The Title V Administrative Agency in Alaska is the Section of Women’s, Children’s and Family Health (WCFH), located in the Department of Health and Social Services. The mission of WCFH is to promote the best health outcomes for all Alaska women, children, young adults, and their families of all abilities across the lifespan. WCFH programs are guided by the maternal and child health (MCH) pyramid of health services and aim to improve health status, assure health service access, and eliminate health disparities. Our target populations include pregnant people and their infants, children and adolescents, children, and youth with special health care needs (CYSHCN), those with low-income status, and those with limited access to health services.

2020-2024 Priorities

Alaska’s MCH Population

Alaska is a vast, sparsely populated, culturally diverse state located in the circumpolar north. Of all fifty states, Alaska’s population has the highest proportion of Indigenous people, as well as veterans and active-duty military. The MCH population, as well as the general population, experiences several negative health outcomes at higher rates than the national average, some of which are illustrated below. Protective factors, particularly those connected to culture, play a key role in the resilience of Alaska’s people. 

This year, WCFH added a new priority in response to the pressing need to eliminate health inequities. Within the context of colonization, discrimination and loss of traditional lifestyles, the Alaska Native population faces the most significant health disparities across domains. Since the 1970’s, large investments in infrastructure have contributed to significant improvements in life expectancy, infant mortality, and infectious disease for Alaska Native people. However, disparities persist, including in key MCH outcomes such as postneonatal mortality; child, adolescent (especially youth suicide), and maternal mortality; and oral health.

Alaska’s framework for needs assessment, program planning, and performance reporting

Alaska’s MCH priorities are identified in statewide needs assessments conducted every five years and re-examined annually. In early 2020, WCFH leadership selected National Performance Measures (NPMs) to track and demonstrate impact of efforts to address priorities for 2020-2024. State Performance Measures (SPMs) were developed to address priority needs that were identified but not adequately addressed by the NPMs. The group considered the availability of data, the likelihood a change in the measure would be seen during the five-year grant period, and how closely linked the measure was to actual work being done by Alaska’s Title V program. The selection of performance measures was informed by the Division of Public Health Strategic Plan and Healthy Alaskans 2030 Leading Health Indicators. Alignment of the work of Title V with other programs is critical to assure transparency, reduce duplication and breakdown silos.

The WCFH Strategic Plan describes the work of WCFH as falling into four distinct categories. These categories also reflect the work and priorities of the Division of Public Health:

1. Serve as Alaska’s chief strategists for existing and emerging public health issues
2. Protect life, health, and safety through core public health functions
3. Serve as the trusted source of health information
4. Strengthen essential public health infrastructure, services, and partnerships

Key Strategies of the Alaska Title V 2020-2024 State Action Plan, By Domain

Women

• Identify and partner with public and private providers statewide to improve and expand their preventive health services through ongoing quality improvement models.
• Review all pregnancy-associated deaths through the Maternal Child Death Review (MCDR), generate actionable recommendations for all preventable deaths and increase awareness about the MCDR program.
• Engage hospitals and birthing facilities in data-driven, collaborative quality improvement focused on reducing severe maternal morbidity in partnership with the Alaska Perinatal Quality Collaborative.

Perinatal/Infant

• Leverage multi-sector partnerships to provide evidence-based and culturally appropriate safe sleep materials and education for high-risk families.
• Partner with birthing center clinical staff to effectively screen pregnant/postpartum people for substance use including tobacco, alcohol, marijuana, and substances that may impair judgment, including prescribed medications, in order to identify infants at high risk for Sudden Unexpected Infant Death.

Children

• Support and expand statewide systems for parents and caregivers, providers, educators, and community-based service agencies in use of standardized screening tools and provider education for developmental screening.
• Review all child deaths through the MCDR, generate actionable recommendations for all preventable deaths, and increase awareness about the MCDR program.
• Support school nurses and counselors with injury prevention education and trauma- informed care best practice information.

Adolescent

• Increase the number of youth friendly clinics.
• Coordinate and provide continuing education and workforce development for providers working with adolescents.
• Promote preventative medical visits and education on youth health literacy, including education on the importance of a well visit.

CYSHCN

• Develop resources for adolescents to learn skills for transitioning to adult care, and increase education to adolescents, their caregivers, educators, and medical providers on this topic.
• Partner with the UAA Center for Human Development to implement Project ECHOs to increase caregiver and provider knowledge and skills.
• Reduce gaps and barriers to specialty care by supporting expanded tele-health solutions and workforce development activities

Cross-Cutting and Systems-Building

• Utilize existing platforms and capacity to contribute to rapid assessment of needs and dissemination of data and best practice information during emergencies.
• Promote or provide workforce training and support for self-care and vicarious trauma exposures.
• Conduct ongoing assessment of equity impacts of Title V strategies across domains.
• Collect, analyze, and disseminate data and information on health equity topics.

TITLE V ROLE IN ASSURING COMPREHENSIVE, COORDINATED, FAMILY CENTERED SERVICES

WCFH seeks and values parent and consumer feedback on all programs and recruits Alaskan parents, providers, and communities to help set priorities and initiate activities, keeping the family and consumer voice and leadership central. As a standard, all advisory committees include at least one parent. All staff can participate in Strengthening FamiliesTM training, which is designed to help professionals emphasize family strengths, culture, and voice.

During 2016-2021, WCFH administered the federal Early Childhood Comprehensive Systems grant, which prioritizes family engagement in all activities in three place-based communities. WCFH also created trainings to promote parent engagement, expand parent confidence, choice, systems change and individual advocacy for their children. WCFH also incorporates the voice of youth into public health programming through the Youth Alliance for a Healthier Alaska. The Perinatal Quality Collaborative is also recruiting patients to help inform quality improvement processes from the patient perspective.

TITLE V PARTNERSHIPS

Strong partnerships and a collaborative approach are critical for systems development, implementation, service delivery and, ultimately, achieving the mission of Title V. All programs and services within WCFH are delivered in collaboration with others. WCFH administers and coordinates many other federal grants in addition to Title V. There are long-standing collaborative relationships with Tribal Health on numerous ongoing projects and initiatives.

WCFH partners with many other DHSS programs through data sharing agreements and joint initiatives, including the Division of Behavioral Health, Early and Periodic Screening, Diagnostic and Treatment Program, Children's Health Insurance Program, WIC, Office of Substance Misuse and Prevention, Office of Children’s Services, and the Section of Chronic Disease Prevention and Health Promotion. WCFH co-coordinates the Alaska Early Childhood Coordinating Council with DEED. WCFH also collaborates with DEED on the administration and evaluation of the Parents as Teachers home visiting program. Through partnership with the Alaska Primary Care Association, WCFH collaborates with Federally Qualified Health Centers throughout the state. WCFH also works with out-of-state providers to coordinate pediatric sub-specialty clinics.

The Title V Director serves as an All Alaska Pediatric Partnership Board member. WCFH facilitates the Alaska PQC, which includes partners such as the hospital association, numerous birthing facilities, ACOG and other women’s and children’s health organizations, and individual clinicians.