Associations between state economic and health systems capacities and service use by children with special health care needs.

To examine the relationship between measures of state economic, political, health services, and Title V capacity and individual level measures of the well-being of CSHCN. We selected five measures of Title V capacity from the Title V Information System and 13 state capacity measures from a variety of data sources, and eight indicators of intermediate health outcomes from the National Survey of Children with Special Health Care Needs. To assess the associations between Title V capacity and health services outcomes, we used stepwise regression to identify significant capacity measures while accounting for the survey design and clustering of observations by state.

The relationship between state capacity measures and allocations to children and youth with special needs within the MCH Services Block Grant.

Objectives: To examine the association between state economic, political and health services capacity and state allocations for Title V capacity for Children and Youth with Special Health Care Needs (CSHCN).

Methods: Numerous datasets were reviewed to select 13 state capacity measures: per capita Gross State Product (economic); governor's institutional powers and legislative professionalism (political); percent of Children with Special Health Care Needs, percent of uninsured children, percent of children enrolled in Medicaid, state health funds as a percent of Gross State Product, ratio of Medicaid to Medicare fees, percent of children in Medicaid enrolled in managed care, per capita Medicaid expenditures for children, ratios of pediatricians/family practitioners and pediatric subspecialists per 10,000 children, and categorical versus functional state definition of CSHCN (health). Five measures of Title V capacity were selected from the Title V Information System, four that reflect allocation decisions by states and the fifth a state assessment of the role of families in Title V decision-making: ratio of state/federal Title V spending; per capita state Title V spending; percent of state Title V spending on CSHCN; state per child spending on CSHCN; and, state Title V Family Participation Score.

Predictors of referral to the North Carolina Child Service Coordination Program among infants with orofacial clefts.

Objective: North Carolina has several programs that identify high-risk women and children for needed services, including the Child Service Coordination Program (CSCP). This study determines CSCP referral rates among infants with orofacial clefts (OFCs) and predictors of CSCP referral. We hypothesized receiving Medicaid and maternity care coordination (MCC) services increases the likelihood of CSCP referral.

Improving the accessibility of an analytic and technical skills MCH toolbox.

Objectives: To assess our analytic and technical skills website for accessibility and to make necessary corrections.

Methods: We used commercially available software (Jaws and LIFT for Dreamweaver) and an individual with visual impairments to evaluate our self-instructional, analytic, and technical tools. We identified problems in tables, images, multimedia content, PDF files, and links.

Registry to referral: using birth defects registries to refer infants and toddlers for early intervention services.

Background: Although many birth defect surveillance systems were developed for the primary purpose of monitoring trends and conducting epidemiologic studies, a number of programs have recognized the potential of birth defects monitoring systems for identifying and referring children who may be eligible for services. Because almost all surveillance programs maintain a registry of all children who have been diagnosed with birth defects in a particular state or other defined geographic region, registries can play an important role in identifying eligible children and providing timely referral to specialized services.

Methods: We sent electronically an 18-question survey to the Centers for Disease Control and Prevention's list of State Birth Defects Surveillance Contacts in all 50 states, the District of Columbia, and Puerto Rico.

Online analytic and technical training.

The authors describe the effect of online analytic and technical skills training tools on professional development and practice. Three questions were addressed: (1) Will maternal and child health and other public health professionals register for and engage in online training opportunities? (2) Was this mode of instruction perceived to be an effective means for learning specific skills? and (3) What was the impact of the tools on user knowledge, confidence, practice, and sharing of skills with colleagues? Evaluating open-enrollment online training posed significant challenges. Nonetheless, registration data and the responses to the online surveys affirmed that the opportunity for asynchronous, online learning was an effective means for learning specific skills.

Identifying children in need of ancillary and enabling services: a population approach.

Children with chronic or disabling conditions use health, education and social services at a higher rate than their healthy peers. Estimates of the number of children in need of these specialized services are widely varied and often depend on categorical definitions that do not account for either the diversity or commonality of their experiences. Developing methods for identifying the population in need of services, particularly children likely to use long-term ancillary (audiology, occupational, physical or speech therapy, or social work) and/or enabling services (special equipment, personal care assistance, respite care, transportation, or environmental modifications), is essential for effective policy and program implementation.