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What’s Best for the Public Health of Montanans?

What’s Best for the Public Health of Montanans?. An ethics-based framework for reconsidering Montana’s maternal child health home visiting program selection and award process. “This initiative will give children a healthier start…” US Health Secretary Sebelius.

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What’s Best for the Public Health of Montanans?

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  1. What’s Best for the Public Health of Montanans? An ethics-based framework for reconsidering Montana’s maternal child health home visiting program selection and award process

  2. “This initiative will give children a healthier start…”US Health Secretary Sebelius • ACA provides $1.5 billion to states for home visiting services to maternal, infant, and child population.

  3. Deep, Unique Roots

  4. Watershed Moment in MCH Policy and Funding

  5. Partners in a Good Trend

  6. Falling Behind

  7. I.Who is at Risk?

  8. II. Are Programs Effective?

  9. III. Best Value for Public Funds? • Every low birthweight baby or preterm birth costs states bewtween $28,000 and $40,000 in medical care costs. • 6 - 10% of births will be premature and will account for 50% of Medicaid funds spent in infants

  10. IV. Burdens on Citizens? • Voluntary, but we must guard against stigma of targeting high risk folks. • To the contrary, we can prevent and relieve health burdens suffered by vulnerable women, infants, and children. • Save tax dollars for health care and social welfare costs.

  11. Evidence of Program Effectiveness • 79% reduction in abuse and neglect • 35% less ER use • Higher vocabulary skills at age 6 • Higher reading and math skills at age 9 • 20% reduction in welfare use

  12. V. Is the Outcome Fair? • Serve as many citizens as possible. • Use the funds as intended and allocate it expediently. • Allow for a variety of approaches. • Involvement of local programs and citizens must be obtained.

  13. “an unprecedented opportunity”

  14. Public Accountability • What do we tell our citizens? • What do we tell our legislators? • What do we tell ourselves?

  15. References • Principles of the Ethical Practice of Public Health • Cook and Hoas, Ethical Decisionmaking Process • Montana DPHHS Final MIECHV Plan • Pew Charitable Trust, Issue Brief, May 2010 • Nurse Family Partnership (www.nursefamilypartnership.org) • Olds, David, “Effects of Nurse Home Visiting on Maternal and Child Funcioning: Age-4 Follow-up of a Randomized Trial” Pediatrics(online at http://pediatrics.aappublications.org.content/120/4/e832.full) • Gostin, Lawrence O., ed., Public Health Law & Ethics, Regents of the University of California, 2010

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