1. Why we have legal and ethical responsibility to
educating the youth and protecting their health
beyond the standard
Alexis Holt
Promoting Wellness
for our children
2. The Benefits
Improve the quality of your students’
education
Wellness lessons provide essential
education
The benefits of wellness education reach
far beyond the classroom
Provides fulfillment of Maslow Hierarchy
of Needs (Abraham Maslow, 1943)
◦ Theory of Human Motivation (1943)
3. Maslow Hierarchy of Need
Maslow. Theory of Human
Motivation (1943).http://www.educatorstechnology.com/2014/09/wonderful-chart-integrating-maslow.html.
Sept, 2014.
4. How will we do this?
The Who, What, Where, Why,
When & How
POSDECORB (Gulick, 1937)
◦ Classical PA
◦ Functional elements of administration
6. Planning
Look at current policies in effect and
perform an analysis - Is it legal, ethical,
effective?
◦ Accountability
What is currently working?
◦ Are schools and government policies
focused on the right things?
CHILD NUTRITION REAUTHORIZATION HEALTHY, HUNGER-
FREE KIDS ACT OF 2010
8. Organizing
Implementation, accountability &
effectiveness
Phases of policy
Formulation
Implementation
Evaluation
The Guide to Community Preventive Services (CG)
Healthy People 2020 (HP)
The U.S. Preventive Services Task Force (USPSTF)
9.
10. Staffing
Diversity
◦ Social Exchange Theory (Homans,1985)
“Social Behavior as Exchange - He defined social
exchange as the exchange of activity, tangible or
intangible, and more or less rewarding or costly,
between at least two persons.”
Managing and Valuing Diversity: Challenges to
Public Managers in the 21st Century (Ewoh,
2013)
Modeling impact of diversity management (Pitts,
2006)
Hawthorne Studies (Mayo &Roethlisberger,
11. Directing & Coordinating
Why a national program is important
◦ Ethical reasoning
Accountability
Higher Standard
◦ Principles for the declaration on human
governance (Cox, 2006)
12. Reporting & Budgeting
Analysis of program & Budgeting
◦ How are you going to do it?
Introduction to Program Evaluation for Public
Health Programs (www.cdc.gov)
◦ How do you know the success level?
Cost-effectiveness and cost-benefit analyses for
public health programs (Smith, 1968)
Cost-Benefit and Cost-Effectiveness Analysis
(Frick, 2007)
13. References
Bevans, K. B., Sanchez, B., Teneralli, R. and Forrest, C. B. (2011), Children's
Eating Behavior: The Importance of Nutrition Standards for Foods in Schools.
Journal of School Health, 81: 424–429. doi: 10.1111/j.1746-1561.2011.00611.
Retrieved April 27, 2015.
Budgeting. (n.d.). Retrieved April 27, 2015, from
http://www2.fiu.edu/~ganapati/3003/budget.html
Cox, R. (2009). Ethical Management and Leadership. In Ethics and integrity in
public administration concepts and cases (pp. 193-194). Armonk, N.Y.: M.E.
Sharpe.
Frick, K. (Director) (2007, January 1). Cost-Benefit and Cost-Effectiveness
Analysis. Lecture conducted from The Johns Hopkins University and Kevin Frick, .
Homans, George (1961). Social Behavior: Its Elementary Forms. New York:
Harcourt Brace Jovanovich. p. 13.
Guidelines for School Health Programs to Promote Lifelong Healthy Eating. (1996,
June 14). Retrieved April 27, 2015, from
http://www.cdc.gov/mmwr/preview/mmwrhtml/00042446.htm
Pitts, David, Modeling the Impact of Diversity Management (August 2005). Andrew
Young School of Policy Studies Research Paper Series No. 06-18. Available at
SSRN: http://ssrn.com/abstract=893860
Smith, W. F. (1968). Cost-effectiveness and cost-benefit analyses for public health
programs. Public Health Reports, 83(11), 899–906.
STORY, M., NANNEY, M. S., & SCHWARTZ, M. B. (2009). Schools and Obesity
Prevention: Creating School Environments and Policies to Promote Healthy
Eating and Physical Activity. The Milbank Quarterly, 87(1), 71–100.
doi:10.1111/j.1468-0009.2009.00548.
Hinweis der Redaktion
In the 12 years since U.S. Surgeon General David Satcher sounded the alarm about the nation’s epidemic of childhood obesity in his Call to Action to Prevent and Decrease Overweight and Obesity, real progress has ensued. The federal school wellness mandate became law in 2006 and the Healthy, Hunger-Free Kids Act that strengthened and modified that mandate followed in 2010.
Today, schools are a focal point for addressing the urgent need for improved nutrition and physical activity — and the academic success they enable. And the economic costs of creating healthier schools pale in comparison to the price tag for inaction.
Improve the quality of your students’ education by teaching a topic left out of standard curriculum
Wellness lessons provide essential education that can lead to more academic success
The benefits of wellness education reach far beyond the classroom
Human actions are directed toward goal attainment, any given behavior could satisfy several functions at the same time. i.e. going to a pub could satisfy one’s need for self-esteem and social interaction
Just as POSDECORB can be fitted each of the major activities and duties of any chief executive, the same theory can be applied to the planning and execution of a program, with such magnitude.
Planning, Organizing, Staffing, Directing, Coordinating, Reporting, Budgeting
Planning, that is working out in broad outline the things that need to be done and the methods for doing them to accomplish the purpose set for the enterprise
Effective Implementation In Practice: Integrating Public Policy and Management (Bryson Series in Public and Nonprofit Management) by Jodi Sandfort (Author), Stephanie Moulton
What is currently working?
About half of elementary school teachers 52% have had formal nutrition teaching training
U.S. Department of Education, National Center for Education Statistics. Nutrition Education in Public Elementary School Classrooms, NCES 2000-040, by Carin Celebuski and Elizabeth Farris. Shelley Burns, project officer. Washington, DC: 2000.
88% of elementary school teachers reported that they taught lessons about nutrition to their students in the 1996-97 school year. More kindergarten through second-grade teachers 92% taught nutrition than did third- through fifth-grade teachers 83%.
U.S. Department of Education, National Center for Education Statistics. Nutrition Education in Public Elementary School Classrooms, NCES 2000-040, by Carin Celebuski and Elizabeth Farris. Shelley Burns, project officer. Washington, DC: 2000.
WHAT IS THE CHILD NUTRITION REAUTHORIZATION BILL?
The Healthy, Hunger-Free Kids Act of 2010 authorizes funding for federal school meal and child nutrition programs and increases access to healthy food for low-income children. The bill that reauthorizes these programs is often referred to by shorthand as the child nutrition reauthorization bill. This particular bill reauthorizes child nutrition programs for five years and includes $4.5 billion in new funding for these programs over 10 years.
Many of the programs featured in the Act do not have a specific expiration date, but Congress is periodically required to review and reauthorize funding. This reauthorization presents an important opportunity to strengthen programs to address more effectively the needs of our nation’s children and young adults.
WHAT DOES IT DO?
Improves Nutrition and Focuses on Reducing Childhood Obesity
Gives USDA the authority to set nutritional standards for all foods regularly sold in schools during the school day, including vending machines, the “a la carte” lunch lines, and school stores.
Provides additional funding to schools that meet updated nutritional standards for federally-subsidized lunches. This is an historic investment, the first real reimbursement rate increase in over 30 years.
Helps communities establish local farm to school networks, create school gardens, and ensures that more local foods are used in the school setting.
Builds on USDA work to improve nutritional quality of commodity foods that schools receive from USDA and use in their breakfast and lunch programs.
Expands access to drinking water in schools, particularly during meal times.
Sets basic standards for school wellness policies including goals for nutrition promotion and education and physical activity, while still permitting local flexibility to tailor the policies to their particular needs.
Promotes nutrition and wellness in child care settings through the federally-subsidized Child and Adult Care Food Program.
Expands support for breastfeeding through the WIC program.
Increases Access
Increases the number of eligible children enrolled in school meal programs by approximately 115,000 students by using Medicaid data to directly certify children who meet income requirements.
Helps certify an average additional 4,500 students per year to receive school meals by setting benchmarks for states to improve the certification process.
Allows more universal meal access for eligible students in high poverty communities by eliminating paper applications and using census data to determine school-wide income eligibility.
Expands USDA authority to support meals served to at-risk children in afterschool programs.
Increases Program Monitoring and Integrity
Requires school districts to be audited every three years to improve compliance with nutritional standards.
Requires schools to make information more readily available to parents about the nutritional quality of meals.
Includes provisions to ensure the safety of school foods like improving recall procedures and extending hazard analysis and food safety requirements for school meals throughout the campus.
Provides training and technical assistance for school food service providers.
WHAT IS THE TIME FRAME?
USDA will work with states, school districts and neighborhoods to implement the provisions of the bill and Americans will start to see changes in their communities over time.
Thirty-seven percent reported training as an undergraduate or graduate
student (averaging 1.8 courses per teacher);
· Twenty-six percent reported participating in workshops, inservice, or
summer institutes (averaging 7.2 hours per teacher);
· Fourteen percent reported some other professional development training
(averaging 2.5 courses per teacher); and
· About 84 percent reported doing research and reading on their own.
PROJECT HIGHLIGHT: Diabetes Prevention and Control Alliance
A partnership between UnitedHealth Group, the YMCA of the USA, and retail pharmacies, the Diabetes Prevention and Control Alliance helps to enhance linkages between clinical and community-based preventive services through innovative programming. The Diabetes Prevention Program helps people with prediabetes eat healthier, increase physical activity, and learn about other health-promoting behavior modifications. The Diabetes Control Program links people with diabetes to local pharmacists who are trained to help them manage their condition and follow their physicians’ treatment plans.*
Over 90 percent of schools report that they are successfully meeting the updated nutrition standards. Students across the country are experiencing a healthier school environment with more nutritious options. The new meals are providing children more whole grains, fruits and vegetables, lean protein and low-fat dairy, as well as less sugar, fat, and sodium.
About Fuel Up to Play 60
Fuel Up to Play 60 is an in-school nutrition and physical activity program launched by National Dairy Council (NDC) and National Football League (NFL), in collaboration with United States Department of Agriculture (USDA). The program encourages youth to consume nutrient-rich foods (low-fat and fat-free dairy foods, fruits, vegetables and whole grains) and to achieve at least 60 minutes of physical activity every day. Fuel Up to Play 60 also receives support from the U.S. Departments of Education and Health and Human Services; several health and nutrition professional organizations, including the American Dietetic Association and the School Nutrition Association; and financial support from GENYOUth Foundation, which raises funds for Fuel Up to Play 60 and other in-school programs that address healthy eating and physical activity.
Program Progress
The program’s first progress report since launching nationally in 2009 shows that schools are making progress in promoting healthier eating habits and increasing physical activity among students.1 Impact to date includes:
• Nationwide, more than 70,000 schools serving about 36 million students are enrolled in Fuel Up to Play 60. The program is supported by U.S. Department of Agriculture, U.S Department of Health & Human Services, and several health and nutrition organizations like Action for Healthy Kids, American Academy of Pediatrics and the School Nutrition Association.
Organizing, that is the establishment of the formal structure of authority through which work subdivisions are arranged, defined, and co-ordinated for the defined objective.
The Guide to Community Preventive Services (CG), or Community Guide, is a resource to help states, communities, and other organizations choose population-based programs and policies to improve health and prevent disease. It is based on systematic scientific reviews of evidence and recommendations by the Task Force on Community Preventive Services, an independent, non-Federal, volunteer body of public health and prevention experts, whose members are appointed by the Director of CDC. The purpose of the Community Guide is to provide information and recommendations about interventions including their effectiveness; population specific guidance; economic considerations and return on investment; additional benefits or harms associated with the intervention; and, areas for further research. By providing these tools, the Community Guide aims to reduce bias in how conclusions are reached, improve the power and precision of results, summarize evidence about the effectiveness of particular approaches for addressing a public health problem, analyze application of findings, and identify knowledge gaps and needs for additional research.
Healthy People 2020 (HP) provides science-based, 10-year national objectives for promoting health and preventing disease. Since 1979, Healthy People has set and monitored national health objectives to meet a broad range of health needs, encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of our prevention activity. The development process strives to maximize transparency, public input, and stakeholder dialogue to ensure that Healthy People 2020 is relevant to diverse public health needs and seizes opportunities to achieve its goals. Since its inception, Healthy People has become a broad-based, public engagement initiative with thousands of citizens helping to shape it at every step along the way. Drawing on the expertise of a Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020, public input and a Federal Interagency Workgroup, Healthy People provides a framework to address risk factors and determinants of health
Actions
The Federal Government will
• Support delivery of clinical preventive services in various health care and out-of-home care settings, including Federally Qualified Health Centers; Bureau of Prisons, Department of Defense, and Veterans Affairs facilities; and among Medicare providers.
• Improve monitoring capacity for quality and performance of recommended clinical preventive services.
• Identify, pilot, and support strategies to reduce cardiovascular disease, including improving screening and treatment for high blood pressure and cholesterol.
• Encourage older adults to seek a free annual Medicare wellness visit, a new benefit provided by the Affordable Care Act.
• Educate clinicians, Federal employees, and the public (especially those in underserved populations) about coverage improvements and elimination of cost-sharing for clinical preventive services as set forth in the Affordable Care Act.
• Encourage adoption of certified electronic health record technology that meets Meaningful Use criteria, particularly those that use clinical decision supports and registry functionality, send reminders to patients for preventive and follow-up care, provide patients with timely access to their health information (e.g., lab results, discharge instructions), identify resources available to patients, and incorporate privacy and security functions (e.g., encrypting health information to keep it secure, generating audit logs to record actions).
• Improve use of patient-centered medical homes and community health teams, which are supported by the Affordable Care Act.
• Promote and expand research efforts to identify high-priority clinical and community preventive services and test innovative strategies to support delivery of these services.
• Develop new and improved vaccines, enhance understanding of the safety of vaccines and vaccination practices, support informed vaccine decision-making, and improve access to and better use of recommended vaccines.
• Research complementary and alternative medicine strategies to determine effectiveness and how they can be better integrated into clinical preventive care.
Partners Can
State, Tribal, Local, and Territorial Governments can
• Increase delivery of clinical preventive services, including ABCS, by Medicaid and Children’s Health Insurance Program (CHIP) providers.
• Foster collaboration among community-based organizations, the education and faith-based sectors, businesses, and clinicians to identify underserved groups and implement programs to improve access to preventive services.
• Create interoperable systems to exchange clinical, public health and community data, streamline eligibility requirements, and expedite enrollment processes to facilitate access to clinical preventive services and other social services.
• Expand the use of community health workers and home visiting programs.
The U.S. Preventive Services Task Force (USPSTF) is a leading independent panel of non-Federal experts in prevention and evidence-based medicine. The USPSTF makes recommendations about the use of clinical preventive services including screening, counseling, and preventive medications. Their recommendations focus on services delivered in primary care to people without signs or symptoms of particular conditions. USPSTF recommendations are used by primary care teams and the patients they serve to determine together which services are right for each individual. The USPSTF utilizes a transparent process and bases its recommendations on independent systematic reviews of the published medical evidence conducted by AHRQ Evidence-based Practice Centers. The USPSTF recommends clinical preventive services when the benefits for the population outweigh the harms (grade A and B). It recommends against services when the harms for the population outweigh the benefits (grade D). For some clinical preventive services, the balance of benefits and harms may be small or too close to call, in which case the USPSTF recommends shared decision making between patients
Staffing, that is the whole personnel function of bringing in and training the staff and maintaining favorable conditions of work;
“Instead of treating the workers as an appendage to ‘the machine’,” Jeffrey Sonnenfeld notes in his detailed analysis of the studies, the Hawthorne experiments brought to light ideas concerning motivational influences, job satisfaction, resistance to change, group norms, worker participation, and effective leadership. (Jeffrey A. Sonnenfeld, "Shedding Light on the Hawthorne Studies," Journal of Occupational Behavior, Vol. 6, 1985, p. 125. )
Directing, that is the continuous task of making decisions and embodying them in specific and general orders and instructions and serving as the leader of the enterprise
Co-Ordinating, that is the all important duty of interrelating the various parts of the work
Page 193 Raymond Cox
Reporting, that is keeping those to whom the executive is responsible informed as to what is going on, which thus includes keeping himself and his subordinates informed through records, research, and inspection.
According to Aaron Wildavsky, a preeminent expert, a budget is:
a prediction of expenses;
the "link between financial resources and human behavior in order to accomplish policy objectives";
a representation in monetary terms of governmental activity
a record of the outcomes of the struggle over political preferences; and "attempts to allocate scarce financial resources through political processes in order to realize disparate visions of the good life."
According to the Office of Management and Budget:
"The budget system of the United States Government provides the means for the President and Congress to decide how much money to spend, what to spend it on, and how to raise the money they have decided to spend. Through the budget system, they determine the allocation of resources among the agencies of the Federal Government. The budget system focuses primarily on dollars, but it also allocates other resources, such as Federal employment."
Why is a Budget required?
Accountability: Public is not taxed any more than that required for appropriate government functions
Prioritization: Identify those public functions to which scarce resources should be allocated
What are the major components of a Public Budget?
Revenues: Funds that are raised through various means.
Expenditure: Funds used for spending on specific programs or capital projects.
What are the revenue sources for a government?
The revenue sources differ depending on the level of government (i.e. federal, state, and local). Although the federal government collects most amount of tax, states and local governments have a wider menu of choices with respect to taxing:
Federal government:
Federal taxes
Individual and Corporate taxes
Capital gains tax
Excise (i.e. manufacturing) taxes
Social security tax (Federal Insurance Contributions Act, FICA tax).
Inheritance and estate taxes
Borrowings (e.g. treasury bonds)
User charges
State governments
Intergovernmental transfers
State taxes
Individual and Corporate taxes
Sales taxes
Fuel taxes
Inheritance and estate taxes
Special taxes on specific products/ services (e.g. tobacco, alcohol, parimutuels)
Licenses (business; occupation; hunting and fishing; motor vehicles; motor vehicle operators; public utilities)
Lottery
Borrowings (e.g. state bonds)
Local governments (city/ county)
Intergovernmental transfers
Local taxes
Property taxes (ad valorem)
Sales tax
Special Assessments (for special districts like school districts; mosquito districts; water management districts; business improvement districts; etc.)
User fees/ charges
Borrowings (e.g. local bonds)
