1. AMCHP Association of Maternal & Child Health Programs Maintaining a Focus on Maternal and Child Health Jeffrey G. Lobas, MD

2. AMCHP Association of Maternal & Child Health Programs Challenges for MCH Resources Competition between Priorities Evidence-Based Approaches Attitude/Culture Silos/Isolationism Leadership Workforce

3. AMCHP Association of Maternal & Child Health Programs MCH Block Grant Funding 1985-2006

4. AMCHP Association of Maternal & Child Health Programs Services # of States Affected Family Planning 14 Children’s Services14 Adolescent Health13 CSHCN 8 Program Development17 Impact of Title V Reductions

5. AMCHP Association of Maternal & Child Health Programs Problem-solving during Cutbacks: I  Reduction of administrative expenses  Consolidation  Less expensive alternatives  Changing the way services are delivered  Contracts  Resource sharing  Service integration  Negotiating better Contracts  Improving Contract Administration  Better employee oversight  Use “carry forward” funds for short-term problems

6. AMCHP Association of Maternal & Child Health Programs Problem-solving during Cutbacks: II  Cost-Shifting –Medicaid –Insurance –Partners –Families  Seek funds from reductions in other programs.  Replace lost funds with new state funds  Cut back lower priority services –Administrative services usually first for reductions –Geographic locations –Services delivered –Populations covered  Eliminate lower priority services

7. AMCHP Association of Maternal & Child Health Programs Competition “Disease of the Month” Individual Health vs. Population Medicine Bioterrorism/Disaster Preparedness “Health Coverage” Pet Projects Lack of Focus Consolidation

8. AMCHP Association of Maternal & Child Health Programs Evidence-Based Practice Science of Maternal and Child Health Research Orientation Performance Measures Outcomes Evaluation which is Rigorous

9. AMCHP Association of Maternal & Child Health Programs Attitude/Culture “ I’m mad as hell and I am not going to take it anymore.” Network-Peter Falk

10. AMCHP Association of Maternal & Child Health Programs Silos/Isolation Public/Private Relationships Separate View of the world Disenfranchised view of public health

11. AMCHP Association of Maternal & Child Health Programs Leadership and Workforce Cultivating new leaders Mentoring and Maintaining leaders Valuing leadership

12. AMCHP Association of Maternal & Child Health Programs Accepting the Challenge Advocacy Partnerships “Just say no!” Science/Outcomes Innovation Leadership Development

13. AMCHP Association of Maternal & Child Health Programs Partnerships AMCHP CityMatCH AAP/AAFP/ACOG CDC MCHB ASTHO Family Voices Others!-SAMHSA, etc.

14. AMCHP Association of Maternal & Child Health Programs Advocacy National Advocacy State Level Professional Organizations

15. AMCHP Association of Maternal & Child Health Programs “Just Say No”

16. AMCHP Association of Maternal & Child Health Programs Science/Outcomes Projects should include some research question Rigorous evaluation is a valid research approach “if we don’t publish, we didn’t do it” We owe it to move the body of knowledge forward University’s think about research differently

17. AMCHP Association of Maternal & Child Health Programs Innovation Adapt new approaches and try them on a small scale Develop new approaches and study it Plan/Do/Study/Act cycle

18. AMCHP Association of Maternal & Child Health Programs Leadership Development Partner Individualize Develop a strategy Competencies

19. AMCHP Association of Maternal & Child Health Programs Stop the Madness!!!!!

20. AMCHP Association of Maternal & Child Health Programs Our Vision is our Legacy