How to use this page
Click on a heading to expand it and learn more about any topic.
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
The Washington State Diabetes Network is a group of public, private, community, tribal and academic partners working together to address and prevent diabetes. Network members and partners who also work with cardiovascular disease can serve on the Cardiovascular Disease and Diabetes Network Leadership Team. To engage with regional coalitions, access webinars, learn about serving on the Cardiovascular Disease and Diabetes Network Leadership Team, and obtain updates, visit 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. A third Diabetes Epidemic and Action Report is due December 2019. 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:
- Diabetes Prevention Program (DPP) for people with prediabetes or at high risk of developing type 2 diabetes, it is a year-long program that supports lifestyle changes to reverse prediabetes and help prevent or delay type 2 diabetes. In Washington, DPP is offered to members of the Public Employees Benefits Board Program at no cost, to several other employers, and is covered by Medicare. Find DPP classes available in your region or reach out to the Heart Disease, Stroke, and Diabetes Prevention Program to learn about how to offer one.
- Diabetes Self-Management Education and Support (DSMES) focuses on patients with diabetes, and provides one-on-one coaching to support diabetes self-care. In Washington, DSMES providers can seek Medicaid reimbursement and may receive national accreditation or recognition from the American Association of Diabetes Educators or the American Diabetes Association. All insurance programs in Washington that are regulated by the Office of the Insurance Commissioner are required to cover DSMES. For more information on referrals to or payment for DSMES, contact DOH’s Heart Disease, Stroke, and Diabetes Prevention Program.
- Healthy Eating/Active Living (HEAL) works on programs that help people eat healthy and be active where they live, work, and play.
- Healthiest Next Generation Initiative, focuses on collaborative solutions to improving the health of children.
- Community Health Worker Training provides free courses to community health workers, including a section on prediabetes and diabetes.
- Apple Health managed care contracts include incentives for diabetes performance measures for HbA1c control, blood pressure controlled for diabetes patients, and diabetes eye exam.
- Medicaid Health Homes provide care coordination and management to individuals with diabetes and one or more additional chronic conditions, including mental health conditions.
- Community Living Connections services include diabetes support groups, Meals on Wheels, nutrition counseling, and Enhanced Fitness.
- 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.
Efforts supporting the plan include:
- Medicaid Transformation projects through Accountable Communities of Health to address opioid misuse disorder in their regions.
- Recommendations from the Bree Collaborative established by the Washington State Legislature, including opioid use disorder treatment recommendations, opioid prescribing guidelines for dental practitioners, pain guidelines and prescribing metrics. Also see the Bree Collaborative’s Working Together to Impact the Opioid Epidemic.
- Provider access to patient prescription history through Washington State Prescription Monitoring Program.
- Grant-funded efforts to expand treatment, social support, and chronic pain management for opioid use disorder, including the state targeted response to opioid crisis grant and the Prescription Drug Overdose Prevention for States.
- Public awareness campaign through Department of Social and Health Services, including downloadable media tools, available
- at GetTheFactsRx.com.
The current version includes recommended actions and 2017 progress report.
Additional information and resources may be found on the Department of Health opioids web page.
Oral Health Connections: A three-year pilot in select counties to connect pregnant women and people with diabetes to ongoing dental care with integrated care coordination.
Access to Baby and Child Dentistry: A program that trains pediatricians in providing oral health assessments and preventive dental care for infants and young children; and provides guidance to dental providers in caring for babies and young children in the dental office setting.
School-based dental sealant programs, health care facilities and senior center dental care: State practice acts allow registered dental hygienists to provide preventive dental services outside the dental office--in school-based settings, in health care facilities, and in senior centers without a dentist present.
Community water fluoridation: The Department of Health supports community water fluoridation as safe, effective, and beneficial for all ages to reduce tooth decay. Approximately 56 percent of Washington residents on public water systems have access to optimally fluoridated drinking water.
New provider models: Washington State allows Dental Health Therapists, a new provider type, to provide dental care on tribal lands.
Rural Health Centers Dental Services pilot: The first Rural Health Center dental clinic in the state of Washington to address the needs of Medicaid patients and under and uninsured residents of rural Jefferson County. Co-located in the Sheridan Medical Office Building, which currently houses primary care and integrates with behavioral health. This model allows affordable dental services to be fully integrated into other aspects of health care.
Tele dentistry: Allows for patients in remote locations to be seen by a dentist in another location.
Reducing emergency department use for non-traumatic dental conditions: Swedish Community Specialty Clinic (SCSC) and Swedish Medical Center have developed a program for reducing emergency department use for dental pain. The attending physician will refer the dental patient for a priority early morning visit the next day at a nearby dental clinic. If the patient has complex surgical needs, an on-call dentist is consulted and can refer the patient to SCSC, which provides dental staffing and general dentistry residents to provide complex care.
The Washington State Tobacco Prevention and Control Strategic Plan focuses on four main goal areas, each with strategies and tactics:
- Reduce tobacco-related disparities.
- Prevent tobacco use among youth and young adults with emphasis on nicotine consumed through electronic cigarettes/vapor products.
- Leverage resources for promoting and supporting tobacco cessation.
- Eliminate exposure to secondhand smoke and electronic cigarette/vapor emissions.
Helping tobacco users quit can lead to short and long term reduction in tobacco-related disease, deaths and health care costs, Public health supports health care systems in consistently diagnosing and treating tobacco use and dependence.
Insurance companies are in compliance with the Affordable Care Act when they cover:
- Individual, group and telephone-based cessation counseling
- All seven FDA-approved cessation medications with no cost sharing or prior authorization requirement
Tobacco cessation services are to be covered with no out-of-pocket costs. However, the extent to which health plans follow these federal guidelines varies. There are large and rural populations in the state with no reliable access to cessation services.
Access to free or nominal cost cessation counseling and medications is critical to the success of tobacco prevention policies including legislation that raises the minimum legal sales age and smoke-free policies. Cessation efforts also reduce youth initiation; 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 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 Pilot Project
A clinic pilot project was implemented in each of the five MCOs September 2017 through January 2018. The five participating clinics conducted verified the list of clinic patients, modified procedures to better manage their patient population and promote well-child visits, and engaged in peer learning. Based on the success of this pilot project the expectation is to bring it to more than 30 clinics 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 and parent preferences about appointment reminders.
- Clinic management – includes webinars on correct billing for well-child visits, and valuable new reports available from managed care organizations contracted to provide Apple Health.
Child Profile Health Promotion
The Child Profile Health Promotion System is Washington State’s centralized immunization and well-child visit reminder system. The Department of Health uses the system to send health and safety information to all families in the state with children aged birth to six years.
Information is in English and Spanish and timed to correspond with the American Academy of Pediatrics’ recommended schedule of well-child visits. Parents receive the information from the department about two weeks before each visit.
The information in the mailings is based on Bright Futures Guidelines and designed to help parents prepare for the well-child visit, including which immunizations may be due.
Parents receive 17 health promotion mailings over six years.
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.