HRSA/MCHB 2005 FEDERAL/STATE PARTNERSHIP MEETING

PUBLIC HEALTH ACROSS THE LIFESPAN

AMCHP

JEFF G. LOBAS: Thank you, John. I'm not only a parent, I'm a pediatrician, and I've certainly taken care of children throughout my career. And I'm really honored to be here today, and I want to thank MCHB, John, Cassie, Peter, for allowing us as representatives of the association to present this morning.

I remember it was actually eight years ago I attended my first partnership meetings, and I remember I was completely lost. I had been a practicing pediatrician and I had just really heard about Title V at that point, and I wandered around aimlessly, it was a meeting they were trying to do in the beginning put name tags on and I'm this bureau and that bureau and you'd have to ask questions and it was a strange new world for me, for sure.

And part of the purpose of this talk is for new directors to find out a little bit more about the association of Maternal Child Health programs and for directors who have been here a while to find out where we have been and where we're going as an association. As many of you know, Iowa 's special needs program is housed at the University of Iowa. As such I'm in the faculty and Department of Pediatrics. I have a new boss that came about six months ago, cardiologist, researcher from NYU, and as he got to know us or me he asked: What is this Title V thing? And what are you doing and why are you traveling so much?

And when your new boss asks you that I guess you need to do some soul searching and come up with some answers. So I did some soul searching, and as many of you know, Iowa has a rich tradition in leadership in Maternal Child Health. John McQueen, who is a figure that we all know, was from Iowa, and Dick Nelson, who was my predecessor, was a strong advocate and leader for the Maternal Child Health world, and I'll never forget my first, my interview with Dick about the job. He had become dean, and I said, "Dick what is this Title V why are you doing this and why would I leave my position in Minnesota to come here?"

And Dick got very excited, he was a Norwegian, so excitement was ‑‑

But he got excited. And he said, Jeff, this Title V and this job is a platform, and it's an opportunity to be a voice for those that don't have a voice. And he went on to say that it's a way that we can be part of doing what is right and what is good for women and children and families. And by the end of that interview I had decided, wow, I really want this job. And eight years later here I am.

And Title V really has been that for me, and the association has really been that for me. I've invested a lot and really have made a difference for me, and we were talking last night, with committee chairs and there's been a number of occasions where I really feel as a member of AMCHP I have had that opportunity to interface with leaders and really make a difference for women and children in this country.

So AMCHP really can be a vehicle to have our voices heard and those of our families that we serve heard. It can be a vehicle for creating synergy and innovation and it certainly can be a vehicle for convenient and collaborating, and my hope is that it's truly at a time of change, vehicle for positive change. So I really invite all of you to become part of AMCHP and see the value in it.

We chose the title Responding to Times of Challenge. Certainly we've all experienced challenging times. I stood up here last year and talked about I'm mad as hell and I'm not going to take it anymore. And as we were really struggling with some financial situations in Iowa and we had drawn the line in the sand with our state about: Are you committed to this special needs program or not? And in fact I'm happy to say that we're here. We were supported by our state Legislature and we're stronger than ever and doing really good things in Iowa.

So the association's been through a lot of transition. We've transitioned from a council to a board, from where members did most of the work to a staff to an executive director to a CEO and I will say I will report it's not been an easy transition whatsoever. And we certainly are a work in progress.

Some facts about AMCHP. It was established in 1944. We have 20 staff, with multiple funding sources. The purpose of AMCHP is really to support the maternal child and special needs director and state Title V programs. We struggled with our purpose a lot. And I'll talk a little bit about our strategic plan in a minute. There are numerous benefits. And for those at the new director's meeting the other day, a new director from DC stood up and said to Peter, well, you know I'm new here. So he was in my position eight years ago. But AMCHP offers a mentor program for leaders. So I would really ask you to contact us and we can get you hooked up in this mentor program. And one of our missions is really to help in that orientation and transition.

We have a board of directors that are elected. We're adding two family representatives to that board. We have committees right now but as of last night, this slide probably changes because I think we've really hit upon we need to change our committee structure dramatically. So that will remain to be seen what that looks like. Let's just say we have committees and a way for members to be involved.

So some of these challenges that you've all experienced as leaders have been federal financing, state financing and complex difficult problems, and health disparities, and we as an organization have spent a significant amount of time struggling with all of these challenges and how do we as an association and state programs address these issues.

So what I'm going to do today is talk about our strategic plan, which I am happy to say is in its final form and will be on our website I think later next week. It is a ‑‑ well, slide says four years but as of last night we said why do a four‑year cycle when the Block Grant needs assessments on a five‑year cycle. So we'll be on our strategic planning cycle, we're trying to make as you see we're in real time change here. So we are going to be on a cycle that goes along and integrates with the Block Grant cycle.

This process involves board, staff, committee members, partners. MCHB, CDC. Although it feels like a four‑year process it's been an 18 month process. And we hope it's consistent with the plans of our federal partners. And consistent with the needs of our members.

So I'm a real believer in strategic planning as a dynamic document that really guides and maps our future, and it starts with a vision, and our vision for AMCHP is in fact healthy children, healthy families and healthy communities.

We talked a lot about what the vision should be, and we felt simple is better and this really sums up what we're about.

Our mission really sums up how we're going to ‑‑ what's our part, what's our niche in creating these healthy children, family and women. It's through supporting state maternal and child health programs and it's through providing national leadership on issues affecting women and children.

So I'm going to go through our goals, and we use what I call a narrative strategic planning process so the actual document has a brief paragraph, which I'm going to take some things from. But the first goal we have is there will be an action‑oriented national agenda to improve the health of women and children.

So this is really about policy. It's really about leadership at a national level. Now, how are we going to achieve that? Well, our first strategy is to create in advance a collaborative agenda for maternal child health with other national organizations, and I'll read in the document. "It is through collaboration and partnerships with key stakeholders and organizations with similar interests that AMCHP believes it is possible to develop a unified and concerted effort which results in the development of a common agenda for women and children."

And it goes on to talk about part of this is adequate and sustainable resources. But this is, AMCHP really feels its role is linkage and partnering with like minds.

The next strategy for this would be promote national policies. National policies guide and direct efforts at the state level which affect programs serving women and children and AMCHP will lead efforts at promoting policies which improve these at the state level.

The next is there's evaluate an impact. I think the common thread through the strategic plan is the continuous quality improvement theme.

AMCHP believes that it is essential to actively assess the effect of these policies on the state's ability to serve its population. It's through that effort that the programs will undergo continuous improvement. The last strategy for this goal will be support a national agenda for MCH with a strong state focus. I think the board and many of us fear that with all the issues financially that MCH at the state level is going to lose its focus and in fact some states have been usurped and integrated into other departments and have really lost its MCH focus. So we really feel it's important to concentrate on this MCH focus at the state level, and thus this strategy. And AMCHP believes that any national agenda must be reflected in a focus on MCH at the state level and is committed to developing and supporting strategies to assist states in that end.

So the next goal is about leadership. I think we felt strongly that after policy, we need strong leaders at every level of the MCH system. And how are we going to do that? The first strategy is to assess and address MCH leadership work force development needs. Again, with partners. We don't propose that we are the national leaders or work force development, but we have a role of a convener collaborator and a lot of expertise available to us. So working with the partners and members we will assess the needs at all levels to develop a work force of strong, talented and effective leaders in the MCH field.

And we go on to talk about also attracting and training new leaders to the work force.

Strategy number two is about ensuring strong leadership. Again this is a continuous quality improvement effort. AMCHP will work with its members to continuously improve and maintain the skills of MCH leaders at all levels, including family leaders utilizing the most effective leadership developed methods available. So we're really committing to building strong leaders and monitoring and being part of that whole process.

And the last strategy is around promoting family partnerships and family leadership. The fact that we added two members on the board that are family members makes a statement about our commitment to families. And we firmly believe that families should be involved in decision making at every level, and we're really committed to making that happen.

The next goal is about evidence‑based practices. And the way the document reads is MCH systems and policies and programs will be aligned to evidence‑based practices at all levels.

The strategies here, the first relates to improving health outcomes to eliminate health disparities and what the document says is we believe that the ultimate goal of MCH policies and programs is to improve the health and eliminate disparities in the MCH population. And it's through the development and spread of evidence‑based practices that this occurs, and it's through systems and infrastructure that state programs are best able to contribute to this effort. And we're very committed to this. We've been doing a lot with the Division for Children with Special Needs and state leader programs and medical home, and in every area we need to take that approach about evidence‑based practices and spreads.

And then part of this also is encouraging sustainable based systems by finding strategies to pay for this at the state level. So we hope, we propose that we will help identify, develop and maintain these resources at the state level.

So the last goal is really an internal goal. AMCHP will be an effective and efficient organization and I think that's where it all starts. And we're committing ourselves to be a learning organization one that is continuously improving.

The way we will do that we'll expand and maintain strategic partnerships. We will seek out and develop a core group of partners that we'll develop communication strategies and partnerships with. We will continuously evaluate and improve our effectiveness at every level, board, staff, members. We certainly honor the needs and we will ensure the financial health of the association. That really, both communication and finances are the lifeblood of our organization. And we're very committed to that.

Now, within this, we have a number of focus areas that we've talked about: Early childhood, women, preventive health, adolescent preventive health, emotional behavioral health, children with special needs, health disparities. I think obesity, oral health have to be on the agenda. And somehow these focus areas will be taken up within these goals and we will address how do state programs, how does AMCHP address each one of these focus areas. It goes on to talk about how we evaluate but in a very real sense this is our map of where we're headed.

The next step will be to engage members, engage the existing committees in developing performance measures for each of these goals, and then in fact that will lead to the activities, and I see it as an iterative process but we've laid the ground work for the next five years to take us into the future, with looking at policy, leadership and evidence‑based practice as well as looking internally.

So with that said, I'll turn it over to Pete to talk about some of the other implications.