Maternal and Child Health 101

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Maternal and Child Health 101

• Gina Febbraro, MPH
• Maternal and Child Health Program Manager
• Colorado Department of Public Health
  Environment
• www.mchcolorado.org

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Maternal and Child (MCH) Health

• The professional and academic field that
  focuses on the determinants, mechanisms and
  systems that promote and maintain the health,
  safety, well-being and appropriate development of
  children and their families in communities and
  societies in order to enhance the future health
  and welfare of society and subsequent
  generations" (Alexander, 2004).

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MCH Program Areas

• Medicaid, CHP
• Mental Health
• Newborn Screening
• Overweight / Obesity
• Oral Health
• Prenatal Health
• Physical Activity
• Reproductive Health
• School Health
• Smoking and Tobacco Cessation
• STI / STD
• Teen Pregnancy Prevention
• Women's Health
• Workforce Development

• Adolescent Health
• Child Health
• Children and Youth with Special Health Care Needs
  
• Emergency Preparedness
• EPSDT
• Family Planning
• Family and Consumer Involvement
• Health Care Financing
• Health Equity
• HIV Prevention
• Infant Mortality
• Injury and Violence Prevention

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MCH System

• Federal / National,
• State,
• Local Components

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Primary Federal / National Level Partners

• Maternal and Child Health Bureau
• Housed within HRSA at Dept. of HHS
• Association of Maternal and Child Health Programs
• CityMatCH

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Maternal and Child Health Bureau

• Mission To provide national leadership and to
  work in partnership with States, communities,
  public-private partners, and families to
  strengthen the maternal and child health (MCH)
  infrastructure, assure the availability and use
  of medical homes, and build knowledge and human
  resources in order to assure continued
  improvement in the health, safety, and well-being
  of the maternal and child health population.
• Population All Americas pregnant women,
  infants, children, adolescents, and their
  familiesincluding women of reproductive age,
  fathers, and children with special health care
  needs.

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Title V MCH Block Grant

• Began in 1935 as part of Social Security Act
• Administered by MCHB
• Only federal program devoted to improving the
  health of all women, children and families.
• Serves 33 million women and children in the U.S.
• 80 percent of all American children are served by
  one or more maternal and child health programs

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Title V MCH Block Grant

• Provides 662 million in formula funding to state
  MCH programs
• Competitive grant opportunities
• Special Projects of Regional and National
  Significance (SPRANS) grants
• Community Integrated Service Systems (CISS)
  grants.
• Healthy Start Initiative

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National Efforts / Resources

• 18 National Performance Measures / 6 Outcomes
  
• MCH Essential Services for Public Health
• MCH Pyramid

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Public Health ApproachFound at
http//www.sprc.org/library/phasp.pdf on 8/27/09
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Colorado Maternal and Child Health
www.mchcolorado.org
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• Colorado Department of Public Health and
  Environment
• Mission To optimize the health of women,
  children and families using a public health
  approach that supports community action,
  facilitates capacity building, strengthens
  infrastructure and enhances systems of care.
• Who we are
• Director
• Program Manager
• Health Planner
• Program Assistant
• 3 MCH Generalists 3 OPP Consultants
• 3 Core funded Units and MCH Program Staff CASH,
  Womens Health, CSHCN
• Other Units and Program Staff in PSD
  Immunization, Oral Health, COPAN, Nutrition
  Services, STEPP, ISVP

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Colorado MCH Title V Funding

• 7.2 million total
• 3.24 million to state-level activities (45)
• 3.96 million to local partners and programs
  (55)

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Colorado MCH Program Administration

• What we do and why
• See Logic Model

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Key State-level MCH Activities

• Title V Block grant application and reporting
• 5-year state-level needs assessment
• Manage budget and allocate funds to state-level
  programs
• Administer funds to MCH at local health agencies

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Key State-level MCH Activities

• Oversee MCH data development, compilation,
  interpretation, and dissemination
• Promote evidence-based programs
• Professional development / training / TA to state
  and local partners
• Disseminate resources local, state, national
• Facilitate/coordinate learning opportunities
  (annual meeting, webinars, lab sessions)
• Offer TA on program, administration issues

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State-level MCH Program Areas

• Child, adolescent and school health
• Children with special health care needs
• Prenatal
• Oral health
• Immunization
• Injury, suicide and violence prevention
• Physical activity and nutrition
• Tobacco prevention, cessation
• Nutrition services (WIC, Child and Adult Care
  Food Program)

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Examples of State-level MCH

• Teen motor vehicle fatality prevention
• Coordinated school health
• Positive youth development
• Healthy Baby Campaign
• Immunization registry
• Medical home systems building

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Local Maternal and Child Health in Colorado
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Local MCH-funded Partners

• 15 Local health agencies 2 HCP Regional Offices
  (Health Care Program for Children with Special
  Needs)
• Boulder, Broomfield, Delta, Denver, El Paso,
  Jefferson, Larimer, Las Animas/Huerfano, Mesa,
  Northeast, Otero, Pueblo, San Juan Basin,
  Tri-County, Weld, HCP South Central Region, HCP
  Northwest Regional Office
• 39 County Nursing Services Receive very small
  amount of MCH funds

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Local Health Agencies in CO

• Staffing Levels
• Leadership
• Expertise
• Partners/collaboration
• Local assessment, planning, implementation,
  evaluation

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Local MCH Funding Levels

• Range from 38,087 for smaller counties and
  health agencies such as Broomfield
• To 997,377 for larger counties and health
  agencies such as Tri-County

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MCH Local Health Agency / State Fiscal
Partnership

• Administered like a grant program
• Contractual relationship
• Funding based on funding formula
• Federal fiscal year (Oct 1 Sept 30)
• Invoice for services rendered
• Contract management system
• Monitoring mechanisms
• Fiscal and program staff involved

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MCH Local Health Agency / State Program
Partnership

• 3 program areas funded Child/adolescent,
  prenatal, and children with special health care
  needs
• State MCH Generalist Model
• State MCH Program Specialists
• Provide consultation, technical assistance, and
  professional development opportunities
• Supportive relationship two way communication /
  sharing
• Opportunities for collaborative
• decision-making/planning

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MCH Local Health Agency Planning Process

• Begins in February prior to fiscal year start
• Once every three years
• Intensive assessment and planning process in
  partnership with MCH Generalists / Program
  Specialists
• Create three year plan, budget, budget narrative

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LHA Assessment Planning

• Orientation meeting on planning process
• MCH Guidelines
• Step-by-step guides
• MCH web site (MCH data)
• Dissemination of county-level MCH data set and
  county-level trend analyses
• EPE staff consult with MCH staff to review county
  MCH data before planning meeting

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LHA Agency Planning Meeting

• Attendance
• LHA staff
• Local community partners
• MCH Generalist / Program Manager
• CDPHE EPE Staff
• MCH Checklist a tool to assist in the review
  and consideration of county-level MCH data (if
  available)
• Review data and complete checklist in planning
  meeting
• Discuss possible MCH priorities and strategies
  for three-year plan
• Identify relevant action guides

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LHA Planning Process

• LHA drafts plan and works with Generalist and
  Program Specialists
• July 1 plan submission
• Assess LHA feedback on planning process

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LHA Plan Implementation and Reporting Process

• Plan is dynamic and can change over time
• Ongoing communication / consultation between MCH
  Generalist and LHA
• Year-end report on plan implementation
• Numbers served for Title V

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Local MCH Program Examples

• Teen motor vehicle fatality prevention
• Coordinated school health
• Positive youth development
• Healthy Baby Campaign
• Immunization registry
• Medical home systems building

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• QUESTIONS?
• Gina Febbraro, MPH
• MCH Maternal and Child Program Manager
• 303 692 2427
• gina.febbraro_at_state.co.us
• www.mchcolorado.org
• Thank you!