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PHOTOCOPY PRESERVATION Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a publication. Publications have not been scanned in their entirety for the purpose of digitization. To see the full publication please search online or visit the Clinton Presidential Library's Research Room. 4/4 Reach ANNUAL SEPORT GANNETT Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a publication. Publications have not been scanned in their entirety for the purpose of digitization. To see the full publication please search online or visit the Clinton Presidential Library's Research Room. 4/4 URBAN WOMEN'S HEALTH AGENDA MAYOR'S TASK FORCE ON WOMEN'S HEALTH A Project of the Department of Health of the City of Chicago June, 1993 7561 TABLE OF CONTENTS Urban Women's Health Agenda pp. 1-11 Appendices National Women's Health Programs pp. 13-16 Sample Bibliography of Readings in Women's Health pp. 17-20 Members, Mayor's Task Force on Women's Health pp. 21-22 SENT BY 4- 2-94 ; 1:19PM ; OFFICE OF THE MAYOR- COMM/RESEARCH: 2/ 3 4/4 WOMEN'S BUSINESS DEVELOPMENT CENTER KEDY M. BATHER Co-Director, Women's Business Development Center, advocate of women's economic development issues, providing management, marketing and financial assistance to wamen owned businesses since 1985. President, Chicago Institute for Economic Development since 1980 providing employment and economic development programs and services. President, Hedy H. Ratner and Associates, à public affairs, public relations, resource and management consulting firm since 1984. Former Executive Director, Chicago Film and Video studio Foundation working to promote film and video in Chicago and Illinois; Assistant Commissioner of Education, Department of Education in Washington D.C.; Assistant Superintendent of Cook County Schools; teacher and librarian. Co-Chair, Mayor's Women's Health Task Force. Member, Chicago Network; Chicago Finance Exchange; Capital Circle; Women's Issues Network; City Treasurer's Small Business and Banking Advisory committee; Affirmative Action Advisory council or the Metropolitan Water Reclamation District and Metropolitan Pair and Exposition Authority; Founding Board Member, Alliance for Economic Development and Alliance of Minority and Female Contractors Association since 1988; Coordinator, Illinois Women's Economic Development Summit; fiscal/agent, Illinois State Treasurer's Women's Finance Initiative; Awards: U.S. SBA 1988 Advocate of the Year; 1993 Entrepreneur of the Year by Ernst & Young and Merrill Lynoh, Business and Professional Women 1993 Annual Corporate Award; 1989 Female Entrepreneur of the Year Award; 1993 Economic Development Council, Special Award. President Emeritus and Founder, Women in Film/Chioage in 1984; formerly board member of Steppenwolf Theatre, Illinois Arts Alliance, WBKZ Radio, Facets Multimodia, Chicago Cable Access Corporation, Academy for the Performing and Visual Arts. Education: Graduate degrees from DePaul University, University of Chicago and CAROL DOUGAL, DIRECTOR HEDY RATNER, DIRECTOR # SOUTH MICHIGAN, SUITE 400 CHICAGO, ILLINOIS 60603 (312) 853-3477 FAX (312) 853-0145 SENT BY: 4- 2-94 ; 1:20PM ; OFFICE OF THE MAYOR- COMM/RESEARCH: # 3/3 This project has been a collaboration which included with my long time friend and colleague, Rebecca give, whose firm, The Give Group led the strategic development of the idea and execution of the Urban Women's Health Agenda. SENT BY: 3-29-94 : 7:01PM ; OFFICE OF THE MAYOR- 912024562317;# 1/20 City of Chicago Richard M. Daley. Mayor care Office of the Mayor Cin Hall, Room 507 MORTHS 4Th 121 North LaSalle Street Chicago. Illinois 60602 (312) 744-3300 FAX COVER SHEET DATE: March 29, 1994 SENDER NAME: Kathleen Hett SENDER FAX #: 312/744-2769 SENDER DIRECT PHONE #: 312 / 744 - 7256 TO: Patty Solis -White House Scheduling/Advance RECEIVING FAX #: 202/456-2317 RECEIVING DIRECT PHONE #: 202/456-7560 COMMENTS/INSTRUCTIONS: Here is some additional background information on the Infant Welfare Society, one of the two potential sites for Monday's visit. I'll contact you tomorrow to discuss Further details. K. THIS TELECOPY MESSAGE CONTAINS 20 PAGES INCLUDING COVER SHEET. IF YOU DO NOT RECEIVE ALL PAGES. CALL IMMEDIATELY. SENT BY: 3-29-94 ; 7:01PM ; OFFICE OF THE MAYOR- 912024562317:# 2/20 Infant Welfare Society of Chicago Officers Landa K. Meterdiecks Pressient Mrs. George I. Hilder March 29, 1994 Vice President Ca-Chairman Development Jerry Kalov Vice President Ce Chairman Development Ms. Kathleen Hett Nathan P. Einier Vice President Chairman Services Brenda K. Sollitt Public Relations Office- Mayor's Scheduling office City of Chicago Vice President Chairman Benefits 121 North LaSalle Street David 1. Doerge Suite 406 Vine President Chairman Investments Suzanne Murin Chicago, Illinois 60602 4th 649 Vice President Chairman Board Decreipment Cynthia Armour Dear Ms. Hett: jabo Treasurer Chairman Pinance Rody P. Biggert Secretary I was very pleased to learn that the Infant Welfare Society of Chicago is one Chairman Personnel Morrist Weeden of the agencies being considered for a site visit by Hillary Rodham Clinton Assistant Treasurer during her forthcoming trip to Chicago. We are proud of the quality services Gail Mitchell Assistant Secretary we are able to provide to our city's medically indigent families, and are Directors confident that our clinic would be a most appropriate site for any public Mrs. Daniel Bowman Mrs. David Brikema discussion of health care reform, for the following reasons. Landa Celesia Bryan (. Cressey Muller Davis Infant Welfare is representative of free standing, community-based Gregory A. DeFelice Alison B. Deniston facilities, experienced in serving individuals with limited access to basic health Aida 1.. Giachello, Ph.D. Mrs. John 1. Gmiteo care. Such primary care clinics will be central to any plan for universal health Judith E. Hicks Carol B. Holmes services. Sandan M. House l'iniothy B. Johnson Fdward Kennedy Ryan A. Kelin Infant Welfare provides care to a low-income and primarily minority William 1. Lawlor. 111 Kristin V. Mackae population (85 percent Hispanic). Our patient families are the "working poor" Mrs. James M. McMullan Dolores Moncada who are without insurance or public aid coverage, a primary target group in Toweph D. Morates any health reform plan. Norman II. Olsen, D.D.S. Herbert F. Philipaborn Jr., M.D. Michael Rosenbaum Mary Jane Scheel The majority of our direct service staff is bicultural and bilingual in Allen R. Signal Jones 11 Stacke Spanish, which facilitates responsive and efficient care. John Sollivan Pamels Tothot Mrs. Louis 1. Thomas, Jr. tohn 1. Willudm, M.D., MPH Infant Welfare's focus is on comprehensive and preventive services, which Rachel Wille Call S. Wolft enables us to provide more effective care with fewer resources, and decrease Robert A. Woods the need for more expensive and difficult to provide treatment. Honorary Directors Vernon Arrocur Stewarth Dison Infant Welfare recently renovated and expanded its clinic facility in order Mrs. Paul Harvey Hartley C. Laycock. Ir. to increase services. The clinic is physically attractive and would provide an Mrs Robert IT. McDougal, Iv. effective backdrop to any public discussion led by Mrs. Clinton, and present Andrew M. Nally, III Mor Conway 11. Olmated a compelling visual picture of hands-on medical care. Irving Seamon, Jr. John W. Stimpson John l'. Volkman Charles S. Winston Executive Director Frances Cinthes, R.N., M.B.A. 1931 North Halated Street Chicago, Illinois 60614 312.751.2800 Fax 312. 751.8804 SENT BY: 3-29-94 ; 7:01PM ; OFFICE OF THE MAYOR- 912024562317:# 3/20 Infant Welfare has more than an 80 year history and reputation of providing quality health care in Chicago to changing populations of poor immigrant women and children - and accomplishing this in a responsive and cost-effective manner. At the same time, Infant Welfare has a vision for the future which focuses on making care accessible to all families who want to keep their children healthy. We feel certain that a site visit at the Infant Welfare Society clinic could portray a dramatic argument for the best of universal comprehensive and preventive care, and benefit all concerned. I hope that the attached materials will convey that potential to you, and that you may be willing to advocate for Infant Welfare as the site for Mrs. Clinton's visit. In the interim, I would be happy to answer any questions you may have, and invite you to visit our clinic to meet our patients and staff and see our services firsthand. Thank you for your consideration and interest. We look forward to hearing from you. Sincerely yours, Phyllis Kinneak Phyllis Kinnerk Development Director SENT BY: 3-29-94 : 7:02PM ; OFFICE OF THE MAYOR- 912024562317:# 4/20 Infant Welfare Society of Chicago OUR MISSION is "10 provide services for the healthy physical and mental development of disadvantaged children to give them a founda- rion for a future productive and wholesome life." OUR HISTORY began in 1911 when the infant Welfare Society was established to reduce the spiraling infant mortality rate. Milk dispensing stations were established 111 low-income areas and medical services for children and their mothers were added. In 1925. Infant Welfare was the first medically oriented agency to add a mental health component. Neighborhood stations were consolidated and the present facility was opened in 1970 to deliver expanded services more efficiently. In 1989. Infant Welfare received the Johnson & Johnson Community Health Care Award, a national award recognizing exemplary projects which help the medically underserved to obtain care. In 1992. the clinic was renovated and expanded to increase services. OUR SERVICES include medical. dental and mental health care for women and children. Clinics are open six days and four evenings each week and serve more than 13,000 poor minority children and their mothers. Last year, approximately 74,000 health service visits and counseling sessions were provided. A Pediatric Medical Clinic provides 15.500 treatment and preventive visits 10 children from birth to eighteen. including screening, immunizations. sick care and medication. Special pediatric services include :1 lead poisoning prevention program. pedintric cardiology and ophthalmology evaluations. an asthma clinic, audiovisual screening. and participation in a research program to inoculate infants against leading causes of meningitis using a new vaccine. one of which is now recommended as standard by the American Academy of Pediatrics. A Pediatric Dental Clinic provides 14,000 preventive and restorative services and orthodontic treatment to children from six months to 20 years ofage. For many emergency patients it is the first time they have seen a dentist. In addition. Infunt Welfare treats teens through a special dental session funded as part of the Youth Options Unlimited program. A Teen Clinic meets the increasing needs of more than 700 adolescent boys and girls for medical care. health information, education and counseling in weekly after-school sessions. An Obstetric/Gynecology Clinic. in affiliation with Illinois Masonic Medical Center. provides prenatal and post-partum care, family planning, well-woman gynecological care. health education, and child development and parenting information through 7.500 visits annually to low-income women. Health educators provide parents with vital information on community services. home safety, poison prevention. literacy, immuni- zations and child development in the patient waiting area four times duily. A Cood Start Program sends a health educator to the homes of isolated pregnant women and new mothers to instruct them about health care. nutrition and breastfeeding to insure their children's healthy development. \ Laboratory provides 32.000 diagnostic services annually, including tests for pregnancy. lead poisoning, parasitism. tuberculosis and sexually transmitted diseases. A Home Visiting Program provides bilingual mental health therapists who counsel emotionally troubled young children and their families in their own homes. make referrals and act as advocates for the families. A Clinic-based counselor assists patients with their critical social, emotional and practical needs through short-term counseling, crisis intervention and referrals. Ancillary services include preschool Interacy and learning-through-play programs. educational and enrichment projects for both parents and children. a resule shop. and practical help through a food pantry and children's clothing and equipment distribution. SENT BY: 3-29-94 ; 7:02PM ; OFFICE OF THE MAYOR- 912024562317;# 5/20 COSI EFFICIENCY is demonstrated by Infant Welfare's low inflation rate for the cost of service visits compared to national averages. While national medical costs have increased an average of 108 percent over each of the last four years, Infant Welfare's costs have compounded just 3.2 percent annually. Clinic visits include medical and dental treatment. immunizations. laboratory tests, medication, social work services. education and prevention services. FEES FOR SERVICES are on a sliding scale according to patients' incomes. Medications are provided free or III a substantially reduced cost. No one is denied care because of inability to pay. OUR PATIENTS are the "working poor" and medically indigent women and children in the Chicago area's underserved communities. Most have no Public Aid or insurance coverage and the average income of our patients is significantly below the federal poverty level. More than 80 percent of the patients are Hispanic, 10 percent are African-American. and 10 percent are Caucasian. Asian or Native American. OUR BOARD OF DIRECTORS is composed of forty-three members committed to the agency mission. Full Board meetings are held every other month: committees meet in alternate months to formulate policy and accomplish planning and development goals. THE AUXILIARY, composed of 31 chapters and more than 1.500 volunteers. provides generous financial support and numerous diverse voluntary services. FINANCIAL SUPPORT comes from various sources including fees and grants (19.2 percent). individuals including the Anxiliary (29.9 percent). United Way (10.3 percent). investment income 17.4 percent) and other sources (3.2 percent). Significant grants for special programs and campaigns have been received through the Healthy Moms/Healthy Kids and Healthy Start programs. and from the Acina Foundation. The Chicago Community Trust. The Field Foundation of Illinois, the Lloyd A. Fry Foundation, Children's Cure Foundation. the Robert R. McCormick Tribune Foundation. the Polk Brothers Foundation. the Dr. Scholl Foundation and the Washington Square Health Foundation. WE SEEK HELP to respond to the increasing needs of our high-risk population for the following reasons: In our target areas. the infant mortality rate is higher than in some Third World countries. Hispanic women in Chicago are three times more likely than other groups to receive no prenatal care which contributes to infant deaths, birth detects and illness. A SI investment in prenatal care can save $3.38 in cost of care for kiw birthweight infunts, and $2 for care in their first year of life. Need for ambulatory care exceeds Chicago's current capacity by more than 2 million visits each year. One-third of the uninsured in Illinois are children Forty percent of Chicago's Hispanic population is without health insurance. Twenty percent of the children we serve suffer from irun deficiency anemia. Fifty percent of children sereened have toxic levels of lead in their blood. Many of these conditions can be treated III an early stage, thus preventing more scrious. painful and expensive-to-treat illnesses. Additional information can be obtained from the Executive Director The Infant Welfare Society of Chicago 1931 North Halsted Chicago, Illinois 60614 312-751-2800 Fax 312-751-8804 SENT BY: 3-29-94 ; 7:02PM ; OFFICE OF THE MAYOR- 912024562317:# 6/20 RESPONDING For 82 years. the Infant Welfare Society of Chicago has worked to combat infant mortality and help children grow healthy and TO THE strong. We are meeting this challenge today by: CHALLENGES administering preventive health care toour patients--Chicago's working poor OF 1993 keeping patient fees at a minimum--the average visit remains $5.00. even though health care costs continue to escalate educating our parents and children individually and through new health education sessions four times a day affiliating with a major teaching hospital to improve and enhance continuity of care for expectant mothers and their newborns registering all newborn babies and pregnant women who seek health care extending clinic hours to six days and four evenings per week PROTECHAME establishing a new appointment system to decrease waiting time and to increase patient volume and flow implementing a new literacy program to help foster academic success establishing the patient council to encourage patients' input in clinic issues These quality health services and educational activities con- tinue to be made possible through the generosity and support of individuals and organizations who recognize the importance of keeping children healthy. We have been able to provide additional resources by keeping administrative costs at a minimum. priori- For more information contact: tizing our spending and utilizing the volunteer services of the Auxiliary and the community. Frances Ginther, R.N., M.B.A. However, so much more needs to be done. Executive Director The Infant Welfare Society of Chicago 1931 N. Halsted Chicago, IL 60614 312-751-2800 Patients muv now register in on expedient manner due to our computerized/networked medical records department. SENT BY: 3-29-94 ; 7:03PM ; OFFICE OF THE MAYOR- 912024562317;# 7/20 It's hard to say "no" to working poor families who want to keep their children healthy. The national spotlight on health care AN' TC PA NG reform recently has drawn attention to the critical shortage of services for families who can't afford private medical care and are THE without Insurance or public aid coverage. Eventually. govern- ment plans might finally address the problem. but at Infant CHALLENGES Welfare we know that too many children need help right now. For more than 80 years, Infant Welfare has made essential OF CHANGE medical services accessible to Chicago's most vulnerable chil- dren. Last year. we increased pediatric services by 27.4 percent: however, we are still forced to turn away 20 children each day because our incoming resources cannot keep pace with the increasing demand for services. We anticipate that the system of health care delivery in our country will undergo changes. and we believe that Infant Welfare's model of preventive. community-based health services will be the prototype in proposed managed care systems. To position our- selves to provide optimal service, we recently renovated our clinic to give us the capacity to expand services in the most cost- efficient way; we have formed alliances with other health care and service providers: we are collaborating with health education and research projects: and we have qualified for government pro- grams to bencfit our patients. As always. we will seek to assume vance new leadership in the health care system of the future. and to Lindu Meterdierks. Board president provide even more services to children in need. for the 1993 - 1994 term I hope that you will join Infant Welfare as we anticipate the challenges of change and that you will support us now so we can continue to make health services available to today's indigent children and their mothers. Our patients still need your help. I am pleased to share our annual report with you and I invite you to visit our clinic. meet our patients and join our family of caring. Linda K. Meierdierks Board President our patients still need your help. - SENT BY: 3-29-94 ; 7:03PM ; OFFICE OF THE MAYOR- 912024562317;# 8/20 SERVICE 73,585 total patient visits were provided in FY 1993, an increase of 13 percent over last year. including: ACHIEVEMENTS 32,885 laboratory tests 15,415 pediatric visits 12.392 pediatric dental visits 7,899 gynecological and obstetrical visits 8.000 immunizations 4.174 home visiting/social work service hours 4.000 pediatric annual physicals HOTOGRAPH DAN EXCHMEIER 200 ophthalmology visits 820 teen clinic visits 92 cardiology visits "To provide services for the healthy physical and mental develop- ment of disadvantaged children to give them a foundation for a future productive and whole- some life." MY NAN MMMMMMMM More than 80 percent of our patients completed their immunizations on schedule. Vel only 29 percent of Chicago's inner-city children aged two were immunized at all. SENT BY: 3-29-94 ; 7:03PM ; OFFICE OF THE MAYOR- 912024562317;# 9/20 The Infant Welfare Society is NEW pleased to announce the appoint- ment of Frances Ginther, R.N.. EXECUTIVE M.B.A., as our new Executive Director. DIRECTOR Ms. Ginther comes to us from the Chicago Department of APPOINTED Health where she was employed for more than 15 years. most recently as the Administrative Director of Health Regulations. Ms. Ginther received her master's of business administra- Frances Ginther. R.N., M.B.A. Executive Director tion from DePaul University af- ter completing nursing and edu- cation degrees at both Indiana University and St. Mary-of-the-Woods College. "I have been involved with women's and children's health care all of my professional life. and I am excited to be connected with an organization that I've admired from afar for many years." says Ms. Ginther. In addition to 20 years of wide-ranging experience in public and private health service administration. Ms. Ginther has served on many boards. including the Chicago Abused Women's Coalition--Greenhouse Shelter. the Food Justice Programs. Illinois Caucus on Teenage Pregnancy and March of Dimes Nursing Task Force. "My major goal as executive director, with the support of the Auxiliary, board and staff, is to develop a team to enable the organization to reach its full potential." TABLE OF CONTENTS A Celebration of Progress The Year in Review: Pediatric Clinic 4 PediatricDental Clinic 6 Gynecology/Obstetric Clinic 7 Halsted Street HealthStop 8 Laboratory 9 Health Education 10 Family Services 11 Ryan'sRoom 12 Maintaining the Momentum The Auxiliary's Role 13 The Board of Directors 15 Financial Summary 16 Our Generous Contributors 18 PROTOGRAPH DAN EXCLUDING SENT BY: 3-29-94 ; 7:04PM ; OFFICE OF THE MAYOR- 912024562317:#10/20 PEDIATRIC The infant mortality rate in the Chicago area is higher than in many Third World countries. One third of the uninsured in Illinois CLINIC are children and in 1992. only 29 percent of Chicago's inner-city children age two and under received their full sct of immunizations. The Infant Welfare Society pediatric clinic is doing its utmost to help as many of these children as possible by providing compre- hensive health care. Currently. all children under one year of age who seek health care at Infant Welfare receive it. But many of their brothers and sisters are among the 20 children we must turn away each day. Our medical staff treats approximately 75 children per day. We are pleased that we are also able to offer these children special services that many others take for granted. The ophthalmology clinic operates on a biweekly basis. Eye- glasses are subsidized by the Auxiliary. The pediatric clinic participates in a vaccine study with Children's Memorial Hospital. Each Tuesday, eight to 12 patients are immunized against pneumococcus. a leading cause of child- hood meningitis. Kk IMEIGN Note HAVE 10 A new asthma program was initiated focusing on prevention. Affected children are transitioned from oral medication and. along with their parents. instructed in the use of inhalers to prevent and control the severity of attacks. One-on-one instruction and monthly group sessions provide information that will help them lead a normal life and keep them our of the emergency room. A cardiologist sces approxi- mately seven patients at each bi- weekly session of the cardiology clinic. Developmental screening, in collaboration with Illinois Ma- sonic Medical Center. is offered by a speech therapist. developmen- tal psychologist and social work- NO $2 INTEREST ers bimonthly to identify children in need of intervention. Dr. Michael Dantzer. pediatrician, says. "Sav aaah. as he examines a young girl. SENT BY: 3-29-94 ; 7:04PM ; OFFICE OF THE MAYOR- Hearing screening is 912024562317:#11/20 provided for children three to five years of age during three weekly sessions. The pediatric clinic is cur- rently staffed by two full- time pediatricians. one pe- diatric nurse practitioner. five nurses, one nurse's aide and one health educator. Contractual doctors and nurses complement the full- MISTORAPH BY UNN RECHMEND Malka Marcell. R.N., obtains time staff. However. more information from " patient. medical staff would allow us to care for the many children who lack health care. The medical needs of the working poor are vastly different from lose of middle-income families. For example. lead poisoning. a rtually non-existent condition in most middle-income neighbor- bods. is a problem that affects many Infant Welfare children. lore than half of the young patients tested for lead poisoning equired intervention. Challenges: serve the 15 to 20 children we are forced to turn awayeach day by funding an additional full-time doctor or nurse PROTOGRAPH NY IMM practitioner and support staff Lead poisoning counseling is provide group education during evening and Saturday provided for 45 to 50 patients per hours by funding a second clinic-based health educator week. They are treated with iron supplements and those who require reduce the five month waiting time for cardiology screen- hospital care are usually referred 10 ing by providing a third cardiology session per month Cook County Hospital. provide a nutrition clinic to address the problem of obesity Medical Director Carl Toren M.D., M.P.H., performs an unnual physical on a little hav while mother and sister look on. SENT BY: 3-29-94 : 7:05PM ; OFFICE OF THE MAYOR- 912024562317;#12/20 PEDIATRIC The pediatric dental clinic is one of the few full-service dental clinics DENTAL in the city that offers affordable care to poor children. It provides approximately 1,200 visits per month to children aged six months CLINIC to 20 years and is open six days and three nights per week. Currently, at least 10 patients per week are being transitioned from the 700-child waiting list to receive services in our facility. Services include preventive dentistry--teeth cleaning and fluo- ride treatments, x-rays. oral health education, sealants (plastic coatings for the back teeth): restorations--fillings, crowns and some partial dentures: endodontics--root canal treatment for baby and permanent teeth: periodontics--scaling-root planing and minor periodontic surgeries: orthodontics--full braces "or retainers to straighten or prevent crowding of teeth: and minor oral surgeries. Twice a month an orthodontist treats patients with malocclu- sions that can be corrected by braces. Educational classes are also provided to patients and parents by the health educator and the dental staff. Parents are encouraged to bring babies as young as six months of age to the clinic so the staff may educate the parents on how to prevent Baby Bottle Syndrome and other dental problems. The Infant Welfare Dental Mr Dr. Ghassan Souri. the dental director. Clinic was one of the first clin- astructs a teenage dental patient. ics to comply with the federal OSHA sterilization require- ments for infection control. Additional instruments were needed to allow each patient to have an individual steril- ized package of instruments. A new x-ray machine and pro- cessor were purchased as part of the on-going replacement of dental equipment necessitated by heavy patient use. The staff is composed of three full-time and three part- PHOTOGRAPH (a) IMM A mother is instructed by Luisa Martinez time dentists. a hygienist. five dental assistant. about oral hygienerfor full-time dental assistants. a her haby. dental office manager and one part-time and two full-time dental clerks. Staff attend regularly scheduled seminars to keep skills current. Challenges: eliminate the waiting list by hiring an additional hygien- Dr. Pawlowski. an orthodontist, with ist and support staff Dolores Zumarron. dental assistant, examines u young patient, complete furnishing and hire staff for the sixth dental station SENT BY: 3-29-94 ; 7:05PM ; OFFICE OF THE MAYOR- 912024562317#13/20 HALSTED Should I work full-time or stay in school? What kind of future do I have? Why doesn't anyone understand me? STREET These questions and more run through minds of teenagers every day, often creating numerous pressures and concerns for HEALTH this age group. The Halsted Street Health Stop, our teen clinic. helps teenagers deal with these and other problems. as well as STOP provides basic health services. The teen clinic operates every Wednesday evening. Up to 22 patients. ages 13 to 19. are seen in each session for medical services. including physical exams, laboratory testing, medication and information on fitness and exercise. Group and individual counseling are also available to teens on such topics as sexually transmitted diseases. alcohol/drug/ tobacco abuse and gang violence. Often teens need someone other than a family member to talk to about problems. and the teen clinic guarantees confidentiality. Our bilingual staff offers advice or refers teens to an appropriate community agency for specific needs. Infant Welfare has a program of weekly health education and group discussion sessions focusing on prevention of AIDS and related problems such as sexually transmitted diseases; sub- stance abuse. pregnancy and sexual violence. More than 85 INSTITUAL ITY RHAHOR NEW percent of our teenage patient population is Hispanic. residing in inner-city neighborhoods with high incidences of AIDS/HIV infec- tion. The Adolescent Risk-Reducing Methods Against AIDS pro- gram will provide one male and one female bilingual health educator to facilitate gender specific classes and provide indi- vidual referrals and counseling to adolescents. Infant Welfare is a member of the Youth Options Unlimited (YOU) collaborative. which offers a wide range of programs to adolescents in the West Town community through 10 neighbor- hood service agencies. As part of the project. Infant Welfare now provides approximately five YOU teens with dental care at each weekly teen dental session. Health education sessions. conducted by a YOU health educator and geared specifically for adolescents, are also available for teens through the YOU project. Challenges: increase outreach for our AIDS Risk Reduction and other teen programs educate and encourage teens to utilize YOU programs such as tutoring, drama and career planning classes to further enrich their lives SENT BY: 3-29-94 ; 7:05PM ; OFFICE OF THE MAYOR- he gynecology clinic initiated major service improvements trus ast fiscal year. The clinic was approved as a site for the new GYNECOLOGY/ 912024562317:#14/20 ealthy Moms/Healthy Kids program in January 1993 and now as an affiliation with Illinois Masonic Medical Center, which OBSTETRIC ent into effect May 1. 1993. CLINIC Healthy Moms/Healthy Kids. a managed care program. is a ollaborative effort between the Illinois Department of Public Aid nd the Illinois Department of Public Health. It was implemented ) provide comprehensive care for pregnant women and children nd help them become responsible users of medical services. Under this initiative. equipment such as beepers and an inswering service were acquired to provide patients with 24-hour medical advice. They can dial the on-call doctor or nurse practi- loner whenever they have a question regarding an illness rather han resort to a hospital emergency room. The affiliation with the Illinois Masonic Medical Center facili- ates an improvement in continuity of care for the pregnant voman and her newborn. In the past, the obstetric clinic provided prenatal care but patients would deliver their babies at different hospitals and mother and baby were not seen by an Infant Welfare loctor until six weeks alter the birth. Mothers now can see the same provider throughout the pregnancy and deliv- PHOTOGRAPH M DAR NUMBERSKR ery. and. because Infant Welfare pediatricians have staff privileges at Illinois Masonic, the infant can be examined by the pediatri- clan shortly after birth. The patient receives compre- hensive care with continu- ity from prenatal through delivery and follow-up care. Two board certified ob- stetricians, two bilingual BIRTHING certified nurse midwives S. Aizenstein, M.D., a board certified physician. examines an obstetrical patient. and an OB/GYN nurse practitioner from Illinois Masonic currently staff the obstetric/gynecology clinic at Infant Welfare. Family planning. prenatal. postpartum and gynecologi- cal care are provided five days per week. Pregnant women also have the option to give birth at Illinois Masonic in the Alternative Birthing Center. Challenges: expand hours to provide care six days per week secure funding to facilitate childbirth education classes for pregnant women and their husbands SENT BY: 3-29-94 ; 7:06PM ; OFFICE OF THE MAYOR- 912024562317:#15/20 Approximately 70 percent of laboratory tests are done at Infant LABORATORY Welfare at no cost to the patient. Blood counts, hemoglobin levels. urine analyses. as well as throat and urine cultures are all available for in-house testing. Doctors and nurses can get the results promptly. saving time and assisting them in reaching a diagnosis. The pediatric clinic is responsible for 60 percent of the tests. with the remainder of the tests being generated by the gynecology/obstetric clinic. Tests not performed at Infant Welfare are sent out to either the Chicago Department of Health or a private laboratory. Tests for sexually transmitted diseases, prenatal screening, lead levels and sickle cell anemia screening are examples of the kind of support received from the Department of Health. Other tests- hepatitis. blood chemistries. thyroid studies. infertility studies- are done at a private laboratory for a relatively low cost. For both of these outside labs. the specimens are collected at Infant Welfare and the results returned. so the patients never need to go elsewhere for service. A second full-time lab technician was added in May 1993 to help run the increasing number of tests. Lead testing in particular has greatly increased because of new recommenda- tions by the American Academy of Pediatrics to begin testing at six months of age rather than fifteen months. Furthermore. the E BAR cut-off level considered to be damaging to a child's intellect was Hemunt Nanavaty supervises the lowered from 25 to 10 micrograms of lead per deciliter. resulting laboratory. in the need for intervention in more than half of the children tested. Each of these children requires follow-up testing at regular intervals. A computer has been added and will be networked into the patient registry. Lab results will then be quickly accessible and abnormal results will trigger a response by the staff to contact the patient. Challenges: secure funding to facilitate computer networking secure funding for enrollment in proficiency testing programs Solomom Nigusse. laboratory technician, collects " blood sample from un obstetrical patient. SENT BY: 3-29-94 ; 7:06PM ; OFFICE OF THE MAYOR- 912024562317:#16720 HEALTH Education is a key to preventive health care. All clinic staff educate patients. However. in the past, the scope was limited to one-on-one EDUCATION teaching. We now have health educators, one clinic-based and ones who visits the home. who inform patients about various medical and social issues. CLINIC-BASED HEALTH EDUCATOR In April 1993. a new clinic-based health education program was implemented which allows Infant Welfare parents to learn together Parents who bring their children in for a checkup are engaged in half-hour sessions on topics such as poison control, immuniza- tions. nutrition, dental care and child discipline. The Infant Welfare health educator leads the discussion using visual aids, videotapes and printed materials. Parents are able to share experiences and ask questions and the handouts allow them to refer back to or read information they may have missed during the presentation. Patients are scheduled according to their age* group SO that parents of same-age children may share similar concerns and experiences. Outside speakers are also brought in to inform parents on other relevant topics such as car seat safety, employment. fire prevention and literacy. Miriam Ramirez, the clinic-based health educator. presents u workshop in the Challenges: putient waiting area. hire a second clinic-based health educator to teach evening and Saturday sessions secure funding to create a resource library and handbook HOME-VISITING HEALTH EDUCATOR The home-visiting health educator visits 12 to 15 pregnant women each week who are referred by the prenatal clinic staff The health educator provides childbirth information, nutrition and parenting classes during the four to six visits before the patientz gives birth. and post-partum, newborn care and breast-feeding support during four-to-six visits after the babies' births. She is one call 24 hours per day, seven days a week, and attends many of the births, especially when mothers have no family support. The childbirth education classes are a requirement for women who choose to have their babies in the Alternative Birthing Center at Illinois Masonic Medical Center. Challenges: implement childbirth education classes in the clinic facilitated by a trained childbirth educator parenting education to encourage more mothers to breast feed their babies to ensure better nutrition Amy Currin, the home-visiting health educator, talks with a patient about her SENT BY: 3-29-94 ; 7:07PM ; OFFICE OF THE MAYOR- 912024562317;#17/20 The stresses of a new environment. a foreign culture and no FAMILY familiar faces can take its toll on a family. The Family Services Program of Infant Welfare helps families manage these stresses SERVICES which are often complicated by the demands of raising children in a fast-paced, sometimes threatening, inner-city environment. This department provides an array of services that comple- ment Infant Welfare's medical and dental programs and contrib- ute to its comprehensive approach to health care. The part-time. clinic-based counselor provides evaluations. crisis intervention and referrals to specialized providers in addition to the 895 hours of short-term counseling she provides per year. Approximately 50 percent of her counseling cases need to be referred to specialists in marital or family therapy, or for the treatment of alcoholism or sexual or physical abuse. Some families require more intense counseling and support services and these cases are referred to our Home Visiting Program. Three mental health workers provide more than 2,800 hours of counseling and cducational sessions per year regarding child development and practical parenting methods. They also assist families in resolving crises, connecting them with needed resources and enabling them to advocate for themselves. There is always a waiting list for these services and trained professionals fluent in Spanish are not readily available. Patients have developed a level of trust with Infant Welfare which enables MOTHER - them to accept mental health services here that they may not Director Tina Kalowski. L.C.S.W.. and accept from other qualified professionals. mental health workers prepare to The family services department is currently staffed by one counsel patients in the clinic and in licensed clinical social worker. three mental health home visitors their homes. and one part-time. clinic-based counselor. Challenges: initiate marriage and family therapy provided by a professional trained in the treatment of substance abuse and trauma provide preventive family life education services to families before they require more intensive services Clinic-based counselor, Carmen Alicea, talks with a family. PHOTOGRAPH BY SHAMIN MORWICH SENT BY: 3-29-94 ; 7:07PM ; OFFICE OF THE MAYOR- 912024562317:#18/20 RYAN'S Children waiting for their appointments are introduced to games. books and puzzics which may not be available to them at home ROOM Ryan's Room allows children to engage in educational activities and gives parents the opportunity to learn how to play with their children. A full-time. bilingual child development coordinator organizes the children in age-appropriate activities and crafi projects. Children enjoy coloring or making crafts. playing board games and putting together puzzles while waiting for appointments. Mos' activities emphasize hand-eye coordination and imagination. Par ents are encouraged to interact with their children and instructed how to do similar projects at home. Because many of the boys and girls are recent immigrants. the often do not have much social contact with children their age Many children arrive at Ryan's Room shy and withdrawn. How ever. when brought together. they begin to socialize. With approximately 30 children of varying ages in Ryan's Roon at one time and only one coordinator. it is a challenge to organize activities for their different educational levels: volunteers are always needed. As part of a bilingual literacy program. books would not only be read in Ryan's Room, but given to children to take home to encourage parents to read to their children. Bilingual books wouk help the children more easily associate the English equivalent with their Spanish vocabulary. Ryan's Room allows children to learn and grow both intellectu ally and socially while waiting for siblings' or their own appoint ments. Challenges: implement a bilingual literacy program expand volunteer participation - AMAIN Hundlined SENT BY: 3-29-94 ; 7:07PM ; OFFICE OF THE MAYOR- 912024562317:#19/20 INANCIAL ) UMMARY STATEMENT OF OPERATING FUND, REVENUE, EXPENSES AND CHANGES IN FUND BALANCES OPERATING FUND For the years ended June 30 PUBLIC SUPPORT AND REVENUES 1993 1992 Public Support Contributions $77,233 $99,193 Contributions/Auxiliary 1,006,745 989,427 United Wuy of Metropolitan Chicago 234.028 241,290 Total Public Support 1,318,006 1,329.910 Revenue Fees and grants 1,117,293 756.173 Sale of medical supplies to the public 23,209 28,656 Investment income 169,067 196,036 Miscellaneous 49,339 36,929 Total Revenues 1,358,908 1,017,794 Total Public Support and Revenues 2,676,914 2.347,704 OPERATING FUND For the years ended June 30 EXPENSES 1993 1992 Program Services Home Visiting 226,402 238,337 Pediatric Clinic 656.954 544,950 Gynecology Clinic 469,181 433,409 Dental Clinic 555,264 470,248 Laboratory 110,057 97.948 Total Progrum Services 2,017,858 1,784,892 Supporting Services Management and General 309,666 309,828 Fund raising 131,436 122,750 Auxiliary 320,814 404,472 Total Supporting Services 761,916 837,050 Total Expenses 2,779,774 2,621,942 Excess of Public Support and Revenue over Expenses (102,860) (274,238) Other Changes in Fund Balance 217,796 (64,693) Fund Balances, Beginning of Year 193,929 532,860 Fund Balances (Deficit), End of Year 308,865 193,929 SENT BY: 3-29-94 ; 7:08PM ; OFFICE OF THE MAYOR- 912024562317:#20/20 June 30 Ju 30 all ASSETS 1993 1992 Cash $527.986 & $684,606 Accounts Receivable 52.565 102.739 Prepaid Expenses 1,714 2,648 6. Investments 3,736.162 3.587.278 Property and Equipment Land 115,000 115.000 - Bullding and Improvements 2,042,714 1,986.257 Furniture and Equipment 210.477 261,661 Construction in progress 0 0 Less accumulated depreciation (1,022,262) (976,225) Property and Equipment - 1,345,929 1,386,693 Total Assets 5,664,356 5,763,964 June 30 June 30 # LIABILITIES AND FUND BALANCE 1993 1992 - : : Liabilities Accounts payable and accrued expenses $195,900 286,199 Deferred revenue 104,285 181,899 Total Liabilities 300,185 468,098 Fund Balances Operating Unrestricted (177,331) (105,531) Restricted 5,093 5.324 Auxiliary 481.103 294,136 Board designated investment 2,964.906 3,042,780 Property 1,266,159 1,255,152 Endowment 824,241 804,005 Total Fund Balances 5,364,171 5,295.866 Total Liabilities and Fund Balances 5,664,356 5,763,964 EXPENSE SUMMARY INCOME SUMMARY Personnel 70.3% Fees and Grants 49.2% Supplies 6.5 Individuals including Auxiliary (net) 29.9 Insurance 4.1 United Way 10.3 Outside Services 4.1 Investment Income 7.4 Utilities 2.1 Other 3.2 : Repairs and Maintenance 2.0 100.0% Other 10.9 100.0% Capies of the financial statements of the Infont Welfare Society of Chicago for the year ended June 30. 1993, as certified by Emist & Young. are available upon request. 17 SENT BY: 3-31-94 ; 3:55PM : OFFICE OF THE MAYOR- COMM/RESEARCH: 2/ 5 MEMORANDUM DT: March 31, 1994 TO: Liz White House FR: Kathleen Hett - Mayor Daley's Office, Chicago KH RE: APRIL 4TH HEALTH EVENT As requested, here is the list of the Mayor's Task Force members who have been invited to attend Monday's event. After talking with Julie Hopper, here is the program that has been agreed upon. PROGRAM -Site Tour; -Welcoming remarks by the Exec. Dir. of the Infant Welfare Society or Winfield Moody Clinic; -Hillary Rodham Clinton; -Hedy Ratner; -Brief remarks by selected Task Force members (we've been allowed 3 max, TBD); -Hillary Rodham Clinton (acknowledging/responding to remarks); -Congressman Dan Rostenkowski; -Senator Carol Mosley-Braun. The Task Force members who will speak, will only be allotted a couple minutes each. They will speak on a health topic within their own area of expertise and would direct their remarks to the First Lady. I have circled the members who are being considered to speak and will advise you as soon as they have been determined. If you have any recommendations, please let me know. The focus of everyone's remarks will be women's health issues; specifically, the Mayor's Urban Women's Health Agenda and the tie-in's to the Prosident's National Health Plan. You should have a copy of the Mayor's Health Agenda, if not, please let me know and I'll get you a copy ASAP. SENT BY: 3-31-94 ; 3:56PM ; OFFICE OF THE MAYOR- COMM/RESEARCH:# 3/ 5 PAGE - 2 I will be meeting with Jack Murray, White House Advance, shortly. We will be visiting the Infant Welfare Society and if necessary, the Winfield Moody Health Clinic in order to determine the site. I will contact you when I return to the office so we can discuss further details. I realize we will need to communicate throughout the weekend, SO I thought I'd provide you with some contact numbers for myself. Office - 312/744-7256 Pager - 312/839-1162 Home - 312/755-0128 Talk to you soon! SENT BY: 3-31-94 ; 3:56PM ; OFFICE OF THE MAYOR- COMM/RESEARCH:# 4/ 5 MEMBERS MAYOR'S TASK FORCE ON WOMEN'S HEALTH Ms. Margie Bernard Ms. Shirley Fleming AA President Director Practice Perfect Maternal & Child Programs City of Chicago, Department of Health Ms. Ranjama Bhargava Executive Director Ms. Robyn Gabel Apns Ghar Executive Director IL Maternal & Child Health Coalition Dr. Henry Black Chair, Department of Preventive Medicine Ms. Guadalupe Gouveira Rush Presbytertan/St. Luke's Medical Center Outreach Coordinator Rape Victim Advocates Ms. Cynthis Barnes Boyd, Ph.D. Executive Director Ms. Sharon Green Mile Square Health Center Executive Director Y-ME National Breast Cancer Organization Ms. Sharon Casillas American Indian Health Professional Mr. Philip Greenland, M.D. Chairman, Department of Preventive Medicine Dr. Allan Charles W Dingman Profemor of Cardiology Head of Obstetrics/Cynecelogy Northwestern University Medical School Humana Hospital/Michael Reese Ms. Elizabeth H. Hall Dr. Marage Cohen Manager, Public Relations Director La Leche League International Cook County Women's and Children's HIV Program Ms. Mays Hennessey Ms. Kristine Coryell, Ph.D. Women's Specialist Midwest State Government Relations Manager Illinois Dept. of Alcoholism & Substance Abuse Pflser, Inc. Dr. Linda Holt Ms. Maggie Daley Head of Obstetrica/Gynecology Honorary Chair Rush North Shore Hospital Mayor's Task Force on Women's Health Ms. Arlisha Kennedy Ms. Alice Dan, Ph.D. Director, Learning for Life Director Jane Addams HuM House University of Illinois at Chicago Center for Research on Women & Gender Shells Lyne, RSM Professor of Medical/Surgery Commissioner School of Nursing Dept. of Health, City of Chicago University of Illinois at Chicago Co-Chair, Mayor's Task Force on Women's Health Ms. Marguerite Dixon, Ph.D. Ms. Susan Manilow Former Dean Chairman College of Nursing & Allied Hith. Prof. Mount Sinci Hospital Chicago State University Ms. Virginia Martinez Ms. Maureen Dolan Executive Director Former Executive Director Mujeres Latinas en Accion Women United for a Better Chicago Ms. Elaine Ferguson. M.D. Medical Director Chicago Public Schools SENT BY: 3-31-94 ; 3:57PM ; OFFICE OF THE MAYOR- COMM/RESEARCH: # 5/ 5 Ms. Mary McCauley Dr. Nada Stotland Executive Director Associate Professor, Psychiatry. Lesbian Community Cancer Project University of Chicago Ms. Judy Panko-Reis Ms. Marylin Turner AA Chair Executive Director Health Resource Center for Women with Disabilities Rally to Life Rehabilitation Institute of Chicago Dr. Julian B. Uliman Ms. Hedy Ratner W Obstetrics/Gynecology Department Co-Director, Women's Business Development Center Northwestern Memorial Hospital Co-Chair, Mayor's Task Force on Women's Health Ms. Ruth Rothstein "Hedy is already Dr. Carole Warshaw Director a confirmed Director of Behavioral Science Primary Care Internal Medicine Cook County Hospital speaker Cook County Hospital Chief, Cook County Bureau of Health Services Co-Director, Cook County Hospital Crisis Intervention Project for Battered Women Hemorable Ginger Rugai Alderman Ms. Kate Weger Ward 19 Seminar Co-Chair Health Resource Center for Women with Disabilities Ms. Margie Schaps Rehabilitation Institute of Chicago Co-Director Health and Medicine Policy Research Group Dr. Janet Wolter Professor of Medicine, Senior Attending Physician Ms. Nanetta Silva > Hispin Department of Oneology Health Initiative Director Rush Presbyterian/St. Luke's Medical Center Chicago Foundation for Women Honorable Mary Ann Smith Alderman Ward 48 For further information regarding the Task Force, please call the office of Sheila Lyne, RSM, Commissioner, Department of Health, City of Chicago: 312-747-9870. SENT BY: 3-31-94 ; 3:55PM : OFFICE OF THE MAYOR- COMM/RESEARCH:# 1/5 on of Chicago Richard M. Datey. Mayor Office of the Mayor On Hall. Room 50? 121 North LaSalk Street Chicago. Illinois 60602 (312) 764-3300 FAX COVER SHEET DATE: March 31, 1994 SENDER NAME: Kathleen Helt SENDER FAX #: 312/744-2769 SENDER DIRECT PHONE #: 312/744-7256 TO: Liz- White House RECEIVING FAX #: 202/456-2239 RECEIVING DIRECT PHONE #: 202/456-2131 I'll talk to you soon THIS TELECOPY MESSAGE CONTAINS 5 PAGES INCLUDING CUPPT TF you no NOT RECEIVE AT.P. DACES CART SENT BY: 3-31-94 : 7:16PM : OFFICE OF THE MAYOR- COMM/RESEARCH: # 1/ 3 C lynn Cutler's best friend Cin of Chicago College roommate Richard M. Daley. Mayor Office of the Maver Cin Hall. Room 507 121 North LaSalic Street 4/4 Chicago. Illinois 60602 (312) 744-3300 FAX COVER SHEET DATE: March 31, 1994 SENDER NAME: Kathleen Hext SENDER FAX #: 312/744-2769 SENDER DIRECT PHONE #: 312 / 744-7256 TO: Liz- White House Staff RECEIVING FAX #: 202/ 456-2239 RECEIVING DIRECT PHONE #: 202/456-2131 COMMENTS/INSTRUCTIONS: Here is a copy of the press release I spoke about Also a misc. item. I'm working on getting a bio on Hedy Ratner. I'll talk to you in the A.M. 3 THIS TELECOPY MESSAGE CONTAINS PAGES INCLUDING SENT BY: 3-31-94 7:16PM ; OFFICE OF THE MAYOR- COMM/RESEARCH:# 2/3 Post- It brand fax transmittal memo 7671 of pages To CITY OF CI Michclle From Heather Co. Michael Co. Shadur OFFICE OF TH Dept. Phone 944-48108 Fax 744-2769 Fax 944-5789 Richard M. Daley March 10, 1994 Mayor Dear Friend: It is my pleasure to invite you to join me on Monday, March 21, 1994, for a briefing and press conference with the Mayor's Task Force on Women's Health. The briefing will take place at the Chicago Historical Society, Clark Street at North Avenue, and will begin at 11:00 a.m. Led by Maggie Daley, Honorary Chair; Sheila Lyne, RSM, Commissioner of Health for the City of Chicago; and Hedy Ratner, Co-Director of the Women's Business Development Center, this Task Force is charged with developing a new framework and policy agenda for improving health care delivery for the women and girls of our cities. As you may recall, the Task Force first identified the systemic obstacles which have the most deleterious effect on the health of women, and then summarized their findings in a Phase I report released last June. In the second phase of its work, the Task Force has identified, evaluated and recommended programs and policies which are responsive to the challenges described in the first report. The "Urban Women's Agenda" is the result of this massive effort. The "Agenda" is a quidebook to meet the challenges that prevent urban America's women from achieving the health that is their birthright. To realize our goal for a healthier Chicago, it is imperative that the public and private sectors continue to work together to address the common challenges to women and children living in an urban environment. These challenges to providing hatter health care affect all women and children, regardless of their cultural and racial differences. It is in this spirit that I hope you will attend this briefing. The Historical Society is an especially meaningful location for this event with the opening of "Becoming American Women, a new exhibit which you will be able to view prior to the start of the briefing, beginning at 10:00 a.m. Thank you for your commitment to this important endeavor. Please RSVP to The Sive Group, Inc., which is helping to coordinate this briefing, by calling (312) 944-4868. I hope that you will make every effort to join us March 21. Sincerely, IIV Richal Mayor m Daby AWARD WINNER SENT BY: 3-31-94 ; 7:17PM ; OFFICE OF THE MAYOR- COMM/RESEARCH 3/ 3 CONTR LUCARD OFFICE OF THE MAYOR CITY OF CHICAGO RICHARD M. DALEY MAYOR March, 1994 Dear Friends: In April, 1993, I asked Maggie Daley, Sheila Lyne, R.S.M., Commissioner of Health for the City of Chicago, and Hedv Ratner, Co-Director of the Women's Business Development Center. to convene my Task Force on Women's Health. I believe that now is the time for our nation's cities to propose and adopt policies which encompass innovative strategies for addressing systemic obstacles to better health care for the women and girls of our cities. The Task Force began its work by identifying the systemic problems that have the most deleterious effect on the health of women. The members' comprehensive assessment of these barriore to good health was described in a report presented by me in mid-June to the City of Chicago, to President Clinton, Members of Congress, and health care decisionmakers throughout the nation. In the second phase of its work, the Task Force has identified, evaluated and recommended programs and policies which are responsive to the challenges described in the Phase I report. Specifically, the Task Force considered programs and policies in these areas: Health care delivery and education models including programs sponsored by private and public agencies in Chicago and other municipalities and states. These could be undertaken as joint efforts by Chicago's public agencies and/or in partnership with the private sector. System reform, including the ways in which institutional practices and procedures can be modified through law, regulation, administrative rulings, management practice and program adaptation, so that women and girls are well-served by all health care institutions. The Urban Women's Health Agenda is the result of this massive effort. The Agenda is a guidebook for those of us who believe we must meet the challenges addressed by this Task Force in its first report. These challenges prevent urban America's women and girls from achieving the health that is their birthright. This Task Force, composed of Chicago's best minds on the issue of women's health, has conceived and described a new way to think about women's health at a time when we seek new strategies. Most important of all, we seek an America in which all Americans can fulfill their dreams with a healthy body and spirtt. Sincerely, Mayor