CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau (U.S. Department of Health and Human Services).

A project of the Education Development Center, Inc.

MCH Program Injury and Violence-Related State Performance Measures and Priority Needs, 2014

The Maternal and Child Health (MCH) Services Block Grant (Title V of the Social Security Act of 1935) provides funds to all 50 states, the District of Columbia, and eight territories to promote the health of mothers and children. To accomplish this goal, all states are required to report on 18 National Performance Measures, two of which address injuries.

In addition, every five years, each state is required to conduct a needs assessment which focuses on pregnant women, mothers and infants, children and adolescents, and children and youth with special health care needs. States use the results of their needs assessments to identify the priorities on which they will focus for the next five years. Based on the priorities they choose, each state develops seven to 10 State Performance Measures (SPMs). Although many of the selected priorities and performance measures remain in place until the next needs assessment, states may modify them annually.

The following is a summary of the injury and violence prevention (IVP) related Priority Needs and Performance Measures that states have developed for 2014. A review of the applications submitted for 2014 indicates that all states, the District of Columbia, and Puerto Rico have at least one Priority Need and/or State Performance Measure related to injury and violence prevention.

Priority NeedsForty-eight states, the District of Columbia, and Puerto Rico chose a total of 87 injury and/or violence-related Priority Needs, a decrease in 1 Priority Need as compared to 2013. Twenty-three states (AK, AL, CA,

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NPM #10: The rate of deaths to children aged 14 years and younger caused by motor vehicle crashes per 100,000 children.

NPM #16: The rate (per 100,000) of suicide deaths among youths aged 15 through 19.

CO, DC, GA, IN, KS, MA, ME, MI, MO, ND, NH, NM, OK, OR, PA, RI, VT, WI, WV, WY,) chose more than one. One state (ME) had six IVP-related Priority Needs, while one had five (AK), two states (NM, WV) had four, two states had three (PA, RI), and 17 states had two.

Overall, the number of states choosing each Priority Need remained fairly consistent with those who chose injury-related Priority Needs in 2013. Twenty-one states, the District of Columbia, and Puerto Rico selected either the prevention of unintentional and intentional injuries (10 states), the preven-tion of unintentional injuries (11 states) or the prevention of intentional injuries (two states) as a Priority Need. Eight states chose infant safe sleep, which encompasses the prevention of Sudden Unexplained Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS), as well as the promotion of safe sleep environments while six identified the prevention of intimate partner violence (domestic violence) as a Priority Need.

2014 Injury-Related Priority Needs

Injury and Violence Prevention Category States Total Number of IVP- Related Priority Needs

Child Deaths AR, DE, KY, MN, NC 5Child Maltreatment AK, HI, KY, NE, NM, OR 6Environmental Health/Lead Poisoning DC, IN, MI, NH, NY 5Family Violence ME, NM, OR 3Home Visiting MD, RI 2Intentional Injuries DC, ID 2Intimate Partner Violence – Domestic Violence

AK, ME, MI, NM, OR, WY 7 (NM has 2 PNs in this category)

Maternal Depression AK, CO, CT, KS, ME, NM, PA 7

Mental Health CT, IL, ME, MO, RI, PA, WA, WI 8

Motor Vehicle-Related Injuries/Deaths CO, GA, NH, NM, OK, WV 6

Risk-Taking Behaviors AL, KS, NJ, NM, SD, WV 6Safe and Healthy Community AK, VT, WA, WI 5 (VT has 2 PNs in this

category)Self Injurious Behavior/Suicide Prevention ME, PA, UT, VA 4

SUID/SIDS/Bed Sharing/Safe Sleep/ Suffo-cation

AK, CA, FL, GA, IN, OK, SC, WV 8

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A project of the Education Development Center, Inc.2

Injury and Violence Prevention Category States Total Number of IVP- Related Priority Needs

Unintentional Injuries DE, IA, MA, ME, MT, NH, NM, PR, TN, WV, WY

11

Unintentional/Intentional Injuries AZ, CA, GA, LA, MN, MO, ND, PA, SD, VA

10

Youth Violence (Bullying, Homicide, Sexual Assault, Violence, etc.)

AL, AK, MA, ME, ND, NM 6

Youth Development/ Parenting Skills AL, CA, NM, OR, RI, TX 6

*Note: some Priority Needs fall into more than one category. For that reason, the number of Priority Needs in the table does not match the number of total Priority Needs stated above.

State Performance Measures

Forty-five states, the District of Columbia, and Puerto Rico chose a total of 87 injury and/or violence-related Performance Measures, up from 85 in 2013. Twenty-three states (AK, AZ, CO, DC, FL, IN, LA, MA, ME, MI, MN, NH, ND, NJ, NM, OR, RI, TN, VA, VT, WI, WV, WY) chose more than one, with one state (ME) choosing six, one (AK) choosing five, three states with four (RI, ND, VT), four states (AZ, MA, MI, WV) with three and 14 states (CO, DC, FL, IN, LA, MN, NH, NJ, NM, OR, TN, VA, WI, WY) with two IVP-related Performance Measures.

The number of states with Performance Measures in each category remained fairly stable from 2013 to 2014. The most popular IVP-related Performance Measure continues to be the prevention of child maltreatment, which was chosen by 11 states. This was followed by the prevention of unintentional injuries, which was selected by 10 states. Ten states chose to focus on infant safe sleep, which encompasses the prevention of Sudden Unexplained Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS), as well as the promotion of safe sleep environments, while nine states chose to focus on intimate partner violence (domestic violence and/or teen dating violence). The biggest change in Performance Mea¬sures from 2013 to 2014 was an increase from four states to two in the bullying prevention category.

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CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau (U.S. Department of Health and Human Services).

A project of the Education Development Center, Inc.3

2014 Injury-Related State Performance Measures

Injury and Violence Prevention Category States Total Number of IVP-Related Performance Measures

Bicycle Safety VT 1

Bullying ND, VA 2

Child Deaths/Infant and Fetal Mortality Review AL, AR, AZ, DE, NJ, TX 6Child Maltreatment AK, HI, KY, LA, ME, MN, NE,

NC, VT, WA, WI 11

Environmental Health/Lead Poisoning DC, IN, MI, NH, NJ, NY, VT 7

Home Visiting MD, MN, NM, ND, RI 6 (RI has 2 SPMs in this Category)

Intimate Partner Violence – Domestic Violence AK, ME, MI, NM, NV, OR 6

Intimate Partner Violence – Teen Dating Violence

AK, AZ, MA, MI, WY 5

Maternal Depression AK, CO, IL, MO, OR, WI 6

Mental Health ME, ND, RI, UT, VT 5

Motor Vehicle-Related Injuries/Deaths CO, GA, MA, NH, WV 6 (WV has 2 SPMs in this category)

Poisoning ME 1

Self Injurious Behavior/Suicide Prevention ME, UT 2

SUID/SIDS/Bed Sharing/Safe Sleep/Suffocation AK, AZ, FL, IN, LA, OK, SC, TN, WV

10 (FL has 2 SPMs in this category)

Unintentional Injuries AZ, DE, IA, MT, PA, PR, SD, TN, VA, WY

10

Unintentional/Intentional Injuries AR, ND, OH 3

Violence Affecting Children and Adolescents DC, MA 2

Youth Development/Parenting Skills RI 1

*Note: some Performance Measures fall into more than one category. For that reason, the number of Performance Measures in the table does not match the number of total Performance Measures stated above.

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CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau (U.S. Department of Health and Human Services).

A project of the Education Development Center, Inc.4

Examples of How States Address IVP-Related Performance Measures

State MCH agencies use a wide range of strategies to address their IVP-related Performance Measures. Some examples of these strategies include:

• Promoting safe sleep through the distribution of materials, public service announcements (PSAs), and press releases and the development of a new website.

• Implementing violence prevention and bystander awareness programs for youth in middle school and high school using a structured curriculum focused on healthy relationships.

• Forming a State Drowning Prevention Task Force which addresses coordination between different drowning prevention coalitions, and provides a statewide conference for community health workers to receive training on infant water safety.

• Developing suicide prevention, intervention, and postvention protocols for state employees

• Distributing perinatal materials such as the “Baby and Me” book and the HRSA booklet “Depression During and After Pregnancy”, as well as screening clients using the Edinburgh Postnatal Depression Scale (EPDS).

• Reducing poisonings through adoption of ED Prescribing Guidelines in participating hospitals, improving utilization of the Prescription Drug Monitoring Program (PDMP), identifying “above average” prescribers, and improving accessibility of drug drop boxes in participating counties.

• Strengthening the graduated driver’s licensing law by increasing the minimum driving age and expanding the restricted driving hours for teens, as well as establishing a statutory requirement that allows for primary enforcement of a seat belt law.

• Providing low-income families with an opportunity to purchase a new car seat at minimal cost from an Office of Highway Safety Child Restraint Fitting Station. The Child Restraint Fitting Station is a location that is open year-round where parents can go to have their child safety seats inspected.

• Conducting studies on “Adverse Childhood Experiences” and on the health implications of these experiences for adults.

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CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau (U.S. Department of Health and Human Services).

A project of the Education Development Center, Inc.5

How CSN Helps States Address IVP-Related Priority Needs and Performance Measures

CSN can assist your state in addressing its IVP-related Priority Needs and Performance Measures by:

• Providing information on evidence-based and best practices

• Helping states develop policies and set standards

• Developing comprehensive action plans

• Utilizing surveillance and cost data

• Training and educating health and human service professionals

• Convening key stakeholders

• Building connections between MCH, IVP, and other key stakeholders

• Conducting literature searches

• Linking together states that are addressing similar IVP-related issues

• Providing opportunities for sharing through Communities of Practice, Learning Circles and online Dis-cussion Forums

• Providing information on cost effective IVP strategies and programs.

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CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau (U.S. Department of Health and Human Services).

A project of the Education Development Center, Inc.6

January 2014

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