HJNO Jul/Aug 2022

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2022 37 Launching a Voluntary Registry of Doulas The LDH team is looking for ways for pa- tients to become more engaged and to build more trusting, informed relationships with their providers. This is critical because we know from our health equity work that not all women are comfortable having mean- ingful conversations with providers. As a result, LDH is nowworking to imple- ment a voluntary registry for doulas that we hope will one day provide a path for their services to be compensated as a part of healthcare and then ultimately made avail- able tomore people. Doulas are trained pro- fessionals who help provide physical and emotional support to the mom throughout pregnancy and during post-partum. While doulas do not have medical training, they are highly effective in advocating for the moms and babies they serve. According to the National Black Doulas Association (NBDA), having a doula as a part of a birthing team decreases C-sec- tions by 50%, shortens the time of labor by 25%, and decreases the need for other med- ical interventions by well over 50%. This is especially critical given Black women are two to three times more likely to die during or after childbirth than white women. Our Commitment to You We are taking a fresh policy approach at LDH through our 2021-22 business plan, which calls for new methods of engage- ment — both at the policy level through community engagement and in creating new partnerships. Supporting Louisiana residents from pregnancy through childhood is part of our mission, and as that mission evolves, my team and I will continue to support families wherever we can: in the home, in the pedia- trician’s office, and in the community. n of services designed to make sure new moms and caregivers have what they need to give their babies the best start possible. Reducing Pregnancy-Related Hypertension Our Medicaid team has been collaborat- ing with our Bureau of Family Health to find ways to improve care outside the doctor’s office and the hospital. Between 2011 and 2016, before launching our Reducing Maternal Morbidity Initiative, we found that among 36 pregnancy-relat- ed deaths, three were due to pre-eclampsia (serious blood pressure condition) or ec- lampsia (seizures) and 15 were due to car- diovascular disease with hypertension. In 2020, we reduced severe illness result- ing from high blood pressure by almost 12% and increased timely treatment of chronic hypertension by 210%. But this work was primarily being done in hospitals, and we knew we could be even more successful if we could find ways to engage women be- fore and after pregnancy with remote blood pressure monitoring devices. Our Medicaid team has worked to ensure these devices are covered for recipients if they are at risk of hypertension. The tech- nology of home blood pressure screenings allows women to connect their device with a smartphone, which will remind them to regularly take a blood pressure reading and transmit the readings to providers. Studies show women are nearly twice as likely to take their blood pressure when given remote monitoring devices. It also provides an opportunity for a woman to take control of her own health, think about why a reading might be higher or lower at certain times of the day, and have a more informed conversation with her provider during a visit. Courtney N. Phillips, PhD Secretary Louisiana Department of Health Depression Screenings During Well Child Visits The phrase “meeting people where they are” has become a key mantra in public health because it recognizes that people are best served in ways that make sense for their busy lives. At LDH, we applied this concept to a new initiative that brings men- tal health screening for new moms into the pediatrician’s office. While this might sound like a simple approach, it is a big step for pediatricians who usually care for children, not a new parent or caregiver. In January 2021, Louisiana Medicaid began reimbursing pediatric providers for screening mothers and children’s caregiv- ers for depression during well child visits. Research shows perinatal depression af- fects one in eight women, and Black women are at higher risk. The screenings allow new moms or caregivers to be diagnosed and treated sooner rather than later and in a convenient location — during the two-week well child visit rather than waiting for their six-week post-partum visit. Depression as- sociated with a new baby can occur as soon as the first two weeks after birth. The soon- er a provider can recognize the signs of de- pression, the better it is for mom and child. We are equipping pediatric providers with the screening tools they need to catch the signs of depression among Medicaid recipients, as well as reimbursing providers for the service. We also launched a pilot program among four pediatric providers. The providers will conduct screenings for depression and ex- plore ways to connect caregivers with ser- vices in the community. Our goal is to learn how to best connect providers with com- munity resources and how effective those resources are for caregivers. The data col- lected will help us build stronger networks