Welcome

1. Welcome

2. Perinatal Continuum of Care Tulsa County 2007 From Community Service Council of Greater Tulsa’s Community Profile 2007

3. Family Health Coalition • Established in 1987 to improve access to prenatal care • 109 members from 60 agencies, businesses, government and consumers • Local health system plan articulates with the Oklahoma State Department of Health 5 Year Plan for Maternal and Child Health (Title V) • Conducts on-going assessments and system evaluation • Conducts policy advocacy • Conducts resource and grant development

4. Family Health Coalition Steering Committee Social Marketing Access Committee System Evaluation Community HealthNet Tulsa Hispanic Resource Association

5. Reduction in Fetal & Infant Mortality Improved Access to Prenatal Care Reduction in Low Birth-Weight Babies Reduction in Preterm Deliveries Tulsa’s Perinatal Health Care System Works Outreach(Babyline & Free Pregnancy Testing) Case Management (Healthy Start, Children First & Healthy Families) Client Education(Prenatal, Sexuality & Social Marketing) Provider Training Services Family Planning Prenatal Care Labor & Delivery Pre-conceptual Care Inter-conceptual Care Psycho-social Screening Risk Appropriate Referrals Translation Behavioral Health Treatment Prenatal Health Care Providers Indian Health Care Resource Center Tulsa Health Department OU (OB/Gyn & Family Medicine) Planned Parenthood OSU (OB/Gyn & Family Medicine) Morton Comprehensive Health Center Office of Child Abuse Prevention Funding(Federal Money Healthy Start Funding(Federal Money Graduate Medical Educational Funding (Federal Money Medicaid Funding(Blend of Federal & State Monies GQHC/330 Funding(Federal Money Title V Funding(Federal Money Title XFunding(Federal Money WIC Funding(Federal Money Indian Health Service (Federal Money Philanthropy Corporate Giving Contributions. Family Health Coalition

6. Reduce fetal and infant mortality Reduce low birth weight and very low birth weight infants Reduce prematurity Increase access and continuity in prenatal care Reduce need for high risk obstetrical care Reduce rate of no or late prenatal care Increase access and continuity of family planning Reduce unintended pregnancy Reduce teen birth rate Increase capacity of CBO to provide prenatal and intraconceptional care Increase research and services in women’s health Outcomes and Process Objectives

8. Assessment • Review of Linked Birth and Death Certificate Data 1991-2000(Tulsa Health Department, 2004) • Analysis of Feto-Infant Mortality 1996-2000(Tulsa Health Department, 2004) • Assessment of Reproductive Indicators in Women of Minority Race and Ethnicity in Eastern Oklahoma(Planned Parenthood of Arkansas and Eastern Oklahoma, 2005) • Barriers to Help-Seeking for Economically Disadvantages Parents and Children in Tulsa(Oklahoma State University, 2006) • Barriers to Early Prenatal Care: PRAMS 2000-2003(Oklahoma State Department of Health, April 2007)

9. Assessment • Babyline 1990-2004 Trend Report(Community Service Council, 2006) • Administrative Analysis of Prenatal Data Final Report(Oklahoma Foundation for Medical Quality, 2006) • Tulsa County Profile 2007(Tulsa Health Department, 2007) • Community Profile of Tulsa County 2007(Community Service Council, 2007) • Preliminary Findings 2004 Infant Deaths(Tulsa Health Department, 2007)

10. Infant Mortality

11. Tulsa Fetal-Infant Mortality Review

12. Client Outreach Case Finding Free Pregnancy Testing Planline/Family Planning Babyline/RiskAssessment/Case Management Referral Low and Moderate Risk Care CHC IHCRC Morton OSU OB/GYN OU Family Med PP THD High Risk Care Deliveries Hillcrest Southcrest OSU Med Ctnr Tulsa’s Perinatal System Capacity Morton Private Doctors OSU OU OB/GYN Postpartum & Family Planning Social Marketing CHC IHCRC Morton OSU OU Family Med PP THD

13. Evidence Based Strategies • Outcome performance measures • Community coalitions • Collaborative, public-private partnerships • Consumer/client investments • Outreach and recruitment • Services (prenatal, family planning, women’s health) • Case management/Care coordination • Social marketing • Risk reduction education • Access to services and care • Child care • Transportation • Translation

14. Preconceptional & Interconceptional Care • Education • Babyline & Planline • Free Pregnancy Testing Program • Social marketing • Teen pregnancy prevention Client $1,464,730 annual • Service • Uninsured pool for prenatal care • High risk obstetrical care stabilized • Family planning for the uninsured $2,173,980 annual Outreach Case Finding Free Pregnancy Testing Planline/Family Planning • Access • Expansion of all 3 case management programs • Expansion of risk appropriate referrals (Housing, Grieving support, translation, smoking cessation, etc) Babyline/RiskAssessment $3,781,433 annual • Research • TFIMR • Women’s Health Research Center Safety Net/ Low and Moderate Risk Care Est. $12M endowed CHC IHCRC Morton OSU OB/GYN OU Family Med PP THD $1,399,879 annual High Risk Care Deliveries Hillcrest Southcrest OSU Med Ctnr Navigating Tulsa’s Perinatal System Morton $1,513,280 annual Private Doctors OSU OU OB/GYN $1,454,149 annual Safety Net/Post-partum & Family Planning Social Marketing CHC IHCRC Morton OSU OU Family Med PP THD

15. Wild Cards • HB 1804 Immigration Bill • Unborn Child Legislation • Medicaid for dental coverage during pregnancy • Decrease in Title V funding

16. Risk Factors for Infants

17. Risk Factors for Infants

18. Births to Teens

19. Risk Factors for Infants

20. Risk Factors for Infants

21. HIPAA barrier on transfer of medical records at 36 weeks Risk Factors for Infants • Hispanic culture and self-pay • Inadequate Medicaid global fee