Healthy Start Coalition
of Miami-Dade

Healthy Start

Healthy Start legislation provides for universal risk screening of all Florida's pregnant women and infants to identify those at risk for poor birth, health and developmental outcomes. ALL pregnant women regardless of their marital, economic or immigration status are eligible to participate in the Healthy Start program, if they are at high risk for a poor pregnancy outcome. This includes post-partum women and their infants up to age three.

The goal of Healthy Start is to reduce infant mortality, reduce the number of low birth weight babies and improve health and developmental outcomes. 


pregbed_000012717571smallKey Components

Implemented April 1, 1992, the key components of Florida's Healthy Start include:

  • Universal prenatal and infant risk screening to identify pregnant women and infants at risk for adverse birth, health and developmental outcomes;
  • Healthy Start care coordination and services that support families in reducing the factors and situations that place pregnant women and infants in jeopardy for poor outcomes.

Services

Healthy Start includes targeted support services that address identified risks. The range of Healthy Start services available to pregnant women, infants and children up to age three include:

  • Outreach
  • Care coordination to assure access to needed services
  • Childbirth education
  • Parenting education and support
  • Psychosocial counseling
  • Tobacco education and cessation counseling
  • Breastfeeding education and support
  • Home visiting

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Healthy Start Contracted Providers

You may click on the name of the Provider to be directed to their organization’s website. Please note that not every Healthy Start Contracted Provider has a website.

Avanti Support & Services

555 Biltmore Way, Suite 204

Coral Gables, FL 33134

Phone: (305) 255-5363

Borinquen Medical Centers of Miami-Dade, Inc.

3601 Federal Highway

Miami, FL 33137

Phone: (305) 576-6611

Florida Department of Health in Miami-Dade County
Healthy Start Data Management Office

18255 Homestead Avenue

Miami, FL 33157

Phone: (305) 278-1074

Jessie Trice Community Health Center, Inc.
5361 NW 22 Avenue

Miami, FL 33142

Phone: (305) 637-6400, Ext. 15197

Institute for Child and Family Health, Inc.

9380 Sunset Dr., Suite 245

Miami, FL 33173

Phone: (305) 722-5648

Miami Beach Community Health Center, Inc.

710 Alton Road

Miami Beach, FL 33139

Phone: (305) 538-8835, Ext. 1172

Our Olive Branch

E-mail:amyo@ourolivebranch.com

The Village South / Westcare
11098 Biscayne Blvd., Suite 305

Miami, FL 33161

Phone: (305) 696-0738

University of Miami Perinatal C.A.R.E Program Starting Early Starting Smart (SESS)

Batchelor Children’s Research Institute

1580 NW 10th Avenue, 5th Floor

Miami, Florida 33136


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What is the Healthy Start Risk Screen?

Florida Statute 383.14 requires that all pregnant women be offered the Healthy Start Prenatal Risk Screening at their first or consequent prenatal visit and the Healthy Start Infant (Postnatal) Risk Screening be offered to parents or guardians of all infants born in Florida before leaving the delivery facility. Healthy Start risk screens identify risk factors so women and infants may be referred for services that complement and assure continued participation in prenatal and infant health care.

How were the screening forms developed?

The Healthy Start screening instruments (prenatal & infant) were developed by a workgroup that included physicians, nurses, social workers, researchers, program specialists and other professionals knowledgeable in the field of maternal and child health. The instruments were created after extensive research and analysis of risk factors and a statewide advisory council later approved the forms.

Have the screens been evaluated for validity?

The risk screens have been evaluated to determine their success in identifying those women and infants most at risk for adverse outcomes. Current studies that have linked birth outcomes to Healthy Start screening data suggest that both screening instruments are effective.

Studies indicate that:

The Healthy Start Prenatal Screen is:

  • Predictive of preterm birth (34 weeks since LMP) and LBW< 2000 Grams
  • Of 87K women screen in 2001, 35% were at an increased risk.
  • 48% of the women who had an adverse birth had a positive screen.
  • Women with positive scores are 1.7 times or 70% more likely to experience preterm birth or to have a low birth weight infant.

The Healthy Start Infant (postnatal) screen is:

  • Predictive of post-neonatal death
  • 12% screen positive (score of 4+)
  • 51% of post-neonatal deaths occur among the 12%
  • Infants who score 4 or more on the Healthy Start screen are 6 times as likely to die during the post-neonatal period (28 -364 days after birth) than those who score less than 4.

(Data from Healthy Start Annual Report 2003)

Are the screening forms available in more than one language?

Screening forms are available in English, Spanish & Creole.

What is the goal of screening?

Healthy Start risk screening is the collection of information on the designated prenatal & infant (postnatal) screening forms. The form is scored to assess risk and to identify those infants most at risk for adverse health outcomes. Screening is the first step to identify Healthy Start service recipients. It is our goal to ensure that all newborns and pregnant women are screened for risk factors. The majority of pregnant women and infants will not be eligible for Healthy Start services, as they will not have the risk factors required. However, the data collected in the risk screen enables the state of Florida to analyze the factors that have the greatest impact on birth outcomes and the factors that most affect residents of our County.

The Healthy Start Coalition of Miami-Dade staff monitors the trends for the Healthy Start Screening forms both Prenatal and Postnatal. The following reports show the current trends found from 1995 – present by Calendar Year (Janaury 1 – December 31):

Prenatal Forms Processed: Miami-Dade

Prenatal Forms Processed: Miami-Dade vs. Florida

Prenatal Forms – Consent to Screening: Miami-Dade vs. Florida

Prenatal Forms – Consent Rate: Miami-Dade vs. Florida

Prenatal Forms – Positive Score: Miami-Dade vs. Florida


Postnatal Forms Processed: Miami-Dade

Postnatal Forms Processed: Miami-Dade vs. Florida

Postnatal Forms – Consent to Screening: Miami-Dade vs. Florida

Postnatal Forms – Consent Rate: Miami-Dade vs. Florida

Postnatal Forms – Positive Score: Miami-Dade vs. Florida


Comparison of Prenatal Screens vs. Postnatal Screens Processed in Miami-Dade


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Healthy Start Services include:

Outreach
Outreach includes participant identification, public and private provider recruitment and community education.  Outreach has traditionally meant case finding and/or participant identification.  Healthy Start outreach is more broadly defined to include not only participant identification, but also, public and private provider recruitment and community education activities.  Outreach is approached systematically in a family-centered, community-based manner in order to promote improved pregnancy and infant health outcomes.

Individualized Care Coordination
Care coordination services provide the knowledge, encouragement, referrals, and support necessary to maximize families’ health, well-being and self-sufficiency.  Care coordinators achieve this goal by helping participants receive the appropriate interventions they need to improve situations that place them at risk.  Care coordinators strive to assure the participant’s continued involvement in prenatal and child health care, as well as other needed community and Healthy Start services.

Childbirth Education
Childbirth education refers to activities that provide information and education to the pregnant woman and her family, both during early and late pregnancy, which promote healthy outcomes for the woman and her infant.  Childbirth education can be provided at any location in the community.  The location should meet the needs of the participant by encouraging and supporting attendance.

Childbirth Education includes a comprehensive curriculum that is culturally sensitive and applicable for the participants receiving the service.  When possible, classes are offered in the participant’s native language.  Childbirth education services are intended to provide information to pregnant women in order to assure the most positive birth experience and outcome for her and her family.

Breastfeeding Education
Breastfeeding is the optimal method of infant feeding and nurturing.  The American Academy of Pediatrics (AAP) policy statement “Breastfeeding and the Use of Human Milk” cites research indicating that breastfeeding provides health, nutritional, immunologic, developmental, psychological, social, economic, and environmental advantages unmatched by other feeding options.  Human milk is recommended as the preferred feeding for all infants, including premature and sick newborns, with rare exceptions, for at least the first year of life, and longer as mutually desired by mother and child.  Breastfeeding also benefits women, reducing the risk of premenopausal breast cancer and ovarian cancer.

Breastfeeding education and support services are:

  • The provision of anticipatory guidance and support in order to prevent breastfeeding problems and to address barriers to breastfeeding, and
  • Those services provided to postpartum women to increase the duration and exclusivity of breastfeeding and to enable them to overcome any perceived breastfeeding problems

Parenting Education

Parenting education and support services are based on a comprehensive curriculum that is culturally sensitive and applicable for the participant(s) receiving the service.  The curriculum content has a prevention-based focus to reduce factors that are associated with placing children at health, social, or behavioral risk.

Parenting support and education provides comprehensive information and education related to the care of the newborn, infant, and child.  This service includes information on normal growth and development, anticipatory guidance, changes in family dynamics, attachment behaviors, nutrition, resource management, safety, child injury prevention, immunizations, and child abuse prevention.

Psychosocial Counseling
Psychosocial counseling is provided to Healthy Start families to address situational and developmental stress.  It is provided in a confidential setting to individuals, couples, groups or families.  The goal is to reduce identified risk factors and maximize positive pregnancy outcomes and infant/child health and development.

Psychosocial counseling is a relationship that occurs between a skilled professional counselor and an individual, family, group, or community for the purpose of helping to overcome specific emotional or social problems and achieve specified goals for well-being.  This is a form of psychosocial counseling that emphasizes prevention and the interface between the individual and the individual’s environment.

Tobacco Education and Cessation
Tobacco education and cessation counseling is provided to Healthy Start families in order to reduce the incidence of prenatal smoking and to reduce the harmful effects to the mother and developing fetus when the mother ingests chemicals from tobacco or is exposed to passive smoke.  Passive smoke is damaging to all household members.  Infants and young children are particularly vulnerable to upper and lower respiratory disease caused by tobacco smoke.

Tobacco education and cessation services include assessment of stage of change (pre-contemplation, contemplation, preparation, action, maintenance, relapse), provision of educational brochures, specific assistance in how to quit smoking, support services and relapse services.  Nicotine patches or other pharmaceutical aids may be used in conjunction with these services.

Substance Abusing Pregnant Women
Substance Exposed Children and their Families
Prenatal substance abuse has a clear impact on the health of the pregnant woman.  Drugs and the woman’s lifestyle can affect fetal development, the infant’s birth weight, mortality and development.  Based on responses to the National Pregnancy and Health Survey (1996), an estimated 5.5 percent of pregnant women acknowledge that they used an illegal drug during pregnancy.

Identification of use/abuse of alcohol and/or illegal substances can be determined by:

  • The woman’s own admission to staff,
  • A positive drug toxicology,
  • A staff member witnessing the use, and/or
  • A report from a reliable source.

Interconceptional Education & Counseling
Interconceptional education and counseling services provide comprehensive information and education related to the optimal health status needed by any eligible woman of reproductive age to improve the birth outcome of a potential pregnancy. This service includes information on access to care, baby spacing, nutrition, physical activity, maternal infections, chronic health problems, substance abuse, smoking, mental health and environmental risk factors.


Referring to Healthy Start

If you are not an OB/GYN and/or Prenatal Care provider or a Hospital, and you would like to refer a client to our program, you may do so by having them fill out a Healthy Start Referral Form. Please ensure that you and the client complete the following:

  • Referral Source Information
  • All Demographic Information from the Client
  • Reason for the Referral
  • Signature of the Client Consenting to Participate in the Program (required and can not be processed without the signature)
  • Signature of the Referral Source

You may click below for the referral form:

Healthy Start Self-Referral Form English 8 1 2015

Healthy Start Self-Referral Form Spanish 8 1 15

At this time, we do not have a referral form in Creole. Should you have any further questions regarding this form and/or need assistance to complete it, we encourage you to contact us at 305-541-0210 and ask to speak to one of our Team members.


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