Tuesday, December 19, 2017

2017 Year-End Summary

Buncombe County’s Infant Mortality work has been mainly led by two cross-sector groups this year: the Community Centered Health Home Grant, based at MAHEC, and the Home Visitors Collaborative, led by the YWCA. 

The Community Centered Health Home Initiative started from a relationship with Children First/CIS’s advocacy initiative, The Success Equation, to address policy issues related to the social determinants of health and received funding from Blue Cross Blue Shield of NC.  It is based on a successful and paradigm-shifting model from the Prevention Institute that prioritizes engaging residents of a particular community in long-term leadership and relationship as they identify strategies and work together toward improving the health of their neighbors, making clinical changes based on resident feedback, and addressing policies that are preventing people from reaching their full health potential. The key to this initiative’s success has been using shared decision making which included many key partners in a Steering Committee: MAHEC, Pisgah Legal Services, ABIPA, resident leaders from Pisgah View and Hillcrest Apartments, Children First/CIS, the YWCA, Homegrown Babies, North Carolina Center for Health and Wellness,  Buncombe County Health and Human Services, Buncombe County Government, CHIP, Nurse Family Partnership, WNCCHS, Community Care of WNC, Vaya Health,  The Buncombe County Initiative originally engaged with women in Pisgah View Apartments, but it is now growing to be more of a county-wide “movement.” CCHH has had some major achievements over the past year:

  • Six resident leaders of Pisgah View Apartments and Hillcrest completed training to become birth doulas and are working on their DONA certification through a training with local organization, Homegrown Babies, to work with lower-resourced African-American women who would otherwise not have access to this kind of birthing support, now operating under the name Sistas Caring 4 Sistas
  • A group of women meet in Pisgah View Apartments once a month, Mother to Mother,  to share ideas, create relationships and determine the best steps to creating the community capacity the community wants to see
  • Five of the resident leaders completed training to be a Breastfeeding Peer Counselor
  • Two of the resident leaders completed the Tobacco Cessation Specialist training
  • One of the resident leaders completed the Community Leadership Essentials training through the Center for Creative Leadership
  • Doulas entered into a contract with the YWCA Motherlove program to provide doula services to teen mothers 
  • One of the resident leaders, Nikita Smart, joined the CCHH Board
  • Nikita Smart wrote and was awarded a Tipping Point grant from Buncombe County to further the ability of the doulas to serve more clients
  • MAHEC joins with Pisgah Legal Services to have on-site legal advice and support for patients dealing with housing uncertainty, eviction, and other economic conditions that directly impact health.
  • MAHEC providers and staff begin to be trained in the Racial Equity Institute's two-day anti-racism training, to address implicit bias and structural racism within the healthcare setting 
  • MAHEC will be entering into a redesign of the physical structure of the clinic to be more open and inviting
  • Four resident leaders were trained to provide Lamaze Childbirth  Education classes
  • Four Doulas became MAHEC PRN staff members to provide more reliable way to compensate them for services.
  • Doulas have had/currently 19 African-American clients and 13 high-risk women of other demographics for a total of 32 clients.
  • MAHEC received a two-year implementation grant from BCBS, continuing the work CCHH started in 2015, that was a grant co-written by all of the partners engaged in the initiative over a 6 month period that prioritizes building community capacity, making clinical shifts, making environmental and policy changes, and creating a strategic communications plan to further this model. 

The Home Visitors Collaborative includes participants from Nurse Family Partnership, CCWNC, Asheville Buncombe Institute for Parity Achievement (ABIPA), Project NAF (Nurturing Asheville and Area Families), Motherlove, and Verner's Early Head Start, Buncombe County Prevention Services. This group just formed at the start of 2017, so the first several meetings were devoted to participants learning about the various programs and establishing both the logistics and the shared vision for future meetings. The group has also researched and shared information on successful models in other communities (the Home Visitors Collaborative in Kalamazoo was the basis for this collaborative). They have broken their work into three areas with initiatives active in each:
  • Customer Service: 
    • Exploring ways to collect information from mothers who have recently given birth about their prenatal and birth experience, social support, etc.
    • Creating an inter-agency brochure/rack card with all the program's eligibility and referral information to educate providers and community about options.
  • Awareness and Training:
    • Supporting ABIPA in disseminating their recently-created preconception health presentation (targeted at teens)
    • Identifying common trainings for all agencies with home visitors (including Racial Equity Institute)
    • Sharing more ACEs/Resilience information with clients and community
  • Data: 
    • Currently creating a "wish list" of data they would like to be able to get from other sources to inform their services and also their reach/impact (possible sources: MAHEC/Mission/Medicaid...)
    • Identifying measures the home visiting programs currently collect that could be shared/aggregated to better measure their reach and impact

Friday, November 11, 2016

October 19th Workgroup Meeting Agenda Notes & Update

Thank you for the great energy and work at our October 19th Meeting! We are grateful for the time you took out of your day to join us for this meeting, and we are honored to work with all of you!

Update since the October 19th meeting:
Amanda Read, YWCA MotherLove Program and LaVie Montgomery, Project NAF, will be visiting Kalamazoo, Michigan for Kalamazoo Infant Mortality Community Action Initiative's 3rd Annual Strategic Intent Meeting where they will learn more about how Kalamazoo is combating infant mortality in their city. Dr. Arthur James will be the keynote speaker at the event, and they also plan to attend a luncheon with Dr. James as well.  Amanda and LaVie would like to know if you have any questions or input that you would like addressed on their visit to Kalamazoo. Please send your thoughts to Amanda at amanda.read@ywcaofasheville.org by 11/15.

Next Steps

The strategies/actions that arose from our meeting were:

Action Item
Root Causes of Death data
  • Expand Child Fatality Prev. Task Force to include MAHEC Ob/Gyn physician to go deeper into mother’s health record and social determinants of health as possible contributors to infants’ deaths

Dr. Jennifer Mullendore and Dr. Cindy Brown will work with the Child Fatality Prevention Team to expand representation and gather this data. 
Home Visiting Programs
  •   Convene all programs that currently do home visitation (NFP, Project NAF, Motherlove, CCWNC, Verner, etc.) to identify where the gaps are, etc. (There was discussion about this growing into a longer-term home visitation collaborative, if useful).
  • Pilot post-partum (health care) home visitation

CHIP staff will work with Ami Greene and Dr. Beth Buys to explore next steps
  • Advocacy implementation plan around NC Perinatal Health Strategic Plan

Dr. Arthur Ollendorff and Greg Borom will meet to finalize plan. If you are interested in participating in this effort, please contact Maggie Adams, Community Centered Health Home Project Coordinator at maggie.adams@mahec.net

Below are links to the meeting materials as well as the scorecard below:
  • A link to the scorecard can be found here.

Diving Into Health Disparities and Health Equity

It has been a few months since we last met.  Since that time, CHIP Partners have had many opportunities to learn about the issues that frame our CHIP priorities -specifically around health disparities & health equity.  For a summary of two of these events, please click here. In addition to these events, we've also completed the first iteration of our Infant Mortality scorecard, as well as conducted research into data and strategies.

It's now time to reconvene and determine which strategies we collectively want to work on. Our next meeting is scheduled on:

October 19th; 3-5pm
Cherokee Room, MAHEC Education Building
121 Hendersonville Road, Asheville


New information/data on the curve(s) we are focused on turning
  • Root causes of death- update from BC Child Fatality Prevention Team
  • Other data we need?
New information or insight on the story behind those curves
  • Reflection on our time with Dr. Arthur James
  • Update on movement/activity since then
Partners with a role to play (Partner Updates)
  • Community Centered Health Home
  • Buncombe County Health & Human Services
  • Other updates?
New information on what works to do better in our community
  • NC Perinatal Health Strategic Plan
  • NICHQ recommendations

Between now and our meeting, I also ask that you visit the scorecard and provide feedback on what is missing or needs to be changed. The following link is to the main Buncombe County CHIP Scorecard that includes all of our priority work.  A brief video tutorial is provided to help you learn how to navigate the scorecard.  Scroll down the page to find our Infant Mortality Result where all our work to-date has been captured.  

Tuesday, August 30, 2016

Exciting Events Informing CHIP Work

August was a busy month filled with many opportunities for CHIP partners and the community to learn about the issues that frame our CHIP priorities –specifically around health disparities & health equity.  For a summary of two of these events, please read below.

An Evening with Dr. Arthur James
On August 18th, over 60 community shareholders, leaders, and health providers spent an evening with Dr. Arthur James, a pediatrician and obstetrician, who has had positive success in reducing disparities in infant mortality in Ohio and Michigan through community-wide efforts. Dr. James' presentation highlighted for our community that WE CAN make a difference. 

This event was sponsored by the Community Centered Health Home (CCHH) team in order to bring awareness to this issue.  This event launches the CCHH team's advocacy efforts that will work to eliminate disparities in pregnancy and birth outcomes in Buncombe County. If you would like to learn more about the efforts of the CCHH, please contact Maggie Adams at maggie.adams@mahec.net. Please click here for Dr. James’ presentation.

The 2016 Diversity Summit: Transforming Healthcare Equality into Equity

On August 19th, MAHEC and Mission Health hosted The 2016 Diversity Summit: Transforming Healthcare Equality into Equity. Over 130 participants were challenged to make equity a priority in their lives, communities, and organizations. The keynote address by Dr. Arthur James from Ohio State University inspired all in attendance. The afternoon gave us an opportunity to work in small groups on how to achieve equity. New relationships and partnerships were formed and current relationships were deepened. MAHEC's Regional Education is very proud to have been able to bring a diverse group of presenters together to affect lasting change in our community.  Please click here for Dr. James’ presentation.