Overview and context of the population domain

 

Louisiana continues to have one of the highest rates of maternal mortality in the country. Based on a review of all maternal deaths, the Louisiana Pregnancy-Associated Mortality Review (PAMR) committee determined that 87% of pregnancy-related deaths and 88% of pregnancy-associated deaths were potentially preventable. Non-Hispanic Black women represent a disproportionate number of pregnancy-associated deaths. In 2021, while Black women represented 36% of the births in Louisiana, they represented 58% of deaths.3

 

A pregnancy-related death is defined as a death during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by the pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy. In 2021, COVID-19, cardiovascular conditions, and cardiomyopathy were the top causes of pregnancy-related mortality in Louisiana. A pregnancy-associated death is defined as a death during or within one year of pregnancy, from a cause that is not related to the pregnancy.  In 2021, substance use disorder, motor vehicle collision, and homicide were the leading causes of pregnancy-associated mortality in Louisiana. In 2025, the Louisiana Department of Health launched a concerted effort to reduce pregnancy-associated opioid overdose deaths by 80% within three years.4 

 

Another key measure of maternal health is maternal morbidity. Hospital discharge data shows that the rate of severe maternal morbidity remains high in the state.  The rate has risen from 71.7 cases per 10,000 delivery hospitalizations in 2018 to a rate of 81.1 cases per 10,000 delivery hospitalizations in 2022.5 Hemorrhage complications and renal complications are the leading causes of severe maternal morbidity.  

 

The 2026 - 2030 Title V Program will maintain investment in the state’s maternal health surveillance systems including the Pregnancy Risk Assessment Monitoring System (PRAMS), Pregnancy Associated Mortality Review (PAMR), and Domestic Abuse Fatality Review (DAFR). Title V will also continue to support the infrastructure for technical assistance and capacity building to ensure the provision of high quality family planning and reproductive health services in the clinical systems affiliated with the state’s Title X program. The program will also support the Louisiana Perinatal Quality Collaborative’s (LaPQC) implementation of evidence-based, quality improvement initiatives aiming to improve birth outcomes throughout the state. Access to behavioral health services will be improved through the development and implementation of a provider-to-provider Mental Health Consultation system that encompasses universally available consultation and education, as well as more intensive technical assistance to the home visiting workforce. Coordination and statewide leadership for perinatal policy and initiatives will be strengthened through provision of funding and/or technical support to the Louisiana Perinatal Commission, the Doula Registry Board, and the new Maternal Health Task Force.  

 

 

Planned Title V efforts and alignment with women / maternal health priorities

 

Priority Need: Reliable data is available to inform policy makers, providers, and MCH populations engaged in the design, monitoring, and evaluation of MCH policies and services.

 

Objective 1.1

In FFY2030, at least 80% of maternal and infant health constituents report that they are “highly” or “very highly” satisfied with the quality of data products available to inform strategic decision-making.

 

Strategy 1.1.1: Improve key constituents' (policymakers, providers, MCH populations) understanding of the drivers and underlying factors contributing to Louisiana's maternal health outcomes by directly carrying out epidemiological surveillance/investigations, disseminating health education messages, and presenting recommendations to improve maternal health policies and services.

Access to timely and reliable data is critical to ensuring that key constituents develop data-informed policies and services. As Louisiana’s Title V MCH agency, the Bureau of Family Health plays an important role in surveillance of key maternal and infant health data indicators.  Public health surveillance includes monitoring changes in data trends over time as well as monitoring disparities across sub-population groups. Louisiana’s Title V Program routinely conducts surveillance of state vital records to monitor trends in overall maternal mortality.  In addition, hospital discharge data and emergency department data are utilized for surveillance of data related to severe maternal mortality and other indicators related to maternal health and wellbeing.

 

When concerning trends or disparities are identified via routine surveillance, specific studies or programs are launched to support additional investigation.  These epidemiological investigations may result from legislative mandates, requests from the Commission on Perinatal Care and Prevention of Infant Mortality (Perinatal Commission), or from other Title V supported maternal health programs.  Ongoing maternal health epidemiological investigation programs including the Pregnancy Risk Assessment Monitoring System (PRAMS) Program and maternal mortality review panels including the Pregnancy Associated Mortality Review (PAMR) and the Domestic Abuse Fatality Review (DAFR).  PRAMS, PAMR and DAFR each have legislative mandates.  The relevant legislation for each requires submission of periodic reports to the Louisiana legislature. Currently, legislative reports are distributed to legislators identified in the relevant legislation. They are also posted on the Bureau of Family Health’s websites and shared with data partners such as steering committee members, case review panel members, and programmatic partners. In FFY2026, the Bureau of Family Health will continue to assess current data reports and products to determine if they are accessible and useful for data seekers and researching if there are more accessible options for publishing and disseminating data related to maternal health.

 

In FFY2024, the Bureau published state, regional, and parish-level maternal and child health data indicators in a Tableau dashboard on the Department’s website. In FFY2026, the Bureau will continue to refine the dashboard and assess if any additional indicators are appropriate for the dashboard.

 

Pregnancy Risk Assessment Monitoring System (PRAMS)

The CDC-funded Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based surveillance system that collects state- and site-specific data on the experiences and health of women before, during, and shortly after pregnancy. Launched in 1987 (Louisiana in the late 1990s), Pregnancy Risk Assessment Monitoring System helps identify groups at higher risk for health problems, track trends over time, and measure progress toward improving maternal and infant health outcomes. Pregnancy Risk Assessment Monitoring System covers about 81% of all U.S. births.

 

Pregnancy Risk Assessment Monitoring System supports public health action by:

•          Monitoring changes in maternal and infant health indicators,
•          Identifying women and infants at higher risk for health concerns, and
•          Measuring progress toward improving outcomes for mothers and babies.

 

The Louisiana Pregnancy Risk Assessment Monitoring System remains the only data source that captures detailed information on maternal behaviors and experiences—such as prenatal and postpartum care, mental and physical health, breastfeeding, housing, income, and education. Pregnancy Risk Assessment Monitoring System provides unique, state-level data that Title V programs rely on to track key maternal and infant health indicators, including:

•          Postpartum Depression/Anxiety – Women experiencing symptoms after birth
•          Postpartum Visit – Women who attended a checkup after delivery
•          Mental Health Screening – Women screened for depression or anxiety
•          Infant Safe Sleep – Babies placed to sleep safely
•          Housing Instability – Mothers who experienced unstable housing
•          Preventive Dental Visit – Women who received dental care during pregnancy
•          Breastfeeding – Trends in practices, experiences, challenges, and support needs

 

These insights are not duplicated elsewhere in such detail, making Pregnancy Risk Assessment Monitoring System a unique data source. Survey data are published annually and a surveillance report is periodically produced.

 

Expanding awareness of and access to these data reports is essential to ensure that all partners can collaborate effectively and use shared insights to drive improvements in maternal health across the state. In FFY2026, a specific area of focus will be to develop and publish an interactive data dashboard that will replace the annual Pregnancy Risk Assessment Monitoring System data report. The Bureau’s epidemiologists will also explore how, if, and when to implement Small Area Estimates using Pregnancy Risk Assessment Monitoring System data. Pregnancy Risk Assessment Monitoring System also contains qualitative data in the form of quotes from moms. Relevant qualitative data are being provided to data requesters to add richness to the quantitative data they request. This will continue in FFY2026.

 

Pregnancy-Associated Mortality Review (PAMR)

Louisiana Pregnancy-Associated Mortality Review’s mission is to protect and promote the health of women and families in Louisiana through surveillance, multidisciplinary case review, timely reports, and provision of actionable recommendations. Pregnancy-Associated Mortality Review works to quantify and understand pregnancy-associated deaths in order to create actionable, comprehensive recommendations to prevent future deaths through epidemiological surveillance and multidisciplinary case review. In FFY2026, Pregnancy-Associated Mortality Review will continue to produce reports and supplemental data products that include findings of the Pregnancy-Associated Mortality Review committee’s review of deaths, as well as recommendations targeted toward specific constituent groups (i.e. healthcare providers, healthcare and birthing facilities, healthcare systems, policy makers, insurance payers, government and public health agencies, community organizations, and patients and families).

 

In addition to published data products, dissemination of Pregnancy-Associated Mortality Review data and recommendations will be accomplished through presentations at meetings and conferences that include representation from a variety of constituent groups. Data and recommendations will also be presented to regional Community Action and Advisory Teams. The Pregnancy-Associated Mortality Review team is planning a statewide, virtual maternal mortality summit in the Spring of 2026 to share findings and convene constituent groups around prevention recommendations in the Pregnancy-Associated Mortality Review report and drive change.

 

Domestic Abuse Fatality Review (DAFR)

The Domestic Abuse Fatality Review Panel is a multidisciplinary team who meet quarterly to review deaths due to domestic abuse. We prioritize pregnancy-associated deaths due to domestic abuse because data has proven that homicide is one of the leading causes of death for pregnant women and intimate partner violence during pregnancy has been shown to contribute to maternal mortality from pregnancy-associated deaths. Through the review of de-identified case information, the team determines gaps in systems (healthcare providers, criminal and civil justice, laws and legislation) and training needs to reduce and prevent deaths due to domestic abuse in Louisiana. The Domestic Abuse Fatality Review Panel uses information gathered during case review to prepare an annual report containing data and recommendations to aid and protect victims of domestic violence. The report is submitted to the governor and legislature and shared with key constituents (healthcare providers, criminal and civil justice systems, domestic violence service providers, and community organizations) to enlist their help in implementing the strategies developed by the Panel.

 

In FFY2026, the Domestic Abuse Fatality Review will publish an annual report of its findings. The Domestic Abuse Fatality Review will work with other Bureau of Family Health programs such as the Maternal, Infant, and Early Childhood Home Visiting, the Pregnancy Associated Mortality Review, and Child Death Review teams as well as other outside organizations such as the Louisiana Emergency Response Network, the Domestic Violence Prevention Commission, the Acadiana Family Tree, and others to begin implementation of select recommendations. The goal to implement four recommendations from the 2023 annual report over the next two years. The Domestic Abuse Fatality Review has partnered with the La Coalition Against Domestic Violence and the Tulane Violence Prevention Institute to pilot a Bi-Directional Referral System between domestic violence and healthcare service providers to ensure victims of domestic violence are being screened properly and receiving the services and resources they need. The Domestic Abuse Fatality Review will also share and track the dissemination of information and findings.

 

SPM ESM 1.1 - In FFY2026, at least 5 maternal health data products will be produced or updated and disseminated to key constituents to facilitate data-informed decision-making.

 

Priority Need: Communities and families have timely access to reliable and accessible information.

 

Objective 1.2

In FFY2030, at least 80% of maternal health constituents will report that they “frequently” or “very frequently” share maternal health education messages with their families and other community members.

 

Strategy 1.2.1: Improve community leaders' understanding of effective strategies for responding to key risk and protective factors affecting maternal and infant health by convening community action and advisory teams.

Community Action and Advisory Teams provide an important mechanism to address this need. These teams serve as trusted liaisons between the Maternal and Child Health program and the populations it serves, fostering bidirectional communication, trust, and ensuring that initiatives are culturally competent, contextually appropriate, and community-informed. The Community Action and Advisory Teams are organized into nine regional teams across the state, each with distinct local representation and priorities. Each regional Community Action and Advisory Team is composed of community members and organizations dedicated to promoting the health and safety of Louisiana’s families. They work together to identify and address family health issues, prioritize needs, and implement solutions. This regional structure ensures that each Community Action and Advisory Team is tailored to the specific needs and dynamics of its community, fostering effective collaboration and impactful outcomes.

 

In FFY2026, each of the 9 regional Community Action and Advisory Teams will convene quarterly and engage with approximately 360 partners across the state, including healthcare providers, mental health professionals, community organizations, law enforcement, coroners, and death scene investigators.

 

In FFY2026, Title V supported MCH Coordinators plan to incorporate pregnancy-associated mortality review data presentations at regional Community Action and Advisory Team meetings and to review recommendations from the Pregnancy Associated Mortality Review report to broaden the focus of Community Action and Advisory Team efforts improve maternal health outcomes. The Pregnancy Associated Mortality Review report recommendations for hospitals and health systems are implemented through the Louisiana Perinatal Quality Collaborative, and there are a range of recommendations that may be implemented by local partners and communities.

 

SPM ESM 2.1 - In FFY2026, at least 300 community leaders will receive information and resources supporting the design of local maternal health education efforts.

 

Priority Need: Community / family leaders and CBOs meaningfully participate in the design, monitoring, and evaluation of MCH policies and services.

 

Objective 1.3

In FFY2030, at least 80% of family, community and/or community based organization leaders report that they are “highly” or “very highly” satisfied with the training and/or coaching received to support their meaningful participation in the design, monitoring and evaluation of maternal and infant health policies and services.

 

Strategy 1.3.1: Training and coaching for family, community, and community based organization leaders participating in Title V supported maternal and infant health programs and activities.

The mission of the Bureau of Family Health (BFH), Louisiana’s Title V agency, is “to elevate the strengths and voices of individuals, families, and communities to catalyze transformational change to improve population health.” Aligned with this mission, the Bureau is committed to continuously improving two-way exchange of information and meaningful participation1 of communities and families in the design, monitoring, and evaluation of Title V supported programs. This commitment to shifting power to communities and families is integrated into (1) the strategies and tactics used in the delivery of direct and enabling services to individuals and families, (2) the design, monitoring, and evaluation of systems strengthening programs and services, (3) the formulation and promotion of policy and legislation affecting the state’s MCH populations, and (4) the processes guiding the overall strategy of the Bureau.

 

In recent years, the Title V Program has supported increased participation of community and/or family leaders in decision-making mechanisms including program steering/advisory meetings or state-mandated Boards, Councils, and Commissions.  However, efforts to prepare community/family leaders to effectively, or “meaningfully”, participate in these mechanisms have been varied and largely dependent on the leadership of the individual program/project manager.  The 2026 - 2030 state action plan will increase focus on truly shifting power to community/family leaders and the community based organizations closest to the state’s MCH populations by supporting the development and piloting of standardized processes for recruitment, onboarding, and continuous mentoring and leadership development.  In FFY2026, the Title V Program will prioritize completing an assessment of training and capacity building needs and interests and identification of an institutional partner to support the design and delivery of capacity building activities for community/family leaders. Recognizing that there are numerous experienced leaders currently participating meaningfully in Title V supported program activities, a peer to peer learning strategy is anticipated to be a core component of the approach to the community/family leader empowerment strategy.  

 

The Louisiana Pregnancy Risk Assessment Monitoring System Steering Committee, the Domestic Abuse Fatality Review Committee, and the Pregnancy Associated Mortality Review Committee each include representation of six community based organizations serving the maternal and infant populations of the state. In FFY2026, these teams will continue to recruit representatives from community-based organizations and individuals with lived experience from across the state as members of the Pregnancy-Associated Mortality Review committee and will continue to implement an onboarding process that includes a New Member Welcome Package as well as a scheduled orientation prior to receiving cases for review. 

 

Since its inception, the LaPQC has prioritized engaging patients, families, and communities as a foundational element of its structure and implementation model. Foundational to all LaPQC initiatives is its “faculty”. An LaPQC faculty is an initiative specific advisory mechanism including clinical subject matter experts as well as community based organizations and “patient partners”. Faculty help to inform the planning and implementation of LaPQC initiatives and also serve as a direct resource to participating teams. Birthing hospitals are now required to have a patient partner on their improvement team for the 2025-2026 Birth Ready and Gift Designation period. In FFY2026, the LaPQC will continue to pilot and refine approaches to strengthen meaningful partnerships with patient, family, and community representatives.

 

The Louisiana Perinatal Quality Collaborative (LaPQC) will also continue to provide technical assistance to participating hospitals to reinvent their traditional birthing hospital task force into a Hospital Community Task Force. The LaPQC team, in partnership with Coffective, supports teams in progressing through 4 benchmarks that ensure that the community’s priorities are addressed and implementation of quality improvement processes is informed by community voice. The hospital leaders, a designated community expert, and key community partners will co-create a Hospital Community Task Force (HCTF) with rotating leadership, a shared agenda, and shared decision-making. The goal is to improve power dynamics between the hospital and community and co-create quality improvement priorities and actions to be more relevant and thus more effective in closing birth and breastfeeding-related disparities.

 

SPM ESM 3.1 - In FFY2026, at least 15 family, community, and/or CBO leaders will receive training/coaching to support their meaningful participation in the design, monitoring, and evaluation of maternal and infant health policies and services.

 

Priority Need: MCH systems of care have improved capacities to ensure access to quality maternal and infant health services.

 

Objective 1.4

(a) In FFY2030, at least 90% of women will attend a postpartum checkup within 12 weeks after giving birth. (b) In FFY2030, at least 85% of women who attended a postpartum checkup will report that they received the recommended care components.

 

Strategy 1.4.1: Improve access to quality family planning services by providing funding and technical assistance to the Office of Public Health's Bureau of Regional and Clinical Operation’s (BRCO) Parish Health Units.

Improving access to and quality of reproductive health services has been integral to Louisiana’s strategy of improving maternal and perinatal outcomes. As Louisiana’s sole Title X Family Planning Services grantee, The Bureau of Family Health’s (BFH) Reproductive Health Program is recognized as an important resource in the state with expertise around national clinical guidelines, including the Quality Family Planning (QFP) Guidelines. The Bureau has significant expertise in direct provision of comprehensive reproductive health services to high-need populations; geographic analysis of need and provider access; and adequate coverage policies.

 

BFH provided reproductive health services through 57 Parish Health Units (PHU), which are under the management of the Office of Public Health. These safety-net services include adult and adolescent nurse and provider visits with advanced practice registered nurse (APRN) and registered nurse (RN) providers. Each Title X location offers a broad range of U.S. Food and Drug Administration (FDA) approved contraceptive methods, including natural family planning methods, and provides client-centered contraceptive services on-site, via telehealth, or by referral. Most clients receive convenient same-day access to their method of choice, if not medically contraindicated.

 

In FFY2026, the BFH Reproductive Health Program (RHP) will continue to develop and implement systems strengthening strategies utilizing good practices and lessons learned from other Title V funded programs within the BFH. Inspired by the developmental screening toolkit (discussed in the Child Health domain), the RHP will continue to build and launch an interactive online toolkit that healthcare providers can use to build capacity to incorporate high-quality reproductive health services into their practice. Content for the website is expected to be based on the Quality Family Planning (QFP) and other recommendations, guidelines, and best practices in the reproductive health field. Incorporating good practices from the Title V funded LaPQC Gift and Birth Ready hospital designation programs, the Title X program is also designing a quality designation system to recognize primary care practices that have demonstrated successful implementation of sexual and reproductive health services into their daily practice.

 

Title V funding will be utilized to provide financial and technical support to a network of primary care providers including one urban adolescent and young adult-focused health center and two five rural  Federally Qualified Health Centers (FQHCs).  These providers serve as critical access points in many communities and provide care to many low-income and/or uninsured individuals. The providers are meeting service needs as it applies to administrative, fiscal, and program activities.  For example, there were only two sites who needed minor improvements and, subsequently, provided reasonable responses to adjust services to meet compliance requirements.

 

In FFY2026, the Bureau of Family Health (BFH) and Bureau of Regional and Clinical Operations (BRCO) will co-implement an Information & Education (I&E) Advisory Committee The I&E Advisory Committee will hold meetings online and utilize a RedCap website portal for easier access to uploading, retrieving, and submitting documents for approval to and from various Public Health Units within the clinical network.  The I&E Advisory Committee offers training and education through the approved materials for individuals, families, and community-based organizations.  The I&E Advisory committee will approve the materials in online meetings.  Within those meetings, as an option, the advisory committee members can choose to include a public audience or community participants in the decision making process by holding focus groups or providing surveys for ad-hoc community review.  Advisory committee members can hold focus groups altogether or separately.

 

Strategy 1.4.2: Improve access to doula services by facilitating doula registration with the Louisiana Doula Registry Board.

In FFY2026, the Doula Registry Board will improve marketing efforts that target registry eligible doulas. Targeted messaging explaining the benefits of the doula field and registering with the Board. Targeted messages will be developed to explain the benefits of the doula field and the benefits of registering with the Doula Registry Board.  Marketing and media messaging will target doulas, doula training organizations and be disseminated by registered doulas, the Doula Registry Board and doula training organizations.

 

Strategy 1.4.3: Improve access to safe and quality birthing services by providing technical assistance to birthing hospitals, freestanding birthing centers and other clinical and community based providers

Perinatal Quality Collaboratives (PQCs) have been recognized by national leaders as an effective strategy to address critical drivers of health outcomes, while improving the efficiency, effectiveness, and cost of healthcare. Louisiana is represented in the National Network of Perinatal Quality Collaboratives (NNPQC) and serves as the state’s lead entity for implementing the American College of Obstetricians and Gynecologists (ACOG) Alliance for Innovation on Maternal Health (AIM) patient safety bundles. The LaPQC priorities and actions are guided by public health data and advisement from health system partners and advocates, in and outside of Louisiana. Data-related guiding priorities originate primarily from the Louisiana Pregnancy Associated Mortality Review (PAMR). The LaPQC serves as the primary “action” arm of the public health cycle, advancing recommendations that apply to healthcare providers and healthcare systems.

 

Since its launch in 2017, the Louisiana Perinatal Quality Collaborative (LaPQC) has advanced the use of quality improvement (QI) science across birthing facilities statewide. Through targeted pilot projects, intensive statewide initiatives, and designation programs, the LaPQC has helped embed best practices into routine perinatal care.

 

Louisiana hospital administrators and clinical teams now expect ongoing QI coaching and support from the LaPQC to implement and sustain evidence-based care. Patients, families, and community advocates also expect Louisiana hospitals and care providers to deliver safe, patient-centered, and respectful perinatal care. Importantly, LaPQC participation is now a licensure requirement for all birthing hospitals in the state.  The LaPQC’s initiatives and designation programs employ nationally-recognized methods to improve the safety and quality of clinical care. The implementation of strategies to achieve desired outcomes will be guided by national best practice recommendations, state surveillance data, and feedback from participating teams, subject matter experts, and patient and community partners.

 

In FFY2026, the LaPQC will continue to implement the Louisiana Birth Ready Designation Program to recognize participating LaPQC birthing facilities and create a system of sustained evidence-based change. With two tiers of achievement — Birth Ready and Birth Ready+ — this designation, developed in 2021, recognizes facilities’ consistent, healthcare and quality improvement work. Louisiana Birth Ready Designation also celebrates improved perinatal health outcomes, the result of implementing safe, patient-centered and dignified clinical practices to improve outcomes for all women who give birth in Louisiana. Each Designation level includes the following five areas of requirement: participation in collaborative learning; patient-centered care; policies and procedures; structures and education; and outcome and process measures.

 

In FFY2026, the LaPQC will partner with subject matter experts to create standardized, interactive hospital dashboards that allow hospitals to identify disparities in maternal and newborn health outcomes. In addition, the LaPQC will finalize and implement standardized report templates that communicate disparities across audiences, including policymakers, providers, and MCH populations.

 

In FFY25, the Louisiana Birth Ready Designation criteria were updated, and the designation transitioned from a one-year to a two-year cycle to align with Louisiana Gift Designation and give teams sufficient time to test and scale improvements. As part of the new two-year process, birthing hospitals will complete an Annual Maintenance Survey to assess their progress toward meeting requirements and identify areas where additional coaching support may be beneficial. Through FFY26 and FFY27, the LaPQC will continue supporting birthing hospital teams in meeting the Louisiana Birth Ready Designation requirements for calendar years 2025 and 2026.

 

The Safe Births Initiative 4.0 aims to address both preparation for postpartum transition and substance use disorder in efforts to improve maternal and infant outcomes in Louisiana. In FFY2026, the Safe Births Initiative will continue to support participating teams in sustaining improvement in obstetric hemorrhage, hypertension, obstetric sepsis and reducing low-risk Cesarean delivery births.

 

In addition to the Safe Births Initiative, the LaPQC will continue to implement multiple other initiatives aiming to improve maternal health outcomes in the state.  The LaPQC will continue and conclude its third iteration of the Caregiver Perinatal Depression Screening (CPDS) in pediatrics clinics during FFY2026 to support screening and referral pathways for caregivers impacted by postpartum depression. The Obstetric Readiness in Emergency Departments (ORED) initiative will continue to engage the state’s emergency departments in training, collaborative learning and quality improvement technical assistance to improve obstetric readiness. Drill trainings will also be incorporated as a strategy to support hands-on, skills-based training to emergency department staff.

 

Through the Community Birth Initiative (CBI), the LaPQC, in partnership with the state’s freestanding birth centers, will continue to build on FFY2025 efforts to establish policies, protocols, and procedures related to readiness, recognition and response to obstetric postpartum hemorrhage and neonatal emergencies. The LaPQC will also work with subject matter experts to plan, execute, and implement a model for multidisciplinary drills and collaboration between hospitals and freestanding birth centers as one strategy to improve transfer from a community-based setting to a hospital.

 

Strategy 1.4.4: Improve access to caregiver depression screening & referral by providing technical assistance including training and tele-consultation services to perinatal providers.

The Title V supported consultation system uses a two-tiered approach—universal and targeted—to build the capacity of frontline health care providers in recognizing and responding to behavioral health needs of maternal and child populations. The universal tier provides guidance and education to any frontline health care provider seeking a one-time consultation, offering timely support on common behavioral health questions without the need for ongoing engagement. The targeted tier offers ongoing, individualized support for providers managing complex or high-risk cases, including case-based consultation, clinical guidance, and opportunities for deeper collaboration with behavioral health specialists.

 

The Provider-to-Provider Consultation Line (PPCL) occupies the universal tier of the mental health consultation system. PPCL is a no-cost provider-to-provider telephone consultation and training program that is available to any healthcare provider in Louisiana who is caring for pregnant and postpartum women and children and youth ages birth to 21. PPCL has a team of licensed mental health professionals and medical experts who staff a phone line that providers can call when they have a question regarding a specific patient or have a more general question related to mental health and substance use. PPCL is also able to provide up-to-date information on local community and telehealth mental and behavioral resources. Satisfaction survey results indicate that 100% of responding providers are extremely satisfied with the support received through PPCL. One provider stated, “PPCL is my ‘life line’ during a busy schedule to ensure mental health counseling for my patients.”

 

Targeted mental health consultation (MHC) has become a foundational component of quality services within the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) teams that have been established in multiple regions of the state. MHC is a critical support for our home visiting workforce, offering guidance, education, and support as staff navigate complex client needs. Providing home visitors and their supervisors with access to mental health expertise and support also helps the MIECHV program to manage the risk for its large number of high acuity cases. Evaluation results show that MHC both increases home visitors’ self-efficacy and knowledge in navigating client mental health concerns.

Education, universally available to all clinicians in the state or targeted on specific provider types and/or mental health issues, for frontline healthcare providers is an integral component of BFHs mental health consultation system. Using the evidence-based Extension for Community Health Outcomes (ECHO) model, PPCL holds monthly training sessions on perinatal and pediatric mental health topics to providers statewide and, in Fall 2025, will be facilitating the REACH Institute's three-day intensive Patient-Centered Mental Health in Pediatric Primary Care (PPP) training for 35 of Louisiana’s prescribing pediatric providers. In partnership with the Louisiana Perinatal Quality Collaborative (LaPQC), PPCL is also supporting the implementation of the Caregiver Perinatal Depression Screening in Pediatric Practices (CPDS) Learning Collaborative, a quality improvement initiative focused on assisting pediatric practices to improve their implementation of perinatal depression screening and response in the pediatric well-child visits. Leveraging the infant and early childhood expertise across teams, consultants have also developed and implemented the Foundations of Infant Mental Health (FIMH) training for any provider working with young children. Consultants working with the MIECHV team provide more targeted education to the home visitors and actively participate in the monthly case conferences and team meetings.

 

ESM PPV.1 - In FFY2026, at least 76% of birthing hospitals in Louisiana will achieve Louisiana Birth Ready and Louisiana Birth Ready Plus designation.   ESM PPV.2 - In FFY2026, at least 85% of providers participating in the perinatal mental health ECHO training will have improved knowledge, attitudes, and/or behaviors.

 

Priority Need: Quality steering / advisory mechanisms ensure policymakers, providers, and MCH populations are effectively collaborating to design, monitor, and evaluate MCH policies and services.

 

Objective 1.5

In FFY2030, at least 80% of participants "strongly" or "very strongly" agree that the steering / advisory mechanism is “effectively contributing to the improvement of maternal and infant policies and services”.

 

Strategy 1.5.1: Improve maternal health policies and services by directly convening steering / advisory mechanisms that include participation of policymakers, providers, and MCH populations.

The Title V Program supports state and local steering/advisory mechanisms including public bodies (i.e., boards, commissions, councils, etc.), program/project specific steering or advisory committees, and other planning and coordination mechanisms. Louisiana’s Title V Program places significant emphasis on ensuring meaningful participation of constituents including policymakers, providers, and people (MCH populations) in the steering / advisory mechanisms.  The program recognizes that participants in Title V supported steering / advisory mechanisms have varying levels of familiarity with:

•          existing state statutes and/or administrative codes relevant to MCH programs and services
•          the metrics used to monitor health outcomes and evaluate MCH programs and services
•          the strengths and weaknesses of existing programs and services
•          national standards and best practices for MCH programs and services

 

While bringing people with different areas of expertise is essential for quality steering / advisory mechanisms, a common foundation of understanding facilitates effective dialogue, problem solving, and consensus building. Louisiana’s Title V Program contributes to effective dialogue by providing guidance for the recruitment and onboarding of new members, providing training to ensure Title V supported program staff clearly understand their roles and responsibilities, and by providing ad-hoc support when needed.  Title V supported steering/advisory mechanisms related to maternal health include:  

 

Louisiana Commission on Perinatal Care and Prevention of Infant Mortality

The Commission on Perinatal Care and Prevention of Infant Mortality was established in 1989 by Louisiana Revised Statute 40:2018 to improve maternal and infant health outcomes in the state. The Commission is composed of 16 members, including 14 healthcare and public health providers appointed by the governor, and two members appointed by the Louisiana Legislature Per statute, the Commission was established within the Louisiana Department of Health (LDH). Support for the Commission is provided through the LDH Office of Public Health (OPH), Bureau of Family Health (BFH) which leads the state’s public health assessment, assurance and policy functions related to maternal and child health.

 

The Commission on Perinatal Care and Prevention of Infant Mortality is authorized by R.S. 40:2018 and the Commission’s core functions include reviewing current regulations and laws affecting perinatal health, seeking grants for mortality studies, and contracting research as needed. The commission has the authority to access relevant health data and vital records to conduct studies, ensuring confidentiality and legal protections for sensitive information.

 

The Commission’s goals focus on improving infant health outcomes through data comparison and research, proposing healthcare financing plans, and enhancing education and public policies through public presentations and targeted discussions. Specific targets include reducing infant mortality rates to no more than nine per thousand live births, lowering the percentage of low birth weight babies, and decreasing disparities across regions and demographics. Overall, the Commission’s efforts aim to support Louisiana’s progress toward healthier pregnancies and infants through research, policy review, and community education.

 

Doula Registry Board

Act 182 of the 2021 Regular Legislative Session proposed the establishment of the Doula Registry Board within the Louisiana Department of Health. The Act, outlining rules, roles, responsibilities and procedural requirements of the Board, was successfully promulgated in November 2023 and codified into law. The Louisiana Doula Registry Board consists of 15 voting members and 16 non-voting member positions. The board serves as a commission under the Louisiana Department of Health for the purpose of creating a registry for doulas seeking health insurance reimbursement to promote safe and quality care for every mother and every birth in this state.

 

The Doula Registry Board, focusing on registering eligible doulas for insurance reimbursements, is contributing to the acceptance and use of doulas in the state and especially rural environments by aiding in doula accessibility, and making doula training organizations more visible. State agencies, healthcare providers, community organizations, and educational institutions are key constituents working to advance these goals.

 

The Doula Registry Board is authorized by R.S. 22:1059.1 to create a registry for doulas seeking health insurance reimbursement to promote safe and quality care for every mother and every birth in this state. The Board is charged with reviewing applications for doulas to register and receive health insurance reimbursement, approving applications to designate registered doula status, notifying applicants of approval or denial of doula registration status, and maintaining a statewide registry of doulas approved for health insurance reimbursement in Louisiana.

 

The Louisiana Doula Registry is a database of individuals who hold registered doula status in Louisiana, granted by the Louisiana Doula Registry Board. The Registry serves as a list of doulas who have satisfied all of the requirements stipulated by Louisiana law for registration, which makes them eligible for insurance payment for doula services. Insurance companies will be able to use the registry to identify doulas who have met the registration requirements. Additionally, the public will be able to use the Registry to find registered doulas whose services may be covered by insurance. For more information, consumers need to connect with their insurance company to learn about their plan benefits.

 

PRAMS Steering Committee

The Pregnancy Risk Assessment Monitoring System (PRAMS) has a steering committee made up of 20-25 members representing public health, healthcare, academia, and community-based organizations interested in maternal and child health and supporting PRAMS data collection and moving data to action. The steering committee convenes at least once a year. At the meeting, they receive an overview of PRAMS and recent data highlights. Members are engaged to share their data to action stories and to share ideas for how to raise awareness of PRAMS among potential participants. The steering committee members are also engaged as needed when there are opportunities to add new questions to the survey, to apply for a survey supplement, and to share findings.

 

Federal restrictions paused CDC PRAMS operations from January-July 2025. Louisiana PRAMS anticipates a resumption of data collection activities mid-summer at least for the final year of this grant funding cycle (i.e. through March 2026).  Uncertainties about future federal funding and the importance of PRAMS data necessitated contingency planning to transition to a standalone state surveillance system. In FFY2026 as the need for these measures become clearer, steering committee members may become more involved in developing such a program.  Involvement may involve decision making around future survey topics and questions, fundraising, survey dissemination, and participant recruitment.

 

Maternal Mortality Review Panels

Maternal mortality review panels including the Pregnancy Associated Mortality Review (PAMR) and the Domestic Abuse Fatality Review (DAFR) each include participation of maternal health policymakers, providers, and community based organizations.  In FFY2026, Title V supported mortality review panels will continue to carry out their function of reviewing mortality data and producing actionable recommendations for the continuous improvement of maternal health policies and services. 

 

SPM ESM 4.1 - In FFY2026, at least 80% of Title V supported steering / advisory mechanisms produce actionable recommendations to improve maternal and infant health policies and services.

 

 

Priority Need: State policies relevant to MCH programs and services are modernized to align with current day public health functions.

 

Objective 1.6

By FFY2030, at least 2 maternal health policy priorities have been advanced through 2 stages of the policy process towards implementation or other resolution.

 

Strategy 1.6.1: Contribute to advancing maternal health policy priorities through the five stages of the policy process (Identification, Analysis, Strategy and Policy Development, Enactment, Implementation) by producing data / information briefs and providing subject-matter expertise to inform policy dialogue.

Legal statutes, or laws, are the foundation of the federal and state MCH policy framework. In addition to legal statutes, the Louisiana Administrative Code (LAC) is the official, state-certified compilation of rules adopted or amended by Louisiana state agencies, which provide detailed guidance for the implementation of many state programs, services, and functions. Over the past several years, the Title V Director and program staff have identified the need to revise state laws and/or associated rules in order for them to more accurately reflect current-day needs and functions. There are many areas of state policy that have become outdated and need to be modernized so that they can more effectively achieve their original intent and advance or protect health. Some areas identified include the need to strengthen regulations and monitoring of levels of maternal care; extensive revision of historical policies intended to ensure access to high quality sickle cell services statewide; and a policy architecture needed to ensure that the newborn screening system is able to adapt expeditiously as national recommendations change. In addition, many of the rules associated with the Office of Public Health statewide clinical network require review since they were promulgated at a time when Title V provided more extensive direct clinical services. 

 

The Title V supported Policy and Legislation section provides technical assistance to all Title V supported programs. Utilizing the CDC Policy Process as a framework for strategic planning, the policy section provides expertise to facilitate advancing policy priorities through each of the five stages: Problem Identification, Policy Analysis, Strategy and Policy Development, Policy Enactment, and Policy Implementation. The Policy and Legislation section delivers internal training and capacity building activities to improve Title V workforce skills for policy analysis, policy development, rulemaking, and engaging with policymakers.

 

In FFY2026, the Policy and Legislation section will collaborate with Title V-supported programs to identify and prioritize policy priorities and to develop strategies to facilitate advancing policy priorities to the next stage of the policy process. With a focus on priority needs identified in the 2025 Title V Needs Assessment and highlighted in the 2026 - 2030 State Action Plan, programs will be supported to scan existing legislation and review current administrative code to identify policy gaps or opportunities for modernization.  

 

A critical component of this strategy is to ensure key constituent input in policy development. Programs will be supported to develop data / information briefs to facilitate dialogue with key constituents including state agency leadership staff, steering / advisory mechanism members, community / family leaders, and all key Title V workforce staff. Lastly, programs will be supported to develop strategies for engaging key constituents in the policy development stage of the process. In addition to engagement with Title V supported steering / advisory mechanisms, engagement with Medicaid quality committees and related work groups is anticipated to be a key activity in the policy development process.

 

SPM ESM 5.1 - In FFY2026, at least 1 data / information brief is produced to inform policy dialogue.