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Iowa’s Maternal , Child Health and Planning Business Plan CHILD HEALTH Who we are...

A public-private partnership that... • Promotes access to regular preventive services for children through contracts with 22 agencies covering all of Iowa’s 99 counties • Fosters age appropriate growth and development by promoting early identification of children’s health concerns and referral for diagnosis and treatment • Assists to establish medical and dental homes for their children • Targets low income families – children on Medicaid and those who are uninsured and underinsured • Strives to meet family needs and remove barriers to accessing health care by linking families to community-based, culturally appropriate services

What we do... Labs such as blood lead testing Health Outreach Interpretation education and for enrollment promotion in Medicaid & Developmental hawk-i testing

Informing families of newly Medicaid enrolled Care Coordination children about regular Home visits preventative health for nursing care or social work services

Immunizations counseling Oral health Transportation screening and to health care prevention providers

2 Iowa’s Maternal Health, Child Health and Business Plan FAST FACTS

Through Iowa’s I-Smile™ Children from low 81% of Medicaid enrolled initiative, 62% more Medicaid- income households have children received at least enrolled children saw a dentist poorer health outcomes. one preventive health in 2012 than in 2005, nearing In Iowa, 28% of children the same level of access as exam in 2012. children with private dental are enrolled in Medicaid. Iowa Medicaid 2012 CMS 416 Report and 2011 Census insurance. Iowa Medicaid Enterprise and 2011 Census Iowa Medicaid SFY 2012 Medicaid Claims Data

Why we do it...

Identifying health conditions early is critical for children’s optimal growth and development. The future health of the U.S. population and the nation’s healthcare costs depend upon health behaviors established in childhood.

Reduced healthcare Increased A healthier future costs productivity workforce

Our impact...

children were enrolled in Iowa’s Child Health program FFY 2012 Child and Adolescent and received 609,000 services to support their access to Reporting System 187,556 medical and dental care. (CAReS)

of children enrolled have a medical home compared to FFY 2012 CAReS and 2010 only 70% of children with public insurance in the general Household Health 94% population. Survey

times transportation services were provided for children that otherwise would not have been able to get to health FFY 2012 CAReS 9,677 appointments.

of all low-income children enrolled in the program had FFY 2010 and 57.5% a dental home in 2012, up from 35% in 2010. 2012 CAReS

Iowa’s Maternal Health, Child Health and Family Planning Business Plan 3 MATERNAL HEALTH

Who we are...

A public-private partnership that... • Manages 21 community based maternal health agencies covering all of Iowa’s 99 counties • Provides services to improve birth outcomes and maternal and health, with a particular focus on reducing health disparities and ensuring racial equity • Helps pregnant women establish medical and dental homes for their • Improves health care by linking women to community-based, culturally appropriate services, and supporting their ability to get the services they need • Recognizes the values of psychosocial support in promoting healthy pregnancy

What we do...

Transportation to health care providers Social assessment and Home visits guidance Health for nursing education or social work services

Health screening Tobacco/ Care Coordination for... Substance Abuse

Assess health insurance needs immediate enrollment Domestic in Medicaid Oral health Nutrition violence screening and counseling prevention Interpretation

4 Iowa’s Maternal Health, Child Health and Family Planning Business Plan FAST FACTS

49% of non-hispanic black Untreated oral disease Women from low women in Iowa who just during pregnancy may income households had a new baby report an pose a risk to the health have poorer birth annual family income of of both a woman and her outcomes. under $10,000. . Vital Records 2012 Iowa Barriers to Prental Care Survey 2012 MCH Journal, 2006

Why we do it...

We aim to reduce health disparities for low income pregnant women to improve birth outcomes and lower cost.

40% of Iowa births are to Medicaid Partnering with medical providers eligible women. We work to and Medicaid improves birth improve their birth outcomes through outcomes, which also lowers preventative health services. Medicaid costs. Vital Records 2012

Our impact...

Women’s Health women and their were served in 2012. Information 11,105 System, FFY 2012

is saved in Neonatal Association of spent in Maternal and Child Intensive Care Unit (NICU) Health Programs counseling for pregnant women. $3 costs for every $1 (AMCHP)

The total cost for a woman to receive ALL Maternal Health program services IME Claims Data is 1/5 of the cost of ONE DAY in the Neonatal Intensive Care Unit (NICU). 2013

Association of Promotion of breastfeeding reduces total medical costs due to reduced Maternal and Child Health Programs illnesses, prescriptions and hospitalizations. (AMCHP)

Iowa’s Maternal Health, Child Health and Family Planning Business Plan 5 FAMILY PLANNING Who we are...

• At the core of the Family Planning program is the provision of high quality and cost-effective family planning and related preventive health services for low-income women and men. • There are two Title X grantees in Iowa, funding services to residents in all 99 counties. • Family planning centers play a critical role in ensuring access to voluntary family planning information and services for their clients. • Services are based on ability to pay. • Title X provides individuals and couples the information and means to exercise personal choice in determining the number and spacing of their children, contributing to positive birth outcomes and improved health for Iowa’s families.

What we do...

Pregnancy testing Reproductive and counseling life counseling and Clinics preconception counseling that promote Screening which assists clients with goal flushots, Tdap and treatment setting, completing an education, vaccines and HPV for sexually securing employment, spacing vaccines transmitted , and maximizing (STIs) the potential for a healthy Screening for health conditions pregnancy when they which contribute to want one chronic disease such as , heart and lung Preventative disease, , health services, Breast and substance abuse, cervical depression and intimate including... screening Community partner violence Education A broad range of FDA-approved contraceptive methods and related exams, Health history and physical counseling counseling and referral exams What we don’t do... Title X services do not include or abortion related services.

6 Iowa’s Maternal Health, Child Health and Family Planning Business Plan FAST FACTS Over 60% of family In Iowa, the cost Title X provides In 2011, the planning clients identify associated with providing significant savings to percent of women the family planning clinic publicly funded family taxpayers. In 2009, with an inter- as their planning services to for every $1 spent pregnancy interval provider since they are a woman is less than on family planning, of less than 18 not likely to see another the potential cost of an $3.78 was saved in months was just provider for health . averted costs. over 33%. related screenings. Public Policy Center, Public Policy Center, IDPH Bureau of Health University of Iowa, 2009 Women’s Health Issues, 2012 University of Iowa, 2009 Statistics, 2012 Why we do it...

The overall number These women may This translates to a of Iowa births The high percentage not seek contraceptive need for subsidized decreased 5% from of Medicaid-paid services because contraceptive 2008 to 2011. births suggests of cost, and may services and supplies, that a significant At the same time the be more likely to along with other number of women percent of Medicaid have unintended of reproductive age reimbursed births pregnancies and services, especially are under the federal increased from 38% need post-partum for low-income level. in 2008 to 40% in contraceptive services. women. 2011.

IDPH Bureau of Health Statistics and Iowa Medicaid Enterprise

Our impact...

unduplicated clients were served by Iowa’s Title X agencies in 2012. In 2013, Iowa Title X agencies are Iowa Family Planning Report 17,996 projected to serve 18,351 unduplicated clients with a Title X 2012 investment of $72.64 per client annually.

Guttmacher of Iowa’s women in need were served by publicly funded Institute, 78,950 clinics in 2010. 2010

unintended unintended 21,000 pregnancies 10,400 births 7,200 were averted due to the provision of contraceptive services by Title X clinics in 2010.

Guttmacher Institute, 2012

Iowa’s Maternal Health, Child Health and Family Planning Business Plan 7 Published January 2014