2. Founded in 1995 by the National Association of Community Health Centers, Community HealthCorps is the largest health-focused, national AmeriCorps program that promotes healthcare for America’s underserved, while developing tomorrow’s healthcare workforce.

3. The mission of Community HealthCorps is to improve healthcare access and enhance workforce development for community health centers through national service programs. The vision of Community HealthCorps is to become a national service pipeline for careers in community health centers that is improving access to necessary primary and preventative care services for the medically underserved.

4. An Introduction to Performance Measurement for Community HealthCorps Members Program Year 2011-12

5. Performance Measurement Defined The Logic Model & Components Our Philosophy & Assumptions Our Performance Measures Documenting Data What Happens to Data Agenda

6. I Came to Serve Not Collect Data! If it wasn’t measured, it didn’t happen.

7. What is Performance Measurement? OFFICIAL DEFINITION: The process of regularly measuring the outputs and outcomes produced that allows tracking of amount of work done and the impact of work on program beneficiaries. WHAT THAT MEANS: The process of regularly measuring what you get done, how much, and the impact of what you did on the people you are trying to help.

8. The AmeriCorps Logic Model Needs & Assets InputsActivitiesOutputs Intermed- iate Outcome End Outcome Intended Results Program Planning

9. The AmeriCorps Logic Model Nuts & Bolts: Program Planning Community Needs/Assets Identified local need to address Identified local assets $$, agencies, people & resiliency Inputs Resources used by the program such as financial, people, and organizations Activities What the program does with the resources to address community needs & make a difference

10. The AmeriCorps Logic Model Nuts & Bolts: Intended Results Outputs What got done Counts # of services delivered, work or products created Intermediate Outcome Changes that fall short of significant benefit Satisfaction Knowledge End Outcome Significant change with lasting benefit in the lives of people Healthy birth

11. … is to improve health care access and enhance workforce development through community health center sponsored AmeriCorps including VISTA (Volunteers in Service to America), and related programs. The Mission of Community HealthCorps…

12. Our Philosophy: Social Determinants of Health “Social determinants of health are the circumstances in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources…which are themselves influenced by policy choices.” (World Health Organization) Most Responsible for Health Inequities Access to services Access to resources (e.g., grocery stores) Discrimination by social grouping (e.g., race, gender, or class) Employment Education Health insurance coverage Housing Socioeconomic status – (e.g., income) Transportation Social / Environmental stressors

13. Community health centers will serve the needs of people very well with adequate capacity. The Community Health Worker role is an example of a major way members serve the needs of community and health center organizations. Members positively impact an organizations’ capacity to serve patients/clients. Member service housed in Enabling Services should be the priority placement within health centers in adequately address social determinants of health. People need assistance with adopting self-care practices, and navigating health and social services. Our Logic Model: Assumptions

14. Performance Measures by Type

15. Key AmeriCorps Service Activity Measured (Our Performance Measures) Delivery of Health Services Health Education Reducing Childhood Obesity Volunteer Generation Enroll new people in a health insurance, health services, or health benefits program. Provide language translation services. Assist health centers in increasing knowledge and helping to change unhealthy lifestyles of recipients, focusing on topics such as general wellness, preventive disease management, or other goals to improve overall health. Recruit and coordinate new non-AmeriCorps volunteers to participate in health center activities, such as distributing health promotion material around communities or health fairs. Encourage children/youth to participate in physical activities that are designed to target and reduce childhood obesity.

16. Delivery of Health Services OUTPUT New unduplicated clients enroll in health insurance, health services, or health benefits programs. AND/OR… New clients receive language translation services. INTERMEDIATE OUTPUT New unduplicated individuals who are uninsured, economically disadvantaged, medically underserved, or living in rural areas will use preventive and primary health care services and programs. END OUTCOME These economically disadvantaged individuals will improve their health status and overall quality of life.

17. Uninsured: An individual who does not have insurance coverage. Economically disadvantaged individuals: Those who meet income eligibility for Medicaid or SCHIP within the state they live. Medically underserved: An individual who lives in a medically underserved area as defined by Health & Human Services (HHS). Healthcare services: Accessible, comprehensive, continuous, & coordinated care to preserve health within the community. Preventative health care services: Any activity that is conducted with a goal of preventing/detecting illness. Primary health care: The basis of health care and is defined as an individual’s essential form of health care. Translation vs. Interpretation: Translation is the written conversion of one language to another, and Interpretation is the spoken conversion of language to another. Delivery of Health Services: Definition of Key Terms

18. Delivery of Health Services: How to Measure Clients receiving language translation services (output): Count unduplicated new clients who receive the language translation services (can be either written or verbal). If an encounter involves more than one person (e.g., family members), count each individual separately. Enrolling patients in health insurance / FQHC programs (output): Count unduplicated new clients who were newly enrolled in a health insurance, health services, or health benefits program as a result of grantee activities. Count each client only once. Example: Enrolling an unduplicated client in health insurance and then enrolling that same client in a health service would count as one client. Included - records or data (application and follow-up) on client enrollment and health insurance status. Individuals utilize preventive / primary health care services & programs (intermediate outcome): Count unduplicated new individuals who actually use the preventive and primary health care services and programs, as a result of the grantee’s activities.

19. Examples of instruments (tools) that can be used to track this information prior to entering it into OnCorps. Delivery of Health Services: Tools Electronic enrollment logs Electronic interpretation logs Electronic translation logs Electronic medical records Practice management system

20. Health Education OUTPUT New unduplicated clients participate in health education programs. STRATEGY: Whether focused on the importance healthy oral health habits or educated teens recovering from substance abuse on the importance of fitness and nutrition, members will assist health centers in increasing knowledge and helping to change unhealthy lifestyles of service recipients. Members will most often assist certified health educator staff to deliver set curricula (or design new curricula) to populations that are not currently served in this capacity by existing resources. KEY TERM: Health Education Programs: An educational process where information is given to individuals about community health status, health care needs, positive health behaviors and health care policy issues.

21. Health Education: How to Measure New clients in health education programs: Count unduplicated new clients who participate in the health education program. If the health education program has multiple sessions, topics, etc., count the client once. Do not count clients by number of sessions. For example, if a health education program meets once a month for one year, and has 12 participants who complete, then only report 12 (not 144). (Photo: Community HealthCorps 2005 Health Fest)

22. Reducing Childhood Obesity OUTPUT Unduplicated children and youth participating in in-school or after school physical education activities with the goal of reducing childhood obesity. STRATEGY: Members will engage children and youth in physical activities as part of a comprehensive set of health service activities that, in concert are designed to address childhood obesity. For example, physical activity will be combined with the provision of healthier choice snacks and drinks, and nutrition health education that includes caregivers of participating children and youth. (Photo: East Boston Neighborhood Health Center End of Year Celebration)

23. Reducing Childhood Obesity: How to Measure & Key Terms Reducing childhood obesity: Count of the number of unduplicated children actively participating in the activities. Not just the number enrolled or even the number attending, but rather the number who engage in the activities. Count each child only once. KEY TERMS: Physical Education: An physical activity that is in addition to any school or after-school provided activities that aim to reduce obesity and to maintain a healthier lifestyle.

24. Volunteer Generation OUTPUT Unduplicated non-AmeriCorps volunteers recruited & coordinated. STRATEGY: Members mobilize and support individuals in one-time and ongoing needs such as arranging transportation, facility improvements, volunteer readers, organizing health fairs and neighborhood distribution of health promotion materials. For example, members can assist with recruiting patients or clients to serve on the Board of Directors or other take on volunteer roles. (Photo: AmeriCorps Week 2008)

25. Volunteer Generation: How to Measure Recruiting & Coordinating Volunteers: Count unduplicated new Non-AmeriCorps volunteers, which are individuals who use their time and talent(s) to benefit or impact gaps in community services under no formal obligation to do so and without receiving external rewards such as monetary or insurance benefits. Do not count volunteers by number of service activities. For example, if a service activity occurs once a week for one month, and has 10 volunteers who were engaged, then only report 10 (not 40).

26. Disadvantaged children & youth College students (must be enrolled in a degree-seeking program) Baby boomers (those born between 1946 & 1964) Among all volunteers recruited, members should keep track of whether the volunteer was participating as “one-time” or “on-going” Volunteer Generation: Special Populations

27. Direct Service Report / Team Direct Service Report Member / Team Development Report Capacity Building Report For more details of how to report within this system, refer to the tutorials and guidance posted on the OnCorps resources page. OnCorps Service Reporting Tool(s) You Use

28. The following three items are important when reporting in OnCorps: 1. First time patients/ clients 2. Patients new to the service activity itself 3. Ongoing patients among each service activity What does the member need to know when working with a patient/client?

29. Why do members need to collect these numbers about patients/clients they serve? 1.First time patients/clients – Nationally we look at how many unduplicated patients the program serves each year 2.Patients new to the service activity itself – This will help determine the number of unduplicated people across individual activities (which is what we pull for the output performance measure numbers) 3.Ongoing patients among each service activity – This helps determine the utilization and initial outcome numbers among activities and performance measures

30. Great Stories & Reflection Logs

31. Share your great stories Highlight your service experiences that you think express the impact that: − You have on others − The program has in the community − The program has on you Stories Are Data Too!

32. Completely true Has a Beginning, Middle and End (the peak) Be Descriptive! Create pictures using words The Anatomy of a Great Story

33. Examples: Word Images Sight “After the third time I helped Jason find help, he no longer walked into the health center with slumped shoulders and bewildered eyes.” Sound “I could barely think with all the loud clamor of the construction outside.” Sight, Smell and Sound Combined “The neighborhood seemed like a place that once was, but the sweet scent of flowers and laughter carried by the summer wind gave me a sense of possibility, hope for this place, and the people in it. So then I asked myself, ‘what can WE get done’.”

34. Seize the Moment: The best time to write down your thoughts is as they come to mind – not always possible. Reflection Logs in OnCorps: Establish a routine of recording each day. Editing can come later. These logs could help build a Great Story. Ask for Help: Receiving constructive feedback strengthens over time. Share your stories in OnCorps and at www.communityhealthcorps.org. The Habit of Documenting Stories:

35. Log in to OnCorps Under Reporting in the main header, there are options to enter ‘Reflection Logs’ and ‘Great Stories’. Reflection Logs: These should act as a daily or almost daily journal. Entries should be should capture your most recent activities. Great Stories: These are all-encompassing stories that should reflect your immense impact in the program using the tips described earlier. Reflection Logs & Great Stories can be saved for later edits. OnCorps Story Reporting Tool(s) You Use

36. Now what?

37. For monitoring the progress of all Community HealthCorps programs For publicizing our successes – telling the story For responding to requests for information from Congress and other stakeholders For identifying trends and issues that may lead to opportunities for improving: – peer learning; – policy; and – training and technical assistance. What happens to all the information I collect?

38. Accuracy is the Key to Good Data Never Guess or Estimate

39. Gather data in designated area as a daily routine such as at the end of each day The program coordinator and the organization you serve with are there as support – So ask for help as needed. Most important for information to be accurate The longer you wait the more you will forget – the detail gets lost - even the things we do or use often (utilize the Reflection Logs to aide your Great Story). Point to remember: – Data collection for measuring success is simply “taking a closer look” Key Points about Information Tracking for Reports

40. For further information about Community HealthCorps, visit www.communityhealthcorps.org