Through legislation and Iowa Administrative Code Chapter 641.76 the IDPH is designated as the entity to apply for Title V Block Grant funding and administer Iowa’s Maternal and Child Health services. IDPH’s BFH 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.

IDPH’s Bureau of Oral and Health Delivery Systems (OHDS) collaborates with BFH to develop programs to reduce barriers to oral health care and reduce dental disease through prevention.

The CYSCHN program is administered by Child Health Specialty Clinics (CHSC) in the Division of Child and Community Health (DCCH) at the University of Iowa. IDPH contracts with CHSC to provide services for CYSCHN 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 BFH and OHDS 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 program utilizes logic models for the Title V population domains: Maternal Health, Child and Adolescent Health, Hawki (Iowa’s CHIP), and Oral Health. Within each logic model, 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 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.

Adolescent Health Collaborative

The Adolescent Health Collaborative, established in 2014, is an intra-agency group within IDPH comprised of programs that serve adolescents and young adults. Members include staff from alcohol and substance use, teen pregnancy prevention, family planning, violence and injury prevention, immunizations, STD/HIV prevention, mental health, and suicide prevention.

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 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 assist with the planning, development, and evaluation of programs and policies that impact the System of Care for Iowa CYSHCN. Members come from areas across the state, both rural, and urban, with primarily mothers, one father and one youth member. Each February, the FAC participates in a “Day on the Hill” with the Iowa Legislature. A member of the FAC serves on the MCH Advisory Council.

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 provides information to legislators and other stakeholders about successes and barriers children and their families are facing to accessing services and supports statewide.

RAP Family Advisors

In addition to their role on the RAP Expert Panel Advisory Committee, RAP Family Advisors have additional opportunities to share information and advise the Regional Autism Assistance Program.

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 such as bullying, obesity, and early hearing detection and intervention.

Iowa’s Title V staff are regularly involved in research 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.

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.