Project Name: Infant Mortality Prevention and Reduction Initiative

Project Overview: Erie County, one of 88 counties in the state of Ohio, has the highest infant mortality rate in the state for African American babies, and in 2013, the state ranked 46th overall in infant deaths. The racial disparities are staggering, with Black babies experiencing 35.4 infant deaths per 1,000 live births as compared with 1.5 deaths per 1,000 for white babies, with the result that the state was tied for 50th place – the worst in the nation – in Black infant deaths. These significant disparities reflect social determinants of health that disproportionately affect the area’s African-American community, including high poverty rates, extensive un-insurance or underinsurance, poor educational opportunities and outcomes, and substandard housing.

The goal of the Infant Mortality Prevention and Reduction Initiative was to prevent and reduce infant mortality overall, with an emphasis on reducing infant deaths in the African-American community, and improve outcomes for vulnerable and underserved children and their mothers.

Project objectives were to:

• Increase access to care for pregnant women and infants;
• Enhance and expand pediatric services;
• Attain recognition as a patient-centered medical home;
• Increase collaboration among local health care providers and other health care professionals; and
• Strengthen the county’s capacity to collect, monitor and track utilization and outcomes data necessary for systems improvements.

• 2015-2016 Key Grant Activities
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  • Developed the infant mortality supplemental questionnaire to the 2015/2016 Erie County Community Health Assessment;
  • Analyzed data collected from the questionnaire to create, in collaboration with the Hospital Council of Northwest Ohio, a comprehensive six-county cross sectional “2016 Health Assessment: Women of Childbearing Age” which provides new data on coverage, access, and utilization of reproductive health care services for women of childbearing ages in the six-county Northwest Ohio region. The assessment was distributed to key stakeholders, including other community-based providers, the state health department and the primary care association;
  • Conducted outreach to and convened planning and strategy meetings with local stakeholders and other collaborating organizations; and
  • Planned and convened, on April 1, 2016, a summit on the theme of “Improving Futures for Healthy Babies”, keynoted by Senator Sherrod Brown (D-Ohio) and with a diverse group of more than 225 stakeholders in attendance.
• 2015-2016 Key Project Outcomes
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  • Established an ongoing leadership group of community health centers, hospitals, and public health and community partners from the six Northwest Ohio counties to develop a collaborative approach to reducing infant mortality in the region.
  • Identified and prioritized service needs for pre-conception, prenatal, post natal and infant care.
  • Tested new care delivery strategies including community health worker services.
• 2016-2017 Key Grant Activities
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  • Engaged a Community Health Worker to connect at-risk mothers and babies to health care information, services, and resources;
  • Provided pre-conception and prenatal services to reduce the incidence of prematurity and improve birth outcomes;
  • Enhanced the pediatric care team to expand capacity;
  • Expanded mobile outreach services;
  • Participated in statewide quality initiatives to improve birth outcomes and reduce prematurity and infant mortality, including the Ohio Perinatal Quality Collaborative focused on improving access to progesterone to prevent premature birth and the Mom’s Quit for Two prenatal smoking cessation project. With the Ohio Department of Health and Ohio Association of Community Health Centers, engaged in an effort to promote access to and utilization of Long Acting Reversible Contraceptives (LARC);
  • Established a school-based health center and weekly onsite dental services with area schools;
  • Adopted population health management software to improve data collection, reporting, and analysis; and
  • Enhanced communications and messaging and implemented automated patient reminder and recall systems to deliver important health and wellness information and improve visit show-rates.

• 2016-2017 Key Project Outcomes

  • ECCHC received Level 2 Patient-Centered Medical Home (PCMH) recognition from the National Committee for Quality Assurance (NCQA) in July 2017. The center was recognized by the Ohio Association of Community Health Centers (OACHC) as a top performer among Ohio’s CHCs for the measures of prenatal entry into care in the first trimester and live birth weights <2500 gms, in June 2017.
  • The center increased the number of well-child visits by 6% from 542 (2016 annualized) to 576 (2017 annualized) and gained 173 new pediatric patients from January through September 2017.
  • The CHW provided 122 home visits, 88 health center visits, 15 off-site visits and 29 agency/outreach visits. Women were offered individualized education and referred for resources such as Cribs for Kids, Baby Boxes and Safe Sleep strategies to at-risk mothers.
  • The center is scheduled to open the area’s first inpatient detox facility by the end of 2017, implementing a center-developed, evidence-based protocol to effectively treat substance-addicted prenatal patients.

Additional Project Partners: Firelands Regional Medical Center, Ohio Association of Community Health Centers, Erie County Job and Family Services, Ohio Department of Health, Child Fatality Review Board, Ohio Commission on Minority Health, Hospital Council of Northwest Ohio/Pathways Project, and Erie County Board of Health.

About the Grantee:

The Erie County Community Health Center (ECCHC) was established in 2011 by the Erie County Health Department (ECHD). ECCHC is a federally qualified health center that provides primary care, prenatal care, women’s health care, sexually transmitted infection clinic, pediatrics, school and work physicals, senior health care, men’s health care, and dental services to Erie County residents. ECCHC provided care to 4,000 individuals in 2014.

Website at www.eriecohealthohio.org