By Ed Oliver

In a letter to Massachusetts News, the Director of Public Education at the Children’s Trust Fund, Shereen Tyrell, emphatically denied that Healthy Families does any searching for new mothers. "We do not do any hospital screening to identify first-time parents eligible for services. There is no investigation or screening done to determine which families are eligible for services. The program is open to all parents age 20 and younger."

However, when Massachusetts News checked with Milford Hospital we learned that screening and referrals are handled routinely by their case management office. Cathy Perry, the person who screens and makes referrals explained, "What we do here is screen each mother who delivers a baby. I look at every chart. If they meet the criteria, which is age 20 or under and it’s their first baby, we give them literature and talk with them about the program. Most of the time they’ll say, ‘Oh yeah, that sounds really good.’ Then we’ll make the referral to the Healthy Families program."

When specifically asked what she looks for in the charts, she answered, "Age and if it’s her first baby." Perry did not mention whether or not she shares other information or "at-risk" criteria with Healthy Families, such as income or marital status. She did say if a girl has had more than one child, she will refer her to the "Good Start" home visiting program.

It is not known how every hospital, clinic, doctor and school in Massachusetts handles screening to determine eligibility for the Healthy Families program. The letter from Children’s Trust Fund denies it occurs at all. If House Bill 2529 passes, every new mother under 21 will be systematically identified and assessed according to law.

Explaining how she refers mothers to Healthy Families, Perry said, "If they are in labor when they come in, I don’t talk to them about it. The next day I usually visit all the mothers. Usually the day they’re leaving, I’ll make the referral. So it’s upon discharge they are referred, but I already talked to them some beforehand."

Critics point out that at such a time, the mother is physically and emotionally drained and in a highly vulnerable position when approached about the program.

Perry said, "Sometimes they say they are not interested in a home visiting program. In that case we don’t refer them. It’s an optional program, but we do try to reach everybody.

"Healthy Families always follows up with us. Sometimes they call a mother we referred who says she’s not interested. They let us know if a girl refused the service."

It is not known if those mothers who refused services are then reported to DSS by the hospital, if they are determined to be "at-risk."

Addressing privacy concerns, a nationwide study published last year by the Physicians’ Resource Council of the Alabama Family Alliance confirms that in many cases, Healthy Families programs receive confidential screening information from doctors and hospitals.

The study says in some situations, hospitals and clinics actually allow assessment workers from the program to have direct access to confidential maternal medical records. In other situations, where the assessment worker is not allowed access to records, they are allowed to enter hospital rooms and administer a "verbal screen" to new mothers in search of "risk factors."

The study questions whether new mothers are giving informed consent before they are referred by the hospital to the program. "Initial investigations indicate there may be no consent in some cases. When consent forms are obtained prior to referral, these are often included with many other forms signed when a mother in labor is admitted to the hospital," it says.

Milford Hospital does not use referral consent forms, according to Perry. She said they verbally introduce the mother to the program, get her permission and make a notation to that effect in her chart. Perry admitted that a mother may not give it much thought when she consents to the program. "They’re only in the hospital for forty-eight hours after they had a regular delivery. They are getting bombarded with so much information that last day, maybe they just haven’t processed it," she said.
 

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