In FFY22, Wyoming received $1,018,201 in Title V federal funding, notwithstanding approved direct assistance budget. Wyoming’s Title V allocation is based on the total numbers of women of childbearing age (ages 15-44), infants and children ages 0-18, and individuals ages 0-44 living in poverty.

At the time of writing, Wyoming’s MCH Block Grant expenditures ($1,018,201) for FFY22 were categorized into the following categories, with all percentages:

• Preventive and Primary Care Services for Children (42.6%)
• Services for Children with Special Health Care Needs (31.5%)
• Administrative (6.8%)
• Other (Family) (19.1%)

Because WY MCH is still in the spend down period at the time of submission, the above categories and percentages reflect actual expenditures mid-September 2023, grant/contract encumbrances, and any remaining obligated/expected expenditures, including salaries. Please see the field notes on Form 2 for more details.

The WY MCH met the minimum 30% requirement for both Preventive and Primary Care Services for Children and Services for Children with Special Health Care Needs, and spent less than the maximum 10% of funds on administrative costs. The Other, or Family, category supports salary/benefits and key activities of the Women and Infant Health Program.

The majority of Wyoming’s Title V funding supports the state-level workforce and grants and contracts with partner organizations to address Wyoming’s seven MCH priority needs. Specifically, Title V funding supports 2.5 full-time program manager positions, which are organized according to the population groups they serve, two full-time CSH Benefits and Eligibility Specialists, and 1.5 health program coordinator positions. This funding structure aligns well with the Title V population domain framework and assures dedicated resources within each domain. In FFY22, Title V direct assistance funding also supported one full-time CDC-assigned MCH senior epidemiology advisor who provided technical assistance and scientific guidance supportive of all MCH programs, with a specific emphasis on support for the Women and Infant Health Program. This position was vacated in late FFY22.

The partnership between WY MCH and MCH Epidemiology is essential to assure the unit is continually assessing and monitoring the needs of Wyoming communities, as well as the success of programming. State matching funds and other federal funds are leveraged to fund the remaining WY MCH and MCH Epidemiology staff. Title V funding also supports a portion of one staff position in the Injury and Violence Prevention Program.

WY MCH contracts with a leadership coach and strategic planning consultant to support staff professional development and strategic planning and implementation efforts.

In FFY22, Title V funds supported the following Wyoming programs/projects, each aligned with the state priority need it addresses:

• Genetics clinics (promote preventive and quality care for children/adolescents, including those with special health care needs)
• Continued child physical activity toolkit implementation (increase childhood physical activity/promote healthy and safe children)
• Initial planning and preparation for Bright Futures ECHO series (increase childhood physical activity/promote healthy and safe children)
• Partnership with the Wyoming Governor’s Office and other state partners for ACE training (increase childhood physical activity/promote healthy and safe children)
• Children’s special health program (improve systems of care for CYSHCN)
• Distribution of CDC Hear Her Campaign Materials and Maternal Mental Health Hotline Materials (prevent maternal mortality more broadly)
• Perinatal Quality Collaborative (PQC) coordination and partnership development/recruitment (increase MMRC recommendations implemented)
• Continued distribution of safe sleep materials, in partnership with PHN and other community partners and providers (increase safe sleep practices and environments)
• Continued tobacco cessation promotion among pregnant women, in partnership with PHN and Title X clinics (decrease smoking during pregnancy)
• Youth Council coordination services (promote preventive and quality care for adolescents; promote healthy and safe relationships/connectedness)
• Teens in the Driver’s Seat pilot program initiated (increase adolescent seatbelt use; schools using evidence-based teen driver safety programs)
• Sources of Strength youth resiliency program expansion (prevent adolescent suicide)
• MOU with the WY Department of Education for state school nurse activities in support of Title V priorities (all priorities)
• Continued partnership with Uplift for ongoing community and family engagement support and family leader development (all priorities)
• Completion of focus groups for all priority domains to better understand community needs, barriers, and resources desired to inform program planning and implementation (all priorities)

WY MCH benefits from $2,375,591 in State and Trust and Agency funds (newborn screening fees) required to meet the 1989 MOE and State match.

State funds support the delivery of home visitation services and CSH care coordination services provided by PHN or local health departments in all 23 Wyoming counties, as well as limited gap-filling financial assistance to eligible families served by the CSH Program, including high-risk pregnant women and infants cared for by Level III providers. CSH is a payer of last resort for enrolled clients who meet medical and financial eligibility criteria. In order to be eligible for assistance, families must first apply for Medicaid, KidCare CHIP, and/or the Federal Marketplace. Trust and Agency funds support operations of the statutorily-required NBS Program.

State General Funds used for the infant immunization Prevnar, childhood immunizations Proquad/Varivax, and Public Health Nursing MCH Consultant (2) salary and benefits also assist with meeting the required MOE and match.

See Form 3a for a breakdown of WY MCH expenditures by population type (pregnant women, infants <1 year of age, children ages 1-21 (including adolescents), children with special health care needs, and other).

See Form 3b for a breakdown of WY MCH expenditures by service type (direct, enabling, and public health services and systems).

Finally, WY MCH also administers other federal funds to address core priorities and to complement Title V efforts. In reporting other federal expenditures, we used the grants’ budget cycle that aligned most closely with the Title V FFY22 budgeted period to report expenditures. Some grant cycles follow a typical federal fiscal year (October through September), while others are on different cycles. See the field notes in Form 2 for more details by each federal funding source reported.

The 2021-2025 Title V Needs Assessment and strategic planning processes provided the WY MCH with direction for leveraging available resources to impact the health and wellness of Wyoming’s families across all population domains. Title V funding, in combination with other federal funds (e.g. PREP, RPE), will continue to fund WY MCH positions. Three positions, the MCH Grants & Contracts Specialist/Title V Block Grant Coordinator, MCH Unit Manager, two epidemiologists, and two state-level home visiting public health nurse staff are funded fully or partially (over 75%) with state Match/MOE funds.

Wyoming’s required MOE is greater than the legislatively-required match. Several programs assist in maintaining this level of funding effort: NBS, PHN Home Visitation Program, CSH, and Immunizations. WY MCH’s FFY23 budget includes $1,827,776 in State General Funds and $547,815 in program income from NBS. WY MCH remains able to meet the required MOE of $2,375,591.

WY MCH’s proposed budget for FFY24, as reflected in Form 2, includes the following budget items, with brief descriptions about how those funding allocations are directed toward Title V priorities.

• Prevention and Primary Care for Children: $331,023 (32.5%) - directly supports staffing, infrastructure, and programs and strategies to address child health and adolescent health priorities, such as child physical activity, adolescent suicide prevention, and adolescent motor vehicle safety.

• Children with Special Health Care Needs: $443,482 (43.6%) - directly supports staffing, infrastructure, and programs and strategies to support systems of care for CYSHCN, such as the Children’s Special Health Program, genetics clinics, and supporting and improving access to telehealth.
• Other/Family: $171,091 (16.8%) - directly supports staffing, infrastructure, and programs and strategies to address woman/maternal and perinatal/infant health priorities, such increasing safe sleep practices, decreasing tobacco use in pregnancy and postpartum populations, and increasing well woman visits.
• Administrative Costs: $72,605 (7.1%) - directly supports cross-cutting needs, such as community and family engagement partnerships, language access services, and professional consultation, implementation support, and leadership and team development.
• State MCH Funds: $1,827,776 - directly supports staffing, infrastructure, and programs and strategies such as PHN home-visiting and CSH client support and care coordination.
• Program Income (NBS): $547,815 - directly supports the administration of the Newborn Screening Program.
• Total State MOE: $2,375,591 - reflected in the State MCH Funds and Program Income (NBS) items above.