Title V Purpose and Design

The Child and Family Health (CFH) Division at the Minnesota Department of Health (MDH) provides collaborative public health leadership that works to change, support, and strengthen systems to ensure the health and well-being of Minnesota’s children, families, and communities. The CFH Division serves as the state-level administrator of the Title V MCH Block Grant, ensuring the responsibilities set forth by the federal Maternal and Child Health Bureau are met.

Minnesota’s Title V program is committed to be more community and family-centered, data-driven and evidence-informed, and the program has undertaken steps through further community engagement and collaboration to understand the lived experiences of the populations experiencing the worse health disparities and their priorities and challenges to obtain optimal health. The CFH Division partners with the state’s Local Public Health (LPH) agencies – who receive two-thirds of Minnesota’s Title V funding – to carry out the core public health functions of assessment, assurance, and policy development. The Division also partners with MDH’s Health Equity Bureau to connect with Minnesota’s diverse communities in our efforts to advance health equity and reduce health disparities among populations and communities where health inequities exist.

Minnesota’s Title V efforts primarily focus on the Public Health Services and Systems or Enabling Service levels of the Title V MCH Pyramid, with relatively little direct services continuing to be covered by block grant funding (less than 10% of federal Title V funding goes toward direct services). This means that most of our efforts focus on either 1) enabling people to access care or improve health outcomes, or 2) focus on developing the infrastructure to ensure people can access care and live healthy lives.

Minnesota’s Framework for Improving Outcomes for MCH Populations

Minnesota recognizes that the health and well-being of women, children (including those with special health needs), and families is determined by a variety of interconnecting factors – not just on individual behaviors or medical care. While we are proud of our success in keeping most Minnesotans healthy, we also acknowledge that “the opportunity to be healthy is not equally available everywhere or for everyone in Minnesota.”[1] In order to be able to reach our goal of an equitable and just system for our MCH populations, we strive to apply the Healthy Minnesota 2022 Partnership’s framework into all our CFH Division and Title V work. The Healthy Minnesota Partnership came into being to develop innovative public health priorities, goals, objectives, and strategies to improve the health of all Minnesotans, and to ensure ownership of these objectives and priorities in communities across the state of Minnesota. The efforts of the Healthy Minnesota Partnership focus on the health of the state as a whole, and the membership of the partnership reflects a broad spectrum of interests. Healthy Minnesota 2022 emphasizes creating conditions that allow people to be healthy, conditions that assure a healthy start and create environments that support health throughout life. The Partnership identified three priorities to guide their work to improve health and well-being across Minnesota – 1) the opportunity to be healthy is available everywhere and for everyone, 2) places and systems are designed for health and well-being, and 3) all can participate in decisions that shape health and well-being (see Figure 1). Each of the priorities has two key conditions to track using an array of indicators.

Figure 1. Healthy Minnesota 2022 Priorities

In addition to recognizing the importance of advancing the Healthy Minnesota 2022 priorities, the CFH Division incorporates the following principles into our efforts to improve systems for Minnesota’s women, children, and families:

• Trauma-Informed: Recognizing the widespread impact of trauma on MCH populations, while also considering community resiliency and assets.
• Interconnectedness: Understanding that many of the issues that MCH populations face are linked together.
• Life-Course: Emphasizing that many early life experiences have a lasting impact on health and development.
• Continuous Quality Improvement: Encouraging all team members to continually ask, “How are we doing?” and “How can we do better?” So we are continually improving effectiveness of practices, policies, and programs.
• Evidence-Based and Informed Practices: Using the best evidence possible to identify the best options for practices or programs.
• Data-Driven: Using the best scientific data and methods available to make decisions, this can include using community knowledge or experience if there is a lack of data.
• Community-Driven: Recognizing that many solutions lie within communities.

Community-Focused Strategic Planning

The CFH Division at MDH acknowledges that to advance MCH outcomes and equity, we need to work together in authentic, collaborative, and innovative ways. This is the only way that we will be able to “move the needle” in reducing the disparities in our communities. Therefore, we have taken a different approach toward our current needs assessment, prioritization, and strategy development/strategic planning process. The foundation of this new approach rests in the belief that solutions lie within the community and as such, the focus is on engaging with the community to ensure that we are planning and implementing programs and initiatives that will have the greatest impact and benefit.

Following the completion of our statewide needs assessment, Minnesota entered a strategic planning process. The intent of the strategic planning process was to authentically engage with the community in the development of a set of strategies to address the priority needs which were identified during the needs assessment. These strategies would be used to guide the work of the CFH Division for the next five years and are incorporated into the state’s Title V MCH Block Grant action plan.

Minnesota received assistance from the National MCH Workforce Development Center in developing a community-focused strategic planning process. The first stage of this process was establishing a Strategic Planning Steering Committee to help develop, drive, and champion the strategy development process. The Steering Committee was composed of CFH Division staff, representatives from LPH agencies and the University of Minnesota, and family leaders. Members and their roles are detailed below in Table 1.

Table 1. Strategic Planning Steering Committee Membership

The Strategic Planning Steering Committee developed a vision and values for the Strategic Plan. The values describe how the state aspires to work in partnership with the community. Though they were developed specifically for the strategic planning process, the vision and values are also serve as a framework for CFH Division and Title V work going forward. Figure 2 below details the vision and values for the Strategic Plan.

Figure 2. CFH Strategic Plan Vision and Values

The Steering Committee served as the central leadership group for the strategic planning, and then a set of Strategy Teams was established. A Strategy Team was established for each of the priority needs identified through the needs assessment. The purpose of the Strategy Teams was two-fold:

• Identify and develop strategies to address the priority need.
• Review and evaluate progress on implementing strategies.

The process took a collective approach toward leadership – meaning that there was not a hierarchical structure. Rather, the process was community-driven with strategic guidance coming from the Steering Committee.

Each Strategy Team included 20-30 members. Composition of groups was dependent on the priority need the team addressed; however, in general, teams were composed of the following representatives:

• MDH Staff
• Other State Agency Staff
• LPH Staff
• University/Academic Staff
• Community-Based Organization Staff
• Providers and Payers
• Advocates
• Youth and Family Representatives
• Interested Community Members
• Data/Research Scientist/Epidemiologist Staff

More information on the recruitment and composition of the Strategy Teams is included in the Public Input section of this application.

The Strategy Teams were led through a similar process to determine strategies to address their priority need. Figure 3 provides a visual of the process. More information on the methods of recruiting Strategy Teams and the strategy development process can be found in the Supporting Documents at the end of this application.

Figure 3. Strategy Development Process Steps

After the Teams identified strategies and next steps for moving forward, we had intended to engage with them at minimum on an annual basis to discuss ongoing needs and challenges related to the priority areas, provide updates on our progress in implementing the strategies, help problem solve on barriers that are encountered, and celebrate achievements. Due to the COVID-19 pandemic and staff reassignments, we were not able to engage with the teams as initially planned during the last year. However, moving forward into FY2022, we are working to re-engage with Strategy Teams and build better processes into the future.  

[1] MDH (2014). Advancing Health Equity in Minnesota: Report to the Legislature. Retrieved from: https://www.health.state.mn.us/communities/equity/reports/ahe_leg_report_020114.pdf.