Maternity Advisory Committee (MAC) Application

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This is the application for the Colorado Department of Health Care Policy and Financing's (HCPF) Maternity Advisory Committee!

Were you covered by Medicaid (Health First Colorado or Child Health Plan Plus) during your pregnancy? Want to share your experience and help create and change the policy for Health First Colorado pregnant and postpartum members?

Join our Maternity Advisory Committee! The Committee provides input on existing and future Medicaid policies, shares their stories, and points out challenges faced during pregnancy and postpartum experiences.

The Maternity Advisory Committee has between 15 and 20 members. Our goal is to develop a diverse group of people of different races/ethnicities, ages, number of pregnancies, locations (for example, people from rural Colorado), and pregnancy experiences.

The Maternity Advisory Committee meets online on the last Tuesday of each month. Members will be paid to attend the meeting and can live anywhere in Colorado.

To qualify for the Committee, you should have had Medicaid coverage at some point during your pregnancy experience (including Health First Colorado, Child Health Plan Plus, or emergency Medicaid coverage). A pregnancy experience can include: live births, stillbirths or newborn losses, miscarriages (including ectopic pregnancies), and abortions or terminations.

To apply to become a member of the Maternity Advisory Committee, complete this application form. If you have any questions about the Maternity Advisory Committee, you can email Brooke Greenky (brooke.greenky@state.co.us) or Anoushka Millear (anoushka.millear@state.co.us). Your responses will remain confidential and will only be used for this application. Submit your application before October 15, 2023.

Thank you for sharing your experience!

First Name *

E-mail *

What are your pronouns? (she/her, he/him, they/them, other) *

What is your race and ethnicity? (for example, American Indian/Alaska Native, Asian, Black/African American, Hispanic/Latinx, Native Hawaiian/Pacific Islander, White/Caucasian) *

What county did you live in during your pregnancy? *

Were you/your family enrolled in Health First Colorado (Colorado's Medicaid program) or and/or Child Health Plan Plus (CHP+) during your pregnancy? (check all that apply)

*

Health First Colorado (Colorado's Medicaid program)

Child Health Plan Plus (CHP+)

Unsure

Other:

Required

How long ago was your last experience with pregnancy, birth, and/or postpartum care? *

0-1 year

1-2 years

2-5 years

5+ years

Please share how your health care experience(s) during pregnancy, labor and/or postpartum have led you to want to participate in the Maternity Advisory Committee. (recommended 2-5 sentences) *

How did your race/ethnicity, gender identity, location, age, health conditions, or other related factors shape your pregnancy, birth, and/or postpartum experience(s), if at all? (recommended 2-5 sentences) *

Have you had experiences with any of the following during your pregnancy, birth, and/or postpartum experience(s) that you feel comfortable sharing? (check all that apply) *

Chronic conditions (for example, diabetes, heart disease, auto-immune diseases)

High risk pregnancy

Experienced complications

Mental health

Substance use

Difficulty accessing care or other services

Other [please explain in the question below]

Required

If you selected one or more checkboxes in the previous question, please explain your experience. (recommended 2-5 sentences)

Do you have any additional skills, experiences, and/or perspectives that would benefit the committee? (recommended 2-5 sentences) *

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