The CT DPH’s State Systems Development Initiative (SSDI) is designed to develop, enhance, and expand state Title V MCH data capacity for its needs assessment and performance measure reporting in the Title V MCHBG program. The three SSDI program goals for the FY 2018-2022 project period 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.
2. Advance the development and utilization of linked information systems between key MCH datasets in the state.
3. Support program evaluation activities around the NPMs that contribute to building the evidence base for the Title V MCH Block Grant program.

 

Connecticut is three-quarters of the way through Year 3 of the five-year project period at the time of this reporting. The most recent accomplishment was the submission of Connecticut’s FY 2021 Title V MCHBG Application/FY 2019 Annual Report in September 2020, which included the five-year Needs Assessment (Goal 1).

 

One continuing barrier has been in obtaining Medicaid data files. For the past several years, Connecticut has not had access to linked birth-Medicaid data. In the past, the Connecticut Department of Social Services (DSS) had provided linked birth data to Medicaid status at the time of delivery; this linkage was completed by a DSS subcontractor. The last birth year for which data were provided was 2012 because DSS’s subcontractor was defunded. Marc Camardo, Connecticut Title V MCH Director and SSDI Project Director, worked with staff in the Community, Family Health and Prevention Section, Vital Records, and the DPH Legal Office during Project Year 1 to successfully execute a Memorandum of Understanding (MOU) with DSS, which also serves as the Inter-Agency Agreement required by the MCHBG (Goal 2). While this did enable Connecticut to receive aggregate data for Form 6 for birth years 2013-2017, DSS did not agree to provide the DPH with the linked data set. Mr. Camardo and internal colleagues will be pursuing this in the upcoming project year.

 

Work on the multi-stage evaluation of Every Woman Connecticut (EWCT)/One Key Question (OKQ) initiative (Objective 3.1) began during this project year after delays in the contract the previous year; the contract was finally executed in November 2019.

Goals and Objectives

Goal 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. 

 

Objective 1.1: By July 15th annually, complete data analyses for all measures required for the MCHBG Application/Annual Report.

Data collection and analysis for reporting on all measures required for the FFY 2021 MCHBG Application/FFY 2019 Annual Report was completed. Coordination of these activities for the FFY 2022 Application/FFY 2020 Annual Report will begin during the current year and will be completed in the upcoming project year.

 

Objective 1.2: By July 15, 2020 and annually thereafter, complete data analyses for the five-year Needs Assessment for submission with CT’s FY 2021 MCHBG Application/FY 2019 Annual Report and for ongoing MCH program needs assessment.

Work on the new five-year Needs Assessment began in August 2019 and was finalized in August 2020 for submission with the FFY 2021 MCHBG Application/FFY 2019 Annual Report in September 2020. Health Resources in Action (HRiA) was the contractor that led the previous five-year Needs Assessment and subsequent annual updates for the DPH. During the current project year, HRiA once again coordinated the five-year Needs Assessment in partnership with SSDI staff. Between March and June 2020, a series of meetings were held with internal and external stakeholders to review data and vote on priority needs. Once these were identified, a series of meetings were again held with DPH staff and external partners to identify related goals, objectives, and strategies. The SSDI Project Director, Project Coordinator, and other epidemiologists from the MCH Epidemiology Unit analyzed and/or procured data for most of the indicators provided to HRiA. The Pregnancy Risk Assessment Monitoring System (PRAMS) alone supplied data to HRiA for nearly 100 indicators, and later provided baseline data for newly created SPMs and ESMs.

 

Goal 2. Advance the development and utilization of linked information systems between key MCH datasets in the state.

 

Objective 2.1: By November 30, 2018 and annually thereafter, have the capacity to report on all of elements of the Minimum/National Data Set (M/NDS).

Connecticut is able to collect data for every indicator in the Minimum Data Set (M/NDS).

 

Objective 2.2: By November 30, 2018 and annually thereafter, have the capacity to report on all of elements of the Core/National and Core/State Data Sets (C/NDS and C/SDS).

Connecticut is able to collect data on all but two indicators in the Core Data Set: 1) Child Immunizations by 2 Years – Medicaid patients only, and 2) Adolescent Immunizations by 13 Years – Medicaid only. The Connecticut Immunization Registry can provide data for all children statewide but does not have information on Medicaid status. An interface with the Medicaid data system was not able to be included with the implementation of the new Immunizations Registry due to the technical complexity and associated cost. This may be a future enhancement to the system through collaboration with the Community Health Network, Inc. (CHN, Inc.), Connecticut’s Medicaid Administrative Services Organization (ASO).

 

While Connecticut is able to obtain data for the measures related to Newborn Bloodspot Screening, there are some caveats.

 

1. Percentage of presumptive positive results for time-critical conditions communicated to newborn’s healthcare provider within five (5) days of life.

Connecticut is able to report this, but within 24-48 hours (working days) of receipt of sample to healthcare provider and treatment center, not days of life.

2. Percentage of presumptive positive results for non-time critical conditions communicated to newborn’s healthcare provider within seven (7) days of life).  

Connecticut is able to report this, but within 48 hours (working days) of reporting to doctor and treatment center, not days of life.

3. Percentage of results (both positive and negative results) communicated to the newborn's healthcare provider by standard reporting means within seven (7) days of life. 

Connecticut is able to report positive and negative results, but within 7 working days of the receipt of sample in the lab, not days of life.

 

The caveats described above are process-driven, outside the control of SSDI staff, and will not likely change in the near future.

 

Objective 2.3: By November 30, 2022, increase the number of data sources identified in the SSDI Performance Measure that the State has consistent annual and direct access to 8.

Connecticut has consistent annual and direct access to 7 of the 8 data sources identified in the SSDI Performance Measure. Medicaid is the one data source for which access has been an ongoing challenge. Although CT SSDI staff worked with staff in Vital Records and the Legal Office to successfully execute a new interagency MOU, DSS did not agree to provide DPH with the linked data set. SSDI staff and internal colleagues will continue pursuing this in the upcoming project year.

 

Although the agency has access to the other 7 data sources, several factors have prevented the routine linkage of these data sources to birth records. These factors, outlined below, are outside of the control/auspices of SSDI staff.

 

Vital Records Death

DPH’s Health Statistics and Surveillance Section (HSSS) performs the linkage of birth and death data to create annual cohort files. This linkage is done upon the creation of the final mortality file for a calendar year. Infant mortality is a key indicator for MCH programs, so the availability of this linked data set is extremely valuable to Title V programs. Connecticut is in the process of implementing an electronic death registry (EDR) module in the Connecticut Vital Records System (ConnVRS) that will replace the current paper registry system that creates substantial delays in accessing infant death data. The new EDRS will not be fully implemented as a web-based platform until 2021 due to difficulties onboarding users during COVID-19. The COVID-19 pandemic interrupted the timeline for implementing the web-based EDRS. Since hospital staff, funeral homes, town clerks, and the State vital records office were overwhelmed with a surge in deaths due to COVID-19, it was not reasonable to implement a new system and the full roll-out has been pushed to 2021. Connecticut has begun entering all paper death certificates into the new system as of June 2020 which has allowed for some benefits of the new system to be realized. During the current project year, Connecticut has significantly improved our timeliness of death records sent to the CDC National Center for Health Statistics (NCHS) from a few months to a few weeks.

 

WIC

In the past, WIC had entered into data-linkage agreements with Vital Records in order to link their respective data files for the purpose of determining the percentage of WIC participants co-enrolled in WIC & Medicaid/HUSKY A, and to identify and actively recruit those low-income pregnant and postpartum women and children under age five not already enrolled in both programs. Such co-enrollment has been shown to enhance the timely delivery of key health and nutrition services, and to improve birth outcomes.

 

In recent years, however, several barriers have prevented these linkages from being performed, including:

1. inconsistent labeling of the Primary Insurance Source in the DPH Vital Records’ birth file, making it impossible to accurately determine Medicaid/HUSKY A enrollment, and thus co-enrollment in WIC/Medicaid;

 

2. limited staff time coupled with significant competing priorities in both cooperating programs within DPH; and,

 

3. CT WIC’s transition to a new EBT-capable Management Information System (MIS), the data source for the WIC file used for linkages.

Now that the new MIS is in place, the WIC epidemiologist would like to pursue data linkage for the purposes of a) determining co-enrollment in WIC & Medicaid/HUSKY A and then, coupled with GIS mapping, pinpoint geographic areas which require greater focus of recruitment efforts; and b) use it as a QA tool to compare, for example, birth-related data in the WIC database vs. the birth file. The earlier data sharing agreement between WIC and Vital Records had expired and WIC staff would like to pursue this in the coming year. Currently, the WIC epidemiologist is more interested in the Medicaid/HUSKY A dataset because WIC wants to capture women while they're pregnant rather than postpartum, when WIC's impact would be lessened considerably; this is the big advantage of the DSS dataset. However, as described earlier, DPH has been unable to obtain Medicaid/HUSKY A data from DSS. Because DPH’s Acting Commissioner is the Commissioner of DSS, we hope this is something that could be achieved in the future. Once quality assurance measures are completed in ConnVRS to improve the data in the Primary Insurance Source field (e.g., offering hospital staff a drop-down menu or limited selection of options to prevent all the free-form variations on HUSKY/HUSKY A/Medicaid/State, etc), the WIC epidemiologist will purse the renewal of that data sharing agreement.

 

Newborn Bloodspot and Newborn Hearing Screening

Creating linkages of high-quality child health information has been a continued priority for the Connecticut SSDI project. Past SSDI project years have included ongoing efforts to implement the web-based MAVEN application, which provides a comprehensive child health profile. The newborn screening module, MAVEN: Newborn Screening System (NSS), has facilitated the linkage of birth and newborn screening records for 8.5 years and will continue to provide access to this information in the new SSDI Project period. Currently, the following databases are integrated into the Maven: NSS - Newborn Bloodspot Screening, Newborn Hearing Screening, Birth Defects Registry, Critical Congenital Heart Disease Screening, Children and Youth with Special Health Care Needs Registry, birth records, Childhood Lead Surveillance System and Family Wellness Healthy Start.

 

The Maven: NSS application includes an automatic de-duplication algorithm, as well as multiple numeric validation rules that maintains the integrity of the child data records entered into the system. A two-way, automated matching process between ConnVRS and the Maven: NSS is completed 15 days after the system entry date based on an algorithm that achieves a greater than 97% match rate. Prior to ConnVRS, a flag had been included in the automated matching process that would pick up any changes to a particular record within 120 days of birth. For example, if a baby is adopted at 2 months of age, this information will import and update the child’s record in Maven: NSS. Coding for this needs to be built back into the system by the DPH IT Department. Currently, the only records that import, after the initial import at 15 days, are records that are entered late with Vital Records. A new electronic record is automatically created for children born in CT who do not have a matching record in the Maven: NSS from the birth record. These cases are identified and reviewed to make sure they are not duplicate records. With regular monitoring in place, the 2012-2019 NSS birth counts were the closest they have ever been to the former vital records system (EVRS) occurrent birth count.

 

After EVRS was moved to the new ConnVRS application in January 1, 2016, an updated vital records roster import file was implemented in the Maven: NSS at the end of April 2016. Currently, these records are imported daily. What is not yet included in this new import are any changes made in the Vital Records record within 120 days since birth or any record that was not submitted to Vital Records within 15 days of birth. Originally, it was anticipated that this would be corrected by December 2019. However, due to barriers beyond control the DPH IT Department, it has not yet been completed. This is a critical feature that needs to be added back into the automated import. Several ConnVRS fields have also changed that require changes to the Maven: NSS vital records roster import file to more accurately capture specific demographic changes, such as multiple races. The congenital anomalies section in ConnVRS has also changed and Maven: NSS needs to be remapped to accurately support birth defects reporting. Progress has been made on testing the mapping to receive all fields that map exactly without needing to change the imports. These changes were moved to the Production environment in September 2018. Some of the fields that required the remapping of the data that is captured differently in ConnVRS were updated and remapped so that it will import into Maven NSS. This was completed in March 2019. The mother’s education field was remapped and completely reimported for the 2017 birth year and is now part of the daily import. When the other remapping is completed, all ConnVRS files from January 1, 2016 forward will be reimported into Maven NSS. The biggest barriers to this have been lack of resources from the IT department. The staff person that needs to do this from IT has had other priorities with the ConnVRS database that had to be completed. The next step for remapping the Congenital Anomalies section and other sections that are new was anticipated to be completed by March 2020 so that annual birth defects reporting could be completed by the end of May 2020. In March 2020, the CDC and National Birth Defects Prevention Network (NBDPN) changed their focus and moved to collecting data every other year. The 2020 data was pushed back to 2021 so this update to the Congenital Anomalies section was also put on hold by DPH IT.

 

In February 2018, a new question package was implemented to capture Critical Congenital Heart Disease Screening on every baby that is born in the state of Connecticut. This was implemented to meet a new state statute that went into effect “on or after January 1, 2018.”

 

Information derived from the Maven: NSS application has improved Connecticut’s ability to report on the MCHBG providing data for numerous objectives, outcome and performance measures.  The CT NBS Program at the State Laboratory (CT NBS) is in the process of developing reporting modules in Maven that will simplify the extraction of information for MCHBG reporting.  

 

Maven: NSS has also improved the quality and accessibility of child health information for the CT NBS Program at the State Laboratory, Newborn Hearing Screening, Birth Defects Registry, Children and Youth with Special Health Care Needs, and Lead programs to support their work. 

 

Hospital Discharge

Starting in 2009, hospitals began reporting emergency department and inpatient hospitalization discharge data directly to DPH. Data from all hospitals is received within 7 months after the end of a calendar year. Previously, data had to be purchased from the Connecticut Hospital Association, which was extremely costly and took additional time because of the contractual process to obtain the data. DPH currently has data up to and including calendar year 2018, and 2019 data is expected to be received in September 2020. These data have been used to report on several measures in the MCHBG Application/Annual Reports. Expanded analyses and/or linkages to other data sources (e.g., birth and death records) can be completed to gain additional information, such as the cost associated with adverse birth outcomes, maternal morbidity and mortality, and neonatal abstinence syndrome. Linkages using birth and hospital discharge data are primarily performed by HSSS staff to meet project-specific needs. However, staff capacity has been overstretched for many years, which has hindered additional linkages.

 

The Connecticut SSDI project has had a longstanding commitment to supporting the implementation of the PRAMS survey to expand and sustain state data capacity. The ongoing study of birth outcomes and associated risk factors has yielded a better understanding of the impact of maternal health and behaviors on the infant and mother during pregnancy and postpartum. Although vital records birth data are available to measure such outcomes of interest as low birth weight, preterm delivery, and the receipt of early and adequate prenatal care, the ability to examine important outcomes and behaviors in-depth had been restricted in Connecticut because of the limited information about key risk and protective factors available from birth certificate data.

 

PRAMS provides data about maternal health, experiences, and behaviors during the perinatal period, which enhances data capacity surrounding risk and protective factors among Connecticut mothers. The goals of PRAMS are to: 1) Provide statewide data about maternal health, experiences, and behaviors during the perinatal period; 2) Better understand the relationship between maternal risk factors, behaviors, and attitudes and adverse pregnancy and postpartum outcomes; and 3) Investigate racial and ethnic disparities in maternal risk factors, behaviors, attitudes and pregnancy and postpartum outcomes.

 

Data for the 2013-2018 surveillance years are available. These data have been provided to numerous programs within DPH, including reporting to the MCHBG, as well as a wide network of MCH partners statewide to support their work. Data dissemination has been achieved via fact sheets, data reports, presentations, and ad hoc data requests. The SSDI Coordinator is also the PRAMS PI, Project Director, Coordinator and Analyst. She will continue to work on additional data products in addition to fulfilling ad hoc data request. Data for the 2019 surveillance year will be weighted soon and is expected by Fall 2020; these data will include information from a special opioid survey supplement.

 

CT PRAMS was awarded additional funds to implement an opioid supplement. Supplements to the PRAMS survey allow the CDC, state health departments, and others to respond to emerging issues that arise during the data collection cycle, including responses to emergency surveillance needs. One such emerging issue is the opioid epidemic, which has been recognized as a nationwide crisis. PRAMS is uniquely positioned to provide population-based data on maternal behaviors and experiences related to opioid use among recent postpartum women. PRAMS data will complement other CDC opioid surveillance efforts by filling gaps in data, including information about opioid use by the mother, reason for use (including assessment of misuse), interactions with health care providers related to prescribing and counseling, and need for and access to treatment services. These data will be integrated into national, state, and local efforts to address the opioid crisis. Data collection began at the start of the 2019 surveillance year in April 2019 and although we were only required to collect data for six batches, CT PRAMS committed to a full surveillance year in order to provide more robust data. Once these data are received, they will be analyzed, and the results will be disseminated to our partners working on this issue.

 

Goal 3. Support program evaluation activities around the NPMs that contribute to building the evidence base for the Title V MCH Block Grant program.

 

Objective 3.1: By November 30, 2022, complete a multi-stage evaluation of Every Woman Connecticut/One Key Question initiative.

The EWCT evaluator co-constructed the evaluation plan and templates with EWCT leadership; conducted 10 in-depth stakeholder interviews with the EWCT Advisory Committee; and transcribed and analyzed all data and compiled a report for EWCT leadership and Advisory Committee members. The report assessed the work of EWCT based on feedback from the initiative’s stakeholders and identified needs of the initiative as well as areas for growth and opportunity. The report contained six areas of recommendations for the coming year including: 1) achieving clarity on mission and objectives; 2) focus on sustainability planning; and 3) creating explicit roles and structure for the EWCT Advisory Committee. Over the next year, the evaluator will work with EWCT Leadership to measure the extent these recommendations are implemented into the work.

 

1. Plans for Upcoming Budget Year

Goal 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.

In the upcoming project year, SSDI staff will coordinate and/or perform data collection and analysis for reporting on all measures required in the FFY 2022 MCHBG Application/FFY 2020 Annual Report, as well as the annual needs assessment updates.

 

Goal 2. Advance the development and utilization of linked information systems between key MCH datasets in the state.

During the upcoming project year, SSDI staff will continue work to support the availability and use of the indicators identified in the Minimum/Core Data Sets (MDS), as well as attempt to reduce barriers to the data linkages outlined in the new SSDI Performance Measure. Many factors are outside the control/auspices of SSDI Project staff. Therefore, while SSDI staff may advocate for certain steps to be taken to increase the availability of data and performance of data linkages, SSDI staff has limited authority.

 

Minimum/Core Data Sets (MDS)

Currently, Connecticut is able to collect data for every indicator in the Minimum and Core Data Sets except for two. As discussed above, the Connecticut Immunization Registry can provide data for all children statewide but does not have information on Medicaid status. An interface with the Medicaid data system was not able to be included with the implementation of the new Immunizations Registry due to the technical complexity and associated cost. This may be a future enhancement to the system through collaboration with the Community Health Network, Inc. (CHN, Inc.), Connecticut’s Medicaid Administrative Services Organization (ASO). Although SSDI staff do not have authority over this change, staff can continue to advocate for this enhancement if changes to the system are planned.

 

SSDI Performance Measure

The goal of the new SSDI Performance Measure, The percent of programs promoting and facilitating state linkage capacity for direct annual access to MCH electronic health data, is to ensure state capacity for accessing electronic MCH health data to support planning, monitoring, and evaluation on a timely basis.

 

Linkages to birth records using vital records death, newborn bloodspot, and newborn hearing screening data are being done on a consistent, annual basis. SSDI funds have been allocated to help support the vital records birth and death modules in ConnVRS. This will facilitate improved availability and timeliness of vital records data to MCH programs. As discussed above, barriers to linkage of the birth data with other data sets listed in the SSDI Performance Measure are outside the control/auspices of SSDI staff. However, if feasible, SSDI staff will provide any requested support from programs in their data linkage efforts.

 

SSDI staff will continue their efforts to address barriers to Medicaid data. Although CT SSDI staff worked with staff in Vital Records and the Legal Office to successfully execute a new interagency MOU, DSS did not agree to provide DPH with the linked data set. SSDI staff and internal colleagues will continue pursuing this in the upcoming project year. In the past, DSS hired a contractor to perform the linkage, then the linked file was provided back to DPH. Because that contract is no longer in place, it remains to be determined who would perform the linkage. If DSS agrees to the linkage but is not able to finance a vendor, SSDI staff will explore internal options. Several epidemiologists in HSSS are capable of performing this linkage and are a natural choice to facilitate timely access to the linked data.

 

PRAMS is referenced in the new SSDI performance measure in terms of access and timeliness, but the measure does not include linkage to birth records as part of the indicator measurement. In part, this is because PRAMS participants are selected from birth records and selected birth record fields are included in the PRAMS data set. A description of PRAMS data has already been provided above. SSDI funds have been allocated to help support the implementation of PRAMS, therefore helping ensure regular access to statewide MCH data not available from any other source. The SSDI Project Coordinator also serves as the PRAMS PI, Project Director, Coordinator and Analyst. She regularly provides data to the Title V MCHBG and other internal and external partners to support their work with the MCH population. She will continue to do so during the upcoming project year.

 

CT PRAMS elected to add a COVID-19 supplement to the survey. The questions were developed by CDC and underwent cognitive testing. Title V MCHBG funds are being used to fund this supplement as CDC PRAMS does not currently have funding for this. The supplement will begin with the October 2020 batch and run at least through the end of the 2020 surveillance year. However, depending on the course of the pandemic and available funds, we will explore the possibility of extending the supplement beyond the March 2021 batch.

 

These supplemental questions are an effort to begin collecting population-based data on how the lives of Connecticut’s mothers are being impacted by COVID-19 infection and the COVID-19 pandemic. The questions will allow us to describe the number of moms who feel that they may have been infected with COVID-19, whether or not that was confirmed by a test. We will also be able to divide women into groups that were not at all affected, somewhat affected, or greatly affected by the societal effects of the pandemic. Taken in conjunction with the rich information that PRAMS already gathers on the lives of women around pregnancy, we may be able to quantify the degree of disruption across many different life domains.

 

PRAMS is uniquely positioned to provide population-based data on maternal behaviors and experiences related to COVID-19 among recent postpartum women. PRAMS data will complement other CDC COVID-19 surveillance efforts by filling gaps in data, including interactions with health care providers in person and by telemedicine, testing and results exposure/infection, and economic/emotional hardship. Other relevant data from the non-supplemental portion of the PRAMS survey can also be provided to state and national partners, including contraceptive use, family planning, receipt of prenatal care, and more.

 

Goal 3. Support program evaluation activities around the NPMs that contribute to building the evidence base for the Title V MCH Block Grant program.

The next steps in the multi-stage evaluation of the EWCT/OKQ initiative that will take place in the upcoming grant year are:

 

1. Develop and administer a survey on changes in knowledge, attitudes, and behaviors in the Connecticut MCH provider and policy community related to the EWCT work. The evaluator will develop and administer the survey, analyze the results, and present the results to the EWCT Advisory Committee for feedback and to guide the evaluation work in the next year. 

 

2. Work with the EWCT Advisory Group to align metrics and data that already exist to capture the extent the EWCT initiative has impacted process and outcomes related to MCH work in Connecticut. The evaluator will work with EWCT partners to identify data in their systems that can be considered a metric of change related to EWCT and will then compile data and create a shared dashboard to examine change in MCH indicators related to EWCT.

 

2. Use of Minimum/Core Dataset Indicators

During the reporting period, the Minimum/Core (M/C) Dataset indicators were used in a variety of ways to further SSDI’s purpose to develop, enhance, and expand state and jurisdictional Title V MCH data capacity for its needs assessment and performance measure reporting in the Title V MCH Block Grant. Because SSDI staff are also the staff in charge of the Title V MCHBG, the use of many of these indicators has been standard practice for decades, before the M/C Dataset existed as a collective body. Many indicators, such as injury-related and newborn screening, do not fall under the auspices of the CT Title V Director. Therefore, our partners utilize those or similar indicators for their own operations, program planning, and quality improvement.

 

Many of these indicators have been used in documents that drive decision-making, including the Title V MCHBG applications and needs assessments, CT Title V MCHBG Allocation Plan, DPH State Health Assessment and State Health Improvement Plan, and the Connecticut Plan to Improve Birth Outcomes. Recently, many of the indicators were used for the Healthy Start needs assessment and factored into the decision to expand the project area from Hartford-only to also including New Britain.

 

SSDI activities have contributed in many ways (e.g. analytic capacity, funding) to providing the Title V MCHBG, other DPH programs, and outside partners with a vast array of data. For example, SSDI provides funds to support the new electronic vital records system, ConnVRS, because vital records birth and mortality data provide a significant percent of the M/C Dataset indicators, as well as those needed for Title V MCHBG reporting. SSDI also provides funds to support PRAMS, another significant data source for the Title V MCHBG, internal DPH programs, and external partners.

 

SSDI staff continue to promote the linkage of state MCH databases and partner with several internal colleagues to achieve these linkages, when possible. Colleagues in HSSS routinely link birth, death, and fetal death files for the purpose of generating data to monitor fetal and infant mortality rates and related disparities. Staff in that section also link birth and hospital discharge data periodically to support different projects. The SSDI Director continues efforts to generate and obtain linked birth-Medicaid data, but continues to face barriers at DSS. Finally, as described above, WIC staff are seeking to renew the birth and Medicaid/HUSKY A data access and linkage efforts.

 

Public reporting of the M/C Dataset indicators, as well as other data supported in part by SSDI activities and funding, are disseminated to internal and external partners in a variety of ways, including via the DPH Dashboard; PRAMS fact sheets, reports, presentations, and ad hoc data requests; posting of MCHBG info and application on DPH website; and emails or presentations to the MCH Coalition.

 

These indicators have also been used to introduce two epidemiology staff who are newer to the MCHBG application and needs assessment process and contributed to this year’s application/annual report. SSDI staff reviewed these indicators and their importance to providing a basic MCH data infrastructure within and across states. These indicators and others will be used in the upcoming 5-year Title V MCHBG needs assessment process, which these two staff people will be a part of.