The NC Title V Office uses State Systems Development Initiative (SSDI) funding to maintain the current SSDI Project Coordinator’s position. The primary role of this position is to help increase the Office's capacity to utilize and analyze data to assess, plan and evaluate maternal and child health services provided by the Title V Office, the WICWS, and the DCFW/WCHS. Two goals of the current grant are to 1) build and expand state MCH data capacity to support the Title V MCH Block Grant program activities and contribute to data-driven decision making in MCH programs, including assessment, planning, implementation, and evaluation; and 2) to advance the development and utilization of linked information systems between key MCH datasets in the state. These goals complement the work of the NC Title V Office as a whole.

It is fortunate for the Title V Office that the NC SCHS has a long history of collecting vital statistics data, linking data with infant birth certificates, and in conducting statewide surveys; thus, the work of the SSDI Project Coordinator is to promote data utilization and provide better means of data distribution. The SCHS website houses the Tracking Maternal and Child Health Data in NC webpage which provides trend data for the Minimum/Core (M/C) Dataset for Title V MCH Block Grant programs that is compiled annually by the SSDI Project Coordinator.

The Title V Office partnership with the SCHS supports accessible, timely and linked MCH data systems, as documented on Form 12. Since 1985, NC has linked Medicaid newborn hospitalization records to live birth certificates to identify which births were to families enrolled in Medicaid. This birth file with added health services data is referred to as the NC Composite Linked Birth File. Data from this birth file are posted on the SCHS website in a variety of ways. Data that are linked annually to the live birth file include:

• Medicaid newborn enrollment records
• Medicaid maternal delivery records
• Summary of Medicaid newborn costs in the first 60 days of life
• Summary of Medicaid infant costs in the first year of life
• Prenatal WIC records
• Infant death records
• Maternal death records
• Birth defects cases identified through the Birth Defects Registry surveillance system
• Pregnancy Risk Assessment Monitoring System (PRAMS) survey data

Linkages with hospital discharge records for newborns and for mothers/delivery records are currently under development.

The Perinatal Epidemiologist, a position supervised by the SSDI Project Coordinator, has direct electronic access to the NC Composite Linked Birth File as well as to other vital statistics data, hospital discharge, and emergency department data. In addition, she can access newborn hearing screening data from WCSWeb Hearing Link. Staff members within the Genetic Newborn Screening Unit in the DCFW/WCHS have access to newborn bloodspot screening data, and the epidemiologist in the DCFW/CNSS has access to additional WIC data. While the Title V Office has had consistent access to PRAMS data for many years (and access to the electronic data source on an as needed basis), an application for CDC funding was not submitted by SCHS in 2020. The SCHS has committed to conducting an in-house PRAMS-like survey to obtain similar data for Title V surveillance; however, as of June 2022, this survey has not been produced.

The SSDI Project Coordinator and Perinatal Epidemiologist serve on the Maternal Health Innovation (MHI) Evaluation Team and have helped orient the new MHI Epidemiologist hired in February 2021. The Perinatal Epidemiologist supports the work of the Maternal Mortality Review Committee (MMRC) by identifying pregnancy-associated deaths through multiple data sources including vital statistics data linkages, literal cause(s) of death recorded on death certificates, diagnoses record on hospital discharge and emergency department data, and pregnancy checkbox information on the death certificate. She also prepares data reports on severe maternal morbidity for use by the Title V Office and WICWS and collaborates with academic and HRSA colleagues. Having served on the Epi COVID Data Team, the Perinatal Epidemiologist is now also able to use Covid-19 case data to identify and confirm all maternal deaths due to Covid-19 and provide the MMRC with Covid case transcripts that will be used to support maternal case reviews. In addition, she makes annual presentations to the Child Fatality Task Force and relevant committees regarding infant and child deaths.

The SSDI Project Coordinator is responsible for coordinating the completion of the MCH Block Grant narrative by working with the Title V Director, CYSHCN Director, and staff members of the WICWS, Immunization Branch, and DCFW. She provides rationale for the MCH Block Grant national and state performance measure objectives and assists with the development of the evidence-based or -informed strategy measures (ESMs) and the State Action Plan. She works with data coordinators, epidemiologists, and evaluators within DPH and DCFW to compile the necessary data for the Block Grant. The Federally Available Data (FAD) Excel workbook is extremely helpful in making comparisons from one year to the next and across demographic and other subgroups.

As its state-specific goal required in the SSDI grant application process, NC chose option b – Provide data support to states participating in quality improvement (QI) activities (e.g., Collaborative Improvement and Innovation Networks [CoIIN]) –for its programmatic focus over the 5-year funding period based on the SSDI Project Coordinator’s ongoing involvement in the CoIIN efforts to reduce infant mortality. She continues serve as coordinator of #impactEQUITYNC, which is a partnership of the Title V Office, WICWS, DCFW/WCHS, and several non-profits. #impactEQUITYNC was initially started to create and promote the use of a Health Equity Impact Assessment tool, but in the upcoming year will also be taking on some of the work initially begun with the Social Determinants of Health CoIIN. The SSDI Project Coordinator worked with a subgroup of #impactEQUITYNC members to revise the Health Equity Impact Assessment Tool.

As needed, the SSDI Project Coordinator also provides data support to staff members across DPH and DCFW. Recent and ongoing examples of this support include serving as the chair of the Data and Evaluation Work Group of the Perinatal Health Equity Collective, assisting with ongoing evaluation of the ICO4MCH initiative, and serving as a co-coordinator of the NC DPH Epidemiology and Evaluation Team. In May 2022, the Data and Evaluation Work Group finalized a summary highlighting the accomplishments and challenges experienced with implementation of the 2016-2020 Perinatal Health Strategic Plan.