MCH Needs Assessment Priorities Setting Meeting Augusta Maine

MCH Needs Assessment Priorities Setting Meeting Augusta, Maine January 21, 2020

The Team • Maine Center for Disease Control Maryann Harakall, Maternal and Child Health Program Director • Altarum Brenda Wolford, Project Director Renee Schwalberg, Consultant • University of Southern Maine Erika Lichter, Associate Research Professor Barbara Poirier, Policy Associate Maine Center for Disease Control and Prevention 2

What is Title V? Maternal and Child Health Block Grant to states for the health of women, infants, children, and children with special health care needs Title V of the Social Security Act of 1935 Federal funds provided with a State maintenance of effort Maine Center for Disease Control and Prevention The oldest public health program in the nation States submit a report and plan annually and a needs assessment every 5 years • The needs assessment forms the basis for the 5 -year action plan 3

Needs Assessment Population health status in 5 domains: women’s and maternal health, perinatal and infant health, child health, adolescent health, and CSHCN Analyses of health data Surveys, advisory groups, feedback from the community Maine Center for Disease Control and Prevention 4

Priority Needs • Seven to 10 priority needs • Targeted interventions • Monitor progress using National and State performance measures Maine Center for Disease Control and Prevention 5

Key Informant Interviews Survey Methods Domain listening sessions Input forums Data analysis Maine Center for Disease Control and Prevention

Findings to Date • Compiled the data and identified the top 5 issues among all data sources • Under each issue, identified sub-issues that were discussed across the multiple data sources Maine Center for Disease Control and Prevention 7

Perinatal and Infant Health Data Source Top Priorities by Data Source Domain Listening Sessions 1. 2. 3. 4. Access to Care (score: 16) Drug-affected Babies (score: 11) Infant and Fetal Mortality (score: 10) Infant Care (score: 10) Community Input Forums 1. 2. 3. 4. 5. Social determinants of health Infant and maternal mental health/post-partum depression Substance exposed babies Infant mortality Breastfeeding Key Informant Interviews 1. 2. 3. 4. 5. Trauma /Abuse/ACEs Infant Mortality Substance Exposure Safe Sleep Breastfeeding Priorities Survey – Non-professional 1. 2. 3. 4. 5. Child abuse and neglect (56%) Parental drug and alcohol use during pregnancy (43%) Vaccinations (43%) Breastfeeding (37%) Parental mental illness (32%) 1. 2. 3. 4. 5. 6. Child abuse and neglect (50%) Parental mental illness (50%) Parental drug and alcohol use during pregnancy (46%) Parental substance abuse (46%) Vaccinations (27%) Breastfeeding (27%) (n = 909) Priorities Survey – Professional (n = 401) Maine Center for Disease Control and Prevention 8

Perinatal and Infant Health Top 5 Priorities • Access to care • Infant mortality • Drug-affected babies • Social determinants (ACEs) • Breastfeeding Maine Center for Disease Control and Prevention 9

Women and Maternal Health Top 5 Priorities • Access to care • Mental health • Substance use disorders • Maternal morbidity and mortality • Obesity Maine Center for Disease Control and Prevention 10

Child Health Top 5 Priorities • Access to care • Early childhood services • Social determinants • Mental health • Physical and oral health Maine Center for Disease Control and Prevention 11

Adolescent Health Top 5 Priorities • Mental health • Substance use • Access to family planning services • Bullying/harassment • Violence Maine Center for Disease Control and Prevention 12

Children with Special Health Care Needs Top 5 Priorities • Transition • Care coordination • State-level coordination • Access to care • Caregiver stress Maine Center for Disease Control and Prevention 13

Overview for Today Maine Center for Disease Control and Prevention 14

Background Handouts Information to assist with the priority rating process includes the following: Epidemiological data on prevalence, trends, and disparities Basic background information on the economic impact of the issue List of current priorities National performance measures as a reference Maine Center for Disease Control and Prevention 15

Priority Rating Criteria 1. 2. 3. 4. 5. 6. 7. 8. 9. Prevalence/magnitude Trend Impact across the lifespan Evidence-based interventions Health equity Measurable Leadership support Stakeholder support Economic impact Maine Center for Disease Control and Prevention 16

Criteria Rating Process • Review the priority rating tool for an explanation of criteria and rating scale. • Briefly discuss each criterion and use the blank template to rate each criterion on a scale of 1 -5. • The notetaker will tally the ratings and identify the top two issues in each domain. • Review the top two issues to ensure this is what the group wants for priorities. • Present top two priority issues to the full group, with rationale for choosing these issues based on the criteria. Maine Center for Disease Control and Prevention 17

National Performance Measures NPM Women/ Maternal Health Well-woman visit Low-risk cesarean delivery Perinatal/ Infant Health Risk-appropriate perinatal care Breastfeeding Safe sleep Child Health Adolescent Health Developmental screening Injury hospitalization Physical activity Bullying Adolescent well-visit Medical home Transition Preventive dental visit Smoking Adequate insurance Children with Special Health Care Needs Maine Center for Disease Control and Prevention 18

Your Mission • Break into groups by Domain. • Review the background materials provided. • Using the Priority Rating Tool, discuss the topics and rate the identified priority issues within your Domain. • Tally the results to identify 1 -2 priority needs. • Report out to the larger group. Maine Center for Disease Control and Prevention 19

Questions? Maryann Harakall Maternal and Child Health Program Director Maryann. harakall@maine. gov 207 -557 -2470 20