Women/Maternal Health Domain
Well Woman Care Plan
(October 2022 – September 2023)
National Performance Measure:
Percent of women with a past year preventative visit.
Well Woman Care Strategy #1:
Strengthen early identification of and supports for women’s behavioral health needs
State level activities/timeline:
- State MCH Staff will participate in and build upon inter-/intra-agency efforts to address maternal behavioral health needs, specifically substance use disorders and depression/suicide
Timeline: 10/1/22-9/30/23
- MCH will partner with Oregon Department of Human Services to support Oregon’s implementation of Plans of Care for infants prenatally exposed to substances as required by the Child Abuse Prevention and Treatment Act (CAPTA). The Plans of Infant Care implementation in Oregon is focused on prenatal outreach and connection to services and supports for the family to prevent involvement with Child Protective Services. We will participate in the planning and implementation of the expansion of Nurture Oregon into rural Oregon. Nurture Oregon is an integrated care model for pregnant families that includes peer support, prenatal care, substance use and mental health treatment, care coordination, and other services.
Timeline: 10/1/22-9/30/23
- State MCH Staff will continue to support best practices in screening and referral for perinatal mood disorders in Oregon’s home visiting programs.
Timeline: 10/1/22-9/30/23
Local level activities/timeline:
- Tillamook County plans to increase the use of the Edinburgh Postnatal Depression screening tool, completing the screen for every client at their initial visit to determine a baseline, in the 3rd trimester, and after delivery.
- Union County plans to work on implementing screening and referrals for perinatal mood disorders in all clinical settings.
Timeline: 10/1/22 – 9/30/23
Well Woman Care Strategy #2:
Support advanced training, coaching and quality improvement activities for home visitors related to well woman care.
ESM:
1.2: Among local grantees who select well woman care, percent who report improved knowledge, skills, or policies based on provided technical assistance.
State level activities/timeline
- In collaboration with the MCH Nurse and MIECHV teams, we will conduct a statewide survey of home visiting programs to better understand their training needs around well woman care. The results will be used to plan future trainings and quality improvement initiatives for the home visiting teams.
Timeline: 10/1/22-1/1/23
- The MCH Nurse Team will support the implementation of a new data collection system for some of the nurse home visiting programs. The new system will allow for an improved understanding of the needs and barriers to well woman care for home visiting clients and support quality improvement initiatives by local home visiting programs.
Timeline: 10/1/22-1/1/23
Local level activities/timeline:
- Jackson County will provide an advanced level contraceptive training on motivational interviewing for home visiting staff.
Timeline: 10/1/22 – 1/1/2023
Well Woman Care Strategy #3:
Support efforts to improve diversity in the workforce
ESMs:
1.3. Completion of environmental scan of organizations and partners to facilitate determining Title V’s role in increasing diversity in the perinatal workforce.
1.4. Number of OHA Office of Equity and Inclusion Certified Community Health Workers.
State level activities/timeline:
- Provide support to Oregon’s Coalition of Local Health Officials as they build a strategic plan for recruiting and retaining a diverse public health workforce in Oregon.
Timeline: 10/1/22-9/30/23
- Partner with MCH Nurse Team and the Oregon Center for Children and Youth with Special Health Needs to develop the role of Community Health Workers (CHWs) in the Babies First! and CaCoon home visiting programs and support CHWs working in those programs.
Timeline: 10/1/22-9/30/23
Local level activities/timeline
NA - no local grantees chose to work on this strategy.
Well Woman Care Strategy #4:
Ensure access to culturally responsive preventive clinical care for low income and undocumented women.
ESM:
1.1: Percent of new mothers who have had a postpartum checkup.
State level activities/timeline:
- Strengthen partnership with Oregon Perinatal Collaborative to improve community engagement and equity efforts.
Timeline: 10/1/22-9/30/23
- Conduct a needs assessment, convene stakeholder workgroup, and implement recommended changes to refocus and revitalize the Oregon MothersCare Program.
Timeline: 10/1/22-9/30/23
- Promote anti-racism training and resources addressing perinatal health.
Timeline: 10/1/22-9/30/23
- Collaborate with state Medicaid to support access to doulas, lactation services, 12-month post-partum coverage and home visiting. Partner with Family Connects Oregon team to ensure coverage by commercial plans for universally offered newborn nurse home visiting.
Timeline: 10/1/22-9/30/23
Local level activities/timeline:
- Josephine County will partner with organizations and shelters that serve unhoused people to ensure access for preventive reproductive care. A nurse practitioner and a clinician in the community will go out to visit and discusses the care that public health offers in family planning, well woman care, STD and STI options. Underserved women in the community are encouraged to visit the health department for any of these services and they offer referrals to other programs such as Screenwise.
- Baker County will promote the availability of well woman visits at the Health Department though outreach events and venues. In addition, they will provide customer satisfaction surveys to women who come to appointments and provide gift cards for those who fill out the survey.
- Klamath County will implement a well woman care pilot study with clinics and the local Coordinated Care Organization to identify and contact Oregon Health Plan patients to get them seen for preventive care. They will also carry out a Well Woman Care awareness campaign in collaboration with Oregon Tech's Integrated Student Health Center.
- Morrow County will provide referral and follow up for well woman care and other reproductive health services to clients who present at the Health Department.
- Polk County will attend outreach events to promote well woman care in collaboration with partners. They will be engaged in planning and relationship building between internal programs (e.g. WIC, OMC, Reproductive Health) and they will develop a standardized process for providing education and referral among programs.
Timeline: 10/1/22 – 9/30/23
Well Woman Care Strategy #5:
Establish community based perinatal, women's and infant health advisory groups to share best practices, strategize and impact policy change. Engage affected communities including people of color in leadership.
State level activities/timeline:
- Provide technical assistance and facilitate shared learning among Title V grantees in community engagement best practices.
Timeline: 10/1/22-9/30/23
- Support the Oregon Perinatal Collaborative in building capacity to engage clients and community-based organizations.
Timeline: 10/1/22-9/30/23
- Participate in the newly forming Family Partnership Collective convened by Multnomah County Health Departments.
Timeline: 10/1/22-9/30/23
Local level activities/timeline:
- Douglas County will continue to convene a local perinatal task force.
Timeline: 10/1/22-9/30/23
Well Woman Care Strategy #6:
Partner with state Maternal Mortality and Morbidity Review Committee (MMRC) to understand contributing factors to maternal morbidity and mortality.
State level activities/timeline:
- Participate in state planning for the MMRC and use recommendations to inform Title V. Share information and recommendations from the Committee with Title V partners.
Timeline: 10/1/22-9/30/23
Local level activities/timeline:
NA - no local grantees chose to work on this strategy.
Well Woman Care Strategy #7:
Explore the role of Oregon’s Birth Anomaly Surveillance System (BASS) within MCH and Title V.
State level activities/timeline:
- Partner with the BASS team to identify opportunities for collaboration with Title V and Title V partners.
Timeline: 10/1/22-9/30/23
- Support the development of a strategic plan for the BASS program.
Timeline: 10/1/22-9/30/23
Local level activities/timeline:
NA - no local grantees chose to work on this strategy.
Critical partnerships:
Local grantees including local health departments and Tribes. The Oregon Perinatal Collaborative and local perinatal task forces. Home Visiting programs at the state and local levels. The Oregon Coalition of Local Health Officials. Oregon’s Maternal Mortality and Morbidity Review Committee. Oregon Medicaid and Oregon Department of Human Services. Oregon’s Birth Anomaly Surveillance System. The Oregon Health Authority’s Alcohol and other Drug Alignment Team.
Other Title V Work in the Women’s/Maternal Health Domain
Oregon’s Title V program will continue to provide leadership for policy and system development efforts related to maternal/women’s health including support for universally offered home visiting and ensuring that health system transformation addresses the need for comprehensive, culturally responsive women’s and maternal health services. Title V will also continue to support programs and initiatives such as Oregon MothersCare, maternal mental health, as well as oral health for pregnant women. Additional efforts for the coming year are outlined below.
- The MCH Title V team will partner with the Oregon Department of Human Services to support Oregon implementation of Plans of Safe Care as required by the Child Abuse Prevention and Treatment Act (CAPTA). Plans of Safe Care implementation will be piloted in coordination with the expansion of Nurture Oregon, a model of integrated maternity care and substance use disorder treatment.
- Title V staff will partner with Nurture Oregon and Oregon’s Overdose Initiative Workgroup to address risk and protective factors for opioid use and overdose prevention.
- Title V will continue to support Oregon’s Maternal Mortality and Morbidity Review Committee (MMRC), a governor-appointed committee that reviews deaths that occurred during pregnancy or the year after the end of pregnancy in Oregon. The committee determines issues that contributed to each death and decides upon recommendations to improve systems of care for pregnant people and ultimately decrease future deaths from happening. The MMRC is comprised of a multidisciplinary group of individuals throughout the state that have experience promoting maternal health and wellness, and includes representation from public health, mental health, community-based organizations, and healthcare professionals.
The MCH Title V staff will support Medicaid partners in implementing the new State Plan Amendment for 12-month postpartum eligibility.
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