Background:
On July 28, 2017, NorthPoint received notice of award of $338,588 beginning July 1, 2017 and ending June 30, 2019 for the purpose of decreasing infant mortality among persons of color in North Minneapolis. The funds allow for increased staffing to provide additional services for those identified as high risk. The strategy includes a care coordinator to scheduling a 6-week post-partum office visit with a provider and a care-planning meeting. During the care planning meeting the care coordinator and patient will co-identify patient priorities, some of which may be met through an internal NorthPoint referral (MFIP support and navigation, behavioral health care, substance abuse treatment, health insurance counseling, etc.). For services not provided directly by NorthPoint, the care coordinator will contact the appropriate partner organization to arrange to connect the patient/participant directly to the agency. These services may include nutrition and breastfeeding support along with food vouchers, home visits or intense parent education, for example.
Participants and their infants will be monitored by the care coordinator, or at least monthly to ensure that they are accessing needed services and making progress toward achieving goals established in the care plan. The care coordinator will remind parents of infant well-child visits and immunizations needed, and provide other support as needed.
NorthPoint has been provided the above services since July 1, 2016 and has seen success in positive outcomes. This funding allows continuation of this service and ongoing quality improvement to build upon current positive outcomes. Funds will support a 1.0 FTE Medical Assistant, 1.0 FTE Social Worker, and .15 FTE Internal Evaluator.