Cross-Cutting Issues

Annual Report - FY2022

Activities in this domain were carried out by all MSDH MCH offices, bureaus, and programs during the reporting period:

The following section outlines strategies and activities implemented between 10/1/2021-9/30/2022 to meet the objectives and show improvement on the measures related to child health:

Priority: Mental Health across MCH Populations

NPMs, NOMs, SPM, and ESMs:

• SPM 8 - Strengthen mental, social and emotional health and well-being through partnerships and programs that build capacity and reduce stigma.

Objective: By 2022, partner with a community-based perinatal and postpartum program to provide services to at least 30 women on maternal mental health, breastfeeding, baby basics, safe sleep, infant/child safety and childbirth preparation.

Strategy: Provide mental health services to women in the perinatal and postpartum period.

Activities: Collaboration with Mom.ME on the provision of mental health services to women in the perinatal and postpartum period was described in the Women’s / Maternal Health section.

PRIORITY: Implicit Bias/Discrimination/Racism & Health Equity

NPMs, NOMs, SPM, and ESMs:

• SPM 6 - Percentage of pregnant women and new mothers who felt they were treated unfairly while receiving services.
• SPM 7 - Develop and implement MCH workforce development policies addressing racial equity for all Title V program staff and subrecipient staff.

Objective: By September 30, 2024, embed racial and social justice throughout the MSDH's current culture, systems, policies and practices.

Strategy: Develop structures and processes to consistently center the experiences and ideas of historically marginalized populations

Activities: The MCH Workforce Development Office identified current policies and gaps regarding internships and professional development for the MSDH Title V and Health Service program staff and subgrantees to include implicit bias, discrimination, diversity, inclusion and racial equity. Currently, MSDH has Health in All Policies (HiAP)-CLAS Internal Assessment for FFS, Contracts, Plans, Subgrants, Policies, MOUs, and RFPs form. The form was created to provide a guide to ensure all programs, subgrantees, and contracts conform to a Health in All Policy framework and align with National Standards for Culturally and Linguistically Appropriate Services in Health and Healthcare. For example, the form requires responses to determine the impact on historically marginalized or discriminated populations (i.e., age, class, race, ethnicity, immigration status, gender, sexual orientation, geographic location).

The Early Hearing and Detection Intervention (EHDI) program establish an Inclusion and Diversity Plan. The purpose of this plan is to promote and foster a culture that values diversity, equity, and inclusion throughout the EHDI program and the diverse communities that the program serves.

Objective: By September 30, 2024, build alliances with historically marginalized and minoritized physicians and other stakeholders.

Strategy: Provide education and training to strengthen clinicians’ knowledge of public health and structural/social drivers of health and inequities

Activities: The MIHB partnered with the Institute for the Advancement of Minority Health (IAMH) as a subgrantee during the reporting period.  IAMH held five (5) workshops that implemented an evidence-based anti-racism curriculum.  The workshops were facilitated by Dr. Tanya Funchess, Assistant Professor in the College of Nursing and Health Professionals at the University of Southern Mississippi. All workshops were held virtually via the Zoom Platform.  Overall, 44 participants representing 19 organizations attended at least one workshop in the series.  All workshops were evaluated by measuring knowledge prior to and after content delivery via online pre and post survey.

To assist with increasing knowledge and awareness on the importance of culturally competent and responsive healthcare providers, in 2017, Office of Oral health team members received national train the trainer training to provide culturally competent training to healthcare systems and organizations throughout the state.  Over this reporting period, Office of Oral Health team members partnered with the Office of Preventive Health and Health Equity staff to provide Cultural Competence Training to the following entities:  Pearl River Valley Head Start, Mississippi Department of Transportation, East Central Health Net, Jackson State University-School of Public Health, and Mississippi Delta Community College (dental hygiene program).

Strategy: Engage in cross-sector collaboration and advocacy efforts.

Activities: In June 2022, the OCAH posted a Notice of Funding Opportunity (NOFO) for potential partners to assist the MSDH with achieving key MCH goals and objectives. Through this process two partners, Six Dimensions and Teen Health Mississippi, were selected to assist with supporting MCH Programs in health equity work. The agreement with Six Dimensions outlined plans to provide consulting services to MCH Programs to review internal policies, procedures, and practices through a health equity lens and to develop plans to implement with the MCH populations, professionals, and external stakeholders for each respective program. The agreement with Teen Health Mississippi outlined plans to conduct focus groups specifically with teens in populations experiencing health disparities in the state (e.g., individuals with disabilities, people of color, LGBTQ youth) to identify the unique experiences and to develop educational materials for internal and external professionals who serve these teen populations on being teen friendly and welcoming to underserved populations to address and eliminate health disparities. This work will be continued for the remainder of this planning cycle.

Objective: By June 30, 2022, continue collaboration with the Office of Policy Evaluation, Health Equity, and Government Relations to educate providers on promoting a culturally and linguistically appropriate healthcare setting. (BCCP Program)

Strategy: Collaborate with the Office of Health Equity and Office of Policy and Evaluation to develop material in accordance with healthy literacy guidelines for the program’s health literature disseminated at outreach events.

Activities: There were no activities for this strategy conducted in Women’s Health during the reporting period, as the work had already been accomplished in the prior reporting period. By close of the reporting period, 229 requests for materials had been received since MS-BCCP implemented the online request process in mid-June 2021.

The Office of Child and Adolescent Health (OCAH) engaged in several meetings to review existing materials and to create guidelines for revisions and all subsequently developed materials to ensure an appropriate balance of graphics and text, the literacy level of the text shared, ensuring graphics were representative of the MCH populations in the state and did not contain stereotyped images (e.g., always using a white or male healthcare professional or using stereotypical images or graphics to represent populations). The OCAH developed a guidance document outline the recommendations and checklist to review all subsequent materials prior to finalization.

Strategy: Explore resources for translating program materials to Spanish, Vietnamese, and any other language needed to allow for improved accessibility of information.

Activities: Outreach materials and two MS-BCCP forms requiring patient signature were translated to Vietnamese through intra-agency resources during the reporting period. Materials were already available in English and Spanish. During the reporting period, there were two requests for materials in Vietnamese and Spanish.

Family Planning continued to collaborate with STD/HIV services by providing Family Planning Waiver materials and condoms as requested by that program.  Continuous efforts were made to ensure the integration of literacy, age appropriate and cultural/linguistic materials are included in all preconception health messages and outreach activities.  Educational materials were translated into other languages and disseminated to each county health department and Title X delegate agencies to provide clinicians with tools to better educate clients served.

Objective: By September 31, 2023, develop and implement MCH workforce development policies addressing racial equity for all Title V program staff and subrecipient partners.

Strategy: Incorporate racial equity training into individual staff training plans and minimum strategic planning requirements into subrecipient agreements.

Activities: In June 2022, the OCAH posted a Notice of Funding Opportunity (NOFO) for potential partners to assist the MSDH with achieving key MCH goals and objectives. Through this process two partners, Six Dimensions and Teen Health Mississippi, were selected to assist with supporting MCH Programs in health equity work. The agreement with Six Dimensions outlined plans to provide consulting services to MCH Programs to review internal policies, procedures, and practices through a health equity lens and to develop plans to implement with the MCH populations, professionals, and external stakeholders for each respective program. The agreement with Teen Health Mississippi outlined plans to conduct focus groups specifically with teens in populations experiencing health disparities in the state (e.g., individuals with disabilities, people of color, LGBTQ youth) to identify the unique experiences and to develop educational materials for internal and external professionals who serve these teen populations on being teen friendly and welcoming to underserved populations to address and eliminate health disparities. This work will be continued for the remainder of this planning cycle.

Strategy: Provide support and education to MCH Title V regional and central office staff, and interagency staff on planning and implementing MCH programs with attention to racial equity and upstream factors.

Activities: With Health Services, the MCH Workforce Development Office hosted various webinars surrounding such topics. They included Declaring Racism as a Public Health Crisis, Cross-Cultural Communication-Cognition and Language, Reimagining a Public Health System to Build an Equitable Tomorrow, Advancing Equity and Justice by Connecting Evaluations to Strategy, Provider-Driven Innovation: Reducing Disparities, Messaging Health Equity to Decision-Makers, A Model for Addressing Racism and Belonging, Addressing Rural Health Disparities with Data, and Best Practices in Public Health Communication to Promote Equity and Inclusion.

The MCH Strategic Planning Team, consisting of Title V Core team members, hosted a Diversity, Equity and Inclusion strategic planning meeting in November 2022. This was the second of four MCH Steering Committee meetings. The purpose of the meeting was to review the current cross cutting/systems building State Action Plan objectives, identify how MCH Program were performing relative to the proposed strategies (i.e., ranging from completely new work to this has been core work for the program for many years), determine how to assess the needs of the community relative to the issue, identify any standards to be adopted across MCH programs and in programmatic policies regarding Diversity, Equity and Inclusion, and identify ways of incorporating professional development on Diversity, Equity and Inclusion into individual staff training plans, clinicians’ knowledge about structural drivers of health and inequity, long with provide support and education to MCH Title V staff with attention to racial equity and upstream factors.

Strategy: Pilot racial equity training with internal and statewide partners.

Activities: There were no activities reported for this strategy during the reporting period.

Strategy: Review MCH Tile V current policies that address racial equity.

Activities: The MCH Workforce Development Office identified current policies and gaps regarding internships and professional development for the MSDH Title V and Health Service program staff and subgrantees to include implicit bias, discrimination, diversity, inclusion and racial equity. Currently, MSDH has Health in All Policies (HiAP)-CLAS Internal Assessment for FFS, Contracts, Plans, Subgrants, Policies, MOUs, and RFPs form. The form was created to provide a guide to ensure all programs, subgrantees, and contracts conform to a Health in All Policy framework and align with National Standards for Culturally and Linguistically Appropriate Services in Health and Healthcare. For example, the form requires responses to determine the impact on historically marginalized or discriminated populations (i.e., age, class, race, ethnicity, immigration status, gender, sexual orientation, geographic location).