Federation of County Networks
“Feeling the Strength of Our Own Spirit…
Developing a Plan to Address
Comprehensive Approaches to Perinatal
and Family Health
Taking it to the Streets:
Organizing, Planning-ACTION
May 20th 2005
Mario Drummonds, MS, LCSW, MBA
Board Treasurer,
Federation of County Networks, Inc.
FCN MISSION:
The FCN mission is to reduce
fragmentation in the maternal, perinatal and
child health systems; to improve outreach
and access to care for economically
challenged women who may be pregnant
and parenting and their families; to enhance
and ensure collaboration and coordination
among providers; to provide training and
technical assistance to maternal and child
health providers; and to assist in local
health systems planning.
Programmatic Activities:
Regional Program Coordination
Local Health System Collaboration and
Planning
Technology –Virtual Private Perinatal
Network
MCH Management & Clinical Training
Advocacy
Policy Agenda/Direction
Healthy Start Coordination
EXTERNAL ENVIRONMENT SCAN:
Opportunities:
1. National, state and local focus on reducing
racial disparities in health outcomes within the
foundation, government and private sectors
2. NYSDOH RFP focusing on chronic disease
management by making a six million dollar
investment across New York State. States
around the country are under increasing fiscal
pressure to develop disease management
programs that provide quality health care for
those most in need, while alleviating some of
the cost pressures facing Medicaid
EXTERNAL ENVIRONMENT SCAN:
3. National, state and local focus on fighting
childhood and adult obesity
4. NYC over the last four years has invested 20
million dollars in community-based solutions
to IMR reduction
5. NIH recently released an eleven-year multi-year
RFA that focuses on research and practice
activities to reduce racial disparities in health
outcomes
EXTERNAL ENVIRONMENT SCAN:
6. National Patient Navigator Program legislation
moving fast through Congress that projects to
allocate 25 million dollars a year to address
structural and cultural barriers to healthcare
EXTERNAL ENVIRONMENT SCAN:
7. Renewed focus in Washington on utilizing
information technology to computerize medical
records. Health experts say that moving to
electronic records, which would reduce paper
handling and eliminate unnecessary or
duplicative tests, could cut 10 percent or more
from the nation’s $1.7 trillion a year health care
spending. A digital system should sharply
reduce medical errors, which are estimated to
be responsible for 45,000 to 98,000 deaths a
year, more than breast cancer, AIDS or motor
vehicle accidents, according to the Institute of
Medicine of the National Academy of Sciences
EXTERNAL ENVIRONMENT SCAN:
8. Large numbers of immigrant women from
Mexico, Dominican Republic, and West Africa
have migrated from their home communities
and have developed homes in Queens,
Central & East Harlem and the South Bronx
EXTERNAL ENVIRONMENT SCAN:
9. ACS, NYC Department of Homeless Services,
and NYCDOH have begun to collaborate on
several projects to improve the care of pregnant
and parenting women throughout NYC
10. Former President Clinton joins fight against
childhood obesity by launching a public service
campaign and funding new program models that
show potential for reducing the problem
11. Merck Company Foundation has released a
call for proposals to develop a comprehensive
campaign against childhood asthma
EXTERNAL ENVIRONMENT SCAN:
12. Gov Pataki’s uncertainty about running for a
fourth term creates the conditions for a
Democratic Governor in Albany that could
support many of our MCH policy initiatives
13. On April 21, 2005, Mayor Bloomberg
announced the Healthy Women/Healthy Babies
Initiative to reduce unintended pregnancies.
Over 3 million dollars will be invested in
partnership with community-based and health
care organizations to increase awareness and
access to emergency contraception and family
planning and expand the Nurse Family
Partnership Program
EXTERNAL ENVIRONMENT SCAN:
14. Centers for Medicare & Medicaid Services
have been experimenting with pay-forperformance demonstration projects in 270
hospitals around the country concluding
financial incentives can improve care. Highperforming hospitals receive bonuses totaling
$7 million per year. Poorly performing hospitals
may face financial penalties in the third year
EXTERNAL ENVIRONMENT SCAN:
15. A coalition of politicians and health
providers over the last year have pushed for the
passage of Timothy’s Law that calls for the
expansion of mental health services. The law
would eliminate discriminatory and unequal
mental health and substance abuse coverage by
insurance companies. The NYS Assembly has
passed the legislation. More work has to be
done in the Senate to pass the bill
Threats:
1. MCH community has not made any strides in
reducing low birth weight rates in high-risk
communities
2. Congress and the NYS governor has attempted
to cut the Medicaid budget
3. NYC IMR rate increased from 6.0 to 6.5 between
2002 and 2003
4. NYC LBW rate remained constant between
2002 and 2003
Threats:
5. Depressed pregnant women throughout NYC
have to wait over six weeks for an appointment
with a therapist
6. Fort Greene, Jamaica East and Tremont have
the highest IMR in NYC in 2003
7. One in four New Yorkers do not exercise, one in
six is obese, and one in 13 has diabetes
8. Black and Latina women in NYC have a life
expectancy almost 5 years shorter than white
woman.
Threats:
9. Black and Latina women in NYC are more than
twice as likely as white women to die from
pregnancy-related complications
10. Data suggests that women are more obese
than men. An estimated 30% of black women,
26% of Latina women, 15% of white women and
10% of Asian women are obese.
11. Midwives and OB’s are unable to practice
due to increases in malpractice insurance that
is closing freestanding birthing centers
Threats:
12. NYS legislature has developed a commission
to examine the closing of hospitals throughout
NYS. Closing the wrong hospital could increase
barriers to care for poor and working women we
serve
13. The number of teens in foster care who
become pregnant is on the rise as well as the
quality of health and social services delivered to
teens in the foster care system is poor
(NYC Public Advocates Report May 2005)
Threats:
14. Reductions in affordable housing and the
development of a citywide gentrification
movement has forced poor and working class
women and their families to move from their
traditional neighborhoods to more affordable
communities in the South Bronx and Brownsville
that will become flashpoints for poverty and
family dislocation over the next five years
Threats:
15. African American women who report experienc
of discrimination based on their race
or skin color appear to have an increased risk of
poor pregnancy outcomes according Dr. Sarah
Mustillo, of Duke University School of Medicine,
Durham North Carolina. Black women are more
likely than white women to experience premature
delivery and to have low birth-weight babies, but
the discrepancy is not fully explained by factors
such as prenatal care, genetics and
socioeconomic factors. The study above reveals
evidence that chronic stress from racial
discrimination may play a role in poor birth
outcomes
Threats:
16. HIV infection and abusive relationships are
especially difficult for women based on the
finding of a new study showing increased risks
for depression and suicide attempts in women
afflicted with both of these problems according
to Andrea C. Gielen, deputy director of the
Center for Injury Research and Policy at Johns
Hopkins Bloomberg School of Public Health who
conducted the study and authored the report
Threats:
17. In 2003, more than 1 in 4 babies were born by
Cesarean section. The Cesarean section rate
of 26.1% is the highest ever reported in the
United States. The World Health Organization
states that the Cesarean rate should be no
more than 10-15%. Studies have indicated that
a woman is 4-7 times more likely to die as a
result of Cesarean surgery than vaginal birth.
Studies also show that babies born by
Cesarean surgery are 5 times more likely to be
admitted to an intermediate or intensive care
nursery. The increasing Cesarean section rate
is a major public health concern for maternal
and infant health
Threats:
18. Research conducted by clinicians from
Columbia University’s Mailman School of
Public Health and the Mount Sinai School of
Medicine found that pollutants in the air in
Upper Manhattan, the South Bronx and
neighborhoods surrounding the World Trade
Center area have been linked to lower birth
weight babies and smaller skulls in African
American babies. High rates of child asthma
have been found in these same communities
as well as an increased risk of cancer
Threats:
19. New Yorkers with diabetes are twice as likely
to experience depression, anxiety,
schizophrenia, and other disorders causing
serious psychological distress than those
without diabetes according to a NYCDOH/MH
study published late last year in the Center for
Disease Control’s Morbidity and Mortality
Weekly Report. The study also found that
individuals with co-occurring diabetes and
serious psychological distress are more likely
than those with diabetes only to experience
poor physical and mental health, live in
poverty, and lack access to health care and
social support. Diabetes is now the fourth
leading cause of death in New York City
INTERNAL MCH SYSTEM REVIEW:
STRENGTHS: PEOPLE-CULTURE-PROCESSSTRUCTURE
1. NYC has some of the best and largest health
care facilities in the world
2. NYC has 3 Healthy Start grantees, 9 lay model
home visiting programs, 3 nurse family
partnership programs and 5 CHWP operating
in NYC
3. Two years ago NYCDOH/MH built local public
health offices in Central Brooklyn, Central
Harlem and the South Bronx
STRENGTHS: PEOPLE-CULTURE-PROCESSSTRUCTURE
4. Through mandatory testing of newborns,
care management and counseling of highrisk mothers, the HIV mother-to-child
transmission rate has decreased from 10%
1993 to less than 2% in 2003. In NYC, 321
newborns were infected with H.I.V. in 1990,
the year the virus peaked among newborns
in the city. In 2003, five babies were born
with the virus
STRENGTHS: PEOPLE-CULTURE-PROCESSSTRUCTURE
5. More than half of the hospitals in NYS have
joined an effort to save 7,000 lives over the
next year or so by applying best practices to
improve quality of care (Daily News 5/16/05)
Healthcare Association of New York State
6. As the general population ages, more women
over 35 are deciding to have a child
STRENGTHS: PEOPLE-CULTURE-PROCESSSTRUCTURE
7. The Citywide Coalition to End Infant Morality has over
sixty community-based agencies delivering various
maternal and child health services throughout NYC. This
network of providers is maturing and delivering better
results
8. Across New York State the regionalization of perinatal
care has started. In NYC, the Citywide Regional Perinatal
Forum and local borough forums of hospitals and
community-based organizations have begun to
determine the MCH needs in their areas and develop
borough-specific action plans to address identified
needs.
9. The NYCDOH/MH has developed plans to screen
patients at all HHC hospitals for depression and make it
a routine part of primary care, much like a blood
pressure test or a cholesterol reading.
WEAKNESSES: PEOPLE-CULTURE-PROCESSSTRUCTURE
1. MCH care system fragmented
2. Uninsured population in downstate region
over 2 million
3. 40% of NYC hospitals are operating in the red
4. More New Yorkers die from medical mistakes
each year than from highway accidents, breast
cancer, or AIDS
WEAKNESSES: PEOPLE-CULTURE-PROCESSSTRUCTURE
5. Recently, Jacobi Hospital in the Bronx failed to tell
307 women that they had abnormal cancer-test
results. These women did not receive follow-up care
6. Racial disparities in care and outcomes is prevalent
even at some of the best medical centers
7. Constant movement from one provider to another
characterizes the patient base within the MCH
system in NYC where a woman might secure her
prenatal care at one facility and deliver at another.
Continuity of care suffers and patients move to the
providers that respect them and deliver quality care-
HAVE MEDICAID CARD WILL TRAVEL!
WEAKNESSES: PEOPLE-CULTURE-PROCESSSTRUCTURE
8. The maternal mental health provider network is weak
across NYC. There are not enough clinicians who are
trained to screen, diagnose or treat various perinatal
mood disorders
9. Nursing shortage in NYC can be described as a health
care state of emergency that has negative
consequences to patient safety, the quality of patient
care and morale issues among existing nursing staff
10. Medicaid poorly reimburses mental health providers
who manage the care of pregnant, emotionally
depressed women
WEAKNESSES: PEOPLE-CULTURE-PROCESSSTRUCTURE
11. The health and mental health care systems
are poorly integrated to meet the growing
needs of pregnant and parenting women
Perinatal Depression Campaign
Performance Objectives:
By December 31, 2006, FCN’s perinatal mood disorder
social marketing poster campaign will have motivated
at least 1,000 pregnant and parenting women to seek
mental health care in NYC and every year until 2009
By December 31, 2006, FCN’s maternal mental health
training program will have organized at least 50 grand
round trainings of doctors, nurses, midwives, and
social workers that will begin to standardize the
expectations of practice to screen, diagnose, and treat
various perinatal mood disorders
Perinatal Depression Campaign
Performance Objectives:
By December 31, 2007, FCN will develop a citywide
network of trained individual and group therapists
that are willing and have the skills to screen,
diagnose and treat various perinatal mood disorders
By December 31, 2006, a statewide movement to
address the funding, slot capacity, and practice
development issues regarding perinatal mood
disorders will be built mobilizing contacts
throughout NYC and upstate New York where the
Mayor of NYC and the Governor of New York State
will support new funding and systems change
proposals to strengthen the system of care to
address this problem
Perinatal Depression Campaign
Performance Objectives:
By May 31, 2009, two NYC schools of social
work, one medical school and one psychology
department will develop specialty programs to
produce students trained to appropriately screen,
diagnose and treat various perinatal mood
disorders.
Perinatal Depression Campaign Action Areas:
Legislative Actions:
1. Develop a brief narrative that summarizes the
clinical, waiting list/slot capacity, provider
training, and stigma-marketing issues related
to treating various perinatal mood disorders in
the down state region by 8/18/05. The narrative
should describe the problem and point to
solutions for each problem identified
2. Use the narrative to develop a legislative fact
sheet, legislative action letters and other
communication vehicles that will be used to
bring about reforms by 8/30/05
Perinatal Depression Campaign Action Areas:
3. Form Perinatal Depression Legislative Action
Team that is representative of all the networks,
Healthy Start and home visiting programs within
the downstate region that will be charged with
implementing this plan by 9/8/05
4. Action Team should study Timothy’s Law and
Assemblyman James Brennan’s proposed bill (A.
2016) that would force OMH to repeal the
regulation enforcing Medicaid Neutrality
Perinatal Depression Campaign Action Areas:
5. Begin setting up meetings in Albany with
targeted republican and democratic
legislators in the Senate and Assembly to
persuade them to support the above
legislation
6. Set up a meeting with the Commissioner of
State OMH to understand OMH’s position
on Timothy’s Law and Medicaid Neutrality
7. Contact Speaker Silver & Senator Bruno to
present our case concerning the perinatal
mood disorder problems and solutions and
win their support
Perinatal Depression Campaign Action Areas:
8. Set up meetings with Governor Pataki’s
health and social service representatives in
Albany, Ms. Renee Rider, Director of Human
Services Programs, State Capital, Room 253
and Mark Kissinger, Executive Chamber, State
Capital to make our case and position our
narrative as a campaign issue that the governor
must address. Show how the issue relates to
key constituencies that any republican
candidate for governor must develop an
informed response
Perinatal Depression Campaign Action Areas:
9. Meet with the democratic candidate for
governor, Attorney General Eliot Spitzer and
transform our case statement into a
campaign issue for him
10. Make contact with our friends at 1199
Hospital Worker’s Union and see if they can
transmit our legislative narrative into a print
and electronic media campaign during the
election period and right before the budget
debate begins in December 2005
Perinatal Depression Campaign Action Areas:
11. Begin letter writing and phone bank
activities to targeted legislators starting on
November 20, 2005
12. Action Team should have at least three
operatives completing media work (letters
to editor, story development, press
conference planning, phone follow up work
with health reporters, etc.) to achieve the
passage of the two laws
Perinatal Depression Campaign Action Areas:
13. Attend September 2005 APN meeting to
communicate FCN’s overall action plan and
secure commitments from the networks in
other parts of NYS to our political narrative
14. Set up a meeting with State Senator Jeff
Klein and his staff who sponsored
Timothy’s Law to target the coalition of
mental health parity activists who support
the legislation and join their movement
Perinatal Depression Campaign Action Areas:
15. Organize clergy across NYC and secure
their support for our PPD legislative
objectives by organizing “Clergy Day to
Treat Perinatal Mood Disorders.” Get
major clergy leaders and coalitions in NYC
to attend a press conference focused on
our core message/narrative
Perinatal Depression Campaign Action Areas:
Social Marketing Anti-Stigma Actions:
1. Work with NMPP and the NYCDOH/MH to review their
recent perinatal depression anti-stigma campaign and
obtain some of the unused proofs to develop a
citywide perinatal mood disorder poster campaign by
November 30th 2005
2. Secure NMPP’s Social Health Marketing Group to
retouch some of the photo’s, headlines and poster
copy to produce drafts for a FCN PPD citywide
campaign
3. Develop a mini proposal to the foundation community
to secure resources to mass produce the campaign
poster and secure 250,000 for citywide dissemination
Perinatal Depression Campaign Action Areas:
4. Develop radio and television public service
announcements and work to get them placed as
well as secure free time within mainstream, local
print and electronic media throughout NYC
5. Work the radio talk show circuit communicating
our core messages concerning the PPD problem
and fiscal, legislative and network development
solutions
Perinatal Depression Campaign Action Areas:
Provider Network Development Actions:
1. Study the network development work of MHRA, NMPP
and the Black Psychiatrists of Greater New York who
are developing a network of clinicians in Harlem who
treat maternal mental health problems
2. Each Citywide Coalition to End Infant Mortality
Borough Coordinating Body will take responsibility for
organizing maternal mental health networks throughout
their borough beginning on December 1, 2005
3. The FCN executive director will computerize each
borough network database and distribute the list to all
perinatal networks, community health worker
programs, Healthy Start sites, etc
Perinatal Depression Campaign Action Areas:
4. Borough networks should meet quarterly to determine
the need for maternal mental health services in the
area, the status of the service network (strengths &
weaknesses), network training needs and develop an
action plan for network development by January 30th
2006
5. Each borough network should develop clinical and
referral protocols and MOU’s to formalize network
communications and to ensure each patient obtains
the best level of care to meet her needs
6. Integrate grand rounds trainings with network
development activities to ensure that all clinicians
develop their knowledge base to screen, diagnose, and
treat various perinatal psychiatric disorders
Perinatal Depression Campaign Action Areas:
7. By May 20, 2006, each borough network will present
a status report at the FCN annual conference
Perinatal Depression Campaign Action Areas:
Workforce Training Actions:
1. Set up meetings with two medical school deans and
one school of social work dean to persuade the
decision makers to develop core curriculum and a
training practice area focused on producing students
with core skills to screen, diagnose and treating
perinatal mood disorders starting on January 22, 2006
2. Connect media, legislative and research work plan
activities to create the right conditions to positively
influence university leadership to adopt our workforce
training objectives
Perinatal Depression Campaign Action Areas:
3. Secure three of the top national maternal mental
health clinicians to practice in NYC and complete the
administrative and fund development tasks to create
a fellowship that will attract medical and psychiatry
students to enroll and graduate with special
knowledge of treating perinatal psychiatric disorders
4. Attend all of the schools of social work in NYC and
Long Island to educate their deans and curriculum
committee chairs about the need to train and deploy
more social workers who have special skills
screening for, diagnosing and treating perinatal mood
disorders
Perinatal Depression Campaign Action Areas:
5. Develop concept paper on Centers of
Excellence on Maternal Mental Health and
develop a funding proposal that one or two of the
universities would manage to make New York City
or New York State the national intellectual center
for policy, research and practice for treating
various perinatal mood disorders
Perinatal Depression Campaign Action Areas:
Organization Mobilization Actions:
To achieve the objectives and tasks outlined above, FCN
must partner with the following entities and persuade
them to join our campaign:
MHRA, Black Psychiatrists of Greater New York and
Associates (BPGNY), New York City Home Visiting
Council, COFFCA, New York State Mental Health
Association, Mailman School of Public Health, APN, New
York State March of Dimes, New York State Perinatal
Association, National Association of Social Workers,
National Association of Black Social Workers, New York
State Midwife Association, New York State Nurses
Association, NYC Health & Hospitals Corporation,
Perinatal Depression Campaign Action Areas:
Organization Mobilization Actions:
1199 Hospital Workers Union, Greater New York
Hospital Association, NYSDOH Bureau of Women’s
Health, New York State Office of Mental Health, New
York State Psychiatric Institute, ACOG, New York
State Nurses Association, PCAP Coordinators
Network, HRSA/MCHB
Perinatal Depression Campaign Action Areas:
Research Action Steps:
1. Continue to submit proposals to NIH, CDC and the
National Institute of Mental Health for specific grants
that focus on women’s mental health in pregnancy and
the postpartum period. Current NIMH funding round
closes on May 6, 2006.
2. In February 2003, S450 and HR846 were introduced in
the 108th Congress. The bills call for the Secretary of
Health and Human Services, working through the
Director of NIMH, to provide for basic, epidemiological,
diagnostic, clinical, and intervention research on
postpartum depression and psychosis. All FCN
networks and research institutions should take
advantage of the above funding streams to advance
the theory and practice of treating perinatal mood
disorders today!
Perinatal Depression Campaign Action Areas:
3. Support and disseminate MHRA’s research to
develop a new screening tool called the MIC
Behavioral Risk Factor (BRF) Screen. Currently,
they are testing the instrument at all of their MIC
sites and will release an updated scale by
September 2005.
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
By June 30th, 2006, a social marketing poster and
radio campaign will have been developed and rolled
out throughout NYC promoting family exercise,
proper nutrition, the development of more fresh fruit
& vegetables coops entitled Healthy Communities,
Healthy Families/Healthy Women’s Movement
By June 30th, 2007, an active research and practice
movement will have been built to understand the
relationship between various chronic diseases
(asthma, obesity, diabetes, depression, high blood
pressure) and maternal, child and family health
outcomes.
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
By June 30th, 2008, the FCN working with its citywide
partners will help to strengthen and rebuild an effective
women’s and family health movement across NYC
where NYCDOH/MH Vital Statistics will document 9%
declines in health indicators in the areas of maternal
and child obesity, diabetes, asthma, maternal
depression and high blood pressure
By June 30th, 2009, a women & family move your body
movement will have been built throughout NYC where
families will have access and use community exercise,
Weight Watchers, meditation, aerobics facilities to
combat and manage various chronic diseases
associated with poor health outcomes.
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
Legislative Actions:
1. FCN activists will begin to work with the City Council,
the Mayor’s Office and the Commissioner for the
NYCHA to obtain authority to utilize the community
rooms of housing authority sites for exercise, Weight
Watcher sessions, and dance classes throughout NYC
2. The Citywide Coalition to End Infant Mortality will
educate the City Council and the Mayor’s Office and
secure 10 million dollars that will cover the costs of the
chronic disease and birth outcome focus to FCN’s
work. This work hypothesizes to reduce the low birth
weight rate in high-risk NYC communities by 2% by
2009 can be achieved by reducing prevalence of
various chronic diseases women of child bearing age
possess by 9% before, during and after the pregnancy
period.
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
Social Marketing Actions:
1. The FCN executive director and board leadership will
secure resources and hire a consultant to conduct
focus groups to determine the content and means of
delivering specific health messages that promotes
women’s and family healthy behaviors throughout
NYC starting on September 1, 2005
2. The final copy of the focus group report and draft
proofs of the radio and poster campaign will be
presented before the FCN board for review and
approval by January 1, 2006
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
3. The FCN executive director will secure resources from
the private sector or government sector to produce
300,000 posters and purchase over $150,000 in
targeted radio time to roll out the campaign in
communities where chronic diseases flourish by April
1, 2006
4. FCN board and executive leadership will secure public
service time at targeted radio and television stations
and tour the talk show circuit promoting the Healthy
Communities, Healthy Families Healthy Women
campaign to NYC audiences beginning on June 1, 2006
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
Provider Network Development Actions:
1. FCN leadership will meet with the directors of the NYCbased Healthy Start, CHWP, Home Visiting and Nurse
Family Partnership programs to discuss their training
needs concerning managing various chronic diseases
and their relationship to infant mortality and low birth
weight reductions starting on August 8, 2005
2. FCN leadership will meet with the DOHMH and HHC
Chronic Disease Collaborative to obtain assistance to
develop a case management and health education
MCH protocol that will be implemented by the MCH
program staff outlined above to better manage chronic
diseases before, during and after the pregnancy
period. The meeting will take place by September 28,
2005
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
Provider Network Development Actions:
3. A special case management and health education
protocol will be developed to manage the relationship
between maternal diabetes/obesity and maternal
depression based on the November 2004 study
findings by the NYCDOH/MH that revealed a causal
relationship. This protocol will be developed by
December 1, 2005
4. NMPP will work with Weight Watchers of America staff
to expand the number of Weight Watcher sites from
Harlem to sites in the other boroughs in poor and
working class communities throughout NYC starting
November 2005 and ending by June 30th, 2006
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
Workforce Training Actions:
1. FCN leadership will meet with the directors of the NYCbased Healthy Start, CHWP, Home Visiting and Nurse
Family Partnership programs to discuss their training
needs concerning managing various chronic diseases
and their relationship to infant mortality and low birth
weight reductions starting on August 8, 2005
2. Once the Chronic Disease/Birth Outcome Network is
developed focused training sessions will begin starting
on October 1, 2005 on diabetes, asthma, depression,
high blood pressure and obesity at MCH training sites
across NYC
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
Workforce Training Actions:
3. By December 12, 2005, Dr. Lu’s presentation on
Internatal Care will be transformed into a case
management and health education program model to
deliver women’s health services beyond the pregnancy
period. Healthy Start and Home Visiting contractors
should use the base proposal to secure funding from
local, state and federal funding streams to build the
infrastructure for this type of care over the next five
years throughout NYC
Chronic Disease/Birth Outcome Campaign
Performance Objectives:
Workforce Training Actions:
4. Program directors and supervisors should monitor the
results of the above training to ascertain if practice and
knowledge saturation has been achieved by line and
supervisory staff. Administrative staff should complete
six-month chart reviews and administer maternal
satisfaction surveys to monitor results of new learning
on patient care
Mobilization Actions
To achieve the objectives and tasks outlined above, FCN need to
partner with the following entities and persuade them to join our
campaign:
American Diabetes Associations, Weight Watchers of
America, MHRA, Black Psychiatrists of Greater New York
and Associates (BPGNY), New York City Home Visiting
Council, COFFCA, New York State Mental Health
Association, Mailman School of Public Health, APN, New
York State March of Dimes, New York State Perinatal
Association, National Association of Social Workers,
National Association of Black Social Workers, New York
State Midwife Association, New York State Nurses
Association, NYC Health & Hospitals Corporation, 1199
Hospital Workers Union, Greater New York Hospital
Association, NYSDOH Bureau of Women’s Health, New
York State Office of Mental Health, New York State
Psychiatric Institute, ACOG, New York State Nurses
Research Action Steps:
1. NMPP has collaborated and submitted at least seven
proposals with academic community partners over the
last three months to reduce the incidence of adult and
childhood obesity and managing diabetes (Type 1 &
Type 2) among community residents in Harlem. Most
of these projects were submitted to CDC and NIH.
When or if these projects are funded, they will add to
the body of knowledge exploring the relationship
between chronic disease management before, during
and after the pregnancy period relationship to
improving maternal and child health outcomes
Research Action Steps:
2. Citywide Coalition to End Infant Mortality borough
coordinating bodies starting on August 1, 2005, will
begin to reach out to their university partners to
conduct applied public health research to develop best
practice models to combat obesity, high blood
pressure, asthma, diabetes and depression
3. The results of the above citywide research efforts will
be used to upgrade the knowledge possessed by
collaborative members who will utilize new knowledge
to improve practice
Planning/Action Summary:
This plan is now in your hands colleagues. If we
implement the tasks as planned, the MCH industry
throughout New York State will strengthen its
infrastructure and new knowledge and practice will be
created that could improve birth outcomes and the health
of mothers.
By no means are we communicating that the road ahead
will be easy. However, if we stay committed to confronting
and transforming the reality that is right before us, we will
be able to overcome the obstacles that could block the
achievement of our performance objectives.
Planning/Action Summary:
This plan cannot be achieved by just deploying downstate
resources. We will need to mobilize statewide resources
and organizations to help institutionalize our advocacy
agenda, research and practice findings as permanent
components of the MCH system of care throughout New
York State.
This plan is FCN’s best effort to predict industry change
within the maternal and child health business. However,
it is not enough to see what might be happening next, we
must dedicate ourselves to executing the actions steps
above to be better positioned to survive and thrive in the
new industry climate defined above.