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“The Power of Partnership” Meeting Today’s MCH Challenges Through Partnerships October, 2004

This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation In Slide Show, click on the right mouse button Select “Meeting Minder” Select the “Action Items” tab

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“The Power of Partnership” Meeting Today’s MCH Challenges Through Partnerships October, 2004

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  1. This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation • In Slide Show, click on the right mouse button • Select “Meeting Minder” • Select the “Action Items” tab • Type in action items as they come up • Click OK to dismiss this box • This will automatically create an Action Item slide at the end of your presentation with your points entered. “The Power of Partnership”Meeting Today’s MCH Challenges Through PartnershipsOctober, 2004 Health Resources And Services Administration Maternal And Child Health Bureau Peter C. Van Dyck, MD, MPH

  2. MCHB LEADERSHIP

  3. “The Power of Partnership” Goals • To communicate a shared vision, and to present new and critical information relevant to performance measurement, policy, program and administrative changes • To generate MCH partners through increased awareness…to provide opportunities for working together

  4. “The Power of Partnership” Goals • To identify critical issues facing the MCH population and opportunities for collaborative effort that can move effectively to meet the needs of the MCH population

  5. MCHB Strategic Plan Mission • “To provide national leadership and to work, in partnership with states, communities, public-private partners, and families to strengthen the MCH infrastructure, assure the availability and use of medical homes, and build the knowledge and human resources, in order to assure continued improvement in the health, safety and well-being of the MCH population”

  6. MCHB Strategic Plan Mission • “The MCH population includes all America’s women, infants, children, adolescents and their families, including women of reproductive age, fathers, and children with special health care needs(CSHCN)”

  7. MCHB Vision Statement • “MCHB believes in a future America in which the right to grow to one’s full potential is universally assured through attention to the comprehensive physical, psychological, and social needs of the MCH population. We strive for a society where children are wanted and born with optimal health, receive quality care, and are nurtured lovingly and sensitively as they mature into healthy, productive adults.

  8. MCHB Vision Statement • The Bureau seeks a Nation where there is equal access for all to quality health care in a supportive, culturally competent, family and community setting. “

  9. MCHB Values Statement • “To achieve its mission, the Bureau relies on personal, population-based, systems and resource building approaches to promote the health, safety, and well being of the Nation’s MCH population. Bureau efforts are driven by a commitment to the following values:

  10. MCHB Values Statement • Affordable and accessible high quality care for all • Accountable, regularly monitored and evaluated evidence-based quality care • Preventive, protective health care that address individual’s physical, psychological, and social needs

  11. MCHB Values Statement • Comprehensive, coordinated care in medical homes that includes direct and enabling services • Consumer-oriented, family-centered and culturally-competent care linked to community services • Continually improving health care based on research, evaluation, training/education, technical assistance, and the dissemination of up-to-date information

  12. MCHB Strategic Plan Goals • Provide National Leadership for Maternal and Child Health by creating a shared vision and goals for MCH, informing the public about MCH needs and issues, modeling new approaches to strengthen MCH, forging strong collaborative partnerships, and fostering a respectful environment that supports creativity, action, and accountability for MCH issues.

  13. MCHB Strategic Plan Goals • Eliminate health disparities in health status outcomes, through the removal of economic, social and cultural barriers to receiving comprehensive timely and appropriate health care

  14. MCHB Strategic Plan Goals • To assure the highest quality of care through the development of practice guidance, data monitoring, and evaluation tools; the utilization of evidence-based research; and the availability of a well-trained, culturally diverse workforce

  15. MCHB Strategic Plan Goals • To facilitate access to care through the development and improvement of the MCH health infrastructure and systems of care to enhance the provision of the necessary coordinated, quality health care

  16. MCH BUREAU PERFORMANCE

  17. MCHB Customer Satisfaction Survey • Last year MCHB contracted for a customer satisfaction survey of the end users of MCHB sponsored services • Limited to recipients of direct and enabling services • Both block grant funded and discretionary grant funded projects

  18. MCHB Customer Satisfaction Survey • Scores—MCHB State grantee projects scored 91 • Environment (including waiting time)=89 • Staff/employees=94 • Quality of services=93 • Information=93

  19. MCHB Customer Satisfaction Survey • Scores—MCHB discretionary grantee scored 91 • Environment (including waiting time)=89 • Staff/employees=93 • Quality of services=91 • Information=91

  20. MCHB Customer Satisfaction Survey • These scores must be compared to the average Federal agency score for 2003 of 71 • MCHB did good! • We will be sending our scores to those who participated • For more info contact Dr. Jacob Tenenbaum in the Office of Data and Program Development

  21. CORE PUBLIC HEALTH SERVICES DELIVERED BY MCH AGENCIES DIRECT HEALTH CARE SERVICES (GAP FILLING) Examples: Basic Health Services and Health Services for CSHCN MCH CHC EPSDT SCHIP ENABLING SERVICES Examples: Transportation, Translation, Outreach, Respite Care, Health Education, Family Support Services, Purchase of Health Insurance, Case Management, Coordination with Medicaid, WIC and Education POPULATION--BASED SERVICES Examples: Newborn Screening, Lead Screening, Immunization, Sudden Infant Death Counseling, Oral Health, Injury Prevention, Nutrition and Outreach/Public Education INFRASTRUCTURE BUILDING SERVICES Examples: Needs Assessment, Evaluation, Planning, Policy Development, Coordination, Quality Assurance, Standards Development, Monitoring, Training, Applied Research, Systems of Care and Information Systems

  22. MCH BUREAU ACCOUNTABILITY

  23. MCHB Program Strengths • Genuine partnership between federal government, states, and communities • Statement of priorities consistent with the healthy people 2000 and 2010 goals • Commitment to both federal and state financing evidenced by match of 4 federal to 3 state dollars

  24. MCHB Program Strengths • 5 year needs assessment planning • Framework that targets states’ expenditures to the entire MCH population--infants, children, adolescents, women, pregnant women, CSHCN • Flexibility for states’ to tailor programs • Commitment for coordination with all other major children’s programs--idea, WIC, medicaid, SCHIP, nutrition, headstart, early intervention

  25. MCHB Program Strengths • Special federal project grant authorities • SPRANS--enhance major purposes of state formula grants (15% set aside of the total title v appropriation) • CISS--enhance state and local communities ability to increase the comprehensiveness of local service delivery systems (12 3/4% set aside of the total title v appropriation over $600 million)

  26. MCH Bureau Performance Measurement System MCHB PRIORITIES AND GOALS MCHB PROGRAM AND RESOURCE ALLOCATION MCHB PERFORMANCE MEASURES MCHB OUTCOME MEASURES MCHB NEEDS ASSESSMENT HEALTH STATUS INDICATORS PERINATAL MORTALITY STATE BLOCK GRANT STATE/ NATIONAL INDICATORS I. DECREASE DISPARITIES INFANT MORTALITY DIRECT HEALTH SPRANS HEALTHY PEOPLE 2010 NEONATAL MORTALITY II. INCREASE QUALITY ENABLING SERVICES HEALTHY START POSTNEONATAL MORTALITY LEGISLATIVE PRIORITIES POPULATION BASED EMERGENCY SERVICES FOR CHILDREN CHILD MORTALITY III. IMPROVE INFRASTRUCTURE PARTNERSHIPS INPUT TRAUMATIC BRAIN INJURY INFRASTRUCTURE SERVICES INFANT DEATH DISPARITY

  27. Discretionary Grants--Levels of Performance Data • Standardized family of 30-35 national performance measures • Set of standardized forms similar to those in the block grant • Minimal data set for each Division beyond that in performance measures • Selected grantee performance measures from large grantee programs • Other—administrative or leadership data • Standardized application and guidance

  28. Title V SPRANS Performance Measurement System SPRANS NEEDS ASSESSMENT HEALTH STATUS INDICATORS SPRANS PRIORITIES AND GOALS SPRANS PROGRAM AND RESOURCE ALLOCATION SPRANS PERFORMANCE MEASURES SPRANS OUTCOME MEASURES PERINATAL MORTALITY DSCSHCN STATE/ NATIONAL INDICATORS I. DECREASE DISPARITIES INFANT MORTALITY DIRECT HEALTH DCAFH HEALTHY PEOPLE 2010 NEONATAL MORTALITY II. INCREASE QUALITY ENABLING SERVICES DRTE POSTNEONATAL MORTALITY LEGISLATIVE PRIORITIES DPSWH POPULATION BASED CHILD MORTALITY DSCH III. IMPROVE INFRASTRUCTURE PARTNERSHIPS INPUT INFRASTRUCTURE SERVICES ODIM INFANT DEATH DISPARITY

  29. Numbers Served In MCH Block Grant Program, 1997 And 2003 SOURCE: TITLE V INFORMATION SYSTEM

  30. MCHB BUDGET 2005

  31. The MCH Bureau Authorizing Legislation • MCH Services Block Grant (Title V, Social Security Act) • Traumatic Brain Injury (Section 1252, Public Health Service Act) • Healthy Start (Title III, Public Health Service Act, Section 330H) • Newborn Hearing Screening (Title III, Public Health Service Act, Section 399M)

  32. The MCH Bureau Authorizing Legislation • Poison Control Center (Section 6, Poison Control Center Enhancement and Awareness Act, P.L. 106-174) • Abstinence Education Community (Title V, Social Security Act, Section 501 (a)(2)) • Abstinence Education State (Title V, Social Security Act, Section 510) • Emergency Medical Services Children (Section 1910, Public Health Service Act)

  33. MCH Formula and Allocation • Whenever the total appropriation exceeds $600 million; • 12.75% of the amount is used to fund the Community Integrated Service System (CISS) set-aside program • Remainder is allocated as 85% to States and 15% retained by the Secretary for SPRANS projects

  34. MCH Formula and Allocation • The amounts appropriated for States are allocated as follows; • Funds appropriated up to $422,050,000 are distributed on the basis of the amount awarded in FY 1983 • Above $422,050,000 are distributed on the basis of the number of low-income children (under 18) in each State in relation to the total number of such children nationally

  35. The MCH Budget for 2004 and 2005(millions) FY2004 2005(PB) 2005(H) 2005(S) • MCHBG…$729.8..$729.8..$729.8..$734.8 • State….…$594.4....$606.3…$595.9…..$597.4 • SPRANS..$104.9….$107.0….$105.2....$105.4 • CISS….….$15.0…...$16.6…..$14.8.…...$15.0 • Earmark..$15.5…...$0.0…....$14.0….…$17.0 1-numbers may not add due to rounding

  36. MCH Formula and Allocation • Whenever the total appropriation exceeds $600 million; • 12.75% of the amount is used to fund the Community Integrated Service System (CISS) set-aside program • Remainder is allocated as 85% to States and 15% retained by the Secretary for SPRANS projects

  37. The MCH Budget for 2004 and 2005(millions) FY2004 2005(PB) 2005(H) 2005(S) • Healthy Start…$97.8..$ 97.8….$ 97.8....$105.0 • Hearing………..$ 9.9..$ 0.0 …$ 9.9..…$ 9.9 • EMSC…………..$19.9...$ 19.9….$ 19.9....$ 20.4 • Poison Cont.1..$23.7...$ 23.7….$ 23.7….$ 24.0 • AbEd Com.2….$70.0...$181.9...$105.0...$100.0 • AbEd State3….$50.0…$ 50.0.….$ • TBI………………$ 9.4….$ 9.4…..$ 9.4….$ 9.4 1)Transferred to Health Programs Bureau 2)Proposed to transfer to ACF in 2005 3)Transferred to ACF 1-numbers may not add due to rounding

  38. The MCH Budget for 2004 and 2005(millions) FY2004 2005(PB) 2005(H) 2005(S) SPRANS Earmarks • Oral Health…..$4.97…..$0.0 …..…$5.0………$5.0 • Sickle Cell….…$3.97.....$0.0……...$4.0........$4.0 • Epilepsy……....$2.98…..$0.0…..….$3.0……...$3.0 • Genetics….……$1.99…..$0.0……...$2.0……...$2.0 • Mental Health.$1.59…..$0.0…..….$0.0……...$3.0 1-numbers may not add due to rounding

  39. MCH BUREAU HISTORY

  40. The MCH Block Grant (Title V) history • 1912--Creation of the Children’s Bureau • “to investigate and report on the status of children and on their common as well as special needs” • 1913—Prenatal Care published • 1914—Infant Care published • 1921--Sheppard-Towner Act • First federal grant-in-aid program to States for health, “to promote the welfare and hygiene of maternity and infancy” • 1930—American Academy of Pediatrics

  41. The MCH Block Grant (Title V) history • 1935--Title V of the Social Security Act • Grants-in-aid to States for MCH programs, services for crippled children, and child welfare services • 1943—Autism is officially described by Dr. Leo Kanner • 1950—disposable diapers are invented by Marion Donovan

  42. The MCH Block Grant (Title V) history • 1957—Mental retardation programs • Congress earmarked $1M for demonstration clinical programs for children with mental retardation • 1962—St. Judes founded by Danny Thomas • 1963-5—MIC and C & Y programs • Three new grants: NICU, family planning, dental care • 1968—electronic fetal monitoring first used • 1969--Administration transferred to the Public Health Service

  43. The MCH Block Grant (Title V) history • 1981 (OBRA ‘81)--Converted Title V to a block grant by combining seven categorical programs; • MCH/CSHCN • SSI • Lead screening • Genetic diseases • SIDS counseling programs OBRA ‘81 • Hemophilia treatment centers • Adolescent program grant

  44. The MCH Block Grant (Title V) history • 1982—Prenatal test for sickle cell disease • 1984—Emergency medical services for children enacted • 1989 (OBRA ‘89)--Introduced major changes • Application with needs assessment and priorities • Measurable objectives • Budget accountability • Documentation of match • Maintenance of effort

  45. The MCH Block Grant (Title V) history • 1991—Healthy start enacted • 1996—Abstinence education program begun • 2000—Performance measures, CSHCN survey, www.mchdata.net, newborn screening, abstinence, poison control, bioterrorism

  46. The MCH Block Grant (Title V) history • 2004—Performance measures, CSHCN survey, child health survey, anti-bullying campaign, early childhood, newborn screening, women’s health, discretionary grants reporting system, data and evaluation, training strategic plan

  47. MCH BUREAU LAW

  48. The MCH Block Grant (Title V) States’ Program 501(a)(1)(a-d) • “Title V authorizes appropriations to states to improve the health of allmothers and children” • “To provide and assure mothers and children... Access to quality maternal and child health services” • “To reduce infant mortality…preventable diseases and handicapping conditions among children…increase number of...Immunized children…”

  49. The MCH Block Grant (Title V) States’ Program 501(a)(1)(a-d) • “To increase low income children receiving health assessments and…diagnosis and treatment services” • “Promote health…by providing prenatal, delivery, and postpartum care…” • “Promote health of children by providing preventive and primary care services…”

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