Family Health Administration
Overview
October 2011
Donna Gugel, MHS, Acting Director
Family Health Administration (FHA)
Programs
With federal, state and special funds, including 20 federally funded grants,
Family Health Administration works with communities to improve the health
of all Marylanders, giving special attention to vulnerable populations in the
areas of
Maternal-child health
Family planning & reproductive health
Genetics and children with special health care needs
Women, Infants & Children (WIC)
Cancer control
Tobacco use prevention
Chronic disease & injury prevention
Oral health
Public health data, policy & planning
Chronic rehabilitative facilities
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Maryland Department of Health and Mental Hygiene
Family Health Administration
October 2011
Acting Director
Donna Gugel, MHS OFFICE OF ORAL HEALTH
Dental Director
Harry Goodman, DMD, MPH
Deputy Director
David Long
DEER’S HEAD LEGISLATION & REGULATIONS FINANCIAL HEALTH POLICY
HOSPITAL CENTER Director MANAGEMENT & PLANNING
Mary Beth Waide, CEO Christi Megna, Esq. Director Director
Joyce Wilkerson Vacant
WESTERN MD
HOSPITAL CENTER
Cindy Pellegrino, CEO
CENTER FOR OFFICE FOR OFFICE OF CENTER FOR CENTER FOR OFFICE OF
MATERNAL & GENETICS & THE CANCER HEALTH CHRONIC
CHILD CHILDREN WITH MARYLAND SURVEILLANCE PROMOTION, DISEASE
HEALTH SPECIAL WIC & CONTROL EDUCATION & PREVENTION
Director HEALTH CARE PROGRAM Director TOBACCO Director
Bonnie Birkel, NEEDS Director Courtney Lewis CONTROL Audrey Regan,
RN, MPH Director Jacqueline Acting Director PhD
Donna X. Harris Marlette-Boras Dr. Donald Shell
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Family Health Administration (FHA)
A public health focus on maternal-child health and
chronic disease prevention
Mission
To protect, promote and improve the health of all
Marylanders and their families through community-based
public health efforts, giving special attention to at-risk
and vulnerable populations.
Vision
A future in which all Marylanders and their families enjoy
optimal health and well-being.
Values
Diversity – Communication – Respect
Strategic Approach
FHA relies on the power of prevention and community
partnerships to improve maternal and child health and
prevent chronic diseases.
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Family Health Administration (FHA)
Aiming to improve health outcomes…Successes
Infant Mortality Teen Birth Births
4% decrease over the past 10 years 23% decrease over the past 10 years
Source: MD Vital Statistics
Source: MD Vital Statistics
Childhood Lead Poisoning Heart Disease / Cancer Mortality
82% decrease in elevated blood lead 24% decrease in heart disease mortality
over the past 10 years 14% decrease in cancer mortality
over the past 10 years
Source: MDE Lead Registry
Source: MD Vital Statistics
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Family Health Administration (FHA)
Aiming to improve health outcomes…Successes
Hospital-specific VLBW-specific neonatal
mortality rates have improved by 12% for
Level III facilities over the past 12 years
1994-1995 2005-2006
Tobacco use reduction (2000-2006) of 48.6% (middle school), 36.1% (high school), 15.4% (adults), and
26.1% (pregnant women) over 6 years
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Family Health Administration (FHA)
Aiming to improve health outcomes…Challenges
Infant Mortality Disparities Late Prenatal Care
Black/white disparity of >2:1 persists 35% increase in late prenatal care
rate over the past 10 years
Source: MD Vital Statistics
Source: MD Vital Statistics
Low Birth Weight Overweight and Obesity
2% increase in low birth weight rate in 47% increase in obesity over the past 10 years
Maryland over the past 10 years
Source: BRFSS
Source: MD Vital Statistics
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Family Health Administration (FHA)
A diverse array of public health service programs
that cover the life span
Maryland Family Planning Program Maryland WIC Program
144,531 family planning & Each month over 150,000
reproductive health visits for 78,699 pregnant, postpartum and
low-income, uninsured clients per breastfeeding women and
year – served through a network of children up to age 5 receive
80 sites statewide. nutrition services through a
network of 85 sites statewide.
Clinical Genetics Services
7,805 individuals received Newborn Screening Program
counseling and case 76,090 newborns screened and
management services last year. followed up for hereditary
disorders and hearing
Kids in Safety Seats (KISS) impairments.
Over 3,000 child safety seats Oral Health
distributed and/or inspected last
year. Over 10,000 children and adults
received clinical dental care in a
local health department dental
Tobacco Use Prevention clinic setting last year.
Over 9,000 individuals received
Tobacco Quitline services and over Sexual Assault Prevention
60,000 students received tobacco Over 200,000 students
education training last year. received sexual assault
prevention education.
Chronic Disease Prevention Breast & Cervical Cancer Services
Over 8,000 clients received blood Screening program served over
pressure and cardiovascular risk 13,000 last year.
screenings.
Diagnosis and treatment program
8 served over 3,700 last year.
Family Health Administration (FHA)
A diverse array of public health services that
cover the life span
FHA Chronic Rehabilitative Care Facilities –
• Chronic hospital care and treatment to patients requiring acute rehabilitation, as well
as complex medical management for respiratory, coma, traumatic brain injury, spinal
cord injury, wound management, and quarantined tuberculosis;
• Long-term comprehensive care for patients no longer in need of hospital level care
but whose needs require services that are beyond those typically offered in private
sector nursing homes;
• Inpatient and outpatient renal dialysis services.
Deer’s Head Hospital Center
Salisbury, Maryland
• Mission – To provide compassionate
interdisciplinary care to meet the
needs of the community.
• FY 2009 Budget – $23 million
• FY 2008 ADC – 80
• FY 2008 Kidney Dialysis – 169
Western Maryland Hospital Center
Hagerstown, Maryland
• Mission – To give Marylanders a second
chance for a quality of life through
exceptional rehabilitation and healthcare
services in a healing environment.
• FY 2009 Budget – $23 million
• FY 2008 ADC – 72
• FY 2008 Kidney Dialysis – 38
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Family Health Administration (FHA)
A population health focus on systems of care
Perinatal Collaboratives Children with Special Health Care
Collaborative efforts involving local Needs – Centers of Excellence
health departments, community Public health infrastructure for
providers, hospitals, academic CSHCN is supported by this network
centers, MIEMSS, Maryland of academic center based pediatric
Patient Safety Center, and others specialists.
to improve the perinatal system of
care. Maryland Asthma Control Program
Established under House Bill 420
Early Childhood Comprehensive (2002), the goal of the program is to
System reduce asthma-related death,
Statewide partnerships with MSDE, disability, and health disparities in
DHR, MDE, community and faith- both children and adults. Funded in
based organizations to develop an part by the CDC, the program
infrastructure that promotes the conducts surveillance and supports
health and well-being of children a statewide coalition with partners
and ensures children entering that include the Asthma and Allergy
school ready to learn. Foundation and the American Lung
Association. Community and
Provider Capacity Building school-level interventions are being
Multiple strategies designed to recruit developed and implemented.
primary care physicians, dentists and Community-Based Primary Prevention
other health care professionals
through Loan Assistance Repayment Policy and environmental change,
Programs (LARP), National Health public information, peer support, care
Service Corps, J-1 Visa Waiver coordination and community-based
Program, National Rural Recruitment strategic planning efforts (including
and Retention Network (3RNet) and the Maryland Comprehensive Cancer
through designation of Medically Plan, Maryland Childhood Obesity
Underserved Areas (MUAs) and Plan, and Maryland Rural Health
Health Professional Shortage Areas Plan) that promote healthy behaviors.
(HPSAs). 10
Family Health Administration (FHA)
Moving toward data-based decision-making
Pregnancy Risk Assessment Behavioral Risk Factor Surveillance
Monitoring System (PRAMS) System (BRFSS)
Ongoing, population-based CDC risk Ongoing CDC telephone surveillance
factor surveillance system designed program designed to collect data on
to identify and monitor selected the behaviors and conditions that
maternal behaviors that occur before place Marylanders at risk for chronic
and during pregnancy. Findings disease, injury, and disability.
enhance the understanding of Findings can be used to characterize
maternal behaviors and their health behaviors, ascertain the
relationship to pregnancy outcomes. prevalence of risk factors, and target
demographic groups with increased
Birth Defects Reporting and needs.
Information System (BDRIS) Youth and Adult Tobacco Surveys
Collects data for establishing Maryland’s only source of county
incidence rates, monitoring of level data on youth and adult tobacco
trends in incidence with reference use and tobacco-related health
to possible preventable behaviors. Data collected is used in
environmental causes and statutory allocation of CRF funds to
distribution of information on the local health departments, is
defects and available services to consistent with CDC best practices,
families of affected infants. and is an instrumental component of
evaluation.
National Violent Death Reporting Maryland Cancer Registry
System (NVDRS) Collects, maintains and reports
Maryland was 1 of the first 6 information about Marylanders who
states to be awarded the CDC develop cancer – through
NVDRS grant to examine all submission of all incident cancer
incidents of violent deaths in reports by hospitals, radiation
Maryland, including homicides, therapy centers, cancer diagnostic
suicides, accidental firearm labs, freestanding ambulatory care
deaths, and undetermined deaths. facilities, surgical centers and
11 physicians.
Family Health Administration (FHA)
Future Issues – FY 2011
Babies Born Healthy
In collaboration with multiple partners, FHA is committed to improving the State’s
perinatal outcomes and reducing infant mortality through its Babies Born Healthy
Initiative. Reducing infant mortality by 10% by 2012 is a Governor’s priority goal.
This initiative focuses on prevention services, quality improvement, and perinatal
data systems. Partnerships including those with the Maryland Patient Safety
Center Perinatal Collaborative and the MIEMSS Maternal-Neonatal Transport
System are of special interest and warrant continued support.
Oral Health
In response to Maryland’s dental crisis, DHMH convened a Dental Action
Committee (DAC) in 2007 to assess the state of dental access and make
recommendations for achieving a dental home for Maryland’s children. DAC
recommendations focused on Medicaid financing and systems changes, public
health initiatives, education initiatives, and scope of practice changes needed to
strengthen the dental health delivery system. This has led to a Governor’s fiscal
year 2009 dental initiative, with $2 million targeted to strengthening the dental
public health infrastructure. FHA’s Office of Oral Health has taken the public
health lead by establishing new dental clinics in underserved communities and
expanding school-based dental health services.
Federal Funding
Family Health Administration depends on multiple federal funding sources in
order to advance its mission. In fiscal year 2010, Maryland will receive
additional federal stimulus dollars, as part of the new Communities Putting
Prevention to Work project which will focus on Healthiest Maryland, including
improving nutrition and physical activity, as well as tobacco use prevention.
Other federal funding sources critical to FHA’s mission include the Title V
Maternal-Child Health Block Grant, Title X Federal Family Planning Program,
WIC, and CDC categorical grants. Advocating for increased federal funding and
new State general dollars is needed to support these important public health
prevention programs.
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