Building and supporting accessible, timely and linked MCH data systems: BFH continues to utilize State Systems Development Initiative (SSDI)  grant funding to support MCH data collection and reporting in the MCH Block Grant, improve cross-program MCH data linkages and assure direct annual access to timely electronic MCH health data. The SSDI Coordinator and in-kind support staff consistently maintain access to Birth, Death, Medicaid. Special Supplemental Nutrition Program for Women, Infant and Children (WIC), Newborn Bloodspot Screening, Newborn Hearing Screening, Hospital Discharge and PRAMS datasets as documented on Form 12. This access has remained constant even in the midst of the COVID-19 pandemic. Having electronic access to all datasets has allowed access and maintenance of these files to continue while working remotely via a secure virtual private network.

This year, SSDI used multiple indicators from both the minimum and core datasets to fulfill numerous data requests from internal and external partners. SSDI also provides yearly data to the KIDS COUNT Data Center, a project funded by the Annie E. Casey Foundation to provide accurate, timely data on child well-being at the local, state and federal levels. Nonprofits, community members, the media and government officials use KIDS COUNT data to better understand the needs of children in their communities. Data submitted from BFH are published on the online KIDS COUNT Data Center, as well as on the Agenda for Children website, with attributions to BFH. Elements from the minimum and core datasets that were used in this data request include teen births, low birthweight, very low birthweight, preterm births, and infant mortality.

Additionally, SSDI annually submits data elements from the minimum and core datasets to the Environmental Public Health Tracking Program. This year these elements included 19 data years of preterm birth, very preterm birth, low birth weight, very low birth weight, infant mortality, fertility, maternal mortality, and sex ratio data. For more than a decade, the Environmental Public Health Tracking Program has collected, integrated, and analyzed non-infectious disease and environmental data from a nationwide network of partners. Louisiana is one of 26 state and local health departments to be part of the U.S. Center of Disease Control and Prevention’s (CDC) National Environmental Public Health Tracking Network. The purpose of this Program is to deliver information and data to protect the nation from health issues arising from or directly related to environmental factors.

Utilizing the minimum and core datasets, two of the most frequently used linked datasets are the Pregnancy Risk Assessment Monitoring System (PRAMS) and birth file linkage and the Medicaid and birth file linkage. After the weighted PRAMS survey data are obtained from the CDC, SSDI in-kind staff are responsible for linking the PRAMS survey respondents to their respective birth records. This linkage of data allows the Bureau to obtain additional indicators and outcomes on the mother and baby that are not limited to the survey questions. Because of SSDI support, BFH also receives Medicaid eligibility data from partners at the University of Louisiana to analyze outcomes based on Medicaid status. The minimum and core dataset elements are also used for population and mortality surveillance, program evaluation and analyses to detect changes in the health status of the MCH population on a routine basis.

Louisiana SSDI also supports the PRAMS program by providing data analytic support with linking the PRAMS data to vital records birth data, computer coding support and subject matter expertise with analyzing and translating the data. Additionally, the SSDI Coordinator and in-kind support staff provide continuous support to the PRAMS program year-round by reviewing and editing the syntax code that is used to pull the monthly random sample of women to be surveyed, analyzing survey and linked data (birth and survey), preparing birth files for weighting, and creating annual data books, surveillance reports and factsheets. After each calendar year, PRAMS data files must be reconciled and sent to the CDC for weighting. This weighting process allows the program to take data from a sample of Louisiana mothers and generalize it to the whole population of mothers. Final weighted files are used to fulfill data requests, produce data reports, and aid in tracking Title V measures.

Enabling ongoing Title V program assessment, monitoring and reporting: The SSDI Coordinator and DAT staff support Title V by providing data and reporting support. In order to report consistently and on the most currently available data, the SSDI Coordinator assists with the creation of “special use” datasets from Vital Records as well as the identification of census population estimate files. This ensures that all staff are using the same datasets with consistent numerators and denominators to report on measures. The SSDI Coordinator and team are responsible for the completion of all Block Grant continuation application data forms and provision of these data to Title V staff to be entered into the Title V Information System (TVIS). SSDI also supports Title V by assisting with the creation of new NPM and ESM targets. New targets are created using federally available data and trend function methodology.

Each state’s Title V Program is charged with ensuring that pregnant women, women of childbearing age, infants, children, adolescents, and children with special health care needs have access to high quality primary and preventive health care services. Louisiana’s SSDI program has historically supported this through routine data linkage of birth and death records, hospital discharge, and Medicaid eligibility and claims; routine analyses and interpretation to support the annual Title V Block Grant submission, the cyclical Title V Needs Assessment, departmental data dashboards, and publications; and ad hoc data analyses for internal planning and policy initiatives, specialized data briefs, partner data requests, and legislative inquiries. The SSDI Coordinator has led or coordinated analytic efforts for many of the population health MCH measures for the Needs Assessment and grant reporting, working with other members of the DAT as applicable. SSDI in-kind support staff have also consistently provided data support for the five-year Title V Needs Assessment, priority and performance measures selection, annual reports, and evaluation. SSDI staff also participate in the annual federal block grant review process to learn the strengths and weaknesses of the application and potential ways to strengthen overall programming, data analytics and evaluation.

Key SSDI program activities:  While the five-year Needs Assessment represents a comprehensive approach to assessing MCH needs, emerging needs in each of the five maternal and child health domains are monitored on an annual basis with SSDI support. Stakeholders participating in ongoing needs assessment activities are provided with the most current data available for each of the selected priority indicators. Parish, regional and state level data depicting updated indicators are provided to stakeholders on a yearly basis for identification of priority geographical areas for program focus. The SSDI Coordinator and in-kind staff create data reports known as parish (county), regional and state profiles. The profiles include BFH’s most frequently requested data elements as well as those most relevant for MCH program planning. Currently, these reports are created and scheduled for dissemination at least twice a year. SSDI staff are working to automate these reports in order to make their utilization and dissemination easier for staff and stakeholders.  SSDI staff will continue to analyze the data, disseminate the profiles to MCH stakeholders and post the results on the BFH and Louisiana Department of Health (LDH) websites.

The SSDI Coordinator is instrumental in coordinating efforts to support the state and national SSDI goals. She is responsible for leading the efforts to support Title V monitoring and reporting functions, assisting with the development and utilization of key MCH datasets and supporting program evaluation activities. Specifically, she mobilizes the DAT epidemiologists to assist with the completion of Title V reporting, manages, updates and edits Vital Records and other supplemental datasets for utilization by all DAT epidemiologists and ensures that data validations and documentation are maintained for all indicator reporting and target setting. The SSDI Coordinator is also responsible for monitoring the progress of SSDI activities, budget and the completion of grant reporting such as progress reports and performance reports. The SSDI Coordinator effectively serves as the liaison between Title V leadership and the SSDI program, while also helping to ensure the integrity of data reporting, indicators and activities.