HomeMy WebLinkAboutReports - 2024.01.18 - 40929
AGENDA ITEM: Application to the Michigan Health Endowment Fund for the 2024 Maternal and
Infant Health Initiative Mental Health Consultation for Maternal Infant Health Home Visiting Staff
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 #2023-3680
Motion to approve the submission of the 2024 Maternal and Infant Health Initiative grant application
to the Michigan Health Endowment Fund in the amount $200,000 for the period October 1, 2024
through September 30, 2026.
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, 2026. The grant provides funding to 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. The grant
funds will be used to address targeted policies, practices, and procedures at the local or practice
level that impact or prohibit the best outcomes for mothers and infants. Funds will also be used to
develop innovative methods for connecting pregnant and parenting people to mental and behavioral
health services.
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. MHEF Application MH Cons - 2024 Final
3. MHEF Evaulation Approach MHC 121523
4. MHEF Work Plan MHC 121523
5. Michigan Endowment Fund 2024 MIH_2024_RFP (2)
6. 2024-MIH-Application-Questions-Preview (2)
7. Concept Paper MHEF (draft watermark) Mental Health Consultation (2)
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 Home Visitor Mental Health Consultation
FUNDING AGENCY: Michigan Health Endowment Fund
DEPARTMENT CONTACT PERSON: Stacey Sledge 248-452-2151
STATUS: Application (Greater than $50,000)
DATE: 01/05/2024
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 (01/05/2024)
Department of Human Resources:
Approved by Human Resources. No position impact. – Hailey Mattews on behalf of Heather Mason (01/02/2024)
Risk Management and Safety:
Approved. No County insurance requirements. – Robert Erlenbeck (01/02/2024)
Corporation Counsel:
Approved. Corp Counsel has reviewed and has no legal issues with the application as presented. – Bradley Benn
(01/03/2024)
Michigan Health Endowment Fund: 2024 Maternal & Infant Health Initiative
Project Information
Project Details
Title: Mental Health Consultation for Health Division and Maternal Infant Health Home Visiting
Programs.
Request Amount: $200,000
Project Start Date: 10/1/2024
Project End Date: 9/30/2026
Geographic Reach: Pontiac, Michigan
Project Overview
The increased understanding of the pervasiveness of trauma and its connections to physical and
behavioral health and well-being, have propelled a growing number of organizations and service
systems to explore ways to make their services more responsive to people who have experienced
trauma. Likewise, the Oakland County Health Division has incorporated trauma informed
interventions into existing program models and recently implemented new programs to educate
and support clients who have experienced trauma in their lifetime.
The implementation of the trauma informed approach for individuals and the family units
enrolled in these programs is well established. The trauma informed interventions have offered
clients the opportunity to understand the effect of adversity on the individual, family, and society
and continue the conversation to also understand the power of resiliency strategies to mitigate the
enduring effect of trauma on their health, social functioning, parenting practicing and future
generations.
Trauma informed best practices recommend that trauma informed approaches extend into
supervision, policies, and organizational culture. The health division is poised to transition from
the trauma specific programing into the organizational system wide approach. A mental health
consultant will guide the completion of an organizational trauma assessment tool and facilitate
an organizational trauma informed implementation plan. The consultant will provide
departmental presentations on strategies that will decrease burnout, increase self-care, create an
understanding of professional boundaries, increase competency related to emotional intelligence
crisis management, vicarious trauma, conflict/resolution, and trauma-informed care. Offering
these staff development trainings will improve in inter-departmental communication, trauma-
informed management, organizational sustainability, employee retention and motivation and
most importantly enhance the impact and depth of staff - client interactions.
Key Collaborative Partners: Oakland County Health Division, Great Start Collaborative and
Executive Group, Oakland County Best Start for Babies Collaborative, Nurse Family
Partnership. In addition, many of the collaborative partners will consist of community members
from the target groups we aim to serve.
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
The MDHHS Birth equity plan promotes Mental, Behavioral Health, & Well-being as
one of the four priority areas. According to the plan the mental and behavioral health of
pregnant and parenting individuals greatly impact their physical health, the parent-child
relationship, and health outcomes for their baby.
Early childhood mental health is essential for healthy development, particularly in social
emotional development, which promotes resilience and reduces risks for various challenges. To
ensure the best outcomes for parents and babies, screening for perinatal mental health disorders
and substance use is crucial for connecting individuals with necessary care and support. The
sooner that someone has access to needed mental and behavioral health services, the more
opportunity there is to increase growth, development, and resiliency factors.
In alignment with the equity plan, Oakland County Health Division Public Health
Nursing staff implement universal screening for mental and behavioral health needs and
improved access to quality service by referring the clients to community mental health providers
and referring to OCHD programs that focus on providing trauma-based information and support.
Adverse childhood experiences (ACEs) are widespread in Michigan with two-thirds
(68%) of Michigan adults and more than half (58%) of Michigan youth reporting one or
more. Adverse experiences are a risk factor for numerous health risk behaviors, such as smoking,
and for negative health outcomes, such as depression, unintended pregnancies, and asthma.
According to the Michigan Behavioral Risk Factor Survey data collected between 2013
and 2019 the number of adults who have experienced ACEs and the impact of those ACEs
remains about the same. Among all Michigan adults, 20% experienced 4 or more ACES, 25%
experienced 2-3 ACEs and 24% experienced 1 ACE.
Research from the original ACE study published by CDC demonstrates a dose response
between the number of ACEs and a greater risk for the individual to take part in risking health
behavior or experience negative health outcomes. The data demonstrates this dose response
among Michigan adults. Those who experienced 1 or more ACEs had a 0.7 greater risk of
reporting poor physical health in the last month, 1.9x greater risk of experiencing poor mental
health in the last month and 1.5x greater risk of being diagnosed with depression.
The Michigan Youth Risk Behavior Survey (YRBS) asks high school youth about the
number of ACEs they have experienced in their lifetime. According to 2019YRBS data, 63%,
reported one or more ACE. 15% experienced 4 or more ACEs and 22% experienced 2-3 ACEs.
46% of youth who experienced 4 or more ACEs seriously considered suicide, 25% experienced
sexual violence, 63% did not use a condom during their last intercourse, 44% drank alcohol and
44% used marijuana in the last month.
The Oakland County ACE data extracted from the Michigan Behavior Risk Factor
Survey demonstrates 49% of those surveyed experienced 1-3 ACEs and 20% experienced 4 or
more ACEs. Those who experienced 1 or more ACEs had an increased risk of being diagnosed
with depression and experiencing poor general health in the month prior to the survey.
One in five women have a history of childhood maltreatment, and 34% of pregnant
people with a history of childhood maltreatment will develop post-traumatic stress disorder
(PTSD) during their perinatal year. The ACE surveys completed by clients that are pregnant or
identify as birthing parents and enrolled in public health home-based programs demonstrated
57% of the clients that completed a survey experienced 5 or more ACEs, 17% experienced 2-3
ACEs and 1% experienced 1 ACE.
During the pandemic, even more children and families expressed experiencing stress and
trauma, and in the pandemics wake there are unprecedented levels of mental health problems in
children and parents.
Trauma informed interventions implemented by trained professionals have proven to
impact pregnant persons and parent’s awareness of the impact of ACEs. The interventions have a
positive effect on their choices, health risk behaviors, and parenting practices. Implementing the
strategies of programs such as the Survivor Mom’s Curriculum, the Nurturing Parent Program
and HOPE provides the client a structured setting to discuss their adversity and build a plan for
resilience.
References
MDHHS Advancing Healthy Births: AN EQUITY PLAN FOR MICHIGAN FAMILIES &
COMMUNITIES (2024-2028) retrieved 12/14/23
Prevalence of Trauma and Toxic Stress in Michigan (2019) Retrieved 12/14/2023
https://www.michigan.gov/mdhhs/adult-child-serv/childrenfamilies/tts/btim/pttsm
Oakland County Health Division Resilience Workgroup, ACE Survey Report (2023)
A Quasi‐experimental Outcomes Analysis of a Psychoeducation Intervention for Pregnant
Women with Abuse‐related Posttraumatic Stress Heather Rowe, Mickey Sperlich, Heather
Cameron, Julia Seng DOI:https://doi.org/10.1111/1552-6909.12312
Applicant Capacity and Experience
The Oakland County Health Division has developed a comprehensive plan with targeted
activities to support healthy families and communities. 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 provide client
education on ACEs, trauma and resilience utilizing the HOPE frame work, NEAR@ Home
toolkit and most recently training 3 public health nurses as Survivor Mom’s Companion Tutors.
The breadth and depth of these programs showcase the Oakland County Health Division's
commitment to providing education, intervention, and community referrals to support to
individual clients, families, and the community to improve mental, behavioral health, wellbeing,
growth and resiliency. The ability to support the health division and community-based staff with
a mental health consultant to provide training, reflective processing and self-care will strengthen
the impact of our trauma informed approach.
Disparities and Health Equity
The mental health consultant will significantly improve the trauma informed practices of
the health division and support the well-being of staff that provide direct services to clients who
have experienced adversity. Educating pregnant clients and birthing parents on the impact of
ACES is shows to empower individuals to rediscover their power and capacity to move toward
healing and remove the stigma and the shame of adversity. By focusing on interventions and
strategies that target pregnant and birthing individuals they have an opportunity to implement
resilience strategies to break the cycle of intergenerational trauma cycles. This upstream,
preventive approach has the potential to narrow health disparities by providing trauma informed
access to education and resources, ultimately fostering a healthier population and reducing the
burden on broader community 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. This program will also support the retention of nurses and
health division staff that understand how to engage in self-care activities and avoid vicarious
trauma.
Staff will also be trained to use the Transitions To Success curriculums that define
specific treatment protocols with a 20-domain assessment tool based upon the Arizona Self-
Sufficiency Matrix. The tool assesses and measures social determinant exposures affecting heath
and economic self-sufficiency. TTS trains direct care staff to teach clients to prioritize, identify
and ensure access to all available services and supports across their community. CARE
(Coordinating All Resources Effectively) management of existing resources integrated with peer
mentoring, financial literacy and volunteerism empower clients (equipped with their CARE Plan)
to achieve improved health, educational and economic success for themselves and their families.
Target Population
The mental health consultant will provide quarterly training to the health division’s 300
employees on trauma informed approaches. Conduct monthly group reflective processing for 60
community based public health nurses that conduct trauma informed maternal child health
services including Survivor Mom’s Program staff.
Collaboration
The partners chosen for this project will be internal Oakland County Health Division
stakeholders. Each health division unit commits to understanding a trauma informed universal
approach. The health division is multidisciplinary and includes community based and clinical
staff. The collaboration between units will strengthen the relationship between the community
based public health staff and clinical staff and could lead to additional partnerships and
collaboration in the future. Division staff serve the entire county of Oakland and residents from
neighboring counties.
Organization Role
Oakland County Health Division •Implement
•Promote at community level
•Schedule staff to participate in the consultant
trainings
Great Start Collaborative and
Executive Group
•Promote trauma informed client programing
Oakland County Best Start for
Babies Collaborative
•Promote trauma informed practices.
•Educate collaborative partners
Nurse Family Partnership •Promote trauma informed practices
•Refer clients to intervention programs
•Participate in trauma and wellness professional
development trainings
•Integrate information into existing program
WIC •Promote trauma informed practices
•Refer clients to intervention programs
•Participate in trauma and wellness professional
development trainings
•Integrate information into existing program
Waterford Community Coalition •Promote the OCHD home based nursing
programs including SMC, NPP and NFP
Work Plan
See appendix A.
Potential Impact
Evaluation Approach
See appendix B.
Outcomes
1. The short-term outcome we anticipate is for health division staff to participate in trauma
informed training. We anticipate increased staff’s self-efficacy around trauma informed
approaches. The long-term outcome we anticipate is an improvement in institutional
policies and implement universal mental and behavioral health screening for all pregnant
and birthing people. Develop innovative methods for connecting pregnant and parenting
people to mental and behavioral health services, including telehealth, inhome services,
and making resources available where people already are (e.g., schools, healthcare
offices).
Estimated Budget (2 years): $200,000
Category Items Included Amount – Year 1 Amount – Year 2
Mental Health
Consultant Fees
Four presentations to
the Health Division
staff /year (space
rental, meals, and
beverages)
Monthly (12) Nursing
team meeting: skill
development and
group facilitation
Mental health
consultation for staff
managing a client’s
emergency situations
$50,000 $50,000
Transitions to
Success consultant
TTS data collection,
research &
evaluation, analyzing
& compiling business
data for poverty
intervention, and
community
collaborations,
engagement and
education and access
to the TTS online
Community Portal.
$20,000 $15,000
Training Supplies and
Materials
Training program
supplies, printing
needs, staff journal
and wellness supplies
$30,000 $20,000
Incentives Supplies for trauma
related client
education i.e..
breathing necklace
$5,000 $5,000
Mindfulness books
for kids
(customized products
with program logo)
Conference and
Travel
attendance at state
and local conferences
(registration fee,
travel expenses)
$2,500 $2,500
Total $107,500 $92,500
Appendix B: EVALUATION APPROACH
Inputs Activities Target
Date
Outputs Short Term
Outcomes
Long Term
Outcomes
•Human
•Financial
Create staff
educational
material (handouts)
Months
1-6
Create at least 5 trauma
informed handouts for staff
to utilize during training
Provide tangible
educational
material to disperse
to active
participants in the
program.
Provide tangible
education material
to disperse to
clients that receive
services at the
health division
•Human
•Financial
Identify and
purchase items that
can be distributed
to clients for trauma
related support
Month 1-6 Distribute
wellness/resilience items to
clients receiving services
through health division
programs
Clients will receive
the items with
instructions on how
to use the item.
Clients will practice
using the items.
•Human
Schedule 4
trainings for health
division staff on
trauma informed
care
Months
1-12
All staff will participate and
complete an evaluation
demonstrating an
improvement in knowledge
Staff will have an
increased in
knowledge in
trauma approaches
Staff will
implement trauma
approaches with
clients that receive
services at the
health division
locations
•Human Schedule monthly
reflective
processing sessions
for home visiting
staff
Month 1-
12
All nursing staff will
participate in reflective
processing.
The staff will
understand the
components of
reflective processes
The staff will
practice the
components of
reflective processes
and practice the
parallel process
with clients.
· 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
community.
Will train direct
care staff to teach
clients to prioritize,
identify and ensure
access to all
available services
and supports.
Improve health,
educational, and
economic success
for the targeted
community.
•Human Be available for
emergency mental
health consultation
for home visiting
staff
Month 1-
24
Appendix A: WORK PLAN
Objective Key Tasks Person
Responsible
Start
Date
End Date
Program Development
and Planning
1. Schedule meetings with Health Division leadership
team, and consultant to guide program development.
2. Develop program goals, objectives, and key
performance indicators (KPIs)
3. Schedule meeting with Health Division leadership
team and the TTS trainer.
Andrea Agboka Month 1 Month 2
Educational Material
Development
1. Identify trauma informed educational materials to
educate staff about the prevalence and impact of
trauma on individuals, families, and the community,
personalize the materials with Oakland County
prevalence data and community resources.
2. Identify and purchase wellness/self-care materials to
support staff that work directly with trauma affected
clients.
2. Develop an internal webpage for staff to use as a
reference for trauma informed educational material,
internal and external referral resources, and staff
development modules.
3. Consultant will develop recorded modules for new
staff to complete during onboarding.
OCHD Resilience
Team
OCHD Health
Education Unit
Month 1 Month 6
Outreach and Promotion 1. Promote the trauma informed OCHD programs
including the Nurturing Parent Program, Survivor
Mom’s Companion and Community Nursing
programs.
HE, Community
Partners.
Month 1 Continuou
s
Program
Implementation
1. Conduct the quarterly trainings for all staff.
2. Conduct trauma monthly groups.
3. Schedule a meet and greet with the consultant and
explain the role of the mental health consultant and how
to access services in an emergency situation
OCHD Resilience
Workgroup/Andre
a Agboka/ Marcia
Andrews
Month 2 Continuou
s
Evaluations and
Adjustments
1. Conduct ongoing evaluation using KPIs to assess the
program's effectiveness and identify areas for
improvement.
2. Gather feedback from participants through surveys and
staff interviews.
3. Make necessary adjustments to the program based on
evaluation results.
4.Utilize the TTS program to evaluate a complete
assessment of social determinants of health and care
coordination with community resources.
All Month 12 Month 15
Sustainability and
Expansion
1. Develop a sustainability plan, including strategies for
ongoing funding, community engagement, and program
integration into existing healthcare services.
OCHD Month 18 Month 24
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.
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:
Home Visitor Mental Health Consultation Concept Paper 2024
Title: Mental Health Consultation for Maternal Infant Health Home Visiting Staff
Organization Name: Oakland County Health Division
Project State Date: 10/1/2024
Project End Date: 9/30/2026
Geographic Reach: Oakland County, Michigan
Priority Area: 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.
Address targeted policies, practices, and procedures at the local or practice level that impact or
prohibit the best outcomes for mothers and infants.
Problem Statement:
The increased understanding of the pervasiveness of trauma and its connections to physical and
behavioral health and well-being, have propelled a growing number of organizations and service
systems to explore ways to make their services more responsive to people who have experienced
trauma. Likewise, the Oakland County Health Division has incorporated trauma informed
interventions into existing program models and recently implemented new programs to educate
and support clients who have experienced trauma in their lifetime.
The implementation of the trauma informed approach for individuals and the family units
enrolled in these programs is well established. The trauma informed interventions have offered
clients the opportunity to understand the effect of adversity on the individual, family, and society
and continue the conversation to also understand the power of resiliency strategies to mitigate the
enduring effect of trauma on their health, social functioning, parenting practicing and future
generations.
Trauma informed best practices recommend that trauma informed approaches extend into
supervision, policies, and organizational culture. The health division is poised to transition from
the trauma specific programing into the organizational system wide approach. A mental health
consultant will guide the completion of an organizational trauma assessment tool and facilitate
an organizational trauma informed implementation plan. The consultant will provide
departmental presentations on strategies that will decrease burnout, increase self-care, create an
understanding of professional boundaries, increase competency related to emotional intelligence
crisis management, vicarious trauma, conflict/resolution, and trauma-informed care. Offering
these staff development trainings will improve in inter-departmental communication, trauma-
informed management, organizational sustainability, employee retention and motivation and
most importantly enhance the impact and depth of staff - client interactions.
Brief Overview: We will implement a multifaceted system wide approach to trauma informed
care for staff at the Oakland County Health Division. A mental health consultant will offer
customized and standard training on burnout, self-care, boundaries, emotional intelligence, crisis
management, vicarious trauma, conflict/resolution, and trauma-informed care. These training
courses have improved inter-departmental communication, trauma-informed management,
organizational sustainability, and employee retention and motivation.
A Mental Health Consultant will be used to support the staff and program supervisors with
building strengths-based attitudes and practices, reflective practice, and reflective supervision.
These skills will further strengthen the staff’s positive relationships with clients and families
when traumatic events and adversity are part of their experience. These strategies will help staff
become aware of assumptions and judgments about concerning behaviors and interactions that
may prevent recognizing underlying trauma and strengthen fragile relationships with families
who have experienced past trauma or who are experiencing current trauma.
The Public Health Nurses in the Nurturing Parent Program implement a 16-week evidenced
based, family-centered trauma-informed initiative designed to build nurturing parenting skills as
an alternative to abusive and neglecting parenting and child-rearing practices. The long-term
goals are to prevent recidivism in families receiving social services, lower the rate of multi-
parent teenage pregnancies, reduce the rate of juvenile delinquency and alcohol abuse, and stop
the intergenerational cycle of child abuse by teaching positive parenting behaviors. Program
interventions are supported by valid and reliable self-report inventories, Adult and Adolescent
Parenting rating scales and the Adverse Childhood Experiences Survey. On average 135 families
graduate from the program per year.
The Survivor Moms' Companion is a psychoeducational program designed to help pregnant and
birthing people/parents with a history of childhood maltreatment and other trauma break the
cycles of abuse and psychiatric vulnerability in their lives and the lives of the newly born by
providing information, skills training, and emotional support. Tutors will meet with Survivor
Moms once a week, in their home, 30-minute sessions, for 5 to 11 sessions. SMC education
centers around Post Traumatic Stress Disorder symptom management emotion regulation, and
interpersonal regulation. Client assessments include the pre assessment of Adverse Childhood
Experiences Survey and the pre and post assessments PTSD, dissociation, depression, anger, and
interpersonal sensitivity assessments. The clients enrolled have reported a considerable level of
need for this type of intervention. 100% of the reported ACE scores are 6 or more (max # is 10),
60% of clients report a PTSD score greater than 50 (>33 may indicate PTSD), 80% of clients
report depression score greater than 13 (> 12 may indicate depression), 100% report an elevated
anger expression score (>8), and 40% reported an elevated interpersonal sensitivity score (>18).
The post score demonstrated a significant decrease in the associated symptoms assessed.
Investing in a mental health consultant will fill a critical need for the SMC program. SMC Tutors
who are not themselves licensed therapists are strongly encouraged to have a licensed mental
health professional (i.e., MSW, PhD, PsyD, MD) who agrees to consult as needed. The rationale
for this requirement is that a tutor may not have the education or experience in mental health to
make a judgment about a client who may not be safe and warrants urgent referral or emergency
services. Additionally, there is an assumption that staff working with clients that have
experienced trauma should expect to be affected by trauma work.
In addition to the programs listed above, the essential programs of the health division support
clients that have experienced intimate partner violence, human trafficking, substance use
disorders, newly diagnosed HIV and other STI diagnosis, death of a child due to a complex
chronic medical diagnosis. Each of these programs are staffed by nurses and support staff that
provide education, care coordination, case management services in a safe space for clients to
engage in services without judgement or preconceived ideas. By investing in this project we will
strive to ensure that clients are universally welcomed by a staff that realizes the widespread
impact of trauma and understands potential paths for recovery; recognizes the signs and
symptoms of trauma in clients, families, staff, and others involved with the system; and responds
by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks
to actively resist re-traumatization.
The incidence of adversity experienced by our client population emphasizes the burden of
trauma and the possibility of staff experiencing secondary trauma without the added support of
reflective practices, trauma informed policies and organizational support. Investing in these
efforts contributes to the broader goal of improving population health and reducing the burden of
broader community level trauma in historically marginalized communities.
Marginalized communities may also experience an increased incidence of poverty. The Health
Division is committed to utilizing Transition to Success® (TTS) an evidence-based standard of
care to treat the condition of poverty as an environmentally based medical condition, integrating
uniform protocols and analytics to directly respond to the social determinants of health. TTS
protocols create a coordinated, uniform system of care and common analytics across healthcare,
human service, government, education, and faith-based organizations. The best practices
embedded in TTS, have demonstrated an improvement in health, education and economic self-
sufficiency outcomes for children, youth, adults, older adults, and other high-risk populations in
six states, including Michigan. A core group of Health Division staff have completed the initial
TTS training. With the investment of this funding, the Health Division will continue to train
direct care staff to teach clients to prioritize, identify and ensure access to all available services
and support across their community. The staff will use the CARE (Coordinating All Resources
Effectively) approach to coordinate the resources offered to clients and integrate peer mentoring,
financial literacy and volunteerism to empower clients (equipped with their CARE Plan) to
achieve improved health, educational and economic success for themselves and their families
and have a lasting impact on the health and wellbeing of the community.
Several far-reaching impacts of the program include optimized health status among the
participants, healthier families, and enhanced community well-being. In essence, the program
aims to utilize multifaceted trauma informed initiatives to empower individuals impacted by
trauma to understand their experience and create an enduring positive impact on the health
trajectory of future generations.
To support
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. 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
Mental Health
Consultant Fees
Four presentations to
the Health Division
staff /year (space
rental, meals, and
beverages)
Monthly (12) Nursing
team meeting: skill
development and
group facilitation
Mental health
consultation for staff
managing a client’s
emergency situations
$50,000 $50,000
Transitions to
Success consultant
TTS data collection,
research &
evaluation, analyzing
& compiling business
data for poverty
intervention, and
community
collaborations,
engagement and
education and access
to the TTS online
Community Portal.
$20,000 $15,000
Training Supplies and
Materials
Training program
supplies, printing
needs, staff journal
and wellness supplies
$30,000 $20,000
Incentives Supplies for trauma
related client
education i.e..
breathing necklace
$5,000 $5,000
Mindfulness books
for kids
(customized products
with program logo)
Conference and
Travel
attendance at state
and local conferences
(registration fee,
travel expenses)
$2,500 $2,500
Total $107,500 $92,500