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 May 6, 2009

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The First Hundred Days 

By Mike R. Fraser, PhD

Wednesday, April 29, 2009, marked President Obama’s 100th day in office. The hundred day marker has become an important way point for new presidents and seemingly even more important to news networks and pundits who view it as the end of the “honeymoon” period for new presidents. The first presidential “Hundred Days” started on a cold, gray Washington morning March 4, 1933, when President Franklin Delano Roosevelt delivered his inaugural address to a hurting nation. The subsequent 100 days were a whirlwind of policy and legislative activity during which he attacked the economic and social problems of the day head on. As we know now, FDR was incredibly successful in rolling out New Deal programs that continue to serve America today – a powerful testament to the bold moves he took with Congress to address a country in the throes of serious crisis. 

Sound familiar? I have spent the last 100 days reading about the New Deal and thinking about FDR’s legacy and parallels between FDR’s social programs and those of our new president. It is interesting to think about how much of the policy and legislative activity in Washington these days is similar to New Deal policies crafted and debated in the first 100 days of FDR’s presidency. In 1933, the Great Depression was on everyone’s mind, bank reform and financial regulation were a top priority, and programs to employ thousands were rolled out across the country. Today, the same concerns dominate our policy agenda – economic recovery, banking reform, and programs to get people back to work. 

What I didn’t realize until I started my research project was that one of FDR’s signature programs – Social Security – was part of a “Second Hundred Days” period that took place later in his Administration and didn’t become law until 1935. I certainly didn’t realize that the Social Security Act just barely passed Congress and made to the president’s desk. It is fascinating to think about our current health reform debate and compare that to the debates that took place almost 75 years ago at the start of Social Security. The concerns about “social insurance” and big government in 1935 are strikingly similar to what we hear today. I certainly didn’t know that Social Security, including what we now know to be Title V, was a radical social experiment as controversial then as universal health care coverage is now.

What does all this mean to us today? There can be no doubt that President Obama’s first hundred days have certainly been good for women and children. There is no coincidence that the first act of Congress and the first piece of legislation the president signed was the Lilly Ledbetter Fair Pay Act of 2009 which addresses pay discrimination between male and female employees. Subsequent victories for women and children include the expansion of SCHIP and major provisions in the American Recovery and Reinvestment Act (ARRA), including $87 billion dollars to help states fund Medicaid and new monies for childhood immunizations. While there was no specific “win” for the Title V Maternal and Child Health Block Grant in the ARRA there are positive signs that maternal and child health will be center stage in the future, including a White House Council on Women and Girls led by the First Lady, and MCH programs, such as nurse home visiting programs, that have significant outlays in the President’s 2010 federal budget. 

While the first hundred days are important and set a tone for our new Administration, the second hundred, the third hundred, and yes, even the last 100 will be important too. The work we have to do and the bold new programs that need to be tried are complex and will take time to make it through the legislative process. Health reform is moving fast and while not accomplished in his first 100 days it seems clear that something will be accomplished soon to expand health coverage to all Americans. The 2010 President’s Budget was not released in his first 100 days (making for an interesting appropriations process this spring) but that important document used to set the Administration’s priorities will be forthcoming shortly. I am hopeful it will include major increases for maternal and child health programs in 2010. 

Last night I re-read President Roosevelt’s inaugural address from March 4, 1933. On the eve of a global influenza pandemic, and continued economic troubles, I took to heart the now famous line penned by FDR over 75 years ago: “This great nation will endure as it has endured, it will revive and will prosper. So, first of all, let me assert my firm belief that the only thing we have to fear is fear itself – nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.” America’s future rests in our women, children and families. Should we let fear paralyze us as it paralyzed many of our leaders in 1933? Or should we embrace these times for the opportunity they present to us, and to our leaders? Let’s not let our present fears cloud our future dreams – let’s use these next hundred days to recommit ourselves to a second New Deal for America’s families, one that includes the best of your work in the states and one that includes the best of our leadership in Washington.

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Congress Returns, Approves Secretary Sebelius Nomination, Tackles Budget and Health Reform
Congress returned this past week - just as the swine flu outbreak took center stage. On Tuesday April 28 the U.S. Senate confirmed the nomination of Kathleen Sebelius as secretary of health and human services by a vote of 65-31. On Wednesday, Congress gave final approval to its $3.5 trillion federal budget outline, generally advancing President Obama’s policy initiatives on health care, energy and education while not yet spelling out the difficult details of how to pay for them. The final Congressional budget resolution incorporates the amendment passed last month by Sen. Dodd and Sen. Hatch calling for an increase in the Title V Maternal and Child Health Block Grant, but we again stress that the budget resolution is non-binding. This means that the heavy work will occur in the coming months as the Appropriations Committees work to hammer out the details and mark-up the FY 2010 bills, which is expected to occur in July. The White House is also expected to soon issue its detailed budget request for FY 2010 which will give us a better sense of what’s in store for Title V and how we can tailor our advocacy messages.  

Health Reform Update
Congress is continuing to pursue an aggressive approach to passing a health reform bill this year. The latest announcements from Congressional leaders indicate they intend to mark up legislation as early as June and will try to complete a bill by the August recess. AMCHP staff is meeting weekly with key Congressional staff to discuss the importance of including issues of importance to women, children, adolescents and children with special health care needs in any bill that emerges. We are also actively exploring potential interest in including a special initiative in health reform focused on reducing infant mortality rates and related disparities that could be linked to the Title V MCH Block Grant. 

Finally, we have also engaged in dialogue with leadership of the Association of State and Territorial Health Officials (ASTHO) and other affiliated state public health groups to coalesce around advocacy on behalf of all state public health programs. Specifically, we are promoting the concept that any health reform bill should create and maintain a dedicated, stable funding stream for preventive and population based public health programs. This would ideally create a larger pool of funding for all public health programs in the future, and would specifically benefit the HRSA and CDC programs serving MCH populations. We intend to provide regular updates in the coming months as the health reform debate heats up, and will soon announce an all-member conference call to discuss emerging developments and seek additional member guidance on key advocacy messages. In the meantime, any questions can be directed to Brent EwigAMCHP Director of Policy and Government Affairs at (202) 266-3041.

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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 home visiting program, 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. Best Practice submissions are accepted on a rolling basis. However, to be considered for the current round of reviews, applications must be submitted by June 12.

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.   

Webcast on Weight Gain by BMI Among U.S. Women
The CDC will host a webcast on “Gestational Weight Gain by Body Mass Index Among U.S. Women Delivering Live Births, 2004-2005: Fueling Future Obesity” on May 6 from 2 to 3 p.m. (EST). To register, visit here 

Webinar on Evidence Based Practice in Child Welfare
he National Child Welfare Resource Center for Organizational Improvement will host a webinar on “Evidence Based Practice in Child Welfare” on May 7 at 2:30 p.m. (EST). A national expert will provide an introduction to evidence based practices in child welfare and advice for child welfare agencies on identifying and using these practices. Leaders and managers from agencies will also share the benefits and challenges they have faced as they have worked to adopt evidence based practices. The session will also include time for questions. To register, visit here 

Seeking Successful Preterm Birth Programs!
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) is creating an inventory of successful programs that are working to reduce low birth weight and preterm birth. They are especially interested in programs that have demonstrated their success through a formal evaluation process.  

To contribute to the inventory, please submit a brief (less than 1 page) summary with the following information:  

  1. Name of the program
  2. Target audience(s)
  3. Short description of program activities
  4. Evaluation results
  5. Website of program (if applicable)  

Please submit your response to Jessica Hawkins. The deadline for submissions is May 11. 

Seeking Nominations for National MCH Epidemiology Awards
The Coalition for Excellence in MCH Epidemiology announces the ninth year of the National MCH Epidemiology Awards. The Coalition is recruiting nominees for the 2009 awards.  Nominees are individuals, teams, institutions, and leaders of institutions who have made significant contributions to improving the health of women, children and families through epidemiology, applied research and the effective use of data. These awards recognize research, teaching, leadership and effective public health practice and recognize individuals and organizations at a community, state and national level. For more details on how to nominate and the awards criteria, visit here. Deadline for nominations will be June 1, 2009.   

Call for MCH Case Studies
Maternal and Child Health projects of all kinds are needed (community-based/indigenous, public health, NGO, foundation-funded initiatives) to be used in the "International Case Studies in Maternal and Child Health," a textbook for health professionals. The deadline for submissions is September 30. Priority will be given to case studies written by, or in collaboration with, local voices. All questions and submissions should be addressed to the editor Ruth C. White, PhD, MPH, MSW.

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Is your state currently conducting fatherhood initiatives in MCH within your programmatic work? Please include maternal and child health efforts outside of that which you may be conducting with adolescent health. Email your response to Jessica Hawkins.


AMCHP members Melita Jordan, Director, Maternal & Child Health at the Pennsylvania Department of Health and member of AMCHP’s Board of Directors; Bob Nystrom, Adolescent Health and Genetics Section Manager at the Oregon Department of Health Services; and Gwen Winters, State Adolescent Health Coordinator at the Mississippi Department of Health along with Title V staff, Teresa Ryan, MCH Nurse Manager/Adolescent Health Coordinator from the Oklahoma Department of Health serve as members of AMCHP’s Adolescent Reproductive and Sexual Health Disparities (ARSH) Advisory Workgroup. The purpose of the workgroup, which includes key adolescent health stakeholders from federal agencies, national organizations, foundations and state health and education agencies, is to provide advice to AMCHP as we develop program strategies related to ARSH disparities. On April 20, 2009, AMCHP convened a face-to-face meeting of the advisory workgroup at AMCHP’s office in Washington, DC. The group considered results of AMCHP’s ARSH disparities member assessment and interviews, discussed successes and challenges related to their work on these issues, and generated an array of capacity-building support ideas that could be implemented with AMCHP members. AMCHP’s internal ARSH disparities workgroup, which, in addition to AMCHP adolescent health staff, Sharron Corle, Associate Director and Lissa Pressfield, Program Manager, also includes Michelle Alletto, Manager, Public Policy & Government Affairs, Jessica Hawkins, Program Manager, Women's & Infant Health and Lauren Ramos, Director of Programs, will be spending the next several months examining the outcomes from the meeting and strategizing next steps. 

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General Maternal & Child Health  

Influenza Resources for Maternal and Child Health Professionals
AMCHP continues to work with the Centers for Disease Control and Prevention (CDC) and state health agencies to monitor the emerging swine flu situation. The CDC is actively investigating isolated human cases of swine influenza A (H1N1) in several states (CA, TX, OH, KS, NY) and is working closely with Canada and Mexico and with the WHO. The CDC is continuously updating investigation information. To view the resources, visit here 

Dr. Magda Peck’s Keynote Speech
This personal essay is from a lecture delivered by Dr. Magda Peck, at the John C. MacQueen Annual Luncheon, on Tuesday, February 24, 2009, in conjunction with AMCHP’s annual conference in Washington, DC. To download the essay, visit here 

New Report on a Tobacco-Free Environments for Families
The report, “Helping Families Thrive: Key Policies to Promote Tobacco-Free Environments for Families,” developed by the partners of the National Partnership for Smoke-Free Families, presents public health facts related to smoking, evidence-based policy solutions that affect families with young children, and then makes policy action recommendations. To download the report, visit here

New Issue Brief
The Issue Brief, “Impact of Primary Care Case Management (PCCM) Implementation in Medicaid and SCHIP,” published by the Child Health Insurance Research Initiative (CHIRI™), finds that children enrolled in the Alabama and Georgia Medicaid programs were less likely to use emergency departments, but were also less likely to use well-child and other primary care after the implementation of PCCM. Physician participation in Alabama and Georgia Medicaid also declined over the PCCM implementation period. To download the brief, visit here.

Women's Health

New Brief on Women’s Mental Health Prevention
The Women’s Health Partnership, a collaboration between AMCHP and CityMatCH to identify and promote unique state and local MCH roles and opportunities to improve women’s health before and between pregnancies, produced an issue brief that underscores the importance of mental health as a component of overall injury and chronic disease prevention. In addition, the brief highlights the importance of building comprehensive systems of support and service to improve women’s mental health as well as the overall status of women’s health. Learn more 

New CDC Products on Fetal Alcohol Spectrum Disorders (FASD)
CDC announces the availability of several new products that can guide in the identification, prevention and management of FASDs. For more information about these products, visit here 

  • Fetal Alcohol Spectrum Disorders (FASD) Competency-Based Curriculum Development Guide for Medical and Allied Health Education and Practice
    This guide is designed to improve prevention, identification, and management of FASDs and can be used to develop educational programs and materials in a range of formats based on the needs of learners. Based on seven core competencies, it is intended for use with medical and allied health students and practitioners.
  • Reducing Alcohol-Exposed Pregnancies: A Report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect
    This report reviews current evidence on prevention strategies to reduce alcohol use and alcohol-exposed pregnancies, provides recommendations on promoting and improving these strategies, and offers future research directions in the field of FASD prevention. It also serves as a guide for those in the research and practice fields interested in selecting and implementing effective, scientifically tested interventions for women at risk for an alcohol-exposed pregnancy.
  • A Call to Action: Advancing Essential Services and Research on Fetal Alcohol Spectrum Disorders – A Report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect
    This Call to Action highlights ten recommendations to improve and expand efforts regarding early identification, diagnostic services, and quality research on interventions for individuals with FASDs and their families. The intent of this report is to guide federal, state and local agencies, researchers and clinicians, family support groups, and other partners on actions needed to advance essential services for individuals with FASDs and their families and to promote continued intervention research efforts.

Children's Health

New Study on the Disparities in Obesity
A recent study, “Disparities in Obesity and Overweight Prevalence Among US Immigrant Children and Adolescents by Generational Status,” published by the Journal of Community Health, examines the disparities in obesity and overweight prevalence among immigrant and U.S.-born children and adolescents. To read an abstract, visit here.

Adolescent Health

New Brief on Family Strengths and Adolescent Outcomes
The research brief, “Exploring The Links Between Family Strengths and Adolescent Outcomes,” published by Child Trends, finds that family strengths are associated with significantly better outcomes for adolescents in both lower-income and higher-income families. Specifically, adolescents from families that have these strengths are more likely to perform well in school, to avoid risky behaviors, and to demonstrate positive social behaviors than are adolescents from families that lack these strengths. To download the brief, visit here.

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Upcoming FY 2009 Autism Research Funding Opportunities at MCHB/HRSA
Deadline: May 15
R40 MCH Autism Intervention Research Program will support up to four (4) two-year research projects ($400,000 per year) on evidence-based practices for interventions to improve the health and well-being of children and adolescents with autism spectrum disorders (ASD) and other developmental disabilities. Consistent with HRSA’s mission as the access agency to provide services to underserved populations, applicants are particularly encouraged to propose research studies that address the needs of underserved populations, as well as barriers to receipt of interventions. Examples of research topics of interest to MCHB include but are not limited to the following:

• Family well-being, coping, resilience and social networks;

• Variations in access to services affecting family functioning in diverse populations;

• Transition into adulthood, including employment and healthcare issues; and

• Service systems and infrastructure.  

To learn more, visit here

Cooperative Agreements for Linking Actions for Unmet Needs in Children’s Health Grant
Deadline: May 20
The Substance Abuse and Mental Health Services Administration, Center for Mental Health Services is accepting applications for fiscal year (FY) 2009 for Cooperative Agreements for Linking Actions for Unmet Needs in Children’s Health (Project LAUNCH). The purpose of Project LAUNCH is to promote the wellness of young children, birth to 8 years of age. Project LAUNCH will award cooperative agreements to states, territories and tribes, each of which will select a locality within the larger jurisdiction to be a partner in Project LAUNCH. States, territories and tribes will bring together child-serving systems to develop a vision and a comprehensive strategic plan for promoting the wellness of all young children, and will develop policies, financial mechanisms and other reforms to improve the integration and efficiency of the child-serving system. States, territories and tribes will identify and work closely with a locality that will engage in infrastructure reform, and will use Project LAUNCH funds to enhance and expand the delivery of services and practices that promote the wellness of young children and their families. To learn more, visit here 

2009 Family Planning Research Cooperative Agreement
Deadline: May 26
This announcement seeks applications from public and non-profit private entities to conduct data analyses and related research and evaluation on issues of interest to the family planning field. Many persons have observed that gaps exist in the array of data and analyses needed by administrators, planners and researchers in the field of family planning. The need for such data is likely to increase. Therefore, funds available under this announcement are for projects to increase the availability of data and research-based information which will be useful to family planning administrators and providers, researchers and officials of local, State and the Federal government, including OPA, in order to improve the delivery of family planning services to persons needing and desiring such services. To learn more, visit here  

CDC Funding Available for Reducing Risks for an Alcohol-Exposed Pregnancy in High Risk Women
Deadline: June 8
The purpose of the program is to reduce alcohol-exposed pregnancies by supporting and establishing the capacity of STD programs in public health departments to 1) implement and evaluate the Project CHOICES Intervention model for reducing risks for an alcohol-exposed pregnancy (AEP) in high risk women during the preconception period; 2) develop a data collection and monitoring system to evaluate changes in alcohol use of patients, evaluate effective contraception use, to determine reduced risk for AEP and other relevant sociodemographic information including risks associated with AEP ; and 3) develop a report describing how the CHOICES intervention model was modified or tailored to fit STD clinics, process and outcome evaluation measures, and lessons learned from implementation of the project. To learn more, visit here 

CDC Funding Available for Fetal Alcohol Syndrome
Deadline: June 8
The purpose of this program is to: (1) determine the prevalence of fetal alcohol syndrome (FAS) within a geographically-defined area (statewide, multiple states, or regions of a state) that may include high risk population subgroups, using the common, multiple source surveillance methodology developed by the Fetal Alcohol Syndrome Surveillance Network (FASSNet); (2) improve the capacity of an existing surveillance system (e.g., birth defects, developmental disabilities) to ascertain infants and children with FAS and generate population-based surveillance data; (3) establish or expand relationships with facilities or programs where children with FAS are likely to be diagnosed or receive services, such as genetics and other specialty clinics, early intervention programs, special education programs, special needs registries, and other programs or settings for children with developmental disabilities; (4) evaluate the surveillance system methodology in terms of completeness of case ascertainment, data quality, ability to generate a prevalence estimate for FAS, and the potential for monitoring trends; and (5) implement provider training and education on FAS to improve case ascertainment. To learn more, visit here 

CDC Funding Opportunity for Early Hearing Detection and Intervention (EHDI) Tracking, Surveillance and Integration
Deadline: June 15
The purpose of the program is to (1) Enhance the tracking and surveillance systems for the EHDI program to accurately identify, match, and collect unduplicated individual identifiable data (not estimated or aggregated) at the State/Territorial EHDI program level, (2) Enhance the capacity of EHDI state and territorial programs to accurately report the status of every occurrent birth throughout the EHDI process for the purpose of evaluating the progress of the National EHDI goals, and (3) Develop and Enhance the capacity of EHDI programs to integrate the EHDI system with other State/territorial screening, tracking and surveillance programs that identify children with special health needs. 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. 

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AMCHP is Recruiting for an Associate Director for Women’s and Infant Health
The Associate Director is accountable for the development, implementation and evaluation of program activities related to women’s and infant health, maternal and child health, data and assessment through cooperative agreements and other funding sources. The Associate Director leads the Women’s and Infant Health Team and contributes to the advancement of MCH programs. This position leads the tracking, analysis, and reporting on federal and state programs impacting women’s and perinatal health and plays a critical role in fund development for women’s and infant programmatic efforts. To download the job description, visit here. For additional information, please contact Lauren Ramos.



National Day to Prevent Teen Pregnancy
May 6

American College of Nurse-Midwives 54th Annual Meeting & Exposition
May 21-27
Seattle, WA 

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

36th Annual International Conference on Global Health:
New Technologies + Proven Strategies = Health Communities

May 26-30
Washington, DC 

The Bill & Melinda Gates Institute's 7th Annual Summer
Institute in Reproductive Health & Development

June 1-12
Baltimore, MD 

Leadership, Legacy, and Community: A Retreat to Advance Maternal and Child Health Scholarship and Practice
July 20-22
Oakbrook, IL

Health Forum and the American Hospital Association's 17th Annual Leadership Summit
July 23-25
San Francisco, CA  

World Breastfeeding Week 2009 -
Breastfeeding: A Vital Emergency Response
Are you ready?
August 1-7

National Conference on Health Communication, Marketing and Media
August 11-13
Atlanta, GA 

CityMatCH 2009 Urban Maternal and Child Health Leadership Conference
August 22-25
New Orleans, LA

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