PUBLIC HEALTH UPDATE

BY LORY MERCER BSN, RN, PHN, MCAH PROGRAMS MANAGER AND MARIYA RABOVSKY-HERRERA BSN, RN, PHN, MCAH COORDINATOR

Fredrick Douglas said, “It is easier to build strong children than to repair broken men”. The greatest opportunity to protect and improve the health of our communities begins in pregnancy and infancy. Public Health Services’ MCAH programs support families in raising strong and healthy children, through both direct services and systems-level interventions. As a physician, you may have often felt that your pregnant or parenting patients need extra help, additional education, or case management that you wish you had the time or the resources to address. MCAH is here to help fill in those gaps and provide those resources to your patients as well as provide comfort to you knowing that follow up will be offered to them.

Most MCAH services are provided in the home. This creates a different power dynamic than clinic-based services. MCAH staff develop long-term trusting relationships with the whole household - the foundation upon which to motivate meaningful behavior change. Due to COVID-19, MCAH also offers video or telephone appointments in lieu of, or in addition to, in-person home visits.

All services are always free of charge to the patient. Referrals are very welcome! If any of the programs listed below would be of interest to you and your patients, please call the MCAH program at 209.468.3004 or by email at mcah-info@sjcphs. org. In return, you will receive a “universal” referral form to complete. Once received, MCAH staff will contact your families directly with the program(s) that best fits their needs.

• Nurse Home Visiting: Public Health Nurses (PHNs) visit medically high-risk mothers, infants, and children. Our nurses are prepared to answer questions, submit referrals and come to visits with equipment to weigh and measure infants and take maternal blood pressures. Home visits with the PHN are approximately every 4 weeks. Eligibility: Anyone who is pregnant, any parent/caregiver of a baby under 1 year old, or a parent/caregiver of a child up to 5 years old with special healthcare needs (any child with medical or developmental needs requiring services beyond that of typical children).

• Healthy Families San Joaquin: With over 500 sites in the U.S, the Healthy Families America (HFA) model focuses on strengthening parentchild relationships and interactions and is most beneficial for families with social risk factors or child welfare involvement. Home visits with a Family

Support Specialist begin weekly, and then decrease in frequency. This is an evidence-based program; 19 publications of randomized controlled trials found

drastic reductions in preterm birth rates, incidence of child abuse/neglect, family violence and crime, and found strong increases in child health, maternal health, economic self-sufficiency, and school readiness among families who participated in an HFA program versus those who did not. Eligibility: Anyone who is pregnant or has a newborn less than 2 weeks old.

• Black Infant Health: This program addresses racial disparities in birth outcomes by empowering and supporting African American women to have healthy pregnancies and healthy babies. There are 10 prenatal and 10 postpartum group sessions in a culturally affirming setting. Women also have individual appointments with a nurse, a mental health professional, and a family health advocate. Group sessions explore pregnancy and parenting topics, as well as African American history, coping with experiencing bias or racism, and self-advocacy and empowerment. Women identify personal strengths and develop life goals. Eligibility: Black or African

American women ages 16 or older, who are pregnant or have given birth in the last 6 months. Ideally, women enroll early in pregnancy in order to receive the full scope of the program.

• Safe Sleep San Joaquin: SIDS and sleep-related deaths continue to be a leading cause of infant deaths.

Families who do not have a safe sleep environment for their infant can receive a free portable crib after receiving safe sleep education from MCAH staff. Eligibility: Must be pregnant or have a baby less than 6 months old.

• Perinatal Equity Initiative: MCAH is funding four community agencies to carry out evidence-based curricula that improve Black and African American birth outcomes. A fatherhood initiative called “Passport to

Fatherhood” is offered by Mary Magdalene Community

Services. They serve men of any race whose partner is an African American woman, pregnant or less than 3 months postpartum. Another three community-based organizations: Delta Health Care, California Health Collaborative, and Amelia Ann Adams Whole Life Center, are offering individualized one-on-one support through the “Sista Coach” program for women who are pregnant or less than 3 months postpartum. These agencies report effectiveness of their services back to PHS using Results Based Accountability, and also receive technical assistance from our Public Health staff.

• SIDS Program: Per state law, local health departments are notified of every sudden unexpected infant death. A

Public Health Nurse reaches out to the family in order to provide bereavement support, resources, referrals, and assistance the family may need. The nurse sends a report on each death to the state SIDS program, so that commonalities and contributing factors can be studied and understood. Referrals for bereavement support are also accepted for pregnancy loss or any infant death.

(CPSP): You may already be participating in CPSP – a program for OB providers to receive increased reimbursement for pregnant patients with Medi-Cal. Our

Public Health CPSP Coordinator provides technical assistance to clinics regarding the CPSP program implementation, as well as resources and learning opportunities for OB providers and their clinic staff. If you are a CPSP provider, or considering becoming one, please connect with us so we may assist you!

Ensuring that all babies survive and thrive is an issue too multidimensional for responsibility to rest in any one place. We hope that you reach out to us to collaborate, refer, and partner on improving the health of our community.

Again, to reach us, call 209.468.3004 or email us at mcah-info@sjcphs.orgLory Mercer, the MCAH Program Manager, can be reached at 209.468.8408 or lmercer@sjcphs.org