Maternal and Child Health Advisory Task Force
Friday, March 13, 2015
MEETING SUMMARY
Members Present:
Jane Auger
Ken Bence
Joan Brandt
Kristin Teipel
Neal Holtan
Deb Purfeerst
Wendy Ringer
Nancy Taff
Martha Overby
Stephanie Graves
Meredith Martinez
Susan Morris
Rosemond Owens
Michelle O’Brien
Members Absent:
Mary Braddock
Carolyn Allshouse
Jamie Stang
Carol Grady
MDH Staff:
Susan Castellano
Cecilia Wachdorf
Sue Ewy
Ed Ehlinger
Guests:
Steve Masson (DHS)
Jeanne Ayers
Sarah Cox
Maggie Diebel
Kathy Wick
Katy Schalla Lesiak
Erin Bodeau
INTRODUCTIONS AND CHAIR REMARKS
Ken Bence, Chair of the Task Force welcomed members and guests, and introductions were
made. Ken asked for a motion to approve the agenda and December meeting minutes.
Meredith Martinez made a motion to approve and Joan Brandt seconded the motion. Motion
carried.
MINNESOTA DEPARTMENT OF HEALTH UPDATES
Commissioner Ehlinger and Assistant Commissioner Ayers provided updates on MDH
activities.
Commissioner Ehlinger
• Paul Allwood accepted the appointment of Assistant Commissioner for the Health Protection
Bureau. He is coming from the University of Minnesota where he was Assistant Professor and
Adjunct Professor of Environmental and Occupational Health. He started his work as Assistant
Commissioner last week.
• Dan Pollock, new Deputy Commissioner for the Department of Health, has spent most of his
time since joining MDH leading legislative work during this session.
• The Commissioner spoke on his visit with the Secretary of Health from Germany. Minnesota has
a trade mission with Germany. Germany has many business ties in Minnesota with companies,
such as 3M and Medtronic. The Koch Institute (Germany’s CDC), has been addressing social
determinants of health (SDoH) issues. Germany spends half of what the US spends in health
care, and their health outcomes are better on a magnitude of 2 times those in Minnesota.
Germans receive 98 days of paid family leave.
• The health department’s white paper on the health impacts of paid leave was sent to the
legislature. The report found that paid leave decreases infant mortality, maternal depression
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and parent sick days, and increases parental bonding and breastfeeding. As the discussion about
paid leave policy moves forward, this report shows paid leave to be an effective strategy for
improving the health of Minnesota, reducing disparities and preventing disease.
o Our public health system has to start working on all of the other conditions impacting
infant mortality.
o Asst. Commissioner Jeanne Ayers added that we have to make it possible to say this
issue is both/and. We have to address disparities. We have to continue what we’re
doing. In addition, we need to do what would not normally be deemed part of public
health work such as working on paid parental leave and increasing the minimum wage.
The Commissioner was confirmed yesterday. The only issues raised were around data and data
privacy. The way we share health information impacts health, especially around mental health
information sharing.
ASTHO (Association of State and Territorial Health Officials)
o The Commissioner is President-Elect of the ASTHO. Priorities of the group include
continuation of the Prevention Health Block Grant and making 317 Immunization funds
available.
o Mary Wakefield, Administrator of the Health Resources and Services Administration
(HRSA) is now the Acting Deputy Secretary of the U.S. Department of Health and Human
Services (HHS). She is very interested in home visiting.
ASPR (Office of the Assistant Secretary for Preparedness and Response) wants each region to
have a center of response to Ebola. Three hospitals in Chicago want to join together to be the
regional center. Minnesota also wants to be considered for a regional center. The University of
Minnesota together with all hospitals in the state will put in an application.
Legislative session
o The MDH budget included Local Public Health extension, Home Visiting, and extension
of the Task Force.
o Bills being watched
 Bill requiring all kids to get screened by an optometrist at school-based Early
Childhood Screening visits.
 Bill proposing EPI pens to be available in all restaurants and camps
 Bill amending Medical Examiners authority based on recent incidences of
autopsies against the wishes American Indian families in the Duluth area.
Medical Examiners are quite independent. Tribes are coming up with a proposal
to balance religious/spiritual expressions and public safety.
 Bill to require all parents to sign permission for student to take student survey
 Licensing for lactation consultants (should it be about breastfeeding, not just
lactation consultants)
 Examining causes of stillborn deaths – advocates to look at elective deliveries,
non-medically indicated; there was an interest in fetal/infant mortality reviewsthis could re-energize this issue to review the cause of death
 Additional home visiting proposal from Nurse-Family Partnership (NFP)
 Proposal to increase TANF payment by $100
 Health Impact Assessments being requested through legislature
 Criminalize substance abuse in pregnant women (if the baby dies, it would be a
felony charge for the mother); other states have gone through this like TN, who
has a very different data privacy environment than ours
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 Opting out of immunization requirements
The Task Force would like to develop a process for weighing in and providing
recommendations to the Commissioner on legislation. There was discussion about how
to do this given the short-turn around time.
 It would be helpful to have specific asks – Do you have an opinion on this?
Rosemond asked if the Department of Health had any events planned around National Minority
Health Month in April.
o The Commissioner responded that the Department will be hosting an event in
recognition of Public Health Week in April. There is no particular event planned outside
of that for National Minority Health Month.
o Rosemond suggested that this month would be an opportunity to highlight some of the
issues MDH is working on, including sharing parts of the Advancing Health Equity report
throughout the month.
Collaborative Improvement and Innovation Network (CoIIN)
o Minnesota is leading the Social determinants of Health (SDoH) CoIIN in Region 5. There
are now national CoIIN efforts around SDoH.
o Infant mortality reduction plan should be coming out soon. A press release will be
coming in April.
o A new report on health equity is being developed with data directly from clinics,
performance on clinical measures and a community perspective. This report will be
shared with the Task Force when it is released.
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COMMUNITY AND FAMILY HEALTH DIVISION UPDATES
Division Updates are included in the written handout. Additional updates included:
• Updated MN vision for adolescent health: All MN youth thrive
• The Prematurity Task Force sunset. The work will continue and the group will meet
under the Perinatal Health Coalition. Reports were provided to heads of related
committees in the legislature.
• Susan spoke about the possibility of additional language being added to the Task Force
statute, encouraging the Task Force to review stillbirths, including current data and
protocols. She was asked if she could speak on behalf of the Task Force and she offered
that she thought the Task Force would take the legislative language encouraging the
Task Force to look into the issue very seriously.
o Would this effect fetal/infant mortality reviews? The City of Minneapolis was
going to put forward language but decided not to proceed due mostly to data
privacy opposition. This legislative authority could have helped inform the
request for research around stillbirths.
o Regarding the Task Force weighing in on proposed legislation, Ken spoke to how
the Task Force will need to operate differently if asked to review stillbirths and
make recommendations to the Commissioner on legislative issues. There were
concerns of how Task Force members can quickly endorse recommendations of
the Task Force if they (the members) are part of a larger or national entity from
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which they need to seek approval. A review of the process of endorsing or
making recommendations to the Commissioner within 24 hours will be discussed
in the Executive Committee.
REVIEW OF REVISED 2015 WORK PLAN
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After discussion at the December meeting, the content of the work plan was
reorganized into 3 sections: Tasks, Ongoing Task Force Monitoring, and Work
Group/Committee Updates.
Ken asked for a motion to approve the work plan. Joan Brandt made a motion to
approve and Deb Purfeerst seconded the motion. Motion carried.
CHILD AND TEEN CHECKUPS (C&TC) UPDATE
Katy Schalla Lesiak, MDH Child Health Consultant, and Steve Masson, DHS, (on behalf of Anne
Kollmeyer) presented an overview and updates on the C&TC program. See attached
presentation.
Key takeaways from the discussion include:
• Participation rates decrease with age
o Incentive with gift cards helped increase participation rates
o One county with 80% participation rate – have bilingual/bicultural staff, access
to care is better
o Participation rate with private insurance and MA is basically the same, so this is a
bigger issue than just with the Medicaid population.
• Pilot program where C&TC conducted in schools?
• Need for data sharing around child checkups because of all of the providers delivering
screening services; this issue has been addressed to some degree in other states.
• Health plans are providing trainings with providers on claims and billing.
• Sports physicals are becoming well child visits. This becomes complicated with Minute
clinics doing sports physicals.
• There are trainings available for applying fluoride varnish
o Community Health Workers can provide the service and the payment is the same
using code D1206.
• Recommended vs. required components of the visits
o Developmental, social, and maternal depression screening is recommended.
o There are core ingredients of the visit that must be completed to receive
advanced payment.
o What triggers a change from recommended to required?
 Ongoing policy development – is there evidence to warrant the change?
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Duplication – for example, fluoride varnish – children getting it from
dental provider and again at C&TC visit.
TITLE V NEEDS ASSESSMENT PRIORITY REVIEW
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Bonika Peters led the group through a review of the top priorities gathered through
Minnesota’s 2015 Title V Needs Assessment. See attached presentation and notes.
MEMBER NEWS AND ISSUES
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Wendy Ringer – PACER Center will be hosting a workshop on “Anxiety from the Inside
Out” presented by Dr. Read Sulik. Crosby, Stills & Nash will be performing at PACER’s
Annual Benefit on May 2, 2015.
Meredith Martinez – Minnesota was awarded 6 grants for Early Head Start-Child Care
Partnerships-$6 million was awarded to provide services for infants and toddlers, reduce
the waiting list for Head Start programs in Minnesota; There is support from the
Governor around universal pre-k; Help Me Grow MN is currently in its planning year
with the National Help Me Grow to participate in that model and provide more seamless
coordination with an array of services. There are 4 work groups – health care provider
outreach, community outreach and engagement, data, and access points, which will be
wrapping up this fall; Race to the Top pilot on electronic access to ASQ and ASQ-SE
developmental/socio-emotional screening tools (available in different languages) to be
implemented by May.
Rosemond Owens – A conference will be held in St. Cloud where Dr. Stephen Nelson will
be speaking on health disparities.
Joan Brandt – sponsoring Marnita’s Tables around education, health (April) and safety
(May)
Stephanie Graves – Healthy Start contracted with Wilder to do research with providers
that work with the American Indian community. Findings will be used to develop talking
points or modules to train providers and law enforcement on how to work better
together with this community.
Neal Holtan – Engaging with United family practice to have a structured conversation on
how to reach out on topics such as chronic disease, early childhood, violence/trauma.
Nancy Taff – The Minnesota Health Plans’ Collaboration Plan 2015-2019 is complete and
posted on the MN Council of Health Plans and MDH websites. The collaboration plan
outlines how health plans collaborate with local public health and communities. The last
section of the plan lists all of the collaborations.
Susan Morris – Participating in local Help Me Grow; Lots of changes happening for the
county around child protection, tasks from the Governor.
Jane Auger – Scholarships for children in foster care are being expanded; Supporting
kids birth to 5 taken out of their homes through a contract with St. Davids.
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Ken Bence – MPHA’s third policy forum was held on the topic Zip Code Matters. The last
forum will be held on May 8th on the topic Where We Eat at the New Brighton
Community Center. The MPHA 2015 Annual Conference: Social Determinants of Health Where You Live Matters will be held May 28-29, 2015 in Duluth, MN. A 2-week
membership drive will start the week of March 16th. There is a $50 membership fee to
join MPHA. MPHA will be supporting Healthy Kids Coalition on their lobby day on March
25th. Medica Foundation has released its grant opportunities in the areas of behavioral
health (closes April 17th), early childhood health and organizational core mission support
geared towards greater MN (May 1-May 29th).
OTHER ISSUES
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Recommendations to C&TC
o Improve ways to do outreach
o Understand where families are when they are not sick
o Messaging (preventive piece)
o Targeted outreach to CYSHN for preventive well check-ups
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