The Maternal and Child Health Services Block Grant, Title V of the Social Security Act, is used to address the state’s maternal and child health priorities. In 2023, Oklahoma benefited approximately 1.3 million women, infants, and children with Title V programs. In Oklahoma, Title V is administered by the Oklahoma State Department of Health (OSDH) and the Oklahoma Department of Human Services (DHS), in close partnership with the Oklahoma Family Network (OFN). This assures families have a voice in the services they receive.

Needs Assessment Overview and Determination of Title V Priorities:
 

Figure 1. Oklahoma Process for 2021-2025 Needs Assessment

In 2019, MCH analysts collected data on MCH health indicators from a variety of sources, including birth and death certificates, population-based surveillance systems, school-based surveys, and focus groups; See Figure 1. A public input survey was released in March to identify emergent needs. Tribal listening sessions were conducted with nine of the largest tribal nations in the state and their health care providers. MCH then conducted two non-tribal family and community listening sessions, which included families and caregivers of children and youth with special health care needs (CYSHCN). MCH, CSHCN, and OFN used all of the information received to establish the following Title V priorities for 2021-2025, See Table 1. 

The National and State Performance Measures for Oklahoma, and their current data points can be found below in Figure 2.  

Figure 2. Current Performance Measures

Oklahoma’s Progress on National and State Performance Measures:

In Oklahoma, the Title V program utilizes a life-course framework for needs assessment, program planning and performance reporting at the state and local levels. Trainings, data, and activities are structured to emphasize the importance and effectiveness of reducing risk factors and increasing protective factors early in life to reduce poor health and social outcomes later in adolescence and adulthood. The most prominent examples of this are the Preparing for a Lifetime, Its Everyone’s Responsibility, infant mortality reduction initiative led by MCH, and the life-course work accomplished with families through OFN.

Both MCH and CSHCN Title V, in partnership with OFN, support and assure comprehensive, coordinated and family-centered services via a system of trainings, partnerships, contracts, and direct services. The provision of services for MCH populations are accomplished through county health departments, professional service agreements, vendor and state agency contracts, requests for proposals, and invitations to bid. Although administratively separate, the Oklahoma City-County Health Department (OCCHD) and the Tulsa Health Department (THD) are essential MCH partners, providing services and administering projects via direct contracts. MCH continues to be integrally involved with the work of the Oklahoma Perinatal Quality Improvement Collaborative (OPQIC) and the Oklahoma Maternal Health Task Force (OMHTF), which aim to improve the care of women and infants throughout the state and the Children’s State Advisory Work Group (CSAW), which brings together multi-disciplinary professionals in child-serving agencies focused on improving mental and behavioral health for children and youth in the state. CSHCN Title V has contracts in place with the Comprehensive Pediatric Sickle Cell Clinic, Parent Promise Community HOPE Center, JumpStart Clinic, Family Support 360°, the Oklahoma Infant Transition Program (OITP), OFN, Sooner SUCCESS, and the JD McCarty Center, to provide high quality, family-centered CYSHCN services.

Programs administered in some part with Title V funds include: Preparing for a Lifetime, It’s Everyone’s Responsibility; OPQIC, Maternal Mortality Review Committee (MMRC); Period of PURPLE Crying program; Pregnancy Risk Assessment Monitoring System (PRAMS); The Oklahoma Toddler Survey (TOTS) and Youth Risk Behavior Surveillance System (YRBS) surveillance programs; Teen Pregnancy Prevention and Positive Youth Development Projects throughout the state; State Systems Development Initiative; Infant Safe Sleep Cribs and Sleep Sacks Projects; Becoming Baby Friendly Oklahoma, media campaigns, health equity activities, and other-related programs and initiatives.

Maternal/Women:

Accomplishments:

• Continued MMRC and the OMHTF, completing the third Maternal Health Morbidity and Mortality Annual Report.
• Supported maternity clinics in maternity deserts in the state.
• Created and ran public service announcements on streaming services with messages regarding preconception health and healthy pregnancies.

Plans:

• Continue work with the MMR Committee and OMHTF to reduce disparities in maternal health.
• Coordinate maternal health activities with county health departments and the State Maternal Health Innovation Program grant to improve prenatal and postpartum care in areas of need via maternity clinics.

Perinatal:

Accomplishments:

• Provided funding and support for the Oklahoma Mothers' Milk Bank (OMMB) and the Oklahoma Breastfeeding Hotline (OBH). Promoted breastfeeding duration and the establishment of Baby-Friendly Hospitals through funding and support of the Oklahoma Hospital Breastfeeding Education Project (HBEP) and Becoming Baby-Friendly in Oklahoma (BBFOK) Project.
• Distributed cribs to families in need via the cribs project for safe sleep and continued the sleep sack hospital program in 28 birthing facilities. 
• Screened 100% of all newborns in Oklahoma through the Newborn Screening Program and 100% of affected newborns received short-term follow-up and were referred to long-term follow-up care coordination.
• Reduced infant mortality 3-year rate to 6.9 per 1,000 live births, aided by Preparing for a Lifetime efforts and multiple partners.

Plans:

• Continue the media campaign for Preparing for a Lifetime to reduce infant and maternal deaths.
• Continue to partner with and support newborn screening activities in the state.
• Promote breastfeeding initiation and duration through various initiatives.
• Recruit additional delivery hospitals to participate in the Infant Safe Sleep Hospital Sleep Sack and Cribs Projects.

Child:

Accomplishments:

• Provided funding for the Oklahoma Poison Control Hotline for training and technical assistance to families, students, health care providers and child care programs.
• Participated in the Oklahoma State Obesity Plan Stakeholders Group, serving on the early childhood and school age working groups.
• Maintained school health contracts to support physical and social emotional health activities in the state’s two largest school districts and in one statewide school health organization.
• Continued Child Health well and sick care visits in health department districts, including piloting a new model for school-based health clinics.

Plans:

• Promote bullying prevention and suicide prevention trainings in schools across the state.
• Continue work with MCH-funded school nurses to assure evidence-based practices are being followed.
• Continue funding health education and outreach activities.
• Support the provision of well child health visits and mobile school clinics in county health department clinics in areas of high need.

Adolescent:

Accomplishments:

• Supported eight state-funded adolescent pregnancy prevention projects in local county health departments, and administered the Personal Responsibility Education Program (PREP) grant for OCCHD and THD.
• Began planning for the 2nd Biennial Adolescent Health Summit.

Plans:

• Collaborate with local county health departments to establish and support local Public Health Youth Councils (PHYCs) and other youth-involved groups to identify issues within their communities affecting adolescents to find solutions.
• Conduct trainings with others who work with youth using evidence-based methods such as Question Persuade Refer (QPR), Positive Youth Development (PYD), and Life Course Perspective.
• Ensure MCH-funded school health education and promotion programs will continue to provide age and grade appropriate health and wellness information, integrating education and health.

CYSHCN:

Accomplishments:

• Funded parent-to-parent support, sibling support, training, and opportunities for family leadership via OFN.
• Continued funding the OITP, Sooner SUCCESS, Jump Start/Autism Clinic Family Partner, the OU Pediatric Sickle Cell Clinic, and the Oklahoma Family Support 360⁰ Center. Began funding HOPE Center projects.
• Provided supplemental formula, adaptive equipment, and medical care to CYSHCN with financial need that was not covered by Title XIX Medicaid funds.
• Provided funding for respite vouchers.

Plans:

• Continue to provide formula, adaptive equipment, and medical care to CYSHCN with financial need.
• Continue contracts with Sooner SUCCESS, OFN, Jump Start, J.D. McCarty, OITP, Parent Promise, Family Support 360°, and the Sickle Cell Clinic to further work in the state for the families of CYSHCN.
• Promote the transition toolkit for primary care providers.
• Work with partners to identify ways to connect families with services to meet behavioral health needs.

Comments and Suggestions:

MCH, CSHCN, and OFN welcome comments and suggestions for needs and issues not discussed in this Block Grant Application and Annual Report. For more information about this document, the process, to provide comments, or to partner with Title V, please contact:  Joyce Marshall, MCH Title V Director, OSDH at 405-426-8113 or joycem@health.ok.gov or Aubrey McDonald, CSHCN Title V Director, DHS at 918-863-4899 or Aubrey.McDonald@okdhs.org.