Presentation on theme: "What’s Best for the Public Health of Montanans? An ethics-based framework for reconsidering Montana’s maternal child health home visiting program selection."— Presentation transcript:
What’s Best for the Public Health of Montanans? An ethics-based framework for reconsidering Montana’s maternal child health home visiting program selection and award process
“This initiative will give children a healthier start…” US Health Secretary Sebelius ACA provides $1.5 billion to states for home visiting services to maternal, infant, and child population.
Deep, Unique Roots
Watershed Moment in MCH Policy and Funding
Partners in a Good Trend
I. Who is at Risk?
II. Are Programs Effective?
III. Best Value for Public Funds? Every low birthweight baby or preterm birth costs states bewtween $28,000 and $40,000 in medical care costs % of births will be premature and will account for 50% of Medicaid funds spent in infants
IV. Burdens on Citizens? Voluntary, but we must guard against stigma of targeting high risk folks. To the contrary, we can prevent and relieve health burdens suffered by vulnerable women, infants, and children. Save tax dollars for health care and social welfare costs.
Evidence of Program Effectiveness 79% reduction in abuse and neglect 35% less ER use Higher vocabulary skills at age 6 Higher reading and math skills at age 9 20% reduction in welfare use
V. Is the Outcome Fair? Serve as many citizens as possible. Use the funds as intended and allocate it expediently. Allow for a variety of approaches. Involvement of local programs and citizens must be obtained.
“an unprecedented opportunity”
Public Accountability What do we tell our citizens? What do we tell our legislators? What do we tell ourselves?
References Principles of the Ethical Practice of Public Health Cook and Hoas, Ethical Decisionmaking Process Montana DPHHS Final MIECHV Plan Pew Charitable Trust, Issue Brief, May 2010 Nurse Family Partnership (www.nursefamilypartnership.org) Olds, David, “Effects of Nurse Home Visiting on Maternal and Child Funcioning: Age-4 Follow-up of a Randomized Trial” Pediatrics (onl ine at Gostin, Lawrence O., ed., Public Health Law & Ethics, Regents of the University of California, 2010