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Gone Too Soon: Healthy Babies Need Healthy Communities

Oversight and Advisory Committee’s Official Response Sept. 2013

A Special Series By Milwaukee Lifecourse Initiative for Healthy Families

Without a doubt, infant mortality remains a critical concern in our nation. And, in Wisconsin, the disproportionately high African American infant mortality rate prompted the University of Wisconsin School of Medicine and Public Health and the Wisconsin Partnership Program (WPP) to establish the Lifecourse Initiative for Healthy Families (LIHF) for four Wisconsin cities.

The goal of LIHF is to improve community conditions that help African American women and their families achieve healthy birth outcomes.

This summer the Center for Urban Population Health was selected by the WPP to support the implementation of the projects aimed at eliminating the racial disparity in birth outcomes in Milwaukee, Racine, Beloit and Kenosha. And, prior to this, at the request of the WPP, a transition team for the LIHF was asked to provide recommendations to move the LIHF forward.

After comprehensive meetings and dialogues, the Milwaukee LIHF transition team, under Lorraine Lathen, President of Jump at the Sun Consultants, LLC, submitted its recommendations to move the LIHF forward to the WPP on June 12, 2013.

Fast forward two months later, and the WPP has reviewed the transition team’s recommendations, and in a response dated August 27, 2013, agreed with the majority of the ten recommendations proposed by the transition team. Specifically, the Overisight and Advisory Committee’s (OAC) responses were:

1. Backbone agency – An expedited Request for Applications (RfA) process to identify the backbone agency that can be completed within 90 days and involves Milwaukee LIHF Transition Team as reviewers.

The OAC will release a competitive Request for Application (RfA) for a Collaborative Implementation Grant on September 20, 2013, to fund a convening (backbone) agency to reestablish the Milwaukee Lifecourse Collaborative. A panel of expert reviewers will be drawn from national or state health experts and community members, subject to approval of the OAC.

2. Leadership – A Milwaukee LIHF Collaborative led by a steering committee that is supported by the backbone agency.

Its membership should be composed of individuals with demonstrated capacity to support programming in the core areas of the Collaborative’s charge.

The OAC agrees that effective leadership and governance structure, supported by a convening agency, will ensure the long-term success of Milwaukee collaborative work.

The OAC will require all applicants to describe their capacity, specifically with a shared governance model, to maintain an effective collaborative that represents members with experience and capacity in core program areas.

3. Financial resources – An annual budget allocation range between $260,000 and $370,000, over a two-year period to support implementation.

The OAC is examining the implications of the recommended Milwaukee Collaborative funding levels to ensure they are adequate and sufficient for grant expectations, community size and capacity.

It is likely that the OAC will make annual funding available within the recommended range.

4. Infrastructure – A model that involves a steering committee, backbone agency, five work groups, cross sector partners and community members.

The five recommended work groups include: (1) Health Care Access, (2) Strengthening African American Families, (3) Poverty Reduction, (4) Fund Development and 5) Communications.

While it is premature to establish an organizational structure for the proposed collaborative, this recommendation is consistent with the need for an organization structure outlined in the Community Action Plan.

Applicants will be encouraged to review the Community Action Plan as well as recommendations from the Milwaukee LIHF Transition Team report.

5. Capacity building needs – A work group structure that pairs community members with professional mentors. The team also recommends establishing the Milwaukee LIHF Maternal and Child Health Leadership program to help build strategic leadership in impacted communities.

The OAC will direct the Milwaukee Collaborative to link with existing university resources. Leadership training will also be available through the Regional Program Office.

6. Relationship of Collaborative to LIHF Grantees – Interactions between the Collaborative, backbone agency and funded programs should be guided by the principles for achieving collective impact and the Steering Committee, in partnership with the backbone agency, monitors the alignment of the LIHF-funded programs with the mission of the Milwaukee LIHF Collaborative.

This recommendation is consistent with the expectations outlined in the RfA in the Expectations and Assurances section.

Technical assistance and consultation will be provided to support partnership development.

7. Work Plan and Policy Agenda – The policy agenda and work plan will be narrowly focused on poverty reduction, strengthening African American families, increasing health care access and narrowing the geographic focus.

This recommendation is consistent with the Milwaukee Community Action Plan.

Applicants will be required to submit a logic model and project work plan and to clearly, and succinctly, identify goals, outcomes, outcome measures and activities.

Applicants will be required to identify communities and neighborhoods that will be primary service area(s) of the grant.

8. Extension of the Milwaukee LIHF Transition Team –Extending the period of performance for the Transition Team through October 1, 2013 to implement a variety of activities that will support the Collaborative in transitioning to implementation.

The Milwaukee LIHF Transition Team completed its work within the six-month timeline, which concluded on June 30, 2013, and provided a final report to the WPP.

The Regional Program Office has met and continues to meet with the members of the Transition Team as well as other Collaboratives in Beloit, Racine and Kenosha.

Continued involvement of individual Transition Team members is encouraged.

9. Geographic Focus – The geographic focus of the Milwaukee LIHF Collaborative includes 53205, 53206 and/or 53210 zip codes.

These zip codes all have high rates of African American infant mortality and demonstrate greatest need, as defined by the Community Action Plan.

Applicants will be identified in communities and neighborhoods within targeted ZIP code areas (53205, 53206 and 53210), the primary Milwaukee service area(s).

10. Accountability – A monitoring process should be put in place to ensure accountability among all entities, and at all levels.

All approved grantees enter into a contractual relationship with the WPP, on behalf of the University of Wisconsin-Madison and the UW System Board of Regents.

The RfA will provide applicants with the opportunity to describe the collaborative’s shared governance model and clearly articulate reporting relationships within the collaborative structure.

The OAC will assure that the grantee, if funded, is held accountable, including adherence to the approved application, project work plan and budget.

“My hope for the Milwaukee LIHF program is that the wisdom and intellect of young adult, African- American women and men living in the designated areas, is sought, captured and executed to create programming that eliminates the consistent trends resulting in infant death. Although we’ve completed two planning processes, I remain concerned and yet hopeful, that the program will exceed the conventional and do the unprecedented to save the lives of black babies,” said Shawn Green, LIHF Collaborative and Transition Team Co- Chair

The overarching goal of the OAC, the WPP and the transition team is to alleviate or eliminate racial disparities related to infant mortality.

To that end, no matter what methodologies are employed or structures and monitoring systems put in place, all entities remain committed to this singular outcome.

“Our community already has too many disparities— economic, education and health—if we can honestly and sincerely work toward solutions that will give our children better and healthier outcomes, it is my pleasure to be part of that process.

While the work of the Transition Team was completed in June, the heavy lifting takes place now with the Milwaukee Partnership.

I plan to stay engaged with this work as the Milwaukee Partnership works toward giving our babies a better chance at a good, wholesome and healthy life,” said Pastor Roy Lewis, Emmanuel Evangelistic Temple.