“The 100% Community initiative guides “For all of us who believe that we can make us as we embrace the opportunity to everyone’s health, safety, resilience We’re all in this together. design new systems of care and 100% Community and readiness for crisis a priority, We face stark challenges. Pandemics and economic disruptions make safety we urgently need.” this book shows the way.” once comfortable lives vulnerable, while those already enduring adversity — Matt Probst, PA-C, — Dr. Bill Soules, Medical Director, New Mexico State Senator 100% find life impossible. 100% Community is the reset button, providing the El Centro roadmap for how we work together in new ways to create local systems of Family Health health, safety, education and economic stability. In 100% Community, we provide you and your community with the insights to ensure Community that ten vital services are working well. The services that none of us can do without, the “surviving services,” start with medical care and include behavioral health care, safe housing, secure food and transport to vital services. The “thriving services” include parent supports, early childhood learning programs, community schools, youth mentors and job training. Each of these services play a vital role in keeping us safe from adversities—both everyday and unexpected. Ensuring 10 Vital Services for 100% Community shows how we can create a local system of readiness by investing in strong local systems of care, safety and education, and how we can decrease health disparities Surviving and Thriving along with a host of long-standing and costly challenges including adverse childhood experiences, trauma, substance misuse, violence and untreated mental health problems. Ortega Courtney Ortega By harnessing data, research and technology, the public and private sectors can work together with unprecedented levels of collaboration. 100% Community provides a tested, step-by-step guide to creating a seamless local system of health and safety. Together, with ten vital services accessible to 100%, we’re all stronger and safer. Katherine Ortega Courtney, PhD and Dominic Cappello are advocates for solving colliding challenges using data, technology and collaboration. They know why systems that should protect us, can fail us—and teach leadership development and data-driven problem-solving. Dr. Courtney’s expertise in data analysis, · continuous quality improvement, collective impact and experimental psychology Cappello guides communities and organizations through turbulent and timely change. Cappello is a community systems strategist and New York Times bestseller author, whose Ten Talks book series on family safety reached a national audience when his innovative work was featured on The Oprah Winfrey Show. www.10vitalservices.org Katherine Ortega Courtney, PhD and Dominic Cappello PUBLISHED BY SAFETY+SUCCESS COMMUNITIES— A 501(C)(3) NONPROFIT ORGANIZATION Cover photo: Fabio Ballasina on Unsplash Author photos: Don Usner Copyright © 2020 Katherine Ortega Courtney and Dominic Cappello. 100% Community is a registered trademark of 100% Community, LLC All rights reserved. Reproduction or translation of any part of this work beyond that permitted by section 107 or 108 of the 1976 United States Copyright Act without permission of the copyright owner is unlawful. For permissions, contact the authors via www.10vitalservices.org The contents of this book are not intended to substitute for professional medical or behavioral healthcare advice, diagnosis, or treatment. ISBN: 9798637165933 Book design: Bram Meehan To change agents in times both calm and chaotic. Table of Contents 9 · About This Edition 11 · Foreword 14 · The Unskippable Preface: We’re in this together 18 · Acknowledgments 20 · Introduction to the Book, Course, Initiative and Movement 24 · Always Read the Instructions SECTION I: OUR INSIGHTS 27 · PART ONE: 100% 29 · Chapter 1: 100% of Us Can Move From Crisis to Community—Together 32 · Chapter 2: Can We Get to Vital Services When We Need Them—in Times Calm and Chaotic? 36 · Chapter 3: Proving Our Hypothesis 40 · Chapter 4: Our Goal Is 100%, Because We Don’t Leave Out Anyone 45 · Chapter 5: The Root Causes of a Host of Health Challenges 49 · Chapter 6: What Percentage of Our Nation Should Be Able Access Survival Services? 63 · Chapter 7: We Interrupt This Public Health Crisis to Share Another One 76 · Chapter 8: Speaking the Same Language 80 · Chapter 9: Readiness and Radically Altering Course 84 · Chapter 10: Dare to Imagine What a “100% Community” Is 89 · Part One Review: This Is a Test 91 · PART TWO: COMMUNITY 93 · Chapter 11: Courageous Champions vs. Keepers of the Status Quo 102 · Chapter 12: Your Governor Has More Impact on Your Quality of Life than the President 107 · Chapter 13: Early Childhood Is Destiny, So Best to Have an Early Childhood Education and Care Department 113 · Chapter 14: Your Child Welfare Department Requires a Hero and Almost Superhuman Innovation 122 · Chapter 15: Your State Departments of Education and Higher Education Face Their Biggest Test 130 · Chapter 16: The Quality of Our Lives Is in the Hands of “Health” and “Human” Departments 139 · Chapter 17: Your State Department of Economic Development Might Be an Engine for Prosperity 142 · Chapter 18: When Your State Senator Becomes Your Champion, Get Ready for a Wild Ride 149 · Chapter 19: Your County Lawmakers Can Enrich Communities—Especially Your Rural Ones 152 · Chapter 20: City Lawmakers All Say That All Families Really Matter, So Let’s Back That Up with Action 160 · Chapter 21: Your School Board Members Determine If All Students Thrive or If Some Might Be Marginalized 167 · Chapter 22: College and University Leadership Can Address a Public Health Crisis on Campus—and in the Communities They Serve 178 · Chapter 23: Foundation Leaders Have the Power to Make Measurable and Meaningful Change 183 · Chapter 24: Nonprofit Organization Directors Must Decide: Status Quo or Giant Leaps Forward? 186 · Chapter 25: Health Care, Inc. in Your State and Cities Controls Your Health—by Action and Inaction 189 · Chapter 26: National Lawmakers Must Battle Those in the Nation’s Capital to Serve the Most Vulnerable at Home 191 · Chapter 27: The Chamber of Commerce and the Private Sector Must Be Full Partners in Ensuring Surviving and Thriving Services 193 · Chapter 28: The Publishing and Thought Leaders Industry—Helping or Hurting? 200 · Part Two Review: This Is Another Test 203 · PART THREE: COUNTDOWN TO 100% 205 · Chapter 29: Continuous Quality Improvement Guides Us with Data 214 · Chapter 30: Loss and Change: Understanding the Difference between Technical and Adaptive Challenges 219 · Chapter 31: Sharing the Vision to Achieve Collective Impact 222 · Chapter 32: Getting to the 100% Community Goal, Step-by-Step 232 · Chapter 33: Knowing Historical Disparities, Historical Trauma and Resilience 236 · Chapter 34: Measurable and Meaningful Progress: A Timeline 242 · Chapter 35: The Capacity to Train, Facilitate and Learn Is a Gift We Must Share 247 · Chapter 36: Connecting, Improving, Surfing and Muting: Adventures in Tech 265 · Chapter 37: When Epidemics Collide, It’s Time for People to Collaborate 269 · Chapter 38: The Logic of the 100% Community 280 · Chapter 39: Faith 283 · Part Three Review: This Is One More Test SECTION II: YOUR WORK BEGINS 285 · PART FOUR: WORKBOOK FOR ACTION TEAMS 287 · Chapter 40: First We Survive, Then We Can Thrive 290 · Chapter 41: Food@100% 318 · Chapter 42: Housing@100% 341 · Chapter 43: Medical and Dental Care@100% 374 · Chapter 44: Behavioral Health Care@100% 414 · Chapter 45: Transportation@100% 440 · Chapter 46: Parent Supports@100% 470 · Chapter 47: Early Childhood Learning@100% 494 · Chapter 48: Community Schools@100% 531 · Chapter 49: Youth Mentoring@100% 562 · Chapter 50: Job Training@100% 589 · Part Four Review: This Is the Last Test 591 · Epilogue APPENDICES: YOUR VITAL TOOLKIT FOR GETTING STARTED 595 · Appendix A: 100% Community Survey 598 · Appendix B: Assessing Action Team Members’ Knowledge: A Readiness Survey 600 · Appendix C: What about Endnotes? 601 · Appendix D: Action Teams That Achieve Results 606 · Appendix E: Developing a 100% Community Project with CQI 614 · Appendix F: Evaluation Begins with Questions 616 · Appendix G: Engaging with Elected Lawmakers 620 · Appendix H: 100% Community—County Program Org Chart 621 · Appendix I: 100% Community—Partnerships 622 · Appendix J: 100% Community Initiative—Logic Model 623 · Appendix K: 100% Community—Timeline 624 · Appendix L: Crisis-proof County Readiness Checklist 631 · About the Authors About This Edition Katherine Ortega Courtney, PhD and Dominc Cappello As national, state and local leaders use the phrase, “We’re all in this together,” this book shows how we move, united, from crisis to cohesion. “This is the framework we urgently need,” is a response we’re getting to our new edition of 100% Community. This edition is the result of an eight month review by colleagues across our very inter- connected nation, and globe, both pre and post the announcement of the COVID-19 pandemic. As with all things in this time of change, some might say paradigm shift, publishing a book is no longer the act of generating words that become frozen in time. With our technologies and activist thought leaders, content specialists, editors and colleagues working every day with community members, our chapters evolved dramatically since our advance review copy edition was published. Once COVID-19 was acknowledged as a global pandemic, the reviews of our 100% Community model, espe- cially the focus on ensuring medical care and other survival services took on a sense of urgency. Suddenly, state and local leaders saw how vital it was to ensure such services exist for everyone—as suddenly people from across all income groups, in both urban and rural settings, expressed a profound sense of vulnerability. Leaders are seeing how important it is to identify gaps in vital services and create a process for addressing them efficiently and cost-effectively. It is also clear how inter- connected services are—medical issues became a transportation issue, followed by food and housing security issues.