TAG in Action: Identity Wellness Centers

TAG in Action: Identity Wellness Centers


Evelyn Kappeler: Welcome to the webinar “TAG
in Action: Helping to Build Healthy School Communities through Wellness Centers.” The Successful Strategies for Improving Adolescent
Health webinar series is sponsored by the HHS Office of Adolescent Health. This webinar is one of a series highlighting
local, state and national efforts to improve adolescent health, and is part of a national
call to action called Adolescent Health: Think, Act, Grow, or TAG. My name is Evelyn Kappeler. As Director of the Office of Adolescent Health,
I’m very pleased to be with you to talk about TAG, and to share information about a successful
strategy to improve adolescent health. This webinar highlights work by a group called
Identity Incorporated in Gaithersburg, Maryland, which is providing healthcare in schools in
order to improve both health and education outcomes. Today, we’re joined by Carolyn Camacho, the
Youth Centers Director at Identity Inc. Before I turn it over to Carolyn, I’d like
to share a little bit about Office of Adolescent Health and TAG. The Office of Adolescent Health is located
in the U.S. Department of Health and Human Services. The office was first funded in 2010 and charged
by Congress with developing a national plan for improving adolescent health. We’ve used our limited resources and the input
of experts to synthesize what we know about what works [and] spur action in support of
adolescent health. The TAG call to action is a first response
to that charge. With this webinar, we’re pleased to share
an example of the program making it easier for young people to gain access to healthcare. TAG identifies access to healthcare as one
of five essentials for healthy adolescents. TAG builds on the collective work and insights
of many professionals, researchers and family members who know what it takes to promote
the health and healthy development of America’s 42 million adolescents. Teens are generally healthy, yet there are
many missed opportunities to promote adolescent health and to intervene promptly in challenging
health issues that emerge in adolescence and young adulthood. TAG is a comprehensive, strengths-based, positive
youth approach to adolescent health, rather than a risk-based approach. TAG is designed to help young people reach
their full potential as healthy, productive adults. With TAG we hope to spur action across multiple
groups of professionals and organizations, and in communities that all share a common
interest in promoting adolescent health. Stakeholder engagement is a core tenet that
drives all aspects of TAG and reflects our understanding that many determinants of adolescent
health lie outside the health care system. The goals for TAG are the following:
• To raise awareness about the importance of adolescent health;
• To engage stakeholders, including youth serving organizations and caring adults;
• To get adolescent health on the national agenda; and
• To spur action. Long term, TAG contributes to achieving the
Healthy People 2020 objectives for adolescent health developed by HHS. More details about TAG and the Five Essentials
for Healthy Adolescents can be found on the Office of Adolescent Health website. Also, before we begin, I’d like to point
out that the content and views in this next portion of the webcast do not necessarily
represent the official policies of the Office of Adolescent Health, or of HHS. I’m now pleased to turn things over to Carolyn
to learn about the Wellness Center’s [no audio] by Identity Inc. The project aims to improve access to healthcare
for teens by establishing health centers in schools [and] build a community-based, comprehensive
approach that integrates health services and positive youth development programs with schooling. Carolyn? Carolyn Camacho: Thank you very much, Evelyn. Good morning. Since 2008, Montgomery County Health and Human
Services has funded our school-based health centers to improve the health and healthy
development of adolescents in partnership with community-based positive youth providers
like my organization, Identity. In Montgomery County, over the past decade,
our schools have faced the challenges of educating a diverse and rapidly growing population of
youth who have limited access to critical programs and services. These youths have enormous potential but face
many challenges that hinder their ability to succeed, such as poverty, family separation,
discrimination, immigration status, cultural isolation, trauma and other factors that may
lead to risky behaviors, such as teen pregnancy, substance abuse, gang involvement and dropping
out of school. Identity is the lead agency, and we manage
three school-based health and wellness centers that were developed to respond to these challenges. We provide wraparound services, behavioral
health, positive youth development, case management, and our goal is to create opportunities to
ensure that our young people are equipped with the necessary skills to build effective
connections within their communities and to improve their education and employment outcomes. For after all, we know that success in school
is the strongest positive indicator of future health, employment and healthy relationships
as adults. Our goal is to create opportunities to ensure
that young people are equipped with the necessary skills to contribute to their community. We provide services and interventions that
build emotional health by addressing the risk factors and supporting protective factors. We see our young people as assets to be nourished,
not problems to fixed. Through our programs and support systems,
and referrals to behavioral services when necessary, our young people enhance their
connection with their school and family and develop a stronger sense of themselves and
their community and take responsibility for themselves and for their actions. In the Wellness Center, the somatic health
and social service providers work together in the same space in the school to serve the
students. Another key component of our work is our work
with the parents. Montgomery County Health and Human Services
funds 13 school-based health and wellness centers in Montgomery County Public School,
and four of these centers are located in high schools. Back in 2014, as we began to work in two of
our centers, we saw the potential benefits of working more closely with school health
services and how we could have an impact beyond these 13 school-based health centers. One of the nurse administrators attended a
parent session we had organized, and she heard a parent ask a question about where families
could obtain low-cost or no-cost dental health services. Of course, she answered the question and provided
the information. But then she went back, and she made sure
that not just the 13 school-based health centers had that information in the clinic, but that
every health [no audio] in Montgomery County Public Schools had information on low-cost
dental health services in the community had information [no audio]. That’s just one example of how we can extend
the impact of our work beyond the doors of the school-based health centers. On the youth services side, Identity works
in partnership with other agencies that are our partners. We provide positive adult role models, curriculum-based
programs, trauma-informed restorative practices, wraparound support services, arts and recreation
activities and mental health services. Identity and its partners forge touching relationships
with our young people through theoretically sound, but culturally relevant programs that
are based on the positive youth development model. Much of the success of our programs is due
in part to our staff, who are bilingual, culturally competent, and many have similar backgrounds
as the youth in terms of race, ethnicity, language, country of origin and sexual orientation. We’re proud to count former clients who have
been there, done that and have come back to be members of our staff. This slide shows the demographics of the three
high schools where we manage the wellness centers. As you can see, the site selection for the
school-based health centers are based on several different factors: high need, high FARMS population,
diverse student population, substantial number of students who are receiving English as a
Second Language. Last year, in 2017, in the fiscal year, we
served over 1,300 young people and their families at the three school-based health and wellness
centers that Identity manages. The next few slides just give you a picture
of some of the outputs, the demographics of the young people that we serve. The next slide gives you an idea of the risk
profile. While the wellness centers are open to all
the students in the school, we especially target young people who most need our programs
and services. These include youths facing challenges such
as adverse childhood experiences, trauma, family separation and reunification, and youth
who are struggling academically or emotionally. The socio-demographic data that you see here
provides a general picture of the risk profile of the young people that we served in the
last fiscal year. Adolescence is a challenging time for youth
who have every benefit and advantage. But for young people who’ve grown up in poverty
and [are] impacted by other traumatic events, the positive adult role models, the relationships
that they’re able to form with their peers as well, and the programs and services that
we can provide at the wellness centers can be transformational. We’ve compared the rate of exposure of our
participants to adverse childhood experiences with children in Maryland and nationwide,
and our data shows that when we compare our data with the National Survey of Children’s
Health data from 2011 and 2012, we saw that our youth are exposed to ACES and to multiple
ACEs at a higher rate when they’re compared to children in Maryland and nationwide. At the wellness centers, we consider the parents
and families an essential part of the services that we provide to young people. We conduct a family needs assessment with
the parents or guardians of the young people in our curriculum-based programs. Through these assessments, we’re able to provide
a case management support through linkages to social and emergency services available
in the community. Our parent engagement programs build the capacity
of parents to navigate the school system, provide information on resources and services
in the community, and focus on such topics as parent-child communication and healthy
adolescent development. In addition, we strive to create the conditions
for parents to build a network of mutual support in the schools among other parents and in
the community. We know that parents and families are a key
protective factor and ensure the sustainability of our efforts. Identity has developed rigorous data collection
and evaluation methods to measure the effectiveness and impact of our wellness center programs
and service. We’ve developed several metrics to collect
baseline and exit data for each program, and they’re compiled and analyzed by an external
evaluator. In this slide, you can see the youths who
have reported low levels of emotional well-being at baseline showed improvement at exit. You can see here among self-esteem, we showed
improvements in self-esteem, expectations for their future, anger management and conflict
resolution skills, as well as improvements in depression symptoms. People and their relationships with each other
form the cornerstone for creating a safe and healthy learning environment. Again, staying in school and graduating are
the clearest indicators for future success in life. In this slide, we see that young people who
at the baseline had low levels of school connection, after participating in the programs and services
in the wellness center, at exit showed improvement in the different measures for school connectedness. A key tenet of our organization and the positive
youth development model is to meet young people where they are. Our programs seek to build on youth strengths
and help them recognize the consequences of risky behaviors and make healthy, positive
choices. Here we see that youths who at the baseline
had levels of risk factors, at the exit showed improvement or a decrease in gang and delinquent-related
behaviors, substance abuse and unsafe sexual behavior. Researchers over the years have learned a
great deal about the factors that contribute to healthy adolescent development. These include family dynamics, support from
caring adults, school effectiveness, peer influence, value development and social skills. When we work together to provide comprehensive
services onsite with our somatic health partners, it can be transformational. We believe that community-based, positive
youth development providers, when we work closely with our somatic and mental health
providers, we can really make a difference in the lives of our young people. I wonder if you have any questions. Evelyn Kappeler: Thanks, Carolyn, for your
work and for your presentation. Yes, I do have a few questions for you. Can you tell us a little bit about how you
got buy-in you needed to work in the schools? Carolyn Camacho: Evelyn, I think from the
get-go, the schools, as I’ve mentioned, the school-based health centers were an initiative
funded by Montgomery County Health and Human Services in response to the need that they
saw, and the schools were seeing, about a decade ago. They developed criteria, I believe about 22
indicators that they looked for the different schools to rank the schools in who needed
this kind of school-based health center. What we found in all the schools that we work
at that we’re greeted with open arms, and principals and staff really see the benefits
of having comprehensive health and positive youth development services in the schools. Evelyn Kappeler: That’s terrific. Can you tell us a little bit about how you
handle funding and reimbursement for the services that are provided? Carolyn Camacho: Identity is the managing
agency at the wellness centers that we manage, so … it’s a competitive process. We develop a proposal in response to a request
for proposals, and we compete with other community organizations to manage the wellness centers. Evelyn Kappeler: You talked a little bit about
the work that you do with parents. Can you tell us a little bit more about any
of the lessons you’ve learned in working with parents and families? Carolyn Camacho: Yes, I think that building
relationships are the key to being able to impact the lives of young people and their
parents. What we found is that many of the families
of the young people that we serve face many barriers in their daily lives, but they do
have a level of comfort in going to the schools. So … we’re serving all the needs of the
child—the health; the social, emotional well-being of the young person; the fact that
the parents can access, can get connected to the social services in the community; can
get connected to the school; can build relationships with the teachers, the counselors, the administrators
by attending the meetings that we organize in collaboration with our school partners. There’s also opportunities for parent leadership
and student leadership through our wellness center advisory boards. Again, I think that just as we’ve seen, the
importance of connecting young people and having them feel a part of school, I think
the same goes with the parents—that the more that we can encourage that and build
those connections, the better off our young people are. We’ve seen that they’re more likely to stay
in school and graduate, and that’s our common goal. Evelyn Kappeler: The work that you do really
focuses on positive youth development and is a collaborative effort with partners. Can you tell us a little bit more about the
work you do with partners? Carolyn Camacho: Yes, it’s critical. It’s essential. The beauty of the model—and I think it’s
also just the way things are done in our county— we have the health services that are provided
by the health department in the wellness center. And then through the partnership in our wellness
center model, where we have other community organizations with expertise and mental health
and in serving [the] African American population, and we’ve also partnered with ARCH organizations,
everybody brings their strengths to the work, and together we’re able to accomplish a lot
more than we could individually. In addition, we rely on a strong network outside
of a social service provider, again, that we connect with, that we bring in to enhance
our services at the school, but also to connect the families with some of the resources that
are out there as well. Evelyn Kappeler: Terrific, and before we wrap
up, I have one final [question] for you. What are your goals and plans for the wellness
centers moving forward? Carolyn Camacho: We are always striving to
continuously improve our programs and services, especially to continue to respond to the trends
that we see and the needs of our young people in the schools. I would say that one of our key efforts now
is just continuing to strengthen our collaboration with somatic health. For example, as I’ve mentioned before, in
providing trauma-informed care, both our somatic health partners are working to screen young
people who have been impacted by adverse childhood experience. On the positive youth development side, we
work very closely with them, so that we’re also working to build relationships with those
young people and help them heal from the traumatic events in their lives, but also to develop
strategies and tools for themselves, so that they can grow and thrive. We’re also always working to strengthen our
tools so that we can evaluate the impact of our programs and services, and it’s just a
great honor to be able to work with all these wonderful providers and to be able to be involved
in the lives of our young people throughout their high school years. Evelyn Kappeler: Well, thank you, Carolyn. Thank you for sharing such rich information
with us about the wellness centers. On behalf of the Office of Adolescent Health,
I want to thank you for joining us to learn about OAH and TAG and to hear about the wonderful
work going on in Maryland. A special thanks to Carolyn for sharing this
program with us. The TAG effort continues, and we invite you
to get involved and spread the word about TAG within your professional networks. There are several ways in which you can do
this: • You can explore our website. • You can check out the TAG Playbook. • You can join TAG and get email updates. • You can watch one of the TAG Talks videos
with your colleagues. • You can notify your colleagues and grantees
about TAG. • You can encourage your organization to
use TAG action steps and resources. • You can also blog about TAG. We have sample text on our TAG toolkit. • You can ask questions, share ideas and
stay in touch. I urge you to use TAG social media tools to
reach out to some of America’s 42 million teens and folks who care about them. You can do this at #TAG42mil. Here, again, are some of the specific ways
you can connect with Office of Adolescent Health and with TAG:
• You can explore our website, download materials and sign up for e-updates. • You can watch us on YouTube. Send your ideas and questions to [email protected]
. • You can follow the Office of Adolescent
Health on Twitter, @teenhealthgov, and use #TAG42mil. Thank you for [giving us] the opportunity
to share TAG and a great example of TAG in Action with you today.

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