Rural health care services outreach grant program - funding track: special track focus area: maternal health funding preference

Our project qualifies for all three funding priorities: IT serves hpsas, mucs/mups, and focuses on primary care with wellness and prevention strategies. Proposed rural service area: ashley, ouachita, and union counties, arkansas. All designated as rural and as medically underserved areas. ZIP codes: 71635, 71642, 71646, 71658, 71661, 71663, 71676, 71701, 71711, 71720, 71726, 71751, 71764, 71724, 71730, 71731, 71747, 71749, 71750, 71758, 71759, 71762, 71765, and 71768. Target population: the AR birth program will serve all maternal/perinatal women in the three counties with a focus on african american (AA)/black, and hispanic/latino/latina (hispanic) maternal/perinatal patients, ensuring we reach racially/ethnically minoritized communities. In the region, the most minoritized populations are AA/black and hispanic. 100% of the population is rural, 34% is AA/black, 5%, is hispanic, 66% is white, and 2.5% are part of other racial and ethnic groups. Project goals and objectives: the goal of the AR birth outreach program is to improve maternal/perinatal behavioral health outcomes using evidence-based models. Our objectives are: 1) work with our community consortium to develop a coordinated and culturally sensitive screening, triage, and referral process for maternal/perinatal behavioral health conditions (depression, anxiety, substance use disorder) and social determinants of health (sdoh); 2) implement the new maternal/perinatal screening, triage, and referral process within the target geographic region to serve rural residents; 3) train and deploy culturally congruent chws who will help ensure a connection with behavioral health and/or home visiting services (based on screening needs) and help connect patients with resources to address sdoh; 4) create a sustainability plan that includes working with medicaid and other insurers/payers to align quality measures, incentives, and reimbursement. Evidence-based or evidence-informed model(s) project will use: AR birth is grounded in a strong evidence base, utilizing systematic reviews and authoritative reports from hrsa, CDC, and ahrq. The program integrates validated screening tools for depression, anxiety, and suicide risk, as outlined in reports such as the U.S. Preventive services task force's review on perinatal depression and postpartum care. Screening for substance use follows acog guidelines and reviews on opioid use during pregnancy. AR birth also employs evidence-based methods for sdoh screening, informed by studies on respectful maternity care and structural determinants. A triage and referral system ensures that behavioral health and sdoh needs are addressed, guided by reviews on postpartum care and perinatal depression treatment. The program includes trained community health workers (chws) to navigate sdoh barriers, with evidence linking chws to improved equitable maternal care. Additionally, AR birth incorporates home visiting services, a proven strategy for preventing perinatal depression and improving maternal and infant outcomes, as highlighted in hrsa's 2024 maternal health workforce report. Expected outcome(s) of the proposed project: 1) increased health care providers use of evidence-based practices related to maternal/perinatal behavioral health and sdoh; 2) improved health outcomes for maternal/perinatal women in the target counties. Capacity to serve rural underserved populations: AR birth is supported by a strong community consortium with three levels of membership: rural primary partners, statewide guidance contributors, and a community advisory board that incorporates the perspectives of community members with lived experience. The program also leverages existing assets such as arconnect, CHW training, and partnerships with local health care providers to ensure project success.