In Hawaii, the Family Health Services Division (FHSD) serves as state Title V MCH agency. FHSD is committed to improving the health of women, infants, children, including those with special healthcare needs, and families. FHSD works to promote health and well-being using a life course and multi-generational approach to address social determinants of health and health equity.

Because the Department of Health is the only public health agency in the state, FHSD is the only MCH agency in the state and provides all levels of service delivery: direct, enabling, and infrastructure building for all counties. Service contracts for all county/community providers are executed through FHSD central program offices located on Oahu in consultation/coordination with county staff. FHSD programs work to ensure statewide services delivery, as well as infrastructure for data collection, needs assessment, surveillance, planning and evaluation, systems and policy development, and the provision of workforce training and technical assistance to assure quality of care.

FHSD is comprised of three branches—Maternal and Child Health; Children with Special Health Needs; and Women, Infants, and Children (WIC) Services—and several offices and programs at the division level.

At the division-level, FHSD oversees the following programs:

• Title V MCH Block Grant Program
• Early Childhood Comprehensive Systems (ECCS)
• Oral Health Program
• Pregnancy Risk Assessment Monitoring System (PRAMS)
• Office of Primary Care and Rural Health including the Primary Care Office (PCO), State Office of Rural Health, Medicaid Rural Hospital Flexibility Program, and mall Rural Hospital Improvement Program.

The Maternal and Child Health Branch (MCHB) administers a statewide system of services to reduce health disparities for women, children, and families of Hawaii. MCHB programs provide core public health services that establish and maintain public and private partnerships to share information; support program planning; and collaborate on/promote policies to improve outcomes for women, children, and families. Services include training and public awareness to high-risk women, adolescents, and other disparate populations on family planning, perinatal, and interconception care; child and youth wellness; prevention of child abuse and neglect; sexual assault prevention; domestic violence prevention; and home visiting services and family supports. Some of the programs include: The Parent Line, Child Death Review, Maternal Mortality Review, Domestic Violence Fatality Review, and over 35 community provider contracts for women’s health and family planning services.

The Children with Special Health Needs Branch (CSHNB) works to improve access for children and youth with special healthcare needs to a coordinated system of family-centered healthcare services and improve their outcomes. This is addressed through systems development, assessment, assurance, education, collaborative partnerships, and supporting families to meet their health and developmental needs. Programs include:

• Children and Youth with Special Health Needs Section: Children with Special Health Needs, Early Childhood, Hiʻilei Developmental Screening, and Childhood Lead Poisoning Prevention.
• Genomics Section: Genetics, Birth Defects, Newborn Hearing Screening, and Newborn Metabolic Screening.
• Early Intervention Section (EIS): Mandated early intervention services provided through three state-operated programs and 15 purchase of service programs. The Hawaii Early Intervention Coordinating Council, established under HRS §321-353, advises and assists EIS in the performance of its responsibilities under Part C of the Individuals with Disabilities Education Act (IDEA).

The Women, Infants, and Children (WIC) Special Supplemental Nutrition Program is a $29 million United States Department of Agriculture (USDA) Food and Nutrition Service (FNS) federally funded, short-term intervention program. USDA FNS provides federal grants to states for supplemental foods, healthcare referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women and for infants and children up to age 5 who are found to be at nutritional risk. The WIC Branch of FHSD administers the USDA FNS WIC program for the State of Hawaii.

COVID Impacts on Staff: The pandemic resulted in a year of unrelenting and unprecedented change in all aspects of work and personal life. We continue to be challenged to find time to pause, assess, acknowledge current conditions, and respond to the needs of both staff and populations served. Given the consequences of the pandemic, this report reflects changes, delays, and innovations that occurred over the past year.

FHSD Vision/Mission: In FY 2020, FHSD intended to update its vision/mission statement and organizational documents in conjunction with the updating of the DOH strategic plan. In October 2020, consultation was conducted with Karen Treiweiller, MCH consultant and former Colorado Title V director, to assist with this effort. However, both the department and FHSD plans were delayed due to COVID. FHSD hopes to proceed with updates in FY 2022.

Title V Role: To meet the objectives in the Title V 5-year plan, FHSD program leadership roles are varied including:

• Provide or assure services that address system gaps or critical needs
• Convene of stakeholders to address priority issues
• Fund for personnel, services, and activities
• Partner in collaboratives and coalitions
• Provide or broker technical assistance and workforce training
• Secure and share data to help inform planning and policy
• Promote innovative and evidence- based or-informed practices
• Support efforts to develop coordinated, comprehensive, and family-centered systems of care, especially for children and youth with special healthcare needs