3. Expand providers prescription capability to include alternatives such as cooking and physical activity classes.
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1 Maternal and Child Health Assessment 2015 In 2015, the Minnesota Department of Health conducted a Maternal and Child Health Needs Assessment for the state of Minnesota. Under the direction of a community leadership team, this assessment identified nine priorities for improving the health of mothers, children, adolescents, pregnant women, infants, and children and youth with special health needs. Working with stakeholders from across Minnesota, the leadership team identified specific areas of focus for each priority, along with possible measurements, strategies, practices, and action recommendations. We understand that there are some overlap among the nine priority areas; to avoid duplication, most areas of focus are only identified once, even though they could be under multiple priorities. (For example, prenatal care is important for both Preventive Health Care and Healthy Babies, but it is only listed under Healthy and Planned Pregnancy.) These priority sheets were created to provide data and ideas for community members, policy makers, public health professionals, and others working towards improving maternal and child health in Minnesota. Priority: Promote Preventive Health Care Promoting community health, keeping all women and children healthy through access to prenatal care, well woman and child visits, screenings, immunizations, and preventative oral health care. Focus areas: Immunizations Well checkups Oral health Screening and follow up The Maternal Child and Health Assessment Leadership Team identified these specific action recommendations to improve the health of children, adolescents, children and youth with special health needs, pregnant women and mothers through preventive health care in Minnesota: 1. Improve access to preventive health care in rural Minnesota and in tribal areas by increasing access to transportation and quality providers in shortage areas. 2. Establish more integrated care sites, inclusive of services such as, but is not limited to: dental, physical, behavioral and mental health care. 3. Expand providers prescription capability to include alternatives such as cooking and physical activity classes. 4. Promote routine well-woman visits to support the mental and physical health needs of women. 5. Increase developmental and social-emotional screening during well-child visits and appropriate follow-up to support the developmental, social-emotional and physical health needs of children. Page 1
2 Immunizations Objectives: Increase the percentage of children aged 19 to 35 months who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella and pneumococcal conjugate vaccine (PCV) (HP2020). Decrease the percentage of children who receive 0 doses of recommended vaccines by age 35 months. Increase the number of babies with well child visits by 15 months (on track with C&TC by age). Increase routine vaccination coverage for adolescents. Chart 1: Percent of children aged months receiving recommend vaccinations, 2013 Source: Centers for Disease Control and Prevention, Percentage of children aged 19 to 35 months who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella and pneumococcal conjugate vaccine (HP2020). Percent of children up to date on recommended vaccines. Partner with community members and leaders to address cultural barriers and reinforce importance of immunization. Increase awareness and education of immunization among parents, caregivers and children. Support cultural and community based organizations to improve adult and child immunizations rates in at-risk and underserved populations. Family home visiting. Train providers on communication skills regarding immunization for children of all ages. Increase adolescent participation in well child checks. Page 2
3 Well checkups Access to comprehensive, quality preventive health care services is important for the achievement of health equity and increasing the quality of a healthy life for everyone. Objectives: Increase the percentage of children and youth who receive the recommended well child checks. Chart 2: Children (ages 0-20) Well Child Visit Participation Ratio, Minnesota Health Care Programs - FFY 2014 Source: Minnesota Department of Human Services. CMS-416 Report - FFY Analyzed February Participation ratio is the ratio of how many children are eligible to receive at least one well child visit in the year and how many actually received a visit. Percent of all children (0-20) with well child visit in past year. Percent of women with a past year preventive medical visit. Improve the curricula taught in medical schools to focus on prevention and importance of culture, diversity and screenings. Provide adequate time for provider-patient appointments. Provide greater support to local public health agencies to perform outreach activities. Increase access by providing mobile services, alternate care sites (e.g. schools, community centers, churches), and expanding clinic hours. Recognize that best practices vary by culture and develop culturally sensitive materials to meet the needs of various populations. Increase children s usage of well child checks. Improve implementation of well child checks through provider training. Community health workers providing education and increasing access for families and children. Page 3
4 Oral Health Objective: Increase access to dental care, preventative and emergency, for children and youth on MN public plans (insurance). Chart 3: Percent of Children Receiving Preventive Dental Care, 2013 Source: MDH Oral Health Data Portal, Percent of women who had a dental visit during pregnancy. Percent of children, ages 1 through 17, who had a preventive dental visit in the past year. Expand and increase reimbursement for individuals with Medical Assistance, including addressing policy issues that excuse dental providers from obligations to serve children enrolled in public health plans. Provide education to child care providers on oral health and dental screenings. Establish school-based dental sealant programs. Provide mobile dental clinics. Create sustainable, school-based dental sealant programs and/or expanding existing programs to reach children in high risk areas with a special emphasis on children enrolled in Minnesota public programs, low-income uninsured, and under-insured. Screening and Follow up Objectives: Increase the percentage of developmental and social emotional screening among children and adolescents (C&CT). Increase percentage of women receiving postpartum depression and anxiety screening from health care professional Continue early detection for hearing loss and newborn screening. Page 4
5 Chart 4: Mental Health Screening Rate for Children 0 to 60 Months who have had at least one C&CT Visit, Source: Minnesota Department of Human Services. Analyzed September 2014 Chart 5: Developmental Screening Rate for Children 0 to 60 Months who have had at least one C&CT Visit, Source: Minnesota Department of Human Services. Analyzed September Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool. Percent of caregivers screened for postpartum depression within a baby well child check. Percent of babies followed up with a positive screen for hearing loss or genetic screening. Percent of local public health boards implementing highest levels of Follow Along Standards (for screening and following children for developmental and social-emotional development). Expand Help Me Grow model to increase access to school based screening. Use of development and social emotional screening instruments for Child and Teen Checkups. Develop system for screening birth to age 3 with universal access. Increase community awareness of the importance of screening. Implement maternal depression screening and referral at well-child checkups. Promote usage of Child and Teen Checkups through locally run education campaigns for families. Provide early intervention screening and services in home. Page 5
6 Preventive Health Care was identified as a priority, in part, because it was an identified priority, focus, or goal of all of these reports, plans, and organizations: Maternal and Child Assessment Inquiry Feedback MDH 2010 Title V National Performance Measure 2010 Title V State Performance Measure 2015 Title V National Performance Measure Advancing Health Equity Report MDH CDC Healthy People 2020 Children s Defense Fund MN Community Health Boards MN Eliminating Health Disparities Initiative MDH Healthy MN 2020: Statewide Health Improvement Framework Hospital Community Health Needs Assessments MN Infant Mortality Reduction Plan MDH MN Children & Youth With Special Health Needs Strategic Plan MN Council of Health Plans MN Statewide Health Assessment 2012 Prenatal to Three Plan MN Rural Health Advisory Committee MDH Women, Infant and Children MN For more information about the 2015 Maternal and Child Health Assessment, or about the Title V Block Grant, please visit the Minnesota Department of Health webpage at PO Box 64882, St. Paul, MN Health.TitleV@state.mn.us Page 6
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