Focus Area 16: Maternal, Infant, and Child Health: Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

Fetal, Infant, Child, and Adolescent Deaths

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

16-1.

Reduce fetal and infant deaths.

Target and baseline:

Objective	Reduction in Fetal and Infant Deaths	1997 Baseline Rate per 1,000 Live Births Plus Fetal Deaths	2010 Target Rate per 1,000 Live Births Plus Fetal Deaths
16-1a.	Fetal deaths at 20 or more weeks of gestation	6.8	4.1
16-1b.	Fetal and infant deaths during perinatal period (28 weeks of gestation to less than 7 days after birth)	7.3¹	4.4²

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

Target and baseline:

Objective	Reduction in Infant Deaths	1998 Baseline Rate per 1,000 Live Births	2010 Target Rate per 1,000 Live Births
16-1c.	All infant deaths (within 1 year)	7.2	4.5
16-1d.	Neonatal deaths (within the first 28 days of life)	4.8	2.9
16-1e.	Postneonatal deaths (between 28 days and 1 year)	2.4	1.2

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

Target and baseline:

Objective	Reduction in Infant Deaths Related to Birth Defects	1998 Baseline Rate per 1,000 Live Births	2010 Target Rate per 1,000 Live Births
16-1f.	All birth defects	1.4³	0.7⁴
16-1g.	Congenital heart defects	0.46⁵	0.23⁶

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

16-1h. Reduce deaths from sudden infant death syndrome (SIDS).

Target: 0.23 deaths⁷ per 1,000 live births.

Baseline: 0.67⁸ deaths per 1,000 live births were from SIDS in 1999.⁸

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Baseline revised from 7.5 after November 2000 publication.
² Target revised from 4.5 because of baseline revision after November 2000 publication.
³ Baseline revised from 1.6 after November 2000 publication.
⁴ Target revised from 1.1 because of baseline revision after November 2000 publication.
⁵ Baseline revised from 0.53 after November 2000 publication.
⁶ Target revised from 0.38 because of baseline revision after November 2000 publication.
⁷ Target revised from 0.25 because of baseline revision after November 2000 publication.
⁸ Baseline and baseline year revised from 0.72 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

16-2.

Reduce the rate of child deaths.

Target and baseline:

Objective	Reduction in Deaths of Children	1998 Baseline Rate per 100,000	2010 Target Rate per 100,000
16-2a.	Children aged 1 to 4 years	34.1¹	20.0²
16-2b.	Children aged 5 to 9 years	17.2³	13.0⁴

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Baseline revised from 34.6 after November 2000 publication.
² Target revised from 18.6 because of baseline revision after November 2000 publication.
³ Baseline revised from 17.7 after November 2000 publication.
⁴ Target revised from 12.3 because of baseline revision after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

16-3.

Reduce deaths of adolescents and young adults.

Target and baseline:

Objective	Reduction in Deaths of Adolescents and Young Adults	1998 Baseline Rate per 100,000	2010 Target Rate per 100,000
16-3a.	Adolescents aged 10 to 14 years	21.5¹	16.5²
16-3b.	Adolescents aged 15 to 19 years	69.5³	38.0⁴
16-3c.	Young adults aged 20 to 24 years	92.7⁵	41.5⁶

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Baseline revised from 22.1 after November 2000 publication.
² Target revised from 16.8 because of baseline revision after November 2000 publication.
³ Baseline revised from 70.6 after November 2000 publication.
⁴Target revised from 39.8 because of baseline revision after November 2000 publication.
⁵ Baseline revised from 95.3 after November 2000 publication.
⁶ Target revised from 49.0 because of baseline revision after November 2000 publication.

Maternal Deaths and Illnesses

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

16-4.

Reduce maternal deaths.

Target: 4.3¹ maternal deaths per 100,000 live births.

Baseline: 9.9² maternal deaths per 100,000 live births occurred in 1999.²

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 3.3 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 7.1 and 1998 after November 2000 publication.

ORIGINAL OBJECTIVE

16-5.

Reduce maternal illness and complications due to pregnancy.

Target and baseline:

Objective	Reduction in Maternal Illness and Complications	1998 Baseline Rate per 100 Deliveries	2010 Target Rate per 100 Deliveries
16-5a.	Maternal complications during hospitalized labor and delivery	31.2	24.0
16-5b.	Ectopic pregnancies	Developmental	Developmental
16-5c.	Post partum complications, including post partum depression	Developmental	Developmental

Target setting method: Better than the best.

Data source: National Hospital Discharge Survey, CDC, NCHS.

Potential data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

OBJECTIVE WITH REVISIONS
(Including subobjectives deleted)

16-5.

Reduce maternal illness and complications due to pregnancy.

Target and baseline:

Objective*	Reduction in Maternal Illness and Complications	1998 Baseline Rate per 100 Deliveries	2010 Target Rate per 100 Deliveries
16-5a.	Maternal complications during hospitalized labor and delivery	31.2	24.0
~~16-5b.~~	(Subobjective deleted due to lack of data source)*~~Ectopic pregnancies~~	~~Developmental~~	~~Developmental~~
~~16-5c.~~	(Subobjective deleted due to lack of data source)* ~~Post partum complications,~~ ~~including post partum depression~~	~~Developmental~~	~~Developmental~~

* For data control purposes, subobjectives are not renumbered.

Target setting method: Better than the best.

Data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

~~Potential data source:~~ ~~National Hospital Discharge Survey (NHDS), CDC, NCHS.~~

REVISED OBJECTIVE

16-5.

Reduce maternal illness and complications due to pregnancy.

Target and baseline:

Objective*	Reduction in Maternal Illness and Complications	1998 Baseline Rate per 100 Deliveries	2010 Target Rate per 100 Deliveries
16-5a.	Maternal complications during hospitalized labor and delivery	31.2	24.0

* For data control purposes, subobjectives are not renumbered.

Target setting method: Better than the best.

Data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

Prenatal Care

NO CHANGE IN OBJECTIVE

16-6.

Increase the proportion of pregnant women who receive early and adequate prenatal care.

Target and baseline:

Objective	Increase in Maternal Prenatal Care	1998 Baseline Percent of Live Births	2010 Target Percent of Live Births
16-6a.	Care beginning in first trimester of pregnancy	83	90
16-6b.	Early and adequate prenatal care	74	90

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

ORIGINAL OBJECTIVE
16-7.	(Developmental) Increase the proportion of pregnant women who attend a series of prepared childbirth classes. Potential data sources: National Pregnancy and Health Survey, NIH, NICHD; National Survey of Family Growth (NSFG) or National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
16-7.	~~(Developmental)~~ Increase the proportion of pregnant women who attend a series of prepared childbirth classes. Target: 77 percent. Baseline: 66 percent of pregnant women attended a series of prepared childbirth classes in 2000. Target setting method: Better than the best. ~~Potential d~~Data sources: ~~National Pregnancy and Health Survey, NIH, NICHD;~~ ~~National Survey of Family Growth (NSFG) or National Health Interview Survey (NHIS),~~ ~~CDC, NCHS~~ National Survey of Early Childhood Health (NSECH), CDC, NCHS.
REVISED OBJECTIVE
16-7.	Increase the proportion of pregnant women who attend a series of prepared childbirth classes. Target: 77 percent. Baseline: 66 percent of pregnant women attended a series of prepared childbirth classes in 2000. Target setting method: Better than the best. Data source: National Survey of Early Childhood Health (NSECH), CDC, NCHS.

Obstetrical Care

NO CHANGE IN OBJECTIVE

16-8.

Increase the proportion of very low birth weight (VLBW) infants born at level III hospitals or subspecialty perinatal centers.

Target: 90 percent.

Baseline: 73 percent of VLBW infants were born at level III hospitals or subspecialty perinatal centers in 1996–97.

Target setting method: 25 percent improvement. (Better than the best will be used when data are available.)

Data source: Title V Reporting System, HRSA, MCHB.

NO CHANGE IN OBJECTIVE

16-9.

Reduce cesarean births among low-risk (full-term, singleton, vertex presentation) women.

Target and baseline:

Objective	Reduction in Cesarean Births	1998 Baseline Percent of Live Births	2010 Target Percent of Live Births
16-9a.	Women giving birth for the first time	18	15
16-9b.	Prior cesarean birth	72	63

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

Risk Factors

NO CHANGE IN OBJECTIVE

16-10.

Reduce low birth weight (LBW) and very low birth weight (VLBW).

Target and baseline:

Objective	Reduction in Low and Very Low Birth Weight	1998 Baseline Percent of Live Births	2010 Target Percent of Live Births
16-10a.	Low birth weight (LBW)	7.6	5.0
16-10b.	Very low birth weight (VLBW)	1.4	0.9

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

NO CHANGE IN OBJECTIVE

16-11.

Reduce preterm births.

Target and baseline:

Objective	Reduction in Preterm Births	1998 Baseline Percent of Live Births	2010 Target Percent of Live Births
16-11a.	Total preterm births	11.6	7.6
16-11b.	Live births at 32 to 36 weeks of gestation	9.6	6.4
16-11c.	Live births at less than 32 weeks of gestation	2.0	1.1

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
16-12.	(Developmental) Increase the proportion of mothers who achieve a recommended weight gain during their pregnancies. Potential data source: National Vital Statistics System (NVSS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
16-13.	Increase the percentage of healthy full-term infants who are put down to sleep on their backs. Target: 70 percent. Baseline: 35 percent of healthy full-term infants aged under 8 months were put down to sleep on their backs in 1996. Target setting method: Better than the best. Data source: National Infant Sleep Position Study, NIH, NICHD.

Developmental Disabilities and Neural Tube Defects

ORIGINAL OBJECTIVE

16-14.

Reduce the occurrence of developmental disabilities.

Target and baseline:

Objective	Reduction in Developmental Disabilities in Children	1991–94 Baseline Rate per 10,000	2010 Target Rate per 10,000
16-14a.	Mental retardation	131.0*¹	124.5²
16-14b.	Cerebral palsy	33.3^†3	31.6⁴
16-14c.	Autism spectrum disorder	Developmental	Developmental
16-14d.	Epilepsy	Developmental	Developmental

* Children aged 8 years in metropolitan Atlanta, GA, having an IQ of 70 or less.
^† Children aged 8 years in metropolitan Atlanta, GA.

Target setting method: 5 percent improvement.

Data source: Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP), CDC, NCEH.

¹Baseline revised from 131 after November 2000 publication.
² Target revised from 124 because of baseline revision after November 2000 publication.
³ Baseline revised from 32.2 after November 2000 publication.
⁴Target revised from 31.5 because of baseline revision after November 2000 publication.

OBJECTIVE WITH REVISIONS
(Including subobjective deleted)

16-14.

Reduce the occurrence of developmental disabilities.

Target and baseline:

Objective	Reduction in Developmental Disabilities in Children	1991–94 Baseline (unless noted) Rate per 10,000	2010 Target Rate per 10,000
16-14a.	Mental retardation	131.0*¹	124.5²
16-14b.	Cerebral palsy	33.3^†3	31.6⁴
	Reduction in age of identification	Months	Months
16-14c.	Autism spectrum disorder^‡	50 (1996)	48
~~16-14d.~~	(Subobjective deleted due to lack of data source)^§ ~~Epilepsy~~	~~Developmental~~	~~Developmental~~

* Children aged 8 years in metropolitan Atlanta, GA, having an IQ of 70 or less.
^†Children aged 8 years in metropolitan Atlanta, GA.
^‡Age at identification of autism.
^§For data control purposes, subobjectives are not renumbered.

Target setting method: 5 percent improvement.

Data source: Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP), CDC, NCEHBDDD.

¹ Baseline revised from 131 after November 2000 publication.
² Target revised from 124 because of baseline revision after November 2000 publication.
³ Baseline revised from 32.2 after November 2000 publication.
⁴ Target revised from 31.5 because of baseline revision after November 2000 publication.

REVISED OBJECTIVE

16-14.

Reduce the occurrence of developmental disabilities.

Target and baseline:

Objective*	Reduction in Developmental Disabilities in Children	1991–94 Baseline (unless noted) Rate per 10,000	2010 Target Rate per 10,000
16-14a.	Mental retardation	131.0^†1	124.5²
16-14b.	Cerebral palsy	33.3^‡3	31.6⁴
	Reduction in age of identification	Months	Months
16-14c.	Autism spectrum disorder^§	50 (1996)	48

* For data control purposes, subobjectives are not renumbered.
^†Children aged 8 years in metropolitan Atlanta, GA, having an IQ of 70 or less.
^‡Children aged 8 years in metropolitan Atlanta, GA.
^§Age at identification of autism.

Target setting method: 5 percent improvement.

Data source: Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP), CDC, NCBDDD.

¹ Baseline revised from 131 after November 2000 publication.
² Target revised from 124 because of baseline revision after November 2000 publication.
³ Baseline revised from 32.2 after November 2000 publication.
⁴ Target revised from 31.5 because of baseline revision after November 2000 publication.

NO CHANGE IN OBJECTIVE

16-15.

Reduce the occurrence of spina bifida and other neural tube defects (NTDs).

Target: 3 new cases per 10,000 live births.

Baseline: 6 new cases of spina bifida or another NTD per 10,000 live births occurred in 1996.

Target setting method: 50 percent improvement. (Better than the best will be used when data are available.)

Data source: National Birth Defects Prevention Network (NBDPN), CDC, NCBDDD.

NO CHANGE IN OBJECTIVE

16-16.

Increase the proportion of pregnancies begun with an optimum folic acid level.

Target and baseline:

Objective	Increase in Pregnancies Begun With Optimum Folic Acid Level	1991–94 Baseline Percent	2010 Target Percent
16-16a.	Consumption of at least 400 µg of folic acid each day from fortified foods or dietary supplements by nonpregnant women aged 15 to 44 years	21	80
		Concentration in ng/ml	Concentration in ng/ml
16-16b.	Median RBC folate level among nonpregnant women aged 15 to 44 years	160	220

Target setting method: Better than the best.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

Prenatal Substance Exposure

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

16-17.

Increase abstinence from alcohol, cigarettes, and illicit drugs among pregnant women.

Target and baseline:

Objective	Increase in Reported Abstinence in Past Month From Substances by Pregnant Women*	2002–03¹ Baseline (unless noted) Percent of Pregnant Women	2010 Target Percent of Pregnant Women
16-17a.	Alcohol	90²	95³
16-17b.	Binge drinking	96⁴	100
16-17c.	Cigarette smoking^†	87 (1998)	99
16-17d.	Illicit drugs	96⁵	100

* Pregnant women aged 15 to 44 years.
^† Smoking during pregnancy for all women giving birth in 1998 in 46 States, the District of Columbia, and New York City.

Target setting method: For 16-17a and 16-17c, better than the best; for 16-17b and 16-17d, complete elimination.

Data sources: National Survey on Drug Use and Health (NSDUH), SAMHSA; National Vital Statistics System (NVSS), CDC, NCHS.

¹ Baseline year revised from 1996–97 after November 2000 publication.
² Baseline revised from 86 after November 2000 publication.
³Target revised from 94 because of baseline revision after November 2000 publication.
⁴ Baseline revised from 99 after November 2000 publication.
⁵ Baseline revised from 98 after November 2000 publication.

ORIGINAL OBJECTIVE
16-18.	(Developmental) Reduce the occurrence of fetal alcohol syndrome (FAS). Potential data source: Fetal Alcohol Syndrome Network (FASNet), CDC, NCEH.
OBJECTIVE WITH REVISIONS
16-18.	~~(Developmental)~~ Reduce the occurrence of fetal alcohol syndrome (FAS). Target: 0.1 cases per 1,000 live births. Baseline: Fetal alcohol syndrome occurred in 0.4 per 1,000 live births* in 1995–97. Target setting method: Better than the best. ~~Potential d~~Data source: Fetal Alcohol Syndrome Surveillance Network (FASSNet), CDC, ~~NCEH~~NCBDDD. * Based on data from Alaska, Arizona, Colorado, and New York.
REVISED OBJECTIVE
16-18.	Reduce the occurrence of fetal alcohol syndrome (FAS). Target: 0.1 cases per 1,000 live births. Baseline: Fetal alcohol syndrome occurred in 0.4 per 1,000 live births* in 1995–97. Target setting method: Better than the best. Data source: Fetal Alcohol Syndrome Surveillance Network (FASSNet), CDC, NCBDDD. * Based on data from Alaska, Arizona, Colorado, and New York.

Breastfeeding, Newborn Screening, and Service Systems

ORIGINAL OBJECTIVE

16-19.

Increase the proportion of mothers who breastfeed their babies.

Target and baseline:

Objective	Increase in Mothers Who Breastfeed	1998 Baseline Percent	2010 Target Percent
16-19a.	In early post partum period	64	75
16-19b.	At 6 months	29	50
16-19c.	At 1 year	16	25

Target setting method: Better than the best.

Data source: Mothers’ Survey, Abbott Laboratories, Inc., Ross Products Division.

OBJECTIVE WITH REVISIONS

16-19.

Increase the proportion of mothers who breastfeed their babies.

Target and baseline:

Objective	Increase in Mothers Who Breastfeed	1998 Baseline (unless noted) Percent of Mothers	2010 Target Percent of Mothers
16-19a.	In early post partum period	64	75
16-19b.	At 6 months	29	50
16-19c.	At 1 year	16	25
16-19d.	Exclusively through 3 months	43 (2002)	60
16-19e.	Exclusively through 6 months	13 (2002)	25

Target setting method: Better than the best.

Data sources: Mothers’ Survey, Abbott Laboratories, Inc., Ross Products Division; National Immunization Survey (NIS), CDC, NIP and NCHS.

REVISED OBJECTIVE

16-19.

Increase the proportion of mothers who breastfeed their babies.

Target and baseline:

Objective	Increase in Mothers Who Breastfeed	1998 Baseline (unless noted) Percent of Mothers	2010 Target Percent of Mothers
16-19a.	In early post partum period	64	75
16-19b.	At 6 months	29	50
16-19c.	At 1 year	16	25
16-19d.	Exclusively through 3 months	43 (2002)	60
16-19e.	Exclusively through 6 months	13 (2002)	25

Target setting method: Better than the best.

Data sources: Mothers’ Survey, Abbott Laboratories, Inc., Ross Products Division; National Immunization Survey (NIS), CDC, NIP and NCHS.

ORIGINAL OBJECTIVE
16-20.	(Developmental) Ensure appropriate newborn bloodspot screening, followup testing, and referral to services. 16-20a. Ensure that all newborns are screened at birth for conditions mandated by their State-sponsored newborn screening programs, for example, phenylketonuria and hemoglobinopathies. 16-20b. Ensure that followup diagnostic testing for screening positives is performed within an appropriate time period. 16-20c. Ensure that infants with diagnosed disorders are enrolled in appropriate service interventions within an appropriate time period. Potential data source: Title V Performance Measures, HRSA, MCHB, National Newborn Screening and Genetic Resource Center.
OBJECTIVE WITH REVISIONS (Including subobjective deleted)
16-20.	(Developmental) Ensure appropriate newborn bloodspot screening, and followup testing~~, and referral to services~~. 16-20a. Ensure that all newborns are screened at birth for conditions mandated by their State-sponsored newborn screening programs~~, for example, phenylketonuria~~ ~~and hemoglobinopathies~~ by matching the number screened by the State to birth certificate information. 16-20b. Ensure that followup ~~diagnostic~~ testing for screened positives is performed within an appropriate time period by monitoring the period from time of birth to initial diagnosis~~within an appropriate time period~~. ~~16-20c.~~ (Subobjective deleted due to lack of data source) ~~Ensure that infants with~~ ~~diagnosed disorders are enrolled in appropriate service interventions within an~~ ~~appropriate time period.~~ Potential data source: Title V Performance Measures, HRSA, MCHB, National Newborn Screening and Genetic Resource Center (NNSGRC).
REVISED OBJECTIVE
16-20.	(Developmental) Ensure appropriate newborn bloodspot screening and followup testing. 16-20a. Ensure that all newborns are screened at birth for conditions mandated by their State-sponsored newborn screening programs by matching the number screened by the State to birth certificate information. 16-20b. Ensure that followup testing for screened positives is performed within an appropriate time period by monitoring the period from time of birth to initial diagnosis. Potential data source: Title V Performance Measures, HRSA, MCHB, National Newborn Screening and Genetic Resource Center (NNSGRC).

ORIGINAL OBJECTIVE
16-21.	(Developmental) Reduce hospitalization for life-threatening sepsis among children aged 4 years and under with sickling hemoglobinopathies. Potential data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
16-21.	~~(Developmental)~~ Reduce hospitalization for sickle cell disease among children aged 9 years and~~for life-threatening sepsis among children aged 4 years and~~ ~~under with sickling hemoglobinopathies~~ under. Target: 33.0 discharges per 100,000 children aged 9 years and under. Baseline: 41.3 hospital discharges for sickle cell disease per 100,000 children aged 9 years and under occurred in 1995–99. Target setting method: 20 percent improvement. ~~Potential d~~Data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.
REVISED OBJECTIVE
16-21.	Reduce hospitalization for sickle cell disease among children aged 9 years and under. Target: 33.0 discharges per 100,000 children aged 9 years and under. Baseline: 41.3 hospital discharges for sickle cell disease per 100,000 children aged 9 years and under occurred in 1995–99. Target setting method: 20 percent improvement. Data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

ORIGINAL OBJECTIVE
16-22.	(Developmental) Increase the proportion of children with special health care needs who have access to a medical home. Potential data source: Title V Reporting System, HRSA, MCHB.
OBJECTIVE WITH REVISIONS
16-22.	~~(Developmental)~~ Increase the proportion of children with special health care needs who have access to a medical home. Target: 100 percent. Baseline: 53 percent of children with special health care needs received care in medical homes during 2001. Target setting method: Total coverage. ~~Potential d~~Data source: ~~Title V Reporting System~~National Survey of Children With Special Health Care Needs (NSHCN), CDC, NCHS, and HRSA, MCHB.
REVISED OBJECTIVE
16-22.	Increase the proportion of children with special health care needs who have access to a medical home. Target: 100 percent. Baseline: 53 percent of children with special health care needs received care in medical homes during 2001. Target setting method: Total coverage. Data source: National Survey of Children With Special Health Care Needs (NSHCN), CDC, NCHS, and HRSA, MCHB.

ORIGINAL OBJECTIVE
16-23.	Increase the proportion of Territories and States that have service systems for children with special health care needs. Target: 100 percent. Baseline: 15.7 percent of Territories and States met Title V for service systems for children with special health care needs in FY 1997. Target setting method: Total coverage. Data source: Title V Block Grant Application Form 13, HRSA, MCHB.
OBJECTIVE WITH REVISIONS
16-23.	Increase the proportion of ~~Territories and States that have service systems~~ ~~for~~ children with special health care needs who receive their care in family-centered, comprehensive, and coordinated systems. Target: 100 percent. Baseline: ~~15.7~~35 percent ~~percent of Territories and States met Title V for service~~ ~~systems for~~of children with special health care needs received their care in family-centered, comprehensive, and coordinated systems in ~~FY 1997~~2001. Target setting method: Total coverage. Data source: ~~Title V Block Grant Application Form 13,~~ National Survey of Children With Special Health Care Needs (NSHCN), CDC, NCHS, and HRSA, MCHB.
REVISED OBJECTIVE
16-23.	Increase the proportion of children with special health care needs who receive their care in family-centered, comprehensive, and coordinated systems. Target: 100 percent. Baseline: 35 percent of children with special health care needs received their care in family-centered, comprehensive, and coordinated systems in 2001. Target setting method: Total coverage. Data source: National Survey of Children With Special Health Care Needs (NSHCN), CDC, NCHS, and HRSA, MCHB.

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