CDI-Meeting-Highlights-Packet-October-2018

• Arizona Department of Forestry and Fire Management, Children’s Action Alliance, Creighton Community Foundation, Flagstaff Shelter Services, and Ajo Center for Sustainable Agriculture h

COMMUNITY DEVELOPMENT & INNOVATION ADVISORY COMMITTEE

October 25, 2018 from 4:30 – 6:30PM

Vitalyst Health Foundation, 2929 N Central Ave #1550, Phoenix, AZ 85012 Conference Line (602) 385-6524 Passcode 6504#; Zoom: https://zoom.us/j/229989243

VITALYST HEALTH FOUNDATION MISSION

To connect, support and inform efforts to improve the health

of individuals and communities in Arizona

Proposed Meeting Results:

1 All CD&I member to actively participate in LOI Discussion

2 CD&I Board members to decide on which LOIs to move forward to Full Proposal

INTERNS: Megan Phillips, Ingrid Okonta

COMMUNITY: Richard Crews, Teresa Mabry

Meeting Agenda

4:30pm Welcome, Session Objectives, & Introductions

• Respond to any questions since Orientation Session & August Highlights

• Review Staff Recommendations

• Discussion & Action on LOIs

• Make official recommendation of LOIs to move to full proposal

Priscilla called the meeting to order at 4:36pm

4:45pm Context Setting & Review of Group Agreements:

• Context Setting

• Review Working Guidelines/Group Agreements

• Review Consensus Building and Decision process

• Time limits on discussions

• Review Scoring Criteria

5:00pm Review Staff Recommendations

• Review Conflicts of Interest

• Gather additional information

Melanie presented staff recommendations based on reviewer data from staff, board, and

community

• Arizona Department of Forestry and Fire Management, Children’s Action Alliance, Creighton Community Foundation, Flagstaff Shelter Services, and Ajo Center for Sustainable Agriculture had 2/3 or higher approval to move to proposal from all three reviewer groups

• Staff recommended moving the following for full proposal: Arizona Department of

Forestry & Fire Management, Children’s Action Alliance, Hushabye Nursery, Creighton Community Foundation, Flagstaff Shelter Services, Ajo Center for Sustainable

Agriculture, Amistades, Inc., South Mountain WORKS Coalition, and Hopi Cancer Services

• Staff recommended moving the following to programmatic funding: Arizonans

Concerned About Smoking, AZ Faith Network, Addiction Haven, and Equality AZ

5:20pm Committee Discussion & Action on LOIs

• CD&I Committee decides which LOIs to request a full proposal The Board will receive the recommendations of the CD&I committee as information only (not for a full Board vote)

Arizona Department of Forestry and Fire Management, Children’s Action Alliance, Creighton Community Foundation, Flagstaff Shelter Services, and Ajo Center for Sustainable Agriculture

• Essen and Priscilla suggest requesting full proposals from the organizations that were consistently in reviewer’s top 5

• Kathy motions for a vote and Essen seconds Motion passes unanimously

Hushabye Nursery

• Concerns include that it is not an innovative proposal or representing systems change and discomfort with funding an ED salary Also, there may be other funders more appropriate or potential partners in funding for this project

• Full proposal was requested by staff and board reviewers, but not by majority of

community reviewers

• Staff recommends moving forward because an ED would greatly expand their capability for obtaining additional funding and there are only 2 others of this type of ED

• Essen motions for a vote and Kathy seconds Motion passes unanimously

Arizona Faith Network

• Staff recommends moving to programmatic funding

AZ Concerned About Smoking

• Sue and Pam feel that it is a system change that would improve the health of children, particularly minority populations, and that it is a very innovative approach

• Concerns from staff include that it’s not appropriate for an innovation grant because it is

an expansion of existing work and there is low state level interest Staff recommends moving to programmatic funding

• Kathy motions for a vote and Sydney seconds Motion passes unanimously

Amistades, Inc

• Concerns are that LOI is not clear in what the money would actually be used for Others felt it was very innovative and full proposal would give opportunity to clarify questions

• Essen motions for a vote and Colby seconds Motion passes unanimously

South Mountain WORKS Coalition

• Concerns are mostly around sustainability and financial status of the organization Others feel that it was more like programmatic work

• Colby motions for a vote and Essen seconds Motion passes unanimously

First Place AZ

• Concerns are that it is based on a medical home model/standard of care which is not innovative, and it appears to be more like a research study Another concern is that it missed the self-efficacy and patient-centered approach that is standard in ASD projects and did not specifically address health equity

• Kathy motions for a vote and Sydney seconds Motion initially ties at 4-4 and then passes 6-3

Hopi Cancer Support Services

• Essen motions for a vote and Sydney seconds Motion passes 7-1

Northern Arizona University

• Sue motions for a vote and Essen seconds Motion passes unanimously

Girl Scouts of Southern AZ

• Concerns are that money would be more impactful elsewhere

Full Proposal Requested:

1 Arizona Department of Forestry and Fire Management

2 Children’s Action Alliance

3 Creighton Community Foundation

4 Flagstaff Shelter Services

5 Ajo Center for Sustainable Agriculture

11 Hopi Cancer Support Services

12 Northern Arizona University

6:20pm Closing

• follow-up

• reflection

6:30pm Adjourn

Upcoming Meetings

• Next Board of Trustees Meeting - November 29, 2018 from 4:00-6:00pm

• IG Full Proposal Review – January 28-February 8, 2019

• IG Presentations – February 11-14 from 1:00-4:00pm each day

 in-person, Zoom, or recording

• Next CD&I Committee Meeting – February 28, 4:30-6:30pm

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V ITALYST H EALTH F OUNDATION - 2019 I NNOVATION G RANT LOI S

TOTAL SCORE

% FULL PRO- POSAL

ENDATION Other Funder

RECOMM-DISCUSSED – Staff Recommended for Full Proposal

Park Rx - is to pilot an innovative approach

to environmental and medical care systems change that supports active living and improved physical and mental health and community cohesion

Staff Recommendation:

proposal

Comments: Biggest barrier could be City Parks & Rec, Will this actually change medical systems?, Is there interest to partner with community organizations in marginalized areas?

Staff Recommendation:

proposal

Comments: Concern that the impact will be incremental rather than transformational, Feasibility based on the fiscal implications to the state?, disaggregation of foster system data/outcomes

by race/ethnicity, unclear if this is an extension of existing work, is there opportunity to continue

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partnering with Casey Family Programs?

by Vitalyst, Hushabye Nursery expects provider partners (Dignity, PHX Children’s Hospital, MIHS, etc.) to incorporate the new practice in their standard operating

procedures and protocols for care

Staff Recommendation:

proposal

Comments: How is community at the table developing this? Concern about funding an Executive Director position

Past investment: Hushabye received planning grant ($10,000)

Current: a TAPAZ fiscally sponsored project

Staff Recommendation:

proposal

Comments: Would like to see clear engagement of people impacted in the community (parents, teachers), community school concept, need better clarity of what they hope to accomplish

affordable housing HCTs, comprised of an FSS Housing Case Manager, a North Country Healthcare primary care provider, and a behavioral health provider from The Guidance Center, will work in coordination

to improve housing and health outcomes among individuals experiencing

Staff Recommendation:

proposal

Comments: needs evaluation and dissemination plan, how is the additive/different than what Circle the City is doing?

N AZ Healthcare Foundation*

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homelessness Once participants transition to housing stability and their acute physical and behavioral health needs are met, other social determinants of health, such as economic and educational opportunity, will be addressed as well Will employ rapid rehousing model

due to frontier region with limited resources

*funded some pre-work leading up to this point

Ajo Center for

of Arizona’s agriculture, as well as develop a shared system for administering the

apprenticeships which will aid in the implementation of this legislation once passed This will include determining qualifications for the farmers and organizations to host apprentices, and qualifications for those applying We will also explore accreditation of the program by community colleges and/or universities

of change is being underestimated, Need more detail and clarity for the project, concern about cultural relevance and connection to systemic issues

Current investment:

programmatic grant

$35,000 for Healthy Communities Starts in Schools project

Staff Recommendation:

programmatic funding Comments: not fit for innovation grant due to expansion of existing work, and lack of state level

$110,000

2 years

74.25 60% PROPOSAL

(8-0) BHHS Legacy, AZ Community Foundation,

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… Tanner Community Dev Corp., American

Heart Association, American Lung

Association, Cancer Action Network, Inc., Preventing Tobacco Addiction Fdn, Tobacco Control Legal Consortium, Truth Initiative, Campaign for Tobacco-Free Kids

interest at this point How does this include teens in forming the policy?

Account for cultural factors?

Virginia G Piper

Amistades intends to create a collaborative safe space for families, healers,

neighborhood advocates, non-profits, and schools to organize and acquire culturally-based healing and advocacy training targeting this objective

Staff recommendation:

Proposal

Comments: concern about how the work will continue (sustainability) Need more specificity on what they will doing Is there a partnership with Mi Familia Vota?

S AZ, Agnes Haury at UofA

no harm, acceptance, community power and sustainability The goal is to generate a process for integrating trauma informed approaches into communities, community health work, community building and education

Staff recommendation:

Proposal

Comments: Questions about Sustainability, possibly partner with Southwest Human Development – Trauma Informed work with UMOM At the end of 2 years, what will be different and how will we know?

Did not indicate amount

2 years

71.85 55% PROPOSAL

(8-0)

Helios, Piper Resiliency

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hub-and-connecting other providers and support systems (spokes)

Staff recommendation:

programmatic

Comments: medical home model that is not innovative – moving towards standard

of care, research study, no discussion of health equity

or sustainability How individuals with ASD are at the table developing the work?

Past investment: consultant

to convene Autism group of 7-10 organizations ($7,000)

on the Hopi Reservation

Staff recommendation:

Proposal

Comments: Articulate cancer rates in Hopi community (state health assessment) Need to ensure community representation early-on Might be good to narrow the focus beyond health screenings

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HIV Prevention Program to adapt an existing HIV prevention curriculum and to pilot test and implement a culturally adapted

HIV/AIDS curriculum in 4 schools on the Navajo Nation

Staff recommendation: Not recommended for proposal

or programmatic

Comments: Realistic to accomplish in 12 months?

Who are the community partners? What is the role of community members (e.g

youth) in curriculum creation? Feels driven by NAU rather than the Navajo communities

$125,000

1 year

66.95 47% PROPOSAL

(7-0, Sydney had to leave early)

DISCUSSED – possible programmatic work with budget reallocation in January

advocacy, promoting fair ordinances and court practices and faith-based models of housing innovation We are partnering with individuals and families affected by the crisis

by providing them with training and organizing opportunities to engage them in developing solutions to attain and maintain access to affordable housing

Recommendation: Based on direct alignment with our current work, move to programmatic funding where they can be more flexible with funding and start sooner (Jan vs Jun) CJ

in support of this recommendation

$125,000

2 years

75.29 62% OTHER

Corporation for Supportive Housing, SJHMC Community Grants

Concerns: only one partner, lack of community-based partners to be engaged in the development process, have other Girl Scout’s

$100,000

2 years

67.15 50% OTHER

Community Foundation of

S AZ, Flynn Foundation,

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on experience and mentorship in advocacy and civic engagement skills, allowing them space to develop their voices and make meaningful changes in their community far before they gain the right to vote

developed something similar?

Women’s Foundation of

weaknesses in the continuum of prevention, active addition, treatment and recovery Task forces would be made up of: police, fire, hospital, education (middle & high), pharmacy, faith leaders

Recommendation: not the best fit for innovation grant, Tempe has a task force like this – move to

programmatic funding where they can be more flexible with funding and start sooner (Jan vs Jun)

$125,000

2 years

65.52 52% OTHER

BHHS Legacy, SE Legacy, BCBS Mobilize AZ, Mercy Maricopa, NARBHA, N

AZ Healthcare Foundation

Recommendation: Based on direct alignment with our current work, move to programmatic funding where they can be more flexible with funding and start sooner (Jan vs Jun)

SP, JF & CJ in support of this recommendation

Did not indicate

60.63 21% OTHER

AZ Community Foundation, Community Foundation for S AZ, Southern AZ Women’s Foundation

program will provide information, skills, resources and support needed to sustain and

Concerns: Not an innovation grant, no partners listed, programmatic

Recommendation: establish historical connection to TCDC

re-$125,000

2 years

54.21 26% OTHER

AZ Community Foundation, First Things First

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empower parents in their own communities

The program will engage twenty parents in a train-the trainer model, which has been used successfully in many other program

applications

Innovation Potential-The purpose of this project – Park Rx - is to pilot an innovative approach to

environmental and medical care systems change that supports active living and improved physical and mental health and community cohesion The Park Rx elements and framework have been

successfully implemented in different ways and scales throughout the country A local example is in Tucson where the BEYOND Foundation has successfully partnered with 65 health care practitioners to prescribe Park Rx to over 1,050 patients, and new patients are requesting to be prescribed Park Rx In Maricopa County, we are proposing a similar cost-effective approach to bridging primary health care and local park and community resources that both changes the culture and practices of clinical care and strengthens community ownership of neighborhood assets Success will be a result of

collaboration between private and public partners including community members, organizations, and government agencies

Individuals and their families and friends that spend time in public open spaces have increased

physical activity and improved mental health Under Park Rx, clinicians will prescribe (a certain

amount of) walking in local parks to their patients Doctors and other caregivers will participate in organized group walks or guided hikes (Walk with a Doc) with their patients (and family members and friends) to reinforce the importance of developing healthy and consistent walking habits and time in nature Park Rx relies on existing neighborhood or community parks and/or trails to develop spending time in nature and walking, to impact positive health outcomes such as decreasing chronic disease

Systems Change - This pilot seeks to change a community health clinic’s approach to treating and preventing chronic disease by connecting clinicians and patients outside of the clinic walls in ways that model healthy behaviors Through Park Rx, clinicians will prescribe walking and spending time in parks to their patients and their families, sometimes with clinical staff or other community role models, including but not limited to, the local librarian, a local teacher, and a dietitian Patients, on the other hand, will improve their health by being more physically active outdoors or by simply spending time in nature Communities will be strengthened as greater numbers of residents reassert their ownership and stewardship of neighborhood parks and increased connectedness

We intend to pilot Park Rx in a neighborhood with challenging park infrastructure and legitimate resident safety concerns During the pilot we will conduct walking audits with MIHS patients and community members, and work with the City of Phoenix to reduce access to the park barriers and fix selected infrastructure and safety concerns as identified by the community These improvements should attract more park users and encourage them to spend more time in the park When the pilot project ends, the clinic will sustainably continue implementing Park Rx in a renovated local park with new trees and shade, benches, a designated walking path (perhaps with WalkPHX designation), and other opportunities for outdoor physical activities

Health Equity Lens - The community clinic for this pilot serves a low-income population in South

Central Phoenix with well-established health disparities and challenging systems and community factors Clinic patients, staff and community partners will collectively identify barriers preventing them using the park such as park access and lack of heat mitigation, and will advocate for needed improvements and infrastructure changes made through this Park Rx partnership collaboration

Community partners - This project will not be successful without a strong partnership among

multiple stakeholders Participating organizations include, but are not limited to:

Arizona Department of Forestry and Fire Management (DFFM) – Applicant and grant coordinator John Richardson has experience with Park Rx in Tucson and wants to implement this project in

Arizona Department of Forestry and Fire Management

Page 2

Maricopa County The Department’s vision is to spread this project throughout Arizona and to create

a stronger link between parks/nature, residents and healthcare One deliverable of the pilot will be a framework that can be replicated, with some adjustments, in other parts of Arizona

Maricopa County Department of Public Health (MCDPH) – Will actively collaborate with MIHS staff

and patients and support pilot coordination and communication among project participants, in

addition to providing available public health data

Maricopa Health Integrated Systems (MIHS) – Will implement Park Rx at the 7th Avenue Family Health

Center, training staff and scheduling Walk with a Doc and similar events and collecting program data

to support pilot evaluation

Harmon Library – Adjacent to Harmon Park, the library can serve as a water stop and a walking

destination The library will support any physical activity programming the project plans to conduct

Lowell Elementary school – Located near Harmon Park, the elementary school can serve as a walking

destination to its discovery area Walkers can use the school’s yard for walking and playing

City of Phoenix Parks and Recreation – Will consider selected improvements in Harmon Park

identified by the community and collaborate with other partners and other City departments

The Nature Conservancy (TNC) – Will consult on tree and shade canopy, using knowledge gained with

the Nature’s Cooling Systems Project

Trees Matter – Will assist with tree planting, planning and implementation

AZ Sustainability Alliance - Will assist with tree planting planning and implementation

Phoenix Revitalization Corporation – Will participate in project coordination and consultation

Sustainability - After pilot initiation that includes staff training, community development and improved park infrastructure, the project can be sustained through continued MIHS support and involvement We expect to see MIHS continuing to implement this comparatively low-cost project by changing protocols that reinforce Park Rx With shade and infrastructure improvements complete, the park will strengthen social cohesion among community members

Health Outcomes - Park Rx will improve park access and infrastructure, with increased social

cohesion resulting in patients (children and adults) spending time in natural environments with increases in physical activity and healthy weight, and increased glycemic control and reduced

diabetes Reductions in cardiovascular, respiratory, neurological, digestive, and mental disease should follow

Budget - We are requesting $125,000 to support infrastructure improvements in Harmon Park as

well as access to the park, and to leverage additional funds provided by other agencies and grants The budget will be used for: adding a new trail in the park and fixing existing trails; fixing minor access

to the park barriers; outdoor furniture; walkability audits; MIHS project coordinator; community engagement; participants’ incentives; and printing materials Planting of trees to shade the trail and installation of irrigation are also budgeted for although we anticipate donations and support by other agencies and organizations

C h i l d r e n ’ s A c t i o n A l l i a n c e

A Voice for Arizona’s Children since 1988

3030 North Third Street, Suite 650 | Phoenix, AZ 85012 | (602) 266-0707 phone | (602) 263-8792 fax

738 N 5 th Avenue, Tucson, AZ 85705 | (520) 329-4930 phone

www.azchildren.org | caa@azchildren.org

Fostering Advocates Arizona

September 28, 2018 Vitalyst – Innovation Grant Letter of Intent

Innovation Potential: Each year in Arizona nearly 1,000 young adults age out of foster care

without a permanent supportive family While some young people are extraordinarily resilient and able to navigate through the trauma and challenges they faced as survivors of child abuse and neglect, the data tells us that alumni of foster care experience worse outcomes than their peers in the general population These outcomes cross a variety of spectrums, including

education and employment, housing and early parenthood Nationally, one in five 19-year-olds and more than one in four 21-year-olds who experienced foster care will become homeless In Arizona, the 2012-2013 school year saw just 33% of high school seniors in foster care graduate compared to 78% for all Arizona students By age 21, more than 40% of young people in

Arizona who experienced foster care will be parents Systems barriers create life-long

consequences for a young person’s ability to succeed

A recent Chapin Hall research study found that young people who stay connected to services beyond age 17 are less likely to report homelessness; more likely to have a high school diploma and attend college; and more likely to have access to food and emotional support compared to youth who simply leave foster care when they turn 18 Fortunately, there is now a unique and timely opportunity in Arizona to re-examine our community structures, laws, policies and

financing to strengthen services and expand supports for youth aging out of foster care to age 26 Children’s Action Alliance (CAA) is an independent voice for Arizona children at the state capitol and in the community and the home of Fostering Advocates Arizona (FAAZ), a

community collaboration that partners with alumni of foster care and child welfare stakeholders

to build political will for state level policy improvements Utilizing the FAAZ collaborative framework that brings the diverse voices of the 25-member Community Advisory Board together with the 12-member Young Adult Leadership Board, we will research and convene community conversations to inform and influence decision-makers at the State Capitol, Department of Child Safety (DCS), the courts and the community to support, expand, and improve supports and services to help Arizona youth from foster care thrive and succeed

Systems Change: Since 2000, the state has offered extended foster care to age 21 More recent

research on trauma and adolescent brain development, and new data on racial and ethnic

disparities have convinced us that Arizona state policies and practices need to be examined to better incorporate supportive and engaging youth services and to help address the racial and ethnic equity of young people in care Systems change is possible due to the recent passage of the 2018 federal Family First Prevention Services Act (FFA) and related law provisions FFA allows Arizona the option to extend critical services, including one-on-one case management, financial assistance with housing and post-secondary education and life-skills training to young adults who have experienced foster care up to age 26 For the first time, DCS has included in its strategic plan a goal to “increase successful transitions to adulthood of all children 14+ while in foster care.” DCS has also agreed to collaborate with CAA /FAAZ with technical assistance from The Annie E Casey Foundation (AECF) to conduct a fiscal impact study to determine the feasibility of drawing down available federal funding for extended foster care services to young

adults in Arizona This fiscal study will start in January of 2019 and is expected to conclude in June of 2019

Health Equity Lens: With funding from Vitalyst, our project proposes the following effective,

equitable and sustainable elements: (1) Collaborate with alumni of foster care, DCS, the courts and community stakeholders to examine current state laws, policies, practices and finances to support extended care services up to age 26; (2) Develop a FAAZ Young Adult Leadership Policy Brief including recommendations to improve the quality and availability of services to older youth from foster care; (3) Share the FAAZ Policy Brief findings and recommendations at

a 2020 FAAZ Youth Leadership Day at the Capitol and at community convenings to create

dialogues and enhance relationships between decision-makers, stakeholders and young adults; and (4) Continually work toward the implementation of the recommendations that focus on the long term well-being of young adults and their contribution to a wholistic healthy community

Community Partners: In 2013, Children’s Action Alliance partnered with the national Jim

Casey Youth Opportunities Initiative (JCYOI), housed within the Annie E Casey Foundation, to launch FAAZ and became one of the 18 JCYOI states working to improve outcomes for older youth in foster care FAAZ’s strength lies in its collaboration with the 12 member FAAZ Young Adult Leadership Board, a board of alumni of foster care, and its Community Advisory Board that includes representatives from DCS, Arizona’s Children Association, Casey Family

Programs, Maricopa County Juvenile Court, Arizona Department of Juvenile Corrections, Tumbleweed Center for Youth Development, Jewish Family and Children’s Services, Mercy Care, Maricopa Community Colleges, Maricopa County Office of the Legal Advocate,

International Rescue Committee, United Health Care Through these collaborations, FAAZ invests in the leadership and professional development of young people to share their first-hand knowledge and experiences to promote programs and services that are equitable and will lead to long term well-being of youth

Sustainability: Over the past five years, FAAZ has been supported, in part, by grants and

technical assistance from AECF In 2018, we received $80,000 from AECF and $25,000 from

the Arizona Community Foundation to support FAAZ Additionally, we recently summited a

$20,000 grant request to the State Policy Advocacy Reform Center (SPARC) for the period from November 2018 to May 2019 that would lay the foundation for this project We will work to secure continued funding from AECF and plan to seek out other funding opportunities for general FAAZ activities The overall state policy and practice changes proposed in this request, and as adopted by DCS and other stakeholders, will be sustained with state and federal funds as well as community-based resources

Health Outcomes: The project’s focus on older youth in, and transitioning from, foster care

will focus on outcomes in the area of health, housing, education, and economic well-being; including the percent and number of young people participating in after-care services, receiving housing support, reporting a high school diploma or GED at age 19, reporting being employed at

17, 19 and 21, and those aged 18 to 26 enrolled in and receiving AHCCCS health benefits All outcomes will include tracking of racial and ethnic disparities that may exist

Budget: CAA is requesting $120,000 over the next two years to provide critical resources for

our collaborative efforts Funds would provide staff support to drive this work, leadership

development and engagement of alumni of foster care to convene and educate policy-makers, administrators and community stakeholders on their policy brief recommendations

Vitalyst Health, Innovation Grant 2019 Submissions RE: A school-centered model for services delivery and reimbursement

Thank you for your open invitation to the community to submit LOIs for the 2019 Innovation Grant Cycle, exploring opportunities to impact the social determinants of healthy communities in innovative ways As Vitalyst Health may be aware, Creighton Community Foundation is focused on developing community vibrancy through multi- generational community capacity building strategies integrated into school-centered neighborhood models Our strategies often incorporate a number of social determinants In

partnership with ASU REACH Institute, Creighton School District, and a developing multi-member

Creighton Community Health Coalition, we submit this Letter of Intent to approach Vitalyst's Innovation Grant 2019 cycle, provided we are invited to do so, for seed and exploratory funding around school- centered neighborhood wellness services

Background

The Creighton boundary area in Phoenix contains a number of extremely low-income neighborhoods, suffering from low engagement in formal systems of care Our primary sub-communities of focus – south of Thomas Road, between 16 th and 40 th Streets – lack widespread engagement with preventative care or formal systems of treatment, often from lack of benefits enrollment (often due to lack of rights, lack of education/awareness, or exceeding benefit income restrictions while still lacking a living wage) These patterns are typical of low-income communities, and these particular communities contain populations below the Federal Poverty Line, and contain child populations where the 85% of children attending public schools (versus charter/private) reflect a 99% qualification rate for Federal Title I free or reduced lunch programs

Among these communities, we continuously look for opportunities to disaggregate health care access into places and relationships of hyper-localized trust, in order to build stronger long-term relationships with care providers, stabilize highly mobile communities, and potentially "move the needle" on

community health Schools as neighborhood resources can broadly deliver services in places with higher levels of trust, and with the right investments can draw in community members not currently connected with schools, thereby increasing community trust, altering care patterns and social determinants, and lead to significant changes in community vibrancy and outcomes (as demonstrated by the U.S

Department of Education's Full Service Community School models) Current school funding restricts even student-facing services, and third-party partnerships often are poorly integrated into sites and/or irregular over time Opening doors to direct school provision of broader services or deeper integration

of partner services through emergent reimbursement opportunities (RHBA changes and Promotora models) have potential to address existing challenges, and set the stage for making an even broader assortment of services accessible in centers of trust disaggregated from traditional system of care service points While our ambitions are enormous, we look for small steps that may allow us to

systematically advance single services or test cases with clear starting and ending goals, especially when those advancements may apply to other communities throughout the state

The Project

In the intersection of access to care, social cohesion, and educational opportunity, we are proposing the formation of a coalition to conduct exploration, advocacy, and development of a school-centered model for services delivery and reimbursement of wellness services, using an evidence-based school-friendly anxiety mitigation solution with lightweight multi-faceted deployment (Compass for Courage) as a test and evaluation case while developing a state-wide model

A core team will deploy ASU REACH Institute's evidence-based Compass for Courage

(https://compassforcourage.com) in 3 models across 6 school sites, while working with a multi-sectoral coalition to develop a reimbursement model Specifically, a 3 member core team and a variety of

partner organizations will support and follow the start of anxiety program delivery while exploring delivery and billing practices compatible with and supported by the Arizona School Board Association, Arizona Department of Education, Federal privacy regulations (HIPAA/FERPA) and public school governance practices

We propose to integrate this work with deployment of a non-labor intensive social emotional (anxiety) program that 1) addresses school social emotional goals in a highly attractive way, 2) actively delivers a service that is highly compatible with existing medical diagnostic and billing codes (ICD-9 300 series and ICD-10 F40s,F41s,F93), and 3) provides opportunity to test and evaluate services engagement and billing practices in three different staffing models with contrasting mixtures of paraprofessional, promotora, and professional resources Most importantly, this program provides an attractive use case among broad school audiences (social emotional learning, high anxiety/trauma engagement) as well as providing discovery and evaluation opportunities around the delivery of services The general prevalence of pediatric anxiety is 8% to 12%

in childhood, and as high as 35% in adolescence (Merikangas et al., 2011) For this reason, Social Emotional Learning, Trauma-informed practices, restorative practices, and various other trends have gained great interest in schools across the nation In predominantly Hispanic/Latino (H/L) communities representative of Creighton, there are typically higher rates of separation anxiety, more trauma (or PTSD), and higher anxiety-related somatic/physiological problems (Ginsburg & Silverman, 1996; Pina & Silverman, 2004; Varela et al 2004) H/L culturally demonstrate higher anxiety sensitivity, which places them at higher risk for panic attacks and depression in early adulthood and beyond (Pina & Silverman, 2004) Almost all of these variations for H/L are linked to low SES status, burden, and trauma exposure typical of Creighton

Health Outcomes: Alongside a forming coalition of community partners, with success this project will 1)

address notable anxiety levels in low income schools, 2) evaluate specific blended school and community delivery models around those services (6 schools, 3 delivery models) that may inform future wellness services delivery, and 3) develop a comprehensive framework for reimbursement of future school-based wellness services

Core Partners: ASU REACH Institute, Creighton Community Foundation (fiduciary agent), Creighton

School District, Banner Health, Crossroads, Terros Health Additional Partners: We expect to engage participation from a 12 sector Creighton Coalition for Community Health coming together prior to a

2019 Drug Free Communities grant Moreover, we would hope to engage Vitalyst Health directly for advisory and advocacy services Indirectly, this project will help fuel the formation of this coalition and other future community health initiatives, and set the stage for local school engagement with coalition

Sustainability: Development of a reimbursement model for public school systems (where licensed

providers currently provide a wide range of non-integrated services for free by harvesting reimbursements) is expected to lead to a sustainable revenue model for the core wellness service being used as a test case, and open the door to various other sustainable services

Budget: We anticipate 2 years of execution, with phased utilization of a core team of 3 additional

personnel across organizations: a community promotora (District/Foundation), a reimbursement/policy/research specialist (ASU), and a program manager responsible for coordinating task force and evaluation activities (Foundation) Materials and operational costs are minimal, with limited materials costs for Compass for Courage, and operational costs for task force / coalition meetings, and consultative costs for advocacy support Our proposed budget will be $125,000