A Snapsh t of Maternal and

Child Health

2000

hot oF Maternal and Child Health 2000
Title V Title V Title V

A Snapshot

of Maternal

and Child

Health

2000

U.S. Department of Health and Human Services

Health Resources and Services Administration

Maternal and Child Health Bureau

December 2000

i
Note to the Reader

The data in this publication were collected individually—as reported by each

State or jurisdiction. Sources of data, data collection methods, and data

reporting practices differ. Data reported in this publication may include actual

counts, estimates, or blank cells if data were not available at the time of

reporting.

ii
Table of Table of Table ofC ntents C ntents C ntents

Chapter I: The Status of Maternal and Child Health, 1998...................................3

Numbers of Note.......................................................................................................3

The Rate of Births for Teenagers Aged 15 through 17.....................................4

The Rate of Suicide Deaths Among Youths Aged 15-19 ..................................4

The Percentage of “Very Low Birth Weight” Infants Delivered at Facilities for

High-Risk Deliveries and Neonates ....................................................................4

The Percentage of Mothers Who Breastfeed

Their Infants at Hospital Discharge ...................................................................4

Socioeconomic Context for MCH Population (1998) ..........................................4

Population Data .................................................................................................5

Family Composition ...........................................................................................5

Children in Poverty ............................................................................................5

Working Mothers ...............................................................................................5

Child Care .........................................................................................................5

School Dropouts ................................................................................................5

Uninsured Women and Children ........................................................................6

Current Maternal and Child Health Challenges and Priorities ..................................6

Special Projects of Regional and National Significance (SPRANS) ....................6

Universal Newborn Hearing Screening ...............................................................7

Figure I-1: Common Priority Need Areas ............................................................7

Other Newborn Screening .................................................................................8

Healthy Child Care America 2000 ......................................................................8

Healthy Start ......................................................................................................9

Poison Control Centers.....................................................................................10

The National Survey of Children with Special Health Care Needs (CSHCN) ....10

CompCare ..........................................................................................................11

Office of Women’s Health ...............................................................................11

Office of Data and Information Management (ODIM) .......................................12

Chapter II: Title V 1998 National Summary Data................................................13

The 1998 National MCH Outcome Measures .........................................................13

Infant Mortality Rate ........................................................................................13

Ratio of Black to White Infant Mortality Rates ..................................................14

Neonatal Mortality ............................................................................................14

Postneonatal Mortality .....................................................................................14

Perinatal Mortality ............................................................................................14

iii
Child Mortality ..................................................................................................14

Selected 1998 National MCH Performance Measures ...........................................15

Specialty Services for Children with Special Health Care Needs (CSHCN) .......15

Children Immunized (Ages 19 – 35 Months) Against 9 Diseases .....................15

Births to Teens Aged 15 – 17 ..........................................................................16

Deaths to Children Aged 1 – 14 (Caused by Motor Vehicle Crashes) .............16

Score for Family Participation in Programs and Policies of CSHCN Programs ..16

Very-Low-Birth Weight (VLBW) Births ...............................................................17

Infants Born to Women Who Received First Trimester Prenatal Care ..............17

Telephone Access to MCH Information ...................................................................17

Figure II-1:Total Hotline Calls by Year ............................................................17

Who Title V Helps and How Much was Spent ...........................................................18

Figure II-2:Title V—MCH Federal-State Block Grant Partnership: Number of

Individuals Served and Population Group .........................................................18

Figure II-3: Title V—MCH Federal-State Block Grant Partnership

Expenditures by Populations Served FY98 .......................................................18

Title V—MCH Federal-State Block Grant Partnership Expenditures...................19

Figure II-4: Title V—MCH Federal-State Block Grant Partnership by Source

of Funds FY-98 ...............................................................................................19

Figure II-5: MCH Federal-State Partnership Fund—FY98 ..............................19

Total MCH Expenditures ........................................................................................19

Title V—MCH Federal-State Block Grant Partnership Expenditures by MCH

 Levels of Services .................................................................................................20

Figure II-6: MCH Pyramid of Health Services ...................................................20

The Story of Gabriella ............................................................................................20

Chapter III: Maternal and Child Health—An Overview and Brief History ......23

The MCH Partnership—Its Roots and Milestones ...................................................23

Title V MCH Federal-State Partnership—How It Works Today ................................24

Figure III-1: The MCH Pyramid of Health Services ..........................................25

The MCH Pyramid Framework ...............................................................................25

Level I: Direct Health Care Services ...............................................................25

Level II: Enabling Services ...............................................................................26

Level III: Population-Based Services ................................................................26

Level IV: Infrastructure Building Services .........................................................26

Legislative Funding and Program ..........................................................................26

MCHB Organization ...............................................................................................27

Office of the Director .......................................................................................27

Office of Data and Information Management (ODIM) .......................................27

Figure III-2: Maternal and Child Health Organizational Chart .....................28

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Office of Women’s Health ................................................................................29

Division of State and Community Health (DSCH) ..............................................29

Division of Child, Adolescent, and Family Health (DCAFH) ...............................29

Division of Perinatal Systems and Women’s Health (DPSWH) ..........................29

Division of Services for Children with Special Health Needs (DSCSHN) ............30

Division of Research, Training, and Education (DRTE) ....................................30

Appendix

A. Title V Snapshots of the States and Jurisdictions ....................................31

Alabama ..........................................................................................................32

Alaska ...........................................................................................................36

American Samoa ...........................................................................................40

Arizona .............................................................................................44

Arkansas .............................................................................................48

California ...........................................................................................52

Colorado ...............................................................................................58

Connecticut ............................................................................................62

Delaware ............................................................................................66

District of Columbia ...........................................................................70

Florida ................................................................................................74

Georgia .............................................................................................78

Guam ..................................................................................................82

Hawaii ..............................................................................................86

Idaho .................................................................................................90

Illinois .................................................................................................94

Indiana ................................................................................................98

Iowa ...................................................................................................102

Kansas ..............................................................................................106

Kentucky ...........................................................................................110

Louisiana ........................................................................................114

Maine ................................................................................................118

Marshall Islands .............................................................................122

Maryland ............................................................................................126

Massachusetts ...............................................................................130

Michigan ............................................................................................136

Micronesia, Federated States of ...................................................140

Minnesota .......................................................................................144

Mississippi .....................................................................................148

v
Missouri ........................................................................................152

Montana ........................................................................................156

Nebraska ......................................................................................160

Nevada ..........................................................................................164

New Hampshire ..............................................................................168

New Jersey ........................................................................................172

New Mexico ..................................................................................176

New York .....................................................................................180

North Carolina .............................................................................186

North Dakota ...................................................................................190

Northern Mariana Islands ...........................................................194

Ohio ...............................................................................................198

Oklahoma .....................................................................................202

Oregon ..........................................................................................206

Palau .............................................................................................210

Pennsylvania .................................................................................214

Puerto Rico .................................................................................218

Rhode Island .................................................................................222

South Carolina ..............................................................................226

South Dakota ...............................................................................230

Tennessee .....................................................................................234

Texas .................................................................................................238

Utah .................................................................................................242

Vermont .........................................................................................246

Virgin Islands ................................................................................250

Virginia ...........................................................................................................254

Washington .......................................................................................258

West Virginia .....................................................................................262

Wisconsin .............................................................................................266

Wyoming .........................................................................................270

B. How the Title V Block Grant Works ...........................................................275

C. MCHB Strategic Plan ..................................................................................279

D. Organizational Links ...................................................................................283

E. Glossary .......................................................................................................291

vi
F reword F reword F reword

1

This 2000 Snapshot of Title V and Maternal and Child Health not only

marks the millennium milestone, it also marks the 65th anniversary of the

Social Security Act and the birth of Title V. Enactment of the Title V legislation

in 1935 was the historical marker. The Congress of the United States began

to recognize that it was important for each State to have an infrastructure

which ensures access to appropriate health care, especially for those we

have come to call the Maternal and Child Health population.

This 2000 Snapshot provides the most comprehensive picture to date of how

the Title V Federal-State Partnership works and what is happening in each of

the 59 States and jurisdictions. In addition to the Title V MCH Services Block

Grant to States Program information, this edition also includes a listing of the

Special Projects of Regional and National Significance (SPRANS) and other

Federal MCH grants to each State and jurisdiction.

The numbers in this report reveal good news and progress in many areas. In

Chapter I we note specific encouraging examples. The good news becomes

especially apparent as we examine progress within specific individual States.

For example, some States have already met or exceeded the Healthy

People 2010 expectations on certain specific health indicators.

The numbers also reveal that much remains to be done. For example, in this

wealthy Nation with all of its advances in medicine, each year 1 million

women deliver infants who did not receive adequate prenatal care. That

means that every 30 seconds, another baby is born who should have had a

better chance for a truly healthy start! We can and must do better.

Let us keep our eyes on the goal as, together, we work for a healthier new

millennium for all who live in the United States and its jurisdictions.

Peter C. van Dyck, M.D., M.P.H.

Associate Administrator for Maternal and Child Health

Health Resources and Services Administration
3

CHAPTER 1 CHAPTER 1 CHAPTER 1 The Status of

Maternal and

Child Health,

1998

This chapter presents a picture of maternal and child

health in 1998 on three dimensions: First, four

remarkable trends that illustrate the progress being made

by the States in meeting maternal and child health needs;

second, the socio-economic context for the 1998 Title V

Information System data; and third, a rundown of National

and State priority concerns and highlighted initiatives.

Numbers of Note

This section highlights the progress of the 50 States and

Puerto Rico on four specific dimensions. The data

indicators that support these assertions are taken from

the State Title V Maternal and Child Health Block Grant

Reports for 1998.

Two areas for discussion relate to the adolescent

population; two other data segments concern mothers

and infants:

• Teen pregnancy rates are dropping.

• Teen suicide rates are on the decline.

• More “Very Low Birth Weight” infants are born at

risk-appropriate facilities.

• Breastfeeding is on the rise.

Greater detail on the data that provide this encouraging

news is detailed below, but first a word of explanation

about the Performance Measures from which these

“numbers of note” are collected.

As a part of their annual Title V Maternal and Child

Health Block Grant Reports, all States are required to

report on a core set of Performance Measures.

Performance Measures describe a specific maternal and

child health need that, when successfully addressed, can

lead to a better health outcome within a specific time

frame. Most of the Performance Measures correspond to

one of the National Healthy People 2000 (and now 2010)
4

Goals. States may also elect to set their own State

targets. What follows is a discussion of each of four

specific Performance Measures, which are alluded to

above.

Performance Measure: The Rate of Births for

Teenagers Aged 15 through 17 years

The U.S. Department of Health and Human Services has

made the reduction of teen pregnancy a priority in its

1997 strategic plan. Teen pregnancy is deemed a major

threat to healthy and productive lives. Teen parenting is

associated with the lack of high school completion and

with initiating a cycle of poverty for mothers.

The Healthy People 2000 goal is to lower the rate of teen

pregnancy to no more than 50 per 1,000 births; the 2010

goal is for a still lower rate, down to no more than 46 per

1,000 births to teenagers aged 15 through 17 years. In

1998, 47 of 51 States (92 percent) met the Healthy

People 2010 goal of no more than 46 per 1,000 births to

teens ages 15 through 17. All except four States set their

own State target for even fewer births for this age group

than the Healthy People 2010 goal. Sixty-seven percent

(34 of 51) States met their own State-set goals, most of

which were below (i.e., more ambitious) than the Healthy

People 2010 goal.

Performance Measure: The Rate of Suicide

Deaths Among Youths Aged 15-19

Suicide is the third leading cause of death in the United

States among youths aged 15-19. In many States, teen

suicide ranks as the second leading cause of death for

this population. The Healthy People 2000 goal is to

reduce the teen suicide rate to no more than 8.2 teen

suicides per 100,000 teens ages 15-19. The more

challenging 2010 goal strives to lower the rate to no

more than 6 per 100,000.

In 1997, the United States reported 10.8 teen suicides

for every 100,000 teens aged 15-19 in the population. In

1998, the Block Grant report showed that 28 States were

below the 1997 United States rate of 10.8 per 100,000.

Further, in 1998 five States were already below the

Healthy People 2010 goal of 6 per 100,000. A majority,

35 of 51 States (69 percent) met their own 2000 Stateset targets in 1998.

Performance Measure: The Percentage of “Very

Low Birth Weight” Infants Delivered at Facilities

for High-Risk Deliveries and Neonates

“Very low birth weight” infants (less than 1,500 grams)

are more likely to survive and thrive if they are born/

cared for in an appropriately staffed and equipped facility

with a high volume of high-risk admissions. This measure

indicates the percentage of very low birth weight infants

(less than 1,500 grams) who are born at risk-appropriate

facilities.

The Healthy People 2000 and 2010 goal is that at least

90 percent of all infants who weigh less than 1,500

grams at birth are born in an appropriately staffed and

equipped facility. In 1997, the United States achieved a

73 percent value on this performance measure. In 1998,

28 of 51 States (55 percent) reported a better rate than

the 73 percent achieved in 1997, and 4 of 51 States (8

percent) had already met the Healthy People 2010 goal

of at least 90 percent. In 1998, 42 percent of States (21

of 51) had met or were within 2 percent of meeting their

State-set target for 2000.

Performance Measure: Percentage of Mothers

Who Breastfeed Their Infants at Hospital

Discharge

The advantages of breastfeeding are indisputable and

include nutritional, immunological, and psychological

benefits to both infant and mother. The Healthy People

2000 and 2010 goal is to increase the percentage of

mothers who are breastfeeding their infants at the time of

hospital discharge to at least 75 percent.

The overall indicator for the United States in 1998 was

64 percent. In the 1998 Block Grant report, 21 of the 59

States and jurisdictions (36 percent) were above, i.e.,

they improved upon the 64 percent reported for the

United States overall. In the 1998 Block Grant report, 10

of 51 (17 percent) States were already scoring better

than the Healthy People 2010 goal of 75 percent.

Socioeconomic Context for

MCH Population (1998)

The statistics presented in this section provide a view of

the environment and challenges faced by the maternal

and child population and those who provide health

services for them. These contextual data lend
5

perspective to the snapshot of maternal and child health

provided in this report.

Population Data

In 1999, the 85 million children through the age of 21 in

the United States represented 31.3 percent of the total

population; adults aged 22–64 accounted for 56 percent;

and persons aged 65 and over represented 12.7 percent

of the total population. The median age in the United

States for all races was 35.5.

Since 1990, the number of children under 5 years of age

has increased by 0.5 percent. The number of children

ages 5–19 years has increased by 11.7 percent. In the

same period, the number of persons aged 65 and over

has increased 10.6 percent.

Family Composition

In 1998, there were 70.9 million family and 31.6 million

non-family households—69.1 and 30.9 percent of U.S.

households. Of the family households, there was an

average of 3.18 members per household. Approximately

68 percent of American children lived with two parents, a

number down from 77 percent in 1980.

Single parents comprised 27.3 percent of the family

households with their own children under 18. There were

2.1 million father-child and 9.8 million mother-child family

groups—related and unrelated subfamilies as well as

family households. Approximately 23 percent of all

children lived with only their mothers, 5 percent with only

their fathers, and 4 percent with neither of their parents.

Since 1996, the percentage of children living with only

one parent has not changed significantly.1

Children in Poverty

In 1998, there were 12.8 million related2 children under

18 years of age living in families with income below the

Federal poverty level of $16,6603 for a family of four.

This figure reflects a 4.3 percent decrease from 1997.

This population comprised 18.3 percent of all related

children living in families. The proportion of children living

in poverty is declining, although a greater percentage of

black and Hispanic children are poor compared to white

children. One in seven white children is poor compared

to one in three black and Hispanic children.

The number of children in poverty has fallen by

approximately 577,000 since 1997, but this number still

represents 1.7 million more children than were reported

to be living in poverty in 1980. Over this period (1997–

1980), the number of persons 65 years of age and over

living in poverty decreased by almost 500,000.

Of the 12.8 million related children under 18 years of age

living in poverty, 59.4 percent live in homes headed by a

single mother; 35.4 percent live in homes headed by

married parents; and 5.2 percent live in homes with other

compositions.

Working Mothers

In 1998, 65 percent of mothers with preschool aged

children (younger than 6 years) were in the labor force

(either employed or looking for work), and 61 percent

were employed. Of those mothers, 70 percent were

employed full-time and 30 percent worked part-time.

Of women with children ages 6–17, 78 percent were in

the labor force in 1998 and 74 percent were employed.

Of employed mothers, 77 percent worked full-time and

23 percent worked part-time.

Child Care

In 1997, 41 percent of children under 5 years of age

whose mothers worked were cared for by persons other

than their parents for 35 or more hours per week. While

42 percent of children in families with higher incomes

spent more than 35 hours a week in some form of child

care, slightly less, or 40 percent of children in lower

income families, were in care for the same number of

hours. However, a smaller proportion of children from

families with lower incomes (21 percent) were in part-time

care compared to children in higher income families (27

percent). Children 3 and 4 years old were more often in

multiple child care arrangements (44 percent), compared

to younger children (34 percent).

School Dropouts

As of October 1998, approximately 479,000 youths ages

15–24 had dropped out of high school in the previous 12

months. Those who dropped out of high school during

this period represented 4.8 percent of students enrolled

in high school in 1997.

In 1998, Hispanic students were the most likely to drop

out, and dropouts represented over one-fourth of
6

Hispanic young adults. The 1998 data represent a 16.6

percent increase from the 1997 Hispanic dropout rates.

Both the white and black dropout rates increased slightly

between 1997 and 1998.

Students most likely to drop out of school in 1998 were

those living in the western States, boys, and students

aged 19 and older. Also, students living in low-income

families were four times more likely to drop out of high

school than those in higher income families.

Uninsured Women and Children

Overall, the status of children’s health care coverage did

not change significantly from 1997 to 1998. In 1998, of

the 44.3 million (16.3 percent of total population)

uninsured persons in the United States, 11.1 million were

children under 18 years of age and 21 million were

females. For all children under 18 years of age, this

comprised 15.4 percent of the 72 million children in the

age category. Among poor children, 3.4 million were

uninsured, making up 30.6 percent of all uninsured

children in 1998, a number and percentage that are

statistically unchanged from the previous year. By

ethnicity, Hispanic children were far more likely to be

uninsured (30.0 percent) than children in other racial or

ethnic groups, and of the 11.1 million uninsured children,

19.7 percent were Black, 16.8 percent were Asian and

Pacific Islander, and 10.6 percent were non-Hispanic

White.4

Current Maternal and Child Health

Challenges and Priorities

This section highlights some of the most current

priorities for the Maternal and Child Health Bureau and

for the Title V MCH Federal-State Partnership.

Special Projects of Regional and National

Significance (SPRANS)

SPRANS is a discretionary grant program administered

by MCHB. The SPRANS role is integral to the Bureau’s

national leadership in the field of maternal and child

health. Funds for SPRANS complement Block Grant

funds to the States to fulfill the mission and strategic

goals of MCHB. (See Appendix C for the full text of these

goals.).

SPRANS is a special set-aside of the MCH Block Grant

under Title V. In 1981, when Congress reorganized

existing MCH programs and amended Title V under the

Omnibus Reconciliation Act, the Block Grant was created

and several distinct discretionary set-aside programs

were consolidated. Today this consolidated program is

commonly known as SPRANS.

SPRANS funds, just as with other Title V funds, are

directed toward the provision of core public health

services, as represented in the four levels of the MCHB

public health services pyramid (see Chapter III). While

SPRANS funds may be directed at any one of the four

levels, they are most frequently directed to activities that

strengthen the maternal and child health/public health

infrastructure, and thereby complement other uses of

Title V funds.

Through grants and contracts, SPRANS provides

projects of regional and national significance, research,

training, activities related to genetic disease, and

hemophilia grants. Each year Congress comments on

the use of SPRANS funds and stipulates that the

program should address certain areas (for example,

Traumatic Brain Injury; fluoridation, newborn screening);

and in some instances, Congress specifies the amount of

funds that should be directed to specific activities or

issue areas.

In addition to the important role of SPRANS in enhancing

the work of State Title V Programs, SPRANS funds also

facilitate the development and activities of a broad range

of public and private sector partners (e.g., professional

associations, schools of public health, other training

programs, the research community, State and

community-based agencies and organizations).

As with other programs/funds administered by MCHB, the

Bureau holds itself and its grantees accountable for the

use of SPRANS funds through the development of clearly

articulate performance measures. These measures

reflect MCHB’s strategic goals and plan and complement

performance measures for the States under the Block

Grant.

SPRANS evaluations are carried out to improve program

implementation, develop new approaches, and measure

program impact/success. Evaluation is carried out on

three levels: project, program, and portfolio. 1) Project

evaluation is of individual grants, focusing on projectspecific goals and objectives. 2) Program evaluation is of

an initiative or specific grouping of grants; for example,

evaluation of Healthy Futures/Healthy Tomorrows or of

Healthy Start. 3) Portfolio evaluation is of the entire set of
7

SPRANS projects and programs to assess the

extent to which the grant program as a whole

(a) meets stated program goals and

objectives, and (b) contributes to meeting

broad MCHB goals.

SPRANS grants that were ongoing in Fiscal

Year 1997—the reporting period for this

report—are enumerated (by State, title,

recipient, amount, and location) as part of the

State pages in Appendix A.

Universal Newborn Hearing Screening

MCHB has been instrumental in providing the

infrastructure that assures newborn screening

for hearing impairment—before the newborn is

discharged from the hospital.

In March 1993, a National Institutes of Health

(NIH) Consensus Development Conference

recommended that all babies be screened for

hearing loss before discharge from the

hospital. This recommendation is based on

clear and compelling evidence that congenital

permanent hearing loss can lead to

educational deficits and behavioral problems.

At that time, only two States—Hawaii and

Rhode Island—had legislative mandates

requiring newborn hearing screening for all

babies born in the State. Now 30 other States

(including most of the larger States) have

passed laws requiring universal newborn

hearing screening. At least eight other States

are currently working on similar legislation.

Currently, about 46 percent of all infants born

in the United States are screened. Thirty-five

percent of those screened are in States with

enacted legislation; 11 percent in States

without legislation that requires universal

newborn hearing screening. States with

enacted legislation account for nearly 75

percent of all births in the United States

annually. The majority of these States require

full implementation of screening by December

2002. By the end of 2001, the expectation is

that 75 percent of all infants born in the United

States will be screened at birth, and by the end

of 2002, 85 percent of all infants will be

screened. The bulk of the funding for this

initiative is coming from the States and from

third-party payers.

7

Figure I-1
8

While universal newborn hearing screening programs

are growing at a rapid pace, appropriate and timely

diagnosis and intervention continue to be a major

challenge. In some areas, as many as 60 percent of

newborns receive no follow-up after diagnostic

confirmation. Links between screening programs, the

infant’s medical home, family support, and early

intervention programs are not yet well-established

nationwide.

In April 2000, the Maternal and Child Health Bureau

awarded grants to 22 States to assist with the planning,

development, implementation, and refinement of early

hearing detection and intervention programs. This

initiative addresses critical gaps by supporting grants to

the States to: (1) develop and expand statewide

universal newborn hearing screening programs, (2) link

screening programs to intervention within the community

service system, (3) monitor the impact of early detection

and intervention on child, family, and systems, and (4)

provide technical assistance.

Other Newborn Screening

In its leadership role, MCHB helps States initiate and

maintain newborn metabolic screening programs and

statewide genetics programs. The Bureau also helps

States develop statewide capacity for testing, counseling,

education, and a system of referral.

In 1998, MCHB requested and funded the American

Academy of Pediatrics to convene a Newborn Screening

Task Force to provide scientific recommendations to

strengthen newborn screening programs. The report,

Serving the Family From Birth to the Medical Home: A

Report From the Newborn Screening Taskforce, was

published in Pediatrics as a supplement to the August

2000 issue (106:2:383-422). The report identifies the

following key issues: the need for all State newborn

screening systems to keep pace with new technology;

the need for uniform screening systems across States;

ethical concerns surrounding residual blood samples;

privacy and consent issues and the need for public

awareness. The specific recommendations will be

implemented over the next 5 years.

Other projects include:

• The National Newborn Screening and Genetic

Resource Center. MCHB established the Center

to offer technical assistance to States in newborn

screening, including an on-site comprehensive

program review followed by a written report.

• Enhancing the Implementation of Tandem Mass

Spectrometry for Newborn Screening Programs.

The proceedings of this national working group

meeting will be published in early 2001.

• Consensus Development Conference on PKU.

MCHB co-sponsored a conference, entitled,

PhenyllFetonuria: Screening and Management

and also sponsored the Meta-Analysis of Early

Treated PKU Treatment Outcome as part of the

study.

• Development of Cystic Fibrosis Newborn

Screening Strategies for Multiethnic Populations.

This MCHB project is to develop a protocol for

obtaining genetic information and refining

newborn genetic testing methods in

heterogeneous populations using cystic fibrosis

newborn screening as a model.

• Multi-Ethnic Newborn Screening for the

Hemoglobinopathies. This MCHB project is to

evaluate strategies for detecting the

thalassemias in diverse screening populations.

• Planning Grants. In fiscal years 1999 and 2000,

MCHB established planning grants to strengthen

the development of statewide health information

systems to integrate public health and health

services data and to strengthen the involvement

of newborn screening programs in public health

infrastructure development.

Healthy Child Care America 2000

MCHB has provided support for 51 State Health Systems

Development in Child Care (HSDCC), Healthy Child

Care America (HCCA) grants, first awarded in FY1996.

Each served as State focal points for health and safety

in child care, and developed integrated health, child

care, and social service systems in their respective

States. Building upon MCHB’s investment, and based

upon State Title V and Child Care program suggestions,

a Phase II has been implemented.

This initiative, Healthy Child Care America 2000, has the

following three components: (1) Quality Initiative, which

focuses on the development and implementation of

State programs that address quality assurance

(improved State health and safety in child care
9

standards); (2) Infrastructure Building (statewide

networks of child care health consultants); and (3)

Access to Health Insurance (related to Medicaid and the

State Children’s Health Insurance Program [SCHIP]) and

Medical Homes.

The quality assurance component of Healthy Child Care

America 2000 must support the dissemination, adoption,

and use of MCHB’s Caring For Our Children, Guidelines

For Out-of-Home Child Care Programs and SteppingStones to Using Caring For Our Children. Using a variety

of approaches, including technical assistance and

regulatory reform, applicants develop a statewide

systems approach to improve the quality of health and

safety for children in child care settings.

The infrastructure building component supports the

identification, training, and deployment of health and

child care professionals as health consultants to child

care programs. Each applicant must establish a link with

MCHB’s National Training Institute for Child Care Health

Consultants, currently located at the University of North

Carolina’s School of Public Health, for the purpose of

developing and implementing the State-based child care

health consultant system.

The access to health services (and health insurance)

component plans, develops, implements, and monitors

progress in using the child care environment as an

appropriate access point for health insurance for

enrolled children. This program component works in

partnership with other State entities to assure that child

health insurance programs such as Medicaid and SCHIP

provide access to a medical home for children in child

care programs.

All applications incorporate: a statewide systems

approach; a broad definition of health, which includes

public health, medical, dental, nutritional, mental health,

substance abuse prevention, injury prevention,

psychosocial, and fiscal services; community-level family

and provider (including health and child care)

involvement; inclusion of relevant disciplines; explicit

plans for enhancing cultural competence among child

care providers and planners; effective use of public and

private, local, State, and national resources; and plans to

sustain the proposed project after termination of the

grant.

Healthy Start

Healthy Start is a community-based program, which was

implemented in 1991 with 15 demonstrations to reduce

infant mortality and low-birth-weight babies in areas with

high infant mortality rates. The initial Healthy Start

projects designed their own strategies based on local

needs and resources. The demonstration program

ended in 1997. Ninety-four communities currently

participate in Healthy Start.

In late 2000, MCHB announced a new focus for the

Healthy Start Initiative. Healthy Start communities are

now required to build strong linkages with statewide

maternal and child health programs and to offer a “core”

set of proven interventions.

This fresh direction for Healthy Start is based on lessons

learned from the 6-year evaluation of the first 15 Healthy

Start projects and recommendations of the HHS

Secretary’s Advisory Committee on Infant Mortality. The

new direction is also consistent with the Children’s Health

Act of 2000, which was passed by Congress and signed

by the President on October 17, 2000.

Healthy Start communities have the flexibility to design

programs based on local needs, but they must use

model strategies that have proven track records. Each

program must include outreach, case management,

health education, and community consortiums. Services

must be prioritized based on local maternal and child

health needs assessment data. Programs must also

build strong alliances with statewide MCH performance

goals and data collection efforts to track progress and

strengthen long-term sustainability. Special attention is

required for substance abuse, domestic violence, mental

health, and other critical services needed for women at

high-risk and their families.

The lessons learned from the first 15 Healthy Start

communities are detailed in the final report of the 6-year

evaluation of the demonstration, Reducing Infant

Mortality: Lessons Learned from Healthy Start. That

report and two others, The Effect of Healthy Start on

Infant Mortality and Birth Outcomes and The

Implementation of Healthy Start: Lessons for the Future,

can be found in the publications section of the MCHB

web site: www.mchb.hrsa.gov.

A number of the Healthy Start projects achieved

impressive results for moms and babies who are at high

risk, but many learned that reducing infant mortality in

high-risk areas was more challenging than expected.
10

The early demonstrations included 13 urban and 2 rural

Healthy Start sites. The urban sites included Baltimore,

Birmingham, Boston, Chicago, Cleveland, Detroit, the

District of Columbia, New Orleans, New York City,

Northwest Indiana, Oakland, Philadelphia, and

Pittsburgh. The rural sites were the Pee Dee Region of

South Carolina and the Northern Plains (19 tribal

communities in North and South Dakota, Nebraska, and

Iowa).

Eight of the 15 projects increased prenatal care visits to

health care professionals for pregnant women. Nine

projects had lower infant mortality rates during the

evaluation period, as did comparison sites and the

nation. Two communities—Pittsburgh and New Orleans—

had rates that could be attributed to Healthy Start

interventions. These two sites cut infant mortality rates

by 50 and 38 percent respectively—well ahead of the

nation generally. Four sites—Birmingham, New Orleans,

Oakland, and Philadelphia—had fewer preterm births.

Three sites—Birmingham, Detroit, and the District of

Columbia—had significant reductions in the number of

very low birth weight babies. And Birmingham, Boston,

and Pittsburgh had very-low-birth weight reductions.

Some of these communities may have more up-to-date

local evaluations that show greater improvements.

The new framework for Healthy Start is contained in the

guidance for grantees, which is available at

www.mchb.hrsa.gov.

Poison Control Centers

The Maternal and Child Health Bureau received $3

million in fiscal year 2000 to assist the nation’s Poison

Control Centers. Congress appropriated these funds to

• continue the work begun by CDC and MCHB in

the previous year to establish a national toll-free

number for poison control services. The

telephone access and related activities are

carried out under a cooperative agreement with

the American Association of Poison Control

Centers. One-half of the MCHB appropriation has

been expended for the implementation of the

number and development of a national public

education campaign. The toll-free number is

expected to be operational by spring 2001.

• assist poison control centers in planning and

stabilization efforts. MCHB is assisting a limited

number of States in which access to poison

control services is in jeopardy, because (1) a

center is closing, (2) a center is having to

drastically reduce service, (3) or services are

totally unavailable to the majority of the State’s

population. MCHB provides crisis intervention for

centers at very high risk, which is essential to

stabilization of the national system. The States

that received 1-year funding are Alaska, Hawaii,

Michigan, New Mexico, South Carolina,

Tennessee, and Washington.

• support related system enhancement such as the

development of uniform patient management

guidelines.

In February 2000, President Clinton signed PL 106-174,

The Poison Control Center Enhancement and

Awareness Act. The legislation provides funds primarily

to stabilize the poison control centers and to make a

variety of system improvements. The authorization for

this legislation is set at approximately $26 million. MCHB

expects funds to be appropriated in the Fiscal Year 2001

budget, for about $20 million. MCHB has established a

Poison Control Stakeholders Group with representation

from approximately 16 national organizations, including

the American Academy of Pediatrics, to assist in

development of the new program.

The National Survey of Children with

Special Health Care Needs (CSHCN)

In October 2000 the Maternal and Child Health Bureau

(MCHB), in partnership with the National Center for

Health Statistics (NCHS), launched the first-ever national

survey to establish State and national prevalence

estimates for Children with Special Health Care Needs

using a common definition and a uniform measure of

identification. The survey provides State-specific and

national information on access to, and adequacy of,

health care for this population of children and families.

The information obtained will be used for several

purposes including: (1) establishing State-specific

baseline data for the Title V Maternal and Child Health

State Block Grant reporting requirements; (2) guiding

State needs assessment and program planning activities;

and (3) reporting on the Healthy People 2010 National

Health Objectives.

In addition to the State and national data generated for

CSHCN and their families, the survey provides limited

data on the health insurance status of typically
11

developing children. For low-income, uninsured children,

the survey collects information on families’ knowledge of

and access to Medicaid and the State Child Health

Insurance Program (SCHIP).

The National Survey on CSHCN is administered through

the State and Local Area Integrated Telephone Survey

(SLAITS). This mechanism, developed by the National

Center for Health Statistics (NCHS), uses the sampling

frame for the National Immunization Survey (NIS).

Approximately 5,000 telephone interviews per State will

be conducted in order to identify the targeted 750

CSHCN per State. This is the number needed to provide

a statistically significant sampling.

The interview format consists of a screener to identify all

CSHCN in each household interviewed. This screener,

the Living With Illness (LWI) measure, was developed by

the Foundation for Accountability (FACCT) and provides

a functional approach to identify CSHCN, which is

consistent with the definition established by the MCHB

and endorsed by the American Academy of Pediatrics

(AAP). The LWI measure is currently used by several

Federal programs and has recently received approval by

the National Council on Quality Assurance (NCQA) for

inclusion in HEDIS, as a quality assurance measure for

health insurance plans.

In households where a child with a special health care

need is identified using the LWI screener, the remainder

of the CSHCN survey will be administered to obtain

information related to insurance status; adequacy of

insurance; access to care; care coordination; satisfaction

with care; and the impact of the health care system on

the health and well-being of the child and family. The

additional components of the survey for typically

developing children and low-income uninsured children

will also be administered at this time.

The survey, launched in October 2000, will be in the field

for one year, until October 2001. State-specific data will

be available as early as spring 2002.

CompCare

Congress passed the State Children’s Health Insurance

Program (SCHIP) in 1997. At that time, the Department of

Health and Human Services recognized that insurance

coverage alone would not be enough to ensure that the

targeted children would receive the care they need. The

Department realized that an effort to develop quality

systems of care in the community from which these

children would receive care would be needed for SCHIP

to succeed. HRSA and the Agency for Health Care Policy

Research (AHCPR) were assigned the lead role, working

with the Health Care Financing Administration (HCFA), to

develop these systems of quality care in the community.

CompCare is a technical assistance program set up to

work with MCHB/HRSA and HCFA in their joint effort to

develop systems of care in support of the SCHIP

Program.

The technical assistance provided through CompCare is

long-term, based upon the outline of a development

plan, not upon short-term discrete contacts. Some

examples of technical assistance currently being

provided are: the development of management systems

to strengthen quality assurance/quality improvement

efforts for children’s health services; the development of

protocols for improving the integration of child health

efforts among key State agencies; the assessment of

and strengthening of child and adolescent care provider

capacity, and the enabling of States and their systems

partners to identify their systems goals, the components

of an ideal system, resources needed and available, and

strategies to effectively address barriers impeding

utilization of services.

Office of Women’s Health

The field of women’s health evolved over the last century

from a limited focus on social and biomedical factors that

influenced a woman’s capacity to reproduce and care for

her family, to an exploration of the broader factors that

influence her capacity to function fully in all aspects of

her life. The need for this evolution is further supported

by the fact that women’s life expectancy has increased.

Through the exploration of these broader factors, public

health policy and program administration has recognized

the need for a more holistic approach to women’s health

that covers the life span. A life span approach does not

fragment interventions by focusing on discrete segments

of the woman’s life (e.g., adolescence, prenatal period,

middle age) but rather optimizes outcomes through

prevention-oriented interventions that pro-actively touch

all phases of her development. To achieve this, a

comprehensive, culturally-appropriate system of medical

and support services must be coordinated through the

local, State, and Federal levels to ensure an effective

and responsive approach to women’s health needs.
12

Regarding data sources: Unless otherwise

noted, the data in this chapter are from

the Title V Information System (TVIS)

database (www.mchdata.net) or from

Child Health USA 2000, Maternal and

Child Health Bureau, Health

Resources and Services

Administration, U.S. Department of

Health and Human Services,

September 2000.

1 Source: Census Bureau,

Household and family

characteristics, March 1998,

October 1998.

2

 Related children in a family

includes householder’s own

children and all other children in

the household who are related to the

householder by blood, marriage, or

adoption.

3

 Based on the U.S. Census Bureau’s

poverty threshold, which is calculated

using the Consumer Price Index from the

previous calendar year.

4

 Source: U.S. Census Bureau, Current

Population Survey, March 1999 and 2000.

Consistent with the evolution in women’s health, MCHB’s focus on

reproductive and women’s health has evolved over time from

workforce-related issues that originated in the Department of Labor’s

Children’s Bureau of 1912 to a focus on reproductive health services

for poor and underserved women and medical and support services

for their children with the authorization of the Title V Maternal and

Child Health Services Block Grant. Since 1992, the MCHB has

actively developed programs around women’s health. In so doing,

MCHB energized its commitment to actively explore broader aspects

of women’s health as provided by Federally-funded maternal and

child health programs. The revitalization presented a more

proactive opportunity to improve both birth outcomes and longterm women’s health status through prevention-based

interventions that expanded provider and consumer

knowledge and practice in many areas of health promotion,

including preconception health and primary care standards

as well as reduction of risk and health disparities for

women, children, and families.

Additionally, in July 2000, HRSA’s Office of Women’s Health

(OWH) was administratively placed in MCHB. This move

provided new opportunities for MCHB to more effectively

collaborate and coordinate with all HRSA Bureaus to

address the needs of all women throughout their life span

and to act as liaison with programs outside of HRSA that are

serving the same population. In support of HRSA’s mission, the

OWH coordinates women’s health activities across more than 80

HRSA programs. This cross-cutting and unifying role strengthens

the MCHB programmatic focus to eliminate gender disparities and to

ensure that all women receive culturally competent, quality care. This

linkage provides close ties with MCHB programs that serve more

than 2.2 million women.

Office of Data and Information Management (ODIM)

To support the mission of the Maternal and Child Health Bureau

(MCHB) with renewed emphasis in data, the Bureau created the

Office of Data and Information Management (ODIM) in 1999. The

ODIM is charged with three main functions: (1) to enhance data

capacity at the regional, State, and local level; (2) to analyze

data concerning the MCHB programs and strategic plan

goals; and (3) to build capacity in the MCH epidemiology

field. MCHB directs significant attention to advancing and

strengthening essential public health functions and to

assisting State and local MCH programs with enhancement

of analytic capability in the assessment of needs, monitoring

of efforts, and evaluating outcome performance.
13

CHAPTER 2 CHAPTER 2 CHAPTER 2 Title V 1998

National

Summary Data

Infant Mortality Rate

Statement

of Measure

National

1998 Results HP 2000 Goal

7.2 Infant mortality rate

(per 1,000 live births) 7

This chapter has four sections: 1) A reporting of the 1998

National Maternal and Child Health (MCH) Outcome

Measures, 2) Selected 1998 National MCH Performance

Measures, 3) a summary of Telephone Access to MCH

Information, and 4) Who Title V Helps and How Much Was

Spent.

1998 National MCH Outcome Measures

The maternal and child health outcome measures are

primarily measures of mortality for a range of populations.

Mortality rates are used nationally and throughout the

world as sentinel indicators of a population’s health. In the

United States, progress has been made in reducing

mortality rates for the MCH populations, but the rate of

decline has slowed in the past decade.

A statement of the measure, the 1998 results, the Healthy

People 2000 goal, and commentary on the 1998 results is

provided for each of the six outcome measures.

Title V’s efforts to ensure the delivery of high-quality care

to all pregnant women and infants continues to play an

important role in the reduction of infant mortality rates in

the United States. In 1998, the infant mortality rate was

7.2 deaths per 1,000 live births. This rate, which was

unchanged from 1997, is the lowest ever recorded in

the United States. However, this rate still ranks 26th

among the industrialized nations of the world. The

Healthy People 2000 target for infant mortality is 7 deaths

per 1,000 live births1

.
14

Neonatal Mortality

Statement

of Measure

National

1998 Results HP 2000 Goal

4.8 Neonatal mortality rate

(per 1,000 live births) 4.5

Statement

of Measure

National

1998 Results HP 2000 Goal

Postneonatal Mortality

Postneonatal

mortality rate (per 1,000 live births)

 2.4 2.5

Statement

of Measure

National

1998 Results HP 2000 Goal

Perinatal Mortality

Perinatal mortality rate

(per 1,000 live births

and fetal deaths)

7.2 No corresponding HP 2000 goal

Statement

of Measure

National

1998 Results HP 2000 Goal

Child Mortality

Child death rate

(per 100,000 children aged 1-14)

24 28

In 1998, the black infant mortality rate was 2.4 times that

of whites. Between 1997 and 1998, the rate of death

among white infants remained unchanged at 6.0, while

the rate for blacks increased from 14.2 to 14.3. The

Healthy People 2000 goal for infant mortality among

blacks is 11 per 1,000 live births.

Statement

of Measure

National

1998 Results HP 2000 Goal

Ratio of Black to White Infant Mortality Rates

Ratio of black to white

infant mortality (per 1,000 live births)

 2.4/1 No corresponding

HP 2000 goal for

this measure

In 1998, 18,918 infants younger than 28 days died,

which resulted in a neonatal mortality rate of 4.8 deaths

per 1,000 live births. These deaths are largely due to

internal causes such as disorders due to short gestation

(preterm birth) and low birth weight and congenital

anomalies (birth defects). The Healthy People 2000

national goal for this indicator is 4.5 deaths per 1,000

live births.

In 1998, 9,453 infants younger than 28 days to 11

months died. The postneonatal mortality rate was 239.8

deaths per 100,000 live births, which represents a 2.2

percent decline from 1997. The postneonatal mortality

rate for blacks is at least two times that for whites for

most of the leading causes of postneonatal mortality.

Postneonatal mortality includes deaths from 28 days to

less than 1 year of age. These deaths are more likely to

be from external causes and to reflect the environment

and care a child receives. The leading causes of

postneonatal mortality are Sudden Infant Death

Syndrome (an event that is becoming less frequent as

parents learn to put their infants to sleep on their backs),

congenital anomalies, and injuries.

Perinatal mortality includes deaths in the late prenatal

period (after 28 weeks’ gestation) as well as the neonatal

period (the first 6 days of life). This measure reflects the

health of the pregnant woman, the pregnancy

environment, and the care a woman and infant receive

during pregnancy and birth. In 1998, the perinatal

mortality rate was 7.2 deaths per 1,000 live births. There

is no corresponding Healthy People 2000 objective for

this indicator.

There were 13,042 deaths of children ages 1–14 in

1998. Injury, regardless of intent, was the primary cause

of death in this age group. Among 1–4 year-old children,

injuries accounted for 44 percent of all deaths, followed

by deaths due to congenital anomalies (birth defects),

homicide, malignant neoplasms (cancer), and diseases

of the heart.

Injuries comprised 47.7 percent of all deaths among 5–

14-year-old children, followed by malignant neoplasms,

homicides, congenital anomalies, diseases of the heart,

and suicide.

Childhood death rates have declined

substantially over the past several

decades. Death rates for children ages 1–

4 years of age decreased 3.4

percent from 1997, while those

aged 5–14 years decreased more

than 4.3 percent. The

1998 overall child death

rate of 24 per 100,000

children shows favorable

change when compared to the

1997 rate of 25 child deaths per

100,000.
15

Selected 1998 National MCH

Performance Measures

National performance measures describe specific

maternal and child health needs that, when successfully

addressed, can lead to a better health outcome within a

specific time frame. States must set 5-year performance

objective targets and report annually on their progress

for each of the national and State measures.

Each measure has six major components: a goal,

measure, definition, Healthy People 2000 objective, data

source, and a significance statement. These components

are described in detail—for each of 18 core measures—

on the Title V Internet site (www.mchdata.net). For

some States, some measures represent a “work in

progress,” because the States are in various

developmental stages of data collection. Therefore, the

Internet site also contains footnotes that provide

explanatory material to enhance understanding or

highlight special conditions or concerns in specific

States.

Of the 18 national performance measures, seven have

been selected for this “Snapshot.” Each of the seven are

presented as follows:

For many CSHCN, Title V is the only source for services

such as surgeries, durable medical equipment, care

coordination, and assistive technology. Historically, Title

V has played a strong role in assuring that this

population of children and families receive the

comprehensive services required to meet their unique

needs. The services included in this measure are

representative of those often required by CSHCN and

provided by Title V CSHCN programs. For this measure,

a degree rating of 9 out of 9 is a perfect score and would

indicate that the measure’s area of coverage has been

fully met.

One point is awarded for each of the following service

provisions:

• Medical and surgical subspecialty services;

• Occupational therapy and physical therapy

services;

• Speech, hearing, and language services;

• Respiratory services;

• Durable medical equipment and supplies;

• Home health care;

• Nutrition services;

• Care coordination; and

• Early intervention services.

Infectious diseases remain important causes of

preventable illness in the United States, despite

significant reductions in incidence in the past

100 years. Vaccines are among the safest

and most effective preventive measures.

This performance measure reports the

percent of children through age 2

who have completed

immunizations for measles,

mumps, rubella, polio,

diphtheria, tetanus,

pertussis, haemophilus

influenza, and hepatitis B.

Statement

of Measure

National

1998 Results HP 2000 Goal

Specialty Services for Children with

Special Health Care Needs (CSHCN)

Number of specialty

services for Children

with Special Health

Care Needs (CSHCN)

8 of 9 8.5 of 9

Statement

of Measure

National

1998 Results HP 2000 Goal

Children Immunized (Ages19-35 Months)

Against 9 Diseases

Children immunized

(ages 19-35 months)

against 9 diseases

79% 90%

This measure rates the degree to which special services

for CSHCN programs provide or pay for specialty and

subspecialty services, including care coordination not

otherwise accessible or affordable to its clients. Because

CSHCN are more likely to incur catastrophic expenses,

and because they have ongoing health and medical

needs that extend beyond those of typically developing

children, they are more likely to be uninsured or

underinsured.

The Omnibus Budget Reconciliation Act of 1989

authorized State Title V programs to provide

rehabilitation services for disabled individuals under the

age of 16 to the extent medical assistance is not

provided by Medicaid, and to provide—and promote—

family-centered, community-based coordinated care,

including care coordination services.
16

Teen parenting may be associated with lower rates of

school completion, initiating a cycle of poverty for

mothers and their children. In addition, pregnant teens

are less likely than women in their 20s and 30s to receive

early and continuous prenatal care, and they are more

likely to smoke and use alcohol during their pregnancies.

The objective for Healthy People 2000 is 50 pregnancies

per 1,000 females aged 15–17. In 1998, the live birth

rate per 1,000 adolescent females was 30.4 for ages 15–

17, down from 32.1 in 1997.

There are several probable reasons for this encouraging

trend, which has occurred during a period of intensive

efforts by both public and private sectors to reduce teen

pregnancy. Overall, our society has tried to send strong

messages to adolescents regarding responsible sexual

behavior, including abstinence, and for those teenagers

who are sexually active, the use of effective

contraceptive methods. Many communities have

developed teen pregnancy prevention programs. Both

male and female adolescents are now less likely to be

sexually active, and sexually active adolescents are more

likely to use contraception.

and under, 23 percent are as motor vehicle occupants,

10 percent are as pedestrians, and 3 percent are as

bicyclists. Riding unrestrained is the greatest risk factor

for death and injury among child occupants of motor

vehicles. Great progress has been made: In 1999, the

National Highway Traffic Safety Administration reported

that 91.7 percent of children ages 4 and under are riding

with restraints; 8.7 percent of the children in this age

group are still riding unrestrained.2

Statement

of Measure

National

1998 Results HP 2000 Goal

Deaths to Children Aged 1-14

(Caused by Motor Vehicle Crashes)

Deaths to children

aged 1-14 caused by

motor vehicle crashes

(per 100,000 children)

24 28

Statement

of Measure

National

1998 Results HP 2000 Goal

Score for Family Participation in Program &

Policies of CSHCN Programs

Score for family

participation in programs and policies

of CSHCN Program

9 of 18 10 of 18

Statement

of Measure

National

1998 Results HP 2000 Goal

Births to Teens Aged 15-17

Birth to Teens aged

15-17 years (per 1,000

teens aged 15-17)

30.4 50

In 1998, motor vehicle crashes were the leading cause

of injury death among 5-to-14-year old children. Trafficrelated injuries are a major cause of hospitalization and

medical spending for children as well. The death rate for

1–4-year-olds is 4.1; for 5–14-year-olds is 4.6. The

overall rate for deaths to children (1–14) caused by

motor vehicle crashes is down to 4.43, which represents

achievement of the Healthy People 2000 goal.

Traffic-related injuries are the leading cause of death

and a major cause of hospitalization and medical

spending for children. Of these fatalities for children 14

Legislation enacted in 1989 mandates that health

programs supported by the MCH Bureau provide and

promote family-centered, community-based, coordinated

care. Title V programs have provided over a decade of

national leadership in implementing these principles or

major components of a family/professional partnership.

One way in which these partnerships are realized is

through strategies that include family members working

as partners along with providers in Title V programs to

develop, implement, and evaluate Title V programs.

Each State was asked to assess family participation in

their CSHCN program by ranking themselves on six

program characteristics. Each characteristic is rated on

a 4-point scale (0 = not met, 1 = partially met, 2 = mostly

met, 3 = completely met) making possible a total score of

18 points.

The six services are as follows:

• Family members participate on advisory committees or task forces and are offered training,

mentoring, and reimbursements, when appropriate.

• Financial support (financial grants, technical

assistance, travel, and child care) is offered for

parent activities or parent groups.

• Family members are involved in the Children

with Special Health Care Needs’ elements of

the MCH Block Grant Application process.

• Family members are involved in in-service

training of CSHCN staff and providers.
17

• Family members are hired as paid staff or

consultants to the State CSHCN program (a

family member is hired for his or her expertise

as a family member).

• Family members of diverse cultures are involved in all of the above activities.

Infants born weighing less than 1500 grams (about 3

pounds, 5 ounces) are at highest risk for poor health

outcomes, including developmental delays, physical and

visual impairments, cognitive difficulties, and account for

up to half of infant deaths. While the VLBW rate for the

population as a whole is low—only 1.5 percent of births

in 1998—the rate in cities with populations over 100,000

was 1.7. The Healthy People 2000 target for this

indicator is 1 percent of all live births.

The proportion of mothers beginning prenatal care in the

first trimester of pregnancy increased for the ninth

consecutive year, rising from 82.5 percent in 1997 to

82.8 percent in 1998.

However, the racial disparity for early entry into

prenatal care persists. In 1998, 84.8 percent

of white mothers, as compared with 73.3

percent of black mothers, received

early prenatal care.

Women younger than 20 are much

less likely than older women

to receive early

prenatal

care.

Telephone Access to

MCH Information

To aid families in

obtaining

information about

the State Title V and

Title XIX (Medicaid)

programs and about other

relevant health and healthrelated providers and

practitioners, Title V legislation

requires that State maternal and

child health agencies maintain

a toll-free hotline.

A national toll-free number

(1-800-311-BABY)

automatically connects callers

to the hotline in the State from

which they are calling. A

Spanish language hotline

(1-800-504-7081) is also

provided nationally. Clients can

also call the number in their State

directly.

To promote further awareness, some States operate

additional hotlines such as Florida’s “Family Health Line,”

the “Oregon Health Safenet,” or Puerto Rico’s “Linea

Interactiva.”

The bar graph below shows the combined total of all calls

to State MCH hotlines from 1996 to 1998. The difference

between the number of calls in 1996 and the number in

1998 (377,783 calls) represents a 78 percent increase in

the public’s use of this service.

Very Low Birth Weight (VLBW) Births

Statement

of Measure

National

1998 Results HP 2000 Goal

1.5% Very low birth weight live births 1%

Statement

of Measure

National

1998 Results HP 2000 Goal

Infants Born to Women who Received

First Trimester Prenatal Care

Infants born to women

who received first

trimester prenatal care

82.8% 90%

To help

families

learn

about

maternal

and child

health

care.

1996 1997 1998

481,970

771,972

Figure II-1. Total Hotline Calls by Year

0

200,000

300,000

400,000

500,000

600,000

700,000

100,000

800,000

900,000 859,753
18

Who Title V Helps and

How Much was Spent

In 1998, the Title V MCH Federal-State Block Grant

Partnership served more than 26 million pregnant

women, infants, and children, including Children with

Special Health Care Needs (CSHCN). This number shows

that 2 million more individuals were served in 1998 than

were served in 1997.

As shown in Figure II-2

above, “Title V—Number of

Individuals Served,” the

MCH populations are

classified as Pregnant

Women, Infants (less than

one year of age), Children

(from 1 to 22 years of age),

Children with Special Health

Care Needs, and Others,

which is constituted

primarily of services to

women.

As the data table shows, in

both 1997 and 1998,

children (1 to 22 years)

compose the largest group

within the populations

served, followed by infants

and pregnant women.

Of the nearly 3.8 million mothers who gave birth in the

United States in 1998, Title V served nearly 58 percent of

them, mostly by providing prenatal or postnatal care

services. Of the nearly 3.9 million babies born, Title V

ensured that almost all of them—over 99 percent —

received newborn genetic screening services such as

phenylketonuria (PKU) and hypothyroid screening, Title

V also served nearly 100

percent of the infants born

for either newborn

screening or some other

significant service during

their first year of life. Of the

84 million children (through

age 21) in the United States

in 1998, Title V served

more than 16 million or

nearly 19 percent, for a

range of services including

immunization, lead

screening, injury

prevention, and other

preventive health or oral

health services.

Nearly one million children

with special health care

needs were served.

CSHCN are children from

Population Served

FY98 Number of

Individuals Served

Figure II-2. Title V—MCH Federal-State Block Grant Partnership: Number of Individuals

Served and Population Group

FY98 Percent

of all

Individuals

Served

FY97 Number of

Individuals Served

Pregnant Women 2,268,820 9% 1,963,797 8.2%

Infants (<1 year) 3,140,720 12% 2,907,840 12.1%

Children (1 to 22 years) 17,624,074 67% 16,456,435 68.5%

CSHCN 860,599 3% 875,648 3.7%

Others 2,267,911 9% 1,810,999 7.5%

Totals 26,162,124 100% 24,014,719 100%

FY97 Percent

of all

Individuals

Served

Populations

Served

Figure II-3. Title V—MCH Federal-State

Block Grant Partnership Expenditures by

Population Served—FY98

Expenditures

FY 1998

Pregnant Women $428,660,632 15.5%

Infants (<1 year) 306,727,242 11.1%

Children (1 to 22 years) 691,290,128 25.1%

CSHCN (Special Needs) 1,013,093,671 36.7%

Others 210,143,907 7.6%

Administration 109,731,870 4%

Totals $2,759,436,215 100%

Percent of

Total
19

birth to age 22 who have or are at increased risk for

chronic physical, developmental, behavioral, or

emotional conditions, and who require health and related

services of a type or amount beyond that required by

children generally. At least 30 percent of Federal dollars

allotted to each State are earmarked for services to

CSHCN, a figure that is supplemented by State and other

funds.

It is estimated that CSHCN constitute approximately 18

percent of all children, which suggests there are about

15 million children with conditions ranging from moderate

health problems to severe disabilities. Because of limited

funds, Title V was able to serve fewer than 1 million of

these children.

Figure II-3 on the left shows the disbursement of the Title

V MCH Federal-State Block Grant Partnership dollars

into six categories—the five population groups described

in the previous section, plus expenditures to administer

the Title V program—a low 4 percent.

The highest percentage of Title V expenditures was for

CSHCN—36.7 percent, or more than $1 billion. Those in

the children (1 to 22 years) cohort ranked second in

expenditures (25.1 percent) or more than $691 million.

Pregnant women ranked third in expenditures at 15.5

percent or $428.6 million; infants (less than 1 year)

fourth at 11.1 percent or $306.7 million.

CSHCN, with ongoing health and medical needs that

extend beyond those of typically developing

children and with the likelihood of being

uninsured or under-insured, receive the

most dollars from the Title V partnership.

While they make up 3 percent of those

served by Title V, they require 36.7

percent of the dollars.

Title V—MCH Federal-State

Block Grant Partnership

Expenditures

Figure II-4 pie chart breaks out the FY98

MCH Partnership Block Grant

Expenditures by source of funds.

Total MCH Expenditures

Figure II-5 above shows an even more complete

picture of the MCH funding. The table includes both

the Title V Block Grant and the monies expended

for other Title V grants, which include the Title V

Special Projects of Regional and National

Significance (SPRANS), the Title V—Community

Integrated Service Systems (CISS), the Title V

Abstinence Education Program, and the

Emergency Medical Services for Children (EMSC),

Healthy Start, and Traumatic Brain Injury grant

programs. (See Chapter III for descriptions of the

grant programs.)

Figure II-5. MCH FEDERAL-STATE PARTNERSHIP FUNDS—FY 982

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

$156,950,146

$3,012,329,464

$2,759,436,215

$95,943,103

Percent:

91.6%

5.2%

3.2%

100%

Figure II-4. Title V —MCH FederalState Block Grant Partnership

Expenditures by Source of

Funds—FY98
20

In 1998, the Title V MCH Block Grant Program

served more than 26 million pregnant women,

infants, and children, including Children with

Special Health Care Needs (CSHCN). To give

this enormous statistic a human face and to

illustrate how Title V intervenes, the following

story is presented. Although the central

character, Gabriella, is fictional, her story is

not; it is a composite of the daily, real-life

stories heard around the country from Title

V programs in action. Although the

pyramid structure is invisible to Gabriella,

she receives services from all four tiers of

health services.

Title V MCH Federal-State Block Grant

Partnership Expenditures by MCH Levels

of Services

Title V is often the health safety net for those

who have no access or little other access to

health care. As Figure II-2 in the previous

section shows, more than 26 million

mothers and children received care

through the Title V Maternal and Child

Health (MCH) Program in 1998.

Conceptually, Title V MCH

services are delivered at four

service levels, which form a

pyramid (See Figure II-6).

Starting at the apex,

they are Direct Health

Care Services,

Enabling

Services,

Populationbased

Services, and Infrastructure Services. The 1998

expenditures and examples of services provided at each

of these four levels are enumerated in the pyramid.

The St ry of Gabriella

Total FY1998 MCH Federal-State Partnership

Block Grant Expenditures • $2,759,436,215 (100%)

$1,281,913,558 (46.5%)

$691,566,487 (25.1%)

$389,799,970(14.1%)

$395,259,436 (14.3%)

Figure II-6. MCH Pyramid of Health Services

20
21

several of them speak Spanish, Gabriella

attends all of her prenatal care appointments. At

her first visit the health care provider took her

medical history. She received a physical

examination that included internal (pelvic) and

breast exams; a check of her heart, lungs, eyes,

ears, nose, and throat; and measurement of her

weight and height. Blood and urine laboratory

tests were performed, her blood pressure

checked, and a pap smear was taken to check

for possible problems that might affect the

pregnancy. The health care provider talked with

her about a plan of care—a schedule of visits,

diet, exercise, and the importance of

immediately adopting a “no use” of alcohol or

other drugs (including tobacco) lifestyle so that

her unborn child will have a healthy start in life.

Further, the health care provider talked with

Gabriella about substance use counseling

services and set up an appointment for her.

Gabriella accepts the help and makes major

lifestyle changes—giving up alcohol and other

drugs for the health of her unborn child.

(Enabling Services.) Now enrolled within the

local system of care, Gabriella is overseen by a

case manager who works with a team to

introduce the pregnant woman to a host of other

useful services, including food stamps and WIC

enrollment, Medicaid eligibility, and numerous

education programs about nutrition, pregnancy,

parenting, and even employment.

The long-awaited day arrives. At the local

community hospital, Gabriella gives birth to a

healthy baby boy she names Roberto. Before

she leaves the hospital, newborn blood work

screenings are provided (to detect for several

genetic disorders such as phenylketonuria

(PKU), galactosemia, and congenital

hypothyroidism). Also, a newborn hearing

screening is provided to Roberto before hospital

discharge. The goal of these blood and hearing

tests is to identify health problems as soon as

G abriella is a single 18-year-old mother-to-be

who is 4 months pregnant and has not been

to a health care provider for prenatal care.

She is unemployed, lives in run-down urban

housing, and uses drugs and alcohol to escape

her bleak reality.

The State’s Department of Health Title V MCH

program is very visible in Gabriella’s community.

It is the primary source of Direct Health Care

Services for many families in this

neighborhood.

(Enabling Services) The local health

department sends outreach workers to canvas

the neighborhood looking for mothers and

children in need of help. One of Gabriella’s

friends talks to an outreach worker about her

pregnant friend and points to where Gabriella

can be found. The bilingual outreach worker

visits Gabriella at her apartment and spends

some time talking to her about her pregnancy,

her living situation, and the next steps she needs

to take to give her unborn child a better chance

of being healthy at birth. At first Gabriella was

uncomfortable about the visit of a health

department representative and offered very little

information. The outreach worker did confirm

that Gabriella has no health insurance and has

not yet seen a health care provider during this

pregnancy. Only able to speak a little English,

Gabriella is unsure about going to a clinic and

skeptical of government programs. On her

second visit, the outreach worker convinces

Gabriella of the importance of prenatal care and

arranges an initial visit with a health care

provider at a local clinic. Gabriella is reassured

to learn that she will be able to communicate

with the caregivers in her native Spanish

language.

(Direct Health Care Services) Because clinic

staff members are culturally sensitive and

21
22

possible in order to provide immediate treatment, prevent serious

complications, and provide resources, if needed. The Populationbased Services tier of the pyramid provides these newborn

screening services to all newborns in the nation.

Although Gabriella and her newborn still have many milestones to

achieve, she now faces her challenges with stronger hope, new

knowledge, and determination—thanks to the existence of the Title

V Federal-State Partnership and its strong foundation

(Infrastructure-building Services). Her local family resource

center—a part of the local public health infrastructure—will

always be there as a health safety net with a continuum of

services from postnatal care to well-baby checks to

breastfeeding support. It is important to the Title V program

that every woman, infant, and child has a medical home—

direct care provided by a well-trained provider who is

known to the family, care that is accessible, continuous,

comprehensive, family-centered, coordinated, and

compassionate.

Happily, Gabriella now lives in well-kept public housing. She

is receiving vocational training and working part-time in order

to support her new family. While in the Title V system of care,

Gabriella is introduced to health insurance coverage for her

family, and Roberto is now enrolled in the State’s Children’s

Health Insurance Program (SCHIP) and goes to a primary care

clinic regularly for well-baby care check-ups.

Not all stories have such a constructive ending. Some pregnant

women continue to engage in unhealthy behaviors and deliver

their babies prematurely, creating serious physical and

developmental challenges—and frequently life-threatening

situations—for themselves and their newborns. Many children

in the United States have undetected physical and

emotional problems that could be treated. Many others are

victims of child abuse and neglect. Poor health of a parent

may leave a family desolate. Living conditions may

deteriorate into an unhealthy situation. Title V programs

strive to keep the public health commitment by

identifying the needs of the most vulnerable populations

and responding with appropriate systems of care3

.

1

Regarding data sources: As in Chapter

I, unless otherwise noted, the data in

this chapter are from the Title V

Information System (TVIS)

database (www.mchdata.net) or

from Child Health USA 2000,

Maternal and Child Health

Bureau, Health Resources

and Services Administration,

U.S. Department of Health

and Human Services,

September 2000.

2

 Sources: National Vital

Statistics Reports, Table 19,

Vol. 48, No. 11, July 24, 2000.

Traffic Safety Facts 1999—

Children, Table 3, U.S.

Department of Transportation,

National Highway Traffic Safety

Administration.

3

For more examples from the States of

the services offered in relation to the

pyramid’s four levels of service, go to

www.mchdata.net and search the

Summary Reports section for State

Profiles.

EndNotes

22
23

CHAPTER 3 CHAPTER 3 CHAPTER 3 Maternal and

Child Health:

An Overview &

Brief History

The MCH Partnership:

Its Roots and Milestones

The story begins in August 1935, in the midst of the Great

Depression. Federal health programs are experiencing

cutbacks and the health of mothers and children is in

decline. President Franklin Delano Roosevelt signs into

law new legislation to promote and improve maternal and

child health nationwide. Title V of the Social Security Act is

born. Title V was created as part of broad social, rather

than health, legislation. The legacies of Title V programs

are deep and widespread. Sixty-five years later, Title V

remains the longest lasting public health legislation in our

Nation’s history.

Some of the highlights of Maternal and Child Health

development across the decades are described below:

1935-1940. Title V provides programs for maternity,

infant, and child care, and a full range of medical services

for children, including children with congenital disabilities.

By 1938, every State except one has a Crippled

Children’s (CC) program aimed at the social and

emotional, as well as the physical, needs of these

children. They represent the first medical care programs

supported on a continual basis with Federal grants-in-aid

money.

1940s. The Emergency Maternity Infant Care (EMIC)

program, administered by the Maternal and Child Health

Bureau and the State Title V agencies, establishes a

service delivery system that provides free and

complete maternity and infant health care for the

wives and infants of the four lowest grades of

servicemen. At the time of its implementation, EMIC

represents the most extensive public medical care

program in U.S. history.

1950s. New program initiatives are developed to respond

to new information about infant mortality rates and risks

and information that points to the movement of health
24

care providers away from the cities and rural areas

toward suburban areas. In addition, this decade sees the

beginning of special funding for projects targeting

“mentally retarded” children, later referred to as MR

funds.

1960s-1970s. The Maternal and Infant Care Programs

(MIC) and Children and Youth Programs (C&Y) provide

comprehensive child and reproductive health care

services to millions of low-income women and children.

The services developed by the programs for prenatal

care, well-baby care, and family planning become models

for the country.

1970s. The Improved Pregnancy Outcomes Program

(IPO) promotes greater access to appropriate levels of

care for pregnant women and infants in chosen

geographic regions. The 34 States that participate in this

program—including 13 that have very high rates of infant

mortality—experience greater rates of decline in infant

mortality than does the rest of the country.

1980s. The Maternal and Child Health Services Block

Grant is created in 1981, consolidating under Title V

seven former categorical child health programs into a

single program of formula grants to States supported by

a Federal special projects authority. States adopt injury

prevention as a public health issue. The Emergency

Medical Services for Children (EMSC) program is created

in recognition of the fact that children have special needs

when they are critically ill or injured. The program

provides training and education in pediatric emergency

health care and influences the development of pediatric

emergency equipment and standards.

1990s. The Maternal and Child Health Bureau and its

partners remain dedicated to improving the health of all

the Nation’s women and children. Significant

amendments to Title V in 1989 and adoption of the

Government Performance Results Act (GPRA) of 1993

usher in an era of greater sophistication in assessing

unmet service needs and improved accountability in

measuring program performance and strengthening an

already close Federal-State partnership. State data on

health status and services are collected electronically

and made available nationally via the Title V Information

System web site at www.mchdata.net. Major new child

health legislative initiatives—Healthy Start in 1991 and

the State Child Health Insurance Program (SCHIP) in

1997—target long-standing national concerns over infant

mortality and uninsured children, drawing heavily on

MCH professional expertise and organizational support.

Abstinence Education is added to Title V in 1996 as a

categorical program, separate from the Block Grant.

2000. The Maternal and Child Health Bureau assumes

responsibility for new legislative programs to support

Newborn Hearing Screening and Poison Control Centers.

Major new funding for community-based abstinence

education is added.

The Title V MCH Federal-State

Partnership—How It Works Today

The Government Performance and Results Act (GPRA)

of 1993 required the establishment of measurable goals

that can be reported as part of the budgetary process,

linking funding decisions with both State-identified

Maternal and Child Health (MCH) needs and solutions as

1909

First White House

Conference on

the Care of

Dependent

Children

1912

Children’s

Bureau created

by Congress,

placed in

Department of

Labor

1913

Prenatal Care

published by

Children’s

Bureau, first-ever

pamphlet on topic

1914

Infant Care

published by

Children’s Bureau

(continues in 1999,

in its current edition

to be a bestseller)

1915

Establishment of a

Birth Registration

Area (10 States

and the District of

Columbia)

1921

Sheppard-Towner Act established

national policy that the people,

through their Federal, State, and

local governments, share

responsibility for helping to provide

community services that children

need for a good start in life

The Maternal and Child Health Timeline

24
25

well as performance. (The mechanics of the block grant

application and reporting process are described in

Appendix B.)

GPRA also requires that each Federal agency develop

comprehensive strategic plans, annual performance

plans with measurable goals and objectives, and annual

reports on actual performance compared to performance

goals. MCHB has implemented a Strategic Plan (1998-

2003), which focuses—through leadership, performance,

and accountability—on accomplishment of three overarching goals: 1) to eliminate health disparities in health

status outcomes, through the removal of economic,

social, and cultural barriers to receiving

comprehensive, timely, and appropriate health care;

2) to ensure 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; and 3) 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. (The

full text of the MCHB

Strategic Plan is

provided as

Appendix C.)

1929

Sheppard-Towner Act

lapses due to significant

opposition from the

Catholic Church, the

Public Health Service,

and the American

Medical Association

1930

Dissident group of

pediatricians resign

from AMA in protest

and form the

American Academy

of Pediatrics

1930

White House

Conference

produces

“Children’s

Charter”

1934

Department of Labor’s Annual Report

recommends 3 major programs: (1)

aid to dependent children, (2) welfare

services for children needing special

care, and (3) maternal and child

health services including services for

crippled children

The MCH Pyramid Framework

The MCH Partnership—at both the Federal and State

levels—uses a four-level construct, a pyramid, in

planning and reviewing each State’s MCH services,

budgets, and gaps. (See pyramid inset, Exhibit III-1.) This

conceptual framework is used in the annual Title V

application and reporting process. Specific service

examples for each of the levels are enumerated below:

Level I: Direct Health Care Services

At the pinnacle of the pyramid are direct services for

individuals in the MCH population. Usually these

services are delivered on a one-on-one basis,

between a health professional and a patient, in

an office, clinic, or emergency room. Direct

services “fill gaps” in both the public and

private sector; i.e., MCH funds expended at

this level represent the last health care

option available for these children and

their families. When all children and

families have access to

appropriate and affordable

health care, the funds

required at the pinnacle

level will be the smallest

percentage of the four

levels.

25

1935

Recommendations 2 & 3

(Department of Labor

Report) were enacted into

law as Title V of the Social

Security Act, administered

by Children’s Bureau,

Department of Labor

Figure III-1. The MCH Pyramid of Health Services
26

Level II: Enabling Services

Enabling services enhance the opportunity for some

families in the MCH population to gain access to, and

maximum benefit from, the basic service array. These

may include transportation to services, translation

services for those who do not speak English, respite care

for family caregivers, health education, purchase of

health insurance, case management, coordination with

Medicaid, WIC, and education. For many who are

disadvantaged, geographically or culturally isolated, or

who have special and complicated health needs,

enabling services are essential to accessing care.

Level III: Population-Based Services

While the first two levels of the pyramid provide services

for individuals or families, population-based services are

available for the entire MCH population. These services

include disease prevention, health promotion, and

outreach.

Familiar population-based services include immunization

campaigns, injury prevention initiatives, abstinence

education, and lead poisoning prevention and screening.

Less familiar are services such as newborn metabolic

screening, newborn hearing screening, and counseling

for families whose infant has died from Sudden Infant

Death Syndrome (SIDS).

Population-based services must always be available,

must be offered statewide, and must be of uniform

quality. They must be available whether the mother or

child receives care in the private or public system, in a

rural clinic or an HMO, and whether insured or not

insured. These services often require special expertise in

systems analysis, counseling, or epidemiology.

All State MCH programs provide population-based

services and develop and maintain the population-based

service systems. They sometimes share responsibility

with another public health organization such as a

university’s school of medicine.

Level IV: Infrastructure Building Services

Investments at this, the foundation level of the pyramid,

ensure a quality health care system today and tomorrow.

All State MCH programs provide these core public health

functions, which are vital to maintaining the general

health of the MCH population. The combination of Level

III population-based services and Level IV infrastructurebuilding services is the foundation for the

comprehensive system of health care delivery upon

which the top level of the pyramid—direct personal

health care—is dependent.

Infrastructure-building activities, which are often less

visible to the public, include needs assessment,

planning, policy development, evaluation, coordination,

quality assurance, standards development, monitoring,

training, and research. Without these essential services,

the other levels of the pyramid could not operate

effectively. Investments at this level of the pyramid

ensure the continued improvement of access to

Maternal and Child Health and a reduction of the high

proportion of resources required for “gap filling” at the

Direct Health Care Services level.

Legislative Funding and Program

Today, the Maternal and Child Health Bureau

administers six major programs funded largely by the

1943

Emergency

Maternity and

Infant Care

enacted (PL78-

156)

1946

Children’s Bureau

transferred to the

Federal Security

Agency, Social

Security Administration

1953

Federal Security

Agency becomes

the Department of

Health, Education,

and Welfare

1954

Mental

retardation

becomes a

Title V

program

priority

1963

Children’s Bureau

transferred to the

Welfare Administration,

Department of Health,

Education, and Welfare

1963

Maternal and Child

and Mental

Retardation Planning

Amendments (MR

Programs, MIC

Projects, Research

Program)

26

The Maternal and Child Health Timeline
27

U.S. Congress. In FY2000, these programs have a total

Federal budget of $877.4 million, as follows:

· The Maternal and Child Health Services Block

Grant (Title V, Social Security Act), $709 million

· The Healthy Start Initiative (Section 301, Public

Health Service Act),

$90 million.

· Emergency Medical Services for Children

Program (Section 1910, Public Health Service Act),

$17 million

· The Abstinence Education Program (Section 510,

Title V, Social Security Act), $50 million

· Traumatic Brain Injury (Section 1252, Public Health

Service Act),

$5 million

· Universal Newborn Hearing Screening (Section

301, Public Health Service Act; Title VI of LaborHHS-Education Appropriations Act for FY 2000, PL

106-113) $3.4 million

· Poison Control Centers Program (Poison Control

Center Enhancement and Awareness Act), $3 million

MCHB Organization

To administer the programs above, the Bureau is

organized into Offices, Divisions, and Branches as

depicted in Figure III-2 on the next page. Programmatic

responsibilities of the major subdivisions are

enumerated:

Office of the Director

The Office of the Director provides leadership and policy

direction for all program activities of the Bureau.

Through a national public affairs program, the

Communications staff educate the media, legislators,

other Federal officials, health professionals, and

consumers about the value and contributions of Title V

programs. The Office of Operations and Management,

through its three branches—Financial Management,

Grants Management, and Management Policy and

Services—manages the Bureau’s budget and financial

activities, administers the Bureau’s grant programs, and

provides Bureau-wide advice, guidance, and services

pertaining to management policy and administrative

support services. The Office of Program Development

manages the Bureau’s policy planning, legislative, and

evaluation activities. Major cross-cutting areas of

responsibility include strategic planning, Government

Performance and Results Act (GPRA), quality

assurance, managed care, the State Child Health

Insurance Program (SCHIP), Medicaid demonstrations

and waivers, and Office of Management and Budget

(OMB) clearances and regulatory activities.

Office of Data and Information

Management (ODIM)

ODIM was created in 1999. The Office provides national

leadership in building data capacity to improve the use

of information for the health of mothers and children at

local, regional, national, and international levels. These

activities strengthen the application of data for needs

assessment, policy development, program planning,

evaluation, and resource allocation. Illustrative data

1965

Social Security

amendments

(Children and Youth

Projects, Training

Program, Dental

Projects) enacted

1969

Title V moved to

Public Health

Service

1967

Social Security

amendments

(Family Planning

Services and

Projects, Intensive

Newborn Projects)

enacted

1965

Children’s Bureau

transferred to Social

and Rehabilitation

Service, Department

of Health, Education,

and Welfare

27

1976

SSI Program for

Children enacted

1973

Maternal and Child

Health Service split

between Bureau of

Community Health

Services and the Office

for Maternal and Child

Health Service
28

analysis activities include the preparation of Child Health

USA (published annually) and Healthy People 2000/2010

(as co-lead for the maternal and infant health section).

The Capacity Enhancement activities includes the

Graduate Student Internship Program, the MCH

Epidemiology Doctoral Support Supplements, and the

MCH DataSpeak Conferences.

Figure III-2.

1984

Emergency

Medical Services

for Children

enacted

1988

Pediatric

AIDS

projects

developed

in Title V

set-aside

1989

SSA amendments—

accountability of State

Programs increased

1990

MCHB

established,

within HRSA,

to administer

Title V

1991

Healthy

Start

enacted

1981

OBRA ‘81, FMCH

programs consolidated

into single Title V Block

Grant to States

1980

Department of Health,

Education and Welfare

split into Department of

Health and Human

Services & Department

of Education

28

The Maternal and Child Health Timeline
29

Office of Women’s Health

This office provides leadership and guidance in

developing policy and in establishing goals and priorities

to affirm the Health Resources and Services

Administration’s (HRSA) response to women’s health

issues across the life span. The Director of the Office

serves as the chair of the HRSA Women’s Health

Coordinating Committee, whose members help

coordinate women’s health issues across bureau, center,

and office program activities, respectively. In addition, the

Office works with other Federal and State Government

agencies, educational and professional entities, and

public and private organizations to promote opportunities

for partnership, to eliminate barriers to care, and to

support a culturally competent health professions

workforce that improves the health status of all women,

their families, and their communities.

Division of State and Community Health (DSCH)

DSCH provides national leadership, direction, and

administrative oversight for the Title V Maternal and Child

Health Services Block Grant Program, the State Systems

Developments Initiative, and the Abstinence Education

programs. The Division is the Federal Government’s

primary liaison with each of the 59 State and Jurisdiction

Maternal and Child Health programs.

Division of Child, Adolescent, and Family

Health (DCAFH)

DCAFH is the national focal point for improving health

care for America’s children and adolescents. Its

preventive and primary care programs raise national

awareness of such issues as the need for safe and

healthy out-of-home childcare and the special

emergency medical needs of children. Strategies include

promoting national campaigns on safety and violence

prevention that have proven effective in reducing illness,

injury, and death among children and adolescents. The

Division takes a lead role in encouraging

comprehensive, community-based health care that

combines public and private resources and promotes

environments where healthy behaviors can develop.

DCAFH’s Infant and Child Health Branch programs

include Health and Safety in Child Care Settings; the

Public-Private Partnership for Health of Children in Outof-Home Care; and the Sudden Infant Death Syndrome/

Infant Death (SIDS/ID) Programs. The Adolescent

Health Branch/Office of Adolescent Health supports

Comprehensive Approaches to Adolescent Health at the

national, State, and community levels and school-based

health initiatives such as the national Center for Schoolbased Health Care, two training and technical assistance

Centers for Mental Health in Schools, and a National

Coordinating Committee on School Health. Programs of

the Injury and Emergency Medical Services Branch

include the Injury and Violence Prevention Program, the

Poison Control Centers Support Program, the

Emergency Medical Services for Children (EMSC)

Program, the Traumatic Brain Injury (TBI) State

Demonstration Grant Program, and the Community

Integrated Services Systems (CISS) Program.

Division of Perinatal Systems and Women’s

Health (DPSWH)

The Division develops and implements initiatives that

promote healthy pregnancies and births and assures

quality health care for all women. Major programs and

initiatives include: the Healthy Start Initiative; three

demonstration programs—Improving Screening for

Alcohol Use During Pregnancy Among Providers,

Improving Systems of Care for Pregnant Women

Experiencing Domestic Violence, and Innovative

Approaches to Promoting Positive Health Behaviors in

Women; the MCH Providers Partnership Cooperative

Agreements, which address health promotion/risk

reduction behaviors to improve the general health of

women of reproductive age as well as their perinatal

health; and the Perinatal Substance Abuse

Prevention Program, in which technical assistance is

provided to Healthy Start sites around screening and

prevention of perinatal substance abuse. The Mortality/

Morbidity Review Programs encompass three

1992

National Parent

Resource Center

survey documented

family participation

1998

Title V

Information

System

established by

MCHB

1996

Abstinence

Education

Program added

to Title V
30

initiatives—a State Fetal and Infant Mortality Review (FIMR) Support Program, a State

Mortality/Morbidity Review Program, and a FIMR National Resource Center. A university-based,

MCHB-funded Perinatal and Women’s Health Policy Center identifies, develops, and analyzes

information that assists policy makers at the national, State, and local levels in their efforts to

enhance the health status of women of reproductive age.

Division of Services for Children with Special Health Needs (DSCSHN)

The DSCSHN plays a national leadership role in the development and implementation of

comprehensive, community-based, family-centered, culturally competent, coordinated systems

of care for Children with Special Health Care Needs (CSHCN) and their families. The

Integrated Services Branch promotes leadership and support for the development and

implementation of innovative, replicable models of community-based care for CSHCN in

six program areas: Medical Home; Financing/Managed Care; Family Professional

Partnership/Cultural Competence; Healthy and Ready to Work; Community Integrated

Services; and Universal Newborn Hearing Screening. The Genetic Services Branch

facilitates the early identification of children with genetic conditions and works to

increase public and professional knowledge of how genetic diseases affect health in

order to create more responsive systems of care. It administers programs in five

areas: Newborn Screening; Emerging Issues in Genetics; Improving Genetic Literacy;

Health Professions Training; and Hemophilia and Other Chronic Diseases.

Division of Research, Training, and Education (DRTE)

DRTE provides leadership in improving the quality of health by supporting applied

research to advance and improve the operation and effectiveness of maternal and child

health (MCH) services; by investing in interdisciplinary, long-term MCH professions training

and continuing education programs; and by promoting access to care through communitybased health care demonstration programs. The Research Branch oversees a multi-year

research agenda, which consists of 11 broad program areas and 15 priority issues/questions

linked to the MCHB Strategic Plan. Sixty projects are in the active portfolio. Through the

Training Branch, Title V funds 14 categories of training that are focused primarily on longterm training at the graduate and postgraduate levels, with the goal of developing high levels of

skill, competence, and leadership in maternal and child health. In addition, continuing

education-development grants are awarded for short-term, non-degree training in maternal

and child health. In FY2000, 140 grants for professional training have been awarded.

Interdisciplinary Training programs have faculty from several professional disciplines who

function as a team. These programs include: Leadership Education in Adolescent Health

(LEAH), Maternal and Child Health Leadership Education in Neurodevelopmental

Disabilities (LEND), Pediatric Pulmonary Centers, and Schools of Pubic Health.

Examples of Discipline-Specific Training include: Behavioral Pediatrics, Graduate

Medical Education in Historically Black Colleges and Universities, a MCH Mentorship

Program for high school and undergraduate college students (particularly inner-city youth),

Nutrition, and Pediatric Dentistry. Through its Continuing Education and Development

activities, the Division offers short-term programs by institutions of higher learning to

facilitate timely transfer and application of new information, research findings, and

technology related to MCH and to update and improve the new knowledge and skills of

professionals in programs serving mothers and children. Other Division programs include the

Healthy Tomorrow Partnership for Children Program and the Bright Futures Project.

For more

information

on the

Offices,

Divisions, and

programs of the

Maternal and Child

Health Bureau,

contact the MCHB

Communi-cations

staff at (301) 443-

0205 or go to

www.mchb.hrsa.gov.
31

Appendix A Appendix A Appendix A

This “appendix” contains a comprehensive picture of the

Title V Maternal and Child Health Federal-State

Partnership in each State and jurisdiction. In addition to

details of the Block Grant expenditures and populations

served, a complete listing of all Federal MCH grants

active in FY98 is provided. The States and jurisdictions

are sequenced alphabetically.

The first two pages for each State include a narrative

description of the State’s Maternal and Child Health

program (reproduced from the State’s “Maternal and

Child Health Block Grant to States Program 1998 Annual

Report”), Maternal and Child Health Federal-State

Partnership Expenditures by populations served, source

of funds, and by category of service; numbers of

individuals served; and an array of National and State

MCH Performance and Outcome Measures.

The subsequent 1 to 4 pages for each State enumerate

all Federal MCH grants that were active in the State

during FY98. Grant programs include the Title V Special

Projects of Regional and National Significance (SPRANS),

the Title V Community Integrated Service Systems (CISS),

the Title V Abstinence Education Program, and the

Emergency Medical Services for Children (EMSC),

Healthy Start, and Traumatic Brain Injury grant programs.

MCH grants and contracts to universities and nongovernment organizations such as professional

associations are listed within the State where the

organization resides.

The last page for each State provides a bar graph of

the State’s Hotline Call activity and Title V contact

information for the State (as reported in the Title V

1998 Annual Report).

For easy reference while reading the State pages, you

may fold out the Endnotes flap on the back inside cover.

The Glossary (Appendix E) is also a useful reference.

Title V:

Snapshots of

the States and

Jurisdictions
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

32

4,351,999

62,074

The Title V Program is administratively located within the Bureau

of Family Health Services (BFHS), a major unit within the Alabama

Department of Public Health (ADPH). Through BFHS, ADPH

administers all aspects of the Title V Program except services for

children with special health care needs (CSHCN). Children’s

Rehabilitation Service (CRS), administered by the Alabama

Department of Rehabilitation Services (ADRS), is the lead agency

for services to CSHCN. This arrangement requires close

collaboration between ADPH and CRS. In addition to the Title V

Program, BFHS administers the Title X Family Planning Grant, the

Special Supplemental Nutrition Program for Women, Infants and

Children, and the State Dental Program. In addition to

administering CRS, ADRS administers the Alabama Hemophilia

Program.

26,850

58,668

61,772

22,300

89,553

259,143

$31,359,507

$4,888,808

$16,388,170

$16,908,720

$0

$6,025,206

$75,570,411

ALABAMA

$3,321,354

$81,978,501

$75,570,411

$3,086,736
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participated on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

33 ALABAMA

9 of 9

100.3%

87%

43.2

8.8

42.3%

53.3%

17 of 18

2%

82.4%

10.1

2

6.6

3.5

15.5

34.1

9 of 9

99.95%

90%

41.3

6.7

66.2%

70%

16 of 18

1.9%

86.6%

8.6

1.71

5.6

3.1

12.1

33.7

The gonorrhea case rate per 100,000 youths aged 15-19 1288.2

36%97

2 of 18

9 of 15

1125.9

36%

4 of 18

13 of 15

3

3

3

3

2

3

17

Public high school students who smoked cigarettes in past 30 days

State score on development and use of MCH databases

State score on quality assurance system for services provided to CSHCN
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—Special Projects of Regional

and National Significance

• Advances in Pediatric Pulmonary Care:

Interdisciplinary Approaches to Asthma

and Home Care of Technology-Dependent

Children, University of Alabama at

Birmingham, Birmingham, $27,000

(SPRANS-Training-Continuing Education)

• DeKalb/Cherokee Perinatal System

Improvement Project, DeKalb Baptist

Medical Center, Fort Payne, $55,017

(SPRANS-MCHIP)

• Education for Maternal and Child Health

Leadership at the University of Alabama

in Birmingham, University of Alabama at

Birmingham, Birmingham, $391,433

(SPRANS-Training-School of Public Health)

• Interdisciplinary Leadership Education in

Neurodevelopmental and Related

Disabilities, University of Alabama at

Birmingham, Birmingham, $632,682

(SPRANS-Training-LEND/Leadership Ed

Neuro Dev)

• Maternal and Child Health Skills Training

Institute, University of Alabama,

Birmingham, Birmingham, $272,250

(SPRANS-Training-Continuing Ed/Policy

Center)

• Monitoring Child Health in Medicaid

Primary Care Case Management Systems

in the State of Alabama, University of

Alabama at Birmingham, Birmingham,

$67,500 (SPRANS-MCHIP)

• Pediatric/Adolescent Nutrition Training

Program, University of Alabama at

Birmingham, Birmingham, $76,415

(SPRANS-Training-Nutrition)

• Pediatric Pulmonary Center, University of

Alabama at Birmingham, Birmingham,

$299,893 (SPRANS-Training-Pediatric

Pulmonary Center)

• Prenatal Abstract Database, Mobile

County Health Department, Mobile,

$45,000 (SPRANS-MCHIP)

• State Systems Development for Children,

Alabama Department of Public Health,

Montgomery, $100,000 (SPRANS-MCHIPSSDI)

• TEEN (Teens Empowered through

Education and Nurturing), Family Oriented

Primary Health Care Clinic, Mobile,

$50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

• Toward an Effective Approach for the

Prevention of Preterm Birth, University of

Alabama at Birmingham, Birmingham,

$5,000 (SPRANS-Training-Continuing

Education)

ALABAMA CONTINUED

ALABAMA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL AND NATIONAL

SIGNIFICANCE (SPRANS)

Development of a Regionalized Pediatric Care System for

Hemoglobinopathies in Alabama—A Rural State, University of Alabama at

Birmingham, Birmingham, $118,106 (SPRANS-Genetics)

This project strives to develop a regionalized, comprehensive system of care for children with

hemoglobinopathies in Alabama. Goals and objectives of the program include establishment of a

comprehensive care network to include one central and six regional clinics about 2 hours’ drive

from the central clinic in Birmingham, identification of community physicians interested in caring for

sickle cell patients, and the development of an educational arm of the regional network, and

outcome analysis of the network’s impact. Local physicians are identified through direct mailings,

phone contact, and attendance at organizational and educational meetings. The educational

efforts will be implemented by formal lecture series with CME credit as well as informal

discussions with patients, families, nurses, physicians, and sickle cell counselors at the regional

clinics as well as a quarterly educational newsletter for physicians and patients.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS-Title V)

Rural Alabama Perinatal and Pediatric Program, West Alabama Health

Services, Inc., Eutaw, $50,000 (CISS-CISS-COG)

This project, the Rural Alabama Perinatal and Pediatric Program (RAPPP), proposes to develop and

implement an innovative perinatal and pediatric health care model that brings together health and

human services and places such services in one physical setting: A structural “one-stopshopping” integrated health and human services program. This model is patterned after the

successful Rural Alabama Integrated Perinatal and Pediatric Health Improvement Program

(RAIPPHIP), a CISS project implemented in the west rural Alabama counties of Greene and Hale by

West Alabama Health Services in 1993. This model includes a community-based home visitation

program utilizing indigenous lay persons as an integral part. RAPPP will address the barriers

imposed by fragmented health and human services by increasing access and utilization of these

services by pregnant women and their children ages 0 to 1 residing in the rural county of Sumter

through the integration of services. This process will be facilitated by the formation of a

Coordinating Council that will bring together all agencies, organizations, and individuals that are

involved with maternal and child health and human services within the project county and State to

implement and design the community specific project.

Title V—ABSTINENCE EDUCATION PROGRAM

Alabama Abstinence Education Program, Alabama Department of Public

Health, Montgomery, $1,081,058 (Abstinence Ed)

Include community-based grants and a media campaign. Through a competitive grant process,

organizations throughout the State can apply for funding to implement community-based

abstinence education programs. The media campaign will include traditional media efforts such as

TV public service announcements, news releases, billboards, and radio public service

announcements. The greatest share of the funding for media will be used to underwrite the cost

of four satellite conferences designed for at-risk teens.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Alabama EMSC State Partnership Grant, Alabama Department of Public

Health, Montgomery, $75,000 (EMSC-PRTNER)

The goals and objectives of this project coincide with the goals and objectives of the Federal

“Healthy People 2000” document, the Alabama “Healthy People 2000” document, and the mission

statement of the Alabama Department of Public Health, Emergency Medical Services (EMS) Division

for the prevention and reduction of morbidity and mortality related to trauma and emergency

medical conditions. The first-year objectives of this emergency services for children (EMSC)

project are to (1) institutionalize EMSC in State EMS systems by forming the Alabama EMSC

advisory committee; (2) complete the pediatric needs assessment instrument; (3) identify the

medical, trauma, and special health care needs of the pediatric population, and formulate

prioritized goals to improve the statewide pediatric deficiencies; and (4) pilot the “Pediatric

Education for Paramedics” course, and evaluate how well emergency medical technicians 34 perform on the credentialing examination. Second-year objectives are to (5) formulate strategies
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

ALABAMA

Other FY 98 MCH Grant

Programs

for statewide implementation of EMSC; (6) formulate strategies for assessment of implemented

EMSC programs; (7) implement the educational component statewide; and (8) conduct a

prospective study utilizing the National Registry of Emergency Medical Technicians Advanced

Level Examinations (Pediatric Module) scores as performance indicators of the variations of

pediatric course work during primary education.

HEALTHY START

Healthy Start, Mobile County Health Department, Mobile, $1,790,740 (Healthy

Start-Community)

The TEEN Project is a replication of the Healthy Start Risk Reduction and Prevention Model that

addresses the multifactorial problem of teenage pregnancy with its sequelae of low birthweight,

infant mortality, high incidence of sexually transmitted infections, dropping out of school, and

welfare dependence. Through the collaborative provision of perinatal medical and high-risk infant

developmental services; adolescent male and female preventive outreach in public housing, public

schools, and the juvenile justice system; computer-based educational/career competency

development; case management and individual/group counseling; interpersonal mentoring; and

self-reliance–enhancing opportunities, the TEEN Project will create an environment where

adolescents can self-monitor risk behavior through accurate information and alternative choices.

TRAUMATIC BRAIN INJURY

Alabama’s Interactive Community-Based Model for Children With Traumatic

Brain Injury, Alabama Department of Rehabilitation Services, Montgomery,

$199,996 (Traumatic Brain Injury-Implementation)

The goal of this project is to expand Alabama’s Interactive Community-Based Model to develop a

statewide service system designed to foster optimal outcomes for children with traumatic brain

injury (TBI) and their families. The objectives are to (1) increase interagency collaboration and

linkages to improve access to comprehensive individual and family-centered services along the

continuum of care; (2) develop and implement education and training programs to address various

stages of recovery along the continuum of care (acute care, rehabilitation, education, vocational,

psychosocial, long-term care, and community reintegration) for survivors, families, and

professionals; and (3) develop a replicable predischarge model to be used in acute care sites in

the development of long-term resource plans for TBI survivors.

$3,321,354

$3,086,736

$6,408,090

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS-Title V)

• Health Systems Development in Child

Care, Alabama Department of Public

Health, Montgomery, $50,000 (CISSCISS-Child Care Program)

HEALTHY START

• Birmingham Healthy Start , Jefferson

County Department of Health,

Birmingham, $1,021,000 (Healthy StartMentor)

Title V Program, contact:

Thomas M. Miller, MD, MPH

Director, Bureau of Family Health Services

Alabama Department of Public Health The RSA Tower PO Box 303017

Montgomery, AL 36130

Phone: (334) 206-2940

Fax: (334) 206-2950

Title V Program’s services for Children with Special Health Care

Needs, contact:

Christine Kendall, MSW, MBA

Director

Children’s Rehabilitation Service

2129 East South Boulevard

PO Box 11586

Montgomery, AL 36111-0586

Phone: (334) 281-8780

Fax: (334) 281-1973

5,000

15,000

20,000

25,000

30,000

35,000

40,000

10,000

2,025

35,168 37,915

35
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

36

614,010

9,926

The Section of Maternal, Child and Family Health (MCFH), is the

agency which administers the State of Alaska’s Title V funds,

provides health services and support to families, child-bearing

women, and children with special health care needs (CSHCN). The

Section functions within the Division of Public Health in the Department of Health and Social Services.

990 

10,400 

4,450 

2,458 

4,959 

23,257 

$814,095

$1,621,098

$842,021

$5,122,155

$592,254

$1,157,476

$10,149,099

ALASKA

$524,576

$10,825,506

$10,149,099

$151,831
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

37 ALASKA

6 of 9

100.5%

75%

26

7.2

86%

19%

11 of 18

1%

80%

7.7

2.3

4.2

3.8

10.1

39.7

6 of 9

97.5%

81%

23

6.6

86%

20%

11 of 18

1%

86%

7

1.6

4

3.1

9.7

37

Percentage of unintended births

Percentage of women who smoke prenatally

Percentage of people who experience intimate partner violence during their lifetime

Percentage of mothers putting infants down to sleep on their backs

41%97

18%97

40%97

48%97

38%

14%

34%

65%

2

2

1

2

2

2

11
Selected FY 98 Title V and

Other MCH Grant Annotations

38

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

Developing Systems of Specialty Care in Rural and Remote Alaska, Alaska Department of

Health and Social Services, Section of Maternal, Child and Family Health, Anchorage,

$100,000 (SPRANS-MCHIP-SSDI)

Specialty health care for children with special health care needs only exists in Alaska’s largest

city, Anchorage. For children who live outside of the Anchorage area specialty services are

accessed through periodic clinics held on an itinerant basis. This project is exploring the design of

a system of specialty care for children with special health care needs in rural and remote Alaska,

including data collection, linkage of data systems, collaboration with regional and local health

providers and communities, and local institutionalization of such a system.

Healthy Tomorrows Partnership for Children, Southcentral Foundation, Anchorage,

$50,000 (SPRANS-MCHIP-Healthy Tomorrows)

New Beginnings in Native Health is a home visitation program working with pregnant mothers and

new parents with the goal of getting families off to a good start and thus preventing child abuse

and neglect. Emphasis is placed on strengthening positive parent-child interactions, reducing

family stress, and promoting healthy child growth and development. The program is modeled after

the Hawaii Healthy Families/Healthy Families America Program. Home visitation is long term, from 3

to 5 years in duration. The program receives referrals at prenatal and birth primarily from the

Alaska Native Medical Center and Public Health Nursing.

Parent Navigation: Integrated Pathways Between the Medical Home and Early

Intervention System, Stone Soup Group, Anchorage, $111,050 (SPRANS-MCHIPIntegrated Services)

The Stone Soup Group will develop a family-centered model for care coordination for families of

children with special health care needs that establishes linkage between the medical home,

subspecialty clinics, and early intervention services. In Alaska, where distances are great,

pediatric subspecialists are scarce, and many parents and providers may be unfamiliar with the

terrain, parent navigators will guide families and providers to appropriate supports and services.

A visual blueprint will be developed to chart the early intervention delivery system. In addition,

training and workshops will be offered to parents and providers. The goal of this project is to

ensure that at any point of entry, families of children with special health care needs will have

access to the information necessary to map a successful course for their child and family.

Rural TOTS, REACH Infant, Learning Program, Juneau, $50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

Reducing the severity of chronic health and developmental disability in children and families in rural

southeast Alaska is the aim of the project. We will focus on providing families with local access to

early intervention and medical services. Family service coordination and developmental

assessments will be provided in the community. This program will shift the model from the medical

model to the family-centered model.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS-Title V)

Alaska’s Plan for Home Visitation, Alaska Department of Health and Social Services,

Anchorage, $50,000 (CISS-CISS-COG)

Alaska has high rates of child abuse and neglect. In a 5-year period beginning with1990, the

number of reports of harm that were made to child protective services increased by 61 percent.

The postneonatal mortality rate in Alaska is 2.4 times national rates. Alaska’s children, birth to 5

years old, die at nearly 3 times the rate of children in the United States in general. The health and

social service delivery system in Alaska focuses on the provision of treatment services. Few

programs focus on prevention and intervention for children at risk of poor health and social

outcomes including child abuse and neglect. The goal for Alaska’s Plan for Home Visitation is to

reduce infant and child morbidity and mortality and assure that children grow up in a nurturing

environment through the expansion of home visiting services for children and families who are at

risk. Project objectives will be accomplished by establishing a Universal Home Visiting

Collaboration Committee to develop a statewide plan for expansion of home visitation services. A

ALASKA CONTINUED

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Alaska Domestic Violence Training

Project, State of Alaska, Section of

Maternal, Child, and Family Health,

Anchorage, $35,000 (SPRANS-MCHIP-PN)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS-Title V)

• Community Integrated Service System: A

Comprehensive System for Behavior

Support, Stone Soup Group, Anchorage,

$50,000 (CISS-CISS-COG)

ALASKA

Other FY 98 MCH Grant Programs
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

39

Title V Program, contact:

Pamela T. Muth

MCFH Section Chief

1231 Gambell Street

Anchorage, AK 99501

Phone: (907) 269-3400

Fax: (907) 269-3414

Title V Program’s services for Children

with Special Health Care Needs, contact:

Karen Martinek

Special Needs Services Unit Manager

1231 Gambell Street

Anchorage, AK 99501

Phone: (907) 269-3400

Fax: (907) 269-3465

conference will be held annually to provide skill building and networking opportunities for families

with young children, families receiving home visiting services, and providers of services to young

families. The skill-building sessions will focus on methods for delivering family-centered services,

achieving cultural competency, early brain development, stress reduction, child rearing techniques,

and other relevant areas. The project also supports implementation of statewide performance

measures for existing home visiting programs.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Promotion Through Youth Developmental Assets Building, Division of Public

Health, Anchorage, $78,526 (Abstinence Ed)

“Abstinence Promotion Through Youth Developmental Assets Building” will increase the assets in a

young person’s life by increasing asset-based policies, programs and practices in Alaska families,

churches, schools, and communities. The more assets in young people’s lives, the more likely they

will abstain from sexual intercourse, alcohol, and other drug use. This combined abstinence and

assets initiative has two components: 1) Provide educational workshops and technical assistance

to communities as they implement asset building measures; and 2) Develop an Alaskan Assets

booklet that describes “how-to” build assets in children and youth.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Reduction/Prevention of Intentional Injuries Among Children/Youth, Alaska Department of

Health, Juneau, $151,831 (EMSC-Enhancement)

The project seeks to implement effective injury prevention strategies among children at greatest

risk for specific injuries as identified through the Alaska Trauma Registry and by injury fatality

records. We will determine what types of childhood injuries in certain Alaskan regions are

increasing in severity or frequency, or are continuing to occur at a significantly higher rate than

the national average for each age group. Then we will identify or develop an effective injury

prevention program for each type of injury identified by the serious injury and mortality data for the

targeted population of children at greatest risk of specific injuries. By 1996, we will have a 50-

percent decrease in the number of serious injuries and injury fatalities in the regions receiving

injury prevention programs for the age groups identified at greatest risk of injury.

500

1,500

2,000

2,500

3,000

3,500

4,000

1,000

N/A

2,304

1,500

$524,576

$151,831

$676,407
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

40

63,000

1,688

The Department of Health, American Samoa Government (ASG) is

the state agency that administers Title V Program. The following

services are included within Title V’s administrative control:

*Health Education

*Prenatal & Post-Natal Care

*Well Child Care

*School Health Services

*CSHCN Outreach/Follow-up activities

*Quality Improvement and In-service activities

*Pediatric Consultation

*Nutrition Services

*Social Services

*Family Planning Outreach

1,598

1,634

13,113

356

*

16,701

$127,059

$127,058

$272,267

$272,266

$18,152

$90,755

$907,557

AMERICAN SAMOA

$127,792

$1,035,349

$907,557

$ 0
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

41 AMERICAN SAMOA

9 of 9

76%

18

4.7

81%

3 of 18

.7%

20%

14.7

10

4.6

18.2

37.8

9 of 9

77%

18

1.6

82%

6 of 18

.45%

22%

13.

9.5

3.5

17

34

Mothers in the WIC program who breastfed infants at 6 months of age

Women who attended prenatal care clinics and participated in at least one nutrition

education session (per total number of women attending prenatal care clinics)

Pregnant women screened for Hepatitis B

Children who are 15 months old and vaccinated for Hepatitis B

10%

97%

21%

84%

13%

97%

92%

75%

2

1

0

1

1

2

7

* Data not available * Data not required
Selected FY 98 Title V and

Other MCH Grant Annotations

42

AMERICAN SAMOACONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

State Systems Development Initiative, American Samoa Government, Pago

Pago, $82,800 (SPRANS-MCHIP-SSDI)

The main goal of this project is to create a computerized, networked interagency

data tracking system to screen, identify, and provide appropriate, comprehensive

family-centered services for infants, toddlers, and children through age 21 with

special health care and learning needs. The project will continue to build on the

efforts of years 1–3 of State Systems Development Initiative funding during which

an interagency, cooperative approach to meeting the needs of the children with

special health care needs population was established.
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

43

$127,792

$0

$127,792

Title V Program, contact:

Diana Tuinei, RN, MPH

Title V Coordinator

Department of Health

Pago Pago, AS 96799

Phone: (684) 633-2263/4606

Fax: (684) 633-5379

Title V Program’s services for Children

with Special Health Care Needs, contact:

Diana Tuinei, RN, MPH

Title V Coordinator

Department of Health

Pago Pago, AS 96799

Phone: (684) 633-2263/4606

Fax: (684) 633-5379

75

225

300

375

450

525

600

150

200

400 400
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

4,668,631

78,243

The Arizona Department of Health Services was established as the

State Public Health Agency in 1973 under A.R.S. Title 36 and is

designated as Arizona’s Title V Agency. The Bureau of Community

and Family Health Services, in which the Office of Women’s and

Children’s Health and the Office of Children with Special Health Care

Needs are located, provides policies and standards development,

comprehensive planning, community organization and development,

training and technical assistance, and direct provision of screening,

preventive and curative services.

13,910

7,157 

585,181 

15,349 

24,080 

645,677 

$3,435,516

$4,352,709

$1,676,794

$6,778,165

$245,753

$1,386,805

$17,875,742

ARIZONA

$1,503,302

$19,626,636

$17,875,742

$247,592

44
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

ARIZONA

9 of 9

95.8%

78%

35

8.4

74.5%

39.1%

12 of 18

1.2%

74.4%

7.2

1.6

4.5

2.6

11.9

33.1

9 of 9

96.5%

80%

45

7.1

73%

85%

13 of 18

1.0%

76.0%

7.6

2.0

4.8

2.6

10.2

31.9

Hospitalizations for nonfatal injuries and poisonings (per 100,000 adolescents aged 15-19)

Licensed child care centers meeting national health and safety quality standards

Hospitalizations for asthma (per 100,000 children aged 1-14)

Preventable deaths to children under age 18 (per 100,000 children)

500.297

*

225.597

22.596

480

10.5%

205

19.5

2

2

2

2

2

2

12

* Data not available 45
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Improving Managed Care for Children

with Chronic Health Care Needs by

Including Parents as Participating

Partners in the Medical Home, Phoenix

Pediatrics/Planning for Success/Pilot

Parent Partnership, Phoenix, $116,462

(SPRANS-MCHIP-Integrated Services)

• Development of Integrated Systems for

Child Health, Arizona Department of

Health Services, Phoenix, $100,000

(SPRANS-MCHIP-SSDI)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS-Title V)

• Gila County Teen Pregnancy Prevention,

Gila County Health Department, Globe,

$49,999 (CISS-CISS-COG)

• Health Systems Development in Child

Care—A Collaborative Approach, Arizona

Department of Health Services, Phoenix,

$50,000 (CISS-CISS-Child Care Program)

• Health System and Integration, Mohave

County Department of Health and Social

Services, Kingman, $50,000 (CISS-CISSCOG)

• West Yavapai Service Integration Project,

Children’s Council, Inc., Prescott, $50,000

(CISS-CISS-COG)

ARIZONA CONTINUED

ARIZONA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Improving Access to and Utilization of Genetic Services to Arizona’s

Hispanic Population, Arizona Department of Health Services, Phoenix,

$192,704 (SPRANS-Genetics)

Barriers to genetic services for Arizona’s Hispanic population are cultural,

linguistic, economic, and geographic. In an attempt to overcome some of these

barriers, genetic clinics have been provided in outlying communities with training

in genetics for lay health workers to aid in identification and referral of patients and

inservices on genetics for health professionals. Spanish language classes and

workshops on Hispanic culture have been provided to genetic service providers

and public health staff to increase cultural sensitivity and competency.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS-Title V)

Community Health Systems Development TA Network, Arizona Department

of Health Services, Phoenix , $50,000 (CISS-CISS-COG)

The Arizona Department of Health Services Office of Women and Children’s Health

(OWCH) will establish a self-sustaining network for technical assistance related to

community health systems development in Arizona. Initial participants will include

OWCH staff, county and Native American tribal health department staffs, and local

participants in maternal and child health systems development efforts. Over time,

the network will expand to include a variety of local, State and national resources

for technical assistance (TA) and training. The TA Network will offer training for

trainers and technical assistance providers who serve local target groups, skillbuilding trainings for people involved in health systems development efforts

sponsored by county and tribal health departments, and customized technical

assistance to facilitate success in developing and carrying out community health

systems plans.

Title V—ABSTINENCE EDUCATION PROGRAM

Arizona Abstinence Only Education Program, Arizona Department of Health

Services, Phoenix, $894,137 (Abstinence Ed)

The program is to reduce the rate of out-of-wedlock pregnancies and births

through delivery of educational programs and a media campaign that stress

“Abstinence until Marriage.” Target populations include school age children from 9

to 18, males and females, parents, adults in high out-of-wedlock birth age groups,

and youth at risk of early sexual activity.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Arizona EMSC State Partnership Grant, Arizona Department of Health

Services, Phoenix, $60,000 (EMSC-PRTNER)

Project goals and objectives include the following: (1) Recruit and hire an

emergency medical services for children (EMSC) coordinator; (2) create and

support an EMSC resource center; (3) create and support an EMSC advisory

council, and hold at least three meetings; (4) develop a plan and data collection

tools to assess EMSC personnel, equipment, facilitiy and training needs, and

resources; (5) conduct an assessment of training needs; (6) for surveillance and

evaluation purposes, develop an inventory of existing injury-related data, evaluate the

quality of available data, formulate the research questions that the data need to

address, and prepare a report of baseline data for the research questions; (7) develop

a training plan from the results of the training needs asessment for the various EMSC

providers, and provide the necessary training in year 2; and (8) conduct a statewide

injury prevention conference to promote awareness of EMSC issues.

46
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

TRAUMATIC BRAIN INJURY

Arizona Kids With TBI, Arizona Department of Economic Security, Phoenix,

$187,592 (Traumatic Brain Injury-Implementation)

Arizona Kids with TBI will take the vision of a continuum of care for children with

traumatic brain injury (TBI) and their families from the current status of a fragmented

system into a model service delivery system. Forty children with TBI in two pilot

sites will be entered into the service delivery system provided by the Arizona

Department of Health Services, Office for Children with Special Health Care Needs,

which is an integrated, interdisciplinary service approach that includes long-term

planning for family involvement and support for successful return to the community.

The project (1) provides training to increase knowledge about pediatric TBI to

emergency room staff, hospital discharge planners, hospital social workers, case

service coordinators, special educators, and other appropriate professional staff; (2)

provides training to family members on case plans; (3) develops protocols for

emergency room staff, hospital discharge planners, and special educators; (4)

provides low-literacy, culturally sensitive, and translated information for family

members; (5) monitors gaps and roadblocks in services; and (6) increases

interagency collaboration to result in service system change.

$1,503,302

$247,592

$1,750,894

Title V Program, contact:

Marianna D. Bridge, RNC, MS

OWCH Office Chief

411 North 24th Street

Phoenix, AZ 85008

Phone: (602) 220-6550

Fax: (602) 220-6551

Title V Program’s services for Children

with Special Health Care Needs, contact:

Susan H. Burke, Ed.D.

Chief, OCSHCN

1740 W. Adams

Phoenix, AZ 85007

Phone: (602) 542-1860

Fax: (602) 542-2589

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

8,274 8,509

5,885

47
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

2,538,303

36,865

The Arkansas Department of Health (ADH) is a centralized state agency

that oversees public health operations in all seventy-five counties in the

state through six bureaus, ten regional area offices and ninety-five local

health units. Title V is administered by the Maternal and Child Health

Section of the ADH Bureau of Public Health Programs (BPHP). The

Children with Special Health Care Needs program (CSHCN) is administered by the Division of Medical Services, Children’s Medical Services,

Arkansas Department of Human Services. The services within Title V’s

administrative control include: Children with Special Health Care Needs

programs, Medicaid Outreach and Education (MOE), Newborn Screening, Adolescent Health, School Health, SIDS, Child Health Clinic Services, Injury, Fire and Burn Prevention, Child Health Support Services,

Maternity Services, Nurse Midwife Project, Perinatal Outreach, Lay

Midwife Project, Infant Mortality Initiatives, Pap Smear Follow-up, Family

Planning, Hearing, Speech and Vision Screening, Dental Screening and

Breastfeeding Services.

16,969

23,529

 84,058

15,159

*

139,715 

$5,373,894

$2,753,257

$3,942,921

$4,663,552

$3,225,715

$1,316,231

$21,275,570

ARKANSAS

$1,516,439

$23,179,515

$21,275,570

$387,506

48
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

ARKANSAS

8 of 9

98.2%

86%

40.9

6.9

60%

3.5%

15 of 18

1.8%

75.8%

8.8

2

5.3

4.5

9.7

38

8 of 9

98.5%

90%

43.0

10.7

13%

85%

16 of 18

1.2%

80%

8.2

1.3

4.5

2.5

11.7

28

Infant deaths reviewed and/or investigated

Children age 0 to 18 below 200 percent of poverty enrolled in a child health insurance program

Births to unmarried women

Pregnant women counseled for HIV testing

*

9%

35.1%

74%

98%

41%

32.8%

95%

3

2

3

2

3

2

15

* Data not available 49
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Maternal and Child Health Set-Aside State

Systems Development Initiative,

Arkansas Department of Health, Little

Rock, $100,000 (SPRANS-MCHIP-SSDI)

• University Affiliated Training Program,

University of Arkansas for Medical

Sciences, Little Rock, $430,434 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS-Title V)

• Arkansas CISS/HSDCC, Arkansas

Department of Health, Little Rock, $49,427

(CISS-CISS-Child Care Program)

• Integrated Health Service Delivery

System, St. Mary’s Hospital, Rogers,

$50,000 (CISS-CISS-COG)

• Our Children First Coalition, Our Children

First Coalition, Inc., Texarkana, $50,000

(CISS-CISS-COG)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Incorporation of Emergency Medical

Services for Children into Arkansas EMS,

University of Arkansas for Medical

Sciences, Little Rock, $74,594 (EMSCPRTNER)

• Outcomes Assessment in Pediatric

Trauma Patients, University of Arkansas

for Medical Sciences, Little Rock,

$144,241 (EMSC-Target)

ARKANSAS CONTINUED

ARKANSAS

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Statewide Infant Mortality Review Support Project, Arkansas Department of

Health, Little Rock, $126,574 (SPRANS-MCHIP-FIMR)

A statewide review of approximately 300 deaths by community multidisciplinary

review teams will provide information needed to implement program changes and/

or policy changes to better address infant mortality in the state. The Arkansas

Department of Health will designate project coordinators in each of its 10 health

management areas. Coordinators will assure formation of local review teams,

gathering of medical record and home visit data for each death, and review an

aggregation of findings by the local review teams. Recommendations will be

submitted to the Governor’s Perinatal Advisory Board. Recommendations will be

developed by the board for the Governor, State Health Officer, and State Board of

Health.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS-Title V)

Arkansas Community Integrated Service System Program, Arkansas

Department of Health , Little Rock, $50,000 (CISS-CISS-COG)

This new initiative will conduct community-based training to improve the ability of

local and State providers to respond to underserved populations of African

Americans and children with special health needs, and an emerging Hispanic

population. We will also provide technical assistance to communities to improve

the level of knowledge of existing needs and resources and increase local

capacity to address community identified needs.

Title V—ABSTINENCE EDUCATION PROGRAM

Arkansas Abstinence Education Program, Arkansas Department of Public

Health, Little Rock, $660,004 (Abstinence Ed)

The program is to increase the level of abstinence education provided to schoolage children within the State. Specific activities include: a state conference to

showcase available abstinence-only curricula and current concepts; grants to

communities around the state to sponsor abstinence education programs; a

statewide media campaign to promote abstinence among school-age youth; and,

an evaluation of the funded projects.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Quality and Cost Containment in Pediatric Intensive Care, Arkansas

Children’s Hospital, Little Rock, $168,671 (EMSC)

This study investigates the relationship between cost containment and the quality

of care in pediatric intensive care settings. We will: (1) Develop a pediatric

morbidity prediction system; (2) document variations in pediatric intensive care

mortality rates, morbidity rates, severity of illness/injury, and resource use based

on the race and the insurance status of the patient; (3) explain variations in

mortality, morbidity, and resource use with age, race, gender, and illness/injury

severity; and (4) estimate relationships among insurance status, resource use,

mortality, and morbidity.

50
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$1,516,439

$387,506

$1,903,945

Title V Program, contact:

Richard Nugent, M.D.

Medical Director, MCH

4815 W. Markham, Slot 41

Little Rock, AR 72205

Phone: (501) 661-2199

Fax: (501) 661-2055

Title V Program’s services for Children

with Special Health Care Needs, contact:

Nancy L. Church, R.N.

Assistant Director

P.O. Box 1437, Slot 526

Little Rock, AR 72203-1437

Phone: (501) 682-1464

Fax: (501) 682-8247

4,000

12,000

16,000

20,000

24,000

28,000

32,000

8,000

23,570

27,797

9,190

51
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

32,666,550

521,661

Title V funds are administered by the Maternal and Child Health (MCH)

Branch and Children’s Medical Services (CMS) Branch in the State of

California. These two Branches are part of the Primary Care and

Family Health Division which also includes WIC, the Office of Family

Planning, the Genetic Disease Branch, Comprehensive School Health

Program, and Primary Care and Rural Health Systems Branch

(including Native American Health). The MCH Branch conducts

statewide assessment of needs, develops policies, plans and programs to improve the health of women, infants, adolescents, and

families in California utilizing the core public health functions. The CMS

Branch is responsible for the Child Health and Disability Prevention

Program (CHDP), California Children Services (CCS) program, and the

Genetically Handicapped Persons Program (GHPP). CCS is the

Children with Special Health Care Needs program.

524,174

550,596

1,735,101

133,007

*

2,942,878

$41,367,728

$37,465,997

$113,358,502

$912,760,406

$0

$2,703,636

$1,107,656,269

CALIFORNIA

$9,975,446

$1,122,720,543

$1,107,656,269

$5,088,828

52
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

CALIFORNIA

9 of 9

98.9%

75%

35.7

3

41.3%

8.5%

13 of 18

1.1%

80.8%

5.9

2.4

3.9

2

8.8

20.2

9 of 9

99%

78%

34.7

2.2

45%

50%

14 of 18

1.1%

84.6%

5.2

2.5

3.4

1.6

7.1

18.0

Maternal mortality (per 100,00 live births)

Deaths caused by homicide (per 100,000 15-to-19-year olds)

Deaths caused by motor vehicle accidents (per 100,000 15-to-19-year olds)

Children who received at least one preventive medical exam during the year and

are living at less than 200% of Federal poverty level

*

*

18.796

*

5.6

16.2

15.7

50%

2

1

3

3

3

1

13

* Data not available 53
Selected FY 98 Title V and

Other MCH Grant2 Annotations

CALIFORNIA CONTINUED

TITLE V—SPECIAL PROJECTS OF

REGIONAL AND NATIONAL SIGNIFICANCE

• 8% Early Intervention Project - Health

Care Program, American Academy of

Pediatrics, Orange, $49,980 (SPRANSMCHIP-Healthy Tomorrows)

• ACCESS-MCH: Center for Automation and

Care Coordination Enhancing Service

Systems in Maternal and Child Health,

Children’s Hospital of Los Angeles, Los

Angeles, $354,003 (SPRANS-MCHIPIntegrated Services)

• California Connections: Assuring Access

to Preventive Services Under Reformed

Systems of Health Care for Children With

Special Health Needs and Their Families

(Priority Area: Provider Preparation),

University of Southern California , Los

Angeles, $200,000 (SPRANS-MCHIPManaged Care/Health Care Reform)

• Cancer Genetics Education for Primary

Care Providers, City of Hope National

Medical Center, Duarte, $121,034

(SPRANS-Genetics)

• Center for Occupational Science-Based

Leadership Training in Pediatric

Occupational Therapy, University of

Southern California, Los Angeles,

$126,027 (SPRANS-Training-Occupational

Therapy)

• Collaborative Office Rounds for Pediatric

Practitioners, University of California, San

Francisco, San Francisco, $12,000

(SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Comprehensive Adolescent Training and

Mentor Program, Charles R. Drew

University of Medicine and Science, Los

Angeles, $166,653 (Training-Historically

Black Colleges)

• Coordinated National Effort to Guide

Hospital– and Community–Based Primary

Care in the First Days of Life and

Parenting, University of California, San

Francisco, San Francisco, $275,051

(SPRANS-Research-FI)

• Crossing Cultural Boundaries: An

Ethnographic Study, University of

Southern California, Los Angeles,

$220,263 (SPRANS-Research)

• Pacific Southwest Regional Genetics

Network (PSRGN), Public Health Institute,

Berkeley, $327,008 (SPRANS-Genetics)

• Northern California Thalassemia Center,

Children’s Hospital of Oakland, Oakland,

$300,000 (SPRANS-Genetics)

• Establishment of the Olive View-UCLA

Prenatal Diagnosis Unit Aimed at an

Underserved Multiethnic Perinatal

Population, Olive View Medical Center,

Sylmar, $167,788 (SPRANS-Genetics)

• Health Care Utilization: Pediatric Organ

Transplantation, University of California,

Los Angeles, Los Angeles, $156,589

(SPRANS-Research)

CALIFORNIA

Other FY 98 MCH Grant Programs

Title V—Special Projects of Regional and National Significance

(SPRANS)

National Adolescent Health Information Center, University of California, San

Francisco, San Francisco, $380,000 (SPRANS-MCHIP)

The National Adolescent Health Information Center establishes a central point for

the development of a coordinated and integrated activity in the area of adolescent

health. The center provides this assistance to the Maternal and Child Health

Bureau by coordinating with existing national adolescent health efforts,

collaborating with available resources within MCHB and other Federal and private

agencies, conducting short- and long-term policy analyses of legislative changes

(especially in the area of health care and welfare reform) that will effect the

adolescent population, identifying and disseminating information about exemplary

programs, and developing strategies for highlighting the needs of special

populations.

Infancia Feliz, Vista Community Clinic, Vista, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

The overriding goal of Infancia Feliz is to improve the health status of low-income

infants (primarily of newly immigrated Mexican parents) during the period from

birth to 2 years by developing an enhanced perinatal support program. First-year

objectives include (1) recruitment and training of at least 10 “consejeras,” or

counselors, from the community who will function as mentors for the new mothers

and their families, (2) enrollment of at least 40 mother/infant pairs in the program,

and (3) attainment of at least 75 percent compliance with immunization and wellchild schedules during the first 2 years of life. The project offers a family-centered

approach that emphasizes culturally appropriate care for infants.

Title V—Community Integrated Service Systems (CISS)

Children’s Regional Integrated Service System, Children’s Hospital

Oakland, Oakland, $50,000 (CISS-CISS-COG)

With the Children’s Regional Integrated Service System, 23,000 children with

special health care needs in 10 California counties will be served within a

seamless, integrated system, addressing the lack of coordination and

collaboration among the region’s State Title V programs (CCS). Differing county

standards and processes place obstacles in the way of consumers and providers.

The project will improve networking and coordination through creation of a regional

planning group of CCS programs, providers, and consumers; reduce cross-country

program differences through regional standards; and improve regional data

capacity through a regional information system.

Healthy Start Initiative

Healthy Start Initiative Phase II, San Bernardino County Health Department,

San Bernardino, $2,100,000 (Healthy Start-Community)

In an effort to win the war over infant mortality in the poorest neighborhood in the

poorest city in San Bernardino County, CA, this project seeks to empower the

community and the family, enhance medical service delivery, and link consumers

to service providers. The goals of the project are to (1) reduce infant mortality, low

birthweight, preterm births, and perinatal substance exposure; (2) increase

access to and maintenance of perinatal care; and (3) increase resident education

and employment marketability.

54
TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$9,975,446

$5,088,828

$15,064,274

CALIFORNIA

Other FY 98 MCH Grant

Programs

Emergency Medical Services for Children (EMSC)

Emergency Medical Services for Children Partnership Grant, California

Emergency Medical Services Authority, Sacramento, $60,000 (EMSCPRTNER)

The major goal of this project is to promote the implementation of emergency

medical services for children (EMSC) and encourage the integration of the

EMSC program in all emergency medical services (EMS) systems to

institutionalize and improve emergency and critical care services for the

children of California. The project will sponsor an annual conference to promote

EMSC, discuss issues, and provide information on integrating EMSC to (1)

local EMS agencies, hospital administrators, pediatricians, emergency

physicians, emergency nurses, and pediatric intensivists; (2) representatives of

managed care organizations and prehospital service providers; (3) State and

Federal health officials involved with pediatric and critical care in California, and

(4) all other participants in the EMSC continuum, including consumer or

community representatives, special populations (Native Americans), and

special needs groups.

• Home Versus Group Visits After Early

Postpartum Discharge, Kaiser

Permanente, Oakland, $230,792

(SPRANS-Research)

• Infant ETS Exposure: Clinic-Based

Maternal Counseling, San Diego State

University, La Mesa, $261,602 (SPRANSResearch)

• Interdisciplinary Adolescent Health

Training Project, University of California,

San Francisco, San Francisco, $362,000

(SPRANS-Training-Adolescent Health)

• Interdisciplinary Maternal and Child Health

Training Program, University of California,

Los Angeles, Los Angeles, $362,001

(SPRANS-Training-School of Public Health)

• Interparental Conflict and Adolescent

Violence, University of California, San

Francisco, $284,404 (SPRANS-Research)

• Leadership Training for Public Health

Nutrition, University of California, Los

Angeles, Los Angeles, $124,011

(SPRANS-Training-Nutrition)

• Managed Care Health Plans: Introducing

Family-Centered Care, Parents Helping

Parents, Inc., Santa Clara, $155,000

(SPRANS-MCHIP-Managed Care/Health

Care Reform)

• Managed Care Policy and Children with

Special Health Care Needs Cooperative

Agreement, University of California at San

Francisco, San Francisco, $375,000

(SPRANS-MCHIP-Managed Care/COOP)

• Maternal, Child, and Adolescent Nutrition

Leadership Program, Regents of the

University of California at Berkeley,

Berkeley, $120,327 (SPRANS-TrainingNutrition)

• Maternal and Child Health Leadership

Education in Behavioral Pediatrics,

University of California, San Francisco,

San Francisco, $115,096 (SPRANSTraining-Behavioral Pediatrics)

• National Center for Infant and Early

Childhood Health Policy, University of

California, Los Angeles, Los Angeles,

$446,135 (SPRANS-Training-Continuing Ed/

Policy Center)

• Policy Information & Analysis Center for

Middle Childhood & Adolescence,

University of California, San Francisco,

San Francisco, $250,000 (SPRANSTraining-Continuing Ed/Policy Center)

• Reforming Financing and Service Delivery

Arrangements for Children with Special

Needs, University of California, San

Francisco, San Francisco, $0 (SPRANSMCHIP-Integrated Services)

• Region IX Nutrition Mentoring Project,

University of Southern California, Los

Angeles, $49,470 (SPRANS-TrainingContinuing Education)

• San Diego Homeless Adolescent Health

Care Project: Medical Outreach for High

Risk Teens and Their Families, Logan

Heights Family Health Center, San Diego,

$50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

• South County Infant Loss Project, Tiburcio

Vasquez Health Center, Inc., Union City,

$75,000 (SPRANS-MCHIP-SIDS)

55
Other FY98 MCH Grant Programs

CALIFORNIA CONTINUED

• State Systems Development Initiative,

California Department of Health Services,

Sacramento, $100,000 (SPRANS-MCHIP-SSDI)

• Strengthening Genetics in Primary Care for

Asians and Pacific Islanders, Association of

Asian Pacific Community Health Organizations,

Oakland, $125,000 (SPRANS-Genetics)

• Team Approach to Services for Children With

Special Health Care Needs: Nutrition Makes a

Difference, University of Southern California,

Los Angeles, Los Angeles, $71,114 (SPRANSTraining-Nutrition)

• Training in Maternal and Child Health,

University of California at Berkeley, Berkeley,

$316,752 (SPRANS-Training-School of Public

Health)

• Training and Technical Assistance Center for

Mental Health in Schools, University of

California, Los Angeles, Los Angeles, $270,000

(SPRANS-MCHIP-Mental Health of School-Age

Children and Adolescents)

• UCLA University Affiliated Program

Interdisciplinary Leadership Training in

Neurodevelopmental and Related Disabilities,

University of California, Los Angeles, Los

Angeles, $441,000 (SPRANS-Training-LEND

Leadership Ed Neuro Dev)

• University of Southern California’s University

Affiliated Program: Interdisciplinary

Leadership Education in Neurodevelopmental

and Related Disabilities (LEND), University of

Southern California, Los Angeles, $587,871

(SPRANS-Training-LEND-Leadership Ed Neuro

Dev)

TITLE V—COMMUNITY INTEGRATED SERVICE

SYSTEMS

• Anderson and Happy Valley Healthy Children

and Families Partnership Project, Shasta

Community Health Center, Redding, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• California FIMR Support Program, March of

Dimes, Oakland, $150,966 (SPRANS-MCHIPFIMR)

• California Fluoridation Implementation Project,

Dental Health Foundation, San Rafael, $30,000

(SPRANS-MCHIP-Fluoride)

• CISS for California’s Children, University of

Southern California, Los Angeles, $50,000

(CISS-CISS-COG)

• CISS/Increase Health Access, Community

Health Councils, Inc., Los Angeles, $50,000

(CISS-CISS-COG)

• Community Health Integrated Resources

Project, Southwest Community Health Center,

Santa Rosa, $50,000 (CISS-CISS-COG)

• Cost Benefit Analysis of Enhanced Perinatal

Support Services in Medicaid Managed Care,

University of California at San Francisco, San

Francisco, $67,500 (SPRANS-MCHIP-Data)

• Establishing a Community-Based Interagency

Services System for Children With Special

Health Care Needs in Los Angeles County,

Public Health Foundation Enterprises, Inc., City

of Industry, $50,000 (CISS-CISS-COG)

• Fragile Infant Special Care Program,

Edgewood Children’s Center, San Francisco,

$0 (SPRANS-MCHIP)

• Healthy Child Care California, San Diego State

University Foundation, San Diego, $50,000

(CISS-CISS-Child Care Program)

• Humboldt Healthy Families Collaborative

Project, Humboldt County Public Health

Department, Eureka, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• Injury Prevention Targeted Resource Center,

Data Analysis Resource Center: Resource

Center for Utilizing Injury Data for Prevention,

San Diego State University Foundation, San

Diego, $44,000 (SPRANS-MCHIP)

• Maternal and Child Health Continuing

Education and Development for Enhanced

Analytical Skills, University of California at

Berkeley, Berkeley, $294,691 (SPRANS-MCHIPData)

• MCH Service Federal Set Aside Programs, San

Mateo County Perinatal Council, Belmont,

$50,000 (CISS-CISS-COG)

• Region IX Hemophilia Care Program,

Orthopaedic Hospital, Los Angeles, $820,383

(SPRANS-Hemophilia)

• San Diego County Dental Health Initiative, San

Diego Child Health and Disability Prevention

Program, San Diego, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• San Diego Kids Health Assurance Network,

Children, Youth and Families Health - CHDP

Program, San Diego, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• San Diego Kids Health Assurance Network -

Information Management System, County of

San Diego, San Diego, $50,000 (CISS-CISSCOG)

• Vista Townsite Neighborhood Partnership for

Maternal and Child Health, Vista Community

Clinic, Vista, $50,000 (CISS-CISS-COG)

HEALTHY START INITIATIVE

• Fresno Healthy Start, Fresno County Health

Services Agency, Fresno, $1,342,661 (Healthy

Start-Community)

• Oakland Healthy Start Program, Alameda

County Health Care Services Agency, East

Oakland, $1,400,426 (Healthy Start-Mentor)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN

• National EMSC Resource Alliance (NERA),

Research and Education Institute, Inc.,

Torrance, $185,741 (EMSC-Enhancement)

56
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

Title V Program, contact:

Rugmini Shah, M.D.

Chief, Maternal and Child Health Branch

714 P Street, Room 750

Sacramento, CA 95814

Phone: (916) 657-1347

Fax: (916) 653-3962

Title V Program’s services for Children

with Special Health Care Needs, contact:

Maridee A. Gregory, M.D., M.P.H.

Chief, Children’s Medical Services Branch

714 P Street, Room 350

Sacramento, CA 95814

Phone: (916) 654-0832

Fax: (916) 653-8271

10,000

30,000

40,000

50,000

60,000

70,000

80,000

20,000

66,638

46,356

76,397

57
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

3,970,971

59,577

The Colorado Department of Public Health & Environment, Family and

Community Health Services Division (FCHSD), administers the Title V

program of maternal and child health services. Information about the

program can be found on the World Wide Web at http://

www.cdphe.state.co.us/fc/fchom.html. The complete text of the MCH

Block Grant Application can be downloaded from:

www.cdphe.state.co.us/fc/mch/mchblock.html.

Children with special health care needs are included in the Division’s

responsibilities, as are WIC and the Child and Adult Care Food

Program. However, immunization services are located outside the

FCHSD, in the Disease Control and Environmental Epidemiology

Division, and injury prevention efforts are located in the Emergency

Medical Services and Prevention Division.

3,714

54,875

88,357

8,272

18,338

173,556

$2,060,641

$0

$3,304,797

$6,549,056

$0

$1,157,981

$13,072,475

COLORADO

$3,117,169

$16,264,644

$13,072,475

$75,000

58
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

COLORADO

9 of 9

96.5%

75%

30.9

4.7

81%

79%

13 of 18

1.3%

82.9%

7

2.4

4.7

2.3

11.5

22.2

9 of 9

*

90%

29.5

3.5

85%

85%

13 of 18

1.3%

85%

6.7

2.2

4.5

2.2

11

22

The rate of deaths to adolescents age 15-19 caused by motor vehicle crashes

per 100,000 children

The proportion of public school students who have access to health services

through school-based health centers

Percent of Medicaid-eligible children who receive dental services as part of their

comprehensive services

The rate of homicides among teens 15-19

2497

*

17%

*

25

4.9

20%

5.5

2

2

2

2

3

2

13

* Data not available 59
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Colorado Leadership Education in

Neurodevelopmental and Related

Disabilities Training Program, University

of Colorado, Denver, $300,000 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• Colorado State Systems Development

Initiative, Colorado Department of Public

Health and Environment, Denver,

$100,000 (SPRANS-MCHIP-SSDI)

• Educating State Legislators About

Maternal and Child Health Issues,

National Conference of State Legislatures,

Denver, $95,785 (SPRANS-MCHIP-PIC)

• Expanded School Health Resource

Project, University of Colorado, Denver,

$178,799 (SPRANS-MCHIP-Mental Health

Services)

• Leadership Option: Care of Children With

Disabilities, University of Colorado,

Denver, $159,545 (SPRANS-TrainingNursing)

• Mountain States Regional Genetic

Services Network, Colorado Department

of Public Health and Environment,

Denver, $274,379 (SPRANS-Genetics)

• National Center for Leadership

Enhancement of Adolescent Programs

(LEAP), Colorado Department of Public

Health and Environment, Denver,

$200,000 (SPRANS-MCHIP-Adolescent

Health)

• Region VIII Hemophilia Diagnostic and

Treatment Centers, University of Colorado

Health Sciences Center, Denver, $356,385

(SPRANS-Hemophilia)

• Regional Clinical Care Guidelines and

Protocols To Improve Health Care

Services for Infants and Children with

Sickle Cell Disease in Colorado and

Arizona, University of Colorado Health

Sciences Center, Denver, $94,632

(SPRANS-Genetics)

• Universal Newborn Hearing Screening,

University of Colorado, Boulder, Boulder,

$373,261 (SPRANS-MCHIP-Integrated

Services)

COLORADO CONTINUED

COLORADO

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

National Resource Center for Health and Safety in Child Care, University of

Colorado, Denver, $390,000 (SPRANS-MCHIP-CC)

To promote informed decision-making about health and safety out-of-home child

care, we will provide health and safety technical information, training networks,

materials, and resources to diverse consumers including State MCH offices, State

and local resource and referral agencies, public and private child care providers,

Head Start programs, and parent-consumers. The project will develop, maintain,

and update data bases and collections, and develop effective dissemination routes

and mechanisms for target audiences. A consortium of formal and informal

partnerships that is national in scope and State-based in implementation will be

developed. Program monitoring will track implementation and use; outcomes will

be evaluated through participant questionnaires and user surveys.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS-Title V)

Colorado’s Health Systems Development in Child Care Grant, Family and

Community Health Services Division, Denver, $50,000 (CISS-CISS-Child Care

Program)

This project facilitates the development of community-based integrated systems

for child care, which include both health and social support services throughout

Colorado. At the conclusion of the 3-year grant, four communities will have

successfully developed an integrated community-based system of child care,

providing documentation of planning and implementation processes, and including

the pitfalls, benefits, and recommendations for additional communities to develop

their own integrated system for child care services.

Title V—ABSTINENCE EDUCATION PROGRAM

State of Colorado Abstinence Education Project, Colorado Department of

Public Health and Environment, Denver, $544,383 (Abstinence Ed)

The goal for the State of Colorado is to reduce out-of-wedlock teen births and

sexually transmitted diseases through the support of local abstinence education

programs and public awareness campaigns. The Colorado Department of Public

Health and Environment will provide technical assistance, monitoring, and

establish a resource and communication network.

60
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Colorado EMSC Partnership Grant, Colorado Department of Public Health

and Environment, Denver, $75,000 (EMSC-PRTNER)

The overall goal for this project is to establish additional staff time dedicated to

emergency medical services for children (EMSC) activity at the regional level to

enhance the local effectiveness of EMSC efforts. Two half-time positions will be

established during year 1 through contracts with influential regionally based

organizations. These staff members will work with the State’s EMSC program to

achieve the following goals: (1) Establishment of a local EMSC presence with

organizations, institutions, and groups dealing with pediatric emergency care

issues; (2) State representation on regional councils dealing with emergency

medical services and trauma care issues; (3) assured provision of EMSC technical

assistance to local PIER officers; (4) availability of local EMSC representation at

public gatherings to provide public information and education in EMSC issues; (5)

availability of local technical assistance in injury prevention activities for local

groups and organizations; (6) locally based presentation of pediatric interactive

video and skills lab training; (7) creation of a local source for the distribution of

EMSC training resources; (8) establishment of a local EMSC presence with all

regional public school districts; (9) participation in the development of a public

school first-aid needs assessment tool; (10) implementation of the resulting needs

assessment tool on a regional basis; and (11) local input into the evaluation of the

needs assessment results.

$3,117,169

$75,000

$3,192,169

Title V Program, contact:

Merril Stern, Director

Family & Community Health Services Division

FCHSD-ADM-A4 Colorado Dept. of Public Health & Environment

4300 Cherry Creek Drive South

Denver , CO 80246

Phone: (303) 692-2302

Fax: (303) 753-9249

Title V Program’s services for Children with

Special Health Care Needs, contact:

Joan Eden, Director

Health Care Program for Children with Special Needs

FCHSD-ADM-A4 Colorado Dept. of Public Health & Environment

4300 Cherry Creek Drive South

Denver, CO 80246

Phone: (303) 692-2389

Fax: (303) 782-5576

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

6,496 7,502

N/A

61
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

3,274,069

43,820

The Department of Public Health, the state’s leader in public health

policy and advocacy, is the agency which administers Connecticut’s

Title V program. Title V funding allows the state to address the health

concerns of the Maternal and Child populations in areas of need

throughout the state, through community based programs and interventions. These programs include Healthy Start, Maternal Mortality

Review, Genetics and Newborn Screening, Children with Special Health

Care Needs, School Based Health Centers, Pediatric Primary Care,

Oral Health, and the Adolescent Pregnancy Prevention/Young Parents

Program. The health needs of the population along the continuum from

birth through the reproductive years are addressed by these programs.

Additionally, state capacity supported by Title V funding allows for

ongoing planning and policy making activities regarding the state’s

MCH population, both within the department, between state agencies,

and in other, pertinent statewide health care arenas.

17,822

51,638

75,471

5,284

52,963

203,178

$778,576

$2,018,835

$5,446,041

$3,334,648

$70,088

$283,707

$11,931,895

CONNECTICUT

$662,346

$13,987,889

$11,931,895

$1,393,648

62
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

CONNECTICUT

8 of 9

102%

87%

22.497

397

65.5%97

**

 13 of 18

1.6%97

82.4%97

7.297

2.997

5.697

1.697

10.997

19.597

8 of 9

98%

90%

21.6

2.8

68%

**

13 of 18

1.4%

88.5%

6.4

2.5

4.5

1.8

9.8

23.4

Women who smoked during pregnancy

Death rate due to intentional and unintentional injury (per 100,000 1-19 year olds)

Children and adolescents enrolled in Medicaid who received an EPSDT screening

service during the past year

CSHCN clients who are enrolled in State CSHCN program and have a written

health care service plan

9.7%97

16.797

60.16%

84%

9.4%

16.5

62%

86%

2

2

2

3

3

1

13

* Data not available 63
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Children’s Health Network, Hartford

Primary Care Consortium, Hartford, $100

(SPRANS-MCHIP-Data)

• Collaborative Office Rounds Group in

Psychosocial Developmental Pediatrics,

Yale University, New Haven, $12,000

(SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Early Intervention CONNECT, University of

Connecticut, Farmington, $0 (SPRANSMCHIP)

• Prenatal-to-Pediatric Transition Project,

Fair Haven Community Health Clinic, Inc.,

New Haven, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Health Systems Development in Child

Care Program, Connecticut Office of the

Governor, Hartford, $50,000 (CISS-CISSChild Care Program)

CONNECTICUT CONTINUED

CONNECTICUT

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Behavioral Pediatrics Training Program, Yale University, New Haven, $69,762

(SPRANS-Training-Behavioral Pediatrics)

The purpose of the Behavioral Pediatrics Training Program is to train future

academicians and leaders in the field of behavioral and developmental pediatrics.

Interdisciplinary training is provided in clinical skills, education and communication

skills, and community and policy issues related to children and families. In

addition, faculty provide training in child development and behavior to residents,

students, and pediatric practitioners.

State Systems Development Initiative, Connecticut Department of Public

Health, Hartford, $100,000 (SPRANS-MCHIP-SSDI)

The goal of the SSDI project is to establish an integrated data system to augment

the present infrastructure and allow access to MCH data by program staff,

managers, and community partners. Results of the CHSCN needs assessment

and data from other programs and agencies will be incorporated into the MCH

data bases. A protocol for conducting a needs assessment and a method for

converting MCH-INFO into a Windows compatible file will be developed.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Maternal and Child Health Services Set-Aside Program, Connecticut

Department of Public Health, Hartford, $50,000 (CISS-CISS-COG)

Oral health, an integral part of overall health and well-being, is in grave jeopardy

with severe access problems for uninsured, underinsured, and otherwise

vulnerable people in Connecticut. The purpose of the Connecticut Community

Oral Health Systems Development Project is to enhance the development of

service systems at the community level to address the oral health and related

needs of at-risk children and their families, as facilitated and guided by the efforts

of community-based work groups.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, State of Connecticut Department of Public Health,

Hartford, $330,484 (Abstinence Ed)

The reduction of out-of-wedlock births to teens aged 15 to 17 years is the project

goal. Activities include, in year one, a targeted media campaign focusing on

teens, their parents, adult males, and the general community at large. The

campaign is intended to raise public awareness about the viability of an

abstinence-only approach to preventing teen pregnancy. Subsequent years will

transition to funding locally based service programs for youth at risk aged 9 to 14,

to encourage these youth to delay the onset of sexual activity and prevent out-ofwedlock births and other health-related adverse consequences. Throughout the 5-

year project period, collaborative relationships will be established and maintained

between the Department of Public Health and appropriate Federal, State, and local

agencies as these relationships are viewed as integral to the success of the

initiative and the accomplishment of its goals.

64
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Emergency Medical Services for Children, Connecticut Department of Public

Health, Hartford, $201,235 (EMSC-Implementation)

On the systemwide level in Connecticut, emergency medical services (EMS)

capabilities for pediatric patients have been incorporated into general

improvements of the overall EMS system. The major goals of the project are to:

(1) Identify the current status of EMS pediatric capability in the State through a

review and analysis of the efforts to enhance local programs; and (2) create a plan

to develop comprehensive programs of emergency medical services for children

(EMSC) in a coordinated, systemic fashion. Through this project the State will, for

the first time, have an individual whose sole responsibility and focus will be the

development of a statewide EMSC system.

HEALTHY START

Healthy Start New Haven, Community Foundation for Greater New Haven,

New Haven, $1,192,413 (Healthy Start-Community)

The New Haven Healthy Start project will strengthen the community’s maternal

and child health infrastructure to achieve long-term infant mortality and morbidity

reduction goals consistent with those set forth by “Healthy People 2000.” In part

because of the achievements of two existing consortia, citywide infant mortality

rates have declined. However, maternal and child health problems remain highly

concentrated in some geographic areas. Existing maternal and child health

strategies must be refined, particularly as the State transitions to a medicaid

managed system of care. The independent consortia have identified three project

goals around which they will coordinate their efforts and resources. These goals

are to (1) strengthen the city’s maternal and child health and support services

infrastructure, (2) increase access to perinatal care for all women of childbearing

age and their infants, and (3) increase knowledge and awareness among providers

of their responsibilities and the health care options related to perinatal health care.

$662,346

$1,393,648

$2,055,994

Title V Program, contact:

Title V Program, contact:

Beth Weinstein

Director, Family Health Division

Dept. of Public Health 410 Capitol Ave.

MS# 11 FHD PO Box 3403

Hartford, CT 06134-0308

Phone: (860) 509-8066

Fax: (860) 509-7720

Title V Program’s services for Children

with Special Health Care Needs, contact:

Lisa Davis, RN, MBA

Supervisor, MCH Unit

Dept. of Public Health 410 Capitol Avenue

MS# 11 MAT PO Box 340308

Hartford, CT 06134-0308

Phone: (860) 509-8074

Fax: (860) 509-7720

4,000

12,000

16,000

20,000

24,000

28,000

32,000

8,000

30,000

21,690

N/A

65
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

523,124

7,686

The Office of Maternal and Child Health’s mission is to plan,

promote and coordinate a state-based system of comprehensive

health services in the public and private sectors in the District of

Columbia for all mothers, children and adolescents, including

children with special health care needs. OMCH is the single state

agency that administers the Title V Maternal and Child Health

Services Block Grant, and it is also responsible for developing and

assuring the implementation of programs addressing special

maternal and child health problems including infant mortality, teen

pregnancy, metabolic disorders, disabilities and barriers to accessing appropriate health services.

1,526

14,866

13,449

892

5,697

36,430

$1,249,255

$1,249,195

$1,873,800

$1,873,800

$5,205,041

$694,005

$12,145,096

DISTRICT OF COLUMBIA

$8,054,335

$24,586,048

$12,145,096

$4,386,617

70
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

DISTRICT OF COLUMBIA

7 of 997

94.6%97

73%97

65.897

3.597

38%97

19.6%

10 of 18

3.5%97

66.7%

13.197

5.397

9.697

3.597

17.497

47.697

7 of 9

100%

90%

70.2

4.4

46%

75%

13 of 18

2.5%

70%

11

1

9.0

2.0

16.8

40

Live births to women who received adequate prenatal care

Medicaid enrollees under 21 years old who have received EPSDT screenings

Women who smoked during pregnancy

Women who consumed alcohol during pregnancy

58.5%97

55%

5.5%97

2.27%97

62%

60%

6.25%

2%

3

3

0

0

2

2

13

71
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Accessing a Primary Health Care Home

Through Case Management, District of

Columbia Department of Human Services,

Washington, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• Bright Futures and Managed Care:

Promoting Healthy Infants, Children and

Adolescents, National Institute for Health

Care Management, Washington, $191,734

(SPRANS-CISS/MCHIP-PIC)

• Comprehensive Care for Infants with

Sickle Cell Disease, Children’s Hospital,

Washington, $100,000 (SPRANSGenetics)

• District of Columbia Systems

Development Initiative (DCSDI), District of

Columbia Department of Human Services,

Washington, $100,000 (SPRANS-MCHIPSSDI)

• Girl Neighborhood Power!: Building

Bright Futures for Success, National

Healthy Mothers, Healthy Babies

Coalition, Washington, $200,000

(SPRANS-MCHIP-Girl Power)

• Graduate Nursing Program—NurseMidwifery, Georgetown University,

Washington, $156,929 (SPRANS-TrainingNursing)

• Healthy Adolescents Project, American

Psychological Association, Washington,

$100,000 (SPRANS-MCHIP-PIPPAH)

• Improving Access to and Utilization of

Genetic Services Among an Indigent

African-American Patient Population at

Howard University Hospital (HUH),

Howard University College of Medicine,

Washington, $158,377 (SPRANSGenetics)

• Improvement of Perinatal Health Care:

The Collaborative Ambulatory Research

Network, American College of

Obstetricians and Gynecologists,

Washington, $209,410 (SPRANSResearch-OD/SP)

• Interdisciplinary Leadership Education,

Georgetown University, Washington,

$530,180 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• Leadership Preparation in

Communication Disorders and Cultural

Diversity: Interdisciplinary Training for

Maternal and Child Health, Howard

University, Washington, $115,096

(SPRANS-Training-Communication

Disorders)

• Making Dreams Possible for Hispanic

Teens, Mary’s Center for Maternal and

Child Care, Inc., Washington, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Maternal and Child Health National Center

for Cultural Competence, Georgetown

University Child Development Center,

Washington, $255,000 (SPRANS-MCHIPIntegrated Services)

• MCH Partnership for Information and

Communication, American Association of

Health Plans, Washington, $187,835

(SPRANS-CISS/MCHIP-PIC)

• MCH Partnership for Information and

Communication, Association of Maternal

and Child Health Programs, Washington,

$1,074,492 (SPRANS-MCHIP-PIC)

• MCH Partnership for Information and

Communication (PIC), Association of State

and Territorial Health Officials,

Washington, $116,129 (SPRANS-MCHIPPIC)

DISTRICT OF COLUMBIA CONTINUED

DISTRICT OF COLUMBIA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

National Network for Children with Special Needs, Georgetown University,

Washington, $2,669,034 (SPRANS-MCHIP-Integrated Services)

The National Network Project for Children With Special Needs is designed to

support countries, States, territories, and communities in building family-centered,

culturally competent, community-based systems of integrated services and

supports for children with or at risk for a wide range of special needs. The project

promotes systems development with an array of partners in the public and private

sectors by providing training and technical assistance, developing and

disseminating information, and convening meetings and workshops.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Nurturing MCH Community Leadership in the District of Columbia for the

21st Century: The MCH Community Leadership Network, District of

Columbia Healthy Start, Inc., Washington, $50,000 (CISS-CISS-COG)

The goal of this project is to strengthen community-based MCH leadership in the

seven District of Columbia neighborhoods experiencing the greatest effects of the

high rates of poverty. These neighborhoods also have the poorest health status

indicators (e.g., infant mortality and child abuse and neglect). The project’s five

objectives are to (1) identify 35 grassroots community members (five in each

neighborhood) for MCH leadership training; (2) coordinate MCH leadership

selection and training with three existing community-based MCH activities (DC

Healthy Start, Inc., the Healthy Families/Thriving Communities Collaboratives, and

the OMCH Parent Council); (3) facilitate ongoing MCH training sessions for

community leaders; (4) use future MCH professionals enrolled in area HBCUs in

the support of neighborhood MCH leaders by designing community-based MCH

educational experiences in the seven target neighborhoods; and (5) create MCH

community action assignments for MCH community leaders and students.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Grant, D.C. Department of Health, Office of Maternal &

Child Health, Washington, $120,439 (Abstinence Ed)

This is an abstinence-based teen pregnancy prevention program designed to

decrease the prevalence of teen pregnancy and related health problems (STDs) in

the target population. Some specific goals include promoting abstinence to youth,

increasing the capability of youth service organizations to provide abstinencebased education, and increasing the number of youth who receive abstinencebased education in the target area. Activities include a public awareness

campaign, curriculum development, training of service providers, and delivering

abstinence-based education to youth ages 9-14.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

EMSC National Resource Center, George Washington University,

Washington, $337,989 (EMSC-Enhancement)

The EMSC National Resource Center provides EMSC projects with consultation on

coalition building, project startup, public policy and long-term funding, injury

prevention, and issues related to CSHN/Rehabilitation. Technical assistance includes

telephone conferences, presentations at State, regional, and national meetings, and

dissemination of information related to EMSC issues. The NRC also works closely

with national organizations and with Federal, State, and local agencies to increase

public awareness and to improve grassroots support for EMSC.

72
TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

District of Columbia Healthy Start Project, District of Columbia Department

of Human Services, Washington, $2,520,980 (Healthy Start-Mentor)

D.C. Healthy Start and its 195-member consortium provide case management/care

coordination, transportation, and training and education to reduce fragmentation of

prenatal and social services for low-income African-American women. Toward the

overall goal of reducing infant mortality and morbidity, current objectives include

enrolling substance abusing pregnant women into care at earlier stages, enhancing

coordination of case management and substance use services, reducing

transportation barriers, and increasing home visiting and outreach services.

TRAUMATIC BRAIN INJURY

Traumatic Brain Injury Demonstration Grants Program, District of Columbia,

Washington, $75,000 (SPRANS-Traumatic Brain Injury-Plan)

The District of Columbia ranks 11.1 percent above the national norm for brain injury

deaths; this fact prompts the need for the development of a culturally sensitive

integrated system of care. Through the implementation of a District-wide needs

assessments, gaps in services and recommendations regarding best practices will

be identified. As a result, a comprehensive action plan will be developed to guide

survivors of traumatic brain injury, their families, service providers, and

administrators in the provision of appropriate services.

$8,054,335

$4,386,617

$12,440,952

• National Business Partnership To Improve

Family Health, Washington Business Group

on Health, Washington, $125,000 (SPRANSMCHIP-PIC)

• National Governors’ Association/Maternal

and Child Health Partnership for Information

and Communication, National Governors’

Association, Washington, $160,000

(SPRANS-MCHIP-PIC)

• National Healthy Mothers, Healthy Babies

Coalition PIC, Healthy Mothers, Healthy

Babies Coalition, Inc., Washington, $225,576

(SPRANS-MCHIP-PIC)

• Partnership for Fetal and Infant Mortality

Review, American College of Obstetricians

and Gynecologists, Washington, $350,000

(SPRANS-MCHIP)

• Partnership for Information and

Communication: Local Health Departments,

National Association of County and City

Health Officials, Washington, $100,000

(SPRANS-MCHIP-PIC)

• Partners in Program Planning for Adolescent

Health, National Association of Social

Workers, Washington, $99,991 (SPRANSMCHIP-PIPPAH)

• Partners in Program Planning for Adolescent

Health, American Bar Association Center on

Children and the Law, Washington, $100,000

(SPRANS-MCHIP-PIPPAH)

• Partners in Program Planning for Adolescent

Health Initiative, American Nurses

Association, Washington, $100,000

(SPRANS-MCHIP-PIPPAH)

• Public/Private Sector Partnership for

Maternal and Child Health, Grantmakers in

Health, Washington, $92,520 (SPRANSMCHIP-PIC)

• Residency Training in Community Settings,

Howard University, Washington, $166,593

(SPRANS-Training-Historically Black

Colleges)

Title V—COMMUNITY INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• Community Integrated Service System,

Health Systems Development in Child Care:

Healthy Kids, D.C. Program, Department of

Human Services, Washington, $50,000

(CISS-CISS-Child Care Program)

• District of Columbia Community-Based MCH

Problem-Solving Network, Department of

Human Services, Washington, $50,000

(CISS-CISS-COG)

HEALTHY START

• District of Columbia Healthy

Start, District of Columbia

Department of Health,

Washington, $1,452,648

(Healthy Start-Community)

DISTRICT OF COLUMBIA

Other FY 98 MCH Grant Programs

FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

Title V Program, contact:

Michelle S. Davis, MSPH

Interim Chief

Department of Health OMCH

825 North Capitol Street N. E. 3rd Floor

Washington, DC 20002

Phone: (202) 442-5925

Fax: (202) 442-4947 or 442-4948

Title V Program’s services for Children

with Special Health Care Needs, contact:

Joyce Brooks, MSW

Interim Deputy Dir./Special Needs Coordinator

Department of Health OMCH

825 North Capitol Street N.E. 3rd Floor

Washington, DC 20002

Phone: (202) 442-5925

Fax: (202) 442-4947 or 442-4948

4,000

12,000

16,000

20,000

24,000

28,000

32,000

8,000

30,290

15,132 15,049

73
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

743,603

10,578

The Title V program is administered through the Division of Public

Health in the Department of Health and Social Services. It is part of

the Family Health Services Branch of the Community Health Care

Access Section. Included in this Branch are children with special

health care needs, school based health centers, infant mortality,

and child health.

1,707

11,085

25,312

2,732

*

40,836

$515,692

$523,426

$8,145,824

$523,426

$1,196,349

$107,372

$11,012,089

DELAWARE

$274,495

$13,487,034

$11,012,089

$2,200,450

66
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

DELAWARE

6 of 9

99.9%

83%

43.697

4.297

59.3%

60%

8 of 18

1.7%97

82%97

7.897

2.697

5.397

2.597

8.997

23.597

5 of 9

99%

87%

42

3.9

58%

70%

14 of 18

1.5%

85%

7.3

2.4

5.0

2.5

8.8

22.2

Extremely low birth weight for black infants among all live births to black women

Youth who consumed alcohol in past 30 days

Hospital discharge rate per 10,000 children with asthma (5-17 years of age)

Live births within 24 months of giving birth to another child (exclusive of multiple births)

*

*

*

*

13.1%

41%

310

20%

2

1

2

1

0

2

8

* Data not available 67
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Ecumenical Partnership for CommunityBased, Family-Centered Health Services,

Delaware Ecumenical Council on

Children and Families, Wilmington,

$50,000 (CISS-CISS-COG)

DELAWARE CONTINUED

DELAWARE

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Delaware Systems Development Initiative: Children’s Health Care, Delaware

Department of Health and Social Services, Dover, $93,560 (SPRANS-MCHIP-SSDI)

Implementation of a Health Care Financing Administration 1115 Waiver for

medicaid managed care (The Diamond State Health Plan) began in January 1996.

Delaware’s FY 1998 State Systems Development Initiative focuses on improving

the Division of Public Health’s (DPH) capacity to (1) monitor/evaluate the impact of

medicaid managed care on clients and service utilization, and (2) develop

partnership agreements with medicaid managed care organizations that describe

interagency coordination with federal programs [i.e. the Special Supplemental

Nutrition Program for Women, Infants and Children (WIC), Immunizations] and

joint community-based prevention projects (i.e., School-Based Health Centers,

Adolescent Pregnancy Prevention).

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Delaware Healthy Child Care Campaign, Delaware Department of Health,

Dover, $50,000 (CISS-CISS-Child Care Program)

The overall goal of this project is to increase awareness of health and safety

issues in child care programs through a collaborative effort of public and private

agencies. Activities include the development of a health and safety newsletter,

development of a Standards of Care document that focuses on children with

special health care needs, and formation of a consortium to include key players in

child care, health care, and early intervention Part H programs. By implementing

the “Blueprint for Healthy Child Care America” recommendations from “Healthy

People 2000,” and “Healthy Delaware 2000,” the Healthy Child Care Campaign

hopes to achieve safer environments for children and their caregivers, more

developmentally appropriate child care programs, and increased multidisciplinary

comprehensive recommended health services.

Title V—ABSTINENCE EDUCATION PROGRAM

Delaware Abstinence Education Program, Division of Public Health, Dover,

$80,935 (Abstinence Ed)

Assisting teens to postpone the initiation of sexual involvement by changing

norms and teaching teens needed skills is the project goal. Expansion of the

existing Campaign for Our Children media campaign to promote abstinence will

help change norms and promote parent child communication. Mini-grants will be

awarded to local community groups to teach young teens needed skills. The

Alliance for Adolescent Pregnancy prevention is the statewide teen pregnancy

prevention coalition in Delaware and will be responsible for implementing the

proposed activities.

68
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Delaware Emergency Medical Services for Children Program, Delaware

Health and Social Services, Dover, $50,000 (EMSC-Plan)

The major goals and objectives of this emergency medical services for children

(EMSC) project are to (1) conduct a comprehensive needs assessment of the

current emergency medical services (EMS) system, and ascertain its ability to

meet the needs of pediatric patients; (2) develop a State EMSC advisory

committee that will make specific recommendations on actions to improve

pediatric emergency care in Delaware and will assist in the development of a plan

for the delivery of optimal pediatric care; (3) explore and pursue appropriate funding

sources for implementing the above recommendations; and (4) maintain an EMSC

office in the State Emergency Medical Services Suite, and take measures to

ensure that the EMSC program is visible and active in the EMS community.

HEALTHY START

Wilmington Healthy Start, Medical Center of Delaware, Wilmington,

$2,100,000 (Healthy Start-Community)

The Wilmington Healthy Start Initiative will address the needs of the maternal and

infant population of the city by addressing the three major goals identified by the

consortium. These goals include (1) partnering with the city of Wilmington to reduce

infant mortality by providing communication between the project, providers, and

clients; (2) identifying, enrolling, and ensuring follow through of clients in need of

Healthy Start services; and (3) promoting healthy lifestyles to reduce infant mortality.

TRAUMATIC BRAIN INJURY

TBI Planning Grant, Delaware Health and Social Services, New Castle,

$50,450 (Traumatic Brain Injury-Plan)

The goals of this project are to (1) form an advisory board to assess the needs of

individuals with traumatic brain injury and their families, (2) develop an action plan

to address the needs identified, and (3) increase agency coordination.

$274,495

$2,200,450

$2,474,945

Title V Program, contact:

Joan Powell

Family Health Services Director

Jesse Cooper Building P.O. Box 637

Dover, DE 19903

Phone: (302) 739-4785

Fax: (302) 739-6653

Title V Program’s services for Children

with Special Health Care Needs, contact:

Loretta Newson

CSHCN Director

Jesse Cooper Building P.O. Box 637

Dover, DE 19903

Phone: (302) 739-4785

Fax: (302) 739-6653

400

1,200

1,600

2,000

2,400

2,800

3,200

800

2,691

2,956

N/A

69
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

14,915,980

195,637

The Department of Health is the agency responsible for the administration of the Title V program in Florida. Maternal and child health responsibilities are divided between Family Health Services (pregnant women

and children) and Children’s Medical Services (children with special

health care needs). The Department of Health administers health

programs through its county health departments and Children’s Medical

Services offices. Healthy Start continues to be our priority maternal and

child health initiative in Florida. Healthy Start is designed to ensure

access to maternal and child health services to all women and children

in Florida. Other efforts towards improving maternal and child health

include services to substance exposed newborns, Fetal and Infant

Mortality Review projects, improving pregnancy outcomes, prenatal

smoking cessation, and pregnancy associated mortality review. Services

for children with special health care needs include the Early Intervention

Program, high risk obstetrical satellite clinics, Regional Perinatal

Intensive Care Centers and clinic based medical and therapeutic care.

80,841

75,637

207,020

47,581

168,065

579,144

$68,275,789

$7,905,306

$97,291,519

$102,768,978

$0

$19,837,285

$296,078,877

FLORIDA

$4,857,798

$305,092,907

$296,078,877

$4,156,232

74
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

FLORIDA

9 of 9

99%

82.9%

36.4

4.9

62.4%

7.5%

9 of 18

1.6%

83%

7.1

1.9

4.7

2.5

11.8

27

9 of 9

99%

85%

33.9

4.6

60%

40%

18 of 18

1%

90%

6.41

1.8

4.0

2.1

12.2

22

Pregnant women reporting domestic violence on the PRAMS survey

Women who smoked during pregnancy

Children under 2 years old who have HIV (per 100,000 2-year-olds)

Hospitalizations for asthma in children (0-14 years; per 1,000 hospital discharges)

5.55%

11.2%

7.5

5.86

7.0%

10%

5.0

2.5

2

1

3

1

1

1

9

75
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Child Development Center and Training

Facility, University of Miami, Miami,

$618,726 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• Comparative Analysis of Children with

Special Health Care Needs in Managed

Care: The Development of Empirically

Based Models, Institute for Child Health

Policy, Gainesville, $160,000 (SPRANSMCHIP-Managed Care/Health Care Reform)

• Florida Systems Development Initiative,

HRS State Health Office/CMS, Tallahassee,

$100,000 (SPRANS-MCHIP-SSDI)

• Healthy Start System Development

Project, University of South Florida,

Tampa, $67,500 (SPRANS-MCHIP-Data)

• Maternal and Child Health Training Grant,

University of South Florida, Tampa,

$280,281 (SPRANS-Training-School of

Public Health)

• MCH Network Telecommunications (MCHNet) and Distance Learning (MCH-NetLink)

Project, Institute for Child Health Policy,

Gainesville, $150,000 (SPRANS-MCHIPData)

• Physical and Developmental Environment

of the High-Risk Infant: Enhancing

Recovery, Improving Outcome, and

Reducing Preventable Mortality, University

of South Florida, Tampa, $100,000

(SPRANS-Research-OD/SP)

• University of Florida Pediatric Pulmonary

Center Leadership, University of Florida,

Gainesville, $270,075 (SPRANS-TrainingPediatric Pulmonary Center)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Healthy Child Care Florida, Florida

Children’s Forum, Tallahassee, $50,000

(CISS-CISS-Child Care Program)

• Healthy Families Jacksonville:

Development of a Community Integrated

Service System, Jacksonville Children’s

Commission, Jacksonville, $50,000

(CISS-CISS-COG)

HEALTHY START

• Partners for a Healthy Baby Institute,

Florida State University, Tallahassee,

$521,000 (Healthy Start-Mentor)

• St. Petersburg Healthy Start Federal

Project, Pinellas County Health

Department, St. Petersburg, $1,265,250

(Healthy Start-Community)

FLORIDA CONTINUED

FLORIDA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Center for Policy and Program Coordination, Institute for Child Health

Policy, Gainesville, $753,333 (SPRANS-MCHIP-Adolescent Health)

The purpose of the Center for Policy and Program Coordination is to promote

coordination and collaboration between MCHB and other organizations regarding

program and policy initiatives on behalf of children with special health care needs

(CSHCN), to facilitate information sharing and staff development, and to provide

technical assistance to State CSHCN programs developing statewide systems of

primary and special health needs care. In support of its mission, the center

coordinates the activities of several Federal working groups, including the Federal SSI/

CSHCN Work Group, and the Healthy and Ready to Work Network. The center has

implemented a series of multistate Supplemental Security Income (SSI) meetings to

promote interagency and family partnerships at the State and local levels on behalf of

CSHCN and SSI beneficiaries. The center has developed and disseminated training

materials, implemented teleconferences, and created a World Wide Web site.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Helping FIMR Projects Implement Change and Improve Local Systems of

Care, Florida Department of Health and Rehabilitative Services, Tallahassee,

$50,000 (CISS-CISS-COG)

The purpose of this project, Helping FIMR Projects Implement Change and Improve

Local Systems of Care, is to help state FIMR projects establish systems of care that

address problems which affect fetal and infant mortality, to minimize the affect of

those factors on the infant mortality rate. Florida’s FIMR projects have become

established and have initiated the review process, but they need training and technical

assistance that focuses on implementing changes in their local communities to

assure that systems of care are implemented to address identified needs. Goals of

this project are to help FIMR projects establish systems of care, to operate as the

statewide training coordinator for Florida FIMR activities, to serve as the liaison for

Florida to the NFIMR, to collect and disseminate information, and to provide technical

assistance. The project will provide technical assistance and training through on-site

visits, conference calls, annual conferences, and the maintenance of a reference and

resource library. The project will produce a quarterly newsletter.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Plan, Department of Health, Tallahassee, $2,207,883

(Abstinence Ed)

The goal of the abstinence education plan is to reduce adolescent pregnancy by

promoting abstinence outside of marriage. This will be accomplished by awarding

funds to selected counties around the State through a request for proposal

process. Proposals will provide specific plans for local activities targeting 9-14

year olds for interventions to promote abstinence. Evaluation and monitoring of

grantees’ activities will assure that awarded funds are used appropriately and

solely in reference to abstinence education.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

EMSC State Partnership Grant, Florida Department of Health, Tallahassee,

$70,049 (EMSC-PRTNER)

This emergency medical services for children (EMSC) project in Florida has

identified a number of goals to be met with the assistance of the State’s EMSC

advisory committee. The goals are to (1) pass legislation that provides statutory

authority for the institutionalization of EMSC in Florida; (2) conduct a needs

assessment, as designed by national EMSC; (3) ensure the development of liaisons

within the Florida prehospital and hospital communities; (4) develop a mechanism to

76 review pediatric rehabilitation in Florida; and (5) implement minimum guidelines for
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$4,857,798

$4,156,232

$9,014,030

Title V Program, contact:

Annette Phelps, A.R.N.P., M.S.N.

Bureau Chief, Family and Community Health

Family Health Services 2020 Capital Circle,

S.E. Mail Bin #A13

Tallahassee, FL 32399-1707

Phone: (850) 487-1321

Fax: (850) 488-2341

Title V Program’s services for Children

with Special Health Care Needs, contact:

Phyllis J. Sloyer, M.P.A.

Division Director for CMS Network

Children’s Medical Services 4052 Bald

Cypress Way Mail Bin #A06

Tallahassee, FL 32399-1707

Phone: (850) 487-2690

Fax: (850) 488-3813

2,000

6,000

8,000

10,000

12,000

14,000

16,000

4,000

13,142

9,754

12,987

pediatric medical education and for continuing pediatric medical education for

medical directors, emergency medical technicians, and paramedics. The EMSC

advisory committee will provide technical assistance and support.

HEALTHY START

Central Hillsborough County Healthy Start Project, University of Florida,

Tampa, $2,099,933 (Healthy Start-Community)

This project aims to reduce infant mortality and low birthweight and to improve the

quality and quantity of perinatal health care by ensuring access to personally

acceptable and risk-appropriate health care and support services for project-area

women, new mothers, and their infants. Using three Healthy Start intervention

models, Community-Based Consortium, Care Coordination/Case Management, and

Enhanced Clinical Services, this interagency project seeks to (1) develop

community capacity for preventing infant mortality and low birthweight; (2) build on

inherent strengths and abilities of women and their families to nurture, support, and

protect infants from the time of preconception, through conception, to age 1 year;

and (3) improve perinatal clinical services for women and infants in the project area.

TRAUMATIC BRAIN INJURY

Community Access, Support and Linkages System (CASALS), Florida

Department of Labor and Employment Security, Tallahassee, $200,000

(Traumatic Brain Injury-Implementation)

Florida’s Community Access, Support and Linkages System project will enhance

and expand the existing continuum of care and long-term supports for individuals

with TBI through the development of interagency linkages and partnerships at both

the State and community levels. Activities will include the development of

community-based models of interagency collaboration, development of

interagency problem-solving mechanisms and linkages, development of a system

of training and technical assistance to community service providers, and

development of a statewide model for systems change. Outcomes will include

identification of policy changes needed in State and community agencies to

improve access to long-term supports and to ensure that the needs of persons

with TBI are addressed in the existing service delivery systems.

77
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

7,642,207

122,368

The Family Health Branch, part of the Division of Public Health, Department of Human Resources is Georgia’s Title V agency. The charge of

the Branch is promoting the health of the State’s mother and infants,

women of childbearing age, children, adolescents, and children with

special health care needs. The Branch works toward: 1) early and

comprehensive health services to women of childbearing age and their

infants in an environment that fosters personal dignity; 2) timely and

comprehensive health services to children which promote the optimal

attainment of their individual abilities; and 3) comprehensive health

services to adolescents in an environment that fosters personal

responsibility, encourages independence, and promotes positive

behaviors. To carry out these responsibilities, the Branch is involved in

policy and planning activities, oversees the operations of various MCH

programs in local health departments and other organizations, and

provides technical assistance and training.

81,102

113,986

850,000

15,105

*

1,060,193

$26,493,827

$40,667,220

$122,898,011

$30,686,580

$14,670,701

$1,643,741

$237,060,080

GEORGIA

$6,269,538

$243,533,618

$237,060,080

$204,000

78
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

GEORGIA

9 of 9

100%97

81%

40.3

6.8

54%97

31.2%

14 of 18

1.8%

84.6%

8.5

2.2

5.8

2.6

14.197

28.2

9 of 9

100%

85%

48.6

6.7

60%

90%

18 of 18

1.7%

87.7%

7.9

2.4

5.2

3.0

10.8

29.8

Georgia counties with an active “SAFE Kids” type broad-based injury prevention coalition.

Asthma-related hospitalization among children, 0-21 years of age per 100,000.

Degree to which the State addresses prevention of tobacco, alcohol, and other

substance abuse by children and adolescents

Implementation of a comprehensive approach addressing maternal substance abuse.

38%

418.197

2 of 15

5 of 12

42%

325.2

8 of 15

9 of 12

3

2

3

1

3

2

14

* Data not available 79
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Cobb Health Futures Alliance, Cobb

County Board of Health, Marietta, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Development and Maintenance of a

Communication and Coordination

Network for the Delivery and

Enhancement of Genetic Services within

HHS Region IV, Emory University, Atlanta,

$327,750 (SPRANS-Genetics)

• Family Health Branch Family Involvement

& Support Project, Georgia Department of

Human Resources, Atlanta, $100,000

(SPRANS-MCHIP-SSDI)

• Followup Tracking and Outcome of Infants

with Sickle Syndromes in Region IV,

Emory University , Atlanta, $144,191

(SPRANS-Genetics)

• Georgia Newborn Sickle Cell Screening

and Tracking Program, Georgia

Department of Human Resources, Atlanta,

$100,000 (SPRANS-Genetics)

• Leadership Development for NurseMidwives in the Public Sector, Emory

University, Atlanta, $135,087 (SPRANSTraining-Nursing)

• Maternal Child Health Care Exposure for

Students & Residents, Morehouse

University, Atlanta, $166,593 (SPRANSTraining-Historically Black Colleges)

• National Parent to Parent Support and

Information System: Managed Care and

Health Care Issues, National Parent to

Parent Support and Information System,

Blue Ridge, $150,000 (SPRANS-MCHIPManaged Care/Health Care Reform)

• Region IV South Regional Hemophilia

Program, Hemophilia of Georgia, Inc.,

Atlanta, $209,953 (SPRANS-Hemophilia)

HEALTHY START

• Heart of Georgia Healthy Start Initiative,

Lauren County Health Department, Dublin,

$799,172 (Healthy Start-Community)

• Healthy Start Initiative, Chatham-Savannah

Youth Futures Authority, Savannah,

$898,381 (Healthy Start-Mentor)

GEORGIA CONTINUED

GEORGIA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Council of Regional Networks for Genetic Services (CORN), Emory

University, Atlanta, $383,800 (SPRANS-Genetics)

The Council of Regional Networks for Genetic Services (CORN) is a national

genetics organization that provides the opportunity for an exchange of ideas,

dissemination of information, sharing of resources and expertise, and

opportunities to coordinate activities related to the provision of genetic services in

public health. The membership consists of a coalition of representatives from the

national sickle cell programs, the regional genetic networks, consumers, and

public health professionals. CORN’s overall mission is to increase the availability

and accessibility of genetic services as an integral component of comprehensive

maternal and child health services supported by Title V. CORN’s goals are

achieved through the dedication of volunteer committees, whose activities are

overseen by a board of directors representing its member organizations.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Health Systems Development in Child Care, Department of Human

Resources, Atlanta, $50,000 (CISS-CISS-Child Care Program)

Aims of the project include developing an ongoing forum for sharing information

and address common issues among child health and public health providers;

ensuring provision of appropriate information and technical assistance through

needs assessment and analysis; and developing and maintaining a clearinghouse

of child health and safety information. Objectives will be achieved through the

collaboration of key stakeholders in child care providers, child care advocates,

public health, child welfare, regulatory services, and parents.

Title V—ABSTINENCE EDUCATION PROGRAM

Georgia’s Abstinence Education Plan, Georgia Department of Human

Resources, Atlanta, $1,450,083 (Abstinence Ed)

Georgia has some of the highest adolescent pregnancy and birth rates in the

United States. Our proposed project’s overall goal is to reduce adolescent sexual

activity, with a focus on groups most at-risk for out-of-wedlock births. To effectively

address the dilemma of early adolescent sexual activity and its resulting

consequences, our abstinence education plan places priority on local projects

that target early adolescents ages 10-14, or fourth through eighth grade students.

Innovative abstinence-only projects targeting older teens aged 15-19 will also be

considered. For example, programs serving youth in detention centers, substance

abuse treatment centers, and other unique settings are examples in which serving

older adolescents would be considered appropriate.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Georgia EMS for Children, Atlanta Department of Human Resources, Atlanta,

$150,000 (EMSC-Enhancement)

Goals of the project are to provide tiered training to public safety officers,

prehospital emergency medical services (EMS) personnel, primary health care

providers, and emergency department and critical care personnel; affect

community behavior by providing public information and education programs on

injury prevention and the care of critically ill or injured children; and build the

capacity of the EMS system to address the needs of pediatric patients and

evaluate system effectiveness. We will establish a cadre of EMS injury prevention

specialists to conduct 2,000 injury prevention presentations in community settings

and train 10,000 people in bystander care and/or Pediatric Basic Life Support; and

establish surveillance and quality improvement capacity. 80
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Healthy Start Initiative Phase II: Augusta/Richmond County, Augusta/

Richmond County Partnership for Children and Families Inc., Augusta,

$1,304,528 (Healthy Start-Community)

Two overarching needs identified during the needs assessment process are to

improve access to currently underutilized perinatal services and significantly

reduce adolescent pregnancy. To improve access to services, the Augusta/

Richmond County Community Partnership for Children and Families will implement

the Care Coordination/Case Management and Outreach and Client Recruitment

Models. To reduce adolescent pregnancy, the partnership will implement the

Adolescent Programs Model. Overall goals are to ensure that no woman of

childbearing age or her infant is overlooked by the system in receiving the care and

support necessary for healthy development and to achieve significant reductions in

adolescent pregnancy so that Augusta/Richmond County’s figures are lower than

the national average.

TRAUMATIC BRAIN INJURY

A Planning Grant To Assess the Service Needs of Georgians With Traumatic

Brain Injuries, State Health Planning Agency, Atlanta, $54,000 (Traumatic

Brain Injury-Plan)

This project will enhance the State’s core capacities to serve Georgians with

traumatic brain injury (TBI). The project will support three major activities: (1) A

statewide resource analysis of programs and services for persons with disabilities,

the degree to which persons with TBI are eligible to receive services through these

programs, and the extent to which persons with TBI are actually served by these

programs; (2) a statewide needs assessment of the full spectrum of services for

persons with TBI from initial trauma care through community reintegration and

lifelong support, as reported by individual consumers, their families, and service

providers; and (3) a stakeholders’ conference to establish a statewide action plan

to develop comprehensive community-based services that address priority needs.

$6,269,538

$204,000

$6,473,538

Title V Program, contact:

Rosalyn K. Bacon, M.P.H.

Director, Family Health Branch

Division of Public Health Department of Human Resources

2 Peachtree Street, Room 8-100

Atlanta, GA 30303

Phone: (404) 657-2850

Fax: (404) 657-7307

Title V Program’s services for Children with

Special Health Care Needs, contact:

Wendy S. Sanders, M.Ed.

Acting Team Leader, Office of Children with Special Needs

Services

Division of Public Health Department of Human Resources

2 Peachtree Street, 7th floor

Atlanta, GA 30303

Phone: (404) 657-2724

Fax: (404) 657-2763

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

10,254

9,030

10,700

81
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

161,000

4,318

Guam’s MCH Program is administered by the Bureau of Family Health

and Nursing Services (BFHNS), Department of Public Health and Social

Services. BFHNS provides and/or assists in the planning, developing,

coordinating, evaluating and implementing the federally funded and locally

mandated programs such as: the Family Planning Program, the State

System Development Initiative Project, the Abstinence Only Education

Program, Public Health Clinics, Home Care Program, Community Health

and Outreach Services, Quality Assurance and Improvement and Staff

Development Programs. The BFHNS, through organized community

efforts, focuses on delivering safe, competent and cost-effective health

care services to individuals and their families in various environments

such as school, home and workplace and/or clinical settings. The major

emphasis of health care services is prevention targeted towards high-risk

individuals and families not adequately or appropriately served by

traditional and predominant health care delivery and financing system(s).

527

1,166

134

235

2,681

4,743

$208,669

$105,832

$108,827

$282,219

$0

$78,311

$783,858

GUAM

$359,830

$1,193,643

$783,858

$49,955

82
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

GUAM

4 of 997

99%

67%

49

2.2

10%

5%

10 of 18

1%

68%

8.5

*

4.5

4.5

17

31

6 of 9

100%

75%

47

2.07

30%

15%

15 of 18

.97%

75%

8

*

4.3

4.0

13

28

Adolescents 12-17 years old who reported using alcohol, inhalants, cigarettes,

marijuana, or crystal methamphetamines

Mistreated and/or neglected children under 18 years old (per 1,000 children)

Childbearing-aged women screened for cervical cancer

Children who meet criteria for obesity

.4%

3.5%

70%

50%

.2%

2.5%

74%

40%

2

2

2

2

0

2

10

* Data not available 83
Selected FY 98 Title V and

Other MCH Grant Annotations

GUAM CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE

(SPRANS)

Maternal and Child Health Leadership Continuing Education for Pacific

Islands, University of Guam, Mangilao, $49,499 (SPRANS-TrainingContinuing Education)

It is believed that the existing primary health care services for infants, children,

and pregnant women (including adolescents) will improve in depth and breadth

through leadership training of MCH service providers and interagency staff with the

emphasis being made on the critical thinking and problem-solving processes. A

training module will be developed for use in conducting island jurisdictions’

workshops with finalization of content from participants feedback to integrate

cultural and local factors, and to be distributed to each jurisdiction for use in

conducting future continuing education training programs. Jurisdiction workshops

will take place over a 3-year period with a followup workshops for each jurisdiction

9 to 12 months after the initial workshop. The onsite jurisdiction workshops will

include evaluation of the training module by participants to produce a document

that acknowledges training problems and needs, integrates cultural learning styles

reflective of the various cultures, and uses existing MCH problems and concerns

for acquisition of critical thinking and problem-solving skills.

Pacific Basin Maternal and Child Health Resource Center, University of

Guam, Mangilao, $150,000 (SPRANS-MCHIP)

The overall mission of the project is to enhance the well-being of families in the

U.S.-related islands of the Pacific Basin by helping health care professionals gain

access to the knowledge and resources necessary to overcome or reduce the

health problems faced by each of the jurisdictions. The overall goal is to improve

the health status of women and children in the U.S.-related Pacific Islands by

expanding the Pacific Basin Maternal and Child Health Resource Center

(PBMCHRC) services to professionals and communities in each jurisdiction and to

serve as a central source of information and technical assistance for all who have

maternal and child health concerns.

Project TASI: Guam State System Development Initiative, Guam Department

of Public Health and Social Services, Agana, $90,836 (SPRANS-MCHIP-SSDI)

The ultimate goal of this project is to prevent child abuse and neglect of newborns

and children in the targeted population through early identification and intervention.

The program focuses on reducing stress, enhancing family functioning (such as

parent-child interaction and bonding), and providing optimal child development. In

addition, the project will focus on reducing fragmentation, improving care

coordination, and, ultimately, enhancing the effectiveness of health and welfare

services available to at-risk children and their families.

84
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Grant Program, Department of Public Health and

Social Services, Government of Guam, Agana, $69,495 (Abstinence Ed)

Guam’s program will focus first on building capacity for delivery of abstinence

education through a Train the Trainer Workshop. The program will facilitate

organizing members of the community—families, service providers, and church

members—to form a Partnership for Abstinence. The Health Educator will continue

collaborative efforts with agencies and organizations. Barriers to abstinence that

are embedded in culture and language will be identified in order to improve

communication and abstinence education within the community.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Guam EMS for Children Planning Grant, Guam Department of Health and

Social Services, Agana, $49,955 (EMSC-Plan)

The goal of this project in Guam is to prevent trauma deaths and long-term disability

by providing a better coordinated system for proper assessment and care of lifethreatening emergencies. Emergency medical services and trauma systems will

link prehospital, hospital, and rehabilitation services. Plans include recruiting an

EMSC project coordinator and acquiring a computer and software that will allow the

project to gather and analyze data on emergencies involving children.

$359,830

$49,955

$409,785

Title V Program, contact:

Peter John Camacho

Chief Public Health Officer

P.O. Box 2816

Hagatna, Guam, 96932

Phone: (671) 735-7110

Fax: (671) 734-7097

Title V Program’s services for Children

with Special Health Care Needs, contact:

Peter John Camacho

Chief Public Health Officer

P.O. Box 2816

Hagatna, Guam, 96932

Phone: (671) 735-7110

Fax: (671) 734-7097

8

24

32

40

48

56

64

16

24

40

N/A

85
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,193,001

17,583

The Title V program is administered by the Family Health Services

Division, Hawaii State Department of Health. The Title V program

administers the following programs: maternal and child health,

children with special health needs, IDEA Part C and WIC programs.

5,665

17,341

71,170

8,567

29,600

132,343

$4,775,449

$6,970,134

$10,402,783

$7,586,539

$3,296,984

$510,792

$33,542,681

HAWAII

$1,500,556

$35,043,237

$33,542,681

$ 0

86
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

HAWAII

7 of 9

99.7%

80%

27.8

6.4

72.3%

94%

10 of 18

1.8%

81.3%

6.7

1.3

5.1

1.6

6.2

18.9

7 of 9

99%

85%

25

4

75%

97%

12 of 18

1%

83%

5.5

1.0

3.8

1.7

5

16

Public school children 12-17 years old who consumed alcohol in past 30 days (grades 9 to 12)

Public school children 12-17 years old who smoked tobacco products in past 30 days

Child abuse/neglect cases of children from birth to 5 years old (per 1,000 children)

Prevalence of neural tube defects among fetal deaths and live births (per 10,000 live births)

40.3%

29.2%

9.7

9.08

38%

27%

8.5

8.0

2

2

1

2

1

2

10

87
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Hawaii Fluoridation Systems

Development Project, Hawaii Department

of Health, Honolulu, $30,226 (SPRANSMCHIP-Fluoride)

• Managed Care in Hawaii: Impact on

Children with Special Health Needs,

Hawaii Department of Health, Honolulu, $0

(SPRANS-MCHIP-Managed Care/Health

Care Reform)

• Maternal and Child Health

Interdisciplinary Leadership Education for

Health Professionals Caring for Children

With Neurodevelopmental and Related

Disabilities, University of Hawaii at

Manoa, Honolulu, $441,500 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• Maternal and Child Health Training

Program, University of Hawaii, Manoa,

Honolulu, $322,323 (SPRANS-TrainingSchool of Public Health)

HAWAII CONTINUED

HAWAII

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Enhanced Community Health Options (ECHO) Ko’olauloa Healthy

Tomorrows, Hawaii Department of Health, Honolulu, $49,988 (SPRANSMCHIP-Healthy Tomorrows)

The Ko’olauloa Healthy Tomorrows project seeks to address system problems

that currently exist and to improve access to child health services for families

residing in the area. This goal will be realized through increased and coordinated

outreach services, promotion of an integrated system of comprehensive health

care, improved continuity of care through home visiting, increased paternal

participation in accessing health care, and provision of developmental/

psychological assessments of at-risk children. The project will work with the

existing health care system and the community to provide a community-based,

family-centered, comprehensive, and culturally relevant system of care.

Health and Education Collaboration Project, Hawaii Medical Association,

Honolulu, $225,000 (SPRANS-MCHIP-Integrated Services)

The Health and Education Collaboration Project intends to use interprofessional

collaboration as a personnel preparation model. It will train health, social service,

and education professionals to work collaboratively with the ultimate goal of

providing children with special health care needs and their families, particularly

those from underserved populations, with family-centered, community-based, and

coordinated care. Because of the absence of an effectual collaborative system of

services, the project will determine ways professionals can help families through

the system by (1) working with the National Commission on Leadership in

Interprofessional Education to identify the essential elements of collaborative

practice; (2) training a regional staff of the Healthy and Ready to Learn (HRTL)

program to implement and field test the practice of collaboration in a nationally

recognized service program; (3) creating linkages between HRTL and university

training programs; and (4) disseminating information on the essential elements of

collaborative training and service provision at the regional, State, and national

levels.

Malama Pono: Family Professional Partnership in the Medical Home,

Hawaii Medical Association, Honolulu, $150,000 (SPRANS-MCHIP-Integrated

Services)

Barriers to achieving functional, comprehensive, family-centered medical homes

for children with special health care needs have been identified. Malama Pono will

develop, implement, and evaluate strategies to overcome these barriers in three

target communities in Hawaii. Managed care organizations and community

stakeholders including consumers will participate in the project. Project products

will include a set of tested strategies for achieving medical homes in communities,

and a set of outcome indicators and measurement strategies.

State Systems Development Initiative, Hawaii Department of Health,

Honolulu, $100,000 (SPRANS-MCHIP-SSDI)

The purpose of the Development of Comprehensive, Community- Based Systems

of Care in Hawaii (SSDI) Project is to facilitate the linkage of family-centered,

community-based systems of care by developing data linkages and by providing

technical assistance to communities. The primary focus of the SSDI project in

Hawaii is on interagency collaboration. By improving interagency collaboration,

the Family Health Services Division also seeks to improve state support for

communities involved in systems development.

88
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Keiki Care: Nurturing Hawaii’s Children, Hawaii Department of Health,

Honolulu, $50,000 (CISS-CISS-Child Care Program)

The overall project goal is to develop an integrated preschool service system that

responds to the needs of these preschool children. Services will be voluntary and

will be provided to the greatest extent possible in natural child care environments

identified by families. Goals and objectives include collaborating with the

Department of Education to develop appropriate service options for children;

working with preschool and child care programs to find appropriate placement

options in natural environments for children with emotional-behavioral disorders;

and providing training, support, and consultation/technical assistance for

preschool, child care, and Head Start providers and family members to meet the

needs of children with emotional-behavioral disorders and other developmental

delays.

Title V—ABSTINENCE EDUCATION PROGRAM

Smart Moves with Abstinence Only Education, Department of Health, Family

Health Services Division, Honolulu, $131,519 (Abstinence Ed)

The project goals are to improve the health of our youth through abstinence-only

education and to facilitate parent/significant adult and local community interest

and action in adolescent health. The Boys and Girls Club’s science-based

research curriculum, Smart Moves, will target 9-12 year old young people in site in

each of the four State counties. Activities will include: education, skill building,

social group session/events; inclusion of parents/significant adults, peer leaders,

and mentors; community building through advisory boards to generate interest and

program resources; and working with the media to promote the program and

activities related to adolescent wellness.

$1,500,556

$0

$1,500,556

Title V Program, contact:

Nancy L. Kuntz, M.D.

Chief, Family Health Services Division

P.O. Box 3378

Honolulu, HI 96801

Phone: (808) 596-4122

Fax: (808) 586-9303

Title V Program’s services for Children

with Special Health Care Needs, contact:

Patricia Heu, M.D.

Chief, Children With Special Health Needs

Branch

741 Sunset Avenue

Honolulu, HI 96801

Phone: (808) 733-9070

Fax: (808) 733-9068

1,000

3,000

4,000

5,000

6,000

7,000

8,000

2,000

6,471 6,836

4,084

89
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,228,684

19,391

The Bureau of Clinical and Preventive Services, Idaho Department of

Health and Welfare, administers the Title V MCH Program. The

Bureau is composed of six programs including; Children’s Special

Health Program; Reproductive Health Program; Epidemiology

Program; WIC Program; Immunization Program; and the STD/AIDS

Program. Title V funds support staff and/or programs in the Bureau

of Health Promotion (Injury Prevention Program), the Bureau of

Laboratories (Genetics Program), and the Center of Vital Statistics

and Health Policy (Perinatal Analyst and MCH Needs Assessment).

4,428

19,103

132,850

2,276

6,378

165,035

$294,212

$1,126,707

$2,324,619

$2,137,980

$317,571

$310,900

$6,511,989

IDAHO

$502,045

$7,014,034

$6,511,989

$ 0

90
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

IDAHO

8 of 9

98.1%

72%

24.5

7.5

67.1%

51.8%

0 of 18

1%

78.7%

7.2

3.3

4.6

2.6

9.8

28.9

8 of 9

98.3%

76%

25.5

7.3

70.5%

59%

14 of 18

.6%

82.0%

7.0

0

4.0

2.6

9.8

28.3

Child deaths reviewed by Idaho Child Mortality Review Team

Children born to mothers with Hepatitis B who received HBIG and Hepatitis B vaccines

Proportion of all pregnancies seen in reproductive health clinics that are unintended

Percent of positive pregnancy tests in reproductive health program participants

of less than 20 years of age

N/A

69%

 N/A

N/A

94

92

65

13%

2

2

2

2

0

2

10

91
Selected FY 98 Title V and

Other MCH Grant Annotations

IDAHO CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Healthy Tomorrows Partnership Project, YWCA of Pocatello, Pocatello,

$47,007 (SPRANS-MCHIP-Healthy Tomorrows)

In Pocatello, unofficial reports by Intake and Treatment Services indicate that 75 to

80 percent of reported cases of child abuse/neglect involve some form of substance

use. Project goals are as follows: Identify 30 clients in year 1, 30 clients in year 2,

and 30 clients in year 3 from the at-risk target population for services and provide

home visitor services to address the needs of substance-abusing parents. The

program will emphasize early identification and intervention, followed by intensive

and prolonged visits, coupled with referrals to other local resources. Home visits

with each client/family will occur at a minimum of once a week.

Idaho’s State Systems Development Initiative, Idaho Department of Health

and Welfare, Boise, $100,000 (SPRANS-MCHIP-SSDI)

The project goals are to identify associations between birth outcomes and

prenatal care within communities, develop community awareness of weaknesses

within the system, and subsequently share information with communities in need

of information about potential resources. Also, the project will assess the

adequacy of data used to classify children with special health care needs (CSHN)

and determine the prevalence of CSHN conditions. Objectives include identifying

associations between prenatal care and birth outcomes; communicating the

findings of the first objective to those providing services, program managers,

leaders within communities, and other interested entities; and working with

communities to develop strategies to address weaknesses within the system and

share information with them about potential resources.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Community Decision Making in Child Health: Linking Families, Child Care,

and Health Care Services, Mountain States Group/Child Care Connections,

Boise, $50,000 (CISS-CISS-COG)

Community Decision Making in Child Health will create local strategies from

improving three Ada County child health status issues: immunization rates, child

abuse rates, and unintentional injury rates. CDM, a planning process that

empowers a community to take ownership of its health systems concerns, will be

used. The project will also build the capacity of local child care providers to offer

healthy and safe care, and to connect families with needed health care services

and information. A guidebook on CDM in Child Health will be developed.

Healthy Families in a Healthy Community, Harms Memorial Hospital,

American Falls, $49,810 (CISS-CISS-COG)

This project targets improved health care for migrant families and increased rates

for childhood immunization and adequate prenatal care in the total community.

Health status data will be collected from migrant families to develop appropriate

services strategies. A Community Health Council will be facilitated through

interest-based negotiation to develop a protocol defining a community-based,

culturally competent, collaborative service system with target service strategies to

achieve outcomes. Community involvement will be achieved through Asset-Based

Community Development. A Rural Integrated Service Manual will be developed.

92
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

Idaho Health Systems Development in Child Care Project, Idaho Department

of Health and Welfare, Boise, $50,000 (CISS-CISS-Child Care Program)

The project focuses on promoting local collaborative efforts that address one or

more of the goals stated in the “Healthy Child Care America Blueprint for Action.”

The goal is to expand health systems in child care settings by assisting

communities to create collaborative groups, develop action plans, and implement

local projects. All community projects funded under this program will receive

ongoing technical assistance and monitoring to assure program quality and

compliance with Federal guidelines and contract provisions.

Title V—ABSTINENCE EDUCATION PROGRAM

Adolescent Pregnancy Prevention/Abstinence Education, Idaho Department

of Health and Welfare, Boise, $205,228 (Abstinence Ed)

The initiative will develop community-based adolescent pregnancy prevention

programs with an abstinence message. These programs will be either educational

or motivational. Primary target audience will be 10-14 year olds and parents.

Secondary target audiences will be 15-19 year old males and females.

$502,045

$0

$502,045

Title V Program, contact:

Roger A. Perotto

Chief, Bureau of Clinical and Preventive Services

Idaho Dept. Health and Welfare

450 West State Street 4th Floor Cenarrusa Building

Boise, ID 83720

Phone: (208) 334-0670

Fax: (208) 332-7346

Title V Program’s services for Children with

Special Health Care Needs, contact:

Brett Harrell

Manager, Childrens Special Health Program

Idaho Dept. Health and Welfare

450 West State Street 4th Floor Cenarrusa Building

Boise, ID 83720

Phone: (208) 334-5963

Fax: (208) 334-6581

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

6,602

8,885

2,946

93
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

12,045,326

182,588

State MCH Administration. The Maternal and Child Health Services

Block Grant is administered by the Illinois Department of Human

Services. The Department transfers 32.1 percent of the block grant

to the University of Illinois at Chicago, Division of Specialized Care

for Children, to support the state’s program for Children with Special

Health Care Needs. The Department works closely with the Illinois

Department of Public Health regarding the operations of its genetics, childhood lead poisoning, vision and hearing and oral health

programs.

94,973

177,108

2,848,265

24,626

100,938

3,245,910

$10,902,585

$16,684,616

$10,351,082

$24,527,900

$13,008,422

$ 600,000

$76,074,605

ILLINOIS

$5,640,950

$90,152,781

$76,074,605

$8,437,226

94
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

ILLINOIS

9 of 9

97.1%97

74%

34.497

3.197

35.6%97

21.3%97

9 of 18

1.6%97

81.1%97

8.297

2.797

5.497

2.897

11.997

2197

9 of 9

99%

76%

35

3.7

42%

30%

10 of 18

1.5%

85%

8.0

2.6

5.1

2.9

11.3

25.8

Women who received adequate prenatal care

Live births within 18 months of giving birth to another child or terminating a pregnancy

CSHCN clients 14 years old and over and their families who received comprehensive

transition planning to promote awareness of adult services

Infants and childbearing-aged women who received genetic testing, counseling,

and follow-up services

72.2%96

17.3%96

*

*

75%

15%

80%

5.%

2

2

0

1

2

2

9

* Data not available 95
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• AAP/MCHB Collaborative Agreement to

Promote Pediatric Provider Participation

in the Healthy Tomorrows Partnership for

Children Program, American Academy of

Pediatrics, Elk Grove Village, $535,000

(SPRANS-MCHIP-PIC)

• Collaborative Office Rounds Group on the

South Side of Chicago, University of

Chicago, Chicago, $11,923 (SPRANSTraining-Continuing Ed/Collaborative

Office Rounds)

• Comprehensive Care Services Model for

Infants with Sickle Cell Disease Identified

by Newborn Screening, Hektoen Institute

for Medical Research, Chicago, $197,775

(SPRANS-Genetics)

• Illinois Maternal Child Health Leadership

Network, Illinois Department of Public

Health, Springfield, $100,000 (SPRANSMCHIP-SSDI)

• Maternal and Child Community Health

Science Consortium, University of Illinois

at Chicago, Chicago, $250,000 (SPRANSTraining-Continuing Education)

• Maternal and Child Health Training Grant,

University of Chicago, Chicago, $35,000

(SPRANS-Training-Social Work)

• Maternal and Child Health Training

Program, University of Illinois at Chicago,

Chicago, $364,393 (SPRANS-TrainingSchool of Public Health)

• MCH Analytic Skills Online, University of

Illinois at Chicago, Chicago, $197,521

(SPRANS-MCHIP-Data)

• MCH-INFO: Analytic Software Tool for

Needs Assessment, University of Illinois,

Chicago, $60,000 (SPRANS-MCHIP-Data)

• National Practice-Based Network to

Improve Children’s Health Care, American

Academy of Pediatrics, Elk Grove Village,

$794,045 (SPRANS-Research)

• Partners for Program Planning in

Adolescent Health, American Medical

Association, Chicago, $100,000

(SPRANS-MCHIP-PIPPAH)

• Pediatric Care for Infants of Parenting

Teens: A Collaborative Medical

Developmental Approach, Illinois Masonic

Medical Center, Chicago, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Project TELL: Teens Educating, Learning

and Leading, University of Illinois at

Chicago, Chicago, $50,000 (SPRANSMCHIP-Healthy Tomorrows)

• Quality Community Managed Care for

Children with Special Health Care Needs,

University of Illinois at Chicago, Chicago ,

$149,559 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

• Regions V and VII MCH Leadership

Conference, University of Illinois at

Chicago, Chicago, $25,000 (SPRANSTraining-Continuing Education)

ILLINOIS CONTINUED

ILLINOIS

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Medical Home Program for Children with Special Health Needs, American

Academy of Pediatrics, Elk Grove Village, $191,854 (SPRANS-MCHIPManaged Care/Health Care Reform)

The American Academy of Pediatrics, Medical Home Program for Children with

Special Needs, is a community-based initiative designed to provide a mechanism for

communication, collaboration, and idea exchange for pediatricians who treat

children with special needs. This program offers guidance and advice on

establishing the “medical home” as a regular part of community-based care; defines

the training needs of pediatricians and office staff who care for these children; and

explores the fiscal impact of treating this population in a pediatric office. Program

activities include the design and dissemination of educational materials that support

efforts to create medical homes for children with special needs. Program staff also

provide technical assistance at Academy and non-Academy meetings nationwide,

and collaborate with other organizations involved in improving the delivery of health

care services to children with special needs.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Illinois’ Coalition for Health System Development in Child Care, Illinois

Department of Public Health, Springfield, $50,000 (CISS-CISS-Child Care

Program)

The coalition will develop training and technical assistance resources that will, in

turn, help communities link child care providers with health and social support

services and enhance the knowledge and skills of child care providers. Goals

include linking child care facilities and health and other service providers;

improving access to services by children and families; and improving the health

status of children, families, and child care providers by developing and field testing

a training and technical assistance program for interested communities. The

materials will be evaluated through changes in system performance and

reductions in the incidence of injuries, infectious diseases and absenteeism

among children and child care provider staff.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Project, Illinois Department of Human Services,

Division of Community Health and Prevention, Springfield, $2,096,116

(Abstinence Ed)

The Illinois Abstinence Education Project is intended to increase the number of

adolescents who abstain from sexual activity until marriage. While the incidence

of live birth, abortion, and sexually transmitted diseases are rare among 10 to 14-

year-olds (all less than 1.5 per 1,000), these problems increase significantly

among 15- to 17-year-olds (all in excess of 15 per 1,000). More than 80 percent of

teenage births in 1995 were to single mothers. The Project’s goals and objectives

are to reduce the proportion of adolescents who have engaged in sexual

intercourse, reducing the incidence of sexually transmitted diseases among 15 to

19 year-olds; reduce the fertility rate among 15-to-17-year-olds; and to reducing

the pregnancy rate (live births, fetal deaths, and abortions) among 15-to-17-yearolds. The project will support community-based, abstinence-only programs

targeted primarily to 9-to-14-year-olds in high risk areas of the State.

96
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Implementation of an Emergency Medical Services for Children in Illinois,

Loyola University of Chicago, Maywood, $125,932 (EMSC-Implementation)

The project aims for: (1) A significant reduction in the pediatric mortality caused

by trauma; (2) a 10-percent reduction in the associated morbidity caused by

unintentional injury; (3) a 10-percent reduction in pediatric homicides; and (4) the

implementation of the necessary elements that will not only attain the first three

goals, but enable the Illinois Emergency Medical Services for Children to sustain

these achievements. A focus program on violence prevention that includes the

victims and perpetrators as well as community groups, educators, parents, and

health care workers will be implemented.

HEALTHY START

Chicago Area Healthy Start Project, Illinois Department of Public Health,

Springfield, $2,521,000 (Healthy Start-Mentor)

The Chicago Healthy Start Initiative supports five Family Centers, which are onestop centers for medical and social services and care coordination activities. The

centers provide case management, health education, alcohol and substance

abuse prevention, and job preparation services. The centers also provide

transportation services and episodic child care to remove access barriers. The

Family Centers were developed by the CHSI Consortium. The Consortium

continues to be actively involved in marketing, evaluation, and formulating plans to

sustain the Family Centers after the end of Healthy Start funds.

TRAUMATIC BRAIN INJURY

Illinois TBI Planning Project, Department of Human Services, Springfield,

$48,125 (Traumatic Brain Injury-Plan)

Brain injury survivors, family members, providers, and State agencies are well

aware of the range of problems that may result from brain injury. The purpose of

the Illinois TBI Planning Project is to identify unmet needs of persons with

traumatic brain injury (TBI) and to describe resources needed to meet those

needs. Project goals, which will facilitate the development of the Illinois State

Implementation Plan, include (1) administration and analysis of a comprehensive

statewide consumer needs assessment, and (2) production of an updated TBI

resource directory that identifies services available within the State.

$5,640,950

$8,437,226

$14,078,176

Title V Program, contact:

Stephen E. Saunders, M.D., M.P.H.

Associate Director

Office of Family Health Illinois Department of Human Services

 535 West Jefferson Street

Springfield, IL 62761

Phone: (217) 782-2736

Fax: (217) 782-4890

Title V Program’s services for Children with Special

Health Care Needs, contact:

Charles N. Onufer, M.D.

Director

Division of Specialized Care for Children

2815 West Washington Street, Suite 300 Box 19481

Springfield, IL 62794-9481

Phone: (217) 793-2340

Fax: (217) 793-0773

4,000

12,000

16,000

20,000

24,000

28,000

32,000

8,000

23,000

26,000

• Satisfaction with and Utilization of Prenatal

Care, University of Illinois , Chicago,

$210,487 (SPRANS-Research)

• Use of Child Health Services by Hispanic

Families, University of Illinois at Chicago,

Chicago, $172,277 (SPRANS-Research)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• EMSC Regional Leadership Conference on

Injury Prevention, Loyola University of

Chicago, Maywood, $25,004 (EMSC/TRNGContinuing Education)

• The Adoption and Appraisal of EMSC

Standards, Loyola University of Chicago,

Maywood, $92,446 (EMSC-Target)

HEALTHY START

• Aunt Martha’s Healthy Start Initiative

Adolescent Program, Aunt Martha’s Youth

Service Center, Inc., Matteson, $871,014

(Healthy Start-Community)

• East St. Louis Healthy Start Initiative,

Southern Illinois Healthcare Foundation, Inc.,

East St. Louis, $800,763 (Healthy StartCommunity)

• Healthy Start Southeast Chicago, Southside

Health Consortium, Chicago, $2,011,742

(Healthy Start-Community)

• Westside Healthy Start: Strengthening

Community-Based Systems of Care, Sinai

Family Health Centers, Chicago, $1,941,200

(Healthy Start-Community)

ILLINOIS

Other FY 98 MCH Grant Programs

21,500

97
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

5,899,195

85,122

The Indiana State Department of Health (ISDH) administers the Title

V grant through Maternal and Child Health Services (MCHS) which

resides in the Public Health Services Commission (PHS). PHS also

houses Children’s Special Health Care Services (CSHCS), which is

the state program for Children with Special Health Care Needs.

MCHS administered programs include: Prenatal Substance Use

Prevention Program, Indiana Perinatal Network, Fetal and Infant

Mortality Review projects, Preventive and Primary Child Health Care,

Indiana RESPECT (Reducing Early Sex and Pregnancy by Educating

Children and Teens), Newborn Screening, Indiana Childhood Lead

Poisoning Prevention Program, Family Care Coordination, Prenatal

Care Services, Prenatal Care Coordination, Adolescent Health

Center, Family Planning Services, Genetic Diseases Program, Sickle

Cell Program, and the Childhood Injury Prevention Program.

29,865

84,782

50,717

9,314

42,455

217,133

$2,765,874

$ 934,027

$6,284,159

$19,316,051

*

$497,431

$29,797,542

INDIANA

$2,104,700

$36,050,859

$29,797,542

$4,148,617

98
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

INDIANA

7 of 9

99.9%

75%

28.4

5.497

58%

29.4%

14 of 18

1.3%

78.5%

8.197

2.297

5.297

2.997

11.197

27.297

7 of 9

99%

90%

32.1

4.3

45.8%

90%

15 of 18

1.2%

78.8%

7.5

2.1

5.2

2.3

11.2

29.9

HIV exposed infants as a result of perinatal transmission that remain HIV positive

by 18 months of age

Pregnant women in MCHS program who reduced or stopped smoking

Establish a population-based perinatal education system

Infants born to black women receiving prenatal care beginning in the first trimester

4%97

73.9%

YES

65%

20%

76%

YES

67%

2

2

0

1

2

2

9

* Data not available 99
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Behavioral Pediatrics Training Program,

Indiana University, Indianapolis, $12,185

(SPRANS-Training-Behavioral Pediatrics)

• Collaborative Office Rounds, Indiana

University, Indianapolis, $12,000

(SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Indiana’s Integrated Services for Children

with Special Health Care Needs, Indiana

State Department of Health, Indianapolis,

$200,000 (SPRANS-MCHIP-Integrated

Services)

• Indiana University Adolescent Health

Training Program, Indiana University,

Indianapolis, $318,205 (SPRANS-TrainingAdolescent Health)

• Interdisciplinary Leadership Education ,

Indiana University, Indianapolis, $476,688

(SPRANS-Training-LEND/Leadership Ed

Neuro Dev))

• Neonatal Nutrition Training Program

(NNTP), Riley Hospital for Children,

Indianapolis, $78,580 (SPRANS-TrainingNutrition)

HEALTHY START

• Indianapolis Prevention of Adolescent

Pregnancy, Marion County Health

Department, Indianapolis, $1,448,805

(Healthy Start-Community)

INDIANA CONTINUED

INDIANA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Indiana Perinatal Systems Strategic Plan/INPHO, Indiana State Department

of Health, Indianapolis, $100,000 (SPRANS-MCHIP-SSDI)

This project integrates two priority projects at the Indiana State Department of

Health: (1) Indiana Perinatal Systems Strategic Plan (IPSSP); and (2) Indiana

Network for Public Health Organizations (INPHO). Indiana is not expected to

meet the “Healthy People 2000” objectives for several measures of health for the

perinatal population. In addition, there are extensive problems to overcome in

data collection, evaluation, and dissemination for providers and consumers. The

goal of this project is to create and deliver the electronic information system and

networking necessary to support the IPSSP. In this initial phase, pilot sites have

been identified and recruited, the initial system has been defined using universal

enrollment and income forms, and the software has been developed and installed.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Healthy Child Care Indiana, Indiana Parent Information Network, Inc.,

Indianapolis, $50,000 (CISS-CISS-Child Care Program)

This project will expand and provide ongoing support to child care providers and

families caring for children with special health needs in Indiana. During the first

quarter of the project year, staff will increase collaboration among family and

community leaders through the establishment of a project advisory committee of

no less than eight representatives of Indiana family, child care, and community

organizations. During the third quarter of the project year, project staff will

increase the awareness of family and community leaders about training activities

and resources for inclusive child care, special sitter programs, automotive car seat

safety, fire safety, and other topical areas through a series of a least three regional

training retreats. Project staff will conduct formative and summative evaluations.

Title V—ABSTINENCE EDUCATION PROGRAM

Indiana Abstinence Education, Indiana State Department of Health,

Indianapolis, $857,042 (Abstinence Ed)

The Indiana Abstinence Education Block Grant program will positively impact

adolescent pregnancy and birth rates and the incidence of adolescent sexual

intercourse and sexually transmitted infections by building the capacity of Indiana

youth to chose to abstain from sexual intercourse. A training series and

community grants will allow local youth-serving organizations to provide quality

abstinence education to Indiana youth. A statewide media campaign will provide

positive messages regarding the choice to abstain from sexual intercourse.

100
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Indiana EMSC Implementation, Indiana State Emergency Management

Agency EMS Division, Indianapolis, $250,000 (EMSC-Implementation)

The emergency medical services for children committee identified several barriers

impeding the delivery of pediatric emergency medical services and emergency

health care for children. This project will implement four goals to impact these

educational, injury control, regionalized care, and data collection and analysis

issues, ultimately improving the emergency treatment for children in Indiana. It is

the continued purpose of this project to build the foundation for coalitions and

networks within existing groups to provide competent, comprehensive, and

regionalized care from the scene to the medical home, with data analysis

capability to provide information to the local community injury control coalition to

impact change locally for a safer community.

HEALTHY START

Northwest Indiana Healthy Start, Northwest Indiana Health Department

Cooperative, Hammond, $2,449,812 (Healthy Start-Mentor)

Northwest Indiana Healthy Start has identified the following goals to address the

critical issues facing the citizens of Northwest Indiana: (1) Reduce infant mortality

and improve maternal and infant health through the provision of accessible

coordinated care; (2) decrease individual and community high-risk behaviors; and

(3) provide accurate information to the community about the Healthy Start project

and health education activities that lead to healthy pregnancy outcomes.

$2,104,700

$4,148,617

$6,253,317

Title V Program, contact:

Judith A. Ganser, M.D., M.P.H.

Medical Director

2 North Meridian Street, Section 7C

Indianapolis, IN 46202

Phone: (317) 233-1240

Fax: (317) 233-1299

Title V Program’s services for Children

with Special Health Care Needs, contact:

Wendy Gettelfinger, R.N., M.S.N., J.D., Director

2 North Meridian Street, Section 7B

Indianapolis, IN 46202

Phone: (317) 233-5578

Fax: (317) 233-5609

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

9,092

9,933 9,728

101
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

2,862,447

37,282

The Iowa Title V Maternal and Child Health Services Block Grant

Program — the Bureau of Family Services/Division of Family and

Community Health, Iowa Department of Public Health, conducts a

statewide assessment of needs, develops policies, plans, and

programs to improve the health of women, infants, children, adolescents and families in Iowa; and also administers Family Planning.

Iowa Child Health Specialty Clinics administer the Children with

Special Health Care Needs component of the program.

4,577

2,413

19,036

5,430

*

31,456

$1,815,299

$69,098

$ 5,556,057

$ 4,306,285

$ 0

$ 415,102

$12,161,841

IOWA

$2,499,726

$16,074,510

$12,161,841

$1,412,943

102
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

IOWA

9 of 9

99.2%

89%

18.6

4.9

58%

40.8%

10 of 18

1.3%

86.3%

6

3.3

4.1

1.9

9.7

24.4

9 of 9

99.5%

85%

21.7

5.8

59.7%

75%

15 of 18

1.4%

86.5%

7

2.3

4.5

1.8

10.2

24.6

Women who received Medicaid services during pregnancy

Low-income, MCH eligible children 1-4 years old who have completed a dentist referral

Infants under 1 year of age who are enrolled in Medicaid and received care

coordination services

High-risk infants who received follow-up services at 30 months of age

*

13.4%

28%

57%

45%

20%

50%

70%

2

2

1

1

3

1

10

* Data not available 103
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Adolescent Transition: Healthy & Ready To

Work, University of Iowa, Iowa City,

$188,793 (SPRANS-MCHIP-Adolescent

Health)

• Adverse Effect of Cow Milk in Infants,

University of Iowa Hospitals and Clinics,

Iowa City , $189,630 (SPRANS-Research)

• Alternative Dispute Prevention and

Resolution Systems and Processes for

Children with Special Health Care Needs

and Their Families in Managed Care

Settings, University of Iowa, Iowa City,

$247,753 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

• Great Plains Genetics Services Network,

University of Iowa, Iowa City, $217,442

(SPRANS-Genetics)

• Iowa Leadership Education in

Neurodevelopmental and Related

Disabilities, University of Iowa, Iowa City,

$441,045 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• Pediatric Dentistry Training in Care of

Special Children, University of Iowa, Iowa

City, $185,909 (SPRANS-Training-Pediatric

Denistry)

• State Systems Development Initiative,

Iowa Department of Public Health, Des

Moines, $100,000 (SPRANS-MCHIP-SSDI)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Health Leadership Iowa, CISS,

Community Organization Grants Program,

Iowa Department of Public Health, Des

Moines, $49,530 (CISS-CISS-COG)

IOWA CONTINUED

IOWA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Great Plains Regional Comprehensive Hemophilia Centers Program-Region

VII, University of Iowa Hospitals and Clinics, Iowa City, $404,716 (SPRANSHemophilia)

The project strives to ensure that a full range of services exist to extend and refine

the life of adolescent and young adult patients with congenital bleeding disorders

and partners at risk for infectious disease; collaborate with and complete outreach

to Amish communities at risk for hemophilia and infectious disease to provide

diagnostic and comprehensive hemophilia clinic services; and expand services

that improve the quality of life for females with coagulation disorders and infectious

diseases. Age-appropriate educational resources will be identified, peer support

group activities will be coordinated, and individualized education and counseling

will be provided during comprehensive clinic.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Community Integrated Service Systems, Health Systems Development in

Child Care Program, Iowa Department of Public Health, Des Moines, $50,000

(CISS-CISS-Child Care Program)

A functional and structural relationship will be established between the child health

and child care systems. Project goals are to: Establish and maintain a statewide

linkage between Child Care Resource and Referral (CCR&R) entities; establish

and sustain a structure for planning, evaluating, and improving the health

component of child care; and develop, implement, and evaluate a public

awareness and marketing plan for regional and community activities to support

and sustain healthy and safe child care options within each CCR&R service

delivery area. Outcomes will measure if the system changes improve access to

safe and supportive child care and health care services.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, Iowa Department of Public Health, Division of Family

& Community Health, Des Moines, $424,908 (Abstinence Ed)

Reducing the rate of pregnancy, out-of-wedlock births, and STDs in teens is the

goal of this project. The project addresses the legislative priorities for abstinenceonly education through pilot curriculum implementation and evaluation and

facilitation of the development of assets in youth to build a foundation for sexual

restraint and abstinence before marriage.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Emergency Medical Services for Children, Iowa Department of Public Health

Bureau of Emergency Medical Services, Des Moines, $250,000 (EMSCImplementation)

The goals of this project are to (1) develop foundational elements of the

emergency medical services (EMS) system to address the needs of pediatric

patients; (2) provide broad-based levels of pediatric training to out-of-hospital EMS,

primary health care, emergency department, and critical care personnel; and (3)

strengthen school and community behavior by providing public information and

educational programs on unintentional injury prevention and pediatric basic life

support awareness.

104
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Des Moines Healthy Start/Urban City, Visiting Nurse Services, Des Moines,

$1,088,563 (Healthy Start-Community)

To address major gaps in services and reduce factors associated with high infant

mortality rates within sectors of Des Moines’ maternal and infant population, the

Des Moines Healthy Start/Urban City project will build on the state and city’s

current infant mortality reduction efforts through the consortium and two

intervention strategies: (1) expansion of care coordination and case management

and (2) facilitating primary care and support service capacity.

TRAUMATIC BRAIN INJURY

Meeting the Needs of Iowans With Traumatic Brain Injury, Iowa Department of

Public Health, Des Moines, $74,380 (Traumatic Brain Injury-Plan)

The State of Iowa seeks to enhance its capacity to provide comprehensive

services for persons with traumatic brain injury (TBI). This project seeks to

improve the information available regarding Iowans with TBI who are outside the

acute care setting. The project objectives are to (1) develop, distribute, and

analyze a statewide needs assessment that addreses the full spectrum of needs

and services necessary for the care of individuals with TBI; and (2) develop a

statewide action plan for the implementation of a comprehensive community-based

system of care that encompasses all aspects of TBI services and addreses the

needs of the family as well as the individual.

$2,499,726

$1,412,943

$3,912,669

Title V Program, contact:

M. Jane Borst

Title V Director, Bureau Chief

Family Services Bureau

321 E. 12th Street Lucas State Office Bldg.

Des Moines, IA 50319-0075

Phone: (515) 281-4911

Fax: (515) 242-6384

Title V Program’s services for Children

with Special Health Care Needs, contact:

Dr. Jeffrey Lobas

Director, Child Health Specialty Clinics

University Hospital School

100 Hawkins Drive, Room 247B

Iowa City, IA 52242-1011

Phone: (319) 356-1118

Fax: (319) 356-3715

750

2,250

3,000

3,750

4,500

5,250

6,000

1,500

3,611

4,715 4,486

105
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

2,629,067

38,422

The Kansas Department of Health and Environment’s Bureau for

Children, Youth & Families (BCYF) administers the Title V Maternal

and Child Health Services Block Grant in Kansas. The Title V

program supports needs assessment and activities designed to

improve the health status of women, particularly mothers and

women of reproductive age, as well as infants and children, including children with special health care needs. Funds are directed to

supporting essential Maternal and Child Health services, prevention

programs and safety net services for the uninsured. The Bureau for

Children, Youth & Families provides leadership and direction for

such programs as: Children with Special Health Care Needs,

Newborn Screening, Infant-Toddler, Nutrition and WIC Services,

Maternal & Infant Health (M&I), Family Planning, Child and Adolescent Health, School Health, Healthy Start Home Visitors, Teen

Pregnancy Prevention and Abstinence Education.

9,905

37,434

34,776

10,972

15,947

109,034

$2,014,696

$ 705,143

$3,122,779

$3,223,514

$0

$1,007,348

$10,073,480

KANSAS

$1,157,733

$12,112,034

$10,073,480

$880,821

106
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

KANSAS

9 of 9

100%

71.1%

25.3

7.4

66.1%

5%

4 of 18

1.4%

85.7%

6.9

1.4

4.5

2.4

8.6

28.4

9 of 9

99.9%

78%

26

6.1

72%

99.9%

7 of 18

1.1%

85.7%

7.8

2.5

4.9

2.4

8.9

28

Live births and fetal deaths from women with reported history of alcohol consumption

Children born with spina bifida and other neural tube defects (per 10,000 children)

Children at birth to 4 years old who die in residential fires (per 100,000 children)

Child care centers that have staff trained through Healthy Child Care Kansas

.68%

4.4

3.9

12%

.77%

6.0

3.6

30%

1

1

1

0

1

0

4

107
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Healthy Children Project: School DropOut Prevention, Wichita Primary Care

Center, Wichita, $49,984 (SPRANS-MCHIPHealthy Tomorrows)

• Leadership in Occupational Therapy

Service Systems (LOTSS), University of

Kansas, Kansas City, $30,890 (SPRANSTraining-Occupational Therapy)

• State Systems Development Initiative,

Kansas, Kansas Department of Health

and Environment, Topeka, $100,000

(SPRANS-MCHIP-SSDI)

KANSAS CONTINUED

KANSAS

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Leadership Education in Neurodevelopmental Disabilities, University of

Kansas, Kansas City, $535,674 (SPRANS-Training-LEND/Leadership Ed

Neuro Dev)

This project enhances maternal and child health through interdisciplinary

leadership education in neurodevelopmental and related disabilities and provides

continuing education to professionals serving MCH populations and other

agencies serving children with special health needs. Trainees each year

experience a well-structured, supervised, and integrated core curriculum

consisting of didactic and practicum experiences. Long-term followup of trainees

samples leadership skills for services in maternal and child health–related fields.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Systems Building for Children with Special Health Care Needs in Child Care

Settings, Kansas Department of Health and Environment, Topeka, $50,000

(CISS-CISS-Child Care Program)

The project strives to reach consensus regarding protocols for providing services

to meet children’s health needs in the child care setting; provide a manual for child

care providers addressing protocols for providing services to children with special

health needs (CSHN); and provide training for child care providers to assure that

all children, including CSHN, will have access to quality child care services. A

task force will build on interagency collaborations and define protocols for

providing services to CSHN in child care settings. A “train-the-trainer” model will

be used to assure that training is available at the local level across Kansas.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, Kansas Department of Health and Environment,

Topeka, $391,185 (Abstinence Ed)

The planned activities are to decrease teen pregnancy rates for those aged 15-17

and the rate of live births among females aged 15-17 and to lower the occurrence

of sexually transmitted diseases among teenagers aged 15-19 by implementing

an abstinence education program that promotes the value of sexual abstinence

until marriage, develops refusal skills, and improves the self-concept.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Kansas EMSC Implementation Project, Kansas Board of Emergency Medical

Services, Topeka, $250,000 (EMSC-Implementation)

This project plans to evaluate Kansas’ current pediatric capabilities and to develop

a comprehensive 5-year emergency medical services plan for children. The goal

of the project is to (1) improve the emergency care of children across the State

through programs of public education and medical provider training and (2) further

monitor the long-term impact of these eforts through enhanced prehospital

recordkeeping.

108
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Healthy Start/North-East Wichita, Wichita/Sedgwick County Department of

Community Health, Wichita, $630,821 (Healthy Start-Community)

To address critical needs and to further collaborate efforts to reduce perinatal and

infant mortality outcomes, this Healthy Start project has identified one major goal:

Reduction of the incidence of infant mortality from 28.6 per 1,000 births to 17 per

1,000 births by January 2001. The four subgoals are to (1) initiate the

implementation of a community plan for building client capacity through the

identification and facilitation of assets and resources; (2) establish and implement

a client-driven care coordination system for determining client assets and needs

as well as accessing community resources to meet the needs; (3) increase first

trimester prenatal care through increased client recruitment in 80 percent of the

target population; and (4) decrease low birthweight to 10 percent in referred

prenatal clients.

$1,157,733

$880,821

$2,038,554

Title V Program, contact:

Cassie Lauver, ACSW

Director

Bureau for Children, Youth and Families

Kansas Department of Health and Environment

900 SW Jackson, Suite 1052

Topeka, KS 66612-1220

Phone: (785) 296-1310

Fax: (785) 296-8626

Title V Program’s services for Children

with Special Health Care Needs, contact:

Jamey Kendall, RN, BSN

Director

Special Health Services

Kansas Department of Health and Environment

900 SW Jackson, Suite 1005

Topeka, KS 66612-1220

Phone: (785) 296-1316

Fax: (785) 296-8616

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

7,641 8,119 7,784

109
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

3,936,499

54,329

The Kentucky Department for Public Health administers the Title V

programs, with 35% of it going for children with special health care

needs. Other important services include SSDI/Disabled Children’s

Program, well child, prenatal, family planning, teen pregnancy

prevention, nutrition, core health education, resource persons,

genetics, metabolic services and lead poisoning prevention.

32,324

37,102

171,995

16,060

71,100

328,581

$2,110,020

$ 1,900,689

$ 1,798,274

$ 9,084,605

$ 30,545,809

$ 1,526,731

$ 46,966,128

KENTUCKY

$1,854,617

$51,424,392

$46,966,128

$2,603,647

110
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

KENTUCKY

9 of 9

99.5%

79%

35.3

7.2

20.5%

45%

3 of 18

1.4%

85%

7.2

1.6

4.6

2.6

10.2

29.6

9 of 9

99.5%

83%

34

6.7

24%

49%

8 of 18

1.2%

86%

6.9

1.57

4.3

2.58

9.9

26.8

Substantiated incidence of child abuse, neglect or dependency (per 1,000 children)

Families receiving support services and/or parenting assistance through home visiting programs

Counties with comprehensive child safety education and injury prevention programs

Children who are either above or below the recommended weight for height

27.6

15%

76%

12.5%

26

18%

81%

10%

2

1

0

0

0

0

3

111
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Childhood Lead Poisoning Prevention

Training and Resource Center Project,

Jefferson County Health Department,

Louisville, $112,879 (SPRANS-Genetics)

• Children’s Healthcare Options Improved

Through Collaborative Efforts and

Services (CHOICES), Kentucky

Commission for Children with Special

Health Care Needs, Louisville, $0

(SPRANS-MCHIP)

• Commission for Children with Special

Health Care Needs Comprehensive

Sickle Cell Services, Commission for

Children with Special Health Care Needs,

Louisville, $53,300 (SPRANS-Genetics)

• Covington Young Families Project: A

Community Responds to the Health and

Social Support Needs of Adolescent

Mothers and Their Children, St. Elizabeth

Medical Center, Edgewood, $48,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Kentucky State Systems Development

Initiative, Kentucky Department of Public

Health, Louisville, $100,000 (SPRANSMCHIP-SSDI)

• Family Care Center Home Network,

Lexington-Fayette Urban County

Government, Lexington, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Kentucky Integrated Resources in

Schools, Kentucky Department for Health

Services, Frankfort, $150,000 (SPRANSMCHIP-Mental Health of School-Age

Children and Adolescents)

HEALTHY START

• Voices of Appalachia Healthy Start

Project, Whitley County Health

Department, Williamsburg, $307,448

(Healthy Start-Community)

KENTUCKY CONTINUED

KENTUCKY

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Choices Transition Project, Kentucky Department of Health, Louisville,

$299,950 (SPRANS-MCHIP-Adolescent Health)

Youth with disabilities are much less likely than their nondisabled peers to finish

high school, pursue postsecondary education, get jobs, or live independently. The

purpose of the CHOICES Transition Project is to use the existing CHOICES

infrastructure to develop models of preparation for transition into adult health care,

work, and self-sufficiency for young people served by Shriners Hospitals and State

Title V CSHCN agencies. The project builds on the foundation of the national

public-private partnerships developed through CHOICES, which coordinate

services of Shriners Hospitals, State Title V CSHCN, Early Intervention, and

Vocational Rehabilitation programs.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Fun Play in Safe Areas, Lexington-Fayette County Health Department,

Lexington, $50,000 (CISS-CISS-Child Care Program)

The project strives to increase safety awareness and practices in outdoor play

areas in child care settings and expand the current structure and serve as a

support system to the local and State infrastructure focusing on child care health

and safety in Kentucky. By the end of the project year, 75 percent of the licensed

child care centers and family homes will make at least three changes to increase

safety in the play area.

Title V—ABSTINENCE EDUCATION PROGRAM

Kentucky Abstinence Education Project, Division of Maternal and Child

Health, Frankfort, $990,488 (Abstinence Ed)

The Project is to teach Kentucky school-age children the value of sexual

abstinence through a media campaign and educational and other activities.

112
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$1,854,617

$2,603,647

$4,458,264

Title V Program, contact:

James S. Davis, M.D., Director

Division of Adult & Child Health

275 East Main Street

Frankfort, KY 40621

Phone: (502) 564-4830

Fax: (502) 564-8389

Title V Program’s services for Children

with Special Health Care Needs, contact:

Ann Marks

Executive Director

Commission for Children with Special Health Care Needs

982 Eastern Parkway

Louisville, KY 40217

Phone: (502) 595-4459 ext. 267

Fax: (502) 595-5673

35

105

140

175

210

245

280

70

260

208

260

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

EMS for Children in Kentucky, University of Kentucky, Lexington, $250,000

(EMSC-Implementation)

This project strives to provide education in the care of critically ill children to

health care workers in rural areas of Kentucky. We will use existing data

bases to provide epidemiologic data on severely injured children. These data

can then be used to help organize and assess the care of children in Kentucky.

The project will assess the costs, utilization, and barriers to access of followup

care available to pediatric patients identified by continuing surveillance.

HEALTHY START

Louisville and Jefferson County Healthy Start Initiative, Jefferson County

Health Department, Louisville, $2,046,199 (Healthy Start-Community)

The issue of infant mortality will be addressed through a coordinated,

neighborhood-based consortium of prevention and early intervention services.

Major goals include the following: (1) Reduce infant mortality in the project

area, (2) increase initiation of prenatal care during the first trimester and

improve clients’ attitudes toward the importance of prenatal care and healthy

lifestyles, (3) reduce the incidence of low birthweight infants, and (4) reduce

birthrates, as well as pregnancy rates, to adolescents under age 18.

113
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

4,368,967

66,888

Louisiana’s Title V program is administered by the State Sections of

Maternal and Child Health and Children’s Special Health Services.

These programs are housed within the Office of Public Health’s

Division of Health Services. The Office of Public Health is one of the five

major agencies within the Louisiana Department of Health and

Hospitals.

The MCH program serves a large portion of the State’s large medically

indigent MCH population, providing personal health services and local

public health functions at parish health units distributed throughout the

State. In addition to direct service provision, MCH is involved in enabling, population-based, and infrastructure building services such as

outreach, case management, screening, public education, policy

development, and provider training.

CSHS has nine regional offices which serve as clinic sites.

55,205

65,947

65,267

8,466

*

194,885

$6,919,274

$ 7,809,260

$14,682,783

$9,459,690

$0

*

$38,871,007

LOUISIANA

$2,411,252

$44,482,709

$38,871,007

$3,200,450

114
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

LOUISIANA

9 of 9

95.8%

82%

40.2

6.4

37.3%

51%

16 of 18

2.1%

81.9%

9.1

2.4

5.9

3.2

12.5

32

9 of 9

100%

88%

40.4

7

41%

60%

18 of 18

1.82%

84%

8.3

1.8

5.0

3.1

11.2

35.5

Women who used alcohol or tobacco products during their pregnancy

SIDS cases that have a complete autopsy and death scene investigation

Children under 18 years who have been abused or neglected (per 1,000 children)

Licensed day care centers with a health consultant

16.7%

55%

12.4

31%

13%

75%

10

40%

3

3

2

2

3

3

16

* Data not available 115
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Community-Based Collaboration for the

Expansion and Replication of an

Interdisciplinary Early Childhood Clinic for

Children at High Risk for Developmental

Delay, Children’s Special Health

Services/MCH/OPH, New Orleans,

$100,000 (SPRANS-MCHIP-SSDI)

• Louisiana: Healthy & Ready To Work,

Louisiana State University, New Orleans,

$187,465 (SPRANS-MCHIP-Adolescent

Health)

• Louisiana Pediatric Pulmonary Center,

Tulane University, New Orleans, $311,650

(SPRANS-Training-Pediatric Pulmonary

Center)

LOUISIANA CONTINUED

LOUISIANA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Transition to Adult Care for Adolescent Sickle Cell Patients, Tulane

University, New Orleans, $134,287 (SPRANS-Genetics)

This project is intended to develop an effective program for transferring patients

with sickle cell disease from child-centered pediatric care to adult-oriented care.

The project uses a multidisciplinary approach to provide services to adolescent

patients between the ages of 12 and 22 in the Sickle Cell Center of Southern

Louisiana at Tulane Medical Center. The project centers around a transition clinic

for sickle cell patients who are 15 to 22 years old, an educational program starting

at 12 years old for adolescents and their parents, and the development and use of

assessment tools to ascertain readiness of the patients for transition to adultcentered care.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

State Systems Development for Healthy and Safe Child Care in Louisiana,

Louisiana Office of Public Health, New Orleans, $50,000 (CISS-CISS-Child

Care Program)

The project will establish a State process to determine the vision of healthy and

safe child care environments in Louisiana and create a plan to achieve that vision.

Increases will occur in (1) the number of child care providers using health care

consultants, (2) linkages between child care centers and health and social

support providers, (3) health promotion activities in child care centers, and (4)

availability of child care service for children with special health needs.

Title V—ABSTINENCE EDUCATION PROGRAM

Louisiana Abstinence Education/Youth Development Initiative, Office of

Public Health, Section of Maternal and Child Health, New Orleans,

$1,627,850 (Abstinence Ed)

Louisiana’s goals are to decrease the rates of pregnancy, birth, and STD’s, to

decrease risk behaviors, and to educate young people concerning the importance

of attaining self-sufficiency before engaging in sexual activity.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Louisiana EMSC Enhancement, Louisiana Bureau of EMS, Baton Rouge,

$112,450 (EMSC-Enhancement)

Prevention programs and increased lay/professional education were increased to

impact Louisiana’s high pediatric morbidity and mortality rates in all areas of injury

and acute illness. The goals are to decrease the incidence and severity of

pediatric trauma and acute, life-threatening illness, improve health care provider

skills and their confidence levels in managing these patients, and ensure that

critically ill or injured children receive optimum care from the most appropriate

facility in a timely manner. Activities will include continued coalition building to

establish working groups of individual interested in emergency medical services for

children (EMSC) in all regions of the State, efforts aimed toward voluntary adoption

of the EMSC council–recommended guidelines and protocols for pediatric

emergency care, data collection with linkages through the continuum of care

related to pediatric trauma and acute illness, and institutionalization of the EMSC

program/activities in the regions to assure continuation beyond the project period.

116
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Great Expectations/Healthy Start, City of New Orleans Health Department,

New Orleans, $3,088,000 (Healthy Start-Mentor)

Great Expectations/Healthy Start Phase II is a comprehensive health and social

services program that links community residents and leaders, community-based

organizations, business leaders, governmental entities, health care advocates, and

others to work toward the goal of reducing infant mortality in New Orleans. The

major strategies from Phase I are retained in Phase II in three models: the

Community Care Center, the Teen Awareness Center, and a transportation model.

Goals are as follows: (1) Increasing the availability and quality of community-based

perinatal services, (2) utilizing community residents as outreach workers to bring

pregnant women into the perinatal care system and to track and monitor their care,

(3) providing case management services for high-risk pregnant women and at-risk

infants to reduce risk factors that result in poor pregnancy outcomes, (4) facilitating

health system improvements through coordination between providers, (5) involving

community in owning and solving problems that contribute to infant mortality and

poor health status, and (6) using micro level marketing and community events to

increase awareness about GE/HS and create community support.

$2,411,252

$3,200,450

$5,611,702

Title V Program, contact:

Joan Wightkin, MPH

MCH Administrator

Office of Public Health

325 Loyola Avenue Room 612

New Orleans, LA 70112

Phone: (504) 568-5073

Fax: (504) 568-8162

Title V Program’s services for Children

with Special Health Care Needs, contact:

Linda Rose, MCD

CSHS Administrator

Office of Public Health

325 Loyola Avenue Room 607

New Orleans, LA 70112

Phone: (504) 568-5055

Fax: (504) 568-7529

750

2,250

3,000

3,750

4,500

5,250

6,000

1,500

4,355 4,131

5,174

117
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,244,250

13,733

The Title V program is administered through the Division of Community and Family Health in the Bureau of Health within the Department of Human Services. Programs included in Title V are: Oral

Health, Childhood injury Prevention and Control, Teen and Young

Adult Health, Women and Children’s Preventive Health Services,

Coordinated Care Service for Children with Special Health Needs,

Genetics, SSDI, and MCH Nutrition.

7,975

13,384

87,116

2,247

*

110,722

$500,384

$1,089,336

$3,255,698

$3,430,198

$932,252

$173,755

$9,381,623

MAINE

$782,664

$10,240,287

$9,381,623

$76,000

118
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MAINE

8 of 9

99.3%

86%

11.2

5.1

59.2%

14%

7 of 18

1%

88.4%

5.197

097

3.497

1.897

3.197

21.697

9 of 9

99%

87%

16

4.7

66%

24%

9 of 18

1%

90%

5.5

2.68

4.0

1.6

4.5

20.4

Mothers who breast fed infants at 6 months of age

Children 6-8 years old who need dental treatment

Deaths caused by motor vehicle accidents (per 100,000 15 to 21-year-olds)

Children and adolescents who are overweight

25.5%

28%96

27.9

13%

34%

20%

27

11%

3

3

0

0

0

1

7

* Data not available 119
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Homeless and At-Risk Youth Health

Services, Portland Public Health

Division, Portland, $49,950 (SPRANSMCHIP-Healthy Tomorrows)

• Maine Adolescent Transition Project,

Maine Bureau of Health, Augusta,

$176,767 (SPRANS-MCHIP-Adolescent

Health)

• Maine State Level Partnerships for

Mental Health in Schools, Maine

Department of Human Services, Augusta,

$150,000 (SPRANS-MCHIP-Mental Health

of School-Age Children and Adolescents)

• MCH Continuing Education and

Development Training, University of

Southern Maine, Portland, $33,480

(SPRANS-Training-Continuing Education)

• Pediatric Partnership To Protect Children

in Rural Maine, The Spurwink Clinic,

Portland, $49,999 (SPRANS-MCHIPHealthy Tomorrows)

MAINE CONTINUED

MAINE

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

State Systems Development Initiative, Maine Department of Human

Services, Augusta, $100,000 (SPRANS-MCHIP-SSDI)

The purpose of Maine’s State Systems Development Initiative (SSDI) Project is to

strengthen existing community-based systems of care for mothers and children

through the use of a computer network. Cooperating State and community-based

health and social service agencies, private providers, and consumer families use

the network to transmit and collect client-specific and/or statistical planning/

monitoring information. The network is both secure and rapid in its transmissions.

Maine is a rural State where long travel distances, limited public transportation,

and the concentration of specialty services in more urban areas, create

challenges for families to access health care and other MCH services. Maine

SSDI established a computer online service called the “Pine Tree State Bulletin

Board” (PTBBS), which enables confidential transmission of client-specific referral

and other medical information, posting of public information about health and

social service opportunities and initiatives, rapid retrieval of data from providers and

grantee agencies, and direct messaging between consumers, State and local

agencies, and providers. The PTBBS is accessible by computer modem from tollfree telephone lines within Maine and by Telnet/Internet access. The SSDI

Program also develops software and provides technical assistance to cooperating

community-based agencies to assist them in the collection, entry, and transmittal

of data to program managers at the Bureau of Health.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Health Systems Development in Child Care, Main Department of Human

Services, Augusta, $50,000 (CISS-CISS-Child Care Program)

Support services will be developed to help child care providers meet a higher level

of health and safety standards. The project will pilot health services/child care

partnerships that would allow the State to determine how to effectively incorporate

health care services into child care settings. Expanded and ongoing support will

be given to child care providers and families caring for children with special health

needs. Goals and objectives will be measured on a quarterly basis.

Title V—ABSTINENCE EDUCATION PROGRAM

Maine’s Abstinence Education Media Campaign, Maine Department of

Human Services, Augusta, $172,468 (Abstinence Ed)

The goal of the project is to increase public awareness statewide of the issues of

adolescent sexuality focusing on abstinence as a method of reducing adolescent

pregnancy. The goal will be achieved through a television media campaign that

focuses on the target group of all adolescents ages 14 and under and their parents.

The impact of the campaign will be evaluated through surveys and focus groups.

120
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Maine EMSC Partnership Project, Maine Board of Emergency Medical

Service, Augusta, $76,000 (EMSC-PRTNER)

The goal of this project is to complete the institutionalization of emergency

medical services for children into Maine’s EMS system and create a new capacity

in the system to help prevent youth suicide. A partnership between Maine EMS

and Medical Care Development, Inc. will arrange for four 2-day training sessions to

prepare regional trainers to conduct suicide prevention training for ambulance

attendants and emergency room personnel in all six EMS regions. The project will

contract with suicide prevention experts at the University of New England to

conduct the sessions for the trainers and will pay for the EMS instructors who

receive this instruction to offer courses in their respective EMS regions to

ambulance and targeted emergency room personnel. In addition to the suicide

prevention training, the project will support the regions by offering an EMSC

refresher course that will be coordinated by the training director at Maine EMS.

$782,664

$76,000

$858,664

Title V Program, contact:

Valerie J. Ricker, MSN, MS, NP

Director, Family Health Programs

151 Capitol Street 11 State House Station

Augusta, ME 04333-0011

Phone: (207) 287-5396

Fax: (207) 287-4631

Title V Program’s services for Children

with Special Health Care Needs, contact:

Toni Wall

Program Manager, CSHN

151 Capitol Street 11 State House Station

Augusta, ME 04333-0011

Phone: (207) 287-3311

Fax: (207) 287-5355

3,000

9,000

12,000

15,000

18,000

21,000

24,000

6,000

16,900 18,125

6,500

121
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

60,000 (UN report)

2,745 (’97 Snapshot)

The Constitution of the Marshall Islands designates the Ministry of

Health and Environment (MOHE) as the “state” health agency. The

MOHE is the only legislatively authorized agency that provides

health care to the people of the Marshall Islands. The Bureau of

Primary Health Care (PHC) is one of five major bureaus within

MOHE and is responsible for all preventive and primary care

programs. The Division of Public Health is under the PHC Bureau

and includes the MCH/CSHCN Program. This program provides

health and health-related services for mothers, infants, children,

adolescents, and their families.

1,650

1,650

38,027

245

0

41,572

$108,722

$88,678

$101,454

$75,122

$0

$41,550

$415,526

MARSHALL ISLANDS

$150,000

$565,526

$415,526

$0

122
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MARSHALL ISLANDS

8 of 9

81%

17.6

16.6

98.5%

8 of 18

.2%

33%

25.5

15.2

6.7

28.5

92.5

9 of 9

90%

100

0

99%

15 of 18

0%

50%

25

10

8

23

25

* *

3

1

1

1

1

1

8

*

* Data not available * Data not required 123
Selected FY 98 Title V and

Other MCH Grant Annotations

MARSHALL ISLANDS CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Community-Based Maternal and Child Health Education Project for Systems

Development, Bureau of Primary Health Care, Majuro, $100,000 (SPRANSMCHIP-SSDI)

The goal of this State Systems Development Initiative (SSDI) project is to

establish community-based health education systems in which the community

provides active support for services in maternal and child health programs

including breastfeeding and preventive services programs. For the Ministry of

Health and Environment (MOHE) to provide accurate feedback for the

communities, it is essential that medical record systems be established in the

dispensaries. Data collected will be used to work with communities to establish

ways to strengthen preventive services programs. In addition, the MOHE realizes

the significance of the SSDI project, and it is essential that ministry is in

compliance with all the requirements for the project.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

CISS Project To Enhance Services to Pregnant Women, Infants, and

Children by Improvement on Health Information Systems, RMI Ministry of

Health and Environment, Majuro, $50,000 (CISS-CISS-COG)

The goal of this project is to computerize the health information system to

increase access and thereby enhance “one-stop” shopping of existing integrated

services to the population, especially pregnant women, infants, and children—

including those with special needs—and their families. We hope to achieve our

goal by using our own staff to improve the existing health information system

towards self-reliance. When desired knowledge is lacking among the staff,

outside consultation will be used. This initiative is designed to be shared with the

entire Nation when accepted.

124
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$150,000

$0

$150,000

Title V Program, contact:

Ms. Justina Langidrik, MPH

Asst. Secretary of Health and Environment

Ministry of Health and Environment

PO Box 16

Majuro, MH 96960

Phone: (692) 625-3360

Fax: (692) 625-3432

Title V Program’s services for Children

with Special Health Care Needs, contact:

Ms. Florence Peter

MCH Coordinator

Ministry of Health and Environment

PO Box 16

Majuro, MH 96960

Phone: (692) 625-3360

Fax: (692) 625-3432

4,000

12,000

16,000

20,000

24,000

28,000

32,000

8,000

N/A N/A N/A

125
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

5,134,808

71,972

The Maryland Department of Health and Mental Hygiene is the

designated Title V Agency in the State. There is no designated

MCH Administration, however, all of the MCH program components

are in the Community and Public Health Administration.

70,151

69,214

57,864

14,125

0

211,354

$4,347,678

$0

$8,907,414

$7,394,570

$0

$197,346

$20,847,008

MARYLAND

$7,055,665

$32,994,850

$20,847,008

$5,092,177

126
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MARYLAND

8 of 9

109%

80%

28.1

2.4

58.197

7.9%

6 of 18

2%97

88.9%97

8.697

397

6.2

2.497

14.497

23.197

8 of 9

100%

84%

28.5

3.1

65%

50%

12 of 18

1.9%

90.0%

7.8

1.9

5.0

2.3

12.4

22.5

Hospitalization for asthma rate among children aged 0-9 (per 10,000)

Women who do not smoke during pregnancy

Perinatal health care organizations participating in statewide perinatal data system

Death rate of children aged 1-4 caused by sickle cell disease (per 1,000)

61.997

88.9%

92%

797

45

90%

100%

4

1

0

1

0

3

1

6

* Data not available 127
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Advancing Education and Public Policy

Development for Women’s Health and

Perinatal Concerns, Johns Hopkins

University , Baltimore, $675,000

(SPRANS-Training-Continuing Education)

• Advancing Family-Centered Care: A

Training and Technical Assistance

Project, Institute for Family-Centered

Care, Bethesda, $0 (SPRANS-MCHIP)

• Advancing Mental Health Services in

Schools, University of Maryland,

Baltimore, $274,567 (SPRANS-MCHIPMental Health of School-Age Children and

Adolescents)

• Alliance of Genetic Support Groups,

Alliance of Genetic Support Groups,

Chevy Chase, $186,728 (SPRANSGenetics)

• Behavioral Pediatrics Training at Johns

Hopkins, Johns Hopkins University,

Baltimore, $110,485 (SPRANS-TrainingBehavioral Pediatrics)

• Behavioral Pediatrics Training, University

of Maryland at Baltimore, Baltimore,

$112,631 (SPRANS-Training-Behavioral

Pediatrics)

• Children’s Safety Network Economics

and Insurance Resource Center, National

Public Services Research Institute,

Landover, $43,750 (SPRANS-MCHIP)

• Data Utilization and Enhancement, The

Johns Hopkins University, Baltimore,

$25,000 (SPRANS-MCHIP-Data)

• Development of a Comprehensive

Maternal Child Health Service System,

Maryland Department of Health and

Mental Hygiene, Baltimore, $100,000

(SPRANS-MCHIP-SSDI)

• Evaluating the Cost–Effectiveness of a

Statewide Program of Coordinated

Comprehensive Care for Children With

Sickle Cell Disease, Maryland Department

of Health and Mental Hygiene, Baltimore,

$140,000 (SPRANS-Genetics)

• Evaluation of Hawaii’s Healthy Start

Program, Johns Hopkins University,

Baltimore, $125,301 (SPRANS-Research)

• Graduate Education in Adolescent Health

Care, University of Maryland at Baltimore,

Baltimore, $93,680 (SPRANS-TrainingAdolescent Health)

• Healthy Tomorrows Parenting Program,

Johns Hopkins Bayview Medical Center,

Baltimore, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• Healthy Tomorrows Program for Children,

Spanish Catholic Center, Inc., Silver

Spring, $50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

• Injury Prevention in an Urban Pediatric

Clinic, Johns Hopkins University,

Baltimore, $322,922 (SPRANS-Research)

• Maryland Perinatal Outcome Review

Program, Maryland Department of Health

and Mental Health, Baltimore, $140,310

(SPRANS-MCHIP-FIMR)

• Maternal and Child Health Science

Consortium, Johns Hopkins University,

Baltimore, $277,500 (SPRANS-TrainingContinuing Education)

MARYLAND CONTINUED

MARYLAND

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Perinatal Care System Development to Reduce Infant Mortality on

Maryland’s Eastern Shore, Maryland Department of Health and Mental

Hygiene, Baltimore, $150,000 (SPRANS-MCHIP-PN)

The Maryland MCHIP Project will establish an effective, regional perinatal care

system in a five-county area on the Eastern Shore. Perinatal health indicators

including infant mortality will improve as a result. Key objectives of the project are

to establish formal systems structures, to develop quality of care standards, and

to engage the community in promoting the health of woman and infants. Formal

systems structures will include a Regional Perinatal Board, a Regional Perinatal

Coordinator, and local Healthy Mothers/Healthy Babies coalitions. Continuous

quality improvement activities, provider education programs, and the development

of preconception health and smoking cessation interventions are the primary

activities that will be conducted. Community involvement and coalition building

result from strategies based on a community-based needs assessment.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Reducing Preterm Birth by Bacterial Vaginosis Screening, The Johns

Hopkins University, Baltimore, $265,518 (CISS-Research)

The goal of this community-based intervention study is to determine the effect of a

screening/treatment program for bacterial vaginosis (BV) that will be integrated

into existing prenatal services. The program will identify and treat 2,500

asymptomatic and symptomatic pregnant African-American women with BV from

four east Baltimore community clinics to reduce preterm and low-birthweight

births. Partners of asymptomatic women in the treatment arm will also be

assessed and treated whenever possible.

Title V—ABSTINENCE EDUCATION PROGRAM

Maryland Abstinence Education and Coordination, Maryland Department of

Health and Mental Hygiene, Office of Children’s Health, Baltimore, $535,712

(Abstinence Ed)

The goal of the Maryland Abstinence Education Program is to reduce the rates of

sexual activity among pre-teens and early adolescents. Activities include

developing new abstinence education programs in the context of after school

programs, supporting a statewide abstinence media campaign, establishing an

abstinence education coordinating committee, forming an Advisory Group, and

evaluating the Program.

128
TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Maryland EMSC Partnership, Maryland Institute for Emergency Medical

Services Systems, Baltimore, $99,539 (EMSC-PRTNER)

This project plans to establish partnerships and increase collaboration with existing

partners to enhance the emergency medical services for children (EMSC) program

at the Maryland Institute for Emergency Medical Services Systems (MEIMSS). This

effort will become an integral part of the statewide emergency medical services

(EMS) and EMSC programs in Maryland. These partnerships will focus on two

specific projects: (1) Expanding injury prevention initiatives at the State, regional,

and local levels based on injury patterns, and creating a written and online resource

document for EMS providers; and (2) developing a faculty group and instructor

resources based on existing continuing education workshops on children with

special health care needs. Training conferences will be held in the five regions of the

State to increase the availability of the workshop across Maryland.

HEALTHY START

Baltimore City Healthy Start, Baltimore City Health Department, Baltimore,

$4,992,638 (Healthy Start-Mentor)

The Baltimore City Healthy Start Project has had the goal of reducing the infant

mortality (IMR) of 20.1 in the Healthy Start Project Area by 50 percent over a 5-

year period during the demonstration phase of the Healthy Start project.

Baltimore’s IMR is one of the highest rates among U.S. cities, attributable to

barriers to care and high-risk lifestyles resulting in the lack of early and continuing

prenatal care and low birthweight births. Baltimore’s Healthy Start activities to

address these problems during Phase II of the program include the provision of

case management and care coordination services to women in two target areas

within the project area, offering very intensive door-to-door outreach and

recruitment to ensure all pregnant women are enrolled, and operating two

Neighborhood Healthy Start Centers providing a host of support and collocated

services to promote healthy birth outcomes.

$7,055,665

$5,092,177

$12,147,842

• Maternal and Child Health Social Work

Training Project, University of Maryland at

• Baltimore, Baltimore, $125,365 (SPRANSTraining-Social Work)

• Maternal and Child Health Training Program

in Neurodevelopmental Disabilities, The

Johns Hopkins University, Baltimore,

$1,368,969 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• National Policy Center on Managed Care

Policy and Children with Special Health Care

Needs, Johns Hopkins University, Baltimore,

$350,000 (SPRANS-MCHIP-Managed Care/

COOP)

• New Bridges to Improved Child Health,

Department of Women’s and Children’s

Services, Baltimore, $50,000 (SPRANSMCHIP-Healthy Tomorrows)

• Partnership for Genetic Services MARHGN

Pilot Program, Alliance of Genetic Support

Groups, Chevy Chase, $107,886 (SPRANSGenetics)

• Poverty and the Ecology of African-American

Children, Johns Hopkins University,

Baltimore, $331,473 (SPRANS-Research)

• Preventing Mental Health Problems in Ill

Children, The Johns Hopkins University,

Baltimore, $368,640 (SPRANS-Research)

• Promoting Psychosocial Child Health

Supervision and Care, Johns Hopkins

University, Baltimore, $12,000 (SPRANSTraining-Continuing Ed/Collaborative Office

Rounds)

• Three-Generation Intervention Among

Adolescent Mothers, University of Maryland

School of Medicine, Baltimore, $200,523

(SPRANS-Research)

• Training Program in Maternal and Child

Health, Johns Hopkins University, Baltimore,

$411,705 (SPRANS-Training-School of Public

Health)

Title V—COMMUNITY

INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• Health Systems Development

in Child Care, Department of

Human Resources, Baltimore,

$50,000 (CISS-CISS-Child

Care Program)

MARYLAND

Other FY 98 MCH Grant Programs

Title V Program, contact:

Bonnie Birkel, C.R.N.P., M.P.H.

Director, Center for Maternal and Child Health

Maryland Department of Health and Mental Hygiene

201 W. Preston Street

Baltimore, MD 21201

Phone: (410) 767-6721

Fax: (410) 333-5223

Title V Program’s services for Children

with Special Health Care Needs, contact:

Susan Panny, M.D.

Director, Office of Genetics and Children with

Special Health Care Needs

Maryland Department of Health and Mental Hygiene

201 W. Preston Street

Baltimore, MD 21201

Phone: (410) 767-6730

Fax: (410) 333-5047

5,000

15,000

20,000

25,000

30,000

35,000

40,000

10,000

35,216 36,553

1,057

129
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

6,147,132

81,411

The Massachusetts Title V Maternal and Child Health Services Block

Grant Program – the Bureau of Family and Community Health (BFCH),

Massachusetts Department of Public Health – conducts a statewide

assessment of needs, develops policies, plans, and programs to

improve the health of women, infants, children, adolescents and

families in Massachusetts. It also administers WIC, Early Intervention

(Part C., IDEA), major portions of the Preventive Health and Health

Services Block Grant, the Massachusetts Tobacco Control Program,

and a number of chronic disease prevention and health promotion

programs. The Bureau is committed to protecting and improving the

health status, functional status and quality of life of Massachusetts

residents across the life span, with special focus on at-risk populations, low-income groups, and cultural and linguistic minorities. To this

end, the Bureau focuses its efforts and resources on health promotion,

systems building, quality improvement, and assurance of access to

preventive, primary and specialized health services.

11,838

11,859

240,585

22,988

39,924

327,194

$10,058,561

$2,626,294

$37,207,233

$29,315,473

$2,903,866

$1,199,246

$83,310,673

MASSACHUSETTS

$6,755,082

$92,974,819

$83,310,673

$2,909,064

130
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MASSACHUSETTS

9 of 997

100%97

79%

1997

1.897

66.3%

35%

13 of 1897

1.4%97

83.5%97

5.397

2.197

497

1.397

8.797

15.397

9 of 9

100%

90%

18

1.3

70%

90%

15 of 18

1.35%

86%

5.2

2.2

4

1.2

8.3

17

The degree to which children with special health care needs and their families have

appropriate health care management plans

Medicaid enrolled children and youth receivieng annual preventive dental service

Women who report not smoking during their current pregnancy

The rate (per 100,000) of chlamydia cases among females aged 15 through 19.

9

*

*

*

22

40%

88%

1200

2

3

1

3

3

1

13

* Data not available 131
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Boston University Occupational Therapy

Leadership Center, Boston University,

Boston, $131,794 (SPRANS-TrainingOccupational Therapy)

• Bright Futures Resource Center for

Curricula, Boston Children’s Hospital,

Boston, $68,593 (SPRANS-TrainingContinuing Education)

• Case Management to Provide Family

Support and Preventive Services

Following Infant Deaths, Boston City

Hospital, Boston, $75,000 (SPRANSMCHIP-SIDS)

• Comprehensive Care for Cooley’s

Anemia, Thalassemia, Institute for

Community Inclusion, Boston, $244,286

(SPRANS-Genetics)

• COR Substance Abuse Network Program,

Boston Children’s Hospital, Boston,

$12,000 (SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Development of an Integrated Transition

Program in Hemoglobinopathies for

Adolescent Patients, Brigham and

Women’s Hospital, Boston, $134,263

(SPRANS-Genetics)

• Early Intervention Collaborative Study:

Age 10 Followup, Brandeis University,

Waltham, $262,389 (SPRANS-Research)

• Ensuring Quality: Monitoring the Impact

of Managed Care and Health Care Reform

on Children with Special Health Care

Needs and Their Families, Massachusetts

Health Research Institute, Inc., Boston,

$205,000 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

• FIRSTLink Data Utilization and

Enhancement Initiative, Massachusetts

Department of Public Health, Boston,

$94,700 (SPRANS-MCHIP-Data)

• Guiding Appropriate Pediatric Services

(GAPS) for Children With Special Health

Care Needs and Their Families, University

of Massachusetts Medical School,

Worcester, $204,940 (SPRANS-MCHIPIntegrated Services)

• Harvard Maternal and Child Community

Health Science Consortium, Harvard

University, Boston, $100,000 (SPRANSTraining-Continuing Education)

• Injury Prevention for Pregnant and

Parenting Teens: A Home Visiting Model,

New England Medical Center, Boston,

$50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

• Innovations in Care, Children’s Hospital,

Boston, $79,513 (SPRANS-MCHIPIntegrated Services)

• Interdisciplinary Leadership for M.R.

Personnel (Developmental Evaluation

Center in the Institute for Community

Inclusion), Children’s Hospital, Boston,

$517,557 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

MASSACHUSETTS CONTINUED

MASSACHUSETTS

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Children’s Safety Network: Adolescent Violence Prevention Resource

Center, Education Development Center, Inc., Newton, $181,287 (SPRANSMCHIP)

The Education Development Center (EDC) operates an Adolescent Violence

Prevention Resource Center to provide State MCH agencies with information,

resources, materials, and technical assistance that will result in developing new

programs and improving current efforts throughout the health system and within

communities. The resource center’s ultimate mission—to improve the science

and practice of youth violence prevention—is being accomplished in collaboration

with the Maternal and Child Health Bureau. Evaluation activities will determine:

(1) What information, resources, technical assistance, and training State MCH

agencies and others need to improve their ability to prevent and reduce adolescent

violence, and how those needs evolve over time; (2) how

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Massachusetts FIRSTLink Community Organization Project , Massachusetts

Department of Public Health, Boston, $50,000 (CISS-CISS-COG)

This project seeks to develop community capacity to implement the FIRSTLink

system statewide. FlRSTLink is a universal, prospective computerized screening

of birth certificate information to identify newborns and families with potentially

adverse health or developmental outcomes, and to link these infants with

community-based services. Community resource teams receive the FlRSTLink

referral online, contact the families, and offer a home visit, through which linkage

to local health care and family support resources is made. The community

organization project will convene and facilitate community planning teams to plan

and implement the linkage component and provide technical assistance to these

teams in effective collaboration and provision of family-centered, culturally

competent services.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, Massachusetts Department of Public Health, Boston,

$739,012 (Abstinence Ed)

The media campaign will significantly increase the percentage of youth who remain

abstinent, particularly in minority and Hispanic communities, by increasing selfesteem and community support. Target groups include preteens, parents, and young

males aged 20-24. Media messages may include radio, brochures, and posters.

132
TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Children’s Safety Network National Injury and Violence Prevention Resource

Center , Education Development Center, Inc., Newton, $237,727 (EMSC/

MCHIP-Children’s Safety Network)

The long-term goal of the Children’s Safety Network at the Education Development

Center (CSN-EDC) is to ensure that objectives in the Maternal and Child Health

Bureau 10-year plan for injury prevention are addressed and that MCH agencies

make measurable progress toward meeting the “Healthy People 2000” objectives.

The primary target groups are MCH directors, State MCH injury contacts, injury

prevention liaisons in the 10 Public Health Service regional offices, State

adolescent health coordinators, the Association of Maternal and Child Health

Programs, and new Injury Prevention Targeted Resource Centers. Process and

outcome evaluations include an annual analysis of CSN-EDC’s computerized

Contact Forms Database, monthly progress reports, resource material evaluations

by target audiences, and written workshop evaluations.

HEALTHY START

Boston Healthy Start Initiative, Trustees of Health and Hospitals of the City of

Boston, Inc., Boston, $2,521,000 (Healthy Start-Mentor)

Infant mortality is a significant health problem in Boston, the emotional aspects of

which are further exacerbated by wide racial disparities in the presence of some of

the world’s most renowned medical institutions. The Boston Healthy Start

Initiative (BHSI) seeks to address the problem through the empowerment of

individuals, families, and communities; the enhancement of services, access and

utilization; and the establishment of a more coordinated service system and

program linkages. Targeting those neighborhoods with the highest infant mortality

rates, BHSI has outlined seven outcome objectives that will reduce infant mortality

by 50 percent by 1997. The objectives include reducing low birthweight births,

decreasing postdischarge infant mortality, increasing utilization of health services,

increasing community participation in BHSI, establishing coordination and

linkages among service providers, improving social conditions of project area

residents, and increasing culturally and ethnically appropriate public information

and health education materials.

$6,755,082

$2,909,064

$9,664,146

• Leadership Education in Adolescent Health,

Children’s Hospital of Boston, Boston,

$347,734 (SPRANS-Training-Adolescent

Health)

• Leadership Education in Behavioral

Pediatrics, Children’s Hospital of Boston,

Boston, $231,329 (SPRANS-TrainingBehavioral Pediatrics)

• Managed Care Enhancement Project,

Massachusetts Department of Public Health,

Boston, $50,000 (SPRANS-MCHIP)

• Massachusetts Bright Futures Campaign: A

State Systems Development Initiative,

Massachusetts Department of Public Health,

Boston, $100,000 (SPRANS-MCHIP-SSDI)

• Massachusetts Initiative for Youth with

Disabilities, Massachusetts Department of

Health, Boston, $189,395 (SPRANS-MCHIPAdolescent Health)

• Maternal and Child Health Training Grant,

Boston University, Boston, $326,117

(SPRANS-Training-School of Public Health)

• Maternal and Child Health Training, Harvard

University, Boston, $298,407 (SPRANSTraining-School of Public Health)

• MCH Leadership Education in Behavioral

Pediatrics, Boston University, Boston,

$120,863 (SPRANS-Training-Behavioral

Pediatrics)

• MCH Regional Continuing Education

Program, Boston University, Boston, $31,247

(SPRANS-Training-Continuing Education)

• Mothers’ Mentors Project, Medical

Foundation, Boston, $50,000 (MCHIP-Healthy

Tomorrows)

• New England Regional Genetics Group

(NERGG), Massachusetts Health Research

Institute, Inc., Boston, $267,888 (SPRANSGenetics)

• Preschool Asthma Education Project, Boston

Medical Center, Boston, $49,691 (SPRANSMCHIP-Healthy Tomorrows)

• Project Healthy Asian Teens, South Cove

Community Health Center, Boston, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Project SEED, Dimock Community Health

Center, Roxbury, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• Promoting Injury Prevention Through

Innovative Approaches, Harvard University,

Boston, $29,793 (SPRANS-TrainingContinuing Education)

• Region I Comprehensive Hemophilia Care

Program, Medical Center of Central

Massachusetts – Memorial, Worcester,

$340,969 (SPRANS-Hemophilia)

• Resources for FAS: Charting the Future,

Boston University School of Medicine,

Concord, $24,983 (SPRANS-TrainingContinuing Education)

• Serving the Underserved: Curricular

Development, Boston Children’s Hospital,

Boston, $68,611 (SPRANS-Training-Continuing

Education)

• Shriver Center University Affiliated Program

Neurology Service, Massachusetts General

Hospital, Waltham, $532,708 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

MASSACHUSETTS

Other FY 98 MCH Grant Programs

133
Other FY98 MCH Grant Programs

• Social Context of Puerto Rican Child Health

and Growth, Wellesley College, Wellesley,

$251,843 (SPRANS-Research)

• Training Program in Behavioral and

Developmental Pediatrics, University of

Massachusetts, Worcester, $43,170

(SPRANS-Training-Behavioral Pediatrics)

Title V—COMMUNITY INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• Links for Families, Boston Medical Center,

Boston, $50,000 (CISS-CISS-COG)

• Maternal and Child Health Services Federal

Set-Aside Program, City of Holyoke Board of

Health, Holyoke, $50,000 (CISS-CISS-COG)

• Max Care: Maximizing the Health and Safety

of Children in Out-of-Home Care,

Massachusetts Department of Public Health,

Boston, $50,000 (CISS-CISS-Child Care

Program)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Enhancing Emergency Medical Services for

Children in Massachusetts, Massachusetts

Department of Health, Boston, $101,000

(EMSC-Enhancement)

• Medical Care of Children During Disaster,

University of Massachusetts Medical Center,

Worcester, $49,337 (EMSC/TRNG-Continuing

Education)

MASSACHUSETTS CONTINUED

134
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

Title V Program, contact:

Sally A. Fogerty

Assistant Commissioner

Massachusetts Department of Public Health

250 Washington Street, 5th floor

Boston, MA 02108-4619

Phone: (617) 624-6090

Fax: (617) 624-6020

Title V Program’s services for Children

with Special Health Care Needs, contact:

Sally A. Fogerty

Assistant Commissioner

Massachusetts Department of Public Health

250 Washington Street, 5th floor

Boston, MA 02108-4619

Phone: (617) 624-6090

Fax: (617) 624-6020

7,000

21,000

28,000

35,000

42,000

49,000

56,000

14,000

52,611 51,023

38,444

135
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

9,817,242

133,666

Michigan’s MCH program is administered by the Department of

Community Health through the Community Living, Children and

Families and Medical Services Administrations. Services under the

authority of the Community Living, Children and Families Administration include family planning, adolescent health, oral health, WIC,

childhood lead poisoning prevention, prenatal care, prenatal care

wraparound services, newborn screening, child health, and MCH

HIV/AIDS. Services under the authority of the Medical Services

Administration include Children’s Special Health Care Services.

120,475

132,518

2,279,091

27,550

108,074

2,667,708

$58,200

$44,458,204

$14,098,594

$34,139,719

$ 9,714,621

$ 46,896

$102,516,234

MICHIGAN

$3,683,287

$108,460,172

$102,516,234

$2,260,651

136
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MICHIGAN

9 of 9

100%

79.8%

25.497

5.197

56.8%97

25.1%

17 of 18

1.6%97

81.2%97

8.197

2.997

5.697

2.597

10.397

25.597

9 of 9

100%

90%

28.4

4.7

60%

65%

18 of 18

1.4%

85%

7.5

2.3

4.5

2.5

9

25

Term low birth weight births in Michigan

Pregnancies that are unintended

Black pre-term births in Michigan

Rate of pregnancy to female teenagers aged 15-17 (per 1,000)

2.8%95

49.4%95

18.5%95

49.195

2.6%

45%

17.5%

34.2

3

3

2

3

3

3

17

137
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Collaborative Office Rounds, University of

Michigan, Ann Arbor, $12,000 (SPRANSTraining-Continuing Ed/Collaborative

Office Rounds)

• Family Health Continuum Project,

Saginaw Cooperative Hospitals, Inc.,

Saginaw, $174,000 (SPRANS-MCHIP-PN)

• Fellowship Program in Dental Care for

Special Pediatric Populations, University

of Michigan, Ann Arbor, $37,148

(SPRANS-Training-Pediatric Denistry)

• FOCUS at Ele’s Place, Ele’s Place,

Lansing, $49,895 (SPRANS-MCHIPHealthy Tomorrows)

• Madres y Niños Colonia Health Program,

Midwest Migrant Health Information

Office, Monroe, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• Michigan Evaluation of Children with

Special Health Care Needs Managed Care

Arrangements, Michigan Department of

Public Health, Lansing, $150,000

(SPRANS-MCHIP-Managed Care/Health

Care Reform)

• Michigan Fetal and Infant Mortality

Review Support Program, Michigan

Department of Community Health,

Lansing, $149,962 (SPRANS-MCHIP-FIMR)

• Region V-East Hemophilia

Comprehensive Care Network,

Hemophilia Foundation of Michigan, Ann

Arbor, $393,485 (SPRANS-Hemophilia)

• State Systems Development Initiative,

Michigan Department of Community

Health, Lansing, $100,000 (SPRANSMCHIP-SSDI)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Health Systems Development in Child

Care, Michigan Department of Health,

Lansing, $50,000 (CISS-CISS-Child Care

Program)

HEALTHY START

• Detroit Healthy Start Program, City of

Detroit Health Department, Detroit,

$821,000 (Healthy Start-Mentor)

• Healthy Start in Kalamazoo, Kalamazoo

County Human Services Department,

Nazareth, $624,843 (Healthy StartCommunity)

MICHIGAN CONTINUED

MICHIGAN

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

West Michigan Community Interactive Information System, Butterworth

Health System, Grand Rapids, $249,439 (SPRANS-MCHIP-Data)

The purpose of this project is to use information technology to determine needs,

focus interventions, and assess the effectiveness of services to improve the health

and development of vulnerable women and children. Three goals are identified: (1)

Create a community infrastructure, linked to decision-making bodies, to support

the development of an integrated information system; (2) use information

technology to create a community-based MCH information system that can be

accessed by multiple stakeholders to enhance data analytic capabilities; and (3)

improve maternal and child health by assisting the community to enhance data

collection, focus interventions, and assess the effectiveness of services.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Improving Health/Development of Low Income Pregnant Women,

Butterworth Health System, Grand Rapids, $367,798 (CISS-Research)

The goal of the study is to evaluate MOMS (Mothers Offering Mothers Support),

an intervention program that uses a peer support team consisting of a case

management nurse, a paid health advocate, and volunteer mothers. The peer

support network maintains weekly contact with low-income pregnant women at

clinics, in homes, and in a variety of community locations. The study will

compare women who receive the current standard of care provided by prenatal and

maternal support services with women who receive care through MOMS. Data on

stress, depression, social support, life course development, health risk behavior,

self-esteem, parenting and infant development, and mastery will be collected for

500 women at 4 different clinic sites.

Title V—ABSTINENCE EDUCATION PROGRAM

Michigan Abstinence Partnership (MAP), Michigan Department of

Community Health, Lansing, $1,899,560 (Abstinence Ed)

MAP aims to improve the lives of Michigan’s children by encouraging them to lead

healthier lifestyles—avoiding risky behaviors such as sexual activity and the use

of alcohol, tobacco, and other drugs. MAP, through its committee structure and

local coalitions, will provide information, positive media influences, skill-building

opportunities, and a supportive environment for children aged 9-14 years.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Michigan’s Pediatric Emergency Development System (M-PEDS), Michigan

Department of Public Health and the University of Michigan, Lansing,

$118,053 (EMSC-Enhancement)

The project’s short-term goal is to develop and pilot a system of emergency

medical services for children (EMSC) in three rural northern Michigan MCAs that

have limited access to pediatric specialty and critical care. The long-term goal is

to implement the pilot project throughout Michigan, forming a statewide EMSC

system that provides optimal pediatric emergency care to all children. Hospitals

throughout the State of Michigan will be accessed and classified as to their ability

to care for critically ill and injured children; patient needs will also be matched to

hospital resources and transfer distances will be limited if possible.

138
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Maajtaag Mnobmaabzid (A Start of a Healthy Life), Inter-Tribal Council of

Michigan, Inc., Sault Ste. Marie, $696,755 (Healthy Start-Community)

To address the high incidence of health risk behaviors for infant mortality within the

rural Michigan Native America tribal communities, the Inter-Tribal Council of

Michigan, Inc., as a consortium of the federally recognized tribes, has identified

the following goals: (1) Reduce the incidence of high-risk behaviors within the

target population; (2) enhance available services through increased collaboration

with local and surrounding area health care agencies; (3) reduce the high-risk

behaviors among the adolescent population; and (4) increase cultural sensitivity

among health care providers. The consortium will be extended to increase

participation of local project area consumers and agency health care service

providers. Together, consortium members will work with project staff to ensure that

objectives and goals are achieved.

$3,683,287

$2,260,651

$5,943,938

Title V Program, contact:

Virginia Harmon

Deputy Director, Community Living, Children & Families

Michigan Department of Community Health

3423 North ML King, Jr. Blvd., P.O. Box 30195

Lansing, MI 48909

Phone: (517) 335-9371

Fax: (517) 335-8560

Title V Program’s services for Children with

Special Health Care Needs, contact:

Jane Finn

Director, Children’s Special Health Care Services Plan Division

Michigan Department of Community Health Medical Services Admin.,

Capitol Commons Center

400 South Pine, P.O. Box 30479

Lansing, MI 48909

Phone: (517) 241-8207

Fax: (517) 241-8970

7,000

21,000

28,000

35,000

42,000

49,000

56,000

14,000

43,376

49,950

5,875

139
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

114,000(U.N. report)

3.624 (’97 snapshot)

Since the National Government of the Federated States of Micronesia

is designated as a ‘state’ agency for receiving all U. S. Federal funds,

the Division of Health Services of the Department of Health, Education

and Social Affairs, administers the Title V funds. From the FSM

National Government, Title V funds are allotted to each State Governor

as the direct allottee. However, it is the Director of Health Services who

becomes the sub-allottee of these funds from the Governor’s office.

Although the allotment advice issued by the Governor’s office does not

bear the MCH Coordinator’s name, each State MCH Coordinator is

ultimately responsible for the administration of Title V funds in order to

ensure that planned activities and primary care and preventive services

for mothers, pregnant women, infants, children, adolescents and

children with special health care needs are met. Children with Special

Health Care Needs Program is based at each state public health and

under the direct supervision of the MCH Coordinator.

2,874

2,744

48,082

707

5,407

59,814

$190,404

$144,835

$245,111

$248,453

$169,840

$116,498

$1,115,141

FEDERATED STATES OF MICRONESIA

$92,083

$1,207,224

$1,115,141

$ 0

140
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

FEDERATED STATES OF MICRONESIA

6 of 9

74.3%

34.5

9.3

93.9%

7 of 18

*

20.3%

21.5

14.9

6.6

*

51.4

9 of 9

70%

22

6.5

100%

10 of 18

*

26%

22

15

7

*

16

Pregnant women screened for Hepatitis B surface antigen

Women in the MCH Program who received a Pap smear, appropriate referrals

for treatment when positive, and follow-up after referral

Infants who were exclusively breast fed at 6 months of age

Head Start Program children surveyed to determine the rate of decayed, missing, or filled teeth

52.1%

15.6%

48.1%

69.8%

57%

21%

52%

100%

2

1

0

1

1

2

7

* Data not available * Data not required 141
Selected FY 98 Title V and

Other MCH Grant Annotations

FEDERATED STATES OF MICRONESIA CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Federated States of Micronesia State Systems Development Initiative

Project, Federated States of Micronesia Department of Health Services,

Palikir, Pohnpei, $92,083 (SPRANS-MCHIP-SSDI)

The overall goal of this project is to (1) develop a community-based, primary care–

focused, prevention-oriented, comprehensive, and integrated system of

interagency services for children and their families and (2) ensure the development

of an administrative infrastructure and staff training needed to implement the

system in all four States of the Federated States of Micronesia. The project will

complete the development of policy and procedures for individual family service

planning (incorporating the principles of family-centered care and providing

intervention services) and components of the MCH system of services for infants,

young children, and preschool children (including educational modules for parents

and followup services).

142
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$92,083

$0

$92,083

Title V Program, contact:

Eliuel K. Pretrick, M.O., M.P.H..

Secretary

Division of Health Services, Department of HESA

P. O. Box PS 70

Palikir, Pohnpei, FM 96941

Phone: (691) 320-2619/-2643/-2872

Fax: (691) 320-5362

Title V Program’s services for Children with

Special Health Care Needs, contact:

Jeff Benjamin

MCH Coordinator

Division of Health Services, Department of HESA

P. O. Box PS 70

Palikir, Pohnpei, FM 96941

Phone: (691) 320-2619/2643/2872

Fax: (691) 320-5263

4,000

12,000

16,000

20,000

24,000

28,000

30,000

8,000

N/A N/A N/A

143
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

4,725,419

65,202

The Minnesota Department of Health administers the Title V program.

Examples of programs under the control of the Family Health Division

Director include: the MCH Special Projects grant program; the Family

Planning Special Projects grant program; the Minnesota Education Now

and Babies Later (ENABL) program; the State System Development

Initiative; the Community Integrated Service System project; the Minnesota Children with Special Health Needs program; the Supplemental

Nutrition Programs; Abstinence Education; the American Stop Smoking

Intervention Study (ASSIST) project and the Tobacco Free Communities

for Children project; the Coordinated School Health Project; Part C

(formerly Part H); the Minnesota Healthy Beginnings amd targeted

home visiting programs; the infant mortality reduction initiative; the

Lactation Friendly Workplace program; the Follow Along program; the

oral health program; an array of injury prevention projects; the Fitness

Fever program; the Power Plus program; and the WOLF project.

11,985

63,623

25,770

7,309

4,915

113,602

$6,425,908

$ 1,084,051

$6,882,619

$7,224,000

$781,902

$1,662,781

$24,061,261

MINNESOTA

$4,193,109

$28,462,656

$24,061,261

$208,286

144
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MINNESOTA

9 of 9

98.7%

83%

17.897

4.697

72%97

22%

6 of 18

1.197

84.1%

5.997

3.297

3.797

2.297

6.897

2197

9 of 9

100%

90%

18.1

2.9

75%

85%

13 of 18

1.05%

90.41%

5.45

1.55

3.4

2.14

7.12

16

Number of local public health agencies which track children with identified risk

factors which may lead to chronic illness/disability

Children with disabilities placed in out of home placement due to disability

Women who use alcohol, tobacco, and other drugs during pregnancy

Incidence of substantiated child maltreatment by persons responsible for child care (per 1,000)

63

2.0%

12.9%97

8.6297

65

1.9%

12.08%

7.38

0

2

0

1

3

0

6

145
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Adolescent Health Training Program,

University of Minnesota, Minneapolis,

$345,796 (SPRANS-Training-Adolescent

Health)

• Adolescent Nursing Graduate Training

Program, University of Minnesota,

Minneapolis, $164,508 (SPRANS-TrainingNursing)

• Children With Special Health Care Needs

and Their Families: Building on Cultural

Strengths, University of Minnesota,

Minneapolis, $24,987 (SPRANS-TrainingContinuing Education)

• Collaborative Office Rounds—Pediatrics,

Child Psychiatry, University of Minnesota,

Minneapolis, $12,000 (SPRANS-TrainingContinuing Ed/Collaborative Office Rounds)

• Continuing Education in Maternal

Nutrition, University of Minnesota,

Minneapolis, $53,201 (SPRANS-TrainingContinuing Education)

• Does Education Limit Lead Burden?,

University of Minnesota School of

Medicine, Minneapolis, $164,599

(SPRANS-Research)

• Does Lead Burden Alter

Neuropsychological Development?,

University of Minnesota School of

Medicine, Minneapolis, $340,116

(SPRANS-Research)

• Establishment of Habitat Health Services,

University of Minnesota, Duluth, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Institute for Leadership in Adolescent

Health, University of Minnesota,

Minneapolis, $29,739 (SPRANS-TrainingContinuing Education)

• Maternal and Child Health Training

Program, University of Minnesota,

Minneapolis, $323,434 (SPRANS-TrainingSchool of Public Health)

• Minnesota State and Local Partnership for

Mental Health in Schools, Minneapolis

Public Schools, Minneapolis, $150,000

(SPRANS-MCHIP-Mental Health of SchoolAge Children and Adolescents)

• Minnesota’s State Systems Development

Initiative , Minnesota Department of

Health, Minneapolis, $100,000 (SPRANSMCHIP-SSDI)

• North Star Elementary School-Based

Community Health Center, Minneapolis

Department of Health and Family Support,

Minneapolis, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• Project ACCORD, Advancing Child

Centered Outcomes Through Relationship

Development, Minnesota Department of

Health, Minneapolis, $144,526 (SPRANSMCHIP-Managed Care/Health Care

Reform)

• Project Connect: Connecting Providers

with Health Care Reform Information

Benefiting Youth with Special Health

Needs, National Center for Youth with

Disabilities, Minneapolis, $154,903

(SPRANS-MCHIP-Managed Care/Health

Care Reform)

MINNESOTA CONTINUED

MINNESOTA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Ready 2 Work Family Center Community Transition Services, Pacer Center

Inc., Minneapolis, $189,395 (SPRANS-MCHIP-Adolescent Health)

Employment is the main concern for youth with chronic illness and disabilities,

according to the first large survey of Minnesota youth with disabilities done

collaboratively in 1995 by PACER Center’s Project Youth and Minnesota Children

with Special Health Care Needs (MCSHCN). Despite this priority, 71 percent of

people with disabilities of working age are unemployed. Youth with disabilities

planning transition from school to work face many obstacles to finding employment,

including a system of services that are fragmented and do not meet the needs of

individuals. The need for providing transition services on a community level that truly

address the priorities and concerns of youth is apparent. PACER Center’s project,

Ready to Work: Family-Centered Community Transition Services (Project

FACCTS), addresses the need to develop comprehensive family-centered

community-based transition services for youth with disabilities.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Project Connect, Mille Lacs County Public Health, Milaca, $50,000 (CISSCISS-COG)

The overall goal of this project is to develop a seamless continuum of integrated

services for pregnant women and for children including children with special

health needs (CSHN) in Mille Lacs County. Project objectives include

enhancing service coordination and integration among service providers in Mille

Lacs County; increasing the capacity of service providers to deliver appropriate

and consistent mental health, chemical health, and parenting screenings,

interventions, referrals, and preventive strategies; and providing technical

assistance to service providers for the development of coordinated outreach

activities to target families in rural populations. The objectives of Project

Connect will be accomplished through organization, developent, and training of

the newly-formed Community Connections Concil of psychosocial service

providers in Mille Lacs County, and by bolstering the infrastructure of service

provision in the county through telecommunications systems development.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education in Minnesota, Minnesota Department of Health,

Division of Family Health, Minneapolis, $613,756 (Abstinence Ed)

The project will use a community health promotion approach to reduce adolescent

pregnancy and promote a standard of abstinence for youth 14 and under. This will

be accomplished through a statewide media campaign for parents/caregivers and

grants to communities for activities targeting youth.

146
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

PED Skills Transfer and Retention: EMS Team Approach, Minnesota

Department of Health, Minneapolis, $108,286 (EMSC-Enhancement)

This project develops a system that reinforces training and skills retention through

practice, improves the availability of equipment, increases understanding of correct

procedures, and supports outcome-based data review. We strive to improve

access to outcome data for prehospital providers by developing reports using local

data for each participating agency and to enable prehospital providers to design a

training delivery system for pediatric emergency care based on local needs. We

will develop and evaluate a continuous quality improvement process for prehospital

providers, which will demonstrate whether skills can be transferred and retained

and which will also identify what factors improve outcomes.

TRAUMATIC BRAIN INJURY

Minnesota Plan for the Integration of Traumatic Brain Injury, Minnesota

Department of Human Services, St. Paul, $100,000 (Traumatic Brain InjuryImplementation)

Minnesota’s vision of services for persons with traumatic brain injury (TBI) is based on

a model service delivery system that is coordinated by an Interagency Leadership

Council consisting of representation from consumers and State agencies. The next

logical steps that must be completed to achieve the vision are (1) formalizing

interagency collaboration to improve access and comprehensiveness of services,

(2) cross-referencing the fragmented data collection system to provide a more

comprehensive picture of the needs of persons with TBI, and (3) developing a

replicable predischarge model to be used by acute care hospitals to anticipate and

address potential problems that the person with TBI may have in community

reintegration.

$4,193,109

$208,286

$4,401,395

Title V Program, contact:

Jan Jernell

Director, Division of Family Health

Minnesota Department of Health

P.O. Box 64882

85 East Seventh Place

St. Paul, MN 55164-0882

Phone: (651) 281-9883

Fax: (651) 215-8953

Title V Program’s services for Children

with Special Health Care Needs, contact:

Phyllis Wright-Slaughter

Supervisor, Research and Policy Unit

Minnesota Department of Health

P.O. Box 64882

85 East Seventh Place

St. Paul, MN 55164-0882

Phone: (651) 281-9966

Fax: (651) 215-8953

500

1,500

2,000

2,500

3,000

3,500

4,000

1,000

2,200

3,038

N/A

MINNESOTA

Other FY 98 MCH Grant Programs

• Project Dialogue: Conflict Resolution for

Minnesota Families of Children with Special

Health Needs, Pathfinder Resources, Inc., St.

Paul, $150,000 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

• Prospective Investigation of Twin Gestation,

University of Minnesota, Minneapolis,

$264,779 (SPRANS-Research)

• Public Health Nutrition Training Grant,

University of Minnesota, Minneapolis,

$122,440 (SPRANS-Training-Nutrition)

• University of Minnesota, University of

Minnesota, Minneapolis, $184,697 (SPRANSResearch)

Title V—COMMUNITY INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• Community Partners for Healthy Families,

Meeker, McLeod, Sibley Community Health

Services, Litchfield, $50,000 (CISS-CISS-COG)

• Countywide Integration of a Social Services

System, Beltrami County Public Health Nursing

Service, Bemidji, $50,000 (CISS-CISS-COG)

• FamilyNet Shared Information System, Cass

County/Leech Lake Reservation Children’s

Initiative, Walker, $50,000 (CISS-CISS-COG)

• Health Care Without Borders, Clay County

Public Health, Moorhead, $50,000 (CISSCISS-COG)

• Minnesota Caring for Children with Special

Health Needs, Minnesota Department of

Health, St. Paul, $50,000 (CISS-CISS-Child

Care Program)

• Minnesota’s Statewide Community Integrated

Service System Initiative for Primary and

Special Health Care Needs of Women and

Children, Minnesota Department of Health,

Minneapolis, $50,000 (CISS-CISS-COG)

• Nursing Education: Children

With Special Health Needs,

University of Minnesota,

Minneapolis, $210,233 (CISS/

TRNG-Nursing)

147
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

2,752,092

42,939

The Mississippi State Department of Health is the state agency

responsible for administering the Title V Program in Mississippi.

MCH Block Grant funds are allocated in the MSDH central office to

the Bureau of Women’s Health, and the Bureau of Child/Adolescent

Health. The Children’s Medical Program, which is the program of

services for Children With Special Health Care Needs, is located

organizationally within the Bureau of Child/Adolescent Health. All

are located organizationally with the Office of Personal Health

Services (OPHS), which is responsible for all maternal and child

health functions. These two OPHS bureaus provide services for the

three major populations targeted by the MCH Block Grant: pregnant

women and infants, children and adolescents, and children with

special health care needs. The OPHS is also responsible for

administering the statewide family planning program and the

Women, Infants and Children Supplemental Food Program (WIC).

14,985

42,831

44,322

6,249

65,387

173,774

$5,000,628

$ 0

$3,544,162

$7,913,327

$ 0

$781,706

$17,239,823

MISSISSIPPI

$1,385,195

$18,866,637

$17,239,823

$241,619

148
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MISSISSIPPI

7 of 9

99.8%

84.2%

47.2

11.2

41.7%

94%

7 of 18

2%

80.1%

10.2

2.3

6.2

4

12.4

42

9 of 9

99.9%

90%

46.9

8.5

38%

98.5%

13 of 18

2.1%

81.6%

10.0

2.0

6.1

3.9

12.3

36.2

Prevalence of infants born with neural tube defects

Children testing positive for genetic disorders who received appropriate treatment and follow-up

Adolescents’ use of tobacco products

The rate of repeat births (per 1,000) for teenagers less than 19 years old

3%

73%

30.3%

22.3

4.4%

78%

29%

20.5

2

2

1

0

1

1

7

149
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Improving Mississippi’s

Hemoglobinopathy Screening Followup

Project, Mississippi State Department of

Health, Jackson, $123,675 (SPRANSGenetics)

• Partners in Action for a Total Health

System (PATHS), Mississippi State

Department of Health, Hattiesburg,

$100,000 (SPRANS-MCHIP-SSDI)

MISSISSIPPI CONTINUED

MISSISSIPPI

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Mississippi Fetal and Infant Mortality Review Project, Mississippi State

Department of Health, Jackson, $142,229 (SPRANS-MCHIP-FIMR)

The Mississippi fetal and infant mortality rate (FIMR) project will reduce infant

mortality in the State by establishing a data base of practice patterns and other

salient factors that have contributed to infant mortality in the counties in the

project area. The FIMR project also will establish standards for continuation of the

FIMR process throughout the State. The State intends to publish the information

gleaned from the project as a means of educating the lay and medical

communities about the contributing factors to infant mortality.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Maternal and Child Health Services Federal Set-Aside Program, Coastal

Family Health Center, Biloxi, $50,000 (CISS-CISS-COG)

The project aims to establish a community coalition charged with the

development, implementation, and analysis of a local maternal and child health

needs assessment. The activities to follow the needs assessment are the

improvement of integrated service systems, the enhancement of local perinatal

health services, and restructuring of preventive health services for women and

children.

Title V—ABSTINENCE EDUCATION PROGRAM

Mississippi Statewide Plan for the Provision of Abstinence Education,

Mississippi State Department of Health, Jackson, $1,062,752 (Abstinence Ed)

The program will provide community-based abstinence education services to teens

10-19 years of age. The effort will have a profound effect in the reduction of

problems such as low birth weight infants, infant mortality, and sexually

transmitted diseases. Contracts will be established with local organizations for the

provision of these services.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Emergency Medical Services for Children, Mississippi State Department of

Health, Jackson, $50,000 (EMSC-Plan)

The goals of this project are to evaluate Mississippi’s current pediatric capabilities

and to develop a comprehensive 5-year emergency medical services for children

(EMSC) plan. This project seeks to complement the existing emergency medical

services (EMS) established in Mississippi by creating an EMSC coordinated

system. The hiring of a State EMSC coordinator wil be accomplished first. The

EMS advisory council will make recommendations to a coalition of individuals who

are active in pediatrics, and the State Department of Health will make subsequent

appointments. A needs assessment will be formulated and distributed throughout

the State.

150
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Delta Futures: A Healthy Start Initiative, Mississippi Primary Health Care

Association, Jackson, $125,000 (Healthy Start-Mentor)

The Mississippi Healthy Start Initiative aims to achieve these goals: (1) Reduce

infant mortality by 20 percent in eight rural counties in the Mississippi Delta

region; (2) increase to at least 90 percent the proportion of all pregnant AfricanAmerican women who receive prenatal care in the first trimester of pregnancy; (3)

increase by 50 percent the number of adolescents who use family planning for the

project area; (4) provide efficient and effective screening tests for genetic disorders

and disabling conditions for all infants; and (5) increase to 95 percent the

proportion of the population that completes the basic immunization series by age

2. The administrative project staff will be in a central location so that they can

provide support to the project area and the county coordinators.

TRAUMATIC BRAIN INJURY

Mississippi’s Statewide Traumatic Brain Injury Planning Project, Mississippi

Department of Rehabilitation Services, Jackson, $66,619 (Traumatic Brain

Injury-Plan)

The purpose of the project is to develop a strategic plan for the statewide provision

of TBI services. A survey of current needs and resources will be obtained. Results

will be used by representatives from multiple agencies and organizations, including

consumers and their families, to jointly develop an action plan to generate a

statewide comprehensive community-based system of care.

$1,385,195

$241,619

$1,626,814

Title V Program, contact:

Hazel Gaines

Bureau Director

Mississippi State Department of Health Office

of Personal Health Services

2423 N. State Street/P.O. Box 1700

Jackson, MS 39215

Phone: (601) 576-7464

Fax: (601) 576-7825

Title V Program’s services for Children

with Special Health Care Needs, contact:

Mike Gallarno

Children’s Medical Program, Director

Children’s Medical Program P.O. Box 1700

Jackson, MS 39215

Phone: (601) 987-3965

Fax: (601) 987-5560

200

600

800

1,000

1,200

1,400

1,600

400

927 1,000

1,300

151
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

5,438,559

75,358

The administration of the MCH Block Grant is under the direction of the

Director of the Division of Maternal, Child and Family Health within the

Missouri Department of Health. The Title V program supports needs

assessment and activities designed to improve the health status of

women, particularly mothers and women of reproductive age, and

infants and children, including children with special health care needs.

Funds are directed to supporting essential Maternal and Child Health

services and prevention programs. Services under Title V administrative control include abstinence only initiatives (Project Delay), family

planning, alternatives to abortion, Missouri School-Age Children’s

Health Services Program, community water fluoridation, disabilities

prevention and injury control activities, and the Adult Head Injury

Services program. Numerous other programs and services funded

through the MCH Block Grant, general revenue, and other funds are

under the Title V Director’s control and include Medicaid case management services, Elks Mobile Dental Unit and others.

1,028

77,987

38,059

5,647

41,708

164,429

$2,317,667

$3,684,628

$7,343,312

$6,957,058

$4,459,356

$1,228,053

$25,990,074

MISSOURI

$2,030,131

$29,790,422

$25,990,074

$1,770,217

152
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MISSOURI

9 of 9

100.4%

83%

29.1

6.4

52.3%

2.3

10 of 18

1.4%

84.9%

7.6

2.7

4.9

2.7

10.8

27.3

9 of 9

100%

90%

29

3.2

64%

50%

14 of 18

1.00%

89%

7.0

1.8

4.4

2.3

10.3

25

Women with inadequate prenatal care

Inadequate spacing (less than 18 months)

Women who have reported smoking during pregnancy

Child care facilities receiving health and safety consultation

11.0%

10.5%

19.0%

18.9%

10.0%

10.2%

17.5%

22.0%

3

2

2

1

1

1

10

153
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Choices of Life for Adolescence Success,

Washington University, St. Louis,

$127,310 (SPRANS-Research)

• Family Friends: Neighborhood Volunteer

Corps, Children’s Mercy Hospital, Kansas

City, $50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

• Missouri Partnership for Leadership

Education, University of Missouri,

Columbia, $285,000 (SPRANS-TrainingLEND/Leadership Ed Neuro Dev)

• Mom/Kid Trial: A Multicomponent Abuse

Prevention Program, University of

Missouri, Columbia, $323,530 (SPRANSResearch)

• State Systems Development Initiative

2000, Missouri Department of Health,

Jefferson City, $100,000 (SPRANS-MCHIPSSDI)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• A Community Collaboration on Relevant

Decisions (ACCORD), University of

Missouri, Kansas City, Kansas City,

$50,000 (CISS-CISS-COG)

HEALTHY START

• Missouri Bootheel Healthy Start Project,

SIDS Resources, Inc., St. Louis, $652,359

(Healthy Start-Community)

MISSOURI CONTINUED

MISSOURI

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Reduce Death in Infancy, Sudden Infant Death Syndrome Resources, Inc.,

St. Louis, $75,000 (SPRANS-MCHIP-SIDS)

The project goals are to: (1)

Support families following an infant’s death in the six-county area by expanding

SIDS Resources, Inc.’s existing comprehensive and integrated systems of

information and counseling services to include all families who experience an

infant death and (2) provide updated preventive information aimed at reducing

infant mortality in this region. Measures used to achieve these goals will include

establishing systems for project collection, analysis, and evaluation; expanding

the system of professional education; and disseminating project results to

appropriate national, State, and local agencies.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Healthy Child Care Missouri, Missouri Department of Health, Jefferson City,

$50,000 (CISS-CISS-Child Care Program)

Ensuring safe, healthy, and developmentally appropriate environments for children

in licensed and license-exempt child care facilities is the overall goal of the

Healthy Child Care Missouri. One objective for the first year is to increase the use

of child care nurse consultation program services statewide to improve the child

health and safety knowledge and practices of child care providers and children and

families served. Future objectives include assisting child care facilities to comply

with health and safety child care licensing rules; and increasing linkages at the

community level between child care providers and health services and resources.

Title V—ABSTINENCE EDUCATION PROGRAM

Missouri Department of Health, Division of Maternal, Child and Family

Health, Jefferson City, $969,291 (Abstinence Ed)

A major goal of this project is the delay of early sexual activity, using strategies of

public awareness, abstinence-only education, STD prevention education, and

parent-child sexuality education.

HEALTHY START

Kansas City Healthy Start, Heart of America United Way, Kansas City,

$1,570,254 (Healthy Start-Community)

This project seeks to improve the health outcomes for pregnant women and their

infants through (1) expansion of a consortium structure to involve more consumers

in community planning to prevent infant mortality; (2) coordination of services

across providers to meet clients’ assessed needs; (3) an outreach program to

recruit pregnant women and families into the program; (4) education for risk

factors associated with infant mortality; and (5) services to adolescents that

promote pregnancy prevention and improve health care and parenting skills for

pregnant and parenting adolescents. The area selected has high infant mortality

rates and a large number of families with low incomes.

154
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

TRAUMATIC BRAIN INJURY

Missouri Traumatic Brain Injury Demonstration Project, Missouri Department

of Health, Jefferson City, $199,963 (Traumatic Brain Injury-Implementation)

The goal of the project is a planned, comprehensive community-based collaboration

of traumatic brain injury (TBI) survivors, their families, and service providers to

achieve outcomes of community inclusion, independent living/housing, competitive

employment, and satisfaction. Connecting people to resources, reinforcing

collaboration, and comprehensive supports drive the project model. Programs and

activities include the Early Intervention and Mentor Network; the TBI Leadership

Academy; the Person-Centered Planning Process, Personal Futures Planning;

educational resources and materials; utilization of distance learning resources; and

a local community-based crisis intervention team for children and adults.

$2,030,131

$1,770,217

$4,452,707

Title V Program, contact:

Glenda Miller

Division Director

Missouri Department of Health Division of

Maternal, Child and Family Health

 P.O. Box 570

920 Wildwood Drive

Jefferson City, MO 65102-0570

Phone: (573) 526-5520

Fax: (573) 526-5348

Title V Program’s services for Children

with Special Health Care Needs, contact:

Glenda Miller

Division Director

Missouri Department of Health Division of

Maternal, Child and Family Health

 P.O. Box 570

920 Wildwood Drive

Jefferson City, MO 65102-0570

Phone: (573) 526-5520

Fax: (573) 526-5348

1,000

3,000

4,000

5,000

6,000

7,000

8,000

2,000

5,490

6,200

2,985

155
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

	
	






	






	
 !


"

"#

880,453

10,795

Title V supports services administered by the Family and Community Health Bureau in the Health Policy and Services Division, in the

Montana Department of Public Health and Human Services. Other

programs/services in the administrative control of the Family and

Community Health Bureau includes Title X Family Planning, WIC,

CISS Healthy Child Care, SSDI project on Data Integration, Abstinence , Lead Prevention, Genetics Services and Newborn Screening.

5,314

7,229

49,386

1,379

16,736

80,044

$1,369,718

$737,692

$1,686,940

$1,500,453

$703,944

$218,188

$6,216,935

MONTANA

$384,546

$6,888,122

$6,216,935

$286,641

156
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

MONTANA

6 of 9

99%

88.4%

19.4

4.5

72.5%

29.9%

5 of 18

1%

82%

6.4

1

3.8

2.6

10

17.8

6 of 9

99.9%

90%

23

7

72%

33%

10 of 18

1%

83%

7.0

1

4.5

2.61

8

15

Rate of firearm deaths among youth aged 15-19

Women reporting alcohol use in pregnancy

Infants who are breast fed at 6 months

Medicaid eligible children receiving dental services as part of comprehensive services

7.86

1.8%

37.7%

25%

5.7

2%

39%

25.2%

3

1

0

0

0

1

5

157
Selected FY 98 Title V and

Other MCH Grant Annotations

MONTANA CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Maternal and Child Health Data Integration Projection, Montana Department of

Public Health and Human Services, Helena, $100,000 (SPRANS-MCHIP-SSDI)

Montana’s MCH Data Integration Project addresses local public health services

providers’ need to share appropriate client information among relevant MCH-related

programs in order to more completely and efficiently serve clients. The project

also addresses local and State needs to assess the effectiveness of programs in

addressing public health concerns. The development of Montana’s Integrated

Data for Evaluation and Assessment (MT IDEA) system in the Department of

Public Health and Human Services will serve to pull together the client service

information of Family Planning; the Special Supplemental Nutrition Program for

Women, Infants and Children (WIC); Immunization; Montana’s initiative with highrisk pregnancies; Children with Special Health Care Needs (CSHCN); Early and

Periodic Screening, Diagnostic and Treatment (EPSDT), Partnership to

Strengthen Families (child abuse prevention), and the Dental programs. It will link

statewide systems to the integrated program system, including Aid to Families

with Dependent Children, medicaid, and vital statistics. It provides a bridge to the

integration of the Federal Individuals with Disabilities Education Act, Part H

services with Title V services.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Blackfeet PRIDE (Prenatal & Infant Development Education) Project,

Blackfeet Tribe Head Start Program, Browning, $48,107 (CISS-CISS-COG)

The Blackfeet PRIDE Project, using the home-based approach, will focus on

prenatal and infant development. At least 20 Blackfeet pregnant women will

participate in a Comprehensive Wellness Program. These participants will

support the need for similar programs to begin focusing on early health prevention

and intervention. Local agencies will link services through interagency

agreements, especially when families are in high-risk categories. Cultural

elements will be implemented within all phases of training, using the Parent

Handbook as a resource guide.

Healthy Child Care Montana, Montana Department of Public Health & Human

Services, Helena, $50,000 (CISS-CISS-Child Care Program)

Forging collaborative partnerships between health care and public health providers

to implement the action steps is the project’s primary goal. Objectives include

developing a new or modifying the existing Missoula curriculum for public health

staff to use in working with child care providers; and increasing the number of

county public health agencies who provide a comprehensive health and safety

resource for child care providers from fewer than 10 to a minimum of 25 by

September 30, 1999.

Title V—ABSTINENCE EDUCATION PROGRAM

Assets for Abstinence, Montana Department of Public Health and Human

Services, $186,439 (Abstinence Ed)

“Assets for Abstinence” is a comprehensive, structured program that gives youth

the tools to postpone sexual activity and helps parents educate, inform, and teach

family values to their children. This will be accomplished through a local

community asset-building program, which names and nurtures the core

experiences needed for healthy development. The centerpieces of this approach

will be a peer education program and train-the-trainers component that will use

accessible, qualified resource people in participating communities.

158
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Montana EMSC Data, Injury Prevention, and Training Program, Montana

Department of Health and Environmental Sciences, Helena, $153,760 (EMSCImplementation)

This project strives to: (1) Improve pediatric data by establishing an automated

statewide prehospital data collection system; (2) make Montana a “safe State” by

developing a coordinated statewide, data–driven injury prevention program in the

department of health and environmental sciences; and (3) improve pediatric

emergency education of emergency health care providers by taking advantage of

current alternative technologies. A family-centered approach to prevention and

public information will be used. The Utah EMSC interrupted linear video

workbooks will be reformatted to interactive CD-ROM.

Montana Establishing an EMS Continuum of Excellence, Montana

Department of Public Health and Human Services, EMS and Injury

Prevention Section, Helena, $132,881 (EMSC-Target)

This project seeks to establish an EMS Continuum of Excellence and a

commitment to quality as the underlying philosophy for the strategic planning,

operation, management, and improvement of all components of Montana’s

emergency medical services (EMS) system, including the provision of emergency

medical care to pediatric patients. The project will serve as a national model for a

statewide system of quality improvement (QI) that is integral to the overall

statewide EMS system management structure. The objectives of the project are

to (1) ingrain the philosophy of quality for all components of Montana’s EMS

system; (2) establish and reward EMS services and facilities of excellence, share

these best practices with other services, and modify EMS licensing rules to

provide for licensing of services based on maintenance of a QI system; (3) improve

the information and analysis components of the trauma care and EMS delivery

system; (4) develop the system capability both locally and statewide to develop

and monitor measurable performance indicators, and use this information to

improve the EMS Continuum of Excellence; and (5) improve the medical direction

component of Montana’s EMS Continuum of Excellence.

$384,546

$286,641

$671,187

Title V Program, contact:

Jo Ann W. Dotson, RN, MSN, Bureau Chief

Family & Community Health Bureau

MT Dept. of Public Health & Human Services

Cogswell Building, Room C-314

1400 Broadway

Helena, MT 59620

Phone: 406-444-4743

Fax: 406-444-2606

Title V Program’s services for Children

with Special Health Care Needs, contact:

Sharon Wagner, MPH

Section Supervisor

Special Health Services

MT Dept. of Public Health & Human Services

Cogswell Building, Room C-314,

1400 Broadway

Helena, MT 59620

Phone: 406-444-3617

Fax: 406-444-2606

100

300

400

500

600

700

800

200

651

787 758

159
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,662,719

23,534

The Nebraska Title V Maternal and Child Health Services Block Grant is administered by the Perinatal and Child Health Program, which is in the Family Health

Division of Preventive and Community Health within the newly formed Nebraska

Health and Human Services System. The PCH Program conducts a statewide

assessment of needs, develops policies, plans, and programs to improve the

health of women, infants, children, adolescents and families in Nebraska. The

Family Health Division also administers WIC, CSFP, Family Planning, Immunizations,

School Health, Newborn Screening and Genetics, PRAMS, and Adolescent Health.

The Title V/Children With Special Health Care Needs Program, known as the

Medically Handicapped Children’s Program, is located in the Special Services for

Children and Adults Division within the Office of Individual and Community

Services. Other programs administered by this Division include the Aged and

Disabled Medicaid Waiver which also serves children, Early Intervention Medicaid

Waiver, Early Intervention Program (co-administered with the Dept. of Education,

Special Education Branch), Medicaid in Public Schools Program, and the Katie

Beckett plan amendment.

3,550

3,581

23,730

4,097

24,692

59,650

$1,671,099

$751,957

$2,240,407

$2,019,460

$681,991

$200,000

$7,564,914

NEBRASKA

$1,016,122

$9,071,036

$7,564,914

$490,000

160
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NEBRASKA

9 of 9

100%

75%

20.6

6.5

57.1%

12.4%

12 of 18

1.3%

83.6%

7.3

2.9

4.8

2.5

10.4

23.8

9 of 9

100%

90%

20

5

75%

25%

14 of 18

1

90%

7.7

1.3

5.3

2.6

10

18.0

Incidence of confirmed SIDS cases (per 1,000 live births) among African American

and Native American infants

Childbearing age women who report smoking in the last 30 days

Incidence of neural tube defects (per 10,000 live births)

Hospitalizations for injuries (per 100,000 birth to 14) (intentional and unintentional)

3.3

25.1%

4.25

6,289

3

21%

3.5

5,100

2

2

3

1

3

1

12

161
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Family Empowerment and Service

Coordination on the Information

Superhighway, Center on Children,

Families, and the Law, Lincoln, $0

(SPRANS- MCHIP-Managed Care/Health

Care Reform)

• Municipal Maternal and Child Health

Partners Project, University of Nebraska,

Omaha, $178,900 (SPRANS-MCHIP-PIC)

• Nebraska State Systems Development

Initiative, Nebraska Department of Health,

Lincoln, $100,000 (SPRANS-MCHIP-SSDI)

NEBRASKA CONTINUED

NEBRASKA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Monroe-Meyer Rehabilitation Institute Interdisciplinary Training Program,

University of Nebraska, Omaha, $441,045 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

This project provides community-based and center-based, family-centered,

interdisciplinary training in 14 disciplines to graduate students and postdoctoral

fellows intent on attaining future health careers. The program addresses the

critical health care needs of Nebraskans while at the same time it provides

leadership training at the preprofessional and continuing education level.

Programs and materials developed at the Monroe-Meyer Rehabilitation Institute

are disseminated nationally and regionally.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Access to Health Care & Child Care Through Resource & Referral Services,

Nebraska Department of Social Services, Lincoln, $50,000 (CISS-CISS-Child

Care Program)

The goals of this project are to (1) link child care providers and the families they

serve with preventive and primary health care services within their local

communities and (2) improve the health and well-being of children through access

to appropriate, safe, child care. Annual analysis of the indicators and surveys will

make up a significant portion of the evaluation.

Title V—ABSTINENCE EDUCATION PROGRAM

Nebraska Abstinence Education Grant Program, Nebraska Department of

Health and Human Services, Lincoln, $246,177 (Abstinence Ed)

Nebraska’s Abstinence Education Grant Program will focus on reducing the risk of

adolescent pregnancy and sexually transmitted diseases among youth through

community-based, family-centered, collaborative abstinence education models,

and a statewide information campaign. An ongoing evaluation of five community

projects is included.

162
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$1,016,122

$490,000

$1,506,122

Title V Program, contact:

Paula Eurek, RD

Administrator, Family Health Division

Services Agency of the NE Health and Human Services System

 301 Centennial Mall South

Lincoln, NE 68509-5044

Phone: (402) 471-3980

Fax: (402) 471-7049

Title V Program’s services for Children

with Special Health Care Needs, contact:

Mary Jo Iwan

Administrator, Special Services for Children & Adults Division

Services Agency of the NE Health and Human Services System

301 Centennial Mall South

Lincoln, NE 68509-5044

Phone: (402) 471-9345

Fax: (402) 471-9455

100

300

400

500

600

700

800

200

788

704

542

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Ensuring the Future for Nebraska’s Children, Nebraska Department of Health

and Human Services, Lincoln, $50,000 (EMSC-Plan)

The goals of the project are to access and evaluate Nebraska’s current emergency

capabilities and develop a 5-year comprehensive emergency medical services for

children (EMSC) plan. The outcome will be the integration of children’s unique

needs into every component of Nebraska’s EMS systems. These goals will be

accomplished through contact with key medical personnel having expertise in

pediatric trauma and health care. An EMSC advisory committee appointed by the

Nebraska Director of Health, along with numerous surveys from other EMSC

programs throughout the Nation, will provide expert firsthand data valuable to the

Nebraska program.

HEALTHY START

North Omaha Healthy Start, Housing Authority of the City of Omaha, Omaha,

$440,000 (Healthy Start-Community)

The proposed North Omaha Healthy Start Initiative will address infant mortality

within the ENE area by focusing on the barriers to prenatal and infant health care

caused by fragmented health and social service systems.

163
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,746,898

28,669

Nevada’s Title V Program is administered through the Bureau of

Family Health Services, which resides within the Nevada Department of Human Resources, State Health Division. Programs and

initiatives address areas of prenatal care, including perinatal

substance abuse prevention and Baby Your Baby, children with

special health care needs, including newborn screening and

multidisciplinary specialty clinics, and children and adolescents,

including adolescent clinics, dental services, teen pregnancy

prevention and injury prevention. Title V also supervises the WIC

Program and Special Children’s Clinics in Reno and Las Vegas,

which provide early intervention services for affected children and

their families.

5,463

28,219

21,181

7,148

*

62,011

$808,892

$ 0

$768,109

$1,643,540

$ 0

$91,450

$3,311,991

NEVADA

$337,534

$3,724,525

$3,311,991

$75,000

164
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NEVADA

9 of 9

99.8%

73%

36.2

3.8

51%

0%

8 of 18

1.3%

76.7%

6.9

2.7

3.4

3.5

9

24

9 of 9

99%

78%

37

4.5

53%

30%

12 of 18

1%

79%

6.0

1.3

3.8

2.4

9

25

CSHCN access to case management and enabling services

Substantiated incidence of child abuse and neglect cases for children ages 0-19 (per 1,000)

Rate of hospital discharge (per 100,000 youth) for intentional injury

Degree to which the Nevada MCH Prenatal program supports or pays for prenatal care,

including dental care, not otherwise or accessible to its clients

50.7%

19

148.8

1.9%

50%

15

140

1.7%

2

2

3

1

3

1

12

* Data not available 165
Selected FY 98 Title V and

Other MCH Grant Annotations

NEVADA CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Nevada Maternal and Child Health State Systems Development Initiative

Primary Care Development Project, Nevada State Health Division, Carson

City, $100,000 (SPRANS-MCHIP-SSDI)

The purpose of Nevada’s Maternal and Child Health State Systems Development

Initiative Primary Care Development Project was to develop a statewide,

comprehensive, community-based primary health care system for underserved

children and their families. The project was collocated with the Primary Care

Cooperative Agreement in the Primary Care Development Center within the Nevada

State Health Division. The project’s goals included the following: (1) Improve

access to primary health care and preventive care services for Nevadans by

expanding the number of community health centers that treat children and pregnant

women; (2) increase the number of primary care providers available to care for

Nevadans by expanding health professions training opportunities and educating

more midlevel practitioners; and (3) promote universal access to primary health care

and preventive care for Nevada’s children and adolescents. Activities included

needs assessments, targeted community development, support for designating

underserved areas (federal Health Professional Shortage Areas and MUA/Ps),

strengthening the NHSC, production of the Nevada Primary Care Access Plan,

development of data for the Title V Block Grant, and maintenance of the Primary

Care Data Base. Materials developed included the Nevada Primary Care Access

Plan and the structure of the Primary Care Data Base.

Nevada State Planning and Fluoridation Systems Development, Nevada

Department of Human Resources, Carson City, $30,000 (SPRANS-MCHIPFluoride)

The goal of Nevada’s State Planning and Fluoridation Systems Development

Project is to promote the fluoridation of Nevada’s community water systems.

Activities include an assessment of a 1997 effort to pass mandating legislation.

Based on the assessment, an educational campaign with a multimedia

component to promote community water systems fluoridation will be developed

and implemented. A Resource and Policy Assistance Center for Community

Water Systems Fluoridation will also be developed and made available to the

public. Existing oral health community and State committees and coalitions will

be expanded to support the campaign.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Nevada HSDCC Project, Nevada Department of Human Resources, Carson

City, $50,000 (CISS-CISS-Child Care Program)

A resource library of videotapes and other materials will be developed to provide

effective onsite training to caregivers in child care settings. In addition to

purchasing or obtaining such materials that pertain to appropriate subject matters,

the project will develop and produce videotapes and other materials for training in

State-specific subjects, including the social and health care service systems and

the appropriate methods for families to access such services. Effectiveness of the

training will be evaluated by giving pretraining and post-training tests at the time of

initial testing and at subsequent testings.

166
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education to Reduce Teen Pregnancy in Nevada, Nevada State

Department of Human Resources, Division of Health, Carson City, $157,534

(Abstinence Ed)

Through a statewide media campaign, school-based assemblies, and local-level

developed and directed activities, sexual abstinence will be promoted to reduce

Nevada’s pre-teen and teen pregnancy rates.

TRAUMATIC BRAIN INJURY

Nevada Cares Project, Nevada Department of Employment, Training and

Rehabilitation, Carson City, $75,000 (Traumatic Brain Injury-Plan)

The project seeks to reassess Nevada’s approach for dealing with survivors of

traumatic brain injury (TBI). Project activities are to (1) update the 1989 and 1990

State needs assessments of TBI services, funding streams, resource availability,

barriers, and policy recommendations; (2) update the statewide action plan to

ensure a comprehensive community-based system of care; (3) develop a

replicable, predischarge model to be used in acute care sites; (4) examine and

report policies, practices, attitudes, and funding constraints; (5) identify and plan

for cultural issues related to effective systems access and service delivery; and (6)

determine the feasibility and cost to fully implement the Centers for Disease

Control and Prevention Guidelines for Surveillance of Central Nervous System

Injury within the Nevada Head Trauma Registry.

$337,534

$75,000

$412,534

Title V Program, contact:

Judith M. Wright

Bureau Chief

Nevada State Health Division Bureau of Family

Health Services

505 E. King Street, Room 200

Carson City, NV 89702-4792

Phone: (775) 684-4285

Fax: (775) 684-4245

Title V Program’s services for Children

with Special Health Care Needs, contact:

Gloria Deyhle, RN

MCH/CSHCN Nurse Consultant

Nevada State Health Division Bureau of Family

Health Services

505 E. King Street, Room 200

Carson City, NV 89702-4792

Phone: (775) 684-4285

Fax: (775) 684-4245

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

6,600

8,331

N/A

167
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,185,048

14,429

The Title V Program is located within the Office of Community and

Public Health (OCPH). Administration of the MCH Block Grant is

assigned jointly to the Bureau of Maternal & Child Health (BMCH)

for services to women, infants and children and to the Bureau of

Special Medical Services(SMSB) for services to children with

special health care needs. The state’s Family Planning Program

also resides in the BMCH. SMSB is also responsible for managing

the Catastrophic Illness Program for adults with specific chronic

diseases and the Ryan White Title II Home Care Program for

persons with HIV/AIDS.

1,906

1,456

19,686

4,238

*

27,286

$310,126

$ 310,126

$1,085,115

$3,050,313

$581,223

$35,732

$5,372,635

NEW HAMPSHIRE

$865,722

$6,676,190

$5,372,635

$437,833

168
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NEW HAMPSHIRE

9 of 9

97.7%

82%

14

3

62.9%

22.9%

16 of 18

1.1%

89.6%

5

*

3.5

1.5

7.9

18.2

9 of 9

99.2%

90%

13.5

2.8

65%

25%

18 of 18

.8%

90%

5

*

3.5

1.5

8.5

18.2

Pregnant women attending State-funded prenatal clinics who have an HIV test

Women statewide who smoked during pregnancy

Deaths of teens aged 15-19 caused by motor vehicle crashes (per 100,000)

Families whose infant is suspected to have died of SIDS who have received

NH SIDS Program Services

72%

16.3%96

19.896

100%

95%

12%

18

100%

3

3

3

3

3

1

16

* Data not available 169
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Collaborative Study Group:

Psychosocial-Developmental Aspects of

Child Health, Dartmouth College, Hanover,

$11,836 (SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Health and Education Leadership Project:

Support of Students With Chronic Health

Conditions Through School Principal

Leadership Training, Dartmouth College,

Lebanon, $24,913 (SPRANS-TrainingContinuing Education)

• New Hampshire Alliance for Maternal and

Child Health Interdisciplinary Leadership

Education in Neurodevelopmental and

Related Disabilities Program, Dartmouth

University, Lebanon, $441,045 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• New Hampshire Systems Development

Initiative, New Hampshire Division of

Public Health Services, Concord,

$100,000 (SPRANS-MCHIP-SSDI)

• Rural Medical Home Improvement

Project, Hood Center for Family Support,

Lebanon, $107,987 (SPRANS-MCHIPIntegrated Services)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• New Hampshire Home Visiting Network

and Development Project, New

Hampshire Department of Health and

Human Services, Concord, $50,000

(CISS-CISS-COG)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Children With Special Health Care Needs

Targeted Issues, Dartmouth College,

Hanover, $59,461 (EMSC-PRTNER)

• What Constitutes “Appropriate” Use of

EMSC for Children in Managed Care,

University of New Hampshire, Durham,

$150,000 (EMSC-Target)

NEW HAMPSHIRE CONTINUED

NEW HAMPSHIRE

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

New Hampshire Oral Health Project, New Hampshire Department of Health

and Human Services, Concord, $30,000 (SPRANS-MCHIP-Fluoride)

The New Hampshire Oral Health Project seeks to ultimately improve the oral

health of the children of New Hampshire by hiring a part-time dental health

coordinator to be a central resource for preventive oral health efforts and assist the

State and communities to develop community water fluoridation efforts by

collaborating with the public and private sectors.

Seacoast HealthNet, Seacoast HealthNet, Exeter, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

Seacoast HealthNet, a network of health care professionals that provides improved

access to medical care for uninsured, low-income residents in 21 towns of the

Seacoast area of New Hampshire, is using a Healthy Tomorrows grant to extend

the health education it is able to provide to parents and children. Three home

health educators extend the breadth and effectiveness of the education begun by

the care coordinators during enrollment, and corresponding educational sessions

for providers help ensure coordination of what families learn and what providers

emphasize during health supervision visits. As families and providers become

better partners in the management of specific ambulatory care sensitive

conditions, rates at which children are hospitalized for these diagnoses are

expected to fall.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

New Hampshire Child Health/Child Care Project, Community Health Institute,

Concord, $49,941 (CISS-CISS-Child Care Program)

The overarching goal of the project is to build a system for assuring health and

social support services in child care environments. A two-pronged approach will

be taken using the strategies of capacity building, training, and networking. The

project will have major areas of emphasis for each of the 3 years: Access to

primary health care and health screenings, general health issues, and prevention

of injuries in the child care setting; children with special health care needs and

linking with social and emotional support services; and health and safety

education for children, parents and staff, and working with family child care

providers.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

New Hampshire Emergency Medical Services for Children Targeted Issues,

Dartmouth College, Trustees of Dartmouth Medical School, Hanover,

$149,872 (EMSC-Target)

This project plans to implement the pediatric section of the statewide trauma plan

and create a pediatric trauma care system in New Hampshire. The project will (1)

identify and designate all acute care facilities in the State by level of pediatric care

according to the trauma plan, (2) develop a cordinated system of interfacility

transfer and transport according to the plan, (3) educate medical professionals

regarding the appropriate use of the plan and the role they will play in its success,

and (4) familiarize the public with the pediatric trauma system.

170
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

TRAUMATIC BRAIN INJURY

New Hampshire TBI Planning Project, New Hampshire Division of

Developmental Services, Concord, $78,500 (Traumatic Brain Injury-Plan)

The goals of the project are to identify the unmet needs of traumatic brain injury

(TBI) survivors and their families and to plan an infrastructure of services that will

significantly enhance the capacity of both State and private organizations to work

collaboratively and effectively across disciplines and agencies for the benefit of

New Hampshire’s survivors of TBI and their families. Activities include organization

of a statewide TBI advisory board representing survivors and their families and the

continuum of care of services; expansion of the role and responsibilities of the

Division of Developmental Services, Acquired Brain Injury Services, and the

designated staff person to include planning activities for all TBI survivors regardless

of the survivor’s age at onset of injury; development of statewide needs

assessment surveys to assess the needs of consumers, families, professionals,

and providers; and development of a statewide action plan to address the needs of

TBI survivors and their families based on the results of the statewide survey.

$865,722

$437,833

$1,303,555

Title V Program, contact:

Joan Ascheim

Bureau Chief

Office of Community and Public Health

Bureau of Maternal & Child Health

6 Hazen Drive

Concord, NH 03301

Phone: (603) 271-4516

Fax: (603) 271-4519

Title V Program’s services for Children

with Special Health Care Needs, contact:

Jane Hybsch RN, MHA

Bureau Chief

Office of Community and Public Health

Special Medical Services Bureau

6 Hazen Drive

Concord, NH 03301

Phone: (603) 271-4596

Fax: (603) 271-4902

300

900

1,200

1,500

1,800

2,100

2,400

600

2,250 2,250

N/A

171
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

8,115,011

114,550

In New Jersey the administration of the MCH Block Grant, including the program for

children with special health care needs, is organizationally located within the Department of

Health and Senior Services, Division of Family Health Services. The division’s organization

is based on function, rather than categorical programs. Two service units, within the

Division of Family Health Services, have direct responsibility for MCH activities:

Maternal, Child and Community Health MCCH) has oversight of the Maternal and Child

Health Consortiums (MCHC), the Healthy Mothers Healthy Babies Coalitions (HMHB), FAS

risk reduction perinatal addiction services, HealthStart, the Black Infant Mortality Reduction

Awareness Campaign, comprehensive maternity services and outreach and education,

preventive and primary care services including child and adolescent health services, oral

health, childhood lead poisoning prevention services, Title X-family planning, breast and

cervical cancer control initiative, the primary care cooperative agreement, medical home

project (SSDI), and the federally qualified health center (FQHC) expansion program.

Special Child and Adult Health Services (SCAHS) administers programs and services to

assure that all persons with special health needs have access to comprehensive,

community based, culturally competent and family centered care. The Birth Defects

registry provides for early identification and surveillance. Newborn screening follow-up is

within SCAHS. Specialized pediatric evaluation and treatment services are managed by

SCAHS along with community based case management services for children with special

health care needs. Services for adults include hereditary disorders, diabetes control,

Huntington’s disease, and chronic renal disease. The MCH Epidemiology Program is under

the Office of the Medical Director within the Office of the Assistant Commissioner.

110,465

110,465

128,943

67,839

30,788

448,500

$3,098,440

$ 2,065,628

$ 7,335,197

$ 8,581,631

*

$972,652

$22,053,548

NEW JERSEY

$1,355,791

$25,892,039

$22,053,548

$2,482,700

172
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NEW JERSEY

8 of 9

99.8%

78%

20.6

2.7

42.6%

29.9%

16 of 18

1.6%

77.6%

5.8

2.6

4.2

1.6

11.5

18.5

9 of 9

99%

90%

20.1

2.4

55%

50%

16 of 18

1.6%

90%

5.0

2.3

4.3

1.9

11.0

19.1

Repeat pregnancies among adolescents 15-19 years of age

Black preterm infants in New Jersey

Newborns with confirmed positive biochemical screening tests receiving appropriate treatment

Implementation of commmunity-based fetal and infant mortality reviews

**

**

100%

28%

18%

18%

100%

100%

3

3

2

3

2

3

16

* Data not available 173
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Expanding Resources and Improving

Genetic Services Using the Mid-Atlantic

Regional Human Genetics Network

(MARHGN): A Seven-State Consortium,

University of Medicine and Dentistry of

New Jersey, Newark, $239,138 (SPRANSGenetics)

• Incorporating Genetics into Primary Care

Practice, University of Medicine and

Dentistry of New Jersey, Newark,

$123,582 (SPRANS-Genetics)

• New Jersey Project: Providing a Health

Care Home in a “Neighborhood of

Services,” New Jersey Department of

Health, Trenton, $100,000 (SPRANSMCHIP-SSDI)

HEALTHY START

• Healthy Start for Essex County, New

Jersey State Department of Health,

Trenton, $307,841 (Healthy Start-Mentor)

NEW JERSEY CONTINUED

NEW JERSEY

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Trenton Loves Children - Home Visitor Project, City of Trenton, Trenton,

$50,000 (SPRANS-MCHIP-Healthy Tomorrows)

The project seeks to improve the health and well-being of families with infants and

young children by tracking health measures, and providing in-home assessment,

education, and support for appropriate use of primary health care and essential

social support services; and reevaluate the role of the local public health agency in

response to the impending changes in health care and the move to managed care

in New Jersey by working with the State agencies for Health and Human Services.

Health outcome measures (prenatal visits, gestational age, birthweight,

immunization status by age 2, lead screening, developmental assessments,

vision and hearing testing) will be improved for infants, children, and families

participating in the project.

Title V—ABSTINENCE EDUCATION PROGRAM

New Jersey Abstinence Education Project, New Jersey Department of Health

and Senior Services, Trenton, $843,071 (Abstinence Ed)

The New Jersey Abstinence Education Project will develop or enhance youth

groups, community education, mentoring, and/or parenting skills building

programs. The project will target children and adolescents who are 10-14 years of

age who live in high need areas of the State. The Project will strive to increase the

number of youth who postpone initiation of sexual intercourse; reduce the number

of teenage pregnancies and teenage births; enhance an adolescent’s ability to

reject unwanted sexual advances, and provide parents/families with an opportunity

for skills training in parent/child communication.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

New Jersey EMS for Children Program Partnership, New Jersey Department

of Health and Senior Services, Trenton, $75,000 (EMSC-PRTNER)

This project seeks to support emergency medical services for children (EMSC)

efforts in New Jersey by using Federal funds to partially support the EMSC

program manager position and to print New Hampshire’s PACE (Planning to Avoid

Childhood Emergencies) and Colorado’s ECHO (Everyone Can Help Others)

materials. Federal funds would supplement, not supplant, existing State EMSC

funds, which could be used for the following initiatives: (1) A data base to link

trained educators in head and spinal cord injury prevention with speakers who are

physically impaired and with secondary schools; (2) a pediatric injury prevention

program, targeting children who are currently in or recently discharged from

pediatric rehabilitation, to decrease recidivism; and (3) a pediatric pedestrian

safety program.

174
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Camden Healthy Start Project, Southern New Jersey Perinatal Cooperative,

Pennsauken, $2,099,859 (Healthy Start-Community)

The Camden Healthy Start Project is a coordinated, collaborative effort of health

and social service providers, city agencies, community-based organizations, other

voluntary agencies, community leaders, and consumers. This comprehensive

proposal will decrease infant mortality and low birthweight births as well as

increase access and utilization of health and social services particularly in the

area of maternal and child health. The existing Healthy Mothers/Healthy Babies

effort of outreach will be greatly enhanced through the addition of the Momobile

under the Outreach Model of Intervention. In addition, the Risk Prevention and

Reduction Model will specifically address substance use and abuse as they affect

women, their infants, and their families. There will be an expansion of hours of

services, transportation, child care, and treatment locations throughout the city of

Camden. The Adolescent Program model will expand the School-Based Youth

Services Program and after-school programs to prevent and reduce the number of

adolescent pregnancies but also provide a significant and effective program for

adolescent males.

$1,355,791

$2,482,700

$3,838,491

Title V Program, contact:

Celeste Andriot Wood

Director of Community Health Services

PO Box 364 50 East State Street

Trenton, NJ 08625-0364

Phone: (609) 984-1384

Fax: (609) 292-9599

Title V Program’s services for Children

with Special Health Care Needs, contact:

Marilyn Gorney-Daley, D.O.

Acting Director of Special Child & Adult Health

Services

PO Box 364 50 East State Street

Trenton, NJ 08625-0364

Phone: (609) 984-0755

Fax: (609) 292-9599

500

1,500

2,000

2,500

3,000

3,500

4,000

1,000

3,057 3,028

2,104

175
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,736,931

27,318

The Family Health Bureau of the Public Health Division, New Mexico

Department of Health, administers the Title V MCH Program. It comprises the Bureau Chief; the MCH Medical Director; and programs with

staff for MCH Epidemiology, Maternal & Child Health unit including

County MCH Councils, Adolescent Health/Youth Development, and the

Children’s Medical Services serving CSHCN. The Title V Block Grant

administers contracts that include the Maternal and Infant Care (MIC)

Project of the University of New Mexico in Albuquerque. Title V funds

support immunization services, an epidemiologist position in Vital

Records Title V data needs and for the linked Medicaid +live birth

analysis project, and a health educator position in the Childhood Injury

Prevention program in the EMS/Injury Prevention Bureau. Programs

with other funding sources that serve the MCH population and that are

in the Family Health Bureau include the Nutrition and WIC Programs,

Dental Health Program, Families FIRST Perinatal Case Management

and Title X Family Planning.

5,105

26,226

95,805

12,256

26,540

165,932

$1,857,635

$504,204

$3,655,293

$4,631,727

$0

$0

$10,648,859

NEW MEXICO

$2,248,603

$12,972,462

$10,648,859

$75,000

176
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NEW MEXICO

8 of 9

100.8%

78%

48.3

7.9

73%

92.6%

11 of 18

1.1%

63.8%

7

1.6

4.2

2.8

6.4

30.1

8 of 9

100%

76%

44

8.5

75%

100%

16 of 18

1.0%

70%

7

1.6

4.5

2.5

4.7

28

Counties adopting the conceptual framework of Healthy Youth/Healthy Communities

through an Assets/Resiliency model approach when working with youth

First newborns/moms receiving support services/parenting through community

home visiting/ support programs

State Title V program has a coordinated program of maternal, fetal, infant, and child death review

State has a program for birth defects prevention and surveillance

48%

17%97

2

7

60%

26%

4

8

2

2

1

2

3

1

11

177
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Cultural Aspects of Health Care,

University of New Mexico, Albuquerque,

$30,000 (SPRANS-Training-Continuing

Education)

• Double Rainbow: Integrated Service

System Helping Families Reach the Pot of

Gold, Southwest Communication

Resources, Bernalillo, $115,658

(SPRANS-MCHIP-Integrated Services)

• Family Voices, Family Voices, Algodones,

$210,000 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

• Family Voices Partnership for Information

and Communication , Family Voices, Inc.,

Algodones, $124,998 (SPRANS-MCHIP-PIC)

• New Mexico Interdisciplinary Leadership

Education in Neurodevelopmental and

Related Disabilities (LEND) Program,

University of New Mexico, Albuquerque,

$441,045 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• New Mexico State Systems Development

Initiative , New Mexico Department of

Health, Santa Fe, $100,000 (SPRANSMCHIP-SSDI)

• Pediatric Pulmonary Center, University of

New Mexico, Albuquerque, $283,557

(SPRANS-Training-Pediatric Pulmonary

Center)

• Puentes Program (Taos Teen Parent

Support Program), Presbyterian Medical

Services, Santa Fe, $49,977 (SPRANSMCHIP-Healthy Tomorrows)

• Southwest/Rocky Mountain MCH Institute

Network, University of New Mexico,

Albuquerque, $25,000 (SPRANS-TrainingContinuing Education)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Community Managed Care Project,

Valencia County Coalition for Families,

Children, and Communities, Los Lunas,

$50,000 (CISS-CISS-COG)

• Community Oversight of a Local Child

Health System, Northern New Mexico

Health Care Alliance, Las Vegas, $50,000

(CISS-CISS-COG)

NEW MEXICO CONTINUED

NEW MEXICO

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Helping Indian Children of Albuquerque, All Indian Pueblo Council, Inc.,

Albuquerque, $50,000 (SPRANS-MCHIP-Healthy Tomorrows)

The first goal of this project is to improve access to and use of health care and

related resources by urban Indian children and their families. The second goal is

to improve the health status, functional ability, and developmental capability of

urban Indian children with limiting conditions and special needs. This long-term

health status goal, relevant to “Healthy People 2000” objectives, relates directly to

problems inherent in the current health system (i.e., inadequate access to and

utilization of services).

New Mexico Mental Health Advocates for Students, New Mexico Department

of Health, Santa Fe, $150,000 (SPRANS-MCHIP-Mental Health of School-Age

Children and Adolescents)

New Mexico children suffer from a very high rate of risk factors for serious

emotional disturbance, including poverty, domestic violence, and substance

abuse. The State of New Mexico would include primary mental health care as a

component of overall primary health care in school-based health centers, but

currently lacks the State-level collaborative infrastructure necessary to coordinate

and administrate this service statewide. The goals set for the proposed project

reflect the health system changes required to develop a sufficient infrastructure at

the State level to expand mental health services in the schools. The project

ultimately proposes a wide range of basic objectives that are expected to improve

health and education for students in both their family and community

environments, while also addressing the factors that result in high-risk behaviors.

Specific objectives include the development of advocacy and networking efforts to

increase the public awareness of children’s mental health needs and the role that

school could play in service delivery, the hiring of a State-level project coordinator,

an orientation conference, and as-needed trainings for school districts statewide,

and the establishment of permanent funding sources for school-based mental

health within each participating State agency.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Health Systems Development in Child Care Program, New Mexico

Department of Health, Santa Fe, $50,000 (CISS-CISS-Child Care Program)

The project seeks to develop a comprehensive system for health care in child care

settings in New Mexico that coordinates services provided by many agencies.

We will increase immunization rates for children; conduct health education and

safety education and promotion programs for children, families, and child care

providers; and expand and provide ongoing support to child care providers and

families caring for children with special needs.

178
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Through Assets Initiative, New Mexico Department of Health,

Santa Fe, $518,368 (Abstinence Ed)

The project purpose is to develop assets within youth, families, and communities

supporting abstinence from sexual, age inappropriate behavior, which places youth

at risk for pregnancy, sexual abuse, and sexually transmitted disease. Multiple

opportunities will be provided for family and youth participation in the planning,

implementation, and evaluation of the project both on the State and local level.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

EMSC State Partnership Grant for New Mexico, New Mexico Department of

Health, Santa Fe, $75,000 (EMSC-PRTNER)

The initial goal of this project is to accomplish a statewide emergency medical

services for children (EMSC) needs assessment and develop a strategic plan for

EMSC as a new component of the recently adopted Emergency Medical Services

(EMS) 2000/2005 Plan. The project is designed to ensure that the comprehensive

emergency care needs of children are appropriately addressed by the overall EMS

and trauma care system in a State where children of all ages have a

disproportionately high rate of injury.

$2,248,603

$75,000

$2,323,603

Title V Program, contact:

Marilyn Sakara

Acting Chief, Family Health Bureau, Public Health Division

New Mexico Department of Health

1190 St. Francis Drive

Santa Fe, NM 87502-6110

Phone: (505) 476-8587

Fax: (505) 476-8512

Title V Program’s services for Children

with Special Health Care Needs, contact:

Marilyn Sakara,

Children’s Medical Services Program Manager

Family Health Bureau

Public Health Division

New Mexico Department of Health

1190 St Francis Drive

Santa Fe, NM 87502-6110

Phone: (505) 827-2548

Fax: (505) 827-1697

500

1,500

2,000

2,500

3,000

3,500

4,000

1,000

3,500 3,550 3,575

179
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

18,175,301

258,207

The New York State Department of Health’s Division of Family and Local

Health administers the Title V Maternal and Child Health Services Block

Grant in New York State. The Title V program supports needs assessment, policy development and activities designed to improve the health

status of women, particularly those of reproductive age, as well as

infants and children, including children with special health care needs.

Funds are directed at supporting essential “gap-filling” maternal and

child health services, prevention programs, and safety net services for

the uninsured. The Division of Family and Local Health includes the

Bureaus of Women’s Health, Child and Adolescent Health, Dental Health

and Local Health Services. This division provides the leadership and

direction for the majority of Title V and Title V-related programs, including

Family Planning, Adolescent Pregnancy Prevention, Lead Poisoning

Prevention, School-Based Health Centers, Sudden Unexplained Infant

Death Program, Early Intervention and the Physically Handicapped

Children’s Care Coordination/Case Management Program.

424,516

259,192

5,492,930

60,763

302,709

6,540,110

$48,864,112

$96,890,731

$42,666,276

$328,377,306

$33,284,527

$28,951,734

$579,034,686

NEW YORK

$9,193,637

$595,995,548

$579,034,686

$7,767,225

180
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NEW YORK

9 of 9

100%

68%

23.297

2.797

58.9%97

11%97

7 of 1897

1.6%97

73.1%97

6.797

297

4.797

297

13.397

20.197

9 of 9

100%

72%

18

1.9

64%

18%

18 of 18

1.1%

78%

6.6

1.8

4.9

1.8

11.5

21

Black births less than 2.5 kg (per 100 live births)

Hospitalizations for self-inflicted injuries for 10- to 19- year olds (per 100,000)

Hospitalization rate for asthma in children aged birth to 14 years (per 100,000)

Women who smoke during pregnancy (per 100 women)

11.8%97

70.397

513.397

18.697

11%

72

420

10.0

2

1

1

1

1

1

7

181
Selected FY 98 Title V and

Other MCH Grant Annotations

NEW YORK CONTINUED

NEW YORK

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Managed Care for Children With Special Health Care Needs, New York State

Department of Health and Health Research, Inc., Rensselaer, $158,826

(SPRANS-MCHIP-Managed Care/Health Care Reform)

The purpose of the project is to develop guidelines and outcome indicators for

asthma, spina bifida, and sickle cell disease for managed care providers. The

delivery of services in a managed care framework can be beneficial for children

with special health care needs (CSHCN) because they will have access to a

primary provider on a continuous basis, there are no lifetime caps, and the

managed care organization has access to a network of specialty providers.

However, experience to date has suggested that managed care organizations

often do not have the proper providers within the network and they do not have

experience in determining medically necessary services. Bringing parents,

specialists, and managed care organizations together with the State’s DOH and

DSS in a collaborative model, the project will develop guidelines and outcome

indicators to assist managed care plans in improving access to medically

necessary services.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

New York City–Wide Perinatal Association, Brooklyn Perinatal Network, Inc.,

Brooklyn, $50,000 (CISS-CISS-COG)

The Collaborative of Perinatal Networks will be established by five communitybased perinatal networks in the New York City metro region, representing Bronx,

Brooklyn, Manhattan, Queens, and Suffolk. The collaborative will coordinate

service delivery and consolidate administrative functions to attract managed care

contracts in this era of diminished public health funding. The project will address

community needs for an integrated city-wide vehicle to coordinate services;

coordinate analysis of community and citywide needs; and develop cost-effective

community-based, service delivery systems, administrative systems, and a

management information system.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, New York State Department of Health, Albany,

$3,377,584 (Abstinence Ed)

The past 10 years have seen a rise in adolescent pregnancy in New York State.

Goals of the project are to develop and implement a 1) statewide, large-scale

media campaign through a public/private partnership with major advertising

agencies and 2) a community-based initiative to reduce adolescent pregnancy

through a competitive solicitation.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

New York City Emergency Medical Services for Children Resources , New

York University School of Medicine, New York, $150,000 (EMSC-Target)

The goals of this emergency medical services for children project are to (1) create,

distribute, and evaluate the “Teaching Resource for Instructors in Prehospital

Pediatrics for Paramedics and Intermediate EMTs” (TRIPP-PIE); and (2) institute

both a plan to update the TRIPP and the TRIPP-PIE on a regular basis and a

system to nationally apprise EMT and paramedic instructors of significant

changes in prehospital pediatric patient care strategies as they are developed.

Project objectives are to (1) develop and distribute the TRIPP-PIE, (2) measure its

effectiveness through the evaluation tool being developed, and (3) implement the

plan for updating the teaching resource.

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Alternatives for Developmental Screening

in Primary Care, Medical and Health

Research Association of New York City,

Inc., New York, $127,850 (SPRANSResearch)

• Birth Record Enhancements of the New

York State Medicaid Managed Care

Encounter System, New York State

Department of Health, Albany, $67,500

(SPRANS-MCHIP-Data)

• Childhood Disability: Assessing Equity of

Different Definitions, Albert Einstein

College of Medicine, Bronx, $37,500

(SPRANS-MCHIP-Data)

• Comprehensive Care for Infants and

Children with Sickle Cell Disease,

Brookdale University Hospital and

Medical Center, Brooklyn, $166,834

(SPRANS-Genetics)

• Data Utilization and Enhancement of Data

Systems for Maternal Child Health

Programs, Monroe County Health

Department, Rochester, $67,500

(SPRANS-MCHIP-Data)

• Education Program in Genetics for Primary

Care Providers, Cornell University, New

York, $125,000 (SPRANS-Genetics)

• Effect on Breastfeeding of Pacifiers and

Bottle Feeding, University of Rochester,

Rochester, $241,781 (SPRANS-Research)

• Family Professional Training and

Information Center, New York State

Department of Health and Health Research,

Inc., Albany, $0 (SPRANS-MCHIP)

• Family Support After an Infant Loss Home

Visit Program, Monroe County Department

of Health, Rochester, $75,759 (SPRANSMCHIP-SIDS)

• Geographic Information System to

Enhance and Support Maternal and Child

Health Data Analysis for Developing

Comprehensive Systems of Care, New

York State Department of Health, Albany,

$67,500 (SPRANS-MCHIP-Data)

• Harlem Adolescent and Child Total

Services, Northern Manhattan Network,

New York, $50,000 (SPRANS-MCHIPHealthy Tomorrows)

• Healthy Tomorows Partnership for

Children, East Harlem Pediatric Asthma

Working Group, New York, $49,741

(SPRANS-MCHIP-Healthy Tomorrows)

• Home Nursing to Avoid Pediatric

Hospitalization, University of Rochester,

Rochester, $327,207 (SPRANS-Research)

• Improved Prenatal Detection of the

Fragile X Mutation, Research Foundation

for Mental Hygiene, Inc., Staten Island,

$116,617 (SPRANS-Research)

• Improving Access to Genetic Screening

and Counseling for Tay-Sachs and Other

Relevant Diseases in the Hasidic

Community, New York State Department of

Health and Health Research, Inc.,

Rensselaer, $99,125 (SPRANS-Genetics)

182
TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Healthy Start/New York City, Medical and Health Research Association of New

York City, Inc., New York, $2,546,000 (Healthy Start-Mentor)

Healthy Start/NYC (HS/NYC) is a coordinated, collaborative, community-driven

effort of health and social services providers; city and State agencies; community

leaders, clients, residents, and organizations; and other voluntary agencies whose

goal is to significantly reduce infant mortality and improve maternal and child

health in three impoverished, inner city areas. HS/NYC seeks to (1) increase the

number of Service Area (SA) women aged 10–44 who benefit from health care and

social services, by providing comprehensive case management services that are

culturally and linguistically sensitive; (2) ensure that every SA pregnant woman

receives prompt, affordable prenatal care via case management and by

strengthening the links among providers offering this service and other health care

and social services; and (3) strengthen, empower, and mobilize HS/NYC’s

communities so they take responsibility for infant mortality and join forces to

eradicate it. To achieve its aims, HS/NYC has expanded and enhanced existing

city, State, and community-based initiatives. The project’s community-based

social/health case management programs have served a cumulative total of more

than 12,000 families. The dynamic interplay among project area and service area

lead agency initiatives is a unique feature of HS/NYC that assures both central

accountability and community leadership.

TRAUMATIC BRAIN INJURY

New York State Traumatic Brain Injury Demonstration Program for CulturallyCompetent Services in New York City, New York State Department of Health ,

Troy, $195,550 (Traumatic Brain Injury-Implementation)

Minority individuals with traumatic brain injury (TBI) in New York State have a

distinct need for culturally competent discharge materials. In addition, these

individuals and their families have a pressing need for support groups led by peers.

Both a plan to educate health care providers about TBI and improve the flow of

services for people with TBI and a sophisticated tracking system that equalizes

information and provides access to services at all provider sites are essential.

This project will address those problems and offer solutions at four selected

hospital sites in diverse communities within the New York City area.

$9,193,637

$7,767,225

$16,960,862

• Interdisciplinary Leadership Education in

Neurodevelopmental and Related Disabilities

(LEND) Project, Westchester Institute for

Human Development, Valhalla, $522,479

(SPRANS-Training-LEND/Leadership Ed Neuro

Dev)

• Interdisciplinary Leadership Education

Project, University of Rochester, Rochester,

$442,770 (SPRANS-Training-LEND/Leadership

Ed Neuro Dev)

• Interdisciplinary Leadership Training in

Neurodevelopmental and Related

Disabilities, Albert Einstein College of

Medicine, Bronx, $441,045 (SPRANS-TrainingLEND/Leadership Ed Neuro Dev)

• Mount Sinai-Cornell University Regional

Hemophilia Diagnostic and Treatment

Centers, Mount Sinai School of Medicine,

New York, $650,003 (SPRANS-Hemophilia)

• Network Coordination and Communication for

the Genetics Network of the Empire State

(GENES), Health Research, Inc./New York

State Dept. of Health, Albany, $299,797

(SPRANS-Genetics)

• New York Hospital - Cornell Medical Center

Cooley’s Anemia Project for Comprehensive

Care, New York Hospital, New York, $279,658

(SPRANS-Genetics)

• Pediatric Pulmonary Center Maternal and

Child Health Bureau Training Grant, Mount

Sinai School of Medicine, New York,

$369,165 (SPRANS-Training-Pediatric

Pulmonary Center)

• Program To Promote Access and Utilization of

Genetics and Maternal Health Services in the

Asian Community, New York Hospital , New

York , $125,000 (SPRANS-Genetics)

• Rochester MCH Leadership Education in

Adolescent Health, University

of Rochester, Rochester,

$299,362 (SPRANS-TrainingAdolescent Health)

NEW YORK

Other FY 98 MCH Grant Programs

183
Other FY98 MCH Grant Programs

• Social Work Training in Maternal and Child

Health Care, Syracuse University, Syracuse,

$28,624 (SPRANS-Training-Social Work)

• State Systems Development Initiative, New

York State Department of Health, Albany,

$100,000 (SPRANS-MCHIP-SSDI)

• To Improve and Integrate Health Services

Within a Community or Geographic Area for

Infants and Young Children with Sickle Cell

Disease Identified Through State Newborn

Screening Programs, Children’s Hospital of

Buffalo, Buffalo, $88,225 (SPRANS-Genetics)

• Training Program in Behavioral Pediatrics,

Albert Einstein College of Medicine, Bronx,

$191,185 (SPRANS-Training-Behavioral

Pediatrics)

Title V—COMMUNITY INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• Health Systems Development in Child Care

Program, New York State Department of

Health and Health Research, Inc., Albany,

$50,000 (CISS-CISS-Child Care Program)

• Homeless High-Risk Youth Community

Integrated Service System, Empire State

Coalition of Youth and Family Services, Inc.,

New York, $50,000 (CISS-CISS-COG)

• Rochester Early Enhancement Project:

Community Systems Building, Primary Mental

Health Project, Inc., Rochester, $50,000

(CISS-CISS-COG)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• New York State Department of Health

Emergency Medical Services for Children

Program, New York State Department of

Health, Troy, $73,425 (EMSC-PRTNER)

HEALTHY START

• Buffalo Healthy Start Initiative, Buffalo

Regional Task Force for Comprehensive

Prenatal-Perinatal Services Network

Development Inc., Buffalo, $702,364 (Healthy

Start-Community)

• Downstate Healthy Families Connections

Project, Center for Children and Families,

Inc., New York, $1,824,629 (Healthy StartCommunity)

• Healthy Start Rochester, Perinatal Network of

Monroe County, Inc., Rochester, $916,489

(Healthy Start-Community)

• Syracuse Healthy Start Initiative, Onondaga

County Health Department, Syracuse,

$1,358,768 (Healthy Start-Community)

NEW YORK CONTINUED

184
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

Title V Program, contact:

George T. DiFerdinando, M.D., M.P.H.

Director, Division of Family and Local Health

New York State Department of Health

Corning Tower Room 890

Albany, NY 12237-0657

Phone: (518) 473-7922

Fax: (518) 473-2015

Title V Program’s services for Children

with Special Health Care Needs, contact:

Christopher Kus, M.D.

Director, Bureau of Child and Adolescent Health

New York State Department of Health

Corning Tower Room 219

Albany, NY 12237-0618

Phone: (518) 474-2084

Fax: (518) 473-8673

13,000

39,000

52,000

65,000

78,000

91,000

104,000

26,000

35,500

98,000

27,495

185
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

	
	






	






 	!"#

	"





$
	%!&







'(






7,546,493

111,688

The Maternal and Child Health Block Grant is administered by the

NC Department of Health and Human Services, Division of Public

Health, Women’s and Children’s Health Section.

72,103

125,227

172,674

64,787

143,897

578,688

$48,146,061

$19,439,212

$49,049,895

$54,651,580

$14,938,326

$805,866

$187,030,940

NORTH CAROLINA

$5,405,993

$192,721,500

$187,030,940

$284,567

186
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NORTH CAROLINA

9 of 9

100%

83%

40.7

0

40%

24.4%

10 of 18

1.9%

83%

9.2

2.7

6.5

2.8

14.5

29.8

9 of 9

100%

90%

42.5

3.5

75%

75%

14 of 18

1.7%

85%

8.4

1.9

5.9

2.6

13

28

Children less than 6 with elevated lead blood levels

Women who gained more than 15 pounds during pregnancy

Children in regulated child care settings served by a qualified child care health consultant

Women who smoke during pregnancy

3.3%

87%

43.4%

15.1%

.8%

100%

85%

14.0%

2

2

2

2

1

1

10

187
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• African-American Children’s Transition to

School, University of North Carolina,

Chapel Hill, $213,509 (SPRANS-Research)

• Beyond Year 2000: Public Health Social

Work Practice, University of North

Carolina at Chapel Hill, Chapel Hill,

$25,000 (SPRANS-Training-Continuing

Education)

• Clinical Center for the Study of

Development and Learning, University of

North Carolina at Chapel Hill, Chapel Hill,

$580,260 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• Enhancing Data Utilization Skills Through

Information Technology, University North

Carolina at Chapel Hill, Chapel Hill,

$250,000 (SPRANS-MCHIP-Data)

• Future of Pediatric Education II Project,

Education of the Pediatrician Workgroup,

Wakeforest University School of

Medicine, Winston-Salem, $38,544

(SPRANS-Training-Continuing Education)

• MCH Public Health Social Work

Leadership Training Center, University of

North Carolina at Chapel Hill, Chapel Hill,

$117,131 (SPRANS-Training-Social Work)

• Pediatric Dentistry Center, University of

North Carolina at Chapel Hill, Chapel Hill,

$171,904 (SPRANS-Training-Pediatric

Denistry)

• Postgraduate Programs in Maternal and

Child Health, University of North Carolina

at Chapel Hill, Chapel Hill, $45,444

(SPRANS-Training-Physical Therapy)

• Public Health Nutrition Training: Maternal

and Child Health Training Grant, University

of North Carolina at Chapel Hill, Chapel

Hill, $154,152 (SPRANS-Training-Nutrition)

• Role of Early Family Supports in Adult

Self-Sufficiency, University of North

Carolina at Chapel Hill, Chapel Hill,

$169,065 (SPRANS-Research)

• Sickle Cell Young Child Health Initiative,

University of North Carolina, Chapel Hill,

$100,000 (SPRANS-Genetics)

• State Systems Development for Children

and Adolescents, North Carolina Division

of Maternal and Child Health, Raleigh,

$100,000 (SPRANS-MCHIP-SSDI)

• Training Program in Maternal and Child

Health, University of North Carolina at

Chapel Hill, Chapel Hill, $384,489

(SPRANS-Training-School of Public Health)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Southeastern Regional EMSC

Conference, Duke University Medical

Center, Durham, $24,601 (EMSC/TRNGContinuing Education)

NORTH CAROLINA CONTINUED

NORTH CAROLINA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Region IV North Comprehensive Hemophilia Centers, Wake Forest

University, Winston-Salem, $367,661 (SPRANS-Hemophilia)

This hemophilia project has established four regional goals: (1) Regional services

will support the hemophilia comprehensive care and prevention of complication

activities at treatment centers in Region IV North; (2) comprehensive services will

be provided for girls and women with congenital coagulation disorders; (3)

hemophilia nurse coordinators will have a reevaluation of needs, and will receive

technical assistance and professional support; and (4) comprehensive services

will be provided for parents and their young children with coagulation disorders.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Healthy Child Care North Carolina Initiative, North Carolina Department of

Environment, Health and Natural Resources, Raleigh, $50,000 (CISS-CISSChild Care Program)

The Healthy Child Care North Carolina Initiative addresses health and safety

issues related to child care through comprehensive statewide collaboration

between the child care and health care communities. The goal of this initiative is

to enhance the quality of child care by promoting linkages that increase the

number of qualified health consultants available to child care providers and families

while strengthening the quality of consultation through an integrated network of

education at the State level. The program will provide training and awareness

activities for pediatricians, local and regional health department staff, child care

licensure consultants, social service child care coordinators, family practice

physicians, dental health professionals, child care resource and referral agencies,

Head Start, early intervention specialists, and child care providers. The objectives

will be achieved through systematic, statewide planning, coordination, and

collaboration with over 55 agencies, associations, institutions, and provider groups.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education in North Carolina, NC Division of Maternal and Child

Health, Raleigh, $1,151,876 (Abstinence Ed)

Reducing the rates of sexual activity, unintended pregnancies and out-of-wedlock

births among teens are the goals. Enhancement of existing abstinence education

programs in the public schools is the strategy.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

North Carolina EMSC Partnership Grant, North Carolina Department of

Health, Raleigh, $60,000 (EMSC-PRTNER)

The goals of this project are to (1) continue to improve the integration of primary

care providers into the North Carolina emergency medical services for children

(EMSC) system, (2) provide continuing education in pediatric emergency care for

emergency medical services personnel and nurses, (3) develop a workshop on

preparedness for pediatric emergencies in emergency departments, and (4)

provide coordination and integration of EMSC activities.

188
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Healthy Start Baby Love Plus, North Carolina Department of Health, Raleigh,

$1,486,958 (Healthy Start-Community)

To address the most critical needs of pregnant women and infants in a sevencounty area in rural eastern North Carolina, to promote community involvement in

improving birth outcomes, and to reduce factors associated with high infant

morbidity and mortality, the North Carolina Division of Maternal and Child Health

and its consortium have identified five strategies to be carried out. They include

the following: (1) Support and empower a Community-Based Consortium; (2)

enhance existing care coordination; (3) provide casefinding services; (4) provide or

enhance the provision of specialized services that will prevent and reduce both

individual and systemic risk factors; and (5) provide facilitating services that will

reduce barriers to accessing services.

TRAUMATIC BRAIN INJURY

TBI Project A.C.C.E.S.S., North Carolina Department of Human Resources,

Raleigh, $199,966 (Traumatic Brain Injury-Implementation)

The goal of the project is to enhance the systems in place in North Carolina for the

care, education, and support of child and adolescent survivors of TBI and their

families. A replicable predischarge model that can be used in acute care sites will

be developed. This model will build on appropriate and timely identification, care

coordination, interagency collaboration, education and training, family support, and

improved data collection for purposes of program monitoring, research, and

outcomes evaluation. Specific program objectives are to (1) provide children

whose injuries do not require hospitalization with appropriate and timely screening,

intervention, education, and followup to help them function as closely as possible

to their pre-injury capacity; (2) provide children whose injuries do require

hospitalization with coordinated care and followup; (3) improve data collection

systems; (4) provide families with information and support throughout the recovery

process; (5) educate families and survivors, health care professionals, community

service providers, and the general public through the design/dissemination of

appropriate protocols, training, and education materials; and (6) design a model

that can be maintained and replicated.

$5,405,993

$284,567

$5,690,560

Title V Program, contact:

Kevin Ryan, MD, MPH

Section Chief

NC Dept of Health and Human Services

Women’s and Children’s Health Section

Mail Center 1916

Raleigh, NC 27699-1916

Phone: (919) 715-3400

Fax: (919) 715-3807

Title V Program’s services for Children

with Special Health Care Needs, contact:

Thomas J. Vitaglione, MPH

Head, Children and Youth Branch

NC Dept of Health and Human Services

Women’s and Children’s Health Section

Mail Center 1916

Raleigh, NC 27699-1916

Phone: (919) 715-3302

Fax: (919) 715-3187

4,500

13,500

18,000

22,500

27,000

31,500

36,000

9,000

32,684

26,196

30,871

189
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

638,244

7,932

The Title V Program in North Dakota is administered by two state

level departments. The Maternal and Child Health (MCH) Division of

the North Dakota Department of Health (DoH) supervises programs

related to women, infants, children, and adolescents while the

Children’s Special Health Services (CSHS) Division of the North

Dakota Department of Human Services (DHS) administers programs

related to children with special health care needs.

2,760

9,187

90,088

1,799

14,026

117,860

$434,437

$844,739

$1,134,363

$1,065,178

$123,200

$87,749

$3,689,666

NORTH DAKOTA

$276,220

$4,213,533

$3,689,666

$247,647

190
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NORTH DAKOTA

8 of 9

100%

83%

16.9

4.1

57.7%

39%

10 of 18

1%

84%

6.2

2.1

3.8

2.4

9.2

37.3

8 of 9

100%

83.5%

16.8

4.1

59%

41%

12 of 18

1%

85.5%

5.8

2.1

3.4

2.2

9.0

37.1

Rate of abuse and neglect in infants and children from birth to age 5 (per 1,000)

Medicaid-eligible children who receive dental services as part of their comprehensive services

Ratio of school nurses to students in North Dakota (per 1,000)

Ratio of Native American infant mortality rate to white infant mortality rate (per 1,000)

6.1

32.8%

.62

1.49

6.0

33.5%

.82

1.40

3

2

1

1

2

1

10

191
Selected FY 98 Title V and

Other MCH Grant Annotations

NORTH DAKOTA CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

North Dakota State Systems Development Initiative, North Dakota State

Department of Health , Bismarck, $100,000 (SPRANS-MCHIP-SSDI)

The North Dakota State Systems Development Initiative (SSDI) is a means by

which the Maternal and Child Health and Children’s Special Health Services State

agencies can combine efforts to develop and implement systems of services to

meet the primary preventive health care needs of all children and their families at

the community level. This involves the development of a State-level infrastructure

that supports the development of systems at the community level that will meet

the physical health care needs as well as the psychological and social health

related needs of children and their families. North Dakota’s SSDI promotes

incorporation of all key programs that address the health care needs of children

and their families into the State-level systems development infrastructure to

ensure a holistic approach to meet the health care needs of North Dakota’s

children and families. This is accomplished by working with the State, Regional,

and Tribal Children’s Services Coordinating Committees as well as State-level and

community agencies including local public health departments and county social

service offices.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

North Dakota Health Systems Development in Child Care Program, North

Dakota Department of Human Services, Bismarck, $50,000 (CISS-CISS-Child

Care Program)

Goals of the project are to provide safe and healthy child care environments for

North Dakota’s children including those with special health needs; make available

information regarding immunizations and easily accessible immunizations for

children in child care settings; make available access to quality health, dental,

and developmental screening and comprehensive followup for children in child

care; and provide health and mental health consultation, support, and education

for children and families receiving child care services and child care providers.

Ongoing support will be expanded and provided for the child care providers and

families caring for children with special health needs.

192
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

Title V—ABSTINENCE EDUCATION PROGRAM

North Dakota Abstinence Education Project, Maternal and Child Health

Division, Bismarck, $126,220 (Abstinence Ed)

Reduction in teen sexual activity, which results in teen pregnancy, out-of-wedlock

births, sexually transmitted diseases, and other associated health problems is the

goal of this project. This will be done within the local communities by enhancing the

awareness and knowledge about the importance of educating youth in abstaining

from sexual activity outside of marriage. Possible activities include: the use of the

“Baby Think It Over” program, use of existing services, and enhancement of current

school health programs through educational materials and lectures.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

North Dakota EMSC Planning Grant, University of North Dakota, Grand

Forks, $247,647 (EMSC-Implementation)

We will initiate a planning process leading toward the introduction of a statewide

emergency medical services for children (EMSC) program. One objective is to

establish an EMSC advisory board and four EMSC task force committees with

representation from health care providers. The project will be completed in

sequential stages: Organization; data collection and analysis; assessment and

recommendation; and coalition building and agenda setting,. Dissemination of the

report will be a key element in building a statewide coalition around the issue of

EMSC. Further, it will lay the groundwork for a process of intervention and change

to come later in the implementation stage.

$276,220

$247,647

$523,867

Title V Program, contact:

Sandra L. Anseth, R.N., B.S.N.

Director

Division of Maternal and Child Health

N.D. Department of Health

600 East Boulevard Avenue, Dept. 301

Bismarck, ND 58505-0200

Phone: (701) 328-2493

Fax: (701) 328.1412

Title V Program’s services for Children

with Special Health Care Needs, contact:

Tamara Gallup-Millner, R.N., B.S.N.

Deputy Director

Children’s Special Health Services

N.D. Department of Human Services

600 East Boulevard Avenue, Dept. 325

Bismarck, ND 58505-0269

Phone: (701) 328-2436

Fax: (701) .328-2359

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

10,986

9,804 9,788

193
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

70,000 (UN report)

1,462

Title V funds are administered by the Maternal and Child Health

Program under the Division of Public Health in the CNMI. It provides

preventive and primary services for pregnant women, mothers,

infants, children, adolescents, and children with special health care

needs. It conducts needs assessment , develops policies, plans

and programs to improve the quality of health for all of the population in maternal and child health. The program works with other

programs in ensuring provision of services, i.e., it collaborates with

the Public School System in early intervention program. Funds are

used to ensure delivery of health care services, i.e., recruitment of

personnel, and enables the Program to perform health education

and outreach activities.

1,201

1,421

15,876

448

5,764

24,710

$267,625

$175,633

$175,633

$478,532

$ 0

$96,781

$1,194,204

NORTHERN MARIANA ISLANDS

$1,044

$1,371,292

$1,194,204

$176,044

194
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

NORTHERN MARIANA ISLANDS

8 of 9

86.3%

27.8

0

97.2%

8 of 18

.6%

22.7%

8.4

7.7

.7

13.4

35.9

9 of 9

94%

20

20.9

100%

9 of 18

.6%

25.2%

7.2

6.9

1.5

6.1

32.77

Degree to which state provides nutrition education information to students aged 5-12

Overweight school-aged children

Pregnant women screened for chlamydia

Mothers who breast fed their infants at 6 weeks and at 4 months

19.8%

52%

17%

43.7%

45%

24%

18%

37%

3

1

2

1

0

1

8

* Data not available * Data not required 195
Selected FY 98 Title V and

Other MCH Grant Annotations

NORTHERN MARIANA ISLANDS CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Maternal and Child Health Services Federal Set-Aside Program,

Commonwealth of the Northern Mariana Islands Department of Public Health

and Environmental Services, Saipan, $98,856 (SPRANS-MCHIP-SSDI)

This project seeks to improve, upgrade, and expand three major local maternal

and child health (MCH) initiatives: (1) Surveillance and data gathering with the

Commonwealth Health Center computer information system, (2) community-based

educational programs for mothers and children, and (3) expanded outreach

services. These initiatives will enhance the current MCH Block Grant activities in

the Commonwealth of the Northern Mariana Islands. The project will prove

replicable in the other Micronesian governments and will serve as a model tracking

system to ensure that all children, young adults, and mothers receive

comprehensive health care.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Emergency Medical Services for Children Planning Grant, Commonwealth

of the Northern Mariana Islands Department of Public Safety, Saipan,

$175,000 (EMSC-Implementation)

The project goal is to extend emergency medical services and trauma systems

linking prehospital, hospital, and rehabilitation services to prevent death and longterm disability. This project will determine the most culturally appropriate

methods to improve access to health care for pediatric target groups by

developing mechanisms to reduce language barriers and educate adults to

pediatric services available, how to more quickly access the system and how they

may be more involved by learning to provide services themselves within their

subpopulations.

196
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$1,044

$176,044

$177,088

Title V Program, contact:

Margarita Torres-Aldan

Maternal and Child Health Coordinator

P.O. BOX 409 Chalan Kanoa

Saipan, MP 96950

Phone: (670) 234-8950 extension 2022

Fax: (670) 233-0214

Title V Program’s services for Children

with Special Health Care Needs, contact:

Margarita Torres-Aldan

Maternal and Child Health Coordinator

P.O. BOX 409 Chalan Kanoa

Saipan, MP 96950

Phone: (670) 234-8950 extension 2022

Fax: (670) 233-0214

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

5,000

9,600

N/A

197
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

11,209,493

152,794

The Ohio Department of Health administers the Title V Program.

The Department conducts a statewide assessment of needs,

develops policies, plans and implements programs to improve the

health of women, infants, children, adolescents and families in

Ohio. Programs within the Title V administrative structure which are

coordinated with the MCH Block grant include: Oral Health Services

programs to improve access to dental care; Part C Early Intervention program including Ohio Early Start (birth to three at-risk

services) and the Welcome Home Newborn Visitation Program; Title

X family planning services; WIC program; Primary Care and Rural

Health Services; AIDS Client Resources; and CDC’s School Health

Infrastructure Grant and Childhood Lead Poison Prevention Program.

20,562

152,567

55,646

31,572

35,283

295,630

$11,163,526

$4,742,675

$23,348,552

$32,687,973

$0

$1,021,499

$72,964,225

OHIO

$4,847,600

$80,392,825

$72,964,225

$2,581,000

198
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

OHIO

8 of 9

98%97

76.2%

28.4

4.3

53.9%

8%

18 of 18

1.5%97

84.8%97

7.897

2.497

5.297

2.697

14.997

24.397

9 of 9

100%

85%

26.9

3

53%

9%

18 of 18

1.36%

87%

7.0

2.1

5.0

2.4

14.4

24.8

Women receiving adequate prenatal care according to the Kotelchuck Index

Unintended pregnancy rate in women of childbearing age (per 1,000)

Children and adults who receive genetic evaluation and counseling through a regional

comprehensive genetic center (per 100)

Children with obvious need for dental care

47.8%

840.2

19.197

*

48.0%

725

20.6

20%

3

3

3

3

3

3

18

* Data not available 199
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Behavioral Pediatrics Fellowship

Training, Case Western Reserve

University, Cleveland, $111,115 (SPRANSTraining-Behavioral Pediatrics)

• Children with Special Health Care Needs

Continuing Education Institute, Children’s

Hospital, Columbus , $229,932 (SPRANSMCHIP-Managed Care/Health Care

Reform)

• Collaborative Office Rounds, Case

Western Reserve University, Cleveland,

$11,999 (SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Fellowship Training in Behavioral

Pediatrics, Columbus Children’s Hospital,

Columbus, $42,415 (SPRANS-TrainingBehavioral Pediatrics)

• Interdisciplinary Training Project in

Adolescent Health Care, Children’s

Hospital Medical Center, Cincinnati,

$336,889 (SPRANS-Training-Adolescent

Health)

• Ohio Systems Development Initiative,

Ohio Department of Health, Columbus,

$100,000 (SPRANS-MCHIP-SSDI)

• Pediatric Health Supervision to Promote

Literacy, Case Western Reserve

University, Cleveland, $68,510 (SPRANSResearch)

• Psychiatry Study Groups for Public/

Private Pediatricians, Children’s Hospital

Medical Center, Cincinnati, $12,000

(SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Psychosocial Sequelae of

Bronchopulmonary Dysplasia and Very

Low Birthweight-Phase Two, Case

Western Reserve University, Cleveland,

$390,715 (SPRANS-Research)

• Resident Curriculum in DevelopmentalBehavioral Pediatrics, Children’s

Hospital, Columbus, $39,931 (SPRANSTraining-Continuing Education)

• Toledo Healthy Tomorrows, Toledo

Hospital Children’s Medical Center of

Northwest Ohio, Toledo, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• University Affiliated Cincinnati Center for

Developmental Disorders (UACCDD)

Maternal and Child Health

Interdisciplinary Leadership Education for

Health Professionals Caring for Children

With Neurodevelopmental and Related

Disabilities (MCH LEND), University of

Cincinnati, Cincinnati, $883,587 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• Violence Prevention Training Institute,

Wright State University, Dayton, $189,333

(SPRANS-Training-Continuing Education)

• Web Site for Developmental and

Behavioral Pediatrics, Children’s

Hospital, Columbus, Columbus, $68,412

(SPRANS-Training-Continuing Education)

OHIO CONTINUED

OHIO

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Hamilton County Transitions Project: Phase One, Lighthouse Youth

Services Inc., Cincinnati, $189,395 (SPRANS-MCHIP-Adolescent Health)

Following upon an extensive needs assessment process, Hamilton County

Adolescent Transitions will undertake a program designed to help fill gaps in local

transitions planning efforts. The program will provide training for youth, parents,

and professionals, operate an Information and Referral Center, work with a target

group of youth involved in public systems to ensure transition planning is carried

out and meets individual needs, and establish a collaborative group to support

communications between and among youth, parents, and professionals.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Grandparent/Grandchildren Initiative, Wright State University, Dayton,

$50,000 (CISS-CISS-COG)

Current public policy does not support the special concerns of children in the

permanent but not legal custody of a grandparent. Frequently, grandparents

cannot register their grandchildren for school or obtain adequate health care. The

Grandparent/Grandchildren Initiative through the Center for Healthy Communities

in Dayton, OH, will convene a communitywide network of policymakers and

service providers to develop a coordinated, more responsive system of services for

“skip generation” families in the community. Goals of the project are to accurately

access the extent of the skip generation population in the community, increase

awareness and knowledge of skip generation family concerns among service

providers, and make necessary changes in public policy to better support skip

generation families.

Title V—ABSTINENCE EDUCATION PROGRAM

Ohio’s Abstinence Education Program, Ohio Department of Health,

Columbus, $2,091,299 (Abstinence Ed)

The Ohio Department of Health intends “to provide abstinence education, and

where appropriate, mentoring, counseling, and adult supervision to promote

abstinence from sexual activity, with a focus on groups that are likely to bear

children out of wedlock.” Ohio’s teen pregnancy problem is overwhelming.

Complicating the issue is the varying cultural and economic differences found in

each of the 88 counties. Ohio plans to build upon the existing model of local

autonomy developed by the Ohio Wellness Block Grant in pregnancy prevention

programming. Ohio will provide Federal funds to interested agencies through a

competitive grant process. Successful applicants will “custom” design and

implement programs that have an abstinence-only message.

200
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Enhancement of the State of Ohio’s EMSC System, Ohio Department of

Public Safety, Columbus, $60,000 (EMSC-PRTNER)

The project goals are to (1) improve and standardize care for out-of-hospital

pediatric patients through the use of standardized emergency medical technician

(EMT) protocols, with particular attention to the EMT-Basics; (2) raise the level of

understanding of emergency medical services directors in Ohio concerning

pediatric care provided by the EMT-Basics; (3) raise the understanding among

EMTs, school nurses, and child care center providers of children with special

health care needs; (4) improve and standardize first-aid training for child care

center personnel through the development and implementation of an updated

training curriculum and training program; and (5) raise the level of understanding

among child care center providers concerning the importance of injury prevention

and up-to-date first-aid training.

HEALTHY START

Greater Cleveland Healthy Family/Healthy Start Project, Cleveland

Department of Public Health, Cleveland, $2,521,000 (Healthy Start-Mentor)

The Greater Cleveland Healthy Family/Healthy Start Consortium’s goal is the

reduction of infant mortality rates among the city’s highest risk populations of

women. The consortium consists of institutional health care and social service

providers, volunteers, clergy, residents, managed care organizations, and project

participants and area residents who participant in the grassroots Neighborhood

Consortia. The consortium’s strategies in Phase II of the Healthy Start Initiative

include enrollment of at-risk pregnant and parenting women in the community into

outreach supportive services; prevention education and enrollment of adolescents

within the school system; education and advocacy on the part of incarcerated

women; and education of project staff, providers, and the community at large

regarding the preventable causes of infant mortality.

$4,847,600

$2,581,000

$7,428,600

Title V Program, contact:

Kathryn K. Peppe, R.N., M.S.

Chief, Div. of Family & Community Health Services

Ohio Department of Health

246 N. High Street

Columbus, OH 43215

Phone: (614) 466-1663

Fax: (614) 728-3616

Title V Program’s services for Children

with Special Health Care Needs, contact:

James Bryant, M.D.

Chief, Bureau for Children with Medical Handicaps

Ohio Department of Health

246 N. High Street

Columbus, OH 43215

Phone: (614) 466-1700

Fax: (614) 728-3616

7,000

21,000

28,000

35,000

42,000

49,000

56,000

14,000

49,792 49,907 50,176

OHIO

Other FY 98 MCH Grant Programs

Title V—COMMUNITY INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• Ohio’s Health Systems Development in

Child Care Project, Ohio Department of

Human Services, Columbus, $50,000 (CISSCISS-Child Care Program)

201
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

3,346,713

49,461

The Title V Program is administered by two state agencies. The Oklahoma State Department of Health (OSDH) administers programs for

women, infants and children; the Department of Human Services (DHS)

administers the program for children with special health care needs. The

OSDH Dental Service provides the Dental Education program. The

Maternal and Child Health Service includes the following programs:

Adolescent Health, School Health, Behavioral Health, Child Abuse

Prevention, Lead Poisoning Prevention, Early Childhood Development,

Family Planning, Health and Safety in Child Care, Immunization, MCH

Assessment and Systems Development, Maternity, Newborn Hearing

Screening, Newborn Metabolic Disorder Screening, Birth Defects

Registry, Genetics Service Network, Nutrition, Pediatrics, Social Work,

Regional MCH Systems staff, Early Intervention, Speech, Language and

Audiology, and Sudden Infant Death. DHS, Family Support Services,

includes three programs: Supplemental Security Income - Disabled

Children’s Program, CSHCN, and Crippled Children’s Program.

6,025

48,160

10,228

16,727

65,366

146,506

$3,862,918

$1,681,068

$3,511,186

$3,881,419

$519,943

$ 1,396,388

$14,852,922

OKLAHOMA

$1,515,975

$17,823,950

$14,852,922

1,455,053

202
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

OKLAHOMA

9 of 9

100%

78%

36.6

6.5

62.1%

11.2%

11 of 18

1.2%

78.3%

7.5

2.3

4.5

2.9

11.4

32.7

9 of 9

100%

90%

33.4

6.5

60.5%

40%

18 of 18

1.00%

82%

7.4

1.6

4.7

2.7

9.4

26

Women who have an unintended pregnancy (mistimed or unwanted) resulting in a live birth

Neural tube defects among live births in OK (per 1,000)

Adolescents, grades 9-12, smoking tobacco products

Fathers who are involved in the care-giving of their newborns

46.7%

5.19

33.0%

*

45%

6.5

32%

*

2

2

1

2

2

2

11

* Data not available 203
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Leadership in Pediatric Physical Therapy

Education, University of Oklahoma,

College of Allied Health, Oklahoma City,

$125,805 (SPRANS-Training-Physical

Therapy)

• Oklahoma Leadership Education Program

in Neurodevelopmental Disabilities and

Related Disorders, University of

Oklahoma, Oklahoma City, $300,000

(SPRANS-Training-LEND/Leadership Ed

Neuro Dev)

• Training Program in Communication

Disorders, University of Oklahoma,

Oklahoma City, $133,333 (SPRANSTraining-Communication Disorders)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Capacity Building Within Oklahoma’s

MCH Program: Assisting Local

Communities To Improve Their Service

Systems, Oklahoma State Department of

Health, Oklahoma City, $50,000 (CISSCISS-COG)

OKLAHOMA CONTINUED

OKLAHOMA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Oklahoma State Systems Development Initiative, Oklahoma State

Department of Health, Oklahoma City, $100,000 (SPRANS-MCHIP-SSDI)

The primary construct of this State Systems Development Initiative (SSDI) is to

provide support for Oklahoma communities engaged in systems development

concerning children with special health needs and their families. Within this

construct, two principal ongoing activities will be maintained: Building capacity

within local communities to perform local needs assessments and enhancing

local leadership skills necessary for translating local needs into policy and

improved systems intervention.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Oklahoma Health Systems Development in Child Care, Oklahoma

Department of Health, Oklahoma City, $50,000 (CISS-CISS-Child Care

Program)

In keeping with the “Healthy People 2000” goals and the Oklahoma MCHB Title V

Block Grant plan for the pediatric population and their families, the long-term goals

of this initiative are to: Decrease the morbidity and mortality from injuries in the

0–6 population attending child care programs in the State; decrease the incidence

of communicable disease in the 0–6 population attending licensed facilities in the

State; and establish a clearly defined vision to address the health and safety

needs of children in child care and their families. Short-term goals are to:

Strengthen and expand collaborative efforts in Oklahoma to provide healthy and

safe child care environments; implement the Healthy Child Care Campaign in

Oklahoma; and address the need for appropriate and available child care for

children with special needs.

Title V—ABSTINENCE EDUCATION PROGRAM

Oklahoma Abstinence Education Project Abstract, Oklahoma State

Department of Health, Oklahoma City, $756,837 (Abstinence Ed)

This project is to reduce teen pregnancy and sexually transmitted disease rates

by delaying the onset of sexual intercourse. Community-based projects from

among selected medically accurate and age-appropriate curricula will be funded to

promote sexual abstinence among youth 9-14 years of age.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

EMSC State Partnership , University of Oklahoma, Oklahoma City, $60,000

(EMSC-PRTNER)

The goals and objectives of this project are to (1) continue to work toward

allocation and appropriation of State funds for emergency medical services for

children (EMSC) in Oklahoma through the current EMSC Resource Center Act of

1995; (2) implement injury prevention curriculums for prehospital providers; (3)

increase public awareness of appropriate use of the 911 system, and develop

strategies to disseminate this information to primary care providers, clinics, and

health maintenance organizations; and (4) continue to develop, implement, and

update pediatric continuing education programs in collaboration with State

agencies.

HEALTHY START

Tulsa Healthy Start Initiative, Tulsa City-County Health Department, Tulsa,

$1,320,131 (Healthy Start-Community)

To address the more critical needs of Tulsa’s maternal and infant population and to

204
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

reduce factors associated with high infant mortality rates, consortium planners of the

Tulsa Healthy Start initiative set its goal as reduction of the infant mortality rate of

the project area by 50 percent. Its subgoals are to increase the rate of entry into

first trimester care by 20 percent; decrease the rate of unintended pregnancies by 5

percent; increase the utilization rate of WIC for women by 23 percent, for infants by

25 percent, and for children by 47 percent; and to increase the rate of completed

immunizations by children 2 years of age by 10 percent. The Tulsa Area Perinatal

Coalition will expand its activities in partnership with Tulsa City-County Health

Department to support each project goal, subgoal, and objective. Consortium

membership recruitment, development of an information management system,

expansion of care coordination and case management through existing consortium

members and field-based services, door-to-door and school-linked outreach and

client recruitment, expansion of existing translation and transportation services, and

social marketing in support of community awareness and reduction in missed

prenatal and well-baby appointments will form core project activities. Selected

activities derive from data that substantiate identified needs for enhanced and

expanded services in problem domains corresponding to each core activity.

TRAUMATIC BRAIN INJURY

Oklahoma Traumatic Brain Injury Services Planning Project, Oklahoma State

Department of Health, Oklahoma City, $74,922 (Traumatic Brain Injury-Plan)

The overall goal of this project is to establish the infrastructure and an action plan to

implement a statewide system of comprehensive and coordinated services for persons

with traumatic brain injury. Services must (1) ensure access; (2) include all relevant

disciplines and provide for consumer participation; (3) ensure cultural competence of

consumers and providers in the system; (4) effectively use public, private, and

government resources; and (5) build core capacity so that the system or services will

be sustained beyond the project period. Although the degree of consequent disability

relates directly to the location and severity of the brain injury, appropriate acute,

rehabilitation, and ongoing community-based services are essential to reduce the

survivor’s level of impairment, impede the disabling process, and provide opportunities

for the patient and the family to learn ways to maintain health, independence, and

quality of life, including physical, psychosocial, and cultural dimensions.

$1,515,975

$1,455,053

$2,971,028

Title V Program, contact:

Edd D. Rhoades, MD, MPH,

Chief, Maternal and Child Health Service

Oklahoma State Department of Health

1000 N.E. Tenth Street

Oklahoma City, OK 73117-1299

Phone: (405) 271-4477

Fax: (405) 271-1011

Title V Program’s services for Children

with Special Health Care Needs, contact:

Raymond Haddock

Division Administrator, Family Support Services

Oklahoma Department of Human Services

 P.O. Box 25352

Oklahoma City, OK 73125

Phone: (405) 521-3079

Fax: (405) 521-4158

700

2,100

2,800

3,500

4,200

4,900

5,600

1,400

400

4,834

338

205
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

3,281,974

45,273

The Oregon State Health Division, of the Dept of Human Resources,

administers the Title V Program. The services located in the Title V

agency include grants to counties, policy and program development

and evaluation, population-based assessment and surveillance, and

leadership and coordination of health systems and services for MCH

populations, including high-risk pregnant women, infants and

children, adolescents, and children with special health care needs.

35,729

14,118

27,227

7,748

*

84,822

$2,867,985

$5,337,756

$7,180,720

$3,258,894

$1,613,661

$445,081

$20,704,097

OREGON

$2,814,634

$25,497,885

$20,704,097

$1,979,154

206
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

OREGON

9 of 9

100%

75%

26.4

4.897

66%97

12.2%

5 of 18

.9%

79.9%

5.697

1.597

3.497

2.297

8.297

23.797

9 of 9

100%

90%

25

4

75%

19%

10 of 18

1%

90%

5.2

3.1

2.9

1.9

8.7

22

Pregnancies among women 15-44 that are intended

8th graders free of involvement in the previous month from tobacco

Low income children 1-4 with iron deficiency

CSHCN receiving care coordination services

52%

*

*

*

57%

85%

16%

45%

2

1

1

1

0

0

5

* Data not available 207
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Building Community-Based Systems of

Care for Maternal and Child Health,

Oregon Health Division, Portland,

$100,000 (SPRANS-MCHIP-SSDI)

• Community Consultants in the Care of

Children with Special Health Care Needs,

Oregon Health Sciences University,

Portland, $0 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

• Community Perinatal Service Systems

Development Project, Oregon State

Health Division, Portland, $187,370

(SPRANS-MCHIP)

• Community Solutions Project, Oregon

Health Sciences University, Portland,

$189,395 (SPRANS-MCHIP-Adolescent

Health)

• Community Water Floridation Planning for

Oregon, Oregon Department of Human

Resources, Portland, $30,000 (SPRANSMCHIP-Fluoride)

 • Higher Education Curricula for Integrated

Service Programs, Teaching Research

Division , Monmouth, $285,000 (SPRANSMCHIP-Integrated Services)

• Kids’ Clinic, Eugene School District 4J,

Eugene, $50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

• Latino Medical Access Coalition, Well

Child Care Project, Sacred Heart Medical

Center Foundation, Eugene, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Maternal and Child Health Leadership

Education in Oregon, Oregon Health

Sciences University, Portland, $613,409

(SPRANS-Training-LEND/Leadership Ed

Neuro Dev)

• Next Steps: The Oregon Spina Bifida

Project—Building a Community-Based

Health Delivery System for Children with

Special Health Care Needs, Oregon

Health Sciences University, Portland, $0

(SPRANS-MCHIP)

• Pacific Northwest Regional Genetics

Group (PacNoRGG), Oregon Health

Sciences University, Eugene, $264,911

(SPRANS-Genetics)

• Region X Comprehensive Hemophilia

Diagnosis and Treatment Centers , Oregon

Health Sciences University, Portland,

$208,661 (SPRANS-Hemophilia)

• Triggering ‘Need to Know’: Barriers to

Learning Genetics, Oregon Health

Sciences University, Portland, $124,935

(SPRANS-Genetics)

OREGON CONTINUED

OREGON

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Families as Participants: Working Within a Managed Care System, Oregon

Health Sciences University, Portland, $150,877 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

The Families as Participants Project: Working Within a Managed Care System

(FAP) is funded to promote partnerships between families of children with special

health care needs (CSHCN) and managed care plans (MCPs). The project works

to ensure that family input, cultural appropriateness, and services available to

CSHCNs will not be neglected as health care reform is enacted. Information and

mentoring will be provided for diverse families of CSHCN to help them become

responsible consumers, and to make their needs and preferences heard at the

individual and the policy level. As FAP helps both CSHCN families and MCPs

learn of the needs and limitations of the other, it is intended that MCPs will

develop systems for open and clear communication with all enrollees. Effective

collaboration will promote the development of procedures in which problems are

resolved to both parties’ satisfaction.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Community Outreach and Action for Children Who Are Hispanic (COACH),

Oregon Health Sciences University, Portland , $50,000 (CISS-CISS-COG)

The project seeks to increase access to and use of health and related services for

these children in a Hispanic community in Oregon and to increase the cultural

competence of care providers and the service system that serves these children.

A community health worker outreach program based on the Promotora model of

working with community members to increase use of health services will be

developed within the Care Coordination Program and a cultural competence plan

will be developed in the Oregon Services for Children with Special Health Needs

service delivery system.

Title V—ABSTINENCE EDUCATION PROGRAM

Oregon Students Today Aren’t Ready for Sex (STARS), Oregon Health

Division, Portland, $460,076 (Abstinence Ed)

STARS’ purpose is to reduce teen pregnancy through an abstinence-only

education program delivered to 6th and 7th grade students by teen leaders who help

students learn and practice the refusal skills they need to resist peer pressure

and delay sexual involvement. The goal of the STARS program is to assist in

achieving the Oregon Benchmark of 15 pregnancies per 1,000 females aged 10-17

years of age by the year 2000.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Oregon Improvements for Emergency Medical Services for Children,

Oregon Health Division, Portland, $75,000 (EMSC-PRTNER)

To integrate with more modern data base managers, the Oregon Trauma Registry

(OTR) must be updated to a more compatible format. Data elements specific to

medically ill children will be integrated into the pediatric component of the OTR,

which now collects data on injured children only. The new data base will be

named the Oregon Trauma/EMSC Registry, and it will collect information on

children with either an injury or a medical ailment. Data from the updated registry

will be used to further establish statewide standards and policy for emergency

medical, trauma, and critical care services for children. Registry information will

also be used by State and local entities to assess and plan strategies for the

prevention of injury and illness, evaluate and monitor quality of care, and conduct

research on emergency medical services for children. 208
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Healthy Start Phase II Replication Initiative for White City, Oregon, Jackson

County Department of Health and Human Services, Medford, $919,211

(Healthy Start-Community)

The most salient objectives of this project in rural White City, OR, are to (1)

complete initial risk assessment on all clients, both prenatal women and infants,

and assist 90 percent of those who need special risk reduction referral services to

obtain helpful and appropriate followup; (2) ensure that all women of childbearing

age, as well as pregnant women, have adequate and affordable access to primary

and perinatal health care services; (3) significantly reduce the infant mortality rate;

(4) significantly reduce the number of infants with positive drug screens at birth; (5)

significantly increase infant birthweights; (6) significantly increase the rates of

adequate prenatal care; (7) significantly decrease the incident rate of adolescent

pregnancies; and (8) significantly improve child nutrition and growth rates for

children ages birth to 5 years.

TRAUMATIC BRAIN INJURY

Improving Access to Services for Individuals With TBI in Oregon, Oregon

Department of Education, Salem, $69,971 (SPRANS-Traumatic Brain

Injury-Plan)

The goals of the project are to (1) conduct a statewide needs assessment to

identify gaps in available services and barriers to accessing existing services for

individuals with traumatic brain injury (TBI) in Oregon and their families and (2)

develop an action plan to improve access to services for this population by making

currently fragmented services more accessible and coordinated.

$2,814,634

$1,979,154

$4,793,788

Title V Program, contact:

Donalda Dodson, R.N., M.P.H.

Center Director

Center for Child and Family Health

Oregon Health Division

800 N.E. Oregon Street, Suite 825

Portland, OR 97232

Phone: (503) 731-4398

Fax: (503) 731-4083

Title V Program’s services for Children

with Special Health Care Needs, contact:

Clifford J. (Jerry) Sells, M.D., M.P.H.

Director

Child Development and Rehabilitation Center

P.O. Box 574

Portland, OR 97207

Phone: (503) 494-8369

Fax: (503) 434-6868

2,100

6,300

8,400

10,500

12,600

14,700

16,800

4,200

15,459 15,922

12,302

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Integrating Public Health Into Child Care,

Oregon Department of Health, Portland,

$50,000 (CISS-CISS-Child Care Program)

HEALTHY START

• Multnomah County Health Department,

Multnomah County Health Department,

Portland, $914,972 (Healthy StartCommunity)

OREGON

Other FY 98 MCH Grant Programs

209
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

19,000 (U.N. Report)

377 (based on CIA

estimate 19.88

births/1000)

The MCH Title V fund is administered by the Director of the Bureau of

Public Health under the Direction of the Ministry of Health. The Ministry of

Health’s finance office works closely with the National Treasury which is

under the Ministry of Administration in monitoring the funds. The National

Treasury is responsible for preparation and timely submission of the

annual Financial Status Reports. The MCH program works with other

entities of the Ministry of Health in data collection, needs assessment

and surveys, as well as promotional activities. The Director of Public

Health works closely with the Minister of Health in policy development as

well as program plans effecting services for women, pregnant women

and mothers, children, adolescent, children with special health needs,

and families. A team consisting of the Chief of the Division of Primary

and Preventive Services, administrator, and coordinator, assist the

Director in the implementation of program plans. The Interagency office

serves as the link for all other agencies in providing coordinated

services for children with special needs including those who are at risk

for developing disabling condition.

474

397

6,621

261

*

7,753

$51,391

$17,130

$25,695

$51,391

$148,052

$17,130

$310,789

PALAU

$149,995

$460,784

$310,789

$ 0

210
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

PALAU

9 of 9

*

97%

16.2

0

100%

*

11 of 18

.4%

31.4%

10.7

*

10.7

0

14.3

66.7

9 of 9

*

99%

19.8

20

100%

*

14 of 18

1%

65%

8.8

*

4

3

10.9

32

Mothers who exclusively breastfeed their babies up to age 3 months and 6 months

Children aged 13-14 and 16-17 who receive risk behavior assessment and

counseling as a part of their annual physical exam.

Anemia screening for infants born with low birth weight

Develop support system for parents and families that address their needs for

parenting skills discipline, and other lifecycle issues

56%

12%

80%

7

75%

40%

95%

8

2

2

2

2

1

2

11

* Data not available 211
Selected FY 98 Title V and

Other MCH Grant Annotations

PALAU CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Palau Interagency Coordinating Project, Ministry of Health, Koror, $100,000

(SPRANS-MCHIP-SSDI)

The primary goal of the project is to build on the progress made during the first

project period and continue to make culturally relevant and sustainable advances

in infrastructure development related to building systems of care for all children,

including those with special needs and their families. Objectives include clinical

management of children with special needs, public awareness of those with

special needs, and disabilities legislation. Family and community involvement are

emphasized in all aspects of the project.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Palau Child Care Center and Child Care Skills Training Facility, Republic of

Palau, Koror, $49,995 (CISS-CISS-Child Care Program)

The Ministry of Health will incorporate the HSDCC funding into already existing

plans for a child care program. We will: (1) Organize and staff a fully functioning

child care center and; (2) develop an on-island Child Care Skills Training Center for

people who provide child-centered services and anyone wishing to develop these

skills for employment in the private sector. We will develop a child care skills

curriculum and training modules, and identify on-island trainers to be used.

212
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$149,995

$0

$149,995

Title V Program, contact:

Caleb Tyn. Otto, MBBS, MHA

Director, Bureau of Public Health

P. O. Box 716

Koror, Palau , 96940

Phone: (680) 488-1757 or 488-3116

Fax: (680) 488-3115

Title V Program’s services for Children

with Special Health Care Needs, contact:

Joaquina Ulenghong

MCH Coordinator

P. O. Box 96940

Koror, Palau , 96940

Phone: (680) 488-1757 or 488-3116

Fax: (680) 488-3115

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

9,880

N/A N/A

213
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

12,001,451

145,899

The Title V Maternal and Child Health Services Block Grant is administered by the Bureau of Family Health in the Pennsylvania Department

of Health. Within the Bureau of Family Health, staff in the Divisions of

Maternal and Child Health and Special Health Care Programs conduct

a statewide assessment of needs, and develop plans and programs to

improve the health of pregnant women, infants, and children, including

children with special health care needs. The Bureau of Family Health

also includes the state’s WIC program.

43,667

9,290

67,084

33,593

63,340

216,974

$3,930,708

$2,798,803

$49,784,044

$11,538,260

$11,935,696

$1,413,587

$81,401,099

PENNSYLVANIA

$4,297,421

$94,487,911

$81,401,099

$8,789,391

214
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

PENNSYLVANIA

7 of 9

100%

80%

21.8

4.4

55.1%

10.4%

11 of 18

1.5%

82.4%

7.6

2.9

5.3

2.3

21.8

21.8

9 of 9

100%

90%

19

3.4

54%

15%

18 of 18

1.2%

88%

6.9

2.2

5.0

2.2

10.8

19.3

Death rate among children (ages 1-14) resulting from unintentional injuries per 100,000

Ratio of trained child care health consultants to the number of regulated child care centers

Percent of child deaths (0-19) reviewed by a local child death review team

Percent of sexually active teens aged 15-17 using Title V Family Planning Program

9.097

1:3097

70%97

33.4%

8.8

1:24

50%

38%

3

2

0

2

3

1

11

215
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Birth Defects Surveillance System,

Pennsylvania Department of Health,

Harrisburg, $99,129 (SPRANS-MCHIPSSDI)

• Center for Leadership in Pediatric

Physical Therapy, Allegheny University of

the Health Sciences, Philadelphia,

$123,087 (SPRANS-Training-Physical

Therapy)

• Early Cortisol Replacement to Prevent

BPD: Pilot Study, Pennsylvania State

Universtiy, Hershey, $165,764 (SPRANSResearch)

• Establishing a Leadership Education in

Neurodevelopmental and Related

Disabilities Program at Children’s

Seashore House and University of

Pennsylvania, Children’s Seashore

House, Philadelphia, $410,282 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• Joint Public Health Social Work Training,

University of Pittsburgh, Pittsburgh,

$159,864 (SPRANS-Training-Social Work)

• Nurse-Midwives, Leaders in MCH

Planning, University of Pennsylvania,

Philadelphia, $198,737 (SPRANS-TrainingNursing)

• Preparing Pediatricians for Careers in

Academic Behavioral Pediatrics: The

MCH/PENN Partnership, Children’s

Hospital of Philadelphia, Philadelphia,

$110,593 (SPRANS-Training-Behavioral

Pediatrics)

• Project REACH: Replication, Education,

and Action for Children’s Health Care,

University of Pittsburgh, Pittsburgh,

$38,413 (SPRANS-Training-Continuing

Education)

• Regional Hemophilia and Diagnostic

Treatment Center, Thomas Jefferson

University Hospital, Philadelphia,

$574,098 (SPRANS-Hemophilia)

• University, Community, Leaders and

Individuals with Disabilities: The “UCLID”

Center at the University of Pittsburgh,

University of Pittsburgh, Pittsburgh,

$300,000 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• York City Project Girl Achieving Pure

Potential, Crispus Attucks Association,

York, $197,384 (SPRANS-MCHIP-Girl

Power)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Healthy Child Care Pennsylvania,

Pennsylvania Chapter of the American

Academy of Pediatrics, Rosemont,

$50,000 (CISS-CISS-Child Care Program)

PENNSYLVANIA CONTINUED

PENNSYLVANIA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

York City Project Girl Achieving Pure Potential, Crispus Attucks

Association, York, $197,384 (SPRANS-MCHIP-Girl Power)

Girls and young women are faced with many unique problems obstructing their

paths to success. Negative gender-based messages can damage a girl’s selfesteem, and disparities in education, economics, and health care can impede her

ability to achieve and reach her goals. Girls living in impoverished communities

and those faced with the problems of racism and lack of cultural diversity are in

need of assistance to improve their self-esteem and encourage healthy life

choices. The services offered through this program will empower girls to make

smart decisions, respect one another, and reach for their full potential. Evaluation

will focus on decreasing the rates of school dropouts, teen pregnancy, STD

transmission, and risky behaviors.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Realizing the Potential for Integrating Managed Care and Community-Based

Maternal and Child Health Services in Philadelphia, Philadelphia

Department of Public Health, Philadelphia, $50,000 (CISS-CISS-COG)

The goal of the project is to facilitate the integration and coordination of

community based maternal and child health support services with services

provided under Medicaid managed care. There are four concert objectives to

accomplish this goal: 1 ) to increase the ability of CBO’s to operate in a managed

care environment, and to improve their readiness to negotiate with. and market

their services to, managed care organizations (MCO’s); 2) to inform and educate

Medicaid managed care organizations about the opportunities for, and the

importance of collaborating with community-based agencies; 3) to establish an

ongoing assessment process that will identify both the opportunities for, and the

barriers to CBO and MCO collaboration and service system integration; and, 4) to

create a mechanism for sharing information and promising CBO and MCO

collaborative agreements, as well as identifying practical solutions to overcome

barriers to such agreements.

Title V—ABSTINENCE EDUCATION PROGRAM

Pennsylvania Abstinence Education & Related Services, Pennsylvania

Department of Health, Bureau of Maternal and Child Health, Harrisburg,

$1,820,070 (Abstinence Ed)

The overall goal is to reduce pregnancies among teens, ages 15-17, without a

corresponding increase in the abortion rate. Activities include community-driven

abstinence education, mentoring, counseling, parental supervision programs, and

services. Others include a statewide media campaign, professional, peer, and

parent training and technical assistance, and curricula building within schools.

The plan identifies the role of teens, parents, peers, professionals, school,

government health departments, and media in abstinence education and related

services and defines relevant strategies and interventions for each.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Predicting the Need for Hospitalization in Childhood Asthma, University of

Pennsylvania, Philadelphia, $293,785 (EMSC/Research)

This project aims to (1) identify those signs and symptoms that are associated

with the need for hospitalization in acute asthma of children and (2) develop and

validate a clinical prediction rule to differentiate those children requiring admission

from those capable of discharge. The creation of a new tool to improve accuracy

216
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

of prediction of short-term outcomes in acute childhood asthma will reduce both

inappropriate admission and discharge, with enormous potential for reducing both

economic costs and morbidity. Approximately 768 children, mostly AfricanAmerican, ages 2 years and older, treated in the emergency department of the

Children’s Hospital of Philadelphia for acute asthma will comprise the sample for

this study.

HEALTHY START

Healthy Start/Pittsburgh and Allegheny County, Allegheny County Health

Department, Pittsburgh, $5,000,000 (Healthy Start-Mentor)

Healthy Start/Pittsburgh and Allegheny County is a collaborative, communitydriven initiative to reduce the rate of infant mortality by 50 percent over 4 years

through improved access to health services and holistic interventions to address

quality of life issues affecting women of childbearing age. Strategies include

expansion and coordination of health care and social services; outreach via media

exposure, a telephone “Help Line,” and indigenous workers; individualized case

management and home visiting by core teams, public health nurses, and social

workers; and monitored referral to a wide range of community-based services,

including family planning, substance abuse treatment, transportation, and child

care. Local specialty service needs are defined by the six regional consortia, and

appropriate providers of the services are identified through an RFP process.

Through ongoing collaboration with public officials, hospitals, community health

centers, private practitioners, school districts, and health and human service

agencies, Healthy Start has established professional partnerships as well as

community-based networks to maximize existing resources, ensure increased

accessibility to and acceptability of services to mothers at risk for poor pregnancy

outcomes and their infants, and enhance the potential for continuation of services

when Federal grant funding ends.

$4,297,421

$8,789,391

$13,086,812

Title V Program, contact:

Daniel L. Brant

Acting Director

Bureau of Family Health Room

733 Health & Welfare Building

P.O. Box 90

Harrisburg, PA 17108

Phone: (717) 787-7192

Fax: (717) 772-0323

Title V Program’s services for Children

with Special Health Care Needs, contact:

C. Gail Stock

Director

Division of Special Health Care Programs Room

724 Health & Welfare Building

P.O. Box 90

Harrisburg, PA 17108

Phone: (717) 783-5436

Fax: (717) 772-0323

15,000

45,000

60,000

75,000

90,000

105,000

120,000

30,000

47,407

85,332

41,238

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Applying Biomechanical Epidemiology to

Injury Prediction, Children’s Hospital of

Philadelphia, Philadelphia, $ (EMSC)

• Developing a Pediatric Severity of Illness

Model for Transport Systems Evaluation

and Triage, University of Pittsburgh,

Pittsburgh, $144,220 (EMSC-Target)

HEALTHY START

• Healthy Start Chester, Crozer-Keystone

Health System, Chester, $384,823 (Healthy

Start-Community)

• Healthy Start Initiative for Chester County,

PA, Maternal and Child Health Consortium

of Chester County, Inc., West Chester,

$445,563 (Healthy Start-Community)

• Healthy Start Initiative, Philadelphia

Department of Public Health, Philadelphia,

$2,521,000 (Healthy Start-Mentor)

PENNSYLVANIA

Other FY 98 MCH Grant Programs

217
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

12,001,451

145,899

The Assistant Secretariat for Health Promotion and Protection of the

PRDH administers the MCH/CSHCN programs. In Puerto Rico,Title

V programs supports directs services not covered in the GIP and in

areas out of the HCR. Title V funds are also used to support needs

assessment and other activities geared to improve the health status

of WCBA, infants, children and CSHCN. Among the most relevant

programs which are implemented with Title V funds we want to high

light the following: The Home Visiting Program, and the Comprehensive Adolescent Program. The Title V provide leadership and

supervision to other related programs, such as SSDI, Healthy Start,

Early Intervention and Abstinence Education and Perinatal Alcohol.

26,865

7,236

22,323

10,123

49,787

116,334

$5,310,519

$3,156,658

$8,679,153

$10,009,837

$0

$1,443,371

$28,599,538

PUERTO RICO

$2,052,757

$31,823,470

$28,599,538

$1,171,175

218
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

PUERTO RICO

8 of 9

96.5%

87.9%

51.9

3.4

48.4%

1%97

7 of 18

1.3%

78.2%97

10.8

*

8.197

3.197

1797

25.197

7 of 9

95%

90%

54

3.0

56%

5%

11 of 18

1.1%

87%

8.5

6.0

2.5

15

25.5

Establish a home visiting program in at least 90% of the island by the year 2,000

Incidence rate of neural tube defects (NTD’s) (per 1,000)

Birth rate among girls 10-14 years of age (per 1,000)

Death rate for children aged 1-14 caused by asthma (per 1,000)

**

**

**

**

90%

1.3

2.1

.5

2

2

0

2

1

0

7

* Data not available * Data not required 219
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• COFANI Medical Home of Coamo, COFANI

Medical Home, Inc., Coamo, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Improvement of the Role of Primary Care

Providers in the Delivery of Genetic

Services in Puerto Rico, University of

Puerto Rico, San Juan, $125,000

(SPRANS-Genetics)

• Maternal and Child Health Project,

University of Puerto Rico, San Juan,

$233,716 (SPRANS-Training-School of

Public Health)

• Puerto Rico State Systems Development

Initiative, Puerto Rico Department of

Health, San Juan , $95,023 (SPRANSMCHIP-SSDI)

PUERTO RICO CONTINUED

PUERTO RICO

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Increasing Breastfeeding in Puerto Rican Women, Centro Pediatrico de

Lactancia y Crianza, Inc., San Juan, $50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

The purpose of Proyecto Lacta is to improve health status, functional ability, and

developmental capabilities of medically indigent infants who receive services at the

San Juan Public Health Clinics through the goal of increasing the breastfeeding

rates, identified as being well below the goals of “Healthy People 2000.” The

objective of the project is to increase by 100 percent the exclusive breastfeeding

rates at 1 month among the medically indigent through education of the health

care professionals that serve this population, and provide affordable clinical

services directly to the mother-infant pair with difficulties by a lactation consultant

with supervision of a pediatrician. The first of yearly studies on breastfeeding

rates in a private and a public hospital was completed, evaluated, and improved.

The second study is underway. Education of health care professionals was

performed in all CDTs through 1- to 2-hour small group programs. Staff has

participated in activities coordinated by other community organizations as well as

providing their expertise to governmental agencies. Telephone support for the

health care professionals and mothers is provided. Spanish literature for patients

and health care providers is available at the Web site.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Puerto Rico Health System Development in Child Care Project, Puerto Rico

Department of Health, San Juan, $50,000 (CISS-CISS-Child Care Program)

The project aims to reduce the fragmentation of health services and support for

families; increase the coordination between public and private agencies to

decrease cost and to provide choices to clients; propitiate the participation of the

people in child care centers as focal points of the communities; and increase the

quality and accessibility of social and support resources. The project will be

divided into three phases.

Title V—ABSTINENCE EDUCATION PROGRAM

Puerto Rico Abstinence Education Program, Puerto Rico Department of

Health, San Juan, $1,449,018 (Abstinence Ed)

The purpose of the Puerto Rico Abstinence Education Program (PRAEP) is to

reduce sexual engagement and its consequences among adolescents: The

propose project is expected to reduce the increasing percentage of babies born to

women under 20 years of age and school desertion because of pregnancy, among

others. To achieve the goal and objectives, the following strategies will be

implemented: an educational curriculum in grades 5 through 12; an educationalmotivational program; mass communications; and socio-recreational activities;

and a coalition.

220
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

EMSC and Families Program in Puerto Rico, University of Puerto Rico, San

Juan, $227,216 (EMSC-Implementation)

The goals of this project in Puerto Rico are to (1) build up the capacity of the State

emergency medical services system to address the needs of pediatric patients;

(2) establish an adequate pediatric data base for outcome measurement and

surveillance; (3) increase the level of knowledge, skills, and resources available for

first-responders and hospital staff to care for children during the prehospital and

emergency room phases of an emergency; and (4) provide support to established

injury prevention initiatives. This project is the first serious effort to include

emergency medical services for children within the framework of the family in the

agenda of several agencies and the legislature in Puerto Rico.

HEALTHY START

Puerto Rico Healthy Start Program, Puerto Rico Department of Health, San

Juan, $943,959 (Healthy Start-Community)

In pursuing the reduction of the high infant mortality rates in Puerto Rico, the MCH

program and the Advisory Board identified the following five goals: (1) Promote

early and continuous high-quality prenatal care and establish home visiting

services for identified high-risk pregnant women; (2) reduce the percentage of

unintended pregnancies and promote adequate spacing between pregnancies for

participating women in the Home Visiting Program; (3) reduce unhealthy behaviors

among pregnant women such as tobacco use, substance abuse, alcohol

consumption, poor nutritional practices, and others; (4) promote healthy growth

and development and improve infant health measures among participants of the

Home Visiting Program; and (5) improve coordination mechanisms across the

different levels of the health care system as well as with the network of agencies

and community-based programs serving the MCH population.

$2,052,757

$1,171,175

$3,223,932

Title V Program, contact:

Roberto Varela-Flores, MD, MPH

MCH Director

PO BOX 70184

San Juan, PR 00936

Phone: (787) 274-5678

Fax: (787) 274-5523

Title V Program’s services for Children

with Special Health Care Needs, contact:

Naydamar Perez de Otero, MD, MPH

CSHCN Director

PO BOX 70184

San Juan, PR 00936

Phone: (787) 274-5660

Fax: (787) 274-5523

250

750

1,000

1,250

1,500

1,750

2,000

500

248

1,610

364

221
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

988,480

12,599

The Rhode Island Department of Health, Division of Family Health

administers the Title V Program, including the Children with Special

Health Care Needs programs. The Division is responsible for the

assessment of health and developmental needs among children and

young families, for planning effective systems and measures to

address those needs, for evaluation of programs and policies affecting

the health and development of children, and for management of

maternal and child health programs providing prevention services to

women and children through community agencies. In addition to the

Title V Block Grant, Abstinence Education and State Systems Development Initiative, the Division administers the following federal programs:

WIC and Farmers Market Nutrition; Title X Family Planning; IDEA Part C;

CDC Disabilities and Health, Immunization, INPHO, and Lead Poisoning Prevention. The Division receives support from a number of private

foundations and other sources including: Robert Wood Johnson’s

Making the Grade and All Kids Count.

1,757

4,224

39,725

3,700

11,741

61,147

$568,409

$3,115,454

$3,033,176

$4,211,516

$0

$138,091

$11,066,646

RHODE ISLAND

$440,429

$11,732,018

$11,066,646

$224,943

222
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

RHODE ISLAND

9 of 9

99.8%

81%

26.5

1.1

55.4%

99.7%

18 of 18

1.6%

89.5%

7.6

2.8

5.7

1.9

10.3

14.5

9 of 9

100%

90%

25

.5

65%

100%

18 of 18

1.0%

92%

5.5

1.3

4.5

1.0

7.5

12

Children in child care, aged 18 months or older, who are up to date on their immunizations

Students in schools with health centers who are enrolled in school-based health centers

Children age 6 or less in at-risk population subgroups tested with lead levels

greater than or equal to 10mg/dl

At-risk newborns who receive a home visit from the family outreach program

during the early newborn period

87.4%

48.1%

10.4%

54.8%

95%

70.0%

9.5%

65.0%

3

3

3

3

3

3

18

223
Selected FY 98 Title V and

Other MCH Grant Annotations

RHODE ISLAND CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Brown University Leadership Education in Behavioral Pediatrics, Rhode

Island Hospital, Providence, $110,837 (SPRANS-Training-Behavioral

Pediatrics)

New training guidelines from the American Board of Pediatrics Residency Review

Committee mandate that pediatric residencies include 2 months of behavioral

pediatrics in their training programs. This project addresses the need for wellprepared pediatric academicians in behavioral pediatrics who can develop and lead

these programs. It creates a model training program, through the collaboration of

experts in the fields of child advocacy, public health, child psychiatry, adolescent

medicine, behavioral research methodology, and biostatistics as well as

behavioral, developmental, and primary care pediatrics. Fellows are mentored in

the practice of behavioral pediatrics in a broad range of community and hospitalbased settings. They develop a research project and carry it through to

publication and presentation, and then use it to write a grant proposal.

Community networks as well as academic programs are strengthened through

collaborations and continuing education.

Foster Children’s Assessment, Referral, and Care Coordination Project,

Rhode Island Public Health Foundation, Providence, $50,000 (SPRANSMCHIP-Healthy Tomorrows)

Approximately half of all foster children in Rhode Island experience difficulty in

accessing primary medical care. The purpose of the project is to develop a

cooperative system involving primary care physicians, foster parents, and state

child protection agency caseworkers to ensure that all foster children have a

“medical home.” The project establishes procedures by which (1) a network of

participating physicians is developed who will accept foster children in their

medical practices; (2) the state child protection agency furnishes a communitybased care coordination agency with names of families with newly placed foster

children; (3) the care coordination agency contacts foster families, and provides

home assessment visits and referral services, as needed; and (4) reports on

services provided to the foster child’s physician and caseworker. An initial pilot

project has been successfully completed in a rural/suburban area and a statewide

system is being established.

Pulling It All Together with Parents as Partners, Rhode Island Department of

Health, Providence, $100,000 (SPRANS-MCHIP-SSDI)

Many families with newborns returning to high-risk environments in urban areas of

Rhode Island are not being engaged by maternal and child health programs

successfully. Teams of parents, community advocates, local service providers,

and Family Health staff will assess qualitatively the real and perceived barriers to

utilization of preventive services. Programs will redesign their methods for

engaging families to ensure access and utilization of services that strengthen

families and bring children to school ready to learn.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Rhode Island’s Creative Linkages for Healthy Child Care Project, Children’s

Friend and Service/Child Care Training System, Pawtucket, $50,000 (CISSCISS-Child Care Program)

Project goals are to develop a seamless system to promote the growth and

development of all young children, including those with special health needs; have

child care programs that provide quality safe and healthy environments for young

224 children; and educate parents about the need for healthy and safe environments to
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

enhance their children’s development. A coordinating committee will established,

with representatives from the major State departments, consumers/parents, and

child care directors.

Title V—ABSTINENCE EDUCATION PROGRAM

Men 2 B Mentoring Academy, Rhode Island Department of Health,

Providence, $129,592 (Abstinence Ed)

This project intends to equip men who work with adolescent and pre-adolescent

boys, in communities where teenagers are most likely to bear children out-ofwedlock, with the information, skills and support they need to move boys in positive

directions. The project will maximize existing community assets by using State and

local resources to provide training and support services to men who serve as role

models and mentors in varied capacities. Training will focus on recognizing

underlying factors associated with too early sexual intercourse and other adolescent

risk-taking behaviors, developing resiliency factors and good character in youth, and

identifying problems that require referrals for additional help.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

A Model for the Coordination of EMS for Children with Special Health Care

Needs, Rhode Island Department of Health, Providence, $224,943 (EMSCTarget)

The first project goal is to develop a functional model for regional emergency

medical services (EMS) systems that coordinates emergency care of children with

special health needs (CSHN), emphasizing communication, education, and

cooperation among families, primary care and specialty physicians, local EMS

providers, hospitals, and regional 911 centers. We will create and maintain a data

base containing emergency medical information for CSHN. The second goal is to

promote a family-centered approach to emergency care for CSHN. We will

facilitate networking among parents of CSHN.

$440,429

$224,943

$665,372

Title V Program, contact:

William H. Hollinshead, MD, MPH

Medical Director

Rhode Island Department of Health/Family Health

3 Capitol Hill, Room 302

Providence, RI 02908

Phone: (401) 222-4655

Fax: (401) 222-1442

Title V Program’s services for Children

with Special Health Care Needs, contact:

Peter R. Simon, MD, MPH

Deputy Medical Director

Rhode Island Department of Health/Family Health

3 Capitol Hill, Room 302

Providence, RI 02908

Phone: (401) 222-5928

Fax: (401) 222-1442

1,750

5,250

7,000

8,750

10,500

12,250

14,000

3,500

12,245 12,073 12,236

225
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

3,835,962

53,877

The South Carolina Title V Maternal and Child Health Services

Block Grant Program is coordinated through the Division of State

and National Initiatives, Health Services, Department of Health and

Environmental Control. This Division provides the leadership and

coordination of the overall MCH activities in DHEC. Roles of the Title

V program include conducting a statewide assessment of needs

(led by the Branch of MCH Epidemiology within DHEC) developing

policies, plans and programs to improve the health of women,

infants, children, children with special health care needs, adolescents and families in South Carolina. Other programs within the

administrative control of the Department include WIC, Family

Planning (Title X), and the Individuals with Disabilities Act - IDEA

(BabyNet) for children 0-3.

21,498

37,730

161,257

13,589

116,356

350,430

$9,560,110

$4,307,575

$18,989,207

$22,056,503

$21,792,280

$0

$76,705,675

SOUTH CAROLINA

$1,407,056

$82,184,490

$76,705,675

$4,071,759

226
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

SOUTH CAROLINA

8 of 9

99%

91.8%

39.7

6.597

32.8%

17.4%

15 of 18

1.9%97

80.5%97

9.597

2.497

6.797

2.797

17.297

27.697

8 of 9

99%

90%

36

7.4

37%

60%

17 of 18

1.7%

87%

7.9

2.2

5.7

2.1

15.5

29.6

Medicaid newborns in the state receiving a DHEC home visit

Infants from black women who entered prenatal care in the first trimester

Medicaid children who have received a primary care service

Degree to which the state assures a transition system is developed for children

aging out of the CSHCN program

*

*

*

9

77%

77%

87.9%

11

3

2

1

3

3

3

15

* Data not available 227
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• A Model for Integrated Health Serivces for

Infants With Sickle Cell Anemia, Medical

University of South Carolina, Charleston,

$99,974 (SPRANS-Genetics)

• Neonatal Nutrition Training, Medical

University of South Carolina, Charleston,

$58,847 (SPRANS-Training-Nutrition)

• Program To Transition Patients With Sickle

Cell Disease From Pediatrics to the Adult

Care Setting, Medical University of South

Carolina, Charleston, $76,308 (SPRANSGenetics)

• Second Chance Club: A Family-Centered

Intervention for Adolescent Mothers,

Medical University of South Carolina,

Charleston, $49,170 (SPRANS-MCHIPHealthy Tomorrows)

• Stop the Hurt: Issues for Physicians

Caring for Children, Medical University of

South Carolina, Charleston, $12,000

(SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

• Working Together: Community Fetal,

Infant, and Child Fatality Reviews, South

Carolina Department of Health and

Environmental Control, Columbia,

$100,000 (SPRANS-MCHIP-SSDI)

HEALTHY START

• Healthy Start: A Rural Community

Partnership, United Way of South

Carolina, Columbia, $931,760 (Healthy

Start-Mentor)

• Low Country Healthy Start: A Multi-County

Partnership for the Reduction of Infant

Mortality, South Carolina State Office of

Rural Health, Columbia, $1,450,764

(Healthy Start-Community)

SOUTH CAROLINA CONTINUED

SOUTH CAROLINA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Public-Academic Partnership for School-Based Health, South Carolina

Department of Mental Health, Columbia, $149,000 (SPRANS-MCHIP-Mental

Health of School-Age Children and Adolescents)

The ultimate goal of this project is to increase opportunities for children and youth

to be full participants in education. Project objectives include improving the

coordination of health and mental health services in school settings, involving

students from a predominantly minority college in school health services, and

demonstrating that improved coordination of and access to mental health services

for school-age children will improve other aspects of the children’s lives. The

project will establish programs in two local school districts to demonstrate how

communities can work together to address the mental health needs of students.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Health Systems Development in Child Care, South Carolina Department of

Health, Columbia, $50,000 (CISS-CISS-Child Care Program)

The project seeks to develop a comprehensive system integrating health and other

support services into child care; improve the quality of child care; and increase the

supply of child care. A steering committee will develop recommendations that will

be used to guide the development of a comprehensive plan for child care in the

State, identify gaps, develop Memoranda of Agreement among agencies and

organizations, produce a resource directory for child care programs and parents,

and oversee a study with public policy recommendations on child care for Family

Independence Act recipients.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, South Carolina Department of Health and

Environmental Control, Columbia, $811,757 (Abstinence Ed)

Abstinence education interventions targeting unmarried pre-adolescents,

adolescents, and males and females between 20-24 years of age will be funded.

In 1994, among women of all ages and socioeconomic status having an

unintended pregnancy, over 74 percent were not married. In October 1997, the

State will develop a comprehensive, coordinated statewide plan to address

unmarried sexual behavior.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Regionalization of Care for Pediatric Patients, South Carolina Department of

Health and Environmental Control, Columbia, $75,000 (EMSC-PRTNER)

The overall goal for this project is to reduce the mortality and morbidity of pediatric

medical and trauma patients by improving the regional systems of care for the

pediatric patient in a State with a pediatric population at high risk for mortality and

morbidity from childhood injury, trauma, and illness. Specific project objectives

are to (1) increase pediatric training, (2) establish regional systems of care for

pediatric emergencies through improved plans and protocols, (3) improve the

current injury surveillance system, (4) conduct ongoing data analysis, and (5)

pursue additional collaborative efforts.

228
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Healthy Start Richland County South Carolina, Richland Memorial Hospital,

Columbia, $1,544,235 (Healthy Start-Community)

This project is designed to address high infant mortality rates in an urban, lowincome area of Richland County, SC, and to increase access to perinatal and wellchild care. Richland Memorial Hospital, in collaboration with the Richland County

Health Partners Consortium, plans to implement the following three models of

intervention: (1) Community-Based Consortium, (2) Outreach and Client

Recruitment, and (3) Enhanced Clinical Services. The models will address the

inadequate supply of perinatal providers, develop a formal mechanism to link

medical and social service providers with each other and with the community,

address recruitment and retention of clients, develop employable skills and jobs for

low-income women, and inform and educate the community.

TRAUMATIC BRAIN INJURY

South Carolina TBI State Planning Grant, South Carolina Department of

Disabilities and Special Needs, Columbia, $70,000 (Traumatic Brain

Injury-Plan)

Further development and strengthening of core capacity components in South

Carolina for a service delivery system to benefit persons with TBI is the goal of this

project. The objectives are to (1) establish a State-level TBI advisory committee

with representatives of service providers and TBI consumer organizations to provide

leadership and guidance for system development; (2) assist the efforts of TBI

consumer organizations to provide information and support to TBI survivors and to

effectively represent the TBI population in local and State forums; (3) conduct a

statewide needs assessment that addresses the service and support needs of

persons with TBI and their families; (4) complete a state action plan to provide

practical guidance to relevant agencies concerning the direction and priorities for

future development of comprehensive services and individual supports for persons

with TBI; and (5) train service coordinators, service providers, and TBI consumer

organizations in the principles and implementation of person-centered supports

that will enhance and build capacity in the current and future service system for

persons with TBI.

$1,407,056

$4,071,759

$5,478,815

Title V Program, contact:

Marie Meglen, MS CNM

MCH Director, Title V Director

SC Department of Health and Environmental

Control Box 101106

Columbia, SC 29211

Phone: (803) 898-0872

Fax: (803) 898-0380

Title V Program’s services for Children

with Special Health Care Needs, contact:

Linda Price

Director, CRS Branch

SC Department of Health and Environmental

Control Box 101106

Columbia, SC 29211

Phone: (803) 898-0789

Fax: (803) 898-0613

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

10,180

7,837 7,456

229
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

738,171

10,288

The South Dakota Title V Maternal and Child Health Services Block

Grant is administered through the Department of Health Division of

Health and Medical Services Office of Family Health (OFH). The

program conducts a statewide assessment of needs, develops

policies, plans, and provides for programs to improve the health of

women, infants, children, adolescents, and families in South

Dakota. OFH is also responsible for WIC, family planning, coordinated school health, and public health nutrition.

Additional information regarding MCH programs as well as other

programs administered by the division (i.e., communicable disease,

immunizations, Ryan White, and disease prevention programs can

be found at www.state.sd.us/doh.

3,739

10,385

52,374

5,576

10,301

82,375

$426,083

$564,808

$1,457,785

$1,253,734

$481,915

$222,417

$4,406,742

SOUTH DAKOTA

$3,475,906

$8,007,600

$4,406,742

$124,952

230
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

SOUTH DAKOTA

5 of 9

99.9%

77%

25.7

8.8

62%

47.4%

6 of 18

1.2%

82.4%

8.9

2.5

4.5

4.5

6.8

35.2

5 of 9

99%

90%

25.3

6.4

62.7%

50%

8 of 18

1%

84%

6.5

.6

3.6

2.9

5.8

28

Women on WIC or Babycare who smoked prior to pregnancy and report

they stopped during pregnancy

High school youth who self-report tobacco use in the past 30 days

Children and adolescents who are overweight or obese

The Native American infant mortality rate (per 1,000 live births)

*

*

*

*

40%

38%

10%

13.5

1

1

1

1

0

2

6

* Data not available 231
Selected FY 98 Title V and

Other MCH Grant Annotations

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• EMSC Regional Conference, University of

South Dakota School of Medicine, Sioux

Falls, $25,297 (EMSC/TRNG-Continuing

Education)

• South Dakota Leadership Education in

Neurodevelopmental and Related

Disabilities (LEND) Project, University of

South Dakota, Sioux Falls, $441,045

(SPRANS-Training-LEND/Leadership Ed

Neuro Dev)

• South Dakota State Systems Development

Initiative Application, South Dakota

Department of Health, Pierre, $94,283

(SPRANS-MCHIP-SSDI)

SOUTH DAKOTA CONTINUED

SOUTH DAKOTA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Girl Neighborhood Power: Building Bright Futures for Success, Youth and

Family Services, Rapid City, $200,000 (SPRANS-MCHIP-Girl Power)

The goals of the Girl Neighborhood Power project in four low-income

neighborhoods in Rapid City are to reduce adolescent pregnancy by 20 percent

to a rate of 44.5 per 1,000 adolescent girls by the year 2002 and to reduce current

alcohol use by adolescent girls by 20 percent to 41.8 percent by the year 2002.

To help girls successfully navigate adolescence and build healthy futures, the

project seeks to help them identify academic and nonacademic interests, identify

possible career goals, and become committed to their community. The racial

composition of these neighborhoods is 79 percent white (4 percent Hispanic), 16

percent Native American, and 5 percent other races. Twenty-eight percent of the

households in these neighborhoods have an annual income of less than $10,000.

of Health, Pierre, $94,283 (SPRANS-MCHIP-SSDI)

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Healthy Child Care South Dakota, South Dakota Department of Social

Services, Pierre, $50,000 (CISS-CISS-Child Care Program)

The goal of the project is to expand established networking of the Family

Resource Networks (FRNs) and the Early Childhood Enrichment (ECE) projects to

achieve a centralized network and one-stop shopping for educational information,

consultation, and health services for families and child care providers in South

Dakota’s communities and the nine reservation areas. Activities include the

formation of a state-level internal working committee and five regional councils to

increase statewide networking for promotion of safe and healthy child care

environments and provision of high-quality, accessible information and services for

families, children, and child care providers. Activities will also include efforts to

provide screening services in each region and the reservations and to promote

statewide awareness of healthy child care.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Grant, South Dakota Department of Health, Pierre,

$169,578 (Abstinence Ed)

Although abstinence education efforts, in various forms, are currently underway in

South Dakota, youth survey results and health statistics dealing with teenage

sexual activity indicate that there continues to be a need for further abstinence

based education. The goal of the South Dakota Department of Health’s

Abstinence Education Grant is to reduce teenage pregnancy and subsequently to

reduce the health risks, both physical and psychological, that accompany early

sexual activity. The majority of the first year’s grant funds will be sub-granted out

to local organizations and individuals who are committed to piloting abstinence

based education programs and activities. Representatives from five State agencies

will provide input into coordinating the project’s activities and will work with the

counselors, educators, families, and health care providers who will be responsible

for educating our youth on the advantages of practicing abstinence.

232
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Emergency Medical Services for Children System Enhancement, University

of South Dakota, Sioux Falls , $99,655 (EMSC-Enhancement)

The project seeks to improve the pediatric data-collection component within the

State emergency medical services (EMS) system; develop and implement

pediatric triage and transport guidelines for the State; enhance the pediatric

education component by providing instructor training for the medically underserved

Native American population within the State and region; and move the South

Dakota emergency medical services for children (EMSC) into a permanent position

within the State department of health. Trauma-registry software will be purchased

for the State.

HEALTHY START

Northern Plains Healthy Start, Aberdeen Area Tribal Chairmen’s Health

Board, Aberdeen, $2,521,000 (Healthy Start-Mentor)

The infant mortality rate for the Northern Plains Indians is 18.4 deaths per 1,000

live births, compared to the U.S. rate of 9.8 for all races. The goal of the project

is to reduce infant mortality by 50 percent for the Northern Plains Indian population

of 17 tribes and 2 Indian communities within the four States making up the area.

Project activities are designed to ensure that (1) the community has access to

providers; (2) individuals have transportation to services; (3) materials are designed

and disseminated in culturally appropriate formats; (4) traditional Indian family

values are acknowledged when providing direct health care services; and (5)

community and home-based services for outreach, health education, case

management, and tracking of program participants are provided.

$3,475,906

$124,952

$3,600,858

Title V Program, contact:

Colleen Winter

Director, Office of Family Health

South Dakota Department of Health

Division of Health and Medical Services

615 East Fourth Street

Pierre, SD 57501-1700

Phone: (605) 773-3737

Fax: (605) 773-5509

Title V Program’s services for Children

with Special Health Care Needs, contact:

Nancy Hoyme

CSHS Program Administrator

South Dakota Department of Health

Division of Health and Medical Services

615 East Fourth Street

Pierre, SD 57501-1700

Phone: (605) 773-3737

Fax: (605) 773-5942

50

150

200

250

300

350

400

100

332

138

341

233
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

5,430,621

77,396

Maternal and Child Health (MCH) is administered by the Health

Service Administration Bureau of the TN Department of Health. MCH

is responsible for Genetic and Newborn Screening Services;

Women’s Health including Family Planning, Prenatal Services and

the Perinatal Regionalization System; Child and Adolescent Health

Services including home visiting programs, Child Care Resource

Centers and Child Fatality Review; Services for CSHCN are called

Children Special Services (CSS) and are under the administration of

MCH. In addition to payment of needed medical services not

covered by other sources, CSS has a care coordination component

and a parent network called the Parents Encouraging Parents

Program . In 1998, CCS was assigned the responsibility for the

Tennessee Technology Access Project (TTAP) which is funded by

the Department of Education.

24,153

50,632

267,485

4,695

181,456

528,421

$733,721

$1,572,263

$8,175,767

$6,502,604

$13,355,470

$2,196,183

$32,536,008

TENNESSEE

$2,829,687

$35,440,694

$32,536,008

$74,999

234
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

TENNESSEE

8 of 9

100%

86.6%

36

6.1

53.9%

53%

12 of 18

1.6%

84%

8.4

2.4

5

3.3

9

28

8 of 9

100%

90%

35

7.1

57.3%

85%

14 of 18

1.5%

86%

8.0

2.3

4.8

3.2

8.6

27.6

Decrease number of neural tube defect births by 1 percent (per 100,000 live births)

after 2 years of nutrition education at the local and regional levels in a calendar year

High school students using tobacco (cigarettes and smokeless tobacco)

High school students using alcohol

Cases of HIV infected infants (status reported by year of birth)

64%

38%

44%

1.4

62%

33%

39%

1

2

3

0

2

3

2

12

235
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Communication Disorders in Children,

Vanderbilt University, Nashville, $166,667

(SPRANS-Training-Communication

Disorders)

• Continuing Education for Rural Public

Health Nurses, University of Tennessee at

Chattanooga, Chattanooga, $25,000

(SPRANS-Training-Continuing Education)

• Graduate Training Program in Public

Health Nutrition, University of Tennessee

at Knoxville, Knoxville, $125,173

(SPRANS-Training-Nutrition)

• Interdisciplinary Leadership Training (InLeT)

for Health Professionals Caring for Children

With Neurodevelopmental and Related

Disabilities, University of Tennessee,

Memphis, Memphis, $815,595 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• Interdisciplinary Leadership Training in

Feeding of Children With Special Health

Needs, University of Tennessee,

Memphis, Memphis, $54,450 (SPRANSTraining-Continuing Education)

• OB/GYN Training for Family Medicine

Residents, Meharry Medical College,

Nashville, $163,233 (SPRANS-TrainingHistorically Black Colleges)

• Pediatrics-Child Psychiatry Continuing

Education, Vanderbilt University, Nashville,

$12,000 (SPRANS-Training-Continuing Ed/

Collaborative Office Rounds)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Tennessee Health System Development in

Child Care Program, Tennessee

Department of Health, Nashville, $50,000

(CISS-CISS-Child Care Program)

TENNESSEE CONTINUED

TENNESSEE

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Adolescent Risk Behavior Prevention Program, Girls Incorporated of

Memphis, Memphis, $200,000 (SPRANS-MCHIP-Girl Power)

This project by Girls Incorporated of Memphis and Girl Neighborhood Power will

provide girls ages 9–14 the skills and experience necessary to make positive,

healthy choices; to attain economic independence; to avoid risky behaviors; and

to develop as competent contributing members of our society. Specific activities

will be informal and interactive with targeted learning objectives. Girls will learn

refusal skills, employment-seeking techniques, how to access health services,

self-protection, conflict resolution, and handling personal relationships. They will

meet role models who are working in career areas of interest to them, who are

community leaders, and who live in their neighborhoods. These activities will be

conducted in a safe, challenging, and girl-centered environment.

State Systems Development Initiative, Tennessee Department of Health,

Nashville, $100,000 (SPRANS-MCHIP-SSDI)

The SSDI project goal is to ensure the highest level of quality services to mothers,

children, and their families, through establishment of an integrated data

management system that addresses MCH/CSHCN issues and meets Federal,

State, and local needs. The approach has been to develop systems

infrastructure. The primary objective is to integrate the five metropolitan counties’

data systems with the Patient Tracking, Billing, and Management Information

System (PTBMIS) being used in 90 rural counties. This objective will be met by

December 1997.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Community Diagnosis Collaborative, Memphis/Shelby County Community

Service Agency, Memphis, $50,000 (CISS-CISS-COG)

The Collaborative for Community Diagnosis was formed to address identified

community health care delivery problems including inadequate prenatal and

postnatal care, low birthweight infants, high infant mortality, inadequate primary

care for young children between the ages of 0 and 2-1/4, inadequate special

service delivery for children with special needs, and inadequate outreach services

for the target population. The project goal is to develop a Community Diagnosis

Process to examine local health problems and develop an integrated health care

delivery system for pregnant women in the target population. Project objectives

include gathering and analyzing data, identifying obstacles that impede problem

solving, identifying resources, and compiling a Community Diagnosis Document.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Only Education, Tennessee Department of Health, Maternal and

Child Health, Nashville, $1,067,569 (Abstinence Ed)

Tennessee proposes to use community-based abstinence only education programs

as an additional means of addressing the problem of adolescent pregnancy. The

overall goal is to reduce the pregnancy rate in the 15-17-year-old group. The

programs will target the 10-17-year-olds, with particular emphasis on the 10-14-yearold group, to provide resiliency and strengthen the skills necessary to abstain from

sex. Community-based Regional Health Councils will be used to select and fund a

minimum of 12 local projects to provide abstinence only education to the target

group. These projects must meet certain parameters set by funding guidelines and

the State MCH office. In addition, materials for media campaigns will be available

statewide to increase awareness of the value of abstinence.

236
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Tennessee EMSC State Partnership Grant, Vanderbilt University Medical

Center, Nashville, $74,999 (EMSC-PRTNER)

The overall goal of this project is to institutionalize emergency medical services for

children (EMSC) into the Tennessee emergency medical services (EMS) system.

The coordinator of the project will (1) facilitate the statewide coalition on injury

prevention, (2) provide linkage service to the Tennessee division of the American

Trauma Society for EMSC data acquisition and analysis, (3) facilitate the

continued development of the EMSC newsletter and bulletin board, and (4)

coordinate EMSC education courses and dissemination of information regarding

emergency care plans for children with special health care needs, and (5) work

with SPEC and the State EMS division for EMSC.

$2,829,687

$74,999

$2,904,686

Title V Program, contact:

Mary Jane Dewey

Director, MCH

425 5th Avenue North, 5th Floor

Nashville, TN 37427-4701

Phone: (615) 741-7353

Fax: (615) 741-1063

Title V Program’s services for Children

with Special Health Care Needs, contact:

Jacque Cundall, RN,C

Director, Children’s Special Services

425 5th Avenue North, 5th Floor

Nashville, TN 37427-4701

Phone: (615) 741-8530

Fax: (615) 741-1063

15

45

60

75

90

105

120

30

100

73

100

237
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

19,759,614

342,283

The Texas Department of Health administers the Title V program. The

Associateship for Community Health and Resources Development is

responsible for administering all Title V programs, including MCH

services, services to CSHCN, and several SPRANS grants. In addition,

the Associateship administers newborn screening; genetic services;

family planning (under Titles X, XIX and XX); a cytology laboratory;

Texas Health Steps (EPSDT) and Texas Health Steps-Comprehensive

Care Program (for CSHCN); Medicaid Medical Transportation; public

health dental programs, including fluoridation and sealants; the

Medically Dependent Children Program (Title XIX waiver program for

CSHCN who qualify for a nursing home level of care); Pre- and School

Vision and Hearing Screening Program; the Program for the Amplification of Children of Texas; Title XIX Targeted Case Management for

Pregnant Women and Infants; and the WIC program.

124,692

88,064

460,493

26,848

187,951

888,048

$15,314,409

$731,392

$24,821,723

$33,028,004

$15,158,809

$10,908,656

$99,962,993

TEXAS

$7,120,847

$108,010,200

$99,962,993

$926,360

238
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

TEXAS

8 of 9

96.1%

74%

48.697

5.497

60.5%97

12.1%

11 of 18

1.3%97

77.1%97

6.497

1.997

3.897

2.797

9.697

26.297

8 of 9

98%

77%

50

5.5

75%

70%

12 of 18

1%

85%

5.5

1.7

3.5

2.5

9.0

24

Prevalence of carious lesions among 3rd - 7th grade children

Rate (per 10,000 live births) of neural tube defects-affected babies.

Well child visits by Title V funded agencies

Rate of elevated blood lead levels among Medicaid eligible children up to age 6 (per 1,000)

47%

10.597

44%

45

43%

10

50%

45

2

1

2

2

2

2

11

* Data not available 239
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Genetic Provision in Primary Care

Settings in South Texas, University of

Texas, San Antonio, $125,000 (SPRANSGenetics)

• Health Care Reform for Children With

Special Health Care Needs: Cost and

Utilization Project, University of Texas

Health Science Center at Houston,

Houston, $160,000 (SPRANS-MCHIPManaged Care/Health Care Reform)

• Leadership Education in Adolescent

Health, Baylor College of Medicine,

Houston, $277,049 (SPRANS-TrainingAdolescent Health)

• PediPlace, Inc., Lewisville, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Reducing Cultural Barriers to the

Provision of Genetic Services in South

Texas, University of Texas Health Science

Center at San Antonio, San Antonio,

$176,351 (SPRANS-Genetics)

• San Antonio Triethnic Children’s Blood

Pressure Study, University of Texas, San

Antonio, $142,418 (SPRANS-Research)

• Seniors and Volunteers for Childhood

Immunization: A Sustainable Model,

University of North Texas, Denton,

$27,367 (SPRANS-Training-Continuing

Education)

• South Texas Center to Study Children with

Special Health Care Needs, University of

Texas Health Science Center at San

Antonio, San Antonio, $249,999 (SPRANSMCHIP-Managed Care/Health Care Reform)

• Texas Genetics Network (TEXGENE),

Texas Department of Health, Austin,

$190,000 (SPRANS-Genetics)

• Texas Newborn Screening

Hemoglobinopathy Program, Texas

Department of Health, Austin, $99,951

(SPRANS-Genetics)

• Texas State Systems Development

Initiative Project, Texas Department of

Health, Austin, $99,998 (SPRANS-MCHIPSSDI)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• A Vision for Children: Collaborative

Community Advocacy Initiative To

Improve Health and Well-Being of

Children, Any Baby Can, Inc., San Antonio,

$50,000 (CISS-CISS-COG)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Emergency Medical Services for

Children: A Model for Knowledge Transfer

and Utilization to the Yet Uncommitted,

University of Texas, Dallas, $109,866

(EMSC-Enhancement)

• Texas EMS for Children State Partnership

Grant, Texas Department of Health, Austin,

$70,514 (EMSC-PRTNER)

TEXAS CONTINUED

TEXAS

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Hemophilia Comprehensive Care, University of Texas Health Science Center

at Houston, Houston, $500,623 (SPRANS-Hemophilia)

The goals for the hemophilia treatment centers are to (1) provide a full range of

comprehensive care services, including medical and psychosocial services, for all

persons with hemophilia and related bleeding disorders, and for all complications of

this disease; (2) provide education to patients’ families, providers, and the community

concerning the latest forms of treatment for congenital bleeding disorders and related

complications and the prevention strategies that reduce morbidity associated with

hemophilia; and (3) provide outreach to persons with congenital bleeding disorders

who are not currently receiving these comprehensive services. The goal for the region

is to provide regional services to support the hemophilia comprehensive care and HIV

risk reduction activities of hemophilia treatment centers in each of the 12 hemophilia

program regions of the Maternal and Child Health Bureau.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Healthy Child Care North Texas, Texas Department of Health, Arlington,

$50,000 (CISS-CISS-Child Care Program)

The goals of the project are to encourage strong partnerships between community,

public, and private health agencies to increase access to resources for child care

providers, optimize health and safety standards in early childhood settings, and

provide ongoing assessment of health protection and health promotion indicators

in child care facilities. The project will develop and distribute a series of manuals

on public health issues, behavior management, and community resources,

develop a simple data base to collect data; and focus attention on children with

possible health problems, and pilot onsite health screening programs at selected

low-income, minority child care sites in both rural and urban settings.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, Texas Department of Health, Austin, $4,922,091

(Abstinence Ed)

Contracts will be developed to provide abstinence education, mentoring and

counseling programs, demonstration projects, a statewide education campaign,

and program evaluation with the goal of decreasing the incidence of teenage

sexual activity and pregnancy rates.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Outcomes-Based Office Practice Emergency Self-Assessment Tool, The

University of Texas, Southwestern Medical Center at Dallas, Dallas, $150,000

(EMSC-Target)

This project describes a method for determining the preparation, skills, drugs, and

equipment necessary to provide the optimum outcome for the management of

office practice pediatric emergencies. The project will test the hypothesis that the

skills, equipment, and drugs necessary for an emergency-prepared office practice

are dependent on three factors: The severity and complexity of patients seen, the

time to access a pediatric-ready advanced life support ambulance unit, and the

time to access a definitive-care emergency facility. The goals of the project are to

(1) recruit a group of 500 practicing physicians who are willing to study emergency

outcomes in an office practice; (2) develop generic policies, procedures, treatment

algorithms, and protocols that are necessary to ensure an emergency-ready

pediatric practice; (3) provide quarterly feedback to study participants; and (4)

provide an outcome-based self-administered office practice emergency assesment

tool. The project seeks to collect 50,000 emergency encounters from a minimum

of 500 office practice physicians. 240
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Healthy Start Dallas, Dallas County Hospital District, Dallas, $521,000

(Healthy Start-Mentor)

Dallas Healthy Start Consortium is a coordinated, collaborative effort of health and

social services providers; city, county, and State agencies; community leaders;

volunteers; and consumers. The goal is to reduce infant mortality significantly by

1997 through systematic interventions that can be sustained beyond the period of

federal funding. Strategies include outreach and client recruitment, transportation

of women and children to medical appointments and related services, and a

collaborative network of prevention and risk reduction services.

TRAUMATIC BRAIN INJURY

Texas Traumatic Brain Injury Statewide Action Plan, Texas Rehabilitation

Commission, Austin, $74,980 (Traumatic Brain Injury-Plan)

There is no single State, public, or private agency in Texas responsible for

organizing the services and supports to individuals with traumatic brain injury (TBI)

and their families. Existing services for individuals with brain injuries are

fragmented. Project activities include establishing a State TBI advisory board,

conducting a statewide needs assessment, completing a policy analysis,

developing a statewide action plan, and recommending a State agency to

incorporate the board and/or the State plan.

$7,120,847

$926,360

$8,047,207

Title V Program, contact:

Debra Wanser, R.N., M.P.

Community Health and Resources Development,

Texas Department of Health

1100 W. 49th St.

Austin, TX 78756

Phone: (512) 458-7321

Fax: (512) 458-7358

Title V Program’s services for Children

with Special Health Care Needs, contact:

Susan Penfield, MD

CSHCN Planning and Policy Development Division

Texas Department of Health

1100 W. 49th St.

Austin, TX 78756

Phone: (512) 458-7700

Fax: (512) 458-7238

700

2,100

2,800

3,500

4,200

4,900

5,600

1,400

4,506 4,550 4,346

241
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

2,099,758

45,165

The State Health Department’s Division of Community and Family

Health Services incorporates all Title V programs in Utah as mandated by state and federal law, as well as the Individuals with

Disabilities Education Act (IDEA) - Part C and the State WIC

program.

7,259

43,116

9,067

4,320

3,851

67,613

$5,103,413

$4,692,813

$11,320,370

$9,517,060

$1,377,519

$1,210,692

$33,221,867

UTAH

$795,051

$34,528,807

$33,221,867

$511,889

242
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

UTAH

8 of 9

98.3%

71%97

24.897

7.897

81.5%97

64.6%97

12 of 18

1.1%97

83%97

5.897

297

3.697

2.297

8.597

26.597

7 of 9

98.5%

80%

24.5

7.78

83%

95%

13 of 18

1.0%

83.2%

5.7

2

3.4

2.0

8.3

26.47

Use of bicycle helmets among bicyclists 5-12 years of age

Use of vehicle safety restraints among child occupants under 9 years of age

Neural tube defects (per 10,000 live births)

Pregnant women with adequate weight gain who deliver live born infants

12.65%97

68.7%97

6.797

81.3%97

22.0%

78%

6.4

81.6%

2

1

3

3

2

1

12

243
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Fluoridation of Water Supplies in Salt

Lake City and County, Salt Lake City

County Health Department, Salt Lake City,

$30,000 (SPRANS-MCHIP-Fluoride)

• Transportable MCH Information Internet

Data Query Module, Utah Department of

Health, Salt Lake City, $89,392 (SPRANSMCHIP-Data)

• Utah’s State Systems Development

Initiative Project, Utah Department of

Health, Salt Lake City, $100,000 (SPRANSMCHIP-SSDI)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Emergency Medical Services for

Children/State Partnership Grant, Utah

Department of Health, Salt Lake City,

$75,000 (EMSC-PRTNER)

• EMSC With Special Health Care Needs,

Utah Department of Health, Salt Lake City,

$147,842 (EMSC-Target)

• Epidemiology and Cost of Emergency

Medical Services Provided to Children,

University of Utah, Salt Lake City, $

(EMSC)

UTAH CONTINUED

UTAH

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Opening Doors into Rural Communities, Utah State University, Logan,

$199,993 (SPRANS-MCHIP-Integrated Services)

Opening Doors into Rural Communities represents the collective work of a

consortium comprising four rural communities (Lewiston, ID; Pocatello, ID;

Moberly, MO; and Augusta, ME) coordinated by Opening Doors to enhance the

development of service integration strategies that address the four

recommendations by the Federal Interagency Coordinating Council. The goals of

the project are to (1) highlight existing service integration strategies already in

place within rural communities; (2) develop action plans that address rural

community needs; (3) evaluate effectiveness based on supporting medical homes,

adequate insurance coverage, family satisfaction, cultural competence,

coordination, and community-based systems; and (4) develop a materials

package that can be disseminated.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Health Systems Development in Child Care, Utah Department of Health, Salt

Lake City, $50,000 (CISS-CISS-Child Care Program)

This project will stimulate and support collaborative, coordinated statewide and

community-based efforts to ensure safe, healthy, developmentally appropriate

child care environments for all children, including children with special health

needs. Funds from this grant will be used to hire a nurse who will identify existing

resources to organize a curriculum and systems to provide training, on Child Care

Facilities, Environmental Health and Safety.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Program for Utah Youth, Utah Department of Health,

Division of Community and Family Health Services, Salt Lake City, $325,666

(Abstinence Ed)

Utah’s Abstinence Education Program will target youth, both boys and girls,

between the ages of 9 and 14 years of age through community-based projects.

Program goals include reducing adolescent sexual activity, adolescent pregnancy

and birth rates, and adolescent sexually transmitted diseases. Two priority needs

have been identified: 1) abstinence education for younger youth, boys and girls,

between the ages of 9 and 14 years of age, incorporating strategies that reduce

risk factors for adolescent sexual activity, and 2) the development of education

programs for parents of youth in the target ages to provide knowledge, skills, and

techniques to facilitate discussions of abstinence and related issues between

parents and their children.

244
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

National Emergency Medical Services for Children Data Analysis Resource

Center (NEDARC), University of Utah, Salt Lake City, $289,047 (EMSCEnhancement)

The University of Utah School of Medicine will establish the National EMSC Data

Analysis Resource Center (NEDARC) to provide technical assistance with data

management and analysis. The project will identify relevant data sets that are

currently available or under development in each of the States, including

prehospital data sets, hospital files, and trauma registries. Technical assistance

will be provided to State EMS agencies, State Maternal and Child Health Bureaus,

and other agencies in evaluating EMS and EMSC by using relevant data sets to

generate informative reports. NEDARC will establish an Internet World Wide Web

server, and all of the project’s educational materials will be provided on that server.

$795,051

$511,889

$1,306,940

Title V Program, contact:

Kathleen B. Glasheen

Director, Bureau of Maternal and Child Health

PO Box 142001

Salt Lake City, UT 84114-2001

Phone: (801) 538-6869

Fax: (801) 538-9409

Title V Program’s services for Children

with Special Health Care Needs, contact:

Vera Frances Tait

Director, Bureau of CSHCN

PO Box 144610

Salt Lake City, UT 84114-4610

Phone: (801) 584-8239

Fax: (801) 584-8488

3,000

9,000

12,000

15,000

18,000

21,000

24,000

6,000

17,296

22,833

N/A

245
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

590,883

6,582

Title V is administered by the Vermont Department of Health (VDH), a

department within the Agency of Human Services. Services within Title

V’s administrative control include: Direct services (multidisciplinary

clinic-based services to children with special health needs of all ages;

well-child visits and immunizations for children without access to

preventive health care; public health nurse home visits to pregnant

women and infants to one year); Enabling services (outreach, information and referral, and administrative case management for children

enrolled in Medicaid; nursing, social work care coordination, and

respite care for CSHN; Medicaid prior-authorization of certain medical

and dental services); Population based services (school-based

fluoridation program; oral health education; newborn screening, SIDS

program); Infrastructure building services (collaboration with Medicaid

and managed care; primary care medical home support; interagency

and community-based health care systems planning; cultural competency training). In addition, CSHN is in the administrative home for

Vermont’s Part C Early Intervention system.

2,646

2,024

5,826

3,624

*

14,120

$144,839

$208,696

$1,388,117

$1,469,153

$0

$116,002

$3,326,807

VERMONT

$820,084

$4,244,856

$3,326,807

$97,965

246
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

VERMONT

9 of 9

99%

86%97

12.197

4.497

55.9%97

4.3%

15 of 18

1%97

87.9%97

6.197

*

4.297

1.897

897

23.197

9 of 9

99%

90%

14.8

4.0

61%

4.5%

18 of 18

.6%

90%

6.7

*

4.4

2.3

7.9

19

Medicaid infants from birth through 12 months who receive a home visit through

the Healthy Babies system of care

Low income children (with Medicaid) that utilize dental services in a year

Agency of Human Services (AHS) districts with a community-based hearing screening

and diagnostic follow-up program (hearing outreach program) for children

Youth aged 12-17 who use alcohol

33%97

45.5%97

25%97

51%97

50%

52%

100%

45%

3

3

2

2

3

2

15

* Data not available 247
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Peoples’ Co-op Doulas: A Pregnancy and

Parenting Peer Support Program, Minority

Business Association, Burlington,

$50,000 (SPRANS-MCHIP-Healthy

Tomorrows)

• Vermont Interdisciplinary Leadership

Education for Health Professionals

Program (VT-ILEHP), University of

Vermont, Burlington, $300,000 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• Vermont’s Comprehensive, CommunityBased System of Care for Children and

Adolescents, Vermont Department of

Health, Burlington, $100,000 (SPRANSMCHIP-SSDI)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• CISS/Child Health Vermont, Vermont

Department of Health, Burlington, $50,000

(CISS-CISS-COG)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• New England EMSC Telemedicine

Conference, University of Vermont

College of Medicine, Burlington, $25,568

(EMSC/TRNG-Continuing Education)

VERMONT CONTINUED

VERMONT

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Partnerships for Change, University of Vermont, Burlington, $200,229

(SPRANS-MCHIP-Integrated Services)

The goal of the project is to improve systems of care for children with special

health care needs and their families by working with family and professional

groups to implement changes in the education and practice of professionals. The

project employs family/ professional, interprofessional and interorganizational

collaborative processes and family-centered, community-based, culturally

competent, and coordinated approaches in the implementation of the following

objectives: (1) With families, develop and disseminate models of interprofessional

collaborative education and practice; (2) develop and implement changes in social

work education and practice; (3) work in partnership with other professional groups

to facilitate changes in education and practice; and (4) work with families and

professionals to identify models of community practice, and develop and

disseminate recommendations for changes in community practice. Methods

include quantitative and qualitative data collection from focus groups and surveys

and interviews with families, professionals, students, and faculty in order to

develop curriculums and training materials about interprofessional collaboration

and support the inclusion of relevant content in pre-practice and inservice

education for all disciplines. Additional qualitative research with children, families,

and professionals will contribute to the dissemination of community practice

models. Materials include bibliographies, annotated bibliographies and selected

readings, position papers, training outlines, curriculums and curriculum strategies,

survey instruments, and monographs.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Vermont Health Systems Development in Child Care Program, Vermont

Department of Health, Burlington, $50,000 (CISS-CISS-Child Care Program)

The project was developed to make health and child care a focal point in systems

development work at the State level and to meet the health training and

consultation needs of child care providers. A training-for-trainers curriculum will be

developed, informed both by systems development work at the State level and by

the provider-to-provider experience of a child care nurse consultant assigned to

work with providers in child care settings. Interdisciplinary teams, consisting of a

child care nurse consultant, regional child care trainer, a child care provider, a

parent, and a local pediatric primary care provider, will be trained and will design

local training and technical consultation models to be conducted by the nurse and

child care trainer for child care providers in their communities.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education, Vermont Department of Health, Burlington, $69,855

(Abstinence Ed)

This project will promote abstinence by “teaching youth how drug and alcohol use

increases vulnerability to sexual advances.” As part of a larger substance abuse

prevention media effort, a media campaign will be developed for middle school

students and their parents/guardians. In addition, an abstinence-only education

advisory committee will be formed to give input to future grant activities.

248
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Vermont Emergency Medical Services for Children State Partnership Grant,

Vermont Department of Health, Burlington, $72,397 (EMSC-PRTNER)

This emergency medical services for children (EMSC) project has identified goals in

seven key areas: (1) Resource management—include pediatric issues in all

aspects of emergency medical services (EMS) development; (2) human resources

and training—improve and expand pediatric emergency training programs for health

professionals; (3) transportation—ensure that prehospital and interhospital pediatric

transport meets children’s needs; (4) public information and education—expand the

availability of injury prevention, first aid, and CPR programs; (5) medical direction—

include pediatric protocols in medical direction for all EMS agencies; (6) regulation

and policy—ensure a coordinated approach to EMSC; and (7) evaluation and

research—improve data collection systems, data analysis methodology, and

research to describe and evaluate emergency medical care for children.

$820,084

$97,965

$918,049

Title V Program, contact:

Patricia Berry

Community Public Health Division Director

Division of Community Public Health

Vermont Department of Health

108 Cherry Street

Burlington, VT 05402

Phone: (802) 863-7333

Fax: (802) 863-7229

Title V Program’s services for Children

with Special Health Care Needs, contact:

Carol Hassler, Director

Children with Special Health Needs Program

Vermont Department of Health

 108 Cherry Street

Burlington, VT 05402

Phone: (802) 863-7338

Fax: (802) 863-7635

45

135

180

225

270

315

360

90

345 348

311

249
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

94,000 (UN report)

1,800

The Virgin Islands Title V Maternal and Child Health Services Block

Grant Program is operated as a single, Administrative Unit within

the Virgin Islands Department of Health. The Administrative Unit,

headed by the Director of MCH & CSHCN, is responsible for

conducting the state-wide assessment of needs, agency management, program planning and implementation, policy development,

and intra-agency collaboration. Within the Administrative Unit are

Program Administrators on each island who oversees financial and

clinic management functions. MCH & CSHCN administered programs included: Preventive and Primary Child Health Care, Newborn

Screening, Prenatal Care Services, Prenatal Care Coordination,

Genetic Disease Program, and Subspecialty Care Services.

516

1,818

4,502

1,477

1,269

9,582

$348,329

$348,329

$835,988

$975,320

$0

$278,663

$2,786,629

VIRGIN ISLANDS

$236,509

$3,214,912

$2,786,629

$191,774

250
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

VIRGIN ISLANDS

8 of 9

95.3%

83%

4897

097

40%

20%

11 of 18

2%97

53%

10

10.3

6.8

3.1

24.597

21.897

9 of 9

96%

90%

50

3.5

75%

96%

18 of 18

1%

90%

7.0

1

4.5

2.0

9.5

28

Pregnant women who received no prenatal care

Rate of asthma hospitalizations (per 100,000)

Prenatal patients certified with medical assistance program (MAP)

Live births to mothers who exceeded maximum established weight gain during pregnancy

*

91897

24%97

17%

3.5%

160

60%

10%

3

3

3

1

0

1

11

* Data not available 251
Selected FY 98 Title V and

Other MCH Grant Annotations

VIRGIN ISLANDS CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Coordination of Services for Children With Special Health Care Needs,

Virgin Islands Department of Health, Christiansted, St. Croix, $100,000

(SPRANS-MCHIP-SSDI)

This State Systems Development Initiative (SSDI) project is designed to assist the

maternal and child health/children with special health care needs (CSHCN)

program in developing a comprehensive community-based, family-centered,

culturally sensitive, and coordinated service system. The SSDI coordinator’s role

is to implement the networking component of the project. Efforts to cultivate the

interactive communication and collaboration among public and private providers for

children with special health care needs and their families will result in an

improved, efficient, effective, and accessible service system for the CSHCN

families and the professionals serving this target population. In addition, ongoing

educational training sessions are planned for the professional staff and family

support groups.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Program, U.S.V.I. Department of Health, St. Thomas,

$136,509 (Abstinence Ed)

The Abstinence Education Program will promote “sexual abstinence” as a healthy

choice. The targeted age group is persons 13-19 year of age. Planned activities

include a one-day training seminar in “sexual abstinence,” for adolescent service

providers, a six-week group counseling program to be delivered seven times in

different island locations, a Walk-a-Thon to raise public awareness, posting of

bilingual posters, and distribution of print materials. A pre- and post-evaluation will

be carried out as part of the 6-week counseling program.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Virgin Islands Emergency Medical Services for Children, Virgin Islands

Department of Health, St. Croix, $191,774 (EMSC-Implementation)

The goals of the Virgin Islands Emergency Medical Services for Children project

are to: (1) Promote collaboration and coordination among public and private

agencies delivering emergency services to children; (2) develop a regional system

of care serving neonatal and pediatric populations; (3) provide comprehensive

training in Basic Life Support (CPR) and Advanced Pediatric Life Support (PALS);

and (4) promote injury prevention through a public awareness program. A

multidisciplinary coalition will advocate, develop solutions, recommend legislative

strategy, and stimulate development of a comprehensive, statewide system of

emergency medical services for children in the Virgin Islands.

252
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$236,509

$191,774

$428,283

Title V Program, contact:

Mavis L. Matthew, MD, MPH

Director, MCH & CSHCN Program

3012 Estate Golden Rock

Christiansted, St. Croix, VI 00820

Phone: (340) 713-9926

Fax: (340) 713-9928

Title V Program’s services for Children

with Special Health Care Needs, contact:

Mavis L. Matthew, MD. MPH

Director, MCH & CSHCN Program

3012 Estate Golden Rock

Christiansted, St. Croix, VI 00820

Phone: (340) 713-9926

Fax: (340) 713-9928

15

45

60

75

90

105

120

30

115

90 85

253
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

6,791,345

94,351

The Virginia Department of Health is authorized by Section 32.1-77

of the Code of Virginia to administer the Maternal and Child Health

Services Block Grant funds. Within the VDH, the Block Grant is

managed by the Office of Family Health Services. The services

provided with this funding include prevention and primary care

services for pregnant women and mothers, prevention and primary

care for infants, children and adolescents, and non-pregnant women

of childbearing age. Services are also provided for children with

special health care needs.

10,359

91,664

64,522

11,160

43,081

220,786

$2,343,587

$1,710,507

$7,265,466

$11,845,083

$2,298,748

$0

$25,463,391

VIRGINIA

$8,252,199

$36,382,597

$25,463,391

$2,667,007

254
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

VIRGINIA

7 of 9

104.4%97

72%97

25.997

3.797

58%97

2%97

4 of 18

1.6%97

84.3%97

7.8

2.397

5.597

2.597

7.297

22.497

7 of 9

100%

90%

21.6

3.2

75%

85%

12 of 18

1.0%

87%

7.0

1.7

4.5

2.3

5.8

19

Children and adolescents who have a specific source of ongoing primary care

Unintentional injury hospitalizations rate for children 1-14 (per 100,000)

Incidence of hospitalization for assault injuries among people aged 10-19 (per 100,000)

Rate of neural tube defects among live births in Virginia (per 10,000)

82%97

175.797

30.697

9.197

90%

167.5

23.5

5.0

1

1

1

0

0

1

4

255
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Caring Community for Children in Foster

Care Project, Parent Educational

Advocacy Training Center, Fairfax,

$140,799 (SPRANS-MCHIP-Integrated

Services)

• Comprehensive Health Investment

Project of Abingdon, People Incorporated

of Southwest Virginia, Abingdon, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Families—The Vital Link: Models of

Family/Professional Leadership for

Reformed Systems of Health Care, Parent

Educational Advocacy Training Center,

Fairfax, $150,000 (SPRANS-MCHIPManaged Care/Health Care Reform)

• Guiding Primary Care Providers To

Access and To Use Medical Genetics

Information Electronically, Eastern

Virginia Medical School, Norfolk,

$124,746 (SPRANS-Genetics)

• Maternal and Child Health

Interdisciplinary Leadership Education

Program in Neurodevelopmental and

Related Disabilities (MCH-LEND), Virginia

Commonwealth University, Richmond,

$300,000 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• National Consortium to Advance

Education and Public Policy, Georgetown

University, Arlington, $6,080,361

(SPRANS-Training-Continuing Ed/Policy

Center)

• State Systems Development Initiative,

Virginia Department of Health, Richmond,

$84,752 (SPRANS-MCHIP-SSDI)

Title V—COMMUNITY INTEGRATED

SERVICE SYSTEMS (CISS—Title V)

• Healthy Child Care Virginia, Prince

William Health System, Manassas,

$50,000 (CISS-CISS-Child Care Program)

• Healthy Families South Hampton Roads,

Family Services of Tidewater, Inc.,

Norfolk, $50,000 (CISS-CISS-COG)

• Richmond Healthy Start–CISS Project,

City of Richmond Health Department,

Richmond, $50,000 (CISS-CISS-COG)

HEALTHY START

• Virginia Healthy Start Initiative, Virginia

Department of Health, Richmond,

$209,6007 (Healthy Start-Community)

VIRGINIA CONTINUED

VIRGINIA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

National Parent Consortium for Maternal and Child Health, National Parent

Network on Disabilities, Alexandria, $292,922 (SPRANS-MCHIP-PIC)

The National Parent Consortium on Maternal and Child Health was formed in 1995

by the National Parent Network on Disabilities as a vehicle to enhance

communication between the Maternal and Child Health Bureau and families.

Through a diverse working group of 13 organizations, 6 Regional Consultants, and

more than 200 member sites nationwide, the consortium communicates with

families on issues concerning maternal and child health. Through electronic mail

and a Web site, plus more traditional methods, the consortium staff disseminates

information to families. The consortium also represents the perspectives of

families at various maternal and child health meetings and on projects such as

Bright Futures for Families.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Healthy Families Arlington/CHIP Integrated Service Systems, Northern

Virginia Family Service, Falls Church, $50,000 (CISS-CISS-COG)

The Department of Human Services (DHS) in Arlington County Virginia and

Northern Virginia Family Service have formed a public/private partnership to

implement the Healthy Families and Comprehensive Health Investment Project

(CHIO) models in Arlington. Both Healthy Families and CHIP are collaborative,

community-based efforts coordinating the delivery of child health and family

services. In implementing the Healthy Families/CHIP models, the Arlington

County/Northern Virginia Family Service partnership will build on available services

within Arlington County’s DHS, will develop better coordination among the DHS

programs and will strengthen the link between DHS and externally based

community programs. CISS funding is sought for additional staff to organize the

participating community service providers in their efforts to consolidate information

management systems within the context of the Healthy Families and CHIP

programs in Arlington. This would allow concurrent development of the service

delivery partnerships and the data management infrastructure needed to support

this integrated effort, thus enhancing efficiency and avoiding duplication of efforts

by the various participating service providers in the community.

Title V—ABSTINENCE EDUCATION PROGRAM

Virginia Abstinence Education Initiative, Virginia Department of Health,

Richmond, $828,619 (Abstinence Ed)

Using experimental methods to evaluate four models of abstinence-only education,

this project will attempt to identify effective components of the models by tracking

program participants longitudinally and contrasting non-participants over a 5-year

period. A statewide media campaign will be developed to provide adolescents in

Virginia, aged 10-15, with alternatives to early sexual onset, which will result in

improving health, as well as decreasing the incidence of teenage pregnancy.

256
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Needs Assessment & Development of Strategic Plan for EMS for Children in

Virginia, Virginia Commonwealth University, Richmond, $50,000 (EMSC-Plan)

Enhancing the capacity of the existing emergency medical services (EMS)

system in Virginia to care for acutely ill and injured children and prevent injuries is

the project goal. Objectives include expanding the understanding of and

commitment to emergency medical services for children (EMSC) by recruiting and

appointing individuals committed to EMSC and agency stakeholders of EMSC to

the EMSC task force, and convert the task force to a standing subcommittee of

the State EMSC advisory board; and completing a statewide needs assessment

using established EMSC survey tools to identify strengths and weaknesses of the

existing EMS in caring for children.

HEALTHY START

Richmond Healthy Start Initiative, Richmond City Health Department,

Richmond, $521,000 (Healthy Start-Mentor)

The Richmond Healthy Start Initiative-Special Projects Consortium seeks to: (1)

Establish an expanded partnership of consumers, organizations, and individuals to

improve the organization of resources for women, children, and families; (2)

increase perinatal case management, expand home visiting programs, implement

the Healthy Families America and Infant Mortality Review Programs, and expand

perinatal substance abuse services; (3) support a community transportation

system linked to short-term child care; and (4) provide education and information

programs in schools, community centers, and churches in three targeted zones.

The expectation is that community ownership, program development,

implementation, and evaluation will result in successful efforts to reduce infant

mortality and enhance women’s, infants’, and children’s health.

$8,252,199

$2,667,007

$10,919,206

Title V Program, contact:

Janice M. Hicks, Ph.D.

Senior Policy Analyst

Office of Family Health Services

Virginia Department of Health

1500 East Main Street, Room 104

Richmond, VA 23219

Phone: (804) 371-0478

Fax: (804) 692-0184

Title V Program’s services for Children

with Special Health Care Needs, contact:

Nancy Bullock, RN, MPH

Director, Children w/Special Health Care Needs Program

Division of Child and Adolescent Health

Office of Family Health Services

1500 East Main Street, Room 138

Richmond, VA 23219

Phone: (804) 786-3693

Fax: (804) 225-3307

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

9,147

10,573

N/A

257
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

5,689,263

79,663

The Department of Health (DOH) is the state agency which administers the Title V program in the state of Washington. The Title V

Program, called Maternal and Child Health (MCH) is located in the

Division of Community and Family Health, under the direction of the

Assistant Secretary, Maxine Hayes, M.D., M.P.H. MCH is divided

into the following programs: Maternal Infant Health, Children and

Adolescent Health and CHILD Profile, Children with Special Health

Care Needs, Genetics, Immunization and an Assessment unit (see

pages 17-24 for a description of these services). These programs

provide much of the infrastructure services funded through Title V,

with the majority of direct health care, enabling and population

based Title V services contracted and provided through 34 local

health jurisdictions and other agencies throughout the state.

18,194

77,568

27,299

9,165

7,403

139,629

$1,873,476

$3,855,664

$9,670,350

$5,034,485

$465,355

$744,420

$21,643,750

WASHINGTON

$4,743,539

$26,562,265

$21,643,750

$174,976

258
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

WASHINGTON

8 of 9

98.6%97

79%97

25.397

4.297

86.8%97

3.2%

15 of 18

1%97

83.3%97

5.697

1.897

3.497

2.397

8.597

21.897

8 of 9

98.5%

83%

23.8

3.0

92.1%

3.2%

16 of 18

.95%

87.4%

5.5

2.2

3.4

2.1

8.3

21.5

Pregnancies (live births, fetal, deaths, abortions) that are unintended

Women who receive counseling from their prenatal health care providers on tests for

identifying birth defects or genetic disease

Pregnant women abstaining from smoking

Pregnant women abstaining from alcohol

52.7%97

90.5%97

85.4%97

93.9%97

49.8%

90%

87.0%

93%

3

3

2

2

3

2

15

259
Selected FY 98 Title V and

Other MCH Grant Annotations

WASHINGTON CONTINUED

WASHINGTON

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Washington Comprehensive Sickle Cell Disease Program (WCSCDP),

Children’s Hospital, Seattle, $171,400 (SPRANS-Genetics)

The goals of this project include decreasing morbidity and mortality in infants and

children with sickle cell disease and increasing general awareness and

understanding of sickle cell disease among medical, professional, and lay persons

in Washington. A key and novel feature is a planned transition for sharing the

financial responsibility of medical and social services provided by this program with

private and community-based organizations. The effectiveness of this program will

be evaluated annually based on demographic data, outcome of laboratory studies,

initial followup, and outcome data of the followup care component.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Interactive Video Teleconferencing in a Community Organization Care

Network, Yakima Valley Memorial Hospital, Yakima, $50,000 (CISS-CISS-COG)

This project proposes to integrate care for Children with Special Health Care Needs

and Families (CSHCN&F) living in isolated, culturally unique, poor, rural

communities across a six county area in the State of Washington. Currently,

infants and children in these six counties cannot all be adequately served because

of cultural inhibitions, the high proportion living in poverty, the lack of pediatric and

child behavior specialists and the lack of local professionals sufficiently trained in

the management of CSHCN&F. The Interactive Video Teleconferencing (IVTC)

Community Organization Care Network will use technological advances in

communication to increase access to specialized pediatric medical and

psychological consultations and educational trainings for a greater number of

CSHCN&F and their providers at a lower cost without sacrificing quality.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Program, Washington State Department of Health,

Olympia, $739,012 (Abstinence Ed)

The Washington State Department of Health’s Abstinence Education Program

targets the problem of teen pregnancy and subsequent out-of-wedlock births

through three approaches. Community-based abstinence education interventions

will be supports in six to eight communities and will include a component for

evaluation. Approximately 40 local school districts will also receive support to

assist youth in designing and producing media campaigns promoting sexual

abstinence. The third approach is the development of public education, both

statewide and at the local level.

Title V—SPECIAL PROJECTS OF REGIONAL

& NATIONAL SIGNIFICANCE (SPRANS)

• Adolescent Health Training Program,

University of Washington, Seattle, $95,666

(SPRANS-Training-Adolescent Health)

• Assuring Pediatric Nutrition Care in the

Community: Training and Electronic

Consultation, University of Washington,

Seattle, $33,288 (SPRANS-TrainingContinuing Education)

• Children and Adolescents With Special

Health Care Needs: Family Community,

University of Washington, Seattle, $158,751

(SPRANS-Training-Nursing)

• Children’s Village, Center for Child Health

Services, Yakima, $96,416 (SPRANSMCHIP-Integrated Services)

• Collaborative Adolescent Medicine

Round—Pediatrics/Child Psychiatry, Seattle

Children’s Hospital and Medical Center,

Seattle, $12,000 (SPRANS-TrainingContinuing Ed/Collaborative Office Rounds)

• Community Assessment of Needs and

Health Systems Performance, Children’s

Hospital Seattle, Seattle, $97,366 (SPRANSMCHIP-Data)

• Community Health Care Project,

Washington Parents Are Vital in Education

(PAVE), Tacoma , $64,306 (SPRANS-MCHIPManaged Care/Health Care Reform)

• Early Child Care Study of Children with

Special Health Needs, University of

Washington, Seattle , $227,834 (SPRANSResearch)

• Gaining and Growing: Assuring Nutritional

Care of Preterm Infants in the Community,

University of Washington, Seattle, $25,000

(SPRANS-Training-Continuing Education)

• Helix Education Project, Children’s

Hospital and Medical Center, Seattle,

$101,019 (SPRANS-Genetics)

• Innovative Approaches to Educating

Clients and Providers for Effective Life

Long Care of Metabolic Disorders,

University of Washington, Seattle, $135,000

(SPRANS-Genetics)

• Interdisciplinary Leadership Training in

Neurodevelopmental and Related

Disabilities, University of Washington,

Seattle, $809,983 (SPRANS-Training-LEND/

Leadership Ed Neuro Dev)

• Leadership Training in Pediatric Physical

Therapy, University of Washington, Seattle,

$149,193 (SPRANS-Training-Physical

Therapy)

• Linkages and Outcomes for Children (LOC),

Washington State Department of Health,

Olympia, $150,000 (SPRANS-MCHIPManaged Care/Health Care Reform)

• Maternal and Child Health Public Health

Training, University of Washington, Seattle,

$358,587 (SPRANS-Training-School of

Public Health)

• Maternal Birthweight and Reproductive

Outcome, University of Washington,

Seattle, $141,736 (SPRANS-Research)

• National Fathers’ Network (NFN):

Developing Inclusive Systems of Health

Care Delivery for Fathers and Families of

Children with Special Needs, National

Fathers’ Network, Bellevue , $80,000

(SPRANS-MCHIP-Integrated Services)

260
TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

$4,743,539

$174,976

$5,093,491

• Parents, Peer Educators and Head Start:

Building Healthy Tomorrows, Puget Sound

Educational Service District, Burien, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Partners’ Forum: A Washington State Model

To Ensure Access to Quality Genetic

Services for Persons Enrolled in Managed

Care, Washington Department of Health,

Seattle, $61,293 (SPRANS-Genetics)

• Partnerships for Improved Community Care

(PICC), Children’s Center of Providence

General Medical Center, Everett, $145,000

(SPRANS-MCHIP-Managed Care/Health Care

Reform)

• Pediatric Pulmonary Training, University of

Washington, Seattle, $296,511 (SPRANSTraining-Pediatric Pulmonary Center)

• Preparing Providers to Care for Children with

Special Health Care Needs in a Reformed

Health System, University of Washington,

Seattle, $169,895 (SPRANS-MCHIP-Managed

Care/Health Care Reform)

• State Systems Development Initiative

Approach for Quality Assurance, State of

Washington, Department of Health, Olympia,

$99,451 (SPRANS-MCHIP-SSDI)

• Washington State Genetic Education Project

(GEP) for Primary Care Providers (PCPs),

Washington State Department of Health,

Seattle, $124,832 (SPRANS-Genetics)

Title V—COMMUNITY INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• Community Systems Development, State of

Washington Department of Health, Olympia,

$50,000 (CISS-CISS-COG)

• Health Systems Development in Child Care,

Washington State Department of Health,

Olympia, $50,000 (CISS-CISS-Child Care

Program)

EMERGENCY MEDICAL

SERVICES FOR CHILDREN

(EMSC)

• Region X Injury Prevention

Training Conferences,

University of Washington,

Seattle, $25,000 (EMSC/

TRNG-Continuing Education)

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Adolescent Drowning Risk Assessment and Prevention, Washington State

Department of Health, Olympia, $149,976 (EMSC-Target)

This project aims to assess the problem of drowning for 15–19-year-olds because

little is known about the risk-taking for drowning among adolescents and to

develop interventions because none are specifically designed to address risk

factors for this age group. The ultimate goal is to reduce drownings among

adolescents 15–19 years of age in Washington State over a 2-year period through

a systematic approach to drowning prevention. Objectives of the project are to (1)

undertake a pilot project to determine risk-taking behavior in adolescent

submersions; (2) establish the emergency department’s role in drowning

prevention education; (3) develop intervention strategies and tools that focus on

education, policy, and technology; and (4) target three emergency medical

services/trauma regions throughout the State for an adolescent- and familyfocused community drowning prevention campaign.

WASHINGTON

Other FY 98 MCH Grant Programs

Title V Program, contact:

Rita Schmidt

Director of MCH Programs

New Market Industrial Complex, Bldg. 7

P.O. Box 47880

Olympia, WA 98504-7880

Phone: (360) 236-3581

Fax: (360) 586-7868

Title V Program’s services for Children

with Special Health Care Needs, contact:

Jan Fleming

Manager of OCSHCN

New Market Industrial Campus, Bldg. 7

P.O. Box 47880

Olympia, WA 98504-7880

Phone: (360) 236-3521

Fax: (360) 586-7868

3,000

9,000

12,000

15,000

18,000

21,000

24,000

6,000

21,654

19,221

N/A

261
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

1,811,156

20,747

The Office of Maternal and Child Health is the agency in West

Virginia State government which administers Title V. West Virginia’s

Office of Maternal and Child Health is located within the State’s

Bureau for Public Health. The Bureau’s overall goal is to attain and

maintain a healthier environment for all West Virginians by placing a

special emphasis on community-based programming that facilitates

an accessible service delivery system.

In line with the Bureau for Public Health, the Office of Maternal and

Child Health provides operational guidance and support to providers

throughout West Virginia to improve the health of families. In

addition to providing funding support for actual service delivery, the

Office of Maternal and Child Health funds projects intended to

develop new knowledge that will ultimately improve the service

delivery of the health community.

20,735

20,735

95,257

5,126

*

141,853

$4,415,649

$9,900

$4,722,615

$12,671,284

$6,878,695

$666,557

$29,364,700

WEST VIRGINIA

$1,619,216

$32,937,116

$29,364,700

$1,953,200

262
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

WEST VIRGINIA

9 of 9

99.8%

82%97

26.797

11.997

48.4%97

8%97

10 of 18

1.5%97

82%97

9.597

1.997

6.497

3.197

13.197

25.697

9 of 9

95%

90%

21.98

4.0

41%

100%

18 of 18

1.0%

87%

7

1.5

4.5

2.2

8.0

23.5

Women greater than or equal to 18 years of age receiving a Pap smear within preceding 3 years

Women with prenatal care paid for by Medicaid receiving 1st trimester prenatal care

Women not smoking during pregnancy

Eligible children receiving EPSDT

81%

73.26%97

76.11%97

73.7%

85%

81%

78%

50%

3

2

0

1

3

1

10

* Data not available 263
Selected FY 98 Title V and

Other MCH Grant Annotations

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Building Family-Professional

Collaboration in West Virginia, West

Virginia University/West Virginia

Research Corporation, Morgantown, $0

(SPRANS-MCHIP)

• Leadership Education in the Area of

Disabilities (LEAD), West Virginia

University, Morgantown, $441,045

(SPRANS-Training-LEND/Leadership Ed

Neuro Dev)

• State Systems Development Initiative,

Office of Maternal and Child Health,

Charleston, $100,000 (SPRANS-MCHIPSSDI)

WEST VIRGINIA CONTINUED

WEST VIRGINIA

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Infant Temperament: Neonatal–5 years in Rural Appalachia, Marshall

University, Huntington, $540,635 (SPRANS-Research)

This is a continuation of an earlier funded project on infant temperament. Two

research questions will be addressed in this study. First, what continuity exists

between (1) certain temperament and mother-infant relationship qualities in

infancy, and (2) both preschool behavior problems and early school adjustment?

Second, how do environmental factors such as poverty and low parental education

levels, cultural values regarding education and achievement, and individual

differences in temperament and mother-child relations interact to influence early

school adjustment and performance?

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

West Virginia Health Systems Development in Child Care, Governor’s

Cabinet on Children and Families, Charleston, $50,000 (CISS-CISS-Child

Care Program)

The project strives to reduce fragmentation, focus on prevention, increase system

integration and coordination of services at the local level, emphasize health and

child care, and build long-term capacity to support integrated prevention efforts

among schools, health, mental health, and the early childhood community. The

initiative implemented through a one-stop shopping model of Starting Points

Neighborhood Centers for Young Children and Their Families in seven targeted

communities.

Title V—ABSTINENCE EDUCATION PROGRAM

West Virginia Abstinence Education Project, West Virginia Department of

Health and Human Services, Bureau for Public Health, Charleston, $487,536

(Abstinence Ed)

The 10-to-14-year-old age group will be targeted. A planning group/Advisory

Council is being formed. Evaluation of the program will be carried under the

direction of the Office of Maternal and Child Health’s Division of Research,

Evaluation and Planning.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Preparing the West Virginia EMS System for the Child of the Year 2000,

West Virginia University, Morgantown, $258,984 (EMSC-Implementation)

The project addresses the emergency needs of children and their families over the

entire spectrum of emergency care in West Virginia (WV). We will develop a 5-

year plan for emergency medical services for children (EMSC) modeled after the

national EMSC 5-year plan; and an EMSC–WV coalition of lay persons and

concerned corporations to foster EMSC in West Virginia, provide in-kind services

to the coalition, raise money to augment Federal and State funds. We will

address the needs of at-risk children (children in foster care families, technologydependent children, and children with special needs) who require specialized

medical attention. Finally, we will develop a child injury prevention program that

will address the needs of at-risk families.

264
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

TRAUMATIC BRAIN INJURY

West Virginia TBI Planning Grant, West Virginia Division Rehabilitative

Services, Charleston, $75,000 (Traumatic Brain Injury-Plan)

This project will enable the State to design and conduct a statewide needs and

resources assessment and develop a plan to provide a full continuum of services

to persons with traumatic brain injury (TBI). A current need exists for the

delineation of a model for a statewide service delivery system that provides for the

identification, acute treatment, postacute treatment, rehabilitation, community

reentry, and ongoing support systems that are necessary following the occurrence

of a TBI. The ultimate goal of the project is to place West Virginia in a position to

implement a plan that improves the quality of life for an individual with a brain injury

and their loved ones through expanded services as well as enhanced service

coordination. Activities necessary for completing the project include the use of

small teams/focus groups reporting to a TBI advisory board and project staff,

conducting a statewide needs/resources survey, consultation with experts on TBI

issues, plan development, and public hearings.

$1,619,216

$1,953,200

$3,572,416

Title V Program, contact:

Patricia Moss, MSW, LCSW, ACSW

Director, Office of Maternal and Child Health

1411 Virginia Street East

Charleston, WV 25301

Phone: (304) 558-5388

Fax: (304) 558-2183

Title V Program’s services for Children

with Special Health Care Needs, contact:

Vacant

Director, Division of Children’s Specialty Care

1116 Quarrier Street

Charleston, WV 25301

Phone: (304) 558-3071

Fax: (304) 558-2866

3,500

10,500

14,000

17,500

21,000

24,500

28,000

7,000

24,000

20,000

22,872

265
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

5,223,500

67,450

The Title V MCH Block Grant funds are administered from the DOH,

within the Bureau of Public Health, Maternal and Child Health

Section. The MCH Section (including the Children with Special

Health Care Needs Program) is clearly demarcated within the

Division as the designee for administration of the Title V activities.

This clear demarcation is critical for ensuring comprehensive

program activity and a single point of accountability.

9,689

69,832

41,957

1,896

27,405

150,779

$3,242,141

$419,022

$8,720,622

$5,489,664

$4,909,968

$638,307

$23,419,724

WISCONSIN

$3,851,879

$29,097,290

$23,419,724

$1,825,687

266
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

WISCONSIN

8 of 9

99.4%97

77%

21.197

4.597

65%97

9.2%97

10 of 18

1.2%97

84.4%97

6.597

2.497

4.497

2.197

9.897

25.497

9 of 9

99.9%

90%

17

3.8

75%

20%

15 of 18

1.0%

90%

6.9

2.6

4.5

2.5

9.0

18

Children less than 12 years of age who receive one physical exam a year

Women who use tobacco during pregnancy

High school youth who self-report tobacco use over the past 30 days

Women enrolled in WIC during pregnancy who initiated breastfeeding

70%97

18%97

35%97

43%97

80%

13%

25%

60%

3

2

1

2

0

2

10

267
Selected FY 98 Title V and

Other MCH Grant Annotations

WISCONSIN CONTINUED

WISCONSIN

Other FY 98 MCH Grant Programs

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

Madison’s Girl Neighborhood Power Project, City of Madison, Madison,

$200,000 (SPRANS-MCHIP-Girl Power)

The mission of this project is to help preadolescent girls build successful futures,

negotiating the difficult transition from childhood to adolescence with their selfconfidence, physical health, and career aspirations strong. The goals of the

project are to (1) develop girls’ interest in community service and recreation; (2)

develop their interpersonal and social skills; and (3) provide information,

resources, relationships, and an environment that supports healthy development.

Specific objectives include increasing decision-making skills, improving selfimage, increasing commitment to community, developing trusting relationships

with health care providers, and increasing healthy diet and exercise.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Portage County Community Integrated Service System Project, Portage

County Department of Health and Human Services, Stevens Point, $50,000

(CISS-CISS-COG)

The project seeks to coordinate and integrate family and health services in

Portage County to provide a system of universal, accessible, developmentally

oriented, and accountable health care to residents. Goals include improving the

local capacity of communities to better address their family and health service

systems; and improving family-centered health service delivery to women and

children from low-income, rural, and racial and ethnic minority populations.

Title V—ABSTINENCE EDUCATION PROGRAM

Wisconsin Abstinence Education Project, Wisconsin Division of Children

and Family Services, Madison, $795,859 (Abstinence Ed)

The Wisconsin Abstinence Education Project will focus its abstinence promotion

efforts on a media campaign and on agencies committed to the abstinence before

marriage message and other recognized risk factors of teen pregnancy.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Improving EMS for Children State Partnership Grant, Wisconsin Department

of Health and Family Services, Madison, $75,000 (EMSC-PRTNER)

The overall goal of this project is to create a lead agency to identify and readdress

the specific needs in pediatric emergency medical services (EMS). The project

will continue to integrate children’s unique needs into all components of EMS,

including the injury prevention program. Specific goals are to (1) reformulate an

emergency medical services for children (EMSC) advisory group; (2) collect,

update, and redistribute existing EMSC materials; (3) develop new EMSC

materials and products; (4) link the EMSC project with existing State resources,

including the injury prevention program and the MCH section; and (5) look at EMS

data specific to pediatric treatment and care.

Title V—SPECIAL PROJECTS OF

REGIONAL & NATIONAL SIGNIFICANCE

(SPRANS)

• Center for Leadership in Occupational

Therapy Education, University of

Wisconsin, Madison, Madison, $140,406

(SPRANS-Training-Occupational Therapy)

• Clinician Help for Mothers of Infants with

Lung Disease, University of Wisconsin

School of Nursing, Madison, $261,536

(SPRANS-Research)

• Great Lakes Regional Genetics Group,

University of Wisconsin at Madison,

Madison, $202,862 (SPRANS-Genetics)

• Nationwide Blood Lead and Erythrocyte

Protoporphyrin Proficiency Testing

Program, University of Wisconsin at

Madison, Madison, $221,193 (SPRANSGenetics)

• Pediatric Pulmonary Center, University of

Wisconsin at Madison, Madison,

$303,159 (SPRANS-Training-Pediatric

Pulmonary Center)

• Region V West Hemophilia

Comprehensive Care Network, Great

Lakes Hemophilia Foundation, Inc.,

Wauwatosa, $487,163 (SPRANSHemophilia)

• State Systems Development Initiative,

Wisconsin Department of Health and

Family Services, Madison, $100,000

(SPRANS-MCHIP-SSDI)

• Teen Pregnancy Service & Adolescent

Primary Care, Milwaukee Adolescent

Health Program, Milwaukee, $50,000

(SPRANS-MCHIP-Healthy Tomorrows)

• Wisconsin Maternal and Child Health

Interdisciplinary Leadership Education in

Neurodevelopmental and Related

Disabilities, University of Wisconsin,

Madison, Madison, $499,741 (SPRANSTraining-LEND/Leadership Ed Neuro Dev)

• Wisconsin Statewide Genetics Network

for Primary Care Providers, University of

Wisconsin, Madison, $125,000 (SPRANSGenetics)

• Women’s Health/Maternal Newborn

Nursing Training Grant, University of

Wisconsin at Madison, Madison,

$214,960 (SPRANS-Training-Nursing)

268
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

HEALTHY START

Honoring Our Children With a Healthy Start, Great Lakes Inter-Tribal Council,

Inc., Lac du Flambeau, $1,140,030 (Healthy Start-Community)

Through this project, Honoring Our Children With a Healthy Start, the Great Lakes

Inter-Tribal Council will address the critical needs of native women and infants

living on 10 reservations in Wisconsin and will seek to reduce the high infant

mortality rate. Goals of the project are to (1) bring together providers and perinatal

participants to work to improve the perinatal system, reduce the risk in the

community, and provide communitywide education about the importance of good

prenatal care and well-child exams; (2) provide supportive services to perinatal

women that will enhance prenatal care coordination and well-child services; and (3)

foster healthy parent-child relationships and reduce the incidence of child abuse

and neglect.

TRAUMATIC BRAIN INJURY

Wisconsin TBI Demonstration Grant Program, Wisconsin Department of

Health and Family Services, Madison, $38,000 (Traumatic Brain Injury-Plan)

This project will establish the first three State-level core capacity components by

September 30, 1998, and the action plan and implementation phase by September

30, 1999. The process used to develop or expand on these components will (1)

include involvement of relevant disciplines, (2) make provisions for survivor, family,

and service provider input and participation, and (3) encompass the diversity of the

State. The long-term plan will emphasize service expansion with the objectives of

early intervention, appropriate care, adequate knowledge and training, and a

coordinated service system resulting in prevention of injury and reducing the

magnitude of secondary injury and other losses due to traumatic brain injury.

$3,851,879

$1,825,687

$5,677,566

Title V Program, contact:

Susan Uttech

Section Chief, Family Health

Bureau of Family and Community Health

W. Wilson, Room 351

P.O. Box 2659

Madison, WI 53701-2659

Phone: (608) 267-3561

Fax: (608) 267-3824

Title V Program’s services for Children

with Special Health Care Needs, contact:

Susan Uttech

Section Chief, Family Health

Bureau of Family and Community Health

W. Wilson, Room 351

P.O. Box 2659

Madison, WI 53701-2659

Phone: (608) 267-3561

Fax: (608) 267-3824

1,500

4,500

6,000

7,500

9,000

10,500

12,000

3,000

9,798

8,103

9,603

Title V—COMMUNITY INTEGRATED SERVICE

SYSTEMS (CISS—Title V)

• CISS: Health Systems Development in Child

Care Program (HSDCC): Wisconsin Health

and Child Care Systems Project, Wisconsin

Department of Health and Family Services,

Madison, $50,000 (CISS-CISS-Child Care

Program)

• Healthy Families Manitowoc County,

Manitowoc County Health Department,

Manitowoc, $50,000 (CISS-CISS-COG)

• Honoring Our Children, Great Lakes InterTribal Council, Inc. (GLITC), Lac du Flambeau,

$50,000 (CISS-CISS-COG)

• Start Right Community Development Project,

Children’s Service Society of Wisconsin,

Wausau, $50,000 (CISS-CISS-COG)

EMERGENCY MEDICAL SERVICES FOR

CHILDREN (EMSC)

• Project UJIMA: Youth Violence Intervention/

Prevention, Medical College of Wisconsin,

Milwaukee, $155,976 (EMSC-Target)

HEALTHY START

• Milwaukee Healthy Beginnings Project,

Black Health Coalition of Wisconsin, Inc.,

Milwaukee, $416,681 (Healthy Start-Mentor)

WISCONSIN

Other FY 98 MCH Grant Programs

269
Populations

 Served

Number of

Individuals Served

Expenditures

FY ’98

Pregnant Women

Infants (<1 year)

Children (1 to 22 yrs)

CSHCN (Special Needs)

Others3

Administration

TOTALS

State

Population5

Live Births5

The MCH Federal-State

Partnership

Title V Federal-State Block Grant

Expenditures4 by Source of Funds

MCH PARTNERSHIP FUNDS—FY 982

Title V Federal-State Block Grant Expenditures by

Number of Individuals Served and Population Group4

Other Title V Grant Programs:

TOTAL MCH Partnership Funds

Title V Federal-State Block Grant:

Other MCH Grant Programs:

480,907

6,252

The Department of Health’s Division of Public Health houses the Title V

program in Wyoming. Wyoming’s MCH program also houses Children’s

Health Services (CHS), the state’s program for children with special

health care needs (CSHCN). The CHS program includes: Lead screening and counseling; care coordination services for CSHCN; newborn

intensive care; end-stage renal; lead poisoning screening, and parent

services for CSHCN.

Other MCH administered programs include: Best Beginnings for

Wyoming Babies (our perinatal systems development initiative); Home

Visiting for Pregnant and Parenting Families; Adolescent Health; Family

Planning; Help Me Grow-Safe Kids; and High Risk Maternal. MCH funds

are also earmarked for the Dental Health Programs dental screening

(sealants) and severe crippling maloclusion programs. MCH also funds

the State Health Officer, the State Geneticist, and their support staff.

6,245

6,680

98,472

3,137

*

114,534

$320,899

$426,527

$551,783

$2,319,820

$97,385

$27,353

$3,743,767

WYOMING

$230,935

$4,102,707

$3,743,767

$128,005

270
Number of specialty services for Children with Special Health Care Needs (CSHCN)

Percent of newborns screened for 4 major genetic disorders

Percent of children immunized (ages 19-35 months) against 9 diseases

Rate of births to teens aged 15-17 years (per 1,000 teens aged 15-17 years)

Rate of deaths to children aged 1-14 caused by motor vehicle crashes (per 100,000 children)

Percent of mothers who breast fed their infants at time of hospital discharge

Percent of newborns screened for hearing impairment before hospital discharge

State assurance of family participation in CSHCN programs & policies

Percent of very low birth weight live births

Percent of infants born to women who received first trimester prenatal care

Infant mortality rate (per 1,000 live births)

Ratio of black to white infant mortality

Neonatal mortality rate (per 1,000 live births)

Postneonatal mortality rate (per 1,000 live births)

Perinatal mortality rate (per 1,000 live births)

Child death rate (per 100,000 children aged 1-14)

Title V - Selected National MCH Performance Measures7 State 1998 Results State Year 2000 Goal

Title V - National MCH Outcome Measures7

Title V - Selected State-Determined MCH Performance Measures7

State 1998 Results State Year 2000 Goal

State 1998 Results State Year 2000 Goal

Participate on task forces and offered training.

Financial support offered for parent groups.

Involved in Block Grant Application process.

Involved in inservice training of staff.

Hired for expertise as family member.

Members of diverse cultures involved.

 FY 98 Total:

State Assurance of Family Participation

in CSHCN Program and Policy

Title V Federal-State Block Grant

Expenditures4 by Category of Service6

Total Possible: 18

SCALE: 0 = not met; 3 = completely met

WYOMING

9 of 9

98.2%

77%

23.2

12.1

78.3%

89.5%

14 of 18

1.2%

82.5%

5.897

197

3.197

2.797

797

31.397

9 of 9

98%

90%

19

3.5

62%

97%

16 of 18

1%

89%

6.4

.86

4.0

2.4

9.5

28

Care coordination for high-risk pregnant women with infants

Low birth weight babies

Adolescent alcohol use

Adolescent smoking

26.4%97

9%

55%

37%

30%

5.9%

46%

34%

3

3

2

2

3

1

14

* Data not available 271
Selected FY 98 Title V and

Other MCH Grant Annotations

WYOMING CONTINUED

Title V—SPECIAL PROJECTS OF REGIONAL & NATIONAL

SIGNIFICANCE (SPRANS)

State System Development Initiative, Wyoming Department of Health,

Cheyenne, $100,000 (SPRANS-MCHIP-SSDI)

Wyoming’s State Systems Development Initiative project seeks to establish a

State and local interagency collaborative systems development process; ensure

community leadership and participation in problem identification and resource

allocation; promote and market the benefits of quality primary and preventive

health care to the health care community; ensure access to primary and

preventive services; and ensure that all Wyoming women, infants, children, and

adolescents receive appropriate primary care to help reduce mortality and

morbidity through prevention and early identification of health problems.

Title V—COMMUNITY INTEGRATED SERVICE SYSTEMS (CISS—Title V)

Wyoming’s CISS/HSDCC Program, University of Wyoming, Laramie, $50,000

(CISS-CISS-Child Care Program)

The project takes a multidisciplinary, integrated approach to promotion of safe,

healthy, and developmentally appropriate environments for all children in child

care; provision of training and ongoing consultation to child care providers and

families in the areas of social and emotional health, emphasizing the

interrelatedness of social, emotional, and physical development in children; and

an increase in parental and child care provider awareness of and involvement in

existing community health services programs. One of the activites for year 1 is to

conduct 1-day workshops for 400 child care providers, parents, and interested

health professionals in 6 targeted regions in the State.

Title V—ABSTINENCE EDUCATION PROGRAM

Abstinence Education Grant, Wyoming Department of Health, Cheyenne,

$80,935 (Abstinence Ed)

“Sex Can Wait Wyoming” is Wyoming’s statewide media campaign to promote

abstinence as the social norm for children aged 9 to 14 in an effort to encourage

this population, as they become high school students, to delay intercourse and

avoid other risk-taking behavior believed to be a precursor to early sexual activity.

EMERGENCY MEDICAL SERVICES FOR CHILDREN (EMSC)

Wyoming EMSC Project: Implementation Phase, Wyoming Office of

Emergency Medical Services, Cheyenne, $128,005 (EMSC-Implementation)

Goals of this project are to: Develop a comprehensive plan for the delivery of

emergency medical services for children (EMSC); develop and implement a data

and surveillance system to obtain accurate data and information on which to make

long-term decisions regarding emergency medical services in Wyoming; and

reduce morbidity and mortality among Wyoming’s children. A statewide task

force will be appointed to study the issues of EMSC in Wyoming and produce a

written State plan.

272
FOR MORE INFORMATION ON TITLE V:

State Hotline Calls/Year

To help

families

learn

about

maternal

and child

health care.

1-800-311-BABY;

en espanol: 1-800-504-7081

1996 1997 1998

TOTAL:

Other Title V Grant Programs:

Other MCH Grant Programs:

$230,935

$128,005

$358,940

Title V Program, contact:

Phyllis Sherard

Manager, MCH Section

Wyoming Department of Health

465 Hathaway Building

Cheyenne, WY 82002

Phone: (307) 777-7942

Fax: (307) 777-5402

Title V Program’s services for Children

with Special Health Care Needs, contact:

Dorothy Ailes

Manager, CSHCN Program

Wyoming Department of Health

467 Hathaway Building

Cheyenne, WY 82002

Phone: (307) 777-7941

Fax: (307) 777-5402

125

375

500

625

750

875

1,000

250

936

624

864

273
275

Appendix B Appendix B Appendix B How the

Title V Block

Grant Works

The Maternal and Child Health Services Title V Block

Grant to States program has operated as a Federal-State

partnership for 65 years. When the Social Security Act

was passed in 1935, the Federal Government, through

Title V, pledged its support of State efforts to extend and

improve health and welfare services for mothers and

children. Title V of the Social Security Act has been

amended a number of times in ensuing years to reflect

the expansion of the national interest in maternal and

child health.

Development of the MCH Federal-State

Partnership

Title V was converted to a block grant as part of the

Omnibus Budget Reconciliation Act of 1981. In the

Omnibus Budget Reconciliation Act of 1989, Congress

sought to balance the flexibility of the block grant with

greater accountability by requiring State Title V programs

to report on progress on key maternal and child health

indicators and other program information. Thus the block

grant legislation identifies a theme and central core of

accountability within the flexibility of State-identified

Maternal and Child Health (MCH) needs and solutions.

This theme, the request for Federal funds to assist the

States in the design and implementation of MCH

programs that would meet their own particular needs,

while at the same time asking them to account for the use

of those funds, was embodied in the requirements

contained in guidance documents for block grant

applications and annual reports. In 1996, the Maternal

and Child Health Bureau (MCHB) began a process of

programmatic assessments and planning activities

aimed at improving those guidance documents.

The Government Performance and Results Act (GPRA) of

1993 required the establishment of measurable goals that

can be reported as part of the budgetary process, thus
276

linking funding decisions with performance. Among its

purposes, GPRA is intended to “...improve Federal

program effectiveness and public accountability by

promoting a new focus on results, service, quality, and

customer satisfaction.” GPRA requires each Federal

agency to develop comprehensive strategic plans,

annual performance plans with measurable goals and

objectives, and annual reports on actual performance

compared to performance goals.

The MCHB effort to respond to GPRA requirements

coincided with other planned improvement of the block

grant guidance. The Division of State and Community

Health, MCHB, was given the responsibility of rewriting

and combining the Title V application and the annual

report into a single performance-based document. The

block grant application/annual report guidance and forms

that resulted and that were contained within the 1998

edition of the Maternal and Child Health Services Title V

Block Grant Program—Guidance and Forms for the Title

V Application/Annual Report served two purposes: they

ensured that the States and jurisdictions could clearly,

concisely, and accurately tell their MCH “stories”; and,

they became the basis by which MCHB met its GPRA

Block Grant to States Program reporting requirements.

The Electronic Reporting Package (ERP)

 The State and Federal need for an electronic version of

the application and reporting forms, coupled with the

GPRA requirement to show performance measures and

outcomes, spurred the creation of an electronic

information system. The Maternal and Child Health

Bureau partnered with the National Center for Education

in Maternal and Child Health (NCEMCH) to develop the

Electronic Reading Package (ERP) and the Internet

accessible Title V Information System (Title V IS).

This user-friendly database application provides the

electronic means for States to report data in a consistent

format. Each State agency for maternal and child health

was given a copy of the ERP software to install on its

computer system. State staff prepared all pertinent

information and returned the data on disks to MCHB for

review.

In addition to generating printed forms and electronic

data, the ERP also automates calculation, updates

multiple forms simultaneously, and alerts States when

conflicting or unacceptable figures appear. Thus the

quality of the final data product has been improved as

well. The ERP also includes standard word-processing

templates for the narrative portion of the application and

annual report. The purpose of the ERP is to provide a

tool for better planning, management, measures of

progress, and information on program costs in relation to

what is being achieved.

The Electronic Reporting Package was introduced to the

States at the annual meeting of the Association of

Maternal and Child Health Programs (AMCHP) in March

1998. It was mailed to all 59 States and jurisdictions for

use in preparing their 1999 Title V Maternal and Child

Health Block Grant to States Program applications.

While the ERP is designed to be user-friendly, ERP is a

complex program. In database terms it contains:

• 1640 data fields;

• 380 programmed routines;

• 89 layouts; and

• 118 records for online help and instructions.

The Title V Information System Database

The picture on the facing page shows the process for

data submission, review, and posting on the Web site.

The information gathered through the Electronic

Reporting Package (ERP) is now accessible to the public

via the Internet at www.mchdata.net.

The data on the Web site can be searched under five

categories.

• Financial Data— Title V budgets and expenditures.

• Program Data — Title V programs and services,

including quantitative data on the reach of Title V

programs across different populations and the

number of callers to the State hotline numbers.

• National “Core” Measures—18 Performance and 6

Outcome Measures.

• State “Negotiated” Measures—up to 10 measures,

selected by each State, which have direct relevance

to that State’s own maternal and child health

challenges.

• Summary Reports—Title V Maternal and Child Health

Block Grant to States Program Profile, including a

brief narrative program description and the names,
277

addresses, and telephone numbers of the State

Maternal and Child Health Director and the State’s

contact for the Title V Program for Children with

Special Health Care Needs (CSHCN).

The complete set of data from the ERP—based on the

States’ 1998 annual reports and their 2000

applications—is the basis for the data that is currently on

the Title V IS Web site (www.mchdata.net). This same

data set is the basis for the information presented in this

Snapshot of Maternal and Child Health,2000.
279

Appendix C Appendix C Appendix C MCHB

Strategic Plan

Vision

The Maternal and Child Health Bureau (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. 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.

Mission

The mission of the Maternal and Child Health Bureau

(MCHB) is to provide national leadership and to work in

partnership with States, communities, public-private

partners, and families to strengthen the maternal and

child health (MCH) infrastructure, assure the availability

and use of medical homes, and build knowledge and

human resources, in order to assure continued

improvement in the health, safety, and well-being of the

MCH population. The MCH population includes all of

America’s women, infants, children, adolescents and their

families, including women of reproductive age, fathers,

and children with special health care needs (CSHCN).

Values

• Affordable and accessible high quality care for all.

• Accountable, regularly monitored and evaluated

evidence-based quality care.

• Preventive, protective health care that addresses

an individual’s physical, psychological, and

social needs.
280

• 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.

Goals and Objectives

The Maternal and Child Health Bureau (MCHB) provides

leadership to improve access to comprehensive,

culturally sensitive, quality health care for all women,

infants, children, adolescents and their families, including

women of reproductive age, fathers, and children with

special health care needs (CSHCN). The Bureau has set

the following goals and objectives for the year 2003,

which are consistent with the Health Resources and

Services Administration (HRSA) Strategic Plan and the

Healthy People 2010 objectives.

GOAL 1.

Eliminate barriers and health disparities

Goal: To eliminate health disparities in health status

outcomes through the removal of economic, social, and

cultural barriers to receiving comprehensive, timely, and

appropriate health care.

1.1 Increase the number of pregnant women receiving

prenatal care in their first trimester to 8.5 percent.

Base: 82 percent in 1997.

Data Source: National Vital Statistics Systems, NCHS.

1.2 Increase the number of pregnant women and

children (ages 1–22) receiving Title V services who

enroll in and have Medicaid and the Children’s

Health Insurance Plan (CHIP) coverage from 6 to 8

million.

Base: 6,040,534 pregnant women and children

receiving Title V services had Medicaid and CHIP

coverage in 1997.

Data Source: Title V Block Grant Application.

1.3 Reduce the incidence of low birth weight to 6.5

percent of live births.

Base: 7.5 percent in 1997.

Data Source: National Vital Statistics Systems,

NCHS.

1.4 Reduce the incidence of infant mortality to 6.0 per

1000 live births.

Base: 7.1 per thousand live births in 1997.

Data Source: National Vital Statistics Systems,

NCHS.

1.5 Reduce the ratio of the black infant mortality rate to

the white infant mortality rate to 2.0.

Base: 2.3 in 1996 (black: 14.6 per 1000; white: 6.3

per 1000).

Data Source: National Vital Statistics Systems,

NCHS.

1.6 Ensure that all newborns are screened, diagnosed,

and provided treatment for disorders identified by

State-specific newborn screening programs.

Base: 90 percent of newborns received an initial

screening for PKU, congenital hypothyrodisim,

galactosemia, and sickle cell disease in 1997.

Data Source: Council of Regional Genetics Service

Networks, Title V Block Grant Application.

1.7 Ensure that 98 percent of children through age 2

have completed age appropriate immunizations.

Base: 90 percent in 1997.

Data Source: CDC and State immunization records.

1.8 Decrease the number of uninsured children under

age 18 from approximately 11 million to 6 million.

Base: 11 million uninsured children in 1998.

Data Source: The 1998 base was the current

population survey; Title V Block Grant Application.

1.9 Increase the number of children (ages 1–20)

receiving oral health services under Medicaid to 50

percent.

Base: 20 percent of the children in Medicaid (1995).

Data Source: Medicaid Program and Financial

Statistics, Office of the Inspector General’s Report,

“Children’s Dental Services under Medicaid: Access

and Utilization,” April 1996.
281

GOAL 2.

Assure Quality of Care

Goal: To assure the highest quality of care through the

development of practice guidances, data monitoring, and

evaluation tools; the utilization of evidence-based

research; and the availability of a well-trained, culturally

diverse workforce.

2.1 Assure that 50 percent of all infants and children

(ages 0–22), including CSHCN, are enrolled in a

medical home.

Base: 10.2 percent in 1997.

Data Source: The 1997 base is from the Title V

Block Grant Application and Report and a Family

Voices survey; Title V Block Grant Application. Note:

This is presently available only for CSHCN.

2.2 Assure that States, managed care organizations,

and related partners receive training to increase

their capacity to address quality of care issues for

children, including CSHCN, in managed care

settings by implementing 15 new training courses.

Base: Three in process as of 1998.

Data Source: MCHB.

2.3 All (100 percent) MCHB long-term training grantees,

and selected other appropriate grantees, will include

cultural competency training as part of their

curriculum.

Base: Unknown in 1998.

Data Source: MCHB grant applications and progress

reports.

2.4 Enhance the capacity of all States to utilize data and

information for the analysis, assessment, monitoring,

and evaluation of unmet needs and the quality of

care at the State and local levels.

Base: Unknown in FY1997.

Data Source: The Title V Block Grant Application/

Report.

2.5 Develop an evidence and scientific knowledge base

specifically directed at implementing the MCHB

Strategic Goals/Objectives in 85 percent of all new

MCHB research grants.

Base: 40 percent in 1998.

Data Source: MCHB training grant progress reports.

2.6 Assure that 75 percent of all MCH trainees remain in

the MCH field to meet the geographic and skills mix

necessary to assure quality of care to the MCH

population.

Base: Unknown in 1998.

Data Source: MCHB training grant progress reports.

2.7 Implementation strategies will be developed for eight

major, recently published best practice guidelines.

Base: None developed as of 1998.

Data Source: MCHB.

2.8 Increase the number of women (age 18 and older)

counseled by their health care provider on each of

seven selected health behaviors by 10 percent.

Base: The percentage of women, ages 18 and older,

counseled by their health care provider in 1997 was:

1. Smoking: 29 percent.

2. Diet/weight: 46 percent

3. Physical activity: 49 percent

4. Alcohol/drug use: 23 percent

5. STDs: 16 percent

6. Concerns about safety and violence: 8 percent

7. Folic acid: 3 percent.

Data Source: Health Concerns Across a Woman’s

Lifespan: the Commonwealth Fund 1998 Survey of

Women’s Health and the March of Dimes/Gallup

Folic Acid Survey, 1998.

GOAL 3.

Improve the Health Infrastructure and System

Goal: 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.

3.1 Increase the number of State oral health programs

with program directors to 36.

Base: 26 States, as measured by the number of

States with oral health directors/programs,

March 1999.

Data Source: Association of State and Territorial

Dental Directors.

3.2 Increase the number of States that have

implemented comprehensive injury prevention

programs to 59.
282

Base: Zero in 1998. Source: State and Territorial

Injury Prevention Directors’ Association.

3.3 Assure that all States have health systems to

promote and protect the health and safety of

children (ages 1–22) in child care settings.

Base: 5 States had systems in 1998.

Data Source: MCHB grant applications and reports.

3.4 Increase to 25 the number of States that utilize

linked MCH electronic data bases in their needs

assessments, planning, evaluation, and reporting

activities.

Base: Unknown in 1998.

Data Source: Title V Block Grant Applications and

Title V Information Systems utilization data.

3.5 Increase the Title V Special Projects of Regional and

National Significance (SPRANS) grantees who use

the SPRANS Electronic Reporting Package (ERP)

for program and financial data reporting to 100

percent.

Base: None in 1998 as the SPRANS ERP was just

being developed.

Data Source: MCHB.

3.6 Increase the number of States having in place

pediatric guidelines that identify the ability of acute

care facilities to provide pediatric emergency and

critical care to 30.

Base: 18 States in 1997.

Data Source: EMSC Annual Grantees Survey,

MCHB, HRSA.

3.7 Increase the percentage of States that have

comprehensive systems of quality care for children

(ages 1–22) that integrate health, mental health,

and substance abuse services to 50 percent.

Base: None in 1997.

Data Source: Title V Block Grant Applications,

States that are ranked “good to excellent” in the Title

V Application on Form 13. Note: This is presently

available only for CSHCN.

3.8 Increase the number of States that have integrated

and comprehensive systems for women’s health

services to 20.

Base: 9 States in

1996.

Data Source:

Association of State

and Territorial

Health Officials.

Title V Block Grant

Application.

3.9 Increase the

percentage of States

that implement cultural

competency policies,

procedures, and practices

to 100 percent.

Base: 13 States had cultural

competency policies,

procedures, and practices in

1995.

Data Source: Title V Block

Grant Application/Annual

Reports and the National

Center for Cultural

Competence.

3.10 Increase the

percentage of States

that demonstrate

family/professional

partnerships in

policy

development and

program

implementation to

100 percent.

Base: 24 employ

family members and

47 used families in an

advisory capacity in

1997.

Data Source: Title V Block

Grant Application and Family

Voices.
283

Appendix D Appendix D Appendix D Organizational

Links

The Web site at www.mchdata.net provides a one-stop

link to a wealth of organizational resources. Each site has

been evaluated for the usefulness, reliability, and

timeliness of the maternal and child health (MCH)

information presented and for the ease with which users

can move around and access information. The list is not

intended to be comprehensive; rather it offers a sample of

quality sites that are useful starting points for those

interested in MCH topics.

The Web site address is included for each organization.

Alternatively, log on to www.mchdata.net, click on the LINK

button, and experience the ease of being “hot linked” to

any of the organizations described in this section. (Even

more sites are listed on the Web.)

The list of sites below is organized by the following

categories:

• Advocacy

• Consumer Health and Safety

• Data

• Federal Government

• General Information Resources and Libraries

• MCH Policy and Research Centers

• National MCH Policy Consortium

• National MCH Resource Centers

• Professional Associations

• State Information
284

Advocacy

Also see National MCH Resource Centers.

The Alan Guttmacher Institute (AGI)

www.agi-usa.org

Reproductive health research, policy analysis, and public

education. Includes statistics, periodicals, fact sheets,

and policy papers.

Children’s Defense Fund (CDF)

ww.childrensdefense.org

Information for educating the Nation about the needs of

children. Includes key facts about children in each State

and information about the Children’s Health Insurance

Program (CHIP), news releases about legislation

affecting children, a parent resource network, and

information about CDF’s programs and initiatives.

Families USA Foundation

www.familiesusa.org

Information about the organization’s efforts to achieve

high-quality, affordable health care for all Americans.

Includes reports and updates on topics such as child

health care expansion.

Consumer Health and Safety

Also see Advocacy, General Information Resources and

Libraries, Federal Government, National MCH Resource

Centers, Professional Associations, and State

Information.

Britannica Internet Guide: Health and Medicine

www.eblast.com

Annotated links to health and medicine sites on the

World Wide Web; the sites have been rated on their

quality and include subjects such as children’s health

and women’s health. Developed by Encyclopedia

Britannica.

Consumer Product Safety Commission (CPSC)

www.cpsc.gov

Product recall notices; publications on a variety of safety

topics; a mechanism for reporting unsafe products; and a

“4 Kids” section on safety. CPSC is an independent

Federal regulatory agency.

HealthWeb

www.healthweb.org

Links to evaluated health-related Internet resources on

over 60 subjects, including pediatrics and women’s

health. HealthWeb is a collaborative project of the health

sciences libraries of the Greater Midwest Region (GMR)

of the National Network of Libraries of Medicine (NN/LM)

and those of the Committee on Institutional Cooperation

(CIC).

MEDLINE plus

www.nlm.nih.gov

Selective list of authoritative health information sources

to help consumers research their health questions. Child

development and pregnancy are among the MCH topics

covered. Developed by the National Library of Medicine.

Pediatric Points of Interest

http://www.med.jhu.edu/peds/neonatology/poi.html

Searchable collection of links to resources in children’s

health. Developed by the Department of Pediatrics at

Johns Hopkins University.

The New York Times on the Web:

Women’s Health

http://www.nytimes.com/specials/women/whome/index.html

Articles about a wide variety of women’s health issues

that have appeared in the New York Times; women’s

health data; and a guide to related Web sites.

Data

Also see Advocacy, Federal Government, National MCH

Resource Centers, and State Information.

FedStats

http://www.fedstats.gov/

Access to the statistical information produced by more

than 70 federal agencies for public use; links to data on

MCH-related topics, including births, breastfeeding, child

care, children, youth, infant mortality, and prenatal care.

FedStats is maintained by the Federal Interagency

Council on Statistical Policy.

KIDS COUNT

http://www.aecf.org

Information about this national and state-by-state effort

to track the status of children in the United States;

provides access to the KIDS COUNT database and

publications on child health topics. KIDS COUNT is a

project of the Annie E. Casey Foundation.

National Center for Health Statistics (NCHS)

http://www.cdc.gov/nchs

National data on such MCH-related topics as prenatal

care, births, infant mortality, and child health; information
285

about surveys and data collection systems, such as the

National Maternal and Infant Health Survey (NMIHS).

Publications available include Health, United States;

America’s Children: Key National Indicators of WellBeing; Healthy People 2000 Review; and National Vital

Statistics Reports. NCHS is part of the Centers for

Disease Control and Prevention.

U.S. Census Bureau

www.census.gov

Social, demographic, and economic information;

publications that include current survey reports and

historical time series tables; and data on MCH-related

topics, including births, child care, children, health

insurance coverage, households, families, and fertility.

The site contains the Statistical Abstract of the United

States. The Census Bureau is part of the U.S.

Department of Commerce.

Youth Indicators, 1996:

Trends in the Well-Being of American Youth

http://nces.ed.gov/pubs/yi/index.html

Data about American youth on topics such as

demographics and family composition, family income,

school, health, citizenship, and future goals. Developed

by the National Center for Education Statistics, U.S.

Department of Education.

Federal Government

Also see Data, Consumer Health and Safety, General

Information Resources and Libraries, and State

Information.

Agency for Health Care Policy and Research

(AHCPR)

http://www.ahcpr.gov/

Information about AHCPR’s research activities in areas

such as children’s health and women’s health; clinical

practice guidelines; quality assessment publications and

tools; and data and findings, such as the results from the

Medical Expenditure Survey. AHCPR is part of the U.S.

Department of Health and Human Services.

Administration for Children and Families (ACF)

http://www.acf.dhhs.gov/

Describes ACF’s programs and services that promote

the economic and social well-being of families and

children. ACF is part of the U.S. Department of Health

and Human Services.

Bureau of Primary Health Care (BPHC)

http://www.bphc.hrsa.dhhs.gov/

Describes BPHC’s programs and the people they serve;

offers several databases, including models that work and

state profiles from a primary care perspective. BPHC is

part of the Health Resources and Services

Administration, U.S. Department of Health and Human

Services.

Centers for Disease Control and Prevention

(CDC)

http://www.cdc.gov/

Information for health professionals and consumers

about diseases, disabilities, health risks, and specific

populations, including infants, children, adolescents, and

women; access to publications, databases, and other

products, such as the CDC Prevention Guidelines, CDC

Wonder, the Agency for Toxic Substances and Disease

Registry’s Hazardous Substance Release/Health Effects

Database (HazDat); and downloadable issues of

Morbidity and Mortality Weekly Report (MMWR). CDC is

an agency of the U.S. Department of Health and Human

Services.

Health Care Financing Administration (HCFA)

http://www.hcfa.gov/

Information about Medicare, Medicaid, and child health

insurance programs; also includes publications and

forms, statistics and data, and information about

research and demonstration projects. HCFA is part of the

U.S. Department of Health and Human Services.

Health Resources and Services Administration

(HRSA)

http://www.hrsa.gov

Overview of HRSA’s programs and information about

grants and contracts; site contains a section on

children’s health that includes a compendium of outreach

models for reaching children and ensuring that they

receive health insurance. A special section includes an

extensive fact sheet on women’s health and HRSA’s

agenda for women’s health. HRSA is part of the U.S.

Department of Health and Human Services.

Maternal and Child Health Bureau (MCHB)

http://www.mchb.hrsa.gov/

Describes MCHB’s projects and initiatives on behalf of

America’s children and families; includes MCHB Federal

Register notices, grants guidance, and publications.

MCHB is part of the Health Resources and Services
286

Administration, U.S. Department of Health and Human

Services.

National Institute of Child Health and Human

Development (NICHD)

http://www.nichd.nih.gov/

Scientific and technical publications and information for

health professionals and consumers. NICHD is part of the

National Institutes of Health, U.S. Department of Health

and Human Services.

Office of Disease Prevention and Health

Promotion (ODPHP)

http://odphp.osophs.dhhs.gov/

Describes ODPHP’s programs and services; includes

announcements, online publications, and links to other

sites supported by ODPHP, such as the Healthy People

2010 Development Site and the Healthy People 2000

Initiative. ODPHP is part of the U.S. Department of Health

and Human Services.

Office of Minority Health Resource Center

(OMHRC)

http://www.omhrc.gov/

Publications on minority health issues; a minority health

materials database that includes topics such as child

health, family-life education, and prenatal care; a

minority health organizations database; and a minority

health community and career programs database.

OMHRC is part of the Office of Minority Health, U.S.

Department of Health and Human Services.

General Information

Resources and Libraries

Also see Consumer Health and Safety.

National Library of Medicine (NLM)

http://www.nlm.nih.gov/

Includes information about accessing NLM’s databases

and electronic information sources (including free access

to MEDLINE), finding information on health and other

medical topics, and NLM’s research and special

information programs. NLM is part of the National

Institutes of Health.

NETLINKS

http://www.jhuccp.org/netlinks/

Database of over 1,000 Internet resources for people

working in health, population, and international

development. Each entry includes a link to the resource,

a brief description, and contact information. MCH-related

topics include adolescent health, breastfeeding, child

health, immunization, and pregnancy. NETLINKS is

compiled and maintained by the Media/Materials

Clearinghouse at the Johns Hopkins Center for

Communication Programs.

Public Health InfoLinks

http://www.sph.emory.edu/PHIL/

Links to many public health resources on the World Wide

Web, including government, professional associations,

and non-governmental organization sites. Also contains

links to foundation and grant resources, journals and

publications, library and research tools, educational

resources, and materials on the history of public health.

Developed by the Rollins School of Public Health at

Emory University.

Schools of Public Health

http://www.lib.umich.edu/hw/public.health/schools.html

Links to the World Wide Web sites of the schools of

public health in the United States and internationally.

Developed by the University of Michigan School of Public

Health Library.

MCH Policy and Research Centers

Also see National Maternal and Child Health Policy

Consortium.

Institute for Child Health Policy (ICHP)

http://www.ichp.edu/

Includes information and publications about the institute’s

programs and research, which focus on children in

managed care with a special emphasis on children with

special health care needs. Also contains resources

about distance outreach and education, including

MCHNetLink, a monthly electronic newsletter on

information technology relating to the MCH community.

ICHP is a statewide institution of Florida’s state university

system.

National Center for Children and Poverty

(NCCP)

http://cpmcnet.columbia.edu/dept/nccp/

Offers child poverty facts, news releases, reports, and

NCCP’s newsletter, Child Poverty News and Issues;

includes summaries of NCCP’s program activities on

topics such as child care, welfare reform, and families

under stress. NCCP is part of the Columbia University

School of Public Health.
287

The Future of Children

http://www.futureofchildren.org/

Includes the full text of the journal Future of Children,

which describes current research and policy issues

relating to the well-being of children. The journal is

published by The David and Lucile Packard Foundation.

National Maternal and

Child Health Policy Consortium

The four university-based centers listed below are

designated by the Maternal and Child Health Bureau

(MCHB) as members of a consortium that will provide

policy and research expertise to MCHB and the MCH

community.

• National Center for Education in Maternal

and Child Health (NCEMCH)

http://www.ncemch.org/

This Georgetown University links page is part of the

NCEMCH Web site. Learn more about NCEMCH and

its program and policy activities.

• National Center for Infancy and Early

Childhood Health Policy

http://healthychild.ucla.edu

This is the University of California at Los Angeles

School of Public Health site. The center’s activities

and its staff are described at http://www.ph.ucla.edu/.

• Policy Information and Analysis Center for

Middle Childhood and Adolescence

http://www.ucsf.edu/

This University of California at San Francisco Web

site is under development.

• Women’s and Children’s Health

Policy Center

http://www.med.jhu.edu/wchpc/

Johns Hopkins University School of Public Health.

Describes the center, its mission, and current

projects; and includes policy news briefs and a

publications list.

National MCH Resource Centers

Center for the Prevention of School Violence

http://www.ncsu.edu/cpsv/

Newsletters, research briefs, and other information about

the prevention of school violence. Includes a Web

conferencing forum for exchanging ideas on the topic.

The Center is located at North Carolina State University.

Children’s Safety Network (CSN)

http://www.edc.org/HHD/csn/

Contains publications and resources produced by CSN

and other injury prevention projects of the Education

Development Center, Inc., which are aimed at maternal

and child health and other injury prevention

professionals. CSN is funded by the Maternal and Child

Health Bureau (MCHB).

Gaining and Growing:

Assuring Nutritional Care of Preterm Infants

http://staff.washington.edu/growing/

Checklists, decision trees and other resources for

community health professionals who work with premature

infants, especially those with very-low- birth weight.

Gaining and Growing is funded by a grant from the

Maternal and Child Health Bureau.

March of Dimes Birth Defects Foundation (MOD)

http://www.modimes.org/

Information for health professionals and consumers

about prenatal care, birth defects, maternal and infant

health statistics, and how to get involved in improving the

health of babies by reducing birth defects and infant

mortality. Includes information in Spanish.

National Fathers’ Network (NFN)

http://www.fathersnetwork.org/

Resources for fathers and families of children with

special health needs and the professionals who serve

them. Contains articles by fathers, abstracts on NFN’s

books and videotapes, the DADS newsletter, and

information for professionals about father-friendly

services. NFN is funded by the Maternal and Child Health

Bureau.
288

National Information Center for Children and

Youth With Disabilities (NICCYD/NICHCY)

http://www.nichcy.org/

Information for families, educators, and other

professionals about disabilities and disability-related

issues, with a special focus on children and youth.

Publications include fact sheets, parent guides, student

guides, bibliographies, and state resource sheets that list

the organizations and agencies within each state that

address disability-related issues. Several publications

have been translated into Spanish and are available

online. NICHCY is a project of the Academy of

Educational Development.

National Maternal and Child Health

Clearinghouse (NMCHC)

http://www.nmchc.org/

Includes the Maternal and Child Health Publications

Catalog; visitors can order publications online or link to

full-text clearinghouse publications. Also contains MCH

state resource sheets and links to MCH publications from

other sources. NMCHC is funded by the Maternal and

Child Health Bureau.

National Sudden Infant Death

Syndrome Resource Center (NSRC)

http://www.circsol.com/sids/

Includes fact sheets, bibliographies, and other

publications about SIDS for parents and professionals.

NSRC is sponsored by the Maternal and Child Health

Bureau.

National Women’s Health

Information Center (NWHIC)

http://www.4women.gov/

Information for health professionals and consumers on

topics such as adolescent health, breastfeeding,

pregnancy, and women with disabilities. Includes an

extensive FAQ section and access to NWHIC’s

publications and organizations databases. NWHIC is a

project of the Office on Women’s Health in the U.S.

Department of Health and Human Services.

Zero to Three: National Center

for Infants, Toddlers and Families

http://www.zerotothree.org/

Contains publications and information about Zero to

Three’s programs and services for parents and

professionals promoting the healthy development of

infants and toddlers.

Professional Associations

American Academy of Pediatrics (AAP)

http://www.aap.org/

Resources for parents and professionals about infants,

children, adolescents, and young adults, as well as

information about AAP’s advocacy work, research,

publications, membership, and meetings.

American Academy of Family Physicians

(AAFP)

http://www.aafp.org/

Information on a wide range of medical problems and

health issues that affect families; contains AAFP’s

publications, including patient handouts, flow charts for

self-diagnosis and self-care, position statements, and the

association’s journal, American Family Physician.

American College of Nurse-Midwives (ACNM)

http://www.midwife.org/

Resources for professionals and consumers on birth

control, pregnancy, childbirth, and midwifery. The site

offers access to the table of contents of the Journal of

Nurse-Midwifery and full-text access to their news

journal, Quickening. Professional information includes

standards for practice, core competencies, and a code of

ethics.

American College of Obstetricians

and Gynecologists (ACOG)

http://www.acog.com/

Resources for women and health professionals on

women’s health issues; includes ACOG’s publications

catalog and the table of contents of recent issues of

Obstetrics and Gynecology.

American Dental Association (ADA)

http://www.ada.org/

A one-stop shopping site for oral health information for

health professionals and consumers. The site includes

position statements, fact sheets, product information,

and a dentist directory; it also contains information about

oral health for children and parents.
289

American Dental Hygienists’ Association

(ADHA)

http://www.adha.org/

Includes information for health professionals and

consumers on the oral health of children and

adolescents. Contains an oral health education section

for kids.

American Dietetic Association (ADA)

http://www.eatright.org/

Nutrition resources for health professionals and

consumers that include position papers, fact sheets,

press releases, and other publications; MCH-related

topics include child nutrition and nutrition during

pregnancy. The site also contains abstracts of articles

appearing in the Journal of the American Dietetic

Association.

American Medical Association (AMA)

http://www.ama-assn.org/

Includes resources for physicians and consumers on

topics such as children’s health, adolescent health, and

women’s health. Also contains information about AMA’s

policy and advocacy work, accreditation, education

opportunities, products, services, and publications,

including abstracts from its journal, JAMA.

American Nurses Association (ANA)

http://www.nursingworld.org/

Includes policy papers and position statements for health

professionals; MCH-related topics include immunizations,

reproductive health, and home care after delivery. The

site also contains information about continuing education

opportunities available online, ANA’s legislative activities,

membership, and access to ANA’s journals.

American Public Health Association (APHA)

http://www.apha.org/

Fact sheets, policy statements, and news releases about

public health issues, including children’s health and

reproductive health. Includes the table of contents and

abstracts from the American Journal of Public Health and

an online order form for APHA’s publications.

Association of Maternal

and Child Health Programs (AMCHP)

http://amchp1.org/

Fact sheets and issue briefs on topics concerning Title V

programs; includes a publications list with ordering

instructions.

CityMatCH

http://www.citymatch.org/

Newsletters and descriptions of policy reports aimed at

urban MCH leaders and others interested in MCH

programs for major cities and counties; includes an “Aska Colleague” service.

National Conference of State Legislatures

(NCSL)

http://www.ncsl.org/

Information about current state legislative issues and

NCSL’s activities and publications; MCH-related topics

include child health insurance, school health, and

emergency medical services for children. In addition,

NCSL’s StateServ contains state legislative information,

policy analysis, and news on children’s health insurance,

adolescent health, environmental health, HIV/AIDS and

STDs, and immigrant policy.

NGA Online

http://www.nga.org/

Describes the efforts of the National Governors

Association to improve maternal and child health in the

states. Includes issue briefs and other publications on

MCH issues, such as the State Children’s Health

Insurance Program, child care, and school violence.

State Information

Also see AMCHP, CDF, KIDS COUNT, NCSL, and NGA.

HRSA State Profiles

http://www.hrsa.gov/profiles.htm

Profiles on each state, including demographic data;

health status and health care access indicators; health

care provider resources; top five causes of death; rates

of infectious diseases; and Health Resources and

Services Administration (HRSA) programs, funding, and

collaborative efforts. Compiled by HRSA, which is part of

the U.S. Department of Health and Human Services.

Maternal and Child Health

State Resource Sheets

http://www.nmchc.org/stateprofiles

MCH-related contacts for each state. Provided by the

National Maternal and Child Health Clearinghouse.
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Appendix E Appendix E Appendix E Glossary

Administration (of Title V Funds). The State’s

management of the Title V allocation. By statute, the

funds available for this activity or cost item are limited to

10 percent of the Federal Title V allotment.

Block Grant. A consolidated Federal funding award

program to States for multiple health-related programs

and services based on a set of specified requirements

involving planning, accountability, and systems

development. With MCHB, awards are based upon

primary outcome and performance measures affecting

maternal and child health, and its general purpose is to

improve the health of all mothers and children in the

Nation. The program has three components: Formula

Block Grants to the 50 States, the District of Columbia,

and eight Jurisdictions; Special Projects of Regional and

National Significance (SPRANS); and Community

Integrated Service Systems (CISS) Grants.

Care Coordination Services for CSHCN. Those

services that promote the effective and efficient

organization and utilization of resources to assure access

to necessary comprehensive services for children with

special health care needs and their families. [Title V Sec.

501(b)(3)]

Child Death Rate. Mortality rate of children ages 1–14

years. The formula is the number of children’s deaths

per 100,000 children aged 1–14.

Childbearing Age. The age range of women from

15–44 years.
292

Children. In this document, an individual—who is not

otherwise included in any other classification—is defined

as a child from the time of his or her first birthday

through the 21st year.

Children With Special Health Care Needs (CSHCN).

(For budgetary purposes—) Infants or children from birth

through the 21st year—who the State has elected to

provide with services funded through Title V CSHCN

program—who have health problems requiring more than

basic routine care, including children with or at risk of

disabilities, chronic illnesses and conditions, and healthrelated education and behavioral problems. (For

planning and systems development—) Those children

who have or are at increased risk for chronic physical,

developmental, behavioral, or emotional conditions and

who also require health and related services of a type or

amount beyond that required by children generally.

Children With Special Health Care Needs (CSHCN)—

Elements of a Service System:

1. State Program Collaboration With Other State

Agencies and Private Organizations. States

establish and maintain ongoing interagency

collaborative processes for the assessment of needs

with respect to the development of community-based

systems of services for CSHCN. State programs

collaborate with other agencies and organizations in

the formulation of coordinated policies, standards,

data collection and analysis, financing of services,

and program monitoring to assure comprehensive,

coordinated services for CSHCN and their families.

2. State Support for Communities. State programs

emphasize the development of community-based

programs by establishing and maintaining a process

for facilitating community systems-building through

mechanisms such as technical assistance and

consultation, education and training, common data

protocols, and financial resources for communities

engaged in systems development to assure that the

unique needs of CSHCN are met.

3. Coordination of Health Components of

Community-Based Systems. A mechanism exists in

communities across the State for coordination of

health services with one another. This includes

coordination among providers of primary care,

habilitative and rehabilitative services, other specialty

medical treatment services, mental health services,

and home health care.

4. Coordination of Health Services With Other

Services at the Community Level. A mechanism

exists in communities across the State for

coordination and service integration among

programs serving CSHCN, including early

intervention and special education, social services,

and family support services.

Classes of Individuals. Authorized persons to be

served with Title V funds. See individual definitions under

“Pregnant Women,” “Infants,” “Children With Special

Health Care Needs,” “Children,” and “Others.” (Also

referred to in the Chapter IV State data snapshot pages

as “populations” served.)

Community. A group of individuals living as a smaller

social unit within the confines of a larger one due to

common geographic boundaries, cultural identity, a

common work environment, common interests, et cetera.

Community-based Care. Services provided within the

context of a defined community.

Community-based Service System. An organized

network of services grounded in a plan developed by a

community and based upon needs assessments.

Coordination (See Care Coordination Services.)

Culturally Competent. The ability to provide services to

clients that honor different cultural beliefs, interpersonal

styles, attitudes, and behaviors; and the use of

multicultural staff in the policy development,

administration, and provision of those services.

Culturally Sensitive. The recognition and

understanding that different cultures may have different

concepts and practices with regard to health care; the

respect of those differences, and the development of

approaches to health care with those differences in mind.
293

Deliveries. Women who received a medical care

procedure associated with the delivery or expulsion of a

live birth or fetal death (gestation of 20 weeks or

greater).

Direct Health Care Services. Those services generally

delivered one-on-one between a health professional and

a patient in an office, clinic, or emergency room, which

may include primary care physicians, registered

dietitians, public health or visiting nurses, nurses certified

for obstetric and pediatric primary care, medical social

workers, nutritionists, dentists, sub-specialty physicians

who serve children with special health care needs,

audiologists, occupational therapists, physical therapists,

speech and language therapists, and specialty

registered dietitians. Basic services include what most

consider ordinary medical care, inpatient and outpatient

medical services, allied health services, drugs, laboratory

testing, X-ray services, dental care, and pharmaceutical

products and services. State Title V programs support—

by directly operating programs or by funding local

providers—services such as prenatal care, child health

including immunizations and treatment or referrals,

school health and family planning. For CSHCN, these

services include specialty and subspecialty care for

those with HIV/AIDS, hemophilia, birth defects, chronic

illness, and other conditions requiring sophisticated

technology, access to highly trained specialists, or an

array of services not generally available in most

communities.

Enabling Services. Services that allow or provide for

access to and the derivation of benefits from, the array

of basic health care services and include such things as

transportation, translation services, outreach, respite

care, health education, family support services, purchase

of health insurance, case management, coordination with

Medicaid, WIC, and education. These services are

especially required for the low income, disadvantaged,

geographically or culturally isolated, and those with

special and complicated health needs. For many of these

individuals, the enabling services are essential, for

without them access is not possible. Enabling services

most commonly provided by agencies for CSHCN include

transportation, care coordination, translation services,

home visiting, and family outreach. Family support

activities include parent support groups, family training

workshops, advocacy, nutrition, and social work.

Family-centered Care. A system or philosophy of care

that incorporates the family as an integral component of

the health care system.

Government Performance and Results Act (GPRA).

Federal legislation enacted in 1993 that requires Federal

agencies to develop strategic plans, prepare annual

plans setting performance goals, and report annually on

actual performance.

Health Care System. The entirety of the agencies,

services, and providers involved or potentially involved in

the health care of community members and the

interactions among those agencies, services, and

providers.

Infant Mortality Rate (IMR). A globally accepted

measure indicating general health status equal to the

number of infant deaths occurring from birth through 364

days per 1,000 live births. The rate typically used is

deaths per 1,000 live births.

Infants. Children under one year of age who are not

included in any other class or population of individuals

served.

Infrastructure Building Services. The services that

are the base of the MCH pyramid of health services and

form its foundation are activities directed at improving

and maintaining the health status of all women and

children by providing support for development and

maintenance of comprehensive health services systems.

These services include development and maintenance of

health services standards/guidelines, training, data, and

planning systems. Examples include needs assessment,

evaluation, planning, policy development, coordination,

quality assurance, standards development, monitoring,

training, applied research, information systems, and

systems of care. In the development of systems of care it

should be assured that the systems are family centered,

community based, and culturally competent.

Local Funds. Those monies derived from local

jurisdictions within the State that are used for MCH

program activities.
294

Low Income. An individual’s or family’s income, which is

determined to be below the official poverty income line as

defined by the Office of Management and Budget and

revised annually in accordance with section 673(2) of the

Omnibus Budget Reconciliation Act of 1981.

Maternal and Child Health Bureau (MCHB). The

administrative and program headquarters, within the

Federal Government’s Department of Health and Human

Services, which administers the Federal Block Grant for

maternal and child health (Title V of the Social Security

Administration Act) to the States. MCHB also directs

other program activities, such as Healthy Start, the

Emergency Medical Services for Children, Abstinence

Education, and grants for HIV coordinated services and

access to research for women, infants, children, and

youth programs.

MCH Pyramid of Health Services. See individual

definitions of the types of services under “Infrastructure

Building,” Population Based Services,” Enabling

Services,” and “Direct Health Services.”

Measures. See Performance Measures.

Needs Assessment. A study undertaken to determine

the service requirements within a jurisdiction. For

maternal and child health purposes, the study is aimed at

determining: 1) What is essential in terms of the

provision of health services; 2) What is available; and 3)

What is missing.

Neonatal. Infant age period defined as birth to 28 days.

Perinatal. Age period ranging from a fetal state greater

than or equal to 20 weeks gestation to infant life under 7

days.

Performance Indicator. The statistical or quantitative

value that expresses the result of a performance

objective.

Performance Measure. A narrative statement that

describes a specific maternal and child health need, or

requirement, that, when successfully addressed, will lead

to, or will assist in leading to, a specific health outcome

within a community or jurisdiction and generally within a

specified time frame. (Example: “The rate of women in

[State] who received early prenatal care in 19__. This

performance measure will assist in leading to [the health

outcome measure of] reducing the rate of infant mortality

in the State).

Performance Measurement. The collection of data on,

recording of, or tabulation of results or achievements,

usually for comparing with a benchmark.

Performance Objectives. A statement of intention with

which actual achievement and results can be measured

and compared. Performance objective statements clearly

describe what is to be achieved, when it is to be

achieved, the extent of the achievement, and target

populations.

Population Based Services. Preventive interventions

and personal health services, developed and available

for the entire MCH population of the State rather than for

individuals in a one-on-one situation. Disease

prevention, health promotion, and statewide outreach

are major components. Common among these services

are newborn screening, lead screening, immunization,

Sudden Infant Death Syndrome counseling, oral health,

injury prevention, nutrition, and outreach/public

education. These services are generally available

whether the mother or child receives care in the private

or public system, in a rural clinic or an HMO, and whether

insured or not.

Populations Served. Persons who are authorized to be

served with Title V funds. See individual definitions under

“Pregnant Women,” “Infants,” “Children With Special

Health Care Needs,” “Children,” and “Others.”

Postneonatal. Infant age period ranging from 28 to 364

days.

Pregnant Woman. A female from the time that she

conceives to 60 days after birth, delivery, or expulsion of

fetus.
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Prenatal Care. Health care and health education

services accessed and used by an expecting mother

during the three trimesters of gestation prior to birth.

Preventive Services. Activities aimed at reducing the

incidence of health problems or disease prevalence in

the community, or the personal risk factors for such

diseases or conditions.

Primary Care. The provision of comprehensive personal

health services that include health maintenance and

preventive services, initial assessment of health

problems, treatment of uncomplicated and diagnosed

chronic health problems, and the overall management of

an individual’s or family’s health care services.

Process. Process results are indicators of activities,

methods, and interventions that support the achievement

of outcomes (e.g., improved health status or reduction in

risk factors). A focus on process results can lead to an

understanding of how practices and procedures can be

improved to reach successful outcomes. Process results

are a mechanism for review and accountability, and as

such, tend to be shorter-term than results focused on

health outcomes or risk factors. The utility of process

results often depends on the strength of the relationship

between the process and the outcome. Process results

should answer the question, “Why should this process be

undertaken and measured (i.e., what is its relationship to

achievement of a health outcome or risk factor result)?”

Process Objectives. The objectives for activities and

interventions that drive the achievement of higher level

objectives.

Program Income. Funds collected by State MCH

agencies from sources generated by the State’s MCH

program to include insurance payments, MEDICAID

reimbursements, HMO payments, et cetera.

Regions. See table on the inside cover of this

document, which shows how the United States and its

jurisdictions are organized into 10 Federal regions.

Risk Factor Objectives. Objectives that describe an

improvement in risk factors (usually behavioral or

physiological) that cause morbidity and mortality.

Risk Factors. Public health activities and programs that

focus on reduction of scientifically established direct

causes of, and contributors to, morbidity and mortality

(i.e., risk factors) are essential steps toward achieving

health outcomes. Changes in behavior or physiological

conditions are the indicators of achievement of risk factor

results. Results focused on risk factors tend to be

intermediate term. Risk factor results should answer the

question, “Why should the State address this risk factor

(i.e., what health outcome will this result support)?”

State. In this document, State includes the 50 States

and the 9 jurisdictions of the District of Columbia, the

Commonwealth of Puerto Rico, the Virgin Islands, Guam,

American Samoa, the Commonwealth of the Northern

Mariana Islands, the Republic of the Marshall Islands, the

Federated States of Micronesia, and the Republic of

Palau.

Technical Assistance (TA). The process of providing

recipients with expert assistance of specific healthrelated or administrative services that include: systems

review planning, policy options analysis, coordination

coalition building/training, data system development,

needs assessment, performance indicators, health care

reform wraparound services, CSHCN program

development/evaluation, public health managed-care

quality standards development, public and private

interagency integration, and identification of core public

health issues.

Title V of the Social Security Act of 1935. The

Federal statute that authorizes the Government program,

which administers the Title V Maternal and Child Health

Block Grant to States Program allocation, including the

application and reporting process.

Title XIX. The section of the Social Security Act

amended in 1965 that provides the MEDICAID program.

Within maternal and child health care, Title XIX provides

services for pregnant women and infants who meet

eligibility requirements.
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Title XXI. A provision of the 1997 Social Security Act that

created the State Children’s Health Insurance Program

(CHIP) that provides funding to States to initiate and

expand children’s health assistance programs to

uninsured, low-income children.

Total MCH Funding. All the Maternal and Child Health

(MCH) funds administered by a State MCH program,

which is made up of the sum of the Federal Title V

Maternal and Child Health Block Grant to States Program

allocation, the Applicant’s funds (carryover from the

previous year’s MCH Block Grant allocation—the

unobligated balance), the State funds (the total matching

funds for the Title V allocation—match and overmatch),

Local funds (total of MCH dedicated funds from local

jurisdictions within the State), Other Federal funds

(monies other than the Title V Block Grant that are under

the control of the person responsible for administration

of the Title V program), and Program Income (those

funds collected by State MCH agencies such as

insurance payments, MEDICAID, and HMO’s.).

Trimester. Refers to one of the three periods of time

comprising gestation, ranging from conception to

expulsion of the fetus. In a 40-day gestation period,

trimesters are arranged as 0–14 weeks, 14–28 weeks,

and 28–40 weeks.

Types of Services. The major kinds or levels of health

care services covered under Title V activities. See

individual definitions under “Infrastructure Building,”

“Population Based Services,” “Enabling Services,” and

“Direct Health Care Services.”

Very Low Birth Weight. The at-birth weight of an infant

who is less than 1500 grams (or less than 3.3 lbs.).
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3. Others. Illustrations of State

reported other individuals served includes mostly services to women. Other

expenditures include the use of MCH funds available from other sources such as foundations.

4. Expenditures data may contain anomalies. States use different methodologies and multiple sources of data,

data reported on this table may include actual counts, estimates, or blank cells if data are not available at thetime of reporting. Figures displayed here are for the Federal fiscal year (October 1 through September 30). SomeStates use different fiscal years or budget on a biannual basis. Detailed information on the Federal Reportingguidance to the States can be found at www.mchdata.net.

5. Population and Live Births data provided by the Population Estimates Program, Population Division, U.S.

Bureau of the Census, Washington, DC. Exceptions are noted on some Jurisdictions.

6. Categories of Service: Direct Health Care Services are generally delivered one-on-one between a health

professional and a patient in an office, clinic or emergency room, which may include primary care physicians,registered dietitians, public health or visiting nurses, nurses certified for obstetric and pediatric primary care,medical social workers, nutritionists, dentists, sub-specialty physicians who serve children with special healthcare needs, audiologists, occupational therapists, physical therapists, speech and language therapists, specialty registered dietitians. Enabling Services allow or provide for access to and the derivation of benefits fromthe array of basic health care services and include such things as transportation, translation services, outreach,respite care, health education, family support services, purchase of health insurance, case management,coordination with Medicaid, WIC, and education. These services are especially required for the low income,disadvantaged, geographically or culturally isolated, and those with special and complicated health needs.Population-Based Services include the preventive interventions and personal health services, developed andavailable for the entire MCH population of the State rather than for individuals in a one-on-one situation. Diseaseprevention, health promotion, and statewide outreach are major components. These services include newbornscreening, lead screening, immunization, Sudden Infant Death Syndrome counseling, oral health, injury prevention, nutrition and outreach/public education. Services are generally available whether the mother or childreceives care in the private or public system, in a rural clinic or an HMO, and whether insured or not. Infrastructure Building Services provide the foundation of the MCH pyramid of health services. They support development and maintenance of comprehensive health services systems including development and maintenance ofhealth services standards/guidelines, training, data and planning systems.

7. Title V Measures: National Performance Measures. All States report annual progress toward achieving the

target they set for the 18 national performance measures. This table displays data from 10 of the 18 measures.To see how a State did on all 18 measures, or for more detail on the significance of a given measure, the Stategoal, and the numerator and denominator for the State’s indicator, see the National “Core” Measures section ofthe data base at www.mchdata.net. Rates are based on individual State populations. National Outcome

Measures. All States report annually on their progress toward achieving the target they set for the six nationaloutcome measures. For more detail on a State’s outcome measure and actual result (e.g., the numerator ordenominator), see the National “Core” Measures section of the data base at www.mchdata.net. Rates arebased on individual State populations. State-Determined Performance Measures. Each State reports on 7 to

10 “Negotiated” performance measures that they develop and have approved by MCHB. This allows States tomeasure progress toward achieving goals that are specific to their State. Four measures were selected for thistable. Each measure is linked to a detailed description with objectives and annual data. To see the full set ofState Negotiated Measures, go to the “State Negotiated Measures” section of the data base atwww.mchdata.net. Rates are based on individual State populations.

8. MCH grants and contracts to universities and non-government organizations such as professional associations

are listed within the States where those organizations reside.
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