Kansas Maternal & Child Health Council

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Kansas Maternal & Child Health Council OCTOBER 4, 2017 MEETING

Welcome Approval of Minutes DENNIS COOLEY, MD, CHAIR

MCH Block Grant Application/Report UPDATES

2018 MCH Block Grant Public input period: June 16-July 7 2018 Application/2016 Annual Report Submitted: July 14 Federal Title V Block Grant Review: August 10 Application & Annual Report Re-submit: September 26 Final publications and resources available by October 2017 Access to application and/or MCH State Action Plan: www.kdheks.gov/bfh or www.kansasmch.org NOTE: Federal Title V Guidance is undergoing Revision. Changes will impact NPMs, Cross-cutting domain, and more.

Published Links/Documents http://www.kdheks.gov/bfh

Special Presentations: MCO MCH Investments AMERIGROUP SUNFLOWER HEALTH PLAN UNITED HEALTHCARE

Maternal & Child Health Programs Presented by Janette Spear, RN, BSN, CCM

Pregnant Women & Children Behavioral Health & Specialty Therapies Life, Health & Wellness Pharmacy Benefits Total Solution Integration Physical Health Behavioral Health Pharmacy Services Ancillary Services Care Management Software HCBS for I/DD Populations In-Home Services Care Coordination IT Systems Member Telehealth Services Benefit Management Person- Centric Programs Vision Benefits Specialty Pharmacy Benefits Dental Benefits 10/4/2017

Identifying At-Risk Pregnancies NOP Notification of Pregnancy Forms Member Provider Health Plan Staff Claims NOP Report No NOP Report Enrollment File 10/4/2017

It s everyone s responsibility to identify pregnant members A key goal is to maximize Notification of Pregnancy intake: Standardized form Multiple intake sources Education program Providers Employees Members Incentives Providers Employees Members 10/4/2017

The NOP Starts the Process of Care Management and Appropriate Involvement NOP Provides Important medical/social data Proprietary Risk Score for Each Member Low-risk group Mediumrisk group High-risk group Receive educational materials Watch and Monitor Case Management

Start Smart for Your Baby (SSFB) Promotes education and communication to ensure a healthy pregnancy for our members and first year of life for their babies Objective is to decrease preterm deliveries, low birth weight, and poor health outcomes by increasing prenatal, postpartum and pediatric care How does a member become enrolled in Start Smart? A: NOP Form Pregnancy Packets, Incentives, Breast Pump Program, Newborn Packets 10/4/2017

Focus on Prenatal and Postnatal Care Case Management Nurses Social Workers Program Coordinators MemberConnections Prenatal Initiative Community Baby Showers NICU Kits Behavioral Health Services Substance Abuse Depression Pharmacy 17P 10/4/2017

Baby Showers Start Smart for Your Baby Baby Showers Other Community Baby Showers in Partnership with Social Service Agencies Our SSFB Baby Showers Games Healthy Food EPSDT Coord. & RN L&D Breastfeeding Postpartum care Finding a pediatrician Vaccination schedule 10/4/2017

10/4/2017 EASEL EXAMPLE ART

Value-Added Benefits Boys & Girls Clubs Adopt-a-School Puff Free Pregnancy Farmers Markets Vouchers Mosquito Repellant CentAccount Rewards 10/4/2017

Related to Prenatal and Postnatal Care $15 - When you notify us you are pregnant by submitting a completed Notification of Pregnancy (NOP) form within your first trimester. For a member to be eligible for these specific rewards, she must notify us of her pregnancy by submitting a completed NOP form. $15 - For every 3rd prenatal doctor visit ($45 Max.) $10 - For a postpartum doctor visit. Must be completed between 21-56 days after you deliver your baby. $10 - For each infant well care visit up to 15 months old. ($60 max.). These visits are recommended before 30 days old, and at 2, 4, 6, 9, 12, and 15 months old. 10/4/2017

Community Engagement FIMR Community Action Teams (Fetal and Infant Mortality Review) KCK Topeka Wichita Sponsorships Becoming a Mom prenatal education series Safe Sleep Task Force Envolve Center for Health Behavior Change Collaboration with Envolve PeopleCare, Washington University St. Louis, and Duke University 10/4/2017

Safe Sleep Sponsor Safe Sleep Taskforce Wyandotte County Goal: Reduce infant deaths by helping families who cannot afford a safe-sleep environment for their infant 100 Graco Pack n Play portable cribs 100 Halo Infant Sleepsacks 100 Graco fitted sheets Partner agencies carrying out the Assessment, Education & Distribution to eligible clients: USD 500 Parents as Teachers, WYCO Infant Toddler Services, Turner House Clinic, The Family Conservancy, KUMC Project Eagle, USD 200 Parents as Teachers 10/4/2017

Envolve Center for Health Behavior Change Peer Coaching with a Pediatric Obesity Program Can the support of peers as health coaches improve outcomes in a lifestyle change intervention for families with obese children? Face-to-face interactions with a trained peer coach enhancing telephonic coaching Assessing weight and measurements; fruits, vegetables, and sugary drinks consumed; activity levels Focus on home environment before and after 10/4/2017

Healthy First Steps 10/04/2017 Mary Sunshine Delgado MSN, RN, APRN HFS MCH-PC John Esslinger MD, MMM- CMO, UHC- Kansas Helping people live healthier lives

Healthy First Steps HFS is a program aimed to improving the health and well-being of pregnant women and children participating in our managed Medicaid health plans. The HFS program focuses on the importance of prenatal and postpartum care in addition to the social determinants of health. The goal of the program is to achieve the best health outcomes for women and infants. This program gives pregnant mothers the information, education and support they need for a healthy birth outcome. 22

State Premature Birth Rates Current US Preterm Birth Rate = 9.6% March of Dimes goal = 8.1% by 2020 23 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

HFS Program Goals 24 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Goals Increase member and provider engagement; Increase prenatal and postpartum visits/care; Decrease pre-term births and NICU admissions; Enhance relationships and support to network providers and practitioners; Improve access to obstetrical care and reduce health disparities and barriers to care. This program will address the needs of pregnant member and infants across medical, behavioral health, and social services. Improve overall maternal and infant health and well being. 25 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

HFS Program Objectives 26 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Population Identification Data sources include: Member eligibility files (State 834 file indicators) Presumptive eligibility information (where applicable) Notification by state partners, such as Medicaid case workers Claims data Blended Census Reporting Tool (BCRT) Admission, Discharges and Transfers (ADT) files Provider Referrals and Obstetrical Risk Assessment Forms (OBRAF) Member self-identification or caregiver referrals Internal staff referrals Health Risk Assessment (HRA) data Data from Electronic Medical Record feeds when available 27 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

28 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Stratification process: High Risk or Healthy? Alcohol use Autoimmune disorder Diabetes Domestic violence Eating disorder Heart failure High blood pressure Smoking Short interconception interval Human Immunodeficiency Virus (HIV) Homelessness Kidney disease Methadone treatment Multiple gestation Polycystic Ovary Syndrome Sickle cell Cont d next slide 29 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Stratification process: High Risk or Healthy? Previous preterm deliveries (under 37 weeks) Emergency room utilization in the prior 6 months (2 or more visits) Previous delivery resulting in a neonatal intensive care unit admission Current antepartum inpatient admission Body Mass Index of less than 18.5 or greater than 40 Serious Mental Illness Maternal age under 18 years old or age 35 years or older 30 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Coordination of care HFS program works closely with other areas of the health plan to coordinate member care needs. United Healthcare's HFS program offers a multi-faceted approach to engagement and service delivery Through provider incentives, partnerships, point-of-service coordination, technology, and innovative programming we are able to quickly and effectively address the needs of our pregnant members and infants. 31

32 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Services and Supports Text4baby Baby blocks Transportation Myhealthline Smoking Cessation Kids health 24 hour nurse line Wellness calendar Makena /17P Healthify 33 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Community Resources Community clinics Kansas Breastfeeding Coalition La Leche League March of dimes Nurse Family Partnership WIC 34 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Health Education for all members Consistent with the HFS program s commitment to addressing health disparities, member education and materials will also address psychosocial issues such as cultural or religious beliefs concerning pregnancy and delivery, perceived barriers to meeting treatment requirements and access, transportation, and financial barriers to obtaining treatment. 35 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

36 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Insert from the Kansas MCH website 37 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Contacts Mary Sunshine Delgado MSN, RN, APRN HFS MCH-PC UHC Maternal Child Health Program Coordinator Email: mary_delgado@uhc.com John Esslinger, MD UHC Chief Medical Officer Email: john.esslinger@uhc.com 38 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Q&A with the MCOs CONNIE SATZLER, ENVISAGE

Lunch & Networking

KanCare Updates KASEY SORELL, KDHE DIVISION 0F HEALTH CARE FINANCE

Domain Group Work SPECIAL PRESENTATIONS W/REFLECTION

Domain Group Plan 1. Brainstorming: Start with a quick round of big ideas from members of the group what did you hear as far as areas of alignment and opportunity for the population domain? Consider the community-based Medicaid services/supports and initiatives currently underway. Identify specific areas of alignment with the MCH state plan by domain. Determine next steps for collaboration/action to expand and/or advance efforts in partnership with Managed Care Organizations. Reminder: All groups must consider cross-cutting/life course and special health care needs. 2. Starting with the high-level list developed by your group, begin discussing each topic address each column on the small group discussion tool. 3. Report out to the larger group!

Domain Group Worksheet

Domain Group Assignments Women & Maternal Health Priority 1 (WM) Priority 6 (CC) Facilitators: Stephanie & Diane Child Health Priority 3 (C) Priority 7 (CSHCN) Facilitators: Kayzy & Debbie Perinatal & Infant Health Priority 4 (PI) Priority 2 (CC) Facilitators: Carrie & Tamara Adolescent Health Priority 5 (A) Priority 8 (CC) Facilitators: Connie & Aarion

Ground Rules 1. Stay present (phones on silent/vibrate, limit side conversations). 2. Invite everyone into the conversation. Take turns talking. 3. ALL feedback is valid. There are no right or wrong answers. 4. Value and respect different perspectives (providers, families, agencies, etc.) 5. Be relevant. Stay on topic. 6. Allow facilitator to move through priority topics. 7. Avoid repeating previous remarks. 8. Disagree with ideas, not people. Build on each other s ideas. 9. Capture side topics and concerns; set aside for discussion and resolution at a later time. 10. Reach closure on each item and summarize conclusions or action steps.

PRAMS Update: Year 1 LISA WILLIAMS & JULIA SOAP, KDHE BUREAU OF EPIDEMIOLOGY & PUBLIC HEALTH INFORMATICS

Mental Health First Aid UPDATE: CARRIE AKIN, KDHE & PAT KINNAIRD, CENTRAL KS MENTAL HEALTH CENTER

Kansas MCH Website Info http://www.kansasmch.org/mhfa.asp

Home Visitor Trainings 10/17/17 SW Region - Garden City 10/18/17 NW Region - Hays 10/19/17 NC Region - Beloit 10/23/17 SE Region - Chanute 10/24/17 NE Region - Whiting 10/25/17 SC Region - Hutchinson

State Child Death Review Board 2017 ANNUAL REPORT (2015 DATA)

SCDRB Annual Report

Home Visiting WEBSITE, STORIES, AND RESOURCES

New! Home Visiting Landscape http://kshomevisiting.org http://kshvlandscape.org

KMCHC Member Announcements

Future Meeting Dates JANUARY 17, 2018 APRIL 18, 2018 SET 2018-2019 MEETINGS

Closing Remarks DENNIS COOLEY, MD, CHAIR