Maternal and Child Health Assessment 2015
In 2015, the Minnesota Department of Health conducted a Maternal and Child Health Needs Assessment for the state of
Minnesota. Under the direction of a community leadership team, this assessment identified nine priorities for improving
the health of mothers, children, adolescents, pregnant women, infants, and children and youth with special health needs.
Working with stakeholders from across Minnesota, the leadership team identified specific areas of focus for each priority,
along with possible measurements, strategies, practices, and action recommendations. We understand that there are some
overlap among the nine priority areas; to avoid duplication, most areas of focus are only identified once, even though they
could be under multiple priorities. (For example, prenatal care is important for both Preventive Health Care and Healthy
Babies, but it is only listed under Healthy and Planned Pregnancy.)
These priority sheets were created to provide data and ideas for community members, policy makers, public health
professionals, and others working towards improving maternal and child health in Minnesota.
Priority: Ensure Adequate and Accessible Care
Ensuring all Minnesotans have access to adequate coordinated, timely, culturally appropriate and effective health
care; including oral care.
Focus areas:
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Culturally responsive care
Medical homes and health care homes
Affordable and timely care
Adequate health insurance coverage
The Maternal Child and Health Assessment Leadership Team identified these specific action recommendations to
improve access to care in Minnesota:
1. Improve access to preventive health care in rural Minnesota by increasing access to transportation and quality
providers in shortage areas.
2. Establish more integrated care sites that accept public plan coverage and are inclusive of services such as, but not
limited to: dental, physical, behavioral and mental health care.
3. Increase access to and use of medical homes (Health Care Homes) for children and youth with special health
needs (CYSHN) and promote a comprehensive, coordinated, and integrated system of services and supports for
CYSHN and their families.
4. Ensure adequate health insurance coverage for maternal and child populations.
5. Expand providers’ prescription capability to include alternatives such as cooking and physical activity classes.
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Culturally Responsive Care
Objectives: People are able to find and use health care that is responsive to their culture and/or identity.
Communication between health care providers and patients and families has an impact on health outcomes. While these
measurements are not available consistently about the general population, measurements are available for children with
special health needs.
Chart 1: Doctors are sensitive to family culture and values, MN children with special health needs, age 0-17
Source: National Survey of Children with Special Health Care Needs, 2009-2010. *Non-Hispanic.
Chart 2: Doctors are always sensitive to family culture and values, MN children with special health needs, age 0-17,
racial/ethnic breakdown
Source: National Survey of Children with Special Health Care Needs, 2009-2010. *Non-Hispanic.
Measurements/outcomes for culturally responsive care:
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Percent of children and youth with special health needs who receive culturally-responsive, comprehensive,
family-centered and coordinated care.
Examples of strategies or practices to support culturally responsive care:
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Expand funding for initiatives towards improving culturally responsive care.
Incorporate comprehensive data collection of sexual orientation and gender identity in electronic health records.
Create more opportunities for local community health events and outreach.
Increase the number, training, and utilization of Community Health Workers.
Increase and provide culturally appropriate assistance for navigating systems.
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Identifying and/or creating new strategies to address racial/ethnic disparities, focusing on prevention and early
detection.
Provide culturally specific designed service coverage.
Provide cultural competency and interaction training for health care practitioners.
Medical homes and health care homes
Objective: Increase and improve the quality of care coordination for all populations.
Chart 3 and 4: Percent of Children and Youth with Special Health Needs and All Children who receive
coordinated, ongoing, comprehensive care within a medical home
Source: National Survey of Children’s Health, 2011/2012 and the National Survey of Children and Youth with Special Health Care
Needs, 2009/2010.
Minnesota Children with Special Health Needs Who Receive Effective Care Coordination
Subgroup
Age Group
0 – 5 years old
6 – 11 years old
12 – 17 years old
Sex of Child
Male
Female
Race/Ethnicity
Hispanic
White, non-Hispanic
Black, non-Hispanic
Other, non-Hispanic
Specific Types of Special Health Needs
Managed by prescription medications
Above routine need/use of services
Prescription medications and service use
Functional limitations
Emotional, Behavioral, or Developmental Issues
One or more emotional, behavioral, or developmental
issues
No qualifying emotional, behavioral, or developmental
issues
% Receiving Effective Care
Coordination
44.9%
41.5%
41.7%
39.9%
46.5%
22.2%**
45.2%
33.8%**
44.0%
38.6%
39.2%
50.6%
44.8%
38.1%
44.6%
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Subgroup
% Receiving Effective Care
Coordination
Insurance Type
Private insurance only
47.2%
Public insurance only
35.2%
Both public and private insurance
40.6%
Uninsured
4.3%**
Household Income
0-99% federal poverty level (FPL)
30.4%
100-199% FPL
33.8%
200-399% FPL
44.0%
400 FPL or more
52.6%
Source: National Survey of Children and Youth with Special Health Care Needs, 2009/2010 ** Estimates based on sample sizes too
small to meet standards for reliability/precision
Measurements/outcomes for care coordination:
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Percent of children with and without special health care needs having a medical home.
Percent of children with special health care needs who receive effective care coordination.
Examples of strategies or practices to support care coordination:
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Improve knowledge and understanding of health care home among families, providers and communities.
Broaden and increase medical home reimbursement.
Revise the current care coordination tier method to reflect the needs of children.
Increase capacity for more staff to provide care coordination.
Break down silos in the greater care system (e.g. health, education, housing, etc.).
Allow reimbursement for care coordination services for children without medically complex conditions.
Define and promote coordinated, culturally responsive, family-centered care for families and providers.
Build awareness that the health care home should focus on quality of life indicators in addition to clinical
indicators.
Use plain language for definitions, especially for care coordination.
Provide families clear definitions of roles for existing care coordinators that will provide efficient and effective
services to meet children’s and family’s needs.
Provide tools and navigators for parents to identify and manage their child’s services and providers, including
knowledgeable contacts in a resource directory.
Develop tools that will encourage providers and parents to release information for sharing among health care
professionals for the purpose of better coordination of care.
Supporting use of Community Health Workers through educating providers and clinic managers on best practices
for utilizing CHWs in improving health in diverse communities.
Affordable and timely care
Objective: Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care, dental
care, or prescription medicines.
Nationally, in 2009-2010, 34.9% of children with special health care needs had difficulty accessing community based
services (as found on www.kidscount.org, 11/2105).
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Chart 5: Percent of parents who did not experience difficulties or delays because there were waiting lists, backlogs,
or other problems getting appointments for child(ren).
Source: Data Resource Center for Child and Adolescent Health, 2011.
Measurements/outcomes for affordable and timely care:
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Percent of parents who did not experience difficulties or delays because there were waiting lists, backlogs, or
other problems getting appointments for their child(ren).
Percent of all persons who were unable to obtain or delayed in obtaining necessary medical care, dental care, or
prescription medicines.
Percent of all persons who were unable to obtain or delayed in obtaining necessary medical care.
Percent of all persons who were unable to obtain or delayed in obtaining necessary dental care.
Examples of strategies and practices to promote affordable and timely care:
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Develop plans with dental care providers to increase access to quality oral health care for persons on Medical
Assistance throughout the state.
Increase access to Health Care Homes for children in foster care.
Increase the availability of and access to quality mental health services, especially in rural Minnesota.
E-health—adoption and effective use of electronic health record systems and other health information technology
to improve health care quality, patient safety, and ability of individuals and communities to make the best possible
health decisions.
Adequate Health Insurance Coverage
Objective: Ensure all Minnesotans possess adequate health insurance coverage.
Insurance coverage, for children and adolescents, is considered adequate if it a) covers needed services, b) covers needed
providers, and c) reasonably covers costs.
Chart 6: Percent of Minnesotans with adequate insurance coverage for children and adolescents.
Source: National Survey of Children’s Health, 2011-2012.
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Measurement/outcome for adequate insurance coverage:
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Percent of Minnesotans with adequate insurance coverage for children and adolescents.
Examples of strategies and practices to ensure adequate insurance coverage:
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Provide assistance in completing application forms through community-based organizations, schools, hospitals,
etc.
Linking public health insurance with other public programs such as WIC, Head Start.
Simplifying the application forms, combining with other applications.
Use of “insurance navigators,” community based support for applying for insurance.
Adequate and Accessible Care was or is an identified priority, focus, or goal of all of these reports, plans, and
organizations:
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MCH Assessment Inquiry Feedback
2010 Title V National Performance Measure
2015 Title V National Performance Measure
Adolescent Health Action Plan
Advancing Health Equity Report
CDC Healthy People 2020
Children’s Defense Fund – MN
Community Health Boards
Healthy MN 2020: Statewide Health Improvement Framework
ISAIAH’s Campaign Priorities
MN Children & Youth With Special Health Needs Strategic Plan 2013-2018
MN Council of Health Plans
MN Statewide Health Assessment 2012
Prenatal to Three Plan
Rainbow Health Initiative
Rural Health Advisory Committee
For more information about the 2015 Maternal and Child Health Assessment, or about the Title V Block Grant, please
visit the Minnesota Department of Health webpage at http://www.health.state.mn.us/divs/cfh/na/ .
On the data charts above, all races are non-Hispanic ethnicity.
PO Box 64882, St. Paul, MN 55164-0882
651-201-3760
[email protected]
http://www.health.state.mn.us/divs/cfh/na/MCHNeedsAssessment.html
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