20-24 Table 3 CSHCN Infants, Children and Youth Served (a) Number Served (b) Total Served (c) Title XIX % (d) Title XXI % (e) Private/ Other % (f) None % (g) Unknown % Infants <1 yr Children and Youth 1 to 25 years 12-24 months 25 months- 4 years 5-9 10-14 15-19 20-24 Table 4 Women Served (a) Number Served (b) Total Served (c) Title XIX % (d) Title XXI % (e) Private/ Other % (f) None % Unknown % (g) Women 25+ 25-29 30-34 35-44 45-54 55-64 65+ Table 5 Other (a) Number Served (b) Total Served (c) Title XIX % (d) Title XXI % (e) Private/ Other % (f) None % Unknown % (g) Men 25+ TOTAL SERVED: ________________ INSTRUCTIONS FOR THE COMPLETION OF FORM 5 NUMBER OF INDIVIDUALS SERVED (UNDUPLICATED) By Type of Individual and Source of Primary Insurance Coverage For Projects Providing Direct Health Care, Enabling or Population-based Services Enter data into all required (unshaded) data cells. If an actual number is not available, make an estimate. Please explain all estimates, in a note.
DEFINITION Numerator: Total number of longterm trainees (≥ 300 contact hours) participating in MCHB training programs reported to be from underrepresented racial and ethnic groups. (Include MCHB-supported and non-supported trainees.) Denominator: Total number of longterm trainees (≥ 300 contact hours) participating in MCHB training programs. (Include MCHB-supported and non-supported trainees.) Units: 100 Text: Percentage The definition of “underrepresented racial and ethnic groups” is based on the categories from the U.S. Census. HEALTHY PEOPLE 2020 OBJECTIVE Related to Healthy People 2020 Objectives: AHS-4: Increase the number of practicing primary care providers ECBP-11: (Developmental) Increase the proportion of local health departments that have established culturally appropriate and linguistically competent community health promotion and disease prevention programs DATA SOURCE(S) AND ISSUES Data will be collected annually from grantees about their trainees. MCHB does not maintain a master list of all trainees who are supported by MCHB longterm training programs. References supporting Workforce Diversity: In the Nation’s Compelling Interest: Ensuring Diversity in the Healthcare Workforce (2004). Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (2002). Institute of Medicine. SIGNIFICANCE HRSA’s MCHB places special emphasis on improving service delivery to women, children and youth from communities with limited access to comprehensive care. Training a diverse group of professionals is necessary in order to provide a diverse public health workforce to meet the needs of the changing demographics of the U.S. and to ensure access to culturally competent and effective services. This performance measure provides the necessary data to report on HRSA’s initiatives to reduce health disparities. Data Collection Form For Detail Sheet #09 Report on the percentage of long-term trainees (≥300 contact hours) who are from any underrepresented racial/ethnic group (i.e., Hispanic or Latino, American Indian or Alaskan Native, Asian, Black or African-American, Native Hawaiian or Pacific Islander, two or more race (OMB). Please use the space provided for notes to detail the data source and year of data used.
____ Other (Specify)_________ TOTAL Number of Medium term Trainees: _________ Short Term Trainees DEFINITION: Short-term trainees are trainees with less than 40 contact hours in the current reporting year. (Continuing Education participants are not counted in this category) Total number of short term trainees during the past 12-month grant period________ Indicate disciplines (check all that apply) Audiology Dentistry-Pediatric Dentistry – Other Education/Special Education Family/Parent/Youth Advocacy Genetics/Genetic Counseling Health Administration Medicine-General Medicine-Adolescent Medicine Medicine-Developmental-Behavioral Pediatrics Medicine-Neurodevelopmental Disabilities Medicine-Pediatrics Medicine-Pediatric Pulmonology Medicine – Other Nursing-General Nursing-Family/Pediatric Nurse Practitioner Nursing-Midwife Nursing – Other Nutrition Occupational Therapy Parent Physical Therapy Psychiatry Psychology Public Health Respiratory Therapy Social Work Speech-Language Pathology Other (Specify) Technical Assistance/Collaboration Form DEFINITION: Technical Assistance/Collaboration refers to mutual problem solving and collaboration on a range of issues, which may include program development, clinical services, collaboration, program evaluation, needs assessment, and policy & guidelines formulation. It may include administrative services, site visitation and review/advisory functions. Collaborative partners might include State or local health agencies, and education or social service agencies. Faculty may serve on advisory boards to develop &/or review policies at the local, State,
B. Provide information below on the 5-10 most significant technical assistance/collaborative activities in the past year. In the notes, briefly state why these were the most significant TA events. Title Topic of Technical Assistance/Collaboration Select one from list A and all that apply from List B. Recipient of TA/Collaborator Intensity of TA Primary Target Audience List A (select one) Clinical care related (including medical home) Cultural Competence Related Data, Research, Evaluation Methods (Knowledge Translation) Family Involvement Interdisciplinary Teaming Healthcare Workforce Leadership Policy Prevention Systems Development/ Improvement List B (select all that apply) Women’s/Reproductive/ Perinatal Health Early Childhood Health/ Development (birth to school age) School Age Children Adolescent CSHCN/Developmental Disabilities Autism Emergency Preparedness Health Information Technology Mental Health Nutrition Oral Health Patient Safety Respiratory Disease Vulnerable Populations* Racial and Ethnic Diversity or Disparities Other Other Divisions/ Departments in a University Title V (MCH Programs) State Health Dept. Health Insurance/ Organization Education Medicaid agency Social Service Agency Mental Health Agency Juvenile Justice or other Legal Entity State Adolescent Health Developmental Disability Agency Early Intervention Other Govt. Agencies Mixed Agencies Professional Family and/or Consumer Group Foundations Clinical Programs/ Hospitals Other (specify) One time brief (single contact) One time extended (multi-day contact provided one time) On-going infrequent (3 or less contacts per year) On-going frequent (more than 3 contacts per year) Local Within State Another State Regional National International 1 Example G- Policy 11- Oral Health E - Education 2 2 "Vulnerable groups," refers to social groups with increased relative risk (i.e. exposure to risk factors) or susceptibility to health-related problems. This vulnerability is evidenced in higher comparative mortality rates, lower life expectancy, reduced access to care, and diminished quality of life.
For up to 10 of the most significant CE activities in the past project year, list the title, topics, methods, number of participants, duration and whether CE units were provided. In the field notes, briefly state why these were the most significant CE events (e.g., most participants reached; key topic addressed, new collaboration opportunity, emerging issues, diversity of participants (other than healthcare workers etc)) Title Topic: List A select one Topic: List B: select all that apply Primary Target Audience Local State Another state Regional National International Method* In-person Distance Mixed Number of Participants Continuing Education Credits Provided? (Yes/No) Clinical (including medical home) Cultural Data, Research, Evaluation Methods (Knowledge Translation) Family Involvement Interdisciplinary Teaming Healthcare Workforce Leadership Policy Prevention Systems Development/ Improvement Women’s Reproductive/ Perinatal Health Early Childhood Health/ Development (birth to school age) School Age Children Adolescent CSHCN/Developmental Disabilities Autism Emergency Preparedness Health Information Technology Mental Health Nutrition Oral Health Patient Safety Respiratory Disease Vulnerable Populations* Racial and Ethnic Diversity or Disparities Other (specify) 1. 2. 3. * "Vulnerable groups" refers to social groups with increased relative risk (i.e. exposure to risk factors) or susceptibility to health-related problems. This vulnerability is evidenced in higher comparative mortality rates, lower life expectancy, reduced access to care, and diminished quality of life. Center for Vulnerable Populations Research. UCLA.