Title V: Mississippi View JUANITA GRAHAM, DNP, RN MISSISSIPPI STATE DEPARTMENT OF HEALTH
Back in the day… Title V of the Social Security Act Created in 1935 to improve the health of mothers and children Featured programs to: ◦ Reduce infant mortality ◦ Improve maternal and infant health ◦ Improve child care and parenting Same goals today ◦ – but economic times are different, and state methods differ greatly
MCH Pyramid of Direct Health Care Services Health Services Enabling Services Population Based Services Infrastructure Building Services
Direct Health Services Enabling Services Population Based Services Infrastructure “Reversed Pyramid”
Social Determinants of Health The social determinants of health are the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are shaped by a wider set of forces such as economics, social policies, and politics. (WHO, 2013)
Social Determinants – Mississippi Experience Where we are born, grow up, live, work, and age ◦ Rural Systems in place to deal with illness ◦ Underserved Economics, social policies, & politics ◦ Recruitment & growth
Title V Block Grant The old method – 5-year cycling program based on a Statewide Needs Assessment Federal & State indicators Following the pyramid model of MCH services Population groups ◦ Women & infants ◦ Children & Adolescents ◦ CYSHCN
Title V 3.0 Transformation The new method – 5-year cycling program based on a Statewide Needs Assessment Federal & State indicators Following the 10 essential functions of public health Population domains ◦ Maternal & Women’s Health ◦ Perinatal Health ◦ Child Health ◦ Youth & Young Adult Health ◦ CYSHCN ◦ Lifecourse Issues
Direct Health Services Enabling Services Population Based “Reversed Pyramid” Services Infrastructure Women & Infants Child & Adolescents CYSHCN
Public Health Functions Maternal & Women’s Health Perinatal Health Child Health Youth & Young Adult Health CYSHCN Lifecourse Issues
Direct Health Services Enabling Services How might TV-3.0 impact states like Population Based Services MS who depend Infrastructure upon current system to fill gaps in health care system?
State Systems Development Initiative “SSDI” Infrastructure support grant for the Title V Formerly, minimal restrictions on how used except “infrastructure” & “capacity” building Mississippi - Data Unit
State Systems Development Initiative In 3.0 version, basically mandated 3 goals ◦ Needs Assessment ◦ CoIIN ◦ C/MDS (Core/Minimum Data Sets) Tough decisions
Statewide Needs Assessment Opportunity to review statewide assets & deficits Engage stakeholders Establish 5-year state priorities Review current activities for relevance, feasibility, evidence, etc… Tough decisions?
The Argument for ROI Therein lies the argument for ROI “What we’ve always done” vs. “The biggest bang for the buck” Value-based decision-making
The Argument for ROI What produces the best health outcomes? ◦ Evidence drawn from the literature What produces the best financial outcomes? ◦ Evidence drawn from the numbers
Utilizing ROI Need to “defend” an established program Data availability Team approach ◦ Epidemiology ◦ Program ◦ Policy
Utilizing ROI Communicating the value of MCH
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