Title V in Louisiana serves as a provider and facilitator of high-quality services and innovative practices that protect and promote the health of women, children, and children and youth with special health care needs (CYSHCN). Housed within the Louisiana Department of Health (LDH), Office of Public Health (OPH), Bureau of Family Health (BFH), Title V leads the state efforts to improve health outcomes for the maternal and child health (MCH) and CYSHCN populations in Louisiana. BFH works to improve the health of the state’s residents and the health-promoting capacity of its systems by:
- Monitoring data to identify, understand, and respond to complex challenges and opportunities
- Aligning efforts and resources to improve community health
- Testing, scaling, and spreading solutions and services that are grounded in best practices and evidence
- Building coordinated partnerships to advance common goals
Like other states, the health and well-being of women, children, and families in Louisiana is influenced by the strengths, challenges, and changes in the state and in local community systems. Louisiana’s Title V program has continuously evolved to adapt and respond to changes within these complex systems, with a particular focus over the past five years on increasing the state’s capacity to monitor and understand population health and inform healthcare policy and practice.
Over the past 18 months, the COVID-19 pandemic has impacted all levels of the healthcare system, including the health status of the population and the ways in which public health entities - including Title V - work to promote health. The full impact of the pandemic on the physical, mental, and economic health of the Louisiana Title V population will not be fully understood for some time.
Louisiana has experienced a high burden of COVID-19 cases and deaths. Early in the pandemic, cases of COVID-19 grew more rapidly in Louisiana compared to other states. Governor John Bel Edwards responded swiftly with stay-at-home orders that mandated the closure of several public spaces across the state, including schools, gyms, restaurants, beauty salons, and other commercial venues. Like many other states, Louisiana adopted a phased reopening plan, with staggered phases mandating capacity limitations on public gatherings and business closures based on projected risk of exposure. Throughout 2020 and 2021, Louisiana moved between phases, at times rolling backwards into earlier phases to accommodate increasing infection rates.1
At time of writing (August 2021), infection rates, deaths, and hospitalizations due to COVID-19 are on the rise in Louisiana, mostly due to the Delta variant. Nearly 3,000 Louisianans are currently hospitalized for COVID-19. More than 450 of these patients are on ventilators. Unvaccinated people make up 89% of current COVID-19 cases, 80% of deaths, and 91% of hospitalizations. At time of writing, 39.4% of the state population have completed a vaccine series, and the governor has issued a statewide indoor mask mandate until further notice.1,2
The following sections describe the most significant changes that have occurred in recent years in the state and the healthcare system.
Understanding the Health Status and Needs of the MCH Population in Louisiana
The Place: Louisiana is the 31st largest state in the country, covering an area of 43,204 square miles along the Gulf of Mexico (Map 1). Louisiana consists of flat lowlands located on the coastal plain of the Gulf of Mexico and the Mississippi River’s alluvial plain. The economy is heavily dependent on its fertile soils and water to support farming and fishing industries. Louisiana also is one of the leading producers of natural gas and petroleum.
Of Louisiana’s 64 parishes (counties), 30 are considered rural per the U.S. Health Resources and Services Administration.3 The largest urban centers include New Orleans and Baton Rouge. Hurricanes, industrial contamination, and loss of wetlands all represent natural and unnatural disasters that pose threats to the economy, safety, and well-being of Louisiana’s communities and residents. Significant historical events in the past decade include the British Petroleum oil spill of 2010; severe flooding in 2016; tornados and flooding due to Hurricane Harvey in 2017 and Hurricanes Laura, Delta, and Zeta in 2020; and persistent coastal land loss of the protective wetlands.
The People: Louisiana’s population of about 4.6 million people encompasses a distinct multicultural and linguistic landscape that has been influenced by centuries of colonialism and servitude. Today, the majority of the population in Louisiana identifies as White (58.7%), Black (32%), 5.1% identify as Hispanic/Latino, 1.7% Asian (majority Vietnamese), 1.8% two or more races, and 0.5% American Indian/Alaskan Native, with four federally recognized American Indian tribes and several state/local tribes.4,5 Louisiana is unique in that nearly four out of every five residents were born in-state.4 The state is known for its community-oriented culture. With a 300-year history, Louisiana has some of the longest-lasting cultural traditions in the United States.
Challenges and Strengths: There are many challenges and strengths present in Louisiana’s systems, politics, and communities that affect the health and wellbeing of the state’s maternal and child population. The Louisiana Title V Program identifies these challenges and strengths through the lens of the social determinants of health (SDOH): the conditions in which people are born, live, learn, work, and play. Specifically, social and community context, economic stability, education, neighborhood environments, and health and healthcare all pose various challenges and opportunities for health.
Louisiana’s history of colonization, slavery, and legalized racism disempowered and oppressed portions of Louisiana’s population over multiple centuries. While laws and policies have changed over time, these historical inequities continue to take a significant toll on communities in the state and are perpetuated, often unknowingly, through bias in institutions and systems. The resulting and persistent racial disparities can be best interpreted in light of the conditions in which people are born and live--conditions largely affected by historical and institutional structures and policies that create and sustain differential access to resources and systems of influence and authority.
Economic instability poses a major challenge to the attainment of health for many Louisianans. In 2019, about one in five residents lived at or below the FPL, with 27.2% of all children (under age 18) living in poverty. The average household in Louisiana earned approximately $14,000 less than the national household income, and Black households made significantly less annually ($30,540) than White households in Louisiana ($60,288), according to American Community Survey 2019 5-year estimates.4 Conditions of poverty pose unique challenges for CYSHCN families. For parents and caregivers with CYSHCN, full-time employment means less time spent coordinating care for their children. Parents of CYSHCN are more likely than parents of non-CYSHCN to report cutting hours or quitting jobs as a result of their child’s health issues.6 Additionally, out-of-pocket medical expenses for this population are more extensive than those of non-CYSHCN, regardless of insurance coverage.
In addition to economic instability, low educational attainment is a challenge. Adults in Louisiana are less likely to finish high school than their peers across the US, and 20.6% of students with disabilities drop out of high school, which is higher than the national average of 16%. More than 103,000 students in Louisiana were suspended in the 2019-2020 school year (57,196 in-school suspensions, 46,113 out-of-school suspensions). These numbers are significantly smaller than past years due to the 2020 stay-at-home orders, however students of color continued to be more commonly suspended than white students.7
Due to the challenges, Louisianans consistently have poorer health outcomes compared to the rest of the nation. According to America’s Health Rankings 2020, Louisiana ranked 50th in the nation in overall health.8 Low birth weight (LBW), preterm birth (PTB), infant mortality, maternal mortality, and CYSHCN status remain significant challenges for the MCH population.
In 2020, Louisiana had the fourth highest infant mortality rate in the US. Approximately 474 babies born to Louisiana resident mothers die before their first birthday, an average of more than 9 babies per week. Similar to nationwide trends, Black infants in Louisiana die at twice the rate of White infants. Sudden Unexpected Infant Death (SUID) cases represent 20% of all infant deaths in the state, though many SUIDs are determined to be accidental suffocation and strangulation in bed (ASSB) upon further investigation.9
According to Louisiana’s latest Maternal Mortality Report, there are 24.6 maternal deaths per 100,000 births in the state, compared to 17.4 deaths per 100,000 nationally.10,11 Within Louisiana, disparities by race are significant: for all pregnancy-associated deaths in Louisiana, black mothers are more than twice as likely to die as white mothers.10 Compared to the national average, Louisiana has a higher proportion of CYSHCN. Approximately 24% of children in Louisiana have special health care needs.6
In recent years, opioid use and abuse has become a pressing issue. The rate of drug related deaths has increased in Louisiana from 13 per 100,000 deaths in 2014 to 21.3 per 100,000 deaths in 2019, according to America’s Health Rankings.8 Neonatal Opioid Withdrawal Syndrome (NOWS) is also a growing concern, which will be further discussed in the State Action Plan section on Women’s/Maternal Health.
Impact of COVID-19: As of August 2021, more than 649,000 cases of COVID-19 have been confirmed in Louisiana. Nearly 12,000 Louisianians have died, and thousands more have been hospitalized.1 Conditions like diabetes, hypertension, heart disease, and obesity have been identified as risk factors for COVID-19 complications.11 The Louisiana population has higher-than-national-average rates for nearly all of these risk factors. This leaves Louisianians especially susceptible to complications and deaths due to COVID-19.
The first COVID-19 vaccine in Louisiana was administered on December 14, 2020. Health care workers were the first to receive the vaccination, followed by elderly and other at-risk populations. As of May 13th, 2021, anyone is eligible to receive the vaccine in Louisiana, including children. To date, 1.8 million Louisianians have completed their vaccination series, and more than 2.2 million vaccination series have been initiated.2
The economic impacts of the pandemic and subsequent statewide quarantine were significant and immediate: between March 2020 and April 2020, unemployment increased from 6.7% to 15.1%. As the pandemic progressed and Louisiana moved into later phases of reopening, these numbers began to decline. As of July 2021, the unemployment rate is down to 6.6%.13
While state-level data are not available, national data suggest that both the pandemic and the isolation of quarantine have increased mental health issues like depression and anxiety. A 2021 report from the Kaiser Family Foundation found that during the pandemic, about 4 in 10 adults in the U.S. reported symptoms of anxiety or depression, up from 1 in 10 adults in the first half of 2019. Young adults (18-24) in particular have been impacted, with 56% reporting symptoms of anxiety or depression during the pandemic.14 A poll conducted early in the pandemic showed that people who were sheltering in place (47%) were more likely to report negative mental health effects resulting from stress related to coronavirus than among those not sheltering in place (37%).15 Though necessary to prevent the spread of the virus, social isolation has long been linked to feelings of loneliness and depression in the scientific literature. Research has also demonstrated that job loss is associated with increased depression, anxiety, and low self-esteem, and may lead to higher rates of substance abuse and suicide. The public health crisis precipitated by COVID-19 is ongoing, and its economic, social, and emotional impacts continue to unfold.
While Louisiana continues to experience ongoing challenges related to this pandemic, recent changes in healthcare coverage could not have been timelier. Historically, Louisiana had one of the highest uninsured rates in the nation. In July of 2016, Medicaid was expanded to all adults under 138% of the federal poverty line (FPL) (children were not part of this expansion population because children in that income range are already eligible for public insurance coverage). With that change in health policy, Louisiana experienced one of the largest reductions in the uninsured rate for any state.16 With the expansion of Medicaid, more than 516,000 adult men and women have gained health care coverage under public insurance. With the inclusion of the expansion population, Medicaid is now responsible for approximately 1.5 million child and adult participants in Louisiana.16 Furthermore, Medicaid expansion has had a significant positive impact on Louisiana’s economy: within the first year of Medicaid expansion, more than 19,000 new jobs were created and $178 million in new state and local revenues were generated.17 Economic gains are expected to continue, with the state projected to save $1 billion by 2028 due to Medicaid expansion.18
Another strength in Louisiana is the long-standing commitment to facilitating healthcare coverage for children. Louisiana has achieved and sustained high rates of coverage for children. Between 2009 and 2016, the percentage of uninsured children decreased from 7% to 3%, and this decrease has been sustained for several years.19 More than half of CYSHCN in Louisiana have public insurance which is higher than the national average.6
Louisiana's early care and education system has also undergone significant change in an effort to better serve the state's families. Child care licensing was unified with other early education programs under the Louisiana Department of Education in 2015 in order to create a cohesive early childhood system and improve school readiness. This system has continued to stabilize and mature, though access to childcare subsidies remains more limited than a decade ago.20 According to the State of Babies Yearbook 2021, Louisiana lags behind the national averages for every measure associated with positive early learning experiences.21 Given the state of early childhood education in Louisiana, Governor Edwards has declared this issue a top priority for his second term.
In 2019, Louisiana had the highest incarceration rate of any state (680 people per 100,000 are sentenced to more than one year under state or federal jurisdiction in Louisiana, compared to 419 per 100,000 nationally).22 The laws and policies that affect this rate are multifaceted and include sentencing laws for non-violent offenses, the state’s approach to funding jails and prisons, the privatization of facilities, and a lack of investment in services and supports. Under Governor Edwards, the state has begun efforts to reform the criminal justice system and as a result the prison population is beginning to decline. While these changes are promising, additional reform is necessary.
Systems of Care for Vulnerable and Underserved Populations
Financing and Integration of Services: In 2012, Louisiana Medicaid began transitioning from a fee-for-service system to Healthy Louisiana, a network of five managed care organizations (MCOs) to cover Medicaid services for children and adults. As of 2015, the state's MCOs have been responsible for both physical health and behavioral health benefits.
Mandatory MCO populations include the majority of Medicaid eligible population groups including children under 19 years of age, individuals and families receiving Temporary Assistance for Needy Families (TANF), Child Health and Maternity Program (CHAMP)-Child Program, Deemed Eligible Child Program, foster care children, youth aging out of foster care, former foster care children through the age of 26, Regular Medically Needy Program, Louisiana Children’s Health Insurance Program (LaCHIP), Blind/Disabled Children, eligible parents and caregiver relatives, pregnant women, LaMOMs, breast and cervical cancer program, aged, blind and disabled adults, Supplemental Security Income (SSI) Program, individuals diagnosed with tuberculosis and the new adults expansion population. Although there are populations excluded from managed care such as dual-eligible (those who receive both Medicare and Medicaid), waiver recipients, and individuals in long-term care, individuals receiving services through the 1915(c) Home and Community Based Waivers, such as Children’s Choice, are considered voluntary opt-in populations for MCO services and benefits. Furthermore, some dual-eligible are mandatorily enrolled in the MCOs for Specialized Behavioral Health Services, and non-emergency medical transportation.
The MCOs are required to cover all state plan services including the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) at or above the Medicaid published rate, unless the provider/MCO contract allows a different reimbursement rate. These plans also have flexibility to provide other services that will help meet their members' needs through value-added benefits or additional network coverage. Plans are required to report on certain quality measures, with plans offering incentives to both providers and members. Examples of various incentives for members include gift cards for preventative care such as wellness checks, sexually transmitted infection (STI) screenings and prenatal and postnatal care. Extra benefits offered include dental care and hearing aids for adults, tobacco cessation and weight management.
In February 2019, the state Medicaid program released a competitive solicitation to re-bid MCO contracts. Initially, four companies were selected for the new MCO contracts - three companies that currently hold contracts and one new insurer. The two insurance companies that were not selected filed a legal protest that prevented the new contracts from being awarded. In January 2020, the governor signed emergency contracts with the existing five MCOs to prevent disruption of health care coverage for enrollees. In August 2020, LDH announced that rather than continue with the legal proceedings, a new solicitation would be issued. In June 2021, LDH released the new RFP, which places emphasis on health equity, maternal and child outcome improvement, behavioral health integration, delivery system reform, disaster planning and recovery, Department of Justice settlement agreement requirements, fraud, waste and abuse initiatives, and increased MCO accountability. LDH plans to announce the awarded contracts in November 2021.
Health Services Infrastructure: Overall, Louisiana is recognized as having a substantial and growing unmet need for primary care services. As of April 2021, the US Health Resources and Services Administration (HRSA) recognized 155 primary care shortage areas in the state, compared to 141 in 2018 and 148 in 2020. The number of mental health shortage areas also increased; there are now 151 recognized mental health shortage areas, compared to 129 in 2018 and 144 in 202023. Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) are essential to addressing these needs. Louisiana currently has 260 FQHCs operated by 39 community health center organizations, and 160 RHC providing primary care and mental health services in the state. Furthermore, a statewide network of 58 school-based health centers affiliated with OPH BFH provide additional access, in particular for adolescents.
Services related to mental health are a critical need, as reflected in the federal shortage area designations, the OPH State Health Assessment, and the 2020 Title V Needs Assessment. The Healthy Louisiana MCOs are required to ensure network adequacy based on the Centers for Medicare and Medicaid Services (CMS) guidelines and assist their members with making arrangements for access to services, including transportation upon request. The EPSDT mandate makes fulfilling this need a state obligation, in addition to a contractual obligation. However, the specific gaps and problems are not well documented. Assessing the health system performance related to mental health needs will be a priority for Title V. In addition, Title V has begun to prepare for scaling provider capacity-building interventions. Provider-to-provider consultation to support first-line identification and management of social-emotional and psychiatric concerns is one such system-strengthening intervention that has been gaining interest in Louisiana.
Like other states, telemedicine assumed an unexpected and critical role in the delivery of healthcare in Louisiana as a result of the COVID-19 pandemic. While statewide data on the volume of telehealth visits is not available at this time, some health systems have reported that their telemedicine visits have increased from an average of 14 per day to well over 1,000 per day.24 The ability to quickly assemble an infrastructure for telemedicine under such critical circumstances has proven to be an unanticipated strength of Louisiana’s healthcare system and by leveraging this unprecedented momentum, Louisiana can continue to strengthen and refine this capability over time.
Changes in OPH Services: Louisiana's statewide network of OPH Parish Health Units (PHUs) once served as the state’s main provider of primary care for low-income women, children and families. Over the past 15 years, however, care has been transitioned to private providers (such as FQHCs) as Medicaid has become more widely accepted. PHUs now primarily provide essential public health services, with a focus on high-quality family planning and sexually transmitted disease (STD) services, WIC (Women, Infants, and Children), CYSHCN safety-net specialty services, immunizations, and tuberculosis testing and treatment. Funded through Title V federal and state allocations, PHUs in LDH Regions 2-9 (see Figure 2 below) provide a total of 29 sub-specialty and genetics clinics for CYSHCN. Additionally, 57 of the 70 PHUs provide Title X-sponsored reproductive health services, with programmatic oversight provided by the BFH Reproductive Health Program (RHP).
Figure 2. Louisiana Department of Health Administrative Regions
While the reproductive health and CYSHCN clinics were beginning to explore telehealth options, the SARS-CoV-2 pandemic expedited the timeline and prompted major changes in service delivery through the PHUs. Within two weeks of the stay-at-home orders and clinic closures, Title V-supported staff worked across programs and clinical service lines together with OPH nursing and revenue teams to develop a HIPAA-compliant virtual visit platform, train clinic staff, and implement telehealth visits at all PHUs.
A phased reopening of PHUs and prioritization of clinical services that require traditional office visits is anticipated. Until all PHUs are cleared to be open and fully-operational, telehealth will continue to be recommended for most services. In the long term, telehealth services will likely continue in some capacity after PHUs resume in-person clinic operations. However, certain types of telehealth services have only been available throughout the SARS-CoV-2 pandemic due to temporary changes in regulatory and reimbursement policies. Despite the many unknown factors impacting future health care delivery, BFH is actively planning for post-pandemic direct service operations and exploring options for telehealth sustainability and expansion, especially for underserved communities.
With most women, children, and CYSHCN generally accessing care in community settings, Louisiana’s Title V Program has been working to redefine Title V’s role in fulfilling the mandates to ensure access to and the quality of services. For CYSHCN, the charge is even broader, encompassing assurance of a coordinated, community-based, family-centered system of care for all CYSHCN in the state. In 2019, BFH began a series of internal evaluations of programs that provide clinical services. A key part of the assessment was a statewide scan of certain key provider types for CYSHCN historically eligible served in the OPH PHU through the Children’s Special Health Services (CSHS) and Genetics clinics. The initial evaluation showed that several geographic areas continue to lack local providers. To get an accurate understanding of the service gaps experienced by families around the state, BFH is currently conducting landscape assessments of all of the specialty services available to CYSHCN in each region. BFH is contacting all specialty providers in each region to gather information such as insurance plans accepted, waitlist length, openings for new patients, and ability to treat patients with certain medical conditions. The results of the landscape assessments will inform future Title V strategies to strengthen the system of care for all CYSHCN in Louisiana and ensure that the Title V safety net clinical services are accessible to all eligible CYSHCN who need them.
State Health Agency Priorities and Influence on Title V Service Delivery
There are several significant priorities within LDH, OPH, and OPH BFH that affect Title V programming:
- COVID-19 Response: The main priority of LDH continues to be ensuring a robust, data-informed state and local response to the ongoing coronavirus pandemic. At various times throughout the pandemic, BFH staff including the Title V Director, have been called upon to temporarily serve in emergency response roles. As Louisiana continues to face recurrent surges and emergent variants of the virus, LDH will remain nimble and innovative in its approaches to mitigate the impacts of this global emergency, and Title V staff and leadership will contribute to the efforts as needed.
- State Health Assessment: In 2019, LDH OPH earned accreditation through the Public Health Accreditation Board. As part of OPH’s ongoing efforts to maintain accreditation, OPH is currently conducting a new State Health Assessment (SHA), which will then inform the development of the next State Health Improvement Plan (SHIP). The Title V Strategy Manager and the BFH Injury Epidemiologist are members of the core SHA/SHIP steering committee, which will ensure that the 2020 Title V Needs Assessment findings and resulting MCH and CYSHCN priorities are considered throughout the SHA/SHIP process.
- LDH Business Plan: In 2020, the Secretary of LDH charged office and bureau leadership across the department to develop a comprehensive LDH Business Plan to promote coordinated strategy and accountability across the department. The Louisiana Medicaid and Title V programs are currently working closely together to develop the portion of the business plan related to maternal and child health. The MCH-focused strategies aim to improve maternal health outcomes, strengthening Louisiana’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) system, and improving systems that support breastfeeding initiation.
Louisiana State Statutes and Regulations
Louisiana Revised Statutes
LA Rev Stat 40:1081.2- Providers attending newborn children must test for LDH approved/required genetic diseases
LA Rev Stat 40:1081.5 - LDH establishes and operates clinics in cooperation with medical schools at LSU and Tulane to treat those with sickle cell anemia
LA Rev Stat 40:1081.1 -LDH to establish programs for combating phenylketonuria, congenital hypothyroidism, galactosemia, sickle cell disease, biotinidase deficiency, and other genetic conditions
LA Rev Stat 40:2018.3 - LDH establishes the Louisiana Sickle Cell Commission
LA Rev Stat 40:1081.7 - LDH to establish local programs to treat victims of sickle cell anemia and components of treatment
LA Rev Stat 40:1081.8 - Outlines functions of the sickle cell navigator program, to be administered by LDH under direction of Sickle Cell Commission; implemented upon appropriated funding
LA Rev Stat 40:1071-5 - (CSHS Enabling legislation): Designates OPH to cooperate with Title V of the Social Security Act; receive and expend federal funds for services to extend and improve services for children with special health care needs.
LA Rev Stat §40:31.3 - (ASHP Enabling legislation): The Office of Public Health, Department of Health and Hospitals [currently Louisiana Department of Health], shall establish an adolescent school health initiative.
LA Rev Stat 40:2018 (Perinatal Commission Enabling Legislation) - Establishes the Commission on Perinatal Care and Prevention of Infant Mortality.
LA Rev Stat 40:2019 - (Child Death Review Enabling Legislation) - Establishes a child death review panel, protocols, criteria for reporting and investigations for the unexpected deaths of children below the age of fifteen and the ability to suggest recommendations within the agencies presented on the state panel.
LA Rev Stat 40:1081.1-7 (Newborn Screening and Sickle Cell Programs Enabling Legislation) - Authorizes LDH to screen for and establish programs designed to reduce mortality and morbidity from sickle cell disease and other genetic conditions.
LA Rev Stat 40:1285.1-.5 (Lead Screening Program Enabling Legislation) - Establishes a program for the prevention, screening, diagnosis, and treatment of lead poisoning in the Office of Public Health; Mandatory reporting of lead poisoning cases required; comprehensive records
LA Rev Stat 46:2263-4 (Newborn Hearing Screening Enabling Legislation) - Establishes within OPH a program to provide for the early identification and follow-up of infants susceptible to a hearing disability, of deaf or hard of hearing infants, and of infants who have a risk factor for developing progressive hearing loss; establishes an advisory council.
LA Rev. Stat. 46.2351-2356 (Louisiana Commission for the Deaf Enabling Legislation) - Establishes the Louisiana Commission for the Deaf within the Louisiana Department of Health; defined duties; permits LDH hiring of executive officer of the commission; permits receipt of money from any source.
LA Rev. Stat. 40; 31.41-48 - (LBDMN Enabling Legislation): Establishes a system to collect, analyze, and disseminate data regarding birth defects and to provide information to families regarding services available and prevention programs.
LA Rev Stat 46:447.1 (Reproductive Health Program Enabling Legislation)- Establishment of a family planning program to provide family planning education and contraceptives for public assistance recipients.
LA Rev Stat 46:973 - Allows the Office of Public Health to provide a special program of preventive, health, and medical care and health education services for adolescents that concentrates on adolescent pregnancy and pregnancy prevention.
LA Rev Stat 46:974 - Asks that OPH maintain a statewide toll-free number to advise pregnant women on available resources.
LA Rev Stat 40:1061.17 - Pertains to Abortion Alternatives/Woman’s Right To Know.
LA Rev Stat 13:5713 - Instructs the coroner to report SIDS to the Director of the Parish Health Unit within 48 hours.
LA Rev Stat 40:1086.1-4 - Defines Shaken Baby Syndrome and Sudden Unexpected Infant Death Prevention major public health priorities for the state and authorizes LDH to conduct public awareness activities.
LA Rev Stat 17:407.40 - Assigns OPH to provide information and resources to the state Department of Education for such training and for other areas of training required for employees of early learning centers in promoting the health, safety, and welfare of children.
LA Rev Stat 17:407.23 - Louisiana Early Childhood Education Act (Act 3, 2012) - Establishes the Early Childhood Care and Education Network; Board of Ed must coordinate with the DCFS and LDH to align the standards for the licensing of child care facilities, including the requirements for participation in the Louisiana Quality Start Child Care Rating System, with the standards established for early childhood education programs.
LA Rev Stat 40:1075.4 - Emergency Medical Services for Children Program (1995) -
Establishes an Emergency Medical Services for Children Program and shall include a full-time coordinator, education programs for EMS personnel, guidelines for referring, guidelines, inter-hospital transfer system for critically ill or injured children and pediatric rehabilitation units.
LA Rev Stat 40:1086.12 - Neonatal opiate withdrawal syndrome pilot project
Charges LDH with creating a pilot demonstration project to optimize outcomes associated with Neonatal Opioid Withdrawal Syndrome (NOWS).
The Healthy Moms, Healthy Babies Act (Act 497, 2018) -
Creates within the Louisiana Department of Health the Healthy Moms, Healthy Babies Advisory Council for the purpose of working with existing state entities to address racial and ethnic disparities in maternal health outcomes and incorporate a community-engaged, equity-focused lens on maternal death and morbidity.
Language Equality and Acquisition for Deaf Kids (LEAD K) Task Force (Act 455, 2018) -
Establishes the Language Equality and Acquisition for Deaf Kids (LEAD-K) Task
to develop a resource for parents to monitor and track deaf or hard of hearing children's language acquisition and developmental stages and to develop a framework for assessing children who are deaf or hard of hearing for the purpose of ensuring they have the opportunity to achieve kindergarten readiness in an equitable manner.
Early Childhood Care and Education Commission (Act 693) -
Establishes the Early Childhood Care and Education Commission charged with establishing pilot programs in high-performing community early childhood care and education networks that will further efforts to improve kindergarten readiness.
Louisiana Administrative Code (Regulations):
LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 17. Children’s Special Health Services Chapters 49 - 59
LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 55. Birth Defects Surveillance System Chapter 161-163
LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 19. Genetic Diseases Services Chapter 63 Neonatal Screening; 6303.
LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 18. Disability Prevention Program Chapter 70. Lead Poisoning Prevention Program; 7001-7009
LAC Title 48, Public Health-General, Book 2 of 2; Part I; Subpart 13. Family Planning Chapter 35-37
LAC Title 51, Sanitary Code, Part XXI Day Care Centers and Residential Facilities, Chapter 3, Child Day Care Centers, #9
DOE Child Care Development Fund Bulletin 137 – Early Learning Site Licensing Regulations requires three hours of training by a child health care consultant on infectious diseases, health, safety, and/or food service preparation.
LAC Title 5, Chapter 65,6501, 6503 (April, 1987)- Authorizes LDH to operate Regional Genetic Clinics
LAC Title 5, Chapter 69, 6901, 6903 (Aug, 2014)- LDH establishes Genetic Diseases Program Advisory Committee
Louisiana Children’s Code:
LA Child Code 609. Mandatory and permitted reporting
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