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 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 Community HealthNet Steering Committee Social Marketing Access Committee System Evaluation Tulsa Hispanic Resource Association

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

6. Outcomes and Process Objectives Reduce fetal and infant mortality Reduce low birth weight and very low birth weight infants Reduce prematurity 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

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) 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) 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. Tulsa’s Perinatal System Capacity Social Marketing Client Outreach Case Finding Free Pregnancy Testing Planline/Family Planning Babyline/Risk Assessment/Case Management Referral CHC IHCRCMortonOSU OB/GYN OU Family Med PPTHD High Risk Care Low and Moderate Risk Care Morton Private Doctors OSU OU OB/GYN Deliveries OSU Med Ctnr SouthcrestHillcrest Postpartum & Family Planning CHCMortonIHCRCOSU OU Family Med PPTHD

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

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

16. Risk Factors for Infants

18. Births to Teens

19. Risk Factors for Infants

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