Course Syllabus Credit Hours: 3 Meeting Time: Tuesdays 9:30-12:20 Meeting Place: Ed 2 South L28-2304 Instructor: Beth McManus, PT, MPH, ScD E3360, Building 500 (303) 724-6528 Beth.mcmanus@ucdenver.edu Introduction: In this course students will learn and apply program management concepts and policy analysis methods to choose among potential policy and programmatic solutions to improve the health outcomes of pregnant women, infants, children, and children with special health care needs. Course Description: This course will address maternal and child health issues from a health systems and health services research perspective. Students will apply program management concepts and policy analysis methods to describe and interpret data relevant to MCH programs and policies. Specifically, students will use MCH data to weigh the health, fiscal, administrative, legal, social, and political trade-offs of policy options. Additionally, students will learn how healthcare financing, organization, and quality interact to influence service delivery for pregnant women, infants, children, and children with special health care needs. Course Learning Objectives: Students should be able to: (1) Describe the uses of population-based data in MCH program management; (2) Understand the relationship between organizational structure and performance, with a focus on MCH programs; (3) Describe the relationship between the public policy-making process and management of MCH programs; (4) Understand the elements of MCH services policy including the financing and organization of care for pregnant women, infants, children, and children with special health care needs; (5) Describe the public policy process in the U.S., including allocation of responsibility among levels of government and between the public and private sectors; (6) Apply policy analysis methods to evaluate policy options and recommendations; (7) Apply advocacy and leadership concepts to programmatic and policy solutions to MCH problems. CSPH Competencies: Identify and interpret public health laws, regulations, and policies related to CR-HSMP 4 specific health programs and the delivery of health services. CR-HSMP 5 Demonstrate an understanding of tools used to analyze public policy issues. Assess and explain the effects of policy development and implementation at all CR-HSMP 6 levels (federal, state, local) on the practice of public health. 1
CR-HSMP 7 Analyze health policy issues, including the health, fiscal/economic, administrative, legal, social, ethical and political implications. Include in the analysis an awareness of issues that transcend national boundaries and/or have global implications. MCH-specific Competencies: 1. Apply knowledge of management and organizational theories and practices to the development, planning, staffing, administration, and evaluation of public health programs, including the implementation of strategies promoting integrated service systems for MCH populations. 2. Develop, justify, and present a budget. 3. Develop the background and significance section of a grant application and/or develop the rationale for a program or intervention, incorporating scientific, methodological, and practice knowledge and skills as appropriate. 4. Demonstrate knowledge and understanding of the significant past and current national legislative mandates relevant to the development and delivery of maternal and child health services. 5. Demonstrate knowledge and understanding of the structure and roles of legislative, judicial, and administrative bodies at the national, state, and local levels. 6. Demonstrate knowledge and understanding of he organization and financing of health services in the United States and the position of MCH within the system. 7. Demonstrate knowledge and understanding of the theories and mechanisms of MCH policy development and implementation within the scope of health and other public policy programs in the United States. 8. Collect and summarize data relevant to a particular policy/problem; articulate the health, fiscal, administrative, legal, social, and political implications of each policy option. 9. State the feasibility and expected outcomes of and barriers to achieving each policy option and decide on the appropriate course of action. 10. Write a clear and concise policy statement, position paper, and/or testimony appropriate for a specific audience. Required Textbook: Essentials of Management and Leadership in Public Health by Robert E Burke and Leonard H. Friedman; Jones and Bartlett Publishers; Sudbury, MA 2011 A Practical Guide for Policy Analysis: The Eightfold Path to More Effective Problem Solving, 4th Edition by Eugene Bardach; CQ Press; Washington, DC 2005 Recommended Textbook: Designing and Managing Programs: An Effectiveness-Based Approach by Peter M. Kettner, Robert M. Moroney, and Lawrence L. Martin; SAGE Publications; Thousand Oaks, CA 2013 Public Health Leadership Putting Principles into Practice 5 th ed by Louis Rowitz; Jones and Bartlett Publishers; Sudbury, MA. 2
Kingdon, J. W. Agendas, Alternatives and Public Policies, 2nd Edition. Longman/Addison Wesley Educational Publishers, Inc, New York, 2003. EVALUATION: Class Participation (10%) Project Proposal Concept Paper (25%). Students will write a project proposal concept paper for the Kellogg Foundation s Healthy Kids initiative. The scope of the proposal should address the Healthy Kids mission to make progress in ensuring all children grow and reach optimal well-being by living in secure families, having access to fresh, local healthy food, physical activity, and access to quality health care. The format and requirements for the concept paper will be handed out in class. The concept paper is due Friday December 5, 2014 by 5 PM. Policy Brief (15%). Students will write a policy brief. Students will be given a research article related to the health of pregnant women, infants, children, or children with special healthcare needs. Based upon the research findings described in the article, students will write a 1-page policy brief. Content and format for the policy brief will be discussed in much further detail in class. The policy brief is due September 23, 2014 in class. Policy Analysis Critique (15%). Students will be given a published MCH policy analysis. Students are expected to critically analyze the problem statement, background, landscape, options, and recommendations according to Teitelbaum & Wilensky s rubric Checklist for Writing a Policy Analysis (p.262). The paper should not exceed 5 pages, double-spaced with 11-point font (Arial or Times New Roman) and 1 margins. The Policy Analysis Critique is due October 21, 2014 in class. Presentation of Concept Paper (15%). Students will pitch their grant proposal to a mock funding agency (e.g., Foundation Board, study committee, etc.) in a 15 minute presentation. Each presentation will include: a) Background and Significance of the MCH problem (2 slides), b) study / project aims (1 slide), c) characteristics of the sample to be studied (1 slide), d) methods to address project / study aims (2 slides), d) preliminary analyses (e.g., using publically available MCH databases; 2 slides), e) strengths and limitations of the proposal (with strategies to address proposal limitations), f) justification for amount requested (1 slide), and f) potential impact of the project to MCH policy or programs (1 slide). Presentations will occur in class December 2, 2014. 3
Problem Sets (20%). Students will complete 4 problem sets for a total of 20 points. Problem Set #1, Using Data as a Basis for Policy: Students will be presented with data describing an MCH issue. The will a) define the problem, b) summarize and interpret the data, c) suggest three policy alternatives to address the problem. Due September 16, 2014 in class. Problem Set #2, Choosing Between Policy Alternatives: Students will be given a policy brief with different policy options to address an MCH issue. For each option, they will apply 3 criteria (e.g., cost-benefit, timeliness, feasibility, targeted impact etc.) to each policy option and present the results in a side-by-side table. Due October 7, 2014 in class. Problem Set #3, State MCH Performance Measures: Students will choose 3 MCH state performance measures and, in a 1-page data brief, present the 5-year trend for each performance measure. The brief should also include a brief interpretation of the data presented. Due November 11, 2014 in class. Problem Set #4, MCH Budget: Students will complete a MCH budget worksheet to describe the costs associated with expanding a school-based immunization delivery program. Due November 25, 2014 in class. Expectations: I. Class attendance & Participation A. Attendance is not required, but is highly recommended. There will be many in-class small group discussions. Having all students participate in class, generally and in the small group discussions, will make for a livelier and productive learning experience. B. If you miss any of the in-class activities, as either unexcused or excused absences, you will not be able to make these points up in the future. While participation points may be small compared to other assignments, borderline grades will be decided based on your participation in class. II. Policies: A. Academic Honesty: We take the issue of academic honesty seriously and you should too. Acts that constitute academic dishonesty include plagiarism, cheating during exams, fabrication and/or falsification of work. Academic dishonesty will result in failure of the course. Please stay far away from acts that could be possibly construed as dishonest. If you need any further clarification of this policy, please feel free to ask. You are responsible for observing the College of Liberal Arts and Sciences guidelines on academic integrity and honor: 4
http://www.ucdenver.edu/academics/colleges/clas/facultystaff/policies/pages/academicintegrity.aspx In all of your written assignments, we expect to see your own thoughts and words. We look for evidence that YOU understand the concepts covered in class. Thus, it is very problematic if you copy others words rather than interpret them into your own text. Plagiarism is the use of another person s words or ideas without crediting that person. This is applicable to all source materials, whether they are lecture slides from this course, Wikipedia, or any scholarly material. If you copy anything verbatim, you will receive no credit for that assignment, regardless of whether you provide a citation for the material. Plagiarism and cheating will not be tolerated and either may lead to failure on an assignment, in the course, and/or dismissal from the University. B. Make-up Work/Exams: All assignments must be submitted as noted on the course calendar. If you are absent, you must have a valid reason to make up an exam or course assignment. You must notify Drs. McManus within 24 hours if you miss an exam or course assignment and provide documentation for an excused absence, e.g., physician or health center note, obituary notice, etc. If you do not have a valid reason, with documentation, you will not be allowed to make up the assignment. C. Late Assignments: No late assignments will be accepted without an excused absence and proper documentation. D. Holidays: Students with religious holidays that conflict with the exams or assignment due dates should notify Dr. McManus of those dates at least within 24 hours of the holiday. E. Access, Disability, and Communication: The University of Colorado Denver is committed to providing reasonable accommodation and access to programs and services to persons with disabilities. Students requesting accommodations should contact: The Office of Disability Resources & Services (DRS) is located in Building 500, Room W1103. Students can contact the office at (303) 724-5640 or sherry.holden@ucdenver.edu. 5
Their staff will assist in determining reasonable accommodations as well as coordinating the approved accommodations. III. Civility: A. Adherence to the Student Conduct Code is expected. I am committed to creating a climate for learning, characterized by respect for each other and the contributions each person makes to class. I ask that you make a similar commitment. B. Please turn off cell phones during class. Appropriate and courteous use of all technology will be expected of all students. Texting, emailing, and talking on cell phones during class will not be tolerated. If you need to make an emergency phone call or text, please quietly leave the classroom and return once you are finished. C. Courtesy of fellow classmates is expected at all times. This includes: a) arriving to class on time, b) quietly excusing yourself during class if you need to leave, c) respecting other students views and opinions, and d) fully participating in small group discussions, in-class activities, and assignments. Failure to consistently comply with any or all of these civility policies will result in a loss of participation points, potentially reducing your final grade, at the course instructor s discretion. Course Schedule Session 1 Introduction MCH Policy and the policy-making process, 8/26/2014 Course Overview Markel, H. and Golden, J. Children s History of MCH Policy in the US public health policy in the United States: How the past can inform the future. Policy-Making Processes Health Affairs. 2004; 23(5): 147-152. Additional considerations for policy implementation In-class activity: Case study of policy alternatives for comprehensive sexual education in Minnesota Starfield, B. US Child Health: What s amiss, and what should be done about it? Health Affairs. 2004; 23(5): 165-170. Markel H, Golden J. Successes and missed opportunities in protecting our children s health: The critical juncture in the history of children s health policy in the United States. Pediatrics 2006; 6
Session 2 Data as a Basis for Policy, 9/2/2014 Defining your problem Applying evidence to policy recommendations Identifying alternatives, considering costs and fidelity to a policy-governed program In-class activity: Writing Policy Briefs 115(4):1129-33. Lippit, JA. Policy and Policy Making for Infants, Toddlers, and Their Families: A Primer for Practitioners. Zero to Three June/July 2001: 4-8. Suggested Reading: Kingdon, J. W. Chapters 5 and 9. In Agendas, Alternatives and Public Policies, 2nd Edition. Longman/Addison Wesley Educational Publishers, Inc, New York, 2003. Rabito, F., White, L. and Shorter, C. From research to policy: targeting the primary prevention of childhood lead poisoning. Public Health Reports. 2004; 119:271-278. Fielding, J.E., Briss, P.A. Promoting Evidenced-Based Public Health Policy: Can We Have Better Evidence And More Action? Health Affairs. 2006; 25(4): 969-978. Scott, K.G., Mason, C, A., Chapman, D.A. The Use of Epidemiological Methodology as a Means of Influencing Public Policy. Child Development. 1999; 70(5): 1263-1272. Session 3 Policy Analysis I, 9/9/2014 Policy Analysis Framework Guest Lecture: Susan Rifkin, PhD Session 4 Policy Analysis II, 9/16/2013 Weighing policy alternatives and identifying outcomes and trade-offs of policy recommendations In-class activity: critiquing a policy analysis Bardach, E. Part I The Eighfold Path. A Practical Guide for Policy Analysis. The Eightfold Path to More Effective Problem Solving. CQ Press, Washington, DC., 2005. Chapter 13. Structuring a Policy 7
Analysis. In: Teitelbaum, J.B. and Wilensky, S.E. 2013. Essentials of Health Policy and Law. Second Edition. Burlington, MA: Jones and Bartlett Learning/American Public Health Association Press. *****Problem Set #1 Due in class******** Suggested Reading: Chambers DE. Chapter 2: Overview of a style of policy analysis: A value critical approach in Social Policy and Social Programs: A Method for the Practical Public Policy Analyst. Macmillan Publishing Company, New York, 2010. pp. 7-37. Session 5 Policy Analysis III, 9/23/2014 Communicating findings effectively In-class activity: writing and delivering your elevator pitch *******Policy Brief due in class*********** Grob G. Writing for Impact (Chapter 25). In: Handbook of Practical Program Evaluation (eds, Wholly JS, Hatry HP, Newcomer KE). John Wiley and Sons: San Francisco, CA; 2010. Fact sheet: Communicating with Policymakers: Delivery Tips 101, AcademyHealth Revising for Conciseness and Clarity, Audience Analysis, and Eliminating Wordiness available The Purdue Online Writing lab (OWL), available at: https://owl.english.purdue.edu/owl /resource/648/02/ Session 6 MCH Policy and Advocacy, 9/30/2014 How does advocacy fit into public health policy? Advocacy Concepts and Processes Guest Speaker: TBD, Children s Health Advocacy Initiative Petersen, D. and Hess, C. Advocacy and Policy Development in Maternal and Child Health in Maternal and Child Health: Programs, Problems and Policy in Public Health, 2nd Edition. Kotch JB, Ed. Jones and Bartlett Publishers, Sudbury, MA, 2005. pp.651-670. Christoffel, K.K. Public Health Advocacy: process and product. American Journal of Public Health 2000; 90:722-726. Carlisle, S. Health Promotion, Advocacy 8
and Health Inequalities: A Conceptual Framework. Health Promotion International. 2000; 15(4): 369-376 Kirwan A. The art of possible: Getting Involved with policy change. Zero to Three June/July 2001; 9-15. Session 7 Bridging Policy and Program Management, 10/7/2014 Translating policy mandates into actual public health programming challenges & opportunities In class activity: Case Study of Part C early intervention services for infants and toddlers with developmental delays and disabilities Case study of Mental health services in New Hampshire ******Problem Set #2 Due in class******* Bardach, E. Appendix B: What governments do. The Eightfold Path to More Effective Problem Solving. CQ Press, Washington, DC., 2005. Implementing and sustaining an effective service delivery approach: Stages and steps. NECTAC Publications, December 2011. Hebbeler K, Spiker D, Kahn L. Individuals with Disabilities Act s Early Childhood Programs: Powerful Vision and Pesky Details. Topics in Early Childhood Education 2012; 31(4):199-207 Session 8 Introduction to Management and Leadership Concepts, 10/14/2013 Introduction to Planning and Organizational Design / Theory In-class activity: Case study of population health management for kids with chronic conditions Chapters 2 and 3 in Essentials of Management and Leadership in Public Health by Robert E Burke and Leonard H. Friedman; Jones and Bartlett Publishers; Sudbury, MA 2011 Systems approach to organizational change (Chapter 3) In: Rowitz L. Public Health Leadership Putting Principles into Practice. Jones and Bartlett: Boston, MA 2003. Leadership and the planning process (Chapter 10). In: Rowitz L. Public Health Leadership Putting Principles into Practice. Jones and Bartlett: Boston, MA 2003. 9
Session 9 Linking MCH Financing, Economics, & Program Management, 10/21/2014 Finance and Health Economics Measures of Health Status In-class activities: MCH cost-effectiveness case studies ******Policy Analysis Critique Due in class****** Chapter 6 in Essentials of Management and Leadership in Public Health by Robert E Burke and Leonard H. Friedman; Jones and Bartlett Publishers; Sudbury, MA 2011. Session 10 Use of Data for Program Management of Public Health Organizations I, 10/28/2014 Needs Assessment Chapters 3 and 4 in Designing and Managing and Effective Programs: An Effectiveness-Based Approach by Peter M. Kettner, Robert M. Moroney, and Lawrence L. Martin; SAGE Publications; Thousand Oaks, CA 2013 Session 11 - Use of Data for Program Management of Public Health Organizations I, 11/4/2014 MCH (Title V) Performance Measures, Monitoring, and Evaluation Overview of secondary data analysis and comparative effectiveness research (using secondary databases) methods for MCH. Performance Measures, Monitoring, and Program Evaluation (Chapters 10 & 11) in Designing and Managing and Effective Programs: An Effectiveness-Based Approach by Peter M. Kettner, Robert M. Moroney, and Lawrence L. Martin; SAGE Publications; Thousand Oaks, CA 2013 Informatics in Public Health Management (Chapter 8) in Essentials of Management and Leadership in Public Health by Robert E Burke and Leonard H. Friedman; Jones and Bartlett Publishers; Sudbury, MA 2011 Leadership in Assessment (Chapter 6) in: Rowitz L. Public Health Leadership Putting Principles into Practice. Jones and Bartlett: Boston, MA 2003. 10
Session 12 Grant Writing, Fund Raising, and Program Management, 11/11/2014 Introduction to Different Types of Budgeting Systems Budgeting for Control, Management and Planning In-class activity: Creating a budget in Excel ******Problem Set #3 Due in class***** Chapters 12 and 13 in Designing and Managing and Effective Programs: An Effectiveness-Based Approach by Peter M. Kettner, Robert M. Moroney, and Lawrence L. Martin; SAGE Publications; Thousand Oaks, CA 2013 Chapter 11 in Essentials of Management and Leadership in Public Health by Robert E Burke and Leonard H. Friedman; Jones and Bartlett Publishers; Sudbury, MA 2011 Session 13 Leadership and MCH Policy Development and Assurance, 11/18/2013 Overview of leadership principles and Chapter 12 in Essentials of Management challenges and Leadership in Public Health by Robert E Burke and Leonard H. Guest Lecture: Kathy Kennedy, PhD Friedman; Jones and Bartlett Publishers; Sudbury, MA 2011 Leadership in Policy Development (Chapter 7) in: Rowitz L. Public Health Leadership Putting Principles into Practice. Jones and Bartlett: Boston, MA 2003. Leadership in Assurance (Chapter 8) in Rowitz L. Public Health Leadership Putting Principles into Practice. Jones and Bartlett: Boston, MA 2003. Session 14 Ethics, 11/25/2014 Healthcare Ethics Ethics in Practice Professionalism in Public Health Guest Lecture: Heather Fitzgerald, RN Ethics Nurse Consultant, Children s Hospital Colorado Chapter 7 in in Essentials of Management and Leadership in Public Health by Robert E Burke and Leonard H. Friedman; Jones and Bartlett Publishers; Sudbury, MA 2011 ****Problem Set #4 Due***** 11
Session 15 12/2/2014 In-Class Presentations *****Concept Paper Due Friday 12/5/2014 by 5 PM******* 12