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Consortium for Oral Health Systems Integration and Improvement

Title V MCH Services Block Grant Oral Health Toolkit


5-Year Needs Assessment and National Performance Measure for Oral Health (NPM 13)

Title V funds are distributed to MCH programs in 59 states and jurisdictions. In 2021, 27 states and jurisdictions selected one or both parts of NPM 13 (see NPM 13 States and Jurisdictions). OHRC has gathered resources to help state MCH programs and state oral health programs advance their action plan for oral health improvement.

Resources

5-Year Needs Assessment and National Performance Measure for Oral Health (NPM 13)

Strategies, Measures, and Data Sources

Infographics

Best, Emerging, and Promising Practices

Background

In 2015, the Maternal and Child Health Bureau revised the process that states use for the Title V maternal and child health (MCH) block grant 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 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.

NPM 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

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.

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.

Data for the national outcome measures and national performance measures will come from national data sets and will be pre-populated, as available, for the states, the territories, and the District of Columbia. The data source for NPM 13.1 is the Pregnancy Risk Assessment Monitoring System (PRAMS). The data source for NOM 14 and NPM 13.2 is the National Survey of Children's Health (NSCH).

For 13.1, the numerator is the number of women who had a dental visit during pregnancy and the denominator is the number of live births.
For 13.2, the numerator is the number of infants, children, or adolescents, ages 1 through 17, who had a preventive dental visit in the past year, and the denominator is the number of infants, children, or adolescents, ages 1 through 17.

NPM 13 States and Jurisdictions

Twenty-seven states and jurisdictions selected NPM 13.

Alabama, American Samoa, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Guam, Idaho, Illinois, Iowa, Maine, Marshall Islands, Maryland, Michigan, Mississippi, Montana, Nebraska, New Jersey, New Mexico, Palau, Puerto Rico, South Carolina, Utah, Vermont, Virginia, and West Virginia.

States and jurisdictions that selected NPM 13 are highlighted in blue.

Map showing states and jurisdictions that selected NPM-13.