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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Adequate Insurance.

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Strategy. Relief Funds

Approach. Establish a state relief fund to support families of CYSHCN with financial burdens

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Overview. Many families raising children and youth with special health care needs. (CYSHCN) have higher routine expenses for such things as transportation to and from appointments, parking, electricity, and specialized clothing that health insurance does not typically cover but that are directly related to a child’s health needs. Families also incur additional expenses to modify a vehicle for housing. To help with the extraordinary expenses that can overwhelm a family’s budget, several states have relief funds that help families avoid financial hardship and medical debt.[1]

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts, guidelines, or committee statements; these strategies are consistent with accepted theoretical frameworks and have good potential to work. Often there is literature-based evidence supporting these strategies in related topic areas that indicate this approach would prove effective for this issue. Further research is needed to confirm effects in this topic area.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Boston University's Catalyst Center Financing Strategies Database

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
  • Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of state agencies for organizations collaborating to establish and administer the relief fund. (Measures multi-sector engagement in supporting families)
  • Number of outreach activities conducted to inform families of CYSHCN about the relief fund. (Measures efforts to raise awareness and promote utilization)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of relief fund applications processed within the established timeframe. (Measures the efficiency and responsiveness of the program)
  • Percent of families reporting satisfaction with the relief fund application process and communication. (Shows the quality of the family experience)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of community-based organizations and family support groups engaged to promote the relief fund. (Leverages trusted partners for outreach)
  • Number of healthcare providers and care coordinators trained to refer families to the relief fund. (Engages the healthcare sector in connecting families to resources)

OUTCOME MEASURES:

  • Number of emergency room visits for hospitalizations avoided among CYSHCN due to the financial support provided by the relief fund. (Demonstrates potential cost savings)
  • Number of families able to access needed therapies, equipment, for home modifications that were previously unaffordable. (Reflects the fund's impact on access to care)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of eligible families of CYSHCN in the state who apply for and receive assistance from the relief fund. (Measures the penetration and reach of the program)
  • Percent of annual program costs covered by dedicated state funding vs. grants for donations. (Reflects the level of public investment and sustainability)

OUTCOME MEASURES:

  • Percent of CYSHCN whose health needs are met without significant financial hardship due to the relief fund. (Demonstrates the ultimate goal of the program)
  • Percent increase in the number of CYSHCN who receive early intervention and preventive services due to reduced financial barriers. (Shows the long-term impact on health outcomes)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs. Relief Funds Financing Strategy.
https://ciswh.org/project/the-catalyst-center/financing-strategy/relief-funds/

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.