2 Attachment B - PERFORMANCE AND SYSTEMS OUTCOME MEASURES

Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System

Attachment B - Form 2 - Revised

OMB: 0906-0017

Document [docx]
Download: docx | pdf

Shape1

OMB No: 0906-0017

Expiration Date: 07/31/2021








THE MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING PROGRAM




FORM 2






PERFORMANCE AND SYSTEMS OUTCOME MEASURES








Public Burden Statement: The information collected will be used to provide quality improvement guidance and technical assistance and to help inform the development of early childhood systems. The OMB control number for this project is 0906-0017 and expires xx/xx/2x Public reporting burden for this collection of information is estimated to average 360 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857.

MEASURE 1



1.

BENCHMARK AREA: MATERNAL AND NEWBORN HEALTH


CONSTRUCT: PRETERM BIRTH

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Percent of infants (among mothers who enrolled in home visiting prenatally before 37 weeks) who are born

preter m following program enrollment

4. SPECIFICATION


NUMERATOR: Number of live births (index child or subsequent children among mothers who enrolled in home visiting prenatally before 37 weeks) born before 37 completed weeks of gestation and after enrollment


DENOMINATOR: Number of live births after enrollment who were born to mothers enrolled in home visiting prenatally before 37 weeks

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 0



1.

BENCHMARK AREA: MATERNAL AND NEWBORN HEALTH


CONSTRUCT: BREASTFEEDING

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Percent of infants (among mothers who enrolled in home visiting prenatally) who were breastfed any amount at 6 months of age

4. SPECIFICATION


NUMERATOR: Number of infants aged 6-12 months (index child among mothers who enrolled in home visiting prenatally) who were breastfed any amount at 6 months of age


DENOMINATOR: Number of infants aged 6-12 months (index child among mothers who enrolled in home visiting prenatally) enrolled in home visiting for at least 6 months

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 3



1.

BENCHMARK AREA: MATERNAL AND NEWBORN HEALTH


CONSTRUCT: DEPRESSION SCREENING

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of primary caregivers enrolled in home visiting who are screened for depression using a validated tool within 3 months of enrollment (for those not enrolled prenatally) or within 3 months of delivery (for those enrolled prenatally)

4. SPECIFICATION


NUMERATOR: For those not enrolled prenatally, number of primary caregivers enrolled in home visiting

who are screened for depression within the first 3 months since enrollment; for those enrolled prenatally, the number of primary caregivers screened for depression within 3 months of delivery


DENOMINATOR: For those not enrolled prenatally, the number of primary caregivers enrolled in home visiting for at least 3 months; for those enrolled prenatally, the number of primary caregivers enrolled in

home visiting for at least three months post delivery

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. When there is no documentation of whether a screening occurred using a validated tool, but all other data elements are known, then the primary caregiver should be included in the denominator (if eligible), but not in the numerator. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:


7. NOTES

8. Measurement Tool Utilized


Indicate the validated measurement tool(s) utilized to address this measure

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 4


1.

BENCHMARK AREA: MATERNAL AND NEWBORN HEALTH


CONSTRUCT: WELL CHILD VISIT

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of children enrolled in home visiting who received the last recommended visit based on the American Academy of Pediatrics (AAP) schedule

4. SPECIFICATION


NUMERATOR: Number of children (index child) enrolled in home visiting who received the last recommended well child visit based on the AAP schedule


DENOMINATOR: Number of children (index child) enrolled in home visiting

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown, including if a home visit occurred but the home visitor did not collect the data. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 5



1.

BENCHMARK AREA: MATERNAL AND NEWBORN HEALTH


CONSTRUCT: POSTPARTUM CARE

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of mothers enrolled in home visiting prenatally or within 30 days after delivery who received a postpartum visit with a healthcare provider within 8 weeks (56 days) of delivery

4. SPECIFICATION


NUMERATOR: Number of mothers enrolled in home visiting prenatally or within 30 days after delivery who received a postpartum visit with a healthcare provider within 8 weeks (56 days) of delivery


DENOMINATOR: Number of mothers who enrolled in home visiting prenatally or within 30 days after delivery and remained enrolled for at least 8 weeks (56 days) after delivery

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.



MEASURE 6


1.

BENCHMARK AREA: MATERNAL AND NEWBORN HEALTH


CONSTRUCT: TOBACCO CESSATION REFERRALS

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of primary caregivers enrolled in home visiting who reported using tobacco or cigarettes at enrollment and were referred to tobacco cessation counseling or services within 3 months of enrollment.

4. SPECIFICATION


NUMERATOR: Number of primary caregivers enrolled in home visiting who reported using tobacco or cigarettes enrollment and were referred to tobacco cessation counseling or services within 3 months of enrollment


DENOMINATOR: Number of primary caregivers enrolled in home visiting who reported using tobacco or cigarettes at enrollment and were enrolled for at least 3 months

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown, including if there is no documentation of whether the primary caregiver used tobacco or cigarettes at enrollment since inclusion in the denominator cannot be determined if the screening result is unknown. When there is no documentation of whether a referral was provided, but all other data elements are known and inclusion in the denominator can be determined,

then the primary caregiver should be included in the denominator (if eligible), but not in the numerator.


6.b. Value – Enter the number of cases missing from measure calculation:


All cases of missing data should be excluded from the measure calculation.


7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 7



1.

BENCHMARK AREA: CHILD INJURIES, ABUSE, NEGLECT, AND MALTREATMENT AND EMERGENCY DEPARTMENT VISITS


CONSTRUCT: SAFE SLEEP

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of infants enrolled in home visiting that are always placed to sleep on their backs, without bed-sharing and without soft bedding

4. SPECIFICATION


NUMERATOR: Number of infants (index child aged less than 1 year) enrolled in home visiting whose

primary caregiver reports that they are always placed to sleep on their backs, without bed-sharing and without soft bedding


DENOMINATOR: Number of infants (index child) enrolled in home visiting who were aged less than 1 year during the reporting period

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 8



1.

BENCHMARK AREA: CHILD INJURIES, ABUSE, NEGLECT, AND MALTREATMENT AND EMERGENCY DEPARTMENT VISITS


CONSTRUCT: CHILD INJURY

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Rate of injury-related visits to the Emergency Department (ED) during the reporting period among children enrolled in home visiting

4. SPECIFICATION


NUMERATOR: Number of parent-reported nonfatal injury-related visits to the ED during the reporting period among children (index child) enrolled in home visiting


DENOMINATOR: Number of children (index child) enrolled in home visiting

5.

VALUE FOR REPORTING PERIOD (rate)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 9



1.

BENCHMARK AREA: CHILD INJURIES, ABUSE, NEGLECT, AND MALTREATMENT AND EMERGENCY DEPARTMENT VISITS


CONSTRUCT: CHILD MALTREATMENT

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Percent of children enrolled in home visiting with at least 1 investigated case of maltreatment following enrollment within the reporting period

4. SPECIFICATION


NUMERATOR: Number of children (index child) enrolled in home visiting with at least 1 investigated case of maltreatment following enrollment within the reporting period


DENOMINATOR: Number of children (index child) enrolled in home visiting

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 10



1.

BENCHMARK AREA: SCHOOL READINESS AND ACHIEVEMENT


CONSTRUCT: PARENT-CHILD INTERACTION

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of primary caregivers enrolled in home visiting who receive an observation of caregiver-child interaction by the home visitor using a validated tool

4. SPECIFICATION


NUMERATOR: Number of primary caregivers enrolled in home visiting who receive an observation of

caregiver-child interaction by the home visitor using a validated tool


DENOMINATOR: Number of primary caregivers enrolled in home visiting with children reaching the target age range

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. When there is no documentation of whether the index child received an observation of caregiver-child interaction by the home visitor using a validated tool, but all other data elements are known, then the index child should be included in the denominator (if eligible), but not in the numerator. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:


7. NOTES

8.

Measurement Tool Utilized


Indicate the validated measurement tool(s) utilized to address this measure

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 11



1.

BENCHMARK AREA: SCHOOL READINESS AND ACHIEVEMENT


CONSTRUCT: EARLY LANGUAGE AND LITERACY ACTIVITIES

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of children enrolled in home visiting with a family member who reported that during a typical week s/he read, told stories, and/or sang songs with their child daily, every day

4. SPECIFICATION


NUMERATOR: Number of children (index child) enrolled in home visiting with a family member who reported that during a typical week s/he read, told stories, and/or sang songs with their child daily, every day


DENOMINATOR: Number of children (index child) enrolled in home visiting

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value – Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 12



1.

BENCHMARK AREA: SCHOOL READINESS AND ACHIEVEMENT


CONSTRUCT: DEVELOPMENTAL SCREENING

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of children enrolled in home visiting with a timely screen for developmental delays using a validated parent- completed tool

4. SPECIFICATION


NUMERATOR: Number of children (index child) enrolled in home visiting with at least one screening within the AAP-defined age groups during the reporting period


DENOMINATOR: Number of children (index child) enrolled in home visiting reaching the specified time frame during the reporting period

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. When there is no documentation of whether a screening occurred using a validated tool, but all other data elements are known, then the child should be included in the denominator (if eligible), but not in the numerator. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES



8.

Measurement Tool Utilized


Indicate the validated measurement tool(s) utilized to address this measure

Shape10

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the

missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 13



1.

BENCHMARK AREA: SCHOOL READINESS AND ACHIEVEMENT


CONSTRUCT: BEHAVIORAL CONCERN INQUIRIES

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of postnatal home visits where primary caregivers were asked if they have any concerns regarding their child’s development, behavior, or learning

4. SPECIFICATION


NUMERATOR: Number of postnatal home visits where primary caregivers enrolled in home visiting were asked if they have any concerns regarding their child’s development, behavior, or learning


DENOMINATOR: Total number of postnatal home visits during the reporting period

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. If a home visit occurred, but there is no documentation of whether the primary caregiver was asked about behavioral concerns, then the home visit should be included in the denominator (if eligible i.e., postnatal visit), but not in the numerator. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES


* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 14



1.

BENCHMARK AREA: CRIME OR DOMESTIC VIOLENCE


CONSTRUCT: INTIMATE PARTNER VIOLENCE SCREENING

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of primary caregivers enrolled in home visiting who are screened for intimate partner violence (IPV) within 6 months of enrollment using a validated tool

4. SPECIFICATION


NUMERATOR: Number of primary caregivers enrolled in home visiting who are screened for IPV using a validated tool within 6 months of enrollment


DENOMINATOR: Number of primary caregivers enrolled in home visiting for at least 6 months

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. When there is no documentation of whether a screening occurred using a validated tool (including if a screening did not occur because the caregiver was male and they only have validated tools for use among female caregivers), but all other data elements are known, then the primary caregiver should be included in the denominator (if eligible), but not in the numerator. All cases of missing data should be excluded from the measure calculation.


6.b. Value – Enter the number of cases missing from measure calculation:


7. NOTES

8.

Measurement Tool Utilized


Indicate the validated measurement tool(s) utilized to address this measure

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 15



1.

BENCHMARK AREA: FAMILY ECONOMIC SELF-SUFFICIENCY


CONSTRUCT: PRIMARY CAREGIVER EDUCATION

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Percent of primary caregivers who enrolled in home visiting without a high school degree or equivalent who subsequently enrolled in or maintained continuous enrollment in middle school or high school, or completed high school or equivalent during their participation in home visiting

4. SPECIFICATION


NUMERATOR: Number of primary caregivers who enrolled in or maintained continuous enrollment in middle school or high school, or completed a high school degree or equivalent after enrollment in home visiting (and met the conditions specified in the denominator)


DENOMINATOR: Number of primary caregivers without a high school degree or equivalent at enrollment

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.

MEASURE 16



1.

BENCHMARK AREA: FAMILY ECONOMIC SELF-SUFFICIENCY


CONSTRUCT: CONTINUITY OF INSURANCE COVERAGE

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Percent of primary caregivers enrolled in home visiting for at least 6 months who had continuous health insurance coverage for the most recent 6 consecutive months

4. SPECIFICATION


NUMERATOR: Number of primary caregivers enrolled in home visiting who reported having continuous health insurance coverage for the most recent 6 consecutive months at the most recent data collection time point in the reporting period


DENOMINATOR: Number of primary caregivers enrolled in home visiting for at least 6 months


5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. All cases of missing data should be excluded from the measure calculation.


6.b. Value – Enter the number of cases missing from measure calculation:

7. NOTES

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 17



1.

BENCHMARK AREA: COORDINATION AND REFERRALS FOR OTHER COMMUNITY RESOURCES AND SUPPORTS


CONSTRUCT: COMPLETED DEPRESSION REFERRALS

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Percent of primary caregivers referred to services for a positive screen for depression who receive one or more service contacts

4. SPECIFICATION


NUMERATOR: Number of primary caregivers enrolled in home visiting who received recommended services for depression (and met the conditions specified in the denominator)


DENOMINATOR: Number of primary caregivers enrolled in home visiting who had a positive screen for depression within 3 months of enrollment (for those not enrolled prenatally) or within 3 months of delivery (for those enrolled prenatally) and were referred for services

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. Data are also considered missing if there is no documentation of whether a referral was provided. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:


7. NOTES

8.

Measurement Tool Utilized


Indicate the validated measurement tool(s) utilized to address this measure

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 18



1.

BENCHMARK AREA: COORDINATION AND REFERRALS FOR OTHER COMMUNITY RESOURCES AND SUPPORTS


CONSTRUCT: COMPLETED DEVELOPMENTAL REFERRALS

2.

TYPE OF MEASURE


Systems Outcome

3.

PERFORMANCE MEASURE


Percent of children enrolled in home visiting with positive screens for developmental delays (measured using a validated tool) who receive services in a timely manner

4. SPECIFICATION


NUMERATOR: Number of children enrolled in home visiting who a) received individualized developmental support from a home visitor; b) were referred to early intervention services and receive an evaluation within

45 days; OR c) were referred to other community services who received services within 30 days (and met the condition specified in the denominator)


DENOMINATOR: Number of children enrolled in home visiting with positive screens for developmental delays (measured using a validated tool)

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. When there is no documentation of whether a referral was provided, but all other data elements are available and inclusion in the denominator can be determined, then the primary caregiver should be included in the denominator (if eligible), but not in the numerator. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:

7. NOTES

8.

Measurement Tool Utilized


Indicate the validated measurement tool(s) utilized to address this measure

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.


MEASURE 19



1.

BENCHMARK AREA: COORDINATION AND REFERRALS FOR OTHER COMMUNITY RESOURCES AND SUPPORTS


CONSTRUCT: INTIMATE PARTNER VIOLENCE REFERRALS

2.

TYPE OF MEASURE


Performance Indicator

3.

PERFORMANCE MEASURE


Percent of primary caregivers enrolled in home visiting with positive screens for IPV (measured using a validated tool) who receive referral information to IPV resources

4. SPECIFICATION


NUMERATOR: Number of primary caregivers enrolled in home visiting who received referral information to IPV resources (and met the conditions specified in the denominator)


DENOMINATOR: Number of primary caregivers enrolled in home visiting with positive screens for IPV (measured using a validated tool) within 6 months of enrollment

5.

VALUE FOR REPORTING PERIOD (percentage)


Value:


Numerator:


Denominator:

6.

MISSING DATA*


6.a. Definition


Data are considered missing if one or more data elements needed to determine inclusion in the numerator or denominator are unknown. When there is no documentation of whether a referral was provided, but all other data elements are available and inclusion in the denominator can be determined, then the primary caregiver should be included in the denominator (if eligible), but not in the numerator. All cases of missing data should be excluded from the measure calculation.


6.b. Value Enter the number of cases missing from measure calculation:


7. NOTES

8.

Measurement Tool Utilized


Indicate the validated measurement tool(s) utilized to address this measure

* Note: When the percent of missing data is ≥10%, a table note should be provided that addresses the reason for the missing data, and if possible, plans to reduce the amount of missing data in future reporting.



OPTIONAL MEASURE 1



1.

BENCHMARKHEALTH NEWBORN AND MATERNAL AREA:


CONSTRUCT:SUBSTANCE USE SCREENING

2.

TYPEMEASURE OF


PerformanceIndicator

3.

PERFORMANCEMEASURE


Percentscreened for unhealthy alcohol use, nonmedical prescription drug use, and illicit drug use using a validated tool within 6 months of enrollment are who visiting home in enrolled caregivers primary of

4.SPECIFICATION


NUMERATOR:Number of primary caregivers enrolled in home visiting who were screened for both unhealthy alcohol use and drug use using validated tool(s) within 6 months of enrollment


DENOMINATOR: Number of primary caregivers enrolled in home visiting for at least 6 months

5.

VALUE(percentage)PERIOD REPORTING FOR


Value:


Numerator:


Denominator:

6.

MISSINGDATA*


6.a.Definition


Data are considered missing if one or more datacalculation. measure the from excluded be should data of missing cases All numerator. the in not but eligible), (if denominator the in included be should elements are known, then the primary caregiver occurred using a validated tool, but all other data there is no documentation of whether a screening numerator or denominator are unknown. When elements needed to determine inclusion in the


6.b.calculation: measure from cases missing of number the Enter Value


7.NOTES

8.Utilized Tool Measurement


Indicatemeasure this address to utilized tool(s) validated measurement the

*reporting. future data in missing of amount to reduce the plans possible, if data, and missing the for reason the addresses that provided be should note table a ≥10%, data is of missing percent the When Note:



OPTIONAL MEASURE 2



1.

BENCHMARK AREA: COORDINATION AND REFERRALS FOR OTHER COMMUNITY RESOURCES ANDSUPPORTS


CONSTRUCT:SUBSTANCE USE REFERRALS COMPLETED

2.

TYPEMEASURE OF


SystemsOutcome

3.

PERFORMANCEMEASURE


Percentor more service contacts one receive who for substance use screen positive a for services to referred primary caregivers of

4.SPECIFICATION


NUMERATOR:the denominator) in specified conditions the met (and for substance use services recommended received who visiting home in enrolled caregivers primary of Number


DENOMINATOR:unhealthy alcohol use and/or drug use for screen positive a had who visiting home in enrolled caregivers primary of Number (measured using a validated tool) within 6 months of enrollment and were referred for services

5.

VALUE(percentage)PERIOD REPORTING FOR


Value:


Numerator:


Denominator:

6.

MISSINGDATA*


6.a.Definition


Data are considered missing if one or more datacalculation. measure the from excluded was provided. All cases of missing data should be if there is no documentation of whether a referral numerator or denominator are unknown. Data are also considered missing elements needed to determine inclusion in the


6.b.calculation: measure from cases missing of number the Enter Value


7.NOTES

8.

MeasurementUtilized Tool


Indicatemeasure this address to utilized tool(s) validated measurement the

*reporting. future data in missing of amount to reduce the plans possible, if data, and missing the for reason the addresses that provided be should note table a ≥10%, data is of missing percent the When Note:






























DEFINITIONS OF KEY TERMS



Construct Number

Construct

Key Term Definitions

1.

Preterm Birth

Preterm Birth: a birth before 37 completed weeks of gestation (defined as up to 36 weeks and

6 days).1

2.

Breastfeeding

Breastfeeding: in addition to breast milk fed directly from the mother to the infant, breastfeeding also includes feeding the infant pumped or expressed breast milk.

3.

Depression Screening

Depression: aligned with each grantee’s validated depression screening tool’s definition of

depression.

4.

Well-Child Visit

AAP schedule for Well-Child Visits: Updated AAP 2017 Recommendations for Pediatric

Preventive Health Care https://www.aap.org/en-us/Documents/periodicity_schedule.pdf

5.

Postpartum Care

Postpartum Care Visit: A postpartum visit is a visit between the woman and her health care provider to assess the mother’s current physical health, including the status of pregnancy-related conditions like gestational diabetes, screen for postpartum depression, provide counseling on infant care and family planning as well as screening and referrals for the management of chronic conditions. Additionally, a provider may use this opportunity to conduct a breast exam and discuss breastfeeding. The American College of Obstetricians and Gynecologists

recommends that mothers receive a postpartum care visit within 6 weeks after delivery. 2

6.

Tobacco Cessation Referrals

Tobacco Use: combustibles (cigarettes, cigars, pipes, hookahs, bidis), non-combustibles (chew,

dip, snuff, snus, and dissolvables), and ENDS.

7.

Safe Sleep

No definitions required

8.

Child Injury

Injury-related Emergency Department Visit: Injuries refer to the following causes of

mechanisms of injury: motor vehicle, suffocation, drowning, poisoning, fire/burns, falls, sports and recreation, and intentional injuries, such as child maltreatment.3

9.

Child Maltreatment

Investigated Case: all children with an allegation of maltreatment that were screened-in for investigation or assessment and further received an investigation. 4 A screened-in report is one

that is accepted for investigation or assessment based on the state’s screen-in criteria. 5

10.

Parent-Child Interaction

No definitions required

11.

Early Language and Literacy Activities

No definitions required

12.

Developmental Screening

Developmental Delay: delays in any or all areas including cognitive, social, language, sensory,


1 Behrman R, Stith Butler A. eds. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press, 2007.

2 Optimizing postpartum care. Committee Opinion No. 666. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;127:e187–92. Retrieved from https://www.acog.org/-

/media/Committee-Opinions/Committee-on-Obstetric-Practice/co666.pdf?dmc=1&ts=20180221T1421452301

3 Centers for Disease Control and Prevention. National Action Plan for Child Injury Prevention. 2012. Retrieved from http://www.cdc.gov/safechild/NAP/background.html#unint

4 Child Welfare Information Gateway. Child Maltreatment 2015: Summary of Key Findings. Retrieved from https://www.childwelfare.gov/pubs/factsheets/canstats/

5 Child Welfare Information Gateway. Screening and Intake. Retrieved from https://www.childwelfare.gov/topics/responding/iia/screening/





and emotional development.6

13.

Behavioral Concern Inquiries

No definitions required

14.

IPV Screening

Intimate Partner Violence: physical violence, sexual violence, stalking and psychological aggression (including coercive acts) by a current or former intimate partner. An intimate partner is a person with whom one has a close personal relationship that can be characterized by the

following: emotional connectedness, regular contact, ongoing physical contact and sexual behavior, identity as a couple, familiarity and knowledge about each other’s lives. 7

15.

Primary Caregiver Education

No definitions required

16.

Continuity of Insurance Coverage

Continuous Health Insurance Coverage: having health insurance coverage without any lapses.

17.

Completed Depression Referrals

Recommended services: specific techniques and intervention models delivered in the context of client characteristics, culture, and preferences that have shown to have positive effects on outcomes through rigorous evaluations and have demonstrated to achieve positive outcomes for

the client.8

18.

Completed Developmental Referrals

Developmental Delay: delays in any or all areas including cognitive, social, language, sensory, and emotional development.6

19.

IPV Referrals

Intimate Partner Violence: physical violence, sexual violence, stalking and psychological aggression (including coercive acts) by a current or former intimate partner. An intimate partner is a person with whom one has a close personal relationship that can be characterized by the

following: emotional connectedness, regular contact, ongoing physical contact and sexual behavior, identity as a couple, familiarity and knowledge about each other’s lives. 7

Optiona l

Measure 1

Substance Use

Screenings

Unhealthy Alcohol Use and Drug Use: Definitions of unhealthy alcohol and drug use should align with each awardees’s validated substance use screening tool’s definition.

Optional

Measure 2

Completed

Substance Use

Referrals

Recommended services:pecific techniques and intervention models delivered in the context of client characteristics, culture, and preferences that have shown to have positive effects on outcomes through rigorous evaluations and have demonstrated to achieve positive outcomes for the client.S 8











6 U.S. National Library of Medicine, National Institutes of Health. Psychological Index Terms via Unified Medical Language System, 2015. Retrieved from http://ghr.nlm.nih.gov/glossary=developmentaldelay

7 Centers for Disease Control and Prevention. Injury Prevention and Control: Division of Violence Prevention, 2015. Retrieved from http://www.cdc.gov/violenceprevention/intimatepartnerviolence/definitions.html

8 Home Visiting Collaborative Improvement and Innovation Network.

DRAFT REVISION – MARCH 25, 2021


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title3.Revised Form 2 - Benchmark Performance Measures
AuthorCheca, Cristina (HRSA)
File Modified0000-00-00
File Created2021-12-30

© 2024 OMB.report | Privacy Policy