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Massachusetts

Current Assignee: Since October 2003, there has been an assignee located with the Massachusetts Department of Public Health (MDPH), Boston MA

Current Fellow: Since July 2004, there has been a master’s prepared fellow working with the assignee

Projects/Impact:

• Addressing Racial Disparities in Perinatal Outcomes: As a result of the data and strategy presented, Massachusetts was selected as one of five states to address racial and ethnic disparities in perinatal outcomes. In collaboration with the Association of Maternal Child Health Programs (AMCHP), MDPH is working with community partners to target 5 cities where racial/ethnic disparities in infant mortality/prematurity/low birth weight are highest. These 5 communities are developing specific community action plans to address disparities, which will also be incorporated in a statewide action plan to address disparities. In addition, Massachusetts targeted its participation in the Matrixed Analytic Training for Reproductive Maternal and Child Health Training (MATRICHS) on racial and ethnic disparities on perinatal outcomes. The Massachusetts MATRICHS team, sponsored by CDC, in collaboration with the University of Rochester, includes members of the 5 target cities. Analytic capacity has been improved in these target cities and the state has applied for a grant to study anthropologic factors contributing to unintended pregnancy in Puerto Rican women.
  
• Improving referral to Early Intervention (EI): The assignee is the lead investigator in the evaluation of the Massachusetts’ EI program, one of the most extensive programs in the U.S. By analyzing EI referral patterns for very low birth weight infants, the assignee found that infants of uninsured or black mothers were less likely to be referred or referred early. These results were used by the Commissioner to advocate for Medicaid waivers, and EI program leaders improved minority outreach.
  
• Improving the measurement of quality care delivery: The assignee is a Department’s representative in collaboration with Massachusetts' neonatal intensive care units in the Neonatal Quality Improvement Consortium (NeoQIC). The assignee is helping to facilitate the linkage of clinical data to MDPH vital and health services data through the Pregnancy and Early Life Longitudinal database (PELL). This data will provide valuable information on quality of care, practice improvement, infant morbidity, and service utilization. Massachusetts will be one of few states to integrate clinical and population data for population-based measurement of infant morbidity and quality care improvement.
  
• Revising Massachusetts’ regulation on perinatal levels of care: Provided clinical and policy expertise that helped form a state-wide perinatal regulation revision workgroup to address highly controversial issues surrounding hospital certification for levels of maternal and newborn care. As a result, new state regulations will include more detailed information regarding maternal and family-centered care, culturally-competent care, specific staffing and credentials for neonatal ventilation in level III and level II hospitals (special care nurseries). The assignee also incorporated statewide reporting of care delivery and complications to high-risk infants (e.g. very low birthweight infants) into the revised regulations. This will assure monitoring of population-based outcomes among the state’s highest risk infants and provide data for quality assurance measures at the state and hospital level. Completion of the regulations is anticipated to occur in a timely manner and in conjunction with newly proposed American Academy of Pediatrics’ national guidelines.

State-Related Publications

Barfield W, Clements K, Lee K, Kotelchuck N, Wilber N, Wise. Using Longitudinally Linked Data to Improve Early Intervention Referral. Pediatr Res 2004; 55(4); 523A:2963.

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Page last reviewed: 2/8/08
Page last modified: 3/6/06
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion