Current Work and Initiatives

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Adverse Childhood Experiences

The Washington State Essentials for Childhood Initiative supports safe, stable and nurturing relationships and environments.

The Pediatric Transforming Clinical Practice initiative (P-TCPi) focuses on improved health outcomes and increased access to behavioral health services for children.

Washington State Office of Public Instruction supports Compassionate Schools, focused on students whose academic performance is impacted by exposure to stress and trauma.

Many local and regional groups are implementing trauma-informed approaches to family and community health and well-being. The nature of the specific efforts vary but they share a common mission to prevent adverse childhood experiences and promote resilience. Information can be found through:


Leadership and local engagement

Washington State Diabetes Network, is a group of public, private, community, tribal and academic partner working together to address and prevent diabetes. To engage with regional coalitions, access webinars, and obtain updates check out the Washington State Diabetes Connection.

Report to the Legislature

The Washington State Legislature directed the Department of Health, Department of Social and Health Services, and Health Care Authority to submit an annual report to the Legislature in 2015. The second Diabetes Epidemic and Action Report was released in September 2017. The report includes updated data as well as agency action plans, recommended strategies and considerations for legislation.

Ongoing programs and initiatives: Multiple efforts support diabetes prevention and management. Several worth highlighting:

  • Population health initiatives to reduce obesity focus on nutrition, physical activity, screen time, and breastfeeding.
  • Community and state initiatives include:
  • Individual level education
  • Ensuring insurance coverage
  • Improving organizational supports
  • Built environment such as roads and grocery stores
  • Public policy
  • Many communities have coalitions to address obesity, nutrition, breastfeeding, and/or obesity prevention.
  • State agency partners work to include nutrition and physical activity in their policies, systems and environments; and to collaborate on projects that positively affect multiple outcomes such as active transportation, built environment and healthy food system.
  • The Women, Infants and Children Nutrition Program (WIC) at Department of Health provides education and vouchers for healthy food for pregnant women and children up to age 5.
  • The Healthy Eating Active Living Program (HEAL) at the Department of Health focuses on policy, systems and environmental changes to prevent obesity.
  • Breastfeeding Friendly Washington (BFWA) is an initiative encouraging hospitals to promote and support breastfeeding.
  • The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program includes direct education along with policy, systems and environmental changes to serves low income populations in Washington.
  • The Food Insecurity Nutrition Incentives Program has a Fruit and Vegetable Prescription Program where patients who are on the SNAP program receive Fruit and Vegetables Prescriptions, which work like coupons.
  • Healthiest Next Generation is a state-wide initiative to support the health of children through collaboration of public and private partners.

The WA State Interagency Opioid Response Plan is a comprehensive strategy developed by state agencies, local health departments, professional organizations and community groups. Goals include:

  • Prevent opioid misuse and abuse.
  • Identify and treat opioid use disorder.
  • Prevent deaths from overdose.
  • Use data to detect opioid misuse/abuse, monitor morbidity and mortality, and evaluate interventions.

The current version includes recommended actions and 2017 progress report.

Other statewide opioid initiatives include:


The Washington State Tobacco Prevention and Control Strategic plan focuses on four main goal areas, each with strategies and tactics:

  1. Reduce tobacco-related disparities.
  2. Prevent tobacco use among youth and young adults with emphasis on nicotine consumed through electronic cigarettes/vapor products.
  3. Leverage resources for promoting and supporting tobacco cessation.
  4. Eliminate exposure to secondhand smoke and electronic cigarette/vapor emissions.

The goal that relates most to short-term healthcare is promoting and supporting tobacco cessation.

With the advent of the federal Affordable Care Act, tobacco cessation services are to be covered with no out-of-pocket costs, but few health plans in Washington State follow these federal guidelines. Large and rural populations of the state have no reliable access to cessation services.

Encouraging and helping people who use tobacco quit is one of the quickest approaches to reducing tobacco-related disease, death and healthcare costs. Public health supports the efforts of the healthcare sector to consistently diagnose and treat tobacco use and dependence.

The Affordable Care Act recommends insurance cover individual, group and telephone-based cessation counseling and all 7 FDA-approved medications to help people quit using tobacco.

Access to free or nominal cost cessation counseling and medications is an important part of efforts to pass tobacco prevention and tobacco-free policies such as raising the minimum legal sales age, smoke-free multiunit housing, colleges, behavioral health, and workplace campuses. Cessation efforts also reduce youth initiation as children not exposed to tobacco are less likely to use tobacco products.

Well Child Visits

Performance Improvement Projects

Health Care Authority and Department of Health convened a Performance Improvement Plan (PIP) workgroup with the five managed care organizations (MCOs) contracted to provide medical insurance coverage to Apple Health (Medicaid) clients. The goal is to increase rates of well-child visits five percent by July 2019.

The PIP workgroup conducted focus groups and key informant interviews with parents throughout Washington to identify barriers that impede parent/caregiver ability to complete well-child visits. Preliminary data indicate that clinic hours, wait times, and perceived value are barriers. Many parents reported not understanding what providers were doing during the visit, especially if they had not had well-child exams when young. This preliminary information helped inform the Well-Child Visit Recommended Strategies.

Clinic Pilots

Clinic pilot projects were implemented in each of the five MCOs September 2017 through January 2018. The five participating clinics conducted assessments, modified procedures to better manage their patient population and promote well-child visits, and engaged in peer learning. Based on initial results the expectation is to bring it to scale in 2019. This page will be updated as plans for expansion move forward.

Pediatric Transforming Clinical Practice Initiative

Washington is one of two states that received funding from Centers for Medicare and Medicaid Services to work with providers to increase their ability to provide effective and efficient care for patients through the Pediatric Transforming Clinical Practices Initiative (P-TCPI).

Washington State is committed to increasing the rates of well-child visits, especially for the most vulnerable children. To achieve this, P-TCPI efforts focus on three main areas:

  • Patient engagement – includes providing incentives for well-child visits.
  • Provider education – includes tip sheets on Academy of Pediatrics recommendations.
  • Clinic management – includes webinars on correct billing for well-child visits.

Maternal Child Health

The Maternal Child Health Block Grant supports activities at the state and local levels on maternal and child health. These efforts include Universal Developmental Screening, adverse childhood experiences, and children and youth with special health care needs. You can find out about local activities through your local health jurisdiction.