MCHB ALL GRANTEES MEETING

MCHB Divisions and Offices

October 4-7, 2004

DAVID HEPPEL: I tend to be a little oblivious, especially in situations like this. So when I was coming in today and up until today--I’m sorry. Is this better, Bill? When I was coming in today, I thought the group I was going to see in front of me was the new MCH state directors. When I walked in this room, being the perceptive person that I am, I recognized that that was not the case. And a chill came over me because what I’m supposed to be talking about here are the activities that are going on, and now I realize, under most circumstances, most of what I say is said to an audience who doesn’t know the truth. Well, here, there will be at least one of you who will know when I say any given thing, whether or not I’m telling the truth. And so I am more than a little nervous. The Division of Child, Adolescent and Family Health are made up of two units. It addresses the general health needs, as opposed to the special health needs, which you’ll hear about from Earl in just a minute, of all children and adolescents. Our 22 members are divided between two units. One area of focus is--one unit focuses on infant and early childhood health and the other on adolescent health.

The Division programs are authorized primarily through Title V through the MCH services Block Grant, but also separate legislation on authorizing emergency medical services for children. This is what one of my professors used to call an, “Oh, hell slide.” There’s too much information to absorb. What the slide depicts are the program categories that these two units administer. The Division is involved in a wide variety of efforts, which cover a multitude of health and related areas. And obviously, today we can only skim the surface of what we do, but I hope it will give you a flavor. We’ll start in the adolescent unit. It’s activities can be categorized under the following themes, and I’ll say a little bit about each: The National Coordinating Committee on School Health promotes collaboration across 70 health education and nutrition organizations to improve the health, safety, nutrition and educational achievements of students. It is a governmental and non-governmental group and Trina Anglin is the director of that. The Center for School Based Healthcare improves the quality of care provided by and develops a financial sustainability of school based health centers.

In the area of mental health, there are two national centers, which strengthen the ability of schools and school districts, communities and health and mental health service providers to address students’ mental health needs and psychosocial issues through training and infrastructure development. The integrated health and behavioral healthcare initiative, through planning and implementation grants, stimulates development on innovative community based model service systems that integrate physical health and medical care with mental healthcare and substance abuse prevention, and the treatment of services for children, adolescents and their families. Just parenthetically, there is in the 2005 HRSA preview another category, which encourages collaboration at the state level between health and mental health. Some of you might be interested in that. The partners in program planning for adolescent health is a collaboration of eight national membership professional organizations that promote adolescent health and youth development agenda and use a Healthy People 20/10 framework in individual as well as collaborative organizational activities.

There are approximately one million practitioners among these eight membership organizations. It provides us in MCH with a chance of really reaching out in a broad way. The National Coordinating Committee on School Health, you just heard about. The Adolescent Health Resource Cooperative Agreement Program has three centers to provide assistance. These are both to providing assistance to states, to communities and to practitioners. The National Adolescent Health Information Center is a general adolescent information center. The Public Policy Analysis and Education Center works particularly for MCH in helping us develop new policies and analyze existing policies, governmental policies in adolescent health. And the state adolescent health resource center for MCH personnel is particularly targeted toward those of you who are responsible for adolescent within the MCH program. Just coming out is the national initiative to improve adolescent health by the year 2010. This group got together and coned down on all of the Healthy 20/10 objectives and looked at those that were most important for adolescent health, and based on those, has come up with a strategic plan to improve that resource.

The Emergency Medical Services for Children Program--actually one of the reasons I walked in here late this morning was we had an example of some help in that area. I was going down Route 29 in Maryland when everything came to a halt. I then heard the sound of a helicopter, turned to the news radio station in Washington to see what was going on. And what had happened was that there was a car crash approximately two blocks ahead of me. In that crash was a child, among others, at least according to the radio reports. And the helicopter was part of the Maryland system for emergency medical services, which has received help from this program. And I hope that they did a good job. They certainly got things got done quickly, because it wasn’t too late when I got here. These programs look at children’s needs starting with medical home, from prevention to emergency response in the field to the emergency department through and rehabilitation and back to the medical home. The program is a long-time partnership of the Maternal and Child Bureau and the National Highway Traffic Safety Administration, and you can see the program priorities.

The oral health program, although there’s no mandated Title V Block Grant oral health program component, one of the eighteen performance measures collects data on the number of third grade students who have sealants placed on their molars, and it is a performance measure that was selected by both the state programs and the federal MCH program. The discretionary programs in oral health are designed to compliment Block Grant activities, to further encourage improvement in accessing oral health programs, to build federal professional partnerships, to expand infrastructure and to meet the Healthy People 20/10 oral health objectives. In the area of infant and child health, we have the Sudden Infant Death Syndrome Program, the Child Health Systems Development Program, community organization program, community organization grants, which are part of the CISS program that Dr. van Dyck mentioned before. And then, special programs in health and safety and childcare and comprehensive early childhood systems grants. Within the Healthy Childcare American, childcare health and safety is something that MCH has been involved with since at least the mid-80s.

There are three core program areas which you see on the slide that have been developed through a series of discretionary grants, both grants going to individual states and grants going to organizations to assist state programming. We have, for example, the Academy of Pediatrics has done a wonderful job in working with us and with the administration on children and families in working on providing health consultants to childcare providers. The Early Childhood Comprehensive Systems Development Program is the newest activity that we have going, and those of you from states are aware of this; there are five major areas of response to this program. They’re the ones listed in the bullets below. The idea is to try to come up with a more coherent approach to dealing with the needs of young children. In the area of injury and violence prevention, we mentioned the health, mental health, safety and schools; this is a new guidance that’s coming out. It’s similar to what was done in the childcare realm a number of years ago. This guidance will be released tomorrow as part of Child Health Day. It’s a collaboration with the Academy of Pediatrics and the Association of School Nurses.

As you heard earlier, Stephanie Brim in this unit is responsible for the development of the National Youth Bullying Prevention Campaign. She has done a wonderful job with that. And also in the area of injury prevention is the Children’s Safety Network. This is a general resource tool that is set up for all states and communities to look at injury prevention programs. If you have activities in this area that you’re interested in developing, the Children’s Safety Network serves as a quality control device as well as a technical assistance device. And finally last and well, I guess not least, the Partnership for Information and Communication. This is an activity that this division takes on on behalf of all the other components of the Maternal and Child Health Bureau. It was set up to attempt to find a way to get information that is important to the health of mothers and children out to a wide variety of decision-making groups or membership organizations of decision makers that can influence MCH and provide them with information that they can share with their members in a way that their members understand. In other words, the National Business Group on Health, the people who are part of that organization, react a little bit differently than say the Healthy Mothers/Healthy Babies Coalition.

So by providing support to these various organizations, we hope to be able to get our message across to these groups; also to hear what they’re concerned in the area of maternal and child health. And with that, I’ll turn it over to Merl, and we’ll deal with special health needs.