Community-based services for parents and caregivers

To ensure a safe and seamless transition from hospital to community, it is essential to develop a referral path for infants and birth parents. This may involve having a multidisciplinary network of national, regional, and local community resources, for both the patient and the family including: Pediatric specialists and subspecialists, obstetricians and gynecologists, adult primary care providers, social workers, home visiting services, addiction specialists, infectious diseases specialists, mental health and behavioral clinicians, recovery coaches, MOUD providers, community health workers, support groups, peer coaches, and other community services. 

For assistance expanding your network, consider these resources:

• Bright Futures tip sheet for ideas on creating effective partnerships with your community
• A template to develop local community-based linkages such as the one on aap.org: Referral and Follow Up for Screenings
• The AAP Care Coordination Resources 

The AAP handout, Parent-Infant Dyad Community Resource Mapping to identify local interventional care and community support services.