Search Results: MCHLine

Annotation: This brief offers lessons from six states on how federal Medicaid cuts result in reductions in access to oral health care for people with low incomes. Examples are provided about how cuts have restricted access to care, shifted costs from one part of the health care system to others (e.g, hospital emergency departments), and led oral health professionals to leave the Medicaid network. Information is presented on how cuts have affected California, Maryland, Massachusetts, Missouri, Oregon, and Pennsylvania.

Contact: Community Catalyst, 30 Winter Street, 10th Floor, Boston, MA 02108, Telephone: (617) 338-6035 Fax: (617) 451-5838 E-mail: [email protected] Web Site: https://www.communitycatalyst.org Available from the website.

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Keywords: Access to health care, California, Costs, Low income groups, Maryland, Massachusetts, Medicaid, Missouri, Oral health, Oregon, Pennsylvania, State information

Annotation: This report presents case studies highlighting 4 state programs (in Iowa, Missouri, Ohio, and Wisconsin), among 15 that received Centers for Disease Control and Prevention funding in 2024 to improve oral health in their state. Each case study provides information on what the program is doing to improve students' oral health, what has worked for the state's dental sealant program, how the state has advanced infection control and prevention, and lessons learned.

Contact: Association of State and Territorial Dental Directors, 3858 Cashill Boulevard, Reno, NV 89509, Telephone: (775) 626-5008 Fax: (775) 626-9268 E-mail: [email protected] Web Site: https://www.astdd.org Available from the website.

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Keywords: Dental sealants, Government funding, Infection control, Iowa, Missouri, Ohio, Oral health, School age children, State programs, Wisconsin

Annotation: This workbook provides guidance on addressing fatal injuries, particularly intimate partner violence (IPV), homicide, suicide, and motor vehicle collisions (MVCs), as significant contributors to maternal mortality. It summarizes the evidence on the heightened risks of homicide and suicide for pregnant and postpartum women, with disparities among adolescents, Black women, and those with mental health conditions or IPV history. Environmental factors like poverty, lack of support, and firearm access also play a role. The workbook presents concerning data from Missouri's Pregnancy-Associated Mortality Review on injury-related deaths, finding that homicides and suicides, often involving firearms and IPV, accounted for a significant portion of pregnancy-related mortality. Younger women, Black women, Medicaid participants, and those in metropolitan areas were disproportionately impacted. MVCs were a leading cause of deaths not directly related to pregnancy. Key recommendations are provided for healthcare providers and community organizations to improve screening, intervention, support, and prevention efforts around mental health, IPV, and vehicle safety to reduce maternal injury deaths. Resources and references are included for further training and implementation.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Data, Guidelines, Injury prevention, Maternal mortality, Missouri, Risk factors, State initiatives

Annotation: This workbook provides guidance for implementing evidence-based practices to improve care for pregnant and postpartum individuals with cardiovascular disease (CVD). It summarizes the evidence on the significant risks of CVD in pregnancy, which can exacerbate pre-existing conditions or lead to new disorders due to the hemodynamic changes of pregnancy. The workbook presents data from Missouri's Pregnancy-Associated Mortality Review, finding that CVD accounted for 30% of pregnancy-related deaths from 2017-2021, with most deemed preventable and Black women disproportionately impacted. To address this crisis, the AIM Cardiac Conditions in Obstetric Care patient safety bundle components are provided, with detailed strategies for implementing universal cardiac risk screening, rapid response protocols, cardio-obstetric teams, care coordination, patient education, and equity-focused data monitoring. Emphasis is placed on early recognition, diagnosis, and treatment to prevent complications and death. Resources and references are included for further training and implementation.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Cardiovascular diseases, Evidence-based medicine, Guidelines, Maternal morbidity, Maternal mortality, Missouri, Obstetrical complications, Perinatal care, Postpartum care, Prevention, Quality improvement, Resources for professionals, State initiatives

Annotation: The workbook outlines evidence-based practices for improving recognition of and response to obstetric hemorrhage, including hemorrhage risk assessments categorized as low, medium, and high risk that should be completed on admission, during labor, and post-delivery. It emphasizes the critical importance of quantification of blood loss using volumetric containers, weighing scales, or computerized image recognition rather than estimation, as postpartum hemorrhage occurs in about 40% of low-risk birthing people. The workbook presents the Alliance for Innovation on Maternal Health Patient Safety Bundle components, which include stage-based management plans, hemorrhage supply carts, immediate access to hemorrhage medications, standardized education for obstetric teams, multidisciplinary drills, and case review processes. It addresses Missouri-specific data showing obstetric hemorrhage as the fourth leading cause of pregnancy-related deaths from 2018-2020, with significant racial disparities in transfusion rates, and notes that between 54% to 90% of hemorrhage-related deaths are preventable. The workbook includes extensive resources for implementation including assessment tools, quantification worksheets, stage-based guidelines, simulation training materials, and patient debriefing forms, and provides trauma-informed guidance for supporting patients and families after hemorrhage events.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Emergency medical services, Hemorrhage, Missouri, Obstetric care, Obstetric complications, Postpartum hemorrhage, Quality improvement, State MCH Programs

Annotation: This workbook addresses obstetric emergency triage and care for health care providers, particularly those in nonobstetric settings and maternity care deserts. The workbook presents evidence on the critical access challenges facing pregnant and postpartum patients, noting that one in 12 women live in areas with low or no access to maternal health care and that 41.7% of Missouri counties are defined as maternity care deserts compared to 32.6% nationally. It outlines comprehensive strategies for hospitals without obstetric services, including implementation of education and simulation drills for emergency deliveries and maternal emergencies such as hypertension, sepsis, and hemorrhage, creation of emergency medication kits, use of algorithms and early warning systems, and establishment of partnerships with tertiary medical centers for consultation and transfer agreements. The workbook details the complete Alliance for Innovation on Maternal Health Emergency Triage and Care Patient Safety Bundle components, covering readiness requirements such as rapid response team identification, recognition and prevention measures including pregnancy screening protocols, response protocols for routine births in nonobstetric settings and obstetric emergencies, and reporting and systems learning processes including huddles and debriefs. It emphasizes trauma-informed care principles and respectful, equitable care for all patients, and includes extensive resources for obstetric triage tools, emergency protocols, simulation training materials, transport guidelines, telehealth consultation resources, and patient education materials. The workbook specifically addresses Missouri's challenges with rural hospital closures and provides evidence-based practices to ensure continual readiness for obstetric patients in all hospital settings.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Access to care, Emergency health services, Missouri, Obstetrical care, Resources for professionals, Rural health, State initiatives, Triage

Annotation: This workbook serves as a resource for health care providers addressing maternal sepsis recognition and treatment in pregnant and postpartum patients. The workbook presents evidence on maternal sepsis as the body's life-threatening response to infection, noting that between 2017 and 2019, infection was the fourth leading cause of pregnancy-related death in the United States, with Black women having more than twice the risk of maternal sepsis compared to white women. Included are key challenges in maternal sepsis recognition and recommended procedural approaches. The workbook details the complete Alliance for Innovation on Maternal Health Sepsis in Obstetric Care Patient Safety Bundle components, covering readiness requirements including multidisciplinary team protocols and rapid response procedures, recognition and prevention measures such as evidence-based sepsis screening tools and infection prevention protocols, response protocols emphasizing early antibiotic administration within one hour and source control measures, and reporting and systems learning processes including multidisciplinary case reviews and bias consideration. The workbook addresses Missouri-specific data showing infections as the fifth leading cause of pregnancy-related deaths from 2018-2020, with sepsis as the fourth leading indicator for severe maternal morbidity and significant racial disparities noted, and includes extensive resources for sepsis evaluation flow charts, screening tools, simulation training scenarios, order sets, and patient education materials.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Emergency health services, Guidelines, Infectious complications complications, Missouri, Protocols, Resources for professionals, Sepsis, State initiatives

Annotation: This resource workbook for healthcare providers addresses evidence-based care practices for maternal-infant dyads affected by substance use disorder. The workbook presents key evidence-based practices including universal screening with validated tools following the screening, brief intervention and referral to treatment process, medications for opioid use disorder such as buprenorphine and methadone for pregnant and postpartum people, and the Eat, Sleep, Console model of care for infants experiencing neonatal abstinence syndrome. It emphasizes that substance use disorder is a chronic medical condition requiring evidence-based treatment and highlights the importance of trauma-informed, anti-racist care to address stigma and discrimination. The workbook includes the Alliance for Innovation on Maternal Health Care for Pregnant and Postpartum People with Substance Use Disorder patient safety bundle components organized into readiness, recognition and prevention, response, reporting and systems learning, and respectful care categories. It presents outcomes from the Missouri Neonatal Abstinence Syndrome Collaborative showing a 23.9% reduction in transfer rates for infants diagnosed with or at risk for withdrawal, and discusses Missouri's maternal mortality data indicating that mental health conditions including substance use disorder were the primary cause of pregnancy-related deaths from 2018 to 2020. Resources include screening tools, educational materials, guidance documents for urine drug testing and plans of safe care, and training opportunities specific to Missouri providers.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Guidelines, Infant health, Maternal health, Missouri, State initiatives, Substance use disorders

Annotation: This resource workbook for healthcare providers addresses integrating mental health care into obstetric settings to improve outcomes for pregnant and postpartum people. It presents evidence-based guidance including universal screening recommendations for depression, anxiety, bipolar disorder, and post-traumatic stress disorder at multiple points during the perinatal period, with particular emphasis on screening for bipolar disorder prior to initiating antidepressant treatment due to risks of mania, psychosis, and suicide. The workbook advocates for behavioral health therapy as the priority treatment for mild to moderate conditions and stresses the importance of trauma-informed care, anti-racism training, and addressing social drivers of health to create safe environments for disclosure and treatment. It includes the Alliance for Innovation on Maternal Health Perinatal Mental Health Conditions patient safety bundle components organized into readiness, recognition and prevention, response, reporting and systems learning, and respectful care categories. The publication highlights Missouri data showing mental health conditions as the leading cause of pregnancy-related deaths from 2018 to 2020, with suicide deaths doubling and all mental health-related deaths found to be preventable. Resources include screening tools, provider toolkits, educational materials, and information about the Missouri Maternal Health Access Project, a statewide perinatal psychiatry access program.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Mental health, Missouri, Obstetrical care, Perinatal care, Service integration, State Initiatives

Annotation: This workbook provides guidance for implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on severe hypertension in pregnancy. It summarizes the evidence on hypertensive disorders of pregnancy, including classifications, diagnostic criteria, and treatment recommendations from ACOG, with a focus on timely treatment of severe hypertension (≥160/110 mm Hg) with first-line antihypertensive medications within 30-60 minutes to prevent maternal stroke. The workbook discusses considerations in diagnosing and managing preeclampsia, which can progress rapidly and become life-threatening without prompt intervention. It highlights data on hypertensive disorders from the Missouri Pregnancy-Associated Mortality Review and provides action steps for implementation of the AIM bundle among Missouri maternal health stakeholders. Resources and references are included for further education and training.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Guidelines, Hypertension, Maternal health, Missouri, Perinatal care, Pregnancy induced hypertension, Prenatal care, Resources for professionals, State initiatives

Annotation: This workbook provides guidance for implementing preconception and interconception care, which focuses on optimizing the health of individuals before and between pregnancies to improve maternal and infant outcomes. It summarizes the evidence on the importance of addressing modifiable risk factors prior to pregnancy, such as chronic disease management, nutritional status, substance exposure, and preventive health services. The workbook highlights concerning trends in maternal morbidity and mortality in the U.S., with stark racial disparities, and presents Missouri-specific data on conditions like hypertension, diabetes, and obesity that contribute to adverse outcomes. Evidence-based recommendations are provided for key components of preconception and interconception care across health care settings, including family planning, preventive screenings, chronic disease management, breastfeeding support, and depression screening. The workbook offers clinical tools and resources for providers to implement this care to promote optimal health for birthing people.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Guidelines, Health care disparities, Missouri, Preconception care, Prevention, Primary care, Risk factors, State initiatives

Annotation: This workbook provides guidance for implementing evidence-based practices to improve postpartum care during the transition from hospital discharge to outpatient follow-up. It summarizes trends in U.S. maternal mortality, with more than 50% of pregnancy-related deaths occurring in the postpartum period. The workbook outlines ACOG's updated recommendations for postpartum care as an ongoing process through 12 weeks after birth, including an initial visit within 3 weeks and a comprehensive visit by 12 weeks. It presents Missouri-specific data on the timing and causes of pregnancy-related deaths, low postpartum visit attendance rates, and shortages of obstetric and mental health providers. Key objectives and strategies are provided for improving postpartum transitions, such as implementing discharge templates and processes, increasing postpartum visit attendance, screening for medical and mental health conditions, providing linkages to specialist and community-based care, and leveraging Medicaid coverage extensions. The AIM Postpartum Discharge Transition Bundle components and resources for implementation are included.

Contact: Missouri Perinatal Quality Collaborative , Missouri PQC, Missouri Hospital Association , 4712 Country Club Drive, Jefferson City, MO 65109-4541, Telephone: 573-893-3700 E-mail: https://mopqc.org/contact Web Site: https://mopqc.org

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Keywords: Guidelines, Health care disparities, Missouri, Patient discharge, Postpartum care, Quality improvement, State initiatives

Annotation: This report highlights findings from the Improving Postpartum Care Affinity Group, a quality improvement initiative convened by the Centers for Medicare & Medicaid Services from April 2021 to April 2023. Nine states participated in the affinity group to develop and test interventions addressing the high rates of preventable maternal mortality and morbidity in the United States, with nearly two-thirds of maternal deaths occurring during the postpartum period. The report describes how state teams used data-driven approaches to identify disparities and quality improvement opportunities, select measures to monitor their projects, and evaluate intervention impacts. It presents four main categories of interventions tested by participating states: targeted case management services for high-risk beneficiaries, postpartum cardiac care including blood pressure monitoring and cardiomyopathy protocols, support from doulas and community health workers with home visiting programs, and beneficiary and provider education and support tools. The document includes specific examples from states such as South Carolina's pilot addressing gaps in behavioral health screening, Georgia's work to improve provider use of postpartum visit codes, and Texas's blood pressure cuff distribution program for hypertensive beneficiaries.

Contact: U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, Telephone: (800) 633-4227 Secondary Telephone: (877) 267-2323 Fax: Web Site: https://www.cms.gov

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Keywords: Data analysis, Georgia, Kansas, Kentucky, Maternal morbidity, Maternal mortality, Missouri, Models, Oklahoma, Postpartum care, Prevention, Quality improvement, South Carolina, State initiatives, Texas, Wyoming

Annotation: This report provides information from a survey of federally qualified health care centers on the impact of the COVID-19 pandemic on the oral health workforce in Missouri. The survey includes questions on staffing issues and appointment wait times. Information on dentists, dental assistants, and dental hygienists is presented, and action steps to address the problem of an insufficient oral health workforce in the state are offered.

Contact: Missouri Department of Health and Senior Services, Office of Dental Health, P.O. Box 570, Jefferson City, MO 65102-0570, Telephone: (573) 751-5874 E-mail: [email protected] Web Site: http://health.mo.gov/living/families/oralhealth/index.php Available from the website.

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Keywords: COVID-19, Disease transmission, Infectious diseases, MIssouri, Oral health, Service delivery, State materials, Surveys, Virus diseases

Annotation: This report provides information about the oral health of individuals with intellectual or developmental disabilities in Missouri. Topics include oral hygiene, dental sealants, treated and untreated tooth decay, treatment urgency, and history of rampant tooth decay. Information about survey participants’ ages, genders, races, and ethnicities, as related to these topics, is included.

Contact: Missouri Department of Health and Senior Services, Office of Dental Health, P.O. Box 570, Jefferson City, MO 65102-0570, Telephone: (573) 751-5874 E-mail: [email protected] Web Site: http://health.mo.gov/living/families/oralhealth/index.php Available from the website.

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Keywords: Adults with special health care needs, Children with special health care needs, Chronic illnesses and disabilities, Dental caries, Dental hygiene, Missouri, Oral health, State surveys, Treatment

Annotation: This report provides information about the Missouri Oral Health Preventive Services Program (PSP). It discusses why oral health is important and covers the following topics as they relate to PSP participants: demographics, oral hygiene, dental sealants, treatment of tooth decay, treatment urgency, caries incidence, early childhood caries incidence, and white spot lesion incidence.

Contact: Missouri Department of Health and Senior Services, Office of Dental Health, P.O. Box 570, Jefferson City, MO 65102-0570, Telephone: (573) 751-5874 E-mail: [email protected] Web Site: http://health.mo.gov/living/families/oralhealth/index.php Available from the website.

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Keywords: Dental caries, Dental sealants, Fluoride, Missouri, Oral health, Prevention, State programs, Statistical data, Treatment

Annotation: [This issue of the Commonwealth Fund's "Transforming Care" focuses on regional partnerships that aim to bolster access to maternity care in rural communities. Included are descriptions of regional model programs aimed at expanding the maternity workforce in rural areas, ramping up maternity telemedicine programs; and creating perinatal collaboratives and provider networks.

Contact: Commonwealth Fund, One East 75th Street, New York, NY 10021, Telephone: (212) 606-3800 Fax: (212) 606-3500 E-mail: [email protected] Web Site: http://www.commonwealthfund.org

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Keywords: Arkansas, Maternal health, Maternal health care, Missouri, Model programs, New Mexico, Rural health, Utah

Annotation: This presentation features Joy Burkhard and Kay Matthews, founders of 2020 Mom and Shades of Blue respectively, who outline strategies for strengthening the maternal behavioral health workforce through effective recruitment, funding, training, and retention approaches. Working with multidisciplinary teams from Nevada, Missouri, and Indiana, they aim to showcase best practices, explore diverse funding sources, and highlight innovative programs addressing maternal behavioral health needs. The speakers emphasize the critical nature of this work, noting that maternal mental health remains severely underserved with one-third of Americans living in mental health professional shortage areas, while primary care and obstetrical/gynecological services face similar resource gaps.

Contact: Association of Maternal and Child Health Programs, 1825 K Street, N.W., Suite 250, Washington, DC 20006-1202, Telephone: (202) 775-0436 Fax: (202) 478-5120 E-mail: [email protected] Web Site: http://www.amchp.org

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Keywords: Staff development, Work force, Behavioral medicine, Recruitment, Retention, Nevada, Missouri, Indiana, Texas

Annotation: This report provides information about Missouri’s 2020–2025 oral health plan. It includes eight goals: (1) support access to preventive oral health services and emergency dental care; (2) provide oral health information to health professionals; (3) support oral health workforce development; (4) identify, investigate, monitor, and report on oral health problems, determinants, and disparities; (5) coordinate and participate in policy development to improve oral health in Missouri; (6) implement and collaborate with oral-disease-prevention programs; (7) reduce oral health disparities; and (8) implement, evaluate, and report on the 2020–2025 plan. Activities are described for each goal.

Contact: Missouri Department of Health and Senior Services, 1730 East Elm, P.O. Box 570, Jefferson City, MO 65102-0570, Telephone: (573) 751-6400 Fax: (573) 751-6041 E-mail: [email protected] Web Site: http://www.dhss.mo.gov Available from the website.

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Keywords: , Access to health care, Missouri, Oral health, Prevention, Program coordination, Public policy, State programs

Annotation: This report describes oral health trends and disparities in Missouri. It includes key findings, national comparisons, and trends. Other topics include demographics, community water fluoridation, oral health status of school-age children and adults, preventive health care for school age children and adults, tobacco use and cancer risk, older adults, perinatal oral health,hospitalizations and emergency department visits, and access to care. Regional and local data are also included.

Contact: Missouri Department of Health and Senior Services, Office of Dental Health, P.O. Box 570, Jefferson City, MO 65102-0570, Telephone: (573) 751-5874 E-mail: [email protected] Web Site: http://health.mo.gov/living/families/oralhealth/index.php Available from the website.

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Keywords: Access to health care, Health disparities, Health status, Missouri, Oral health, Population surveillance, State surveys, Statistical data, Trends