Colorado’s MCH Program

Colorado’s MCH program is administered by the Colorado Department of Public Health and Environment (CDPHE). MCH collaborates with programs across CDPHE, other state agencies and statewide organizations, local public health agencies and community partners to implement strategies that have a population impact on Colorado’s statewide MCH priorities.

2021-2025 MCH Priorities

The MCH Framework for the current five-year block grant cycle is based on the statewide MCH needs assessment and prioritization process that was completed in 2020 that resulted in the following seven prioritized needs:

• Create safe and connected built environments
• Increase prosocial connection
• Promote positive child and youth development
• Improve access to supports
• Increase social emotional wellbeing
• Reduce racial inequities
• Increase economic mobility

MCH Priority Implementation

Evidence-informed strategy measures and associated objectives are outlined in logic models and action plans for each priority and are posted on www.MCHColorado.org. The logic models and action plans, used to guide Colorado’s state and local MCH work, are a combination of best and promising practices, along with emerging practices to drive innovation. MCH funds are leveraged with state resources, as well as aligned with other federally-funded programs and initiatives, to support priority implementation efforts. MCH funds are also used to build the capacity of the state and local MCH workforce in the areas of racial equity, community inclusion and moving upstream. Interim progress toward the performance measures is tracked through quarterly performance management reporting and evaluation summaries are produced each year to monitor impact on each priority. A summary for each MCH priority and associated performance measure is included below.

Create Safe and Connected Built Environments

State Performance Measure 3: Percent of children ages 0-17 years who live in a supportive neighborhood.

Daily experiences such as feeling safe, taking a walk, visiting a park, having healthy food nearby, and being part of social networks are critical to physical, mental, and social well-being. Thoughtful planning and design of a community’s buildings, streets, sidewalks, transportation networks, parks, and homes can make it easier for children, youth, and families to engage, connect with others, and access resources in their communities. Safe and accessible built environments increase opportunities for physical activity by being able to walk, bike, or wheelchair roll to everyday destinations and decrease violence by creating safer environments for people to meet and connect. The MCH program funds built environment staff to build cross-sector partnerships and increase capacity for implementing place-based policy strategies that promote equity, community safety, and activity-friendly routes.

Increase Prosocial Connection

National Performance Measure 9: Percent of adolescents, ages 12 through 17, who are bullied or who bully others.

Data and research has shown that youth who have a trusted adult are less likely to experience bullying, as well as other health outcomes like suicide and substance use. Research also shows that if prevention efforts are focused on those who are most disproportionately impacted, it will also improve the outcomes for other youth. Evidence-based strategies supported through Colorado’s MCH program include integrating a positive youth development approach into youth-serving programs throughout the state and supporting model policies and practices, such as Gender Sexuality Alliances, which increase trusted adults in young people’s lives and enhances school climate and connectedness. The MCH program also supports the implementation of best practice youth violence prevention programs in schools.

Promote Positive Child and Youth Development

National Performance Measure 4: A) Percent of infants who are ever breastfed and B) Percent of infants breastfed exclusively through 6 month

Families experiencing low socioeconomic status have greater breastfeeding disparities, are more likely to experience barriers to breastfeeding, and thus have lower breastfeeding rates. The MCH program is focused on increasing the number of Baby-Friendly designated hospitals that serve high proportions of Medicaid paid births to decrease the breastfeeding disparities.

Research shows as the number of evidence-based Baby-Friendly Hospital Initiative’s Ten Steps to Successful Breastfeeding practices increase in a hospital, breastfeeding rates increase as well. This is especially true for families enrolled in Medicaid or have no health insurance, as well as among families participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), where significant increases in breastfeeding initiation and long term success is shown when Baby-Friendly policies were in place at a hospital.

Improve Access to Supports

National Performance Measure 11: Percent of children with and without special health care needs having a medical home

A core component of a medical home is timely access to specialty care, including behavioral health. In Colorado, only 15 out of 64 counties have a child psychiatrist, which creates a barrier for identifying, diagnosing and connecting children with complex behavioral health needs with services and supports. One of the recommendations included in the MCH-funded policy agenda, The ABC’s of Health Equity for Children and Youth with Special Health Care Needs: A Policy Agenda for Colorado, centers on strengthening the capacity of the primary care provider network through telehealth and e-consultation. To advance this policy recommendation and strengthen access to behavioral health consultation and expertise statewide, MCH partners with the Pediatric Mental Health Institute and the Department of Psychiatry at the University of Colorado to implement the Colorado Pediatric Psychiatry Consultation and Access Program. The program offers pediatric primary care providers a phone, email or telehealth consultation with a child psychiatrist to support diagnosis or treatment. Enrolled practices can also receive continuing education opportunities tailored to their community, free screening tools and educational materials. 

National Performance Measure 6: Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool

While Colorado remains in the top tier amongst states for developmental screening rates, barriers in the process to access evaluation and intervention services after screening still remain. In 2022, approximately 22% of Early Intervention Colorado referrals were closed before completing the process. Barriers between child and family-serving systems in Colorado make it difficult to access and share data to know when children are screened, referred and, ultimately, whether they are able to access needed services. This results in children and families not receiving appropriate and timely support, and providers being unable to help coordinate care. To address this challenge, the MCH program is supporting a developmental screening and e-referral pilot project to improve communication and coordination among providers, early intervention partners, and families. 

Increase Social Emotional Wellbeing

State Performance Measure 4: Percent of women of reproductive age (18-44 years) who report good mental health

As outlined in Postpartum Behavioral Health in Colorado, depression and anxiety continue to be the most common conditions that people experience before and after pregnancy. To improve the awareness and knowledge of pregnancy-related depression among pregnant and postpartum women and to improve women’s perceptions and attitudes toward seeking support, Colorado’s MCH program supports provider education and a statewide public awareness campaign. MCH also coordinates the state’s Maternal Mortality Review Committee. Based on Colorado’s most recent review committee data, suicide and unintentionaloverdose continue to be leading causes of maternal mortality. The MCH program is an active partner in the Colorado Perinatal Care Quality Collaborative, which supports the implementation of the Alliance for Innovation on Maternal Health (AIM) care for pregnant people with substance use disorders patient safety bundle,  with 19 hospitals throughout Colorado.

National Performance Measure 14a: Percent of women who smoke during pregnancy

People who smoke during pregnancy are more likely to experience a fetal death or deliver a low birth weight baby. The MCH program partners with the state’s tobacco prevention, education and cessation program to implement evidence-based strategies in every county in Colorado to reduce the number of pregnant people who smoke, such as the community-based Baby and Me Tobacco Free Program and the QuitLine Pregnancy Protocol Program. Quit rates for QuitLine average 37% vs. 4-7% for unaided quit attempts. Those who access the Quitline are up to seven times more successful than people who try to quit unaided. A study of the Colorado Baby and Me Tobacco Free Program found program participants saw a 24% to 28% reduction in the risk of preterm birth and a 24% to 55% reduction in the risk of neonatal intensive care unit admissions.

Reduce Racial Inequities

State Performance Measure 2: Number of points for racial equity related policy, practices and systems changes implemented at the program, division and department level

Colorado’s MCH program integrates strategies and activities to advance racial equity across each of the priorities. In addition, the program tracks changes to state and  local  policies and practices and assesses the potential impacts those systemic and institutional changes may have across staff and programs that serve the MCH population. While reducing racial inequities is a priority unto itself, strategies to impact racial inequities are integrated across the action plans for all seven statewide MCH priorities.

Increase Economic Mobility

State Performance Measure 1: Percent of households that spend more than 30% of household income on housing costs (Note: this year the measure has changed to “State Performance Measure 5: Percent of children in poverty according to the supplemental poverty measure” as a more proximal measure of the strategies being implemented to impact the economic mobility priority)

The connection between economic status and health is well-established, and poverty can have serious effects on children’s long-term health. Among U.S. children younger than 18 years of age, one-third (33.2%) live in families with incomes below 200 percent of the federal poverty level ($50,200 for a family of four), the level at which Colorado families can be economically self-sufficient (The Self-Sufficiency Standard for Colorado 2018, Colorado Center on Law and Policy). Colorado is an increasingly expensive place to live, and many Colorado families have trouble meeting critical needs. Expanded tax credits support economic mobility and are associated with reduced child and household poverty, increased food security, and fewer adverse childhood events. MCH coordinates a tax outreach campaign, created a partner toolkit and provides statewide resources and information to help Coloradans access federal and state tax credits through Get Ahead Colorado.