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Women
Babies
Families
Communities
The Baltimore City Healthy Start, Inc.The Baltimore City Healthy Start, Inc.
Overview and ImpactOverview and Impact
““Helping Mothers Have Healthy Babies”Helping Mothers Have Healthy Babies”
VisionVisionTo embrace our role as a leader in providing and coordinating services for pregnant, postpartum, interconceptional women and their babies living in vulnerable conditions in Baltimore City.
MissionMissionBaltimore City Healthy Start is committed to improving the health and well-being of pregnant, postpartum and interconceptional women, their babies, and families by providing comprehensive, supportive services in the communities where they live.
Baltimore City Healthy Start, Inc. Baltimore City Healthy Start, Inc. One of the original 15 Healthy Start projects created in 1991 to
address disparities in infant mortality (death of an infant before 1st birthday).
The only federally funded program of its kind in Maryland. Has served over 12,000 pregnant and postpartum women over its
17 years. The Lead Agency for the United Way of Central Maryland funded
Success By 6® Program. Baltimore’s Lead Agency on a NIH funded national community-
based participatory research study on the impact of stress and racism on birth outcomes.
Direct Service * Community Collaboration * Research * Public AwarenessDirect Service * Community Collaboration * Research * Public Awareness
Baltimore City Healthy Start, Inc. Board of Directors
Baltimore City Healthy Start, Inc. President & CEO
Executive Assistant
Chief Clinical Services and Q A Chief Financial Officer
Director Healthy Education & Marketing
Success By 6® Program
Belly Buddies
Evaluation Consultant
Finance Department
MIS Department
BSAS Care Coordination
Organizational Chart
HR Department
CRNPs & OB/GYN
Analyst
Director Special Populations
Director Life Planning Institute
Director Healthy Start
Guiding Light Program
Mobile Delivery System
Chrysalis House Healthy Start
Employment Support Program
& Computer Lab
CCHN
Healthy Start Programs
Forest Park/Walbrook
Dorchester/Ashburton
Morrell Park/Violetville
Allendale/Irvington/South Hilton
Healthy Start Program Success By 6® Initiative Healthy Babies Breastfeeding
Program Substance Abuse
Care Coordination Early Childhood Development In Home/In Center
Family Planning Program Life Planning Institute Belly Buddies Prenatal Program Chrysalis House
Healthy Start Program
Outreach and Recruitment Case Management and Home Visiting Pregnancy Testing Prenatal Groups Postpartum Care Breastfeeding Education and Classes Family Planning and Interconceptional Care Parenting Groups Early Childhood Development Services Healthy Relationship Counseling Emergency Food & Clothing Pantries Family Advocacy Visual Lead Inspection Workforce Development/Employment Readiness Drop-In Child Care STD Testing, Counseling and Treatment HIV Testing and Referral Mental Health Screening and Treatment Substance Abuse Screening and Referral Transportation
ProgramsPrograms ServicesServices
Service Area Current
Healthy Start, Inc.
Satellite Offices
• Home-Based
• Center-Based
• Mobile Delivery System*
Low Birth WeightLow Birth Weight
Very Low Birth WeightVery Low Birth Weight
Interconceptional CareInterconceptional Care
STDSTD
The Healthy Start Impact On:The Healthy Start Impact On:
Percent LBW (Maryland / Baltimore City / Healthy Start)
10.712.3
1110
11.5
8.9
11.712.8 12.9
8.5
13.612.6
0
2
4
6
8
10
12
14
16
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Per
cen
t L
BW
Maryland Baltimore Healthy Start HP 2010
Percentage LBW (Maryland/Baltimore City/Healthy Percentage LBW (Maryland/Baltimore City/Healthy Start)Start)
Source: HHS-HRSA Baltimore City Healthy Start, Inc. Performance Report 2006-07
VLBW (Maryland / Baltimore City / Healthy Start VLBW (Maryland / Baltimore City / Healthy Start Clients)Clients)
Source: HHS-HRSA Baltimore City Healthy Start, Inc. Performance Report 2006
VLBW (Maryland / Baltimore City / Healthy Start Clients)
1.6
2.6
1.8
3.3
4
1.4
2.6
3.3
2.2
0.70.9
2.4
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Per
cent V
LB
W
MD Baltimore City Healthy Start HP2010
Facts to know: 623 Infants died in Maryland in 2007Facts to know: 623 Infants died in Maryland in 2007
Low Birth WeightBirths-CY 2007
Infant DeathsCY2007
State of Maryland 9.1 8.0
Blacks in Maryland 13.9 14.0
Baltimore City 12.8 11.3
Blacks in Baltimore 15.1 15.5
Healthy Start * 8.5 5.3
*98% of Healthy Start Clients are African-American.Healthy Start clients accounted for 4% of Baltimore City births in 2007.
Interconception CareInterconception Care
Rates of inter-pregnancy interval greater than 12 months among Healthy Start pregnant-enrolled clients for calendar year 2007.
Pregnancy Outcome Condition Num Denom Percent
Live Birth >= 12 months 109 145 75.2%(Outcome = 4) >= 24 months 74 145 51.0%
>= 36 months 54 145 37.2%>= 48 months 37 145 25.5%>= 60 months 22 145 15.2%
Miscarriage >= 12 months 16 31 51.6%(Outcome = 1) >= 24 months 7 31 22.6%
>= 36 months 6 31 19.4%>= 48 months 4 31 12.9%>= 60 months 1 31 3.2%
Stillbirth >= 12 months 1 1 100.0%(Outcome = 2) >= 24 months 0 1 0.0%
>= 36 months 0 1 0.0%>= 48 months 0 1 0.0%>= 60 months 0 1 0.0%
Elective Abortion >= 12 months 10 29 34.5%(Outcome = 3) >= 24 months 6 29 20.7%
>= 36 months 5 29 17.2%>= 48 months 4 29 13.8%>= 60 months 1 29 3.4%
Impact on Sexually Transmitted Diseases Impact on Sexually Transmitted Diseases (STD)(STD) 1993 urine samples were collected and submitted
for Chlamydia Trachomatis (CT) and Neisseria Gonorrhoeae (GC) screening from September 1999 until March 2007.
The overall prevalence’s of CT and GC for the study period were 10.1% (201/1993) and 2.8% (55/1993) respectively.
The CT prevalence for 1999 was 18.2% with a decrease to 8.3% for 2006.
The prevalence of GC significantly decreased from a high of 9.1% in 1999 to a low of 1.3% in 2006.
Baltimore City Healthy Start has initiated a similar in-home screening for HIV/AIDS in October 2006.
Case Management ModelCase Management Model
Recruitment of Pregnant or Postpartum Client with Infant 6 months old or less
Participant Identification Form is completed (PIF)
Client is routed to interviewer
Interviewer completes Enrollment Packet and assigns client to Case Management team and to NHA (Neighborhood Health Advocate)
Interviewer submits enrollment packet to MIS
MIS data enters applicable data from interview packet
MIS submits enrollment packet to record’s clerk
Records clerk establishes a chart and notifies the assigned Case Management team of the new repeat or reactivated client
The Case Manager alerts the NHA of the new client. The NHA sends out an introductory letter
Case Management ModelCase Management Model
Within 10 days of the notification, the NHA conducts an orientation visit
Within 14 days of the orientation visit, the CM conducts a care plan visit
Home visits are conducted biweekly until client is exited from the program at 13 months old the family /infant is home visited once a month
HIV Testing, Growing Great Kids, Family Planning, Mental Health Services, etc.
Home visiting Checklists / Progress notes
Checklist or submitted to High Nurse Specialist / Submitted to MIS
High Risk Nurse Specialist submits reviewed checklist to MIS MIS enters applicable data and submits checklist, progress notes, etc. to the records
clerk for filing Special procedures for the Certified Nurse Practitioner and ancillary staff are
outlined in the Case Management Protocol.
How We Measure Success How We Measure Success Baltimore City Healthy Start, Inc. Baltimore City Healthy Start, Inc.
Quality DashboardQuality Dashboard
Quality Management SystemQuality Management System
HR Services
Office of Finance MIS
Direct Services Centers
Satellites Mobile Unit
Data Application Process
Procedures/Protocols
EmployeesEmployees Funders Auditors/IRS
Software Hardware Data Entry Data Reporting
Customers Management of Employees
Baltimore City Healthy Start Baltimore City Healthy Start Quality Quality
DashboardDashboard
Infant Mortality Very Low Birth Weight Rate Low Birth Weight Rate Interconceptional Interval Perinatal Depression
Lead Levels Prenatal Care Rate Pediatric Medical Home Immunization Rate HIV/STD
Outstanding Clinical OutcomesOutstanding Clinical Outcomes
Efficient Procedural ProcessesEfficient Procedural Processes
CollaborationsCollaborations
Success By 6Success By 6®®
Historic East Baltimore Collaborative
Historic East Baltimore Collaborative
Greater West Baltimore Healthy Communities
Collaborative
Greater West Baltimore Healthy Communities
CollaborativeIn partnership with Parents, Community Representatives and
Martin Luther King, Jr. Early Head Start * Center for Urban Families * Lee’s Blessed Family Daycare Walter F. Perkins Daycare Center * JHU Injury Free Coalition for Kids
Coalition to End Childhood Lead Poisoning * Casey Family Services * The ARK Daycare Mercy Supportive Housing, Inc. * AMERIGROUP * Concord Baptist Church * Umoja Head Start Academy
Save Another Youth/Stop The Violence Coalition * Tuerk House, Inc. * East Baltimore Development Inc. Ames Shalom Community, Inc. * Community Building & Partnership
Enoch Pratt Free Library/North & Pennsylvania Avenues Branch ٠ Coppin Heights Community Development Corporation
Coalition of Advocates for Poverty and Healthcare Solutions
In partnership with Parents, Community Representatives and
Martin Luther King, Jr. Early Head Start * Center for Urban Families * Lee’s Blessed Family Daycare Walter F. Perkins Daycare Center * JHU Injury Free Coalition for Kids
Coalition to End Childhood Lead Poisoning * Casey Family Services * The ARK Daycare Mercy Supportive Housing, Inc. * AMERIGROUP * Concord Baptist Church * Umoja Head Start Academy
Save Another Youth/Stop The Violence Coalition * Tuerk House, Inc. * East Baltimore Development Inc. Ames Shalom Community, Inc. * Community Building & Partnership
Enoch Pratt Free Library/North & Pennsylvania Avenues Branch ٠ Coppin Heights Community Development Corporation
Coalition of Advocates for Poverty and Healthcare Solutions
Healthy Start Clients with MCO StatusHealthy Start Clients with MCO Status
AMERIGROUP
COVENTRY
HELIX
JAI
MD PHYS
PRIORITY PARTNERS
UNITED HEALTH CARE
OTHERS
23.8%
24.9%
17.3%
24%
4.6%
1.5%2.1%1.8%
Chrysalis House Healthy Start ProjectChrysalis House Healthy Start Project
Transitional Housing Transitional Housing for Pregnant Ex-for Pregnant Ex-
OffendersOffenders
Mobile Delivery SystemMobile Delivery System
West Baltimore ExpansionWest Baltimore Expansion
Healthy Start Satellite Office LocationsHealthy Start Satellite Office Locations
Allendale/Irvington/South Hilton Allendale/Irvington/South Hilton Sacred Zion Full Gospel Baptist Sacred Zion Full Gospel Baptist
ChurchChurch
Morrell Park/Violetville Morrell Park/Violetville St. Mark’s United Church Of St. Mark’s United Church Of
ChristChrist
Dorchester/Ashburton Dorchester/Ashburton
The IVY Family Support CenterThe IVY Family Support Center
Forest Park/Walbrook Forest Park/Walbrook Women Accepting ResponsibilityWomen Accepting Responsibility
Cradle of HopeCradle of HopeCampaignCampaign
The Cradle of Hope Campaign is Baltimore City The Cradle of Hope Campaign is Baltimore City Healthy Start’s public awareness initiative and Healthy Start’s public awareness initiative and fundraising program designed to inform and fundraising program designed to inform and
mobilize the citizens of our city, especially mobilize the citizens of our city, especially women, around the issues contributing to infant women, around the issues contributing to infant
mortality, low birth weight and premature births.mortality, low birth weight and premature births.
Project Project AwareAware
““He who has health has hope. He who He who has health has hope. He who has hope has everything.”has hope has everything.”
anonymous Arabic proverbanonymous Arabic proverb