Columbia Memorial Hospital ramps up support for parents


By Sue Cody


Misty and Kendra 2.AAn innovative pilot program at Columbia Memorial Hospital (CMH) aims to break the cycle of Adverse Childhood Events (ACEs) by coaching new parents.


The Family Transitional Care pilot identifies and supports parents who may need help to overcome their own childhood issues on the way to being better parents.


Kendra Gohl, Care Management manager at CMH, says the idea for the pilot grew out of the hospital’s work with mothers who need resources to overcome drug or alcohol use to keep their children.


“We started talking to Child Protective Services (CPS), having a social worker in our prenatal clinic and pediatric clinic one day a week. We saw our CPS cases drop,” Kendra says.


She heard of ACEs work being done at Oregon Children’s Clinic and had an “Ah-ha!” moment.


“Wow — this is exactly what we are doing on the prenatal side, in our own little way,” Kendra says. “We’re screening parents for high-risk situations and trying to intervene before they have their kiddo.


“That’s when we started looking at ACEs and put in a request for grants to fund a position,” Kendra says. The Columbia Pacific Coordinated Care Organization is funding the family transitional care coordinator for its first year.


How it works


At the CMH prenatal clinic, women who are 20-24 weeks pregnant are offered a chance to take the ACE survey. At the pediatric clinic, parents of babies who are four months or older also take the survey. Surveys are administered and treated confidentially.


The ACE survey measures 10 types of childhood trauma, such as sexual, verbal or physical abuse, as well as physical and emotional neglect.  The more ACEs one has, the higher the risk of drug and alcohol abuse, incarceration, job insecurity and chronic diseases such as cancer and heart disease.


In the Family Transitional Care pilot, parents with a score lower than 4 (out of 10) are invited to meet with the coordinator, Misty Bottorff, who can connect them to social services programs.


If the score is 4 or higher, Misty reaches out to parents and helps connect them with resources to meet their needs. These include community nonprofits, like Clatsop Behavioral Health, The Harbor, Northwest Parenting, CPS and Northwest Early Learning Hub, that help with parenting skills.


“We just want to help people be the best parents they want to be,” says Misty, who is a licensed clinical social worker. “Everything is confidential. There is no judgment.”


She is three months into the year-long pilot and seeing some success already.


“I had a homeless mommy,” Misty says. “She was on a CPS (Child Protective Services) birth alert. I tried to get her to go to a maternity home. She finally agreed, and now they have a safety plan in place. She gets to keep her baby.”


Women who have already had a child outplaced by CPS must accomplish a list of approximately 10 steps to keep their next baby, such as finding a place to live that is safe from abuse and neglect, or getting off drugs. Misty helps them complete this process.


“That list can be overwhelming,” Misty says. She guides women by helping them tackle one step at a time.


In addition to the ACE survey, parents also take a resiliency survey. This helps Misty work with parents to show them where they have already been successful.


“We focus on strengths, in spite of trauma they might have had as kids.”


Breaking the ACE cycle


Pediatric clinics have been using the ACE survey for several years to screen parents for childhood trauma that may affect their parenting. However, not many prenatal clinics offer the ACE survey, so the CMH pilot may contribute new information in this area.


Early intervention is important to change the outcomes of children with trauma-affected parents. “Trauma in previous generations could play a big part in parenting,” Dr. David Willis says, in an Aces Too High article ( Willis is director of the Division of Home Visiting and Early Childhood Systems in the U.S. Department of Health and Human Services’ Health Resources and Services Administration.


“The ACE data could clearly help us move upstream,” Willis says, “targeting how to begin to work with families, to understand how the trauma endured by parents in their childhood impacted attachment with their own children.”


Kendra said the pilot fits well with other community efforts.


“This is the first step in trauma-informed care,” says Kendra. Being trauma-informed means engaging people in a safe, healthy way that takes into consideration physical, emotional and psychological traumas they may have experienced.


The Way to Wellville and its partners are collaborating to make Clatsop County a trauma-informed community.

ACE Questionnaire DARS Pg 1

ACE Questionnaire DARS Pg 2