The CT Title V Program and our partners recognize the importance of access to a comprehensive health and mental health care system for all children, with a focus on underserved children and health equity. CT Title V works to advance improvements in collaboration with providers, policymakers, consumers, and state agencies with an emphasis placed on developmental promotion, developmental monitoring, early screening, evaluation, and intervention.

CT activities around developmental screening continue to address shared strategies including: conducting an education and awareness campaign that targets families and communities on the importance of developmental screening; train community and healthcare providers to improve screening rates and coordination of referrals and linkage to services within the state; and engage in cross systems planning and coordination of activities around developmental screening.

Cross system planning and coordination of activities include a Title V staff member to continue to attend the Help Me Grow Advisory Council meeting that focused on developmental screening efforts including a focus on establishing a statewide learning collaborative to bring together developmental screening initiatives to increase understanding of screening practices and create an informed system of developmental promotion, developmental monitoring, early detection, linkage, and referral.

Screening to Succeed regional call to action efforts will continue through the increase of developmental awareness and promotion, developmental screening, and connecting to services by providing families and providers with the knowledge, resources, and tools for effective coordination and community wide implementation. Staff from Department of Public Health, University Center for Excellence in Developmental Disabilities, Child Development Infoline, Wheeler Clinic, Office of Early Childhood, Help Me Grow Advisory Committee and the Developmental Screening Workgroup of the State Health Improvement Plan will continue to support efforts to expand developmental screening through the implantation of community action plans.

Child Development Infoline (CDI) has an updated family friendly web site that offers the Ages and Stages Questionnaires online along with developmental milestones. CDI has a supply of “Learn the Signs. Act Early.” Materials available on site for distribution for families and providers available in both English and Spanish. CT DPH has updated the Where is Bear? Book in English and Spanish to include CT referral information to United Way 2-1-1 Child Development Infoline.

School Based Health Centers actively ensure that immunizations are updated, and numerous SBHC have chosen immunizations as a Results Based Accountability outcome measure as well. Title V staff and our partners will work with the DPH Immunizations Program to disseminate information, including Advisory Committee on Immunization Practices (ACIP) guidelines and to promote the necessity of adhering to immunization schedules; and to advocate for the coverage of vaccines by all insurers. In addition, SBHCs perform oral health screenings and referral.

Immunizations

The Immunization Program will plan to provide all vaccines to approximately 700 providers statewide including private physician offices, community health centers, School Based Health Centers, urgent care centers and local health departments. The Connecticut Vaccine Program (CVP) is funded through a combination of state and federal monies. The state monies are from an assessment tax on all health insurers doing business in the state of Connecticut. This assessment allows us to provide the majority of all nationally recommended vaccines for privately insured children up through 18 years of age free of charge.

Pediatric outpatient visits and routine childhood vaccination have declined substantially during the COVID-19 pandemic, leaving children and communities at risk for outbreaks of vaccine-preventable diseases. In response, the CT DPH Immunization Program has supported providers to remind parents that vaccinations are safe and important through activities including: Surveying providers on their ability to provide catch-up and coordinating with the State Department of Education on recommendations for health assessment records; Sending memos and resources to pediatric providers via Everbridge mass communication system and posting on: https://portal.ct.gov/DPH/Immunizations/CVP---Information-for-Providers; Posting on CT DPH social media sites to promote vaccine catch up, such as the Center for Disease Control and Preventions (CDC) Call to Action; Sharing resources and social media toolkits with providers and local Immunization Action Plan (IAP) Contractors conducting outreach and education to raise immunization rates; Preparing and posting a letter encouraging providers to onboard with CT WiZ as a strategy for real-time reporting and utilizing reminder recall reports; Continuing to onboard providers with CT WiZ; Promoting and posting updated reminder recall reports training on the CT WiZ Training website: https://portal.ct.gov/DPH/Immunizations/CT-WiZ-Patient-Management; Sharing AAP and CDC messaging/webinars/resources on routine catch up at local IAP Advisory meetings.

Office of Oral Health

The Office of Oral Health’s (OOH) will continue to facilitate the CT Dental Sealant Advisory, a statewide stakeholder group that meets quarterly to provide guidance and technical assistance to the SEAL CT! program. Despite COVID-19, the group maintained strong attendance and participation, meeting virtually.  Resources to promote sealants and the safety of preventative visits during COVID-19 were created in English and Spanish and shared with partners for broad utilization. A 30 second public service announcement (PSA) was also created to promote sealants. In collaboration with the CT Dental Sealant Advisory, the OOH will host an annual workshop in the Fall of 2022 to bring together dental sealant and school-based oral health partners to discuss different caries risk assessments and management by providing an overview and comparison between assessments developed by the American Dental Association, the American Academy of Pediatric Dentistry, and the CT Dental Health Partnership. 

To support the OOH’s continued efforts to implement data driven strategies and activities to improve the oral health status of CT’s children, the OOH recently conducted the Every Smile Counts children’s survey. Every Smile Counts is an oral health survey of kindergarten and third grade students throughout CT. The Association of State and Territorial Dental Directors, a CDC contractor, provides a randomized sample by county and OOH partners with the CT State Department of Education to provide additional demographic data. The survey was conducted during the 2021-2022 school year with the final report being available by the end of 2022. The survey is conducted every five years to collect data on the oral health status of children in CT to drive the OOH’s strategies and activities to address children’s oral health through interventions, health education, and policy recommendations.

Funded by a HRSA oral health workforce grant, the OOH continues to work with Community Health Center, Inc. (CHCI), a federally qualified health center, to implement the Medical Dental Integration Project (MDIP), which addresses common modifiable risk factors for childhood obesity and dental caries. The OOH developed a Nutrition and Oral Health Toolkit for Dental Providers, which includes a nutrition and oral health assessment that dental providers utilize in preventive dental appointments to identify at risk children. These children are then referred to primary care or nutrition services for follow up. The dental provider conducts in chair counseling and goal setting using motivational interviewing. The project also includes a bidirectional referral component where pediatric patients who do not have a dental home or are overdue for regular preventive dental care are identified in medical settings and referred to dental. The project is being implemented in five sites throughout the state with the intention to be rolled out to all CHCI sites upon the conclusion of the pilot. 

The OOH also convenes and facilitates a Medical Dental Integration Advisory, which brings together stakeholders throughout CT interested in or working towards medical dental integration. The Advisory meets quarterly and provides technical assistance to the MDIP. The OOH, in collaboration, with the Advisory, will be hosting an annual workshop Fall of 2022 focused on closing the communication gap between primary care and dental and how to integrate oral health intro primary care.

Nutrition, Physical Activity, and Obesity (NPAO) Program

The NPAO Program will continue to expand the existing ECE site initiatives by working with new and existing partner organizations. The NPAO Program is entering into the last year of a five-year grant cycle for the CDC SPAN funding. The goal is to apply for another five-year cycle of funding from CDC to supplement SNAP-Ed funds to continue existing initiatives or identify alternate sources of funding.

Go NAPSACC: In this last year of SPAN funding, the NPAO Program is working with technical assistance consultants (TAs) in the state to ensure all currently enrolled ECE sites complete the module(s) they are working on by finishing their action plan goals and a second self-assessment by the end of September 2023, so data can be collected on best practice achievement. New sites will be enrolled with the goal of completing their selected module(s) by September 2023.  Technical assistance and any additional recruitment is supported by state and local partners, including the Regional Education Service Centers (RESC) Alliance and the City of Hartford Department of Children, Families, and Recreation.

CEC: The NPAO Program is hosting a CEC Three-Day Training Academy in June 2022, to recertify staff trainers and train 15 ECE classrooms/30 teachers in CEC implementation. Once recertified, the NPAO Program and  the University of St. Joseph plan to offer at least CEC trainings statewide to train 30 ECE classrooms/60 teachers on CEC implementation from October 1, 2022-September 30, 2023 and provide technical assistance and support following the training.

Nutrition and Physical Activity Education: The NPAO Program, with the University of St. Joseph plans to conduct at least 128 sessions and workshops from October 1, 2022 - September 30, 2023 for a total of 960 participants.  

School Based Health Center Nutrition Education: The NPAO Program will work with the MCH Block Grant staff to distribute the School Based Health Center Nutrition Education handout among School Based Health Centers for use during the school year.