Opportunities for Collaboration: the MCHB Title V Block Grant and Healthy Start
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1 Opportunities for Collaboration: the MCHB Title V Block Grant and Healthy Start Presented by Kathy Best, Project Officer/ Region I MCH Consultant Shirley A. Smith, Region II MCH Regional Nurse Consultant DHHS/HRSA Maternal and Child Health Bureau Division of State and Community Health
2 Our Leaders The President Donald Trump Secretary, HHS Tom Price Administrator, HRSA George Sigounas Associate Administrator, MCHB Dr. Michael Lu Division of State and Community Health Michele Lawler
3 HHS Organizational Chart
4 Reimagine HHS: Secretary Price s Six Principles Engagement Empowerment Service Performance Stewardship Sustainability
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6 FY 2016 HRSA Budget: $10.5 Billion Program Primary Health Care HIV/AIDS Maternal and Child Health Health Workforce Rural Health Healthcare Systems Program Management Dollars $5.1 billion $2.3 billion $1.3 billion $1.2 billion $150 million $110 million $154 Million
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8 Title V Maternal and Child Health Block Grant to States Program Funding based on the number of children in poverty Matching grant program 30% for services for children with special health care needs 30% percent for preventive/primary care services for children 5 year Needs Assessment priority needs selection of measures selection of strategies
9 MCH Block Grant Three Tier Performance Measure Framework 9 National Outcome Measures National Performance Measures Evidence-Based or Evidence-Informed Strategy Measures
10 10 MCH Block Grant Performance Measure Framework National Outcome Measures (NOMs) are for population health assessment 15 National Performance Measures (NPMs) identified across 6 population domains As available, NPMs and NOMs are drawn from national data sources and prepopulated for States to analyze. If data are not available, States will provide their own data. Evidence-based/informed strategy measures (ESMs) are key to understanding and demonstrating impact of Title V investments on NPMs and longer term NOMs. Not just showing that NPMs/NOMs change but how Title V may influence those changes
11 National Performance Measures # Short Title Data Source MCH Population Domain 1 Well-woman visit BRFSS 2 Low-risk cesarean delivery NVSS Women s/maternal 3 Risk-appropriate perinatal care NVSS + AAP 4A,B Breastfeeding initiation and exclusive through 6 months NIS Perinatal/Infant 5 Safe sleep PRAMS 6 Developmental screening NSCH Child 7 Injury hospitalization 0-9 years and years HCUP-SID 8 Physical activity 6-11 years and years NSCH, YRBSS 9 Bullying perpetration and victimization NSCH, YRBSS 10 Adolescent well-visit NSCH 11 Medical home NSCH 12 Transition NSCH Child and/or Adolescent Adolescent CSHCN 13A,B Preventive dental visit during pregnancy, childhood PRAMS, NSCH 14A,B Smoking during pregnancy NVSS, NSCH Cross-cutting/Life course 15 Adequate insurance NSCH
12 Opportunities for Alignment and Assistance # NPM Program CoIIN Resource Center CMS Core Quality Measure HEDIS- Set NCQA 1 Well-woman visit Healthy Start Access to Care Postpartum visit X 2 Low-risk cesarean delivery Healthy Start Alliance for Innovation in Maternal Health Low-risk cesarean 3 Risk-appropriate perinatal care Infant Mortality Proposed 4 Breastfeeding Healthy Start Home Visiting Leadership Education in MCH Nutrition Program Home Visiting 5 Safe sleep position Healthy Start Infant Mortality National Action Partnership to Promote Safe Sleep Home Visiting 6 Developmental screening Home Visiting Home Visiting Leadership Education in Neurodevelopmental and Related Developmental Screening Disabilities (LEND) 7 Injury hospitalization Child Safety Children's Safety Network EMS National Resource Center 8 Physical activity Leadership Education in MCH Nutrition Program Weight Assessment and Counseling 9 Bullying HRSA Bullying Prevention Children's Safety Network Initiative 10 Adolescent well-visit AYAH AYAH National Resource Center Adolescent well-care visit Leadership Education in Adolescent Health 11 Medical home Healthy Start D70 - systems integration National Center for Medical Home Improvement CAHPS (all children and chronic LEND conditions) 12 Transition Got Transition LEND 13 Preventive dental visit Oral Health Oral Health Resources Center Preventive Dental Services 14 Smoking Healthy Start Infant Mortality Smoking and Tobacco Use Cessation 15 Adequate insurance Healthy Start Catalyst Center X X X X
13 State Priorities, State Performance Measures, and State Outcome Measures
14 Most Common State Priorities in 2015 Topic # (%) Access to Care and Health Status 59 (100%) Improving Health OR Access to Health Care 55 (93%) Improving Health 37 (63%) Improving Access to Health Care 48 (81%) Medical Home OR Care Coordination 40 (68%) Disparity Reduction 20 (34%) Oral Health OR Access to Oral Health Care 27 (46%) Mental Health and Access to Mental Health Care 29 (49%) Specialists, Screening, Immunizations, Other Care 46 (78%) Developmental Screening/Early Intervention 29 (49%) Transition Care 20 (34%)
15 Most Common State Priorities in 2015 Topic # (%) Healthy Pregnancies 55 (93%) Prenatal, Pre- and Interconceptional Health and Health Care 46 (78%) Preconceptional or Interconceptional Care 39 (66%) Pregnancy Outcomes-LBW and IM and MM 41 (69%) Infant Mortality 39 (66%) Healthy Living 54 (92%) Healthy Lifestyles in General, Nutrition, Exercise, Weight 49 (83%) Obesity and Overweight 20 (34%) Nutrition and/or Exercise 19 (32%) Breastfeeding 25 (42%) Risk Behavior in General, Substance Use, Sexual Risk 33 (56%) Any Substance Use 30 (51%) Tobacco Use 25 (42%) Drug/Substance Use 17 (29%) Miscellaneous/Uncategorized 33 (56%) Support Families/Parenting/Healthy Relationships 19 (32%) Injury Prevention 28 (47%)
16 Most Common SPMs/SOMs not overlapping with NPM/NOMs Topic # States Healthy Pregnancy 25 Teen Births 11 Agency/Workforce 20 Mental Health 17 Depression 11 Prenatal/Postpartum screening/prevalence 9
17 Contact Information Shirley A. Smith, RN, MS MCH Regional Nurse Consultant DHHS HRSA Maternal Child Health Bureau Division of State and Community Health Region II NY Regional Division Jacob Javits Federal Building, Room 3337 New York, NY phone: fax: Kathy K. Best, MBA MCH Regional MCH Consultant/ Project Officer DHHS HRSA Maternal Child Health Bureau Division of State and Community Health Region I Boston Regional Division JFK Federal Building, Room 1826 Boston, MA phone: kathy.best@hrsa.hhs.gov
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