In addition to the epidemiology support described in the previous two sections, additional MCH data capacity efforts are managed through the Early Childhood and Family Support Division’s (ECFSD) Business Systems and Operations (BSO) Section.

The BSO team is led by Chris Santucci, who completed one year as the BSO Supervisor in August 2021.  Mr. Santucci’s background includes: Master of Arts degree in Sociology; seven years of leadership experience gained in the military and private sectors; five years’ experience in the technology field, specializing in cybersecurity practices; and current pursuit of a Master of Business Administration. He directly supervises the following BSO team members (areas of focus included):

• Blair Hendricks: WIC M-SPIRIT System Lead;
• Nathan Senn: Computer Support Specialist for WIC M-SPIRIT System and Child Care Under the Big Sky (CCUBS);
• Lanny Wilbur: Children and Youth with Special Health Care Needs (CYSHCN) Database Administrator for CSHS HiTrack data system and the Child Health Referral Information System (CHRIS);
• Tom Wolff:  Montana Maternal and Early Childhood Home Visiting (MTmechv) Database Administrator;
• Melody Olson: Child Care Under the Big Sky (CCUBS) Data Steward and Analyst; and,
• Laura Brown: Business Analyst and Technical Writer for all ECFSD programs.

The BSO manages and offers technical support to the majority of the maternal and child health (MCH) programs’ data information systems.  The systems specific to the FCHB are as follows:

• WIC M-SPIRIT System;  
• Title X Family Planning database Ahlers;
• Maternal, Infant, Early Childhood Home Visiting (MIECHV) case management data system MTmechv;
• Children and Youth with Special Health Care Needs (CYSHCN) Child Health Referral Information System (CHRIS), HiTrack system for hearing assessment and management and newborn screening follow-up;
• The Fetal, Infant, Child, and Maternal Mortality Review (FICMMR) Prevention Program records the data for fetal, infant, and child mortality reviews into the National Center for Fatality Review and Prevention, Child Death Review (CDR) System. 

BSO staff are currently overseeing several enhancement initiatives for these FCHB-housed data systems.  These enhancements, not funded by the State Systems Development Initiative (SSDI), include: 

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

• The WIC M-SPIRIT system has been in its current form of operation since 2010 and is part of a multi-state consortium.  It is being enhanced into a web-based system called SPIRIT Web. SPIRIT Web will provide real-time, quality data to local, state, and federal partners.  Before it is released to the 85 WIC clinics within the state of Montana, it will be beta tested by a select number of WIC Clinics. Training will be provided by both the consortium and Montana state-level staff.  It is anticipated SPIRIT Web will be live by early 2022. 

Title X Family Planning

• Staff are working with the State Information Technology Services Division to develop a new SQL-based system called FPAccess, replacing the Title X Family Planning database Ahlers. FPAccess will allow for easier data quality management, data entry, and reporting for 13 Title X contractors, at 20 service sites. Additionally, state Title X staff will have access to their contractors’ data in “real time” thus assisting staff with their federal reporting requirements.  It will be tested by contracted staff and state staff, and is anticipated to go live in early 2022

Fetal, Infant, Child, and Maternal Mortality Review (FICMMR)

• Montana’s FICMMR program entered into a Data Use Agreement (DUA) with the National Center for Fatality Review and Prevention in September 2012, for the purposes of allowing local FICMMR Teams’ review data to be entered into the Child Death Review (CDR) System.  FICMMR Teams continue to enter the data for their fetal, infant, and child death reviews into CDR Version 5.1. 

Preliminary discussions have begun with the MT Office of Vital Records, the MCH Epidemiologist, the FICMMR Coordinator, and the Title V Director to explore proceeding with a business process enhancement project.  The goal is to mitigate errors by standardizing key data fields and keep death certificate numbers static across the system.  These data fields include:

• State ID
• Child’s First Name
• Child’s Last Name
• Child’s Date of Death
• Child’s Age
• Child’s Age Category   

Additionally, staff are collaborating to develop a process which will standardize the MT Office of Vital Records death certificate number naming convention.  That future conversation will occur after the process is shared with the Office of Vital Records, with the aim to have the new process in place by the end of calendar year 2021. 

It is anticipated that Montana’s recent data quality recognition by the National Center for Fatality Review and Prevention, in preparation for their 5 Years of the National Center’s Data Quality Initiative, will be enhanced by the discussions with the Office of Vital Records.   Montana is one of three states that will be recognized for their data quality improvements: “Montana’s average proportion of missing and unknown responses for the 48 CORE priority variables declined from 9.75% to 4.8%, a 51% reduction.” 

Healthy Montana Families (HMF) Home Visiting Program

• MT’s HMF is supported with federal MIECHV and state Montana Initiative for the Abatement of Mortality in Infants (MIAMI) funds.  This has allowed 20 counties, and four tribal areas, to implement the home-visiting models of: Parents as Teachers; Nurse Family Partnerships (NFP); Family Spirit; and, Safecare. The MTmechv Database Administrator created a HMF Administrative Database which collects the administrative and financial data for the four models. The data can be entered by program staff through forms that are included in the database within the Access application.  The Admin database is used by program staff to track all administrative aspects of the models and implementing agencies, including: budgets; expenses; contracts; and, personnel data.

• In October 2022, HMF will update the NFP forms used by sites to ensure that the NFP data meets the annual HRSA/MIECHV Performance Report requirements. Currently, the MIECHV Database Administrator acquires the NFP HRSA data through a monthly export of text files from NFP. Having all HRSA required data within MTmechv will greatly improve the efficiency of completing the annual HRSA report.

• The MIECHV vendor contract with Sunquest terminates on January 31, 2023. Staff have begun discussions to explore the internal application process that would identify next steps related to procurement and ongoing database maintenance and operations.

Children and Youth with Special Health Care Needs (CYSHCN)

• In January of 2021, HiTrack went through a state security review, which identified opportunities to strengthen controls.   The CYSHCN Database Administrator established the security documentation for the 80 HiTrack users, comprising 26 hospitals, and enforced security best practices to bring the HiTrack system into compliance with DPHHS Technology Services Division policy and best practices.
• The division is working to implement Okta authentication into the CHRIS System. to provide an easier user experience when logging in to the system and provides industry-standard security.

Maternal Health Innovation

The CDC Wonder Online Database reports Montana’s 2011-2015 maternal mortality ratio was 25.7 deaths per 100,00 births, ranking Montana as having the 12th highest maternal mortality ratio nationwide and the third highest in the Western States.  This data, plus Montana’s innovative approach to decrease maternal mortality, led to HRSA funds to launch the Montana Obstetric and Maternal Support (MOMS) program.

The division created an Access-based Maternal Mortality (MM) database to house the data collected on maternal deaths occurring between October 1, 2013 through December 31, 2019.  Local FICMMR teams submitted a 20-page Maternal Mortality Review (MMR) form to the State FICMMR Coordinator, who conducted a data quality review prior to officially closing any maternal death cases. The MMR database mirrored the paper form, which because of its size and complexity, was designed to allow for multiple data queries. The MM database went live in Fall, 2020 and is now ready to be used by program partners. 

Also within the ECFSD,  are these three Early Childhood Services Bureau (ECSB) data systems:

• Child and Adult Care Food Program (CACFP): Currently designed to manage the food programs claiming and approval system. 

• Child Care Under The Big Sky (CCUBS): CCUBS is the primary data system used to manage childcare provider licensing, family eligibility for childcare assistance through the Best Beginnings Child Care Scholarship Program, and contracts for professional services and staff support.

CCUBS is undergoing a large-scale modernization effort, which is focused on optimizing current infrastructure with enhancements designed to: streamline business processes; employ security best practices; and, better serve Montanans by replacing legacy processes and infrastructure with current technology.

• MedCompass: MedCompass is a care-management system currently under development to aid the Part C Early Intervention for Children with Developmental Disabilities program. The system, developed in coordination with the Montana Developmental Disabilities Program (DDP) and the Montana Program for Automating and Transforming Healthcare (MPATH) Medicaid modernization project, consolidates all program data, benefits, and care coordination for individual members into one place.

MedCompass aims to streamline and enhance Part C’s services, claims management, and the member experience while consolidating program processes and payment services into one system that directly connects with the Montana Medicaid database.  The member experience will be enhanced by providing members and their guardians access to their information and care coordination in one place through the member self-service portal.