In January 2020, the Department of Public Health and Human Services (DPHHS) established the Early Childhood and Family Support Division (ECFSD). The ECFSD includes the programs housed in the Family and Community Health (FCHB) and Early Childhood Services (ECSB) Bureaus, the Prevention and Early Intervention Unit, and No Kid Hungry.  The Division Administrator (DA) oversees the FCHB, ECSB, Fiscal and Operations Bureau (FOB), Prevention and Early Intervention Unit, the Business Systems/Operations Unit, and No Kid Hungry.

The ECFSD mission to better coordinate existing services for children and families remains strong.  The ECFSD structure continues to evolve as DPHHS and Division programmatic needs are identified.  On August 9, 2021, DPHHS leadership announced that the agency had completed an overall organizational health assessment that will guide the agency’s restructuring plan.  The new DPHHS structure is included as a Supporting Document   (https://dphhs.mt.gov/News/2021/08/DPHHSAnnouncesagencyrestructuring.) Since then, the following key personnel changes have been announced: hiring a new Medicaid Director; resignation of DPHHS Director Adam Meier, effective August 2022; and promotion of DPHHS Chief of Staff, Charlie Brereton, to the Director’s position.

In its second year, the ECFSD experienced continued turnover and is assessing the most effective organizational structure for moving forward, especially related to fiscal and operations support for the programmatic bureaus.  All Divisions within DPHHS have support through centralized human resources, budget management, fair hearings, and public information.  The ECFSD Division Adminstrator Jamie Palagi resigned her position in June 2022. A new Division Administrator, Tracey Moseman, is set to beging work on August 13, 2022. The Title X grant, administered by DPHHS for over 50 years, was awarded to a non-profit through a competitive funding process.

The DPHHS Human Resources (HR) Office assists with the recruitment and hiring processes and provides onboarding training for all new hires.  In addition to the HR training, an employee engagement committee within ECFSD developed an ECFSD New Employee Manual, which expands on the DPHHS HR training. Some programs have developed their own onboarding materials to support new employee training specific to program competencies, these include: Chilren’s Special Health Services (CSHS), Oral Health, Maternal Review and Prevention, and the Primay Care Office.

Annually, all employees are required to complete refresher trainings from DPHHS HR, and the Technology Services Division, on topics such as: The Health Insurance Portability and Accountability Act (HIPAA); safety in the workplace; and internet safety.  Additionally, DPHHS HR offers monthly supervisory-focused online trainings, with topics selected from a DPHHS formal survey.  Topics have included “How Managers Can Use the Employee Assistance Program (EAP)”, What You Need to Know About the Human Rights Bureau and Discrimination Laws,” and “COVID 19 Management.”  ECFSD staff are encouraged to take these trainings.

The Title V MCHBG State Action Plans (SAP) are overseen by the Title V Director/Maternal and Child Health Coordination (MCHC) Section Supervisor and CSHCN Director/ Children’s Special Health Services (CSHS) Section Supervisor.The MCHC Section remains steady with five program specialists (PS) and the inclusion of a Nurse Consultant/Grant Administrator who oversees the Maternal Mortality Review and Prevention Program (MMRP). 

MCHC PS are responsible for the SAP as follows:  NPM 1: Montana Obstetrics & Maternal Support (MOMS) Program Specialist; NPM 5: Fetal, Infant Child & Maternal Mortality Review (FICMMR) Program Specialist; NPM 13: Oral Health Program Specialist; and the MCHBG Program Specialist has specific responsibility the County Public Health Department (CPHD) contracts, SPMs 1 and 2, plus overall responsibility for the SAP. 

The ECFSD Leadership Team elected to have the Adolescent Health Program Specialist (AHPS) report directly to the Title X Director and subsequently now to the FCHB Bureau Chief.   The AHPS continues to: support the NPM 9 state action plan; and works directly with CPHD’s that have selected an adolescent-focused FICMMR prevention activity.  

Within the last six months, both the Oral Health Program Specialist and MMRP staff members have opted to pursue career advancements.  Both positions are being recruited.     

The CSHS Section, now a five-person team, experienced changes in the past year and turn-over in the following positions: MAPP-Net Program Specialist, Program Assistant, and Title V CYSHCN Program Specialist.  Staff in these position had been in them for less than one year. All positions have been successfully filled. CSHS attempted to recruit a VISTA for the 2022 calendar year however were unsuccessful in attempts in both January and July, based on low applicant turn-out and graduate school opportunities. CSHS will reassess internal strategy and VISTA recruitment strategies, as the state department has seen a drastic reduction in the amount of VISTA applications in 2022 compared to 2020 and 2021.

The ECFSD Leadership Team created the ECFSD Workforce Development Policy and Procedure (WDPP). The WDPP outlines expectations for all the ECFSD positions and encourages individualized professional development.  The WDPP will be updated to reflect the new HR performance management system, TALENT, which, has been implemented across the State of Montana. DPHHS employee’s have begun to document two time-based, measurable, goals that align with agency goals. This system will allow the State to track performance across all state departments, and ensure alignment with key agency objectives.

The CSHS and MCHC staffs’ job descriptions, at a minimum, reflect the necessary skills, knowledge, abilities, and experience needed for their positions on day one.  New employees to state government are required to have a probationary performance evaluation, which includes SMART goals (Specific, Measurable, Attainable, Realistic, Timely) to be completed within the six-month probationary period.   This evaluation, when combined with the staff member’s annual performance review and their reflective supervision meetings, are opportunities to identify their professional development needs. Staff have also identifed their won TALENT goals, which are reviewed with their supervisor on a quarterly basis.

In September 2021, DPHHS employee’s were required to return to in-office work. An external contractor was hired to conduct an analysis of the risk/benefits of remote work across the State of Montana. Staff input received through interactive meetings and online survey’s will be used to inform the results, which should be released by Autumn of 2022. Requests to telework are not accepted until the results of the survey have been released, telework is approved by leadership, and the Department of Administration has put policies into place.

Staff are encouraged to avail themselves of training from the State Professional Development Center (PDC), housed in the Department of Administration.  The PDC offers training on topics such as: Excel for Beginners to Advanced; planning and organizing; writing clearly and concisely; and, in response to COVID-19, Telework Made Easy. Other opportunities include: participating in Public Health and Safety Division training opportunities; attending federal grantee online trainings, i.e., Health Resources & Services Administration (HRSA) and Centers for Disease Control (CDC); and participating in section and bureau specific trainings, such as the one attended by the MCHC Section on specialized GIS Mapping.  ECFSD managers participated in Collaborative Safety Science training together as a team.

ECFSD staff were queried on their immediate and emerging training needs, and in response, bi-monthly Lunch & Learns were established.  The Lunch & Learns have featured updates from these ECFSD standing committees: Diversity, Equity, Inclusion; and Employee Engagement.  ECFSD subject and program matter experts have also been featured in areas such as: budget creation; and, Federal/State-funded services such as the Children’s Trust Fund and No Kid Hungry; there are also program specific presentations.

The CSHS staff have also participated in trainings offered through a partnership with a state university, specific to: Diversity, Equity and Inclusion; and Budget Management. Additionally, CSHS staff have applied to be part of the AMCHP CYSHCN New Director and emerging professional leadership academies. CSHS staff is currently in the process of applying for technical assistance specific to CYSHCN Standards of Care. All CSHS staff will participate in this training and identify specific elements within the standards of care for additional study. As part of the effort to improve the section's competency and practice around health and racial equity, the CSHS team spends 15 to 30 minutes at every staff meeting reviewing readings on health disparities and equity topics.

The Title V MCHBG and CSHCN Directors have expanded their working relationship to include their respective MCHBG Program Specialists.  Monthly meetings include topics such as: collaboration on NPMs; cross-training on programs; financial/budget discussions and block grant application logistics. CSHS is taking on a more active role in supporting the Title V MCHBG Application & Report, and working with local public health entities.  Title V MCHBG and CSHCN Directors hosted a team-building meeting with activities for all MCH and CSHS staff, with the goal of building relationships to support program collaboration.

ECFSD staff are involved in planning the 9th Annual Great Beginnings, Great Families Conference (GBGF), which will be held in August 2022. The conference aims to the connect programs, providers, and partners  involved in the state’s early childhood, and maternal, child and adolescent health (MCAH) systems. It also serves as a training and workforce development opportunity for state and local staff.  Pre-meetings will be held by ECFSD programs including: CSHS, Part C and Healthy MT Famlies.