Priority:  Increase access to family planning services

The following strategies and activities are planned for FY21:

Strategy 1: Remove barriers to care at Title X clinics across the state and provide high-quality, non-coercive, culturally competent family planning services to all clients.

Activity 1a: Utilize the results of teen/male/LGBTQ+ friendly surveys that were conducted in all Title X clinics in FY20 to guide implementation of strategies to reduce barriers to care among these vulnerable populations.

Activity 1b: Promote use of reproductive life plan assessments at Title X clinics by training Tennessee Department of Health family planning providers.

Activity 1c: Deliver family planning services through telehealth as a means to reach underserved populations.

Activity 1d: Pilot the Person-Centered Contraceptive Counseling Measure survey at one Title X site. In order to ensure a racially/ethnically diverse sample, the pilot sight will be chosen based on the demographic distribution of family planning patients.

Strategy 2: Increase awareness of the availability of Title X family planning services in Tennessee and of how to access these services through community education and outreach.

Activity 2a: Create an information packet with resources and information on birth spacing and on how to access postpartum family planning services for distribution during TennCare presumptive eligibility visits.

Activity 2b: The Adolescent Pregnancy Prevention and Rape Prevention Education Program Directors will educate sub-grantees about family planning services available through Tennessee Department of Health.

Activity 2c: The Tennessee Breast and Cervical Screening Program will educate contracting providers outside of local health departments about the availability of family planning services through the Tennessee Department of Health.

Strategy 3: Promote mental health and increase client confidence in care through provision of client centered, trauma-informed care.

Activity 3a: Require completion of a webinar on providing trauma-informed care for Tennessee Department of Health family planning providers as part of the Title X annual training.

Activity 3b: Form a collaborative working group between the Tennessee Department of Health’s Family Planning Program and the Tennessee Department of Mental Health and Substance Abuse.

Priority:  Pregnancy-Associated Mortality

The following strategies and activities are planned for FY21:

Strategy 1: Increase evidence-based practice implementation at hospitals on topics identified by the Maternal Mortality Review Committee (MMRC)

Activity 1a: Contract with Tennessee Hospital Association to provide simulation training to birthing hospitals on top topics leading to maternal death as identified by the MMRC. Birthing hospitals in the grand region of the state with highest disparities will be given top priority for simulation training.

Activity 1b: Contract with Tennessee Initiative for Perinatal Quality Care (TIPQC) to develop a speaker’s bureau to train birthing hospital staff on topics identified by the MMRC. Birthing hospitals in the grand region of the state with the highest disparities will give given top priority for training.

Activity 1c: Provide real-time alerts quarterly to hospitals and other healthcare providers on emerging issues as identified by the MMRC with a minimum of 1 recommendation in each alert focused on disparities.

Activity 1d: Provide consultation and education on high risk OB care to health care providers through the regional perinatal centers with the highest number of educational consults being in the grand region with the most disparities.

Strategy 2: Increase community involvement to improve maternal health outcomes

Activity 2a: Convene a maternal health task force, with a minimum of 25 members, quarterly to highlight innovative and best practices for preventing maternal death. The task force will include membership from the Office of Minority Health and Disparities Elimination to represent disparate populations.

Activity 2b: Fund up to 5 community agencies to implement MMR recommendations related to top topics identified by the MMRC including substance abuse, domestic violence and mental health issues.  Proposals will be evaluated on how well they are addressing disparate populations.

Strategy 3: Improve mental health among women of childbearing age

Activity 3a: Screen women enrolled in CHANT and evidence-based home visiting (EBHV) for depression with a specific emphasis on Middle Tennessee participants.

Activity 3b: Provide Question, Persuade, and Refer (QPR) training to CHANT and evidence-based home visiting staff with a particular emphasis on Middle Tennessee participants.

Strategy 4: Improve preconception and prenatal health through increased enrollment in both family planning and presumptive eligibility

Activity 4a: Increase the number of women of childbearing age participating in family planning by expanding and promoting telehealth to better reach those people living in rural areas.

Activity 4b: Increase the number of women applying for presumptive eligibility by developing an outreach plan and collaborating with a minimum of 1 partner to reach disparate populations.

Strategy 5: Increase surveillance of maternal deaths

Activity 5a: Identify pregnancy-associated deaths and facilitate state Maternal Mortality review Committee meetings.  The Committee will identify age, race and place for each death reviewed to identify disparities.

Activity 5b: Through the Maternal Mortality Review Committee, determine proportion of deaths that are pregnancy-related along with contributing factors. For each pregnancy-related death determine age, race and place of death to identify disparities.

Activity 5c: Develop recommendations based upon MMRC findings for inclusion in the Maternal Mortality annual report and dissemination to relevant stakeholders. These recommendations will include reference to specific disparities identified in the reviews.