Child Health Action Plan (October 1, 2023-September 30, 2024)

Priority Need: Increase developmental screenings and referrals to early intervention for children  

DHEC’s Title V continues to strategize with partners to address developmental screening and follow-up more effectively across the state. As a strategy to increase developmental screening and referrals in SC, a gap analysis was performed.  This analysis was not only performed to be understand the landscape of screening efforts, but also to inform development of a screening registry and future educational efforts.  Results from a gap analysis performed by USC Core for Applied Research and Evaluation (CARE) team revealed that while developmental screening is happening in in abundance across the state, follow-up services and surveillance is lacking.  

The Child Well Being Coalition (CWBC) under the purview of Title V will be leading efforts to translates the findings of the gaps analysis from data to action, which includes convening a developmental screening task force.  One strategy specifically being explored by the CWBC leadership is the hosting of a developmental screening summit.   The summit will build on activities started several years ago and garner support for new activities going forward. The information garnered from the gap analysis will also be used to plan and execute a statewide developmental screening registry.  

Other Title V efforts to address developmental screenings and referrals include expanding SC DHEC partnership with Help Me Grow SC and PASOs.  SC DHEC’s Title V program will be initiating a contract with Help Me Grow to increase their care coordinators that provide early intervention follow-up and resources. Help Me Grow will furthermore utilize their Network Partner Program to promote and connect families to developmental screenings. Each of their Network partners have created a format for connecting families to screenings as well as meet the unique needs and challenges within their local communities. Expanding their care coordinator capacity will also allow Help Me Grow to expand their current 28 screening partnerships with local early care and education centers, pediatric offices and our state’s infant and early childhood mental health consultation network and intend to keep growing our screening partnerships. 

Help Me Grow will continue to serve as the CDC’s Learn The Signs Act Early Ambassador for SC which focuses on increasing developmental monitoring along with early literacy. Title V will remain a partner among others throughout the state.

Similarly, SC DHEC’s Title V program will be expanding its partnership with PASOs.  Its current contract supports the implementation of Connections for Child Development (CCD) program in the Midlands region of the state, providing developmental screening to high need communities in the area.  The expansion will allow PASOs to move into new communities using its Community Health Workers (CHWs) model.  During a one-on-one educational session, the PASOs CHW will screen parents of young children for knowledge and will assist them in screening the development of the children by using the ASQ-3 and ASQ SE-2 screening tools. The partnership with PASOs supports Title V performance measure NPM 6: percent of children, ages 10-71 months, receiving a development screening using a parent-completed screening tool and will continue to provide the education, early intervention referrals, and follow-up needed among families served by PASOs.

Moreover, for the first time, the Title V program will invest in the training of CHWs across the state by supporting stipends to add twenty-five additional CHWs annually who will receive MCH competency training as well.  Competency training will include topics on safe sleep as well as maternal mortality prevention and awareness.  This will support PASOs and impact SC DHEC’s Title V performance measure ESM 1.2: (increasing) counties identified as having low utilization of preventive health visits among women that are served by a Community Health Worker.  

While great emphasis is being place on developmental screening, the First Sound Hearing program will continue its statewide implementation with external partners to develop a video of SC families stressing the importance of follow-up to be used by hospitals with parents whose infants fail the newborn hearing screening.  The program will continue to work with BabyNet and Beginnings SC (family support) to improve referral processes from First Sound to their programs.

Priority Need: Improve coordinated and comprehensive health promotion efforts among the child and adolescent populations.

NPM 8.1: Percent of children, ages 6 through 11, who are physically active at least 60 minutes per day 

DHEC’s Division of Nutrition, Physical Activity, and Obesity Prevention will continue to partner with Title V and work with the South Carolina Department of Education, the Alliance for a Healthier Generation, the MUSC Boeing Center for Children’s Wellness, the South Carolina Alliance for Health, Physical Education, Recreation, and Dance (SCAHPERD), BlueCross® BlueShield® of South Carolina Foundation, the University of South Carolina, Healthy Palmetto and school districts across the state to increase physical activity rates of children in SC public schools before, during, and after school hours. SC FitnessGram will continue to collect and improve the use of students’ health-related fitness data. Tailored communication will be disseminated to school, community, and state stakeholders to raise awareness of student fitness and to use the data as a common measurement in decision-making and goal setting. Statewide and regional professional development opportunities will be provided to school and other stakeholders on how to use the data to improve practices and policies, such as local wellness policies and open community use of school recreational areas policies.

In addition, the SC FitnessGram Influencer School Districts will continue to be engaged for the intervention to increase opportunities for physical activity by implementing evidence-based best practices leading to improved cardiorespiratory fitness of students. Current and new partners will be engaged to align school health efforts with statewide and local actions to prioritize physical activity in schools and improve student health.

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

The Division of Oral Health (DOH) will continue to improve coordination between oral health services and well child visits in 2023 and 2024. DHEC will continue to strengthen its collaboration with the Department of Health and Human Services and the SC Oral Health Coalition to collect data about the number of providers that have completed the Improving Health through Oral Health Integration training. Additionally, Medicaid data will be collected and shared annually regarding the number of fluoride varnish applications that have been completed for children in the medical and dental setting, including the QTIP practices. The SCDHHS will continue to review and support dental services for children with a focus on reducing and preventing early childhood caries with preventative interventions including fluoride varnish and silver diamine fluoride.

The DOH will expand its statewide reach by utilizing and training regional Community Health Workers through a partnership with the Center for Community Health Alignment housed at the Arnold School of Public Health at the University of South Carolina to provide oral health education, deliver preventive messages and disseminate resources for pregnant women, infants, and children at the community level. In-person provider trainings that support medical dental integration models will also continue through partnerships with the SC Primary Health Care Association and the SC Dental Association. Additionally, the DOH will continue to train Postpartum Newborn Home Visitation and Nurse Family Partnership staff members in oral health anticipatory guidance and preventive message delivery on a bi-annual basis.

A comprehensive report detailing the statewide oral health needs assessment results will be compiled and disseminated by February 2024 to raise awareness about the status of adolescent oral health at the county and state level. The DOH staff will also continue to connect with school nurses through the AHEC online training that encourages the utilization of a basic screening survey to assess a student’s oral health status and support school-based efforts to reach families with preventive oral health messaging. DHHS staff in collaboration with its dental vendor will provide trainings to school-based programs on an annual basis as it relates to Medicaid policies and processes.