In Maryland, persistent racial disparities exist in maternal and infant health, contributing to increased rates of infant mortality and maternal mortality. While strides have been made to improve the health outcomes of birthing people and children in this state, there is significant work to be done to reduce the disparities between racial groups. Infants of Black women experience increased rates of infant mortality and preterm birth compared to infants of White women. Additionally, Black women have been found to have nearly twice the rate of severe maternal morbidity (SMM) as compared to White women. The rate of SMM for Asian Pacific Islander birthing people and Hispanic women is nearly 1.4 times that of White women.

There are complex medical and social factors that contribute to these adverse outcomes, and we acknowledge the need for a multipronged approach to optimize the health of birthing people and babies. Traditional models of care have not demonstrated reductions in disparities, and evidence-based research has shown that alternative models of care may be necessary to address the complex health and social factors around maternal health.

Through their Statewide Integrated Health Improvement Strategy (SIHIS), the State has identified group prenatal care as a promising intervention with the best potential to reduce preterm births, reduce maternal morbidity and improve maternal infant outcomes at the population level.

Click here to access our Policy and Billing document. This resource offers a short overview of Centering, as well as state-specific billing, coding and documentation information.

Award Details

CHI will support the expansion of CenteringPregnancy in Maryland to three new practice locations in support of its effort to improve outcomes with the Centering model of group care as part of the second year of this expansion effort.

These awards will cover one year of implementation support from the CHI team, including:

Centering365 implementation plan

• Remote support from a dedicated CHI Advisor
• Centering launch site visit
• Site accreditation visit and determination
• Centering facilitation training for four participants
• Centering facilitation training seats for one additional participant
• Advanced facilitation training for five participants
• Patient curriculum materials and leader kit
• Site license fee (implementation year covered, ongoing annual fee to be covered by the site)
• Direct monetary award of $7,500 to support Centering start-up needs identified by the site

Retail value of in-kind CHI products and services is $38,390

*Funding is subject to availability

Application Requirements

Interested applicants must meet the following criteria to be considered:

• Are a Federally Qualified Health Center (FQHC), Community Health Center, Local Health Department, Birth Center or Healthcare System or licensed provider of prenatal care services. Documentation must be submitted with the application
• Have provider eligibility through Maryland Medicaid as an individual provider or group practice. Document proof must be provided with the application
• Complete the Centering Healthcare Institute Readiness Assessment and provide a certificate as proof of completion
• Have a sufficient volume of prenatal patients (at least 150 per year, hopefully, more)to support robust group care
• Provide care to at least 60% Medicaid recipients OR consist of at least 50% non-white individuals.

Additional Selection Criteria:

In addition to the application requirements outlined in the previous section, the selection process will take into account practice types and geographies. While providers of prenatal care in any Maryland Jurisdictions may be awarded, granting opportunities will be prioritized in the following jurisdictions contributing to elevated severe maternal morbidity rates.

Preference will be given to entities that provide clinical care to predominantly Medicaid, charity care, and/or uninsured patients (e.g., FQHCs, community health centers, hospital-based clinics, etc.). In addition, the following counties, which are listed in no particular order, have been identified as priority communities for CenteringPregnancy expansion by the Maryland Department of Health.

Priority Jurisdictions for CenteringPregnancy

1. Baltimore City
2. Montgomery County
3. Howard County
4. Washington County
5. Carroll County
6. Charles County
7. Baltimore County
8. Prince George’s County
9. Anne Arundel County
10. Frederick County
11. Harford County
12. Wicomico County

How to Apply

Please submit a Centering Readiness Assessment and schedule a follow up call with CHI Practice Services. Please indicate that you are interested in being considered for this opportunity.

Once sites complete the CHI Readiness Assessment they will be contacted by Mary Fitzmaurice, Director of Business Development at CHI, to schedule a phone discussion to assess the site’s readiness for CenteringPregnancy.

Qualifying candidates whose readiness is verified by the CHI team following the phone discussion will be invited to submit the application materials listed below. The application form will include supplementary questions to round out the information provided on your Readiness Assessment on the following topics: community need, patient engagement, measuring success, community buy-in and leadership, sustainability, and budget.

• Letter of intent describing the vision for Centering in your practice
• Supplemental question responses
• Planning Your Centering Budget document
• Letter of Support
• Proof of status
  • Must be a Federally Qualified Health Center (FQHC), Community Health Center, Local Health Department, Birth Center or Healthcare System or licensed provider of prenatal care services.
  • Must have provider eligibility through Maryland Medicaid as an individual provider or group practice.

The Request for Applications (RFA) narrative outlines in detail the application requirements and process, selection criteria, services and support awarded as well as project activity and timeline.

Deadline: Rolling within the grant period until awards are exhausted

Requirements before Implementation begins

Awardees will be required to complete the following documentation before starting implementation.

• Account Information Form
• Master Site License
• Service Agreement
• Memorandum of Understanding (MOU)

Please direct questions about the CenteringPregnancy model or this RFA to Mary Fitzmaurice, CNM, MSN, Director of Business Development, Centering Healthcare Institute at mfitzmaurice@centeringhealthcare.org