In July of 2005 the Coalition began a comprehensive initiative to improvethe Healthy Start Postnatal screening rate. Since August of 2005 aCoalition staff member has visited each hospital/birth facility quarterly.Quarterly visits provide education regarding the benefits of Healthy Startand other available resources. These visits also serve as the basis todevelop a better understanding of how important it is to offer screeningin a manner that encourages consent and how to make appropriatereferrals for factors other than score. Through this collaboration, theCoalition has been able to learn more about the specific needs of eachfacility and to provide feedback to their staff. This feedback loopreinforces the value of the program to area hospitals/birthing facilities,encourages good screening practices and contributes to the commongoal of improving screening rates.

Florida Statute 383.14 mandates that the Healthy Start Infant (Postnatal)Risk Screening be offered to parents or guardians of all infants born inFlorida before leaving the hospital/birth facility. Screening is the first steptoward identifying at-risk infants. Research indicates that Infants who

score 4 or more on the Healthy Start Infant Risk Screen are at least sixtimes more likely to experience post-neonatal infant mortality than thosewho score below 4 on the screen1. When completed accurately theHealthy Start Infant Risk Screen ensures that various maternal and childhealth services will be available to those moms and families who needthem in a timely manner, and allows for their information to be sharedfor future contact. The majority of infants will not be eligible for HealthyStart services, as they will not have the risk factors required. However,the data collected in the risk screen enables the state of Florida toanalyze the factors that have the greatest impact on birth outcomes andthe factors that most affect residents of our County.

In partnership with local hospitals, the Healthy Start Coalition of Miami-Dade has been working diligently to ensure that every newborn isscreened for risk factors, and referred for Healthy Start services if theyqualify. This effort has required that the Coalition maintain a collaborativerelationship with all twelve birthing facilities in Miami-Dade County byensuring they are well informed about the Healthy Start Infant Risk Screen.

For more information about the Healthy Start Coalition of Miami-Dade's programsand services, please visit our website at www.hscmd.org or contact us at (305) 541-0210.

Volume 6, Issue 1 2009

Healthy Start CommuniqueHealthy Start CommuniqueA publication of the Healthy Start Coalition of Miami-Dade

Healthy Start Infant Screening Rate Over 95%Three years after the start of outreach initiative, rates remain high

Healthy Start Infant (Postnatal) Screen Consent Miami-Dade County, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

2 HEALTHY START COALITION OF MIAMI-DADE

Homestead HospitalHomestead Hospital has maintained an average rate of 99% from July 2005 to June 2008 improving dramatically from their lowestrate of 39% in June of 2005 to the high rate of 100% in June of 2008. Congratulations to Health Information Management DirectorRosie Hernandez, Health Information Management Manager Rayza Enriquez, Health Information Management Supervisor VanessaRisatti, and Birth Certificate Clerks Jessica Alfonso and Chandraine Aparbal.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Homestead Hospital, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Palmetto General HospitalPalmetto General Hospital has maintained anaverage rate of 87% from July 2005 to June 2008improving dramatically from their lowest rate of 1% inJuly of 2005 to the high rate of 99% in June of2008. Congratulations to Health InformationManagement Director Erna Rappaport, HealthInformation Management Supervisor Jaime Calero,and Birth Certificate Clerks Sandra Sanchez-Ydrovoand Monica Gilbert.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Palmetto General Hospital, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

The average Healthy Start Infant Screening rate for Miami-Dade Countyfor contract years 2007-2008 reached an astounding 96.58%. This is a131% increase over January 2005, and significantly higher than thecurrent state average of 85.42% for that same period. This edition of theHealthy Start Communiqué includes detailed charts reflecting theHealthy Start infant screening data for all of the hospitals/birthingfacilities in Miami-Dade County for the last three contract years (CY):2005-2006, 2006-2007 and 2007-2008. The graphs compare eachfacility's rate of “yes” consent to screening.

The Healthy Start Coalition of Miami-Dade would like to congratulate all ofthe Miami-Dade County hospitals and their staff for their tremendousachievements these last three years! We look forward to continuedcollaboration in our efforts to ensure that all babies get a Healthy Start in life!1Healthy Start Standards and Guidelines, Chapter 3. State of Florida 2007.

Photo: Rosalina Butao (center) Nurse Clinician for Women’sServices, Manuel Fermin (right) CEO of the Healthy Start Coalitionof Miami-Dade and Genna Marx (left) Vice-President of the Board ofDirectors for the Healthy Start Coalition of Miami-Dade.

3NEWSLETTER

Jackson North Medical CenterJackson North Medical Center has maintained an average rate of 97% from July 2005 to June 2008 improving dramatically from theirlowest rate of 1% in June of 2005 to the high rate of 94% in June of 2008. Congratulations to Health Information Management DirectorAndrea Romero, Health Information Management Assistant Administrator Odalys Martinez, Health Information ManagementSupervisor Kim Martins, and Birth Certificate Clerks Cynthia Smith and Hedy Thompson.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Jackson North Medical Center, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Jackson South Community HospitalJackson South Community Hospital has maintained an average rate of 100% from July 2005 to June 2008. This is the highestlong-term rate in Miami-Dade County. Congratulations to Health Information Management Director A. Cheryl Smith, Health InformationManagement Assistant Director Charity Zeigler, and Birth Certificate Clerks Lupe Urdanivia, Delma Mariscal and Patricia Kuehl.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Jackson South Community Hospital, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

The average Healthy Start Infant Screening rate for births occurring inMiami-Dade County from July 1, 2007 to June 30, 2008 reached an

astounding 96.5%. The state average during that time period was 85.42%.

Photo: Cynthia Smith (center) Birth Certificate Clerk, Manuel Fermin(right) CEO of the Healthy Start Coalition of Miami-Dade andGenna Marx (left) Vice-President of the Board of Directors for theHealthy Start Coalition of Miami-Dade.

Photo: Lupe Urdanivia (center) Birth Certificate Clerk, ManuelFermin (right) CEO of the Healthy Start Coalition of Miami-Dadeand Genna Marx (left) Vice-President of the Board of Directors forthe Healthy Start Coalition of Miami-Dade.

4 HEALTHY START COALITION OF MIAMI-DADE

South Miami HospitalSouth Miami Hospital has maintained an average rate of 91% from July 2005 to June 2008 improving dramatically fromtheir lowest rate of 35% in September of 2006 to a high rate of 99% in June of 2008. Congratulations to HealthInformation Management Director, Rosie Hernandez, Health Information Management Manager Rayza Enriquez,Health Information Management Supervisor Vanessa Risatti and Birth Certificate Clerks Maribel Simbaco and Mayra Arias.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, South Miami Hospital, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

North Shore Medical CenterNorth Shore Medical Center has maintained anaverage rate of 99% from July 2005 to June 2008. Thisis one of the highest rates in Miami-Dade County.Congratulations to Health Information ManagementDirector Erna Rappaport, Health InformationManagement Supervisor Lystra John and BirthCertificate Clerks Marjory Martinez and Jean Larkin.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, North Shore Medical Center, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Jackson Memorial HospitalJackson Memorial Hospital has maintained anaverage rate of 93% from July 2005 to June 2008improving dramatically from their lowest rate of 10% inJune 2005 to the high rate of 95% in June of 2008.Congratulations to Health Information ManagementDirector Andrea Romero, Health InformationManagement Manager Assistant AdministratorAndrea Williams, and Birth Certificate Clerks MercyAlvarado and Chakina Davis.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Jackson Memorial Hospital, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Photo: Rosalina Butao (center), Nurse Clinician for Women’sServices, Manuel Fermin (right) CEO of the Healthy Start Coalitionof Miami-Dade and Genna Marx (left) Vice-President of the Board ofDirectors for the Healthy Start Coalition of Miami-Dade.

5NEWSLETTER

Mercy HospitalMercy Hospital has maintained an average rate of76% from July 2005 to June 2008 improvingdramatically from their lowest rate of 2% in October of2005 to a high rate of 98% in June of 2008.Congratulations to Health Information ManagementDirector Silvia Ortiz, Health Information ManagementManager Anabel Rodriguez and Birth CertificateClerks Tamor Comas and Wilmarie Lopez.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Mercy Hospital, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Hialeah HospitalHialeah Hospital has maintained an average rate of 93% from July 2005 to June 2008 improving dramatically from their lowest rateof 3% in July of 2005 to the high rate of 100% in June of 2008 making them the hospital with the most improved rate. Congratulationsto Health Information Management Director Maday Kennedy, Health Information Management Supervisor Felicia Harris and BirthCertificate Clerks Rosa Checa and Maria Valentine.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Hialeah Hospital, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Photo: Maria Valentine (center) Birth Certificate Clerk, ManuelFermin (right) CEO of the Healthy Start Coalition of Miami-Dadeand Genna Marx (left) Vice-President of the Board of Directors forthe Healthy Start Coalition of Miami-Dade.

6 HEALTHY START COALITION OF MIAMI-DADE

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Baptist Hospital Miami, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Baptist Hospital of MiamiBaptist Hospital of Miami has maintained an average rate of 91% from July 2005 to June 2008 improving dramatically from theirlowest rate of 71% in August of 2005 to the high rate of 100% in June of 2008. Congratulations to Health Information ManagementDirector Rosie Hernandez, Health Information Management Manager Rayza Enriquez, Health Information Management SupervisorVanessa Risatti and Birth Certificate Clerks Maribel Simbaco and Mayra Arias.

Mount Sinai Medical CenterMount Sinai Medical Center has maintained an average rate of 87% from July 2005 to June 2008 improving dramatically from theirlowest rate of 49% in July of 2005 to the high rate of 100% in June of 2008. Congratulations to Women and Children’s Services DirectorKathy Washburn, Assistant Director Maria Guerrero and Birth Certificate Clerk Matilda Misrahi.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Mount Sinai Medical Center, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Photo: Rosalina Butao (center) Nurse Clinician for Women’sServices, Manuel Fermin (right) CEO of the Healthy Start Coalitionof Miami-Dade and Genna Marx (left) Vice-President of the Board ofDirectors for the Healthy Start Coalition of Miami-Dade.

Photo: Matilda Misrahi (center) Birth Registrar, Manuel Fermin(right) CEO of the Healthy Start Coalition of Miami-Dade and GennaMarx (left) Vice-President of the Board of Directors for the HealthyStart Coalition of Miami-Dade.

7NEWSLETTER

Kendall Regional Medical CenterKendall Regional Medical Center has maintained an average rate of 71% from July 2005 to June 2008 improving dramatically fromtheir lowest rate of 15% in July of 2005 to the high rate of 99% in June of 2008. Congratulations to Health Information ManagementDirector Denis Lopez, Health Information Management Supervisor Geyga Reyes, and Birth Certificate Clerks Hilda Martinez andKristy Morales.

Miami-Dade County Healthy Start Infant (Postnatal)Screen Consent, Kendall Regional Medical Center, 2005-2008

Data Source: Office of Planning, Evaluation and Data Analysis Ad-Hoc Reports, 10/2008

Photo: Hilda Martinez (center) Birth Certificate Clerk, ManuelFermin (right) CEO of the Healthy Start Coalition of Miami-Dadeand Genna Marx (left) Vice-President of the Board of Directors forthe Healthy Start Coalition of Miami-Dade.

The Healthy Start Prenatal Risk Screen is a freequestionnaire designed to help identify any factors about apregnant woman’s health, living environment, or day-to-day activities that may negatively affect a mother or baby.The risk screen identifies women who are at an increasedrisk for preterm delivery or for delivering a low birth weightinfant. A score of 6 or more on the screen indicatesincreased risk or a “positive” screen. If a woman scores 6 ormore and is referred, the program can then providechildbirth preparation, nutritional counseling, parentingeducation and other targeted support services thataddress identified needs.

In 2008, the Florida Department of Health, in collaborationiwth a workgroup made up of Florida Healthy Start Coalitions,Healthy Families and universities, revised the Healthy StartUniversal Prenatal Risk Screen. Their Healthy StartResearch Workgroup used a systematic evidence-basedprocess to select and update risk factors for the prenatalscreen. A request for new potential risk factors was widelydistributed as part of the process. The research workgroupused consensus to decide which old and new potential riskfactors merited possible inclusion and further study. Eachselected risk factor was assessed for its association with poorpregnancy outcomes, its ability to be ascertained reliably bywritten screen, and its potential to be influenced by HealthyStart Services. This assessment included a scientific review ofthe literature and an evaluation of current and potential risk

Healthy Start UniversalPrenatal Risk Screen Revised

(Continued on next page)

701 S.W. 27th Avenue, Suite 1401Miami, FL 33135

This newsletter is funded by The Children’s Trust. The Trust is a dedicated source of revenue established by voter referendum

to improve the lives of children and families in Miami-Dade County.

“Working Togetherfor Healthier

Moms and Babies”

factors using Florida’s Healthy Start and birth certificate data. Theassessment can be made available upon request. The Researchworkgroup used this assessment to decide which risk factors shouldbe included on the screen.

For more information about the new Healthy Start Prenatal RiskScreen including a tutorial on how to properly administer thescreen, detailing the change in risk factors and scoring criteria visitthe Healthy Start Coalition of Miami-Dade website athttp://www.hscmd.org/documents/HSCMD_Rev_Prenatal_Risk_Screen_Provider_Training_9.24.08.ppt or you may visit the website

for the Florida Department of Health at http://www.doh.state.fl.us/family/mch/hs/hs.html. If you have additional questions or wouldlike to schedule an in-service at your office, contact the Coalitionat 305-541-0210.

Completed Healthy Start Prenatal Risk Screens should be sent to:Miami-Dade County Health DepartmentHealthy Start Data Management Office

18255 Homestead Avenue, Miami, FL 33157-5564305-234-5400