MIECHV Program: Performance Measurement November 27, 2012

1. MIECHV Program: Performance Measurement November 27, 2012 Carlos Cano, MD, MPM Division of Home Visiting and Early Childhood Services Maternal and Child Health Bureau

2. Overview • Legislatively Required Performance Measurement System • Federal Data Collection • Opportunities

3. Affordable Care Act • MIECHV program: Section 2951 of the Affordable Care Act of 2010 (P.L. 111-148) • Amends Title V of the Social Security Act to add the Maternal, Infant, and Early Childhood Home Visiting Program under Section 511 • ACF and HRSA collaboration • $1.5 billion over 5 years

4. Priority Populations • Families in at-risk communities • Low-income families • Pregnant women under age 21 • Families with a history of child abuse or neglect • Families with a history of substance abuse • Families with a history of tobacco use • Families with children with low student achievement • Families with children w/ developmental delays • Families w/ individuals who served in Armed Forces

5. Evidence-based Home Visiting Models 1. Child First 2. Early Head Start-Home Visiting 3. Public Health Nursing Early Intervention Program for Adolescent Mothers (EIP) 4. Early Start (NZ) 5. Family Check-Up 6. Healthy Families America (HFA) 7. Healthy Steps 8. Home Instruction for Parents of Preschool Youngsters (HIPPY) 9. Nurse-Family Partnership (NFP) 10. Oklahoma CBFRS 11. Parents as Teachers (PAT) 12. PALS Infant 13. Safecare Augmented

6. Data Collection on Six Goals(Benchmark Areas) • Maternal and newborn health (8 constructs) • Child injuries; child abuse, neglect, or maltreatment; emergency department visits (7) • School readiness and achievement (9) • Crime (2) or domestic violence (3) • Family economic self-sufficiency (3) • Coordination/referrals to community resources (5)

7. Grantee Measurement System: Development • Legislation: Three-year measurement cycle • Report to Congress due December, 2015 • Distinct from research/evaluation (MIHOPE) • TA and Federal feedback during review of plans • Refinement of benchmark indicators • Federal-State Partnership • Develop a robust measurement system • Balancing two values: accountability and improvement • Data reporting for first implementation year: Fall of 2012

8. Indicator Development: Roadmap • Name of the performance measure • Process or outcome • Operational definition • key terms specified; participants included and excluded from the calculation; type of scoring: if percent, numerator/denominator • Measurement tool utilized or question(s) posed • Definition of improvement • Before and after comparisons (e.g., performance in year 1 vs. year 3) • Data collection plan • Persons responsible; source of data (e.g., self-report or administrative data); frequency of collection.

9. Overview • Legislatively Required Measurement System • Federal Data Collection • Opportunities

10. Federal Collection System: Prerequisites • Select an electronic collection system • Select already existing applicable forms • Develop new MIECHV-specific forms • Obtain approval from OMB under PRA • Specify system requirements for new forms • Inform grantees on the use of the electronic system

11. Discretionary Grants Information System (DGIS) • A web-based system • Over 900 MCHB-funded grantees report data online • Areas (Forms 1,2,4, 6, pubs and prods) • Budget/Financial • Programmatic

12. Interagency Data Work Group • Selected 5 DGIS forms • Developed 2 new HV forms for unique MIECHV data needs • HV form 1: Socio-demographic data and service utilization • HV form 2: Grantee-selected performance measures • Modified DGIS contract to include collection and analysis capabilities for MIECHV • Specified DGIS requirements for new forms • Conducted webinars for grantees • Obtained OMB approval

13. Accessing DGIS-HV • Screenshot of Main Menu

14. Overview • Legislatively Required Measurement System • Federal Data Collection • Opportunities

15. MIECHV Measurement: Opportunities • Research (MIHOPE) • Advance the knowledge in HV the maternal and early childhood heath and development field • Improvement (Benchmark area-related data) • Data can drive quality improvement efforts • Common data framework: catalyst for collaboration & partnerships common agenda  system integration • Across home visiting programs in a geographic area • Other early childhood programs (child care and education) • Medical homes

16. Flexibility for Grantees • Select performance measures: process or outcome • Select measurement tools • Define improvement (targets not required) • Design data collection plan • Improvement shown for a fraction of constructs

17. Next Phase: Quality Improvement • Pivoting from measurement towards QI • Individualized TA • Regional meetings • Plan to establish a learning collaborative • Enlisting grantees • Selecting 4-6 areas of improvement • Preliminary development of a shared sub-set of indicators

18. Resources and Contact Information HRSA/MCHB website: http://mchb.hrsa.gov/programs/homevisiting/ HomVEE website: http://homvee.acf.hhs.gov/ Monique Fountain Hanna, MD, MBA, Project Officer for Region III Office: (215) 861-4393 mfountain@hrsa.gov Carlos Cano, MD, MPM, Senior Medical Advisor, Office: (301) 443-8951 ccano@hrsa.gov

19. Thank you