Utilizing Data and Social Marketing Best Practices for School Based/Linked Health Advocacy

1. Utilizing Data and Social Marketing Best Practices for School Based/Linked Health Advocacy The Ohio School Based Health Care Association

2. Presentation Objectives Objectives:PART 1: • Overview of Ohio School Based Health Care Association and school based and linked services in Ohio • Understand what SB/LHCs look like • Discuss impact of health care reform on school based and linked care • Understand data collection/resources and how to incorporate data into social marketingPART 2: • Identify a case study of social marketing/data for advocacy in Ohio • Understand advocacy basics • Create, via team role playing, an advocacy/outreach plan for your school health team

3. Vision, Mission and Goals The Association is an organization committed to improving the health and well-being of Ohio’s children and adolescents within the context of their families through promotion of locally tailored school based/linked health care. Growing collaboration between schools and communities to provide better access to health care for Ohio's children

4. Vision, Mission and Goals Vision • School-based/linked health centers will be an accepted and integrated part of the health care and education continuum throughout the state of Ohio. • OSBHCA supports SB/L HC’s through advocacy, technical assistance, professional and community education, and a communication and information network.

5. History of OSBHCA • 1995: Ohio’s school based/linked health centers began meeting as an informal network to discuss strategies for sustainability and program development. • The geographic dispersion of the centers and their lack of resources prompted the formation of a coalition to support the existing centers and foster the development of additional ones.

6. History of OSBHCA • 2001: The Ohio School Based Health Care Association (OSBHCA) was formally organized as a non-profit 501c3 through funding from the Health Foundation of Greater Cincinnati. • 2006: Contract Executive Director Hired • 2008: State Advocacy Director added to contract staff • 2009 Field Coordinator Hired • 2010 Strategic Partnership defined for intense work with other related state groups

7. SBHCs: Across the Country N = 1912 Submitted as of November 2009

8. School Based and Linked Care in Ohio • http://vimeo.com/9353980 • East Cleveland • Western Brown • NW Local • CPS (majority of sites) • St. Bernard Elmwood Place • Springfield City • Austintown Fitch • Dayton City (linked) • CCS and SW City (linked) • Southern Local (emerging) • Lima and Allen/Hardin Counties (emerging) • Manchester Local (emerging)

9. Association “Membership” • 20 SBHCs serving 50 schools • 26 SBHCs in 2004-2005 NASBHC Census • More MH-school programs than primary based or linked, mobile dental or P-MH • Dental programs: • Ohio Dept of Health reports there are 19 sealant programs in 43 counties serving about 30,000 children annually in 600 schools. • CincySmiles Foundation serves about 6000 of those kids in 7 counties in 340 schools

10. Guiding Principles • School based/linked health care promotes well being and long term success by addressing the medical, dental, mental health and health education needs of children and adolescents. • School based/linked health services are comprehensive, coordinated and provided along a continuum of care including promotion, early intervention and treatment. • Services for youth should be appropriate, accessible, affordable, coordinated and safe. • School based/linked health services reduce barriers to learning and support academic success. • School based/linked health services are most effectively delivered according to the CDCs Coordinated School Health Model

11. Why school based /linked health care?

12. Supports the school Focuses on the community Focuses on the student Provides comprehensive care Advances health promotion activities Implements effective systems Provides leadership in adolescent and child health About School Based/Linked Care

13. What do SB/LHC facilities look like?

14. General SBHC Facility Guidelines School-Based Health Center should include1,500 to 2,000 square feet per 700 students • Infirmary • Private office space • Secure storage area(s) • Private exam and treatment rooms • Utility area(s) • Laboratory • Waiting area • Reception area • Individual heating and ac systems • Separate entrances and parking space • Dedicated phone, electrical and internet wiring

15. Actual SBHC Square Footage Guidelines • Waiting area/reception 75–200 • Office (each) 60–120 • Resting area/infirmary 100–200 • Examination room (each) 80–100 • Restrooms 50–120 • Laboratory 80–150 • Record storage 50–75 • Storage (general) 50–100 • Conference room 120–200

16. SBHC Floor Plan Examples • Silver City, NM SBHC Floor Plan (SBHC converted from two large classrooms)

17. SBHC Floor Plan Examples • Hypothetical Free-standing SBHC example

18. Alternative Models: Mobile Units • Oral Health-CincySmiles Foundation • http://vimeo.com/9350857

19. Ohio Realities in school based/linked care • Community Schools • Multiple Sites • Oral Health • Telemedicine

20. What does health care reform mean to school based/linked health?

21. Health reform and SBHCs • The Patient Protection and Affordable Care Act (P.L. 111-148) signed into law on March 23 • Key provisions for SBHC found at title IV, Subtitle B, Section 4101

22. Quick overview of §4101 • Section 4101(a) versus Section 4101(b) • Paragraph (a): Capital funds • Paragraph (b): Operations funds

23. Section 4101(a):Capital and Equipment Funds • Grants for the Establishment of School-based Health Centers • $200 million over 4 years, starting in FY2010 • Limitations: only for expenditures for facilities • Acquisition or improvement of land, facility, equipment • No funds for personnel or to provide health services

24. Section 4101(b): Operations authorization • Grants for costs of the operation of school-based health centers • Equipment; training; management and operation; and salaries for physicians, nurses, and other personnel • Authorizes spending but doesn’t allocate it

25. Operations funding: The Uncertainty • No funds appropriated • Our request: $50 million for FY2010 appropriations bill

26. Data Collection Resources and Planning

27. An accurate appraisal of the current situation (strengths, concerns, and general conditions) of a community’s population A collection of secondary and first hand information and data from a wide range of relevant sources and audiences What is a Community Needs Assessment?

28. A process for: identifying needs and resources in a community determining gaps between what a situation is and what it should be establishing priorities An opportunity to paint a picture of the conditions in a community and sharpen your perceptions of the critical issues children and families face What is a Community Needs Assessment?

29. Better understand the community in which you will be working Become aware of needs and concerns you never knew about Locate hidden strengths or underutilized resources that could be developed Document need Make sure future actions are aligned with expressed community needs Why Identify Needs and Resources?

30. ADVOCACY!!! Garner greater support and involve more people in subsequent action Give voice to individuals in the community who have not traditionally been solicited for comment Convince outside funders and supporters Make decisions based on priorities and documented needs Why Identify Needs and Resources?

31. Presentation Objectives Objectives:PART 1: • Overview of Ohio School Based Health Care Association and school based and linked services in Ohio • Understand what SB/LHCs look like • Discuss impact of health care reform on school based and linked care • Understand data collection/resources and how to incorporate data into social marketingPART 2: • Identify a case study of social marketing/data for advocacy in Ohio • Understand advocacy basics • Create, via team role playing, an advocacy/outreach plan for your school health team

32. Step 1:Involve stakeholders Establish working group to guide the planning and implementation of Community Needs Assessments Planning and Implementing the Assessment

33. Step 2:Determine the Objectives and Outcomes of the Assessment What are you really interested in knowing? Your questions will flow from this. What is your vision? How will you use the information obtained? Which issues, questions, and behaviors are of particular interest? What don’t you know about these issues? What questions do you need to answer? Planning and Implementing the Assessment

34. Step 3:Identify secondary data sources Find out what outside resources can be used What public reports exist (examples of sources: census data, vital statistics, reports) Have other studies been done? Are there experts in the community who can help you? Planning and Implementing the Assessment

35. Step 4: Choose your approach/ approaches for gathering new information Most common approaches: Key informant interviews Focus groups Public forums Surveys Planning and Implementing the Assessment (cont)

36. Planned Approach to Community Action (PATCH) developed by CDC effective model for planning, conducting, and evaluating community health promotion and disease prevention programs Used by diverse communities in US and other nations to address health concerns PATCH Guide for local coordinator has sample surveys and data collection tools Web site (now CHANGE tool) useful Planning and Implementing the Assessment

37. Needs Assessment • Helps you determine where you are at, existing resources and gaps • Paints a picture of the school, the community, the environment • Helps you determine what the model needs to be and the types of services • Necessary to make a solid plan for implementation

38. Data Resources • www.healthlandscape.org • Public Health Data • Free and Reduced Lunch Numbers • Department of Health Vital Statistics • County Medicaid and Child Protective Services Statistics

39. Marketing Defined "Marketing is a dialogue over time with specific groups of customers whose needs you understand in depth and for whom you develop an offer with a different advantage over the offer of your competitors.” www.buildingbrands.com

40. Social Marketing Defined • A process for influencing human behavior on a large scale, using marketing principles for the purpose of societal benefit rather than commercial profit • At the heart of the social marketing approach is the understanding of your audiences’ needs and wants and the commitment to create programs, plans, and practices to help them solve their problems

41. Product Price Place Promotion Four ‘P’s of Traditional Marketing

42. The Marketing Mix • Price (value) • Product (solution) • Place (access) • Promotion (info)

43. Publics Partnership Policy Purse Strings Four Additional ‘P’s of Social Marketing

44. Who are the people outside your constituency that you need to engage to increase your success? Whose support do you need inside your organization to increase your success? Publics

45. Are there other organizations… doing similar work with which you could collaborate? that could bring needed resources and skills? that would be politically advantageous to align with ? Partnership

46. Are there any policies that could be highlighted to heighten interest in SBHCs? Are there ways to showcase influential policymakers who endorse the policy? Policy

47. Is the funding you currently have sufficient to achieve all of your objectives? Is there the potential of corporate sponsorship of your SBHC? Purse Strings

48. How do I tie this all together?

49. Case Study: Southern Local • Relevant Information: • School RN becomes NP • Close ties to an underserved community • Interested in a school based health center • Contacted OSBHCA • Needs Assessments already completed • Presented the data to school board

50. Teacher Staff Survey