Priority Need: Developmental Delays

NPM-6.0: Percent of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year

Annual Plan FY23:

The Early Childhood Utah (ECU) program’s mission statement is: To promote and support a strong foundation of health and wellbeing such that all Utah children enter school ready to learn and go on to lead healthy, happy and productive lives. The ECU program accomplishes this mission by:

• Helping families and early childhood programs understand developmental milestones and how to use the Ages and Stages Questionnaires®; third edition (ASQ®;-3) and the Ages and Stages Questionnaires®; Social-Emotional, second edition (ASQ®;SE-2) to promote optimal child development.
• Developing data infrastructure and data systems in order to effectively collect, analyze, and use data to drive smart and effective policy, funding, and programmatic decisions.
• Coordinating and facilitating the work of the Early Childhood Utah Advisory Council, which brings statewide early childhood partners together to improve system-wide collaboration and coordination to ensure young children enter school healthy and ready to learn.

The ECU program intends to achieve our objectives by improving collaboration and coordination with community-based early childhood service providers in order to develop a seamless continuum of services for families and children from prenatal to three in Utah. ECU will further develop and unite the early childhood community through the Early Childhood Utah Advisory Council (ECU Advisory) and the Governor’s Commission on Early Childhood (Commission).

ECU will engage in the continued development and/or improvement of the many systems of care that families and children come into contact with. These efforts will include the promotion of universal developmental screening with an emphasis on the incorporation of ASQ-3 and ASQ: SE-2 with state and community-based health systems and primary care providers. Finally, ECU will promote the availability and use of early childhood data to guide the decision-making processes.

The ECU program will collaborate and coordinate closely with the child, youth, and family division/offices/programs in the new Department of Health and Human Services. Collectively, we will aim to advance a common vision of promoting universal developmental screening. Our programs will strive to reach objectives related to NPM-6, which tracks and aims to increase the percentages of children, ages 9 months through 36 months, who receive a parent-completed developmental screen. Directly related to this objective, over the next three years, ECU will actively participate in a new Statewide Coordinated Developmental Screening Project (ASQ project). This project has been vetted and endorsed by the Early Childhood Utah Advisory Council and the Governor’s Early Childhood Commission.

The new ASQ project involves multiple state and community-based agencies along with medical providers and is targeted to receive financial support through the American Rescue Plan Act (ARPA). The new ASQ project calls for the establishment of multiple Brookes ASQ Online Enterprise Accounts hosted by various state agencies, community-based organizations, and large scale medical networks (hospitals).

ECU will assist LHDs with reaching tiered ASQ goals and objectives. The ECU program will work closely with the LHDs to help them achieve their NPM-6 related goals and objectives, listed here:

Tier 1 - Goal: Increase ASQ Online Training and Promotion

• Promote ASQ Online training and the use of ASQ Online screening with community-based organizations.
• Attend ECU Advisory Council meetings.

Tier 2 - Goal: ASQ Trained and Ready to Use ASQ

• Conduct ASQ Online screens with clients through the WIC, Home Visiting, Early Intervention and/or other LHD programs.

Tier 3 - Goal: Advanced ASQ Utilization

• Establish and implement a schedule to complete screens at 6, 12, 18, and 25 months; along with 3, 4, and 5 years of age.
• Integrate billing Medicaid into the service delivery system, i.e. determine if codes 96110 and 96127 can be utilized by the LHD to bill for developmental screens.

ECU will provide assistance by participating in regularly scheduled collaborative meetings, by providing ASQ training and individualized, supportive technical assistance. ECU will continue to distribute emails with information regarding the importance of developmental screening along with training information offered through Brookes Publishing. ECU will share the quarterly ASQ training calendar with the LHDs and encourage them to participate, especially new providers/caregivers. ECU will continue to invite LHD staff to participate in the ECU Advisory Council and/or to engage in any of the five ECU Advisory Council subcommittees. The ECU program will track and share reports regarding each LHDs’ goals, objectives, and screening summary efforts. ECU will provide incentives to programs that increase their screening rates throughout FY23.

ECU will expand ASQ Online enrollment opportunities to new pediatric and early childhood service providers. Throughout FY23, the ECU program will engage with Department of Health and Human Services (DHHS) programs that are either new to the ASQ screening tool or are familiar with ASQ but are not trained/enrolled in the DHHS ASQ Online Enterprise Account. ECU will also continue collaborative work with programs co-located in the Division of Family Health such as WIC, the Home Visiting Services and Supports program, the Maternal and Infant Health program, the Integrated Services program, and the IDEA Part C Early Intervention program (Baby Watch).

Additionally, ECU will continue its outreach and coordination with programs managed by the Division of Child and Family Services, programs such as Child Abuse and Neglect Preventative Services and Foster Care. Through these established and new relationships, ECU will identify new caregivers and programs that are interested in receiving training on the ASQ-3 and ASQ: SE-2. Ideally, training will lead to the enrollment and participation of new programs in the DHHS ASQ Online Account.

With support from the HRSA-MCH based Early Childhood Comprehensive Systems grant (ECCS), ECU covers the current expenses associated with ASQ training, ASQ onboarding and ongoing costs per screen for programs participating in the DHHS Enterprise Account. Also with support from the ECCS grant, in FY23, ECU will provide a small monetary incentive to select programs that accelerate/broaden their developmental screening practices. In addition to efforts around promoting the healthy development of young children, ECU will also coordinate and align training activities and resources with the Maternal and Infant Health program’s Maternal Mental Health Screening initiative. Both programs will share messaging about the importance of screening expectant and new mothers along with screening their newborn babies.

Finally, the ECU program will continue to offer technical assistance to other states that are in the process of developing an ECIDS and/or a statewide developmental screening program. Addressing disparities and inequities in the FAD, ECU will continue to utilize ECIDS, ASQ, and other reports, such as the Prenatal-to-3 Policy Impact Center’s Utah Policy Roadmap and focused community-based collaborations to ensure developmental screening opportunities are universal and that communities discovered to be under-resourced are targeted for intervention. ECU will also utilize the Office of Health Disparity’s health equity report, the Utah Health Improvement Index along with the Utah Data Research Center’s Area Deprivation, and the P20 Pipeline research as resources to identify communities that are struggling with helping their children reach developmental milestones and thus, not arriving at school healthy and ready to learn. ECU will also participate in and facilitate the opportunity for additional ECU Advisory Committee Members to participate in formal equity and disparity training developed and endorsed by the department.

Proposed Activities:

• Engaging in quarterly LHD director meetings
• Distributing regular emails with training information
• Provide ASQ onboarding and ongoing technical assistance
• Offer quarterly ASQ training opportunities
• Invite LHD directors to attend ECU Advisory Council and/or ECU Subcommittee meetings quarterly
• Engage in bi-monthly meetings with DHHS partners and share screening information and resources throughout the Division of Family Health and the Division of Child and Family Services
• Share screening information and resources with the Early Childhood Utah Advisory Council
• ECU will share maternal mental health screening information with the Early Childhood Advisory Council to gain additional support and to identify new partners
• Orchestrate the activities of the Early Childhood Utah Advisory Council, engage in subcommittee meetings and work, and guide the development of proposals made to the Governor's Early Childhood Commission
• Develop and deploy new ECIDS reports, modernize the security and functionality of ECIDS, track and improve ECIDS utilization, and offer technical assistance to other states

Priority Need: Oral Health

NPM-13.2: Percent of children, ages 1 through 17, who had a preventive dental visit in the past year

Annual Plan FY23:

In FY23, the Oral Health Program (OHP) plans to continue to collaborate with Medicaid to increase the number of children who receive preventive dental visits and receive needed dental treatments. The Oral Health Program will continue to work with the dental group within Utah Medicaid.

The Oral Health Educator (OHE) will work with the Utah Dental Association (UDA) to encourage participation in programs for underserved children in Utah including but not limited to the Give Kids A Smile program operated by the UDA and partners. The OHE will work with the UDA to continue to encourage dentists to see children with Utah Medicaid dental benefits. Efforts will also be continued to encourage first dental visits by age one as recommended by the American Academy of Pediatrics and the American Academy of Pediatric Dentistry.

The OHE and designated interns will continue to provide oral health education and dental referrals to middle and high school students in select schools within Canyons, Granite, Weber, and Tooele School Districts and educational materials to the Utah School for the Deaf and the Blind. The OHE and future interns will also be available for virtual presentations in other districts. In the 2021-2022 school year the OHE and interns were able to return to in-person presentations. Virtual presentations and recordings are available to schools that request them. The OHE continues to collaborate with local dental hygiene programs to provide education resource booths at back-to-school nights in middle schools.

The OHE will continue to work with and promote teledentistry to increase access to care for school-based programs. The OHP will continue inter-professional collaborations and outreach to vulnerable populations with the University of Utah’s PA Program. The OHE, in collaboration with Utah’s dental hygiene liaison, will provide training to PA students on the AAP’s Oral Health Risk Assessment and applying fluoride varnish. The OHP and PA program will screen migrant farm children through the migrant Head Start programs and parents through the migrant farm workers screening days.

Proposed Activities:

• The OHE will continue to work with and promote teledentistry to increase access to care for school-based programs.
• The OHP will continue to provide oral health articles bi-annually for the American Academy of Pediatrics Utah Chapter newsletter. As well as bi-annual newsletters for the WIC Wire and Flash.
• The OHP will continue to use the updated 12 Oral Health Messages modules and magnets and share with WICs, Head Start, and Home Visiting etc. Maternal & Infant oral health messages are included in this.
• In the interim, the OHE will work with the Utah Dental Association to encourage participation in programs for underserved children in Utah.
• The OHE in collaboration with OHP Interns will continue to provide middle school students with the adolescent oral health campaign, educational intervention and local dental resources. This will be available in person and virtually.
• The OHP will continue inter-professional collaborations and outreach to vulnerable populations with the University of Utah's PA Program.
• The OHE will continue to work with the State Nurse Collaborator to create an oral health toolkit for all school RNs in Utah. Including information from the American Academy of Pediatrics on oral health risk assessment, trauma, and nutrition. Once this is finalized they will collaborate to disseminate the toolkit.

State Priority Area: Family Connectedness

SPM-2: Percent of family members who live in the household that ate a meal together 4 or more days per week

Annual Plan FY23:

During FY23, the Office of Maternal and Child Health (MCH) in collaboration with the Violence Injury Prevention (VIPP) and Healthy Environments Active Living (HEAL) program (formerly known as EPICC), will continue activities to support increased family meals. The activities planned for July 1, 2022 - June 30, 2023 include HEAL's promotion of family mealtime through “A Way to HEAL, Utah” podcast (https://podcasts.apple.com/us/podcast/a-way-to-heal-utah/id1497138073?ign-mpt=uo%3D4), the Governor's proclamation of September as Healthy Family Meals Month, communication tools for parents, such as conversation cards, Teen Speak and Families Talking Together classes, and partner training by VIPP staff.

Proposed Activities:

• Promote and distribute conversation cards to Utah families. "Conversation Cards" are a deck of cards with pre-printed questions or conversation starters for parents to utilize with their teens or preteens. The cards can be used to promote healthy, relationship-building conversation during family meals. The Conversation Card resource was developed in collaboration with the Missouri Department of Health & Senior Services.
• Promote and implement the Families Talking Together intervention with approximately 100 parents. This evidence-based program increases the ability of parents to communicate about sexual decision making, set boundaries, and engage more positively with their teen(s). Ultimately, increased conversation and stronger relationships with parents decreases the initiation of risky behaviors, such as sexual activity. Local partners are trained in the intervention and assist MCH in reaching parents more broadly in communities across the state.
• Offer at least one virtual Teen Speak class per month to approximately 120 parents and youth-serving professionals. This evidence-based program utilizes motivational interviewing principles to support parents and trusted adults in improving communication skills and strengthening youth-adult relationships. Data suggests that teens who can identify a strong relationship with at least one trusted adult are less likely to use drugs or alcohol, engage in sexual activity, or attempt suicide.
• Maintain relationships with partners, including Utah Foster Care, the Utah State Board of Education, LHDs, Local Education Authorities, home visitors, and other youth and family serving agencies in order to effectively promote and implement interventions, strategies, and resources.
• Work with Utah's governor to proclaim September 2022 as Healthy Meals Month.
• Produce and promote bi-monthly to weekly episodes of the A Way to HEAL, Utah podcast (https://podcasts.apple.com/us/podcast/a-way-to-heal-utah/id1497138073?ign-mpt=uo%3D4)