Fetal and Infant Mortality Review Programs Improve Community Systems
This report is prepared by
Jodi Shaefer, RN, PhD, Director
and
Hanan Abdulahi, Program Specialist
National Fetal and Infant Mortality Review Program
American College of Obstetricians and Gynecologists
National Center for Fatality Review and Prevention< MPHI
Acknowledgement and thank you to the many local FIMR programs and state FIMR
coordinators who contributed this information. Their dedication and commitment to the
community is what improves the health of families.
This document was supported, in part, by Michigan Public Health Institute, thru funding from
the Maternal and Child Health Bureau, Health Resources and Services Administration Grant
#UG7MC28482
Copies of this document are available online at www.NFIMR.org
NFIMR report on programs in USA and Puerto Rico, June 2016 1
Table of Contents
Background………………………………………………………………………………... 3
2015 FIMR Program Information ……………………………………………….. 4
Cases reviewed and race ……………………………………………………………. 4
Maternal/Family Interview ………………………………………………………… 4
Funding sources, statute and theoretical basis for program……….. 5
FIMR Child Death Review collaboration……………………………………… 6
Actions taken because of FIMR in selected states ……………..………. 7
Training and Support by NFIMR …………………………………………………14
Conclusion …………………………………………………………………………..…….14
Appendix A: Number of FIMR programs and state coordinators…15
Appendix B: Program specific detail …………………………………………. 16
NFIMR report on programs in USA and Puerto Rico, June 2016 2
Fetal and Infant Mortality Review Programs Improve Community Systems*
Background
FIMR is a community-owned action-oriented, process to improve service systems. It examines
medical, non-medical and systems related factors contributing to fetal and infant death at the
community level. Consequently, each program reports activities tailored to their community. Data
programed in the current database developed by FIMR coordinators, Michigan Department of Health
and Human Services and NFIMR provide key demographic information with risk and protective factors.
But, it is the rich and unique detail from FIMR programs that tell us how to successfully prevent fetal and
infant death.
The FIMR approach is unique because cases are de-identified and include a family interview to
determine the family’s perspective on factors that may have contributed to the infant’s life and
death. The mother is frequently the interviewee and provides the essential consumer view.
The family interview yields valuable information about social and environmental aspects
surrounding the fetal or infant death. Most communities select the cases for review based on
risk and/or population factors. De-identified cases are discussed by a multidisciplinary case
review team (CRT) that makes recommendations for system change. A community action team
(CAT) that includes community leaders, takes these recommendations to action. State and
national Maternal and Child Health (MCH) agencies have examined ways to implement the
FIMR process and other MCH morbidity and mortality events to maximize their efforts. Many
of these key elements of the FIMR model had been refined by the National Fetal and Infant
Mortality Review Program (NFIMR) over the past 25 years.
The following report is a summary of 2015 program data from 142 FIMR programs. This
summary includes FIMR program information including location of FIMR program, core FIMR
functions, and program activities. Outcomes as a direct result of FIMR action from selected
programs are included. Some questions from the child death review survey are included. All
FIMR programs were requested via Survey Monkey which was open from December 2015
through May 2016. Selected FIMR programs were contacted by phone to validate and clarify
responses. Selected aggregate data is presented followed by state specific information.
__________________
*Note that this is the first report of FIMR programs documented with information from each
program. FIMR programs are in communities with high disparities and most do not have a state
coordinator. It is a testimony to their dedication that they continue to improve systems through
the FIMR process.
NFIMR report on programs in USA and Puerto Rico, June 2016 3
2015 FIMR Program Information
142 of 177 FIMR programs and state coordinators responded from 31 states (80% response
rate). Appendix A lists all state coordinators and FIMR programs. Please note that all
percentages presented in this document are based on individuals who responded. The lead
agency for 81% (91/112, 30 skipped item) of these programs is the county/city health
department. Healthy Start is the lead for 13% of programs surveyed. Other lead agencies
include perinatal coalitions/networks (5%), and 2% hospital or other. Federal Healthy Start
participates in 40% of FIMR programs.
Cases Reviewed and Race
Eighty-seven percent of FIMR programs provided data on number of cases reviewed in 2015.
Programs checked fetal death review (90%), neonatal deaths (75%), Post neonatal deaths (69%)
and other (42%). Some programs reported fetal and infant deaths jointly. It is important to
note the FIMR programs are the only systematic and comprehensive approach to examine fetal
deaths with community level information and prevention recommendations.
Table1: Number of cases reported
Number of cases
Fetal deaths
1,387
Neonatal deaths
1,014
Post neonatal deaths
731
Other*
618
Total cases
3,750
*These data are reported by coordinators of combined fetal and infant death. Child deaths
are excluded.
FIMR programs focus on diverse populations that have racial and ethnic disparities in their
reported fetal and infant mortality. The largest groups served are African American and
Hispanic. Very diverse populations are served by each program and included in Appendix B.
Maternal/Family Interview
The interview is the hallmark of the FIMR process as it provides data on issues surrounding the
fetal or infant death in the family/mother’s own words and from that perspective. Some
programs report challenges in obtaining maternal/family interviews. However, programs
completing maternal/family interviews strongly endorse the value of these data to inform
system gaps. Almost two thirds (55%) of FIMR programs report obtaining information from an
interview with a family member. Challenges include; difficulty contacting mothers and
obtaining permission for the interview, lack of trained interviewers, funding, family refusal, and
new programs just beginning the FIMR process. In summary, the success with engaging
mothers varies among programs with some rates reaching 100% (Table 2).
NFIMR report on programs in USA and Puerto Rico, June 2016 4
Table 2: Selected FIMR programs and percent with maternal interviews.
Location
Total cases
% Maternal Interview
Woodland CA
8
50%
Wilmington DE
65
30%
Plentywood MT
3
100%
Oklahoma City OK
120
30%
Indianapolis, IN
107
36%
Jacksonville, FL
29
40%
Omaha NE
26
20%
Knoxville TN
102
43%
Kenosha WI
21
50%
Funding sources, statute and theoretical basis for program
Reported funding sources for FIMR programs vary, 39% report funding from county/city health
department and 41% from Title V. Q6 provides the detail response for funding.
Q6: What are the current funding source(s) for your program? (check all that apply)
Answered: 128 Skipped: 14
NFIMR report on programs in USA and Puerto Rico, June 2016 5
Seventy-six percent of programs report that there is a statute to protect FIMR teams.
FIMR programs have a theoretical basis for their services, see Q11. The top theories are life
course, perinatal periods of risk and the NFIMR publications on cultural
competence/bereavement support.
Q11: Which of these theories/methods are being implemented in conjunction with FIMR?
Check all that apply (answered 102 skip 40)
FIMR Child Death Review collaboration
Sixty percent of programs report using a two tier system with separate case review and
community action teams. Collaboration is the core of FIMR with 83% of programs collaborating
with child death review (CDR) (Q9). Staff work on CDR & FIMR and attending each other’s
meetings are the top approaches to collaboration followed by leadership in one organization
and joint prevention messages.
NFIMR report on programs in USA and Puerto Rico, June 2016 6
Q9: What does CDR and FIMR collaboration look like in your community? Check all that apply
(Answered: 131 Skipped: 11)
FIMR programs report on their specific community education, service system improvement,
policy advocacy, improved practices, and professional training. These data are listed for each
local program in Appendix B. Additional information about specific actions taken by the FIMR
program was also asked. In summary, top actions FIMR programs initiated as a direct result of
FIMR data include safe sleep, bereavement support, preconception/interconception care,
prenatal care, mental health support and intervention for substance abuse.
FIMR programs were asked to provide specific examples of action taken as a direct result of
their FIMR program. Selected examples are included to illustrate the variety of approaches
FIMR programs have taken to improve the health of their communities. All responses are
included in Appendix B. It is exciting and inspiring to read how local programs are meeting the
needs of their community with innovation and limited resources. The dedication of FIMR
programs to the health of community is impressive.
Actions taken because of FIMR in selected states:
Yolo County CA:
Problem: Persistent and increasing presence of maternal mental health concerns in FIMR Cases.
Recommendation: Develop a county wide collaborative to address maternal mental health.
concerns. Interventions: Collaborative created. Multiyear action plan created and parts carried
NFIMR report on programs in USA and Puerto Rico, June 2016 7
out that include sustainability of the collaborative/stakeholder engagement, resource building
and reducing stigma. Outcomes: Successful awareness campaign in 2015 to reduce stigma that
is growing in 2016. Blue Dot Campaign will be presented at the national 2016 PSI Conference.
Joint Provider Mapping Project in progress by Yolo and Butte counties to assess needs of
providers serving women along their life course (primary care, Peds, and OB).
Humboldt County CA
Problem: Many deaths reviewed included unsafe sleep environments.
Recommendation: All babies need a safe sleep environment. Interventions: Movie Theatre
Campaign. Outcomes: I do not have data available from 2014 yet.
Problem: Maternal depression has been linked with attachment problems in infancy.
Recommendation: Improve attachment problems by educating the community on Perinatal
Mood and Anxiety Disorders.
Interventions: Pec Indman, PhD addressed more than 225 community members at an all-day
conference. Outcomes: I am attempting to obtain data specific to Humboldt County on PSI, but
have not been able to yet.
Alameda County CA
Problem: Many gaps in service for perinatal depression screening and referral. FIMR identified
that many women are never screened during perinatal period.
Recommendation: Started perinatal depression screening and referral project at public health
WIC sites. Interventions: Trained all WIC staff in screening and referral set up infrastructure for
referral. Outcomes: 10,000 women have been screened at WIC since beginning the project.
About 15% screen positive. About 20-30% of those accept referrals. We are working on
evaluating the effectiveness of this intervention.
Contra Costa County CA:
Problem: Lack of referrals to substance abuse treatment, smoking cessation, nutrition
counseling and other services was noted in cases of at-risk pregnant women.
Recommendation: Care coordination and referrals to specialty services, such as substance
abuse treatments, should be made by providers and documented for at-risk mothers and
infants should increase. Interventions: Training of PNC providers on completion of importance
of state sponsored referrals Outcomes: Review of ongoing cases over the first year.
Anne Arundel County MD:
We developed a website for both families and providers on issues relating to pregnancy and
healthy babies- http://aahealthybabies.org/
We are now working on substance abuse in pregnancy with our birthing hospitals testing for
substance abuse- http://aahealthybabies.org/pdf/PAdeathbrief.pdf
NFIMR report on programs in USA and Puerto Rico, June 2016 8
Cecil County Health MD:
Problem: There is a lack of prenatal care received by the Hispanic population in our community,
resulting in poor outcomes, including increased fetal deaths.
Recommendation: FIMR Team discussed the possibility of opening a free clinic for prenatal care
to the Hispanic population that could not afford it.
Interventions: The free clinic is in the planning stage at this time. A plan is being formulated by
using prior statistics collected to prove the need and be presented to the CEO of the local
hospital as a possible funding source. Will also be presented to other local businesses including
OB/GYN providers. Outcomes: Still to be determined, if a free clinic can be established
Harford County MD
Problem: Significant increase in number of substance exposed newborns (SEN) born at local
hospital. Per DSS referrals, our county ranked 4 of 23 in 2014.
Recommendation: Develop a post-partum referral process from local hospital discharges of
SENs to LHD and DSS.
Intervention: Local hospital screens all deliveries and refers 100% of SENs to LHD and DSS.
Intervention: LHD implemented a small home visiting program for SENs and mothers to
ensure/refer to drug treatment, mental health, medical home for mom and baby, compliance
with pediatric care/postpartum exam, parenting, supplies, community resources/safe sleep.
Outcome: Local hospital is referring 100% of SEN cases to DSS and LHD. DSS and LHD hold
monthly multi-d meetings to review cases and develop plan for care.
Chattanooga-Hamilton County TN:
Lack of resources for safe sleep space for babies.
Provided pack n plays with sheets and Halo sleep sacks to more than 100 individualspartnerships with a wide variety of community agencies to identify those in need.
Lack of knowledge of safe sleep practices. Conducted a large scale safe sleep media campaign.
Safe sleep messages on buses, in large screens in food court area of mall, pre-show at 2 local
movie theaters, on screen in department of motor vehicle locations in the county.
Reduction of women smoking while pregnant needed. Partnered with Baby and Me program to
promote and offer program in our community.
Lack of education regarding prenatal care information and child/infant care. Promotion of
Text4Baby program. Lack of information and promotion of kick counting/fetal movement
monitoring in pregnancy. Promotion of Count the Kicks education/information and app.
Communication issues between providers and with pregnant mother. Developed prenatal
passport and distributed to all OB providers in the county.
Louisiana:
Problem: Growing number of NAS cases in Louisiana and a sense that legislature was going to
get involve. Recommendation: Intervene so any decisions made by legislature would be
informed and promote the wellbeing of Louisiana's families.
Intervention: A study resolution passed legislature in 2015 granting permission for the Perinatal
Commission on the Prevention of Infant Mortality (the State-level FIMR action body) to conduct
a study resolution on NAS. Outcomes: Study will be complete in March 2016.
NFIMR report on programs in USA and Puerto Rico, June 2016 9
Jacksonville FL:
Increase in sleep related deaths in homes where a crib and basinet were available. A limited
survey was done to determine the reason parents were sleeping with their infants. The results
of the survey indicated the parents felt "safer", we are expanding our survey to determine the
population's definition of "safe sleep" and to determine the context of "safe" i.e street violence,
rodents/pests or mother's comfort. In the meantime, we have been able to target education to
overcome barriers to the infants not being placed in their own beds
Miami FL:
Problem: Insufficient bereavement support services for families who experienced a pregnancy
or infant loss.
Recommendation: Implementation of bereavement programs at hospitals and increase in
bereavement support services
Interventions: Training of community members (hospital staff, local organizations, general
community) on Perinatal Bereavement.
Outcomes: Between July 2011 and December 2015, our program conducted twenty-one (21)
perinatal bereavement professional development seminars attended by four hundred seventyeight (478) individuals
Capitol Area Health Start Coalition, FL
FIMR recognized a need for preconception health and community education to African
American girls, focusing on the importance of personal hygiene, healthy lifestyles and proper
nutrition and has put a program, STRONGER Girls, to address these issues. It is currently at one
school in a predominantly African American neighborhood. It is hoped that with additional
funding, it can be expanded to other schools.
Healthy Start Coalition of Hardee, Highlands, and Polk Counties FL:
Problem: There was an increase of women presenting to their obstetrician or the local
hospital's emergency rooms with issues pertaining to dehydration.
Recommendation: Provide the obstetricians, hospitals, and home visitors educational
resources and tools to promote the importance of water consumption and staying hydrated
during pregnancy.
Intervention: When teaching the pregnant women about hydration during pregnancy providers
and home visitors would have a visual tool to utilize with the teaching.
Outcomes: The women presenting to obstetrician offices and local hospital emergency rooms
for dehydration decreased.
Problem: There were issues presented during the CRT findings dealing with access to prenatal
care for minority pregnant women.
Recommendation: The committee created an educational tool to input in the local newspaper
and at all local churches that had high population of minorities present. This tool provided
information for ways women could access prenatal care. In addition, committee members met
with the local transportation committee and implemented a bus stop near a local provider that
was needed.
Outcomes: There was an increase in appointments completed for the local providers.
NFIMR report on programs in USA and Puerto Rico, June 2016 10
Southern NJ Perinatal Coalition:
Problem: Maternal Obesity reported in 43% of cases
Recommendation: Due to lack of one to one nutritional support in PNC sites (only group at
WIC) increase involvement of Nutritional education at PNC sites by SNAP Ed and education to
Home Visiting programs in County
Outcomes: SNAP Ed in place in FQHC's and Home visitors trained. We will continue to monitor
rates.
Marion County Health Department IN:
Problem: Need for knowledge of home visitors about signs & symptoms of Neonatal Abstinence
Syndrome.
Recommendation: NAS speaker for in service of signs & symptoms of NAS
Intervention: Planning of in service for home visitors of three community programs
Outcomes: Continued assessment of home visitor needs for substance use assessment and
referrals for treatment options.
Chicago IL:
Problem: No perinatal loss support group on south side of Chicago.
Recommendation: Through a focus group meeting of parents, who had experienced a loss, the
need for a support group on the mid-south side of Chicago was discussed. From this discussion
it was determined that a support group was indeed needed.
Intervention: Monthly support group meetings at one of the local charter high schools was
started.
Outcome: Monthly meetings held for one year at the local high school at no charge. One year
later the school wanted to charge a rental fee for the space. The meeting site was changed to
the hospital at no cost. Due to lack of staff to support the monthly meetings, meetings were
changed to meet for Mother's/Father's Day and October Day of Remembrance. Families were
referred to other support groups on the north, west side of Chicago and south suburbs. A
graduate student who lives on the south side (Schweitzer Fellow) had experienced a fetal loss
and wanted to be involved in working with families who had also experienced a loss. She was
referred to FIMR from one of the north side support groups housed at a level three hospital.
Through her networking with other agencies and community organizations, two meeting sites
were located. The first meeting was December 12, 2015 at a local neighborhood community
center. The Mother's/Father's Day and October National Day of Remembrance activities will
continue along with the support group meetings.
Washoe County NV:
The Washoe County FIMR CAT Team is assisting with updating the resource directory (211)
through the MCH coalition. In addition, efforts have been made to implement a media
campaign to encourage early and regular prenatal care. The Community Action Team has
initiated working with the District Attorney and hospitals to devise a system to collect baseline
data that can be utilized to help develop a plan to address the issue of fetal drug exposure. The
FIMR annual report was distributed to the FIMR Case Review Team and the Community Action
NFIMR report on programs in USA and Puerto Rico, June 2016 11
Team. The report was also shared with the Maternal Child Health Advisory Board and the
Washoe County District Board of Health. Evaluation of the actions are unavailable at this time
as we are in the beginning phases of implementation.
Canton Ohio:
Problem: Lack of safe sleep education in the hospitals.
Recommendation: Re-educate nurses on safe sleep and provide an education check list prior to
mother’s discharge from the hospital.
Interventions: Both local hospitals provide uniform safe sleep education and sleep sacks prior
to mother and babies discharge.
Problem: Late prenatal care and poor outcomes.
Recommendation: Push for and increase on centering pregnancy care.
Interventions: Local push to increase enrollment in centering prenatal care at one local
hospital. The other local hospital is working to set up a centering pregnancy care program
Missouri:
We have established a collective impact initiative in our community called Flourish St. Louis to
address infant mortality by bringing diverse sectors together in new ways. FIMR will help
provide data and critical information about factors contributing to infant and fetal deaths that
can lead to best practices and adoption of key policies.
Dallas Texas:
Problem: Mothers reporting a desire and need for more consistent prenatal education.
Recommendations: Find and promote existing prenatal education in the community.
Intervention: Promote the text4baby app through the Community Action Network (DHS version
of CAT).
Outcome: Review of text4baby statistics showed increase of users by 1600% from 52 to 830
individuals in a 6-month period. The county was recognized for the most participants in the
state of Texas.
Problem: 51% of FIMR mothers were overweight and of that number 62% were obese.
Recommendation: Collaborate with providers at a women's community clinic to provide
screening, education, care coordination and referrals to specialty services.
Intervention: Create a program at women's community clinic to screen for obesity, provide
education, follow-up and care coordination through the use of the "Someday Starts Now" tool.
Outcome: Ongoing, since the beginning of the program six months ago.
Anaconda Deer Lodge County Public Health, MT
Problem: Lack of referrals and resources for parenting skills, substance abuse/cessation, at risk
population factors.
Recommendation: Care coordination, create and coordinate referrals among resources,
establish Parents as Teachers home visiting program, and other home visiting programs;
Interventions: Training of PCP, other community organizations on referral system and
importance of programs.
Outcomes: Starting to build home visiting culture with increase in referrals.
NFIMR report on programs in USA and Puerto Rico, June 2016 12
We are a high risk community which is starting to build a system of programs and resources to
reduce social determinants of health and other risk factor.
Mississippi Department of Health
Problem: Lack of referrals by providers to Family Planning through the health department.
Recommendation: All women in prenatal classes and postpartum are referred to Family
Planning.
Interventions: Training of PNC providers at every CRT meeting.
Outcomes: Review of ongoing cases show an increase in referrals to FP as noted on the medical
records.
Problem: Initial chart reviews in 2012 showed High rates of SIDS cases.
Recommendation: FIMR RN review with coroners to verify SIDS vs asphyxia/overlay.
Interventions: Proposed expanded trainings of coroners at state meetings; met with 12 county
coroners and their assistants on a quarterly basis first two years. Met with state Medical
Examiners.
Outcomes: Cases are correctly designated.
Problem: Lack of consistent Infant Safe Sleep information being given to new
parents/grandparents/foster parents.
Recommendation: Collaborate with MS SIDS Alliance to provide standardization of training.
Interventions: Nine delivering hospitals visited in collaboration with MS SIDS Alliance to provide
standardization of training. MS SIDS Alliance provided public recognition of hospitals
completing the following: All MCH hospital staff trained with the NICHD/March of Dimes CE
program; All parents to view the NICHD Infant Safe Sleep video and sign form acknowledging
that they saw DVD (or declined).
Outcomes: All 10 hospitals completed the above; FIMR involved with public recognition of 2 of
the hospitals. MS State office also providing books for all new parents on safe sleep.
Interventions: Trainings completed; parents instructed and viewed DVDs.
Outcomes: SUIDs decreasing, although much still to do.
Problem: Public awareness of infant safe sleep lacking.
Recommendation: Conduct a one-day CE Infant Safe Sleep Conference.
Interventions: Conference conducted in November 2014, 165 attendees included nurses, social
workers, faith based, community leaders, foster parents, child care workers.
OUTCOMES: Train the trainer programs continuing; faith based meeting with 8 faith leaders
trained and provided with pack n plays.
Puerto Rico:
Problem: In the 2009-2011 reviews 69% received early prenatal care.
Recommendation and Intervention: By recommendation of the FIMR Review Team, findings
and recommendations were shared in presentations to health care providers in 2 main
conferences.
OUTCOMES; Upon review of the 2012-2015 cases there was an increase to 89% receiving
prenatal care. PNC in PR has improved over the years. By 2014, VS data shows that about 86%
of live births in PR, their mothers initiated PNC during the first trimester of pregnancy. Average
NFIMR report on programs in USA and Puerto Rico, June 2016 13
Annual Percent Change (AAPC) trend analysis shows a significant increase of 0.6% since 2005
(81.5%).
Training and Support by NFIMR
NFIMR publications, list serve, and website are described as very helpful. Current FIMR
resources provide valuable information for programs. Peer to peer communication between
programs was identified as a need and NFIMR provided that connection. Site visits by the
NFIMR director is viewed as extremely helpful, informative, and greatly appreciated. FIMR
programs specifically requested regional and/or national meetings to network, discuss local
issues and improve practice. Additional materials on funding and sustainability for local
programs was requested and posted on the NFIMR website. Programs are looking forward to
the final database. Question 40 lists the roles of NFIMR.
Q40: Which of the following needs have been addressed by NFIMR?
Conclusion
FIMR programs report numerous examples of how FIMR is effective in addressing many of the
identified contributing factors to fetal and infant mortality in their communities. Utilizing an
anonymous case review approach where committee members represent an interdisciplinary
team yields a wide range of recommendations for prevention that can be implemented by the
CAT and converted into action. The FIMR data driven approach assists communities to address
high disparity in these deaths.
Finally, it was Tip O’Neill, former Speaker of the United States House of Representatives who is most
closely associated with the phrase, “all politics is local”. This phrase also applies to decreasing fetal and
infant mortality disparities. It is the local FIMR program that identifies system gaps and mobilizes the
community to own and fix the problems. This is an effective approach when counting does not change
the numbers.
NFIMR report on programs in USA and Puerto Rico, June 2016 14
Appendix A: Number of FIMR programs and state coordinators
State Coordinators
Jared Parrish
Amy Stratton
Mari Tylan
Joan Kelley for Anne Pedrick
No state coordinator
No state coordinator
Rhonda Brown
No state coordinator
Gretchen Martin
No state coordinator
Robin Gruenfeld
No state coordinator
No state coordinator
Latoya Hill
Alison Whitney
Jeff Spitzley
Michelle Chiezah
No state coordinator
No state coordinator
Kari Tutwiler
No state coordinator
Margaret Gray
Rebecca Gonzales
No state coordinator
No state coordinator
Andrea Filio
No state coordinator
No state coordinator
Rachel Heitmann, April Kincaid transition
No state coordinator
Megan Kimberly
No state coordinator
Katie Gillespie
Abby Collier
No state coordinator
No state coordinator
Total programs
State
AK
AL
CA
DE
CO
DC
FL
IL
IN
KS
LA
KY
ME
MD
MD
MI
MN
MS
MO
MT
NE
NJ
NV
SC
SD
OH
OK
PA
TN
TX
UT
WV
WI
WI
WY
PR
Number of FIMR programs
1
2
16
2
1
1
16
1
4
5
9
1
1
21
13
2
2
2
34
2
3
1
1
2
9
3
1
5
3
1
1
7
1
1
175
NFIMR report on programs in USA and Puerto Rico, June 2016 15
Appendix B: Program specific detail
State coordinators and local FIMR programs are listed in this report. Seventeen of 31 states have a state
coordinators.
Amy Stratton is the Alabama state coordinator.
Name: Amy Stratton
Organization: ADPH
State: AL
Which Agency leads the coordination of your FIMR program?: Regional Perinatal
Network/Prenatal/Perinatal Coalition
Do members of a federal Healthy Start participate in your FIMR team(s)?: Yes
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR collaboration look like in your community?
Birth and death records are obtained from the Center for Health Statistics and shared among the CDR
and FIMR programs. Programs work together through CoIIN efforts.
Which of these theories/methods are being implemented in conjunction with FIMR?:
Life Course Theory, Perinatal Periods of Risk
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin? : 2009
Approximately how many cases do you review in 2015 by category?:
Fetal Deaths:
50
Neonatal Deaths: 100
Post neonatal Deaths: 100
Percentage of Interview: 10%
Two tiered system: Yes
Please tell us more about your Community Action Team. The CAT is: Is Regionally based with
members that represent many partnering organizations and professions. For example, social workers,
education, nurse family partnership, community advocates, etc. Some of the CATS are conducted in
collaboration with other groups. For example, Children's Policy Councils, Breastfeeding coalitions, etc.
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign to promote family planning or STD screening
Conduct a media campaign to address disparities in infant health
Promote breastfeeding, hold a town health fair, Develop culturally relevant health education
materials,
Meet with community based organizations, Publish an annual FIMR report,
Other (please specify) Address unsafe sleep.
Service Systems Improvement: Develop a 24/7 prenatal hotline,
Eliminate a gap in MCH services, Improve referral patterns among agencies, Partner with local MOD
Prematurity Campaign, Streamline MCH Medicaid application processes.
Policy/Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Report the FIMR findings to the State MCH Director.
Improved Practices, Programs, and Policies: Initiate or expand public health case management,
Expand hospital quality assurance standards,
Implement screening for smoking.
Professional Training: Conduct provider training on prematurity/preterm labor management
NFIMR report on programs in USA and Puerto Rico, June 2016 16
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement SIDS training programs, Develop a community resource directory.
Actions taken because of FIMR:
PROBLEM: Pre-existing medical conditions such as asthma, hypertension, diabetes, mental health
disorders, obesity, etc. existed in 83.3 percent of all review FIMR cases in 2013.
RECOMMENDATION: Limited case management and referral to a medical home for the approximately
25 percent of women who remain on full Medicaid after their 60 day post-partum visit and who have
ever experienced and adverse pregnancy outcome.
INTERVENTION: Social Work Case Management protocol and referral process established and enacted
statewide. OUTCOMES: Since February 2013 there have been more than 1,500 referrals for ICC Case
Management with more than 1,000 of these mothers accepting services. Services provided include
connecting mothers with a medical home, connecting infants with a primary provider, and providing
education teaching, resources, and referrals as needed.
PROBLEM: Non-medically indicated early elective deliveries prior to 39 weeks gestation
RECOMMENDATION: Work with collaborators statewide to educate providers about the increased
risks for mothers and infants. Collaborate with the Alabama Hospital Association to encourage
delivering hospitals to have a "hard stop" policy to address EED.
OUTCOMES: 88 percent of hospitals with an EED rate of zero from July 2014 through April 2015.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 1
tribes/nations)
Asian (Please specify country of origin) 1
Black/ African American (If specific culture, please name)
Mother 46 Father 26
Pacific Islander (Please specify if Native Hawaiian,
<1 Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto
10
Rican, Cuban, Descendants of Spain, Central and/or South American)
White (Please specify country of origin) Mother 46 Father 32
Other (please specify) < Asian Indian, Chinese, Filipino, Korean, Other Asian, Two or more races
Special Populations: No
Population in your FIMR catchment area:
Total population in the catchment area: Statewide
Total number of live births:
(2014) 59,532
Total number of fetal deaths:
unknown
Total number of infant deaths:
517
Annual Budget: 1.1 million
How many funded staff are on the state level?: 6
How many in-kind staff are on the state level?: Administrative Asst. (25%), Data Analyst (25%),
Nurse Coordinator (contracted)
What are the functions of the state program?:
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: Reviews local findings,
Make formal recommendations
If yes, what are the functions of the board?: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 17
Sam Hyde is the former Alaska state coordinator & Jared Parrish is the current.
Name: Sam Hyde
Organization: State of Alaska-Section of Maternal Child and Health
State: Alaska
Which Agency leads the coordination of your FIMR program?: Data not provided
Do members of a federal Healthy Start participate in your FIMR team(s)?: Our community does
have a federal Healthy Start, but they do not participate in FIMR
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR collaboration look like in your community?: Data not provided
Which of these theories/methods are being implemented in conjunction with FIMR?:
Statute to protect FIMR programs: No, we have not had great experiences trying to get CDR/FIMR
programs put into statute
Is the program currently reviewing cases? : No
In what year did Case Reviews first begin? : Data not provided
Approximately how many cases do you review in 2015 by category?:
Fetal Deaths: 0
Neonatal Death: 4
Post neonatal Death: 25
Percentage of Interview: 0
Two tiered system: No
Please tell us more about your Community Action Team. The CAT is: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Improved Practices, Programs, and Policies: Data not provided
Policy Advocacy: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations)
14.8 (Alaska Native)
Asian (Please specify country of origin)
6.1
Black/ African American (If specific culture, please name)
3.9
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other) 1.3
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
6.8
White (Please specify country of origin)
61.9
Special Populations:
Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: 0
How many funded staff are on the state level?:
0
How many in-kind staff are on the state level?:
0
What are the functions of the state program?:
0
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 18
Maria Jocson is the former California state coordinator and Mari Tylan is the current coordinator.
Name: Maria Jocson
Organization: California Department of Health
State: CA
Which Agency leads the coordination of your FIMR program: State Department of Public Health,
MCAH Division, coordinates the implementation of local FIMR programs.
Do members of a federal Healthy Start participate in your FIMR team(s): Local FIMR Programs may
have participation from Health Start entities.
Reviews with FIMR program participation: Local FIMR programs may participate in these reviews.
What does CDR and FIMR collaboration look like in your community: Depending on the local FIMR
program, there will be varying degrees of CDR and FIMR collaboration.
Which of these theories/methods are being implemented in conjunction with FIMR?: Life Course
Theory, Perinatal Periods of Risk, NFIMR Publications on Cultural Competence/ Bereavement support
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin? : 1991
Approximately how many cases do you review in 2015 by category?: 502 fetal and infant deaths
Percentage of Interview: Yes
Two tiered system: Yes
Please tell us more about your Community Action Team. The CAT is: Depending on the local FIMR
program, the CAT may be developed solely for FIMR, part of an existing coalition or advisory group, or
a combination of the two.
Community Education:
Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to promote prenatal alcohol and drug cessation,
Conduct a media campaign to promote family planning or STD screening,
Conduct a media campaign to address disparities in infant health,
Conduct a media campaign about risks of prematurity,
Promote breastfeeding, hold a town health fair, Hold a FIMR town meeting,
Develop culturally relevant health education materials,
Meet with community based organizations, Publish an annual FIMR report.
Service Systems Improvement: Develop a 24/7 prenatal hotline, eliminate a duplication of MCH
services, eliminate a gap in MCH services, Eliminate a gap in family planning services,
Improve referral patterns among agencies, Improve bereavement referral services,
Implement “one-stop-shopping” prenatal care, Partner with local MOD Prematurity Campaign,
Improve/develop transportation routes to MCH services with the City or County Transportation
Department, Streamline MCH Medicaid application processes.
Improved Practices, Programs, and Policies: Initiate or expand public health case management,
Expand hospital quality assurance standards, Expand services to homeless women and children,
Expand services to pregnant substance abusers, enhance services to bereaved families,
Expand family planning services, Implement standardized prenatal risk assessment,
Improve cultural competency protocols, Implement screening for domestic violence,
Implement screening for substance abuse, Implement screening for smoking,
Implement screening for postpartum depression.
Policy Advocacy:
NFIMR report on programs in USA and Puerto Rico, June 2016 19
Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH, Report FIMR findings
to the Mayor, County Executive, and/or other officials on an annual basis
Report the FIMR findings to the State MCH Director.
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider education programs (e.g., management of IUGR, diabetes in pregnancy, etc.)
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement cultural competency training, Implement SIDS training programs, Develop a community
resource directory, Implement bereavement training, Implement cultural competency assessment for
FIMR team members.
Actions taken because of FIMR:
Objective: Increase preconception health knowledge among teen population in San Diego County
Intervention: From Sept. 2012-Aug. 2014, over 7,500 girls (target population 11-18 years old) received
a Being Healthy Teen Wheel through schools, clinics and community-based organizations in San Diego
County
Outcomes: Evaluation surveys (826 received) showed that 88% were able to incorporated wheel
information into routine activities; 92% strongly agreed/agreed that wheel was culturally and
linguistically appropriate; 100% strongly agreed/agreed wheel helped with discussion of healthy
behaviors/lifestyle choices
Ethnic Populations: Data not provided
Special Populations: Yes, African American, Native American, Asian American populations are some
examples, depending on the local FIMR program
Population in your FIMR catchment area: Question will be answered by local FIMR programs
individually
Annual Budget: Approximately $500,000
How many funded staff are on the state level?: 3
How many in-kind staff are on the state level?: varying number
What are the functions of the state program?: Technical assistance to local teams, Coordination of
local teams, Training of local teams, Data collection and reporting.
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
If yes, what are the functions of the board?: Data not provided
Name: Carole Mcgregor
Organization: Alameda County Public Health
State: CA
Approximate cases reviewed:
Reviews with FIMR program participation: Other SIDS review
What does CDR and FIMR look like in your community?
Currently there is no collaboration , Staff works on both CDR and FIMR , Members attend each other's
meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 20-30%
Community Education:
Meet with community based organizations, Publish an annual FIMR report,
NFIMR report on programs in USA and Puerto Rico, June 2016 20
Public information campaign to promote safe surrender of infants who might otherwise be
abandoned
Service Systems Improvement: Eliminate a gap in MCH services,
Improve referral patterns among agencies,
Improve bereavement referral services
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Initiate or expand public health case management,
Enhance services to bereaved families,
Implement screening for postpartum depression
Professional Training:
Actions taken because of FIMR:
Problem: many gaps in service for perinatal depression screening and referral. FIMR identified that
many women are never screened during perinatal period.
Recommendation: Started perinatal depression screening and referral project at public health WIC
sites. Interventions: trained all WIC staff in screening and referral set up infrastructure for referral.
Outcomes: 10,000 women have been screened at WIC since beginning the project. About 15% screen
positive. About 20-30% of those accept referrals. We are working on evaluating the effectiveness of
this intervention.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0
tribes/nations)
Asian (Please specify country of origin) 20% Black/ African American (If specific culture, please name)
35% Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of
Spain, Central and/or South American)25% Foreign-Born/ Immigrants 10%
Other (please specify) 1 mixed Caucasian/AA
Special Religious or Cultural Subgroups: Yes, Muslim
Population in your FIMR catchment area:
Total population in the catchment area: 1,579,000 in 2013
Total number of live births: 19,050 in 2013
Total number of fetal deaths: 82
Total number of infant deaths: 69
Annual Budget: 20,000/year
Name: Sara Hernadez-Singh
Organization: County of San Bernardino Dept of Public Health
State: CA
Approximate cases reviewed:
Fetal Deaths: 3
Neonatal Deaths: 3
Post neonatal Deaths: 9
Reviews with FIMR program participation: Other SIDS review
What does CDR and FIMR look like in your community? Cases are triages into FIMR or CDR
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: Parents refuse to accept interview and there are no funds for incentives.
NFIMR report on programs in USA and Puerto Rico, June 2016 21
Community Education: Promote breastfeeding, Develop culturally relevant health education
materials.
Service Systems Improvement: Data not provided.
Policy Advocacy: Other, Develop policy for hospitals to use.
Improved Practices: Data not provided.
Professional Training: Implement SIDS trainings programs.
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: No
Annual Budget: Data not provided
Name: Elaine Anthony
Organization: Kern County Public Health Services
State: CA
Approximate cases reviewed:
Fetal Deaths: 25
Neonatal Deaths: 25
Post neonatal Deaths: 25
Reviews with FIMR program participation: Child Death Review Team
What does CDR and FIMR look like in your community? Currently there is no collaboration, Members
attend each other’s meetings, and Prevention recommendations are shared.
Statute to protect FIMR teams: No
Two-tiered system: Yes
Percentage of interviews: 50%
Why interview is not done: Unable to locate the parents because they are either homeless or moved.
Community Education: Promote breastfeeding
Service Systems Improvement: Improve bereavement referral services
Policy Advocacy: Discuss findings with Public Health Administration to collaborate on ways to educate
the public regarding infant mortality.
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: FIMR case reviews make community partners aware of ongoing
trends and barriers to healthy outcomes for infant’s due
to perinatal women's ability to attain prenatal care.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 874,589
Total number of live births: 14,552
Total number of infant deaths: 7.0/1,000
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 22
Name: Natalie Berbick
Organization: Contra Costa Health Services
State: CA
Approximate cases reviewed:
Fetal Deaths: 14
Postneontal Deaths: 1
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings,
Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Promote breastfeeding and meet with community based organizations.
Service Systems Improvement: Eliminate a gap in MCH services , Improve referral patterns among
agencies , Improve bereavement referral services.
Policy Advocacy:
Report the FIMR findings to the State MCH Director
Develop a policy in collaboration with City or County
law enforcement offices or emergency services
Improved Practices:
Initiate or expand public health case management , Enhance services to bereaved families.
Professional Training: Implement SIDS training programs.
Actions taken because of FIMR:
PROBLEM: Lack of referrals to substance abuse treatment, smoking cessation, nutrition counseling
and other services was noted
in cases of at-risk pregnant women.
RECOMMENDATION: Care coordination and referrals to specialty services, such as substance abuse
treatments, should be made by providers and documented for at-risk mothers and infants should
increase.
INTERVENTIONS: Training of PNC providers on completion of importance of state sponsored referrals
OUTCOMES: Review of ongoing cases over the first year
Ethnic Populations:
Asian (Please specify country of origin) 40%
Black/ African American (If specific culture, please name) 10%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain,
Central and/or South American) 20%
White (Please specify country of origin) 20%
Foreign-Born/ Immigrants
10%
Special Religious or Cultural Subgroups: Yes, African American
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 23
Name: Claudia Benton
Organization: Ventura County Public Health
State: CA
Approximate cases reviewed:
Fetal Deaths, Number 35
Other, please specify type of review & number Infant deaths: 43
Reviews with FIMR program participation: Child Fatality Review,
Child Abuse and Neglect Review,
Suicide Review Panel, Other SIDS review
What does CDR and FIMR look like in your community?
Staff works on both CDR and FIMR, Members attend each other's meetings, Cases are triaged into
FIMR or CDR , Meetings are coordinated,
Prevention recommendations are shared
Statute to protect FIMR teams: Data not provided
Two-tiered system: Yes
Percentage of interviews: 6
Community Education: Conduct a media campaign to promote prenatal alcohol and drug cessation,
Promote breastfeeding.
Service Systems Improvement: Improve referral patterns among agencies,
Improve bereavement referral services ,
Partner with local MOD Prematurity Campaign
Policy Advocacy: Report the FIMR findings to the State MCH Director.
Improved Practices: Implement screening for substance abuse,
Implement screening for postpartum depression.
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement SIDS training programs , Implement bereavement training.
Actions taken because of FIMR:
Problem: obese pregnant women Recommendation: more training for staff
Interventions: All day training to Comprehensive perinatal service workers and other health care
providers in collaboration with MOD. Comenzando Bien curriculum with emphasis in nutrition.
Outcome: 50 people participated.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0
tribes/nations)
Asian (Please specify country of origin) 0
Black/ African American (If specific culture, please name)
5
Pacific Islander (Please specify if Native Hawaiian,
0
Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto
50
Rican, Cuban, Descendants of Spain, Central and/or South American)
White (Please specify country of origin) 45
Foreign-Born/ Immigrants
Special Religious or Cultural Subgroups: Yes, Hispanics
Population in your FIMR catchment area:
Total population in the catchment area 846178
Total number of live births
10038
NFIMR report on programs in USA and Puerto Rico, June 2016 24
Total number of fetal deaths 35
Total number of infant deaths 43
Annual Budget: Data not provided
Name: Erma Riley
Organization: MCAH
State: CA
Approximate cases reviewed:
Fetal Deaths, Number : 25
Neonatal Deaths, Number: 20
Reviews with FIMR program participation: Child Death Review Team
What does CDR and FIMR look like in your community? Currently there is no collaboration, staff
works on both CDR and FIMR.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 5%
Why interview is not done: Data not provided
Community Education: Promote breastfeeding, Meet with community based organizations,
Collaboratively worked with Family on access to LARC for women, receive a grant for decreasing
disparities among African American women.
Service Systems Improvement: Collaborate with the Faith based Community to bring
awareness and decrease infant mortality
Policy Advocacy: Invited to speak at SF Board of Supervisor Meeting to
declare infant mortality in the month of October.
Improved Practices: Expand family planning services, Implement standardized prenatal risk
assessment, Implement screening for postpartum depression.
Professional Training: Implement SIDS training programs, Implement bereavement training.
Actions taken because of FIMR:
We partnered with MCAH Family Planning to ensure that all women of childbearing age have access
to family planning services including.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 850,000
Total number of live births: 9,000
Total number of fetal deaths: 25
Total number of infant deaths: 20
Annual Budget: Data not provided
Name: Nancy Calvo
Organization: Solano County Health & Social Services
State: CA
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR, Other
MCAH leads coordination efforts. SIDS Coordinator attend the CRD meetings.
NFIMR report on programs in USA and Puerto Rico, June 2016 25
Statute to protect FIMR teams: Not sure
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to promote prenatal alcohol and drug cessation,
Conduct a media campaign to address disparities in infant health, Promote breastfeeding,
Develop culturally relevant health education materials,
Publish an annual FIMR report
Service Systems Improvement: Eliminate a duplication of MCH services,
Improve referral patterns among agencies,
Streamline MCH Medicaid application processes
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Expand services to pregnant substance abusers, Implement screening for
domestic violence, Implement screening for substance abuse, Implement screening for smoking,
Implement screening for postpartum depression.
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.), Implement SIDS training programs
Actions taken because of FIMR: In 2015, the Solano FIMR Team produced the FIMR Sleep-Related
Death Report, the report includes recommendations. Staff provided trainings regarding Safe Sleep to
licensed childcare providers and Train the Trainer target to the African American community.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 400,000
Total number of live births: 5,200
Total number of fetal deaths: 35
Total number of infant deaths: 29
Annual Budget: 30,000
Name: Anna Sutton
Organization: Yolo County HHSA
State: CA
Approximate cases reviewed:
Fetal Deaths: 3
Neonatal Deaths: 2
Post neonatal Deaths: 3
Reviews with FIMR program participation : Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: No
Two-tiered system: No
Percentage of interviews: 50%
Why interview is not done: FIMR Program Data is based on chart review and using an "issues
checklist" developed by the California DPH. The maternal interview is done separately and presented
as part of case review.
NFIMR report on programs in USA and Puerto Rico, June 2016 26
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to encourage early and continuous prenatal care, Develop culturally
relevant health education materials, publish an annual FIMR report.
Service Systems Improvement: Eliminate a gap in MCH services, improve referral patterns among
agencies, Improve bereavement referral services.
Policy Advocacy: 5 year FIMR reports are sent to State MCAH.
Improved Practices: Enhance services to bereaved families, Implement screening for postpartum
depression.
Professional Training: Trainings offered around domestic violence and motivational interviewing
offered to providers.
Actions taken because of FIMR: Problem: persistent and increasing presence of maternal mental
health concerns in FIMR Cases. Recommendation: Develop a county wide collaborative to address
maternal mental health concerns. Interventions: Collaborative created. Multiyear action plan created
and parts carried out that include sustainability of the collaborative/stakeholder engagement,
resource building and reducing stigma. OUTCOMES: successful awareness campaign in 2015 to reduce
stigma that is growing in 2016. Blue Dot Campaign will be presented at the national 2016 PSI
Conference. Joint Provider Mapping Project in progress by Yolo and Butte counties to assess needs of
providers serving women along their life course (primary care, Peds, and OB).
Ethnic Populations: Data not available
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 200000
Total number of live births: 2500
Total number of fetal deaths: 10/year
Total number of infant deaths: 5/year
Annual Budget: guessing it's about $17K, but it's rolled into the whole MCAH Budget.
Name:
Quinn Wells
Organization: Sacramento County DHHS
State: CA
Approximate cases reviewed: 30
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR, Members attend each
other's meetings, Cases are triaged into FIMR or CDR, Meetings are coordinated,
Prevention recommendations are shared
Statute to protect FIMR teams: Data not provided
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign to promote prenatal alcohol and drug cessation,
Conduct a media campaign about risks of prematurity
Meet with community based organizations
Service Systems Improvement: Improve referral patterns among agencies
Partner with local MOD Prematurity Campaign
Policy Advocacy: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 27
Improved Practices: Initiate or expand public health case management
Professional Training: Conduct provider training on prematurity/preterm labor management,
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement cultural competency training , Implement SIDS training programs , Develop a community
resource directory
Actions taken because of FIMR: Infant mortality rate high for African American Women
Public Health Nurses hired to provide case management services for pregnant AA women.
Special Religious or Cultural Subgroups: No
Ethnic Populations: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Erica Alexander
Organization: Fresno County Department of Public Health
State: CA
Approximate cases reviewed:
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR, Other,
The SIDS coordinator attends child death review
Statute to protect FIMR teams: Yes
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions Taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Name: Sue Seaters
Organization: Placer County HHS
State: CA
Approximate cases reviewed:
Fetal Deaths:
7
Neonatal Deaths, Number: 12
Post neonatal Deaths, Number: 2
Reviews with FIMR program participation: Child Fatality Review , Child Abuse and Neglect Review
What does CDR and FIMR look like in your community? Joint reviews are conducted, Meetings are
coordinated, Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 28
Community Education: Promote breastfeeding, Meet with community based organizations, Publish
an annual FIMR report.
Service Systems Improvement: Improve referral patterns among agencies , Improve bereavement
referral services, Streamline MCH Medicaid application processes.
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Initiate or expand public health case management , Expand services to pregnant
substance abusers, Enhance services to bereaved families , Implement screening for postpartum
depression.
Professional Training: Implement SIDS training programs , Develop a community resource directory
Actions taken because of FIMR:
Problem:
Continue seeing sleep related deaths in our communities.
Recommendation: offer outreach to licensed daycare workers on Safe to Sleep recommendations and
materials. Also provide materials for parents whose children attend the daycares.
Intervention: At least once annually give a presentation, partnering with the County Coroner, to
licensed daycare providers through the office of education.
Outcomes: Reinforcing safe sleep guidelines promoted by the AAP; daycare providers are able to
provide documentation to support the manner in which they sleep all babies in their centers (unless a
MD has provided documentation for sleep position to be other than supine). Decrease in infant
deaths in daycare settings.
Ethnic Populations:
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain,
Central and/or South American)
14% Mexican
White (Please specify country of origin)
78% USA
Other (please specify)
4% India
Special Religious or Cultural Subgroups:
No
Population in your FIMR catchment area:
Total population in the catchment area: 379,649
Total number of live births: 3684
Total number of fetal deaths: 714
Annual Budget: Data not provided
Name: Allison Tans
Organization: Humboldt County DHHS-Public Health
State: CA
Approximate cases reviewed:
Fetal Deaths: 14
Neonatal Deaths, Number:
0
Post neonatal Deaths, Number: 1
Other, please specify type of review & number Child: 5
Reviews with FIMR program participation: Child Fatality Review , Suicide Review Panel, Other SIDS
review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR, Funding is shared,
Cases are triaged into FIMR or CDR, Meetings are coordinated,
Prevention recommendations are shared.
NFIMR report on programs in USA and Puerto Rico, June 2016 29
Statute to protect FIMR teams: No
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: We would include it if we had any to include. There was a gap in
interviews the year prior to the prior FIMR Coordinator's retirement.
Community Education: Develop culturally relevant health education materials
Publish an annual FIMR report, Other (please specify)
Conduct a media campaign to encourage safe sleep
Service Systems Improvement: Improve referral patterns among agencies,
Improve/develop transportation routes to MCH services with the City or County Transportation
Department, Streamline MCH Medicaid application processes
Policy Advocacy: Data not provided
Improved Practices: Expand services to pregnant substance abusers, Other (please specify)
We are working on recommending implementation of screening for substance abuse and for
postpartum depression to all county providers.
Professional Training: Other (please specify)
Some have been done in the past
Actions taken because of FIMR:
PROBLEM: Many deaths reviewed included unsafe sleep environments. RECOMMENDATION: All
babies need a safe sleep environment. INTERVENTIONS: Movie Theatre Campaign. OUTCOMES: I do
not have data available from 2014 yet.
PROBRLEM: Maternal depression has been linked with attachment problems in infancy.
RECOMMENDATION: Improve attachment problems by educating the community on Perinatal Mood
and Anxiety Disorders.
INTERVENTIONS: Pec Indman, PhD addressed more than 225 community members at an all-day
conference. OUTCOMES: I am attempting to obtain data specific to Humboldt County on PSI, but have
not been able to yet.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 134,623
Total number of live births: 1,396
Total number of fetal deaths: 14
Total number of infant deaths: 4
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 30
Colorado has no state coordinator.
Name: Melanie Cyphers
Organization: Weld County Department of Public Health Environment
State: CO
Approximate cases reviewed:
Fetal Deaths: 4
Neonatal Deaths: 1
Reviews with FIMR program participation: Data not provided.
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR,
Funding is shared, Members attend each other's meetings.
Statute to protect FIMR teams: No, the state is not involved in FIMR. Our county has the only FIMR in
the state
Two-tiered system: Yes
Percentage of interviews: 100
Why interview is not done: Data not provided
Community Education: Media campaign on safe sleep
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Enhance services to bereavement
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: Yes, East African Refugees in our community but have not
reviewed any deaths from their community
Population in your FIMR catchment area:
Total population in the catchment area: 277,670
Total number of live births: 3901
Total number of fetal deaths: 18
Total number of infant deaths: 23
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 31
Anne Pedrick is the Delaware state coordinator.
Name: Anne Pedrick
Organization: Child Death Review Commission
State: DE
Approximate cases reviewed:
Other, please specify type of review & number Still working on 2015 data
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR, Funding is shared,
Cases are triaged into FIMR or CDR , Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 24%
Community Education: Publish an annual FIMR report, Other (please specify)
Publish Kicks counts materials.
Service Systems Improvement:
Eliminate a gap in MCH services, Improve referral patterns among agencies,
Improve bereavement referral services.
Policy Advocacy: Report the FIMR findings to the State MCH Director
Report annual report findings to the Governor and legislature.
Improved Practices:
Enhance services to bereaved families, Expand family planning services,
Implement standardized prenatal risk assessment.
Professional Training: Implement SIDS training programs , Implement bereavement training
Actions taken because of FIMR:
Recommendation:
Support prenatal education on fetal movement tracking as a standard of obstetric care.
Action/Intervention
In 2011, the Division of Public Health and the Delaware Healthy Mother and Infant Consortium
developed the Fetal Kicks Count program, a social marketing campaign that targets health care
providers and pregnant women with the message that fetal movement tracking, beginning at 24
weeks gestation, is an important indicator of fetal health.
Outcomes: The Fetal Kicks Count program was developed and implemented in less than six months
after discussion and a recommendation made at a FIMR CRT meeting. Toolkits— including education
brochures and Kicks Count tracker pocket booklets for recording a baby’s daily movements— were
distributed to prenatal providers statewide in 2011.
A perinatal collaborative education coordinator also provides support to ensure providers have the
Kicks Count toolkits and are comfortable implementing the clinical follow-up
for decreased fetal movements. The FIMR database will continue to track the proportion of women
with documented prenatal education on fetal movement tracking.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: 180,000
NFIMR report on programs in USA and Puerto Rico, June 2016 32
Name: Joan M. Kelley
Organization: Child Death Review Commission
State: DE
Approximate cases reviewed:
Fetal Deaths: 30
Neonatal Deaths: 30
Postneonatal Deaths: 5
Reviews with FIMR program participation : Maternal Mortality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Funding is shared, Cases are triaged into FIMR or CDR
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 30
Community Education: Publish an annual FIMR report
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Initiate or expand public health case management, Expand family planning
services.
Professional Training: Fetal Kick Counts statewide media campaign in past 4 years and ongoing.
Actions taken because of FIMR: DE will be happy to share our annual report which will include 2
years’ worth of data and should be published in the spring. Please contact me or the Director of CDRC
if interested.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 33
Quartil Robinson is the former Florida state coordinator and Rhonda Brown is the current coordinator.
Name: Quartil Robinson
Organization: Florida Department of Health
State: FL
Which Agency leads the coordination of your FIMR program?: The state health office contracts with
11 state Healthy Start Coalitions to conduct FIMR projects.
Do members of a federal Healthy Start participate in your FIMR team(s)?: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR collaboration look like in your community?: Data not provided
Which of these theories/methods are being implemented in conjunction with FIMR?:
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases? : Data not provided
In what year did Case Reviews first begin? : FIMR project funding to Healthy Start coalitions began
in 1993
Approximately how many cases do you review in 2015 by category:
28 case reviews are required by contract for
each funded FIMR project per fiscal year
Percentage of Interview: Data not provided
Two tiered system: Data not provided
Please tell us more about your Community Action Team. The CAT is: CAT is a contract requirement
for funded FIMR projects. Non applicable to the state health office
Community Education: Data not provided
Service Systems Improvement: Data not provided
Improved Practices, Programs, and Policies: Data not provided
Policy Advocacy: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Problems, recommendations, and interventions will vary by county
and community needs.
Ethnic Populations: Data not provided
Special Populations: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: 11 FIMR projects are funded at $21,784 each
How many funded staff are on the state level?: 0
How many in-kind staff are on the state level?: 2
What are the functions of the state program?: Technical assistance to local teams,
Provides funding to 11 FIMR projects through the state Healthy Start Coalitions.
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
NFIMR report on programs in USA and Puerto Rico, June 2016 34
Name: Odeth O’Meally
Organization: Palm Beach County FIMR
State: FL
Approximate cases reviewed:
Fetal Deaths:
30
Infant Deaths: 50
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community?
FIMR funding agency (Program officer) is represented
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 20%
Community Education:
Develop culturally relevant health education materials, Meet with community based organizations,
Publish an annual FIMR report, (1) Educate over 80% of the county's OB/GYN of
FIMR (2) Lunch N' Learn RE: Rethinking the role of nutrition in infant mortality.
Service Systems Improvement: Improve bereavement referral services.
Policy Advocacy:
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis Report
the FIMR findings to the State MCH Director.
Improved Practices:
Enhance services to bereaved families, Implement standardized prenatal risk assessment
Professional Training:
Conduct provider education programs (e.g., management of IUGR, diabetes in pregnancy, etc.)
Develop a community resource directory, Develop FIMR brochure Developed bereavement
community resource directory
Actions taken because of FIMR:
Problem: OB/GYN in PBC lack of knowledge about the FIMR process
Recommendation: Increase OB/GYN provider knowledge
Provide education to OB/GYN
Outcome: Annual report and brief education given to over 85% of OB/GYN through Healthy Mothers
Healthy Babies in 2015
Problem: Families unable to find MCH bereavement resources in PBC
Recommendation: Create a reference tool to assist families in locating of bereavement support
Intervention: Create a county specific bereavement guide
Outcomes: Bereavement directory sent out to 100% of mothers selected for a maternal interview.
Additionally, bereavement document made available to all MCH organization associated or involved
in FIMR
Ethnic Populations: Data not available
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: (PBC: 1,308,741) (Female 12-45: 580,467)
Total number of live births:
14,433
Total number of fetal deaths:
108
Total number of infant deaths:
69
Annual Budget: $135,959
NFIMR report on programs in USA and Puerto Rico, June 2016 35
Name: Brandy Gehrken
Organization: Coastal OB/Gyn Healthy Start
State: FL
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Data not provided
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Amy Olen
Organization: Healthy Start Coalition of Miami-Dade
State: FL
Approximate cases reviewed:
Fetal Deaths: 14
Neonatal Deaths: 11
Post neonatal Deaths: 7
Reviews with FIMR program participation: Child Fatality Review, Domestic Violence Review, Child
Abuse and Neglect Review
What does CDR and FIMR look like in your community? Member’s attend each other’s meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: We complete outreach attempts for all FIMR cases, however we have a
high rate of cases that we are unable to locate as well as a number of cases that decline interviews.
Community Education: Promote breastfeeding, Hold a town health fair,
Develop culturally relevant health education materials.
Service Systems Improvement: Improve referral patterns among agencies, Improve bereavement
referral services, Partner with local MOD Prematurity Campaign.
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Enhance services to bereaved families, Expand family planning services.
Professional Training: Conduct provider training on prematurity/preterm
NFIMR report on programs in USA and Puerto Rico, June 2016 36
labor management, Conduct provider education programs (e.g., management of IUGR, diabetes in
pregnancy, etc.), Conduct provider training on use of screening tools
(e.g., substance use, domestic violence, etc.) Implement cultural competency training , Implement
SIDS training programs , Implement bereavement training.
Actions taken because of FIMR:
Problem: Insufficient bereavement support services for families who experienced a pregnancy or
infant loss.
Recommendation: implementation of bereavement programs at hospitals and increase in
bereavement support services
Interventions: training of community members (hospital staff, local organizations, general
community) on Perinatal
Bereavement.
Outcomes: o Between July 2011 and December 2015, our program conducted twenty-one (21)
perinatal bereavement
professional development seminars attended by four hundred seventy-eight (478) individuals.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 2,662,874
Total number of live births 31,990
Total number of fetal deaths 240 (7.4 per 1,000 live births)
Total number of infant deaths 147 (4.7 per 1,000 live births
Annual Budget: $21, 784
Name: Theresa Chimel
Organization: Escambia County Healthy Start Coalition
State: FL
Approximate cases reviewed:
Fetal Deaths, Number: 15
Neonatal Deaths, Number: 20
Post neonatal Deaths, Number: 7
Reviews with FIMR program participation: Child Abuse Death Review - we don't review all cases of
child death, just those under investigation for abuse
What does CDR and FIMR look like in your community? Members attend each other's meetings ,
Other (please specify), We attend meeting of the Child Abuse Death Review team
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: We have not been successful in getting mothers to be receptive to the
interview process. We are currently working on a new approach to contacting mothers coupled with
bereavement support.
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to encourage early and continuous prenatal care, conduct a media
campaign to promote prenatal alcohol and drug cessation, Conduct a media campaign about risks of
prematurity.
Promote breastfeeding, Hold a town health fair, Hold a FIMR town meeting, Meet with community
based organizations, Publish a FIMR newsletter, Other (please specify)
NFIMR report on programs in USA and Puerto Rico, June 2016 37
conduct a media campaign to encourage safe sleep.
Service Systems Improvement: Eliminate a duplication of MCH services , Eliminate a gap in MCH
services, Partner with local MOD Prematurity Campaign
Policy Advocacy: Data not provided
Improved Practices: Initiate or expand public health case management,
Expand hospital quality assurance standards,
Implement standardized prenatal risk assessment
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.)
Implement SIDS training programs , Develop a community resource directory
Actions taken because of FIMR: Due to lack of funding, we have struggled to adequately meet the
needs of our community. Over the past two years through our FIMR process, we have identified the
need for comprehensive bereavement services. However, we have only been able to conduct one
training and have yet to fully implement the program because the funds we receive to conduct the
FIMR program aren't enough to even cover the abstraction process. Any programs or services we
identify as a community gap must be funded by other means, often through fundraising efforts or
small grants.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area:
Total population in the catchment area 306,000
Total number of live births
3800
Total number of fetal deaths 28
Total number of infant deaths 30
Annual Budget: 21,784
Name: Sandra Despagne
Organization: Healthy Mothers, Healthy Babies of Broward Inc.
State: FL
Approximate cases reviewed: We are currently still reviewing 2015 deaths. We
are contracted to review 57 fetal and infant deaths. So far we have selected 44 cases for review 27
fetal and 17 infants
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 15%
Why interview is not done: We attempt to conduct maternal/ paternal interview with each selected
case, however we get a lot of declines from the parents or no response to our letters and phone calls.
Also, if a case is in litigation, we do not request a maternal interview.
Community Education: Conduct a media campaign to address disparities in infant health
Meet with community based organizations, Publish an annual FIMR report,
Conduct a media campaign to promote infant safe sleep practices.
Service Systems Improvement: Eliminate a gap in family planning services, Improve referral patterns
among agencies, Improve bereavement referral services , Partner with local MOD Prematurity
Campaign.
NFIMR report on programs in USA and Puerto Rico, June 2016 38
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis.
Improved Practices: Expand hospital quality assurance standards, Other (please specify)
Implement Model Behavior curriculum.
Professional Training: Implement SIDS training programs, Other (please specify) Conduct provider
training on perinatal bereavement support and MCH conference based on FIMR findings.
Actions taken because of FIMR:
Problem: In 2013-2014, there were a total of 38 infant deaths that had a primary cause as sleep
related or had a contributory cause of being in an unsafe sleep environment or unsafe sleep position
at time of death.
Recommendation: Implement a Safe Sleep Awareness campaign to decrease the number of sleep
related deaths in the community.
Intervention: The implementation of the best practice "Medical Model Behavior" Program to educate
hospital nurses, physicians and staff on the promotion of safe sleep practices for newborns.
Implementation of Direct on Scene Education Program. DOSE is a program utilized by first responders
to deliver the "safe sleep" message for all infants in the communities’ that they serve.
Outcomes: Over 120 first responders have been trained in Broward County. Based on the preliminary
data sleep related deaths have decreased in the county.
Ethnic Populations:
Black/ African American (If specific culture, please name)
69%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
23%
Special Religious or Cultural Subgroups: Yes, Hispanics, Haitians, Jamaican, Russian, African
American, Caribbean.
Population in your FIMR catchment area:
Total population in the catchment area Estimated population of Broward -1,838,844
Total number of live births:
21,541
Total number of fetal deaths: 223
Total number of infant deaths: 118
Annual Budget: 211, 181
Name: Melisa Reddick
Organization: Chipola Healthy Start Coalition
State: FL
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? No collaboration
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training : Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 39
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Tonya Akwetey
Organization: Healthy Start Coalition of Hardee, Highlands, and Polk Counties
State: FL
Approximate cases reviewed:
Fetal Deaths:
14
Neonatal Deaths: 6
Post neonatal:
8
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 1
Community Education: Promote breastfeeding, meet with community based organizations,
Promote relevant health information for some of the challenges and issues presented from the
Case Review Team Meetings.
Service Systems Improvement: Improve bereavement referral services, Improve/develop
transportation routes to MCH services with the City or County Transportation
Department, Streamline MCH Medicaid application processes.
Policy Advocacy: Data not provided
Improved Practices: Due to the FIMR Project there is a more heightened awareness at one of our
main local hospitals. In addition, there is more involvement of key
stakeholders in the FIMR Project.
Professional Training:
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement SIDS training programs, Develop a community resource directory
Actions taken because of FIMR:
Problem: There was an increase of women presenting to their obstetrician or the local hospital's
emergency rooms with issues pertaining to dehydration.
Recommendation: Provide the obstetricians, hospitals, and home visitors educational resources and
tools to promote the importance of water consumption and staying hydrated during pregnancy.
Intervention: When teaching the pregnant women about hydration during pregnancy providers and
home visitors would have a visual tool to utilize with the teaching.
Outcomes: The women presenting to obstetrician offices and local hospital emergency rooms for
dehydration decreased.
Problem: There were issues presented during the CRT findings dealing with access to prenatal care for
minority pregnant women.
Recommendation:
The committee created an educational tool to input in the local newspaper and at all local churches
NFIMR report on programs in USA and Puerto Rico, June 2016 40
that had high population of minorities present. This tool provided information for ways women could
access prenatal care. In addition, committee members met with the local transportation committee
and implemented a bus stop near a local provider that was needed.
Outcomes: There was an increase in appointments completed for the local providers.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 760200
Total number of live births 8959
Total number of fetal deaths 50
Total number of infant deaths 52
Annual Budget: 21,784.00
Name: Leisa J. Stanley
Organization: Healthy Start Coalition of Hillsborough County Inc.
State: FL
Approximate cases reviewed:
Fetal Deaths, Number: 0
Neonatal Deaths, Number: 21
Post neonatal Deaths, Number: 17
Other, please specify type of review & number 0
Reviews with FIMR program participation: Child Fatality Review , Domestic Violence Review,
Maternal Mortality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings ,
Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: We attempt to conduct maternal interviews but have approximately a
25%-30% response rate.
Community Education: Conduct a media campaign to promote prenatal alcohol and drug cessation,
Conduct a media campaign to address disparities in infant health, promote breastfeeding, hold a
FIMR town meeting, Develop culturally relevant health education materials,
Meet with community based organizations
Service Systems Improvement: Eliminate a gap in MCH services, improve referral patterns among
agencies, Improve bereavement referral services, Partner with local MOD Prematurity Campaign,
Streamline MCH Medicaid application processes.
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH,
Report the FIMR findings to the State MCH Director, Develop local or state legislation.
Improved Practices: Expand services to pregnant substance abusers, enhance services to bereaved
families, Implement screening for domestic violence, Implement screening for substance abuse,
Implement screening for smoking, Implement screening for postpartum depression
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.), Implement SIDS training programs, and Develop a community resource
directory.
Actions taken because of FIMR: I would need to email this to you in a word document. Please let me
know where to email this information.
Ethnic Populations: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 41
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area
Total number of live births
Total number of fetal deaths
Total number of infant deaths
Annual Budget: 30,000
1 million
17000
100-120
120-140
Name: Tracy Claveau
Organization: Northeast Florida Healthy Start Coalition
State: FL
Approximate cases reviewed:
Fetal Deaths, Number: 15
Neonatal Deaths, Number: 11
Post neonatal Deaths, Number: 3
Reviews with FIMR program participation: No
What does CDR and FIMR look like in your community? Currently there is no collaboration
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 40%
Community Education: Meet with community based organizations, publish an annual FIMR report
Publish a FIMR newsletter.
Service Systems Improvement: Improve bereavement referral services.
Policy Advocacy: Data not provided.
Improved Practices: Enhance services to bereaved families.
Professional Training: Implement SIDS training programs.
Actions taken because of FIMR: Increase in sleep related deaths in homes where a crib and basinet
were available. A limited survey was done to determine the reason parents were sleeping with their
infants. The results of the survey indicated the parents felt "safer", we are expanding our survey to
determine the population's definition of "safe sleep" and to determine the context of "safe" i.e street
violence, rodents/pests or mother's comfort. In the meantime we have been able to target education
to overcome barriers to the infants not being placed in their own beds
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 900,000
Total number of live births
18,000
Total number of fetal deaths 149
Total number of infant deaths 143
Annual Budget: 26,000
Name: Hillary Smith
Organization: Healthy Start at All About Women OBGYN
State: FL
Approximate cases reviewed:
NFIMR report on programs in USA and Puerto Rico, June 2016 42
Fetal Deaths, Number Since October 2015, I believe that we have reviewed less than 10 fetal deaths.
Neonatal Deaths, Number
At least 2 neonatal deaths.
Post neonatal Deaths, Number Less than 10
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community?
Members attend each other's meetings , Prevention recommendations are shared
Statute to protect FIMR teams: Not sure, we keep integrity, confidentiality and anonymity
Two-tiered system: Yes
Percentage of interviews: 100%
Why interview is not done: As much as information that is able to be collected is collected
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
conduct a media campaign to promote prenatal alcohol and drug cessation, conduct a media
campaign to promote family planning or STD screening,
Conduct a media campaign to address disparities in infant health
Conduct a media campaign about risks of prematurity
Promote breastfeeding, hold a FIMR town meeting, meet with community based organizations,
Other (please specify) Walk to Remember.
Service Systems Improvement: Eliminate a gap in family planning services,
Improve referral patterns among agencies, Improve bereavement referral services.
Policy Advocacy: I am not sure. I have only been attending FIMR since Oct 2015.
Improved Practices: Initiate or expand public health case management, expand hospital quality
assurance standards, expand services to homeless women and children, expand services to pregnant
substance abusers, enhance services to bereaved families, Expand family planning services,
Implement standardized prenatal risk assessment, Improve cultural competency protocols,
Implement screening for domestic violence, Implement screening for substance abuse,
Implement screening for smoking, Implement screening for postpartum depression.
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider education programs (e.g., management of IUGR, diabetes in pregnancy, etc.)
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.
Develop a community resource directory; Implement bereavement training.
Actions taken because of FIMR: PROBLEM: Substance abuse prevalent among expecting mothers on
the rise RECOMMENDATION: Education on risk of substance abuse in ob. offices, health department,
hospitals, media, etc. drug tests for expecting mothers who want Medicaid insurance.
INTERVENTIONS: Substance abuse training for providers, hospitals, health department, social
workers, etc. OUTCOMES: decrease in babies born dependent on substances and in the NICU. high
yield and low cost.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Faye Gardner
Organization: Capital Area Healthy Start Coalition
State: FL
Approximate cases reviewed:
Fetal Deaths:
13
NFIMR report on programs in USA and Puerto Rico, June 2016 43
Post neonatal Deaths:
16
Reviews with FIMR program participation: Child Fatality Review, Child Abuse and Neglect Review.
What does CDR and FIMR look like in your community? Members attend each other’s meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: Low maternal response to interview requests
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to promote family planning or STD screening, Promote breastfeeding,
Develop culturally relevant health education materials, Meet with community based organizations,
Publish an annual FIMR report.
Service Systems Improvement: Eliminate a gap in MCH services,
Improve referral patterns among agencies, Improve bereavement referral services,
Partner with local MOD Prematurity Campaign, Streamline MCH Medicaid application processes
Policy Advocacy:
Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis
Improved Practices: Data not provided
Professional Training: Conduct provider training on prematurity/preterm labor management
Implement SIDS training programs
Actions taken because of FIMR: FIMR recognized a need for preconception health and community
education to African American girls, focusing on the importance of personal hygiene, healthy lifestyles
and proper nutrition and has put a program, STRONGER Girls, to address these issues. It is currently at
one school in a predominantly African American neighborhood. It is hoped that with additional
funding, it can be expanded to other schools.
Ethnic Populations:
Black/ African American (If specific culture, please name)
60% White (Please specify country of origin)
33%
Other (please specify) 7%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 369998 (2014)
Total number of live births:
4023 (2014)
Total number of fetal deaths:
28 (2014)
Total number of infant deaths:
28 (2014)
Annual Budget: $21784
Name: Michelle T. Schaefer
Organization: Healthy Start Coalition of Pinellas
State: FL
Approximate cases reviewed:
Fetal Deaths: 19
Neonatal Deaths: 8
Post neonatal Deaths: 13
Reviews with FIMR program participation: CDR
NFIMR report on programs in USA and Puerto Rico, June 2016 44
What does CDR and FIMR look like in your community? Members attend each other’s meetings,
Prevention recommendations are shared
Statute to protect FIMR teams:
Unsure what is meant by "protect FIMR teams". We have a statute that allow us to collect
information from providers.
Two-tiered system: Yes
Percentage of interviews: 30%
Community Education: Conduct a media campaign to address disparities in
infant health, promote breastfeeding, hold a town health fair, develop culturally relevant health
education materials, meet with community based organizations,
Publish an annual FIMR report, Publish a FIMR newsletter.
Service Systems Improvement:
Eliminate a duplication of MCH services, Eliminate a gap in MCH services, Improve referral patterns
among agencies, Improve bereavement referral services, Streamline MCH Medicaid application
processes.
Policy Advocacy: Report FIMR findings to the Mayor, County
Executive, and/or other officials on an annual basis, Report the FIMR findings to the State MCH
Director.
Improved Practices:
Expand hospital quality assurance standards , Expand services to pregnant substance abusers Enhance
services to bereaved families, Improve cultural competency protocols ,Implement screening for
smoking , Implement screening for postpartum depression, Other (please specify) Nutrition.
Professional Training: Conduct provider training on prematurity/preterm
labor management, Conduct provider education programs (e.g., management of IUGR, diabetes in
pregnancy, etc.) Conduct provider training on use of screening tools (e.g., substance use, domestic
violence, etc.)
Implement cultural competency training, Implement SIDS training programs,
Develop a community resource directory, Implement bereavement training.
Actions taken because of FIMR:
Problem: Obesity
Recommendation: Nutritionist at home service
Intervention: Hired a nutritionist for the Healthy Start team
Outcomes: More women receiving nutritional counseling
Ethnic Populations:
Black/ African American (If specific culture, please name)
21
White (Please specify country of origin)
16
Other (please specify)
2
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Total number of live births 8100
Annual Budget: 21000
Name: Kelly Byrns-Davis
Organization: Bay, Franklin, Gulf Healthy Start Coalition, Inc.
State: FL
Approximate cases reviewed:
NFIMR report on programs in USA and Puerto Rico, June 2016 45
Fetal Deaths, Number: 10
Neonatal Deaths, Number: 15
Post neonatal Deaths, Number: 3
Other, please specify type of review & number 28 for year
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 10%
Community Education: Publish an annual FIMR report
Service Systems Improvement: Improve bereavement referral services
Policy Advocacy: Data not provided
Improved Practices: Expand services to pregnant substance abusers , Enhance services to bereaved
families
Professional Training: Implement bereavement training, Other (please specify) Substance Abuse Task
Force
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 46
Illinois has no state coordinator.
Name: Virginia Julion
Organization: FIMR
State: IL
Approximate cases reviewed:
Fetal Deaths, Number: 16
Neonatal Deaths, Number: 16
Post neonatal Deaths, Number: 0
Other, please specify type of review & number: 0
Reviews with FIMR program participation: Other (please specify)
FIMR Case Review, HIV FIMR Case Review
What does CDR and FIMR look like in your community? Currently there is no collaboration
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 12% of all referrals consented to interview
Community Education: Meet with community based organizations
Service Systems Improvement: Developed a collaboration with Better Birth Outcomes to address
interconceptual health.
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Problem: No perinatal loss support group on south side of Chicago.
Recommendation: Through a focus group meeting of parents, who had experienced a loss, the need
for a support group on the mid-south side of Chicago was discussed. From this discussion it was
determined that a support was indeed needed.
Intervention: Monthly support group meetings at one of the local charter high schools was started.
Outcome: Monthly meetings held for one year at the local high school at no charge. One year later
the school wanted to charge a rental fee for the space. The meeting site was changed to the hospital
at no cost. Due to lack of staff to support the monthly meetings, meetings were changed to meet for
Mother's/Father's Day and October Day of Remembrance. Families were referred to other support
groups on the north, west side of Chicago and south suburbs. A graduate student who lives on the
south side (Schweitzer Fellow) had experienced a fetal loss and wanted to be involved in working with
families who had also experienced a loss. She was referred to FIMR from one of the north side
support groups housed at a level three hospital. Through her networking with other agencies and
community organizations, two meeting sites were located. The first meeting was December 12, 2015
at a local neighborhood community center. The Mother's/Father's Day and October National Day of
Remembrance activities will continue along with the support group meetings.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, Muslim, Hindu and Jewish
Population in your FIMR catchment area:
Total population in the catchment area: 2,722,389 2014 estimate US Census Bureau
Total number of live births
42,805 - 2010 Illinois Department of Public Health
Total number of infant deaths 318 - 2010 Illinois Department of Public Health
Annual Budget: $164,000
NFIMR report on programs in USA and Puerto Rico, June 2016 47
Gretchen Martin is the Indiana state coordinator.
Name: Gretchen Martin
Organization: Indiana State Department of Health
State: Indiana
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Data not provided
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: I am the state coordinator and this role is very new, so this
information will have to be provided by our local teams.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Jeri Kenning
Organization: Vanderburgh County Health Dept.
State: IN
Approximate cases reviewed:
Approximately how many cases do you review in 2015 by category?
Fetal Deaths, Number: 13
Neonatal Deaths, Number: 13
Post neonatal Deaths, Number: 1
Reviews with FIMR program participation : None currently, but will be participating in CFR & Ch
Abuse/Neglect in the next few months
What does CDR and FIMR look like in your community? Currently there is no collaboration, other
(please specify) See above
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: We originally did maternal interviews, but stopped doing them after we
had little success in meeting with those families. Incentives were offered, including support, but still
few families were interested. We are currently planning on re- starting these interviews in the coming
year.
Community Education: Conduct a media campaign about risks of prematurity, Promote
breastfeeding, Meet with community based organizations, Publish an annual FIMR report, Safe Sleep
NFIMR report on programs in USA and Puerto Rico, June 2016 48
project for crib distribution, community education for prenatal clients to access transportation to
prenatal appts, easier Medicaid enrollment.
Service Systems Improvement: Improve referral patterns among agencies
Policy Advocacy: Initiate a Mayoral or Governor’s proclamation of a day or week promoting MCH
Improved Practices: Expand hospital quality assurance standards, Implement screening for domestic
violence, Implement screening for substance abuse, and Implement screening for smoking
Professional Training: Develop a community resource directory
Actions taken because of FIMR: Problem- A lack of safe sleep was noted for several years as a factor
in 2+ infant deaths annually. Recommendation-A Safe Crib program was needed in our community.
Interventions: Community partners reached out, sought grants, & we received a grant to allow free
pack n plays to be given to those families who needed one. As a requirement, they had to watch a
video and receive safe sleep info prior to receiving the PNP.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0tribes/nations): 0
Asian (Please specify country of origin) 1%
Black/ African American (If specific culture, please name)
14%
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other) 1%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American) 9%
White (Please specify country of origin) 75%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: 210,000
Annual Budget: 20,000
Name: Amy Williams
Organization: Elkhart County Health Dept., Healthy Beginnings: Elk Co FIMR
State: IN
Approximate cases reviewed:
Fetal Deaths, Number 0
Neonatal Deaths, Number
0
Post neonatal Deaths, Number 0
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Cases will typically include family interview but
Our program has not yet started reviewing cases.
Community Education: We have not yet started reviewing cases. We are
currently meeting with other community based organizations to establish community connections
and build our CRT & CAT. We hope to be able to have more community actions related to Community
Education once our program gets started!
Service Systems Improvement: We have not yet started reviewing cases. We hope to contribute
community actions related to “Service Systems Improvement/Linkages” once our program gets
started!
Policy Advocacy: We have not yet started reviewing cases. We hope to take Policy/Advocacy where
we will connect to the political body that has the ability to make policy change and take action.
NFIMR report on programs in USA and Puerto Rico, June 2016 49
Improved Practices: We have not yet started reviewing cases. We hope to be able to contribute
community actions to Improve Practices, Programs and Policies if found necessary.
Professional Training: We have not yet started reviewing cases. We hope to be able to take actions
that will result in the development of specific training or training materials for providers in our
community if found that these actions are needed.
Actions taken because of FIMR: We haven't reviewed any cases yet but hope to be able to be able to
contribute information on our future successes at a later time.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Genice Smithson
Organization: East Central Indiana FIMR
State: IN
Approximate cases reviewed:
Fetal Deaths:
12
Neonatal Deaths: 3
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Joint reviews are conducted,
Meetings are coordinated, Prevention recommendations are shared,
We review vital records of infant and fetal death then split for review of actual cases.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Promote breastfeeding, Develop culturally relevant health education
materials, Meet with community based organizations, We have participated in health fairs, we have a
text messaging system, FB page, and twitter.
Service Systems Improvement: Improve bereavement referral services,
Other (please specify) We distribute MOD material.
Policy Advocacy: Improve bereavement referral services,
Other (please specify) We distribute MOD material
Improved Practices:
Expand services to pregnant substance abusers, Implement screening for domestic violence,
Implement screening for substance abuse, Implement screening for smoking,
Implement screening for postpartum depression.
Professional Training: Education programs on safe sleep initiative
Actions taken because of FIMR: Problem: Infant deaths relating to unsafe sleep practices.
Recommendation: Care coordination and education in safe sleep practices, and referrals for pak-nplays, infant deaths should decrease.
Interventions: AAP guidelines for safe sleep practices and environment for all staff in the Women and
Children's Service.
Line at local hospital, family residency clinics, Women's Health Clinic, and EMS/Fire Departments.
Posters and brochures to be distributed from hospital, Women's Clinic, Family Residency Clinic, OB
offices, Perinatal Center, EMS/Fire Departments, and local Health Department.
NFIMR report on programs in USA and Puerto Rico, June 2016 50
Outcomes: Review of ongoing FIMR cases and survey on community knowledge on safe sleep
practices and environment ongoing.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 294,738 (2010 Census)
Total number of live births 1600-1800
Annual Budget: Data not provided
Name: Teri Conrad
Organization: Marion County Public Health Department
State: IN
Approximate cases reviewed:
Fetal Deaths: 25
Neonatal Deaths: 50
Post neonatal Deaths: 32
Reviews with FIMR program participation: Child Fatality Review, Stillbirth Review Programs, LWB
Review with NFP Clients
What does CDR and FIMR look like in your community?
Staff works on both CDR and FIMR, the recent NFIMR training was attended by DCS
members & they have joined the FIMR team.
Statute to protect FIMR teams:
Have used the CFR statute. But there is a need for one.
Two-tiered system: Yes
Percentage of interviews: 36%
Community Education: Conduct a media campaign to encourage early and
continuous prenatal care, conduct a media campaign to promote prenatal
alcohol and drug cessation, conduct a media campaign to promote family
planning or STD screening, Develop culturally relevant health education materials
Meet with community based organizations, these actions are in collaboration with other MCH
Programs.
Service Systems Improvement: Improve referral patterns among agencies,
Improve bereavement referral services.
Policy Advocacy: Data not provided
Improved Practices: Enhance services to bereaved families, Implement screening for smoking,
In collaboration with other MCH agencies.
Professional Training: Data not available
Actions taken because of FIMR:
Problem: Need for knowledge of home visitors about signs & symptoms of Neonatal Abstinence
Syndrome.
Recommendation: NAS speaker for in service of signs & symptoms of NAS
Intervention: Planning of in service for home visitors of three community programs
Outcomes: Continued assessment of home visitor needs for substance use assessment and referrals
for treatment options.
Ethnic Populations:
NFIMR report on programs in USA and Puerto Rico, June 2016 51
American Indian/ Alaska Native (Please
specify
NA tribes/nations)
Asian (Please specify country of origin)
10% Burma, India, Black/ African
American (If specific culture, please name)
55%
Pacific Islander (Please specify if Native Hawaiian,
Guamanian, Samoan or Other)
0
Hispanic/ Spanish/ Latino (Please specify
Mexican, Puerto
Spain, Central and/or South American)
7% Rican, Cuban, Descendants of
White (Please specify country of origin)
36%
Special Religious or Cultural Subgroups: Yes
Population in your FIMR catchment area:
Total population in the catchment area: 852,866
Total number of live births: 12,415
Total number of fetal deaths: 118
Total number of infant deaths: 116
Annual Budget: 142,000 (Including 2 full time nurse staff and 2
irregular part time nurses.
NFIMR report on programs in USA and Puerto Rico, June 2016 52
Kansas has no state coordinator.
Name: Diane Creek
Organization: Shawnee County Health Agency
State: KS
Approximate cases reviewed:
Fetal Deaths, Number: 5
Neonatal Deaths, Number: 3
Reviews with FIMR program participation: None
What does CDR and FIMR look like in your community? We have met with the CDR Executive
Director once to talk about the possibility of collaboration.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: We've had a hard time getting moms to agree to an interview. We've had
one interview. We've changed our Maternal Interviewer in the hopes that it will help engage moms.
Community Education: Community Baby Shower with the emphasis being Safe Sleep
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: We just finished our first year of CRT. Recommendations are
currently going to the CAT. We are very early in the process.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Our program will serve special religious or cultural subgroups
if we encounter them. So far we haven't.
Population in your FIMR catchment area:
Total population in the catchment area 178,000
Total number of live births
2339 in 2014
Total number of fetal deaths not available
Total number of infant deaths 15 in 2013. Most current data
Annual Budget: Data not provided
Name: Jennifer Allen
Organization: Unified Government Public Health Department
State: KS
Approximate cases reviewed:
Fetal Deaths: 8
Post neonatal Deaths: 1
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 50%
Community Education: Meet with community based organizations, Press release and media coverage
about infant mortality in our county. Pregnancy and infant loss
NFIMR report on programs in USA and Puerto Rico, June 2016 53
candle light vigil.
Service Systems Improvement: Improve referral patterns among agencies, Improve bereavement
referral services, Streamline MCH Medicaid application processes
Policy Advocacy: Include the Mayor or County Executive as a FIMR,
Community Action Team member.
Improved Practices: Enhance services to bereaved families, Expand family planning services,
Implement screening for smoking, Implement screening for postpartum depression.
Professional Training: Implement SIDS training programs, smoking cessation.
Actions taken because of FIMR: We are currently working with the Kansas Medicaid program
(KanCare) on expediting Medicaid cards for pregnant women. We are in the very early stages of this
process
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 158,000
Total number of live births: 3,000
Total number of fetal deaths: 18
Total number of infant deaths: 6
Annual Budget: 83,650
NFIMR report on programs in USA and Puerto Rico, June 2016 54
Name: Sarah Talley
Organization: Geary County FIMR
State: KS
Approximate cases reviewed:
Fetal Deaths:
4
Neonatal Deaths:
3
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 43%
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign about risks of prematurity, Promote breastfeeding, Develop culturally
relevant health education materials, Meet with community based organizations, Publish an annual
FIMR report
Service Systems Improvement: Improve referral patterns among agencies, Improve bereavement
referral services
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Include the Mayor or County Executive as a FIMR Community Action Team member,
MOA with US Military to allow record abstraction
Improved Practices: Enhance services to bereaved families
Professional Training: Implement cultural competency assessment for FIMR team members
Actions taken because of FIMR: Data not provided
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0tribes/nations)
Asian (Please specify country of origin) 0
Black/ African American (If specific culture, please name)
9%
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other)
0%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
13%
White (Please specify country of origin) 38%
Other (please specify) 40% multi-race
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 34,362
Total number of live births:
1,052
Total number of fetal deaths:
5
Total number of infant deaths: 5
Annual Budget: $74,900
NFIMR report on programs in USA and Puerto Rico, June 2016 55
Robin Gruenfeld is the Louisiana state coordinator.
Name: Robin Gruenfeld
Organization: Louisiana Bureau of Family Health
State: LA
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review ,
Other SIDS review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR, Funding is shared,
Members attend each other's meetings, Cases are triaged into FIMR or CDR, Prevention
recommendations are developed jointly, Prevention recommendations are shared, Other (please
specify), We have joint Community Action Team meetings at the regional level.
Statute to protect FIMR teams: No
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: We do not presently conduct maternal interviews.
Community Education: Conduct a media campaign to encourage early and continuous prenatal
care, Conduct a media campaign to encourage early and continuous prenatal care, Conduct a
media campaign to promote family planning or STD screening, Conduct a media campaign about
risks of prematurity, Promote breastfeeding, Develop culturally relevant health education
materials, Meet with community based organizations, Publish an annual FIMR report
Service Systems Improvement: Develop a 24/7 prenatal hotline,
Partner with local MOD Prematurity Campaign , Streamline MCH Medicaid application processes
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on
an annual basis, Include the Mayor or County Executive as a FIMR Community Action Team
member, Report the FIMR findings to the State MCH Director, Develop local or state legislation
Improved Practices: Implement screening for domestic violence, Implement screening for
substance abuse, Implement screening for smoking, Implement screening for postpartum
depression
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.)
Implement SIDS training programs , Develop a community resource directory
Actions taken because of FIMR:
PROBLEM: Growing number of NAS cases in Louisiana and a sense that legislature was going to get
involved RECOMMENDATION: Intervene so any decisions made by legislature would be informed
and promote the wellbeing of Louisiana's families
INTERVENTION: A study resolution passed legislature in 2015 granting permission for the Perinatal
Commission on the Prevention of Infant Mortality (the State-level FIMR action body) to conduct a
study resolution on NAS
OUTCOMES: Study will be complete in March 2016.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, We have a high concentration of Latino and
Vietnamese populations in certain areas
Name: Shelley Ryan Gray
NFIMR report on programs in USA and Puerto Rico, June 2016 56
Organization: Bureau of Family Health
State: LA
Approximate cases reviewed:
Fetal Deaths, Number in 2014-16
Neonatal Deaths, Number in 2014-18
Post neonatal Deaths, Number Included in Neonatal deaths
Other, please specify type of review & number SUID is handled with Child Death Review
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR, Members attend each other's meetings,
Meetings are coordinated, Prevention recommendations are developed jointly,
Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Supported Safe Sleep through an October 2015
Campaign.
Service Systems Improvement: Improve bereavement referral services
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Expansion of Nurse Family Partnership and Parents as Teachers
Home Visiting programs. Bringing a Black Mother's
Breastfeeding Support program to a low income community. Expanding GIFT program.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Martha Hennegan
Organization: Department of Health and Hospitals, Office of Public Health
State: LA
Approximate cases reviewed:
Fetal Deaths: 1
Neonatal Deaths: 1
Post neonatal Deaths: 18
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review,
Other SIDS review.
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR,
Members attend each other's meetings, Joint reviews are conducted, Prevention recommendations
are developed jointly , Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Ethnic Populations: Data not provided
Percentage of interviews: Data not provided
Community Education: Promote breastfeeding, Meet with community based organizations.
NFIMR report on programs in USA and Puerto Rico, June 2016 57
Service Systems Improvement: Eliminate a duplication of MCH services ,Eliminate a gap in MCH
services, Improve bereavement referral services , Implement “one-stop-shopping” prenatal care
Policy Advocacy: Report FIMR findings to the Mayor, County
Executive, and/or other officials on an annual basis, Include the Mayor or County Executive as a FIMR
Community Action Team member, Report the FIMR findings to the State MCH Director.
Improved Practices: Expand services to homeless women and children , Improve cultural competency
protocols.
Professional Training: Implement cultural competency training
Actions taken because of FIMR:
State MCH coordinators contacted every delivering hospital in the state, requested they review their
safe sleep policy, provide an initial evaluation and post review once given the most recent materials
from MCH regarding Safe Sleep.
Over the course of 6 months, many hospitals revised their admission assessment to include the
question "where will your baby sleep when you are home" in conjunction with that question about
the infant car seat. Additionally, virtually
ALL hospitals enhanced their parent/family education about Safe Sleep and received a certificate as
Safe Sleep Champion.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: No
Annual Budget: Data not provided
Name: Lisa Norman
Organization: Bureau of Family Health, Louisiana Office of Public Health
State: LA
Approximate cases reviewed:
Fetal Deaths, Number: 9
Neonatal Deaths, Number: 4
Post neonatal Deaths, Number: 5
Other(SUID): 7
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review,
Other SIDS review, CDC SUID review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR, Funding is shared,
Members attend each other's meetings.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to promote prenatal alcohol and drug cessation
Promote breastfeeding, Hold a town health fair, Hold a FIMR town meeting,
Develop culturally relevant health education materials
Meet with community based organizations
Service Systems Improvement: Eliminate a gap in MCH services, Improve referral patterns among
agencies, Improve bereavement referral services, Partner with local MOD Prematurity Campaign.
Policy Advocacy: Report the FIMR findings to the State MCH Director
Develop a policy in collaboration with City or County law enforcement offices or emergency services
Develop local or state legislation.
NFIMR report on programs in USA and Puerto Rico, June 2016 58
Improved Practices: Expand hospital quality assurance standards , Expand services to homeless
women and children, Expand services to pregnant substance abusers , Implement screening for
domestic violence, Implement screening for substance abuse , Implement screening for smoking.
Professional Training: Implement SIDS training programs , Develop a community resource directory
Actions taken because of FIMR: Data not provided
Ethnic Populations:
American Indian/ Alaska Native (Please specify
tribes/nations)
1
Asian (Please specify country of origin)
0
Black/ African American (If specific culture, please name)
56
Pacific Islander (Please specify if Native Hawaiian,
Guamanian, Samoan or Other)
0
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto
Rican, Cuban, Descendants of Spain, Central
and/or South American)
1
White (Please specify country of origin)
38 USA
Data not available
4
Special Religious or Cultural Subgroups: Yes, Migrant workers, primarily Hispanic, seasonal workers in
nursery/plant business Small local Czech community
Population in your FIMR catchment area:
Total population in the catchment area 308,348 (2014)
Total number of live births
4173 (2006-2010)
Total number of fetal deaths unknown (request submitted to state BFH Epidemiologist; will forward
when received)
Total number of infant deaths unknown (request submitted to state BFH Epidemiologist; will forward
when received
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 59
Latoya Hill and Alison Whitney are the Maryland state coordinators.
Name: Alison Whitney
Organization: Maryland Department of Health and Mental Hygiene
State: MD
Which Agency leads the coordination of your FIMR program?: County/City Health Department,
Other (please specify) Also at the state level
Do members of a federal Healthy Start participate in your FIMR team(s)?: Data not provided
Reviews with FIMR program participation: In some counties, team members overlap between CFR
and FIMR.
What does CDR and FIMR collaboration look like in your community?: Leadership is housed in one
organization, Staff works on both CDR and FIMR, Funding is shared,
Members attend each other's meetings , Cases are triaged into FIMR or CDR
Which of these theories/methods are being implemented in conjunction with FIMR?: Varies from
team to team.
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin? : 1990s
Approximately how many cases do you review in 2015 by category?: Data not provided
Percentage of Interview: Data not provided
Two tiered system: Yes
Please tell us more about your Community Action Team. The CAT is: Developed solely for the FIMR
program
Community Education: Promote breastfeeding, Hold a town health fair,
Meet with community based organizations, Other (please specify) Specific to local teams
Service Systems Improvement: Improve referral patterns among agencies,
Partner with local MOD Prematurity Campaign , Other (please specify) Specific to local teams
Policy Advocacy: Report the FIMR findings to the State MCH Director
Develop a policy in collaboration with City or County law enforcement offices or emergency services
Improved Practices, Programs, and Policies: Implement standardized prenatal risk assessment ,
Other (please specify) Specific to local teams
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.) Implement SIDS training programs, Specific to local teams.
Actions taken because of FIMR: PROBLEM: Reported maternal history of tobacco use
RECOMMENDATION: Improve provider knowledge of available tobacco cessation services
INTERVENTION: Obtaining funds from DHMH’s tobacco grant fund, PATCH, and holding a smoking
cessation strategic planning summit for over 70 providers
OUTCOMES: Pending
Ethnic Populations: Data not provided
Special Populations: No
Population in your FIMR catchment area:
Total population in the catchment area: 5.976 million
Total number of live births: 73, 588
Total number of fetal deaths: 566
Total number of infant deaths: 476
Annual Budget: $2,102,403
How many funded staff are on the state level?:
2
NFIMR report on programs in USA and Puerto Rico, June 2016 60
How many in-kind staff are on the state level?:
0
What are the functions of the state program? Technical assistance to local teams,
Coordination of local teams , Training of local teams, Data collection and reporting
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
Name: Latoya Hill
Organization: Maryland DHMH
State: Maryland
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Data not provided
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Kristen Newman
Organization: Prince George’s County Health Department
State: MD
Approximate cases reviewed:
Fetal Deaths: 8
Neonatal Deaths: 0
Post neonatal Deaths: 0
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR , Funding is shared, Members attend each other's meetings.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Meet with community based organizations
Service Systems Improvement: Improve referral patterns among agencies, Partner with local MOD
Prematurity Campaign
Policy Advocacy: Report to the FIMR findings to the State MCH Director
Improved Practices: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 61
Professional Training: Implement SIDS training programs
Actions taken because of FIMR:
PROBLEM: Lack of educational opportunities for service providers for women, infants and families
within the community. Lack of networking opportunities for organizations and providers of
community resources that support infant mortality.
RECOMMENDATION: Create educational opportunity(s) that allow service providers to remain up to
date on national and local initiatives that allow for coordination of services and the ability to network
to support one another.
INTERVENTIONS: Held one-day Infant Mortality Conference that allowed for networking and
educational sessions covering national and local initiatives along with current issues of concern.
OUTCOMES: Conference well attended, increased service coordination and networking allowed for
on-going information sharing to improve services for women, infants and families in the community.
Formal statistics not yet available, conference held this past fall.
Ethnic Populations:
American Indian/ Alaska Native (Please specify
0
tribes/nations)
Asian (Please specify country of origin)
0
Black/ African American (If specific culture, please name)
75 %
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
25%
White (Please specify country of origin) 0
Foreign-Born/ Immigrants
12.5%
Other (please specify) 0
Special Religious or Cultural Subgroups: Yes
Yes, this program serves a large immigrant population that encompasses a wide array of religious and
cultural subgroups. ie.. Hispanic (Guatemalan, Honduran, El Salvadoran, Nicaraguan); Thai;
Vietnamese; Guinea; Congo; Nigerian;
Tanzania; Ghana. Religious subgroups: Jehovah Witness, Hindu, Islam, Roman Catholic, Baptist are
some of the subgroups.
Population in your FIMR catchment area:
Total population in the catchment area: 904,430
Total number of live births: 12,288
Total number of fetal deaths: 140
Total number of infant deaths: 92
Annual Budget: Data not provided
Name: Tina Baird
Organization: Allegany County Health Department
State: MD
Approximate cases reviewed:
Fetal Deaths: 2
Neonatal Deaths: 2
Post neonatal Deaths: 1
Reviews with FIMR program participation: Child Fatality Review
NFIMR report on programs in USA and Puerto Rico, June 2016 62
What does CDR and FIMR look like in your community? There is no CDR in my community, Child
Fatality Review Board does death review of birth- age 18
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 80%
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to promote prenatal alcohol and drug cessation,
Conduct a media campaign to promote family planning or STD screening,
Conduct a media campaign to address disparities in infant health,
Conduct a media campaign about risks of prematurity,
Meet with community based organizations.
Service Systems Improvement: Eliminate a duplication of MCH services, Eliminate a gap in MCH
services, Eliminate a gap in family planning services, Improve referral patterns among agencies,
Improve bereavement referral services , Implement “one-stop-shopping” prenatal care,
Improve/develop transportation routes to MCH services with the City or County Transportation
Department, Streamline MCH Medicaid application processes.
Policy Advocacy:
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis, report
the FIMR findings to the State MCH Director.
Develop a policy in collaboration with City or County law enforcement offices or emergency services.
Improved Practices: Expand hospital quality assurance standards,
Expand services to pregnant substance abusers, Enhance services to bereaved families,
Expand family planning services, Implement standardized prenatal risk assessment,
Implement screening for substance abuse, Implement screening for smoking,
Implement screening for postpartum depression
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc. Implement SIDS training programs , Develop a community resource directory
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Judy Churn
Organization: Hartford County Health Department
State: Maryland
Approximate cases reviewed:
Fetal Deaths: 2
Neonatal Death: 2
Post neonatal Death: 5
Reviews with FIMR program participation: Child Fatality Review, FIMR and CFR Coordinator is same
person
What does CDR and FIMR look like in your community?
Staff works on both CDR and FIMR, Members attend each other's meetings, Cases are triaged into
FIMR or CDR, Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
NFIMR report on programs in USA and Puerto Rico, June 2016 63
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Data not provided
Service Systems Improvement: Improve referral patterns among agencies
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices:
Initiate or expand public health case management, Expand services to pregnant substance abusers,
Implement screening for domestic violence, Implement screening for substance abuse , Implement
screening for smoking, Implement screening for postpartum depression.
Professional Training: Data not provided
Actions taken because of FIMR:
P: Significant increase in number of substance exposed newborns (SEN) born at local hospital. Per DSS
referrals, our county ranked 4 of 23 in 2014.
R: Develop a post-partum referral process from local hospital discharges of SENs to LHD and DSS.
I: Local hospital screens all deliveries and refers 100% of SENs to LHD and DSS.
I: LHD implemented a small home visiting program for SENs and mothers to ensure/refer to drug
treatment, mental
health, medical home for mom and baby, compliance with pediatric care/postpartum exam,
parenting, supplies,
community resources/safe sleep.
O: Local hospital is referring 100% of SEN cases to DSS and LHD. DSS and LHD hold monthly multi-d
meetings to review cases and develop plan for care.
New problem: Local hospital only delivers 40% of county residents. Other deliveries are out of county,
and out of county hospitals do not refer cases to LHD. Will need to work on non-referring hospitals.
Ethnic Populations:
Black/ African American (If specific culture, please name)
10
White (Please specify country of origin)
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total number of live births: 2900
Total number of fetal deaths: 10-15
Total number of infant deaths: 8-10
Annual Budget: Data not provided
90
Name: Patti Murphy
Organization: Washington County Health Department
State: MD
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Cases are triaged into FIMR or CDR,
Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 1%
Community Education: Promote breastfeeding, Develop culturally relevant health education
materials, Meet with community based organizations.
NFIMR report on programs in USA and Puerto Rico, June 2016 64
Service Systems Improvement: Improve bereavement referral services ,Partner with local MOD
Prematurity Campaign, Improve/develop transportation routes to MCH services with the City or
County Transportation Department Streamline MCH Medicaid application processes.
Policy Advocacy:
Improve bereavement referral services, Partner with local MOD Prematurity Campaign,
Improve/develop transportation routes to MCH services with the City or County Transportation
Department, Streamline MCH Medicaid application processes
Improved Practices:
Expand services to homeless women and children,
Expand services to pregnant substance abusers.
Professional Training: Conduct provider education programs (e.g.,
management of IUGR, diabetes in pregnancy, etc.)
Actions taken because of FIMR:
Problem: Parents still using bumper pads and drop sided cribs. Recommendation: Teaching needed to
educate parents regarding the dangers of this. Interventions; Educational materials provided to
pediatricians, PCP's and community regarding
the dangers of bumper pads and drop sided cribs. Problem: Unsafe sleep practices still being used by
parents.
Recommendation: Education provided to providers regarding safe sleep practices. A letter
encouraging all providers to teach this to parents and grandparents was also included in their
materials. Intervention: A packet of safe sleep material was distributed to all providers in the county.
Special Religious or Cultural Subgroups: Yes, any group that has a loss
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Lisa Helms Guba
Organization: Anne Arundel County Department of Health
State: MD
Approximate cases reviewed:
Fetal Deaths:
4
Post neonatal Death: 4
about 80 fetal/infant deaths per a year
FIMR Programs in other reviews: Child Fatality Review, Other (please specify)
Heroin Overdose Fatality Review Committee
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR, Funding is shared,
Members attend each other's meetings, Cases are triaged into FIMR or CDR, Meetings are
coordinated, Prevention recommendations are developed jointly, and Prevention recommendations
are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 25%
Why interview is not done: We send a letter to all moms who have had a fetal/infant loss that reside
in our county. Typically, we do 2 maternal interviews/year and typically just with the mother.
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
NFIMR report on programs in USA and Puerto Rico, June 2016 65
Conduct a media campaign to promote prenatal alcohol and drug cessation
Conduct a media campaign to address disparities in infant health
Conduct a media campaign about risks of prematurity, promote breastfeeding, develop culturally
relevant health education materials, meet with community based organizations, publish an annual
FIMR report, publish a monthly healthy babies press release; send letters to ob/gyn and pediatricians
on safe sleep.
Service Systems Improvement: Improve referral patterns among agencies,
Improve bereavement referral services, Streamline MCH Medicaid application processes
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices:
Expand services to pregnant substance abusers, enhance services to bereaved families,
Expand family planning services, Implement screening for domestic violence,
Implement screening for substance abuse, Implement screening for smoking,
Implement screening for postpartum depression
Professional Training: Implement SIDS training programs
Actions taken because of FIMR: We developed a website for both families and providers on issues
relating to pregnancy and healthy babies- http://aahealthybabies.org/
We are now working on substance abuse in pregnancy with our birthing hospitals testing for
substance abuse- http://aahealthybabies.org/pdf/PAdeathbrief.pdf
We have a new statewide substance abuse in pregnancy toolkithttp://aaphysicians.org/pdf/substance-use-in- pregnancy.pdf
We developed a flyer on substance abuse in pregnancyhttp://aahealthybabies.org/pdf/AlcoholDrugUsePregnancy.pdf We developed an annual report on
infant health - http://aahealth.org/pdf/infant-health-report-2015.pdf
We developed rack cards for both families and providers- http://aahealthybabies.org/parents-infantres.html
Problem- 28 infants have died from SIDS in our county since 2010. However, a recent postpartum
survey of County Healthy Start parents found only 48 percent of clients received education from their
pediatricians, even fewer, six percent, reported obtaining such information from their obstetricians.
Recommendation: Send a letter to all pediatricians and obs in our county in 2015 and 2016.
Intervention- Letter sent to all pediatricians and obs in our county in 2015 and 2016.
Outcome- Review infant death cases with a decrease in the number of SIDS/SUID Cases.
Ethnic Populations:
Asian (Please specify country of origin) 5%
Black/ African American (If specific culture, please name)
70%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American) 5%
White (Please specify country of origin) 20%
Foreign-Born/ Immigrants
4%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
NFIMR report on programs in USA and Puerto Rico, June 2016 66
Total population in the catchment area: 560,133 (in 2014)
Total number of live births:
6968
Total number of fetal deaths
35
Total number of infant deaths 37
Annual Budget: $38,687 (budget is for FIMR, CAT team and Child
Fatality Review)
Name: Melissa Aftoora
Organization:
State: MD
Approximate cases reviewed:
Fetal Deaths: 3
Neonatal Deaths: 2
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR ,
Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Why interview is not done: We receive cases and records long after the fetal or infant death it's
difficult to get a maternal interview.
Community Education: conducted a media campaign to encourage Safe Sleep
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Expand services to pregnant substance abusers
Professional Training: Data not provided
Actions taken because of FIMR: Each year our team does the March for babies walk through the
March of dimes in May and we raise 500.00 each year.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Cathy Costa
Organization: Baltimore City Health Department
State: MD
Approximate cases reviewed:
Fetal Deaths: 20
Neonatal Deaths: 8
Postneonatal Deaths: 2
Reviews with FIMR program participation: Child Fatality Review , Domestic Violence Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR , Funding is shared, Members attend each other's meetings , Cases
are triaged into FIMR or CDR.
Statute to protect FIMR teams: Yes
NFIMR report on programs in USA and Puerto Rico, June 2016 67
Two-tiered system: Yes
Percentage of interviews: 25
Why interview is not done: We attempt to get interviews for all cases, but are only successful in
about a quarter to a third of all cases.
Community Education: Conduct a media campaign to promote prenatal alcohol and drug cessation
Conduct a media campaign to promote family planning or STD screening
Promote breastfeeding, hold a town health fair, develop culturally relevant health education
materials, Meet with community based organizations, Publish an annual FIMR report,
Extensive community education on smoking cessation.
Service Systems Improvement: Eliminate a duplication of MCH services, eliminate a gap in MCH
services, Eliminate a gap in family planning services, Improve referral patterns among agencies ,
Improve bereavement referral services, Improve Prenatal Risk Assessment processes.
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis
Include the Deputy Mayor as a Community Action Team member
Improved Practices: Initiate or expand public health case management, expand services to pregnant
substance abusers, enhance services to bereaved families, Expand family planning services,
Implement standardized prenatal risk assessment, Implement screening for substance abuse,
Implement screening for smoking.
Professional Training: Conduct provider education programs (e.g., management of IUGR, diabetes in
pregnancy, etc.)
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement bereavement training.
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Lower Shore Tri-County FIMR
Organization: Wicomico, Worchester & Somerset Health Department
State: MD
Approximate cases reviewed: 12 fetal deaths reported, 4 Infant reported
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR, Funding is shared,
Members attend each other's meetings.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: Although efforts are always made to interview family - it is typically
declined by the family stating they would like to "move on" or we are unable to reach the family (last
known address or phone number is no longer correct)
Community Education: Promote breastfeeding, Meet with community based organizations
Service Systems Improvement:
NFIMR report on programs in USA and Puerto Rico, June 2016 68
Name: Betsy Bridgett
Organization: Calvert County
State: MD
Approximate cases reviewed:
Fetal Deaths:
5
Neonatal Deaths:
5
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization , Staff works on both CDR and FIMR, Funding is shared
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 10
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Eliminate a gap in MCH services, Eliminate a gap in family planning services ,Improve referral patterns
among agencies, Improve bereavement referral services.
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
Lower Shore FIMR Community Action Plan July 2014 – June 2016
Goal: By the end of FY 2016, heighten community awareness of the importance of preconception,
prenatal health care and other services to promote healthy birth outcomes.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area Tri-County 2014 -179,073
Total number of live births
1914
Total number of fetal deaths 27
Total number of infant deaths 18
Annual Budget: Data not provided
Name: Lois Beverage
Organization: Charles County Department of Health
State: MD
Approximate cases reviewed:
Fetal Deaths, Number: 17
Neonatal Deaths, Number: 0
NFIMR report on programs in USA and Puerto Rico, June 2016 69
Post neonatal Deaths, Number:3
Other, please specify type of review & number: 0
Reviews with FIMR program participation: Child Fatality Review,
Child Abuse and Neglect Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization ,
Staff works on both CDR and FIMR, Members attend each other's meetings , Meetings are
coordinated, Prevention recommendations are shared
Statute to protect FIMR teams: If No, Please Explain Why
I am not sure I understand this question
Two-tiered system: Yes
Percentage of interviews: Data not available
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
conduct a media campaign to address disparities in infant health, conduct a media campaign about
risks of prematurity, Promote breastfeeding,
Other (please specify) Safe Infant Environment
Service Systems Improvement: Improve/develop transportation routes to MCH services with the City
or County Transportation Department
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis
Improved Practices: Implement screening for drug abuse
Professional Training: Implement training on care of the drug affected newborn.
Actions taken because of FIMR: Concern regarding safe sleep environment for infants. Distribution
of safe sleep DVD, face to face education by trained professionals, outcome: reduction in unsafe sleep
related deaths.
Ethnic Populations: Data not available
Special Religious or Cultural Subgroups: Yes
Population in your FIMR catchment area: Unknown
Annual Budget: $49,000.00
Name: Jan Sparks
Organization: Frederick County Health Dept. of Maryland
State: MD
Approximate cases reviewed:
Fetal Deaths, Number: 14
Neonatal Deaths, Number: 4
Post neonatal Deaths, Number: 0
Other, please specify type of review & number: 0
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR , Funding
is shared, Prevention recommendations are developed jointly , Prevention recommendations are
shared
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 83 % 5 out 6 reviews, the other case interview
done by hospice nurse involved since mother was pregnant again and did not want to interview
Community Education: Develop culturally relevant health education materials
NFIMR report on programs in USA and Puerto Rico, June 2016 70
Meet with community based organizations, Publish an annual FIMR report,
Media Ad program for vehicle heat safety; Focus on Health u tube and local county government
channel.
Service Systems Improvement: Improve bereavement referral services
Policy Advocacy: Report the FIMR findings to the State MCH Director
Other (please specify) State FIMR Coordinator
Improved Practices: Enhance services to bereaved families
Professional Training: Implement bereavement training
Actions taken because of FIMR:
Problem: Lack of collective brochure for mothers with perinatal loss
Recommendation: Develop brochure for OB offices, hospitals, funeral homes with information for
bereavement services Interventions: Brochure in English, Spanish, and Burmese developed and
distributed to local funeral homes, OB offices, Pregnancy Centers, Parish Nurses, local and out of
county hospitals where county mothers deliver.
Outcomes: During maternal interview, 80% of mothers say they have seen the brochure or have it. It
has been helpful
Ethnic Populations:
Black/ African American (If specific culture, please name)
16%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)17%
White (Please specify country of origin) 50%
Foreign-Born/ Immigrants
11%
Other (please specify) 5%
Data not provided
11%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 245,000
Total number of live births: 2,700
Total number of fetal deaths: 15
Total number of infant death:13
Annual Budget: 24,000
Name: Susan Russ
Organization: Caroline County Health Department
State: MD
Approximate cases reviewed:
Fetal Deaths:
2
Neonatal Deaths: 4
Post neonatal Deaths: 2
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 0
Community Education: Develop culturally relevant health education materials
Meet with community based organizations
NFIMR report on programs in USA and Puerto Rico, June 2016 71
Service Systems Improvement: Eliminate a gap in MCH services,
Improve referral patterns among agencies,
Improve/develop transportation routes to MCH services with the City or County Transportation
Department.
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Expand services to pregnant substance abusers,
Improve cultural competency protocols, Implement screening for domestic violence,
Implement screening for substance abuse, Implement screening for smoking,
Implement screening for postpartum depression.
Professional Training: Develop a community resource directory
Actions taken because of FIMR:
Problem: Delay in receiving referrals from local providers/hospitals/DHMH have resulted in
ineffective case reviews and lack of maternal interviews.
Recommendation: Need improvement in timeliness of receiving referrals.
Interventions: Contact and training with local providers on the importance of more timely referrals so
that case review quality improves.
Outcomes: This process is ongoing with local providers - goal is to improve case reviews and obtain
more maternal interviews. This goal will also help to improve the Mid-Shore FIMR collaborative team
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0% tribes/nations)
Asian (Please specify country of origin) 0% Black/ African American (If specific culture, please name)
45%
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)0% 25%
White (Please specify country of origin) 25%
Foreign-Born/ Immigrants
5%
Special Religious or Cultural Subgroups: Yes, Hispanics from Central American countries
Population in your FIMR catchment area: Data not provided
Annual Budget: $22,482
Name: Ruth Baker
Organization: Dorchester County Health Department
State: MD
Approximate cases reviewed:
Fetal Deaths, Number: 5
Neonatal Deaths, Number: 0
Post neonatal Deaths, Number: 0
Other, please specify type of review & number: 0
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Hold a town health fair, Other (please specify)
NFIMR report on programs in USA and Puerto Rico, June 2016 72
Conduct a media campaign on safe-sleep
Service Systems Improvement:
Policy Advocacy: Data not provided
Improved Practices: Implement standardized prenatal risk assessment, Implement screening for
domestic violence, Implement screening for substance abuse,
Implement screening for smoking
Professional Training: Data not provided
Actions taken because of FIMR: regional team noted increased incidents of fetal deaths related to
safe sleep. Media campaign launched with PSA spots shown at the local movie theaters regarding safe
sleep. Decrease noted in cases of fetal death related to sleep issues. Wallet inserts created and hand
out that gave information on signs & sx. of preterm labor and dental care in pregnancy.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, Hispanic/Spanish speaking
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Cindy Marucci-Bosley
Organization: Carroll County Health Department
State: MD
Approximate cases reviewed:
Fetal Deaths: 2
Neonatal Deaths, Number: 2
Post neonatal Deaths, Number: 2
Reviews with FIMR program participation : Child Fatality Review, Domestic Violence Review,
Maternal Mortality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR, Funding is shared, Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 10%
Community Education: Conduct a media campaign to promote prenatal alcohol and drug cessation
Service Systems Improvement:
Policy Advocacy: Report the FIMR findings to the State MCH Director, Develop a policy in
collaboration with City or County law enforcement offices or emergency services.
Improved Practices: Initiate or expand public health case management, Expand hospital quality
assurance standards, Implement screening for domestic violence, Implement screening for substance
abuse, Implement screening for postpartum depression.
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: 24,000
NFIMR report on programs in USA and Puerto Rico, June 2016 73
Name: Tina Bell, BSN, RN
Organization: Cecil County Health Dept., Health Promotion Division
State: MD
Approximate cases reviewed:
Fetal Deaths: 6 to 8
Reviews with FIMR program participation:
What does CDR and FIMR look like in your community? Prevention recommendations are shared,
Funding is shared, Staff works on both CDR and FIMR, and Leadership is housed in one organization.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to promote prenatal alcohol and drug cessation
Conduct a media campaign about risks of prematurity, Develop culturally relevant health education
materials, Meet with community based organizations.
Service Systems Improvement: Eliminate a gap in MCH services
Policy Advocacy: Conduct provider training on use of screening tools (e.g., substance use, domestic
violence, etc.)
Improved Practices: Expand services to pregnant substance abusers, Enhance services to bereaved
families, Implement screening for domestic violence, Implement screening for substance abuse,
Implement screening for smoking, Implement screening for postpartum depression
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.)
Actions taken because of FIMR: Problem: There is a lack of prenatal care received by Hispanic
population in our community, resulting in poor outcomes, including increased fetal deaths.
Recommendation: FIMR Team discussed the possibility of opening a free clinic for prenatal care to the
Hispanic population that could not afford it.
Interventions: The free clinic is in the planning stage at this time. A plan is being formulated by using
prior statistics collected to prove the need and be presented to the CEO of the local hospital as a
possible funding source. Will also be presented to other local businesses including OB/GYN providers.
Outcomes: Still to be determined, if a free clinic can be established
Special Religious or Cultural Subgroups: Yes, Hispanic & African American mostly. There are some
Asian & Indian cultures also present in the community as well as Jewish and Islamic Religious groups.
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 74
Jeff Spitzley is the Michigan state coordinator, Cassandra McNulty is the former state coordinator.
Name: Cassandra McNulty
Organization: Michigan Department
State: MI
Which Agency leads the coordination of your FIMR program?: State Coordination with local
cooperation and autonomy
Do members of a federal Healthy Start participate in your FIMR team(s)?: Yes
Reviews with FIMR program participation: At the state level, I currently only participate in the SIDS
review; we are looking at having me involved in CDR in 2016
What does CDR and FIMR collaboration look like in your community? No collaboration; occasionally
CDR attends our meetings but do not invite us to theirs.
Which of these theories/methods are being implemented in conjunction with FIMR?: Life Course
Theory
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases?: Yes
In what year did Case Reviews first begin? : 1991
Approximately how many cases do you review in 2015 by category?
Fetal Deaths, Number 12 (all programs)
Other, please specify type of review & number 102 Infant Deaths (all programs- we do not
separate out neonate and post neonate in reporting
Percentage of Interview: 10%
Two tiered system: Data not provided
Please tell us more about your Community Action Team. The CAT is: A combination, please specify
maternal interviews vary by local team; some make them a priority, others do not. All teams have a
two- tiered system and some kind of CAT.
Community Education: State supported local efforts but did not spearhead state-wide efforts as part
of FIMR
Service Systems Improvement: State supported local efforts; additionally enhanced bereavement
support services
Improved Practices, Programs, and Policies: State supported local efforts but did not spearhead
state-wide efforts as part of FIMR
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH,
Report Findings to MDHHS, Developed state legislation for safe sleep training in day care settings;
working on legislation to ban the sale of bumper pads in MI.
Professional Training: State supported local efforts and additionally provided FIMR new coordinators
training, cultural competency training and online bereavement training to FIMR teams. Additionally
worked on online infant safe sleep training for health care providers.
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Populations: Yes, Middle Eastern in Dearborn (Muslim and Chaldean). Large refugee
populations in Grand Rapids and Detroit.
Population in your FIMR catchment area:
Total population in the catchment area: 9, 910,000
Total number of live births: 114,399
Total number of fetal deaths: 748
Total number of infant deaths: 763
NFIMR report on programs in USA and Puerto Rico, June 2016 75
Annual Budget: 190,994 (case abstraction only)
How many funded staff are on the state level?: 1
How many in-kind staff are on the state level?: 0
What are the functions of the state program? Technical assistance to local teams,
coordination of local teams, training local teams, data collection and reporting, ensuring quality and
consistency across teams, consulting.
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
If yes, what are the functions of the board?: Technical assistance to local teams , Other (please
specify), coordination of local teams, training local teams, data collection and reporting, ensuring
quality and consistency across teams, consulting
Name: Erin Somerlott
Organization: Calhoun County Public Health Department
State: MI
Approximate cases reviewed:
Fetal Deaths:
5
Neonatal Deaths:
0
Post neonatal Deaths: 0
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Currently there is no collaboration, Staff
works on both CDR and FIMR
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: Transient population, no nurse home visitor at this time.
Community Education: Conduct a media campaign to promote prenatal alcohol and drug cessation
Promote breastfeeding, Meet with community based organizations, Publish an annual FIMR report
Service Systems Improvement: Data not provided
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: $20000
Name: Mary Kops
Organization: Jackson County Health Department
State: MI
Approximate cases reviewed:
Fetal Deaths:
0
Neonatal Deaths:
7
Post neonatal Deaths:
3
Other:
0
NFIMR report on programs in USA and Puerto Rico, June 2016 76
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR ,
Members attend each other's meetings , Prevention recommendations are shared,
Prevention recommendations are developed jointly , Cases are triaged into FIMR or CDR
Statute to protect FIMR teams: Data not provided
Two-tiered system: Yes
Percentage of interviews: 30%
Community Education: Develop culturally relevant health education materials
Meet with community based organizations, Publish an annual FIMR report ,
Infant Mortality/Safe Sleep education to CNA's and RN students from U of M and MSU
Service Systems Improvement: Improve referral patterns among agencies, Improve bereavement
referral services
Policy Advocacy:
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis
Improved Practices: Enhance services to bereaved families, Implement screening for smoking
Professional Training: Other (please specify)
Multiple training on Safe Sleep to variety of organizations i.e., nursing students, staff, kids fest, and
parish nurses.
Actions taken because of FIMR: Due to restructuring of CAT team we have had very little action over
the last two years but however we are continuing to track recommendations and hope to implement
actions over the next two years.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 160,248
Total number of live births
1866
Total number of infant deaths 8
Annual Budget: $92,554
Name: David Roth
Organization: Oakland County Health Division
State: MI
Approximate cases reviewed:
Fetal Deaths: 0
Neonatal Deaths: 17
Postneontal Deaths: 6
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR,
Prevention recommendations are shared
Statute to protect FIMR teams: Approved Research Project
Two-tiered system: Yes
Percentage of interviews: 15%
Community Education: Conduct a media campaign to encourage early and
continuous prenatal care
Conduct a media campaign to promote family
NFIMR report on programs in USA and Puerto Rico, June 2016 77
planning or STD screening
Conduct a media campaign about risks of prematurity
Promote breastfeeding, Hold a town health fair,
Develop culturally relevant health education materials
Meet with community based organizations
Service Systems Improvement:
Eliminate a duplication of MCH services, Eliminate a gap in MCH services,
Improve referral patterns among agencies , Improve bereavement referral services , Partner with
local MOD Prematurity Campaign, Streamline MCH Medicaid application processes.
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis Report the FIMR findings to the State MCH Director
Improved Practices: Initiate or expand public health case management, expand hospital quality
assurance standards, expand services to homeless women and children, expand services to pregnant
substance abusers, enhance services to bereaved families, Improve cultural competency protocols,
Implement screening for smoking, Implement screening for postpartum depression.
Professional Training: Data not provided
Actions taken because of FIMR:
Problem: Lack of access to prenatal care
Recommendation/interventions: Outreach to pregnant women, enrolled women in Medicaid,
facilitate access to Medicaid OB providers. Problem: Lack of awareness of Safe Sleep
Recommendation/interventions: media campaigns, client teaching during home visits,
crib distribution and community outreach. Problem: Low levels of breastfeeding initiation
Recommendations/interventions: support for hospitals to baby friendly certified, media
campaigns, community education, development of materials to encourage breast feeding support for
Fathers
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, Hmong Immigrant Populations: Hispanic and Arabic
Population in your FIMR catchment area:
Total population in the catchment area 1,231,640
Total number of live births 13,501
Total number of fetal deaths 53
Total number of infant deaths 90
Unknown Source:
http://www.mdch.state.mi.us/pha/osr/chi/profiles/frame.html
Annual Budget: County funded
Name: Deborah Rhodes
Organization: Saginaw County Health Department
State: MI
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Two separate meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 78
Community Education: Conduct a media campaign to encourage early and
continuous prenatal care, conduct a media campaign to promote family
planning or STD screening, meet with community based organizations,
Publish an annual FIMR report.
Service Systems Improvement: Implement “one-stop-shopping” prenatal care,
Increase public safety around MCH service sites in
collaboration with City or County law enforcement
Policy Advocacy: Data not provided
Improved Practices: Initiate or expand public health case management,
Expand services to pregnant substance abusers, Expand family planning services
Professional Training: Conduct provider training on prematurity/preterm
labor management, conduct provider education programs (e.g.,
management of IUGR, diabetes in pregnancy, etc.)
Actions taken because of FIMR: We have a Doctors dinner to discuss FIMR findings.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: 15 reviewed cases about 4,000
Name: Raeanne Madison
Organization: Inter-Tribal Council of Michigan
State: MI
Approximate cases reviewed:
Fetal Deaths, Number: 0
Neonatal Deaths, Number: 5
Post neonatal Deaths, Number: 10
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to promote prenatal
alcohol and drug cessation, promote breastfeeding, Hold a town health fair,
Develop culturally relevant health education materials, meet with community based organizations,
publish a FIMR newsletter, Conduct a media campaign and community outreach
to promote infant safe sleep.
Service Systems Improvement: Eliminate a duplication of MCH services,
Eliminate a gap in MCH services, Eliminate a gap in family planning services,
Improve referral patterns among agencies.
Policy Advocacy:
Initiate a tribal council declaration of a day or week
promoting MCH (Michigan Breastfeeding Awareness Month August).
Improved Practices: Improve cultural competency protocols, implement screening for smoking.
Professional Training: Conduct provider training on use of screening tool, Implement cultural
competency training, Develop a community resource directory, Implement training on historical
trauma, maternal depression, infant safe sleep, and Native American cultures.
NFIMR report on programs in USA and Puerto Rico, June 2016 79
Actions taken because of FIMR:
PROBLEM: Our communities were experiencing high rates of Postneontal deaths with associated
unsafe sleep factors present.
RECOMMENDATION: Saturate the community with consistent safe sleep messaging.
INTERVENTIONS: Provided culturally-centered safe sleep and breastfeeding education to communities
through health fairs and gatherings. Provided all MCH health care providers in tribal service areas
with materials about safe sleep to ensure consistent messaging to tribal families.
OUTCOMES: Community gatherings were evaluated and rated very highly among attendees in terms
of changing thinking and behavioral intentions around safe sleep. Ongoing case reviews of infant
deaths provide feedback on other factors that our team can address through our coalition.
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations) 100% (many mixed-race - see below)
Black/ African American (If specific culture, please name)
25%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
10%
White (Please specify country of origin)
50%
Special Religious or Cultural Subgroups: Yes, American Indians
Population in your FIMR catchment area: We serve all tribal communities in the
state of Michigan including urban and reservation service areas.
Annual Budget: We do not have a specified budget for FIMR; however, we use Healthy Start and
Tribal Home Visiting funds to coordinate FIMR meetings with staff quarterly meetings
including travel and staff time.
Name: Lori Devos
Organization: Macomb County Health Department
State: MI
Approximate cases reviewed:
Fetal Deaths: 0
Neonatal Deaths: 5
Post neonatal Deaths: 11
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Hold a town health fair, develop culturally relevant health education
materials, Our CAT team has been focusing on sponsoring safe
sleep events in our community.
Service Systems Improvement: Improve bereavement referral services
Policy Advocacy: Invite the Mayor or County Executive to contribute
to the FIMR annual report, Develop a policy in collaboration with City or County
law enforcement offices or emergency services .
Improved Practices: Expand services to pregnant substance abusers, Enhance services to bereaved
families, Implement screening for substance abuse.
Professional Training:
NFIMR report on programs in USA and Puerto Rico, June 2016 80
Implement cultural competency training , Implement SIDS training programs , Implement
bereavement training.
Actions taken because of FIMR:
Our CAT team has held several health fairs to educate families on safe sleep. Some were specific to
the Arabic community in our area.
Ethnic Populations: Data not available
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 855,000
Total number of live births 9400
Total number of fetal deaths 51
Total number of infant deaths 67
Annual Budget: Data not provided
Name: Jane Kessler
Organization: Oakland County Health Division
State: MI
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Data not provided
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations:
Total population in the catchment area 2,722,389 2014 estimate US Census Bureau
Total number of live births
42,805 - 2010 Illinois Department of Public Health
Total number of infant deaths 318 - 2010 Illinois Department of Public Health
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Alysia Osoff
Organization: Ingham County Health Department
State: MI
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR, members
attend each other’s meetings.
NFIMR report on programs in USA and Puerto Rico, June 2016 81
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 0
Community Education: FIMR Stakeholder Luncheon to generate interest
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Part of our healthy start grant
Name: Sarah MacDonald
Organization: Spectrum Health
State: MI
Approximate cases reviewed:
Fetal Deaths: 4
Neonatal Deaths: 37
Post neonatal Deaths: 19
Other, please specify type of review & number Elective Terminations that received live birth
certificates - 2
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Our home interview numbers have gone down - we had 6 home interviews
completed in 2015.
Community Education: Promote breastfeeding, Meet with community based organizations, Publish
an annual FIMR report, Conducted a media campaign to encourage safe sleep for infants, presented
infant mortality data at a community meeting about disparities in infant mortality
Service Systems Improvement: Eliminate a duplication of MCH services, Improve referral patterns
among agencies, Improve bereavement referral services
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Enhance services to bereaved families, Expand family planning services ,
Implement screening for substance abuse, Implement screening for postpartum depression
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.), Implement cultural competency training, Develop a community resource
directory , Other (please specify), Safe sleep trainings, held conference on Perinatal Mood Disorders
Actions taken because of FIMR: Data not provided
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations):
2%
Asian (Please specify country of origin)
2%
Black/ African American (If specific culture, please name)
26%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
16%
NFIMR report on programs in USA and Puerto Rico, June 2016 82
White (Please specify country of origin)
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
53%
Name: Deb Lenz
Organization: Kalamazoo County Health & Community Services
State: MI
Approximate cases reviewed:
Fetal Deaths: 0
Neonatal Deaths: 0
Post neonatal Deaths: 4
Reviews with FIMR program participation : Child Fatality Review, Child Abuse and Neglect Review
What does CDR and FIMR look like in your community? Members attend each other's meetings;
Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to address disparities in infant health
Service Systems Improvement: Eliminate a duplication of MCH services, Eliminate a gap in MCH
services, Improve referral patterns among agencies, Eliminate a gap in family planning services,
Policy Advocacy: Eliminate a duplication of MCH services, Eliminate a gap in MCH services,
Eliminate a gap in family planning services, Improve referral patterns among agencies.
Improved Practices: Implement standardized prenatal risk assessment,
Implement screening for domestic violence, Implement screening for substance abuse,
Implement screening for smoking, Implement screening for postpartum depression.
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc., Implement SIDS training programs.
Actions Taken because FIMR: Data not provided
Ethnic Populations:
Black/ African American (If specific culture, please name): 50
White (Please specify country of origin): 50
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: n/a
Annual Budget: n/a
Michelle Chiezah is the Minnesota state coordinator.
Name: Michelle Chiezah
Organization: Minnesota Department of Health
State: MN
Approximate cases reviewed: 0
Reviews with FIMR program participation : Child Fatality Review
What does CDR and FIMR look like in your community? Currently there is no collaboration,
Leadership is housed in one organization
NFIMR report on programs in USA and Puerto Rico, June 2016 83
Statute to protect FIMR teams: No, Statute expired and trying to get it reinstated
Two-tiered system: Yes
Percentage of interviews: 0
Why interview is not done: We interview the mom or other next close kin who is an adult
Community Education: Hold a town health fair, developing a culturally-competent curriculum to
address racism experienced by the American Indian population in healthcare system
Service Systems Improvement: Results from FIMR led to a staff liaison position being created at one
of the local hospitals to create a linkage between the American Indian community and broader
healthcare community
Policy Advocacy: Report the FIMR findings to the State MCH Director, Invited state health
commissioner to host listening session about health challenges facing the American Indian population
in our state
Improved Practices: Improve cultural competency protocols, Created an American liaison position at
local hospital to link the American Indian population with broader community services
Professional Training: Implement SIDS training programs
Actions Taken because of FIMR: Revamping our FIMR program, and many individuals who
participated in previous CAT or CRT have been helping out with that process
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations) 90-100%
Black/ African American (If specific culture, please name)
90-100%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 84
Mississippi has no state coordinator.
Name: Arletha Howard
Organization: Tougaloo College/Delta HealthPartners Healthy Start Initiative (Delta Regional FIMR)
State: MS
Approximate cases reviewed:
1 case was reviewed in 2015 and 1 CR was
conducted in the Month of October 2015
Reviews with FIMR program participation: Infant Death Review
What does CDR and FIMR look like in your community?
There is no CDR in my community,
Prevention recommendations are developed jointly , Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 100%
Community Education: Conduct a media campaign to promote family planning or STD screening
Promote breastfeeding
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Mary Craig
Organization: Mississippi State Department of Health
State: MS
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: No
What does CDR and FIMR look like in your community?
There is no CDR in my community, Currently there is no collaboration , Leadership is housed in one
organization , limited CDR and only at the state level
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Promote breastfeeding, Meet with community based organizations, Publish
an annual FIMR report, collaborate with March of Dimes on media messaging; at the local level, we
have no funding for media.
Service Systems Improvement: Eliminate a gap in family planning services, improve referral patterns
among agencies, Improve bereavement referral services, Partner with local MOD Prematurity
Campaign.
NFIMR report on programs in USA and Puerto Rico, June 2016 85
Policy Advocacy: Report findings after every CRT and CAT meeting to more than 150 medical
providers, nurses, social workers, public health, community leaders. provide data to the state
physician overseeing FIMR.
Improved Practices: Initiate or expand public health case management, expand hospital quality
assurance standards, expand services to pregnant substance abusers, enhance services to bereaved
families, expand family planning services, Implement standardized prenatal risk assessment, Improve
cultural competency protocols, Implement screening for substance abuse,
Implement screening for smoking.
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider education programs (e.g., management of IUGR, diabetes in pregnancy, etc.)
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement cultural competency training, Implement SIDS training programs, Implement bereavement
training,
Implement cultural competency assessment for FIMR team members
Actions taken because of FIMR:
PROBLEM:
Lack of referrals by providers to Family Planning through the health dept. RECOMMENDATION: All
women in prenatal classes and postpartum are referred to Family Planning INTERVENTIONS: Training
of PNC providers at every CRT meeting
OUTCOMES: Review of ongoing cases show an increase in referrals to FP as noted on the medical
records.
PROBLEM: Initial chart reviews in 2012 showed High rates of SIDS cases RECOMMENDATION: FIMR
RN review with coroners to verify SIDS vs asphyxia/overlay
INTERVENTIONS: Proposed expanded trainings of coroners at state meetings; met with 12 county
coroners and their assistants on a quarterly basis first two years. Met with state Medical Examiners.
OUTCOMES: Cases are correctly designated
PROBLEM: Lack of consistent Infant Safe Sleep
information being given to new parents/grandparents/foster parents
RECOMMENDATION: Collaborate with MS SIDS Alliance to provide standardization of training.
INTERVENTIONS: 9 Delivering hospitals visited in collaboration with MS SIDS Alliance to provide
standardization of training. MS SIDS Alliance provided public recognition of hospitals completing the
following: All MCH hospital staff trained with the NICHD/March of Dimes CE program; All parents to
view the NICHD Infant Safe Sleep video and sign form acknowledging that they saw DVD (or declined)
OUTCOMES: All 10 hospitals completed the above; FIMR involved with public recognition of 2 of the
hospitals. MS State office also providing books for all new parents on safe sleep.
INTERVENTIONS: Trainings completed; parents instructed and viewed DVDs OUTCOMES: SUIDs
decreasing, although much still to do.
PROBLEM: Public awareness of infant safe sleep lacking. RECOMMENDATION: Conduct a one-day CE
Infant Safe Sleep Conference
INTERVENTIONS: Conference conducted in November 2014, 165 attendees included nurses, social
workers, faith based, community leaders, foster parents, child care workers
OUTCOMES: Train the trainer programs continuing; faith based meeting with 8 faith leaders trained
and provided with pack n plays.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0
NFIMR report on programs in USA and Puerto Rico, June 2016 86
tribes/nations)
Asian (Please specify country of origin) 0
Black/ African American (If specific culture, please name)
38%
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American) 0
3% unknown
White (Please specify country of origin) 59%
Foreign-Born/ Immigrants
unknown
Special Religious or Cultural Subgroups: Yes, Baptist, Catholic, Methodist, etc.
Population in your FIMR catchment area: Total number of live births 6,055
Annual Budget: 50,000 approx. for regional FIMR
NFIMR report on programs in USA and Puerto Rico, June 2016 87
Kari Tutwiler is the Montana state coordinator
Name: Kari Tutwiler
Organization: State Public Health Human services-FICMMR
State: MT
Which Agency leads the coordination of your FIMR program?:
The state Dept. Public Health & Human Services leads the coordination of overall program, local,
county teams perform the actual work.
Do members of a federal Healthy Start participate in your FIMR team(s)?: Our community does not
have a Healthy Start program
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR collaboration look like in your community?: Leadership is housed in one
organization, There is no separation between FIMR & Child Review.
Which of these theories/methods are being implemented in conjunction with FIMR: Data not
provided
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin?: 1990-1991 Pilot sites first began
Approximately how many cases do you review in 2015 by category:
Fetal Deaths, Number We have averaged 56 fetal deaths from 2011- 2014. Final 2015 data is not
available until July 2016.
Neonatal Deaths, Number
Final 2015 data not available until July 2016.
Percentage of Interview: Data not provided
Two tiered system: No
Please tell us more about your Community Action Team. The CAT is: Our county review team also is
the community action team.
Community Education: Promote breastfeeding, Hold a town health fair
Service Systems Improvement: Increase public safety around MCH service sites in collaboration with
City or County law enforcement
Policy/Advocacy: Develop local or state legislation
Improved Practices, Programs, and Policies: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Populations: Data not provided
Population in your FIMR catchment area:
Total population in the catchment area 986,415
Total number of live births
Won't have final 2015 data until July 2016.
Total number of fetal deaths Averaged 56 fetal deaths in MT from 2011- 2014.
Annual Budget: 55,000
How many funded staff are on the state level?: 1.0 FTE
How many in-kind staff are on the state level?: 6
What are the functions of the state program?: Technical assistance to local teams ,
Coordination of local teams , Training of local teams, Data collection and reporting.
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
NFIMR report on programs in USA and Puerto Rico, June 2016 88
Name: Vicki Ruby
Organization: Sheridan County Public Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths, Number: 1
Neonatal Deaths, Number: 1
Post neonatal Deaths, Number: 1
Reviews with FIMR program participation : Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 100%
Why interview is not done: N/A
Community Education: Hold a town health fair, Meet with community based organizations conduct a
media campaign to promote prenatal alcohol and drug cessation, promote breastfeeding
Service Systems Improvement: Improve referral patterns among agencies, Increase public safety
around MCH service sites in collaboration with City or County law enforcement.
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Report the FIMR findings to the State MCH Director, Develop a policy in collaboration
with City or County law enforcement offices or emergency services.
Improved Practices: Implement screening for substance abuse,Implement screening for smoking
Professional Training: Data not provided
Actions Taken because of FIMR: There are no birthing hospitals nor ob services in this county.
Referrals to services for at-risk mothers and infants are made by local clinicians, the WIC Program, and
mental health services.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0
tribes/nations)
Asian (Please specify country of origin) 0
Black/ African American (If specific culture, please name)
0
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
:
50%
White (Please specify country of origin):
50%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area : 700
Total number of live births: 0
Total number of fetal deaths: 0
Total number of infant deaths: 0
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 89
Name: Tracy Knoedler
Organization: Gallatin City-County Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths:
2
Neonatal Deaths:
0
Post neonatal Deaths:
1
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Why interview is not done: We have not customarily done this unless we need additional information
outside of what's available from the medical and police records.
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Karen Maloughney
Organization: Butte-Silver Bow Health Department
State: MT
Approximate cases reviewed: Fetal Deaths, Number 1
Other, please specify type of review & number Child Death Review - Four Cases
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR,
Joint reviews are conducted, Prevention recommendations are developed jointly,
Prevention recommendations are shared.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to promote family
planning or STD screening, Promote breastfeeding
Service Systems Improvement: Data not provided
Policy Advocacy: Report FIMR findings to the Mayor, County
Executive, and/or other officials on an annual basis, Develop local or state legislation.
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
NFIMR report on programs in USA and Puerto Rico, June 2016 90
For the two years that I have been conducting FICMMR reviews (we do not separate fetal deaths from
infant/child deaths), our biggest prevention effort has been with suicide. Our county had three
suicides within a six-week time frame and then eight months later, two more suicides that were three
months apart. Our state ranks extremely high in suicide rates, not only in children under 18, but in
adults as well. In the 2015 Legislative session, House Bill 374 was sponsored for our Suicide
Prevention Team. This bill was passed into law. This new law allows for suicide and
prevention training be available to every teacher or specialist who applies for certification renewal.
We are hoping that this new law, along with other prevention efforts, will help us decrease the
number of suicides in our state.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Katherine Basirico
Organization: Anaconda Deer Lodge County Public Health
State: MT
Approximate cases reviewed:
Fetal Deaths:
0
Neonatal Deaths:
0
Postneonatal Deaths:
0
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Yes
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Community Education: Promote breastfeeding, Other (please specify)
new to position - building on and creating new team
Service Systems Improvement: Eliminate a gap in MCH services,
Eliminate a gap in family planning services, Improve referral patterns among agencies,
Improve bereavement referral services, Implement “one-stop-shopping” prenatal care,
Increase public safety around MCH service sites in collaboration with City or County law enforcement,
Streamline MCH Medicaid application processes
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH,
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis
Include the Mayor or County Executive as a FIMR Community Action Team member, Invite the Mayor,
County Executive or other elected official to chair a FIMR town meeting, Invite the Mayor or County
Executive to contribute to the FIMR annual report, Report the FIMR findings to the State MCH
Director, Develop a policy in collaboration with City or County law enforcement offices or emergency
services, Develop local or state legislation
Improved Practices: Initiate or expand public health case management,
Expand services to pregnant substance abusers,
Enhance services to bereaved families,
Expand family planning services,
Implement standardized prenatal risk assessment,
Improve cultural competency protocols,
NFIMR report on programs in USA and Puerto Rico, June 2016 91
Implement screening for domestic violence,
Implement screening for substance abuse,
Implement screening for smoking,
Implement screening for postpartum depression
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider education programs (e.g., management of IUGR, diabetes in pregnancy, etc.)
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement cultural competency training, Implement SIDS training programs, Develop a community
resource directory, Implement bereavement training,
Implement cultural competency assessment for FIMR team members
Actions taken because of FIMR: Problem: Lack of referrals and resources for parenting skills,
substance abuse / cessation, at risk population factors. recommendation: care coordination, created
and coordinate referrals among resources, establish Parents as teacher’s home visiting program,
other home visiting
Interventions: training of PCP, other community organizations on referral system and importance of
programs Outcomes: starting to build home visiting culture with increase in referrals
We are a high risk community which is starting to build a system of programs and resources to reduce
social determinants of health and other risk factor.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Darleen Williams
Organization: Powder River Public Health
State: MT
Approximate cases reviewed:
Fetal Deaths:
0
Neonatal Deaths:
0
Post neonatal Death: 0
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review , Suicide
Review Panel, Homicide Review Panel
What does CDR and FIMR look like in your community?
Leadership is housed in one organization , Staff works on both CDR and FIMR , Joint reviews are
conducted, Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: No deaths in 2015
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 92
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Tammy Matt
Organization: CSKT Tribal Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths, Number 6
Post neonatal Deaths, Number 3
Other, please specify type of review & number 2 maternal
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review ,
What does CDR and FIMR look like in your community?
Staff works on both CDR and FIMR, Joint reviews are conducted, Meetings are coordinated,
Prevention recommendations are developed jointly , Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 50%
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Promote breastfeeding, Other (please specify) working on media campaign regarding bed sharing
Service Systems Improvement: Improve referral patterns among agencies
Policy Advocacy: Develop a policy in collaboration with City or County law enforcement offices or
emergency services
Improved Practices: Improve cultural competency protocols,
Implement screening for domestic violence, Implement screening for substance abuse,
Implement screening for smoking , Implement screening for postpartum depression.
Professional Training: Data not provided
Actions taken because of FIMR: we have had a high number of infant deaths related to co-sleeping
and are working on a collaborative media campaign for public education
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, CSKT Tribes
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Kathy Helmuth
Organization: Richland County Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths, Number: 2
Other, please specify type of review & number: 1 Infant
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR,
Funding is shared, Joint reviews are conducted, Other (please specify)
We are a frontier county. Our one team reviews all Fetal, Infant, Child and Maternal deaths.
Statute to protect FIMR teams: Yes
NFIMR report on programs in USA and Puerto Rico, June 2016 93
Two-tiered system: No
Percentage of interviews:100%
Why interview is not done: I reviewed this survey and cannot find where I would have indicated that
our data does not include info from a family member. We do include it by interview. Family are not
invited or allowed at the team meetings.
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Our experience is not overly helpful as our numbers are so small and
our deaths have been largely from unpreventable causes that have not led to public prevention
efforts.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 10,000
Total number of live births: 140
Total number of fetal deaths: 2
Total number of infant deaths: 1
Annual Budget:
Data not provided
Name: Karyn Johnston
Organization: Granite County Public Health
State: MT
Approximate cases reviewed:
Fetal Deaths:
0
Neonatal Deaths:
0
Post neonatal Deaths: 0
Other, please specify type of review & number 0
Reviews with FIMR program participation: Child Fatality Review , Suicide Review Panel, Homicide
Review Panel, Other SIDS review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR , Joint
reviews are conducted
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews:
Why interview is not done: It's up to the County Coroner
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 94
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Kim Franchi
Organization: Jefferson County Public Health
State: MT
Approximate cases reviewed: Other, please specify type of review & number 3 children(MVC) 2
teenages (suicide)
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR ,
Members attend each other's meetings , Joint reviews are conducted,
Prevention recommendations are shared
Statute to protect FIMR teams: No
Two-tiered system: No
Percentage of interviews: My information typically comes from coroner
interview with family and would be 40%.
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Promote breastfeeding, Hold a town health fair
Service Systems Improvement: Improve referral patterns among agencies ,
Improve bereavement referral services
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Implemented a home visiting service to new and expectant mothers.
Provide educational information on various topics relevant to FIMR issues, and in particular issues
currently affecting our community.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Cynthia Grubb
Organization: Pondera County Health Department
State: MT
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review , Domestic Violence Review, Child
Abuse and Neglect Review
What does CDR and FIMR look like in your community? Currently there is no collaboration
Statute to protect FIMR teams: Yes
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 95
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Carol McDivitt
Organization: Glacier County Health Department
State: MT
Approximate cases reviewed: Fetal Deaths, Number
5
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR , Other
regional MOU with larger City/ County Health Dept to review local cases
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Promote breastfeeding, Hold a town health fair
Service Systems Improvement: Data not provided
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
Ethnic Populations:
American Indian/ Alaska Native (Please specify
tribes/nations)
80
White (Please specify country of origin)
20
Special Religious or Cultural Subgroups: Yes, Hutterite Colonies
Population in your FIMR catchment area: Total population in the catchment area
Annual Budget: Data not provided
600
Name: Kami Doughty
Organization: oneHealth
State: MT
Approximate cases reviewed:
Fetal Deaths, Number
1
Other, please specify type of review & number
Child review 1
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review , Other
SIDS review
What does CDR and FIMR look like in your community? Our FICMMR review team puts their reports
into the online CDR data base
Statute to protect FIMR teams: Yes
NFIMR report on programs in USA and Puerto Rico, June 2016 96
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Develop culturally relevant health education materials
Educational materials placed at site of drowning regarding swimmer safety, personal flotation
devices, etc.
Service Systems Improvement: Data not provided
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
Problem: Lack of education at a local recreational area on how to use PFDs and the importance of
avoiding fatigue while swimming.
Recommendation: Educational instructions and advisements regarding water safety be placed on the
admittance board at the entrance of the recreational area.
Interventions: PHN to put signs and posters up at the entrance to the recreational area. Outcomes:
No drownings at the recreational area in 2015.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0
tribes/nations)
Asian (Please specify country of origin) 0
Black/ African American (If specific culture, please name)
0
Pacific Islander (Please specify if Native Hawaiian,
0
Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto
0
Rican, Cuban, Descendants of Spain, Central and/or South American)
White (Please specify country of origin) 100%
Special Religious or Cultural Subgroups: Yes
Population in your FIMR catchment area:
Total population in the catchment area 19,400
Total number of live births
360
Total number of fetal deaths 2
Total number of infant deaths 1
Annual Budget: Data not provided
Name: Katlynn Reed
Organization: RiverStone Health
State: MT
Approximate cases reviewed:
Fetal Deaths, Number 7
Neonatal Deaths, Number 16
Postneonatal Deaths, Number 9
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to encourage early and
NFIMR report on programs in USA and Puerto Rico, June 2016 97
continuous prenatal care, conduct a media campaign to promote family
planning or STD screening, Conduct a media campaign to address disparities in
infant health, Promote breastfeeding,
Meet with community based organizations
Service Systems Improvement: Data not provided
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
Problem-Increasing awareness of SIDs and Co-sleeping deaths
Recommendation- provide educational materials to new parents, expand on presentation of
materials
Intervention-distributed several copies of safe to sleep books, magnets, posters etc. to several areas
of community.
Purchased a mobile crib to display the correct furnishings and placement of baby, which can be easily
moved to different locations.
Outcomes-ongoing, first review not yet complete
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Christina Robinson
Organization: Stillwater Billings Clinic
State: MT
Approximate cases reviewed: Fetal Deaths:
2
Reviews with FIMR program participation:
Child Fatality Review , Maternal Mortality Review , Suicide Review Panel, Homicide Review Panel
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR , Funding is shared,
Members attend each other's meetings.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 50%
Why interview is not done: Only reviewed 2 cases and one was done prior to my employment
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to promote prenatal alcohol and drug cessation
Conduct a media campaign to promote family planning or STD screening
Conduct a media campaign about risks of prematurity
Hold a town health fair,
Meet with community based organizations
Service Systems Improvement: Eliminate a duplication of MCH services ,
Eliminate a gap in MCH services
Policy Advocacy: Report the FIMR findings to the State MCH Director
Develop a policy in collaboration with City or County law enforcement offices or emergency services
Improved Practices: Initiate or expand public health case management ,
NFIMR report on programs in USA and Puerto Rico, June 2016 98
Enhance services to bereaved families , Implement standardized prenatal risk assessment
Professional Training: Conduct provider training on prematurity/preterm labor management
Develop a community resource directory
Actions taken because of FIMR: Re-establishing the FICMMR team
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, Hutterite, Jehovah Witness, Native American, home
school
Population in your FIMR catchment area:
Total population in the catchment area : 9290
Annual Budget: Data not provided
Name: Megan Olson
Organization: Prairie County Public Health Department
State: MT
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR,
Funding is shared, Joint reviews are conducted, Meetings are coordinated,
Prevention recommendations are developed jointly , Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Ella Tweten
Organization: Valley County Health Department
State: MT
Approximate cases reviewed: Other, please specify type of review & number child death review
one
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: one out of one
Community Education: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 99
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: We send a letter to each family with a new child from our
community, let them know our services and encourage a home visit if they would like. Included in the
mailing is info on immunizations, safe sleep and WIC resources.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Julie Stroh
Organization: Missoula City-County Health Dept.
State: MT
Approximate cases reviewed:
Fetal Deaths, Number: 6
Neonatal Deaths, Number: 4
Post neonatal Deaths, Number: 1
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Currently there is no collaboration
Statute to protect FIMR teams:
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: The Health Dept. does many of these activities, but not necessarily the FIMR
team
Service Systems Improvement: The Health Dept. does many of these activities but not necessarily the
FIMR team. We would like to implement some of the above, such as bereavement referral services
and one-stop shopping prenatal care
Policy Advocacy: Current funding does not allow for staff time to implement the above activities,
though we would be interested in many of them
Improved Practices: Staff limitations related to funding
Professional Training: Same as above comments
Actions taken because of FIMR:
Problem: Lack of referrals to substance abuse and smoking cessation services. Recommendation:
Create a Resource Guide for Health Care Providers.
Interventions: The Resource Guide is still a work in progress. One practice has also hired a Social
Worker to make referrals for clients or provide contact information to community resources.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 112,000
Total number of live births: 1200
Total number of fetal deaths: Refer to State data
Total number of infant deaths: Refer to State data
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 100
Name: LuAnn Burgmuller
Organization: Ravalli County Public Health
State: MT
Approximate cases reviewed:
Fetal Deaths, Number: 0
Neonatal Deaths, Number: 0
Post neonatal Deaths, Number: 0
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Promote breastfeeding,
Develop culturally relevant health education materials
Meet with community based organizations, Other (please specify)
Promoted water safety throughout community
Service Systems Improvement: Streamline MCH Medicaid application processes
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Problem: Major river running through several communities in our
county. River has dangerous low-head dam which has been site of several accidents and one death of
a 6-year-old girl. Recommendation: Closure of section of river containing low head dam during times
of high-water. Education of community members about importance of wearing lifejackets/river safety
awareness. Interventions: Supported Montana FWP in passing rule to close river section temporarily
during high risk water levels. Conducted lifejacket and water safety campaign at several local events
(i.e.
Farmer's Market, Spring Fair, etc.) Distributed water safety material to local river outfitters and
recreational businesses. Outcomes: No river deaths in 2015, but review and interventions will
continue year by year.
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations) 0.8%
Asian (Please specify country of origin) 0.1% Black/ African American (If specific culture, please
name)
0.14%
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American) 0.4% 1.8% White (Please specify country of origin)
96%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 41,000
Total number of live births
300
Total number of fetal deaths <5 per 1000
Total number of infant deaths <5 per 1000
NFIMR report on programs in USA and Puerto Rico, June 2016 101
Annual Budget: 38,000.
Name: Sue Snitker
Organization: Indian Health Service
State: PHN MT
Approximate cases reviewed:
Fetal Deaths, Number 2
Neonatal Deaths, Number 2
Post neonatal Deaths, Number 2
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review, Child
Abuse, and Neglect Review
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 100%
Why interview is not done: Our clients in health care are also the cases we review, so 1st hand
information is always used.
Community Education: Conduct a media campaign to encourage early and
continuous prenatal care,
Conduct a media campaign to promote prenatal alcohol and drug cessation,
Conduct a media campaign to promote family planning or STD screening,
Conduct a media campaign about risks of prematurity, Promote breastfeeding,
Develop culturally relevant health education materials
Service Systems Improvement: Eliminate a gap in MCH services,
• Eliminate a gap in family planning services,
• Implement “one-stop-shopping” prenatal care,
• Streamline MCH Medicaid application processes
Policy Advocacy:
Improved Practices: Expand services to pregnant substance abusers,
• Expand family planning services,
• Implement screening for domestic violence,
• Implement screening for substance abuse,
• Implement screening for smoking,
• Implement screening for postpartum depression
Professional Training: Develop a community resource directory
Actions taken because of FIMR:
we need local planning to decrease substance abuse! Increase use of reversible contraception.
Special Religious or Cultural Subgroups: NO
Population in your FIMR catchment area: Total population in the catchment area 10,000
Total number of live births 300
Total number of fetal deaths 2
Total number of infant deaths 2
Annual Budget: Data not provided
Name: Marianne Saylor
NFIMR report on programs in USA and Puerto Rico, June 2016 102
Organization: Public Health
State: MT
Approximate cases reviewed: Other, please specify type of review & number 4 children
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review , Child
Abuse and Neglect Review, Suicide Review Panel, Homicide Review Panel
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Up to this point, we have had no need to interview family members
Why interview is not done:
Community Education: Conduct a media campaign to promote family planning or STD screening
Promote breastfeeding, Hold a town health fair, Meet with community based organizations
Service Systems Improvement: Data not provided
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Report the FIMR findings to the State MCH Director, Develop a policy in collaboration
with City or County law enforcement offices or emergency services
Improved Practices: Enhance services to bereaved families,
Expand family planning services,
Implement screening for smoking
Professional Training: Data not provided
Actions taken because of FIMR: Problem: minimal Family planning & after care
Recommendation: develop a family planning clinic & advertise a follow up after care
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Karen Morey
Organization: Sanders County Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths:
0
Neonatal Deaths:
0
Post neonatal Deaths:
3
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Prevention recommendations are shared
Statute to protect FIMR teams:
Two-tiered system: No
Percentage of interviews:
Why interview is not done: We glean all our information from the coroner, MD, ambulance, deputies
Community Education: Promote breastfeeding, Develop culturally relevant health education
materials, Meet with community based organizations
Service Systems Improvement: Develop a 24/7 prenatal hotline , Eliminate a gap in family planning
services, Improve referral patterns among agencies
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis
NFIMR report on programs in USA and Puerto Rico, June 2016 103
Include the Mayor or County Executive as a FIMR Community Action Team member
Improved Practices: Data not provided
Professional Training: Conduct provider education programs (e.g., management of IUGR, diabetes in
pregnancy, etc.)Develop a community resource directory
Actions taken because of FIMR: Small county with lack of resources. No family planning within 100
miles.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Byrnne Leftridge
Organization: Flathead City-County Health Department
State: MT
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation : Data not provided
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: Data not provided
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Why interview is not done: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Ethnic Populations: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Melissa Brummell
Organization: Madison County Public Health
State: MT
Approximate cases reviewed:
Fetal Deaths, Number 0
Neonatal Deaths Number: 0
Post neonatal Deaths, Number 0
Reviews with FIMR program participation : Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 0
Community Education: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 104
Service Systems Improvement: Improve referral patterns among agencies, Improve bereavement
referral services.
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Develop a community resource directory
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 7500
Total number of live births: 53
Total number of fetal deaths: 0
Total number of infant deaths: 0
Annual Budget: Data not provided
Name: Jennifer Chappell
Organization: Sweet Grass Public Health
State: MT
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review ,
Suicide Review Panel, Homicide Review Panel, Other SIDS review
What does CDR and FIMR look like in your community? Leadership is housed in one organization
Statute to protect FIMR teams: Yes
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Community Education: Hold a town health fair
Service Systems Improvement: Eliminate a duplication of MCH services
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Expand family planning services ,
Implement screening for domestic violence ,
Implement screening for substance abuse
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc. Implement SIDS training programs, Implement bereavement training ,
Implement cultural competency assessment for FIMR team members.
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Eva Kerr
Organization: Meagher County Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths, Number 0
Neonatal Deaths, Number
0
NFIMR report on programs in USA and Puerto Rico, June 2016 105
Post neonatal Deaths, Number 0
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Data not provided
Statute to protect FIMR teams: I would think so, but not 100% sure. I am fairly new to
this position and have not had a case yet.
Two-tiered system: Yes
Percentage of interviews: 0
Community Education: Promote breastfeeding, Hold a town health fair, Meet with community based
organizations
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations:
American Indian/ Alaska Native (Please specify
5% tribes/nations)
Asian (Please specify country of origin)
0
Black/ African American (If specific culture, please name)
1%
Pacific Islander (Please specify if Native Hawaiian,
Guamanian, Samoan or Other)
0
Hispanic/ Spanish/ Latino (Please specify
Mexican, Puerto
Spain, Central and/or South American)
3% Rican, Cuban, Descendants of
White (Please specify country of origin)
91%
Special Religious or Cultural Subgroups:
No
Population in your FIMR catchment area:
Total population in the catchment area 2000
Total number of live births
15
Total number of fetal deaths 0
Total number of infant deaths 0
Annual Budget: Data not provided
Name: Sue Hansen
Organization: Beaverhead County Public Health
State: MT
Approximate cases reviewed:
Fetal Deaths, Number 0
Neonatal Deaths, Number 1
Post neonatal Deaths, Number 0
Other, please specify type of review & number 0
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Funding is shared, Joint reviews are conducted,
NFIMR report on programs in USA and Puerto Rico, June 2016 106
Prevention recommendations are developed jointly
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Why interview is not done: Team did not indicate need to interview family
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Total population in the catchment area 9000
Total number of live births 100
Annual Budget: Data not provided
Name: Leigh Estvold
Organization: Lake County Public Health Dept.
State: MT
Approximate cases reviewed:
Fetal Deaths:4
Neonatal Deaths: 2
Post neonatal Deaths: 3
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review , Other
(please specify) fetal
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR,
Funding is shared, Joint reviews are conducted, Prevention recommendations are developed jointly
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Due to lack of funding we haven't had any successful campaigns in
the past 2 years.
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations)
75 primarily confederated Salish & Kootenai and Crow
White (Please specify country of origin) 2
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 40000
Total number of fetal deaths 4
NFIMR report on programs in USA and Puerto Rico, June 2016 107
Total number of infant deaths 2
Annual Budget: Data not provided
Name: Barbara Mau’s
Organization: Wibaux County Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths:
0
Neonatal Deaths:
0
Post neonatal Deaths: 0
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? Neighboring County inputs information and
collaborates with our county to perform reviews
Statute to protect FIMR teams: Data not provided
Two-tiered system: Yes
Percentage of interviews: 0
Community Education: Promote breastfeeding, Hold a town health fair,
Develop culturally relevant health education materials
Meet with community based organizations
Service Systems Improvement: Develop a 24/7 prenatal hotline, Eliminate a gap in MCH services,
Improve referral patterns among agencies.
Policy Advocacy: Data not provided
Improved Practices: Initiate or expand public health case management
Professional Training: Implement SIDS training programs
Actions taken because of FIMR: Using the MCH funding, we have implemented postnatal visits to
new moms, which allows us to provide information on immunizations, safe sleep, poison control
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes
Population in your FIMR catchment area: 12-15/year
Annual Budget: we only receive MCHBG funds-$1735.00/year
Name: Timber Dempewolf
Organization: Dawson County Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths Number: 2
Neonatal Deaths, Number: 1
Post neonatal Deaths Number: 1
Reviews with FIMR program participation : Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR, Cases are
triaged into FIMR or CDR, Meetings are coordinated, Prevention recommendations are developed
jointly, and Prevention recommendations are shared
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 108
Community Education: Promote breastfeeding, Meet with community based organizations
Service Systems Improvement: Improve referral patterns among agencies
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Implement SIDS training programs, Develop a community resource directory
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 9500
Total number of live births: 100
Total number of fetal deaths: 1
Total number of infant deaths: 1
Annual Budget: Data not provided
Name: Kristi Aklestad
Organization: Toole County Health Department
State: MT
Approximate cases reviewed:
Fetal Deaths, Number: 0
Neonatal Deaths, Number: 0
Post neonatal Deaths, Number: 0
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 100
Community Education: Promote breastfeeding,
Meet with community based organizations,
Service Systems Improvement: Implement screening for smoking
Policy Advocacy: Data not provided
Improved Practices: Implement screening for smoking
Professional Training: Data not provided
Actions taken because of FIMR:
Problem: adolescent suicide ideation in combination with an actual adolescent suicide
Recommendation: educate community members and school staff regarding risks for suicide and how
to respond Intervention: QPR training for 100% of the schools in our county (all certified staff) and
other community member, ASIST training offered for school and community
Outcome: all certified staff attended QPR, 26 community members, including public health and first
responders and some school staff, attended ASIST training
Ethnic Populations: Total population in the catchment area
5200
Special Religious or Cultural Subgroups: Yes, Hutterite
Population in your FIMR catchment area: Total population in the catchment area
5200
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 109
Missouri does not have a state coordinator.
Name: Lora Gulley
Organization: Maternal Child and Family Health Coalition
State: MO
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Currently there is no collaboration
Statute to protect FIMR teams: No
Two-tiered system: Yes
Percentage of interviews: 30%
Community Education:
Conduct a media campaign to encourage early and continuous prenatal care,
Conduct a media campaign to address disparities in infant health, Develop culturally relevant health
education materials, Meet with community based organizations.
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
We have established a collective impact initiative in our community called Flourish St. Louis to
address infant mortality by bringing diverse sectors together in new ways. FIMR will help provide data
and critical information about factors contributing to infant and fetus deaths that can lead to best
practices and adoption of key policies.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
Name: Mary Jean Brown
Organization: MCHC
State: MO
Approximate cases reviewed:
Fetal Deaths: 13
Neonatal Deaths: 10
Post neonatal Deaths, Number deaths after 4 wks.= 4deaths, all other 6 died <
3wks.= 10
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review
What does CDR and FIMR look like in your community? Members attend each other’s meetings
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Community Education: Conduct a media campaign to encourage early and
continuous prenatal care, conduct a media campaign to encourage early and
continuous prenatal care
Promote breastfeeding, Develop culturally relevant health education materials
Meet with community based organizations,
NFIMR report on programs in USA and Puerto Rico, June 2016 110
Publish an annual FIMR report, Our FIMR report is not annual. Twice in 10 yrs. We
held a town hall meeting with MODHSS for maternal
mortality.
Service Systems Improvement: Improve bereavement referral services, Streamline MCH Medicaid
application processes, working on the Medicaid process
Policy Advocacy: Report the FIMR findings to the State MCH director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
Problem: Lack of or late prenatal care. Interventions: Surveyed the city for places that did proof of
pregnancy and cost and then published the list in our community resource guide. The proof of
pregnancy is no longer needed to enroll in
Medicaid, but many, many providers did not know that. Wrote a white paper on the slow response to
enrolling clients in Medicaid. Working now to advertise that no proof of pregnancy is required.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total number of live births 7205 (2012 data)
Total number of fetal deaths 45 (2009 data)
Total number of infant deaths IMR 7.1 (2009 data)
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 111
Nebraska does not have a state coordinator.
Name: Carol Isaac
Organization: Douglas County Health Department
State: NE
Approximate cases reviewed:
Fetal Deaths:
0
Neonatal Deaths:
16
Post neonatal Deaths:
10
Reviews with FIMR program participation : Data not provided
What does CDR and FIMR look like in your community? Our State CDR liaison attends our FIMR
meetings and we present annually to the State CDR Team (we focus on our FIMR Annual Report)
Statute to protect FIMR teams: This is a yes and no answer for us. The NE legislative
statues which give our state team the authority to CDR also give us the authority to do infant death
review, but not fetal death review. We do not have any specific FIMR statutes in place at this time.
Two-tiered system: Yes
Percentage of interviews: 20%
Community Education: Promote breastfeeding, develop culturally relevant health education
materials, meet with community based organizations, Publish an annual FIMR report,
A preconception heath education program known as the Teen Outreach Program (TOP) was expanded
to a total of 4 community sites, safe sleep education was implemented by home visitors with the
MIECHV Program in Douglas County (program oversight is provided by DCHD), a train-the trainer
session to promote preterm labor education was developed for local home visitation programs and
implemented by DCHD in partnership with the MOD, maternal depression screening was
implemented by the MIECHV Program in an attempt to identify the extent of perinatal depression in
Douglas County.
Service Systems Improvement: Eliminate a duplication of MCH services, Eliminate a gap in MCH
services , Improve bereavement referral services ,Partner with local MOD Prematurity Campaign ,
Partnered with local law enforcement re: training on utilizing the CDC SUID crime scene investigation
checklist when investigating SUID cases, partnered with NE Perinatal Q.I. Collaborative in getting
Count the Kicks information in hands of all birthing hospitals and OBs across NE.
Policy Advocacy: Include the Mayor or County Executive as a FIMR Community Action Team member,
Report the FIMR findings to the State MCH Director
Improved Practices: Enhance services to bereaved families, Implement screening for postpartum
depression.
Professional Training: Conduct provider training on prematurity/preterm labor management
Implement SIDS training programs, develop a community resource directory, Other (please specify)
Our resource directory was specific for medical providers who needed to refer women to mental
health providers who were expert in the area of perinatal depression. It was an on-line directory.
Actions taken because of FIMR: Data not provided
Ethnic Populations:
Asian (Please specify country of origin) 4% (Korea)
Black/ African American (If specific culture, please name):
38%
NFIMR report on programs in USA and Puerto Rico, June 2016 112
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American):
12% (South America)
White (Please specify country of origin) 46% (U.S.)
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 543, 244
Total number of live births: 8,275
Total number of fetal deaths: 59
Total number of infant deaths: 43
Annual Budget: $62,000
NFIMR report on programs in USA and Puerto Rico, June 2016 113
Rebecca Gonzales is the Nevada state coordinator.
Name:
Jan Houk
Organization: Washoe County Health District
State: NV
Approximate cases reviewed:
Fetal Deaths: 21
Neonatal Deaths: 20
Post neonatal Deaths: 1
Other: 0
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR, and FIMR,
Prevention recommendations are shared.
Statute to protect FIMR teams: Not sure, but our FIMR program is authorized to access medical
records for confidential review purposes on behalf of the State Health Officer.
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: At first we had problems getting demographic information to contact
moms. Since then, it has been hard to make contact with the moms as phone numbers frequently
change and we have a transient population. We have made changes to our approach and have been
able to interview more moms.
Community Education: Conduct a media campaign to encourage early and
continuous prenatal care. Conduct a media campaign to encourage early and
continuous prenatal care, conduct a media campaign to promote prenatal
alcohol and drug cessation, hold a FIMR town meeting, meet with community based organizations,
Publish an annual FIMR report , Other (please specify) Improve Database for 211
Service Systems Improvement: Eliminate a gap in MCH services, Improve referral patterns among
agencies, Streamline MCH Medicaid application processes.
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Report the FIMR findings to the State MCH Director.
Improved Practices: Enhance services to bereaved families, Implement screening for substance
abuse.
Professional Training: Develop a community resource directory.
Actions taken because of FIMR:
The Washoe County FIMR CAT Team is assisting with updating the resource directory (211) through
the MCH coalition. In addition, efforts have been made to implement a media campaign to encourage
early and regular prenatal care. The Community Action Team has initiated working with the District
Attorney and hospitals to devise a system to collect baseline data that can be utilized to help develop
a plan to address the issue of fetal drug exposure. The FIMR annual report was distributed to the
FIMR Case Review Team and the Community Action Team. The report was also shared
with the Maternal Child Health Advisory Board and the Washoe County District Board of Health.
Evaluation of the actions are unavailable at this time as we are in the beginning phases of
implementation.
Ethnic Populations:
American Indian/ Alaska Native (Please specify
1
tribes/nations)
Asian (Please specify country of origin)
2
NFIMR report on programs in USA and Puerto Rico, June 2016 114
Black/ African American (If specific culture, please name)
4
Pacific Islander (Please specify if Native Hawaiian,
Guamanian, Samoan or Other)
1
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto
Rican, Cuban, Descendants of Spain,
Central and/or South American)
14
White (Please specify country of origin)
33
Foreign-Born/ Immigrants
unknown
Data not available
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 450000
Total number of live births: 5300
Total number of fetal deaths: 42
Total number of infant deaths: 39
Annual Budget: Data not provided
9
NFIMR report on programs in USA and Puerto Rico, June 2016 115
Margaret Gray is the New Jersey state coordinator.
Name: Maggie Gray
Organization: New Jersey Department of Health
State: NJ
Which Agency leads the coordination of your FIMR program?: NJ Department of Health- provide
grants to the MCHC to do local FIMR
Do members of a federal Healthy Start participate in your FIMR team(s)?: Yes
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR collaboration look like in your community?: Data not provided
Which of these theories/methods are being implemented in conjunction with FIMR?: Life Course
Theory
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin? : Data not provided
Approximately how many cases do you review in 2015 by category: Varies per region
Percentage of Interview: Varies per region
Two tiered system: No
Please tell us more about your Community Action Team. The CAT is: Developed solely for the FIMR
program
Community Education: Many of the other programs within the DOH utilize the information from
FIMR and implement it in their programs.
Service Systems Improvement: Data not provided
Policy/Advocacy: Data not provided
Improved Practices, Programs, and Policies: Data not provided
Professional Training: NJ also has a SIDS program that works collaboratively with the FIMR programs
Actions taken because of FIMR: varies per region
Ethnic Populations: Data not provided
Special Populations: Data not provided
Population in your FIMR catchment area:
Data not provided
Annual Budget: Varies per region
How many funded staff are on the state level?: Data not provided
How many in-kind staff are on the state level?: 1
What are the functions of the state program?: Technical assistance to local teams , Coordinator of
state team/board , Coordination of local teams , Training of local teams
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
If yes, what are the functions of the board?: Data not provided
Name: Sheryl Dwyer
Organization: Central Jersey Family Health Consortium
State: NJ
Approximate cases reviewed:
Fetal Deaths, Number: 33
Neonatal Deaths, Number: 18
NFIMR report on programs in USA and Puerto Rico, June 2016 116
Post neonatal Deaths, Number: 1
Other, please specify type of review & number: 6 maternal interviews
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? no collaboration
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 12
Community Education: Promote breastfeeding, Meet with community based organizations, Publish a
FIMR newsletter.
Service Systems Improvement: Improve bereavement referral services, Other (please specify)
NJ has a central intake program, based at each MCH consortium, FIMR distributes the information
regarding Central Intake at meetings
Policy Advocacy: State Stillbirth legislation was enacted in 2014, FIMR continues to educate hospitals
and providers regarding the legislation
Improved Practices: Enhance services to bereaved families, Other (please specify)
Within the Maternal Child Health Consortium we have a Post-Partum Depression program and have
increased referrals to the program for mothers who have had a perinatal death; Perinatal Addictions
grant addresses smoking cessation, substance and alcohol use; Central Intake links women and
families to services
Professional Training: Conduct provider education programs (e.g., management of IUGR, diabetes in
pregnancy, etc.), Implement bereavement training
Actions taken because of FIMR:
PROBLEM: Need to educate community regarding smoking cessation programs. FIMR case reviews
Identified lack of knowledge by mothers of importance of fetal movement awareness and acting upon
changes. Need for community workers to be knowledgeable regarding smoking cessation and fetal
movement counts so they can educate their clients properly.
RECOMMENDATION: Community bulletin to be created and distributed to community organizations
with “Did You Know” topics as well as information relevant to Fetal/Infant Mortality according to
FIMR recommendations.
INTERVENTION: Community health worker bulletin created entitled "DID YOU KNOW: A Community
Bulletin". Topics included Smoking Cessation Program, Fetal Movement Awareness and Fetal Infant
Mortality Review. This Bulletin’s target audience is Community Health Workers, Home Visitation
providers and community organizations that provide services to pregnant/childbearing age women.
The goal of the bulletin is to provide health maintenance and preventative care information to the
community providers. The bulletin has been distributed at the County Coalition meetings to
community providers and to the Home Visitation Programs. It will also be posted on the CJFHC
website. OUTCOMES: Well received by the intended audience; an electronic survey link was provided
and results have not been tabulated.
PROBLEM: Recommendation for interconceptual care during FIMR case reviews. Maternal interviews
identified a lack of compassion and information from providers. Lack of autopsy or alternative to
autopsy for evaluation of stillbirth.
RECOMENDATION: Collaborate with other agencies to develop interventions to disseminate
information on Interconceptual care.
INTERVENTION: Central Jersey Family Health Consortium has been collaborating since July 2014 with
the March of Dimes and the 2 other Consortiums on a Stillbirth/Interconceptual Care Project for
providers. The project is in the final stages of design and editing. The toolkits will include evidence
NFIMR report on programs in USA and Puerto Rico, June 2016 117
based literature, resource lists for providers/families, communication points for providers, letter to
parents regarding autopsy/testing/alternatives to autopsy, birth plan for perinatal loss, provider key
points for the postpartum visit and interconceptual care. Once completed, presentations for
providers at our region hospitals will be done and toolkits will be given to providers. A link will be
provided on magnets that will be distributed to hospitals, clinics and providers. All information will be
available on the CJFHC website.
OUTCOME: Intervention not instituted to date.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, Observant Jewish, Asian Indian
Population in your FIMR catchment area:
Total population in the catchment area 2,869,254 (2013 est)
Total number of live births
29,770 (2013)
Total number of fetal deaths 180 (2013)
Total number of infant deaths 64 (neonatal 2013), 23 post neonatal (2012)
Annual Budget: Data not provided
Name: Judy Stark
Organization: Southern NJ Perinatal Cooperative
State: NJ
Approximate cases reviewed:
Fetal Deaths, Number 30
Neonatal Deaths, Number 6
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Currently there is no collaboration
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 10%
Community Education:
Conduct a media campaign to encourage early and continuous prenatal care, Develop culturally
relevant health education materials, meet with community based organizations
Service Systems Improvement: Improve referral patterns among agencies,
Improve bereavement referral services.
Policy Advocacy: Report the FIMR findings to the State MCH Director.
Improved Practices: Enhance services to bereaved families.
Professional Training: Conduct provider education programs, implement bereavement training
Actions taken because of FIMR:
Problem: Maternal Obesity reported in 43% of cases
Recommendations: due to lack of one to one nutritional support in PNC sites (only group at WIC)
increase involvement
of Nutritional education at PNC sites by SNAP Ed and education to Home Visiting programs in County
Outcomes: SNAP Ed in place in FQHC's and Home visitors trained. We will continue to monitor rates.
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 391,106
Total number of live births 3969
NFIMR report on programs in USA and Puerto Rico, June 2016 118
Total number of fetal deaths 26
Total number of infant deaths 35
Annual Budget: Data not provided
Name: Carly Woman Ryan
Organization: Partnership for Maternal Child Health of Northern New Jersey
State: NJ
Approximate cases reviewed:
Fetal Deaths: 65
Neonatal Deaths: 25
Post neonatal Deaths, Number: 5
Reviews with FIMR program participation: Child Fatality Review,
Child Abuse and Neglect Review
What does CDR and FIMR look like in your community? FIMR staff attends CDR meetings
Statute to protect FIMR teams: Covered by general public health authority at state
Department of Health
Two-tiered system: Yes
Percentage of interviews: 18
Community Education: Conduct a media campaign about risks of prematurity
Develop culturally relevant health education materials
Meet with community based organizations, Other (please specify)
Physician and community education regarding kick counts, physician and nursing education regarding
stillbirth management and diagnosis and prevention in subsequent pregnancies, work with Medicaid
to create a media campaign regarding early prenatal care and presumptive eligibility.
Service Systems Improvement: Eliminate a gap in MCH services, improve referral patterns among
agencies, improve bereavement referral services, Implement “one-stop-shopping” prenatal care,
Partner with local MOD Prematurity Campaign , Streamline MCH Medicaid application processes
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Expand hospital quality assurance standards , Enhance services to bereaved
families ,Implement standardized prenatal risk assessment , Implement screening for domestic
violence , Implement screening for substance abuse , Implement screening for postpartum depression
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider education programs (e.g., management of IUGR, diabetes in pregnancy, etc.
Develop a community resource directory , Implement bereavement training
Actions taken because of FIMR: Data not provided
Ethnic Populations:
Asian (Please specify country of origin) 5% Black/ African American (If specific culture, please name)
33%
Pacific Islander (Please specify if Native Hawaiian, Guamanian, Samoan or Other) 0%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American) 21%
White (Please specify country of origin) 38%
Foreign-Born/ Immigrants
31%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 5,011,192
NFIMR report on programs in USA and Puerto Rico, June 2016 119
Total number of live births
60,022
Total number of fetal deaths 391
Total number of infant deaths 223
Annual Budget: $92,000
NFIMR report on programs in USA and Puerto Rico, June 2016 120
Andrea Filio is the Ohio state coordinator.
Name: Andrea Filio
Organization: Ohio Department of Health
State: OH
Which Agency leads the coordination of your FIMR program?: Different local teams pick their own
agencies to lead
Do members of a federal Healthy Start participate in your FIMR team(s)?: Determined by local FIMR
teams
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR collaboration look like in your community?: Determined by local FIMR
teams
Which of these theories/methods are being implemented in conjunction with FIMR?: Data not
provided
Statute to protect FIMR programs: Data not provided
Is the program currently reviewing cases? : Data not provided
In what year did Case Reviews first begin?: I am the coordinator at the state level. The different
local FIMR teams are at various stages.
Approximately how many cases do you review in 2015 by category?: Data not provided
Percentage of Interview: Data not provided
Two tiered system: Yes
Please tell us more about your Community Action Team. The CAT is: Determined by local FIMR
teams
Community Education: Data not provided
Service Systems Improvement: Data not provided
Policy/Advocacy: Data not provided
Improved Practices, Programs, and Policies: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Determined by local FIMR teams
Ethnic Populations: Data not available
Special Populations: Data not available
Population in your FIMR catchment area: Data not available
Annual Budget: Data not available
How many funded staff are on the state level?: 1
How many in-kind staff are on the state level?: Data not provided
What are the functions of the state program?: Technical assistance to local teams, Training of local
teams
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
Name: Lauren Rose-Cohen
Organization: Columbia Public Health
State: OH
Approximate cases reviewed:
Fetal Deaths:
21
Neonatal Deaths:
6
NFIMR report on programs in USA and Puerto Rico, June 2016 121
Post neonatal Deaths:
3
Reviews with FIMR program participation: Other SIDS review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 33%
Community Education: Meet with community based organizations, Publish an annual FIMR report
Service Systems Improvement: Improve bereavement referral services , Other (please specify)
Developed a comprehensive grief services directory for our county. This is distributed to all agencies
included in the brochure and mailed to all families who've experienced a loss. We also are
collaborating with WIC to improve outreach to eligible families who've had a loss so they will get their
WIC benefits after the demise.
Policy Advocacy: Data not provided
Improved Practices: Enhance services to bereaved families
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area : 1,212,000
Total number of live births: 18,000+
Total number of fetal deaths: 140
Total number of infant deaths: 150
Annual Budget: Data not provided
Name: Latoya Dickens
Organization: Canton City Health Department
State: OH
Approximate cases reviewed: Fetal Deaths, Number 1
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community?
Currently there is no collaboration, there are some community members who are on the
FIMR and CDR teams. Currently the two teams are not working together.
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 100
Community Education: Conduct a media campaign to address disparities in
infant health, Develop culturally relevant health education materials
Meet with community based organizations
Service Systems Improvement: Improve bereavement referral services
Policy Advocacy: Report FIMR findings to the Mayor, County
Executive, and/or other officials on an annual basis, Report the FIMR findings to the State MCH
Director.
Improved Practices:
Expand hospital quality assurance standards, enhance services to bereaved families,
Improve cultural competency protocols.
Professional Training:
NFIMR report on programs in USA and Puerto Rico, June 2016 122
Implement SIDS training programs, Develop a community resource directory,
Implement bereavement training
Actions taken because of FIMR:
Problem: Lack of safe sleep education in the hospitals
Recommendation: reeducate nurses on safe sleep and provide an education check list prior to
mother’s discharge from.
Hospital Interventions: Both local hospitals provide uniform safe sleep education and sleep sacks prior
to mother and babies
discharge.
Problem: late prenatal care and poor outcomes
Recommendation: push for and increase on centering pregnancy care
Interventions: local push to increase enrollment in centering prenatal care at one local hospital. The
other local hospital
is work to set up a centering pregnancy care program
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 74,000
Total number of live births 4,000
Total number of fetal deaths 21
Total number of infant deaths 337
Annual Budget: 30,233.96
Name: Karen Carr
Organization: Butler County Health Department
State: OH
Approximate cases reviewed:
Fetal Deaths, Number 14 (still missing some end of the year data)
Neonatal Deaths, Number: 16
Post neonatal Deaths, Number: 5
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Staff works on both CDR and FIMR ,
Members attend each other's meetings,
Prevention recommendations are developed jointly,
Prevention recommendations are shared, Other (please specify)
Future plan to work on prevention recommendations jointly
Statute to protect FIMR teams: State of Ohio has not put FIMR under CFR though
there has been discussion to do this.
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: New FIMR program. Have had low response rate to letters sent out for
FIMR interviews. FIMR nurse is part time and does not have time to do door to door outreach. Have
had one interview.
Community Education: Developed grief resource brochure for the county
Service Systems Improvement: Data not provided
Policy Advocacy: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 123
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: We have not had any recommendations/interventions since our CRT
hasn't met yet.
Ethnic Populations:
Black/ African American (If specific culture, please name)
25%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American)
25%
White (Please specify country of origin) 50%
Other (please specify) 2 cases have been reviewed; one with an interview.
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 371,272
Annual Budget: Data not provided
Name: Angela Newman White
Organization: Cuyahoga County Board of Health
State: OH
Approximate cases reviewed:
Fetal Deaths, Number
Neonatal Deaths, Number
4
3
Post neonatal Deaths, Number
0
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization, Staff works on both CDR and FIMR , Members attend each
other's meetings, Joint reviews are conducted, cases are triaged into FIMR or CDR , Meetings are
coordinated.
Statute to protect FIMR teams: There is only a statute for chart review
Two-tiered system:
Yes
Percentage of interviews: 86%
Community Education: Develop culturally relevant health education materials
Service Systems Improvement: Improve bereavement referral services
Policy Advocacy: Data not provided
Improved Practices: Enhance services to bereaved families, Implement screening for postpartum
depression
Professional Training: Develop a community resource directory
Actions taken because of FIMR:
Problem: Parent(s) experiencing a fetal loss expressed disappointment in not having a birth certificate
available for their stillborn baby- noted in 100% of fetal interviews.
Recommendation: Make parent(s) experiencing a fetal loss aware that Ohio does offer a Stillbirth
Commemorative Abstract Birth Certificate for free.
Interventions: Family Interviewer includes the information and paperwork about the availability of
Ohio's Stillbirth Commemorative Abstract Birth Certificate in a mailing that is sent to all fetal death
families.
NFIMR report on programs in USA and Puerto Rico, June 2016 124
Outcomes: Review of ongoing contact (verbal, electronic, family interview) 100% of families with fetal
loss would like to send in the paperwork to request the Stillbirth Commemorative Abstract Birth
Certificate.
Problem: Lack of a comprehensive and current grief resource guide for Cuyahoga County was noted in
100% of family interview cases.
Recommendation: Create a comprehensive grief resource guide that can be kept up-to-date for
Cuyahoga County that is made available to all families experiencing a fetal and/or infant loss.
Intervention: The FIMR Family Interviewer has created a comprehensive grief resource guide for
Cuyahoga County that is mailed to all families in Cuyahoga County that experience a fetal and/or
infant death. This guide is kept up-to-date by the FIMR Family Interviewer.
Outcomes: to be determined. Initial feedback during family interviews have been positive.
Ethnic Populations:
Black/ African American (If specific culture, please name)
29%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American) 14% (Puerto Rican)
White (Please specify country of origin) 57%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 1.2 million
Total number of live births
14,500 (2015)
Total number of fetal deaths 122 (2015)
Total number of infant deaths 137 (2015)
Annual Budget: 30,000
Name: Tracy Styka
Organization: Mahoning County District Board of Health
State: OH
Approximate cases reviewed:
Fetal Deaths: 0
Neonatal Deaths: 6
Reviews with FIMR program participation : Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR , Funding is shared, Members attend each other's meetings , Cases
are triaged into FIMR or CDR.
Statute to protect FIMR teams: Data not provided
Two-tiered system: Data not provided
Percentage of interviews: Data not provided
Community Education: No recommendations or accomplishments to date, since we are just getting
started
Service Systems Improvement: No recommendations or accomplishments to date, since we are just
getting started
Policy Advocacy: no recommendations or accomplishments to date, since we are just getting started
NFIMR report on programs in USA and Puerto Rico, June 2016 125
Improved Practices: no recommendations or accomplishments to date, since we are just getting
started
Professional Training: no recommendations or accomplishments to date, since we are just getting
started
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Ethnic Populations: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 126
Oklahoma does not have a state coordinator.
Name: Kelli McNeal
Organization: OKC- County Health Department
State: OK
Approximate cases reviewed:
Fetal Death:
54
Neonatal Deaths:
36
Post neonatal Deaths: 30
Reviews with FIMR program participation: Maternal Mortality Review
What does CDR and FIMR look like in your community? Members attend each other’s meetings
Statute to protect FIMR teams: No
Two-tiered system: Data not provided
Percentage of interviews: 30
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign to address disparities in infant health
Hold a FIMR town meeting, Develop culturally relevant health education materials,
Publish a FIMR newsletter
Service Systems Improvement: Improve bereavement referral services ,Partner with local MOD
Prematurity Campaign
Policy Advocacy: Report the FIMR findings to the State MCH Director
Develop local or state legislation
Improved Practices: Enhance services to bereaved families, Implement screening for postpartum
depression.
Professional Training: implement SIDS training programs
Actions taken because of FIMR:
Problem: Lack of standardized data Recommendation: Use of the SUIDI form
Interventions: Approach law enforcement on the utilization of the SUIDI form and conduct trainings.
Outcomes: Over 32 law enforcement agencies, including tribal police in 5 county region now have
signed a pledge to use the SUIDI form during infant death scene investigations.
Ethnic Populations: Data not available
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area approximately: 1.2 million
Total number of live births: 12,000
Total number of fetal deaths: 54 in 2015 (preliminary numbers)
Total number of infant deaths: 81 in 2015 (preliminary numbers)
Annual Budget: $290,000
NFIMR report on programs in USA and Puerto Rico, June 2016 127
Pennsylvania does not have a state coordinator.
Name: Emily Donovan
Organization: Philadelphia Department of Public Health Division of Maternal, Child, and Family Health
State: PA
Approximate cases reviewed:
Fetal Deaths: 0
Neonatal Deaths: 0
Post neonatal Deaths: 3
Other, please specify type of review & number: 0
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Members attend each other's meetings;
Cases are triaged into FIMR or CDR
Other (please specify) CDR shares data with FIMR
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 33%
Community Education: Plans: formed working groups to ban crib bumpers and conduct media
campaign about safe sleep
Service Systems Improvement: Data not provided
Policy Advocacy: Plans-develop a policy/ordinance in the city
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR:
PROBLEM: Crib bumpers have led to asphyxiation deaths and death from climbing over the side of the
crib. RECOMMENDATION: Develop an ordinance to ban the sale of crib bumpers in Philadelphia.
INTERVENTIONS: Formation of a CAT working group to ban the sale of crib bumpers in Philadelphia
through City leadership.
OUTCOMES: (in progress)
PROBLEM: Although safe sleep education at labor and delivery is mandated in hospitals in
Philadelphia, parents and guardians do not always follow the recommendations.
RECOMMENDATION: Conduct a media campaign to educate mothers, fathers, grandparents, other
guardians, and community members about safe sleep in order to reinforce messages that may have
only been given once to parents. INTERVENTIONS: Formation of CAT working groups to (1) develop
safe sleep messages appropriate for various types of audiences in the community and (2) disseminate
the safe sleep messages in order to reach communities experiencing the highest infant mortality
rates.
OUTCOMES: (in progress)
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, Of our FIMR members, we have an organization
committed to improving Black Women's health and a faith leader who is well connected with the
Christian faith community.
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 128
Puerto Rico does not have a state coordinator.
Name: Cindy Calderon, MD
Organization: PR NFIMR MCAH PR DOH
State: PR
Approximate cases reviewed:
Fetal Deaths: 0
Neonatal Deaths, Number from 2011 to 2015: 16 cases evaluated
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? There is no CDR in my community
Statute to protect FIMR teams: No, There is no law for FIMR in PR
Two-tiered system: Yes
Percentage of interviews: all cases from 2011 to 2015 included a maternal interview
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign to promote prenatal alcohol and drug cessation
Promote breastfeeding, Develop culturally relevant health education materials
Publish an annual FIMR report
Service Systems Improvement: Improve referral patterns among agencies, improve bereavement
referral services, Streamline MCH Medicaid application processes, Other (please specify)
improve presence of nutritionist services in WIC clinics
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Report the FIMR findings to the State MCH Director
Other (please specify) Advocating for the development of a Bill for FIMR in PR
Improved Practices: Enhance services to bereaved families
Professional Training: Conduct provider education programs (e.g., management of IUGR, diabetes in
pregnancy, etc.), Results were presented in 'poster presentations in two local forums directed to
health care providers, Women’s Preventive Care Update in November 1, 2015 and in the Annual
Puerto Rico Physician Convention December 2015CoHealth
Actions taken because of FIMR:
PROBLEM: In the 2009-2011 reviews 69% received early prenatal care RECOMMENDATION and
INTERVENTION: By recommendation of the FIMR Review Team, findings and recommendations were
shared in presentations to health care providers in 2 main conferences OUTCOMES; Upon review of
the 2012-2015 cases there was an increase to 89% receiving prenatal care . PNC in PR has improved
over the years. By 2014, VS data shows that about 86% of live births in PR, their mothers initiated PNC
during the first trimester of pregnancy. Average Annual Percent Change (AAPC) trend analysis shows a
significant increase of 0.6% since 2005 (81.5%)
Ethnic Populations: Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban,
Descendants of Spain, Central and/or South American)
100%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 3,500,000
Total number of live births: 34,493
Total number of fetal deaths: 11.7 for each 1,000 live births
Total number of infant deaths: 7 for each 1,000 live births
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 129
Rachel Heitmann is the Tennessee state coordinator and April Kincaid is transitioning to that position.
Name: Rachel Heitmann
Organization: Tennessee Department of Health
State: TN
Which Agency leads the coordination of your FIMR program?: State Health Department
Do members of a federal Healthy Start participate in your FIMR team(s)?: Our community does not
have a Healthy Start program
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR collaboration look like in your community?: Leadership is housed in one
organization , Staff works on both CDR and FIMR , Members attend each other's meetings
Which of these theories/methods are being implemented in conjunction with FIMR?: Perinatal
Periods of Risk
Statute to protect FIMR programs: Yes
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin? : 2010
Approximately how many cases do you review in 2015 by category?: Other, please specify type of
review & number:
176 total deaths reviewed in 2015
Percentage of Interview: Yes
Two tiered system: Yes
Please tell us more about your Community Action Team. The CAT is: Most teams are developed
solely for the FIMR program but one area of the state already had an
existing safe sleep coalition that they are using as their community action team
Community Education: Hold a town health fair, Meet with community based organizations, Publish
an annual FIMR report
Service Systems Improvement: Improve bereavement referral services,
Partner with local MOD Prematurity Campaign.
Improved Practices, Programs, and Policies: Expand hospital quality assurance standards
Policy/Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH
Professional Training: Conduct provider training on prematurity/preterm labor management
Implement SIDS training programs
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Populations: Data not provided
Population in your FIMR catchment area:
Total population in the catchment area: 3,160,875
Total number of live births: 41,563
Total number of fetal deaths: 309
Total number of infant deaths: 311
Annual Budget: Data not provided
How many funded staff are on the state level?: 1
How many in-kind staff are on the state level?: 25
What are the functions of the state program?: Technical assistance to local teams, Training of local
teams
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
NFIMR report on programs in USA and Puerto Rico, June 2016 130
Name: Autumn Mays
Organization: East TN. Regional Office
State: TN
Approximate cases reviewed: Post neonatal Deaths, Number 50
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? Currently there is no collaboration
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 60%
Community Education:
Conduct a media campaign to promote prenatal alcohol and drug cessation, promote breastfeeding,
hold a town health fair, Develop culturally relevant health education materials
Meet with community based organizations, Publish an annual FIMR report,
Other (please specify) Safe Sleep campaign.
Service Systems Improvement: I feel like we should collaborate with Child Fatality. I think in some
ways FIMR is a duplication of child fatality because the cases get reviewed by both teams/
Policy Advocacy: Report the FIMR findings to the State MCH Director
Develop local or state legislation
Improved Practices: Initiate or expand public health case management, expand services to homeless
women and children, expand services to pregnant substance abusers, enhance services to bereaved
families, expand family planning services, Implement standardized prenatal risk assessment,
Implement screening for domestic violence, Implement screening for substance abuse,
Implement screening for smoking , Implement screening for postpartum depression.
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Develop a community resource directory , Implement bereavement training
Actions taken because of FIMR: Problem: unsafe sleep deaths
recommendation and intervention: safe sleep campaign
outcomes: we have noted a decline in unsafe sleep deaths in Tennessee
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Yes, we do not discriminate against any religion or cultures.
We review if a baby dies in our region and falls in our cohort.
Population in your FIMR catchment area: Data not provided
Annual Budget: 1600.00; 1800.00 travel, 1900.00 for brochures and
pamphlets; Rural HD do not get a budget but metros do
Name: Lisa Vincent
Organization: Chattanooga-Hamilton County Health Department
State: TN
Approximate cases reviewed:
Fetal Deaths:
8
Neonatal Deaths:
14
Post neonatal Deaths:
6
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization
NFIMR report on programs in USA and Puerto Rico, June 2016 131
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: We have about a 30%-40% interview rate, so being less than half of the
cases reviewed, that would not be a typical situation to have an interview. We attempt to contact all
of the mothers to conduct interviews.
Community Education: Conduct a media campaign to encourage and educate on Safe Sleep
Service Systems Improvement: Improve referral patterns among agencies, Partner with local MOD
Prematurity Campaign , Other (please specify), Provide folic acid and PNV in all HD clinics and home
visiting programs; provide standardized positive pregnancy test packets in all HD clinics
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Expand hospital quality assurance standards, Expand services to homeless
women and children, Implement screening for smoking ,Implement screening for postpartum
depression, Safe sleep Gold level national certification of local hospital system
Professional Training: Conduct provider training on use of screening tools (e.g., substance use,
domestic violence, etc.)Develop a community resource directory , Other (please specify) Safe sleep
training
Actions taken because of FIMR: Lack of resources for safe sleep space for babies: provided pack n
plays with sheets and Halo sleep sacks to more than 100 individuals- partnerships with a wide variety
of community agencies to identify those in need.
Lack of knowledge of safe sleep practices. Conducted a large scale safe sleep media campaign. Safe
sleep messages on buses, in large screens in food court area of mall, pre-show at 2 local movie
theaters, on screen in department of motor vehicle locations in the county.
Reduction of women smoking while pregnant needed. Partnered with Baby and Me program to
promote and offer program in our community.
Lack of education regarding prenatal care information and child/infant care. Promotion of Text4Baby
program. Lack of information and promotion of kick counting/fetal movement monitoring in
pregnancy. Promotion of Count the Kicks education/information and app.
Communication issues between providers and with pregnant mother. Developed prenatal passport
and distributed to all OB providers in the county.
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations): 1
Asian (Please specify country of origin)
5
Black/ African American (If specific culture, please name)
60
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto
16
Rican, Cuban, Descendants of Spain, Central and/or South American)
White (Please specify country of origin) :
94
Special Religious or Cultural Subgroups: Yes, Hispanic population, Asian population
Population in your FIMR catchment area:
Total population in the catchment area: 350,000
Total number of live births: 4,000 per year
Total number of infant deaths: 28 in 2013
Annual Budget: $230,000
Name: Katherine Larsen
Organization: Knox County Health Department
State: TN
NFIMR report on programs in USA and Puerto Rico, June 2016 132
Approximate cases reviewed:
Fetal Deaths:
1
Neonatal Deaths:
15
Post neonatal Deaths: 10
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community?
Leadership is housed in one organization , Staff works on both CDR and FIMR , Members attend each
other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: 1%
Community Education: Conduct a media campaign to encourage early and continuous prenatal care
Conduct a media campaign to promote prenatal alcohol and drug cessation
Service Systems Improvement: Eliminate a gap in family planning services,
Improve bereavement referral services
Policy Advocacy: Data not provided
Improved Practices: Expand services to pregnant substance abusers,
Enhance services to bereaved families,
Implement screening for substance abuse
Professional Training: Implement bereavement training
Actions taken because of FIMR: Data not provided
Ethnic Populations:
Black/ African American (If specific culture, please name)
34.6
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain,
Central and/or South American)
3.86
White (Please specify country of origin)
57.76
Other (please specify)
7.76
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 448.644
Total number of live births: 5255
Total number of fetal deaths: unknown
Total number of infant deaths: 32
Annual Budget: Data not provided
Name: Jamila Batts
Organization: Shelby County Health Department
State: TN
Approximate cases reviewed:
Fetal Deaths:
51
Neonatal Deaths:
13
Post neonatal Deaths:
33
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization ,
Members attend each other's meetings , Cases are triaged into FIMR or CDR , Prevention
recommendations are shared
NFIMR report on programs in USA and Puerto Rico, June 2016 133
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: 30
Community Education: Conduct a media campaign to encourage early and continuous prenatal care,
Promote breastfeeding, Meet with community based organizations, Publish an annual FIMR report.
Service Systems Improvement: Eliminate a gap in MCH services, Improve bereavement referral
services, Partner with local MOD Prematurity Campaign ,
Streamline MCH Medicaid application processes
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Report the FIMR findings to the State MCH Director
Improved Practices: Enhance services to bereaved families
Professional Training: Implement SIDS training programs
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 134
Texas does not have a state coordinator.
Name: Alexei Collins
Organization: Dallas Healthy Start
State: TX
Approximate cases reviewed:
Fetal Deaths:
12
Neonatal Deaths:
8
Post neonatal Deaths:
2
Reviews with FIMR program participation: Data not provided
What does CDR and FIMR look like in your community? A Dallas Healthy Start staff member attends
CDR meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: Data not provided
Community Education:
Meet with community based organizations,
Publish an annual FIMR report , Promote existing text4baby campaign.
Service Systems Improvement: Improve referral patterns among agencies, Improve bereavement
referral services, Partner with local MOD Prematurity Campaign, Other (please specify)
Reduce duplication and gaps in MCH services.
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis
Develop local or state legislation.
Improved Practices:
Enhance services to bereaved families, Other (please specify)
Implement program and screening for obesity
Professional Training: Conduct provider training on prematurity/preterm labor management
Conduct provider education programs (e.g., management of IUGR, diabetes in pregnancy, etc.)
Conduct provider training on use of screening tools (e.g., substance use, domestic violence, etc.)
Implement bereavement training.
Actions taken because of FIMR:
Problem: Mothers reporting a desire and need for more consistent prenatal education.
Recommendations: Find and promote existing prenatal education in the community.
Intervention: Promote the text4baby app through the Community Action Network (DHS version of
CAT).
Outcome: Review of text4baby statistics showed increase of users by 1600% from 52 to 830
individuals in a 6-month period. The county was recognized for the most participants in the state of
Texas.
Problem: 51% of FIMR mothers were overweight and of that number 62% were obese.
Recommendation: Collaborate with providers at a women's community clinic to provide screening,
education, care coordination and referrals to specialty services.
Intervention: Create a program at women's community clinic to screen for obesity, provide education,
follow-up and care coordination through the use of the "Someday Starts Now" tool.
Outcome: Ongoing, since the beginning of the program 6-months ago.
Ethnic Populations:
Asian (Please specify country of origin) 4.5% Indian
NFIMR report on programs in USA and Puerto Rico, June 2016 135
Black/ African American
American
Hispanic/ Spanish/ Latino
50% of total: 9% Kenyan, 18% Nigerian, 73%
41% of total: 89% Mexican, 11% El Salvadorian
White (Please specify country of origin) 4.5% American
Foreign-Born/ Immigrants
27%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area: 2,218,899
Total number of live births: 39,712
Total number of fetal deaths: 678
Total number of infant deaths: 504
Annual Budget: 112,000
NFIMR report on programs in USA and Puerto Rico, June 2016 136
Name: John Duah
Organization: San Antonio Healthy Start
State: TX
Approximate cases reviewed: Data not provided
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: Yes
Percentage of interviews: We expect to conduct maternal interviews as
part of our review process. We will share the data with you in the near future.
Community Education: Promote breastfeeding, develop culturally relevant health education
materials, meet with community based organizations, Other (please specify)
We do not have enough information on our program to share at this time.
Service Systems Improvement: Eliminate a gap in family planning services ,
Improve referral patterns among agencies, Improve bereavement referral services, Partner with local
MOD Prematurity Campaign, Improve/develop transportation routes to MCH services with the City or
County Transportation Department, Increase public safety around MCH service sites in collaboration
with City or County law enforcement, Develop a 911 system, Streamline MCH Medicaid application
processes.
Policy Advocacy: Invite the Mayor or County Executive to contribute to the FIMR annual report
Report the FIMR findings to the State MCH Director. We anticipate inviting the Mayor/an elected
official to be part of our FIMR program
Improved Practices:
Initiate or expand public health case management ,
Expand hospital quality assurance standards, Expand services to homeless women and children ,
Expand services to pregnant substance abusers, enhance services to bereaved families,
Expand family planning services, Implement standardized prenatal risk assessment,
Improve cultural competency protocols, Implement screening for domestic violence,
Implement screening for substance abuse, Implement screening for smoking,
Implement screening for postpartum depression
Professional Training:
Implement SIDS training programs, Develop a community resource directory
Implement cultural competency assessment for FIMR team members
Actions taken because of FIMR: As indicated earlier, we are in the process of launching our FIMR
program in the coming months. We expect to share our recommendations with you in the near
future. Regardless, we anticipate that care coordination and resource referrals will be a major
component of our policy recommendations when all is done
Ethnic Populations: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 1,813,421
Total number of live births
26,590
Total number of fetal deaths 154
Total number of infant deaths 162
Unknown
0
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 137
Megan Kimberly is new Utah state coordinator, information provided by Laurie Bash completed form.
Name: Laurie Bash
Organization: Utah Department of Health
State: Utah
Which Agency leads the coordination of your FIMR program?: State health department
Do members of a federal Healthy Start participate in your FIMR team(s)?: Our community does not
have a federal Healthy Start
Reviews with FIMR program participation: Child Fatality Review, Domestic Violence Review,
Maternal Mortality Review
What does CDR and FIMR collaboration look like in your community?: Leadership is housed in one
organization, Members attend each other's meetings
Which of these theories/methods are being implemented in conjunction with FIMR?:
Statute to protect FIMR programs: No
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin? : 1993
Approximately how many cases do you review in 2015 by category?
Fetal Deaths, Number 0; Neonatal Deaths, Number 90; Post neonatal Deaths, Number 10
Percentage of Interview: 0
We do not have the funding to conduct these interviews. We have one FTE who does both infant and
maternal death reviews.
Two tiered system: No
Please tell us more about your Community Action Team. The CAT is: Data not provided
Community Education: Work with perinatal quality collaborative to share
findings and support activities (such as prematurity prevention)
Service Systems Improvement: Partner with local MOD Prematurity Campaign
Improved Practices, Programs, and Policies:
Expand hospital quality assurance standards
Policy Advocacy: Report the FIMR findings to the State MCH Director;
Develop local or state legislation
Professional Training: Develop a community resource directory
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Special Populations:
Data not provided
Population in your FIMR catchment area:
Total population in the catchment area 2,942,902
Total number of live births 51,164
Total number of fetal deaths 273
Total number of infant deaths 251
Annual Budget: data not provided
How many funded staff are on the state level?:
data not provided
How many in-kind staff are on the state level?:
data not provided
What are the functions of the state program?:
data not provided
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 138
West Virginia does not have a state coordinator.
Name: Melissa Baker
Organization: WV OMCFH
State: WV
Approximate cases reviewed:
Fetal Deaths, Number 0
Other, please specify type of review & number approximately 150 total infant deaths per year
Reviews with FIMR program participation: Child Fatality Review, Maternal Mortality Review,
Other SIDS review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR,
Members attend each other's meetings
Statute to protect FIMR teams: Yes
Two-tiered system: No
Percentage of interviews: Data not provided
Why interview is not done: no interviews are conducted - only chart records and death scene
investigations where notes have been recorded of conversations with family members
Community Education: Publish a FIMR newsletter
Service Systems Improvement: Data not provided
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a
day or week promoting MCH,
• Report the FIMR findings to the State MCH Director,
• Develop local or state legislation
Improved Practices:
Expand hospital quality assurance standards , Expand services to pregnant substance abusers
Professional Training:
Conduct provider education programs (e.g.,
management of IUGR, diabetes in pregnancy, etc.)
Implement SIDS training programs
Actions taken because of FIMR: Data not provided
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total number of live births 21000per year in the state
Total number of infant deaths roughly 150 per year
Annual Budget: only covers salary for nurses that complete chart abstracts
NFIMR report on programs in USA and Puerto Rico, June 2016 139
Katie Gillespie and Abby Collier are the Wisconsin state coordinators.
Name: Abby Collier
Organization: Children’s Health Alliance of Wisconsin-Children’s Hospital of Wisconsin
State: WI
Which agency leads the coordination of your FIMR program?
Do members of a Federal Healthy Start participate in your FIMR team?
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review , Citizen
Review Panel
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR, Funding is shared, Members attend each other's meetings, Joint
reviews are conducted, Cases are triaged into FIMR or CDR, Meetings are coordinated,
Prevention recommendations are developed jointly, Prevention recommendations are shared.
Which of these theories/methods are being implemented in conjunction with FIMR:
Life Course Theory, Perinatal Periods of Risk, NFIMR Team Cultural Competency Assessment
Statute to protect FIMR teams: No
Is the program currently reviewing cases? : Yes
In what year did Case Reviews first begin? : Varies
Approximately how many cases do you review in 2015 by category?
Fetal Deaths:
300
Neonatal Deaths:
150
Post neonatal Deaths, Number: 100
Two-tiered system: Yes
Please tell us more about your Community Action Team. The CAT is: Some FIMR teams have a
separate CAT, while others utilize existing coalitions. At the state level, there is a state council that
makes recommendations
Percentage of interviews: Varies depending on site. Average 40 percent
Community Education: Data not provided
Service Systems Improvement: Eliminate a duplication of MCH services,
Eliminate a gap in MCH services, eliminate a gap in family planning services, improve referral patterns
among agencies, improve bereavement referral services, and Implement “one-stop-shopping”
prenatal care.
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH.
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis.
Include the Mayor or County Executive as a FIMR Community Action Team member.
Invite the Mayor, County Executive or other elected official to chair a FIMR town meeting.
Invite the Mayor or County Executive to contribute to the FIMR annual report.
Report the FIMR findings to the State MCH Director.
Develop a policy in collaboration with City or County law enforcement offices or emergency services,
Develop local or state legislation.
Improved Practices: Expand hospital quality assurance standards, expand services to pregnant
substance abusers, enhance services to bereaved families, Expand family planning services,
Implement standardized prenatal risk assessment, Improve cultural competency protocols,
Implement screening for domestic violence, Implement screening for substance abuse,
Implement screening for smoking, Implement screening for postpartum depression.
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 140
Special Religious or Cultural Subgroups: Yes, Amish
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
How many funded staff are on the state level? 1
How many in-kind staff are on the state level? 2
What are the functions of the state program? Technical assistance to local teams, Coordinator of
state team/board, Training of local teams, Data collection and reporting.
Is there a state-level advisory board that reviews local findings and makes state-level
recommendation? Yes
If yes, what are the functions of the board? Reviews local findings, make formal recommendations,
write annual reports.
Name: Katie H. Gillespie
State: WI
Organization: Wisconsin Department of Health Services
Which Agency leads the coordination of your FIMR program?: County/City Health Department
Do members of a federal Healthy Start participate in your FIMR team(s)?: No
Does your community have the following reviews:
Reviews with FIMR program participation: Child Fatality Review , Maternal Mortality Review
What does CDR and FIMR collaboration look like in your community:
Leadership is housed in one organization, Staff works on both CDR and FIMR, Funding is shared,
Members attend each other's meetings, Cases are triaged into FIMR or CDR, and meetings are
coordinated.
Which of these theories/methods are being implemented in conjunction with FIMR?: Life Course
Theory, Perinatal Periods of Risk
Statues to protect FIMR programs: Yes
Is the program currently reviewing cases?: Yes
In what year did Case Reviews first begin? : 1993
Percentage of Interviews: Data not provided
Two-tiered system: Data not provided
Please tell us more about your Community Action Team. The CAT is: Data not provided
Community Education: Data not provided
Service Systems Improvement: Data not provided
Improved Practices, Programs, and Policies: Data not provided
Policy Advocacy: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations: Data not provided
Population in your FIMR catchment area: Data not provided
Annual Budget: Data not provided
How many funded staff are on the state level?: 4
How many in-kind staff are on the state level?: 0
What are the functions of the state program: Technical assistance to local teams, Coordinator of
state team/board, Training of local teams, Data collection and reporting.
Is there a state-level advisory board that reviews local findings and makes state-level
recommendations?: No
NFIMR report on programs in USA and Puerto Rico, June 2016 141
Name: Leah Meidl
Organization: Wood County Health Department
State: WI
Approximate cases reviewed:
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community?
Leadership is housed in one organization , Members attend each other's meetings , Cases are triaged
into FIMR or CDR
Statute to protect FIMR teams: No, currently working on state legislation
Two-tiered system: No
Percentage of interviews: 35%
Why interview is not done: Data not provided
Community Education:
Promote breastfeeding,
Meet with community based organizations, Publish an annual FIMR report,
media campaign on kick counts and oral health
Service Systems Improvement: Improve referral patterns among agencies,
Improve bereavement referral services
Policy Advocacy: Develop local or state legislation
Improved Practices: Enhance services to bereaved families
Professional Training: Data not provided
Actions taken because of FIMR: Data not provided
Ethnic Populations:
American Indian/ Alaska Native (Please specify tribes/nations)
2.5%
Asian (Please specify country of origin) 2.5%
White (Please specify country of origin) 95%
Special Religious or Cultural Subgroups: Yes, Amish/Mennonite
Population in your FIMR catchment area:
Total population in the catchment area 180,000
Unknown
unknown, 3 counties participating
Annual Budget: Data not provided
Name: Daniel Stattelman-Scanlan
Organization: Public Health Madison and Dane County
State: WI
Approximate cases reviewed:
Fetal Deaths: 30
Neonatal Deaths: 20
Post neonatal Deaths: 10
Reviews with FIMR program participation: Child Fatality Review does not meet regularity-trying to
get going again
What does CDR and FIMR look like in your community?
Staff works on both CDR and FIMR, Members attend each other's meetings,
NFIMR report on programs in USA and Puerto Rico, June 2016 142
Prevention recommendations are developed jointly.
Statute to protect FIMR teams: I believe this is being worked on now, there is
language in statute about Child death review and authority of health department to do surveillance.
Two-tiered system: No
Percentage of interviews: Data not provided
Why interview is not done: We began maternal interviews in 2015. We are beginning to integrate
these into the case review.
Community Education:
Develop culturally relevant health education materials
Meet with community based organizations, Publish an annual FIMR report,
Conduct a campaign around safe sleep
Service Systems Improvement: Eliminate a gap in MCH services,
Improve referral patterns among agencies,
Improve bereavement referral services, Other (please specify)
Improved screening for diabetes, improve referral for opiate addiction, improved management for
women with opiate addiction
Policy Advocacy: Report FIMR findings to the Mayor, County Executive, and/or other officials on an
annual basis, Report the FIMR findings to the State MCH Director
Request to state government assign a Legislative Council STudy Committee on Prevention of
Premature births, Provide education to policy makers about effective ways to prevent infant
mortality/ unsafe sleep deaths
Improved Practices: Expand hospital quality assurance standards,
Expand services to pregnant substance abusers,
Enhance services to bereaved families,
Implement screening for smoking, Other (please specify)
improved screening for diabetes early in pregnancy
Professional Training: Implement SIDS training programs
Actions taken because of FIMR:
FIMR Report is available here: http://publichealthmdc.com/family/documents/FIMR2012.pdf
Safe Sleep Campaign: https://www.chawisconsin.org/PDF/IP4_Dane_County_Safe_Sleep.pdf
State SUID Report: https://www.chawisconsin.org/documents/IP5SUIDreport.pdf
PROBLEM: High number of infants dying in unsafe sleep environment RECOMMENDATION: Have
consistent safe sleep message for families and providers
INTERVENTIONS: Training of providers, clinic, hospital, home visitors, WIC staff and families- new
parents, faith community. Also media campaign with bus signs, billboards and radio PSA.
OUTCOMES: Surveyed mothers at WIC about safe sleep and campaign. Assessed ongoing causes of
infant death. Still reviewing the impact.
PROBLEM: Poor understanding of SUID vs SIDS and factors that may put infant at risk.
RECOMMENDATION: Use the CDC SUID Classification system for all cases.
INTERVENTIONS: Worked with local Pathologist and medical examiner reports to code each case and
improve understand of the cases and aggregate data.
Ethnic Populations:
American Indian/ Alaska Native (Please specify 0tribes/nations)
Asian (Please specify country of origin) Hmong/Chinese Black/ African American (If specific culture,
please name) 23%
NFIMR report on programs in USA and Puerto Rico, June 2016 143
Pacific Islander (Please specify if Native Hawaiian,
0
Guamanian, Samoan or Other)
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto
3
Rican, Cuban, Descendants of Spain, Central and/or South American)
White (Please specify country of origin) 65
Other (please specify) 9 (Hmong, other Asian, native American and
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area 500,000
Total number of live births
6000
Total number of fetal deaths 30/year
Total number of infant deaths 30/year
Annual Budget: $150,000??
Name: Margaret Gesner
Organization: Central Racine County Health Department
State: W
Approximate cases reviewed:
Reviews with FIMR program participation: Child Fatality Review
What does CDR and FIMR look like in your community? Leadership is housed in one organization,
Staff works on both CDR and FIMR,
Funding is shared,
Members attend each other's meetings,
Joint reviews are conducted,
Meetings are coordinated,
Prevention recommendations are developed jointly,
Prevention recommendations are shared
Statute to protect FIMR teams: No, currently under development
Two-tiered system:
Fetal Deaths, Number 0
Neonatal Deaths, Number 3
Post neonatal Deaths, Number 7
Other, please specify type of review & number 2 fetal
Percentage of interviews: 50%
Why interview is not done: Data not provided
Community Education:
Meet with community based organizations,
Other (please specify)
Work toward a hybrid CDR/FIMR team
Service Systems Improvement: Data not provided
Policy Advocacy: Report the FIMR findings to the State MCH Director
Improved Practices: Data not provided
Professional Training: Data not provided
Actions taken because of FIMR: Team has not identified any areas for action at this time
Special Religious or Cultural Subgroups: NO
Population in your FIMR catchment area: Total population in the catchment area 195000
NFIMR report on programs in USA and Puerto Rico, June 2016 144
Total number of live births 2375
Total number of fetal deaths 2
Total number of infant deaths 21
Annual Budget: 40000
Name: Karen Michalski
Organization: City of Milwaukee Health Department
State: WI
Approximate cases reviewed:
Fetal Deaths: 25
Neonatal Deaths: 25
Post neonatal Deaths: 15
Reviews with FIMR program participation: Child Fatality Review, Domestic Violence Review,
Maternal Mortality Review
What does CDR and FIMR look like in your community? Members attend each other's meetings
Statute to protect FIMR teams: No
Two-tiered system: No
Percentage of interviews: Data not provided
Why interview is not done: A majority of the mothers are contacted but only a small percentage
choose to participate.
Community Education: Conduct a media campaign to promote prenatal alcohol and drug cessation,
Conduct a media campaign to address disparities in infant health, Meet with community based
organizations.
Service Systems Improvement: Eliminate a duplication of MCH services, eliminate a gap in family
planning services, and Improve bereavement referral services.
Policy Advocacy: Initiate a Mayoral or Governor's proclamation of a day or week promoting MCH
Report FIMR findings to the Mayor, County Executive, and/or other officials on an annual basis
Invite the Mayor or County Executive to contribute to the FIMR annual report, Report the FIMR
findings to the State MCH Director.
Improved Practices: Expand hospital quality assurance standards, Enhance services to bereaved
families, Expand family planning services
Professional Training: Conduct provider education programs (e.g., management of IUGR, diabetes in
pregnancy, etc.)Implement SIDS training programs , Develop a community resource directory ,
Implement bereavement training
Actions taken because of FIMR: Data not provided
Ethnic Populations:
Black/ African American (If specific culture, please name)
50%
Hispanic/ Spanish/ Latino (Please specify Mexican, Puerto Rican, Cuban, Descendants of Spain, Central
and/or South American):
25%
White (Please specify country of origin)
25%
Special Religious or Cultural Subgroups: No
Population in your FIMR catchment area:
Total population in the catchment area : 600000
Total number of live births: 10000
Total number of fetal deaths: 75
NFIMR report on programs in USA and Puerto Rico, June 2016 145
Total number of infant deaths: 100
Annual Budget: 5000 excluding salaries
Name: Gianna Ventura
Organization: Kenosha County Division of Health
State: Wisconsin
Approximate cases reviewed:
Reviews with FIMR program participation: Child Fatality Review, Suicide Review Panel
What does CDR and FIMR look like in your community?
Staff works on both CDR and FIMR,
Cases are triaged into FIMR or CDR,
Prevention recommendations are shared
Statute to protect FIMR teams: No, still in development process
Two-tiered system: Yes
Percentage of interviews: Data not provided
Why interview is not done: Would like to implement maternal interviews. In development process
and exploring feasibility
Community Education: Promote breastfeeding, Develop culturally relevant health education
materials, Meet with community based organizations
Service Systems Improvement: Eliminate a gap in MCH services , Eliminate a gap in family planning
services ,Improve referral patterns among agencies , Improve bereavement referral services
Policy Advocacy:
Report the FIMR findings to the State MCH Director, Report FIMR findings to the Board of Health
Improved Practices: Expand services to homeless women and children, expand services to pregnant
substance abusers, enhance services to bereaved families, expand family planning services, Improve
cultural competency protocols, Implement screening for substance abuse.
Professional Training: Conduct provider training on use of screening tools
(e.g., substance use, domestic violence, etc.) Implement cultural competency training,
Develop a community resource directory, Implement cultural competency assessment for FIMR
team members
Actions taken because of FIMR: Problem: There was a lack of coordination and communication
between birthing hospitals and our community.
Special Religious or Cultural Subgroups: No
Ethnic Populations:
Population in your FIMR catchment area:
Data not provided
Annual Budget: Data not provided
NFIMR report on programs in USA and Puerto Rico, June 2016 146