2005 Oregon Maternal and Child Health Needs Assessment Report. MCH System Capacity

Transcription

1 2005 Oregon Maternal and Child Health Needs Assessment Report MCH System Capacity Office of Family Health Oregon Public Health Department of Human Services Spring 2006

2 A report that summarizes the strengths and needs of Oregon s maternal and child health service system capacity.

3 2005 Oregon Maternal and Child Health Needs Assessment Report MCH System Capacity Spring 2006

4 ACKNOWLEDGEMENTS The following people provided extensive support, expertise, critique and patience during the year it took to complete this Assessment: Katherine Bradley Donalda Dodson Molly Emmons Isabelle Barbour Eve Pepos Nurit Fischler Diane Ponder Ken Rosenberg Sherry Spence Pat Westling Claudia Bingham Bob Nystrom Sue Woodbury Lorraine Duncan Jane Foust Beth Epstein Julie McFarlane Jeanne Atkins Lisa Millet Robert Nickel Cathy Renken Marilyn Hartzell Diane Smith Becky Adelman Marilyn Sutherland Marti Franc Jan Kaplan Casey Milne Tom Milne And the staffs of the Office of Family Health and the Child Development and Rehabilitation Center, and Oregon s county health departments and their partners, who enthusiastically and unselfishly care for the children and families of Oregon.

5 Table of Contents Executive Summary... 1 Methods... 2 Findings Local Public Health Systems... 4 Findings State Public Health Systems... 6 Recommendations... 9 Resources...11 Appendix...13

6

7 Executive Summary The Five-Year Needs Assessment for Oregon s Title V-Maternal and Child Health Block Grant 1 program provides a timely opportunity to review health status and trends, identify priorities, and set goals for improving health of children and families. This assessment was guided by a Leadership Group that included the Office of Family Health at the Oregon Department of Human Services and the Oregon Center for Children and Youth with Special Health Needs at the Oregon Health and Science University. These organizations jointly assessed the health system capacity and health priorities for women, infants, children, and adolescents as well as special populations such as children and youth with special health needs. The assessment process covered two areas. One assessment researched priorities for improving health of mothers, children and families. The parallel assessment researched the needs to improve the capacity of the public health system in addressing health priorities. State and local public health professionals, partners, and staff participated in the assessment, providing knowledgeable perspectives on the strengths and needs for healthy families and adequate public health services. Secondary information sources included existing data sources, local public health plans, and collaborative assessment processes. This report on MCH System Capacity, along with its companion report on Health Priorities, provide foundations for planning maternal and child health programs and services, and for developing structures to better implement programs and services. The culmination of both assessment findings resulted in Aims to guide the work of Oregon s Title V-MCH Block Grant programs over the next few years. The Aims for Oregon s MCH programs are: Children s health needs are always met. Individuals and families exhibit healthy lifestyles. Children, adolescents and families experience optimal mental health and social emotional development. Parents and providers are confident in caring for children. Racial and ethnic disparities are eliminated. Strong leadership is helping to reduce morbidity and mortality of the maternal and child health population. 1

8 Capacity Assessment Report Methods Public health capacity was a priority among Oregon s public health programs over the course of For several years, public health leadership has weakened, while demands for public health response have increased during times of economic downturn and emergency preparedness needs. The Oregon DHS Health Services, the Conference of Local Health Officials (CLHO), and Office of Family Health (Title V Agency) collaborated to assess the capacity of Oregon s public health system to perform the core public health functions and essential services. Essential Maternal and Child Health Services * 1. Assess and monitor maternal and child health status to identify and address problems. 2. Diagnose and investigate health problems and health hazards. 3. Inform and educate the public and families about maternal and child health issues. 4. Mobilize community partnerships between policy makers, health care providers, families, the general public, and others to identify and solve maternal and child health problems. 5. Provide leadership for priority setting, planning, and policy development to support community efforts to assure the health of women, children, youth and their families. 6. Promote and enforce legal requirements that protect the health and safety of women, children and youth, and ensure public accountability for their well-being. 7. Link women, children and youth to health and other community and family services, and assure access to comprehensive, quality systems of care. 8. Assure the capacity and competency of the public health and personal health workforce to effectively and efficiently address maternal and child health needs. 9. Evaluate the effectiveness, accessibility, and quality of personal health and population-based maternal and child health services. 10. Support research and demonstrations to gain new insights and innovative solutions to maternal and child health-related problems *Ten Essential MCH Services are the same as the public health services, but focused on MCH populations. 2

9 Two national assessment instruments were used to conduct the public health capacity assessment, and the results were analyzed along with a separate assessment of the Office of Family Health s role in the early childhood system, and Local Capacity for Adolescent Public Health. The resources for the full capacity assessment are as follows: State and County public health system capacity: The National Public Health Performance Standards (NPHPS) 2 assessment instrument Conducted in early 2004 Statewide capacity assessment included approximately 60 public health leaders and partners County health department assessments in 11 counties, including local partners. MCH public health system capacity: The Capacity Assessment for State Title-V (CAST-5) 3 Conducted in late 2004 and early 2005 Integrated CAST-5 with NPHPS for three of the 11 county health departments to assess both public health systems and delivery of MCH services specifically Staff-level assessment of 3 Essential Services within Office of Family Health Assessment of OFH s work with the Early Childhood System Appreciative Inquiry to assess how the Office of Family Health (OFH) can best promote child health through partnerships with other sectors of the Early Childhood System. Participants of this assessment included state staff from the Perinatal, Child and Adolescent Health, Reproductive Health, Oral Health, Genetics, Women s Health, WIC, and Immunization programs County-level adolescent health capacity Brief Adolescent Health Systems Capacity Assessment, adapted from a national state-level assessment tool 4 The assessments were designed to capture various elements of the ten essential services and other capacity measures without duplication. The results cover various aspects of capacity, providing a broad scan of the real needs and strengths. The overall assessment method was somewhat coincidental, as results of several processes occurring at the same time were compiled and compared together. The analysis of the results affirmed common themes about state and local public health capacity across the spectrum of data resources. 3

10 Findings Local Public Health Systems County Capacity Assessments In 2004, Oregon conducted National Standards assessment of 9 county public health departments. With the MCH assessment, three additional counties were selected (Lincoln, Klamath, and Clackamas Counties) to assess capacity of both the public health system and the MCH services system. The NPHPS tool was used to assess ten essential local public health system services. The CAST-5 5 tool was adapted to assess local level MCH service capacity. County health departments invited staff, local stakeholders, partners, and parent representatives from the communities, with participation ranging from 25 people to 60 people across all three counties. Both instrument scores used the scale of the NPHPS tool for consistency. Local MCH Assessments Conducted in these Counties Lincoln County (2003): Population 44,400 Children <24 12,604 Pop. Density 45/sq mi Births 429 Medicaid Births 249 Birth rate 9.5/1000 Klamath County (2003): Population 64,800 Children <24 22,121 Pop. Density 11/sq mi Births 836 Medicaid Births 435 Birth rate 12.9/1000 Clackamas County (2003): Population 356,250 Children <24 119,341 Pop. Density 181/sq mi Births 4,019 Medicaid Births 1,134 Birth rate 11.4/1000 *Source: Oregon Center for Health Statistics, 2003 The NPHPS results were consistent with the nine county assessments previously conducted using the NPHPS tool. The scores across all three counties had a fairly consistent correlation between the CAST-5 results and the NPHPS results. The local process included SWOT (Strengths, Weaknesses, Opportunities and Threats) with key health department managers and stakeholders to facilitate action on the assessment findings. Consistent themes across all three health departments included the following strengths for local systems: 4 Community collaboration Strong and dedicated staff Community support Community programs Shared planning and resources

11 The lead weaknesses and concerns across the three health departments included: Poor access to care High rates of socio-economic problems in the community, such as drug use, child abuse, poverty, unemployment Lack of resources Poor connections with school health Individual county concerns and needs: Score 100 MCH CAST-5 vs. NPHPSP Three County Essential Public Health CAST-5 NPHPS Milne and Assoc. Lack of staff with Spanish-speaking skills to serve Hispanics (Lincoln) High youth suicide rates (Klamath) High rate of birth defects and medically complex problems diagnosed after one year of life (Klamath) Duplication of services (Clackamas) Poor communication between some agencies (Clackamas) County Adolescent Health Capacity Assessment Local public health systems have been lacking in the area of adolescent health policies and programming. While specific funding for broad-based programming is minimal at present, efforts are underway nationally and in Oregon to improve the public health system response to the health needs of Oregon s adolescent population. The Adolescent Health Section in the Office of Family Health conducted an assessment of local system capacity. The national System Capacity for Adolescent Health: Public Health Improvement Tool, was a state level tool developed by the Association of Maternal and Child Health Programs and the National Network of State Adolescent Health Coordinators (NNSAHC) with support from the Annie Casey Foundation in Oregon developed and used a modified and abbreviated version of this tool for local assessment. County health administrators and public health nurse supervisors for each of the 35 county health departments convened a group of their adolescent health stakeholders to complete the tool. Twentyseven of the 35 county health departments returned a completed tool. Though a more inclusive and comprehensive effort would better analyze a community s capacity, the Oregon Brief Systems Capacity Assessment Tool demonstrated a potentially effective and user friendly method to measure the adolescent health capacity of local public health departments. 5

12 The findings of this assessment identified several strengths as well as needs to support adolescent health in communities. Local public health systems have a high capacity to form partnerships to support adolescent health, yet these partnerships tend to lack both youth and family involvement. The positive youth development approach is an effective model for improving community partnership networks. Local systems have a low capacity for planning and evaluation, especially in the adolescent public health area. Many counties, regardless of population size, have difficulty in creating the space and time to break from day to day activities to assess and plan for the future and to evaluate current strategies. Additional resources and technical assistance from the state and federal public health organizations is needed to improve this capacity area. This assessment, the first conducted in Oregon, and the first using an adapted national tool for local assessment, helped to raise awareness of the public health needs of the adolescent population. In some instances, the process served as a catalyst for building an adolescent health focus in county public health departments. By increasing the formal commitment to the adolescent population, progress in other capacity areas may be facilitated by raising the visibility and the resources devoted to the adolescent (10-24 year-old) population. Findings State Public Health Systems State Public Health System Capacity Assessment An assessment of Oregon s public health system was conducted in June 2004 to find out the system s strengths and needs. Changes in state level agency organization and reduction of services due to lack of funding and reduced economic status, had created the impression that Oregon s public health system was losing its effectiveness and leadership. The National Public Health Performance Standards tool was used and about 60 stakeholders and partners participated in the two-day process. The NPHPS assessment provided critical information about the public health system across the state, including those areas of strengths and deficiencies as documented through the discussions. The system s strengths found in this assessment included the state s capacity to plan and implement most of the public health essential services, with technical assistance and support. The findings found the public health 6

13 system lacking in meeting standards of evaluation and quality improvement and in resources. These deficits included: A statewide profile to identify changes and trends in factors in population health status Office of Family Health CAST- 5 vs. NPHPSP Results A statewide public health improvement plan to mobilize and support community health improvement Consistent efforts to address public health workforce issues in partnership with national and state level organizations and the academic community A statewide public health research agenda Score EPHS#1 EPHS#4 EPHS#9 Essential Public Health Service CAST-5 NPHPSP Milne and Assoc. State-level MCH Capacity Assessment The Title V-MCH program in the Office of Family Health found the results of the statewide and local capacity assessments rich with information relevant to the five-year needs assessment. To round out the perspectives and understanding of areas to strengthen or sustain, it was necessary to hear from those responsible for leading, coordinating and implementing public health and MCH programs the staff of the Office of Family Health. The CAST-5 instrument was used, focusing on three of the Essential Services for MCH services that were not represented by the statewide NPHPS assessment. The essential services selected were: #1: Assess and monitor health status #4: Mobilize partnerships #9: Evaluate effectiveness and quality of services Participants included staff and managers for programs such as Perinatal Health, Infant and Child Health, Adolescent Health, WIC, Immunization, Family Planning, Women s Health, Genetics, and Oral Health. Relative strength was found for Essential Services #1 and #4 compared to the NPHPS, though Essential Service # 4 mobilizing partnerships fairly low in the NPHPS. The greatest deficiency appeared in #9 evaluation of effectiveness and quality scoring much lower than the statewide NPHPS. Program evaluation was consistent theme across the local level MCH assessments and the local Adolescent Health Capacity assessment. Program evaluation capacity for MCH Programs is a concern nationally, and in Oregon, this weakness resonated throughout the state and local assessments. Additional work will need to be undertaken to define what this deficiency means in terms of function and resources available for evaluations suitable for improving and advocating for maternal and child public health. State Level - MCH/Early Childhood Systems Assessments The Oregon Early Childhood System is a term used to describe those services, supports, organizations, and providers that strive to assure and promote early development of infants and young children. A team of public agency leaders coordinates the public system of social services, health, and education agencies. While public health capacity assessments identified capacity of public

14 health systems, Oregon s early childhood systems were also engaged in strategic planning and assessment through the State Early Childhood Comprehensive Systems (ECCS) Initiative 7. This information was analyzed along with the information compiled by the capacity assessments discussed above. The ECCS Initiative activities included an appreciative inquiry assessment of programs within the Office of Family Health (OFH). The purpose of this assessment was to develop a shared understanding of OFH s work in the Early Childhood System and to develop strategies for strengthening OFH s contribution to Oregon s system of early Childhood Services and supports. The process was focused on planning in five areas for the 0-8 year old population: Health insurance and Medical care Mental Health and Social-Emotional Development Early Care and Education Parent Education Family Support OFH program staff participated in staff meetings, and in topic-specific sessions in each of the five focus areas. The process culminated in an All-Staff meeting to bring together the threads of information in response to the following questions: How can the Office of Family Health best promote the health of Oregon s Young Children and families through the Early Childhood System? How do we use what we know about our strengths/contributions, and our dreams for OFH s work with the Early Childhood System to craft a plan for action? The answers to these questions convey the needs at the OFH level. As the ECCS is closely intertwined with Title V and MCH programs, the results of this process are included to round out the picture of capacity strengths and needs from statewide public health system to local public health and MCH systems, and then to the State MCH office Level. The top internal infrastructure issues and needs that OFH identified through this process included: Leadership in clarifying and communicating expectations and focusing on identified priorities Organizational infrastructure to support and dedicate staff to partnership building and collaboration with external stakeholders Staff support promoting cross-disciplinary work, manageable workloads, and improved compensations

15 Recommendations The findings of the capacity assessment are helpful in identifying the common themes, strengths, and needs that are essential to adequately address MCH health issues. These recommendations are goals for state and local public health organizations to plan and evaluate programs, policies and services. Data and information needs to be accessible for analysis and reporting to support development of state and community health profiles and system improvement and monitoring. Collaborations with health providers, social services, community organizations and family representatives need to be included in MCH program and policy development to assure quality, coordinated, familycentered services. Program evaluation and quality improvement systems are needed to measure effectiveness and improve delivery and outcomes of programs and services. Support for community and statewide advocacy is needed to improve public health resources, policies and programs that address the needs of communities. State and local maternal and child health leaders need to set priorities and goals to plan and implement organizational and community efforts. The next steps require planning and development to make progress towards these recommended goals. Strengthened capacity at the state level will improve its ability to engage partners and provide leadership across the maternal and child health system in Oregon. Outlined below are focus areas identified by the Office of Family Health to begin implementing these recommendations. Policy advocacy and leadership: Define policy and advocacy related to state-level public health programs and develop recommendations for structures and methods that enable OFH to provide leadership across Oregon s maternal and child health system. Program evaluation: Identify resources needed to improve office-wide capacity for evaluation activities and develop recommendations to enhance evaluation of OFH programs, services and activities. 9

16 Program infrastructure: Develop recommendations for cross-office interventions and programs that are supported by collaborative, coordinated decision-making and work processes, and create a culture that values collaboration, creativity, effectiveness, efficiency and staff morale. 10

17 Resources Local Public Health Improvement Plans Local Commission for Children and Families Plans Conference of Local Health Officials: Maternal and Child Health Committee Association of Oregon Public Health Nurses Oregon DHS Health Services, Public Health Staff Oregon DHS, Office of Multicultural Health 11

18 12

19 Appendix Capacity Assessments Source For Findings The summary below represents needs according to the 10 Essential Services, the early childhood system integration in OFH, and the local adolescent health capacity. The Summary results are sorted according to the system that was assessed: Public health system state and local whole public health systems MCH system local MCH systems, Office of Family Health state-level system OFH links with Early Childhood Systems Office of Family Health programs Adolescent health capacity county health departments It is important to note that only the Public Health System and the MCH System assessments used the Ten Essential Services in the instrument. The findings from the OFH Early Childhood and Local Adolescent Health assessment which used other processes or instruments, are organized by Essential Services to highlight the commonalities and to facilitate planning. Therefore, the findings not assessed or no comments means that none of the findings from these assessments fit into that Essential Service category. 13

20 14 Findings For Capacity Needs by Public Health Essential Service Note: all entries are verbatim from assessment discussions and brainstorming, without editing, collected in the context of the assessment processes and meetings. Local adolescent health: Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Limited capacity to monitor adolescent health needs and conduct resource assessments Strengthen comprehensive data collection and analysis, focusing on: integration (e.g. FamilyNet), data sharing, filling data gaps (e.g. Local and State Office: Assessment scores were greater than 50%, or substantially or fully met Local: Access to and utilization of current technology Population-based community health profile elementary age children) Dedicate more resources to transforming data into information to use for policy/program development Collect, analyze and disseminate data and information on children s health status to voters, families, legislators, providers, educators, and other stakeholders Organize data in a public health profile Compile and provide data to organizations for surveillance Develop uniform set of health indicators Provide standard set of healthrelated data to partners Share system-wide resources to monitor health status State: #1: Assess and monitor health status ( Not assessed) (No comments) ( Not assessed) Local: Assessment scores were greater than 50%, or substantially or fully met State: Provide screening tests in response to exposures to health hazards #2: Investigate health problems & hazards

21 Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Develop consultation capacity in OFH to support childcare providers and other providers and partners, including a marketing plan Provide or assure education for the public and professionals on health status and child health/development topics Local adolescent health: Findings For Capacity Needs by Public Health Essential Service Conduct some public education around adolescent health issues Local: Utilize a system for identifying existing and emerging health education and health information needs appropriate for target audiences State: Covered in public health system Local: Health education and health promotion activities State: Deliver culturally and linguistically appropriate health education and health promotion materials and activities Involve the population served in the design and implementation of reviews Use resources for effective health communication, and health education and promotion interventions # 3: Inform, educate and empower the public 15

22 Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Promote coordination and support for partner providers to focus on prevention and health promotion Local adolescent health: Need to focus on partnerships with families and youth High capacity to form partnerships in support of adolescent health 16 Findings For Capacity Needs by Public Health Essential Service Local: Provide information to targeted community audiences on local MCH along a service continuum Improve communication and relationships within DHS and between DHS/OFH external early childhood partners Increase family and youth involvement in OFH policy and program design, development, implementation and evaluation Increase OFH facilitation, liaison and collaboration with public/private stakeholders Use the coordinated school health model as a base for expanded partnerships Actively work with child protective services such as multidisciplinary groups; provide more accessible data information; invite external partners to presentations/trainings; use technology more effectively Collaborate with stakeholders and partners on developing and improving a comprehensive, integrated approach to home visiting starting before birth Increase local agency capacity through TA and needs assessment to improve collaborations with social services and parent education. status, trends and needs Convene, stimulate, and/or provide resources (e.g. staffing, funding) for community coalitions Local and State: Actively solicit and use community input about MCH needs Respond to community MCH concerns as they arise Provide funding and/or technical assistance for community-driven and generated initiatives and partnerships among public and/or private community stakeholders State: Local: Constituency development Community partnerships State: Build constituencies to address health issues Brief state and local policy leaders using established procedures and time lines Provide consultation and training to local health systems and state partners to build partnerships for community health improvement Evaluate and review constituencybuilding and partnership facilitation activities, including participation and commitment of its partners Share system-wide resources to develop constituencies and mobilize partnerships # 4: Mobilize partnerships

23 Findings For Capacity Needs by Public Health Essential Service Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Align state office policies and undertake joint policy, funding and program development in areas related Synchronize policies and programs using a client-centered philosophy, within our current partnerships within Local adolescent health: Local: Public health policy development Community health improvement process to early childhood OFH provides data and elevates the visibility of the impact of uninsured children DHS Advocate for increased capacity of the child and family mental health service system to address both prevention and treatment. Advocate and promote universal developmental screening Ensure that issues of access and health disparities rise to the top and stay in the forefront of decision-makers at all levels (including the voting public & legislators), through OFH role to collect, analyze and disseminate data to all stakeholders and decisionmakers Provide technical assistance and support to local public health systems and state partners to develop community health improvement plans, community development plans, and local State: # 5: Leadership for policy development and advocacy operational plans Evaluate and review progress towards state-wide health improvement and policy impact Use information systems that provide useful data for policy development and planning 17

24 Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Coordinate the regulatory and educational functions of public health ( Not assessed) with the Childcare Division. OFH works within DHS to assure alignment of state OARs and statutes with best practices for child health and child care Local adolescent health: Limited capacity to work on policy development specific to adolescent health 18 Findings For Capacity Needs by Public Health Essential Service Local: Assessed as partially or adequately met State: Ensure administrative processes are customer-centered Evaluate and review technical assistance provided to local public health systems and state partners regarding enforcement Share system-wide resources to implement enforcement activities # 6: Promote and enforce health policies

25 Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Integrate prevention and screening/ early identification of risk conditions for mental health into public health ( Not assessed) Local adolescent health: Findings For Capacity Needs by Public Health Essential Service ( Not assessed) Local: Identifying personal health settings Promote universal developmental screening Assure that children and parents have access to prevention, screening, diagnosis and treatment for mental health/social emotional development issues through partnership collaborations Increase access to care and reduce health disparities by including Information and Referral as an access to care issue (e.g., SafeNet-toll-free line); create linkages between existing health systems, formal/informal services needs of populations Assuring linkage of people to personal health services Work with health care providers to assure care for persons living in State: the state Incorporate perspectives of those who experience problems with accessibility and availability of health care Share system-wide resources to effectively provide needed personal services Use a workforce skilled in managing health services quality improvement programs # 7: Link & assure access to services 19

26 Local adolescent health: No time or staff to adequately focus on adolescent health Used tool as springboard to prioritize adolescent health within existing workforce 20 Findings For Capacity Needs by Public Health Essential Service Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Provide education and resources on child health and development to social Local: Support employees to promote crossoffice, cross-disciplinary work and partnership building as a critical job priority, not as an add-on to already full jobs Local: Public health leadership service workers and foster homes Assure that the public health workforce and other early childhood service providers are educated about mental health and social/emotional development, and trained to refer to mental health services. development Workforce assessment State: Assist in workforce development Assure availability of educational courses to enhance workforce skills Facilitate partner linkages to improve educational offerings Evaluate and review workforce assessment activities Assess achievements of workforce development plan Use system of life-long learning for workforce Use leadership development programs for statewide workforce Use programs to develop cultural competencies among state wide and personal health services workforce #8: Workforce development

27 Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Promote increased use of information technology to improve multidisciplinary patient care, QI, and public health surveillance through medical/health care systems improvement, such as electronic medical records, e-exchange of data, child health profiles for use by providers Local and state: Utilize data for quality improvement at the municipal and regional levels Perform comparative analysis of programs and services Local adolescent health: Findings For Capacity Needs by Public Health Essential Service Evaluation and planning for adolescent health activities and services are underdeveloped or under utilized Support and/or assure routine monitoring and structured evaluations of State: Local: Evaluation of population-based services and local public health system State: Provide technical assistance in evaluating performance of the state-funded services and programs Provide and/or assure technical assistance to local health agencies in conducting evaluations Provide resources for and/or collaborate with local health or other appropriate agencies in collecting and analyzing data on consumer satisfaction with services/programs and community perceptions of health needs, access issues, and quality of care Disseminate information about the effectiveness, accessibility, and quality of personal health and populationbased MCH services Assume a leadership role in generating and disseminating information on private sector MCH outcomes Essential Public Health Services Offer consultation and guidance to conduct consumer satisfaction studies Review evaluation and quality improvement Manage current evaluation resources and develop new resources # 9: Evaluate effectiveness and quality of services 21

28 22 Findings For Capacity Needs by Public Health Essential Service Local adolescent health: ( Not assessed) (No comments) ( Not assessed) Essential Services Public Health System: MCH Systems: OFH/Early Childhood System: Local: Capacity for epidemiological, policy and service research State: Have and implement a public health research agenda Have a statewide communication process for sharing research findings on innovative public health practices Evaluate and review the state s ability to engage in public health research and communicate its findings Evaluate and review the ability to provide technical assistance with application and relevance of research findings Use findings from reviews to improve research activities #10: Support research and demonstrations

29 (Footnotes) 1 The federal Title V, Maternal and Child Health Block Grant requires states (Title V Agencies) to conduct a needs assessment of the maternal and child health population every five years, to select priorities and performance measures, and to monitor progress in addressing needs. 2 National Public Health Performance Standard Program, Centers for Disease Control, 3 Capacity Assessment for State Title V, Johns Hopkins University Women s and Children s Health Policy Center, Association of Maternal and Child Health Programs and Maternal and Child Health Bureau, data-cast5.htm 4 System Capacity for Adolescent Health, Adolescent Health Coordinators Network, Association of Maternal and Child Health Programs and Anne E. Casey Foundation, 5 See Footnote 3. 6 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health; Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Adolescent Health; National Adolescent Health Information Center, University of California, San Francisco. Improving the Health of Adolescents and Young Adults: A Guide for States and Communities. Atlanta, GA: Early Childhood Systems Planning Project, Health Resources and Services Administration, Maternal and Child Health Bureau,

30

31

32 If you have a disability and need this document in an alternate format, call Office of Family Health at (971) fax (971) If you know of others who will need this accommodation, please let them know it is available. Visit our web site at: Office of Family Health Oregon Public Health Department of Human Services Spring 2006