Call Number:

Ms. Coll. 760

Repository:

University of Pennsylvania: Kislak Center for Special Collections, Rare Books and Manuscripts

Extent:

56 boxes

Language:

English

Preferred Citation:

Maternity Care Coalition records, Kislak Center for Special Collections, Rare Books and Manuscripts, University of Pennsylvania

Date:

1960-2009 (inclusive) and 1980-2007 (bulk)

Creator:

Maternity Care Coalition

Form:

Correspondence, Machine-readable artifacts, Photographs, and Audiovisual materials

Abstract:

The business records of the Maternity Care Coalition (MCC), a Philadelphia-based organization devoted to preventing infant mortality. Founded in 1980, the Maternity Care Coalition continued to operate at the time of the donation in 2009. The bulk of the materials comprise community outreach and client education materials, research materials, and publications. Also present within the collection are newspaper clippings, a number of media appearances captured on VHS, reel-to-reel, and audio cassettes, as well as a series of photographs that span the years 1985 to 2005.

The Maternity Care Coalition (MCC) was founded in 1980 in response to Philadelphia's growing infant-mortality rates. Seven Philadelphia area organizations, comprising healthcare professionals and welfare and women's rights groups, joined together to start MCC. They included: the Philadelphia Welfare Rights Organization, the Childbirth Education Association of Greater Philadelphia, the Health Law Project, University of Pennsylvania Law School, Concern for Health Options Information, Care and Education (CHOICE), Institute of Social Medicine and Community Health (ISMCH), and American College of Nurse Midwives, Pennsylvania Chapter. MCC's efforts targeted Philadelphia neighborhoods with the highest infant-mortality rates and sought to reduce the number of preventable infant deaths.

From the organization's early stages, MCC's primary focus was on providing health education services while increasing the involvement of local and state government as well as health and welfare agencies. In time, the mission of the Maternity Care Coalition became "to improve maternal and child health and wellbeing through the collaborative efforts of individuals, families, providers, and communities." To achieve this goal, MCC developed community-based maternity services that emphasized improved accessibility to care and increased the prevention emphasis of existing services.

MCC has supported a number of programs since its founding in 1980. As of 2009, these programs have included the MOMobile Project, Early Head Start, Family Start, Healthy Start, and Cribs for Kids. MCC has also had strong and consistent involvement with preventative education efforts focusing on a wide spectrum of issues such as Perinatal Depression, Breastfeeding Awareness, HIV/AIDS Prevention, Services to Incarcerated Women and Parent Education Groups. Other issues that MCC has provided education, support and referrals to Philadelphia communities on are nutrition, safe sleep and SIDS, immunizations and child development. Through these various education efforts, MCC has focused on connecting families to healthcare, education, job training, childcare, public benefits, and housing. MCC also distributes necessities such as baby supplies, emergency food, and maternity clothes.

MCC Programs

One of MCC's most successful community outreach efforts, the MOMobile Project, began in 1989 after MCC secured a Philadelphia Department of Public Health contract. Employing community health workers, known as Advocates, the MOMobile Project focused on reaching out to low-income pregnant women, new parents, infants and their families in the communities where they live. Since the program's beginnings, over 50,000 Philadelphia families have relied on the MOMobile Project to provide them with getting the vital support, health services, and information they need to make healthy choices.

As of 2009, the MOMobile Project has eight neighborhood specific sites, which include: Delaware County, Norristown, North Central, Northeast, Northwest, Riverside, South Philadelphia and West Philadelphia. MOMobile Advocates provide the following services:

• Drive distinctive brightly-colored mini-vans through their communities reaching out to at-risk pregnant and newly parenting adolescents and women.

• Work with families to develop a plan for getting the help they need.

• Link families to healthcare, education, job training, childcare, public benefits, and housing.

• Educate on child development and health and wellness issues.

• Refer to needed services and resources.

• Distribute baby supplies and emergency food.

• Support and encourage parents to achieve their goals for themselves and their children.

The specific issues that MOMobile Advocates focus on are breastfeeding, family planning, HIV/AIDS and sexually transmitted diseases, preventing and confronting domestic violence, parenting skills, lead poisoning prevention, and environmental health. The MOMobile Project also sought to connect parents to health insurance, child care, quit-smoking programs, crisis intervention services, housing, TANF and public benefits, immunizations, translation and interpretation, infant and maternity clothes, help in returning to work or school, emergency food and formula, and treatment for alcohol and drug abuse.

Early Head Start (EHS) is another program spearheaded by MCC. EHS is a comprehensive child development program which offers free linguistically and culturally appropriate health, education, and social services to income eligible families that include a pregnant woman and/or children aged 0-3.

Research Initiatives

MCC conducted a number of research studies using a Community-Based Participatory Research (CBPR) approach. These research studies include the following topics: perinatal depression; criminal justice and recidivism; maternal obesity and nutrition; utilization of community health workers; HIV education and prevention. The MCC Research Department also tracks and evaluates all MOMobile program outcomes via the Changing Tables database.

The design and implementation of Changing Tables, an automated, interactive data records system to support and track the case management of MOMobile families, strengthens MCC's infrastructure; MCC converts existing client data into Changing Tables, installs the system at all its MOMobile sites, and trains MOMobile Advocates to enter and retrieve data through the system

MCC Structure

In August of 2009, MCC employed 90 staff members and had 23 members serving on their Board of Directors. The nominating committee proposes a slate of individuals with diverse backgrounds, expertise and skills. Board members each serve a 3-year term and can serve up to 3 terms or 9 years. Four of these members serve as officers and new officers are elected each year.

Volunteer Workers

MCC work has relied heavily on receiving help from volunteer workers. Over 700 volunteers provide crucial support in the following areas: serving on committees, in-office work, at MOMobile® sites, at parties and special events, supporting the Cribs for Kids initiative, managing donations such as toys, baby items, and food, with special events such as the Family Gift Connection, Celebrating Mothers on Mother's Day, and the Golf Classic.

Families Served

Since 1989 (when MOMobile® started), direct service provided to more than 70,000 families. In 2008-2009: 5277 education contacts; 1509 families served; 2263 home visits; 2252 deliveries of supplies; 145 children enrolled in EHS (South Philadelphia and Norristown); 89 attended Riverside Correctional Facility prenatal and new parent workshops; 3741 phone calls to Cribs for Kids hotline; 2,591 cribs delivered; Family Gift Connection served 488 children from 168 families.

Funding

In FY 2010: Government (76%) (72 % of Government funding is EHS); Foundations (12%); Individuals (4%); Healthcare Organizations (2%); United Way (3%); Research Grants (1%); Corporations (1%); Other (1%).

Maternity Care Coalition Historical Highlights: 1980 to 2009

1980

• MCC is founded to reduce preventable infant deaths by improving the accessibility and prevention emphasis of existing maternity services by helping targeted neighborhoods to develop new community based services.

• Eight local organizations found MCC, including: Philadelphia Welfare Rights Organization, Childbirth Education Association of Greater Philadelphia, Health Law Project, University of Pennsylvania Law School, CHOICE, Institute of Social Medicine and Community Health, and American College of Nurse Midwives, Pennsylvania Chapter.

• MCC focuses on education directed to neighborhoods with highest infant mortality rates and to the leadership of health and welfare agencies, as well as city and state legislative bodies.

1981

• MCC shares offices with Philadelphia Welfare Rights Organizations.

• Sister Teresita Hinnegan conducts study for Hahnemann.

• MCC protests Presbyterian Hospital closing obstetrical unit.

1982

• MCC receives first foundation funding amount of $15,000.

• MCC holds public hearing to oppose cut backs in Maternal Infant Care (MIC) and Women, Infant & Children's Nutrition (WIC) programs and presents petitions to state officials.

1983

• West Philadelphia neighborhoods develop plan for Tri-Community Maternity Center, a free-standing birth center subsequently stymied by the Hospital of the University of Pennsylvania and the Welfare Department.

1984

• MCC threatens lawsuit regarding hospitals requiring preadmission deposit for obstetrics.

• MCC organizes citywide meeting for African-American Clergy.

1985

• First public Annual Meeting, Adolescent Pregnancy, with Thurmond Evans, is held.

1986

• First part-time Executive Director, Julie Cadwallader-Staub, is hired.

• MCC moves to 1415 North Broad Street in Philadelphia.

• MCC kicks off opening of the Strawberry Mansion Health Center.

• MCC receives first United Way Community Development Grant.

1987

• MCC works for expansion of Medical Assistance in Pennsylvania (COBRA option); MCC lobbies for Philadelphia hearing on Medical Assistance.

• Annual Meeting, Tale of Three Cities, includes speakers from Hartford, New York City and Washington D.C.

• MCC begins outreach and counseling in Strawberry Mansion for 191 clients.

1988

• MCC implements Community Maternity Worker program in Strawberry Mansion with two part-time Advocates.

• MCC secures funding from Scott Paper Company to hire full-time executive director; writes Robert Wood Johnson proposal for Local Funders in Health Initiatives Program with support of eight local foundations spearheaded by the Samuel S. Fels Fund.

• MCC organizes Infant Mortality Hearing in Philadelphia City Council.

• MCC hosts first citywide Annual Meeting, Conference on Perinatal Cocaine Use.

• The Board of Directors holds its first retreat.

1989

• First full-time Executive Director, JoAnne Fischer, is hired.

• MCC receives Philadelphia Department of Public Health contract to develop and conduct MOMobile Project.

• MCC receives Robert Wood Johnson grant, Philadelphia Department of Public Health contract and funding from eight local foundations for $1.4 million over four years for Community Maternity Projects.

• MCC sponsors Annual Meeting Conference on Support to Families of Drug Using Pregnant Women.

• MCC lobbies Philadelphia City Council for additional Maternity Service Program funds.

1990

• MCC secures funds from National March of Dimes to develop Latina MOMobile Program.

• Strawberry Mansion Community Maternity Care Project expands, offering more intensive case management and parent education.

• West Philadelphia Community Maternity Project, Neighborhood and Latina Advisory Committees established.

• Annual Meeting focuses on Mothers and Babies at Risk: Sexually Transmitted Diseases and AIDS.

• Policy and Advocacy Committee focuses on WIC eligibility and Syphilis alert, Healthy Beginnings and Maternal Infant Health budget.

1991

• MCC moves offices to 511 North Broad Street in Philadelphia.

• MCC hires staff for the Policy and Advocacy Committee and the Program Development and Evaluation Committee.

• MCC Policy and Advocacy Committee focuses on New Health Commissioner, City Health Center Legislation, Immunization, Health Care for Uninsured Children and Healthy Start funding.

• Community Maternity Project and MOMobile revise record keeping for more intensive case management.

• Annual Meeting, Good Intentions are Not Enough: Cultural Diversity in MCH, is held.

• MCC serves 1752 pregnant women and a total of 3,360 clients.

• Annual Appeal initiated.

• Pew Charitable Trust funds Latina MOMobile.

• Phoebe Haas Charitable Trust funds purchase and outfitting of Latina MOMobile.

• Board engages in long range planning process which includes survey of Board, staff, competitors, collaborators, funders, donors and clients.

1992

• MCC establishes Delaware Valley Partnership for Healthier Babies; co-sponsors "Baby Your Baby" media campaign.

• MCC Annual Conference, Health Reform: Time to Push for Mothers and Babies, is held.

• JoAnne Fischer receives Women's Way Award, Women of Courage, for contributions to women, children and families.

• MCC organizes National Summit on Universal Maternity Care and Health Reform in Washington, D.C.

• MCC is plaintiff in Scott vs. DPW - EPSDT lawsuit.

• Board establishes Fundraising and Public Relations Advisory committees.

• Board revises Bylaws.

• MCC receives Healthy Start funding for West Philadelphia MOMobile/Healthy Start Express.

• MCC concludes Robert Wood Johnson sponsored Community Maternity Project (CMP); Melinda Jenkins, Ph.D. presents dissertation on the CMP program evaluation.

1993

• Policy and Advocacy Committee launches breastfeeding initiative; commissions focus group on managed care and Maternal and Child Health.

• MCC hires a Director of Finance and Communication/Community Relations Program Associate.

• MCC initiates Adolescent Program with support of Junior League and William Penn Foundation.

• MCC Annual Conference, Safe Mothers, Safe Babies; Domestic Violence and Pregnancy, is held.

• With Women's Law Project and United Way, MCC publishes guide "Pregnant Women: Rights & Resources under the Law."

• Connelly Foundation supports Latina MOMobile with funding in the amount of $30,000.

• Policy and Advocacy Committee focuses on early discharge and breastfeeding.

• MCC computerizes donor and client data and revises client intake forms.

• MCC sponsors first "House Party," where supporters invite friends to learn about and contribute to MCC.

• MCC conducts "Get the Lead out Program" with Health Management Alternatives and Philadelphia Citizens for Children and Youth.

• MOMobiles and Community Maternity Projects combined serve over 2,000 women in fiscal year 1992-93.

1994

• MCC staff is now at 35.

• MCC unifies MOMobile and Community Maternity Projects.

• South Philadelphia MOMobile receives funding from Mercy Health Plan and moves to be more independent.

• MCC moves Main Office to 2000 Hamilton Street.

• MOMobiles and Community Maternity Projects combined serve over 2,200 women in fiscal year 1993-94.

1995

• MCC establishes two school-based MOMobiles at Overbrook and Strawberry Mansion High Schools.

• The South Philadelphia MOMobile establishes a permanent home at 1605 Catherine Street in Philadelphia.

• MCC convenes Tenth Annual Conference, Baby Blues--Before and Beyond: Promoting Mental Health and Coping with Mental Illness among Pregnant Women & Parents of Infants.

• MCC merges with Pennsylvania Healthy Mothers, Healthy Babies, giving birth to a stronger voice for women and children state-wide.

• Computerized client data base to facilitate uniform reporting and quality assurance monitoring is implemented.

• MCC revises its mission statement and develops a set of statements of belief for the agency.

1996

• MCC staff now at 57 full-time and part-time staff.

• MCC establishes a MOMobile at Germantown Hospital, expanding the total MOMobile program to nine sites.

• MCC develops a model HIV prevention program, integrating HIV education and prevention strategies into the work of each MOMobile team.

• MOMobile programs serve over 3,000 women and their families, completing nearly 2,500 home visits and making 4,785 referrals for health and social services.

• MCC hosts its first fundraising event in Western Pennsylvania, a House Party in Pittsburgh.

• Eleventh Annual Conference, Pregnant Pause: Time to Talk About Teens, Sex and the Next Generation, draws over 800 participants to the Pennsylvania Convention Center.

• MCC provides consumer education and advocacy to fight cuts in safety net services proposed by federal and state "welfare reform."

• Policy and Advocacy staff help critique and provide guidance for the PA Department of Health's Health Choices program, which creates a managed care system for the state's Medical Assistance population.

1997

• MCC convenes Ethics, Maternal & Child Health, and Managed Care, a Roundtable featuring well-known bioethicist Arthur Caplan, Ph.D. and a panel of providers, consumers, and experts in public health, public policy and managed care.

• Funding is secured to purchase MOMobile vans for the South Philadelphia and Strawberry Mansion sites.

• Education and Advocacy program hosts Working for Mothers & Babies in PA: Post-Election Strategies, drawing over 100 maternal and child health advocates, providers, and policy makers from across the state to Harrisburg to discuss strategies to promote policies that work for families.

• Education and Advocacy staff collaborates with MOMobile staff to initiate a grassroots consumer education campaign about HealthChoices, the State's mandated managed care plan for Medical Assistance recipients.

• The William Penn Foundation awards MCC a two-year grant, totaling $461,195, to strengthen infrastructure, support and management information systems.

• Director of Family Services is hired.

• MCC hosts a two-day Future Search Forum, Exploring Strategies to Improve the Health & Well-Being of Mothers, Infants, and Their Families in Pennsylvania Over the Next Ten Years, drawing stakeholders from across the state and bringing together funders, providers, policy makers, families, clients and advocates to forge a common vision of Maternal and Child Health in the next decade.

• MCC contracts with the four managed care companies designated by Health Choices to serve Pennsylvania's Medical Assistance families.

• MOMobile programs serve over 3,000 women and their families: completing nearly 3,500 home visits, offering lead poisoning education to over 1,329 families and providing HIV prevention education to 1,666 pregnant women and their families.

• Twelfth Annual Conference, Blueprint for the Village: Families and Communities Building the Future, draws over 600 to the Pennsylvania Convention Center.

1998

• MCC sponsors session on Making Managed Care Work for Mothers and Babies in Harrisburg; MCC plays a key role in developing and assuring the passage of a managed care "Patients' Bill of Rights," which provides consumer protections including disclosure provisions and grievance procedures.

• With Philadelphia Citizen's for Children and Youth and the Philadelphia Department of Public Health Office of Maternal and Child Health, MCC hosts an Invitational Roundtable of 125 practitioners, policy makers, advocates, consumers and insurers to explore ways to ensure accountability, measuring the quality of maternal and child health services provided by managed care organizations through Pennsylvania's Health Choices program.

• The design and implementation of Changing Tables, an automated, interactive data records system to support and track the case management of MOMobile families, strengthens MCC's infrastructure; MCC converts existing client data into Changing Tables, installs the system at all its MOMobile sites, and trains MOMobile Advocates to enter and retrieve data through the system.

• Board completes a year-long Strategic Planning Process to "ensure MCC's long term ability to remain economically sound and deliver valuable and sustainable programs and services in areas of direct service, education, research and advocacy."

• MCC tests advocates on MOMobile Core Competencies to determine areas of individual and collective strengths and areas for improvement; trainings are designed to fit individual and group needs; special writing workshops developed for staff.

• MCC conducts a survey comparing the use of health and human services between MOMobile clients and non-clients. Measurements of client satisfaction with the MOMobile program indicate that over 70% of clients surveyed would switch their health plans if their current plan did not offer MOMobile services. Outcome and developed logic models to guide future MOMobile research.

• MCC develops and disseminates 2,000 copies of a "How to Guide for Families," designed to help families access cash assistance, health insurance, and nutrition programs in the new welfare system.

• MCC establishes a Main Line MOMobile, stationing a MOMobile Advocate to work with over 70 families at Bryn Mawr Family Practice and Lankenau Hospital. A new partnership is formed with the YMCA of Greater Philadelphia to initiate a new Early Head Start Program in South Philadelphia.

1999

• MCC celebrates the opening of the tenth MOMobile site located in Norristown, Montgomery County.

• MCC celebrates the opening of the eleventh MOMobile site located in Upper Darby, Delaware County.

• Women's Health, Children's Futures, the first Annual Educational Series for professionals, advocates, and policymakers serving women and children, is held at the College of Physicians of Philadelphia; the series is conducted in three (standing room only) sessions, covering topics ranging from housing issues to social conditions as a primary cause of disease to the "Secret Lives of Poor Women."

• MCC holds The Governor's Budget briefing with over 50 persons attending.

• A test mailing of a Mother's Day card to over 3,000 new donors emerges as the first step in a strategy to develop an affinity between Mother's Day and MCC in order to further the agency's marketing and fund development goals.

• A public outcry for a MOMobile in the Northeast results in securing funding for the twelfth MOMobile site.

• The name "Changing Tables" is service-marked and a logo is designed.

• With the Philadelphia Department of Public Health and the Twenty-First Century League Mousetrap grant, MCC responds to Temporary Assistance for Needy Families (TANF) welfare changes by:

* Hiring a full-time Welfare-to-Work Coordinator.

* Conducting a six-part TANF training series for MCC staff.

* Hiring and training ten TANF recipients as transitional workers.

* Developing client needs assessment and TANF module for Changing Tables.

* Sponsoring agency Welfare-to-Work Program Retreat.

* Creating opportunities for approved community service.

* Developing TANF brochure in five languages (English, Spanish, Vietnamese, Laotian and Cambodian) and distributing 20,000 copies.

* Assisting city with urgent, targeted outreach to families at highest risk.

* Working with Community Legal Services to challenge TANF work requirements for teen parents in school.

* Advocating, along with the Women's Law Project, for the State to change domestic violence exemption.

* Demonstrating nationally how community health worker model can be applied to assist in transition from welfare to work.

• MCC participates in a Robert Wood Johnson Covering Kids grant program to conduct Children's Health Insurance Program outreach, enrollment and education of Communities of Faith.

• MCC participates in Montgomery County Commissioner's Infant Mortality Hearings and Development of Infant Health Plan, contributing to the designation of Norristown as a medically underserved area eligible for federal funds.

• MCC receives the Eastern College Award for Nonprofit Excellence.

2000

• MCC collaborates with Women's Christian Alliance and is awarded a four-year grant from the Center for Disease Control, totaling over $850,000, for HIV prevention with African American Women.

• Family Gift Connection (FGC) collects gifts for over 800 children in the Delaware Valley; Giving Partners is increased by 25% and is coordinated by the energetic FGC volunteer elves.

• Mother's Day 2000 Honoring Motherhood Campaign is launched; a contract is signed with GivingCapital.com; first on-line giving generates over $6,000 for Mother's Day 2000.

• Baby Basics program is created in partnership with local Body Shops; in-kind donations of basic items are collected for new moms and babies.

• MCC hosts 45 volunteers from Jewish Federation of Greater Philadelphia for United Way Day of Caring, completing three different agency projects.

• MCC celebrates the opening of the 12th MOMobile site located in Northeast Philadelphia.

• MCC's Family Album Annual Report gets a face lift with a new look and format.

• MCC receives over 8,000 coats for area families in need of "warmth" for the Fresh Fields/WXPN Annual Coat Drive.

• In-kind furniture is donated by SmithKline Beecham to expand MCC administrative offices at 2000 Hamilton Street.

• Phase I Advancement Research of MCC's new Major Donor campaign is completed.

• Professional Education Series 2000 session, Nicotine: Drug Challenge of the Millennium, is held for the first time in a suburban location at the William Penn Inn in Gwynedd, PA.

• The Empowerment Study is launched at three sites - Norristown, Latina and Strawberry Mansion.

• Early Head Start (EHS) federal site reviews and acknowledge the quality of MOMobile/EHS services; reviewers remark that "all aspects and elements of the home based curriculum are excellent...and exceed standards"; also noted were the "excellent relationships" of Advocates with the families with whom they work.

• Early Head Start's home-based component is fully enrolled all year.

• ELECT students' graduation rates totals 78%.

• MCC collaborates with Community Legal Services and succeeds in having changes made on the eligibility intake process for school based subsidized daycare for its Welfare to Work Program.

• The American Public Health Association accepts Making TANF Work for Mothers and Babies: A Community Based Organization's Response to Welfare Reform for presentation at its Annual Meeting.

• All MOMobile sites complete core competency training in how to Support, Educate and Advocate to Ensure that Each of Your Clients can Access All Public Benefits to which They are Entitled.

• Leadership continuity addressed by revising the Bylaws to extend Board terms to a maximum of 3 three-year terms.

2001

• MCC's Empowerment Study, aimed at assessing the impact of the MOMobile program, is implemented at Strawberry Mansion, Latina, and Norristown MOMobile sites.

• DeShawn Snow, wife of 76er, Eric Snow, becomes active with MCC as celebrity spokesperson of the Mother's Day Campaign and hosts a successful house party for Sixer's Wives.

• Mother's Day campaign raises over $60,000.

• MCC Staff and Consultants Present at American Public Health Association Annual Meeting. Topics include: MCC's Information System and Welfare Reform, Making TANF Work for Mothers and Babies; and Translating Research and Policy into Service.

• MCC's Executive Director and Early Head Start Program Coordinator present on MCC's Early Head Start Program at Zero to Three/Early Head Start National Conference in Washington, DC.

• MCC awarded a grant from the Pennsylvania Tobacco Prevention Network to foster smoke-free pregnancies among Latina clients. A program was developed and implemented at the Norristown and Latina MOMobile sites. Over 100 women sign a pledge to commit themselves to a smoke-free pregnancy.

• As part of MCC's Healthy Living Program, MCC develops and implements an HIV counseling and testing post-card system to confirm that clients are receiving HIV testing. The system is piloted at the North, Strawberry Mansion, and West MOMobile sites.

• MCC's Professional Education Series addresses immigrant health, maternal and child nutrition, and environmental health; Guest speakers include Woodie Kessel, Assistant Surgeon General of the United States Government.

• MCC awarded funds from Environmental Protection Agency's Healthy Homes Initiatives to address environmental health.

• MCC votes to continue as an affiliate of the Healthy Mothers, Healthy Babies Coalition in its effort to establish collaborations at the national level.

• ELECT site closes after School District of Philadelphia cancels contract with the Strawberry Mansion and Overbrook High Schools. Overbrook's site changes name to Overbrook/Main Line.

• Web-based version of MCC's Client Data Management System, Changing Tables®, is completed.

• MCC chosen as recipient of Philadelphia Care's Arden Theater benefit. MCC raises over $3,000 from donations made at final dress rehearsal.

• United Way establishes new funding guidelines and nearly doubles MCC's allocation.

• Norristown and Overbrook/Main Line sites hold their first Community Advisory groups.

• South Philadelphia/Early Head Start MOMobile relocates to 2000 Mifflin Street.

• MOMobile program serves 3,339 women and families.

• MCC begins the Vulnerable Adults Self-Sufficiency Project in North and West Philadelphia with $125,000 support from the Pew Fund for Vulnerable Adults.

• MCC joins PA DPW's Community Connections Initiative: A collaboration of six community-based agencies in North Philadelphia under the Leadership of Temple University's Center for Social Policy and Community Development.

• MCC receives a capacity building grant from the William Penn Foundation totaling $351,890 over two years to further develop the REA program.

2002

• MCC receives National Safe Motherhood Award and contributes a square to the Safe Motherhood Quilt Project; participates in CDC National Summit on Safe Motherhood.

• Diane Croce joins the MCC team as chairperson of the 2002 Mother's Day Campaign and secures Citizens Bank corporate sponsorship for MOMobile Mother's Day events. Mother's Day Campaign raises over $93,000.

• MCC enhances its relationship with the Philadelphia 76ers and is designated an official Sixer's charity. MCC sells Mother's Day cards at 3 Sixer's home games. Comcast Public Service Announcements featuring Diane and Pat Croce and DeShawn and Eric Snow are broadcast on many local stations.

• MCC awarded a grant from Delaware County Tobacco Settlement funds to conduct Smoking Cessation program.

• MCC's Professional Education Series addresses: the role of communities of faith in childbirth and childrearing; maternal and infant mental health; and the Safe Motherhood framework.

• MCC loses funding from hospital systems due to dramatic increase in malpractice insurance that exacerbates hospital fiscal crises and prompts major cuts to community health programs.

• North Philadelphia MOMobile relocates to 703 North 8th Street.

• MCC implements expanded Healthy Start program in West Philadelphia.

• MCC's website receives a record 33,500 hits.

• MCC receives first grant from Taylor Hospital Foundation and a third Children's Trust Fund grant to expand service in Delaware County.

• MCC implements EPA-funded Healthy Homes Initiative at Germantown MOMobile.

• MCC presents testimony to state legislators and PA DPW staff on TANF Reauthorization, PA's Extended TANF proposal, and the Child Care and Development Block Grant.

• MCC undertakes more ambitious efforts to assist clients in accessing the Food Stamp Program beginning with initial training for designated sites on Food Stamp Prescreening.

• MCC testifies at a Pennsylvania House Health and Human Services Committee hearing to advocate for the commencement and full funding of AdultBasic, a new health insurance program for adults in Pennsylvania.

• MCC's Empowerment Study pilot yields positive results showing significant impact of participation in the MOMobile program on clients' self-perception of decision-making skills, self-sufficiency and self-determination, as well as communication with healthcare provider and job-readiness.

• MCC responds to the aftermath of the events of 9/11/01 by sharing expert advice on talking with young children about such tragedies and the feelings they raise. In addition, as a result of the events, MCC workload increased because Advocates confronted with immigrants frightened for the safety of their families, laid-off airport workers seeking public benefits for the first time, and a grandmother who became an infant's primary caretaker when both parents were called for reserve duty.

2003

• The American Public Health's Association's (APHA) Annual Meeting is held in Philadelphia in November, 2002. MCC named as the official host charity of the meeting. 18 staff members participate in the meeting, and MCC staff members and consultants present at 11 different sessions.

• MCC, in partnership with Montgomery Early Learning Centers and Montgomery County Head Start, is chosen to join 160 agencies throughout the nation that manage Early Head Start Programs. Building upon the success of the Norristown Area MOMobile, MCC and its partners establish the first Early Head Start program in Montgomery County.

• MCC receives a $325,352 grant from the USDA to conduct a research project to analyze and increase food stamp program enrollment among eligible yet nonparticipating families. This program is implemented in Delaware and Montgomery counties, and MCC hires its first Food Stamp Coordinator.

• MCC receives $25,000 from the Office of Women's Health for Community-based Breastfeeding Promotion. MCC convenes a breastfeeding advisory committee and works with the local media to publicize the National Breastfeeding Awareness Campaign. MCC explores collaborating with the state's Healthy Babies hotline to provide breastfeeding support for mothers statewide, and secures federal funds to develop a breastfeeding website.

• MCC successfully submits proposal to the Philadelphia Department of Public Health to expand and intensify MCC's immunization outreach and case management in Germantown and the Northeast. With the funds, MCC creates an Immunization Coordinator position.

• MCC explores integrating doula services in its programs, holding a training session for MOMobile staff and researching doula programs from around the country. Six staff members attend training for doula certification.

• MCC's Professional Education Series addresses fatherhood, immunization education, and health literacy.

• MCC staff members and supporters honor their foremothers by recognizing the work of Helen Faust, early advocate for pregnant and parenting teens in the Philadelphia public schools, and Helen Rodriquez-Trias, a nationally recognized health care advocate for women, children, persons with AIDS, and the poor. Three MCC staff members also present on the history of the women's health movement in Philadelphia at APHA and at a special session of MCC's Professional Education Series.

• MCC focuses on fathers, holding a PES on fatherhood, and creating a fatherhood video featuring Eric Snow and his Eric's Challenge program for fathers and sons. MCC also collaborates with Jay Fagan on a research proposal for an Early Head Start fatherhood program. Six sites hold Father's Day POMs or conduct other activities for dads.

• MCC welcomes Patricia Smith to the West Philadelphia MOMobile. Ms. Smith is MCC's first intern through the Citizens Bank Community Service Sabbatical, a program in which Citizens Bank employees take a 3-month sabbatical to work in community organizations.

• PEW funds MCC capacity building efforts, supporting Quality Assurance efforts that result in extensive revisions to MCC's client database management system, Changing Tables.®

• MCC joins the Philadelphia and Pennsylvania Welfare Coalitions, and helps write policy briefs on federal TANF Reauthorization. MCC also presents testimony on TANF to the leadership of the PA Department of Welfare.

• Ed Rendell is elected governor of Pennsylvania. Donna Cooper, Director, Governor's Policy Office, presents the Governor's "Plan for a New Pennsylvania" to 50 REA committee members, Philadelphia policy leaders, and MCC staff members.

• MCC is extensively quoted in the local press for its expert perspective on how the malpractice crisis and the closing of many of departments harshly impacts low-income pregnant women.

• Lisa Thomas-Laury joins MCC Mother's Day Campaign, "Celebrating Mothers 2003," as honorary co-chairperson. Diane Croce continues to serve as co-chair. Mother's Day Campaign raises over $120,000, an MCC record.

• MCC enhances its relationship with Comcast, Citizens Bank, and the 76ers. MCC secures Kremp Florist as "Celebrating Mothers 2003" campaign sponsor.

• MCC receives record publicity during the Mother's Day campaign, with 2 PSAs shown during commercial time slots, and segments on MCC shown on a variety of television and news programs.

• After war breaks out in Iraq in March, MCC holds a special Mother's Day event with military moms at the Willow Grove Navy Center.

• MCC establishes a Chief Operating Officer position, promoting Bette Begleiter to Deputy Executive Director.

• New MOMobile site in Sharon Hill opens as a second location of the Delaware County MOMobile.

• Additional administrative office space in Hamilton Street office is acquired to accommodate a growing number of staff and volunteers.

• JoAnne Fischer honored as a Woman of Distinction by the Philadelphia Business Journal.

• MCC and Philadelphia Society for Services to Children receive a grant from GlaxoSmithKline and the United Way to explore a potential merger/strategic alliance. A task force retains Fairmount Ventures to conduct a feasibility study of the collaboration. Fairmount Ventures recommends a merger but the PSSC Board decides not to pursue.

2004

• With a grant from the William Penn Foundation and a greater focus on research in maternal and child health, the position of Director of Research and Evaluation is created.

• The Director of Research, Education, and Advocacy is given the new charge of leading MCC's public policy efforts, especially around the obstetrics crisis for childbearing families in the Philadelphia region.

• Two articles on the findings of MCC's Empowerment Study, which measured the outcomes of the MOMobile intervention, were published in the peer-reviewed "Journal of Community Psychology."

• The MCC Board convenes an ad-hoc Board Development Committee that meets for six months. Out of its many recommendations, the committee proposes four Bylaws changes that extend the maximum term length for the acting President of the Board, require Board members to sign a Conflict of Interest policy, detail the Board's policy around absences from Board meetings, and permanently create a Governance Committee of the Board. The Board approves all Bylaws changes at its March 2004 meeting.

• MCC's Professional Education Series focuses on food policy and obesity, incarcerated parents, and school readiness.

• Executive Director JoAnne Fischer testifies before the Philadelphia City Council on shifting priorities in city funding for services to pregnant women. These funding shifts result in MCC losing Title V funding for its MOMobile program.

• Felicia Washington, a Master of Public Health (M.P.H.) candidate at the Drexel University School of Public Health, completes a research project at MCC on increasing breastfeeding rates among low-income African American women.

• MOMobile clients and their families attend 79 educational Parent Outreach Meetings on a number of topics such as breastfeeding, literacy, nutrition, budgeting, and immunizations.

• MCC's Cribs for Kids Program is launched. MCC receives a grant from the CJ Foundation and the proceeds of the WAWA SIDS Walk in New Jersey to purchase cribs for MOMobile families and to provide educational materials on safe sleep environment.

• MCC's Early Head Start Program in the Norristown area is fully enrolled at 60 and a waiting list is started.

• The 2004 Celebrating Mothers campaign is the most successful to date. MCC raises over $150,000 with the help of honorary co-chair Andrea Thome and sponsorship from Citizens Bank and the Phillies. MCC is named the beneficiary of the Phillies Mystery Ball event.

• MCC holds a tea at the 2003 Flower Show to kick off the 2004 Celebrating Mothers Campaign. The event raises over $4,000 and becomes an MCC tradition.

• MCC is instrumental in bringing the story of formula companies' intervention in the National Breastfeeding Awareness Campaign to national media attention. After MCC shares the story with both 20/20 and CBS II, 20/20 produces and airs a segment on the controversy.

• MCC Board Vice President Mary Posner is named Volunteer of the Year by Main Line Life magazine for her extensive volunteer and Board service for MCC.

• MCC begins planning for its 25th Anniversary in 2005.

2005

• One of the year's major highlights is MCC's 25 Anniversary. The year culminates with 600 friends of MCC s at a truly special celebration on September 29 at the Hyatt Penn's Landing. The event features a live and silent auction and a new video sponsored by Comcast, highlighting MCC's history mission, programs and future.

• As part of MCC's 25th Anniversary, two professional education programs are held on Childbirth at a Crossroads. Presentations include an International Women's Day Stakeholder's Speak session of stakeholders, policymakers, and practitioners who discuss the question: Is there a healthcare crisis affecting prenatal and obstetric services today? In the second session, How Beliefs and Practice Evolve, Our Bodies, Ourselves authors Judy Norsigian, Robbie Davis-Floyd, (MCC's own) Elizabeth Lindsey, along with Ruth Wilf and JoAnne Fischer explore critical historical and current issues for childbearing families.

• Cribs for Kids experiences extraordinary growth after a series of articles by the Daily News' Jill Porter exposes the serious risks associated with co-sleeping. Our Cribs for Kids hotline receives over 4000 phone calls leading to the provision of over 2500 cribs to MCC and regional families. MCC partners with the City's Department of Human Services, Health Department, Naomi Post and many others to educate the community about safe sleep and to meet this pressing need.

• In recognition of National Breastfeeding Awareness Week, MCC co-sponsors a press conference with PA Senator Connie Williams who introduces legislation to support breastfeeding mothers.

• Hold successful event on September 28 attended by over 60 guests to announce the Breastfeeding Friendly Business Awards and launch a "Breastfeeding Welcome here" decal campaign.

• Co-Chairs Diane Croce and Lynn Doyle lead a successful Mothers Day campaign raising $185,000 for MCC programs.

• In collaboration with the Philadelphia Workforce Development Corporation, Family Start is launched, providing important support to 200 new mothers who are in TANF job training programs.

• Due to significant city, state and federal cuts in funding, three MOMobile sites – Strawberry Mansion, Germantown and Sharon Hill – are closed. In addition two sites – Latina and North –merge and became the newly named North Central MOMobile. Despite these traumatic cuts, services are provided to almost 4,400 families.

• Cizely Kurian, public health student completes her Drexel Community-based Master Project, a photo essay project on women & welfare and wins several awards including: Third Place Winner of the Department of Health and Human Services' 2005 Secretary's Award for Innovations in Health Promotion; Winner of the 2005 Drexel Research Day award for Innovations in Education and Outreach

2006

• Childbirth at a Crossroads is published, bringing together extensive research, stakeholder and provider interviews and identifying troubling trends and promising recommendations. The report is released at a successful press conference moderated by MCC Board member, Sara Lomax-Reese, and includes Gene Bishop (physician health advocate and chief writer)Estelle Richman (PA Secretary of Welfare), Joanne Grossi (PA Deputy Secretary for Health Promotion and Disease Prevention) and Andrew Wigglesworth, President of the Delaware Valley Healthcare Council.

• MOMobile Program serves almost 5,000 families, including 1,800 participants in Parent Outreach Meetings.

• Robert Wood Johnson Foundation's Local Initiative Funding Partners awards MCC a four year $475,000 grant to open a MOMobile Program at Riverside Correctional Facility. MCC is successful in raising the 1:1 match required by RWJ.

• MCC creates a Diversity Task Force to explore and promote diversity within MCC. An all staff full day training offered by the National Coalition Building Institute is very well received.

• MCC continues to serve as a critical training site for our future maternal and child health practitioners, providing internships for over 45 students from area medical, graduate, university, community college and high schools.

• Demand for safe sleep education and cribs persist, seriously taxing MCC staff and budget. In his annual budget speech, Mayor Street recommends that the City contribute $250,000 to the Cribs for Kids program. The Cribs for Kids program is reorganized to include face-to-face contact with families by home visits and workshops throughout the city. Staffing and funding is increased.

• Mother and son, Will and Carolyn Smith, are this year's Celebrating Mothers honorary co-chairs. Two sold-out teas, corporate sponsorships and a successful Mother's Day card campaign raise almost $185,000.

• Mark Michaels organizes golf benefit for MCC. First annual "Celebrating Fathers Golf Classic" is conceived and raises over $15,000.

2007

• Our newest MOMobile, the Riverside MOMobile opens at the Riverside Correctional Facility, serving over 150 women through prenatal and postpartum groups, and case management during incarceration and up to one year after release.

• The OB crisis grows with the closing of Jeanes Hospital's Obstetrics services. This is the 14th hospital maternity service eliminated in the last ten years. MCC takes the lead in bringing this issue (and the need for enhanced access to prenatal care) to decision makers in Philadelphia and Harrisburg, the community, media, and managed care providers.

• MOMobile Program serves nearly 4,500 families through home visits, consultations and Parent Outreach Meetings.

• Family Start services expand to Delaware County; Family Start in Philadelphia continues to grow, serving over 300 women and their babies.

• Cribs for Kids program revises services, providing in person contact and safe sleep education to every family who receives a crib. The demand for cribs remains high – the Cribs hotlines processes over 3,300 phone calls; close to 2,200 cribs are distributed.

• The Pew Charitable Trust awards a 3 year grant to provide a perinatal depression prevention program to MCC's clients.

• In collaboration with the Family Planning Council, the Pennsylvania Perinatal Partnership, MCC delivers extremely well received perinatal depression training throughout the State.

• Mothers Day Co-Chairs Diane Croce and Carolyn Smith lead a record breaking campaign, surpassing our fundraising goal by raising $209,000. 79 donors become members of MCC's new Carnation Club by donating $1000 or more. The annual kick-off Tea is moved to the Marriott and is successful in raising friends, funds and enthusiasm for MCC and the Mothers Day campaign.

• The second annual Celebrating Fathers Golf Classic raises $23,000 through corporate sponsorships, a silent auction and participant fees.

• MCC board engages in Strategic Planning with assistance of consultant Shelby Miller. Recommendations include developing a logic model for MCC planning that will emphasize Impacts and Outcomes rather than Goals and Objectives. Strategies for financial viability include focusing on pursuing multi-year grants and MCC's need for a long term fund development plan.

2008

• MCC releases the report, Survey of Prenatal Care Availability for Medicaid Managed Care Recipients in Philadelphia, which documents the barriers to prenatal care for the Medicaid population. MCC continues to lead advocacy efforts in bringing the needs of childbearing families (and the need for enhanced access to prenatal care and birthing facilities) to decision makers in Philadelphia and Harrisburg, the community, media, providers and managed care providers.

• MOMobile Program serves over 3,000 families through home visits, consultations and Parent Outreach Meetings.

• MCC partners with the Drexel School of Medicine's Partnership for the Comprehensive Care Program and Neighbor to Neighbor, a community development corporation of the First African Baptist Church in Sharon Hill, PA. Together, these three institutions form the Office of Minority Health HIV prevention program. Staff from the Delaware County MOMobile are trained to give clients HIV rapid tests and enhanced HIV prevention education. HIV 101 workshops for adults and teens are held at the First African Baptist Church, where a highly successful testing day results in almost 150 congregants learning their HIV status.

• Cribs for Kids program provides in person contact and safe sleep education to every family who receives a crib. The Cribs hotline processes almost 3,400 phone calls; over 2,500 cribs are distributed. Cribs for Kids staff present at national conferences and provide training throughout Southeastern Pennsylvania to providers and families.

• MOMobile Advocates receive training on the Edinburgh Post-Natal Depression Scale (EPDS) and begin screening clients using the tool. The Pew-funded Perinatal Emotional Support Program begins offering seven in-home intensive intervention sessions to clients who are identified to be at risk for perinatal depression. Women who complete the program have significantly improved EPDS scores.

• In collaboration with the Family Planning Council and the Pennsylvania Perinatal Partnership, MCC continues to provide extremely well received perinatal depression training throughout the State.

• Mother's Day Co-Chairs Diane Croce and Carolyn Smith reprise their successful leadership of the campaign, and the fundraising goal of $200,000 is surpassed by $8,000. Patti LaBelle, a Philadelphia favorite is announced as Honorary Chair at the annual kick-off Tea held at the Philadelphia Marriott Downtown. Eileen Fisher staff attends the tea and sponsor a very successful shopping day for MCC (raising over $10,000). We welcomed 7 corporate event sponsors and raise over $81,000 to start off the campaign. 89 donors become members of MCC's Carnation Club by donating $1,000 or more during this fiscal year.

• The second annual Celebrating Fathers Golf Classic is held at Scotland Run and raises $61,000 through corporate sponsorships, a silent auction and participant fees.

• Obtain contract from Keystone Mercy Health Plan to assist them in locating and providing service to pregnant participants who may need additional support.

• Partner with the Pennsylvania Perinatal Partnership and Family Planning Council and provide leadership in the planning and implementation of training throughout the state for providers on perinatal depression.

2009

• The MOMobile program served 1,607 women and 547 babies.

• MCC enrolled 91 pregnant and parenting women into four different parenting classes. 59 parenting class sessions were also provided.

• 261 participants registered for Family Start Services, 51% of which completed the program, and 35% returned to their respective training program or employment.

• Over 200 parenting skills pre-tests and over 150 postpartum bonding surveys were completed by MOMobile clients.

• MCC released Insuring Healthy Births Report at a rally in May. MCC and sponsoring organizations read the stories of four women who have either lost insurance, had difficulty obtaining insurance, or can barely afford their plan.

• MCC has maintained an organizing presence with the group of Northeast residents concerned about access to maternity services.

• E-Alerts were sent to the Board of Directors on the following topics: Breastfeeding rates, Access to prenatal care in Norristown, Healthcare reform, Contacting Senators to support PA Access to Basic Care, Closure of the Chestnut Hill Hospital maternity ward, Possible closure of Northeastern Hospital, PCCY's Kid Budget Campaign, the Economic Stimulus legislation, Children's Health Insurance Program legislation, Insuring Healthy Births Report and Rally.

• Six Breastfeeding Friendly Workplace awards were given in September with over 100 attending.

• Breast Pump Fact Sheets have been written and distributed for parents and physicians about how to access breast pumps for Medicaid clients.

• MCC participated in an invited national panel to provide recommendations to HHS on the next "Breastfeeding Blue Print."

• A summary report of the research identifying the barriers women face obtaining insurance, the types of insurance available, and how other states provide funding for women in their childbearing years was produced.

• The MCC Keystone Mercy Outreach Initiative successfully completed 155 "locator services" and conducted 106 prenatal assessments. 71 clients completed Follow-through services.

• The Standard Operating Procedures was successfully revised in April 2009 and was published on MCC's new Staff Intranet.

• On May 1, 2009 MCC was named as the grantee and assumed full responsibility for the South Philadelphia EHS Site. The program was funded to serve 85 slots (22 pregnant women, 33 Home-based children, and 30 center-based children). As of June 30, 2009, the total enrollment was 86.

• The Norristown EHS site has maintained a full home-based enrollment. As of June 30, 2009 the total enrollment was 39.

• Two sessions (5 groups per session) met at North Central MOMobile and participated in the HIV SISTA group intervention. 13 women were served.

• 2,591 cribs were distributed through the Cribs for Kids program.

• MCC partnered with the First Candle/SIDS Alliance to bring their nationally-recognized continuing education training curriculum for nurses to Philadelphia. 60 nurses and social workers attended the training and reported that it was highly valuable. The program provided SIDS risk reduction and safe sleep education to nurses in a variety of settings in order to assist them in working with patients to reduce infant mortality risks and create safe sleep policies and practices in the hospital, clinic and home settings.

• 100 incarcerated and newly-released women are enrolled in the Riverside case management program annually.

• Vilma Maldonado and Althea Elliott received doula training in September 2008. During this fiscal year, MOMobile at Riverside staff were present at the 20 births.

• 582 newly registered clients were screened with the EPDS and received education about signs and risks of perinatal depression. Ninety Five (95) newly registered clients in EHS and Riverside were screened with the EPDS and received education about signs and risks of perinatal depression. One hundred twenty five (125) clients scored 12 or higher on the EPDS and were referred to the Perinatal Depression Coordinator for further assessment.

• MCC worked in collaboration with Communities in Schools to address the needs of clients being served by the ELECT program, providing a four hour training session on maternal depression to 45 ELECT staff members. • Greentree, Mellon, Philadelphia Workforce Development Corporation and Einstein Medical Center along with the Department of Community and Economic Development (Dwight Evans) became strategic funding partners of the Northwest MOMobile, which opened on April 16, 2009 at 6607-6609 W. Chew Avenue in Philadelphia.

• Research department has worked with Rhonda Boyd to fund a community based participatory research project focused on maternal depression; proposal to NIMH received approval but there was no funding available. MCC planned to resubmit to NIMH in the spring.

• MCC create a Facebook page and send invitations to the members for the Tea and Mother's Day campaign and golf outing.

• MCC developed a 403b plan document.

• 28 administrative and program leadership staff attended a training covering leadership styles and general supervisory skills.

The Maternity Care Coalition (MCC) Records contain the institutional records of the Philadelphia-based community-health organization and span the years of 1965 to 2009. The collection consists of 56 boxes, and two oversized folders. The bulk of the collection is concentrated within the span of years between MCC's establishment in 1980 to the early 2000s. Those collection materials from before 1980 are concentrated within Series IX. This series comprises records from Walter J. Lear's Institute of Social Medicine and Community Health (ISMCH) Collection, an organization closely tied to the Maternity Care Coalition. The Maternity Care Coalition Records were donated to the Rare Book and Manuscript Library in 2009 by the Maternity Care Coalition and Walter J. Lear.

Primary types of materials within the collection include:

1. Community Outreach and Client Education Materials. As MCC's primary goal was to enable mothers to make better choices for themselves and their children, educational materials are found throughout the collection in series I, II, IV, and IX. Spanning the years 1960 to 2007, the following types of informative materials can be found: Teen Pregnancy Focus Group packets, Early Head Start Program information, and breastfeeding awareness materials.

2. Research Materials. These are concentrated in series II, IV, and IX, and span the years 1967 to 2007. Research materials focus on a number of issues, primarily related to healthcare, managed care, and government programs such as TANF, Welfare to Work, and Food Stamps. General research materials on subjects such as pregnancy and reproductive health, sexuality, and feminism are concentrated in Series IX, Walter J. Lear's Institute of Social Medicine and Community Health (ISMCH) Papers on Maternity Care Coalition.

3. Publications. These are concentrated in series VI and IX. These published materials come from a number of sources: government organizations such as the U.S. Department of Health and Human Services, non-government groups such as Planned Parenthood, and The Pew Charitable Trusts, and reports published directly by the Maternity Care Coalition.

Also present within the collection are media materials that relate to the long term organizational planning and mission of the Maternity Care Coalition. Media appearances are captured on a variety of formats, such as reel-to-reel, VHS tapes, audio cassettes, and DVD's. A photographic catalog of MCC from the years spanning 1985 to 2005 is contained within Series VI.