The Healthy Start Initiative is a national 5-year demonstration program that uses a broad range of community-driven, system development approaches to reduce infant mortality and improve the health and well-being of women, infants, children, and families. This volume, fifth in the series, deals with the topic of collaborating with managed care organizations. The book is designed to assist Healthy Start projects and their subcontracting service providers in developing proposals and entering into contracts with health maintenance organizations (HMOs) that serve Medicaid clients. It is designed to help these organizations: (1) understand and evaluate the needs and responsibilities of HMOs; (2) evaluate the capabilities of the Healthy Start project and its subcontractors; (3) identify the specific needs of targeted HMOs, and evaluate and adapt the organizational structure and services of the Healthy Start project and its service providers to meet those needs; (4) develop and market a managed care proposal; and (5) propose and negotiate a managed care contract. This report has 11 chapters: (1) "Introduction"; (2) "HMOs: The Basics"; (3) "Your State's Medical Managed Care Program and Opportunities for Healthy Start"; (4) "Factors Influencing an HMO's Willingness to Contract with a Healthy Start Project"; (5) "Becoming an Attractive Partner to HMOs"; (6) "Preparing To Act as a Contractor to HMOs"; (7) "Strategic Planning: How To Decide What Services To Offer to HMOs"; (8) "Developing and Marketing a Managed Care Proposal"; (9) "Proposing and Negotiating a Contract"; (10)"Ongoing Issues"; and (11) "Conclusion." Five appendices contain a glossary of terms, annotated HMO-Healthy Start Project contracts, a Healthy Start Project subcontractor agreement, a list of state Medicaid directors, and state maternal and child health contacts. (LPP)

This volume describes the experiences of each of the 15 rural and urban Healthy Start initiatives. These projects were set up in areas that had infant mortality rates that were 1.5 to 2.5 times the national average. Project locations include major cities such as Chicago, Illinois; Boston, Massachusetts; and Oakland, California, and rural areas in South Carolina and the Plains states. The projects brought together families and community organizations to design and implement new procedures in an intensive effort to reduce the infant mortality rate in their communities by one-half within 5 years. In this report, representatives from each of the projects share the lessons they learned in planning and implementing the Healthy Start initiative to reduce infant mortality. While some speakers discuss unique aspects of their programs, many stress common themes. Recurrent themes in the reports include community involvement, consortia development, management and governance, program initiatives, provider issues, and sustainability. These themes are outlined in the executive summary at the beginning of the volume. (BAC)

Children are the foundation of the United States, and supporting them is a key component of building a successful future. However, millions of children face health inequities that compromise their development, well-being, and long-term outcomes, despite substantial scientific evidence about how those adversities contribute to poor health. Advancements in neurobiological and socio-behavioral science show that critical biological systems develop in the prenatal through early childhood periods, and neurobiological development is extremely responsive to environmental influences during these stages. Consequently, social, economic, cultural, and environmental factors significantly affect a child's health ecosystem and ability to thrive throughout adulthood. Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity builds upon and updates research from Communities in Action: Pathways to Health Equity (2017) and From Neurons to Neighborhoods: The Science of Early Childhood Development (2000). This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.