What’s Happening in El Dorado County? Lynnan Svensson, MSN, RN, PHN El Dorado County HHSA, Public Health Division lynnan.svensson@edcgov.us

EL Dorado ACEs Collaborative Vision: Everyone thrives in a safe, supportive, and nurturing environment Mission: To prevent and heal ACEs by promoting ideas, policies, and practices that increase awareness, compassion, and resilience in El Dorado County Over 100 active members  8 Sector WGs, Steering Committee, Quarterly Collaborative Meetings Almost 3 Years Old Action Plan

Community Hubs Community Hubs are partners who provide prevention and early intervention strategies within our libraries and neighborhoods to help strengthen communities and families in El Dorado County A collaborative project between the First 5 El Dorado Commission, EDC Library, EDC Health and Human Services Agency (MCAH and MHSA Programs), EDC Child Abuse Prevention Council and EDC Office of Education ` Why were the Hubs created? Many needs assessments performed in the County, including the 2014 Maternal, Child and Adolescent (MCAH) Health Needs Assessment, showed that El Dorado County has high rates of domestic violence and hospitalization of youth and women of childbearing age due to substance use and behavioral health issues. Community partners agreed that primary prevention and early intervention strategies are needed to get ahead of these issues and to help build a healthier and more resilient county; they also agreed that working together to accomplish the best outcomes for families is imperative.

Community Hubs: Approach 1 2 3 4 5 S L What are Community Hubs? Hubs bring prevention and early intervention services to communities, libraries and schools - where families, work, live and play L What are Community Hubs? Community Hubs are 5 teams of parenting, literacy and health specialists located throughout El Dorado County who assist families with the everyday challenges of raising children and connect them to community resources. The Hubs partners provide prevention and early intervention strategies within our libraries and neighborhoods to help strengthen communities and families in EDC.   Who can come to the Community Hubs? Expectant parents and families with children 0-18 years of age are invited and welcomed at the Community Hubs to participate in early literacy, family engagement and health activities. Where are the Community Hubs? Community Hubs are physically located in each El Dorado County Supervisorial district within a public library in: El Dorado Hills, Cameron Park, Placerville, Georgetown, and South Lake Tahoe. While these are central places where Hub activities occur, any place where Community Hub partners serve families within a community is a Hub.

Community Hubs: Funding Partner Funding Source 2016-20 El Dorado County Health and Human Services Maternal Child Adolescent Health (MCAH) (federal match funding and PH Realignment) ~$2,846,481 Mental Health Services Act Innovations (MHSA)   $2,760,021 First 5 El Dorado Commission $937,500 for healthy children, $860,000 for early literacy, $480,000 for family engagement and $680,000 for high quality child care $2,957,500 First 5 CA Commission Four year match funding to support high quality child care $1,544,593 El Dorado County Library Estimated four year match funding for early literacy staffing and operations. $860,000 El Dorado County Office of Education Child Abuse Prevention Council $255,000 Total Funding $11,223,595 El Dorado County has leveraged funding for prevention and early intervention services for expectant parents & families with children ages 0-18 What partners are involved in the Hubs project? First 5 El Dorado Children and Families Commission EDC Library EDC Office of Education, Child Abuse Prevention Council EDC Office of Education, Early Care and Education Planning Council EDC Health and Human Services Agency, Maternal, Child and Adolescent Health Program EDC Health and Human Services Agency, Mental Health Commission through MHSA Innovations Funding

Community Hubs: Toxic Stress In addition to childhood trauma, there are other types of pervasive toxic stress. El Dorado County’s current data exceeds the state average in key precursors to toxic stress: Substance use diagnoses per 1,000 hospitalizations of pregnant females ages 15-44 Substance use hospitalizations per 100,000 population ages 15 to 24 Mood disorder hospitalizations per 100,000 female population ages 15 to 44 Mental health hospitalizations per 100,000 population ages 15 to 24 Domestic Violence calls per 100,000 population In the absence of a caring relationship, adverse childhood experiences can disrupt healthy brain development

Community Hubs: Resiliency Family Strengthening Approach to Building Resiliency: Social connections Knowledge of parenting and child development Social and emotional competence in children Parental resilience Concrete support in times of need

Strong families are essential for healthy communities Community Hubs: Resiliency Community Hub Teams have been established to build resilient families with protective factors: connections, knowledge, understanding, resilience and concrete support: Increasing access to services Applying a trauma informed approach Establishing trust and building relationships Offering opportunities to build knowledge and awareness Providing services reflecting the cultural diversity of the communities they serve Using data to inform local priorities Strong families are essential for healthy communities

Community Hubs: Teams What is a Hub Team? Community Health Advocates (Health Outreach & Linkages) Family Engagement Specialist (Parenting) Early Childhood Literacy Specialist (Literacy) Public Health Nurse (Preventive Health) How do I find my Hub Team Members? www.first5eldorado.com What is offered at each Hub? Each Hub has a multi-disciplinary team that includes an Early Childhood Literacy Specialist, Family Engagement Specialist, Community Health Advocate and Public Health Nurse with the common goal to increase resiliency in families. Each Hub offers activities focused on early literacy and reading, child development and parenting, and preventative health activities and services. These services are provided at no cost to the families.

Community Hubs: Partners at Work Early Literacy – Mother Goose on the Loose, School Outreach, STEAM Family Engagement – Play and Learn, School Outreach, STEAM, Parenting Education, Basic Needs Community Health Advocates – Outreach Events, Community Engagement, Health Education, Health Linkages, Basic Needs Public Health Nurses – Short-Term Case Management, Community Needs Assessments & Outreach Plans, Provider Education & Outreach

Community Hubs: Collective Impact MCAH Needs Assessment and 5 Year Action Plan First 5 Strategic Plan Public Health CHIP High Quality Childcare BOS Healthy Communities Strategic Plan EDC ACEs Collaborative HHSA Program Collaboration Chronic Disease Prevention Hub Affiliates Community Messaging

Community Hub Profile Data Hub level data provides the opportunity to identify barriers and strategies to address local issues that reduce long term costs: Encouraging collaborative partnerships and pooled resources rather than siloed approaches Prioritizing populations with specific, cost effective strategies rather than one size fits all Promoting prevention efforts, far more cost effective than treatment Build relationships that lead to support prior to crisis rather than providing crisis services The County has diverse and isolated communities often overlooked because data is aggregated countywide, neutralizing income, geography and language barriers impacting children and families

Community Hub Reporting Community Hub Profiles First 5 El Dorado Commission Community Needs Assessments EDC Public Health Nursing Countywide summary of family strengths and the impacts of toxic stress over time Offers considerations to build resilient families within each Community Hub: Summarizes local demographics, families, economics, health and education Describes the impact of Hub Services Integrates the Public Health Nursing outreach plans based upon the CNAs Suggests priority populations, strategies and partners A detailed Community Needs Assessment (CNA) and Outreach Plan completed by Public Health Nursing staff for each Community Hub in the County: The Assessment provides a health summary for all communities within the Hub Each community has a demographic profile with key informant interviews and windshield surveys Outreach plans include goals and objectives designed to meet the unique health needs of each Community Hub www.first5eldorado.com/community-hubs

CNAs and Community Profiles https://www.first5eldorado.com/community-hubs

Community Hubs: Messaging Collaborative, Countywide Messaging: Connections matter to developing healthy brains, caring relationships and thriving communities Positive interactions are the foundation for healthy brain development at any age In the absence of a caring relationship, childhood trauma can disrupt healthy brain development Promoting healthy brain development is essential to community development Communities can promote healthy brain development through relationship building