AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006
EDDIE TOWNSON: Good morning. Welcome to AMCHP on a cold morning in this room. I’m glad I’ve got coffee to keep me awake this morning and keep me warm. To give you a little background, about six years ago I sat, not particularly this room but in this presentation. I was new to Maternal and Child Health. I had come out of the private substance abuse and treatment field and had moved into public health and started in what was called the States Systems Development Initiative which is a HRSA grant that a lot of people there at the complex know about. And over time working through Maternal and Child Health then I have moved into Family and Community Involvement Coordinator for our branch. I also coordinate our Title V Block Grant application which Betsy was talking about, which led to me coordinating the Title V needs assessment last year. And now I’m here. So if you stick around for a little while, you could be doing a presentation in a cold room in about six years.
I never thought that I would ever be doing this when I was sitting in that room six years ago. To start off with the Georgia Family Health branch, we serve as our Title V agency within Georgia. The branch is part of the Georgia Division of Public Health, which is also part of the Georgia Department of Human Resources. And at the branch we believe that healthy and well educated children and families are the keys to optimal individual growth and development essential to maintaining safe and economically sound communities. This is just to give you a little background on our stuff. We believe in prevention and community ownership, ethical decisions, and commitment to the scientific process. Out statewide goals, and I’ll go deeper into this also in the presentation, is improving health status, improving services, and building systems capacity.
And what I’m going to do is go through some of our programs and also tie these back into some of our needs assessment stuff at the very end. The way our branch is set up is we have four population teams. We have the Office of Women’s Health, Infant and Child Health, Adolescent Health and Youth Development, and Children with Special Needs. And the reason why I have an asterisk there is in a lot of states, the Children with Special Healthcare Needs and MCH kind of sit apart. Within Georgia we are all together under one branch.
All these population teams fall under our programs and services section, which actually we have five sections. But there’s Programs and Services; Policy Planning and Evaluation, which I’ll go into a little deeper detail, which handles our Block Grant application, which handles our needs assessment, which does a lot of training around our MCH programs; our Data team; Nutrition; and Oral Health. And I’ll show you how these lay across our programs also later on in the presentation.
The Office of Women’s Health provides leadership and resources to communities in the development, use, and continuous improvement of a continuum of healthcare that supports and improves a quality of life for women and their families. And these are some of the programs within the Office of Women’s Health. Our Babies Born Healthy, which is a state funded program for mothers that don’t qualify for health insurance or Medicaid and actually before I came down here on Friday, we are going through some legislative changes where some of the legislation may be trying to cut this program within the state of Georgia. We sent out word through the grapevine, through all of our families and our partners and all of the communities that we can get a hold of to let them know this is coming down the line.
Then we also have Perinatal Case Management which is a partnership with the Division of Public Health and the Department of Community Health which provides case management to pregnant Medicaid women in Georgia.
Pregnancy Related Services, or PRS, which is also a Medicaid program which reduces infant illness and death rate and improving the quality of life for new mothers and their infants. The regional perinatal centers, we have six within Georgia and they provide a system of comprehensive perinatal care services for pregnant women.
Our Resource and Mothers Program, which I love the Resource and Mothers Program. It does some wonderful, wonderful work in Georgia. And it focuses on pregnant and parenting teens by providing trained experienced women and men to provide guidance and support. We do this through our program and also through a lot of our partners. Our Healthy Start sites, we have four in Georgia that do an outstanding job about resource and mothers’ education.
Family Planning also sits in the Office of Women’s Health which is also Title X and provides comprehensive reproductive health services to women of childbearing age and their partners.
Onto to Infant and Child Health. ICH provides leadership and resources to communities in the development of a comprehensive system of care designed to improve the health and wellbeing of infants and children and their families. Our Children’s First program is a single point of entry into a wide range of public help programs. And this is kind of like our catch-all. All children are enrolled in Children’s First. And it’s not actually a program; it’s a process. Which we try to explain to a lot of people, and you don’t get it until you actually look at the process. But it makes sure that all children are able to access the public health system.
School Health, which provides education and development programs to school health personnel in order to ensure high quality healthcare.
Our Newborn Screening program which is an amazing program in itself. It maintains and supports a comprehensive statewide system to ensure that all newborns receive screening for seven inherited metabolic diseases and sickle cell disorders. Also this is being increased, I believed it being increased now through legislation to ten or 11 metabolic diseases.
Other program include SIDS, the Universal Newborn Hearing Screening and Healthy Childcare Georgia. SIDS is contracted out. They’re a contractor. Healthy Childcare Georgia is also contracted out. We used to have it in-house and now we’ve moving to have it contracted because now we’re realizing there are programs out there that can work with us and do this much better out in the communities than we may be able to. We don’t have all the answers or all the resources.
Adolescent Health and Youth Development. Program services provide a network of community based support to help adolescents succeed as they move into adulthood by focusing on the assets of individual youth and their families. And some of the programs include our Abstinence Only education, which enhances the skills and improves the health status of Georgia’s adolescents through collaboration with families, communities, and schools, and other public and private organizations throughout Georgia.
Community Involvement, which we have community involvement across the branch but there’s one particular program within Adolescent Health and Youth Development that we call Community Involvement.
There’s also the Violence Against Women program which just actually moved back into Adolescent Health and Youth Development. And we are in the process now of doing a rape prevention education needs assessment within this program.
Okay. And it just stopped. Excuse me just a minute. That was a quick presentation, wasn’t it? Okay. It’s not going to work. I’ll have to do it this other way, then. Just one second. You get to see the background of what I’ve got up here. Okay. Here we go. Part of the Adolescent Health and Youth Development is also part of the Comprehensive Adolescent Health Centers. There’s 39 of these in all of Georgia’s health districts and the Comprehensive Adolescent Health Center is actually a wonderful example of how communities and families can come together to save a program. About two years ago there was legislative talk, there was also talk among Department of Human Resources, of wiping out these programs, taking away the teen centers, because they didn’t see what the work was that the teen centers did. There was a huge, huge outcry among families and among communities to save these programs and every single one of them were saved, whereas they were going to wipe out all of them. And after this happened we actually went back out and did a needs assessment with Title V and one of the things that came up then, again, was how important teen centers are to the communities which they are a part of.
Children with Special Healthcare Needs. The CSN focus is to provide program development, leadership guidance and resources, and the development and division of comprehensive, integrated, and coordinated systems of service for children with special needs birth to age 21 and their families. These services are designed to maximize the potential level of developmental and health wellbeing as well as to minimize the secondary complications for this population which is a very technical sort of definition.
We have the Babies Can’t Wait program which is Georgia’s comprehensive coordinated state wide interagency service delivery system for infants and toddlers for ages birth to three.
We also have CMS, which is Children’s Medical Services, which directly provides and coordinates specialty medical evaluations and treatment for eligible children birth to age 21 with chronic medical conditions.
And then we have high risk infant follow-up which provides services to infants birth age to one who are at increased risk for health and developmental problems due to their medical conditions at birth. And actually, one of our new state performance measures deals directly with high risk infant follow-up.
Our nutrition section and our oral health section overlay our entire branch. They’re not stand alone. They’re not within one particular area. And it’s a joint effort and it’s out there to prevent obesity and other chronic diseases through healthy eating and physical activity initiatives across the lifespan.
Some of the programs in the nutrition section are a Five a Day program, a breastfeeding program, and our folic acid initiative, which folic acid actually is also one of our new state performance measures.
The oral health section aims to prevent dental disease for children through education, prevention, and early detection. I messed that up. One of the programs is the fluoridation program. We also through our oral program have six traveling buses that travel around the state and provide screening and services within the schools and also in community centers.
Georgia and some other states are kind of divided in half. The north part of the state has a lot of services, is kind of metropolitan. The lower half the state is very rural. We have many counties where there are no dentists within 200 or 300 miles. So the oral health program really helps a lot. Plus, our oral health program does so much work and we only have two people in this program. We have our head dentist and one of his assistants to help him out. And they do an amazing job.
Policy Planning and Evaluation section, where I started. We identify priority needs through needs assessment, research best practices, evaluate programs and analyze policies.
The data section which works with our database development, they provide data representation for the branch. They collect and compile information from external resources and also provide technical assistance around data for the branch.
And this, I don’t know if you can see it back here, but this is kind of what our branch is, how everything’s laid out. We have our four population teams which actually overlap each other some way. And then we have the sections that go all the way across the population teams, including Children’s First because, like I said, it’s a process and not a program.
Now I want to go in a little bit into the needs assessment. Now we’re going to talk about the second half of the program today but I just want to give you a little background on this. And I don’t know if you’ll be able to see this. It’s in your handouts, though. But this is sort of our needs assessment process which we did in Georgia. And I’ll go through it very briefly. We collected information from several different areas. It was kind of casting out a wide net and bringing it into something smaller. In phase three we pulled all this information together. Phase four we came up with our priorities working with our partners and I can go into this in greater detail later on in our discussion. And then in phase five we came up with our new priorities and our performance measures. And we’re in the process now of coming up with plans around those priorities and performance measures for our next application which is due in July. At the back of my presentation also.
UNKNOWN SPEAKER: Can you read those purple squares in phase two, where you got the information?
EDDIE TOWNSON: Sure. There? That’s quantitative of data: focus groups, let’s see, these were consumer focus groups. The second one is the needs assessment advisory group which is a large group, which we did a focus group on. The third is another focus group which were planners and coordinators for our programs from across the state. And then the last one was a web based survey which we did with stakeholders, and interviews we did with stakeholders also.
UNKNOWN SPEAKER: Thank you.
EDDIE TOWNSON: You’re welcome. And also, all of this, as Betsy said, is out on the web now. The needs assessment is out there and I actually put all this in our needs assessment out on the web on the HRSA web site.
And these are our new state performance measures. We came up with ten. We only had to come up with seven but Georgia wanted to come up with ten. And these are not the only thing we’re looking at. These are just some of the things that we are able to measure very well, that we know that we’re doing a good job at but we will continue to do other work also.
And here’s the one around high risk infant follow-up. Can everyone read these? Okay. Here’s the one around folic acid. We’ve been doing work around folic acid for years now but we’ve added a new performance measure in around it. Here’s the second half of them. There’s SIDS and then this one here was one that I really liked because we’re trying to –I don’t know if anyone else here knows, we’re losing public health staff right and left and we’re having to make sure that we can do the best work with what we have. So we are increasing our education around our local public health staff.
And all this information can be found out on the Georgia Family Health branch website. Our application for Title V is also out there. And then if you have any other questions, here’s my address and my phone number. Thank you.