Headquarters U.S.

Air Force
Integrity - Service - Excellence

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

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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Headquarters U.S. Air Force

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Questions?

Headquarters U.S. Air Force

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Assignments for Pregnant Members

Lt Col Leslie Formolo HQ AF/DPPPA

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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Headquarters U.S. Air Force

Integrity - Service - Excellence

Questions?