Perinatal/Infant Health – Application Year
Illinois’ priority for Infant and Perinatal Health Domain is:
- Support healthy pregnancies to improve birth and infant outcomes. (Priority #3)
During FY24, Title V will utilize the following strategies to support healthy pregnancies and improve birth and infant outcomes:
During FY24, IDPH and Title V will continue to administer the Illinois Administrative Perinatal Centers (APC) Grant Program. The 10 APCs supported by Title V through the APC program will continue to monitor and provide consultation to the birthing and non-birthing hospitals in their respective networks. This consultation will help to improve maternal, child, and infant health outcomes across Illinois. Key activities in which the APCs will engage include standardizing M&Ms case reviews, messaging on postpartum warning signs, educating EMS providers and non-birthing hospitals for emergency perinatal care to lower very pre-term birth deliveries outside a Level III facility, supporting ongoing simulations for obstetrical hemorrhage at birthing hospitals to prevent maternal morbidity and mortality, and providing neonatal resuscitation education to birthing hospital clinicians to assist with the understanding of stabilization for neonates. IDPH’s perinatal nurses will continue to provide site visits and attend morbidity and mortality reviews at the hospitals.
OWHFS, Title V and the Illinois Perinatal Advisory Committee (PAC) will finalize the new administrative rules regarding the perinatal and maternal levels of care. OWHFS will be working with their legal team to complete the draft. Once the draft is completed, it will be shared with birthing hospitals and other key stakeholders for feedback that will be reviewed and incorporated as necessary. OWHFS hopes to submit a final version of the rules through the Illinois rulemaking process and publish rules in FY24.
3-B. Implement surveillance systems to assess the impact of COVID-19 on pregnant women and neonates, including use of CDC’s Surveillance of Emerging Threats to Mothers and Newborns (SET-NET) system and development of system to track universal testing of pregnant women admitted for labor and delivery.
Illinois’ participation in the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) for COVID-19 during pregnancy was completed during FY23. No further data collection or submission to CDC is anticipated during FY24.
The Title V epidemiology team is currently (in FY23) working on analysis of the data collected through this project to assess the impact of prenatal SARS-CoV-2 on maternal and infant outcomes. It is anticipated that several data products will be created from these analyses. Some of these products may not be finalized until FY24.
3-C. Support the Fetal and Infant Mortality Review (FIMR) program that identifies factors that contribute to fetal and neonatal loss and subsequent adverse pregnancy outcomes and develops recommendations to improve quality care as well as address social determinants of health.
The Fetal Infant Mortality Review (FIMR) initiative is a nationwide systems strategy supported by the American College of Obstetricians and Gynecologists (ACOG) to identify non-medical factors that contribute to fetal and neonatal loss and subsequent adverse pregnancy outcomes. The goals include eliminating disparities in perinatal, infant, and maternal health; and directing resources and proposing interventions to improve access to, utilization of, and full participation in comprehensive perinatal and women’s health services, particularly for women at higher risk for poor health outcomes.
In FY24, Title V will support the two existing FIMRs and explore opportunities to support additional FIMRs. IDPH will implement a data use agreement to provide FIMR teams with vital records and APORS data to increase the referrals and bolster the strength of the program.
3-D. Support the Illinois Perinatal Quality Collaborative (ILPQC) in its implementation of obstetric and neonatal quality improvement initiatives in birthing hospitals.
This is the same as strategy 2-I. Information about this activity is available in the narrative for the Women’s/ Maternal Health Domain.
3-E. Convene partners to support statewide efforts to improve breastfeeding outcomes and reduce disparities.
The OWHFS will continue to participate on a collaborative project known as the Illinois State Physical Activity and Nutrition Program (ISPAN). This project, which began in 2019, aims to build on the significant accomplishments made in physical activity and nutrition policy, systems, and environmental change. The purpose of this collaborative program is to reduce chronic disease and increase the health and well-being of Illinoisans by reducing disparities.
The collaborative projects most aligned with Title V activities focus on increasing the number of places (e.g., pediatric/ family practices, WIC sites) that implement supportive breastfeeding interventions. Title V will support future pending programs that focus on establishing a statewide learning collaborative and provide training and support for local health departments, which may include scholarships for WIC staff to become certified lactation consultants. DHS will continue to convene its learning collaborative utilizing seven regional breastfeeding task forces across the state. In addition, DHS will continue to provide scholarships for WIC staff to become certified lactation consultants or specialists. DHS will also continue to offer scholarship opportunities for community partners to attend these WIC breastfeeding trainings with the goal of increasing access to lactation support professionals (CLC/CLS/IBCLC) with similar lived experiences among rural, Black/African American, and Latina women.
During FY 24, Title V will continue to partner with organizations, such as ILPQC and the administrative perinatal centers, to explore opportunities to educate moms with opioid use disorder about safe breastfeeding practices, as well as education around pregnancy and opioid use. In addition, Title V will continue to track the number of Baby-Friendly facilities and the proportion of births occurring in these facilities.
In FY24, Title V will continue to support the recently launched breastfeeding initiative entitled, Enhancing and Expanding Breastfeeding – Illinois (EEB). This initiative seeks to bolster the substantial progress Illinois has made on measures related to breastfeeding over the past several years (e.g., increase in breastfeeding initiation rate). The specific objectives of the program include improving the continuity of care and support for breastfeeding throughout the state, enhancing workforce development through training and the creation of tools for health care professionals who provide services to pregnant individuals, and developing and implementing programs that promote health equity in lactation support.
The Bureau of Home Visiting (BHV) within the Illinois Department of Human Services Division of Early Childhood (IDHS-DEC) includes state-funded home visiting programs as well as federally-funded home visiting programs (federal funds are from the Maternal Infant and Early Childhood Home Visiting program, or MIECHV). During FY 24, BHV will continue our partnership with the Illinois State Physical Activity and Nutrition (SPAN) program, led by the Illinois Public Health Institute (IPHI), with the shared goal of improving breastfeeding outcomes for home visiting families. In FFY2024, BHV will continue to plan professional development opportunities for home visitors, building on the successes of past trainings and responding to feedback from the field. The support of the Title V program will enable BHV to continue to offer advanced supports to home visitors, to improve breastfeeding outcomes among families served.
3-F. Partner with the Illinois Department of Corrections (DOC) and two state women’s correctional centers to support ongoing health promotion activities for incarcerated women and staff training, and to ensure women and babies receive Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services while residing in DOC facilities.
This is the same as strategy 1-B. Information about this activity is available in the narrative for the Women’s/ Maternal Health Domain.
3-G. Support and collaborate with the Illinois Task Force on Infant and Maternal Mortality Among African Americans to assess the impact of overt and covert racism on pregnancy-related outcomes, identify best practices and effective interventions, address social determinants of health, and develop an annual report with recommendations to improve outcomes for African American women and infants.
This is the same as strategy 2-D. Information about this activity is available in the narrative for the Women’s/Maternal Health Domain.
3-H. Provide support to pregnant women at risk for poor birth outcomes through an array of case management and home visiting programs by the Illinois Department of Human Services (DHS) Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program; and ensure DHS programs align with Title V priorities.
MIECHV
Title V will continue to support MIECHV in its effort to serve pregnant women at risk for poor birth outcomes through an array of case management and home visiting. Title V will also work with DHS to ensure alignment of priorities across both agencies. BHV has aligned the requirements for the state-funded home visiting programs to include the MIECHV benchmarks. In FFY2024, BHV anticipates increases in state and federal home visiting funding to expand services. The continued partnership with the Title V Program to identify locations and opportunities for program expansion will aid in further alignment of priorities. In this way, BHV can target expansion funding to communities with the greatest risk factors, based on Title V data.
IL-ECCS
Title V will continue to support DHS as it executes its Early Childhood Comprehensive Services (ECCS) grant from the Health Resources and Services Administration (HRSA). IL-ECCS focuses on enhancing the P-3 statewide maternal and early childhood system of care by establishing a Universal Newborn Supports System (UNSS) that better connects moms and babies to programs and services; working across state agencies to establish a clearly aligned and sustainable infrastructure to support a stronger and more efficient and effective P-3 system; and aligning policy, data, and financing mechanisms to support and sustain a coordinated and comprehensive P-3 system. Title V will continue to participate on the IL-ECCS Cross Sector Advisory Committee/Care Coordination Committee to provide advice on the project and recommend strategic directions, policy, and financing changes. Public Act 102-0665 (effective 10/08/2021) requires that HFS will allow for postpartum care provided by a wide range of providers including doulas. Title V will continue to inform HFS on the implementation of this new provider type reimbursement model for doula and home visitor programs.
3-I. Support the Chicago Department of Public Health (CDPH) in implementation of Family Connects Chicago to ensure nurse home visits for all babies and parents immediately following birth and linkage to a network of community supports to assist with longer term, family identified needs.
CDPH will continue to implement its Family Connects pilot at specific Chicago hospitals during FY24. The program establishes a system of coordinated perinatal referral that uses universal nurse home visiting to identify the needs of families with newborns and connect them to appropriate supports and services. Family Connects will not only engage with the birthing person and their partner, but also, consider services for the entire family, including the mother’s other children. These additional services may include, but are not limited to, providing families tools, resources, and support on health care, infant care, safe homes, and parent support. CDPH intends to engage all 15 maternity hospitals participating in Family Connects, the Community Alignment Boards, and the Family Connects Citywide Advisory Board to review data, discuss implementation, and evaluate the model. In addition, CDPH will work toward providing at least 60% of Chicago residents who give birth at Chicago birthing hospitals. Through FCC, CDPH will aim to support at least 75% of birthing people and their families who participate in FCC to successfully access at least one needed service or resource via referral. Finally, CDPH will work toward implementing high quality services that achieve a satisfaction rate of at least 96% of participating birthing persons and their families.
In FY 24, Title V will support CDPH to continue its collaboration with an array of MCH stakeholders. As part of ongoing citywide scaling efforts, CDPH anticipates that by the close of FY24, all birthing hospitals in Chicago will be offering FCC services to Chicago families welcoming newborns that are designed to support heathy infants and families.
The FCC model will continue to rely heavily on community alignment to function optimally in FY24. Ongoing community alignment functions include enhancing access to services for needs identified during home visits, improving family connections with providers, identifying system-level issues, and elevating policy issues. Chicago has adapted the model to address the city’s scale and diversity of communities by organizing the city into 6 regions, each of which have a unique community alignment board. These boards consist of health and social service providers, early childhood providers, individual community members, advocates, and other maternal child health stakeholders.
Additional Programs
3-J. Promote infant safe sleep education through community-based educational activities and campaigns.
Sudden Unexpected Infant Deaths (SUID) are defined as deaths that occur suddenly and unexpectedly in infants less than 1 year of age, and whose cause of death are not immediately obvious. The cause of SUID may be due to suffocation, asphyxia, entrapment, infection, ingestions, metabolic diseases, cardiac arrhythmias, trauma (accidental or non-accidental), or sudden infant death syndrome (SIDS). SUID is the third leading cause of infant mortality in Illinois and the overall SUID rate in Illinois has remained steady since 2000. During 2020, 111 babies died from SUID before their first birthday. Infants born to non-Hispanic Black women are six times as likely to die from SUID as infants born to non-Hispanic White women; SUID is one of the largest contributors to the inequity in overall infant mortality between Black and White infants in Illinois. Furthermore, not only is SUID more common among Infants born to non-Hispanic Black women, but it is more common among residents of the city of Chicago and urban counties outside the Chicago metro area, infants born to women younger than 25 years of age, and infants born to women who have had at least one other child.
In FY24, Title V will review the FY 23 launched program entitled Baby-ZZZ Safe Sleep Program which partnered with maternal and child health community stakeholders to expand community-based promotion of safe sleep practices and employ a risk reduction approach to improve sleep environments for all Illinois infants. Specific program objectives included: leveraging the state’s campaign to promote consistent and inclusive safe sleep messaging; increasing awareness of infant safe sleep practices and providing risk reduction education and training for parents, caregivers, and early childhood professionals, such as home visitors, family case managers, and other health care providers; conducting trainings/education that include, but are not limited to, maternal stress, breastfeeding promotion, smoking cessation, and sleep environments; identifying social determinants of health and other barriers to safe sleep practices amongst families in the community and adopting culturally relevant resources/approaches to address these barriers (e.g., cribs, pack-n-plays); employing risk reduction approaches that acknowledge families’ existing practices and provide additional opportunities to improve sleep environment and other safe sleep practices; and understanding and identifying stressors that may contribute to unsafe sleep practices; and developing and implementing strategies to foster social and family supports and improve maternal mental health.
Title V will also continue to work with the Illinois interagency team on Safe Sleep. DHS, CDPH, DCFS, and IDPH began collaborating in FY23 on a statewide safe sleep campaign. The campaign will include safe sleep awareness communication and messaging activities that are culturally accessible and focused on safe sleep practices, breastfeeding, and injury prevention. In addition, the campaign will have a component that focuses on resources, such as free cribs and safe sleep prevention kits.
3-K. Partner with the University of Illinois at Chicago, School of Public Health, Division of Health Policy and Administration (UIC-HPA) to explore the influence of healthcare provider access and the casual effects of events or policies on this access.
This is the same as strategy 2-L. Information about this activity is available in the narrative for the Women’s/Maternal Health Domain.
3-L. Partner with the University of Illinois at Chicago (UIC) through the Center for Research on Women and Gender (UIC-CRWG) enhance all emergency departments (EDs) understanding and ability to recognize and provide care for pregnant and postpartum birthing person.
This is the same as strategy 2-M. Information about this activity is available in the narrative for the Women’s/Maternal Health Domain.
Emerging Issues
Sudden Unexpected Infant Deaths
Sudden Unexpected Infant Deaths (SUID) are defined as deaths that occur suddenly and unexpectedly in infants less than 1 year of age, and whose cause of death are not immediately obvious. The cause of SUID may be due to suffocation, asphyxia, entrapment, infection, ingestions, metabolic diseases, cardiac arrhythmias, trauma (accidental or non-accidental), or sudden infant death syndrome (SIDS). SUID is the third leading cause of infant mortality in Illinois and the overall SUID rate in Illinois has remained steady since 2000. During 2020, 111 babies died from SUID before their first birthday. Infants born to non-Hispanic Black women are six times as likely to die from SUID as infants born to non-Hispanic White women; SUID is one of the largest contributors to the inequity in overall infant mortality between Black and White infants in Illinois. Furthermore, not only is SUID more common among Infants born to non-Hispanic Black women, but it is more common among residents of the city of Chicago and urban counties outside the Chicago metro area, infants born to women younger than 25 years of age, and infants born to women who have had at least one other child.
In FY24, Title V will continue to support the newly launched (FY23) program entitled Baby-ZZZ Safe Sleep Program by partnering with maternal and child health community stakeholders to expand community-based promotion of safe sleep practices and employ a risk reduction approach to improve sleep environments for all Illinois infants. During FY24, four grantees will continue to be supported in SUID reduction efforts. Specific program objectives include: leveraging the state’s campaign to promote consistent and inclusive safe sleep messaging; increasing awareness of infant safe sleep practices and providing risk reduction education and training for parents, caregivers, and early childhood professionals, such as home visitors, family case managers, and other health care providers; conducting trainings/education that include, but are not limited to, maternal stress, breastfeeding promotion, smoking cessation, and sleep environments; identifying social determinants of health and other barriers to safe sleep practices amongst families in the community and adopting culturally relevant resources/approaches to address these barriers (e.g., cribs, pack-n-plays); employing risk reduction approaches that acknowledge families’ existing practices and provide additional opportunities to improve sleep environment and other safe sleep practices; and understanding and identifying stressors that may contribute to unsafe sleep practices; and developing and implementing strategies to foster social and family supports and improve maternal mental health.
Title V will also continue to work with the Illinois interagency team on Safe Sleep. DHS, CDPH, DCFS, and IDPH are collaborating to create a statewide safe sleep campaign. The campaign will include safe sleep awareness communication and messaging activities that are culturally accessible and focused on safe sleep practices, breastfeeding, and injury prevention. In addition, the campaign will have a component that focuses on resources, such as free cribs and safe sleep prevention kits.
Ensuring population-based metabolic and hearing screening for Illinois newborns
In FY24, the IDPH Newborn Screening Section will continue its various activities through EDHI. Such activities include:
- Continuing with the business agreement collaboration with Illinois Hands and Voices, Guide by Your Side.
- Launching a rebuild of the illinoissoundbeginning.org website with expanded parent materials and full translation into Spanish
- Continuing to utilize the Continuous Quality Improvement (CQI) methodology to improve screening, diagnosis, intervention, and parent support.
- Finalizing the Administrative Rules for the Newborn Screening Program.
- Working with the National Center for Hearing Assessment and Management to develop an out of hospital birth version of the Newborn Hearing Screening Training Curriculum.
Outreach and disseminating information
IDPH will explore partnering with the Governor’s Office of Early Childhood Development (GOECD) to use the communication mechanisms within the Illinois early childhood education and care system to facilitate public awareness.
- Illinois Cares for Kids is an information hub where Illinois parents, grandparents, caretakers, teachers, and childcare providers can access information related to early childhood in Illinois. Information is provided by age, allowing for a focus on infants and toddlers.
- Ready4K, is a free research-based text messaging program for parents in Illinois. Ready4K helps support parents, increases children’s learning, and provides a method for the state to share customized early childhood messaging consistently with families.
- The GOECD newsletter is distributed monthly to over 7000 early educators, caregivers, family members, researchers and other stakeholders and routinely includes health information.
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