NIRH and the Hawaii Maternal & Infant Health Collaborative (HMIHC) are continuing their partnership and work on statewide systems change to ensure access to LARC in the inpatient hospital setting. This year, HMIHC is developing buy-and-bill programs in two hospitals in an effort to create sustainable models for immediate postpartum LARC access. This effort will especially benefit people in rural communities, patients with private insurance, and those who have limited access to care due to immigration or income status. HMIHC is also advocating for private insurers to match the state’s Medicaid policy, which reimburses hospitals for immediate postpartum LARC device placement, and is working in hospitals across the state to build stakeholder support and cultivate provider-champions who will lead implementation within their health systems. NIRH has supported this work since 2018.