The Orange County Healthy Start Coalition, Inc. (OCHSC) is part of a statewide system established by legislation in 1992 to decrease Florida's high rate of infant mortality. Through use of a prenatal risk-screening instrument, pregnant women are offered a screening assessment at their first prenatal care appointment for factors that place them at high risk for having a poor pregnancy outcome such as a low birth weight baby or a fetal/infant death. Those women who score at-risk are offered an array of services that have been shown to decrease a woman's risk for a poor birth outcome (e.g., care coordination, smoking cessation, nutrition counseling, mental health counseling, childbirth education, home visiting) through the Healthy Start program. Similarly, parents of newborns are offered an infant screening designed to identify infants at risk for poor developmental and health outcomes; the parents of those infants who score at-risk are offered Healthy Start services aimed at improving these outcomes. As a result of the Healthy Start legislation, Florida's infant mortality rate has decreased by 20.5% (from 8.8 in 1992 to 7.0 in 2004). However, we continue to struggle with the problem of racial disparity in birth outcomes: African-American (AA) infants are twice as likely to die before their first birthday as White babies and are twice as likely to be born with low birth weight (LBW). The implications of having healthy babies for the community are vast: for every $1 spent on preventing an unhealthy birth, $6 is saved in neonatal intensive care costs, recurrent hospital/medical expenses, exceptional student education, child abuse/neglect investigations, disability and dependency costs. OCHSC is committed to working to reduce our rates of poor birth outcomes.