Reproductive, Maternal & Child Health

Program Overview

Healthy families are the center of a healthy community. By helping young men and women, mothers, and children access reproductive, maternal, and child health services, CPAA intends to support families, mitigate the impact of adverse childhood experiences (ACEs), and build resilience in our region.

Top Metrics for Improvement

Metrics for this project are currently in draft form and are being updated by the Health Care Authority. The metrics under consideration include:

• Number of partners trained by selected model / approach: projected vs. actual and cumulative
• Number of partners participating and number implementing each selected model / approach
• Chlamydia Screening in Women Ages 16 to 24
• Mental Health Treatment Penetration (Broad Version)
• Outpatient Emergency Department Visits per 1000 Member Months
• Substance Use Disorder Treatment Penetration
• Well-Child Visits in the 3rd, 4th, 5th, and 6th Years of Life
• Childhood Immunization Status (Combo 10)
• Contraceptive Care – Access Measures (NQF# 2903, 2902)
• Timeliness of Prenatal Care: Prenatal care in the first trimester of pregnancy
• Well-Child Visits in the First 15 Months of Life

Outcome

• Provide “trauma informed” training to members of the community and professionals such as teachers, nurses, doctors, hygienists, and dentists. Trauma informed care involves learning how to recognize, understand, and positively respond to the effects of trauma.
• Reduce the teen pregnancy rate.
• Increase the number of people using long acting reproductive contraceptives.
• Increase chlamydia screenings in women ages 16-24.
• Increase first trimester prenatal care.
• Increase the number of children seeing their doctor for regular well child check-ups and immunizations.

Evidence-Based Approach

Reproductive Health Screenings, Home Visits, Well Child Visits & Immunizations:
• A planned pregnancy is a healthier pregnancy. Reproductive Health Screenings are simple questions asked during regular doctor visit to help families stay health and plan for when to have a baby.
• Home Visits would expand access to existing home visiting program so pregnant moms and families who need additional support could be eligible to receive in-home services. Three home visiting strategies areas we are looking at: Nurse Family Partnership, Parents as Teachers, and Family Spirit.
• Regular Well Child Visits and Immunizations are crucial for health and prevention. We are looking to implement practices that will improve regional well child rates (for ages 3-6) and childhood immunization rates. These practices occur in the doctor’s office such as Bright Futures and Stony Brook Children’s Hospital Enriched Medical Home Intervention.

Stakeholders

Community-Based Social Service Organizations, Medicaid Managed Care Organizations, OBGYNs, Pediatricians, Primary Care Providers, Public Health, Health Care Administrators

Transformation Timeline and Milestones

Project Work Group is working on:

1. Current state assessment
2. Identify Domain 1 strategies that support project
3. Finalize target populations and evidence-based approaches
4. Determine partnering providers
5. Complete implementation plans
6. Plan describing regional transition to fully-integrated managed care

Project Implementation in 2019, and scaling-up in 2020.

Social Determinants of Health and Chronic Disease

Preventing and mitigating the impact of adverse childhood experiences (ACEs) has been a top regional priority for CPAA since its inception. Many of these adverse experiences tend to be generational, i.e., there is a much greater risk of ACEs when families are raising children in adverse community environments, where socio-economic status tends to be low, where built environments are unhealthy, and where there are few community and family resources.

In general, CPAA’s population is more vulnerable than the statewide population. The region has slightly higher unemployment, more children in poverty, lower median household income, and higher rates of persons receiving food stamps. Additionally, the region has lower childhood immunization rates, higher rates of children participating in Aid to Families programs, higher rates of students eligible for free and reduced price lunches, and higher teen pregnancy rates.

This project area and the focus on supporting healthy families corresponds with CPAA’s overall focus on prevention and early intervention strategies as a key building block in our region’s vision of better health for our residents and a healthier community.

Project Area Contact

For more information, contact Caroline Sedano, Program Manager: sedanoc@crhn.org