UNC Center for Maternal and Infant Health Presentation to the Dean of the School of Medicine August 2, 2007 Sarah Verbiest, MSW, MPH, DrPH(C), Executive Director John Cotton, MD, Co-Director, Pediatrics Kathryn Menard MD, MPH, Co-Director, Obstetrics

What We Do Clinical Service Health Services Research Statewide Programs & Policies

Perinatal Care Coordination Fetal anomalies & complex infants Perinatal multidisciplinary care conference Treatment plan, coordination with specialists, local providers, and community resources Education, counseling, support Center has over 7 years experience providing complex prenatal & pediatric care management. The Center has served over 4,000 mothers, babies and families.

Maternal Transport Includes resident education and community provider communication Special Infant Care Clinic Fosters coordination among over a dozen subspecialties and community pediatricians Perinatal Hospice Patient Education Services Committee Postpartum Care Clinic Special Services

Infant Patients Served By County complex infants (followed for a year, up 33%) 352 high-risk infants/toddlers

Prenatal & Transport Patients Served By County prenatal patients with fetal anomalies 317 maternal transports 300 community providers (includes pediatricians)

Clinical Service and Research: Health Informatics Manage perinatal database Monthly QI reports to hospital NICU Annual Report OB Monthly Report 64 data requests for research Other database management Pericare, Genetics Newborn Screening Webmaster for 17P order forms and DVD Hospital Locator Algorithms National Preconception Curriculum NICU Family Board

Health Outcomes Research: Postpartum Prevention Plus Program Reduce the risk of recurring poor birth outcomes by improving the health of high-risk mothers. Mothers of NCCC infants and mothers who had a fetal or infant demise Funded by the March of Dimes and the Dean’s Investments for the Future Fund

Research Dissemination: Reducing Recurring Preterm Birth Advisory Committee Coordinated distribution to 240 women at 30 clinics by 78 providers across NC in 5 months Secured Medicaid Reimbursement Education to providers statewide Patient & Provider Materials

Key = Physicians who prescribed 17P = Women who have received 17P = Videoconference Sites February-June 2007 Research Dissemination: 17P Impact

Presentations & Publications National Perinatal Social Work Conference UNC Perinatal Hospice: A Pathway to Integrated Care (Welborn, Rentrope, Crenshaw) National Summit on Preconception Health The Postpartum Plus Prevention Program: Interconception Care for Mothers of Preemies: A Preliminary Report (poster – Shores, Verbiest, Menard, Brown) Taking Action in North Carolina: the Development of a Statewide Preconception Health Plan (Brown, Mullenix, Verbiest, Long-Valentine) The Postpartum Visit: A Missed Opportunity for Preconception Care (Verbiest) The Policy & Finance of Preconception Care: Commercial and Public Payers Reimbursement Patterns at UNC (Menard, Felton, Boggess, Verbiest) American Public Health Association and NC/SC Perinatal Association Reducing the Risk of Recurring Preterm Birth: The North Carolina 17P Project (Verbiest, Menard, Holliday) Baby Love Conference: Helping Families Copes with Birth Defects – from Prenatal Diagnosis to the First Birthday (Welborn) NACCHO National Webcast: Preconception Health and Healthcare – Highlights from North Carolina (Verbiest) September 2007 NC Medical Journal Community Health Educators’ Roles in Improving Patient Education (Auger,Verbiest) Looking Back, Moving Forward: North Carolina’s Path to Healthier Women and Babies (Verbiest)

Programs and Policy: Preconception Health Promotion National CDC Committee NC Action Plan Planning Major Request to Launch a Statewide Campaign SCHIP expansion to high risk moms for one year postpartum GDM PP Management

NC Health Policy Leadership NC Institute of Medicine – Steering Committee for the Health Literacy Task Force NC Perinatal Association – Board Member Statewide Communications/Website Child Fatality Task Force – Leadership Team Perinatal Health Committee SIDS/Safe Sleep Subcommittee Breastfeeding Policy Workgroup

Programs and Policy: Leaders in Quality Coordinated North Carolina MFM Network Meeting – May 2007 Develop a clinical, public health, research and policy agenda, strengthen ties among MFM specialists in NC, and foster a greater spirit of collaboration and advocacy MFM Network Communication Partnership with the California Maternal Quality Care Collaborative Participated in Perinatal Quality Collaborative Planning Efforts