Within the Early Childhood and Family Support Division (ECFSD), there are three Maternal and Child Health Epidemiologist (MCHE) positions, two Program Evaluators, and one Data System Manager. Three of these positions have vacancies. The MCHE Section contains the following positions:

1. Research & Evaluation Supervisor, Vacant
2. Pregnancy Risk Assessment Monitoring System (PRAMS), Coordinator and Epidemiologist
3. MMRI/Adolescent Health Epidemiologist, Vacant
4. Spatial Epidemiologist
5. Early Childhood Program Evaluator
6. Data System Manager
7. Preschool Development Evaluator, Vacant

The Research & Evaluation Supervisor, formerly Senior MCHE Supervisor position, was created in 2018 and recently became vacant, in April 2023. The Research & Evaluation Supervisor designated roles/responsibilities include PRAMS Principal Investigator and Grant Director; State Systems Development Initiative (SSDI) Grant Director; Supervision of the MCH Epidemiology Section; coverage for MCHE vacancies; and ECFSD projects as assigned.

The PRAMS Coordinator/Epidemiologist was hired in October 2022. The PRAMS Coordinator duties include: acts as a liaison to the Centers for Disease Control and Prevention (CDC) for PRAMS; develops and revises the PRAMS data collection protocol and survey instrument; oversees sampling procedures and ensures that monthly samples are prepared in a timely manner; monitors PRAMS surveillance activity and oversees all PRAMS data collection activities; analyzes and disseminates PRAMS data results and responds to all PRAMS data requests. In addition, this position leads the PRAMS Steering Committee in planning program enhancements and methods of data dissemination and utilization.

The PRAMS Data Support Specialist was hired in November 2021. Contributions include: overseeing mail operations; managing project inventory; data entry; and phone phase monitoring. This position is funded by PRAMS.

The MMRI/Adolescent Health Epidemiologist position is vacant and is currently posted for recruitment. The MMRI/Adolescent Health Epidemiologist’s primary responsibilities are to support MCHC Section in fulfilling their obligations regarding the MCH Block Grant. Contributions include but are not limited to: Develop surveillance plans; Conduct needs assessments; Program evaluation; Statistical analysis; and data interpretation.

The Spatial Epidemiologist was hired in December 2022. Duties include using geographic information systems and statistics to describe, analyze, and visualize program data for the Division. They also work on projects that include: PRAMS Breastfeeding Map; Food Access Map; and Maternal Health outcomes.

The Early Childhood Program Evaluator was hired in January 2023. This position’s contributions include: designing and implementing program evaluations; analyzing data; and developing trainings related to program evaluation and quality improvement for ECFSD programs.

Montana has experienced fluctuations in MCHE capacity since its creation. The MCHE Section was formed in October 2018, when the Public Health and Safety Division established state leads for its three main epidemiology subject matter areas: communicable disease, chronic disease, and maternal and child health. In 2017 Montana had 4.0 FTE MCHE positions: PRAMS, Maternal, Infant and Early Childhood and Home Visiting (MIECHV), SSDI, and an MCH generalist (which served as an epidemiologist for all non-MIECHV MCH programs).

In 2018, the MCHE Section was established, and MCHE capacity grew from 4.0 FTE to 7.0 FTE following the creation of three new positions: a Senior MCHE Supervisor (i.e., the state lead for MCHE), an adolescent health epidemiologist, and an oral health/nutrition epidemiologist. These epidemiologists were directly supported with federal funding from their respective programs.

DPHHS underwent a restructuring in 2020 where the MCHEs were moved from the Public Health and Safety Division to the newly formed Early Childhood and Family Support Division. In 2022 the MCHE section had another restructure where the MCHEs were moved from the individual programs within the Division to the newly formed Business Systems and Operations Bureau.

The increasing nationwide demand for epidemiologists coupled with both an increasing cost of living and limited salary increases in Montana have made recruitment for MCHEs challenging. The MCHE positions have been circulated with in and out-of-state graduate programs and through MCHE listservs and epidemiologist job boards (i.e., CSTE, AMCHP). Despite these efforts Montana has had very few applicants who meet the minimum qualifications for its MCHE positions (i.e., master’s degree and a minimum of three years relevant experience).

To address the continued reduction in the MCHE workforce and DPHHS MCHE capacity, DPHHS has continued contracting with external partners to oversee grant-required activities previously overseen by state MCH epidemiology staff (e.g., data collection, needs assessments, and evaluations).