Fiscal year 2020 was a challenging year for the MCH workgroup within the Women’s Domain.  At the start of this grant cycle, workgroup members actively participated in meetings and activities related to the MCH Needs Assessment process.  March - September found workgroup members actively involved with the Department of Health’s COVID response.  Members fulfilled various roles within the COVID Surge including: leading community mitigation efforts, completing COVID investigations for active cases, responding to web Emergency Operations Center calls, contact tracing, 10-day call backs (to release clients from isolation), and staffing the COVID -19 information hotline.  Every member of the workgroup was assisting in one way or another either part or full-time.  Despite these challenges, the workgroup continued addressing strategies on the current state action plan.  The results of these efforts are described below.

Priorities for the 2015-2020 Women/Maternal Domain:

• Promote preconception/inter-conception health; and
• Promote oral health for all populations

Under the National Performance Measure/Domain framework, one National Performance Measure (NPM) was chosen and the objectives, strategies, and activities are identified within the State Action Plan. In addition to the activities listed on the State Action Plan there are other women/maternal health efforts that MCH team members support to assist in addressing the priority needs.  Efforts included:

• Office of Child and Family Services’ (OCFS) Community Health offices promoted Health Coverage Open Enrollment (November 1 – December 15, 2020) by dispersing Get Covered South Dakota’s pamphlets to client’s who did not have health coverage.  The pamphlet provides instructions on how to sign up for health insurance on the Marketplace, how to get help in signing up (location of Navigators) and the location of all Community Health Centers in South Dakota (SD) that have a sliding fee scale for services and are a part of the Community Healthcare Association of the Dakotas (CHAD).
• Department of Health (DOH) partnered with Delta Dental in SD to promote oral health for new moms:  Delta Dental distributed a SMILE kit to all new moms at birthing hospitals across the state.  Resources included in the kits: an adult size toothbrush and a handout Tips on Caring for Your Teeth.  Delta Dental distributed 8,500 Smile Kits in calendar year 2019.
• DOH’s Tobacco Program promoted smoking cessation services for pregnant and postpartum women by:

• Placing ads in SD Medical Journal (2,000 subscribers)
• Posting Facebook ads targeting women of childbearing age
• Collaborating with Delta Dental to provide QuitLine information to families who have a smoker in the home.  Delta Dental’s Regional and Mobile clinics placed a QuitLine sticker on a child’s take-home paperwork when the child reported that someone in their home smokes.  In 2019, Delta Dental staff gave out 1,248 stickers with QuitLine information.

At the end of this reporting period the MCH Impact Team workgroup members assigned to each National or State Performance Measure were asked to complete a data collection form.  The data collection form was a checklist of the strategies that the program was to address during the grant year. The workgroup members rated the degree to which the strategies were implemented, and the percentage of completion is included as the ESM for each measure.  In addition to this assessment for each measure, data was reported to provide a quantitative context for each strategy. This ESM process allowed us to better report progress to date on all strategies.  Data collection forms can be found at the link below: 

  https://doh.sd.gov/documents/MCH/2020/DetailSheet_NPM1_FY20.pdf

DOH Strategic Plan Goal 1: Enhance the accessibility, quality, and effective use of health resources.

National Performance Measure 1: Percent of women ages 18-44 with a past year preventive medical visit (data source: BRFSS)

Data Statement:

The routine checkup item changed in 2018 and is not comparable to previous survey years. Due to this change, it is not possible to determine whether the original target was reached. In 2019, South Dakota ranked 36th in the nation, with 70.4% of women having a preventive visit in the past year compared to a U.S. rate of 72.8%. This was down from a South Dakota rate of 77.6% in 2018 but the absolute changes from last year to current year and from state to U.S. rate are not significant.

The full-length South Dakota MCH Annual Data Summary can be found here:

https://doh.sd.gov/documents/MCH/2022_SDMCH_DataSummary.pdf

State Objective:

By June 30, 2020, increase the percent of women, ages 18 through 24 years, who had a preventive medical visit in the past year from 59.3% (2016) to 66.2%. (data source: BRFSS)

State Objective Data Statement:

The routine checkup item changed in 2018 and is not comparable to previous survey years. Due to this change, it is not possible to determine whether the original target was reached. In 2019, South Dakota ranked 36th in the nation, with 70.1% of women ages 18 through 24 years having a preventive visit in the past year compared to a U.S. rate of 71.3%.

Strategies:

1.         Partner with other agencies (state and other) to promote yearly preventive visits.

• MCH team continued to partner with the SD Women, Infants, and Children’s (WIC) Program to promote Well Women visits:  Well Women visit referrals increased from 317 in FY ‘19 to 347 in  FY ‘20 in spite of changes to WIC certifications during the pandemic. (Most certifications were extended or completed over the phone during the pandemic.)
• MCH team continued partnering with the Bureau of Human Resources (BHR) to promote Well Women visits:  BHR sent out reminder letters to all 18-39-year-olds reminding them to see their provider yearly for a preventive visit (evidence-based strategy).  The letters include a list of preventive services covered at 100%.  In FY ‘20 (07/01/2019-06/30/2020) 31% of women between the ages of 18-24 submitted a claim for a preventive visit (CPT codes 99385 & 99395). Up 1% from last year.
• Partnered with the SD Family Planning program to promote Well Women visits:  SD Family Planning has 23 locations across the state each offering annual exams to clients on a sliding scale fee.
• The NPM #1 interagency team did not meet during this grant year due to members responding to the pandemic.

Challenges: 

• The MCH program has limited outside partners in this arena.  We need to reach out to other community partners and stakeholders to be part of the initiative.

1.2.      Educate women on the importance of yearly preventive visits.

• BHR promoted a yearly preventive visit at all SD state employee health screening sites across the state. This years’ promotion included a one-sided handout dispersed from the sign-in table (11,308 health screenings were completed in FY 2020: July 2019-June 2020).
•  Data briefs on preconception care, prenatal care, and postpartum care were disseminated to 160 partner/stakeholders as part of the MCH Needs Assessment to encourage promotion of a Well Women visit.  Data presented was from the 2018 SD PRAMS.
• A Facebook post titled 11 Life Changing Reasons to Get Well Women Check-ups ran on For Baby’s Sake Facebook page for Women’s Health Month in May.  The post had a link to For Baby’s Sakes Website Scheduling Annual Well Women Check-ups and ACOG’s Well Women Exam infographic. An ad also ran on Snap Chat to reach a younger audience.   A second Facebook post, An Ounce of Prevention also ran during this grant year. Refer to social media metrics table for all post and ad reach.

• An ad was placed in Black Hills Parent magazine to promote yearly preventive visits for all family members.  Black Hills Parent magazine reports a readership of 80,000 and distributes copies to 475+ locations throughout the Black Hills of SD.

Challenges:

• Finding an effective way to disseminate information that young women will read and act on.

1.3 Implement training for Office of Child and Family Services staff related to preconception/inter-conception health.

•    The SD Family Planning PowerPoint training (developed in FY 2019) was revised to include new clinic locations across the state.

• A training module was developed for the OCFS field staff on the All Women Count program delineating services it provides to low income women.
• A training module was developed to include the SD Tobacco Program’s offerings for women in their childbearing years.

Challenges:

• Field staff were unable to complete any of the above trainings this FY as they were surged to assist with COVID investigations in March 2020 and continued to work on COVID response through the end of this grant period.

• Determining the most effective way to provide training with limited budget.

ESM: The degree to which the South Dakota Title V program has implemented evidence-based or informed strategies to assure that all women are aware of the importance of annual well women visits

 69% completion of identified strategies.