Priorities:

Foster safe, stable, and nurturing environments for Alaskan children.

Increase connection to behavioral and mental health information, training, resources, and supports for families and providers.

Increase partnerships and connections with community agencies to support access to basic needs.

Plan for the application year: October 2025 – September 2026

There are two NPMs for the Children’s Domain. The first is the percent of children with and without special health care needs having a medical home. This NPM reflects WCFH work to improve access to health care, including continuous and coordinated services. When children receive care in a medical home, meaningful relationships can be established with health care providers. Through these relationships, medical and social needs of a child can be addressed, thereby increasing a child’s chance of growing up in a safe, stable, and nurturing environment.

The second NPM for the Children’s Domain tracks the percentage of children ages 9 to 35 months who received a developmental screening in the past year using a parent-completed tool. This measure reflects WCFH’s ongoing commitment to promoting and supporting evidence-based developmental screening across a variety of settings, including child care, Part C/Early Intervention, home visiting programs, Head Start, and medical providers. Increasing awareness of child development is a key protective factor and aligns directly with the priority of creating safe, stable, and nurturing environments for Alaska’s children.

The ESM for this domain relates to the second NPM by looking at the percent of home visitors within MIECHV and State Parents as Teachers programs who demonstrate proficiency in administering and interpreting the Ages and Stages Questionnaire (ASQ) tool after training. (Assesses the quality and effectiveness of staff training efforts). This ESM aims to support home visiting programs administered by WCFH to affectively administer the ASQ. Trained home visiting professionals play a vital role in promoting healthy child development by administering standardized developmental screenings to families. As trusted partners who visit families in their homes, these professionals are well-positioned to observe children in their natural environments and build strong, supportive relationships with caregivers. Administering validated screening tools, such as the ASQ, allows home visitors to identify potential developmental delays or concerns early often before children enter formal early childhood or educational systems.

Strategies:

1. Support and expand statewide systems (e.g., Help Me Grow, Learn and Grow, ILP, and home visiting programs) and resources for parents/caregivers, providers, educators, and community-based service agencies in use of standardized screening tools.

WCFH will continue to collaborate with parents, providers, community organizations, and Medicaid to increase awareness and use of the Ages and Stages Questionnaire (ASQ) as a standardized, parent-completed developmental screening tool. There have been improvements in the use of ASQ online screening in Alaska, and the gains made through the previous Early Childhood Comprehensive Systems (ECCS) Grant have and will continue to be sustained through the facilitation of the Universal Developmental Screening Advisory Committee (UDSAC). The Early Childhood Program Manager and Neurodevelopmental Specialist facilitate this committee, and the purpose of the UDSAC is to bring key stakeholders together to ensure that all children and their caregivers have access to developmental screening in Alaska. The Advisory Committee will accomplish this through:

1. Streamlining efforts to maximize efficiency 

2. Coordinating data sharing 

3. Ensuring access to training on developmental screening and screening tools for all voluntary or mandated screeners, including early childhood education, home visitors and health care providers

4. Providing stakeholder input on the statewide ASQ Online system 

5. Increasing family-focused education on developmental screening 

The UDSAC is a cross-sector and multi-stakeholder committee that will continue to meet the UDSAC goals through four active work groups that will ensure that developmental screening efforts are sustained and accessible statewide. Participants include Medicaid, Early Intervention, the statewide coordinated intake and referral service (CIRS), Title V, Maternal, Infant, & Early Childhood Home Visiting (MIECHV), home visitors, Tribal health, pediatric providers, the Alaska Mental Health Trust Authority, Learn & Grow (childcare quality recognition and improvement system program), regional leaders for early childhood initiatives, and many others. 

In recognition of the importance of monitoring and supporting the mental health of Alaska children as noted in the needs assessment, the UDSAC will also focus on the promotion and utilization of the ASQ-SE:2 and other standardized social emotional screening tools over the next year.

Alaska’s CIRS operates under the Help Me Grow National model and is a system that connects children and families with the services they need. The statewide CIRS originally launched in the ECCS place-based communities and now accepts calls and referrals statewide. They have and will continue to grow and expand their outreach statewide by utilizing their growing staff and the in-house centralized access point (CAP). The director of statewide CIRS also serves as the CDC’s "Learn the Signs. Act Early" representative for Alaska and continues working alongside the Early Childhood Systems Specialist to refine CDC milestone materials, ensuring they better represent Alaskans. Funding from the Preschool Development Grant Birth through Five Renewal (PDG B-5) will support the creation of additional ASQ companion documents that are tailored to support specific communities and regions in Alaska. The forecasted regions for FY26 include the Bristol Bay, Southcentral, and Kotzebue regions. These resources aim to provide Alaska specific standardized screeners like the ASQ, making them more relevant and effective to the different populations they serve.

The CIRS will also continue circulation of the updated CDC Amazing Me! children’s books with Alaskan context and illustrations from Alaskan artists, as well as the updated CDC Milestone Moments booklets that are effective in the context in which Alaskan families live. These materials will be provided to any early childhood related organizations for free upon request. With PDG B-5 funding, these books will also be translated into some Alaska Native languages over the next year.

2. Support school nurses and counselors in their work to build safe, stable, and nurturing environments for children.

WCFH will continue to partner with the Department of Education and Early Development (DEED) to ensure that the curricula used has the most current and relevant Alaska data. Additional data elements were included in our recently renewed data sharing agreement to include details about access to school counselors and nurses and types and duration of suspensions.  We will be exploring these additional data elements and seeking to incorporate community level indicators such as the Alaska school climate and connectedness survey.  New linkages will be made to include Head Start data to understand the educational interventions and impact on trajectories with the interplay with adverse childhood experiences (ACES).  Finally, the regional educational laboratory serving the Northwest region (REL NW), was going to be using ALCANLink data to conduct focused studies on educational outcomes. This group was unfunded leaving DEED without this important assessment, WCFH will fill this gap by conducting a simplified assessment based on prior analyses with different outcomes.

The Title V-funded School Health Nurse Consultant (SHNC) will continue to oversee the School Health and Nursing Services (SHNS) program to provide continuing education, statewide guidance, and resource support for school health services staff and school nurses through online trainings, annual conferences, and electronic communications such as the SHNS program website and listserv. The SHNC will continue to facilitate the School Health Nurse Advisory Committee (SHNAC) twice-monthly meetings for ongoing district support and to address the health and safety needs of students by ensuring that school nursing and health service practices are evidence-based and align with national and state guidance.  In addition, a community of practice group for rural school nurses will continue to meet twice-monthly to provide a dedicated space for collaboration and to address school health challenges specific to rural school health and nursing.

The School Health ECHO will continue to provide current education on school health topics for school nurses, local providers, and school administrators and teachers. Monthly sessions will be developed and provided virtually in the 2025-2026 school year. This ECHO is provided through a collaboration between the DEED and the Division of Public Health. The Department’s part-time pediatrician will support the Title V School Health Nurse Consultant related to content and presentations at the School Health ECHO. Sessions will also highlight the unique challenges faced by rural school districts without formal school health or nursing services to address specific identified needs in supporting student health and chronic disease management in communities where access to medical care is limited and SBHC and school nurse services are not available.

The SHNC will continue to work with Seattle Children’s Hospital providers for the continuation of a monthly Mental and Behavioral Health Educational Series for school nurses and counselors in the 2025-2026 school year. Educational and didactic learning sessions will focus on behavioral mental health topics impacting students, staff, and school communities in Alaska such as anxiety management, crisis intervention, supportive medication management, and interventions for symptomology impacting attendance and educational performance.

The SNHS program, in partnership with DEED, will host a full-day educational offering during the 2026 School Safety and Well-Being Summit.  The offering will aim to support rural school districts without school nursing and health services staff which will provide guidance and practical support so they can best meet the health-related needs of their school community and students. Newly developed Hearing and Vision E-Learning courses will be highlighted and made available online through DEED’s eLearning Library for school districts to utilize in training or refreshing staff in the performance of these school health screenings.

3. Provide analytic and programmatic support for partners and systems serving families and communities.

The Public Health Informaticist plays a key role in providing analytic and programmatic support to systems serving families and communities by leading data and continuous quality improvement (CQI) efforts for both the MIECHV Nurse-Family Partnership program and the state-funded Parents as Teachers (PAT) program. For the MIECHV program, the Informaticist conducts monthly data analyses and prepares CQI data summaries, facilitating monthly meetings with the home visiting team to review progress, identify areas for improvement, and plan future CQI initiatives. The Informaticist also ensures year-round data quality assurance in preparation for annual federal grant reporting. For the state-funded PAT program, the Informaticist provides ongoing data support and technical assistance to four grantees through regular meetings and contributes to evaluation efforts to assess program impact. These efforts have been instrumental in driving continuous program improvement and are planned to continue. In the coming year, this role will support program expansion by integrating a new MIECHV grantee implementing the PAT model.

Addressing ACEs requires multiple cross-sector partnerships. Several partners, including Tribal health organizations, public health nurses, and clinical providers are interested in implementing and testing the prebirth household challenges screener developed from Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project data. These partnerships will be developed to understand how to move the screener to use and validate its performance when implemented.  WCFH is also working closely with the Alaska Mental Health Trust Authority and Rasmuson Foundation to explore ways to increase dissemination of ACEs data. Initial efforts are working towards establishing a paid position within a non-profit entity (e.g., Center for Safe Alaskans) that can champion this work using the toolkit of information created by the State on ACEs.

The MCH Epidemiology Unit continues to receive support from the Alaska Mental Health Trust Authority to fund a Epidemiology Specialist position in the Unit focused on child development, family violence, addiction, and mental health. This position provides analytical support to several programs and systems, including child welfare, education, the All Alaska Pediatric Partnership, State Immunization Program, PAL-PAK, and multiple non-profit organizations, to inform prevention strategies and guide decision-making. The MCH Epidemiology Unit works closely with the Early Intervention and Head Start to support evaluation and analysis projects and is integrating education data into ALCANLink to explore factors that impact trajectories and performance. In addition, staff are developing targeted analyses for the Alaska Mental Health Trust Authority to better understand the needs of its beneficiary population.

The Alaska PRAMS program will continue to provide data on mothers who have 5 social supports during the postpartum period for the Scorecard of Key Issues Impacting Alaska Mental Health Trust Beneficiaries. The Scorecard provides evaluation measures for the Alaska Division of Behavioral Health’s 2025-2029 Comprehensive Integrated Mental Health Program Plan. Part of this plan is a focus on prevention and Early Intervention efforts that build resilience and address trauma in individuals who are at risk of developing disabling conditions. As stated in the Scorecard, “Research shows that social support is a major buffer of postpartum depression and can improve outcomes for infants, young children, and their families. The presence of social supports, as reported by mothers after giving birth, can help predict early childhood experiences and provide an opportunity to increase individual and community-level supports at a critical developmental period.” In 2023, 79.7% of postpartum Alaskan women stated that they have access to all five social supports asked about on PRAMS, which included measures of financial support, physical support, and emotional support. At the time of this report, the availability of PRAMS data beyond 2023 is uncertain, however given the importance of PRAMS data for Alaska’s Title V program, efforts are in progress to obtain the 2024 data and continue data collection in future years.

4. Collect, analyze, and disseminate data to better understand child wellbeing in Alaska (e.g., ALCANLink, PRAMS, CUBS, education data sources, etc.). 

The MCH Epidemiology Unit will prioritize collecting, analyzing, and disseminating data related to child wellbeing that can support and target existing resources for prevention. To increase access to data resources the MCH Epidemiology Unit will maintain and develop online data dashboards and ensure that resources such as reports, documents, presentations, and questionnaires (where applicable) are available.  

Key resources that will continue and be enhanced include ACEs comprehensive surveillance, ALCANLink, and the Childhood Understanding Behaviors (CUBS) survey.

Adverse Childhood Experiences: The MCH Epidemiology Senior Scientist collaborates closely with the Section of Chronic Disease Prevention and Health Promotion (CDPHP) Injury Prevention Unit to conduct comprehensive ACEs surveillance. The guiding ACEs surveillance framework developed by the MCH Epidemiology Senior Scientist has been widely successful in helping communicate ACEs research and has served as a driving force for our development.

• First, the Overcoming ACEs through Resilience (OARs) survey was implemented in 2024 with another year of data collection occurring in 2025. We are developing academic partnerships to conduct focus groups with individuals who experienced ACEs to understand how the results of the survey resonate with them, the perceived impact of the experience(s) on their health, and what types of messages would be most informative to promote prevention. Using this qualitative and quantitative data, the academic partners (student projects and or class projects) will create a toolkit of information that can shared broadly.
• Second, the ACEs data has been centralized on a common data dashboard to increase availability. This dashboard includes data from ALCANLink, the National Survey of Children’s Health, OARS, and Syndromic Surveillance data. We will continue to expand and update this resource to ensure that our partners and public have access to the most current ACEs data.
• Third, ALCANLink data will be used to explore the relationship between ACEs accumulation by age three and the interplay with education outcomes and how infant learning and Head Start may mitigate effects.

Alaska Longitudinal Child Abuse and Neglect Linkage Project (ALCANLink): DEED had identified a regional partner who was going to use ALCANLink data to understand how changes in household stressors between pre-birth and early childhood and the effect on 3rd grade reading scores, attendance, school suspensions, the need for an education learning plan, and the impact of on-sight school nurse on child outcomes. This partner however funding and no longer has capacity to do this work.  The MCH Epidemiology Unit will now be conducting many of these analyses. School readiness and performance is a strong indicator of household and community strengths, and identifying mutable factors is critical for prevention and improving health and thus a priority. ALCANLink will also be writing up and sharing results on analysis projects that were recently completed related to factors influencing timely vaccination completion, fetal alcohol syndrome (FAS), and cleft conditions.

The ALCANLink project was expanded and now includes birth cohorts from 2009 – 2021 which represents almost 140,000 Alaskan births. With this expansion, new challenges arose with three PRAMS phases. The ALCANLink team will create standardized cross-phase datasets to improve replication of research and use of this federated data system. The SQL data base and ETL process was streamlined, and new cross-walked ID’s will be added to the system (Head Start, ILP, Vaccinations).

The ALCANLink Epidemiologist will be focusing analysis projects on understanding the impact of Early Intervention and Head Start and Early Childhood Education performance.

Childhood Understanding Behaviors Survey (CUBS): The Alaska CUBS survey, which began data collection in 2020, will be revised over the upcoming year with the Phase 7 questionnaire currently planned to go into the field in 2026 (2023 births). The Phase 6 survey added more Alaska specific questions about supportive activities with the child (i.e., hiking, picking berries, fishing, and other outdoor activities) as well as established questions about protective factors such as reading time and time spent with their father, having a well child check in the previous year, existence of a medical provider who knows the child well (a measure of a medical home), and any problems accessing healthcare. The Phase 7 revision process during summer-winter of 2025 will involve conversations with a variety of early childhood partners to better understand data gaps and needs, as well as which questions may no longer be needed.

Data for CUBS are collected through three modes: mail, phone, and web. In addition to revising questions and adding or removing questions based on Steering Committee and other partner input for Phase 7, the CUBS program plans to evaluate the effectiveness of phone interviews and the contribution of this mode of data collection to overall response rates. The CUBS staff will be considering whether the large amount of effort and cost for phone data collection is worth the additional responses collected through this mode and may consider options such as eliminating the phone mode, only attempting phone interviews with specific sub-populations, or conducting phone prompts (calls to remind participants of the survey but not attempt a full interview).

The CUBS program primarily disseminates data through the online Data Visualization Tool, which was created by the MCH Epi Senior Scientist using R Shiny. This Tool currently allows users to query CUBS results from the full Phase 5 dataset (data collected 2015-2019), and the first three years of the Phase 6 survey (2020-2022). The application includes trends, geographic data, and the ability to cross-tabulate any two variables in the dataset. CUBS data will continue to be shared as requested for child health needs assessments, program evaluations, and other uses. The CUBS Coordinator also responds to multiple summary data requests throughout the year from individuals and programs. Given recent changes to the Alaska Department of Health website, the CUBS program will be re-evaluating how best to disseminate information and data from CUBS through a public website and may increase efforts to share information through Gov Delivery email newsletters.

The CUBS survey will continue to include open-ended questions at the end of the survey asking respondents to share resources they have used that other parents might like to know about, and to describe any resources or information that they wish they had to support them in raising their child. Responses will continue to be shared periodically via email with Title V and early childhood state leadership, as well as in other venues as appropriate. CUBS is primarily funded by the Title V Block Grant.

5. Increase early childhood systems support for families through community partnership.

WCFH values the unique knowledge and perspectives within each Alaska community. Strengthening early childhood systems requires a multi-tiered approach that supports both local communities and broader state-level initiatives.

The Alaska Early Childhood Network (ECN) is a peer-to-peer network connecting early childhood coalition leaders and coordinators across Alaska. It offers a collaborative space where communities can share experiences, support one another, and elevate early childhood initiatives. ECN is a partnership co-led by the Early Childhood Systems Manager.

Over the next year, WCFH plans to continue its collaboration with CIRS to facilitate monthly ECN meetings and advisory committee sessions, guided by ECN participants. The ECN Advisory Committee plays a crucial role in shaping meeting agendas, ensuring discussions remain relevant while fostering connections and resource-sharing among professionals. This year marks a significant milestone with the first ECN Advisory Council meeting taking place in Soldotna, Alaska, strengthening community engagement. Additionally, an external contractor will continue evaluating ECN’s impact, assessing member connections, participation value, and providing recommendations for ongoing growth and improvement.

6. Support efforts to improve access to basic needs for Alaska families with children, including access to high quality and affordable child care.

The WCFH team collaborates with agencies and engages in advisory boards and committees to integrate a public health perspective into early childhood initiatives. Through key programs, they work to enhance access to high-quality child care and other basic needs across Alaska.

Alaska Alliance for Healthy Kids Early Care and Education: The Alaska Alliance for Healthy Kids Early Care and Education is dedicated to enhancing early care and education systems across the state while fostering healthier environments through improved physical activity, nutrition, and obesity prevention efforts. WCFH staff actively contribute to the workgroup, gaining insights into Centers for Disease Control (CDC) funding provided to the Alaska Department of Health. This funding supports the adoption of national standards for nutrition, physical activity, and breastfeeding, along with the expansion of Farm to Early Care and Education (ECE) initiatives within statewide ECE systems.

Thread & SEED: Thread, Alaska’s Child Care Resource and Referral organization, manages the Alaska System for Early Education and Development (SEED), which supports early care and education specialists through the SEED Career Ladder. This system acknowledges credit-based education and training while providing workforce support, including financial assistance, professional development reimbursements, travel funding, CDA application fees, and scholarships. WCFH staff continues to contribute to the SEED Steering Committee, helping ensure early childhood systems are examined to identify and remove barriers, so that all families, especially those facing challenges, can access the support they need.

Preschool Development Grant Birth through Five (PDG B-5): The PDG B-5 funding supports early childhood services for children from birth to age five. Administered by a Leadership Team composed of members from the Division of Public Assistance, Child Care Program Office (CCPO), WCFH, and DEED, the grant completed the statewide early childhood needs assessments and updated the Alaska Early Childhood Strategic Direction for 2025-2030. PDG B-5 funds continue to strengthen family engagement, quality improvement, workforce compensation, infant mental health initiatives, and direct services for young children. By participating in the PDG Leadership Team, WCFH continues to ensure that public health and maternal-child health perspectives shape program decisions. The grant promotes collaboration among programs within a mixed-delivery system, which includes child care centers, family child care providers, Head Start, state pre-kindergarten programs, and home visiting services. It is anticipated that WCFH will be the lead entity for the next grant cycle beginning 1/1/26.

Pyramid Model Leadership & Implementation: The Alaska Early Childhood Pyramid Model Partnership was re-established in 2023 to develop a state action plan aimed at expanding Pyramid Model practices across Alaska. In collaboration with the Pyramid Model Consortium, the partnership created a strategic framework to guide the statewide implementation of the model.

Additionally, the partnership successfully completed the exploration and planning phase for key components essential to the Pyramid Model’s implementation, including:

•          State Leadership Team (SLT)
•          Professional Development Network (PDN)
•          Implementation systems
•          Data and Evaluation systems

Staff from WCFH contribute to the Alaska Pyramid Statewide Leadership Team (SLT), which enhances early childhood systems by designing, implementing, and sustaining the Pyramid Model. This multi-tiered framework fosters social and emotional development through inclusive practices, family partnerships, and workforce development.

Additionally, WCFH staff play an active role in the Implementation Committee, where they are contributing to the development of the Alaska Hiking Trail, a new Implementation Application designed to support emerging programs.

The State Leadership Team is eager to explore the potential establishment of two to three new Implementation sites in 2025, further advancing the Pyramid Model’s reach and impact across Alaska. It is anticipated that Alaska will be the lead agency for the Pyramid model in SFY27.

Alaska Financing Policy Projects (FPP) Zero to Three Cohort: WCFH staff actively participate in the Infant and Early Childhood Mental Health Financing Policy Project (IECMH-FPP) as members of the Alaska FPP cohort. Through this learning community, cohort members engage in peer-to-peer collaboration, receive expert technical assistance, and take part in knowledge-sharing opportunities aimed at strengthening Infant and Early Childhood Mental Health (IECMH) systems in Alaska.

At present, the Alaska cohort is focused on developing public outreach and educational materials to promote awareness and foster support for IECMH initiatives throughout the state.

7. Offer continuing education, professional development, and increased coordination of health service supports between providers serving children and youth.

Ages and Stages Questionnaires: WCFH staff support professionals in developmental screening by providing training on the Ages and Stages Questionnaires (ASQ) and Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). This ensures that providers across Parents as Teachers, Child Care, and the Early Intervention programs are well-equipped to conduct effective screenings. In addition to in-person training, WCFH plans to incorporate Brooks Training's online, self-paced introductory modules—once available through the state Learning Management System—expanding access to screening education for all providers, including health care professionals. These efforts strengthen early identification practices, enabling timely interventions for children at risk of developmental delays. Through advocacy and awareness initiatives, we further promote best practices, increase participation in screening programs, and ultimately improve developmental outcomes for children while enhancing support for families.

To support the relationship with all types of applicable providers, the CIRS, in partnership with WCFH, will continue to offer many free training opportunities. To increase the knowledge and use of developmental screening, they will offer free online developmental screening training through the State of Alaska Learning Management System, which includes a CYSHCN module. This training is for all types of providers (medical providers, home visitors, early childhood educators, etc.) who want to administer developmental screening appropriately. Certificates of Medical Education (CMEs) and an optional Maintenance of Certification Part 4 (MOC-4), a credit needed by physicians who are board certified in general and subspecialty pediatrics is offered. The CIRS will also offer three training modules specifically for medical providers:

1. Developmental surveillance and screening, connecting families to services with Help Me Grow Alaska.

2. Postpartum depression and anxiety, opportunities in a pediatric setting. 

3. Early relational health, opportunities in a pediatric setting. 

These modules will also offer continuing education credits for medical professionals through partnership and accreditation with the Department of Health. The Title V MCH Director serves as a content reviewer for continuing education credit. The course was last reaccredited in May 2024.

Providers will also continue to have access to the Strengthening Families toolkit for free on the CIRS website. 

Facilitating Attuned Interaction (FAN): The FAN approach serves as both a conceptual framework and a practical tool, aimed at strengthening relationships and encouraging reflective practices. Supported by the PDG B-5 and implemented by Alaska Child Welfare Academy at the University of Alaska Anchorage through an interagency agreement with WCFH, FAN helps practitioners observe parents closely, tailor their interactions to parents' current engagement levels, and respond in a flexible, supportive manner. This model emphasizes five essential processes for effective communication: Calming, Feeling, Thinking, Doing, and Reflecting.

Strengthening Families Alaska: Strengthening Families is a research-based initiative designed to build resilience within families, support child development, and reduce the risk of abuse and neglect. It works by engaging families, organizations, and communities to reinforce five essential protective factors, which in turn lead to broader systemic improvements at local, state, and national levels. This training equips participants with strategies to incorporate protective factors into their work and within Alaskan communities. By fostering these supports, families become empowered, creating environments where children can grow and thrive. The Strengthening Families Alaska training is funded through the PDG B-5 and facilitated by Alaska Child Welfare Academy at the University of Alaska Anchorage through an interagency agreement with WCFH.