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Kansas Health Foundation and United Methodist Health Ministry Fund
Kansas Breastfeeding Initiative - Request for Proposals
I.
Introduction
Through this Request for Proposals (RFP), the Kansas Health Foundation (KHF) and United
Methodist Health Ministry Fund (UMHMF) will fund organizations to implement CDCRecommended Strategies to promote and support breastfeeding mothers and babies. This
initiative will support organizations in further developing and implementing breastfeeding
initiatives in coordination with health care systems, health care providers, public health
professionals and community efforts.
It is evident breastfeeding provides immediate and lifelong nutrition and health benefits for
mother and child and larger economic, environmental and social benefits to families and
communities. Breastfed babies have a lower risk of becoming obese, developing asthma, Type 1
diabetes and respiratory infections. Studies show that babies who exclusively receive breast milk
during the first six months of their lives have better educational and emotional outcomes.
Breastfeeding also benefits mothers, lowering women’s chances for ovarian and breast cancer,
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hypertension and heart disease. Therefore, barriers to breastfeeding in the community,
workplace and other settings must be addressed.
“Across the U.S., most mothers hope to breastfeed; it is an action that mothers can take to
protect their infants’ and their own health. Support from their families, communities, clinicians,
health care leaders, employers and policymakers makes it possible for mothers to breastfeed
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their babies.”
Unfortunately, many babies and mothers are missing out on the benefits of breastfeeding. In
Kansas, according to the Breastfeeding Report Card (2014) from the National Center for Chronic
Disease Prevention and Health Promotion, the number of newborn infants that started to
breastfeed in 2011 was approximately 77 percent. However, the duration of breastfeeding was
less than recommended. Of the infants born in 2011, 40 percent were breastfeeding at six
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months of age and just 22 percent by 12 months. To give all mothers and babies the best
chance at breastfeeding success, our culture needs to change, and support for breastfeeding
in hospitals, workplaces and communities needs to improve.
To promote these efforts, KHF and UMHMF hosted the Kansas Health Summit on Breastfeeding at
the Kansas Leadership and Kansas Health Foundation Conference Center in September 2014.
The purpose of the summit was to convene national and state-level experts to explore
opportunities for a healthier Kansas by overcoming barriers to breastfeeding. During the summit,
participants had the opportunity to learn about resources and contribute to developing change
strategies to support breastfeeding, with the ultimate goal of improving breastfeeding initiation
and duration rates in Kansas. Exhibit A includes the Kansas Health Summit on Breastfeeding
report which details the summit outcomes.
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W.K Kellogg Foundation, First Food 2014 Message Guide
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http://www.usbreastfeeding.org/Portals/0/Coalitions/Teleconferences/2011-10-11-Teleconf-Handouts.pdf
3
Centers for Disease Control and Prevention Breastfeeding Report Card, United States 2014
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Through this RFP, the initiative will continue the momentum of the summit and support the
following activities as outlined in The CDC Guide to Strategies to Support Breastfeeding Mothers
and Babies:
1. Maternity care practices to support breastfeeding related to the immediate prenatal
care during labor and birth and postpartum.
2. Professional education to improve the knowledge, skills, attitudes or behaviors of
healthcare providers in relation to the importance of breastfeeding.
3. Access to professional support from healthcare professionals, such as doctors, nurses and
lactation consultants.
4. Peer support programs to encourage and support pregnant and breastfeeding women.
5. Support for breastfeeding in the workplace through corporate policies developed to
support breastfeeding women.
6. Support for breastfeeding in early care and education through childcare arrangements
that support breastfeeding mothers and ensure staff are trained to handle breast milk
and mothers’ feeding plans.
7. Access to breastfeeding education and information during prenatal and intrapartum
periods to increase the mother’s knowledge and skills and develop positive attitudes
toward breastfeeding.
8. Social marketing to promote breastfeeding practices in community, hospital or
workplace settings and educate policymakers and the public about healthy infant
nutrition practices and support programs.
9. Monitor and address the marketing of infant formula to ensure potential negative effects
on breastfeeding are minimized.
II.
Required Letter of Intent and Application Deadline
Applicants are required to notify KHF and UMHMF of their intent to submit a proposal. Letters of
Intent must be received by 5 p.m. on April 17, 2015. Proposals submitted by organizations that
do not submit a letter of intent by the deadline will not be reviewed. Organizations submitting
letters of intent are not required to submit a full proposal.
The letter of intent must include:
• Name and address of the applicant organization
• Primary contact person’s name, title and contact information
• Reason for interest in this initiative (two paragraphs or less and identification of CDC
recommended strategy to be implemented.)
• Description of proposal (should be two paragraphs or less)
Letters of Intent must be submitted using KHF’s online proposal module via the following link:
https://www.GrantRequest.com/SID_1062?SA=SNA&FID=35090.
Grant proposals must be submitted via KHF’s online module by 5 p.m. on May 15, 2015.
Applicants should submit the proposal in advance of the deadline in the event of any
technical issues.
III.
Who May Apply
KHF and UMHMF anticipate a broad range of organizations will be supported through this RFP,
which may include:
• Organizations/coalitions currently addressing breastfeeding rates in Kansas
• Health care providers and organizations
• Local and state government
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•
•
•
•
Organizations that participated in the Kansas Health Summit on Breastfeeding
Organizations addressing worksite wellness
Organizations with expertise in chronic disease prevention and health promotion
Organizations serving childcare providers
Eligible applicants are nonprofit and government organizations well-positioned to implement
strategies related to the RFP objectives. Applicant organizations must be classified as tax-exempt
under Section 501(c)(3) of the Internal Revenue Code. Private foundations and Internal Revenue
Code Section 509(a) (3) organizations are not eligible for funds through this initiative.
To better ensure sustainability of the grant-funded activities, collaboration is strongly
encouraged particularly for those organizations with smaller revenue. Applicants may be a
single organization, a partnership of anchor organizations and /or an organization representing
a larger coalition. Multiple partners may submit a joint proposal that reflects a collaborative
approach. In such a situation, one organization would serve as the named applicant/grantee
and be responsible for administration of grant funds and other compliance requirements.
To avoid any real or perceived conflicts of interest, KHF and UMHMF reserve the right to not fund
organizations that contract with or receive grants, sponsorships or other forms of support from,
including grants or sponsorships, tobacco companies or soft drink manufacturers. Applicants
must include a signed statement describing any financial relationship with tobacco companies
or soft drink manufacturers.
IV.
Available Funding and Grant Period
Applicants are eligible to apply for awards ranging from $25,000 to $100,000. The award
determination will include the relative cost effectiveness of the proposals. The maximum grant
period is 36 months beginning July 1, 2015, and ending June 30, 2018. If desired, applicants may
propose a shorter project period than the maximum. Payment schedules will vary depending
on whether the grant is funded by KHF or UMHMF. Both funders will provide grant payments in
advance of work being completed.
KHF and UMHMF anticipate awarding a combined amount of up to $1 million through this RFP.
Grants will be awarded from either KHF or UMHMF.
V.
Monitoring and Evaluation
Grantees must submit their completed deliverables and grant reports according to the schedule
outlined in the grant agreement. The grant agreement requires grantees to participate in any
independent evaluation.
VI.
Grant Exclusions
Grant funds may not be used to support any of the following activities:
o Medical research
o Contributions to capital campaigns
o Operating deficits or retirement of debt
o Endowment programs
o Activities supporting political candidates or voter registration drives, as defined in
IRC section 4945(d)(1)
o Vehicles, such as vans or buses
o Medical equipment
o Real estate acquisitions
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o
o
VII.
Direct mental health services
Direct medical services (Does not apply to lactation consultant services.)
Optional Applicant’s Meeting
Potential applicants are strongly encouraged to participate in a webinar that will provide an
overview of the RFP, describe the application process and answer applicant questions. The
date and time of the webinar is: April 10, 2015, at 3:30 p.m.
Applicants may register for the Breastfeeding Initiative webinar through KHF’s website at:
www.kansashealth.org/breastfeeding.
VIII.
Proposal Requirements
Proposals will be submitted using KHF’s online proposal module. To be considered, the
submission must include:
A. Cover Page (completed online)
B. Proposal Narrative (attached/uploaded with online proposal)
C. Budget and Justification Template (attached/uploaded with online proposal)
D. Financial Relationship Statement Template (attached/uploaded with online proposal)
E. Acknowledgement of Agreement Review (attached/uploaded with online proposal)
F. Financial Documents (if applicable)
During proposal reviews, preference will be given to those that clearly demonstrate one or more
of the following:
• A strong multi-sector collaborative approach
• Strategies that leverage or build upon efforts outlined in The CDC Guide to Strategies to
Support Breastfeeding Mothers and Babies
• Strategies that will improve the health of low-income Kansans and/or other populations
disproportionately affected by low breastfeeding rates
A. Cover Page
The Cover Page is completed online and requires the following information:
• Organization information (including organization name, address, phone, email, etc.)
• Primary contact information
• Project Term
B. Proposal Narrative
The Proposal Narrative is limited to 15 single-spaced pages and must be developed using 12point Times New Roman font and one-inch margins. Clearly organize the Proposal Narrative
using the following six sections.
1. Executive Summary (up to one single-spaced page)
• This section is not scored but should provide the KHF, UMHMF and reviewers with
an overview of the proposed activities and intended outcomes.
• Provide the following on the Executive Summary page:
i. Project title.
ii. Requested funding amount.
iii. Focus of the grant proposal: supporting breastfeeding moms and babies.
iv. Brief narrative overview of the proposal. The KHF and UMHMF will likely
draw from this narrative overview when announcing grant awards.
2. Applicant Capacity and Experience (up to three single-spaced pages)
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•
•
•
•
•
Describe applicant organization’s mission and how the breastfeeding
proposal is related to that mission.
Describe applicant’s capability and resources to ensure timely start-up and
implementation of the proposed activities.
Identify and describe qualifications and related experience of key personnel
who would direct/oversee the grant-funded activities.
Describe applicant’s experience with similar projects.
Identify any other organizations that will serve in key roles for the project.
3. Population and Statement of Need (up to two single-spaced pages)
• Identify and describe the population and/or organizations that would be
impacted by the proposed activities.
• Describe the impact of obesity on this population.
• Substantiate statement of need using relevant data.
4. Proposed Project Plan and Timeline (up to five single-spaced pages)
• Provide a narrative description of the proposed strategies and
implementation plan.
• If your proposal includes “programs for individual behavior change” or
“community design construction,” clearly describe how these activities will
support a broader systems and/or environmental change.
• Discuss how the efforts and/or anticipated outcomes will be sustained
beyond the funding period.
• On a single page, included in the five-page total for this section, provide a
timeline that clearly identifies the major activities that would occur during
each quarter (three-month period) of each year of the grant term.
• This section has one of the highest point values for the proposal. Ensure
adequate detail is provided to allow reviewers to clearly understand the
proposed project.
5. Proposed Project Objectives (up to one single-spaced page)
• Provide at least five SMART (specific, measurable, attainable, relevant and
time-bound) objectives for the proposal. Refer to KHF’s guidance document
to develop SMART objectives provided in Exhibit B.
• At least one objective must be related to the anticipated impact the grantfunded initiative will have on the population.
• Proposed objectives should reflect what applicant organization expects to
achieve and will be able to measure over the course of the grant term.
• Grantees will report progress toward the proposed objectives on an annual
basis: 1) after the first 12 months (August 1, 2016) and each subsequent year.
• Grantees’ proposed objectives will be used by external evaluators, KHF and
UMHMF staff to assess the impact of funded grants.
6. Staffing (up to two single-spaced pages)
 Identify and describe the qualifications of staff involved in this project and
their expertise in leading breastfeeding policy interventions.
 If potential candidates have been identified, provide examples of the
individual’s experience overseeing/directing similar grant-funded
activities.
 Provide a resume for the individuals designated as key personnel
(Attach/upload as a separate file to the attachments page of the online
proposal.)
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C. Budget and Justification Template
The Budget and Justification Template must be submitted with the proposal. Provide a
clear budget narrative and justification for all potential costs.
D. Financial Relationship Statement Template
Applicants must submit a signed Financial Relationship Statement Template to verify the
organization has no contracts with and receives no funding from, including grants or
sponsorships, tobacco companies or soft drink manufacturers or describe any such
relationships.
E.
Acknowledgement of Agreement Review
To ensure applicant organization is able to accept a grant from the KHF or UMHMF, the
organization must submit a signed Acknowledgement of Agreement Review. Applicants
with concerns regarding the Grant Agreements may submit such concerns to Elissa
Buller, grants officer, at (316) 491-8410 or [email protected].
F.
Financials (Required unless applicant is a government entity)
• IRS Form 990
• Most recent unaudited financial statement (balance sheet)
• Most recent audited financial statement
IX. Scoring Process
Proposals will be reviewed by KHF and UMHMF staff and external content experts.
Proposals receiving the highest overall scores and meeting all proposal requirements will
be eligible for funding. Point values for scoring are outlined in the table below:
Breastfeeding Scoring Table
Proposal Section
Maximum Score
Executive Summary
Not scored
Capacity and Experience
30
Population , Statement of Need and Readiness
20
Proposed Project Plan and Timeline
30
Proposed Project Objectives
10
Staffing
10
Budget
10
110
Total
X.Timeline
RFP Released
RFP Informational Webinar
Letter of Intent due
Proposals due
Grant awards announced
Grant term begins
Progress and financial status reports due
Grant term ends
Final progress and financial status reports
due
Page Limit
1
3
2
5
1
2
NA
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April 1, 2015
April 10, 2015 3:30 p.m.
April 17, 2015 by 5:00 pm
May 15, 2015 by 5:00 pm
June 3, 2015
July 1, 2015
August 1, 2016, 2017, 2018
June 30, 2018, unless applicant requests shorter
grant term
30 days after project end date
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Identifying Evidence-Based Strategies
Applicants can find information regarding potential evidence-based strategies to support
breastfeeding moms and babies from many sources. The following resources may be helpful in
developing the proposal:
http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf
http://www.cdc.gov/breastfeeding/pdf/BF-Guide-508.PDF
http://www.surgeongeneral.gov/library/calls/breastfeeding/calltoactiontosupportbreastfeeding
.pdf
http://www.usbreastfeeding.org/Employment/WorkplaceSupport/tabid/105/Default.aspx
Additional questions? Submit questions regarding the Breastfeeding Grants RFP via email, with
the subject, “Breastfeeding Initiative,” to Chan Brown, program officer, at [email protected] or
Katie Ross at [email protected].
Questions and responses will be listed on a Frequently Asked Questions (FAQ) document on KHF
and UMHMF’s website at www.kansashealth.org/breastfeeding and www.healthfund.org/KBI.
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Exhibit A
REPORT
O N
T H E
Convened Thursday, September 25, 2014
Sponsored by:
Kansas Health Foundation &
United Methodist Health Ministry Fund
Report prepared by Sarah Jolley, MA
Wichita State University
Center for Community Support and Research
Table of Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Final Recommendations . . . . . . . . . . . . . . . . 4
Informational Sessions . . . . . . . . . . . . . . . . . 5
Breakout Sessions . . . . . . . . . . . . . . . . . . . . . 5
Focus Group with Moms . . . . . . . . . . . . . . . . 9
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
O P P O R T U N I T I E S
F O R
A
H E A L T H I E R
K A N S A S
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OVERVIEW
On Thursday, September 25, the Kansas Health Foundation and the United Methodist Health
Ministry Fund hosted the Kansas Health Summit on Breastfeeding at the Kansas Leadership
Center and Kansas Health Foundation Conference Center in Wichita, Kansas. The purpose of
the day was to convene national, state and local experts to explore opportunities for a
healthier Kansas by overcoming barriers to breastfeeding. The Summit also provided the
opportunity for the more than 160 participants to learn about available resources and
contribute to the development of change strategies in Kansas to support breastfeeding,
with the ultimate goal of improving breastfeeding initiation and duration rates. This report
highlights the results of the Summit.
FINAL RECOMMENDATIONS
One purpose of the Summit was to determine priority recommendations for Kansas to improve
breastfeeding rates. The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies
served as a foundation for consideration of a wide range of evidence-based strategies. These
strategies were divided into four topic areas, each of which addressed two of the strategies
recommended in the guide. Each topic area was discussed by one of four breakout groups.
Through this process, eight priority recommendations for Kansas -- two from each breakout
group -- were presented to the larger group. All participants had the opportunity to vote on
their top three recommendations from the list of eight. This group voting process resulted
in the following recommendations being identified as the top three (vote counts included):
No. 1: Breastfeeding Families - Awareness of Resources
Pursue a Kansas-wide public awareness campaign based on a website that has a
comprehensive list of breastfeeding community resources available in each county
with a cohesive look that includes an app and an after-hours hotline. Votes: 68
No. 2: Primary Care Physicians - Scorecard/Designation related to their
Support of Breastfeeding
Develop a scorecard (that leads to a designation) to create a competitive environment
for supporting breastfeeding -- for primary care providers.Votes: 43
No. 3: Hospitals - Breastfeeding Clinics
Develop more hospital-based breastfeeding clinics for moms/babies after hospital
discharge. Votes: 36
Although a voting process such as this has limitations, it provided valuable insight into what
participants perceive as the greatest needs, timeliest opportunities and most available
resources for advancing breastfeeding in Kansas. It is anticipated that discussions regarding
all of the strategies will enable individuals, funders, coalitions and other organizations to
continue efforts to improve the health of Kansans through increased breastfeeding rates.
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INFORMATIONAL SESSIONS
The morning was full of information provided by a variety of featured speakers and panelists.
Dr. Robert Moser, Secretary of the Kansas Department of Health and Environment (KDHE),
opened the Summit with an overview of the barriers and opportunities for change related
to breastfeeding in Kansas. His presentation included state-level statistics within the context
of the importance of this health issue to multiple sectors of Kansas. Dr. Moser provided
comparisons of the U.S., Kansas and other regional states breastfeeding initiation and duration
percentages.
Some of the most startling comparisons to national averages included: Kansas
Breastfeeding initiation rates at 77.4% compared to the U.S. rate at79.2% and
Nebraska’s rate at 82.4%. Kansas statistics indicated 40.3% reported any
breastfeeding at six months compared to the U.S. rate of 49.4% and Colorado
at 55.2%. Kansas exclusive breastfeeding rates at six months were 11.4% compared
to the U.S. rate of 18.8% and Oklahoma at 15.5%. These statistics provided additional
support for the case to focus efforts on addressing barriers in Kansas.
Following Dr. Moser’s statewide look at breastfeeding, Dr. Todd Wolynn, a board certified
pediatrician and lactation consultant from Pittsburgh, Pennsylvania, provided a national
perspective, making the case for breastfeeding and taking action on this issue. His presentation
focused on important influences that affect breastfeeding nationally and included action steps
to support breastfeeding initiatives in multiple sectors at the state and local level. Dr. Wolynn
provided a clinical education luncheon for physicians and resident physicians on “breastfeeding
medicine” as the new standard of care that is both sustainable and profitable.
After hearing Dr. Moser and Dr. Wolynn, a group of panelists talked about the importance of
improving support for breastfeeding from the state’s perspective. Dr. Moser moderated the
panel, which included Lana Gordon (Secretary, Kansas Department of Labor), Jan Clausing (Human
Resources Director, Kansas Department of Corrections) and Martha Hagen (Breastfeeding
Coordinator, Nutrition and Women, Infants and Children (WIC) Services, Bureau of Family
Health, KDHE). The final speaker for the morning was Kansas Insurance Commissioner, Sandy
Praeger, who spoke about issues involving healthcare coverage for breastfeeding.
B R E A K O U T S E S S I O N S : Creating a Blueprint for Improving
Breastfeeding Rates in Kansas
Following the morning’s informational sessions, the afternoon was dedicated to participants’
discussion of strategies to improve breastfeeding rates in Kansas, using the CDC Guide
recommendations. Each of the four breakouts focused on two recommendations in the CDC
Guide to Strategies to Support Breastfeeding Mothers and Babies. Participants in these
sessions were tasked with identifying two achievable approaches for concentrated efforts
in Kansas. These were structured in the following groups:
1) Maternity Care and Professional Education;
2) Access to Professional Support and Peer Support;
3) Education on Breastfeeding and Social Marketing; and
4) Workplace and Childcare.
These four areas were identified based on the nine strategies provided in the CDC Guide to
Strategies to Support Breastfeeding Mothers and Babies (www.cdc.gov/breastfeeding/pdf/BFGuide-508.PDF). Each breakout session included a brief presentation from a panel of experts
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connected to the strategy area followed by a facilitated discussion around possible gaps and
other statewide efforts that may be relevant.
Following the panel presentation and facilitated discussion, the group had the opportunity to
develop specific recommendations. The task of each breakout group was to look at all of the
possibilities and answer the question: Where is the best opportunity? They returned to the
large group with two priority recommendations to help make progress on that strategy area
in Kansas. The two priority recommendations from each group are listed below. The full list of
recommendations developed by each group is in the Appendix.
Maternity Care and Professional Education
This group focused on CDC Strategy 1: Maternity Care Practices and CDC Strategy 2: Professional
Education. These two strategies emphasize the importance of promoting, protecting and
supporting breastfeeding within the maternity care setting and professional education system.
This group also discussed how hospital policy changes and maternity procedures and practices
influence infant feeding and child health. The panel specifically covered current state and local
initiatives, including: the Baby-Friendly Hospital Initiative, High 5 for Mom and Baby Program
and professional education and physician residency breastfeeding training.
Karen Wambach, Professor with the University of Kansas School of Nursing, acted as the
chairperson. Panelists for this group included:
• Gwen Whittit
High 5 for Mom & Baby Program Coordinator
• Kathy Walker
Lactation Services Manager, Wesley Medical Center
• Barb Morrison
Associate Professor, Wichita State University
• Michelle Sanders Kansas Perinatal Quality Collaborative, Shawnee Mission Health
• Dr. Tracy Williams Assistant Professor, Department of Family and Community
Medicine, University of Kansas School of Medicine-Wichita
The top two recommendations developed by this group include the following:
No. 1: Develop more hospital-based breastfeeding clinics for moms/babies after hospital
discharge.
• Must be self-sustaining
• Covered by lactation service reimbursement
No. 2: Develop a scorecard (that leads to a designation) to create a competitive environment
for supporting breastfeeding – for primary care providers.
• Provide funding for Educating Physicians in the Communities (EPIC) training
• Need programming, education, scholarships, administrative support, involve
family medicine, pediatric association, Kansas Breastfeeding Coalition
Professional Support and Peer Support
This group focused on CDC Strategy 3: Access to Professional Support and CDC Strategy 4: Peer
Support Programs. These CDC strategies emphasize improving peer and professional support
for breastfeeding. This session provided an overview of the preventive services in the Affordable
Care Act, including breastfeeding support and models of culturally-sensitive community
collaborations. Other featured topics included WIC, community clinics, hospitals, La Leche League
and health plans.
Libby Rosen, Professor of Nursing Care of Childbearing Families at Baker University School of
Nursing, acted as chairperson. Panelists for this group included:
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• Martha Hagen Nutrition and WIC Services, Kansas Department of Health
and Environment
• Stephanie Wolf Nurse Manager, Saline County Health Department
• Sherry Payne Executive Director, Uzazi Village
• Marsha Connor Vice President Network Strategy, UnitedHealthCare
• Theresa Weigel La Leche League of Kansas
The top two recommendations developed by this group include the following:
No. 1: Pursue increased availability of breastfeeding support for peers and professionals
across the state -- reducing barriers, filling the maps -- which would require funding,
Spanish/language training, and these partners: local health departments, clinics,
breastfeeding coalitions, Kansas Department of Health and Environment, and hospitals.
No. 2: Pursue KanCare covered benefits for education, counseling and supplies for
breastfeeding support which would require money, knowledge about other successful
programs and these partners: Kansas Department of Health and Environment (KDHE);
managed care organizations (MCOs); La Leche League, Kansas Breastfeeding Coalition;
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); Kansas
Academy of Family Physicians (KAFP); certified nurse midwives; American Congress of
Obstetricians and Gynecologists (ACOG); Association of Women’s Health, Obstetric, and
Neonatal Nurses (AWOHNN) and hospitals.
Workplace and Childcare
This group focused on CDC Strategy 5: Support for Breastfeeding in the Workplace and CDC
Strategy 6: Support for Breastfeeding in Early Care and Education. These strategies emphasize
supporting breastfeeding mothers in the workplace and childcare settings. This group
discussed strategies and resources already being used to encourage breastfeeding in these
environments. The group worked to identify barriers and determine focus areas to engage
Kansas employers and childcare providers to improve breastfeeding support.
Elizabeth Ablah, Associate Professor with the Department of Preventive Medicine and Public
Health at the University of Kansas School of Medicine-Wichita, served as chairperson for this
breakout. Panelists for this session included:
• Brenda Bandy
Program Director, Kansas Breastfeeding Coalition, Inc./
Business Case for Breastfeeding
• Kami Cohorst
Child Care Aware of Kansas
• Aubrey Wiechman
WorkWell Kansas Coordinator
• Mary Beth Chambers Manager of Corporate Communications, Blue Cross Blue Shield
of Kansas
• Sandy Grantello
Obstetrics Nurse Case Manager, Amerigroup
The top two recommendations developed by this group include the following:
No. 1: Coordinate efforts among those who already work with employers, which would also
include a checklist of questions to ask your insurance provider about coverage for
breastfeeding support.
No. 2: Expand buy-in, understanding, and implementation of breastfeeding friendly policies and
practices related to Early Care and Education (ECE). (Clarification of the ECE acronym was
added after the event. The recommendation statement may not have been clear when
participants voted.)
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Education on Breastfeeding and Social Marketing
This group focused on CDC Strategy 7: Access to Breastfeeding Education and Information and
CDC Strategy 8: Social Marketing. These CDC strategies emphasize communications and
marketing related to breastfeeding. Current campaigns were presented. Potential approaches
to providing breastfeeding education and support, such as social media, were also discussed.
Lauren Lueck, member of the Board of Directors of United Methodist Health Ministry Fund and
communications professional, served as chairperson of the breakout. Panelists included:
• Jeff Willett
Vice President for Programs, Kansas Health Foundation
• Diane Dalrup
Becoming a Mom Program, March of Dimes
• Melissa Hudelson Baby Buffer website, Kansas Chapter, American Academy
of Pediatrics
• Debra Cooper
Member Connections, Sunflower Health Plan
• Heather Lingner Medical Management – Case Management, Sunflower Health Plan
The top two recommendations developed by this group include the following:
No. #1: Pursue a Kansas-wide public awareness campaign based on a website that has a
comprehensive list of breastfeeding community resources available in each county
with a cohesive look that includes an app and an after-hours hotline. We will need
resources such as funding, healthcare providers, vendors, knowledge and partners like
breastfeeding supporters..
No. #2: Propose an International Board Certified Lactation Consultants/Lactation Consultants
(IBCLCs/LCs) of Color mentoring program, especially in rural areas to encourage more
IBCLCs and younger IBCLCs. We will need resources like funding, staffing and partners,
such as the Kansas Breastfeeding Coalition, to make matches.
Note:
CDC Strategy 9: Addressing the Marketing of Infant Formula was not addressed by any of the breakout groups.
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FOCUS GROUP WITH MOMS
At the end of the day, five breastfeeding mothers (two with their babies) stayed to share
their thoughts about the day. These mothers were asked to think about the future for
breastfeeding moms in Kansas and answer the following questions:
• What is the best thing we did today?
• What sounds most promising?
• What still concerns you?
• What is still missing and/or needs attention?
These women all agreed that it was inspiring to see such an effort for this important
cause. They were excited to see men in attendance and to see support from them.
These moms said the best thing we did today was brainstorm real possibilities with
a variety of people -- nurses, doctors, program people, moms, etc. The people who
were present for these discussions have the ability to make these changes happen -to create change in our state to better support breastfeeding. They also noted that
different groups from different communities came together to fill gaps and make
progress on this issue.
While they felt there was a successful push to get medical providers to
the Summit, there was also concern that there is not enough buy-in
from physicians. These moms stressed the importance of making sure
physicians have updated/continuing education related to breastfeeding
and its benefits. Each mother could provide an example of someone
saying, “...but my doctor said…” in relation to something about breastfeeding that is not accurate (e.g., formula and breast milk are equivalent,
ok to start cereal or other solids before six months).
Some other concerns expressed were related to unaccommodating employers, women
not knowing their rights and/or women being afraid to advocate for themselves. This
situation creates frustration for everyone involved, especially mothers and babies. They
also noted a significant concern is the continuing disparity between cultures and classes
related to breastfeeding and finding ways to close the gap. They want education and
resources to be available for moms from all walks of life.
This group of women had additional ideas around promoting and supporting breastfeeding.
They pointed out that while at the hospital mothers are required to watch certain
educational videos prior to being discharged with their newborns (e.g., about purple
crying, ABCs to bed). Would it be possible to include something about breastfeeding at
that time? These moms noted that helping new moms have realistic expectations about
breastfeeding could be helpful -- breastfeeding isn’t always easy. Mothers and babies
have to learn, and every baby is different. We need to find ways to support struggling
moms, and moms have to be willing to accept help in this area.
Another note was that while there are benefits of breast milk, there are also benefits
from the breastfeeding experience (i.e., receiving breast milk directly from the breast as
opposed to from a bottle). They mentioned the importance of normalizing breastfeeding
for everyone and that the media can impact this (in positive and negative ways).
9
S U M M A R Y O F T H E D AY
Dr. Todd Wolynn closed the Summit with the following call to action:
Be brave. Explore the side paths. Use your resources. Sure, there are obstacles,
but we can address these obstacles head on. We should be willing to risk hearing
“no” and then take that “no” and do something with it. We have an amazing
opportunity here. What will we do with it?
EVENING RECEPTION
The day was followed by an evening reception at Wesley Medical Center which included a panel
discussion focused on moving toward baby-friendly maternity care. This session introduced
the Ten Steps to Successful Breastfeeding and the Baby-Friendly Hospital Initiative. The
discussion focused on benefits and barriers hospitals face when working to achieve this
designation.
Kathy Walker (Lactation Services Manager) and other Wesley staff panelists: Dr. Laurie Gwyn
(Director of Well Newborn Services and Assistant Professor at the University of Kansas School
of Medicine), Carol Hancock (Postpartum Manager), Jenny Way (Physician Relations and
Outreach Manager) and Holli Taylor (Lactation Consultant) shared Wesley Medical Center’s
experience, including obstacles and achievements, over the past 22 months as it seeks to
become the first hospital in Kansas to be certified as a Baby-Friendly Hospital. Jolynn Dowling
(Instructor for Wichita State University School of Nursing) joined the panel to share about the
involvement of the Wesley Baby Friendly community team.
KANSAS BREASTFEEDING COALITIONS CONFERENCE
The day after the Kansas Health Summit on Breastfeeding, the Kansas Breastfeeding Coalition
hosted the Kansas Breastfeeding Coalitions Conference at Wesley Medical Center. More than
70 people from 20 different communities attended. In addition to hearing from Dr. Todd Wolynn,
participants learned about starting and sustaining a coalition, community engagement activities
and statewide programs. They were able to put these ideas into action for their coalition during
an action plan work session that afternoon.
This event was an opportunity for those involved in breastfeeding coalitions to celebrate their
work and create action plans for specific work they would like to do to continue promoting and
supporting breastfeeding in their communities.
Want to know more about this report?
Contact Sarah Jolley: [email protected]
10
Wichita State University's Center for Community Support and Research (CCSR) is dedicated to creating and
sustaining positive change within organizations and communities across the state of Kansas. CCSR’s skilled
teams work directly with community coalitions, non-profit health and human services organizations, and self-help
groups from an interdisciplinary perspective. Serving Kansas for over 30 years, CCSR staff are Kansans who truly
care about Kansas communities.
APPENDIX
Each of the four breakout groups developed recommendations related to a topic area and
brought two recommendations back to the larger group. This Appendix includes all
recommendations provided by each of the four breakout groups, including each group’s top
two recommendations, which are also provided in the text of the report.
Each recommendation is connected to a specific strategy in the CDC Guide to Strategies to
Support Breastfeeding Mothers and Babies (www.cdc.gov/breastfeeding/pdf/BF-Guide-508.PDF).
Following each recommendation, the strategy and, in some cases, the action step are noted
along with the proper page reference in the CDC Guide.
Maternity Care and Professional Education
Recommendation No. 1
Develop more hospital-based breastfeeding clinics for moms/babies after hospital discharge
• Must be self-sustaining
• Covered by lactation service reimbursement
Connects to CDC Strategy 3, Action Step 2 on p. 17
Recommendation No. 2
Develop scorecard (that leads to a designation) to create a competitive environment for
supporting breastfeeding -- for primary care providers
• Provide funding for Educating Physicians in the their Communities (EPIC) training
• Need programming, education, scholarships, administrative support, involve family medicine,
pediatric association, Kansas Breastfeeding Coalition
Connects to CDC Strategy 2 on p. 11
Recommendation No. 3
Develop technical prompts with education in hospital and physician electronic medical records
to give best lactation info and ensure best procedures
• Partner with content expert, tech providers, provider reps
• Training and distributor and funding
Connects to CDC Strategy 1 on p. 5 and CDC Strategy 2 on p. 11
Recommendation No. 4
Provide skills-based training for primary care providers
• Education programs
• Lactation consultants
• Growth (?) from March of Dimes
• Part 2 of High Five
Connects to CDC Strategy 1, Action Step 3 on p. 8
Recommendation No. 5
Basic education to physician and patients (full community) that formula feeding is not equal to
breastfeeding
• Media
• Marketing
• Dist. Network
Connects to CDC Strategy 8, Action Steps 3 and 4 on p. 39
11
Peer and Professional Support
Recommendation No. 1
Pursue increased availability of breastfeeding support for peers and professionals across the
state -- reducing barriers, filling the maps -- which would require funding, Spanish/language
training, local health departments, and these partners: local health departments, clinics,
breastfeeding coalitions, Kansas Department of Health and Environment (KDHE), and hospitals
Connects to CDC Strategy 4 on p. 19
Recommendation No. 2
Pursue KanCare covered benefits for education, counseling, and supplies for breastfeeding
support which would require money, knowledge about other successful programs and these
partners: Kansas Department of Health and Environment (KDHE), managed care organizations
(MCOs), La Leche League, Kansas Breastfeeding Coalition, Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC), Kansas Academy of Family Physicians (KAFP),
certified nurse midwives, American Congress of Obstetricians and Gynecologists (ACOG),
Association of Women’s Health, Obstetric, and Neonatal Nurses (AWOHNN), and hospitals
Connects to CDC Strategy 3, Action Step 1 on p. 17
Recommendation No. 3
Bridge program at WIC for breastfeeding peer counselors to mentor women of color
Resources: money/funding, new advocate, Special Supplemental Nutrition Program for Women,
Infants, and Children (WIC) support
Partners: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC),
International Board Certified Lactation Consultants (IBCLCs)
Increase diversity, color conscious hiring
Connects to CDC Strategy 4 on p. 19
Recommendation No. 4
Enhance continuity of care for pregnant women and moms care transition points
Resources: Coalitions, philanthropy
Partners: Hospitals, healthcare providers, clinics, doctors, Obstetricians/Gynecologists, Special
Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Connects to CDC Strategy 3 on p. 15
Recommendation No. 5
Pursue KanCare covered benefits for breastfeeding support
Resources: people and money and knowledge about successful programs
Partners: Kansas Department of Health and Environment, managed care organizations,
La Leche League, Kansas Breastfeeding Coalition, Special Supplemental Nutrition Program for
Women, Infants, and Children (WIC), Kansas Academy of Family Physicians (KAFP), American
Academy of Pediatrics, Kansas Medical Society, certified nurse midwives, American Congress
of Obstetricians and Gynecologists (ACOG)
Connects to CDC Strategy 3, Action Step 1 on p. 17
Recommendation No. 6
Improve education at nursing and med school, requires change in accrediting body
expectations, and data, new curriculum
Partners: American Academy of Pediatrics (AAP), Kansas State Nurses Association (KSNA),
University of Kansas, Wichita State University
Connects to CDC Strategy 2 on p. 11
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Recommendation No. 7
Increase availability of breastfeeding support (peer and professional) across the state (reduce
barriers) (maps)
Resources: money/funding, Spanish speakers, training local health departments
Partners: Local health departments, clinics, breastfeeding coalitions
Connects to CDC Strategy 4 on p. 19
Recommendation No. 8
Close generational and cultural gaps among expectant families regarding breastfeeding
Resources: Public service announcement, media, managed care organizations
Partners: managed care organizations (MCOs)
Connects to CDC Strategy 4 on p. 21
Recommendation No. 9
Integrating breastfeeding education in continuing nursing education (CNE)/continuing medical
education (CME) opportunities
Resources: Doc groups, Kansas State Nurses Association (KSNA), etc.
Connects to CDC Strategy 2 on p. 13
Work Place and Childcare
Recommendation No. 1
Coordinating efforts among those* that already work with employers
*Those = Department of Labor, local agencies, WorkWell Kansas, Chronic Disease Risk Reduction, local public
health departments, worksite wellness practitioners
Resource: Someone/some entity to serve in this role
Connects with CDC Strategy 5, Action Step 4 on p. 24
Recommendation No. 2
Expand buy-in, understanding, and implementation of breastfeeding friendly policies and
practices (related to early care and education – ECE)
• Providers, parents, those working with childcare providers
• Education/training for providers and parents
• Kansas Department of Health and Environment (KDHE), Kansas State Department of
Education (KSDE), Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC), Child and Adult Care Food Program (CACFP), La Leche League
Connects with CDC Strategy 6, Action Steps 2, 5, and 6 on p. 30
Recommendation No. 3
Develop a checklist for consumers to ask their insurance company about coverage for
breastfeeding support
Resources: List of questions, definition of different supplies, printed cards (with website) at
offices, for undocumented/underinsured, good start would be Missouri Breastfeeding Coalition,
someone to manage website (maybe not needed) and marketing, 3rd trimester checklist, Human
Resources could provide Family and Medical Leave Act (FMLA) info, pdf to post/provide various
places
Note: This has already been done by the National Women’s Law Center
Connects to CDC Strategy 3, Action Step 1 on p. 17
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Access to Info/Social Marketing
Recommendation No. 1
Pursue a Kansas-wide public awareness campaign based on a website that has a comprehensive
list of breastfeeding community resources available in each county with a cohesive look that
includes an app and an after-hours hotline. We will need resources such as funding, healthcare
providers, vendors, and knowledge and partners like breastfeeding supporters.
Connects to CDC Strategy 3, Action Step 4 on p. 17
Recommendation No. 2
We propose an International Board Certified Lactation Consultants/Lactation Consultants
(IBCLCs/LCs) of Color mentoring program, especially in rural areas to encourage more IBCLCs
and younger IBCLCs. We’ll need resources like funding, staffing, and partners like the Kansas
Breastfeeding Coalition to make matches.
Connects to CDC Strategy 3 on p. 15
Recommendation No. 3
We propose a Kansas campaign with Kansas Breastfeeding Coalition website application,
hotline for information, with further support resources like funding, Information Technology (IT),
with healthcare providers/ vendors, breastfeeding supports, and county information
Connects to CDC Strategy 3, Action Step 4 on p. 17
Recommendation No. 4
We propose an effort to add a systems change checklist item for family physicians to ask about
breastfeeding
Resources: need educators
Partners: partner with all physician levels
Connects to CDC Strategy 2, Action Step 2 on p. 12
Recommendation No. 5
We need a train-the-trainer program to get consistent breastfeeding education into rural Kansas
areas
Resources: money/funding, develop program, messaging
Partners: Kansas Breastfeeding Coalition
Connects to CDC Strategy 2, Action Step 1 on p. 12
Recommendation No. 6
Providers need to engage/participate in existing regular public health meetings and be engaged
in solution
Partner with Kansas Public Health Association (KPHA) (primary care/public health interest) -Who? Kansas Department of Health and Environment (KDHE), hospitals, and Federally Qualified
Health Centers (FQHCs)
Connects to CDC Strategy 2 on p. 11
Recommendation No. 7
Having consistent training programs with incentive for breastfeeding providers
Resources: need funding for incentive
Partners: Facility administrators, Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC)
Connects to CDC Strategy 2 on p. 11
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Recommendation No. 8
We propose an International Board Certified Lactation Consultant (IBCLC) mentoring program
especially in rural areas with Kansas Breastfeeding Coalition making matches
Resources: money/funding
Connects to CDC Strategy 2, Action Step 2 on p. 12
Recommendation No. 9
We would like breastfeeding educators and health providers to go to an accredited course every
2 years
Resources: course, breastfeeding collaborators, High 5
Partners: Kansas State Board of Healing Arts (KSBHA) or continuing medical education (CME)
licensing
Connects to CDC Strategy 2 on p. 11
Recommendation No. 10
We propose social media training available to key communicators via web
Resources: County staff allowed to use social media
Partners: website developer
Connects to CDC Strategy 8 on p. 37
Recommendation No. 11
Online breastfeeding education for clinical providers
United States Lactation Consultant Association-International Lactation Consultant Association
(USLCA-ILCA) -- webinars
Connects to CDC Strategy 2, Action Step 4 on p. 12
O P P O R T U N I T I E S
F O R
A
H E A L T H I E R
K A N S A S
15
SP ONSOR E D
BY :
309 East Douglas | Wichita, Kansas 67202
316-262-7676 | Toll free 800-373-7681
www.kansashealth.org
100 East First | Hutchinson, Kansas 67501
620-662-8586 | Toll free 800-369-7191
www.healthfund.org
Exhibit B
SMART Objectives
Developing SMART Objectives
One way to develop well-written objectives is to use the SMART approach. Developing
specific, measurable objectives requires time, orderly thinking, and a clear picture of the
results expected from program activities. The more specific your objectives are, the easier it
will be to demonstrate success.
SMART stands for
Specific
Measurable
Attainable/Achievable
Relevant
Time bound
Specific - What exactly are we going to do for whom?
The “specific” part of an objective tells us what will change for whom in concrete terms. It
identifies the population or setting, and specific actions that will result. In some cases it is
appropriate to indicate how the change will be implemented (e.g., through training).
Coordinate, partner, support, facilitate, and enhance are not good verbs to use in
objectives because they are vague and difficult to measure. On the other hand, verbs such
as provide, train, publish, increase, decrease, schedule or purchase indicate clearly what
will be done.
Measurable - Is it quantifiable and can WE measure it?
Measurable implies the ability to count or otherwise quantify an activity or its results. It also
means that the source of and mechanism for collecting measurement data are identified,
and that collection of these data is feasible for your program or partners.
A baseline measurement is required to document change (e.g., to measure percentage
increase or decrease). If the baseline is unknown or will be measured as a first activity step,
that is indicated in the objective as, “baseline to be determined using XXX database,
20XX.” The data source you are using and the year the baseline was obtained is always
specified in your objective statement. If a specific measurement instrument is used, you
might want to incorporate its use into the objective.
Another important consideration is whether change can be measured in a meaningful and
interpretable way given the accuracy of the measurement tool and method.
Attainable/Achievable - Can we get it done in the proposed time frame with the resources
and support we have available?
The objective must be feasible with the available resources, appropriately limited in scope,
and within the program’s control and influence.
Sometimes, specifying an expected level of change can be tricky. To help identify a target,
talk with an epidemiologist, look at historical trends, read reports or articles published in the
scientific or other literature, look at national expectations for change, and look at programs
with similar objectives. Consult with partners or stakeholders about their experiences. Often,
talking to others who have implemented similar programs or interventions can provide you
with information about expected change.
In some situations, it is more important to consider the percentage of change as a number
of people when discussing impact. Will the effort required to create the amount of change
be a good use of your limited resources?
Relevant - Will this objective have an effect on the desired goal or strategy?
Relevant relates to the relationship between the objective and the overall goals of the
program or purpose of the intervention. Evidence of relevancy can come from a literature
review, best practices, or your theory of change.
Time bound - When will this objective be accomplished?
A specified and reasonable time frame is incorporated into the objective statement. This
takes into consideration the environment in which the change must be achieved, the
scope of the change expected, and how it fits into the overall work plan. It may be
indicated as, “By December 2010, the program will…” or, “Within six months of receiving the
grant...”
Using SMART Objectives
Writing SMART objectives also helps you to think about and identify elements of the
evaluation plan and measurement, namely indicators and performance measures. An
indicator is what you will measure to obtain observable evidence of accomplishments,
changes made, or progress achieved. Indicators describe the type of data you will need to
answer your evaluation questions. A SMART objective often tells you what you will measure.
A performance measure is the amount of change or progress achieved toward a specific
goal or objective. SMART objectives can serve as your performance measures because
they provide the specific information needed to identify expected results.
Getting Started
To develop SMART objectives, use the template below and fill in the blanks:
By_____/_____/_____, ___________________________________________________
[WHEN—Time bound] [WHO/WHAT—Specific]
from _____________________ to __________________________________________
[MEASURE (number, rate, percentage of change and baseline)—Measurable]
Adapted from materials developed by the Institute of Medicine and Centers for Disease Control
Kansas Health Foundation Budget and Justification Template
Budget Table
Please complete the budget table below. Follow the format provided below keeping in mind that
your organization may request up to $100,000 during the grant period:
TOTAL
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Budget Category
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Personnel (existing)
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Fringe (up to 25% of Personnel)
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*Indirects (maximum 10% of direct grant costs)
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*The Kansas Health Foundation will allow indirect costs (costs that are not project-specific but instead support the organizations overhead) up
to a maximum of ten percent of the requested grant amount. Indirects are those costs that are not easily identified with a specific program, yet
are necessary to the operation of the program. Examples: postage, telephone bills, printer ink, facility rent or lease, utilities.
Kansas Health Foundation Budget and Justification Template
Budget Narrative
In addition to the Budget Table, include a brief explanation of each budget category and the basis
for the calculation.
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(Please limit annual salary increases to 3%)
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Financial Relationship Statement
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Check the statement that most accurately describes the applicant organization’s financial
relationships with tobacco companies i and soft drink manufacturers ii. Attach a description of
any such financial relationships.
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____________ The applicant organization does not accept monetary donations,
contributions, sponsorships, in-kind gifts, loan of goods or services under any condition from
any tobacco company or soft drink manufacturer.
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Signature
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____________ The applicant organization does accept monetary donations, contributions,
sponsorships, in-kind gifts, loan of goods or services under any condition from any tobacco
company or soft drink manufacturer. We have attached a description of our relationships.
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A list of tobacco companies can be found at: http://www.hsph.harvard.edu/administrative-offices/faculty-affairs/facultyappointments/policy-on-tobacco-related-companies/index.html.
ii
Vending machines do not need to be described unless on-site vending is a contractual deliverable between the applicant
organization and a soft drink manufacturer.
Kansas Health Foundation
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Acknowledgement of Agreement Review
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Signature of Authorized Representative of Applicant Organization
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The undersigned confirms it (i) has reviewed the Kansas Health Foundation’s (“Foundation”) template
Agreement submitted herewith (“Agreement”), (ii) has obtained all feedback regarding such
Agreement that it deems necessary, including from its legal counsel and other advisors, and (iii) if its
proposal is accepted by Foundation, it will accept the terms of the Agreement in substantially the
form attached here. The undersigned acknowledges that if it is unwilling to sign any resulting
Agreement in the form presented, Foundation may revoke any prior approval of the proposal.
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