Maternal and Child Health in Ohio: 2010 and Beyond Cuyahoga County CFHS Consortium 2009 Fall Meeting Jo Bouchard, MPH, Chief Bureau of Child and Family Health Services Ohio Department of Health

Overview: Learn about … MCH priorities as result of statewide needs assessment New/innovative programs/initiatives addressing key MCH priorities. 2

Objectives: Learn about … Plans for the 2011 grant cycle for the Child and Family Health Services Program (CFHS). 3

Ohio’s MCH Block Grant Needs Assessment (NA) Title V requires statewide needs assessment every 5 years Goal is to identify need for:  Preventive and primary care services for pregnant women, mothers, infants, children and Children with Special Health Care Needs (CSHCN) 4

Ohio’s MCH Block Grant NA Multi-year process  Engage stakeholders  Assess needs and identify desired outcomes  Examine strengths and capacity  Select priorities  Develop action plan  Monitor progress 5

Ohio’s MCH Block Grant NA Top Priorities – Children  Increase access to adequate and culturally appropriate prevention, early identification and treatment services.  Prevent unsafe behaviors such as substance use, risky sexual behaviors, violence and the behaviors most likely to cause intentional and unintentional injuries and illness. 6

Ohio’s MCH Block Grant NA Top Priorities – Children  Provide family-centered services and education to support child/family health.  Recognize and reduce the negative impact of social determinants of health.  Reduce environmental exposures that contribute to chronic illness, injury and disability. 7

Ohio’s MCH Block Grant NA Top Priorities – CSHCN  Increase the number of standardized medical homes.  Increase capacity for the medical home to screen, diagnose and access comprehensive medical and non-medical specialty services through use of evidence-based tools. 8

Ohio’s MCH Block Grant NA Top Priorities – CSHCN  Provide families with the support and networks they need to participate in all aspects of family care.  Enhance the system of reimbursement for basic primary care services, and provide incentives for innovative service delivery.  Improve capacity to collect and utilize available CSHCN data to drive future decision making. 9

Ohio Infant Mortality Task Force 10 Purpose: To take a fresh look at infant mortality and disparities in Ohio and make recommendations to address these challenges.

Ohio Infant Mortality Task Force Process: The task force, supported by ODH, held 4 plenary sessions and many committee meetings & conference calls throughout spring and summer

Task Force Recommendations Recommendation I: Provide comprehensive reproductive health services and service coordination for all women and children before, during and after pregnancy. Recommendation II: Eliminate health disparities and promote health equity to reduce infant mortality. 12

Task Force Recommendations (continued) Recommendation III: Prioritize and align program investments based on documented outcome and cost effectiveness. Recommendation IV: Implement health promotion and education to reduce preterm birth. 13

Task Force Recommendations (continued) Recommendation V: Improve data collection and analysis to inform program and policy decisions. Recommendation VI: Expand quality improvement initiatives to make measurable improvements in maternal and child health outcomes. 14

Task Force Recommendations (continued) Recommendation VII: Address the effects of racism and the impact of racism on infant mortality. Recommendation VIII: Increase public awareness on the effect of preconception health on birth outcomes. 15

Task Force Recommendations (continued) Recommendation IX: Develop, recruit and train a diverse network of culturally competent health professionals statewide. Recommendation X: Establish a consortium to implement and monitor the recommendations of the Ohio Infant Mortality Task Force. 16

17 For more information, visit the task force’s Web site: /imtf/imtf.aspx

Statewide collaboration to support initiatives that achieve measureable improvements in children’s health care and outcomes through improvement science. 18

OHIO Initiatives Concerned About Development Ohio Perinatal Quality Collaborative Addressing the Childhood Obesity Epidemic Solutions for Patient Safety Chapter Quality Network – Asthma Program 19

Preconception Health for Adolescents Action Learning Collaborative Ohio is one of 6 states selected to participate in ALC sponsored by AMCHP Promote reproductive health across an individual’s lifetime by promoting preconception health strategies for adolescents. 20

Action Learning

Ohio’s ALC Project Strategy Disseminate evidence-based interventions address risk factors related to reproductive health that effect preconception health of teens. Inform new statewide public health/school health alliance, serves as advisory body to the SPI. 22

23 Child and Family Health Services Program

24 Challenges We Face in FY2011 Federal & State Budget Cuts Political Perceptions of Public Health Competing Priorities Health Disparities Needs Exceed Resources

25 CFHS Priority Issues Birth Outcomes – Disparities Preconception/ Interconception Health Social/Emotional Health Child Fatality Review SIDS Overweight Children Childhood Lead Poisoning Childhood Immunizations

26 CFHS Priority Populations Low-income women, children and families in racial and ethnic groups that are disproportionately affected by poor health outcomes Geographic areas and populations of highest need

27 CFHS Funded Components FY09 71 grantees were funded for the Community Health Assessment Component 63 grantees were funded for the Child and Adolescent Component 43 grantees were funded for the Perinatal Component 21 grantees were funded for the Family Planning Component 13 grantees were funded for the OIMRI Component

28 FY2011 CFHS Grant Process Feb. 2010: RFP released April 2010: due to ODH July 2010: NOA to subgrantees

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Cuyahoga County CFHS Program History of Partnership MetroHealth Center for Community Health Northeast Ohio Neighborhood Health Services, Inc. (NEON) University Hospitals Case Medical Center Cleveland Regional Perinatal Network Center for Adolescent Health - Case Western Reserve University Fairview Hospital School-based Health Center

Cuyahoga County CFHS Components – CHA, C&AH, PN, OIMRI Serve women, infants, children, adolescents of Cuyahoga County Conduct Community Health Assessment Provide Monitoring and Evaluation of Program Components 32

CFHS Accomplishments Successful CFHS Consortium Greater Cleveland.localhealth.info website Ohio Women’s Wellness Symposium Wellness Policy Program

CFHS Accomplishments Child and Adolescent Health Direct Care Improving birth outcomes via care coordination Community Outreach/Presentations

THANK YOU! 35