>> THE DEPARTMENT OF HEALTH
SERVICES IS CRACKING DOWN ON
PRENATAL PROGRAMS PAID FOR BY
MEDICAID, AND NOW CITY AND STATE
ELECTED OFFICIALS ARE CALLING
FOR ACCOUNTABILITY.
THE MILWAUKEE JOURNAL SENT NIL L
BROKE THE STORY OF MILLIONS OF
DOLLARS BEING BILLED TO MEDICAID
ON THE PART OF PROGRAMS DESIGNED
TO IMPROVE BIRTH OUTCOMES FOR
LOW INCOME PREGNANT WOMEN.
WISCONSIN HAS THE HIGHEST BLACK
INFANT MORTALITY RATE IN THE
NATION, AND NARROWING
DISPARITIES IS A PRIORITY OF
HEALTH OFFICIALS.
ACCORDING TO ITS REPORTING, THE
NEWSPAPER FOUND WISCONSIN HAS
SEEN A 400% INCREASE IN NEW
APPLICATIONS TO OPEN PRENATAL
CARE COORDINATION COMPANIES IN
RECENT YEARS, BILLING MEDICAID
THOUSANDS OF DOLLARS PER CLIENT
AND MAKING NEWLY MINTED
MILLIONAIRES OUT OF COMPANY
OWNERS.
THE DEPARTMENT OF HEALTH
SERVICES REPORTS IT HAS REFERRED
FOUR COMPANIES TO THE STATE
JUSTICE DEPARTMENT FOR CRIMINAL
INVESTIGATION.
OUR NEXT GUEST SAYS SHE'S BEEN
TRYING TO SOUND THE ALARM ON
CORRUPTION IN THE PRENATAL
INDUSTRY FOR YEARS.
BRIA GRANT JOINS US NOW.
THANKS VERY MUCH FOR DOING SO.
>> GOOD AFTERNOON.
THANK YOU FOR HAVING ME.
>> I WANT TO POINT OUT YOU'RE
THE EXECUTIVE OF DIRECTOR OF AN
ORGANIZATION THAT TRAINS
COMMUNITY HEALTH WORKERS AND
HAVE WORKED IN PRENATAL CARE AS
WELL INCLUDING ON A STATE-WIDE
LEVEL TO IMPROVE SUCH CARE.
WHY HAVE YOU BEEN SOUNDING THE
ALARM ON THIS BURGEONING
INDUSTRY?
>> WELL, LET ME JUST BE CLEAR,
NOT JUST PRENATAL CARE BUT
CHRONIC CONDITION, OUR WORK IS
ADDRESSING SOCIAL DISPARITIES,
WHICH CONTRIBUTE TO POOR HEALTH
OUTCOMES.
AND SO ESSENTIALLY THAT IS WHAT
WE WANT TO IMPROVE IN OUR STATE.
OUR STATE LEADS IN POOR HEALTH
OUTCOMES FOR CHILDREN OF COLOR,
AS WELL AS CHRONIC CONDITIONS
FOR PEOPLE OF COLOR.
SO WE WANT TO MAKE SURE THAT
WHILE WE ARE SPENDING THE
DOLLARS, WHICH WE WANT TO HAVE
THE INVESTMENT, BUT THE
INVESTMENT SHOULD CORRELATE WITH
IMPROVEMENT OF BIRTH OUTCOMES.
>> BUT YOU SAW THIS HAPPENING,
THEREBY TRYING TO SOUND THE
ALARM ON FRAUD?
>> SO ONE OF THE THINGS I WILL
SAY, YOU KNOW, SOMETIMES PEOPLE
JUST DON'T KNOW, RIGHT?
SO THERE ARE NO CHECKS AND
BALANCE AS FOR ENSURING WHO ARE
FACILITATING PROCESSES
APPROPRIATELY, YOU JUST CONTINUE
TO DO THE THINGS YOU'VE BEEN
ALLOWED TO DO.
OUR GOAL IS TO ENSURE THAT THERE
IS A PROCESS OF ACCOUNTABILITY
FOR BOTH THE STATE LEVEL AND THE
COMMUNITY LEVEL, WHERE SERVICES
ARE BEING DELIVERED, SO THAT WE
CAN SEE THAT IMPROVED OUTCOME IN
BIRTH OUTCOMES.
>> ABSOLUTELY.
CAN YOU GIVE US AN EXAMPLE OF
HOW FRAUD MIGHT BE PERPETRATED
IN THIS PRENATAL CARE INDUSTRY?
>> WELL, YOU KNOW, SOMETIMES YOU
HAVE INDIVIDUALS WHO DON'T HAVE
A METHOD OF IDENTIFYING IF A
CLIENT IS WORKING WITH SOMEONE
ELSE, AND SO THEY MAY ENGAGE
THEM IN SERVICES AS WELL AND
BILL FOR SERVICES THAT ARE ALSO
BEING PROVIDED IN AND BILLED
THROUGH ANOTHER AGENCY.
SOMETIMES IT'S KNOWN, SOMETIMES
IT'S NOT KNOWN.
ADDITIONALLY, INDIVIDUALS MAY
PROVIDE CARE TO MULTIPLE
FAMILIES, DOCUMENTING SOMETIMES
THE SAME TIME THAT THEY'RE
DELIVERING THIS CARE, WHERE IF
WE HAD A PROCESS THAT HELPED TO
BE ABLE TO BETTER TRACK THAT
ENGAGEMENT WITH FAMILIES, WE
SIGNIFICANTLY REDUCE SOME OF
THAT DUPLICATION OF WORK.
>> SO FO FOUR MILWAUKEE COMPANIS
HAVE NOW HAD THEIR MEDICAID
REIMBURSEMENTS CUT OFF.
IN YO UR MIND, IS YOUR MIND, ISF
TOO LONG IN COMING?
>> WELL, ABSOLUTELY, RIGHT,
BECAUSE IT JUST TOOK SO LONG TO
GET HERE BEFORE IT WAS
RECOGNIZED THAT THESE MOMS
WEREN'T BEING SERVED.
AND I THINK THAT'S THE LARGER
ISSUE.
WHILE OF COURSE WE WANT TO MAKE
SURE WE'RE SPENDING OUR DOLLARS
RESPONSIBLY, THERE ARE FAMILIES
THAT ARE NOT RECEIVING THE
SERVICES THAT'S BEING REPORTED
TO HAVE BEEN RECEIVED.
AND SO THAT DEFINITELY IS ANISH
YOU'LL WHEN WE THINK OF INFANT
MORTALITY, THE DISPARITY BETWEEN
BLACK AND WHITES IS JUST
DISHEARTENING.
IN MILWAUKEE, WHILE THERE'S BEEN
AN OVERALL DECLINE IN INFANT
MORTALITY, FOR BLACKS, IT'S 14.9
AND FOR WHITES, IT'S 4.6.
SO TO HAVE THAT GAP IS A HUGE
ISSUE, AND TO KNOW THAT WE HAVE
THE DOLLARS FOR THE INVESTMENT
TO IMPROVE ON THAT AND THAT IT'S
NOT COMING TOGETHER IS REALLY
WHAT WE WANT TO ADDRESS.
>> BECAUSE ALSO, THERE ARE
LEGITIMATE PRENATAL CARE
COMPANIES DOING GOOD WORK IN
THIS WAY.
CAN YOU TELL ME ABOUT THE KIND
OF WORK THAT THOSE COMPANIES ARE
DOING?
>> ABSOLUTELY.
WE TRAIN A PLETHORA OF COMMUNITY
COORDINATORS, COMMUNITY HEALTH
WORKERS, AGENCIES USE US AS A
GO-TO FOR FORMALIZED TRAINING.
THE MODEL THAT WE FACILITATE HAS
BEEN SHOWN TO IMPROVE BIRTH
OUTCOMES SIGNIFICANTLY AND HAVE
A COST SAVINGS ASSOCIATED WITH
IT, AND AGAIN, THIS IS NOT JUST
IN BIRTH OUTCOMES, WE KNOW THAT
A LARGE NUMBER OF OUR MOMS
EXPERIENCE HYPERTENSION DURING
THEIR PREGNANCY, SO BEING ABLE
TO ADDRESS THAT SO THAT WE CAN
HAVE A HEALTHY BIRTH WEIGHT, AS
WELL AS TAKE MOMS TO FULL TERM
IS A PART OF THE WORK THAT WE'RE
DOING.
>> WITH LESS THAN A MINUTE LEFT,
WHAT GOES IN TO ASSURING THESE
GOOD HEALTH OUTCOMES FOR BABIES
AND MOTHERS?
>> ABSOLUTELY.
SO WHEN WE THINK ABOUT OUR
HEALTH, 20% IS IN THE FOUR WALLS
OF THE CLINIC, PHYSICAL.
THE OTHER 80% OF OUR WHOLE
HEALTH IS WHERE WE WORK, SLEEP,
EAT AND PLAY.
SO AS MOM'S STRESSES ARE NOT
MANAGED, IF I HAVE HOUSING
ISSUES, IF I HAVE UNHEALTHY
EATING PRACTICES BECAUSE I JUST
DON'T HAVE THE EDUCATION, IF I
DON'T HAVE ACCESS TO THE PROPER
RESOURCES TO BRING STABILITY TO
MY LIFE, THEN THAT'S GOING TO
CAUSE ME TO HAVE A STRESSOR THAT
MAY CREATE HIGH BLOOD PRESSURE,
THAT MAY CREATE STRESS IN THE
WOMB THAT DOESN'T ALLOW FOR ME
TO HAVE THE HEALTHY BIRTH
OUTCOME.
SO THE WORK WE DO IS TO TRAIN
THOSE COMMUNITY HEALTH WORKERS
ON HOW TO ADDRESS THE WHOLE
FAMILY, INCLUDING BRINGING THE
FATHER INTO THE PICTURE, BECAUSE
THAT'S A HUGE COMPONENT TO A
HEALTHY BIRTH OUTCOME AND A
MOM'S STRESSORS.
SO THAT IS WHAT WE WANT TO MAKE
SURE, THAT WE HAVE A WHOLE
HEALTH APPROACH THROUGH ENSURING
OUR FAMILY CAN BE HEALTHY.
>> GREAT INFORMATION.
BRIA GRANT, THANK YOU VERY MUCH.