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HomeMy WebLinkAboutReports - 2024.01.18 - 40927 AGENDA ITEM: Application to the Michigan Health Endowment Fund for the 2024 Maternal and Infant Health Initiative Preconception Nutrition and Wellness Program DEPARTMENT: Health & Human Services MEETING: Board of Commissioners DATE: Thursday, January 18, 2024 6:00 PM - Click to View Agenda ITEM SUMMARY SHEET COMMITTEE REPORT TO BOARD Resolution #2023-3673 Motion to approve the grant application submission to the Michigan Health Endowment Fund for the 2024 Maternal and Infant Health Initiative Program in the amount $200,000 for the period October 1, 2024 through September 30, 2025. ITEM CATEGORY SPONSORED BY Grant Penny Luebs INTRODUCTION AND BACKGROUND The Oakland County Health Division is applying for the 2024 Maternal and Infant Health Initiative grant from the Michigan Health Endowment Fund in the amount of $200,000 for the period October 1, 2024 through September 30, 2025. The grant provides funding to address increased access to protective and clinical intervention, including improved screening before, during, and after pregnancy for health risks and connection to treatment or services to improve outcomes for pregnant individuals and their infants. The grant application has completed the Grant Review Process in accordance with the Grants Policy. POLICY ANALYSIS This application and future acceptance of this grant does not obligate the County to any future commitment and continuation of this program is contingent upon continued future levels of grant funding. BUDGET AMENDMENT REQUIRED: No Committee members can contact Michael Andrews, Policy and Fiscal Analysis Supervisor at 248.425.5572 or andrewsmb@oakgov.com, or the department contact persons listed for additional information. CONTACT Leigh-Anne Stafford, Director Health & Human Services ITEM REVIEW TRACKING Aaron Snover, Board of Commissioners Created/Initiated - 1/18/2024 AGENDA DEADLINE: 01/18/2024 6:00 PM ATTACHMENTS 1. Grant Application Sign Off 2. 2024 Preconception Nutrition and Wellness Program MHEF Application 3. 2024-MIH-Application-Questions-Preview (1) 4. Concept Paper MHEF 2024 Preconception Nutrition and Wellness Program 5. MHEF 2024 Preconception Nutrition and Wellness Program MHEF Evaulation Approach 6. Michigan Endowment Fund 2024 MIH_2024_RFP (1) COMMITTEE TRACKING 2024-01-09 Public Health & Safety - Recommend to Board 2024-01-18 Full Board - Adopt Motioned by: Commissioner Ajay Raman Seconded by: Commissioner Ann Erickson Gault Yes: David Woodward, Michael Gingell, Penny Luebs, Karen Joliat, Christine Long, Robert Hoffman, Philip Weipert, Gwen Markham, Angela Powell, Marcia Gershenson, William Miller III, Yolanda Smith Charles, Charles Cavell, Brendan Johnson, Ajay Raman, Ann Erickson Gault, Linnie Taylor (17) No: None (0) Abstain: None (0) Absent: Kristen Nelson, Michael Spisz (2) Passed GRANT REVIEW SIGN OFF – Health & Human Services/Health Division ======================================================================================= GRANT NAME: 2024 Preconception Nutrition and Wellness Program Grant FUNDING AGENCY: Michigan Health Endowment Fund DEPARTMENT CONTACT PERSON: Stacey Sledge 248-452-2151 STATUS: Application (Greater than $50,000) DATE: 12/19/2023 Please be advised that the captioned grant materials have completed internal grant review. Below are the returned comments. You may now obtain the Board Chair’s signature for submittal of the application. The grant application package (which should include this sign-off and the grant application with related documentation) should be submitted to the Board of Commissioners for placement on the next agenda(s) of the appropriate Board of Commissioners’ committee(s). DEPARTMENT REVIEW Department of Management and Budget: Approved – Sheryl Johnson (12/19/2023) Department of Human Resources: Approved by Human Resources. No position impact. – Heather Mason (12/12/2023) Risk Management and Safety: Approved. No County insurance requirements. – Robert Erlenbeck (12/12/2023) Corporation Counsel: Approved. No legal issues with application language– Bradley Benn (12/14/2023) Michigan Health Endowment Fund: 2024 Maternal & Infant Health Initiative Project Information Project Details Title: Preconception Nutrition and Wellness Program Request Amount: $200,000 Project Start Date: 10/1/202 Project End Date: 9/30/2026 Geographic Reach: Pontiac, Michigan Project Overview Problem Statement: The Pontiac community experiences significant health disparities, particularly in the infant mortality rate among non-Hispanic blacks/African Americans compared to non-Hispanic whites. Preterm birth is the leading cause of infant mortality. The preterm live birth rate in Pontiac is high compared to Oakland County and the State of Michigan. Black infants were about two times as likely as white infants to be born prematurely. Conversely, this community lacks access to comprehensive preconception nutrition and wellness guidance. This gap in preventative health hinders the potential for optimal maternal and infant health and necessitates the development of a structured and accessible program to address these challenges. Key Partners: Oakland County Health Division, Great Start Collaborative and Executive Group, Oakland County Best Start for Babies Collaborative and Breastfeeding Friendly Collaborative, Oakland County Local Leadership home visiting group, Nurse Family Partnership, WIC, Trinity Health, and Honor Community Health. None of the partners will receive direct financial support through this project. Potential Impact: Through health education and other program activities, we anticipate seeing increased self-efficacy around healthy eating, optimized intake and status of the micronutrients iron and folate through food and dietary supplementation, and modified body weight from improved diet, lifestyle, and physical activity. Several far-reaching impacts of the program include optimized health status among the participants, healthier pregnancies, and enhanced community wellbeing. Utilizing upstream initiatives to empower individuals to make informed choices will create an enduring positive impact on the health trajectory of future generations. Project Narrative Project Significance Preterm birth has profound effects on the infant, the family, and society. While survival rates of preterm birth have improved over the years, it remains the single leading cause of death for children under five years of age.1 Preterm infants have an increased potential for short- and long-term health challenges. Families bear the emotional toll and financial burden of medical bills and ongoing healthcare needs. On a societal level, the long-term consequences of preterm birth can strain healthcare systems and resources. Additionally, there may be educational and economic implications as these children may face cognitive and motor development challenges, impacting their academic achievements and potential contributions to society. In 2021, 15.3% of all births occurring in Pontiac, Michigan, were premature, significantly higher than the national average of 10.49%2. The rate of preterm birth in Oakland is highest for black infants (15.4%), followed by Hispanics (9.0%), Whites (8.9%), and Asian/Pacific Islanders (8.6%).3 While there has been a concerted effort to increase access to prenatal care, the rate of adverse birth outcomes, such as preterm births, continues to remain consistent. Studies show that pre-pregnancy obesity increases the risk of preterm births.45 In the state of Michigan, 32% of mothers were obese at the start of pregnancy. Black mothers are disproportionally more likely to 1 152 million babies born preterm in the last decade. (2023, June 15). PAHO/WHO | Pan American Health Organization. Retrieved November 27, 2023, from https://www.paho.org/en/news/15-6-2023-152-million-babies-born-preterm-last- decade#:~:text=Preterm%20birth%20is%20now%20the,of%20disability%20and%20developme ntal%20delays. 2 Characteristics of the Mother or Infant, as a Percentage of Live Births Pontiac City and Michigan Residents, 2021. (2022, November 14). Vital Stats Michigan . Retrieved November 27, 2023, from https://vitalstats.michigan.gov/osr/chi/births14/frameBxChar.html 3 Preterm birth rate by race/ethnicity: Oakland, 2019-2021 Average. (2023). March of Dimes | PeriStats. Retrieved November 27, 2023, from https://www.marchofdimes.org/peristats/data?top=3&lev=1&stop=63&reg=99&sreg=26&creg= 26125&obj=1&slev=6 4 Liu B, Xu G, Sun Y, et al. Association between maternal pre-pregnancy obesity and preterm birth according to maternal age and race or ethnicity: a population-based study. Lancet Diabetes Endocrinol. 2019;7(9):707-714. doi:10.1016/S2213-8587(19)30193-7 5 Marchi, J., Berg, M., Dencker, A., Olander, E. K., & Begley, C. (2015, May 28). Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obesity Reviews, 16(8), 621–638. https://doi.org/10.1111/obr.12288 be obese (42.7%) at the beginning of pregnancy than other races.6 Of the 43 infant deaths that occurred in Pontiac between 2017 through 2022, 49% of the birth mothers were categorized as obese. 7 Systematic reviews show that healthcare providers miss opportunities to offer lifestyle interventions addressing pregnancy risks in overweight or obese.8910 Implementing interventions to optimize maternal body mass index and nutrition status in women of childbearing age reduces adverse birth outcomes and promotes overall maternal and child health.11 The rate of adverse birth outcomes and obesity rate showcase the need for obesity-specific preconception counseling. Applicant Capacity and Experience The Oakland County Health Division has developed a comprehensive plan with targeted activities to reduce infant mortality. The maternal and child public health services offered at the health division include community nursing home visiting, Nurse Family Partnership (NFP), nutrition home visiting services, Women's Infant and Children (WIC), Children's Special Health Care Services (CSHCS), Fetal and Infant Mortality Review (FIMR), Nurturing Parent Program, and lead testing and casework. The community nurses and dietitians provide client education, collaboration and outreach, assessments, screening, breast and chest feeding promotion, and referrals and resources to their clientele. The breadth and depth of these programs showcase the 6 Percent of Singleton Births by Mother’s BMI at Start of Pregnancy, and Maternal Weight Gain by Percent of Mother’s BMI Classification1, By Race and Hispanic or Middle Easterner Ancestry, Michigan Residents, 2021. (2021). Vital Stats Michigan . Retrieved November 27, 2023, from https://vitalstats.michigan.gov/osr/Natality/WeightGainPer.asp 7 Ronk , A. (2023). Infant Mortality Report - Pontiac, Michigan . Oakland County Health Division . 8 Lan L., Harrison C.L., Misso M., Hill B., Teede H.J., Mol B.W., Moran L.J. Systematic review and meta-analysis of the impact of preconception lifestyle interventions on fertility, obstetric, fetal, anthropometric and metabolic outcomes in men and women. Hum. Reprod. 2017;32:1925– 1940. doi: 10.1093/humrep/dex241. 9 Forsum E., Brantsæter A.L., Olafsdottir A.S., Olsen S.F., Thorsdottir I. Weight loss before conception: A systematic literature review. Food Nutr. Res. 2013:57. doi: 10.3402/fnr.v57i0.20522. 10 Lassi Z.S., Bhutta Z.A. Risk factors and interventions related to maternal and pre-pregnancy obesity, pre-diabetes and diabetes for maternal, fetal and neonatal outcomes: A systematic review. Expert Rev. Obstet. Gynecol. 2013;8:639–660. doi: 10.1586/17474108.2013.841453. 11Marshall NE, Abrams B, Barbour LA, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol. 2022;226(5):607-632. doi:10.1016/j.ajog.2021.12.035 Oakland County Health Division's commitment to reducing infant mortality. The ability to expand to allow preconception services would only strengthen the impact on the community. Disparities and Health Equity The Preconception Nutrition and Wellness Program has the potential to significantly reduce health disparities and improve overall maternal and infant health outcomes. Educating women of childbearing age about the importance of nutrition and healthy lifestyle choices before conception can empower women to make informed health decisions. By focusing on interventions and strategies that target the period before conception, we can address potential health risks and optimize the overall reproductive health of the individual. This upstream, preventive approach has the potential to narrow health disparities by providing equal access to education and resources, ultimately fostering a healthier population and reducing the burden on healthcare systems. Moreover, this program can contribute to breaking the cycle of intergenerational health disparities, positively impacting the well-being of current and future generations in the community. Target Population This proposed program will serve an estimated 200 participants. We will advertise the program to women of childbearing age residing in Pontiac, Michigan, seeking to learn more about preconception health. All participants will receive access to preconception information, a health module created by a Registered Nurse, and resources located on the health division's webpage. Those who are overweight or obese will receive comprehensive, personalized, and accessible nutrition counseling led by a Registered Dietitian Nutritionist. The education and resources provided will positively impact the participants' current and future families. Collaboration The partners chosen to collaborate on the Preconception Nutrition and Wellness Project have missions that align with that of the Oakland County Health Division. Each agency commits to reducing infant mortality in the community. We chose partners from multisector agencies, including public health and clinical settings, to strengthen the program's effectiveness. This collaboration will also strengthen the relationship between the public health and clinical sectors and could lead to additional partnerships and collaboration in the future. All the partners are engrained in the community of Pontiac and consist of community members from the target groups we aim to serve. Organization Role Oakland County Health Division •Implement •Promote at community level •Refer clients for intervention Great Start Collaborative and Executive Group •Promote at community level •Refer clients for intervention •Host professional development trainings •Host parent workshops •Integrate information into existing program Oakland County Best Start for Babies Collaborative •Promote at community level •Educate collaborative partners •Host professional development trainings •Integrate information into existing program Nurse Family Partnership •Promote at community level •Refer clients for intervention •Host professional development trainings •Integrate information into existing program WIC •Promote at community level •Refer clients for intervention •Host professional development trainings •Integrate information into existing program Oakland County Local Leadership Home Visiting Group •Educate collaborative partners •Refer clients for intervention Trinity Health •Educate and refer clients to intervention •Host professional development trainings •Intervention may make referrals back to agency for any issues identified during intervention Honor Community Health •Educate and refer clients to intervention •Host professional development trainings •Intervention may make referrals back to agency for any issues identified during intervention Work Plan See appendix A. Potential Impact Evaluation Approach See appendix B. Outcomes 1. The short-term outcome we anticipate for the participant is access to crucial nutritional and health guidance. We anticipate increased self-efficacy around healthy eating, optimized intake and status of the micronutrients iron and folate through food and dietary supplementation, and modified body weight from improved diet, lifestyle, and physical activity. The long-term outcome we anticipate is an optimized individual health status, healthier pregnancies, and a decrease in preterm births. 2. The short-term impacts we anticipate at the organizational level are increased awareness of the importance of preconception health and increased levels of participant engagement. The long-term outcomes we anticipate are partnership development and enhanced organizational reputation. Collaboration on a single project could lead to additional collaborations in the future that would duly benefit the organization and the community. Our goal is to become a reputable resource for preconception health so we can replicate our program in other counties and health departments throughout Michigan. 3. The short-term outcome we expect at the community level is increased awareness of the multiple maternal and child public health services offered at the health division. Our long-term goal is to develop trust within the community and integrate their feedback on the program to meet the community's needs better. Our goal of reducing preterm births would improve the overall health of the residents, lower healthcare costs, enhance community well-being, and break the cycle of health disparities in future generations. 4. We will conduct participant satisfaction surveys and hold focus groups with the community to collect qualitative data on the effectiveness of the proposed program. Quantitative methods will include data points such as percent weight loss, nutrient analysis, and hemoglobin levels. We will use non-invasive methods such as a scale for weight and a Masimo Pulse CO-oximeter to screen for low iron levels. The data sources we will evaluate include information from our IT department regarding website visits, modules completed, and referrals submitted. 5. Our evaluation plan will include program participants and community members. In addition to conducting ongoing evaluations to assess the program's effectiveness and areas of improvement, we will also gather feedback directly from the community. Evaluations will include surveys, focus groups, and individual interviews. Adjustments to the program will be made based on the evaluation results. Other Impacts The Preconception Nutrition and Wellness Program will deliver evidence that showcases the importance of preventative health interventions in maternal and child health. The program will also act as a framework for other health departments to replicate. We will achieve sustainability by making all client education materials, toolkits, and the self-study module developed during the duration of the program available for all healthcare and public health facilities to use at no cost. Recordings of professional development training sessions and workshops will be available online after the completion of the program. Additionally, the economic benefit from the program will be two-fold, benefiting the individual family and society at large. Regarding individual families, a lower preterm birth rate can improve their economic stability due to reduced medical expenses and long-term care needs. Regarding society, a decrease in preterm births would result in a decrease in overall healthcare savings. Estimated Budget (2 years): $200,000 Category Items Included Amount – Year 1 Amount – Year 2 Supplies and Materials program supplies, printing needs, client education materials $40,000 $40,000 Travel daily in-state travel $12,500 $12,500 Medical Supplies health instruments (Masimo hemoglobin device, scales) $20,000 $0 Incentives supplies for outreach (customized products with program logo) $15,000 $15,000 Training in-person staff trainings to local providers (space rental, meals and beverages) $12,500 $13,000 Conference and Travel attendance at state and local conferences (registration fee, travel expenses) $7,500 $7,000 Interpreter Fees provide translation to non-English speaking participants, translate client material $2,500 $2,500 Total $110,000 $90,000 2024 MATERNAL & INFANT HEALTH INITIATIVE APPLICATION QUESTIONS To help organizations work collaboratively in submitting proposals to our 2024 Maternal & Infant Health Initiative, we’re sharing the application questions below. PLEASE NOTE THIS DOCUMENT IS FOR REFERENCE ONLY. ALL APPLICATIONS MUST BE SUBMITTED THROUGH OUR ONLINE GRANT PORTAL BY 5:00 P.M. ET ON JANUARY 26, 2024. PROJECT INFORMATION PROJECT DETAILS In this section, we’ll ask for the basics: Project Title, Request Amount, Project Start Date, End Date, and Geographic Reach. More info can be found in the grant portal. PROJECT OVERVIEW The questions in this section are aimed at capturing a brief summary of your work. You will have the opportunity to provide more details on your proposal in the following sections. Problem Statement: In a few sentences and in plain language, what is the key issue or problem you are trying to address, and how will this project improve outcomes for pregnant individuals and their infants? Key Partners: List the project's key partners. If they will receive direct financial support through this project, please indicate the anticipated amount for each partner. Potential Impact: In three sentences or less, describe the key outcomes from your project and why you know this work will be impactful if funded. PROJECT NARRATIVE This section provides the opportunity to expand in greater detail about your proposal. 1. PROJECT SIGNIFICANCE: Why is working on this issue or topic important for improving the health of pregnant individuals and their infants? What data or other evidence supports the need for the issue or topic you seek to address? How will the work outlined in this proposal impact the issue or topic you just described? WHAT WE'RE LOOKING FOR: Projects that clearly demonstrate the need to work on a key issue or problem in the geography you are looking to serve through a comprehensive literature review, surveys or needs assessments, expert consultations, and input from the target population(s) and community. 2. APPLICANT CAPACITY AND EXPERIENCE: Provide a brief statement of how this project aligns with your organization's mission and priorities and describe your organizational experience and capacity to lead this project. In other words, why is your organization best suited to take on this proposed work? WHAT WE’RE LOOKING FOR: Proposals should clearly demonstrate, with evidence of past success or through new partnerships, that project partners have the capacity and expertise to implement the proposed work. 3. DISPARITIES AND HEALTH EQUITY: How does your project aim to reduce health disparities or promote health equity? WHAT WE’RE LOOKING FOR: Equitable projects that: • Benefit or increase access for populations most affected by a health issue; • Remove barriers to health; • Empower communities; and • Engage community leaders in decision making. 4. TARGET POPULATION: Who and how many Michigan residents will be served by this project (e.g., 200 total participants or 75 infants)? WHAT WE’RE LOOKING FOR: • Projects that target the Health Fund priority populations for this RFP of pregnant individuals and infants. • Projects focused on health care access improvements for pregnant individuals, infants and adolescents are of special interest. • Very often the health of parents and caregivers has an impact on the children in their care. When applicable, include information on how a family may be directly or indirectly impacted by the project. 5. COLLABORATION: Explain why you and each one of the partners in your proposal are best suited to do the work outlined in the initiative, both today and for the long-term sustainability of the work. Please describe how you will engage with the target population(s) and community in the planning, implementation, or evaluation of the project. WHAT WE’RE LOOKING FOR: • Projects that have or will include the target population(s) and community in the planning, implementation, or evaluation of the project. • Projects that include multi-sector partnerships with defined roles and responsibilities. Proposals that include formal letters of commitment from key partners. • Proposals that focus on one organization will be less competitive. 6. WORK PLAN: Please provide more details about the proposed project, including a timeline and description of any milestones, reports, deliverables, or end products that will be completed by your organization or your partners. POTENTIAL IMPACT EVALUATION APPROACH All proposals are required to submit a document outlining a proposed project evaluation approach. We are interested in understanding the impact of your proposed project. We want to understand how you will be improving health outcomes for those you're proposing to serve and how you will measure those outcomes. For some helpful resources to develop an evaluation approach, read the Health Fund's Evaluation Approach: How-to Guide, which details common measures our projects frequently use. Applicants are not required to use the resources provided to develop their approach. OUTCOMES If applicable, please detail the following: 1. What short- and long-term outcomes or impacts do you anticipate for individuals or participants involved in your initiative? 2. What short- and long-term outcomes or impacts do you anticipate at the organizational level? 3. What short- and long-term outcomes or impacts do you anticipate at the system/community level? 4. What qualitative and/or quantitative methods, tools, or data sources will you use? 5. How will your evaluation plan uphold principles of equity in terms of community participation, data disaggregation, using feedback to improve program delivery, or other aspects? (See the Equitable Evaluation Initiative for more information.) NOTE: Short-term outcomes are outcomes that will be achieved during the performance period of the grant. Long-term outcomes detail the impact that grant will have beyond the performance period of the grant. More information on outcome types is available in the grant portal. OTHER IMPACTS Please detail what other benefits this project will likely achieve, both short and long-term. (e.g., inform broader policy, produce health care savings, potential replicability in other areas, or potential for sustainability beyond the grant period) In addition to answers to these questions, applicants will provide budget information, required attachments, and other proposal materials through the grant portal. Please log in to get started, and view our RFP for more information about our priorities and required organizational documents. Michigan Health Endowment Fund: Maternal and Infant Nutrition Concept Paper 2024 Title: Preconception Nutrition and Wellness Program Organization Name: Oakland County Health Division Project State Date: 10/1/2024 Project End Date: 9/30/2025 Geographic Reach: Pontiac, Michigan Priority Area: Increased access to protective and clinical interventions. Problem Statement: The Pontiac community experiences significant health disparities, particularly in the infant mortality rate among non-Hispanic blacks/African Americans compared to non-Hispanic whites. Preterm birth is the leading cause of infant mortality. The preterm live birth rate in Pontiac is high compared to Oakland County and the State of Michigan. Black infants were about two times as likely as white infants to be born prematurely. Conversely, this community lacks access to comprehensive preconception nutrition and wellness guidance. This gap in preventative health hinders the potential for optimal maternal and infant health and necessitates the development of a structured and accessible program to address these challenges. Brief Overview: We will design the proposed Preconception Nutrition and Wellness Program for women of childbearing age in Pontiac, Michigan. An upstream approach will encourage healthy eating and positive health habits during the preconception and interconception periods to decrease adverse birth outcomes and promote overall maternal and child health. By focusing on interventions and strategies that target the period before conception, we can address potential health risks and optimize the overall reproductive health of the individual. Investing in these efforts reduces the likelihood of complications during pregnancy and contributes to the broader goal of improving population health and reducing healthcare disparities. Building on the existing maternal and child home visiting programs offered at the Oakland County Health Division would expand services to women seeking crucial nutritional and health guidance during their preconception and interconception periods. An estimated 100 participants per year, or 200 participants overall, will be served by this proposed program during the duration of the grant. Participants will receive comprehensive, personalized, and accessible nutrition counseling led by a Registered Dietitian Nutritionist (RDN) and preventative health screenings and education led by a Registered Nurse (RN). In addition to individualized services, we will create and distribute a provider toolkit and self-study module on preconception health to local healthcare providers and community members. These efforts will fill a critical gap in the community by addressing the lack of preconception guidance, which is proven to have a lasting impact on maternal and child health. The Preconception Nutrition and Wellness Program will provide women of childbearing age access to crucial nutritional and health guidance to decrease adverse birth outcomes and promote overall maternal and child health. Through health education and other program activities, we anticipate increased self-efficacy around healthy eating, optimized intake and status of the micronutrients iron and folate through food and dietary supplementation, and modified body weight from improved diet, lifestyle, and physical activity. Several far-reaching impacts of the program include optimized health status among the participants, healthier pregnancies, and enhanced community well-being. In essence, the program aims to utilize upstream initiatives to empower individuals to make informed choices and create an enduring positive impact on the health trajectory of future generations. Key Collaborative Partners: Oakland County Health Division, Great Start Collaborative and Executive Group, Oakland County Best Start for Babies Collaborative, Oakland County Local Leadership home visiting group, Nurse Family Partnership, WIC, Trinity Health, and Honor Community Health. In addition, many of the collaborative partners will consist of community members from the target groups we aim to serve. Estimated Budget (2 years): $200,000 Category Items Included Amount – Year 1 Amount – Year 2 Supplies and Materials program supplies, printing needs, client education materials $40,000 $40,000 Travel daily in-state travel $12,500 $12,500 Medical Supplies health instruments (Masimo hemoglobin device, scales) $20,000 $0 Incentives supplies for outreach (customized products with program logo) $15,000 $15,000 Training in-person staff trainings to local providers (space rental, meals and beverages) $12,500 $13,000 Conference and Travel attendance at state and local conferences (registration fee, travel expenses) $7,500 $7,000 Interpreter Fees provide translation to non-English speaking participants, translate client material $2,500 $2,500 Total $110,000 $90,000 Appendix B: EVALUATION APPROACH Inputs Activities Target Date Outputs Short Term Outcomes Long Term Outcomes •Human •Financial Create client educational material (handouts) Months 1-6 Create at least 5 client handouts about preconception health. Provide tangible educational material to disperse to active participants in the program. Provide tangible education material to local healthcare providers to disperse to their patients. •Human Develop a provider toolkit (website) Months 1-6 Establish a resource hub of information about preconception health for providers to access located on health division website. Will have at least 100 recorded visits to the webpage. Will have at least 100 recorded visits to the webpage annually. •Human •Financial •IT Expertise Develop a self- guided preconception health module (online) Months 1-6 Design and record a self- guided preconception health module that will be located on health division website. Will have at least 100 completed modules by program participants. Will have at least 100 completed modules by members of the community annually. •Human •IT Expertise Create a user- friendly public facing website (online) Months 1-6 Develop a user-friendly facing webpage located on the health division website that houses client educational materials, provider toolkit, outreach material, and module. Will have at least 100 recorded visits to the webpage. Will have at least 100 recorded visits to the webpage annually. •Human •Organizational Incorporate Transition to Success (TSS) protocols and analytics Month 1- ongoing Utilize the Transitions to Success (TSS) 20-domain assessment tool (based upon the Arizona Self-Sufficiency Matrix) to measure social determinant exposures in the Will train direct care staff to teach clients to prioritize, identify and ensure access to all available services Improve health, educational, and economic success for the targeted community. community related to preconception. and supports related to preconception and maternal health. •Human •IT Expertise Build a note template for nutrition assessments and nursing interventions on an electronic medical record Month 3-6 Record all participant notes and interventions on an electronic medical record. Track all participants progress and collect feedback. Utilize all data for continuous improvement and to conduct research based off interventions. •Human •Organizational •Community Resources •Financial Launch coordinated outreach campaign Month 4-ongoing Create online referral form, develop outreach materials (flyers, posters), and share information about program via online and in person to members of the community. Generate at least 100 referrals. Generate at least 50 referrals annually. •Human •Financial Provide home and virtual visits to eligible participants Month 4-ongoing Based off referrals, provide individualized nutrition counseling to eligible participants. Participants will achieve at least a 5% reduction in weight and increase nutrient measures. Decreased rate of maternal obesity and preterm births in the targeted community. 2024 MATERNAL & INFANT HEALTH INITIATIVE. REQUEST FOR PROPOSALS. A. PROGRAM OVERVIEW PRIORITY AREAS The 2024 Maternal and Infant Health Initiative is seeking community-driven and locally-focused projects that address the priority areas listed below and improve outcomes for pregnant individuals and their infants. Projects must incorporate at least one of these categories (examples are not exhaustive): ® Address service delivery environment barriers to improve access to equitable health care for girls, women, and mothers through improved integration of medical, behavioral, public health, and social services. Examples: Regional perinatal quality collaborative initiatives, home visiting programs, co- location, launch of doula services, and care coordination/ inter-professional health care teams. ® Increase access to protective and clinical interventions including improved screening before, during, and after pregnancy for health risks as well as referral and connection to treatment or services. Examples: Interventions related to sexually transmitted infections, intimate partner violence, mental health, substance use disorders, maternal depression, targeted provider training to improve care delivery, and community or practice-based interventions aimed at improving birth equity and other social determinants of health. ® Address targeted policies, practices, and procedures at the local or practice level that impact or prohibit the best outcomes for mothers and infants. We’re looking for implementation of structural changes in communities and organizations that help families navigate and remove barriers to maternal and infant health. Examples: Streamlining and simplifying process for families seeking services and supports, expanded and routine use of screening tools and standard processes for referral and follow-up, and implementation of data-driven interventions that are focused on equity in access, care, and outcomes. GRANT TIMELINE November 14, 2023 Grant portal opened for applicants December 8, 2023 Concept papers due by email at 5:00 p.m. ET (strongly encouraged) January 26, 2024 Application due by 5:00 p.m. ET May 15, 2024 Awards announced 2024 Maternal & Infant Health Initiative 2 A competitive proposal will focus on a specific target population and include local data to illustrate the need for the intervention. Projects may build on local or regional work and priority will be given to projects that are community-driven and locally focused and align with the Health Fund's mission and goals and promote health equity for infants, girls and women. OFFICE HOURS We are excited to offer opportunities for applicants to speak with Health Fund program staff and ask questions related to the grant cycle and program priorities prior to submitting a concept paper. This should not replace the submission of a concept paper. Participation in office hours will not impact the status of a proposal. Please register here to schedule a 20-minute Zoom meeting with the team. • ADDRESSING DISPARITIES AND PROMOTING HEALTH EQUITY Across all priority areas, the Health Fund seeks proposals that address disparities and promote health equity. What does that look like? Equitable programs: 1. Benefit or increase access for populations most affected by a health issue; 2. Remove barriers to health; 3. Empower communities; and 4. Engage community leaders and members in decision-making B. ELIGIBILITY AND GRANT AMOUNT ELIGIBILITY Nonprofits, local units of government, and the State of Michigan are eligible for grants. To be eligible to apply for a grant under this initiative, applicants must: R Be recognized by the Internal Revenue Service as a nonprofit organization; R Serve Michigan residents; R Have a current certified financial audit or independently reviewed financial statements; and R Have at least 1 FTE. EXCLUDED FROM FUNDING CONSIDERATION X Clinical research X Loans X Health-related emergencies* X Capital projects X Litigation X Ongoing program operations and staffing X Lobbying activities X Tuition costs and related fees X Organizations that discriminate because of age, race, ethnic origin, religion, sexual orientation, disability, or gender GRANT AMOUNT The Health Fund anticipates awarding grants between $50,000 to $200,000. We welcome proposals toward the smaller end of that range. Applicants may apply for a one or two-year * The Health Fund might in some situations consider support to address longer-term rebuilding or other needs following emergency situations. 2024 Maternal & Infant Health Initiative 3 grant, but the total request is limited to $200,000. Please be sure to clearly identify your funding requests per year in your proposal, along with any other associated program revenue. An organization may apply for a grant no larger than 20% of its annual operating budget. Fiduciary, or financial sponsor, agreements may be considered for small organizations to meet the budgetary or eligibility requirements listed below. We welcome ideas from all types of eligible organizations, regardless of size or funding request. Applicant organizations with annual operating budgets less than $10 million may request indirect costs up to 30% of the total grant budget. Applicant organizations with annual operating budgets at or above $10 million may request indirect costs up to 20% of the total grant budget. The percentage is based on the primary applicant’s operating budget size. The indirect cost line item should include indirect costs for all project partners. C. REVIEW CRITERIA AND EVALUATION REVIEW CRITERIA Here’s what we look for when program staff and subject matter experts review proposals. We don’t expect proposals to include all of these, but we encourage you to be clear about how your project addresses one or more (not a prioritized list): • Collaboration. The project demonstrates collaboration, including community/participant involvement in planning and implementation, multi-sector partnerships with defined roles and responsibilities related to the project, and leverage of external resources. • Empowering communities. The project empowers communities to support their ongoing health needs or challenges, and it engages with community leaders to share in decision- making. • Health equity. The project benefits the populations most affected by the health issue, removes barriers to health, empowers communities to support their ongoing health needs or challenges, and engages with community leaders to share in program design and decision-making. • Innovation. The project supports new or enhanced programs or strategies. • Long-term impact. The project has the potential to achieve significant long-term impact by implementing effective models or supporting needed innovation. • Measurable outcomes. The project has clear outcomes and the potential to have a measurable impact on improving health or quality of life. • Strategic alignment. The project aligns with the Health Fund’s mission, strategies, and goals and with the priorities in this RFP. EVALUATION All proposals are required to submit a document outlining a proposed project evaluation approach. This document should not exceed three pages in length, and a one-page document is sufficient. This evaluation approach could be a logic model or a theory of change, or another format. The document should describe the relationship between project activities, outputs, short- and long-term outcomes, and overall impact(s). Short-term outcomes are outcomes that will be achieved during the performance period of the grant. Long-term outcomes detail the impact that grant will have beyond the performance period. 2024 Maternal & Infant Health Initiative 4 For some helpful resources to develop an evaluation approach, read the Health Fund’s Evaluation Approach: A How-To Guide, which details common measures our projects frequently use. Applicants are not required to use the resources provided to develop their approach. D. APPLICATION PROCESS CONCEPT PAPERS We know proposals that have a concept paper are more competitive, so we ask that we learn more about your idea before you submit a proposal. You can do this by submitting a two-page concept paper or talking to us. If you decide to send a concept paper, please address the following: •Project title and organization name •Project start date and end date •Geographic reach of project, area the project intends to serve •Problem statement or key issue you aim to address •Brief overview of the project, including potential impact – short and long-term. •Key collaborative partners and responsibilities of each partner •Estimated draft budget Concept papers need to be submitted by email to grants@mihealthfund.org by December 8, 2023 to be considered. APPLICATIONS Applications must be submitted electronically through the Health Fund website using the grants portal. Using Google Chrome, applicants will first be required to create an account. It may take 48 hours for your account to be approved. Once approved you will receive login credentials via email. While the grants portal does not have a word limit function, we require applicants to keep the total narrative within the equivalent of 10 standard pages. The Health Fund also reserves the right to confidentially share proposals with external reviewers and other foundation partners. Full proposals must be received by 5 p.m. on January 26, 2024. Proposals submitted after the deadline will not be considered. E. RESOURCES The following resources may be useful as you develop your proposal. KEY STEPS 1.Submit a concept paper via email by 5:00 p.m. (ET) on December 8, 2023. 2.Applicant receives initial feedback, including whether the concept is likely to be competitive. 3.Apply using Health Fund grant portal by 5:00 p.m. (ET) on January 26, 2024. 4.Applications are reviewed by program staff and subject matter experts. Clarifying questions may be sent. 5.Awards are announced. 2024 Maternal & Infant Health Initiative 5 •Michigan Mother Infant Health and Equity Improvement Plan •Health Statistics and Reports (MDHHS) •Kids Count Data Book (Michigan League for Public Policy) •Community Health Needs Assessment – Non-profit hospitals are required to complete community health needs assessments with public input once every three years and the report must be made available through the hospital website. •Clinical or non-clinical data related to the project location, to be used as baseline to measure programmatic progress. •Michigan Profile for Health Youth (MiPHY) •Behavioral Risk Factor Surveillance System Prevalence & Trends Data – Explore by Location o Metropolitan Statistical Areas (MMSAs) •Michigan Behavioral Risk Factor Survey – Regional and Local Health Department Tables •Robert Wood Johnson Foundation County Health Rankings data •Institute for Healthcare Improvement QI Essentials Toolkit: Maternal Health •Evaluation Resources for current and prospective grantees •Medicaid Policy Bulletin on doula services For more information on the Health Fund’s grantmaking priorities and previous grants, you can view our grantmaking webpage and also our Frequently Asked Questions page. If you have further questions on grant or application processes, please email grants@mihealthfund.org. F. MORE INFORMATION AND FURTHER QUESTIONS The Michigan Health Endowment Fund works to improve the health and wellness of Michigan residents and reduce the cost of healthcare, with a special focus on children and seniors. For helpful tips and additional information, please visit the Maternal & Infant Health Initiative page on our website. For more information on our grantmaking, view our Frequently Asked Questions. If you have further questions, please contact Grace Brooks at grace@mihealthfund.org. The Health Fund Board of Directors has sole responsibility for all grant decisions.