III.E.2.b.v.a. Public and Private Partnerships - Missouri - 2022
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Collaborative Work with Federal, State & Non-Governmental Partners
Maternal/Infant Health
DHSS Title V Program team members were involved in several efforts that have enhanced a systems approach to ensure access to quality health care and needed services for Missouri’s MCH population. DHSS and the Missouri Hospital Association continued to work together as on the Maternal and Child Learning Action Network (MC-LAN) and the Alliance for Innovation on Maternal Health (AIM). The MC-LAN provides guidance, knowledge-sharing and peer support in developing strategic quality initiatives based on the Triple Aim principles. The committee partners with the communities they serve to achieve better communication, and educate and impact the public on quality and safety initiatives of the health care community. AIM is a national data-driven maternal safety and quality improvement initiative, and Missouri was designated as an AIM state in 2018. As part of the current Obstetric Care for Women with Opioid Use Disorder AIM Bundle, the Missouri Neonatal Abstinence Syndrome Collaborative was formed to focus on developing improvements in care related to the care of substance-exposed newborns, including keeping the mother-infant dyad intact; incorporating the functional assessment model Eat, Sleep, Console into practice; and establishing Safe Plans of Care of the mother and the infant.
DHSS partners with several organizations serving Missouri’s Bootheel counties to support the Rural Maternity Obstetrics Management Strategies (RMOMS) grant, which was awarded to Saint Francis Healthcare System in Cape Girardeau. The RMOMS grant seeks to support health care providers, hospitals, public health, and social support agencies to work together with communities to build on local resources to meet the health care needs of women and newborns and create a new model of service delivery.
DHSS collaborates with the Department of Social Services (DSS), MO HealthNet Division, on Maternal Opioid Misuse (MOM) grant efforts. The MOM model supports the coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery. The MOM model has the potential to improve quality of care for pregnancy and postpartum Medicaid beneficiaries with opioid use disorder through state-driven transformation of the delivery system surrounding this vulnerable population.
DHSS applied to participate in the Association of State and Territorial Health Officials (ASTHO) and the Association of Maternal and Child Health Programs (AMCHP) Promoting Innovation in State & Territorial MCH Policymaking (PRISM) Learning Community. In addition to the Title V MCH Director, who serves as the team lead, the core team includes MCH and behavioral health representation from DSS, MO HealthNet Division; Department of Mental Health; University of Missouri Kansas City (UMKC) Institute for Human Development; and local public health. The PRISM Learning Community provides technical assistance and capacity building to support and advance policy implementation within states and territories to equitably address substance misuse and addiction and mental health disorders in women, children, and families within the context of the COVID-19 pandemic.
Lastly, the DHSS Title V MCH Director collaborated with the UMKC Institute for Human Development to submit an application for the HRSA Emerging Issues in Maternal and Child Health funding opportunity to address the increasing rates of maternal opioid and other substance use disorders.
Child/Adolescent Health
On August 28, 2021, nearly all early childhood programs across state government will be consolidated in a single Office of Childhood, allowing early childhood work across state government to become more streamlined and effective. DHSS Home Visiting, Early Childhood, Safe Cribs, and Child Care Health Consultation programs, all of which receive Title V funding and contribute to the Title V MCH State Action Plan, are moving to the new Office of Childhood. To meet the authorizing legislation requirements of Section 509 of the Social Security Act, a new MOU between DHSS and the new Office of Childhood at the Department of Elementary and Secondary Education (DESE) is being developed to establish: DHSS Title V Program authority and oversight for Title V allocations to DESE and the programs receiving Title V funding; accountability measures and reporting requirements related to Title V funding allocations; and interagency MCH data sharing and reporting requirements. A MOU was executed between the DHSS Title V Program and DESE Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program to collaborate on programs and activities to improve maternal, infant, and child health outcomes.
The DHSS MOU with DSS and Children’s Trust Fund (CTF) to facilitate exchange and use of information regarding incidences of child maltreatment and/or neglect among DHSS or CTF Home Visiting (HV) program clients is being updated to also include the new DESE Office of Childhood. The goal is to use the data to assess the degree to which families enrolled in HV have lower substantiated/called-in reports, and whether the number of reports for clients with multiple reports declines over time as they are enrolled longer and work with their home visitors to develop their parenting and resiliency skills. In addition, the MOU has been narrowed to collect only the data needed to comply with Missouri’s required Maternal, Infant, and Early Childhood HV (MIECHV) performance measure reporting for comparison between MIECHV, Title V funded HV programs, and CTF HV outcomes.
The State Dental Director plays an essential role in state oral health programs. DHSS entered into an agreement with DSS for Missouri’s Dental Director position to be split between both agencies. The interaction between DSS and DHSS is especially important due to this dual placement. The Dental Director must be able to discuss MO HealthNet dental benefits based on dental expertise and data provided by Missouri’s Oral Health Program and DSS staff. This role must also communicate with other dental professionals about dental public health issues important to both DSS and DHSS.
The DHSS Title V Program partners with the Missouri Show-Me School-Based Health Alliance (SMSBHA) to advance and advocate for school-based health care programs. The SMSBHA creates synergy around school-based health through education and training programs, networking, data collection and evaluation, advocacy, and provision of technical assistance for sites. The SMSBHA started in 2014 as a statewide multi-agency task force, and only 5 school districts had some form of school-based health center. In 2019-2020, the Alliance conducted the first ever statewide SBH census, and subsequently expanded the definition of a SBH program to include not only SBHCs, but the following other SBH program types: school-based mental health, mobile, telehealth, school-linked, and school-based oral health programs. Census results showed, as of 2020, there were 675 SBH programs across Missouri, with 41 being SBH centers. The number of school districts that have some type of SBH program is now 256, serving over 500,000 Missouri students. Information from the census was also used to create the SBH Program Directory to facilitate peer-to-peer learning and networking. Continued involvement in the Alliance assures the health care needs of children are met and the integrity of the school environment is preserved as partners work together to improve children’s health, educational opportunities, academic achievements, and ultimately, life outcomes.
Children and Youth with Special Health Care Needs
The Bureau of Special Health Care Needs (BSHCN) partners with several public and private entities in support of children with special health care needs through both formal and informal relationships. Contracts are in place with local public health agencies to provide service coordination on a regional basis for the BSHCN Children and Youth with Special Health Care Needs (CYSHCN) Program. The CYSHCN Service Coordinators in each region specialize in resource referrals and are knowledgeable and connected with local businesses, agencies, churches, and philanthropic organizations. SHCN Family Partners are also experts in connecting with public and private partners to link families of children with special health care needs with the appropriate resources. SHCN staff members are involved with the various counsels including: the Missouri Assistive Technology Advisory Council, the Missouri Developmental Disabilities Council, and the State Interagency Coordinating Council through DESE. In addition, SHCN administers the Missouri Brain Injury Advisory Council. Involvement on these councils is another example of how SHCN staff members connect with various public and private partners.
Collaborative Work with Federal, State & Non-Governmental Partners
Maternal/Infant Health
DHSS Title V Program team members were involved in several efforts that have enhanced a systems approach to ensure access to quality health care and needed services for Missouri’s MCH population. DHSS and the Missouri Hospital Association continued to work together as on the Maternal and Child Learning Action Network (MC-LAN) and the Alliance for Innovation on Maternal Health (AIM). The MC-LAN provides guidance, knowledge-sharing and peer support in developing strategic quality initiatives based on the Triple Aim principles. The committee partners with the communities they serve to achieve better communication, and educate and impact the public on quality and safety initiatives of the health care community. AIM is a national data-driven maternal safety and quality improvement initiative, and Missouri was designated as an AIM state in 2018. As part of the current Obstetric Care for Women with Opioid Use Disorder AIM Bundle, the Missouri Neonatal Abstinence Syndrome Collaborative was formed to focus on developing improvements in care related to the care of substance-exposed newborns, including keeping the mother-infant dyad intact; incorporating the functional assessment model Eat, Sleep, Console into practice; and establishing Safe Plans of Care of the mother and the infant.
DHSS partners with several organizations serving Missouri’s Bootheel counties to support the Rural Maternity Obstetrics Management Strategies (RMOMS) grant, which was awarded to Saint Francis Healthcare System in Cape Girardeau. The RMOMS grant seeks to support health care providers, hospitals, public health, and social support agencies to work together with communities to build on local resources to meet the health care needs of women and newborns and create a new model of service delivery.
DHSS collaborates with the Department of Social Services (DSS), MO HealthNet Division, on Maternal Opioid Misuse (MOM) grant efforts. The MOM model supports the coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery. The MOM model has the potential to improve quality of care for pregnancy and postpartum Medicaid beneficiaries with opioid use disorder through state-driven transformation of the delivery system surrounding this vulnerable population.
DHSS applied to participate in the Association of State and Territorial Health Officials (ASTHO) and the Association of Maternal and Child Health Programs (AMCHP) Promoting Innovation in State & Territorial MCH Policymaking (PRISM) Learning Community. In addition to the Title V MCH Director, who serves as the team lead, the core team includes MCH and behavioral health representation from DSS, MO HealthNet Division; Department of Mental Health; University of Missouri Kansas City (UMKC) Institute for Human Development; and local public health. The PRISM Learning Community provides technical assistance and capacity building to support and advance policy implementation within states and territories to equitably address substance misuse and addiction and mental health disorders in women, children, and families within the context of the COVID-19 pandemic.
Lastly, the DHSS Title V MCH Director collaborated with the UMKC Institute for Human Development to submit an application for the HRSA Emerging Issues in Maternal and Child Health funding opportunity to address the increasing rates of maternal opioid and other substance use disorders.
Child/Adolescent Health
On August 28, 2021, nearly all early childhood programs across state government will be consolidated in a single Office of Childhood, allowing early childhood work across state government to become more streamlined and effective. DHSS Home Visiting, Early Childhood, Safe Cribs, and Child Care Health Consultation programs, all of which receive Title V funding and contribute to the Title V MCH State Action Plan, are moving to the new Office of Childhood. To meet the authorizing legislation requirements of Section 509 of the Social Security Act, a new MOU between DHSS and the new Office of Childhood at the Department of Elementary and Secondary Education (DESE) is being developed to establish: DHSS Title V Program authority and oversight for Title V allocations to DESE and the programs receiving Title V funding; accountability measures and reporting requirements related to Title V funding allocations; and interagency MCH data sharing and reporting requirements. A MOU was executed between the DHSS Title V Program and DESE Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program to collaborate on programs and activities to improve maternal, infant, and child health outcomes.
The DHSS MOU with DSS and Children’s Trust Fund (CTF) to facilitate exchange and use of information regarding incidences of child maltreatment and/or neglect among DHSS or CTF Home Visiting (HV) program clients is being updated to also include the new DESE Office of Childhood. The goal is to use the data to assess the degree to which families enrolled in HV have lower substantiated/called-in reports, and whether the number of reports for clients with multiple reports declines over time as they are enrolled longer and work with their home visitors to develop their parenting and resiliency skills. In addition, the MOU has been narrowed to collect only the data needed to comply with Missouri’s required Maternal, Infant, and Early Childhood HV (MIECHV) performance measure reporting for comparison between MIECHV, Title V funded HV programs, and CTF HV outcomes.
The State Dental Director plays an essential role in state oral health programs. DHSS entered into an agreement with DSS for Missouri’s Dental Director position to be split between both agencies. The interaction between DSS and DHSS is especially important due to this dual placement. The Dental Director must be able to discuss MO HealthNet dental benefits based on dental expertise and data provided by Missouri’s Oral Health Program and DSS staff. This role must also communicate with other dental professionals about dental public health issues important to both DSS and DHSS.
The DHSS Title V Program partners with the Missouri Show-Me School-Based Health Alliance (SMSBHA) to advance and advocate for school-based health care programs. The SMSBHA creates synergy around school-based health through education and training programs, networking, data collection and evaluation, advocacy, and provision of technical assistance for sites. The SMSBHA started in 2014 as a statewide multi-agency task force, and only 5 school districts had some form of school-based health center. In 2019-2020, the Alliance conducted the first ever statewide SBH census, and subsequently expanded the definition of a SBH program to include not only SBHCs, but the following other SBH program types: school-based mental health, mobile, telehealth, school-linked, and school-based oral health programs. Census results showed, as of 2020, there were 675 SBH programs across Missouri, with 41 being SBH centers. The number of school districts that have some type of SBH program is now 256, serving over 500,000 Missouri students. Information from the census was also used to create the SBH Program Directory to facilitate peer-to-peer learning and networking. Continued involvement in the Alliance assures the health care needs of children are met and the integrity of the school environment is preserved as partners work together to improve children’s health, educational opportunities, academic achievements, and ultimately, life outcomes.
Children and Youth with Special Health Care Needs
The Bureau of Special Health Care Needs (BSHCN) partners with several public and private entities in support of children with special health care needs through both formal and informal relationships. Contracts are in place with local public health agencies to provide service coordination on a regional basis for the BSHCN Children and Youth with Special Health Care Needs (CYSHCN) Program. The CYSHCN Service Coordinators in each region specialize in resource referrals and are knowledgeable and connected with local businesses, agencies, churches, and philanthropic organizations. SHCN Family Partners are also experts in connecting with public and private partners to link families of children with special health care needs with the appropriate resources. SHCN staff members are involved with the various counsels including: the Missouri Assistive Technology Advisory Council, the Missouri Developmental Disabilities Council, and the State Interagency Coordinating Council through DESE. In addition, SHCN administers the Missouri Brain Injury Advisory Council. Involvement on these councils is another example of how SHCN staff members connect with various public and private partners.
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