Association of State Public Health Nutritionists Annual Meeting June - - PowerPoint PPT Presentation

Association of State Public Health Nutritionists Annual Meeting

June 11, 2018

Laura Kavanagh, MPP Acting Associate Administrator Maternal and Child Health Bureau (MCHB) Health Resources and Services Administration (HRSA)

HRSA Overview

• Mission: To improve health and achieve health equity

through access to quality services, a skilled workforce, and innovative programs

• Provides grants and cooperative agreements to more than

3,000 awardees, including community and faith-based

• rganizations, colleges and universities, hospitals, state,

local, and tribal governments , and private entities

• Serves tens of millions of people, including people living

with HIV/AIDS, pregnant women, mothers and their families, and those unable to access quality health care

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HRSA-wide Efforts

• Priority Workgroup on Childhood Obesity
• Representatives from across HRSA Bureaus and Offices
• Develop innovative and collaborative solutions to

address childhood obesity

• Several pilot projects underway
• RD Collaborative
• Part of a HRSA-wide effort convening staff clinicians to

leverage skills and expertise

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HRSA Supports Primary Care

Community Health Centers

• Roughly 1,400 centers operate more than 10,400 service delivery sites

across the U.S. and territories

• Nearly 26 million people rely on a HRSA-funded health center for care,

including 1 in 10 children

• Health centers exceed national averages for pediatric patients who receive

weight assessment and counseling for nutrition and physical activity à In 2016, 62.9% of patients ages 3 to 17 had BMI % and counseling documented Health Workforce

• Improves the health of underserved and vulnerable populations
• Strengthen the health workforce and connect skilled professionals to

communities in need

• Approximately 10,200 National Health Service Corps and 1,900 NURSE

Corps clinicians provide care to over 12 million people nationwide, including

• ver 3.5 million rural residents

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HRSA Supports Rural Health

• The Federal Office of Rural Health Policy provides policy

support to the Office of the Secretary and supports a number of rural health programs, including rural health networks and telehealth

• Rural grantees are addressing childhood obesity through:
• Delta States Rural Development Network Program
• School-based Telehealth Network Grant Program
• Rural research projects
• Create County- and Census Tract-Level Estimates of

Childhood Obesity in the United States

• Identifying Obesogenic Communities in the United States
• Childhood Obesity Toolkit for Rural Areas

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HRSA Supports Maternal and Child Health

• Title V MCH Block Grant Program
• Title V programs include strategies specific to childhood obesity prevention
• Of the 15 National Performance Measures, two are obesity-prevention/

management related: Breastfeeding (NPM 4; 50 states/jurisdictions selected) and Physical Activity (NPM 8; 27 states/jurisdictions selected)

• Children’s Healthy Weight Collaborative Improvement and Innovation Network

(CoIIN)

• Platform for sharing and testing evidence-informed and evidence-based

best practices across communities and states in order to address a common issue

• Strengthen states' efforts to address the National Performance Measures

and National Outcome Measure related to obesity management and prevention

• Support the implementation of policies and practices related to nutrition,

physical activity, and breastfeeding

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HRSA Supports Maternal and Child Health

• Childhood Obesity Grand Challenge – Using Technology to

Prevent Childhood Obesity in Low-Income Families and Communities

• Use innovative challenge mechanism to engage with non-

traditional partners to the develop multiple novel and scalable interventions

• Currently in the Design Phase
• Expert Panel consists of key stakeholders

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HRSA Supports Maternal and Child Health

• MCH Nutrition Training Program
• Currently fund 6 Centers of Excellence in MCH Nutrition
• Training focuses on leadership in pediatric and maternal nutrition and is

designed to provide both clinical and public health approaches to working with MCH populations

• Expanding program; new cycle begins July 1st with 8 grantees
• Childhood Obesity Enhancement projects
• Partnership with ASPHN
• Provide national and state leadership
• Bolster the public health nutrition workforce
• Promote intersection between clinical, public health, and community

nutrition

• Coordinate MCH Nutrition Council

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HRSA Supports Maternal and Child Health

• Bright Futures
• HRSA-supported program with the American Academy of Pediatrics
• Provides evidence-informed, age-appropriate recommendations and

anticipatory guidance for preventive well-child visits for clinicians and parents

• New effort: develop content-specific training and implementation tools for

primary care clinicians in settings such as health centers

• Focus on effective weight assessment and counseling for nutrition and

physical activity

• Develop and test electronic health record/health information technology

tools

• Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV)
• Gives pregnant women and families, particularly those considered at-risk,

necessary resources and skills to raise children who are physically, socially, and emotionally healthy and ready to learn

• Provides guidance to caregivers on nutrition and physical activity
• Includes performance measures on breastfeeding, well child visits

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HRSA Supports Maternal and Child Health

• Healthy Start
• Initiative targeted to the needs of vulnerable mothers and

infants living in communities with exceptionally high rates

• f infant mortality
• Healthy Start Breastfeeding Training Initiative aims to

increase breastfeeding initiation and duration rates to those set in Healthy People 2020

• Research and Data
• Healthy Weight Research Network
• National Survey of Children’s Health

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Title V of the Social Security Act

Maternal and Child Health (MCH) Services Block Grant

Application/Annual Report Guidance

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Instructions to states/ jurisdictions for preparing and submitting an Annual Report, Application and Five-year Needs Assessment, per legislative requirements

Application/Annual Report Guidance

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Guiding Principles

Delivery of Title V services within a public health service model Data-driven programming and performance accountability Partnerships with individuals/families/ family-led organizations (i.e., family partnership)

Application/Annual Report Guidance

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• Consistent with the block grant concept, the Maternal

and Child Health (MCH) Application/Annual Report Guidance retains the rights of each state/jurisdiction to:

• Determine its own MCH priority needs;
• Develop tailored strategies for addressing the

identified needs; and

• Assume accountability in achieving measurable

progress towards stated program goals.

• Narrative and data reporting requirements in the

Application/Annual Report Guidance are based on the Title V legislative requirements, with consideration given to reducing burden for states wherever possible.

Performance Measure Framework

Characteristics

• National Performance Measures (NPMs) are tied to one of five

MCH population domains:

• Women’s/Maternal Health
• Perinatal/Infant Health
• Child Health
• Adolescent Health
• CYSHCN
• States choose at least five of the 15 NPMs across the five

population domains (one in each domain).

• Data from federal partners are prepopulated for NPMs and

National Outcome Measures (NOMs).

• States identify strategies and develop at least one related

Evidence-Based or -Informed Strategy Measures (ESMs) for each selected NPM.

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State MCH Block Grant Program

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NPM # National Performance Priority Areas MCH Population Domains 1 Well-woman visit Women/Maternal Health 2 Low-risk cesarean delivery Women/Maternal Health 3 Risk Appropriate Perinatal Care Perinatal/Infant Health 4 Breastfeeding Perinatal/Infant Health 5 Safe sleep Perinatal/Infant Health 6 Developmental screening Child Health 7 Injury Hospitalization Child Health and/or Adolescent Health 8 Physical activity Child Health and/or Adolescent Health 9 Bullying Adolescent Health 10 Adolescent well-visit Adolescent Health 11 Medical home Children with Special Health Care Needs, Child and Adolescent Health 12 Transition Children with Special Health Care Needs and Adolescent Health 13 Preventive Dental Visit – Pregnancy Preventive Dental Visit – Child/Adolescent

Women/Maternal Health, Child Health and/or Adolescent Health

14 Smoking – Pregnancy Smoking – Household

Women/Maternal Health, Child Health and/or Adolescent Health

15 Adequate insurance

Child Health, Adolescent Health and/or Children with Special Needs

Title V Information System (TVIS)

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Title V Information System (TVIS)

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NPM #4 – Title V Information System

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NPM #8 – Title V Information System

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NOM #20 – Title V Information System

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ESMs - Title V Information System

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Priority Needs - Title V Information System

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Select Region(s), State(s) or National Select one

• r more

Domain(s) Narrow the search with a Key Word Download the results to Excel for further analysis

Priority Needs - Title V Information System

Key Word Search: Nutrition

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