Missouri Bootheel Perinatal Network
BPN aims to improve maternal and infant health in Dunklin, Mississippi, New Madrid, Pemiscot, Scott, and Stoddard counties. The six target counties, all located within the Bootheel region in the southeastern part of the state, are home to nearly 30,000 women of reproductive age. Within this region, all standard health status indicators are worse than in the state and nation, including asthma, diabetes, obesity, heart disease, high blood pressure, high cholesterol, and cancer mortality. Rates of low birthweight and infant mortality are also higher in these rural counties compared to the state and national rates. Maternal systems of care are often siloed and two major hospitals discontinued obstetrics services in 2014 and 2018, leaving many women in the region with no local services.
BPN has the largest network and expected patient population of the three awardees. The network, which is led by St. Francis Medical Center, includes four health care systems, six health departments, three behavioral health agencies, three support service agencies, a Federally Qualified Health Center (FQHC), and MO HealthNet (the state Medicaid agency). BPN will maintain partner engagement in this large and complex network through regular workgroup meetings.
The network’s overarching goal is to increase access to prenatal, labor and delivery, and postpartum services for mothers and babies with an initial focus on mothers with high-risk pregnancies. BPN intends to increase service availability through several primary strategies:
- Expand training opportunities and bolster inpatient and emergency obstetric care through hospital-based simulations and educational offerings to emergency medical services and non-delivering hospitals;
- Extend the network’s racial equity educational programs to partners with the goal of reducing racial and ethnic inequities in health care access and outcomes;
- Use telehealth to expand the network’s prenatal and postpartum clinic care and support services, including specialty care and ancillary services (e.g., nutrition consultants); this process will include soliciting community input for telehealth decisions, utilizing technical assistance resources from national telehealth programs, and collaborating with state and national maternal health organizations to obtain medical equipment for telehealth clinical partners; and
- Develop standardized processes for assessing risk and making referrals, including leveraging current regional patient navigation/care coordination service providers, aligning referral processes, and developing a risk assessment tool and decision tree to guide care protocols.