ANNUAL20REPORT14

Tran

sition

s

July 1, 2013 - June 30, 2014

FiNANciAL REPORT

iNcOME• ComprehensivePrenatalPerinatalServicesNetwork (NewYorkState)Ended9/30/13............................................... $42,622

• MaternalInfantCommunityHealthCollaborative— NewYorkState(startdate10/01/13)........................................... 494,062

• MedicaidRedesignHealthInformationTechnology— NewYorkState(startdate01/01/14)........................................... 244,849

• HealthyStart (FederalHealthResourcesandServicesAdministration).............. 483,716

• HealthyMomHealthyBaby (MonroeCountyDepartmentofPublicHealth)Ended9/30/13...... 25,000

• CommunityPartnershipforBreastfeedingSupport (UniversityofRochester)................................................................. 6,889

• 39WeeksToolkit (AssociationofPerinatalNetworks/MarchofDimes)......................59,121

• Contributions................................................................................12,974

TOTAL........................................................................................ $1,369,233

EXPENSES• Personnel................................................................................ $402,204

• StaffTravelandTraining................................................................22,547

• EducationalProgramsandMaterials.......................................... 194,958

• HealthyStartCenters................................................................. 240,598

• CommunityHealthWorkerProgram(BabyLove)......................... 60,219

• CommunityInfrastructureSupport............................................. 336,449

• Occupancy................................................................................... 41,440

• AdministrativeServices................................................................ 65,769

TOTAL........................................................................................ $1,364,184

SURPLUS(DEFICIT).......................................................................... $5,049Note:Preliminary,unauditedresults

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3%

29%

36%

2%

18%

14%

35%

18%

2%

4%

1%

25%

4%

3%

1%

5%

One change will be with board leadership. When my term expires in June, I will have completed seven years as a director. It has been an honor serving as President the past two years. Lisa Smith takes my place and I know the board will take flight under her leadership.

The board has been planning another significant transition, that of the Executive Director Patricia Brantingham, who will retire in October. She has guided the agency through significant growth and will leave us well-positioned for the future. In this issue of the Annual Report, you will see the results of her leadership in 2013.

As always, the make-up of the board will change. Byron Kennedy is stepping down from the board. We are grateful for his service to the agency and support of the mission. We welcome directors: Patti Carter-Morrison, Lorna Washington, Alicia L. Evans and Komekia Peterson.

The board also recognizes the outstanding work of the Perinatal Network staff: Sherita Bullock, Maternal Infant Community Health Coalition Program Manager; Anita Black, Healthy Start Project Director; Ashley Bush, Health Educator; Yolanda Sayres, Outreach Coordinator; Diane Seely, Information Technologist; and Jacqueline Procope-Isaacs, Program Assistant & Office Manager. Together, we are committed to a vision where the PNMC inspires our entire community to work together to understand and support effective strategies that give all babies in our community an optimal start… and make butterflies through the change.

This agency and the relationships I have gained as a result of my tenure have greatly enriched my life. I am grateful for the opportunity to serve. I wish Lisa and the Board, as well as our new director and the staff, best wishes for a year filled with the excitement that comes from new beginnings.

I look forward to watching your new work take flight!

Transition is a passage from one state, stage, subject, or place to another. It is like

the caterpillar within the chrysalis. Let’s call it the process of creating butterflies.

Over the past five years, perinatal health has undergone its own transition.

Our focus was on pregnancy and up to six-months after birth. The butterfly is

that perinatal health is now defined along the spectrum of Life Course Health

Development. So too, the Perinatal Network of Monroe County is undergoing a

metamorphosis and 2014 will be a year filled with creating butterflies.

Sincerely,

Kevin A. Berg

OFFicERSKevinA.Berg,PresidentVisitingNurseServiceofRochesterandMonroeCounty,Inc.LisaS.Smith,VicePresidentEaglesWingsConsultingDeborahTuttle,R.N.,M.P.S.,SecretaryCarlaD’Angelo,MPH,TreasurerExcellusBlueCrossBlueShield

DiREcTORSGinaBliss,CPA,CFEKronergambleandCompanyKellyJ.Bowen,RN,BSAugustFamilyBirthPlaceUnityHealthSystemMichaelA.Dedee,MSWMonroeCountyDepartmentofPublicHealthBrettE.Farrow,Esq.LawOfficesofPullano&FarrowPLLCKimHess,MBA,CHIEMonroePlanforMedicalCareLindaJohnson,RNMSCCMCOHN-sMVPHealthCareByronKennedy,MD,PhD,MPHMonroeCountyDepartmentofPublicHealthMarkMandryckyExcellusBlueCrossBlueShieldLynneScalzoExcellusBlueCrossBlueShieldJamesB.Sutton,RPA-CRochesterGeneralMedicalGroupFranWeisbergWeisbergConsulting

PERiNATAL NETwORk STAFFAnitaBlackHealthyStartProjectDirectorPatriciaBrantinghamExecutiveDirectorSheritaBullockCPPSNProgramManagerAshleyBushHealthEducatorJacquelineProcope-IsaacsProjectAssistant/OfficeManagerYolandaSayresOutreachCoordinatorDianeSeelyInformationTechnologyAssistant

If nothing ever changed, there’d be no butterflies. —AuthorUnknown

PERiNATAL NETwORk BOARD OF DiREcTORS

An idea whose time has come? PNMC did not create the Centering® model and we are not affiliated with the Centering Healthcare Institute that promulgates the model nationally. But we have believed for many years in the efficacy of group care, funding the model at our Comienzo Sano partnership with Rochester General Hospital since 2007. We have appreciated the success of the Rochester Adolescent Medicine Program that was one of the earliest group prenatal care programs in the country. We heard from some local practices that they were interested. It seemed the right time to investigate how to leverage current programs, local interest, and national expertise to support a community-wide transition.

We saw an opportunity to do three things: ensure that group care in Rochester enjoys the benefit of an evidence-based model with its documented processes and

TransitionscENTERiNgPREgNANcy® MODEL

PNMC invited the clinical managers of all the OB practices that serve

low income women in the city to an information session about the

CenteringPregnancy® model of group-based prenatal care, hoping that half

would come. 23 individuals registered. We proposed to the group that we

would fund consultation to implement the CenteringPregnancy model, hoping

that four would make the commitment to transform their practices. We were

astonished when eight practices – nearly all the practices that serve our city

population—not only attended the meeting, but embraced the opportunity to

transition to this model of care.

structure; create cost savings by bringing the Centering Healthcare Institute to Rochester to meet all the practices together and negotiating on behalf of multi-site practices; and create and nurture a learning community of group prenatal care providers. The response told us that we could provide the catalyst that enables nearly all the practices that serve low income women in Rochester to transition to a new standard of prenatal care.

what value does PNMc bring? The project officially kicked off on April 7 when the Centering Healthcare Institute offered a community-wide CenteringPregnancy Model Overview. The Centering Healthcare Institute then met with the individual practices and will continue to consult with the practices for two years to ensure that practices work through the start-up challenges successfully. PNMC is fully funding their services.

The practices have requested that PNMC continue to convene the group of practices so that they can learn from one another—an extension of the concept of Centering itself. Scott Hartman, M.D., Director of Women’s Services and Co-Director, Maternal-Child Health Fellowship University of Rochester Department of Family Medicine said, “CenteringPregnancy is an innovative model of group prenatal care that has been shown to reduce preterm birth and cesarean sections in multiple research studies. Our city wide initiative will make this exciting model available to a diverse population and should help improve many perinatal outcomes in Rochester. Perinatal Network has played a critical role in the city wide initiative as the organizer and coordinator of funding and leadership to make it all happen. Their work will have a far reaching positive impact on our community.”

Catalyst in Transforming Prenatal Care

ANNUAL20REPORT14 ThE cENTERiNg PREgNANcy MODEL

Centeringisanevidence-basedredesignofhealthcaredeliverythathelpstopromotesafety,efficiency,effectiveness,timeliness,culturallyappropriatepatient-centeredcare,andmoreequitablecare.Centeringisamodelofgrouphealthcarethatincorporatesthreemajorcomponents:assessment,education,andsupport.Patientsmeetwiththeircareproviderandothergroupparticipantsforanextendedperiodoftime,usually90-120minutes,atregularlyscheduledvisitsoverthecourseoftheircare.Centeringpromotesgreaterpatientengagement,personalempowermentandcommunity-building.Atthestartofatypicalsession,patientshaveabriefindividualassessmentwiththecareprovider,takepartinself-careactivities,useself-assessmenttoolstobeginthinkingaboutkeytopics,enjoyrefreshments,andhaveinformalconversationwiththeotherparticipants.Whenthegroup“circlesup”,thereisdiscussionfacilitatedbythecareproviderabouthealthtopicsthatbuildsonthegroup’sunderstandingandsharedexperiences.Groupsarelively,interactive,andpatient-centered.Thebenefitstotheproviderareextendedtimewithpatientswithoutrepeatingthesameinformationoverandoveralldaylongandmoremotivatedpatients.Thebenefitstothepatientaremoretimetoaskquestionsandexploreawiderangeoftopics,empowermentforself-care,andthesupportofwomenlikethemselves.

ThREE cOMPONENTSAssessment(healthcare)isprovidedbyalicensedhealthcareproviderduringthegrouptimeandinthegroupspace.Eachparticipanthasabriefindividualcheck-upwiththeprovider.Patientsparticipateinself-careactivitiesincludingassessingtheirownweightandbloodpressure.Bothpatientsandprovidercontributetothedataonpatients’charts.Educationisconductedinafacilitativeratherthandidacticstyle.TwoFacilitatorsleadeachgroup.Therearecontentguidelinesforeverysession,buttheactualgroupdiscussionisdeterminedlargelybytheinterests,needs,andconcernsofthegroup.EachpatientreceivesaCenteringNotebookwitheducationalmaterialforat-homereference.CriticaltotheempoweringdesignofCenteringaretheSelf-AssessmentSheets(SAS)whichareusedbyparticipantsatthebeginningofeachsession.TheseSASintroducethetopic(s)forthatsessionandprovideaspringboardforthefacilitateddiscussion.Support,friendships,andcommunity-buildingareimportanttotheCenteringmodel.Thesearefosteredbytheuseofnametags,stabilityofthegroup,interactiveactivities,andrefreshmentsateverysession.Becausethefacilitatorsandthegroupparticipantsmeetfor90-120minutesonaregularbasis,trustandcamaraderiedevelop.Oftenmemberschoosetomeetsociallyoutsidetheappointmenttime.

...assessment, education and support.

Creating Links, One at a TimePNMc OUTREAch

With her big, warm smile and infectious laugh, Yolanda Sayres can go from

complete stranger to trusted confidant in the time it takes to do a load of

laundry. For Yolanda, PNMC’s Outreach Coordinator, her workplace is the

laundromat one day, the corner bodega or the Foodlink Curbside Market truck

the next. Her workplace is where she can meet and interact with the women

who become our clients.

Her task is daunting…finding the women who are pregnant, or might be

pregnant, and not in care, not insured, not secure in their housing, clothing,

food and transportation. Women who have fallen through more cracks in the

system than most of us ever knew existed. The task: instantly connecting

with them, engaging in conversation, opening their hearts to trust a perfect

stranger with their needs. Yolanda is tasked with linking them with the

resources to get the care and services they need to have some hope of having

a healthy baby.

Making connectionsMitch Gruber had been Yolanda’s connection with Foodlink, a critical resource for many of the women in the City of Rochester. Mitch and people like him make Yolanda’s task easier by connecting with Yolanda, learning what she does, and seeing how they can contribute to healthy pregnancies. It took months of gently persistent persuasion, but Mel, the Assistant Store

Manager at Walmart, finally agreed to let Yolanda set up a table in the store to conduct outreach. And that led to another connection: Dawn Hirsh, the Vision Center Manager at Walmart Vision Center wanted to offer her services to the students of Rochester City School District to bring eyeglass repair into schools but didn’t know how to approach district officials. Yolanda made the link and the

schools are thrilled to have someone helping their kids with eyeglass repairs.

PNMC outreach has become a regular fixture at the Monroe Community College Damon Center Campus, encountering young women who are pushing through barriers, with a career goal and pursuing a degree. Many are pregnant or at risk of becoming pregnant unintentionally. PNMC is also a partner in the MCC/RCSD Pathways to Success program that provides support services to high school students who are pregnant or parenting, linking them to MCC for continued education and to support services they need to ensure that they are able to continue and complete school.

Connections with these and many other organizations in the community produce opportunities to do the hard work of meeting women and adolescents for whom physical, emotional, and mental stresses appear to have overtaken their lives. Hope—a term that is delivered from every outreach team member to every woman that is encountered is priceless! The next step depends on each individual. Outreach is here to provide a catalyst, a link, and a future for pregnant and parenting women in the City of Rochester to create the best possible opportunity to have a healthy baby, a healthy mom, and an even healthier community.

Catalyst Multiplies Baby Love Capacity BABy LOVE

Create a new Community Health Worker program or collaborate to expand an

existing program? That was the choice presented by the requirement of the

NYS Department of Health to include a CHW component in our new Maternal

and Infant Community Health Collaborative grant. We have the skills to

manage such a program and we could do so economically because of our very

low administrative overhead cost. But could we provide the most value to the

most families in a stand-alone program?

Rochester is home to a long-cherished community health worker program, Baby Love, managed by the UR Medicine social work division. We asked Mardy Sandler, Chief Social Worker and manager of the program, what a partnership might look like. Mardy described the pain and frustration her community health workers felt when they ended services to a new family when the baby reached six months—a requirement imposed by capacity constraints. They knew that there would be a whole new bundle of challenges along with the joy of a new baby and few resources to help. They knew, too, that when women have had a difficult pregnancy and perhaps a poor birth outcome, there is a window of opportunity to postpone the next pregnancy, address the underlying problems, and establish a foundation for a healthy future. How could we add capacity in the most cost-effective way?

collaborative ApproachThe answer was clear: expand the partnership. Baby Love is partly funded by the Monroe Plan for Medical Care and MVP, the two largest Medicaid Managed Care organizations in Rochester, because they have measured the impact of the program on NICU admissions of their members. If we could get these funders

to agree to the importance of continuing support through the interconception period, we could leverage the existing CHW teams, enabling all of them to stay with their families during the critical first year of the baby’s life. Together, we met with Kim Hess, Chief Operating Officer of the Monroe Plan for Medical Care. Monroe Plan understands collaboration and they understand leverage.

“Monroe Plan invests in Baby Love support for our most challenged moms because of the evidence that it reduces NICU admissions,” Kim said later. “But this is labor-intensive work and therefore very expensive, and it isn’t reimbursed by Medicaid. So when Perinatal Network and Baby Love suggested that by adding one team of CHWs funded by PNMC they could extend the support provided by all the Baby Love teams, we could not have been happier. This additional capacity offers our high-need mothers and infants improved overall health, safety, stability, and a positive life course trajectory.”

Linda Johnson at MVP echoed Kim’s assessment: “MVP appreciates the collaborative approach to improving the health of our families and fully supports the expansion of Baby Love to our high-need families.”

ANNUAL20REPORT14

...improving the health of our families...

Her task is daunting…

Your donation to the Perinatal Network will ensure that our community outreach continues to find pregnant women in need, that our staff brings the voice of the community to academic researchers, that pregnant women know who to call when they are scared or sick.

Give conveniently and securely through our website, www.PerinatalNetwork.net or send contributions to the Perinatal Network, 339 East Ave. Ste. 203, Rochester, New York 14604. We thank you, our moms thank you, our babies thank you.

A hEALThy BABy BEgiNS wiTh yOU

You, too, can be part of the Perinatal Network. Join the Consortium. Attend a

workshop. Invite our health educator to present to your group. Suggest a topic

for provider or consumer education. “Friend” us on Facebook. And give.

PerinatalNetworkofMonroeCounty339EastAvenueSuite203Rochester,NY14604(585)546.4930www.PerinatalNetwork.net

HealthyStartCenter/UnitySt.Mary’sCampus89GeneseeStreet Rochester,NY14611(585)368.3490

ComienzoSano/HealthyStart(Bilingual:English/Spanish)ClintonFamilyHealthCenter293UpperFallsBoulevardRochester,NY14605(585)922.0228