TVIS Instructions - FY 2021 Application/FY 2019 Annual Report · Web viewApplication/Annual Report Guidance and the Appendix of the Supporting Documents. The FY 2021 Application/FY

User Guide

FY 2022 Application/FY 2020 Annual Report

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportTABLE OF CONTENTS

List of Figures.................................................................................................................................7

TVIS Introduction.........................................................................................................................10

TVIS Access from EHBs.................................................................................................................10

Browser Requirements.............................................................................................................10

Registration in EHBs................................................................................................................. 11

Creating the Application...........................................................................................................11

Completing the Budget Information in the EHBs......................................................................12

Accessing TVIS.......................................................................................................................... 14

Managing Peer Access..............................................................................................................14

TVIS Navigation and Form Information........................................................................................15

TVIS Main Menu.......................................................................................................................15

TVIS Navigation.........................................................................................................................15

Form Navigation.......................................................................................................................15

Form Lock................................................................................................................................. 17

System Timeouts...................................................................................................................... 18

Form Notes...............................................................................................................................18

Form Validation Messages........................................................................................................19

Form Validation Navigation......................................................................................................20

Form Status Checker.................................................................................................................21

Data Alerts Page.......................................................................................................................21

Submitting the Application/ Annual Report..............................................................................22

Form 2: MCH Budget/Expenditure Details...................................................................................22

Form 2 Access...........................................................................................................................22

Form 2: Application Budgeted: Lines 1 - 8................................................................................22

Form 2: Application Budgeted: Lines 9 and 10.........................................................................24

Form 2: Annual Report Expended: Lines 1 - 8...........................................................................26

Form 2: Annual Report Expended: Lines 9 and 10....................................................................27

Form 3a: Budget and Expenditure Details by Types of Individuals Served..................................28

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual Report

Form 3a Access.........................................................................................................................28

Form 3a: Application Budgeted................................................................................................28

Form 3A: Section IA...............................................................................................................28

Form 3A: Section IB...............................................................................................................29

Form 3a: Annual Report Expended...........................................................................................29

Form 3A: Section IA...............................................................................................................29

Form 3A: Section IB...............................................................................................................30

Form 3b: Budget and Expenditure Details by Types of Services..................................................31

Form 3B Access.........................................................................................................................31

Form 3b: Application Budgeted................................................................................................31

Form 3B: Section IIA..............................................................................................................31

Form 3B: Section IIB..............................................................................................................32

Form 3b: Annual Report Expended..........................................................................................32

Form 3B: Section IIA..............................................................................................................32

Form 3B: Section IIB..............................................................................................................33

Form 4: Number and Percentage of Newborns and Others Screened, Cases Confirmed, and Treated........................................................................................................................................ 34

Form 4: Newborn Screening Program, Lines 1, 2, and 3...........................................................34

Newborn............................................................................................................................... 34

Other Newborn.....................................................................................................................36

Older Children & Women......................................................................................................36

Long-Term Follow-Up............................................................................................................37

Form 5: Count of Individuals Served BY TITLE V & Total Percentage of Populations Served BY TITLE V......................................................................................................................................... 37

Form 5a: Count of Individuals Served BY Title V.......................................................................38

Form 5b: Total Percentage of Populations Served by Title V....................................................40

Form 6: Deliveries and Infants Served by Title V and Entitled to Benefits under Title XIX...........42

Form 6: Section I, Unduplicated Count by Race/Ethnicity........................................................42

Form 7: State MCH Toll-Free Telephone and Other Appropriate Methods Data.........................43

Form 7: Application Year..........................................................................................................43

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Form 7: Section A..................................................................................................................43

Form 7: Section B..................................................................................................................43

Form 7: Reporting Year.............................................................................................................44

Form 7: Section A..................................................................................................................44

Form 7: Section B..................................................................................................................44

Form 8: State MCH and CSHCN Directors Contact Information...................................................45

Form 9: List of MCH Priority Needs..............................................................................................45

Form 10: National Performance Measures (NPM).......................................................................48

form 10: NPM LIST PAGE & Detail Sheets.................................................................................48

form 10 NPMs: Manage National Performance Measures (NPMs)/Select National Performance Measures (NPMs)...............................................................................................51

form 10: NPM Federally Available Data (fad)...........................................................................54

form 10: NPM Data Entry.........................................................................................................54

Form 10: NPM Annual Indicator Reporting...........................................................................55

Form 10: NPM Annual Objectives.........................................................................................61

Form 10: National Outcome Measures (NOM)............................................................................61

form 10: NOM Detail Sheets.....................................................................................................61

form 10: NOM Federally Available Data (fad)...........................................................................62

form 10: NOM Data Entry.........................................................................................................63

Form 10: State Performance Measures (SPM).............................................................................64

Form 10 spms: List Page........................................................................................................64

Form 10 spms: Renumber Measures.....................................................................................65

Form 10: Creating new spms.................................................................................................68

Form 10: SPM Data Entry.........................................................................................................69

Form 10: SPM Annual Indicator Reporting............................................................................69

Form 10: SPM Annual Objectives..........................................................................................70

Form 10: SPM DATA Entry - INACTIVATING the Measure.....................................................70

Form 10: State Outcome Measures (SOM)..................................................................................71

Form 10 sOms: Renumber Measures....................................................................................71

FORM 10: CREATING NEW SOMS..........................................................................................74

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Form 10: SOM Data Entry.........................................................................................................74

Form 10: SOM Annual Indicator Reporting...........................................................................74

Form 10: SOM Annual Objectives..........................................................................................75

Form 10: SOM DATA Entry - INACTIVATING the Measure.....................................................76

Form 10: Evidence-Based or -Informed Strategy Measures (ESM)..............................................76

Form 10 ESms: Renumber Measures....................................................................................77

CREATING NEW ESMS...........................................................................................................80

Form 10: ESM Data Entry......................................................................................................... 81

Form 10: ESM Annual Indicator Reporting............................................................................81

Form 10: ESM Annual Objectives..........................................................................................82

Form 10: ESM DATA Entry - INACTIVATING the Measure.....................................................82

Form 11: Other State Data...........................................................................................................83

Form 12: MCH Data ACCESS AND LINKAGES................................................................................83

State Action Plan Table................................................................................................................87

State Narrative.............................................................................................................................90

Narrative Sections.................................................................................................................... 90

Word Upload Documents.........................................................................................................92

Character Count/Page Count................................................................................................93

View Documents...................................................................................................................... 94

View Last Year’s Content..........................................................................................................95

PDF and/OR Image Upload Sections.........................................................................................95

Section I.A: Letter of Transmittal...........................................................................................95

Section IV: Title V-Medicaid IAA/MOU..................................................................................96

Section V: Supporting Documents.........................................................................................96

Section VI: Organizational Chart...........................................................................................97

508 Accessibility....................................................................................................................... 98

Use Styles to Create Headings.............................................................................................100

Print Version.............................................................................................................................. 103

Printing the Print Version.......................................................................................................105

Additional Resources.................................................................................................................107

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportAppendix....................................................................................................................................109

List of Possible Validation Errors............................................................................................109

List of Possible Validation Data Alerts....................................................................................115

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportLIST OF FIGURES

Figure 1: EHBs Application Status Overview Screen....................................................................12

Figure 2: EHBs Section A-C Screen...............................................................................................12

Figure 3: EHBs Section A Screen..................................................................................................13

Figure 4: EHBs Section A-C Screen...............................................................................................13

Figure 5: EHBs Section C Screen...................................................................................................13

Figure 6: EHBs Application Status Overview................................................................................13

Figure 7: Form Navigation Buttons..............................................................................................16

Figure 8: Form Navigation Buttons - Review Page.......................................................................16

Figure 9: Screen Showing Logout.................................................................................................18

Figure 10: Form and Field Notes..................................................................................................19

Figure 11: Note Icon after Note Entered......................................................................................19

Figure 12: Form 2, Line 9, Select Grant Programs........................................................................25

Figure 13: Form 2, Line 9, Add Grant Programs...........................................................................25

Figure 14: Form 3b, Line 4, Add/Other........................................................................................33

Figure 15: Form 4.........................................................................................................................36

Figure 16: Edit Priority Need........................................................................................................46

Figure 17: Add Priority Need........................................................................................................47

Figure 18: NPMs – 2021-2025 National Performance Measures.................................................49

Figure 19: 2016-2020 NPMs........................................................................................................ 49

Figure 20: Form 10 NPM Detail Sheet Example...........................................................................50

Figure 21: Manage NPMs Page....................................................................................................51

Figure 22: Form 10 Select NPMs Page.........................................................................................52

Figure 23: Form 10 Select NPMs Page – Unselect Measure.........................................................52

Figure 24: Form 10 NPM FAD Display Page Example...................................................................54

Figure 25: Form 10 NPMs – FAD tables for Federal Data Available measures – Example 1:........56

Figure 26: Form 10 NPMs – FAD table for Federal Data Available measures – Example 2 (Newly Selected Measure in FY 2021 Application/FY 2019 Annual Report):...........................................57

Figure 27: Form 10 NPMs – FAD table for NSCH measures – Example 1.....................................57

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 28: Form 10 NPMs - State Provided Data Table for NPMs Previously Selected................59

Figure 29: Form 10 NPMs - State Provided Data Table for NPMs Newly Selected in FY 2021 Application/FY 2019 Annual Report:............................................................................................60

Figure 30: Form 10 NOM Detail Sheet Example...........................................................................61

Figure 31: Form 10a NOM FAD Display Page Example.................................................................62

Figure 32: NOM Data Entry Page - FAD Available........................................................................63

Figure 33: NOM Data Entry Page - FAD Not Available.................................................................64

Figure 34: 2021-2025 State Performance Measures:..................................................................65

Figure 35: 2016-2020 State Performance Measures:..................................................................66

Figure 36: Renumber SPMs - 1.....................................................................................................66

Figure 37: Renumber SPMs – 2....................................................................................................66

Figure 38: 2021-2025 State Outcome Measures:........................................................................72

Figure 39: 2016-2020 State Outcome Measures.........................................................................72

Figure 40: Renumber SOMs – 1...................................................................................................72

Figure 41: Renumber SOMs – 2...................................................................................................73

Figure 42: 2021-2025 ESMs.........................................................................................................77

Figure 43: 2016-2020 ESMs.........................................................................................................78

Figure 44: Renumber ESMs – 1....................................................................................................78



Figure 47: Form 12.......................................................................................................................86

Figure 48: Linkages – Data Source is Linked to Another Data Source (Optional)........................86

Figure 49: Other Data Sources (Optional)...................................................................................87

Figure 50: State Action Plan Table...............................................................................................88

Figure 51: Characters/Pages Remaining......................................................................................93

Figure 52: View and View Last Year’s Content.............................................................................95

Figure 53: Supporting Documents Page.......................................................................................97

Figure 54: Accessibility Checker Results......................................................................................99

Figure 55: Word Header Menu..................................................................................................100

Figure 56: Word Lists Menu.......................................................................................................101

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 57: Word Insert Table Feature........................................................................................102

Figure 58: Word Format Picture – Entering Alt Test..................................................................102

Figure 59: Example of Using Test to Accompany Color..............................................................103

Figure 60: Genetate New Print Version.....................................................................................104

Figure 61: Download Print Version............................................................................................105

Figure 62: Print Version.............................................................................................................105

Figure 63: Printing the Print Version..........................................................................................106

Figure 64: Printing the Legal Size State Action Plan Table.........................................................107

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportTVIS INTRODUCTION

The Title V Information System (TVIS) primarily serves as an online, web-accessible interface for the submission of the 59 State and jurisdictional Title V MCH Block Grant Applications/Annual Reports each year on or around July 15th. Note: The submission due date for the 2022 Application/2020 Annual Report is September 1. TVIS is designed to capture the performance data and other program and financial information contained in the State Applications/Annual Reports, which includes descriptive information on State Title V-supported efforts, State MCH partnership efforts and other program-specific initiatives of the State in meeting its MCH needs.

Integrated with HRSA’s grants management system (i.e., the HRSA Electronic Handbooks (EHB)), TVIS collects key financial, program, and performance data reported by States in their yearly MCH Block Grant Applications/Annual Reports. Examples of the data that are collected include information on populations served, budget and expenditure breakdowns by source of funding, individuals served breakdowns of MCH populations by race/ethnicity, other State data (OSD), and performance and outcome measure data for the national and State measures. Reporting on performance relative to the national measures is used to assess national progress in key MCH priority areas and to facilitate the Bureau’s annual Government Performance and Results Act of 1993 (GPRA) reporting.

Please note: This instruction manual is geared to provide web system assistance. This manual includes very minimal programmatic information and guidance. For additional programmatic information and guidance, please refer to the Title V MCH Block Grant Application/Annual Report Guidance and the Appendix of the Supporting Documents.

The FY 2022 Application/FY 2020 Annual Report will go live on April 1, 2021. The FY 2022 Application/FY 2020 Annual Report must be submitted by September 1, 2021 at 11:59pm Eastern Time.

TVIS ACCESS FROM EHBs

BROWSER REQUIREMENTS

TVIS has been developed with coding technologies that make the system more sleek and modern. Unfortunately, old web browsers, such as Internet Explorer 9 will not allow you to fully utilize the new user experience.

The following web browsers will be supported by TVIS.

Internet Explorer 10.0 or greater

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Google Chrome

We are aware that State departments may only have Internet Explorer 9 or lower versions currently available. Prior to April 1st , please coordinate with your local IT department to upgrade, if possible, to Internet Explorer 10 or to install Google Chrome for staff members who will be using TVIS.

If your State is unable to upgrade to one of the minimum browsers, please contact your HRSA Project Officer for further assistance.

REGISTRATION IN EHBS

The Title V Information System (TVIS) is integrated with HRSA’s grants management system, the Electronic Handbooks (EHB). User registration, access to TVIS, and submission of your application will take place through EHB. Registration of all your State users in the EHB is necessary.

All Users Who Will Be Working on Your State’s Block Grant Application must be registered in EHB: Register individually in EHB, creating a user name and password and linking to the State organization that received the block grant funding by using the grant number.

If you registered last year and have a username and password, go to https://grants.hrsa.gov/webexternal/ and log in to verify access to EHB. If you have not been in the EHB for more than 90 days, you will be prompted to change your password.

If you are new and have not registered, do the following: Go to https://grants.hrsa.gov/webexternal/ to register. Click on the link “Create an

Account” button on the Login page. Provide the identifying information requested. Use the grant number associated with your State’s Block Grant to link to your

organization.

MCH Directors no longer need to provide a list of all your users and their usernames for TVIS.

CREATING THE APPLICATION

The instructions below list the steps to create a TVIS application in EHBs. Note: Each State is permitted to create only one application in the EHB.

1. Click the “Grants” tab at the top of the screen.2. Click the “Search Funding Opportunities” under the Application section on the sub-tab.3. Locate the funding announcement number, HRSA-22-001, and click the “Apply in EHBs”

link that appears to the right of the listing.4. Click “Begin New Application” to the right of your organization listing.

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5. Enter the eligibility code in the Eligibility Code field. (In order to get the Eligibility Code, please contact your State MCH Director. Eligibility Codes will be emailed to the State MCH Director on April 1, 2021.) Select “New” for the Application Type, and click “Continue.”

6. The Application – Status Overview page will be displayed.

COMPLETING THE BUDGET INFORMATION IN THE EHBS

You must complete Section A-C in the EHBs in order to complete the financial forms in TVIS. The steps for completing this section are listed and shown below:

From the Application Status Overview page. Click “Update” to the right of Section A-C.

Figure 1: EHBs Application Status Overview Screen

Section A-C will appear. Click “Update” to the right of Section A.

Figure 2: EHBs Section A-C Screen

Enter your Federal and Non Federal amounts in the available fields. When complete, click “Save and Continue” to save your information.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 3: EHBs Section A Screen

You will arrive back at Section A-C. Click “Update” to the right of Section C.

Figure 4: EHBs Section A-C Screen

In Section C, enter the Non-Federal amounts for Applicant, State, Local, Other, and Program Income. Ensure that the sum of these amounts equal the Non-Federal Total you entered in Section A. When complete, click “Save and Continue.”

Figure 5: EHBs Section C Screen

Now that Section A-C in the EHBs has been saved, you can begin Form 2 in the TVIS. In order to access the TVIS, click “Update” to the right of the Program Specific Information in the Application Status Overview page.

Figure 6: EHBs Application Status Overview

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportACCESSING TVIS

Once you have created your EHB application for the first time, please follow the steps below in order to login and access your EHBs application and TVIS.

1. Login to EHBs.2. Click the “Tasks” tab towards the top of the screen.3. Click “Grant Applications” under the Grants section in the left-side menu.4. Click the “Edit” link to the right of the application listing.5. EHBs application will be displayed. Click “Update” to the right of the Program Specific

Information.6. The TVIS Main Menu page will be displayed.

MANAGING PEER ACCESS

The creator of the application can manage peer access. He/she can grant other users registered under the organization access to view or edit the application. If another user needs access to the application, the creator can follow the steps below:

1. Login to EHBs.2. Click the “Tasks” tab towards the top of the screen.3. Click “Grant Applications” under the Grants section in the left-side menu.4. Click the scroll down arrow next to the “Edit” link to the right of the application listing. 5. Click the “Manage Peer Access” link in the scroll down list.6. On the Peer Access page, click the “Authorize New Users” button towards the top of the

page. 7. A list of all users that are registered under the organization shall appear on the page. 8. Click the “Authorize Access” link to the right of the user you wish to grant peer access.9. Check the privileges you would like to grant the user, and click “Save and Continue.” 10. Privileges include:

View: this allows user to view the EHBs application but cannot access the TVIS. Edit: this allows users to access and perform data entry in the TVIS. Submit to AO: this allows users to submit the completed application to the

assigned Authorizing Official for final review and submission to HRSA. Submit to HRSA: this will be disabled for any user that does not have the

Authorizing Official role.

For assistance in registering in the EHBs, please visit https://help.hrsa.gov/display/public/EHBSKBFG/Registration+and+User+Accounts+FAQs

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https://help.hrsa.gov/display/public/EHBSKBFG/Registration+and+User+Accounts+FAQs


TVIS NAVIGATION AND FORM INFORMATION

TVIS MAIN MENU

The Main Menu is the TVIS home page. This is the landing page that appears when accessing the TVIS from the EHBs. All forms in the TVIS Application/Report are listed on the Main Menu. To access a form, click on the corresponding hyperlinked title of the form. The forms are grouped by form type, e.g., financial, program, etc. The status of the required forms is displayed to the right of each form title. For additional information regarding the status, please refer to Form Status Checker section of these instructions.

Please note the first time that you arrive at the Main Menu, you will see a message stating "Retrieving Last Year's Data." This will only take about 10 seconds. This will only happen the first time that the TVIS is opened and will not occur again throughout the release.

TVIS NAVIGATION

The financial forms (forms 2, 3a, and 3b) must be completed in a specific order. Both forms 3a and 3b may not be started until form 2 has been completed.

Other than the financial forms, all forms may be completed in any order you choose.

In order to access a form, you may click the hyperlinked title of the form in the Main Menu page or click the title of the form under the left-side navigation menu.

FORM NAVIGATION

Each form is divided into different sections identified by tabs towards the top of each form. The last tab in each form is a Review tab. This screen will display the information entered throughout the sections of the forms. If you would like to make changes to the information shown on the Review tab, please navigate to the appropriate section using the tabs or Previous/Next buttons displayed at the top or bottom of each page.

After completing a section in a form, you may select “Prev” button or “Next” button to save the information. The different navigation buttons are listed and explained below:

Prev button will save the information entered in the section and bring you to the previous section in the form. “Prev” will not be an active option under the first section of each form.

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Cancel button will bring you back to the Main Menu. “Cancel” will not save any newly entered information. If you select “Cancel” at any point, you will receive a system message indicating that any unsaved data will be lost for which you must confirm.

Next button will save the information entered in the section and bring you to the next section in the form. “Next” will not be an active option under the last section of each form.

Finish button will only be listed as an option on the Review tab of each form. By clicking “Finish,” you are indicating that you are done working on the form at that time. If all errors have not been addressed or all required fields in all the sections of the form have not been completed, the form will remain in “In Progress” status. However, as long as all errors are addressed in the form and all required fields are completed in all sections, this form will be in “Completed” status. By clicking “Finish,” you will be directed to the Main Menu page. If you have clicked “Finish” on a form and is in “Completed” status, you may still go back into the form to edit and change data if you need to. For more information regarding statuses, please refer to the Form Status Checker section of these instructions. Please note: if all required fields are entered and all validations are addressed, there is no need to click “Finish.” The form will still be complete.

Figure 7: Form Navigation Buttons

Figure 8: Form Navigation Buttons - Review Page

Partial Saving:

The concept of partial saving is introduced in Form 5 and in the new Form 12 from FY 2022 Application/FY 2020 Annual Report onward. The following are main features and functionalities of this partial saving concept:

Under this ‘Partial Saving’ concept, there will be no Review page for the form. There will be no Prev, Cancel, Next, and Finish buttons. There will be a button called ‘Save Draft’ displayed at the bottom right in the data entry

page.

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Upon clicking the ‘Save Draft’ button, users will be able to save the data entered until that time.

Users can save the data as they enter by clicking on the ‘Save Draft’ button. Users are no longer forced to have values in all required fields to be able to save the data entered by using the Save Draft button.

Users can partially save the data, navigate to other forms/sections in TVIS and come back to continue the data entry for Form 5/Form 12 where the partially saved data will be displayed.

Once all the required fields’ data entry are complete, the ‘Save Draft’ button will change into ‘Save’ button.

Once all the validations/errors are rectified, the status of the form in the Form Status Checker will be complete.

FORM LOCK

Each of the data entry forms in the TVIS has a lock feature. This means that as soon as a user begins viewing any data entry section of a form, the specific form becomes locked by that user. If a second user from the organization attempts to access that form at that time, the second user will see a message indicating that the form is locked. The form will remain locked until the user leaves the form.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportSYSTEM TIMEOUTS

As with all of the EHB-integrated systems, there is a 30-minute timeout limit. After 30 minutes of inactivity, the system will time you out. The system does not recognize typing as activity, so please save as you go. In order to save, please use the “Prev” and “Next” buttons.

After 25 minutes of inactivity, a pop up message will appear asking to continue or cancel your session. The pop up blocker feature must be off in order to receive this message.

When you are done with your session, please make sure to logout of the system by clicking “Logout” in the upper right corner.

Figure 9: Screen Showing Logout

FORM NOTES

All forms display note sections. Notes are available in every form at the form-level. Notes at the form-level should be used to add a comment that pertains to the whole form. In order to add a form-level note, please click the “Add Note” icon on the bottom left of the form header. Once a note has been entered and saved, the button will read “Edit Note.” All form-level notes will accept up to 3,000 characters.

Many of the forms also display note icons at the field-level. Notes at the field-level should be used to add a comment that pertains to a specific set of data, for example, to explain a validation. In order to add a field-level note, please click the blue note icon to the right of the field. Once a note has been entered and saved, the icon will turn green. All field-level notes will accept up to 2,000 characters.

Both form and field-level notes can be edited or deleted.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 10: Form and Field Notes

Figure 11: Note Icon after Note Entered

FORM VALIDATION MESSAGES

Forms may display different types of validation messages. These types of validation messages and their descriptions are listed below:

Required Field Validations: Fields that are required are marked with a red asterisks (*). If States do not enter a value in these fields, a message will appear indicating the field is required. The page will not save without entering a value into required fields.

o Partial Saving: Partial saving has been implemented in Form 5 and Form 12. Until all the required fields are entered, the other errors/validations might not be displayed. When the required fields are complete, then the other errors/validations will be displayed.

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Cross-Field Validation Errors: Some validations may ask that a specific value(s) must be corrected. The information on the page will still save; however, the form will not be in “Complete” status until this information is corrected. In some cases, the message may say to correct the information or add a field-level note to explain. In these cases, the error will go away as long as the information is corrected or a field-level note is entered.

Cross-Form Validation Errors: There are a few errors that will compare values across two forms. These errors will appear only on the latter of the two forms included in the message. The information on the page will still save, however, the form will not be in “Complete” until this information is corrected or a field-level note is entered.

Data Alerts: Some validations will be displayed as Data Alerts. Data Alerts are only applicable for Form 2, Form 4, Form 5, and Form 10 NOMs. Data Alerts will only appear under the Review tab of each form or in the Data Alerts section in TVIS except for Form 10 NOMs and Form 5 where you will see Data Alerts in the Data Entry page also. These are warnings to advise you of flagged elements in your data for your review/clarification. These flagged elements in your data may not be incomplete or in error, but rather sections you may wish to review, revise, or may benefit by adding explanatory notes. Data Alerts will not prevent you from completing the form.

o Form 2 and Form 4 Data Alerts: These Data Alerts will only appear on the review page, and they are indicated by this icon: To view the Data Alert, click the “icon.” In some cases, the Data Alert will be removed if a field-level note is entered, and in some cases, the Data Alert will remain even when a field-level note is entered.

o Form 5 Data Alerts: These Data Alerts will appear on the data entry page and review page, and they are are indicated by this icon: . States will need to click on the icon to view the Data Alert. These Data Alerts will remain even when a field-level note is entered.

o Form 10 National Outcome Measure Data Alerts: These Data Alerts will appear on the data entry page and the review page. They will be shown directly. States will not need to click an icon to view the Data Alert. For these Data Alerts, even if a note is entered, the Data Alert will remain.

There are two types of Data lerts:

Data Watches: Data Watches are Data Alerts that will go away if a field-level note is entered.

Data Warning: Data Warnings are Data Alerts that will remain even if a field-level note is entered.

FORM VALIDATION NAVIGATION

Forms 2 through 6 and Form 12 will display a “Show Validations” button towards the top left corner of each data entry section.

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The “Show Validations” button will display all validations on the form, including required fields, cross-line validations and cross-form validations. All required fields must be completed before cross-line validations and cross-form validations can be displayed.

Users must complete all required fields in order to continue to the next section; however, users can continue to the next section with cross-line or cross-form validations. Once all validations are addressed, “Show Validations” will display a message stating that there are no validations.The form will not be complete until all validation errors have been addressed. All validation errors will also be displayed in the Error Summary section of the Review tab of the form and on the Forms Status Checker.

To hide the validations, click the “Hide Validations” button.

FORM STATUS CHECKER

All forms are listed on the Form Status Checker. The status of each form is shown to the right of the form listing.

Users will be able to export/print the tabular display of the Form Status Checker validation results by clicking on the “Export Form Status” button on this page.

The possible statuses of each form are listed below along with their descriptions:

Not Started indicates that a form has not been saved at least once. In Progress indicates that a form has been saved at least once. Complete indicates that all sections of the form have been completed, and all

validations have been corrected or addressed by a field-level note (where applicable). Even if a form is complete, you may still access the form and make any updates. You may continue to make updates to completed forms up until the time that you submit the Application/Annual Report within EHBs.

DATA ALERTS PAGE

The Data Alerts Page is accessible from the left side menu or the TVIS Main Menu. All Data Alerts that are active in the form (have been triggered) are displayed under the Data Alerts page. These are listed by form and by Data Alert type (warning and watch).

Data Alerts will not prevent users from submitting the Application/Annual Report, but they should be reviewed by the users for accuracy.

Users are not required to view this page. The same Data Alerts that will appear on this page will also appear in their respective forms.

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There are two types of data alerts:

Data Watches: Data Watches are Data Alerts that will go away if a field-level note is entered.

Data Warning: Data Warnings are Data Alerts that will remain even if a field-level note is entered.

SUBMITTING THE APPLICATION/ ANNUAL REPORT

The FY 2022 Application/FY 2020 Annual Report must be submitted by September 1, 2021 at 11:59pm Eastern Time.

There is no button within TVIS to submit the Application/Annual Report. The submit button is in the EHBs for the entire application (which includes forms and narrative completed within the TVIS).

Because the TVIS is located under Program Specific Information in the EHBs application, as long as all forms and sections in the TVIS are complete, the Program Specific Information will be shown as complete.

Once all sections in the EHBs application are complete, you may submit your EHBs application.

FORM 2: MCH BUDGET/EXPENDITURE DETAILS

FORM 2 ACCESS

Form 2 cannot be completed until Section A-C in the EHBs is completed. Many of the fields on Form 2 are pre-populated from the information provided in Section A-C of the EHBs. If the Budget Information in the EHBs is not yet completed, all fields populated in Form 2 will display zeros which will not pass the validation. Please make sure this information is complete and accurate before proceeding to the Program Specific Information section and accessing Form 2. Instructions on completing Section A-C of the EHBs can be found on page 9 of this manual.

All fields marked with a red asterisk (*) indicates a required field. Please enter a value even if it is zero.

FORM 2: APPLICATION BUDGETED: LINES 1 - 8

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportMost of these fields are pre-populated from the Budget Information in Section A-C. If any of these amounts need to be updated, please update them in Section A-C of the EHBs. See page 9 of this manual for instructions on completed Section A-C of the EHBs.

Line 1: The amount of the application year budgeted Federal Allocation is pre-populated from the amount entered in the Federal field of Section A Budget Information in the EHBs.

Line 1A: Enter the amount of the application year budgeted Federal allotment for Preventive and Primary Care for Children. The percentage of the Federal Allocation (Line 1) that this amount represents will be calculated by the system. This amount must be at least 30% of the Federal Allocation (Line 1) application year budgeted.

Line 1B: Enter the amount of the application year budgeted Federal allotment for Children with Special Health Care Needs. The percentage of the Federal Allocation (Line 1) that this amount represents will be calculated by the system. This amount must be at least 30% of the Federal Allocation (Line 1) application year budgeted amount.

Line 1C: Enter the amount of the application year budgeted Federal allotment for the Title V Administration. The percentage of the Federal Allocation (Line 1) that this amount represents will be calculated by the system. This amount must be less than or equal to 10% of the Federal Allocation (Line 1) application year budgeted amount.

Line 2: The amount of the application year budgeted Subtotal of Lines 1A-C is auto-calculated with the sum of the amounts entered in Lines 1A-C. This amount does not include Pregnant Women and All Others. The totals of Lines 1A, 1B and 1C must be less than or equal to the application year budgeted Federal Allocation (Line 1).

Line 3: The amount of the application year budgeted State MCH Funds is pre-populated from the amount entered in the State field of Section C Budget Information in the EHBs.

Line 4: The amount of the application year budgeted Local MCH Funds is pre-populated from the amount entered in the Local field of Section C Budget Information in the EHBs.

Line 5: The amount of the application year budgeted Other Funds is pre-populated from the amount entered in the Other field of Section C Budget Information in the EHBs.

Line 6: The amount of the application year budgeted Program Income is pre-populated from the amount entered in the Program Income field of Section C Budget Information in the EHBs.

Line 7: The amount of the application year budgeted Total State Match is pre-populated from the information in Lines 3 through 6. Line 7 must be greater than or equal to 75% of the Federal Allocation (Line1).

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Line 7a: The amount of your State’s FY 1989 Maintenance of Effort will be pre-populated. The amount in Line 7 must be greater than or equal to your State’s FY 1989 Maintenance of Effort amount.

Line 8: The amount of the application year budgeted Federal-State Title V Block Grant Partnership Subtotal is pre-populated from the information in entered in Line 1 and Lines 3 through 6 budgeted.

FORM 2: APPLICATION BUDGETED: LINES 9 AND 10

Line 9: Select the application year budgeted Federal funds other than the Title V Block Grant that are directly under the control of the Title V Program Administrator. Click the “Add drop-down” button next to “Select Grant Programs.” The system will not require you to select any grant programs. However, if you select a grant program from the drop-down list, you must enter the corresponding application year budgeted amount. In order to remove a program, click the corresponding “Remove” button under the Action column.

The programs listed in the drop-down list are the other federal programs that were identified by MCHB. The drop-down list will be reviewed and updated prior to every TVIS application to add or remove programs as necessary.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 12: Form 2, Line 9, Select Grant Programs

If a program is not available for selection under the drop-down list, please click the “Add” button next to “Add Grant Programs.” For any other programs added, the system will prompt you to select the Department and Agency of the grant program. If the agency that you would like to add is not available under the drop-down, select “Other” from the agency drop-down. Please enter the program name in the field provided, and please enter the corresponding application year budgeted amount. There is no limit to the number of programs a State can add. In order to remove a program, click the corresponding “Remove” button under the Action column.

Figure 13: Form 2, Line 9, Add Grant Programs

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportIf you wish to add a grant program under a Department that is not available to select as a pre-defined selection, please contact your Project Officer.

Line 10: The amount of the application year budgeted Other Federal Funds Subtotal is pre-populated from the information entered in Other Federal Funds (Line 9).

FORM 2: ANNUAL REPORT EXPENDED: LINES 1 - 8

To the right of each Annual Report year expended field in Form 2, the system will display the Annual Report year budgeted amount. These amounts are pre-populated from the previously submitted application where the Annual Report year budgeted amounts were provided and may not be edited. All amounts entered in Form 2 for the Annual Report year expended fields have a 10% (+ or -) tolerance when compared to the Annual Report year budgeted amount.

For example, if the Annual Report year budgeted amount for a specific field was $100.00, if the Annual Report year expended amount is less than $90.00 or more than $110.00, a Data Alert will be displayed. If these amounts are not within 10% (+ or -) of the Annual Report year budgeted amount, a Data Alert will be displayed on the Review tab of the form requesting that field-level note be added to explain the difference between the budget and expenditure. These are considered data watches, and they will be removed if a field-level note is entered. For additional information regarding Data Alerts, please refer to the Form Validation Messages section of these instructions.

Line 1: Enter the Annual Report year expended Federal Allocation amount.

Line 1a: Enter the amount of the Annual Report year expended Federal allotment for Preventive and Primary Care for Children. The percentage of the expended Federal Allocation (Line 1) that this amount represents will be calculated by the system. This amount should be at least 30% of the Federal Allocation (Line 1) expended amount. If this is not the case, a validation error will trigger. The validation error can be removed by correcting the information or entering a field-level note to explain.

Line 1b: Enter the amount of the Annual Report year expended Federal allotment for Children with Special Health Care Needs. The percentage of the expended Federal Allocation (Line 1) that this amount represents will be calculated by the system. This amount should be at least 30% of the Federal Allocation (Line 1) expended amount. If this is not the case, a validation error will trigger. The validation error can be removed by correcting the information or entering a field-level note to explain.

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Line 1c: Enter the amount of the Annual Report year expended Federal allotment for the Title V Administration. The percentage of the expended Federal Allocation (Line 1) that this amount represents will be calculated by the system. This amount must be less than or equal 10% of the Federal Allocation (Line 1) expended amount. If it is, a validation error will trigger. The validation error can be removed by correcting the information or entering a field-level note to explain.

Line 2: The amount of the Annual Report expended Subtotal of Lines 1A-C is auto-calculated with the sum of the amounts entered in Lines 1A-C. This amount does not include Pregnant Women and All Others. The totals of Lines 1A, 1B, and 1C must be less than or equal to the Annual Report expended Federal Allocation (Line 1).

Line 3: Enter the Annual Report year expended State MCH Funds amount.

Line 4: Enter the Annual Report year expended Local MCH Funds amount.

Line 5: Enter the Annual Report year expended Other Funds amount.

Line 6: Enter the Annual Report year expended Program Income amount.

Line 7: The amount of the Annual Report year expended Total State Match is pre-populated from the information in Lines 3 through 6. Line 7 expended should be greater than or equal to 75% of the expended Federal Allocation (Line1) and should be greater than or equal to your State’s FY 1989 Maintenance of Effort amount. If either of these are not the case, a validation error will trigger. The validation error can be removed by correcting the information or entering a field-level note to explain.

Line 8: The amount of the Annual Report year expended Federal-State Title V Block Grant Partnership Subtotal is pre-populated from the information entered in Line 1 and Lines 3 through 6 expended.

FORM 2: ANNUAL REPORT EXPENDED: LINES 9 AND 10

Form 2, Lines 9 and 10 will be pre-populated with the programs you selected/entered during the FY 2020 Application. These pre-populated programs may not be removed from the list. For each program listed, enter an expended amount. For a program listed where there was no amount expended, please enter zero in the Expended Amount column. Please enter a field-level note to explain zero in the expended amount for a program. To the right of the expended amount field, the system will display the Annual Report year budgeted amount. These amounts are pre-populated from the FY 2020 Application. The budgeted amounts are displayed for reference and may not be edited.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportAdditional grant programs that were not entered in the FY 2020 Application may still be added to report expenditures. Please see the Form 2: Application Budgeted: Lines 9 and 10 section for instructions on completing this portion of the form.

FORM 3A: BUDGET AND EXPENDITURE DETAILS BY TYPES OF INDIVIDUALS SERVED

FORM 3A ACCESS

Form 3a is only available once users complete Form 2. Much of the information on Form 3a are validated against the information provided in Form 2. Please make sure Form 2 is complete and accurate before proceeding to Form 3a.


FORM 3A: APPLICATION BUDGETED

FORM 3A: SECTION IA

Please note that the Federal Totals of Individuals Served on Form 3a do not include Title V Administrative Costs.

Line IA.1: Enter the application year budgeted Federal MCH allocation for Pregnant Women.

Line IA.2: Enter the application year budgeted Federal MCH allocation for Infants < 1 Year of Age.

Line IA.3: Enter the application year budgeted Federal MCH allocation for Children 1 through 21 Years of Age. The Children 1 through 21 Years of Age amount must equal the application year budgeted amount of Preventive and Primary Care for Children (Line 1a) on Form 2. If these two amounts differ, a validation error will be triggered. The validation error can be removed by correcting the information or entering a field-level note to explain.

Line IA.4: Enter the application year budgeted Federal MCH allocation for CSHCN. The CSHCN amount must equal the application year budgeted amount of Children with Special Health Care Needs (Line 1b) on Form 2. If these two amounts differ, a validation error will be triggered. The validation error can be removed by correcting the information or entering a field-level note to explain.

Line IA.5: Enter the application year budgeted Federal MCH allocation for All Others.

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Federal Total of Individuals Served: The system will calculate the sum of the amounts entered for Lines IA.1 through IA.5. The Federal Total of Individuals Served must be equal the application budgeted Federal Allocation (Line 1) amount on Form 2 less than the Title V Administration Cost (Line 1c) in Form 2.

FORM 3A: SECTION IB

Line IB.1: Enter the application year budgeted Non-Federal MCH allocation for Pregnant Women.

Line IB.2: Enter the application year budgeted Non-Federal MCH allocation for Infants < 1 Year of Age.

Line IB.3: Enter the application year budgeted Non-Federal MCH allocation for Children 1 through 21 Years of Age.

Line IB.4: Enter the application year budgeted Non-Federal MCH allocation for CSHCN.

Line IB.5: Enter the application year budgeted Non-Federal MCH allocation for All Others.

Non-Federal Total of Individuals Served: The system will calculate the sum of the amounts entered for Lines IB.1 through IB.5.

FORM 3A: ANNUAL REPORT EXPENDED

FORM 3A: SECTION IA

Line IA.1: Enter the Annual Report year expended Federal MCH allocation for Pregnant Women.

Line IA.2: Enter the Annual Report year expended Federal MCH allocation for Infants < 1 Year of Age.

Line IA.3: Enter the Annual Report year expended Federal MCH allocation for Children 1 through 21 Years of Age. The Children 1 through 21 Years of Age amount must equal the Annual Report year expended amount of Preventive and Primary Care for Children (Line 1a) on Form 2. If these two amounts differ, a validation error will be triggered. The validation error can be removed by correcting the information or entering a field-level note to explain.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportLine IA.4: Enter the Annual Report year expended Federal MCH allocation for CSHCN. The CSHCN amount must equal the Annual Report year expended amount of Children with Special Health Care Needs (Line 1b) on Form 2. If these two amounts differ, a validation error will be triggered. The validation error can be removed by correcting the information or entering a field-level note to explain.

Line IA.5: Enter the Annual Report year expended Federal MCH allocation for All Others.

Federal Total of Individuals Served: The system will calculate the sum of the amounts entered for Lines IA.1 through IA.5. The Federal Total of Individuals Served must be equal the Annual Report year expended Federal Allocation (Line 1) amount on Form 2 less than the Title V Administration Cost (Line 1c) in Form 2.

FORM 3A: SECTION IB

Line IB.1: Enter the Annual Report year expended Non-Federal MCH allocation for Pregnant Women.

Line IB.2: Enter the Annual Report year expended Non-Federal MCH allocation for Infants < 1 Year of Age.

Line IB.3: Enter the Annual Report year expended Non-Federal MCH allocation for Children 1 through 21 Years of Age.

Line IB.4: Enter the Annual Report year expended Non-Federal MCH allocation for CSHCN.

Line IB.5: Enter the Annual Report year expended Non-Federal MCH allocation for All Others.

Non-Federal Total of Individuals Served: The system will calculate the sum of the amounts entered for Lines IB.1 through IB.5.

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FORM 3B: BUDGET AND EXPENDITURE DETAILS BY TYPES OF SERVICES

FORM 3B ACCESS

Form 3b is only available once users complete Form 2. Some information on Form 3b is validated against the information provided in Form 2. Please make sure Form 2 is complete and accurate before proceeding to Form 3b.


FORM 3B: APPLICATION BUDGETED

FORM 3B: SECTION IIA

Line IIA.1: The system will calculate the sum of the application year budgeted values entered in Lines IIA.1a, IIA.1b and IIA.1c. If this amount is incorrect, please change the amounts in Lines IIA.1a, IIA.1b and IIA.1c.

Line IIA.1a: Enter the application year budgeted Federal MCH allocation for Direct Services for Preventive and Primary Care Services for all Pregnant Women, Mothers and Infants up to one year in age.

Line IIA.1b: Enter the application year budgeted Federal MCH allocation for Direct Services for Preventive and Primary Care Services for Children. Line IIA.1c: Enter the application year budgeted Federal MCH allocation for Direct Services for CSHCN.

Line IIA.2: Enter the application year budgeted Federal MCH allocation for Enabling Services.

Line IIA.3: Enter the application year budgeted Federal MCH allocation for Public Health Services and Systems.

Federal Total: The system will calculate the sum of the amounts entered for Lines IIA.1 through IIA.3. If this amount is incorrect, please change the amounts in Lines IIA.1 through IIA.3. The Federal Total amount must equal the application year budgeted Federal Allocation (Line 1) amount on Form 2.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 3B: SECTION IIB

Line IIB.1: The system will calculate the sum of the application year budgeted values entered in Lines IIB.1a, IIB.1b and IIB.1c. If this amount is incorrect, please change the amounts in Lines IIB.1a, IIB.1b and IIB.1c.

Line IIB.1a: Enter the application year budgeted Non-Federal MCH allocation for Direct Services for Preventive and Primary Care Services for all Pregnant Women, Mothers and Infants up to one year in age.

Line IIB.1b: Enter the application year budgeted Non-Federal MCH allocation for Direct Services for Preventive and Primary Care Services for Children. Line IIB.1c: Enter the application year budgeted Non-Federal MCH allocation for Direct Services for CSHCN.

Line IIB.2: Enter the application year budgeted Non-Federal MCH allocation for Enabling Services.

Line IIB.3: Enter the application year budgeted Non-Federal MCH allocation for Public Health Services and Systems.

Non-Federal Total: The system will calculate the sum of the amounts entered for Lines IIB.1 through IIB.3. If this amount is incorrect, please change the amounts in Lines IIB.1 through IIB.3.

FORM 3B: ANNUAL REPORT EXPENDED

FORM 3B: SECTION IIA

Line IIA.1: The system will calculate the sum of the Annual Report year expended values entered in Lines IIA.1a, IIA.1b and IIA.1c. If this amount is incorrect, please change the amounts in Lines IIA.1a, IIA.1b and IIA.1c.

Line IIA.1a: Enter the Annual Report year expended Federal MCH allocation for Direct Services for Preventive and Primary Care Services for all Pregnant Women, Mothers and Infants up to one year in age.

Line IIA.1b: Enter the Annual Report year expended Federal MCH allocation for Direct Services for Preventive and Primary Care Services for Children. Line IIA.1c: Enter the Annual Report year expended Federal MCH allocation for Direct Services for CSHCN.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportLine IIA.2: Enter the Annual Report year expended Federal MCH allocation for Enabling Services.

Line IIA.3: Enter the Annual Report year expended Federal MCH allocation for Public Health Services and Systems.

Line IIA.4: Using the list of direct services provided, enter the amount of Federal Funds expended for this service. Additional services may be included by checking “Add Other” and entering the type of service that is supported. Please enter an amount in these fields even if it is zero. The total Annual Report year expended amount for all services selected in Line IIA.4 must equal the Annual Report year expended amount in Line IIA.1.

Figure 14: Form 3b, Line 4, Add/Other

Federal Total: The system will calculate the sum of the amounts entered for Lines IIA.1 through IIA.3. If this amount is incorrect, please change the amounts in Lines IIA.1 through IIA.3. The Federal Total amount must equal the Annual Report year expended Federal Allocation (Line 1) amount on Form 2.

FORM 3B: SECTION IIB

Line IIB.1: The system will calculate the sum of the values entered in Lines IIB.1a, IIB.1b and IIB.1c. If this amount is incorrect, please change the amounts in totals of Lines in Lines IIB.1a, IIB.1b and IIB.1c.

Line IIB.1a: Enter the Annual Report year expended Non-Federal MCH allocation for Direct Services for Preventive and Primary Care Services for all pregnant women, mothers and infants up to one year in age.

Line IIB.1b: Enter the Annual Report year expended Non-Federal MCH allocation for Direct Services for Preventive and Primary Care Services for Children.

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Line IIB.1c: Enter the Annual Report year expended Non-Federal MCH allocation for Direct Services for CSHCN.

Line IIB.2: Enter the Annual Report year expended Non-Federal MCH allocation for Enabling Services.

Line IIB.3: Enter the Annual Report year expended Non-Federal MCH allocation for Public Health Services and Systems.

Line IIB.4: Using the list of direct services provided, enter the amount of Non-Federal Funds expended for this service. Additional services may be included by checking “Other” and entering the type of service that is supported. Please enter an amount in these fields even if it is zero. The total Annual Report year expended amount for all services selected in Line IIB.4 must equal the Annual Report year expended amount in Line IIB.1.

Non-Federal Total: The system will calculate the sum of the amounts entered for Lines IIB.1 through IIB.3. If this amount is incorrect, please change the amounts in Lines IIB.1 through IIB.3.

FORM 4: NUMBER AND PERCENTAGE OF NEWBORNS AND OTHERS SCREENED, CASES CONFIRMED, AND TREATED

Total Births by Occurrence: Enter the total number of occurrent births for the State. Total births by occurrence are to be defined as “all births that occur in the State regardless of residency.” States should use the number submitted by the Vital Records program to the National Center for Health Statistics.

Please note that the Total Births by Occurrence is related to the Total Infants in State in Form 6. While these figures are not expected to match, if they differ by more than 10%, a validation error will be displayed, and you must correct the information or enter a field-level note explaining the discrepancy on Form 6.

Form 4 is designed for States to complete the information from the FY 2020 Annual Report year. This Annual Report year is not editable.

FORM 4: NEWBORN SCREENING PROGRAM, LINES 1, 2, AND 3

NEWBORN

Total Births by Occurrence: Enter the total number of occurrent births for the State. The Total Births by Occurrence is required in order to proceed with entering information in Form 4.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportData Source Year: Enter the 4-digit year for which Form 4 data is gathered from. The data source year should be defined as calendar year, January 1 – December 31.

Line 1 Core RUSP Conditions: For columns A through D, please enter the aggregate numbers for the number of infants that received a Core Recommended Uniform Screening Panel (RUSP) screening. In addition, please select the Core RUSPs from the drop-down list that were conducted in your state. To add one program at a time, click the “Add” drop-down list. If you would like to select and report on all Core RUSP conditions, click “Select all core RUSPs.” In order to remove a program, please click the corresponding “Remove” button under the Action column.

If aggregate data is not available, please check the box stated “Aggregate Data Not Available.” You will be required to enter a note. If “Aggregate Data Not Available” is checked, the fields to enter aggregate numbers will become disabled. You will still have the ability select Core RUSP Conditions conducted in your state.

Column A: Enter the aggregate number of infants that received a Core RUSPs screening. The system will calculate the percentage field based on the number receiving at least one screen out of the total birth by occurrence entered at the top of the form. Please note that if the number receiving at least one screen (column A) is greater than the total births by occurrence, a validation error will trigger, and the information must be corrected.

Column B: Of the number that received at least one valid screen in column A for Core RUSPs, enter the aggregate number of out-of-range results. Please note that if the number of out-of-range results (column B) is greater than the number receiving at least one valid screen (column A), a validation error will trigger, and the information must be corrected. If the number of out-of-range results (column B) is equal to the number receiving at least one valid screen (column A), a validation error will trigger, and either the information must be corrected or a field-level note must be entered.

Column C: Of the number of out-of-range results in column B for Core RUSPs, enter the aggregate number of confirmed cases. If the number of confirmed cases (column C) is greater than the number of out-of-range results (column B), a validation error will trigger, and the information must be corrected.

Column D: Of the number of confirmed cases in column C for Core RUSPs, enter the aggregate number referred for treatment. The system will calculate the percentage field based on the number referred for treatment out of the number of confirmed cases. Please note that if the number referred for treatment (column D) is greater than the number of confirmed cases (column C) for a test or program entered, a validation error will trigger, and the information must be corrected.

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If the number referred for treatment (column D) is less than the number of confirmed cases (column C) for a test or program entered, a data alert will appear. This is a data watch and will not prevent the form from being completed. This data alert will appear on the review page and under the Data Alerts page. This alert will no longer appear if the information is corrected or a field-level note is entered in column D.

Figure 15: Form 4

OTHER NEWBORN

Line 2 Other Newborn: To enter a newborn screening test that is not available under the Core RUSP list in Line 1, click the “Add” button and enter the name of the test. For each test entered in Line 2, please enter the corresponding individual numbers in columns A through D. In order to remove a program, please click the corresponding “Remove” button under the Action column.

OLDER CHILDREN & WOMEN

Line 3 Older Children and Women: To enter a screening program for older children and women, click the “Add” button and enter the name of the test. For each test entered in Line 3, please enter the corresponding individual numbers in columns A through D. In order to remove a program, please click the corresponding “Remove” button under the Action column.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportPlease note that the data alert applicable to Lines 1 and 2 regarding the number referred for treatment (column D) being less than the number of confirmed cases (column C) does not apply to Line 3.

LONG-TERM FOLLOW-UP

Line 4: This is a required field. Long-term follow-up (follow-up beyond referring an infant for treatment) varies based on State policy and practice. Please describe your State’s practice for monitoring infants with confirmed diagnoses, including what information is obtained and for how long infants are monitored.

FORM 5: COUNT OF INDIVIDUALS SERVED BY TITLE V & TOTAL PERCENTAGE OF POPULATIONS SERVED BY TITLE V

Data collection for Form 5a and Form 5b are combined under Form 5.

There will no longer be separate Form-level notes for Form 5a and Form 5b. There will now only be one Form-level note for “Form 5.”

The purpose of Form 5a and Form 5b is two-fold:

Form 5a, Count of Individuals Served by Title V, enables States to track and report on the number of individuals who were served by the Title V program within the top two levels (direct services and enabling services) of the MCH Pyramid.

Form 5b, Total Percentage of Populations Served by Title V, enables States to track and report on the total percentage who received a Title V-supported service within all three levels of the MCH Pyramid (direct services, enabling services, and public health services and systems).

Since States began to report Title V program participant data in the 1990’s, MCH programs have seen a shift in the delivery of services from direct primary care MCH services to public health and preventive services within well-coordinated and comprehensive systems of care that are designed for the MCH population. This shift has resulted in a need for more complete reporting of individuals served by Title V, which goes beyond an unduplicated count of individuals served (often derived from reimbursement data or individual client records for MCH direct and enabling services).

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportIt is recognized that precisely quantifying the number of individuals reached through the administration or promotion of population-based services and systems (e.g., injury prevention and education, regionalized systems of perinatal care, newborn screening programs) is difficult, and informed estimates are often required. Relying only on reimbursement data or individual client program records supported by Title V, however, can lead to serious underestimates of the number of individuals in a State who actually received and benefitted from a Title V-supported service. For this reason, Form 5b was developed to better capture the full “reach” of the State’s Title V program in serving its MCH population.

Forms 5a and 5b are designed for States to complete the information from the FY 2020 Annual Report year. This Annual Report year is not editable.


Please note: Partial Saving has been implemented in Form 5. Partial Saving is explained under the section ‘Form Navigation’ in this document.

FORM 5A: COUNT OF INDIVIDUALS SERVED BY TITLE V

Column A: Title V Total Served: States should report an unduplicated number of the individuals served by Title V in each of the listed MCH population groups: Pregnant Women, Infants < 1 Year of Age, Children 1 through 21 Years of Age, Children with Special Health Care Needs, and Others.

Line 3a, Children with Special Health Care Needs 0 through 21 Years of Age is a subset of Lines 2 and 3, Infants < 1 Year of Age and Children 1 through 21 Years of Age. The number entered in Line 3a must be less than the sum of the numbers entered in Lines 2 and 3 and in addition, must be greater than zero. If the amount entered in Line 3a equals the sum of the amounts entered in Lines 2 and 3, a field-level note must be provided to explain why the values are equal.

Enter the best possible estimate for an unduplicated count of individuals served by the Title V program across the top two levels (i.e., Direct Services and Enabling Services) of the MCH Pyramid, regardless of the primary source of coverage. These services would include all individuals served by total dollars reported on Form 2, Line 8. The system will calculate the Total row for Title V Total Served by the sum of the values entered in each of the MCH population groups.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportA field-level note is required for each population group (Pregnant Women, Infants < 1 Year of Age, Children 1 through 21 Years of Age, Children with Special Health Care Needs 0 through 21 Years of Age, and Others) for Column A Title V Total Served. The field-level note should include all methods, data sources, and included services/programs used to obtain the amounts for each population group.

Columns B through F: Primary Source of Coverage: Report the percentages of individuals who were served by Title V within the listed classes and their primary source of coverage. These counts may be estimates. If individuals are covered by more than one source, the primary source of coverage should be reported. The sum of the values entered in columns B through F for each row must equal 100%. For any population group in which a zero was indicted in the Total Served field, the corresponding columns B through F will be disabled and are not required.

Reference Data that provides insurance breakdowns may be used to determine the numbers entered in the Primary Source of Coverage fields. In order to view this, please click on “Form 5a Reference Data” link towards the lower, left of the Form 5a table on the Form 5 page.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 5B: TOTAL PERCENTAGE OF POPULATIONS SERVED BY TITLE V

States should report an estimate for the total percentage of populations who received a Title V-supported service in each of the listed MCH population groups across all levels of the MCH Pyramid, including public health services and systems.

Column 1: Populations Served by Title V: Displays the five population groups served by Title V.

Column 2: Reference Data: For each population group, the reference data of the State/Jurisdiction will be displayed.

For Jurisdictions, ”Not Available” might be displayed for the population group “Children with Special Health Care Needs 0 through 21 Years of Age.”

Column 3: Use Reference Data?: The ability to select Yes or No will be available. Selecting Yes or No will be required.

Column 4: Denominator: If Yes is selected under the Use Reference Data column, the reference data value for the respective population will be populated under the Denominator column. The value would be display only. If No is selected under the Use Reference Data column, the cell for the respective population under the Denominator column will be editable and a value will be required. The Denominator value must be greater than zero. Children with Special Health Care Needs 0 through 21 Years of Age Denominator must not be greater than the sum of the Denominators of Infants < 1 Year and Children 1 through 21 years of age.

For Jurisdictions (Children with Special Health Care Needs 0 through 21 Years of Age ONLY), if Yes is selected under the Use Reference Data column, “Not Available” might be displayed under the Denominator column. The Not Available would be display only.

Column 5: Total % Served: Enter the best possible estimate for a total percentage of each population group served by the Title V program across all levels of the MCH Pyramid (i.e. direct services, enabling services, and public health services and systems). The numbers must be between 0 and 100 (values with one decimal place will be accepted). However, the number entered in Line 3a, Children with Special Health Care Needs 0 through 21 Years of Age must be greater than zero.

Column 6: Form 5b Count (Calculated): The values in the respective fields shall be auto-calculated by multiplying the Denominator value by the corresponding Total % Served value. Form 5b Count (Calculated) of Children with Special Health Care Needs 0 through 21 Years of Age must not be greater than the sum of Form 5b Count (Calculated) of Infants < 1 Year of Age and the Form 5b Count (Calculated) of Children 1 through 21 years of age.

For Jurisdictions, Form 5b Count (Calculated) field for Children with Special Health Care

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Needs 0 through 21 Years of Age will be display only and blank if ”Yes” was chosen under “Use Reference Data?” and if the Denominator value was Not Available.

Column 7: Form 5a Count: The cells under this column will display the respective population values from the Form 5a Title V Total Served column. The values will be synchronized where a change to either the Form 5a Count value in the Form 5b Table or the Form 5a Title V Total Served value in the Form 5a Table will change both fields. Form 5a Count must be lesser than or equal to Form 5b Count (calculated).

A field-level note is required for each population group (Pregnant Women, Infants < 1 Year of Age, Children 1 through 21 Years of Age, Children with Special Health Care Needs 0 through 21 Years of Age, and Others). The field-level note should include all methods, data sources, and included services/programs used to obtain the percentages for each population group.

Reference Data and corresponding data source references can be viewed by clicking on “Form 5b Reference Data” link towards the lower, left of the Form 5a table on the Form 5 page.

Data Alerts: Form 5 includes two data alerts. These data alerts will be Data Warnings where they will remain even if a field-level note is entered.

a. If Form 5a Count is greater than or equal to 90% of Form 5b Count (calculated), a Data Alert will be triggered and displayed.

b. If Form 5b Total % Served for Others is greater than or equal to 50%, a Data Alert will be triggered and displayed.

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FORM 6: DELIVERIES AND INFANTS SERVED BY TITLE V AND ENTITLED TO BENEFITS UNDER TITLE XIX

It is recognized that there will be overlap between the reported totals for “Title V Served” and “Eligible for Title XIX,” due to an individual’s changing insurance eligibility status during the course of a year (i.e., “churning”). Form 6 asks for all individuals who are served by Title V and an estimate of the individuals in the State who are eligible for Title XIX.

The form does not ask for a report on those individuals served by Title V who are also eligible for Title XIX. Form 6 is designed for States to complete the information from the FY 2020 Annual Report year. This Annual Report year is not editable.


FORM 6: SECTION I, UNDUPLICATED COUNT BY RACE/ETHNICITY

Line 1. Total Deliveries in State: Enter the number of total deliveries in the State for race/ethnicity listed in columns B through I. The system will calculate the amount in column A, Total with the sum of the numbers entered in columns B through I.

Line 1. Title V Served (Total Deliveries in State): Enter the number of Title V Served total deliveries in State for race/ethnicity listed in columns B through I. The system will calculate the amount in column A, Total with the sum of the numbers entered in columns B through I.

Line 1. Eligible for Title XIX (Total Deliveries in State): Enter the number of Eligible for Title XIX total deliveries in State for race/ethnicity listed in columns B through I. The system will calculate the amount in column A, Total with the sum of the numbers entered in columns B through I.

Line 2. Total Infants in State: Enter the number of total infants in the State for race/ethnicity listed in columns B through I. The system will calculate the amount in column A, Total with the sum of the numbers entered in columns B through I.

Please note: The Total Infants in State under Column A is expected to be within 10% (+ or -) of the Total Births by Occurrence reported in Form 4. A data validation will be triggered if there is a greater than a 10% difference, requesting that a note be provided to explain the discrepancy.

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Line 2. Title V Served (Total Infants in State): Enter the number of Title V Served total infants in State for race/ethnicity listed in columns B through I. The system will calculate the amount in column A, Total with the sum of the numbers entered in columns B through I.

Line 2. Eligible for Title XIX (Total Infants in State): Enter the number of Eligible for Title XIX total infants in State for race/ethnicity listed in columns B through I. The system will calculate the amount in column A, Total with the sum of the numbers entered in columns B through I.

FORM 7: STATE MCH TOLL-FREE TELEPHONE AND OTHER APPROPRIATE METHODS DATA

All fields marked with a red asterisk (*) indicate a required field. Please enter a value even if it is zero.

FORM 7: APPLICATION YEAR

FORM 7: SECTION A

Form 7, Section A requires that States complete Lines 1 through 4 for the Application Year and Lines 1 through 5 for the Annual Report year.

HRSA understands that some States do not use a toll-free hotline. For these States, a checkbox will be displayed on the form where States can check and opt out of completing section A. This opt out checkbox will only be available for States that may not have a toll-free hotline.

Line 1: Enter your State’s Primary MCH Toll-Free “Hotline” Telephone Number. If this number has an extension, you may enter the extension in the field provided.

Line 2: Enter the name of your State’s Primary MCH Toll-Free “Hotline.”

Line 3: Enter your State’s Name of the Contact Person for the State’s MCH “Hotline.” This is the individual who should be contacted with any concerns about the State’s primary toll-free MCH “Hotline.”

Line 4: Enter your State’s Contact Person’s Telephone Number. If this number has an extension, you may enter the extension in the field provided.

FORM 7: SECTION B

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportForm 7, Section B for the Application year is an optional section. States can complete any or all Lines 1, 3, and 5.

Line 1: Enter your State’s Other Toll-Free “Hotline” Names. Each name entered should be separated by a comma.

Line 3: Enter your State’s Title V Program Website Address.

Line 5: Enter your State’s Title V Social Media Websites. Each website entered should be separated by a comma.

FORM 7: REPORTING YEAR

FORM 7: SECTION A

Line 1: Enter your State’s Primary MCH Toll-Free “Hotline” Telephone Number. If this number has an extension, you may enter the extension in the field provided.

Line 2: Enter the name of your State’s Primary MCH Toll-Free “Hotline.”

Line 3: Enter your State’s Name of the Contact Person for the State’s MCH “Hotline.” This is the individual who should be contacted with any concerns about the State’s primary toll-free MCH “Hotline.”

Line 4: Enter your State’s Contact Person’s Telephone Number. If this number has an extension, you may enter the extension in the field provided.

Line 5: Enter the Number of Calls Received on the State’s MCH “Hotline” during the Annual Report year. Please note that this field will only accept numeric values and no text.

FORM 7: SECTION B

Form 7, Section B for the Annual Report year is an optional section; however, if States answer Line 1, then Line 2 will become required; If States answer Line 3, then Line 4 will become required and; If States answer Line 5, then Line 6 will become required.

Line 1: Enter your State’s Other Toll-Free “Hotline” Names. Each name entered should be separated by a comma.

Line 2: Enter the Number of Hits to your State’s Other Toll-Free “Hotlines.” This number should be an aggregate number for all the “Hotlines” entered in Line 1. Please note that this field will only accept numeric values and no text.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportLine 3: Enter your State’s Title V Program Website Address.

Line 4: Enter the Number of Hits to your State’s Title V Program Website entered in Line 3. Please note that this field will only accept numeric values and no text.

Line 5: Enter your State’s Title V Social Media Websites. Each website entered should be separated by a comma.

Line 6: Enter the Number of Hits to your State’s Title V Social Media Websites. This number should be an aggregate number for all the websites entered in Line 5. Please note that this field will only accept numeric values and no text.

FORM 8: STATE MCH AND CSHCN DIRECTORS CONTACT INFORMATION

All fields marked with a red asterisk (*) indicate a required field.

Line 1: Enter the information for your State’s Title V Maternal and Child Health (MCH) Director.

Line 2: Enter the information for your State’s Title V Children with Special Health Care Needs (CSHCN) Director.

Line 3: Enter the information for your State’s Family or Youth Leader. This line is optional, but if you choose to provide this information, you are required to complete all the information.

FORM 9: LIST OF MCH PRIORITY NEEDS

Priority needs will be pre-populated from the previous application/annual report.

States must list at least seven priority needs, and no more than ten.

For each priority need, indicate whether it is a new priority need for this five-year reporting cycle, if it is being continued from the previous five-year cycle, or if the need is a revised version of a need from the previous five-year cycle.

Note: The order of the priority needs in Form 9 from top to bottom is not meant to indicate a priority order.

All priority needs entered in Form 9 will be available for selection in the State Action Plan Table.

In order to add a priority need, click the “Add” button. Enter the priority need and indicate the type (new, revised, or continued) in the pop up window. Enter the Action Note. Click the Save Changes button to complete adding the priority need. Figure 17 will illustrate the ‘Add’ feature to add a new priority need for Form 9.

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States may edit a priority need to revise and/or delete a priority need, if needed. States may add a new priority need as long as not all ten needs have been identified. Please note that the system will require an Action Note to edit, delete, or add a priority need. Please note that the Action Note is saved to the system action history and will not be accessible after clicking “Save Changes.”

Please only edit a need to change the wording or update the Priority Need Type. Do not use the Edit feature to change the meaning of the need. To Edit a need, click “Edit” to the left of the need in the form. Click the “Edit” button in the Edit Priority Need box that is displayed. States may then edit the need. In order to save this change, please enter an Action Note explaining why the need was edited in the note field provided.

Note: Action Notes will not appear in the Print Version. If you want the explanation for editing or adding a priority need to appear in the Print Version, you should provide the explanation in the note field for that specific priority need.

Deleting a need will delete the need from Form 9, and this need will automatically be deleted from the entry in the State Action Plan (SAP) table. To delete a need, click “Edit” to the left of the need in the form. Click the “Delete” button in the Edit Priority Need box that is displayed. Please enter a note explaining why the need is being deleted and click “Save Changes.” Please confirm that you intend to delete the need by clicking “Ok” in the delete confirmation box that is displayed. Depending on whether deleting the need resulted in less than seven priority needs listed, an additional need may be required. Figure 16 will illustrate the ‘Edit’ and ‘Delete’ features for a priority need in Form 9.

Figure 16: Edit Priority Need

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Figure 17: Add Priority Need

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FORM 10: NATIONAL PERFORMANCE MEASURES (NPM)

FORM 10: NPM LIST PAGE & DETAIL SHEETS

States were required to select/continue at least five NPMs and select/continue up to 15 NPMs into the new needs assessment reporting cycle in the FY 2021 Application/FY 2019 Annual Report. Even if States wanted to keep the same NPMs as they had in the past, they had to select these NPMs to continue into the new needs assessment reporting cycle.

The options to continue/ not continue/select NPMs are being extended in the FY 2022 Application/FY 2020 Annual Report.

The requirements and validations to select at least five NPMs and one unique NPM per population domain are still valid.

Form 10 NPMs list page will not be accessible until Form 9 is complete. States need to define their priority needs before they select their measures.

State Selected NPMs under the 2016-2020 Needs Assessment Reporting Cycle and chosen to ‘Continue’ under the 2021-2025 will be displayed in the list page in a table under the header 2021-2025 National Performance Measures (Figure 18). There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘Yes’ button will be pre-selected for the measures in this table. Selecting No will move the measure to the ‘2016-2020 National Performance Measures’ table (Figure 19). If new NPMs that were selected in the FY 2021 Application/FY 2019 Annual Report, Continue Reporting in 2021-2025? column will display NA.

State Selected NPMs under the 2016-2020 Needs Assessment Reporting Cycle and chosen to ‘Not Continue’ under the 2021-2025 will be displayed in the list page in a table under the header 2016-2020 National Performance Measures (Figure 19). There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘No’ button will be pre-selected for the measures in this table. Selecting Yes will move the measure to the ‘2021-2025 National Performance Measures’ table (Figure 18).

When moving an NPM from 2016-2020 National Performance Measures table to 2021-2025 National Performance Measures table, all associated ESMs will be displayed in the ‘ESMs - Pending Assignment to a Needs Assessment Reporting Cycle’ table in the Form 10 ESMs list page and a functionality to continue or not continue these ESMs will be available for the State under the Continue Reporting in 2021-2025? column. When moving an NPM from 2016-2020 National Performance Measures table to 2021-2025 National Performance Measures table, all

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual Reportassociated ESMs will be moved to the ‘2016-2020 ESMs’ table and a functionality to continue these measures will not be available for the State under the Continue Reporting in 2021-2025? column.

Figure 18: NPMs – 2021-2025 National Performance Measures

Figure 19: 2016-2020 NPMs

Detail Sheets are available for each measure. States may click ‘View’ under the Detail Sheet column corresponding to each measure on the NPM list page.

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Figure 20: Form 10 NPM Detail Sheet Example

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 10 NPMS: MANAGE NATIONAL PERFORMANCE MEASURES (NPMS)/SELECT NATIONAL PERFORMANCE MEASURES (NPMS)To select new NPMs or update the pre-defined population domain selections States previously selected for NPMs under multiple domains, please click the “Manage NPMs” button towards the upper, right of the Form 10 List of NPMs page.

The Manage NPM page will display a table listing each NPM, its associated population domain(s), whether the measure was selected in the previous cycle and whether the measure has been selected yet in the current cycle.

Figure 21: Manage NPMs Page

To select or update population domain selections for any NPM, click the corresponding “Manage” button under the Action column. The Select NPM page will appear and display the NPM number, NPM title, and its associated population domain(s). After making the population domain selections, if needed (selecting/updating population domains for multi-domain measures will be discussed in further detail below in this section), click the “Select Measure” button to select the measure. After selecting the measure, click the “Return to Manage NPMs” button towards the bottom, left of the page to continue selecting/updating NPMs.

Please note: The Manage button will NOT be displayed for NPMs under the following two conditions:

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NPMs that were previously selected in 2016-2020 cycle and are NOT continuing in the 2021-2025 cycle

Non-multi-domain NPMs that were previously selected in the2016-2020 cycle and are continuing in the 2021-2025 cycle (NPM 1, 2, 3, 4, 5,6, 7, 8, 9, 10, 13.1, and 14.1).

Figure 22: Form 10 Select NPMs Page

After a NPM is selected, States will have the ability to unselect the measure, if needed. To do so, from the Select NPM page, click the “Unselect Measure” button.

Figure 23: Form 10 Select NPMs Page – Unselect Measure

NPMs #7, #8, #13 and #14 (.1 and .2 NPMs)When selecting NPM #7, NPM #8, NPM #13 or NPM #14, States would need to select the NPM by part (i.e. NPM #7.1, NPM #13.2, etc.). To select both parts of the measure (.1/.2), they must be selected individually

Multi-domain measures - Ability to select as a new measure for FY 2021 Application/FY 2019 Annual Report:

NPM 11: Children with Special Health Care Needs will be pre-selected and not editable. Child Health and Adolescent Health check boxes will be enabled for select/unselect.

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NPM 12: Children with Special Health Care Needs will be pre-selected and not editable. Adolescent Health check box will be enabled for select/unselect.

NPM 13.2: Child Health and Adolescent Health check boxes will be enabled for select/unselect.

NPM 14.2: Child Health and Adolescent Health check boxes will be enabled for select/unselect.

NPM 15: Child Health, Adolescent Health, and Children with Special Health Care Needs check boxes will be enabled for select/unselect.

Multi-domain measures – Ability to make changes in predefined population domains:

NPM 11 – Children with Special Health Care Needs will be pre-selected and not editable. Child and/or Adolescent Health domain will be pre-selected if these domains were selected for NPM 11 in the FY 2020 Application/FY 2018 Annual Report. States will have the ability to select/unselect the Child Health and Adolescent Health domains.

NPM 12 - Children with Special Health Care Needs will be pre-selected and not editable. Adolescent Health domain will be pre-selected if this domain was selected for NPM 12 in the FY 2020 Application/FY 2018 Annual Report. States will have the ability to select/unselect the Adolescent Health domain.

NPM 13.2 – Child Health and/or Adolescent Health domain will be pre-selected if these domains were selected for NPM 13.2 in the FY 2020 Application/FY 2018 Annual Report. States will have the ability to select/unselect these domains.

NPM 14.2 - Child Health and/or Adolescent Health domain will be pre-selected if these domains were selected for NPM 13.2 in the FY 2020 Application/FY 2018 Annual Report. States will have the ability to select/unselect these domains.

NPM 15 - Child Health and/or Adolescent Health and/or Children with Special Health Care Needs domain will be pre-selected if these domains were selected for NPM 15 in the FY 2020 Application/FY 2018 Annual Report. States will have the ability to select/unselect these domains.

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FORM 10: NPM FEDERALLY AVAILABLE DATA (FAD)In an effort to reduce State burden and facilitate analysis, annual performance data (indicator/numerator/denominator and stratifier data) for the NPMs will be provided, as available, to the States for their use in analyzing data and determining objectives for measures.

To view the Federally Available Data for a NPM, click “View” under the Federally Available Data column corresponding to the measure NPM list page.

Figure 24: Form 10 NPM FAD Display Page Example

If FAD for a specific measure is not available for your State, the system will display the following message:

Federally Available Data (FAD) for this measure is not available/reportable for your State.

FORM 10: NPM DATA ENTRY

To access the NPM Data Entry form, click the title of the measure on the Form 10 List of NPMs page.

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FORM 10: NPM ANNUAL INDICATOR REPORTING

FEDERALLY AVAILABLE DATAThe most recent Federal data will be displayed in a tabular format (if the data is available for the State). If the data comes from more than one data source, a separate table will be displayed for each data source (as available). For NPMs selected by the State in previous years, 2016 - 2020 reporting years data will be displayed. For the National Survey of Children’s Health data, data from the 2017 - 2020 reporting years will be displayed. If a NPM was newly selected last year, only the most recent data for the 2019 and 2020 reporting years will be displayed.

The data displayed will consist of the following fields.

Annual Indicator Numerator Denominator Data Source Data Source Year

These fields will not be editable.

The table’s reporting year may be different from the year in the data source field. The data source year indicates the most recent year’s data available at the time of the reporting year.

Please Note: The Annual Objective field displayed in the table does not come from Federal data. This data is pre-populated from past Applications/Annual reports if the NPM was selected in previous years. However, if a NPM is newly selected this year, the Annual Objective field will be blank.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 25: Form 10 NPMs – FAD tables for Federal Data Available measures – Example 1:

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 26: Form 10 NPMs – FAD table for Federal Data Available measures – Example 2 (Newly Selected Measure in FY 2021 Application/FY 2019 Annual Report):

Figure 27: Form 10 NPMs – FAD table for NSCH measures – Example 1

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STATE PROVIDED DATA

For NPMs selected by the State in previous years, the 2016 - 2020 reporting years State provided data tables will be displayed. If a NPM is newly selected last year, the 2019 and 2020 reporting years’ State Provided Data will be displayed.

If Federal data are available for a measure and State, States will have the option to provide their own data. To enter State data, click the checkbox in the State Provided Data table to open up the fields for editing.

If Federal data are not available for a measure and State, the checkbox is automatically checked and disabled, and States are required to enter the data. Providing State Data will consist of entering data in the following fields:

Annual Indicator Numerator Denominator Data Source Data Source Year Provisional or Final

Please Note: The Annual Objective field displayed in the table is pre-populated from past Applications/Annual Reports if the NPM was selected in previous years. However, if a NPM is newly selected this year, the Annual Objective field will be blank.

Because all NPMs are either percentage or rate measures, either the annual indicator or the numerator and denominator are required. For percentage measures, the annual indicator must be between 0 and 100. For rate measures, the annual indicator must be between 0 and 1,000 (for rate of 1,000), 0 and 10,000 (for rate of 10,000), or 0 and 100,000 (for rate of 100,000).

Figure 28: Form 10 NPMs - State Provided Data Table for NPMs Previously Selected

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Figure 29: Form 10 NPMs - State Provided Data Table for NPMs Newly Selected in FY 2021 Application/FY 2019 Annual Report:

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 10: NPM ANNUAL OBJECTIVESPlease note: Annual Objectives will not be collected for NPMs assigned to the 2016-2020 needs assessment reporting cycle.

For each NPM, States must enter annual objectives through 2026. Depending on whether the NPM was selected in a previous year, annual objectives from previous years will be pre-populated, but may be edited.

If the NPM is a percentage, the annual objective must be between 0 and 100. If the NPM is a rate, the annual objective must be between 0 and the number of units for the specific rate.

FORM 10: NATIONAL OUTCOME MEASURES (NOM)

Data for NOMs will be prepopulated, where possible. States do not provide performance objectives for NOMs.

The List of National Outcome Measures page will display all of the outcome measures by number and title.

FORM 10: NOM DETAIL SHEETS

Detail sheets are available for each measure. States may click “View” under the Detail Sheet column corresponding to each measure on the NOM list page.

Figure 30: Form 10 NOM Detail Sheet Example

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FORM 10: NOM FEDERALLY AVAILABLE DATA (FAD)

In an effort to reduce State burden, MCHB will pre-populate the NOMs from national data sources, as available, to assist the States in preparing the yearly Title V MCH Block Grant Applications/Annual Reports.

To view the Federally Available Data (FAD) for a measure, click “View” under the FAD column corresponding to the measure on the NOM List page.

Figure 31: Form 10a NOM FAD Display Page Example

If FAD for a specific measure is not available for your State, the system will display the following message:

Federally Available Data (FAD) for this measure is not available/reportable for your State.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 10: NOM DATA ENTRY

States should enter data for all NOMs but are required to complete the NOM Data Entry form only for the NOMs that are linked to their selected NPMs. Please see the following scenarios in regards to entering data for a NOM:

When FAD is available for your State for a specific measure:o States are provided the multi-year data and have a link to view additional FAD.o States are not required to add provisional data.o States may provide provisional data. If “Provide Provisional Data” has been

clicked, the fields (Annual Indicator, Numerator, Denominator, Data Source and the Data Source Year) become required.

Figure 32: NOM Data Entry Page - FAD Available

When FAD is not available for your State for a specific measure:o The State- provided data (Annual Indicator, Numerator, Denominator, Data

Source, and the Data Source Year) are required by default if a linked NPM for this measure is selected.

o If data is not available, click “Data Not Available” to opt out of entering data.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 33: NOM Data Entry Page - FAD Not Available

Even though States are not required to enter data if they check the “Data Not Available” checkbox, States will receive a data alert if all scenarios below exists:

FAD is not available for the State, and A State has selected an NPM that is linked to the NOM, and States do not provide any data or click “Data Not Available.”

FORM 10: STATE PERFORMANCE MEASURES (SPM)

FORM 10 SPMS: LIST PAGE

Form 10, State Performance Measures, will list each SPM that was created in Form 10 SPMs. This will display SPMs that are newly created this year and SPMs that were created in previous years.

Form 10 SPMs list page will not be accessible until Form 9 is complete. States need to define their priority needs before they select their measures.

SPMs newly created/continued in the 2021-2025 Needs Assessment Reporting Cycle will be displayed in the list page in a table under the header 2021-2025 State Performance Measures (Figure 34). There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘Yes’ button will be pre-selected for the measures under this table. Selecting ‘No’ will move the measure to the ‘2016-2020 State Performance Measures’ table (Figure 35). This column will display ‘NA’ for the new measures created in the 2021-2025 Needs Assessment Reporting Cycle.

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If your State retained any SPMs in the 2016-2020 Needs Assessment Reporting Cycle by not moving them to the new Needs Assessment Reporting Cycle, then those SPMs will be displayed in a table under the header 2016-2020 State Performance Measures. There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘No’ button will be pre-selected for the measures under this table. Selecting ‘Yes’ will move the measure to the ‘2021-2025 State Performance Measures’ table.

FORM 10 SPMS: RENUMBER MEASURESStates will have the ability to renumber the measures continued/created under the 2021- 2025 needs assessment reporting cycle if they have more than one SPM under the 2021-2025 needs assessment reporting cycle. Figure 36 and Figure 37 will provide details on how renumbering of SPMs works.

Figure 34: 2021-2025 State Performance Measures:

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 35: 2016-2020 State Performance Measures:

Figure 36: Renumber SPMs - 1

Click on the Renumber Measures button:

Figure 37: Renumber SPMs – 2

Use the up/down arrows under the Move column to move and renumber the measures. Click on the Save button to save the changes.

Please note: The up arrow in the first row and down arrow in the last row will not perform any action.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 10: CREATING NEW SPMS

To address State priorities not addressed by the National Performance Measures, States created State Performance Measures (SPMs) and established performance objectives for each of the measures (in Form 10, State Performance Measures (SPMs)).

In previous years, States were required to create at least three and no more than five SPMs. This rule changed in the FY 2019 Application/FY 2017 Annual Report. Creating SPMs are optional. There is no minimum or maximum number of SPMs a State may create.

All SPMs created during the previous Application/Annual Reports are displayed on the Form 10 List of SPMs page.

States may create new SPMs under the 2021-2025 needs assessment reporting cycle, if needed. To create a SPM, click the “Add New” button on the Form 10 SPM List Page, and enter the following information:

Measure Title: This is a required field. Please enter the Measure Title. The character limit for this field is 250 characters.

Population Domain(s): Please select which Population Domain the measure is linked to. States may choose one or more Population Domains. However, if Cross-Cutting/Systems Building is selected, no other Population Domain may be selected.

Goal: This is a required field. Please enter the Goal. The character limit for this field is 250 characters.

Unit Type: This is a required field. Please select the unit type for the measure. Only one unit type may be selected.

Unit Number: Depending on the unit type selected, please select the unit number. For a percentage, ratio or text measure, the system will automatically calculate the unit number. For a rate measure, please select 1,000, 10,000, or 100,000. For a scale measure, please define the value for scale in the field provided, the field will allow up to 4 numeric characters. For a count measure, please define the value for count in the field provided, the field will allow up to 7 numeric characters.

Numerator: This is a required field. Please enter the Numerator. The character limit for this field is 250 characters. If the measure is a text or a unit type where the numerator is not applicable, enter “NA” in the numerator field.

Denominator: This is a required field. Please enter the Denominator. The character limit for this field is 250 characters.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFor text and count measures, since the denominator is not applicable, the denominator field will be grayed out and will not be open for data entry.

Healthy People 2030 Objective: This is not a required field. However, States may enter into the Health People 2030 Objective field, and the character limit for this field is 1,000 characters.

Data Sources and Data Issues: This is a required field. Please enter the Data Sources and Data Issues. The character limit for this field is 2,000 characters.

Significance: This is a required field. Please enter the Significance. The character limit for this field is 2,000 characters.

To access the SPM Data Entry form, click the title of the measure on the Form 10 List of State Performance Measures (SPMs) page.

FORM 10: SPM DATA ENTRYFORM 10: SPM ANNUAL INDICATOR REPORTING

States must enter indicator data for all SPMs created in previous years. Previously entered indicator data will be pre-populated, but may be edited. For SPMs newly created during this Application/Annual Report year (FY 2022 Application/FY 2020 Annual Report), indicator data will be optional and not required until the 2022 reporting year. Indicator data consists of the following:

Annual IndicatorNumeratorDenominatorData SourceData Source YearProvisional or Final

Please Note: The Annual Objective field will be pre-populated if the SPM was created in a previous year.

Based on the unit type and number entered on the detail sheet for the SPM, the Annual Indicator, Numerator, and Denominator fields may have specific conditions.

For percentage, rate, and ratio measures , either the annual indicator or the numerator and denominator are required. For percentage measures, the annual indicator must be between 0 and 100. For rate measures, the annual indicator must be between 0 and 1,000, 0 and 10,000, or 0 and 100,000 based on the number selected when creating the rate measure. For ratio measures, the annual indicator must be between 0 and 2,000.

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For scale measures , the annual indicator is not available. States will only be required to enter a numerator. The numerator must be between 0 and the unit number entered on the detail sheet. The denominator will be pre-populated with the unit number entered on the detail sheet.

For text measures , the annual indicator requires a selection or yes or no. The numerator and denominator will not be available.

For count measures , the annual indicator must be between 0 and the unit number entered on the detail sheet. The numerator and denominator will not be available.

FORM 10: SPM ANNUAL OBJECTIVESPlease note: Annual Objectives will not be collected for SPMs assigned to 2016-2020 needs assessment reporting cycle.

For each SPM, States must enter annual objectives through 2026. Depending on whether the SPM was created this year or in a previous year, annual objectives from previous years will be pre-populated, but may be edited.

Based on the unit type and number selected for the SPM, the annual objectives must be within that specific range.

For percentage measures , the annual objectives must be between 0 and 100. For rate measures , the annual objectives must be between 0 and 1,000, 0 and 10,000, or

0 and 100,000 based on the number selected when creating the rate measure. For ratio measures , the annual objectives must be between 0 and 2,000. For text measures , the annual objective must specify yes or no. For count or scale measures , the annual objective must be between 0 and the number

entered when creating the measure.

FORM 10: SPM DATA ENTRY - INACTIVATING THE MEASURE

States may choose to inactivate a SPM on the data entry page. To mark a SPM as inactive, please follow the steps below:

Check the box next to the “Inactivate Measure” button. Select a reason for inactivating the measure (Completed, Replaced, Other). If other is

selected, please enter a reason. Enter the required indicator data and click “Next” to save the information.

Please note: Future year Annual Objectives will not be collected if the SPM is marked as Inactive.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFor measures which were marked as Inactive during the current Application/Annual Report year, States may reactivate the measure by going to the Form 10 SPMs page, and clicking “Reactivate” under the Measure Status column. For measures that have been reactivated, States will be required to click on the measure title, and enter/edit the Annual Objectives.

The ablity to inactivate SPMs is disabled for the FY 2022 Application/FY 2020 Annual Report.

FORM 10: STATE OUTCOME MEASURES (SOM)Form 10 State Outcome Measures will list each SOM that was created in Form 10 SOMs. This will display SOMs that are newly created this year and SOMs that were created in previous years.

Form 10 SOMs list page will not be accessible until Form 9 is complete. States need to define their priority needs before they select their measures.

SOMs newly created/contintued in the 2021-2025 Needs Assessment Reporting Cycle will be displayed in the list page in a table under the header 2021-2025 State Outcome Measures (Figure 38). There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘Yes’ button will be pre-selected for the measures under this table. Selecting ‘No’ will move the measure to the ‘2016-2020 State Outcome Measures’ table (Figure 39). This column will display ‘NA’ for the new measures created in 2021-2025 Needs Assessment Reporting Cycle.

If your State retained any SOMs in the 2016-2020 Needs Assessment Reporting Cycle by not moving them to the new Needs Assessment Reporting Cycle, then those SOMs will be displayed in a table under the header 2016-2020 State Outcome Measures. There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘No’ button will be pre-selected for the measures under this table. Selecting ‘Yes’ will move the measure to the ‘2021-2025 State Outcome Measures’ table.

FORM 10 SOMS: RENUMBER MEASURESStates will have the ability to renumber the measures continued/created under the 2021- 2025 needs assessment reporting cycle if they have more than one SOM under the 2021-2025 needs assessment reporting cycle. Figure 40 and Figure 41 will provide details on how renumbering of SOMs works.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 38: 2021-2025 State Outcome Measures:

Figure 39: 2016-2020 State Outcome Measures

Figure 40: Renumber SOMs – 1

Click on the Renumber Measures button:

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 41: Renumber SOMs – 2

Use the up/down arrows under the Move column to move and renumber the measures. Click on Save button to save the changes.

Please note: The up arrow in first row and down arrow in the last row will not perform any action.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 10: CREATING NEW SOMSStates are able to create (although not required) one or more State Outcome Measures (SOMs) based on its MCH priorities, provided that none of the NOMs address the same priority area. If SOMs were created for previous years, States established performance objectives for each of the measures (in Form 10 State Outcome Measures (SOMs)).

There is no limit on the number of SOMs a State can create.

All SOMs created during the previous Application/Annual Reports are displayed on Form 10 List of SOMs page.

States may create new SOMs, under the 2021-2025 needs assessment reporting cycle if needed. To create a SOM, click the “Add New” button on the Form 10 SOM List Page, and enter the same information as described under Form 10 State Performance Measures Creating New SPMs section.

FORM 10: SOM DATA ENTRY

To access the SOM Data Entry form, click the title of the measure on the Form 10 List of State Outcome Measures (SOMs) page.

FORM 10: SOM ANNUAL INDICATOR REPORTING

States must enter indicator data for all SOMs created in previous years. Previously entered indicator data will be pre-populated, but may be edited. For SOMs newly created during this Application/Annual Report year (FY 2022 Application/FY 2020 Annual Report), indicator data will be optional and not required until the 2022 reporting year. Indicator data consists of the following:


Please Note: The Annual Objective field will be pre-populated if the SOM was created in a previous year.

Based on the unit type and number entered on the detail sheet for the SOM, the Annual Indicator, Numerator and Denominator fields may have specific conditions.

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For percentage, rate and ratio measures , either the annual indicator or the numerator and denominator are required. For percentage measures, the annual indicator must be between 0 and 100. For rate measures, the annual indicator must be between 0 and 1,000, 0 and 10,000, or 0 and 100,000 based on the number selected when creating the rate measure. For ratio measures, the annual indicator must be between 0 and 2,000.




FORM 10: SOM ANNUAL OBJECTIVESPlease note: Annual Objectives will not be collected for SOMs assigned to 2016-2020 needs assessment reporting cycle.For each SOM, States must enter annual objectives through 2026. Depending on whether the SOM was created this year or in a previous year, annual objectives from previous years will be pre-populated, but may be edited.

Based on the unit type and number selected for the SOM, the annual objectives must be within that specific range.




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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFORM 10: SOM DATA ENTRY - INACTIVATING THE MEASURE

States may choose to inactivate a SOM on the data entry page. To mark a SOM as inactive, please follow the steps below:

Check the box next to the “Inactivate Measure” button. Select a reason for inactivating the measure (Completed, Replaced, Other). If “Other” is


Please note: Future year Annual Objectives will not be collected if the SOM is marked as Inactive.

For measures which were marked as Inactive during the current Application/Annual Report year, States may reactivate the measure by going to the Form 10 SOMs page, and clicking “Reactivate” under the Measure Status column. For measures that have been reactivated, States will be required to click on the measure title, and enter/edit the Annual Objectives.

The ablity to inactivate SOMs is disabled for the FY2022 Application/FY2020 Annual Report.

FORM 10: EVIDENCE-BASED OR -INFORMED STRATEGY MEASURES (ESM)

Form 10, Evidence-Based or –Informed Strategy Measures, will list each ESM that was created in Form 10 ESMs.

When moving an NPM from 2016-2020 National Performance Measures table to 2021-2025 National Performance Measures table, all associated ESMs will be displayed in the ‘ESMs - Pending Assignment to a Needs Assessment Reporting Cycle’ table in the Form 10 ESMs list page and a functionality to continue or not continue these ESMs will be available for the State under the Continue Reporting in 2021-2025? column. When moving an NPM from 2016-2020 National Performance Measures table to 2021-2025 National Performance Measures table, all associated ESMs will be moved to the ‘2016-2020 ESMs’ table and a functionality to continue these measures will not be available for the State under the Continue Reporting in 2021-2025? column.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportESMs newly created/contintued in the 2021-2025 Needs Assessment Reporting Cycle will be displayed in the list page in a table under the header 2021-2025 Evidence-Based or –Informed Strategy Measures (Figure 42). There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘Yes’ button will be pre-selected for the measures under this table. Selecting ‘No’ will move the measure to the ‘2016-2020 Evidence-Based or –Informed Strategy Measures table (Figure 43). This column will display ‘NA’ for the new measures created in 2021-2025 Needs Assessment Reporting Cycle.

If your State retained any ESMs in the 2016-2020 Needs Assessment Reporting Cycle by not moving them to the new Needs Assessment Reporting Cycle, then those ESMs will be displayed in a table under the header 2016-2020 Evidence-Based or –Informed Strategy Measures. There will be a column titled Continue Reporting in 2021-2025? in this table which will display two radio buttons called ‘Yes’ and ‘No’. ‘No’ button will be pre-selected for the measures under this table. Selecting ‘Yes’ will move the measure to the ‘2021-2025 Evidence-Based or –Informed Strategy Measures ’ table.

FORM 10 ESMS: RENUMBER MEASURESStates will have the ability to renumber the measures continued/created under the 2021- 2025 needs assessment reporting cycle if they have more than one ESM for at least one NPM under the 2021-2025 needs assessment reporting cycle. This ability will be enabled only when all the ESMs have been assigned to a needs assessment reporting cycle. Figure 44, Figure 45, and Figure 46 will provide details on how renumbering of ESMs works.

Figure 42: 2021-2025 ESMs

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Figure 43: 2016-2020 ESMs

Figure 44: Renumber ESMs – 1

Click on the Renumber Measures button.


Select an NPM from the drop-down to renumber the ESMs linked to that NPM:

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Use the up/down arrows under the Move column to move and renumber the measures. Click on Save button to save the changes.

Please note: The up arrow in first row and down arrow in the last row will not perform any action.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportCREATING NEW ESMSTo address each National Performance Measure selected by the State, States created Evidence Based or –Informed Strategy Measures (ESMs) and established performance objectives for each of the measures (in Form 10: Evidence-Based or -Informed Strategy Measures (ESMs)).

States are required to have at least one active ESM for each of the National Performance Measures selected by the State. For NPMs split into two parts (NPM 7.1/7.2, NPM 8.1/8.2, NPM 13.1/13.2/ and NPM 14.1/14.2), at least one ESM must be assigned to each part. There is no maximum number of ESMs a State can create.

All ESMs created are displayed on Form 10 List of ESMs page. States are able to create new ESMs this year, if needed under the 2021-2025 needs assessment reporting cycle. To create an ESM, click the “Add New” button on the Form 10 ESMs List page, and enter the following information:

Measure Title: This is a required field. Please enter the Measure Title. The character limit for this field is 250 characters.

National Performance Measure: This is a required selection. Please select the National Performance Measure for which this ESM links. Only the NPMs selected by your State will be available for selection.

ESM Subgroup(s) (if relevant): This is an optional field. However, States may choose one or more ESM subgroup(s). Assigning ESM Subgroups is only applicable for ESMs linked to the following NPMs:

NPM 7.1 NPM 7.2 NPM 8.1 NPM 8.2 NPM 11 NPM 12 NPM 13 NPM 14 NPM 15

Goal: This is a required field. Please enter the Goal. The character limit for this field is 250 characters.

Unit Type: This is a required field. Please select the unit type for the measure. Only one unit type may be selected.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportUnit Number: Depending on the unit type selected, please select the unit number. For a percentage, ratio or text measure, the system will automatically calculate the unit number. For a rate measure, please select 1,000, 10,000, or 100,000. For a scale measure, please define the value for scale in the field provided, the field will allow up to 4 numeric characters. For a count measure, please define the value for count in the field provided, the field will allow up to 7 numeric characters.

Numerator: This is a required field. Please enter the Numerator. The character limit for this field is 250 characters. If the measure is a text or a unit type where the numerator is not applicable, enter “NA” in the numerator field.

Denominator: This is a required field. Please enter the Denominator. The character limit for this field is 250 characters. If the unit type is text or count, the denominator field will be grayed out and will not be available for data entry.

Data Sources and Data Issues: This is a required field. Please enter the Data Sources and Data Issues. The character limit for this field is 2,000 characters.

Evidence-based/informed strategy: This is a required field. Please enter the Evidence-based/informed strategy. The character limit for this field is 2,000 characters.

Significance: This is a required field. Please enter the Significance. The character limit for this field is 2,000 characters.

FORM 10: ESM DATA ENTRY

To access the ESM Data Entry form, click the title of the measure on the Form 10 List of Evidence-Based or –Informed Strategy Measures (ESMs) page.

FORM 10: ESM ANNUAL INDICATOR REPORTING

States must enter indicator data for all ESMs created in previous years. Previously entered indicator data will be pre-populated, but may be edited. For ESMs newly created during this Application/Annual Report year (FY 2022 Application/FY 2020 Annual Report), indicator data will be optional and not required until the 2022 reporting year. Indicator data consists of the following:


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Please Note: The Annual Objective field will be pre-populated if the ESM was created in a previous year.

Based on the unit type and number entered on the detail sheet for the ESM, the Annual Indicator, Numerator, and Denominator fields may have specific conditions.

For percentage, rate, and ratio measures , either the annual indicator or the numerator and denominator are required. For percentage measures, the annual indicator must be between 0 and 100. For rate measures, the annual indicator must be between 0 and 1,000, 0 and 10,000, or 0 and 100,000 based on the number selected when creating the rate measure. For ratio measures, the annual indicator must be between 0 and 2,000.




FORM 10: ESM ANNUAL OBJECTIVES

Please note: Annual Objectives will not be collected for ESMs assigned to 2016-2020 needs assessment reporting cycle. For each ESM, States must enter annual objectives through 2026. Depending on whether the ESM was created this year or in a previous year, annual objectives from previous years will be pre-populated, but may be edited.

Based on the unit type and number selected for the ESM, the annual objectives must be within that specific range.




FORM 10: ESM DATA ENTRY - INACTIVATING THE MEASURE

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportStates may choose to inactivate an ESM on the data entry page. To mark an ESM as inactive, please follow the steps below:

Check the box next to the “Inactivate Measure” button. Select a reason for inactivating the measure (Completed, Replaced, Other). If “Other” is


Please note: Future year Annual Objectives will not be collected if the ESM is marked as Inactive.

For measures which were marked as Inactive during the current Application/Annual Report year, States may reactivate the measure by going to the Form 10 ESMs page, and clicking “Reactivate” under the Measure Status column. For measures that have been reactivated, States will be required to click on the measure title, and enter/edit the Annual Objectives.

For the Needs Assessment submission year, the ablity to inactivate ESMs is disabled for the FY2022 Application/FY2020 Annual Report.

FORM 11: OTHER STATE DATA

The purpose of Form 11 is to make available other State data for infant mortality, low birth weight, and MCH workforce outlined in the Title V legislation. The data are available for download in an Excel spreadsheet for your review via a link in Form 11. No data entry is required in Form 11.

FORM 12: MCH DATA ACCESS AND LINKAGES

This form provides information on the State Title V Program’s capacity for consistently accessing electronic health data to support planning, monitoring, and evaluation on a timely basis. Please complete all data cells for the reporting year. All cells, except as noted in the instructions below, are required fields for completion of this form. A form note can be added for the form, and a field note can be added for each row in TVIS.

There are eight rows in the Form 12 Data Entry Table for which the data entry is mandatory (except for column F). The eight rows are:

1) Vital Records Birth2) Vital Records Death3) Medicaid4) WIC5) Newborn Bloodspot Screening6) Newborn Hearing Screening 7) Hospital Discharge

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8) PRAMS or PRAMS-like

Column (A): Access - State Title V Program has Consistent Annual Access to Data Source: Rows 1 through 8: There will be two radio buttons called Yes and No displayed for selection. Selecting an option is required for Form 12 to be complete.

Column (B): Access - State Title V Program has Access to an Electronic Data Source: Rows 1 through 8: There will be two radio buttons called Yes and No displayed for selection. Selecting an option is required for Form 12 to be complete.

Column (C): Access – Describe Periodicity: Rows 1 through 8: The following options will be displayed in a drop-down titled Select Periodicity.

Daily More often than Monthly Monthly Quarterly Semi-Annually Annually Less Often than Annually Never

Selecting an option is required for Form 12 to be complete.

Column (D): Access - Indicate Lag Length for Most Timely Data Available in Number of Months: Rows 1 through 8: The data entry field for Column (D) will be enabled only when Column (C) data entry is complete for a row. If ‘Never’ is the option chosen under Column (C), then Column (D) will show ‘NA’ by default. If any other option than ‘Never’ is chosen under Column (C), then Column (D) will be open for data entry and a text box with up and down scroll buttons will be displayed. The data entered should be any value between 0 and 60 to indicate the Number of Months. Only integer values can be entered. The value can also be chosen by using the up and down scroll buttons.

Column (E): Linkages - Data Source is Linked to Vital Records Birth: Rows 1 through 8: For Row 1, the data entry will be disabled for this column. For rest of the rows, there will be two radio buttons called Yes and No displayed for selection. Selecting an option is required for Form 12 to be complete.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportColumn (F): Linkages – Data Source is Linked to Another Data Source (Optional): Rows 1 through 8: The data entry for this column is optional and not required for Form 12 to be complete. To Add a Data Source name, click on the Add/Edit button displayed in the row. A pop-up will be displayed (Figure 48). Type the name of the Data Source in the text box provided and click on the Add button. The added Data Source name will be displayed under the title List of Linked Data Source(s) in a text box. The Data Source name can be edited in this text box at any time. The Data Source name can be removed anytime by clicking on the remove icon/button displayed next to the text box. This pop-up will display an OK button and Cancel button at the bottom. Upon clicking OK, the added Data Source name will be added in the respective row.

The character limit for each Data Source name is 60 and there is no limit to the number of Data Source names that can be added for a row.

Other Data Source(s) (Optional):

To add a Data Source not listed in the first 8 rows, users will have to click the Add button available in the information text displayed under the Other Data Source(s) (Optional) section (Figure 49). Adding other data source details is optional.

Upon clicking the Add button, a row will be added to the table displayed in this section. A text box will be displayed under the Data Sources column for the users to enter a Data Source name. The character limit for the Data Source name is 60. The added Data Source name can be edited at anytime in the text box. Once a row is added, entering a data source name and data entry for columns A through E are required for Form 12 to be complete. Column (F) is optional. Data entry is similar to the first 8 rows.

There will be an additional column displayed in the Other Data Source(s) table called Action. This Action column will display a remove/trash icon and move up/move down arrows. Upon clicking the remove/trash icon, the added row can be removed. The move up/move down arrows shall be used to move the added rows up and down. The up arrow in first row and down arrow in the last row will not perform any action.

Please note: Partial Saving has been implemented in Form 12. Partial Saving is explained under the section ‘Form Navigation’ in this document.

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Figure 47: Form 12

Figure 48: Linkages – Data Source is Linked to Another Data Source (Optional)

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 49: Other Data Sources (Optional)

STATE ACTION PLAN TABLE

Please note: Before beginning to work on the State Action Plan (SAP) table, ensure that all Priority Needs in Form 9 are updated, new NPMs are selected, and State measures are created as needed and assigned to the appropriate population domain(s). The SAP table will not be accessible until Form 9 and NPM selections are complete. Any changes to the Priority Needs, NPM selections, and State measures (including inactivating measures) will change the SAP table entries, and in some cases, remove the entire SAP table entry.

The Five-year SAP table is intended to serve as a working tool for States in developing an Action Plan that addresses the state and national MCH priorities identified through the Five-year Needs Assessment process.

To access the SAP table section, click the SAP table link from the TVIS Main Menu.

The SAP table is divided into separate tabs for each population domain. States must add entries to each of the population domains.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 50: State Action Plan Table

There are two methods to add an entry under each tab.

Method #1: Add an entry from scratchTo add an entry, click the “Add” button towards the upper, right of each page. States will then have the option to select a Priority Need and/or a NPM, SPM, or SOM. States are required to add at least one objective and one strategy to each entry, but may add as many as needed. The character limit for each objective and strategy is 1,000 characters. If the entry includes a NPM, the linked NOMs and ESMs that are assigned or added to the 2021-2025 needs assessment reporting cycle will be automatically pre-populated in the entry.

Please note: Form 10 NPMs, SPMs, and SOMs that are assigned or added to the 2021-2025 needs assessment reporting cycle will be available for selection while adding an entry.

Method #2: Add an entry by copying objectives and strategies from a previous entryIf the MCHB format was used by the State last year, States may copy over all objectives and strategies from an entry entered last year into a new entry for this year. To do so, please follow the steps below:

Click the “Copy” button towards the upper, right corner of the page. A list of all entries under all population domains will appear. Click the expand icon to the right of an entry. Click the “Copy” button on the expanded entry. The add entry page will appear, and all objectives and strategies from the copied entry

will be pre-populated. States may choose to edit/delete a copied-over objective and/or strategy or add additional objectives and/or strategies to the entry.

Please note that priority needs and/or measures will not be copied over, and these will need to be added to the entry.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportPlease note the following rules when adding measures to an entry:

If a NPM is added to an entry, no SPM or SOM may be added to that same entry. If a SPM is added to an entry, no NPM or SOM may be added to that same entry. If a SOM is added to an entry, no NPM or SPM may be added to that same entry.

For an entry to be complete, it must include one of the following combinations:

One Priority Need and one National Performance Measure, at least one strategy, and at least one objective.

One Priority Need and one State Performance Measure, at least one strategy, and at least one objective.

One Priority Need and one State Outcome Measure, at least one strategy, and at least one objective.

One Priority Need, at least one strategy, and at least one objective (as long as the priority need is linked to a NPM or SPM in at least one other entry).

One National Performance Measure, at least one strategy, and at least one objective. One State Performance Measure, at least one strategy, and at least one objective. One State Outcome Measure, at least one strategy, and at least one objective.

In order to complete the entire SAP table, the following validations must be resolved:

All Priority Needs in Form 9 must be represented in the entire SAP table. All priority needs entered in Form 9 must be linked to a NPM or SPM in at least one

entry. All NPMs selected in Form 10 NPMs must be represented under the respective

population domains. All active SPMs created in form 10 SPMs must be represented at least once in the entire

SAP table. All active SOMs (if any) created in Form 10 SOMs must be represented at least once in

the entire SAP table.

Users will have the option to edit an entry or delete an entry, if needed:

To edit an entry, click the “Edit” button to the left of an entry listing. To delete an entry, click the “Edit” button, and click “Delete” towards the bottom, left of

the page.

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STATE NARRATIVE

The State Narrative consists of several required sections. To access the State Narrative, click the State Narrative Main Menu from the TVIS Main Menu.

NARRATIVE SECTIONS

The table below displays all the sections and sub-sections in the State Narrative. All header sections are shaded in gray. The columns to the right of each section/sub-section indicates whether it is a required section, the file format required, and the character/page limits. Required sections are also noted with a red asterisks in the system.

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Section Required Section?

File Format Character/Page Limit

I. General Requirements No (header) N/A N/AI.A. Letter of Transmittal Yes Image Upload N/AI.B. Face Sheet No N/A N/AI.C. Assurance and Certifications Yes N/A N/AI.D. Table of Contents No N/A N/A

II. Logic Model No (header) N/A N/AIII. Components of the Application/Annual Report No (header) N/A N/A

III.A. Executive Summary No (header) N/A N/AIII.A.1. Program Overview Yes Word Upload 5 PagesIII.A.2. How Federal Title V Funds Complement State-Supported MCH Efforts

Yes Word Upload 1 Page

III.A.3. MCH Success Story Yes Word Upload 1 PageIII.B. Overview of the State Yes Word Upload 45,000

III.C. Needs Assessment Update Yes Word Upload 30,000 III.D. Financial Narrative No (header) N/A N/A

III.D.1. Expenditures Yes Word Upload 15,000III.D.2. Budget Yes Word Upload 15,000

III.C. Five-Year State Action Plan No (header) N/A N/AIII.E.1. Five-Year State Action Plan Table No (header) N/A N/AIII.E.2. State Action Plan Narrative Overview

No (header) N/A N/A

III.E.2.a. State Title V Program Purpose and Design

Yes Word Upload 25,000

III.E.2.b. State MCH Capacity to Advance Effective Public Health Systems

No (header) N/A N/A

III.E.2.b.i. MCH Workforce Development


III.E.2.b.ii. Family Partnership Yes Word Upload 25,000III.E.2.b.iii. MCH Data Capacity No (header) N/A N/A

III.E.2.b.iii.a. MCH Epidemiology Workforce


III.E.2.b.iii.b. State Systems Development Initiative (SSDI)


III.E.2.b.iii.c. Other MCH Data Capacity Efforts


III.E.2.b.iv. MCH Emergency Planning and Preparedness.

15,000

III.E.2.b.v. Health Care Delivery System

No (header) N/A N/A

III.E.2.b.v.a. Public and Private Partnerships


III.E.2.b.v.b. Title V MCH – Title XIX Medicaid Inter-Agency Agreement (IAA)


III.E.2.c. State Action Plan Narrative by Domain

No (header) N/A N/A

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Section Required Section?

File Format Character/Page Limit

State Action Plan Introduction

No (Optional) Word Upload Shared character limit of 450,000Women/Maternal Health

Annual ReportYes Word Upload

Women/Maternal Health Application Year

Yes Word Upload

Perinatal/Infant Health Annual Report

Yes Word Upload

Perinatal/Infant Health Application Year

Yes Word Upload

Child Health Annual Report Yes Word UploadChild Health Application Year Yes Word UploadAdolescent Health Annual Report

Yes Word Upload

Adolescent Health Application Year

Yes Word Upload

CSHCN Annual Report Yes Word UploadCSHCN Application Year Yes Word UploadCross-cutting/Systems Building Annual Report

No (optional) Word Upload

Cross-cutting/Systems Building Application Year

No (optional) Word Upload

III.D. Public Input Yes Word Upload 15,000III.E. Technical Assistance Yes Word Upload 15,000

IV. Title V-Medicaid IAA/MOU Yes PDF Upload N/AV. Supporting Documents No (optional) PDF Upload N/A

VI. Organizational Chart Yes PDF Upload N/A

WORD UPLOAD DOCUMENTS

Word upload narrative sections will display a corresponding “Upload” button under the Action column. Only files with a .doc or .docx extension may be uploaded. To upload a document, please following the steps below:

Click the corresponding “Upload” button under the Action column for the specific section.

Locate and select the Word document on your computer from the “Choose File to Upload” popup window.

Click the “Open” button. Click “Ok” to the confirmation message that the section content has been uploaded

successfully.

Please note: Each subsequent Word upload to a specific section will overwrite the previously uploaded document content. You will see the filename of the uploaded document below the

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportView and Upload buttons.

Each Word document must contain at least 25 characters. If the Word document does not contain at least 25 characters, a message will be displayed, and the document will not be uploaded.

CHARACTER COUNT/PAGE COUNT

All Word upload narrative sections will display the characters remaining out of the characters allotted below each section/sub-section title. For each document, please check the character count prior to uploading the document. To do so, please click “Review” in the Word menu, and click “Word Count.” Make note of the characters (with spaces) to ensure that this is not higher than the characters allotted for the section/sub-section. If the number of characters in the Word document exceed the number of characters allotted for a narrative section, the system will not accept the document, and a message will be displayed indicating the characters in the document exceed the characters allotted.

The three subsections under Section III.A. Executive Summary have page limits instead of character limits. A page counter will be displayed below each section title instead of a character counter. If the number of pages in the Word document exceed the number of pages allotted for a narrative section, the system will not accept the document, and a message will be displayed indicating that the document exceeds the page limit allotted. Users will have to reduce/truncate the document to fall within the page limit and then upload the document.

Figure 51: Characters/Pages Remaining

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportVIEW DOCUMENTS

Once a Word document has been uploaded or a file has been uploaded in the Letter of Transmittal, Title V-Medicaid IAA/MOU, Supporting Documents, and Organizational Chart sections, States may view the uploaded file/document by clicking the corresponding “View” button under the Action column for the respective section. Word documents may also be downloaded by clicking “Download File” in the upper right corner of the view content. Please note: The “View” button will only be enabled once a document/file has been uploaded.

Narrative "View” functionality was enhanced during the FY 2020 Application/FY 2018 Annual Report year and a warning notification was added to display if TVIS detects content in your Word document that exceeds the 1-inch margin. This notification will not prevent you from submitting, but it is advisable to use the enhanced “View” functionality and if any content is overlapping the ”simulated” 1 inch margin, there is a high chance the content will get cutoff in the print version. When this happens, you should revise your Word document and upload again.

Note: Even if you do not see the notification, you are strongly encouraged to use the ‘View’ to double-check your content.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportVIEW LAST YEAR’S CONTENT

For some of the Word upload narrative sections/sub-sections, States may view the content that they provided last year. This feature is only available for sections/sub-sections that were mapped to a sections/sub-sections in last year’s State Narrative. To view last year’s content, please click the corresponding “View Last Year’s Content” button under the Last Year’s Content column for the respective section. States may also download this content by clicking “Download File” in the upper right corner of the content.

Please note: View Last Year’s Content will not be available for the sub-sections under III.C. Five Year Needs Assessment Summary since this year is the beginning of the new needs assessment reporting cycle.

Figure 52: View and View Last Year’s Content

PDF AND/OR IMAGE UPLOAD SECTIONS

SECTION I.A: LETTER OF TRANSMITTAL The Letter of Transmittal must be uploaded as a scanned image file to this section. The following image file formats are allowed: TIFF, JPG, PNG, and GIF. If your State is requesting a waiver of a 30 percent allotment, the required documentation must be included in the Letter of Transmittal.

To convert a Letter of Transmittal in PDF to a supported uploaded format, please follow the steps below:

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1. Take a screen print of your image (using SnagIt, Snipping Tool, Print Screen (from your keyboard) etc.).

2. Copy the image into a Microsoft Paint document.3. Save the Paint document with a PNG extension.

Please note: Special characters (i.e., &, ‘, $, etc.) in the filename will prevent the file from being uploaded. Please make sure to remove any special characters from the filename.

To upload a the Letter of Transmittal, click “Modify” under the Action column to the right of the Letter of Transmittal section on the State Narrative Main Menu.

Upon arriving at the Letter of Transmittal page, follow the steps below: Click the “Select File” button. Locate and select the file on your computer from the “Choose File to Upload” popup

window. Click the “Open” button. Click the “Upload File” button.

Once the file is uploaded, States may view the uploaded file or delete the uploaded file. The date and time (Eastern Time) that the file was uploaded is also displayed.

SECTION IV: TITLE V-MEDICAID IAA/MOU

The Title V-Medicaid IAA/MOU must be in a PDF format.

To upload a the Title V-Medicaid IAA/MOU, click “Modify” under the Action column to the right of the Title V-Medicaid IAA/MOU section on the State Narrative Main Menu. Upon arriving at the Title V-Medicaid IAA/MOU page, follow the steps below:

Click the “Select File” button. Locate and select the file on your computer from the “Choose File to Upload” popup

window. Click the “Open” button. Click the “Upload File” button.


SECTION V: SUPPORTING DOCUMENTS

The Supporting Documents is an optional section which allows States to upload up to five attachments. All attachments must be in a PDF format. Each file uploaded may not exceed 10 megabytes.

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To upload a supporting document, click “Modify” under the Action column to the right of the Supporting Documents section on the State Narrative Main Menu. Upon arriving at the Supporting Document page, follow the steps below:

Click the “Upload” button. Locate and select the file on your computer from the “Choose File to Upload” popup

window. Click the “Open” button.

Each attachment will be displayed in the order that it was uploaded. The date and time (Eastern Time) that the file was uploaded will be displayed. States may move an attachment up or down using the appropriate arrows under the corresponding Move column to reorder the files.

Once the file is uploaded, States may view the uploaded file or delete the uploaded file by clicking on the appropriate icon under the corresponding Action column.

Figure 53: Supporting Documents Page

SECTION VI: ORGANIZATIONAL CHART

The Organizational Chart must be in a PDF format.

To upload the Organizational Chart, click “Modify” under the Action column to the right of the Organizational Chart section on the State Narrative Main Menu. Upon arriving at the Organizational Chart page, follow the steps below:

Click the “Select File” button.

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Locate and select the file on your computer from the “Choose File to Upload” popup window.

Click the “Open” button. Click the “Upload File” button.


508 ACCESSIBILITYStates should reach out to their internal department to determine if they have standards, recommendations, and guidance for creating accessible Word documents prior to uploading the Word documents into the TVIS. However, some best practices for making documents 508 compliant are discussed below.Section 508 requires Federal agencies to ensure that individuals with disabilities have access to and use of information technology that is comparable to that provided to individuals without disabilities. Assistive technology (AT) is used by individuals to help them understand electronic information.Word versions 2010 and later allow users to check the accessibility of a document. To do so, follow the steps below:

Click “File” Click “Check for Issues” under the Inspect Document section. Click “Check Accessibility”

Any errors, warnings, and tips will be displayed.

Errors: content that is very difficult or impossible for people with disabilities to understand.

Warnings: content that is challenging for people with disabilities to understand. Tips: content that people with disabilities can understand, however, could be better

organized or presented to improve their experience.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 54: Accessibility Checker Results

There are many requirements that go into creating accessible Word documents. All instructional documents and full checklists can be accessed by visiting https://section508.gov/best-practices . However, these instructions will discuss some best practices in preventing some of the most commonly triggered accessibility errors.

Some of the best practices for making documents 508 compliant are as follows: Use Styles to Create Headings Use Built-in Features to Create Lists Use Built-in Features to Create Data Tables Create Accessible Images and Other Objects Create Unambiguous Names for Links Use of Text to Accompany Color

In general, all fonts used in Word documents should be set to:

At least 12 point size A sans serif font, such as Arial, Tahoma, or Verdana Serif font, such as Cambria, should not be used as they have small decorative lines

added as embellishments and when magnified, appear blocky.

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https://www.section508.gov/content/build/create-accessible-documents

TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportUSE STYLES TO CREATE HEADINGS

Headings are used to break-up content and make finding information easier. AT cannot infer meaning from just formatting (such as bold or underlined text). Styles create a structure that AT can quickly access.

To use Styles to create headings, follow the steps below:

Under the Home tab, locate the “Styles” option. Click on the style you want and then type your heading, OR Type your heading and then click on the style you want to use.

Please use different Header Styles (Heading 1, Heading 2, etc.) to indicate different header levels within the document.

Figure 55: Word Header Menu

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportUSE BUILT-IN FEATURES TO CREATE LISTS

Lists are used to break-up and simplify content. AT cannot infer meaning from just formatting (by use of dashes and tabs). Using built-in list features creates a structure that AT can identify.

To use the built-in list features, follow the steps below:

Under the Home tab, locate the “Paragraphs” option. Click on the list feature you want and then type your list item, OR Type your list item and then click on the list you want to use.

Figure 56: Word Lists Menu

USE BUILT-IN FEATURES TO CREATE DATA TABLES

Tables create a structure that AT can use to read information in the correct order (left to right then top to bottom). When creating tables in the document, please use the built-in table feature rather than creating the appearance of a table by using tabs or spaces. Images of tables cannot be made accessible . Keep data tables simple (use one row of column headers and no merged or split cells).

To use the built-in table feature, follow the steps below:

Under the Insert tab, click the “Table” icon, and select “insert a Table” from the drop-down.

Insert the number of columns and rows you need for your data table. Only type headers into the first row and identify the header row. Select the first row, right click, and select “Table Properties.” Under the Row tab, check the box next to “Repeat as Header row at top of each page,”

and click “Ok.”

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Figure 57: Word Insert Table Feature

In addition, Alt-Text is needed for all tables. To add Alt-Text to images, please follow the steps below:

Right click on the table, and select “Table Properties.” Click the tab titled “Alt Text.” Enter information that states the purpose and/or function of the table in both the Title

and Description fields.

CREATE ACCESSIBLE IMAGES AND OTHER OBJECTS

AT cannot infer meaning from images and other objects. Images and other objects include pictures, images of text, images of tables, shapes, icons with hyperlinks, etc. Therefore, Alt-Text is needed for all images.

To add Alt-Text to images, please follow the steps below:

Right click on the image, and select “Format Picture. “ A Format Picture menu should appear. Click the icon for “Layout and Properties.” Select the “Alt Text,” and enter information that states the purpose and/or function of

the object (in about 250 characters or less) in both the Title and Description fields.

Figure 58: Word Format Picture – Entering Alt Test

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportCREATE UNAMBIGUOUS NAMES FOR LINKS

It is important to provide unambiguous names or context for links that describe the destination, function, or purpose so that AT can correctly identify information.

Examples of Unambiguous Links http://google.com https://health.maryland.gov/pages/index.aspx Maryland Department of Health Website

Example of Ambiguous Links

Our State Website Go to our state website by clicking here

USE OF TEST TO ACCOMPANY COLOR

Do not rely on color-coding alone. The meaning of color cannot be detected by AT. Create text that duplicates the meaning of the color.

Figure 59: Example of Using Test to Accompany Color

PRINT VERSION

The Print Version allows States to view and print a copy of their Application/Annual report. This version will display all of the information entered in the TVIS.

In order to generate the print version, click the “Print Version” link under the left-side menu. The Print Version Generation page will appear. Click the “Generate New Print Version” button to begin the generation process. Based on your content, the print version generation process may take up to 10 or 15 minutes. Please note: Once the generation process begins, you may not navigate to other sections in the TVIS until the generation process is complete.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 60: Genetate New Print Version

Once the process is complete, a link to the PDF along with the date and time for which it was generated will appear on the screen, and it will be ready for download.

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Figure 61: Download Print Version

Figure 62: Print Version

PRINTING THE PRINT VERSION

When printing the print version, be sure to open it up in Adobe Reader. If your default view is PDF Viewer, you will have to change it to Adobe Reader. Ensure that “Fit” is selected under Page Sizing and Handling and “Auto portrait/landscape” is selected under Orientation.

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportFigure 63: Printing the Print Version

Within the print version, States may download their State Action Plan table by going to section III.E.1. The following two links appear:

State Action Plan Table – Data Entry View State Action Plan Table – Legal Size Paper View

Please note: If printing the Legal Size Paper View, please make sure to select “Legal” as the paper size in your print properties/options.

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Figure 64: Printing the Legal Size State Action Plan Table

ADDITIONAL RESOURCES

For additional assistance, please contact the following for specific types of questions:

HRSA Call [email protected]

Contact the HRSA Call Center for the following types of assistance: User Accounts/Registration Username/Password resets Accessing the TVIS User Access/User Privileges Budget Information in the Applications (Sections A-C) SF-424

TVIS Support [email protected]

Contact the TVIS Support Team for the following types of assistance: Form Errors

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mailto:[email protected]



Narrative/State Action Plan Errors TVIS Defects TVIS Main Menu/Form Status Checker TVIS Navigation

HRSA Project Officer and MCHB Programmatic [email protected]

Contact your HRSA Project Officer for the following types of assistance: Grant Assistance Programmatic Questions

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TVIS INSTRUCTIONS FY 2022 Application/FY 2020 Annual ReportAPPENDIX

The following table displays all the possible validation messages for forms 2, 3a, 3b, 4, 5a, 5b, and 6. These forms contain many possible validations, the list below is a comprehensive list of all these validations. This list only includes data validations. This list does not contain messages for required fields. The columns show the form for which the validation applies, the section of the form, the type of validation, and the message. A shading legend is provided above the tables.

LIST OF POSSIBLE VALIDATION ERRORS

The following table displays all the possible validation errors for forms 2, 3a, 3b, 4, 5a, 5b, and 6. These must be addressed in order to submit the TVIS.

Data Error: These are errors that must be corrected in order to remove.

Data Error: These are errors that either must be corrected or must have a field-level note added to remove the error.

Form Section Type ValidationForm 2 Application

Budgeted Data Error Must correct or enter a field-level note to remove

Line 1A, Preventive and Primary Care for Children, Application Budgeted is less than 30% of the Federal Allocation, Application Budgeted. Please correct or add a field-level note indicating that a waiver is being requested.

Form 2 Application Budgeted

Data Error Must correct or enter a field-level note to remove

Line 1B, Children with Special Health Care Needs, Application Budgeted is less than 30% of the Federal Allocation, Application Budgeted. Please correct or add a field-level note indicating that a waiver is being requested.


Data ErrorMust correct to remove

Line 1C, Title V Administrative Costs, Application Budgeted is greater than 10% of the Federal Allocation, Application Budgeted. Please correct.



The sum of the budgeted amounts for Line 1A, Preventive and Primary Care for Children, Line 1B, Children with Special Health Care Needs, and Line 1C, Title V Administrative Costs, is greater than Line 1, Federal Allocation. Please correct.

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Form Section Type ValidationForm 2 Application

BudgetedData ErrorMust correct to remove

The value in Line 7, Total State Match, Application Budgeted is less than 75% of the value in Line 1, Federal Allocation, Application Budgeted. Please correct.



The value in Line 7, Total State Match, Application Budgeted is less than State’s 1989 Maintenance of Effort Amount. Please correct.

Form 2 Annual Report Expended

Data ErrorMust correct or enter a field-level note to remove

The value in Line 1A, Preventive and Primary Care for Children, Annual Report Expended is less than 30% of the Federal Allocation, Annual Report Expended. Please correct or add a field-level note indicating the reason for the discrepancy.



The value in Line 1B, Children with Special Health Care Needs, Annual Report Expended is less than 30% of the Federal Allocation, Annual Report Expended. Please correct or add a field-level note indicating the reason for the discrepancy.



The value in Line 1C, Title V Administrative Costs, Annual Report Expended is greater than 10% of the Federal Allocation, Annual Report Expended. Please correct or add a field-level note indicating the reason for the discrepancy.



The sum of the annual report expended amounts for Line 1A, Preventive and Primary Care for Children, Line 1B, Children with Special Health Care Needs, and Line 1C, Title V Administrative Costs, is greater than Line 1, Federal Allocation, Annual Report Expended. Please correct.



The value in Line 7, Total State Match, Annual Report Expended is less than 75% of the value in Line 1, Federal Allocation, Annual Report Expended. Please correct or add a field-level note indicating the reason for the discrepancy.


Data ErrorMust correct or enter a field-

The value in Line 7, Total State Match, Annual Report Expended is less than State’s 1989 Maintenance of Effort Amount. Please

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Form Section Type Validationlevel note to remove

correct or add a field-level note indicating the reason for the discrepancy.

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Form Section Type ValidationForm 3a Application

BudgetedData ErrorMust correct or enter a field-level note to remove

Children 1 through 21 Years, Application Budgeted does not equal Form 2, Line 1A, Preventive and Primary Care for Children, Application Budgeted. Please correct or add a field-level note indicating the reason for the discrepancy.

Form 3a Application Budgeted


CSHCN, Application Budgeted does not equal Form 2, Line 1B, Children with Special Health Care Needs, Application Budgeted. Please correct or add a field-level note indicating the reason for the discrepancy.

Form 3a Annual Report Expended


Children 1 through 21 Years, Annual Report Expended does not equal Form 2, Line 1A, Preventive and Primary Care for Children, Annual Report Expended. Please correct or add a field-level note indicating the reason for the discrepancy.



CSHCN, Annual Report Expended does not equal Form 2, Line 1B, Children with Special Health Care Needs, Annual Report Expended. Please correct or add a field-level note indicating the reason for the discrepancy.

Form 3a Application Budgeted


Federal Total of Individuals Served, Application Budgeted is not equal to Form 2 Line 1, Federal Allocation <value> less Line 1C, Title V Administrative Costs <Value>, Application Budgeted. Please correct.



Federal Total of Individuals Served, Annual Report Expended is not equal to Form 2 Line 1, Federal Allocation <value> less Line 1C, Title V Administrative Costs <Value>, Annual Report Expended. Please correct.

Form 3b Application Budgeted


Federal Total, Application Budgeted does not equal Form 2 Line 1, Federal Allocation, Application Budgeted. Please correct.

Form 3b Annual Report Expended


Federal Direct Services Line 4 Total, Annual Report Expended must equal the value in Line 1, Direct Services Annual Report Expended field. Please correct.

Form 3b Annual Report Expended

Data ErrorMust correct to

Federal Total, Annual Report Expended does not equal Form 2 Line 1, Federal Allocation,

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Form Section Type Validationremove Annual Report Expended. Please correct.

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Form Section Type ValidationForm 3b Annual Report

ExpendedData ErrorMust correct to remove

Non-Federal Direct Services Line 4 Total, Annual Report Expended must equal the value in Line 1, Direct Services Annual Report Expended field. Please correct.

Form 4 Newborn Data ErrorMust correct to remove

Aggregate Total Number Receiving at Least One Valid Screen (Column A) is greater than Total Births by Occurrence. Please correct.

Form 4 Newborn Data Error Must correct or enter a field-level note to remove

Aggregate Total Number of Out-of-Range Results (Column B) is equal to Aggregate Total Number Receiving at Least One Valid Screen (Column A). Please correct or enter a field-level note to explain.


Aggregate Total Number of Out-of-Range Results (Column B) is greater than Aggregate Total Number Receiving at Least One Valid Screen (Column A). Please correct.


Aggregate Total Number Confirmed Cases (Column C) is greater than AggregateTotal Number of Out-of-Range Results (Column B). Please correct.


Aggregate Total Number Referred for Treatment (Column D) is greater than Aggregate Total Number Confirmed Cases (Column C). Please correct.

Form 4 Other Newborn and Older Children & Women


Total Number Receiving at Least One Screen (Column A) is greater than Total Births by Occurrence. Please correct.



Total Number Presumptive Positive Screens (Column B) is equal to Total Number Receiving at Least One Screen (Column A). Please correct or enter a field-level note to explain.



Total Number Presumptive Positive Screens (Column B) is greater than Total Number Receiving at Least One Screen (Column A). Please correct.



Total Number Confirmed Cases (Column C) is greater than Total Number Presumptive Positive Screens (Column B). Please correct.

Form 4 Other Newborn Data Error Total Number Referred for Treatment

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Form Section Type Validationand Older Children & Women

Must correct to remove

(Column D) is greater than Total Number Confirmed Cases (Column C). Please correct.

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Form Section Type ValidationForm 5a Data Entry Data Error

Must correct to remove

Pregnant Women, Columns B through F does not equal to 100%. Please correct.

Form 5a Data Entry Data ErrorMust correct to remove

Infants < 1 Year of Age, Columns B through F does not equal to 100%. Please correct.


Children 1 through 21 Years of Age, Columns B through F does not equal to 100%. Please correct.


Children with Special Health Care Needs 0 through 21 years of age, Columns B through F does not equal to 100%. Please correct.


Children with Special Health Care Needs 0 through 21 years of age Total Served cannot be greater than the sum of the values for Infants< 1 Year Total Served and Children 1 through 21 Years of Age Total Served. Please correct.


Children with Special Health Care Needs 0 through 21 years of age must be great than zero. Please correct.

Form 5a Data Entry Data ErrorMust correct or enter a field-level note to remove

The value in Line 3a, Children with Special Health Care Needs 0 through 21 years of age Total Served equals the sum of Line 2, Infants < 1 Year of Age Total Served and Line 3, Children 1 through 21 Years of Age Total Served. Please correct or add a field-level note indicating thereason.


Others, Columns B through F does not equal to 100%. Please correct.

Form 5b Data Entry Data ErrorMust correct to remove

Children with Special Health Care Needs 0 through 21 years of age must be greater than zero. Please correct.


Form 5b Children with Special Health Care Needs 0 through 21 years of age Denominator cannot exceed the sum of Form 5b Infants < 1 Year Denominator and Form 5b Children 1 through 21 Years of Age Denominator. Children with Special Health Care Needs 0 through 21 years of age are a subset of all infants and Children. Please

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Form Section Type Validationcorrect.


Children with Special Health Care Needs 0 through 21 years of Age, Form 5b Count(Calculated) cannot exceed the sum of Infants < 1 Year, Form 5b Count(Calculated) and Children 1 through 21 Years of Age, Form 5b Count(Calculated). Children with Special Health Care Needs 0 through 21 years of Age are a subset of all infants and Children. Please correct.

Form 5a and Form 5b

Data Entry Data ErrorMust Correct to remove

<population name>, Form 5a Count cannot exceed Form 5b Count (Calculated). Form 5a includes direct and enabling services while Form 5b adds public health services and systems. Please correct.

Form 6 Data Entry Data ErrorMust correct or enter a field-level note to remove

Total Infants in State is not within 10% (+ or -) of the Total Births by Occurrence on Form 4. Please correct or add a field-level note indicating the reason for the discrepancy.

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LIST OF POSSIBLE VALIDATION DATA ALERTS

The following table displays all the possible data alerts for forms 2, 4, and 10 NOMs. Data Alerts are only applicable to these forms. These do not need to be addressed in order to submit the TVIS.

Data Alert (Data Warning): These are alerts that will only appear on the Review page and the Data Alerts page. These will only be removed if corrected. These will not be removed by entering a field-level note.

Data Alert (Data Watch): These are alerts that will only appear on the Review page and the Data Alerts page. These will be removed if corrected or a field-level note is entered.

Form Section Type ValidationForm 2 Review Page

Annual Report Expended

Data Alert (Data Watch)Must correct or enter a field-level note to remove – will only appear on the Review page

The value in Line 1, Federal Allocation, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please correct or add a field-level note indicating the reason for the discrepancy.

Form 2 Review Page Annual Report Expended


The value in Line 1A, Preventive and Primary Care for Children, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please correct or add a field-level note indicating the reason for the discrepancy.



The value in Line 1B, Children with Special Health Care Needs, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please correct or add a field-level note indicating the reason for the discrepancy.


Data Alert (Data Watch)Must correct or enter a field-level note to remove –

The value in Line 1C, Title V Administrative Costs, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please add a field-level note indicating the

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Form Section Type Validationwill only appear on the Review page

reason for the discrepancy.

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Form Section Type ValidationForm 2 Review Page

Annual Report Expended


The value in Line 3, State MCH Funds, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please add a field-level note indicating the reason for the discrepancy.



The value in Line 4, Local MCH Funds, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please add a field-level note indicating the reason for the discrepancy.



The value in Line 5, Other Funds, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please add a field-level note indicating the reason for the discrepancy.


Data Alert (Data Watch) Must correct or enter a field-level note to remove – will only appear on the Review page

The value in Line 6, Program Income, Annual Report Expended is greater or less than 10% of the Annual Report Budgeted. Please add a field-level note indicating the reason for the discrepancy.

Form 4 Review PageNewborn


CoreRUSP Conditions – Aggregate Total Number Referred for Treatment (Column D) is less than the Aggregate Total Number Confirmed Cases (Column C). Please add a field-level note to explain.

Form 4 Other Newborn


<ProgramName> – Total Number Referred for Treatment (Column D) is less than the TotalNumber Confirmed Cases (Column C). Please add a field-level note to explain.

Form 5 Data Entry page and Review Page

Data Alert (Data Warning)Must correct to

<population name>, Form 5a Count is greater than or equal to 90% of the Form 5b Count (calculated). Please

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Form Section Type Validationremove check that population based services

have been included in the 5b Count and not in the 5a Count.

Form 5 Data Entry page and Review Page

Data Alert (Data Warning)Must correct to remove

Reported percentage for Others on Form 5b is greater than or equal to 50%. The Others denominator includes both women and men ages 22 and over. Please double check and justify with a field note.

Form 10 NOMs

Review Page Data Alert (Data Warning)Must correct to remove

Data has not been entered for NOM XX. This outcome measure is linked to the selected NPM XX. Please add a field-level note to explain when and how data will be available for tracking this outcome measure.

Form 10 NOMs

Review Page Data Alert (Data Warning)Must correct to remove

A value of zero has been entered for the numerator in NOM XX. Please review your data to ensure this is correct.

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