Rural Health Care Services Outreach Grant Program - Target Population: BCFS Health and Human Services (BCFS HHS) proposes the “Mommy and Me” program to serve the Black, Indigenous, and people of color (BIPOC) population in Angelina, Cherokee, and Nacogdoches Counties, Texas. These populations have historically suffered from poor health outcomes, health disparities, and other inequities. Our program will address the limited access to maternal care by providing comprehensive services, including case management, care coordination, and community-based education initiatives to improve maternal and child health outcomes. Project Goals and Objectives: The “Mommy and Me” program aims to: Decrease infant mortality, adverse birth outcomes, and health disparities. Improve access to maternal health education. Enhance access to prenatal, perinatal, postpartum, and well-woman care. Reduce high-risk behaviors contributing to poor perinatal outcomes. Establish a community-driven consortium to improve care coordination. Evidence-Based Models: The program will implement the Healthy Start and Perinatal Health Partnership frameworks, integrating standardized screenings such as the Perceived Stress Scale (PSS), Women Abused Screening Tool (WAST), Kotelchuck Adequacy of Prenatal Care Utilization Index, and depression screening tools (PHQ-2, Edinburgh Postpartum Depression Scale). The program will provide case management, education, care coordination, and referral services to address social determinants of health. Expected Outcomes:60% of participants will obtain health insurance.60% of pregnant participants will receive prenatal care in the first trimester.60% of postpartum participants will receive follow-up care.60% of participants will receive preventive annual visits.60% of participants will be screened for depression and interpersonal violence, with 95% receiving referrals if screened positive.60% of participants will abstain from tobacco use. Capacity to Serve Rural Underserved Populations: BCFS HHS has over 20 years of experience in delivering maternal health services in underserved communities through programs such as Healthy Start in Smith County, Texas. Our initiatives have successfully reduced infant mortality rates and expanded access to maternal care services. We have established strong community partnerships and implemented a consortium to address social determinants of health. In April 2024, BCFS HHS expanded to the Deep East Texas region, operating the Texas Home Visiting (THV) and Healthy Outcomes through Prevention and Early Support Family Resource Center (HOPES-FRC) programs to serve pregnant individuals and families with children ages 0-5. Funding Preference Qualification: BCFS HHS qualifies for funding preference based on the following criteria: Previous HRSA Awards. Designation as a Health Professional Shortage Area (HPSA) for Angelina, Cherokee, and Nacogdoches counties. Medically Underserved Community/Populations (MUC/MUPs)designation in Nacogdoches County.
