H&HS Strategic Plan, Tier 1 Outcomes: Reducing Adverse Childhood Experiences
As you may remember from a couple weeks ago, Alicia introduced the three tier one outcomes.
These are essentially goals that are shared between all the divisions and programs in the H&HS
Department. One of these outcomes is to reduce the impact of Adverse Childhood Experiences,
Mary Ellen Bennett from the Human Services Division visits Lane County Behavioral Health to
talk with Cathy Calisch, a licensed marriage and family therapist in the Child and Adolescent
MARY ELLEN: We are inside the building of Behavioral health, in the Child Room.
Cathy: This is the play room, one of our therapy rooms where we work with children and
MARY ELLEN: Can you tell me about what are ACEs? Why do you think it’s important for the
department to reduce them?
CATHY: ACE’s stands for Adverse Childhood experiences, originated by a study from the Centers
for Disease control and Prevention and Kaiser Permanente. They came up with a pretty
substantial connection between things that occur in childhood or the environment around
childhood and then later social emotional cognitive problems, health problems, even leading to
early death. It’s a good focus for the county.
MARY ELLEN: So what are some examples of ACEs?
CATHY:There are 10 that have been identified:
• Emotional abuse
• Physical abuse
• Sexual abuse
• Emotional neglect
• Physical neglect
• Mother treated violently
• Household substance abuse
• Household mental illness
• Parental separation/divorce
• Incarceration household member
Those 10 events could occur either singularly or in multiple occurrences and impact the later
health of the child.
Health risks that can occur are:
• Depression and anxiety
• Poor school functioning
• Alcohol and other drug abuse
• Early sexual activity
• Early pregnancy
• Domestic and intimate partner
• Heart disease
• Liver disease
• Pulmonary disease (COPD)
• Sexually transmitted diseases
• Suicide attempts
MARY ELLEN: What are some strategies for reducing ACEs in Lane County?
CATHY: People can start to recognize if they see families in need, maybe notice that they have
one, or two or more of these adverse conditions in the family. Some will impact them more that
others, but the accumulation of them, they are finding, increases the risk.
MARY ELLEN: It sounds like a strategy is to identify situations, families, children that are
experiencing ACEs. And try to intervene, get them into programs, and try to get them into
programs like yours here at Behavioral health.
Every division, every program and even every employee can possibly do something to pitch in!
For more information on ACEs, please visit the Centers for Disease Control and Prevention
Next week: Tier 1 Outcomes continued – Reducing the number of smokers in Lane County (with
Jennifer Jordan of Public Health)
Tier 1 Outcomes, continued: Improving Fiscal Sustainability
Nathaline Frener with Matthew Sterner & Chaz Dutoit
About this outcome: This outcome is critical for the long-term sustainability of Health & Human Services. It recognizes the importance of examining our systems for possible improvement as well as identifying appropriate funding models for the critical services delivered in H&HS. This acknowledges and seeks to address the fact that the environment within which the department operates has shifted significantly, with County general funds dropping dramatically.
NATHALINE: Hi, my name is Nathaline Frener with the Family Mediation program, and today I’m going to be talking with you about fiscal sustainability. There are two folks for you to meet today -- Matt with Youth Services, specifically with the MLK Program, and Chaz with Behavioral Health -- to find out creative ways they are financing some of their programs.
MATT: In the past few years, we’ve been able to expand our parking for a number of different reasons. One of those reasons is simply because UO has expanded their structures on the other side of the MLK Blvd, They haven’t expanded their parking, they’ve expanded the baseball diamond, they’ve expanded their soccer field, which has really condensed a lot as far as parking for some of their large donors, for folks that like to park have RV’s, and spending a lot of time tailgating and getting ready for the football games.
With our adoption of the armory and getting the armory back after the National Guard moved on to Springfield, that has given us probably another one-third in additional parking revenue as we had in the past. These are dollars exceptionally important to our program, discretionary dollars that we can spend on things that our population really needs. Whether it’s education, support services like bus passes, IDs, interview clothing – these are things like that we wouldn’t normally be able to just have discretionary decision-making around what we spend our money on.
CHAZ: We’re really fortunate to provide parking during U of O football games. The lion’s share of that money goes to support client services. A chunk goes to assist with indigent clients paying for their medications, for folks that don’t have any kind of insurance options or ability to pay.
We also use it to support services that otherwise the state wouldn’t pay for. So, that could be anything from assisting parents with childcare so they can come in to groups and treatment, to providing community resources that otherwise the client couldn’t pay for that supports their therapeutic outcomes.
One of the things we were able to do is create a gardening group. So we invested some money to set this up to create a gardening group for our clients, so this is the kind of flexible funding we are able to use with the money that we get.
MATT: This year, because of the armory and because of some expanded partnerships, as well as pushing the envelope as far as finding new places to park, we’re looking at getting over $100,000 in revenue for our discretionary program.
Intro: Good morning, Health & Human Services. I’m Julie Hynes from Public Health. In today’s message, we’re talking with Jennifer Jordan about the next Tier 1 Priority, “Reducing the number of smokers in Lane County.”
Why is tobacco a Tier 1 Priority?
Tobacco is the leading cause of preventable death in Lane County, in Oregon, and the United States. About 450,000 deaths due to tobacco in the United States and here in Oregon, about 7,000 deaths are linked to tobacco use, and here in Lane County about 700 deaths, or two people a day are dying from tobacco use.
We have very good evidence for what can be done to drive down those rates, and we’ ve had an awful lot of success in this area in the past, not just here in Lane County, but in Oregon and across the country.
Lane County Public Health & Access to Services
I think the first thing that comes to mind for most people when we think tobacco prevention is tobacco cessation, or helping people quit. That is an important part of what we do, because we know that 80 percent of smokers in Oregon want to quit. Our role is referring people to the Oregon Tobacco Quitline (1-800-QUIT-NOW) where they have professional quit counselors that can support people in their quit attempts. We know that working with a quit counselor is effective in helping people quit and stay quit.
[The quitline is free for all Oregon residents, operates from 4am to midnight 7 days a week, and services are available in nearly 200 languages.]
Policy Work: Past, Present & Future
Due to previous work of this program, we have all of our K-12 school districts are tobacco-free campuses, and so now we’ll have kids moving from K-12 campuses to the University that now has tobacco free campuses, and then to more and more worksites that are tobacco-free as well.
Creating the environment that discourages tobacco use really makes big steps toward change social norms around tobacco. What we’ll see, and what we’re seeing, is fewer kids starting tobacco in the first place.
Internally, we are working on expanding the Health & Human Services’ tobacco-free campus policy to our Department’s newly-added Youth Services campus, and the county’s main Public Services Building. We’re also involved in work to ensure that our new Coordinated Care Organization’s (Trillium), PeaceHealth’s and Public Health’s developing Community Health Improvement Plans address tobacco use; expanding upon our work with our local housing authority (HACSA) by encouraging other entities to adopt policies to protect people from exposure to tobacco smoke in their homes; and we are engaging in initial discussions to further expand access to equitable and timely tobacco cessation services to clients by integrating promotion of the Quitline throughout the department and more.
People deserve convenient access to smokefree places and foods and activities that help them live well. Healthy options should be expected, not something we have to search out. It’s the only way we’ll bring an end to rising chronic diseases in our community.
My job this Monday morning is to remind you about the three videos you just saw and to cover where we’re going with our outcomes. So today I want to remind you about the Tier 1 Outcomes, which are those outcomes that cut across all of Health & Human Services.
And if you remember, they were:
- Reduce the number of smokers in Lane County
- Reduce the percent and impacts of Adverse Childhood Experiences (ACEs)
- Improve fiscal sustainability within our department
So those are the three outcomes; you had a chance to meet and here from the folks that are doing work already in those areas within Health & Human Services.
What’s next with the Tier 1 Outcomes?
At the end of this week, I’m going to meet with managers and we’re going to look at those three outcomes for Tier 1 and we’re going to look at strategies to move the needle on those outcomes. As I said, in the video you’ve already seen what we’re currently, but what more can we do? So, as we decide the strategies, we’ll decide how we’re going to actually achieve them. So in a future video, we’re going to tell you about each of those outcomes and the strategies behind them.
I have gotten a lot of feedback about the video we did around the pen and the pillars (if you can name a pillar to get a pen). I want to thank everyone that participated and had a good time with that. We’re still collecting video and are planning on doing another one. So, if you haven’t received one of these green pens, please look for members of the link team, who will be asking if you can name the four pillars.
As a reminder, the pillars of Health & Human Services are:
- Integration & Prevention
- Information & Analytics
Commit one of those to memory, and hopefully you’ll be willing to be in the video. People really enjoyed getting the opportunity to see their coworkers.
I want to thank you for taking the time to listen, to learn about our pillars for Health & Human Services, and to really get an understanding of Tier 1 Outcomes. I want to remind you that we’re also working on our Tier 2 Outcomes, which are the outcomes that cut across the clusters, and our Tier 3 Outcomes, which are ones that are unique to the divisions. We’ll be bringing those to you in future casts.
Thank you so much. Have a great day!