Program Details

Practice Type:	Promising
Program Name:	Washington County School-Based Chemical Health Initiative
Organization:	Washington County Department of Public Health and Environment
Web site:	http://www.co.washington.mn.us/
Overview:	The Washington County Student Chemical Health Initiative is a collaborative project among five school district superintendents, the Washington County Administrator, and the directors of the county’s public health, community services, and corrections departments. The vision of the project is to implement a county-wide, comprehensive, and coordinated school-based chemical health system which reflects best practices and is supported through stable and long-term funding. The goals of the system are to reduce student chemical use and improve educational performance by providing the “right resource to the right kid at the right time.” Community agencies were also involved in designing and implementing the system. School and county funds were pooled to place Chemical Health Prevention Specialists (CHPS) in six senior high schools in the county in the fall of 2004. The project has the potential to serve 13,272 students in grades 9-12. The objectives established for the Initiative by an appointed chemical health task force included: Implement services at six senior high schools during the 2004-2005 school year. Provide screening, initial intervention, referral and case management. Provide transition and recovery support. Provide education resources for youth, school staff and parents. Market the services to parents, school staff and communities.
Year Submitted:	2005
Responsiveness and Innovation:	The Washington County Department of Public Health and Environment conducted a community health assessment in 2003. Thirteen problems were identified and prioritized for the department to address over the next five years. Adolescent risk taking behavior due to inconsistent family and community supports for health youth development was identified as the adolescent health problem established though the assessment process. This identified problem examined all adolescent risk factors including alcohol and drug use, tobacco, mental health, violence, sexuality, nutrition, and physical activity. Ongoing collaborative public health work with schools, law enforcements, and service providers indicated that there was inconsistent or no direct services to address chemical health issues for adolescents in the county. Simultaneously, there was a convergence of discussions by county administration, county department directors, community agencies, and school districts superintendents related to the need for collaborative attempts to solve community problems with a limited number of dollars. Chemical health issues were discussed because they cross all systems and are costly to address. There was an identified need for a systems change to incorporate a shared service model that would provide consistent chemical health services county wide. At the same time, the Washington County Family Service Collaborative was contemplating a redesign for more effective use of federal time shared funding (Local Collaborative Time Study - LCTS) for serving youth and families on a county wide basis. Utilizing the methods of Collaborative Leadership, the Department staff were asked to collect community input on the topic of adolescent chemical health issues through a series of school/county dialogues sessions to help define, determine and prioritize needs. Staff collected current data from relevant state and local sources including the 2001 Minnesota Student Survey and Chemical Dependency Treatment Data to established a starting point for discussion and ideas for action. Each of the five school districts in the county hosted one of the dialogue sessions. The overall attendance of 120 people represented schools, local service providers, parents, youth, law enforcement, county government, and health care. Each session focused on three key questions for discussion and input: What are the chemical health issues facing the community? What are our assets? What can we do together to address the chemical health issues facing the county? Common themes for answering the above questions included: addressing the community culture and out-of-school time; providing adequate alcohol, tobacco and drug education for parents, students and staff; enforcement of underage drug use laws; and system coordination. Two of the themes, system coordination and enforcement, emerged with the highest level of interest and highest number of action recommendations from dialogue participants.
Agency and Community Roles:	Each partner and stakeholder was able to contribute to the outcome of the developed shared service model. Some of the roles included: Department of Public Health and Environment facilitated dialogues and reported findings to administrators. Schools districts were responsible for inviting stakeholders to the dialogues and providing meeting space. Department of Public Health and Environment facilitated the Chemical Health Task Force which met from January 2004 through September 2004 to work on the Vision, Values, Goals, Strategic Plan and Action items moving toward implementation. Planning progress was reported to county and school administration. A total of 11 meetings were held involving 20 people for 533 hours of in kind time. A local community agency provided space for meetings. Members of the Chemical Health Task Force developed a host agency selection process-this resulted in one of the county school districts being selected as the employer and supervisor of all Chemical Health Prevention Specialists. A collaborative interview process for hiring Chemical Health Prevention Specialists was conducted involving school personnel from each district. Washington County Department of Community Services serves as fiscal agent and training for federal LCTS funds through the Washington County Family Service Collaborative (now the Washington County Children and Family Council). Washington County Public Health and Environment provides county wide coordination of the ongoing work of the Initiative. Work teams have been established with partners to evaluate and measure outcomes.
Costs and Expenditures:	The provision of chemical health services is funded through the following sources: Local Collaborative Time Study (LCTS) Funds ($185,000) School contributions towards CHPS staff salary in 2004-2005 school year ($22,680) St. Croix Valley Health and Care Research Foundation contribution ($20,000) Public Health Senior Community Health Specialist as the County Wide Chemical Health Coordinator ($34,112) In-kind volunteer time contributions for Chemical Health Task Force and School-Based Team ($18,672) Bayport and Andersen Foudnation Grant to Hazelden Treatment Center ($70,000/year for 3 years) In addition to the financial contributions of the LCTS funds, there are numerous hours of in-kind time contributed to the project including a half time County Wide Chemical Health Coordinator provided by Public Health Staff, numerous agency contributions of time to the School Based Team and support provided by participating schools including space, computers, supervision, and other support. In addition, there is strong commitment from all the school superintendents and county administration to continue to provide services. Commitment is assured through a formal joint agreement among schools, county and community agencies for the Washington County Children and Family Council. The school districts involved in the project have made an ongoing financial commitment to the project and plans are underway to expand the services to the junior high level once further funding is secured. All of these contributions combined form the essential foundation for providing chemical health prevention and early intervention services for each school district in the county.
Implementation:	The Washington County Department of Public Health and Environment conducted a community health assessment in 2003. Thirteen problems were identified and prioritized for the department to address over the next five years. Adolescent risk taking behavior due to inconsistent family and community supports for health youth development was identified as the adolescent health problem established though the assessment process. This identified problem examined all adolescent risk factors including alcohol and drug use, tobacco, mental health, violence, sexuality, nutrition, and physical activity. Ongoing collaborative public health work with schools, law enforcements, and service providers indicated that there was inconsistent or no direct services to address chemical health issues for adolescents in the county. Simultaneously, there was a convergence of discussions by county administration, county department directors, community agencies, and school districts superintendents related to the need for collaborative attempts to solve community problems with a limited number of dollars. Chemical health issues were discussed because they cross all systems and are costly to address. There was an identified need for a systems change to incorporate a shared service model that would provide consistent chemical health services county wide. At the same time, the Washington County Family Service Collaborative was contemplating a redesign for more effective use of federal time shared funding (Local Collaborative Time Study - LCTS) for serving youth and families on a county wide basis. Utilizing the methods of Collaborative Leadership, the Department staff were asked to collect community input on the topic of adolescent chemical health issues through a series of school/county dialogues sessions to help define, determine and prioritize needs. Staff collected current data from relevant state and local sources including the 2001 Minnesota Student Survey and Chemical Dependency Treatment Data to established a starting point for discussion and ideas for action. Each of the five school districts in the county hosted one of the dialogue sessions. The overall attendance of 120 people represented schools, local service providers, parents, youth, law enforcement, county government, and health care. Each session focused on three key questions for discussion and input: What are the chemical health issues facing the community? What are our assets? What can we do together to address the chemical health issues facing the county? Common themes for answering the above questions included: addressing the community culture and out-of-school time; providing adequate alcohol, tobacco and drug education for parents, students and staff; enforcement of underage drug use laws; and system coordination. Two of the themes, system coordination and enforcement, emerged with the highest level of interest and highest number of action recommendations from dialogue participants.
Sustainability:
Lessons Learned:	1) Systems change is slow: the expectation was that all six high schools implement the shared service model at the same time. This would have been hard enough to do in just one school – but all six were done at the same time! There were challenges in communication about the project and understanding roles and expectations of the CHPS. To address this, the County-Wide Chemical Health Coordinator and Supervisor met with each school two times in the fall – once to explain the Initiative and then again to check in several weeks later to see how things were going and to troubleshoot issues. Continuing issues are dealt with on an ongoing basis by the supervisor and County-Wide Chemical Health Coordinator. 2) Turf issues arose with several school staff who felt as though the CHPS were going to “take over their jobs.” In addition, some CHPS were viewed as “outsiders” because they were employed by a different school district. Staff at schools needed time to get to know the CHPS, see their skills, understand their role and expertise, and integrate them into the school setting. 3) Staff Expertise: two of the CHPS had never worked in schools before and in addition to learning the job, they needed to learn about working in a school setting. This provided an extra challenge to these two in that there are unique challenges to working in schools. 4) “But we’ve always done it this way!” In some schools there was resistance to changing the way things had always been done – even if it was going to get students help in a coordinated way. Personalities clashed in some schools and CHPS and school staff needed to figure out a way to work together and change the system for the greater good of the students. 5) Having the right people at the table from the very beginning – two schools did not have school principals who were actively involved in the project from the very beginning. This was a challenge when it came to implementing the shared service model in that there was not buy in or understanding from two key people in positions of power. 6) “Let’s see how much we can get the prevention specialist to do!” Once the CHPS started, they were asked to do many things that went beyond their job description. Time was needed for all involved to learn about the parameters of the CHPS job description and their role in the school. 7) School Based Team – this group was formed from two different groups – the Chemical Health Coordinators and the Chemical Health Task force. There were challenges in blending these two groups and getting them to think about the new focus and direction. In addition, the Chemical Health Coordinators went from a networking group to a working group with expectations that all would pitch in. This combined group is still “forming and storming” and trying to figure out the future direction of the CHPS and the Initiative.

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