A group of Jefferson County health professionals and community leaders have charted a course forward for improving the mental and physical health of the community.
The recently completed Jefferson County Community Health Improvement Plan (CHIP) zeroes in on mental and physical health as its top priorities, along with a series of objectives, strategies to act on those objectives and ways to measure results.
But because of the COVID-19 pandemic, a third priority, accountability for county funds supporting service providers, will have to be addressed at a later time. The pandemic has also caused the Jefferson County Public Health Department to take a step back from leading the CHIP process, but the plan is for the department to return to that role once the pandemic has subsided, according to Boulder City Council President Drew Dawson, who along with Alison Richardson with the Jefferson Local Development Corporation, took over the leadership of the steering committee once the pandemic began to stress the health department.
The plan was built on information compiled in a Community Health Assessment completed in 2019 and each objective has a three-year action timeline.
To address mental health, the CHIP has identified three objectives over the next three years:
•Decrease the percentage of Jefferson County youth who report depression on the Youth Risk Behavior Survey from 41.5% to 36% or by about 5.5%.
•Decrease the percentage of county residents who perceive access to mental health care to be a major problem from 53% to 48%.
•Decrease the number of drug use hospitalizations from 210.7 per 100,000 to less than 200 per 100,000.
To address physical health, the following three objectives were set:
•Improve timely access to care for 90% of patients with time-sensitive conditions such as stroke, cardiac arrest, overdose, trauma and sepsis.
•Improve access to healthcare by reducing the top three barriers — transportation, cost and insurance, by 5%.
•Providing increased access areas for safe physical activity across Jefferson County from 57% to 62% by 2023.
The 5% targeted change for each objective was chosen because it was considered a reasonable goal to shoot for, said Jefferson County Prevention Specialist Barb Reiter, who was a member of the steering committee creating the plan.
The steering committee felt that 5% was doable, she said.
The objectives were followed by specific strategies to reach the objectives’ goals. Each strategy includes the party responsible for implementation.
For example, the plan calls for increasing the number of youth screened for depression, such as during sports physicals and at school, with the goal of reaching 50-75% by December 2023.
Jefferson County high school students are currently randomly screened through the Youth Risk Behavior Survey, which is administered through the Office of Public Instruction, said Reiter. Students in grades eight, ten and twelve are also screened through the Prevention Needs Assessment, which is administered by the Department of Public Health and Human Services.
The two-year interval is to track a student’s progress to see if depression or substance abuse is increasing, said Reiter.
The schools receive general results, not individual results, to these screenings, said Reiter. The screenings hit on larger issues, such as depression, bullying and alcohol use, and are used to see if a pattern is developing, she said.
If so, the schools can tailor programs to address those issues, said Reiter.
Jefferson County likely reached the 50-75% benchmark with the Prevention Needs Assessment last year, but that varies year by year, said Reiter.
Another strategy is to implement the PAX curriculum in county elementary schools, with performance measured by having two of the six schools being supplied support and supplies.
The PAX curriculum is also known as the good behavior game, said Reiter.
It’s a way for children to use basic social and emotional skills in the classroom, she said.
Rather than being reprimanded, the child is shown how to take responsibility for his or her actions, said Reiter, adding that Clancy Elementary is the only school in the county using the curriculum at this time.
It’s a program that works to inhibit negative behavior by having students create a map of a “wonderful classroom,” and then work to create and maintain it through self-management behaviors, according to the program offered by the Education Development Center.
The program can be expanded to include how children interact with other adults during their day, such as the bus driver, or librarian, said Reiter.
On the physical health side, strategies include assessing data to evaluate compliance with national EMS performance standards and conducting a feasibility study for a county-wide ambulance service district.
The county is currently served by a multitude of ambulance services, to include the Jefferson Valley EMS and Rescue, the volunteer Boulder Ambulance Service operated by the City of Boulder, the private Eagle Ambulance service that serves the northern end, as well as providing backup to the Boulder-Basin area. There are also several out-of-county ambulance services to include St. Peter’s Hospital Ambulance service in Helena and A-1 Ambulance, a private service out of Butte.
This would be a way to look at providing a steady stream of income to volunteer ambulance services and allow those services to provide a consistent level of care 24 hours a day, seven days a week, along with alleviating the burden providing that service is putting on volunteers, said Dawson.
The plan also calls for publishing a white paper outlining the pros and cons and methods for establishing a county-wide integrated health program and increasing the number of residents capable of administering CPR with an AED for out-of-hospital cardiac arrests.
To increase the availability of safe areas for physical activity, the plan calls for implementing the Boulder River Trail Master Plan and Feasibility Study.
Boulder recently completed a master plan for a series of multi-use trails and sidewalks in and around the city to increase connectivity. The plan was adopted by the City Council in September and can be used to enhance grant funding applications. The plan was part of the Boulder Development Fund’s group of projects, funded by $500,000 allocated by the state to compensate for the closing of the Montana Development Center.
2019 Health Assessment
The 2019 Community Health Assessment surveyed community members and received 101 responses. The top four concerns were access to mental health services, followed by mental/behavioral health, access to affordable health insurance, addiction and substance abuse and access to medical and emergency care.
Ironically, at the time the survey was taken, communicable or infectious diseases was second from the bottom of concerns.
Next steps
The next step is to incorporate the various portions of the CHIP into the strategic plans for those agencies that support mental and physical health in the community. Specifically, the Jefferson County Health Department will create a Strategic Plan to guide their efforts overall and ensure they include the areas of the CHIP they are supporting.
The members of the steering committee will also meet quarterly to assess progress on the main objectives.
The plan will be made available to the public. The 2019 Health Assessment is posted on the Jefferson County Public Health Department page on the county’s website.
