Bureau of Family Health

Transcription

1 Bureau of Family Health PUBLIC HEALTH FACT SHEET SERIES ABOUT THE PROGRAM The Bureau of Family Health works to promote optimal health for all Louisiana women, children, teens and families through: Provision of reliable data to monitor health and well-being, guide programs, and inform public policy Preventive and educational services that are grounded in best practices and evidence to promote optimal health and well-being Policy and educational initiatives to improve access to medical, behavioral health and supportive services, and to improve community health Partnerships with communities, government, and academia to advance common goals Major areas of focus: Statewide surveillance of fetal, infant, child, and maternal morbidity and mortality Data linkage and analysis of risk and protective factors related to maternal and child health Analysis of health and community systems for women and children Prevention of infant deaths, preterm births, and low birth weight births through public information campaigns, provider education, policy changes, and system quality improvement initiatives Provide and promote quality reproductive health clinical services statewide Implement programs that provide social, emotional, and psychological support to pregnant women, children, and families Promote healthy nutrition and breastfeeding Prevent childhood injuries and fatalities such as those due to motor vehicle crashes, drowning, falls, fires, violence and child abuse or neglect WHO WE SERVE The citizens and communities of Louisiana, state government partners, medical and social service providers, community partners, policy makers, and researchers. FUNDING SOURCES Maternal and Child Health Focused (SFY 15 Means of Financing) Federal Title V Maternal and Child Health Block Grant $3,935,090 Federal Maternal, Infant, and Early Childhood Home Visiting and Title V $14,893,182 State Funds $2,676,500 Medicaid Reimbursement for Services $725,000 Temporary Assistance for Needy Families $3,196,750 Other CDC; HRSA; SAMHSA grants $1,894,764 Other Grants: Action for Healthy Kids; Kellogg $123,000 $27,444,286 Page 1 of 24 Updated 1/6/2015

2 Reproductive Health and Pregnancy Prevention Focused Federal Title X $4,660,800 Federal Title V $750,000 State Funds $5,728,559 Medicaid Reimbursement for Services $4,300,000 Teen Pregnancy Prevention $2,246,333 $17,685,692 KEY LEADERS AND STAFF Amy Zapata, Director Bureau of Family Health (504) , Amy.Zapata@la.gov Cynthia Suire, BFH Supportive Services Team Lead 2501 Charity Street, Abbeville, LA (337) , Cynthia.Suire@la.gov Michelle Alletto, BFH Clinical Services Team Lead (504) , Michelle.Alletto@la.gov Karis Schoellmann, BFH Communications, Innovation & Action Team Lead (504) , Karis.Schoellmann@la.gov Lyn Kieltyka, State MCH Epidemiologist (504) , Lyn.Kieltyka@la.gov Jane Herwehe, BFH Data Action Team Lead (504) , Jane.Herwehe@la.gov Tracy Hubbard, BFH Business Operations 628 North 4 th Street, Baton Rouge, LA (225) , Tracy.Hubbard@la.gov Karen Webb, Project LAUNCH (504) , Karen.Webb@la.gov SERVICES PROVIDED Data collection, linkage, and analysis (epidemiology) of health and well-being indicators are conducted through the Data Action Team (see page 6 for an overview). Comprehensive reproductive health services and teen pregnancy prevention services are provided through the Family Health Clinical Services Team (see page 19 for an overview). Implementation of Maternal, Infant, Early Childhood Home Visiting (MIECHV) models, including Nurse- Family Partnership (NFP), Parents as Teachers (PAT) and limited infant mental health consultation and crisis intervention for children and families who have experienced violence or trauma are provided by the Family Health Supportive Services Team (see page 15 for an overview). Health education, communication, training and systems-strengthening efforts are coordinated through the Communications, Innovation & Action Team. These include population health promotion efforts, training and education for providers, and working with communities and systems such as medical care, supportive services, and early care and learning to strengthen the important environments where people live, work, play and get care (see page 10 for an overview). Page 2 of 24 Updated 1/6/2015

3 Policy development and support to promote best-practices is the work of knowledgeable staff throughout the program. Staff expertise includes, but is not limited to, reproductive health, perinatal and pediatric clinical practice, early childhood development, grief and trauma, sexual violence, injury prevention, obesity prevention, breastfeeding, health communications, health promotion theory and practice, and data measurement and analysis. The BFH Team s innovative approach includes bringing programs to Louisiana such as NFP before home visiting was embraced nationally as an early childhood strategy, and incorporating social marketing in the maternal and child health promotion efforts. Bureau staff members are key participants in major state priority policy initiatives including partnership with Medicaid to improve birth outcomes and reproductive health services, an interagency effort to address substance exposed newborns, and the current early care and education realignment activities. Number of Contracts: 54 in SFY 15 HOT BUTTON ISSUES Infant mortality prevention is a major area of focus nationally with MCH Title V Directors and State Health Officials in federal Regions IV and VI participating in a national Collaborative, Improvement, and Innovation Network (CoIIN) project with HRSA. As a result of Louisiana's CoIIN efforts, all hospitals have taken steps towards adopting the American Academy of Pediatrics 2011 Recommendations for a Safe Infant Sleeping Environment. Louisiana has also improved training and outreach to coroners and death scene investigators related to this issue. Analytic capacity of the Data Action Team continues to grow in to ensure the program is able to provide timely and actionable data to inform policy initiatives, program priorities, and quality improvement efforts. BFH personnel are working closely with DOE to ensure strong DHH participation in the implementation of the Louisiana Early Childhood Education Act (Act 3, 2012). With support through the Early Childhood Comprehensive Systems grant, Project LAUNCH, and MIECHV, the Bureau is developing an interagency early childhood Collective Impact Team towards mitigation of toxic stress and trauma for young children in our systems efforts include the development of an Early Childhood Policy Leaderships Institute, development of a common vision and measures across agencies, and implementation of targeted system improvements. The Bureau of Family Health is actively exploring public health s role in the promotion of health equity. MANDATES AND REPORTING REQUIREMENTS Mandates: Social Security Act - Maternal and Child Health Block Grant (42 U.S.C ); Personal Responsibility and Work Opportunity Reconciliation Act of Temporary Assistance for Needy Families Block Grant (Federal Pub.L ); Social Security Act, Title V, 511 (42 U.S.C. 711), as added by 2951 of the Patient Protection and Affordable Care Act (P.L ) and amended by section 209 of the Protecting Access to Medicare Act of 2014 (P.L ); Violent Crime Control and Law Enforcement Act of 1994 (Federal H.R. 3355, Pub.L ); Child Death Investigation (L.S.A. R.S. 40:2019). Page 3 of 24 Updated 1/6/2015

4 Reporting Requirements: Annual grant reporting requirements: HRSA Title V Maternal and Child Health Block Grant; State System Development Initiative (SSDI); Early Childhood Comprehensive Systems (ECCS); Maternal, Infant, Early Childhood Home Visiting grants (MIECHV). CDC - CDC -Pregnancy Risk Assessment Monitoring System (PRAMS); Rape Prevention and Education (RPE); Sudden Unexpected Infant Death (SUID) Surveillance; OAH Teen Pregnancy Prevention Program and Wyman Center, Inc.; SAMHSA Project LAUNCH. Legislative reports: Louisiana Child Death Review Report (annual). IMPACT: OUTCOMES AND PERFORMANCE INDICATORS Below are some of the key outcome measures monitored by the Bureau of Family Health. Please refer to the program-specific descriptions for additional measures. Infant Mortality (Number of deaths per 1,000 live births) Rate N/A State Ranking N/A Preterm Birth (Percentage of births born less than 37 weeks gestation) Percentage 15.3% 15.6% 15.1% 14.7% 15.4% State Ranking Low Birth Weight (Percentage of infants born less than 2500 grams) Percentage 10.8% 10.9% 10.7% 10.6% 10.8% State Ranking Cigarette smoking in last trimester of pregnancy (national ranking not possible) Percentage N/A 13.8% 15.2% 14.1% 14.9% MAJOR STAKEHOLDERS Community Partners: Regional Fetal Infant Mortality Review and Child Death Review Teams all regions; Louisiana Public Health Institute; Tulane University School of Public Health Mary Amelia Women s Center, MCH Leadership Training Program Region 1 and Global Community & Behavioral Health Sciences Department; Baptist Community Ministries Region 1; Healthy Start Orleans, Baton Rouge; Women in Fatherhood Initiative Orleans based; and the Healthy Start-City of New Orleans Partnership to Elimination Disparities in Infant Mortality Action Learning Collaborative team; March of Dimes-statewide; People s Institute-Orleans based; Louisiana Partnership for Children and Families statewide, Louisiana Family Planning Community Advisory Board statewide, Institute of Women and Ethnic Studies Region 1. Page 4 of 24 Updated 1/6/2015

5 Major Contractors: See Data Action Team for contracts related to data and epidemiology; see Clinical Services Team for contracts related to family planning services and teen pregnancy prevention; see Communications, Action, and Innovation Team for contracts related to health education, communications, and early childhood comprehensive systems; mortality case review and action processes, obesity, breastfeeding, sexual violence; see Maternal Infant Early Childhood Home Visiting for MIECHV contracts; see Family Planning for Family Planning contracts. Other contractors include: Louisiana State University School of Medicine, PCG, and the Children s Bureau. Collaborating Statewide Programs: DHH Medicaid; DHH Center for Health Care Innovation Technology; DHH-OPH Vital Records; DHH-OPH Children s Special Health Services; DHH-OPH Family Planning; DHH-OPH STD/HIV Program; DHH-OPH WIC; DHH-OPH Chronic Disease Program; DHH-OCDD Early Steps; DCFS Child Welfare; DCFS Child Development and Early Learning; DOE Early Childhood; Office of the Governor - Executive Director Children s Cabinet. Collaborating Committees and Councils: Louisiana Commission on Perinatal Care and Prevention of Infant Mortality Louisiana Early Childhood Advisory Council State Interagency Coordinating Council for IDEA Part C Louisiana Mental Health Planning Council Louisiana State Child Death Review Panel Louisiana Council on Obesity Prevention and Management Louisiana Breastfeeding Coalition Sexual Violence Primary Prevention Committee Louisiana Protective Order Steering Committee Louisiana Action for Healthy Kids RESOURCES FOR CLIENTS/PATIENTS Partners for Healthy Babies: Call BABY or visit PartnersforHealthyBabies.org (English) or AliadosParaBebesSanos.org (Spanish) Nurse-Family Partnership and Parents as Teachers: Refer clients by calling BABY or visiting PartnersforHealthyBabies.org Text4baby: Subscribe at text4baby.org Partners for Healthy Babies Social Media: Visit facebook.com/sammythestork or twitter.com/sammythestork BFH e-newsletter: Subscribe at PartnersforHealthyBabies.org Rape Prevention and Education: For information visit lafasa.org or for assistance call HOPE or visit rain.org. Reproductive Health Program website: visit HealthyChoicesLA.org Abortion Hotline: Call Page 5 of 24 Updated 1/6/2015

6 OPH-BFH Data Action Team (Epidemiology) ABOUT THE PROGRAM The Data Action Team collects, links, analyzes and interprets data related to the health of women, children, and families. The team provides data driven leadership and support to: Monitor health and well-being among Louisiana's women, children, and families Guide program planning and evaluation Inform health and other public policy initiatives Evaluate the effectiveness, accessibility, and quality of health services Support public health research Translate objective data to inform actions WHO WE SERVE The BFH Data Action Team provides analysis and interpretation of data related to the health of women, children, and families to public health and community staff and programs, policy makers, researchers and the public. ELIGIBILITY CRITERIA Activities and data analyses of the Data Action Team include all Louisiana residents as well as non-residents who receive health care services in Louisiana. Specific populations of focus include women of reproductive age, pregnant women, infants, children, and families. FUNDING SOURCES Epidemiology activities are embedded throughout the Bureau s teams to ensure that data inform and drive state and local level actions. There is not a single dedicated funding stream or budget. Some data collection activities, such as investigation of infant mortality, child deaths, and maternal mortality, are reflected in the Communications, Action, and Innovation Team. Major support comes from the Health Resources and Services Administration (HRSA)State System Development Initiative (SSDI) supporting data linkage($126,350); CDC Pregnancy Risk Assessment Monitoring System (PRAMS) grant ($145,791) and CDC FOUNDATION ($100,000); CDC Sudden Unexpected Infant Death (SUID) Surveillance ($86,000); HRSA Maternal, Infant, Early Childhood Home Visiting (MIECHV) grant ($100,000); and the HRSA Title V MCH Block Grant state award for MCH services ($500,000). KEY LEADERS AND STAFF Amy Zapata, Director Bureau of Family Health (504) , Amy.Zapata@la.gov Lyn Kieltyka, State MCH Epidemiologist (504) , Lyn.Kieltyka@la.gov Jane Herwehe, Data Action Team Lead (504) , Jane.Herwehe@la.gov Page 6 of 24 Updated 1/6/2015

7 Megan O Connor, PRAMS Project Coordinator (504) , Megan.OConnor@la.gov Jessica Diedling, MIECHV Data Analyst (504) , Jessica.Diedling@la.gov Melissa Brown, Epidemiologist (504) , Melissa.Brown2@la.gov Cara Bergo, Mortality Surveillance Epidemiologist (504) , Cara.Bergo@la.gov Daniel Anderson, Epidemiologist (504) , Daniel.Anderson@la.gov SERVICES PROVIDED Data Collection and Management: Louisiana Pregnancy Risk Assessment and Monitoring System (LaPRAMS): A statewide surveillance system designed to identify factors associated with low birth weight deliveries and other outcomes by describing maternal behaviors and experiences before, during, and shortly after pregnancy. Fetal Infant Mortality Review (FIMR): A community-based sentinel surveillance system and action oriented process that assesses, monitors, and works to improve service systems and community supports. Child Death Review (CDR): A legislatively mandated review of all unexpected deaths among children age 14 years and younger to reduce the incidence of injury and deaths. Pregnancy Associated Mortality Review (PAMR): Identification and review of deaths of pregnant and postpartum women to identify risk factors and prevention opportunities. Maternal, Infant, Early Childhood Home Visiting (MIECHV): Local management of MIECHV data to monitor implementation quality, productivity, and outcomes. Data Linkage: Agreements are in place with Vital Records, Medicaid, WIC, Hospital discharge, Newborn Screening, Birth Defects, STD/HIV and other public health program data. Data Analysis: Epidemiologists analyze and interpret data to monitor health and assist with program planning, evaluation, and policy development. Data Translation: Fact sheets, issue briefs, reports, and presentations are routinely distributed; special analyses are completed upon request Students and young professionals training: the Data Action Team hosts students from the Tulane and LSU Schools of Public Health, Tulane School of Medicine, Xavier University, Graduate Student Epidemiology Program, and Council of State and Territorial Epidemiologists. HOT BUTTON ISSUES Parish and regional data profiles illuminate factors driving specific maternal and child health outcomes locally Louisiana PRAMS was selected by Kellogg Foundation to help identify and monitor needs of African American women in New Orleans with specific focus on improving the health of women and children surrounding the time of pregnancy. Targeted indicators include socio-economic status; experiences with racism, care received during pregnancy, and breastfeeding practices. Louisiana is one of nine states funded to implement a supplemental Sudden Unexpected Infant Death Case Registry module into the existing Child Death Review data system. Page 7 of 24 Updated 1/6/2015

8 Louisiana is one of several states piloting CDC s new maternal mortality data collection system. The mortality surveillance epidemiologist will continue to drive improvement efforts to ensure complete, timely, and actionable data for the state s FIMR, CDR, and PAMR programs. The Bureau of Family Health secured a competitive award from the Association from Maternal and Child Health Programs (AMCHP) to advance analytic and intervention approaches related to maternal mortality. The Bureau of Family Health secured competitive technical assistance from AMCHP to advance the program s ability to calculate and communicate about Life Course Metrics indicators, with a focus on concentrated disadvantage and child maltreatment ( In SFY 15, BFH is continuing to work closely with the new OPH Center for Population Health Informatics to increase health indicator Geographic Information Systems mapping capacity and quality monitoring initiatives. MANDATES AND REPORTING REQUIREMENTS Mandates: Child Death Investigation (L.S.A. R.S. 40:2019) Reporting Requirements: Annual grant reporting requirements: HRSA/MCHB - MCH Title V Block Grant; State Systems Development Initiative Grant (SSDI). CDC - Pregnancy Risk Assessment Monitoring System (PRAMS); Sudden Unexpected Infant Death (SUID) Surveillance. Legislative reports: Louisiana Child Death Review Report (annual). DATA AND SYSTEMS System Purpose Ten key indicators Associated systems Louisiana Vital Records Birth, death, and fetal death registration; health monitoring Infant mortality rate, low birth weight, preterm birth, prenatal care entry, prenatal care adequacy, interpregnancy interval, gravida, parity, previous poor birth outcomes, and elective deliveries prior to 39 completed weeks gestation. Associated with NCHS, NAPHSIS, CDC PRAMS, HRSA/MCHB through Title V Block Grant reporting PRAMS To identify factors associated with low birth weight deliveries and other outcomes by describing maternal behaviors and experiences before, during, and shortly after pregnancy Self-reported contraceptive use before and after pregnancy, pregnancy intention, breastfeeding initiation and duration, smoking and alcohol use, prepregnancy height and weight, vitamin use prior to pregnancy, maternal oral health, infant sleep position, infant safe sleep bedding, infant car seat use, and presence of smoke detectors in home. CDC PRAMS, HRSA/MCHB through Title V Block Grant reporting Page 8 of 24 Updated 1/6/2015

9 Basinet To supplement fetal and infant death certificates to better understand the totality of circumstances surrounding each death in our state. Fetal or infant cause of death, maternal characteristics at delivery presentation, maternal comorbidity, detailed pregnancy history, detailed delivery information, detailed information on provision of neonatal care, social support and environmental factors, and referrals for supports and services during pregnancy. N/A Child Death Review, including supplemental SUID registry To supplement child death certificate information to better understand the circumstances surrounding each unexpected child death. Cause of death, detailed injury information, crash scene investigation reports, EMS reports, living environment, autopsy information, death scene investigation reports, police reports, social service history, and caretaker history and information. National Child Death Review and CDC SUID case registry MAJOR STAKEHOLDERS Community Partners: Tulane University School of Public Health Mary Amelia Women s Center; Louisiana State University School of Public Health; New Orleans Healthy Start; W. K. Kellogg Foundation. Contractors: Louisiana Public Health Institute for epidemiology positions housed within the BFH. The Centers for Disease Control and Prevention (CDC) also subsidizes the State MCH Epidemiologist assignee via the Title V Block Grant award. Collaborating Programs, Committees, and Councils: MCH Epidemiology Workgroup members: DHH-OPH Vital Records; DHH-OPH Infectious Epidemiology; DHH-OPH Children s Special Health Services; DHH-OPH Chronic Disease Program; DHH-OPH STD/HIV Program; Louisiana Public Health Institute; Tulane University School of Public Health. Perinatal Surveillance Workgroup members: DHH-OPH Vital Records; DHH-OPH Children s Special Health Services; DHH-OPH Family Planning; DHH-OPH STD/HIV Program; DHH-OPH Infectious Epidemiology; DHH-OPH Chronic Disease Program; DHH-OPH WIC DHH Center for Public Health Informatics DCFS Child Welfare Louisiana Commission on Perinatal Care and Prevention of Infant Mortality Louisiana State Child Death Review Panel RESOURCES FOR CLIENTS/PATIENTS PartnersforHealthyBabies.org/providers/data -ORhttp:// Page 9 of 24 Updated 1/6/2015

10 OPH-BFH Communications, Innovation, and Action Team ABOUT THE PROGRAM PUBLIC HEALTH FACT SHEET SERIES The Communications, Innovation, and Action Team (CIA) provides communication, education, training and policy development statewide to improve health outcomes by: Providing links to information and resources through help lines and websites Providing educational activities founded in best practices and theory Identifying community and system-level issues to improve health outcomes Facilitating community and system-level actions Advancing the BFH program towards ongoing innovation WHO WE SERVE The citizens and communities of Louisiana, state government partners, medical and social service providers, community partners, policy makers, and researchers. FUNDING SOURCES The BFH Communication, Innovation, and Action Team, a new unit formed in SFY13, represents public health in practice and support to all of the BFH program activities. While some grant funded initiatives will live in this team, there is not a single dedicated funding stream or budget. In addition, some staff responsible for data collection activities for surveillance of sentinel events, such as investigation of infant mortality, child deaths, and maternal mortality, are housed in the Communications, Innovation, and Action Team. Major support comes from the HRSA Title V MCH Block Grant state award and match for MCH services (approximately $2,000,000); sexual violence prevention grants ($894,764). KEY LEADERS AND STAFF Amy Zapata, Director Bureau of Family Health (504) , Amy.Zapata@la.gov Vacant, State MCH Coordinator (504) , Jane.Herwehe@la.gov Karen Webb, Project LAUNCH and Sex. Viol. (504) , Karen.Webb@la.gov Karis Schoellmann, CIA Team Lead (504) , Karis.Schoellmann@la.gov Becky Majdoch, CIA Team (504) , Rebecca.Majdoch@la.gov Leslie Lewis, Obesity Prevention (504) , Leslie.Lewis@la.gov Marci Brewer, Breastfeeding Promotion (504) , Marci.Brewer@la.gov Page 10 of 24 Updated 1/6/2015

11 SERVICES PROVIDED Health Education and Communications Partners for Healthy Babies: Campaign to promote healthy behaviors to reduce infant mortality. Includes a 24/7 confidential helpline and website to connect women and families to resources and information PartnersforHealthyBabies.org (AliadosParaBebesSanos.org for Spanish) and BABY. Partners for Healthy Babies Social Media: Social media campaign for BFH via Twitter and Facebook. SIDS/Safe Sleep Campaign: Social marketing to reduce infant s risk of suffocation and SIDS. Includes the website featuring online resources, an interactive safe sleep game and health education. BFH enewsletter: Provides stakeholders regular updates from the Bureau of Family Health. Text4Baby: Work with National Healthy Mothers, Healthy Babies Program to promote health and safety tips from pregnancy through child s 1 st birthday via weekly texts. Nutrition and breastfeeding promotion: Patient education and media campaigns in partnership with other programs and health advocates. Rape Prevention &Education: Provides prevention education to students and communities statewide. Strengthening BFH Systems Mortality Surveillance to Drive Community and System Change: The Bureau s MCH Regional Coordinators are dedicated staff housed in each of the state s public health regions. They are a key link between the department s MCH priorities and local communities. With Data-to-Action as their focus, the MCH Regional Coordinators have the primary responsibility for the state s sentinel MCH mortality surveillance and action processes: Fetal and Infant Mortality Review (FIMR), Child Death Review (CDR), and Pregnancy Associated Mortality Review (PAMR). Findings from these reviews catalyze local and level improvements to care systems, health and safety policies and practices, and public education. Improving Health Policies and Practices in Child Care Settings: An initiative resulting from the 2010 MCH Needs Assessment is the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) program in child care centers. NAP SACC enhances policies, practices, and environments to promote nutritional food quality, physical activity amount and quality, and staff-child interactions. In addition, the BFH is working with the Louisiana Breastfeeding Coalition (LBC) and a physician at Our Lady of the Lake to implement a breastfeeding support (time and space to express and promote safe storage and handling and support for breastfeeding families) program in Louisiana child care centers. Improving Health Policies and Practices in Schools: BFH works with the DHH-OPH Health Promotion Team and the Department of Education to provide funding and technical assistance to 3 Louisiana school districts to develop and/or improve district School Health Advisory Councils and continue the School Wellness Policy Implementation Project. DHH-OPH BFH chairs the Louisiana Action for Healthy Kids (AFHK) State Team. LA AFHK offers technical assistance and free resources to schools across the state to implement nutrition and physical activity programs in the schools. Breastfeeding: BFH provides technical assistance and a special designation opportunity for birthing facilities via The Gift program. By adopting the 10 Steps of The Gift, facilities implement policies that support and promote breastfeeding. The Gift is aligned with the prestigious Baby-Friendly designation. The State Breastfeeding Coordinator is also assisting teams from 4 hospitals with their participation in the National Initiative for Children s Healthcare Quality (NICHQ) breastfeeding quality Page 11 of 24 Updated 1/6/2015

12 initiative, Best Fed Beginnings. Two hospitals have achieved Baby-Friendly designation as of September Early Childhood Comprehensive Systems: Through Early Childhood Advisory Council (ECAC), BFH supports and partners in the state s development of early childhood systems to promote the health, well-being, and school readiness of young children. In SFY 14, the Bureau of Family Health formed an inter-agency Collective Impact Team with the aim of reducing toxic stress and trauma across systems. LAUNCH: Linking Action to Unmet Needs in Children s Health (LAUNCH) is federally funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). LAUNCH aims to ensure that all children, ages 0 to 8, reach social, emotional, behavioral, physical, and cognitive milestones. This grant is a collaborative effort between the Office of Public Health and the Office of Behavioral Health. LAUNCH focuses on improving coordination and collaboration across systems that serve young children and their families, providing greater access to high-quality care and evidence-based programs for young children and their families, and raising awareness and increasing knowledge about young child wellness through public education and workforce development activities. Improvement in each of these areas will help establish a foundation for children to thrive in school and beyond. The communities of focus are Lafayette, Acadia, and Vermilion parishes. Training BFH personnel provide technical assistance to clinical and social service providers on screening for tobacco and other substance use and domestic violence; perinatal depression; breastfeeding; nutrition; and other related topics. Formal trainings also include: Infant Mental Health: A program that provides an overview of infant mental health, normal social and emotional development in infancy, infant behavior and cues, attachment theory and classifications, cultural and ethnic influences on parenting, psychopathology, assessment, and intervention. The course targets professionals who work with infants and their caregivers. Child Care Health Consultants Health and Safety Training Certification (CCHC): Health professionals who complete this training are able to provide the 3 clock hours of health and safety training to child care center staff as required by licensing regulations (approximately 140 trained each year). An online portal was created in 2014 to enable individuals who are unable to attend the face to face training to become certified as a CCHC. HOT BUTTON ISSUES Infant mortality prevention is a major focus nationally with MCH Title V Directors and State Health Officials in federal Regions IV and VI. Early care and education system changes resulting from the Louisiana Early Childhood Education Act (Act 3, 2012) present the opportunity for BFH and OPH to provide input on indicators of quality for child care and early learning settings; health and safety requirements; and training for CCHC. BFH breastfeeding promotion efforts are being boosted with additional investments to support community awareness and improvements in hospital practices that support breastfeeding initiation. Page 12 of 24 Updated 1/6/2015

13 MANDATES AND REPORTING REQUIREMENTS Mandates: Social Security Act - Maternal and Child Health Block Grant (42 U.S.C ); Violent Crime Control and Law Enforcement Act of 1994 (Federal H.R. 3355, Pub.L ); Child Death Investigation (L.S.A. R.S. 40:2019). Reporting Requirements: Annual grant reporting requirements: HRSA - MCH Title V Block Grant; Early Childhood Comprehensive Systems (ECCS). CDC - Rape Prevention and Education (RPE); Sudden Unexpected Infant Death (SUID) Surveillance; SAMHSA Linking Action to Unmet Needs in Children s Health (LAUNCH) Legislative reports: Louisiana Child Death Review Report (annual); Louisiana Early Childhood Advisory Council Report (semi-annual). IMPACT: OUTCOMES AND PERFORMANCE INDICATORS Partners for Healthy Babies Information Line and Website Year # of calls 7,003 9,856 7,001 5,301 3,600 # of website visits 14,449 7,940 7,788 6,007 11,739 Nutrition and Physical Activity Self-Assessment of Child Care Centers (NAP SACC) Year # of centers # of children 2000 ~2000 ~ # of staff 750 ~750 ~700 ~ Louisiana Action for Healthy Kids School Grants Year # of funded schools TBD 8 26 # of students TBD 28,080 15,932 Breastfeeding Rates Year BF initiation BF at 6 months Exclusive at 3 months Gift Designation Year Total # of Gift Designated hospitals Page 13 of 24 Updated 1/6/2015

14 MAJOR STAKEHOLDERS Community Partners: Regional Fetal Infant Mortality Review and Child Death Review Teams all regions; Tulane University School of Public Health Mary Amelia Women s Center and MCH Leadership Training Program Region 1; Baptist Community Ministries Region 1; March of Dimes statewide; New Orleans Breastfeeding Coalition; Louisiana Breastfeeding Coalition. Major Contractors: Southeast Louisiana AHEC-statewide services, and Regions 1, 3, 7, 8; Southwest Louisiana AHEC-Region 2, 4, 5; Extra Mile Region 6; Martha Hennegan Region 9; Tulane University School of Public Health Global Community Health and Behavioral Sciences Department-statewide; Motivational Educational Entertainment statewide (MEE); Trumpet-statewide; American Pregnancy Associationstatewide; LaFASA statewide; Tulane University School of Medicine Department of Psychiatry and Neurology. Collaborating Programs, Committees, and Councils BFH Health Education and Communications Workgroup members: DHH-OPH Children s Special Health Services; DHH-OPH Environmental Epidemiology; DHH-OPH Health Promotion Program; DHH-OPH Oral Health Program; DHH-OPH WIC; DHH-OPH HIV/STD Program; DHH-Bayou Health. State agency programs: DHH-OPH Nutrition; DCFS Child Welfare; DOE School Wellness; DHH-Office of Behavioral Health Louisiana State Child Death Review Panel Louisiana Early Childhood Advisory Council Louisiana Council on Obesity Prevention and Management Louisiana Breastfeeding Coalition Sexual Violence Primary Prevention Committee Louisiana Protective Order Steering Committee LAUNCH Councils: Young Child Wellness Collaborative (State Level); Young Child Wellness Council (Local Level) RESOURCES FOR CLIENTS/PATIENTS Partners for Healthy Babies: Call BABY(2225) or visit PartnersforHealthyBabies.org (English) or AliadosParaBebesSanos.org (Spanish) Nurse-Family Partnership and Parents as Teachers: Refer clients by calling BABY or visiting PartnersforHealthyBabies.org SIDS/Safe Sleep Reproductive Health information and resources HealthyChoicesLA.org Text4baby: Subscribe at text4baby.org Partners for Healthy Babies Social Media: Visit facebook.com/sammythestork or twitter.com/sammythestork Rape Prevention and Education: For information visit or for assistance call HOPE(4673) or visit rain.org. Breastfeeding resources: Page 14 of 24 Updated 1/6/2015

15 OPH-BFH Family Health Supportive Services Team: Maternal, Infant, Early Childhood Home Visiting Program ABOUT THE PROGRAM PUBLIC HEALTH FACT SHEET SERIES The Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program envisions a future where all people of Louisiana have the opportunity to grow, develop and live in an environment that is nurturing, supportive, and safe and that promotes the physical, mental, and social health of individuals, families, and communities. Toward this vision, the MIECHV Program provides innovative maternal health, early childhood and family development expertise as a major contributor to building Louisiana s early childhood systems of care. MIECHV implements evidence-based home visitation, the Nurse-Family Partnership (NFP), statewide and Parents as Teachers (PAT) to complement NFP in the Shreveport and Monroe regions of the state. WHO WE SERVE NFP is available in all 9 administrative regions in Louisiana and has served more than 13,900 families with over 298,100 completed home visits since inception. In the NFP model, registered nurses work with first time mothers and their families in their homes and environments from early in pregnancy until the child s second birthday. Nurse home visitors work with families to set goals related to the mother s health, family and friend relationships and nurturing parenting and includes connection to available community resources. PAT, implemented in SFY 14 in regions 7 and 8, is serving low income pregnant women, and families with young children in their home and through community group sessions. In SFY 14, PAT staff served 252 families with 1380 completed home visits. Specially trained PAT parent educators work with families, including the mother, fathers and caretakers, on topics related to child development, parent-child interaction and family well-being and health. FUNDING SOURCES and REVENUE GENERATION The MIECHV budget, as part of the total BFH budget, is derived from the following sources: Federal Title V Maternal and Child Health Block Grant Federal Maternal, Infant & Early Childhood Home Visiting (MIECHV) State Funds Temporary Assistance for Needy Families KEY LEADERS AND STAFF Amy Zapata, Director Bureau of Family Health (504) , Amy.Zapata@la.gov Paula Zeanah, Infant Mental Health Program Director and MIECHV Clinical Developer (504) , Paula.Zeanah@la.gov Cynthia Suire, BFH Supportive Services Team Lead 2501 Charity Street, Abbeville, LA (337) , Cynthia.Suire@la.gov Cindy Hilger, MIECHV Statewide Nurse Consultant 5604-B Coliseum Blvd., Alexandria, LA (318) x213, Cindy.Hilger@la.gov Page 15 of 24 Updated 1/6/2015

16 Luwana Marts, MIECHV Regional Nurse Manager/Consultant 133 West 112 th Street, Cut Off, LA (985) , Anita Hillman, MIECHV Regional Nurse Manager/Consultant 5604-B Coliseum Blvd., Alexandria, LA (318) , Christy Chapman, MIECHV Regional Nurse Manager/Consultant 6614 Main Street, Winnsboro, LA (318) , Sonya Myers, MIECHV Coordinator (504) , Jessica Diedling, MIECHV Data Analyst (504) , SERVICES PROVIDED All MIECHV services are voluntary and are offered to eligible families. MIECHV services are provided via DHH with OPH employees and through contractual partnerships with several state and community organizations. MIECHV-NFP serves first-time, Medicaid eligible pregnant women and their first born child until the child is two years old. Participants must have no previous live births and enroll before 29 weeks of gestation. MIECHV-PAT serves low income women and families with children under kindergarten age, with priority enrollment beginning in pregnancy and during the newborn s first 12 months. There are currently sixteen NFP teams throughout the and two PAT teams serving at-risk parishes in regions 7 and 8. Number of contracts: 16 in SFY15 HOT BUTTON ISSUES Louisiana DHH-OPH-BFH is the lead agency for the administration of the federal MIECHV Program Grant. Louisiana received both the 5 year formula and 4 year competitive MIECHV grants in 2010 and 2011, respectively. The combined grants have allowed for expansion of Louisiana s NFP services, in addition to implementing complementary quality, evidence-based, effective MIECHV models, including PAT. The grant activities also focus on strengthening and supporting the MIECHV models with the augmentation of the Infant Mental Health (IMH) component, an outreach component, local clerical support and necessary data analysis and coordinator functions. The grants continue to focus on sustainability efforts and on studying, planning for and implementing efficient, competitive business operations and use of technology. A robust evaluation will inform BFH program priorities and add to the body of knowledge in MIECHV regarding the IMH and outreach components, as well as the complementary MIECHV model(s). This major grant opportunity will also foster continued efforts of MIECHV to contribute to and build a robust early childhood system of care within Louisiana. MANDATES AND REPORTING REQUIREMENTS Mandates: MIECHV is funded using a braided, diverse funding mechanism with federal and state mandates including the Social Security Act - Maternal and Child Health Block Grant (42 U.S.C ); Personal Responsibility and Work Opportunity Reconciliation Act of Temporary Assistance for Needy Families Page 16 of 24 Updated 1/6/2015

17 Block Grant (Federal Pub.L ); Social Security Act, Title V, 511 (42 U.S.C. 711), as added by 2951 of the Patient Protection and Affordable Care Act (P.L ) and amended by section 209 of the Protecting Access to Medicare Act of 2014 (P.L ). Reporting Requirements: For purposes of the ACA MIECHV grants, DHH-OPH-BFH must report quantifiable, measurable outcomes in defined constructs related to the following: maternal and child health improvements child injuries, child abuse, or maltreatment prevention, and reduction of ER visits school readiness and achievement improvements crime or domestic violence reduction family economic self-sufficiency improvements coordination and referrals for other community resources and supports improvements To meet the grant requirements around quantifiable, measurable improvement in these benchmark areas, DHH-OPH-BFH will enhance its existing home visitation monitoring and evaluation processes by collecting and reporting data on multiple constructs within each of these benchmark areas. Annual Grant reporting requirements for MCH Title V Block Grant Monthly, quarterly, annual Department of Children & Families(DCFS) TANF reporting Periodic agency performance reporting IMPACT: OUTCOMES AND PERFORMANCE INDICATORS (Nurse-Family Partnership Only) Select Measures-Louisiana Nurse-Family Partnership SFY 14 SFY 13 SFY 12 SFY 11 SFY 10 Change in maternal health habits, during pregnancy, from program intake to 36 weeks gestation*: Cigarette smoking Marijuana use Change in experience of violence between program intake and 36 weeks gestation*: Physical abuse Fear of partner -18% -59% -17% -56% -16% -58% -17% -52% -17% -51% -27% -52% -25% -53% -19% -54% -14% -48% -25% -49% Breastfeeding initiation rates 55% 54% 53% 49% 47% Immunization Rates: Current at 24 months for toddlers** 92% 91% 90% 90% 91% Workforce participation change for clients >18 years old at intake: employment at enrollment to employment at child s 2 nd birthday: +24% +21% +29% +16% +16% Marital status change from program intake to child s 2 nd birthday, as indicator of stable partner relationship +12% +10% +15% +12% +9% # of families served (unduplicated count, OPH data) 2,982 3,150 3,530 3,259 3,011 # of completed home visits (OPH data) 30,743 33,826 36,257 34,309 30,970 *statistically significant at p <.05, **NFP objective: 90% Sources: Efforts to Outcomes (ETO) Database, MIECHV Monthly Reports, and/or NFP Quarterly Summary Tables. Page 17 of 24 Updated 1/6/2015

18 MAJOR STAKEHOLDERS Community Partners: Aside from the contractual partnerships within the regions to implement the services, MIECHV acknowledges key supportive partnerships with the Louisiana Home Visiting Campaign, Pew Center on the States, Louisiana Chapter of the American Academy of Pediatrics, Louisiana Association of Juvenile and Family Court Judges, Entergy, Louisiana Association of United Ways, West Monroe West Ouachita Chamber of Commerce, Louisiana Association of Nonprofit Organizations, March of Dimes, Agenda for Children, National Association of Social Workers, Louisiana Chapter, Children s Defense Fund Louisiana, United Way s Success by Six, Prevent Child Abuse Louisiana, Shreveport Community Foundation, Children s Coalition in Region 8, Family Tree in Region 4, Atmos Energy, Baptist Community Ministries, Louisiana State Nurses Association, LSU and Tulane Schools of Public Health, and various universities schools of nursing. Contractors: MIECHV currently implements NFP and PAT through partnerships with Southeast Louisiana Area Health Education Center in regions 1, 3, 4, 6, 7, 8, and 9, Capital Area Human Service District in region 2, Nicholls State University in region 3,, Southwest Louisiana Area Health Education Center and Family Youth Counseling in region 5, Louisiana State University Health Science Center in region 7, Franklin Medical Center in region 8 and Tangipahoa Parish Government and St. Tammany Parish Hospital in region 9, Jean Valliere and Yasmin Welch Infant Mental Health, Tulane University and Louisiana Public Health Institute (LPHI). Collaborating Programs: DHH-OPH-BFH staff has contributed key MIECHV personnel and expertise to the enactment and implementation of ACT 3, legislation with the intent of creating a comprehensive and integrated delivery system for early childhood care and education to ensure that every child enters kindergarten healthy and ready to learn. Key collaborators for the development of ACT 3 are Louisiana s major child serving agencies- DHH, DCFS and Department of Education. In addition, local MIECHV implementing agencies are working collaboratively with various ACT 3 pilots. RESOURCES FOR CLIENTS/PATIENTS Clients and providers can access information about and referral to Louisiana s MIECHV-NFP and PAT via the Partners for Health Babies telephone line and website, BABY and PartnersforHealthyBabies.org. Additional information can be found at and Page 18 of 24 Updated 1/6/2015

19 OPH-BFH Family Health Clinical Services (Reproductive Health) ABOUT THE PROGRAM The goal of the Clinical Services Team, which includes Title X Family Planning and Teen Pregnancy Prevention Programs is to lower teen pregnancy rates, to reduce sexually transmitted infections, and to provide individuals and families with the information and means to determine the number and spacing of their children. The Title X Family Planning Program [Public Law ] was enacted in 1970 as Title X of the Public Health Service Act. Title X is the only Federal grant program dedicated solely to providing access to contraceptive services, supplies, and information to all who want and need them. WHO WE SERVE The Clinical Services Team has played a critical role in ensuring access to a broad range of high-quality reproductive and preventive health services for thousands of low-income and uninsured individuals. Reproductive Health services are currently being provided in 62 parish health units and one contract site across the state of Louisiana. Total Served (January 1, 2014-December 10, 2014, unduplicated clients/patients): 40,780 Total Adolescents (up to 19 years): 6,164 Total Adults (20 years and older): 34,616 Total Male: 5,564 Total Female: 35,216 Number of Contracts: 13 ELIGIBILITY CRITERIA By law, priority is given to persons from low-income families [Source: The Louisiana Reproductive Health Program seeks to provide comprehensive reproductive services to males, females, and adolescents. FUNDING SOURCES and REVENUE GENERATION Reproductive Health and Pregnancy Prevention Focused Federal Title X $4,660,800 Federal Title V $750,000 State General Funds $5,728,559 Medicaid Reimbursement for Services $4,300,000 Teen Pregnancy Prevention $2,246,333 $17,685,692 Page 19 of 24 Updated 1/6/2015

20 KEY LEADERS AND STAFF Amy Zapata, Director Bureau of Family Health (504) , David Holcombe, MD, Interim Medical Director (504) , Briana Spruille White, Program Manager (504) , Michelle Alletto, BFH Clinical Services Team Lead (504) , Gail Gibson, Family Planning Nurse Consultant (504) , Carolyn Wise, Outreach Coordinator (504) , Ashley Burman, Data Monitor (504) , SERVICES PROVIDED Clinical Services: To ensure that Louisiana families grow healthy and strong, the following comprehensive reproductive health services are included by the Reproductive Health Program: Laboratory Tests Preventive Health Screenings STD/HIV Testing and Treatment Counseling Health Education Community Outreach Referral Services Pregnancy Testing Abstinence Counseling Immunizations Contraception Services Sterilization Vouchers Male Reproductive Health Services Reproductive Health Quality Collaborative: The RHP is working with selected FQHCs in high need areas to determine whether and how quality reproductive health services could be provided in comprehensive primary care settings in Louisiana. Facilitated by the Louisiana Public Health Institute (LPHI), each cohort will participate in this collaborative learning endeavor for one year. Advisory Board: In October of 2014, the RHP will hold the first meeting of a new program advisory board with a diverse membership, including reproductive health care experts, providers, payers, FQHC leaders, community advocacy organizations, influential supporters, and other stakeholders. The board will meet on a quarterly basis, convened by LPHI. Page 20 of 24 Updated 1/6/2015

21 HOT BUTTON ISSUES Medicaid Take Charge Plus Program enrollment and utilization Provision of Comprehensive Services in FQHC s Abortion Alternatives Initiative-Woman s Right to Know The Louisiana Family Planning Program does not fund Planned Parenthood MANDATES AND REPORTING REQUIREMENTS Title X of the Public Health Service Act authorizes the Secretary of Health and Human Services (HHS) to award grants for projects to provide family planning services to any person desiring such services, with priority given to individuals from low income families. Title X Requirements regarding the provision of family planning services under Title X can be found in the statute (Title X of the Public Health Service Act, 42 U.S.C. 300, et seq.) and in the implementing regulations which govern project grants for family planning services (42 CFR part 59, subpart A [pdf, 103 kb]). Sterilization of clients as part of the Title X program must be consistent with 42 CFR part 50 subpart B, ("Sterilization of Persons in Federally Assisted Family Planning Projects"). Section 1001 of the Public Health Service Act, as amended, authorizes grants "to assist in the establishment and operation of voluntary family planning projects which shall offer a broad range of acceptable and effective family planning methods and services (including natural family planning methods, infertility services, and services for adolescents)." Title X regulations further specify that "These projects shall consist of the educational, comprehensive medical, and social services necessary to aid individuals to determine freely the number and spacing of their children" (42 CFR 59.1). Title X statute requires that, to the extent practicable, Title X service providers shall encourage family participation in family planning services projects. Section 1008 of the Public Health Service Act, as amended, stipulates that "None of the funds appropriated under this title shall be used in programs where abortion is a method of family planning." OPA 99-1: Compliance with State reporting laws: FY1999 Omnibus Appropriations bill (P.L ) Section 219 states, Notwithstanding any other provisions of law, no provider of services under title X of the Public Health Service Act shall be exempt from any State law requiring notification, or reporting of child abuse, child molestation, sexual abuse, rape or incest. *Source: Legislative Mandates: Louisiana Children s Code Art. 609A states, Any mandatory reporter who has cause to believe that a child s physical or mental health or welfare is endangered as a result of abuse or neglect or that abuse or neglect was a contributing factor in a child s death shall make a child abuse report. Said abuse or neglect includes inadequate supervision, exploitation, involvement in any sexual act with a parent or any other person aiding in the toleration of the child s sexual involvement, the child s involvement in pornographic displays or any other sexual activity constituting a crime under Louisiana laws. Sexual crimes according to Louisiana law include rape, incest, carnal knowledge of a juvenile, indecent behavior with a juvenile, sexual battery, oral sexual battery, and molestation of a juvenile. Louisiana mandatory reporters are health practitioners, mental health or social services practitioners, teachers, child care providers, police officers or law enforcement officials, commercial film or Page 21 of 24 Updated 1/6/2015