Blueprint for Children

The West Virginia Chapter of the American Academy of Pediatrics (WV AAP) has long advocated for preventive care, including immunizations, as a fundamental component of pediatric health and disease prevention within the medical home setting. Extensive evidence-based research consistently demonstrates that immunizations save lives. West Virginia upholds one of the nation’s strongest school-entry immunization policies, permitting only medical exemptions for required vaccinations. In contrast, states with weaker immunization laws that allow nonmedical exemptions have seen a rise in unvaccinated children. This trend has contributed to outbreaks of diseases such as pertussis (whooping cough) and measles in neighboring states with higher numbers of unvaccinated students. West Virginia students deserve the freedom to attend school without the fear of exposure to preventable diseases.

• The WV AAP urges legislators to oppose any attempts to weaken immunization policies by modifying the exemption process in any way, ensuring that West

States, including West Virginia, have made significant progress in expanding children’s health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act. However, recent setbacks have threatened these gains. As coverage rates stagnate or decline, the West Virginia Chapter of the American Academy of Pediatrics (WV AAP) underscores the need to identify and enroll eligible children, improve systems to maintain continuous coverage, and ensure parents have access to health insurance to support their families’ well-being. Medicaid and CHIP play a vital role in serving West Virginia’s most vulnerable children, supporting their healthy development and long-term success.

• The WV AAP remains committed to protecting and enhancing children’s health coverage through these essential programs, particularly for vulnerable populations such as children in foster care, kinship care, transient guardianship, and those with special health care needs.
• The WV AAP advocates for policies that expand access to physicians and specialists through telehealth, promote payment parity for telehealth services, and include coverage for telephonic visits.

The WV AAP supports strengthening financial support for early care and education programs to ensure the stability and sustainability of childcare centers. This includes continued financial stabilization of the childcare system through enrollment-based payments and categorical reimbursement to support the children of childcare staff.

The WV AAP advocates for policies that combat food insecurity among children and families by ensuring access to nutritious food. This includes expanding universal school meal programs, increasing reimbursement rates for the Child and Adult Care Food Program (CACFP), and funding initiatives such as Produce “Rx,” FNV Rx & Fresh Connect, and SNAP Stretch to improve access to fresh, healthy foods.

Preventing youth tobacco and vaping initiation and exposure are important to reducing tobacco-related diseases. Preventing youth tobacco and vaping initiation and exposure are important to reducing tobacco-related diseases.

• WV should enact and enforce laws that mandate smoke and vape free environments to reduce exposure and protect children from tobacco-related diseases.
• WV AAP supports universal screening of caregivers and assisting them in reducing and eliminating tobacco use.
• WV AAP supports measures that will decrease tobacco and nicotine use and increase recommended funding for prevention and cessation services – specifically restricting youth access to vaping products and nicotine pouches,

Adverse Childhood Experiences (ACEs) and toxic stress have profound and lasting effects on children’s health, quality of life, economic stability, and educational outcomes. Research confirms that ACEs are widespread, affecting individuals across all income levels. Protecting young children from adversity is a science-backed approach to addressing some of society’s most persistent and costly challenges, including educational underachievement, reduced economic productivity, criminal behavior, and health disparities.

• Training for physicians and health care professionals should emphasize the importance of trauma-informed care in pediatric practice to more effectively support the health and well-being of children and their families.
• The WV AAP advocates for the implementation and evaluation of evidence-based, family-centered interventions—regardless of provider or setting—that incorporate care coordination, reduce toxic stress, mitigate its harmful effects, and foster resilience in young children.

The children’s mental health crisis continues to escalate. In 2021, the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and the Children’s Hospital Association declared a national emergency in children’s mental health, emphasizing the severe impact of the COVID-19 pandemic on top of pre-existing challenges. Ensuring that children have access to affordable, high-quality mental health care is critical.

Even before the pandemic, rates of childhood mental health issues and suicide had been steadily rising for over a decade. By 2018, suicide had become the second leading cause of death among youth ages 10-24. Research indicates that between March and October 2020, emergency department visits for mental health emergencies surged by 24% among children ages 5-11 and by 31% among adolescents ages 12-17. Additionally, in early 2021, emergency department visits for suspected suicide attempts increased by nearly 51% among girls ages 12-17 compared to the same period in 2019.

Access to timely, effective mental health care is essential to prevent adverse outcomes such as poor academic performance, declining overall health, and injury or death from suicide attempts.

• The WV AAP supports legislation aimed at expanding affordable and accessible mental health services for children, including increased availability of telehealth options for mental health care.
• The WV AAP advocates for increased funding for mental health resources in schools and communities to ensure easier access to critical mental health services.

Substance use disorders remain a growing problem among young people. The rate of “nonmedical use” (i.e., use without a prescription or more than prescribed) of opioid medication by adolescents (aged 12-17) and young adults (aged 18-25) more than doubled between 1991-2012, and the rates of opioid use disorders, including heroin addiction, and fatal opioid overdoses increased in parallel. Neonatal Abstinence Syndrome (NAS) is another devastating consequence from the substance use epidemic that impacts the most vulnerable population in West Virginia.

• The WV AAP supports increasing resources to improve access to medication-assisted treatments.
• In WV, 14% of babies are born exposed to substances, and among those, 1 in 3 are diagnosed with NAS. West Virginia has among the highest incidence rate of NAS in the country. WV AAP remains willing and able to continue to collaborate with state partners to ensure adequate care for children impacted by this epidemic.
• As the substance use epidemic continues to contribute to rising foster care placements, the WV AAP promotes policies that provide access to evidence-based treatment for the whole family.

Every child has the right to live in a safe home, play in secure environments, and grow up without the fear of firearm violence. Gun violence is a public health crisis that profoundly impacts children and must be addressed through evidence-based policies. As pediatricians, we educate parents on the safe storage of firearms and advocate for measures to protect children—yet we also rely on our elected leaders to take a common-sense approach in advancing comprehensive gun violence and firearm injury prevention policies.

• The WV AAP is dedicated to safeguarding children from firearm-related injuries and violence.
• Acknowledging the devastating impact of firearms on children, adolescents, and young adults, the AAP supports firearm regulations, including a ban on assault weapons and high-capacity magazine sales, as effective measures to reduce firearm-related harm.
• We urge legislators to oppose any policies that weaken gun violence and firearm injury prevention laws, as these put children’s safety at risk.