1. Maternal Child Health (MCH) Services Program MCH District Nurse Consultants & Cindy Leuthen, RN Maternal Child Health Services Program Manager Public Health Nursing Coordinator cindy.leuthen@health.mo.govcindy.leuthen@health.mo.gov (573) 526-0449 FFY 2012 MCH Services Contract Opening

2. Hand outs were e-mailed to you from Brenda Buschjost Please put phones on mute by pressing mute button or *6 Questions after each section and again at the end Type in questions in the chat box Please complete the evaluation to be submitted after the webinar Welcome and Housekeeping..

3. Today’s Agenda  Maternal Child Health Contract Overview  Community Engagement  Life Course Perspective and Risk & Protective Factors  A Data PIE  Wrap-Up

4. FFY 2012 MCH Services Contract  Access to contract documents  Posted on the Center for Local Public Health Services INTRANET page: URL addresses: http://dhssnet/LPHS/lpha_info.htm http://10.33.60.3/LPHS/lpha_info.htm

5. Purpose To support a leadership role for local public health agencies within coalitions and partnerships at the local level to build MCH systems and expand the resources those systems can use to respond to priority health issues.

6. MCH HEALTH ISSUES BY COUNTY

7. Deliverables  Shall work with community to maintain, develop, and enhance a system to address the priority health issue  Should address risk and protective factors that influence health disparities within families and communities through the life course perspective  Shall demonstrate progressive yearly growth toward the third-year system outcomes specified in the approved work plan  Shall meet system outcomes from approved work plan by September 30, 2014

8. Reporting  Shall submit reports using the forms and/or formats specified by the Department  Shall be submitted via e-mail attachment to the following MCH Services Program staff: District Nurse Consultant / Program Manager/ Health Program Representative

9. Reporting  FFY 2012 – Progress Report– February 15 th and Year-End Report – October 31, 2012.  FFY 2013 – same as this year  In the third year (2014), you will send the progress report in February and then the Contract Outcome Report (a different report than “Year-end Report”) in October of 2014.

10. Progress Report

15. Progress Report continued…

16. Funding Provisions  Funding for this three-year contract is for one year, with two subsequent years, based on availability of funds  MCH funds are to be considered payer of last resort  Funds must be expended during the contract year  Funding shall be used to expand or enhance activities that improve the health of mothers and children, and address local MCH issues  No cash payments to recipients of MCH services, for land or building purchases, or major medical equipment

17. Funding Provisions  Funds shall not indirectly or directly support abortion services  Funds shall not be used to provide comprehensive family planning services  Minimum of 30% should be directed toward children with special health care needs  Individuals below 100% Federal Poverty Level shall not be charged for services  Shall not be used to supplant any state or federal funds for any services

18. Subcontracting Provision  Contractors may subcontract, but contractor must do majority of work (more than 50%)

19. Year-End Report Year-End Report is due October 31 st You are reporting on the entire contract year. E-mail the report as an attachment to your District Nurse, Cindy Leuthen and Tiffany Tuua

29. Match Funding Page  Completed as part of the Year-End Report  “Over or beyond” general MCH expenditures from October through September Track throughout the year Do not include contract funding  Only Non-federal/state monies are reported Any local fees/taxes/grants/awards Type “not reporting” in total amount if you do not have anything to report  Complete bottom portion regardless of total amount entered

31. Submit DH-38 by 15 th of month following the month services were provided Invoice number format: MCHmmyy ( Oct 2011= MCH1011 ) MCH Invoicing Invoice for 1/12 of total contract award

32. Invoicing  Use DH-38 – Vendor Request for Payment – submit by mail, fax, or as an e-mail attachment  E-mail MUST have a legal electronic signature:  Assure invoice is dated and signed – signature must be last day of month or later  Contact Maurita Swartwood:  573-526-2003  maurita.swartwood@health.mo.gov maurita.swartwood@health.mo.gov NEW!

33. Amendments  May request to amend the work plan or system outcomes  Priority health issue may not be amended  Submit amendment request by March 31 st or prior to February if requesting to amend activities  Submit request on dated agency letterhead with original or electronic signature  Include revised work plan on template (revision date at bottom)

34. MCH Services Contracts Benefit Everyone Women and Children Babies, Families, and Communities

35. Community Engagement

36. What is Community Engagement?  “The process of working collaboratively with groups of people who are affiliated by geographic proximity, special interests or similar situations with respect to issues affecting their well- being.” From Principles of Community Engagement, CDC, 1997Principles of Community Engagement

37. Community Engagement “Community engagement refers to the process by which individuals and organizations build ongoing, permanent relationships for the purpose of applying a collective vision for the benefit of a community.” (Wikipedia)

38. Community Engagement Community engagement is an integral part of each level within the Spectrum of Prevention :

39. A fundamental practice of public health “The most effective way to achieve public health goals, especially toward the elimination of disparities in health status, is to actively engage those experiencing the problems in every aspect of addressing them.” Community Engagement

40. Partnership does not mean Engagement Community partnerships are relationships between partners for the purpose of a collective benefit. Community engagement builds “social capital” -- social ties, networks, and support -- which is associated with better community health and well-being. http://www.health.state.mn.us/communityeng

41. Moving forward in Community Engagement  Determine the goals of the plan  Plan out who to engage  Develop strategies to engage those individuals you already know and strategies to engage those individuals you do not yet know  Prioritize activities  Create an implementation plan  Monitor progress  Maintain those relationships

42. Have the Conversation  Public Hearing  Influencing the Like-Minded  Top-Down  Building a Decision-Making Hierarchy  Goals / Strategic Plan  Public Relations  Community Conversation  Understanding Those Not Like-Minded  Bottom-Up  Establishing a Stakeholder Network  Values / Vision  Community Engagement Communication (Old Way) Engagement (New Way)

43. Life Course

44. The Life Course Perspective

45. Health Disparities  Why do health disparities persist across population groups?  What are the factors that influence the capacity of individuals or populations to reach their full potential for health and well- being?

46. Key Life Course Concepts  Today’s experiences and exposures influence tomorrow’s health (Timeline).

47. Key Life Course Concepts  Health pathways are particularly affected during critical or sensitive periods. (Timing)

48. Risk and Protective Factors Risk FactorsProtective Factors

49. Risk FactorsProtective Factors

50. Key Life Course Concepts  Inequality in health reflects more than genetics and personal choice. (Equity)

51. A Life Course Perspective Lu MC, Halfon N. Racial and ethnic disparities in birth outcomes: a life-course perspective. Matern Child Health J. 2003;7:13-30.

52. Life Course Influences Health

53. A Data PIE

54.  Overview  The MCH system of prevention and the nursing process: Assessment Planning Implementation Evaluation

55. Assessment Data  Finding Data National State County  Collecting Data Surveys Focus groups Pre-test Observational studies  Using Data Evidence-based decision making Recruitment of key stakeholders Sustainability/funding Community Engagement Outcomes

56. Assessment: Finding Data National (http://www.cdc.gov/DataStatistics) Behavioral Risk Factor Surveillance Survey (BRFSS) Pediatric Nutrition Surveillance System (PedNSS) and Pregnancy Surveillance System (PNSS) State (http://www.health.mo.gov/data)http://www.health.mo.gov/data Youth Tobacco Survey (YTS) Chronic Disease and Risk Factors

57. Chronic Disease Survey

58. Assessment: Finding Data County Community Data Profiles (CDP) http://www.health.mo.gov/data American Community Survey http://mcdc1.missouri.edu/sf1_2010/sf1_2010_menu.html and http://mcdc1.missouri.edu/acsprofiles/acsprofilemenu.htmlhttp://mcdc1.missouri.edu/acsprofiles/acsprofilemenu.html County Health Rankings http://www.countyhealthrankings.org/missouri http://www.countyhealthrankings.org/missouri Missouri Information for Community Assessment (MICA) http://health.mo.gov/data/mica/MICA/

59. Assessment: Collecting Data Survey Examples: National – BRFSS State – YTS County - CDP Focus Groups Topic specific Population of interest

60. Assessment: Collecting Data Pre-Test – assess knowledge Example: danger of tobacco usage Observational Studies – assess behavior Example: bicycle helmet usage in a city park

61. Evidence-based decision making Recruitment of Key Stakeholders Sustainability/ Funding Community Engagement Evaluation Planning: Using Data

62. Implementation: Evidence-Based  Evidence-based intervention strategies Association of Maternal and Child Health Programs (AMCHP) http://www.amchp.org/AboutAMCHP/BestPractices/InnovationStation/Pag es/default.aspx Community Health Improvement Resources (CHIR) http://health.mo.gov/data/chir/index.html Centers for Disease Control (CDC) http://www.cdc.gov/healthycommunitiesprogram/tools/index.htm Community Guide http://www.thecommunityguide.org/index.html#topics National Policy and Legal Analysis Network (NPLAN) http://www.nplanonline.org/

63. Evaluation  Evaluation  Process evaluation Examples: staff MCH activity logs, intervention activity logs, participant feedback forms  Impact evaluation Examples: Pre- and post-test, post-intervention surveys or focus groups, and observational studies  Outcome evaluation Examples: comparing baseline and end of intervention data, after three years of funding what is different?

64. Evaluation  Steps to design an evaluation plan: Decide what will be included in the evaluation BEFORE implementing an intervention Prepare evaluation questions for each aspect of the evaluation Identify appropriate methods for collecting evaluation information Determine a timeline for collecting and analyzing evaluation data Make a plan on how to share the evaluation results in the community

65. Evaluation Resources CHIR: http://health.mo.gov/data/chir/index.htmlhttp://health.mo.gov/data/chir/index.html Community Toolbox: http://ctb.ku.edu/en/tablecontents/sub_section_main_1352.htm http://ctb.ku.edu/en/tablecontents/sub_section_main_1352.htm Evaluation made Very easy, Accessible, and Logical (EVAL) http://www.acewh.dal.ca/eng/reports/EVAL.pdf http://www.acewh.dal.ca/eng/reports/EVAL.pdf AHELP Program Evaluation Webpage http://www.ahelp.org/Evaluation/Tools.aspx http://www.ahelp.org/Evaluation/Tools.aspx

66. Resources  Other resources:  MCH Intervention and Data Resource Guide Evaluation Guide to Outcomes-based Evaluation http://www.managementhelp.org/evaluatn/outcomes.htm Evaluating your Community-based Program Part II http://www.aap.org/commpeds/htpcp/EvalResources.html  AMCHP resource on best practice http://dhssnet/LPHS/lpha_info.htm

67. A Data PIE  Key Points of A Data PIE  Identify existing data  SOS (Steal Others Stuff)  Pre- and Post-measures MUST be the same tool  Include the community throughout the Assessment, Planning, Implementation, and Evaluation (APIE) process  Use evidence-based best practice  Evaluate MCH system of prevention efforts

68. Questions???

69. Thank You!!!