Capacity Assessment for State Title V CAST5

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Capacity Assessment for State Title V (CAST-5)

• Assisting states and territories in optimizing
  their capacity to address key maternal and child
  health issues

www.amchp.org/cast5
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CAST-5 Goal

• To help every state and territory understand and
  optimize its capacity to identify and address key
  MCH issues, including issues pertaining to CSHCN,
  in order to bring about desired public health
  outcomes.

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MCH Strategic Capacity Planning Framework
Systems Context demographic changes ? changes in
public programming for families ? competition and
collaboration
Organizational Environment Mission Goals Core
Functions Services Activities
Organizational Capacity Structural Managerial
Resources Human Process Resources
Effects Performance Measures Outcome Measures
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MCH Strategic Capacity Planning Framework
Organizational Capacity
Structural and Managerial Resources
Human and Process Resources

• authority
• (statutory base)
• organizational
• relationships
• data availability and analytical capacity
• information systems
• organizational
• structure and
• staffing
• funding

• political latitude
• direct
• indirect
• expertise, competency, and skills
• in-house staff
• borrowed or
• purchased
• staff resources
• organizational culture

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The CAST-5 Tools
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The CAST-5 Process
Answer Core Questions
Prioritize Needs
Develop Action Plan
Rate Process Indicators for each Essential Service
Assess Capacity Needs
Review the 10 MCH Essential Services
SWOT Analysis
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Overview of Core Questions

• Represent a fundamental level of MCH program
  functioning.
• Assist in determining whether the program is
  meeting basic operational requirements.
• Provide an important context and back-drop for
  deliberations.
• Can sometimes identify overall areas in need of
  future attention.

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Core Questions Tool

• Have you established the vision/goals for the MCH
  population?
• Given the Title V needs assessment, have you
  identified the priority health issues and desired
  population health outcomes?
• Have you identified the political, economic, and
  organizational environments for addressing
  priority health issues?

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Core Questions Tool

• What are the macro-level strategic directions for
  the Title V program in light of the responses to
  the previous questions?
• Have you identified the programmatic
  organizational strategies you will use to
  implement the strategic directions and to achieve
  the desired population outcomes?

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The CAST-5 Process
Answer Core Questions
Prioritize Needs
Develop Action Plan
Rate Process Indicators for each Essential Service
Assess Capacity Needs
Review the 10 MCH Essential Services
SWOT Analysis
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Example of Process Indicatorfor Essential
Service 1Assess and monitor maternal and child
health status to identify and address problems.
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The CAST-5 Process
Answer Core Questions
Prioritize Needs
Develop Action Plan
Rate Process Indicators for each Essential Service
Assess Capacity Needs
Review the 10 MCH Essential Services
SWOT Analysis
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The CAST-5 Process
Answer Core Questions
Prioritize Needs
Develop Action Plan
Rate Process Indicators for each Essential Service
Assess Capacity Needs
Review the 10 MCH Essential Services
SWOT Analysis
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Capacity Needs Tool

• Categories of capacity in CAST-5
• Structural resources
• Data/information systems
• Organizational relationships
• Competencies/skills

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Structural Resources

• Financial, human, and material resources
  policies and protocols and other resources held
  by or accessible to the agency that form the
  groundwork for the performance of core functions
• Examples Permissive/supportive environment for
  data sharing Access to training programs in data
  collection and management

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Data/Information Systems

• Technological resources enabling state of the art
  information management and data analysis
• Examples MIS system linking population-based
  data to program data standardized definitions
  and categories in systems of data collection and
  transmittal

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Organizational Relationships

• Partnerships, communication channels, and other
  types of interactions and collaborations with
  public and private entities
• Examples Relationships with professional
  associations Relationships with non-Title V
  state programs and agencies

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Competencies/Skills

• Knowledge, skills, and abilities of Title V staff
  and their partners in the MCH system
• Examples Analytic skills Understanding of
  quantitative and qualitative research
  methodologies

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Page 19
Overview of CAST-5 Second Edition, February 2004
Page 19
CAST-5 Capacity Needs
Structural Resources
1) Authority and funding sufficient for
functioning at the desired level of performance

• Examples
• Sufficient authority and immunity (statutory,
  etc.) for carrying out the function at the
  desired level of performance
• Adequate funding for carrying out the function at
  the desired level of performance/intensity
• Authority to accept and utilize grants,
  donations, and other funds

2) Routine, two-way communication channels or
mechanisms with relevant constituencies

• Examples
• A means of regular communication with all
  relevant constituencies (e.g., newsletter,
  listserv)
• Identified staff or institutionalized process for
  reviewing communication channels where local
  concerns might be voiced (e.g., local news
  venues)
• Mechanisms for information dissemination
• Effective dissemination of information to media
  and other networks
• Formal mechanism for disseminating information
  about MCH status, goals, initiatives, and
  evaluation findings to the public on a routine
  basis
• Written protocols for informing the public about
  MCH threats and appropriate public response

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Page 20
Overview of CAST-5 Second Edition, February 2004
Capacity Needs Scoring Worksheet
For use with the more detailed Capacity Needs list
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The CAST-5 Process
Answer Core Questions
Prioritize Needs
Develop Action Plan
Rate Process Indicators for each Essential Service
Assess Capacity Needs
Review the 10 MCH Essential Services
SWOT Analysis
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The CAST-5 Process
Answer Core Questions
Prioritize Needs
Develop Action Plan
Rate Process Indicators for each Essential Service
Assess Capacity Needs
Review the 10 MCH Essential Services
SWOT Analysis
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Use and Implementation

• Flexible process to accommodate broad or narrow
  scope of assessment
• Use of all assessment components or a subset
• Assessment of overall Title V program or specific
  program areas or populations

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Use and Implementation

• Transitioning to core functions roles
• Long-term strategic planning
• Training and planning tool for incoming Title V
  directors and senior staff
• Developing plans for enhancing specific
  functional areas (e.g., data capacity)

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CAST-5 will help you

• Think strategically about program priorities and
  focus
• Identify areas in which programs can coordinate
  and maximize resources
• Clarify mission and infrastructure needs for
  marketing to policymakers
• Examine and strengthen external resources and
  relationships

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CAST-5 will NOT

• Result in a list of programs, services, and/or
  staff to cut
• Be a repository of budgetary information

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Looking Forward

• To this program-building journeyand beyond!