MCHB ALL GRANTEE MEETING

Divisions and Offices

October 4-7, 2004

CASSIE LAUVER: Thank you, Ann. Actually, I was very tempted to substitute the pictures that I have up there that you’ll see of staff with my new grandson, but I decided that that might not be the best thing today. But if any of you are interested after the meeting, see me. I already have pictures. Let’s see if I can make this work. I see them here. Well, thank you, Ann. And as Ann said, my responsibility with the Bureau is directing the Division of State and Community Health. And that is the division that has the oversight of the maternal and child health Block Grant to states. And as you can see on the screen, the mission of the division is to work in partnership with states, primarily through the MCH Block Grant, to work with communities and grantees to assure continued improvement in the health and safety of the MCH population.

And just to tell you a little bit about the Block Grant to states, there is a Block Grant that goes to all 59 states and territories, so all 50 states, Washington D.C. Puerto Rico, Virgin Islands , and the six Pacific jurisdictions. It’s a formula grant, a mandatory formula grant, and that’s different than many of the grantees that are discretionary grants. And Dr. van Dyck earlier, in his presentation, gave you a little bit of background information about where that formula comes from. And first, there is a base that comes from--historically from the amount of money that were going to states for a variety of programs when it was Block Granted after 1981. In 1983, there was a standard base set, and then on top of there is an amount of dollars, and right now, it’s close to $600 million that we administer in the division that go out to the states. And the formula part of that, as he explained earlier, comes from the number of children in poverty in that state compared to the total number of children in poverty in the United States . And, in fact, that formula was just redone last year based on the 2000 Census data. So it does change over time.

Also, one of the differences between the Block Grant and the discretionary grants that many of you are, are the discretionary grants for the most part, are time limited. You apply, they’re competitive and they’re for a specific point of time. The Block Grant is an ongoing grant. All of the states and jurisdictions submit annually an application and annual report. So last July 15, the states applied for their 2005 application and at the same time, filed an annual report for 2003. As stated earlier, this meeting coincided with the annual partnership meeting that we had with the states. And obviously, we’ve grown in this meeting. But just interested, many--we have a lot of veteran directors out there, and we do have some new ones, though, here today, I know, and as well as some of the veterans. So just to raise your hands for those folks out in the audience that are state directors that represent either state MCH or children with special needs programs. Great. So I see you--excellent. Interspersed without the other grantees. The functions of the division: The function is to service project officers.

So as staff in the Division, we have a staff that serves at least one, if not more, serves as project officers for each of the state programs, and they’re assigned by region. Another function is to track state progress in meeting performance measures. And we’ll talk about that a little bit more, but Dr. van Dyck shared a little bit of information about that expectation now going across all of grantees. Well, for some time now, all states are reporting on performance measures--18 national performance measures, seven to ten state performance measures, health systems capacity indicators--indicators that look at how states are performing relative to the infrastructure--the capacity in the state, as well as long-term outcome objectives. And we also coordinate technical assistance. We do administer another program, and this is a discretionary program within the Division, and that is, as you see up there, SSDI; that stands for State Systems Development Initiative. And this is a discretionary grant of limited funds up to $100,000. The state TITLE V Agency is the eligible applicant for this particular program.

It’s been around now for about 13 years, and it has evolved over time, always looking and focusing on state systems development; but currently, the purpose of these grants is to focus on state data capacity. And some examples of what that might be would be linking birth/death records, linking WIC databases with Medicaid databases. States are required every five years to submit a statewide maternal and child health needs assessment. And in fact, next year on July 15, each state will be submitting a needs assessment. And states have been very, very busy over the last 18 months--year to 18 months in developing their needs assessment for submission, although in actuality, this is an ongoing process for them. And I think that many states have used their SSDI grants to support that needs assessment activity. And I would just also plug that these needs assessments can be very helpful, I think, to all of the grantees here.

And when they’re submitted next year, hopefully by this time next year, we’ll have them up on the web available. And so it’s a good idea to communicate and work with your state programs because there’s a lot of valuable information that can be shared through this process. And do we have SSDI coordinators here today? A few out there, I see. A lot of times, the state directors share those hats. But I would imagine that we will have some of the coordinators here, as well. Also up there you see the Division administers the abstinence education programs. And I’ll just mention this briefly because many of the state programs have obviously administered the state portion, the state Block Grant portion, of abstinence education. As some of you may be aware, that program was transferred to ACF, another administration with the Department of Health and Human Services last July. So we’ve been in the process of transition with that program and there is transition going on with the discretionary portion with that as well. And finally, one of the functions of the Division is to orchestrate the annual meeting.

And this year it was our privilege to work with Ann Drum, other folks in the division and many, many people--grantees, in putting this meeting on. The priority areas of the division: We analyze Title V data, so this is information, both Dr. Van Dyck and Dr. Cogan talked out, how rich these data can be and that we’ll be collecting it now from all of the grantees. But each year, as I said, each of the jurisdictions submit data--performance measures, health status indicators, outcome objectives--and these data tell a very rich story for maternal and child health. They are state specific data so all of the grantees, if you’re interested, go on and look at that. And it also, from the federal perspective or national perspective, gives us an excellent idea and a picture of maternal and child health nationally. And the web address for that--so the states submitted their Block Grant application in July. They are already available. They’ve made modifications after they’re review.

Our contractors have cleaned those data and, in fact, last Friday, those new data became available on our web site, so you have very current information. You can either go to the mchdata.net website to find those data, or you can actually go the Maternal and Child Health Bureau, the www.mchb.hrsa.gov website. Click on data, click on Title V information system, and voila, there it is. You can query it yourself by state, by region. You can put data together, actually on there and be interactive with it. You can query the narrative section by keyword searches. So there is an excellent opportunity, not only for us, but for any of you to analyze the data that are on there. A second priority area is identifying--we have best practice, but it’s really promising practice because states are very diverse; what works well in one state may not be the best thing for another. But we really are trying to look at promising practice and we can do that by looking at the performance measures that states are providing data to us about. And when we do that, we do see that there may be some states that are doing very well in a particular performance measure.

And when we see that, we want to take a better look at that and see if, in fact, they are doing something that can be valuable to other states and other grantees. We do have a contract with the Shep Center at the University of North Carolina at Chapel Hill to work with us around promising practice and looking at some of those areas that we’ve identified states may be doing something very special and that we want to share. And we also know that some states may not be doing so well in some performance measure, and may be interested in technical assistance, and that really is the third priority area, and that’s to coordinate technical assistance opportunities. We also work with a contractor there. It’s part of the state Block Grant application process, where there’s a form in the application where they submit requests for technical assistance. There’s an online web location where those grantees can request technical assistance in any particular field. States tell us that the most valuable technical assistance that they can have is working with other states, working with their peers, and working with other grantees.

And so we encourage that and provide technical assistance there. And I’ll just mention briefly, and again, because all of the grantees will be going to web-based submission, this is really nothing new for the states; for the last two years, they’ve been submitting their applications via the web. They’ve been providing information on performance measures. This is something that all of your applications will look like. And you saw the hands raised of some individuals here that are with those programs, and so if you want to commensurate or talk to them and find out that it really has turned out to be a fairly easy process, you might want to get with them over the course of the meeting. I mentioned earlier that the staff in the division are assigned two states by region, and you’ll have these PowerPoint’s online so you can find out the individuals--Audrey Kirk (inaudible), Carol O’Toole, Josh Kochelle, Mary Beth Reed, Pam Eason, Elizabeth Walcup, and myself, all act as project officers.

Just quickly, and this is where I was going to put my grandson, but as you see, this is really staff in the division and you can recognize faces, perhaps and go up and introduce yourself. These folks are all project officers in the division. Joe Leech is our new project officer for the SSCI grant. Joe, we’re fortunate to have, had been working with the abstinence education program and with its transition, we’ve been able to have Joe come with us and work on SSCI. This is the abstinence education staff: Michelle Laller, Donna Hutton, Scott Schneider, Debra Keel-Dickens, and finally, last but not least, our administrative support staff that we would not survive on a daily basis without them. So thank you very much.