Action Collaborative Application Preparation Guide and Frequently Asked Questions

We’re excited you are interested in applying for the 2026-27 National Step Up Together Action Collaborative. The Action Collaborative application is designed to help the Step Up Together team understand your community birth-hospital partnership, current integration efforts, and readiness to participate in a Full Transfer Drill.

The application does not have to be completed at one time.
You can Save and Continue later which will provide you with a custom link to the current state of your form submission, with the option of sending the link via email.

Before starting the application, we recommend gathering the information below.
We’ve also included sample Letters of Support below for your partner organization(s).

Frequently Asked Questions can be found below.

1. Applicant Contact Information

Be prepared to provide:

  • Name of person completing the application
  • Credentials
  • Email address
  • Phone number

2. Full Transfer Drill Type

You will be asked:

  • What type of Full Transfer Drill are you intending to run?
    • Birth Center Transfer Drill
    • Home Birth Transfer Drill
    • Other applicable model

3. Community Birth Practice Information

For either Birth Center and Home Birth applicants prepare:

  • Center or Practice name
  • Location and/or Service Area
  • Names and titles of proposed participants
  • Provider types

If Applying as a Birth Center Prepare:

  • Birth center accreditation status (CABC)
  • State licensure status
  • Distance (in miles) to the collaborating hospital

4. Hospital Partner Information

Prepare:

  • Collaborating hospital name
  • Hospital location
  • Names and titles of proposed hospital participants
  • Level of neonatal care available
  • Information about relevant hospital services and capabilities

5. Integration and Collaboration

The application asks about your current relationship between community birth providers and the hospital. Be prepared to describe:

Existing Integration Model

  • Shared protocols or agreements
  • Transfer procedures
  • Collaborative meetings
  • Privileging arrangements
  • Communication pathways
  • Other integration efforts

Relationship Strengths

  • What is working well in the relationship
  • Existing successes or collaborative efforts

Relationship Challenges

  • Barriers to collaboration
  • Communication challenges
  • System or process gaps you hope to improve

6. EMS / Transport Partner Information

You will be asked whether you have identified an EMS or transport partner for the Full Transfer Drill.

If yes, prepare:

  • EMS or transport service name
  • Service location and coverage area
  • Description of EMS structure
  • EMS involvement in community birth integration efforts
  • Names and titles of proposed EMS participants

7. Action Collaborative Participation Questions

Why do you want to participate? (Maximum 300 words)

Consider addressing:

  • Why this work is important to your team
  • Current opportunities for improvement
  • Goals for participation
  • Expected benefits for patients, families, and providers

Commitment and Readiness

You will be asked to:

  • Confirm your understanding of participation expectations
  • Describe any concerns or reservations about participation
  • Explain how your team plans to meet the collaborative requirements

8. Letters of Support

Applications must include a letter of intent from the partner organization confirming their commitment to participate. Teams also have the option to include a letter of intent from EMS, which is strongly encouraged but not mandatory.


👉 To make this easier, we’ve created downloadable templates you can use and customize for your application.

Frequently Asked Questions

Who should apply?

Action Collaboratives are best suited for teams that have already done some level of planning and engagement between community and hospital partners, such as meeting to map out transfer processes or formally review transfers that have occurred. At minimum, teams must include one participant from the community birth setting (home or birth center) and one participant from a hospital. Having an EMS partner is a plus, but not required—we’ll help teams bring EMS to the table if they aren’t already engaged.

Generally, the participants in the Action Collaborative include:

From the birth center or home birth practice:
A lead midwife and/or lead birth assistant or another clinical team member delegated to run drills

From EMS:
The Education Coordinator or Hospital EMS coordinator

From the hospital:
Nurse educator, Nurse manager, OB-Gyn and/or NICU department leadership

Additional stakeholders are involved in the drills. 

What is the time commitment?

The Action Collaborative runs for 5 months and includes 7 virtual sessions (recorded for later access), plus planning and running at least one Partial Transfer Drill and one Full Transfer Drill. Most teams spend about 2–3 hours per month on program activities, not including the drill itself. A Full Transfer Drill, including an interdisciplinary debrief, generally lasts 4 hours. A Partial Transfer Drill can be completed in 30-90 minutes.

What are Partial and Full Transfer Drills?
  • Partial Transfer Drills simulate an emergency and “talk through” the transfer steps, often within a single site.
  • Full Transfer Drills run the emergency in real time, from the community birth site through EMS transport to the hospital. Both are valuable for identifying strengths and gaps.
What support do teams receive?

Teams get access to Step Up Together Drill Kits, expert coaching, and a peer learning community. Drill Kits include detailed scenarios, setup guides, observation tools, and debriefing resources. Faculty are available for individual coaching, and some teams may receive on-site support.

Is there a cost to participate?

No. Thanks to grant funding from the Skyline Foundation and our partnership with NACPM, there is no fee for participating facilities.

How do we choose between the home birth and birth center cohort?

For the first time, Step Up Together is offering two simultaneous cohorts: one focused on home birth drills and one focused on birth center drills. The main difference is where your drill will originate—at a home birth or a birth center. Even if your practice serves families in both settings, you’ll only need to choose one pathway for your team’s drill. Both cohorts will meet at the same time, and you’ll be able to decide which track to follow after the first session once you’ve had a chance to learn more. Recordings for both cohorts will be available to all participants.

Do participants earn CNE / CME?

We are currently reapplying for contact hours to be provided for participants in the Action Collaborative for the 7 virtual sessions. Drill participants will also have an opportunity to earn CNE or CME contact hours. Details will be provided to participants prior to the start of the Action Collaborative.

What outcomes can we expect?

You can expect to complete a Full Transfer Drill and an interdisciplinary debrief yielding quality improvement insights and next steps, even if you have never done this kind of drill before. In previous Action Collaboratives, approximately 70% of teams have completed a Full Transfer Drill by the end of the program, and most remaining teams have successfully completed a drill on their own after the program ends.

Past Action Collaborative participants reported:

  • Stronger interprofessional relationships
  • Increased confidence in emergency transfers
  • Improved teamwork and communication
  • Concrete quality improvements in protocols, documentation, and EMS engagement
What representation should our team include, and what letters of intent are required?

Each team must include at least one participant from a community birth setting (home birth or birth center) and one participant from a hospital. This ensures the interdisciplinary collaboration that is core to the Action Collaborative.

Applications must include a letter of intent from the partner organization confirming their commitment to participate. For example:

  • If a birth center or home birth practice is applying, a hospital letter of intent is required.
  • If a hospital is applying, a letter of intent from a birth center or home birth practice is required.

Teams also have the option to include a letter of intent from EMS, which is strongly encouraged but not mandatory.

👉 To make this easier, we’ve created downloadable templates you can use and customize for your application.