Virginia Maternal and Child Health Block Grant Snapshot Healthy Start Regional Meeting Amanda Khalil, RN, BSN,MPH
Virginia Title V Performance Measures National Performance Measures (n=8) Safe Sleep Oral Health Early Elective Delivery (or Low Risk Cesarean) Reduction Tobacco Cessation for Pregnant Women Medical Home CYSHCN then all Children Transition CYSHCN then all Children Child Adolescent Injury Developmental Screening State Performance Measures (n=3) Maternal Mental Health Screening and Intervention including Substance Use Disorder (strategy - VNPC) Reduction in unintended pregnancy including among adolescents Infant Mortality Reduction particularly the health inequities
Why Virginia is Successful Transforming Title V 1. Fully Embracing Transformation 2016 2. Realignment of infrastructure (evidence based) 2016 Alignment of programs eliminate siloes (Title V, Home Visiting, Reproductive Health) Family-driven priorities and programs Data informed initiative 3. Systems Building Approach Medical Neighborhood, home visiting 4. Full Family Involvement at all stages 5. Ongoing CQI or informal assessment and revisions
Infant Mortality CoIIN Safe Sleep Online professional development training for nurses, local health department staff, home visitors Safe sleep toolkit for infant caregivers Mass communication Website hosting for safe sleep education and messaging (safesleepva.com) Environmental scan of VA sleep promotion activities Standardization for home visiting program messaging CQI with PDSA cycles with home visitors & health dept staff using the standardized safe sleep messaging
Evolving FORM: Transformation Life Course Model Health Domain 1 Women/Maternal Health Long Term Follow Up DCLS, CDC HRSA, Title V Blood Spot, CCHD, EHDI Birth Defects Registry Health Domains 2 & 3 Infant & Child Health Health Domain 6 Cross Cutting (division, home visiting) Title X Locality Pre- and Inter-conception care Family Planning Comprehensive Reproductive Health age 18 + Newborn Screening Health Domain 5 CYSHCN age birth to 1 age 6 to 17 School and Adolescent Health School Nursing age 1 to 5 Early Childhood Health Abstinence Education Program MIECHV, Healthy Start, Resource Mothers Kindergarten Readiness Workforce development Universal Early Developmental Screening Health Domain 3 Child Health MIECHV HRSA Healthy Start HRSA Resource Mothers GFTANF Title V sources GAP in Program Legend Title V Health Domains Population and Program Focus Age categories Growth Areas Teen Pregnancy Prevention Title V Match/ GF Healthy Young Men initiative Health Domain 4 Adolescent Health DCFH 2016 Deagle Virginia
State Level Staff Local Health Dept. Steering Committee Stakeholders Time /Money Community members Resources Hospitals Mothers Infants Children Adolescents Families Women Pregnant Women Communities SMEs Maternal & Child Health Grant (Title V) Logic Model Specific Aims: Reducing infant mortality Providing comprehensive coordinated care for all women before, during, and after pregnancy and childbirth; Providing preventive and primary care services for infants, children and adolescents Providing comprehensive care for children and adolescents with special health care needs Reducing unintended pregnancy INPUTS Activities OUTCOMES (5years) IMPACTS DCFH/CRD 4.17 Health Department: Establish work plans with objectives to reduce infant mortality Identify implementation plan for selected MCH priorities Implement evaluation plan (process, impact and outcome) Central Office: Establish workplans with objectives to reduce infant mortality Identify implementation plan for selected MCH priorities Implement evaluation plan (process, impact and outcome) Identify action objectives: National Performance Measures State Priority Measures Other Emerging Issues Opiod use Mental Health Zika Local Community Health Assessments: Select priorities that meet community needs & assets ongoing Local Health Districts Other state agencies FQHCs Capacity & Data Allocation of MCH dollars to 35 health districts used to performance measures 35 Health Districts to address x number of MCH National/State priorities. Administration: Allocation and monitoring of MCH funds Fiscal Accuracy Fiscal Accountability Fiscal Transparency Continuous Quality Improvement Technical Assistance for all programs Workforce Development Aligning funds with priorities Annual Needs Assessment: Ongoing Needs Assessment occurs through feedback from program sites, program participants and MCH staff participation in State Boards, Committees and Task Forces (e.g., Zika, Opioid Use) State Performance Measures Women/Maternal Health Increase percentage of live births that were intended Increase percent of women with a live birth that received postpartum contraception/mental health counseling Cross-cutting/Life Course (Mental Health) Decrease percentage of high school students who report attempting suicide during the past 12 months Cross-cutting/Life Course (Infant Mortality) Decrease percentage of infants born preterm (gestational age less 37 week completed) Increase in healthy equity and reduce disparities in MCH Decrease Infant Mortality Improve Access and Quality of Care National Performance Measures Perinatal/Infant Health Increase percentage of infants placed to sleep on their backs Child Health and/or Adolescent Health Injury Prevention Bright Futures as standard of pediatric care (AAP) Adolescent Health Injury Prevention Physical Activity (revising) Children with Special Health Care Needs Increase percentage of all children with a medical home Increase percentage of children with and without special health care needs who received services to make transitions to adult health care Cross-cutting/Life Course Decrease percentage of pregnant women who smoke Decrease percentage of children who live in households where someone smokes/tobacco use
Questions?