Increase the number of after-school and community based physical activity and health promotion activities.

In WV, schools are often the central hub for communities and school playgrounds are often the only playgrounds or adequate space in a community for physical activity in a safe environment. The majority of communities are not walkable and do not have easily accessible trails. In 2015, the WV Legislature passed a new limited liability law that allows school facilities to stay open after hours without fear of lawsuits. It also allows children and members of the community to use facilities after school through “shared use” activities. The Adolescent Health Initiative’s (AHI) 8 regional community-based Adolescent Health Coordinators (AHCs) have worked with schools over the last 2 years to identify where shared use activities are happening and assist in program development and implementation. While most schools have a playground open to the public, many playgrounds need repairs or have very little equipment. Many schools have expressed barriers such as lack of funding and available staff to offer organized after school activities. The AHCs will continue to work with schools to obtain grant funding and/or community sponsorships (corporate, municipal, etc.) to expand or upgrade playground equipment and provide necessary equipment or materials for activities, such as archery clubs, fitness programs, and school/community gardens. The AHI will also work with community-based groups to offer other initiatives to combat obesity, such as motivational campaigns, establish or expand local “farmer’s markets”, organize 5k races, sports tournaments, weight loss challenges, etc.

The OMCFH’s HealthCheck Program began implementing the Coordinated Approach to Child Health (CATCH) program. The initial program began in partnership with three summer camps to offer organized, supervised physical activity for a minimum of 60 minutes per day. Activities include volleyball, basketball, softball, “ultimate frisbee” and dance, with leadership comprised from staff volunteers. The HealthCheck program will work to expand CATCH in the coming year to include camps occurring in the fall and additional summer programs.

Assist the WVDE in the facilitation of evidence-based professional development opportunities for schools and administrators.

In previous years, the Bureau for Public Health (BPH) provided funding to the WV Department of Education (WVDE) for eight Regional School Wellness Specialists (RSWSs) housed within the WVDE’s Regional Education Service Agencies across the state. The RSWSs provided physical activity professional development opportunities for school personnel on behalf of the OMCFH. However, the WV Legislature voted to dissolve the Regional Education Service Agencies during FY 2018, effectively eliminating the RSWS positions. To ensure these professional development opportunities continue, the AHI Director will serve on the WVDE’s Health and Wellness Leadership committee to help identify ways the AHCs can aid in facilitating professional development through their existing initiatives such as the Let’s Move WV! and the West Virginia Active Schools Challenge as well as other adolescent wellness initiatives.

Work with school personnel to provide technical assistance to increase physical activity throughout the day as outlined in Policy 2510.

WV Board of Education Policy 2510 recognizes that healthy lifestyles and academic success are interwoven; promotes wellness activities that extend beyond course requirements; and increases physical activity for all students. This policy provides opportunities for existing arts courses to incorporate additional movement-based work into the course content. Arts teachers may play a key role in providing leadership and expertise to develop a plan for school-wide implementation of additional physical activity. For those schools that do not have the number of certified physical education teachers or required physical setting, rigorous dance coursework might be developed as an alternative program and submitted for approval to meet the physical education requirements. As part of WVDE’s health and wellness efforts, the WVDE will provide funding to the 8 regional AHCs to promote and share data from Youth Risk Behavior Surveillance (YRBS) Surveys conducted in 2019. The AHCs worked with 116 middle and high schools to conduct those surveys across the state. will They will capitalize on those connections with school administrators and staff throughout the year to identify and implement movement-based activities and the development of alternative and/or school wide programs.

Continue oral health surveillance of children ages one through six through the Basic Screening Survey (BSS) to inform program and policy development.

Over the next year, the Oral Health Program will reconvene its surveillance system for children.  The 2019/2020 state oral health surveillance will focus on the Universal Pre-K population and will be the second time this BSS will be conducted.  Although the State Oral Health Surveillance Plan does not currently include a BSS for the adolescent population, the OHP will develop a plan to include eighth-grade BSS. The OHP is also in transition to completing state surveillance as an internal activity and will be building this capacity over the next year.

Promote and educate pediatric care providers on importance of establishing a dental home for children ages 0-6, with an emphasis on age 1 dental visits.

In order to increase the number of children with preventive visits, the Program will encourage its colleagues and partners to intervene with children at multiple points.  The OHP continues to work with the state AAP chapter, WV Association of School Nurses, the WV Primary Care Association and internal partners (HealthCheck and CYSCHN) to educate non-dental providers on the importance of oral disease prevention in the medical setting and referral to a dental home at six months or emergence of the first tooth.

Promote and educate pediatric care providers on fluoride varnish application for children ages 0-21 years.

Educate non-dental pediatric healthcare providers on the updates to fluoride varnish services, including hands-on training and promotion of the Smiles for Life Curriculum Course 6: Caries Risk Assessment, Fluoride Varnish and Counseling.  The OHP also plans to use information and resources from involvement in the 2018 National MCH Workforce Development Center Cohort to inform training and education of non-dental providers on fluoride varnish application in the medical setting.

Promote and educate dental care providers on service delivery of age 1 dental visits.

The OHP will continue to work with the state’s only dental school, West Virginia University, as well as the schools of dental hygiene to promote the importance of establishing a dental home for children at or before the age of 1.  Upcoming work with state dental workforce will also support this activity through training of WVU dental students on current pediatric best practice and establishment of a pediatric residency program.

Support implementation of West Virginia Board of Education (WVBE) Policy 2423 requiring a dental examination for students at school entry and grades 2, 7 and 12.

Maintain the Oral Health Services Module in collaboration with the West Virginia Department of Education and the West Virginia Statewide Immunization Information System. This module is utilized by dental and school health professionals to document dental examinations for school children at school entry, 2nd, 7th and 12th grades in alignment with West Virginia Board of Education Policy 2423: Health Promotion and Disease Prevention.

Offer evidence-based cessation curriculums to pregnant women, recently delivered women, mothers and other household members via home visiting services.

The West Virginia Home Visitation Program will work with home visiting programs to ensure all pregnant women who smoke are provided multiple evidence-based smoking cessation strategies.  Current strategies within WV include Tobacco, Baby and Me, the Tobacco Quitline, SCRIPT and www.Smokefree.gov website for text messaging on smoking cessation.  Efforts have been made to streamline the process for the Tobacco Quitline to better support women requesting services. A review of current smoking cessation brochures and handouts will be completed to make sure information is current and appropriate for the families served.

Medical Home/Insurance

Work with insurance providers to promote the coverage of medical necessary services.

To ensure Title V funds are being utilized as a last resort, the CSHCN Program plans to focus efforts to work with the education system to coordinate medical foods benefits between the education system, Medicaid, MCOs, WIC, and Title V funding.

Additionally, the CSHCN Program will work with the MCOs and Medicaid’s EPSDT benefit to expand the definition of medical necessity for medical foods beyond complete enteral nutrition through a feeding tube to, minimally, include children who receive all of their nutrition through formula/medical foods regardless of feeding route.

Provide easily accessible, medical necessary nutrition services as a payer of last resort.

The CSHCN Program will continue to provide medically necessary nutrition services as a payer of last resort. The CSHCN Program administration team will explore the option of supporting feeding and swallowing therapy clinics by completion of an evaluation of services and locations of services though out the state.  

Formalize data sharing agreements with third party payers to allow for continued monitoring of unmet needs and adequacy of insurance.

The CSHCN Program will continue to participate in DHHR efforts to improve data sharing and matching among internal and external partners to best serve children with special health care needs.  The program will also continue to explore opportunities to centralize data sources through a care coordination platform to increase staff efficiency and delivery of comprehensive services for this population. West Virginia’s Title V program will leverage MCO data sharing agreements to receive the necessary data to refine how plans of care are being implemented and understand the impact of plans of care.