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Presentation Title Lorem ipsum dolor sit amet, consectetur adipiscing elit. Community Prevention and Wellness:

Presentation Title Lorem ipsum dolor sit amet, consectetur adipiscing elit. Community Prevention and Wellness: Addressing Social Determinants of Health Samantha Kinney, MPH Yamhill County Public Health

Yamhill Community Care Organization 501(c)3 collective-impact, grassroots nonprofit Investment in prevention and intervention: •

Yamhill Community Care Organization 501(c)3 collective-impact, grassroots nonprofit Investment in prevention and intervention: • • • Primary care, behavioral health, oral health Care management Peer support Community programs Early childhood and family supports Infrastructure and capacity-building Governed by multi-sector committees: • • • Board of Directors Quality and Clinical Advisory Panel Early Learning Council Community Advisory Council Community Prevention and Wellness (CPW) Resources: • Incentive and transformation funds • Early Learning funds • Partners – early childhood, social services, HHS, clinics/hospitals • Community interest and buy-in 2

Community Prevention and Wellness (CPW) CPW Board Committee: • Develop comprehensive population-based plan on

Community Prevention and Wellness (CPW) CPW Board Committee: • Develop comprehensive population-based plan on health and wellness for Yamhill Community members; individually and population-based interventions. • Members include Health and Human Services, Lutheran Community Services and Yamhill Community Care Organization. Goals and Responsibilities: • Infuse community health and wellness models, including both organizational and programmatic approaches. • Identify best practices that are currently available • Recommend funding of initiatives, activities, programs and interventions. • Leverage external funding and resources. Community Prevention and Wellness Community Health Improvemen t Plan Coordinated Care Organization 2. 0 Addressing Social Determinants of Health 3

Partners in Prevention, Health and Education All School-based packages include: Flight Team Crisis Line

Partners in Prevention, Health and Education All School-based packages include: Flight Team Crisis Line Utilization Threat Assessment Mental Health First Aid Training Emergency Department Screening Population and Health Prevention Program Complete Services Complete access to mental health services for all students in each district, regardless of insurance status. 50/50 cost-share contract between HHS or LCSNW and each school district, which includes the dedicated therapist based at each school, spectrum of mental and behavioral health services. Oregon Health Plan (OHP) Primary Services School- or clinic-based mental health services limited to students in Yamhill County public schools covered under the Oregon Health Plan*. No cost share required; however, in-kind space and staff support is provided by district staff. 4

Prevention and Intervention Services 5

Prevention and Intervention Services 5

The PAX Good Behavior Game (PAX GBG) • Classroom teams in elementary school earn

The PAX Good Behavior Game (PAX GBG) • Classroom teams in elementary school earn small rewards for being on-task and cooperative. • PAX GBG employs trauma-informed prevention strategies for teachers to use, that blend seamlessly with PBIS and RTI. • Kernels in the PAX Good Behavior Game System: • PAX Vision • I’m a PAX Leader • PAX Quiet • Granny’s Wacky Prizes • Beat the Timer • PAX Stix • PAX Tootle Notes • PAX Voices • PAX Hands and Feet • OK/Not Ok 6

PAX GBG: Addressing Social Determinants of Health 2016 and 2017 participating districts: Willamina Sheridan

PAX GBG: Addressing Social Determinants of Health 2016 and 2017 participating districts: Willamina Sheridan Yamhill-Carlton PAX Implementation 2018 participating districts: Willamina Sheridan Yamhill-Carlton Dayton Newberg 2016 -17 School Year Evaluation Results N of Youth N of Staff 8000 350 PAX Partners 7000 School Staff Trained 300 6000 Students Reached 250 5000 200 4000 150 3000 Prosocial behaviour Psychological problems Self regulation Emotional problems 100 2000 50 1000 0 Year Impact by this year ≈ 1, 800 children 0 2016 2017 2018 2019 2020 7

Timeline of benefits First Month More time for teaching and learning Less stress for

Timeline of benefits First Month More time for teaching and learning Less stress for staff and students First Year Better attendance Fewer referrals Fewer service needs Less illness Happier families Less vandalism Better academics Two-three years Special education averted Oppositional Defiance averted ADHD averted 5 -15 years No tobacco Less alcohol Fewer conduct disorders Less depression Less crime, violence, suicide High school graduation & university 8

Predicted Benefit of PAX GBG in Yamhill County School Districts The Washington State Institute

Predicted Benefit of PAX GBG in Yamhill County School Districts The Washington State Institute for Public Policy estimates the benefit to cost ratio of GBG is $72. 07. If every in Yamhill County Elementary Schools, the cost is estimated at $9. 96 per student. Predicted Net Benefit $ 60, 000. 00 $ 50, 000. 00 $ 40, 000. 00 Lifespan Benefit Health Care Monetary Benefit $25, 000 $20, 000 $15, 000 Lifespan Benefit$ 30, 000. 00 $ 20, 000. 00 $ 10, 000. 00 $1, 131 1, 771 3, 500 7, 507 (Year 2017) 2018) 2019) 2020) Youth Reached (K-3 rd Grade Students) per Year of PAX Implementation $10, 000 $5, 000 $0 1, 131 (Year 2017) 1, 771 (Year 2018) 3, 500 (Year 2019) 7, 507 (Year 2020) Youth Reached (K-3 rd Grade Students) per Year of PAX Implementation 9

Meta-Analysis of Program Effects The estimates shown are based on the Washington State for

Meta-Analysis of Program Effects The estimates shown are based on the Washington State for Public Policy, using the John Hopkins Randomized Control Trial Study. Reach is based on kindergarten through third grade exposed to the PAX GBG after two years. Fewer Young People will… 2017 2018 2019 2020 Youth (k-3) Reached 823 1, 323 2, 678 4, 895 Commit & be convicted of a serious violent crime 8 13 26 48 Develop serious drug addiction 79 127 257 471 Become regular smokers 54 87 176 322 Develop serious alcohol addictions 29 47 95 173 Contemplate suicide 40 64 130 237 Attempt suicide 54 87 176 322 Predicted Benefits 10

Investing into the FUTURE Yamhill CCO has begun a Community Prevention & Wellness Fund

Investing into the FUTURE Yamhill CCO has begun a Community Prevention & Wellness Fund (CPWF) to support initiatives that will improve the long-term health of all residents in Yamhill County and reduce the rising costs of healthcare, social services and special education. Funding • Building prevention as a value in business relationships • Identifying cost savings in other areas and directing to prevention funds • Grant and foundation funding • Investment models that may take on risk for the success of the program • Publicly-funded partners 11

Funding Model • Medicaid dollars through Pay-forperformance rewards. • Local Prevention dollars through local

Funding Model • Medicaid dollars through Pay-forperformance rewards. • Local Prevention dollars through local foundations. • YCCO contracts with dental, behavioral and medical providers. 12

Addressing Social Determinants of Health in Yamhill County Together! Acknowledgements Dayton School District Mc.

Addressing Social Determinants of Health in Yamhill County Together! Acknowledgements Dayton School District Mc. Minnville School District Newberg School District Sheridan School District Willamina School District Yamhill Carlton School District