Title V in NH does not work in a vacuum. The success of its programs has to do with integral partnerships, both funded and non-funded, with governmental partners as well as community-based agencies. Leveraging federal and state program resources contributes to the delivery capacity of NH’s State Title V.

This is reflected in the work of the Early Childhood Integration Team (ECIT), of which both MCH and BFCS staff belong. The ECIT brings together all programs serving young children with and without special health care needs within DHHS serving children, from infancy through eight.

MCH also works with the Office of the Chief Medical Examiner (OCME). Not only do they collaborate on all fatality reviews (child, sudden unexpected infant death, sudden death in the young, and maternal), the two work through data sharing agreements and MOUs on the National Violent Death Registry and the State Unintentional Drug Overdose Reporting System.

This past year, MCH’s Home Visiting Program, for the very first time, collaborated with NH DHHS’s Division for Children, Youth and Families (DCYF) on a joint request for proposals and a contract award process enlarging the scope of the current use of Healthy Families America (HFA) to include HFA’s Child Welfare Protocol Services. This will enable services to another 195 families statewide with children under age two, specifically referred by DCYF.

MCH began work with both the Southern NH Area Health Education Center (SNHAHEC) and the North Country Health Consortium (NCHC-the Northern part of the state’s AHEC) on the topic of community health worker (CHW) education, support of the current and expanding CHW infrastructure and utilization within the State’s healthcare and social services system. NH’s CHWs job responsibilities are different dependent upon the agency for whom they work. However, all improve access to social determinants of health needs through resource navigation. In June of 2022, MCH was able to hire a new position, a Community Engagement Specialist, with leveraged COVID 19 pandemic funds. This position has worked in tandem with SNHAHEC and NCHC along with others to help increase CHW staffing, training and. In particular, MCH’s Community Engagement Specialist established a monthly CHW Community of Practice meeting whose format consists of one or two presentations on various social and health topics and then dedicated time to share strategies, success stories, ask questions and network with one another. This non-mandated meeting has become very successful with representatives from all agencies in NH having CHWs participate. Three of the Title V funded CHCs utilize a portion of their funding for a CHW (all three related to maternal health, breastfeeding, etc.)The map below shows the zip code locations of where various organizations in NH have CHWs with many different types of funding.

MCH is also involved with the NCHC led NH CHW Coalition who have formed a committee researching and working on plans for certification. Both the NCHC and the SNAHEC each independently offer training curricula. Recently, the MCH Community Engagement Specialist won the NH CHW Coalition “Award of Excellence: Stakeholder of the Year”, which for having been in her position for only a year is a great honor.

Another state partnership with great importance to MCH’s work is with the Bi-State Primary Care Association (Bi-State). Bi-State provides training and technical assistance to FQHCs and FQHC Look-Alikes (8/10 Title V funded CHCs) to improve programmatic, clinical, operation and financial performance. MCH’s Quality Improvement and Clinical Services Program meets monthly with Bi-State as well as DPHS’s Rural Health and Primary Care Section to discuss State Performance Measure #1, “MCH contracted CHCs that have met or exceeded the target indicated on their enabling services work plans” and leveraged Title V funds for Bi-State’s Recruitment Center contract, of which the focus is on behavioral health. Bi-State is also the conduit for funding to their agencies for CHW support and expansion, with the primary purpose of addressing health disparities and social determinants of health within the health care setting.

On a national level, MCH works very closely with the National Center for Fatality Review and Prevention (the Center). In addition to providing technical assistance on fatality review processes, the Center does QI on the SUID and SDY case data that is entered into its child death registry. This enables MCH to facilitate analyses on the data, leading to a better understanding of how and why infants and children die in the State and catalyzes actions to prevent other deaths.

The Center has invited the MCH administered (and Title V funded personnel) NH Child Fatality Review Committee (CFRC) to participate this year in a Diversity, Equity and Inclusion learning collaborative where members will work with a consultant to implement and advance health equity through the child fatality process. In addition, the Center gave the 2023 “Theresa M. Covington (founder of the Center) Award for Excellence in Fatality Review” to the NH CFRC’s Co-Chair, Dr. Marc Clement.

BFCS continues as an early adopter and leader in the Charting the Life Course (CtLC) initiative in the Division of Long Term Supports and Services (DLTSS). One of the Program Managers participates in the CtLC Community of Practice, which is coordinated by UNH through a contract with DLTSS.

The BFCS Family Support Administrator is the DLTSS representative to the State’s Family Support Council, which is governed by He-M 519.01 to support regional family councils and advise the Department. Agenda items are formulated by members in cooperation with the Family Support Administrator and are an avenue for arbitration and mediation conflict resolution between Area Agencies (for developmental services) and regional family councils. The Family Support Administrator promotes a strong, positive relationship and collaboration between the Area Agencies and their councils through participation and BFCS provides administrative support.  Each of the ten (10) regional Family Support Councils appoints a representative to the State Family Support Council to report on the challenges faced by families and needs of those children involved with the developmental services system.  For the past two years, the BFCS Family Support Administrator has worked with Area Agencies to assure they identify a Family Support Coordinator whose primary responsibility is to work with the regional family council and Area Agency. This individual is responsible for addressing questions and concerns of the regional family council and providing assistance.

One BFCS Nurse Consultant continues her involvement with the NH Transition Community of Practice.  In this role, she participates in the planning of the annual summit, which often receives sponsorship from Title V through BFCS, and the NH Transition CoP Educational Series. Through this involvement, BFCS assures the inclusion of health care transition from pediatric to adult providers and the role of health care coordination and family support when assisting youth and families through this important period.

The CSHCN Director continues to represent DHHS on NH’s Council for Youth with Chronic Conditions (CYCC), the only statewide organization that has a legislative mandate to focus on the issues affecting children and adolescents with chronic health conditions. Members include families of CSHCN, legislators, pediatric specialists, school nurses, service providers, NHFV, and state administrators from DHHS and the Department of Education.  In 2022, the CYCC continued efforts to increase NH’s understanding of the needs children with chronic conditions and of those caring for them. As part of the ongoing Title V Needs Assessment activities, the Council Chair participated in BFCS’ Stakeholder meetings focused on making quality improvements to the existing Health Care Coordination and Family Support programs. In October 2022, the Community Health Institute/JSI Research & Training Institute completed the Needs Assessment that was funded by the Council.  The findings and PhotoVoice Gallery Exhibitions were shared with stakeholders and NH leaders.   

Finally, the BFCS Family Support Administrator and Part C Coordinator participate in the Interagency Coordinating Council (ICC), which is federally mandated under Part C of the Individuals with Disabilities Education Improvement Act. It serves as an advisory group to the BFCS as the state agency that oversees Family Centered Early supports and Services for children birth to age three who have or are at risk of having developmental delays, and their families. The mission of the ICC is to promote and increase the quality of Family Centered Early Supports and Services and Preschool Special Education supports and services to eligible children, birth through five years, and their families.