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Project Name: Integrated Maternal Health Services (U2E)
Applicant Title: BEXAR COUNTY HOSPITAL DISTRICT
Abstract Text: Organization Address and Contact University Health, 4502 Medical Drive, MS# 96-1, San Antonio, Texas 78229 Project Director: Anna G. Taranova, MD, MS, Deputy Chief Public Health, Innovation and Equity Officer. xxx-xxx-xxxx xxxxxxxxxxxxx@xxxx.xxx www.universityhealth.com Funds requested: Year 1 – $1,715,550 Year 2 – $1,799,976 Year 3 – $1,799,967 Year 4 – $1,799,995 Year 5 – $1,799,996 Project Background and Purpose University Health proposes creating a Multidisciplinary Navigation Team model to build a sustainable integrated maternal health services program and capitalize on its extensive experience establishing Texas Rural Maternity and Obstetrics Management Strategies (TX-RMOMS) in Texas State Health Region 8. The proposal aims to improve access to continuous, coordinated multidisciplinary care for women of childbearing age living in Bexar (pronounced bear) County and South Texas. The Mama-Bexar Program aims to improve maternal health outcomes by implementing integrated maternal health services supported by patient navigation services. The sustainable model will increase equitable access to care and provide quality, equitable and comprehensive care for pregnant and postpartum people seen in the University Health network of 23 clinics, at its hospital, and multiple rural South Texas locations. The population of focus is pregnant individuals who experience health disparities and have limited access to social and mental health services, beginning with clients at University Health’s network of clinics in Bexar County and expanding to other partnering sites through the existing TX RMOMS network. The proposed Mama-Bexar program will advance health equity and address barriers to care in Bexar County and South Texas. In 2022, the University Health population of pregnant patients was comprised of 85% of persons on Medicaid or without insurance. Of this population, 87% were people of color. Texas ranks among the top ten in maternal mortality and ranks last nationally in percentage of pregnant mothers accessing prenatal care within the first trimester. Chronic diseases such as obesity, hypertension, and diabetes in Texas are above the national average and appear as comorbidities in pregnancy, introducing preventable risks to pregnancy, birth outcomes, and infant health. One in four Texas mothers is in a healthcare coverage gap, making prenatal care less likely and adverse outcomes more likely. Recent legislative actions regarding women’s reproductive health have reduced the presence of women’s health providers, decreasing access to care. Project Methods The model for integrated maternal healthcare focuses on three axes. The first axis corresponds to clinical pathways, the second to social determinants of health (SDoH), and the third to mental wellness. These three axes are backed by routine screening and significant navigation/case management support, resulting in a multidisciplinary navigation team. The model incorporates multidisciplinary teamwork, in which the team comprises at minimum one RN Coordinator, one patient navigator, and one Licensed Mental Health Professional to navigate to and provide comprehensive services. Clinical Social Workers, doulas, and other members of the pregnancy care workforce will also participate in this Multidisciplinary team model. Project Outcomes Among expected outcomes for the population of focus are increased access to and decrease in barriers to care, lower rates of appointment no-shows, improved levels of maternal health literacy, and improved pregnancy and infant health outcomes. The project anticipates implementation at University Health and multiple rural Texas Health Region 8 locations. The project model will be disseminated via conference presentations, publications, and in-person meetings with stakeholders and partners.