Gina Hofert

The Suda Institute, United States

Title: Breaking the Silos, Not the Law: A Cross-Sector Collaborative Care Model for Pregnant and Postpartum Individuals with Substance Use Disorder

---

Biography

Gina Hofert, MPH is the Chief Executive Officer of The Suda Institute and implementation lead for the nationally recognized Substance Use Network (SUN) Project, a cross-sector collaborative care model serving pregnant and postpartum individuals with substance use disorders. She specializes in implementation science, health systems transformation, maternal and child health, substance use disorder policy, and cross-sector collaboration. With SUN Project partners, Hofert led the design and implementation of the SUN Project's governance structure, legal framework, care coordination model, funding strategy, and sustainability plan. She has served as a co-investigator on multiple Institutional Review Board (IRB)-approved research studies and has contributed to numerous peer-reviewed publications evaluating adolescent health and systems-level interventions. Hofert has presented at dozens of national and international conferences on collaborative care models, confidentiality infrastructure, implementation science, and health systems change. Her work focuses on translating research into sustainable practice to improve outcomes for mothers, infants, families, and communities.

Abstract

Fear, stigma, and systemic barriers to care contribute to significant health disparities among pregnant and postpartum individuals with substance use disorders (SUD). They often require services from multiple systems, including healthcare, behavioral health, public health, child welfare, recovery support services, and community-based organizations. Across countries, confidentiality and privacy requirements protect patient rights and build trust in healthcare systems, but they can also create barriers to information sharing and care coordination, contributing to fragmented services and poorer maternal and infant outcomes.
The objective of this work was to develop and evaluate a legally compliant, cross-sector collaborative care model that improves coordination while protecting patient privacy. The Substance Use Network (SUN) Project was implemented in North Carolina, USA, to integrate obstetric care, medications for opioid use disorder, behavioral health, child welfare, public health, peer support, and community-based services through shared governance, legal agreements, informed consent processes, workforce training, and structured care coordination.
Evaluation methods included participant surveys, medical record review, qualitative feedback, systems assessment, and hospital outcome analysis. Findings from 2019–2023 demonstrated strong maternal and infant outcomes, including 94% treatment adherence, 87% term births among singleton pregnancies, 100% term delivery among participants entering care during the first trimester, and no maternal or infant deaths among enrolled participants. Follow-up data collected in 2025 showed that 84% of participants with available child welfare data maintained custody of their infant one year postpartum. Hospital data demonstrated a 30% reduction in symptomatic neonatal abstinence syndrome between 2021 and 2023.
The SUN Project demonstrates that confidentiality protections do not have to be barriers to coordinated care. While legal frameworks differ across jurisdictions, the challenge of balancing privacy with collaboration is universal. This presentation will describe the legal framework, implementation strategies, lessons learned, and practical tools used to create an integrated system of care that improved communication, coordination, and outcomes for mothers, infants, and families experiencing health disparities.