III.E.2.c. State Action Plan Narrative by Domain
The narrative below describes the rationale for why Mississippi selected certain measures and provides detailed narrative to link the selected NPM’s, SPM’s with Mississippi’s identified state priorities.
Guide for Reading Mississippi’s MCH Block Grant Narrative
The following section contains a report on the accomplishments and challenges of the previous year as (FFY19) and a description of strategies and activities for the upcoming year (FFY20). One person does not write the MCH Block Grant Application for Mississippi. Multiple programs (with MCH teams) submit narrative to provide a landscape for MCH activities in the state of Mississippi. This section is organized by the five MCH population domains. The information within each domain is organized as follows:
1. Introduction to MCH Priority area
- Priority
- National Performance Measure or State Performance Measure (NPM or SPM)
- Program purpose and summary
2. Annual Report (FFY2019) (Accomplishments and Challenges)
- Statement of Priority Area
- Objective selected to address NPM and or SPM
- Strategy(s) selected to accomplish objective
- Rational for selected strategy
- Strategies and Activities reporting information
- Evidenced Based Measure (ESM) reporting
- Other programmatic narrative/activities
- Emerging issues
- Success stories
3. Plan for the Application Year (FFY2020)
- Statement of Priority Area
- Objective selected to address NPM and or SPM
- Strategy(s) selected to accomplish objective
- Rational for selected strategy
- Planned Strategies and Activities
- Evidenced Based Measure (ESM) planning
Introduction:
Women/Maternal Health
Priority:
- Reduce low birth weight and premature birth (SPN 6)
- Increase access to early prenatal care (SPN 7)
NPM 1: Well-woman visit (% of women with a past year preventive medical visit)
SPM 1: Percentage of women who smoke in the last three month of a pregnancy
Program Purpose and Summary
The Office of Women’s Health partners with internal and external providers to serve the uninsured and underinsured in Mississippi. The goal is to provide women access to comprehensive health services to ensure healthier women, mothers and infants. These services are provided in house, contracted out or through partnerships developed across the state. Under the Office of Women’s Health Office, there are a two bureaus.
The Breast and Cervical Cancer program (BCCP) is a screening program for the medically underserved women in the state. According to the American Cancer Society, there will be an estimated 2,370 new cases of breast cancer in Mississippi during 2019 and only 67.7% of women ages 40 years and older received a mammography during 2016. The United States was at 72.4% in 2016. The BCCP provides outreach education, promotion awareness, screening and case management services. Cervical screening services are available for uninsured or underinsured women between the ages of 40 and 64 and mammography screenings to uninsured or underinsured women between 50 and 64 years of age. Special exceptions are available for those women between the ages of 18-39. There are special funds from other organizations which are available for women ages 40-49 to receive a screening mammogram. Diagnostic procedures and case management services are provided to women with abnormal findings. Referrals are made to the Mississippi Division of Medicaid for treatment coverage, if a woman is diagnosed with a malignancy or pre-cancerous condition. The BCCP has contractual partnerships with 297 facilities throughout the state. There is a coordinated effort between the BCCP and Comprehensive Reproductive Health program to ensure that women who qualify for the Family Planning Waiver receive appropriate referrals.
The Perinatal High-Risk Management/Infant Services System (PHRM/ISS) is a case management program for Medicaid eligible, medically high risk pregnant and post-partum women and Medicaid eligible, medically high risk infants up to one year of age. PHRM/ISS case managers have the flexibility to provide individualize the health care, nutritional and psychosocial support, home visits, and health education to meet the individual health needs of the pregnant and post-partum woman and infants as seen by an individualized care plan. In addition, the PHRM/ISS program is able to enhance services above the “Traditional PHRM/ISS” in order to add in components to meet the patient’s needs. Through the addition of the Expectant and Parenting Teen project, funding from the Pregnant Assistance Fund, the needs of 17-19 year old pregnant and parenting women who would otherwise not qualify for the “Traditional PHRM/ISS” are being served. The incorporation of telehealth within the PHRM/ISS program is multi-faceted. The partnership with UMMC Center for Telehealth provided the opportunity for the PHRM/ISS program to use the Health Harmony portal/services in order to accomplish this purpose via remote patient monitoring and mobile communications. MSDH clinic to clinic technology is being used to fill the gaps of a declining workforce. These projects are to identify if the use of the equipment will increase the number of visits by overcoming the barrier of transportation and remoteness in such a rural state and working with family schedules for appointments.
Given the high burden of chronic disease among Mississippi’s adult population, and the importance of preconception/ interconception health on birth outcomes, a focus on preventive care for women of childbearing age is a priority for Mississippi. Preventive care encompasses a number of components, including physical exams, screening tests (including labs), and counseling. NPM 1 measures the percentage of women with a past year preventive visit. According to the 2015-2016 BRFSS, the percentage of women ages 14-44 who received a well-woman visit is 71.8%. Per the 2018 BRFSS, 82.3% of women between the ages of 21-65 received a cervical cancer screen. Per the 2016 BRFSS, percentage of females age 13 to 17 receiving the HPV immunization was 34.4%. Increasing the percentage of women who complete preventive visits should improve not only the health of a mother (and thus reduce the chronic disease burden) but also improve birth outcomes by improving a mother’s preconception/ inter-conception health.
Per the Mississippi State Department of Health’s Infant Mortality Report 2019, during 2018 the Mississippi Infant Mortality Rate was 8.43 deaths per 1,000 live infants born. This represents a 3.3 % rate decrease from 2017 rate of 8.72. Racial disparities are seen in the infant mortality rates, as evidenced by the black infant mortality rate at 11.6 deaths per 1,000 live births compared to the white rate of 5.9 deaths per 1,000 live births. Infant mortality may be impacted by several factors such as the mother's health before and during the pregnancy, complications of pregnancy, and environmental and social factors. The mother's health before or during pregnancy may be influenced by exposure to tobacco, alcohol and/or other drugs, her chronic illnesses such as obesity, hypertension, and/or diabetes, and whether or not the pregnancy was planned. The leading causes of infant mortality continue to be preterm birth, sudden unexpected infant deaths related to unsafe sleeping environments and birth defects. https://msdh.ms.gov/msdhsite/static/resources/8015.pdf There are various protective efforts utilized to address the infant mortality rates in Mississippi looking at providing information on improving the women's health, sleeping environments, and infant health.
Per HHS, Mississippi ranked 3rd highest out of 51 states during 2016 for teen birth rates among females ages 15 to 19. The United States teen birth rate (births per 1,00 females ages 15-16) in 2016 was 20.3; for Mississippi it was 32.6. https://www.hhs.gov/ash/oah/facts-and-stats/national-and-state-data-sheets/adolescent-reproductive-health/mississippi/index.html Through the Pregnant Assistance Fund, the PHRM/ISS case management program has been focused on serving this teen population. Here is a link to a video regarding the program: https://msdh.ms.gov/msdhsite/_static/44,0,363.html and summary of the program provided by the Office of Adolescent Health: https://msdh.ms.gov/msdhsite/_static/resources/7797.pdf. Data from FY16 is found here. https://msdh.ms.gov/msdhsite/_static/resources/7803.pdf
Prescription opioid and other drug use has been a focus of the Mississippi State Department of Health during 2019, especially with the increased risk to infants in utero exposed to substances. Per the 2019 report “Neonatal Hospitalizations Related to Substance Use in Mississippi: Surveillance Report, 2010-2017”, hospital stays related to substance use spiked from 113 in 2010 to 689 in 2017. The cost for this hospitalization is $32,451 and Medicaid was responsible for 77% and the total hospital charges at a cost of $23,255,948 in 2017. https://msdh.ms.gov/msdhsite/_static/resources/8164.pdf Per the “Opioid Prescriptions among Reproductive-Aged Women in Mississippi, 2012-2017”, an estimated 27.7% of reproductive-aged women with private insurance and 39.4% of reproductive-aged women with Medicaid filled an opioid prescription between 2008 and 2012 in the United States. During 2017, 9/1% of all opioid prescriptions in Mississippi were dispensed to women. During the same year, women of childbearing age filled 16.0% of all opioid prescriptions in the state. https://msdh.ms.gov/msdhsite/_static/resources/8240.pdf
The various partnerships, MSDH uses a variety of strategies and activities to address the needs of uninsured, underinsured and high-risk women throughout Mississippi. Through the family planning waiver, women are provided a means to preconception and inter-conception health care, where without this they may not receive these services. Increasing the percentage of women who receive health visits with education regarding effective forms of birth control to help improve their health before becoming pregnant, referrals for tobacco, alcohol, and/or drug services, and inter-conception care, assists in improving birth outcomes. Improving access through the family planning waiver, in one way MSDH is addressing low birth weight and premature birth through preconception/interconception health. Our focus is to address the woman's preconception/ interconception health across the life span via a well woman visit.
The purpose of PHRM/ISS is to help reduce the infant mortality rate and to help reduce the rates of low and very low birth weight infants in Mississippi. The case management program addresses this by direct services to women and infants. Through committees, boards, and community presentations, the program is able to increase networking opportunities, engage partners to broaden the reach of the program, and share knowledge and skills to benefit the participants. Through an ongoing partnership with the Mississippi State University, Social Science Resource Center, they were able to create an Overview of the PHRM/ISS program with data summarizing the characteristics of the population served. https://msdh.ms.gov/msdhsite/_static/resources/8434.pdf
As people more and more turn to various social media for medical knowledge, using social media to promote preventive visits became an opportunity. In following the philosophy of “meeting the patient where they are at” the Office of Women’s Health turned to social media as a platform to promote preventive health knowledge and encourage preventive health medical visits. Some studies reflect that social media helps to empower patients regarding health care and compliments the information provided by providers not replace the providers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000484/ The purpose of the social media postings is to provide accurate information for patients to read, think about scheduling a screening appointment with their provider and use the information to start talking with their provider. In joining with other programs and organizations, the goal is to promote the same message and avoid providing any mixed messages around the same topic.
Women’s/Maternal Health Annual Report
Accomplishments and Challenges
Priority Area: Reduce low birth weight and premature birth.
Objective 1: To increase awareness about all Office of Women’s Health program and well woman health visits by participating on community advisory boards and take part in vendor exhibits booths at professional organizations.
Strategy 1: The Office of Women's Health Director, PHRM/ISS Director, Fatherhood Coordinator, and Marketer will work with internal MSDH staff and External MSDH partners to identify opportunities for collaboration.
Rationale for Strategy 1: The PHRM/ISS program is working to increase the referral rate of offered services to reach a broad, diverse audience. The Breast and Cervical Cancer program already receives the majority of referrals from outside providers. With staff participating in the advisory boards, there is the potential of helping to engage and broaden the community’s knowledge about the population served.
Activity 1a: Identify two additional external partners in order to obtain "a seat at their table" and learn about their resources for partnerships/ collaborations.
Report Activity 1a: Office of Women’s Health program staff continue to have a strong visible presence with several community-focused events and collaborative Office of Women’s Health program staff continue to have a strong visible presence with several community-focused events and collaborative opportunities. These opportunities allow staff to provide information and resource materials regarding the BCCP, Family Planning Waiver, and PHRM/ISS programs, emphasizing services available to both external stakeholders and potentially eligible participants. Within the PHRM/ISS program, there have been numerous opportunities for the program to provide a representative for various planning and advisory committees for other organizations or agencies. Since July 1, 2019, the PHRM/ISS program staff have met with 43 different stakeholder organizations of which 9 are regular meetings where the representative is part of the advisory group. Approximately 2,488 individuals/community members were reached through the partnerships and collaborations. During the spring of 2019, the Marketer resigned from MSDH. At this time, the position has not been filled.
The BCCP staff continue to explore unique outreach activities to increase the number of women screened into the program. BCCP staff participated in a screening activity for women attending Homecoming at Alcorn State University, October 12, 2019. People of all ages, specifically women of the targeted age group were present and many from the surrounding small towns such as Port Gibson, Lorman, Natchez, and Wilkerson were present. On November 2, 2019, the program provided a Health Educational Seminar at the Rankin County Restitution Center for 210 women of which 48% requested to receive a referral card for the program.
The BCCP program staff participated in a faith-based initiative, “Faith in the Fight”, providing free breast cancer education screening prevention and support services on November 9, 2019. There was a total of 24 women screened. Of the overall total, 19 were enrolled into the Breast and Cervical Cancer Program and 5 had insurance coverage.
The Office of Women’s Health collaborate the PHRM/ISS program, Mississippi Public Health Institute and Department of Mental Health for a specific training on pregnant and parenting women using substances. MSDH has been award the Overdose to Action (OD2A) grant where a case management program will focus on one county, Harrison, to provide services to pregnant and parenting woman using substance. These collaborations are just one way of bringing each program to the “table” in order to discuss community and program structures needed to meet the needs to this population. The case management program is estimated to begin before July 2020.
Report Activity 1b: Of the 43 different activities for the PHRM/ISS staff with stakeholders, 22 were presentations and/or professional exhibit booths. At each event where program materials were disputed, an account of the number of items distribute is collected and sign in sheets are taken to know the number of people reached. This information is used to decide if the program will return for future events.
The BCCP program collaborated with the Mississippi Department of Human Services on October 16, 2019 providing information regarding breast health and screenings for those women that are uninsured or underinsured. During the event, participants were encouraged to share the information with their family members and others’ that may need the services offered by the program.
The BCCP program partnered with the human resource personnel of the Mississippi Department of Public Safety and The United State Postal Service. Program staff partnered with The Mississippi State Penitentiary of Parchman Prison System staff on October 5, 2019 for their 2nd Annual Health and Wellness Family Day. This is the second year of participation connecting with and providing information to the staff and their families, promoting a healthy community and providing a means of awareness of the services offered by the BCCP that are available to assist them. The USPS held a large employee wellness fair on October 20, 2019. Emphasis was stressed on the importance of breast and cervical cancer screenings and the importance of early detection of cancer.
Objective 2: By October 2020, increase the number of clients in PHRM/ISS case management by 5%.
Strategy 2: The PHRM/ISS program promotes a 2 to 4 weeks post-partum medical visit with all women and discusses inter-conception care with parenting women. As the caseload increases, more will be educated and encouraged regarding a well woman visit.
Rationale for Strategy 2: In FY18, the PHRM/ISS program numbers declined decreasing the message to high risk pregnant and parenting women regarding the need for a well woman check-up. A major barrier to the program is limited staff capacity. As the program is working to increase staff capacity, it will continue to track the number of clients on the program and quality of services provided such as referrals and health education regarding inter-conception care. The program will continue to use telehealth services to address the barriers.
Activity 2a: Compare the baseline data for the traditional PHRM/ISS to the MSDH clinic to clinic telehealth for differences in case load numbers. (discontinue)
Report Activity 2a: The following data has been collected using the MSDH PHRM/ISS Database. Information entered into the database is input by county level case managers on a monthly basis. Data is not verified for accuracy through any other source (i.e. MSDH Vital Records, Medicaid Claims, Envision, etc.). Discussions are occurring on how to validate this information for future reports.
The state-wide total unduplicated maternity patients served in FY18 - 1,960; in FY19 – 2,206; infant patients service in FY18 - 1,471; in FY19 – 1,484. Professional visits received for maternity in FY18 – 10,636; in FY19 – 8,378; infant professional visits received in FY18 – 8,218; in FY 19 – 5,192. Of women who were enrolled in the case management program from July 1, 2017 to June 30, 2019, case managers were able to report a date for the post- partum six week check up 57% the time. While this is a small segment of the population, women in the PHRM/ISS program are high risk, where a well woman visit is especially important.
Due to change in the structure of the Mississippi State Department of Health, the telehealth project has been closed October 2019. The staff were integrated into the traditional PHRM/ISS program and the contract for telehealth services within this program was discontinued.
Activity 2b: Review policies and forms within the projects and update policies and forms as these projects continue to evolve. (discontinue)
Report Activity 2b: Due to change in the structure of the Mississippi State Department of Health, the telehealth project has been closed October 2019. The staff were integrated into the traditional PHRM/ISS program and the contract for telehealth services within this program was discontinued.
Activity 2c: The program will track compliance of the use of the pilot app for consideration of expanding use within the PHRM/ISS program. (discontinue)
Report Activity 2b: Due to change in the structure of the Mississippi State Department of Health, the telehealth project has been closed October 2019. The staff were integrated into the traditional PHRM/ISS program and the contract for telehealth services within this program was discontinued.
Objective 3: By September 2020, the program will increase the number of outside MSDH referrals to the program by 5%.
Strategy 3: To increase the number of formal MOUs from 8 to 9 in order to increase the number of referral sources for PHRM/ISS.
Rationale for Strategy 3: The PHRM/ISS program is working to expand their referral base from within MSDH to external partners as the program is evolving to address the needs of special populations. It is important to formalize these relationships. PHRM/ISS has been identifying groups of high-risk pregnant women and infants who need case management services but may not qualify for other types of case management provided in the state. These are the MOUs and relationships the program is seeking. Once the relationships are identified, the administrative staff will be providing training for the county level case managers to enhance their knowledge and skills for the population.
Activity 3a: Conduct an assessment to identify populations, which would benefit from case management ervices and guide programmatic activities.
Report Activity 3a: The PHRM/ISS program is tracking several referral sources by having the referrals sent to the program administrative office for recording and processing. During FY19, there were 1,204 referrals processed; During FY20, there have been 783 referrals processed in the first seven (7) months. This is a 12% increase for FY20 compared to FY19. Starting March 2020 with the introduction of COVD-19, the number of referrals has seen a slight decrease compared to the beginning of the fiscal year but will be monitored as the months progress.
PHRM/ISS program staff have networked and collaborated to leverage additional formal and informal partnerships for referrals and continuity of care with community health centers/FQHCs, delivering hospitals, OB/GYN offices, and pediatricians, in addition to community-based, faith-based, and other youth-serving organizations. The Community/ Faith-Based/Fatherhood Coordinator continued to participate in numerous outreach/marketing events along with representation for the program and agency on various community boards. In addition, state-level staff continued to provide leadership and oversight for leveraging various important partnerships for sustainability, including continuing operations under an MOU to receive referrals from the Mississippi Department of Child Protective Services for substance-affected infants and families – (CARA Project). During FY19, the PHRM/ISS program processed 314 referrals, approximately 26 referrals a month from the CARA project alone. During FY20 as of April 20, 2020, the PHRM/ISS program has processed 330 CARA referrals, approximately 33 per month from the CARA project. This is a 23% increase per month. Of the referrals received, the program is able to contact 78% of the participants. The other 22% are not able to be reached due to incorrect phone numbers or not answering the calls. OF the 78% contacted, seventy-five percent (75%) accept the program and 25% decline. These 75% referrals are then sent to the counties for engagement and case management.
Through the recent MSDH award for an opioid grant, OD2A, the Office of Women’s Health will be partnering with a community health center for case management referrals. The development of this relationship, case management model and referral system are in the beginning stages, with a goal of starting referrals close to July 2020.
Activity 3b: Provide training to program staff to delivery evidence-based interventions to populations in case management.
Report Activity 3b: The PHRM/ISS program has provided the following trainings to staff and community partners: Safe Sleep Environment; Oral Health Education; Post-partum Depression; Screening, Brief Intervention, and Referral to Treatment (SBIRT); about the CARA project in Mississippi; Medication Assisted Treatment (MAT); Inpatient treatment options for pregnant and parenting women; FAS/NAS; and Developmental Milestones of infants. (see MCH Workforce Development Capacity for more details about each training and outcomes of knowledge during the trainings.)
Office of Women’s Health, PHRM/ISS, the Community Health Center Association of Mississippi, and Office of Tobacco partnered together for an evidence-based model surrounding tobacco cessation exclusively designed for pregnant and parenting women. To prepare for the roll out of this innovative evidence-based pilot project, three PAF funded (3) teen case management specialists, the State PHRM/ISS Director, and the Health Programs Specialist, Sr. (HPS), received training to become BABY & ME Tobacco Free Program™ (BMTFP) facilitators on December 12, 2019. BMTF is an evidence-based smoking cessation program delivered via psychosocial counseling sessions to pregnant and post-partum women. The program follows a standard curriculum which guides the counseling sessions founded on motivational interviewing techniques. Participants receive vouchers to purpose diapers when they demonstrate progressively reduced use of tobacco products. The 3 teen specialists will implement the program in Warren, Sharkey, Claiborne, Lowndes, Noxubee, and Jones counties. The State PHRM/ISS Director and HPS will provide leadership for the pilot project. Details for program implementation are being worked out with a roll out date of April 1, 2020 being anticipated. Due to the developments from COVID-19, this project has been delayed until July 2020.
In March 2020, MSDH was providing a summit for all social workers within the agency. This summit will focus on the importance of Public Health Social Work; human trafficking; supporting families before and after an emergency/disaster; updates on the Insurance Marketplace; and self-care as a social worker. Due to COVID-19 and social distancing, this summit has been pushed back to late June 2020. Decisions will be made on whether to host the summit, move the summit into FY21 or have the submit but using web-conferencing.
During the fall 2019, the PHRM/ISS Regional leadership staff partnered with Mississippi Thrive! to provide training to the case management staff. Mississippi Thrive! is a partnership between the University of Mississippi Medical Center’s pediatrics’ arm, Children’s of Mississippi and Mississippi State University’s Social Science Research Center. The goal of the Child Health and Development Project: Mississippi Thrive! is simple. Since brains grow rapidly during the earliest years, we provide information and resources to improve developmental health for children ages birth-5 years. One in six children experience developmental delays, but thankfully, identifying and addressing these delays early helps them have more successful outcomes. It’s why we’re creating a comprehensive system of early childhood screenings and interventions. When our children thrive, Mississippi Thrives!” https://mississippithrive.com/about-us/our-mission/ In order to provide resources for the case managers to use during discussions with families surrounding infant development, following this training, the Office of Women’s Health partnered with the MSDH print shop to make copies of the CDC approved health education materials, Learn the Signs. Act Early. on milestones 2 months, 4 months, 6 months, 9 months, 1 year, and 18 months. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-2mo.html
The case management staff will use these handouts as educational material during sessions, read them to the families, provide suggestions on developmental growth to watch for with their infant, and how to have a conversation with the infant’s primary care provider. Four of the five supervisors were able to supply information about the number of PHRM/ISS Staff who was invited and the number of PHRM/ISS staff who attended. Of this group, 84% of the PHRM/ISS staff attended the training.
Strategy 4: The Office of Women's Health will work to identify National Health Observances related to women's preventive health, identify one health risk, work with internal MSDH and External MSDH partners to find social media messages for posting.
Rationale for Strategy 4: The purpose of this strategy is to utilize a variety of programs’/ organizations’ social media platforms inside and outside MSDH in order to reach a broader audience without sending mixed messages for different programs/ organizations.
Activity 4a: Continue to pull the list of National Health Observances to identify months and events focused around women's preventive health services
Report Activity 4a: Between October 2019 and December 2019, the program continued to work with the MSDH Office of Communications to post on social media (Facebook and Twitter). Starting October 2019, the Office of Communications began to track more than just numbers of impressions and reaches.
|
Social Media |
|
|
49,895 |
|
|
Total Reach |
52,125 |
|
October-December 2019 |
|
|
Desktop |
44.6% - 46.8% use |
|
Mobile |
49.6% - 52.5% use |
|
Tablet |
2.8 – 3.6% use |
|
Facebook followers – Mississippi |
|
|
October 2019 |
22,778 (period) |
|
December 2019 |
24,680 (period) |
|
Increase over three-month period |
1,902 |
|
January 2020 Monthly Website Activity |
||
|
|
# of Unique Pageviews |
%of Views Compared to MSDH webpages |
|
Pregnancy and Perinatal Health |
102 |
3.25% |
|
/Women’s Health |
81 |
2.58% |
|
Breastfeeding |
68 |
2.17% |
|
Perinatal High-Risk Management |
62 |
1.98% |
|
Teen Pregnancy |
6 |
.19% |
Activity 4b: Continue to reach out to internal and external MSDH partners to develop joint messages for social media postings.
Report Activity 4b:The Office of Women’s Health continues to partner with other MSDH programs to provide media campaigns for various months. During the month of October 2019, OWH and BCCP partnered for a television campaign focused on promoting Well Women visits in Sunflower, Leflore, Washington, Humphreys, Tallahatchie, Bolivar, and Coahoma counties. The campaign encouraged women to contact a local provider to schedule their annual visit for a breast exam. The campaign ran from 10/12/19 to 10/31/19 on targeted platforms for broadcast television and cable. Spots were on the following: Suddenlink Greenville, WABG TV, EABG TV, WSVT TV, and WNBD TV. Television household demographic profile for the Greenwood-Greenville, MS (Leflore and Washington counties) area includes:
|
Race/Ethnicity for Population |
|
|
Race/Ethnicity |
Population |
|
White |
49,700 |
|
Black |
81,400 |
|
Hispanic |
3,400 |
|
Asian/Pacific |
1,100 |
|
Other |
2,800 |
|
Females by Age |
|
|
Less than 18 |
21,300 |
|
18-24 |
8,500 |
|
25-34 |
11,500 |
|
35-44 |
10,500 |
|
45-54 |
10,900 |
|
55-64 |
12,100 |
|
Household Income by Households |
|
|
$10,000 - $19,999 |
12,281 |
|
$20, 000 - $34,999 |
12,767 |
|
$35,000 - $49,999 |
8,660 |
|
$50, 000 - $74,999 |
8,967 |
|
$75,000 - $99,999 |
4,890 |
The television spots were run throughout the day to include some shows such as: NBC Today Show, The Delta News, and ABC Good Morning.
Activity 4c: Work with external partners to identify their contact for social media postings and review of their guidelines.
Report Activity 4c: The Office of Women’s Health used the social media posts provided by Women’s Prevention Services Initiative (WSPI). These messages ran during the month of February 2020 on Facebook and Twitter.
Strategy 5: The Office of Women's Health will identify similar promotional themes surrounding well woman visits and health exams for internal MSDH and external MSDH partners to promote the social media posting by MSDH. Increase the number of postings throughout the month.
Rationale for Strategy 5:
As the Office of Women's Health moves toward using social media and as social media changes, there is the need to monitor each type of social media for client engagement and use. This is identified by a different means for each social media using the following: Likes, views, impressions. By monitoring the "likes, views, and impressions" will help to monitor where to invest time and resources for upcoming monthly observances and type of medium used such as video, links to webpages, or informational knowledge.
Activity 5a: Continue to monitor monthly postings surrounding well woman visits and preventive health services for women.
Report Activity 5a:
During the months of October 2019 and January 2020, a local physician was featured on a television talk show covering topics for each month and the importance of early cancer detection. He also discussed the importance of early detection to an audience of individuals graduating from a Technical School with approximately 300+ attendees. Radio announcements and radio talk shows have been aired carrying the message of the importance of early cancer detection and free screenings. The BCCP received an increase of 53 telephone calls from individuals expressing interest in the program and when asked, they stated they heard about the program on the radio or television. The program staff maintains a log of the identified caller on a secured site and provide them with the names and telephone numbers of contract providers in their area.
Activity 5b: By working with the Office of Communications, increase the number of postings and re-postings throughout the month.
Report Activity 5b: The BCCP collaborated with MSDH Office of Communications for various projects during this reporting period. The social media campaigns for the past six months totaled 1,055 unique views to the Breast Cancer Prevention and Breast and Cervical Cancer web pages and related social media posts reached a total of approximately 13,555. The Office of Women’s Health, BCCP and North Sunflower Hospital partnered together for television advertisements in October 2019. The staff obtained a baseline for Breast Screenings between October 2018 and March 2019 in Sunflower county and surrounding counties (Sunflower, Leflore, Washington, Humphreys, Tallahatchie, Bolivar, and Coahoma). This information will be compared to the October 2019 to March 2020 to see if in the Sunflower county and surrounding counties had an increase in screenings after the television campaign.
Women/Maternal Health (Office of Women’s Health) /Evidenced Based Measure Reporting (ESM)
ESM 1: # of social media message months promoting women's preventive health services.
ESM 1 Report: Between October 2019 and December 2019, the program continued to work with the MSDH Office of Communications to post on social media (Facebook and Twitter).
Total Impressions: 49,895
Total Reach: 52,125
The Office of Women’s Health used the social media posts provided by Women’s Prevention Services Initiative (WSPI). These messages ran during the month of February 2020 on Facebook and Twitter.
The Office of Women’s Health continues to partner with other MSDH programs to provide media campaigns for various months. During the month of October 2019, OWH and BCCP partnered for a television campaign in Sunflower, Leflore, Washington, Humphreys, Tallahatchie, Bolivar, and Coahoma counties. The campaign ran from 10/12/29 to 10/31/19 on targeted platforms for broadcast television and cable. Spots were on the following: Suddenlink Greenville, WABG TV, EABG TV, WSVT TV, and WNBD TV.
ESM 2 Report: Between October 2019 and December 2019, the program continued to work with the MSDH Office of Communications to post on social media (Facebook and Twitter).
Total Impressions: 49,895
Total Reach: 52,125
|
Use by Device Type |
|
|
Device Type |
Use |
|
Desktop |
44.6% - 46.8% |
|
Mobile |
49.6% - 52.5% |
|
Tablet |
2.8%- 3.6% |
|
Facebook Followers----- Mississippi |
|
|
Month |
Followers |
|
October 2019 |
22,778 |
|
December 2019 |
24,680 |
|
Tablet |
2.8%- 3.6% |
An increase of 1,902 over the three-month timeframe.
|
January 2020 Monthly Website Activity for Unique Page Views |
||
|
Program |
Percentage |
Unique Pageviews |
|
Pregnancy and Perinatal Health |
3.25% |
102 |
|
Women’s Health |
2.58% |
81 |
|
Breastfeeding |
2.17% |
68 |
|
Perinatal High-Risk Management/Infant Services System (PHRM/ISS) |
1.98% |
62 |
|
Teen Pregnancy |
.19% |
6 |
ESM 3: Attend and partner with a number of community groups to promote well woman and health service visits while increasing the total number of activities attended from 50 to 60 by September 2020
ESM 3 Report: PHRM/ISS program staff have networked and collaborated to leverage additional formal and informal partnerships for referrals and continuity of care with community health centers/FQHCs, delivering hospitals, OB/GYN offices, and pediatricians, in addition to community-based, faith-based, and other youth-serving organizations. The Community/Faith-Based/Fatherhood Coordinator continued to participate in numerous outreach/marketing events along with representation on various community boards. In addition, state-level staff continued to provide leadership and oversight for leveraging various important partnerships for sustainability, including continuing operations under an MOU to receive referrals from the Mississippi Department of Child Protective Services for substance-affected infants and families – (CARA Project).
Through the recent MSDH award for an opioid grant, OD2A, the program will be partnering with a community health center for program referrals. The development of this relationship and referral model is currently in the beginning stages, with a goal of starting referrals close to July 2020.
Office of Women’s Health program staff continue to have a strong visible presence with several community-focused events and collaborative opportunities. These opportunities allow staff to provide information and resource materials regarding the BCCP and PHRM/ISS programs, emphasizing services available to both external stakeholders and potentially eligible participants. Within the PHRM/ISS program, there have been numerous opportunities for the program to provide a representative for various planning and advisory committees for other organizations or agencies. Since July 1, 2019, the PHRM/ISS program staff have met with 43 different stakeholder organizations of which 9 are regular meetings where the representative is part of the advisory group. Approximately 2,488 individuals/community members were reached through the partnerships and collaborations.
The BCCP staff continue to explore various outreach activities to increase the number of women screened into the program. Staff participated in the screening of women during one of the major university’s festivities at Alcorn State University located in Lorman, MS. During the homecoming activities on October 12, 2019, people of all ages, specifically women of the targeted age group were present and many of the locals in the surrounding small towns such as Port Gibson, Lorman, Natchez, Wilkerson, and several other neighboring towns were present.
Collaboration between the PHRM/ISS program, Mississippi Public Health Institute, Department of Mental Health and a community health center has strengthened our community partnerships to focus on a case management program that addresses pregnant and parenting women substance use. These collaborations will bring each program to the “table” in order to discuss community and program structures needed to meet the needs to this population. The case management program is estimated to begin before July 2020.
Of the 43 different activities for the PHRM/ISS staff with stakeholders, 22 were presentations and/or professional exhibit booths. At each event where program materials are provided, they are accounted for and sign in sheets are taken.
The BBCP program collaborated with the Mississippi Department of Human Services on October 16, 2019 providing information regarding breast health and screenings for those women that are uninsured or underinsured. During the event, participants were encouraged to share the information with their family members and others’ that may need the services offered by the program. In addition to this state agency, the BCCP program partnered with the human resource personnel of two other agencies, the Mississippi Department of Public Safety and The United State Postal Service. The USPS held a large employee wellness fair on October 20, 2019. Emphasis was stressed on the importance of breast and cervical cancer screenings and the importance of early detection of cancer. Program staff partnered with The Mississippi State Penitentiary of Parchman Prison System staff on October 5, 2019 for their 2nd Annual Health and Wellness Family Day. This is the second year of participation connecting with and providing information to the staff and their families, promoting a healthy community and providing a means of awareness of the services offered by the BCCP that are available to assist them.
ESM 4: # of MOUs with referral sources for the PHRM/ISS case management program.
ESM 4 Report: The PHRM/ISS program has three MOUs for program referrals and one contract with the Mississippi SIDS and Safety Alliance. The PHRM/ISS program has a creating community presence with organizations, medical providers and hospitals. It is through these informal relationships that the PHRM/ISS program receives outside MSDH referrals.
Women/Maternal Health Annual Report (Office of Tobacco Control)
SPM 1: Percentage of women who smoke in the last three months of a pregnancy
Program Summary and Purpose:
The Office of Tobacco Control (OTC) works to reduce secondhand smoke exposure, prevent youth tobacco use, increase adult cessation, and reduce tobacco-related disparities. Tobacco use is the leading preventable cause of death, disease and disability in Mississippi. We have 34 Tobacco-Free Coalitions that cover each county of the state. These coalitions focus on engaging those in the community to advocate for smoke-free spaces, educate on the dangers of tobacco use, and make community members aware of cessation services. The coalitions have been instrumental in advocating for smoke-free communities and adding vaping language to these ordinances.
We work with health systems across the state (clinics, hospitals, health organizations, etc.) to increase referrals to the Mississippi Tobacco Quitline. We have worked for over eight years with all 21 federally qualified health systems to make Quitline referrals, as well as to make comprehensive cessation services a standard of care. Electronic health referrals to the Quitline are also a priority. We have a bi-directional system in place with Coastal Family Health Center and University of MS Medical Center.
Mississippi Title V works to address the impact of tobacco use through the Office of Tobacco Control (OTC). Tobacco use is the leading cause of preventable death, disease, and disability across Mississippi and the United States. Approximately 5,400 Mississippians die each year from their own smoking. Direct costs to Mississippians for tobacco‐related illnesses include an estimated $1.23 billion in medical costs and $319.7 million in Medicaid payments. The Medicaid burden per household is $954 per year in federal and state taxes. Nationally, more than $1.8 billion annually is drained from the economy because of healthcare costs and lost productivity (Campaign for Tobacco-Free Kids, accessed 2/14/20).
According to the 2018 Behavior Risk Factor Surveillance Survey data, 20.5% of Mississippians smoke and 18.1% among females who smoke. Smoking is more prevalent among white females than black females, 20.7 and 12.9, respectively. The percentage of Mississippi adults who reported current cigarette smoking was significantly higher among those with less than High School (HS) (35%) compared to other educational levels and higher among those with an annual household income of less than $15,000 (32.1%) compared to those with household incomes of $35,000 to 49,999, or $50,000 or more. To consistently address tobacco use for lower SES populations, we will continue to partner with health systems and organizations, such as the Health Center Association of MS, that serve this population. To address tobacco use among women of child-bearing age and pregnant women relative to infant mortality, SIDS, and secondhand smoke exposure, the Office of Tobacco Control (OTC) participates in COIIN (Collaborative Improvement and Innovation Network) and related infant health programs to coordinate strategies that educate women about tobacco use dangers before, during and after pregnancy.
Strategy 1: The OTC, in collaboration with its partners, will continue to work to reduce the prevalence of tobacco/alternative tobacco products among women ages 18-44.
Rationale for Strategy 1: Increase cessation among women of childbearing age to promote better birth weights and infant health.
Activity 1a: Promote the availability of cessation treatment services and resources via the Mississippi Tobacco-Free Coalitions, statewide partners, healthcare providers, and stakeholders to shape interventions and activities that address pregnancy and the implications of tobacco use during pregnancy.
Report Activity 1a: The OTC partnered with the Community Health Center Association of Mississippi to implement the BABY & ME – Tobacco Free Program. This is a smoking cessation program created to reduce the burden of tobacco use among women during the prenatal and postpartum period. The program was implemented in 10 MS Community Health Centers. The program was promoted through fliers, emails, health fairs, and website to Mississippi Tobacco-Free Coalitions, statewide partners, healthcare providers, and stakeholders.
Activity 1b: Ensure pregnant women have access to tobacco and drug counseling and educational services. (The OTC ensures access to treatment services for tobacco/alternative tobacco products; other substances are excluded).
Report Activity 1b: The MS Quitline along with the BABY & ME – Tobacco Free Program provides pregnant women access to tobacco counseling in over 70 of Mississippi’s 82 counties.
Strategy 2: The OTC will continue to empower the MS Tobacco-Free Coalitions and other partners to provide education to local municipalities and counties on the importance of a smoke-free environment.
Rationale for Strategy 2: The OTC is working in collaboration with partners and sub grantees to continue efforts to educate and inform municipalities on the impact of and the benefits of Smoke-free policies to reduce tobacco use, increase cessation rates, and reduce secondhand smoke exposure.
Activity 2a: Engage with local officials at the Mississippi Municipal League (MML) Conference and the MS Annual Board of Supervisors Conference, annually, regarding the health and economic benefits of local comprehensive, smoke-free ordinances.
Report Activity 2a: The OTC continues to partner with the Mississippi Municipal League and the MS Board of Supervisors to provide information to local municipalities during their annual conferences and throughout the year on the advantages of smoke-free/tobacco-free environments and to recognize cities who have passed local smoke free ordinances;
Activity 2b: Provide education, awareness, and resources to municipalities regarding the importance of local ordinances to protect citizens from the dangers of second-hand smoke.
Report Activity 2b: The OTC continues to work through the Mississippi Tobacco-Free Coalitions to educate and empower local elected officials on the health and economic impact and the benefits of implementing smoke-free ordinances within their 34 municipalities that cover the 82 counties.
Evidenced Based Measure (Office of Tobacco Control)
ESM 1: # of women ages 18 - 44 who access the Quitline for cessation services
ESM 1 Report: There were 929 women ages 18 - 44 who accessed the Quitline for cessation services
ESM 2: Number of Mississippi communities (cities, counties, etc.) with comprehensive smoke-free ordinances.
ESM 2 Report:There are 165 smoke-free communities and five smoke-free counties.
Other Programmatic Activities (Office of Women’s Health)
The MSDH Office of Pharmacy partners with the Office of Women’s Health to have pharmacy students learn more about public health and women’s health. Through this project, students completed training modules surrounding STD and pregnancy, 17P, opioids and pregnancy, oral health and pregnancy, and NAS. The students were instrumental in developing some of the training tools used for fall 2019 PHRM/ISS trainings. The pharmacy students reviewed the Cancer Drug Program within the Office of Women’s Health, treatments for breast cancer, and the structure of the MSDH Pharmacy department. They did not identify ways to expand the drug distribution program for medications. They did identify creative ideas on how to promote the program for further use by patients.
The Breast and Cervical Cancer Program (BCCP) provides outreach activities/educational materials to promote awareness and public education through collaborations with community groups and organizations. Conduct screening services, diagnostic services, referrals and case management through contracts with community health centers, health departments, private providers and hospitals. The Breast and Cervical Cancer Program continues to form partnerships with various organizations statewide. Some of these organizations include: the MS Department of Corrections, MS Network for Cancer Control, Fannie Lou Hamer Cancer Foundation, MS Comprehensive Cancer Control (MP3C), Office of Preventive Health, Families First, and the Adams County Sheriff’s Department. In addition, the program initiated the Community-Clinical Linkage, focusing on the implementation of the Evidence Based Intervention (EBI) with one Health System, Jackson-Hinds Comprehensive Health Center (JHCHC) who is one of the major partners of the BCCP providing breast and cervical cancer screening services for the underserved women in the state of Mississippi (MS). Additionally, the program has selected two other health system, that the program staff will be working closely with going forward during the calendar year of 2020. The goal of the EBI is to reach the uninsured and under-insured women in the community who would otherwise not have access to the services offered by the program.
The PHRM/ISS program started collaboration with the MSDH Office of STD/HIV to focus on the specialized needs of pregnant women diagnosed with an STD during pregnancy. To support the partnership for referrals and to ensure the program staff were equipped with the knowledge base and skill set for managing patients with chlamydia, gonorrhea, and/or syphilis, the PHRM/ISS program requested specialized training in best practices for providing case management to high risk individuals affected by STDs. Training related to best practices was held September 26, 2018 by a national level consultant from National Alliance of State and Territorial Directors and the National Coalition of STD Directors. Summer 2019, the PHRM/ISS program developed talking points and a documentation tutorial for staff. Using the Healthy Start Epic Center, evidence-based practice, surrounding STDs and Pregnancy – the Facts, created health education sheets from CDC: STDs and Pregnancy; Chlamydia: Gonorrhea; Syphilis; and Genital Herpes, this health education material has been provided to the case managers along with condoms for case management participants. https://www.cdc.gov/std/pregnancy/the-facts/default.htm The program is currently reviewing charts for use and fidelity to the program. Due to the developments of COVID-19, this project has been delayed until July 2020.
MSDH's programming for expectant and parenting teens was recognized as an OAH Pregnancy Assistance Fund Program Successful Strategy via a publication it produced in September 2018. The data informing this publication was provided from FY2016 and FY2017 annual reporting and performance measure data. ( https://www.hhs.gov/ash/oah/grantprograms/pregnancy-assistance-fund/successful-strategies/mississippi-state-department-of-health/index.html) This grant ends June 30,2020. Per the funder, it will not be renewed due to legislative changes.
MSDH PAF program created the Baby/Parenting Station located in the Jones, Coahoma, Union, Hinds, Lauderdale, Adams and Harrison County Health Departments. The station is housed in a former clinic exam room in each of the County Health Departments. The parenting station include several modules that teen participants are guided through, including safe sleep, bathing, car seat safety, diapering, feeding, developmental tasks and play, and life skills for young parents. Each parenting station promotes the father of the baby and/or male significant other to be involved in the parenting station. If a father of the baby and/or male significant other does participate, he is provided developmental tools to take home in order to continue the lessons learned at the parenting station. As the project has progressed, the program leadership identified the need to provide the interactive health education in other counties not originally identified in this project. The mobile parenting stations have expanded to the following eligible counties: Tallahatchie, Panola, Desoto (Hernando), Monroe, Clay, Pontotoc, Sharkey-Issaquena, Warren, Yazoo, Clarke, Leake, Lowndes, Neshoba, Noxubee, Franklin, Jefferson, Wilkerson, Covington, Forrest, Wayne, George, Stone, and Jackson Counties. In addition, the mobile parenting stations allow all identified counties to bring the portions of the parenting stations into the homes of the participants, and not limiting this intervention to only when they come into a MSDH county clinic for services.
Health education and teaching is delivered through modules which aligned with the Florida State University Partners for Healthy Baby curriculum and supported by additional medically accurate and evidence-based materials vetted by larger federal entities, including CDC, HRSA, HHS, and NICHD. A system was also developed for participants to earn development tools/materials that assist with basic physical, health, safety and other needs for themselves and their babies.
Per the program manager over parenting stations, “We have been very successful in helping the participants enter parenthood, feeling prepared and confident in their emerging parenting skills. The parenting stations also allow teen parents and their infants to learn how to interact with one another through developmental tasks and play.”
Case managers and staff serving under the PAF grant in the grant-supported counties continue to make considerable efforts to identify, enroll, and serve the target population. During the reporting period, 312 expectant teens, 171 parenting teens, and 54 dually enrolled teens ages 19 and under, and 226 infants born to teens, totaling 763 unduplicated participants, have been provided enhanced case management services statewide under the PHRM/ISS program. An additional 135 infants were born to teen participants and were followed until their mothers’ services terminated at 60 days post-partum or before but were not enrolled in the program for continued services under the infant. Of the total number of participants (763), 26% (n=196) resided in one of the 15 grant-supported counties. Additionally, 92 participants were served by teen specialists covering other counties not specifically targeted under the grant, resulting in 38% (n=288) of all participants being served by a teen specialist. Monthly, case managers across all counties are expected to submit and update census reports, which detail the demographic information for all participants of PHRM/ISS case management services. Individual participant electronic health records are accessible by program staff for more extensive reviews to determine the level of direct services provided related to personal health, child health, education and employment, concrete supports, parenting supports, and referrals to other services. Program staff use information extracted from the EHR to complete data collection to be used for performance measure reporting.
Here is an example of what this program has meant to the participants. A 17-year-old teen already enrolled in the PHRM/ISS Pregnancy Assistance Fund program came to her scheduled appointment feeling overwhelmed and excited at the same time about her new bundle of joy coming in just a few weeks. This teen was the first to participate in the Parenting Station in her home county. Social Worker and Nurse taught the expectant mom how to bathe a baby, put the baby in a car seat correctly, feed and diaper the baby, and the use of a bulb and medicine drop appropriate if her bundle of joy was to become sick. These techniques were demonstrated with baby dolls and actual baby supplies. The teen was also able to practice being a mom while at the parenting station. The Social Worker and Nurse provided the teen mother with a pack-n-play from MS SIDS and Safety Alliance program, Cribs for Kids program, thoroughly went over safe sleep environment procedures (back to sleep) and they practiced how to put up and take down crib appropriately. Additional health education covered while using the parenting station included: preparing for labor and delivery, what to expect during labor, and development and behaviors appropriate for her newborn baby. The soon-to-be mom expressed that she enjoyed the training and felt more confident about being a new mom.
Other Programmatic Activities (Office of Tobacco Control)
In order to further address the vaping concerns among the youth population, the OTC continuously seeks opportunities to engage communities regarding vaping. The OTC has partnered with The Partnership for a Healthy Mississippi (PHM) to expand the reach of providing education and awareness on the effects of vaping. The PHM works in schools and throughout communities to provide awareness, education, and cessation messaging. These activities are an additional tool in addressing the vaping epidemic.
Emerging Issues (Office of Women’s Health)
Opioid addiction: Title V, Section 503, “Infant Plan of Safe Care,” of S. 524, “Comprehensive Addiction and Recovery Act of 2016” was signed into law (Public Law 114-198) on July 22, 2016. The bill amends the Child Abuse Prevention and Treatment Act (CAPTA) to address the health and substance use disorder treatment needs of the infant and affected family or caregiver; and to ensure the development and implementation by the State of monitoring systems regarding the implementation of plans to determine whether and in what manner local entities are providing, in accordance with State requirements, referrals to and delivery of appropriate services for the infant and affected family or caregiver. The collaborative response required under the CARA legislation has demanded the Mississippi State Department of Child Protective Services (MDCPS) to go beyond addressing immediate safety concerns of substance-exposed infants to addressing caregivers’ substance-use treatment and the infants’ well-being and developmental needs.
To support MDCPS in its mandate, effective late FY18, MSDH and the Mississippi Department of Child Protective Services (MDCPS) entered into a MOU between agencies to support a cross-system partnership for referrals of infants and their families to PHRM/ISS for outreach and delivery of appropriate services. The partnership follows the basic tenants ascribed by the Substance Abuse and Mental Health Services Administration (SAMSHA)’s: A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders (2016). (Substance Abuse and Mental Health Services Administration (SAMSHA)’s: A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders (2016).)
Referrals target infants identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal drug exposure or a Fetal Alcohol Spectrum Disorder, who have been reported to MDCPS by medical providers under the CARA federal mandate. To ensure the success of this partnership, a licensed master level social worker (LMSW) at the MSDH Central Office provides primary oversight and initial outreach on all referrals received. Individuals interested and agreeable to participate in PHRM/ISS services are then referred to the county-level for enrollment. Between the partnership launched on June 1, 2018 and February 2020, MSDH has received 708 referrals for infants identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal drug exposure or a Fetal Alcohol Spectrum Disorder, the most of any single public or private-sector partner to MDCPS in this effort.
MSDH has been awarded the grant “Overdoes Data to Action” (OD2A) grant. Per the project narrative, the Mississippi State Department of Health (MSDH) will utilize Overdose Data to Action (CDC-RFA-CE19-1904, “OD2A”) funding to facilitate enhanced data collection, data collaboration, and data reporting protocols while developing multiagency partnerships that lead to the improved utilization of resources, the acquisition and deployment of actionable data, and other systems enhancements that directly impact OUD and SUD-related morbidity and mortality. The OD2A grant provides for a case management program in Harrison county. The population served will be women using or having used substances during current pregnancy, and infants exposed to substances prenatally. The case management program will partner with a local FQHC for referrals and coordination of care. Other referrals will also be accepted via the CARA project, hospitals and other providers. The Office of Women’s Health is reviewing evidence-based case management programs as potential programs to replicate.
The opioid-related problems present in Mississippi are among the most formidable in the nation. The 2018 Mississippi Morbidity Report (34[1], November 2018) underscores the daunting contours and scope of this problem. Despite modest declines in the state’s opioid analgesic prescribing rates since 2012, Mississippi retains the unenviable ranking of having the fourth highest opioid prescription rate in the US. Mississippi’s unusually high opioid prescribing rate is exceeded only by Tennessee, Arkansas, and Alabama.
Coronavirus has impacted both bureaus under the Office of Women’s Health. In the BCCP program, leadership staff continue to work on processing data and medical records. Many of the county level MSDH staff who would have enrolled patients into the program have been placed on Orders to assist with contact tracing for the coronavirus pandemic. This is impacting the number of referrals obtained from the MSDH health department clinics. The office has been receiving an increase number of calls from women who have lost their insurance due to work closures under the “shelter in place” orders. These women are being referred to outside BCCP contract providers for enrollment into the BCCP program, screenings and if needed, diagnostic testing. In addition, the community event, See, Test, and Treat, scheduled for Saturday, April 25, 2020 has been postponed.
Since the pandemic occurred, the PHRM/ISS program staff are remaining in contact with patients and families though telephone calls. By May 2020, the case management staff will have access to an audio/visual HIPAA compliant platform to reach out to patients and families who want a telehealth visit as their case management visit. The case managers are regularly checking in with patients and families, providing support, health education and referrals as needed. Providers, hospitals and other partners such as CARA, are continuing to send referrals to the program. While enrollments are on hold until the “shelter in place” is lifted, these referrals receive outreach, support and referrals to necessary community services as needed.
The Social Services Office, under the OWH, has been collecting and disseminating to the public health social workers (PHSWs) list of community resources, webinars and health educational facts sheets from CDC, ASTHO, and other reliable sources. This office provided the PHSWs with the Mississippi Department of Mental Health phone number for patients who may be feeling depressed, anxious, or other emotions surrounding the pandemic. The webinars are to provide the PHSWs with increased knowledge, such as review of shaken baby syndrome, and the tools necessary to address the ever-changing needs of families due to the pandemic. Fact sheets have focused on, but not limited to, ways to decrease isolation, addressing domestic violence while sheltering in place, depression and anxiety, guidelines for pregnancy and breastfeeding if exposed to COVID-19, and how to make the most of a delivery if a support person is not able to be with you.
Success Story (Office of Women’s Health and Tobacco Control)
On June 11, 2019, the BCCP staff actively participated in the “See Test and Treat (STT)” event held at the University of Mississippi Cancer Institute Center for women (21 – 64 years old) who were deemed eligible for this one-day event sponsored by the University of Mississippi Medical Center through grant funding received from the College of American Pathologist (CAP). The BCCP was one of many organizations that served as an active partner for this event. The program was instrumental in getting three of the surrounding FQHC’s to join in pre-screening and enrolling women as well as establishing a medical home afterwards for the women to receive continued follow-up care the next year. The screenings were opened to women in Hinds, Madison, Yazoo and Rankin counties. On the day of the event, program staff had a table set up with brochures, health education material information, literature and flyers about the program and services offered that they could share and interact with the participants on a one-on-one basis. There was a total of 103 participants, a 3% decrease from last year but a 60% increase from when the program started in 2017. Fifty-seven women received screening mammograms with 21 requiring follow-up, 44 Pap Smears with no malignancies identified, 7 trich identified (referred for treatment) and 7-8 with concerning symptoms that were not malignant nor dysplasia (cervical polyo, post-menopausal bleeding, etc.). All were referred for additional follow-up to appropriate providers. The organizers of the event will again utilize the services of the FQHC’s and social media.
Yearly, The BCCP staff provide a health educational seminar to the women incarcerated at the restitution center. During the November 2019 educational seminar, the 210 women were provided information regarding the importance of early detection of breast cancer and the warning signs. During the previous event, on April 26, 2019 event, there were 203 women in attendance. The women were encouraged to share the information with family and friends during conversations and visits. A total of 96 of the 210 women (48%) signed up for additional information about screening services. The participants name, age, projected release date, county and address were collected during the event. BCCP Reminder Post Cards will be utilized as a referral system for the women that participated and signed the “sign-in” log at the November seminar. These cards are provided to the Restitution Chaplain, who distributes them to the participants. This referral card has information regarding BCCP enrollment requirements and screening location that includes the address and contact information for the screening provider. The BCCP staff will cross check enrollment to find out the outcome of this project.
Quitting for The Right Reasons
This is Shalia Carter’s story told by the Baby & Me Tobacco-Free Program staff person: Shalia is a black female pregnant with her second child. She didn’t think she could quit smoking until she realized the impact that nicotine could have on the health and future of her unborn baby. The “Baby and Me Tobacco Free Program” made it possible for her to quit smoking for good by giving her the knowledge and incentive she needed. Shalia came in at approximately 8 weeks pregnant. She decided that June 13th would be her quit date. She had been smoking for 3 years. She quit smoking when she was pregnant with her first child but resumed smoking shortly after the birth. Realizing that quitting and staying quit is easier said than done, she reached out for help. She wanted to give this child what she was not able to give her first - a smoke free environment to grow up in. She made up her mind to fight this addiction with everything she had. She began cutting back on the amount of cigarettes that she smoked daily. When she came for her first visit, she was told about the “Baby and Me Tobacco Free Program.” She immediately knew that this program was right for her. It offered the incentive that she needed. After completing her visit with the Ob/Gyn, she was brought over to visit with me to find out more about the program. She especially wanted to hear about how to get free diapers.
I explained to her that quitting smoking was the most important thing that she could do for her health and the health of her unborn child. I told her that she had to complete four prenatal visits before she gave birth and that she must be tobacco free by the 3rd visit. She would be tested on each visit using the carbon monoxide monitor. If she was tobacco free at this time, she would receive her first $25.00 voucher which could only be used to purchase diapers and baby wipes. I also informed her that after giving birth she could remain in the program for 12 months, receiving 1 voucher each month if she was tobacco free. Mom can also have a support person. This must be a person who smokes and expects to live in the house with mom for the first year after the baby is born. They must agree to stop smoking and come in once per month to be tested using the carbon monoxide monitor. If they are smoke free, two $25.00 vouchers are given to purchase diapers and baby wipes at Kroger or Walmart.
On December 27th, 2020, Shalia delivered a 7lb 11oz baby boy. She has attended her second postpartum visit and is still tobacco free.
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