Crosscutting/Life Course Action Plan (October 1, 2020-September 30, 2021)

Division of Oral Health: The Division of Oral Health (DOH) will impact each population domain in 2020 and 2021. For example, the oral health needs of pregnant women and infants across the whole state will continue to be addressed internally and externally by leveraging existing partnerships. The DOH will continue to support and expand intra-departmental collaborations with WIC and CYSHCN, the Bureau of Chronic Disease and Injury Prevention (CDIP), and the Bureau of Population Health Data Analytics and Informatics (PHDAI). 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 an annual basis for the next 5 years. These trainings will also continue to be assessed for their effectiveness through an online survey. This survey will be used to measure changes in knowledge and beliefs and also to gather feedback on how the training can be improved to better support home visitation staff in providing oral health education, preventive messaging and resources. Provider trainings will also continue through a partnership with the SC Primary Health Care Association. By increasing oral health knowledge and provider confidence in addressing the oral health needs of pregnant women and infants, the health of women, infants, children, and high-risk populations will continue to be positively impacted and improved.

DHEC and RFA will continue to collaborate with CDC to facilitate an enhanced data collection tool for the PHDPP dental sealant providers to include measures of sealant effectiveness compatible with CDC’s SEALS. Due to contractual conflicts, the sealant effectiveness was not completed for this school year. A contract is now in place to resume the enhanced data analysis, including sealant effectiveness, to assist the CDC with their SEALS analysis. During Year 1, the Prevention Coordinator will conduct an assessment of the dental providers that currently operate under Mobile Dental Program permits issued by the SC Department of Labor, Licensing and Regulation. This information will be included in the Dental Sealant Needs Assessment, which will also include data from a repeat of the SC School Nurse Survey, and the 2017-2018 Statewide Oral Health Needs Assessment to determine the burden of dental disease and presence of dental sealants among of SC’s K-5 and 3rd Grade children. A more complete dataset will assist DHEC and the PHDPP Leadership Team in evaluation of the impact of school-based dental sealant programs on the oral health of school-aged children in SC, including underserved children who are eligible for the federal Free and Reduced Lunch Program. This dataset will be enhanced by additional data sources such as the Annual State Synopsis, the CDC Annual State Progress Report, the National Center for Education Statistics (NCES), and SEALS.

The POWER Pee Dee initiative will continue and expand its reach to support the network of school nurses, community advocates, and dentists dedicated to addressing the oral health needs of school aged children in the Pee Dee. School nurses will continue to be trained in basic screening surveys and telehealth skills. They will also receive resources to support their efforts to address the oral health needs of school age children. This initiative will also work with Community Health Educators and Early Head Start/Head Start program staff to reach parents with effective preventive messaging with a focus on sustained behavior change within the home. In addition, the DOH will conduct a Head Start Oral Health Screening survey in 2021. These screenings will be conducted by healthcare professionals including: dentists, hygienists and nurses. These screeners will complete a certified training coordinated by the DOH. The findings of the Head Start Oral Health Screening survey will be utilized to evaluate the State’s preventive oral health programs for young children, determine the need for additional dental programs and describe the oral health status of South Carolina’s children that are enrolled in Head Start Programs.

DOH will expand initiatives with WIC, CHSCN, DHEC regional office MCH programs, and the Bureau of CDIP staff. The DOH will continue to collaborate with outside partners through the SC Oral Health Coalition to address oral health issues for early childhood, school-aged children, adolescents, pregnant women and vulnerable adults including those with diabetes. The DOH will continue its initiative with Camp Burnt Gin by training camp staff and providing resources and tools to promote positive oral health for individuals with special needs. Staff will also continue outreach and education activities on preventive oral health for children with special needs by participating in events sponsored by EdVenture, Family Connection and other community-based outreach organizations.

The partnership with the SC Dental Association and the Columbia Marionette Theater will continue the puppet show tour in 2020-2021 with a goal to increase the number reached to 11,500 students with an increased focus on reaching vulnerable populations identified through the Oral Health Needs Assessment county level results. The DOH will also continue to provide DHEC approved communication and outreach activities designed to improve oral health outcomes across the lifespan, cultures, and socio-economic statuses. Internal and external partnerships will expand opportunities to address oral health for women, infants, children, adolescents, young adults, and vulnerable adults including those with pre-diabetes/diabetes.

MCH Epidemiology: The MCH Epidemiology will continue to support the MCH Bureau with data and epidemiological support, utilizing various data sources to inform and evaluate programs and policy. The MCH Epidemiology team will also be gaining access to the Pregnancy Risk Assessment Monitoring System data and will work collaboratively with the Division of Surveillance in the PHDAI Bureau to prepare and analysis plan and conduct analyses, noting the many indicators that can help inform on Title V activities and strategies.  The team will continue to prepare and present maternal and infant health indicators at County-level Data Walks to help inform community partners as they select their top public health priorities and develop their Health Improvement Plans. The MCH Epidemiology team will also continue to build data capacity by carrying out the activities and meeting the goals of the SSDI grant.

Health Equity: As many services return to normal business post COVID-19 restriction, the bureau’s racial equity training will be rescheduled for late summer to early fall 2020. This Racial Equity Institute Phase 1 training will help develop the agency’s capacity of better understanding racism in its institutional and structural forms. With shared language and a clearer understanding of how institutions and systems are producing unjust and inequitable outcomes, the agency should be better positioned to support a culture of equity across programs and deputy areas.

The Division of Collaborative Health Improvement plans to continue its efforts to support health equity by providing technical assistance to community partners that are working to implement the goals and strategies outlined in the state's first ever health equity plan, "Collaborative Strategies for Advancing Health and Racial Equity In South Carolina." Internal DHEC efforts will consist of strengthening our Core Advisory Committee's work on health equity through policy and training efforts. These objectives will support DHEC's core values and support the work being done to bring awareness to the impact of health inequities on the families that make up our community.

Immunization Division: The Immunization Division will continue to collaborate with the MCH Bureau and partners, such as the BOI, to provide general direction and supervision of vaccination, screening, and immunization in SC. The Immunization Division will continue to administer the Federal Vaccines for Children program in SC to provide vaccines for eligible children 18 and under.

The SC Adolescent Immunization Task Force will continue to work with statewide stakeholders to improve adolescent immunization rates. The immunization division is also collaborating with a statewide DHEC work-group that is focusing on local health departments ability to increase HPV coverage levels. The division plans to implement the new Immunization Information System (IIS) in fall 2020.

STD/HIV:

Perinatal HIV Exposure Reporting for the Division of Surveillance, Assessment, and Evaluation—Throughout the October 1, 2020 to September 30, 2021 year, the Perinatal HIV Surveillance Coordinator will continue to meet with regional MCH Program Managers to coordinate efforts to improve health care services and follow up for women living with HIV and children perinatally-exposed to HIV and syphilis.

Pediatric Services in the Division of HIV/STD/Viral Hepatitis—The Data to Care Pediatric Services Coordinator will continue to utilize surveillance data to identify not in care (NIC) clients aged 2-24 and link them or re-engage them back into HIV medical care.

During the reporting year of October 1, 2020 to September 30, 2021, the Data to Care Pediatric Services Coordinator along with the Perinatal HIV Surveillance Coordinator will continue to conduct Case Review Team (CRT) meetings and Community Action Team (CAT) meetings. The program expects to hold at least two, no more than three CRT meetings during this period. Each meeting reviews three to five cases. Approximately two CAT meetings will also be held during this time. The program areas will meet as needed with the staff from the MCH program to coordinate services and improve upon existing prevention systems for women, infants, and families around the state.

The Data to Care Pediatric Services Coordinator along with the Perinatal HIV Surveillance Coordinator aim to present at the South Carolina STD/HIV/Viral Hepatitis Conference in October 2020, if the abstract is accepted. The presentation will be primarily focused on the FIMR/HIV program.

Ending the Epidemic—In the future, regular Ending the Epidemic Statewide Workgroup meetings will be held quarterly. Additionally, subcommittees will meet regularly via conference calls, online meetings, and/or in-person to discuss findings, issues and to reiteratively provide and receive community participatory feedback.

South Carolina intends to significantly reduce new HIV infections from an average of 761 a year to less than 350 per year, increase rapid HIV linkages to care, increase medication adherence, increase retention in care, decrease the number of people not receiving HIV medical care from 5,968 to less than 2,000 and increase viral load suppression from 57% to 80% across the state for clients who are consistently engaged in HIV medical care. These data will result from the use of evidence-based interventions and the establishment of a Statewide Rapid Continuum of Care Program, enhancing rapid linkage, reengagement and treatment collaborative efforts between DHEC, Ryan White Part B providers, Community Based Organizations, Correctional Institutions, and Emergency and Pharmacy Departments.

South Carolina has applied to receive additional funding from DHHS to further support the Ending the Epidemic initiative to build on the current activities to strategically advance HIV prevention efforts. Expected short-term and intermediate outcomes within the next five years include measurements around diagnosis, treatment, prevention and response.

Division of Injury and Substance Abuse Prevention (DISAP): DISAP was officially designated the Safe Kids (SK) South Carolina Lead Organization on 6/1/20. An advisory board to guide the SK State Program will be developed, and DISAP will work with the SK Advisory Board and local SK organizations in the development of a strategic plan around preventing childhood injuries. Sub committees will be formed based on need.

The DHEC Child Passenger Safety (CPS) Technician instructors will hold 12 courses throughout the State and will assist partners as needed. DISAP plans to increase the number of CPS technician proxies in the State. Technician proxies can assist technicians in their recertification requirements. Work is planned to develop a stipend program to incentivize class participation by other CPS Technician Instructors in the State.
 

DISAP will participate in the SC Violent Death Reporting System’s (VDRS’s) quarterly meetings and use information obtained from meetings for programmatic planning to include suicide prevention initiatives. DISAP will work the SCVDRS Program and MCH’s Sexual Violence Services Program Coordinator in the development of messaging around four violence-related observances.

DISAP will continue activities related to prevention of opioid misuse and abuse by funding six cohorts of the Strengthening Families program. The Life Skills program will also be implemented in each cohort of parents and children. A health educator will work with schools and other state partners in the development of an opioid prevention toolkit.

Violence—Suicide and Homicide: The Sexual Violence Services Program Coordinator will continue to serve on the SCVDRS Advisory Council. The Sexual Violence Services Program Coordinator, Injury Division director, and SCVDRS will continue to collaborate on the communications plan to address topics crossing all our areas during the designated awareness day, week, or month by updating, or developing new, messages and content for multiple delivery methods. The SCVDRS Research and Planning Administrator will continue to provide South Carolina-specific youth suicide data to support the MCH led Adolescent and Young Adult-Behavioral Health Collaborative Improvement & Innovation Network (AYA-BH CoIIN) local and state-wide efforts. Funding for the CSLC-SC expired April 2020 and CSLC-SC activities will continue through AYA-BH CoIIN.

Tobacco Prevention and Cessation: Within DHEC’s Bureau of Chronic Disease and Injury Prevention, the Division of Tobacco Prevention and Control will continue working on activities to address related MCH Block Grant objectives. The Quitline’s pregnancy-focused tobacco treatment services will continue to be provided statewide, and the Baby and Me, Tobacco Free program will continue to be expanded in other areas of the state. The Quitline’s Prenatal Health Systems Change program plans to work extensively with prenatal care providers and provide training on the Brief Tobacco Intervention screening tool and updated referral protocols.