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Clark County

Community Health Improvement Plan

progress report

July 2017 to December 2017

2016-2019

February 16, 2018

Clark County Task Forces:

Chronic Disease

Healthy Births/Sexuality

Mental Health

Healthy Eating

Physical Activity

Substance Abuse

Tobacco

Introduction________________________________________________________________ The Clark County community has been working on the 2016-2019 Community Health Im-provement Plan. This report reflects the progress of the task force work towards the objec-tives identified by each of the seven priority areas below. The report reflects activities through December 2017.

For more information on the Community Health Assessment or the Community Health Im-provement Plan, please contact the Clark County Combined Health District at [email protected].

Priority 1 – Chronic Disease Prevention

Priority 2 – Healthy Births and Sexuality

Priority 3 - Mental Health

Priority 4 – Healthy Eating

Priority 5 – Increase Physical Activity

Priority 6 – Substance Abuse Prevention, and Treatment

Priority 7 – Tobacco

The following designations indicate the current status of each objective:

- Action has been completed

- Slow Progress/Behind Schedule

- Good Progress/On Schedule

- Watch - due date is in the future

- Little to No Progress/ Intervention Needed

- Action due date is approaching, activity needs to begin

mailto:[email protected]�

Chronic Disease Task Force Progress Report The following information is a synopsis of the progress of the Chronic Disease Task Force in regards to goals and objectives completion. Included are table representations and narrative comments. The tables represent a visual depiction of the progress the task force has made toward the accomplishment of each goal as well as anticipated completion dates.

Chronic Disease: Fluoridation Impact Objective: Fluoridate the community water supply / Decrease the number of Clark County residents with poor

oral health. SMART Objective: By March 2018, the Chronic Disease Task Force will decrease the number of Clark County residents with tooth decay leading to extraction as evidenced by the fluoridation of the public water supply.

Process Objective Related Activities Specific Dates Performance Management 1. Research and development May –August

Chronic Disease: Diabetes Education Impact Objective: Increase self-management, education and awareness surrounding diabetes to create healthy

behavior changes in adults. SMART Objective: By March 2018, the Chronic Disease Task Force will increase the number of patients completing

diabetes education courses as evidenced by the increase of 2 ADA certified sites in Clark County. Process Objective Related Activities Specific Dates Performance Management

1. Identify sites interested in becoming ADA certified 6/20/2016

2. Research the certification process - Application, staffing, cost, approval process, submit to ADA, RHC

representative

10/20/2016

3. Identify instructor(s) and Program Coordinator 10/20/2016

4. Identify dietician to partner with RHC 10/20/2016

5. Identify teaching sites - Ensure that they are accessible - Spanish speakers/translators available

10/20/2016

6. RHC and SRMC begin internal referrals 9/2017

7. Begin teaching courses 9/2017

8. Streamline billing process and financial assistance 9/2017

9. Community Education - Press release, local media outreach, social media

9/2017

10. Repeat process for site expansion When ready

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• Collect data • Facts and myths • Developing infographic and/or fact sheet • Discussions with local businesses in seek of support

2016

2. Contact local manufacturers regarding impact of fluoride on business processes

• Intern sets up appointments

May – September 2016

3. Create marketing plan for distribution of outreach materials, presentations, etc.

July –July 2017

4. Utilize research and development materials to conduct outreach

• Businesses, Civic Groups, etc. • Social Services • Professionals • Which groups are on board to support the effort? Which groups need more

education?

December 2017

5. Utilize research and development materials to conduct education

• Professionals • Social Services • Businesses, civic groups, etc. • General public

January 2017- July 2017

6. Fluoridation ordinance in front of city commission Jan 2018

7. Fluoridation ordinance on the ballot for vote May 2018

Chronic Disease: Congestive Heart Failure Impact Objective: Increase care coordination for Congestive Heart Failure patients.

SMART Objective: By March 2018, the Chronic Disease Task Force will decrease the number of readmissions among unaffiliated Congestive Health Failure patients within 30-90 days of discharge as evidenced by the establishment of

Primary Care Providers/Medical Homes for 50% of patients. Process Objective Related Activities Specific Dates Performance Management

1) Collect data • Number of patients discharged with CHF • How many have a PCP • How many don’t have a PCP • What are the admission criteria • What are the discharge criteria

June 2016 – August 2016

2) Establish Case Manager for CHF patients August 2016 – October 2016

3) Establish procedure for CHF patients • At admission call designated person at RHC • 1 physician has two spots/week • Make a home health referral

October 2016 – February 2017

4) Track metrics • Weight • Medication compliance • Symptoms

February 2017 – March 2018

5) Track readmissions • 30, 60 and 90 days

February 2017- March 2018





















During the transition from 2017- 2018, many challenges presented for the Chronic Disease Task Force, causing re-evaluation and revision to the strategies for diabetes education, water fluoridation and linkage to care for persons with congestive heart failure. In the pursuit of expansion of American Diabetes Association (ADA) Certified Education sites, it became evident that it would be necessary for Rocking Horse Community Health Center to independently pursue ADA certification rather than through a collaboration with Mercy Health-Springfield Region. Target dates for the implementation will be adjusted accordingly. Fluoridation of Springfield City’s community water supply, as a policy change to improve oral health of the residents, has been met with controversy. The Task Force will continue to effectively employ tools of health promotion, information sharing and expanded collaboration to address the concerns surrounding this recommended best practice.

The profile of access to health care in Clark County is ever changing. The original work plan objectives of referring unaffiliated clients in need of primary care to the local Federally Qualified Health Center are in need of revision due to the emergence of a hospital based clinic, the Bridge Clinic. This change is in need of further evaluation for effectiveness.

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Chronic Disease: Asthma Impact Objective: Positively impact the health and wellness of children with asthma by decreasing the number of

asthma attacks serious enough to require emergency room services by identifying and reducing the number of environmental triggers in the patient’s housing AND by enhancing clinical care by providing information on those

triggers to the clinical care providers. SMART Objective: By March 2019, the Chronic Disease Task Force will decrease the number of asthma attacks that

require emergency room services or treatment by implementing home-based environmental assessments/interventions.

Process Objective Related Activities Specific Dates Performance Management 1. Research current practices

a) Review successful evidence-based practices. b) Review existing CCCHD assessment. c) Produce a map overlay showing schools in identified zip codes. d) Review existing physician/hospital procedures and referral systems. e) Review 2017-2019 OD H State Health Improvement Plan and ODH Action

Plan for Chronic Disease priority topic (chronic disease: reduce child asthma).

Action Items 1.1 Attend Healthy Homes meetings (statewide). 1.2 Update IAQ/Asthma Trigger checklist and report form. 1.3 Review data.

1.4 Compare information on coding practices and check assessment practices at SRMC, RHC & PA.

December 2017 1.1

1.2

1.3

1.4

2. Engage strategic partners to develop an effective home-based environmental assessment program a) Local physician(s) h)Community Mercy Med-Assist b) S RMC i)CHF – grant funding c) Rocking Horse Center k) Pediatric Associates d) CCCHD l) Clark County Pharmacists Assoc. e) Dayton Children’s Hospital m)United Senior Services f) RAPCA n) Members of public g) Head Start offices o)Community Mercy Med-Assist h) WSU Center for Healthy Communities / School of Nursing i) Clark County School Nurses – School-Based Asthma Therapy

Group will meet bi-monthly.

Action Items

2.1 Provide list. 2.2 Provide a written IAQ policy. 2.3 Produce bilingual info material, and a report form. 2.4 Visit offices to solicit referrals. 2.5 Include school nurses in program / workgroup.

December 2017 2.1

2.2

2.3

2.4

2.5

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2.6 Apply for CHF grant in 2017. 2.7 Apply for CHF grant in 2018. 2.8 Include Clark County pharmacists in program / workgroup.

2.6

2.7

2.8

3. Implementation a) Identify priority population / target audience b) Contact and persuade physicians et al c) Provide referral system for care providers – e-mail, phone, & webpage d) Conduct assessments, ID needs, provide reports to care providers e) Facilitate environmental remediation, if possible using grant funding. f) Conduct follow-up activities to check on progress and provide (as much as

possible) needed services or materials. g) Train school nurses to provide evidence-based care for students with asthma

(e.g. Asthma Action Plans), assess their schools, and recognize asthma exacerbation.

Action Items 3.1 Identify target audience via clinic/physician lists. 3.2.1 Conduct office visits and solicit referrals. 3.3 Provide usable referral system for care providers. 3.4 Conduct IAQ visits, collect data, & make recommendations. 3.5 ID needs & find solutions & conduct follow-up. 3.6 Contact school nurses and schedule training meetings.

March 2019 3.1

3.2

3.3

3.4

3.5

3.6















Pending 2018 2.7



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4. Evaluation a) Track changes in environments and behaviors to evaluate the program and

assure that the goals of the program are being met. Track needs. Track supplies provided.

b) Compare Clark County data to that from other agencies and research projects. Track referrals from school nurses, physicians, SRMC, self-referrals, and other referrals to better understand how to market the program. Solicit permission to use “personal stories” to assist with grant-funding.

c) Evaluate SRMC ED data to determine if ED visits have decreased. d) Publish results in peer-reviewed journal and/or present results at educational

conference to contribute to the development of an Asthma Home Visiting process guide, as recommended by ODH State Action Plan.

Action Items

4.1 Collect and record data for research purposes 4.2 Compare data to other agencies and projects 4.3 Statistically analyze SRMC ED /CCCHD asthma data 4.4 Distribute results and recommendations

Mar 2019 4.1

4.2

4.3

4.4

The Asthma Subgroup is implementing their strategy of increasing referrals to the Asthma Program, providing in-home environmental assessments, and collecting assessment data. The subgroup received a 2017 Community Health Foundation grant to purchase needed supplies such as mattress and pillow covers, and has distributed these items. The subgroup continues to increase its strategic partners, including Springfield Regional Medical Center (SRMC), primary care providers, pharmacists, and school nurses. Monthly e-newsletters with asthma information are sent to school nurses and a school nurse training date (in association with Dayton Children’s Hospital) is scheduled in 2018. An asthma presentation was made to the Clark County Pharmacists Association and SRMC is taking the first steps to refer asthmatic clients from its Emergency Department to the Asthma Program.”












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Healthy Births/Sexuality Task Force The following information is a synopsis of the progress of the Healthy Births and Sexuality Task Force in regards to goals and objectives completion.

Healthy Births/Sexuality: Information Sharing Impact Objective: Minority populations and other vulnerable populations have increased access to sexual health

information and services SMART Objective: By March 2019, the Healthy Births & Sexuality Task Force will demonstrate increased community

outreach to minority populations through a 30% increase in culturally appropriate sexual health information. Process Objectives Related Activities Specific Dates Performance Management

1. Identify key community partners who serve minority populations a) Identify effective avenues of distribution, (including reaching out to agencies

that serve minority populations), using appropriate materials b) Develop and implement a distribution plan

Updated: March 2019

Healthy Births/Sexuality Task Force: Teen Birth Rates Impact Objective: Decrease in the teen birth rate for 15-17 year olds for Clark County

SMART Objective: By March 2019, the teen birth rate will decrease from 19.5 births /1,000 to 15 births /1,000 for 15-17 year olds.

Process Objectives Related Activities Specific Dates Performance Management 1. Local school districts receive the information necessary to

make informed choices regarding sexual health education. a) Survey all city and county school districts to assess current state of

reproductive health education. b) Create a questionnaire to research this issue with all districts.

March 2017

2. Increase access to sexual health information and services. a) Research options for sexual health and services for teens. b) Increase information and education about birth control options, including

LARC (Long Acting Reversible Contraception).

March 2019

3. Equip parents with information and education regarding sexual health and risks of initiating early sexual activity.

a) Identify effective ways of reaching parents. b) Help parents identify their own values and communicate them clearly to their children.

March 2019

Healthy Births/Sexuality: Prenatal Care Impact Objective: Increase in percent of infants born to pregnant women receiving prenatal care beginning in the first

trimester. SMART Objective: By March 2019, the percentage of Clark County women who initiate prenatal care in the first 12 weeks

of pregnancy will increase by 20% from 57% to 73% as a result of public information promoting early identification of pregnancy- Prenatal Service Directory

(Data: Ohio rate for 2015 = 73.6% Clark rate = 57% HP 2020 rate = 77%) Process Objectives Related Activities Specific Dates Performance Management 1. Increase the county wide distribution of Prenatal Service

Directory. a) Revise and update Prenatal Service Directory and reprint in both English

and Spanish b) Identify five key community collaborators who provide pregnancy related

services c) Contact the collaborating entities and arrange for face to face meeting

regarding the task force plan, with the objective of creating buy in and targeted distribution of the Prenatal Service Directory

d) Continue wide distribution of the Prenatal Service Directory to strategic locations in addition to health care providers (i.e. drugstores, coffee shops, hair salons, etc)

e) Use social media to distribute Directory electronically.

March 2019











2. Identify additional vulnerable populations in the community and the key community partners that serve them, including but not limited to: homeless, incarcerated, in recovery from addiction and people with chronic mental health issues or developmental delays. a) Identify effective avenues of distribution, including reaching out to agencies

that serve the above identified populations, using appropriate materials b) Develop and implement a distribution plan

Updated: March 2019

In working toward reduce the teen birth rate the survey tool used with the schools was not successful so the group decided to approach the gathering of needed information in a less formal manner. Once gathered, that information will be used to educate the community about what education is being offered in each school district.

The Prenatal Directory pamphlet, which is reviewed annually, has now been widely distributed to Clark County agencies and organizations as proposed. Distribution will be ongoing as will the review process. Agencies can utilize the directory to assist clients in identifying needed services.

In an effort to increase community outreach to minority population the task force formally adopted a realignment of this goal to include a directory of services to promote healthy sexuality (family planning, STI prevention etc.). Additionally, the task force decided to explore the creation of a “kit” that the HBHS members will take into the community for distribution, ensuring accurate and culturally appropriate information is being disseminated to those needing educational literature.

Also, during this review period, the task force was presented with new data around the infant mortality rates, pregnancy rates and the rate of STIs. This new data will be beneficial when accessing current and future goals and objectives. In addition, the task force was educated about the newest State Health Assessment (SHA) and State Health Improvement Plan (SHIP). Task force goals were reviewed during this last time period and task force members will be considering revision of plans/goals/objectives in order to more closely align with the SHIP.



Healthy Eating Task Force Progress Report

The following information is a synopsis of the progress the Healthy Eating Task Force is achieving in regards to completion of specific goals and objectives. Included are table representations and narrative comments.

Healthy Eating: Education in Schools

Impact Objective: Increase knowledge surrounding healthy eating and physical activity in low-income areas within Clark County

SMART Objective: By March 2017, the Healthy Eating Task Force will increase the number of students receiving nutrition education as evidenced by an increase in 2 schools allowing CCCHD to provide nutrition education within their

curriculum. Process Objectives Related Activities Specific Dates Performance Management

• Research schools: • Free/Reduced lunch % • BMIs • Current programming in schools

Dec 16/Jan 17

• Create presentation/outreach materials

Dec 16/Jan 17

• Attend Superintendent meetings to present idea Feb – March 2017

• Meet with principals of targeted schools April - May 2017

• Implement programming in selected schools Sep 2017

• Provide ongoing assistance from CCCHD Ongoing

• Evaluate programming Spring 2017

Healthy Eating: Community Engagement for Assessment Impact Objective: Increase community engagement in low-income areas within Clark County

SMART Objective: By December 2017, the Healthy Eating Task Force will increase community engagement regarding healthy eating as evidenced by the creation and completion of a community needs survey.

Process Objectives Related Activities Specific Dates Performance Management 1. Design community needs survey • Brainstorm survey questions ; Prepare survey; translate survey to Spanish;

review survey with all members; print surveys

April – May 2016

2. Administer survey • Distribute survey to social service agencies – USS, CCCHD, WIC, Second Harvest,

DJFS, RHC, New Carlisle Community Health Center, OSU Extension

May – June 2016

3. Collect surveys Week of July 18

4. Analyze results July – August 2016



















5. Share results with stakeholders + social services January 2017

6. Use data to create plan of action November 2016 – July 2017

7. Survey created for target market in New Carlisle Feb – May 2017

8. Analyze survey and create pilot program for New Carlisle May – Aug 2017

9. Assess results of pilot program. September-October, 2017

10. Create sustainability plan for transportation. November-January, 2018

Healthy Eating: Food Pantry Impact Objective: Decrease obesity rates in low-income areas within Clark County

SMART Objective: By December 2017, the Healthy Eating Task Force will increase access to healthy food options as evidenced by an increase in 1 client choice food pantry.

Process Objectives Related Activities Specific Dates Performance Management 1. Select food pantry interested in converting to a client

choice food pantry • Create list of local food pantries in priority area; Contact pantry managers to

gauge interest and barriers with current model being used; Relay to pantry manager the benefits and importance of converting to a client choice food pantry; Survey interest/concerns of pantry manager; Identify current process for ordering and distributing food; Identify distribution rates of food meeting the recommended dietary guidelines for Americans; Make verbal or written agreement with pantry manager to pursue client choice initiative

Dec 16-Mar 17

2. Make infrastructure changes needed for increasing access to healthier food options

• Assess needs of pantry; Assist pantry manager/volunteers with choosing a “set up model”; Identify local donors; Recruit additional volunteers; Make an inventory list of needed resources and suppliers; Purchase supplies and equipment; Provide nutrition resources and educational activities for food pantry volunteers; Provide ongoing technical assistance

September 2017

3. Market Client Choice Pantry to the local community and host a “kick-off” event

• Develop plans for kick-off; Develop flyers and distribute among community residents and coalition members; Write press release and distribute to local newspaper; Invite media to kick-off event; Hold kick-off event

March 2017– February 2018

4. Conduct a follow-up survey of the community to identify any successes and/or deficits in the client choice food pantry • Develop survey questions for pantry clients; Administer survey; Evaluate survey;

Review survey and make needed changes to pantry according to results; Calculate distribution increase of healthy foods; Provide ongoing technical assistance; Consider standardizing model to invite additional client choice conversions in Clark County and produce tool kit.

September 2017—March 2018







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The following information is a synopsis of the Healthy Eating Task Force in its goal in achieving completion of specific goals and objectives for 2017.

Summary: The Healthy Eating Task Force continues to actively pursue goals in 3 main focus areas: community engagement, community education, and community access. These areas allow the task force to align their efforts with an evidence-based emphasis creating a movement towards improved health status, stronger growth in development of youth, and overall disease reduction. Below is an overview of the very successful year and activity taking place in Clark County. Community Engagement Community engagement regarding healthy eating was achieved through a community needs assessment in 2016. The results of this survey helped gain insight into barriers low-income families face throughout Clark County related to healthy eating. After sharing results with partnering organizations, area stakeholders, and social services, more discussion was held to address the largest barrier identified – Transportation. Addressing this barrier coincides with the Creating Healthy Communities coalition and grant objective targeting the New Carlisle community. A more specific survey about transportation needs was developed and collected in New Carlisle and the results were utilized to develop a transportation program. This program was executed initially on opening day of the New Carlisle Farmer’s Market, June 24, 2017 and also operated on two additional dates.

New Carlisle Farmer’s Market Transportation Pilot

New Carlisle Farmer’s Market supported and assisted in implementing a pilot program last summer in providing transportation into downtown New Carlisle during market days (Saturdays). This shuttle was offered on three days and provided transit between downtown New Carlisle and Park Layne Elementary School. The project was completed once per month in June, July and August, 2017 with the following results:

June 24, 2017 10am-12noon 24 riders July 31, 2017 10am-12noon 50 riders August 26, 2017 10am-12noon 37 riders

TOTAL 111 riders

Sustainability plans have been created and local partners in the New Carlisle community plan to offer transportation during market days again during the upcoming 2018 season.

Community Education Another goal of the task force is to increase knowledge surrounding nutrition in low-income areas of Clark County. Currently, Health Education is not a mandated course in Ohio schools. The CATCH program, a curriculum that includes 30 minutes of physical activity with 5-10 minutes of nutrition education, was implemented in second grade classrooms in both Fulton Elementary and Lincoln Elementary Schools. This programs includes the activities and snacks related to the nutrition message focusing on “go, slow, and woah” foods. This goal was achieved through a collaboration of efforts with the CCCHD Early Childhood Division and Physical Activity Task Force. As a result of this program, noted changes reported by students were an increase in physical activity, decrease in TV watching, and increase in nutrient dense food choices. At Fulton alone, 23 students reported choosing fruit over candy at the start of the program. This increased to 44 students out of 46 during the post-survey. A sustainable program in Lincoln Elementary continues in the 2017-2018 school year utilizing portions of the CATCH curriculum. This program is offered after school and emphasizes both healthy eating choices and physical activity. The task force continues to seek additional routes to include nutrition education in more classrooms in Clark County. Community Access The Healthy Eating Task force has finalized their goal to increase access to healthy food options by converting local food pantries to the client choice method. The Creating Healthy Communities (CHC) coalition finalized the conversion of four sites in 2017 and created a sustainability program to continue converting interested locations in 2018. At least six other sites will likely convert to client choice in 2018. The CHC coalition supported the creation of a client choice manual which is also part of the sustainability plans. As another important facet of increasing access to healthy foods in Clark County, the Clark County Food Council development was finalized in 2017 with heavy involvement of the Healthy Eating task force team. A steering committee, partnering organizations, stakeholders, and community members have been meeting throughout the year to progress with plans addressing a need for a more formalized ability to connect Clark County’s food needs and abilities to one another. June 5, 2017 marked an important meeting where a consensus was made for the structure of the Clark County Local Food Council. Representatives of the task force will be in each of the 4 identified subcommittees of the council: education, marketing, business development, and food access. Final membership for the Food Council was reached in December, 2017 as well as the structure of the four committee groups. CCCHD and the Healthy Eating task force will be working closely with the Food Council, particularly since many representatives coincide. Initial Food Council meetings are occurring in February, 2018 to develop strategic plans for 2018 and beyond. The Healthy Eating task force will plan to participate in Food Council projects as those details are communicated.

Mental Health Task Force Progress Report

The following is an update on the progress the Mental Health Task Force has made toward meeting the goals and objectives created to address the mental health needs of the community.

Impact Objective: To improve the awareness and use of a locally available on-line self-assessment tool for adolescents through adults to identify depression and risk of suicide. Use of the tool also connects the participant

directly to information about local mental health services availability, location and service hours SMART Objective: For 2017 - increase raw participation by 20% in the Mental Health Services HANDS Depression

Screening Tool through promotion and direct referral; to improve the demographic breadth and balance of participants as identified by gender, age and other pertinent demographic discriminants. To provide an immediate

referral guidance tool for gatekeepers that promotes the screening tool or more direct referral as deemed necessary. To regularly identify the source of referrals as an indication of program impact and efficacy.

Process Objectives Related Activities Specific Dates Performance Management Update the Mental Health Recovery Board Suicide Warning Signs wallet card to include more information on local mental health contact information.

9/1/2016

Develop a Gatekeeper assessment and referral resource, Simple wallet size design for ease of carry and reference.

July 19, 2016

Complete a retrospective evaluation of demographic and general data trends from the MHS HANDS Depression Tool for past 12 months.

November 1, 2016

Conduct referral program orientation to identified trainers: Gatekeepers, First Responders, Law Enforcement and LOSS Team.

October 2016

Revise MHS intake procedures to include identification of referral source.

September 2016

Begin regular evaluation and reporting of MHS HANDS data and trends

January 2017

Begin regular evaluation and reporting of MHS intake referral source data.

January 2017

Identify additional Gatekeeper agency opportunities March 2017

















Mental Health Task Force: Physician Impact Plan

Impact Objective: To improve coordination of efforts between individual treating physicians and the community of mental health service providers

SMART Objective: By January 1, 2017 – a survey of local physicians will be conducted to identify referral practices when dealing with or prescribing medications for a mental health condition; a survey of local mental health service providers will be conducted to identify contact information, types of services and referral requirements; a complete

and regularly updated referral list of mental health service providers will be available to all local physicians. Process Objectives Related Activities Specific Dates Performance Management

Develop a general physician survey tool for distribution. Amended objective: Committee sub-group develop a short survey tool for distribution to area GP’s and Pediatricians. Provide the survey to the CCCHD for distribution to known physician contacts. Evaluate and report survey results.

February 2018

Develop a mental health service provider survey tool for distribution Establish a distribution list Evaluate and compile the survey results Print the resulting referral guide Distribute the guide to all local physicians and referring agencies

February 24 2018

Mental Health Task Force: Youth Sub-committee Impact Objective: Create a seamless continuum of care from the school through the various medical and social service

agencies when dealing with school-age children in Clark County who present with suicidal ideation or other acute mental health issues

SMART Objective: By August 2017, the MH Task Force will implement a Parental Consent to Treat and Release Information form and protocol for use by all Springfield and Clark County School districts

Process Objectives Related Activities Specific Dates Performance Management Develop a county-wide policy for information sharing among Clark County schools, hospitals, physician offices and any agency providing mental health services for school-aged children

a. Obtain approval for a policy from all pertinent agencies and offices. b. Create Consent for Release of Information form agreeable to all parties. c. Create a tool for information sharing to be used among all agencies and

offices

9/2017 – 1/2018

Prepare schools for implementation a. Obtain a memorandum of Understanding with schools, agencies and

offices county-wide. b. Schedule dates for training schools

10/2017 – 4/2018

Implement program a. Implement programming b. Phase in building by building c. Document the process

11/2017 – 5/2018

Implement policy a. Educate schools, agencies and parents to expect this as part of the

process when a child is referred for mental/behavioral health services

10/2016 – 10/2017 Ongoing



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Evaluate Utilization 3/2018 Ongoing

Share results with community and CHIP Group a. Summarize results of program b. Present results to community via press release, social media, etc. c. Share results with CHIP Group at next meeting.

9/2018

Mental Health Task Force: Youth Sub-committee Suicidal Ideation Impact Objective: Reduce the incidence of reported suicidal ideation among middle school-age children in Clark County.

SMART Objective: By March 2017, the MH Task Force will implement evidence-based programs/interventions in Springfield and Clark County School districts for middle school age students.

Process Objectives Related Activities Specific Dates Performance Management Invite key personnel from city and county school districts, RHC and SRMC.

a. Contact school-based personnel who work with children in crisis. b. Contact personnel from the RHC who work with children in crisis. c. Contact the ED manager of SRMC.

4/2016 – 5/2016

Research evidence-based programs. a. Utilize the CCCHD evidence-based practices repository for resources. b. Research Botvin Life Skills program currently in use in Urbana and Miami

County schools. c. Determine appropriate program based on student needs and level of

success. d. Determine cost of program. e. Once chosen, acquire all documents/tools necessary to implement

program.

4/2016 - 8/20/16

Prepare schools for implementation. a. If necessary, develop and complete Memorandum of Understanding with

schools. b. Determine school personnel needed for implementation. c. Discuss implementation process with school administration. d. Select dates and times to begin implementation. e. Implement training of personnel f. Continued meetings with superintendents and school officials.

8/2017-7/2018

Implement program a. Develop and document process steps b. Implement programming

8/2017 –6/2018

Evaluate program a. Obtain documentation from participating schools b. Analyze data c. Compile results and share with schools

9/17-6/18

Share results with community and CHIP Group a. Summarize results of program b. Present results to community via press release, social media, etc. c. Share results with CHIP Group at next meeting.

6/18

Mental Health: PAX Good Behavior Game Impact Objective: To improve the efficacy of the elementary educational experience by implementing the validated

PAX GBG curriculum programming for elementary school programs throughout Springfield and Clark County and through training and support of the elementary school teachers.

SMART Objective: 50% of all elementary school programs will support PAX GBG programming in selected classrooms by the beginning of the 2017/2018 academic year. At least one elementary school will support PAX GBG in every

classroom grades 1 through 5 by the beginning of the 2017/2018 academic year. 75% of all elementary school programs will support PAX GBG by the beginning of the 2018/2019 academic year. To increase the number of PAX

GBG trained teachers by at least 40 per year over the next 5 years. Process Objectives Related Activities Specific Dates Performance Management

Train teachers 1. 25 currently in 2016 2. 20 potential in 2016/2017

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The Mental Health Task Force maintains two sub-committees so each group could concentrate their efforts on the objectives they set for their age groups. These sub-committees are titled MHTF – Adult and MHTF –Adolescent. Each sub-committee meets bi-monthly. Both sub-committees come together on a quarterly basis to report out the progress of each group to keep all members updated. The MHTF – Adolescent sub-committee meets bi-monthly. It is the over-arching goal of this group to reduce the incidence of suicidal ideation among the adolescent population in Clark County. Members of this group are working in collaboration with city and county school superintendents and principals to implement programs in the elementary and middle schools that are evidence-based to influence behaviors and everyday decisions. The PAX-GBG program was implemented during the previous CHA/CHIP and continues to add additional grades each year and more schools. As of January 2018 11 schools are participating in the PAX-GBG curriculum with over 70 teachers trained and more than 70 classrooms implemented including all grades in one elementary school and close to all grades in a second school. Evaluation of this program has produced evidence of self-regulation and more attention in the classroom among the students participating in the program. The overall reduction in undesirable behavior in the classroom is 23%. This group introduced the Botvin curriculum to the district superintendents last year for implementation in the middle schools. The goal is to reduce suicidal ideation among the adolescents in Clark County. The task force purchased the Botvin curriculum and funded trainers to teach this program to select school personnel. The curriculum was implemented in two schools 2017-2018 school year. Those schools are Miami View and Tecumseh MS. Tecumseh sent their elementary staff to be trained as well. Catholic Central plans to implement the curriculum in the elementary, middle and high school in the fall of 2018. Tecumseh will add the curriculum to their elementary grades in the fall of 2018 and Greenon will implement theirs at the same time for middle and high school grades. CTC and GRADS are interested as well and meetings are scheduled with Clark-Shawnee and NELSD.

BOTVIN LIFE SKILLS

The task force developed a Community Crisis Response Plan and created a release of information form for parents take with them wherever they seek treatment for their child. This form is to be completed by the physician/counselor/nurse with a plan of care for the child and returned to the school. The purpose of this is to share information regarding the child’s care and ensure follow-up is being done. The plan was utilized in one school and was found to be successful. Meetings with school counselors are in process to discuss this in the hopes of seeing an increase in usage. The Mental Health Adolescent Task Force will continue to partner with the city and county school districts and area agencies to develop and distribute materials and implement education programs that foster support,

3. 40 potential in 2017/2018 4. 40 potential in 2018/2019 5. 40 potential in 2019/2020 6. 40 potential in 2020/2021

Move classrooms to fidelity standard 2019/2020 academic year

Focus on Simon Kenton Elem. For full integration 6/2017

Integrate Lincoln Elem. Into Clark County Program 1/2017

Creating Ongoing trained teacher support and infrastructure Ongoing

Legislative advocacy

Ongoing










improved mental health and greater continuity of care for adolescents. Next steps are implementation of Botvin and PAX-GBG in additional schools and grades and evaluation of programs, training additional staff in the curriculums and countywide utilization of the Community Crisis Management Plan. MHTF – Adult sub-committee meets bi-monthly. This group is working on goals that will help to identify adults with depression and a risk for suicide and connect them with mental health services. The task force has had more than 200 Gatekeepers trained in the QPR model from key personnel in the community. Employees of the CCCHD were provided the QPR training as part of their Cross Divisional Training. The Gatekeepers assess individuals for signs of suicide, remain with them or contact a person of their choosing and refer to MH. Training continues as key community members are identified. Wallet cards listing signs of suicide and the national suicide hotline are distributed. Assessment and referral resource cards were developed for the Gatekeepers to carry. MHS modified their intake procedures and their database and trained personnel to code as Gatekeeper all those who were referred through this method. Referrals to MHS have been low. The Task Force will make contact with Gatekeepers to reinforce the referral process and provide additional trainings as necessary.

What does QPR mean? • Q - Question P - Persuade R - Refer QPR stands for Question, Persuade, and Refer — the 3 simple steps anyone can learn to help save a life from suicide.

As a QPR-trained Gatekeeper you will learn to: • Recognize the warning signs of suicide

• Know how to offer hope

• Know how to get help and save a life The adult task force developed a survey for physicians to identify their referral practices and treatments for their patients diagnosed with mental health conditions. Currently updating the physician emails then the survey will go out by way of Survey Monkey to all adult and pediatric physicians in the community. The task force is also developing a resource list of mental health service providers for physicians to use as a referral resource. This resource list will be added to the Community Health Foundation directory in time for their next update. The Mental Health Adult Task Force will continue to partner with Mental Health Services, Springfield Fire and EMS and other area agencies to recruit and train Gatekeepers to assist and refer persons in the community who may be experiencing a mental health crisis. Next steps include obtaining a list of additional Gatekeepers, scheduling QPR classes to train new Gatekeepers, continued distribution of MHRB suicide prevention wallet cards and Gatekeeper resource materials, distribution and review of physician surveys and tracking Gatekeeper referrals to MHS. Evaluation of referral process for effectiveness is ongoing.

Substance Abuse, Prevention and Treatment Task Force Progress Report

The following information is a synopsis of the progress of the Substance Abuse Task Force in regards to goals and objectives completion. Included are table representations and narrative comments. The tables represent a visual depiction of the progress the task force has made toward the accomplishment of each goal as well as anticipated completion dates.

Substance Abuse: Community Outreach

Impact Objective: Decrease the number of Clark County residents abusing alcohol and other drugs SMART Objective: By March 2019, the Clark County Substance Abuse Prevention Treatment and Support Coalition

will increase community outreach regarding drug addiction. Evaluation: Pre/post survey results will show an increase in knowledge of AOD use and abuse

Process Objectives Related Activities Specific Dates Performance Management

• Create a coalition website Complete, Updates Ongoing

• Create an outreach presentation to include: • Stigma, Education, Services, Treatment, Support

Complete, Updates Ongoing

• Identify presentation sectors • Utilize Task Force community relationships to pull together targeted sectors: Community

Leaders, Business Leaders, Medical Community, Faith-based Community, General Public

• Presenters reaching out to community agencies/contacts to initiate educational events for targeted audiences.


• Conduct pre-evaluation • Evaluation to be developed, Pre-evaluation send with initial invitation or distributed at

sign-in

August 2017

• Deliver to presentation to sites August 2017

• Conduct post-evaluation • Evaluation to be developed, To be completed at end of forum or sent with Thank you.

August 2017

Substance Abuse: Programming

Impact Objective: Decrease the number of Clark County residents abusing alcohol and other drugs SMART Objective: By March 2019, the Clark County Substance Abuse Prevention Treatment and Support Coalition will assist in the prevention of Alcohol and Other Drug Use in Clark County as evidenced by the implementation of

one evidence-based prevention program. Evaluation: School survey results will show an increased knowledge in AOD use and prevention practices


1. Research evidence-based programs • Review curricula, Choose program-Botvin

April 2017

2. Secure Funding • Research Grants/funding sources, Apply

December 2017









MAR JUN DEC

SEP 2017







3. Identify possible implementation sites • Create list of possible sites, Create outreach letter/email, Send letter/call sites to discuss

programming

January 2018

4. Develop implementation plan March 2018

5. Develop MOU from implementation site(s) • Research MOUs, Create document, Sign

April 2018

6. Implement programming May 2018

7. Evaluate programming • Determine evaluation method, Complete evaluation, Analyze results

March 2019

Substance Abuse: Report Out

Impact Objective: Decrease in the number of Clark County residents abusing alcohol and other drugs SMART Objective: By March 2019, the Clark County Substance Abuse Prevention Treatment and Support Coalition

will distribute key data to the community as evidenced by the creation of a quarterly dashboard. Evaluation: Pre/Post surveys will show an increase in knowledge regarding AOD use


• Determine key data needed • Overdoses, Type of drugs being used, Demographics, Mapping


• Determine most efficient way to collect data • Drug Death Review, Children’s Services Drug Birth Report, McKinley Hall Stats, Mercy

Reach Stats, Law Enforcement/EMS stats


• Create quarterly Dashboard • Design, Determine what data to include


• Distribute information • Social service agencies, Mailings, Social media, Media coverage, Other outreach tools

January 2018

• Evaluate Dashboard effectiveness June 2018

Substance Abuse: Equipping Community Partners

Impact Objective: Decrease in the number of Clark County residents abusing alcohol and other drugs SMART Objective: By March 2019, the Clark County Substance Abuse Prevention Treatment and Support Coalition will increase community education regarding substance abuse as evidenced by the distribution of Alcohol and Other

Drug materials to law enforcement, healthcare providers, and other social services agencies.





















Evaluation:


1. Implement ‘Conversations for Change’ program • Identify host sites/partners, Promote program to the community, Hold events


2. Continue education/outreach by request


3. Continue to develop education/outreach materials December 2017

4. Distribute outreach items to social service agencies and law enforcement

• Future outreach/forums: Medical Community, Faith-based Community and General Population

December 2017

The Substance Abuse Prevention and Treatment Task Force/Coalition held its first public Community Forum on September 19th. The event was held at United Senior Services, both attendance and participation exceeded expectations. The forums have been very successful in reaching different segments for our community. Providing education and awareness in regards to the impact of drug addiction and its effect on the community as a whole.

In December the Substance Abuse task force/coalition conducted a strategic planning session. The session was well attended by members of the task force. The facilitator will share insights and make recommendations to the task force/coalition at the January 26, 2018 meeting. The recommendations will be taken under advisement and adjustments will be made to the current workplan to encompass any new goals, objectives or direction.








Additionally, the task force/coalition has created two more sub-committees, Social Media Sub-committee and Data Sub-committee. The purpose of the sub-committess is to assess data and develop tools. Utilizing these to increase the functionality of the task force as a whole. Educational endeavors continue through a muliti-prong approach, Lunch and Learn sessions, The Drug Free Workforce for employers, Botivin Prevention Program in the schools, forums, and speaking engagements. Also, the Warm Hand Off initiative is now in place and the Drug Disposal Bag project is underway.

The Substance Abuse Prevention and Treatment Task Force/Coalition will continue to hold forums in 2018. Also the task force/coalition worked with Shiftology to conduct a strategic planning meeting in December and will receive a recommendation report in January of 2018. Work plans and goals will be adjusted accordingly.

Tobacco-Free Living Task Force

The Tobacco-Free Living Task Force has made continuous progress towards meeting goals. Progress is evident by the completion of objectives set forth by the task force.

Tobacco: Community Engagement

Impact Objective: Increase community engagement regarding tobacco use and prevention SMART Objective: By March 2017, the Tobacco Task Force will increase community engagement regarding tobacco use and prevention as evidenced by the creation of a community-wide outreach video.

Process Objectives Related Activities Specific Dates Performance Management 1. Write and send a letter to schools explaining the

competition • Purpose; Topics students can cover – secondhand smoke, e-cigarettes, effects of

smoking, financial aspect, smoking in parks, etc.

June – August 2016

2. Hold a meeting with those interested in competing to: • Fully explain the project, the guidelines and due date; review process

September 2016

3. Provide Technical Assistance to students creating videos • Contacts; Information

March–April 2017

4. Review submitted videos & provide students with incentives

April 2017–March 2018

Tobacco: STAND Group Impact Objective: Increase youth involvement in preventing and reducing the use of tobacco-nicotine in Clark County SMART Objective: By March 2017, the Tobacco Task Force will increase youth involvement in tobacco-use prevention

Tobacco: Ordinance Impact Objective: Decrease the number of youth (21 and under) using tobacco products SMART Objective: By March 2019, the tobacco task force will increase the minimum age to legally purchase tobacco products as evidenced by the assistance in the implementation of a Tobacco 21 ordinance.

Process Objectives Related Activities Specific Dates Performance Management 1. Gather/create materials for outreach and education on

ordinance • Fact sheet, Talking points , Model language, Additional resources available

May 2016

2. Build coalition for support • Create outreach letter/email; Send letter/email to: CHC, CHF, RHC, MHRB, law

enforcement, Springfield City Schools, NTPRD, OSU Extension; Conduct Tobacco21 training; Gather testimonials from community members, doctors, educators; Identify connection to policy makers and gather contacts

May – December 2016

3. Identify council member/champion • Research past sponsorships; Create outreach letter/email; Who is the strongest

person to champion the effort?

May 2016 – September 2017

4. Present to council members • Reach out to city manager; Get topic onto agenda/set meeting date; Coordinate

with Mr. Geist & Dr. Crane to ensure their availability; Present to council; Await decision

September 2017 –March 2018

5. Media • Springfield News Sun, Education on the problem and solution, Social media

outreach, Coalition relationship with media, New Carlisle News, Springfield Paper

December 2017–March 2018
















as evidenced by the development of one STAND youth group.

Process Objectives Related Activities Specific Dates Performance Management 1. Identify adults in the community interested in supporting

STAND teams • Teachers, Youth group leaders, School nurses, FFA Groups, CTC and Catholic

Central

Jan–Feb 2017

2. Recruit youth to take a stand and become advocates against tobacco

• Letters to schools, youth church groups, youth social service organizations • Recruit at events IE: CTC Kick Butt’s Day 2a.) Gain commitment from students • Students sign pledges

Feb-Mar 2017

3. Train youth to provide tobacco knowledge • Dangers of tobacco use; Prevention; Cessation Services; E-cigarettes

April 2017

4. Plan Counter Marketing Activities • Type, duration, focus audience

Feb-Mar 2017

5. Execute Counter Marketing Activities Mar-May 2017

6. Evaluate May-June 2017

7. Sustainability Plans As of December 2017, STAND Groups are currently active in Springfield High School and Springfield Clark County Technical Center. Counter marketing plans finalized for 2018 including store audits.

September 2017- June 2018

Added December 2017

The Tobacco Free Lifestyle Task Force spent much of 2017 was spent building partnerships to collaborate with multiple stakeholders to promote the Tobacco 21 (T21) policy. The support of the smoke-free task force was key in this success and all projects were shared with the task force group during each meeting. This partner-building emphasis was part of the strategy with the smoke-free open spaces policy work, as well as the open space agreement with Clark State Community College, all key steps in building support for T21. New Carlisle’s smoke-free open and shared spaces policy was passed in 2017 and enforced through the efforts of the Creating Healthy Communities coalition’s work in the New Carlisle pool, the New Carlisle Parks system, including Smith Park and Willowick Park and the New Carlisle Haddix Field baseball/softball field. Finally, the survey conducted in New Carlisle in July and August, 2017 resulted in clear data supporting T21 policy and was summarized for presentation at the New Carlisle City Council meeting, planned for February 8, 2018. Results will be shared at the next Tobacco-free lifestyle task force meeting. Continued efforts should be focused throughout Clark County, including the City of Springfield, for continuing the momentum into 2018 for T21.The next Tobacco-Free Lifestyle task force meeting has been scheduled for February 22 at 3pm at the Springfield-Clark Career and Technology Center (CTC) campus location.

The task force will be supporting large-scale policy work in the form of multi-unit housing smoke-free policy for Springfield Metropolitan Housing Authority (SMHA) in 2018. The HUD policy mandate is a federal requirement and must be implemented locally in Springfield and Clark County on or before August 3, 2018. Policy revision was a key part of the work of the SMHA work team, with members of the task force in attendance. Work will continue on the final policy, expected to be completed in early 2018. During 2017, the task force saw work completed in resident engagement regarding the upcoming policy change, as well as communicating programs in the community for tobacco cessation














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support. Survey work supported the existing data that more than half of residents in all SMHA building sites are current smokers. Cessation service will therefore be critical to the success of the policy in 2018 and that challenge will be one of the task force’s primary goals for 2018. Finally, the task force received a report about the policy draft being written by SMHA’s work team. Although the policy was not completed during 2017, it is expected to be finalized in January, 2018 after revision and final legal review. Additional updates will be provided in the coming months and this objective will continue to the task force’s workplan for 2018. In 2017, Stand, a students against tobacco initiative, conducted 5 counter marketing activities, 40-60 store audits and 10-15 compliance checks. A one-page summary was completed and distributed to many stakeholder meeting groups, including a presentation to the CCCHD Board of Health. Stand group participants also made great strides toward helping Springfield City Schools enact a 100% tobacco free policy. Stand established a great relationship with Springfield Promise Neighborhoods by presenting at their summer camp. Stand also expanded programming to include Springfield High School and Springfield-Clark Career and Technology Center (CTC). Stand groups in Clark County grew to 30 members and will continue to grow in 2018. Stand will be completing more counter marketing activities, store audits, and compliance checks by March 2018. Based on the current grant cycle (scheduled July 1, 2017-June 30, 2018) Stand may be incorporating more policy work into the grant deliverables. This will be formalized during the upcoming grant continuation RFP, expected by mid-February. Working on smoke free public spaces and T21 may be among Stand’s future goals. As directed by the CHIP objectives, an interactive video illustrating the risks of tobacco use was created by the Stand group in 2017. The video highlights the risk factors and consequences of tobacco use. This video will be utilized for counter marketing activities, including disseminating it through posts on Facebook, Instagram, and Twitter at the beginning of March to celebrate Kick Butts Day on March 21, 2018.

Physical Activity Task Force Progress Report In 2017, the Physical Activity Task Force experienced reshaping and reimagining with a change in personnel and leadership. The task force goals were revised to make them specific, measurable, attainable, realistic and timely. A new program was launched to address obesity rates among children in Springfield Promise Neighborhood Schools. The task force is currently running an after school activity club through Springfield Promise Neighborhoods with the goal of increasing knowledge and self-efficacy surrounding physical activity among students at Lincoln elementary school.

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CHIP Organizational Structure

Steering Committee

Chronic Disease

Task Force

4 Goals

Healthy Births and

Sexuality Task Force

3 Goals

Mental Health Adult

Mental Health Adolescent

Task Force

5 Goals

Healthy Eating

Task Force

3 Goals

Physical Activity

Task Force

3 Goals

Substance Abuse

Prevention and

Treatment Task Force

5 Goals

Tobacco

Task Force

3 Goals

Community Health

Improvement Planning

Coordinator

community health improvement plan 2016-20193.2 action items 3.1 identify target audience via...

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