Connect With Us – Introductory Overview of the FCI Model

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Interested in Learning More about the Family Connects Model?

FCI is inviting conversation with anyone interested in learning more about Family Connects. Each session will have a different theme.
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Register here for one or more sessions:


A Universal Approach for Health Equity

March 4, 12-12:30pm EST

Nurses and Community Health Workers in the FC Model

May 6, 12-12:30pm EST

Home Visiting in Rural Communities & Maternity Care Deserts

August 5, 12-12:30pm EST

Using Data to Inform Community Change

October 28, 12-12:30pm EST

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FCI Voices: A Message from Pierce County

Universal Home Visiting for newborns and their families is our priority at Family Connects International. We have made it our mission to strengthen connections for families with newborns and link them directly to health and community care resources. Learn more about Family Connects International today!

Last November, Washington-Pierce County became a certified Family Connects Community Partner. In this post for our blog series “FCI Voices for Universal Newborn Care”, we will learn from Pierce County about the importance of certification in their own words.

A Message from Pierce County, WA

When we launched Family Connects Pierce County in March 2021, we really had no idea if the program would take or what impact we could truly have on families in our community. What we did know, is that we were confident in our local leaders’ decision to choose a reputable national program able to respond to Pierce County’s enduring child welfare crisis, and confident that our implementing agencies were capable and equipped to deliver the program effectively.  Achieving certification means so much to us in Pierce County. As the only Family Connects site operating in Washington State, certification adds credibility to our program. When families feel like they can trust a program and trust our nurses, they will seek the postpartum care they need and deserve, and we can provide the most comprehensive wraparound support to them.

Our road to certification felt very much like a rollercoaster. As soon as we felt like things were moving along well, we would be humbled by a hiccup requiring a swift change in course to respond and redirect. Our implementation specialist was right there with us from the start, and we honestly could not have achieved as much as we did so early in implementation without her thoughtful feedback, knowledge of our unique community, attention to detail, and moving data. When FCI transitioned to a nonprofit and assigned a new implementation specialist, we felt equipped to pivot and continue to support our families with the best postpartum support knowing we built a strong foundation. We are grateful to FCI for their grace in answering our questions and supporting our team along the way.

I would encourage interested communities to first really center the community’s voice in deciding if this program is a right fit for them. Once you’ve achieved that decision, hop on the rollercoaster, and enjoy the ride. There is beauty in the journey, and for us, that beauty has been learning with and from other Family Connects sites, which has only bolstered our local Family Connects program. We have especially found beauty in the families we’ve served, who have trusted us wholeheartedly with a completely new way of thinking about postpartum and the fourth trimester. Without them, there would be no Family Connects Pierce County.

Thank you, Pierce County, for sharing your experience and for providing resources and home-visiting care throughout the year! Interested in launching a Family Connects Partnership? Visit FamilyConnects.org today to learn more!

FCI Voices: The Importance of Universal Home Visiting for Newborns and Their Families



Universal Home Visiting for newborns and their families is our priority at Family Connects International. We have made it our mission to strengthen connections for families with newborns and link them directly to health and community care resources. This is made possible by our community partners across the county. But why is universal home visiting important for families and their newborns? We have asked one of the experts at Family Connects International to explain in their own words the importance of home-visiting care. In this post for our blog series “FCI Voices for Universal Newborn Care”, we will learn from our Nurse Manager and Acting Chief Nursing Officer about the benefits of home visiting for newborns and their families.

Bonnie Hepler, RN, MSW, MSPH, PhD, is our new Nurse Manager and Acting Chief Nursing Officer. Bonnie began at FCI as a Senior Nurse Trainer and was recently promoted.

Here are Bonnie’s thoughts on postpartum home visiting for families with newborns:

“Postpartum home visiting plays a crucial role in supporting families and their newborns. In fact, most high-resource countries across the globe offer some form of universal, in-home support for families with newborns. These visits are invaluable in navigating the physical, emotional, and lifestyle adjustments that come with a new baby. A caring and knowledgeable nurse can help identify and prioritize referrals in collaboration with families as well as help normalize some questions people experience postpartum. From identifying respiratory distress in infants exposed to viruses such as RSV and flu to reminding parents they are doing a great job, every family deserves to feel supported, safe, and seen during the postpartum period”.
-Bonnie Hepler, RN, MSW, MSPH, PhD

FCI’s mission is made possible because of the support, dedication, and drive of both our community partners and the staff here at FCI. Bonnie is one of the many who share that commitment to newborns and families nationwide and utilizes her expertise in nursing to equip our FCI network to deliver quality care year-round.

“I am committed to ensuring that nurses in the FCI network embody excellence and equity in their clinical practice. My passion lies in ensuring that all of our nurses not only possess the knowledge to adeptly support the physiologic processes during the postpartum period but also embody a humble and supportive approach when interacting with families during home visits. It is my belief that a combination of expertise and empathetic care is pivotal in creating a positive and inclusive healthcare experience for every family. My hope is that we can provide nurses with the tools to ensure Family Connects interactions feel helpful and healing in a period that is often associated with trauma and uncertainty”.
-Bonnie Hepler, RN, MSW, MSPH, PhD

Thank you, Bonnie, for this insight! Visit our website to learn how you can help ensure essential connections for equitable outcomes for every newborn and stay up to date on the strides our community partners and FCI team have made to make our mission possible.

Mechanisms of change in external implementation support: A conceptual model and case examples to guide research and practice

Please read an article written by our own Renée I. BoothroydMechanisms of change in external implementation support: A conceptual model and case examples to guide research and practice

The Center for Implementation does great work with implementation support providers and those who support them.  This article is foundational for building on the momentum in the field and creating definition around what implementation specialists actually do.

The article is featured as a critical thought leader in implementation practice in the upcoming September 2023 issue of Implementation in Action, a monthly bulletin for implementers and intermediary organizations who are seeking to apply implementation science in a thoughtful and systematic way. The bulletin goes out to over 9000+ implementers worldwide.

Join the Maternal Mental Health Nonprofit Nation Map

Are you a community-based 501(c)(3) nonprofit organization providing maternal mental health care services? If so, The Policy Center for Maternal Mental Health invites you to get on the map by joining the Maternal Mental Health Nonprofit Nation listserv to connect, ask each other questions about any issue (from service delivery to nonprofit governance), learn about funding opportunities, and more. Joining the listserve also places your non-profit on the Community-Based Organization map.

 

Registration Link:
https://us02web.zoom.us/webinar/register/WN_IGR6Q5vPRbyUD9m7V8lnQQ#/registration

The Center of Excellence for Infant & Early Childhood Mental Health Consultation

November 6 – 8, 2023
The Center of Excellence for Infant & Early Childhood Mental Health Consultation invites you to join our upcoming free virtual conference: Infant & Early Childhood Mental Health Consultation: Equity from the Start

This FREE, virtual conference is specifically geared towards IECMHC consultants, supervisors, managers, consultees, parents, leadership, and funders, but all are invited to attend. Join us to access a range of presentations related to implementing infant & early childhood mental health consultation and promoting justice, equity, diversity, and inclusion for infants, children, families, and the workforce.

Join us for:

  • Over 50 professional learning sessions
  • Opportunities to connect with other individuals in the field of IECMHC
  • On-Demand access through February 6, 2024.
  • Register today! Spots are limited.

NHVRC Model Profile

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Click here for more information on NHVRC

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Family Connects is designed to support whole-person, integrated health for all families of newborns at a moment of life-changing transition. Family Connects nurses are trained to carefully assess newborns and mothers and to discuss concrete next steps to address opportunities and concerns, including seeking immediate medical care when necessary. They work together with families and build from identified strengths to connect them to community resources that meet their needs and preferences. Family Connects nurses also keep the whole family in mind, recommending appropriate mental health services or medical care for other family members as needed—and they follow up to make sure families’ needs are met. Family Connects aims to reach at least 60 to 70 percent of families with newborns in each community it serves.
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What is the model’s approach to providing home visiting services?

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All families in an affiliated community are offered up to three home visits during the first 3 weeks after birth. Home visits last up to 2 hours each. A registered nurse connects with a family in their home shortly after birth to assess the child’s and birthing person’s physical health status (as applicable), assess unique family strengths and challenges, and respond to immediate family needs.
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Who is implementing the model?

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Home Visitors
Family Connects was implemented by 129 full-time equivalent (FTE) home visitors in 2022. Home visiting providers are Registered Nurses with up-to-date professional licenses, who function within the state’s Nurse Practice Act and are trained to provide newborn, caregiver, and family health and psychosocial assessments. Full-time home visitors typically enroll six to eight new families per week.

Supervisors
Family Connects was implemented by 29 FTE nurse supervisors in 2022.
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Where is the model implemented?

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Family Connects operated in 35 local agencies across 16 states in 2022.


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The NHVRC is a partnership of James Bell Associates and the Urban Institute. Support is provided by the Heising-Simons Foundation and previously was also provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the foundations. For a detailed methodology, see the 2023 Home Visiting Yearbook.
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Families Served Through Evidence-Based Home Visiting in 2022

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[av_one_half first min_height=” vertical_alignment=’av-align-top’ space=” row_boxshadow_width=’10’ row_boxshadow_color=” margin=’0px’ margin_sync=’true’ av-desktop-margin=” av-desktop-margin_sync=’true’ av-medium-margin=” av-medium-margin_sync=’true’ av-small-margin=” av-small-margin_sync=’true’ av-mini-margin=” av-mini-margin_sync=’true’ mobile_breaking=” mobile_column_order=” border=” border_style=’solid’ border_color=” radius=” radius_sync=’true’ min_col_height=” padding=” padding_sync=’true’ av-desktop-padding=” av-desktop-padding_sync=’true’ av-medium-padding=” av-medium-padding_sync=’true’ av-small-padding=” av-small-padding_sync=’true’ av-mini-padding=” av-mini-padding_sync=’true’ svg_div_top=” svg_div_top_color=’#333333′ svg_div_top_width=’100′ svg_div_top_height=’50’ svg_div_top_max_height=’none’ svg_div_top_opacity=” svg_div_bottom=” svg_div_bottom_color=’#333333′ svg_div_bottom_width=’100′ svg_div_bottom_height=’50’ svg_div_bottom_max_height=’none’ svg_div_bottom_opacity=” column_boxshadow_width=’10’ column_boxshadow_color=” background=’bg_color’ background_color=” background_gradient_direction=’vertical’ background_gradient_color1=’#000000′ background_gradient_color2=’#ffffff’ background_gradient_color3=” src=” attachment=” attachment_size=” background_position=’top left’ background_repeat=’no-repeat’ highlight_size=’1.1′ animation=” animation_duration=” animation_custom_bg_color=” animation_z_index_curtain=’100′ parallax_parallax=” parallax_parallax_speed=” av-desktop-parallax_parallax=” av-desktop-parallax_parallax_speed=” av-medium-parallax_parallax=” av-medium-parallax_parallax_speed=” av-small-parallax_parallax=” av-small-parallax_parallax_speed=” av-mini-parallax_parallax=” av-mini-parallax_parallax_speed=” css_position=” css_position_location=’,,,’ css_position_z_index=” av-desktop-css_position=” av-desktop-css_position_location=’,,,’ av-desktop-css_position_z_index=” av-medium-css_position=” av-medium-css_position_location=’,,,’ av-medium-css_position_z_index=” av-small-css_position=” av-small-css_position_location=’,,,’ av-small-css_position_z_index=” av-mini-css_position=” av-mini-css_position_location=’,,,’ av-mini-css_position_z_index=” link=” linktarget=” link_hover=” title_attr=” alt_attr=” mobile_display=” mobile_col_pos=’0′ id=” custom_class=” template_class=” aria_label=” element_template=” one_element_template=” av_uid=’av-llmkq3ya’ sc_version=’1.0′]
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18,879

home visits provided
including 7,529 virtual visits

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17,696

families served

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[av_progress_bar title=’White’ progress=’51’ icon_select=’no’ icon=’43’ font=’entypo-fontello’ color=’theme-color’ color1=” color2=” color3=” color_title=” color_title_back=” element_template=” one_element_template=” av_uid=’av-llml67bs-4′ sc_version=’1.0′]
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[av_heading heading=’Caregiver ethnicity’ tag=’h3′ style=” subheading_active=” show_icon=” icon=’ue800′ font=’entypo-fontello’ size=” av-desktop-font-size-title=” av-medium-font-size-title=” av-small-font-size-title=” av-mini-font-size-title=” subheading_size=” av-desktop-font-size=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” icon_size=” av-desktop-font-size-1=” av-medium-font-size-1=” av-small-font-size-1=” av-mini-font-size-1=” color=” custom_font=” subheading_color=” seperator_color=” icon_color=” margin=” margin_sync=’true’ av-desktop-margin=” av-desktop-margin_sync=’true’ av-medium-margin=” av-medium-margin_sync=’true’ av-small-margin=” av-small-margin_sync=’true’ av-mini-margin=” av-mini-margin_sync=’true’ headline_padding=” headline_padding_sync=’true’ av-desktop-headline_padding=” av-desktop-headline_padding_sync=’true’ av-medium-headline_padding=” av-medium-headline_padding_sync=’true’ av-small-headline_padding=” av-small-headline_padding_sync=’true’ av-mini-headline_padding=” av-mini-headline_padding_sync=’true’ padding=’10’ av-desktop-padding=” av-medium-padding=” av-small-padding=” av-mini-padding=” icon_padding=’10’ av-desktop-icon_padding=” av-medium-icon_padding=” av-small-icon_padding=” av-mini-icon_padding=” link=” link_target=” id=” custom_class=” template_class=” element_template=” one_element_template=” av_uid=’av-g4zgd4′ sc_version=’1.0′ admin_preview_bg=”][/av_heading]

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[av_progress_bar title=’Hispanic or Latino’ progress=’35’ icon_select=’no’ icon=’43’ font=’entypo-fontello’ color=’theme-color’ color1=” color2=” color3=” color_title=” color_title_back=” element_template=” one_element_template=” av_uid=’av-co6s94′ sc_version=’1.0′]
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[av_one_third min_height=” vertical_alignment=’av-align-top’ space=” row_boxshadow=” row_boxshadow_width=’10’ row_boxshadow_color=” custom_margin=” margin=’0px’ av-desktop-margin=” av-medium-margin=” av-small-margin=” av-mini-margin=” mobile_breaking=” mobile_column_order=” border=” border_style=’solid’ border_color=” radius=” min_col_height=” padding=” av-desktop-padding=” av-medium-padding=” av-small-padding=” av-mini-padding=” svg_div_top=” svg_div_top_color=’#333333′ svg_div_top_width=’100′ svg_div_top_height=’50’ svg_div_top_max_height=’none’ svg_div_top_flip=” svg_div_top_invert=” svg_div_top_front=” svg_div_top_opacity=” svg_div_top_preview=” svg_div_bottom=” svg_div_bottom_color=’#333333′ svg_div_bottom_width=’100′ svg_div_bottom_height=’50’ svg_div_bottom_max_height=’none’ svg_div_bottom_flip=” svg_div_bottom_invert=” svg_div_bottom_front=” svg_div_bottom_opacity=” svg_div_bottom_preview=” column_boxshadow=” column_boxshadow_width=’10’ column_boxshadow_color=” background=’bg_color’ background_color=” background_gradient_direction=’vertical’ background_gradient_color1=’#000000′ background_gradient_color2=’#ffffff’ background_gradient_color3=” src=” background_position=’top left’ background_repeat=’no-repeat’ highlight=” highlight_size=” animation=” animation_duration=” animation_custom_bg_color=” animation_z_index_curtain=’100′ parallax_parallax=” parallax_parallax_speed=” av-desktop-parallax_parallax=” av-desktop-parallax_parallax_speed=” av-medium-parallax_parallax=” av-medium-parallax_parallax_speed=” av-small-parallax_parallax=” av-small-parallax_parallax_speed=” av-mini-parallax_parallax=” av-mini-parallax_parallax_speed=” css_position=” css_position_location=” css_position_z_index=” av-desktop-css_position=” av-desktop-css_position_location=” av-desktop-css_position_z_index=” av-medium-css_position=” av-medium-css_position_location=” av-medium-css_position_z_index=” av-small-css_position=” av-small-css_position_location=” av-small-css_position_z_index=” av-mini-css_position=” av-mini-css_position_location=” av-mini-css_position_z_index=” link=” linktarget=” link_hover=” title_attr=” alt_attr=” mobile_display=” mobile_col_pos=’0′ id=” custom_class=” template_class=” aria_label=” element_template=” one_element_template=” show_locked_options_fakearg=” av_uid=’av-3qoa5k’ sc_version=’1.0′]
[av_heading heading=’Child age’ tag=’h3′ style=” subheading_active=” show_icon=” icon=’ue800′ font=’entypo-fontello’ size=” av-desktop-font-size-title=” av-medium-font-size-title=” av-small-font-size-title=” av-mini-font-size-title=” subheading_size=” av-desktop-font-size=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” icon_size=” av-desktop-font-size-1=” av-medium-font-size-1=” av-small-font-size-1=” av-mini-font-size-1=” color=” custom_font=” subheading_color=” seperator_color=” icon_color=” margin=” margin_sync=’true’ av-desktop-margin=” av-desktop-margin_sync=’true’ av-medium-margin=” av-medium-margin_sync=’true’ av-small-margin=” av-small-margin_sync=’true’ av-mini-margin=” av-mini-margin_sync=’true’ headline_padding=” headline_padding_sync=’true’ av-desktop-headline_padding=” av-desktop-headline_padding_sync=’true’ av-medium-headline_padding=” av-medium-headline_padding_sync=’true’ av-small-headline_padding=” av-small-headline_padding_sync=’true’ av-mini-headline_padding=” av-mini-headline_padding_sync=’true’ padding=’10’ av-desktop-padding=” av-medium-padding=” av-small-padding=” av-mini-padding=” icon_padding=’10’ av-desktop-icon_padding=” av-medium-icon_padding=” av-small-icon_padding=” av-mini-icon_padding=” link=” link_target=” id=” custom_class=” template_class=” element_template=” one_element_template=” av_uid=’av-llmlivr3′ sc_version=’1.0′ admin_preview_bg=”][/av_heading]

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[av_heading heading=’Child insurance status’ tag=’h3′ style=” subheading_active=” show_icon=” icon=’ue800′ font=’entypo-fontello’ size=” av-desktop-font-size-title=” av-medium-font-size-title=” av-small-font-size-title=” av-mini-font-size-title=” subheading_size=” av-desktop-font-size=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” icon_size=” av-desktop-font-size-1=” av-medium-font-size-1=” av-small-font-size-1=” av-mini-font-size-1=” color=” custom_font=” subheading_color=” seperator_color=” icon_color=” margin=” margin_sync=’true’ av-desktop-margin=” av-desktop-margin_sync=’true’ av-medium-margin=” av-medium-margin_sync=’true’ av-small-margin=” av-small-margin_sync=’true’ av-mini-margin=” av-mini-margin_sync=’true’ headline_padding=” headline_padding_sync=’true’ av-desktop-headline_padding=” av-desktop-headline_padding_sync=’true’ av-medium-headline_padding=” av-medium-headline_padding_sync=’true’ av-small-headline_padding=” av-small-headline_padding_sync=’true’ av-mini-headline_padding=” av-mini-headline_padding_sync=’true’ padding=’10’ av-desktop-padding=” av-medium-padding=” av-small-padding=” av-mini-padding=” icon_padding=’10’ av-desktop-icon_padding=” av-medium-icon_padding=” av-small-icon_padding=” av-mini-icon_padding=” link=” link_target=” id=” custom_class=” template_class=” element_template=” one_element_template=” av_uid=’av-ld52o8′ sc_version=’1.0′ admin_preview_bg=”][/av_heading]

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[av_heading heading=’Caregiver primary language’ tag=’h3′ style=” subheading_active=” show_icon=” icon=’ue800′ font=’entypo-fontello’ size=” av-desktop-font-size-title=” av-medium-font-size-title=” av-small-font-size-title=” av-mini-font-size-title=” subheading_size=” av-desktop-font-size=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” icon_size=” av-desktop-font-size-1=” av-medium-font-size-1=” av-small-font-size-1=” av-mini-font-size-1=” color=” custom_font=” subheading_color=” seperator_color=” icon_color=” margin=” margin_sync=’true’ av-desktop-margin=” av-desktop-margin_sync=’true’ av-medium-margin=” av-medium-margin_sync=’true’ av-small-margin=” av-small-margin_sync=’true’ av-mini-margin=” av-mini-margin_sync=’true’ headline_padding=” headline_padding_sync=’true’ av-desktop-headline_padding=” av-desktop-headline_padding_sync=’true’ av-medium-headline_padding=” av-medium-headline_padding_sync=’true’ av-small-headline_padding=” av-small-headline_padding_sync=’true’ av-mini-headline_padding=” av-mini-headline_padding_sync=’true’ padding=’10’ av-desktop-padding=” av-medium-padding=” av-small-padding=” av-mini-padding=” icon_padding=’10’ av-desktop-icon_padding=” av-medium-icon_padding=” av-small-icon_padding=” av-mini-icon_padding=” link=” link_target=” id=” custom_class=” template_class=” element_template=” one_element_template=” av_uid=’av-llmmcesk’ sc_version=’1.0′ admin_preview_bg=”][/av_heading]

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[av_heading heading=’Caregiver education’ tag=’h3′ style=” subheading_active=” show_icon=” icon=’ue800′ font=’entypo-fontello’ size=” av-desktop-font-size-title=” av-medium-font-size-title=” av-small-font-size-title=” av-mini-font-size-title=” subheading_size=” av-desktop-font-size=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” icon_size=” av-desktop-font-size-1=” av-medium-font-size-1=” av-small-font-size-1=” av-mini-font-size-1=” color=” custom_font=” subheading_color=” seperator_color=” icon_color=” margin=” margin_sync=’true’ av-desktop-margin=” av-desktop-margin_sync=’true’ av-medium-margin=” av-medium-margin_sync=’true’ av-small-margin=” av-small-margin_sync=’true’ av-mini-margin=” av-mini-margin_sync=’true’ headline_padding=” headline_padding_sync=’true’ av-desktop-headline_padding=” av-desktop-headline_padding_sync=’true’ av-medium-headline_padding=” av-medium-headline_padding_sync=’true’ av-small-headline_padding=” av-small-headline_padding_sync=’true’ av-mini-headline_padding=” av-mini-headline_padding_sync=’true’ padding=’10’ av-desktop-padding=” av-medium-padding=” av-small-padding=” av-mini-padding=” icon_padding=’10’ av-desktop-icon_padding=” av-medium-icon_padding=” av-small-icon_padding=” av-mini-icon_padding=” link=” link_target=” id=” custom_class=” template_class=” element_template=” one_element_template=” av_uid=’av-llmll7lg’ sc_version=’1.0′ admin_preview_bg=”][/av_heading]

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[av_heading heading=’Caregiver age’ tag=’h3′ style=” subheading_active=” show_icon=” icon=’ue800′ font=’entypo-fontello’ size=” av-desktop-font-size-title=” av-medium-font-size-title=” av-small-font-size-title=” av-mini-font-size-title=” subheading_size=” av-desktop-font-size=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” icon_size=” av-desktop-font-size-1=” av-medium-font-size-1=” av-small-font-size-1=” av-mini-font-size-1=” color=” custom_font=” subheading_color=” seperator_color=” icon_color=” margin=” margin_sync=’true’ av-desktop-margin=” av-desktop-margin_sync=’true’ av-medium-margin=” av-medium-margin_sync=’true’ av-small-margin=” av-small-margin_sync=’true’ av-mini-margin=” av-mini-margin_sync=’true’ headline_padding=” headline_padding_sync=’true’ av-desktop-headline_padding=” av-desktop-headline_padding_sync=’true’ av-medium-headline_padding=” av-medium-headline_padding_sync=’true’ av-small-headline_padding=” av-small-headline_padding_sync=’true’ av-mini-headline_padding=” av-mini-headline_padding_sync=’true’ padding=’10’ av-desktop-padding=” av-medium-padding=” av-small-padding=” av-mini-padding=” icon_padding=’10’ av-desktop-icon_padding=” av-medium-icon_padding=” av-small-icon_padding=” av-mini-icon_padding=” link=” link_target=” id=” custom_class=” template_class=” element_template=” one_element_template=” av_uid=’av-4mvm9k’ sc_version=’1.0′ admin_preview_bg=”][/av_heading]

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Percentages may not add to 100 due to rounding. • The number of home visits includes 10,167 in-person visits, 7,529 virtual visits, and 1,183 follow-up visits.
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