Program Overview

The Title V grant is dedicated to improving health outcomes in New Mexico’s maternal, infant and child populations. Across programs, federal funds are blended with state funds and program revenues to allow a broader scope of program activities.  All the Title V funded programs struggle with unmet needs and try to balance the breadth of services with depth.  A defined and continuous focus on health equity and family-consumer partnerships throughout all the programs has strengthened the Title V program in NM.  While federal funding does not support all the essential work in community-based organizations, we in Title V have made a concerted effort to partner with community and consumer-led work and collaborate with other state agencies to provide outreach to diverse entities and expand our reach.

The following State Priority Areas were identified from the 2020 Needs Assessment for the five-year period 2020-2025:

More detail on each Program area (population domain) is provided below.

Maternal Health

The Maternal Health Program (MHP) is the regulating body for licensing both certified nurse-midwives (CNMs) and licensed midwives (LMs), in New Mexico. In 2019, the CNM Practice Rule was revised to help clarify processes in regulatory and disciplinary actions and to include guidance on opioid and controlled substance prescriptions. In the Fall of that year, the MHP was asked to re-open the rule again to address the expansion of the CNM practice to include treatment of “clients/patients” instead of just treatment of male partners for sexually transmitted infections. This rule was heard for public comment in October 2021 after being delayed almost a year due to the COVID-19 pandemic.

Licensed midwives in New Mexico face multiple barriers including difficult billing options for Medicaid-covered births. The MHP addresses these and other concerns in quarterly LM meetings and in policy improvement whenever possible. After a new online application for licensure was launched in 2019, significant challenges persisted in 2020 and 2021, but the MHP is working to resolve technical barriers and make midwifery license renewal more efficient. Although NM does not regulate, certify, or reimburse doulas at the state level, Title V also seeks to support training and reimbursement avenues for this important segment of the MCH workforce.

The MHP and MCH Epidemiology program collaborates in managing the Maternal Mortality Review committee (MMRC) in New Mexico. The MMRC has reviewed 97 pregnancy-associated deaths occurring during pregnancy or up to a year following delivery (2015-2020).  The committee deliberates on the preventability of deaths, identifying contributing factors such as substance use or mental health, and makes recommendations to improve systems of care for pregnant, delivering, and postpartum people. The MMRC disseminates findings for policy and programmatic change. With funding and technical assistance from the Centers for Disease Control and Prevention, the MHP and MCH Epidemiology staff work to improve case abstraction, case review, and analysis.

Starting in late 2018 NM became an AIM state, which was a collaborative initiative to enroll hospitals in patient safety bundles. The hospitals report process measures and follow a quality improvement design, measured by outcome measures on severe maternal morbidity. Participating hospitals who enroll engage in all NM patient safety bundles, which will soon include the bundle for caring for pregnant and postpartum people with substance use disorder. In 2021, nearly all birthing hospitals participated, and two Indian Health Services facilities participated in process and QI measures even though their outcome data cannot be shared in the AIM portal.

Changes in the New Mexico Perinatal Collaborative board, structure and potential areas of focus have recently forced a pause to evaluate next steps, however during the reporting period collaboration to onboard and provide outcome data to new hospitals continued.

Maternal Health Program staff completed a CDC standardized assessment and follow-up consultations with birthing facilities on neonatal and maternal/obstetric levels of care in NM and in bordering states in 2019. Staff met with NM birthing hospitals to establish final neonatal and maternal levels of care in 2020 for facilities where there was discordance between the self-assessed level and the level identified by the CDC LOCATe tool. While this work has primarily focused within the maternal health domain, there are opportunities to leverage assessment of neonatal levels of care through the NM Hospital Association, the NM Pediatric Society and community advocates.

Infant/Perinatal Health

Efforts to support a diverse and equitable perinatal and early child health workforce continue, and strategies for the planning year include improvements to the CARA navigation, evaluation and opportunities for families struggling with addiction. Trauma informed trainings sponsored by ECECD

The Office of Injury Prevention and Family Health Bureau Title V programs collaborate in programming and communications to improve safe sleep for infants through education, surveillance, and partnerships with community programs such as home visiting and medical practices. Both programs participate with the Office of the Medical Investigator (OMI)- led Child Fatality Review in the Sudden Unexpected Infant Death (SUID) Registry. These programs drafted an inter-agency Safe Sleep Strategy in 2019, which now has input and engagement from ECECD, CYFD, the NM Breastfeeding Task Force, and the UNM Prevention Research Center. The partners meet quarterly to promote messaging, best practices, and evidence-based resources to community and state programs.

Efforts to promote safe sleep were drawn back into sharp focus during the reporting period, and we are moving forward with a statewide media campaign to address disparities and overall rates of sudden unexpected infant death SUID.

Oral Health

The NM State Office of Oral Health (OOH) provides preventive care to early head start, head start, preschool, and school-aged children throughout New Mexico in urban/rural schools. OOH also provides funding to deliver dental treatments and prevention at no cost to low-income and uninsured children and pregnant women. With combined funding from the CDC, the program is hoping to increase the number of middle and high schoolers having screening, dental sealant program, and referral to dental care through School-Based Health Centers. Additionally, the OOH is working to promote fluoridated water consumption among Albuquerque and Santa Fe metro residents. Title V funds are used to purchase fluoride varnish (used at preschool clinics), educational materials (oral health curriculum), and staff attendance at the annual National Oral Health Conference.  Educational materials are used to support the CHI Saint Joseph Foundation home visiting program to improve oral health education, promotion, and support to pregnant women and their babies, before and after birth.  Fewer oral health services were provided during the report year as the COVID-19 pandemic reduced opportunities to provide in-person care.

Child Health

New Mexico created a new Early Childhood Education and Care Department (ECECD), where staff received the Early Childhood Comprehensive Systems-Act Early (ECCS-AE) grant in 2021. The ECCS team includes Title V staff and other stakeholders working to improve developmental and social/emotional screening in early childhood and increase parent access to early childhood information and resources. 

Along with collaboration from DOH Title V programs and the Office of Injury and Violence Prevention, ECECD provides programming to parents and families with young children, facilitates data sharing, analysis goals, and shared staff training. Title V promotes awareness and evidence around Adverse Child Experiences in New Mexico. Title V and ECECD staff joined the DOH Office of Injury Prevention in an ACE’s learning network with the Association of State and Territorial Health Officials (ASTHO) to assess the readiness of trauma-informed work in New Mexico. Findings indicated a great deal of buy in and enthusiasm for cross-sectoral work which can be amplified through Title V.

 Children and Youth with Special Health Care Needs (CSHCN)

The Children and Youth with Special Health Care Needs (CYSHCN) program, Children’s Medical Services (CMS), has been specifically focused on increasing numbers of CYSHCN who receive care in a Medical Home and ensuring successful transitions to adult healthcare. CMS employs licensed medical social workers trained in the provision of care coordination for CYSHCN from birth to age 21, helping to bridge the gaps in the healthcare system and link families to needed services.  This coordination of care across settings leads to an integration of services, which decreases health care costs, reduces fragmentation of care, and improves the experience for the patient and family. 

The Newborn Genetic Screening program of CMS is part of the Mountain States Regional Collaborative and is participating in the second year of the Underserved Populations Project (UPP) which was undertaken to develop strategies to increase access to genetic services for individuals in rural, Hispanic, and American Indian communities in the Mountain States.

Family involvement is a strength in New Mexico with the national headquarters of Family Voices based in Albuquerque. We also have the Family-to-Family (F2F) program through Parents Reaching Out, EPICS (supporting Native American families who have children with special needs), the Navajo Family Voices, and the strong family advocacy component of the Center for Development and Disabilities (CDD) at the University of New Mexico.

Adolescent Health

The NM Family Planning Program (FPP) supports Title V by providing evidence-based prevention programs and clinical services to decrease the teen birth rate through increasing access to reproductive clinical services, increasing awareness of birth control options, and providing educational programming. NM FPP promotes three population-based strategies: service learning and positive youth development programs, adult/teen communication programs, and comprehensive sex education programs. NM Title V continues to support the implementation of two evidence-based unintended teen pregnancy prevention programs and one parent workshop: Teen Outreach Program (TOP) and Project AIM (Adult Identifying Mentoring) for teens and From Playground to Prom: Talking with Your Child about Sexuality. TOP is implemented in nine counties at 13 sites statewide by seven different organizations.

The NMDOH Office of School and Adolescent Health continues to lead the NM Adolescent & Young Adult Health (AYAH) Collaborative Improvement & Innovation Network (CoIIN), which consists of members from Title V Maternal & Child Health, Apex Evaluation, Albuquerque Public Schools, Programs for Adolescents, the University of New Mexico and other partners, are working together to improve and infuse key stakeholder input into the implementation and evaluation of the NM Youth Peer to Peer Helper (YP2PH) Program. OSAH funds approximately 40 program sites statewide. Through the NM Youth Peer to Peer Helper Program, we help over 500 students each year with coping and resilience tools.