Conversations with the Division of Healthy Start & Perinatal Services. February 15, 2018

Transcription

1 Conversations with the Division of Healthy Start & Perinatal Services February 15, 2018

2 Meeting Logistics Please note the following: This session is being recorded, and will be archived for future viewing. Members are encouraged to participate in the discussion by typing your comment/asking questions using the chat box. 2

3 3 Webinar Agenda Topic Housekeeping Welcome and Announcements HRSA/MCHB Updates Healthy Start Program Update HS National Evaluation Update HS Data Reporting Healthy Start CoIIN Update EPIC Center Update Question & Answer Speaker Megan Hiltner Johannie Escarne IM COIIN: Vanessa Lee and Maria Reyes Benita Baker and Maria Benke Robert Windom Chris Lim Kori Eberle Suz Friedrich All Participants

4 Welcome CDR Johannie Escarne, Acting Deputy Director 4

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8 HRSA/MCHB Updates Vanessa Lee, MPH Infant Mortality CoIIN Coordinator/Project Officer Division of Healthy Start & Perinatal Services Maria Lourdes F. Reyes, MD, MPH PCI Director of US & Border programs PI, Border States IM CoIIN

9 9 What is a CoIIN? Collaborative Improvement and Innovation Network Is a platform and methodology for participants to engage in collaborative learning together as virtual cyberteams, around a common aim, applying quality improvement methods, to spread and scale policy and program innovation - which in turn accelerates improvement in strategies that contribute to desired outcomes.

10 10 Infant Mortality CoIIN 2.0 IM CoIIN 2.0 Coordination & Support Backbone Organizations (Grantees) Participating State Teams Association for Maternal & Child Health Programs (AMCHP) Social Determinants of Health (SDOH) AMCHP SDOH CoIIN MA, RI, FL, KY, NC, SC, IL, OH, WI, NM, TX, NV, OR National Institute for Children s Health Quality (NICHQ) Safe Sleep/ Disparities in Sudden Unexpected Infant Death (SUID) HRSA/MCHB DATA Contractor (Abt Associates) NICHQ Safe Sleep CoIIN PCI Border States CoIIN UNC-Chapel Hill Preconception CoIIN AR, MS, NY, TN AZ, CA, NM, TX CA, DE, NC, OK Project Concern International (PCI) Prenatal Care & SDOH among women in border communities University of North Carolina (UNC) Chapel Hill Preconception Care

11 11 IM CoIIN (HRSA ) Purpose: Aims/Objectives Overall goal of IM CoIIN is to reduce infant mortality in areas with high annual rates, as well as disparities in infant mortality and related perinatal outcomes, through support of 1) collaborative improvement, 2) collaborative innovation, and 3) the spread and scale of best practices to reduce infant mortality. Specific aims/objectives of IM CoIIN are to: 1) Achieve measurable improvements in specific aims as defined by the CoIIN teams during the project period 2) Accelerate the development and/or discovery of innovations and new evidence to reduce infant mortality, as well as disparities in infant mortality and related perinatal outcomes 3) Support dissemination, spread and scale of best practices to reduce infant mortality as well as disparities to stakeholders in all states/jurisdictions

12 Infant Mortality CoIIN: Designed for Action Define Scope and Nature of the Problem Establish SMART aims. Aims Strategies Identify state/local/communitylevel opportunities to achieve Aims. Select measures to track progress towards Aims over the next mos. Measures Build and Sustain Cyberteams

13 13 CoIIN-wide Measures States on a CoIIN team submit data annually on the following initiative-wide measures for the duration of the project period: Infant mortality rate (overall and by disparities) Neonatal mortality rate (overall and by disparities) Post-neonatal mortality rate (overall and by disparities) Preterm-Related Mortality Rate (overall and by disparities) Sudden Unexpected Infant Death (SUID) mortality rate (overall and by disparities) Preterm birth rate (overall and by disparities)

14 14 IM CoIIN Grantees: IM CoIIN SDOH Backbone Organization Aim Statement State Partners Project Leadership Association of Maternal & Child Health Programs (AMCHP) By Spring 2020, all state teams will develop, adopt, or improve at least two policies and/or practices at the state or local level which will directly impact social determinants of health. FL, IL, KY, MA, NV, NM, NC, OH, OR, SC, TX, RI, WI Caroline Stampfel, Jeanette Kowalik

15 15 IM CoIIN Grantees: Safe Sleep CoIIN to Reduce Infant Mortality Backbone Organization National Institute for Children s Health Quality (NICHQ) Aim Statement By 2020, decrease by >10% SUID across 4 states by increasing adoption of the ABCs of safe sleep. States reporting racial disparities among sleep-related deaths at baseline will reduce disparity by > 5%. State Partners AR, TN, MS, NY Project Leadership Z Levesque, Aviel Peaceman

16 16 IM CoIIN Grantees: Backbone Organization Aim Statement State Partners Project Leadership Preconception CoIIN University of North Carolina at Chapel Hill (UNC) By 2020, four states, in collaboration with the core CoIIN team and clinic partners, will develop an adaptable model to effectively integrate preconception care into preventive care visits by: 1) working with clinics, consumers and communities to co-create and implement screening tool(s) and response strategies 2) enhancing state capacity to support implementation and preconception wellness 3) disseminating the model(s) statewide and nationally CA, DE, OK, NC Sarah Verbiest, Katherine Bryant

17 BORDER STATES IM CoIIN Border States CoIIN Common Aim Increase early prenatal care utilization by 10% among women in targeted impact areas through the development of place-based improvement strategies that address the social determinants of health. Cross-cutting Approaches 1) Improved ACCESS to early and ongoing prenatal care 2) Increased EMPOWERMENT

18 Our Interstate Team Our State Leads

19 Why Early Prenatal Care? Associated with improved birth weight and decreased risk of preterm delivery, both of which are important contributors to infant mortality. Increases the opportunity for mothers and families to access other supports (health, social, legal, environmental, etc.) that can impact the health of both mother and baby across the life course. Proxy indicator for access to health care in general National Healthy People 2020 goal Widely tracked across clinical and community entities that will participate in the IM CoIIN

20 WHO Framework on SDOH 3/16/

21 Social Determinants of Health factors in Border States Border States demonstrate significant challenges with the social determinants of health known to influence infant mortality Lower high school graduation rates (84% vs 87.3% national) Higher rates of poverty (18.2% vs 15.5% national) Higher rates of inadequate health insurance coverage (84.6% vs 88.3% national) among women of reproductive age (WRA) years 17.25% foreign born (compared to 13.2% nationally) Twice as many are non-english speakers (2.7% vs. 1.4% nationally; ACS 2016). Higher rates of unplanned pregnancies (48-62% across Border States vs. 45% in the US) Higher rates of teen births (average 28.8 per 1,000 live births vs nationally

22 Strategic Objectives 1. Develop and maintain a strong, sustainable network of interstate, state and local impact site CoIINs committed to achieving measurable improvements in reducing IMR disparities by addressing social determinants of health through a culture of collaborative learning, innovation and quality improvement. 2. Accelerate the development and/or discovery of improvement strategies and new evidence to reduce IMR and disparities by addressing social determinants of health in local impact sites. 3. Support dissemination, spread and scale of evidence-based improvement strategies to reduce infant mortality and disparities by addressing social determinants of health to stakeholders in all states/jurisdictions.

23 PROPOSED TIMELINE: YEAR ONE TEAM CALL 1 October 30, pm PT Introduce CoIIN members, processes Introduce SDOH framework ID existing resources TEAM CALL 2 TBD Define the challenge Teams share state/local strategies and priorities Share initial data and disparities; assess data capacity IN PERSON CONVENE January, 2018 Define common Theory of Change Trainings in QI, Innovation, GainX and other tools Agree on innovation criteria (impact/feasibility) and target pops Identify common success measures Get ready to launch state teams TEAM CALLS Feb Apr 2018 Share SDOH improvement strategies ideas State CoIIN mobilization Continue strengthening data capacity Prepare for Design Sprints in local impact sites DESIGN SPRINTS May 2018 Produce testable prototype model for PDSA cycles Create testing plan for state and local partners TEAM CALL June Share innovation prototypes and PDSA testing plans PDSA Learning Sessions June - September Share PDSA testing results Provide input on testing plans SELECT INNOVATION based on Action Periods: Time for teams to take what they learned, identify areas for improvement, build connections, and start testing on a small scale PDSA Action Period 1 PDSA Action Period 2 PDSA Action Period 3

24 Next Steps for State Teams FEBRUARY: Identify key state-level partners to engage in the CoIIN Present to key partners CoIIN objectives, deliverables, timeline, recommendations and opportunities to engage in CoIIN activities Build consensus around the following for your state: Innovation challenge question(s) based on How Might We (HMW) menu Population(s) of focus (initial) Geographic target area(s) (initial) MARCH: Facilitate ideation workshops to generate innovation ideas APRIL: Select innovation to prototype in Design Sprint (May)

25 Questions? 25

26 Healthy Start Program Update Ms. Benita Baker Chief, West Branch CAPT Maria Benke Acting Chief, East Branch 26

27 Budget Updates HRSA is currently operating under a continuing resolution that expires on March 23 rd. We are working closely with the budget office to determine the need for any adjustments to current project budgets that are needed. We are dedicated to making decisions about awards as quickly as possible. It is anticipated that both April 1 starts and Nov 1 starts will receive partial funding soon. 27

28 Projected Milestones in 2018 April 1 & Nov 1: projects begin Year 5 of program period. Final year for Regional Meetings. All projects should receive a site visit by September Updates to performance reporting in DGIS: will include benchmark data. 28

29 Performance Reporting Analyze and use program data to: Communicate program successes and challenges. Track progress at the regional and national levels. Inform programmatic discussions and decisions for current project. Inform the next project period. Save the Date! February 28, 2018, 3:00pm ET DGIS webinar Dial-in: Participant Code:

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32 Healthy Start Meetings Healthy Start Regional Meetings (Required) 1. Atlanta, GA: April 9 10, States: MS, AL, AR, LA, FL, GA 2. Raleigh, NC: May 22 23, States: KY, NC, SC, TN, VA, WV, MI, OH 3. Chicago, IL: June 25 26, States: KS, MO, IA, OK, NE, IL 4. Denver, CO: July 10 11, States: MN, WI, IN, OR, CO, SD, NV, CA, TX, NM, AZ 5. Washington, DC: August 7 8, States: NJ, MD, DC, NY, MA, CT, PA National Healthy Start Association Fatherhood Summit (pre-conference): March 24-25, 2018 Spring Conference: March 25-28, 2018 Healthy Start Plenary: March 27, 2018, 3:30pm 5:15pm 32

33 Healthy Start is Seeking Public Input Anticipate a Notice of funding opportunity (NOFO) for next Healthy Start project period. Opportunity to provide feedback to the Healthy Start Program: Save the Date! March 1, 2018 (tentative): Listening Session Through late March (date TBA): Public Comment Period Details will be announced in the Federal Register 33

34 Healthy Start National Evaluation Update Robert Windom 34

35 Healthy Start Evaluation Data Use Agreement Timeline ( from January 2018) January 2017 December 2017: Healthy Start grantees consent mothers who delivered or will deliver babies in 2017 and collect individual identifiers No later than February 28, 2018: Final deadline to submit completed DUA for participation in the evaluation

36 Healthy Start Evaluation Data Use Agreement Timeline (continued) April 2018: Grantees provide Healthy Start participant individual identifier variables to state VRO for linkage to birth records May 2018: VROs match Healthy Start participant data with available maternal and infant information, and transfer linked data along with non-participant control data to HRSA Summer 2018: Analysis begins

37 Data Agreement Status As of 2/12/18: 40 Total VRO Jurisdictions 26 fully executed DUAs signed by VRO, HS grantees, and HRSA 4 Pending signatures (CA, KS, KY, NYC) 9 Pending IRB or Legal Review (AZ, FL, IL, OK, PA, SD, TN, TX, VA) 1 Declined (IN)

38 PRAMS Oversampling Birmingham AL New Haven CT Augusta GA Des Moines IA New Orleans LA BOSTON MA Sault Sainte Marie MI Detroit MI Portageville MO Rochester NY Medford OR Portland OR Pittsburgh PA Springfield PA

39 Points of Contact Robert Windom: Phone: Ansley Marcellus: Abt Associates:

40 Healthy Start Data Reporting Chris Lim 40

41 Healthy Start Monitoring & Evaluation Data (HSMED) Reporting REQUIREMENTS: If your organization has not submitted all calendar year (CY) 2017 client-level data, to the HSMED, please do so as soon as possible. The HSMED will not accept any 2017 data after 06/29/2018. All 2017 data will be considered final on this date and will not be able to be adjusted/changed. Your assigned HRSA PO will be reaching out to you to review what client-level data are missing in the HSMED system. You do not need to wait until 06/29/2018 to finalize your 2017 data. You are encouraged to do so as soon as possible but no later than 06/29/2018. REMINDER: When uploading data collected across multiple months, please name upload files with the reported months. Example: files with data 01/2017 through 12/2017 could include Jan Dec2017. within the naming convention. If your organization is not able to submit an upload of previous months client-level data, for CY 2017, by 06/29/2018, communicate to your assigned HRSA PO why, so he/she will discuss an acceptable reporting schedule. 41

42 Healthy Start Monitoring & Evaluation Data (HSMED) Reporting REQUIREMENTS (cont d): If your organization has yet to attempt data uploads into the HSMED system, an attempt to upload must be made by no later than 03/02/2018. Failure to meet this deadline may result in restriction of funds, for your grant organization. UPDATES: Client-level data uploads, as of _02/05/2017_ 95 grantees attempted HSMED client-level uploads 5 grantees have not attempted uploads 42

43 Healthy Start Monitoring & Evaluation Data (HSMED) Reporting (Cont d) REMINDERS: Organizations are required to upload, at a minimum, HS Screening Tool 1: Demographic Form data for each and every HS women client. Therefore, the total number of Demographic data uploaded should match the number of women clients enrolled for services. HRSA/MCHB continues to use these multiple data points as a quality control check. Without a client s Demographic Tool information uploaded into the HSMED: A client may not be counted towards the total clients served. Other Healthy Start Screening Tools data cannot be uploaded into the HSMED until Tool 1 has been uploaded, as all of the other tools data are connected to a client unique identifier that is required for Tool 1. 43

44 Healthy Start Monitoring & Evaluation Data (HSMED) Reporting (Cont d) REMINDERS (cont d): The HSMED system is acessed via the following URL: by a registered HSMED user. All registered users are to utilize a grantee assigned HSMED user code, to set up user accounts, ed to all grantee Project Directors, April/May If you are unable to find or retrieve your organization s HSMED user code, the hssupport@dsfederal.com. NOTE: If your organization does not have a registered HSMED user, please designate an evaluator, data manager, project director, etc. to become a HSMED user. Users can retrieve client-level data uploaded into the HSMED, as needed. Monthly client-level data upload - grantees are to upload monthly data into the HSMED, starting the 10 th day of each month, consisting of data collected from the prior month. Example: starting on 03/10/2018, a grantee organization is to upload data collected on clients throughout the month of 02/

45 Healthy Start Monitoring & Evaluation Data (HSMED) Reporting (Cont d) ASSISTANCE: INFORMATION: The HSMED User Tip Sheet, to assist HS grantees understanding of the HSMED data overwrite rules for uploading HS Screening Tools into the HSMED system, was distributed to Project Directors 02/01/2018. It should demystify misunderstandings of the upload rules and provide upload tips, to reduce upload redundancy. The sheet is available on the Healthy Start EPIC Center and the HSMED websites at: and REQUEST: Share the HSMED User Tip Sheet with HSMED users, data managers, responsible vendors, etc. SUGGESTION: Each grantee organization is encouraged to review upload approaches and what data is submitted into the HSMED by checking the upload history and Excel-formatted data downloads, accessible via the HSMED system. An Excel data download conveys what data is actually saved into the HSMED, uploaded by data managers, persons responsible for uploading the data, or responsible vendors. If the uploaded data into the HSMED is different than what your organization had intended to report, corrected data can be uploaded into the HSMED system per tips conveyed within the HSMED User Tip Sheet. 45

46 Healthy Start Aggregate-Level Data Reporting REQUIREMENTS: For organizations that have not submitted all CY 2017 aggregate data, please do so by no later than 03/02/2018. Your assigned HRSA PO will be reaching out to you soon to review what aggregate data are missing. If your organization is not able to submit missing CY 2017 aggregate data, by 03/02/2018, communicate to your assigned HRSA PO why, so he/she will discuss an acceptable reporting schedule. 46

47 Healthy Start Aggregate-Level Data Reporting (Cont d) REMINDERS: Per the 01/30/ CY 2018 Healthy Start Aggregate-Level Data Reporting, DO NOT COUNT clients who STOPPED receiving services as of 12/31/2017, for the new CY 2018 reporting period (01/01/ /31/2018) These clients are no longer active and must not be counted in CY NOTE: Subtract the number of inactive clients from CY 2018 total clients served, measured by data element: 1.c. Total number of HS participants served to date (current calendar year). The latest version of the Healthy Start Aggregate Data Reporting Template, in the writeable MS Excel format, and the corresponding Healthy Start Aggregate Data Reporting Guide, in the PDF form, are available on the Healthy Start EPIC Center website: NOTE: Please, click on the above web link to access the reporting template, to assure your organization is utilizing the correct template version to report aggregate data. 47

48 Healthy Start Aggregate-Level Data Reporting (Cont d) REMINDERS: Each monthly aggregate reporting continues to start on the 10 th day of each month. Example: on 03/10/2018, a grantee organization will begin to complete an aggregate data template Each month your organization is to report on the previous month s data. Example: starting 03/10/2018, all grantees are to submit aggregate data that reports grantee performance throughout 02/01/ /28/2018. Refer to page 6 of the Guide. Each completed Healthy Start Aggregate Data Reporting Template must be named/titled with grant number and reporting month and year. Example: MC#####_ _HS_Data _Report. Refer to page 8 of the Guide. Each completed Healthy Start Aggregate Data Reporting Template must be ed to the Healthy Start Data Mailbox: healthystartdata@hrsa.gov and copied to the assigned HRSA Project Officer (PO). NOTE: include in Subject line: grant number, reporting month, and reporting year. Grantee name is optional, but appreciated. Refer to page 9 of the Guide 48

49 Healthy Start Aggregate-Level Data Reporting (Cont d) REMINDERS (cont d): Aggregate data reporting will continue through CY 2018, until the following factors exist: All 100 grantees are able to regularly upload client-level data, for all clients served, into the HSMED Uploaded client-level data is accurate and valid. Grantee call template data reporting continues. NOTE: call reported data is used to validate aggregate data. 49

50 List of Healthy Start Program Reports Healthy Start Reporting Project Schedule Reports Reporting Submission Due Dates Noncompeting Continuation Progress Reports Performance Reports Monthly HS Aggregate-level Data Report to: Monthly HS Client-level Data Report to the HSMED at Grantee Call Templates 50 Prior to end of budget period By the HRSA EHB s generated due date, after NoA issuance Starting the 10 th of each month, and by no later than the end of the month. Starting the 10 th of each month, and by no later than the end of the month. In the discretion of the assigned MCHB/DHSPS Project Officer

51 Healthy Start Collaborative Improvement and Innovations Network (CoIIN) Update February 2018 Conversations with the Division Webinar

52 Standardization: HS CoIIN Goal Builds a stronger program that provides a consistent, predictable, & replicable experience for HS participants.

53 Overview of HS CoIIN Priorities (Adopted March 2015) Standardize Data Collection and Reporting: Standardize Screening Tools and Processes: Ensures comprehensive and consistent assessment of participants needs. Supports monitoring and evaluation to demonstrate program effectiveness Standardize Care Coordination and Case Management: Defines best practices to improve the health of pregnant women and young families Standardization

54 HS CoIIN Care Coordination and Case Management Initiative Framework Policies and Protocols Workgroup Operationally define CM and CC, highlight distinctions if they exist, and identify alternative terms to guide the Literature Review and Data Sources Workgroups, and Members: Anna Gruver, Sara Kinsman (co-leads) Maxine Vance, Maria Lourdes Reyes, Julie DeClerque, and Kori Eberle Current Practices Workgroup Begin documenting and describing common components and gaps in CC/CM across grantees through review of current grantee applications and currently available data sources to inform the development of any additional data needs and to provide guidance for the Literature Review Workgroup. Members: Lo Berry, Gwen Daniels (co-leads) JoAnn Smith, Megan Young, Rick Greene, Anna Colaner, and Risë Ratney Literature Review Workgroup Review current literature to provide context to the findings of the Data Sources Workgroup. The outcome for the literature review will support current CC/CM HS best practices and address identified gaps. Members: Dianne Browne, Delores Passmore (co-leads) HSNO, Tara Schuler, Jada Shirriel, Lisa Matthews, and Meloney Baty Establish best practices for CC/CM related to providing MCH services.

55 Progress to Date Optimize cross-cutting HS efforts related to CC/CM. Lay the foundation for the next phase of standardization: Established a common definition of care coordination and case management (CC/CM). Analyzed CC/CM themes from Lessons Learned Report. Analyzed strengths and gaps CC/CM practices across HS programs. Reviewed literature related to caseloads and acuity levels.

56 Sharing is a two-way process We value your feedback HS CoIIN Recommendations Feedback & Input HS Programs Looking for your input on: CC/CM definition Competency checklist Intake processes

57 To emphasize: Focus of HS CoIIN Healthy Start as promoting equity; Healthy Start as a standardized system of care; and Standardization as a strategy for sustainability.

58 EPIC Center Update February 2017 JSI/EPIC Center

59 Updates Community Health Worker Course Electronic Screening Tool Update E-news Technical Assistance Coordinators Grantee Self Assessment Tool Training Update Upcoming Webinars National Healthy Start Association Conference Regional Meetings Peer Learning Networks

60 Healthy Start CHW Course Update 789 Users representing 95% of HS grantees!

61 Certificates are ed within 48 hours of course completion

62 Electronic Screening Tool Updates 21 programs submitted for December 94 active users (screeners) 608 screenings total 596 participants Screenings per tool: Demographic form: 504 Pregnant: 361 Preconception: 20 Prenatal: 207 Postpartum: 173 Interconception: 224

63 Crosswalk

64 To stay informed of training and TA opportunities and resources, sign up for e-news and Training Notices. Available to all Healthy Start grantees and their staff Stay connected! Your Technical Assistance Coordinators (TAC) are also available to help connect you to resources.

65 Grantee Self Assessment Tool Request Technical Assistance Technical Assistance

66 Training Opportunities Webinars February 20: 3-4:30pm ET - Program P: Engaging Men in Fatherhood and Care through Gendertransformative programming February 28: 3pm ET: Division hosted - DGIS webinar with Jamie Resnick March 20: 3-4pm ET Orientation to the Self Assessment Tool March 22: 3-4pm ET Criminalization of Substance Use among Pregnant Women in Tribal communities National Healthy Start Association Conference (March 25-28) Register today: ( Regional Meetings Look out for a meeting flyer! Following your meeting, sign up for a PLN! Peer Learning Networks : CAN Coordinators Talk Tuesday! CAN Coordinators February 27 at 3pm ET

67 Questions? For assistance: Contact Us: , toll-free

68 Open Discussion Please type your questions into the chat box. 68

69 69 Contact Information Benita Baker and Maria Benke Branch Chiefs, Division of Healthy Start & Perinatal Services Maternal and Child Health Bureau (MCHB) Health Resources and Services Administration (HRSA) Phone: , Web: mchb.hrsa.gov Twitter: twitter.com/hrsagov Facebook: facebook.com/hhs.hrsa