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1 Presenter Disclosures Transforming a Funding Crisis into a Growth Opportunity: Demonstrating Presentation Collective Impact Title Here Francie Wolgin Marilyn Crumpton June 17, 2015 Line if Needed Additional Francie Wolgin, MSN, RN Marilyn Crumpton, MD, MPH The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose Date Here 1 Vision Rebuilding Public Schools to Revitalize Declining Neighborhoods Presentation Objectives n Describe how to use the community learning center model to involve schools, community stakeholders, potential medical and funding partners interested in expanding SBHCs n Identify how to problem solve challenges and leverage unique opportunities to expand services for students and/or community members n Explain how to attract public/private/state/federal funds for startup and long term sustainability n Define how to demonstrate the collective impact of a transformational SBHC expansion project 3 n Respond to the poor condition of public school buildings n Rebuild all public schools, funded by local levy Facilities Master Plan n $1 Billion local levy to rebuild all schools community investment n Reinvent neighborhoods with schools as the hub Community Learning Centers 4 1

2 Public School Partnerships n Community Learning Center Model n Whole community buy-in n Community engagement process for each neighborhood to be part of redesign of school n Health identified as an unmet need in almost all neighborhoods Community Learning Centers Cincinnati$Public$Schools$ Strategic$Plan$with$ Family$ Green/Healthy$ Mission,$Goals,$and$ Engagement$ Strategies$for$Improving$ Schools! Com$ Student$Outcomes$ Early$ Growing$ Childhood$ Well$ College$ Students,)Families,)Communities)in)) Leave!No! Community)Learning)Centers) Access$ Child!Inside! $ Children s$ Mentoring! Oral$Health$ Network$ MindPeace$ Adopt$ A$Class$ Tutoring$ Business$ SchoolGBased$Resource$Coordination$ Partnership s$ 5 Cross%Boundary%Leadership%Team$provides$infrastructure$through$ the$coordination$of$networks$of$community$agencies$and$resources$ to$support$the$efficient$and$effective$administration$of$community$ Learning$Centers$.$$$ 6 Community Learning Centers n Schools with Resource Coordinators n Community partners with independent selfsustaining funding to address non-academic barriers to learning n District level cross boundary leadership team of network partners From Crisis To Opportunity n Background December 2010 n Half of funding for School Nurses from City n Economic downturn n Decreased revenue from city tax collection n City Council Proposed cuts to CHD of $3.6M No warning of cuts or time to find alternatives Cuts not performance based Targeted CHD Services: School nurse program and testing lab Opportunity sustainable SBHC model 7 8 2

3 THE RESULT: Community Response City of Cincinnati Community and civic leaders stood up in partnership Date: To: April 26, 2011 Civil Service Commission From: Cincinnati Board of Health to advocate and maintain school health services Subject: Layoff Statement of Rationale (School Health and PHC STD Training Center) The Cincinnati Board of Health as the appointing authority for the Health Department is submitting the following statement of layoff rationale to the Civil Service Commission to delete the following positions from the table of organization due to lack of funds: Parents Teachers Students Nurses Code Program Description Public Health Nurse 2 (41 positions) Public Health Nurse 3 (4 positions) (Plus many others; the above edited for brevity) Foundations Churches Civic organizations, United Way Hospitals and others 9 Interact Response 10 Health System Partners Interact for Health Foundation leadership and immediate financial resources to: n Growing Well a collaborative to develop n Continue uninterrupted school health services n Lead a planning effort to: n Enhance school health services n Develop a sustainable long term model to ensure health and academic success of Cincinnati children 11 health services in schools n Partner types n Three Federally Qualified Health Centers Children s Hospital Medical Center operates n Mercy Health n Cincinnati 12 3

4 Growing Well in the School District n Develops Health Network n Represents health partners at district level n Ensures partner integration with school n Works with school & community to design solutions n Works with partners to create sustainable services STEERING COMMITTEE MEMBERSHIP Interact for Health Board of Education Board of Health CHD Cincinnati Public Schools Growing Well Cincinnati Cincinnati Children s Hospital Mercy Health OneSight Community Learning Center Institute Children s Home of Cincinnati MindPeace United Way Deaconess Foundation Greater Cincinnati Foundation Oyler School 13 Work Plan n Determine the need and build a case for support for a sustainable integrated care service model for inner city school children n Consider how a collaborative approach could acquire a broader base of funding and support to provide startup and implementation funding n Integrate data and develop a map to help identify and predict the most sustainable choices or business opportunities DEVELOP A SUSTAINABLE LONG TERM MODEL

5 Health Access Problem Data Sources: PowerSchool Electronic School Nurse Data 17 n Immunization status n Emergency conditions n Chronic conditions reported n Asthma n Body mass index n Medical care referrals n Health center enrollment status n Dental health 18 Schools Who Would Benefit from Health Center n Adequate population n 600 students n 80% Free/Reduced Lunch n Identified unmet health needs n School readiness for partnership n Full time services planned n High schools Funding Model Considerations n Staffing n Productivity n Consent for services n School Integration n Funding/billing considerations

6 NETWORKS OF PARTNERS Engaging New Funding Partners 22 Health Partners n Three Federally Qualified Health Centers n Two Health Systems 23 Key Components n Business Model Development n Planning & Implementation funded by private foundation InterAct for Health n Self-sustaining model after implementation grant n Centers linked to a health system n First centers in 1999 by Children s Hospital n Ten centers by 2011 n Twenty one by

7 Collective Impact n New Model COLLECTIVE IMPACT n New Partnerships n Data Driven Change n Determine the Outcomes n Change the Outcomes n Create community ownership School, Family & Student Engagement

8 Primary Care OneSight Vision Center Improving Outcomes - ROI Vision Partners

9 Dental Services n Partner with School Nurses n Dental Screening n Consent for Services & Transportation n Sealant Program n Portable Dental n Full Time Onsite Dental Centers Delta Dental at Oyler Portable Equipment Permanently Placed CHILDREN S ORAL HEALTH NETWORK OYLER DENTAL CLINIC Estimated Open: August 2013 Use Amount Source Timeline Renovation $25,000 TBD May 13 Clinic Equipment $140,000 TBD June 13 IT Equipment $20,000 TBD June 13 Implementation $150,000 TBD July 13 $335,000 Additional Funds Necessary Delta Dental at Oyler 36 9

10 Four Chair Dental Center in a High School 37 Withrow Third Dental Site in a High School 38 Outcomes n Coordinated medical home & SBHCs n Asthma, Vision & Dental n Development of rural model based on success n New investors in SBHC model implementation n State legislation pending for Community Learning Center model option statewide in Ohio n State workgroup on SBHCs

11 Changes n Expansion 21 primary medical sites with 5 partners n Three dental centers n First Center Oyler 5000 visits in 2 years n One vision center n 3,000 students annually n 54 schools n Several centers operate as community sites n Transportation to hub services Questions? n Asthma control

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