Marin County

Prevention Hub: A Story of Evolution,

Collaboration and Prevention

CARS Presentation

September 4, 2013

Agenda

ObjectivesLearning

Attendees of this webinar will learn:

• How the Prevention Hub was conceptualized and created

• Major challenges and achievements of the Prevention Hub

• Lessons for other counties pursuing cross-system collaboration

Marin CountyPopulation: 252,409 (2010)

Marin residents tend to:

is inequalitymaking us sick? - California Newsreel 2008

The choices

we makeare shaped by the choices

we have...

Marin vs Marin

• Healthiest county in California

• Healthiest county for young people in America

• High income inequality

• Alcohol consumption, particularly binge drinking across the age span, is in the top 5%

Why create a Prevention Hub?

Address

Identify

Improve

Determine

Cross-Divisional Work

Communication

Strategy

Restructuring

Effort

Professional Development

Streamlined

Resources

What is the Prevention Hub?

To work together to advance

effective prevention practices

to improve the health of

all people and communities

in Marin County

• Inclusive & Community-centered

• Cross Sector Collaboration

• Environmental Prevention

• Ingenuity & Innovation

• Adaptability

• Risk Taking

• Integrity

Principles& Values

ReStructuring

• Request to all departments to improve services with existing resources

• HHS assessed opportunities for collaboration

– All six HHS divisions had a prevention thread

• Identified key staff and assessed capacity and readiness of each division

• Communicated how the Prevention Hub adds value to division leads

ReStructuring

• Intentional Institutionalization

– Did not want this to be the “idea of the day”

– Identified two Co-Coordinators

– Recruited cross-divisional staff: not just what you do, but what skills can you bring to the table

– Developed a “virtual” Hub

• Agreed on common language & training needs

Drawbacks of the Past Approach

• No systematic way to coordinate and collaborate

• Services were often limited by grant requirements

• Divisions worked with similar providers and partners with little coordination

• Training and professional development opportunities were limited/siloed

Prevention Hub do?What does the

• Align internal HHS structure to support prevention and community engagement

• Train on specific competencies to build skills of partners and staff

• Cross system strategic planning/allows for synergy across divisions

• Mutually beneficial prevention projects

• Provides a learning community and an incubator for new ideas

The Marin County

Prevention Hub

The

Beginning

Collective Im

pact

• Acknowledged that:

– We have different working styles and cultures

– This was the first time collaborating across divisions

– Some divisions were not accustomed to collaboration

• Agreed to:

– Use direct communication

– Appreciate different styles and cultures

– Share successes and allow for mistakes

WorkingAgreement

Spectrum of Prevention

Influencing Policy and Legislation

Mobilizing Communities and Neighborhoods

Changing Organizational Practices

Fostering Coalitions and Networks

Educating Providers

Promoting Community Education

Strengthening Knowledge and Skills

Assuring access to quality health care

Strategic Direction:

Support Community Action on Prevention

Prevention Priority Area from the National Prevention Strategy –

Objective

(specific,

measureable,

achievable,

realistic, time

limited)

Activity

(specific steps and sub-

steps needed to achieve

the objective)

Individual

and Agency

Partners

(both

internal and

external)

Deliverable

(measures that

can be

specifically

quantified,

include by when)

The Marin County

Prevention HubToday:

Mutually

Beneficial

Projects

& Functions

• Interdepartmental Coordination

• Technical Assistance

• Community Policy Advocacy

• Promoting Evidence Based Practices

• Media & Communications

• Project Planning

Functions of thePrevention Hub

• Have a prevention focus

• Are linked to a priority community need

• Have clearly identified outcomes

• Address issues of equity

• Have synergy across HHS Divisions

• Fit within our values and guiding principles

CriteriaFor Projects

• Marin County Fair- Play Fair

– Policies: smoking, healthy food, alcohol advertising

– TA: responsible beverage services

– Health Promotion- kids run

– Online and social media posting

– Health Ambassadors

– Baby Sanctuary

– USDA SNAP Ed grant (1st in Nation)

Howdoes it work?

• Tobacco Policy Success

– Work with Smoke Free Marin Coalition

– Collaboration with Public Housing

– Municipalities to pass local ordinances

– Board of Supervisors

– San Rafael Ordinances passed

Howdoes it work?

• Rethink Your Drink/Obesity

– Community engagment through HEAL planning process

– Program doing community education

– Policy goal for no soda in County vending machines

– Video to promote

– Board of Supervisors resolution as advocacy opportunity

– Wellness Ambassadors

Howdoes it work?

The Marin County

Prevention HubModel

Projects

• HEAL Framework is the first countywide, coordinated roadmap to improve healthy eating and active living in Marin

• Complex problem requires integrated solutions

• Focus on equity

Builds on community assets and brings together partners from different sectors

•Community Partners: Ag, food policy, Community Based Organizations, Food Bank, Safe Routes, Bike Coalition

•Social Services: CalFresh

•Parks and Open Space: Healthy People, Healthy Parks

•Public Works: Promotes walking and cycling

•Aging: Nutrition and physical activities for seniors

www.marinheal.org and like us on facebook!

• The Hub’s Healthy Retail Campaign aims to improve the health of Marin County through changes to the retail environment

• Community will asses the availability and marketing of tobacco, alcohol and un/healthy food and beverages in 144 stores

• Partners with Cx3 Communities

This Campaign:

• focuses on upstream policy change

• integrates tobacco, alcohol, and healthy food policy objectives within the retail environment

• offers the opportunity to mobilize public health advocates around one environment and build critical mass to leverage social norm change

• Countywide Rx/OTC Abuse Initiative

• Intimate Partner Violence Prevention

• Senior Injury Prevention

• Community Coalitions

OtherProjects

Opportunities& ChallengesOpportunities

• Prevention staff collaborating on projects much more frequently

• Communication has increased

• Share information, resources and expertise

Challenges

• Give up old ways / different expectations

• Concern that priorities will disappear

• Information overload

• Figuring out the next steps

• Different funding timelines

Opportunities& ChallengesOpportunities

• County-wide and local leadership commitment

• View concerns in an integrated way

• Assess outcomes more closely

• Potential to expand stakeholders

Challenges

• “Just another request from the County”

• Struggle to move folks from “reflection” and process outcomes

• Time pressures and concerns about priorities

Opportunities& ChallengesOpportunities

• Partners eager to collaborate

• Focus on equity & social determinants of health

• A good solution solves many problems

Challenges

• Dwindling resources and changing priorities of funders

• Discomfort within a “privileged” county

• Healthiest county

The Marin County

Prevention Hub

Hopes

For

The

Future

The Hub will besuccessful when

Marin County

Prevention Hub

facebook.com/MarinHealthAndHumanServices

twitter.com/MarinHHS

youtube.com/MarinCountyHHS

Marincounty.org/hhs

Sparkie Spaeth – HHS Deputy Directorsspaeth@marincounty.org

Kristen Law, MA – Resource Development Coordinatorklaw@marincounty.org