The Healthy Start Program was signed into law in June 1991 by Florida Governor Lawton Chiles. At that time, the United States had one of the highest infant mortality rates (number of babies who die in the first year of life) in the industrialized world. Florida ranked among the highest in the nation. The greatest single hazard to infant health is to be born with a low birth weight. Infants who weigh less than 5.5 pounds (2,500 grams) are considered low birth weight and are 40 times more likely to die during the first month of life than normal birth weight infants. Of those that survive, one-fourth develop life long problems. The Healthy Start program is credited with helping to reduce infant mortality in Florida by 23%. The program was awarded the National Perinatal Association Award for Programs That Work for state-wide success in lowering adverse birth outcomes among women who received care coordination.
“Infant mortality is not a health problem. Infant mortality is a social problem with health consequences.” ~ Marsden Wagner, MD
Healthy Start Coalitions act as private-public partnerships to guide and monitor this system of care. The coalitions formed around the state to find local solutions to local problems. These not-for-profit organizations develop plans for service delivery, monitor the system of care and allocate maternal and child healthcare dollars. The major accomplishments of the 32 coalitions around the state have been in community, consumer and provider education, delivery system improvements, and community collaboration.
The coalitions conduct area wide needs assessments and develop locally suited service delivery plans. The service delivery plan consists of a community assessment, data review, health problem analysis and an action plan. The actions steps outline coalition and contracted provider obligations, community-wide and system related issues, and specific interventions. Later, the coalitions play the lead role in assuring the plan is implemented and monitoring the system of contracted care. Each year, the plans are reworked in accordance with accomplished goals and changing resources.
Healthy Start Screening
Consumers of care are evaluated, by healthcare providers, through the use of the Healthy Start Prenatal and Postnatal screening instruments. These screening questionnaires evaluate pregnant women and infants according to medical and socioeconomic factors to determine if they are at-risk for a poor pregnancy outcome. While it is Florida law that all pregnant women and infants be offered the opportunity to be screened by their healthcare provider, it is strictly voluntary on the part of the consumer. If they choose to be screened and screen a score of four or more (or are referred by their doctor for other reasons), they are invited to participate in the Healthy Start program. The program is offered at no cost to the consumer.
The Healthy Start Care Coordination Provider (in this county, the Osceola County Health Department is under contract with the coalition to provide Healthy Start Services) team of nurses and social workers contact the individual to determine the level of need and other related activities. Services include care coordination, childbirth education, parenting education, smoking cessation, case management, nutritional counseling, psychosocial counseling, and breast feeding education and support. These services can improve the health status of women and infants as well as save the costs of high-end medical care.
Healthy Start Osceola
The Healthy Start Coalition of Osceola County, Inc. (HSCOC) is a non-profit, 501(c)3 organization established in 1994 to develop and implement quality systems of care for maternal and child health, as well as allocate the related health care dollars going into the community. Community leaders, health care providers, consumers and residents make up the membership of the coalition.
The mission of the Healthy Start Coalition of Osceola County, Inc. is “to promote the health and well being of mothers, babies, and families in our community.”
Our goal is to improve pregnancy, health and developmental outcomes for residents of St. Cloud and all of Osceola County. We work to reduce infant mortality & morbidity, low birth weight & preterm births and increase access to care to give all children the best potential for a healthy and productive life.
The HSCOC is charged with the responsibility of development of a service delivery and strategic plan in the area of health and support services for pregnant women and children in Osceola County. As part of this process, an in-depth needs & resources assessment is done and corresponding plan is then implemented and monitored. Information is recorded and reported to the Florida Department of Health.
The HSCOC has established a network of all physicians that see pregnant women and hospitals that deliver babies for this area. These physicians and hospitals screen all pregnant women and infants for possible risk factors for poor birth outcomes. Those that screen as at risk can voluntarily be referred for Healthy Start care coordination.
The HSCOC contracts with the Osceola County Health Department to provide care coordination services by a team of nurses, social workers and others. These care coordinators follow the patient throughout the pregnancy or infant’s first year to provide support, education, and referrals for resources.
The HSCOC also has successfully leveraged other funding to carry out the service delivery plan and support special projects.
- to assure that the existing economic, social and geographic barriers to maternal and child health, including prenatal and infant health care are minimized, and that an adequate number of health care providers are available to assist pregnant women and their children;
- to promote and protect the health and well-being of all pregnant women and their children through the provision and accessibility of health care programs to fully meet the health requirements of this population;
- to establish a partnership between the private and public sector, state and local government, community alliances and maternal and child health care providers to provide coordinated community based care for pregnant women and infants;
- to enhance communication, information gathering and sharing among public and private sectors on needs and services required by mothers and their infants to reduce adverse outcomes;
- to evaluate the community’s needs and use of resources for the health and welfare of mothers and their infants; and
- to plan for new and expanded services for mothers and infants and to avoid duplication and fragmentation of existing services.
- conducting local needs assessment and data analysis of maternal and child health issues
- developing community level strategic plans for maternal and child health services (service delivery plans)
- selecting service providers through competitive processes
- allocating state and federal funds to private and public direct service providers
- managing sub-contracts
- providing quality assurance of purchased services
- providing oversight and monitoring of the maternal and child heath services within a defined geographic area
- leveraging additional resources
Areas of Priority
- Low Birth Weight & Prematurity Prevention – which includes early prenatal care, smoking cessation, nutrition education, drugs & alcohol education, and sexually transmitted disease prevention
- Outreach & Awareness – continually monitoring fetal and infant deaths & targeting populations for outreach, partnering with surrounding counties, consumer & provider screening education, and communication between various components of care
- Women’s Health during childbearing years – stresses the importance of personal responsibility for one’s own health, pre-pregnancy health education, well care for women, family planning education, and teen pregnancy prevention
- Access to Care – consumer healthcare coverage, quality provider networks, minority health disparities, Medicaid reform, emergency management and legislative issues
- Child Safety Education – Sudden Infant Death Syndrome (SIDS), Shaken Baby Syndrome, motor vehicle safety, and other injury prevention