Maternal Child Health (MCH) Services Program

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FFY 2012 MCH Services Contract Opening

• Maternal Child Health (MCH) Services Program
• MCH District Nurse Consultants
• Cindy Leuthen, RN
• Maternal Child Health Services Program Manager
• Public Health Nursing Coordinator
• cindy.leuthen_at_health.mo.gov [phone]

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Welcome and Housekeeping..
Hand outs were e-mailed to you from Brenda
Buschjost Please put phones on mute by pressing
mute button or 6 Questions after each section
and again at the end Type in questions in the
chat box Please complete the evaluation to be
submitted after the webinar
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Todays Agenda

• Maternal Child Health Contract Overview
• Community Engagement
• Life Course Perspective and Risk Protective
  Factors
• A Data PIE
• Wrap-Up

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FFY 2012 MCH Services Contract

• Access to contract documents
• Posted on the Center for Local Public
• Health Services INTRANET page
• URL addresses
• http//dhssnet/LPHS/lpha_info.htm
• http//10.33.60.3/LPHS/lpha_info.htm

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Purpose

• To support a leadership role for local public
  health agencies within coalitions and
  partnerships at the local level to build MCH
  systems and expand the resources those systems
  can use to respond to priority health issues.

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MCH HEALTH ISSUES BY COUNTY

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Deliverables

• Shall work with community to maintain, develop,
  and enhance a system to address the priority
  health issue
• Should address risk and protective factors that
  influence health disparities within families and
  communities through the life course perspective
• Shall demonstrate progressive yearly growth
  toward the third-year system outcomes specified
  in the approved work plan
• Shall meet system outcomes from approved work
  plan by September 30, 2014

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Reporting

• Shall submit reports using the forms and/or
  formats specified by the Department
• Shall be submitted via e-mail attachment to the
  following MCH Services Program staff District
  Nurse Consultant / Program Manager/ Health
  Program Representative

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Reporting

• FFY 2012 Progress Report February 15th and
  Year-End Report October 31, 2012.
• FFY 2013 same as this year
• In the third year (2014), you will send the
  progress report in February and then the Contract
  Outcome Report (a different report than Year-end
  Report) in October of 2014.

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Progress Report
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Progress Report continued
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Funding Provisions

• Funding for this three-year contract is for one
  year, with two subsequent years, based on
  availability of funds
• MCH funds are to be considered payer of last
  resort
• Funds must be expended during the contract year
• Funding shall be used to expand or enhance
  activities that improve the health of mothers and
  children, and address local MCH issues
• No cash payments to recipients of MCH services,
  for land or building purchases, or major medical
  equipment

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Funding Provisions

• Funds shall not indirectly or directly support
  abortion services
• Funds shall not be used to provide comprehensive
  family planning services
• Minimum of 30 should be directed toward children
  with special health care needs
• Individuals below 100 Federal Poverty Level
  shall not be charged for services
• Shall not be used to supplant any state or
  federal funds for any services

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Subcontracting Provision

• Contractors may subcontract, but contractor must
  do majority of work (more than 50)

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Year-End Report

• Year-End Report is due October 31st
• You are reporting on the entire contract year.
• E-mail the report as an attachment to your
  District Nurse, Cindy Leuthen and Tiffany Tuua

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Match Funding Page

• Completed as part of the Year-End Report
• Over or beyond general MCH expenditures from
  October through September
• Track throughout the year
• Do not include contract funding
• Only Non-federal/state monies are reported
• Any local fees/taxes/grants/awards
• Type not reporting in total amount if you do
  not have anything to report
• Complete bottom portion regardless of total
  amount entered

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MCH Invoicing
Submit DH-38 by 15th of month following the
month services were provided Invoice number
format MCHmmyy (Oct 2011 MCH1011)
Invoice for 1/12 of total contract award
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Invoicing

• Use DH-38 Vendor Request for Payment submit
  by mail, fax, or as an e-mail attachment
• E-mail MUST have a legal electronic signature
• Assure invoice is dated and signed signature
  must be last day of month or later
• Contact Maurita Swartwood
• 573-526-2003
• maurita.swartwood_at_health.mo.gov

NEW!
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Amendments

• May request to amend the work plan or system
  outcomes
• Priority health issue may not be amended
• Submit amendment request by March 31st or prior
  to February if requesting to amend activities
• Submit request on dated agency letterhead with
  original or electronic signature
• Include revised work plan on template (revision
  date at bottom)

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MCH Services Contracts Benefit Everyone

• Women and Children

• Babies, Families, and Communities

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Community Engagement
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What is Community Engagement?

• The process of working collaboratively with
  groups of people who are affiliated by geographic
  proximity, special interests or similar
  situations with respect to issues affecting their
  well-being.

From Principles of Community Engagement, CDC, 1997
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Community Engagement

• Community engagement refers to the process by
  which individuals and organizations build
  ongoing, permanent relationships for the purpose
  of applying a collective vision for the benefit
  of a community.
• (Wikipedia)

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Community Engagement

• Community engagement is an integral part of each
  level within the Spectrum of Prevention

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Community Engagement

• A fundamental practice of public health

• The most effective way to achieve public health
  goals, especially toward the elimination of
  disparities in health status, is to actively
  engage those experiencing the problems in every
  aspect of addressing them.

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Partnership does not mean Engagement

• Community partnerships are relationships between
  partners for the purpose of a collective benefit.
  
• Community engagement builds social capital --
  social ties, networks, and support -- which is
  associated with better community health and
  well-being.

http//www.health.state.mn.us/communityeng
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Moving forward in Community Engagement

• Determine the goals of the plan
• Plan out who to engage
• Develop strategies to engage those individuals
  you already know and strategies to engage those
  individuals you do not yet know
• Prioritize activities
• Create an implementation plan
• Monitor progress
• Maintain those relationships

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Have the Conversation

• Communication (Old Way)

• Engagement (New Way)

• Community Conversation
• Understanding Those Not Like-Minded
• Bottom-Up
• Establishing a Stakeholder Network
• Values / Vision
• Community Engagement

• Public Hearing
• Influencing the Like-Minded
• Top-Down
• Building a Decision-Making Hierarchy
• Goals / Strategic Plan
• Public Relations

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Life Course
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• The Life Course Perspective

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Health Disparities

• Why do health disparities persist across
  population groups?
• What are the factors that influence the capacity
  of individuals or populations to reach their full
  potential for health and well-being?

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Key Life Course Concepts

• Todays experiences and exposures influence
  tomorrows health (Timeline).

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Key Life Course Concepts

• Health pathways are particularly affected during
  critical or sensitive periods. (Timing)

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Risk and Protective Factors

• Risk Factors

• Protective Factors

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• Risk Factors

• Protective Factors

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Key Life Course Concepts

• Inequality in health reflects more than genetics
  and personal choice. (Equity)

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A Life Course Perspective
Lu MC, Halfon N. Racial and ethnic disparities in
birth outcomes a life-course perspective.
Matern Child Health J. 2003713-30.
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Life Course Influences Health
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A Data PIE
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A Data PIE

• Overview
• The MCH system of prevention and the nursing
  process
• Assessment
• Planning
• Implementation
• Evaluation

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Assessment Data

• Finding Data
• National
• State
• County
• Collecting Data
• Surveys
• Focus groups
• Pre-test
• Observational studies

• Using Data
• Evidence-based decision making
• Recruitment of key stakeholders
• Sustainability/funding
• Community Engagement
• Outcomes

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Assessment Finding Data

• National (http//www.cdc.gov/DataStatistics)
• Behavioral Risk Factor Surveillance Survey
  (BRFSS)
• Pediatric Nutrition Surveillance System (PedNSS)
  and
• Pregnancy Surveillance System (PNSS)
• State (http//www.health.mo.gov/data)
• Youth Tobacco Survey (YTS)
• Chronic Disease and Risk Factors

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Chronic Disease Survey
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Assessment Finding Data

• County
• Community Data Profiles (CDP)
• http//www.health.mo.gov/data
• American Community Survey
• http//mcdc1.missouri.edu/sf1_2010/sf1_2010_menu.
  html
• and http//mcdc1.missouri.edu/acsprofiles/acsprof
  ilemenu.html
• County Health Rankings http//www.countyhealthrank
  ings.org/missouri
• Missouri Information for Community Assessment
  (MICA)
• http//health.mo.gov/data/mica/MICA/

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Assessment Collecting Data

• Survey Examples
• National BRFSS
• State YTS
• County - CDP
• Focus Groups
• Topic specific
• Population of interest

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Assessment Collecting Data

• Pre-Test assess knowledge
• Example danger of tobacco usage
• Observational Studies assess behavior
• Example bicycle helmet usage in a city park

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Planning Using Data

• Evidence-based decision making
• Recruitment of Key Stakeholders
• Sustainability/ Funding
• Community Engagement
• Evaluation

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Implementation Evidence-Based

• Evidence-based intervention strategies
• Association of Maternal and Child Health Programs
  (AMCHP)
• http//www.amchp.org/AboutAMCHP/BestPractices/Inno
  vationStation/Pages/default.aspx
• Community Health Improvement Resources (CHIR)
• http//health.mo.gov/data/chir/index.html
• Centers for Disease Control (CDC)
• http//www.cdc.gov/healthycommunitiesprogram/tools
  /index.htm
• Community Guide
• http//www.thecommunityguide.org/index.htmltopics
  
• National Policy and Legal Analysis Network
  (NPLAN)
• http//www.nplanonline.org/

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Evaluation

• Evaluation
• Process evaluation
• Examples staff MCH activity logs, intervention
  activity logs, participant feedback forms
• Impact evaluation
• Examples Pre- and post-test, post-intervention
  surveys or focus groups, and observational
  studies
• Outcome evaluation
• Examples comparing baseline and end of
  intervention data, after three years of funding
  what is different?

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Evaluation

• Steps to design an evaluation plan
• Decide what will be included in the evaluation
  BEFORE implementing an intervention
• Prepare evaluation questions for each aspect of
  the evaluation
• Identify appropriate methods for collecting
  evaluation information
• Determine a timeline for collecting and analyzing
  evaluation data
• Make a plan on how to share the evaluation
  results in the community

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Evaluation Resources

• CHIR http//health.mo.gov/data/chir/index.html
• Community Toolbox http//ctb.ku.edu/en/tablecont
  ents/sub_section_main_1352.htm
• Evaluation made Very easy, Accessible, and
  Logical (EVAL) http//www.acewh.dal.ca/eng/report
  s/EVAL.pdf
• AHELP Program Evaluation Webpagehttp//www.ahelp
  .org/Evaluation/Tools.aspx

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Resources

• Other resources
• MCH Intervention and Data Resource Guide
• Evaluation
• Guide to Outcomes-based Evaluation
• http//www.managementhelp.org/evaluatn/outcomes.h
  tm
• Evaluating your Community-based Program Part II
• http//www.aap.org/commpeds/htpcp/EvalResources.ht
  ml
• AMCHP resource on best practice
• http//dhssnet/LPHS/lpha_info.htm

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A Data PIE

• Key Points of A Data PIE
• Identify existing data
• SOS (Steal Others Stuff)
• Pre- and Post-measures MUST be the same tool
• Include the community throughout the Assessment,
  Planning, Implementation, and Evaluation (APIE)
  process
• Use evidence-based best practice
• Evaluate MCH system of prevention efforts

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Questions???
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Thank You!!!