H4953016

Healthy Start Initiative-Eliminating Racial/Ethnic Disparities - UNITEWI, a non-for-profit agency with a statewide health equity agenda, submits this application for HRSA-24-033, Healthy Start Initiative: Eliminating Disparities in Perinatal Health. UNITEWI trains community health workers (CHW) across the state to address the social determinants of health (SODH) to eliminate disparities in perinatal health; consequently, using the Pathways Community Hub model and CHW workforce, UNITEWI can cost-effectively address disparities in multiple counties.

In Wisconsin, black infants are three times more likely to die before their first birthdays than non-Hispanic white infants, particularly in major urban areas. For these reasons, UNITEWI will work with African American populations within Wisconsin’s largest urban counties of Dane, Kenosha, Milwaukee and Racine, with infant mortality rates that exceed the national rate by three times. Through this Healthy Start Initiative, UNITEWI will: place CHWs in community based organizations to provide PNCC and direct services to a minimum of 450 clients: 2 in Milwaukee, and 1 each in Dane and Kenosha/Racine; offer access to clinical services including mental health and doulas; offer a full complement of community education to reach an additional 250 people; convene a Community Advisory Commission; and address the pressing SODH of housing.

UNITEWI is highly experienced in PNCC. The founder and executive director serves on several boards and committees, including the Wisconsin Community Health Worker Network, the City of Milwaukee Board of Health, the UW-Madison PNCC Study Stakeholder Advisory Committee and the Wisconsin Black Child Development Institute. Bria will oversee all aspects of the program, including design and implementation and partner and committee member engagement. Specifically related to improved prenatal care coordination and maternal and infant health outcomes, UNITEWI's work has led to the first Medicaid-supported reimbursement for social determinants of health through an 1154 Medicaid waiver in partnership with the United Healthcare Community Health Plan. This created a new stream of reimbursement for birth outcomes utilizing the Pathways Community Hub model. Additionally, HRSA recently labeled the Doula Project in which UNITEWI is participating a “success story.”

The Wisconsin Title V Program supports the integration of doula services into Medicaid coverage as a key strategy to reduce racial and ethnic disparities in birth outcomes. In partnership with the Division of Medicaid Services, pilot projects are funded to integrate doula services with the Medicaid Prenatal Care Coordination benefit. Wisconsin Medicaid does not provide direct reimbursement to doulas, though doulas provide many services covered by this benefit including prenatal education, breastfeeding support, and connections to community resources to meet key social needs. We aim to create a sustainable, community-based model of PNCC and direct services/care coordination that engages the counties served via the consortium. We also plan to address one of the most significant SODH impacting the target community, housing. Last but not least, we look forward to advancing the community of practice.

Unitemke

NOT APPLICABLE

93.926 - Healthy Start Initiative

HRSA Office of Federal Assistance Management (OFAM) [HHS - HRSA]

Maternal and Child Health Bureau (MCHB) [HHS - HRSA]

Milwaukee, Wisconsin United States

City-Wide

Healthy Start Initiative: Eliminating Disparities in Perinatal Health (HRSA-24-033)

Amendment Since initial award the total obligations have increased 218% from $1,008,154 to $3,208,050.