MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES

LOCAL MATERNAL CHILD HEALTH (MCH) PLAN

FY 2017 (10/1/16 – 9/30/17)

(Please attach to MI E-Grants – on one of the MCH projects detailed expenditure lines)

Select Local Health Department from drop down menu to the right. Select Agency

Contact for additional information on this plan, if needed:

Name:

Email:

Telephone:

Complete the questions, LMCH work plan, and projected outcomes/fund allocation table below.

1.  What are the priority MCH needs (up to five) identified for the community for FY 2016/2017? Describe how these needs were identified (i.e. community or needs assessment). In two to three paragraphs include a summary of the data, methodology, and year data was obtained.

2.  Describe any health disparities1 related to the MCH population noted in your community needs assessment. What are the priority MCH needs identified by your department for FY 2016/2017 related to these health disparities?

LMCH Plan – Document Revision – April 7, 2016

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3.  Which national performance measure(s) and state performance measure(s) will be addressed through your LMCH funding based on the MCH priorities identified in question 1 above? Check all (first column of table) that apply in the table below. It is strongly recommended to select at least one NPM or SPM for FY 17. *NPM numbers reflect the federal NPM designations and therefore the numbering is not sequential.

Check / No.* / Priority Area / National Performance Measure (NPM)
☐ / NPM1 / Well-woman visit / Percent of women with a past year preventive medical visit
☐ / NPM3 / Perinatal care system / Percent of very low birth weight (VLBW) infants born in a hospital with a Level III+ Neonatal Intensive Care Unit (NICU)
☐ / NPM4 / Breastfeeding / A) Percent of infants who are ever breastfed and B) Percent of infants breastfed exclusively through 6 months
☐ / NPM6 / Developmental screening / Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool
☐ / NPM10 / Adolescent well-visit / Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year
☐ / NPM11 / Medical home / Percent of children with and without special health care needs having a medical home
☐ / NPM12 / Transition / Percent of adolescents with and without special health care needs who received services necessary to make transitions to adult health care
☐ / NPM13 / Oral health / A) Percent of women who had a dental visit during pregnancy and B) Percent of children, ages 1 through 17, who had a preventive dental visit in the past year
Check / Priority Area / State Performance Measure (SPM)
☐ / SPM1 / Lead prevention / Percent of children less than 72 months of age who receive a venous confirmation testing within 3 months of an initial positive capillary test
☐ / SPM2 / Safe sleep environments / A) Percent of infants put to sleep alone in their crib, bassinet or pack and play and B) Percent of infants put to sleep without objects in their crib, bassinet or pack and play
☐ / SPM3 / Depression across the Life Course / A) Adolescent SPM TBD and B) Percent of women enrolled in MIHP who are screened for maternal depression
☐ / SPM4 / Provision of medical services and treatment for children with special health care needs / Percent of CYSHCN enrolled in CSHCS that receive timely medical care and treatment without difficulty
☐ / SPM5 / Immunizations / A) Percent of children 19 to 36 months of age who have received a completed series of recommended vaccines (4:3:1:3:3:1:4 series) and B) Percent of adolescents 13 to 18 years of age who have received a completed series Human Papilloma Virus (HPV) vaccine
Check / Local Priority Area / Local Performance Measure (LPM) (optional) (Please Describe)
☐ / LPM1
☐ / LPM2

4.  Provide a brief narrative justification as to why the NPM/SPM/LPM was selected. Include justification for directing funds to this NPM/SPM/LMP.

LMCH Plan – Document Revision – April 7, 2016

Select Local Health Department from drop down menu to the right. Select Agency

Identify the NPM and/or SPM that aligns with the data identified in the MCH priorities from question 1. Select the NPM or SPM on the pull down menus below, OR, specify the LMP defined measure.

Use a separate table for each NPM, SPM or LMP selected. Copy and paste this page for as many work plan tables as needed. Use a separate work plan for each NPM/SPM/LMP Measure selected.

NPM or SPM: Select NPM or SPM

LMP Defined Measure (specify): Click here to enter text.

Please select the appropriate service by pyramid level. See Appendix for definitions and examples.

Data
List local MCH-specific data used to identify the priority NPM/SPM/LMP identified above. / Required Objectives
(note: Objectives should
be SMART: specific, measureable, assignable,
realistic and time-related) / Activities/Strategies
Describe activities and strategies that will be used to directly impact the identified NPM/SPM/LMP / Stakeholders/ Responsible Person / Anticipated Outputs
Describe outputs. What is your evaluation method to determine if you have met your objectives? / Final Reporting
Indicate if objectives and outcomes were met or not met. Provide brief summary of FY 17 activity and outcomes achieved with MCH funds. / Final Progress Reporting
Provide a brief description of any challenges and successes that were experienced. /
Select service by pyramid level. / Choose met or unmet.
Select service by pyramid level / Choose met or unmet
Select service by pyramid level / Choose met or unmet
Select service by pyramid level / Choose met or unmet
Select service by pyramid level / Choose met or unmet.

LMCH Plan – Document Revision – April 7, 2016

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6.  Using the table below, identify service categories that will be supported with MCH funding - Indicate funding allocation per service category by population. Use pulldown menu to indicate the NPM/SPM/LMP used under each category. Please be sure your financial budget allocations match the projections below. The LMCH plan and grant fund distribution in the budget must match. PLEASE NOTE: The blue colored areas are totals for columns and rows. If you highlight the table by clicking on the cross hatch (scroll mouse on table, cross hatch is on upper left corner) after entering your data, and then click on the “F9” function key, it will update the totals in the table. If the table is updated, be sure to refresh totals with cross hatch/ F9 key.

PROJECTED OUTCOMES AND FUNDS ALLOCATED - FY 2016/2017

Service Categories / # of Women (20 – 44) / Amount Allocated
$ / # of Children (0-9) / Amount Allocated
$ / # of Adolescents (10 – 19) / Amount Allocated
$ / TOTAL
Projected
Outcomes / TOTAL Allocation
$
Direct Services Children
1.  Select NPM or SPM / 0 / $0
2.  Select NPM or SPM / 0 / $0
3. Click here to enter text. / 0 / $0
TOTAL Direct Services Children / 0 / $0 / 0 / $0 / 0 / $0.00
Direct Services Women
1.  Select NPM or SPM / 0 / $0
2.  Select NPM or SPM / 0 / $0
3. Click here to enter text. / 0 / $0
TOTAL Direct Services Women / 0 / $0 / 0 / 0
Enabling Services Children
1.  Select NPM or SPM / 0 / $0
2.  Select NPM or SPM / 0 / $0
3. Click here to enter text. / 0 / $0
TOTAL Enabling Services Children / 0 / $0 / 0 / $0 / 0 / $0.00
Enabling Services Women
1.  Select NPM or SPM / 0 / $0
2.  Select NPM or SPM / 0 / $0
3. Click here to enter text. / 0 / $0
TOTAL Enabling Services Women / 0 / $0 / 0 / $0.00
Public Hlth Functions & Infrastructure
1.  Select NPM or SPM
2.  Select NPM or SPM
3. Click here to enter text.
TOTAL Public Hlth Funct & Infra / 0 / 0
TOTALS / 0 / $0 / 0 / $0 / 0 / $0 / 0 / $0.00

LMCH Plan – Document Revision – April 7, 2016

Here are some examples of services by pyramid level. This is not an all-inclusive list.

Direct Services – preventive, primary or specialty clinical services where MCH funds are used to reimburse or fund providers for these services through a process similar to paying a medical billing claim. Examples include preventive visits, primary or specialty care visits, inpatient services, prescription drugs, dental care, vision care, etc.

·  Clinic based services such as family planning clinics or STI clinics

·  Lactation consulting services in clinic setting

Enabling Services – non-clinical services that enable individuals to access health care and improve health outcomes; examples include case management, care coordination, referrals, translation/interpreter services, transportation, health education, risk reduction, health literacy, etc.

·  Health education in an individual or group setting such as breastfeeding classes or prenatal education

·  Interpreter and translation services

·  Using interpreters to do outreach in community venues such as grocery stores, churches, mosques

·  Care coordination visits in a program such as MIHP

·  Group smoking cessation classes

·  Immunization administrative activities such as running reports on who is up to date with immunizations using MCIR, recall efforts, following up on logs, etc.

·  Referrals to specialty or other services (i.e. nutritional classes)

Public Health Infrastructure – activities and infrastructure to carry out core public health functions such as needs assessment, program planning, policy development, implementation, evaluation, quality assurance, workforce development, population based disease prevention campaigns, safe sleep education, etc.

·  Public Awareness campaign to improve a locally defined, data driven problem affecting the MCH population (i.e. improve breastfeeding rates)

·  Analyzing datasets like MCIR-BMI database, birth file records, etc.

·  Convening a community coalition to address a locally defined, data driven problem affecting the MCH population (i.e. safe sleep coalition)

·  Serve on different advisory teams and educate/raise awareness about available health department services for MCH population

·  Conduct a client satisfaction survey for family planning users to ensure that clinic services are meeting the need of clients. Implement quality improvement activities if needed.

·  Epidemiology support for MCH

·  Community wide needs assessment for MCH population

·  Participate in community meetings that work with MCH population such as Safe Harbor’s Children’s Advocacy, Child Death Review Team, Wraparound, Early On, Multi-agency community collaborative, and Stakeholders Community Collaborative

LMCH Plan – Document Revision – April 7, 2016