The purpose of the Maternal, Child and Adolescent Health (MCAH) Collaborative Survey is to inform the State MCAH Division Title V Annual Report of local health jurisdiction (LHJ) involvement in collaborative efforts and identify collective impact efforts and possible opportunities across the State.

In this survey, we are using the term ‘collaborative effort’ to describe what also might be called a collaborative, coalition, community group or partnership. Please complete one survey for each key collaborative effort you participate in (maximum of 3 surveys per LHJ). Key collaboratives are group efforts that your MCAH program leads or plays a key role in and/or was identified in your MCAH Scope of Work for this year. Please answer the questions to the best of your knowledge; there are no ‘right’ answers.

* 1. Name of collaborative effort