The Interagency Agreement (IAA) between the Ohio Department of Health (ODH), which includes Title V MCH, and the Ohio Department of Medicaid (ODM), Title XIX, is updated biannually. The cooperative agreement between ODH and ODM codifies the relationship of shared responsibilities in regard to:

1) Coordination of health services, conducting outreach, program eligibility, and payment for services for Ohio citizens;

2) Performing environmental lead risk assessments for Medicaid-eligible children identified as having elevated blood lead levels;

3) Performing lead hazard abatement activities in the homes of low-income children and pregnant women;

4) Reimbursement of ODH bureaus and/or local public health departments for Medicaid administrative activities provided by them;

5) Maintaining and enhancing the statewide automated Immunization Information System (Impact/SIIS) including the Vaccines For Children Program (VFC) through a collaborative exchange of electronic data from ODM to ODH;

6) Reimbursing ODH the cost of operating the Ohio Tobacco Quit Line to the extent it complies with the State Medicaid Letter (SMDL #11-007) dated June 24, 2011; and

7) Defining the relationships and responsibilities between the parties for the conduct of desk reviews, interim settlements, field audits, and final settlements for ODH's for Children with Medical Handicaps Program (CMH).

As of application submission, the 2021-2023 IAA is in the official authorization and signature process with ODH and ODM leadership and includes the same attachments for key topics as the included 2019-2021 IAA:             

• A- Maternal and Child Health (p9)
• B- Lead (p13)
• C- Medicaid Administrative Claiming (MAC) (p19)
• D- Immunizations (p89)
• E- Smoking Cessation (p93)
• F- Children with Medical Handicaps (p97)
• G- Definitions (p101)
• H- Metabolic Formula (p107)
• I- ODH and ODM System Access (ODM QDSS and ODH Warehouse) (p109)
• J- WIC (p111)

The Title V program facilitates enrollment in Medicaid through a number of programs. Per the ODH IAA with Medicaid, programs, such as WIC, are required to make families aware of Medicaid. Reproductive Health and Wellness Program sites are required to ensure that a Certified Application Counselor (CAC) or Navigator is available to assist Title X clients with Marketplace enrollment as well as ensuring eligible Title X clients are assisted with enrollment into Medicaid. Both ODH and ODM also invest in community workers who are able to facilitate outreach and identification of women and families and support them in connecting to and completing the process for coverage. Funded models of community workers include Community Health Workers, home visitors, and Ohio Equity Institute: Working to Achieve Equity in Birth Outcomes Neighborhood Navigators.

ODH conducts a bi-weekly case conference with the Ohio Department of Medicaid (ODM) to review individual cases where families are experiencing challenges with coverages through MCPs. This process has proven beneficial not only in remediating challenges for individual families, but also in driving policy change and clarification between ODM and the plans. ODH participated in the development of the solicitation for the renegotiation of contracts with the MCPs. ODH will continue to conduct case conference and will assist with orienting new managed care organizations (if any) about the specialized needs of Ohio’s CYSHCN population.

ODM and ODH continue to partner on coordination of infant vitality efforts. Starting in FY 2018, ODM required managed care agencies to provide enhanced prenatal and maternal care through infant vitality efforts. In determining and informing implementation of the strategies for ODM’s infant vitality funding, ODH was an equal partner in identifying evidence-based strategies, scoring and common metrics. Since establishment and investment in these efforts, ODH and ODM continue to work to align investments more effectively through evaluation of these efforts. ODH has also allowed and encouraged the epidemiologists funded through the Ohio Equity Institute: Working to Achieve Equity in Birth Outcomes program to support ODM-funded entities in effective data analysis of local birth outcomes data. ODH participates in bi-weekly meetings with ODM to ensure immediate access to relevant state infant vitality information for funded entities. This collaboration continues to be an important way for ODH and ODM to coordinate infant vitality efforts at the local level.

The Infant Mortality Research Partnership (IMRP), a collaboration between state agencies, researchers, and subject matter experts, uses big data to gain a better understanding of how to lower infant mortality in Ohio. The IMRP team includes the ODH, ODM, Ohio Department of Higher Education, and university researchers across multiple disciplines such as biostatistics, pediatrics, and geography. The current phase of this work 1) expands upon the spatiotemporal analysis to develop a mapping tool to longitudinally assess changes in preterm birth, low birthweight, and infant mortality over time by census tract; 2) developed a health opportunity index by census tract to align health opportunity with birth outcomes; and 3) used the results of the data analytics to develop a risk calculator to predict one-day mortality, very preterm birth (<32 weeks), or preterm birth (<37 weeks) using clinical data. The results will improve upon and expand the previously developed models that focus on factors that increase risk, such as those related to social and behavioral health or structural and institutional factors. Future plans include field testing the risk calculator within a Maternal-Fetal Medicine clinic to inform any edits/refinements of the calculator and incorporation of the calculator into one hospital system electronic health record.

ODH WIC is working closely with the InnovateOhio Platform (IOP) staff on a Medicaid/SNAP/TANF cross-enrollment project. The IOP is an initiative lead by Ohio’s Lieutenant Governor to provide integrated and scalable capabilities that enable state agencies to become more customer-centric and data-driven.

In January 2020, ODM was awarded the Integrated Care for Kids Model (INK) grant through the Centers for Medicare & Medicaid Services’ Center. Ohio’s Title V program is on the partnership council for the project which plans to address behavioral and medical needs of children and improve coordinated care in rural communities. In 2021, Nationwide Children’s Hospital (NCH) assumed responsibilities for the seven-year cooperative agreement with continued partnership from ODM and the partnership council. The planning period began in January 2020, with the council planning interventions and designs to improve care coordination for kids. Implementation will take place in years three through seven (2022-2026) for the planned interventions, and the council will track progress toward meeting program goals.