1. Building State and Local Partnerships to Promote Preconception Health: The Florida Experience Carol Brady, Executive Director, Northeast Florida Healthy Start Coalition, Inc. EveryWoman SE Webinar November 4, 2010

2. Background & Overview MCH in Florida: Key Stakeholders State & Local Collaborations in preconception health (PCH) –Perinatal Periods of Risk (PPOR) Practice Collaborative –Preconception Care (PCC) Community Initiatives (Title V) –VitaGrant Initiative –Black Infant Health Practice Initiative –Interconception Care (ICC) Pilots (MOD) Lessons Learned

3. MCH in Florida State Healthy Start legislation –Created and funded 30 community-based non-profits focused on reducing infant mortality, promoting healthy child development State agency leadership –Title V willing to “think outside box” Strong March of Dimes –History of collaboration (state DOH, local MCH agencies) –Visionary

4. MCH in Florida Stakeholders: offer different strengths, resources, organizational structures, capacity Allowed Florida to create, take advantage of opportunities in PCC Highlight five examples of state-local partnerships

5. PPOR Practice Collaborative Recognition of need to move before and beyond pregnancy (2002) Opportunity to “build a case” using Perinatal Periods of Risk (PPOR) Proposal submitted to MOD to replicate national practice collaborative (CityMatCH) with coalitions and local health departments in seven largest counties

6. PPOR Practice Collaborative Teams met quarterly to analyze data, translate data into practice DOH provided TA, along with other experts Resulted in expansion of HS services to include interconception education and support, in addition to “traditional” case services during pregnancy Link between PCC and disparities Incorporated into state plan (Title V)

7. PCC Community Initiatives $3 million in “extra” Title V funding authorized in 2006 DOH allocated funding to Healthy Start Coalitions (HSC) to develop and implement new CDC recommendations on PCC Focus: community outreach & education, provider education & direct services Streamlined RFP & funding process

8. PCC Community Initiatives Community Outreach  Movie theatre ads: raising awareness among young women  Faith-based partnerships  Collaborations (STEPS, Federal Qualified Health Centers (FQHC), Closing the Gap Grants, Zero Exposure, WIC)

9. PCC Community Initiatives Provider Education  Conferences, workshops, train-the- trainer  Web sites  Info sheets, brochures

10. PCC Community Initiatives Direct Services  Dental care to address periodontal infections: women identified in primary care, family planning clinics  Weight management, nutrition counseling to address obesity  Training, screening, education in private MD offices

11. 2006 – 2008 VitaGrant Initiative MOD funded and partnered with the Department of Health –Provided and distributed educational materials and multivitamins with folic acid to women of childbearing age statewide –Paid for staff outposted in state DOH –Knowledge increased from 3 – 92%; multivitamin consumption increased from 6 percent to 88%

12. Black Infant Health Practice Initiative Advocacy efforts (disparities) resulted in $1 million appropriation for BIHPI (Federal HS) Implemented through DOH in eight counties with largest disparities in birth outcomes (urban, rural) in 2008-09 Teams included state, federal HS, DOH and community representatives Strategies: PPOR, FIMR and community engagement

13. Black Infant Health Practice Initiative Results underscored importance of preconception health on disparities Aligned efforts in communities with state & federal Healthy Start initiatives Strengthened advocacy around preconception health Increased community awareness, engagement around issue

14. ICC Pilots MOD initiated “focused” funding in 2009 Three community-based pilot projects currently funded to develop ICC model for mothers who have had a baby hospitalized in NICU Multi-site evaluation Potential for sustainability through HS

15. Lessons Learned State, local partnerships are more powerful than “top down” or “bottom up” alone. Alliances between public, private and voluntary sectors provide the flexibility required for innovation. Collaborative state, local initiatives can stretch limited resources. Different perspectives – one goal

16. Resources EveryWoman Florida http://everywomanfl.com Preconception Health Indicator Report http://everywomanfl.com/Pages/Healthcare_Providers/Pr econception_Health_Indicator_Report.aspx HS Standards & Guidelines – Chapter 21 ICC Education & Counseling http://www.doh.state.fl.us/family/mch/hs/hstraining/hstrain ing.html