Executive Summary
Idaho Title V Program Overview
What is Title V?
The goal of Idaho’s Title V Maternal and Child Health (MCH) Grant Program is to improve the health and well-being of mothers, infants, and children, including children and youth with special health care needs (CYSHCN), and their families. In Idaho, Title V supports a spectrum of services, from infrastructure-building services like quality assurance and policy development, to gap-filling of direct health care services for CYSHCN.
How does the Title V determine the needs of Idaho families?
Every five years, states are required to conduct a comprehensive, statewide needs assessment to assess the gaps in needs, strengths, and limitations of services available to MCH populations across six domains (identified in the table below). Idaho uses the “Title V Needs Assessment, Planning Implementation, and Monitoring Framework” to guide the needs assessment and program planning process each five-year cycle, with emphasis placed on engaging stakeholders and community partners.
The MCH Program contracts with the Boise State University Center for Health Policy to conduct needs assessment activities, assist with building the state action plan, and assist with data collection and analysis. A phased approach was used to arrive at the state’s final priority needs, which included primary and secondary data collection, theme identification from data, and stakeholder input on prioritization of the most significant health needs for Idaho’s families. Final selection of priorities was based on programmatic capacity, evidence-base, cost, and ability to make a measurable impact.
What are Idaho’s MCH priorities?
Based on the results of the 2015 needs assessment, Idaho selected eight MCH Priorities across the respective population domains. The table below illustrates the selected priorities for Idaho and the corresponding population domain and performance measure.
MCH Domain |
MCH Priority |
National or State Performance Measure |
Women/Maternal Health |
Increase percent of women accessing well-woman care, including prenatal care |
Well-Woman Visits |
Support services, programs, and activities that promote safe and healthy family functioning |
||
Decrease substance abuse among MCH populations |
Smoking During Pregnancy |
|
Perinatal/Infant Health |
Improve breastfeeding rates |
Breastfeeding |
Support services, programs, and activities that promote safe and healthy family functioning |
Safe Sleep |
|
Injury Prevention |
||
Child Health |
Decrease the prevalence of childhood overweight and obesity |
Child Physical Activity |
Improve childhood immunization rates |
Immunizations |
|
Improve maternal and child health population access to medical homes |
Oral Health |
|
Adolescent Health |
Improve maternal and child health population access to medical homes |
Adolescent Well-Visit |
Support services, programs, and activities that promote safe and healthy family functioning |
||
CYSHCN |
Improve maternal and child health population access to medical homes |
Medical Home |
Improve access to medical specialists for CYSHCN |
Specialist Access |
|
Systems-Building |
Improve maternal and child health population access to medical homes |
MCH Workforce Development |
Note: Some priorities were used in multiple domains to justify selection of strategies and linkage to respective performance measures.
How does Title V meet the needs of Idaho’s MCH populations?
Idaho MCH leadership developed a state action plan with specific objectives and strategies to address the eight MCH priorities. The following sections present these objectives and an abbreviated description of notable strategies by each domain area.
Women’s and Maternal Health
Priority Need: Increase percent of women accessing well-woman health care, including prenatal care |
NPM 1: Percent of women, ages 18 through 44, with a preventive medical visit in the past year |
Objective: By September 2020, increase the number of women who are linked to routine well-woman care, including prenatal care during the first trimester. |
Strategies:
|
Priority Need: Support services, programs, and activities that promote safe and healthy family functioning |
NPM 1: Percent of women, ages 18 through 44, with a preventive medical visit in the past year |
Objective: By September 2020, implement the legislatively-required Maternal Mortality Review Committee (MMRC) to review maternal deaths in Idaho and develop recommendations for prevention |
Strategy:
|
Priority Need: Decrease substance abuse among maternal and child health populations |
NPM 14.1: Percent of women who smoke during pregnancy |
Objective: By September 2020, increase the percentage of pregnant women and women of reproductive age that have attempted to quit smoking in the past 12 months |
Strategies:
|
Perinatal and Infant Health
Priority Need: Improve breastfeeding rates |
NPM 4: A) Percent of infants who are ever breastfed, B) Percent of infants breastfed exclusively through 6 months |
Objective: By September 2020, increase the percentage of infants breastfeeding at 6 months of age |
Strategies:
|
Priority Need: Support services, programs, and activities that promote safe and healthy family functioning |
NPM 5: A) Percent of infants placed to sleep on their backs, B) Percent of infants placed to sleep on a separate approved sleep surface, C) Percent of infants placed to sleep without soft objects or loose bedding |
Objective: By September 2020, reduce infant sleep-related deaths by improving safe sleep practices |
Strategies:
|
SPM 3: Unintentional death rate to children 0-4 years of age. |
Objective: By September 2020, fund injury and disease prevention activities to reduce morbidity and mortality rates among young children |
Strategies:
|
Child Health
Priority Need: Decrease the prevalence of childhood overweight and obesity |
NPM 8: Percent of children ages 6 through 11 who are physically active at least 60 minutes per day. |
Objective: By September 2020, help fund and support existing programs and initiatives to expand education and activities focused on physical activity and nutrition for children |
Strategies:
|
Priority Need: Improve childhood immunization rates |
SPM 1: Percent of children at kindergarten enrollment who meet state immunization requirements |
Objective: By September 2020, collaborate with the Idaho Immunization Program to increase vaccination education and vaccine uptake among MCH populations |
Strategies:
|
Priority Need: Improve maternal and child health population access to medical homes (and dental homes) |
NPM 13.B: Percent of children, ages 1 through 17, who had a preventive dental visit in the past year |
Objective: By September 2020, increase the number of women, children, and families who receive information about the importance of regular dental visits and oral health care |
Strategies:
|
Adolescent Health
Priority Need: Improve maternal and child health population access to medical homes |
NPM 10: Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year |
Objective: By September 2020, increase the number of adolescents who receive information about the importance of regular well-visits. |
Strategies:
|
Priority Need: Support services, programs, and activities that promote safe and healthy family functioning |
NPM 10: Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year |
Objective: By September 2020, collaborate with the Idaho Suicide Prevention Program (ISPP) to enhance suicide prevention activities for adolescents. |
Strategies:
|
Objective: By September 2020, develop a plan to increase the public health system’s capacity to address adolescent health issues with recommendations for strengthening and coordinating systems for adolescent health. |
Strategies:
|
CYSHCN
Priority Need: Improve maternal and child health population access to medical homes |
NPM 11: Percent of children with and without special health care needs having a medical home. |
Objective: By September 2020, fund and support services, programs, and activities focused on improving quality of care for CYSHCN. |
Strategies:
|
Priority Need: Improve access to medical specialists for children and youth with special health care needs |
SPM 2: Percent of children with special health care needs who needed or received specialist care in the past 12 months, and experienced some problem accessing care |
Objective: By September 2020, fund and support services, programs, and activities focused on screening, referral, and access to medical specialists. |
Strategies:
|
MCH Systems-Building
Priority Need: Improve maternal and child health population access to medical homes |
SPM 4: Number of health care providers and other professionals who serve MCH populations that receive training with the goal of improving delivery and quality of care |
Objective: By 2020, increase MCH workforce capacity by increasing the number of health care providers and other professionals who participate in topical learning collaboratives. |
Notable Strategies:
|
Services and Systems of Care
The Idaho MCH Program is dedicated to strengthening the systems of care and supporting comprehensive, coordinated, and family-centered services for women and children. The Title V Program has taken an active role in promoting Bright Futures Guidelines and providing topical quality improvement events to encourage various screenings to identify special needs early allowing for prevention or early intervention and treatment. To increase access to medical homes, pediatric specialists, and needed clinical services, the MCH Program contracts with the children’s hospital and public health districts to support specialty pediatric clinics and bring in pediatric specialists from neighboring states to fill pediatric specialty shortages. The MCH Program contracts with two public health districts to pilot the Idaho Medical Home Project, which seeks to build capacity for patient-centered medical home and care coordination by introducing the concepts to pediatric and family practice clinics through intensive practice improvement. Title V funds support the Newborn Screening Program which screens about 99% of Idaho babies for various disorders and ensures babies are linked with appropriate follow-up care. Title V also funds the Children’s Special Health Program which is a direct service, financial support program for Idaho children who meet certain diagnostic and eligibility criteria.
Title V Partnerships
Within an environment of limited resources, health care shortages, and geographic challenges, Title V staff are experts in a variety of MCH areas and are skilled at developing creative and nimble partnerships to address MCH issues. Most often MCH leadership and staff serve as a convener, collaborator, and/or partner to move the needle on MCH issues. One benefit of working in a small state is the tightknit community of public health professionals, social service programs, community organizations, and health care providers, and often, the same stakeholders are “at the table” for many MCH matters. The MCH Program has close working relationships with the Idaho Medical Association, Idaho Chapter of the American Academy of Pediatrics, St. Luke’s Children’s Hospital, Idaho Parents Unlimited, other public health programs, and many health care providers. MCH leadership has been the primary convener with stakeholders to drive policy development, decisions, and activities related to newborn screening program, CCHD screening, infant mortality reduction, CMV education, and implementing a MMRC.
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