Perinatal/Infant Health Plan for Application Year

Results of the Five-Year Needs Assessment demonstrated the need to continue promoting safe sleep as well as breastfeeding; therefore, Title V MCH included NPM 5 as a performance measure. In addition to collaborating with existing partners to promote breastfeeding and safe sleep, Title V MCH will establish new partners to increase the percent of infants placed to sleep on their backs (NPM 5A), on a separate approved sleep surface (NPM 5B) and placed to sleep without soft objects or loose bedding (NPM 5C) will be a priority in future funded efforts.

Title V MCH will continue to partner with NOMHE on efforts including COVID-19 data related to disparity and equity and distribution of a NOHME produced equity toolkit related to COVID-19 impacts. A COVID-19 Nevada MCH population data report will be presented to the MCHAB in partnership with the Office of Analytics, and MCAH will continue to participate in the CDC Pregnancy Surveillance Module in partnership with the lead entity, the Office of Public Health Informatics and Epidemiology.

MCAH will be involved in the Newborn Screening Advisory Board. The EHDI and Title V MCH Programs work closely together and are co-located in the MCAH Section. Both programs will explore possible funded efforts in relation to CCHD and EHDI data collection and capacity development, in concert with SSDI and the Office of Vital Records.

ASTHO OMNI and PRISM efforts to equitably address substance use and addiction and mental health for women, children, and families within the context of the COVID-19 pandemic will be rolled into the Perinatal health Initiative. State interest in formalizing a statewide perinatal quality collaborative will continue to be explored by Title V MCH Program. PRAMS Data to Action reports will include perinatal outcome areas of interest. CS efforts will continue, as will MCAH participation in pregnancy and COVID and MIS-C efforts led by OPHIE, NBS Advisory Board, MSRGN, and Medicaid policy levers to improve birth outcomes. Perinatal concerns will be addressed in relation to PHP and pediatric planning.

Breastfeeding

The Title V MCH Program will reach out to childcare providers in Nevada to continue to promote breastfeeding in Nevada through the Breastfeeding Welcome Here campaign. Efforts to encourage Nevada businesses to sign the Breastfeeding Welcomed Here pledge will continue. Title V MCH Program will manage and promote the Nevada Breastfeeds website statewide and enhance the Breastfeeding Welcome Here Campaign by engaging businesses and childcare providers. The Nevada Breastfeeds website will be maintained, and content updated and refreshed to ensure relevant and timely information is provided for breastfeeding families and interested collaborators, including information for CYSHCN. NHV will continue breastfeeding efforts resulting in their above average uptake of breastfeeding as compared to the Nevada population. Collaboration with WIC on the SPINE project will continue.

Title V MCH Program will attend Breastfeeding Coalition meetings and support DHHS postings related to National Breastfeeding Awareness Week. The Breastfeeding banner will again be hung across Carson Street in Carson City, Nevada promoting August as National Breastfeeding Awareness Month. Shared promotion of Black Breastfeeding Week and Black Maternal Health Week were done with community partners.

Nevada Pregnancy Assessment Monitoring System (PRAMS)

Data collected by PRAMS will be used to monitor the progress of national and state pregnancy and birth-related health measures. PRAMS efforts will also identify and monitor self-reported maternal behaviors and experiences occurring before, during, and shortly after pregnancy among women who deliver live-born infants. Nevada PRAMS purchased promotional items such as hot/cold packs, reusable water bottles, pens, tote bags, posters and flyers which will be provided to OBGYN, pediatricians, vital records, and WIC Clinics across Nevada. PRAMS staff will continue to attend Title V MCH Unit and Block Grant meetings, and the programs will continue closely linked efforts. Title V MCH Program serve on the PRAMS Steering Committee.

All Title V MCH subrecipients will continue to have language in their contracts to educate expectant parents about PRAMS. Promotional materials will be disseminated to suitable agencies educating about PRAMS.

Fetal Infant Mortality Review (FIMR)

The Title V MCH Program will continue funding and serving on the Case Review Team (CRT) of the FIMR Program to reduce fetal and infant mortality in Washoe County. FIMR will identify contributing factors of fetal, neonatal, and postnatal deaths including identification of disparately impacted populations and recommendations to improve outcomes and promote equity. FIMR will facilitate ten CRT meetings where at least forty cases will be reviewed annually each FFY. Community Action Team (CAT) updates will be provided at the Northern Nevada MCH Coalition meetings. The CAT will consider implementing objectives and evaluation components for interventions of policy, systems or community changes needed to reduce fetal, neonatal, and postnatal deaths based on case findings, CRT recommendations, and community input.

The CRT will also be actively involved in the implementation of activities such as birth spacing initiatives and promotion of the Go Before you Show Campaign and the Count the Kicks campaign in Nevada. The CRT will continue to evaluate mortality reduction strategies, maternal substance use challenges, prevention of premature births, disparities, maternal obesity, identification of cases directly or indirectly linked to COVID-19, and other emerging issues.

FIMR will continue to participate in statewide MCH Coalition meetings and events, CDR meetings, Western Regional FIMR, and additional community program activities.

Cribs for Kids/Safe Sleep

The Title V MCH Program funded Cribs for Kids (C4K) Program will continue activities throughout the state. Train the trainer sessions will continue to be offered statewide with a focus on providing survival kits to rural areas and Tribal Nations across the state. Additional trainings will be provided as requested by partners. Technical assistance will be provided as needed, along with ongoing support to ensure agencies are collecting and entering mandatory data on three and twelve-month follow-up surveys.

Safe Sleep Survival Kits will continue to be distributed through partner agencies statewide.

The Title V MCH Program will continue Safe Sleep and Injury Prevention education with Tribal Nations via Indian Health Service clinics and continue support for Safe Sleep Survival Kits and car seats in injury prevention efforts. Clinics participate in Infant Safe Sleep, car seat installation, and additional resources will include drowning prevention, tobacco cessation, substance use in pregnancy, car safety, and other Title V MCH Program resources. All class participants are provided materials to enhance healthy outcomes including safe sleep brochures, Nevada Tobacco Quitline, sobermomshealthybabies.org, PRAMS, Text4Baby, Nevada 211, and the MHP.

The Safe Sleep Media Campaign will continue radio and television public service announcements statewide to promote Safe Sleep for infants. The Title V MCH Director will continue to be an appointee of the Statewide Executive Committee to Review Child Fatalities and will work closely with community partners, the three LHAs, and DCFS to leverage efforts to end preventable infant and child mortality statewide, including SUID.

Perinatal/Infant Health and Wellness

The Title V MCH Program will continue to fund CCHHS and DPBH CHS to promote perinatal and infant health in Carson City and rural counties. Clinic staff will educate parents of infants on the value of securing a medical home, being adequately insured, immunizations, safe sleep, breastfeeding and nutrition, well-child checkups, and reproductive health. CCHHS and CHS will promote Medicaid coverage for long-acting reversible contraceptives immediately postpartum, as well as monitor for symptoms of PMAD. Clinic personnel will distribute various health-related materials provided by the Title V MCH Program. CCHHS will conduct a series of perinatal and infant health courses using evidence-based course curriculum to enhance access to local and state resources. CCHHS will use digital clinic signage and Facebook social media posts to promote Sober Moms, Healthy Babies, PRAMS, Nevada 211, Medical Home Portal, infant immunizations, and Text4Baby.

Nevada 211

Nevada 211 will continue using Title V MCH funding to provide information on health and human service programs throughout the state, including physical, socio-emotional, behavioral, and mental health resources, and support for families of children with and without special health care needs. Enhanced efforts will focus on perinatal and infant health through DPBH provided trainings to call specialist staff. Nevada 211 will provide quarterly data exports to the University of Utah, Department of Pediatrics for the MHP. All Title V MCH subrecipients will have language in their contracts to include promoting Nevada 211 services.