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NYS DOH
Maternal and Infant
Community Health
Collaboratives
Schuyler Center for Analysis
and Advocacy Webinar
August 19, 2014
Presenters:
Michal Acosta, Associate Director
Bureau of Maternal and Child Health
Amy Hauptli, MICHC Program Manager
Bureau of Maternal and Child Health
Perinatal Health Unit
Maternal & Infant Community
Health Collaboratives
3
A needs-driven, community-based collaborative approach
to improve key birth outcomes—preterm birth, low birth
weight, infant mortality and maternal mortality.
Life Course Approach
Strategies addressing…
•Preconception
•Prenatal/Postpartum
• Interconception
Social Ecological Approach
Strategies impacting…
• Individual/Family Level
-Community Health Workers
•Organizational Level
•Community Level
Performance Management
•Enroll women in health insurance
•Ensure women are engaged in health care
•Coordinate services across community programs
•Promote opportunities and supports for healthy behaviors
MIH Components
Maternal and Infant Community Health
Collaboratives (MICHC) – 23 projects
Maternal, Infant and Early Childhood Home
Visiting Initiative (MIECHV) – 10 projects
Pathways to Success – 6 projects
Maternal and Infant Health – Health Information
Technology Pilot Project – 4 projects
Maternal and Infant Health Center of Excellence
(MIH-COE) – to be established
Maternal and Infant Health Initiative
Goal: Improve maternal and infant health outcomes for high-need women and families in targeted communities and reduce racial, ethnic and economic disparities in those outcomes.
Preterm birth
Low birth weight
Infant Mortality
Maternal Mortality
Maternal and Infant Health in NYS
6
0
2
4
6
8
10
12
14
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Perc
ent
of
Liv
e B
irth
s
Low Birth Weight Births by Race/Ethnicity, NYS 2002-2012
NYS White Non-Hispanic Black Non-Hispanic Hispanic HP 2020 Target
Maternal and Infant Health in NYS
7
0
2
4
6
8
10
12
14
16
18
20
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Perc
ent
of
Liv
e B
irth
sPreterm Birth by Race/Ethnicity, NYS 2003-2012
White Non-Hispanic Black Non-Hispanic Hispanic HP 2020 Target
Maternal and Infant Health in NYS
8
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Infa
nt
Death
s per
1,0
00 L
ive B
irth
s
Infant Mortality Rate by Race/Ethnicity, NYS 2002-2012
NYS Black Non-Hispanic White Non-Hispanic Hispanic HP 2020 Target
Maternal and Infant Health in NYS
0
5
10
15
20
25
30
35
Mate
rnal D
eath
s per
100,0
00 L
ive B
irth
s
Three-Year Rolling Average Maternal Mortality Rate, NYS and US 2001-2012
NYS Rest of State New York City US HP 2020 Target
MICHC
Performance Standards
1. High-need women and infants are enrolled in health insurance.
2. High-need women and infants are engaged in health care and other supportive services.
3. Their risk factors are identified and addressed through timely and coordinated counseling, management, referral and follow-up.
4. There are community supports and opportunities in place that help women engage in and maintain healthy behaviors.
County Map of Awards
Maternal Infant Community
Health Collaboratives
Maternal and Infant Community Health
Collaboratives
Performance Management
Collaborative Approach
Systems-based Approach
Life Course Model
Ecological Model
Collaborative Approach
Assessment of Needs and Strengths
Development of Improvement Plan
Implementation of Improvement Plan
Systems-based Approach
Systems that are accessible, effective, and functionally coordinated or integrated can enable service providers to deliver quality services and promote health behaviors and utilize services.
Coordinated outreach, intake, and referral processes across community health and social service programs to assure improved communication, collaboration and coordination.
Life Course Model
Promotes optimal women’s health throughout the
reproductive life span:
• Preconception
• Perinatal / Postpartum
• Interconception
Social Ecological Model
Health is influenced by a multitude of factors at
different ecological levels.
• Individual
• Community
• Organizational
• Policy
MICHC Improvement Strategies
Targeted to Medicaid-eligible populations
Responsive to community needs and strengths
Collaborative
Community Health Worker
Offering and Arranging
Organizational and/or Community level and Individual / Family level strategies
Community Health Workers
(CHW)
Specially trained paraprofessionals recruited from the target community to work directly with high-need women and their families to access health care and other services and to promote healthy behaviors
All 23 MICHC projects have a team of CHWs
Provide outreach, education, assistance with access to needed care, and enhanced social support to high-risk pregnant, postpartum, preconception and interconception women
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Maternal & Infant Community Health
Collaboratives + Oral Health
Improve oral health outcomes for pregnant women and infants
Integrate oral health care into community based perinatal services
Increase % of women who visit a dentist during pregnancy
Increase % of women who receive an assessment for oral health problems and appropriate referral by a prenatal care provider
Increase % of women engaged in healthy behaviors
(e.g., appropriate feeding habits, infant oral hygiene practices)
Disseminate lessons learned with other MICHCs and states
Summary
Promote optimal health across the life span.
Strengthen individual knowledge; change
organizational practices; mobilize communities;
and influence policy.
Collaboratively assess community needs and
resources, and develop collaborative strategies to
address those needs; and
Regularly assess progress in implementing
strategies, and in achieving desired outcomes.
Questions?
Michael Acosta: [email protected]
Amy Hauptli: [email protected]
Bureau of Maternal and Child Health
NYS Department of Health
(518) 474-1911
