ADVANCING PUBLIC HEALTH

Advancing Early Childhood Systems and Infrastructure for 20 States for Health Resources Services Administration’s (HRSA) Maternal and Child Health Bureau

Recognizing that the early childhood period of growth and development is a critical time in a person’s life, the Health Resources Services Administration (HRSA) Maternal and Child Health Bureau (MCHB) established the state Early Childhood Comprehensive System (ECCS) Initiative in 2003. Their goal was to create a more effective system of resources and services for children ages 0-5 and their families. 

Altarum is proud to have supported the MCHB and the ECCS throughout their 20-plus-year journey, most recently by providing workforce training, infrastructure support, and resources to help HRSA and its 20 state grantees achieve their critical goals of building integrated maternal and early childhood comprehensive systems of care.

It is well documented that the first five years of a child’s life are critical for long-term developmental, cognitive, and physical well-being. Despite this knowledge, the statistics about the health of mothers and their young children are alarming. The percentage of infants born preterm and/or with low birthweight has been rising since 2013, as has the percentage of children aged 3-17 who have been diagnosed with developmental disabilities (17%). These are ongoing challenges, with disparities intensified by the pandemic, including caregivers who are experiencing significant decreases in their mental and emotional well-being. 

In 2021, the MCHB funded five-year cooperative agreements in 20 states to build integrated maternal and childhood comprehensive systems of care that are equitable, family centered, sustainable, and inclusive of the health system. These multigenerational programs are intended to focus on the prenatal-to-3-year-old population and have five goals:

  • Building a supporting infrastructure
  • Advancing a common vision
  • Transforming health systems
  • Establishing equity 
  • Developing policy and financing

Implementing these programs, ensuring staff are trained to administer the grants, and facilitating stakeholder collaboration requires program management and training to deliver effective change.

Altarum is providing intensive support to the 20 state grantees to achieve the five goals through the Early Childhood Systems Technical Assistance and Coordination Center (ECS-TACC). The ECS-TACC supports state teams to strategize partnerships, build staff capacity and skills, facilitate stakeholder collaboration, and envision a state infrastructure necessary for building comprehensive services to children and families. 

Among its diverse array of activities, the ECS-TACC has facilitated over 418 technical assistance encounters, with a significant portion dedicated to empowering family leadership. Additionally, the center has conducted site visits and organized numerous training events, such as state partner meetings, evaluation planning sessions, and communities of practice gatherings. Through this technical assistance, the ECS-TACC supports these 20 states in the completion of asset and gap analyses, state early childhood strategic plans, evaluation plans, and annual reports. Altarum works with subject matter experts from Morehouse School of Medicine, Georgetown University, the American Academy of Pediatrics (AAP), the Association of Maternal & Child Health Programs (AMCHP), the Center for the Study of Social Policy (CSSP), and the Children and Adolescent Health Measurement Initiative (CAHMI).

Florence Rivera, Program Manager for Altarum, said, “Each stakeholder, such as the healthcare systems and the many state programs like Title V and Medicaid, has their own way of supporting young children and their families. However, to successfully achieve the long-term big changes the states envision, you need systemic change and the support systems to make it happen. That’s where Altarum and our partners come in. Altarum brings our experience partnering with state programs and helps provide the bridge connecting stakeholders for implementing these programs.”

Altarum has provided broad research, planning, and evaluative services for the MCHB for more than 20 years. In addition to the ECCS, we have:

  • Hosted the inaugural Targeting Health Results for Infants from Vulnerable Environments (THRIVE) event
  • Led a strategic workgroup made up of MCHB staff and staff from 10 historically black colleges and universities to advance discussions and knowledge sharing around maternal and child health
  • Led the Innovations in Newborn Screening Interoperability Resource Center, which has a goal of reducing the morbidity and mortality associated with heritable disorders in newborns and children

The implementation and ongoing success of this program is possible due to the relationships Altarum established with the HRSA and our grant partners: James Bell Associates, Change Matrix, Georgetown University Center for Child and Human Development, and the Morehouse School of Medicine Center for Maternal Health. Ms. Rivera explains, “Altarum understands the unique skill sets that our partners bring to the table to solve the holistic challenges mothers and their young children face. We bring these skill sets together into one cohesive Training and Technical Assistance Center supporting 20 states.” 

Being able to hear from Technical Assistant Specialists what they are seeing and hearing across other state teams is helpful. TA sessions feel like therapy—such a relief and so useful.

– Representative from a state grantee