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MCAH Title-V Local Capacity Assessment

MCAH Title-V Local Capacity Assessment. Sandra Copley MCAH Director Field Nursing Program Manager. Overview. Goals of the Assessment Essential Services Santa Barbara County Population Focus Areas Worse than CA Worse than HP2010 Worsening local indicators

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MCAH Title-V Local Capacity Assessment

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  1. MCAH Title-V Local Capacity Assessment Sandra Copley MCAH Director Field Nursing Program Manager

  2. Overview • Goals of the Assessment • Essential Services • Santa Barbara County Population • Focus Areas • Worse than CA • Worse than HP2010 • Worsening local indicators • 27 Health Indicators

  3. Focus • Primary Focus – assessing the capacity of the local MCAH System to carry out the 10 Essential Public Health Services to Promote Maternal & Child Health in America • Includes assessment of local capacity and all organizations that serve the MCAH population in our jurisdiction • Increase knowledge of MCAH Program Community-wide

  4. Goals of Local MCAH Program • MCAH Goals: • All children will be born healthy to healthy mothers • No health status disparities among racial/ethnic, gender, economic and regional groups • A safe and healthy environment for women, children and their families • Equal access for all women, children and their families to appropriate and needed care within an integrated and seamless system

  5. TenEssential Service Areas 1. Monitor health status to identify and solve community health problems 2. Diagnose and investigate health problems and health hazards in the community 3. Inform, educate, and empower people about health issues 4. Mobilize community partnerships and action to identify and solve health problems 5. Develop policies and plans that support individual and community health efforts

  6. Ten Essential Service Areas - Continued 6. Enforce laws and regulations that protect health insurance and safety 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable 8. Assure a competent public and personal health care workforce 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services 10. Research for new insights and innovative solutions to health problems

  7. Population by City SBC 2008 Estimates N = 428,665 21% 21% 10% 7% 3% 2% 1% 1% 34%

  8. Population by Adult Education Level SBC 2006 Estimates

  9. Population by Age Group SBC 2008 estimates

  10. Population by Race/EthnicitySBC 2008 Estimates 54.3% 36.7% 4.4% 2.5% 0.6% 1.5%

  11. 27 Health Indicators for Title V Needs Assessment

  12. Focus Areas Worse than CA • Local indicators worse than CA • Teen Births • Early Prenatal Care • Overweight Children

  13. Worse than CA: (2B)Births to Teens (age 15-17), SBC and CA 2002-2006 HP2010= 43 per 1,000

  14. Births to Teens (age 15-17)By Race/Ethnicity (addendum 2B)SBC and CA 2002-2006 HP2010= 43 per 1,000

  15. Prenatal Care Begun 1st TrimesterSanta Barbara County and California2002-2006 Percent HP2010 > 90%

  16. Prenatal Care Begun 1st Trimester by Race/Ethnicity Santa Barbara County 2002-2006 Percent HP2010 > 90%

  17. Worse than CA:Overweight Children (age 5-19) (#19B)SBC and CA , 3 Yr. Averages HP2010 = 5.0 PedNSS – local income children in federally funded MCAH programs – not to general population

  18. Focus Areas Worse than HP2010 • Select local indicatorsworse than HP2010 • Low birth weight births (<2500g) * • Very low birth weight births (<1500g) • Preterm births • Post-Neonatal death rate • Early Prenatal care • Overweight children

  19. Worse than HP2010:Percent of Low Birth Weight (#3)(< 2,500 g) SBC and CA 1997-2006 HP2010 = 5.0

  20. Worse than HP2010:Percent of Very Low Birth Weight (#4) (< 1,500 g) SBC and CA 1997-2006 HP2010 = 0.90

  21. Worse than HP2010:Preterm Births (< 37 weeks)(#5)SBC and CA 2002-2006 HP2010=7.6

  22. Worse than HP2010:Post-Neonatal Death Rate per 1,000 births, SBC 2002-2006(#10) HP2010=1.2 Post-neonatal deaths: are deaths occurring between > 28 to 365 days

  23. Focus Areas Worsening local indicators • Local indicators worsening over time • Injury hospitalizations (non-fatal, ages 15-24) • Injury hospitalizations for motor vehicle accidents (non-fatal, age 15-24) • Children living in foster care • Chlamydia rate (females 15-19) • Overweight children • Low Birth Weight live births

  24. Worsening local indicators:Injury Hospitalizations (age 15-24) Non-fatal, SBC and CA 3 Yr. Avg. (#23A)

  25. Worsening local indicators:MVA Hospitalizations (age 15-24) Non-fatal, SBC and CA 3 Yr. Avg. (#24 B)

  26. Worsening local indicators:Children Living in Foster Care (#25)SBC and CA, July 2007 Source: CWS/FHOP

  27. Worsening local indicators:Chlamydia Rate per 1,000 Females (age 15-19), SBC 3 YR. Averages (#21)

  28. Focus Areas Additional • Additional local indicators • Uninsured children (age 0-18) • Child (age 2-11) dental visits • Child (age 2-11) dental insurance • Exclusive breastfeeding at hospital discharge PENDING 2007 DATA from CHIS

  29. Additional:Uninsured Children (age 0-18) SBC and CA 2001,2003,2005 (#16)

  30. Additional: Frequency of Child Dental Visits,(age 2 – 11) SBC and CA 2005 (#18)

  31. Additional:Children without Dental Insurance, (age 2 to 11) SBC and CA, 2005 (#17)

  32. Additional:Exclusive Breastfeeding Rates By Hospital, SBC 2007(#15) HP2010=75.0 SBC AVG = 56.7

  33. Notable Data Highlights • Local percent of childhood overweight (ages 5-19) was the only Title V indicator higher than CA, HP2010, and over time • Low Birth Weight worse than HP 2010 and moving away from the goal

  34. Data Highlights - continued • Local percentage of early prenatal carewas worse than for CA and HP2010, but getting better locally from 1995-2006 • Injury/MVA hospitalization rates (age 15-24) haveincreased locally over time, but are lower than CA

  35. Community Strategic Responses/Collaboratives • MCAH Scope of Work • Kids Network Health Goals and Indicators • United Way • First 5

  36. MCAH Scope of Work • Provide information on community resources, services and referrals to the MCAH population • Promotes community-wide collaboration in the development and implementation of outreach programs and non-duplication of services • Provides a Perinatal Service Coordinator

  37. MCAH Scope of Work – Field Nursing • SIDS program • Promotes Health Insurance Coverage for Children • Promotes a decreasing incidence of overweight children • Promote early access/entry into prenatal care • Promote a decreasing incidence of births to teens 17 & under • Promote dental care for children and you 0-18 y/o • Promote a decreased incidence of substance use for pregnant and parenting women • Promote access to care for women with PPD • Continue to promote the decreasing incidence of maltreatment of children younger than 18 • Continue to collaborate with Children’s System of Care • Maintain collaborative partnership with First 5 Welcome Every Baby

  38. Top MCAH Priority Areas for FY 05-10 • Children without Insurance • Overweight Children • Births to Teens 17 yrs and under • Early Entry into prenatal care • Perinatal Substance Abuse and Teen Drug Use • Dental Care 0-18 yrs

  39. Community Strategies • Kids Network • United Way • First 5

  40. Essential Service # 5 • Provide leadership for priority setting, planning, and policy development to support community efforts to assure the health of women, children, youth and their families. • What are our capacity needs?

  41. Essential Service # 5 - Continued Strengths • Kids Scorecard and Collaborative process • Community Health Status Report includes key MCAH factors and is used county-wide • Collaborative efforts with coalitions and collaboratives have been maintained

  42. Essential Service # 5 - Continued Weaknesses: • MCAH Data from Field Nursing not readily available to the public • Lack of annual communication mechanism about MCAH with stakeholders • MCAH Epi 10% - may need more at critical times • MCAH needs more involvement in the implementation of joint local and State initiatives/policies that directly effect the MCAH population

  43. Essential Service # 5 - Continued Opportunities: • Is an MCAH Advisory Committee warranted? • Annual communication about MCAH with stakeholders? Threats: • Fragile economy and limited spending/changes for all government-related services • Further PHD cuts for fiscal solvency

  44. Capacity Needs • How can the capacity of Essential Service # 5 be improved? • What are the potential challenges on improving this capacity (e.g., impact on local MCAH services, stakeholder concerns, availability of resources). • How can other local organizations, local jurisdictions or the State MCAH Program help improve this capacity?

  45. Essential Service # 7 • Link women, children, and youth to health and other community and family services, and assure access to comprehensive, quality systems of care. • What are our Capacity Needs?

  46. Essential Service # 7 - Continued Strengths • Local networks and public/private partnerships in the community • Diverse staff with strong community ties • Cross-divisional and inter-agency collaboration

  47. Essential Service # 7 - Continued Weaknesses: • Staffing shortages and cuts in the PHD Field Nursing Unit • The MCAH Director has had responsibilities away from community needs secondary to organizational changes in the PHD and lack of PHD Executive knowledge of MCAH State and Federal Guidelines • Lack of financial resources to have competitive nursing salaries • Agencies have various best practices that may be linked to funding resources/grants/federal funding. • Limited bilingual Public Health Nurses in MCAH Field Nursing • Limited Mixteco translators and limited funding to hire

  48. Essential Service # 7 - Continued Opportunities: • Increase efficiencies and accountability in MCAH Field Nursing Program • New leadership and innovative approaches to field nursing • Executive branch of PHD more informed and responsive to needs of women and children in our community Threats: • Fragile economy and limited spending/changes for all government-related services • Further PHD cuts for fiscal solvency

  49. CAPACITY NEEDS • How can capacity of Essential Service # 7 be improved? • What are the potential challenges on improving this capacity (e.g., impact on local MCAH services, stakeholder concerns, availability of resources). • How can other local organizations, local jurisdictions or the State MCAH Program help improve this capacity?

  50. What’s Next…….. Next Meeting Date Suggestions for further SWOT Analysis of Essential Services Stakeholder Needs

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