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Maternal, Child, and Adolescent Health Division

Application Narrative (FY 2023–2024)

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Now accepting public input for our FY 2024-25 dra​ft Title V Application Narrative (PDF). Please send any comments to us by June 18, 2024.

Each year, CDPH/MCAH submits an application narrative for each population domain. The application narrative includes updates on activities based on progress, emerging issues, and needs and ongoing priorities. For each population domain, the application narrative includes the following sections:

  • Priority Need: A health need by population domain that was identified as a high priority during the previous Needs Assessment.

  • Surveillance: A description of how surveillance will be conducted in FY 2023-24, including information on the relevant surveillance efforts, indicators related to the priority need, and data sources used in that domain.

  • Focus Area: A specific area of impact, by priority need, developed by CDPH/MCAH.

  • Objective: A statement of intention with which actual achievement and results can be measured and compared. Objectives are SMART (Specific, Measurable, Achievable, Relevant, and Time-phased).

  • Strategy: An evidence-based recommendation that CDPH/MCAH defined as part of the Title V Needs Assessment process for FY 2021-25.

  • Activities: The list of strategy-specific activities defined by CDPH/MCAH for FY 2023-24. 

For the Needs Assessment, CDPH/MCAH drew from several public health frameworks (e.g., the life course perspective, social determinants of health, and the socio-ecological model) to implement a standard overarching structure and process across population domains. To capture health disparities and inequities, CDPH/MCAH aimed to use a health equity lens throughout and plans to expand this focus in the future.

The priority needs and focus areas were identified through a synthesis of Needs Assessment data from local health jurisdictions; a review of population data and key literature; engagement of MCAH programs and stakeholders through surveys, interviews, and stakeholder meetings; and an assessment of program capacity and key partnerships. CDPH/MCAH designed and facilitated an iterative stakeholder meeting process, ending with seven in-person regional meetings with Local MCAH programs across the state, to fine tune and vet the identified priority needs and focus areas and discuss key activities. In addition, each Domain Team designed a tailored process to further develop their activities and plans.


Women/Maternal Health

Women/Maternal Priority Need 1: Ensure women in California are healthy before, during, and after pregnancy.

Surveillance:

CDPH/MCAH will monitor select quantifiable characteristics to track the health of California women and mothers as part of its routine surveillance efforts. The select indicators and measures, listed in the table above, will be continuously and systematically collected, analyzed, and interpreted to guide program planning, implementation, and evaluation of interventions. CDPH/MCAH will continue to analyze these indicators at the state and sub-state (when possible) levels to identify specific improvement opportunities.

Select Women/Maternal Health Indicators and Measures
Data Source
Well-woman visit
California Behavioral Risk Factor Survey (BRFS)
Maternal Death Reviews
California Pregnancy-Associated Mortality Review (CA-PAMR)
Pregnancy-related mortality California Pregnancy Mortality Surveillance System (CA-PMSS)
Severe maternal morbidity California Patient Discharge Data
Receipt of mental health services Maternal and Infant Health Assessment (MIHA) survey
Interpregnancy interval
California Comprehensive Master Birth File (CCMBF)
Maternal substance use
California Patient Discharge Data

The selected indicators and measures above serve as an early warning system to identify emerging issues, target program interventions, track progress toward specified objectives in the Five-Year Action Plan, allow priorities to be re-evaluated, and inform public health policy and strategies. CDPH/MCAH will utilize information gleaned from health surveillance data to lead, fund, partner, and support efforts at the state and local levels to improve efforts that will lead to desired outcomes.

To provide greater depth in understanding the health status of women and mothers and to uncover health disparities, analysis of these indicators and measures will include stratification by key demographic factors such as race/ethnicity, maternal age, or county as appropriate given the specific measure and the data constraints.

Women/Maternal Focus Area 1

Reduce the impact of chronic conditions related to maternal mortality.

pregnant individual in pain 

Women/Maternal Objective 1

By 2025, reduce the rate of pregnancy-related deaths (up to one year after the end of pregnancy) from 12.8 deaths per 100,000 live births (2019 CA-PMSS) to 12.2 deaths per 100,000 live births.

View dashboard

Women/Maternal Objective 1 | Strategy 1:

Lead surveillance and investigations of pregnancy-related deaths (up to one year after the end of pregnancy) in California.

Activities:

  • CDPH/MCAH will lead and fund pregnancy-related mortality surveillance and public health investigation activities.

  • CDPH/MCAH will lead surveillance and reporting of pregnancy-related mortality as mandated by Health & Safety Codes 123630-123630.4), Senate Bill (SB) 464 – California Dignity in Pregnancy and Childbirth Act, and SB 65 – Maternal Care and Services.

  • CDPH/MCAH will focus surveillance and reporting on disparities to inform MCAH programs and promote health equity in California.

  • CDPH/MCAH will lead and fund data products associated with pregnancy-related mortality.

  • CDPH/MCAH will lead the dissemination of data findings from the California Pregnancy Surveillance System (CA-PMSS) and the California Pregnancy-Associated Mortality Review (CA-PAMR) to raise awareness about trends and disparities in pregnancy-related mortality and prevention strategies.

  • CDPH/MCAH will lead the investigation of COVID-19 related 2020-21 deaths in pregnant or recently pregnant people.

  • CDPH/MCAH will partner with the Centers for Healthy Communities Injury and Violence Prevention Branch to identify risk for intimate partner violence related morbidity and mortality by participating on the CDPH Violent Injury Prevention Initiative.

Women/Maternal Objective 1 | Strategy 2

Partner to translate findings from pregnancy-related mortality investigations into recommendations for action to improve maternal health and perinatal clinical practices.

Activities:

  • CDPH/MCAH will lead the development of data-informed recommendations for prevention of pregnancy-related deaths.

  • CDPH/MCAH will partner with clinical and community stakeholders to disseminate data findings and recommendations from the California Pregnancy-Associated Mortality Review (CA-PAMR) to inform policy and prevention strategies to reduce pregnancy-related morbidity and mortality.

  • CDPH/MCAH will continue to provide funding and support to the California Maternal Quality Care Collaborative at Stanford University for their role to assist providers and institutions in obstetric quality improvement efforts. 

Women/Maternal Focus Area 2

Reduce the impact of chronic conditions related to maternal morbidity.

nurse attending to mother  

Women/Maternal Objective 2

By 2025, reduce the rate of severe maternal morbidity from 104.4 per 10,000 delivery hospitalizations (2020 PDD) to 88.8 per 10,000 delivery hospitalizations.

View dashboard

Women/Maternal Objective 2 | Strategy 1:

Lead surveillance and research related to maternal morbidity in California.

Activities:

  • CDPH/MCAH will lead surveillance and reporting of maternal morbidity, including measurement of trends and disparities, and review of scientific literature to remain current with respect to both scientific methods and emerging issues.

  • CDPH/MCAH will lead surveillance and reporting of severe maternal morbidity as mandated by SB 464 (now Health & Safety Codes 123630-123630.4), the California Dignity in Pregnancy and Childbirth Act. Mandated reporting will occur at least once every three years and will include, but is not limited to, data on the conditions listed in the California Dignity in Pregnancy and Childbirth Act aggregated by state regions and race/ethnicity.

  • CDPH/MCAH will identify and partner with subject matter experts to conduct population-based data analyses to inform decision-making for coordination, support, and possible implementation of coordinated regionalized systems of Maternal Care.

  • CDPH/MCAH will support and collaborate with DHCS/Medi-Cal to reach their Bold Goals (“reduce maternity care disparity for Black and Native American persons by 50% by 2025") through efforts such as introducing the doula benefit to improve culturally competent birth care; extending the post-partum benefit period to 12 months; and defining pregnant and post-partum individuals as populations of Focus to receive Enhanced Care Management.

Women/Maternal Objective 2 | Strategy 2:

Lead statewide regionalization of maternal care to ensure women receive appropriate care for childbirth.

Activities:

  • CDPH/MCAH will continue to fund the Regional Perinatal Programs of California (RPPC) Directors to focus on quality improvement in participating labor and delivery hospitals throughout the state and to coordinate and support a regionalized perinatal system.

  • CDPH/MCAH will continue to partner with the Comprehensive Perinatal Services Program (CPSP), WIC Regional Breastfeeding Liaisons, and local MCAH programs to ensure a coordinated delivery system for women during and after their pregnancy.

  • CDPH/MCAH will continue to coordinate the planning, collaboration, and promotion of integrated regional perinatal systems for the delivery of high quality, risk-appropriate health care and social support to pregnant women and their newborn infants.

  • CDPH/MCAH will fund a contractor to partner with RPPC Directors to improve the system of care for high-risk women by encouraging the growth and maturation of transfer agreements for the provision of risk-appropriate care specific to maternal health needs.

  • CDPH/MCAH will continue to support and sustain a statewide collaborative of public and private entities that combine clinical medicine and systems of care that contribute to improvements in the quality of maternity and obstetric care.

Women/Maternal Objective 2 | Strategy 3:

Partner to strengthen knowledge and skill among health care providers and individuals about chronic conditions exacerbated during pregnancy.

Activities:

  • CDPH/MCAH will lead the development and implementation of a work plan to reduce the rate of diabetes in pregnancy and overweight/obesity in childbearing parents.

  • CDPH/MCAH will conduct public education campaigns with emphasis on building awareness on gestational diabetes, Preconception/Interconception Health, and Postpartum Care.

  • CDPH/MCAH will collaborate with BIH, CHVP, AFLP, and WIC to incorporate the importance of diet, exercise, weight loss, insulin management, and referrals into their education/outreach.

  • CDPH/MCAH will conduct webinars using MyPlates, especially MyPlates for People with Gestational Diabetes and the Perinatal Food Group Recall Tool for Gestational Diabetes.

  • CDPH/MCAH will support referrals on its website to DHCS Diabetes Program and Diabetes Self-Management Education and Support (DSMES) Programs.

  • CDPH/MCAH will continue to collaborate with other CDPH chronic disease programs to promote education to health care providers and linkage to services.

  • CDPH/MCAH will continue to lead the development and dissemination of culturally appropriate materials to address chronic disease in disparate populations.

  • CDPH/MCAH will lead the development of a social media campaign to disseminate information about maternal overweight, obesity, gestational diabetes, and Postpartum Care.

  • CDPH/MCAH will continue to fund local Black Infant Health (BIH) sites to include information about chronic health conditions pertinent to Black women in a culturally responsive manner.

Women/Maternal Focus Area 3

Improve mental health for all mothers in California.

women embracing life  

Women/Maternal Objective 3

By 2025, increase the receipt of mental health services among women who reported needing help for emotional well-being or mental health concerns during the perinatal period from 49.0% (2020 MIHA) to 52.1%.

View dashboard

Women/Maternal Objective 3 | Strategy 1

Partner with state and local programs to disseminate information and resources to reduce mental health conditions in the perinatal period.

Activities:

  • CDPH/MCAH will partner and collaborate with state departments responsible for the provision of mental health services (i.e., CalMHSA, DHCS) to identify gaps and opportunities in the availability, quality, and use of mental health services for women of reproductive age, and support and promote policy that would reduce mental health conditions in the perinatal period.

  • CDPH/MCAH will continue to partner at the state and local levels to identify and promote best practices to address mental health, including stigma and discrimination due to mental health diagnosis.

  • CDPH/MCAH will continue to support state and local workforce development to address mental health with the population we serve.

  • CDPH/MCAH will lead to translate findings from the Maternal Suicide or other PAMR report(s) into a resource for use by health care providers, individuals, and communities.

Women/Maternal Objective 3 | Strategy 2

Partner to strengthen knowledge and skill among health care providers, individuals, and families to identify signs of maternal mental health-related needs.

Activities:

  • CDPH/MCAH will continue to partner with existing MCAH programs and other Title V-funded programs (local MCAH, BIH, Indian Health, AFLP, CHVP Preconception Health) in raising awareness about mental health and promoting mental health resources.
  • CDPH/MCAH will continue to partner with local Perinatal Service Coordinators (PSCs) to support education to providers, local health plans, and community stakeholders on new state requirements for provider screening of mental health at least once during pregnancy and postpartum.

Women/Maternal Objective 3 | Strategy 3

Partner to ensure pregnant and parenting women are screened and referred to mental health services during the perinatal period.

Activities:

  • CDPH/MCAH will continue to partner with MCAH-funded programs (BIH, CHVP, Indian Health, ALFP, local MCAH) to utilize validated mental health screening tools.

  • The DHCS/AIMSS program will continue to partner with Indian Health Service, state and local MCAH, Family Spirit, and other resources to provide evidenced-based screening tools to use for mental health screening on all perinatal and postnatal American Indian women.

  • CDPH/MCAH will continue to partner with PSCs to ensure PSCs educate and promote appropriate referrals to community resources for reproductive aged clients.

Women/Maternal Focus Area 4

Ensure optimal health before pregnancy and improve pregnancy planning and birth spacing.

supportive group of women  

Women/Maternal Objective 4

By 2025, increase the percentage of women who had an optimal interpregnancy interval of at least 18 months from 74.2% (2019 CCMBF) to 76.4%.

View dashboard

Women/Maternal Objective 4 | Strategy 1

Partner to increase provider and individual knowledge and skill to improve health and health care before and between pregnancies.

Activities:

  • CDPH/MCAH will continue to partner, communicate, collaborate, and coordinate preconception and interconception program work, best practices, resources, and education cross-sectionally and department wide.

  • CDPH/MCAH will continue to support and coordinate the Preconception Health Council of California (PHCC) quarterly meetings and biweekly PHCC Executive Committee meetings.

  • CDPH/MCAH will continue to support and share preconception and interconception best practices, resources, and MCAH local program updates to PHCC to guide and inform statewide preconception and interconception efforts.

  • CDPH/MCAH will continue to support the use of the Every Woman California website as a platform for sharing best practices, resources, and education for preconception and interconception health, health care, sexual and reproductive health services (including links to abortion resources), and psychosocial well-being information for the public and health professionals.

  • CDPH/MCAH will support disseminating and promoting best practices, resources, and education from key preconception initiatives and local MCAH programs through statewide channels of communication (i.e., newsletters, eblasts, collaborative updates, briefings, etc.)

  • CDPH/MCAH will conduct webinars on the use of the newly released MyPlate for People Who May Become Pregnant to be used by MCAH programs and health paraprofessionals.

  • CDPH/MCAH will support PSCs in disseminating and encouraging best practices, resources, and education to local health plans and community organizations to promote preconception and interconception care to eligible individuals.

Women/Maternal Objective 4 | Strategy 2

Lead a population-based assessment of mothers in California, the Maternal and Infant Health Assessment Survey (MIHA), to provide data to guide programs and services.

Activities:

  • CDPH/MCAH will continue to partner with the University of California San Francisco (UCSF) Center for Health Equity to refine the MIHA questionnaire with new topics of interest and revise the MIHA sampling plan as needed to ensure representative data at the state, regional, and county levels.

  • CDPH/MCAH will support the UCSF Center for Health Equity to implement data collection activities and maximize participation among individuals selected to participate in the survey.

  • CDPH/MCAH will support the UCSF Center for Health Equity to weight the study data and prepare an annual MIHA analytic dataset and codebook.

  • CDPH/MCAH will partner with the UCSF Center for Health Equity to conduct analyses of CDPH/MCAH priority topics, develop surveillance products, and design and implement scientific research studies.

  • CDPH/MCAH will lead the dissemination of findings in a variety of MIHA data products.

Women/Maternal Objective 4 | Strategy 3

Lead efforts to improve local perinatal health systems utilizing morbidity and mortality data and implement evidence-based interventions to improve the health of pregnant individuals and their infants. 

Activities:

  • CDPH/MCAH will continue to support through technical assistance those fee-for service applicants to become a California Perinatal Service Provider, review the application, and notify the applicant if their application is accepted.

  • CDPH/MCAH will continue to support local Perinatal Service Coordinators (PSC) to ensure pregnant and postpartum populations have access to perinatal and postpartum care.

  • CDPH/MCAH will continue to fund the PSC Annual Meeting or other opportunities to develop a competent workforce.

Women/Maternal Objective 4 | Strategy 4

Fund the DHCS Indian Health Program (IHP) to administer the American Indian Maternal Support Services (AIMSS) to provide case management and home visitation program services for American Indian women during and after pregnancy.

Activities:

  • DHCS/AIMSS will continue to support and provide case management services to their programs using evidenced-based curricula, resources, and tools provided through Family Spirit, the American College of Obstetricians and Gynecologists, and other best practices.

  • DHCS/AIMSS will continue to provide technical assistance to all program case managers to support home visiting -related activities.

  • DHCS/AIMSS will continue to support and share resources, education materials, and training related to American Indian perinatal and postnatal health and well-being.

  • DHCS/AIMSS will continue to support and provide AIMSS programs with online or in-person (when available) training opportunities to keep providers up-to-date with evidenced-based training from CDPH/MCAH, Family Spirit, and other culturally appropriate resources.

  • DHCS/AIMSS program will continue to support and provide education on the importance of following up with their postpartum visits to the obstetrician partners.

Women/Maternal Focus Area 5

Reduce maternal substance use.

pregnant individual breaking smoking habit  

Women/Maternal Objective 5

By 2025, reduce the rate of maternal substance use from 21.1 per 1,000 delivery hospitalizations (2020 PDD) to 19.7 per 1,000 delivery hospitalizations.

View dashboard

Objective 5 | Strategy 1

Lead research and surveillance on maternal substance use in California.

Activities:

  • CDPH/MCAH will lead surveillance of maternal substance use (including measurement of trends and disparities), review of scientific literature, and dissemination of data findings to help inform programs and services.

Objective 5 | Strategy 2

Partner at the state and local level to increase prevention and treatment of maternal opioid and other substance use.

Activities:

  • Support Family Health Outcomes Project (FHOP) in the local dissemination of the Association of State and Territorial Health Officials (ASHTO) Public Health Perinatal Opioid Toolkit, targeting dissemination to counties of greatest need.

  • CDPH/MCAH will partner with CDPH Substance and Addiction Prevention Branch to update the social media toolkit to raise awareness about opioids and pregnancy.

  • CDPH/MCAH will disseminate resources to stakeholders to promote prevention of maternal opioid and substance use.

  • CDPH/MCAH will disseminate consumer-facing resources and education materials via the MCAH website.

Perinatal/Infant Health

Perinatal/Infant Priority Need 1: Ensure all infants are born healthy and thrive in their first year of life.

Perinatal/InfantPriority Need 2: Reduce infant mortality with a focus on eliminating disparities.

Surveillance:
The California Department of Public Health Maternal, Child and Adolescent Health Division (CDPH/MCAH) will monitor select quantifiable characteristics to track the health of California’s infants as part of its routine health surveillance efforts. The following indicators and measures, as listed in the table below, are continuously and systemically collected, analyzed, and interpreted to guide program planning, implementation and evaluation of interventions. These indicators will be analyzed by state, county, race/ethnicity and other sub-state levels to identify specific improvement opportunities.

Select Perinatal/Infant Health Indicators and Measures Data Source
Breastfeeding initiation and duration Maternal and Infant Health Assessment (MIHA) survey and Genetic Disease Screening Program (GDSP), Newborn Screening Data
Infant mortality, including SUID/SIDS CA Birth Cohort File or CA Comprehensive Master Birth and Death Files
Grief and bereavement services SIDS Program Data
Infant safe sleep practices MIHA survey
Preterm birth rate, including rate among infants born to non-Hispanic Black women CA Comprehensive Master Birth File


Perinatal/Infant Focus Area 1

Improve healthy infant development through breastfeeding.

health professional assisting breastfeeding mother  

Perinatal/Infant Objective 1

By 2025, increase the percentage of women who report exclusive in-hospital breastfeeding from 69.7% (2020 GDSP) to 72.5%.

View dashboard

Perinatal/Infant Objective 1 | Strategy 1

Lead surveillance of breastfeeding practices and assessment of initiation and duration trends.

Activities:

  • CDPH/MCAH will lead breastfeeding data collection and surveillance in collaboration with Women, Infants, and Children (WIC), and University of California San Francisco (UCSF) Center for Health Equity utilizing the Maternal and Infant Health Assessment (MIHA) Survey.

  • CDPH/MCAH will lead the dissemination of breastfeeding data findings to increase in-hospital breastfeeding initiation in California.

Perinatal/Infant Objective 1 | Strategy 2

Lead technical assistance and training to support breastfeeding initiation, including the implementation of the Model Hospital Policy or Baby-Friendly Hospital Initiative in all California birthing hospitals by 2025.

Activities:

  • CDPH/MCAH will partner with MCAH programs to include evidence-based breastfeeding guidance within their program curriculum.

  • CDPH/MCAH will partner with Regional Perinatal Programs of California (RPPC) directors and WIC Regional Breastfeeding Liaisons (RBLs) to provide technical assistance on the Model Hospital Policy.

  • CDPH/MCAH will disseminate updated webpage resources to assist local MCAH programs with compliance with the Model Hospital Policy and the Baby-Friendly Hospital Initiative.

  • CDPH/MCAH will identify and disseminate best practices to support health care workers in their efforts to educate families on the importance of the Ten Steps to Successful Breastfeeding.

Perinatal/Infant Objective 1 | Strategy 3

Partner to develop and disseminate information and resources about policies and best practices to promote breastfeeding duration, including lactation accommodation within all MCAH programs.

Activities:

  • CDPH/MCAH will partner to increase the number of clinics adopting the 9 Steps To Breastfeeding Friendly: Guidelines for Community Health Centers and Outpatient Care Settings (PDF), guidelines developed in collaboration with input from community health centers, MCAH and CDPH’s Chronic Disease and Injury Control (CDIC), the California WIC Association (CWA) and the California Breastfeeding Coalition (CBC).

  • CDPH/MCAH will continue to partner with local MCAH Directors, local health jurisdiction Breastfeeding Coordinators, and WIC RBLs to develop and disseminate information to communities and businesses on lactation accommodation laws.

  • CDPH/MCAH will continue to partner with the CWA and CBC on the dissemination and education of the Low Wage Worker Lactation Accommodation Brief developed with the Childhood Obesity Collaborative Innovation and Improvement Network.

  • CDPH/ MCAH will continue to provide training, technical assistance, and resources to American Indian Maternal Support Services (AIMSS) programs to promote breastfeeding among American Indian women.

Perinatal/Infant Focus Area 2

Improve healthy infant development through caregiver/infant bonding.

Parents bonding with newborn 

Perinatal/Infant Objective 1 continued

Perinatal/Infant Objective 1 | Strategy 4

Partner with birthing hospitals to support caregiver/infant bonding.

Activities:

  • CDPH/MCAH will support and promote clearer guidelines on skin-to-skin care and Kangaroo Mother Care through MCAH local programs and RPPC Directors.

  • CDPH/MCAH will lead the development of social media posts and educational materials to raise awareness about the importance of infant/caregiver bonding.

  • CDPH/MCAH will support and expand gender sensitivity in lactation promotion to include breastfeeding.

  • DHCS/AIMSS programs will provide education materials, resources, and training on infant bonding that are culturally appropriate, and evidence based.

  • DHCS/AIMSS programs will continue to utilize state and local MCAH resources, Family Spirit, and other culturally appropriate educational materials for American Indian infants.

Perinatal/Infant Focus Area 3

Reduce Black Infant Mortality.

Black mother kissing infant lovingly 

Perinatal/Infant Objective 2

By 2025, reduce the rate of infant deaths from 3.9 per 1,000 live births (2020 BSMF/DSMF) to 4.0.*

*Note: Even though the objective has been surpassed, California has chosen to keep the target at the same level (4.0) for now because this might have been a statistical fluctuation and we want to ascertain if it is an actual stable trend. 

View dashboard

Perinatal/Infant Objective 2 | Strategy 1

Lead research and surveillance related to fetal and infant mortality in California.

Activities:

  • CDPH/MCAH will lead the data collection and surveillance of fetal/infant mortality utilizing the National Fatality Review Case Reporting System (NFR-CRS).

  • CDPH/MCAH will lead and fund the data collection and surveillance of fetal and infant deaths, including disparities in race/ethnicity, using California vital statistics data files.

  • CDPH/MCAH will lead the development and dissemination of data findings, reports, and presentations related to fetal and infant mortality in California and inform CDPH/MCAH programs (such as BIH, PEI, SIDS, CHVP, AFLP, Local MCAH) about existing disparities in infant mortality.

  • CDPH/MCAH will use local expertise and community input to review cases of infant deaths at the local level, identify and apply lessons learned.

Perinatal/Infant Objective 2 | Strategy 2

Lead planning and development of evidence-based practices and lessons learned for reducing infant mortality rates.

Activities:

  • CDPH/MCAH will partner with the National Center for Fatality Review & Prevention on the use of the NFR-CRS to collect local case reporting by participating local health jurisdictions.

  • CDPH/MCAH will partner with communities experiencing the greatest infant mortality rate disparities to identify feasible and effective approaches to translate infant mortality data into local program improvements and systems change.

  • CDPH/MCAH will continue to support the Center for Infectious Diseases Perinatal Infectious Diseases workgroup with a current focus on reduce rates of congenital syphilis.

Perinatal/Infant Objective 2 | Strategy 3

Lead the California SIDS Program to provide grief and bereavement support to parents, as well as technical assistance, resources, and training on infant safe sleep to reduce infant mortality.

Activities:

  • CDPH/MCAH will work closely with the California SIDS Advisory Council on SIDS/SUID-related infant mortality. CDPH/MCAH will track reporting of infant deaths from local MCAH programs, coroner’s offices, social services, and hospitals.

  • CDPH/MCAH will lead the dissemination of data finding, reports, and presentations for local SIDS programs.

  • CDPH/MCAH will partner with the California SIDS Program to provide training on grief and bereavement support to support families impacted by SIDS, SUID, and other sleep-related infant deaths.

  • CDPH/MCAH will lead the California SIDS Program by increasing awareness, promoting safe sleep education, identifying risk factors, and providing resources.

  • CDPH/MCAH will promote the 2022 American Academy of Pediatrics Recommendations for a Safe Infant Sleeping Environment, endorse dissemination of the Safe to Sleep® education campaign materials, and lead the development of Safe Sleep strategies that address SIDS and other sleep-related causes of infant death.

  • CDPH/MCAH will notify California birthing hospitals of their responsibility to disseminate SIDS risk reduction information to parents or guardians of newborns upon discharge.

  • CDPH/MCAH will lead and fund local MCAH programs (CHVP, AFLP, BIH, and IHP) to provide support to pregnant and parenting families related to safe sleep.

Perinatal/Infant Focus Area 4

Reduce preterm births.

Black couple looking lovingly at their infant 

Perinatal/Infant Objective 3

By 2025, reduce the percentage of preterm births from 8.8% (2020 BSMF) to 8.4%.

View dashboard

Perinatal/Infant Objective 3 | Strategy 1:

Lead research and surveillance on disparities in preterm birth rates in California.

Activities:

  • CDPH/MCAH will lead and fund the data collection and surveillance of preterm births, including disparities in race/ethnicity.

  • CDPH/MCAH will lead the dissemination of data findings, reports, and presentations related to preterm birth in California.

  • CDPH/MCAH will support the completion and dissemination of the California Centering Black Mothers and Infants Report.

Perinatal/Infant Objective 3 | Strategy 2

Lead the implementation of the Black Infant Health (BIH) Program to reduce the impact of stress due to structural racism to improve Black birth outcomes.

Activities:

  • CDPH/MCAH will support local MCAH programs development of public awareness campaigns through BIH funds about heightened risk of Black birthing people.

  • CDPH/MCAH will partner with local health jurisdictions to actively recruit and increase the number of Black women participating in BIH programs and connect them to appropriate resources. 

  • CDPH/MCAH will partner with professional organizations to provide education materials related to preterm birth reduction strategies for pregnant Black women.

Perinatal/Infant Objective 3 | Strategy 3

Lead the implementation of the state general fund effort, Perinatal Equity Initiative (PEI), to support local initiatives to support birthing populations of color.

Activities:

  • CDPH/MCAH will lead learning collaborative cohorts to promote statewide sharing of best practices to decrease the infant mortality rate.

  • CDPH/MCAH will collaborate with experts to support successful implementation of legislated interventions.

  • CDPH/MCAH will support implementation of the PEI interventions at the local level.

  • CDPH/MCAH will support local MCAH programs’ development of public awareness campaigns with PEI funds.

Perinatal/Infant Objective 3 | Strategy 4

Lead the development and dissemination of preterm birth reduction strategies across California.

Activities:

  • CDPH/MCAH will facilitate the process of incorporating preterm birth reduction strategies in all MCAH programs.

  • CDPH/MCAH will develop and disseminate a social media campaign about preterm birth reduction strategies that are tailored to be culturally relevant for particular populations (e.g., African American, American Indian, Latin American, and Asian American).

Child Health

Child Priority Need 1: Optimize the healthy development of all children so they can flourish and reach their full potential.

Surveillance:
CDPH/MCAH will monitor quantifiable characteristics to track the health of California children as part of routine health surveillance efforts. The indicators and measures listed in the table below are continuously and systematically collected, analyzed, and interpreted to guide program planning, implementation, and evaluation of interventions. These indicators will be analyzed at the state and sub-state (where sample-size allowed) levels to identify specific improvement opportunities.

Select Child Health Indicators and Measures Data Sources for Child Health Indicators and Measures
Developmental screening National Survey of Children's Health (NSCH); California Health Interview Survey (CHIS)
Family resilience NSCH
Preventive dental visit NSCH
Childhood overweight and obesity (fifth grade students) California Department of Education, Physical Fitness Testing Research Files (FitnessGram)
Childhood flourishing NSCH
Preventive medical visit Local MCAH program data
Insurance status and adequacy American Community Survey (ACS); NSCH
Family and childhood poverty ACS; Public Policy Institute of CA Poverty Measure
Adverse childhood experiences NSCH; Maternal and Infant Heath Assessment (MIHA) Survey
Food insecurity MIHA; KidsData; CHIS; NSCH
Housing and income inequality County Health Rankings
Reading daily to child (0-5 years) CHIS
Economic stability California Employment Development Department


Child Focus Area 1

Expand and support developmental screening.

Note: Activities related to referrals for a positive result on a development screen are included in the CYSHCN domain plan.

Health professional attending to child during check up 

Child Objective 1

By 2025, increase the percentage of children (ages 9 through 35 months) who received a developmental screening from a health care provider using a parent-completed screening tool in the past year from 34.4% (NSCH 2020-21) to 32.4% . 

Child Objective 1 | Strategy 1

Partner to build data capacity for public health surveillance and program monitoring and evaluation related to developmental screening in California.

Activities:

  • CDPH/MCAH will create a plan for analyzing data from the oversample of the National Survey of Children's Health (NSCH).

  • CDPH/MCAH will continue to fund the Fatal Child Abuse and Neglect Surveillance Program through an agreement with the CDPH Injury and Violence Prevention Branch.

Child Objective 1 | Strategy 2

Partner to improve early childhood systems to support early developmental health and family well-being.

Activities:

  • CDPH/MCAH Title V will coordinate with MCAH/CHVP to identify areas of opportunity to improve early childhood systems coordination and collaboration.
  • CDPH/MCAH will coordinate with First 5 Association, local First 5 programs, and Local MCAH programs on their Help Me Grow and related efforts.
  • CDPH/MCAH will partner with DHCS Indian Health Program's American Indian Maternal Support Services and other programs to promote developmental screening, positive and responsive parenting, reading infant cues, calming/soothing, reading, singing, and playing with their infant.

Child Objective 1 | Strategy 3

Partner to educate and build capacity among providers and families to understand developmental milestones and implement best practices in developmental screening and monitoring within MCAH programs.

Activities:

  • CDPH/MCAH will assess Local MCAH programs’ specific educational and resource needs regarding developmental screening and monitoring of developmental milestones.

  • CDPH/MCAH will partner with WIC and other stakeholders to continue disseminating developmental milestone information, resources, and tools to families.

Child Objective 1 | Strategy 4

Support implementation of Department of Health Care Services (DHCS) policies regarding child health and well-being, including developmental screening.

Activities:

  • CDPH/MCAH will continue to collaborate with DHCS on issues related to child health and well-being and will determine activities specific to this strategy based on collaborative priorities.

Child Focus Area 2

Raise awareness of adverse childhood experiences (ACEs) and prevent toxic stress through building resilience.

Child being bullied 

Child Objective 2

By 2025, increase the percentage of children (ages 0-17 years) who live in a home where the family demonstrated qualities of resilience (i.e., met all four resilience items as identified in the NSCH survey) during difficult times from 83.6% (NSCH 2020-2021) to 84.5%

View dashboard

Child Objective 2 | Strategy 1

Partner with CDPH Essentials for Childhood and other stakeholders to build data capacity to track and understand experiences of adversity and resilience among children and families.

Activities:

  • CDPH/MCAH will continue to build partnerships with CDPH Essentials for Childhood and others and develop capacity to analyze additional child health-related data on topics such as social determinants of health and maternal mental health and substance use.

  • CDPH/MCAH will assess and explore feasibility of adding additional data measures related to childhood adversity and family resilience in MCAH programs.

Child Objective 2 | Strategy 2

Partner to build capacity and expand programs and practices to build family resiliency by optimizing the parent-child relationship, enhancing parenting skills, and addressing child poverty through increasing access to safety net programs within MCAH-funded programs.

Activities:

  • CDPH/MCAH will implement state-funded Future of Public Health efforts focused on building family resilience and primary prevention of child, youth, and family mental and behavioral health needs.

  • CDPH/MCAH will lead within CHVP by improving family resilience through support and education of families on positive parenting and linkage of families to needed services in the community.

  • CDPH/MCAH will assess current practices to promote healthy, safe, stable, nurturing parent-child relationships within its funded programs, including activities and policies that promote positive parent-child interactions, parent-child play activities, co-regulation strategies, and positive parenting practices within MCAH programs.

  • CDPH/MCAH will assess Local MCAH program capacity and needs in the area of economic supports for families, including access to safety net programs (e.g., WIC, CalFresh, school meals, Earned Income Tax Credit, Child Tax Credit, housing subsidies, COVID-related assistance, unemployment) for families.

Child Objective 2 | Strategy 3

Support the California Office of the Surgeon General and DHCS ACEs Aware initiative to build capacity among communities, providers, and families to understand the impact of childhood adversity and the importance of trauma-informed care.

Activities:

  • CDPH/CFH will continue to participate on Surgeon General's Advisory Committees related to increased training and screening of ACEs by California health care providers.

  • CDPH/MCAH will partner to identify and disseminate resources and training opportunities to raise awareness of ACEs and the impact on health outcomes and importance of trauma-informed care across family-serving organizations in California communities.

Child Focus Area 3

Support and build partnerships to improve the physical health of all children.

Toddler on playing at park 

Child Objective 3

By 2025, increase the percentage of children (ages 1-17 years) who had a preventive dental visit in the past year from 74.3% (NSCH 2020-2021) to 82.6%.

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Child Objective 3 | Strategy 1

Support the CDPH Office of Oral Health (OOH) in their efforts to increase access to regular preventive dental visits for children by sharing information with MCAH programs.

Activities:

  • CDPH/MCAH will support the efforts of the CDPH/OOH to improve access to pediatric preventive dental care by participating on the Oral Health Advisory Committee.

  • Based on the CDPH Oral Health Advisory Partnership’s recommendations and strategic plan for oral health, CDPH/MCAH will support CDPH/OOH by sharing information and resources with local MCAH programs. 

Child Objective 4

By 2025, decrease the percentage of fifth grade students who are overweight or obese from 41.3% (2019) to 39.3%.

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Child Objective 4 | Strategy 1

Partner to enable the reporting of data on childhood overweight and obesity in California.

Activities:

  • CDPH/MCAH will review and use, as appropriate, child-overweight-and-obesity-related data collected via surveys (e.g., the National Survey of Children's Health).

  • CDPH/MCAH will identify opportunities with other California state governmental offices (e.g., CDPH's Nutrition Education and Obesity Prevention Branch, CDE) to collect and report additional data related to child overweight and obesity.

Child Objective 4 | Strategy 2

Partner with WIC and others to provide technical assistance to local MCAH programs to support healthy eating and physically active lifestyles for families.

Activities:

  • CDPH/MCAH will lead efforts to promote the newly developed child MyPlates for ages 2-12 years to promote healthy eating in children through local MCAH programs (WIC, AFLP, CHVP, and BIH) social media posts and the MCAH website.

  • CDPH/MCAH will continue to partner with WIC and local MCAH programs to identify best practices and tools to refer and link eligible clients to the WIC program.

  • CDPH/MCAH will maintain and implement the Policies, Systems, and Environmental Change Toolkit on the MCAH website with a focus on nutrition, physical activity, limiting sedentary activity, breastfeeding, and safe communities as a resource.

  • CDPH/MCAH will partner with CDPH Center for Healthy Communities, WIC, California WIC Association, the California Department of Social Services, and others to develop a collective impact by addressing (via nutrition and physical activity) and monitoring child overweight/obesity as well as family food insecurity.

  • CDPH/MCAH will continue collaboration on early childhood education about nutrition and physical activity with Centers for Healthy Communities.

Adolescent Health

Adolescent Priority Need 1: Enhance strengths, skills, and supports to promote positive development and ensure youth are healthy and thrive.

Surveillance:

CDPH/MCAH will monitor quantifiable characteristics to track the health of California adolescents as part of its routine health surveillance efforts. The select indicators and measures listed in the table below are continuously and systematically collected, analyzed, and interpreted to guide program planning, implementation, and evaluation of interventions. These indicators will be analyzed at the state and sub-state levels to identify specific improvement opportunities.

Select Adolescent Health Indicators and Measures Data Source
Referral to preventive services Adolescent Family Life Program (AFLP) data
Adolescent birth rate, ages 15–19 California Birth Statistical Master file (BSMF)/ Comprehensive Master Birth File (CMBF)
Adolescent birth rate disparity ratio - Black: White; Hispanic: White
California BSMF/CMBF
Unintended pregnancy Maternal Infant Health Assessment (MIHA)
Intimate partner violence MIHA
Hormonal or intrauterine device contraceptive use Youth Risk Behavior Survey (YRBS)*
Condom use YRBS
Contraceptive use (Dual use) YRBS
Sexually transmitted infections (STI) STD Control Branch program data
Preventive medical visits National Survey of Children’s Health
Hospitalizations- motor vehicle, mental health and substance use California Patient Discharge data; YRBS*
Living in foster care California Child Welfare Indicators Project
Population size State Population Projections, CA Department of Finance
Insurance status American Community Survey
High school dropout
California Department of Education
Graduation rates
California Department of Education
California Sexual Health Needs Index Multiple sources
Depression (related feelings; suicide ideation) CA Healthy Kids Survey; YRBS*
Teen dating violence CA Healthy Kids Survey; YRBS*
School connectedness CA Health Kids Survey
Have a caring adult that they can talk to about a serious problem National Survey on Drug Use and Health

*Note: California will not have access to 2021 YRBS data because the sample size was too small.

Adolescent Focus Area 1

Improve sexual and reproductive health and well-being for all adolescents.

Small group of adolescents 

Adolescent Objective 1

By 2025, increase the proportion of sexually active adolescents who use condoms and/or hormonal or intrauterine contraception to prevent pregnancy and provide barrier protection against sexually transmitted diseases as measured by the following:

  • percentage of sexually active adolescents who used a condom at last sexual intercourse from 55% to 58%
  • percentage of sexually active adolescents who used the most effective or moderately effective methods of FDA-approved contraception from 23% to 25%.
Adolescent Objective 1 | Strategy 1

Lead surveillance and program monitoring and evaluation related to adolescent sexual and reproductive health.

Activities:

  • CDPH/MCAH will lead in updating and utilizing the California Adolescent Sexual Health Needs Index (CASHNI) to target adolescent health programs in areas of the state with the greatest need.

  • CDPH/MCAH will lead in analyzing data on adolescent birth outcomes and present as part of the Data Visualization Project.

  • CDPH/MCAH will lead surveillance of California adolescent birth rates (ABR), with a focus on identifying inequities, and disseminate findings.

  • CDPH/MCAH will develop and disseminate at least one brief focused on key topics and trends related to ABR and/or adolescent birth outcomes (e.g., repeat births), suboptimal interpregnancy interval in California.

  • CDPH/MCAH will lead monitoring and evaluation of the MCAH adolescent health programs: Adolescent Sexual Health Education Program (ASH Ed) and Adolescent Family Life Program (AFLP).

  • CDPH/MCAH will provide both static and dynamic data dashboards to MCAH adolescent health programs to help maintain and/or improve data quality, monitor program implementation, monitor participant engagement with program, and inform technical assistance and continuous quality improvement efforts.

  • CDPH/MCAH will disseminate MCAH adolescent health programs data and findings and/or statewide population-based surveillance data and research through issue and data briefs and/or programmatic and scientific abstracts and manuscripts. 

Adolescent Objective 1 | Strategy 2

Lead to strengthen knowledge and skills to increase use of protective sexual health practices within CDPH/MCAH-funded programs.

Activities:

  • CDPH/MCAH will lead in developing and disseminating resources for parents/caregivers related to youth-friendly sexual and reproductive health information.

  • CDPH/MCAH will lead in assessing local implementation of new Positive Youth Development (PYD) content around family planning and safer sex that was developed in FY 2020-2021.

  • CDPH/MCAH will lead in using evaluation findings to assess PYD model content, including protective sexual health practices, and identifying areas of improvement needed.

  • CDPH/MCAH will lead in sharing trainings (live or recorded) on protective sexual health practices to local agencies.

  • CDPH/MCAH will lead in providing family planning and safer sex content (as a core program priority) into PYD model basic trainings held in FY 2023-2024.

  • CDPH/MCAH will partner with the CDPH Violence Prevention Initiative to reduce adolescent relationship violence.

Adolescent Objective 1 | Strategy 3

Partner across state and local health and education systems to implement effective comprehensive sexual health education in California.

Activities:

  • CDPH/MCAH will lead and fund implementation of ASH Ed with youth populations who face the greatest inequities in social and health outcomes using evidence-based and evidence-informed curriculum.

  • CDPH/MCAH will lead in coordinating the California Adolescent Sexual Health Work Group (ASHWG) and participate in the Steering Committee to strengthen the network of state health, education partners, and non-governmental organizations working to improve adolescent sexual and reproductive health.

  • CDPH/MCAH will partner with ASHWG to develop and disseminate resources and best practices to local MCAH programs.

  • CDPH/MCAH will partner with ASHWG and its members to share anti-racist resources and information that is applicable to adolescent well-being.

  • CDPH/MCAH will support the Healthy Sexual Development workgroup led by the California Department of Social Services to ensure comprehensive sexual health education is provided to foster youth.

Adolescent Focus Area 2

Improve awareness of and access to youth-friendly services for all adolescents.

Small group of adolescents ages 12-17 

Adolescent Objective 2

By 2025, increase the percentage of adolescents aged 12-17 with a preventive medical visit in the past year from 59.8% (NSCH 2020-2021) to 83.8%.

Adolescent Objective 2 | Strategy 1

Lead to develop and implement best practices in CDPH/MCAH-funded programs to support youth with accessing youth-friendly preventive care, sexual and reproductive health care, and mental health care.

Activities:

  • CDPH/MCAH will continue to partner with local agencies and MCAH programs to implement evidence-based screening tools or evidence-informed assessments to link adolescents to needed services.

  • CDPH/MCAH will partner with local AFLP agencies to develop or update youth-friendly assessments, educational materials, and content with local resources.

  • CDPH/MCAH will lead to ensure CDPH/MCAH program participants are referred to youth-friendly preventive care, mental health care, and sexual and reproductive health care, including the California's Family Planning, Access, Care and Treatment program.

  • CDPH/MCAH will partner in the development and dissemination of recommendations for adolescent preventive care to local MCAH programs.  

Adolescent Objective 2 | Strategy 2

Partner to increase access to and the quality of preventive care for adolescents in California.

Activities:

  • CDPH/MCAH will partner with current CDPH workgroups to increase access to and the quality of preventive care for adolescents.

Adolescent Focus Area 3

Improve social, emotional, and mental well-being and build resilience among all adolescents.

adolescent group 

Adolescent Objective 3

By 2025, increase the percentage of adolescents aged 12-17 who have an adult in their lives with whom they can talk about serious problems from 76.7% (NSDUH 2018-2019) to 79.7%.

Adolescent Objective 3 | Strategy 1

Lead to strengthen resilience among expectant and parenting adolescents to improve health, social, and educational outcomes.

Activities:

  • CDPH/MCAH will lead and fund implementation of AFLP Positive Youth Development (PYD).

  • CDPH/MCAH will lead trainings for local staff to implement the AFLP PYD model.

  • CDPH/MCAH will lead ongoing evaluation activities and make AFLP PYD model updates as needed.

  • CDPH/MCAH will lead implementation and analysis of data from evidence-informed/based assessment tools such as the AFLP Youth Resilience Survey. 

Adolescent Objective 3 | Strategy 2

Partner to identify opportunities to build protective factors for adolescents at the individual, community, and systems levels.

Activities:

  • CDPH/MCAH will partner to disseminate PYD tools and resources to local adolescent and MCAH programs.

  • CDPH/MCAH will lead to ensure youth participation and feedback is embedded in local and state adolescent programs and initiatives.

  • CDPH/MCAH will report on AFLP indicators related to this objective, including whether youth reported having an adult in their lives with whom they can talk about serious problems.

  • CDPH/MCAH will partner with the Essentials for Childhood Initiative, part of CDPH's Injury and Violence Prevention Branch.

  • CDPH/MCAH will lead in promoting best practices for engagement of parents/caring adults. 

Adolescent Objective 3 | Strategy 3

Partner to strengthen knowledge and skills among providers, individuals, and families to identify signs of distress and mental health-related needs among adolescents.

Activities:

  • CDPH/MCAH will lead in assessing need around adolescent mental health.

  • CDPH/MCAH will lead in promoting mental health and well-being trainings and resources via MCAH communications platforms.

  • CDPH/MCAH will support the current Children and Youth Behavioral Health Initiative of the Agency for Health and Human Services to identify upstream protective factors for mental health and well-being.

Children and Youth with Special Health Care Needs (CYSHCN) Health

Children and Youth with Special Health Care Needs Priority Need 1: Make systems of care easier to navigate for CYSHCN and their families.

Surveillance:
The Maternal, Child, and Adolescent Health Division of the California Department of Public Health (CDPH/MCAH) monitored the prevalence of California children and youth with special health care needs (CYSHCN), receipt of services, and county-level planning efforts as part of routine health surveillance efforts. The following indicators and measures listed in the table below are continuously and systematically collected, analyzed, and interpreted to guide program planning, implementation, and evaluation of interventions. These indicators were analyzed at the state and sub-state (where sample size allowed) levels to identify specific improvement opportunities.

Select CYSHCN Health Indicators and Measures Data Sources for CYSHCN Health Indicators and Measures

CYSHCN enrollment in California Children’s Services (CCS) (1-22 years of age and % by health coverage)

CMS Net

Newborn Hearing Screening

Natus database

NPM 12 (transition), NOM 17.1 (prevalence), NOM 17.2 (systems of care)

National Survey of Children’s Health

Number of local MCAH Scope of Work activities (CYSHCN Objective 1 and 3)

Local MCAH Scopes of Work 

CYSHCN Focus Area 1

Build capacity at the state and local levels to improve systems that serve CYSHCN and their families.

Child finger painting 

CYSHCN Objective 1

By 2025, maintain the number of local MCAH programs (44) that chose to implement a Scope of Work objective focused on CYSHCN public health systems and services.

CYSHCN Objective 1 | Strategy 1:

Lead state and local MCAH capacity-building efforts to improve and expand public health systems and services for CYSHCN.

Activities:

  • CDPH/MCAH will lead (fund, guide, and oversee) five innovation grants for local MCAH programs focused on public health strategies to improve support for CYSHCN and their families.

  • CDPH/MCAH will provide technical assistance and training to local MCAH programs as needed on improving systems that serve CYSHCN and their families.

  • CDPH/MCAH will maintain and expand partnerships with CYSHCN system leaders to increase coordination across sectors and improve systems that serve CYSHCN and their families.

CYSHCN Objective 1 | Strategy 2

Lead program outreach and assessment within state MCAH to ensure best practices for serving CYSHCN are integrated into all MCAH programs. 

Activities:

  • The CDPH/MCAH CYSHCN domain team will partner with the CDPH/MCAH Child Health domain team to ensure consistency and coordination and promote best practices within CYSHCN and child-serving MCAH Division programs

CYSHCN Objective 1 | Strategy 3

Partner to build data capacity to understand needs and health disparities in the CYSHCN population.

Activities:

  • CDPH/MCAH will aggregate and analyze a six-year (2016-2021) publicly available National Survey of Children's Health (NSCH) dataset. This aggregated dataset will yield a sample size that will allow us to explore special health care needs status and its main correlates with a somewhat higher degree of accuracy in preparation for analyzing the 2022 NSCH California oversample data.

  • The California Department of Health Care Services/Integrated Systems of Care (DHCS/ISCD), in partnership with the California Perinatal Quality Care Collaborative (CPQCC), will continue to examine existing cardiac datasets to determine whether linkages can be established between CPQCC Neonatal Intensive Care Unit, High Risk Infant Follow-up (HRIF), and cardiac data to increase identification of neonates requiring HRIF follow-up.

  • DHCS/ISCD will continue to assess referrals and loss to follow-up from the HRIF program to identify and address any disparities.

CYSHCN Focus Area 2

Increase access to coordinated primary and specialty care for CYSHCN.

Close up of nurse 

CYSHCN Objective 2

By 2025, increase the percentage of adolescents with special health care needs (ages 12-17) who received services necessary to make transitions to adult health care from 18.4% to 20.2% (NSCH 2016-2020).

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CYSHCN Objective 2 | Strategy 1

Partner on identifying and incorporating best practices to ensure that CYSHCN and their families receive support for a successful transition to adult health care. 

Activities:

  • CDPH/MCAH and DHCS/ISCD will disseminate information to local MCAH and CCS programs on best practices and emerging care coordination opportunities for successful transitions to adult health care.

  • DHCS/ISCD will support CCS counties to collaborate with Medi-Cal Managed Care Plans and pertinent community-based organizations on facilitating transition to adult services for CYSHCN.

CYSHCN Objective 2 | Strategy 2

Fund DHCS/ISCD to assist CCS counties in providing necessary care coordination and case management to CCS clients to facilitate timely and effective access to care and appropriate community resources. 

Activities:

  • DHCS/ISCD will ensure that CCS counties educate families about CCS benefits to assist them in navigating services.

  • DHCS/ISCD will support CCS counties to collaborate with Medi-Cal Managed Care Plans to facilitate care coordination and case management.

  • DHCS/ISCD will ensure that CCS shares best practices with Medi-Cal so that these may be broadly applied to the CYSHCN population.

CYSHCN Objective 2 | Strategy 3

Fund DHCS/ISCD to increase timely access to qualified providers for CCS clients to facilitate coordinated care.

Activities:

  • DHCS/ISCD will continue Interagency Agreements with the University of California, Davis and the University of California, San Francisco to ensure the provision of appropriate specialty/subspecialty medical expertise.

  • DHCS/ISCD will continue to process provider applications for CCS paneling in a timely manner.

  • DHCS/ISCD will continue to improve/streamline CCS review processes to ensure that comprehensive desk reviews and facility site visits are conducted in a timely manner.

  • DHCS/ISCD will continue to implement processes to improve the timeliness of eligibility determinations and service authorization requests.

CYSHCN Priority Need 2: Increase engagement and build resilience among CYSHCN and their families.

CYSHCN Focus Area 3

Empower and support CYSHCN, families, and family-serving organizations to participate in health program planning and implementation.

Group solidarity 

CYSHCN Objective 3

By 2025, maintain the number of local MCAH programs (17) that chose to implement a Scope of Work objective focused on family engagement, social/community inclusion, and/or family strengthening for CYSHCN.

CYSHCN Objective 3 | Strategy 1

Partner to train and engage CYSHCN and families to improve CYSHCN-serving systems through input and involvement in state and local MCAH program design, implementation, and evaluation.

Activities:

  • CDPH/MCAH will provide technical assistance on family engagement to local MCAH programs, including connections to family-serving organizations and trained local family advocates, in collaboration with Family Voices of California t

CYSHCN Objective 3 | Strategy 2:

Fund DHCS/ISCD to support continued family engagement in CCS program improvement, including the Whole Child Model, to assist families of CYSHCN in navigating services.

Activities:

  • DHCS/ISCD will ensure that CCS counties continue to obtain family input by encouraging family participation in transition planning and/or Special Care Center team meetings, advisory committees, and task forces.

  • DHCS/ISCD will continue to promote participation in the family advisory committees of the Whole Child Model health plans.

  • DHCS/ISCD will continue to encourage family representation in the CCS Advisory Group and other pertinent stakeholder groups.

CYSHCN Objective 3 | Strategy 3:

Support statewide and local efforts to increase resilience among CYSHCN and their families.

Activities:

  • The CDPH/MCAH CYSHCN domain team, in partnership with the CDPH/MCAH Child Health Domain team, will support local MCAH programs to enhance trauma-informed and resilience-building practices in case management and public health nursing programs.

  • DHCS/ICSD will support Medi-Cal providers and CCS counties in the promotion of trauma-informed practices in case management.

  • DHCS/ISCD will support CCS counties in informing families of benefits/services and educating them in the navigation of such services.

  • DHCS/ISCD will ensure that CCS counties collaborate with county Departments of Behavioral Health to facilitate referrals to appropriate mental health services for CYSHCN.​​

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