DEPARTMENT: Health
DEPARTMENT HEAD: Jennifer Herriott, MPH
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Ratifying an agreement with Judith Grant to provide Fetal Infant Mortality Review and Maternal Mortality and Morbidity Review (FIMR/MMMR) data abstraction services for the San Antonio Metropolitan Health District in an amount up to $24,999.00 per term.
SUMMARY:
An ordinance ratifying an agreement with Judith Grant to provide case abstraction and family interviewing services for FIMR/MMMR for the San Antonio Metropolitan Health District for a period beginning September 1, 2019 and ending March 31, 2020 which may be renewed for four, one year terms.
BACKGROUND INFORMATION:
Metro Health’s Healthy Start program is responsible for operating a Fetal Infant Mortality Review (FIMR) and/or a Maternal Mortality and Morbidity Review (MMMR). FIMR is a national collaborative effort between the American College of Obstetrics and Gynecology and the Maternal Child Health Bureau dating back to 1990. FIMR is based on a community-wide action-oriented process that examines fetal and infant deaths through clinical abstraction and maternal interviews, determines preventability, and engages communities to take action. FIMR had previously existed in San Antonio from 2008-2011 and was reinstated in May 2015 by Metro Health’s Healthy Start program. Beginning in 2017, Healthy Start also instituted the Bexar County Maternal Morbidity and Mortality Task Force (MMMR). Currently, the Bexar County MMMR operates as a task force that focuses on maternal death and disease at a more local level, and with a specific focus on the first year postpartum, compared to the state task force’s focus on the first 42 days postpartum. It is hoped that the task force will evolve over the next five years of the Healthy Start grant to incorporate reviews of individual cases of maternal mortality and severe morbidity.
Metro Health’s Healthy Start program is funded through the U.S. Department of Health and Human Services (DHHS) Healthy Start Program whose purpose is to engage communities in an effort to reduce infant mortality where rates are over one and a half times the national average through five strategic approaches. The San Antonio Healthy Start (SAHS) Initiative aims to reduce disparities in infant mortality and adverse perinatal outcomes by: 1) improving women’s health, 2) improving family health and wellness, and 3) promoting systems change. A review of individual cases of mortality and morbidity, and trend analysis over time of these cases is critical to improve pregnancy and infant health outcomes. To these activities with the utmost integrity, it is typical for Healthy Start programs to utilize external contractors to meet the DHHS requirement for the clinical abstraction, family interviewing and case preparation that is at the core of mortality and morbidity review processes.
The DHHS Healthy Start Grant is currently authorized to continue through March 31, 2024 and requires Metro Health to secure clinical abstraction services to meet grant requirements through the end of the grant period. Through ratification of the contract with Judith Grant, Metro Health’s Healthy Start Program will be able to satisfy the critical mortality and morbidity review requirement, meet the three strategic approaches and continue its efforts in reducing infant and maternal mortality rates in the San Antonio and Bexar County area.
ISSUE:
Metro Health is requesting ratification of the contract with Judith Grant to provide clinical abstraction, family interviewing and case preparation for the San Antonio Metropolitan Health District’s Healthy Start Program FIMR/MMMR initiatives. The DHHS Healthy Start Program’s FIMR/MMMR is a required grant element, an important quality improvement and surveillance strategy, and improves the accountability and integrity of Metro Health’s Healthy Start program by contracting with external professionals.
ALTERNATIVES:
Should this ratification not be authorized, Metro Health will not be able to meet the FIMR/MMMR requirements of the U.S. Department of Health and Human Services’ (DHHS) Healthy Start Program Grant funding. The Healthy Start Program would need to identify other professionals in the community that can provide similar services to the Healthy Start Program.
FISCAL IMPACT:
This Ordinance ratifies an agreement with Judith Grant to provide FIMR/MMMR data abstraction for the San Antonio Metropolitan Health District for a period beginning September 1, 2019 and ending March 31, 2020 which may be renewed for four, one year terms. Funding in the amount of $24,999.00 per term is provided by the Healthy Start Grant. There will be no additional impact to the General Fund.
RECOMMENDATION:
Staff recommends City Council ratify the agreement with Judith Grant to provide FIMR/MMMR data analysis for the San Antonio Metropolitan Health District for a period beginning September 1, 2019 and ending March 31, 2020 which may be renewed for four, one year terms.