Wisconsin’s ongoing needs assessment activities and the extent to which families, individuals, and other stakeholders were engaged in the process

The Wisconsin Title V Program hired two Community Partnership Specialists in 2021; one specialist dedicated to partnering with Black communities, and one specialist dedicated to partnering with Indigenous communities. These specialists have been working to build trust and rapport among community members for the past year, and the Title V Program will work with them in 2022 to implement various community conversations.

Maternal and child health advisory committee meetings were discontinued in 2021. When asked, committee members identified that participation was important to them because they wanted to receive programmatic updates from Title V regularly. Since this need can be fulfilled in other ways and is not advisory in nature, the Title V Program is working to identify other opportunities to incorporate public input into action plan development and block grant submission.

Noted changes in the health status and needs of Wisconsin’s maternal and child health population, as compared to identified priority needs for the block grant

The 2020 MCH Needs Assessment was completed prior to the development of both the COVID-19 pandemic and the resurfacing of racism as a topic of public health urgency, and as a result, may not accurately reflect current health concerns of Wisconsin residents. Despite this, the Title V Program’s review and categorization of over 500 unique needs assessment themes did identify and intentionally address equity, racial justice, as well as access to quality health services – themes that permeate these emerging health concerns in Wisconsin. The State Systems Development Initiatives Program plans to implement ongoing needs assessment activities in the coming year to capture shifts in public health concerns in Wisconsin’s current landscape, to reconcile any major changes to the 2020 MCH Needs Assessment findings.

Some areas being monitored by the Title V Program currently include social connection, mental health and isolation, breastfeeding initiation, developmental screening and early intervention, and physical activity.

Noted changes in Wisconsin’s Title V Program Capacity or its maternal and child health systems of care, particularly for children and youth with special health care needs, and the impact of these changes on maternal and child health services delivery

Trainings and events continued to be offered in a virtual format throughout 2021. This approach has increased reach to families and professionals with fewer trainings. However, the redirection of local and tribal health agency efforts to respond to the COVID-19 pandemic resulted in lower local capacity for the crucial engagement, coordination, and referral functions that they play for Wisconsin’s families. The Title V Program is beginning to see in early 2022 that with the increase of vaccinations and decrease in new COVID-19 cases, local staff can start returning to maternal and child health-focused work. As of April 2022, many local and tribal health agencies have expressed interest and enthusiasm in being able to return to pre-pandemic projects.

The breadth of Wisconsin’s Title V partnerships and collaborations with other federal, tribal, state, and local entities that serve the maternal and child health population

The Wisconsin Title V Program spent time in late 2020 intentionally reviewing current, past, and potential partnerships or collaborations with maternal and child health-focused organizations throughout the state. The team agreed that becoming more involved, or “showing up” to many of these organizations moving forward, is vital to the progress of Title V work in the state, as well as the program’s commitment to advancing equity and racial justice.

The Title V Program has strong relationships with all local and tribal health agencies in Wisconsin, and funds them to implement projects at the local level to advance Title V performance measures. The Title V Program is also proud of recent partnerships with Wisconsin Medicaid to implement innovative policy initiatives that expand access to doula services and improve prenatal home visiting services. Wisconsin’s Title V Program is actively working to strengthen partnerships with the state WIC program and local WIC projects in addition to community-based organizations such as the African American Breastfeeding Network and Roots 4 Change community health worker collective.

Wisconsin Title V Program partnerships include national, statewide, local, and tribal affiliations:

National Partnerships

• Coffective
• Association of State Public Health Nutritionists
• National Institute for Children's Health Quality
• National Action Partnership to Promote Safe Sleep Improvement Innovation Network
• United States Breastfeeding Committee
• Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity
• AMCHP Family Engagement Community of Practice
• AMCHP Leadership Lab mentor for Family Leaders
• Advancing Systems of Services for Children and Youth with Special Health Care Needs Café
• Region V Maternal and Child Health Leaders
• Maternal and Child Health National Workforce Development Center
• Go NAPSACC (Nutrition and Physical Activity Self-Assessment for Child Care)
• Council of State and Territorial Epidemiologists
• National Network of Child Psychiatric Consultation Programs
• American Public Health Association MCH Section Leadership
• National Resource Center for Patient/Family-Centered Medical Home

Statewide Partnerships

• Home Visiting, Department of Children and Families
• Wisconsin Child Welfare Professional Development System
• Children's Hospital of Wisconsin
• Department of Health Services Children's Long-Term Support Waiver Program
• Wisconsin Alliance for Women's Health
• Prenatal Care Coordination Taskforce
• Fetal Infant Mortality Review Team
• Family Voices of Wisconsin
• Wisconsin Association for Perinatal Care
• WIC Program
• Office of Children’s Mental Health
• Regional Centers for Children and Youth with Special Health Care Needs
• Children's Health Alliance of Wisconsin
• Wisconsin Early Childhood Collaborating Partners
• The Periscope Project
• Wisconsin Breastfeeding Coalition
• Birth to 3 Program
• Wisconsin Department of Justice Office of Crime Victim Services
• Wisconsin Association of Lactation Consultants
• ABC for Health Inc.
• Facebook group for black families of Children and Youth with Special Health Care Needs
• Healthy Early
• Wisconsin Initiative for Stigma Reduction
• Wisconsin Doulas of Color Collective
• Medicaid Services
• Mental Health America
• Children's Committee of the Governor's Council on Mental Health
• Wisconsin Perinatal Quality Collaborative
• Medical College of Wisconsin
• Wisconsin Coalition Against Sexual Assault
• HealthWatch Wisconsin
• Wisconsin Child Abuse and Neglect Prevention Board
• Wisconsin Parent Leadership Collaborative
• Aligning for Adolescent Health
• Wisconsin Care Integration initiative
• Wisconsin Integrated Transition Planning Coalition
• Act Early Wisconsin
• Wisconsin Community on Transition
• Bureau of Children Services Program Access Project
• Children’s Long-Term Support Council
• Providers and Teens Communicating for Health (PATCH) Program
• healthTIDE
• YoungStar, Department of Children and Families
• University of Wisconsin-Madison Division of Extension
• Wisconsin Technical College System
• Supporting Families Together
• Lived Experiences Group Input Team
• Division of Medicaid Services Customer First Strategy workgroup

Local Partnerships

• Parent support groups based on child's condition or disability
• Milwaukee Health Department Office of Violence Prevention
• Harambee Village Doulas
• Public Health Madison Dane County
• Wisconsin Child Welfare Professional Development System
• African American Breastfeeding Network
• Foundation for Black Women's Wellness

Tribal Partnerships

• Native Breastfeeding Coalition
• Tribal Health Centers and Community Health Centers
• Great Lakes Inter-Tribal Epidemiology Center

Efforts undertaken by Wisconsin to operationalize its 5-year needs assessment process and findings

The State Systems Development Initiatives Program has developed a plan for ongoing needs assessment activities throughout the 5-year cycle. A core team of Title V Program epidemiologists will work with the State Systems Development Initiatives Coordinator to implement and analyze ongoing needs assessment findings during interim years. The State Systems Development Initiatives Coordinator is immersed in all action planning activities for the Title V Program, ensuring that needs assessment findings and subsequent priority needs are incorporated throughout all planning and coordination of programmatic activities and objectives. This work will continue throughout the entire five-year block grant cycle.

Changes in organizational structure and leadership

The Title V Program hired a new Title V Director and Maternal and Child Health Unit Supervisor, Fiona Weeks, in January 2021. Fiona has a Bachelor’s degree in Sociology and Community Health from Tufts University and a Master of Science in Public Health from the Johns Hopkins University, with a focus on perinatal health and a graduate certificate in Maternal and Child Health. She was a recipient of the MCH Training grant and completed a post-graduate Population Health Service Fellowship through the University of Wisconsin. She is also a doctoral candidate in Population Health at the University of Wisconsin. Before moving into this role, she served as the Title V Maternal and Child Health Epidemiologist and Project Director for Wisconsin PRAMS from 2017-2021.

The Wisconsin Department of Health Services’ Bureau of Community Health Promotion hired a new Chief Medical Officer, Dr. Jasmine Zapata, in May 2021. Dr. Zapata is a dual-board certified physician in pediatrics and preventive medicine, has a Master of Public Health, and is widely recognized as a community leader and advocate. She has worked as a physician, public health researcher, assistant professor at the University of Wisconsin, and is also an author and advocates for youth empowerment through a variety of initiatives. Dr. Zapata works closely with Title V Leadership.

The Wisconsin Department of Health Services hired a new State Health Officer and Division of Public Health Administrator, Paula Tran, in September 2021. Paula has been a strong public health leader in Wisconsin for more than 10 years and works closely with Title V Program Leadership. She has led and developed community-engaged research projects, statewide health equity efforts and cross-sector alliances, and provided training and technical assistance to affect the social, economic, and environmental determinants of health to advance health equity. Paula has her Master of Public Health degree and Bachelor of Science in Biology from the University of Wisconsin-Madison.

Emerging Issues

The long-term impacts of the COVID-19 pandemic on both maternal and child health populations and the public health workforce are still emerging. While telehealth has made health services and some social supports, like WIC, more accessible to some families, others are still limited by broadband access; moreover, some services, like blood lead screening, cannot be effectively delivered virtually. The Wisconsin Title V program is exploring how to better leverage the new normal of offering virtual services where possible to maximize our reach, while monitoring equity in access to virtual services.

Additionally, the Title V workforce has moved to a hybrid work model, which has also impacted how we work within our teams and how we reach partners and communities. The option to conduct virtual site visits has increased efficiency and decreased the time and travel burden on staff. However, a lack of in-person interaction among and between teams has created openings for misunderstanding and missed opportunities. The Title V program is exploring processes for better onboarding of new staff and opportunities for team building to foster the success of and collaboration among staff in order to optimize program impact.

Five-Year Needs Assessment Summary

(Next submission 2025)