Local Maternal, Child and Adolescent Health

Annual Reports (for Fiscal Year 2017-18)

All Local Health Jurisdictions (LHJs) are required to complete and submit an Annual Report for the following programs:

Maternal, Child, and Adolescent Health (MCAH) Program
Fetal Infant Mortality Review (FIMR) Program
Sudden Infant Death (SIDS) Program

Instructions

Introduction

Information and data reported in the Annual Report enables the MCAH Division to:

Monitor implementation of the Scope of Work (SOW) and the LHJ’s performance in meeting the Title V Block Grant and the State MCAH Program priorities, goals, and objectives
Demonstrate LHJ accountability and responsibility for completing activities described in their individualized SOW and monitor progress toward state and local objectives
Monitor health status and program outcomes for the MCAH population
Provide data for legislative drills and the Title V Grant application which supports MCAH Program funding
Document the changing environment /challenges of local MCAH Programs

These are some of the questions that the Annual Report will answer:

Has the SOW been met?
What and how were services provided?
What were the barriers?
What is unique about the LHJ that impacts MCAH Programs?
What strategies and activities were effective in meeting the goals and objectives?
How is the LHJ addressing local priority health issues?
Has progress been made on addressing LHJ local priorities?

Date Due

The MCAH and BIH Annual Report for the fiscal year ending on June 30th is due August 15th each year.

LHJs may request an extension for submission of the Annual Report if needed. Please send requests in writing (email is acceptable) to your Program Consultant.

Failure to Comply

State MCAH Division may withhold payment on current invoices for failure to submit a complete and timely report.

General Directions

Complete the template documents and save an electronic copy of your completed documents.
When describing activities, accomplishments, barriers and solutions use lists, bullets and short narratives. The intent is for concise reporting, not long narratives.
Title V funds are also used for American Indian (AI) and Children and Youth with Special Health Care Needs (CYSHCN) services. Please describe activities, accomplishments, barriers and solutions to the provision of services to the AI and CYSHCN populations in the applicable sections of the MCAH Annual Report.

Cover Sheet

The cover sheet contains basic information for the Annual Report and is required for all MCAH program reports.

Complete and sign according to the instructions on the form. Convert to PDF and send via email with the entire Annual Report file.

Submission

Submit the Annual Report(s) following these directions:

Document format: Submit all documents requiring an original signature in PDF format. Submit all other documents in Word format.
Naming convention: Title your reports with your LHJ name, the fiscal year, the program name, and the type of report, for example “Alameda 17-18 MCAH AR”, where AR means “Annual Report”.
Email all components of the Annual Report(s) to the email box for the applicable program: Submit MCAH and FIMR reports to MCAHAR@cdph.ca.gov