6:05 p.m. Approval of Minutes from December 8, 2014 Co-Chairs Councilmember George Leventhal and Sharan London

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1 Healthy Montgomery Steering Committee Meeting Monday, March 2, :00 p.m. - 8:00 p.m. Family Services 610 East Diamond Avenue, Suite 100 Gaithersburg, MD :00 p.m. Welcome and Introductions Co-Chairs Councilmember George Leventhal and Sharan London 6:05 p.m. Approval of Minutes from December 8, 2014 Co-Chairs Councilmember George Leventhal and Sharan London HMSC Membership - Update Welcome Leslie Graham, President & Chief Executive Officer, Primary Care Coalition of Montgomery County to the HMSC. 6:10 p.m. HHS Director s Comments Uma Ahluwalia 6:20 p.m. Community Health Needs Assessment Update Dr. Ulder Tillman 6:30 p.m. Community Health Needs Assessment (CHNA) Hospital Presentation - 30 minutes Wendy Friar, Holy Cross Hospital Health Services Cost Review Commission Presentation - 30 minutes Amanda Vaughan, Center for Clinical and Financial Information Steve Ports, Deputy Director, Policy & Operations 7:30 p.m. Action Planning Moving Forward Michael Rhein, Institute for Public Health Innovation 7:45 p.m. Implementation Work Group Reports (HMSC packet and online) Measurement & Evaluation Subcommittee Behavioral Health Obesity Prevention 7:50 p.m. Open Discussion and Wrap-up/Adjourn Co-Chairs Councilmember George Leventhal and Sharan London

2 Healthy Montgomery Measurement & Evaluation Subcommittee Quarterly Report The M&E Subcommittee met in January, and agreed to focus its efforts on providing advisory support to the priority area groups, specifically the Behavioral Health Task Force and the Eat Well Be Active Partnership, as they formulate their plans. A meeting will be planned with M&E Subcommittee Chairs Mike Stoto and Dawn Valentine and the Behavioral Health Task Force subcommittee chairs to explain the role of the M&E Subcommittee and determine how the groups can work together moving forward. The Eat Well Be Active Partnership is in the process of writing its strategic plan. The M&E Subcommittee has offered to provide advisory support to review goals and objectives, and identify corresponding measures, as part of the strategic plan writing process. Additional M&E Subcommittee developments include: Finalizing the M&E Subcommittee charter, which the HMSC is being asked to vote on at the March meeting. Welcoming new member Dr. Tom Lewis, Chief Information Officer of the Primary Care Coalition, who has replaced Sharon Zalewski, who has taken on a new role at the Regional Primary Care Coalition. Developing a regular bi-monthly meeting schedule.

3 Healthy Montgomery Measurement & Evaluation Subcommittee Quarterly Report The M&E Subcommittee met in January, and agreed to focus its efforts on providing advisory support to the priority area groups, specifically the Behavioral Health Task Force and the Eat Well Be Active Partnership, as they formulate their plans. A meeting will be planned with M&E Subcommittee Chairs Mike Stoto and Dawn Valentine and the Behavioral Health Task Force subcommittee chairs to explain the role of the M&E Subcommittee and determine how the groups can work together moving forward. The Eat Well Be Active Partnership is in the process of writing its strategic plan. The M&E Subcommittee has offered to provide advisory support to review goals and objectives, and identify corresponding measures, as part of the strategic plan writing process. Additional M&E Subcommittee developments include: Finalizing the M&E Subcommittee charter, which the HMSC is being asked to vote on at the March meeting. Welcoming new member Dr. Tom Lewis, Chief Information Officer of the Primary Care Coalition, who has replaced Sharon Zalewski, who has taken on a new role at the Regional Primary Care Coalition. Developing a regular bi-monthly meeting schedule.

4 Healthy Montgomery Behavioral Health Task Force Quarterly Report Submitted by Co-Chairs Thom Harr and Kevin Young For the March 2, 2015 HMSC Meeting Behavioral Health Task Force (BHTF) Charter Approved During this reporting period, both the Behavioral Health Task Force and HMSC approved the BHTF Charter (presented at the December HMSC meeting). We have noted two comments offered by the HMSC members that we will keep prominently in mind as we move forward with our work and as we plan for future revisions to the Charter. One comment, in fact, suggested that we update the Charter annually; the other comment suggested that the Charter, specifically the purpose section, state the need for cultural and linguistic competency in addressing the behavioral health needs of those County residents who do not have English as their native language. Behavioral Health Task Force Subcommittees Launched At a meeting on January 20th, the Behavioral Health Task Force launched its three subcommittees to work on the following tasks, as noted in the Charter: (1) Enhancing infomontgomery so that consumers, their families, providers and other social service agency or referral source personnel can easily gain clear, basic information about treatment options, the full range of available services, payment mechanisms, and how to access services; (2) Establish protocols to facilitate safe and appropriate transfer of clients from institutional settings to community behavioral health organizations, primary care organizations and crises centers; and (3) Initiate a process to explore the creation of a coordinated system of care or other formal partnershipbased business agreement to meet the needs of individuals with more serious behavioral health conditions who live in Montgomery County. The subcommittees achieved several goals at the meeting. Reviewed the roles and responsibilities of the Subcommittee chair/co-chairs; elected chair/co-chairs, reviewed and discussed their charge as stated in the Charter and their timeline for completing their work; reviewed a work plan outline, based on the Behavioral Health Action Plan, provided by Healthy Montgomery staff; set a meeting schedule; and discussed preferred communications and information sharing approaches. The elected Subcommittee Co-Chairs/Chairs are: infomontgomery Subcommittee Chair: Stephanie Rosen, NAMI Montgomery County Protocol Subcommittee Co-Chairs: Stefan LoBuglio, Montgomery County Department of Corrections; Jennifer Pauk, Montgomery Cares Behavioral Health Program, Primary Care Coalition; and Celia Young, Montgomery College Coordinated Care Subcommittee Co-Chairs: Arleen Rogan, Family Services, Inc. and Celia Serkin, Montgomery County Mental Health Advisory Committee Brief Subcommittee Reports Since the January 20 th launch of the Subcommittees, the Subcommittee members have met and begun their work. Protocol Subcommittee: The Subcommittee conducted an online survey of its members to ascertain members communication preferences and availability for meetings, catalog the expertise of its members, identify additional expertise needed, ask for members vision of the subcommittee s success, and begin to query members on their knowledge of existing protocols and why and how the protocols need to be improved. They have begun to identify protocol 1

5 challenges, protocols of key actors in the system, and have begun to consider administrative, programmatic, and legislative recommendations. Coordinated Care Subcommittee: The members have selected the core values by which they will operate. They also discussed and identified priorities for needed funding which include: a cost analysis of high users of jail, hospital, acute psychiatric services; information sharing, education, prevention, awareness; enhancing crisis services; more access to care. They also discussed the Pathways Model, identifying risk level of clients, braided funding, better access to an affordable language line; a focus on health disparities, and identifying target populations on which the system would focus. The Subcommittee members are also making arrangements to get additional input from representatives of the Montgomery County Police Department, Faith partners, and EMS. infomontgomery Subcommittee: The members have begun to identify ways in which to enhance the content of and access to behavioral health information on infomontgomery and will work next to prioritize those identified strategies. They also have brainstormed ways to better publicize infomontgomery as a resource. Preparation for February 27 th Meeting On February 27 th, a meeting of the full BHTF is scheduled (Adventist Behavioral Health is providing the meeting space and refreshments; an Adventist Behavioral Health staff member will facilitate the meeting). Originally, the meeting s purpose, as described in the Charter, was to provide an opportunity for the BHTF to review and discuss the state budget and develop an advocacy platform that would address behavioral health budgetary issues. But, after a lengthy discussion with our Subcommittee Co- Chairs, we have decided to alter the purpose of the meeting. Instead of focusing on the state budget, the meeting will focus on the more urgent opportunity the Task Force has to offer timely recommendations to the Healthy Montgomery Steering Committee (HMSC) related to discussions around the FY 2016 Montgomery County budget. The idea is for the Task Force members, on Feb. 27th, to identify two to three recommendations related to improving the behavioral health system of care in the County that would then be further developed at subsequent meetings and offered to the HMSC by the end of March. The Healthy Montgomery Steering Committee members will then have the BHTF recommendations to inform the discussions around the County budget. We have been meeting with HM staff and Adventist Behavioral Health staff to prepare for this meeting. 2

6 Proposed Eat Well Be Active Strategic Plan Outline A. Executive Summary B. Acknowledgements C. Background Healthy Montgomery Action Plan background History of Eat Well Be Active Partnership Description of obesity problem in county Rationale for Long Branch focus County-wide implications D. Partnership Vision, Mission, and Goals E. Strategic Plan Methodology Formation of work groups Structure of monthly meetings Use of planning questions and action planning worksheet F. Recommended Strategies Physical activity as a vital sign, school wellness councils, promotion of new child care regulation implementation around nutrition and screen time; infomontgomery as a means to better disseminate obesity resources Description of strategy o Evidence base o Need strategy addresses o Discussion of any related challenges Goals Objectives Policy implications/ recommendations Measures of success Existing assets Resources needed

7 Eat Well Be Active Partnership Quarterly Report for March 2, 2015 HMSC Meeting Submitted by Co-Chairs Linda Ashburn and Linda Goldsholl The Eat Well Be Active (EWBA) Partnership has progressed this quarter on its work related to the development of a strategic plan and sustainability plan, two primary tasks included in the Healthy Montgomery Obesity Action Plan. The Work Groups have also progressed further in the projects they have undertaken. Strategic Plan and Timeline Healthy Montgomery Staff worked with the co-chairs to develop a draft outline for the Strategic Plan and an accompanying timeline that was presented to the Eat Well Be Active partners at the Feb. 18 th monthly meeting of the work groups. (Please see the outline and timeline attached.) The work groups will be further developing their current ideas for their respective parts of the Strategic Plan specifically, they will work to develop goals, objectives, indicators of success etc. for their proposed action strategies. Members of the Evaluation and Measurement Subcommittee will also provide guidance. The EWBA Coordinating Committee will also be involved in development of the Strategic Plan. The work groups continue to meet monthly to develop action strategies. Whole Foods donated the refreshments for the December 18 th meeting. Community Work Group: Developing an asset map and inventory that lists resources in the Long Branch area related to: Physical Activity, Healthy Eating, Nutrition Education, and Nutrition Counseling. This will also include exploring how best to work within the infomontgomery infrastructure and developing ways to share the asset map information with service providers, nonprofit organizations, residents and others in the community to highlight existing community assets for increased utilization by residents. Health Care Work Group: Incorporating physical activity as a vital sign to identify patients at risk for obesity, as well as corresponding educational materials and resources to share with patients. The group is planning to test the screening questions at Community Clinic, Inc. s Takoma Park location. The health care work group adapted the physical activity as a vital sign strategy used by Kaiser Permanente in California. The health care provider will use patient responses to initiate a conversation with the patient about age-appropriate physical activities and local opportunities to be more physically active (using the community work group s asset map and inventory as a resource). Child Care/Home Work Group: Helping licensed child care centers to successfully implement new state and federal regulations related to providing healthy beverages, reduced screen time, and breastfeeding promotion by integrating key information and messaging into existing training and outreach provided by the County. Public comment periods for the new state and federal

8 regulations will be taking place in the next few months and members of the Partnership will be encouraged to submit comments. School Work Group: Promoting formation of school wellness councils in MCPS Title I schools as a way to advance local implementation of the MCPS school district-wide wellness policy and healthy food and physical activity policies within local schools. Currently, the Principal at Rolling Terrace Elementary School is planning to host an informational meeting (February 24th at one of her regularly-scheduled Principal s Coffee events) about the possibility of forming a school wellness council at the school. Meeting with DHHS Director re: HM Staff Resources and Obesity Data Surveillance We met with HM staff, Uma Ahluwalia, Dourakine Rosarion, and Dr. Tillman on February 3 rd to provide updates, discuss HM resources for staffing, and review the proposed timeline and outline for the strategic plan. The staff needs of the Partnership were discussed as was the decreased HM staff time given the additional focus on the community needs assessment and upcoming new issue areas. Also, of utmost importance is the need to clarify the roles of the Steering Committee in implementation of the Strategic Plan, the expectations of the volunteers in the work groups, and the continuing roles of the Co-chairs. Uma suggested that we reconvene in March. She explained that, after further internal DHHS staff discussions take place regarding HM staff resources and assignments, she can provide more information on the HM staff resources available to the Partnership. At the meeting, we also discussed the obesity data surveillance efforts outlined in the Obesity Action Plan. Dr. Mike Stoto, Co-Chair of the Evaluation and Measurement Subcommittee joined the meeting for this discussion. The following were noted: WIC Data DHHS will contact WIC data and outreach managers to request annual weight status data on WIC participants aged 2-4 by race and ethnicity; MCPS Data Uma reported that DHHS and MCPS are working on a data sharing agreement. Data will be collected on Kindergarten and Grade 6 students beginning school year ; Maryland Youth Tobacco and Risk Behavior Survey These data are to be collected annually from DHMH; MD BRFSS These data can be collected annually from DHMH but the relevance of the data to Montgomery County is questionable. Mike Stoto suggested using data from County Health Rankings instead of (or in addition to) the BRFSS. It was asked if these data can be tracked by DHHS staff and Dr. Tillman stated that much of this is already being tracked. Dr. Tillman took notes and stated she would discuss these data sources with the County epidemiologist.

9 The resource constraints and shifting priorities of HM were discussed with the Coordinating Committee during its meeting on February 11 th in the context of continuing Eat Well Be Active efforts. Members of the Coordinating Committee confirmed their support for this work and desire to continue the monthly meetings of the Work Groups for Eat Well Be Active. Current partners will assist to support the work. The following additional resources were identified: Tanya Edelin (Kaiser) and Marisol Ortiz (PCC) have offered to provide additional support for the work group meetings; University of MD Extension will provide administrative support and student interns to support research and other needs. Sustainability Plan The Eat Well Be Active Coordinating Committee met regularly during this quarter to work with contractor GeMar Neloms to develop a Sustainability Plan. As noted in our previous report, GeMar is funded as part of the LHIC grant awarded by the Maryland Community Health Resources Commission to support the Healthy Montgomery obesity prevention efforts. The Plan will outline strategies for building and supporting the EWBA Partnership and include strategies that focus on partnership recruitment, retention and collaboration to leverage resources, and funding approaches to support the capacity of the initiative and the joint efforts of the partners to address obesity in Montgomery County. So far, the Coordinating Committee has completed the following: A self-assessment to determine if the Initiative is ready to ask for resources. A proposed formal description on what being a Partner in the obesity prevention initiative looks like. Approaches to recruit and retain supporters to collectively achieve goals of EWBA and prioritize which approaches to seek collaboration and funding. Over the next 1-2 months, the Coordinating Committee will draw on the work of the Work Groups to develop and identify broad strategies and potential funding areas and partnerships to support the work group s action plans and develop a draft written plan to provide to the Steering Committee for review and discussion.

10 Proposed Eat Well Be Active Partnership 2015 Timeline Draft strategic plan outline and timeline Finalize work group action plans and draft strategic plan Review and finalize draft strategic plan Present draft strategic plan to HMSC Revise, finalize strategic plan Present final strategic plan to HMSC Hold partnership meeting/ summit Jan.-Feb. March April May June July-August September October