NPM 6: Percent of children, ages 9-71 months, receiving a developmen tal screening using a parentcompleted. screening tool

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Federally Available Data 34.3% (2011/2012 National Survey of Children s Health (NSCH)-revised) 39.3% (NSCH) NPM 6: Percent of children, ages 9-71 months, receiving a developmen tal screening using a parentcompleted screening tool Promote parent and caregiver awareness of developmental screening Work with provider champions to promote developmental screenings within clinical settings to associations of health professionals Iowa s 1st Five program engages healthcare providers in supporting the use of developmental surveillance and screening tools. A partnership between providers and 1st Five staff is established for care coordination, referral, and follow up services. 1st Five will identify parent/caregiver champions that have utilized 1st Five services to provide strategies on reaching families to promote the importance and recognition of developmental screening. Title V Child Health agencies will reinforce the importance of developmental screening through the informing process for newly enrolled Medicaid families. Bureau of Family Health (BFH) will provide Title V Child Health agencies with needed information and resources for this process. BFH staff will identify champions in professional organizations to conduct developmental screening outreach to health professional staff. Identified organizations may include, but are not limited to, the following: American Academy of Pediatrics Iowa Chapter, American Academy of Family Physicians Iowa Chapter, American Academy of Physician Assistants Iowa Chapter, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Iowa Workgroup, and the Iowa Association of Nurse Practitioners. Outreach may include, but is not limited to, screening information displayed in newsletters, trainings, and guide books. Local 1st Five site coordinators (currently engaged with 49 Iowa counties) will work on outreach to front desk office staff. Outreach may include, but is not limited to, screening information displayed in newsletters, trainings, and guide books. Incentives promoting the 1st Five logo may be provided as well. Local 1st Five site coordinators will work with 1st Five Medical Consultants (one family practice physician and one pediatrician) on providing developmental screening trainings to office staff and engaged healthcare partners.

Support retaining reimbursement for developmental screening among newly established Medicaid managed care organizations Maintain requirements for the provision of developmental screening in Title V contract agencies Promote collaboration between Title V, early care and education, and home visiting providers on the provision of developmental screens Local 1st Five sites will engage at least one primary care practice in each county of the service delivery area Local 1st Five sites will promote increasing developmental screening in engaged 1st Five practices Title V Child Health contract agencies are approved Medicaid Screening Centers. Due to the strong working relationship between Title V MCH and Iowa Medicaid Enterprise (IME), BFH staff will work with Medicaid s liaison to continue payable developmental screening services within the new Medicaid MCO payment structure. Billing and payment methodologies among the contracted Medicaid MCOs will be identified and shared with local Child Health Screening Centers. In the Title V Child Health application process and resulting contract, the Bureau of Family Health will continue the requirement for provision of developmental screening services, including maintaining the working relationship with the Area Education Agencies (AEAs) on developmental screening and developmental monitoring under Early ACCESS. Through the Title V Child Health application process and resulting contracts, the Bureau of Family Health will both continue, and enhance collaboration with early care and education providers to encourage developmental screening. Through the Maternal, Infant, and Child Health Home Visiting contract, the Bureau of Family Health will continue to include developmental testing as a REDCap data requirement, and a performance measure for all MIECHV funded contractors. Contracts with local 1st Five sites will include a performance measure to incentivize engagement of primary care practices in each county of the service delivery area (49 total Iowa counties). Contracts with local 1st Five sites will include a performance measure to incentivize increasing developmental screening within engaged 1st Five practices by 5%.

Federally Available Data 29.1% (2011 Youth Risk Behavioral Surveillance Survey) 14.8% (2011/2012 NSCH) 14% (NSCH) NPM 9: Percent of adolescents, ages 12-17 years, who are bullied Evidence-based program implementation Relationship building and coordination at the state level Evidence-based curriculum models related to bullying, mental health, and positive youth development will be identified for implementation with youth, such as Kognito, Olweus, SOS Signs of Suicide, and the Teen Outreach Program. Implementation of this program will be similar to other youth programs where a local agency would provide programming to youth either in a school or community-based setting. Success of this strategy would be measured by the number of youth participating in programming, along with those who attained at least 75% completion of lessons. Programs will also be identified for staff and other adults who interact with youth regarding warning signs and how to address bullying and mental health. With a legislative focus on bullying prevention, efforts will center around relationship building with the Department of Education for statewide coordination, as they are the primary gatekeeper in Iowa. The Adolescent Health team with also partner closely with intra-agency staff working on bullying prevention and mental health to coordinate programming and outreach.

NPM 10: Percent of adolescents with a preventive services visit in the last year Federally Available Data 84.5% (2011 NSCH) Gather and synthesize both qualitative and quantitative data Develop and disseminate patient education and outreach materials Provide resources and additional training for providers 86.5% (NSCH) The adolescent health team will focus on discovering, identifying, and implementing evidence- informed strategies to increase adolescents access to preventive health care visits and to improve the quality of these visits. Needs will be identified through qualitative and quantitative data collection, such as indepth interviews with providers, clinic staff, youth, and parents, as well as analyzing Medicaid claims data. In order to create awareness, the team will develop and disseminate patient education and outreach materials for adolescents, parents, and professionals. The team will work with providers to identify what resources and trainings they need to provide a quality preventive health care visit in which both the Provider and the adolescent feel comfortable. Establishing this relationship early on will increase subsequent preventive visits and prepare adolescents for becoming a health care consumer.

NPM 13: A) Percent of women who had a dental visit during pregnancy and B) Percent of infants and children, ages 1-6 years, who had a preventive dental visit in the last year Federally Available Data A) Not Available (Pregnancy Risk Assessment Monitoring System (PRAMS)) B) 82.1% (2011/2012 NSCH-revised) Inform, educate, and disseminate scientific evidence about importance of prenatal dental screening and treatment Provide targeted outreach for medicaldental integration Expand preventive school-based sealant programs A) 60% (PRAMS) Note: PRAMS data is unavailable. Performance objective was determined using 2013 Barriers to Prenatal Care data (55.0% of women reported going to the dentist). B) 87% (NSCH) Staff will work to Inform, educate, and disseminate scientific evidence about importance of prenatal dental screening and treatment. The Oral Health Center (OHC) will investigate best practices for medical-dental integration, particularly targeting nurse practitioners, physician assistants, and midwives. Staff will review available state and local data to direct efforts in specific areas with low numbers of pregnant women accessing dental services. OHC staff will participate on interagency and other organizational collaborations to address oral health issues for women of childbearing age, infants, children, and adolescents. Medical-dental integration efforts will also focus on the importance of early preventive services for infants/children and use of fluoride varnish and fluoridated water. OHC staff will work with I-Smile coordinators to determine local activities to enhance efforts (e.g. collaboration with 1st Five coordinators). Data will be monitored and reviewed to assist with program development. OHC staff will look for trends regarding lack of dental insurance, Medicaid enrollment, Dental Wellness Plan (Medicaid expansion) use and needs, and School-based Sealant Program (SBSP)/school dental screening results. OHC will continue oral health promotion activities, identifying ways to inform the public and families as well as health care providers about the importance of oral health throughout the life course. Health promotion will include maintaining a Facebook page targeting new moms, I-Smile displays at conferences, newsletter articles, radio spots, and presentations. Local health promotion will include participation in community events, partnering with other organizations

Assure statewide care coordination network that includes dental home referral, tracking, and follow-up for children for messaging, and providing educational materials to families. Population-based preventive dental services will be maintained through local contractors to include children ages 0-2 in public health settings and for children ages 6-14 in SBSP. SBSP will target schools with 40% or greater free/reduced lunch program participation to reach underserved children. Contractors will maintain referral and care coordination services through I-Smile to assure regular dental visits and follow-up treatment is provided.