Crosswalk of Performance Measures

Health Resources and Services Administration

Maternal and Child Health Bureau

Discretionary Grant Performance Measures

OMB No. 0915-0298

Expires: _________

Attachment B-1

Crosswalk of Proposed to Prior
Performance Measures

OMB Clearance Package

DGIS Performance Measure Crosswalk to prior DGIS OMB Package
Performance Measure	Measure Status	Prior PM # (if applicable)	Topic	Data Source
ore 1	New in 2016 Package	N/A	Grant Impact	Prepopulated from NOA; Grantee self-report
Core 2	New in 2016 Package	N/A	Quality Improvement	Grantee self-report
Core 3	New in 2016 Package	N/A	Health Equity – MCH Outcomes	Grantee self-report
CB 1	New in 2016 Package	N/A	State Capacity for Advancing the Health of MCH Populations	Grantee self-report
CB 2	New in 2016 Package	N/A	Technical Assistance	Prepopulated from Domain Measures
CB 3	New in 2016 Package	N/A	Impact Measurement	Grantee self-report
CB 4	Revised in 2016, included in prior OMB approved package	5	Sustainability	Grantee self-report
CB 5	Revised in 2016, included in prior OMB approved package	3, 4	Scientific Publications	Prepopulated from Domain Measures
CB 6	New in 2016 Package	N/A	Products	Prepopulated from Domain Measures
Program Satisfaction	Removed since prior OMB approved package	1	The percent of MCHB supported programs that are satisfied with the leadership of and services received from MCHB.	N/A
Client Satisfaction	Removed since prior OMB approved package	2	The percent of MCHB customers (clients) of MCHB programs that are satisfied with services received from MCHB supported programs.	N/A
Cultural Competence	Removed since prior OMB approved package	10	The degree to which MCHB-funded programs have incorporated cultural and linguistic competence elements into their policies, guidelines, contracts and training.	N/A
Dental	Removed since prior OMB approved package	12	The percent of children under age 21 enrolled in Medicaid for at least 6 months continuously during the year who receive any preventive or treatment dental service.	N/A
Data Evaluation	Removed since prior OMB approved package	13	The percent of States that have MCH staff who perform specific epidemiological activities and other MCH evaluations and analyses.	N/A
Data Evaluation	Removed since prior OMB approved package	14	The percent of States that have MCH staff who perform specific epidemiological activities and other MCH evaluations and analyses.	N/A
Infrastructure	Removed since prior OMB approved package	24	The degree to which MCHB-funded initiatives contribute to infrastructure development through core public health assessment, policy development and assurance functions.	N/A
Data Evaluation	Removed since prior OMB approved package	25	The degree to which States electronically link vital statistics data sets, Medicaid, and other health information systems data sets.	N/A
Infrastructure	Removed since prior OMB approved package	27	The degree to which grantees have mechanisms in place to ensure quality in the design, development, and dissemination of new information resources that they produce each year.	N/A
Infrastructure	Removed since prior OMB approved package	33	The degree to which MCHB-funded initiatives work to promote sustainability of their programs or initiatives beyond the life of MCHB funding.	N/A
WMH 1	New in 2016 Package	N/A	Prenatal Care	Grantee self-report or HS Data Collection
WMH 2	New in 2016 Package	N/A	Perinatal/ Postpartum Care	Grantee self-report or HS Data Collection
WMH 3	New in 2016 Package	N/A	Well Woman Visit/ Preventive Health Care	Grantee self-report or HS Data Collection
WMH 4	New in 2016 Package	N/A	Depression Screening	Grantee self-report or HS Data Collection
WH	Removed since prior OMB approved package	21	The percentage of women participating in MCHB- funded programs who have a completed referral, among those women who receive a referral.	N/A
WH	Removed since prior OMB approved package	22	The degree to which MCHB-funded programs facilitate health providers' screening of women participants for risk factors.	N/A
WH	Removed since prior OMB approved package	35	The degree to which States and communities have implemented comprehensive systems for women’s health services.	N/A
WH	Removed since prior OMB approved package	36	The percentage of pregnant participants in MCHB-funded programs receiving prenatal care beginning in the first trimester.	N/A
WH	Removed since prior OMB approved package	38	The percentage of completed referrals among women in MCHB-funded programs.	N/A
PIH 1	New in 2016 Package	N/A	Safe Sleep	Grantee self-report or HS Data Collection
PIH 2	New in 2016 Package	N/A	Breast Feeding	Grantee self-report or HS Data Collection
PIH 3	New in 2016 Package	N/A	Newborn Screening	Grantee self-report or HS Data Collection
CH 1	New in 2016 Package	N/A	Well Child Visit	Grantee self-report or HS Data Collection
CH 2	New in 2016 Package	N/A	Quality of Well Child Visit	Grantee self-report
CH 3	New in 2016 Package	N/A	Developmental Screening	Grantee self-report or HS Data Collection
CH 4	New in 2016 Package	N/A	Injury Prevention	Grantee self-report
CH	Removed since prior OMB approved package	50	Percent of very low birth weight live births	N/A
CH	Removed since prior OMB approved package	51	Percent of live singleton births weighing less than 2,500 grams	N/A
CH	Removed since prior OMB approved package	52	The infant mortality rate per 1,000 live births	N/A
CH	Removed since prior OMB approved package	53	The neonatal mortality rate per 1,000 live births	N/A
CH	Removed since prior OMB approved package	54	The post-neonatal mortality rate per 1,000 live births	N/A
CH	Removed since prior OMB approved package	55	The perinatal mortality rate per 1,000 live births plus fetal deaths	N/A
CSHN/ Medical Home	Removed since prior OMB approved package	18	The percent of children with special health care needs age 0 through 18 who receive coordinated, ongoing, comprehensive care within a medical home.	N/A
CH/Medical Home	Removed since prior OMB approved package	42	The percentage of all children age 0 to 2 participating in MCHB-funded programs who receive coordinated, ongoing, comprehensive care within a medical home.	N/A
CSHCN 1	Revised in 2016, included in prior OMB approved package	7	Family Engagement	Grantee self-report
CSHCN 2	Revised in 2016, included in prior OMB approved package	40/41	Access to and Use of Medical Home	Grantee self-report
CSHCN 3	New in 2016 Package	N/A	Transition to Adult Health Care	Grantee self-report
CSHN/ Health Insurance	Removed since prior OMB approved package	15	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 needed services.	N/A
CSHN/Health Insurance	Removed since prior OMB approved package	16	The degree to which grantees have assisted in increasing the percentage of pregnant women and percentage of children whose families have continuous and adequate private and/or public insurance, or other financing to pay for needed services.	N/A
CSHN/ Infrastructure	Removed since prior OMB approved package	31	The degree to which grantees have assisted States and communities in planning and implementing comprehensive, coordinated care for MCH populations.	N/A
CSHN/ Youth	Removed since prior OMB approved package	37	The degree to which grantees have worked to increase the percentage of youth who have received services necessary to transition to all aspects of adult life, including adult health care, work, and independence.	N/A
Medical Home	Removed since prior OMB approved package	40	The degree to which grantees have facilitated access to medical homes for MCH populations.	N/A
Medical Home	Removed since prior OMB approved package	41	The degree to which grantees have assisted in developing, supporting, and promoting medical homes for MCH populations.	N/A
AH 1	New in 2016 Package	N/A	Adolescent Well Visit	Grantee self-report
AH 2	New in 2016 Package	N/A	Injury Prevention	Grantee self-report
AH 3	New in 2016 Package	N/A	Screening for Major Depressive Disorder	Grantee self-report
LC 1	New in 2016 Package	N/A	Adequate Health Insurance Coverage	Grantee self-report or HS Data Collection
LC 2	Revised in 2016, included in prior OMB approved package	39	Tobacco and eCigarette Cessation	Grantee self-report or HS Data Collection
LC 3	New in 2016 Package	N/A	Oral Health	Grantee self-report
Training 01	New in 2016 Package	N/A	MCH Training Program and Healthy Tomorrows Family Member/ Youth/ Community Member participation	Grantee self-report
Training 02	New in 2016 Package	N/A	MCH Training Program and Healthy Tomorrows Cultural Competence	Grantee self-report
Training 03	New in 2016 Package	N/A	Healthy Tomorrows Title V Collaboration	Grantee self-report
Training 04	Revised in 2016, included in prior OMB approved package	59	Title V Collaboration	Grantee self-report
Training 05	Revised in 2016, included in prior OMB approved package	85	Policy	Grantee self-report
Training 06	Revised in 2016, included in prior OMB approved package	09	Diversity of Long-Term Trainees	Grantee self-report
Training 07	New in 2016 Package	N/A	MCH Pipeline Program – Work with MCH populations	Grantee self-report
Training 08	New in 2016 Package	N/A	MCH Pipeline Program – Work with underserved or vulnerable populations	Grantee self-report
Training 09	Revised in 2016, included in prior OMB approved package	83	MCH Pipeline - Graduate Program Enrollment	Grantee self-report
Training 10	Revised in 2016, included in prior OMB approved package	08	Leadership	Grantee self-report
Training 11	Revised in 2016, included in prior OMB approved package	84	Work with MCH Populations	Grantee self-report
Training 12	Revised in 2016, included in prior OMB approved package	60	Interdisciplinary Practice	Grantee self-report
Training 13	Included in 2016, no changes from prior OMB approved package	64	Diverse Adolescent Involvement (LEAH-specific)	Grantee self-report
Training 14	Revised in 2016, included in prior OMB approved package	86	Medium-Term Trainees Skill and Knowledge (PPC-Specific)	Grantee self-report
Training	Removed since prior OMB approved package	26	The extent of training and technical assistance (TA) provided and the degrees to which grantees have mechanisms in place to ensure quality in their training and TA activities.	N/A
Training	Removed since prior OMB approved package	58	The percentage of MCH training faculty who demonstrate field leadership in the areas of academic, clinical, public health/policy and advocacy.	N/A
Training	Removed since prior OMB approved package	63	The degree to which LEND programs incorporate medical home concepts into their curricula/training.	N/A
Training	Removed since prior OMB approved package	61	The degree to which MCH long term interdisciplinary trainees report valuing their interdisciplinary training at 1, and 5 years.	N/A
Training	Removed since prior OMB approved package	65	The percent of individuals who participated in long-term nutrition training that are practicing in a Maternal and Child Health (MCH) related field within 5 years after receiving training.	N/A
Training	Removed since prior OMB approved package	82	The degree to which MCH training programs use principles of adult learning, scholarly and scientific research, and effective education models that utilize available technology.	N/A
EMSC 01	New in 2016 Package	N/A	Using NEMSIS Data to Identify Pediatric Patient Care Needs.	Grantee self-report
EMSC 02	New in 2016 Package	N/A	Pediatric Emergency Care Coordination	Grantee self-report
EMSC 03	New in 2016 Package	N/A	Use of pediatric-specific equipment	Grantee self-report
EMSC 04	Included in 2016, no changes from prior OMB approved package	74	Pediatric medical emergencies	Grantee self-report
EMSC 05	Included in 2016, no changes from prior OMB approved package	75	Pediatric traumatic emergencies	Grantee self-report
EMSC 06	Included in 2016, no changes from prior OMB approved package	76	Written inter-facility transfer guidelines that contain all the components as per the implementation manual.	Grantee self-report
EMSC 07	Included in 2016, no changes from prior OMB approved package	77	Written inter-facility transfer agreements that covers pediatric patients.	Grantee self-report
EMSC 08	Included in 2016, no changes from prior OMB approved package	79	Established permanence of EMSC	Grantee self-report
EMSC 09	Included in 2016, no changes from prior OMB approved package	80	Established permanence of EMSC by integrating EMSC priorities into statutes/regulations.	Grantee self-report
EMSC	Removed since prior OMB approved package	66	The degree to which the State/Territory has ensured the operational capacity to provide pediatric emergency care.	N/A
EMSC	Removed since prior OMB approved package	67	The adoption of requirements by the State/Territory for pediatric emergency education for the recertification of paramedics.	N/A
EMSC	Removed since prior OMB approved package	68	The degree to which the State/Territory has established permanence of EMSC in the State/Territory EMS system.	N/A
EMSC	Removed since prior OMB approved package	73	The percent of patient care units in the State/Territory that have essential pediatric equipment and supplies.	N/A
EMSC	Removed since prior OMB approved package	78	The adoption of requirements by the State/Territory for pediatric emergency education for the license/certification renewal of basic life support (BLS) and advanced life support (ALS) providers.	N/A
EMSC	Removed since prior OMB approved package	81	The percent of program participant mothers who breastfeed their infants at 6 months of age.	N/A
EMSC	Removed since prior OMB approved package	69	The percent of States and jurisdictions with pediatric guidelines for acute care to provide emergency and critical care.	N/A
EMSC	Removed since prior OMB approved package	71	The percent of pre-hospital provider agencies in the State/Territory that have on-line pediatric medical direction.	N/A
EMSC	Removed since prior OMB approved package	72	The percent of pre-hospital provider agencies in the State/Territory that have off-line pediatric medical direction.	N/A
HS 01	New in 2016 Package	N/A	Reproductive Life Plan	Grantee self-report or HS Data Collection
HS 02	Revised in 2016, included in prior OMB approved package	17, 20	Usual Source of Care	Grantee self-report or HS Data Collection
HS 03	New in 2016 Package	N/A	Interconception Planning	Grantee self-report or HS Data Collection
HS 04	New in 2016 Package	N/A	Early Elective Delivery	Grantee self-report or HS Data Collection
HS 05	New in 2016 Package	N/A	Intimate Partner Violence Screening	Grantee self-report or HS Data Collection
HS 06	New in 2016 Package	N/A	Father/ Partner Involvement during Pregnancy	Grantee self-report or HS Data Collection
HS 07	New in 2016 Package	N/A	Father and/or Partner Involvement with Child 0-24 Months	Grantee self-report or HS Data Collection
HS 08	New	N/A	Daily Reading	Grantee self-report or HS Data Collection
HS 09	New	N/A	CAN implementation	Grantee self-report or HS Data Collection
HS 10	New	N/A	CAN Participation	Grantee self-report or HS Data Collection
F2F 1	Revised in 2016, included in prior OMB approved package	70	Provide National Leadership for families with children with special health needs	Grantee self-report
Form 1	Included in 2016, no changes from prior OMB approved package	N/A	MCHB Project Budget Details For FY____	Grantee self-report
Form 2	Included in 2016, no changes from prior OMB approved package	N/A	Project Funding Profile	Grantee self-report
Form 3	Revised in 2016, included in prior OMB approved package	N/A	Budget Details by Types of Individuals Served	Grantee self-report
Form 4	Revised in 2016, included in prior OMB approved package	N/A	Project Budget and Expenditures - revisions combine Population-Based Services and Infrastructure Building Services into Public Health Services and Systems	Grantee self-report
Form 5	Included in 2016, no changes from prior OMB approved package	N/A	Number of Individuals Served (unduplicated)	Grantee self-report
Form 6	Included in 2016, no changes from prior OMB approved package	N/A	Maternal & Child Health Discretionary Grant Project Abstract for FY ______	Grantee self-report
Form 7	Included in 2016, no changes from prior OMB approved package	N/A	Discretionary Grant Project Summary Data and Demographics	Grantee self-report
Form 8	Included in 2016, no changes from prior OMB approved package	N/A	MCH Discretionary Grant Project Abstract for FY (For Research Projects ONLY)	Grantee self-report
Technical Assistance/ Collaboration Form	Included in 2016, no changes from prior OMB approved package	N/A	Technical Assistance/Collaboration refers to mutual problem solving and collaboration on a range of issues, which may include program development, clinical services, collaboration, program evaluation, needs assessment, and policy & guidelines formulation.	Based on information reported in Domain measures.
Continuing Education Form	Removed since prior OMB approved package	N/A	Continuing Education programs or trainings that serve to enhance the knowledge and/or maintain the credentials and licensure of professional providers.	N/A
Products, Publications and Submissions Data Collection Form	Included in 2016, no changes from prior OMB approved package	N/A	List of products, publications and submissions addressing maternal and child health that have been published or produced with grant support (either fully or partially) during the reporting period.	Based on information reported in Domain measures.
MCH Training Program Data Forms	New in 2016 Package	N/A	List of all personnel (faculty, staff, and others) contributing to MCH training project

Attachment B-1 | 7