First Trimester Health Care in the Air Force

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First Trimester Health Care in the Air Force

• Jon R. Pearse
• Colonel, USAF Medical Corps
• Chief of Policy, Medical Operations
• Office of the Surgeon General

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First Trimester Health Care

• Family Centered Care (FCC) initiative is a major
  DoD-TRICARE initiative to improve attractiveness
  of delivering ones child within our facilities
• Air Force Medical Service (AFMS) provides
  comprehensive first trimester health care to all
• Special consideration for potential occupational
  stresses and exposures for our service members
• Unique role of the New Parent Support Program for
  all of our beneficiaries

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Summary of Family Centered Care Initiative

• Family Centered Care Initiative (FCC) program
  transforms care delivery from a provider-centered
  to a patient/family centered experience
• Obstetrical-FCC is the first DoD-TRICARE
  Management Activity initiative in this
  transformation
• Elements of the FCC program were derived directly
  from patient and staff responses to multiple
  survey instruments and information obtained from
  MTF convenience samples
• Our objective is to be the provider of choice for
  our families

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Obstetrical-FCC Initiative within the Air Force

• Senior Air Force leadership is actively engaging
  all of our Medical Treatment Facilities (MTFs)
• Increased sensitivity and resources allocated to
  be more Family Centered focused
• Increased funding for staffing improvements
• Tool kits and central resources provided
• Without distinction between service members and
  dependant beneficiaries

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IMPROVEMENTS SEEN

• Many best practices at our facilities
• screening for
• Post-partum depression
• Domestic violence
• Substance abuse, tobacco, alcohol
• Spring Garden Interactive CD-ROM and video
• Award winning pregnancy informational CD and
  video
• Over 10,000 distributed last year
• Eglin is distributing with prenatal vitamins at
  the pharmacy
• This practice being encouraged for all facilities
• Screening Ultrasounds for beneficiaries
• All facilities facilitating children to attend
  prenatal appointments

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More Improvements Seen

• DoD/VA uncomplicated pregnancy guideline
  implementation
• Nurse-educational visit by 6-8 weeks
• First provider visit by 10-12 weeks
• Streamlines visits and standardizes care
• Inline with all American College of Obstetrics
  and Gynecology guidelines
• Increasing continuity of care with provider
• Have seen no net loss of patients after the 2003
  appropriation act
• The act provides same maternal-child benefits for
  those that opt for private sector care

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After a Positive Pregnancy Test

• A standard profile is performed
• Member is taken off of mobility status until 4
  months post partum
• Wearing of certain military gear is restricted
• Gas Masks, Respirators, utility belts
• General duty performance restrictions applied

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The Pregnancy Profile

• Goal is optimal maternal-fetal health
• Duty restrictions balance
• Utmost care in reducing occupational risks to
  fetal development
• Medical needs of the service member
• Members right to participate in unit functions

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Adhere to Federal health and Safety
Recommendations

• The Air Force follows the 1996 Newborns and
  Mothers Health Protection Act is the cornerstone
• OSHA-Occupational Safety and Health
  Administration guidelines followed
• NIOSH-National Institute of Occupational Safety
  and Health followed
• A worksite-occupational evaluation by skilled
  occupational experts occurs expediently when a
  service member becomes pregnant
• Safety information and restrictions for optimal
  maternal-fetal health
• Information is then provided to the member and to
  the members unit

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New Parent Support Program

• Medical Program through Family Advocacy
• Staffed by contracted civilians at the MTF
• All new pregnancies contacted
• Parenting, nutrition, education, breast feeding,
  health classes offered
• To include a Dads 101
• Referrals made to Womens Infants and Children
  (WIC) programs CONUS and OCONUS
• Family Centered Care initiative is actively
  integrating the New Parent Support Program within
  all of our Air Force facilities

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Questions?


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Assignments for Pregnant Members
Lt Col Leslie Formolo HQ AF/DPPPA

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Supporting Agencies Actions

• Actions by Medical Treatment Facility (MTF) and
  Military Personnel Flight (MPF)
• MTF
• Member is medically confirmed as pregnant
• Placed on physical profilefrom date of entry
  until 4 mos after birth
• MPF
• Codes member in personnel system (MILPDS)
• Cancels all pending overseas assignments and
  state-side assignments if report date is after
  the 6th month of pregnancy
• Female member may waive the 4 mos after delivery
  requirement for OS tour if an accompanied tour
  and granted concurrent travel

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Assignments?

• Assignments still possible under these
  conditions
• Overseas locations
• If the baby is to be placed for adoptionfuture
  citizenship issues exceptions Alaska and Hawaii
• Lack of obstetrical care or other medical
  considerations
• Member is assigned to a dependent restricted
  location
• Member assigned to an accompanied tour location
  with duration less than 18 months
• Mandatory PCS moves member will not be assigned
• To any overseas locationlong or short
• To any CONUS location during the closed 12 week
  period6 weeks before and six weeks after
  delivery
• Member may request to proceed on PCS with full
  justification IAW with 36-2110 para 1.5 and
  statement from attending physician

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Questions?