2022-2026 Perinatal Health Strategic Plan

Goal 3 – Improve Health Care for All People of Reproductive Age

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 Point 9. Expand access to high quality health care

  1. Expand Medicaid to provide affordable, comprehensive health, behavioral health, and dental insurance coverage, including mobile health and telehealth, for all
  2. Increase access to and utilization of the comprehensive adolescent well visit, including time for confidential reproductive health conversations between provider and patient
  3. Increase flexibility in office hours of providers to include evenings and weekends, and ensure that care is affordable
  4. Increase the uptake of vaccinations
  5. Implement more community-informed education, including a social media campaign aimed at men, to increase use of preventive health care
  6. Create and engage patient and family advisory councils that have influence in decisions at hospitals and clinics
  7. Increase access to and utilization of medical and dental homes
  8. Expand access to family centered SUD treatment, including services for opioid use disorders
  9. Implement the NC Area Health Education Centers (AHEC) Scholars program to recruit and train students of color and students from rural backgrounds to become providers in underserved areas
  10. Expand the use of health innovations such as mobile health, telehealth, and linked electronic health records (EHR), and maintain gains made in this area during the COVID-19 pandemic
  11. Make it easier for families and people of reproductive age to receive mental, physical, and behavioral health supports, including breastfeeding support, during times of disaster and recovery
  12. Increase the use of Medicaid Transportation to ensure appointments are accessible

 Point 10. Improve access to and quality of maternal care in all settings

  1. Expand the use of evidence-based and evidence-informed models of perinatal care highlighted in the Maternal Health Innovation Program, including doula services, CenteringPregnancy and CenteringParenting, and community health workers
  2. Integrate the Alliance for Innovation on Maternal Health (AIM) bundles championed by the Perinatal Quality Collaborative of North Carolina (PQCNC) into maternal care
  3. Improve access to and utilization of first trimester prenatal care and comprehensive postpartum care
  4. Expand access to prenatal care by passing legislation that allows the Children’s Health Insurance Program (CHIP) to cover immigrants without documentation
  5. Pass legislation supporting full practice authority for certified nurse-midwives
  6. Ensure that all pregnant people and high-risk infants have access to the appropriate level of care that align with national standards
  7. Increase use of the Levels of Care Assessment Tool (LOCATe) by delivering/birthing hospitals
  8. Improve maternal care for incarcerated pregnant people by eliminating the use of shackling and ensuring adequate prenatal and postpartum care, nutrition, and breastfeeding support
  9. Improve WIC utilization in the first trimester by referring pregnant people to local WIC clinics
  10. Increase utilization of dental care by Medicaid for Pregnant Women recipients
  11. Promote access to comprehensive breastfeeding education and support services including medical lactation services
  12. Integrate the CDC’s Hear Her campaign on post-birth warning signs into provider and patient education
  13. Increase use of the North Carolina Psychiatry Access Line (NCPAL)/NC Maternal Health MATTERS Line to improve access to maternal mental health services
  14. Develop an evidence-based assessment tool to aid North Carolina health care facilities in assessing their capabilities for the provision of perinatal mental health care
  15. Increase use of the NC Perinatal Substance Use Project hotline to improve access to Substance Use Disorder (SUD) treatment for pregnant, postpartum, and parenting people
  16. Develop and implement a public health awareness campaign around maternal health for the general public
  17. Support the creation of a statewide 24-hour breastfeeding support hotline
  18. Develop education on trauma-informed breastfeeding support and consultation for maternal and pediatric care providers
  19. Establish a licensure board for the provision of lactation services provided by Lactation Consultants (IBCLCs) and Lactation Counselors (CLCs)

 Point 11. Increase access to preconception, reproductive, and sexual health care for people of reproductive age

  1. Include preconception and reproductive health in health education programs to reach students of all genders in middle schools, high schools, colleges, universities, graduate schools, community colleges, and adult learning programs
  2. Increase Prepaid Health Plan (PHP)/payor implementation of preconception health screenings during primary care visits
  3. Increase the number of programs that provide adolescents with information on reproductive health and healthy relationships (e.g., PREPare for Success)
  4. Eliminate coercion and bias in service delivery and barriers to contraceptive access for people of reproductive age
  5. Implement the “Be Smart” Family Planning Medicaid Program Strategic Plan
  6. Increase access to reproductive life planning and referrals to resources in the NC Perinatal and Maternal Substance Use and CASAWORKS for Families Residential Initiatives
  7. Increase social media campaigns on preconception health awareness (e.g., Ready for Life and Show Your Love)
  8. Implement the “Get Real. Get Tested. Get Treatment.” campaign to increase testing and treatment for sexually transmitted infections

 Point 12. Provide interconception care

  1. Increase the number of primary care providers across the state
  2. Increase the number of primary care providers who accept Medicaid
  3. Expand Medicaid coverage to 12 months for the postpartum period
  4. Expand Medicaid for Pregnant Women (MPW) dental coverage to at least 60 days postpartum
  5. Eliminate coercion in service delivery and barriers to contraceptive access for people of reproductive age, and implement patient-centered decision-making strategies
  6. Increase same-day access to all methods of contraception
  7. Increase pediatric sites partnering to implement efforts focused on maternal health such as depression and tobacco use screenings (e.g., IMPLICIT Network)
  8. Increase reimbursement for services that are recommended by the 4th Trimester Project, especially education on post-birth warning signs
  9. Increase care coordination through the implementation of the Provider Support Network
  10. Increase the number of provider trainings on the AIM postpartum bundle

Last Modified: April 24, 2023