Tomorrow morning at 8:30am, the Joint Legislative Council will meet to consider a series of reports out of special committees. All the reports have interesting and important recommendations to consider, but one is of particular importance to families in Wisconsin – the Special Committee on Infant Mortality.
Wisconsin has one of the worst racial disparity rates with regard to poor birth outcomes in the nation. Infants born to African American women in Wisconsin have been 3 to 4 times more likely to die before their first birthday than infants born to white women. This disparity persists regardless of age, education, prenatal care, or smoking status. It is problem that we must address with a concerted effort around not only the obvious solutions such as access to good pre/postnatal care, but also by addressing the social determinants of health and the impact racism has on birth outcomes. The Special Committee on Infant Mortality recognized the importance of this multifaceted strategy, as well as working with ongoing efforts in Wisconsin to address infant mortality.
The bills recommended by the special committee include:• Requiring cultural competency training for all UW-system and WI Technical College System students in health care or social work occupational tracks to improve patient-centered care.
• Streamlining and expanding the ACCESS (public benefits management) system to include all programs designed to assist low-income people, as well as pursue a single statewide data management system to integrate health, public health, social, and economic assistance services data and information.
• Requiring the Department of Health Services (DHS) to request a waiver from the federal government to provide services and support to pregnant women at risk of negative birth outcomes (presumably these recommendations could be tied in with the proposed healthy birth outcome medical home model of care for pregnant women in the 2011 DHS proposed Medicaid efficiencies).
• Requiring that all women being discharged from the hospital after delivery receive information on breastfeeding and newborn care, as well as a plan for postpartum care follow-up.
• Requiring DHS to prepare an annual report on infant mortality and birth outcomes.
• Allowing nurse-midwives to participate in the Patients Compensation Fund and practice with hospital staff privileges, without requiring that they collaborate in a written agreement with a physician.
• Allowing non-custodial parents, who are in compliance with court ordered support for the child, to receive the Wisconsin Earned Income Tax Credit (EITC), even if someone else also claims that child on their tax benefits.
• Requiring informed consent of the woman before an elective caesarian section or elective procedure to induce pregnancy prior to 39 weeks of gestation.
• Requiring birth certificates to include race or ethnicity, as reported by the infant’s mother.
• Requiring home visiting programs in DHS and the Department of Children and Families (DCF) to work collaboratively and be evidence-based.
• Requiring DHS to prepare an annual report related to hospital neonatal intensive care units.
WCCF urges members of the committee to move forward with the recommendations of the Special Committee on Infant Mortality. Many of these bills will require little fiscally, but have the potential to move us towards better birth outcomes for all Wisconsinites, and that ultimately saves the state in birth-related medical costs — considering that the most recent (2008) DHS numbers show that Medicaid paid for 45% of births in Wisconsin.
This is an area where Wisconsin can and should do better. Doing what we can legislatively to require more data and more effective services will help the other efforts in communities to reduce disparities in birth outcomes.
Sara Eskrich
