1. MIECHV Program: Performance Measurement November 27, 2012
Carlos Cano, MD, MPM
Division of Home Visiting and Early Childhood Services
Maternal and Child Health Bureau

2. Overview Legislatively Required Performance Measurement System
Federal Data Collection
Opportunities

3. Affordable Care Act
MIECHV program: Section 2951 of the Affordable Care Act of 2010 (P.L )
Amends Title V of the Social Security Act to add the Maternal, Infant, and Early Childhood Home Visiting Program under Section 511
ACF and HRSA collaboration
$1.5 billion over 5 years

4. Priority Populations Families in at-risk communities
Low-income families
Pregnant women under age 21
Families with a history of child abuse or neglect
Families with a history of substance abuse
Families with a history of tobacco use
Families with children with low student achievement
Families with children w/ developmental delays
Families w/ individuals who served in Armed Forces

5. Evidence-based Home Visiting Models
1. Child First 2. Early Head Start-Home Visiting 3. Public Health Nursing Early Intervention Program for Adolescent Mothers (EIP) 4. Early Start (NZ) 5. Family Check-Up 6. Healthy Families America (HFA) 7. Healthy Steps
8. Home Instruction for Parents of Preschool Youngsters (HIPPY) 9. Nurse-Family Partnership (NFP) 10. Oklahoma CBFRS 11. Parents as Teachers (PAT) 12. PALS Infant 13. Safecare Augmented

6. Data Collection on Six Goals (Benchmark Areas)
Maternal and newborn health (8 constructs)
Child injuries; child abuse, neglect, or maltreatment; emergency department visits (7)
School readiness and achievement (9)
Crime (2) or domestic violence (3)
Family economic self-sufficiency (3)
Coordination/referrals to community resources (5)

7. Grantee Measurement System: Development
Legislation: Three-year measurement cycle
Report to Congress due December, 2015
Distinct from research/evaluation (MIHOPE)
TA and Federal feedback during review of plans
Refinement of benchmark indicators
Federal-State Partnership
Develop a robust measurement system
Balancing two values: accountability and improvement
Data reporting for first implementation year: Fall of 2012

8. Indicator Development: Roadmap
Name of the performance measure
Process or outcome
Operational definition
key terms specified; participants included and excluded from the calculation; type of scoring: if percent, numerator/denominator
Measurement tool utilized or question(s) posed
Definition of improvement
Before and after comparisons (e.g., performance in year 1 vs. year 3)
Data collection plan
Persons responsible; source of data (e.g., self-report or administrative data); frequency of collection.

9. Overview Legislatively Required Measurement System
Federal Data Collection
Opportunities

10. Federal Collection System: Prerequisites
Select an electronic collection system
Select already existing applicable forms
Develop new MIECHV-specific forms
Obtain approval from OMB under PRA
Specify system requirements for new forms
Inform grantees on the use of the electronic system

11. Discretionary Grants Information System (DGIS)
A web-based system
Over 900 MCHB-funded grantees report data online
Areas (Forms 1,2,4, 6, pubs and prods)
Budget/Financial
Programmatic

12. Interagency Data Work Group
Selected 5 DGIS forms
Developed 2 new HV forms for unique MIECHV data needs
HV form 1: Socio-demographic data and service utilization
HV form 2: Grantee-selected performance measures
Modified DGIS contract to include collection and analysis capabilities for MIECHV
Specified DGIS requirements for new forms
Conducted webinars for grantees
Obtained OMB approval

13. Accessing DGIS-HV
Screenshot of Main Menu

14. Overview Legislatively Required Measurement System
Federal Data Collection
Opportunities

15. MIECHV Measurement: Opportunities
Research (MIHOPE)
Advance the knowledge in HV the maternal and early childhood heath and development field
Improvement (Benchmark area-related data)
Data can drive quality improvement efforts
Common data framework: catalyst for collaboration & partnerships common agenda  system integration
Across home visiting programs in a geographic area
Other early childhood programs (child care and education)
Medical homes

16. Flexibility for Grantees
Select performance measures: process or outcome
Select measurement tools
Define improvement (targets not required)
Design data collection plan
Improvement shown for a fraction of constructs

17. Next Phase: Quality Improvement
Pivoting from measurement towards QI
Individualized TA
Regional meetings
Plan to establish a learning collaborative
Enlisting grantees
Selecting 4-6 areas of improvement
Preliminary development of a shared sub-set of indicators

18. Resources and Contact Information
HRSA/MCHB website: HomVEE website: Monique Fountain Hanna, MD, MBA, Project Officer for Region III Office: (215) Carlos Cano, MD, MPM, Senior Medical Advisor, Office: (301)

19. Thank you