Together, the departments of Health, Human Services, Drug and Alcohol Programs, and Insurance have worked to create a strategic action plan with clear priorities and actionable steps to drive awareness of the maternal health crisis, the work being done to address it, the needs of those with lived experience and those delivering care, and the steps we can take together to change the trajectory of poor maternal health outcomes and persistent disparities in Pennsylvania.
Plan Development
The Project Team was comprised of representatives from the four health agencies and the Governor’s Policy Office, led by the agency secretaries and a steering committee.
Secretaries
- Dr. Val Arkoosh, Department of Human Services
- Dr. Debra Bogen, Department of Health
- Dr. Latika Davis-Jones, Department of Drug and Alcohol Programs
- Michael Humphreys, Insurance Department
Project Team
DHS
- Ana Arcs
- Laina Auletta
- Sara Goulet*
- Dave Grande
- Cristal Leeper
- Leahann Moslak – Project Manager*
DOH
- Maria Dispenziere
- Giselle Hallden*
- Tara Trego*
- Raina Workman
DDAP
- Ashley Walkowiak
- Amanda Wolfe*
- Kelly Ciambra
- Haley Peck
PID
- Caroline Beohm*
- Shannen Logue *
- Lindsi Swartz
In addition to the four core agencies, other state agencies, the Governor’s Affinity Commissions and health care organizations contributed to this plan:Labor & Industry
- Conservation and Natural Resources
- Education
- Environmental Protection
- Governor’s Commission for Women
- Governor’s Next Gen Commission
- Governor’s Commission for LGBTQ+ Affairs
- Governor’s Commission for African American Affairs
- Governor’s Latino Commission
Other Organizations:
- MMRC
- Philadelphia MMRC
- The Black Maternal Health Caucus
- The Women’s Health Caucus
- PA PQC
- JHF Collaborative
- Hospital and Healthsystem Association of PA (HAP)
- National Governors Association
Research
The Project Team chose two strategies to reach people with lived experience: Listening Sessions and a Survey.
Listening Sessions
The listening sessions were hosted by various stakeholders and community-based organizations across the state.
Panelists:
- Dr. Val Arkoosh, Secretary, PA Department of Human Services
- Dr. Deb Bogen, Secretary, PA Department of Health
- Shannen Logue, Deputy Commissioner, PA Insurance Department
- Rep. Morgan Cephas
- Rep. Gina Curry
- Dr. Aasta Mehta, Medical Officer of Reproductive Health, Philadelphia Department of Public Health
- LaQuesha Garland, Director of Development & Social Innovations, Family Health & Birth Center Project Lead
- Jenne Johns, President, Once Upon a Preemie
- Karen Pollack, Executive Vice President of Programs, Maternity Care Coalition
Key Takeaways:
- Black women and birthing individuals are reluctant to access the health care system due to systemic racism and distrust of the health care system.
- Transportation and childcare are barriers to accessing care.
- Women and birthing individuals do not avail themselves of prenatal care as frequently as they should.
- The Momnibus package of the Black Maternal Health Caucus is a critical body of work to support Black women and birthing individuals.
- There is a need for implicit bias training for providers.
- BH/SUD is an ongoing challenge, including the stigma associated with care during pregnancy.
Panelists:
- Anette Nance, Governor’s Commission for African American Affairs
- Moriah Hathaway, Governor’s Commission for Women
- Sara Goulet, DHS Special Advisor to Dr. Val Arkoosh
- Lynette Meadows, The Spot
- East Stroudsburg student leaders
Key Takeaways:
- College students need to seek reproductive care earlier on in their health care journeys, i.e., before they become sexually active
- Health care careers are within the reach of all students, regardless of race or family or personal income level
- Young people are more aware of how to self-advocate
- Providing period products is incredibly important and appreciated; and it provides an opportunity for reproductive health education
Panelists:
- Dr. Val Arkoosh, Secretary, PA Department of Human Services
- Rep. LaTasha D. Mayes, Black Maternal Health Caucus
- Sara Nelis, Maternity Care Coalition
Key Takeaways:
- Women and birthing individuals with disabilities are often treated differently because of their disability.
- Transportation is a barrier for many.
- Lack of paid family leave is a barrier.
- Healthy Start is a trusted partner and service provider.
- Rural areas outside of Allegheny County are hit especially hard by lack of services and Labor & Delivery departments at acute care hospitals.
Participants:
- DHS Secretary Dr. Val Arkoosh
- DOH Secretary Dr. Debra Bogen
- Sen. Dan Laughlin
- Rep. Robert Merski
- Erie Mayor Joe Schember
- Mercy Center Executive Director Jennie Hagerty
- Lauren Carson, Erie County Health Improvement and Preparedness supervisor
- Mary Johnson, Erie County public health educator
- Rebekah Orlando, DHS
- Mercy Center staff:
- Mike Lockhart
- Katie Confer
- Anna Brzozowski
- Erin Dworakowski
- Two Mercy Center residents
Key Takeaways:
- Lack of accessible mass transportation is a challenge for health care, childcare, and employment.
- Women and birthing individuals have health care, it’s just accessing it
- Need to more frequent SDI testing – i.e., coverage for
- Need more education on what care is needed and provided under insurance
Participants:
- DHS Secretary Dr. Val Arkoosh
- Dr. Elizabeth Dierking, MD, FACOG, Department of Obstetrics and Gynecology Chair
- Dr. Nancy Suarez-Tipton, Psychiatrist, Specializing in Women's Health
- Keri Angelozzi, Associate Chief Nursing Officer/Vice President, St. Luke's Hospital Allentown Patient Care
- Fieruz Jabir, Allentown Patient
- Melissa Shafer, St. Luke's Government Relations
- Lauren Sokolski, St. Luke's Marketing
- Nicole Nye and Jessika Haynos, St. Luke's Women and Babies Service Line Administrators
- Allison Blackburn, NICU Patient Care Manager
- Sarah Price, Clinical Coordinator, Labor & Delivery
Key Takeaways:
- Access to care is easier because many patients can walk to the hospital
- There are not enough mental health care providers or appointments for mental health care
- There is a need for more education of patients as to what care they need. Many do not receive care early in their pregnancy.
Participants:
- Rep. Gina H. Curry
- Dr. Tara Harper, Lincoln University Assistant VP for Student Wellbeing and Clinical Operations
- Dr. Serita Porter, Lincoln University Professor
- Briana Corbin, Lincoln University
- Syreeta Bailey-Wilson, Lincoln University Director of the Inclusion and Belonging Centers
- Taylor, Lincoln University student pursuing a health care career
- Dr. Sharee Livingston, UPMC
- Samia Bristow, Maternity Care Coalition Vice President of Programs
- Dr. Sean Shamloo, PA DHS Chief Dental Officer
- Ruby Mundok, E.D. Governor’s Commission on Next Gen
Key Takeaways:
- Programs exist to train next generation of health care providers at all levels; need to encourage younger students to take up these careers
- Dental care is a greater need during pregnancy and postpartum and few know this
- College students don’t always feel heard by health care providers
- Need to educate about reproductive health care earlier on in health journey
- There is mistrust of the health care system
- Resources are available, people need to avail themselves of them
Participants:
- DHS Secretary Dr. Val Arkoosh
- Joe Hollander, CEO, Scranton Primary
- Pennsylvania Insurance Department (PID) Deputy Insurance Commissioner for Product Regulation Shannen Logue
- Jennifer Fitzpatrick, Chief of Staff for Sen. Marty Flynn
- Scranton Mayor Paige Cognetti
- Paula Keenan; RN, Chief Nursing Officer
- Lorna Watkins; Business Office Manager
- Lisa Black Lafferty, LCSW; Behavioral Health Specialist
- Darrin Wiederhold, DMD; Dental Director
- Heidi Mosher, CRNP; Perinatal Department
- Senator Marty Flynn staff
- Representative Bridget Kosierowski staff
Key Takeaways:
- Promote earlier entry into prenatal care
- Speed up provider credentialling
- Need for education
- Transportation is a challenge
- Spouses/partners are not always supportive of women getting care (cultural)
- Need for paid leave
- More access to healthy foods
- Remember that family stress affects health
- TikTok is a means of getting information on pregnancy
- BH/MH are challenging for getting care but telehealth helps
- BH/SUD stigma is real and fear of Children and Youth involvement exists
- Language is a barrier for some
- Reimbursement issues exist in the county
Participants:
- DHS Secretary Dr. Val Arkoosh
- DOH Secretary Dr. Debra Bogen
- Beck Moore, CEO of CAAP
- DDAP Policy Director Ashley Walkowiak
- Tiffanie Keck, Tri County Community Action
- Serina Asekomhe, Chief Program Officer, Tri County Community Action
- Shannon Weeks, Family Development Coordinator, Tri County Community Action
- Dr. Amaka Nnamani, MD, FAAP, Chapter Breastfeeding Coordinator, PA AAP
- Susan Brackbill, DNP, MPH, RNC-NIC, Program Manager, Nurse Family Partnership
- Amanda Shartle, Healthy Start Manager, Hamilton Health (FQHC)
- Caitlyn Cluck, Director of Community Investment, The Foundation for Enhancing Communities
- Hailey Ebersole, WIC Retail Store Coordinator, Hamilton Health (FQHC)
Key Takeaways:
- Use of CHWs aids in care provision and bridge the gap between patient and health care system
- Faith leaders play a role as trusted messengers
- Patients/clients love and use apps
- Transportation is a challenge
- BH needs are great, and access is tough – many could use a provider to come to them
- Home visiting hesitancy can be solved in some instances by beginning with telehealth
Participants:
- There were 49 participants on the 90-minute Zoom call – people with lived experience, advocates, stakeholders.
Two individuals with lived experience shared their stories:
- Latoya Maddox
- Nyota Washington
Key Takeaways:
- Desire to be treated with dignity and like every other pregnant person
- Need to patient ombudsman or other support
- Remember that postpartum trauma can and does occur because of how a person with a disability is treated; training for providers is needed
- Paid family leave
- Provide in-home support services, not everyone has a support system at home
- Teach self-advocacy
- Provide more services remotely, virtually; more information online that’s easy to access
Participants:
- Mae Reale, PCADV
- Sara Goulet
Advocates:
- Laurel House
- A Woman’s Place
- JSH Philly
- DVSCLC
- Crisis Center North
- Centre Safe
- WCS Pittsburgh
Key Takeaways:
- Challenges include childcare, housing, transportation, access to healthcare, tactics of abuse increasing when pregnant, mental health needs – feeling like they have no one to support them; immigrant population needs even more care and support, the course system and child custody laws favoring abuser.
- Access to doulas would be helpful
- Need teen education
- People don’t know what resources are available to them
- Teaching self-advocacy
- More support groups to pregnant and parenting survivors
- There are orgs that provide transportation, but it is very local; there is more need
- Need for more training and collaboration among providers of DV supports and other maternal health providers
- Need for more translators
Participants:
- Sara Goulet
- Karin Rhodes
- Mae Reale (PCADV)
Advocates:
- Jocelyn
- Zoey
- Erika
- Alyssa
- Suella
Key Takeaways:
- Internet access and broadband are very slow and do not support telehealth visits and while folks who live there have access to an emergency room, access to birthing health providers is INCREDIBLY limited and transportation is practically nonexistent.
- We would love to see a move away from "Are you safe at home?" to more easily understood, “Are you safe in your relationships?” or “Are you safe in your everyday life?”
- Providers may be hemmed in by their health system to only ask the “safe at home” option.
- It is SUPER helpful if EVERY single patient gets information about their local DV program on their discharge paperwork (and available in their online portal) in plain language about the resources that are available.
- Despite being in existence for nearly 50 years, one provider finds many clients didn’t know about the resource.
- IDEAS: Promote PA Navigate as a resource and ensure providers of DV services are listed.
- Work to educate MCOs on what DV services are available and perhaps provide CBCM funding to support their work.
Survey
To reach even more people with diverse lived experiences, the project team developed a survey in English and Spanish that asked respondents about their personal experiences with maternal health care services, including physical and behavioral health. The survey received responses from more than 700 people in 56 of Pennsylvania’s 67 counties.
Resources
Department of Human Services
Myana app: Education during the postpartum period is critical and a new app – Myana (Mothers You Are Not Alone) funded by the department and developed by the University of Pittsburgh, gives new moms ready access to timely topics customized to their and their new baby’s needs. Daily topics range from lactation support to baby’s first check-up. App users can find resources and articles to address virtually any concern or interest they have around their and their baby’s health, and on parenting.
Department of Health
Maternal and Infant Health: Maternal health is the health of women during pregnancy, childbirth, and postpartum. By ensuring that women get high-quality care during and after pregnancy, infants can get a healthy start to life.