HJAR Jul/Aug 2021

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2021 27 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement disorder crises, and employ trained staff to assist patients in accessing treatment for mental illness or substance abuse. Maternal Life360 HOMEs This component will target women with high-risk pregnancies and their children. Hospitals can become Maternal Life360 HOMEs, which will provide or work with partner entities to provide evidence-based home visiting services. Home visits will be provided throughout the pregnancy and for the first two years of the infant’s life. According to the Centers for Disease Con- trol and Prevention, Arkansas’ infant mor- tality rate in 2019 was 6.9 infant deaths per 1,000 live births, compared to the national rate of 5.6 deaths per 1,000 live births. Sev- eral home visiting programs are currently working to improve infant and maternal health in Arkansas, including Family Con- nects, Following Baby Back Home, Healthy Families America, HIPPYArkansas, Nurse- Family Partnership, Parents as Teachers and SafeCare. There is scientific evidence that home visiting programs can improve health out- comes. An evaluation of the Following Baby Back Home program, which was developed in 2009 by the University of Arkansas for Medical Sciences Department of Pediatrics, found that infants referred to the program ARHOME will also seek to improve health outcomes for certain high-risk populations through the following three components: Success Life360 HOMEs This component will target young adults who are at risk of poor health due to pov- erty and are in one or more of the following groups: veterans aged 19‒30; people aged 19‒27 who have formerly been in foster care; and people aged 19‒24 who have formerly been in the custody of the state Division of Youth Services or the state Department of Corrections. Acute care hospitals can be- come Success Life360 HOMEs, which will connect patients in this target population with programs that will provide train- ing, education and other support to help them find a path to long-term economic independence. Rural Life360 HOMEs This component will target people who reside in rural areas of the state and who are in need of treatment for serious mental illness or substance abuse disorder. Small rural hospitals can become Rural Life360 HOMEs, which will screen all patients for health-related social needs, refer patients to services in the community when appro- priate, maintain acute crisis units to treat patients in mental illness or substance use between 2013 and 2017 had a significantly lower mortality rate and significantly high- er rates of immunization completion and completion of needed healthcare utilization than a similar group of infants who were not referred to the program. 1 This is an exciting new phase for Arkan- sas’Medicaid expansion program. I am op- timistic about the potential for the Life360 HOMEs approach to improve health out- comes among vulnerable populations, and I am particularly enthusiastic about the op- portunity to accelerate and expand support for mothers and newborns and hopefully lower our too-high infant mortality rate. The approach is not without risk, however. Suc- cess will depend greatly on the participation and leadership of our hospitals and other healthcare providers, as well as the design of the financing model for the Life360 HOMEs. Unlike most state programs, control will be localized rather than centralized, which car- ries with it a risk of reduced adherence to evidence-based practices. As this effort is extended into communities across the state, it will be important to ensure that fidelity is maintained to what we know works. n REFERENCES 1 McKelvey L, Lewis KN, Beavers J, Casey PH, Irby C, and Goudie A. Home-Visiting Support for Low-Birth-Weight Preterm Neonatal Intensive Care Unit Graduates: Examining the Impact of the Following Baby Back Home Intervention. Pe- diatrics published online: June 2021. “According to the Centers for Disease Control and Prevention, Arkansas’ infant mortality rate in 2019 was 6.9 infant deaths per 1,000 live births, compared to the national rate of 5.6 deaths per 1,000 live births. Several home visiting programs are currently working to improve infant and maternal health in Arkansas.”