TITLE V MATERNAL & CHILD HEALTH SERVICES BLOCK GRANT PROGRAM

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Title V Overview

The Kansas Department of Health and Environment (KDHE) is responsible for the administration of programs carried out with allotments under Title V. The Title V Maternal and Child Health (MCH) Services Block Grant is administered by the Bureau of Family Health (BFH) in the Division of Public Health. The mission of the Bureau is to “provide leadership to enhance the health of Kansas women and children through partnerships with families and communities.” In addition to the MCH conceptual framework and public health essential services, the Title V program depends on many strengths—translated through core values and guiding principles—to promote a strong culture of continuous quality improvement, innovation and growth, and a sustained focus on what matters.

MCH Population

Kansas, spanning 82,278 sq. miles, is divided into 105 counties with 627 cities. The US Census Bureau estimates there were approximately 2,913,805 residents living in the state in 2020. Kansas has a unique geographic layout that ranges from urban to frontier counties based on population density. The population density of Kansas was 35.9 inhabitants per square mile in 2020, a 9.1% increase from 32.9 in 2000. In 2020, there was an estimated 35,281 infants or 1.2% of the total population and 829,513 children and adolescents (ages 1-21) representing 28.5%. The number of females in the reproductive/child-bearing age group (ages 15-44) was 562,644, representing 19.3%. In 2019-2020, 20.75% of children ages 0 to 17 (est. 144,547) were identified as having special health care needs. About 20.8% of males under 18 had special health care needs, compared with 20.6% of females.

Title V MCH Priorities and Performance Measures (FFY 2021 - 2025)

Five national and four state performance measures have been selected to address the priorities outlined above. The national performance measures (NPMs) utilize national data sources to track state-level prevalence rates to determine the impact of activities on the populations serves. States must select at least one NPM for each of the MCH population domains (women/maternal, perinatal/infant, child, adolescent, children with special health care needs). The state performance measures (SPMs) were selected where a NPM was not available or appropriate for the state’s identified priorities or objectives. The selected measures are outlined below.

Assessing State Needs

Kansas continuously assesses the needs of MCH populations through an ongoing Needs Assessment, and the State Action Plan is reviewed during interim years. With a goal to maximize the input of internal and external partners, the Title V Five Year Needs Assessment process utilizes a mixed methods approach relying on input from a diverse network of key informants, partners, and community members including families and consumers. The State Systems Development Initiative (SSDI) staff provide data capacity for informed decision-making using a variety of data sources. This comprehensive process and broad approach assist with identifying key priorities used to develop an action plan that addresses and improves MCH in Kansas while leveraging resources and partnerships across the state. Strategies developed to address the NPM’s and SPMs are comprehensive, coordinated and family centered for all MCH population domains. Continuous data monitoring, evaluation and staff review occurs regularly to help identify new and emerging gaps and barriers to services for the Title V population allowing the team to adapt and adjust as needed to improve services and supports.

Title V Activities & Program Highlights by Population Domain

The Title V plan reflects coordination of MCH activities across funding sources, agencies, and local providers. It relies on partnerships, high quality shared measurement, and data to track the impact and effectiveness of services, activities, and strategies. Review each of the associated population domain narratives for additional details about these and other activities, including applicable data and impacts on health outcomes for women, children, and families. The Block Grant Application and Report can be found online at http://www.kansasmch.org.

Women/Maternal & Perinatal/Infant Health

Count the Kicks® (CTK): Title V has a partnership with Healthy Birth Day to implement Count the Kicks®, an evidence-based stillbirth prevention campaign that educates providers and patients about monitoring fetal movements during the 3rd trimester of pregnancy.

Maternal Mortality: The Kansas Maternal Mortality Review Committee (KMMRC) is a collaboration among Title V and key partners to review pregnancy-related deaths, identify causes, and develop recommendations for implementable interventions to prevent future occurrences. The Kansas Maternal Mortality and Morbidity Report contains information and data collected from cases. As a result of this report, formal recommendations led to the Kansas Perinatal Quality Collaborative’s Fourth Trimester Initiative.

Perinatal Quality & Systems of Care: The Kansas Perinatal Quality Collaborative (KPQC) is a partnership with a panel of experts working to improve the quality of care for mothers and infants, affecting measurable improvements in statewide health care and health outcomes. Past work includes developing a comprehensive approach to Neonatal Abstinence Syndrome (NAS) through a lifespan approach crossing several critical periods, involved establishing several levels of prevention, education, and intervention (surveillance to clinical practice improvements) as well as points of education to prevent exposure and reduce the impact when exposure occurs. Currently, the KPQC is focused on the Fourth Trimester Initiative (FTI) aimed at decreasing maternal morbidity and mortality in Kansas. The FTI focuses on quality care and provider communication related to the transition from pregnancy through the postpartum period.  

Perinatal Community Collaboratives: Title V is committed to supporting expansion and sustainability of the Kansas Perinatal Community Collaborative (KPCC) model with local communities and the broader network of local health care and community service providers, as a consistent and proven delivery system for coordinated prenatal care. The model brings prenatal education, clinical care, and wraparound services together.

Breastfeeding: Title V strives to provide consistent messaging around breastfeeding and leverage resources at the state and local levels. Title V has a partnership with the Kansas Breastfeeding Coalition (KBC) to align and support breastfeeding across programs including MCH, WIC, Child Care Licensing, Home Visiting, and others. KBC increases the capacity and strengthens the support of local breastfeeding coalitions, provides technical assistance and support for several initiatives, participates in planning for Community Baby Showers, and assists with updating breastfeeding education for providers and parents.

Safe Sleep: Title V has a partnership with the Kansas Infant Death and SIDS (KIDS) Network to reduce infant mortality through state and local safe sleep targeted efforts. Title V supports the KIDS Network to: facilitate a safe sleep culture within Kansas by training a network of Safe Sleep Instructors; develop and provide training for parents, physicians, home visitors, and child care providers; and promote consistent safe sleep messages across the lifespan. KIDS Network also provides technical assistance on the Community Baby Shower model and the Hospital Safe Sleep Certification and Outpatient Provider Safe Sleep Star programs.

Child & Adolescent Health

Early Childhood Systems Building: The Help Me Grow Kansas (HMG) framework promotes integrated, cross-sector collaboration to build efficient and effective systems. This was the foundation of the All in for Kansas Kids Strategic Plan, supported by Title V partnership and aligned with key MCH activities such as: expanding care coordination to primary care provider settings, implementing the Bridges program (support for families transitioning out of Part C/Infant Toddler Services), and expansion of peer supports through Supporting You.

Preventive Medical Visits (Annual Well Visits): Title V is actively engaged in outreach, promotion, and support to increase access to annual preventive medical visits for children and adolescents. Visits are important for access to comprehensive services including screening and immunizations, referral, and diagnosis and treatment when indicated. Title V promotes Bright FuturesTM as a standard of care in line with the Medicaid EPSDT program and is also focusing on expanding school-based health centers to increase access to care, especially for adolescents. Title V provided funding for a statewide license to access the online Bright Futures Tool and Resource Kit, 2nd Edition.

Behavioral Health: Kansas Title V is working to increase focus on behavioral health interventions, healthy social-emotional development, and cross systems collaboration within the State Action Plan objectives. To expand programming and increase effectiveness, the Title V Behavioral Health Consultant position oversees two federally funded projects focused on behavioral health – Kansas Connecting Communities (launched October 2018) and KSKidsMAP to Mental Wellness (launched July 2019).

Youth Health Initiatives: The Youth Health Guide and WHY (Whole Healthy You) Campaign, brings attention to health awareness events and supports youth in living healthy – physically, mentally, and emotionally. Additionally, Title V used the Adolescent Health Institute’s youth-friendly care tools to support quality improvement strategies and is devoted to providing technical assistance to local agencies to improve adolescent health measures and identify enhancements or improvements to policy. With this support, local MCH agencies will be prepared to clearly state their goals and identify MCH funding needs to meet milestones in future grant applications.

Children with Special Health Care Needs (CSHCN)

Holistic Care Coordination: The Kansas Special Health Care Needs program (KS-SHCN) provides holistic care coordination (HCC) and helps families find, understand, and access services and resources within medical, school, and community systems to achieve optimal child/family health outcomes and empower and prepare parents to support their children. Eligibility for HCC services are expanding to those with medically eligible conditions, regardless of financial status or resources, and families of children three to five years of age who received early intervention through Kansas Early Childhood Developmental Services/Part C.

Transition to Adulthood: Transition planning for youth and adolescents ages 12 and older focuses on transitioning to adulthood in all aspects of life (e.g., pediatric to adult health care systems, self-advocacy, health and wellness, social and recreation, independent living skills, education). Title V works with youth with special health care needs to develop goals that meet their needs and help support self-determination.

Systems of Care for CSHCN: Implementation and advancement of the Kansas State Plan for Systems of Care for CSHCN, along with the National Standards for Systems of Care for CSHCN and the National Care Coordination Standards for CSHCN, provide the road map to strengthen to support stronger systems of care for CSHCN and their families. Title V continues to seek opportunities to establish local- and state-level data sets to inform about the CSHCN population and their needs.

Family & Consumer Partnerships

Peer-to-Peer Support Network: In partnership with the FAC, Title V launched a peer-to-peer support network, Supporting You, to connect parents and caregivers of CSHCN with peers who have like experiences and/or life circumstances. The network is designed to help individuals connect with one another, share ideas and resources, and gain support where it would most benefit. There are three participating programs: KS-SHCN, School for the Deaf, and FAC. The network is currently working to build a statewide program to support foster, adoptive, and kinship families.

Family & Consumer Partnership (FCP) Program: Established in 2021, this program provides technical assistance, support, and capacity to engage in initiatives around peer supports, family leadership, and advisory opportunities. This serves as the framework for local and state Title V programs to assure families are engaged at the level they desire. In partnership with families, a resource toolkit has been developed to support partners in engaging families in planning, implementation, and evaluation of services and programs.

Title V Block Grant Budget

The Federal-State Title V partnership estimated budget for FFY2024 totals $14,422,238 (federal funds $4,854,000; state funds $3,936,667; local funds $5,631,571). Federal and State MCH funds totaling over $5M is allocated for FY2024 to support local agencies in providing community-based, family centered MCH services, including services for individuals with special health care needs.