100% New Mexico Initiative

100% POWER HOUR

FOUR: ASSESSING THE NEED FOR CHANGE

PLEASE NOTE: This page contains supplemental information for attendees of the 7-part 100% New Mexico initiative power hours. Attendance is free, but registration is required. Please register here.

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We are providing the slides and narrative text used in the 100% Power Hour: Assessing the Need for Change being offered quarterly by the Anna, Age Eight Institute. The 7-part webinar series is designed to give 100% New Mexico initiative members an overview of key concepts and issues related to implementing the initiative in their county. Currently nine counties are engaged in the initiative.

Power Hour participants are encouraged to use this page for local presentations in order to increase public awareness of adverse childhood experiences (ACEs), trauma, social adversity and the data-driven prevention strategies.

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Before we begin our presentation, we want to allow for a moment of quiet reflection. Please take a minute to perform the self-care of your choice.

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PART ONE: HOW DO WE KNOW WHAT CHALLENGES EXIST?

The 100% New Mexico initiative, like many health initiatives across the country, seeks to prevent the costly challenges that diminish the lives of children, youth and adults. We don’t lack for data that documents our health challenges. Every state department of health provides data on the incidence of illness, injury and violence, along with reports that detail our student’s troubling experiences with challenges outside the home. We can also review our state’s child welfare data to understand how many children have substantiated maltreatment cases, are in custody, live in foster care awaiting reunification with their parents, are awaiting adoption, or aging out of the systems into a world without family support. We don’t lack data to illustrate how many of our communities are at risk for ongoing substance use disorders, domestic violence, untreated mental health challenges and joblessness. For decades, data have informed us yet failed to move us to action. Until now.

We are united in ensuring that 100% of county residents have access to the ten vital services for surviving and thriving. This presentation will provide an overview on the challenges we seek to prevent, including adverse childhood experiences (ACEs) and social adversity.

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The 100% New Mexico initiative is the centerpiece of the Anna, Age Eight Institute’s programming. It was developed by institute co-directors Katherine Ortega Courtney, PhD and Dominic Cappello who are the co-authors of Anna, Age Eight and 100% Community.

Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment guides communities in addressing epidemic rates of adverse childhood experiences (ACEs) that occur in the home and social adversity that families face outside their door.

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100% Community: Ensuring 10 vital services for surviving and thriving is the blueprint that 100% New Mexico initiative participants are using to assess barriers to vital service and build a countywide system of care that includes timely access to vital services. The book details how we collaborate to build the services in each county.

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The 100% Power Hour 7-part webinar series was developed to provide initiative participants with an overview of key concepts that guide the initiative. This includes the detailed initiative programming to empower local county and city stakeholders as they address challenges through the process of continuous quality improvement: assess, plan, act and evaluate. In this presentation we focus on the assessment process.

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As we begin, we wish to point out three of the most common comments we hear as we discuss the initiative. Some local government representatives will say, “We have the services needed.” Our response is, “What data have you collected to assess resident’s access to the ten vital services for surviving and thriving? Have you asked parents to what degree they can access vital services in a timely manner and what barriers might exist?” Local agency representatives might say, “We offer workshops to help.” We respond, “Workshops can be very helpful but what our most vulnerable residents require is access to vital services. How might we collaborate to address service barriers?” And some change agents might say, “Who exactly are we assessing.” We start the assessment process with a countywide survey, asking parents and youth about their access to ten vital services. We work to ensure that our survey represents residents from all the communities within a county’s borders and all socio-economic levels.

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The goal of the data-driven, county-based and technology-fueled initiative is to empower local stakeholders in ensuring ten vital services for surviving and thriving, all key components of a county and city committed to health equity and racial justice.

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Our goal is to identify the root causes of adverse childhood experiences and work to prevent the ten forms of adversity that include abuse, neglect and living in homes where adults have substance use disorders, engage in violence and have untreated mental health challenges. ACEs can diminish a child’s life in many ways, including their capacity to learn in school, become job ready, maintain steady employment and cope with traumatic feelings without self-medicating.

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The learning objectives of 100% Power Hour #4: Assessing the Need for Change participants completing the webinar will be able to describe an overview of: the definition of assessment, the countywide survey process, assessing barriers to vital services, ACEs and health issues, why we still face the challenges of ACEs and social adversity, assessing the initiative’s three key strategies, and assessing local service provider’s capacity to meet the needs of families.

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The 100% Power Hour process is designed to create a vehicle for building awareness of the initiative and serve as a catalyst for ongoing local community dialogue. The presentation design follows the “teach the teacher” format, developed to allow participants to provide the presentation to their initiative members and local stakeholders. To create an environment for community dialogue, we offer simple guidelines.

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We acknowledge the contribution of all initiative members across the state who have been part of the iterative process of developing the initiative to meet the unique needs of rural and urban families, as well as those serving culturally and economically diverse populations in the south and west. We also are grateful to the state and local lawmakers who have supported the initiative.

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This presentation takes place amid the COVID-19 pandemic and we pause to present an update on progress made with the vaccine implementation and delivery of medical care services for individuals and families across all 33 counties.

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REFLECTION QUESTION: Before moving on, take a few moments to reflect on why life is more challenging in some communities than others.

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PART TWO: WHAT CAN ASSESSMENT TELL YOU AND YOUR LEADERS?

There are important questions to ask, within the context of the 100% New Mexico initiative. A simple one is, “To what degree do county residents endure health, safety and economic challenges? The assessment process that starts with the countywide survey and continues with other assessment activities can provide all county and city leadership with data on barriers to vital services that can address our biggest challenges.

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Part Two begins with a definition of assessment: A process of measuring the nature, quality or capacity of a community and its health, safety and resilience. In the context of our initiative, assessment reveals the challenges and the local capacity to address those challenges in a timely, measurable and meaningful process.

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The 100% New Mexico initiative is guided on the county level by the four-phase process of continuous quality improvement. The phases are assessment, planning, action and evaluation. Assessment is the first phase and the data gathered provides valuable information about both residents and service providers.

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The countywide survey starts with simple questions about a resident’s access to the ten vital services for surviving and thriving. We are seeking to understand the need for services and the challenges accessing them.

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With a completed countywide survey, the county-based 100% New Mexico initiative members will be able to analyze data. This analysis is done in the ten action teams, each one focused on one service area. Through this process the entire initiative membership develops a shared understanding of how the ten interrelated services may be unreachable to some residents.

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Ideally, action team members meet throughout the month as they review each barrier. We know that barriers can include cost, lack of transportation to services, unfriendly hours, inability to qualify or languages spoken by the providers. Lack of access to the internet may also be a barrier when seeking services.

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INSTRUCTION: Please review the barriers, noting how you would prioritize in your county and why.

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Our survey reports are meant to be shared with every mayor, city councilor, county commissioner, school board member and state lawmakers representing your county. These data are the catalyst for ongoing conversations with local leaders about the magnitude of service barriers.

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As you assess barriers, action teams view the challenges within the context of social adversity. Barriers to vital services are but one of the many challenges facing residents of all ages.

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Initiative participants, local leaders and the public can review data on emotional challenges:

  • Youth with persistent feelings of sadness and hopelessness
  • Adult mental distress
  • Suicide death
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Initiative participants, local leaders and the public can review data on substance use disorders:

  • Alcohol-related chronic disease death
  • Alcohol-related deaths
  • Alcohol-related injury deaths
  • Deaths due to drug overdose
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Initiative participants, local leaders and the public can review data on violence and adversity:

  • Child abuse victims
  • Youth history of forced sex (sexual assault)
  • ACEs and rurality
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Initiative participants, local leaders and the public can review data on economic adversity:

  • Teen birth rate for girls age 15–19
  • Percentage of children under 18 living in poverty
  • Percentage unemployed
  • Unstable housing/homeless
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Initiative participants, local leaders and the public can review data on food issues:

  • Food insecurity rate
  • Obesity among adults
  • Obesity among adolescents
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Our health challenges are not new. Why do they exist when they are preventable?

The answer is complex. For decades the nation has tolerated health disparities and barriers to vital services in both rural and urban communities. One attitude has been that people should fix themselves with or without help. As you talk with local leaders and the public you will discover a wide range of attitudes about whether or not to help our most vulnerable families.

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REFLECTION QUESTION: Why have our challenges not been addressed yet?

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PART THREE: HOW PARENT-FRIENDLY ARE SERVICES?

Our work in the assessment process is for each of the ten action teams to connect with service providers in their area. The goal is to conduct informational interviews to understand the capacity of each organization to provide services, as well as connect and align with other service providers offering similar services in the county.

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Initiative action teams can create a weekly schedule of services. For example, in one county the food action team identified all the hours of food security programs, including food pantries and those providing commodities. If one were a working mom with two preschoolers, which services could she easily access during the week?

Each action team will gain valuable insights about how user-friendly a service is for different populations. We need to consider that some parents work full time and can’t access services during the workday. Some parents work the night shift (or two shifts), and some can be car-free. With this understanding, action teams can work with all services providers to align service hours and meet the needs of families seven days a week.

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There are three key strategies to ensure that ten vital services can meet the needs of 100% of families who reside within the county’s borders. These are services that our county and city governments can help support.

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Strategy One: The One-Stop Service Hub

With this strategy, ten action teams work together to bring all services to one location in the most populous city in the county. For a working mom with two preschoolers, this means one visit meets many needs. The transportation action team can review all public transportation options within the county, assessing how residents in communities scattered across the county can access transportation to a main service hub.

In the assessment process, service providers can be interviewed about their interest in being part of a service hub.

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Strategy Two: Every School Becomes a Service Hub

With this strategy, ten action teams work together to bring all services to one location in each school. This is already done, to varying degrees, with the community school model in some parts of New Mexico. There is no easier place for students and their families to access services than the school.

In the assessment process, school leaders can be interviewed about their interest in becoming a fully-resourced community school with the capacity to provide all vital services for surviving and thriving.

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Strategy Three: Access to web-based services

With this strategy, ten action teams work together to bring as many services as possible online. This also means that the initiative works to end the digital divide and ensure 100% of residents internet access.

In the assessment process, service providers can be interviewed about their interest in and capacity to provide all or some of their services online.

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REFLECTION QUESTION: Which of these three strategies might be the easiest to start within your county?

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PART FOUR: HOW DO YOU ASSESS PROVIDERS’ CAPACITY?

Our assessment process provides valuable information about all the service providers in our ten surviving and thriving service areas. We are seeking to strengthen relationships with all providers and support them in meeting the needs of residents.

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The assessment process with service providers is also an invitation to join the initiative and form strong partnerships. Assessment can be viewed as intrusive by some and we seek to have the process seen as one of identifying challenges leading to innovation and empowerment.

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In our Framework for Change guiding the initiative, you can see “D” called “Process” is continuous quality improvement (CQI). The first phase is assessment.

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REFLECTION QUESTION: Who in your county has experience with the assessment process?

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NEXT STEPS: Reflect on the presentation and your notes. Review the books and links to research provided. Reach out to colleagues, friends, family, neighbors and local elected leaders to discuss the 100% New Mexico initiative. We have designed this presentation so that it can be used with local elected officials within city and county government and school board members, agency leaders (representing the ten vital services), representatives from local higher education, faith-based and community-based organizations and your neighbors and friends.

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The next 100% Power Hour is Planning for Change. We hope to see you there. For any questions about the 7-part webinar series, the initiative, research guiding the process or practical steps in starting the initiative, please contact us annaageeight@nmsu.edu.

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