Women/Maternal Health - Application Year
Illinois’ priority for the Women and Maternal Health Domain is:
- Assure accessibility, availability, and quality of preventive and primary care for all women, particularly for women of reproductive age. (Priority #1)
- Promote a comprehensive, cohesive, and informed system of care for all women to have a healthy pregnancy, labor and delivery, and first year postpartum. (Priority #2)
Priority #1 – Assure Accessibility, Availability, and Quality
During FY22, Title V will continue to utilize the following strategies to assure accessibility, availability, and quality of preventive and primary care for all women, particularly for women of reproductive age:
1-A. Support the implementation, dissemination, evaluation, and improvement of the Illinois Healthy Choices, Healthy Future Perinatal Education Toolkit, which includes information and resources for consumers of women during preconception, prenatal, postpartum, and interconception care.
In FY23, EverThrive Illinois will continue to host, update, and promote the Healthy Choices, Healthy Futures Toolkit to build awareness and support healthy pregnancies statewide. It will partner with I PROMOTE-IL to implement an evaluation designed in 2020, focused on adapting content for social service providers.
1-B. Partner with the Illinois Department of Corrections (DOC) and two state women’s correctional centers to support ongoing health promotion activities for incarcerated women and staff training, and to ensure women and infants receive Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services while residing in DOC facilities.
OWHFS will continue to partner with DOC in FY23 to offer health education to incarcerated women, to provide training to corrections staff, to help stock women’s health supplies (such as breast pumping supplies), and to work closely with corrections staff to meet the health needs of women in Illinois prisons. In addition, OWHFS will continue to teach health education sessions using the Helping Women Recover, Beyond Trauma, and Life Smart for Women curricula. Training opportunities for prison health care staff will focus on comprehensive care for expectant mothers, trainings on trauma and adverse childhood experiences (ACEs), and understanding and recognizing the unique health care needs of the LGBTQ+ prison population.
DOC health care staff will participate in simulation trainings. Specifically, the staff will participate in a full simulation of a maternal transport team from the Level III Administrative Perinatal Center coming to pick up a patient in active labor. This simulation allows correction security to test the “lock-down” process for active labor patients, while allowing EMS to enter and treat a woman and neonate in the pregnancy wing or health care wing.
OWHFS will continue to identify new and strengthen existing partnerships with outside agencies to improve and to support the work with DOC. These partnerships include collaborating with the IDPH southern perinatal nurse and the South Central Illinois Administrative Perinatal Center to provide incarcerated women maternal-fetal medicine consultations.
1-C. Implement well-woman care mini grants to assist local entities in assessing their community needs and barriers; and, to develop and implement a plan to increase well-woman visits among women ages 18-44 years based on the completed assessment.
Title V relaunched its well-woman care mini grants that initially began in FY19. The relaunch included two phases to the program: (1) Planning Phase – organizations required to develop a plan to increase well-woman visits in their community and (2) Implementation Phase – organizations are required to implement the plan they developed during the planning phase. During FY23, Title V will support the program and both of its phases.
I-D. Partner with UIC Center for Research on Women and Gender to implement a program at two clinic sites to expand the capacity of health care providers to screen, to assess, to refer, and to treat pregnant and postpartum women for depression and related behavioral health disorders.
This strategy was completed in FY22. There are no activities planned for FY23.
1-E. Support the Chicago Department of Public Health (CDPH) efforts to foster, partner, and collaborate with organizations and agencies providing male and partner involvement programs.
For FY23, CDPH will continue to partner with organizations providing male and partner involvement programming to increase women’s early entry into prenatal care. Title V will support CDPH’s efforts through the Title V mini grant.
Priority #2 – Comprehensive, Cohesive, and Informed System of Care
During FY23, Title V will utilize the following strategies to promote a comprehensive, cohesive, and informed system of care for all women to have a healthy pregnancy, labor and delivery, and first year postpartum:
2-A. Convene and facilitate state Maternal Mortality Review Committees (MMRC and MMRC-V) to review pregnancy-associated deaths and develop recommendations to improve quality of maternal care as well as reduce disparities and address social determinants of health.
Illinois continues its process for identifying pregnancy-associated deaths in Illinois and assuring reviews by the state’s two maternal mortality review committees. MMRC reviews every potentially pregnancy-related death and MMRC-V reviews violent pregnancy-associated deaths due to suicide, homicide, or drug overdose.
Additionally, Title V staff will continue to implement interventions that address maternal mortality as a part of its CDC-funded grant entitled, Preventing Maternal Deaths: Supporting Maternal Mortality Review Committees. Activities under the grant include hosting a statewide maternal health summit and convening key stakeholders to create a multi-pronged strategic plan to improve maternal health based on the recommendations from the MMRCs.
2-B. Partner with the statewide Severe Maternal Morbidity (SMM) Review Subcommittee to develop recommendations for standardizing and improving hospital-level SMM case reviews across Illinois’ Regionalized Perinatal System.
The SMM Review Subcommittee will continue to focus on improving and standardizing hospital-level reviews. The subcommittee will make recommendations regarding training materials, templates, and resource manuals, as needed, to improve the quality of the local reviews within hospitals and APCs.
2-C. Participate in and collaborate with the Illinois Maternal Health Task Force established through the I PROMOTE-IL program (HRSA Maternal Health Innovation Grant) to develop a statewide Illinois Maternal Health Strategic Plan to translate and build on findings and implement recommendations from the Illinois MMRC, MMRC-V, and SMM.
In FY19, the University of Illinois at Chicago (UIC) successfully applied for the HRSA Maternal Health Innovation Grant. The Innovations to ImPROve Maternal OuTcomEs in Illinois (I PROMOTE-IL) program will assist the state in collaborating with maternal health experts and optimizing resources to implement state-specific actions that address disparities in maternal health and improve maternal health outcomes. A key component of the I PROMOTE-IL grant is the Illinois Maternal Health Task Force. Illinois’ Title V director and other Title V staff serve on the task force and its various subcommittees. This relationship is important because OWHFS/Title V is the primary lead for maternal health activities in the state, including maternal mortality and severe maternal morbidity reviews. Title V’s participation ensures the task force is fully integrated into the existing maternal health infrastructure, avoids duplication of efforts, and assists in the tracking of maternal health legislation at the state and federal level to inform additional policy solutions.
During FY23, Title V will continue to participate in and collaborate with the I PROMOTE-IL program and its Illinois Maternal Health Task Force, and the Title V staff, including the director, will continue to serve on the task force and its subcommittees.
2-D. Support and collaborate with the state-mandated Illinois Task Force on Infant and Maternal Mortality Among African Americans to assess the impact of overt and covert racism on pregnancy related outcomes, identify best practices and effective interventions, address social determinants of health, and develop an annual report with recommendations to improve outcomes for African American women and infants.
In FY23, Title V will continue to support and to collaborate with the Task Force on Infant and Maternal Mortality Among African Americans to review the impact of overt and covert racism on toxic stress and pregnancy related outcomes for African American women and infants. In addition, Title V will support the development of reports that include recommendations of best practices and interventions to improve quality and safe maternal and infant care for African Americans.
During FY23, the subcommittees will be involved in various activities. The Community Engagement Subcommittee will collect the perspectives of birthing persons with “lived” experiences through listening sessions regarding their experiences before, during and after pregnancy (prenatal care, labor and delivery and post-partum care). These sessions will be conducted throughout the state with Black/African American community members. The task force will use the data to make additional recommendations to the General Assembly regarding interventions to improve Black/African American infant and maternal health outcomes. The Program and Best Practices Subcommittee will review programs and identify best practices and effective interventions for improving the quality and safety of maternal care, as well as health outcomes before and during pregnancy, to address pre-disease pathways of adverse maternal and infant health. The Systems Subcommittee will review data on social and environmental risk factors for Black/African American women and infants. They will identify key stakeholders the state should engage to address Black/African American maternal and infant mortality in a systematic way.
2-E. Facilitate the collaborative effort between the Illinois Maternal Health Task Force and the Illinois Task Force on Infant and Maternal Mortality Among African Americans to align their strategies and activities towards improving maternal health in Illinois.
During FY23, Title V will continue to facilitate collaboration between the Illinois Maternal Health Task Force and the Illinois Task Force on Infant and Maternal Mortality Among African Americans. The collaboration between both task forces will help to align their strategies and activities and leverage
each groups’ expertise regarding the improvement of Black/African American maternal health, and ultimately, all women across Illinois.
In FY21, Illinois became the first state to receive federal Centers for Medicare & Medicaid Services (CMS) approval of its Continuity of Care and Administrative Simplification 1115 waiver application. The waiver extends Medicaid postpartum coverage from 60 days to 12 months. It also allows Illinois to receive federal match for postpartum Medicaid claims up to one year postpartum, including allowing women to enroll at any time during the first year postpartum if they become eligible. Babies may be covered for the first year of their lives provided the mother was covered when the baby was born. Moms and Babies enrollees have no co-payments or premiums and must live in Illinois. It is important to note that the extended coverage authorized under the waiver will not go into effect until the continuous eligibility under the public health emergency ends.
During FY23, OWHFS and Title V will continue to participate on the state inter-agency committee as it develops implementation, monitoring, and evaluation plans regarding the extended coverage, continuous eligibility, reinstatement, and waiver of hospital presumptive eligibility (HPE).
2-G. Convene and partner with key stakeholders to identify gaps in mental health and substance abuse services for women that include difficulties encountered in balancing multiple roles, self-care, and parenting after childbirth; and leverage expertise to develop recommendations for system level improvements for Title V consideration and implementation.
During FY23, Title V will continue support ILPQC’s efforts to identify strategies to support universal substance use disorder/opioid use disorder (SUD/OUD) screening prenatally and obstetricians’ ability to counsel for Narcan and offer a prescription. In addition to working with ILPQC, Title V continues to explore opportunities with other key stakeholders and include other state agencies, to address the gaps in mental health and substance abuse services for women.
2-H. Assess, quantify, and describe the impact of child care on prenatal, intrapartum, and postpartum care in Illinois, and develop optional strategies and approaches that can be implemented in clinic and hospital settings.
Although the Social Determinants of Health Collaborative, Improvement, and Innovation Network (CoIIN) ended in FY20, Title V continues to assess the need for ‘emergency’ child care in circumstances related to obtaining perinatal care (prenatal appointments, labor and delivery/ hospitals) for women/parents and developing women/family-friendly child care strategies for prenatal and perinatal providers. Title V continues to explore opportunities to engage hospitals and FQHCs in developing and implementing family friendly strategies to address child care needs. Title V will explore leveraging the regional councils and family councils be organized through Birth to Five Illinois by the Illinois early childhood education and care system. These councils may be helpful resources because the enable residents to address the early childhood needs within their own communities.
2-I. Support the Illinois Perinatal Quality Collaborative (ILPQC) in its implementation of obstetric and neonatal quality improvement initiatives in birthing hospitals.
Title V collaborates with ILPQC as it supports hospital teams in implementing strategies that facilitate culture change and improve patient care. In FY23, Title V will continue to support ILPQC’s OB Birth Equity (BE) Initiative. This initiative focuses on hospitals’ capacity to facilitate systems and culture change to achieve birth equity through four key drivers: social determinants of health, data usage, patient and partner engagement, and provider engagement and education. The initiatives’ specific objectives include appropriate screening and linking of patients to resources that address social determinants of health, increasing the proportion of women reporting positive obstetric care experiences, and accurate recording of patient race and ethnicity data.
A second initiative that will be supported in FY23 is the planning phase of the ILPQC’s Neonatal Safe Sleep/SUID QI initiative. ILPQC will begin its planning for this initiative in Fall 2022 with a planned launch in May 2023. The neonatal Safe Sleep/SUID initiative will be created to be inclusive for all birthing hospitals/children’s hospitals and ILPQC will incorporate key birth equity strategies into the initiative.
ILPQC will continue to host its annual conference and meetings. The 10th Annual Conference is scheduled for October 27, 2022, in Lombard and the OB and Neonatal Spring Face-to-Face Meetings are scheduled for May 2023 in Springfield.
2-J. Support the Perinatal Mental Health Program that includes a 24-hour telephone consultation for crisis intervention for women suffering from perinatal depression.
During FY23, Title V will implement the MCH Perinatal Mental Health Program. This program seeks to provide perinatal depression crisis interventions, consultations, resources, and referrals for women who have screened positive for symptoms of perinatal depression. Through this program, NorthShore University HealthSystem will continue to provide a 24/7 hotline (MOMS Line) serving the perinatal population, with each caller receiving a psychosocial assessment by a mental health professional, psychoeducation about perinatal mood disorders and resources, and referrals if desired. It will also disseminate materials promoting awareness of perinatal mood and anxiety disorders in general and the MOMS Line specifically. In all of its efforts to address perinatal mental health and develop improved ways of capturing sociodemographic information from callers, NorthShore will draw from best practices of NorthShore University HealthSystem’s Health Equity and Inclusion Taskforce and the Lifeline4Moms Equity Incubator Group.
In FY23, Northshore plans to revamp its website to promote the awareness materials in a more active and engaging manner. It will also develop plans to update its resource and referral database to make it more accessible and user-friendly, and update the caller database and collect outcomes data on callers served.
Another notable activity for FY23 that Title V will support is NorthShore’s work with the newly created task force addressing emergency department maternal health. This task force is developing trainings and toolkits for emergency departments statewide.
2-K. Partner with Department of Healthcare and Family Services (HFS) (Medicaid agency) in the National Academy for State Health Policy (NASHP) Maternal and Child Health Policy Innovation Program (MCH PIP).
Additional Programs and Emerging Issues
Since 2021, Illinois has had a statewide contraceptive equity initiative (known as Illinois Contraceptive Access Now) recognized by HRSA as an Emerging Issues in Maternal and Child Health grantee (one of seven nationwide). Voluntary, informed access to the birth control method of their choice allows people to decide when and if to have children, supports healthy birth spacing, facilitates educational advancement and leads to better health and economic outcomes for parents and their children. During FY23, Title V will explore opportunities to advance contraceptive equity in Illinois by improving the quality of and access to contraceptive care.
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