The primary goal of this intervention is the prevention of future congenital syphilis cases through adequate treatment. The subsequent goal is ensuring that clients feel supported and involved in their healthcare decisions. This is accomplished by collaborating with their healthcare team and linking them to any needed resources.

A total of 361 women were referred to the case managers in calendar year 2019. 27.90% (n=101) of them were pregnant at the time of the referral. 36.63% (n=37) of these pregnant clients were successfully contacted and 21.62% (n=8) were successfully enrolled. Below are just are a few examples of the successes that the perinatal case managers have been able to accomplish for patients.

Example 1: This patient was referred to case management services in early 2019. During the initial meeting, the case manager provided health education and empowerment. It also became clear that the patient did not seem grasp the importance of proper treatment, and that she was experiencing several barriers that impeded her access to healthcare. This included an unsupportive partner, lack of transportation, and lack of child care. The case manager was able to assist her in overcoming those barriers through enrollment into WIC and SNAP, which was also a benefit to the existing children in the household. The patient was also linked to transportation services through her existing Medicaid plan and was reassured by the case manager that any children that needed supervision could be brought to future appointments. The case manager coordinated with disease intervention specialists and the provider to ensure that the patient received proper treatment. As a result, the patient was able to deliver a healthy baby boy with no complications. The case manager continued to work with the patient throughout the postpartum period.

Example 2: This client was a 20-year-old first time mom who was enrolled into case management in her 2nd trimester. During her initial interview, she expressed that she was nervous about being a first time mother and concerned about her health and the health of her unborn child, since she was currently negative and her partner was HIV positive. The case manager provided extensive education on PrEP, including its uses and recommendations. The case manager then accompanied the patient to her next OB/GYN appointment, where she was told by the provider that an infectious disease specialist would have to oversee the patients use of PrEP. The case manager was able to locate an infectious disease specialist who was close to clients job. She was seen the following week, accompanied by the case manager, and started on PrEP that same day. After this, the patient became anxious about high insurance copays due to this new medication. The case manager worked with her to get her enrolled into LAMoms, which is a form of Medicaid specifically for pregnant mothers and comes with no cost to the patient. She was also enrolled in WIC and the Nurse Family Partnership, where she worked with the NFP nurse on a weekly basis. During this process, the patients partner expressed concern to the case manager about his need for a new provider related to his HIV status. The case manager worked with the patient and partner to link him to care with an infectious disease specialist. The case manager continued to follow the patient through pregnancy, and ultimately she was able to deliver a healthy baby girl with no complications. This patient reported a very satisfactory experience and continues to update the case manager on her health and wellbeing.

It is imperative that any case management services are coordinated with activities performed by disease intervention specialists and other health unit staff. Communication is key to keeping patients on track to adequate treatment. Additionally, provider education must be made a priority in order to create a continuous dialogue pertaining to patient care. The establishment of these relationships will not only ensure patients are adequately treated, but also allow for outside referrals from providers to occur when patients are identified.