State Action Plan Narrative Overview

Idaho Title V Program Purpose and Design

The mission of the Idaho Title V MCH Program is to improve the health and well-being of all mothers, infants, and children, including children with special health care needs, and their families. By embracing the life course model, the MCH Program has made great strides in increasing capacity and strategically aligning programs in order to best address the needs of Idaho’s MCH populations. Since 2011, MCH staffing has doubled in size, primarily through the relocation of relevant programs under the MCH umbrella and allocation of new FTEs to the programs. Today, the MCH Section is home to six program areas and 12 staff with oversight by the Title V MCH Director.

Idaho Title V seeks to build and strengthen the capacity of state and community health care providers and MCH professionals to implement systems of care for women, children, and families; provide gap-filling clinical services to address unmet healthcare needs, especially for children and youth with special health care needs; support implementation of evidence-based programs; pilot homegrown innovative strategies to address the unique needs of the state and assess effectiveness; offer education and outreach to improve health outcomes for individuals and communities; drive policy change; and continuously assess health needs, including the health needs of disparate populations, to drive strategies for achieving health equity.

The MCH Section may be small, however, it is skilled at leveraging partnerships, developing innovative approaches, and collaborating across programs to best serve Idaho’s women, children, and families. Within an environment of limited resources, health care shortages, and geographic challenges, the Title V staff are knowledgeable in a variety of MCH areas and skilled at developing creative and nimble partnerships to address MCH issues. Most often, MCH leadership and staff serve as a convener, collaborator, and partner to move the needle on MCH issues. One benefit of working in a small state is the tightknit community of public health professionals, social service programs, community organizations, and health care providers. It is common that the same stakeholders are “at the table’ for many MCH matters. Over the past couple of years, MCH leadership has been the primary convener with stakeholders to drive policy development, decisions, and activities related to newborn screening, critical congenital heart disease, infant mortality reduction, congenital cytomegalovirus education, and maternal mortality review.

To address the priorities in Idaho’s state action plan, MCH leadership collaborates with a variety of partner programs by allocating Title V funding to public health programs that specialize in respective priority areas. For example, Title V provides funding to the Idaho Oral Health Program to implement school-based oral health assessments for children and to the Idaho Family Planning Program to augment activities funded by the Title X Family Planning Services grant. Title V also contributes funds to the Idaho Tobacco and Prevention Program to implement an Idaho-grown tobacco cessation program for pregnant women and supports the expansion of evidence-based suicide prevention programming in Idaho schools through partnership with the Suicide Prevention Program. MCH and partner programs work together to identify evidence-based programming and monitor implementation and progress of the funded activities.

The MCH Program is skilled at community engagement and has a number of formal and informal partnerships with community-based organizations across the state. Formal partnerships include those directed via contract, subgrant, or memorandum of understanding. Informal partnerships are those in which MCH works closely with another program or organization to provide information, technical assistance, or referrals. MCH leadership and staff also serve on a variety of workgroups, councils, and advisory boards. Currently, staff participate on the Caregiver and Early Education Committee, Idaho Breastfeeding Coalition Board of Directors, Idaho Child Fatality Review Team, Idaho Council on Developmental Disabilities, the Idaho Perinatal Project, the MIECHV Steering Committee, the Newborn Screening Advisory Board, and the Thriving Families, Safer Children work group.

The MCH Program is dedicated to strengthening systems of care and supporting comprehensive, coordinated, and family-centered services for women, children and youth, including children and youth with special health care needs (CSHCN). For children and CSHCN populations, the MCH Program has taken an active role in promoting Bright Futures Guidelines and providing topical quality improvement events to encourage various screenings to identify special needs early, which allows for prevention or early intervention and treatment. Since 2016, the MCH Program has partnered with St. Luke’s Children’s Hospital to host a series of annual learning collaboratives focused on pediatric practice improvement and care delivery. Topics have included integrating oral health care into the primary care setting for children 0 to 5 years of age, implementing developmental screening in primary care settings, and introducing screening for adverse childhood experiences (ACEs) and resiliency in caretakers of young children.

To increase access to medical homes, pediatric specialists, and needed clinical services, the MCH Program contracts with the children’s hospital and some public health districts to support specialty pediatric clinics and bring in pediatric specialists from neighboring states to fill pediatric specialty shortages. Title V funds support the Newborn Screening (NBS) Program which screens approximately 99% of babies born in Idaho for various disorders and ensures babies are connected with appropriate follow-up care when a disorder is detected. The Title V block grant also funds the Children’s Special Health Program (CSHP) which is a direct service, financial support program for Idaho children who meet certain diagnostic and eligibility criteria. CSHP works with families to ensure those eligible are enrolled in Medicaid.

The MCH Program uses Title V funding to support programs and services that offer access to needed care and encourage healthy family functioning. Title V funding builds upon Title X family planning funding to expand services across the state to ensure low-income women and women in rural areas have access to reproductive health services and contraception. The MCH Program supports the Adolescent Pregnancy Prevention (APP) Program to deliver evidence-based sexual health education to youth. The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is a Title V-supported program that offers evidence-based home visiting services to expecting parents and parents of young children across the state.

The Idaho MCH Program plays a significant role in implementing the core public heath functions of assessment, assurance, and policy development. Below are examples of how MCH fulfills the core public health functions to support population-based efforts and services to benefit women, children, and families.

Assessment

• Supports data collection for the state’s only perinatal data system, which monitors the health status and health behaviors of pregnant women and infants.
• Allocates funding to epidemiology programming which supports communicable disease surveillance capacity for MCH populations.
• Explores methods for collecting data related to Neonatal Abstinence Syndrome and diagnosed critical congenital heart defects (CCHD).
• Maintains screening data for CCHD from the birth certificate and conducts quality assurance checks, technical assistance, and follow-up on flagged cases.

Assurance

• Oversees the NBS Program which ensures screening of all babies born in Idaho as mandated by statute and rule.
• Allocates funding to family planning services and gap-filling support for pediatric specialty clinics.
• Supports funding of the Idaho Poison Control Center which provides education regarding poison exposures and establishes a statewide poison control hotline.
• Hosts learning collaboratives for MCH workforce development.
• Conducts comprehensive five-year needs assessment and on-going needs assessment and evaluation activities in partnership with BSU Center for Health Policy.

Policy Development

• Informs and educates the public regarding safe sleep, congenital cytomegalovirus, preconception and interconception health, family planning, pregnancy health, breastfeeding, and newborn screening.
• Offers free transition-to-adulthood kits to help empower youth with special health care needs to take an active role in their health care as they become young adults.
• Convenes stakeholders to identify and rank MCH needs and priorities and develop the Title V state action plan to address the identified priorities.
• In collaboration with partners, MCH leadership proposed rule changes to the Idaho Legislature to add screening for Critical Congenital Heart Disease to the Newborn Screening Program.
• In collaboration with partners, MCH leadership provided information and feedback on legislation to implement a Maternal Mortality Review Committee (MMRC). The MMRC legislation passed and the MCH Program is currently leading implementation.