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 February 10, 2009

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Great Expectations

By Mike R. Fraser, PhD    

Inauguration Day in Washington was an amazing event. With almost two million people in town you could feel the history being made minute-by-minute. The crowds and the energy, the optimism and the hope, were palpable. It was a remarkable day for our country. Images from that day will stay in my memory forever. 

And yet during all the hoopla, the parties, and the celebrations I could not help but feel a twinge of something I did not expect – a feeling of doubt, a nagging question of “can he do it?” was squarely in my mind. So many of us pinned so much hope on one man, our hope for change, our hope for something new, our hope that things will get better. I began to find myself feeling overwhelmed by the dreams we shared for our new administration, almost startled by all the wishes I had to make America better. I asked myself, can he really do it? Can he really meet all of our expectations and deliver on all our hopes, dreams, and promises for the future? 

The expectations many have all placed on our new President and his Administration are immense. The last few weeks have shown just how great our expectations are and just how much work it is going to take to meet those expectations. Mistakes have been made. Partisanship is alive and well. Some of the energy, the optimism, and the hope that were here just two short weeks ago has retreated and the reality of change at a much slower pace than many of us had hoped for is quickly settling in. 

What’s the leadership lesson here? When we talk about leadership we often talk too much about leaders and we forget just how important the followers are too. While we pin much hope on our leaders we have to remember that as followers we also have a role — if not the most important role — in assuring a leader’s success. On Inauguration day I was thinking “Yes He Can.” I forgot the quotation was actually “Yes We Can.” The Inauguration was not just about commissioning a new President, but also commissioning ourselves to our shared purpose. While we place so much hope in our leaders the real power they have is to motivate and inspire us to get the work done, not do all the work themselves. 

What does all this mean for those of us working in maternal and child health? The reality is that while our new Administration may be more likely to support state maternal and child health the constraints on that support are as great as ever and we cannot count on our leaders alone to move our agenda. We have to help move it too. Congressional attention has been so focused on economic recovery and job creation that there is little time to lobby for maternal and child health issues. Our leaders' and followers' voices are needed to amplify the call to invest in maternal and child health. Projected deficits are so immense that any increase in Title V is going to be a tough sell. If we want this to happen, we have to have great expectations for our leaders and great expectations for ourselves. 

Now, more than ever, we need to share the story of the difference we are making in the lives of women, children, and families across the country as MCH leaders, and MCH followers. We have to continue to push our call for increased support for maternal and child health and expect our leaders to do the right thing. While our expectations are great, the work we have to do is greater. I am so glad we are all here doing this important work, together.

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Everything is Up in the Air!

CHIP Reauthorization
First, some great news - last Wednesday, President Obama signed the reauthorization of the Children’s Health Insurance Program. This law will preserve coverage for the approximately seven million children currently enrolled and extend coverage to close to four million more. AMCHP has consistently advocated for this reauthorization and is pleased to join in the celebration of this achievement. A summary of the final provisions included in the bill is available from Families USA here. Additionally, President Obama also issued a directive undoing the Bush Administration’s Aug. 17, 2007 directive limiting eligibility levels for SCHIP.  

Health Provisions in the Economic Recovery Act
As of press time, the Senate was continuing debate on their version of the Economic Recovery Act. Amendments were expected to remove the prevention and wellness funding from the bill, with reports of a bi-partisan workgroup looking for cuts that could gain enough votes for passage. AMCHP has joined with many public health partners in advocating for these funds to be retained, and we will continue to report on where this roller coaster ride ends. 

FY09 and FY2010 Title V Appropriations
Debate on the economic recovery package is delaying finalization of the FY09 omnibus appropriations bill. This needs to be completed before the current continuing resolution expires in early March. We are also anxiously awaiting the first Obama Administration’s proposed budget in the coming weeks to see how the Title V MCH Block Grant makes out in this new environment. We will share details as soon as they are available.

HHS Leadership
The withdrawal of Senator Tom Daschle’s nomination to be the next HHS Secretary has raised many questions about the impact on the Administration’s health policy agenda. Timing on a replacement is uncertain, although reports indicate that key committee’s on Capitol Hill are calling for a quick nomination and moving forward in crafting health reform plans.                                       

Advocacy Opportunities at the AMCHP Annual Conference – We will have several opportunities at the upcoming AMCHP Annual Conference to discuss what this all means for AMCHP’s Legislative Agenda and the future of MCH. We are still working to get a representative from the Administration to join us at the Annual Conference, although the Daschle withdrawal has complicated these efforts. As a final reminder, if you are attending the conference and are able to make visits to Capitol Hill, we urge you to help support the call for full funding of the Title V MCH Block Grant at $850 million. Now more than ever it is key that policymakers understand why Title V is essential in your states and communities, and why full funding is needed. Please contact Josh Brown if you need assistance setting up Hill visits, and feel free to contact him or Brent Ewig or 202-775-0436 with any questions about AMCHP’s advocacy efforts.

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Vote for your AMCHP Board of Directors
The 2009 election for AMCHP’s available Board positions is now open. All AMCHP delegates whose programs have paid dues for the 2008-2009 membership year are eligible to vote. For information on the candidates, please visit, Delegates and family delegates that do not vote electronically may vote in-person at the 2009 Annual Conference. If you have any questions, please contact Nora Lam or call (202) 775-0436. 

AMCHP February Board Meeting
The next AMCHP Board Meeting will be held during our Annual Conference on Saturday, February 21 from 8 a.m. to 2 p.m. Additional information will be provided in the coming weeks. Board Members who will be attending should RSVP to Nora Lam or call (202) 775-0436. 

AMCHP Business Meeting
All members, partners and staff are invited to attend a business meeting on Tuesday, February 24 from 10:15 to 11:45 a.m. during our Annual Conference.  

MCHB Medical Home Meeting
Join MCHB and your fellow MCH and CSHCN Directors at a special meeting on Saturday, February, 21 from 2:30 to 6 p.m. to discuss medical homes and learn more about what is happening in other states and at the national level. During this session, you will hear the results from a recent AMCHP query to assess the level of Title V involvement in medical home initiatives in each state and how the concept of medical home is being used by various Title V programs nationwide. For more information on national medical home initiatives, click here to read a commentary by Marie Mann, MD, MPH, Deputy Chief, Genetic Services Branch, Maternal and Child Health Bureau.

AMCHP to Host Two Workforce Development Events at Annual Conference
Several months ago AMCHP released three Issue Briefs highlighting preliminary results from the 2008 State Title V Workforce Development Survey. The data you provided was invaluable in developing these documents and in helping AMCHP, the Association of Teachers of Maternal and Child Health and The Maternal and Child Health Bureau learn more about MCH and CYSHCN programs and their training needs nationally. On Monday, February 23, AMCHP will offer a workshop on “The State Title V Workforce in 2008: New Data and a Conversation about Addressing Workforce Development” from 10:15 to 11:45 a.m. On Tuesday, February 24, from 2:30 to 4 p.m. AMCHP will host a roundtable to further discuss the results and to address any questions you may have regarding the survey. We invite you to join us to share your views about the role of AMCHP as it relates to workforce development and training and to inform us of what resources would be useful to you and your staff. The roundtable is open to all conference participants but we are especially interested in hearing from directors and program managers that supervise staff. Visit here to register.

AMCHP Women’s Health Information Series Call
The next Women’s Health Call, “Fatherhood Involvement in Maternal and Child Health” will occur on Thursday, February 12 from 3 to 4:30 p.m. (EST). Please register here to receive the call-in number and passcode. For more information, contact Jessica Hawkins or call 202-775-0436.  

Webcast on Children and Health Information Technology (HIT)
HRSA and MCH will present a webcast, “Children and HIT: As a State Title V Director What Do I Need to Know?” on February 12 from 2 to 3 p.m. (EST). This webcast will include discussions about HRSA’s HIT activities, technical assistance resources available to State Title V programs (i.e. Telehealth Resource Centers), issues in telehealth affecting children and other emerging HIT issues. To register, click here 

Children's Health Insurance Program Webcast's “Ask the Experts” webcast, “The Children's Health Insurance Program Reauthorized: What's Next?” will occur on Thursday, February 12 at 2 p.m. (EST). During the webcast, the panel of experts will address such questions as: What is included in the new legislation? What impact will the new legislation have on coverage of uninsured children? What new tools will states have to reach and enroll uninsured children in Medicaid and CHIP? How will new funding affect state efforts to move forward? How will the deepening recession affect these efforts? What does reauthorization mean for broader health reform? The panel of experts will take questions via email in advance of or during the live program. To view the webcast, visit here 

Call for Applications: Grants for Systems of Services for CYSHCN
The Maternal and Child Health Bureau is seeking applications for “The President’s New Freedom Initiative: State Implementation Grants for Systems of Services for Children and Youth with Special Health Care Needs.” The initiative will support up to six grants to assist State Title V Children with Special Health Care Needs programs, family organizations, providers and other partners to implement the six core outcomes of a system of services for children and youth with special health care needs. The guidance is available here or under HRSA-09-159.  The due date for all applications is March 6.

Submit Your Best Practice Today!
AMCHP is seeking submissions of best practices in maternal and child health from around the country. Whether it’s an effective campaign to promote breastfeeding, an outstanding nurse-family partnership, or a proven early intervention program for young children, get the word out about your best practice. AMCHP defines “best practices” as a continuum of practices, programs and policies ranging from emerging to promising to evidence-based. A best practice could focus on the health of women, adolescents, young children, families, or children with special health care needs. Best practice focus areas include preconception care, mental health, data and assessment, financing, program and system integration, workforce development, injury prevention, emergency preparedness, family involvement, or other public health issues. Contribute to AMCHP’s Innovation Station – a growing database of what is working in MCH. 

1) Click here to download a PDF of the submission form.  

2) When you are ready to submit, click here to start the survey. 

For more information on submitting best practices, please contact Darlisha Williams or call (202) 775-0436. 

Family Voices’ Gala
The Family Voices Gala will be held on Monday, February 23, 2009, in conjunction with AMCHP’s Annual Conference at the Marriott Wardman Park Hotel in Washington, DC. AMCHP members get a discounted price! $175 for AMCHP members. For more information, visit Family Voices 2009 Gala. 

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AMCHP member, Rosalyn Bacon, Senior Director of the Office of Birth Outcomes in the Georgia Department of Human Resources, is featured in a new Grantmakers in Health Issue Focus along with Terri Wright, Program Director for health at the W.K. Kellogg Foundation, and former Title V Director in Michigan. This Issue Focus, called Establishing Public-Private Partnerships for Maternal and Child Health, gathers their perspectives on the importance and relevance of the MCH block grant to private funders. Click here to read the interview.


“Does your state have an innovative initiative or program to get Medicaid eligible women into prenatal care early?” Please email your response to Michelle Alletto. 

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General Maternal & Child Health  

Children's Dental Health Month Resource
The National Maternal and Child Oral Health Resource Center (OHRC) in collaboration with the Maternal and Child Health Library at Georgetown University released a new edition of the knowledge path about oral health for infants, children, adolescents and pregnant women. This electronic guide points to resources that analyze data, describe programs, and report on policy and research aimed at improving access to and the quality of oral health care. The knowledge path contains sections with resources for professionals, resources for consumers, and resources on specific aspects of oral health. Topics include child care and Head Start, dental sealants, early childhood caries, fluoride varnish, K-12 education, pregnancy, school-based care, school evaluation mandates and special health care needs. The knowledge path is available here  

Updated Assertive Community Treatment (ACT) Toolkit
The Center for Mental Health Services has released an updated version of the Assertive Community Treatment (ACT) Toolkit. This toolkit highlights services that are provided to those living with serious mental illness in an effort to maintain more stability and guide their transitions back into the community. These services are provided to help with family life, employment, housing, medication, and day-to-day activities, among others. To download the toolkit, visit here 

MCHB Study Assesses Impact of Autism on Families
A Maternal and Child Health Bureau study published in Pediatrics examines the experiences of children with autism spectrum disorder (ASD) and their families. The study reported on the unmet needs of these families in relation to health care and financial, employment, or time problems due to their child’s care. Results also showed that primary care in a medical home was most likely related to fewer financial burdens on the family. To view the study, visit here 

Children's Health    

Updated Report on the Prevention of Rotavirus Gastroenteritis Among Infants and Children
Rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide. In February 2006, a live, oral, human-bovine reassortant rotavirus vaccine (RotaTeq® [RV5]) was licensed as a three-dose series for use among U.S. infants for the prevention of rotavirus gastroenteritis, and the Advisory Committee on Immunization Practices (ACIP) recommended routine use of RV5 among U.S. infants. In April 2008, a live, oral, human attenuated rotavirus vaccine (Rotarix® [RV1]) was licensed as a 2-dose series for use among U.S. infants, and in June 2008, ACIP updated its rotavirus vaccine recommendations to include use of RV1. To view the full report, visit here 

Guide Helps Parents Better Understand Epilepsy
The Epilepsy and Seizure Disorders: A Resource Guide for Parents, published by the Epilepsy Foundation Northern California, was developed by parents and professionals to help parents of children with epilepsy and/or a seizure disorder better understand their child’s condition. To view the guide, visit here 

Revised ADHD Brochure
The brochure, Attention Deficit Hyperactivity Disorder" (ADHD), published by the National Institute of Mental Health, offers information for families on ADHD and its management, including research on medications and behavioral interventions and resources on educational options. To view the brochure, visit here 

Adolescent Health 

Report Examines Media's Influence on Adolescent Sexual Behavior
Published by the National Campaign to Prevent Teen and Unplanned Pregnancy with support from the Centers for Disease Control and Prevention, Managing the Media Monster is intended to inform practitioners and programs about research on adolescents and media influence. To download the report, visit here.    

Study Finds Teens, Young Adults Might Overestimate Condom Use
According to the study, The Validity of Teens' and Young Adults' Self-reported Condom Use, published in the Archives of Pediatrics and Adolescent Medicine, some teenagers and young adults might overestimate how often they use condoms during sex. To view the study, visit here

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Grants to States to Support Oral Health Workforce Activities
Deadline: April 1
Health Resources & Services Administration grants are available to states to improve the accessibility of the oral health workforce for underserved geographic areas and populations. Section 340F defines a designated shortage area as "an area, population group, or facility that is designated by the Secretary as a dental health professional shortage area under section 332 or designated by the applicable State as having a dental health manpower shortage." To learn more, visit here.

Funding Available for Male Involvement in Child Maltreatment Prevention Programs
Deadline: Open
The CDC’s National Center for Injury Prevention and Control solicits research applications that will help advance knowledge of effective strategies for engaging the participation of fathers and male caregivers in evidence-based parenting programs that may prevent child maltreatment. Specific proposals are being sought to take an evidence-based parenting program (that is, a program that has been evaluated using a randomized- or quasi-experimental design with evidence of positive effects on parenting and/or child behavior outcomes) and develop systematic adaptations to the delivery structure, content, and/or materials to target father or male caregiver involvement and engagement in the program. Furthermore, the applications should seek to conduct pilot evaluations of the effects of the adapted programs on participant involvement and engagement in the program; parenting behaviors and male caregiver-child relationships; and child behavior outcomes. To learn more, visit here

Changes in Health Care Financing and Organization Funding Alert
Deadline: Open
HCFO supports policy analysis, research, evaluation and demonstration projects that provide policy leaders timely information on health care policy and financing issues. This call for proposals is intended to support projects that 1.) examine significant issues and interventions related to health care financing and organization and their effects on health care costs, quality and access; and 2.) explore or test major new ways to finance and organize health care that have the potential to improve access to more affordable and higher quality health services. To learn more, visit here.  

Health and Wellness
Deadline: Ongoing
PepsiCo Foundation’s mission in Health and Wellness is to advance and encourage healthy lifestyles and positive behavior change. Initiatives of particular interest are those which address one or more of the following focus areas: community activation, minority communities, school drop-out prevention, and health professionals. For more information, visit here

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 Call for Nominations: ELPH-Emerging Leaders in Public Health
The Emerging Leaders in Public Health (ELPH) program prepares the next generation of committed public health leaders to manage and lead in times of uncertainty.  This program prepares these leaders to expand their influence in their organizations and within their communities. The ELPH program is custom designed for public health (and related) professionals who want to improve their leadership skills for improved planning and decision-making and want to increase their professional network ELPH has embraced the idea that issues of racial and ethnic health disparities in the US can not be addressed without bringing key minority participants and others to the table for the decision-making process. The application deadline is March 31, 2009. To learn more, visit here.



AMCHP’s 2009 Annual ConferenceLaunching MCH: Opportunities for a New Era
February 21-25
Washington, DC 

Family Voices’ Gala – One Heart, Many Voices: The Time is Now!
February 23
Washington, DC

Eighth Annual Forum for Improving Children’s Healthcare: Thrive Together
March 9-12
Grapevine, TX

The Third International Conference on Fetal Alcohol Spectrum Disorder
March 11-14
Victoria, British Columbia, Canada

National WIC Association’s Annual Conference
May 24–27
Nashville, TN  

University of Illinois at Chicago’s MCH Leadership Conference
Chicago, IL
July 20-23 

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