Chiles Center Marks 10 Years and Largest Gift Ever to USF College of Public Health

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It sits on a sprawling, metropolitan college campus. Outside, you’re greeted by swaying palm trees and dancing rays of sunlight bouncing off huge glass windows. It is unmistakably Florida.

What happens inside is even more impressive!

For ten years the Lawton and Rhea Chiles Center for Healthy Mothers and Babies has been changing the lives of countless numbers of families across the state, and garnering the respect of maternal & child health experts across the U.S. and abroad.

The center has received more than $35 million in grants and contracts, starting with its first competitive federal grant in 1997 from the Health Resources Services Administration. It’s involved in numerous projects, applying what they learn through research and education to the delivery of service. The result is a constellation of programs that promote and protect the health of mothers, babies and families.

Dr. Charles Mahan, Dean Emeritus of the USF College of Public Health, with his grandchildren during the Sept. 17 reception for the Chiles Center 10 year anniversary.

As experts gather to mark a decade of service, Dr. Charles Mahan, Dean Emeritus of the USF College of Public Health and Lawton & Rhea Chiles Center for Healthy Mothers and Babies, announced his family’s gift of $1.8 million to the college of public health. It is the largest gift in the college’s history. “It’s a gift from my family, not just from me”, said Dr. Mahan. “We really want to pursue the idea of better outcomes for mothers and babies in Florida through better public health and better medical practice. So that will be the nature of the gift.” The Mahan family gift is eligible for matching funds from the Florida Legislature and, if matched, could total $3.6 million.

Dr. Donna Petersen, the college’s dean and a national maternal & child health expert said “Dr. Mahan has shared with us so many gifts over his many years affiliated with the University of South Florida College of Public Health. It is amazing to us that he would continue to give in order to ensure that mothers and babies and families can be healthy and strong and that USF can continue to contribute to the betterment of lives in communities throughout the world.”

This week, the center will be home-base for international experts here to share their stories, research and hopes during the Preterm Birth Summit. These Public Health professionals, scientists and physicians have ties to a broad range of countries, as well as American universities. They include faculty from Boston University and Yale. The international conference’s centerpiece lecture will be delivered on Sept. 18th by Enrique Gadow, MD, PhD, from Buenos Aires, Argentina. Dr. Gadow is the Head of the Dept. of Research and Chief of the Genetic Unit in the Dept. of Obstetrics and Gynecology, Center for Medical Education & Clinical Research in Buenos Aires.

Learning about what the Chiles Center does makes it easy to understand why they come.

As faculty from the USF College of Public Health prepared for two intense days of discovery, we visited with Marianna Tutwiler, MPA,MSW, a Program Director for the Chiles Center based out of Tallahassee. We asked her to talk about the three projects she and her team are involved in. It presents a small slice of the big picture folks at the Chiles Center are working on.

Refugee Health Status & Health Utilization Project:
Now in its second year, this program is looking at a way to track what medical care, if any, refugees are getting once they arrive. The Chiles Center tries to match refugees who received the required “overseas medical and mental health evaluations” prior to leaving their home countries to those refugees who received care once they arrived in the U.S. “The Department of Health pays for the domestic health screenings here”, notes Tutwiler, “but don’t have a process to keep track of any health treatment that may have been provided after that assessment.”

Refugee Eligibility Training & Technical Assistance:
This program began in the fall of 2000. The Chiles Center trains community based organizations and local government agencies to determine if an individual is, in fact, eligible for refugee services. Those services include English classes, Medicaid, and child care to facilitate employment for refugee parents. “What they were finding several years ago, is that legitimate refugees were not being provided services”, said Tutwiler. At the heart of the problem was refugee serving agencies’ lack of understanding all the immigration documents that a refugee or asylee could arrive with. “Our trainer presents all of the immigration documents to tell if an applicant for services is a refugee. Our trainer teaches ‘Here’s what you do, if you have a person who comes here with nothing’, said Tutwiler. “It gets kind of crazy because some of the documents get taken away from them at the border and, ironically, they’re the very papers they need to prove they are refugees. It’s not just a birth certificate. A lot of people run from their homes with nothing and come to the U.S. only with what they were given in the refugee camps.” To date, the Chiles Center has trained approximately 2,100 people. Among their points of pride is the help they bring to refugee children. Approximately 30 per cent of the refugees who arrive each year are children and may be eligible for health insurance offerred by Florida KidCare. The number of Florida refugee children potentially impacted by the Florida KidCare Training component since October 2006 is approximately 3,000 kids. That 3,000 represents arrivals only. “Yes, they are legal immigrants but they are still very frightened of government agencies”, said Tutwiler, who notes the fear is deeply rooted in bad experiences from their home countries.

“If we can go in and find where there are holes in the community, in the processes that are impeding a child’s access, we are greatly impacting the health of a community. The work that we do, even though it is seemingly removed from the front lines, can impact the system and ultimately impacts the family”, said Tutwiler.

Comprehensive Behavioral Health Assessment Evaluation:
This program began in August 2007 and focuses on children removed from their homes as a result of child abuse. The Chiles Center works closely with the Florida Dept. of Children and Families to see how federally mandated child assessments are used in determining temporary placement and final outcomes in these cases. In cases of child abuse, children under the age of three are required by federal mandate to receive a comprehensive behavioral assessment that includes physical, developmental, social emotional, and mental health evaluations. “When privatization occurred, community based agencies weren’t required to provide a great deal of data”, noted Ms. Tutwiler. The Chiles Center is tracking whether the assessments are used by judges when ordering specific services be administered to the child; are those services done; and whether the assessments are used to make temporary and permanent placement decisions. “One would hope it was being used for ALL of those things and should include interviews with the parents and caregivers”, said Ms. Tutwiler – her teams bringing common sense into a tangled system.

Five weeks into the Comprehensive Behavioral Health Assessment Evaluation program, Tutwiler’s teams are gearing up for in-depth community interviews and a review of case files in five regions of Florida. “There are approximately seven-thousand children under the age of 5 who have been removed from their home and currently living in other arrangements. So our evaluation could, ultimately, increase the number of those children who would receive appropriate assessments and provision of services to meet their physical, social, emotional or developmental needs”, she says.

Talking about kids and families comes easily to Tutwiler. It’s clear this is her calling, as well as her job. Asked what her favorite part of the job is, she finds herself at a loss for words. After a long pause, she laughs. “I really like the planning and the process-oriented type work. Oh that sounds so boring!” she laughs. “I like the kind of linear process – seeing the vision, where this is going.” Speaking to us from her office in Tallahassee, she concludes “I’m just going to do my best up here to continue to seek opportunities where the Chiles Center can continue to do this work.”

Story by Lissette Campos