Liberty City Community Collaborative for Change: A BUILD Health Challenge

January 26, 2016

Meeting Notes

Desired Meeting Results:

 Understanding of membership commitment and expectations.  Selected headline indicators.  Developed a preliminary story behind the safety data in .  Understanding of strategies that have been demonstrated to work at turning the curve.  Made individual Commitment to Action.

The following stakeholders were present for the meeting (1/25/2016):

Participant Organization Steven Marcus Health Foundation of South , President and CEO Elena Napolez Juvenile Assessment Counselor (JSD) Elaine Black Liberty City Community Revitalization Trust Chief Delma Noel-Pratt Dade Police Department - North Operations Division Anthony Williams Belafonte TACOLCY Center Wil Ayala Early Learning Coalition Gina Ford Carrfour Supportive Housing Cecilia Gutierrez Miami Children’s Initiative, President and CEO Captain Eric Garcia Miami Dade Police Department-Northside District Annie Neasman Jessie Trice Community Health Center, Inc., President and CEO Commander Debbie Mills -Model City Police Net Service Area Michael Rivers City of Miami NET Model City Renita Holmes Women’s Association and Alliance against Injustice and Violence (WAAIVE) Cindy Magnole Jackson Health System-Injury Prevention Coordinator Jessica Vallejos-Landestoy Juvenile Services Department Christina Wright Planned Parenthood Ruban Roberts NAACP Vivilora Perkins-Smith Urban Partnership Drug-Free Community Coalition-Gang Alternative Jeff Hurst Florida Department of Children and Families Izegbe Onyango Miami Children’s Initiative Tyra Tate MDCPS-Campus Shield Michele Wyatt Sweeting New Horizons Community Mental Health Center, Inc. Emily D’Agostino Miami-Dade Parks Department Caitlin Alfonso Miami-Dade Parks Department Project Staff Deitre Epps, Co-Facilitator Results-Based Leadership Roderick King, Co-Facilitator and Florida Institute for Health Innovation Project Director Laurie Fucini-Joy, Project Manager Florida Institute for Health Innovation Deltavier Frye, Project Coordinator Florida Department of Health-Miami Dade County

POPULATION ACCOUNTABILITY

Result Statement(s): A Safe and Healthy Liberty City

Indicator List:

Indicators= measures that help to quantify the achievement of the result.

(Rated as high (H), medium (M), or low (L)

Candidate Safety Indicators Communication Proxy Power Data Power Notes Power Firearm Injury Emergency H H H Recommended by Department Rates BUILD team; Participants specifically request Juvenile Firearm Injury Rates Juvenile Violent Charges H H H Recommended by BUILD team Number of Juvenile Arrests Not rated H H Recommended by BUILD team Juvenile Drug and Alcohol Not rated H H Recommended by Related Charges BUILD team Number of Investigations Not rated M L/M Received-Adult and Child (Rates of Abuse/Neglect) Crime Rates Not rated H M/H Number of abandoned houses Not rated M M/H Number of designated safe Not rated L L spaces in the community Amount of participation of Not rated Not rated Not rated individuals in safe spaces Number of pedestrian Not rated M H/M injuries/fatalities Number of abandoned vehicles Not rated Not rated Not rated Pounds of trash collected Not rated Not rated Not rated Abandoned lots Not rated M L/M Number of sexual offenders Not rated M M

Candidate Health Indicators Communication Proxy Power Data Power Notes Power Adult Asthma Emergency H H H Recommended by Department Rates BUILD team Child Asthma Emergency H H H Recommended by Department Rates BUILD team Diabetes Emergency Not rated H H Recommended by Department Rates-Adult BUILD team Diabetes Hospitalization Rates- Not rated H H Recommended by Adult BUILD team Obesity Rate H H M Review availability

of BMI data as a proxy. Participants felt strongly about this indicator. Sale of Alcohol Not rated M M Teen Pregnancy Rate Not rated M M/H Number of Grocery Stores Not rated L M Number of Drug Houses Not rated L L/M Tree Canopy Not rated M L/M Number of Crisis Interventions Not rated M M Number of Arrests of People Not rated M L/M with Mental Illness Suicide Rate Not rated H M/H Communication Power: Does this indicator communicate to a broad range of audiences? Would those who pay attention to your work know what this measure means?

Proxy Power: Does this indicator say something of central importance about the result? Is it a good proxy for other indicators? Data tend to run in a “herd”-in the same direction. Pick an indicator that will tend to run with the herd of all the other indicators that could be used.

Data Power: Is there quality data for this indicator on a timely basis? To be credible, the data must be consistent and reliable. Timeliness is necessary to track progress.

Selected Headline Indicators:

Indicators=measures that help to quantify the achievement of the result

(Rated as high (H), medium (M), or low (L)

Result: A Safe and Healthy Liberty City

Candidate Communication Proxy Power Data Power Notes Headline Power Indicators Juvenile Violent H H H To be decided Charges Juvenile Firearm H H H To be decided Injury Rate Adult Asthma ED H H H To be decided Rates Child Asthma ED H H H To be decided Rates Obesity/BMI Rate H H M To be decided

Turn the Curve Report as contributed on January 25th, 2016

(POPULATION)

Result A Safe and Healthy Liberty City.

Safety Indicator: Total number of violent charges commitment by juveniles occurring 2010-2014 in Liberty City zip codes.

Data Source: Our indicator data was provided by Miami-Dade County Juvenile Services Department. Data was retrieved between the years 2010-2014 for specific zip codes: 33127, 33142, 33147, 33150. Violent charges include aggravated assault and/or battery, weapon or firearm offenses, armed robbery, assault and/or battery (not aggravated), obstruction of justice with violence. Juveniles refer to individuals under the age of 18.

Story behind the data Contributed on January 25, 2016:

What is hindering progress? (Restricting factors)  There is an increase in drug and alcohol use  Gang activity  Guns  Low intelligence level (educational challenges)  Absenteeism  Unhealthy environment  Lack of parental involvement  Little faith-based involvement

What causes the data to improve? (Contributing factors)

 Decrease in juvenile violence  More positive community programs

 Mentorship  Stakeholder involvement  Parental involvement  Partnership with law enforcement

Who are some partners that can help you to address this data?

 Government/politicians  Parents and youth  Teachers and special interest groups  Clergy  Business owners  Community and Civic Organizations  Schools (Universities and colleges)  Drug-Free Coalition

What works to turn the curve (known solutions)?  Change social norms (e.g. billboards)  Media PSA  We ourselves (individual change)  Community involvement  Local and State government  Positive Outlets/outreach  Programs (Parks, headstart, etc.)

What do we propose to do to turn the curve? On January 25, 2016 the group identified the following strategies:  Family Resource Center  Health Education (incl. mental health awareness)  Job Referrals and Job Training  Programs for 0-17 year olds (e.g. Belafonte TACOLCY Center)  Early Education  Adult Services

Safety Indicator #2: Firearm injury emergency department rates occurring 2009-2013 in Liberty City zip codes.

Data Source: Our indicator data was provided by the Florida Department of Health-Miami Dade County Injury Epidemiologist. Data was retrieved between the years 2009-2013 for specific zip codes: 33127, 33142, 33147, and 33150. Firearm injury ED rates refer to nonfatal injuries.

Story behind the data Contributed on January 25, 2016:

How are we doing?  Trending in the wrong direction  Need more current data  Need to separate juvenile data from adult data

What is the story behind the curve? Home:  Home is where it starts!  Young parents  Parents have limited education and parenting skills  Lack of positive role models  Lack of positive community involvement  Lack of father involvement  Generational enabling  Lack of structure, discipline, consequences and consistency School:  Lack of parent/teachers cohesiveness  Lack of parent participation  Lack of aftercare/school activities  Lack of tutoring and mentoring Social/Economic:  Depression/Mental Illness  Lack of hope  Lack of education  Lack of resources  Lack of information  Lack of trust

Who are some partners that can help you to address this data (Stakeholders)?

 Parents  Churches/faith-based organizations  Teachers  Community leaders  Funders  Youth

What works to turn the curve (known solutions)?  Long-term family investment  Setting obtainable goals  Coordinated services/wrap-around  Remove “red tape”-collaboration

What do we propose to do to turn the curve? On January 25, 2016 the group identified the following strategies:  Track history of family disturbances

Health Indicator: Youth and adult asthma emergency department rates occurring 2009-2013 in Liberty City zip codes.

Data Source: Our indicator data was provided by the Florida Department of Health-Miami Dade County Epidemiology Department. It was taken from the Emergency Dept. Data, Florida Agency for Health Care Administration. Data was retrieved between the years 2009-2013 for specific zip codes: 33127, 33142, 33147, and 33150.

Story behind the data Contributed on January 25, 2016:

What is the “end”?  Decrease in number of ED visits due to asthma What is hindering progress (Restricting factors)?

 Drastic change 2009-2010 increase in children ED rates due to asthma  Lack of repairs on homes (e.g. exposure to dust, asbestos, roaches)  Environmental factors (construction)

 Medicaid cuts  Re-gentrification/transition  Lack of access to healthcare

What causes the data to improve (Contributing factors)?

 Increase in awareness of health  Smoking campaigns/laws  Access to healthcare

Who are some partners that can help you to address this data (Stakeholders)?  Health centers such as Jessie Trice, UM, Jackson, Urgent Inc.  Density outlets?  HUD  C.I.L.  Schools/Daycares  Early Learning Coalition  American Heart Association  Code Enforcement-City/County  Sports  EPA/DERM

What works to turn the curve (known solutions)?  Education/Outreach i.e. Kiosk, campaign  Enhancing access to care, i.e. DME/medication  Policy Advocacy Change, i.e. contractors, developers, land owners, property managers  No smoking in public housing (enforcing)

What do we propose to do to turn the curve?  Targeted campaign-Let’s move initiative  Partner with ALA or other industries to implement education and outreach strategies  Increase enrollment in the ACA

Cumulative Turn the Curve Report (POPULATION) This is a summary of the work to date.

Result

A Safe and Healthy Liberty City.

Indicator: Total number of Juvenile Arrests in Liberty City zip codes occurring 2009-2014.

Data Source: Our indicator data was obtained from Miami-Dade County Juvenile Services Department. Data was retrieved between the years 2010-2014 for specific zip codes: 33127, 33142, 33147, and 33150 for total juvenile arrests. Juveniles refer to individuals under the age of 18.

Story behind the data

Contributed on October 28th, 2015:

What has caused the data to decrease? (Contributing factors)

• Not necessarily an indicator of the number of incidents of crime • Need to collect civil citation numbers and look at policy change that often impact these numbers • Types of crimes not indicated • Geographic concentration • Juveniles aging into adulthood (need to look at adult criminal activity) • More prevention programs available in schools and community • Federal funding for diversion program • State funding for diversion program • Parents are active participant in children’s lives • Accountability • Juvenile services-community policing

What is hindering progress? (Restricting factors)

• Not enough parent involvement • Cultural/language barriers • Partnerships not genuine • Accessibility/Mobility • Funding/Economics

What are the most important root cause/prioritized factors to address?

• Population growth • Percentage data

Who are some partners that can help you to address that story?

• Juvenile court system • Police • CBOs • Churches • Transportation • Schools/Educational Institutions • Parents/Extended Family • MCI • Athletic programs • Clergy • Drug Free Coalitions • Civic Organizations • Health and Mental Health Providers • Youth Organizations

What works: (known solutions)

• Mentorship program for youth and parents • Collective Impact-work together through coalitions to address ways to make changes • Beyond Scared Straight Program • Policy changes • Police training • Adequate funding • Youth development programs • Youth/Adult employment • Weekend programs • College tours • Investment in quality early education • Businesses

Indicator: Asthma Emergency Department Rates occurring 2009-2013 in Liberty City zip codes.

Data Source: Our indicator data was compiled by the Florida Department of Health-Miami Dade County Epidemiology Department. It was taken from the Emergency Dept. Data, Florida Agency for Health Care Administration. Data was retrieved between the years 2009-2013 for specific zip codes: 33127, 33142, 33147, and 33150.

What is hindering progress? (Restricting factors)

 Smoking rates  Second-hand smoke exposure  Environmental pollution (highways, transportation)  No good healthy designs  No air filters  Lack of participation and health education  Access to health care  Lack of repairs on homes (e.g. exposure to dust, asbestos, roaches)  Medicaid cuts  Re-gentrification/transition

What causes the data to improve? (Contributing factors)

 Increase in awareness of health  Smoking campaigns/laws  Access to healthcare

What are the most important root cause/prioritized factors to address?

 Lack of cultural competency  Health education needs

Who are some partners that can help you to address that story?

 Parents  Store owners  Local health department  FQHC  CDC  Medical Association  Density outlets?  HUD  C.I.L.  Schools/Daycares  Early Learning Coalition  American Heart Association  Code Enforcement-City/County  Sports  EPA/DERM

What works (known solutions):

 Culturally sensitive and educational advocacy campaign  Movements  Mobile health  Kiosks  Health fairs  Enhancing access to care, i.e. DME/medication  Policy advocacy change, i.e. contractors, developers, land owners, property managers  No smoking in public housing (enforcing)

What do we propose to do to turn the curve?

 Targeted campaign-Let’s move initiative  Partner with ALA or other industries to implement education and outreach strategies  Increase enrollment in the ACA

On January 25, 2016 the group voiced the following concerns:

 Participants want to select asthma as an indicator if and only if obesity data is not readily available.  Need to speak to residents and go beyond looking at quantitative data. Qualitative data is just as important to understand the health and safety of Liberty City residents.  An example was the FIU report that documented women in and allowed them to tell their own stories. Information should be presented in plain language and culturally-competent manner.  Participants want to review Juvenile Firearm Injury Data in addition to Adult rates.

 Zip code data includes significant pieces of other neighborhoods including and Midtown. Ideally, we need census tract-level data.  Power analysis of data sets.  Research/Strategies should be equitable to residents.

Action commitments updates provided by participants:

Individual action commitments are aligned efforts taken with strategic partners to achieve a specific result. Ideally, they should go beyond your current work and be achievable by the next meeting. At the beginning of every meeting, stakeholders are asked to share their updates.

Below are updates to personal commitments to action that were made during the December 18th meeting:

 Jeff Hurst discussed the data he provided on investigations received. He noted that when investigators go out they don’t always capture , they capture general area. He is currently working obtain data that is specific to Liberty City.  Christina Wright discusses the teen pregnancy rates in Liberty City. She noted that the rates in Liberty City are significantly higher compared to the county.  Renita Holmes discussed the findings of her organizations and she will be willing to share if she gets permission from her board and more support.

Additional Notes and Successes from January 25, 2016:

 Cindy Magnole shared that she created the injury tracking system at JHS and has been tracking injuries in the county since 1999.  In reference to the DCF data, Commander Mills noted that the DCF data may be low because the police department may not report to DCF. She noted that for Model City (Liberty City), we average about 55 cases per month per year.  In reference to census tract-level data, Jessica Vallejos-Landestoy stated that her department (JSD) has to go back to zip code level data because of the missing four digits attached to zip codes.

Individual Action Commitments made on January 25, 2016:

Participant Action What will I do? How will I do With whom When will I do How will it Commitment it? will I do it? it? contribute? Elena Napolez Data of Present the data Jessica V. By February 23 arrested youth for firearm charges Jessica Provide Provide juvenile Vallejos- Juvenile arrest arrest data as Landestoy data as requested requested Cindy Magnole Data for Access the data JHS/Trauma Within 2 weeks Show number assaults in ED Center Registry of patients and Send from Liberty contact info to City group members for

health connect Michael Rivers Implement Create strategic CareerSource 3 weeks from employment employment of South FL, today program plan City of Miami targeting Center young adults and adults Izegbe Show a model MCI staff Feb. 23rd, 2016 Onyango of coordinated service/wrap around Debbie Mills Job placement Job placement Identify a male With my Within the next One family at a for 1 male for 1 male and facilitate neighborhood month; by next time the process office meeting Gina Ford Get data on Get data on Stakeholders Key club By next It will be mental illness mental illness and research meeting helpful in the in Liberty City safety component Jeff Hurst Get data on Get data on Our Kids By next Indicators, foster kids foster kids placed meeting complement placed outside outside the Juvenile the home home. See if this Violent Charges plays a role in data juvenile violent charges Vivilora Provide Call Kate W/or Perkins-Smith information on misty status of signage-sale of alcohol to minors posting Eric Garcia Collect data on Obtain data Before Feb. Identify issue in domestic 24th order to disturbances provide within intervention Northside and resources district. Non- contact and contact shootings Cecilia RBA training Send out notice Email the With Deltavier By January Encourage Gutierrez for all and confirm data collaborative and Laurie. 29th. everyone to members and cost with table. Secure participate. Deitre and Dr. the location. King Tyra Tate Connect with Look at the Email Assistant to In two weeks- Provide FIU (school of researchD(?), telephone dean 1st week of additional data nursing) data request results contact February of health from data center Anthony Get data on Make calls By telephone Before On addressing Williams how and what February 15th. teen violence. have local politicians done to address teen violence Elaine Black Identify 5 problem families to

work with D. Noel-Pratt Increase community policing and increase youth programs (combination effort) Michele Wyatt- Research EBP Sweeting endorsed by ALA-adults diagnosed with asthma. Any local organizations working? Wil Ayala Identify Via EIC By next childcare database and meeting. centers in Health Liberty City Foundation that we can contacts and educate and the Lung evidence-based Association activities. Identify other sources of data of obesity in Liberty City Christina Provide better Research Research Tyra Tate By Feb. 24th Assist with the Wright proposals of community-wide strategy plan. health with strategy/partners turning the curve (come up with strategies)

Next Steps:

 Next Meeting February 24th 1-5pm, location TBD  Commitments to Action  Prioritize health and safety indicators and review what works