MATERNAL AND CHILD HEALTH ADVISORY TASK FORCE
Friday, March 14, 2014
MEETING SUMMARY
Members Present:
Carolyn Allshouse
Ken Bence
Joan Brandt
Carol Grady
Neal Holtan
Susan Morris
Michelle O’Brien
Martha Overby
Rosemond Owens
Deb Purfeerst
Wendy Ringer
Kristin Teipel
Members Absent:
Mary Braddock
Stephanie Graves
Joel Hetler
Angela Watts
Guests:
Tricia Brisbine
Ken Smith
Karyn Leniek
MDH Staff:
Jeanne Ayers
Susan Castellano
Michelle Chiezah
Sarah Cox
Barb Dalbec
Ed Ehlinger
DeeAnn Finley
Merhawit Girmay
Sara Hollie
Angela Madera
Pete Rode
INTRODUCTIONS AND CHAIR REMARKS
Ken Bence, Chair of the Task Force welcomed members and guests. Ken asked for a motion to approve the
December 2013 meeting minutes. Rosemond Owens made a motion to approve the September Task Force
meeting minutes. Kristin Teipel seconded the motion. Motion carried. The MCH Executive Committee will be
reviewing the applications for the one Community Health Board representative, and four consumer
representatives after this meeting. The Executive Committee will keep the task force informed as decisions are
made.
MINNESOTA DEPARTMENT OF HEALTH UPDATES
Commissioner Ed Ehlinger and Assistant Commissioner Jeanne Ayers provided updates on MDH activities.
Assistant Commissioner, Jeanne Ayers:
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Advancing Health Equity: Asst. Commissioner Ayers thanked the task force for their involvement in the
Advancing Health Equity initiative and report. The report was submitted on February 1st, 2014 and can be
found on the MDH website at: http://www.health.state.mn.us/divs/chs/healthequity/. The report was
presented in a hearing to the Health Policy Committee. The report gives an opportunity to explore the
determinants of health beyond the medical health care system. It also brings up the opportunity to
explore the narratives around structural racism, and how policies, systems, and environments can lead to
disparities. Next steps in the Advancing Health Equity initiative include:
o Implementing recommendations and determining what legislative priorities and investments are
needed.
o MDH becoming more responsive to the needs of the communities: An example of MDH being
more responsive to the needs of communities is the change in the application and review
process for preconception health grants. Language in the RFP for these grants was changed to
reflect input from community members on evidenced-based practices vs. promising practices.
The program extended the application deadline and provided technical assistance to community
groups.
o “Health in all policies:” The Commissioner will be having a meeting with other Commissioners to
explore how we can begin to incorporate the idea that all policies/etc. passed by government
have an impact on the health of our citizens.
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Setting up the Center for Health Equity: An interim project manager will be hired for the Center,
and then they will begin the process of determining qualifications and a position description for a
Center Director. As a part of this initiative, the Office of Minority and Multicultural Health will
join with the Center for Health Equity and will be able to expand their role as cultural liaisons.
The current Office of Minority and Multicultural Health Director will provide coverage for the
Latino community, and they will be hiring a liaison for African populations. The Eliminating
Health Disparities Grant Program will continue, and they will hire a new grant manager for the
program.
MDH was asked to provide a report to the legislature on income and health. This white paper was
completed, and presents research and data on income and poverty in Minnesota and documents the
relationship between total household income and indicators of health. The white paper can be found on
the Minnesota Department of Health (MDH) website at:
http://www.health.state.mn.us/divs/opa/2014incomeandhealth.pdf.
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Commissioner, Ed Ehlinger:
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Race, Ethnicity, Language (REL) Data: Commission Ehlinger stated that it’s important for the Department
of Health to analyze REL in health care data, but that we do not have a consistent way to gather or
analyze the data. They are looking into a legislative effort to explore a consistent and mandatory way for
collecting and analyzing of the data by REL, but not all groups are supportive of a mandate. This will be a
controversial issue over the legislative session.
Children’s Cabinet: Governor Dayton has appointed Commissioner Ehlinger as the Chair of the Children’s
Cabinet. The Children’s Cabinet includes the Commissioners of Education, Health, and Human Services.
The cabinet has looked into various issues including: Race to the Top, pregnant teens and high risk teens,
prenatal to three efforts, and children’s mental health. As chair of the Children’s Cabinet, Commissioner
Ehlinger, sought recommendations from the MCH Advisory Task Force on how the Cabinet can be used
more effectively. Recommendations included:
o Kristin Teipel: Looking into adolescence. Possibly mirroring with some of the work that is being
done at the federal level on adolescents that are struggling with multiple issues (e.g., foster care,
juvenile justice, etc). Making sure their needs are being met consistently, across the board.
o Tricia Brisbine: Connecting with families and getting feedback from families.
 Ed Ehlinger: The cabinet is having discussion on family involvement, and might be
seeking public input on that. They have looked into doing tours or meetings at places
where families are.
 Barb Dalbec: Suggested that the Children’s Cabinet could engage with the CYSHN Parent
Work Group.
o Ken Bence: Making sure that all the agencies represented in the Children’s Cabinet are aligned on
the bigger systems issues.
o Jeanne Ayers: Could use the MCH Advisory Task Force to make a recommendation to the
Children’s Cabinet about what investments should be made in data gathering (MSS, PRAMS, etc.)
to assure that the data can be gathered from diverse populations.
o Other recommendations can be sent to the Commissioner’s Office.
Medical Marijuana (“Therapeutic Cannabis”): Commissioner Ehlinger has been involved in conversations
with the governor’s office and the legislature regarding the medical marijuana legislation. Commissioner
Ehlinger stated concerns regarding the needs of children (particularly with seizure disorders) and making
sure that they are treated in a medical care system rather than the alternative care system, and
recommends conducting trials to ensure effectiveness with this vulnerable population. They have
identified some researchers who would be interested and could get investigational status to be able to
study the impact of the medical marijuana. They are working on trying to keep this a medical issue and
not a law enforcement issue.
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Pregnant Women in Prisons: MDH has submitted an application to the U.S. Preventative Task Force to
make doula services a recommended preventative service. This is a health equity issue, as there are issues
with pregnant women who are incarcerated and are being released without medical coverage right before
delivery. There are also issues on the impact of parental incarceration on children.
Legislative Updates:
o Newborn Screening Bloodspot Program: the lawsuit has been settled, and MDH will be going to
the legislature to ask for support to cover the legal fees. Will also be asking the legislature for
more clarification on lengthening the time of storage for bloodspots and data to 18 years. This
would aid in quality control measures and the development of new tests. Would need informed
consent to be able to do any research on the bloodspots. By having the data for longer,
researchers would be able to test the bloodspots of children and youth who are diagnosed with
conditions later on to determine if there are any abnormalities or differences in their blood
sample as a newborn.
o E-Cigarettes: Moving forward to have e-cigarettes included in the “Freedom to Breathe” Act, and
have them treated like other tobacco products.
o Tanning Beds: Moving to make it illegal for individuals under the age of 18 years old to use a
tanning bed.
o American Indian Infant Mortality Review Study: Was not included in the governor’s budget, but
MDH provided technical assistance regarding possible language was provided to the City of
Minneapolis as they considered moving bill language forward.
Collaborative Improvement & Innovation Network to Reduce Infant Mortality (CoIIN): A lot of our focus
has been on receiving good medical care, and we have been successful in that. However, the social
determinants of health really make the big difference and we should look into that when thinking of
infant mortality. Each of the four groups has had 1-2 meetings, so substantive content to report yet. The
groups are still working on developing their aim statements.
Health Disparities Work within Big 10 Universities: Looking into the idea of having a collaboration with the
other Big 10 universities around work and research on health disparities. Dr. Ehlinger is working on
developing some plans to put an equity lens on the work of the universities (research, outreach,
community partnerhips, etc).
o Questions/Suggestions from MCHATF:
 Having a common way to frame the idea to encourage all departments and schools to
get on board?
 Being careful not to create even bigger gaps between the communities facing the
disparities. Making sure the research projects are actually engaging the community.
ASTHO – Association of State and Territorial Health Officials: Dr. Ehlinger represents Region 5 on the
board. Had a chance to meet with many of the agency heads on a variety of topics, including: workforce
issues; Accountable Communities for health (integrating public health and medical care in communities);
prescription drug abuse; global infectious disease; Emergency Preparedness; national public health
improvement initiative; Office of Management and Budget – elimination of the Community
Transformation Grants, Preventive Block Grant and chronic disease funding increases – no new money,
will have to manage within budget.
COMMUNITY AND FAMILY HEALTH DIVISION UPDATES
Maternal and Child Health – Susan Castellano:
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Federal funding for the Family Home Visiting Program (FHV) ends in September 2014, but hope that
money will be reauthorized for the program. Even if Congress appropriates the money, the competitive
grant, which makes up about 2/3 of Minnesota’s federal FHV funding is still in question.
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CoIIN: Using a learning collaborative approach in reducing infant mortality. Region 5 has identified four
priorities, and two workgroups have started to work on the priorities. Hope to have a state-level infant
mortality report out this summer after community reviews.
Preconception Health: recommendations are scheduled to come out early summer regarding early
elective deliveries.
Adolescent Health: strategic planning.
Early Childhood: See Handout.
Children and Youth with Special Health Needs – Barb Dalbec:
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The Local Public Health Conference is scheduled for March 19th – 21st. The keynote presentation will be
given by Jeanne McAllister on care coordination and best practices in integrating care/shared care
planning.
Released a Request for Proposals for the testing and evaluation of care coordination models for the
pediatric population. The vendor will conduct a needs assessment and pilot a model to determine best
practices in pediatric care coordination. Proposals are due on March 21st.
The deadline for the Preconception Health Grant applications has been extended to April 4th.
Hearing Screening Guidelines beyond the newborn period have been developed and signed by the
MDH/DHS Commissioners. These will be posted on the MDH website soon. (See Meeting Resources)
An Autism Symposium will be held in April. The purpose of the Symposium is to discuss risks and myths
around Autism Spectrum Disorders and vaccines. The Symposium is intended for the Somali audience, and
will be held in the Somali language.
Standards of Systems of Care for the CYSHN population have been released. Set of standards designed to
help communities, states, and the nation build and improve systems of care for CYSHCN. The standards
address the core components of the structure and process of an effective system of care for CYSHCN.
(See Meeting Resources)
CYSHN submitted an application to the MCH Workforce Development Center for a technical assistance
grant for help in collaborating with other agencies/projects for CYSHN.
MINNESOTA STUDENT SURVEY
Pete Rode, Research Scientist, presented a sampling of results from the 2013 Minnesota Student Survey, and
discussed some significant changes that were made to the survey. See Handout.
MCHATF Discussion, Suggestions, and Recommendations:
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It would be helpful to get a Statewide Conference started again. The conference was helpful in answering
questions on the survey, distributing results, and getting recommendations. Suggestion would be to have
an all-day conference with panels that can show how they’ve used the data in their community or within
their professional groups. Would need to find someone to organize it (possibly a student services
organization). The MCHATF would like to recommend holding a statewide conference on the Minnesota
Student Survey.
One issue with the survey is that larger schools, such as Minneapolis Public Schools have not always
participated, one reason being the cost of having non-English students participate since the survey is only
offered in English at the current time. Minneapolis Public Schools may be participating in 2016 due to a
grant requirement. One barrier to providing the survey in multiple languages is the funding, as the
funding has not increased for the survey in years.
Suggestion was to have this be an issue that the Center for Health Equity look into.
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MEMBER NEWS AND ISSUES
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Wendy Ringer – PACER Center: PACER has been trying to work with MNSure in regard to getting some
data on race and ethnicity for those who have accessed plans via MNSure. PACER was looking into doing
some marketing with certain populations that might not have been accessing MNSure, and wanted some
data to back up their work. They were told, however, that MNSure doesn’t have that information and that
PACER would have to contact the legal department with MNSure to discuss the matter.
Ken Smith – Healthy Start: Submitted a grant application to HRSA for the Healthy Start grant. If they get
that grant, they will be able to increase their executive team to a Community Action Network. Will ask for
input from the MCHATF if that occurs. On April 8th, they are having a panel presentation on ACES and
social determinants of health from 5-7pm.
Martha Overby – March of Dimes: March of Dimes is partnering with MN AAP on newborn screening.
March for Babies is in April.
Rosemond Owens: The executives of CentraCare have reviewed the Advancing Health Equity report.
CentraCare is going to host a diversity conference to start to address structural racism. Conference is on
April 29th. Also have an event on April 10th on leveraging community partnerships. Dr. Petso has increased
developmental screening with Somali children prior to pediatric visits through a grant from MN AAP. They
are helping to validate the tool in the Somali language. They also will be standardizing the refugee
screening tool.
Ken Bence – Chair Update:
o Medica has released its funding priorities and grants – focusing on behavioral health and early
childhood as some of the priorities. Information on these grants can be found on the Medica
Foundation’s website.
o Open Enrollment for MNSure ends on March 31st.
o MNSure is forming a Navigator Task Force. They did not do as well as they thought they would in
reaching all populations, so they want to look into different marketing strategies before this
coming Fall.
o MN Public Health Association: Going to have a Policy Forum on May 9th, the topic will be “The
Silver Tsunami.” If there are trainings or events that you would like to be added to the MPHA
calendar, contact Ken. They are also posting job openings on their LinkedIn page.
o Partnership on Pediatric Obesity: Working with DHS on a fact sheet on reimbursement around
preventive health and obesity services.
AMCHP CONFERENCE UPDATE
Updates were given by those who attended the AMCHP Conference.
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Carol Grady: Was thrilled to see the increased presence and leadership of family scholars and delegates
pushing the needs of MCH and CYSHN.
Wendy Ringer: The conference had a very holistic approach. It was nice to see family participation at the
event, with families presenting. Professionals also presented on importance of family engagement.
Carolyn: The National Family Voices organization has been working with Dr. Lu, and has been compiling
comments to present to him on the MCH 3.0 Transformation. A group was able to meet with him at
AMCHP and she is hoping that will be helpful with the MCH 3.0 process.
Sara Hollie: Was good to see a focus on adolescent health. Attended a meeting about straw measures that
are being considered around youth and adult connectedness.
Kristin Teipel: The adult connectedness measure is being recommended by AMCHP. Also learned about
the University of North Carolina’s MCH Workforce Development Center.
Susan Castellano: There were a lot of sessions on early childhood connectedness.
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TITLE V UPDATE
Transformation of Title V Block Grant: See Handout and Meeting Resources.
Title V Needs Assessment: Will submit the needs assessment July 2015. See Handout.
WORKGROUP UPDATES
See handout.
OTHER ISSUES
Process for Making Recommendations:
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Would draft a formal recommendation.
Executive Committee would then act on behalf of the MCHATF and approve the recommendation.
Executive Committee would then report back to MCHATF on any formal recommendations and their
status.
Future Meeting Topic Suggestions:
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Ken Smith: Homelessness and housing for mothers – access to shelters, back to housing
Susan Castellano: Infant mortality related to homelessness
Rosemond Owens: Community Health Workers – how to work with them, not theoretical on what they
can do, but actual examples of groups that have used them effectively and how they fund them
(Wellshare?)
Doula bill
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