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Maintaining a Focus on Maternal and Child Health

Maintaining a Focus on Maternal and Child Health. Jeffrey G. Lobas, MD. Challenges for MCH. Resources Competition between Priorities Evidence-Based Approaches Attitude/Culture Silos/Isolationism Leadership Workforce. MCH Block Grant Funding 1985-2006. Impact of Title V Reductions.

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Maintaining a Focus on Maternal and Child Health

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  1. Maintaining a Focus on Maternal and Child Health Jeffrey G. Lobas, MD

  2. Challenges for MCH • Resources • Competition between Priorities • Evidence-Based Approaches • Attitude/Culture • Silos/Isolationism • Leadership • Workforce

  3. MCH Block Grant Funding 1985-2006

  4. Impact of Title V Reductions Services# of StatesAffected • Family Planning 14 • Children’s Services 14 • Adolescent Health 13 • CSHCN 8 • Program Development 17

  5. 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 Problem-solving during Cutbacks: I

  6. 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 Administrative services usually first for reductions Geographic locations Services delivered Populations covered Eliminate lower priority services Problem-solving during Cutbacks: II

  7. Competition • “Disease of the Month” • Individual Health vs. Population Medicine • Bioterrorism/Disaster Preparedness • “Health Coverage” • Pet Projects • Lack of Focus • Consolidation

  8. Evidence-Based Practice • Science of Maternal and Child Health • Research Orientation • Performance Measures • Outcomes • Evaluation which is Rigorous

  9. Attitude/Culture “ I’m mad as hell and I am not going to take it anymore.” Network-Peter Falk

  10. Silos/Isolation • Public/Private Relationships • Separate View of the world • Disenfranchised view of public health

  11. Leadership and Workforce • Cultivating new leaders • Mentoring and Maintaining leaders • Valuing leadership

  12. Accepting the Challenge • Advocacy • Partnerships • “Just say no!” • Science/Outcomes • Innovation • Leadership Development

  13. Partnerships • AMCHP • CityMatCH • AAP/AAFP/ACOG • CDC • MCHB • ASTHO • Family Voices • Others!-SAMHSA, etc.

  14. Advocacy • National Advocacy • State Level • Professional Organizations

  15. “Just Say No”

  16. Science/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

  17. Innovation • Adapt new approaches and try them on a small scale • Develop new approaches and study it • Plan/Do/Study/Act cycle

  18. Leadership Development • Partner • Individualize • Develop a strategy • Competencies

  19. Stop the Madness!!!!!

  20. Our Vision is our Legacy

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