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. The WCFH mission 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. Target populations include pregnant people, infants, children, 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. 

In 2021, 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, Alaska’s Indigenous people experience many health disparities. Due to Alaska’s relatively small population size, it is difficult to calculate and report public health information and health disparity statistics for other minority populations. However, evidence of health inequities for Alaska’s other racial minority communities appears in indicators such as severe maternal morbidity, notably for Alaska’s growing Pacific Islander population.

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 work of WCFH falls 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

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

Women/Maternal

• Identify and partner with public and private providers statewide to improve and expand their preventive health services through ongoing quality improvement models.
• 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 (AKPQC).
• Continue to partner with Medicaid and department leadership on the implementation of extending postpartum coverage to one year.

Perinatal/Infant

• Leverage multi-sector partnerships to provide evidence-based and culturally appropriate safe sleep materials and education for families who experience high-risk factors for Sudden Unexpected Infant Death (SUID), including caregiver tobacco use.
• Partner with birth 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, to identify infants at high risk for SUID.
• Collect, analyze, and disseminate data related to alcohol-affected pregnancies, alcohol use among pregnant people, and alcohol use among women of childbearing age.

Children

• Support and expand statewide systems and resources for parents/caregivers, providers, educators, and community-based service agencies in use of standardized screening tools.
• Collect, analyze, and disseminate data to better understand child wellbeing in Alaska.
• Support school nurses and counselors with injury prevention education and trauma- informed care best practice information.

Adolescent

• Support the Alaska Coalition for Healthy Teens and Young Adults.
• Collaborate with partners to facilitate continuing education, workforce development, and increased coordination of health service supports between providers in all settings who work with adolescents.
• Promote youth health literacy and access to preventative medical visits, including education on the importance of a well visit and oral health.

CYSHCN

• Develop resources for adolescent healthcare transition to adult care, and increase education for 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.
• Continue to provide limited gap-filling pediatric specialty clinics and family navigation services as needed and as resources allow.

Cross-Cutting and Systems-Building

• Contribute to assessment of needs and dissemination of data and best practice information to support emergency response.
• Conduct multidisciplinary reviews to identify factors in maternal and child mortality and make culturally appropriate, actionable recommendations to reduce preventable mortality and eliminate disparities.
• Engage with diverse contacts and audiences to increase awareness about maternal and child mortality and promote implementation of prevention recommendations.

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, advisory committees should include at least one person with lived experience. All staff can participate in Strengthening FamiliesTM training, which is designed to help professionals emphasize family strengths, culture, and voice.

WCFH created trainings to promote parent engagement, expand parent confidence, choice, systems change and individual advocacy for their children. The Family ECHO focuses on the CYSHCN family experience and provides training for providers, educators, case managers, family advocates and self-advocates about complex behavior and transition challenges. WCFH also provides limited gap-filling pediatric specialty clinics and family navigation services.

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 Department of Health 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 Children’s Services, the Section of Chronic Disease Prevention and Health Promotion, among others. WCFH co-coordinates the Alaska Early Childhood Coordinating Council with the Department of Education and Early Development (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 contracted medical providers to coordinate pediatric sub-specialty clinics.

The Title V Director served as an All Alaska Pediatric Partnership Board member until April 2023. WCFH facilitates the Alaska PQC, which includes partners such as the hospital association, birthing facilities, ACOG and other health organizations, and individual clinicians.