Way to Wellville organizes strategies


By Sue Cody

Recently, sixty people danced and exercised to upbeat music as part of The Way to Wellville and Sunset Empire Park and Recreation District sponsored “Zumba Free for All” in Seaside’s Broadway Park.

Clatsop County was chosen as one of five areas named in a national challenge to build networks through community organizing to increase access to and use of beneficial services, activities and resources to improve health.

How it started

The Way to Wellville investor Esther Dyson’s dream was to have communities combine their resources, cooperate and invest in healthy living rather than spending trillions of dollars on health care made necessary by unhealthy lifestyles. She noticed most people know the way to get healthy – through activities and quality food – but most don’t initiate change on their own.

Dyson created the Health Initiative Coordinating Council (HICCup), thinking investors would like to support healthier lifestyles. She offered a challenge to communities of fewer than 100,000 people to become one of the Wellville Five. The five communities chosen are taking part in a five-year commitment to improving health in their communities, by developing strategies that improve five health metrics or measurements.

“The whole point of the Way to Wellville is to help communities apply well-known techniques in sustained initiatives that are accountable, measurable and ultimately fundable,” Dyson said.

Clatsop County was chosen because it was “shovel ready,” said Steven Blakesley, Clatsop County health promotion specialist. He is a member of the Clatsop Health Advocacy and Resource Team (CHART) –  a multi-sector community collaborative, focused on improving the health of Clatsop County residents. It meets monthly to help create alignment among agencies and projects.

CHART members were involved in submitting the application for The Way to Wellville, along with Columbia Pacific Coordinated Care Organization (CCO) and CareOregon, an insurance nonprofit that serves Oregon Health Plan and Medicare members.

Columbia Pacific CCO and CareOregon sponsor The Way to Wellville Clatsop County. They offer resources, such as training, communications and staffing.

“Clatsop County had built-in infrastructure through the CCO, so we could implement changes and hire Sydney Van Dusen,” said Debbie Morrow, a member of The Way to Wellville Strategic Advisory Council. They’ve also engaged consultants to help with communications and digital services.

“The Way to Wellville is an extension of what we are already doing [at CHART]. This opportunity brings the expertise and greater access to funds that we haven’t had allowing us to play a bigger game,” Blakesley said.

“The generosity and commitment to leadership from the CCO and CareOregon are phenomenal,” Morrow said. “We wouldn’t be where we are now without their financial investment and support.”

Structure and purpose

The Way to Wellville Strategic Council is composed of 14 community members:
• Steven Blakesley, Clatsop County Public Health, health promotion specialist
• Stacey Brown, United Way of Clatsop County executive director
• Dan Gaffney, Clatsop P3 coordinator, Clatsop Early Childhood Clinic director
• Jeff Hazen, chairman, Sunset Transportation District executive director
• Chris Holen, Baked Alaska, chef/owner
• Nancy Knopf, Columbia Pacific CCO community health partnership manager
• Mark Kujala, Warrenton mayor
• Paulette McCoy, Providence Seaside Hospital, public affairs manager
• Debbie Morrow, Columbia Pacific CCO vice chairwoman, Warrenton school board
• Greg Peterson, vice president, Clatsop Community Bank
• Jill Quackenbush, Clatsop County Juvenile Department prevention supervisor
• Jeanette Schacher, DPT, Home Health and Hospice manager, Columbia Memorial Hospital
• Kristin Tschannen, Seaside Yoga, owner
• Nicole Williams, Clatsop Care Health District CEO

Strategic Council Chair Jeff Hazen said the council is meeting monthly, building from the ground up and creating a business plan.

According to Hazen, Clatsop County is ahead of some of the other Wellville Five communities, because of the council’s ability to work well together and because it has a paid coordinator.

Most council members have full-time jobs, so it requires a staff person to focus on the opportunities that are out there, Hazen said.

“It is fantastic that we have Sydney Van Dusen as our coordinator. She has a high energy level; she’s excited about The Way to Wellville; she’s involved in the community; and respected throughout the county.”

Strategic Council members met with HICCup staff, collected data and attended a ReThink Health seminar. They worked with local agencies, parks and nonprofits to create ideas and opportunities around their business plan.

ReThink Health is donating software that can predict five- to 25-year outcomes to investment in health initiatives.

“We have a solid cross-section of leaders at the table who are working on identifying goals for our focus areas. The end goal is to connect the people who are doing similar work and promote collaboration to create a healthier society,” Morrow said.

“The Way to Wellville envisions a seamless collaborative made up of a strong, robust, vibrant community, from age zero to 21 and beyond,” said Morrow.

The council refined four focus areas:
• Emotional Health 
• Community Wellness
• Health Care Access
• Economic Opportunity

Within each category, there are numerous sectors to be addressed. For instance, in the Emotional Health section, The Way to Wellville is working with partners to support Trauma Informed Care. Dr. David Labby, who recently retired from Health Share of Oregon CCO, gave a presentation to Clatsop County educators, Way to Wellville representatives, health care professionals and other interested individuals about the effects of growing up in adverse conditions.

Trauma can range from family substance abuse and physical or mental abuse to lack of food and neglect. When people who have experienced trauma are treated with understanding and given opportunities to control their own health care, they have better outcomes, Labby reported.

Columbia Pacific CCO has a commitment to increase awareness of Trauma Informed Care, said Nancy Knopf, Columbia Pacific CCO Community Health Partnership manager.

“We want to create awareness about childhood adversity (stress) and encourage all sectors of the community – business, faith-based, corrections, law enforcement, education, etc. – to integrate trauma-informed and resilience-building practices,” said Morrow, who is also a Columbia Pacific CCO board member.

Seaside Heights’ retired Principal Dan Gaffney is leading the Economic Opportunity team. He  presented studies to the Strategic Council about the direct correlation between reading proficiency in the third grade and high school graduation rates. Clatsop County’s high school graduation rate in 2014 was 70 percent and the percentage of children who were fluent in reading by third grade was 69 percent. Those fluent in reading by third grade have more economic opportunities in the future.

In light of that information, the Strategic Council opted to focus on early childhood education. Five years won’t be long enough to measure change in graduation rates, but it will get us started, said Gaffney, who is leading the Clatsop Kinder Ready program. Clatsop Kinder Ready is a  Pre-Kindergarten-Grade 3 partnership focused on preparing children for kindergarten and being fluent readers by third grade.

Sample goals to reach by 2020

• Reduce substance abuse by 50% in children in Clatsop County (from 33.9% in 2014 to 17% in 2020.
• Help support the implementation of Trauma Informed Care practices into area schools. Improve mental health of children by reducing childhood trauma.
• Increase the number of quality preschools using the Quality Rating and Improvement System.
• Improve the high school graduation rate of children in Clatsop County (from 70.5% to 90%).
• Improve the third-grade reading proficiency (from 68% to 90%).
• Increase the community mentoring programs (from 42 participants to 200 participants).

Opportunities for change

Partnering with the Lewis and Clark National Historical Park, the Astoria Parks and Recreation and Sunset Empire Park and Recreation, the two county hospitals, The Way to Wellville is applying for grants for “Rx for Play.” The purpose is to get health care professionals to write prescriptions for patients to get out and exercise.

In Rx for Play, individuals would receive a parking pass to Lewis and Clark National Historical Park, Fort Stevens State Park and park and recreation facilities in Astoria or Seaside. Participants could swim free for three months at one of the pools or use the workout room or go for a walk in the park without having to pay parking fees.

“The idea is to get people out to enjoy the incredible opportunities we have right here in Clatsop County,” said Van Dusen. Many are free, she said, adding that a map of free places to walk, hike, bike and kayak would be included in the Rx for Play.

The cost of doing nothing 

“The cost of doing nothing is the loss of a generation,” said Morrow. “It is the loss of potential, possibilities and productivity of this generation. What we are doing now doesn’t address children’s needs.”

A 2014 Oregon Student Wellness Survey reported 19 percent of 11th graders had seriously considered suicide.

“We need to make a paradigm shift away from archaic social programs that do not address the current issues of this generation and instead make strategic investments into programs that we know work.”

“We are working on strategies in the four focus areas to create the results we want,” Van Dusen said. Currently the United States spends $2.5 trillion on health care, and 40 percent – or $1 trillion – is wasted, according to global management firm Oliver Wyman.

The Weingart Foundation reports it costs an average of $35,000 a year to keep a homeless person on the streets. It only costs $10,000 to put a person through a nine-month program that covers housing, food, case management, job placement and follow-up support.

“If we give people tools, it will save money down the line in 10 to 15 years,” Van Dusen said.

Change is in the air.

There is now a detox and inpatient addiction treatment center in Columbia County for Medicaid Columbia Pacific CCO members. The program, Pathways, is run by Columbia Community Mental Health Inc., with reciprocal privileges for Clatsop and Tillamook counties.

Clatsop County is working on creating Crisis Respite services in Warrenton. Startup costs are  funded by Greater Oregon Behavioral Health Inc. (GOBHI) and Columbia Pacific CCO. The development of this new service, which will address the need of county residents for increased access to supports during a mental health crisis, resulted from collaboration between Clatsop Behavioral Health, Columbia Memorial Hospital, Providence Seaside Hospital and the county.

Pay for Prevention

Ensuring that patients get the best possible care is a key part of improving a community’s health. Clatsop County’s The Way to Wellville sponsors CareOregon and Columbia Pacific CCO are working with local clinics to improve health delivery and offering pay for performance opportunities. They reward providers who meet the state and federal metrics for ensuring their patients receive needed care. They provide educational opportunities to clinics to help them improve care. In 2015, Columbia Pacific CCO allocated $1 million to improve access and clinical quality in their service area, Tillamook, Columbia and Clatsop counties.

Currently 88% of health care spending goes to medical services. With the Social Impact Bond model of funding, government resources are directed toward social programs that provide positive results. The model taps private funders to cover up-front costs of social programs.

The Way to Wellville provides an opportunity to develop investment processes with the support of HICCup and other interested entities. The concept is to participate in projects called Pay for Prevention (also known as Social Impact Financing, Pay for Success or Social Impact Bonds). They help find ways of investing in the upstream supports and services that prevent poor health outcomes in the future without taking away from existing resources.

Most Pay for Preventions follow this process: private funders supply up-front capital to service providers who have the ability to meet needs but lack financial resources. This outside financing makes it so one doesn’t have to take away from existing programs or services. This kind of investment has a focus on creating a feedback loop for the delivery of social/human services. By raising money from private investors to deliver specific intervention packages, one brings in new funders (not government or foundations). They can create sustainable service delivery models as opposed to  models that are dependent on grants and short-term investments.

Currently The Way to Wellville is working on a business plan that it will use to make a business case for investment in projects like Pay for Prevention. HICCup has recently launched The Wellville Accelerator which it will use to recruit outside investors to create new business models and attract capital.

The idea is to come up with strategies that prove successful in improving health and to attract investors.

“I am glad Esther (Dyson) chose smaller communities,” Hazen said. “Rural communities can be leaders in change and innovation. If we are successful here, large cities can use the framework for their programs.”

“For us a big part of the job is getting investors and sustaining the programs to last more than five years,” Hazen said.


More Information

Esther Dyson: on Way to Wellville: http://www.hiccup.co/news/blog/supersize-what-works/

ReThink Health: http://www.org/our-work/rethink-health/

Clatsop County Way to Wellville: www.waytowellville.net

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