Maternal and Child Health Services

Detailed Client Encounter Data Collection

Submit detailed client encounter data in a timely manner, in either paper or electronic format in accordance with the guidance provided by the Children and Families Section, Bureau of Family Health. In order to meet federal reporting requirements, all calendar year client encounter data shall be submitted to the State Agency by January 15 each year.

 

Quarterly  – due by October 15, January 15, April 15 and July 15 submit:

  1. Certified Affidavit of Revenues and Expenditures
  2. MCH Client Satisfaction Survey Cards
    The local health agency will distribute a client satisfaction survey card randomly to at least 20% of clients served. The survey cards will be supplied to the local health agency by the KDHE Children & Families Section. The client is asked to complete the card and then mail it to KDHE for review and feedback to the agency. Survey cards should be sent to KDHE prior to the end of each quarter. A survey card summary report will be e-mailed to the local health agency for program self-evaluation.

Mid–Year  and End-of-Year Narrative Progress Reports – due by January 15 and July 15

Using the Progress Report form, submit a narrative description of program activities covering six months of the contract period (July-December; January-June). The following areas should be addressed in each report:
A 10% penalty of total grant award amount will be assessed for delinquent end-of-year reports beyond August 15th.

 

  1. Priority – Choose the priorities that were chosen on the MCH grant application
  2. Measurement Indicator – Choose all of the indicators that are associated with the priority chosen above.
  3. Outcome Objectives – Copy and paste the objectives identified in your annual MCH grant application.
  4. Progress – Describe program services, strategies, activities, collaborative partners, number served, outreach, care coordination, data to measure progress, how measurement was calculated, etc.
  5. Significant Accomplishments – Describe significant progress or impact, program highlights and/or success stories.
  6. Challenges – Describe any barriers or challenges in working toward your objectives.
  7. Training/Professional Development – List trainings and/or conferences staff attended.
  8. Technical assistance/Training Needs – List any needs or requests.
  9. Updates/Changes – Staff, administration, contact information, program, etc.

Reporting Schedule

Quarters

Grant Reporting Period

Due Date

Forms Due

1

7/1 to 9/30

October 15

  • Affidavit of Revenues and Expenditures
  • MCH Client Satisfaction Survey Cards

2

10/1 to 12/31

January 15

  • Affidavit of Revenues and Expenditures
  • MCH Client Satisfaction Survey Cards
  • Mid-Year Narrative Progress Report

3

1/1 to 3/31

April 15

  • Affidavit of Revenues and Expenditures
  • MCH Client Satisfaction Survey Cards

4

4/1 to 6/30

July 15

  • Affidavit of Revenues and Expenditures
  • MCH Client Satisfaction Survey Cards
  • End-of-Year Narrative Progress Report

 

 

Program Contact Persons

Joe Kotsch, Maternal & Infant Health 785-296-1306 jkotsch@kdheks.gov
Jane Stueve, Child Health & Adolescent Health 785-296-7433 jstueve@kdheks.gov
Barbara Kramer 785-296-1308 bkramer@kdheks.gov

 

Forms Required:

Affidavit of Revenues and Expenditures

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Progress Report

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