VIRGINIA’S MCH WORKFORCE

VDH’s Division of Child and Family Health (DCFH) has experienced and committed staff, all of whom bring passionate, unique and diverse professional and personal life experiences to their work in maternal and child health.  All strive towards positioning themselves as collaborative statewide leaders and subject matter experts in their professional domains.  Recruitment of qualified Title V staff, as well as retention and professional growth is of utmost importance.  Complementary to the MCH Leadership Competencies, DCFH supports continued professional MCH leadership growth for DCFH Leadership and Team members.   Each division identified opportunities for continued education relevant to the programmatic work, and staff are encouraged to participate, recognizing the important role of professional development in workforce capacity.  Additionally, Title V program staff continuously provide technical assistance and support to their grantees and local health department staff.

 Title V funds support partially or in full the following positions:

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 who 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 to strengthen the interview process by assessing for alignment with Title V’s values.  Annual professional development plans and opportunities support tailored growth beyond baseline VDH performance expectations.

STAFF TRAINING AND WORKFORCE DEVELOPMENT

The MCH/Title V Director hosts a monthly team meeting for all Title V-related staff.  All sessions have an invited speaker – both internal team members and external stakeholders – whose topic aligns with the Title V state action plan. This is followed by a data presentation from our MCH Epidemiologist Lead, and then time for conversation, connection and reflection with all team members.

The Office of Family Health Services 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.

MCH Staff, including members of both Division of Child and Family Health and Division of Population Health Data, participate in several national learning collaboratives, including AMCHP, CityMatCH, and the National MCH Workforce Development Center.

LOCAL HEALTH DISTRICTS

Title V provides funding to each of Virginia’s 35 Local Health Districts (LHDs).  The LHD MCH workforce has faced many challenges since the onset of the pandemic in March 2020, and almost all LHDs have reported staffing shortages due to reassignment, staff burn-out, high turnover rates, and unfilled, long-term vacancies.  The majority of the LHDs reported having to shift staffing from MCH activities to COVID-19 response.  As such, staff morale has suffered, increased stress has been endured, and the burden of the pandemic continues to weigh heavily on the emotional and mental health of those still working at the local level.  Restrictions are being lifted, and the LHD MCH workforce is returning to pre-pandemic operations; however, it is imperative to create the supportive structures to ensure that the LHD workforce remains in alignment with the Title V mission and receives enhanced support, education and TA for their success.  In order to meet this goal, intentional restructuring of the relationship between Title V and the LHD MCH staff is underway.  This includes reformatting of LHD annual work plans that are strategically aligned with Title V’s state action plan, utilizing measurable goals and objectives, aggregating activities in such a way that targeted technical assistance can be provided, cross-district work groups can be formed to address shared goals, and local measurements can be obtained. Additionally, each LHD will have the opportunity to participate in MCHSmart, a year-long asynchronous learning opportunity offered by the National Center for Education in Maternal and Child Health at Georgetown University. This opportunity will offer a post-covid re-centering of the MCH Leadership competencies for local MCH professionals, defining their specific knowledge, skills, personal characteristics, and MCH leadership values, and lay out a roadmap for future MCH planning and activities. The revisioned approach to LHD MCH workforce support and development will begin with FY 2023, with rollout and orientation scheduled for the LHD staff in late August 2022.

INVESTMENT IN FUTURE MCH WORKFORCE

CSTE Applied Epidemiology Fellowship Program: In March 2021, the Division of Population Health Data’s application was accepted to serve as a host site for the Class XIX CSTE Applied Epidemiology Fellowship. Modeled after the Centers for Disease Control and Prevention (CDC) EIS program, the fellowship is designed to give recent public health graduates on-the-job training at health departments in preparation for a career as an epidemiologist at the state or local level. In September of 2021, we welcomed Ksenia Primich to the MCH Epidemiology team to complete her fellowship assignment within the Maternal and Child Health subject area. Prescribed fellowship activities and projects support Virginia’s Title V MCH priorities and ongoing needs assessment activities, which include building an infant mortality dashboard, assessing food insecurity and birth outcomes, assessment of historical redlining and health outcomes, and evaluating surveillance systems. The Fellowship is a two-year on-the-job training experience and Fellows are supported by funding from CDC.

National MCH workforce Development Center Internship Program

In Summer 2022, Virginia’s Title V Program sponsored two student internship projects through the National MCH workforce Development Center at University of North Carolina.  The eight-week long internships provided opportunity for four students, paired virtually, to work on projects of high importance to the advancement of maternal and child health  in Virginia. Recommendations from both projects have been incorporated in the state action plan and are detailed in the FY23 Application year reports in the Cross-cutting/Systems Building doman (Project 1) and Perinatal/Infant Health domain (Project 2).

PROJECT #1:  Moving towards Equitable Family Engagement in Virginia

Title V Preceptors:  Dr. Bethany Geldmaker, HRSA VMAP Project Director and Dana Yarbrough, Associate Director,Partnership for People with Disabilities and Virginia Title V Family Delegate)

Interns: Pooja Deshpande, MPH Student at UNC Chapel Hill Gillings School of Global Public Health and Ashley Zuniga, BSW Student at East Carolina University and MCH-Step Scholar in ECU’s LEAP Program

Project details:  The interns explored definitions of equitable family engagement, collaboration and leadership through conducting family focus groups, and key informant interviews of Title V staff as well as national organization staff members.  Themes of equitable family engagement were identified. Recommendations were then developed regarding collaborative definitions of equitable engagement with families, as well as ways in which current practices can be improved or modified to increase equitable engagement with families through Title V at the state level. 

PROJECT #2:  Evaluation of Virginia’s BabyCare Program

Title V Preceptors:  Cindy deSa, MCH/Title V Director, and Dr. Dane De Silva, MCH Epidemiologist Lead

Interns: Candace Jarzombek, MPH Student at Boston University School of Public Health, and  Leslie Osorio Pascual, BSPH East Carolina University and MCH-Step Scholar in ECU’s LEAP PRogram

Project details:  Through examination of the two largest programs in the state,  interns explored Virginia’s BabyCare program, comparing it to the evidence-based home visiting programs currently available in Virginia.  Through literature reviews and interviews with several stakeholders, an evaluation tool was developed, and key informant interviews were conducted. The interns identified how BabyCare complements the current home visiting landscape in Virginia, explored similarities and differences,and provided recommendations back to Title V for strengthening BabyCare as it currently exists, and offered suggestions for leveraging the program in other places across the state that is not currently being served by an evidence-based home visiting program.

Graduate Students in Epidemiology Program (GSEP)

In Summer 2022, Virginia’s MCH Epi Unit also sponsored a student internship project through AMCHP’s Graduate Students in Epidemiology Program. The ten-week long virtual internship provided the opportunity for a student to learn more about MCH Epidemiology and work on projects of high importance to the Title V and MCH Epi team.

PROJECT:  Racial Disparities in the Rate of Severe Maternal Morbidity (SMM) Before and During the COVID-19 Pandemic

Title V Preceptors:  Dr. Dane De Silva, MCH Epidemiologist Lead

Interns: Deidra Clermont, MPH Student at Boston University School of Public Health

Project details:  Severe maternal morbidity (SMM) continues to be on the rise in the United States and varies by states, which is why it remains a Title V NOM. Although overall rates of SMM did not increase significantly between 2019 and 2020 in Virginia, disparities by race/ethnicity continue to persist. Given cancellations due to lockdowns and the disproportionate burden of COVID-19 on populations of color, the purpose of this project was to analyze the rate of severe maternal morbidity (SMM) before and after the start of COVID-19 pandemic, using an interrupted time series design to examine the impact of the pandemic on SMM and racial disparities.

TITLE V TRAINING MODULES:  PROMOTING HEALTHY COMMUNITIES

Title V partners with University of Virginia Office of Continuing Medical Education and HIT Global to create Promoting Healthy Communities, an online learning consortium for continuing education opportunities.  This partnership created an internet presence and virtual space for MCH-related content to be widely available to a broad audience.  Additionally, this partnership allows MCH-related content to provide 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. Bimonthly meetings are held between UVA and representatives from each program to review content, enrollment, and opportunities for advertisement/dissemination of training opportunities.

Currently, Promoting Healthy Communities offers 12 continuing education modules in three categories.  An additional learning module is currently under development.  This module will be aimed at school nurses, developing and supporting their skills, knowledge, and competency regarding suicide prevention, intervention and postvention.