West Virginia Perinatal Partnership 2011 Work Plan Brenda Dawley, MD, Chair, Central Advisory Council

Major Legislative Accomplishments Over 180 lactation professionals trained – Newborn testing expanded to 29 metabolic conditions Maternal Mortality Review Legislation – 2008 Uniform Maternal Risk Assessment HCR Teen Pregnancy study – 2009 HCR 104 & 105-insurance coverage 2009 Infant Mortality Review Legislation– 2011 Sustaining funding for Partnership

Improving the Statewide Perinatal System Guidelines for OB & newborn practices One Call system Connect to Care Hospital Self Assessment Joint – MU & SU CNM Program Perinatal Outreach Education Supporting Breastfeeding Alliance

Identified Costly Medical Procedures Associated with Poor Birth Outcomes High risk newborns transported out of state- lack of NICU beds OB QI – 15 hospitals, reduced elective deliveries <39 weeks by 50% Cord Tissue Study – 8 hospitals participated – 19 % + cords Policy recommendation for Medicaid to extend FP to 24 months post partum. (saving 31.3 M in 5 yrs.)

Guidelines Issued Issued medical guidelines and legal research reports re: drugs in pregnancy, Promoted neonatal tool kit VBAC Guidelines

Unplanned Pregnancy Committee Co-Chairs Denise Smith, MS, CHES; Brenda Dawley, MD; Staff Cinny Kittle, MS; Joyce W. Daniels, MA Legislative initiatives Waiting 24 months Community College project Medicaid extension to 24 mo after birth

Drug Use During Pregnancy Chair: Stefan Maxwell, MD Staff: Janine Breyel Sandy Young, DNP, Amy Tolliver, MS 1. Collaboration between Behavioral Health and Maternity Care providers - WV|SBIRT 2. Outreach Education 3. Newborn Tool Kit 4. Research/Data Collection 5. Collaborative Pilot Projects Proposal

Maternity Provider Shortage Areas Chair: Coy Flowers, MD. Co-Charir: Angelita Nixon, CNM Staff: Ann Dacey, RN - Identify shortage areas - Support MU-SU CNM Program - Help SU develop the Emergency Childbirth Education program - Identify maternity providers

Transport System Chair : Luis Bracero, MD Staff: Ann Dacey, RN Work with STEMS at WV Bureau for PH to set up one call system. Work with hospitals to assure system operates as needed. Evaluate one call system.

Connect To Care PI: Luis Bracero, MD, MFM Staff: Ann Dacey, RN Robin Rector Doug Young - Visit hospital and clinic sites - Work with CAMC Partners on roll out installation, education and training needs. - With CAMC, seek additional funds for further expansion

Hospital Self Assessment Staff: Ann Dacey Schedule and conduct self assessment hospital visits Secure assessment teams Provide hospitals with evidence of completion Post hospitals on web site Work to encourage hospital participation Establish 3-5 year process for reviews

Infant Mortality Review Champions: Joe Werthammer, MD,FAAC and Jay Bringman, MD, MFM Staff: Nancy Tolliver Infant Mortality Review legislation – 2011 Marie Frazier, MD of Marshall

OB QI First Time Mothers Initiative Champions: Luis Bracero, MD, MFM David Jude, MD Jay Bringman, MD, MFM Staff: Nancy Tolliver Joyce Daniels Amy Wenmoth Reduce high section rates for first time mothers.

Perinatal Outreach Education Staff: Shauna Popson, RN, EdD Limiting elective labor inductions to 39 weeks Focus on Late Preterm infant - Early inductions Smoke Cessation in pregnancy and beyond Postpartum hemorrhage Metabolic syndrome and diabetes in pregnancy Breastfeeding education for health providers Preeclampsia Substance abuse in pregnant women Neonatal abstinence syndrome

Support WV Breastfeeding Alliance Staff: Cinny Kittle Yvonne Snyder Stephanie Whitney Christine Compton Jan Wilkes Jane Barber Offer professional lactation education Work with businesses to establish friendly workplace

VBAC Chair: Brenda Dawley, MD, OB-GYN Staff: Nancy Tolliver, RN, MSIR To develop guidelines reflecting ACOG & AMA To respond to request of WV women To improve options for women requesting TOLAC

Thank You! Work with us 2011