1. Striving for Outcomes: Federal Transformation of the Title V Maternal and Child Health Block Grant Bob Bowman, MS, MA, MS Director Maternal and Child Health Division

2. Goals Clearly define Title V Explain how Title V is changing Explain what the MCH program is doing in anticipation of the transformation Explain how the transformation will impact MCH grants

3. What is Title V? Title V Maternal and Child Health Program is the Nation’s oldest Federal-State partnership. Provides a foundation for ensuring the health of the Nation’s mothers, women, children and youth, including children and you with special health care needs and their families.

4. What is Title V? Block grant program was established in 1981. Each year state Maternal and Child Health agencies apply for and receive a formula grant. In Indiana over $5.5 million dollars of Title V funding is made available to grantees annually.

5. Title V Transformation Fall of 2013, Dr. Michael Lu provided a rough outline of the transformation which included: The mission and vision of Title V would not change Importance of federal/state partnership

6. Stressed that if we hope to sustain the current funding to Title V we must be able to tell a national story as to how Title V is moving the needle. Title V Transformation HOWEVER

7. Each state has been therefore challenged to: Title V Transformation Sharpen our focus Sharpen our measurements

8. An update from Dr. Michael Lu Maternal and Child Health Block Grant Transformation, Part II

9. Takeaways from Update

10. Women’s/Maternal Health 1) Well-women’s visit (BRFSS) Definition: % of women 18-44 with past-year preventive visit 2) Low-risk cesarean (Birth Certificate) Definition: % cesarean among term, singleton, vertex, first births Perinatal/Infant’s Health 3) Perinatal Regionalization (Linked birth-AAP Directory) Definition: % VLBWs born in facilities with level III + NICUs 4) Breastfeeding (NIS) Definition: % infants ever breastfed 5) Safe Sleep (PRAMS) Definition:% infants placed to sleep on their backs Updated Performance Measures

11. Young Children’s Health 6) Developmental Screening (NSCH) Definition: % children ages 9-71 months receiving a developmental screening using a parent-completed screening tool Adolescent Health 7) Adolescent well-visit (NSCH) Definition: % of adolescents aged 12-17 with a well-visit in the past year 8) Bullying (YRBSS or NSCH) Definition: % adolescents who report being bullied Child and Adolescent Health 9) Injury (HCUP-State Inpatient Databases) Definition: rate of injury-related hospitalization per population aged 0-19 10) Physical Activity (YRBSS and NSCH) Definition: % of children ages 6-17 who are physically active at least 60 minutes per day Updated Performance Measures

12. Children with Special Health Care Needs 11) Medical Home (NSCH) Definition: % children with and without CSHCN that have a medical home 12) Transition (NSCH) Definition: % adolescents ages 12-17 with and without CSHCN who received services necessary to make transitions to adult health care Cross-cutting or Life Course 13) Oral health (NSCH and PRAMS) Definition: % of women who had a dental visit during pregnancy and % children ages 1-6 with a past-year preventive dental visit 14) Smoking (NSCH and NVSS) Definition: % of women who smoke during pregnancy and % children in households where someone smokes 15) Adequate Insurance Coverage (NSCH) Definition: % children who are adequately insured Updated Performance Measures

13. MCH Division Update For the past several months, the MCH Epidemiology team has been compiling, reviewing and analyzing data for the 5 year Needs Assessment As part of the Needs Assessment, input from partners, stakeholders, and community members to assess the current needs of women, children, and families in Indiana

14. MCH Division Update In addition, members of the MCH Division and the Children’s Special Health Care Services Division have begun identifying priority needs and relating them to national performance measures Ex. Perinatal Regionalization

15. Takeaways from Update

16. Anticipated Impact on MCH Grants More focused New performance measures MUST become sustainable Address areas of the state with the greatest need

17. Final Thoughts If we hope to maintain or even increase the amount of funding Indiana receives in the Title V grant then we must create a more compelling argument In order to do this, we must be more strategic in our approach and we must clearly have an impact on those areas we choose to address. We are partners in improving the health of America’s mothers and children

18. Questions?

19. Resources https://www.surveymonkey.com/s/TITLEV1 Indiana Title V Needs Assessment Public Input For additional information please contact Theresa Hunter at Thunter@isdh.IN.govThunter@isdh.IN.gov