2015
- Title V MCH Services Block Grant Transformation
Title V Block Grant Logic Model. (Click on image to view or download the PDF)
Background
In 2015, the Maternal and Child Health Bureau revised the process that states use for the Title V Maternal and Child Health (MCH) Services Block Grant needs assessment, grant application, and reporting. The transformation aimed to increase accountability by showing the contributions of Title V programs more directly while still maintaining flexibility for the states and reducing their reporting burden. Under the process, there are fewer performance measures, but those remaining are more closely tied to Title V activities and evidence-based or evidence-informed strategy measures (ESMs) that states identify. In addition, data prepopulates from federal sources, wherever possible.
The processes states use for the Title V MCH Services Block Grant needs assessment, grant application, and reporting are based on a three-tiered framework: national outcomes measures (NOMs), national performance measures (NPMs), and ESMs.
NOMs: NOMS primarily include population-level measures of health outcomes for which Title V programs are expected to drive improvements over the 5-year reporting period.
NPMs: States select 5 of 15 NPMs with 1 NPM selected for each of the five MCH population domains. There is no maximum number of NPMs that states can select. Each of the state-identified 7–10 priority needs, as determined through a comprehensive 5-year needs assessment, is addressed by a NPM or state performance measure (SPM). States are not required to establish a minimum or maximum number of SPMs. The NPM on oral health has two parts:
- Percent of women who had a preventive dental visit during pregnancy
- Percent of children and adolescents, ages 1 through 17, who had a preventive dental visit in the past year
States are not required to choose both parts of the NPM on oral health.
ESMs: ESMs assess the impact of the Title V program’s strategies contained in the state action plan. ESMs should be measurable and meaningful (relate to NPM, based on or informed by evidence of effective practice). Many strategies may not have strong evidence of effectiveness with replicated and robust evaluation methods. The term “evidence informed” is meant to convey that there is information suggesting that a strategy could be effective in addressing a NPM, but evaluation data are limited. Evidence-informed strategies may include emerging practices and expert opinion.
The Title V Oral Health [webpage] provides an overview of the Title V MCH Services Block Grant application and shares information and resources to help state MCH programs and state oral health programs include oral health in the 5-year needs assessment, select the NPM on preventive dental visit, develop an SPM on preventive dental visit, and include oral health in the state action plan.
Impact
Women who receive oral health care when they are pregnant are more likely than those who do not to take their children to get oral health care. Early dental visits teach children that oral health is important. Children who receive oral health care early in life are more likely than those who do not to have a positive attitude about oral health professionals and dental visits.
State Title V MCH and oral health programs have long recognized the importance of improving access to, utilization of, and quality of oral health care for pregnant women and children. States monitor and guide service delivery to ensure that children have access to oral health care. Strategies for promoting oral health include providing preventive interventions, such as dental sealants and use of fluoride; increasing the capacity of state and local oral health programs to provide preventive oral health care; evaluating and improving methods of monitoring oral diseases and conditions; and increasing the number of community health centers with oral health components.
Sources
Association of Maternal and Child Health Programs. 2020. AMCHP's Implementation Toolkit for Performance Measure 13: 13.1: Percent of Women Who Had a Preventive Dental Visit During Pregnancy; 13.2: Percent of Children and Adolescents, Ages 1 Through 17, Who Had a Preventive Dental Visit in the Past Year. Washington, DC: Association of Maternal and Child Health Programs.
Maternal and Child Health Bureau, Division of State and Community Health. 2019. Title V Maternal and Child Health Services Block Grant to States Programs. Rockville, MD: Maternal and Child Health Bureau.
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