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Center for Oral Health Systems Integration and Improvement

Title V MCH Services Block Grant Oral Health Toolkit

Introduction

In 2015, the Maternal and Child Health Bureau revised the process that states use for the Title V maternal and child health (MCH) block needs assessment, grant application, and reporting. This 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 new 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 are state identified. In addition, data prepopulates from federal sources, wherever possible.

The processes states use for the Title V MCH block needs assessment, grant application, and reporting are based on a three-tiered framework:

  • National outcome measures (NOMs)
  • National performance measures (NPMs)
  • Evidence-based or -informed strategy measures (ESMs)

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. View the list of NOMs.

NOM Oral Health: The percentage of children and adolescents ages 1–17 who have decayed teeth or cavities in the past year.

States select 5 of 15 NPMs with one NPM selected for each of the five MCH population domains. There is no maximum number of NPMs that states can select. States may continue to implement their state action plan for the 5-year cycle with the 8 NPMs previously chosen. 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.

NPM 13:

  • 13.1: dental visit for pregnant women
  • 13.2: preventive dental visit for children and adolescents
ESMs assess the impact of the Title V program’s strategies and activities 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.

2018 Application/Annual Report Guidance

The Maternal and Child Health Bureau has made several changes to the Title V national performance measures (NPMs) for fiscal program year 2019 (October 1, 2018, through September 30, 2019), as explained in the guidance and an appendix of supporting documents.

MCH Domains:

15 NPMs grouped into 5 MCH population domains (cross-cutting/life course domain eliminated).

While there are no NPMs included in the optional sixth domain (cross-cutting/systems building), a state may choose to develop one or more SPMs to address a priority need that is related to program capacity and/or systems (e.g., workforce development, enhanced data infrastructure). A state is not required to develop a measure for this domain.

National Performance Measures:

States are not required to choose both parts of NPM 13. A state can choose NPM 13.1 without choosing NPM 13.2, or vice-versa.

A state can select both NPM 13.1 and NPM 13.2, but can count NPM 13 as only one measure toward the five MCH population domains. For example

  • A state can count NPM 13.1 for the women/maternal health population domain
    Or
  • A state can count NPM 13.2 for the child health or adolescent health population domain

States may choose to retire up to 3 NPMs (out of the 8 NPMs they selected in 2015), but if it does so, states should provide reasons in its 2018 application for retiring each measure.

Thirty-two states and jurisdictions selected the National Performance Measure (NPM) on oral health, NPM 13:

Alabama, Alaska, American Samoa, Connecticut, Delaware, District of Columbia, Federated States of Micronesia, Georgia, Hawaii, Idaho, Illinois, Iowa, Kentucky, Marshall Islands, Maryland, Massachusetts, Michigan, Montana, New Jersey, New Mexico, New York, North Dakota, Northern Mariana Islands, Oregon, Puerto Rico, Rhode Island, South Dakota, Utah, Vermont, Virgin Islands, Virginia, and West Virginia.

Map showing states and jurisdictions that selected NPM-13.

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