Meeting Packet - Professions & Public Health Subcommittee, House of Representatives (September 21, 2021)
Summary
A meeting packet for the Professions & Public Health Subcommittee of the House of Representatives, Chair Will Robinson, for Tuesday, September 21, 2021, 2:45 PM to 4:00 PM at Webster Hall. After the meeting notice for a workshop on Florida Infant Mortality, the packet contains a biography of Shay Chapman of the Florida Department of Health and Department of Health slides by Shay Chapman on infant mortality rates, objectives, and leading causes of infant mortality in Florida for 2017-2019. It ends with slides from the Florida Association of Healthy Start Coalitions, Inc., naming Cathy Timuta, Chief Executive Officer, and Jane Murphy, Executive Director, that list possible strategies and solutions such as Interconception Care, Doula Services, and Safe Sleep Campaigns.
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“Meeting Packet - Professions & Public Health Subcommittee, House of Representatives (September 21, 2021).”
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Professions and Public Health
Subcommittee
Tuesday, September 21, 2021
2:45 PM – 4:00 PM
Webster Hall (212 Knott)
Meeting Packet
Chris Sprowls Will Robinson
Speaker Chair
Committee Meeting Notice
HOUSE OF REPRESENTATIVES
Professions & Public Health Subcommittee
Start Date and Time: Tuesday, September 21, 2021 02:45 pm
End Date and Time: Tuesday, September 21, 2021 04:00 pm
Location: Webster Hall (212 Knott)
Duration: 1.25 hrs
Workshop on the following:
Florida Infant Mortality
- Shay Chapman, BSN, MBA, Deputy Division Director, Community Health Promotion, Florida Department of
Health
- Cathy Timuta, Chief Executive Officer, Florida Association of Healthy Start Coalitions, Inc.
This meeting will be live-streamed on https://thefloridachannel.org/. Persons wishing to appear in person
to provide testimony are encouraged to complete an electronic appearance record at
www.myfloridahouse.gov. Electronic submissions will be available up to one hour before the meeting starts;
after that time, please fill out an appearance form at the meeting. Seating is limited and will be available on
a first-come, first-served basis.
NOTICE FINALIZED on 09/14/2021 4:02PM by Osborne.Erin
09/14/2021 04:02:11PM Leagis ® Page 1 of 1
DOH
Shay Chapman
Shay Chapman serves as the Deputy Division Director for Community Health Promotion at the
Florida Department of Health. She has been with the Department since 2003 and has served in
many roles, including most recently as the Bureau Chief for Family Health Services. Shay
received a Bachelor of Science in Nursing from Florida State University in 2000, and a Master of
Business Administration with an emphasis on Healthcare Management in 2003. She is currently
the Title V Maternal Child Health Director for the State of Florida and the co-chair for the
Pregnancy-Associated Mortality Review.
Department of Health
DIVISION OF COMMUNITY HEALTH PROMOTION
Florida Infant Mortality Rates
September 21, 2021
Shay Chapman, BSN, MBA
Deputy Division Director, Community Health Promotion
Objectives
Provide infant mortality rates and trends
Examine leading causes of infant mortality
2
2020 Florida Infant Mortality Rate
(Infant deaths per 1,000 live births)
The overall infant mortality rate in Florida is 6 deaths per 1,000 live births
Among non-Hispanic Whites, the infant mortality rate is 4 deaths per 1,000 live births
Among Hispanics, the infant mortality rate is 5 deaths per 1,000 live births
Among non-Hispanic Blacks, the infant mortality rate is 10 deaths per 1,000 live births
3
Infant Mortality Rates,
Florida and U.S. 2011‒2020
12.0
10.0
Rate per 1,000 Live Births
8.0
6.4
5.8
6.0
6.1
5.6
4.0
2.0
0.0
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Florida United States
4
Infant Mortality Rates by Race/
Ethnicity, Florida 2011–2020
12.0
11.6
10.4
10.0
Rate per 1,000 Live Births
8.0
6.4
6.0 5.8
5.2
4.5 4.7
4.0 4.0
2.0
---- National HP2030 Target = 5.0
0.0
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
All Races NH White NH Black Hispanic
Abbreviation: NH = Non-Hispanic
5
Infant Mortality Rates by County,
Florida 2017–2019
6
Leading Causes of Infant Mortality,
Florida 2017–2019
Congenital Malformations, Deformations, and Chromosomal Abnormalities 1.1
Disorders Related to Short Gestation and Low Birth Weight 0.9
Rate per 1,000 Live Births
Unintentional Injuries 0.5
Newborn Affected by Maternal Complications of Pregnancy 0.4
Newborn Affected by Complications of Placenta, Cord, and Membranes 0.3
Sudden Infant Death Syndrome 0.3
0 0.2 0.4 0.6 0.8 1 1.2
7
Thank you!
Shay Chapman, BSN, MBA
Shay.Chapman@flhealth.gov
8
Florida Healthy Start
Cathy Timuta, MBA
Cathy Timuta is the Chief Executive Officer for the Florida Association of
Healthy Start Coalitions (FAHSC) and the Healthy Start MomCare Network,
Inc. which is the administrative services organization for FAHSC. She has
been in these roles since October 2018. Prior to working at the state level,
Cathy was the Executive Director for the Healthy Start Coalition of
Southwest Florida for 19 years. She was a former Board President for
FAHSC as well as former co-chairs for several committees including
Legislative, Data, Contracts, and Managed Care Organizations committees.
Cathy started her career in Minnesota where she received her MBA in
health care administration. She was the Project Manager for the Minnesota
Health Partnership, which was a collaboration of the state of Minnesota, the
Buyer’s Healthcare Action Group (Minnesota’s largest employers), hospital
systems, and health plans. Her passion is to ensure that families have
access to needed healthcare and services to empower parents to give their
every baby a healthy start in life.
HEALTHY START SERVICES
PREVENTING INFANT MORTALITY
Cathy Timuta
Chief Executive Officer, Florida Association of Healthy Start Coalitions
Jane Murphy
Executive Director, Healthy Start Coalition of Hillsborough County
Florida
Health Start
Florida Association of Healthy Start Coalitions
1
HEALTHY START
COALITIONS
Collectively, we:
• Mobilize public and private partners on our
common mission
• Leverage millions of dollars to improve
programs and services for families
• Align efforts with the Florida legislature to
keep them informed of the needs of its
residents and the importance of our
mission
• Serve as a resource for national maternal
and child health initiatives for
dissemination to our thousands of partners
• Conduct assessments of best practices
and trends to transfer knowledge among
our members and our constituents
2
HEALTHY START COALITIONS ARE DEDICATED TO
REDUCING FLORIDA’S INFANT MORTALITY RATE
Infant mortality rate is often used as an
Indicator to measure the health and
well-being of a community.
Infant mortality is the death of an infant during the
First Year of Life
and is calculated as the number of infant deaths
per 1,000 live births.
Infant Mortality is further
classified into:
• Neonatal Deaths
first 27 days of life
• Post-neonatal Deaths
28–364 days of life
These two categories
have different primary
causes of death.
3
PERINATAL
PERIODS OF RISK
MAP FETO-INFANT MORTALITY
Majority of infant deaths are
due to the health of the mother
before she gets pregnant.
4
MAP CONNECTIONS TO ACTION
Prenatal Care
Referral System
High Risk OB Care
Sleep Position
Breast-Feeding
Injury Prevention
5
MATERNAL Healthy Start Show Your Love
HEALTH / Interconception
PREMATURITY
Care CDC Pre/Interconception Care
6
TARGET PARTICIPANTS:
One Key QuestionTM
"Would you like to become pregnant in the next year?"
3rd Trimester or at Enrollment
YES OKEITHER
WAY NO UNSURE
Show Your Love
Show Your Love Checklist/Life Plan
Show Your Love Show Your Love
Checklist/ Baby-to-Be Checklist/ Checklist/
Life Plan (Include education on Life Plan Life Plan
Importance of baby spadng
Baby-to-Be & family planning)
Healthy Woman Healthy Woman
7
MAP CONNECTIONS TO ACTION
Prenatal Care
Referral System
High Risk OB Care
Sleep Position
Breast-Feeding
Injury Prevention
8
Finding pregnant women
and babies at-risk
Florida’s Universal Risk Screen
Healthy Start’s Community Liaisons
9
Connecting families to services
Coordinated Intake and Referral reduces duplication between home visiting programs,
provides family choice of home visiting program, and connects to additional community supports and health plans.
Prenatal & Infant Risk Screens
Community & Health Plan
Referrals
10
Connect
Coordinated Intake and Referral
11
Healthy Start
MATERNAL
HEALTH /
Home Visiting / Providing Relationship-Based
PREMATURITY Face-to-Face Education and Support
Services
12
Prenatal Home Visiting /
Face to Face Services
Month 1 Example
• Maternal and child health
• Nutrition, Diet, Vitamins (PHB)
• Importance of Prenatal Care - Prenatal Visits
• Physical Changes
• Medications During Pregnancy
• Managing Stress - How Stress Affects My Unborn Baby
• Sexually Transmitted Diseases Can Hurt Your Baby
• Importance of Positive Thinking
13
Prenatal Home Visiting /
Face to Face Services
Month 1 Example, continued
Baby’s Development
• Fetal development – how is my baby developing
• Learning begins before birth
Family Development
• Life Goals - (PHB) Small Steps Lead to Big Dreams
• Circle of Support
• Importance of Father involvement
• Financial Needs - Budgeting
14
Prenatal Home Visiting /
Face to Face Services
Month 1 Example, continued
Screening, Referral, Education
and Intervention
• Substance abuse risk profile
• Intimate partner violence
• Tobacco screening
15
MAP CONNECTIONS TO ACTION
Prenatal Care
Referral System
High Risk OB Care
Sleep Position
Breast-Feeding
Injury Prevention
16
Healthy Start
INFANT Home Visiting / Providing Relationship-Based
HEALTH
Face-to-Face Education and Support
Services
17
INFANT HOME VISITING /
FACE TO FACE SERVICES
MONTH 1 EXAMPLE
Mother’s Needs
• Physical Changes, Discomforts, Warning Signs
• Perinatal Depression
• Diet and Exercise
• Sex and Sexually Transmitted Diseases
• Family Planning Choices
• Health Care
• Why it's Best to Wait for the Next Pregnancy
• Emotional Changes
• Postpartum Visit
• Family Planning Waiver
• Contraceptives
18
• Primary Care Provider
Infant Home Visiting /
Face to Face Services
Month 1 Example, continued
Baby’s Development
• Bonding and Attachment -
The Power of Touch, Talk,
Sing, Read
• Responding to Baby's Cues
• Infant Development
• Brain Development
• Watch Me Grow - 1st Month
19
Infant Home Visiting /
Face to Face Services
Month 1 Example, continued
Family Development
• Empowerment
• Relationship and Support -
Father and Family
• Planning and Problem Solving
• Career Development and
Finances - Child Support
• Social Determinants of Health
• Public Assistance, Community
Resources
20
Infant Home Visiting /
Face to Face Services
Month 1 Example, continued
Caring
• Nutrition- Breastfeeding Support, Bottle
Feeding
• Daily Care Routines, Common Concerns
• Health Care - Immunizations and
Well Baby Visit
• Safe Baby - Safe Sleep, Soothing a
Crying Baby, Selection of a Safe Caregiver
• Home Safety
• Car Safety
• Child Care
21
Infant Home Visiting /
Face to Face Services
Month 1 Example, continued
Screening, Referral, Education and
Intervention
• Substance abuse risk
• Perinatal depression
• Introduction to developmental
screening for the baby
• Intimate Partner violence
22
Additional Statewide
Infant Mortality Initiatives
Social Determinants of Health
Needs Assessments
ServiceDelivery Plans
• Safe sleep education in the community.
• Donations for Pack n Plays for families that do not
have a separate bed for their baby.
• Donations for baby supplies.
• Plans of Safe Care partnerships for substance
exposed mothers and infants.
• Outreach/education events in the community to
address health inequities.
• Local projects
23
16,544 BIRTHS IN HILLSBOROUGH
9,877 WOMEN 16,023 NEWBORNS
SCREENED FOR HEALTHY START SERVICES SCREENED BY HEALTHY START PROVIDERS
24
7,449 WOMEN 12,110 NEWBORNS
RECEIVED HEALTH START SERVICES RECEIVED HEALTHY START SERVICES
7,008 PRENATAL 11,871 INFANT
HEALTHY START INITIAL INTAKES HEALTHY START INITIAL INTAKES
25
COORDINATED
INTAKE &
REFERRAL
PRENATAL
26
COORDINATED
INTAKE &
REFERRAL
INFANT
27
INFANT MORTALITY RATE
3-Year Average, Hillsborough County, FL
Ten-Year View
• -22% for the County
• -38% for Non-Hispanic Black
• -16% for Non-Hispanic White 20.00
• No change for Hispanic 18.00
16.00
Needs Assessment, 2016-2018 14.00
• -7% decline for Non-Hispanic Black 12.00
10.00
• No change for Non-Hispanic White
8.00
and Hispanic
6.00
4.00
What happened in 2020? 2.00
• Declining trend beginning in 2015 0.00
• Declines stalled in 2018-2020 2009-11 2010-12 2011-13 2012-14 2013-15 2014-16 2015-17 2016-18 2017-19 2018-20
• There was a net increase in 2020 of 6
County NH Black NH White Hispanic
deaths due mostly to Non-Hispanic
Black post-neonatal deaths
28
HILLSBOROUGH COUNTY INFANT MORTALITY
STRATEGIES & SOLUTIONS BASED ON
FIMR RECOMMENDATIONS:
• Fetal Infant Mortality Review (FIMR) • Pregnancy Medical Home
• Interconception Care - 10 components • Woman & Infant Resource Specialists at
determined by the CDC to improve the health 10 WIC offices
of women before and between pregnancies. • Plan of Safe Care & Pedi Clinic
• Safe Baby • HealthySteps
• Pack ‘n Plays - Prevention of SUIDS, co- • Black Infant Maternal Mortality
sleeping, and not having a crib for baby.
• COVID-19 Response – Transitioned to
• Services to Pregnant Women in Jail remote services within one week,
• Hospital Services - Outreach, intake, screen provided prenatal support, and provided
and provide resources with all new mothers baby supplies to families in need.
through Family Resource Coordinators in local
hospitals: Advent, Brandon, Tampa General
and St. Joseph’s (Women’s, Plant City, South).
29
SAFE BABY
Community-based education to
teach parents and caregivers how to
protect their babies from the leading
causes of preventable deaths:
• Choosing a safe caregiver
• Preventing shaken baby syndrome
• Following safe sleep practices
• Preventing distracted parenting
From October 1, 2020 to present
• 432 Parents of Newborns Received
Developmental Screening
• 659 Professionals Received
Safe Baby Training
• 96% of Survey Respondents said
they put their Babies on their Backs
to Sleep 30
PLAN OF SAFE CARE
RECOGNIZED AS A PROMISING PRACTICE BY THE AMERICAN ACADEMY OF PEDIATRICS
Wrap-around services providing continuous care for mom, baby,
family and caregiver with education, support and health promotion
through Pregnancy Medical Home, Hospital-based Services, and
Substance Exposed Newborn Clinic.
• 1 Doctor and 2 Nurses
• 310 Visits in the PEDI Clinic, Serving 280 Families
• 465 Referrals to Plan of Safe Care
Data from July 1, 2020 through June 30, 2021 31
BLACK INFANT &
MATERNAL MORTALITY FORCE
PURPOSE
The Healthy Start Coalition of Hillsborough County
and REACHUP, Inc. will lead the development of an
intentional and systemic community action plan to
address racial disparity in black infant and maternal
mortality. In collaboration with consumers of services
and other community partners we seek to share the
lived experiences within the data.
The task force will work to raise awareness and pursue
solutions to improve black infant and maternal health
and prevent black infant and maternal death
Hillsborough County.
32
FAHSC RECOMMENDS POSSIBLE
STRATEGIES & SOLUTIONS:
• Interconception Care
• Improving Maternal Health
• Improving Baby Spacing
• Improving Maternal Social Support
• Home Visiting
• Addressing Social Determinants of Health
• Doula Services
• Safe Sleep Campaigns
• Enhanced Medicaid benefits
• Social Marketing Campaign
• Fetal Infant Mortality Review (FIMR)
33
THANK YOU
Cathy Timuta, MBA, Chief Executive Officer
Florida Association of Healthy Start Coalitions, Inc.
Healthy Start MomCare Network, Inc.
2002 Old St. Augustine Rd, Suite E45
Tallahassee, FL 32301
(850) 999-6210
ctimuta@fahsc.org
Jane Murphy, MPA, Executive Director
Healthy Start Coalition of Hillsborough County, Inc.
2806 N. Armenia Ave., Suite 100
Tampa, FL 33607
(813) 849-7990
jmurphy@hstart.org
34
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