Cribs for Kids Referral Instructions

The Alabama Department of Public Health (ADPH) has partnered with the national Cribs for Kids program. This program combines safe sleep education with providing families a safe place for their baby to sleep. Case workers, care coordinators, doulas, and anyone else who works with families or pregnant women can refer a family to Cribs for Kids. Please see below for eligibility and the referral process.

Family Eligibility

1. Any family who does not have a safe place for their baby to sleep and for whom purchasing a crib/ play yard would be a financial hardship. There is no proof of income requirement.
   • Care coordinators can ask “Do you have a safe place for baby to sleep?” If the answer is no, “Do you need help getting one?”
2. The paperwork cannot be submitted more than 4 weeks prior to due date/induction date (whichever is sooner).
3. Families can be referred to Cribs for Kids up to their baby's first birthday.
4. Families with multiples can receive a crib for each infant.

Responsibilities of the Referring Agent (e.g., care coordinator or case worker)

1. Assess whether the family needs a crib and is within the eligibility window.
2. Fill out the necessary forms with the family, confirming delivery address and the need for someone to be home to sign for the delivery.
3. Fill out all applicable fields as accurately as possible, as demographic information is required by the funding source.
4. Provide the required safe sleep education on the Enrollment In-Service Form.
5. Ensure the family understands that it is a portable crib that is offered and understands how to set it up.
6. Submit to ADPH no more than 4 weeks prior to the due date/induction date the necessary paperwork (three forms)
   
   • Cribs for Kids Referral Form
   • Enrollment In-Service Form
   • Hold Harmless Agreement

Please Follow These Steps for Referring a Client or Patient to Cribs for Kids

The required forms can be found on the ADPH Perinatal website. On the forms, enter your information and your agency’s information for the referring source.

1. If the mother has already delivered or is scheduled for induction/c-section, please put the delivery date or scheduled date instead of the due date.
2. Complete the safe sleep teaching as listed on the Enrollment and In-Service Form with the client.
3. Please complete the demographic portion of the forms with the client, ensuring it is legible. Confirm the address and contact number with family for accuracy. Cribs are returned to ADPH if there are address errors or missing apartment numbers.
4. If meeting in person, have the client sign the In-service Form and Hold Harmless Agreement. If completing these forms via phone, please obtain verbal agreement and document it as such.
5. Email all three forms to [email protected], and please carbon copy (cc) the appropriate Regional Perinatal Coordinator based on the mother's county of residence (see Regions below).

Table of Contents:

• Region I
  Colbert, DeKlab, Franklin, Jackson, Lauderdale, Lawrence, Limestone, Madison, Marshall, Morgan
• Region II
  Bibb, Choctaw, Fayette, Greene, Hale, Lamar, Marengo, Marion, Perry, Pickens, Sumter, Tuscaloosa
• Region III
  Calhoun, Cherokee, Chilton, Clay, Cleburne, Coosa, Cullman, Blount, Etowah, Jefferson, Shelby, St. Clair, Randolph, Talladega, Tallapoosa, Walker, Winston
• Region IV
  Baldwin, Clarke, Conecuh, Escambia, Mobile, Monroe, Washington
• Region V
  Autauga, Barbour, Bullock, Butler, Chambers, Coffee, Covington, Crenshaw, Dale, Dallas, Elmore, Henry, Houston, Geneva, Lee, Lowndes, Macon, Montgomery, Pike, Russell, Wilcox

Region I

Tana-kae Lewis, MSN, RN Huntsville Hospital Women’s & Children’s
Email: [email protected]
Phone: 256-265-7980

Region II

Janise Norman, BSN, RN DCH Regional Medical Center
Email: [email protected]
Phone: 205-759-6166

Region III

Cathy Nichols, RN, University of Alabama at Birmingham Hospital
Email: [email protected]
Phone: 205-934-6254

Region IV

Csierra Payne, MSN, RN, USA Strada Patient Care Center
Email: [email protected]
Phone: 251-410-4837

Region V

Kathleen Thomas, BSN, RN, Baptist Medical Center South
Email: [email protected]

The forms for the crib are processed several times a week. Once the request goes to the warehouse, the crib is sent via UPS to the family's home. The referring source will be notified once the crib is shipped. Most deliveries take no more than 3 days. Someone must be present to sign for the delivery.

Although referrals cannot be processed more than 4 weeks prior to due date, whenever possible please also do not wait until the last minute to refer clients to this service. There are occasional delays in shipping out the cribs. If referring a family that has already delivered or referring a family that may deliver and return home within a week of the referral, please discuss emergency temporary safe sleep spaces with the family.

Reminder: Referring sources are expected to follow up with the family twice: at 2-3 weeks after the baby arrives home (Survey 1) and at 6-8 weeks after the baby arrives home (Survey 2). These forms are very short and only take about 2 minutes to complete. Send these forms to [email protected].