In addition to the epidemiology support described in the previous two sections, other MCH data capacity efforts are managed through the Early Childhood and Family Support Division’s (ECFSD) Business Systems and Operations (BSO) Bureau.
The BSO Bureau Chief directly supervises the following positions:
- WIC M-SPIRIT IT System Analyst;
- Child Care Under the Big Sky (CCUBS) Data System Manger;
- QA Analyst supports WIC M-SPIRIT System, Child Care Under the Big Sky (CCUBS), and other Division programs as needed;
- Children and Youth with Special Health Care Needs (CYSHCN) Database System Manager for CSHS HiTrack data system, the Child Health Referral Information System (CHRIS), and PCO Database;
- MT Maternal and Early Childhood Home Visiting (MTmechv) Database System Manager.
- WIC M-SPIRIT System;
- 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;
- Adolescent Health’s primary data management system: REDCap, an open-sourced Public Health database and collection tool administered by the University of Washington Institution of Translational Health Sciences;
- 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.
- PCO Database maintenance and support is provided by the BSOB staff versed in the CYSHCN data systems.
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 release to the 85 WIC clinics within the state of Montana (MT), it will be beta tested by a select number. Training will be provided by both the consortium and MT state-level staff. The current anticipated date for release of SPIRIT Web is live by late 2023.
The current Electronic Benefits Transfer (EBT) contract ends in 2025. Because the project to replace the EBT vendor has a large scope encompassing WIC, SNAP, and TANF, the Human and Community Services Division is leading the procurement with BSO and WIC Staff serving as partners. Requirements have been gathered and entered into the Technology Services Division Project Intake process in preparation for the Request for Proposal (RFP) process.
Fetal, Infant, Child, and Maternal Mortality Review (FICMMR)
MT’s FICMMR program entered into a Data Use Agreement (DUA) with the National Center for Fatality Review and Prevention (NCFRP) 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 6.0.
ECFSD worked with the MT Office of Vital Records (OVR), the MCH Epidemiologist, the FICMMR Coordinator, and the Title V MCHBG Director to proceed with a business process enhancement project. The goal of the project 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
Over the course of the past year and after conversations within OVR and DPHHS Technology Services Division (TSD), an OVR database schema was provided to ECFSD staff to identify the required tables to both satisfy the need and maintain Least Privilege best practices. Once specific tables were identified, TSD’s Vital Statistics Database Administrator provided BSO staff with read-only access to the identified tables which allowed staff to query directly against a copy of the database for the fields needed to upload into the CDR System, and the National Fatality Review Case Reporting System.
The monthly data import into the National Fatality Review Case Reporting System began on Feb 1, 2023. Testing prior to the February launch date was done in the NCFRP test and training site. The import process for the death and birth certification numbers were formatted according to the format prescribed by the Lead MCH Epidemiologist. The end result was to reduce the errant entries into those fields as well as the other fields provided in the import and to reduce the data entry burden on the local FICMMR Team Lead.
The correction of historical death and birth certification numbers according to the approved format was launched May 31, 2023. This will be done yearly (on the last working day of May) to catch and correct those that are not in the correct format. The decision to do yearly updates was decided after phone and email discussions with the State FICMMR Coordinator and the Lead NCFRP Data Analyst.
Healthy MT Families (HMF) Home Visiting Program
The MTmechv Database System Manager maintains and supports the main MIECHV data system from Clinisys. The MIECHV vendor contract with Clinisys ended on January 31, 2023 and a one year exigency extension has been secured to allow ECFSD the time to work through the state procurement process for a new contract. Due to the customized nature of MIECHV, and its continued use being foundational to the Healthy MT Families program, the system has been approved through the State’s Software Exemption program allowing for a direct 10-year contract renewal with Clinisys for continued operations. Work has begun on the new contract. Once that has been completed, the new contract and accompanying documentation will be submitted to DPHHS IT Contracts office for review and processing.
Children’s Special Health Services (CSHS)
The Child Health Referral Information System (CHRIS) contract ended on June 30, 2023. CSHS and the BSO are working to address the path forward. In Spring 2022, DPHHS’s new Chief Information Officer (CIO) implemented a new Project Intake process. BSO and CSHS will follow that process in determining potential options. ECFSD requested and was granted a one-year exigency contract renewal with the current vendor to allow for more time to procure a new system.
Because of frequent collaboration between the two programs, CSHS has engaged the Public Health and Safety Division (PHSD) Laboratory to identify lab system requirements for consideration when procuring a new system to replace the CHRIS system.
CSHS is exploring the option of consolidating systems and having audiologists enter data directly into HiTrack for newborn screenings. The necessary fields are in place and a pilot test has been conducted.
Also, within the Early Childhood Services Bureau (ECSB) in the ECFSD, there are three additional data systems:
Child and Adult Care Food Program (CACFP): Currently designed to manage the food programs claiming and approval system. CACFP is in the process of completing a cross-agency agreement with the Office of Public Instruction (OPI) to utilize the CACFP module in OPI’s existing system, aligning to the State IT Strategic Plan and enhancing inter-agency collaboration. The request for collaboration with OPI has been vetted through the CIO’s new Project Intake process and is now circulating within DPHHS Technology Services Division for approvals to move forward.
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.
ECFSD has hired a Project Manager to navigate the procurement process to acquire a CCUBS replacement system. The Request for Proposal (RFP) was posted May 2023 and a successful bidder is expected to be announced September of 2023.
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 is being developed in coordination with the MT Developmental Disabilities Program (DDP), and the MT Program for Automating and Transforming Healthcare (MPATH) Medicaid modernization project. It 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 MT 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. Current work focuses on creating and validating business reports through the MedCompass interface. These reports have been deployed and quality improvement work continues.
Other Data Capacity Efforts
Data Governance: The BSO Bureau Chief is the Data Governance Lead for ECFSD. In that effort, the BSO Business Analyst, along with the Research and Evaluation Supervisor and ECFSD leadership, are in the process of creating a Data Governance Policy and Procedure document. This will include data sharing policies, data release rules, governance guidance, and technical requirements for ECFSD. Anticipated drafting and implementation date is the end of CY 2023.
Agency Enhancements: DPHHS has several enhancements in process that will aid non-SSDI funded systems and data.
Snowflake: Currently, the State has various agencies which utilize Snowflake as a data repository and marketplace for easier data sharing and collaboration between internal stakeholders. This platform includes basic analytics, and facilitates easier transfer, connection, and access control for various data systems within an agency. The DPHHS Enterprise Data Warehouse (which contains MedCompass data and CCUBS data) is in the process of migrating to Snowflake infrastructure. Currently, half of the CCUBS data fields have been migrated and work continues to migrate the remaining data.
Enterprise Solution Consolidation: To align with state strategic planning, DPHHS’s Technology Services Division is consolidating enterprise applications to provide a better service catalogue for all divisions. The consolidation and creation of a routinely updated service catalogue of both professional services and software will allow for easier collaboration of technology between divisions and allow for easier adoption of new technologies into ECFSD systems. An example of this work is the addition of Snap Surveys as an Enterprise surveillance solution. Initially, ECFSD researched and inquired about Snap Surveys. TSD saw the value of the product for DPHHS as a viable replacement for Survey Monkey, and took over procurement as an Enterprise solution.
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