Healthy Start Workgroup

1. Healthy Start Workgroup Fleda Mask Jackson, Ph.D., M.S. SACIM Presentation November 14,2012

2. Workgroup Objectives • Recommendations for Healthy Start • Recommendations for the evaluation plan (past group) • Recommendations for responses to Healthy Start 3.0 • Language for reauthorization

3. Federal Healthy Start is a network of 105 sites located across the United States providing patient-driven, community-based, culturally competent care to ensure positive perinatal outcomes for the most vulnerable women. Authorized by the Congress in 1991, Healthy Start’s conceptual model of individual social support and the coordination and navigation of clinical and non-clinical services, responsive to the needs of women within their communities, it is a forerunner for the current focus on the SDOH and place-based initiatives. Healthy Start serves 500,000 ethnically and racially diverse women and operates in urban, rural, tribal and border communities. Trained community health workers are integral to Healthy Start providing cost effective care ($4,000 per case) for women and their children (0-2 years old).

4. Work Group Process/Discussions • What is Healthy Start? • What is Healthy Start’s presence and contribution to the national agenda for achieving equitable birth outcomes and moving the needle for infant deaths (Big Idea, Key Implementer for National Agenda); marginalization, lessons learned, assets and experiences, collaboration and expertise for national agenda) • Support for Healthy Start’s new function and design? What is the target? What are the questions? Community transformation, stress reduction resilience (thriving) • Lessons Learned and Vision (forward)

5. Big Ideas • Healthy Start should be a national priority with its presence in every community plagued by the tragedy of disproportionately high infant death rates among the most vulnerable • Healthy Start should become patient-centered community health homes for women, children and families seamlessly integrated with public health and clinical services for both delivery of services and evaluation of outcomes

6. Big Ideas • HS should participate as an expert panelist for the design, implementation, dissemination, and evaluation of a national agenda setting the policies and practices for advancing equitable birth outcomes • Metric be developed that can show the difference in a relatively short time that are more proximal to the intervention method; Long term life course impact of HS (qualitative and quantitative)

7. Healthy Start Workgroup Recommendations • HHS continue Healthy Start as a priority initiative to improve perinatal outcomes in project areas with high rates of infant mortality • HHS give approval for HS grantees to become patient-centered , community-based health teams for women, children and families (ACA: promotion, navigation, case management, community health workers)

8. Recommendations • HHS support new performance standards, evidence-based practices (and innovation) and system building strategies in every Healthy Start community • New data and evaluation to demonstrate effectiveness of Healthy Start’s patient-centered, community driven, strengths-based and culturally competent model (What are the questions?)

9. Recommendations • Healthy Start should be re-reviewed as an evidence-based MIECHV (with new data) • HHS consider HS as the hub for coordinating new place-based initiatives to improve the health of women during their childbearing years and to reduce infant mortality

10. Current Discussion and Next Steps • What is the target/timetable for achieving equitable birth outcomes • Stress, resilience, and thriving • Community transformation (readiness, HS expectation) • Data/Evaluation

11. Healthy Start Workgroup • Fleda Mask Jackson, Ph.D,M.S (chair) • Arden Handler, Dr.P.H. • Kay Johnson, M.Ed.,M.P.H. (SACIM chair) • Milton Kotelchuck, Ph.D., M.P.H. • Joanne Martin, Dr.P.H., RN,FAAN • Ruth Ann Shephard, M.D.,FAAP • Sara Shield, M.D., M.S.