Through legislation and Iowa Administrative Code Chapter 641.76 the legacy Iowa Department of Public Health (IDPH) is designated as the entity to apply for Title V Block Grant funding and administer Iowa’s Maternal and Child Health services. During the most recent session, the Iowa Legislature passed HF2587. This bill will change all legacy IDPH and legacy Department of Human Services references in laws/code/rules to Iowa Department of Health and Human Services. The Family Health Bureau, within the Wellness and Preventive Health Branch, is designated as the lead to apply for funding and to enter into contracts with selected private, nonprofit or public agencies for the assurance of access to prenatal and postpartum care for women, preventive and primary child health care services, and services to children and youth with special health care needs.

The HHS Oral Health Section collaborates within the FHB to develop programs to reduce barriers to oral health care and reduce dental disease through prevention.

The CYSHCN program is administered by Child Health Specialty Clinics (CHSC) in the Division of Child and Community Health (DCCH) at the University of Iowa. HHS contracts with CHSC to provide services for CYSHCN including infrastructure building activities, clinical services, care coordination, and family support. Iowa legislation requires that 37% of Title V Block Grant funds are allocated to CHSC.

Partnerships and collaborations among these internal groups are essential to working towards the goals and mission of the MCH Block Grant. Iowa also recognizes the importance of having local contract agencies to help meet these goals. With varying needs at the local level, agencies are able to assess the health status and needs of their service area to apply for funding to impact selected NPMs and SPMs that are prevalent needs in their areas of the state.

Maternal, Child, and Adolescent Health (MCAH) Regional Consultants from FHB and OH are available to provide technical assistance and consultation to MCAH contract agencies. Consultants are assigned to specific regional contractors to:

• Clarify program requirements and share program expertise and best practice.
• Strengthen the ability of the MCAH contract agency to fulfill the program goals by identifying, exploring, or prioritizing issues.
• Identify or share resources.
• Address funding or billing issues.
• Provide advice and independent, objective perspectives to try to resolve problems or facilitate change.
• Assist with quality assurance and/or quality improvement initiatives.

Iowa’s MCAH services are associated with one of the three pyramid levels: Public Health Services and Systems, Enabling Services, and Direct Services. State Title V population domain leads use the State Action Plan Table and narrative to complete the logic models, which are then adapted to a Request for Proposals (RFP) and subsequent Request for Applications (RFA) to help applicants implement local activities to achieve the identified goals.

All activities within Iowa’s Title V program locally and statewide connect to selected NPMs, SPMs, ESMs, and or the interagency agreements with other state departments (Medicaid, Education, Human Services).

Iowa’s MCH Administrative Manual outlines The Ten Essential Public Health Services to Promote Maternal and Child Health in America. This manual interprets the core public health functions as they relate to MCH and provides the framework for establishing program goals, activities and evaluation. All funded Title V programs in Iowa are expected to follow these core functions. Click here to see the full Administrative Manual.

Iowa’s Title V program staff lead multiple stakeholder groups that address both internal and external MCH issues and/or aspects of MCH programming. Following are descriptions of selected MCH focused groups.

Maternal and Child Health Advisory Council

The MCH Advisory Council contributes to the development of the state plans for Title V, WIC and Title X. The council assists with assessment of needs, prioritization of services, establishment of objectives, and encouragement of support for MCH-related programs. The council also advises the director on health and nutrition services for women and children, supports the development of special projects and conferences, and advocates for health and nutrition services for women and children. Members of the council are appointed by the director, including CYSHCN service providers.

Iowa Statewide Perinatal Care Program

The Iowa Statewide Perinatal Care Program, established in 1973, provides education, development of standards/guidelines of care, consultation to regional and primary providers, and evaluation of the quality of perinatal care delivered in Iowa with the goal to reduce mortality and morbidity of mothers and infants. Through a contract between IDPH and the University of Iowa College of Medicine, these services are offered to all Iowa hospitals providing delivery services. As defined in Iowa Code this team’s work provides critical support and oversight for Iowa’s Regionalized System of Perinatal Care.

Title V MCAH RFP/RFA Work Group

Iowa’s Title V MCAH program contracts with local agencies using an RFP process that ensures coverage in all of Iowa’s 99 counties. This application process includes services for many MCAH related services including: Maternal, Child and Adolescent Health, Oral Health, Hawki (Iowa’s CHIP), Early ACCESS (IDEA, Part C), Child Care Nurse Consultation services and partnerships with other MCH related services (WIC, Childhood Lead Prevention Program, etc). Representatives from these programs participate in the development of this RFP.

Family Advisory Council

In 2014, DCCH created a Family Advisory Council (FAC) to provide feedback regarding the planning, development, and evaluation of programs and policies that will assure a systems-oriented approach to care for Iowa CYSHCN. Members are family members of CYSHCN or self-advocates and represent a broad cross-section of families that DCCH serves across the state. The FAC participates in activities that promote support for CYSHCN with members of the Iowa Legislature. In 2021, a Youth Advisory Council was started, with dual purposes of developing youth leadership skills and providing input into DCCH’s transition to adulthood programs.

RAP Expert Panel Advisory Committee

The Iowa Regional Autism Assistance Program (RAP) coordinates a statewide committee that helps monitor the System of Care for children and families with Autism Spectrum Disorder (ASD). Meetings provide guidance and input from stakeholders. The panel includes family advisors, providers, state agency representatives, and other stakeholders, and provides information to legislators and other stakeholders about successes and barriers children and their families are facing to accessing services and supports statewide.

Partners and collaborators

DCCH staff work with many CYSHCN-focused groups such as the Developmental Disabilities Council, the Iowa Council for Early ACCESS, the Iowa Autism Council, and statewide collaborations focused on issues relevant to CYSHCN such as behavioral health and obesity. The CYSHCN program is co-located and works closely with Iowa’s University Center for Excellence in Developmental Disabilities (UCEDD) and the Iowa Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program.

Iowa’s Title V staff are regularly involved in projects at the national level with AMCHP and other MCH organizations. Evidence is utilized to inform program components or activities within Iowa’s State Action Plan.

HHS Alignment Project

Iowa HHS’s structure has changed over the past several years. On July 1, 2022, the Iowa Department of Public Health (IDPH) and Iowa Department of Human Services (DHS) began the process of becoming one single department (Iowa HHS), with the goal of strengthening coordination amongst existing services and providing more comprehensive services to all Iowans. The merge was complete on July 1, 2023, and it is anticipated the full alignment will further strengthen the Maternal Health program’s collaboration with legacy DHS programs, including Medicaid.

The mission of Iowa HHS is to provide high quality programs and services that protect and improve the health and resiliency of individuals, families, and communities. Additionally, Iowa HHS’s guiding principles are: Data-Driven, Accountable, Integrity, Equity, Communication and Collaboration; these strongly align with the guiding purpose of Title V.

Through aligning the departments, Iowa will be able to achieve several goals including opportunities to better leverage funding sources and the ability to identify potential for expanded funding sources; break down silos to create a unified, integrated behavioral health system; and better access to services and easier navigation of the system for those served. Ultimately, better alignment across departments and programs will lead to improved outcomes for individuals, communities, and the state.

On March 24, 2022, the Departments released the final change package and functional organizational chart. This serves as the roadmap to bring together both agencies under a single leadership structure. This work is the culmination of nearly two years of meetings with Legacy IDPH and Legacy DHS staff, local public health, community partners, stakeholders, and the public to gather feedback on how to establish a unified health and human services agency to better support all Iowans. These conversations resulted in a prioritized set of recommendations on how the agencies can work together to align programs and services. These recommendations are outlined in the final change package published at https://hhsalignment.iowa.gov/. On July 1, 2022 state legislation officially established a unified Department of Health and Human Services. Below is the general timeline for the unification: