Child Health

Annual Report - FY2022

 

Activities in this domain were carried out by the following MSDH offices, bureaus, or programs during the reporting period:

• Early Periodic Screening Diagnosis and Treatment Program (EPSDT)
• Mississippi First Steps Early Intervention Program (MSFSEIP)
• Lead Poisoning Prevention and Healthy Homes Program (LPPHHP)
• Genetics Services Bureau – Newborn Screening Program (NBS) and Mississippi Early Hearing Detection and Intervention Program (EHDI-MS)
• Office of Oral Health

 

The following section outlines strategies and activities implemented between 10/1/2021-9/30/2022 to meet the objectives and show improvement on the measures related to child health:

 

PRIORITY: Increase Access to Care (women, children, adolescents, and families).

 

NPMs, NOMs, SPM, and ESMs:

• NPM 6: Percent of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year
• SPM 3: Percent of children who receive a blood lead screening test at age 12 and 24 months of age.
• SPM 9: Percent of dried blood spot specimen results reported out by day of life 7.
• NOM 13: Percent of children meeting the criteria developed for school readiness (DEVELOPMENTAL)
• NOM 19: Percent of children, ages 0 through 17, in excellent or very good health
• ESM 6.1: The number of participants who received training about Bright Futures Guidelines for Infants, Children, and Adolescents.
• ESM 6.2: Number of health professionals and parents/families who receive training on developmental screening and/or monitoring

 

Objective: By September 30, 2022, increase the percent of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year

 

Strategy: Partner with the Division of Medicaid to identify and address gaps in developmental screening for Medicaid-eligible children, ages 9 to 35 months

 

Activities: The MSDH EPSDT program ensures eligible children and youth receive comprehensive, age-appropriate screening at 3-5 days, one month, two months, four months, six months, nine months, 12 months, 15 months, 18 months, 24 months, and 30 months of age and then, once annually for ages 3-21 years old. These visits include a comprehensive unclothed physical exam, comprehensive beneficiary and family/medical history, developmental history, measurements (including, but not limited to length/height, weight, head circumference, body mass index (BMI) and blood pressure), vision and hearing screenings, developmental/behavioral assessment and/or surveillance, Autism screening, psychosocial/behavioral assessment, tobacco, alcohol and drug use assessment, depression screening, maternal depressing screening, newborn metabolic/hemoglobin screening, vaccine administration, if indicated, anemia screening, lead screening and testing, Tuberculin test, if indicated, dyslipidemia screening, sexually transmitted infection, HIV testing, cervical dysplasia screening, nutritional assessment, and/or dental assessment and counseling. Participants are provided anticipatory guidance, referrals to general and specialty care providers for follow-up diagnosis and treatment, referrals for other supports, such as Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP) benefits, and nutrition through WIC, and support in accessing local primary care providers (PCPs) to establish a medical home and continuity of care.

 

During the reporting period, the MSDH EPSDT Program continued efforts to partner with Medicaid to analyze data on EPSDT visits completed by age and County to determine which geographic areas with gaps in the completion of EPSDT visits, including the provision of developmental screening for Medicaid-eligible children, including those between the ages 9 to 35 months. The MSDH EPSDT Program request data on the number of children eligible for Medicaid by age and County as well as completed EPSDT data disaggregated by age and by County. Analyses of the data obtained resulted in determining significant limitations in the data and how it could be reported. Most importantly, although Medicaid could provide unduplicated counts of children who were eligible by County of residence, the data on completed EPSDT visits by County were reported by County of the facility that conducted the visit rather than the child’s residence. Given how many of the children received services from a primary care provider (PCP) in a different County, the program was unable to determine the counties with the greatest gaps in completion rates.

 

Furthermore, given the complexity of the number of EPSDT visits that may occur over the first three years of life, interpretation of the results for these children is exceptionally difficult. For children under 35 months of age, there are 11 possible visits that could be conducted, with up to six visits possible during the first year of life (i.e., at three-five days, one month, two months, four months, six months, and nine months of age). According to the Bright Futures Periodicity Schedule, children should receive three developmental screenings before 35 months of age, once each at nine months, 18 months, and 30 months of age. Although the Medicaid data were useful in determining the total number of visits completed compared to the number of eligible children and possible total EPSDT visits (i.e., six for infants and five for toddlers), the program could not determine the number of unduplicated children captured in these data and whether the visit completed included a developmental screening.

 

Given these challenges, MCH personnel met with Medicaid representatives to review possible data variables to further refine data extracts to improve the ability to analyze and interpret the results to identify the Counties with greatest gaps in completion of developmental screening.

 

Objective: By September 30, 2021, develop and distribute resources among MSFSEIP and other early childhood stakeholders regarding early identification of infants/toddlers who may be eligible for MSFSEIP services.

 

Strategy: Provide training and technical assistance to referral sources for early intervention to ensure they are embedding developmental screening into their practices with families to ensure all infants and toddlers who may be in need for early intervention services are identified

 

Strategy: Partner with early care and education providers and family-based childcare providers to increase the number of children, ages 9 to 35 months, who receive developmental screening

 

Activities: During the reporting period, the MSFSEIP personnel conducted 1,162 instances of outreach to increase the number of children who received developmental screening and to ensure all infants and toddlers in need of early intervention services were identified. These efforts included personal contacts with referral sources, distribution of literature related to developmental screening, including resources from Learn the Signs Act Early, and participation in health fairs and community events to conduct developmental screenings for infants, toddlers, and preschool children. As a result, MSFSEIP received 4,321 referrals for infants and toddlers with suspected developmental delay.

 

Personal contacts were made with pediatricians and pediatric therapists and individuals who work in clinics and hospitals, early care, and education centers, Child Protective Services, MSDH Programs (WIC, PHRM, and CYSHCN), Head Start, Boys and Girls Club, Salvation Army, and community initiatives (Excel by 5, South Delta). In addition, informational resources regarding the MSFSEIP and developmental screenings were mailed to traditional partners and provided non-traditional ways, such as leaving resources at supermarkets, to ensure information was provide to those with limited access.

 

Personnel also participated in local health fairs and Medicaid/MS-CAN events, including Community Baby Showers, and partnered with local Head Start program to conduct developmental screenings for infants, toddlers, and preschool children.

 

The MSFSEIP provided ongoing training for professionals who work with infants and toddlers with and without disabilities to ensure they have the knowledge and skills to identify children in need of intervention services.

 

The MSFSEIP continued to offer training on the Early Communication Indicator (ECI), one of the Individual Growth and Development Indicators (IGDIs) developed by Juniper Garden at the University of Kansa for monitoring progress on early language development for young children. According to the developers, "The ECI is a brief, repeatable, play-based, observational measure of a child’s communicative performance during a 6-minute play period with a familiar adult. The play session is standardized around one of two toys – either the Fisher-Price House or Farm." The IGDI-ECI provides counts of the use of gestures, vocalizations, single words, and multiple words used to communicate with a play partner which can be combined to provide a total communication score. Performance on the IGDI-ECI can be plotted to show progress over time and development from prelinguistic communication (i.e., mainly gestures and vocalizations) to spoken language (i.e., single words and multiple words). In addition, the individual subskills and the overall communication score can be compared to norms to determine if children are performing similar or dissimilar to typical-developing children.

 

The IGDI-ECI data are used to monitor language development, evaluate the impact of language interventions, and inform goal development on an Individual Family Service Plan (IFSP) provided to infants and toddlers with disabilities enrolled in Part C early intervention services. Prior to the COVID pandemic, the IGDI-ECI was administered quarterly with all infants and toddlers enrolled in early intervention. As a result of the COVID pandemic and subsequent shift to virtual service delivery for many families, the IGDI-ECI was not able to be consistently implemented, as it required in person administration. In September 2021, the MSFSEIP worked with IGDI-ECI consultants to certify 40 EI personnel on adapted procedures to administer the IGDI-ECI virtually. In addition, 5 additional personnel were certified as IGDI-ECI Trainers to ensure the state could sustain these efforts. As a result, the MSFSEIP has resumed quarterly administration with all enrolled infants and toddlers whether they receive services in person or virtually. Continued implementation will support efforts to ensure children enrolled in the MSFSEIP are expected to exit at or near age expectations in their acquisition and use of knowledge and skills, including language/communication.

 

In 2022, the MSFSEIP and Mississippi State University kicked off the Early Intervention Credential – Level I for MSFSEIP and early intervention providers. The Level I Early Intervention (EI) Credential is a 240-hour online certification program consisting of 6 modules focusing on: introduction to EI; family-centered practice; IDEA law; evidence-based intervention and instruction; coordination and collaboration; and professionalism. The Level I Credential is intended as an entry-level credential for all individuals working with young children ages birth to 36 months of age who have developmental delays and disabilities and their families in the state. Nationally, the number of young children identified and enrolled in IDEA services has steadily increased. During the pandemic these trends reversed with fewer children enrolling in services as they did not receive the ongoing health and developmental screenings needed. This under-identification will likely result in more children needing more significant services and increased enrollment necessitating more trained professionals to meet the needs of very young children with disabilities and their families.

 

Objective: By September 30, 2021, collaborate with Mississippi Department of Education to develop state-wide materials for a Child Find public awareness campaign.

 

Activities: During the reporting period, the MSFSEIP Program worked with numerous stakeholders to identify materials for a statewide Child Find public awareness campaign as well as strategies for dissemination of resources.

 

In 2022, the MSFSEIP Program contracted with Morris, West & Baker (MWB) to assist the program with a marketing campaign for early intervention. The campaign is to include mass media ads for television and radio, digital media ads, social media graphics, informational videos, promotional materials, and the redesign of the program symbol.

 

Objective: By September 30, 2020, increase the number of children less than six years of age tested for blood lead from 36,074 by 10%.

 

Strategy: Increase knowledge and awareness among the public, public health professionals, childhood lead prevention workforce members, and other partners and stakeholders about childhood lead poisoning and prevention interventions through tailored education and outreach.

 

Activities: The program met with the Lead Advisory Board four times during this reporting period to review and revise the Blood Lead Screening and Healthy Homes Summary Sheet to identify more children under the age of 72 months who should be tested for lead poisoning.

 

In partnership with MSDH Pharmacy, the pharmacy residents began contacting providers in March 2022 to notify them about the decrease in blood lead reference value from 5 micrograms per deciliter (µg/dL) to 3.5 µg/dL and new recommendations for obtaining a confirmatory venous sample and venous follow-up testing. From April 1, 2022-September 29, 2022, 30 providers were contacted to discuss the following key messages: (a) housing and other products can cause low-level lead exposure; (b) the Centers for Disease Control and Prevention/American Academy of Pediatrics Bright Future guidelines require the Risk Assessment and Healthy Homes Questionnaire to be administered at well-child visits from 6 months to 6 years of age; (c) the Centers for Medicaid and Medicare Services require blood lead testing of Medicaid eligible/beneficiaries at 12- and 24-months of age, or at least once before age 6 if not previously tested; and (d) clinics in Mississippi using the ESA Leadcare machine are required to report all blood lead test and demographic data to the Mississippi State Department of Health Lead Poisoning Prevention and Healthy Homes Program.

 

Objective: By September 30, 2022, decrease the number of children less than six years of age identified with lead poisoning from 251 by 10%.

 

Strategy: Improve data usage that leads to a greater identification of geographic areas and populations at high-risk for lead exposure.

 

Strategy: Increased identification of children exposed to lead and linkage to recommended services.

 

Strategy: Increase the ability to target interventions to high-risk geographic areas and populations.

 

Activities: During the reporting period, the program provided education, telephone counseling, home visits, and environmental assessments to 139 families of children with a confirmed venous blood lead level ≥ 3.5µg/dL. Six (6) families of children with a venous blood lead level ≥15µg/dL qualified for a home visit and environmental assessment; however, only one (1) family accepted the services. One (1) family declined services, and the remaining five (5) families could not be contacted or did not respond to the letters mailed.

 

The program referred 54 families of children with a confirmed venous blood lead level of 10 or higher for long term follow-up and coordination of services. Of these, 28 families less than three years of age were referred to the Mississippi First Steps Early Intervention Program and 26 families of children over the age of three were referred to the Children and Youth with Special Healthcare Needs Program. Of those referred, 18 families accepted services. The remaining families declined.

 

Data sharing agreements have been developed and implemented with three Managed Care Organizations in MS to make referrals for families they insured who could not be reached to schedule program services (i.e., home visit and environmental assessment). This collaborative partnership has ensured that families of children who qualify for services are contacted, and services provided to improve the children’s quality of life.

 

Objective: By December 31, 2021, conduct six (6) virtual hospital staff quality improvement trainings/in-services.

 

Strategy: Facilitate six (6) virtual trainings/in-services that will provide an overview of the screening process mandated by Mississippi Code §§ 41-21-201; 41-21-203; 41-90-1; 41-90-5. Hospital nursery and laboratory staff will be equipped with information and resources to assist in improving newborn bloodspot, CCHD, and hearing screening and reporting, including specimen collection procedures.

 

Activities: A total of six virtual classes comprised of newborn bloodspot collection and critical congenital heart disease training were held from October 1, 2021- May 2022 for health department staff. The training provided examples of proper specimen collection, proper CCHD and hearing screening, and timely transit to increase timely diagnosis reporting and treatment of newborn screening (NBS).

 

Newborn bloodspot collection virtual training was conducted Fall 2021:

• October 19, 2021
• October 20, 2021
• October 21, 2021

 

CCHD and hearing screening virtual trainings were conducted Spring 2022:

• May 20, 2022
• May 24, 2022
• May 26, 2022

 

An evaluation of the training resulted in recommendations to increase training time to allow participants more time to ask questions and provided feedback. Virtual team members also expressed recommendations to keep meetings as interactive as possible. This feedback was used in the development of online training modules available via Health Streams to allow for immediate access and use during New Nurse Orientation and for quarterly training for healthcare providers.

 

Strategy: Update the current dried blood spot specimen collection card to include additional collection variables

 

Activities: In Spring 2022, the MSDH Genetics Advisory Committee considered the addition of X-Linked Adrenoleukodystrophy (X-ALD) to the Mississippi Newborn Screening Panel. The recommendation to add this disorder was not approved until October 2022, as such there were no updates needed for the dried bloodspot specimen collection card during this reporting period.

 

Strategy: Increase timely screening and referral to tertiary centers for babies diagnosed with a positive genetic condition.

 

Activities: During the reporting period, reports were extracted and reviewed from the EPIC database identifying hospitals that screened babies prior to the 24 hour or after 48 hour recommended timeframe. Hospitals were alerted and reminded of protocols. In addition, hospitals were advised to note transfusions cases at the top of the bloodspot card to ensure appropriate follow-up could be provided.

 

Reports were also reviewed to determine which hospitals did not meet the 1-day transit timeline to the assigned laboratory so this delay in procedures could be addressed immediately. Identified hospitals were alerted, and a virtual meeting ensued to discuss probable causes and solutions to prevent future delays. On one occasion, specimens were lost in transit which resulted in a delayed diagnosis report, due to rescreening.

 

Hospitals were contacted virtually to review protocols and expectations to ensure babies are screened timely. During the meeting, hospitals provided feedback regarding barriers that caused early or late screening reporting due to staff turnover, staff increase of duties, staff shortages due to COVID reassignments, and new staff training needs.

 

Strategy: Develop a Quality Improvement (QI) program utilizing the PDSA Cycle and frameworks/tools to manage and monitor all aspects of the NBS program to improve the overall system and ensure a seamless process from screening to closure of newborn screen cases.

 

Activities: During the reporting period, the program transitioned into the new agency electronic health record, EPIC. To support monitoring of cases and timeliness, a report was developed listing newborn screening caseloads for the Regional Nurse Case Managers by county. This allowed the Director to be able to monitor the timeliness of case closures and identify any issues preventing timely case closures. These reports for the Regional Case Managers was combined to create a comprehensive status report for follow-up actions across the state.

 

Throughout the year, the program personnel worked with the EPIC development team regularly to refine the EPIC database, reports, and workflows, resulting in ongoing changes to the system, dashboards, and available reports.

 

Strategy: Identify barriers, challenges, and areas needed for improving screening and collection among hospital nursery and lab staff.

 

Activities: During the reporting period, due to COVID, visits with low performing hospitals to review status and provide recommendations for improvements were contacted virtually. During these meetings, NBS personnel reviewed data from the state lab, via the online portal, identifying critical checklists and timelines.

 

Quarterly, letters were mailed to birthing hospitals with updates regarding RUSP conditions alerts and additions, cost differentiations, highlighting corrective issues for low performing hospitals, and announcements for important upcoming events. A copy of the hospital performance ranking was attached to inform hospitals of their status regarding performance outcomes.

 

PRIORITY: Oral Health

 

NPMs, NOMs, SPM, and ESMs:

• NPM 13.2: Percent of children, ages 1 through 17, who had a preventive dental visit in the past year
• NOM 14: Percent of children, ages 1 through 17, who have decayed teeth or cavities in the past year
• NOM 19: Percent of children, ages 0 through 17, in excellent or very good health
• NOM 17.2: Percent of children with special health care needs (CSHCN), ages 0 through 17, who receive care in a well-functioning system
• ESM 13.2.1: Number of children 0-3 years who had a preventive dental visit with referred dentist
• ESM 13.2.2: Number of referrals of children 0-3 years for a preventive dental visit by MSDH nurses

 

Objective: By 2021, increase public knowledge about the importance of oral health over the entire lifespan from baseline to 12%.

 

Strategy: Continue to Increase Oral Health Awareness; Increase oral health awareness with the three MCH community-based partners.

 

Activities: The Office of Oral Health has continued its focus on getting information to our partners electronically and through social media platforms like Facebook and twitter.  While the Office of Oral Health highlights many health observances and their link to oral health, we generally focus on the months of February (National Children’s Dental Health Month); March (World Oral Health Day); April (Oral Cancer Awareness Month and October (Dental Hygiene Month). Below, see graphic depictions of activities to our webpage or social media platforms.

 

 

Objective: By September 2020, fully integrate oral health literacy into all nine MCH programs within Health Services at MSDH.

 

Strategy: Provide oral health literacy to all MCH programs and their participants within Health Services at MSDH.

 

Strategy: Provide region-specific dental directory to expectant mothers for routine exams and dental procedures during and after pregnancy.

 

Strategy: Monitor dental care coordination efforts.

 

Strategy: Provide oral health education and referral to a dental home in 25 counties to participants of the WIC program.

 

Activities: The Office of Oral Health continues to incorporate integrated templates into EPIC for internal agency use. We have an EPDST template in the EPIC portal. During this reporting period, the pediatrician consultant and oral health program director began to address child health surveillance tools, adolescent tools and the like.

We used the EPDST dental care assessments in EPIC to examine the ease of input and retrieval of data.

 

While these tools are embedded in our EPIC system, generating a report on all fields was not possible. We utilized this reporting period to work with our EPIC team on making sure we could generate a report on the variables indicated in the oral health screening tool and assessing workflow processes and training needs of staff performing the wellness visits. Unfortunately, we were not able to complete this process during the reporting period. Our pedestrian consultant is no longer with the team, and we have had some program revamping and staffing turnover. We look forward to sharing updates to our efforts in the next reporting.

 

Objective: By December 2021, provide a 1-2-hour inter-professional educational training to 107 medical providers and staff in primary care settings in 8 counties on fluoride varnish use and application in medical settings to decrease early childhood caries in children.

 

Strategy: Combat oral disease in MS children and adolescents by integrating oral health education training into the medical setting.

 

Activities: We continued to carry our Cavity Free in Mississippi program supporting fluoride varnish application in primary care settings.  During this reporting period we trained family nurse practitioners, medical assistants, medical doctors, medical provider auxiliary support staff and registered nurses on the importance of interprofessional collaborative practice and oral health assessments in primary care settings. A total of 54 medical providers and staff were trained, representing twelve counties.

 

Over the years, we have strengthened our work with the Mississippi State Board of Dental Examiners, Mississippi Dental Association (MDA) and Mississippi Dental Society (MDS). During this reporting period, we continued to use platforms provided by these entities to connect with dental providers throughout the state, and share program updates to encourage increased care to children and adolescents in the state. ROHCS participated in MDA District Meetings: Feb 4, 2022; February 18, 2022; February 11, 2022, January 221, 2022, January 14, 2022, and January 28, 2022. At these meetings program updates were shared around, oral health surveillance of Head Start children, new child dental forms, the Advancing Prevention and Reducing Childhood Caries in Medicaid and CHIP Affinity initiative, The Screening Brief Intervention and Referral to Treatment program with our office, and community water fluoridation.

 

Additionally, our program director had the opportunity to share with the MDA an article sent through egram to all MDA constituents (over 700) about reducing childhood caries in Mississippi. Similarly, the program director participated in the October 29-20, 2021, MDS Winter Conference sharing similar program updates with MDS constituents.

 

Objective: By October 2021, provide statewide oral disease data collected on 2000 Head Start children by way of the Basic Screening Surveillance.

 

Strategy: Collaborate with Early Head Start and Head Start programs, home visiting programs, and/or WIC clinics to train staff to provide preventive oral health care and referrals to oral health professionals for dental visits.

 

Activities: The 2015-2016 Third Grade Basic Screening Survey results provided evidence that 3rd graders in our State are getting more preventive treatments like sealants and fluoride varnish as well as receiving treatment for cavities and fillings.

 

However, improvements are still needed to reduce dental caries experience in the primary or permanent teeth. A partnership with the MS State Head Start Association and day care centers across the state was established to reduce the number of children developing cavities during their early childhood years During this reporting period, the Oral Health Workgroup did not meet frequently due to staffing issues. However, the oral health program director and the executive director for the MS Head Start Association continuously communicated about how to better address the oral health surveillance needs and the practicality of reporting for the grantees.

 

The scheduled Basic Screening Oral Health Surveillance did not occur because we did not receive the sample demographic information from each of the centers to formulate the methodology. Therefore, there is no data to report on oral health indicators of disease for Head Start children. A child dental health form was created for dental providers to use when completing an oral health screening on children in Head Start and shared with the Mississippi Dental Society and the Mississippi Dental Association. This form was also placed on our agency’s website. Additionally, during this reporting period, we lost our three program epidemiologists which made it more difficult to strategize other ways to collect data from this population of constituents.

 

We, however, maintained our oral health promotion and education activities with Head start agencies. Oral health supplies and educational materials were donated to be distributed to both children who were learning onsite and for those who were learning virtually.

 

Two new regional oral health consultants were hired in the later part of 2021 and trained on the WIC SPIRIT electronic health record system in January of 2022. The Office of Oral Health has trained the new team members on the collaborative partnership with WIC and have connected them with chief nutritionists in their perspective coverage areas.

 

Since this reporting period, we have updated the documentation tools in the SPIRIT portal to allow the WIC nutritionist/or clerk to identify if the participant received oral health education or if a hygiene kit was disseminated.

 

During the summer of 2021, the Office of Oral health hired a dental care coordinator to centralize our care coordination state-wide.  By Fall 2021, dental care coordination management tools were created using an Excel Spreadsheet with a protocol that was shared with all oral health and WIC Team members. Based on the current protocol, all patients identified as not having a dental home and who are okay with us following up with them are placed onto our spreadsheet and later contacted via phone call or email to further assist them in finding a dental home or other resources. Demographic information is collected from patients who are willing and all correspondence with said patients is documented. Recently, this referral process has been expanded and the Office of Oral Health now receives referrals in REDCAP from the WIC department. Now, those patients receive phone follow up and oral health educational information and provider correspondence via the mail to better address their needs. REDCAP allows all WIC staff to refer patients to the office of oral health if they don’t have a dental home or need help finding one; if they are experiencing dental pain or other signs of acute infection and if they have questions related to oral health.

 

While not effective during this reporting period, these meetings resulted in updates to the SPIRIT system, a more synchronized process of retrieving referrals from the WIC department and an increase in partnership opportunities.

 

Objective: By December 2021, establish a comprehensive health collaboration that includes oral health with 10 to 15 faith-based organizations.

 

Strategy: Increase the number of faith-based organizations we work with who provide resources to families.

 

Activities: The Office of Oral Health distributed several oral hygiene kits, toothbrushes, boxes of floss, and educational material to several faith-based organizations throughout Mississippi. Some of those entities include Butterflies by Grace Defined (BBGDF); First Baptist Church of Jackson, MS, Holly Bush Church, Old Bethel Missionary Baptist Church, and Kuntry Kidz Teen Program-Shady Oak Church affiliate. Hollybush Church (Rankin County) and El Bethel Missionary Baptist Church (Tallahatchie County) were given 50 adult and 50 child health fair and blood drive on September 17, 2022. The health fair provided blood pressure checks, Alzheimer’s educational materials, oral health education, smoking cessation information, skin care, COVID vaccinations, diabetes education and autism awareness.

 

Butterflies by Grace Defined by Faith is a Jackson based community organization founded in 2021, whose mission is “to educate, empower and advocate awareness in order to protect victims and survivors of sexual assault, human trafficking and domestic violence.” Forty-five adult hygiene kits and 30 children’s kits were donated to the awareness event held at First Baptist Church of Jackson in December 2021.  In July of 2022, 600 adult hygiene kits, 60 children hygiene kits and 25 oral health educational flyers (60 each) covering vaping, oral cancer, pregnancy and dental tobacco cessation, e cigarettes, oral health and again, and baby’s healthy mouth were donated to First Baptist Church of Jackson’s Dress A Child Event. Kuntry Kidz is a 501c3 located in Collins MS whose mission is to provide positive exposure accessibility to uplifting programs and positive role models for youths growing up in the South were donated 204 hygiene kits for their 8th Annual Teen Empowerment summit on September 13, 2022. Four hundred teens attended the event. The regional oral health consultant working on this event also provided oral health education on vaping, e-cigarettes, diabetes, and sugar and provided an Oral B spin brush as a door prize.

 

Similarly, the Office of Oral Health assisted with the planning and logistics of the March 2022, Lauderdale Dental Mission. Central Baptist Church in Meridian Mississippi was the host site where the event was held. Over 21 churches donated food, snacks, chairs, and support volunteers for this two-day event providing preventive and restorative dental services. A total of 106 patients were seen; 100 teeth extracted, 126 tooth surfaces filled; 47 glucose blood sugar tests, 63 vision screenings; and 14 COVID 19 vaccinations. It was truly a collaborative partnership bringing MSDH partners and community stakeholders together.  Fifty percent of the people screened had an abnormal blood pressure and seven percent had abnormal glucose tests. Those persons were referred for additional assessments and care. Because oral health is important to overall health and well-being, opportunities as such to provide interprofessional collaborative care in a trusted environment aid our efforts of building a healthier Mississippi. Now that the Office of Oral Health has a centralized team member to assist with its dental care coordination efforts, it is planning to create a few flyers about this service to share with said organizations.

 

Objective: By December 2021, increase the opportunities to partner with the Oral Health State Program and Division of Medicaid.

 

Strategy: Work with the Mississippi Division of Medicaid to obtain benchmark information regarding Medicaid-funded dental providers and oral health services.

 

Strategy: Strengthen collaborative partnership with the Division of Medicaid.

 

Strategy: Promote the delivery of preventive oral health care for children and adolescents enrolled in Medicaid by oral health professionals

 

Activities: The Office of Oral Health continued work with the Division of Medicaid with monthly scheduled meetings with the Medicaid staff that work directly with the oral health benefits department. In these meetings, the program director was given insight on how to get Medicaid codes without an associated fee active. Additionally, the program director began attending quarterly meetings with the Division of Medicaid representatives that are held with other MSDH Health Services director’s and their teams.

 

We also continued our work with the Division of Medicaid to find out why in Mississippi, non-medical providers must bill dental CDT codes for this service as opposed to medial CPT codes. We were informed that the Mississippi Division of Medicaid had some concerns about vendor information on supplies and materials and elected to keep this coding under dental. However, we did discuss the possibility of changing these codes to medical CPT codes with the new software launched by the Mississippi Division of Medicaid. Unfortunately, the go live date for the software occurred after this reporting period. We continue to work with them on this initiative. 

 

Also, in our work with the Mississippi Division of Medicaid and partners with the Advancing Prevention and Reducing Childhood Caries initiative, we learned more about the data sharing through the Dental Quality Alliance (DQA). The DQA was established by the American Dental Association to develop performance measures for oral health.

 

It houses a State Oral Health Quality Dashboard that generates reports reflecting analysis of Transformed Medicaid Statistical Information System Analytic files from the Centers for Medicare and Medicaid Services. These tools have been helpful for us in addressing oral health state measures and how we compare nationally.

 

Objective: By September 2021, through oral health promotion and awareness efforts, expose 200 students to careers in dentistry

 

Strategy: Build connections and strengthen opportunities with university and allied health schools with dental degree and dental hygiene degree programs.

 

Activities: The Office of Oral Health continued its efforts with the School of Dentistry (SOD) at the University of Mississippi Medical Center (UMMC) in maintaining a public health presence. Similarly, the Office of Oral Health worked with the school to identify people from the National Health Service Corps who could provide information to students regarding working in public health and the loan payment options. With leveraged funds obtained during this reporting period, the program continued to support dental student rotations to underserved areas throughout the state. With this opportunity, third- and fourth-year dental students rotated working in private and public clinics with faculty dentists throughout the state.

 

This reporting period, our program director introduced Dean Koka to the American Cancer Society and HPV RoundTable efforts.  With provisions for licensed dentist in Mississippi to administer HPV, COVID 19, Flu and Shingles vaccination, an opportunity for dental school faculty and students would be paramount in preventing cancers and disease. Additionally, Dean Koka was introduced to the immunization and vaccination for children team to go over the process for providing vaccinations through the dental school. Fortunately, now, the UMMC School of Dentistry is a vaccination provider and received additional training through the Mississippi State Board of Dental Examiners.

 

April 22, 2022, the MSDH dental director and immunization consultant co-hosted a zoom webinar entitled “Oral Health and Human Papilloma Virus (HPV):  State-wide Efforts to Enhance Dental Provider roles”. The goal of this webinar was to better inform dentists and dental teams in Mississippi on national and state statistics regarding oropharyngeal cancer, importance of oral cancer screenings at each dental visit and opportunities to vaccinate for HPV.