VIRGINIA’S MCH WORKFORCE

 

In Virginia, approximately 31% of Title V block grant federal funding supports 153 positions across four Central Office Divisions of VDH, and MCH staff in all 35 Local Health Districts.  Specifically, there are 58 funded positions in the VDH’s Central Office, all of which provide varying levels of support to MCH programs and/or services.  This includes 7 CYSHCN Care Connection Clinic staff working either in a health district or hospital-based clinic. Currently, there are 8 vacant positions, all currently under recruitment.  Additionally, Title V funding supports approximately 95 MCH staff across all 35 Local Health Districts (LHDs), where services include prenatal care (5 districts) BabyCare (13 districts), and population health-based efforts (17 districts). Staff are experienced and committed, bringing passionate, unique, and diverse professional and personal life experiences to their work in maternal and child health.  Staff have various backgrounds including medicine, public health, social work, epidemiology, nursing, nutrition, health care administration, education, finance, and administrative support. The diversity of education, generation, and qualification creates a workforce that is knowledgeable and skilled to meet the needs of the MCH population.  All strive towards positioning themselves as collaborative statewide leaders and subject matter experts in their professional domains.

 

Virginia’s MCH/Title V and CYSHCN Directors report to the Director of Division of Child and Family Health (DCFH).  Currently, the CYSHCN Director has 9 direct reports, including 7 staff who work in regional Care Connection for Children programs.  The MCH/Title V Director recently added one direct report, specifically to support and enhance success through and across the Local Health Districts. The MCH/Title V Director currently affords a high level of bandwidth for complex and strategic support, oversight, assurance of alignment of Title V funded programs, relationship and partnership building and support, and workforce development support. 

 

The following is a summary of Title V supported positions in VDH’s Central Office:

 

OFFICE OF FAMILY HEALTH SERVICES
Position	Direct reports	Updates
Policy Analyst
*OFHS Program Support		*Vacant

 

DIVISION OF POPULATION HEALTH DATA (DPHD)
Position	Direct reports	Updates
Director, Division of Population Health Data	Division Program Support
MCH EPIDEMIOLOGY
MCH Epidemiology Lead	Women/Maternal Health Sr Epi Infant/Child Health Sr Epi *Newborn Screening & Birth Defects Epi *Reproductive & Perinatal Health Epi Dental Health Epi MCH Program Evaluator	*Vacant
PREVENTION AND HEALTH PROMOTION EPIDEMIOLOGY
Injury & Violence Prevention Senior Epidemiologist	Substance Use Prevention Epi

 

DIVISION OF CHILD AND FAMILY HEALTH (DCFH)
Position	Direct reports	Updates
Director, Division of Child and Family Health	Division Program Support
MCH/Title V Director	MCH Local Health District Coordinator
CYSHCN Director	CYSCHN Program Support Child Devel. Program Coordinator *Blood Disorders Program Coordinator Care Connection Staff (7)	*Vacant
NEWBORN SCREENING
Birth Defects Surveillance Program Coordinator	Critical Congenital Heart Disease Coordinator
Early Hearing Detection and Intervention (EHDI) Program Coordinator	cCMV Follow-up Coordinator EHDI Program Support
MATERNAL AND INFANT HEALTH
Maternal Infant Health Consultant	Substance Exposed Infants Program Coordinator
EARLY CHILD HEALTH
Early Child Health Supervisor/MIECHV Director	Early Child Health Consultant
SCHOOL HEALTH
School Health Nurse Consultant	Special Projects Manager
REPRODUCTIVE HEALTH
Reproductive Health Supervisor/Title X Director	Family Planning QA Nurse Supervisor Adolescent Health Coordinator Youth Advisors (2)

 

DIVISION OF PREVENTION AND HEALTH PROMOTION (DPHP)
Position	Direct reports	Updates
Director, Division of Prevention and Health Promotion
ORAL HEALTH
Maternal, Infant & Adolescent Oral Health Consultant
Special Needs Oral Health Coordinator
INJURY AND VIOLENCE PREVENTION
Injury & Violence Prevention Health Systems Coordinator
Statewide Safety Seat Program Manager
Injury & Violence Prevention Supervisor

 

OFFICE OF THE COMMISSIONER/OFFICE OF COMMUNICATIONS
Position	Direct reports	Updates
MCH Communications/Branding Consultant
Web & Social Media Specialist

 

OFFICE OF CHIEF MEDICAL EXAMINER (OCME)
Position	Direct reports		Updates
Director, Division of Death Prevention
Epidemiologist
Maternal Mortality Program Supervisor		Maternal Mortality Research Associate
Family Violence Program Supervisor		Family Violence Research Associate

 

OFFICE OF FINANCIAL MANAGEMENT
Position	Direct reports	Updates
Fiscal Grant Manager, Operations

 

 

RECRUITMENT AND RETENTION

 

Virginia’s Title V Program is strongest when the MCH workforce values are equity centered, relationship based, and strategic focused. Because there are many initiatives led by Title V that impact both state and community policies and systems, these values are paramount for programmatic success and sustainability. The focus has been on recruiting (and retaining) the right people whose demonstrate a commitment and alignment to these values. Open position descriptions and interview questions have been updated to reflect the needs of the program, and the interview process has been strengthened by the incorporation of situational interviewing. The incorporation of situational interviewing assesses for alignment with MCH leadership competencies, provides work-related performance predictability, and supports strong hiring decisions. Annual professional development plans and opportunities support tailored growth beyond baseline VDH performance expectations.

 

Turnover has been minimal across Title V funded and supportive positions in FY24. In DCFH, two new positions were created and filled during FY24 - The Local Health District MCH Coordinator position who reports to the Title V Director, and a Child Development Clinic Program Coordinator position to provide additional support to the CYSHCN Program. There is one open position, the Blood Disorders Program Coordinator, who reports to the CYSHCN Director, which is under recruitment. DPHD filled the director position and created and filled two senior epidemiologist positions: Women/Maternal Health Sr Epidemiologist and Infant/Child Health Sr Epidemiologist both who previously served as the Reproductive/Perinatal Health Epidemiologist and Newborn Screening Epidemiologist positions. These latter positions bring additional targeted support to the Women/Maternal and Child Health Domains, streamlining reporting of other mid-level epidemiologists, and providing professional growth. Current critical vacancies are: 1) Newborn Screening Epidemiologist; 2) Reproductive and Perinatal Health Epidemiologist; 3) Blood Disorders Program Coordinator.  All open positions are in recruitment.

 

STAFF TRAINING AND WORKFORCE DEVELOPMENT

 

OFHS utilizes a “team of teams” model for monthly staff meetings, allowing division leadership to provide updates and successes over the last month, as well as providing a forum for requests of information or support from other divisions. OFHS leadership supports professional development for all staff. Annual goals for professional development and annual performance reviews are part of all staff positions. Staff professional development opportunities range from internal support to participating in national conferences and trainings. Each Division within OFHS holds monthly team and leadership meetings. The MCH/Title V Director hosts monthly core Title V leadership team meetings and quarterly meetings with the Local Health District Teams. There were no office-wide trainings in 2023.

 

DPHD Journal Club:  The MCH Epidemiologist Lead continues to lead a bi-monthly cross-unit journal club within DPHD, with participation from epidemiological units from MCH, Prevention and Health Promotion, Community Health, Environmental Public Health Tracking, and Cancer. The journal club allows for a discussion of papers and methods and encourages collaboration across epidemiology units by facilitating new projects using existing data sources and identifying research gaps. The journal club also allows epidemiologists to present work at upcoming conferences and new data releases, such as the most recent year data from BRFSS and PRAMS.

 

PARTICIPATION IN NATIONAL LEARNING COMMUNITIES

 

AMCHP Leadership Lab: Two OFHS team members, Samara Lott (DCFH - MCH Local Health District Coordinator) and Mr. Kelly Conatser (DPHD - MCH Epidemiology Lead) participated in AMCHP’s Leadership Lab from September 2023 through May 2024, joining the Adolescent Health Leaders Cohorts (AHLC) and MCH Epi Peer to Peer (P2P), respectively. Through their engagement with participants around the country, as well as one-on-one matched mentorship with AMCHP staff and seasoned national subject matter experts, Both Kelly and Samara leveraged the leadership experience into their professional spaces, utilizing new knowledge and skills obtained through Leadership Lab participation, and both subsequently have experienced career advancement since their participation.

 

Advancing Equity Learning Community (AELC) through National MCH Workforce Development Center:  In 2022, Virginia’s Title V participated in the AELC, a uniquely designed learning opportunity designed to increase Title V teams' knowledge, skills and abilities to systematically and consistently integrate equity across key workflows. Virginia’s AELC Team includes: Title V Director, MIECHV Director, State Resource Mothers and Doula Certification Program Supervisor, and representatives from three LHDs (Mount Rogers, Blue Ridge, and Central Virginia). The Team traveled to the four-day skills institute, participated in the monthly learning webinars, and monthly coaching sessions. This learning community served as an opportunity to build capacity to grow and support the doula community, as Virginia became the fourth state to offer a Medicaid doula benefit. Across 2023, the team continued to meet monthly, and expanded to include several new members, including partners from DMAS. In October 2023, this workgroup was expanded into the Local Health District work plan portfolio of work group selections (see below). Eleven districts now participate in this monthly work group, whose overarching goal is to identify strategies that can be operationalized through the local health districts to support the growth of the doula community and utilization of doula services at the local level.

 

2023 National MCH Workforce Development Center Learning Community:  Virginia’s Title V Program participated in the 2023 Learning Community, with the goal of transforming and strengthening the programmatic relationship between Title V, Reproductive Health, and Injury/Violence Prevention, both internally and with external stakeholders. Through the collective exploration and conversations across this yearlong learning community, the team agreed to center ongoing work around revising the 2021 Maternal Health Strategic Plan, produced by the Northam Administration. Under the leadership of our Office Director, Dr. Vanessa Walker Harris, who played a key role in the development of the initial plan. The learning journey culminated in a day of strategic planning with 27 key members of the Office of Family Health Services during which time the elements of the original strategic plan, including achievements to date, were reviewed, with discussion around new and continued strategic opportunities. Dr. Walker Harris, OFHS Director, continues to facilitate the monthly workgroup that spans across all divisions.

 

CityMatCH Alignment for Action Learning Collaborative:  The Blue Ridge Health District and Birth Sisters of Charlottesville, a doula collective supporting BIPOC mothers, was one of eight teams selected national for the CityMatCH Alignment for Action Learning Collaborative (AAC), a two-year initiative, which began in March 2021, and continued through March 2023. Title V leadership team participates in this highly engaged effort to address racism and implicit bias in the Charlottesville maternal and child health care community. This collaborative is detailed in the CC/SB Annual Report.

 

National Academy for State Health Policy (NASHP) MCH Policy Innovations Program Policy Academy:  Facilitated by DMAS, MCH Team, members of Virginia’s Title V Team and state CBO MCH leadership participated in this two-year Policy Academy, that ended March 2023.The Team focused on two new Medicaid member benefits – the expansion of services for one-year postpartum, and the new doula benefit. Subsequently, the Title V Director and Maternal Infant Health Consultant joined DMAS partners in NASHP’s PIP Alumni Policy Academy to Advance Perinatal Systems of Care which provided a forum for state health officials and Title V partners to engage in peer-to peer learning and share state policy and program innovations. Nine states convened in Washington, DC on Thursday, February 29, 2024 for a mix of presentation and facilitated discussions regarding policy levers and strategies that focused on addressing health-related social needs to improve maternal outcomes for pregnant and parenting people.

 

National Governor’s Association (NGA) Learning Collaborative on Improving Maternal and Child Health in Rural America Virginia is one of eight states participating in this 12-month  learning collaborative through the NGA with support from AMCHP. Virginia’s Interagency Team consists of Agency leadership from DMAS, VDH, and Virginia’s Office of the Secretary of Health and Human Resources. The group will participate in the monthly facilitated convenings with all states and meet separately as a state team to design and implement targeted regional interventions to address the unique community needs of Southwest Virginia to ensure healthy moms, healthy families, and healthy communities.

 

 

YOUTH ADVISOR PROGRAM

 

The Youth Advisor Program was established in 2021 to ensure youth voice expertise, guidance, and feedback on current and future public health initiatives. VDH created two part-time youth advisor positions to ensure that VDH’s programs engage with youth in meaningful ways. The first two youth advisors joined the team in January 2021 and left in May 2022, and their work is summarized in the Cross-Cutting/Systems-Building domain report. Due to significant staff turnover in the Human Resources Office, VDH was unable to fill these positions again until the Spring of 2023. Olivia Washington and Alana Harris joined the team at that time and work together to lead VDH’s Youth Advisory Council and to provide youth feedback on various public health initiatives at VDH. Their strong, innovative work is featured as this year’s MCH Success Story as well.

 

 

LOCAL HEALTH DISTRICTS

 

Title V funds each of Virginia’s 35 Local Health Districts (LHDs). Five of the 35 LHDs provide prenatal care to their communities, 13 districts provide BabyCare nurse home-visiting program, and the remaining 17 districts engage in a variety of MCH-related activities. The LHD MCH workforce faced significant challenges throughout the pandemic, with almost all LHDs reporting sustained staffing shortages, unfilled positions, and difficulty re-engaging with the community as restrictions were lifted, and key partnership programs, like WIC, struggling to reach pre-pandemic utilization rates. Acknowledging that the 35 LHDs are Title V’s most important community partners, it became imperative to ensure the presence of a strong, supportive structure to ensure that the LHD workforce remains in alignment with the Title V mission.

 

Through this revised structure, the LHD teams can receive targeted, enhanced support, education, and TA that values and champions their subject matter expertise for their community and builds connectedness across the shared strengths of district MCH leadership. Beginning in 2022, the Title V Director engaged in a series of structural shifts designed to align the LHD activities more succinctly through structured work plans, reporting methods, as well as alignment across shared interests, strengths, capacity, and funding.

 

This investment of energy has resulted in the necessity to create a new position to further support the work of the local health districts, and the MCH Local Health District Coordinator joined the Title V Team in June 2024. This new team member will play a major role in further strengthening the relationship between Title V and the local health district MCH leadership teams.  The current work plan, described below, will remain in effect throughout FY24 and FY25, as the MCH Local Health District coordinator engages in LHD strengths and capacity assessment as part of the overall state needs assessment, and works with Title V Leadership to create a strong district action plan for the next five year period.

 

                 

 

 

 

 

INVESTMENT IN FUTURE MCH WORKFORCE

 

CDC PUBLIC HEALTH ASSOCIATES - Beginning November 2023, VDH Title V Program welcomed three CDC Public Health Associates, two in OFHS, and one in the Central Shenandoah Health District. The CDC Public Health Associate Program (PHAP) is a two-year paid training program through the CDC where Associates are assigned to public health agencies and work alongside other professionals to gain hands-on experience that will serve as a foundation for their public health careers.

 

Natalie Southerland Office of Family Health Services BabyCare Program Consultant	Natalie is a 2023 CDC Public Health Associate, assigned to the Virginia Department of Health, Office of Family Health Services, Division of Child & Family Health.  Reporting directly to the MCH/Title V Director, her role consists of finding strategic ways to create and implement programmatic structure.  Natalie attended Virginia Polytechnic University (Virginia Tech) and received her bachelor’s in public health. She plans to further her education in Public Health, with plans to specialize in women’s health or global health.
Fahimah Zaman Office of Family Health Services Breastfeeding Friendly Designation Program Coordinator	Fahimah is a 2023 CDC Public Health Associate, assigned to the Virginia Department of Health, Office of Family Health Services, Division of Child & Family Health. Family support the Maternal and Infant Health Consultant on program design and implementation of Virginia’s Five-Star Breastfeeding Friendly Hospital program, distributing program information based on state policies and plans. Fahimah graduated from the University of Rhode Island in 2023 with a Bachelor of Science in Health Studies, and her topics of interest include health equity, tribal health, public health policy and reproductive health.
Aram Del Junco Central Shenandoah Health District Teen Outreach Specialist	Aram del Junco is a 2023 Public Health Associate, assigned to the Central Shenandoah Health District Virginia Department of Health (CSHD VDH) working in Adolescent/School-based STI Prevention and Education. Aram serves as the Teen Health Outreach Specialist for Waynesboro High School in his host site Aram graduated from the University of Virginia in 2023 with a Bachelor of Arts in Global Public Health. He has an interest in addressing health disparities and working to dismantle structures and barriers that result in these inequalities. Aram has the overall goal of working towards true health equity.

 

 

CYSHCN PROGRAM INTERNS:  During FY24, two interns worked with the CYSHCN Director to support the revision of the assessment tool utilized in the Care Connection for Children program, a tool that is utilized by the care coordinators across the 6 statewide clinics to assess client need and level of acuity. Ryan Malpaya, MPH student at Walden University supported this project through Mid-August 2023, leading group meetings with clinic leadership to fully revise the questions on the assessment tool. Christina Harrison, a LEND trainee through Virginia Commonwealth University, completed the project across Fall 2023 and Spring 2024 semesters, ensuring the updates were made in the clinic data reporting system.

 

Virginia’s Title V Needs Assessment Cohorted Internship through George Washington University MCH Center of Excellence: Ten interns through GWU’s MCH Center of Excellence are engaged in a year-long internship through which they are supporting critical elements of the Needs Assessment process. Under the direction of the Title V Director, the Director of the Division of Population Health Data, and contractor, John Dougherty of Human Service Innovations (HSI), the ten interns participate in biweekly calls, and specific activities in two distinct groups.  All interns participated in the design of the community provider/stakeholder survey and the design of the script for the key informant interviews throughout January-May 2024.  Starting June, a group of six interns will conduct the key informant interviews, while a group of four will work closely on aggregating and analyzing the results of the survey and the key informant interviews.  All interns will participate in the focus group planning and will participate in facilitation as able.  Finally, the interns will spend November-December 2024 supporting the HSI contractor in summarizing the needs assessment report.

 

 

TRAINING MODULES:  PROMOTING HEALTHY COMMUNITIES

 

 

 

 

Title V partners with University of Virginia Office of Continuing Medical Education to sustain Promoting Healthy Communities, an online learning consortium for continuing education opportunities for MCH-related content, providing continuing education credits for physicians and nurses as part of their professional education needs; however, the modules are available to everyone for their individual and professional educational needs. www.promotinghealthycommunities.org

 

 

Currently, Promoting Healthy Communities offers 12 CE modules in three categories.  MCH Staff meet bi-monthly with UVA to review participation, content relevance, accuracy, and update needs. Impacted by Covid, enrollment numbers across all modules low; however, the Breastfeeding Friendly and Newborn Screening modules have remained relatively consistent. An estimated 85-90% of learners are Virginia providers. Plans for FY24 are to increase traffic to these sites through targeted marketing initiatives lead by UVA. Title V Staff also plans to explore the possibility of intra-state educational partnerships with other Region III Title V Programs.

 

During FY24, the content updates began for the Breastfeeding modules to ensure alignment with the most recent guidelines from Breastfeeding Friendly USA. The transition modules will be updated in FY24 in collaboration with GotTransition and the Blueprint for Change.