NAS) for the infant to be in the NICU/special care nursery.

Resources

Criterion 5: Have evidence-informed guidelines for chest/breastfeeding when using substances or taking medication to treat opioid use disorder (MOUD) that integrates a trauma-informed and harm reduction approach, supports the birthing person’s preferences, and provides information about benefits and considerations for all feeding options.

Resources

Guidelines

Education

Criterion 6: Practice the use of non-pharmacologic interventions as the first line of treatment for withdrawal symptoms in the infant, centering the parent(s) as the most important aspect to the infant’s care.

Example Practice Documents

Resources

Education

Criterion 7: Align hospital policy for contacting Child Protective Service (CPS) with state policy for reporting and notification. Conduct family-centered, trauma-informed communication with the birth parent about what to expect regarding the reporting or referral process for infants exposed to substances, and what they may expect regarding potential interactions with (CPS).

DCYF Training and Guidelines

Handouts

Education

 

Criterion 8: Have a process in place to support patient care coordination and ensure a comprehensive and supportive transition to outpatient or community services.

One-pager Patient Resources

Postpartum Resources

Education

Criteria 9: Have a process in place to discharge patients who use substances, or use medication for substance use disorder, with naloxone or a prescription for naloxone. Provide patient education about the risk factors of overdose, signs of an overdose, overdose response steps, the use of naloxone, and safe storage (i.e., medication lockbox).

Naloxone Resources

Patient Education

Naloxone for Free

Criterion 10: Have a process in place to submit coded, and chart abstracted substance use disorder data measures through the Maternal Data Center (MDC), the Alliance for Innovation on Maternal Health (AIM) data center, or the Obstetrical Care Outcome Assessment Program (OBCOAP).