Blueprint for Children

The WV AAP has long supported preventive care, including immunizations, in the medical home setting as a major component of pediatric health care and disease prevention. Evidence-based studies have consistently shown that immunizations save lives. WV has one of the nation’s strongest school entry immunization policies, in that WV only allows medical exemptions for immunizations prior to school entry. In states with weak immunization laws that allow nonmedical exemptions, the number of unvaccinated children has increased. When the number of unvaccinated students grows, the likelihood of disease outbreak increases.

• The WV AAP applauds the WV legislature for maintaining strong immunization policies and continues to support these vital public health laws.
• The WV AAP urge legislators to reject any legislation that weakens immunization policy by changing the exemption process.

States, including West Virginia, have made historic gains in covering children thanks to Medicaid, Children’s Health Insurance Program (CHIP), and the Affordable Care Act. However, there have been setbacks. As coverage rates stall or head in the wrong direction, the WV AAP emphasizes the importance to reach and enroll eligible children, focus on system improvements to keep them covered, and ensure that parents have health insurance so they can keep themselves and their families healthy. Medicaid and CHIP serve West Virginia’s most vulnerable children and are critical to children’s healthy development and success in life.

• The WV AAP continues to support protecting and advancing children’s health coverage through these vital
  programs for all children, including the most vulnerable in foster care, kinship care, and transient guardianship
  and children with special health care needs.
• The WV AAP supports policies that increases access to physicians and specialists through telehealth and
  payment parity for telehealth, including telephonic visits.

The emergence of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), in late 2019 led to a global pandemic with dramatic societal and economic impact on individual persons and communities. COVID-19 remains a major global public health threat that dramatically disrupted all sectors of society worldwide. Persons of all ages are at risk for infection and severe disease. The WV AAP continues to advocate that the government response adequately addresses the needs of children, families, and pediatricians.

• WV AAP supports enhancing payment to early care and education programs to keep childcare centers open
  during the COVID-19 pandemic and beyond.
• The WV AAP supports policies that address expanding broadband access to all communities in West Virginia. Broadband is essential for virtual learning, when needed, and to access services via telehealth.
• The WV AAP supports equitable distribution and access to safe and effective COVID-19 vaccination to those
  who are eligible.

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 use and increase recommended funding for cessation
  services – specifically for vaping prevention in adolescents and young adults.

Prevention of childhood obesity, the most prevalent chronic health disease in the pediatric population, remains a priority for the WV AAP. Although many social sectors need to be mobilized to completely address this epidemic, pediatric primary care has a unique role to play as a community resource and an integral part of the solution.

• Because there is no evidence of health benefits of sugary drinks, health-promotion efforts in pediatric practice
  should aim at removing all sugary drinks from children’s diets. WV AAP promotes policies that eliminate sugary drinks access and consumption including support for sugary-sweetened beverage tax and water access in public schools and parks. Research shows this tax must be at least $0.01/ounce to promote health and ensure health care cost savings.
• The WV AAP supports policies that address food insecure children and families to provide nutritious food such
  as universal school meals, increasing the Child and Adult Care Feeding Program (CACFP) reimbursement,
  funding for Produce “Rx” like the FNV Rx & Fresh Connect, and SNAP Stretch.

Adverse Childhood Experiences (ACEs) and toxic stress have a significant, long-term impact on child health, quality of life, economics, and education. Research shows ACEs are common and affect all income levels. Protecting young children from adversity is a promising, science-based strategy to address many of the most persistent and costly problems facing contemporary society, including limited educational achievement, diminished economic productivity, criminality, and disparities in health.

• Physician and health care professional training should focus on the importance of trauma-informed care
  within pediatric practice to address the health of all patients and their families more fully.
• The WV AAP supports the implementation and evaluation of evidenced-based, family-centered interventions (regardless of the provider or venue) that include care coordination and reduce sources of toxic stress and mitigate their adverse effects and assist in building resilience for our young children.

The mental health care crisis continues to impact children. In 2021, the AAP, American Academy of Child and Adolescent Psychiatry (AACAP) and Children’s Hospital Association declared a national emergency in children’s mental health, citing the serious toll of the COVID-19 pandemic on top of existing challenges. It is critical our children have affordable and accessible mental health care. Before the pandemic, rates of childhood mental health concerns and suicide had
been rising steadily for at least a decade. By 2018, suicide was the second leading cause of death for youths ages 10-24 years. Researchers have found that between March and October 2020, emergency department visits for mental health emergencies rose by 24% for children ages 5-11 years and 31% for children ages 12-17 years. In addition, emergency department visits for suspected suicide attempts increased nearly 51% among girls ages 12-17 years in early 2021 compared to the same period in 2019. We must provide our children quality mental health care when needed to avoid adverse outcomes such as poor school performance, a decline in overall health, and injury or death from suicide attempts.

• The WV AAP supports legislation that would provide affordable and accessible mental health services for children. This may include expanding telehealth services for mental health care needs.
• The WV AAP supports funding for mental health resources in schools and communities that would allow
  easier access to 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 the safety of others’ homes, and live without fear of firearms. Gun violence is a public health epidemic that profoundly affects children and must be addressed that way through evidence-based policies. As pediatricians, we counsel parents on proper storage of firearms and do everything in our power to keep children safe – we also depend on our elected leaders to use the same common-sense approach to advance comprehensive gun violence and firearm injury prevention policies.

• We urge legislators to reject any legislation that weakens gun violence and firearm injury prevention laws
that puts children’s safety at risk.