Objective CH-1

By September 30, 2020, increase access to quality preventive services and positive child health outcomes, and increase the number of children who receive early and continuous screening, assessment and referral for physical, developmental, behavioral or emotional conditions as part of primary and specialty care.

 

Strategy CH-1.1

Promote a coordinated, comprehensive early childhood system, including social, emotional and mental health.

 

• Essentials for Childhood (EFC) section staff will continue to partner with, in collaboration with Title V staff in the Children and Youth with Special Health Care Needs (CYSHCN) unit, the state’s Medicaid administrative agency, Health Care Authority (HCA); the Office of the Insurance Commissioner; payers; providers and families to support system changes to improve access, ensure adequate health benefits and require the reimbursement of needed services such as developmental screening, nutrition, oral health, and medical/health homes.

 

• Continue to provide technical assistance to local health jurisdictions (LHJs) doing universal developmental screening-related (UDS) work through Title V contracts.

 

• Support continued development and implementation of Community Asset Mapping (CAM) in local communities with the goal of improving coordinated, comprehensive early childhood systems. The CAM project provides networking and development of resources for screening, referral and responsive services at the local community level for 17 counties focused on developmental screening, either alone or in combination with a focus on autism. The Child Health Annual Report and CYSHCN Annual Report and Plan include details about the CAM project.

 

• Partner with the Department of Children, Youth, and Families (DCYF) and the Washington Association for Infant Mental Health to facilitate ongoing improvements in promoting young children’s social-emotional development and explore ways to increase social-emotional screening as part of developmental screening.

 

Strategies CH-1.2, 1.3 and 1.4

Support infrastructure and use of evidence-based pediatric screening methods that are culturally and linguistically appropriate to achieve universal developmental screening, including social-emotional and mental health screening for young children, and explore behavioral health (maternal depression) screening for parents.

 

Increase parent, public and health professional awareness of developmental milestones and evidence-based well-child care.

 

Encourage coordination of pediatric screening efforts, results and referrals among all screening and referral entities, including but not limited to clinical care settings, medical homes, child-care settings and schools.

 

• Continue to work with partners such as the University of Washington’s (UW) Medical Home Partnerships Project (MHPP), LHJs, Washington Chapter of the American Academy of Pediatrics (WCAAP), DCYF, Home Visiting, the Early Achievers Quality Rating Improvement System, Early Support for Infants and Toddlers, WithinReach and other partners to move the UDS and Help Me Grow Washington (HMG) efforts forward. Continue to spread a UDS perspective across the Prevention and Community Health division programs and identify connections across state agencies and initiatives.

 

• Consider the ways in which we can better support communities to take a more culturally-responsive approach to screening of the individual and environmental factors that promote, or inhibit, optimal early childhood development and seek to support the efforts of communities statewide in developing infrastructure that will ensure their children and families have the supports and services needed to thrive. Many LHJs partners have adopted holistic approaches to UDS that often consider the culturally-specific context of the relationships within which young children develop. Maternal depression screening and parental resilience screening are included in the statewide definition of “universal developmental screening.”

 

• Promote Bright Futures Guidelines to parents, providers and payers for screening and well-child care, including oral and mental health. Use guidelines to facilitate access to medically-necessary services and promote UDS, optimal growth, and development.

 

• Increase access to screening and services for all children in primary care and early childhood education settings.

 

• Provide information at DOH-supported provider and parent trainings about screening and well-child care, which also covers oral health and mental health for children. Provide current, accurate, and consistent information and support on child development and developmental milestones.

 

• Partner with other Department of Health (DOH) units to contract with WCAAP and provide training for pediatric primary care providers across the state that supports use of evidence-based developmental screening methodologies that are culturally and linguistically appropriate.

 

• Participate in continuing education to remain informed on current screening methods.

 

 

• Work with HCA to identify which medical providers are billing for developmental screening, and at which age(s) children are screened. This helps us identify that clients are receiving their covered benefits and moves us toward the goal that all families have equitable access to developmental screenings.

 

• Continue LHJ promotion of developmental screening among community partners, including health care, education, child care and others. DOH will continue to link Title V state and national performance measures to LHJ contracts and provide technical assistance to help them link activities to these measures.

 

• Work with DCYF to take the Project LAUNCH UDS Toolkit that was developed and enhanced to digitize it and host it statewide. This will allow all child care providers to have access to the UDS Toolkit.

 

• Continue to develop the statewide UDS data system, including securing maintenance funding.

 

Strategy CH-1.5

Support efforts of DOH cross-agency Child Health Workgroup to align and leverage work across child health, environmental health, community-based prevention, and surveillance and evaluation, to include oral health, injury prevention, drinking water, healthy food, physical activity, tobacco prevention and other areas.

 

We will continue leading the Child Health Workgroup to ensure communication, coordination and collaboration occurs across DOH as it relates to children’s health and health equity.

 

Status to Date on Objective CH-1

DOH continued to work to secure funding for development of a UDS data system and to identify efficiencies and additional resources to staff critical UDS work. The Health Information Technology for Economic and Clinical Health (HITECH) interagency partnership documents include the opportunity for 90/10 percent federal/state match funding for the child health data system. We are happy to report that the Washington State Legislature funded the 10 percent match in April 2019. We are quickly moving towards building the data system, building upon the business requirements document completed in 2016.

 

We built upon our earlier UDS sustainability plan and developed a draft Universal Developmental Screening Action Plan for DOH (2019-2020). It serves as a planning and communication tool for the agency, related to the many UDS efforts occurring across DOH and among state partners. The draft plan is being vetted by office leadership.

 

It includes two primary strategies: (1) Promote developmental screening as a key action within the early childhood system, and (2) Create a statewide universal developmental screening data system. For the first strategy, responsibilities lie with many partners around the state. DOH will play a supportive role in partnering with key entities such as DCYF and HCA to convene stakeholders, including families; seek funding for best practices; and work with partners and stakeholders to expand knowledge of child development, implement a system for early detection of developmental concerns, and connect children and families to culturally appropriate interventions, supports, and services. The second strategy creates a UDS data system and will be led by DOH, with essential input from multiple agencies, partners, and stakeholders. The action plan grounds the UDS data system within the HMG framework.

 

In 2019, we received baseline data for 2017 and 2018 from HCA identifying which medical providers billed for developmental screening, and at which ages children were screened. We are continuing to work on developing data requirements to look at uptake rates by a variety of indicators. Epidemiologists, our UDS lead, and our CYSHCN nurse are involved in this effort, working with HCA to track the number of clients receiving their screening benefits.

 

We continued LHJ promotion of developmental screening among community partners, including health care, education, child care and others. DOH continued to link Title V state and national performance measures to LHJ contracts and provided technical assistance to help them link activities to these measures.

 

We continued to support the Family Health Hotline at WithinReach and gathered data on Ages and Stages Questionnaires (ASQs) completed by families through WithinReach.

 

Great MINDS (Great Medical Homes Include Developmental Screening) training for providers continued in federal fiscal year (FFY) 2019 and is expected to continue in FFY 2020. The Office of Rural Health is conducting an evaluation of the rural Great MINDS trainings and determining next steps for 2020 use of rural funds. They are working with WCAAP to develop an implementation plan for Whidbey Island to see they can successfully implement Great MINDS on the island, and use it as a template for other rural providers to learn implementation strategies. Two Great MINDS trainings were held in May 2019.

 

DOH had partnered with the Pierce County Accountable Community of Health (ACH) and the Korean Women’s Association (KWA) to provide initial funding to pilot the Pathways Model in Pierce County. As a community care agency of the Pierce ACH, KWA invested in a community health worker position to deliver Pathways in their county. Their goals were to increase care coordination and access to medical and non-medical services, help build community partnerships, and reduce maternal and infant health disparities for African American or Black priority populations in Pierce County. In 2019, KWA presented their work at the governor’s Results Washington initiative meeting.

 

Help Me Grow/Project HOPE

With funding from the Robert Wood Johnson Foundation, EFC is working to build a coordinated statewide system of Help Me Grow: a system to ensure communities identify the needs of children, link families to community-based services, and help families support their children’s healthy development.

 

By connecting families to a variety of health and social services, Help Me Grow will help strengthen family well-being and economic security. We continue to inform and support policy and funding proposals and conduct implementation planning to build a Help Me Grow system in Washington, bringing the voices and interest of community partners into this work.

 

Project LAUNCH

In FFY 2019, we are implementing the final year of the Project LAUNCH expansion grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). Ninety licensed child care centers and homes have been engaged in the developmental screening work. The number of early learning professionals that were trained in the ASQ and ASQ:SE (Social Emotional) is 416. Many child care programs added developmental screening to their ongoing practices and policies. In Thurston County, the developmental screening work is being sustained and spreading to other counties through funding from DCYF.

 

We have engaged 26 licensed child care centers and homes in to participate in infant and early childhood mental health consultation across the three Project LAUNCH communities, impacting 223 children. We expect to engage an additional 25 sites by September 2019. Mental health consultants are working closely with existing early learning coaches and consultants, and aligning their work with our state’s quality improvement and rating system (Early Achievers). Mental health consultation is intended to increase the capacity of the early learning professionals to support children’s social emotional well-being and positive behavior.

 

We have applied for FFY 2019 Project LAUNCH funding. The focus of the new grant would be to better link families, early learning, behavioral health, and primary care.

 

Objective CH-2

By September 30, 2020, increase social connectedness, healthy relationships, violence-free environments and community engagement across the life span.

 

Strategy CH-2.1

Decrease the presence of risk factors that contribute to violence and increase the presence of resilience factors that are protective against violence at the individual, family and community levels.

 

The Essentials for Childhood (EFC) initiative is funded by the Centers for Disease Control and Prevention (CDC), with additional support from the Bezos Family Foundation and other sources, as well as in-kind support of participating partners. Title V funded staff also support some of the EFC program work.

 

In Washington, we take our role as stewards of the next generation seriously. We know that our ability to raise healthy children to lead tomorrow’s communities requires smart, innovative thinking today. Every child should have equal opportunity to thrive.

 

A growing body of science tells us that severe or repeated exposure to harmful experiences can cause toxic stress responses in children. These can weaken areas of the brain’s architecture associated with learning, mental illness, and behavioral modulation, which can have life-long implications for poor health. Fortunately, research also suggests that there are things we can do to prevent, buffer and reverse those effects. Safe, stable, nurturing relationships and environments serve as protective factors and are essential for child health and well-being.

 

The EFC initiative builds on more than two decades of pioneering work in our state on understanding and addressing the effects of adverse childhood experiences (ACEs). The cross-sector, public-private partnership works towards the vision: All children in Washington State thrive in safe, stable and nurturing relationships and environments.

 

EFC is implementing year one of our second five-year CDC grant (2019-2023). The new grant builds on the previous work; we have a deeper focus on specific strategies to empower communities to support positive parenting and strengthen family economic security, two proven approaches to reducing abuse and neglect.

 

We will continue to leverage cross-sector partnerships to align activities to prevent childhood trauma, and update and enhance our statewide child abuse and neglect action plan.

 

ACEs and Resilience Community of Practice

The EFC ACEs and Resilience Community of Practice is continuing to build statewide community capacity to reduce ACEs and build resilience. Two in-person events and four webinars are planned for calendar year 2019. The in-person events build on the two successful 2018 events. They will provide opportunities to connect with people across the state who are working to grow trauma-informed, resilient, and compassionate approaches in their communities and work places, so that all children thrive in safe, stable, nurturing relationships and environments. The webinar series will highlight emerging solutions, promising practices, and essential community education. At the end of 2019 we will assess interest and capacity for continuing to convene this community of practice.

 

Support Local ACEs Work

DOH will continue to provide technical assistance to the LHJs on child health and development. We will work with LHJs to continue to participate in community-level planning and initiatives around preventing ACEs and promoting resiliency.

 

We are also exploring opportunities and capacity to develop a strategic communications strategy to support optimal child development and prevent abuse and neglect. We may work with HMG communities or others to co-create, test, and pilot a communications strategy. Our approach is for communities and organizations to build on their strengths to support and empower families with positive parenting norms, systems, and services.

 

Vroom Activation

EFC received a three year grant (2019-2021) from the Bezos Family Foundation to activate Vroom across Washington State. Vroom is a set of asset-based, tested tips for parents of kids from birth through age 5 grounded in child development research (described in more detail in the Child Health Annual Report).

 

EFC will work with partners to use Vroom as part of a strategy promoting parent and caregiver knowledge of parenting skills and child development. It includes promotion of community social environments that support and empower families. These strategies promote bonding and brain development, contributing to mental wellness and risk reduction. We are planning a layered activation strategy that will include light touch, broad reach through statewide partners and networks, and more intensive, funded activation in a few communities.

 

Opioid Misuse Prevention

We will use CDC EFC opioid prevention supplemental funding to support the Spokane Regional Health District’s work. Spokane is piloting community outreach to raise awareness of the need for and availability of treatment for pregnant women with opioid misuse disorder. They plan to build a network of services and pilot an improved outreach program to locate pregnant women in need of but who have not received prenatal or substance misuse-related healthcare.

 

The health district is working with partners, including Molina Healthcare of Washington, a Medicaid managed care organization (MCO) that enrolls the vast majority of Medicaid patients in the region; the Providence Sacred Heart Medical Center obstetrics group and emergency department; Bright Heart Health, a 24/7 on-demand telehealth program that offers wrap-around comprehensive care services for individuals in need of medication assisted treatment; and programs that work directly with pregnant and parenting women impacted by substance misuse disorders such as Nurse Family Partnership, Infant Toddler Network (Birth to Three), CYSHCN program, and Neighborhoods Matter. They are also working closely with Rising Strong, a program that provides evidence-based mental health and substance misuse treatment, along with housing and wrap-around services intended to directly address the multiple needs of these families.

 

Child Death Review

Title V funds will continue to support a State Child Death Review (CDR) Assessment Coordinator epidemiologist position at 0.05 FTE. There are ten local CDR coordinators in the state, covering nine of 39 counties. Two additional counties may begin CDR in 2019: Clark County Public Health has decided to start doing CDR, and Pierce County has applied for funding to resume CDR.

 

DOH will continue to:

 

• Respond to requests for CDR data and share the data to the extent allowed by law.

 

• Support all data reporting and analytic aspects of CDR surveillance in Washington.

 

• Provide technical assistance to LHJs and CDR coordinators, encourage communication among CDR teams and participate in bimonthly conference calls.

 

• Serve as a liaison between LHJs and the National Center for Fatality Review and Prevention at the Michigan Public Health Institute, which hosts the national CDR database.

 

• Analyze CDR data for program planning, evaluation and reports.

 

• Maintain an electronic mailing list to share information with CDR coordinators, CDR team members and other stakeholders.

 

• Continue coordination between CDR staff and the Injury and Violence Prevention team.

 

Strategy CH-2.2

Promote polices that support families with children so they can provide safe, stable and nurturing relationships and environments.

 

The EFC Steering Committee will revisit its legislative policy agenda and is expected to continue to inform or promote policies to support families.

 

Project HOPE and the Help Me Grow Workgroup will continue to support and implement policies to build a statewide HMG system that supports screening and connects families to services and resources they need to support healthy child development.

 

Starting in 2020, eligible Washingtonians will be able to get wage replacement benefits to care for a newborn or newly placed child, care for sick family members, as well as in other qualifying circumstances through Paid Family and Medical Leave. The CDC recognizes paid family leave as a proven strategy for reducing family stress, supporting family well-being, and preventing abuse and neglect. EFC is exploring ways to help the state Employment Security Department promote this new program.

 

Strategy CH-2.3

Increase community capacity to prevent ACEs and promote resilience.

 

• Continue to expand on the success of the ACEs and Resilience Community of Practice event and other partnerships mentioned above under Strategy CH-2.1.

 

• Continue to provide information that can be used to increase community capacity via emails, resource lists, conversations with local ACEs and resilience leaders, and visits to local ACEs and resilience groups.

 

• Participate in cross-agency partnerships to increase state agency and community capacity to prevent and mitigate ACEs, such as Frontiers of Innovation, state-level early learning, home visiting, the state Behavioral Health Advisory Council, and statewide Family Youth System Partner Round Table (FYSPRT).

 

• Work to integrate behavioral health into medical/health homes and Community Asset Mapping coalition work in screening, referrals, interventions and primary care coordination.

 

Strategy CH-2.4

Increase awareness among health providers, families, communities and state systems about the impact of ACEs and toxic stress on lifelong mental and physical health.

 

Through the UW MHPP, we will continue to promote the importance of early brain development and effects of toxic stressors on children, ACEs histories and children’s mental health system changes. For more on this and other MHPP work, see the CYSHCN Annual Report and Plan.

 

Staff will continue to support LHJs and local community leaders, participate on state-level work groups, and inform grants and initiatives on ACEs-related issues. Work will include sharing ACEs and resilience-related information with local, regional and state leaders via emails and resource lists and exploring additional key areas for possible engagement with health providers, families, communities, and state systems for future planning and alignment.

 

Strategy CH-2.5

Engage parents, families, youth, community stakeholders, schools and others to develop community-informed interventions and supports to address violence, safety, environment, mental health and health disparities.

 

Staff will continue to increase understanding of family and community engagement and work to elevate family and community voice in all efforts.

 

The UDS Lead and other staff will work with the MHPP to identify ways to promote inclusion of behavioral health in screening, referrals and interventions, including primary care coordination in communities’ CAM efforts.

 

The UDS Lead will continue to provide technical assistance to the Community Consultants and LHJs doing ACEs and UDS-related work through Title V contracts.

 

The EFC Help Me Grow Workgroup will promote making family perspective first and foremost in systems development, putting families in the center and making it seamless for families to get the services they need.

 

EFC partners will engage parents, caregivers, and community members as we activate Vroom in the state. We will focus Vroom activation on communities furthest from opportunity.

 

The EFC ACEs and Resilience Community of Practice will continue to build statewide community capacity for reducing ACEs and building resilience.

 

EFC staff will support HCA behavioral health and recovery work, including improving access to children’s mental health services, through participation in the statewide FYSPRT.

 

Status to Date on Objective CH-2

Essentials for Childhood has taken great strides in working to increase social connectedness, healthy relationships, violence-free environments and community engagement across the life span. EFC is working to focus action and improve collaboration on three North Star Metrics: Reduce Adverse Experiences, Increase Kindergarten Readiness and Improve Child Health.

 

We are continuing, improving and building on our successes:

 

• Convening partners for coordination and collaboration to align systems, strategies and policies to improve how families experience supports, reduce stress and increase resilience.

 

• Bringing a strong, intentional equity and racial justice lens to the EFC initiative.

 

• Elevating and empowering communities, focusing particularly on those furthest from opportunity, to contribute to statewide policy, systems, and programs, and address their specific challenges.

 

• Building a statewide Help Me Grow system to ensure families can connect to the services and resources they need – when, where and how they need them.

 

• Enhancing our framework and updating our dashboard to be stronger tools for coordination and alignment of child abuse and neglect prevention work across the state.

 

We have also committed to new focuses on:

 

• Changing social norms to support positive parenting. Promote the value that for our state and communities to flourish, we all need to flourish; that parents and caregivers need supports and connections to services to raise successful, healthy children. And knowledge of child development is a protective factor.

 

• Promoting policy and system changes to strengthen family economic security. Family economic security is a protective factor against abuse and neglect. EFC will strengthen, share, and increase support for aligned efforts, including Washington’s new Paid Family and Medical Leave, and systems changes that connect family to social services and resources.

 

• Decreasing the impact of opioid use disorder on pregnant women and children.

 

Objective CH-3

By September 30, 2020, promote and provide support to build capacity and availability of health care, education, resources and services for children ages 0 to 12.

 

Strategy CH-3.1

Collaborate with the Washington State Department of Children, Youth, and Families and the Washington State Health Care Authority to support home visiting services to vulnerable families with young children.

 

• Continue to collaborate with DCYF and Thrive Washington on the statewide partnership and Home Visiting Advisory Committee.

 

• Continue to partner with DCYF and HCA and explore Medicaid options for sustainability.

 

• DOH, DCYF, and the American Indian Health Commission will continue to meet to discuss barriers and opportunities with home visiting services in tribal settings, and the use of culturally appropriate programs and delivery methods.

 

Strategy CH-3.2

Promote community referral and linkages to quality pediatric services and community-based, culturally appropriate resources through partnerships with WithinReach / Help Me Grow Washington / Family Health.

 

• Continue to work closely with WithinReach and the Family Health Hotline to promote child development resource referral and linkages, UDS services, and community information.

 

• Continue to partner with LHJs, Parent to Parent, Fathers Network and other community and parent partners representing culturally diverse parents and families.

 

• Promote community referral and linkages to quality pediatric services, including specialty services, through partnerships such as LHJs, parent support organizations, community health centers and providers, using strategies such as CAM, the state behavioral health Systems of Care partnership, WCAAP, UW Leadership Education in Neurodevelopmental and Related Disabilities (LEND), American Heart Association, March of Dimes and the Western States Genetic Services Collaborative. Provide training and technical assistance for providers on the importance of educating patients on infant and child health and development.

 

• Develop and participate in distribution of Child Health Notes containing up-to-date knowledge on child health topics to providers across the state.

 

• Through Great MINDS and collaborations with UW MHPP, continue to partner with LHJs, community coalitions, HCA, and WCAAP to develop and provide training on UDS and special needs such as autism.

 

Strategy CH-3.3

Partner with the HCA, the Office of the Insurance Commissioner, payers, providers and families to support system changes to improve access, ensure adequate health benefits and require reimbursement of needed services for children, such as developmental screening, nutrition, oral health, habilitative services and medical/health homes.

 

• Provide technical assistance and support to community partners and consumers on how to access health benefits and address gaps in coverage and affordability of co-pays and deductibles.

 

• Explore opportunities to impact state rules around medical benefits and prior authorization processes in order to ensure that families and children have access to medically necessary benefits.

 

• Promote regional training on developmental screening targeted at primary care providers with MCOs.

 

• Work with the Family Health Hotline to maintain resources and referral information on child development for providers as well as parents.

 

• Work through contracts such as the state nutrition contract and feeding teams (groups of professionals that help families work through complex feeding problems when they occur in children and infants) to expand workforce capacity, educate providers and available resources, improve reimbursement for medical nutrition therapy and oral enteral nutrition, and develop support systems for transition from hospital to home. See CYSHCN Application Year Plan for more on the state’s nutrition work supporting CYSHCN.

 

Status to Date on Objective CH-3

We continued to promote and provide support to build capacity and availability of health care, education, resources and services for children by working with partnerships and through contracts. We also continued using strategies such as CAM. We continued to provide training and technical assistance for providers on the importance of educating patients on infant and child health and development; we worked with communities to provide information and resources on ACEs, resilience and social emotional development; and we provided trainings and technical assistance to expand workforce capacity in health and child care settings.

 

Objective CH-4

By September 30, 2020, reduce the rate of unintentional injury hospitalizations among children ages 0 to 19 through collaborative partnerships and increased capacity at state and local levels.

 

Unintentional injury is a leading cause of death and disability among children and carries a significant financial burden. Most events resulting in injury, disability, or death are predictable and preventable. Education can be a primary, cross-cutting intervention, which both directly and indirectly impacts all other components of injury prevention. Training and access to safety devices combined with appropriate education is fundamental to reducing injury rates among children.

 

Public health strategies to prevent injuries among children include four steps: identifying the magnitude of the problem through surveillance and data collection; identifying risk and protective factors; developing and testing interventions; and promoting widespread adoption of evidence-based practices and policies. These four steps are outlined in the CDC’s National Action Plan for Child Injury Prevention and have proven useful and effective strategies for reducing unintentional injury and death of children in Washington.

 

Systematic data on child injury and death is used in defining the problem. Data on the rate of injury and death can show us how an injury problem is changing over time, identify trends in injury to evaluate our efforts and to initiate preemptive action, and inform decision-makers in allocating programs and resources where they are most needed.

 

Using the ACEs model is also useful for identifying driving forces behind the problems and potential solutions. Both positive and negative experiences have shared impact on our health and well-being, including unintentional injuries. By identifying the shared risk and protective factors, we can have a larger impact on reducing injury and death across multiple areas.

 

By gathering current research and best practices, and providing technical assistance to local public health staff, we can address specific injury problems in the most effective manner possible to reduce risk factors while increasing protective factors. Injury prevention strategies that promote active lifestyles in safe environments are effective and achievable means for improving health and well-being at all stages of life.

 

By using local, state and regional collaborative networks and workgroups, such as the Western Pacific Injury Prevention Network (WPIPN) and Safe Kids Coalitions, we can effectively share resources, knowledge and research across the state and employ the most appropriate strategies for each community. Building new collaborative relationships at multiple levels is key to this approach, as it allows us to have access to the best knowledge and practices available to engage and work with communities.

 

Strategy CH-4.1

Provide surveillance of current trends in unintentional child injury and death to identify the top injury risks for Washington State.

 

Child injury and death data throughout the state is reported to DOH through hospital discharge data and death certificates, enabling for identification of areas of risk. This information is reported in the DOH Community Health Assessment Tool (CHAT), which can be queried and reports can be run.

 

State-level unintentional child injury and death data tables from 2009-2013 are available for public access on the DOH Injury and Violence Prevention data web page. More recent and specialized data can be obtained by request to the Injury Data Manager through the same website.

 

Strategy CH-4.2

Identify risk and protective factors through support of traffic engineering strategies (e.g., sidewalks and pedestrian safety medians), which allow pedestrians, bicyclists, motorists and public transportation users to safely move along and across streets.

 

• Partner with Washington Traffic Safety Commission and Department of Transportation to support Complete Streets programs and policies and Safe Routes to School initiatives.

 

• Participate in the Washington Traffic Safety Commission’s Cooper Jones Active Transportation Safety Advisory Council as appointed DOH representative to review and analyze data to improve transportation systems, identify patterns of pedestrian and bicycle fatalities and serious injuries, and report findings and recommendations to the governor annually.

 

Strategy CH-4.3

Develop and test prevention strategies through continued partnership and collaboration with Washington Traffic Safety Commission, Safe Kids Coalitions and the Western Pacific Injury Prevention Network.

 

• Partner with the Washington Traffic Safety Commission’s Child Passenger Safety program and Safe Kids Buckle Up program to support systemic education and enforcement for transporters, law enforcement, and care givers.

 

• Promote the Safest Ride campaign to improve restraint use and proper seating of kids in vehicles. Children under age 13 must be seated in the back seat. Children must be properly secured in a child restraint system or in a booster seat until they reach a height of 4 feet 9 inches.

 

• Support Safe Kids Coalitions and school partners to participate in the Teens in Cars campaign or Impact Teen Driving, evidence-based teen driving safety programs. These programs promote the following safety strategies for families:
  • Make using a seat belt for every ride a habit, starting when kids are young.
  • Be a safety role model by observing speed limits, putting phones away while driving and following the rules of the road.
  • Talk to teens and kids about ways to speak up if a driver of any age isn’t driving safely.

 

Strategy CH-4.4

Assure widespread implementation of injury prevention strategies through collaborative partnerships of community coalitions to distribute health and safety information to children and parents.

 

• Participate with Safe Kids Coalitions to support Walk This Way school pedestrian programs, bicycle rodeos, and Bike to School Days for elementary and middle school children, providing education on safe pedestrian and bike travel for children, parents, and other adult community members.

 

• Support child passenger safety check-up events throughout the state through local Safe Kids Coalitions and Washington Traffic Safety’s Child Passenger Safety program.

 

• Facilitate events that promote safety device use (i.e., life jackets, window stops/guards, helmets, car seats) and provide access to those in need.

 

• Maintain life jacket loaner programs throughout the state in partnership with Drowning Prevention Network and Safe Kids.

 

Status to Date on Objective CH-4

The interagency Active Living committee met in April 2018 to discuss Complete Streets and Safe Routes to School, and how Safe Kids Coalitions are partnering with local schools and city governments to help support these programs and provide safety information for student pedestrians. Partners of this committee include the Office of Superintendent of Public Instruction; Department of Transportation; Washington Traffic Safety Commission; Safe Kids Washington; the Women, Infants and Children Nutrition Program; the Healthy Eating Active Living program; and the Recreation and Conservation Office.

 

Safe Kids Coalitions have been provided with a safe school routes interactive toolkit to share with local schools and communities, and can provide technical assistance in using the toolkit to identify high risk areas for students getting to and from school. The toolkits additionally provide evidence-informed interventions to address identified issues.

 

The Pedestrian Safety Advisory Council met monthly and submitted its annual report to the Governor’s Office in December.

 

Safe Kids Coalitions checked 996 child safety seats and gave out 268 safety seats to families in need through the Buckle Up program (this does not include seat checks conducted and seats given out through other private donor programs that are not reported in the Buckle Up campaign). Certification classes for seat technicians were held quarterly at different sites across the state in partnership with the Washington Traffic Safety Commission’s Child Passenger Safety program.

 

Safe Kids Coalitions were offered $750 mini grants to hold a Teens in Cars program in partnership with their school and community. Wenatchee Public Schools participated in this program.

 

Thirteen local Safe Kids Coalitions provided information and resources to local community members through community events, school programs and child safety seat check events. Each coalition holds at least one community event, typically in the spring, in partnership with local hospitals, first responders and other non-profit organizations providing health and social services in that community. Topics covered included child passenger safety, water safety, fire safety, medication safety, sleep safety, falls prevention, bicycle and wheeled sport safety, sports injury prevention, pedestrian safety and awareness and prevention of child heatstroke in cars. The focus area for each coalition varies depending on the leading causes of child injury and death in their county or region.

 

Safe Kids Coalitions maintain 51 life jacket loaner boards across the state. Currently Thurston, Clark, and Benton-Franklin counties are working to add new loaner boards in public areas.

 

Objective CH-5

By September 30, 2020, work to achieve healthy weight across the life span.

 

Strategies CH-5.1 and 5.3

Help increase access to referral and state nutrition and hunger assistance programs for families and children.

 

Collaborate with Healthiest Next Generation.

 

To minimize duplication, activities that support these strategies and our state performance measure for healthy weight are detailed in the Adolescent Health Application Year Plan, under Objective AH-6.

 

Strategy CH-5.2

Encourage and support breastfeeding to help children maintain a healthy weight throughout their lives.

 

We will continue to promote the Breastfeeding Friendly Washington initiative described in the Perinatal/Infant Health Annual Report, and our breastfeeding support and awareness work on Objective PI-1, described in the Perinatal/Infant Health Application Year Plan.