Postpartum Visit

Percent of women who attended a postpartum checkup within 12 weeks after giving birth and B) Percent of women who attended a postpartum checkup and received recommended care components.

Family Home Visit

Percentage of families who could benefit from family home visiting services that are currently served.

1. Enhance resources, services, and supports that are responsive to community and individual needs and experiences to improve birth experiences perinatal women.
2. Broaden virtual and in-person services for perinatal women.
3. Strengthen health literacy and system navigation by providing community-responsive resources, services, and supports.
4. Improve quality and availability of family-centered mental health and substance use disorder services and resources for perinatal women.

STATE TITLE V

Supported

• Collaborate with Office of Rural Health for data support with definitions in their work, understanding birthing facility experiences in greater MN and closure of labor/delivery services

Reoccurring internal collaboration with staff from the Office of Rural Health and Primary Care (ORHPC) and MDH Maternal and Child Health section. Established in 2023, the Title V Coordinator, State MHI Project Director, and Maternal Access Coordinator regularly attend monthly meetings to discuss obstetrics access in rural health facilities. ORHPC submitted a data request to I-MOM Data Team for data on emergency room deliveries, specifically at hospitals without birthing services. There are opportunities to expand connections with shared partnerships via Title V, doula and midwife services programming, and through the MNPQC with an emphasis on developing rural specific quality improvement technical assistance with health facilities (birthing and non-birthing).

The I-MOM Data Team presented the results to ORHPC, discussed limitations, and identified next steps. Data Team also shared a map, created by I-MOM, showing locations of labor and delivery unit closures across the state, using data provided by ORHPC. It was suggested that the two teams continue to work together and consider ways to collaborate on data to release a joint product. Through this developing partnership, a data staff member from ORHPC agreed to help with internal testing of I-MOM’s data dashboard.

• Implement the Grief and Loss Support Grant with Trusted Community Organization

Minnesota will continue to partner with a trusted community organization that addresses parents’ mental health needs after a perinatal loss, which ideally helps their mental health/coping for future pregnancy, or for the other infant(s)/siblings if the loss was a multiple gestation. The organization will continue outreach to community-based groups and organizations to provide a comprehensive overview of the types of grief and loss services provided, as well as the process used by the organization to connect grieving families to the resources and services they may need.

Connected

• ​ Address Violent Maternal Deaths

Minnesota is partnering with MDH’s Injury and Violence Prevention Section (IVPS) on a maternal violent death project funded by the Office on Women’s Health (OWH). This five-year grant (2021-2026) is designed to reduce deaths among pregnant and postpartum women due to violence with specific interventions around suicide, homicide, and domestic violence. This project aims to 1) enhance surveillance of violent maternal deaths, and 2) expand the evidence-based Confidentiality, Universal Education and Empowerment, Support (CUES) intervention.

The project team will continue working closely with the MMRC, MNPQC, and other local organizations toward achieving these goals, and will engage in the following activities in FFY2026:

• Continue Violent Death Reviews using an updated review protocol. Implement an internal maternal violent death database and quality improvement of reporting forms.
• Continue partnership with the MNPQC and intervention partners to develop and disseminate resources on maternal violence in MN.
• Focus reporting for violent maternal deaths to be shared with MMRC members and partners.
• Develop a dissemination and information sharing plan for data connected to this grant.
• Reimburse MMRC members for participation in this the small sub-working group.
• Form meaningful connections with medical examiners, including relationship-building through visits to county medical examiners’ offices.
• Develop an implementation tracker of recommendations related to maternal violence prevention created during the MVDR workgroup members.

• Develop and Implement a Cannabis and Substance Misuse Prevention and Education Program

The Maternal and Child Health section at MDH has been legislatively (Minnesota Statute 144.197) tasked with developing a cannabis and substance misuse prevention and education program for women who are pregnant, plan to become pregnant, or who are breastfeeding. There are two components of this work:

1. A soft launch that aimed to meet the needs in communication gaps within the Maternal and Child Health section after the legalization of cannabis. The maternal and child health section has developed a fact sheet, provider resource document, and a Women, Infants, and Children (WIC) rack card.
2. A larger prevention and education campaign, encompassing the audiences of both the Child and Family Health division and the Injury Prevention and Mental Health division. As a part of this larger campaign, the Maternal and Child Health section developed an RFP on cannabis and substance misuse prevention for pregnant and breastfeeding women as well as youth under 25. The goal of the RFP is to engage with identified audiences and develop messaging that can be used for a future education and awareness campaign. The total funding available for this project is up to $2,000,000 for through June 2026, with up to $1,300,000 for pregnant and breastfeeding women and $700,000 for youth under 25.

• Enhancing Outcomes for Pregnant and Postpartum Families Impacted by Substance Use Disorder Grant

In 2023, the Minnesota Legislature passed the Comprehensive Drug Overdose and Morbidity Prevention Act. As a part of this legislation, MDH awarded 4 grantees across the state of Minnesota through the Enhancing Outcomes for Pregnant/Postpartum Families Impacted by Substance Use Disorder Grant. The Grantees are to identify, address, and respond to drug overdose and morbidity in women who are pregnant or have just given birth through multitiered approaches including NAS monitoring efforts; implement substance use disorder-related recommendations from the maternal mortality review committee; collaborate with interdisciplinary and professional organizations that focus on quality improvement initiatives related to substance use disorder; promote medication-assisted treatment options, and support programs that provide services in accord with evidence-based care models for mental health and substance abuse disorder.

Minnesota aims to enhance the system used for birth defects to monitor and track NAS/NOWS. These systems are already widely used by hospitals and providers and collect case information with little burden on the reporters. To inform public health interventions for populations impacted by NAS, MDH has contracted with a vendor to conduct an environmental scan to identify current practices and gaps.

Ongoing grant support will be provided to grantees implementing maternal mortality recommendations, as well as increasing access to medication-assisted treatment options, addressing stigma around substance use during pregnancy, collecting baseline data, and applying quality improvement methods to measure and report efforts to improve maternal health outcomes for women with a substance use disorder. During this time the Minnesota will be in the initial strategic planning stage of a NAS surveillance system to be integrated within birth defects monitoring.

• Explore Provision of Telehealth and Mobile Health Services in Rural Communities

The ORPHC connected the MDH MCH section between University of Minnesota partnering with Homeward Health on a grant funded project to evaluate a mobile provider model that will offer prenatal care in rural communities. In MNPQC, LINK hospital participants reported limited availability of local behavioral health providers, long wait times, and difficulty ensuring closed-loop referrals. MNPQC connected teams to peer institutions with strong referral workflows and is exploring telehealth partnerships as a long-term strategy. MCH staff connect regularly with ORHPC to stay informed on rural health partners leading OB simulation. Opportunities include connections with the MNPQC, MN Hospital Association, and family practice providers.

The UMN team, through the Center for Learning Health System Sciences and the Medical School, is partnering with Homeward Health, a rural healthcare and mobile health provider in Minnesota and Michigan, on an ARPA-H-funded program called PARADIGM. The program aims to revolutionize rural healthcare through implementing mobile care delivery platforms - outfitted vehicles with modular equipment - that bring hospital-level services directly to underserved, rural communities. The goal is to develop and implement care via three vehicles in rural areas in Minnesota and Michigan, and for our UMN team to evaluate clinical effectiveness.

The services on each vehicle and the areas of deployment are still under consideration, but are currently projected to be prenatal and postpartum care (without labor and delivery), and advanced wound care. Currently, we are helping Homeward Health in mapping potential deployment areas across Minnesota, including identifying potential healthcare systems/clinics with whom to partner, and engaging with community organizations to develop an implementation plan. Homeward plans to use the coming year to develop community and health system partnerships to create a program that best meets community health needs.

• Grow the Help Me Connect – Doula Registry

Minnesota’s Help Me Connect Online Navigator and Referral System launched in May 2021 as an online navigator to connect expectant families, families with young children birth to 8 years of age, and professionals serving these families to services in their local communities that support healthy child development and family wellbeing. Families and professionals can search a database of over 14,000 available programs and services closest to the family’s home address under topics such as healthy development and screening resources, early learning and childcare programs, pregnancy support services, disability resources, basic needs, and more. The online resource is also available is Spanish, Somali and Hmong.

Minnesota worked with the Help Me Connect team to develop content for a new Pregnant and Expectant Families category that launched August 2023, which also highlighted the challenges and opportunity to connect families to doula and birth worker services through Help Me Connect. This led to the creation of a searchable database that welcomes doulas to submit their information into a survey to be displayed on HMC. Doulas voluntarily share a variety of information about their services, most notably, their language and cultural specializations, which allows visitors to the site to select doulas based on their own criteria. The Help Me Connect program moved to a new state agency – the Department of Children, Youth and Families – in January 2025 with a variety of programs from the Departments of Human Services, Education, and Public Safety that focus on early childhood and family support services. Interagency collaboration between the Department of Health and the Help Me Connect program will continue long-term to maintain connections and assure information on the Help Me Connect platform is maintained and updated consistently.

• Implement Maternal Health Innovations Grant – Innovations for Maternal Health Outcomes in Minnesota (I-MOM)

In FFY2023, MDH was awarded a new HRSA grant on the State Maternal Innovation and Data Capacity Program – creating the I-MOM project (Innovations for Maternal Health Outcomes in Minnesota). The purpose of the I-MOM project is to support state capacity to improve maternal health through quality services, a skilled workforce, enhanced data quality and capacity, and innovative programming that aims to reduce maternal mortality and severe maternal morbidity. Goals include:

1. Build a shared vision for perinatal health: Bring together perinatal health partners, specifically engaging community partners, to create alignment among goals, priorities, and actions to enhance access to a skilled workforce and improve outcomes.
2. Improve data access and expand surveillance: Increase timely, high-quality state perinatal health data to support surveillance and inform the development of innovative perinatal health programs. Improve the collection, reporting and analysis of AIM data: Identify and implement quality improvement bundles (through AIM) and provide training to support quality improvement initiatives designed to improve maternal health outcomes.
3. As a part of the I-MOM project, MDH established a Perinatal Sub-Committee under the existing Maternal and Child Health Advisory Task Force which supported development of Minnesota’s first Perinatal Health Strategic Plan. The I-MOM Project Planner will continue to lead management and implementation of the I-MOM project in FFY2026, including collaboration with Minnesota Title V staff and the MCH Advisory Committee Perinatal Sub-Committee.

• Implement Maternal Mortality and Morbidity Review Program

The goal of Maternal Mortality and Morbidity Review Program is to improve the health outcomes of pregnant women and includes the Maternal Mortality Review Committee (MMRC), which reviews maternal death cases and develops recommendations to prevent future deaths. The Maternal Mortality and Morbidity Review Program activities for FFY2026 include the following:

• Analyze multi-year data and provide demographics, geographic burden, distribution of death, and cause of death, to inform change of practice or policies.
• Review all pregnancy- associated maternal deaths within 18 months of date of death, and document findings and decisions in the Maternal Mortality Review Information Application (MMRIA) to assist with ongoing analysis.
• Expand community member representation on the MMRC. Disseminate committee findings, analysis, and recommendations to internal and external stakeholders annually. Disseminate a report on 5 years of maternal mortality reviews including recommendations to (internal and external) stakeholders.
• Develop targeted reports on leading causes of death in MN for specific stakeholder groups including providers and policy makers.
• Track the implementation of MMRC recommendations at multiple levels.
• Collaborate with partners to strategically develop statewide actionable interventions to reduce contributing factors identified by the case reviews.
• Promote recommendations from our community action team (perinatal subcommittee) to identify strategies and resources needed for the community to implement recommendations to improve pregnancy outcomes.
• Train, and cross-train, internal staff on data management and system processes to improve timely access to case information, abstraction, and data entry.
• Invest in community driven interventions to address maternal mortality and build upon communities’ approaches in maternal health.
• Improve case identification and completion of record collection in partnership with Department of Human Services, other divisions within MDH, the MN Hospital Association, State Medical Examiners, and Law Enforcement entities.
• Develop feasible processes and systems to collect and analyze maternal morbidity data to identify leading causes of morbidity in the state.
• Tailor quality improvement interventions, in conjunction with the MNPQC, to target and address maternal mortality and morbidity.
• Implement an informant interview protocol through a contract with external partners – which reflects a recommendation from the CDC for MMRC partners to use informant interviews for comprehensive case reviews. (Qualitative data gathered from the interviews are used to supplement medical records and other records abstracted for MMRC to review).
• Expand the Hear her campaign to additional populations, their loved ones, and care providers.

• Implement the IMPLICIT Model to Screen for Maternal Risk Factors During Well Child Visits

For many years, the CSHCN and MCH sections in the CFH Division have collaborated on birth defects prevention grants and continue to focus on interconception care and optimizing postpartum mothers’ point of contact with providers through well-child visits. The IMPLICIT model utilizes time in the well-child visit to incorporate maternal risk assessments for mothers and birthing persons to improve birth outcomes. The model includes foci on four behavioral risks affecting future birth outcomes: smoking, depression, family planning and birth spacing, and multivitamin with folic acid use. Not only does this promising practice allow collaboration to integrate services, provide needed services and education to care givers, it also encourages providers to improve their understanding of quality improvement and implementing and evaluating evidenced-based practice in their role. Minnesota plans to continue and expand the evidence-based IMPLICIT model (Interventions to Minimize Preterm and Low Birth Weight Infants using Continuous Quality Improvement Techniques) in Minnesota.

The national IMPLICIT Network developed, assessed, and integrated this evidence-based model for the past 10 years, and are working in partnership with MDH and the March of Dimes to disseminate this interconception model. In FFY2026, MDH will award a new IMPLICIT grant through an RFP process to continue this important activity through 2028.

• Implement the Perinatal Subcommittee Strategic Plan

In August 2022, Minnesota was awarded a State Maternal Health Innovation and Data Capacity Program Grant, which requires creating and implementing a strategic plan that includes activities outlined in the state’s most recent Title V strategic plan. The Perinatal Sub-Committee (PSC), was established as a subgroup of the Maternal and Child Health Advisory Committee. It is a multidisciplinary and community-led committee that is building a shared vision for perinatal health.

The PSC finalized their strategic plan in October 2024, and now serves as a living document to guide the work of Innovations for Maternal Health Outcomes in Minnesota (I-MOM) and other projects. Among the 13 recommendations in the perinatal health strategic plan, are:

• Access to Substance Use Disorder (SUD) and Mental Health Services
• Funding for Substance use Disorder and Mental Health

Community Action Teams (CATs) are being developed to implement actions to address the strategic plan recommendations. The PSC and our partners will participate in evaluating the implementation of the strategic plan; and provide leadership in updating activities and aligning new innovative maternal health programs such as expansion of doula, community health workers, midwife services, and telehealth to address the strategic plan recommendations.

• Implement the Sexual and Reproductive Health Services Grant Program

The SRHS program is administered by MDH and provides pre-pregnancy family planning services for people whose incomes are below the federal poverty level and placed at increased risk for unintended pregnancy. The program supports essential pre-pregnancy family planning services for people of reproductive age who experience barriers, whether geographic, financial, or other, in access to such services. In 2023, eligibility was expanded to include the 12 Minnesota tribes in the geographic area of Minnesota. Grantees provide responsive:

• Education and outreach on medically accurate sexual and reproductive health information.
• Contraceptive counseling, provision of contraceptive methods, and follows-up.
• Screening, testing, and treatment of sexually transmitted infections and other sexual or reproductive concerns.
• Referral and follow-up for medical, financial, mental health, and other services in accord with a service recipient’s needs.

• Partner to Implement the Transforming Maternal Health Model (TMaH)

In January 2025, Minnesota was selected through an application process as one of fifteen states to participate in the TMaH Model through 2035, through the Centers for Medicate & Medicaid Services. The Minnesota state Medicaid program and Minnesota Department of Health are partnering to lead implementation of the TmaH model to improve maternal health care.

Minnesota’ s Maternal Care Access Coordinator and Maternal Health Innovations Coordinator are the MDH representatives serving on the TMaH team. More details will become available as the project is moved further into the pre-implementation period, and toward implementation.

• Promote the Hear Her Campaign

The Hear Her Campaign was created by CDC to expand awareness and conversation around pregnancy-related complications and warning signs. Beginning in April 2024, Minnesota partnered with CDC to launch the campaign across the state and contracted with an advertising firm to maximize reach. Outreach occurred via social media, search engine advertising, radio, and direct emailing from MDH to clinical partners. The campaign message was accessible to families of childbearing age and their support people, as well as clinicians who care for this population. This was an extremely successful campaign that ran from April 18 to August 31, 2024, receiving widespread coverage, including media attention. During the MDH Hear Her campaign, the webpage received 31,917 visitors resulting in 4,193 clicks to CDC resources on maternal risk factors. In FFY2026 Minnesota will continue to partner with CDC’s Hear Her Campaign along with the advertising firm, which has been a successful source of information for our communities and partners. MDH will provide outreach to communities impacted by maternal mortality and provide free materials (via CDC) to clinics, acute care facilities, and community organizations as requested.

• Provide Holistic Health and Wellbeing Support to Women, Pregnant Women, and Their Families Through Family Home Visiting (FHV)

FHV is an effective upstream intervention that serves as a key link to other interventions and community supports and is a notable contributor to improved maternal and infant health outcomes. FHV services in Minnesota are supported by several funding streams including state, federal and local resources. At the state level, MDH oversees and distributes funding for home visiting services provided under Temporary Assistance to Needy Families (TANF) funding, the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, Minnesota Evidence-based Home Visiting, and Minnesota's Nurse-Family Partnership legislation. Together, these funding streams support home visiting programs across the state that serves upwards of 7,200 families.

The Family Home Visiting (FHV) program in Minnesota demonstrates an impressive and comprehensive strategy to support families and strengthen community health outcomes.

In FFY2026, Minnesota will:

• Implement promising practices and evidence-informed strategies to reach communities with limited access to family home visiting services.
• Connect families to needed community services.
• Promote the importance of well-women visits, prenatal and postpartum care, and strive to assure that the women served have health insurance and are connected to a primary care provider.
• Work closely with primary care providers to encourage cross-sector collaboration to provide a comprehensive approach to caring for families during pregnancy and after the birth of their child.
• Support parents early in their role as a child’s first teacher and foster parenting skills that decrease the risk of child abuse.
• Help parents develop safe, stable, and nurturing environments that support healthy development.
• Provide screening, using validated tools, for: depression during the postpartum period; intimate partner violence, parent-child interactions, and developmental and social emotional concerns for children – and, subsequently, make appropriate referrals.
• Provide health information and encouragement to families including, but not limited to, family planning, breastfeeding and child nutrition, and child growth and development.
• This strategic approach not only addresses immediate needs of families but builds a strong foundation for long-term family and community well-being.

• Support Implementation of St Lukes Plus One Doula Program

The Plus One Doula Program at St. Luke’s offers patients the opportunity to receive a partial or full scholarship to hire a doula through Doulas of Duluth. This program helps patients include a doula as part of their pregnancy, birth, and postpartum care team. Doulas provide valuable support throughout pregnancy. Having a doula can lead to a better overall experience during childbirth, a lower chance of complications during labor, fewer negative outcomes, reduced risk of maternal health issues, faster labor progression, up to a 40% reduced likelihood of needing a C-section for low-risk pregnancies, and fewer interventions during labor such as epidurals. Minnesota’s Maternal Care Access Coordinator will continue providing support toward implementation of this program.  

Local Title V

Supported

• Increase Representation of Communities Served within Program Staff and Implementation

LPH agencies in FFY2026 will continue to increase representation of the communities the serve within their program staff and implementation. Local public health agencies use various strategies to recruit and retain staff that reflects the communities they serve and hire staff from communities to serve in community-centric roles, such as community health strategists and community health workers. One approach to increasing community representation is when interviewing candidates to work in local public health programs:

• make sure interview panels have a broad representation.
• exclude names of candidates.
• invite community members be part of the panel.

• Providing Program Services and Resources that are Responsive to Family and Community Needs

LPH agencies and their staff recognize the impacts of community health drivers on individuals, families, and communities and aim to implement their programs with this understanding and the lens that no family or community is the same. Rather, individuals, families, and communities are best served when programs, services, and resources are responsive and flexible to their needs and preferences. In FFY2026, local public health agencies will continue to offer program supports, services, and resources with this responsiveness and flexibility by offering telehealth visits; providing visits based on family preferences such as in the home, clinic, library, coffee shop, etc.; offering options for phone visits when needed; offering appointment times outside of the typical 8-4:30 business day; partnering to provide mobile clinic services; and providing flexibility to accommodate for illness or bad weather, particularly during the winter months and in rural areas of Minnesota. Additionally, local public health staff have learned from families that they might prefer to meet within a group setting either explicitly or in addition to their one-on-one visits – which has led some local public health agencies to offer group connections. For example, one community health board offers monthly gatherings for pregnant or parenting families to share a meal and receive an educational topic in the evenings.

• Uplifting Local Resources, Supports, and Services that are Responsive to Individual, Family, and Community Needs

LPH agencies rely on their ability to collaborate with partner organizations, particularly local community organizations, in order to establish referral partnerships and responsively meet the needs of the individuals, families, and communities they serve. While many local public health agencies offer resources and referrals through established and evolving resource lists, some local public health agencies integrate further resource referrals and activities that aim to address systems families are navigating. For example, one community health board works with families to document their experiences with perinatal providers and systems through a resource app. Another community health board works across five counties to continuously update and provide a resource list to all those receiving their services. This particularly community health board works in partnership with child and teen checkup providers, local family services agencies, and local medical providers to regularly update this resource list and ensure they are all providing the same information to individuals and families. These initiatives will continue in FFY2026.

Connected

• Provide Family Centered Coaching Services

One community health board provides and will continue providing in FFY2026 family centered coaching services to pregnant women through partnership with a community-based organization. Family centered coaching utilizes strategies and tools to provide comprehensive services to families that are responsive to their needs and experiences, including addressing impacts of community health drivers.

• Utilize Community Co-Design to Increase Prenatal Care Access

Community Co-Design is a participatory design process that incorporates community input at every stage of the process from beginning to end. For one Local public health agency, they have utilized community co-design to increase prenatal care access by increasing the number of doulas available to residents, as well as mapping providers and resources and their responsiveness to communities. They will continue these efforts in FFY2026.