The NJ Title V Program (TVP) is uniquely positioned through its leadership and robust partnerships with families, healthcare organizations and other local, state, and federal entities, to address healthcare needs of all mothers, children, and adolescents in the state. The NJ TVP has continued to grow and strengthen with the advent of new and innovative programs, and with the enhancement of the programs already in place.  The TVP facilitates collaboration and partnership with state agencies and organizations including the SPAN Parent Advocacy Network, the NJ Chapter of the American Academy of Pediatrics, the NJ Hospital Association, the state’s Maternal and Child Health Consortia and other local non-profit and community-based organizations.  NJ TVP is committed to advancing creative and evidence-based solutions to the complex health issues facing mothers, infants, and children across the state, with a particular focus on children with special health care needs. NJ’s commitment to the state’s maternal and child health populations is unwavering and continues to fortify as evidenced by its expanded, strategic programming and partnerships.

While NJ has invested resources to address the maternal and child health crises that exist in the state, the proposed plans will take time to produce results. New Jersey continues to experience high rates of maternal mortality and morbidity events and deaths, disproportionately impacting women, and children of color.  The continued efforts promote the health and well-being of families across the state, with an acute focus on the populations on the margins and at highest risk of experiencing preventable morbidity and mortality events and deaths. With continuous fiscal and political state support, New Jersey is in a strong position to improve on MCH work being done and engage in innovative endeavors that complement and enhance the services being provided.

One of the initiatives that has grown in reach over the period of the past calendar year is the Healthy Women, Healthy Families (HWHF) Initiative.  This initiative works toward improving maternal and infant health outcomes for women of childbearing age and their families while reducing racial, ethnic, and economic disparities in those outcomes through a collaborative, coordinated, community-driven approach. This coordinated approach uses CHWs (to complete clinical and social needs assessments) and Connecting NJ Hubs, or county-specific “points of entry,” for clinical assessments. Referrals and tracking occur through a central data management platform.  To improve upon this innovative endeavor, HWHF re-launched in 2023 with a renewed focus on CHW and postpartum doula support, with doula care expanding to serve postpartum birthing people for the first 12 months after delivery, including breastfeeding education and support for nontraditional groups such as partners, grandparents and siblings. Concomitantly, the community doula training program continues to grow, starting as a regional training collaborative and growing into a statewide network of training, doula mentorship, and service provision for Medicaid families and families seeking community doula support.

The NJ TVP has served as a convener and collaborator to traditional health partners and non-traditional, community-based partners such as faith-based organizations. To address social determinants of health, the NJ TVP has taken a more expansive approach to identify and treat the issues most impacting the families in the state of New Jersey, with an acute focus on the populations that experience the worst health outcomes. These profound partnerships are essential in improving pregnancy outcomes, especially among marginal populations, addressing health disparities and structural racism, and reducing Black infant mortality. Utilizing innovative and evidence-based approaches to address cross-cutting issues that impact the health status of the most vulnerable populations is a critical piece of the developed and growing HWHF.

Additionally, NJ TVP partners with the NJ Maternal Health Innovation (MHI) Team at NJDOH and has implemented the Preterm Birth Prevention Program in NJ Communities. TVP engages with healthcare leaders at diverse organizations, for example, NJ sections of the American College of Obstetricians, the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), and the American College of Nurse-Midwives (ACNM); the NJ Perinatal Quality Collaborative (NJPQC); the NJ Health Care Quality Institute (NJHCQI); Federally Qualified Health Centers; hospital associations; regional New Jersey maternal child health consortia; foundations; and birthing hospital facility Chief Executive Officers, maternal health, and quality improvement experts.

Moreover, in response to the substance use crisis in NJ, TVP applied for and received in-depth technical assistance (IDTA) support from the National Center on Substance Abuse and Child Welfare (NCSACW) to develop a State Action Plan. In September 2022, NJ was selected by the NCSACW to participate in the 2023 Policy Academy: Advancing Collaborative Practice and Policy & Promoting Healthy Development and Family Recovery for Infants, Children, Parents, and Caregivers Affected by Prenatal Substance Exposure. The Policy Academy is supported by the Children’s Bureau (CB), Administration on Children, Youth and Families (ACYF), SAMHSA, and HRSA.

This project, led by NJ TVP staff, includes a State Action Plan, developed collaboratively, to increase awareness of and capacity to address SUD during and after pregnancy for birthing individuals in NJ. The State Action Plan includes four overarching goals, all related to enhancing support for birthing people with SUD. The project aims to augment the screening, referral, and follow-up services pathways in the state substance use treatment systems of care. Ultimately, the goal of the IDTA group is to understand where resource gaps exist, creating a formal Plan of Safe Care to be distributed throughout the state and the crafting of a protocol for birthing hospitals and other providers to strategically support birthing people with SUD during and after a birth.

Colleagues in various state departments are working with the NCSACW to understand how pregnant women with SUDs are supported by various health providers and systems as they coordinate care throughout the state. The goal is in creating clinical systems of care that connect pregnant and parenting people with SUD to appropriate levels of care throughout the state. In partnership with cross-system partners, the team led by TVP staff is composed of representatives from the Governor’s Office (GOV), the Office of the First Lady, DCF, DHS, and the Department of Health (DOH).