Sustain Your Efforts

• Policies and Procedures provide the guidance and accountability to ingrain school wellness throughout school culture.
  • Create MOUs among your SBHC, school, medical sponsor, and CBOs to sustain your partnerships. MOUs include the purpose and scope of the partnership, articulate timelines, assign joint roles and responsibilities, and identify joint policies and protocols. Click to see examples of SBHC MOUs:
    • Seattle-King County SBHC MOU
    • General SBHC MOU
  • Policies and procedures have the details to operationalize an MOU. They should evolve over time as needed.  Review them annually and adapt the MOU accordingly.
• Policies are a set of organizational rules and requirements governing a process. Health and wellness policies should include expectations and provisions to create and ensure physical and social and emotional wellness for students.
  
  Health policies can dictate the types of foods and beverages available before, during, and after school- in the cafeteria, for birthday and other celebrations, during fundraisers, etc. Health policies can also include recommendations for physical activity and recess.
  • Review your action plan to identify the policies necessary to execute your school-wide wellness efforts. Look at existing school and district level policies to determine necessary updates to create conditions for school health and wellness.
  • Be sure to include measurable objectives and expectations, responsibilities, and compliance enforcement in your policies.
  • Use sample wellness policies as a guide to establish or update your policies.
    • Oakland Unified School District Wellness Policy
    • Dougherty County School District Wellness Policy
    • Chula Vista School District Wellness Policy
    • Chula Vista Wellness Policy Summary

• Procedures outline how staff should implement the rules (policies) by providing step-by-step instructions, and following the instructions is called a procedure.

Finding funds for your school-wide wellness efforts will provide additional support to enhance your current programs and infrastructure; it can also allow you to expand or replicate your efforts at other sites.

• Funding includes personnel budget items like salary, benefits and indirect costs associated with staffing your school-wide wellness efforts. Funding also includes travel, materials, and more.
• In your action plans, include possible funding sources. Your team should discuss different health and education, and even business-related, funding visions. These could include grants and maximizing billing.
  • Funding sources can include donations, grants, community benefit dollars, allocated funds, or funded staff positions from universities, schools, districts, and SBHC medical sponsors.
  • Other possible funders include local legislators, community businesses, private donors or foundations, and health plans.

• Payment Reform and Billing:
  • Many payment reform and health care delivery pilots are currently underway, with the goal of addressing high healthcare costs and poor health outcomes.
    • Payment reform efforts are geared toward achieving the Triple Aim [xix], — better health for a community, improved patient experiences, at a lower cost.
    • SBHCs have the opportunity to participate in payment reform in multiple ways– serving youth in underserved communities to address health disparities, providing preventive and primary care services encouraged in payment reform, conducting school-wide screenings, and offering whole school populations access to health education opportunities supported by payment reform.
      • SBHCs must secure timely and accurate data on the population they serve and the quality of care they provide.
      • SBHCs should assess, collect, and track social determinants of health (SDOH) such as food insecurity and homelessness of their patients and where possible, the entire school population. There are a number of risk assessment tools available. Some are comprehensive and include sections on Adverse Childhood Experiences (ACES) or Social Determinants of Health (SDOH) and some are specific to SDOH and ACES. Some of these are already included in Electronic Health Records (EHRs).
        • Use EHR diagnostic codes on ACES and SDOH to tell your SBHC and school-wide wellness story. These powerful data collection tools can meet performance measures and show quality improvement, leading to increased payer engagement, and possibly funding.

• Partners serve a key role in sustaining school-wide wellness efforts, connecting schools with resources and expertise, and providing or supplementing services. They can also advocate for the continuation or expansion of your school-wide wellness efforts. Working with partners can provide information and insight; foster other partnerships and/or funders; and lead to financial and non-financial resources to continue the work.
  • Revisit the stakeholder engagement sections and accompanying tools to identify who to engage and the best strategies to do so.
    • Stakeholder Map
    • Stakeholder Plan

• Expanding partners beyond your initial groups can help bring in more resources and support for your work. Sustainability stakeholders may include:
  • School-wide wellness recipients or participants: students and schools staff.
  • Stakeholders who oversee these individuals: parents, school leaders and school district leaders, such as the School Board.
  • Organizations with goals of school wellness: community- based organizations like food banks, and before- and after-school programs.
  • Funders may also share common goals with your wellness team: foundations, health plans, and Medicaid.
  • Health care providers who share a similar mission or goal: hospitals, mental health centers, and even your SBHC Sponsor organization.
• Use the message box and other supporting data and communications to build your case to stakeholders for sustaining school-wide wellness work:
  • Why school-wide wellness is needed, who benefits from it, and the value it creates for your school and community.
  • What problems your efforts address or conditions they create, and how your school-wellness work will help them achieve their priorities.
  • Give a reason to care about sustaining these efforts, and a specific way they can assist.

• Identify your partners, policies, and funds to ensure your school-wide wellness work continues, or grows, in the future. All plans should be realistic, effective, and meaningful.