Maternal and Child Health Advisory Task Force
Friday, December 13, 2013
MEETING SUMMARY
Members Present:
Carolyn Allshouse
Ken Bence
Joan Brandt
Carol Grady
Stephanie Graves
Neal Holtan
Susan Morris
Michelle O’Brien
Martha Overby
Rosemond Owens
Deb Purfeerst
Wendy Ringer
Kristin Teipel
Members Absent:
Mary Braddock
Wendy Hellerstedt
Joel Hetler
Angela Watts
Guests:
Luanne Nyberg
Ingrid Nybert Culp
Laura Cadwell
Sara Sepcheck
Lee Aherns
Willie Ziggenhaugen
Nathanael Tilghman
MDH Staff:
Jeanne Ayers
Susan Castellano
Michelle Chiezah
Barb Dalbec
DeeAnn Finley
Sara Hollie
Jim Koppel
Kathy Wick
INTRODUCTIONS AND CHAIR REMARKS
Ken Bence, Chair of the Task Force welcomed members and guests. Julie Jagim has resigned from the
Task Force to take a position with the Nurse Family Partnership. For that reason, Ken will serve as chair
immediately. There are currently five open positions on the Task Force. This includes one Community
Health Board Representative and four Consumer Representatives. The openings will be posted (and
applications accepted) starting on January 6, 2014. Information can be found on the Minnesota Secretary
of States website at: http://www.sos.state.mn.us/index.aspx?page=308
Ken asked for a motion to approve the September meeting minutes. Rosemond Owens made a motion to
approve the September Task Force meeting minutes. Joan Brandt seconded the motion. Motion carried.
PRESENTATION OF THE BETTY HUBBARD MCH LEADERSHIP AWARDS
Ken Bence introduced Jim Koppel, Deputy Commissioner of MDH. Mr. Koppel presented the statewide
Betty Hubbard MCH Leadership award to Luanne Nyberg. Luanne received the award for work her on
building programs and policies that help children. In 1985 she founded the Children's Defense Fund –
Minnesota. The Children’s Defense Fund – Minnesota focus on the needs of all Minnesota children,
particularly children being raised in low-income households who suffer greater barriers to full
participation in society as a result of being born into poverty. In presenting the award, Deputy
Commissioner Koppel described Nyberg as “the quintessential maternal and child health advocate who
has dedicated her life to assuring accessible and quality health care to the vulnerable families of
Minnesota.”
Information about the 2013 Betty Hubbard Award and more information about Luanne’s considerable
accomplishment can be found on the Task Force webpage at:
http://www.health.state.mn.us/divs/fh/mchatf/bh-past.html
MINNESOTA DEPARTMENT OF HEALTH UPDATES
Deputy Commissioner Jim Koppel and Assistant Commissioner Ayers provided updates on MDH
activities.
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Jim Koppel:
• The November state budget forecast was released in early December. More details are available on
the Minnesota Management and Budget website at: http://www.mmb.state.mn.us/forecastdocuments-nov13. Broadly, there is a state surplus of $1 billion five months into the state fiscal
year. Of this, $200 million is from underspending and $800 million is additional revenue from
property tax. However, the state has several items to pay back from the last several years. This
includes the last of the delayed payments to school systems. While state funding is relatively stable
right now, there are several items still unresolved. There are taxes that were passed during the last
session that may be repealed and the impact of the state conforming to federal tax reforms may both
lead to losses in revenue. Another forecast will be available in February. This may allow for a
sounder forecast as the legislative session starts.
•
It is anticipated that the upcoming legislative session will be a short session given it is a bonding
not a spending year. The MDH has not heard back on most of the legislative proposals sent to the
Governor’s office, but expect to hear back in late January.
•
One initiative that has been approved is an update of the Local Public Health Act. The LPH Act is
being updated to be clearer. This is aligns with Governor Dayton’s “Unsession.” The Governor has
declared the upcoming legislative session an Unsession to clean up legislative language, remove
outdated legislation and examine advisory committees and commissions. More information on the
Unsession can be found on Governor Dayton’s website at: https://mn.gov/governor/unsession/.
•
The Governor is also encouraging a plain language initiative. He would like all agencies to look at
how they communicate (e.g. fact sheets, letters, websites, etc.) and evaluate the clarity of the
communication. This will be something the MDH will work on over the next year.
•
There are a number of reports due to the legislature this year. This includes reports on the
management of e-cigarettes, advancing health equity, and several data reports.
•
The MDH is hopeful that a statute that allows for the implementation of infant mortality reviews
will move forward during the session.
•
The MDH continues to support an increase in the minimum wage. This was proposed last year, but
was not resolved. The governor and leadership in both the House and Senate would like the
increase to happen. Minimum wage is a public health issue as it has an impact on housing,
transportation and nutrition. This is part of the Commissioner’s “health in all policy” framework.
•
Assistant Commissioner Ellen Benavidez is leaving MDH to return to her consultation and
documentarian work. In the interim the divisions in Ellen’s bureau will report to Aggie Leitheiser
and Jim Koppel.
Jeanne Ayers:
• Julie Myrhe has been hired as the new director of the Office of Statewide Health Improvement
Initiatives (OSHII). Julie is currently the Community Health Services Administrator for CarltonCook-Lake-St. Louis Community Health Board. She will be starting work on January 6, 2014.
•
The Minnesota SHIP program has recently released an expanded set of grants to local agencies
(SHIP 3.0). The program is now statewide with the exception of Anoka County. More information
on SHIP can be found on the SHIP website: http://www.health.state.mn.us/ship/
•
The Eliminating Health Disparities Initiative grants were set to expire this year and a new RFP
would have been required. However, given the work the MDH is doing around advancing health
equity, the decision was made to extend the grants for an additional year to determine the impact of
this AHE on the EHDI grant initiative.
•
The Healthy Minnesota Partnership has a strategy team to address how to support a “health in all
policy” approach. The team has chosen an increase in Minnesota’s minimum wage as their first
component to explore the impact on public health. There is another team focused on narrative
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development. This team is exploring how to make big changes happen and how to use data to tell
the story.
•
Last legislative session a statute passed requiring the MDH to develop an Advancing Health Equity
(AHE) report. The first part of the report is an examination of health disparities in Minnesota and
how are they connected to health inequities. The second component of the report is an examination
of policies and systems that create the persistent inequities in the state. The process of developing
the report began with a launch in October with about 100 MDH staff. Subsequently, the MDH has
committed to 100 to 150 conversations about health equity (including one at today’s Task Force
meeting). A draft of the report will be released in January for public comment. More information
about the MDH Advancing Health Equity initiative and statute can be found here:
http://www.health.state.mn.us/divs/chs/healthequity/
•
In an effort to implement changes that will advance health equity, MDH is creating a Center for
Health Equity. This Center will report to the Commissioner of Health and will include the Office of
Minority and Multicultural Health (relocated from the Health Improvement Bureau), the Center for
Health Statistics (relocated from the Health Policy Division), and the Behavioral Risk Factor
Surveillance System (relocated from the Health Policy Division)
COMMUNITY & FAMILY HEALTH DIVISION UPDATE
Maggie Diebel, Community and Family Health Division Director, Susan Castellano, MCH Section
Manger and Barb Dalbec, Children and Youth with Special Health Needs Section Manger provided and
update on Community and Family Health Division activities.
Maggie Diebel:
• The CFH Division had to deal with this fall’s federal government shutdown. The primary impact on
the division was on the WIC and SNAP programs. There was significant amount of time spent on
managing communication. The MDH is much better prepared should this happen again.
•
There has been an increased interest in Neonatal Abstinence Syndrome. The MDH is looking at the
impact, particularly in the American Indian community. The MDH is working with DHS to get a
better understanding of the problem. There has been an increase in prescription and heroin use, but
it is difficult to determine the severity of the problem. The goal is to focus more on drug use
prevention during pregnancy. The Task Force will be hearing more about this in the future.
Susan Castellano:
• The Family Home Visiting legislative report is due in January. Staff are working on the report and
information will be sent to the Task Force when the report is available.
•
The MDH has hosted three Infant Mortality Stakeholder meetings. There has been great
participation for each of the meetings. The stakeholders review recommendations from past work
groups, examined data regarding infant mortality and infant mortality disparities and developed
seven recommendations. These recommendations will be included in a report released this spring.
The initial report will include information about infant mortality, the set of broad recommendations
and next steps. This is consider the first phase of the plan. The plan is to have various groups take
these recommendations and develop more specific strategies and action steps that should be
undertaken by the MDH and the community to reduce infant mortality. These action steps will be
outlined in the second phase of the plan. Information and materials from the meetings can be found
here: http://www.health.state.mn.us/divs/fh/mchatf/InfantMortality.html
•
MDH received another three year federal Student Parent grant. This funding goes to institutions of
higher learning to augment student support centers that help pregnant and parenting college
students complete their education. Minnesota has one of only two higher education grants in the
country.
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Barb Dalbec:
• The MDH is convening a CYSHN Parent/Youth Work Group. The work group will act as an
advisory resource to the Children and Youth with Special Health Needs (CYSHN) Section. The
deadline for application to the work group is December 31. Information about the group (including
application materials) can be found here:
http://www.health.state.mn.us/divs/cfh/program/cyshn/spotlight/parentyouth.cfm
•
The CYSHN Strategic Plan (http://www.health.state.mn.us/mcshn/) addressed care coordination in
the medical home area of responsibility. The MDH is looking for an agency that can model care
coordination in a medical home and spread that model across the state.
•
The CYSHN Section will host a conference in March for early hearing detection and follow-up.
There will be an event during the conference in coordination with health care homes and care
coordinators to explore best practices.
•
The Minneapolis Somali Autism Prevalence Study is being released on Monday. The report
discussed autism prevalence among Somali students in the Minneapolis school system. MDH is
working on a response to the report and next steps. It is clear that all kids need access and
continuous culturally sensitive screening. The MDH has hired a Somali nurse to help with
community engagement. She is working on training community members to share accurate
information regarding autism. Information about the study can be found here:
http://rtc.umn.edu/autism/.
•
The MDH is also working on a legislative report on the feasibility of an autism surveillance system.
Information about this report will be shared when it becomes available.
•
Legal discussions continue regarding newborn screening samples, data and use. There has been
another legal hold has been put on the data that was to be destroyed on November 17, 2013. While
some outside organizations are looking at changes to the newborn screening legislation, MDH is
waiting for a final ruling on the current legislation before proposing any changes.
ADVANCING HEALTH EQUITY – THE MCH ADVISORY TASK FORCE
The MCH Advisory Task Force members participated in a conversation with MDH staff about policies,
processes, and systems that contribute to structural inequities and make recommendations for changes that
will promote health equity in Minnesota. Comments from the discussions will be submitted to the MDH
for inclusion in the advancing health equity report. More information about the MDH Advancing Health
Equity initiative and statute can be found here: http://www.health.state.mn.us/divs/chs/healthequity/
TASK FORCE BUSINESS
Dee Finley shared the final 2014 MCH Advisory Task Force Work Plan for approval. Stephanie Graves
made a motion to approve the 2014 Work Plan. Kristin Teipel seconded the motion. Motion carried. The
2014 Work Plan has been posted on the web at:
http://www.health.state.mn.us/divs/fh/mchatf/workplan.html
MEMBER NEWS AND ISSUES
Meredith Martinez: Minnesota is hosting a Help Me Grow Summit on December 18 and 19. The
summit will explore the national Help Me Grow model. The national HMG model provides infrastructure
for a seamless navigation system for families, including services that would help if children are at risk for
developmental delays. This is different than Minnesota’s current system in that it links to more than early
intervention systems like education, health care, public health, etc. and includes a follow-up or
coordination component built into the system. The National HMG Technical Assistance Center is
providing support to 17 other states. If Minnesota chooses to move forward on the national HMG model,
the Technical Assistance Center will work with the state during a year-long planning process to engage
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stakeholders, solicit input, and identify gaps and opportunities. This effort involves several state agencies,
including education, health and human services.
The following is a link to the National Help Me Grow website: http://www.helpmegrownational.org/.
Also, comments and questions about the consideration of implementing the National Help Me Grow
system in Minnesota can be sent to this e-mail address: [email protected].
Susan Morris: The Association of Minnesota Counties (AMC) is working on addressing sex trafficking.
AMC will host a seminar in March or April to address this issue. The director of Breaking Free spoke
recently at the AMC conference about the impact of sex trafficking on women and families.
Stephanie Graves: The new federal Healthy Start guidance was recently released. Applications are due
January 17th. The revised guidance will be a significant change for Twin Cities Healthy Start. Currently
TCHS works with African American and American Indian communities in St. Paul and Minneapolis.
Given the current risk data, the American Indian population could not be served with this funding. Joan
Brandt added that for the first time in 25 years, Minneapolis and St. Paul chose to apply separately and St.
Paul has chosen not to apply for funding due to the significant addition and work and the short timeframe
for application.
Kristin Teipel: The funding for the Center for Adolescent Health ends in June of 2014 so the Center
looking for opportunities for the future. Currently they are not hearing much good news about ongoing
funding.
Ken Bence: The Minnesota Council of Health Plans and the Minnesota Academy of Pediatrics have a
joint project to address childhood obesity. The project is to help families identify resources that are
currently not part of the health care model. They are working on addressing coverage and reimbursement
for services. More information can be found on the MNAAP website at:
http://www.mnaap.org/obesity.htm
DHS and the Health Services Advisory Committee are working to address the issue of opioid use among
pregnant women. They are exploring the reasons behind the increase and how to avoid the cycle of injury
to dependence to addiction.
The next Minnesota Public Health Association policy forum series on community care givers will be held
January 10. The forum will address A Community of Caregiving: For Aging Parents. More information
can be found on the MPHA website:
http://www.mpha.net/Default.aspx?pageId=1242643&eventId=770240&EventViewMode=EventDetails
Ken has been appointed to the MNsure Health Industry Advisory Committee. The committee will create
systems to screen and limit policies, evaluate the open enrollment process, determine what can be
improved, and what features were missing.
Regarding being Task Force chair, Ken is looking forward to next two years. He wants to help the Task
Force be more action focused and provide good advice back to the Commissioner of Health.
WORK GROUP UPDATES
Infant Mortality Work Group: Updated provided during the Community and Family Health update (see
above).
CYSHN Parent Work Group: Updated provided during the Community and Family Health update (see
above)
Adolescent Health Work Group: Kristin Teipel and Sara Hollie provided an update on the Adolescent
Health Work Group. A small planning team has been meeting to outline the process that will be used to
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develop the state Adolescent Health Plan. The proposal includes two larger meetings in February and
March to initiate the plan, followed by a number of facilitated meetings around the state to solicit input on
the plan from stakeholders and youth. The planning group recently conducted a survey to determine
interest in participating or hosting a local meeting.
Preconception Health Work Group: Martha Overby provided an update on the Preconception Health
Work Group. The work group has met twice. At the last meeting the work group identified three priority
areas – poverty, mental health, family planning, and well woman/postpartum care. Information and
materials from the MCH Advisory Task Force Preconception Health Work Group can be found here:
http://www.health.state.mn.us/divs/fh/mchatf/PreconceptionWG.html
Prematurity Task Force: Martha also provided an overview of the Prematurity Task Force. Going
forward the format of the Task Force meetings will change. They will be providing more webinars to
increase participation by nurses and physicians. Issues being addressed include Neonatal Abstinence
Syndrome, substance abuse, and implementation of the late pre-term discharge checklist. The group is
open to other topics of discussion.
Martha added that the March of Dimes has recently convened an Infant Health Strategy Group to examine
all of the various groups related to infant health, their history, and their purpose. They have hired a
student intern to begin this work. The group will then decide if they should continue to meet.
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