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2022-144-Minutes for Meeting December 13,2021 Recorded 4/15/2022• COMMISSIONERSBOARD OF 1300 NW Wall Street, Bend, Oregon (541) 3 88- 65 70 Recorded in Deschutes County C J2�22_144 Steve Dennison, County Clerk Commissioners' Journal 04/15/2022 4:24:02 PM :0i1 f,S co" v 2� o 2022-144 FOR RECORDING STAMP ONLY 12:00 Noon MONDAY, December 13, 2021 BARNES & SAWYER ROOMS Virtual Meeting Platform Present were Budget Committee Members Bruce Barrett, Bill Anderson and Mike (Maier. Commissioners Phil Chang, Patti Adair, and Anthony DeBone. Also present were County Administrator Nick Lelack; Chief Financial Officer Greg Munn; County Counsel David Doyle (via Zoom Conference Call); Budget Manager Dan Emerson; Budget Analyst Betsy Tucker, and Sharon Keith, Board Executive Assistant (via Zoom Conference Call). Attendance was limited due to the Governor's pandemic order. This meeting was audio and video recorded and can be accessed on the Public Meeting Portal of www.deschutes.org. CALL TO ORDER: Chair Bruce Barrett called the meeting to order at 12:04 PM OPENING COMMENTS: County Administrator Nick Lelack provided opening comments and reviewed the agenda for the meeting. Chair DeBone congratulated Nick Lelack and his new position and commented on the budget process and items to highlight for the upcoming year. Commissioner Chang commented on capital projects, construction needs, and services to the community. Commissioner Adair expressed concern with inflation and the impacts to our community and stressed the need for the County to help our local businesses. Mike Maier commented on BOCC BUDGET MEETING DECEMBER 13, 2021 PAGE 1 OF 5 recreation opportunities and the benefit to our County. Bill Anderson commented on the growth in the County and health insurance rates. BUDGET COMMITTEE REAPPOINTMENT: Mr. Lelack noted the terms for the appointed members of the budget comment and reported the term for Bill Anderson is expiring December 31, 2021 and inquired if he would be interested in serving another term. Commissioner DeBone supported the reappointment. ADAIR: Move approval of Bill Anderson's reappointment for an additional three years. CHANG: Second VOTE: ADAIR: Yes CHANG: Yes DEBONE: Chair votes yes. Motion Carried FY 2021-2022 UPDATE: CFO Greg Munn introduced Budget Manager Dan Emerson and Senior Analyst Betsy Tucker. Mr. Munn provided the County finance update. RECESS: At the time of 12:56 p.m. the meeting went into recess and was reconvened at 1:12 p.m. DEPARTMENTAL BUDGET ISSUES: County Administrator Lelack presented departmental issues for fiscal year 2023. • Health Services: Public health modernization continues to receive additional funds and revenues. Personnel costs are under budget due to vacancies. • Behavioral Health: Trends show they will have less revenue coming in than projected. Business Officer Cheryl Smallman commented via Zoom regarding behavioral health funds. Mr. Lelack acknowledged several capital improvement needs of the department. • Solid Waste Operations: The Knott Landfill cell 9 project has been postponed until the next fiscal year due to the volume of exaction. Perimeter fencing BOCC BUDGET MEETING DECEMBER 13, 2021 PAGE 2 OF 5 and siting projects are underway. Negus Transfer Station is in the planning stages. Interviews are scheduled tomorrow for a new operations director. • Fair and Expo: Trending positive in fund balance. Additional funds are expected for capital improvement needs. • Road Department: Highway fund revenue is exceeding expectations. • Community Development Department: Revenue has increased primarily due to fees with increased valuations and expenditures have decreased. Peter Gutowsky was promoted to the new department director position. • CommunityJustice: Anticipating less than budgeted resources yet significant personnel savings. • Adult Parole and Probation: Anticipating more resources than budgeted due to state funding. Deevy Holcomb was promoted to the new department director position. • Facilities: Mr. Lelack reviewed the projects on the horizon. • 9 1 1 Operations: Additional unplanned revenue received for telephone reimbursement. • DistrictAttorney's Office: No changes • Legal: Current position vacancy for Assistant Counsel. • Natural Resources: There will be matching funds needed for a FEMA grant for a fuels reduction project. Clerk's Office: Trending behind budget amount but nothing significant. RECESS: At the time of 1:55 p.m. the meeting went into recess and was reconvened at 2:13 p.m. OTHER UPDATES: County Administrator Lelack reported Whitney Hale was promoted to Deputy County Administrator and Morgan Emerson was hired as Public Information Officer. • Room Tax Update: Mr. Munn reported on the transient room tax update. • Long -Term Capital and Financing: Facilities Director Lee Randall presented an update on capital improvement projects. • Financial Impacts of Recent Litigation: Deputy County Administrator Erik Kropp reported on the expenses of recent litigations coming from personnel BOCC BUDGET MEETING DECEMBER 13, 2021 PAGE 3 OF 5 issues at the Sheriff's Office and impacts to general liability insurance and to the risk management fund. • Healthy Schools Project with Bend La Pine Schools: Public Health Director Nahad Sadr-Azodi presented regarding the healthy schools project along with Health Services Supervisor Jessica Jacks, Health Services Supervisor Aimee Snyder and Deputy Superintendent Lora Nordquist. • Impact on Labor Shortage: Human Resources Director Kathleen Hinman presented the analysis. • Update on District Attorney's Consultant Plan: District Attorney John Hummel presented the consultant plan for recommendations for the District Attorney's Office. • County Homeless Activity Discussion: Erik Kropp and Program Manager Molly Wells Darling (via Zoom Conference Call) presented an update on the joint office for homelessness pilot program. FY 2022-2023 BUDGET: • Assumptions: Mr. Emerson reported on assessed value increases that will make up revenues. Cost of Living and inflation are high this year. There are 1, Charges to DERC, rates for the rurren1- fiscal year. Health insurance rates 11V %-11 1 �... LV 1 1 J 1 � for 11V ` 1 V Il IIJ - may need to be increased in the next fiscal year for the department and employee. No change in property tax rates. Labor contracts are in negotiations and expected general fund transfers to be similar to last fiscal year. • Calendar/Budget week timing options: Senior Analyst Betsy Tucker presented options for the budget hearing week in 2022 based on comparisons with other Oregon counties. Recommendations were to reduce the department presentation times, create a three day agenda: two days for presentations and one day for deliberation, and start the budget week with a high level financial overview. The other consideration was to hold the hearing week prior to Memorial Day. Commissioner Adair is supportive of moving the budget week to the week prior to Memorial Day. Bruce Barrett supports tightening the department presentations. Mr. Emerson will send out an online poll. • Number of Health Services presentations: Mr. Emerson reported the Health Services department is requesting additional presentations. Mr. BOCC BUDGET MEETING DECEMBER 13, 2021 PAGE 4 OF 5 Lelack suggested a draft budget schedule and the plan will be to move the budget hearing week the week prior to Memorial Day starting on Monday. New Budget book software: The new software will provide flexibility. ADJOURN: Being no further items to come before the Budget Committee, the meeting was adjourned at 5:02 p.m. DATED this Day of .I 2021 for the Deschutes County Board of Commissioners. p ANTHONY DEBONE, CHAIR PHIL CHANG, ICE CHAIR PATTI ADAIR, COMMISSIONER BOCC BUDGET MEETING DECEMBER 13, 2021 PAGE 5 OF 5 Deschutes County Budget Committee Update December 13, 2021 - 12:00 pm — 4:30 pm Barnes & Sawyer Room and Zoom This meeting will also be Live Streamed on the Public Meeting Portal at www.deschutes.org/meetings In response to the continued COVIDI9 public health emergency, we are limiting in -room space to staff and offering virtual attendance for the public through www.deschutes.org/meetings and for staff presenting through Zoom. 12:00 Working Lunch • Call to Order Bruce Barrett, Chair • Opening Comments Nick Lelack, County Administrator Board of County Commissioners 12:20 Budget Committee Re -appointment 12:35 FY 2021-22 Update • County Finance update • American Rescue Plan Act • PERS 1:20 Departmental Budget Issues 2:00 Break 2:15 Other Updates • 2:15 Room tax update • 2:35 Long-term capital and financing • 3:05 Financial impacts of recent litigation • 3:15 Healthy Schools project w/BLP Schools • 3:30 Impact of labor shortage • 3:40 Update on DA's consultant plan (link here) • 3:50 County homeless activity discussion 4:10 FY 2022-23 Budget • Assumptions • Calendar/budget week timing options • Number of Health Services presentations • New Budget Book software Nick Lelack, County Administrator Greg Munn, CFO Nick Lelack, County Administrator Greg Munn Lee Randall, Greg Munn Erik Kropp Nahad Sadr-Azodi, Jessica Jacks, Aimee Snyder & Lora Nordquist Kathleen Hinman John Hummel Erik Kropp & Molly Wells Darling Dan Emerson, Budget Manager 4:30 Wrap up Bruce Barrett, Chair 121812021 ff oTq Cam= 12/8/2021 rr_m 5.7%/year average ro',ath since 014 5.4% FY22 budgeted growth 5,58% actual growth Market Value 11.3%/year average growth since 2014 4 2 12/8/2021 Deschutes County Tax Levies Countywide Levies County Permanent Rate 1.28 1.22 33,413,109 33,664,773 County Library (est. FY22 budget) 0.55 0.55 14,143,804 15,028,135 Countywide Law Enforcement 1.25 1.05 28,420,313 28,689,694 County Extension/4H 0.02 0.02 609,233 614,575 9-1-1 0.43 0.36 9,803,579 9,886,872 Total countywide Levies '3.53 3.20 86,$90,038 97,084,049 Additional Levies Rural Law Enforcement —Sheriff 1.55 1.34 11,813,562 11,905,563 SunriverServiceDistrict— PoliceandFire 3.45 3.31 5,278,077 5,294,330 Black Butte Ranch Service District — Police 1.05 1.05 724,895 736,803 Black Butte Ranch SD Local Option —Police 0.65 0.65 448,788 456,160 Total Add tionai Levies 6.70 6,35 18,265,322 18,392,856 Wh`� E S COG2� O 5 Current & PY collections +5.3%/yea r average since 2017 IN +5.4% est. in FY23 I C 3 12/8/2021 fA 8.5%/year average increase since 2017 4.8% estimated growth in FY22 1.2%/yea r average increase 2000-2012 +15%/year average since 2012 FY22 could be +30% ES N. 2 12/8/2021 IM Economic Development Funds IM 10% average increase/year 10 12/8/2021 Slowly increase rates to balance fund balance 0-2% increase for FY23 in Last rate increase FY17 5% rate decrease in FY20 I 11 American Rescue Plan Act Update IB AdlW 437,M '92.000 35 Aff".W H 14 9190m00 COMM _14 15 Affordable Moll 0-11h1p KWCo,,ll,o,UndTl,SI Up— Affordable and WIM111, HIllS in Sisters, ll- �16 H 17 Habra for ­,lWUP:,, �111, Affl1d bil, Ho,1J,,, in South County,_ H, tYU SuE—,Slxy/C1.I CVHomeHo Repairs � in loathColl, IS Hlb,tlt for Vine 300,000 f., HumanityB ld 12 I. —homes 2 _ SIflo; A H,bA't for H. 31 tfor zl,:Yy 'Slsten WoodlandZ o"" Alyd—l—Af! I f""'o" .E 23 lull,g — and of 5,,l, Coon 1. Rld—d M Reserve f" future lM.od4No/.o1kfo,tQ housing 011AItl 25 AW. Mb" ",..d mdmtrkk 26 BendN,k 69%— ..b-d 30D,000 28 Regional S-41,old Needs M-1.1l IMP —11 Pill 300, 30 ilf—l-ol -1, Ka, (Beld East: Boy—d G,1, C4,o, St Charles) 2.1W.000 71 llfl--:�,�: . -il Klh (Bend Well M 72 t,"l— M,ullls- (to '— ReJmondl 600,000 lofll—to llVi1lgo(,­- lSd,RoJll,dj 3W� 4 Infrastructure Small C—, Cl,-W fund -Ts Wol,.1.:P 0-1.p=�: CMI S.'i — US- 36 "— D1.1— lIlSl-,Y it—lo 406.000 37 W,,kf—D-1oP,ol,, 284, M Workforce Development N1 FlMT,,k 39 W6fl, D—Ilp— A,,I— 1. W "SSOIO A1,Md 1017 Pop, WI(= food voyforOlder AW1, UPI,— ---- .—h—o exwnslon LlW.� 240D" 12 I 0 12/8/2021 --------------- 1'.a Ne /Rro)eCi Request The G.", plate 20U 000 SOO,WU ar aessaess basssso 4,6ssAoo BCM Htteas vets vmage comn„[:mn aepMn 2lw.mo BeNkhem Inn Redmgr.4 9W.OW CMSVe[tion of ClwelanO Avenue Prgttl 2,200,000 2.09D,000 Homeless Q.—h Caunty wide Services 1,065,000 M,w dCamp Cityof Bend 750.b00 750.000 Master plan assistance for homeless service Campus in east Redmond 3Z.050 Ncw f in Pedmosd OperaVnP St, epPen ror Existirq Sisten Cold Weather Shehers 50.000 Ald.—M Oays Village P"$,t 36 ].500 Savinit Grace lnfraxtru[ture Shepherds House Redmond Gtchen 300,000 SiHen Card Weather 5neiter 1,000.000 smolt MeaM1h 30,66S,0S4 S,16$,184 Additional Ca+nry ckanir,e supp!,es and labor )annual) 168.000 AdC:npnal County [:can•nR supplies and labor EY31 49.000 circuit Coun CUV,D prevention 42R,]Sa could Testing 2W.W0 —D testis& - Dr. young 15,000 I.SOD.000 Health Unlr—CMseq�en<gs Higher rated HVAC filters I., C.—f.1-:.. morel liabiary Insvmn[e 8,186 Mobdc mw8ue eapansian unit 82000 Mob,lete[hagm upgrade for the Ckll 6.WD NonH.punt, heath holM acquisroM and rq —1 8,300000 NOnM1 County hea!Ih faults furteture, I,rtNes and equipment 691.]W 0utrea<n Van 05.000 pub:w Hca:N Response CMbngenry 1,SW,000 South County Oulck aesponsc U.1 and Surreys I80,000 Techndcgy enhancemems for ceiemedclne and [o0nboration 2M.W0 temporary Staffing Its COVIb 19 Pesppnse and WVea[h (Contatt tracers. Case!nvestx¢.nors. anJ Call Center staf0 " <n..,n r.......,,,..n„e n. v.s.. — I.000.000 20.m 13 CeteBory/project Requgit 5 f"R" mn8 Request ApRpoll roved 6 ]8 Uvsanmte. for laic d0•� 19 S.0 Busineasi Norrpro4ft Aoi6—e M46AZO 1,600,D00 80 eoysand Girls Club O-d etonomi[Impact 619,dba 81 Business AssistaPCe Waceholder 1,500,000 02 ba pine Chamber of Commerce 25,900 83 Redmond Chamber loarcvenue Bd,W9 Bd Pedmond Chamber Rcdm WParkiet 40,000 85 Pedmond Rotary MOO 86 Ponald McDonald House Chardies M000 81 School of Enr2hme—Ewnpmi[Hardship 520,002 88 Sisters Chamberof Commerce 49,060 89 Sisters Rodeo Assaf I- "0,1)p0 90 Small business grants 5lsters CDC 350,000 91 Sunnver Area Chamberof Commrerce pandemic economic impact ]8,325 92 Sundver Area Small Business AsssWnce Grant Program and HidnR Campa�n 350,1p0 93 Watts lMrostNotttre Z,ZBOp00 2,250,000 94 Do"hvtos countyO farmERl[iency Water Conservation Investment 1,450,000 95 Neighbodmpact souN caunry septic replacement program 1.000.000 96 T—obonne Wastewater System 1,750,000 300.000 97 Tvmalo Sewer System Reterve/Na<eholdcr $00,000 14 T E$ 12/8/2021 PERS Employer Rates Excludes pick up and debt service 0 Current 2021.23 0Advisory 12.31.20 r Estimated 2023-25 24.5% 23.7% 21.0% zz 2s,., 210/ 19.8% .. 18.9% eF r� 16.6% s'-igs3 15.4% r ,sg: IS ".p�, 3 Pik MINN M01 >, Tier 1/2 CGPSRP GS CiPSRP PF 15 W1. Biennial rate cycle • Current 2021-23 rates in effect through FY23. • Advisory rate increase of -3.5 pts due to lowering of assumed rate from 7.2% to 6.9%, an increase of $2.9M in PERS costs Next rate cycle will be based on 12.31.21 earnings which is 17.3%through October If it holds rates are projected to increase only 1.2 points, a $1 Mqkre#�se ME 12/8/2021 Average since 2014 = 5.5% FY22 = 5.65% actual increase on budget of 5.4% FY23 assumption = 5.55% 17 TB® for FY23. Based on 12 month average as of January 31, 2022 Labor contracts 1.0% v 3.5% 18 ES M 12/8/2021 •; change from current FY FY23 is • year of biennial rates Includes i , rate credit from new side account rA New published 19 • 20 Es Es 10 12/8/2021 Other Assumptions for Next Yea] In Property Tax Rates - no change from FY22 Interest Earnings - current pool rate = 0.45%, portfolio rate = 0.65% and declining - FY23 rate TBD * Labor contracts expiring 06.30.22 (911, SO/DCSEA) General Fund Transfers - similar to FY22, TBD General County Reserve Internal Service Funds - continue review of fund balances and contingency requirement 21 Budget_ • , of • Health Services presentations - h• New Budget , • • , 22 11 12/S/2021 am. -TRIM 23 12 12/8/2021 L= TRT county d state history • legislation Eligible uses of funds County•history Other Cities & Counties MEN Piff a • Es 1 12/8/2021 First levied in the county at 5% in 1975 No statute explicitly authorized the tax - imposed under the county's general taxing authority ® No restrictions on use -100% discretionary 1% added twice (1980 and 1988) • 1st 6% spent on tourism promotion (20%) and general county operations (80%) • The 1988 1%was spent on the Welcome Center ancj�,EScoG� tourism promotion 3 11 99.M!*IM • Enacted a 1 % (now 1.5%) state tax and restrictions on local spending ® State revenue funds the Oregon Tourism Commission dba Travel Oregon New local rules 1. Pre-2003 spending ratios must be rpainained in the future 2. f=Uture spending... ._ 1/:31-11 to tourism promotion and tourism - related facilities _ 2/31-d general county operations 4 TRT Collections � Original 7% 3,016,819 Tourism Promotion COVA 863,962 Tourism Facilities Welcome Center Debt Svc 77,000 o Fair, RV Park 940,962 Total Tourism /as 0111111111 of cm,%ections 31 1 General County Purposes Sheriff 2,061,238 Other Admin 14,619 Unallocated aI General Pur oses 2,075,857 1s a percent of rotlectians 69o, a 12/8/2021 *TI.M.76M ID At least 70% of any new tax must be spent on tourism promotion/facilities Remaining 30% may be used for general county purposes ® County levied an add°I 1% in 2014 70% to Fair & Expo operations, 30% to FEE capital reserves 5 A Or tool]% Grp-;z„1 �,, Mc. Totals%�' TRTCollections 3,016,819 12,591,309 1,798,758 14,390,067 Tourism Promotion COVA 863,962 3,903,621 3,903,621 Tourism Facilities Welcome Center Debt Svc 77,000 air, RV Park 25,744 1,259,131 1,2841875 940,962 3,929,365 1,259,132 5, 188,496 tal ToTourism As a oercentof m.Peetions 31% 3i 7>'>�' General County Purposes Sheriff 2,061,238 3,651,787 3,651,787 Other 650,373 650,373 Adman 14,619 195,325 27,904 223,229 Unallocated 4,164,459 4,164,459 511,723 511,723 2,075,857 69% 8,661,944 6s.' 539,627 "'' 9,201,571 Total GerreralP ores 1 A; unzrcentofmtiecfions 3 12/8/2021 FY 2021-22T RT Budget ` Budget `- Projection COG `�uZES n, Change Budget Projection Change Beginning Balance $aS,OOO,Otltl 2.0% 540,000,000 " "Collections 1•$% $35,000,000 ®Tax Rate 1.6% 1.4% $30,000,000 1.2 $25,000,0OO 1.0% $10,000,000 0.4% 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 E3 E3 12/8/2021 Portland Metro Willamette Valley Central North Coast 1p1 Central Coast Southern`` Mt Hood / Gorge South Coast Northeastern Southeastern $- $200,000 $400,000 $600,000 $800,000 $1,000,000 Dollars in Thousands - 2018 Data I 0% 2% 4% 6% 8% 10% 12% 14% 10 ES M 12/8/2021 Tourism and promotion Law enforcement Public road and drainage improvements Parks improvement (restroom and signage) Fair & Expo advertising 11 PROJECTED FY 2022 TOTAL TRT COLLECTIONS txl1f8 c--)-8,7t.--, r SuscainabilityFund $277,495 $SS4,990 12 -IIIIIIIIiiiii- ® Fire protection education Tourism education General county services General Fund Campgrounds s iEs 12/8/2021 • Negative economic impact of pandemic • Defray property tax increases • Road maintenance • Law enforcement • Search and Rescue • E MTs s Enhancing/adding bike and pedestrian ways and maps • Homeless shelters • Parking structure downtown • Hwy 97 bypass near Cascade Village © New Courthouse 13 14 • Reserves • No additional tourism promotion funding • Update Vince Genna Stadium n Restroom infrastructure at local parks • New mountain bike trails • Repair deteriorated corrals, campsites and water systems at horse camp near Sisters • Reconstruct eroded trails at Newberry Crater • Improve signage of cross country ski trails near Three Creek Lake �S ES r Es N O N m a� E a) u 'E E 0 u a bA m +-j C O u V) w 4 u Ln a� 561 a CD k-0 0 73 L.L cx� 4� a U M Irl-mool" 0. 4- L I) MOdom 1") m 0 %I L�J a a wo , w m . 0 4 061, o L�J Lf) 4� QJ E 0 E a) Ln Z5 0 Ln QJ LL 0 50" -1 ml000", 6 lo' 4*-m ----------------- 4 > cd :3 0 MR Sk a mi a a 6 �\ �0w. �) E S CO 4t) �-A ® e ♦ - BEND LAPINE S e h O a 1 $ EDUCAT INC 'rH RIV IBIC CITI I2N5 i Healthy Schools is a partnership between Deschutes County and Bend — La Pine Schools providing public health services directly within schools and school communities using collaborative, systemic, and integrative approaches so thatschool leaders, staff, students, and families in Deschutes County have access to high quality health promoting programs. DESCHUTES COUNTY I Health Services, Public Health, Prevention and Health Promotion For More Information: healthyschools@deschutes.org Rev: 11-22-21 Table of Contents Important Terms and Definitions used in the Healthy Schools Program Plan 2 Summary 4 Rationale for a Healthy Schools Program in Deschutes County 4 Description of Student Health Needs in Deschutes County 5 Recommended Approaches and Frameworks for School Health 8 Design of Healthy Schools in Deschutes County 13 Mission, Goals, and Strategies 16 Key Performance Metrics 17 Implementation Plan 18 Evaluation Plan 25 References 27 Appendix A 31 List of `Tables and Figures Table 1: On -Time Graduation and Chronically Absent Rates for School Districts, Deschutes County 5 Table 2: Select 2019 Healthy Teens Results for Deschutes County 6 Figure 1: Screenshot from Central Oregon Regional Health Assessment representing new chlamydia diagnoses by age group 8 Table 3: 2020 HPV Immunizations for 13-17 year olds in Oregon 8 Figure 2: Whole School, Whole Community, Whole Child model 9 Table 4: Summary of the 10 Components of Coordinated School Health 10 Figure 3: Multi -tier System of Support Model 15 Table 5: Year 1 Timeline Table for Implementation Plan 20 Table 6: Year 2 Timeline Table for Implementation Plan 22 Table 7: Year 3 Timeline Table for Implementation Plan 23 Table 8: Year 4 Timeline Table for Implementation Plan 25 Table 9: Sources of data and timelines for accessing and reporting data 27 4 Important Terms and DefnilOons used'; in the Healthy Schools Program Alan Multi -Tiered System of Supports (MTSS) - a model used in the education field that includes three tiers of supports layered upon each other to meet student needs (PBIS Rewards, 2021) • Tier 1 - The foundational MTSS layer that provides universal supports to all students in a school environment; About 75-90% of students have their needs met through this universal level of support • Tier 2 - A second layer of support, often in small groups, for students with additional needs not fully met by Tier 1 alone; About 10-25% of students need this additional layer of support and have their needs met between Tiers 1 and 2 • Tier 3 - A third layer of support that is usually individualized to provide students with needs not met by Tiers 1 and 2; Less than 10% of students need individualized supports Public Health Prevention Framework - a model used in the public health field that includes three levels of prevention along the continuum of disease development • Primary Prevention - Before a disease or condition ever begins to develop or before someone is exposed to a known disease -causing agent (like a virus, toxin, or addictive substance), primary prevention services aim to reduce preventable risk factors and protect against possible unpreventable risk factors that are commonly associated with a disease or condition • Secondary Prevention - After someone has been exposed to a disease agent or certain risk factors, a disease or condition may be developing without noticeable symptoms, secondary prevention services aim to detect and treat a disease or condition early before symptoms appear to prevent symptoms or adverse effects of an underlying condition that could progress to a more severe level Tertiary Prevention - After a disease or condition has developed symptoms and adverse consequences, tertiary prevention aims to rehabilitate or accommodate the symptoms and consequences to prevent additional adverse effects Institute of Medicine (IOM) Intervention Classification - a model used in the public health field that includes three classifications for the scope of audience or recipients for a service • Universal - services delivered or interventions impacting an entire population, regardless of the level of risk or need for individuals • Selective - services delivered or interventions targeting certain groups of people based on known risk factors or associations • Indicated - services delivered or interventions tailored to an individual based on a specific indicator of disease or condition Optimal Health - the dynamic balancing between fluctuations in the environment and an individual's physical, mental, emotional, social, spiritual, and intellectual health (National Academy of Science, Engineering, and Medicine [NASEM], 2020) School Health - a field of public health centered on promoting health through schools and school communities to create conditions for all students to thrive Coordinated School Health model - a model developed by the Centers for Disease Control and Prevention to improve coordination and alignment of school health improvements across all components of school health Whole School, Whole Community, Whole Child (WSCC) model - an expanded version of the Coordinated School Health model, merging Coordinated School Health with the Whole Child model commonly used in the education field School Health Index - a comprehensive tool aligning with the Coordinated School Health model and the Whole School, Whole Community, Whole Child (WSCC) model, providing standards for school health practices Positive Youth Development (PYD) - an approach to youth development that can be applied to any context and has largely been applied and researched through 4H programs; Many PYD models exist, but one leading model is the Six Cs which focuses on youths' development of character, competence, confidence, connections (to adults and peers), caring/compassion, and contribution to community or society; Social and Emotional Learning is considered one model that aligns with parts of the PYD approach (Shek, Dou, Zhu, and Chai, 2019) Social and Emotional Learning (SEL) - "the process through which all young people and adults acquire and apply the knowledge, skills, and attitudes to develop healthy identities, manage emotions and achieve personal and collective goals, feel and show empathy for others, establish and maintain supportive relationships, and make responsible and caring decisions" (Collaborative for Academic, Social, and Emotional Learning [CASEL], n.d.) School -wide Social and Emotional Learning (SEL) - an approach to extending SEL beyond the classroom and instructional time in order to embed SEL into all aspects of the school environment and engaging youth and families in the process Social and Emotional School Climate - a positive school environment that fosters social, emotional, and mental wellbeing and inclusiveness for all students, staff, and families; a positive social and emotional climate in schools is associated with great school connectedness (Centers for Disease Control and Prevention [CDC], 2009) School Connectedness - a students' belief that adults and peers in school care about their learning and them as individuals; School connectedness has been found to be the "strongest protective factor to decrease substance use, school absenteeism, early sexual initiations, violence, and risk of unintentional injury" and the second most important factor, next to family connectedness, to protect against emotional distress, disordered eating, and seriously considering or attempting suicide (Centers for Disease Control and Prevention [CDC], 2009) 0 Rdt1O11die fQl" a Healthy $ChOOIS PrOgC 'M Li 111 eSCFII#fiES County Schools area logical and efficient setting for public health interventions for youth, with the potential for high impact. Schools are settings where learning is expected and new behaviors are learned and practiced daily. Children and adolescents spend nearly half of their waking hours at school for 13 years of their critical developmental life (National Association of Chronic Disease Directors [NACDD], 2013). More than 95% of youth ages 5-17 can be reached through schools (Centers for Disease Control and Prevention [CDC], 2019). Health, educational attainment, and income potential are highly interrelated (Basch, 2011). Students who are physically, mentally, socially, and emotionally healthy have higher levels of attendance, engagement, and achievement (NACDD, 2017). Similarly, educational attainment is strongly and consistently associated with more health promoting behaviors, better health of oneself and their family, greater job opportunities, higher income, and better control over life and work stressors (NACDD, 2017; Egerter, Braveman, Sadegh-Nobari, Grossman - Kahn, & Dekker, 2011). Healthy People 2030, a 10-year road map for national public health efforts, recognizes the critical influence of education on long-term health outcomes. Healthy People 2030 lists high school graduation as a key social determinant of health, specifically identifying on -time graduation rates as a leading public health objective (Healthy People, n.d.). Students who are chronically absent in Oregon (missing 10% or more of enrolled school days) are less likely to graduate on time (75% on -time graduation rate for chronically absent compared to 91% on - time graduation rate for regular attenders) (Oregon Department of Education [ODE], 2015). Students who are chronically absent in Oregon are also less likely to meet academic standards in reading and math compared to their regular attending peers (ODE, 2015). Students may be chronically absent due to physical health issues (asthma, dental pain, diabetes), mental health (fear, depression, and anxiety), safety issues (bullying and violence), and social factors (hunger, unstable housing and transportation, job loss, or lack of health insurance) (Robert Wood Johnson Foundation, 2016). Absenteeism and temporary or permanent drop out are 2 of the 5 causal pathways for how health affects a student's ability to learn (Basch, 2011). The other 3 ways health impedes learning are: sensory perceptions (vision and hearing), cognition (attention, memory, and executive function), and connectedness to and engagement with adults and peers (Basch, 2011). W7 Deschutes County has 3 public school districts. The table below describes the 4-year graduation rates and chronically absent rates for Deschutes County public school districts for the 2018-2019 school year. About 81% of Bend -La Pine students, 84% of Redmond students, and 91% of Sisters students graduated on time in 2019. Note that these Deschutes County graduation and chronically absent rates are averages. Disparities in these rates exist across multiple groups, including economically disadvantaged and underrepresented minority groups. The table below provides a comparison of these rates for the districts as a whole and for economically disadvantaged, for example. District Group On -time Graduation Rates (18-19) Chronically Absent Rates (18-19) Bend -La Pine Total 81% 21% Bend -La Pine Economically Disadvantaged 70% 30% Redmond Total 84% 27% Redmond Economically Disadvantaged 80% 31% Sisters Total 91% 18% Sisters Economically Disadvantaged 77% 27% Description of Selected Student Health Indicators in Deschutes County Oregon uses multiple surveys and databases to monitor adolescent health. Most common surveys include the former Oregon Healthy Teens and former Oregon School Health surveys and the new Oregon Student Health survey which is combining and replacing the two former surveys as of 2020 (Oregon Health Authority [OHA], 2020a). These surveys gather self - report data from teens through questionnaires administered through schools who choose to participate (OHA, 2020a). Additionally, Oregon has state databases for immunizations and sexually transmitted infections. Below is a description of indicators of adolescent health in Deschutes County. 2019 Oregon Healthy Teens Survey Results for Deschutes County The 2019 Oregon Healthy Teens survey provides us a pre-COVID-19 snapshot of adolescent health. The survey was only administered to 8th and 11th graders. Below is a table and summary of the health status for Deschutes County adolescents. C.1 �� � 5re 6�?-, �;. ,.sc ���* _ �'..:,"� �`<�F,zZr irZ. � we Sw, .s-, , �,,,F✓ t-;,�5'�'ws ''"S .�`l. "` is �w��r�� '�1�� Qr.o �`�a � '�>7 \ Z, r, -.,.o �;;�+`�:.r' t '. �5>t�4us,E„-y.�z. Item .�.e. 8th Grade 11th Grade Difficulty concentrating, remembering, or making decisions 30% 32% Difficulty doing errands alone 9% 10% Unmet physical health care needs 16% 13% Unmet emotional or mental health needs 20% 22% Meeting the Positive Youth Development benchmark 57% 60% Experienced bullying at school or on the way to school in the past 30 days 32% 17% Feeling sad or hopeless for 2 weeks or more 30% 34% Seriously considering suicide 19% 15% Were pressured into having sex n/a 14% 30-day alcohol use 11% 27% 30-day e-cigarette use (vaping) 13% 21% 30-day marijuana use 8% 18% Positive Youth Development In Deschutes County, about 3/5 of students (57% of 8th graders and 60% of 11th graders) meet the Positive Youth Development benchmark. Oregon's Positive Youth Development benchmark assesses a student's physical and mental/emotional health, confidence, competence, social connection to an adult or peer at school, and service to the community (OHA, 2011). Positive Youth Development is a strong predictor of other student health and achievement factors. In Oregon, students reaching the Positive Youth Development benchmark (OHA, 2011): • Are more likely to have As and Bs on their report card • More likely to have healthier behaviors, including more physical activity and healthier diet • Less likely to have riskier behaviors, including substance use, fighting, having sex, and suicide attempts Difficulty with Concentration Remembering, or Making Decisions About 1/3 of 8th and 11th grade respondents (30% of 8th graders and 32.4% of 11th graders) reported disabilities. Most commonly (24.4% of 8th graders and 25.3% of 11th graders) reported was difficulty concentrating, remembering, or making decisions due to a 7 physical, mental, or emotional condition. Difficulty with concentration, remembering, or making decisions are barriers to learning and achievement and risk factors for poor mental health and risky behaviors. Suicide Risk Depression, and Substance Use Suicide is a leading cause of death for Oregon youth. Suicide is a severe outcome of unmet mental health needs. In 2019, 19% of 8th graders and 15% of 11th graders reported seriously considering suicide. About 1/5 of students surveyed (20% of 8th graders and 22% of 11th graders) reported having unmet emotional or mental health care needs over the previous 12 months. About'/a of students surveyed (30% of 8th graders and 34% of 11th graders) reported feeling sad or hopeless for 2 weeks or more, Oregon's indicator for depression. Substance use can be both a coping mechanism for mental, social, and emotional distress, as well as a cause of mental, social, and emotional distress. Oregon uses 30-day substance use as an indicator of frequent, potentially habitual, substance use. For 30-day substance use: alcohol is the most commonly used substance (11% for 8th graders and 27% of 11th graders), followed by e-cigarette (vaping) and marijuana (13% and 8% of 8th graders, respectively, and 21% and 18% of 11th graders, respectively). Sexually Transmitted Infections (STIs) and HPV Immunization Rates Similar to trends across the United States, most sexually transmitted infections (STI) in Deschutes County and Oregon occur between the ages of 15-24 (Central Oregon Health Council [COHC], 2019). Chlamydia is the most common reportable STI (COHC, 2019). Reportable diseases are those that require medical providers and laboratories to report newly diagnosed cases to the public health authority. Below is a table excerpted from the Central Oregon Regional Health Assessment illustrating the distribution of chlamydia diagnoses across age groups (COHC, 2019), illustrating the high number of diagnoses across the 15-24 age groups. Figure 75. Chlamydia incidence rate per 100,000 population by age group, OPHAT, z013-ZO17. HPV (human papillomavirus) is the most common STI. The CDC estimates that about 85% of all sexually active people will have a HPV infection at some point in their lives, usually in their teens or early 20s (CDC, 2021). HPV is not a reportable STI so we do not have state or local HPV rates. HPV is one of few STIs that is preventable with a vaccine. Oregon tracks and reports HPV vaccine series initiation and completion for adolescents 13-17 along with other immunization records. For 13-17 year olds in Deschutes County, 72% have initiated at least 1 dose of the HPV vaccine series and 53% have completed the series (OHA, 2020c). Item I Proportion HPV Series Initiations 72% HPV Series Completion 153% Recommended Approaches and Frameworks for School Health Coordinated School Health and Whole Community, Whole School, Whole Child (WSCC) Model The best practice model for school health is the Coordinated School Health model, developed by the Centers for Disease Control and Prevention (CDC) in 1988. The premise of Coordinated School Health is the alignment, integration, and collaboration between public health and education to improve both health and learning outcomes. The Coordinated School Health approach emphasizes the importance of coordination across 10 components of school health in order to share awareness of health issues and priorities, gain support for addressing health issues, leverage community resources, reinforce consistent health messages, and avoid duplication (NACDD, 2017). The following are recommended core processes for implementing Coordinated School Health (OHA, 2013; NACDD, 2017; RMC Health, 2014): 1. Designating a School Health Coordinator, 2. Establishing a representative school health team, with at least one school administrator, parent, and student, 3. Collaboratively conducting a school health practices assessment, and 4. Collaboratively developing and implementing a school health improvement plan. The Coordinated School Health mode/was recently expanded into the Whole School, Whole Community, Whole Child (WSCC, pronounced "whisk' model, blending together the Coordinated School Health model with a Whole Child model used in the education sector. The blue bands in the expanded WSCC model below contain the original Coordinated School Health model. Many programs and practitioners using the original Coordinated School Health model still refer to their programs and this approach as Coordinated School Health, even though the model is now officially called WSCC by the CDC. Figure 2! Whole School, Whole Community, Whole Child Modei " Health Education 10 Formal, structured health education consists of any combination of planned learning experiences that provide the opportunity to acquire the information and skills students need to make quality health decisions. Health education curricula and instruction should address the National Health Education Standards (NHES), incorporate the characteristics of an effective health education curriculum, and be taught by qualified, trained teachers Physical Education and A comprehensive school physical activity program (CSPAP) is the Physical Activity national framework for physical education and youth physical activity. It reflects strong coordination across five components: • physical education, • physical activity during school, • physical activity before and after school, • staff involvement, and • family and community engagement. Physical education is the foundation of CSPAP, and is an academic subject for grades K-12. Curriculum should be based on the national standards for physical education, and classes should be taught by certified or licensed teachers endorsed by the state to teach physical education. Nutrition Environment The school nutrition environment provides students with and Services opportunities to learn about and practice healthy eating through nutrition education, messages about food in the cafeteria and throughout the school campus, and available food and beverages, including in vending machines, "grab and go" kiosks, school stores, concession stands, food carts, classroom rewards and parties, school celebrations, and fundraisers. School nutrition services provide meals and snacks that meet federal nutrition standards. All individuals in the school community can support a healthy school nutrition environment. Health Services School health services intervene with actual and potential health problems, including providing first aid, emergency care and assessment and planning for the management of chronic conditions (such as asthma, food allergies or diabetes). Health services also facilitates access to and/or referrals to providers, collaborates with community support services, and works with families to promote the health care of students and a healthy and safe school environment. Counseling, Psychological, and Social Services These prevention and intervention services support the mental, behavioral, and social -emotional health of students, and promote success in the learning process. Services include psychological, psychoeducational, and psychosocial assessments; direct and indirect interventions to address psychological, academic, and social barriers 11 to learning, such as individual or group counseling and consultation; and referrals to school and community support services as needed. Social and Emotional This refers to the psychosocial aspects of students' educational Climate experience that influence their social and emotional development. The social and emotional climate of a school can impact student engagement in school activities; relationships with other students, staff, family and community; and academic performance. Physical Environment A healthy and safe physical school environment promotes learning by ensuring the health and safety of students and staff. A healthy school environment will address a school's physical condition during normal operation as well as during renovation, protecting occupants from physical threats, biological and chemical agents in the air, water, or soil, as well as those purposefully brought into the school. Employee Wellness Fostering school employees' physical and mental health protects school staff, and by doing so, helps support students' health and academic success. A comprehensive school employee wellness approach is a coordinated set of programs, policies, benefits, and environmental supports designed to address multiple risk factors (e.g., lack of physical activity, tobacco use) and health conditions (e.g., diabetes, depression) to meet the health and safety needs of all employees. Family Engagement Families and school staff work together to support and improve the learning, development, and health of students. School staff are committed to making families feel welcomed, engaging families in a variety of meaningful ways, and sustaining family engagement. Families are committed to actively supporting their child's learning and development. Community Involvement Community groups, organizations, local businesses, social service agencies, faith -based organizations, health clinics, and colleges and universities create partnerships with schools, share resources, and volunteer to support student learning, development, and health - related activities. School Health Index The Coordinated School Health/WSCC model has a companion tool, called the School Health Index, which serves as comprehensive standards for school health practices, an assessment tool to identify gaps in reaching the standards, and a tool for collaborative prioritization and planning for coordinated school health improvements. The School Health Index's standards are based on decades of CDC analyses comparing youth health data with school policies and practices. The School Health Index includes 11 modules: 1 for each of the 10 components of school health and 1 additional module for school policies and protocols. The School Health Index was recently updated in 2017. 12 Applications of WSCC/Coordinated School Health Coordinated School Health has been implemented across the United States at state, county, district, and school levels. The model and the School Health Index is a process that can be used to address a range of health priorities. Most commonly, Coordinated School Health has been used to address obesity, physical activity, and nutrition, but more areas are beginning to use this model for mental, social, and emotional well-being. At least two states have established legislation requiring Coordinated School Health. Tennessee led the nation in 2006 by adopting Coordinated School Health state-wide, legislating tax -payer funds to institute a Coordinated School Health Office at their state department of education and establishing full-time School Health Coordinators in every district and every school (Tennessee Department of Education [TDE], n.d.). Their primary focus areas are reducing obesity and improving physical activity and nutrition. Tennessee reports that physical activity for students increased from 25% in 2005 to 44% in 2017 (TDE, 2019). The State of Texas also passed legislation to require Coordinated School Health advisory committees in all districts, Coordinated School Health programs in all public schools, and annual school health reports on the Coordinated School Health activities. The Texas requirements include: physical health education designed to prevent chronic diseases, mental health education, substance abuse education, physical education and activity, and parent involvement (Texas Education Code 38.013.). Oregon currently has CDC grant funding, along with 15 other states, to use this model for the Oregon Healthy Schools program. The CDC funding mechanism for Oregon only provides reach into just 6 school districts, none of which are in Central Oregon, and limits their focus to nutrition, physical education/activity, and managing chronic disease. Oregon Healthy Schools is using the School Health Index in the 6 school districts included in their program. Oregon has used the Coordinated School Health model since at least 2010, most strongly whenever grant funding is available because Oregon has not legislated funding toward this model. In 2013, under a larger CDC grant, Oregon implemented Coordinated School Health widely and conducted an analysis of the relationship between schools who reached a "core capacity" for school health and student outcomes. Oregon defined the "core capacity" for school health as: 1. Having a designated school health coordinator, 2. Conducting an evidence -based school health assessments such as the CDC's School Health Index, 3. Having a school health team that includes school leaders and community partners, and 4. Including a health goal and objective in their School Improvement Plan, an educational plan. Oregon's analysis found that 1 in 9 (or 11% of) Oregon's middle/high schools were able to demonstrate "core capacity" and found that those "core capacity" schools: implemented more 13 evidence -based school health practices, had more students reaching the Positive Youth Development benchmark, had healthier student behaviors, higher grades in high schools, 3 fewer attendance violations per 100 students, 4 fewer disciplinary actions per 100 students, and higher 4-year graduation rates. The barriers to reaching core capacity were identified as designated staff time and leadership for facilitating the process. The analysis concluded that having a designated school health coordinator (at least .5 FTE) was the key enabling factor in reaching core capacity, and these associated outcomes Formal Integration - Contracts or formal agreements made between partnering institutions to assure true integration of public health into the school settings and education system structures. School Districts and Deschutes County Health Services are 50/50 funding partners. Staff from partnering agencies are designated to Healthy Schools collaboration. Healthy Schools Steering Committee - A committee including executive representation from each invested partner and other relevant agencies to direct overall program development and provide necessary approvals for integrations. The steering committee also includes an advisory subcommittee composed of veteran education and public health practitioners to advise program operations in between steering committee meetings. District -level Alignment and Improvements - The Healthy Schools Supervisor works closely with designated district office staff to assess and address supports needed for Healthy Schools initiatives. District office staff include the directors of mental, social, and emotional wellbeing; discipline and restorative practices; secondary school curricula; and health services. District - level operations include supporting a district wellness committee; reviewing, recommending, and aiding in the development of district program and protocol developments; providing relevant professional development; providing health communications; and aiding in the implementation of district initiative in school settings with public health specialists. Public Health Specialists in Schools - The core foundation of our Healthy Schools program is embedding a Public Health Specialist (PHS) into each high school to serve as the designated school health coordinator. As previously mentioned in the Recommend Approaches section, a designated school health coordinator, at least 0.5 FTE per school, was identified as the key enabling factor for sustainable school health improvements and improvements in student outcomes. The PHS will be hosted by their high school, but will also provide school health coordination services to the middle schools feeding into that high school as well. 14 As the school health coordinator, the PHS will be responsible for facilitating the collaborative, comprehensive data -driven school health improvement process. The roles and activities of the PHS may differ depending on the unique needs of the schools they serve and the school health needs identified by their school health team. Typical roles of the PHS include: • Conducting school health assessments and reporting results • Developing a school health improvement plan with a variety of school stakeholders, including admin, staff, parents, and students • Coordinating and facilitating implementation of the school health improvement plan through engagements with admin, staff, parents, students, and community -based organizations • Assisting schools with the development and implementation of health, development, or equity goals for school improvement plans • Serving as a liaison between the school and external programs, such as Deschutes County Health Services, School -based Health Center, and community -based organizations • Providing behavioral screenings for students, as needed • Providing resource navigation to admin, staff, parents, and students • Providing evidence -based health education to students and parents • Providing health communications to entire school community and to targeted groups • Providing parenting education to support adolescent health and development • Providing training and coaching to improve evidence -based school health practices • Supporting compliance with state and district health -related policies • Coordinating implementation of school -wide Social and Emotional Learning • Supporting student engagement initiatives and youth -led projects Most of the Public Health Specialists' activities are in the Tier 1 and Tier 2 levels of the Multi - Tier System of Support (MTSS) model commonly used by schools (see Figure 3 below). Tier 1 activities are universal, reaching all students. We aim for the majority of the Public Health Specialist's activities to be Tier 1, which aligns with the Primary Prevention level in the Public Health Prevention Framework commonly used in the public health field. An example of Tier 1 activities are implementing school -wide social and emotional climate changes that affect the entire school environment. Tier 2 in MTSS activities are selective, often for groups of students based on certain risk factors indicating they need an additional layer of support on top of Tier 1 supports. Tier 2 aligns with the Secondary Prevention level of the Public Health Prevention Framework. The Public Health Specialist will provide Tier 2 activities, particularly in the interest of reducing inequities by certain student groups. An example of a Tier 2 activities is facilitating cultural connection activities for Latino/a/x students and families. Tier 3 activities are indicated for an individual based on an individual's need. Students receiving Tier 3 interventions experience significant challenges that require more individualized supports than those provided in Tiers 1 and 2. Tier 3's individualized support can include assistance from specialized professionals such as counselors/therapists. There are few occasions in which Public Health Specialists provide Tier 3 activities. Brief screenings and referrals or program enrollment 15 related to our student health focus areas are examples of Tier 3 activities that would be acceptable, in the absence of other staff members available to perform the service. The Public Health Specialist will not supplant the role of any school staff, but may provide assistance and supports to school staff. figure 3 . Multi ier System of Support Model Student Health Focus Areas - Our data -driven planning process has identified 6 focus areas for student health intervention: • Suicide • Substance Use • Sexually -transmitted Infections • Teen Pregnancy • Immunizations • Positive Youth Development (including Social and Emotional Learning) School Health Improvement Focus Areas: Our stakeholder engagements and literature reviews have identified 3 school health improvement focus areas: • Social and Emotional Climate • Health Education • Family Engagement 16 See the description of these three school health components in the Recommended Approaches section above. Goals • Increase social, mental, emotional, and physical health supports in schools • Increase students reaching Positive Youth Development benchmark • Reduce unmet physical and mental/emotional health needs amongst students • Reduce disparities by race/ethnicity, gender/sexual orientation, and income levels • Increase on -time graduation rates Strategies Our Healthy Schools program will use the following strategies to improve student health: 1. Assessment of resources, readiness, and gaps in evidence -based school health practices a. Use interviewing to assess local school health resources available and how well used b. Use interviewing to identify key stakeholders and readiness for school health improvements c. Use School Health Index to collaboratively assess gaps and priorities in evidence - based school health practices 2. Resource mapping, navigation, coordination, and alignment a. Create a school health resource database to create a navigable school health system b. Use resource database/map to provide resource navigation, coordinate resources to fill gaps, and align resources to improve efficiency and reduce confusion/duplication 3. Collaborative, data -driven prioritization, planning and implementation of evidence -based school health practices a. Use the School Health Index and WSCC Implementation guides to set priorities, create school health improvement plans, and implement evidence -based school health practices 4. Strategic communications for multiple stakeholder groups a. Create a behavior change communications plan b. Use strategic segmentation and messaging to reinforce attitudes, norms, and behavior changes c. Use Success Stories to increase awareness and support for Healthy Schools and communicate progress/achievements 17 5. Continuous monitoring, evaluation, reporting, and quality improvement a. Develop a performance monitoring process b. Conduct Plan -Do -Study -Act cycles to improve quality c. Report progress to key stakeholders on annual bases d. Gather stakeholder feedback from reporting to integrate into program interactions Key Performance Metrics Below is a list of select metrics we will use as indicators of progress towards our program goals. See the full list of metrics in Appendix A. Short-term Metrics: • Healthy Schools will meet Oregon's "Core Capacity" for sustainable school health and implement 3 School Health Index Modules • Healthy Schools' staff, students, and parents/guardians will increase their knowledge of resources and how to access them • Bend -La Pine Schools' Health teachers will increase their knowledge and confidence in delivering evidence- and skills -based health education • Bend -La Pine Schools' Health Education Scope and Sequence and approved curricula will be reviewed and revised as needed, based on readiness. Intermediate Term Metrics: • Healthy Schools' parents/guardians will have increased their knowledge and skills to support their ability to talk to their adolescents about alcohol, drugs, sex, suicide, and mental health concerns • Healthy Schools' staff will implement best practices for health education, social and emotional learning, and restorative early interventions • Healthy Schools will have an increase in the proportion of students reporting that there's someone they can go to at school for help with a health problem • Healthy Schools have an increase in students reaching the Positive Youth Development benchmark Long Term Metrics: • Healthy Schools will have a decrease in students reporting 30-day alcohol, marijuana, and e-cigarette use. • Healthy Schools students will have lower rates of STIs and teen pregnancies • Healthy Schools students will have lower rates of seriously considering suicide • Healthy Schools students will have a decrease in students' unmet physical health care needs • Healthy Schools students will have a decrease in unmet mental/emotional health care needs • Healthy Schools will have an increase in regular attendance rate (90% or more attendance for days enrolled) • Zip codes with Healthy Schools will have an increase in HPV series completion • Healthy Schools will have a decrease in disparities by race/ethnicity, sexual orientation, and income 11 The PHS will launch Healthy Schools in their high school and middle school by: 1.Building relationships with school staff, students, and parents, 2. Identifying champions for school health improvements, and 3. Identifying existing structures or meetings that can be leveraged for school health improvement processes. The PHS will use the School Health Index to collaboratively assess, prioritize, and plan school health improvements. Similar to Oregon Healthy Schools' approach, our Healthy Schools program will focus on implementing 3 SHI modules each year, starting with our priority focus areas: Social and Emotional Climate, Health Education, and Family Engagement. Though it would be ideal to implement all 10 of the SHI modules in year 1, it is not practical considering the time limitations and competing priorities of the school staff. The PHS will aim to integrate the school health improvement process into as many existing structures and activities to reduce the burden onto school staff. Healthy Schools will also partner at the district level to coordinate district -level interventions to support school health interventions, such as professional development, review and revision of Health Education Scope and Sequence and approved curricula, and increasing structural supports for evidence -based health education. The Healthy Schools supervisor will provide district -level supports and coordinate structural changes at the district level. A behavior change communications plan will be developed over the first year. The Healthy Schools team will work with district and public health communications specialists to design the communications plan. The strategic communications plan will be launched in Year 2. See Tables 4-7 below for timeline tables describing the major implementation activities for the 3-year phase in approach. Each activity includes a prefix identifying at which level the activity is occurring. The prefixes include: Program: Including activities that occur between the main partnering institutions to establish and build the program. These activities occur through the Steering and Operations Committees, certain stakeholders such as partnering school leaders, our institutional administration (such as contracts), or our program staff and internal program operations. Program level activities are mostly facilitated by the Healthy Schools supervisor or key partners in each partnering institution. District: Including activities that occur specifically for the district, such as reviewing and revising the district's Health Education Scope and Sequence or providing Health 19 Education professional development for all district staff. These are activities that create structure changes or reach beyond the internal program operations and the current cohort of Healthy Schools included in the program at a given time, such as communications content that goes out to all schools or all district families. Cohort 1: Including activities that occur at the middle and high school included in Healthy Schools (schools receiving a Public Health Specialist) over the 2021-22 school year. Activities occurring in the school cohorts are facilitated by the school Public Health Specialists. Cohort 2: Including activities that occur at the middle and high schools included in Healthy Schools over the 2022-23 school year. Activities occurring in the school cohorts are facilitated by the school Public Health Specialists. Cohort 3: Including activities that occur at the middle and high schools included in Healthy Schools over the 2023-24 school year. Activities occurring in the school cohorts are facilitated by the school Public Health Specialists. 20 ... �� k� ti; ��Y � ;�'\Ca. ^.+'S'.�'�?S� � y �l", d' �'4'S � Ski ty�.s`�i �'S :iJ. 4av"''t°'`�`4Y�s '���`} �j�"��s��,�`.�?�+f � � �..... ����'.' � z,:'. �... ,� si<. �3s 3`,` ,. �Y`:.t ,.a.. `.'1:%,S'z _ , ,, eK ". :�-.+,+� LSG,,.C.,. � ..y=_ ..�i. 'L'om � �`,'s. Q2 Q3 Q4 Year 1 (2021-22) Major Activities Q1 (Jul- (Oct- (Jan- (Apr - Sept) Dec) Mar) Jun) Program: Convene Healthy Schools steering committee x Program: Identify Y1 school cohort x Program: Institutionalize Healthy Schools: contracts and x embed into new/existing institutional structures Program: Hire and train Healthy Schools Staff x x Program: Review student health data to determine x x programmatic focus Program: Develop program strategies, goals, objectives, x x metrics through data review and stakeholder engagements Program: Create program communications materials, x x including Roles/Responsibilities, presentation of student health data to stakeholder groups to increase readiness, and a baseline report with Bend -La Pine student health data Program, District, and Cohort 1: Assess school health x x x resources and develop and continually update school resource map or guide Program and District: Conduct Health Education Teacher x survey to assess Health Education needs District: Provide Health Education report from teacher x survey to district with recommendations District: Provide District -level Health Education professional x x x development based on assessment Cohort 1: Assess opportunities for staff, student, family, and x x community engagement in school health improvement assessment, planning, and implementation process Cohort 1: Identify a variety of school -level stakeholders for x x x and facilitate at least three priority SHI modules: Health Education, Family Engagement, and Social and Emotional Climate. Engaged stakeholders should include: school admin, schools staff affected by the module area, students, and parents/guardians. For students and parents/guardians, include at least 1 representative from each group with 21 higher risk of poor student health outcomes. Cohort 1: Identify school -level stakeholders for and facilitate x x x at least three priority SHI modules: Health Education, Family Engagement, and Social and Emotional Climate Cohort 1: Using SHI: Identify gaps in services/programs and x x x collaboratively prioritize and create a school health improvement plan to address the student health outcomes and program areas of focus Cohort 1: Provide coaching, training, resource navigation x x x and public health services to and with school staff, parents, and students for issues related to our focus areas Program: Continually assess and report successes and x x x challenges for activities at the district level and Cohort 1 schools Program: Develop a behavior change communications plan x x and evaluation plan Cohort 1: Align the school health improvement plan with the x School Design Plan and provide implementation support for the School Design Plan goals related to our focus areas Cohort 1: Publish at least 1 Success Story per high and x middle school Cohort 1: Present a school health improvement report for x school stakeholders describing the achievements and challenges for Year 1's SHI process, findings from assessments, and school health improvement plan progress Program and District: Identify 2022-23 school cohorts to x start Healthy Schools; Gain school leadership commitments to host and integrate new Public Health Specialist into their staff Program and District: Secure 2022-23 funding and recruit 2 x additional Public Health Specialists with expertise in school health, health education, or prevention science 22 S^YY'i' 1SS�i}os5^3e 'SS�i i`��i�'�y � 5�S2 KN'`t�. iti �, ,y zz.. y16Y Q2 Q3 Q4 Year 2 (2022-23) Major Activities Q1 (Jul- (Oct- (Jan- ; (Apr - Sept) Dec) Mar) Jun) Program: Publish a Year 1 Implementation Evaluation x Report Program: Iterate Healthy Schools program based on x implementation reporting from Cohort 1 Program: Conduct intensive professional development for x Public Health Specialist, including supporting Deschutes County Prevention and Health Promotion program implementation for related youth -focused suicide prevention, substance use prevention, positive youth development programs. Program: Develop behavior change communications content x and communication channels needed (such as a website, blog, newsletter) based on assessments conducted in Year 1 Program and Cohort 1: Test behavior change x x communications content with focus groups Cohort 1 and 2: Launch strategic behavior change x x x communications to target audiences Cohort 1: Re-engage school stakeholders and facilitate x x x updates to the school health improvement plan for last year's modules and add these SHI modules: Physical Education and Physical Activity, School Policies and Practices, and Community Involvement Cohort 2: Identify school -level stakeholders for and facilitate x x x at least three priority SHI modules: Health Education, Family Engagement, and Social and Emotional Climate Cohort 2: Using SHI: Identify gaps in services/programs and x x x collaboratively prioritize and create a school health improvement plan to address the student health outcomes and program areas of focus Cohort 1 and 2: Facilitate and track progress for x x x implementing school health improvement plans Cohort 1 and 2: Provide coaching, training, resource x x x navigation and public health services to school staff, 23 parents, and students for issues related to our student health outcomes and program areas of focus Cohort 1: Publish at least 1 Success Story per high and x x middle school District and Cohort 1 and 2: Facilitate 2022 Oregon Student x Health Survey in all Bend -La Pine schools Cohort 1 and 2: Align the school health improvement plan x with the School Design Plan and provide implementation support for the School Design Plan goals related to our focus areas Program: Request 2022 Oregon School Health Survey raw x data and analyze results to assess indicators of progress towards program goals Cohort 2: Publish at least 1 Success Story per high and x middle school Cohort 1 and 2: Present a school health improvement report x for school stakeholders describing the achievements and challenges for Year 2's SHI process, findings from assessments, and school health improvement plan progress Program and District: Identify Cohort 3 schools and secure x commitments to host and integrate Public Health Specialists Program and District: Secure 2023-24 funding and recruit 2 x additional Public Health Specialists with expertise in school health, health education, or prevention science 110 J�)� 'eGyl"l S, u"✓� �:" .: tS !'. mod'-V y� \ i \lv' FS "f, wJ ), l i Year 3'(2023-24) Major Activities Q1 Q2 Q3 Q4 (Jul- (Oct- (Jan- (Apr - Sept) Dec) Mar) Jun) Program: Publish a Year 2 Implementation Evaluation x Report and analysis of key performance indicators from Cohorts 1 and 2 Program: Iterate Healthy Schools program based on x implementation reporting from Cohort 1 and 2 Program: Identify additional funding streams and begin x funding applications M] Program: Conduct intensive professional development for x Public Health Specialist, including supporting Prevention program implementation for related youth -focused suicide prevention, substance use prevention, positive youth development programs. Program: Develop behavior change communications content x and communication channels needed (such as a website, blog, newsletter) based on assessments conducted in Year 2 Cohort 1-3: Launch behavior change communications using x x x segmented dissemination Cohort 1: Re-engage school stakeholders and facilitate x x x updates to the school health improvement plan for previous years' modules and add these SHI modules: Health Services, Counseling, Physical Environment, Nutrition Services Cohort 2: Re-engage school stakeholders and facilitate x x x updates to the school health improvement plan for last year's modules and add these SHI modules: Physical Education and Physical Activity, School Policies and Practices, and Community Involvement Cohort 3: Identify school -level stakeholders for and facilitate x x x at least three priority SHI modules: Health Education, Family Engagement, and Social and Emotional Climate Cohort 3: Using SHI: Identify gaps in services/programs and x x x collaboratively prioritize and create a school health improvement plan to address the student health outcomes and program areas of focus Cohort 1-3: Facilitate and track progress for implementing x x x school health improvement plans Cohort 1-3: Provide coaching, training, resource navigation x x x and public health services to school staff, parents, and students for issues related to our student health outcomes and program areas of focus Cohort 1 and 2: Publish at least 1 Success Story per high x x and middle school Cohort 1 and 2: Align the school health improvement plan x with the School Design Plan and provide implementation support for the School Design Plan goals related to our focus areas 25 Cohort 3: Publish at least 1 Success Story per high and middle school x Cohort 1-3: Present a school health improvement report for x school stakeholders describing the achievements and challenges for Year 3's SHI process, findings from assessments, and school health improvement plan progress Secure funding to continue Healthy Schools with the x capacity built Year 4 (2024-25) Major Activities Q1 Q2 Q3 Q4 (Jul- (Oct- (Jan- (Apr - Sept) Dec) Mar) Jun) Program: Publish a Year 3 Implementation Evaluation x Report and analysis of key performance indicators Program: Iterate Healthy Schools program based on x implementation reporting from Cohort 1-3 Continue Healthy Schools with long-term funding x x x x Support facilitation for the 2024 Oregon Student Health x Survey Request and analyze raw 2024 Oregon Student Health x x Survey data as a 3-year assessment of Healthy Schools Evaluation Plan Summary Healthy Schools is a coordinated school health improvement processdriven by the school community to change and align multiple -components of the school's social and educational environment. Healthy Schools will be coordinating the process of implementing evidence -based programs and practices, which have already been evaluated for effectiveness using rigorous experimental or high-powered epidemiological studies. Our evaluation focus is not to retest the effectiveness of these existing evidence -based practices. Healthy Schools' evaluation focus will be on quality implementation of the coordinated school health improvement process and quality implementation of the evidence -based practices. We will also be monitoring short-, intermediate-, and long-term indicators of student health changes from Healthy Schools implementation. Annual reports will be produced to evaluate the program's implementation process, successes, and challenges; inform stakeholders of the program's 26 activities and progress; describe planned changes for quality improvement; and describe changes in the student health indicators being monitored. Annual Report Details Healthy Schools will produce annual reports on two levels: 1. School -level: By the end of each academic year, each Public Health Specialist will provide their assigned middle and high schools an annual report of their school health improvement process, including their baseline School Health Index scores and changes to their score over the year, the school's identified strengths and areas for improvements, the school health improvements planned and achieved, and recommendations for next year's actions. Public Health Specialists will collect stakeholder feedback to this report and incorporate feedback into the following year's work plan. The feedback from the schools will provide input to program -level changes. 2. Program -level: Before the start of the following academic year, the Healthy Schools program will publish a report including a synthesis of the baseline SHI scores and score changes, identified strengths and areas for improvement, school health improvements planned and achieved, and planned program iterations based on feedback. The annual reports will also include data for key metrics being monitored, as data are available. Some metrics will be available on a yearly basis due to our program tracking or surveillance systems, but most key metrics will only be reportable following even years as the Oregon Student Health Survey is only administered in the Fall of even years. The overarching questions we will aim to address with our Healthy Schools' annual reports are: a. To what extent were our planned major activities completed? (See the Implementation Plan timeline of major activities) b. What were the barriers to implementation? c. What were the facilitators of implementation? d. What is each school's baseline school health status according to the School Health Index scores? What improvements were made to the schools' health status according to the School Health Index scores? e. What gaps in evidence -based school health practices were identified and prioritized? f. What were the identified strengths and areas for improvement? g. To what extent were a variety of school stakeholders included in the school health assessment, prioritization, and improvement planning process? h. To what extent have our student health indicators changed, depending on data availability? i. What program changes are recommended to improve school health and student health? 27 � s y , d, „��',' ,.��. �.�..., � _,D-,..�S n.Q,_. ,.h., S..�...>s1s� ._ ,A-.uyi..K Source Type Timeline for Reporting School Health Index . School health scores Yearly • Strengths and Areas for Improvement • Priorities School Health Improvement • School health improvement process Yearly Plan and Tracking Sheet Oregon Student Health • Perception of supports, resources, and 2023-2024 Survey climate Suicide consideration • Substance Use • Positive Youth Development Unmet Health Needs Orpheus Data • Sexually transmitted infections (STI) Yearly ALERT Data • HPV series completion Yearly Youth Truth Survey • Student, family, and parent engagement Yearly Student, family, and parent perceptions of culture • Student sense of belonging and peer collaboration • Parent perception of communication and feedback References Allen, C.W., Diamond-Myrsten, S., & Rollins, L.K. (2018). School absenteeism in children and adolescents. American Family Physician, 98 (12):738-744. Found at: https://www.aafp.org/afp/2018/"`1215/p738.htmi Basch, C.E. (2010). Healthier students are better learners: A missing link in school reforms to close the achievement gap. Found at: https://www cde state.co.us/sites/default/files/documents/`heaIthandwelIness/download/ healthier students are better learners.pdf Central Oregon Health Council (2019). 2019 Central Oregon Regional Health Assessment. Found at: https•//www deschutes.org/health/page/regional-health-assessment Centers for Disease Control and Prevention (2009). School connectedness: Strategies for increasing protective factors among youth. Found at: https• //www.cdc. gov/healthyyouth/protective/pdf/con nectedness. pdf Centers for Disease Control and Prevention (2021). Reasons to get the HPV vaccine. Found at: https://www.cdc.gov/hpv/`­`parents/vaccine/six-reasons.html Centers for Disease Control and Prevention (CDC, 2019). About Healthy Schools. Found at: https://www.cdc.gov/health schools/about.htm Clinton, C. & Reeder, B, (2015): School attendance, absenteeism, and student success: A research brief for Oregon Department of Education. Found at: https://www.oregon.gov/ode/reports-and- data/resea rchbriefs/Docu ments/Interna I/school-attenda nce-a bsenteeism-a nd -student- success-final.pdf Collaborative for Academic, Social, and Emotional Learning (n.d.). Fundamentals of SEL. Found at: https://casel.org/fundamentals-of-sel/ Egerter, S., Braveman, P., Sadegh-Nobari, T., Grossman -Kahn, R., & Dekker, M. (2011). Exploring the social determinants of health: Issue brief #5 Education and Health. Found at: https://www rwif org/en/library/research/2011/05/education-matters-for-health.htmi Healthy People 2030 (n.d.). Education Access and Quality: Goal: Increase educational opportunities and help children and adolescents do well in school. Found at: https://health gov/healthypeople/objectives-and-data/browse-objectives/education- access-and-quality Healthy People 2030 (n.d.). Education Access and Quality: Goal: Increase educational opportunities and help children and adolescents do well in school. Found at: https•//health gov/healthypeople/objectives-and-data/browse-objectives/education- access-and-quality Healthy People 2030 (n.d.). Schools: Goal: Promote, health, safety, and learning in school settings. Found at: https•//health.govlhealthypeople/objectives-and-data/browse- objectives/schools National Association of Chronic Disease Directors (2013). Speaking education's language: A guide for public health professionals working in the education sector. Found at: https://chronicdisease.org/resource/resmgr/school health/nacdd educationsector guide pdf National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Division of Behavioral and Social Sciences and Education; Board on Children, Youth, and Families; Committee on the Neurobiological and Socio-behavioral Science of Adolescent Development and Its Applications; Backes EP, Bonnie RJ, editors. Washington (DC): National Academies Press (US); 2019 May 16. National Academies of Sciences, Engineering, and Medicine; Health and Medicine (2020). Promoting positive adolescent health behaviors and outcomes: Thriving in the 21st Century. Washington DC: The National Academies Press, http://doi.org/10.17226125552. National Association of Chronic Disease Directors (2017). The Whole School, Whole Community, Whole Child model: A guide to implementation. Found at: https://www.ashaweb.orcl/wp-content/uploads/­"`2017/10/NACDD WSCC Guide Final.pdf Oregon Department of Education (n.d.) Adapted At -A -Glance school and district profiles for the 2019-2020 school year. Found at: https://www.oregon.gov/ode/schools-and- d istricts/reportcards/reportcards/Pages/Adapted-At-A-Glance-1920.aspx 29 Oregon Department of Education (2019). Attendance and absenteeism: Regular attenders (formerly not chronically absent) report: School year 2018-2019. Found at: https•//www oregon gov/ode/reports-and-data/students/Pages/Attendance-and- Absenteeism.aspx Oregon Department of Education (2015). School attendance, absenteeism, and student success. Found at: https://www.oregon.gov/ode/reports-and- data/research briefs/Documents/Internal/school-attendance-absenteeism-and-student- success-final. pdf Oregon Health Authority (2020a). 2020 Student Health Survey. Found at: https://www oregon gov/oha/PH/BIRTHDEATHCERTIFICATES/SURVEYS/Pages/student- health-survgy.aspx Oregon Health Authority (2020b): 2019 Oregon Healthy Teens Survey: Deschutes County Report. Found at: https://www oregon gov/oha/PH/BIRTHDEATHCERTIFICATES/SURVEYS/OREGONHEALT HYTEENS/Documents/2019/County/Deschutes%20County%20Profile%20Report. pdf Oregon Health Authority (2011). Addressing the whole child: Linking health and academic achievement through Positive Youth Development. Found at: https://www oregon gov/oha/PH/HEALTHYPEOPLEFAMILIES/YOUTH/`HEALTHSCHOOL/H KLB/Documents/PYDBench mark. pdf Oregon Health Authority (2013). Investment in school health capacity: Payoffs in health, achievement, and stronger communities. Found at: https://www oregon gov/oha/PH/HEALTHYPEOPLEFAMILIES/YOUTH/HEALTHSCHOOL/H KLB/Documents/Report SHC.pdf Oregon Health Authority (2020). Deschutes County: Adolescent immunization rates. Found at: https://www oregon gov/oha/PH/PREVENTIONWELLNESS/VACCINESIMMUNIZATION/Do cuments/Adols/Deschutes.pdf Oregon Health Authority (2011). Addressing the whole child: Linking health and academic achievement through the Positive Youth Development benchmark. Found at: https://www oregon gov/oha/PH/HEALTHYPEOPLEFAMILIES/YOUTH/HEALTHSCHOOL/H KLB/Documents/PYDBench mark. pdf Robert Wood Johnson Foundation (2016). The relationship between school attendance and health. Found at: https://www.rwjf.org/en/library/research/2016/09/the-relationship- between-school-attendance-and-health. html Robert Wood Johnson Foundation (2016). The relationship between school attendance and health. Found at: https://www rwjf org/en/library/research/2016/09/the-relationship- between-school-attendance-and-health.htmlTexas Education Code 38.013: https://statutes.capitol.texas.gov/Docs/ED/htm/ED.38.htm#38.013 Tennessee Department of Education (2019). Coordinated School Health: 2018-2019 Annual Report. Found at: https•//www to gov/content/dam/tn/education/csh/201819CSHAnnualReportFINAL508co mpliant. pdf 30 Tennessee Department of Education (n.d.). Coordinated School Health. Found at: https://www.tn.gov/education/"`health-and-safgt y/coordinated-school-health.htmI Washington State Health Care Authority (WSHCA, 2019). Prevention Tools: What works, what doesn't. Found at: https://www.theathenaforum.org/best-practices-toolkit-prevention- tools-what-works-what-doesnt 31 Appendix A Full List of Me#rigs Implementation (Process) Metrics Source of Data Each school year in Healthy Schools, a school health team will be Tracking Sheet identified, including representative members who are admin, relevant staff, parents/guardians, and students. By the end of each school year in Healthy Schools, a school health team School Health will assess school health scores, strengths, and areas for improvement Index using the School Health Index in the following order: • Year 1: Social and Emotional Climate, Health Education, and Family Engagement • Year 2: Physical Education and Physical Activity, School Policies and Practices, and Community Involvement • Year 3: Health Services, Counseling, Physical Environment, Nutrition Services By the end of each school year, the school health team will prioritize school School Health health improvements and create a school health improvement plan using Index and the School Health Index, in the following order: School Health • Year 1: Social and Emotional Climate, Health Education, and Family Improvement Engagement Plan • Year 2: Physical Education and Physical Activity, School Policies and Practices, and Community Involvement • Year 3: Health Services, Counseling, Physical Environment, Nutrition Services By the end of each school year, at least two school health improvements Annual School from the school health improvement plan related to our focus areas will be Report implemented with stakeholder engagement. Throughout each school year, Public Health Specialists will track changes School Health to the SHI scores through monitoring school health improvements. Index By the end of each school year, Public Health Specialists will report to their Annual School high and middle schools their baseline SHI scores, changes in SHI scores, Report the school health improvement plan, successes, and challenges. By the end of year 1, Public Health Specialists will produce at least 1 Success Stories Success Story for each high and middle school using the CDC's Success Story guidance. After year 1, Public Health Specialists will publish at least 1 Success Story Success Stories each semester for each high and middle school using the CDC's Success Story guidance. School Health Improvement Outputs Source of Data By the end of year 1 in Healthy Schools, schools will increase the number School Health 32 of practices they are implementing for a positive psychosocial school Index climate according to Module 7, CC1 in the School Health Index. By the end of year 1 in Healthy Schools, schools will increase the number School Health of practices they are implementing to engage all students in extracurricular Index school activities to foster student sense of belonging according to Module 7, CC9 in the School Health Index. By the end of year 2 in Healthy Schools, schools will increase their efforts School Health to communicate with all families about school health activities and Index programs in culturally- and linguistically- appropriate ways, using a variety of communication methods, according to Module 10, CC1 in the School Health Index. By the end of year 2 in Healthy Schools, schools will increase the number School Health of parenting strategies shared and reinforced to parents/guardians, Index according to Module 10, CC2 in the School Health Index. By the end of year 2 in Healthy Schools, schools will increase the School Health opportunities family members have to reinforce learning at home that Index focuses on improving health knowledge and behaviors, according to Module 10, CC5 in the School Health Index. By the end of year 2 in Healthy Schools, school staff will receive School Health professional development on strategies for family engagement, according Index to Module 10, CC7 in the School Health Index. By the end of year 2 in Healthy Schools, school staff will receive School Health professional development on ways to assist parents seeking mental health Index services for students, according to Module 10, CC8 in the School Health Index. By the end of year 2 in Healthy Schools, schools will provide regular School Health updates to families on issues related to all aspects of student health, Index according to Module 10, CC9 in the School Health Index. By the end of year 3 in Healthy Schools, all health education teachers will School Health use age -appropriate sequential health education curricula consistent with Index Oregon and national health standards. By the end of year 3 in Healthy Schools, schools will implement social and School Health emotional learning for all students, according to Module 7, CC5 in the Index School Health Index. By the end of year 3 in Healthy Schools, schools will be using all practices School Health listed to foster a positive psychosocial school climate for all students, Index according to Module 7, CC1 in the School Health Index. By the end of year 3 in Healthy Schools, schools will meet all 6 of School Health 33 strategies to meet the needs of LGBT youth, according to Module 1, SH.6 Index of the School Health Index. Student Outcomes Source of Data By the end of year 2 in Healthy Schools, schools will increase the Oregon Student proportion of students reporting that there is at least one teacher or other Health Survey adult in school that really cares about them by x%.* By the end of year 2 in Healthy Schools, schools will increase the Oregon Student proportion of students reporting that there is someone at their school they Health Survey can go to for help for a physical or mental health problem by x%.* By the end of year 2 in Healthy Schools, schools will increase the Oregon Student proportion of students reaching the positive youth development benchmark Health Survey by x%. * By the end of year 2 in Healthy Schools, schools will increase the Oregon Student proportion of students reporting utilizing school -based health centers by Health Survey x%. * By the end of year 3 in Healthy Schools, schools will increase the Oregon Student proportion of students reporting that adults in their school respect people Health Survey from different backgrounds. By the end of year 3 in Healthy Schools, schools will reduce agreement Oregon Student with the presence of conflict or tension based on race, ethnicity, culture, Health Survey religion, gender, sexual orientation, or disability. By the end of year 3 in Healthy Schools, the proportion of students Oregon Student reporting that they've received health education on healthy and respectful Health Survey relationships will increase by x%.* By the end of Year 3 in Healthy Schools, schools will increase the Oregon Student proportion of 11th grade students reaching the positive youth development Health Survey benchmark by x%.* By the end of Year 3 in Healthy Schools, schools will reduce the disparities Oregon Student in reaching the positive youth development benchmark by income, Health Survey race/ethnicity, and sexual orientation by x%.* By the end of year 3 in Healthy Schools, schools will reduce the proportion Oregon Student of 8th grade and 11th grade students reporting alcohol use in the past 30 Health Survey days by x%.* By the end of year 3 in Healthy Schools, schools will reduce the proportion Oregon Student of 8th grade and 11th grade students reporting e-cigarette use in the past Health Survey 30 days by x%.* By the end of year 3 in Healthy Schools, schools will reduce the proportion Oregon Student 34 of 8th grade and 11th grade students reporting marijuana use in the past Health Survey 30 days by x%.* By the end of year 3 in Healthy Schools, schools will reduce the proportion Oregon Student of students seriously considering suicide by x%.* Health Survey By xx, reduce disparities in substance use and suicide consideration by xx, Oregon Student sexual orientation, and xx by x%.* Health Survey By the end of year 3 in Healthy Schools, zip codes with Healthy Schools will Orpheus Data have x% lower rates of STIs. By the end of year 3 in Healthy Schools, schools will reduce the proportion Oregon Student of students reporting unmet physical health care needs by x%. Health Survey By the end of year 3 in Healthy Schools, schools will reduce the proportion Oregon Student of students reporting unmet mental or emotional care needs by x%. Health Survey By the end of year 3 in Healthy Schools, zip codes with Healthy Schools will ALERT Data have an increase in HPV series completion by x%. By the end of year 3 in Healthy Schools, student attendance rates will At -a -Glance increase by x%. Report By the end of year 3 in Healthy Schools, out -of -school suspension will At -a -Glance reduce by x%. Report *Healthy Schools is committed to data -driven decision maKmg. t-or eacn or the meincs wirn x70 as a placeholder, we are reviewing meaningful and reasonable measures of change set by leading public health entities or found in relevant school -based intervention research and evaluation. 12/13/2021 Steering and operations committees Contract Introduction meeting Survey Recruitment and hiring Model adopted Defined roles and responsibilities Review baseline data and research Listening tours Program and Evaluation plan Program launch Integrations 12/13/2021 PrOdU[tof partner eDg88eDleALs, collaborative planning process, and data review: ^ Ratona|e. G/idence-haser1 »m ch' K4ission' Goals, Strategies, Implementation Plan, Timeline, Metrics, and Evaluation Plan Hea!th«S{h.0O!s Steering Committee Gpp[OVeO Continual feedback and plan revision 1 . Increase health, social, and emotional supports in schools 1 Increase students reaching Positive Youth Development benchmark 3. Reduce unmet physical and mental/emotional health needs amongst students 4.. Reduce disparities by race/ethnicity, gender/sexual orientation, and income levels ' Pubfic Health Specialist meeting with school administrator `e, 12/13/2021 F�tiiita-;ijo Program • • ® Assessing and filling gaps in evidence -based school health practices • Assuring quality, program fidelity, compliance • Expanding reach to whole school, whole community Evaluation Focus Implementation Evaluation and Quality Improvement ® Consulting with OHSU Evaluation Core Annual Reports ® Implementing according to plan ® Monitoring metrics • Revising plan for quality improvements Source Type Reporting School Health Improvement Plan • School health improvement process Yearly KI 12/13/202 1 s Y :2 a z ,ate F-1111"Ing Immed1a8.e gaps; • Substance use screenings • Suicide prevention education Required by district protocol under Oregon's Adi's Act 11+ hours of instructional time relief 100+ 91h grade students Assured quality and fidelity 0 12/13/2021 Office Location of Public Health Specialist: School Counseling Center p In -person schooling ® School staff engagement ® Access to school -level data, comparable, timely I ® Investment Full integration of Public Health Specialist into schools Recruitment and retention of Public Health Specialists ES R M Elm M 1® 0 -I 0 3 rD c 3 m L/) U) w flj 0 0 v 0 -0 rD rD n v� r m rD all (D 0 3 o r+ rD r rD n v rt (Dv W �(A 1p � °1 N • 0 O NJ N r+ o n o 0 v � rD v D 3 "' 0 ` Gi 0-N n tA v D Q,� (D n-iL r 'r n : CU °�°n 0 ai O N v n (D n y rD -n 0 r* D ZT n — n� M n ov-o c c c v c o-oQ c c 0 � _ 0 -n 0 3n' 6 '^ rD Ln n • 3 n' 3 n 3 n• 3 n 3 n' 3 O 3 ~1 o N (D 0 M ci r+ 0 t n r+ 1 0 m x n M n M 000\ Ma n m %ftowo u rn 0 l< O V) (D o rD 0) LA � z v s O - n v D N 0 -� o rt o D V n m M n O m O a a, O 0 v n D r+ O 0 v m M M a N 0 N ® —� z m Z m D D N "a V M M fD P W N ri rt 'n • z > ® 70 0 n(D �_ OT ® r r �. ° o O e tA o _ � Q<.� Q O rD -I r+ Q coZ) C Z N (n Q N (/1 O -% O 0-0 n w � N O -0 �G _ C CD v rN-r ai . • . 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