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MMRC/IMRC membership application

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The Utah-Wyoming Maternal Mortality Review Committee (MMRC) and the Utah Infant Mortality Review Committee (IMRC) conduct interdisciplinary reviews of maternal and perinatal infant deaths. The goal of the committees is to prevent maternal and infant deaths. Committee members include health care providers, social workers, public health professionals, community leaders, and many others with expertise needed to determine the contributing factors to the deaths and to generate recommendations that may prevent such deaths in the future.

Information about an identified death is gathered from death and birth certificates, medical records, autopsy reports, and other pertinent sources of information. Records are abstracted by a trained abstractor and de-identified case summaries are reviewed by the committee. The review process is intended to be educational and prevention-oriented.

The purpose of this application is to select members of the committees. Members will be asked to attend virtual meetings every other month and occasional in-person gatherings, and to sign a confidentiality agreement and other relevant documents. They will also need to attend trainings to equip them to perform their committee work.

Your application will be scored based on your answers to the questions, including how well you describe your experience as it relates to the position(s) you are applying for, how likely you are to contribute to the goals of the committee(s), and how enthusiastic you are about joining.

Once all applications are scored, a subset of applicants will move on to a brief 30 minute interview. From there, one applicant for each open position will be selected as a new committee member.

The deadline to submit this application is April 15, 2024. If you have any questions, contact Suzanne Smith at suzannesmith@utah.gov

What is your name? Please enter the name you would want us to use on our internal membership list, as well as any certificates of service you may receive as a member of a committee. Enter first then last, for example: John Doe

* must provide value

To avoid reinforcing social hierarchies, we do not use titles when addressing each other during committee meetings. For example, Dr. Johnathon Doe, who prefers to be called "Jack" by his friends, would be addressed as "Jack" during committee meetings. Please tell us how you would prefer to be addressed.

* must provide value

Email address

* must provide value

Agency or organization (if any)

Title (if any)

Credentials (if any)

Each committee meets virtually via Zoom every other month (6 times per year) on the 2nd Wednesday from 12 to 2:30 p.m. The MMRC meets on the odd numbered months; the IMRC meets on the even numbered months. Attendance is mandatory. Are you able to attend the meetings?

* must provide value

Yes

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This list shows all positions on the MATERNAL committee for which we are currently taking applications, and what we are looking for in each position. Please indicate the position(s) you are applying for:

Provider: Community midwifery (Expertise in the practice of community (out-of-hospital) midwifery.)

Provider: Emergency medical services (Expertise in providing emergency medical services.)

Provider: Perinatal mental health (Expertise in providing perinatal mental health services, including for postpartum depression and other perinatal mental health conditions.)

Provider: Doula (Expertise in providing doula services.)

Public health: Medicaid (Expertise working with the Medicaid plan of Utah, especially serving perinatal patients.)

Public health: Home visiting (Expertise performing home visiting services, especially with perinatal patients.)

Advocate: Victim/violence (Expertise with victim services or violence prevention organizations in Utah, earned serving as an advocate or via lived experience.)

Government: Law enforcement (Expertise in law enforcement related to domestic violence, substance use disorder, and mental health conditions.)

This list shows all positions on the INFANT committee for which we are currently taking applications, and what we are looking for in each position. Please indicate the position(s) you are applying for:

Provider: Community midwifery (Expertise in the practice of community (out-of-hospital) midwifery.)

Provider: Emergency medical services (Expertise in providing emergency medical services.)

Provider: Perinatal mental health (Expertise in providing perinatal mental health services, including for postpartum depression and other perinatal mental health conditions.)

Public health: WIC - Local (Expertise with a local Utah WIC program.)

Public health: Medicaid (Expertise working with the Medicaid plan of Utah, especially serving perinatal patients.)

Public health: CHW/Home visiting (Expertise as a community health worker or performing home visiting services, especially with perinatal patients.)

Public health: Healthy Start - local (Expertise with a local Utah Healthy Start program.)

Advocate: Victim/violence (Expertise with victim services or violence prevention organizations in Utah, earned serving as an advocate or via lived experience.)

Describe your area(s) of work, expertise, or lived experience with the position(s) you are applying for.
You can have multiple areas of expertise and/or lived experience. Please don't limit yourself to talking about one specific area if you have more than one.

* must provide value

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What agency(ies), populations, groups, or other voices will you represent as a committee member?
This may include the place you work, the type of professional you are, professional organizations you are connected with, other committee(s) you sit on, geographic location where you live or work, or additional pertinent areas of representation, such as your own personal experiences.

* must provide value

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Committee members may be called upon to support translating mortality data into actionable recommendations that will be carried out beyond the review meetings. Thus, it is helpful for members to have direct or indirect influence within their professional or personal lives. This may include being engaged in a professional organization, or sitting on another committee charged with making decisions or recommendations. Describe your influence.

For this question, "influence" is defined as the ability to have an effect on an environment, process, or decision that may be happening around you.

* must provide value

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Describe what interests you about joining the committee(s).

* must provide value

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Describe how you would use the information acquired during your service on the committee(s) to further the work of preventing maternal and infant deaths.

* must provide value

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