Background and Need

Demographics The Commonwealth of Kentucky is a very diversified state with changing topography from fertile plains in the west, used to support agriculture, to the Appalachian Mountain Range in the east used to support lumber and coal industries, to the Bluegrass or Central region of the state, which is world renown for its thoroughbred horse industry.

Kentucky is comprised of 120 counties varying in geographic size, population, income/poverty, and educational attainment. Key areas of Kentucky still remain isolated and distant from major cities, universities and health care services. The 2007 Kentucky Institute of Medicine’s The Health of Kentucky report lists high school graduation and per capita income as two significant barriers to address in improving the health of Kentuckians. Only 9 of Kentucky’s counties have graduation rates about the national average causing its ranking to be 47th among 50 states in the percentage of people age 25 and older who have a high school diploma. Likewise, only 5 Kentucky counties have per capita incomes above the national average. Upon analysis of multiple health variables within all of the state’s counties, those ranking in the bottom ten were all located within the Appalachia region. The far eastern portion of the state, known as Appalachia, consists of 51 counties. Compared to other areas of the state, residents of Appalachia have lower income and education levels and have higher rates of various health problems. Many of these areas have a shortage of health care professionals, resulting in little or no access to primary health care and a heavy reliance on regional hospitals and medical clinics. The Appalachian population is approximately 1,145,000 and is dispersed over 17,714 square miles. Nearly 40% of Appalachians live below the federal poverty level, while 70% lives at or below the federal poverty level. Additionally, only 62% of adults in Appalachia have completed high school, compared to the statewide average of 74%, and the national average of 80.4%. In 2004, the Appalachian Regional Commission reported that Appalachians as a minority group are characterized by significantly high rates of poverty, substandard housing, high unemployment rates, and discriminatory attitudes about their culture. The Appalachian Regional Commission is a federal-state partnership that works with the people of Appalachia to create opportunities for self-sustaining economic development and improved quality of life.

Although much of Kentucky is rural, the central portion of the Commonwealth contains the three most populated areas in addition to increased household incomes and education levels. Of the 100 poorest counties in the United States, in terms of median household income, 29 are located in southeastern Kentucky. Louisville, Lexington, and the Northern Kentucky/Cincinnati suburbs are often referred to as the state’s “golden triangle” and contain a population with far higher incomes, education levels, and access to health services than the rural parts of the state. The economic disparity plays out both at the state level and also between Kentucky’s counties. For example, Kentucky’s wealthiest county (Oldham) has a median household income of $68,130, a figure that is almost $50,000 more than the median household income of Kentucky’s poorest county (Owsley), in the Appalachian region, with a 2004 median household income of $18,377. Graduation rates in the above-mentioned urban counties total between 82-86 percent compared to Owsley County at 68 percent. Additional resources (i.e. colleges and universities, public transportation, medical care, economic opportunities) assist the urban residents with more opportunities.

According to the 2006 American Community Survey, the estimated population of Kentucky is 4,206,074. The American Community Survey is a new nationwide survey that collects information similar to what was collected on the 2000 Census long form, such as income, demographics, home value, and other important data. The county with the smallest population, Robertson County, located in eastern Kentucky had a population of 2,332 in 2006. The county with the largest population of 701,500 is Jefferson County, located in the north central part of the state. In Kentucky, 49% of the total population is male and 51% is female. The racial make-up of Kentucky has remained fairly consistent over time with a slight increase observed among those with Hispanic descent. According to the 2006 Population Estimates from the U.S. Census Bureau, 90.5% of the state’s population was Caucasian, 8.5% African American, 2.7% Other, and 2.0% Hispanic. Kentucky’s population of African-Americans remains substantially lower than the national average of 12.8. The majority of the state’s minority population resides in the Louisville/Jefferson County and Lexington/Fayette County areas. Based on 2006 Census data, 65.5% of African-Americans and 45.6% of other ethnic backgrounds reside in these two areas. Nine out of ten Kentuckians are non-Hispanic whites, and Kentuckians of color live predominately in the state’s urban areas or in counties containing large military bases or rural university town. In fact, according to the 2006 American Community Survey, 38% of Kentucky’s African-American population resides in a single county and school district: Jefferson County (Louisville). Kentucky’s most racially diverse county, however, is Christian County, the home of Fort Campbell. Only a third of Christian County’s population is non-white or Hispanic whites.

Educational Environment Kentucky’s public K-12 educational system is comprised of 174 school districts and 1,238 individual elementary, middle, and high schools. Of the total number of schools, 751 are elementary schools, 222 are middle schools, and 225 are high schools. The number of total students within the 174 districts is 668,337. The Kentucky student population does not have a large amount of diversity with 84.8% white students, 10.6% African-American students, 2% Hispanic population, and less than 3% of other ethnicities. In a large number of the state’s counties, education is a major employer, especially in the more rural and economically challenged communities. Figures from the 2005-06 school year indicate a total of 42,683 teachers, 7,819 other certified staff (e.g. including school and district leadership), and 47,820 adults hired as classified staff (e.g. bus drivers, cafeteria workers, custodians, classroom aides, etc.). Therefore, approximately 18% of the Commonwealth’s population is directly linked to the state’s educational system on a daily basis.

In 1990 education reform was initiated due to a State Supreme Court ruling that the funding mechanism for the Commonwealth’s public education system was deemed unconstitutional. At the center of this decision was an issue of equity. Students in poorer, more

2 rural communities of the state were not recipients of equal instructional resources, funding, and educational supports as were those in more affluent areas. The result of this landmark decision was restructuring and reform known as the Kentucky Educational Reform Act (KERA). Changes included how schools are financed, how decisions are made and who makes them, what kind of learning is expected from students, and what kind of performance is expected of teachers, administrators, and school boards. A critical aspect of KERA is local control. Prior to 1990, much of the decision-making was at the state and district level. Realizing that schools knew their students, teachers, and communities best, a change was made. The School-Based Decision Making (SBDM) initiative puts responsibility for making decisions in the hands of those closest to students – principals, teachers, and parents. While local school boards are still responsible for setting overall district policies, school councils empower parents, teachers, and principals to make the decisions about what happens in their school buildings. Therefore, the SBDM council has a unique role and opportunity in affecting the school’s learning climate.

The mechanism that schools and districts use to ensure students receive quality and equitable education is the Comprehensive School Improvement Plan (CSIP)/Comprehensive District Improvement Plan (CDIP). This document outlines a strategic plan for the school or district to follow to address issues that impact student achievement. These issues may include physical and mental health barriers, safety, instructional deficiencies, or family involvement. Funding, staff responsibilities and timelines are designated within the plan to assist with implementation. Each SBDM council is responsible to ensure that the CSIP is implemented, reviewed, and updated on an annual basis. The primary purpose of the CDIP is to improve student achievement, including school and district strategies and services to address deficiencies and/or sustain or strengthen current efforts. The CDIP should reflect priorities and funding streams consistent with the local school plans. Both schools and districts are required to conduct a thorough needs assessment prior to developing these plans. Kentucky’s CSH staff has worked extensively with Kentucky Department of Education (KDE) school improvement staff and local school districts to integrate coordinated school health and local wellness policies into this planning process.

Kentucky remains one of the few states to include student assessment of health and physical education in the overall accountability score of its Commonwealth Accountability Testing System (CATS). CATS include other content areas such as mathematics, science, social studies, language arts, and arts and humanities, and students are tested in all areas in grades 4, 7, and 10. State standards in Practical Living and Vocational Studies (PLVS), of which health and physical education are a part, have recently been revised and reflect their updated counterparts at the national level. Evaluation of the state PLVS scores shows elementary students with the largest improvement from 71.63 in 2006 from 66.06 in 2000. A score of 79.88 by high school students demonstrated over a six-point gain over the same time frame. The CATS system combines the core content areas, academic indicators, and non-academic indicators (i.e. attendance rates, dropout, retention) into an overall school and district score ranging from 0 to 140. A target date of 2014 has been set by Kentucky’s State Board of Education for all public schools to reach an overall index of 100 (proficiency). Based on the 2006-07 academic year, the state’s graduation rate was 83.26 percent; state retention rates totaled 2.92 percent; 3.31 percent of youth do not

3 finish their education because of dropping out of school; and the state attendance rate was listed at 94.6 percent. Each of these figures highlights some significant non-academic barriers that impede educational attainment. All of Kentucky’s schools continue to strive to meet the overall accountability index of 100 by 2014.

Public Health Environment The Kentucky Department for Public Health (KDPH) is the organizational unit of Kentucky state government responsible for developing and operating all public health programs and activities. These activities include health service programs for the prevention, detection, care, and treatment of physical disability, illness, and disease. KDE works closely with KDPH’s HIV/AIDS Branch, the Sexually Transmitted Disease Program, and the Adolescent Abstinence Program. The HIV/AIDS Branch is responsible for reporting all related statistics to the federal government.

The 56 Health Departments, serving all 120 counties receive funding from KDPH, as well as local funding for their initiatives. Many local health department (LHD) health educators go into Kentucky’s public schools to provide students with educational services on HIV/AIDS, STIs, and teen pregnancy prevention.

Health Status and Disparate Populations Adolescents who engage in risky sexual behaviors are at an increased risk for adverse health outcomes, including HIV and other sexually transmitted infections. Adolescents are more likely to engage in high-risk behaviors, such as unprotected sex, when they are under the influence of drugs or alcohol.

HIV/AIDS Kentucky ranks 34th in the United States with an annual AIDS incidence rate of 6.2 per 100,000 people. As of December 31, 2006, the total cumulative AIDS cases diagnosed was 4,506. Of the total number of cases, 239 were diagnosed between the ages of 13-24. African-Americans make up only 8.5% of Kentucky’s total population, yet they account for 33% of the total cumulative AIDS cases for youth in the state. White youth account for 59% of the cases, and Hispanics account for 7% of the cases yet only account for 2.4% of the total population. Reasons for this disparity seem to be due to an increase in sexual risk factors among minorities. The 2005 Youth Risk Behavior Survey (YRBS) finds African-American adolescents report higher percentages of risky health behavior in areas such as earlier onset of first sexual intercourse, more sexual partners, and current sexual activity.

Since 38.8% of Kentucky African-Americans live in the city of Louisville (Jefferson County), and with one in three living with AIDS in Kentucky an African-American, it is understandable that 42% of AIDS cases live in Louisville. These statistics make Louisville (Jefferson County) an area of focus for HIV Prevention efforts. The Louisville Metro Alliance for Youth 2005 Youth Needs Assessment Report states that Jefferson County Public Schools (JCPS) is the 28th largest public school system in the United States

4 with an annual enrollment of over 97,000 students. The report found significant percentages of Louisville youth participating in risk- taking behaviors including sexual intercourse (31% overall and 48% for 11th graders). The Louisville Metro Health Department reported the birth rate for teenage females in 2002 age 15-19 years was 48.7 births per 1,000 females. This is lower than the rate for Kentucky of 51, but higher than the national rate of 43. Louisville Metro has experienced steady declines in teen birth rates from 1996-2004 in teens age 15-19 years. In 2003, the Louisville Metro Health Department Specialty Clinic reported 733 youth ages 10-19 tested positive for Chlamydia and 397 youth ages 10-19 tested positive for gonorrhea.

Sexually Transmitted Infections (STIs) STI rates in gonorrhea, AIDS, and Chlamydia in Kentucky have risen over the past few years. According to the CDC 2005 Syphilis Surveillance Annual Report, Kentucky reported 52 cases of primary and secondary syphilis in 2005. Kentucky ranks 31st in the United States among rates of syphilis. In 2005, the rates of primary and secondary syphilis among males was 2.4 per 100,000 population compared to a 0.1 per 100,000 rate for females. Racial disparities are also evident in the rates of syphilis cases in Kentucky. The rate among blacks was 2 times that of whites. Six counties in Kentucky had a syphilis rate greater than 2.2 presenting in both urban (Jefferson and Fayette counties) and more rural (Knox, Mason, Nelson, and Jessamine counties) areas.

KDPH Sexually Transmitted Disease Program report on Chlamydia cases in Kentucky shows that the age groups with the highest percentage of cases reported are the 20-24 age group (38%) and the 15-19 age group (35%). Of the known race/ethnicity among the cases in both age groups, white and African-American females were disproportionately affected. The number of cases of Chlamydia from all age groups increased from 8,351 in 2005 to 8,940 in 2006. The same populations affected stayed consistent both years and ranks Kentucky 44th in the United States which has progressively worsened from 2003 when we were ranked 48th.

KDPH Sexually Transmitted Disease Program report on gonorrhea cases in Kentucky showed that in 2006, the age groups with the highest percent of cases were in the 20-24 age group (32%) and the 15-19 age group (24%). Of the known race/ethnicity of cases reported in both age groups, African-American males and females and white females were disproportionately affected. The number of cases of gonorrhea reported has increased from 2,035 in 2005 to 3,277 in 2006. In 2005, more white females age 20-24 reported cases of gonorrhea than African-American females, but in 2006 more cases of African-American females were reported than white females. Kentucky’s rates of gonorrhea have worsened over the past few years and have ranked us 31st amongst the United States.

Teen Pregnancy A teenager who becomes pregnant is at increased risk for involvement with the juvenile justice system, academic failure (including school drop out), social isolation (including family, peers, and community), and poverty. There are also a number of risk factors often associated with teen pregnancy that include early use of alcohol, tobacco, and/or other drugs and emotional, physical, and sexual victimization.

5 In looking at the 2003 and 2005 YRBS data, the percentage of adolescents who had sexual intercourse before age 13 has risen and is almost three times more common in African-American youth than white youth. According to the YRBS data there have been encouraging developments over the past few years in the number of adolescents that have ever had sexual intercourse and the number of adolescents that have had sex during the past three months. Among those youth who have had sex during the past three months, the percentage that drank alcohol or used drugs before their last sexual intercourse has also decreased, but is more prevalent with white youth than African-American youth. It has been proven that alcohol and drug use before sexual activity is linked to an increased risk of HIV infection and STIs.

An analysis from The National Campaign to Prevent Teen Pregnancy shows that teen childbearing in Kentucky cost taxpayers at least $148 million in 2004. Of the total costs, 41% were federal and 59% were state and local. The teen birth rate in Kentucky declined 28% between 1991 and 2004. The progress Kentucky has made in reducing teen childbearing saved taxpayers an estimated $107 million in 2004 alone, but there is still a lot of work to do. According to the National Vital Statistics Reports at CDC, the Kentucky teen birth rate among 15-19 year old teen women ranks 13th highest in the country. The Alan Guttmacher Institute has found that fewer than 17% of teenage pregnancies end in abortion in Kentucky, which makes the high teen birth rate more understandable.

While comparisons between Kentucky and the nation as a whole are useful in some ways, Kentucky differs significantly in demographics, economy, culture, and laws from other states. Such socioeconomic factors affect health. Therefore, the Kentucky Youth Risk Behavior Trend Report compared Kentucky to four nearby benchmark states who had similar demographics – Indiana, North Carolina, Tennessee, and West Virginia. In comparison to these benchmarks states, the sexual behavior levels were not statistically different. Collaboration with these states would be very beneficial to programs and policies developed in Kentucky related to prevention in teen pregnancy, HIV/AIDS, and STIs.

Alcohol, Tobacco, and Other Drug (ATOD) Substance users (including users of alcohol and illicit drugs) are more likely than nonusers to engage in risky sexual behavior and they are less likely than nonusers to rely on condoms. Although the percentage of Kentucky high school students has decreased over the past couple of years, they still rank third in the United States in current tobacco smokers at 26.2% (YRBS 2005). The 2005 YRBS data also shows that some substance use is beginning before the age of 13. Kentucky ranks in the top 10 in the country for the percentage of youth who drank alcohol before age 13 at 28.9% and also in the percentage of youth who tried marijuana before the age of 13 at 10.0%.

The Safe and Drug Free Schools Program at KDE contracts with the Kentucky Center for School Safety to collect school safety data and also develop a report on the data. The Kentucky Center for School Safety was established by legislation and serves as a

6 clearinghouse point for data analysis, research, and dissemination of information about successful school safety programs, research results, and new programs. Included in the report, Kentucky 2006: Safe Schools Data Project, are data pertaining to law violation for drug possession/use, distribution of illegal drugs, and disciplinary actions for drug distribution. The report showed that the most common law violations involved drug abuse. Of the total drug possession and use violations, the most common forms of drugs were marijuana/hashish (56.1%) followed by Alcohol (16.2%), Other drugs (16.0%) which include “designer” drugs such as Ecstasy, and Prescription Drugs (10.3%). More school instituted disciplinary actions for drug possession and use violations were reported in the North central part of the state including Louisville, Lexington, and Northern Kentucky.

School Health Education and Programming Kentucky participates in the School Health Profiles (Profiles) survey, which assists states and local education agencies in monitoring and assessing characteristics of and trends in school health education, programming, and policies by surveying middle and high school principals and lead health education teachers. The last year Kentucky obtained weighted data for the Profiles was 2002. The Profiles data collected in 2006 was unweighted, but the data is comparable to the 2002 data. Of the data collected from participating principals and health education teachers in 2006, it shows that 88% of high schools require that the health education course be taught in 9th grade, 25% in 10th grade, 5% in 11th grade, and 7% in 12th grade. Also within health education courses, the 2006 Profiles shows that only about 15% of health education teachers require volunteer work as part of their health education course. Additionally, 59% of schools use peer teaching in health education. Volunteer work and service learning projects are very important for youth and the community. Youth are resources, both for enhancing the quality of community life today and for building strong communities for the future. Involving youth in their communities helps to build on young people’s strengths and give them hope for the future.

The 2006 Profiles also indicates that Special Education classes are not being taught HIV prevention units or lessons. In fact, only 21% of schools teach HIV education in special education classes. Every school district in Kentucky is a member of one of the eleven Special Education Cooperatives. The cooperatives operate under the direction of the Office of Special Instructional Services and the Division of Exceptional Children Services with the KDE. The mission of the Special Education Cooperatives is to enhance the educational opportunities and outcomes of students by providing effective leadership and delivering specialized services in partnership with KDE, local school districts, institutes of higher education, and other service providers. Statewide there are a total of 109,354 children and youth ages 3-21 with disabilities. Research also shows that physically and mentally disabled individuals have an increased risk of abuse which makes them at a higher risk for HIV, STIs, and unintended pregnancy (Bekaert, S. 2005. Adolescents and Sex: The Handbook for Professionals Working with Young People).

In summary, Kentucky is a poor state with low education levels and many health problems. The HIV Prevention Program can work with schools and communities to assist with these needs.

7 Capacity

The HIV Prevention Program at the Kentucky Department of Education has been in existence for 18 years. It began as a single, isolated program and is now a partner with multiple offices within the Kentucky Department of Education, as well as outside agencies.

Kentucky Board of Education Kentucky law mandates that the Kentucky Board of Education (KBE) promulgate regulations that govern Kentucky’s 174 public school districts and the actions of the Kentucky Department of Education. KBE has 12 members. The governor appoints 11 voting members, seven representing the Supreme Court districts and four representing the state at large. The additional member is the president of the Council on Postsecondary Education who serves as a non-voting member. The members serve four-year terms and may be reappointed. At the beginning of each fiscal year, the membership elects the board chair and vice chair.

In September 2006, KBE revised its strategic plan, based on the General Assembly’s goals for the Commonwealth’s schools and the capacities required of students in the public education system. The Kentucky Board of Education encourages and depends on active partnerships among all of those who can and should contribute to the well-being of youth, including teachers, parents, peers, health professionals and the community. The vision of the Kentucky Board of Education is every child – proficient and prepared for success. To realize this vision, KBE is to provide statewide leadership so that all students emerge from Kentucky’s world-class education system as productive citizens who:  Conduct themselves ethically and with integrity  Demonstrate mastery of capacities required of students in the public education system as defined in KRS 158.645  Demonstrate key elements of complex communication  Think creatively and critically with the ability to problem solve  Develop healthy habits  Contribute economically to society through a selected profession  Actively participate in state and local community initiatives.

In 1990, the Kentucky Education Reform Act (KERA) was passed. The overriding principle of reform was that all children can learn at high levels given time, effort, and opportunity. KERA did the following:  provided equitable resources for all schools  provided additional resources to schools with a lot of children who come to school with disadvantages  eliminated political barriers to good schools  set high standards for the performance of all children, all teachers, all schools, and all districts  provided a statewide network of technology and communication

8  empowered local schools to make decision that would affect their own learning environments  held schools accountable for reaching the new standards  rewarded successful schools and helped unsuccessful schools  recognized that schools with high proportions of economically disadvantaged students need extra help and thus instituted Family Resource and Youth Services Centers (FRYSCs) to address non-academic barriers to learning.

The Commonwealth Accountability Testing System (CATS) is the assessment tool for KERA and is designed to improve teaching and student learning in Kentucky. CATS include the Kentucky Core Content Test, writing portfolios, alternative assessments for students with disabilities, the ACT college entrance exam), and non-academic components. The over-riding goal of CATS is for all schools in Kentucky to reach proficiency. Proficiency is defined as reaching a score of 100 out of 140 on the CATS.

Kentucky is one of the few states to assess health and physical education on the state accountability test. The content area of Practical Living and Vocational Studies includes health and physical education, and students are tested on their knowledge and abilities in these areas in grades 4, 7, and 10. State standards were recently revised in 2006 and reflect national health education standards.

Kentucky Department of Education The Kentucky Department of Education (KDE) maintains an organization structure, which is supportive of health programs and is led by an appointed Commissioner of Education who answers to KBE. Within KDE, there are two bureaus, which are headed by deputy commissioners: the Bureau of Operations and Support Services and the Bureau of Learning and Results Services. Offices within the bureaus are administered by Associate Commissioners. Directors administer divisions within the offices.

In the Bureau of Operations and Support Services, there are three offices: Office of Internal Administration and Support, Office of Education Technology, and Office of Legal, Legislative and Communication Services. Within the Bureau of Learning and Results Services, there are five offices: Office of Special Instructional Services, Office of Leadership and School Improvement, Office of Assessment and Accountability, Office of Teaching and Learning, and Office of District Support Services.

The Office of District Support Services houses the divisions of: Nutrition and Health Services, Facilities Management, Operations, and Data Management. The Division of Facilities Management is responsible for ensuring sanitary, safe and accessible construction of public school buildings and grounds. The Division of Operations provides technical support to ensure district business operations comply with statutory and regulator requirements. The Division of Data management conducts compliant reviews on student attendance, school activity fund, transportation, health insurance, and management. The Division of Nutrition and Health Services administers programs that deliver quality nutrition and nutrition education to Kentucky students and other citizens. These programs are the Child and Adult Care Food Program, National School Lunch Program, School Breakfast Program, Special Milk Program, and

9 Summer Food Service Program for Children. Also housed in this division are the School Nurse Consultant and Coordinated School Health Team, which includes the HIV Prevention Program.

Coordinated School Health Team The Coordinated School Health (CSH) Team consists of the Project Director who also serves as the Team Leader for CSH for KDE, the CSH Consultant, the School Health Consultant, and the HIV Prevention Consultant. The team is funded through a grant to KDE from the CDC Division of Adolescent and School Health. This grant includes funds to administer the Youth Risk Behavior Survey, the CSH Program, and the HIV Prevention Program.

The CSH Team provides professional development, technical assistance, and resources to schools, districts, and other stakeholders in the area of school health. HIV prevention is integrated into CSH. For example, a CSH institute has been held in each of the last 5 years. HIV prevention education has been incorporated into the institute as part of the content. Topics have included curriculum resources and model policies. The CSH Team has also collaborated on providing professional development on policy and curriculum resources.

The CSH Team also monitors critical health behaviors and outcomes of youth. Data on the Indicators for School Health Programs (Indicators) is collected by the CSH Team and the HIV Prevention Program. The Youth Risk Behavior Survey (YRBS), School Health Profiles, and School Health Policies and Programs Study are administered through the CSH Team. YRBS data has been collected since 1989. While a portion of the work for collecting YRBS and Profile data has been contracted out to a state university through a memorandum of agreement, the CSH Team is responsible for overseeing this process and working with schools to obtain the data.

Another tool used to monitor school policies and programs are the Comprehensive District Improvement Plans (CDIP) and Comprehensive School Improvement Plans (CSIP). These are the primary planning tools for schools and districts and are a requirement of KERA. School improvement provides data-driven, research-based framework for defining goals and objectives for improving student learning and for selecting and implementing strategies to improve the instructional and organizational effectiveness of every school. Comprehensive Improvement Planning is used as the means of determining how schools and districts will plan to ensure that students reach proficiency. The process focuses school and district improvement efforts on student needs by bringing together all stakeholders to plan for improvement by focusing planning efforts on priority needs.

As part of this improvement process, Standards and Indicators for School Improvement were developed. There are three standards that are applicable to HIV prevention. Standard 4 is learning environment and school culture. Included in this standard are teachers and non-teaching staff are involved in decision-making, teachers communicate student progress with parents, teachers care about kids

10 and inspire their best efforts, multiple communication strategies are used to disseminate information, and the school provides support for physical, cultural, socio-economic and intellectual needs of all students. Standard 5 is learning environment – student, family and community support. This includes the school leader making parents partners in their student’s education, creating a structure for parent and educator collaboration, and families and communities being active partners in the educational process. Standard 6 is the learning environment, professional growth, development and evaluation. Educators are required to have long-term professional growth plans and professional development (PD) is on going, job embedded, and is aligned to data. The HIV Prevention Program assists school staff in meeting this standard by providing professional development.

HIV Prevention Program The HIV Prevention Program has achieved much success over the 18-year life of the program. Funding under this grant has allowed the HIV prevention program to train local educators throughout Kentucky in effective strategies for helping children develop positive prevention behaviors. According to Indicator data for the current 5-year period, over 20 events on HIV prevention curricula and policy occurred. Professional development events where held for administrators, teachers, school nurses, FRYSCs, and community health educators . Examples of curricula used are Making a Difference, Making Proud Choices, and Reducing the Risk while policy resources have included Someone at School has AIDS. While school staff (e.g., teachers, school nurses, FRYSCs) is the primary target for curriculum trainings, other educators have participated in these opportunities as well. Health educators in local health departments are included in these events because they are partners with their local schools and provide HIV prevention education to the students. Indicator data shows that over 600 people have received professional development on curriculum, and over 115 schools and 90 districts have received technical assistance.

In another effort to provide professional development to health educators in local health departments, the HIV prevention program has partnered with the Kentucky Teen Pregnancy Coalition to include curriculum resources and teaching strategies in their annual fall conference. Most of the members of the coalition are health educators in local health departments. However, other members include FRYSCs, teachers, school nurses, and university personnel.

The HIV prevention program has also trained school nurses, district school health coordinators and HIV coordinators in school districts on model policies for infection control, universal precautions, confidentiality, HIV prevention education, and HIV and athletics. Data from the Indicators of School Health Programs shows that in 2005, model policies on these topics were distributed to 146 of the 174 school districts. Technical assistance was also provided to over 35 schools and school districts, and 40 external partners.

The HIV prevention program has been a partner with the Kentucky Parent Teacher Association over the last 5 years through a memorandum of agreement and has provided training to PTA members, local health department educators, parent educators, and

11 Family Resource/Youth Service Center Coordinators on the importance of parent-child communication and provided them with the skills to educate parents in local communities to improve communication with adolescents.

Since one in three people with AIDS in Kentucky are also African American, several efforts have targeted this population. Almost half of all African Americans in Kentucky live in Jefferson County (Louisville). Therefore, a partnership between the HIV prevention program, the Louisville Metro Health Department, and the Jefferson County Public School District was formed to train teachers and Family Resource/Youth Service Center Coordinators on evidence-based curricula. The HIV prevention program also partnered with 2 Area Health Education Centers in Louisville and Lexington and a Hispanic Center in Bowling Green to train community lay leaders on evidence-based curricula. The lay leaders were then able to educate African American and Hispanic youth and provide any translation necessary and make it culturally competent for each of those populations. Finally, the HIV prevention program has partnered with the HIV Branch at the Kentucky Department for Public Health (KDPH) to provide an African American Hispanic Leadership Conference. While the main conference is targeted to adults, a youth track is also provided.

The HIV prevention program and the entire CSH team work closely with the Health and Physical Education Consultant in the Division of Curriculum. One activity has been to develop units of study for middle and senior high youth on HIV prevention . When education reform was passed in Kentucky in 1990, one of the requirements was for teachers to develop units of study that would meet the needs of their students. Therefore, units of study are a tool used by most teachers. Teachers may or may not use a specific curriculum. The Health and Physical Education Consultant has also been an integral part of the CSH Institute, the interagency team, and curriculum trainings. The Division of Curriculum is currently revising the format for units of study.

KDE and KDPH have a strong partnership in CSH and HIV prevention. A CSH interagency team exists which includes programs from KDE and KDPH. The goal of the CSH Interagency Team is to collaborate on school health issues. Members of the CSH Interagency Team representing HIV prevention are the Abstinence Education and Adolescent Health Coordinator, Title X Family Planning Coordinator, and a consultant from the HIV/AIDS Branch are members of this committee from DPH, as well as the HIV Prevention Consultant and School Health Consultant from KDE. These individuals comprise the HIV subcommittee. In July 2006, the members of the subcommittee attended a professional development session in West Virginia, which was provided by the Professional Development Consortium (PDC). The PDC is also funded by CDC-DASH and provides professional development to all funded partners. The purpose of this event was to incorporate youth development and youth involvement into HIV prevention As a result of this event, the HIV prevention program provided mini grants to FRYSCs to form a youth council and conduct a service- learning project in their community. The subcommittee will be attending another event in January 2008, which is sponsored by the Society of State Directors of Health, Physical Education and Recreation, National Alliance of State and Territorial AIDS Directors, National Coalition of STD Directors, and Association of Maternal and Child Health Programs. The purpose of the National

12 Stakeholder’s Meeting is to strengthen state health and state education partnerships to improve HIV, STD, and unintended teen pregnancy prevention in schools.

The HIV prevention program has also partnered with the Abstinence Education Coordinator at KDPH to provide training and materials on abstinence education materials. For example, the abstinence program and the HIV prevention program have collaborated to provide training on two curricula: Postponing Sexual Involvement and Managing Pressures Before Marriage.

The interagency team has also presented information on the 6 critical health behaviors (sexual risk behaviors, physical activity, nutrition, tobacco, unintentional and intentional injuries, and drug use) at numerous state conferences (e.g., Directors of Pupil Personnel, FRYSC, Kentucky School Nurses Association, and the Tobacco Policy Conference). The purpose of these presentations was to demonstrate integration of all 6 behaviors into a coordinated school health program and comprehensive health education and to provide resources and technical assistance to these audiences.

In the next year, the HIV Branch at the Kentucky Department for Public Health will be targeting minority/heterosexual contact including youth, as well as a Hispanic peer-to-peer pilot project entitled “Promotores De Salud.” This is one of the community lay leader programs through the Area Health Education Center in the Lexington area, and the HIV Prevention Program has used these lay leaders in providing HIV education to Hispanics in the current funding cycle. Prevention of needs of Youth At Risk is incorporated into all risk behavior groups. Other strategies for disparate populations include “Come Together Kentucky Conference for GLBTQ Youth” and “Prevention Strategies for Adjudicated Youth” which is a collaboration between KDPH, KDE, and the Department of Juvenile Justice (DJJ).

The HIV Prevention Consultant is part of the Kentucky HIV/AIDS Planning and Advisory Council (KHPAC). This group has a health department co-chair and a community co-chair. The health department co-chair is a staff person in the HIV/AIDS Branch at KDPH. The consultant is currently an advisor but has applied for full voting privileges and is awaiting approval by the Governor. KHPAC is a merger of the former community planning group (CPG) and the Governor’s Advisory Council on HIV/AIDS. The group merged in February 2006. KHPAC has just completed its 2007 report, which has been sent to Health and Welfare Committee of the state legislature. In this report, KHPAC has included efforts in schools and working with school based decision-making councils as one of its activities. The HIV prevention program will be assisting KHPAC with this activity. The HIV Prevention Consultant at KDE will be providing technical assistance to KHPAC on curriculum standards, current program activities, and other issues in November 2007.

13 Another partner for the HIV prevention program is the Department of Juvenile Justice. During the past 5 years, DJJ has administered the YRBS to youth in detention centers and group homes. Training has also been provided to nurses in juvenile justice facilities on the Making Proud Choices curriculum.

The Coordinated School Health Team has also forged a partnership with their counterparts in other states funded by DASH. The Southern States Collaborative was formed to address common issues in the individual states including HIV. Plans for the future include a web cast for health educators in all of the Southern states to increase awareness of the HIV epidemic and identify strategies for education. Also, the Collaborative plans to develop training for cadre members in all of the Southern states, which will include a HIV track.

Other activities of the HIV Prevention Program include professional development to community education directors and the faith- based community. Additionally, focus groups were conducted with youth to determine their knowledge, attitudes, and preferences on HIV education. The CSH Team has worked with the Rocky Mountain Center to develop a follow up and support protocol for all professional development events.

A new partnership will be formed with the Youth Action Group in western Kentucky. This was developed as a result of being a member of KHPAC. As the council was discussing future efforts for schools, one of the members discussed a project conducted by the Youth Action Group. This project involves peer teaching on HIV education. The HIV Prevention Program will be working with the Youth Action Group in the upcoming grant cycle.

The HIV Prevention Program has also worked with the educational cooperatives. These cooperatives provide assistance and expertise for the benefit of their member school districts. The cooperatives provide comprehensive education services and programs that support the member districts and schools in school improvement efforts. Within the cooperatives are special education cooperatives, which are federally funded from State Share funds awarded to Kentucky under the Part B of the Individuals with Disabilities Education Act. Cooperatives operate under the direction of the Office of Special Instructional Services and the Division of Exceptional Children Services within the Department of Education.

The HIV Prevention Program has a strong network of partners at the national, state, and local level. These partnerships will be sustained and others added in future years to further the HIV prevention program. HIV prevention education will continue to be targeted to disparate populations such as African American youth. The HIV Prevention Program will continue to improve youth involvement in HIV prevention education by forming a new partnership with the Youth Action Group in western Kentucky. Through the strategic planning process, additional issues such as drug and alcohol use and school connectedness will be addressed.

14 Workplan Overview Five-year Goals The HIV Prevention Program will have three goals for the next five-year funding cycle, all of which are included in the program logic model. The first goal will be to increase the number of middle schools, junior high schools, and senior high schools that increase knowledge, skills, and abilities through comprehensive health education to address the 6 critical health behaviors of youth as identified by CDC (i.e., sexual risk taking, alcohol and other drug use, tobacco, unintentional and intentional injuries, physical activity, and nutrition). This goal is consistent with Healthy People 2010 and has a corresponding goal in Healthy Kentuckians 2010. It is also consistent with the HIV subset of the Indicators for School Health Programs and School Health Education Profiles. First-year objectives to address this goal include: a collaboration with HIV Prevention Consultants, Physical Activity/Nutrition/Tobacco (PANT) Consultants, and Project Directors in the Southern States, a professional development event for special education consultants and teachers on HIV education to special education students, and a peer education project for high school students.

The HIV Prevention Consultant is a member of the Southern States Collaborative. The HIV Prevention Consultants in the Southern States will work together to provide a web cast on HIV prevention education in the Southern States. According to the 2004 YRBS Trend Report, sexual behaviors among youth in the Southern States are similar. School Health Profiles (2006) data shows that HIV prevention education is not being taught to special education students. The partnership with the educational cooperatives will continue to provide professional development to the low incidence consultants, special education teachers, and health teachers. Future plans include professional development to parents of special education students. The HIV Prevention Program will collaborate with the Youth Action Group at Heartland CARES Inc. to provide peer education to high school students. Heartland CARES, Inc. is a medical clinic, which serves clients who are HIV positive. The Youth Action Group is comprised of high school students who volunteer at the clinic and also work in their schools to promote HIV education. The Youth Action Group will continue their peer education project entitled “A Day in the Life of Someone with HIV/AIDS” in all high schools in McCracken County and will expand the project into Graves County.

The second goal will be to implement and sustain strong partnerships at the state and local level between education, health, and other agencies in which school-based and community HIV, STI, and unintended teen pregnancy programs and policies complement each other. Partnerships have already been developed in the previous funding cycle. First year objectives to address this goal include: development of a strategic plan and a collaborative project with the Kentucky Teen Pregnancy Coalition. The strategic plan is discussed in detail below.

The HIV Prevention Program will continue its partnership with the Kentucky Teen Pregnancy Coalition to provide teaching resources to high school health teachers. The dissemination of materials will complement a media campaign conducted by the Coalition to coincide with the national day to prevent teen pregnancy.

15 Finally, the third goal will be to implement school-based programs, policies, and prevention strategies to decrease health disparities among youth disproportionately affected by HIV, STIs, and unintended pregnancy. This goal is consistent with the Indicators for School Health Programs and School Health Education Profiles. The first year objective to address this goal will be a collaboration with Jefferson County Public Schools to provide professional development to teachers in the Louisville area.

Strategic Plan In the first year, the HIV prevention program will develop a 5-year strategic plan. In order to develop the plan, numerous partnerships will be explored. For example, Kentucky Child Now has a youth advisory council. The HIV prevention program will pursue the possibility of forming a subcommittee of that advisory council for the purpose of increasing youth involvement in decision making regarding health education curricula and youth development initiatives. The Kentucky School Boards Association is the agency that most school districts refer to when making policy decisions. The HIV prevention program will enlist their assistance in developing strategies for implementing and disseminating policies on infection control, universal precautions, confidentiality and students and staff who may be infected with HIV or AIDS, which was a need identified in the 2006 Profiles data.

The HIV prevention program will also explore an advisory committee for addressing health disparities in rural Appalachia. This region of Kentucky has the highest poverty levels, which is a risk factor for teen pregnancy. Program staff will work with key partners in this region to develop programs, policies, and strategies to lower the health risks for youth in Appalachia. Another potential partner is the Youth Promises Program, which focuses on pregnancy and drug use. The HIV Prevention Program will also continue its partnership with the Kentucky HIV/AIDS Planning and Advisory Council (KHPAC) and will provide professional development to KHPAC members on the strategies to work within the corrections system, as well as strategies for HIV prevention, which include substance abuse prevention. Upon completion of the professional development, members of KHPAC will include strategies in their annual report, as well as the HIV Prevention Program’s strategic plan.

Currently, there is a Commissioner’s Parent Advisory Council (CPAC), which makes recommendations on improving family involvement in schools. The Coordinated School Health Team will work with the CPAC to form a school health subcommittee to assist program staff on increasing family involvement in school health issues including HIV prevention, STIs, teen pregnancy, and increasing family involvement in health education curriculum. The CPAC has 6 objectives: improving school staff relationships with parents; two-way information; parent involvement; parents speaking for each child’s learning needs; multiple learning opportunities; plan and implement substantive work to improve student achievement.

These objectives appear in the Kentucky Family and Community Involvement Guide to Student Achievement. In KRS 158.645, it states that the “General Assembly recognizes that public education involves shared responsibilities. State government, local

16 communities, parents, students, and school employees must work together to create an efficient public school system. Other statutes that address parent involvement are KRS 160.345, KRS 158.6354, KRS 156.497, and KRS 157.3175.

Partnerships currently exist with higher education, Area Health Education Centers, Kentucky Parent Teacher Association, the Abstinence Education program at the Kentucky Department for Public Health, the HIV Branch at KDPH, the Title X Program at KDPH, the Kentucky HIV/AIDS Planning and Advisory Council (formerly the Community Planning Group), local health departments, educational cooperatives, Department of Juvenile Justice, and the Kentucky Teen Pregnancy Coalition. Planning will occur with these stakeholders to develop programs, policies, and strategies to address school connectedness, family connectedness and involvement (including involvement in health education and school improvement), addressing health, racial, and economic disparities among youth, and comprehensive health education in schools, as well as other related issues. The HIV Prevention Program will also work with district health coordinators to assist them in developing sound policies and program for HIV prevention programs at the local level. The strategic planning process will also include other divisions in KDE that work with drug and alcohol use (e.g., Safe and Drug Free Schools and Title IV), the Center for School Safety, and the Preventing Underage Drinking Task Force.

The goals and objectives in the work plan will address the needs of Kentucky youth by: providing professional development to special education teachers so that they will have the knowledge and skills to teach HIV prevention to special needs students; providing resources to high school health teachers so that evidence-based curriculum can be taught to high school youth; providing opportunities for community service and peer teaching to high school students; and providing professional development to classroom teachers in Jefferson County which is culturally sensitive to the needs of African American youth. The collaboration with Jefferson County is to address youth disproportionately affected by HIV because 38.8% of the African American population lives in Jefferson County. The strategic plan will work with multiple partners to devise strategies that complement each other to meet the needs of poverty-stricken youth, as well as those youth who use drugs or alcohol. The strategic plan will also work with partners to increase youth involvement in HIV prevention education.

Workplan activities are coordinated with other programs within KDE and numerous other agencies. For example, the Southern States Collaborative coordinates activities and resources with the CSH Program in Kentucky, as well as with other states funded by DASH. The special education PD event is coordinated with the Division of Special Education, the Health and Physical Education Consultant in the Division of Curriculum at KDE, and the regional special education cooperatives across Kentucky. The HIV Prevention Program will work with the KHPAC by coordinating professional development for its members on substance abuse and the corrections system, which will include the Department of Juvenile Justice. Upon the conclusion of the event, the KHPAC will develop strategies to be implemented and these will be included in the HIV Prevention Program’s strategic plan. The HIV Prevention Program will also collaborate with the Kentucky Teen Pregnancy Coalition.

17 Program Monitoring

The HIV Prevention Program will use multiple ways to monitor and evaluate its efforts. Multiple assessments and tools can holistically capture periodic progress and gaps. By regularly monitoring all activity, immediate feedback will be provided, and this data will be used to plan future activities.

Indicators for School Health Programs: HIV Prevention for State Education Agencies (Indicators) The HIV Prevention Program at the Kentucky Department of Education aligns its work plan to the Indicators and has been collecting this data since 2003. A compilation of all data has been kept so that program staff can determine what areas have been addressed with numerous events and which areas need more attention. Over the current five-year period, activities to support all indicators on policy, curriculum and assessment have occurred. Training Tracker will continue to be the database used to collect the Indicator data. All attendees of professional development events are entered into this database. Schools, districts, and other agencies that receive materials are also included. Over the current five-year period, Indicator data shows that over 600 people have received professional development on curriculum, and over 115 schools and 90 districts have received technical assistance.

School Health Profiles The School Health Profiles is collected biennially in the even years and is administered to principals and lead health teachers. It monitors school health education requirements and content, policies on HIV and AIDS prevention, and family and community involvement in school health programs. Kentucky received weighted data in 1996 and 2002. The unweighted 2004 and 2006 data is consistent with the 2002 data. In the past, collection of School Health Profiles data has been contracted out to a state university. However, in Spring 2008, the School Health Consultant will be responsible for this data collection. The School Health Consultant is a member of the CSH Team and works with both the Coordinated School Health and HIV Prevention Programs. Data from the School Health Profiles is used to plan professional development events, as well as to provide resources such as curriculum and instruction, assessment, and policy development to schools.

Success Stories One standard practice of the HIV Prevention Program is to collect success stories to document impact of the program. Numerous success stories have already been reported to CDC DASH on the HIV prevention program and the HIV Prevention Program will continue to use success stories. One example of a success story is the collaboration of KDE and the Northwest AHEC in Louisville to provide HIV prevention education to African American and Hispanic youth since these populations are disproportionately affected by HIV and AIDS. Evidence based curricula were used (e.g., Making a Difference, Making Proud Choices, and Reducing the Risk). Youth were able to develop communication and negotiation skills. In one year, 52 sessions were conducted for 571 youth. The HIV Prevention Program will continue to obtain success stories from schools, as well as report success stories of the program.

18 Another success story demonstrated the collaboration with the North Central AHEC to provide HIV prevention education to Hispanic youth. Thirty-six community educators or promotores were prepared to educate Latino school age children and parents about the risks and prevalence of HIV/AIDS. These promotores then provided education to 142 Latino school-age children. The program also offered individual teaching and counseling for youth by specially trained promotores. A total of 1077 Latino youth received these services.

Epidemiological and student health risk data YRBS data has been collected since 1989. The CSH Team has worked with a state university, FRYSCs, and local health departments to obtain the data. In the new grant cycle, the School Health Consultant will be responsible for obtaining this data. The HIV Prevention Program will continue to utilize this data to monitor student behaviors.

The purpose of the Kentucky Incentive for Prevention Survey (KIP) is to anonymously assess student use of alcohol, tobacco, and other drug use. It has historically been administered through the Substance Abuse Prevention Program and is administered to 6th, 8th 10th, and 12th graders in Kentucky schools. This data will be used to improve HIV prevention programs and policies, which will be integrated with substance abuse prevention programs. Substance abuse can be linked to an increased risk of sexual risk taking behavior. Therefore, it is important for the HIV Prevention Program to monitor substance abuse in youth.

The HIV/AIDS Branch at KDPH has multiple programs: surveillance, prevention, services, continuing education, and counseling, testing, referral, and partner notification. It is also the lead agency for the Kentucky HIV/AIDS Planning and Advisory Council. The HIV/AIDS Branch documents and maintains the HIV/AIDS case reports data and develops a semi-annual report. This data is used by the HIV Prevention Program to monitor number of cases by age, gender, race, and risk behavior. It also provides county-level data and mortality data.

Other evaluation and monitoring activities An analysis of comprehensive district improvement plans (CDIPs) was conducted to determine what components of CSH were included. The CDIP is the primary planning tool used by school districts. Schools are also required to develop and implement a Comprehensive School Improvement Plan (CSIP). Of all of the 174 district plans, less than 10 plans included HIV prevention, STI prevention, or unintended teen pregnancy. Another analysis of CDIPs will be conducted during the funding cycle to determine if districts are including additional objectives or activities (i.e., implementing policies and programs to address HIV, STIs, and teen pregnancy). Through the current partnership with the Kentucky School Boards Association, programs and policies will be developed through the strategic planning process to increase the number of CDIPs to include HIV, STIs, and teen pregnancy.

19 The Coordinated School Health Team, which includes the HIV Prevention Consultant, has worked with the staff at the Professional Development Partnership at Rocky Mountain Center to develop a follow up and support protocol for professional development. The HIV Prevention Program uses the protocol for all professional development events. Attendees are notified in the marketing materials that an action plan is part of the event and what follow up will be conducted as part of the event. Participants in most professional development events are asked to complete the action plan. Program staff then follows up with them to determine what actions have been taken and what technical assistance may be needed. Follow up has included bringing the participants back together 6 months after the event.

All professional development events are evaluated. Participants are not only asked if the content was appropriate, they are also asked what they will do differently as a result of attending this event, what assistance is needed from KDE, and what further training is needed. Future PD events are planned based upon the evaluation results.

By using all of these sources, data driven decisions can be made to improve programs. For example, Training Tracker data can show if there is too much emphases on curriculum training and not enough on policy training. Evaluations of professional development events will provide data on additional needs, while the follow up and support plans will indicate how much of participants’ learning is being used in the classroom.

20 Project Management and Staffing

The HIV Prevention Program resides in the Division of Nutrition and Health Services at the Kentucky Department of Education (KDE). This division is in the Departments’ Office of District Support Services. The Coordinated School Health (CSH) Program Manager/ Team Leader oversees both the CSH program and the HIV program and has the authority to administer the work plan activities and is responsible for performance evaluations for all CSH staff at KDE. The Program Manager reports directly to the Division Director. The director is responsible for reporting program activities to the KDE leadership and upon request to the Kentucky Board of Education

Paul McElwain is the Division Director for Nutrition and Health Services. In addition to the CSH program, Mr. McElwain is responsible for the Child and Adult Care Food Program (CACFP) and the National School Lunch Program (NSLP).

The HIV Prevention Program will utilize one full-time HIV Prevention Consultant and three part-time positions. These positions are a part-time Project Director, a part-time School Health Consultant, and a part-time Administrative Coordinator.

The HIV Prevention Consultant is a 260-day position and will devote 100% of her time to the HIV Prevention Program as a part of the Coordinated School Health Team. The HIV Prevention Consultant will report directly to the CSH Program Manager/Team Leader. The individual fulfilling this role is Renee White, Ph.D. She has been with the Kentucky Department of Education for seven years.

Dr. White joined KDE as a Cardiovascular Health Consultant and served in this position from December 2000 to March 2003. In this position, she was based in a Regional Service Center. These Centers had close relationships with schools and districts and provided professional development and technical assistance to schools. During this time, she formed a network with school and district personnel and became a valuable resource for school health.

In March 2003, she became the HIV Prevention Consultant. She has continued to work with schools and districts on HIV prevention education and policies. She has also worked closely with local health departments because in many counties, health educators from the health department conduct HIV prevention education in schools. Dr. White has also served on state and local councils and has made presentations at national and state conferences. Dr. White has also attended numerous professional development events to increase her knowledge, skills, and abilities to administer the HIV Prevention Program. Dr. White currently serves on the Board of Directors of the Kentucky Teen Pregnancy Coalition. This coalition provides a spring and fall conference every year and also provides resources to school staff, community partners, and local health department staff in the areas of HIV/AIDS, sexually transmitted infections, and teen pregnancy prevention. Dr. White also serves on the Kentucky HIV/AIDS Planning and Advisory Council and a local school district community advisory council.

21 The CSH Program Manager/Team Leader will oversee the HIV Prevention and Coordinated School Health Programs, as well as the YRBS administration. For budget purposes, the HIV Prevention Program will pay 10% of the Project Director’s salary, fringe, and travel. The current CSH Program Manager/Team Leader is Barbara Donica, who has been at the Kentucky Department of Education for 7 years.

Barbara has been the CSH Program Manager/Team Leader for Coordinated School Health for KDE the last five years. She has over thirty years of health care and education administration experience. Barbara is a retired registered nurse and has worked as a Director of Nursing, Staff Development Director and Continuing Education Director in various health care facilities. Her additional education includes a Bachelors Degree in Adult Education and a Masters Degree in Arts and Sciences with a specialty in organizational development. As the CSH Program Manager/Team Leader, Barbara represents KDE on various school health related committees. She is active in a number of professional organizations at the national level. She serves as the chair-elect of the Communications and Marketing committee for the Society of State Directors of Health, Physical Education and Recreation (Society) and sits on the Society’s Leadership Council. As a committee member on the Advocacy committee for the American School Health Association (ASHA) she represents the association on the Friends of School Health Board.

The School Health Consultant assists the HIV Prevention Program with professional development events and data collection, which includes the administration of the Youth Risk Behavior Survey and the School Health Profiles. The School Health Consultant will serve as a .25 FTE to the HIV Prevention Program, .25 to the Coordinated School Health Program, and .5 FTE to the YRBS administration. Stephanie Bunge currently holds this position, which reports to the CSH Program Manager/Team Leader. She has a Masters degree in Health Education and is a Certified Health Education Specialist. Ms. Bunge has been with the Kentucky Department of Education for over 2 years. Ms. Bunge is also a Board of Directors member for the Kentucky Teen Pregnancy Coalition. This coalition provides a spring and fall conference every year and also provides resources to school staff, community partners, and local health department staff in the areas of HIV/AIDS, sexually transmitted infections, and teen pregnancy prevention.

The School Health Consultant has the role of Professional Development (PD) Coordinator for both the CSH and HIV Prevention programs. As PD Coordinator, the position is responsible for: . Coordinating training events that strengthen professional development related to health education, especially for CDC DASH-funded areas . Ensuring that DASH’s six strategies for professional development are implemented . Monitoring and judging the quality of training design, trainers, implementation, and evaluation of training events. This includes knowing the elements necessary to achieve measurable training goals and objectives and being able to judge the accuracy of the information being presented.

22 . Representing the agency at an annual meeting with other PD coordinators

The HIV Prevention Program will also utilize the Administrator Coordinator. This position will be a .4 FTE and will serve the Coordinated School Health Program as a .55 FTE. The position will serve the YRBS as a .05 FTE and will report to the CSH Program Manager/Team Leader. This position supports all three initiatives with clerical support and is responsible for entering all data into Training Tracker and providing reports to program staff. Alexis Kinsler is currently fulfilling this role and has been in this position for 2 1/2 years. She has worked in the environmental field for 13 years monitoring health and safety programs. She also plans office layout, analyzes and organizes office operations and procedures such as bookkeeping, information management, filing systems, requisitions of supplies and staff calendars and time sheets. Alexis also develops and maintains data systems including tracking the ordering of materials necessary for program activities that include YRBS, HIV and CSH activities. She works with the HIV Prevention Program to design and implement data entry procedures for use with stakeholders and program requirements.

Another integral part of the HIV Prevention Program is the Division of Budgets. Within the Kentucky Department of Education is the Bureau of Operations and Support Services. The Division of Budgets resides with the Office of Internal Administration and Support. The goal of the budget division is to provide direct communication with all departmental program staff in an effort to provide training and instruction that will help each individual better understand and manage their respective programs. The federal budget management branch is the designated staff to provide technical assistance to the CSH, HIV, and YRBS staff funding needs and serves as the portion of accounts to monitor and analyze on a daily basis. All communication to the Procurement and Grants Office (PGO) is coordinated through the budget director and his designated staff and KDE’s Project Director for this funding. This division is an agency liaison with the Governor’s Office for Policy and Management as well as the Legislative Research Commission.