This document provides information about the Healthy Start program in Sarasota County, Florida. It describes the program components, which include universal prenatal and infant risk screening. It notes that Florida law requires offering the risk screening questionnaire to all pregnant women and newborns. It discusses how the Healthy Start Coalition monitors screening rates and provides technical assistance to improve them. Benefits of screening include identifying at-risk infants for early referral to services. The document provides details on the screening, scoring, referral processes and Healthy Start services that are available to families based on screening results or other risk factors.

1. Welcome!
Healthy Start Infant
Screening Training

2. Direct Services
Program Components
• Universal prenatal and infant risk screening
• Healthy Start Care Coordination and
Wraparound Services

3. Risk Screening
Florida Statute 383.14 - requires the screen
(questionnaire) to be offered to all pregnant
women at their first prenatal visit and all
infants before leaving the delivering facility

4. Monitoring
The Healthy Start Coalition
monitors screening rates of the county
and individual providers
and offers technical assistance as needed.
Infant Screening Rate for Fiscal Year 2012-13
Sarasota County 97% Florida 93%

5. Benefits of Infant Screening
Identifies risk factors which could increase an
infant’s risk of death
Assures early referral to Healthy Start for
services
Helps health care providers care for the
“whole patient”
Increases Healthy Start funding in the county

6. More on
Screening
• The Infant Risk Screen is initiated with each
Birth Certificate (BC)
• The person completing the BC must “offer” the
screen and receive consent to conduct the
screen
• Consent must be obtained to send the screen
answers to Healthy Start, and for Healthy Start
to make contact

7. Scoring the
Screen
• A score of 4 or more is an automatic referral to
Healthy Start because of risks which increase
the chance of infant death in the 1st year.
• This is why it is so important to obtain “yes” on
each of the questions about screen
completion, release of information to HS, and
allowing HS to contact the patient.
• In the hospital, scores of 4 or more should be
reported to the patient’s nurse for follow-up.

8. Other Risk Factors for
Eligibility and Referral
• Neonatal Abstinence Syndrome
• Currently substance misuse or abuse – tobacco, drugs, or
alcohol
• Severe depression, active mental illness, or post-partum
depression
• Breastfeeding problems and needs more intensive follow-up
and assistance post-discharge
• Current abuse or neglect in the home
• Homelessness
• Fetal loss after 20 weeks gestation, for interconception health
education when she is ready

9. Self Referral
If the infant does not score a 4 or more, or the
mother or infant do not have any of the other
risk factors for eligibility:
The mother can call Healthy
Start at 861-2905 to discuss
her needs.

10. The Healthy
Start Program IS
A statewide, voluntary program available at no
cost to participants
Designed for prenatal women and infants
Tailored to meet each individual’s needs and
circumstances by providing
referrals, information, and supportive services
Confidential

11. Healthy Start is NOT
It is Risk-Based
• Income-based
• A Medicaid program
• Based on immigration status
• Department of Children and Families

12. Healthy Start
Care
Coordination
Three methods of referral to Healthy Start
1. Infant risk screen score of 4 or more
2. Referrals based on other factors
3. Self-referrals
We have 9 Care Coordinators

13. After a Referral
is Made
• Assignment to a Care Coordinator
• Initial Contact within 5 working days to
determine risk level and assets
• A more in-depth assessment is scheduled
if necessary.
• Ongoing coordination of care commences
as needed.

14. Healthy Start Care
Coordinators
• Make contacts on a regular schedule based
on risk level (P, E, I, II, III)
• Provide education, support, and monitoring
• Make linkages in the community
• Make referrals for wraparound services if
needed

15. Wraparound
Services
• Breastfeeding Education and Support
• Psychosocial Counseling
• Tobacco Education and Cessation
• Childbirth Education
• Nutrition Counseling
• Parenting Education and Support
• Interconception Education
We have 8 Wraparound Service Providers

16. Length of Services
• Prenatal – up to 6-8 weeks post-partum
• Infant – up to 3 years of age
A client can be closed whenever services are
declined, transitioned elsewhere, or when risks are
resolved.
A client remains in care coordination
as long as services are necessary and
the client is actively participating.

17. • Consent to the Healthy Start infant screen - This is
done by stating “yes” to the first statement
• Consent to be contacted/program participation - This
is done by stating “yes” to the second statement
• Consent to release of information - This is done by
stating “yes” to the third statement*
* If the patient states “no” to any of the above statements, she may not be able to
access program services
Recap: How can
a patient begin to
access services?

18. First Consent Item:
Consent to Screen
Second Consent Item:
Consent to Contact/Program
Participation
Third Consent Item:
Consent to Share Information
Electronic Birth Records (EBR)
Consent Items:

19. Patient Contact Info Referral Status
Reason if referral “based
on other factors” or if
scored in but NOT
referred
Electronic Birth Records (EBR)
Patient Contact and Referral:

20. Scored Items
Electronic Birth Records (EBR)
Scored Items View:

21. Patient Signature
Field
Electronic Birth Records (EBR)
Patient Signature Field:

22. Infant Screen – Paper Version
Patient Section: First Consent Item:
Consent to Screen
Third Consent Item:
Consent to Share
Information
Second Consent Item:
Consent to Contact/Program
Participation

23. Infant Screen – Paper Version
Patient Section:
Patient Contact
Information
Patient Signs and
Dates

24. Infant Screen – Paper Version
Provider Section:
Scored Items
Provider Signs
and Dates

25. Infant Screen – Paper Version
Provider Section:
Referral Status
Reason if referral “based on
other factors” or if scored in
but NOT referred

26. How can we increase
consent for the first
consent item?
The first consent item is now auto-populated as “YES” on the
electronic screen. However, consent still needs to be requested
from the mother.
Explain why the screen is important and how it is used.
• Help identify infants and moms that might need help.
• It is so important that we are required by Florida Law to offer
this screen to all new moms.

27. Explain why consent to contact is important.
How can we increase
consent for the second
consent item?
• If you need help this allows Healthy Start to contact you.
• Sometimes mom’s needs change, saying “yes” means
Healthy Start can contact you if you need help later.

28. How can we increase
consent for the third
consent item?
Explain why consenting to releasing information
is important.
• We need permission to share this screening info with
Healthy Start.
• All information is kept private and confidential.
• Healthy Start only shares information that is needed for
your or your baby’s care.

29. When she says yes, you can add:
“You are making a good decision to screen your new
baby. Even if you or your baby may not need services
now, if you do in the future this helps getting you in
Healthy Start more quickly.”

30. If the patient is reluctant
to sign:
• Reinforce that this information is absolutely
confidential.
• Healthy Start follows state laws and HIPAA guidelines.
• The mother’s social security number is entered into
the state data system regardless of consent to share
the Healthy Start Screening Information.

31. If the patient doesn’t want the screen because she
doesn’t think the baby is at risk, let her know that our
Healthy Start Program gets additional funding from
the state the greater the number of screens that are
completed and consents to participate in Healthy
Start. Altruism sometimes enhances consent.
If the patient still refuses any aspect of screening, the
demographic information and provider’s signature
must be entered and the form is attached to the birth
certificate.

32. Discussing the
results if the infant
scores 4 or more:
• Nurse, midwife, or doctor shares the score with the
mother and explains what the risks mean.
• Tell about Healthy Start and the free services offered.
• Let the patient know that a Care Coordinator will be
contacting her soon to learn more about what
services are needed.
• Make sure the patient has authorized consent to
contact and share information!
• Please make sure the patient has brochures about
the Healthy Start and the Infant Screen.

33. According to Florida State Statute, 383.14 (FAC
64-C), the health care provider shall assure that
the parent or guardian is informed of the baby’s
risk status as determined by the infant risk
screening instrument.
Remember!

34. Discussing the results if
the infant does not have
a score of 4 or more:
• Provide the score to the mother
• Discuss Healthy Start and free services offered
• If the patient meets any of the eligibility criteria and
needs referred in “based on other factors” consent
must still be provided by the patient and the same
information is needed as if the infant scored in.
• Please make sure the patient has brochures about the
Healthy Start and the Infant Screen.

35. If at any time in the first year of the baby’s life someone
feels they may need Healthy Start services, they can call
861-2905 to talk to a Care Coordinator.
Patients can always call Healthy Start
for more information about any of the
services offered.
If the patient
wants more
information:

36. For more information…
Contact: Jamee Thumm
Education Coordinator
941.373.7070 ext. 307
jamee.thumm@healthystartsarasota.org
Visit the local Healthy Start Coalition website:
healthystartsarasota.org
Visit the Florida Dept. of Health info. website:
www.healthystartbaby.com