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Vermont Department of Health - Maternal & Child Health Programs and 3 more... less...


Vermont Department of Health

Vermont Department of Health - AHS Goal 1

OLH SHIP-related activities

% of public schools that include information regarding the American Academy of Pediatrics Bright Futures recommendation of an annual well exam on their school’s website, or within a handbook (school, parent, or teacher)

Current Value




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Story Behind the Curve

Updated: April 2015

Author: Division of Maternal and Child Health, Vermont Department of Health

This is a new performance measure for the Division of Maternal and Child Health (MCH) at the Vermont Department of Health (VDH). Although promotion of Electronic Health Records (EHR) and their usage to serve their student population has been an activity of the VDH School Liaisons (12 public health nurses and a nutritionist located in each of the Office of Local Health district offices that work closely with schools) for some time now. An aggregate of those schools currently following this recommendation has not been done, and because this is a new performance measure, no baseline has been established at this time.


What Works

An important connection to MCH’s work with schools is the promotion of an annual well exam as recommended and described by the American Academy of Pediatrics’, Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents in the student’s medical homeThis is Vermont’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) periodicity schedule.

“Bright Futures is a national health promotion and prevention initiative, led by the American Academy of Pediatrics and supported by the Maternal and Child Health Bureau, Health Resources and Services Administration. The Bright Futures Guidelines provide theory-based and evidence-driven guidance for all preventive care screenings and well-child visits. Bright Futures content can be incorporated into many public health programs such as home visiting, child care, school-based health clinics, and many others.”

Schools have an important role in assisting to reduce barriers to accessing the medical home, and educating students, caregivers, and the school community about the importance of receiving recommended well child care.The VDH School Liaisons work with school nurses to increase knowledge related to the periodicity of well exams and the importance of these visits in addressing current and potential needs of students, providing anticipatory guidance to students and parents, and addressing other important aspects of health and wellbeing during these comprehensive well care visits.

Parents and students often receive conflicting messages regarding how often their student should be seen by their provider. Their understanding of the frequency of visits may be partially driven by of what is required for school attendance (i.e. required immunizations, and needed prescriptions or care plan information for such things as asthma, diabetes, seizure disorders, or life-threatening allergies), or for sports clearance (a.k.a. sports physicals, which is an assessment for sports readiness, and generally offers minimal insight into an athlete's total health). Parents might also see acute visits for illness or injury within a year, as having met an annual exam recommendation.

Ultimately by increasing awareness about Bright Futures with students, caregivers, and the school community, and promoting the importance and benefits of having regular well child care, we hope there will be in increase in the % of students reporting they’ve had a well exam within the last year.

Action Plan

The Department of Health will first determine a mechanism to establish a baseline number of schools that currently promote an annual well exam as described in Bright Futures. Once a baseline has been established, the next step will be to determine a mechanism for continually monitoring for individual school requirements related to this subject.

Concurrently, School Liaisons will continue to promote Bright Futures, and the recommendations for an annual well exam, as well as the concept and benefits of having a sports clearance be completed as part of an annual well exam.

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