Healthy Babies funding in limbo as Sedgwick County commissioners weigh its scope

With the watchful eyes of new parents, Alix Erickson and Juan Ruiz look at their 9-month-old daughter, Rosalie, as she plays with a toy airplane.

Erickson, 18, first visited this Healthy Babies office while she was still pregnant.

Now the nurse typically comes to them.

The family is part of the Sedgwick County Health Babies program, designed to combat infant mortality by helping at-risk mothers have healthier births.

The public health program provides consultations, in-home visits, community outreach and education on prenatal health and infant care, said Adrienne Byrne-Lutz, county health director.

Sedgwick County commissioners will consider this week whether to renew a $1 million grant to continue the program.

Sedgwick County has a higher rate of infant deaths than the state and national averages. About 7.7 infants for every 1,000 live births died before their first birthday in Sedgwick County, according to state data from 2009 to 2013.

The $2.04 million program is funded by a $1.02 million federal grant funneled through the Kansas Department of Health and Environment and by matching money from the county.

Sedgwick County’s health department will receive roughly $850,000 from the grant. The remaining $170,000 goes to the Kansas Children’s Service League.

Last year, the commission unanimously accepted the grant after a two-week delay and questions over the effectiveness of Healthy Start, a separate federal grant that also targets infant mortality.

This year’s vote was delayed by two weeks as well. The term of the grant begins Wednesday, the day of the commission meeting. Byrne-Lutz says the delay isn’t a problem if the grant is passed.

But some county commissioners have been skeptical about the scope and cost of federal public health grants, rejecting a couple of grants since a new majority was sworn into office in January.

“It’s a fairly expensive program,” said Commissioner Jim Howell. “I want to make sure we’re effective and efficient.”

‘Support is so paramount’

The program enrolls expectant or new mothers who have risk factors that could contribute to unhealthy pregnancies, which increase the likelihood of problematic births and infant deaths.

Participants – 947 mothers, fathers and babies in 2014 – are referred to the program from family practices around Sedgwick County, Byrne-Lutz said.

An immediate priority for mothers in the program is prenatal care.

“One of our goals is to get them connected with prenatal care within six weeks,” Byrne-Lutz said.

County nurses visit mothers as soon as they take their infant home, Byrne-Lutz said. The frequency of the visits depends on the mother’s risk factors.

“If they’re struggling with depression or had a low-weight baby or they’re struggling with breast-feedings, then we may do more frequent home visits,” she said.

Erickson said she appreciates the in-home visits.

“I like that (the nurse) comes to our house and weighs her so I know she is still growing on time,” Erickson said.

The program is also designed to get the father of the child and other family members to support the mother through the process, Byrne-Lutz said.

“Support is so paramount when you’re pregnant,” she said.

‘Mission creep’

Howell, who will vote on the grant for the first time Wednesday, said the program needs to focus more narrowly on reducing infant mortality.

“There is a lot of mission creep,” he said. “The program has blossomed into a lot larger mission than infant mortality.”

Howell said Healthy Babies is educating mothers on issues – such as car-seat safety, healthy relationships and reducing smoking – further from the root causes of infant mortality.

“More than likely, these mothers are hearing it more than once,” he said.

Reducing deaths from sudden infant death syndrome “should be the number one focus” of the grant, Howell said.

Erickson said she knew a lot about safe sleep anyway because of her previous work at a day care. Ruiz, 19, said he did learn from the educational materials on budgeting.

Commission Chairman Richard Ranzau recently reached out to the Kansas Department of Health and Environment to see which health department grants could be run by private entities.

The nonprofit Medical Society of Sedgwick County took over administering a federal grant aimed at reducing rates of obesity, diabetes, heart disease and stroke after the commission refused the grant earlier this year.

Ranzau said the Healthy Babies money must go through the health department before it goes to private groups like the Kansas Children’s Service League.

Howell said he wishes more mothers could benefit from a $1 million county-wide grant.

“I will probably support Healthy Babies (on Wednesday), but the reality is we’re not touching very many moms,” he said.

‘An extremely complex problem’

Healthy Babies participants have shown progress in the course of the program’s history, Byrne-Lutz said.

First-trimester prenatal care among mothers increased 18.3 percentage points and breastfeeding rose 10.5 points from 2005 to 2014.

Rates of birth weight and prematurity declined more modestly. Low and very low birth weight rates declined 3.4 percentage points and 0.4 percentage points, respectively. Premature births declined 0.8 percentage points.

“Infant mortality is an extremely complex problem that defies a simple solution,” said Jon Rosell, executive director of the Medical Society of Sedgwick County.

That means efforts have to be multifaceted to address the problem, he said.

Infant mortality rates often vary by geography, race and income. For the past 20 years, African-Americans have had infant mortality rates nearly triple those of white non-Hispanics in Kansas.

Infant mortality rates have declined over time in Kansas, but the rate in 2013 saw an uptick because of the state’s historically low birth rate that year.

The county health department also notes that improvements in the infant mortality rate cannot be attributed to any one program, including Healthy Babies.

“Healthy Babies is a very important part of that community-wide effort,” Rossell said.

This story was originally published June 29, 2015 at 7:27 PM with the headline "Healthy Babies funding in limbo as Sedgwick County commissioners weigh its scope."