Centering Model of Care & Learning Community MPCA s Pre-Application Webinar September 9, 2014
Agenda I. Welcome II. Introduction of Partners III. Learning Community Overview, Design and Goals IV. Michigan Health Data V. Centering Overview VI. Learning Community Details and Expectations VII. Next Steps and Timeline VIII.Q & A
MPCA Centering Learning Community Centering Healthcare Institute Model Implementation Plan (MIP) Education and Resource Center MPCA Centering Model of Care & Learning Community Website Educational Conferences Orientation and Launch Meeting Basic Facilitation and Training Advanced Facilitation Training MPCA hosted Coordinator and Provider peer to peer meetings Monthly Coordinator peer to peer meetings Quarterly meetings for Provider/Facilitator
Centering Pregnancy Parenting Webinar ~ 9/9/14 Michigan Department of Community Health Infant Mortality Reduction Plan Statewide Perinatal Care System Brief Overview
Background/History 2009 Appropriations required convening group to restore regional perinatal system of care Formed 3 workgroups with stakeholders across the state Created report Perinatal Regionalization: Implications for Michigan Eighteen recommendations in the report 8
Background/history, cont. 2011 Summit: A Call to Action to Reduce Infant Mortality in Michigan Stakeholders contributed Infant Mortality Reduction Plan developed in 2012 One of the eight strategies is to implement a regional perinatal system Another strategy is to expand home visiting programs to support vulnerable w women and infants 9
Michigan vs. US rates of infant mortality 2003 2013 1 per 1,000 live births 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 8.5 7.6 7.9 8.0 7.4 7.4 7.5 7.1 6.6 6.9 6.6 6.8 6.8 6.9 6.7 6.8 6.5 6.3 6.2 6.1 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 United States Michigan Source: Centers for Disease Control and Prevention, National Center for Health Statistics MI Resident Live Birth & Death Files, Division for Vital Records & Health Stats 10
Figure 1: Infant Mortality Rates, 3 year moving averages, Michigan 2000 2012 25 American Indian 20 African American White per 1,000 live births 15 10 5 0 2000 2002 2002 2004 2004 2006 2006 2008 2008 2010 2010 2012 Years 11
Defining Perinatal Care System Perinatal period is defined as the time beginning before conception and continuing through the first year of life (March of Dimes, TIOP II, 1993) Perinatal Care System is defined as a sustainable community integrated health care system of people, institutions and local resources for women and infants that promotes healthy birth outcomes and babies who survive and thrive. 12
Gogebic 127 Ontonagon 28 Houghton 370 Iron 92 Baraga 82 Keweenaw 18 Marquette 599 Dickinson 273 Alger 76 Delta 362 Schoolcraft 64 Luce 43 Chippewa 336 Mackinac 93 Live Births by County Preliminary 2013 Menominee 318 Charlevoix 227 Antrim 197 Emmet 291 Cheboygan 190 Presque Isle 83 Otsego 229 2611 Alpena Mason 268 Oceana 271 Berrien 1,646 Benzie 156 Manistee 175 Muskegon 2,120 Ottawa 3,363 Grand Traverse 952 Lake 98 Newaygo 531 Allegan 1,280 Van Buren 897 Cass 363 Wexford 422 Osceola 250 Mecosta 390 Kalkaska 164 Montcalm 727 Kent 8,847 Barry 571 Ionia 739 Clare 291 Isabella 647 Eaton 1,109 Kalamazoo 3,163 Calhoun 1,690 St. Joseph 811 Missaukee 154 Branch 508 Crawford 112 Gratiot 401 Clinton 790 Gladwin 240 Oscoda 64 Alcona 60 Ogemaw Iosco 177 232 Key Number of Births Arenac 108 Midland 830 Bay 1,040 Ingham 3,251 Jackson 1,719 Saginaw 2,267 Livingston 1,684 Washtenaw 3,639 Hillsdale 540 Lenawee 1,048 Genesee 4,981 Tuscola 531 Lapeer 791 Oakland 13,429 Monroe 1,393 Wayne 23,441 Huron 300 Sanilac 429 St. Clair 1,545 Macomb 9,354 < 100 100 500 500 1,000 1,001 5,000 > 8,000 13
Ontonagon Keweenaw Houghton Birth Hospitals by Prosperity Regions Gogebic Baraga Marquette Luce Iron Dickinson Alger Delta Schoolcraft Mackinac Chippewa Menominee Emmet Cheboygan Leelanau Charlevoix Antrim Otsego Presque Isle Montmorency 1 Alpena Benzie Grand Traverse Wexford Manistee Kalkaska Crawford Oscoda Alcona Ogemaw Missaukee Roscommon Iosco Arenac Clare Huron Mason Lake Osceola Gladwin Isabella Midland Oceana Newaygo Mecosta Bay Tuscola Sanilac Montcalm Muskegon Kent Gratiot Saginaw St. Clair Genesee Lapeer Ottawa Ionia Clinton Shiawassee Oakland Macomb Key Hospitals by CON 84 - OB (Birthing) Hospital 20 - OB (Birthing)/NICU Hospital Numbers represent State of Michigan Prosperity Regions Allegan Barry Eaton Ingham Livingston Wayne Berrien Van Buren Kalamazoo St. Joseph Cass Calhoun Jackson Washtenaw Branch Hillsdale Lenawee Monroe 14
PERINATAL CARE SYSTEM WITHIN LIFE COURSE PERSPECTIVE PERINATAL LIFECOURSE PERIODS Before & Between Pregnancy Pregnancy Childbirth Neonatal Postpartum Infancy 15
Michigan s Perinatal Care System within Lifecourse Context Preconception & Interconception Care Perinatal Care System Prenatal Care Birth Hospitals Level I Level II (Special Care Nursery) Level III (NICU) Level IV (NICU) Linkage Community Health Resources Primary Care/Medical Homes Developmental Assessment Programs CSHCS and/or Home Visitation Other relevant community care & support resources Address Social Determinants of Health Transportation Access to healthy food Education Housing Employment Family economics Early Childhood Payer Policy Provider Payment Inter facility Transport Care Coordination Point in time Over time Surveillance Analytics Monitoring Workforce/Provider Training System Protocols (Common screening elements) Certificate of Need (CON) & Licensing Universal Outcome Indicators & Metrics Health Connect 360 Quality Assurance and Quality Improvement (Data, Evaluation) 16
Project: centering Pregnancy Parenting 1. Part of the statewide Infant Mortality Reduction Plan 2. Emphasis on innovative prenatal care and parenting models 17
Home Visitation Maternal, Infant, and Early Childhood Home Visiting (MIECHV) supports pregnant women and families. It helps parents of children from birth to age 5 Evidence based home visiting programs demonstrate successful impact on risk factors: Promote safe sleep practices Reduction in new cases of child injury and neglect Reduced child mortality Improving child development and school readiness Reduce crime, including domestic violence Improved maternal health and behavior Reduce unintended pregnancies Improve the coordination and referrals for other community resources and supports Integrate social determinants of health 18
Promote Safe Sleep Practices Reproductive Planning Messaging Promote Breastfeeding Avoid Alcohol in Pregnancy 19
PROMOTION of HEALTHY MOTHERS, BABIES & FAMILIES is the foundation of creating a HEALTHIER MICHIGAN 20
Centering : Essential Elements & Implementation Prepared by CHI for The Michigan Primary Care Association September 2014
A better way to get care 1. Health Assessment 2. Interactive Learning 3. Community Building
Essential 23 Elements
Two-year MIP
Start Up
Training Interactive workshops for providers and support staff that will co-facilitate groups Basic Facilitation (two-day) Advanced Facilitation (one-day
Site Approval Based on CenteringCounts Dashboard Initial approval involves on-site visit w/ group observation Three components 1. Model Fidelity 2. Evaluation 3. Sustainability Renewed annually via CenteringCounts self-report
Questions? It is more work than anticipated. It is more enjoyable and satisfying than anticipated. -Inova Health System, Falls Church VA
Learning Community Details and Expectations
Next Steps September 9, 2014 Pre-Application Announcement Webinar October 3, 2014 Health Center Award Notification September 23, 2014 Applications Due November 19, 2014 Kick off Conference
Questions? Diane Rydahl Clinical Specialist Michigan Primary Care Association 517 827 0486 drydahl@mpca.net