Culture of Health Behavioral Health/Substance Abuse/Poverty Population Draft Framework
Behavioral Health/Substance Abuse/Poverty Group Member List
Contact Name / Organization / EmailWhitney Fear / Steering Committee, Group Co-Chair /
Kathleen Swanson / Steering Committee, Group Co-Chair /
Alicia Hauff / Steering Committee /
First Lady Kathryn Burgum / State Governor's Office /
Mylynn Tufte / ND Department of Health /
Eric Johnson / UND School of Medicine and Health Sciences /
Cody Schuler / Fargo/Moorhead Homeless Coalition /
Senator Tim Mathern / ND State Legislature /
Jackie Gervais / Prairie St. John /
Kathy Moraghan-Olson / Sanford Health /
Debra Johnson / Prairie Harvest Human Services /
Janell Regimbal / Lutheran Social Services /
Mara Jiran / Valley Community Health Center /
Robin Landwehr / Valley Community Health Center /
Kayla Hochstetler / Valley Community Health Center /
Todd Lawley / Catholic Health Initiatives /
Nadine Boe / Northland Health Centers / Nadine V. Boe <>
Carl Young / Behavioral Health Coalition /
John Vastag / Behavioral Health Coalition /
Tessa Wetjen / Otto Bremer Foundation /
Joy Ryan / Dakota Boys and Girls Ranch /
Chris Jones / ND Department of Human Services /
Nancy Mckenzie / Path Administration Office /
Jody Link / Behavioral Health Coalition /
Sherry Burg / Altru Health System /
Elizabeth Faust / Blue Cross/Blue Shield of ND /
Jackie Walsh / Blue Cross/Blue Shield of ND /
Jodi Tescher / Red River Behavioral Health System /
Debbie Swanson / Grand Forks Public Health /
Pam Sagness / ND Department of Human Services /
Bonnie Malo / Division of Community Services, ND Department of Commerce /
Katie Rodacker-Bartch / LPN-Cass County Jail /
To contact:
Chantel Carlson (Community Engagement Manager) and/or Megan Jenson (Community Impact Manager)
United Way Cass Clay
Notes from October Meeting:
· Important to involve employers, chambers of commerce. If we propose increasing services via legislation, we need them to be partners.
· We should loop in with the Governor’s Main Street Initiative
· Should involve health science students in this process, almost 900 high school students are involved with HOSA, also NDAHEC- AHEC is included on the rural group
· Would be a good idea to attend Health Services and Human Services Committee meetings
Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?
Driver 1: Mindsets and Expectations: Awareness of how our individual health affects others- and how the health of our communities influences our own- is key to building a culture of Health. Do our policies reflect our communities needs and values? These measures reflect how we as individuals, families and communities, and as a nation- think about health and well-being.
Examples: Value on Health Interdependence, Value on well-being, public discussion on health promotion and well-being.
What is happening in North Dakota for this driver? Is there work being done in this area now? Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.
Entity/Organization / Brief description of Action / Location / Funding SourceFirst Lady’s Platform / Recovery Reinvented aims to eliminate the shame and stigma of addiction in ND. / State-wide / NDDHS
Private funding
ND Reducing Pharmaceutical Narcotics in our Communities Taskforce / Narcan available by prescription from pharmacists, Good Samaritan law to protect those who report overdose / State-wide / (No state/federal funding)
Sanford Health
BCBS
40+ members
DHS
Heartview
Pharmacy Board
Prescribing Board
Justice Reinvestment Program FTR (Free Through Recovery is behavioral health component) / Will provide funding source for care coordination and recovery support services (peer support) / State-wide / North Dakota
$7 million program
Senate bill 2015
Main Street Initiative / 3 pillars
1) Healthy, Vibrant Communities
2) 21st Century Workforce
3) Smart, Efficient Infrastructure / State-wide / Public-Private partnerships
www.mainstreetnd.com
NDDoH – Suicide Prevention / · Sources of Strength Program
· Zero Suicide Prevention Program
· 211 line / Various / Contact Alison Traynor
NDDoH – Injury Prevention and Control / · Friendships that work Program (Anti-bullying)
· Coaching Boys Into Men Program
· Green Dot Communities Program (violence prevention/intervention) / Various / Contact Deanna Askew
NDDoH – Domestic Violence/Crisis / · Various programs & coalition member (e.g., CAWS) / Various / Contact Deanna Askew & Mallory Sattler
NDDoH – Emergency Preparedness / · Emergency Responder crisis intervention / State-wide / Contact Tim Wiedrich
DHS contracted to Center for Rural Health / · Peer support specialists
· Statewide certification for minimum standards
· Crosswalk between disciplines / State of ND / $500,000 funding from SB 2015 to develop and implement workforce development plan around behavioral health for this biennium
DHS in partnership with boards and associations (chaired by Dr Mclean) / · / State of ND / SB2042 created tiers in behavioral health professions – credentialing. Added nursing, MD, APRN defined under behavioral health.
What are ND’s gaps (geographic and programmatic) for this driver?
Rural communities continue to experience the most difficulty in finding funding for treatment programs. What’s more, they experience greater problems than urban areas in recruiting and retaining behavioral health providers. The current budget crisis in North Dakota has led to dramatic reductions in available money for programmatic additions to existing treatment services.
North Dakota does not have a credentialing process for prevention professionals, preventing that much needed service from being offered in the state…despite over 90% of surveyed North Dakotans stating that they feel it is important. Criminalization of substance abuse disorders has led to the incarceration of those who are in need of treatment services, being that the behavior conducive with their disorders earns them criminal offenses. The leading majority of inmates in North Dakota have either a diagnosed mental health condition or a diagnosed substance abuse disorder. Data sharing and collaboration are nearly non-existent in most communities. Duplicated services and referrals are abundant (ND Department of Human Services, 2016).
Although the opiate epidemic has caused unprecedented mortality rates from substance abuse, alcohol continues to be the most commonly used substance in North Dakota. As many as 30% of adults report binge-drinking at least once in the past 30 days, this is about 6% above the United State average. Underage drinking in North Dakota cost the state about $160 million dollars in medical expenses and loss of wages. North Dakota continues to hold its ranking of 4th in the nation for binge drinking. Nearly half the motor vehicle accidents and new domestic violence cases can be attributed to alcohol consumption (ND Department of Human Services, 2017).
Prevention services in the state are sorely needed. Professionals and citizens consistently report that prevention is important, but there are so few services that are able to be accessed openly. Evidence based prevention services could be saving North Dakota as much as $64 dollars for each dollar invested (ND Department of Human Services, 2017).
Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?
Driver 2: Sense of Community: Residents of socially connected communities are more likely to thrive. Research suggests that individuals who feel a sense of security, belonging, and trust in their environment have better health. People who don’t feel connected to the community are less inclined to engage in health-promoting behaviors or work together for positive change. These measures indicate to what extent people feel a part of their communities.
Examples: Sense of community, social support.
What is happening in North Dakota for this driver? Is there work being done in this area now? Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.
Entity/Organization / Brief description of Action / Location / Funding SourceDBGR / Trauma Informed Care model used / All locations / DBGR
PATH / Foster parents trained in healthy eating, youth and families make plans together / All locations / PATH
BCBSND / Wellness activities offered in numerous communities, free of charge / Various / BCBSND
What are ND’s gaps (geographic and programmatic) for this driver?
Tribal nations in North Dakota continue to report exclusion from many conversations about wellness promotion. Tribal nations in North Dakota, along with reputable experts in the field (Tara Houska for example), testified during the 2017 session promoting a bill that would require cultural competency training for lawmakers. This was rejected citing that the training was unnecessary. The inability of lawmakers to recognize that those experiencing structural racism and segregation from the community of the state were requesting training they felt would help to improve racial relations in North Dakota is unfortunate.
A similar bill that would have prevented discrimination against members of the LBGTQ community was introduced by Representative Joshua Boschee. This measure was also turned down. Currently, there are no laws preventing discriminating against members of this community. According to the CDC (2017), members of this community often do not receive health care services due to discrimination they encounter from health care providers and the social inequities that they experience (CDC, 2017).
Residents of the reservations in North Dakota experience health disparities at a rate that is found nowhere else in the state. For example, the average life expectancy for a man in Sioux County (Standing Rock Reservation) is nearly 15 years less than a male in Cass County (Institute of Health Metrics and Evaluation, 2017). Overall competency regarding issues specific to Native American peoples is low.
Making Health a Shared Value: How can individuals, families and communities work to achieve and maintain health?
Driver 3: Civic Engagement- Civic engagement creates healthier communities by developing the knowledge and skills to improve quality of life. Voting and volunteering are among the many measures of an engaged population. In both cases, people’s actions show they care about the outcomes of their community or their nation, and they want to cultivate positive change. These Measures reflect whether individuals feel motivated and able to participate and make a difference.
Examples: Volunteer engagement, voter participation,
What is happening in North Dakota for this driver? Is there work being done in this area now? Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.
Entity/Organization / Brief description of Action / Location / Funding SourceF5 Project / F5 offers many volunteer opportunities that encourage interaction between the community and felons/inmates. / Various / Various
Fargo PD/Downtown Resource Officer/Gladys Ray Shelter / Community work program allows individuals with fines to work off their fines, volunteers provide meals to participants / Fargo / City of Fargo/Gladys Ray Shelter/Volunteer donation
What are ND’s gaps (geographic and programmatic) for this driver?
The failure of Measure 4 this past election year provides a clear picture of the detriment misinformation can cause. Despite being supported by numerous health organizations and written by health professionals, Measure 4 was rejected by North Dakota voters. The tobacco industry and the ND Petroleum Marketers Association launched a $3.7 million dollar ad campaign against Measure 4, which eclipsed the campaign effort for Measure 4 (Schmidt, 2016).
Measure 4 is an example of the lack of voter empowerment and the effects it is causing on affairs in the state. Ability to fund a campaign is a key indicator of whether or not legislative action is likely to succeed, specifically in regards to ballot measures. North Dakotans are often present in large numbers for volunteer opportunities and there are frequent opportunities for charitable giving in communities all over the state. Following the death of Officer Jason Moszer, the family of the officer received overwhelming support from the community. Voter empowerment and education is likely the higher need under this driver.
Fostering Cross-Sector Collaboration to Improve Well-being: Are Individuals, institutions and communities doing all they can to prevent illness and promote health?
Driver 1: Number and Quality of Partnerships: Research indicates that building relationships among partners is the most challenging aspect of creating change. Measures look at how organizations are working together to improve health and well-being.
Examples: Health department collaboration with community organizations, school districts, workplace health promotion
What is happening in North Dakota for this driver? Is there work being done in this area now? Use Asset map information and expertise of group members to fill in framework. Add additional rows as needed.
Entity/Organization / Brief description of Action / Location / Funding SourceSanford Health, New Life Center, Community Living Services, Tammy’s Angel, YWCA / Providing medical respite for those experiencing homelessness / Fargo / Sanford Health, various grants
Centre Inc., CMS / CMS provides suboxone and methadone for inmates at Centre / Fargo / Bureau of Prisons
ND Department of Human Services / Using Parents Lead materials, prevention approach to reducing substance abuse disorders / State-Wide / Funding goes to local public health departments to fund community based programs
Prairie St John’s/Parole and Probation/F5 / Drug court program contract, 50 individuals in drug court come to treatment 3 evenings per week to complete parole/probation requirement / Region V / State contracted service
What are ND’s gaps (geographic and programmatic) for this driver?
The most commonly named barrier for services in the state is the lack of collaboration between public and private sector agencies. Information sharing continues to be a large problem. Many private sector agencies are not aware of programs available through the public sector, and vice versa. As a result, coordination of care is problematic and many individuals are not connected with available services that they likely qualify for. Duplication of services is also a problem. The time that is wasted sending individuals to services or referral appointments that they are already receiving services for results in less time that could be spent attending to unmet needs (ND Department of Human Services, 2016).