Top 5 Things for MCH Programs to Watch in 2010
By Mike R. Fraser, PhD
It seems like everyone has a list of the top five or 10 things from 2009 of some sort just in time for New Year’s – from best books and music, to best news and photographs of the year. Instead of a list of “top” things from 2009, however, I wanted to be a little more prospective and think through what the top five “Things to Watch” in 2010 may be for AMCHP members. Of course this list is not all inclusive but rather what is on my mind right now. Without a crystal ball it is indeed hard to predict the future but these are educated guesses that I think are pretty solid. As we get deeper in to 2010, be sure to ask me how the list may have changed!
1. Health Reform
2009 ended with a major “bang” when it came to health reform. The historic bills passed in the House and Senate now need to be melded and the final version passed again in both houses before the President can sign the bill into law. What to watch? With all that is in the bill there is a lot to watch as conference negotiations take place. What is crucial to MCH programs? How will the proposed home visiting programs end up? Will MCH programs be eligible for new monies to be made available via a proposed Public Health Investment Fund? How will Medicaid changes and other coverage proposals and requirements impact women, children and families – and especially children and youth with special health care needs? AMCHP is positioning itself to provide technical assistance and support to states when a final health reform bill is passed. January and February will be crucial months for health reform in Washington so stay tuned for more!
2. The Life Course Perspective
Everyone seems to be talking about the life course perspective these days and that will continue in 2010. In sum, the life course perspective posits that events early in life have profound health effects later in life. What does that mean for MCH? Definitely more emphasis on programs that promote preconception health for young women and girls, and more emphasis on the social determinants of health including racism, lack of access to health care and other social goods, and health inequity. Also look for new ways of integrating programs in your agencies that address life stages or developmental periods (e.g., all programs that support pregnant women, or programs that work with children aged 0 to 5). The life course perspective is more about vertical thinking (trajectories) and less about horizontal categories (silos). Therefore we may see more about health across the life span and less about the MCH pyramid of services. With so much going on at the theoretical level, this year needs to be the year that theory is translated into practice. In 2010, AMCHP will work with partners to make the theoretical aspects of the life course perspective real for MCH practice in the states.
3. MCH Services Block Grant Advocacy
We have had a tough go-of -it trying to get full funding for Title V, and other block grant programs have also been flat funded over the past several years. Why? The amorphous nature of a block grant coupled with political interests in promoting specific initiatives and/or addressing targeted problems makes a block grant a less attractive vehicle than new legislation. AMCHP will be testing some new advocacy messages and methods in 2010, and working even harder to talk about the specific ways the block grant addresses MCH issues with the hopes of increasing the overall funding level for Title V. But also look for new, categorical programs that address specific MCH needs (such as home visiting) rather than more funding specifically for the block grant. What does this mean for state MCH programs? We will potentially see funding increases for MCH at the state level, but these will most likely be categorical, not increases to the block grant itself.
4. Best Practices & Evidence Based Programs
Reinventing the wheel is so…2009. In 2010, MCH programs need to find the best of the best and tailor programs that work for their own states. Federally, there is great interest in funding programs that demonstrate evidence of effectiveness – the proposed home visitation legislation is a good example of that. With cuts in funding forecast to continue in 2010, the need to efficiently use existing (limited) resources is even greater. 2010 will be the first full year of AMCHP’s new Innovation Station, an online database currently being populated with best practices from across the country. We want the Innovation Station to be your source of best practices for MCH and will continue to update and expand it in the future. Also important – worst practices. Share what isn’t working with colleagues and peers so they don’t make the same mistakes and can look for new solutions with you. We need to hear from you so we can continue to build our capacity to share best practices and provide you with useful resources and tools to make your work even more effective.
2010 promises to be a year of major change for many health care and public health programs. National, state, and local MCH leadership of all kinds is going to be needed to leverage the opportunities of these changes and create a vision for where MCH programs need to be in a reformed health system. MCH programs will be completing statewide needs assessments in 2010 and these can be used by partners and coalitions to press for support for important MCH needs in your state. State MCH leadership will be needed to bring together coalitions and leverage resources to sustain lasting improvements in maternal and child health building on interest and activities related to MCH needs. Family leadership will be critical to making new programs work and maintaining crucial elements of legacy programs. AMCHP will continue to support state Title V leaders through its various programs and services, including our annual conference and other leadership development activities.
As we look to 2010, we have lots of successes from 2009 on which to build. This issue of Pulse focuses on a number of those successes including a listing of resources that we have developed over the past year. Also of note is the final version of AMCHP’s Strategic Plan which will guide our activities over the next several years. We look forward to hearing more about what you would like to see us do on your behalf in 2010 as we move our strategic plan forward and carry out our mission of supporting state maternal and child health programs and providing national leadership on issues affecting women and children. Happy New Year!