2025 Annual Report

2025 ANNUAL REPORT

2025 Annual Report

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WELCOME

LEADERSHIP

LEAD STORIES

COMMUNITY ENGAGEMENT

EDUCATION

ADVANCEMENT & TECHNOLOGY

NEW PROGRAMS

PATIENT CARE, QUALITY & SAFETY

RESEARCH

AWARDS, HONORS & RECOGNITION

We gratefully acknowledge the team whose work made this annual report possible. Writing was contributed by Angel Pine, Heather Watts, Conan Gasque, Hannah Echols, Teresa Hicks, Tachana Johnson, Emily Williams, Debra L. Gordon, MS, Sarah Handzel, BSN, RN, and Maureen Salamon. Design was provided by Scott LeBlanc and Rebecca Chaffin. Photography was provided by UAB Photography and Children’s of Alabama Photography. Their combined talent and dedication shaped this report.

WELCOME

DEAR FRIENDS AND COLLEAGUES,

Children’s of Alabama, the University of Alabama at Birmingham (UAB) Department of Pediatrics, and the UAB Sections of Pediatric Surgical Subspecialties work together to form the cornerstone for children’s health care in Alabama and the region. We are united by our shared passion for pediatric care, and our collective mission is to deliver exceptional care for children with an unwavering focus on research, innovation, education, and clinical care. Each story in our 2025 Annual Report reflects these pillars and our dedication to this mission. In this report, you’ll read about Yung Lau, M.D., and his appointment as chair of the UAB Department of Pediatrics and physician-in-chief at Children’s—a unique role that requires leadership of both entities. He lays out his vision for the future of both in this report. You’ll also see how we’re using novel treatments, unique procedures, groundbreaking research, and leading-edge clinical care to serve our patients. It’s all a collaborative effort between UAB and Children’s. Pooling our resources and expertise, we offer the latest technology and provide leading-edge personalized care. Our research not only enhances what we do but also sets a benchmark for other pediatric enterprises. Moreover, our focus on education fosters the growth and development of talented, passionate and knowledgeable physicians ready to serve their patients effectively. Looking ahead, we are committed to building on our successes and continuing to provide the best, most advanced care for children and adolescents. Our leadership, talented and compassionate physicians, surgeons, nurses, allied health professionals, and staff each will play a crucial role in shaping our future success. It is through this remarkable collaboration that we will continue to provide world-class care for every child who comes through our doors. We are proud to present this Annual Report as a testament of our collaboration and our commitment to be here for children and families for many years to come.

TOM SHUFFLEBARGER President and CEO Children’s of Alabama

YUNG LAU, M.D. Katherine Reynolds Ireland Chair of Pediatrics Chair of Pediatrics University of Alabama at Birmingham Physician-in-Chief Children’s of Alabama

MIKE CHEN, M.D., MBA Joseph M. Farley Chair in Pediatric Surgery University of Alabama at Birmingham Chief of Pediatric Surgery and Surgeon-in-Chief Children’s of Alabama

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2025 ACADEMIC ANNUAL REPORT

LEADERSHIP

CHILDREN’S OF ALABAMA LEADERSHIP

TOM SHUFFLEBARGER President and Chief Executive Officer Children’s of Alabama

CRAYTON (TONY) FARGASON, MBA, M.D. Medical Director and Vice President, Clinical Affairs

VICKIE ATKINS Vice President, Risk Management

HEATHER HARGIS, MSHA, MBA, FACHE Vice President, Operations

HEATHER BATY, MCD, MBA, AUD Vice President, Ambulatory Operations

ANDREW LOEHR, DNP, RN Senior Vice President and Chief Operating Officer

CHANDLER BIBB, CFRE Chief Development Officer

DELICIA MASON, MNHSA, RN, NEA-BC Vice President, Nursing and Chief Nursing Officer

JAMIE DABAL, MSHA, MBA, FACHE Vice President, Operations

BRIAN MASSEY Vice President, Government Relations

DOUG DEAN Vice President, Human Resources

BRANDY REEVE, MSN, RN, CPN, CENP Associate Vice President, Behavioral Health Services

BETH ROCKER, MSW, LICSW-S, CPXP Associate Vice President, Customer Service

BOB SARNECKI Chief Information Officer

HOWARD SISCO, CPA Vice President, Finance

SANDY THURMOND, MSHA, FACHE, FACMPE Vice President, Primary Care Services

DAWN WALTON, CPA Chief Financial Officer

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UAB DEPARTMENT OF PEDIATRICS LEADERSHIP

YUNG LAU, M.D. Chair UAB Department of Pediatrics

ERIN SHAUGHNESSY, M.D., MSHCM Executive Vice Chair

TAMERA COYNE-BEASLEY, M.D., MPH Vice Chair for Community Engagement

JEFFREY LEBENSBURGER, D.O. Vice Chair for Faculty Development

MICHELE H. NICHOLS, M.D. Vice Chair for Education

RICHARD J. WHITLEY, M.D. Vice Chair for Research

SMITA BHATIA, M.D., MPH Vice Chair for Outcomes

DAVID KIMBERLIN, M.D. Vice Chair for Clinical and Translational Research

LAUREN NASSETTA, M.D. Chief Wellness Officer

CHRYSTAL RUTLEDGE, M.D. Vice Chair for Access and Engagement

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LEADERSHIP

MEDICAL LEADERSHIP

Academic General Pediatrics. . . . . . . . . . . . . Terry Wall, M.D., MPH Adolescent Medicine. . . . . . . . . . . . . . . . . Tamera Coyne-Beasley, M.D., MPH Allergy & Immunology . . . . . . . . . . . . . . . . Prescott Atkinson, M.D., Ph.D. Anesthesiology. . . . . . . . . . . . . . . . . . . Jennifer Eldridge, M.D. Cardiology.. . . . . . . . . . . . . . . . . . . . MarkLaw,M.D. Cardiovascular Surgery. . . . . . . . . . . . . . . . Robert Dabal, M.D. Child Abuse Pediatrics. . . . . . . . . . . . . . . . Michael Taylor, M.D. Critical Care . . . . . . . . . . . . . . . . . . . . Nancy Tofil, M.D., M.Ed. Dentistry/ Oral Maxillofacial Surgery . . . . . . . . . . Janet Jackson, DMD Dermatology. . . . . . . . . . . . . . . . . . . . Ravi Hiremagalore, M.D. Developmental & Behavioral Pediatrics. . . . . . . . . Laura McGuinn, M.D. Emergency Medicine. . . . . . . . . . . . . . . . . Kathy Monroe, M.D. Endocrinology & Diabetes. . . . . . . . . . . . . . Ambika Ashraf, M.D. Gastroenterology, Hepatology & Nutrition. . . . . . . Sandeep Gupta, M.D. General Surgery. . . . . . . . . . . . . . . . . . . Mike Chen, M.D. Genetics.. . . . . . . . . . . . . . . . . . . . . NathanielRobin,M.D. Hematology/Oncology. . . . . . . . . . . . . . . . Girish Dhall, M.D. Hospital Medicine . . . . . . . . . . . . . . . . . . Erin Shaughnessy, M.D., MSHCM Infectious Diseases . . . . . . . . . . . . . . . . . Richard J. Whitley, M.D. Suresh Boppana, M.D. Neonatology. . . . . . . . . . . . . . . . . . . . Waldemar A. Carlo, M.D. Namasivayam Ambalavanan, M.D. Nephrology. . . . . . . . . . . . . . . . . . . . . Daniel Feig, M.D., Ph.D. Neurology. . . . . . . . . . . . . . . . . . . . . LeonS.Dure,M.D. Neurosurgery. . . . . . . . . . . . . . . . . . . . James M. Johnston, M.D. Ophthalmology . . . . . . . . . . . . . . . . . . . Martin Cogen, M.D. Orthopedic Surgery. . . . . . . . . . . . . . . . . Shawn “Skip” Gilbert, M.D. Otolaryngology . . . . . . . . . . . . . . . . . . . Audie Woolley, M.D. Pathology. . . . . . . . . . . . . . . . . . . . . AmyTreece,M.D. Plastic Surgery . . . . . . . . . . . . . . . . . . . Rene’ P. Meyers, M.D. Psychiatry . . . . . . . . . . . . . . . . . . . . . Sonya Pritchard, M.D. Pulmonology and Sleep Medicine . . . . . . . . . . . Hector Gutierrez, M.D. Radiology.. . . . . . . . . . . . . . . . . . . . .RichardMartin,M.D. Rehabilitation Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drew Davis, M.D. Rheumatology. . . . . . . . . . . . . . . . . . . Randy Cron, M.D., Ph.D. Urology.. . . . . . . . . . . . . . . . . . . . . StacyTanaka,M.D.

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Lead Stories 2025 Annual Report

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A Vision

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for the Future

YUNG LAU SHARES VISION AS NEW PHYSICIAN-IN-CHIEF

After serving as interim chair for five months, Yung Lau, M.D., was officially named chair of the University of Alabama at Birmingham (UAB) Department of Pediatrics and physician-in-chief at Children’s of Alabama in March 2025. The only real change, Lau said, was that he could now formally begin planning for the future. His vision for the department is expansive—centered on collaboration and faculty support. But he believes the path to those big goals lies in the small things everyone does every day. Lau stepped into the interim chair role in November 2024, following the announcement that then-chair Mitch Cohen, M.D., would be departing at year’s end to join Stanford. “Dr. Cohen led for a decade and helped build this department into a strong and vibrant group,” Lau said. “It has consistently thrived, and I’ve considered it a privilege to be a part of the department as a faculty member for over three decades. Now, it’s an awesome responsibility to carry on this tradition of excellence.”

The role requires close collaboration between two major institutions: Children’s of Alabama and the University of Alabama at Birmingham. With more than 30 years of experience across both organizations—including in leadership roles—Lau understands their individual missions and how they intersect.

That understanding came into sharp focus in 2007, when Lau led the UAB group in a major collaborative effort between the two institutions. At the time, UAB housed the pediatric cardiac program. But as Children’s leaders planned to build a new hospital tower, they wanted

to bring the program under their roof. Over the next five years, Lau played a significant role in bringing physicians and other clinical staff to assist in the design of the cardiac intensive care units, operating rooms, catheterization labs,

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A VISION FOR THE FUTURE

to reduce barriers and connect silos,” he said.

step-down units and cardiovascular perioperative areas. He then worked closely with Children’s leadership on staffing and operations planning. On October 14, 2012, the program moved into the new building—seamlessly. The success of the move laid the foundation for a quantum leap in the ability of the Pediatric and Congenital Heart Center of Alabama to provide state of-the-art care. Today, the program consistently ranks among the top performing pediatric and congenital heart centers in the nation by numerous metrics, and the Society of Thoracic Surgery has classified the program as an overperforming center—one of 12 in the country. For Lau, who served as the division director of pediatric cardiology from 2012 until his appointment as chair in 2025, the experience left a lasting impression about what’s possible when Children’s and UAB work together. “The opening of the Heart Center marked one of the most satisfying periods of my career,” he said. As he steps into his new role, he hopes to lead more collaborative efforts with similarly meaningful impact. The Heart Center’s success is a powerful example of the synergy between Children’s and UAB—a synergy Lau believes can grow even stronger. “What I’ve seen is a real willingness among leadership across both institutions

Lau has outlined three key priorities to strengthen that collaboration: maximizing current resources in clinical care, education and research; strategically recruiting and developing faculty; and building a resilient foundation of financial stability and physician well-being.

Education and research are cru cial parts of his strategy, and UAB and Children’s have a history of successful collaboration on both. From an education perspective, Children’s serves as the teaching hospital for the UAB pediatric medicine, surgery, psychiatry, research and residency programs. “There’s this deep core of understanding between Chil dren’s and the department that we are really training the future physicians for the state,” Lau said. And that’s a crucial role in a state that, Lau says, needs more physicians and pediatricians. “Part of our duty here is in our obligation to do that,” he added. On the research side, the two institutions work together to “advance knowledge for the children of Alabama and beyond for the future,” Lau said. This benefits both entities, sometimes leads to advancements and breakthroughs that influence the broader world of medicine, and enhances the reputation of both. “When we collaborate more extensively and continue to strengthen those ties of collaboration, two important things happen,” he said. “First, children receive better care, now and in the future. Second, our faculty experience significantly greater job satisfaction.” Faculty support is another central pillar of Lau’s vision. Since becoming chair, he has met with many faculty members—some he’s long known, others he’s come to know better through these conversations.

“When we collaborate [...] two important things happen: first, children receive better care, now and in the future; second, our faculty experience significantly greater job satisfaction.”

YUNG LAU, M.D.

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“ While our goals may be big, the real progress happens in the small steps we take every day.”

“The patients in front of us are the cornerstone of everything we do,” he said. “And while our goals may be big, the real progress happens in the small steps we take every day.” “Yes, having a goal is important,” he continued. “But sometimes if we focus only on the goal, we risk losing sight of what’s happening in the moment—and that can distort the work being done on the ground. Sometimes the things that matter most get sidelined in the name of progress.” With a strong focus on the patient—and through strong collaboration and faculty support—Lau believes UAB and Children’s will continue to deliver exceptional care to every child they serve. ●

What stands out most, he says, is their passion and the profound impact they have on children’s lives. His goal is to listen, support and help them succeed. Lau also acknowledges the tension between moral obligation and financial reality. “That’s just medicine in America today,” he said. But he’s confident the department can thrive within that framework. “I think both institutions understand that we need to maximize our resources—our people and infrastructure— to provide the best possible care, to train the next generation of pediatricians, and to innovate through research,” he said. Though there are multiple facets to Lau’s vision, everything is focused around the patient.

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CHILDREN’S EXPANDS NEONATAL INTENSIVE CARE UNIT

400 + babies rely on the care of Children’s NICU each year 250 + staff members care for preterm and term neonates with a range of conditions 54 private rooms for neonates and infants

In January 2025, Children’s of Alabama announced the expansion of its neonatal intensive care unit (NICU). The NICU is a Level IV unit now with an additional six beds totaling 54 private rooms for neonates and infants. The unit houses four extracorporeal membrane oxygenation (ECMO) rooms, and it is the only unit in the state that provides dialysis for premature infants in addition to ECMO therapy. In recent years, Children’s has experienced record-breaking patient volumes and an increased need for inpatient space to treat infants. The complexity of the care Children’s provides requires the largest team at the hospital: 250 staff members caring for preterm and term neonates with a wide range of conditions. More than 400 babies each year rely on the care of the Children’s of Alabama NICU. “We care for patients from birth to 2 years of age, ranging from critical to our complex chronic population. This addition allows our team to continue to provide family-centered care in private rooms for our smallest patients,” NICU director Jill Jones Smith said. “Our NICU regularly has a waitlist of surgical neonates from referring hospitals that require our services. These extra bassinets will help alleviate wait times and help us get to those patients and families even faster.”

The expanded NICU area will house state-of-the-art facilities such as an additional dedicated nurse station, medication and milk storage room, and equipment room. The project also includes specialty equipment, technology, and furniture, making families’ time at Children’s more comfortable. The Children’s of Alabama NICU continues to serve as a lifeline for Alabama’s youngest patients. ●

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“This addition allows our team to continue to provide family- centered care in private rooms for our smallest patients.”

JILL JONES-SMITH, MSN, RNC-NIC, CNML

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Care at the highest level.

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CONSTRUCTION WRAPS UP ON NEW CRITICAL CARE UNIT

Construction on a new 50-bed critical care unit at Children’s of Alabama wrapped up in mid-November—two months ahead of schedule. Hospital leaders expect to open the new unit by late February 2026. The project, which began in 2024, will relocate and expand the hospital’s Pediatric Intensive Care Unit (PICU) and Special Care Unit (SCU) into a previously shelled space on the 12th floor of the Benjamin Russell building. Children’s began the project in response to the increasing demand for pediatric care, particularly for those with higher acuity needs. “As the only freestanding pediatric organization in the state, Children’s recognized the growing challenge of ensuring we can offer our specialized services to every child in need, regardless of the complexity of their condition,” said Jeannie Etheridge, division director of Inpatient Nursing Services at Children’s. “To address these challenges, it became clear that a newly designed Pediatric Intensive Care Unit was necessary to maintain our high standard of care while expanding our PICU capacity.”

“Children’s recognized the growing challenge of ensuring we can offer our specialized services to every child in need, regardless of the com plexity of their condition.”

JEANNIE ETHERIDGE, MSN, RN, CNML

The project has been a collaborative and multidisciplinary effort, involving a wide range of teams from across the organization, including nursing leaders and bedside staff from the SCU and PICU, physician leaders, respiratory care specialists, integrative care experts, pharmacists, IT professionals, facilities management, and other service partners. Leadership teams have engaged in extensive research to guide the project’s direction. “The 12th floor project reflects our unwavering commitment to meeting the growing demand for specialized pediatric care while maintaining the highest standards of patient care and safety,” Etheridge said. “It is a direct response to the challenges posed by an influx of higher acuity patients and a necessary step in our mission to serve every child who comes through our doors. What began as a need to expand our capacity has now become a vision for the future— one that embraces collaboration, innovation, and a culture of wellness. Together, we are building a future where Children’s of Alabama continues to lead the way in pediatric care, ensuring that we remain a trusted resource for children and families across the state and beyond.” ●

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CHILDREN’S EXPANDS INPATIENT BEHAVIORAL HEALTH SERVICES

“With this addition, we are able to meet the needs of patients who can actively participate in the therapy-focused milieu.”

In February 2025, Children’s of Alabama announced the expansion of its Inpatient Behavioral Health Services. The center opened 11 additional beds to help meet the community’s increasing need for child and adolescent mental health care. “With this addition, we are able to meet the needs of patients who can actively participate in the therapy-focused milieu,” said Bonnie Moore, Director of Nursing at the Behavioral Health Inpatient Center. “This unit ensures a supportive environment for these patients to begin to heal, grow, and develop coping strategies. By providing this space, we empower these patients to understand their emotions, develop coping skills, and set a foundation for lifelong mental and emotional health.” This new 11-bed unit focuses on evidence-based dialectical behavior therapy (DBT), informed skills, and behavioral interventions primarily for patients 12 to 18 years of age. Patient and family involvement is an important aspect of the program. The unit is designed to support the patient’s ability to implement and practice skills throughout their admission, with ongoing coaching from therapists, nurses, and support staff.

BONNIE MOORE, BSN, RN

2025 vs. 2024

+ 7 % increase in behavioral health ED visits

+ 45 % increase in behavioral health admissions

– 35 % decrease in the average time to an available bed

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MENTAL HEALTH

“This unit ensures a supportive environment for these patients to begin to heal, grow, and develop coping strategies”

BONNIE MOORE, BSN, RN

The primary goals of the expansion were to decrease wait times and increase capacity for inpatient care. The impact is already clear. In 2025, the average time to an available bed decreased by 35% compared to 2024, when 43% of behavioral health patients who presented in the Children’s Emergency Department (ED) waited more than six hours for an available bed in the Children’s inpatient unit. The improvement happened despite a 7% increase in behavioral health- related ED visits and a 45% increase in behavioral health admissions. Children’s of Alabama received 4,730 emergency department visits related to behavioral health concerns in 2025. In 2025, the behavioral health team served patients from all 67 counties in Alabama. The improvements come at a time when behavioral health care is an escalating need in the community. Between 2018 and 2024, behavioral health visits to the Children’s Emergency Department increased by 1,405 visits, while inpatient behavioral health admissions rose by 15%, placing growing pressure on existing inpatient resources.. Nationally, according to the Annie E. Casey Foundation 2022 Kids Count Data Book, the percentage of children ages 3 to 17 who had anxiety or depression increased by 25.5% between 2016 and 2022. Much of that growth is attributable to disruptions caused by the COVID-19 pandemic. ●

1 , 405 Between 2018 and 1024 behavioral health visits to the emergenct department increased by 4 , 730 + visits were made to the emergency department related to behavioral health concerns in 2025

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Community Engagement 2025 Annual Report

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COMMUNITY ENGAGEMENT

BRINGING ASTHMA CARE CLOSER TO HOME IN ALABAMA’S BLACK BELT CHILDREN’S DEVELOPS A NEW INITIATIVE TO HELP ASTHMA PATIENTS IN UNDERSERVED REGION

Dallas, Marengo, Perry and Wilcox counties, part of the Black Belt (so named for its rich, dark soil), are four of the poorest counties in Alabama. They also have some of the highest rates of childhood asthma—nearly 12% compared to the state’s 8%—and are severely underserved when it comes to medical care. Two of the counties don’t even have a pediatrician.

4 % Just 4% of the patients seen at Children’s Specialty Asthma Clinic are from the Black Belt.

Yet just 4% of the more than 5,000 patients seen at Children’s of Alabama’s Specialty Asthma Clinic hail from those areas. “We realized these kids weren’t getting to us for help,” pediatric pulmonologist Isabel L. Virella-Lowell, M.D., said. “But Medicaid data showed a high number of asthma-related claims from the area. So we knew there was a gap.”

One reason is distance, with families having to drive up to three hours to reach Birmingham. Thus, many children receive care only during asthma flare-ups at urgent care clinics or emergency rooms rather than ongoing, preventive treatment, said Children’s and University of Alabama at Birmingham (UAB) Pediatric Asthma Program Director Teresa G. Magruder, M.D. Without a primary care physician overseeing their child’s asthma, families find themselves caught in a cycle of crisis-driven care. So instead of hoping kids will come to Birmingham, Virella-Lowell and Magruder are bringing their expertise to the Black Belt. Their mission: improve those dismal asthma statistics by engaging the community at a grass-roots level. The initiative began when Children’s and UAB infectious disease specialist Claudette Poole, M.D., spent time in the area studying water sanitation and parasites. She kept hearing about an asthma crisis and recruited Virella-Lowell and Magruder.

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COMMUNITY

“If the community doesn’t buy in, if they are not engaged, if they’re not supportive, then there’s a limited amount of good we can do.”

ISABEL L. VIRELLA-LOWELL, M.D.

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“Our goal is to raise the level of asthma care across the state, not just at Children’s, but everywhere kids need it.”

The three applied for and received a Health Re sources and Services Administration (HRSA) grant, which provides salary support for the core team and local community and health care partners. It also helps fund the virtual continuing medication education (CME) Project ECHO sessions, health fairs and supplies—such as spirometers and educational materials. Magruder and Virella-Lowell stress the community- based approach of their efforts rather than having Children’s swoop in for just a few months. “We are really trying to improve the capacity of the community and their understanding of delivering asthma care in their own communities,” said Magruder. That means educating the front-line people caring for children, including school nurses, teachers, daycare workers and parents, while providing access to subspecialty care for the severe high-risk patients.

TERESA G. MAGRUDER, M.D.

clinic in 2026 in a space provided by Selma Pediatrics, so families don’t have to travel so far for specialty care. They are also educating clinicians and others who see children with asthma through the aforementioned CME approach Project ECHO (which stands for Extension of Community Healthcare Outcomes), an interactive program that helps clinicians address their own cases. “It’s incredibly important that local physicians are comfortable managing asthma. And asthma care has changed a lot through the years,” said Lowell, who noted the recent release of new guidelines for diagnosing and treating the disease. The program, which is virtual, is available to any clinician throughout the state and beyond who’s interested in maintaining their expertise in pediatric asthma. The Alabama State Asthma Coalition, a statewide group with a diverse mix of experts including environmental experts and respiratory educators, is also playing a role. The coalition helped train the first group of community health workers and hopes to continue that work. Given that asthma affects one out of 10 children, it must be managed locally, Lowell said. “There’s no way that we will ever be able to manage all the really sick asthmatics here at Children’s. So it’s incredibly important that local pediatricians and family doctors are comfortable managing asthma.” “Our goal is to raise the level of asthma care across the state,” Magruder said, “not just at Children’s, but everywhere kids need it.” ●

“If the community doesn’t buy in, if they are not engaged, if they’re not supportive, then there’s a limited amount of good we can do,” Lowell said. “There’s some fatigue in these communities from programs that come and go,” Magruder added. “We know it takes time to build trust.” The two doctors are also partnering with local physicians at Selma Pediatrics and Whitfield Regional Hospital in Demopolis. They hope to open a monthly

The virtual ECHO programs are held the first Friday of the month beginning September 5, 2025, from 12:15–1:00 p.m. via Zoom. Register at https://iecho.org/public/program/PRGM1706628464901THJ41H6DTI.

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COMMUNITY COMMUNITY ENGAGEMENT

CHILDREN’S OF ALABAMA OFFERING MENTAL HEALTH TRAINING FOR SCHOOL PERSONNEL

As the mental health crisis continues across the country, children and teens are in greater need of mental health services than ever before. In many cases, the first person to recognize the child’s need is a teacher. But the teacher may not always know how to help. That’s why Children’s of Alabama recently expanded one of its mental health programs to offer training for school personnel. The program, Pediatric Access to Telemental Health Services (PATHS) , has been around since 2019. Children’s established it—with support and funding from the Alabama Department of Mental Health (ADMH)—in response to the need for more mental health services, especially in rural areas. The initial goal was to help primary care providers understand how to help patients who present with mental health concerns. Through the program, Children’s mental health professionals offer consults or education for providers or even telehealth appointments for their patients. PATHS has since expanded into urban areas, and now, thanks to the extension of a Health Resources and Services Administration (HRSA) grant, Children’s is offering support to school systems across the state. “This is an important step for our program,” PATHS director Margo Harwell, LICSW, PIP, said. “Because they see students daily, school personnel play a critical role in identifying early signs of mental health concerns in students.”

“Because they see students daily, school personnel play a critical role in identifying early signs of mental health concerns in students.”

MARGO HARWELL, LICSW, PIP

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HOW IT WORKS

“We have found that every school system is unique and has different training needs.”

When the PATHS team decided to expand their services to schools, they immediately realized their assistance would differ from what they offer medical centers. Providing on-the-spot consulting for teachers and administrators wouldn’t work, nor would telemedicine appointments. What they could provide, however, was education. They began their efforts in the summer of 2024, meeting with mental health coordinators in school systems across Alabama to discuss what topics might need to be covered in their respective districts. Once those needs were identified, PATHS leaders set up in-person, virtual or hybrid training sessions. “We have found that every school system is unique and has different training needs,” Harwell said. “For example, if schools mention that they have had an increased number of students experiencing anxiety, we can partner with that school to provide a targeted

MARGO HARWELL, LICSW, PIP

training that is focused on strategies to help students manage their anxiety within the school environment.” PATHS leaders have offered training on that topic and others, including behavior management, depres sion, trauma and bullying. They’ve also taught educators how to identify the red flags of mental health concerns among students. The focus is, of course, on how to help students. But educators’ mental health needs are crucial, too. To help with that, the PATHS team offers sessions on self-care. “If a teacher or counselor isn’t caring for themselves, it becomes much harder to have the patience and emotional capacity needed to identify and support a “We have found that every school system is unique and has different training needs.”

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COMMUNITY

child facing mental health challenges or coming from a background of trauma—especially when those students might be exhibiting challenging behaviors,” Harwell said. By practicing better self-care, school personnel may be more likely to recognize that the child who’s acting out may actually be in need of support, she added. The sessions, whatever the topic, are opportunities for discussion among school staff and Children’s mental health experts. “Training sessions include conversations about intervention strategies and guidance on how to help and support students within the school setting who may be experiencing mental health challenges,” Harwell said. Ultimately, they hope to help educators understand how to handle these issues as they arise. Right now, the team is offering training sessions to teachers and counselors. Eventually, they may offer them to support staff or administrators, who often develop close relationships with students, Harwell says. “Think about bus drivers, for example. In many cases, they’re the first person to see a student each morning,” she pointed out. “Some students have the same bus driver for years, so they get to know them and may share their feelings or thoughts. This gives them insight into the child’s concerns or emotional state.” The PATHS program exists because of a HRSA grant awarded to ADMH. The grant is a Pediatric Mental Health Care Access Program (PMHCA) grant, which Children’s helped write. The hospital receives the majority of the money awarded through the grant, which was originally approved in 2018, then extended in 2023. “These grants have been monumental to the building of this program and really sustaining it thus far,” Harwell said. MORE ON THE HRSA GRANT

With the initial grant, Children’s started PATHS and began enrolling primary care practices. Today, 128 practices are enrolled. “The funding has been instrumental in being able to do that,” Harwell added. The partnership with ADMH also has been vital. The organization offers guidance and facilitates collaboration with the other states and organizations through the HRSA network of PMHCA awardees. “This continually challenges us to look at how we’re doing, what we do and how we can continue to improve our program and our processes.” The program’s next improvement may involve expansion into rural emergency departments (EDs). PATHS leaders already have initiated conversations with a few around Alabama. Harwell says the PATHS team hopes to offer access to their consultation lines to extend support if the ED has a child who arrives with mental health concerns. The goal, Harwell says, is not to intervene in situations of acute crisis—that is outside the role of PATHS. “But if a child is in a rural ED and needs to stay for a few days due to, say, lack of available beds, and there are concerns about mild to moderate mental health issues, we want to offer consultation services to support that child’s care,” Harwell said. As the PATHS team keeps an eye toward the future, they’re also aware of how far they’ve come. Mental health care is difficult in Alabama—the non-profit Mental Health America (MHA) in 2019, the year PATHS was founded, ranked the state 7th in prevalence of mental illness among youth and 45th in youth access to care. By 2024, when MHA released its most recent rankings, Alabama had dropped to 14th in youth prevalence of mental illness and risen to 36th in youth access to care. Multiple factors have played a role in the improvements, and Harwell says PATHS is one. “Our state has really taken steps forward,” she said. “I happen to believe the PATHS program has helped with that.” ● THE NEXT STEP THE IMPACT

128 Practices across the state are currently enrolled in the PATHS program

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COMMUNITY COMMUNITY ENGAGEMENT

EXPANDING ACCESS AND SUPPORT FOR CHILDREN

WITH DISABILITIES AND THEIR FAMILIES

“When families feel supported and informed, it changes how they experience care. Our goal is to partner with them, so they are not navigating complex systems alone.”

For families of children with disabilities, accessing health care often means navigating complex systems while managing significant caregiving demands. As more children with complex medical needs require coordinated, long-term care, reducing barriers and wait times has become increasingly important. At the University of Alabama at Birmingham (UAB) Department of Pediatrics, two pediatric faculty members are working to address these challenges by combining clinical care with advocacy, education, and system-level change. Cynthia Wozow, D.O., assistant professor in the Division of Pediatric Rehabilitation Medicine, and Rachel Kassel, M.D., Ph.D., associate professor in the Division of Pediatric Gastroenterology, Hepatology & Nutrition, share a commitment to improving access to care for children with disabilities while ensuring the needs of caregivers are also recognized and addressed. Wozow’s approach to disability advocacy has been shaped by both her clinical work and lived experience. In caring for children with disabilities, she recognized how medical complexity affects entire families, not just individual patients. By intentionally including caregivers in clinical conversations and asking how they are doing as people, Wozow began to identify gaps in support that often go unaddressed. “When families feel supported and informed, it changes how they experience care,” said Wozow. “Our goal is to partner with them, so they are not navigating complex systems alone.” CENTERING THE FAMILY EXPERIENCE

CYNTHIA WOZOW, D.O.

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CHALLENGING MISCONCEPTIONS IN MEDICINE

Those conversations often reveal challenges such as isolation, limited access to resources, and the emotional strain that comes with full-time caregiving responsibilities. Wozow emphasizes partnership, helping families feel supported rather than solely responsible for advocating for their child’s needs. Kassel shares that perspective. She describes many families’ experiences as a scavenger hunt for services, benefits, and therapies their children may qualify for but struggle to access. Streamlining access to care and coordinating services can help reduce delays in treatment and improve the overall experience for families. “Families caring for children with medical complexity already have so much on their plate,” said Kassel. “Streamlining access to care and resources is a critical part of supporting them.”

Both physicians are committed to addressing misconceptions surrounding disability in health care settings. They emphasize that disability should not be viewed as inherently tragic or avoided because of perceived complexity. “People with disabilities are people first,” said Wozow. “They have interests, goals, and relationships just like anyone else.” Kassel adds that hesitation among clinicians often stems from limited exposure and training. By encouraging early and consistent interaction with individuals with disabilities during medical education, she believes providers can develop confidence and competence rather than discomfort.

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NATIONAL LEADERSHIP AND LOCAL IMPACT

Wozow recently participated in the ACGME Summit on Fostering Disability- Inclusive Health Care and Resident Education, which brought together individuals with lived disability experience and health care leaders from across the country. The summit focused on developing a framework to integrate disability education into residency training and improve access to timely, inclusive care. Locally, Wozow and Kassel serve on committees focused on accessibility, engagement, and inclusion within UAB and Children’s of Alabama. Their efforts address practical needs such as accessible clinical spaces, appropriate equipment, and accommodations for patients, families, and trainees, helping ensure children with disabilities receive care without unnecessary delays. They are also involved in advocacy related to insurance coverage, including ongoing conversations around Medicaid access for children with medical complexity. Securing appropriate coverage can reduce financial strain for families and allow caregivers to focus on meeting their child’s needs rather than navigating barriers to care.

“Disability should never compromise the quality of care someone receives.”

RACHEL KASSEL, M.D., PH.D.

RESEARCH INFORMED BY CAREGIVER VOICES

In addition to clinical and advocacy work, Wozow and Kassel are collaborating on an ongoing research project focused on caregiver well-being across Alabama. The study examines stress, isolation, and access to mental health and financial resources among caregivers whose primary responsibility is caring for a child with medical complexity. By engaging caregivers in community settings such as therapy centers and day cares, the research aims to better understand their needs while identifying ways to make caregiving more sustainable. The long-term goal is to help improve quality of life for caregivers by connecting them with resources that support both their mental well-being and financial stability.

LOOKING AHEAD

Wozow and Kassel share a vision of a health care system where disability-inclusive care reduces wait times, meets the full spectrum of patient needs, and recognizes caregivers as essential partners in care. Their work reflects the Department of Pediatrics’ commitment to advancing clinical excellence, education, and research while supporting families beyond the exam room.

“Disability should never compromise the quality of care someone receives,” said Kassel.

Through sustained efforts in clinics, classrooms, research initiatives, and community partnerships, Wozow and Kassel continue working to create a more accessible, compassionate health care experience for children with disabilities and the caregivers who support them every day. ●

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Education 2025 Annual Report

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EDUCATION

PEDIATRIC SIMULATION CENTER CELEBRATES 100,000 TH LEARNER

The Pediatric Simulation Center at Children’s of Alabama celebrated the training of its 100,000th learner since its founding in 2008, transforming how pediatric providers prepare for emergencies and patient care. This milestone marks a major achievement in the center’s mission to improve outcomes through immersive, hands-on education. The center was founded by Nancy Tofil, M.D., MEd, professor in the Department of Pediatrics at the University of Alabama at Birmingham and medical co-director of the Pediatric Simulation Center and division director of the Division of Pediatric Critical Care. Early funding from the Protective Life Foundation and an anonymous donor allowed for the purchase of child, teen and infant simulators, video equipment and the hiring of the center’s first nurse educator.

FROM EARLY SIMULATIONS TO NATIONAL IMPACT

What began with mock codes and small-scale simulations has grown into a nationally recognized training hub. It now serves physicians, nurses, medical and nursing students, respiratory therapists, pharmacists, families and middle and high school students. Over time, the center evolved from promoting its services to becoming a trusted resource that hospital teams regularly

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EDUCATION EDUCATION

seek out for guidance and support. It is known for creating a psychologically safe environment where learners are encouraged to make mistakes, reflect and improve. “The key is to give learners just enough stress to grow and achieve their goals but not so much that they become frustrated,” said Tofil. “When the scenario ends, we want them to take a moment to reflect and talk about what they’ve learned.” In pediatric care, where most patients are typically healthy, medical emergencies are less frequent. Simulation allows healthcare teams to regularly practice high-risk scenarios that they may not encounter during

“The key is to give learners just enough stress to grow and achieve their goals but not so much that they become frustrated.”

NANCY TOFIL, M.D., MED

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“We want to inspire young people to explore healthcare careers by giving them hands-on experiences that show just how many aspects of medicine there are.”

CHRYSTAL RUTLEDGE, M.D.

traditional training. These sessions are scheduled and repeated to build confidence and clinical readiness. One of the center’s most impactful initiatives is the COACHES program , which is nearing its 10th year. The program was created by Chrystal Rutledge, M.D., associate professor in the Division of Pediatric Critical Care and medical co-director of the Pediatric Simulation Center, to bring pediatric simulation training to hospitals across Alabama. Today, the COACHES team travels to nearly 60 hospitals, helping community facilities improve emergency preparedness, assess clinical systems and strengthen pediatric care statewide. The 100,000th learner milestone was celebrated with cake, balloons, sparkling grape juice and a banner. The learner received a swag bag and the team took photos to commemorate the occasion. The event not only marked the scale of the center’s work but also honored the team effort that made it possible.

The center also places a strong emphasis on communication, interprofessional teamwork and inclusion. Simulated scenarios often include parent actors to reflect real-life family dynamics. Training reaches beyond clinical teams, engaging environmental services staff, school nurses and community partners who all play a role in patient safety.

EXPANDING REACH AND INSPIRING FUTURE GENERATIONS

Looking ahead, the Pediatric Simulation Center plans to expand its reach through new technologies such as virtual reality, augmented reality and advanced computer-based simulations. It is also developing new programs to address care disparities and social determinants of health. Through pipeline programs such as the Mini Medical School , led by Shaundra Blakemore, M.D., assistant professor in the Division of Pediatric Emergency Medicine, the center introduces young students to healthcare careers through hands-on learning. “We want to inspire young people to explore healthcare careers by giving them hands-on experiences that show just how many aspects of medicine there are,” said Rutledge. From its founding to its continued leadership by a dedicated team, the Pediatric Simulation Center remains committed to improving pediatric care through education, innovation and collaboration. ●

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EDUCATION EDUCATION SPRING SCRAMBLE 5K MARKS 20 YEARS OF RESIDENT-LED ADVOCACY

What began as a way to bring pediatric residents together outside the hospital has grown into one of the University of Alabama at Birmingham (UAB) Department of Pediatrics’ longest-running traditions. Now celebrating its 20th year, the Spring Scramble 5K continues to bring together residents, faculty, alumni, and community members in support of children and families across Birmingham and beyond. The Spring Scramble is organized through the department’s Coat of Arms, a resident-driven group dedicated to community outreach and child advocacy. Established in 2003, Coat of Arms creates opportunities for residents to engage beyond the clinical setting while supporting children’s health and well-being. In its early years, Coat of Arms explored several fundraising efforts to support community initiatives. Over time, residents identified the need for an event that encouraged broad participation while aligning with the group’s mission of advocacy and service. That vision led to the creation of the Coat of Arms Spring Scramble 5K, which has since become an annual tradition. “We wanted to design an event that residents could take ownership of and feel connected to,” said Michele Nichols, M.D., professor in the Division of Pediatric Emergency Medicine and program director of the pediatric residency program. “The Spring Scramble became a way to raise awareness, support children, and bring people together in a meaningful way.” While the race initially highlighted specific causes such as childhood literacy and healthy weight management, it has since evolved to support Coat of Arms more broadly. This approach allows residents to direct funding toward a wide range of initiatives throughout the year. A TRADITION ROOTED IN RESIDENT LEADERSHIP

“The Spring Scramble reflects who our residents are and what they care about. It’s about coming together to support children and families in ways that truly matter.”

MICHELE NICHOLS, M.D.

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SUPPORTING ADVOCACY YEAR-ROUND

Funds raised through the Spring Scramble support resident-led initiatives that extend far beyond race day. One example is the department’s ongoing partnership with schools in Selma, Alabama, where residents provide backpacks filled with school supplies each year. What began as a response to community need has developed into a sustained effort, with residents packing and delivering supplies annually. “The goal has always been sustainability and community partnership,” said Nichols. “These are projects residents choose, lead, and continue year after year.” Spring Scramble funding also supports health fairs hosted at Birmingham City Schools, where families rotate through educational booths focused on injury prevention, nutrition, asthma education, and literacy. Residents d istribute helmets, books, and other resources while offering guidance to families. Additional initiatives include holiday gift programs for primary care clinic families, partnerships with Blazer Kitchen to address food insecurity, puberty education programs in local schools, and teddy bear clinics that visit schools and community sites. During these visits, residents use stuffed animals to walk children through common medical experiences, helping reduce fear and build familiarity with doctor visits. Safety showers for babies and toddlers are also supported, providing families with education and essential supplies focused on injury prevention.

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