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Getting Ready for the Title V 5-year Needs Assessment: Using the FHOP Data Sources. Gerry Oliva, M.D. UCSF Family Health Outcomes Project July 14th, 2008, San Diego, CA. Today’s Objectives. Successfully navigate the FHOP website to find what you need

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Getting ready for the title v 5 year needs assessment using the fhop data sources

Getting Ready for the Title V 5-year Needs Assessment: Using the FHOP Data Sources

Gerry Oliva, M.D.

UCSF Family Health Outcomes Project

July 14th, 2008, San Diego, CA


Today s objectives
Today’s Objectives the FHOP Data Sources

  • Successfully navigate the FHOP website to find what you need

  • Identify the sources of data for the 27 MCAH indicators

  • Interpret the rate tables in the FHOP Databooks

  • Interpret the trend tables in the FHOP Databooks

  • Use the blank  data templates and other planning tools

  • Using the Title V Indicator Rate table

UCSF Family Health Outcomes Project


Today s agenda
Today’s Agenda the FHOP Data Sources

  • Overview of the Title V planning process- the cliff note version

  • FHOP’s role in county Title V needs assessment

  • Navigating the FHOP Websites - finding what you need

  • Finding and interpreting data for the state MCAH required indicators – using the data spreadsheets and the indicator table

  • Understanding basic public health statistics and using FHOP’s rate tables

  • Review analytical and statistical concepts used in trend analysis – how to interpret trend graphs

UCSF Family Health Outcomes Project


Historical context
Historical Context the FHOP Data Sources

  • Institute of Medicine Future of Public Health Report 1988 - emphasis on the core functions of public health; focus on population based programs and essential public health services (counting numbers served is no longer sufficient)

    • Assessment

    • Planning and Policy Development

    • Assurance

UCSF Family Health Outcomes Project


Historical context1
Historical Context the FHOP Data Sources

  • 1989 - OBRA ‘89 requires federal Title V agency MCHB to monitor a set of HP 2000 indicators

  • 1992 - AB99 Committee in California recommends monitoring a larger number of HP2000 indicators

  • 1993 - California MCH Branch initiates an effort through FHOP to assist funded local MCH programs to monitor these indicators

UCSF Family Health Outcomes Project


Historical context cont
Historical Context (cont) the FHOP Data Sources

  • 1993 - Government Performance and Results Act (GPRA) mandates federal agencies to develop performance measures

  • 1997 - Federal MCHB develops a set of measures and Title V guidance requires states to monitor these

  • 1998 - California MCHB requires local programs to monitor these indicators and incorporate them into their five year needs assessment and plans

UCSF Family Health Outcomes Project


Historical context essential core public health functions
Historical Context: Essential Core Public Health Functions the FHOP Data Sources

  • Core Functions Steering Committee (1994)

    • Included representatives from national organizations and federal agencies

    • Charge: To provide a description and definition of public health

    • Developed the “Public Health in America” statement

UCSF Family Health Outcomes Project


Monitor health status the FHOP Data Sources

Diagnose and investigate

Inform, educate, and empower

Mobilize community partnerships

Develop policies and plans

Enforce laws and regulations

Link people to needed services / assure care

Assure a competent workforce

Evaluate health services

Research

UCSF Family Health Outcomes Project


Historical context for mcah program capacity assessment
Historical context for MCAH Program Capacity Assessment the FHOP Data Sources

  • CDC’s National Public Health Performance Standards Program (NPHPSP) develops tools to assess state PH programs in the 10 areas

  • 1995 AMCHP and Federal MCHB develop a set of 10 essential MCAH functions and the MCAH Pyramid that is used as a framework for the Federal Title V Assessment process.

  • Johns Hopkins School of Public Health in collaboration with AMCHP and Federal MCHB develops the CAST-5 assessment tool that corresponds to the NPHPSP

UCSF Family Health Outcomes Project


10 essential ph services to promote mcah in america
10 Essential PH Services to Promote MCAH in America the FHOP Data Sources

  • Assess and monitor MCAH status to identify and address problems.

  • Diagnose and investigate health problems and health hazards affecting women, children and youth.

  • Inform and educate the public and families about MCAH issues

UCSF Family Health Outcomes Project


10 essential ph services to promote mcah in america1
10 Essential PH Services to Promote MCAH in America the FHOP Data Sources

  • Mobilize community partnerships to identify and solve MCAH problems

  • Provide leadership for priority setting, planning, and policy development to support community efforts to assure the health of the MCAH population

  • Promote and enforce legal requirements that protect the MCAH population and ensure public accountability for their well-being

UCSF Family Health Outcomes Project


10 essential ph services to promote mcah in america2
10 Essential PH Services to Promote MCAH in America the FHOP Data Sources

  • Link women, children and youth to health and other community/family services, and assure access to comprehensive quality systems of care.

  • Assure the capacity and competency of he public health and personal health workforce to effectively and efficiently address MCAH needs

UCSF Family Health Outcomes Project


10 essential ph services to promote mcah in america3
10 Essential PH Services to Promote MCAH in America the FHOP Data Sources

  • Evaluate here effectiveness, accessibility and quality of Personal health and population-based MCAN services

  • Support research and demonstrations to gain new insights an innovative solutions to MCAH problems.

UCSF Family Health Outcomes Project


Federal mchb pyramid
Federal MCHB PYRAMID the FHOP Data Sources

UCSF Family Health Outcomes Project


2000 and beyond
2000 and Beyond the FHOP Data Sources

  • In 1999 Federal MCHB added a requirement for states to monitor a set of needs indicators

  • State MCH programs are awaiting the specific Title V guidance on requirements for the 5 year plan due in 2010

  • California MCAH will require that local MCH programs submit a needs assessment by July of 2009 to use in its document due in July of 2010

UCSF Family Health Outcomes Project


Fiscal and policy changes affecting mcah
Fiscal and Policy Changes Affecting MCAH the FHOP Data Sources

  • National budget deficits are resulting in cuts for basic social and health services for poor families

  • The state Title V Block Grant funds have been reduced several times in the past 5 years with no increases in sight

  • Some of the use of local funds as matching funds for public health nursing functions are being challenged

UCSF Family Health Outcomes Project


New expectations from federal funders
New Expectations from Federal Funders the FHOP Data Sources

  • The CDC has a number of major initiatives on promoting evidence based prevention strategies

  • This requires that state and local governments either use an evidence based model or have an evaluation that provides new evidence on the program’s cost and effectiveness

UCSF Family Health Outcomes Project


New emphases at california dph
New Emphases at California DPH the FHOP Data Sources

  • Focus on planning at the local level

  • Focus on local solutions

  • Increased interest in longitudinal data

  • Explosion of programs using GIS to examine local health issues

UCSF Family Health Outcomes Project


Emerging concepts ecological model

County the FHOP Data Sources

Housing

Laws

Policies

Workplace

Family

City

Child

Community

Healthcare Provider

Daycare

Jobs

School

State

Legal System

Availability of health services

National Politics

Emerging Concepts : Ecological Model

UCSF Family Health Outcomes Project


Emerging concepts life course model
Emerging Concepts: Life Course Model the FHOP Data Sources

Mother overweight/diabetic

Poverty/fast food/food habits in young woman

Infant born LGA/Abnormal GT

Adolescent with increased # fat cells/

abnormal GT

Working Mom-Infant Fed

Formula

School with no PE, unsafe parks

latch key child watches TV /

gets more overweight

Family Culture - high fat, high sugar diet- child overweight

UCSF Family Health Outcomes Project


Generic framework for health problem analysis

Societal/ Policy Level the FHOP Data Sources Level

Lack of Affordable/Accessible Family Planning Clinics

SES Factors

Environmental Factors

Economic factors

Healthcare Policies

Education Policy

Safety

Family/Community Level

Nuclear Family Factors

Community Networks

friends

Connection to religious or other community groups

Local School/ Workplace Factors

Quality issues

Health Care Provider Issues

Individual Level/ Individual Level

Psychosychological Factors

Cognitive Factors

Genetic/Biological Characteristics

Genetic/Biological Characteristics

Health Behaviors

Specific Biological Risk Factors

Immediate Causal Factor(s)

Targeted Indicator

Identified Problem

Consequences

Economic, Physical, etc

Generic Framework for Health Problem Analysis

UCSF Family Health Outcomes Project


2004 local mcah needs assessment
2004 Local MCAH Needs Assessment the FHOP Data Sources

Convene

Public Health/ Community Coalition

Assess 27 indicators & Prioritize

Health Status/Problems

Evaluate/ Measure

Performance

Plan & Implement Programs

Assess Community

Resources & Strengths

Assess MCH Program Capacity

Develop

Objectives

Analyze Problem & Select Interventions

UCSF Family Health Outcomes Project


2009 local mcah needs assessment
2009 Local MCAH Needs Assessment the FHOP Data Sources

Convene

Public Health/ Community Coalition

Assess 27 Indicators/ Review Priorities

Evaluate/ Measure

Performance

Assess Community

Resources & Strengths

Plan & Implement Programs

Assess MCAH Program Capacity

Develop

Objectives

Analyze Problem where no progress made on priority area

UCSF Family Health Outcomes Project


Challenges for local health jurisdictions
Challenges for Local Health Jurisdictions the FHOP Data Sources

  • Monitor results of program cuts

  • Advocate for local resources to sustain threatened programs

  • Advocate at state level for general fund monies to sustain programs

  • Determine where to allocate reduced resources

UCSF Family Health Outcomes Project


Preparing for the 5 year plan
Preparing for the 5-year Plan the FHOP Data Sources

  • MCAH Epi has developed guidelines on what will be required of LHJs

  • MCAH Epi with input from FHOP and county subcommittee has finalize tool for Program Capacity Assessment

  • FHOP is revising the guide “Developing an Effective Planning Process: A Guide for Local Health Programs”

  • FHOP and MCAH Epi are identifying or developing most of the data that local programs will need

  • Trainings will be provided on the essential components of the assessment

UCSF Family Health Outcomes Project


What help can fhop provide during the process
What help can FHOP provide during the process? the FHOP Data Sources

  • The website has been updated with 2006 data for databooks and the other indicators in the indicator table

  • Telephone conference calls will be held to help with specific issues

  • Additional trainings will be held in the 2008-2009 contract year

  • Telephone technical assistance will be provided

UCSF Family Health Outcomes Project


I bet you can t wait to get started
I bet you can’t wait to get started !!!! the FHOP Data Sources

UCSF Family Health Outcomes Project


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