Oregon Maternal and Child Health Title V Grantee Webinar Oregon - PowerPoint PPT Presentation

Oregon Maternal and Child Health Title V Grantee Webinar Oregon Maternal and Child Health Title V Grantee webinar January 10 and Jan 12, 2017

Agenda • Welcome and webinar logistics • Recap of the implementation guidelines and plan/report due dates • Strategies for state-specific priorities – Food Insecurity (Robin Stanton) – Toxic stress, trauma/ACEs (Nurit Fischler) – Culturally/linguistically appropriate MCH services (Wendy Morgan) • New online form for Title V report and annual plan (Maria Ness and Matt Pittney) • Next steps and technical assistance resources 2

Title V Implementation Guidelines- Priority Selection National Priorities State-specific Priorities Well women care Toxic Stress, trauma, ACES Breastfeeding Culturally and linguistically responsive services Physical activity for children Food insecurity Adolescent well visit Oral health Smoking

Title V Implementation Guidelines: Priority Selection Title V Funding level Minimum # of priorities Less than $25,000 per year 1 $25,000 - $99,999 per year 2 $100,000 or more per year 3 All grantees must select at least one national priority to work on. Grantees working on more than one priority can also select state-specific and locally defined priorities.

Implementation Guidelines Strategy Selection – Encouraged to use a variety of strategies from menu of options to address priorities – Grantees working on more than one priority and/or strategy must select at least one strategy at the community, institutional, or societal level Level of influence Examples (spectrum of prevention) Individual/relationship level Strengthening individual knowledge and skills Community level Promoting community education; fostering coalitions or networks Institutional level Changing organizational practices, educating providers Societal level Influencing policy and legislation

Implementation Guidelines • Use of Title V Funds – No more than 10% for indirect costs – Up to 20% of Title V funds can be used for locally-identified MCH work that falls outside of Oregon ’ s Title V priorities and/or strategy menu if approved by OHA

Implementation Guidelines Annual Plan • Annual Plan with selected priorities, strategies, activities and measures due March 1, 2017. • Plan period July 1 2017 – June 30, 2018. Data tracking and reporting • Grantees must report on at least one measure for each strategy they choose to implement. Measures can be locally-defined. • First annual progress report due March 1 2017.

Oregon’s state-specific MCH priorities and strategies  Food Insecurity  Toxic stress, trauma, and ACEs  Culturally and Linguistically Accessible Services (CLAS) 8

State specific Title V priority: Food Insecurity Title V Goal: Reduce food insecurity in families to ensure access to a healthy and nutritious diet for optimal health and development. State Performance Measures: A. Percent of households experiencing food insecurity B. Percent of households with children < 18 years of age experiencing food insecurity State Title V Lead for Food Insecurity: Robin Stanton Robin.w.Stanton@state.or.us (971) 673-0261 9

What is Food Insecurity? Household food security = access by all members at all times to enough food for an active, healthy life. Includes at a minimum: …. and Food Insecurity? Is the limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways (not having to resort to emergency food supplies, scavenging, stealing or other coping strategies). What is Hunger? A potential consequence of food insecurity that results in discomfort, illness, weakness, or pain that goes beyond the usual uneasy sensation. USDA uses the description “very low food security”. USDA Infographic 10

Food Insecurity • Rates remain higher than national average • Oregon rates remain higher than before the recession • FI has significant impacts on health and development 11

Strategies to Reduce Food Insecurity 1. Screen clients for food insecurity* 2. Provide referrals for food assistance* *screening and referral strategies are linked 3. Address risk factors related to food insecurity (eg access, cost & health outcomes, social determinants) during clinic visits 4. Support or provide food security education 12

Strategies to Reduce Food Insecurity 5. Advocate, support or develop partnerships for accessibility to healthy & affordable food; consider wide array of partnerships beyond public health and food advocacy groups 6. Promote access to healthy and affordable food 7. Improve access to food assistance safety net programs 8. Increase economic stability for individuals and families 13

State specific Title V priority: Toxic stress/trauma/ACEs Title V goal: Reduce exposure to toxic stress, trauma and adverse childhood experiences (ACEs); and promote resilience among Oregon’s children, youth and families, and communities. State performance measure: A.) Percentage of new mothers who experienced stressful life events before or during pregnancy. B.) Percentage of mothers of 2 year olds who have adequate social support. State Title V lead for trauma/ACEs : Nurit Fischler nurit.r.fischler@state.or.us 971 673-0344 14

Toxic stress/trauma/ACEs  Adverse childhood experiences and other forms of trauma (historic and personal) are common. 41% of Oregonians have experienced 2 or more ACEs.  Individual and community level protective factors can enhance resiliency an buffer the effects of adversity and trauma. - Relationship is key including: secure attachment, stable and responsive parent/child relationships, meaningful peer and adult relationships for youth, social support, connection to community, culture, and spirituality.  Title V programs promote safe, stable and nurturing relationships and environments - Across the lifecourse - Across settings - Across the spectrum of prevention - Across cultures, ethnicities, and races 15

Shared principles in applying the findings of the ACEs study in Oregon* – Invest upstream in prevention and resiliency – Identify risk early and intervene early – Work across the lifespan – Build bridges across systems – Use data to drive decision-making – Develop a skilled workforce – Empower self-organizing communities * From Ford Family Foundation report: The Adverse Childhood Experiences Study: How are the findings being applied in Oregon?; August 2014

Strategies: Toxic stress/trauma/ACEs 1. Promote family friendly policies that decrease stress and adversity for all parents, increase economic stability, and/or promote health. 2. Provide outreach and education on the importance of early childhood, NEAR* science, and the impact of childhood adversity on lifelong health. 3. Develop community partnerships, inter-agency collaborations, and cross-systems initiatives to prevent/address ACEs and trauma. 17

Strategies: Toxic stress/trauma/ACEs 4. Conduct assessment, surveillance, and epidemiological research. Use data and NEAR* science to drive policy decisions. 5. Develop a trauma-informed workforce and workplaces. 6. Integrate trauma-informed care and culturally-specific approaches into services and systems for children, adolescents and families. 7. Identify children, youth and families experiencing adversity and connect them to needed supports and services. 18

Strategies: Toxic stress/trauma/ACEs 8. Implement community level equity initiatives, and trauma and violence prevention programs. 9. Build community capacity for cohesion, safe and secure places, and equitable opportunities. 10. Strengthen protective factors for individuals and families; support programs that build parent capabilities, social emotional competence, and supportive/nurturing relationships; and foster connection to community, culture and spirituality. 19

State Specific Priority #3: CLAS Standards Culturally and Linguistically Appropriate Services Title V goal: Improving culturally and linguistically services is an important way to address health disparities. Race/ethnicity is a leading determinant of health outcomes, and improving CLAS among MCH populations will lead to better health for families. State performance measure: • A. Percentage of children age 0 - 17 years who have a healthcare provider who is sensitive to their family’s values and customs; • B. Percentage of new mothers who have ever experienced discrimination while getting any type of health or medical care State Title V Lead for CLAS : Wendy Morgan wendy.morgan@state.or.us 971 673-0353 20

CLAS Standards: Strategies • Strategy 1: Provide effective, equitable, understandable, and culturally responsive services • Strategy 2: Develop and improve organizational policy, practices, and leadership to promote CLAS and health equity • Strategy 3: Recruit, promote and support a culturally and linguistically diverse workforce that reflects local communities. • Strategy 4: Educate and train leadership and workforce CLAS policies and practices on an ongoing basis. • Strategy 5: Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them. 21