By Lori Freeman
Chief Executive Officer, AMCHP
Sometimes a year goes by, and you are amazed at the swiftness with which it came and went. Sometimes, you enjoy looking at that year in your rearview mirror in anticipation of the year ahead. Sometimes you worry about what's ahead and plan the best you can. 2016 was that kind of year.
AMCHP's 2016 started with a bang when our annual conference was cancelled due to Snowzilla last January and ended with a bang when we relocated our headquarters to 1825 K Street in October. In the midst of those two major events, which were rather significant distractions, our important work with members, partners and families continued and grew. We had to face one of the most critical threats to our fetuses and babies in decades with the onslaught of Zika. Please read on as I recap our journey together this past year and include some wishes for 2017.
We continue to provide just the right value proposition to our members year after year. Our retention rate stays strong, and this support allows us to continue to provide top-notch programs, services, technical assistance and products that help you do your jobs and make an impact. Making a difference to you is a priority of AMCHP.
My wish for 2017? That AMCHP continues to remain strong, even in the face of adversity, and that we stay laser-focused and committed to our collective vision for a nation that values and invests in the health and well-being of all women, children, families and communities.
Volunteer Association Committees
Our association and board committees are working for you every day, and they work hard. AMCHP has strong association and board committee participation, with a robust and growing volunteer workforce of nearly 150 AMCHP members. Committees include Annual Conference Planning, Best Practices, Governance, Emerging Issues, Family and Youth Leadership, Legislative and Health Care Finance, and Workforce Development.
My wish for 2017 is that you consider joining a committee today – any level of interest at any time is welcomed. There's something for everyone! We now have our call for volunteers open year-round here.
Your AMCHP Board of Directors
Your board of directors, with broad regional, at-large and family representation, commits extraordinary time ensuring AMCHP is a strong, viable organization. This past year, the board continued to engage members around the 2016-2018 strategic plan, guided and supported the organization through the annual conference reschedule, helped to direct the office relocation and provided overarching organizational leadership through the election and resulting administration transition. These are just a few examples of the immense work the board took on.
My wish for 2017? That all AMCHP members are very aware of the work of the board of directors and that members take advantage of participating in their regional calls.
We continue to have a strong, expert 35-member staff. I am biased, but they are amazing! With a staff this large, change is always happening. As AMCHP grows, we also change and evolve to address our growing needs and to stay true to our vision, mission and strategic plan. Obviously, the office move was a tremendous part of our operations this past year. There was also much, much more to celebrate. We had numerous internal promotions; we reorganized the child and adolescent health team; we created a new communications and membership team and hired journalist Patrick Boyle as the team's associate director; and we renamed our health reform team the health systems transformation team.
My wish for 2017? We create the strongest internal infrastructure possible, with the most talented staff available, that supports the organization's membership, partners, strategic goals and objectives.
Partnership and Collaboration
AMCHP is always seen as a strong collaborator, and we sit at many, many tables. With our excellent staff, we are committed to maintaining this role. As one example, our work continued this year with the MCH Collaboration Council, composed of more than 25 national partners working throughout the MCH system with support from HRSA/MCHB Partnership for State Title V Maternal and Child Health Leadership Community grant funding. This council recognizes that a variety of programs make up the network of foundational services that protect and promote the health and well-being of women, children and families. If the leaders who support implementation of key MCH programs aligned behind shared goals, we could help significantly improve maternal and child health outcomes. AMCHP will be coordinating follow-up activities with the Council to create a work plan and move towards measurement of progress.
My wish for 2017 is that the MCH Collaboration Council discovers new and exciting ways to thread our work together, to lower barriers, and to show other industries how a diverse and broad group of organizations truly can come together for stronger impact on their profession.
We were so very fortunate in 2016 to continue to make sound financial headway, despite two very significant events that had the potential to impact our year-end results: the cancelled AMCHP Annual Conference and the office relocation.
After many months of intense preparation and negotiation, we secured full reimbursement through an insurance claim to completely mitigate extensive losses created by the cancellation and rescheduling of the 2016 annual conference. In addition, moving offices is a tremendous expense, and one that we were not prepared for in 2016. Our current lease was not due to end for several years, but we were forced to relocate due to redevelopment of the property. Nevertheless, we were able to successfully offset all of the costs of the move through strong negotiation of the lease termination at our old building and strong negotiation of the landlord buildout allowance at our new building. Through further expense management, we were actually able to contribute dollars to our bottom line in the end. We wrapped the year with an amazing gain in net assets over our prior year and a successful audit with no material findings. With consecutive-year gains in net assets, we continue to address and reverse a prior year audit finding related to successive budgeted deficits. Challenges always remain in implementing and maintaining sound budget practices, accountability and long-term sustainability of funding.
My wish for 2017? We have an opportunity to host our members, partners and other constituents in our beautiful new offices, and that we continue our good financial health with successful grant proposals, well-managed expenses and solid internal controls.
AMCHP continued to coordinate with the Centers for Disease Control and Prevention and with several partners on funded work to support states in their Zika responses and action plans. This includes assisting in communications from federal entities regarding Zika and providing technical assistance to state MCH teams to identify and implement strategies and plans to support preconception and interconception health, increase access to highly effective contraceptives to reduce negative birth outcomes due to the Zika public health emergency, identify strategies and plans to support referrals and follow-up for infants and children affected by Zika, support surveillance activities related to Zika, and increasing MCH Title V programmatic and epidemiological capacity to address Zika and other public health emergencies. AMCHP is coordinating three sessions (one plenary and two special sessions) on Zika at the AMCHP annual conference focused on 1) providing an overview of Zika and review of the Zika pregnancy registry findings; 2) incorporating MCH epidemiology into emergency preparedness and emerging diseases responses; and 3) addressing and planning for secondary prevention and systems of care capacity related to Zika.
My wish for 2017? If we cannot eradicate Zika entirely, it is my hope that we provide full support for surveillance, testing, follow-up on known cases and engage in complete care coordination (including social services and emotional support) for all babies and families impacted by this terrible virus.
This year was marked by a smooth transition to new leadership on the AMCHP program team as we saw valued colleagues take on new roles outside of AMCHP (many at our valued partner organizations) and current staff readily step into new positions. It's a terrific feeling when you have a bench deep enough to be able to advance staff when opportunities arise, and we experienced a lot of that in 2016. Under the very capable leadership of Program Director Caroline Stampfel and her talented staff, we continued to produce countless deliverables for our state MCH leadership, as well as to identify new grant opportunities for AMCHP. We applied for 21 grant proposals worth $15.2 million and were awarded 16 of those grants worth $13.5 million – a tremendous 89 percent success rate! Again, this work will never be accomplished without all hands on deck. I cannot say it enough. Our amazing staff at AMCHP works tirelessly to achieve these results. Please join me in thanking them always for their dedication, support and can-do attitudes. The program team's projects are fully supported and funded by our many partners – some of whom are highlighted below.
My wish for 2017? Our existing partners and new partners continue their commitment to MCH by placing faith and trust in AMCHP to carry out this vital work with the help of a truly stellar group of staff professionals at AMCHP.
Under the excellent direction of Dr. Jeanette Kowalik, associate director of our women's and infant health team; Kate Taft, associate director of our child and adolescent health team; Dr. Cheryl Clark, associate director of our epidemiology and evaluation team; Stacy Collins, associate director of the health systems transformation team; and Ki'Yonna Jones, senior program manager for workforce and leadership development, select highlights from the program team's 2016 accomplishments follow. There are many more, some of which you can read about in each team's article.
- Implementation Roadmap Webinar Series: AMCHP completed a series of Implementation Roadmap webinars on key national performance measures including well-woman visits, breastfeeding, safe sleep, physical activity, adolescent well-visit, medical home, transition, oral health, smoking and insurance.
- Innovation Station: AMCHP has actively worked to further build Innovation Station to house new resources that will be included in a toolkit to support practice implementation.
- Strengthen the Evidence Base: For AMCHP's subcontract from the Johns Hopkins University Strengthen the Evidence project, key work included establishing and promoting four MCH population Communities of Practice (CoPs): Child Health, Children and Youth With Special Healthcare Needs, Women's and Maternal Health and Cross-Cutting/Life Course.
- AIM-Maternal Health: AMCHP continued to serve as a core partner on the American College of Obstetricians and Gynecologists' cooperative agreement from HRSA-MCHB to eliminate 1,000 maternal deaths and 100,000 cases of severe maternal morbidity nationally over the next four years. The project, the Alliance for Innovation on Maternal Health (or AIM – Maternal Health) works with states and major hospital systems to implement maternity safety practices (bundles) to prevent obstetric emergencies and improve care quality.
- National Consensus Framework for Improving Quality Systems of Care for CYSHCN: As part of Phase III of the Standards project, AMCHP, in partnership with the National Academy for State Health Policy, continues to focus on increased outreach to Medicaid and health plans, provision of intensive technical assistance to states and continued effort to condense and streamline the standards for ease of use. The team continues to revise and edit the Standards, including the addition of new federal regulations and guidelines, and reflects feedback from states that have previously implemented the Standards.
- Adolescent and Young Adult Health National Resource Center (AYAH-NRC): The five state teams (Iowa, Mississippi, New Mexico, Texas and Vermont) have been implementing their state-level action plans focused on how to increase access to and the quality of preventive health care visits for adolescents and young adults in their communities. There was a concerted focus on mobilizing the National Strategy Teams (NSTs) to carry out the learning collaborative activities and data collection related to improving access and uptake of preventative services, improving the quality of preventive services and improving state/systems-level policies and practices to assure access to high-quality preventive services.
- Leadership Institute for CYSHCN Directors: The Leadership Institute for CYSHCN Directors was held the day following AMCHP's annual conference. The meeting provided networking activities; highlighted preliminary results of the CYSHCN program profile (described below); and engaged directors in facilitated discussions of emerging issues and upcoming priorities as well as innovative, sustainable methods to engage families and consumers. Additional webinars are being hosted on an as-needed basis, whereby AMCHP staff invite topic-specific experts to participate and provide directors individual training and technical assistance. Over the upcoming years, the Institute will be sustained through AMCHP's larger workforce development initiative, the Leadership Lab.
- Women's Preventive Services Initiative: Since May 2016, AMCHP's Dr. Jeanette Kowalik, PhD, MPH, MCHES, associate director of women's and infant health, represented members on the Multidisciplinary Steering Committee of the Women's Preventive Services Initiative (WPSI). WPSI was established in 2011 "to improve women's health across the lifespan by identifying preventive services and screenings to be used in clinical practice." The Steering Committee was charged with reviewing research related to a wide array of health services coverage for women. This included assessment of the well-woman visit, cervical and breast cancer screening protocols and breastfeeding support. The WPSI 2016 "Recommendations for Preventive Services for Women" Abridged Report is available here.
- Support for the state MCH epidemiology workforce: Funded by the CDC Cooperative Agreement with the Division of Reproductive Health, AMCHP sponsored 17 state MCH epidemiology staff and five CSTE Applied Epidemiology MCH Fellows with a travel scholarship to attend the rescheduled AMCHP 2016 Annual Conference.
- Data communication TA project: In December 2016 AMCHP completed the Data Translation: Data Communication Partnerships project. The project was an eight-month technical assistance opportunity pairing MCH epidemiologists and program management staff with national communication experts to improve data communication skills. Participating state teams (Hawaii, Louisiana, Maine, Michigan, Washington and Wisconsin) presented in December on final projects they worked on throughout the period. In addition to their overall data communication project, states completed short learning assignments after bi-monthly virtual learning events and presented their assignments during virtual peer sharing meetings.
- Medicaid Data Sharing project: With Support from the CDC's Division of Reproductive Health, AMCHP aims to provide technical assistance to MCH epidemiologists/data staff to build partnerships between MCH staff and Medicaid. The desired outcome is to increase the capacity of state MCH and CYSHCN program staff to access Medicaid data in order to assess population health needs and guide programmatic interventions. The MCH Medicaid Data Partnership project kicked off in May with an orientation for the three selected teams: Florida, New Mexico and Hawaii. Through continual engagement, our goal is to assist these states in setting up a data-sharing partnership within the state MCH-Medicaid Interagency Agreement by October 2017.
- Health Reform Resources Updated: The Health Systems Transformation team recently revised nine existing AMCHP documents regarding health reform and specific MCH populations/programs. The overhaul included providing updated national statistics and appropriations information, as well as updates on state projects. These newly revised and formatted documents will be available at the AMCHP conference as well as on the health reform site on amchp.org.
- Perinatal Oral Health National Network: AMCHP is a key partner in the Perinatal Infant Oral Health Quality Improvement National Network, which is led by the Children's Dental Health Project and includes partners from the Association of State and Territorial Dental Directors, the National Academy of State Health Policy and the National Improvement Partnership Network. The Network works with organizations in 11 states to affect systems change that promotes the oral health of women and infants in each state. Epidemiology and Evaluation team staff are involved in learning collaborative activities and establishing CoIIN-like strategies and measures for the project.
- 2016-18 Act Early Systems Grants: AMCHP continued to support the 2014-2016 Learn the Signs. Act Early (LTSAE) State Systems Grantees: Minnesota, Montana, Oklahoma, New Jersey, New Mexico, North Carolina and Wisconsin. The cohort of grants ended in February 2016. AMCHP will be updated the Act Early page with resources and highlights from their projects. In addition, AMCHP expects to receive supplemental funding from CDC through our subcontract with AUCD to support additional grantees this cycle. The request for applications for the 2016-18 grants focuses on increasing parent-engaged developmental monitoring by promoting the adoption and integration of LTSAE materials and training resources into programs and statewide systems that serve young children and their families. AMCHP received applications from over 30 U.S. states and jurisdictions. The review process is underway and AMCHP expects to award up to 12 grants.
- Supporting Economic Analysis of MCH Work: AMCHP provides ongoing virtual support to state/local teams interested in return on investment (ROI) methods. We continue to house the Return on Investment Community of Practice SharePoint site for anyone to join and share resources, experiences and challenges with economic analysis methods in MCH. AMCHP is in the process of converting a recorded full-day ROI skills building training from the AMCHP Annual Conference to share the content widely through the AMCHP website and creation of a learning module. At the APHA Annual Meeting and Expo in October 2016, AMCHP staff Krista Granger presented "Demonstrating the Value of MCH Programs: Lessons Learned from the Association of Maternal & Child Health Programs' Return on Investment Analytic Action Learning Collaborative," where state experiences and lessons learned were shared from the nine states that participated in cohorts one and two of the collaborative.
- Not a bad year at all, but we still must march on and remain assiduous. Please join us as we set forth on a new and exciting journey to shape our vision, mission, new strategic goals and objectives into action. Don't forget, we cannot accomplish these amazing things and further improve without your feedback, input and guidance.
Policy and Government Affairs
We continued our strong policy and advocacy work at AMCHP under the excellent leadership of Brent Ewig and Amy Haddad. This work is not for the faint of heart – especially this year! These two dedicated staff members spend extraordinary amounts of time actively engaging with coalitions in public health and maternal and child health, ensuring that the interests of moms, dads, babies, children, adolescents and all families all have the same opportunity to be healthy and well. Brent and Amy successfully fought for Zika funding this year and continued to monitor the changing administration closely for clue as to future impact on our MCH programs, as well as stayed true to our overall legislative agenda for the year focused on support for Title V and myriad other programs and initiatives impactful for MCH. They worked hard with AMCHP leadership and members to develop the 100-Day MCH Policy Agenda for the new administration and spent significant time on how to best position AMCHP and the field of MCH to leverage new opportunities on the horizon. We will continue discussions on both practical and aspirational policy recommendations for the new president's transition team and set the stage for even more MCH policy in 2017 and beyond.
My wish for 2017? It's lofty, I admit: I'd like for us to stay true to our vision for MCH and consider new opportunities to educate non-traditional champions among our lawmakers as we work towards a unified approach to address this country's most egregious MCH challenges.
I feel ready for the opportunities and challenges that await us in 2017 and look forward to engaging with all of the MCH community together as we work toward what matters to us most: the health and well-being of our nation's moms, dads and kids.