Oklahoma administers the MCH Title V Block Grant through two state agencies, the Oklahoma State Department of Health (OSDH) and the Oklahoma Department of Human Services (DHS). The OSDH, as the state health agency, is authorized to receive and disburse the MCH Title V Block Grant funds as provided in Title 63 of the Oklahoma Statutes, Public Health Code, Sections 1-105 through 1-108. These sections create the OSDH and outline the Commissioner of Health's duties as "general supervision of the health of citizens of the state." Title 10 of the Oklahoma Statutes, Section 175.1 et.seq., grants the authority to administer the CSHCN Program to the DHS.

The OSDH MCH Service manages programs and services for pregnant women, mothers and infants, children and adolescents, while the CSHCN Program oversees those for children and youth with special health care needs. OSDH, as the state health agency, receives federal Title V Block Grant funds and then transfers funds designated for CSHCN to DHS. OSDH and DHS formulate a memorandum of agreement (MOA) which directs the administration and funds for the CSHCN Program. The MOA is attached.

The MCH Title V Program is located in the OSDH within Family Health Services (FHS). The FHS is organizationally placed under Mendy Spohn, Community Health Services Deputy who reports to the Commissioner of Health. Joyce Marshall, Director of MCH, is directly responsible to the Assistant Deputy Commissioner of the FHS, Tina Johnson, who is directly responsible to the Community Health Services Deputy. Dr. Marny Dunlap is currently serving as Medical Director for the Child and Adolescent Health Division and Dr. Pamela Miles is Medical Director for the Perinatal and Reproductive Health Division.

The Title V CSHCN Program is located in the Adult and Family Services Division under Adult and Family Services Director Deborah “Deb” Smith, Adult and Family Services Assistant Director for Program Operations Shawn Franks, and Deputy Director for Programs Linda Cavitt. Carla McCarrell-Williams is the Director of the CSHCN Title V Program. Mrs. Smith reports to Justin Brown, DHS Director. Mr. Franks reports to Mrs. Smith. Mrs. Cavitt reports to Mr. Franks and the CSHCN Director reports to Mrs. Cavitt. The organizational charts for MCH, OSDH and CSHCN are attached.

Programs administered in some part with Title V funds include: Preparing for a Lifetime, It’s Everyone’s Responsibility Infant Mortality Reduction Initiative; the Collaborative Improvement and Innovation Network on Preconception/Interconception Health; Every Mother Counts Maternal Mortality and Morbidity Reduction Initiative; maternity and child health clinics in rural county health departments; Period of PURPLE Crying program; PRAMS, TOTS and YRBS surveillance programs; Teen Pregnancy Prevention Projects throughout the state; State Systems Development Initiative; Fetal Infant Mortality Review; school health programs in the two major metropolitan areas; Becoming Baby Friendly Oklahoma; and other-related programs and initiatives.

MCH and CSHCN contract with the Oklahoma Family Network (OFN) to assure family input is incorporated into the planning, development, and evaluation of Oklahoma’s Title V programs. OFN has created a statewide network of families which enables state Title V programs to engage with families at the individual and community levels on MCH-related issues. The MCH Title V Director, the CSHCN Title V Director, and the OFN Executive Director attend monthly MCH/CSHCN program meetings for strategic planning purposes and to review and discuss progress of relevant initiatives.

Oklahoma’s Title V programs enjoy strong relationships with state and community-based public and private partners, and emphasize through these relationships the goal of promoting and protecting the health of MCH populations. MCH serves as the lead for the state’s infant mortality reduction initiative, Preparing for a Lifetime, It’s Everyone’s Responsibility, with several MCH leadership staff leading topical workgroups (i.e., maternal mood disorders, preconception care, infant safe sleep, breastfeeding, injury prevention) in the initiative. MCH continues to be integrally involved with the work of the Oklahoma Perinatal Quality Improvement Collaborative and the Oklahoma Maternal Health Task Force, which aim to improve the care of women, mothers, and infants throughout the state.

MCH has close working relationships with state level programs and with the Regional Directors of the county health departments. There are multiple opportunities to engage in activities with OSDH leadership to communicate about Title V, including the weekly meeting held by the Assistant Deputy Commissioner for the FHS Directors and regular meetings with the Commissioner and Cabinet Secretary. These meetings provide a space for agency updates, sharing program activities, and networking. In the former, the MCH Title V Director interacts with all FHS Directors, affording an opportunity to discuss crosscutting activities. MCH routinely collaborates with other OSDH programs to address issues of mutual interest, including maternal health, preconception care, family planning, maternal depression, breastfeeding, tobacco use prevention, dental care, obesity, injury prevention, immunizations, newborn hearing and metabolic screening, adolescent pregnancy prevention, school health, family resource and support services, child care, and early childhood.

The provision of services for MCH populations are accomplished through county health departments, professional service agreements, vendor and state agency contracts, requests for proposals, and invitations to bid. Although administratively separate, the Oklahoma City-County Health Department and the Tulsa Health Department are essential MCH partners, providing services or administering projects via direct contracts. Some examples include the Fetal Infant Mortality Review (FIMR) projects, the Personal Responsibility Education Program (PREP) projects, MCH Outreach and School Health programs.

Bullying and youth suicide prevention are priority focus areas in work accomplished with the Oklahoma State Department of Education (OSDE) and the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS). MCH has committed to assist in further building community level infrastructure for recognizing and intervening to prevent youth suicide across the state by assuring staff working with youth provide evidence-based trainings in their areas.

The CSHCN Program oversees the provision of social services to children receiving Supplemental Security Income (SSI). Training and guidance are provided to approximately 600 Family Services Specialists (FSS) throughout DHS, who are responsible for disseminating information about the Supplemental Security Income-Disabled Children’s Program (SSI-DCP) and other services through DHS. FSS make appropriate referrals to the divisions and staff responsible for developing and monitoring service plans. The provision of high quality, coordinated, comprehensive and family-centered systems of services to Oklahoma’s CYSHCN is accomplished through several contracts DHS has in place which include the Oklahoma Family Network, Sooner SUCCESS, Oklahoma Family Support 360° Center, Comprehensive Pediatric Sickle Cell Clinic, Oklahoma Infant Transition Program, Family Partners/JumpStart Clinic, JD McCarty Center, Parent Promise Community Hope Center and the Center for Children and Families, Inc. (CCFI) Community Hope Center. The CYSHCN related services above can be accessed via the Family Services Specialists and on the DHS website.

In Oklahoma, the Title V program utilizes a life course framework for needs assessment, program planning and performance reporting at the state and local levels. Trainings, data, and activities are structured to emphasize the importance and effectiveness of reducing risk factors and increasing protective factors early in life to reduce poor health and social outcomes later in adolescence and adulthood. The most prominent examples of this are the Preparing for a Lifetime, It’s Everyone’s Responsibility infant mortality reduction initiative led by MCH and the life course work accomplished with families through OFN.

The Oklahoma CSHCN Program utilizes federal funds for specialty services to children and youth with special health care needs and their families. Services include neonatal services, specialty services for children with sickle cell anemia, durable medical supplies, supplemental formula, and respite care. The monies enable family partner programs to assist families in finding community-based resources, participate in Title V partnership and decision-making and attend family-professional partnership trainings, like Joining Forces and the Association of Maternal and Child Health Programs (AMCHP) Conference. This helps assure families have a voice in MCH and CSHCN services.

MCH works with partner organizations to develop or promote innovative and evidence-based approaches. Examples include the Maternal Health Innovation grant’s usage of the CHESS Health app to assist providers working with pregnant women with mental health and addiction issues. The CSHCN Director regularly meets with Adult and Family Services Program Managers as well as DHS and OHCA leadership which provides an opportunity to discuss cross-cutting issues that impact the health status of the CSHCN population and their families.

The core public health functions of assessment, assurance, and policy development are integral to Title V’s approach to programs in Oklahoma. All programs, projects and contractors are required to submit data and performance indicators and to assess effectiveness and reach. This is in addition to the on-going efforts of the Title V Needs Assessment and data collection activities in the MCH Assessment Division. Quality assurance processes are put into place by several MCH programs, using data collected during assessments and surveys. Although COVID-19 halted some progress in implementing quality improvement processes into a wider array of programming. MCH and CSHCN are active participants in multiple work groups, boards, and councils designed to influence and improve policy for the MCH population, from Medicaid/Soonercare to Child Death Review Board to Sooner SUCCESS and the Oklahoma Family Network and many more in-between. Staff assist with items like the State Obesity Plan to reduce obesity across the lifespan for Oklahomans and reviewing MCH-related legislation for potential impact to agency programs, budgets and staff for the legislative liaison.