Puerto Rico The MCH Federal-State Partnership

 
The Assistant Secretariat for Family Health and Integrated Services of the PRDoH administers the MCH/CSHCN programs. In Puerto Rico, the Title V Program supports direct services not covered by the GIP, such as the provision of contraceptive methods for low income population and subspecialty services for CSHCN. Title V funds are also used to support needs assessments and other activities geared to improve the health status of WCBA, infants, children, adolescents and CSHCN. Among the most relevant programs which are implemented with the Title V funds we want to highlight the following: the Home Visiting Program and the Comprehensive Adolescent Program. The Title V provides leadership and supervision to other related programs, such as SSDI, Healthy Start, “Comenzando Bien” of March of Dimes, Universal Newborn Hearing Screening, Early Intervention Program, Sexual Abstinence Education Program, Addressing Asthma from a Public Health Perspective and its Surveillance System, Early Childhood Comprehensive Systems and the Birth Defects Surveillance System.		  
MATERNAL & CHILD HEALTH (MCH) MEASURES
Title V - MCH National Performance Measures State 2007 Results State 2012 Goal
The percent of screen positive newborns who received timely follow up to definitive diagnosis and clinical management for condition(s) mandated by their State-sponsored newborn screening programs. 100.0% 100%
The percent of children with special health care needs age 0 to 18 years whose families partner in decision making at all levels and are satisfied with the services they receive. (CSHCN survey) 44.8% 59%
The percent of children with special health care needs age 0 to 18 who receive coordinated, ongoing, comprehensive care within a medical home. (CSHCN Survey) 38.7% 49%
The percent of children with special health care needs age 0 to 18 whose families have adequate private and/or public insurance to pay for the services they need. (CSHCN Survey) 17.0% 23%
Percent of children with special health care needs age 0 to 18 whose families report the community-based service systems are organized so they can use them easily. (CSHCN Survey) 68.0% 77%
The percentage of youth with special health care needs who received the services necessary to make transitions to all aspects of adult life, including adult health care, work, and independence. 9.1% 20%
Percent of 19 to 35 month olds who have received full schedule of age appropriate immunizations against Measles, Mumps, Rubella, Polio, Diphtheria, Tetanus, Pertussis, Haemophilus Influenza, and Hepatitis B. 91.2% 96.5%
The rate of birth (per 1,000) for teenagers aged 15 through 17 years. 29.5 30.2
Percent of third grade children who have received protective sealants on at least one permanent molar tooth. 5.1% 9%
The rate of deaths to children aged 14 years and younger caused by motor vehicle crashes per 100,000 children. 1.0 0.9
The percent of mothers who breastfeed their infants at 6 months of age. 26.5% 32%
Percentage of newborns who have been screened for hearing before hospital discharge. 97.5% 99%
Percent of children without health insurance. 0.4% 0.3%
Percentage of children, ages 2 to 5 years, receiving WIC services with a Body Mass Index (BMI) at or above the 85th percentile. 39.7% 34%
Percentage of women who smoke in the last three months of pregnancy. 1.5% 1.4%
The rate (per 100,000) of suicide deaths among youths aged 15 through 19. 1.0 1
Percent of very low birth weight infants delivered at facilities for high-risk deliveries and neonates. 41.7% 57%
Percent of infants born to pregnant women receiving prenatal care beginning in the first trimester. 82.0% 93%
Title V - MCH National Outcome Measures State 2007 Results State 2012 Goal
The infant mortality rate per 1,000 live births. 5.2 6.3
The ratio of the black infant mortality rate to the white infant mortality rate. 0 0
The neonatal mortality rate per 1,000 live births. 3.5 5.1
The postneonatal mortality rate per 1,000 live births. 1.7 1.7
The perinatal mortality rate per 1,000 live births plus fetal deaths. 5.4 6.2
The child death rate per 100,000 children aged 1 through 14. 6.0 8
Title V - MCH State Performance Measures State 2007 Results State 2012 Goal
The number of HIV positive pregnant women treated with AZT. 98.7% 100%
Establish a Home Visiting program in at least 90% of the Island by the year 2,010. 89.7% 95%
Prevalence of tobacco use among pregnant women 2.6% 1.5%
The birth rate among girls 10-14 years of age 0.9 1
The rate of cesarean section in Puerto Rico 49.1% 23.8%
Develop and maintain an active surveillance system for at least 55 birth defect diagnoses by 2010. 78.2% 100%
Reduce the prevalence at birth of neural tube defects (NTD's) 9.6 5
The rate of deaths to children aged 1-14 caused by asthma 0.3 0.1
State Population: 3,942,375
Live Births: 48,590
 
TITLE V FEDERAL - STATE BLOCK GRANT EXPENDITURES

By Number of Individuals Served and Population Group
Populations Served Number of Individuals Served Expenditures FY 2007
Pregnant Women 42,148  $4,515,957 13.7%
Infants < 1 year old 48,063  $4,515,958 13.7%
Children 1 to 22 years old 77,235  $10,602,683 32.2%
Children with Special Healthcare Needs 7,990  $11,618,631 35.3%
Others 39,377  $0 0%
Administration   $1,627,425 4.9%
Totals 214,813 $32,880,654 100%
 
By Source of Funds
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By Category of Services
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FAMILY PARTICIPATION IN CSHCN PROGRAM
 
Family members participate on advisory committee or task forces and are offering training, mentoring, and reimbursement, when appropriate.
3		  
 
Financial support (financial grants, technical assistance, travel, and child care) is offered for parent activities or parent groups.
3		  
 
Family members are involved in the Children with Special Health Care Needs elements of the MCH Block Grant Application process.
2		  
 
Family members are involved in service training of CSHCN staff and providers.
3		  
 
Family members hired as paid staff or consultants to the State CSHCN program (a family member is hired for his or her expertise as a family member).
1		  
 
Family members of diverse cultures are involved in all of the above activities.
1		  
 
 
FY 2007 Total: 13
Total Possible:

 18
Scale:  0 = Not Met
1 = Partially Met
2 = Mostly Met
3 = Completely Met
 

MCH PARTNERSHIP FUNDS
FY 2007
Title V Federal-State Block Grant:

32,880,654
Other MCHB Grant Programs:

1,099,644
Bioterrorism Grant Program:

0
Total MCH Partnership Funds:

33,980,298
 
 
CONTACT INFORMATION

For More Information on Title V:

Title V Program, contact:
Manuel I. Vargas-Bernal, MD, MPH
Director of the Maternal Child and Adolescent Health Division
PO Box 70184
San Juan , PR 00936-8184
(787) 274-5680
(787) 294-0726
mivargas@salud.gov.pr
 
Title V Program's Services for Children with Special Health Care Needs, contact:
Naydamar Pérez de Otero, MD, MPH
CSHCN Director
PO Box 70184
San Juan, PR 00936-8184
(787) 274-5660
(787) 274-3301
nperez@salud.gov.pr
 
 
FY 2007 TITLE V AND MCHB DISCRETIONARY GRANTS

Note: If the title of the grant is underlined in the list below, you can view a copy of the abstract for that grant by clicking on the title (hyperlink). If the title of grant is not underlined, no abstract is currently available.

Emergency Medical Services for Children (EMSC)
 
EMSC Partnership Grants
UNIVERSITY OF PUERTO RICO
San Juan, PR
$115,000
(EMSC Partnership Grants)

Healthy Start
 
ELIMINATING DISPARITIES IN PERINATAL HEALTH
PUERTO RICO DEPARTMENT OF HEALTH
San Juan, PR
$500,000
(Healthy Start Initiative-Eliminating Racial/Ethnic Disparities)

Title V - Community Integrated Service Systems (CISS)
 
CISS - SECCS (PLANNING)
PUERTO RICO DEPARTMENT OF HEALTH
San Juan, PR
$140,000
(Community-Based Integrated Service Systems (Local/State))

Title V - Special Projects of Regional and National Significance (SPRANS)
 
Healthy Tomorrows Partnership for Children Program
UNIVERSITY OF PUERTO RICO
San Juan, PR
$50,000
(Healthy Tomorrows Partnership for Children Program)
 
PUERTO RICO STATE SYSTEMS DEVELOPMENT INITIATIVE
PUERTO RICO DEPARTMENT OF HEALTH
San Juan, PR
$94,644
(State Systems Development Initiative)

Traumatic Brain Injury
 
Traumatic Brain Injury Protection and Advocacy
OFC OF THE OMBUDSMAN FOR PERSONS W/DISABILITIES
SAN JUAN, PR
$50,000
(Traumatic Brain Injury Protection and Advocacy)

Universal Newborn Hearing Screening
 
Universal Newborn Hearing Screening and Intervention
PUERTO RICO DEPARTMENT OF HEALTH
San Juan, PR
$150,000
(Universal Newborn Hearing Screening and Intervention)
 

* Data not available

Population Data: For the 50 states, the District of Columbia, and Puerto Rico: Population estimates (July 1, 2007), U.S. Bureau of the Census, for the remaining seven jurisdictions: 2007 CIA World Factbook; Washington, DC. Live Births: National Vital Statistics Reports, Vol. 56, No. 7 (December 5, 2007), Centers for Disease Control. 2006 Live Birth data for Guam was not available, therefore 2005 data was used from National Vital Statistics Reports, Vol. 55, No.11 (December 28, 2006), Centers for Disease Control. 2005 data for the Pacific Islands was retrieved from Pacific Regional Information System (PRISM). 2005 Live Birth data was obtained directly from FM.

MCH Partnership Funds – FY 07: This MCH Partnership total includes other MCHB grant programs, which was collected from HRSA’s Electronic Handbook (EHB) System for Fiscal Year 2007.
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