Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.

April 18, 2008

1. PUBLICATION AND TOOLKIT HIGHLIGHT INTERAGENCY AGREEMENTS BETWEEN STATE TITLE V AND TITLE XIX PROGRAMS

State MCH-Medicaid Coordination: A Review of Title V and Title XIX Interagency Agreements serves as a tool to provide technical assistance to state agencies in achieving successful and required coordination between their Maternal and Child Health Block Grant (Title V) and Medicaid (Title XIX) programs. The second edition, developed for the Health Resources and Services Administration's Maternal and Child Health Bureau under contract to Georgetown University, updates seminal work carried out by the Association of Maternal and Child Health Programs. The document begins with a review of federal legislation pertaining to Title V and Title XIX interagency agreements (IAAs) and a summary of how states have incorporated this legislation and other components into their IAAs. The document then presents recommended components and methodologies in developing new IAAs and a model IAA as a template for states. Finally, the document highlights promising practices being carried out by states that have developed successful partnerships through their IAAs. The document is available at http://mchb.hrsa.gov/IAA.

An electronic toolkit containing links to online and printer-friendly versions of the publication, full-text versions of collected state IAAs, a searchable database of key components of state IAAs, and links to additional resources is also available from the MCH Library's Web site at http://www.mchlibrary.info/IAA.

• Approximately 11% of infants and young children from birth to age 5 had an identified special health care need.
• IYCSHCN were more likely than their peers without special health care needs to have an identified usual source of care; to have unmet needs for prescription medication, medical care, and urgent care; and to have problems seeing a specialist.
• IYCSHCN used significantly more medical services than their age-matched peers.
• Total yearly health care expenditures for IYCSHCN were significantly higher than those of their peers without special health care needs ($2,923 vs. $770).
• An estimated 10.5% of families with an infant or young child with special health care needs paid more than $500 over the course of a year for health care expenses, whereas only 2.8% families of with an infant or young child with no special health care needs did so.

• A total of 960 randomly selected charts reflecting a total of 6,806 patient days were evaluated. A total of 2,388 triggers were detected (mean rate of 2.49 triggers per patient) and a total of 107 ADEs were identified (mean rates of 11.1 ADEs per 1,000 patients, 15.7 ADEs per 1,000 patient days, and 1.23 ADEs per 1,000 medication doses).
• Of the 107 ADEs identified in the study, 104 (97.2%) contributed to or resulted in temporary harm to the patient and required intervention; 22% percent were preventable, 17.8% could have been identified earlier, 16.8% could have been mitigated more effectively, and only 3.7% had a voluntary hospital occurrence report associated with the event.
• The medication-management stage during which a medication error was most likely to occur (resulting in a preventable ADE) was the monitoring phase (62.5%; defined as failure to review a prescribed regimen for appropriateness and detection of problems or failure to use appropriate clinical or laboratory data for adequate assessment of patient response to prescribed therapy).
• The medication class most frequently associated with an ADE was analgesics or opioids.
• The most frequent type of ADE was pruritis (severe itching).