amchp association of maternal & child health programs maintaining a focus on maternal and child...
TRANSCRIPT
AMCHP Association of Maternal & Child Health Programs
Maintaining a Focus on Maternal and Child Health
Jeffrey G. Lobas, MD
AMCHP Association of Maternal & Child Health ProgramsChallenges for MCH• Resources• Competition between Priorities• Evidence-Based Approaches• Attitude/Culture• Silos/Isolationism• Leadership• Workforce
AMCHP Association of Maternal & Child Health Programs
MCH Block Grant Funding 1985-2006
$0
$100,000,000
$200,000,000
$300,000,000
$400,000,000
$500,000,000
$600,000,000
$700,000,000
$800,000,000
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
2005
Inmillions
AMCHP Association of Maternal & Child Health Programs
Services # of
States Affected
Family Planning 14
Children’s Services14
Adolescent Health13
CSHCN 8 Program Development
17
Impact of Title V Reductions
Impact of Title V Reductions
AMCHP Association of Maternal & Child Health ProgramsProblem-solving during
Cutbacks: I Reduction of
administrative expenses Consolidation Less expensive
alternatives
Changing the way services are delivered Contracts Resource
sharing Service
integration
Negotiating better Contracts
Improving Contract Administration
Better employee oversight
Use “carry forward” funds for short-term problems
AMCHP Association of Maternal & Child Health Programs Problem-solving during
Cutbacks: II Cost-Shifting– Medicaid– Insurance– Partners– Families
Seek funds from reductions in other programs.
Replace lost funds with new state funds
Cut back lower priority services– Administrativ
e services usually first for reductions
– Geographic locations
– Services delivered
– Populations covered
Eliminate lower priority services
AMCHP Association of Maternal & Child Health Programs Competition
• “Disease of the Month”• Individual Health vs. Population
Medicine• Bioterrorism/Disaster Preparedness• “Health Coverage”• Pet Projects• Lack of Focus• Consolidation
AMCHP Association of Maternal & Child Health Programs
Evidence-Based Practice• Science of Maternal and Child
Health• Research Orientation• Performance Measures• Outcomes• Evaluation which is Rigorous
AMCHP Association of Maternal & Child Health Programs
Attitude/Culture
“ I’m mad as hell and I am notgoing to take it anymore.”
Network-Peter Falk
AMCHP Association of Maternal & Child Health Programs Silos/Isolation• Public/Private Relationships• Separate View of the world• Disenfranchised view of public
health
AMCHP Association of Maternal & Child Health ProgramsLeadership and Workforce
• Cultivating new leaders• Mentoring and Maintaining leaders• Valuing leadership
AMCHP Association of Maternal & Child Health ProgramsAccepting the Challenge• Advocacy• Partnerships• “Just say no!”• Science/Outcomes• Innovation• Leadership Development
AMCHP Association of Maternal & Child Health Programs Partnerships
• AMCHP• CityMatCH• AAP/AAFP/ACOG• CDC• MCHB• ASTHO• Family Voices• Others!-SAMHSA, etc.
AMCHP Association of Maternal & Child Health Programs Advocacy• National Advocacy• State Level• Professional Organizations
AMCHP Association of Maternal & Child Health Programs
“Just Say No”
AMCHP Association of Maternal & Child Health ProgramsScience/Outcomes• Projects should include some
research question• Rigorous evaluation is a valid
research approach• “if we don’t publish, we didn’t do it”• We owe it to move the body of
knowledge forward• University’s think about research
differently
AMCHP Association of Maternal & Child Health Programs
Innovation• Adapt new approaches and try
them on a small scale• Develop new approaches and
study it• Plan/Do/Study/Act cycle
AMCHP Association of Maternal & Child Health Programs
Leadership Development• Partner• Individualize• Develop a strategy• Competencies
AMCHP Association of Maternal & Child Health ProgramsStop the
Madness!!!!!
AMCHP Association of Maternal & Child Health Programs
Our Vision is our Legacy