Capacity Assessment for State Title V (CAST-5)
Preliminary Edition
March 2001
Prepared By
Marjory Ruderman, MHS
and
Holly Grason, MA
A Collaborative Initiative of
The Association of Maternal and Child Health Programs and
The Johns Hopkins University Women’s and Children’s Health Policy Center,
with the Maternal and Child Health Bureau, HRSA, DHHS
Cite as:
Ruderman M, Grason H, 2001. Capacity Assessment for State Title V Programs: Preliminary
Edition. Baltimore, MD: Womens and Childrens Health Policy Center, Johns Hopkins School
of Public Health; and, Washington, DC: Association of Maternal and Child Health Programs.
Capacity Assessment for State Title V Programs: Preliminary Edition was printed by Automated
Graphics Systems, 4590 Graphics Drive, White Plains, MD 20695-3111. Tel: 800-678-8760,
Fax: 310-843-6339.
Capacity Assessment for State Title V Programs: Preliminary Edition is not copyrighted.
Readers are free to duplicate and use all or part of the information contained in this publication.
In accordance with accepted publishing standards, the Johns Hopkins Womens and Childrens
Health Policy Center and the Association of Maternal and Child Health Programs request
acknowledgment, in print, of any information reproduced in another publication.
The Womens and Childrens Health Policy Center
Department of Population and Family Health Sciences
Johns Hopkins School of Public Health
615 N. Wolfe Street
Baltimore, MD 21205
Tel: 410/502-5443
Fax: 410/955-2303
Internet: http://www.med.jhu.edu/wchpc
The Association of Maternal and Child Health Programs
1220 19th Street, NW, Suite 801
Washington, DC 20036
Tel: 202-775-0436
Fax: 202-775-0061
Internet: http://www.amchp.org
Development of this document was supported by cooperative agreements #U93 MC 00101
(WCHPC), #U93 MC 00112 and U01 MC 0001 (AMCHP) with the Maternal and Child Health
Bureau, Health Resources and Services Administration, U.S. Department of Health and Human
Services.
FOREWORD
The genesis of CAST-5 goes back over a dozen years. In the course of the Association of Maternal
and Child Health Programs (AMCHP) first major project after opening its Washington, D.C. office,
feedback from state Title V Program leaders created the first germ of the idea. Partnering with Dr.
Bernard Guyer at the Johns Hopkins University School of Public Health, the AMCHP staff team,
led by myself and Holly Grason, working with AMCHP member leaders including Dr. Peter van
Dyck, developed plans to conduct site visits of state Title V programs. Our purpose was to
understand how the programs were carrying out what we viewed to be core program functions, what
factors influenced how effectively functions were carried out, and what AMCHP, with our federal
partners, could do to strengthen programs.
Our site visits to ten states resulted in the publication Toward the Future of Title V. Our focus and
our findings dovetailed nicely with the simultaneous work of the Institute of Medicine on The Future
of Public Health (1989). Over the past decade of tremendous change in service financing and
delivery systems, in federal - state relations, and in leading causes of disease, disability and death,
we have worked with federal partners, with families, with national organizations, with schools of
public health and others to assist state Title V programs in strengthening their roles and capacities
in line with our own recommendations and those of other public health leadership entities.
With all of our collective work on health and welfare reform, managed care and Medicaid, SCHIP,
care coordination, and perinatal and adolescent health, we did not and could not lose sight of the
basics. These basics are the core functions and the program capacities needed for achieving
objectives for improved health and well being. In the mid-90's we teamed again with Johns
Hopkins, which Holly Grason had now joined, to produce the Public MCH Program Functions
Framework: Essential Public Health Services to Promote Maternal and Child Health in America.
Although begun independently, that work again complemented other efforts in the broader public
health community to better articulate public health core functions.
And now we have returned to the idea first brought to us by state programs in the late 80's. Finding
our site visit protocol itself to be a valuable tool, states encouraged AMCHP to consider adapting
it for use as a self-assessment tool. The need for such a tool was voiced again strongly in the mid
to late nineties, as devolution promised to enhance state roles while state reorganizations and system
changes were affecting, and sometimes destabilizing Title V programs. And while different, CAST
5 again complements nicely a simultaneous effort in the larger public health community to develop
public health performance standards.
That we are now able to deliver this tool is a tribute to many people over the years. Dr. Vince
Hutchins, whom the MCH community now mourns the loss of, supported the award of grant funds
that enabled AMCHP to do this work. Dr. Peter van Dyck, who was an AMCHP leader when this
work was conceived, has continued as a MCH Bureau leader to support and promote a strong federal
and state partnership in this and other areas. Dr. Bernard Guyer and Holly Grason have continued
to provide the leadership, and able staff and consultants like Marjory Ruderman and Gillian Silver
to make ideas real and to craft useful products. AMCHP staff and member leaders including former
CAST-5 Preliminary Edition · March 2001
Assistant Executive Director Karen Van Landeghem, Helene Kent, Millie Jones, Susan Burke, Rita
Schmidt, Tom Miller, and Sally Fogerty along with several close colleagues of state Title V
programs – Judy Gallagher, Arden Handler, Jane Pearson, and Donna Petersen shaped the product
in its current form. MCH and CSHCN staff in the states of Alabama, Colorado, and Ohio piloted
early versions.
AMCHP extends our thanks to them and all of the others over the years who generated, nurtured and
finally delivered on the idea that is now the Capacity Assessment for State Title V (CAST-5). We
now look to all of the state Title V programs to undertake the challenge of organizational selfassessment and provide us their experience and guidance for further refinements.
Catherine A. Hess
Executive Director, AMCHP
March, 2001
CAST-5 Preliminary Edition · March 2001
An Overview of
Capacity Assessment for State Title V
(CAST-5)
Preliminary Edition
March 2001
A Collaborative Initiative of
The Association of Maternal and Child Health Programs and
The Johns Hopkins University Women’s and Children’s Health Policy Center,
with the Maternal and Child Health Bureau, HRSA, DHHS
Table of Contents
Background............................................................................. ii
Goal ........................................................................................ iii
Strategic Capacity Planning Framework ................................ iv
Frameworks for Describing MCH Functions ......................... v
Core Questions ....................................................................... v
CAST-5 Process Map ............................................................. vi
Review of the Ten MCH Essential Services …………..…… vii
Process Indicators ................................................................... vii
Capacity Needs ....................................................................... vii
SWON Analysis ..................................................................... vii
Capacity Development Action Plan ....................................... vii
Assumptions ........................................................................... viii
Format..................................................................................... viii
Use .......................................................................................... viii
Appendix A: MCH Pyramid – MCH Functions Framework
Appendix B: CAST-5 Advisory Group and Staff
Capacity Assessment for State Title V (CAST-5)
&$67 LV D VHW RI DVVHVVPHQW DQG SODQQLQJ WRROV IRU VWDWH 7LWOH 9 SURJUDPV
LQWHUHVWHG LQ H[DPLQLQJ WKHLU RUJDQL]DWLRQDO FDSDFLW\ WR FDUU\ RXW FRUH
PDWHUQDODQGFKLOGKHDOWKIXQFWLRQV&$67LVDQLQLWLDWLYHRIWKH$VVRFLDWLRQ
RI 0DWHUQDO DQG &KLOG +HDOWK 3URJUDPV DQG WKH -RKQV +RSNLQV 8QLYHUVLW\
:RPHQ·V DQG &KLOGUHQ·V +HDOWK 3ROLF\ &HQWHU LQ SDUWQHUVKLS ZLWK WKH IHGHUDO
0DWHUQDO DQG &KLOG +HDOWK %XUHDX &$67 ZDV GHYHORSHG XQGHU WKH GLUHFWLRQ
RIDQ$GYLVRU\*URXSPDGHXSRIFXUUHQWDQGIRUPHU7LWOH9GLUHFWRUVDQGRWKHU
H[SHUWVRQ0&+SUDFWLFHVHH$SSHQGL[%$GGLWLRQDOFRQVXOWDWLRQZDVUHFHLYHG
IURP WKH $0&+3 ([HFXWLYH &RXQFLO DQG UHOHYDQW FRPPLWWHHV DV ZHOO DV IURP
:&+3&IDFXOW\
6SHFLDOWKDQNVJRWRWKHPHPEHUVRIWKH&$67$GYLVRU\*URXSDQGWRWKH7LWOH
9SURJUDPVLQ$ODEDPD$UL]RQDDQG2KLRZKLFKSLORWWHVWHG&$67SULRUWR
WKHSUHSDUDWLRQRIWKLV3UHOLPLQDU\(GLWLRQ7KHH[SHULHQFHVRIVWDWHVZLWKWKLV
HGLWLRQRI&$67ZLOOEHLQVWUXPHQWDOLQGHYHORSLQJIXWXUHLPSURYHGYHUVLRQV
CAST-5 Preliminary Edition Á March 2001
i
%DFNJURXQG
A major strength of the federal-state maternal and child health (MCH) program embodied in Title V
of the Social Security Act (1935 to present) is its potential both to identify and address persistent
and emerging health issues for women, children, and families, and to be adaptive to changes
generated by the larger health services environment. The past decade has seen particularly rapid and
complex changes in social policies and in the health care delivery system, as well as important
challenges from within the public health field. Highlights of these changes include:
S
In 1988, the Institute of Medicine issued its Report on the Future of Public Health,
challenging public health as a field to redefine and regroup itself around the core functions
of assessment, policy development, and assurance. The practice of public health shifted
away from a medical, or treatment, model toward a broader, prevention-oriented
framework.
S
An increasing reliance on insurance strategies for improving population health led to a series
of incremental Medicaid reforms that have variously improved and diminished access to
needed services. Efforts to enact national health care reform legislation failed mid-decade,
but a new federal State Children's Health Insurance Program (S-CHIP) was enacted in 1997.
S
Managed care strategies and market competition increasingly have been used to reduce
health care costs while promoting health systems accountability for population health
outcomes.
S
Welfare reform broke the link between welfare and Medicaid eligibility and in some cases
effectively ended families’ enrollment in Medicaid, even when they remained eligible.
Those women who are no longer eligible for Medicaid once they move into the workforce
are often employed in low-wage jobs without insurance benefits.
S
A series of public program and systems reforms have altered the way government programs
and agencies interact with other community and state entities to achieve public health goals.
Categorical programs are increasingly integrated with other complementary governmental
initiatives. In keeping with this move from a categorical perspective to a systems approach,
many state governments/agencies have reorganized around shared missions and visions and
undergone significant structural changes.
There is growing consensus in the public health field on an articulated set of core public health
functions (assessment, policy development, and assurance), along with an underlying set of ten
essential public health services, as the blueprint for local and state agency operations. In the
maternal and child health field, a corresponding, discipline-specific framework was devised and
disseminated as the Public MCH Program Functions Framework: Essential Public Health Services
to Promote Maternal and Child Health in America (Grason and Guyer, 1995). Given all of these
related efforts, public health agencies are looking internally to understand and specify what is
needed to implement these functions and services in a reconfigured and fluid policy and market
environment.
ii
CAST-5 Preliminary Edition Á March 2001
To that end, and building on the work undertaken mid-decade to produce the Public MCH Program
Functions Framework, the Association of Maternal and Child Health Programs (AMCHP) and the
Johns Hopkins University Women’s and Children’s Health Policy Center (WCHPC), in partnership
with the federal Maternal and Child Health Bureau (MCHB), have prepared a set of tools for states
to use in assessing their capacity to implement these essential services in the context of the scope
and rate of changes taking place in the larger environment. AMCHP’s vision is that this
organizational capacity assessment will set the stage for long-term planning related to program
mission and goals, but will also assist in decision-making about budget, staffing, and staff
development needs.
The Capacity Assessment for State Title V (CAST-5) tools are designed to accommodate wide
variation in state programming structures and to be useful for strategic planning in different health
policy and systems contexts. They can be used collectively for a comprehensive assessment of
program capacity needs that includes the identification of opportunities for capacity development, or
they can be used singly for appraisals of narrower scope. Reflective of the wide range of resources
with which state MCH programs operate, key assessment elements are structured along a
continuum, allowing programs to characterize their capacity needs using relevant reference points.
Moreover, recognizing that responsibility for the health and well-being of MCH populations extends
beyond Title V, the assessment of program resources takes into account the contributions of other
agencies, organizations, and institutions in implementing public MCH functions.
Notwithstanding the need to address demands for flexibility, also at the core of this assessment
framework is the foundation provided by federal statutory1 and executive agency guidance.
Moreover, given work underway nationally to outline broad standards and measures for state and
local public health agency activities, capacities, and competencies (e.g., the work of CDC, ASTHO,
and NACCHO on tools related to the National Public Health Performance Standards Program, such
as MAPP and a state-level public health performance assessment tool), these CAST-5 tools are
structured to correspond to the concepts and domains embedded in those performance assessment
projects. However, CAST-5 extends the assessment of core functions performance to the
organizational and systems-level resources required to fulfill diverse program objectives. This
approach is tailored to the MCH mission and is intended to facilitate strategic organizational and
management planning.
&$672YHUYLHZ
♦ Goal
The goal in developing CAST-5 is: “To help every state and territory understand and optimize
its capacity to identify and address key maternal and child health issues, including issues
pertaining to children with special health care needs, in order to bring about desired public
health outcomes.” Although the tools are presently designed for use at the state level, in the
future they may be reformulated for use by local MCH programs.
1
Such as Title V of the Social Security Act of 1935, the Government Performance and Results Act of 1993 (GPRA),
and the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA).
CAST-5 Preliminary Edition Á March 2001
iii
♦ Strategic Capacity Planning Framework
CAST-5 fits into the larger long-term planning environment for MCH programs, as pictured in
Figure 1. The “MCH Strategic Capacity Planning Framework” addresses three critical
questions: “What do we do,” “To what end,” and “What do we need to accomplish the end
goal(s)?” The core public health functions and MCH essential services describe program
activities and roles within the larger health care environment, answering at least in part the first
question. Guidance related to program performance and outcomes, such as the Title V
Performance Measures and Health Status Indicators, reflect the “to what end” component of the
framework. CAST-5 is meant to answer the questions “what do we have” and “what do we
need to get the job done.” It assists state Title V programs in determining what organizational,
programmatic, and management resources must be developed or enhanced, given what the
program does, in order to fulfill the program’s goals and objectives.
Figure 1. MCH Strategic Capacity Planning Framework
Systems Context
demographic changes, changes in public programming for families, competition and collaboration
Organizational Environment
mission
and goals
core
services
functions and activities
Organizational Capacity
structural/managerial
resources
- authority
(statutory base)
- organizational
relationships
- data availability
and analytical
capacity
- information
systems
- organizational
structure and
staffing
- funding
What do we do?
iv
human/process
resources
Effects
performance
measures
outcome
measures
- political
latitude (direct
and indirect)
- expertise,
competency,
and skills (inhouse staff and
borrowed or
purchased staff
resources)
- organizational
culture
What should be in place to achieve this?
What do we have?
What do we need?
To what end?
CAST-5 Preliminary Edition Á March 2001
♦ Frameworks for Describing MCH Functions
A strategic decision was made by the CAST-5 expert advisory group early in the development
process to frame the tools around the 10 MCH Essential Services (as outlined in the Public
MCH Program Functions Framework). However, the indicators that form the basis for the
assessment tools draw on a large body of related work, including the Title V Pyramid developed
by the MCHB to describe MCH program activities. The decision to follow the essential services
framework reflects the workgroup’s interest in corresponding to other current guidance related
to core functions performance assessment and in using language familiar to policymakers
outside of the MCH sphere. However, the MCH Essential Services are easily understood in
terms of the MCHB Title V Pyramid categories; each essential service can be classified
according to a corresponding level of the Pyramid. As such, the CAST-5 process is relevant to
and congruent with programs’ planning, assessment, and reporting related to the Title V Block
Grant. A reference tool has been developed to help MCH professionals translate from one
framework to the other (Appendix A).
♦ CAST-5 Tools
CAST-5 encompasses several assessment tools: Core Questions, Review of the Ten MCH
Essential Services, Process Indicators, Capacity Needs, and SWON Analysis. In addition,
CAST-5 provides broad guidance on prioritizing program capacity needs and developing
strategies for capacity development.
Figure 2 depicts the CAST-5 process. Further description of assessment components follows:
Core Questions. The Core Questions establish whether the program has identified its general
vision, desired outcomes, and strategies for reaching those outcomes. The first five Core
Questions represent a fundamental level of program functioning and must be met before further
assessment of capacity is undertaken:
1.
Have you established the vision/goals for the MCH population?
2.
Given the Title V needs assessment, have you identified the priority health issues and desired population
health outcomes?
3.
Have you identified the political, economic, and organizational environments for addressing the priority
health issues?
4.
What are the macro-level strategic directions for the Title V program in light of the responses to questions
1, 2 and 3 above?
5.
Have you identified the programmatic organizational strategies you will use to implement the strategic
directions identified in #4 and to achieve the desired population outcomes identified in #2?
For states that cannot answer each of these questions affirmatively or in full, a list of resources
for assistance in expanding that capability is provided. Note that the Core Questions can be
applied at the level of the agency as a whole and/or at the level of each priority or strategic
CAST-5 Preliminary Edition Á March 2001
v
health issue identified.
Figure 2.
Capacity Assessment for State Title V (CAST-5)
CORE QUESTIONS
Where do we want to
go programmatically?
GO TO NEXT ESSENTIAL SERVICE
DISCUSS PROCESS
INDICATORS
for each Essential Service
Where do we need to be to get there?
Where are we now?
IDENTIFY CAPACITY
NEEDS
What do we need to have in place?
CONDUCT ANALYSIS
OF PERFORMANCE
Assess adequacy for
each indicator
Minimally
Adequate
Partially Substantially Fully
Adequate Adequate
Adequate
Assess presence of each
structural resource, data/IS
resource, organizational
relationship, and competency
listed
Identify strengths, weaknesses,
opportunities, and needs
SUMMARIZE CAPACITY
NEEDS ACROSS
ESSENTIAL SERVICES
IDENTIFY STRATEGIES FOR
CAPACITY DEVELOPMENT
vi
•Prioritize Capacity Needs
•Specify a process for creating
a detailed action plan for
capacity development
CAST-5 Preliminary Edition Á March 2001
The final Core Question forms the basis for the subsequent CAST-5 tools:
6. Have you identified the capacity you need to implement the strategies?
States that have not adequately identified the necessary capacity can do so by continuing with
the assessment process.
Review of the Ten MCH Essential Services. This optional interim step in the CAST-5 process
can be used to ensure that each of the assessment team members begins the CAST-5 process
with a common understanding of the 10 MCH Essential Services. This step can also be used
to help identify priority ordering (if desired) of Essential Services for CAST-5 assessment
activities.
Process Indicators. The Process Indicators are used to identify the state’s current and desired
levels of performance of core functions. The state can assess its functioning across all essential
services or choose to focus on a subset for a more limited assessment. For each essential
service, a set of Process Indicators is provided. These indicators reflect program output or
activities along a continuum of “intensity” – i.e., the first indicator in a list represents a more
basic level of performance than does the last. The continuum does not necessarily reflect the
order in which one would approach the task; it simply allows programs of diverse structures and
resources to identify the program outputs they currently achieve and those they aim to achieve in
the future.
The Process Indicators address the interaction of the state Title V program with the local public
health system, primarily by assessing the state’s role in supporting local efforts. They also take
into account the contributions of other entities within the MCH system, recognizing the
importance of system-wide performance and capacity.
Capacity Needs. For each essential service, the Process Indicators are linked to a list of specific
program resources (structural resources, data/information systems resources, organizational
relationships, and competencies/skills), or Capacity Needs, that are necessary to adequately
perform in that area. The adequacy/presence of each Capacity Need is assessed.
States may choose simply to use the lists of Capacity Needs as a checklist for reference in
planning activities. However, additional guidance, as described next, is provided for assessing
capacity needs in greater depth.
SWON Analysis. Each Capacity Needs list is followed by a worksheet to assist the assessment
team in identifying strengths, weaknesses, opportunities, and needs related to program capacity
to perform each essential service. This information is key to moving on to the next and final
step in the CAST-5 process.
Capacity Development Action Plan and Report Templates. The Capacity Needs identified as
needing enhancement are synthesized and condensed across all of the Essential Services. A
worksheet is provided for broad guidance on prioritizing program capacity needs and identifying
strategies for capacity development, within the context of program-specific long-term objectives
CAST-5 Preliminary Edition Á March 2001
vii
and goals. Report templates provide a format for summarizing and encapsulating the key points
and decisions made during the assessment discussions.
♦ Assumptions
Several assumptions have been identified by the CAST-5 advisory workgroup as coming into
play when a state undertakes the CAST-5 process. First, the interpretation of indicators and the
continuum they represent will be colored by state context. Second, the assessment process is
iterative and ongoing; like any quality improvement process, continuous monitoring and
adjustments are key to enhancing agency development. Finally, maintenance of current activity
and/or resources is a strategic choice; although the assessment is designed to facilitate capacity
development, the unique features of each state will determine what steps, if any, are taken with
the assessment results.
♦ Format
In the future, CAST-5 may be computer-based, with links providing easy reference to glossaries,
examples, and other helpful resources.
♦ Use
CAST-5 can be used by states transitioning to a greater focus on public health assessment,
policy development, and quality improvement/assurance roles. Similarly, it can be used to
“recenter” around the MCH mission and determine capacity needs as part of a long-term
strategic planning process. States also express interest in using the assessment as a training and
planning tool for incoming state MCH directors and senior staff. Although the tools have been
conceived of for use in assessing the overall Title V program, some components may be
applicable to specific program areas or populations as well.
A number of strategies for carrying out the assessment have been identified, including being
undertaken by:
• a small management team;
• an individual with knowledge of the full range of program activities and resources;
• a larger group of staff members in conjunction with an aggregated, more detailed
analysis; and
• small workgroups carrying out components of the assessment before reconvening to
consolidate results and move into planning.
It is important to note that the tools are not meant for use in measurement of performance for
research or comparison purposes, and should not be viewed as a means of determining quality of
programs in relation to one another or to a “gold standard.” To date, wide variability in program
context has precluded identification of an “ideal” set of activities and resources. However,
AMCHP is interested in considering use of these tools as a first step in moving toward standards
setting for Title V programs.
viii
CAST-5 Preliminary Edition Á March 2001
$SSHQGL[$
0&+3\UDPLG0&+)XQFWLRQV)UDPHZRUN
Basic
health
care
services;
Health care
services for
CSHCN
Direct Health
Care Services
Framework: 7F*
Transportation, Translation,
Outreach, Respite care, Health
education, Family support services,
Purchase of health insurance, Case
management; Coordination with
Medicaid, WIC, and education
Enabling Services
Framework: 3 A,B,C; 7A,B,C,D,E,H,I,J,K
Newborn screening; Lead screening; Immunization;
SIDS counseling; Oral health; Injury prevention;
Nutrition; Outreach/public education
Population-Based Services
Framework: 3 A,B,C; 7 G; 8 F
Needs assessment; Evaluation; Planning; Policy development; Coordination;
Quality assurance; Standards development; Monitoring; Training; Applied
research; Systems of care; Information systems
Infrastructure Building Services
Framework: 1 A,B,C; 5 A,B,C; 9 A,B,C,D; 2 A,B,C;
6 A,B,C,D,E,F,G,H; 10 A,B; 3 D; 7 L,M; 4 A,B; 8 A,B,C,D,E
*Number/letter combinations refer to the Essential Service number and its subsections outlined in the Public MCH
Program Functions Framework.
3XEOLF0&+3URJUDP)XQFWLRQV)UDPHZRUN
(VVHQWLDO3XEOLF+HDOWK6HUYLFHVWR3URPRWH0DWHUQDODQG&KLOG+HDOWKLQ$PHULFD
$VVHVVDQGPRQLWRUPDWHUQDODQGFKLOGKHDOWKVWDWXVWRLGHQWLI\DQGDGGUHVV
SUREOHPV
'LDJQRVHDQGLQYHVWLJDWHKHDOWKSUREOHPVDQGKHDOWKKD]DUGVDIIHFWLQJ
ZRPHQFKLOGUHQDQG\RXWK
,QIRUPDQGHGXFDWHWKHSXEOLFDQGIDPLOLHVDERXWPDWHUQDODQGFKLOGKHDOWK
LVVXHV
0RELOL]HFRPPXQLW\SDUWQHUVKLSVEHWZHHQSROLF\PDNHUVKHDOWKFDUH
SURYLGHUVIDPLOLHVWKHJHQHUDOSXEOLFDQGRWKHUVWRLGHQWLI\DQGVROYH
PDWHUQDODQGFKLOGKHDOWKSUREOHPV
3URYLGHOHDGHUVKLSIRUSULRULW\VHWWLQJSODQQLQJDQGSROLF\GHYHORSPHQWWR
VXSSRUWFRPPXQLW\HIIRUWVWRDVVXUHWKHKHDOWKRIZRPHQFKLOGUHQ\RXWK
DQGWKHLUIDPLOLHV
3URPRWHDQGHQIRUFHOHJDOUHTXLUHPHQWVWKDWSURWHFWWKHKHDOWKDQGVDIHW\
RIZRPHQFKLOGUHQDQG\RXWKDQGHQVXUHSXEOLFDFFRXQWDELOLW\IRUWKHLU
ZHOOEHLQJ
/LQNZRPHQFKLOGUHQDQG\RXWKWRKHDOWKDQGRWKHUFRPPXQLW\DQGIDPLO\
VHUYLFHVDQGDVVXUHDFFHVVWRFRPSUHKHQVLYHTXDOLW\V\VWHPVRIFDUH
$VVXUHWKHFDSDFLW\DQGFRPSHWHQF\RIWKHSXEOLFKHDOWKDQGSHUVRQDOKHDOWK
ZRUNIRUFHWRHIIHFWLYHO\DQGHIILFLHQWO\DGGUHVVPDWHUQDODQGFKLOGKHDOWK
QHHGV
(YDOXDWHWKHHIIHFWLYHQHVVDFFHVVLELOLW\DQGTXDOLW\RISHUVRQDOKHDOWKDQG
SRSXODWLRQEDVHGPDWHUQDODQGFKLOGKHDOWKVHUYLFHV
10. 6XSSRUWUHVHDUFKDQGGHPRQVWUDWLRQVWRJDLQQHZLQVLJKWVDQGLQQRYDWLYH
VROXWLRQVWRPDWHUQDODQGFKLOGKHDOWKUHODWHGSUREOHPV
Source: Grason H, Guyer B, 1995. Public MCH Program Functions Framework: Essential Public Health Services
to Promote Maternal and Child Health in America. Baltimore, MD: The Women’s and Children’s Health Policy
Center, The Johns Hopkins University.
,QWURGXFWLRQ
&$67LVLQWHQGHGIRUXVHDVDPDQDJHPHQWWRROWRDLGLQLGHQWLI\LQJQHHGVDQG
VHWWLQJ SULRULWLHV UHODWHG WR D SURJUDP·V GHVLUHG UROHV DQG QHFHVVDU\
FDSDFLWLHV7KH&$67WRROVDUHQRWVFRUHGDQGWKHUHDUHQR´ULJKWµRUHYHQ
´EHVWµDQVZHUV5DWKHUWKHSDUWLFXODUFRQWH[WIRUHDFKVWDWH·V7LWOH9SURJUDPÂ
ZLOOVKDSHWKHDVVHVVPHQWUHVXOWV
$V\RXUHDGWKURXJKWKHVHLQVWUXFWLRQVNHHSLQPLQGWKDWWKHYDOXHRI&$67
OLHV LQWKH GLVFXVVLRQV LWVWLPXODWHV :KLOHWKHUH LV D VSHFLILF SURFHVV RU VHW RI
VWHSVVXJJHVWHGIRULWVXVH&$67VKRXOGEHYLHZHGRYHUDOODVDPHDQVWRKHOS
\RXU DVVHVVPHQW WHDP WKLQN WKURXJK DUWLFXODWH DQG GRFXPHQW ZKDW \RXU
SURJUDPGRHVDQGKRZZHOOLWGRHVLW7KLVLVDQRSSRUWXQLW\WRIRFXVRQDUHDV
LQZKLFK\RXUSURJUDPH[FHOVDVPXFKDVRQGHILFLHQFLHV
7KH XOWLPDWHJRDODQGHQGSURGXFWRI&$67LVWKHFUHDWLRQRIDQDFWLRQSODQ
IRURUJDQL]DWLRQDOFDSDFLW\GHYHORSPHQW7KLVSODQFDQEHSDFNDJHGDORQJZLWK
VHOHFWHGDVVHVVPHQWSURFHHGLQJVLQDILQDOUHSRUWWKDWSURJUDPVWDIIFDQUHIHU
WRDVWKH\IROORZWKH LPSOHPHQWDWLRQ RI FDSDFLW\ EXLOGLQJ SURSRVDOV 7KH SODQ
DOVR PD\ EH LQFRUSRUDWHG LQWR 7LWOH 9 %ORFN *UDQW DSSOLFDWLRQV DQGRU RWKHU
SURJUDPVSHFLILF UHODWHG SODQV DV DSSURSULDWH ,Q DGGLWLRQ WR WKLV FRQFUHWH
RXWFRPH WKH &$67 SURFHVV LV OLNHO\ WR VSDUN GLDORJXH DQG FROODERUDWLRQ
DFURVV SURJUDP DUHDV ZKLOH EULQJLQJ 7LWOH 9 VWDII WRJHWKHU WR DUWLFXODWH D
EURDGYLVLRQIRUWKHSURJUDP·VIXWXUH
,QWKHJXLGDQFHWKDWIROORZVEDVLFLQVWUXFWLRQVDUHSUHVHQWHGLQWH[WER[HVWKLV
WH[W RXWOLQHV WKH NH\ VWHSV IRU XVLQJ HDFK &$67 WRRO DQG ZRUNVKHHW ,Q
DGGLWLRQ VXSSOHPHQWDU\ VXJJHVWLRQV WR JXLGH \RXU DVVHVVPHQW WHDP·V
GLVFXVVLRQVDQGH[DPSOHVZKHUHDSSURSULDWHDSSHDULQVKDGHGWH[WER[HV
‡
Throughout this document, the term "state Title V program" is intended to minimally represent those organizational units accountable
for activities undertaken with funds provided to the state through Title V of the Social Security Act (SSA) -- the Maternal and Child Health
Services Block Grant. In addition, however, this unit or a collection of organizational units also may encompass additional authorities, funding,
and accountability for MCH and CSHCN population services (e.g., family planning, WIC/nutrition, early intervention, etc.). Where the term
"Title V administering agency" is used, the intent is to represent the larger organizational body (bodies) within which the MCH and/or CSHCN
(Title V SSA) program(s) function.
Each state undertaking CAST-5 should consider in advance the precise scope and mix of program authorities they wish to include in
their operating definition of "Title V program" for the purposes of their assessment deliberations.
CAST-5 Preliminary Edition Á March 2001
1
&RUH4XHVWLRQV
7KH&RUH4XHVWLRQVUHSUHVHQWWKHIXQGDPHQWDOOHYHORI7LWOH9SURJUDPIXQFWLRQLQJ
7KH\ ZLOO SURPSW \RX WR GHWHUPLQH LI \RXU SURJUDP LV PHHWLQJ VRPH EDVLF
RSHUDWLRQDO UHTXLUHPHQWV DQG SURYLGH D FRQWH[W IRU UHVSRQVHV LQ WKH VXEVHTXHQW
&$67WRROV
•
The Core Questions assess readiness to implement CAST-5; you should be able to answer
“yes” to each of the first three questions and respond completely to questions four and five
before moving on to the remainder of the assessment.
•
The final Core Question assesses whether you have identified the organizational resources
needed to implement various program strategies. If the answer is “no,” proceed with the
remainder of CAST-5 to:
- assess the activities and functions your Title V program should or could be fulfilling,
- identify the organizational resources necessary to carry them out, and
- make plans to acquire these capacities.
•
Even if you answer “yes” to question six, you might now or in the future consider using CAST5 to inform program redesign or expansion.
If you answer “no” to any of the first three questions, you can use information in the Process
Indicators and Capacity Needs to help identify ways to bring your program to the desired level of
basic functioning.
For example, if your program’s vision and goals are not well defined (Core Question #1), you
could look across all of the Essential Services generally, or all of the Process Indicators more
specifically, to articulate the nature and scope of role(s) your Title V program would like to play
(e.g., surveillance; health services/systems quality assurance; traditional gap-filling role).
In addition, several Core Questions are followed by a list of potentially useful resources for
information, consultation, or training relevant to carrying out the activity represented.
Post the answers to the Core Questions for easy viewing and “walk through” the responses with
all assessment participants. It will be helpful to refer to the Core Questions responses throughout
the CAST-5 process, but particularly before prioritizing Capacity Needs.
2
CAST-5 Preliminary Edition Á March 2001
5HYLHZRIWKH0DWHUQDODQG&KLOG+HDOWK(VVHQWLDO6HUYLFHV
7KH 5HYLHZ RI WKH 0DWHUQDO DQG &KLOG +HDOWK (VVHQWLDO 6HUYLFHV SURYLGHV DQ
RSSRUWXQLW\IRUWKHVWDWH·V&$67WHDPPHPEHUVWREHJLQWKH&$67SURFHVVZLWKD
FRPPRQXQGHUVWDQGLQJRI0&+IXQFWLRQVDQGWRLGHQWLI\DSULRULW\RUGHULIGHVLUHG
RI(VVHQWLDO6HUYLFHVIRU&$67DVVHVVPHQWDFWLYLWLHV
•
This is an optional interim step. The group first should respond to the Core Questions and
articulate broad goals for the program linked to the social and political context. This step then
can be used to discuss and clarify the 10 Essential Services.
•
If a subset of Essential Services will be chosen for assessment, this step may help determine
which of the 10 may be most useful for the program to assess.
•
In order to facilitate this review, examples of how each essential service can be implemented at
the state level are provided on pages 12-31 of Public MCH Program Functions Framework:
Essential Public Health Services to Promote Maternal and Child Health in America, which can
be viewed on the Women’s and Children’s Health Policy Center’s web site at
http://www.med.jhu.edu/wchpc/pub/pubs.html.
CAST-5 Preliminary Edition Á March 2001
3
3URFHVV,QGLFDWRUV
7KH 3URFHVV ,QGLFDWRUV UHSUHVHQW SURJUDP RXWSXW DQG DFWLYLWLHV FRUUHVSRQGLQJ WR WKH
0&+(VVHQWLDO6HUYLFHVDWWKHVWDWHOHYHO
•
Read through the full list of Process Indicators before beginning discussions of individual
indicators.
•
For each Process Indicator, mark the response that best reflects how adequately the Title V
program performs the function detailed.
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Responses should be determined in light of “where you want to/need to be,” given the
strategic goals the assessment team has articulated.
•
Contributions of other agencies in the MCH system may be noted for each indicator in the space
provided.
•
Each indicator is accompanied by a set of discussion questions to assist you in determining the
adequacy of program performance.
Some Essential Services have two sections of indicators. Each section represents a different type of
activity or an output with a different focus, and each is preceded by a statement of “section intent.”
(For example, the indicators for Essential Service #1, Assess and Monitor, are grouped in two sections,
Data Use and Data-Related Technical Assistance.) For each Essential Service, and within each
section, the set of Process Indicators reflects program output or activities along a continuum of
“intensity” – i.e., the first indicator in a list represents a more basic level of performance than does the
last. The continuum does not necessarily reflect the order in which one would approach the task; it
simply allows programs of diverse structures and resources to identify the program outputs they
currently achieve and those they aim to achieve in the future.
The bulleted statements in text boxes are provided only for use in stimulating discussion;
these questions are discussion guides only, NOT checklists. For each question, you should be
able to describe concrete examples of each activity or output. If deliberations tend to be focused
exclusively on these questions, try skipping them and referring only to the indicators themselves.
4
CAST-5 Preliminary Edition Á March 2001
&DSDFLW\1HHGV
7KH &DSDFLW\ 1HHGV UHSUHVHQW RUJDQL]DWLRQDO UHVRXUFHV WKDW DUH QHHGHG WR
DGHTXDWHO\ SHUIRUP WKH DFWLYLW\ RU RXWSXW LGHQWLILHG LQ WKH 3URFHVV ,QGLFDWRUV IRU
HDFK(VVHQWLDO6HUYLFH
• Review each Capacity Need listed and discuss the extent to which that resource is sufficiently
present or in need of enhancement.
• Check the box indicating whether the program has or needs each resource. You may record
information not reflected in the simple checkbox format in the needs section of the SWON
worksheet (e.g., if your program only partially meets the need listed, if the response would be
different for a particular program area than for the overall Title V program, or if a particular
resource need is of high priority).
The Capacity Needs are grouped into four categories of resources:
6WUXFWXUDO5HVRXUFHV:
Financial, human, and material resources; policies and protocols; and other resources held by or
accessible to the program that form the groundwork for the performance of core functions.
'DWD,QIRUPDWLRQ6\VWHPV
Technological resources enabling state of the art information management and data analysis.
2UJDQL]DWLRQDO5HODWLRQVKLSV
Partnerships, communication channels, and other types of interactions and collaborations with
public and private entities, including, but not restricted to, local, state, and federal agencies,
professional associations, academic institutions, research groups, private providers and insurers
of health care, community-based organizations, consumer groups, the media, and elected
officials.
&RPSHWHQFLHV6NLOOV
Knowledge, skills, and abilities of Title V staff and/or other individuals/agencies accessible to
the Title V program (i.e., borrowed/purchased staff resources).
CAST-5 Preliminary Edition Á March 2001
5
Adequate funding and adequate authority appear under Structural Resources on every Capacity
Needs list. Having neither adequate funding nor adequate authority should not be seen as an
insurmountable barrier to carrying out the activity. Rather, you may need to strategize about other
mechanisms for obtaining these resources (e.g., non-statutory means of acquiring authority, seeking
grants). Alternatively, you may be able to identify an external entity to carry out the activity on
behalf of your program.
The Title V program must have sufficient numbers of staff (or access to non-Title V staff) with
the competencies/skills listed to carry out the function at the desired level. The numbers of staff
necessary will vary according to program structure and focus.
Determining whether your Title V program houses or has access to personnel in
appropriate numbers with the specified capabilities and expertise should be part of your
deliberations.
Determination of need should be relative to the program’s goals, objectives, and desired role.
Each Capacity Need also should be considered in light of the specific Essential Service and/or
Process Indicator to which it refers. For example, a relationship might be adequate for
coordinating services but not for accessing and using data. The grid to the right of the Capacity
Needs indicates for which specific Process Indicators each Capacity Need is relevant. This
information may be helpful in directing the discussion toward the particular activities or objectives
the Capacity Need should support.
5HPLQGHU
7KH&$67WRROVZHUHGHYHORSHGIRUXVHE\SURJUDPVDFURVVWKHFRXQWU\
RSHUDWLQJXQGHUDEURDGUDQJHRIFRQGLWLRQVDQGFRQWH[WV7KHUHIRUHVRPH
WHUPVHOHPHQWVPD\QRWDSSO\WR\RXU7LWOH9SURJUDP'RQRWOHWWKHQRQ
DSSOLFDEOHDVSHFWVLPSHGHGLVFXVVLRQVDQGWKHXVHRIWKHDVVHVVPHQWWRROV
Notes on Reaching Consensus
It is likely that some discussions in the assessment process will not result in consensus. In these
cases, your group will have to strategize about ways to accommodate different perspectives and use
the disagreement to spark further discussion of program needs.
If the assessment group has trouble reaching consensus on adequacy ratings for Process Indicators
or on responses for Capacity Needs, consider taking a vote. Dissenting views can be recorded in
the notes sections of the templates provided on computer disk. Differences in opinion also may be
reflected by recording salient points in the appropriate sections of the SWON worksheets.
6
CAST-5 Preliminary Edition Á March 2001
6:21$QDO\VLV
7KLVZRUNVKHHWLVSURYLGHGWRDVVLVW\RXUDVVHVVPHQWWHDPLQFRQGXFWLQJDQ
LQGHSWKDQDO\VLVRI\RXUSURJUDP·VSHUIRUPDQFHRIHDFK(VVHQWLDO6HUYLFH
•
For each Essential Service, identify the internal and external strengths, weaknesses,
opportunities, and needs (SWON) that are relevant to undertaking or enhancing the specified
function. Examples of factors to consider are provided for each component of the analysis.
•
Some of these strengths, weaknesses, opportunities, and needs will emerge from your
assessment team’s discussions of the Process Indicators and Capacity Needs; note these
issues on the worksheet as they arise. After completing your discussion of Capacity Needs,
you may go back to the SWON to make additions and revisions.
Detailed Analysis of Performance: Essential Service #1
Assess and monitor maternal and child health status to identify and address problems.
Strengths:
human resources, fiscal resources, technological resources,
social/political factors
Opportunities:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
6$03/(
Weaknesses:
human resources, budgetary restrictions and fiscal resources,
technological resources, social/political factors
Needs:
human resources, fiscal resources, technological resources,
statutory/regulatory changes
page 1
Other Considerations:
past and current federal involvement/activities, state-local
relationships, trends in service population demographics,
organizational culture, organizational structure, competition
and collaboration
page 2
CAST-5 Preliminary Edition Á March 2001
7
6\QWKHVLVDQG6XPPDU\RI&DSDFLW\1HHGVE\'RPDLQ
7KLV ZRUNVKHHW ZLOO DVVLVW \RX LQ FRQGHQVLQJ D ODUJH DPRXQW RI LQIRUPDWLRQ DERXW
FDSDFLW\ QHHGV LQWR D PRUH FRQFLVH DQG PDQDJHDEOH IRUP VXLWDEOH IRU XVH LQ
GHYHORSLQJSURSRVDOVIRUFDSDFLW\GHYHORSPHQW
•
Condense and organize your team’s lists of Capacity Needs across Essential Services into a
shorter, summary version. Group similar items together, identifying areas that can be restated
as a single capacity need.
For example, if relationships with different kinds of community groups appear repeatedly in your
individual lists of Capacity Needs, you can merge the items to express an overarching deficit in
your program’s networking. The strategic issues involved in developing or enhancing those
activities might, however, differ according to the purposes of specific interactions (e.g.,
organizational relationships specifically directed towards disseminating information or towards
garnering support for programs/policies).
Synthesis and Summary of Capacity Needs by Domain
Structural Resources:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
6$03/(
Data/Information Systems:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Organizational Relationships:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Competencies/Skills:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
8
CAST-5 Preliminary Edition Á March 2001
&DSDFLW\'HYHORSPHQW$FWLRQ3ODQ
7KLV ZRUNVKHHW SURYLGHV EURDG JXLGDQFH RQ FUHDWLQJ DQ DFWLRQ SODQ IRU
RUJDQL]DWLRQDOFDSDFLW\GHYHORSPHQWWKHJRDODQGHQGSURGXFWRI&$67
•
Identify a set of priority Capacity Needs for the program, based on the condensed list
developed in the previous worksheet.
As a first step, your assessment team may want to review the program’s context, as
identified in the answers to the Core Questions and in statements of the program’s
vision, mission, and goals. In addition, reviewing the SWON analyses will highlight
cross-cutting capacity needs.
If the list of Capacity Needs seems too lengthy for prioritizing, consider prioritizing
according to broad “needs themes” that will have emerged across Essential Services
and in the SWON analyses. You can then look to the more detailed “laundry list” to
create more specificity.
•
Based on the priority needs, draft action steps for capacity-building actions to be undertaken in
the next year. For each proposed action step, identify a staff member or small team responsible
for drafting a more detailed workplan that can be presented to the larger assessment team at a
later date.
•
You may wish to use the assessment results as recorded in the templates on the computer disk
provided to generate an assessment summary or report for distribution to assessment team
members and other interested parties. The report should be prepared in a manner consistent
with formats ordinarily produced by the Title V program or its administering agency.
Note: While your capacity development plan may involve recruitment of additional staff and/or
redirection of the job responsibilities of existing staff, preliminary steps may need to be undertaken
in the context of current staff composition.
Capacity Development Action Plan
Capacity Development Action Plan:
Priority Capacity Needs:
♦
Capacity Need:
Capacity Need:
6$03/(
Action Step:
Individual/team responsible for developing workplans:
♦
Action Step:
Individual/team responsible for developing workplans:
Capacity Need:
♦
Action Step:
Individual/team responsible for developing workplans:
CAST-5 Preliminary Edition Á March 2001
9
5HYLHZRI$VVHVVPHQW6WHSV
%HVXUH\RXUDVVHVVPHQWWHDPKDVDQVZHUHGWKH&RUH4XHVWLRQVDQGKDV
WKDWLQIRUPDWLRQDYDLODEOHIRUUHIHUHQFH
5HYLHZWKH7HQ0&+(VVHQWLDO6HUYLFHVZLWKWHDPPHPEHUVWRHQVXUHWKDW
HYHU\RQHVKDUHVDFRPPRQXQGHUVWDQGLQJRIWKHP
'LVFXVVWKHDGHTXDF\RIHDFK3URFHVV,QGLFDWRU
5HYLHZDQGLGHQWLI\WKHVWDWXVRIOLVWHG&DSDFLW\1HHGV
$QDO\]HWKHVWUHQJWKVZHDNQHVVHVRSSRUWXQLWLHVDQGQHHGV6:21
UHODWHGWRSHUIRUPDQFHRIDQGFDSDFLW\IRUHDFK(VVHQWLDO6HUYLFH
$SURJUDPPLJKWZLVKWREHJLQWKH6:21VWHSFRQFXUUHQWZLWKVWHSDQGVWHS
10
3URFHHGWKURXJKVWHSVWKURXJKIRUHDFK(VVHQWLDO6HUYLFH
6\QWKHVL]H&DSDFLW\1HHGVDFURVV(VVHQWLDO6HUYLFHVLQWRDVLQJOH
VXPPDU\OLVWEURNHQGRZQE\GRPDLQ
'LVFXVVVWUDWHJLFLVVXHVHJPLVVLRQRYHUDUFKLQJSURJUDPJRDOV
EDUULHUVRSSRUWXQLWLHVHWFDQGSURJUDPFRQWH[WUHODWHGWRSULRULWL]LQJ
&DSDFLW\1HHGV
3ULRULWL]H&DSDFLW\1HHGV
&RPSOHWHRUVSHFLI\DSURFHVVIRUJHQHUDWLQJDGHWDLOHG&DSDFLW\
'HYHORSPHQW$FWLRQ3ODQ
CAST-5 Preliminary Edition Á March 2001
3ODQQLQJIRUWKH$VVHVVPHQW3URFHVV,PSOHPHQWDWLRQ2SWLRQV
7KH IROORZLQJ SDJHV DUH LQWHQGHG WR DVVLVW \RXU 7LWOH 9 SURJUDP LQ
RUFKHVWUDWLQJ WKH &$67 SURFHVV GHFLGLQJ RQ WKH VFRSH RI WKH DVVHVVPHQW
LGHQWLI\LQJ DQG FRQYHQLQJ SDUWLFLSDQWV DQG IDFLOLWDWLQJ WKH DFWXDO DVVHVVPHQW
ZRUN
The CAST-5 tools were designed to be used flexibly to meet varying needs. The tools can be
used in full, or individual components can be selected. The assessment can be carried out at the
level of the governmental MCH system (including non-Title V partners), the level of the Title V
program, or the individual program area level. Each state will need to determine the best
combination of approaches for its program, given staff availability, competing demands on the
program (e.g., whether or not the state legislature is in session, whether the MCHB Block Grant
5-Year Needs Assessment is soon due), and so forth.
9DU\E\6FRSH
9DU\E\´'HSWKµ
9DU\E\3URJUDP(QWLW\
$OO(VVHQWLDO6HUYLFHV
6LPXOWDQHRXVO\
$OO7RRO&RPSRQHQWV
$OO0&+&6+&13URJUDP8QLWV
6HOHFWHG6XEVHWVRI(VVHQWLDO
6HUYLFHV
6HOHFWHG7RRO
&RPSRQHQWV
6HOHFWHG3URJUDP8QLWV
9DU\E\3URFHVV
2QH$FWLRQ3ODQ
2QH$VVHVVPHQW
7HDP
6HSDUDWH$FWLRQ
3ODQV
6PDOO
:RUNJURXSV
,QWHUQDO3URJUDP
3URJUDP
3HUVRQQHO2QO\
0DQDJHPHQW2QO\
%URDG6WDII
,QYROYHPHQW
,QFOXGLQJ
([WHUQDO3DUWQHUV
&RPSUHVVHG
7LPHIUDPH
([WHQGHG
7LPHIUDPH
Those designing a CAST-5 process will want to consider: breadth of perspectives desired, the
implications of various options for integration of ideas, the timeframe available and/or specific
timing goals, and other management and resource parameters.
CAST-5 was pilot tested using a few different approaches, and we have learned the following
about the various implementation options to date:
9DU\E\6FRSH
$VVHVV$OO(VVHQWLDO6HUYLFHV6LPXOWDQHRXVO\
This option is time consuming and requires the most staff commitment, but it is the best way
to get the “big picture.” You should be sure that there are not too many competing output
deadlines for the program within the same 2 to 3 month period.
CAST-5 Preliminary Edition Á March 2001
11
$VVHVV6HOHFWHG6XEVHWVRIWKH(VVHQWLDO6HUYLFHV
This option may feel more manageable in terms of the organizational/management burden
involved, or it may seem to be a more efficient way of delving into a functional area already
determined as a priority for program development. Assessing only selected Essential
Services, however, may leave gaps (e.g., may not sufficiently address data functions or
oversight capacity), and makes it difficult to address inter-relationships among areas of
function. Further, if forward strategic program planning has not occurred to date, it may
prove challenging to determine which Essential Services or set of Essential Services is a
priority.
9DU\E\´'HSWKµ
&RPSOHWH$OO&RPSRQHQWVRI&$67
Completing each step in the CAST-5 process helps to ensure that the end result includes
concrete steps to address identified problem areas and promotes a sense of closure for
assessment participants. Further, the lists of Capacity Needs for each Essential Service are
extremely useful for framing discussions of current and desired program resources and for
encouraging participants to think strategically and “outside the box.”
&RPSOHWH3URFHVV,QGLFDWRUV$VVHVVPHQW2QO\ZLWK6:21$QDO\VLV
Assessing only the CAST-5 Process Indicators will significantly reduce the time commitment
required. In conjunction with a detailed analysis of strengths, weaknesses, opportunities, and
needs related to performance, the Process Indicators can provide a useful framework for
thinking about current program functioning and desired program directions. A sense of
closure is important to the assessment participants and to the process; do not stop short of
generating some form of action plan or outlining next steps to address whatever deficiencies
in performance surface.
9DU\E\3URJUDP(QWLW\
$OO0&+&6+&15HOHYDQW3URJUDPV7RJHWKHU
Including the full range of Title V programs and partners in the assessment process will
increase complexity in responses and may make the process of rating adequacy more
contentious. The management burden and resource commitment also will increase as more
programs are included. However, including a broad range of program units creates an
opportunity for linking capacity and staff/program resources across populations and health
concerns; the CAST-5 process consistently was described by pilot participants as a rare
opportunity to bring together program areas for collaboration and cross-fertilization of ideas.
Additionally, including a variety of perspectives in the assessment process can enrich the
dialogue and provide a more balanced view of program performance and capacity needs.
12
CAST-5 Preliminary Edition Á March 2001
6HOHFWHG3URJUDP8QLWV
Assessing the activities of a single Title V or MCH-related program unit (e.g., Family
Planning, CSHCN, Child/Adolescent Health, Perinatal Health, WIC/Nutrition) will make it
easier to rate adequacy and to reach consensus. Including external partners will be easier to
do without making the group size unwieldy (see “Vary by Process,” below). However, this
approach ignores both conceptual and empirical inter-relationships among population needs
and program efforts.
9DU\E\3URFHVV
2QH$FWLRQ3ODQYV6HSDUDWH$FWLRQ3ODQV
Developing a single action plan or set of “next steps” for all Essential Services (or subset of
Essential Services that were assessed) gives a sense of the “big picture” and reduces
redundancy. You may find that assessment team members may feel the need for a more
immediate sense of closure at each step in the assessment process; developing a separate
action plan for each Essential Service assessed can provide that sense of closure. If many
Essential Services are being assessed, however, developing many action plans will be very
time consuming and will lengthen the overall process. In addition, generating many action
plans in effect bypasses important steps in the CAST-5 process for synthesizing and
condensing identified capacity needs and highlighting overarching themes. Bypassing those
steps may result in disjointed action steps and unnecessary redundancy.
2QH$VVHVVPHQW7HDPYV6PDOO:RUNJURXSV
Using one assessment team to assess all Essential Services (or subset of Essential Services)
will increase the consistency of results and the facility in using the CAST-5 tools.
Depending on the scope of the assessment, using a single assessment team also may increase
the likelihood of “burnout.” Assigning assessment participants to different workgroups may
allow for inclusion of a greater number of staff members and perspectives. If using small
workgroups, you will need to identify both workgroup members (preferably with mixed
professional and program/population perspectives) and a core group of facilitators (to lead
small workgroup discussions and oversee the reporting of small group results).
3URJUDP0DQDJHPHQW2QO\YV%URDG6WDII,QYROYHPHQW
Limiting assessment participants to senior management or program leaders may reduce the
complexity of the task and streamline discussions. Program managers also may have more
knowledge of Title V activities across program areas. Involving a broader range of staff
members with varied professional backgrounds could enhance the quality of the discussions,
increase “buy in” at all levels, and actually serve as an educational or staff development
strategy for new and/or less experienced program professionals.
CAST-5 Preliminary Edition Á March 2001
13
,QWHUQDO3URJUDP3HUVRQQHO2QO\YV,QFOXGLQJ([WHUQDO3DUWQHUV
External partners can be defined both “vertically” – local representation, community
organizations/providers, families/other constituents, etc. – and “horizontally” – other public
programs/agencies such as education, welfare, environmental, and Medicaid/other financing
agencies. Including only internal program personnel may make the assessment process less
complicated. Including external perspectives could help build support for and coordination
with Title V activities. In particular, it will be important to include the director and staff of
the Children with Special Health Care Needs program. You also may wish to include one or
several local representative(s) and a family/consumer representative(s) in some or all
components of the process.
&RPSUHVVHG7LPH)UDPH5HWUHDWYV([WHQGHG7LPH)UDPH
If the assessment work is spread over too long a time period, participants can lose interest,
and the program context could change in ways that affect assessment results. If, on the other
hand, the assessment period is too short, participants can “burn out” or feel so pressed that
the experience is negative rather than team-/program-building. Another timeframe
consideration is when in the overall Title V planning cycle the assessment might be most
useful (e.g., before or after the 5-year Needs Assessment, in anticipation of state budget
development, change in administration).
14
CAST-5 Preliminary Edition Á March 2001
3ODQQLQJIRUWKH$VVHVVPHQW3URFHVV)DFLOLWDWRUV·*XLGH
Implementing CAST-5 is best done with the help of a designated facilitator(s) who plans for and
orchestrates the CAST-5 process. It is not necessary to hire an outside consultant for this
purpose; a Title V staff person with a “big picture” perspective, good organizational skills,
flexibility, and preferably experience with strategic planning concepts and techniques may be the
designated facilitator with equal success. A separate meeting planner can be identified to assist
with logistics like meeting space.
Tasks of the Planner and Facilitator:
Planner
• Obtain meeting space
• Arrange for meals and refreshments
• Distribute assessment materials
• Schedule pre-assessment meeting(s)
Facilitator
• Serve as the contact person and “expert” on CAST-5.
• Hold at least one pre-assessment meeting to acquaint assessment team members with CAST-5
and answer questions related to the assessment logistics and process. (A PowerPoint
presentation on CAST-5 is included on the enclosed disk.)
• Plan the assessment agenda. Identify sections to be carried out in small groups if desired.
• Facilitate the assessment process by introducing sections and tasks, leading discussions or
designating other team members to lead them, and keeping discussions on track and efficient.
Helpful Hints for Facilitators
¾
Designate discussion leaders to function as facilitators for assessment sections related to their
primary program areas.
¾
Designate two recorders for each section/discussion – one to take detailed notes and one to
fill out worksheets.
¾
Think in advance about how you would like to record responses and comments for different
assessment components so that the whole team can follow along (e.g., on the computer with an
LCD projector, a series of flip chart sheets posted on the wall). Keep in mind that some
components will be filled out concurrently, such as the SWON analysis with the Process
Indicators and Capacity Needs.
¾
Become familiar with the instructions for each CAST-5 section. Prior to beginning each
section, and during deliberations as needed, remind the assessment team of both the basic
instructions and the general goal/end product of the activity.
¾
Set time limits to “contain” discussions and promote closure.
CAST-5 Preliminary Edition Á March 2001
15
Core Questions
1.
Have you established the vision/goals for the MCH population?
YES: Go to question #2.
MCH Leadership Skills Training Institute
NO: Go to these resources:
Maternal and Child Health Bureau and
AMCHP Strategic Plans
2.
Given the Title V needs assessment, have you identified the priority health issues and desired population health outcomes?
YES: Go to question #3.
NO: Go to these resources:
MCH Needs Assessment and Planning
Workbook, by Peoples-Sheps
Title V Block Grant Guidance
APEX-PH/MAPP
3.
Have you identified the political, economic, and organizational environments for addressing the priority health issues?
YES: Go to question #4.
APEX-PH/MAPP
NO: Go to these resources:
CAST-5 Preliminary Edition · March 2001
CO-1
4.
What are the macro-level strategic directions for the Title V program in light of the responses to questions 1, 2 and 3 above?
5.
Have you identified the programmatic organizational strategies you will use to implement the strategic directions identified in
#4 and to achieve the desired population outcomes identified in #2?
6.
Have you identified the capacity you need to implement the strategies?
YES: Consider using the remaining CAST-5 tools and guidance as part of a strategic planning
process to strengthen and/or reorient the program’s mission, goals, and structure.
NO: GO TO PROCESS INDICATORS.
CO-2
CAST-5 Preliminary Edition Á March 2001
The 10 Maternal and Child Health Essential Services
This section of the CAST-5 instrument serves two purposes:
1. Reading and/or reviewing this brief summarization of the ten maternal and child health essential services
can help each of the state’s CAST-5 team members begin this process with a common understanding of
them; and
2. Provides a basis for identifying priority ordering (if desired) of essential services for CAST-5 assessment
activities.
After responding to the Core Questions and articulating broad goals for the program linked to the social and
political context and developed strategies, please discuss and clarify as a group the 10 Essential Services listed
below.
In order to facilitate this review, examples of how each Essential Service can be implemented at the state level
are provided on pages 12-31 of Public MCH Program Functions Framework: Essential Public Health Services
to Promote Maternal and Child Health in America, a copy of which can be found on the Women’s and
Children’s Health Policy Center’s web site at http://www.med.jhu.edu/wchpc/pub/pubs.html.
❏ 1. Assess and monitor maternal and child health status to identify and address problems.
A. Develop frameworks, methodologies , and tools for standardized MCH data in public and private sectors.
B. Implement population-specific accountability for MCH components of data systems.
C. Prepare and report on the descriptive epidemiology of MCH through trend analysis.
❏ 2. Diagnose and investigate health problems and hazards affecting women, children, and youth.
A. Conduct population surveys and publish reports on risk conditions and behaviors.
B. Identify environmental hazards and prepare reports on risk conditions and behaviors.
C. Provide leadership in maternal, fetal/infant, and child fatality reviews.
❏ 3. Inform and educate the public and families about maternal and child health issues.
A. Provide MCH expertise and resources for informational activities such as hotlines, print materials, and media campaigns,
to address MCH problems such as teen suicide, inadequate prenatal care, accidental poisoning, child abuse and domestic
violence, HIV/AIDS, DUI, helmet use, etc.
B. Provide MCH expertise and resources to support development of culturally appropriate health education
materials/programs for use by health plans/networks, MCOs, local public health and community-based providers.
C. Implement, and/or support, health plan/provider network health education services to address special MCH problems —
such as injury/violence, vaccine-preventable illness, underutilization of primary/preventive care, child abuse, domestic
violence — delivered in community settings (e.g., schools, child care sites, worksites).
D. Provide families, the general public, and benefit coordinators reports on health plan, provider network, and public health
provider process and outcome data related to MCH populations based on independent assessments.
CAST-5 Preliminary Edition · March 2001
ES-1
❏ 4. Mobilize community partnerships between policymakers, health care providers, families, the general public, and
others to identify and solve maternal and child health problems.
A. Provide needs assessment and other information on MCH status and needs to policymakers, all health delivery systems,
and the general public.
B. Support/promote public advocacy for policies, legislation, and resources to assure universal access to age-, culture- and
condition-appropriate health services.
❏ 5. Provide leadership for priority-setting, planning, and policy development to support community efforts to assure
the health of women, children, youth and their families.
A. Develop and promote the MCH agenda using the Year 2000 National Health objectives or other benchmarks.
B. Provide infrastructure / communication structures and vehicles for collaborative partnerships in development of MCH
needs assessments, policies, services, and programs.
C. Provide MCH expertise to, and participate in the planning and service development efforts of other private and public
groups and create incentives to promote compatible, integrated service system initiatives.
❏ 6. Promote and enforce legal requirements that protect the health and safety of women, children and youth, and
ensure public accountability for their well-being.
A. Ensure coordinated legislative mandates, regulation, and policies across family and child-serving programs.
B. Provide MCH expertise in the development of a legislative and regulatory base for universal coverage, medical care
(benefits), and insurer / health plan and public health standards.
C. Ensure legislative base for MCH-related governance, MCH practice and facility standards, uniform MCH data collection
and analysis systems, public health reporting, environmental protections, outcomes and access monitoring, quality
assurance/improvement, and professional education and provider recruitment.
D. Provide MCH expertise / leadership in the development, promulgation, regular review and updating of standards,
guidelines, regulations, and public program contract specifications.
E. Participate in certification, monitoring and quality improvement efforts of health plans and public providers with respect
to MCH standards and regulations.
F. Provide MCH expertise in professional licensure and certification processes.
G. Monitor MCO marketing and enrollment practices.
H. Provide MCH expertise and resources to support ombudsman services.
❏ 7. Link women, children and youth to health and other community and family services, and assure access to
comprehensive, quality systems of care.
A. Provide a range of universally available outreach interventions (including home visiting), with targeted efforts for hardto-reach MCH populations.
B. Provide for culturally and linguistically appropriate staff, materials, and communications for MCH populations / issues,
and for scheduling, transportation, and other access-enabling services.
C. Develop and disseminate information / materials on health services availability and financing resources.
D. Monitor health plan, facility, and public provider enrollment practices with respect to simplified forms, orientation of new
enrollees, enrollment screening for chronic conditions/special needs, etc.
E. Assist health plans/provider networks and other child/family-serving systems (e.g., education, social services) in
identifying at-risk or hard-to-reach individuals and in using effective methods to serve them.
F. Provide/arrange/administer women’s health, child health, adolescent health, Children with Special Health Care Needs
(CSHCN) specialty services not otherwise available through health plans.
G. Implement universal screening programs — such as for genetic disorders / metabolic deficiencies in newborns, sickle cell
anemia, sensory impairments, breast and cervical cancer — and provide follow-up services.
H. Direct and coordinate health services programming for women, children and adolescents in detention settings, mental
health facilities and foster care, and for families participating in welfare waiver programs that intersect with health
services.
ES-2
CAST-5 Preliminary Edition Á March 2001
(7 continued)
I. Provide MCH expertise for prior authorization for out-of-plan specialty services for special populations (e.g., CSHCN).
J. Administer / implement review processes for pediatric admissions to long-term care facilities and CSHCN home- and
community-based services.
K. Develop model contracts to provide managed care enrollees access to specialized women’s health services, pediatric
centers of excellence and office / clinic-based pediatric subspecialists and to community-site health services, (schoolbased health clinics, WIC, Head Start, etc).
L. Provide expertise in the development of pediatric risk adjustment methodology and payment mechanisms.
M. Identify alternative / additional resources to expand the fiscal capacity of the health and social services systems by
providing MCH expertise to insurance commissions and public health care financing agencies, pooling categorical grant
funding, and pursuing private sector resources.
❏ 8. Assure the capacity and competency of the public health and personal health workforce to effectively and
efficiently address maternal and child health needs.
A. Provide infrastructure and technical capacity and public health leadership skills to perform MCH systems access,
integration, and assurance functions.
B. Establish competencies, and provide resources for training MCH professionals, especially for public MCH program
personnel, school health nurses and school-based health center providers, care coordinators/case managers, home visitors,
home health aides, respite workers, and community outreach workers.
C. Provide expertise, consultation, and resources to professional organizations in support of continuing education for health
professionals, and especially regarding emerging MCH problems and interventions.
D. Support health plans / networks in assuring appropriate access and care through providing review and update of benefit
packages, information on public health areas of concerns, standards, and interventions, plan/provider participation in
public planning processes and population-based interventions, technical assistance, and financial incentives for meeting
MCH-specific outcome objectives.
E. Analyze labor force information with respect to health professionals specific to the care of women and children (e.g.
primary care practitioners, pediatric specialists, nutritionists, dentists, social workers, CNMs, PNPs, FFNPs, CHNs/PHNs)
F. Provide consultation / assistance in administration of laboratory capacity related to newborn screening, identification of
rare genetic diseases, breast and cervical cancer, STDs, blood lead levels.
❏ 9. Evaluate the effectiveness, accessibility, and quality of personal health and population-based maternal and child
health services.
A. Conduct comparative analyses of health care delivery systems to determine effectiveness of interventions and to
formulate responsive policies, standards, and programs.
B. Survey and develop profiles of knowledge, attitudes and practices of private and public MCH providers.
C. Identify and report on access barriers in communities related to transportation, language, culture, education, and
information available to the public.
D. Collect and analyze information on community / constituents’ perceptions of health problems and needs.
❏ 10. Support research and demonstrations to gain new insights and innovative solutions to maternal and child healthrelated problems.
A. Conduct special studies (e.g., PATCH) to improve understanding of longstanding and
emerging (e.g., violence, AIDS) health problems for MCH populations.
B. Provide MCH expertise and resources to promote “best practice” models, and to support
demonstrations and research on integrated services for women, children, adolescents, and families.
CAST-5 Preliminary Edition · March 2001
ES-3
Process Indicators: Essential Service #1
Assess and monitor maternal and child health status to identify and address problems.
1.DU
Data Use
Section Intent/Key Qualities:
¾ Access and utilize up-to-date MCH/public health and related population data
¾ Generate and utilize data in planning cycle activities (e.g., planning and policy development)
1.DU.1 Use public health data sets to prepare basic descriptive analyses related to priority health issues (e.g., PRAMS;
BRFSS; YRBS; live birth, fetal death, abortion, linked live birth/infant death data; community health surveys; census
data; etc.)
•
•
•
•
Does the Title V program have
documentation (e.g., users guide/list of
variables, contact information for the entity
generating the data) for a core set of data
sources?
Does the Title V program have access to raw
data from these sources?
Does the Title V program refer to these data
sources when it becomes aware of emergent
MCH problems?
Does the Title V program have the capacity
to use these data sources to generate
information?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify): _________________________________
1.DU.2 Conduct analyses of public health data sets that go beyond descriptive statistics
•
•
Does the Title V program analyze existing
data sets to identify associations among risk
factors, environmental and other contextual
factors, and outcomes?
Does the Title V program compare health
status measures across populations or against
other states?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify): __________________________________
CAST-5 Preliminary Edition Á March 2001
1-1
1.DU.3 Generate and analyze primary data to address state- and local-specific knowledge base gaps
•
•
•
•
Does the Title V program have established
and routinely used procedures for identifying
knowledge gaps (e.g., community or
professional advisory boards)?
Does the Title V program collaborate with
local health agencies to collect and analyze
data related to these knowledge gaps?
Does the Title V program field surveys or
otherwise collect data on MCH populations
and the health care delivery system?
Does the Title V program use that data to
examine relationships among risk factors,
environmental/contextual factors, and
outcomes?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify): __________________________________
1.DU.4 Interpret and report on primary and secondary data analysis for use in policy and program
development
•
•
Does the Title V program routinely review
the current science base and the results of
current research studies for use in planning
and policy development?
Does the Title V program produce briefs on
selected, timely MCH issues to distribute to
appropriate policy and program-related staff
members?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify): __________________________________
1-2
CAST-5 Preliminary Edition Á March 2001
1.TA.
Data-Related Technical Assistance
Section Intent/Key Qualities:
¾
Enhance local data capacity
1.TA.1 Establish framework/template/standards about core data expectations for local health agencies and other MCH
providers/programs
•
•
Has the Title V program established (or
participated in the development of) maternal
and child health status indicators and
disseminated them to local agencies and
other Title V-funded programs?
Has the Title V program disseminated
maternal and child health status indicators to
local, non-Title V programs/providers?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify): __________________________________
1.TA.2 Provide training/expertise about the collection and use of MCH data to local health agencies or other constituents for
MCH populations
•
•
•
Does the Title V program have an identified
staff person(s) responsible for technical
assistance on data-related matters?
Does the Title V program assist local health
agencies and other MCH providers/programs
in developing standardized data collection
methods related to established MCH
indicators?
Does the Title V program’s budget include
technical assistance to localities on data use?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify): __________________________________
1.TA.3 Assist local health agencies in data system development and coordination across geographic areas so that MCH data
outputs can be compared
•
Does the Title V program earmark funds and
staff time to enhancing local data capacity
through data systems development and
coordination?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify): __________________________________
CAST-5 Preliminary Edition Á March 2001
1-3
Summary Sheet: Essential Service #1
Assess and monitor maternal and child health status to identify and address problems.
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
1-4
1.DU.1 Use public health data sets to prepare basic descriptive analyses related
to priority health issues (e.g., PRAMS; BRFSS; YRBS; live birth, fetal
death, abortion, linked live birth/infant death data; community health
surveys; census data; etc.)
1.DU.2 Conduct analyses of public health data sets that go beyond descriptive
statistics
1.DU.3 Generate and analyze primary data to address state- and local-specific
knowledge base gaps
1.DU.4 Interpret and report on primary and secondary data analysis for use in
policy and program development
1.TA.1 Establish framework/template/standards about core data expectations
for local health agencies and other MCH providers/programs
1.TA.2 Provide training/expertise about the collection and use of MCH data to
local health agencies or other constituents for MCH populations
1.TA.3 Assist local health agencies in data system development and
coordination across geographic areas so that MCH data outputs can be
compared
CAST-5 Preliminary Edition Á March 2001
Job descriptions for program staff that include responsibility for training and technical
assistance
Collaborative planning processes between state and local health agencies
Written standard for minimum data set for all MCH/Title V programs
Written protocols for data integrity and confidentiality
Access to training programs in data collection and management
Routine mechanisms for identifying the information needs of providers, community groups,
the state legislature, and the public
Access to vital statistics, Medicaid, Education, Justice, and other state agency data
Access to private provider/health plan data
Permissive/supportive environment for data sharing
Access to state program and population data in a timely fashion
Designated site/staff responsible for collection of MCH information and resources
Sufficient authority (statutory, etc.) for carrying out this function at the desired level of
performance/intensity
Adequate funding for carrying out this function at the desired level of
performance/intensity
Structural Resources
CAST-5 Preliminary Edition Á March 2001
YY
YY
YY
YY
YY
YY
YY
YY
YY
YY
YY
YY
YY
Need Have
X
X
X
X
X
1.DU.1
X
X
X
X
X
X
1.DU.2
X
X
X
X
X
X
X
1.DU.3
X
X
X
1.DU.4
X
X
X
X
1.TA.1
X
X
X
1.TA.2
Does the Title V program have the capacity to assess and monitor maternal and child health status to identify and address problems?
Capacity Needs: Essential Service #1
X
X
X
1-5
1.TA.3
1-6
Data/Information Systems
1.DU.4
1.TA.1
1.TA.2
X
X
1.TA.3
Environmental agency
Education agency
WIC
Medicaid/SCHIP
Social Services
Family Planning
Other(s) (specify):
X
X
X
1.DU.2
X
1.DU.1
X
1.DU.4
X
X
1.TA.1
X
1.TA.2
1.TA.3
CAST-5 Preliminary Edition Á March 2001
1.DU.3
Relationships specifically must support (as appropriate) 1) access to and dissemination of
data; 2) data collection; 3) collaboration in development and implementation of data
standards;4) assisting the Title V program in carrying out and consulting on research
endeavors; 5) serving as a leading source of information on current state and national MCH
research.
Y Y Vital statistics
Y Y Non-Title V state programs and agencies (check all that are needed):
Need Have
Organizational Relationships
Y Y Access to online databases for literature searches and raw data
X
X
X
1.DU.3
Y Y Information systems integrated across state agencies/units/programs
X
X
1.DU.2
X
X
1.DU.1
Y Y Management Information System linking population-based data to program data
including geocoded data
Y Y Standardized definitions and categories in systems of data collection and transmittal
Y Y Electronic data collection processes and access to core data sets electronically at all levels,
Y Y Adequate technological capacity (i.e., hardware and software) to conduct data analysis
Need Have
Local Health Departments
Community Health Centers
Other local public agencies/facilities serving MCH populations
(e.g., Planned Parenthood, etc.) (specify):
X
1.TA.1
CAST-5 Preliminary Edition Á March 2001
State medical society
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
X
X
X
Y Y Universities/academic centers
X
X
Y Y Insurers and MCOs
Y Y Leadership of key community groups/organizations
Y Y Professional organizations (check all that are needed):
X
Y Y Hospitals and other institutional providers
X
X
X
1.TA.2
X
X
1-7
1.TA.3
X
X
1.DU.4
Y Y Head of the state unit with responsibility for local health operations
X
X
1.DU.3
X
X
1.DU.2
Y Y State organization of health officers
Y Y Individual local health officials/agency or program directors
1.DU.1
Relationships specifically must support (as appropriate) 1) access to and dissemination of
data; 2) data collection; 3) collaboration in development and implementation of data
standards;4) assisting the Title V program in carrying out and consulting on research
endeavors; 5) serving as a leading source of information on current state and national MCH
research.
Y Y Local public providers of health services (check all that are needed):
Need Have
Organizational Relationships
1-8
population (check all that are needed):
Elected officials and other policymakers
General public
Media outlets
Advocacy organizations
Other(s) (specify):
Competencies/Skills
localities for use in a timely fashion
Y Y Ability to produce high quality local data
Y Y Ability to turn high quality local data into information at the state level and return it to
X
X
X
X
X
1.DU.4
X
1.DU.4
X
1.TA.1
X
1.TA.1
X
1.TA.2
1.TA.2
X
X
X
1.TA.3
X
1.TA.3
CAST-5 Preliminary Edition Á March 2001
1.DU.3
Y Y Knowledge of online databases for literature searches and raw data
X
X
1.DU.2
1.DU.3
X
X
X
1.DU.1
1.DU.2
Y Y Knowledge of survey design and instrument development
Y Y Understanding of quantitative and qualitative research and evaluation methodologies
Y Y Data collection, management, and analytic skills
Need Have
Y Y Collaboration among Title V program units
Y Y Commercial software and programming vendors
1.DU.1
Relationships specifically must support (as appropriate) 1) access to and dissemination of
data; 2) data collection; 3) collaboration in development and implementation of data
standards;4) assisting the Title V program in carrying out and consulting on research
endeavors; 5) serving as a leading source of information on current state and national MCH
research.
Y Y Entities seeking/promulgating health, scientific, and policy information on the MCH
Need Have
Organizational Relationships
products
Competencies/Skills
X
CAST-5 Preliminary Edition Á March 2001
X
Y Y Knowledge of adult education methods
X
1.TA.2
X
X
X
1.TA.1
Y Y Knowledge of the public health problem solving paradigm/process
related to data functions and program operations
Y Y Functional knowledge of capacities/constraints of local health agencies and other providers
emerging “hot” topics
consensus development
professional and lay audiences and decision-makers
Y Y Knowledge of MCH content areas reflective of the current science base, including
X
X
1.DU.4
X
X
1.DU.3
Y Y Ability to effectively staff, lead, and participate in policy working groups and facilitate
1.DU.2
X
X
1.DU.1
Y Y Ability to translate data and other scientific and programmatic information for diverse
Y Y Ability to translate health data into viable information for the MCH planning cycle
Y Y Ability to design and produce high quality data-based reports and other information-based
Need Have
1-9
1.TA.3
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
1-11
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Assess and monitor maternal and child health status to identify and address problems.
Detailed Analysis of Performance: Essential Service #1
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
1-13
Process Indicators: Essential Service #2
Diagnose and investigate health problems and health hazards affecting women, children, and youth.
2.1
Use epidemiologic methods to respond to MCH issues and sentinel events as they arise
•
Within the last three years, has the Title V
program undertaken a study of and/or
analysis of existing data on an MCH issue at
the request of the state legislature, the
governor, or community or professional
groups, or in response to media coverage of
an issue?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):________________________________
2.2
•
•
Engage in collaborative investigation and monitoring of environmental hazards (e.g., physical surroundings and other
issues of context) in schools, day care facilities, housing, and other domains affecting MCH populations, to identify
threats to maternal and child health
Does the Title V program work with
agencies responsible for monitoring
environmental conditions affecting MCH
populations to jointly produce or sponsor
reports or recommendations to state and local
legislative bodies?
Does the Title V program establish
interagency agreements with these agencies
for collecting, reporting on, and sharing data
related to environments affecting MCH
populations?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):________________________________
2.3
•
•
•
Develop and enhance ongoing surveillance systems/population risk surveys and disseminate the results at the state
and local levels
Does the Title V program maintain its own
ongoing surveillance systems/populations
risk surveys to address gaps in knowledge?
Does the Title V program regularly evaluate
the quality of the data collected by existing
surveillance systems or population-based
surveys?
Does the Title V program have a routine
means of reporting the results of these
surveillance systems/surveys to localities?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):________________________________
CAST-5 Preliminary Edition Á March 2001
2-1
2.4
•
•
Serve as the state’s expert resource for interpretation of data related to MCH issues
Is the Title V program regularly consulted on
MCH issues by the chief state public health
executive, by other state agencies and
programs, and by state legislators?
Has the Title V program been asked to
participate in the planning process on an
MCH issue for at least one non-Title V
program in the state in the last three years,
either inside or outside of the health agency?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):_________________________________
2.5
•
•
•
•
Provide leadership for reviews of fetal, infant, child, and maternal deaths and provide direction and
technical assistance for state and local systems improvements based on their findings
Do any fetal, infant, or child death review
processes exist in the state, and, if so, does
the Title V program participate in or provide
resources for them?
Does the Title V program provide technical
assistance to localities in conducting FIMRs
and/or child fatality reviews?
Does the Title V program participate in or
provide leadership for a statewide maternal
mortality review program?
Does the Title V program produce an annual
or bi-annual report consolidating the findings
of local and state mortality reviews?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):________________________________
2.6
•
•
Use epidemiologic methods to forecast emerging MCH threats that must be addressed in strategic planning
In the last five years, has the Title V program
conducted an “environmental scan” or other
process to identify emerging changes in the
MCH system of care and/or in the
demographics or health status of MCH
populations?
Did the Title V program use the results of
that process to plan for data collection and/or
analysis to identify avenues for intervention?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):_______________________________
2-2
CAST-5 Preliminary Edition Á March 2001
Summary Sheet: Essential Service #2
Diagnose and investigate health problems and health hazards affecting women, children, and youth.
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
2.1 Use epidemiologic methods to respond to MCH issues and sentinel events
as they arise
2.2 Engage in collaborative investigation and monitoring of environmental
hazards (e.g., physical surroundings and other issues of context) in
schools, day care facilities, housing, and other domains affecting MCH
populations, to identify threats to maternal and child health
2.3 Develop and enhance ongoing surveillance systems/population risk
surveys and disseminate the results at the state and local levels
2.4 Serve as the state’s expert resource for interpretation of data related to
MCH issues
2.5 Provide leadership in reviews of fetal, infant, child, and maternal deaths
and provide direction and technical assistance for state and local systems
improvements based on their findings
2.6 Use epidemiologic methods to forecast emerging MCH threats that must
be addressed in strategic planning
2-3
desired level of performance/intensity
Structural Resources
X
X
Y Y Up-to-date syntheses of research and data on salient MCH issues (e.g., policy briefs)
CAST-5 Preliminary Edition Á March 2001
Y Y Written guide/standards for community MCH needs assessments
X
X
X
2.4
Y Y Designated site/staff responsible for collection of MCH information and resources
community MCH
to the public on a routine basis
X
X
X
X
2.3
Y Y Inventory of community groups and organizations concerned with or affected by state and
X
X
X
X
2.2
X
X
X
X
X
2.1
Y Y Written protocols for data integrity and confidentiality
Y Y Formal mechanisms for disseminating information about MCH status, goals, and initiatives
Y Y Routine training programs in data collection and management
Y Y Sufficient staff resources to engage in interagency activities
the MCH care system as a whole
Y Y Access to data from public and private sources, including private provider/health plan data
Y Y Publicly articulated performance indicators and measures for both the MCH program and
response
Y Y Adequate funding for carrying out this function at the desired level of performance/intensity
Y Y Written protocols for informing the public about MCH threats and appropriate public
Y Y Sufficient authority and immunity (statutory, etc.) for carrying out this function at the
Need Have
X
X
X
X
2.5
X
X
X
X
2.6
Does the Title V program have the capacity to diagnose and investigate health problems and health hazards affecting women, children, and youth?
Capacity Needs: Essential Service #2
2-5
2-6
Data/Information Systems
manner to policy makers and the public
Y Y Information systems integrated across state agencies/units/programs
Y Y Information systems adequate for creating and disseminating information in a timely
Y Y Management Information System linking population-based data to program data
including geocoded data
Y Y Electronic data collection processes and access to core data sets electronically at all levels,
activities; integration of data sets; and the ability to access, report on, and share data
Y Y Standardized definitions and categories in systems of data collection and transmittal
Y Y Adequate computer hardware and software to support efficient data collection and analysis
Y Y Access to online databases for literature searches and raw data
Need Have
2.1
2.2
X
2.4
2.5
X
X
X
X
X
2.6
CAST-5 Preliminary Edition Á March 2001
X
X
2.3
Environmental agency
Education agency
WIC
Medicaid/SCHIP
Social Services
Family Planning
Housing agency
Transportation agency
Other(s) (specify):
CAST-5 Preliminary Edition Á March 2001
Medical Examiner) (specify):
YY Private insurers and MCOs
YY Other entities appropriate for involvement in mortality review programs (e.g., Office of the
YY Hospitals and provider networks
Local Health Departments
Community Health Centers
Other local public agencies/facilities serving MCH populations
(e.g., Planned Parenthood, etc.) (specify):
Y Y Child care facilities/system
Y Y Local public providers of health services (check all that are needed):
X
X
2.1
X
X
2.2
X
X
2.3
2.4
X
X
X
X
X
2.5
X
X
X
X
X
X
2.6
Relationships specifically must support (as appropriate) 1) access to and
dissemination of data; 2) data collection; 3) collaboration in development and
implementation of data standards;4) assisting the Title V program in carrying out and
consulting on research endeavors; 5) serving as a leading source of information on
current state and national MCH research.
Y Y Vital statistics
Y Y Non-Title V state programs and agencies (check all that are needed):
Need Have
Organizational Relationships
2-7
2-8
population (check all that are needed):
Elected officials and other policymakers
General public
Media outlets
Advocacy organizations
Other(s) (specify):
YY Universities and academic centers
Y Y Collaboration among Title V program units
Y Y Entities seeking/disseminating health, scientific, and policy information on the MCH
State medical society
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
Y Y Professional organizations (check all that are needed):
(specify):
X
X
2.6
CAST-5 Preliminary Edition Á March 2001
X
X
X
X
X
X
2.5
X
X
2.4
X
X
2.3
X
X
X
2.2
X
2.1
Relationships specifically must support (as appropriate) 1) access to and
dissemination of data; 2) data collection; 3) collaboration in development and
implementation of data standards;4) assisting the Title V program in carrying out and
consulting on research endeavors; 5) serving as a leading source of information on
current state and national MCH research.
YY Employers of women of reproductive age
YY Leadership of key community groups and organizations
YY Manufacturers
YY State Insurance Commission
Need Have
Organizational Relationships
Competencies/Skills
X
X
X
YY Ability to translate data and other scientific and programmatic information for diverse
YY Ability to design and produce high quality data-based reports and other presentations of
X
YY Ability to effectively staff, lead, and participate in policy working groups
X
YY Ability to develop, evaluate, and communicate policy options
YY Familiarity with the major, routine, state-based surveys and surveillance systems and their
X
CAST-5 Preliminary Edition Á March 2001
information
professional and lay audiences and decision-makers
methodology
X
2.5
X
X
X
X
X
X
X
X
X
X
X
X
X
X
2.4
X
X
X
X
2.3
X
X
2.2
X
X
2.1
YY Knowledge of environmental health risks
conditions affecting MCH populations (e.g., OSHA, DOL)
YY Knowledgeable about the links between culture and health behavior/attitudes
YY Knowledge of relevant regulatory and legal requirements pertaining to environmental
YY Understanding of state trends in women’s and child health
“hot” topics
YY Ability to translate health data into viable intervention plans
YY Knowledge of MCH content areas reflective of the current science base, including emerging
YY Understanding of quantitative and qualitative research and evaluation methodologies
YY Epidemiology skills
YY Data collection, management, and analytic skills
Need Have
X
X
X
X
X
X
X
2.6
2-9
2-10
Competencies/Skills
X
2.4
X
2.5
X
X
YY Ability to leverage support and resources for implementing policies and programs
YY Experience with quality assurance and quality improvement concepts and their application
2.6
CAST-5 Preliminary Edition Á March 2001
X
YY Cultural and community-specific competence
resolution, including “sensitivity” to cultural diversity and its effects on interactions
solicit input from individuals and organizations
X
X
2.3
YY Trained in decision-making processes, group facilitation and negotiation, and conflict
2.2
X
2.1
YY Knowledge of FIMR and other death review models and methods
YY Knowledge of public and private community organizations, and the ability to effectively
YY Knowledge of online databases for literature searches and raw data
information
YY Ability to effectively leverage the media and other networks to communicate health
Need Have
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
2-11
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Diagnose and investigate health problems and health hazards affecting women, children, and youth.
Detailed Analysis of Performance: Essential Service #2
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
2-13
Process Indicators: Essential Service #3
Inform and educate the public and families about maternal and child health issues.
3.IB
Individual-Based Health Education
Section Intent/Key Qualities:
¾
3.IB.1
•
•
•
Assure the provision and quality of personal health education services
Utilize a routine mechanism for identifying existing and emerging health education needs and appropriate target
audiences
Is information from the Title V needs
assessment used in determining priorities for
health education services and appropriate
audiences for those services?
Is the Title V program aware of existing
resources relating to these health education
needs?
Does the Title V program determine what
health education programs and services are
already in place when assessing priorities for
developing new programs?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):__________________________________
3.IB.2
•
•
•
•
•
Conduct and/or fund health education programs/services on MCH topics targeted to specific audiences to promote the
health of MCH populations
Does the Title V program provide grants to
local organizations to implement health
education activities?
Does the Title V program use MCH or other
state dollars to leverage other funds to
support existing health education programs?
Does the Title V program offer technical
assistance, funding, or other incentives to
MCOs to develop and offer health education
programs?
Does the Title V program jointly sponsor and
implement health education activities across
localities?
Does the Title V program collaborate with
other public and private
agencies/organizations in implementing
health education services (e.g., establishing
partnerships with faith-based organizations
or businesses)?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
CAST-5 Preliminary Edition Á March 2001
3-1
3.IB.3 Produce and disseminate evaluative reports on the effectiveness of health promotion and health education
programs/campaigns
•
Does the Title V program collect information
on individuals participating in health education
and promotion programs?
Does the Title V program have a means of
collecting information on segments of target
populations not participating in health
education and promotion programs?
Does the Title V program collect data on
changes in knowledge and behavior resulting
from participation in health education and
promotion programs?
Does the Title V program analyze data on
outcomes with data on contributing factors
and/or participant demographics?
Does the Title V program disseminate results
of these analyses to provider institutions,
publish them in professional journals, or
otherwise share what is learned with interested
parties?
Does the Title V program use information
from these evaluations to make decisions about
continuation of funding or changes in
programming?
•
•
•
•
•
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
3.PB
Population-Based Health Information Services
Section Intent/Key Qualities:
¾ Provision of health information to broad audiences
3.PB.1 Utilize a routine mechanism for identifying existing and emerging population-based health information needs
•
•
•
Is information from the Title V needs
assessment used in determining priorities for
population-based health information
campaigns?
Is the Title V program familiar with a wide
range of health information resources?
Does the Title V program determine what
health information campaigns are already in
place when assessing priorities for
developing new ones?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
3-2
CAST-5 Preliminary Edition Á March 2001
3.PB.2 Design and implement public awareness campaigns on specific MCH issues to promote behavior
change
•
•
•
•
•
•
Has the Title V program contracted for a
comprehensive public awareness campaign
using a variety of media and communication
methods?
Has the Title V program developed business
plans for financing public awareness
campaigns?
Has the Title V program used MCH money
to leverage other funds to support public
awareness campaigns?
Has the Title V program collaborated with
other public and private entities in
implementing public awareness campaigns?
Has the Title V program identified and
educated other entities (including
nontraditional ones) to carry forth priority
health behavior change messages?
Does the Title V program communicate
timely information on MCH topics (e.g.,
current state and national research findings,
MCH programs and services) through press
releases, newsletters, and other contacts with
the media, state agency bulletins, and other
community channels?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
3.PB.3 Develop, fund, and/or otherwise support the dissemination of MCH information and education resources
•
•
•
•
Does the Title V program house a
clearinghouse of state-specific MCH
resources, or does it provide funding or staff
time to support one housed in another agency
or organization?
Does the Title V program maintain or have
access to a library of current national and
state-specific MCH data-based reports?
Is the Title V program approached by
policymakers, consumers, and others to
provide descriptive information about MCH
populations and health status indicators?
Does the Title V program have a regular
means of publicizing its toll-free MCH line
in a manner that is targeted to reach the full
range of MCH constituents in the state?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
CAST-5 Preliminary Edition Á March 2001
3-3
3.PB.4 Produce and disseminate evaluative reports on the effectiveness of public awareness campaigns and other populationbased health information services
•
•
•
•
•
Does the Title V program collect information
on the individuals and organizational entities
reached by health information campaigns and
other methods of disseminating health
information?
Does the Title V program collect data on
changes in knowledge and behavior resulting
from its population-based health information
services?
Does the Title V program analyze data on
outcomes of these services with data on other
contributing factors?
Does the Title V program disseminate results
of these analyses to provider institutions,
publish them in professional journals, or
otherwise share what is learned with
interested parties?
Does the Title V program use information
from these evaluations to make decisions
about continuation of funding or changes in
programming?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
3-4
CAST-5 Preliminary Edition Á March 2001
Summary Sheet: Essential Service #3
Inform and educate the public and families about maternal and child health issues.
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
3.IB.1
Utilize a routine mechanism for identifying existing and emerging
health education needs and appropriate target audiences
3.IB.2
Conduct and/or fund health education programs/services on MCH
topics targeted to specific audiences to promote the health of MCH
populations
3.IB.3
Produce and disseminate evaluative reports on the effectiveness of
health promotion and health education programs/campaigns
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
3.PB.1 Utilize a routine mechanism for identifying existing and emerging
population-based health information needs
3.PB.2
Design and implement public awareness campaigns on specific
MCH issues to promote behavior change
3.PB.3 Develop, fund, and/or otherwise support the dissemination of MCH
information and education resources
3.PB.4 Produce and disseminate evaluative reports on the effectiveness of
public awareness campaigns and other population-based health
information services
3-5
CAST-5 Preliminary Edition Á March 2001
YY Written protocols for data integrity and confidentiality
YY Access to vital statistics, Medicaid, Education, Justice, and other state agency data
state legislature, and the public
YY Designated site/staff responsible for collection of MCH information and resources
YY Routine mechanisms for identifying the information needs of providers, community groups, the
YY Inventory of community groups that reach target populations
education and/or population-based health information services to MCH populations, including
the specific topics covered and other program characteristics (e.g., language, methods, tools)
YY An easily accessible and routinely updated inventory of health care providers and facilities
YY Inventory of public and nonprofit organizations and health plans/providers providing health
YY Authority to accept and utilize grants, donations, and other funds
performance/intensity
YY Adequate funding for carrying out this function at the desired level of performance/intensity
YY Sufficient authority (statutory, etc.) for carrying out this function at the desired level of
Need Have
Structural Resources
X
X
X
X
X
X
X
3.IB.2
X
3.IB.1
X
X
X
3.IB.3
X
X
X
3.PB.1
X
X
X
3.PB.2
Does the Title V program have the capacity to inform and educate the public and families about maternal and child health issues?
Capacity Needs: Essential Service #3
X
X
X
X
X
X
X
3.PB.3
3-7
X
X
X
3.PB.4
Data/Information Systems
Advocacy organizations
Faith-based and cultural groups
Schools and youth organizations
Other(s) (specify):
X
YY Universities/academic centers
Y Y Collaboration among Title V program units
X
X
X
3.IB.1
YY Hospitals, health plans, and provider networks
Local Health Departments
Community Health Centers
Other local public agencies/facilities serving MCH populations
(e.g., Planned Parenthood, etc.) (specify):
Y Y Local public providers of health services (check all that are needed):
3-8
X
3.PB.1
3.PB.2
3.PB.3
X
X
X
3.PB.4
X
X
X
3.IB.2
X
X
X
3.PB.1
X
X
3.PB.2
X
X
X
3.PB.3
X
3.PB.4
CAST-5 Preliminary Edition Á March 2001
X
X
3.IB.3
Relationships specifically must support (as appropriate) 1) conducting health education programs
and health information campaigns; 2) knowledge about existing health promotion and health
information services provided by other entities; 3) disseminating health information and education
resources; 4) evaluating and reporting on health promotion and health information services.
YY Community groups/organizations (check all that are needed):
Need Have
Organizational Relationships
YY Access to and facility with internet-based resources and communication strategies
policy makers and the public
can be readily accessed and used by programs for reporting and decision making
X
3.IB.3
YY Adequate information systems for creating and disseminating information in a timely manner to
3.IB.2
X
3.IB.1
YY Data collection system able to feed data back to programs in a timely manner and in a form that
Need Have
CAST-5 Preliminary Edition Á March 2001
YY Funders (e.g., businesses, private philanthropic organizations, advocacy groups)
State medical society
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
Y Y Professional organizations (check all that are needed):
(check all that are needed):
Health education unit
State data units
Communications office/professional and/or the governor’s public relations office
Other(s) (specify):
YY Other state agencies/units relevant to health promotion and disseminating health information
that are needed):
Medicaid/SCHIP
Private insurers
Social services system
Justice system
Family Planning
Education agency/system
Child care facilities/system
Other(s) (specify):
X
3.IB.1
X
X
X
3.IB.2
X
3.IB.3
X
3.PB.1
X
X
X
3.PB.2
3.PB.3
3-9
X
3.PB.4
Relationships specifically must support (as appropriate) 1) conducting health education programs
and health information campaigns; 2) knowledge about existing health promotion and health
information services provided by other entities; 3) disseminating health information and education
resources; 4) evaluating and reporting on health promotion and health information services.
YY Agencies financing and/or organizing health and social services to MCH populations (check all
Need Have
Organizational Relationships
3-10
(check all that are needed):
Elected officials and other policymakers
General public
Media outlets
Advocacy organizations
Other(s) (specify):
X
CAST-5 Preliminary Edition Á March 2001
X
Relationships specifically must support (as appropriate) 1) conducting health education programs
and health information campaigns; 2) knowledge about existing health promotion and health
information services provided by other entities; 3) disseminating health information and education
resources; 4) evaluating and reporting on health promotion and health information services.
Y Y Entities seeking/disseminating health, scientific, and policy information on the MCH population
Organizational Relationships
Competencies/Skills
X
X
YY Experience and facility in garnering resources from grants, Medicaid, and commercial insurance
X
YY Experience with quality assurance and quality improvement concepts and their application
CAST-5 Preliminary Edition Á March 2001
YY Experience with focus groups and pre-testing messages
X
X
X
X
X
3.IB.3
YY Understanding of quantitative and qualitative research and evaluation methodologies
YY Data collection, management, and analytic skills
X
YY Ability to leverage support and resources for implementing programs
topics
YY Knowledge of MCH content areas reflective of the current science base, including emerging “hot”
X
X
methods, tools, and innovations
populations; ability to adapt curricula/approaches to take into account cultural differences)
YY Knowledge of general theories on education and learning, as well as of specific health education
X
X
3.IB.2
X
X
X
3.IB.1
YY Cultural and community-specific competence (e.g., knowing how and where to reach target
get the message across)
YY Understanding of the political climate in the state
YY Ability to identify and establish relationships with appropriate “messengers” (key figures who can
YY Mass communication skills and/or knowledge of social marketing theories and techniques
information
YY Ability to design and produce high quality, data-based reports and other presentations of
appropriate to diverse audiences
YY Ability to translate data and scientific/health-related information into language and formats
Need Have
X
X
3.PB.1
X
X
X
X
X
X
X
3.PB.2
X
X
X
X
X
X
3.PB.3
3-11
X
X
X
X
X
X
3.PB.4
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
3-13
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Inform and educate the public and families about maternal and child health issues.
Detailed Analysis of Performance: Essential Service #3
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
3-15
Process Indicators: Essential Service #4
Mobilize community partnerships between policymakers, health care providers, families, the general public, and others to
identify and solve maternal and child health problems.
4.1.
•
•
•
Respond to community MCH concerns as they arise
Are community organizations aware of
how and to whom within the Title V
program to communicate their concerns?
Do community organizations communicate
their concerns and interests to the Title V
program on a regular basis?
Does the Title V program have a track
record of responding actively to
community concerns through changes in
policies, programs, or other means?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):__________________________________
4.2.
•
•
Specify geographic boundaries of communities and/or stakeholder groups for targeting interventions and services
Do needs assessments and planning activities
incorporate detailed assessments of the
segments of the community/state to which
services and programs are targeted?
Are community boundaries and/or identities
(definitions) determined with input from
community members themselves?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):__________________________________
4.3.
•
Provide trend information to targeted community audiences on state and local MCH status and needs
Does the Title V program produce issue- and
population-specific fact sheets, briefs, and
other reports that are disseminated to
provider associations, elected officials, and
community organizations?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):__________________________________
CAST-5 Preliminary Edition Á March 2001
4-1
4.4.
•
Actively solicit and use community input about MCH needs
Does the Title V program have a formal
mechanism for including the perspectives of
community members/organizations in
identifying needs?
Does the Title V program provide technical
assistance to local agencies on collaborating
with community organizations in identifying
needs?
•
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):___________________________________
4.5.
•
•
Provide funding and/or technical assistance for community-driven and –generated initiatives and partnerships among
public and/or private community stakeholders (e.g., MCOs, hospital associations, parent groups)
Does the Title V program provide incentives
(e.g., mini grants, adjusted payment rates,
public recognition, develop and/or
disseminate “how to” publications) for
MCOs and other state and local providers of
MCH services to establish consumer
advisory boards?
Does the Title V program fund community
initiatives addressing problems/needs
identified by the community?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):__________________________________
4.6.
•
•
Convene, stimulate, and/or provide resources (e.g., staffing, funding) for coalitions of agencies and/or constituent
professional organizations to develop strategic plans to address health status and health systems issues
Does the Title V program provide technical
assistance and/or monetary contributions to
coalitions?
Has the Title V program obtained funding
from grants for convening or participating in
coalitions or similar collaborative activities?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):__________________________________
4-2
CAST-5 Preliminary Edition Á March 2001
Summary Sheet: Essential Service #4
Mobilize community partnerships between policymakers, health care providers, families, the general public,
and others to identify and solve maternal and child health problems.
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Y
Y
Y
4.4 Actively solicit and use community input about MCH needs
Y
Y
Y
Y
4.5 Provide funding and/or technical assistance for community-driven and
–generated initiatives and partnerships among public and/or private
community stakeholders (e.g., MCOs, hospital associations, parent
groups)
Y
Y
Y
Y
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
4.1 Respond to community MCH concerns as they arise
4.2 Specify community geographic boundaries and/or stakeholders for use in
targeting interventions and services
4.3 Provide trend information to targeted community audiences on state and
local MCH status and needs
4.6 Convene, stimulate, and/or provide resources (e.g., staffing, funding) for
coalitions of agencies and/or constituent professional organizations to
develop strategic plans to address health status and health systems issues
4-3
CAST-5 Preliminary Edition Á March 2001
Y Y Access to online databases for literature searches and raw data
Need Have
Data/Information Systems
Y Y Community advisory structure with a partial or total focus on MCH
state legislature, and the public
Y Y Routine mechanisms for identifying the information needs of providers, community groups, the
community MCH
Y Y Inventory of community groups and organizations concerned with or affected by state and
local concerns might be voiced (e.g., local news venues)
Y Y Adequate funding for carrying out this function at the desired level of performance/intensity
Y Y Accountable staff locus or institutionalized process for reviewing communication channels where
performance/intensity
Y Y Sufficient authority (statutory, etc.) for carrying out this function at the desired level of
Need Have
Structural Resources
4.1
X
X
X
4.1
4.2
X
X
X
4.2
X
4.3
X
X
X
X
4.3
4.4
X
X
X
X
4.4
4.5
X
X
4.5
4.6
X
X
4.6
4-5
Does the Title V program have the capacity to mobilize community partnerships between policymakers, health care providers, families, the general public, and others to
identify and solve maternal and child health problems?
Capacity Needs: Essential Service #4
4-6
Environmental agency
Education agency
WIC
Medicaid/SCHIP
Social Services system
Justice system
Housing agency
Transportation agency
Child care facilities/system
Other(s) (specify):
are needed):
Local Health Departments
Community Health Centers
Hospitals and other private provider agencies
Other(s) (specify):
Y Y Public and private agencies/facilities serving MCH populations at the local level (check all that
(specify):
Y Y Businesses
State medical society
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
Y Y Professional organizations (check all that are needed):
of local health officials)
Y Y State-level organizations that collaborate with local efforts (e.g., MOD, HMHB, state organization
opinion leaders in the community
(specify):
Y Y Leadership of key private, non-profit community and faith-based groups/organizations and other
Y Y Non-Title V state programs and agencies (check all that are needed):
Need Have
X
X
X
X
4.1
X
X
4.2
X
X
X
4.4
X
X
X
X
4.5
X
X
X
X
X
4.6
CAST-5 Preliminary Edition Á March 2001
X
X
X
4.3
professional and stakeholder communities’ input; 2) Making professional and stakeholder
communities aware of Title V program roles and approach the program for collaboration and
problem solving.
Organizational Relationships Relationships specifically must support (as appropriate) 1) Title V program engaging
X
Y Y Ability to translate data and other scientific and programmatic information for diverse professional
CAST-5 Preliminary Edition Á March 2001
Y Y Ability to design and produce high quality data-based reports and other information-based products
and lay audiences and decision-makers
motivates communities
X
X
Y Y Ability to communicate difficult or sensitive health status information in a manner that inspires and
nonprofit, and professional organizations)
X
X
X
4.3
X
4.3
X
X
4.2
4.2
X
X
X
4.1
4.1
Y Y Knowledge of goals, objectives, and priority concerns of national organizations (public/federal,
governmental structure and processes
Y Y Understanding of community development concepts and methods
Y Y Understanding of the communities in the state, including social and political contexts and local
Y Y Grantsmanship
and programs
Y Y Ability to motivate policymakers and leverage support and resources for implementing policies
Need Have
Competencies/Skills
that are needed):
Elected officials, county/city councils, governor’s office, and other policymakers
General public
Local media/periodicals
Advocacy organizations
Other(s) (specify):
Y Y Health plans, insurers, and provider networks
Y Y Other entities relevant to information and policy development on the MCH population (check all
Need Have
X
4.4
4.4
X
4.5
X
4.5
X
X
4.6
X
X
4.6
professional and stakeholder communities’ input; 2) Making professional and stakeholder
communities aware of Title V program roles and approach the program for collaboration and
problem solving.
Organizational Relationships Relationships specifically must support (as appropriate) 1) Title V program engaging
4-7
4-8
Competencies/Skills
X
X
X
X
4.5
X
X
X
X
X
X
4.6
CAST-5 Preliminary Edition Á March 2001
X
Y Y Trained in needs assessment, planning, and evaluation
X
X
X
X
X
Y Y Experience conducting focus groups and community forums
including “sensitivity” to cultural diversity and its effects on interactions
Y Y Cultural competence
Y Y Trained in decision-making processes, group facilitation and negotiation, and conflict resolution,
Y Y Ability to convene and lead groups
providing salient information; facilitating problem-solving)
Y Y Constituency building, community organizing, and coalition development skills
Y Y Facilitation and consultation skills (e.g., listening; sorting through health and political issues;
X
Y Y Ability to effectively staff, lead, and participate in policy working groups
4.4
X
X
X
X
X
4.3
Y Y Ability to effectively solicit input from individuals and organizations
X
4.2
X
X
4.1
Y Y Knowledge of public and private community organizations and existing local partnerships
Y Y Knowledge of online databases for literature searches and raw data
topics
Y Y Ability to effectively leverage the media and other networks to communicate health information
Y Y Knowledge of MCH content areas reflective of the current science base, including emerging “hot”
Y Y Ability to work with communities to produce reports that are useful to them
Need Have
Competencies/Skills
CAST-5 Preliminary Edition Á March 2001
Y Y Understanding of state policy and legislative processes
brokers
Y Y Advocacy skills
Y Y Ability to use the legal and political system to effect change/increase knowledge of key policy
solving
Y Y Knowledge of concepts and methods related to assets-based community diagnosis and problem
Need Have
4.1
4.2
4.3
X
4.4
4.5
X
X
X
4.6
4-9
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
4-11
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Mobilize community partnerships between policymakers, health care providers, families, the general public, and others to identify and solve maternal and child health
problems.
Detailed Analysis of Performance: Essential Service #4
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
4-13
Process Indicators: Essential Service #5
Provide leadership for priority setting, planning, and policy development to support community efforts to assure the health of
women, children, youth, and their families.
5.DD
Data-Driven Decision Making/Planning
Section Intent/Key Qualities:
¾
Routine use of population-based quantitative and qualitative data, including stakeholder concerns
¾
Dissemination of timely data for planning purposes
5.DD.1 Actively promote the use of the scientific knowledge base in the development, evaluation, and allocation of resources
for MCH policies, services, and programs
•
•
•
•
Does the Title V program have a systematic
process for evaluating current data pertaining
to proposed policies, services, and programs?
Does the Title V program regularly consult
with expert advisory panels in the
formulation of policies, services, and
programs?
Are MCH objectives and program plans
based on current health status and other data?
Does the Title V program regularly consult
with published literature, research studies,
and national health data profiles in the
formulation of policies, services, and
programs?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
5.DD.2 Support the production and dissemination of an annual state report on MCH status, objectives, and
programs, beyond the annual Block Grant submission
•
•
•
•
Does the Title V program contribute funds to
the production and dissemination of an
annual MCH state report?
Does the Title V program contribute data
and/or analysis in the production of an
annual MCH state report?
Does the Title V program contribute staff
time to the production and dissemination of
an annual MCH state report?
Does the Title V program provide leadership
for the production of an annual MCH state
report?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
CAST-5 Preliminary Edition Á March 2001
5-1
5.DD.3 Establish and routinely use formal mechanisms to gather stakeholders’ guidance on MCH concerns
•
•
•
•
Does the Title V program routinely consult
with an advisory structure(s) in the
prioritization of health issues and the
development of health policies and
programs?
Does the advisory structure(s) include
representatives of professional associations,
community groups, and consumers/families?
Does the advisory structure(s) refer to current
data in formulating policy stances?
Do members of the advisory structure(s) feel
their input is valued and used in shaping
policy?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
5.DD.4 Use diverse data and perspectives for data-driven planning and priority setting
•
•
Does the Title V program regularly utilize
data from other agencies (state, regional,
local, and/or national)?
Does the Title V program have a systematic
process for using these data to inform state
MCH health objectives and planning?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
5.PD
Negotiating Program and Policy Development
Section Intent/Key Qualities:
Collaboration
Leadership in promoting the MCH mission
¾
¾
5.PD.1 Participate in and provide consultation to ongoing state initiatives to address MCH issues and coordination needs
•
•
•
•
Is the Title V program a member of two or
more state-level advisory councils or
working committees?
Does the Title V program routinely partner
with other agencies or programs in activities
related to training and education, program
and policy development, and/or evaluation?
Does the Title V program serve as agency
representative for one or more private sector
community projects or professional
associations?
Are there key issue areas for which agency
partnerships are lacking?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):__________________________________
5-2
CAST-5 Preliminary Edition Á March 2001
5.PD.2 Develop, review, and routinely update formal interagency agreements for collaborative roles in
established public programs (e.g., WIC, family planning, Medicaid)
•
•
•
Does the Title V program participate in
interagency agreements for joint needs
assessment and/or program planning and
evaluation?
Does the Title V program review and update
these interagency agreements on a reasonable
routine schedule?
Are there programs or issue areas for which
the Title V program does not have
interagency agreements but should?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):__________________________________
5.PD.3 Serve as a consultant to, and cultivate collaborative roles in, new state initiatives, through either
informal mechanisms or formal interagency agreements
•
•
•
Has the Title V program contributed to the
planning process of at least one new state
initiative affecting the MCH population
within the last three years?
Has the Title V program been part of the
implementation of a joint state initiative in
the last three years?
Is the Title V program routinely consulted by
the leadership of other programs to provide
insight into the impact of policies and
procedures on MCH populations?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):__________________________________
5.PD.4 Advocate for programs and policies necessary to promote the health of MCH populations based on the scientific
knowledge base/data and community input
•
•
•
Does the Title V program routinely produce
and/or disseminate MCH science or policy
news to providers and/or the general public?
Does the Title V program serve as a
representative of the health agency at
public/legislative hearings?
Does the Title V program make
recommendations and advocate for state and
local systems improvements based on
mortality review findings (if such reviews
exist in the state)?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):__________________________________
CAST-5 Preliminary Edition Á March 2001
5-3
Summary Sheet: Essential Service #5
Provide leadership for priority setting, planning, and policy development to support community efforts
to assure the health of women, children, youth, and their families.
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition ÁMarch 2001
5.DD.1 Actively promote the use of the scientific knowledge base in the
development, evaluation, and allocation of resources for MCH
policies, services, and programs
5.DD.2 Support the production and dissemination of an annual state report
on MCH status, objectives, and programs, beyond the annual Block
Grant submission
5.DD.3 Establish and routinely use formal mechanisms to gather
stakeholders’ guidance on MCH concerns
5.DD.4 Use diverse data and perspectives for data-driven planning and
priority setting
5.PD.1 Participate in and provide consultation to ongoing state initiatives to
address MCH issues and coordination needs
5.PD.2 Develop, review, and routinely update formal interagency
agreements for collaborative roles in established public programs
(e.g., WIC, family planning, Medicaid)
5.PD.3 Serve as a consultant to, and cultivate collaborative roles in, new
state initiatives, through either informal mechanisms or formal
interagency agreements
5.PD.4 Advocate for programs and policies necessary to promote the health
of MCH populations based on the scientific knowledge base/data and
community input
5-5
X
Y Y A staff member with assigned responsibility/accountability for each priority health
X
X
X
5.PD.4
5-7
X
X
X
X
X
5.PD.3
CAST-5 Preliminary Edition Á March 2001
X
X
X
5.PD.2
X
X
X
X
X
5.PD.1
Y Y A means of regular communication with the constituency
Y Y Designated site/staff responsible for collection of MCH information and resources
X
X
X
X
5.DD.4
Y Y Written protocols for data integrity and confidentiality
X
X
X
X
5.DD.3
X
X
X
X
X
5.DD.2
Y Y Access to relevant state databases
Y Y Permissive/supportive environment for data sharing
and the maternal and child health care system as a whole
Y Y Up-to-date syntheses (e.g., policy briefs) of research and data on salient MCH issues
Y Y Publicly-articulated performance indicators and measures for both the MCH program
Y Y Community advisory structure with a partial or total focus on MCH
and internal working relationships with state and national agencies, organizations,
universities, and other key groups.
Y Y Job descriptions that include responsibility for establishing and building strong external
issue identified in the needs assessment and planning process
performance/intensity
X
X
Y Y Adequate funding for carrying out this function at the desired level of
performance/intensity
X
5.DD.1
Y Y Sufficient authority (statutory, etc.) for carrying out this function at the desired level of
Need Have
Structural Resources
Does the Title V program have the capacity to provide leadership for priority setting, planning, and policy development to support community efforts to assure the health
of women, children, youth, and their families?
Capacity Needs: Essential Service #5
Data/Information Systems
X
X
Y Y Adequate funding to maintain and periodically update information systems and
5-8
agencies
X
X
5.PD.2
X
X
X
X
5.PD.3
5.PD.4
CAST-5 Preliminary Edition Á March 2001
X
Y Y Local-state network allowing the timely transfer of data between local and state
manner
X
X
5.PD.1
Y Y Information systems adequate for creating and disseminating information in a timely
computer-related infrastructure
assistance
Y Y Access to computer support personnel for maintenance, upgrades, and technical
analysis activities; integration of data sets; and accessing, reporting on, and sharing
levels, including geocoded data
X
X
X
X
X
5.DD.4
Y Y Adequate computer hardware and software to support efficient data collection and
X
Y Y Information systems integrated across state agencies/units/programs
X
5.DD.3
X
X
Y Y Management Information System linking population-based data to program data
5.DD.2
Y Y Standardized definitions and categories in systems of data collection and transmittal
Y Y Electronic data collection process and access to core data sets electronically at all
X
5.DD.1
Y Y Access to online databases for literature searches and raw data
Need Have
(specify):
CAST-5 Preliminary Edition Á March 2001
State and local medical societies
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
Y Y Private sector organizations and consumer/community groups
Y Y Professional organizations (check all that are needed):
Y Y Universities/academic centers
Y Y Collaboration among Title V program units
Y Y State Insurance Commission/Health Care Financing Authority
WIC
Medicaid/SCHIP
Social Services system
Family planning
Education agency
Child care facilities/system
Housing agency
Justice system
Other(s) (specify):
Y Y Non-Title V state programs and agencies (check all that are needed):
Y Y Health data units (e.g., vital statistics, organization with hospital discharge data, etc.)
Need Have
X
X
X
X
X
5.DD.1
X
X
X
X
X
5.DD.2
X
X
X
5.DD.3
X
X
5.DD.4
5.PD.1
X
5.PD.2
X
5.PD.3
5-9
X
X
5.PD.4
serving as a leading source of information on current state and national MCH research; 3) being
viewed as a leading source of technical assistance and training for local health agencies.
Organizational Relationships Relationships specifically must support (as appropriate) 1) access to and dissemination of data; 2)
5-10
relevant to key MCH issues from large amounts of material – journals, reports,
newsletters, etc.)
Y Y Information management and communication skills (e.g., ability to cull information
Y Y Knowledge of online databases for literature searches and raw data
emerging “hot” topics
X
X
X
Y Y Knowledge of MCH content areas reflective of the current science base, including
X
X
X
professional and lay audiences and decision-makers
X
5.DD.2
5.DD.2
X
5.DD.1
5.DD.1
Y Y Leadership skills
Y Y Ability to translate data and other scientific and programmatic information for diverse
Need Have
Competencies/Skills
population (check all that are needed):
Elected officials and other policymakers
General public
Media outlets
Advocacy organizations
Other(s) (specify):
Y Y Entities seeking/disseminating health, scientific, and policy information on the MCH
(check all that are needed):
Local Health Departments
Community Health Centers
Hospitals and other private “service” or “provider” agencies
Other(s) (specify):
Y Y Public and private agencies/facilities serving MCH populations at the local level
Need Have
X
5.DD.3
X
5.DD.3
X
X
5.PD.1
X
X
5.PD.1
5.PD.2
5.PD.2
X
X
5.PD.3
X
5.PD.3
X
X
X
5.PD.4
X
5.PD.4
CAST-5 Preliminary Edition Á March 2001
X
X
5.DD.4
X
5.DD.4
serving as a leading source of information on current state and national MCH research; 3) being
viewed as a leading source of technical assistance and training for local health agencies.
Organizational Relationships Relationships specifically must support (as appropriate) 1) access to and dissemination of data; 2)
Competencies/Skills
CAST-5 Preliminary Edition Á March 2001
Y Y Ability to leverage support and resources for implementing policies and programs
Y Y Understanding of state legislative processes and legislative language
affecting MCH populations
Y Y Ability to develop, evaluate, and communicate policy options
Y Y Knowledge of relevant regulatory and legal requirements pertaining to environments
application
Y Y Ability to translate health data/information into viable intervention plans
Y Y Experience with quality assurance and quality improvement concepts and their
Y Y Understanding of quantitative and qualitative research and evaluation methodologies
use data from a variety of sources
Y Y Cultural and community-specific competence
Y Y Data collection, management, and analytic skills, including the ability to access and
Y Y Community organizing and coalition building and development skills
resolution, including “sensitivity” to cultural diversity and its effects on interactions
effectively solicit input from individuals and organizations
X
X
X
5.DD.3
Y Y Trained in decision-making processes, group facilitation and negotiation, and conflict
X
5.DD.2
X
5.DD.1
Y Y Knowledge of public and private community organizations, and the ability to
of information
Y Y Ability to design and produce high quality data-based reports and other presentations
Need Have
X
X
X
5.DD.4
X
X
X
5.PD.1
X
X
5.PD.2
X
X
X
5.PD.3
5-11
X
X
X
X
X
5.PD.4
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
5-13
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Provide leadership for priority setting, planning, and policy development to support community efforts to assure
the health of women, children, youth, and their families.
Detailed Analysis of Performance: Essential Service #5
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
5-15
Process Indicators: Essential Service #6
Promote and enforce legal requirements that protect the health and safety of women, children and youth, and ensure public
accountability for their well-being.
6.LA
Legislative and Regulatory Advocacy
Section Intent/Key Qualities:
¾
Assure legislative and regulatory adequacy
6.LA.1 Periodically review existing state MCH-related legislation to assess adequacy and any inconsistencies in
legislative/regulatory mandates across programs serving MCH populations
•
Does the Title V program include assessment
of MCH legislation in its long-term planning
about needs and priorities for the state’s
MCH population?
In the last 3-5 years, has the Title V program
undertaken or participated in an interagency
review of state legislation affecting programs
serving MCH populations, in order to
address conflicting language and mandates?
In the last three years, has the Title V
program reviewed state health-related
legislation to ensure adequacy of MCH
programming, resource allocation, and
reporting standards?
•
•
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
6.LA.2 Monitor proposed legislation that may impact MCH and participate in discussions about its appropriateness and
effects
•
•
•
Do Title V staff members routinely attend
legislative hearings?
Does the Title V program participate in
legislative hearings?
Does the Title V program prepare and
present testimony at legislative hearings?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
CAST-5 Preliminary Edition Á March 2001
6-1
6.LA.3 Devise and promote a strategy (specific to state constraints/protocols) for informing
elected officials about legislative/regulatory needs for MCH
•
•
•
Does the Title V program have a protocol or
mechanism for addressing problems and
issues arising from assessments of legislation
such as those mentioned in 6.LA.1 and
6.LA.2?
In the last three years, has the Title V
program communicated (e.g., through
meetings or letters) with elected officials
about specific or cross-cutting regulatory or
legislative needs of programs, either directly
or through appropriate state agency
channels?
Does the Title V program regularly provide
science-based information about MCH needs
to the governor’s office, other appropriate
influential cabinet officials, offices of state
legislators, and regulatory agencies?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
6.LA.4 Initiate legislative proposals and/or lead regulatory efforts (specific to state constraints and
protocols) pertaining to MCH concerns when appropriate
•
•
Does the Title V program on an annual basis
consider needs for new legislation or
regulations?
Does the Title V program have a mechanism
for initiating legislative or regulatory efforts?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
6-2
CAST-5 Preliminary Edition Á March 2001
6.CS
Certification and Standards
Section Intent/Key Qualities:
Provide leadership in promoting standards-based care
¾
6.CS.1 Participate in processes led by professional organizations and other state agencies to provide MCH
expertise in the development of licensure and certification processes
•
In the past five years, has the Title V
program provided MCH expertise in state
efforts to develop or revise professional
licensure and certification processes and
standards?
In the past five years, has the Title V
program provided MCH expertise in state
efforts to develop or revise institutional
licensure and certification processes and
standards?
•
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
6.CS.2 Provide leadership to develop and promulgate harmonious and complementary standards that promote excellence in
quality care for women, infants, and children, in collaboration with professional organizations and other state
agencies with regulatory capacity as appropriate
•
•
•
In the past three years, has the Title V
program provided leadership and MCH
expertise in a standards-setting process for
programs and insurers serving MCH
populations (e.g., school health services,
family planning/reproductive health care,
WIC, child care, CSHCN)?
Does the Title V program regularly review
standards for consistency and
appropriateness, based on current advances
in the field?
Does the Title V program promote
interagency consistency in standards?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
CAST-5 Preliminary Edition Á March 2001
6-3
6.CS.3 Integrate standards of quality care into third party contracts for Title V-funded services, other
publicly-funded services (e.g., Medicaid, SCHIP, WIC, family planning), and/or privately-financed services
•
•
•
•
Has the Title V program collaborated with
Medicaid and SCHIP to incorporate MCH
standards and outcomes objectives in
provider contracts?
Has the Title V program incorporated fiscal
and administrative incentives for standardsbased performance and reporting in third
party contracts?
Has the Title V program directly negotiated
with private insurance companies to
incorporate MCH standards of care into their
protocols?
Has the Title V program communicated with
major purchasers of private insurance about
incorporating MCH standards of care into
their contracts with insurers?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
6.CS.4 Develop, enhance, and promote protocols, instruments, and methodologies for use by health plans,
insurance agencies, and other relevant state and local agencies that promote MCH quality assurance
•
•
•
Has the Title V program led or participated
in a process to define perinatal regions and
corresponding standards, convene a perinatal
oversight committee, and conduct process
and outcome analysis?
In the last three years, has the Title V
program provided leadership in promoting
the implementation of existing MCH
standards-based protocols and instruments
(e.g., Bright Futures) across the state?
Has the Title V program promoted and
developed a process to identify quality issues
pertaining to MCH in the state (e.g., infant,
maternal, and child death reviews)?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):__________________________________
6.CS.5 Participate in or provide oversight for quality assurance efforts among regional health providers and systems and
local health agencies and contribute resources for correcting identified problems
•
•
In the past 3-5 years, has the Title V program
conducted record and site reviews of local
and regional health care providers, agencies,
and/or systems?
Has the Title V program allocated financial
and/or staff resources for addressing
deficiencies identified in such reviews?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution specify):___________________________________
6-4
CAST-5 Preliminary Edition Á March 2001
Summary Sheet: Essential Service #6
Promote and enforce legal requirements that protect the health and safety of women, children and youth,
and ensure public accountability for their well-being.
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
6.LA.1 Periodically review existing state MCH-related legislation to assess
adequacy and any inconsistencies in legislative/regulatory mandates
across programs serving MCH populations
6.LA.2 Monitor proposed legislation that may impact MCH and participate
in discussions about its appropriateness and effects
6.LA.3 Devise and promote a strategy (specific to state constraints/protocols)
for informing elected officials about legislative/regulatory needs for
MCH
6.LA.4 Initiate legislative proposals and/or lead regulatory efforts (specific
to state constraints and protocols) pertaining to MCH concerns when
appropriate
6.CS.1
Participate in processes led by professional organizations and other
state agencies to provide MCH expertise in the development of
licensure and certification processes
6.CS.2
Provide leadership to develop and promulgate harmonious and
complementary standards that promote excellence in quality care for
women, infants, and children, in collaboration with professional
organizations and other state agencies with regulatory capacity as
appropriate
6.CS.3
Integrate standards of quality care into third party contracts for Title
V-funded services, other publicly-funded services (e.g., Medicaid,
SCHIP, WIC, family planning), and/or privately-financed services
6.CS.4
Develop, enhance, and promote protocols, instruments, and
methodologies for use by health plans, insurance agencies, and other
relevant state and local agencies that promote MCH quality
assurance
6.CS.5
Participate in or provide oversight for quality assurance efforts
among regional health providers and systems and local health
agencies and contribute resources for correcting identified problems
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
6-5
CAST-5 Preliminary Edition Á March 2001
‰ Y Health statistics/surveillance unit and/or adequate population data
‰ Y Access to public and private provider/health plan data
briefs)
‰ Y Up-to-date syntheses of research and data on salient MCH issues (e.g., policy
organizations
‰ Y Access to current journals and technical bulletins of major professional
effects
‰ Y Up-to-date files on state health-related legislation and regulatory mandates
‰ Y Legal consultation/resources for counsel on legislative language, intents, and
‰ Y Community advisory structure with a partial or total focus on MCH
desired level of performance/intensity
X
X
X
X
X
X
6.LA.2
X
X
‰ Y Sufficient authority (statutory, etc.) for carrying out this function at the
performance/intensity
X
6.LA.1
‰ Y Adequate funding for carrying out this function at the desired level of
Need Have
Structural Resources
X
X
X
6.LA.3
X
X
X
6.LA.4
X
X
X
6.CS.1
X
X
X
X
6.CS.2
X
X
X
X
X
6.CS.3
X
X
X
6.CS.4
6-7
X
X
6.CS.5
Does the Title V program have the capacity to promote and enforce legal requirements that protect the health and safety of women, children and youth, and ensure public
accountability for their well-being?
Capacity Needs: Essential Service #6
6-8
agencies/facilities serving MCH populations at the local and regional levels
‰ Y Local health departments, regional health authorities, and other public
State and local medical societies
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
‰ Y Professional organizations (check all that are needed):
‰ Y State and local advocacy and consumer/community groups
‰ Y Relevant state data units
(specify):
‰ Y Non-Title V state agencies serving MCH populations
Medicaid/SCHIP
Commercial insurance companies
Employers
State Insurance Commission
Health Financing Authority (if applicable)
‰ Y Insurers and insurance oversight stakeholders (check all that are needed):
Y Y Other elected officials (specify):
and/or other committees as appropriate
X
X
X
6.LA.1
X
X
X
X
X
6.LA.2
X
X
X
X
6.LA.3
X
X
X
X
X
6.LA.4
X
X
X
X
6.CS.2
X
X
6.CS.3
X
X
X
6.CS.4
X
X
X
6.CS.5
CAST-5 Preliminary Edition Á March 2001
X
X
6.CS.1
Relationships specifically must support (as appropriate) 1) quality oversight and assurance
functions; 2) collaboration in the development of tools and methods; 3) being viewed as a leading
source of MCH information, policy analysis, and data.
‰ Y State legislators (and/or their staff) serving on health oversight committees
Need Have
Organizational Relationships
Competencies/Skills
X
X
CAST-5 Preliminary Edition Á March 2001
populations
‰ Y Advocacy skills
‰ Y Broad knowledge of both Title V and non-Title V programs serving MCH
‰ Y Ability to effectively staff, lead, and participate in policy working groups
X
X
X
X
X
X
X
6.LA.4
‰ Y Ability to develop, evaluate, and communicate policy options
X
X
X
6.LA.3
X
X
X
X
6.LA.2
‰ Y Ability to use the legal and political system to effect change
or discussions with elected officials
‰ Y Familiarity with the state’s code and regulatory literature/documents
‰ Y Knowledge of agency process and protocols for initiating legislative proposals
‰ Y Understanding of state legislative processes and legislative language
Need Have
6.LA.1
6.LA.4
X
6.CS.1
6.CS.1
6.CS.2
X
6.CS.2
X
6.LA.3
‰ Y Universities/academic centers
6.LA.2
X
6.LA.1
6.CS.3
6.CS.3
6.CS.4
X
6.CS.4
6-9
6.CS.5
X
6.CS.5
Relationships specifically must support (as appropriate) 1) quality oversight and assurance
functions; 2) collaboration in the development of tools and methods; 3) being viewed as a leading
source of MCH information, policy analysis, and data.
‰ Y Hospitals, health plans, and provider networks
Need Have
Organizational Relationships
Competencies/Skills
6.LA.4
6.CS.1
X
‰ Y Knowledge of statewide service delivery systems, utilization patterns, and
6-10
‰ ‰ Familiarity with evaluation methodology
trends
commercial insurance
X
X
X
X
X
X
6.CS.5
CAST-5 Preliminary Edition Á March 2001
X
‰ Y Experience and facility in garnering resources from grants, Medicaid, and
their application
X
X
X
6.CS.4
‰ Y Data and analytic skills
‰ Y Experience with quality assurance and quality improvement concepts and
X
‰ Y Knowledge of and the ability to conduct cost effectiveness analysis
X
X
6.CS.3
X
X
X
X
6.CS.2
‰ Y Negotiation and persuasion skills
environments affecting MCH populations
‰ Y Knowledge of licensing and certification processes in the state
‰ Y Knowledge of relevant regulatory and legal requirements pertaining to
science base, including emerging “hot” topics
diverse professional and lay audiences and decision-makers
X
6.LA.3
‰ Y Knowledge of MCH content areas and clinical skills reflective of the current
6.LA.2
X
6.LA.1
‰ Y Ability to translate data and other scientific and programmatic information for
Need Have
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
6-11
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Promote and enforce legal requirements that protect the health and safety of women, children, and youth, and ensure public accountability for their well-being.
Detailed Analysis of Performance: Essential Service #6
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
6-13
Process Indicators: Essential Service #7
Link women, children and youth to health and other community and family services, and assure access to comprehensive,
quality systems of care.
7.AA
Assure access to services
Section Intent/Key Qualities:
¾
Provide oversight and technical assistance
¾
Ensure access to comprehensive and culturally appropriate services
7.AA.1 Develop, publicize, and routinely update a toll-free line and other resources for public access to
information about health services availability
•
•
•
•
•
Does the Title V program run ongoing TV,
radio, and print advertisements publicizing its
toll-free MCH line?
Does the Title V program provide information
to consumers about public and private health
insurance coverage of MCH services?
Does the Title V program provide information
about publicly funded health services (e.g.,
family planning clinics, WIC sites) at points of
contact with women, children, and families?
Does the Title V program assist localities in
developing and disseminating information and
promoting awareness about local health
services?
Does the Title V program routinely evaluate
the effectiveness and appropriateness of efforts
to disseminate information about health
services availability?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):_____________________________________
CAST-5 Preliminary Edition Á March 2001
7-1
7.AA.2 Provide resources and technical assistance for outreach, improved enrollment procedures, and
service delivery methods for hard-to-reach populations
•
•
•
•
Has the Title V program promoted the
development of statewide or regional
subcontracts with MCOs for outreach and
home visiting services?
Does the Title V program provide leadership
and resources for developing and
implementing innovative methods of health
care delivery (e.g., off-site services such as
mobile vans and storefront health centers)?
Does the Title V program provide technical
assistance to local agencies, providers, and
health plans in identifying and serving hardto-reach populations?
Does the Title V program disseminate
information on best practices among local
agencies, providers, and health plans across
the state?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
7.AA.3 Develop and routinely evaluate tracking systems for universal, high risk, and underserved populations
•
•
Has the Title V program conducted an
evaluation of the newborn screening
(metabolic, hearing, etc.) and follow-up
system in the past five years?
In the last five years, has the Title V program
worked with local agencies to develop
recommendations for and implement
improvements in outreach, identification, and
follow-up of high risk populations?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
7.AA.4 Provide or pay for direct services not otherwise available to CSHCN and other MCH populations
(with Title V or other available funding)
•
•
•
Does the Title V program operate clinics or
provide staff support to existing clinics?
Does the Title V program serve as an MCO
subcontractor for services for CSHCN?
Does the Title V program purchase insurance
coverage?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
7-2
CAST-5 Preliminary Edition Á March 2001
7.AA.5 Provide resources to strengthen the cultural and linguistic competence of providers and services to
enhance their accessibility and effectiveness
•
•
•
•
Does the Title V program train its own staff
in medical Spanish and/or “linguistic
competence” for interacting with clients?
In the past three years, has the Title V
program sponsored continuing education
opportunities for providers on cultural
competence and health issues specific to
racial/ethnic groups represented in the state?
Does the Title V program work with
culturally representative community groups
and local health departments to provide
resources for the preparation of outreach
materials and media messages targeted to
specific audiences?
Does the Title V program provide leadership
and resources for the recruitment and
retention of persons of color and bilingual
persons in maternal and child health
services?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
7.AA.6 Collaborate with other state agencies to identify and obtain resources to expand the capacity of the
health and social services systems, and establish interagency agreements for the administration of capacity-expanding
initiatives/protocols
•
•
•
•
•
Has the Title V program provided MCH
expertise to the Medicaid agency and
insurance commission in developing
proposals for Medicaid waiver programs,
enhanced/wrap-around MCH services, and/or
other initiatives?
Has the Title V program submitted or
supported proposals for private foundation
grants for enhanced MCH services?
Does the Title V program routinely meet
with professional organizations (e.g., ACOG,
AAFP, AAP) and other state agencies to
assess needs and capacity-expanding
opportunities?
Does the Title V program routinely assess
system failures and successes and develop
strategies for making needed improvements?
Does the Title V program routinely review
interagency agreements for effectiveness and
appropriateness?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
CAST-5 Preliminary Edition Á March 2001
7-3
7.AA.7 Actively participate in public insurers’ oversight of health plan/provider enrollment procedures and
development of plans for appropriate provision of services for new enrollees
•
Has the Title V program worked with the
Medicaid agency and Insurance Commission
to develop model enrollment screening
protocols?
Does the Title V program track new
enrollees’ utilization of services?
Does the Title V program interact with
eligibility workers administering Medicaid
managed care enrollment protocols (e.g.,
through joint staff development initiatives)?
Does the Title V program develop consumer
guides and/or other materials and protocols
for assisting consumers in navigating the
health care system?
•
•
•
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
7.CC
Coordinate a system of comprehensive care
Section Intent/Key Qualities:
¾
Provide leadership and oversight
7CC.1 Provide leadership and resources for a system of case management and coordination of services
•
Has the Title V program convened
community service providers and health plan
administrators to develop model contracts for
MCOs that provide for linkages among all
types of health services?
Does the Title V program compile and
distribute information on best practices
across localities?
•
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
7.CC.2 Provide leadership and oversight for systems of risk-appropriate perinatal and children’s care and
care for CSHCN
•
•
•
Does the Title V program support the
establishment of cross-agency review teams?
Does the Title V program develop and
monitor compliance with risk-appropriate
standards of care?
Does the Title V program support and
promote the routine evaluation of systems?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
7-4
CAST-5 Preliminary Edition Á March 2001
Summary Sheet: Essential Service #7
Link women, children and youth to health and other community and family services,
and assure access to comprehensive, quality systems of care.
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
7.AA.7 Actively participate in public insurers’ oversight of health
plan/provider enrollment procedures and development of plans for
appropriate provision of services for new enrollees
‰
‰
‰
‰
7CC.1
‰
‰
‰
‰
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
7.AA.1 Develop, publicize, and routinely update a toll-free line and other
resources for public access to information about health services
availability
7.AA.2 Provide resources and technical assistance for outreach, improved
enrollment procedures, and service delivery methods for hard-toreach populations
7.AA.3 Develop and routinely evaluate tracking systems for universal, high
risk, and underserved populations
7.AA.4 Provide or pay for direct services not otherwise available to CSHCN
and other MCH populations (with Title V or other available funding)
7.AA.5 Provide resources to strengthen the cultural and linguistic
competence of providers and services to enhance their accessibility
and effectiveness
7.AA.6 Collaborate with other state agencies to identify and obtain resources
to expand the capacity of the health and social services systems, and
establish interagency agreements for the administration of capacityexpanding initiatives/protocols
Provide leadership and resources for a system of case management
and coordination of services
7.CC.2 Provide leadership and oversight for systems of risk-appropriate
perinatal and children’s care and care for CSHCN
7-5
X
Y Y Inventory of community groups and organizations concerned with or affected
X
CAST-5 Preliminary Edition Á March 2001
agencies
Y Y Clarity about data sharing and client confidentiality provisions across
for tracking systems, clinical services, and case management
program and the MCH care system as a whole
Y Y Development of written protocols, based on the scientific knowledge base,
X
X
7.AA.3
X
X
X
X
7.AA.2
Y Y Publicly articulated performance indicators and measures for both the MCH
and facilities
Y Y Easily accessible and routinely updated inventory of health care providers
survey, consumer advisory board)
Y Y A means of regular communication with the constituency
Y Y Mechanism for learning about consumer experiences (e.g., routine consumer
by state and community MCH
desired level of performance/intensity
X
X
Y Y Sufficient authority (statutory, etc.) for carrying out this function at the
performance/intensity
X
7.AA.1
Y Y Adequate funding for carrying out this function at the desired level of
Need Have
Structural Resources
X
X
7.AA.4
X
X
X
7.AA.5
X
X
7.AA.6
X
X
X
7.AA.7
X
X
X
X
X
7.CC.1
7-7
X
X
X
X
X
7.CC.2
Does the Title V program have the capacity to link women, children and youth to health and other community and family services, and assure access to comprehensive,
quality systems of care?
Capacity Needs: Essential Service #7
Data/Information Systems
Consumer advocacy groups
Community and neighborhood associations
Faith-based and cultural/ethnic-based organizations
Y Y Youth-serving organizations (including schools)
all that are needed):
Local Health Departments
Community Health Centers
Individual schools and/or school district
Other(s) (specify):
Y Y Hospitals, health plans, provider networks, and private providers
Y Y Public agencies/facilities serving MCH populations at the local level (check
7-8
Y Y Businesses (e.g., supermarkets, drugstores, fast food restaurants)
(specify):
7.AA.1
7.AA.2
X
X
7.AA.3
X
X
7.AA.4
7.AA.5
7.AA.6
7.AA.7
X
X
7.CC.1
7.CC.2
X
X
X
X
X
7.AA.1
X
X
X
X
X
7.AA.3
X
X
7.AA.2
X
X
7.AA.4
7.AA.6
X
X
7.AA.7
X
7.CC.1
7.CC.2
CAST-5 Preliminary Edition Á March 2001
X
X
X
7.AA.5
Relationships specifically must support (as appropriate) 1) outreach and enrollment and public
programs; 2) collaborative provision of professional education aimed at improving cultural
competency; 3) leadership in coordination of services and oversight of the system of care.
Y Y Media and other communication networks
Y Y Community groups/organizations (check all that are needed):
Need Have
Organizational Relationships
Y Y Management Information System integrated across agencies
to clients
Y Y Internal Management Information System for tracking provision of services
Need Have
WIC
Early intervention program
Education agency
Social services agency
Justice system
Family Planning
Other(s) (specify):
X
X
Y Y Universities/academic centers
CAST-5 Preliminary Edition Á March 2001
State and local medical societies
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
Y Y Schools of business or marketing
Y Y Professional organizations (check all that are needed):
X
X
7.AA.2
Y Y Major employers in the community
Y Y Collaboration among Title V program units
Medicaid/SCHIP
Commercial insurance companies
State Insurance Commission
Health Financing Authority (if applicable)
Y Y Insurers and health financing oversight agency (check all that are needed):
7.AA.1
X
X
7.AA.3
X
X
7.AA.4
X
X
X
7.AA.5
X
7.AA.6
X
7.AA.7
X
X
7.CC.1
7-9
X
7.CC.2
Relationships specifically must support (as appropriate) 1) outreach and enrollment and public
programs; 2) collaborative provision of professional education aimed at improving cultural
competency; 3) leadership in coordination of services and oversight of the system of care.
Y Y Non-Title V state programs and agencies (check all that are needed):
Need Have
Organizational Relationships
Competencies/Skills
X
X
Y Y Ability to translate health information/data into viable intervention plans
Y Y Knowledge of statewide service delivery systems, utilization patterns, and
X
X
Y Y Grantsmanship
Y Y Ability to reach the full spectrum of providers serving a range of MCH
7-10
Y Y Knowledge of population health status and needs
methodologies
Y Y Data collection, management, and analytic skills
Y Y Understanding of quantitative and qualitative research and evaluation
populations
commercial insurance for covering personal health services
X
X
X
7.AA.2
Y Y Cultural and community-specific competence
Y Y Experience and facility in tapping into resources from grants, Medicaid, and
Y Y Knowledgeable about the links between culture and health behavior/attitudes
trends
health information
X
X
7.AA.1
Y Y Health communication skills
Y Y Ability to effectively leverage the media and other networks to communicate
theories and techniques
Y Y Expertise in confidentiality law
Y Y Mass communication skills and/or knowledge about social marketing
Need Have
X
X
7.AA.3
X
X
X
7.AA.4
X
X
X
7.AA.6
X
7.AA.7
X
X
X
X
7.CC.1
X
X
X
7.CC.2
CAST-5 Preliminary Edition Á March 2001
X
X
X
X
X
7.AA.5
Competencies/Skills
X
X
7.AA.4
7.CC.1
X
7.CC.2
their application
7-11
X
7.AA.7
CAST-5 Preliminary Edition Á March 2001
X
X
7.AA.6
X
7.AA.5
Y Y Knowledge of health coverage plans and enrollment mechanisms
Y Y Experience with quality assurance and quality improvement concepts and
X
7.AA.3
Y Y Knowledge of and the ability to conduct cost effectiveness analysis
X
7.AA.2
X
7.AA.1
Y Y Experience with fiscal and human resources management
provision
Y Y Negotiation and facilitation skills
Y Y Familiarity with local systems development and comprehensive care
Y Y Expertise in community development
science base, including emerging “hot” topics
Y Y Knowledge of MCH content areas and clinical skills reflective of the current
Need Have
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
7-13
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Link women, children and youth to health and other community and family services, and assure access to comprehensive, quality systems of care.
Detailed Analysis of Performance: Essential Service #7
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
7-15
Process Indicators: Essential Service #8
Assure the capacity and competency of the public health and personal health workforce to effectively and efficiently address
maternal and child health needs.
8.CP
Capacity
Section Intent/Key Qualities:
¾
Assure workforce capacity and distribution
¾
Assure competency across a wide range of skill areas (e.g., technical, cultural, content-related)
8.CP.1 Develop and enhance formal and informal relationships with schools of public health and other professional schools to
enhance state and local public agency analytic capacity
•
•
•
•
Does the Title V program collaborate with
professional schools to conduct analyses as
part of needs assessment, program planning,
evaluation, or other planning cycle activities?
Does the Title V program seek out
internship/practicum students for mentoring
and collaboration?
Do the Title V program and its parent agency
seek out and support academic partnerships
with professional schools in the state (e.g.,
joint appointments, adjunct appointments,
Memoranda of Understanding between the
agency and the school, sabbatical
placements)?
Do Title V staff serve on advisory
committees, student thesis committees,
and/or guest lecture at professional schools in
the state?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):___________________________________
8.CP.2 Monitor the numbers, types, and skills of the MCH labor force available to the state and localities
•
•
•
Does the Title V program collaborate with
federal, state, and local agencies (e.g.,
commerce, labor, HRSA) and/or professional
organizations to assess needs and collect
labor force data on the full spectrum of
health providers for MCH populations in the
state?
Does the Title V program collaborate with
universities in assessing needs and collecting
labor force data?
Does the Title V program regularly obtain
updated data in this area?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):______________________________________
CAST-5 Preliminary Edition Á March 2001
8-1
8.CP.3 Monitor facility/institutional provider and program distribution throughout the state
•
•
Does the Title V program maintain or have
access to a resource inventory of all relevant
programs and institutional providers reaching
MCH populations?
Does the Title V program assess the
geographic coverage/availability of programs
and institutional providers?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):_____________________________________
8.CP.4 Integrate information on workforce and facility/program availability or distribution with ongoing
health status needs assessment in order to address identified gaps and areas of concern
•
•
In carrying out the 5-year needs assessment,
does the Title V program consider workforce
capacity to address identified needs?
Does the Title V program consider workforce
gaps as part of ongoing program planning?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):____________________________________
8.CP.5 Create financial and other incentives and program strategies to address identified clinical professional and/or public
health workforce shortages
•
•
•
Does the Title V program make use of statespecific programs, the National Health
Service Corps, or other programs providing
financial incentives for providers to work in
underserved areas of the state?
Does the Title V program seek opportunities
to host fellows, Epidemiological Intelligence
Service officers, CSTE placements, MCH
Epidemiology program placements, and
professionals from similar programs?
Does the Title V program actively recruit
graduates of public health and other
professional schools?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):______________________________________
8-2
CAST-5 Preliminary Edition Á March 2001
8.CM
Competency
Section Intent/Key Qualities:
¾
Provide and support continuing professional education
¾
Participate in pre-service and in-service training
8.CM.1 Make available and/or support continuing education for targeted professional audiences in public and private
provider sectors on clinical and public health skills, emerging MCH issues, and other topics pertaining to MCH
populations (e.g., cultural competence, availability of ancillary services and community resources, the community
development process)
•
•
•
Does the Title V program collaborate with
state professional associations, universities,
and others in providing continuing education
courses (face-to-face or distance learning)?
Does the Title V program provide training,
workshops, or conferences for state and local
public health professionals and others on key
emerging MCH issues?
Does the Title V program provide or support
in-service training for program staff?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):_____________________________________
8.CM.2 Play a leadership role in establishing professional competencies for Title V and other MCH programs
•
•
Does the Title V program collaborate with
state personnel/human resources offices in
establishing job competencies, qualifications,
and hiring policies?
Does the Title V program include job
competencies and qualifications in contract
requirements with local agencies and in Title
V grants to community-based organizations
and others?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
‰ Performed by another agency/institution (specify):_____________________________________
CAST-5 Preliminary Edition Á March 2001
8-3
Summary Sheet: Essential Service #8
Assure the capacity and competency of the public health and personal health workforce
to effectively and efficiently address maternal and child health needs.
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
8.CP.1
Develop and enhance formal and informal relationships with schools
of public health and other professional schools to enhance state and
local public agency analytic capacity
‰
8.CP.2
Monitor the numbers, types, and skills of the MCH labor force
available to the state and localities
‰
‰
8.CP.3
Monitor facility/institutional provider and program distribution
throughout the state
‰
‰
‰
8.CP.4
Integrate information on workforce and facility/program availability
or distribution with ongoing health status needs assessment in order
to address identified gaps and areas of concern
‰
‰
‰
8.CP.5
Create financial and other incentives and program strategies to
address identified clinical professional and/or public health
workforce shortages
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
‰
‰
‰
‰
‰
‰
‰
‰
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
8.CM.1 Make available and/or support continuing education for targeted
professional audiences in public and private provider sectors on
clinical and public health skills, emerging MCH issues, and other
topics pertaining to MCH populations (e.g., cultural competence,
availability of ancillary services and community resources, the
community development process)
8.CM.2 Play a leadership role in establishing professional competencies for
Title V and other MCH programs
8-1
CAST-5 Preliminary Edition Á March 2001
Y Y Performance standards for Title V staff at the state, regional, and local levels
qualifications
Y Y Access to distance learning technology
Y Y Performance standards for contractors that address competencies, credentialing, and
grants/contracts with local providers and agencies
Y Y Relevant contract language about staffing requirements and credentials incorporated in
providers/facilities and assessing the adequacy of population coverage
Y Y An easily accessible and routinely updated inventory of health care providers and facilities
Y Y Access to mapping software or other mechanisms for identifying the locations of
professional development plans
Y Y Routine assessments of internal unfilled budgeted positions, current workforce skills, and
and internal working relationships with state and national agencies, organizations,
universities, and other key groups
Y Y Job descriptions that include responsibility for establishing and building strong external
performance/intensity
X
X
Y Y Sufficient authority (statutory, etc.) for carrying out this function at the desired level of
performance/intensity
X
8.CP.1
Y Y Adequate funding for carrying out this function at the desired level of
Need Have
Structural Resources
X
X
X
X
X
8.CP.3
X
X
X
X
8.CP.2
X
X
8.CP.4
X
X
X
8.CP.5
X
X
X
8.CM.1
X
X
X
X
8-3
8.CM.2
Does the Title V program have the capacity to assure the capacity and competency of the public health and personal health workforce to effectively and efficiently address
maternal and child health needs?
Capacity Needs: Essential Service #8
8-4
Y Y State personnel/human resources office
Y Y State legislators (and/or their staff) serving on health oversight committees
services for MCH populations (check all that are needed):
Medicaid/SCHIP
Early intervention programs
Social Services agency
Family Planning
Child care facilities/system
Local Health Departments
Community Health Centers
Hospitals, health plans, and provider networks
Other(s) (specify):
Y Y Universities/academic centers
Y Y Public and private agencies/facilities that finance, organize, and provide health and social
State and local medical societies
AAP state chapter
ACOG state chapter
AAFP state chapter
Other associations that promulgate professional competencies and provide professional
education (e.g., nursing, nutrition, social work, dental, substance abuse)
(specify):
Y Y Professional organizations (check all that are needed):
availability (e.g., credentialing and licensing agencies; Bureau of Health Professions;
HRSA, DHHS; ACF, DHHS)
Y Y State and national agencies that regularly monitor and have as their mission workforce
internships/practicums (e.g., CityMatCH)
Y Y National, state, or local organizations/networks that facilitate connecting with students for
Need Have
X
8.CP.1
X
X
X
8.CP.2
X
X
X
X
X
8.CP.4
X
X
X
8.CP.5
X
X
X
8.CM.1
X
X
X
X
8.CM.2
CAST-5 Preliminary Edition Á March 2001
8.CP.3
services; 2) collaboration in establishing professional competencies; 3) collection of and access
to MCH provider data; 4) facilitating the use of student interns and other alternative sources of
workforce capacity.
Organizational Relationships Relationships specifically must support (as appropriate) 1) provision of professional education
Competencies/Skills
CAST-5 Preliminary Edition Á March 2001
including emerging “hot” topics
curricula/approaches to take into account cultural differences
X
X
Y Y Knowledge of MCH content areas and clinical skills reflective of the current science base,
X
Y Y Negotiation and persuasion skills
X
X
Y Y Knowledge of appropriate contracting language
8.CM.1
Y Y Knowledge of distance learning technology
Y Y Knowledge of different theories on education and learning, and the ability to adapt
X
X
8.CP.5
Y Y Experience and facility in leveraging resources and/or obtaining grants
X
X
Y Y Ability to translate health data/information into viable intervention plans
X
8.CP.4
X
X
Y Y Knowledge of statewide service delivery systems, utilization patterns, and trends
X
X
8.CP.3
Y Y Cultural and community-specific competence
X
Y Y Partnership and collaboration skills
8.CP.2
X
X
X
8.CP.1
Y Y Data collection, management, and analytic skills
to lecture and prepare presentations, to develop a research agenda)
Y Y Mentoring and preceptorship skills
Y Y Skills transferable to the academic environment (e.g., ability to obtain a joint appointment,
Need Have
8-5
8.CM.2
Competencies/Skills
8-6
policies
Y Y Knowledge of licensing, credentialing, and accreditation qualifications, procedures, and
in MCH
Y Y Knowledge of organizational management theory/organizational development
Y Y Knowledgeable about performance appraisal systems for state and local public health staff
Need Have
8.CP.1
8.CP.2
8.CP.4
8.CP.5
X
8.CM.1
X
X
8.CM.2
CAST-5 Preliminary Edition Á March 2001
8.CP.3
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
8-7
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Assure the capacity and competency of the public health and personal health workforce to effectively and efficiently address maternal and child health needs.
Detailed Analysis of Performance: Essential Service #8
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
8-9
Process Indicators: Essential Service #9
Evaluate the effectiveness, accessibility, and quality of personal health and population-based maternal and child health
services.
Note: This Essential Service addresses the evaluation of services and programs. Refer to
Essential Service #1 for assessment and monitoring of population health status.
9.1
•
•
•
•
Support and/or assure routine monitoring and structured evaluations of state-funded services and
programs
Are routine process evaluations built into the
planning, implementation, and funding
cycles of Title V-supported programs?
Are routine outcome evaluations built into
the planning, implementation, and funding
cycles of Title V-supported programs?
Do Title V-issued RFPs/RFAs require
monitoring and evaluation strategies,
including the ongoing reporting and sharing
of data?
Do the Title V program’s contracts with local
providers require monitoring and evaluation
strategies?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):_____________________________________
9.2
•
•
Provide and/or assure technical assistance to local health agencies in conducting evaluations
Does the Title V program provide technical
assistance to local agencies in study design,
analysis, and interpretation of evaluation
results?
Does the Title V program provide access to
state data sets to local agencies to facilitate
the implementation of evaluations?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):_____________________________________
CAST-5 Preliminary Edition Á March 2001
9-1
9.3
•
•
•
•
Provide resources for and/or collaborate with local health or other appropriate agencies in collecting and analyzing
data on consumer satisfaction with services/programs and community perceptions of health needs, access issues, and
quality of care
Does the Title V program allocate and/or
advocate for funding for state and local
efforts to collect information on consumer
satisfaction with services and/or programs?
Does the Title V program allocate and/or
advocate for funding for state and local
efforts to collect information on community
constituents’ perceptions of health and health
services systems needs?
Does the Title V program assist localities in
study design, data collection and analysis
(including surveys, focus groups, town
meetings, and other mechanisms) for the
purpose of obtaining community input on
programs and services?
Does the Title V program receive input at
least annually from an advisory structure(s)
composed of parents, community members,
and/or other constituents, and does the
agency use that input in its five year needs
assessment?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):______________________________________
9.4
•
•
Perform comparative analyses of programs and services
Does the Title V program perform analyses
comparing the effectiveness of
programs/services across different
populations or service arrangements?
Does the Title V program compare statespecific data on program effectiveness with
data from other states and/or nationally?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):______________________________________
9-2
CAST-5 Preliminary Edition Á March 2001
9.5
•
•
Disseminate information about the effectiveness, accessibility, and quality of personal health and
population-based MCH services
Does the Title V program report the results
of monitoring and evaluation activities to
program managers, policymakers,
communities, and families/consumers?
Does the Title V program disseminate
information on “best practices” in the state
and nationally?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):______________________________________
9.6
•
•
•
Utilize data for quality improvement at the state and local levels
Does the Title V program provide technical
assistance to local agencies in quality
improvement activities?
Does the Title V program communicate to
local agencies and community
organizations about national (public and/or
non-governmental) efforts, activities, and
resources in quality improvement?
Does the Title V program translate
information from evaluation activities and
best practices reports into state-level
programs and policies?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):_____________________________________
9.7
•
•
Assume a leadership role in generating and disseminating information on private sector MCH outcomes
Has the Title V program identified a core set
of indicators for monitoring the outcomes of
private providers?
Is the Title V program “at the table” in
discussions with insurance agencies, provider
plans, etc. about the use of these MCH
outcomes indicators in their own assessment
tools?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify):_____________________________________
CAST-5 Preliminary Edition Á March 2001
9-3
Summary Sheet: Essential Service #9
Evaluate the effectiveness, accessibility, and quality of personal health
and population-based maternal and child health services.
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
9.3 Provide resources for and/or collaborate with local health or other
appropriate agencies in collecting and analyzing data on consumer
satisfaction with services/programs and community perceptions of health
needs, access issues, and quality of care
Y
Y
Y
Y
9.4 Perform comparative analyses of programs and services
Y
Y
Y
Y
9.5 Disseminate information about the effectiveness, accessibility, and quality
of personal health and population-based MCH services
Y
Y
Y
Y
9.6 Utilize data for quality improvement at the state and local levels
Y
Y
Y
Y
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
9.1 Support and/or assure routine monitoring and structured evaluations of
state-funded services and programs
9.2 Provide and/or assure technical assistance to local health agencies in
conducting evaluations
9.7 Assume a leadership role in generating and disseminating information on
private sector MCH outcomes
9-1
X
‰ ‰ Publicly articulated performance indicators/measures for the MCH program and the MCH
X
X
9.5
X
X
9.6
X
X
X
9.7
CAST-5 Preliminary Edition Á March 2001
‰ ‰ Access to reference resources about current research
‰ ‰ Permissive/supportive environment for data sharing
‰ ‰ Legal basis for data sharing
contractors
‰ ‰ Routine training programs in data collection and management
‰ ‰ Access to public and private provider/health plan data, particularly data collected by
‰ ‰ Job descriptions that include responsibility for routine monitoring and evaluation
X
X
X
X
X
X
X
X
X
X
9.4
‰ ‰ Written protocols for data integrity and confidentiality
X
X
X
9.3
X
X
X
9.2
‰ ‰ Performance standards for contractors
care system as a whole
performance/intensity
X
X
‰ ‰ Sufficient authority (statutory, etc.) for carrying out this function at the desired level of
performance/intensity
X
9.1
‰ ‰ Adequate funding for carrying out this function at the desired level of
Need Have
Structural Resources
9-3
Does the Title V program have the capacity to evaluate the effectiveness, accessibility, and quality of personal health and population-based maternal and child health
services?
Capacity Needs: Essential Service #9
9-4
Structural Resources
including geocoded data
‰ ‰ Standardized definitions and categories in systems of data collection and transmittal
‰ ‰ Electronic data collection processes and access to core data sets electronically at all levels,
‰ ‰ Access to online databases for literature searches and raw data
Need Have
Data/Information Systems
program changes)
‰ ‰ Regular feedback process to LHDs and other grantees for program improvement
‰ ‰ Incentives for program improvement (e.g., compliance with performance expectations,
with options for program solutions/improvement
‰ ‰ Avenue for routine feedback to communities about health status or evaluation findings
and quality of MCH services to relevant stakeholders (e.g., routine reports to
grantees/agencies, “report cards”)
9.2
9.3
9.5
9.6
X
X
X
9.6
X
9.7
9.7
CAST-5 Preliminary Edition Á March 2001
X
X
X
X
X
X
X
X
9.4
X
X
‰ ‰ Effective mechanism for disseminating information to media and other networks
‰ ‰ Regular process for providing directed information about the effectiveness, accessibility,
X
X
9.5
‰ ‰ A means of regular communication with all relevant constituencies (e.g., newsletter)
9.1
9.4
X
9.3
‰ ‰ Accountability/performance standards for program staff/activities
9.2
X
9.1
‰ ‰ Access to information about “model” programs/“best practices” nationally
Need Have
Data/Information Systems
X
X
‰ ‰ National data units (e.g., NHIS, CDC, Labor Department, Social Security Administration)
‰ ‰ Universities/academic centers
CAST-5 Preliminary Edition Á March 2001
X
X
9.1
‰ ‰ State data units (especially vital records)
(check all that are needed):
Medicaid/SCHIP
Family Planning
Private insurers
Social services system
Education agency
Justice system
Other(s) (specify):
X
X
X
9.1
9.2
X
9.3
X
X
9.4
9.5
9.6
X
X
9.2
X
X
X
9.3
X
X
X
X
9.4
9.5
X
X
9.6
Relationships specifically must support (as appropriate) 1) access to data in general; 2)
access to private provider MCH data for low-income families; 3) evaluation of services and
programs.
‰Y Agencies financing and/or organizing health and social services to MCH populations
Need Have
Organizational Relationships
analysis activities; integration of data sets; and the ability to access, report on, and share
‰ ‰ Information systems integrated across state agencies/units/programs
‰ ‰ Adequate computer hardware and software to support efficient data collection and
‰ ‰ Management Information System linking population-based data to program data
Need Have
X
X
9.7
9.7
9-5
9-6
Local Health Departments
Community Health Centers
Other local public agencies/facilities serving MCH populations
(e.g., Planned Parenthood, etc.) (specify):
9.4
X
X
9.5
emerging “hot” topics
X
X
X
X
X
X
X
‰ ‰ Knowledgeable about the links between culture and health behavior/attitudes
‰ ‰ Experience with quality assurance and quality improvement concepts and their application
‰ ‰ Knowledge of MCH content areas reflective of the current science base, including
X
‰ ‰ Data collection, management, and analytic skills
Need Have
Competencies/Skills
X
X
X
X
X
9.6
X
X
9.6
X
9.7
X
X
9.7
CAST-5 Preliminary Edition Á March 2001
X
9.5
X
9.3
X
X
9.4
‰ ‰ Legislators and other policymakers
9.2
X
X
9.3
X
9.1
X
X
9.2
‰ ‰ Public Affairs unit of the state health agency
‰ ‰ Hospitals, health plans, and provider networks
(specify):
‰ ‰ Consumer, family, and other private community organizations
9.1
Relationships specifically must support (as appropriate) 1) access to data in general; 2)
access to private provider MCH data for low-income families; 3) evaluation of services and
programs.
‰ Y Local public providers of health services (check all that are needed):
Need Have
Organizational Relationships
Competencies/Skills
CAST-5 Preliminary Edition Á March 2001
‰ ‰ Leadership and partnership skills
communicate health information
‰ ‰ Ability to leverage support and resources for implementing policies and programs
‰ ‰ Ability to effectively leverage the media, consumer groups, and other networks to
‰ ‰ Ability to translate health data/information into viable intervention plans
products
professional and lay audiences and decision-makers
X
X
X
X
9.5
X
X
9.4
‰ ‰ Ability to design and produce high quality data-based reports and other information-based
X
X
X
9.3
X
X
9.2
X
9.1
‰ ‰ Familiar with state, national, and regional data sources
‰ ‰ Ability to translate data and other scientific and programmatic information for diverse
sampling methodology, key informant interviews, focus groups)
‰ ‰ Knowledge of online databases for literature searches and raw data
‰ ‰ Quantitative and qualitative research and evaluation skills (e.g., survey design and
Need Have
X
X
9.6
X
X
X
X
9.7
9-7
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
9-9
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Evaluate the effectiveness, accessibility, and quality of personal health and population-based maternal and child health services.
Detailed Analysis of Performance: Essential Service #9
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
9-11
Process Indicators: Essential Service #10
Support research and demonstrations to gain new insights and innovative solutions to maternal and child health-related
problems.
10.1
•
•
•
Monitor the progress of state-specific and national MCH research and disseminate results of that research to
providers, public health practitioners, and policy makers
Does the Title V program disseminate a
routine publication containing abstracts of
current MCH research studies?
Does the Title V program routinely
disseminate reports on MCH-related research
and demonstration projects in the state (e.g.,
GAO reports on Medicaid expansion)?
Does the Title V program routinely
disseminate final reports from its own
research studies to clinical and public health
professionals and policymakers?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify): _____________________________________
10.2
•
•
Serve as a source for expert consultation to MCH research endeavors in the state
Is the Title V program viewed by other state
and local agencies and organizations as the
leading source of information on MCH
population characteristics (e.g., health status,
health service use, access to care)?
Do other agencies/programs keep the Title V
program informed about research endeavors
in the state?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify): _____________________________________
10.3
•
•
•
•
Conduct and/or provide resources for state and local studies of MCH issues/priorities
Does the Title V program provide MCH
leadership and resources for local
demonstration projects and special studies of
longstanding and emerging MCH problems?
Has the Title V program responded to RFAs
or otherwise sought funds for state and local
studies?
Does the Title V program participate in
national demonstrations and “best practices”
research?
Does the Title V program coordinate multisite studies within the state?
Minimally
Adequate
Partially
Adequate
Substantially
Adequate
Fully
Adequate
Y Performed by another agency/institution (specify): _____________________________________
CAST-5 Preliminary Edition Á March 2001
10-1
Summary Sheet: Essential Service #10
Support research and demonstrations to gain new insights and innovative solutions
to maternal and child health-related problems.
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
10.1
Monitor the progress of state-specific and national MCH research
and disseminate results of that research to providers, public health
practitioners, and policy makers
Y
10.2
Serve as a source for expert consultation to MCH research endeavors
in the state
Y
10.3
Conduct and/or provide resources for state and local studies of MCH
issues/priorities
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
Minimally Partially Substantially Fully
Adequate Adequate Adequate Adequate
CAST-5 Preliminary Edition Á March 2001
10-3
X
Y Y Permissive/Supportive environment for data sharing
CAST-5 Preliminary Edition Á March 2001
X
Y Y Written protocols for data integrity and confidentiality
X
X
10.3
X
X
X
X
X
X
X
X
10.2
X
10.1
Y Y Routine training programs in data collection and management
Y Y Job description(s) include consultation role
Community MCH
Y Y A means of regular communication with all relevant constituencies (e.g., newsletter, listserve)
Y Y Inventory of community groups and organizations concerned with or affected by state and
Y Y Designated site/staff responsible for collection of MCH information and resources
performance/intensity
Y Y Adequate funding for carrying out this function at the desired level of performance/intensity
Y Y Sufficient authority (statutory, etc.) for carrying out this function at the desired level of
Need Have
Structural Resources
10-5
Does the Title V program have the capacity to support research and demonstrations to gain new insights and innovative solutions to maternal and child health-related
problems?
Capacity Needs: Essential Service #10
10-6
Data/Information Systems
Medicaid/SCHIP
WIC
Early intervention program
Education agency
Social services agency
Justice system
Family Planning
Other(s) (specify):
and dissemination of data; 2) research activities.
Y Y Non-Title V state agencies (check all that are needed):
Need Have
X
10.1
X
10.2
X
X
X
X
X
X
X
10.3
10.1
X
10.3
CAST-5 Preliminary Edition Á March 2001
X
10.2
Organizational Relationships Relationships specifically must support (as appropriate) 1) access to
computer-related infrastructure
YY Access to computer support personnel for maintenance, upgrades, and technical assistance
Y Y Adequate funding to maintain and periodically update the program’s information systems and
activities; integration of data sets, and the ability to access, report on, and share data
Y Y Management Information System linking population-based data to program data
Y Y Adequate computer hardware and software to support efficient data collection and analysis
including geocoded data
Y Y Standardized definitions and categories in systems of data collection and transmittal
Y Y Electronic data collection processes and access to core data sets electronically at all levels,
Y Y Access to online databases for literature searches and raw data
Need Have
CAST-5 Preliminary Edition Á March 2001
Y Y Ability to design and produce high quality data-based reports and other information-based products
and lay audiences and decision-makers
Y Y Ability to translate data and other scientific and programmatic information for diverse professional
Need Have
Competencies/Skills
Y Y State and/or national funding organizations (public agencies, private philanthropies)
Y Y Key community groups/organizations (specify):
State medical society
AAP state chapter
ACOG state chapter
AAFP state chapter
Other(s) (specify):
Y Y Relationships with hospitals, health plans, and provider networks
Y Y Professional organizations (check all that are needed):
level
Y Y National data units (e.g., NHIS, CDC, Labor Department, Social Security Administration)
Y Y Public and private agencies, and community organizations serving MCH populations at the local
Y Y State data units (especially vital records)
Need Have
and dissemination of data; 2) research activities.
X
X
10.1
X
X
X
X
10.1
10.2
X
X
X
10.2
10.3
X
X
X
X
X
10.3
Organizational Relationships Relationships specifically must support (as appropriate) 1) access to
10-7
10-8
Competencies/Skills
Y Y Grantsmanship
methodology, key informant interviews, focus groups)
Y Y Data collection, management, and analytic skills
Y Y Quantitative and qualitative research and evaluation skills (e.g., survey design and sampling
Y Y Knowledge of online databases for literature searches and raw data
MCH issues from large amounts of material – journals, reports, newsletters, etc.)
X
X
Y Y Information management and communication skills (e.g., ability to cull information relevant to key
topics
X
10.1
Y Y Knowledge of MCH content areas reflective of the current science base, including emerging “hot”
Need Have
X
X
X
X
X
10.3
CAST-5 Preliminary Edition Á March 2001
X
X
X
10.2
CAST-5 Preliminary Edition Á March 2001
Weaknesses:
human resources, budgetary restrictions and fiscal resources, technological
resources, social/political factors
Strengths:
human resources, fiscal resources, technological resources, social/political factors
10-9
human resources, fiscal resources, technological resources, statutory/regulatory
changes
Needs:
human resources, statutory/regulatory changes, community/business resources,
social/political changes, technological developments
Opportunities:
Support research and demonstrations to gain new insights and innovative solutions to maternal and child health-related problems.
Detailed Analysis of Performance: Essential Service #10
CAST-5 Preliminary Edition Á March 2001
past and current federal involvement/activities, state-local relationships, trends in
service population demographics, organizational culture, organizational structure,
competition and collaboration
Other Considerations:
10-11
Synthesis and Summary of Capacity Needs by Domain
Structural Resources:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Data/Information Systems:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
CAST-5 Preliminary Edition Á March 2001
SUM-1
Organizational Relationships:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Competencies/Skills:
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
Capacity Requirement #____
SUM-2
CAST-5 Preliminary Edition Á March 2001
♦
♦
♦
Capacity Need:
Capacity Need:
Capacity Need:
CAST-5 Preliminary Edition Á March 2001
♦
Individual/team responsible for developing workplans:
Action Step:
Individual/team responsible for developing workplans:
Action Step:
Individual/team responsible for developing workplans:
Action Step:
Individual/team responsible for developing workplans:
Action Step:
Capacity Development Action Plan:
Capacity Need:
Priority Capacity Needs:
Capacity Development Action Plan
Plan-1
CORE QUESTIONS
1. Have you established the vision/goals for the MCH population?
Vision statement:
“Ensure the health and safety of all families and communities in the state”
Principles related to this vision:
• Use collaborative relationships to address the mission
• Shift from personal health care services to community-based or systems development activities
where appropriate
• Where delivery of direct services remains necessary, they will be community-centered
2. Given the Title V needs assessment, have you identified the priority health issues and
desired population health outcomes?
Priority health issues:
• Barriers to accessing services
• Early sexual activity and adolescent pregnancy
• VLBW and infant mortality in African American population
• Increase in births to uninsured immigrants
• Problems with availability of, access to, and coordination of services for CSHCN
• Limited health education and outreach
• Barriers to accessing dental care for low-income children
Desired health issue-specific outcomes:
• Increased access to oral health care services
• Access to a coordinated system of care for CSHCN
• Decreased rates of infant mortality
• Decreased racial/ethnic health disparities
• Decreased rates of unwed/unintended pregnancies
3. Have you identified the political, economic, and organizational environments for
addressing the priority health issues?
•
•
•
•
•
Shift in provision of direct services (esp. child and prenatal care) from health department to
private providers, except in rural areas with access and availability issues
More difficult to “sell” infrastructure-building programs, since less visible to legislature than
direct services
Demographic changes (increased diversity, aging population)
New governor and new commissioner on children’s issues
Data capacity has increased significantly over past few years
CAST-5 Preliminary Edition Á March 2001
4. What are the macro-level strategic directions for the Title V program in light of the responses to
questions 1, 2, and 3 above?
• Develop collaborative relationships
• Shift from direct services to a population-based systems approach
• Increase family involvement in the CSHCN program and in the broader Title V
program
• Develop and increase access to and use of relevant data to drive decision making and
program design
5. Have you identified the programmatic organizational strategies you will use to implement the
strategic directions identified in #4 and to achieve the desired population outcomes identified in
#2?
•
•
•
•
•
•
•
Collaboration with the state university’s School of Dentistry to place students and residents
in local health agencies
Coordinated plan for state and local family planning and teen pregnancy prevention
programs/services (including abstinence-based information and family planning referral
hotline; seeking TANF funding for depo-provera, establishment of a state-level Office of
Unwed Pregnancy Prevention to fund community-based activities, expanded Medicaid
coverage of family planning)
Establishment of infant and child death reviews
Statewide public awareness campaign for CSHCN services
Increased support for family advisory roles and family support networks
SCHIP and Medicaid outreach and outstationing of eligibility workers
Cultural sensitivity and language training for health department clinic employees and
technical assistance in this area to local health agencies
CAST-5 Preliminary Edition Á March 2001
Data Use
X
___ ___ ___ ___
M P
S F
X
___ ___ ___ ___
M P
S F
X
___ ___ ___ ___
M P
S F
X
___ ___ ___ ___
M P S F
Level of Adequacy
Health department does not typically go beyond descriptive
statistics.
Health department needs to increase their leadership in this area
and re-examine resources and effort. Doing so will provide the
department with a much better understanding of public health
issues for policy and program planning.
Health department monitors programs more so than what is
happening in the general population
Health department does not tend to collaborate with others outside
of it.
Health department feels comfortable when it has a national model
(e.g., PRAMS, YRBS, etc.) but feels less comfortable in building
from the ground up. Family Health Survey is a major endeavor in
this area.
AIDS Program does a good job at this.
Most staff feel that they are not allotted time to do this – they have
other work responsibilities that preclude their spending time on
this.
•
•
•
•
•
•
•
Health department has good documentation, however there is a
need for getting everybody to know the data are available, and to
be more proactive in using the data.
CAST-5 Preliminary Edition Á March 2001
Comments
•
M = Minimally Adequate; P = Partially Adequate; S = Substantially Adequate; F = Fully Adequate
for use in policy and program development
1.DU.4 Interpret and report on primary and secondary data analysis
specific knowledge base gaps
1.DU.3 Generate and analyze primary data to address state- and local-
statistics
1.DU.2 Conduct analyses of secondary data that go beyond descriptive
health issues (e.g., PRAMS; BRFSS; YRBS; live birth, fetal
death, abortion, linked live birth/infant death data; community
health surveys; census data; etc.)
1.DU.1 Identify and routinely use core data sets to address priority
1.DU
Process Indicator
Essential Service #1: Assess and monitor maternal and child health status to identify and address problems.
ASSESSMENT OF ESSENTIAL SERVICE #1 PROCESS INDICATORS
Data-Related Technical Assistance
X
___ ___ ___ ___
M P
S F
X
___ ___ ___ ___
M P
S F
X
___ ___ ___ ___
M P
S F
Level of Adequacy
•
•
CAST-5 Preliminary Edition Á March 2001
The Community Health Assessment Group in health department
will provide this technical assistance.
Title V program is making an effort to train subgrantees but this
effort needs to be coordinated throughout the health department
and with other workforce development efforts.
Some local health departments are stronger in this area than
others.
•
•
•
Title V program develops and disseminates status indicators to
their funded agencies.
AIDS Program monitors process indicators.
Health department and Title V program only have authority over
programs/providers that they fund.
Comments
•
M = Minimally Adequate; P = Partially Adequate; S = Substantially Adequate; F = Fully Adequate
coordination across geographic areas so that MCH data
outputs can be compared
1.TA.3 Assist local health agencies in data system development and
MCH data to local health agencies or other constituents for
MCH populations
1.TA.2 Provide training/expertise about the collection and use of
expectations for local health agencies and other MCH
providers/programs
1.TA.1 Establish framework/template/standards about core data
1.TA.
Process Indicator
ASSESSMENT OF ESSENTIAL SERVICE #1 PROCESS INDICATORS (continued)
CAST-5 Preliminary Edition Á March 2001
No hospital discharge data/private sector data
No or limited data on Hispanic population
Oral health data not widely collected, not complete, etc.
Specific problems with state laboratory data
Data availability is inconsistent across programs/agencies
Accessing data reports from other divisions is difficult given their
other priorities
Inadequate numbers of program staff with analytic/data
management skills
Insufficient technical and computer support for some purposes
State of the art limitations with CSHCN data
Weaknesses:
Good relationship with Medicaid program and other units with
needed data
Good relationship with the University
Have good data staff need to retain them
Have good hardware and software data infrastructure
Recent vigorous Needs Assessment effort including primary data
collection
Department and Bureau have leadership who appreciate the value
of good data
Very good working relationship with personnel in other
departments (e.g., Epidemiology, Medicaid) from whom special
requests are made, and are accommodated (e.g., PRAMS, etc.)
Strengths:
Can only enforce data standards if have fiscal relationships (e.g.,
grant contract)
Local culture not data-oriented
Confidentiality concerns limit data sharing
Data platforms across agencies not all compatible
Generating good data creates more demand for data keeping up
with exponentially growing demand may be a problem
Market for personnel with technical data skills is very
Other Considerations:
More staff with the necessary skills and with designated
responsibility for data/assessment activities and technical
assistance
More time (and/or other arrangements) for staff to make use of
available training resources in data collection, management, and
analysis
More top level analysis/working through of confidentiality issues
Get the locals on board with data approach
Hospital discharge/commercial private sector data
Data on cost, education, foster care, etc. for CSHCN
Needs:
Collaborate more with the University
Environment of accountability can bolster arguments for more
emphasis on data collected at the local level
Distance learning training grant
University epidemiology training grant
National resources being dedicated to data collection (e.g.,
SLAITS)
Opportunities:
SWON ANALYSIS FOR ESSENTIAL SERVICE #1
competitive hard to keep them
CAST-5 Preliminary Edition Á March 2001
CAST-5 Preliminary Edition Á March 2001
SUMMARIZED AND PRIORITIZED CAPACITY NEEDS
ACROSS ESSENTIAL SERVICES
Structural Resources
1. Written standards for minimum data set for all MCH programs
2. Publicly articulated performance indicators and measures for a) MCH/CSHCN; and b) systems (MCH/CSHCN)
as a whole
3. Access to training in data collection, management, analysis; need to spread more among program units/staff
4. Data access:
- Access to data in timely fashion, getting on others priority lists
- Permissive/supportive environment for data sharing; confidentiality issues and data systems availability issues
- Access to private provider/health plan data
5. Clearly articulated accountable staff locus and institutionalized communication channels to learn about local
concerns (CSHCN ok/good here)
6. Adequate funding:
- data related
- community systems development
- care coordination
Data/Information Systems
1. Integrated MIS for tracking provision of services to clients
Organizational Relationships
1. Collaboration with public agencies (beyond Medicaid), provider and payor organizations, community
organizations, and CHDs specifically to address data issues
2. Relationships with other state child/family agencies and community groups with access to at-risk/hard-to-reach
populations (more specific to community level)
3. Relationships with funders/payors of personal health services -- especially limited with business/corporate sector
4. Collaborations to provide professional education services related to enhancing cultural competency (issue for
CSHCN)
5. Enhanced frequency and effectiveness of contact with the media
6. Relationships with opinion leaders at community level exist but could be strengthened
7. Relationships with schools of business
Competencies/Skills
1. Breadth and depth among staff with respect to:
- negotiation/persuasion skills
- grantsmanship
- constituency/program advocacy development
- group facilitation/negotiation/conflict resolution skills
- community development concepts and methods
- assets-based community diagnosis and problem solving
- mobilizing community skills
- cultural competency
- cost-effectiveness analysis (CSHCN)
2. Working with community to produce information/reports that are useful to them
3. Mass communication skills/social marketing
CAST-5 Preliminary Edition Á March 2001
ACTION STEPS IDENTIFIED TO ADDRESS PRIORITIES
After the Capacity Requirements were consolidated and prioritized for the three Essential
Services reviewed, the management team proposed action steps for the top two capacity
requirements in each of three domains - structural resources, organizational relationships, and
competencies/skills.
Structural Resources
Capacity Need I.
Written Standards for Minimum Data Sets
Action Steps:
1. Review currently existing standards; i.e., health status indicators collected by other
states
2. Investigate what type of information will be useful; Discuss with or survey key
stakeholders (funders, providers, legislators, advocacy groups) to determine what
data/information should be collected
3. Determine if and how the information can be collected; Draft data standards
Capacity Need II.
Publicly Articulated Performance Measures
Action Steps:
1. Package Performance indicators for use and so they can be understood by the public
2. Determine state-specific performance indicators (which may differ from MCHB
indicators)
3. Determine performance measures for the state and communities; ask the locals to
determine their own county-specific indicators
4. Develop and disseminate the report card
Organizational Relationships
Capacity Need I.
Collaboration with Public Agencies
Action Steps:
1. As a component activity to address Structural Resources Capacity Needs I and II,
convene a steering committee of key constituencies to solicit their input and
partnership specific to data issues and activities
2. Maintain contact with the Childrens Commissioner in order to tap into the repository
of information for all agencies with a child focus and the annual report produced by
that office
CAST-5 Preliminary Edition Á March 2001
Capacity Need II.
Relationships with other State Child/Family agencies and Community
Groups with Access to At-Risk/Hard-to-Reach Populations (More
Specific to the Community Level)
Action Steps:
1. Relationship building between entities must be someones explicit responsibility
2. Develop partnerships with MCH providers (CSHCN, physicians)
3. Utilize additional research dollars
4. Work on joint initiatives with other agencies and groups (EMS, Health Promotion)
Competencies/Skills
Capacity Need I.
Breadth and depth among staff with respect to:
- Negotiation/Persuasion Skills
- Grantsmanship
- Constituency/Program Advocacy Development
- Group Facilitation/Negotiation/Conflict Resolution Skills
- Community Development Concepts and Methods
- Assets-Based Community Diagnoses and Problem Solving
- Galvanizing Community Skills
- Cultural Competency
- Cost-Effectiveness Analysis (within CSHCN)
Action Steps:
1. Inventory staff competencies (share with staff as an internal resource guide for TA &
Training)
2. Coordinate continuing education with institutions of higher education
3. Budget for workforce development
4. Identify currently available training
5. Make continuing education an ongoing activity
6. Mentoring
Capacity Need II.
Working with communities to produce information/reports that are
useful to them.
Action Steps:
1. See Action Step #3 for Capacity Need 2 of Structural Resources
2. Develop resource libraries
CAST-5 Preliminary Edition Á March 2001
CAST-5 Glossary
Agency: The overarching organizational entity, akin to the Department of Health.
Analytic Skills: Being able to define a problem; determine appropriate use of data and statistical methods
for problem identification and resolution and program planning, implementation and evaluation; select
and define variables relevant to defined public health problems; evaluate the integrity and comparability
of data and identify gaps in data sources; understand how the data illuminate ethical, political, scientific,
economic and overall public health issues; and make relevant inferences from data. (The Public Health
Workforce, 1997, Appendix E)
Assessment: “Regularly and systematically collecting, analyzing and making available information on the
health of a community, including statistics on health status, community health needs, and epidemiology
and other studies of health problems.” (Turnock 1997)
Assurance: “Verifying that services necessary to achieve agreed-upon goals are provided to constituents.
Encouraging actions on the part of others, and requiring action through regulation or by providing
services directly.” (Turnock 1997)
APEX-PH: Assessment Protocol for Excellence in Public Health. A voluntary process for organizational
and community self-assessment, planned improvements, and continuing evaluation and reassessment.
APEX-PH focuses on a health department’s administrative capacity, its basic structure and role in its
community, and the community’s actual and perceived problems. It offers an opportunity for the local
health department to assess its relationships with local government agencies and with community, state
and federal health agencies. (based on Turnock 1997)
BRFSS: Behavioral Risk Factors Surveillance System.
Capacity: The capability to carry out the core functions of public health (assessment, policy development
and assurance). (based on Turnock 1997)
Community: “A group of people who have common characteristics; communities can de defined by
location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or other common
bonds. Ideally there should be collective discussion, decision making and action.” (Turnock 1997)
“A group of individuals living as a smaller social until within the confines of a larger one
due to common geographic boundaries, cultural identity, a common work environment, common interests,
etc.” (MCHB 2000)
Community advisory structure: Group of individuals from community-based organizations who
provide their feedback and perspectives on maternal and child health programs and activities on a formal
or informal but regular basis.
Community diagnosis: Also referred to as community analysis, community needs assessment, health
education planning, and mapping, community diagnosis is the “process of assessing and defining needs,
opportunities, and resources involved in initiating community health action programs.” (Haglund,
Weisbroad and Bracht, 1990)
CAST-5 Preliminary Edition · March 2001
Constituents: The people involved in or served by an organization.
Constituency building skills: The ability to develop alliances and convince people that an individual or
organization represents their interests with regard to the matter at hand.
Contextual factors: Environmental, political, social, economic, and other external influences.
Core data set: (Also minimum data set) Principal repositories of information on program constituents
held by various entities, e.g., WIC, Medicaid, Department of Education, etc.
Facilitation and consultation skills: Listening; sorting through health and political issues; providing
salient information; facilitating problem-solving.
Geocoded data: Information that is able to be identified with and sorted by the address of the person or
entity.
Major Purchasers of Insurance: Employers and the government (through Medicaid, Medicare, for
example).
Management Information System: An organized assembly of resources and procedures required to
collect, process, and distribute data for use in decision making, often set up on computers and shared by
collaborating organizations.
MAPP: Mobilizing for Action through Planning and Partnerships. A tool developed by the National
Association of City and County Health Officials in collaboration with the Centers for Disease Control and
Prevention. MAPP is a community-wide strategic planning tool for improving community health.
Facilitated by public health leadership, this tool helps communities prioritize public health issues and
identify resources for addressing them.
MCH Leadership Skills Training Institute: Offers continuing education and training to increase
leadership skills for key management personnel in State Title V Maternal and Child Health and Children
with Special Health Care Needs programs.
Opinion leaders: Respected community members who can be viewed as spokespersons and authorities.
Oversight: Regulatory and/or administrative supervision.
PRAMS: Pregnancy Risk Assessment Monitoring System.
Program: Organizational entity focusing on a specific topic (e.g., the Title V Program).
Public Health Problem Solving Process: Defining the problem; measuring its magnitude; developing a
conceptual framework for the key determinants of the problem, including the biologic, epidemiologic,
sociocultural, economic and political determinants; identifying and developing intervention and
prevention strategies, setting priorities among strategies and recommended policies; and implementing
and evaluating programs. (Guyer 1997)
Relationship: Interactions between or among individuals or organizational entities. The purpose of the
“relationship” must be kept in mind, and should be defined in context with regard to the specific activity
or output.
CAST-5 Preliminary Edition · March 2001
Stakeholder: Any and all individuals who hold a large interest in the standing or outcome of the issue at
hand.
Surveillance: Public health surveillance has been described as the collection, analysis, and dissemination
of outcome-specific data to describe and monitor health events, with the explicit provision that these
activities be ongoing, systematic and timely, and, most importantly, that they be linked to public health
practices such as intervention and prevention programs. (Thacker and Stroup 1994, Thacker and
Berkelman 1992)
“Understanding of”: Understanding of the communities in the state, including social and political
contexts and other characteristics: “’Knowing’ the community and its constituents is more than an
epidemiological assessment. It involves coordinating and directing activities necessary to identify
constituent groups, analyzing group characteristics and factors that generate constituent involvement, and
assessing current and potential assets (including fiscal, physical, informational, and human resources) that
constituents and their organizations can direct toward resolving community health issues. The tasks
involved in constituent identification and analysis of group characteristics include demographic
groupings; individual and organizational beliefs, values, missions, and goals; and organizational and
leadership structures of constituent groups as well as their history of working with others.” (Nicola and
Hatcher 2000)
YRBSS: Youth Risk Behavior Surveillance System.
References
Guyer B. Problem-Solving in Public Health. Chapter 2 In: Armenian H and Shapiro S (Eds.):
Epidemiology and Health Services Research, Oxford University Press, New York, 1997.
Haglund B, Weisbrod RR, Bracht N, 1990. Assessing the Community: Its Services, Needs, Leadership
and Readiness. Chapter 4 In: Bracht N (ed.): Health Promotion at the Community Level, Newbury Park,
Sage Publications, 1990.
Maternal and Child Health Services Title V Block Grant Program: Guidance and Forms for the Title V
Application/Annual Report. Rockville, MD: Maternal and Child Health Bureau, Health Resources and
Services Administration, DHHS: 2000.
Nicola RM, Hatcher MT. A framework for building effective public health constituencies. Journal of
Public Health Management and Practice 2000; 6(2):1-10.
The Public Health Workforce: An Agenda for the 21st Century. A Report of the Public Health Functions
Projects, DHHS, U.S. Public Health Service, Office of Disease Prevention and Health Promotion,
Washington, DC: 1997.
Thacker SB, Berkelman RL. History of public health surveillance. In: Haperin W, Baker EL, Monson RR,
eds. Public health surveillance. New York: Van Nostrand Reinhold, 1992:1-15.
Thacker SB, Stroup DF. Future directions for comprehensive public health surveillance and health
information systems in the United States. Am J Epidemiol 1994;140:383-97.
CAST-5 Preliminary Edition · March 2001
Tracking and Evaluation/Feedback for the CAST-5 Preliminary Edition
Please complete this form to the fullest extent possible, and fax it to the attention of
Helene Kent, AMCHP, at fax # 202-775-0061. Thank you for your assistance!
1) Describe how your Title V program used CAST-5:
A)
A self-contained assessment
Part of a larger Title V program and/or state agency planning/assessment process
Please describe: ____________________________________________________
B)
Using the full instrument
Using only certain components of the instrument
Which components?_________________________________________________
2) How long did that process take? ___________________________________________________
3) Who was involved in the assessment? (Check all that apply)
Number
_____ Senior Management Team
_____ Program Area Staff
_____ Grantees
_____ Stakeholders from the Community
_____ Individuals from Outside of Title V
_____ Other?
4) What kind of process did your Title V program use to complete the assessment?
A)
Several Working Groups
One Assessment Team
Other (please describe)
___________________
B)
Series of Meetings
Retreat
Other (please describe)
___________________
5) Did your state produce a final report or other documentation of the assessment results and plan
for next steps?
Yes
No
6) If yes, would your Title V program be willing to share that report or other documentation with
Yes
No
AMCHP?
✂
7) How is your state planning to use the assessment results?
8) Will the information about needs generated during the assessment be useful in other Title V
planning and reporting activities?
9) What was most helpful or productive about completing the CAST-5 tool(s)?
10) What was most problematic?
11) What training, technical assistance, or other related resources did you find important or would
have been helpful in completing the CAST-5 process?
12) Please identify any anticipated program changes/outcomes, both short- and long-term, resulting
from completion of CAST-5 in your state/program.
13) Please identify any completed program changes/outcomes, both short- and long-term, resulting
from completion of CAST-5 in your state/program.
14) Have you been involved in any way in the completion of instrument(s) for the National Public
Health Performance Standards Program?
Yes
No
If yes, please describe how you view the relationship between the two instruments:
Complementary
Redundant
Non-related
Other __________________________________________________
Name (please print):
State:
Date:
Please fax the completed form to the attention of Helene Kent, AMCHP, at #202-775-0061.