III.E.2.a. Title V Program Purpose and Design

Indiana’s Title V program is embedded in the work of both the Maternal and Child Health (MCH) Division and the Children’s Special Healthcare Services (CSHCS) Division. While the program is administered in MCH and CHSCN, the work could not be completed without the extensive partnerships with internal divisions as well as subgrantees around the state. The block grant program truly serves as a convener, collaborator, and partner in addressing MCH issues both internally to the Department and externally with other state agencies and organizations. The Title V team aims to support coordinated, comprehensive, and family-centered systems of care at a state, local and community level.

The majority of Title V dollars are sub-granted to organizations around the state completing work at all levels of the MCH pyramid. Current projects are based on population needs that were identified in the 2015 to 2020 needs assessment cycle. However, with the recent completion of the 2020 needs assessment, MCH is planning on making significant adjustments to the Title V program in Indiana. First and foremost, MCH will spend the next year (2020 to 2021) redesigning the way in which funds are administered based on the results from the 2020 needs assessment and the priorities selected in the new state action plan. Instead of funding legacy projects based on needs from five years ago, the Department of Health will streamline who receives funding and how funding is administered over the next five years. This change will allow communities and partners to work together and be innovative to make the biggest impact in their community instead of using a pre-selected program that does not fit their needs. We will no longer rely on ‘cookie-cutter’ grant opportunities, rather we will work with regions to develop their approach based on Life Course Theory Principles.

Beyond a shift in programs and funding offered through Title V, Indiana has selected four cross-cutting measures in the new state action plan that outline a path for growth over the next five year cycle. The State Department of Health has committed to making improvements in access to mental health services, increasing family engagement in Title V work, better sharing digestible data with the public, and ensuring all funding promotes racial equity in the Hoosier state. These four measures were directly identified as needs in the five-year needs assessment, and Title V will only be successful in improving these cross-cutting measures with investment in current and future partnerships.  Over the next five years, Title V will continue seeking input and fostering connections to improve the health of people in their communities.

The Title V program also works to support coordinated, comprehensive, and family-centered systems of care at the state and local levels, especially for children and youth with and without special health care needs. For more than 20 years, the Indiana Title V program has funded care coordination efforts throughout the state.  In partnership with Medicaid, family members, primary care and specialty care providers, and other key state and local stakeholders Indiana is currently piloting place-based care coordination within the health care system to better provide comprehensive family-centered assessment, cross-communication, and integration of services into communities. This includes piloting an innovative payment model through Medicaid for care coordination reimbursement. The Title V program and its partners utilized AMCHP’s National Consensus Standards for Systems of Care for Children and Youth with Special Health Care Needs (CYSHCN). The national standards have also been used to inform state-funded initiatives around care coordination and wrap-around services overseen directly by the CSHCS Division (i.e., sickle cell and visual impairment).

The Title V program is passionate about leading the state and region in MCH issues and all staff are encouraged to serve on related committees, boards, and groups at all levels of implementation. A significant portion of the budget is dedicated to workforce development and capacity building for staff and partners. Staff routinely participate in national collaborative networks, planning committees, and trainings. Indiana is home to the current President of AMCHP Board of Directors, Shirley Payne. As President, Ms. Payne is responsible for assisting in ensuring the effectiveness of the full board, including the creation of the AMCHP Strategic Plan that guides all AMCHP program, policy, and member service activities. Eden Bezy now serves as the Region V Director, representing Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Her responsibilities include convening delegates from the aforementioned five states for regular meetings via phone calls and annual in-person meetings. Ms. Bezy works with state staff to identify and share trends, issues, and news which she then relays to the board and AMCHP staff including any emerging best practices, evidence-based practices, government policies, and opportunities to advance the health and well-being of the MCH population. Having both the Title V/MCH Director and the Title V CYSHCN Director on the AMCHP board shows Indiana’s commitment to promoting health and improving outcomes for the maternal and child population, not only in the state, but nationwide.