>> Angela: This is Angela Weaver.

Are there others on the line?

Hi, Darrin.

>> Mac: This is Mac.

I'm here.

>> Yochai: Yochai is here as well.

>> Angela: Are you the Y?

There you are.

>> Angela: Hi, everybody.

My name is Angela Weaver.

And a couple minutes past 10:00 so I think we are going to go ahead and get started because we have

a lot to cover today.

And I just want to first ask everyone to please mute your line.

We have quite a few people that will be joining so that would be really helpful.

OK.

My echo is gone so thank you.

I wanted to welcome you all to the "Healty Communities: An Assessment and Implementation Framework

to Achieve Inclusion of Persons with Disabilities."

I am the coordinator with the Oregon office on disability and health and I will be your host today.

And as we are going through the webinar, I want you to go ahead and use the chat if you have any

questions that come up.

We will answer those questions at the end.

We have lost about 15 minutes or so for -- blocked 15 minutes for questions.

We will be able to answer those questions through the chat as well as people can unmute their phones

and ask questions.

I also want to let you know that this webinar is being recorded.

So it will be archived and everyone that's registered will be sent a link to the recording as well

as an evaluation that we have left for you to complete.

I am going to start by letting you know who our presenters are today.

So we have Yochai Eisenberg with the institute on disability and human development, from the

University of Illinois at Chicago.

And Yochai is also affiliated with the national center on Health and Physical Activity

and Disability.

Next we are going to hear from Darrin Umbarger, the founder of Clearview Mediation in Pendleton,

Oregon.

Next we will hear from Mac Gillespie and he is the healthy communities coordinator with Benton

County Health Department in Oregon.

And lastly we will hear from Joseph Lowe who is the program analyst with the Aging and People with

Disabilities, here in Oregon's Department of Human Services.

And I am going to read through our learning objectives for this webinar.

Our learning objectives include recognize persons with disabilities as a demographic group that

experiences health disparities.

The second one is to identify two ways a community health assessment tool can guide the development

of community health improvement plans that integrate inclusive policy, systems, and environmental

strategies.

Describe several successful inclusionary efforts taking place in both Benton and Umatilla Counties

in Oregon and their proposed impact on community participation and access to healthy lifestyle

opportunities for persons with disabilities.

And lastly, to understand the steps taking place in Oregon at the state and local levels and how

you, too, can help promote healthy lifestyles for Oregonians with disabilities.

I just want to mention, too, that the funding for this webinar and for the projects that we will be

highlighting is from the Centers for Disease Control and Prevention, the national On birth defects

and developmental disabilities.

And I see there is a little bit of chat with the line being choppy.

I'm just wondering is that for everyone or how is it coming through right now?

Is it OK?

OK.

I'm good.

Thanks, everyone, for your feedback.

OK.

So I'm going to now pass the presentation on to Yochai.

>> Yochai: All right.

Great.

Thank you very much, Angela.

And I am going to start us off by just giving kind of a broader introduction into healthy

communities and disabilities.

And how a pilot project that we were able to work on with Angela and with two communities in Oregon

occurred and kind of describing the context for it.

Then we are going to be able to get into what was actually done in Oregon by hearing from Mac and

Darrin.

From their two communities.

And then find out from Joseph what's going on currently in Oregon that people can get involved with.

To kind of step back, I wanted to just kind of start off by explaining, how disability is described

and has multiple meanings in public health.

And I am going to be talking about two perspectives here on disability that kind of can think about

it through kind of these two maps that we have here in this image.

We can think of maybe these are made by two different cartographers.

They are both asked to make a map of disability and they both develop pretty much the same map,

which appears in this slide.

It's a map of the Chicago yawned area which is made up of data from the American community survey

from 2010 to 2014.

Visually it represents where the prevalence of disability is higher or lower.

Once these maps are made, the two cartographers provided different titles to these two maps.

One is, where is disability?

And the second is, where are people with disability?

And let's say they work for a public Health Department, which title should they use?

And the point is that the introduction and meaning of the maps relate to kind of two perspectives on

disability.

Right?

One perspective views disability predominantly as an outcome.

And the map can help identify where work is needed to prevent disability.

The second perspective sees disability as a demographic characteristic, an identity for a large

subpopulation in the U.S.

It might use this map to examine how well current programs and resources are meeting the needs of

people with disability.

It's also important to see disability as multidimensional and not a one size fits all.

Broadly, it includes people with physical, sensory and cognitive limitations.

However, those broad categories, within those broad categories there are many subcategories that

people identify with.

Next I am going to show the prevalence of disability in the U.S.

Just make sure I'm changing slides here.

OK.

So we look at the prevalence of people of disabilities comprise 13 to 22% of the population, adult

population.

Roughly 38 to 57 million people.

It's a demographic group that anyone might join at any point in their lives.

And it cuts across race, ethnicity and income.

If we look at it by age, we see that 16% of people 18 to 44 have a disability.

27% of people 45 to 64 have a disability.

And 36% of adults 65 and older have a disability.

As you can see disabilities is a significant segment of the population.

And the health of people with disabilities differs substantially from those without disabilities.

This info graphic from the CDC NCBDDD website shows some of the large disparities that exist.

People with disabilities are more likely to be obese, at 38.4% compared to 24.4%.

More likely to smoke, at 30.3%, versus 16.7%.

Have high blood pressure, 41.7% versus 26.3%.

And be inactive, 36.3% versus 23.9%.

Looking at certain chronic diseases, we see that there's also significant differences in the rates

as well where there are two to three times more likely to have these chronic conditions such as

stroke, 6.8% versus 1.4%.

Heart disease, 11.9% versus 4.1%.

And diabetes, 16.8% versus 7.2%.

These data are from, pretty recent data from the 2014.

Looking at data specific to Oregon, we have same, similar kind of patterns in terms of the

differences there between people with and without disabilities.

In terms of those three chronic diseases I shared before.

As well as not reporting any physical activity.

The rates for people with disability much higher than people without disability.

Looking at specific types of disability, we can also see certain differences as well.

This graph is from data that was analyzed from the national health Interview Survey and it shows a

percentage of adults 18-64 who get no aerobic activity by disability type.

We see here that mobility disability is kind of the highest category reporting no aerobic physical

activity and that includes people with serious difficulty walking or climbing stairs.

Then comes people with cognitive disability, and that's people with serious difficulty

concentrating, remember, or making decisions.

Vision difficulty is next at 36%.

Hearing is next at 33%, and then you see people without disabilities at 26%.

So again some very significant differences there when we look at the specific types of disability as

well.

So today I'm going to talk about a concept called inclusion.

And inclusion in health.

We are kind of merging the kind of two disciplines of public health and disability, and that's part

of this project that Mac and Darrin are going to tell you about in a little bit that was funded

through the CDC and through the national association of chronic disease directors, NACDD with

collaboration from NCHPAD, the national industrial on health promotion for persons with

disabilities.

I wanted to share this definition of inclusion which is what the goal of this pilot project was,

inclusion in public health initiatives.

And so this is a definition that was developed through an expert panel that was put together by the

NCHPAD group to put something down in writing in relation to public health.

Inclusion means to transform communities based on social justice principles in which all community

members are presumed competent, are recruited and welcome as valued members of their community,

fully participate and learn with their peers, and experience reciprocal social relationships.

Kind of thinking about how this relates to the kind of healthy communities concept, right, there was

a big push towards policy systems and environmental changes.

And this was kind of disseminated even more broadly with the health impact pyramid, which was

written about by former CDC director Dr. Thomas Frieden, which many of you might be familiar with.

This pyramid shows a relationship, right, between the level of an intervention and the individual

effort and population impact.

And it really kind of corresponds with the socioecological model.

The arrows on each side indicate that intervention at the bottom of the pyramid have increasing

population impact and less individual effort, whereas those at the top of the pyramid require more

individual effort and have less population impact.

As a result, there's been many interventions focused at the second to last level, which is changing

the context to make healthy choice the easier default choice.

Placing healthy foods closer to checkouts.

Making healthy foods comparable to unhealthy foods, physical activity available in one's

neighborhood.

So how does the community health inclusion index, the community health inclusion in general fit in

with this?

I think the issue is that people with disability, for people with disability, if there are still

segregated systems in place in communities.

And that equal inclusion is not provided to people in regards to public health, in regards to

access.

So the focus of community health inclusion is to impact that fourth level, to change the context to

make individual default decisions healthy.

And what we are really trying to do is see how these community health inclusion efforts can fit in

with existing public health interventions and initiatives.

And not be really separate systems of intervention.

And so some of the issues experienced by people with disabilities, in terms of that contextual

level, a lot of times have to do with environmental aspects.

So just kind of sharing quickly a few different barriers that are experienced.

There's a lot towards walkability and getting around.

And being part of walking clubs.

But unfortunately, the infrastructure is not necessarily keeping up with that to allow for people in

wheelchairs, as you see in these pictures, the images on the left where curb cuts are not existent.

In some of that sidewalk infrastructure.

You see an image of entrances where there's only stairs.

And even kind of smaller things, like once you get into a building, there might be certain obstacles

that prevent you from using facilities such as, in this case, fixed benches that are in a locker

room.

There's many important facilitators that would help people in regards to accessing physical activity

and nutrition environments.

And these get to aspects of universal design so these might include accessible buses that have

lifts, having equipment that people with disabilities can actually work out on which is the image on

the second to the left.

This arm ergometer.

The next one is staff feeling confident working with people with disabilities.

An image of a universally designed pool that really exemplifies what inclusion in.

So how does the CHII, which is what I am going to talk about now is the community health inclusion

index, and how does that fit in with changing the context at that second level.

And this is kind of a conceptual model, simple model to show that.

And the need for information about community health inclusion.

So any community there's certain set of opportunities for healthy living.

Many of you might be working on across different communities in Oregon.

And these opportunities help shape the context of the factors that support healthy living.

What's not clear is, which are inclusive?

So we have a map here representing the different opportunities and all the dots are black because we

don't necessarily know which are inclusive.

Which would be good for someone with a disability to go to?

Which provide an opportunity for people with disability to have equal access to the same health and

wellness initiatives offered to other members of the community.

And so that's where the CHII comes in.

And the CHII helps identify both you assets and gaps and provide a picture of inclusion for

communities that can be used as a launching pad for pre70ive policy systems and environmental work.

And so now we see a map on the right here that shows red, yellow, and green dots representing

different levels of need for improvement inclusion.

And this is all kind of following the same logic of trying to change the context of inclusion to

make it easier to engage in healthy living.

So the way that the community health inclusion index, I am going to describe now, it's a multilevel

instrument whose goal is to provide local information on inclusion of healthy living resources in a

community.

It goes from different levels in terms of the macrocommunity level, down to the microcommunity

level, the physical environment.

It goes across sectors and these sectors, schools, workplaces, community institutions, health care

and the community at large, are previously developed by the CDC and try to fit in with other public

health initiatives that are already going on.

Within each sector there's specific types of venues and so it's organized around these different

venues related to physical activity, healthy eating, and community mobility.

Getting around one's community.

And then it's also organized ran specific domains.

These are kind of domains that we think of as defining inclusion really.

And they have to do with the built environment, equipment, programs, staff, and policy.

So an inclusive site would have inclusive aspects to all these different domains.

So the first piece of the assessment is that the macrocommunity assessment.

And this is kind of getting a broader look of inclusion in terms of these aspects of the community

that cut across the whole community.

Involves interactions with community representatives such as transportation officials, local

community planners, people in the local mayor's office that have knowledge of policies and programs

related to public transportation, community design policies, and community health promotion.

Next is the organizational assessment.

And this can be completed through an online survey which can be sent to community partners.

This is really a self evaluation that community organizations do to look at inclusive aspects of

nutrition and physical activity programming, to look at the extent to which staff are educated and

working with persons with disabilities, and to look at policies for both health promotion and

inclusion.

The third part is an on-site assessment where trained raters can go to a facility to examine the

external environment, the internal environment, and venues for physical activity, healthy eating,

and health care.

These are some examples of things that we look in terms of the outside, walking paths, and then on

the inside, looking at whether there is equipment that would be able to be used by someone with a

disability.

The community health inclusion index is part of a larger public health model.

Going to remind people if they can if they're not speaking to put their phones on muted.

Getting some different background noise.

Try to put your phone on mute.

It was just saying that the CHII, the community health inclusion index fits into a larger public

health model which is really about building inclusive healthy communities.

And whose goal is to try to change the context in order to reduce health disparities.

So this six-phase model is similar to other public health models.

It utilizes tools and resources along the way to ensure that people with disability are included in

each step.

And so if you are doing similar efforts, I think hopefully what you will get out of this is some

idea about how that can happen for your work in your local communities.

Phase 1 is the commitment phase.

And this is a really, really important phase in this work in terms of community health inclusion.

It's important to spend time in this phase.

And it's something that, this model is not necessarily the linear because that commitment can keep

coming up along the way.

This is a piece where it's a chance for you to get community organizations involved, and to view

themselves as an asset.

We found that it's critical to help organizations really kind of think beyond their initial ideas of

what disability is, because a lot of times it has to do with preconceptions about the ADA and

misconceptions that they are going to be sued P and so we want them to be compliant for sure but we

want them, we want to start the conversation as, you know, your organization is an asset to

increasing participation among people with disability.

The second phase is the CHII.

So the assessment phase where you are gathering information on community assets and areas of

improvement.

And then step 3 is where the coalition looks at the data that comes from the CHII, comes from the

assessments and prioritizes potential policy systems and environmental strategies.

And this phase there's another tool that is available through NCHPAD, the national center on health

physical activity, called the GRAIDs, guidelines, adaptation including disability.

I will explain a little bit more about what those are in the next slide.

But that's one of the tools that allows people to help at that important planning stage to make sure

that whatever it is they are planning is an inclusive strategy.

From there, kind of with some technical assistance from NCHPAD and NAACD, communities work towards

implementation.

Can go back to evaluation to see what has changed.

And then work towards dissemination to share their stories out to help get more community

organizations, maybe different sectors involved in their work.

And you can see how this can be a continual process.

So the GRAIDs that I was mentioning, these were developed as part of a disability research and

rehabilitation project led by Dr. James Rimmer at the University of Alabama at Birmingham to adopt a

set of guidelines used by the general population adapted for people with disability.

It used the 24 recommended community strategies to prevent obesity, which many people might be

familiar with.

And which are being used across communities in the U.S. for policy systems and environmental work.

And the process of adaptation included scoping reviews, input from expert panel and input from

individuals with disability.

And go into some more, the next phase of community planning and prioritization, this is where

communities, you really are getting your local public health coalitions involved to say, hey, what

have we learned from this assessment process?

And what are some potential strategies that we can use that are inclusive and that will help address

these health disparities that we see in our local communities?

And this is an important step, too, where having representation from the disability community for

prioritization and planning is really important as well.

Just to give you some examples from our pilot study that has this last year, how the -- somebody

needs to mute their line.

Thank you.

Just describing how the CHII and GRAIDs were used together.

So in one of our communities, what they found was that there were lower scores across nine of the

sites sampled related to exercise equipment.

Kind of looking at their community as a whole and doing these assessments, they found there was kind

of a real lack of inclusive exercise equipment.

And so part of their CAP goal, their community action plan goal, was to increase awareness of and

access to inclusive physical activity opportunities.

And then from that, they also used the GRAIDs tool that I mentioned to develop this objective around

increasing the number of sites with physical activity equipment inclusive to persons with

disabilities.

What we saw within our pilot testing, which involved, I didn't mention this, but involved 10

communities across five states, involved local coaches and state experts.

And I think what we saw was that there was this TWIN approach to inclusion to addressing health

disparities.

Where one approach is to have population-wide interventions that are inclusive of people with

disability.

And so some of the examples from the pilot community were trying to be involved with updating a

zoning policy to ensure that the zoning policy was inclusive so that it would help affect community

mobility and physical activity.

And access.

As well as an inclusive way finding system.

So as a way finding system was being developed for a community, the group was working to ensure that

strategies were in place to make sure it was inclusive.

There's also a need for targeted interventions to address the greatest burden for people with

disabilities.

Certain aspects that, of the environment or policies that are just not there yet like the exercise

equipment example that really do still need to be addressed in order for the same access to be

offered to people with disabilities as is offered to people without disability so just quickly,

going to wrap things up by talking about our future directions.

Our plan is to continue with community-level implementation.

We are working on developing a community health inclusion dashboard which would help communities to

be able to see all their data, visualize their results, kind of navigate all this information a

little better.

And be able to compare across communities as well.

We're also going to be rolling out a web-based training for the community health inclusion index as

well as the GRAIDs as well as other resources from the national center on health and physical

activity and disability.

We offer technical assistants for communities using these tools.

And we are also working on trying to make connections to community health needs assessments, as

they're assessments that occur every few years and we think that that's an important piece to

involving the CHII and some of the other resources as well.

So hopefully that gave you a bit of a context of the intersection of health and disability as well

some of the resources available through NCHPAD.

And now I don't know if, Angela, you were going to come back on or if I will turn it back over to

the next speaker.

>> Angela: Yeah, I will go ahead and pull up the next power point.

Then we will have Darrin joining us.

Thanks, Yochai.

That was valley informative.

I really appreciate it.

That's great.

OK.

Darrin, are you on?

>> Dr. Wing Sue: Yes, I am.

>> Angela: You will be able to advance the slides.

>> Dr. Wing Sue: Thank you very much.

I want to let everybody know, my name is Darrin Umbarger and I am from Pendleton, Oregon.

And I have multiple sclerosis so it's kind of a cognitive disease.

So a lot of times I will search for words and things like that.

That will be the time where I give you a little hint where you go.

Ugh, like that.

Bear with me and I will get through this.

What we are doing is reaching people with contributes through healthy communities.

Now, I was teamed up with a lady that was just perfect for this thing.

Because Taylor Smith, with the Umatilla County Health Department, she does things by the book.

She, all that, I am kind of the wandering guy that says, well, let's do this, this, this, and this.

So it worked out pretty good between us.

So let's go ahead with this thing.

I am in the roundup city of Pendleton.

OK.

Next.

Umatilla County, population, 76,720, 71% of the adults are overweight or obese.

14.5 of the population is living with a disability.

Umatilla County public health and Clearview Mediation and disability resource center was the people

doing this.

I want to let you know, I am a wheelchair user myself.

Next, the EOCCO, which is Eastern Oregon coordinated care organization and GOBHI, greater Oregon

health, Behavioral Health agreed to fully fund a memberships to our local gym, the RAC, which is a

racquetball club, a gymnasium and stuff for 40% of the Medicaid population for one year.

This is just a test to see how this will do.

If it works good, then they're going to be doing it for other years.

So it's just a very beginning of it.

They have put in adaptive equipment.

A lot of the stuff that they already had they didn't really realize that it was for people with

disabilities and wheelchair users and stuff like that.

So it was just a matter of moving it to a spot where everybody can get on to it instead of jabbing

it in between other equipment.

Environmental changes and success, the Pendleton provides -- construction at the local parks to

enhance a path of travel with new sidewalks and parking lots to covered patio areas.

So they were asphalt and they were really hard to run, go through and everything.

It was really hard.

But it ended up being very well.

Installation of wheelchair charging stations.

Now, the charging stations for wheelchairs, it was one of the things that was, this whole thing that

we sat down and talked about, what was the most scariest thing about going into your community in a

wheelchair?

Well, one thing is getting stuck in a wheelchair.

You just can't get up and jump out of there.

And that's being changed by curb cuts and stuff like that.

But the other one is having your batteries go dead.

Because then you're just sitting there wherever it dies, and you have no chance of getting out.

So we figured out the best way to get people involved in the community is have certain, well, we

have our parks in Pendleton, Oregon.

Eight of our parks have wheelchair charging stations in them and stuff.

So the Pendleton parks are doing awesome with that.

Three of these are in the local casino.

In Pendleton.

And two are being installed at the Pendleton Aquatic Center.

So for Pendleton almost has 17,000 people.

So it's very good for this area.

To have that many chargings stations up.

Infrastructure, here is the points of travel in the parks to the covered areas now.

They are very clean and goes right to it without roots and everything else having a problem.

Here's our covered area in the park.

And you can see up there is a wheelchair charging station inside the covered area.

So people with disabilities can enjoy the outdoor picnic area with their family.

There's our charging stations.

The next one will be, there it is.

Right there.

So the wheelchair charging station will charge 90% of the wheelchairs.

And on the other side they have a plug-in so if you have an on board charger, they can plug right

straight into 110.

And it's very universal for everywhere.

So-so they're easy plug and play system right now.

If there's any questions, there's me and my address and all that kind of stuff.

I think that's it.

>> Angela: Thanks, Darrin.

>> Dr. Wing Sue: You bet.

>> Angela: Thank you so much.

I am going to have Mac join us.

>> Mac: Yeah.

Great.

Thanks, Angela.

All right.

So I am going to go through quickly so similarly to Darrin.

We went through a similar process, kind of the process that Yochai was talking about at the

beginning of the call.

In Benton County, we were funded to do similar work.

We started off meeting with our community coalition of disability advocates to get an idea of where

to do assessment work in our community.

And so we had an excited group and we ended up doing 17 different assessments all around Benton

County.

So we did assessments in some rural areas and some within the City of Corvallis.

Everything up and down and in between.

And after we did kind of 17 different assessments, we settled on kind of three main areas to do our

work moving forward.

And so the first one here is at the Monroe Community Library.

This is in a rural part of our County, the south part of Benton County.

This was identified at the Monroe library was even though it's a brand-new library built in 2013, a

beautiful space but it unfortunately doesn't have a power assist door.

It doesn't have a great way to get kind of from the parking lot kind of inside the disability

parking is pretty far away from the front door.

And so we identified trying to move that parking closer.

And then also to come up with some funding to be able to allow access.

And especially in this rural community, there aren't a lot of community assets in Monroe.

So making sure that the facilities that do exist are accessible to everyone.

And then the second piece of work that we identified was at SamFit.

It's a series of gyms that are actually funded kind of run through our hospital system, through

Samaritan tan health services.

And they were actually a great partner.

We did a couple of different assessments.

Two of their different gyms.

Really we identified this one partly as a way to highlight some of the great work that we already

are doing.

They have trainers on site that do special kind of special adaptive work with, for people with

disabilities.

And they have some equipment that they are able to use if somebody is perhaps in a wheelchair or

disabled.

That they can use at the facility.

But what we identified to kind of continue to improve there is to add healthy low sodium options in

the vending machines to make sure healthy food is available.

And the other is to come up with a plan sort of ongoing.

Because they're constantly buying new equipment at their gym.

But to have kind of a procedure in place that they will be able to, as they purchase new equipment,

to make sure the equipment they are buying is adaptable and accessible for everybody.

And then kind of the main project that we have worked on is on Second Street in downtown Corvallis.

And just kind of a brief piece of history on that.

We did one of our 17 assessments we did at a theater in downtown Corvallis, the Majestic Theater.

It's almost 100 years old.

And it's kind of a community theater.

And we kind of went into it thinking, wow, this is kind of an older place.

Maybe this will be a place we will see a number of issues.

And they have actually done a great job on the inside of kind of retrofitting as much as possible.

Kind of allowing for people with disabilities to get around and making sure that the bathrooms and

different areas are accessible.

But part of the CHII assessment and part of what we found when we did the assessment is that

actually the accessibility on the outside wasn't great.

If you are somebody, again, perhaps in a he'll chair who or somebody who has a Walker, has

difficulty getting around and you are coming to a show, at the Majestic Theater, there isn't a lot

of parking, a lot of accessibility to the building itself from the outside.

And so we kind of recognized that and as we dug into the project a little further, we found that it

wasn't just an issue at this one theater but really kind of our whole kind of downtown corridor in

the city, a lot of the businesses don't have great accessibility.

And so we are lucky enough here in Corvallis to have Oregon State University as community partner.

And so we were able to partner with a civil engineering class at Oregon State University.

A lot of this work isn't necessarily part of their everyday, isn't necessarily in their wheelhouse

but the students were excited and the professor really jumped in to help us out.

And really what they did was they kind of took our beginning assessment and took off running with

it.

After we identified with them what some of the issues are in terms of accessibility.

They were able to come up with a whole set of recommendations, not just for this area outside

the Majestic Theater, but all of downtown Corvallis starting off with accessibility buy not making

it, we are really reaching the all of the population in Corvallis.

As it is in a lot of communities throughout Oregon and all over the country, we have a quickly

growing aging population in Corvallis.

And so really the more that we can make our downtown more accessible for people with disabilities,

we're making it a lot more accessible for everybody at the same time.

And I will go through a little bit of their recommendations here.

But just as a kind of broad stroke here, they gave this presentation a couple of months ago.

This is the, the students did, to kind of members of our city council and our downtown advisory

board people were part of different advisory boards for the Stu.

Public works staff, a number of interested community members.

And then they kind of broke recommendations that they came up with into kind of small, short to

medium material and long-term improvement.

So low hanging fruit and some if you were able to come up with millions of dollars for a project,

kind of a best case scenario.

So again, one of the things they highlighted was that there are almost 400 mark parking stalls in

the downtown area in Corvallis.

And only 13 of them are ADA stalls or handicap stalls.

And so there was only one on all of Second Street, the main downtown street in Corvallis.

Only one ADA stall on the entire street.

This is trick.

One thing we found is there are really clear standards for kind of putting in a new business, if you

are putting in a new Target or Wal-Mart.

There's a pretty clear standard on how many ADA parking stalls you are required to provide.

It's a little more tricky when it comes to a downtown area where you have a number of businesses

that are kind of moo moving and changing all the time.

And it was really interesting that even city officials weren't quite sure exactly what the standard

was that they were supposed to meet.

And so as part of this project we were able to make some recommendations to increase the number of

stalls.

And then also kind of relocate the number of the stalls that do exist that maybe there are some

stalls in the downtown area but maybe they are not in areas that really would help people the most.

And so kind of the best example of that is this picture here.

This is kind of an aerial view of the post office in Corvallis.

And you can see on the left is our existing condition where you have an access ramp on the west side

of the building.

But the ADA, the accessible stalls are on the north side of the building.

So kind of one of those low hanging fruit recommendations, just to move the stalls.

Kind of a really simple solution.

And one that would make a lot of sense and make sort of public important resource access Sybil to

people.

A number of recommendations like that.

Low hanging fruit.

Part of their longer term recommendations was that, really looking at again sort of the top picture,

is kind of the existing condition.

This is what Second Street looks like now in Corvallis.

It's a one-way street with two lanes going one way.

What they recommended was changing it to a one-lane street with angled back-in parking and allowing

more room for, to have a cycle track on the street.

Really encouraging overall kind of more walkable, bikeable downtown as opposed to one that's more

car oriented.

This is with an eye towards people with disabilities but certainly in terms of the community at

large and how do we promote healthier active transportation in our downtown.

And then over time this is something that could really appeal to businesses as well.

And I think sort of making that case that as people slow down, they're not driving down in their

car, it's a great thing for business.

And that your people are walking down the street, they're biking down street, they are more likely

to stop in your business.

Those are some of the larger recommendations.

And then just really quickly some of our successes and challenges.

Again, we went through that kind of process that Yochai was describing.

We were able to create a number of new community partnerships.

This great connection we have with Oregon State has grown.

This is a class we are going to continue to work with, continue to implement this project.

Being able to create awareness in the community.

Again, with our especially with people at the City around that downtown parking project.

So making sure that as public works or different entities within the city are moving forward with

projects they are as inclusive as they can for people with disabilities.

Again, we have been creating all kinds of ideas that weren't in our original plan.

And then expanding on established County and regional goals for walkability.

And so those are some of our real successes.

A clutch our challenges coming out of it.

Just the assessments, I think we bit off more than we can chew doing 17 different assessments.

That was quite a bit.

Following up with all the different people that had done this assessment work.

Again, there's some stakeholders we weren't quite able to get buy-in.

Some places they did assessments, in the end weren't interested in moving forward with changes or

didn't have the funding to.

And then again what was difficult because we had so many assessments it was hard to narrow our focus

to just three goals.

But all that being said it's been a really, really positive project and one that kind of combining

our forces of disability advocates in the community with our healthy community staff here at the

Health Department has been a great partnership.

And one that we really are hopeful we are going to continue for quite a while now.

And so that's all that I have for now.

>> Angela: Thanks, Mac.

That was a great overview.

Thank you so much.

All right.

Joseph.

Joseph is going to share about us what's happening in Oregon with some continuation of these pilot

projects and others.

>> Joseph: Thank you, Angela.

So like Angela said, from the projects that Darrin and Mac spoke of, using great success stories, so

we just try to figure out a way we could expand this and keep the project going in the State of

Oregon.

So one way we have done that is to try to offer it to disability service advisory councils

throughout the state.

And as you see here, the disability service advisory councils, their purpose is to advise, educate

and advocate the local Aging and People with Disabilities offices and/or the area agencies to the

Department of Human Services on policy, programs, and services that consumers receive.

And to also advise and educate the community on issues concerning the rights and needs of people

with disabilities.

So engaging and supporting DSAC members, like they said, we can get help from NCHPAD and Yochai's

group has been great for providing information that we need and templates and materials.

The very first step, though, is we go out to a DSAC that's interesting and we have a meeting with

them.

Introduce the project, a very high-level overview.

Go to -- built rapport.

Answer any questions and start sharing some of the materials from the CHII and then review the next

steps.

If they show interest it and they continue wanting to learn more, we have a second meeting.

And that meeting is to help them start planning for a community wide meeting and provide the

templates of being able to coordinate and implement that community meeting.

And then during that, they have a meeting preparation time.

They will complete the CHII macro-assessment that Yochai spoke of.

They will disseminate community health participation survey to other people with disabilities and

consumers of Medicaid services in their community.

Just try to get an assessment and a feel for the community from people that actually are within it

on a day-to-day basis.

Then they will start outreach into the news and social media to start making sure everyone is aware

in the community that this meeting is going to happen.

And then they will start inviting their attendees.

Hopefully out of those attendees will be some of their coalition members.

And then they will have the community meeting.

And they will increase the visibility through news media and social media.

They will hopefully be able to recruit coalition members, as I said, through the attendees of this

meeting.

And hopefully they will even be able to recruit some of the potential site locations that would

participate in the assessment.

This is a photo of the DSAC located in Marion County.

And this is their first meeting.

So they are just learning what the CHII assessments and the inclusion project is all about.

And this is a photo of the DSAC in Clackamas County.

This is their meeting number two.

So they are starting to receive some of the materials.

You will see some of them holding the assessment books and looking through it.

They're also discussing what the next steps are to start planning their community meeting.

And why this approach?

We felt like this is a good approach to start building team strength, building team strength and

unity internally for the DSAC members.

It also shows the DSAC as an effective and very impactful organization and it builds rapport with

their community.

It can create and enhance collaborative relationships and community partnerships.

So while the DSAC -- allows the DSAC to promote, advocate for, and include influence changes in

their communities, creating opportunities for healthy living for all people.

It's also access to training and technical assistance from the national partners, which makes the

process completely easy for these kind of groups.

Builds foundation for short and long-term changes in their community.

And it's a less formal and less legal approach to change.

The way we've been trying to communicate it through the councils is that it's an informational and

educational piece for their communities and themselves.

And to not look at it as ADA enforcement.

We are not going in saying, hey, these are the gaps you have in your location, and we're going to

force you to make these changes.

We're just doing it as informational and educational.

And then as you heard earlier, it's a better option if they want to proceed with making changes to

better their location.

And then also if you want to join the efforts here in Oregon, you can contact and/or join your local

DSAC councils.

Or contact myself.

We also want to offer it to be a site to be assessed for accessibility.

If you can, spread the word and encourage participation in your communities.

Some of the areas throughout the State of Oregon does not currently have a disability service

advisory council.

So if you know that your area is one of those, and you still would like your community to

participate, still contact me.

We can get things up and going in your area.

And then this is my contact information along with Angela's and one of her colleagues, West.

That is pretty much all I have.

>> Angela: Great.

Thanks, Joseph.

And thanks again to all of our presenters.

We really appreciate it.

So we have about 15 minutes.

Everyone did great staying on time.

To answer some questions.

So you can either type in your question in the chat or if you would like you can unmute your phone

and ask any of the presenters a question.

I see a couple people typing.

Are there statistics available that outline the financial impact on state and local governments due

to increased health issues for people with disabilities?

Yochai, gym to go ask you this.

We mostly work with some other data sources.

Are you aware of any data sources that address that?

>> Yochai: No.

I feel like I may have seen some specific research studies.

But not any specific data sets that do that.

Very important piece in terms of all this, in terms of kind of gathering evidence and gathering

strengths to this motivation and these local initiatives for sure.

>> Angela: Yeah.

And the City of Eugene, too, I will look and see.

I will talk to some of our epidemiologists here who have done research with our coordinated care

associations to see if they have something helpful towards your question, too.

I can double-check that.

I am not aware of any.

Just like Yochai said.

So Joseph, I will let you take the next question.

Is there a DSAC in Tillamook County?

>> Joseph: There is not one specifically in Tillamook County but the State of Oregon is broke up

into that they call 16 district or regions.

And Tillamook County is included in the merge of district 1 and district 3.

So the DSAC that is located in Marion County represents all of the counties that are in districts 1

and 3.

So they try to outreach to Tillamook and Clatsop and Yamhill and Marion.

There's one other one I'm drawing a blank at now.

To make sure that they have representation.

So if you are interested in trying to contact them and join them, just let me know and I can put you

in contact with that person.

>> Angela: Thanks, Joseph.

Do you see the next question, Harney County?

Another question.

>> Joseph: Let me see.

There is not one currently in Harney County.

I have been in conversation with the district manager for the two districts that are out there, 13

and 14.

And she is interested in trying to get one started out there.

But she is wanting to hear from the community, make sure there is interest before she goes through

the process of creating it again.

>> Angela: Wonderful.

OK.

Joseph, can you see those questions for you?

Another one from Jolene about the person in Douglas County?

>> Joseph: So answering what is that person's name, it is Sandy, the district manager for 13 and 14.

Then Douglas County, let me see.

Yes, there is one in Douglas County.

I think they meet in the roseburg office.

And I also see Kimberly's email so I will email her that information as soon as we are finished

here.

>> Angela: Great.

Any other questions about the project or any overview questions that you would like clarification

about?

From either Benton County, Umatilla County or Yochai?

You can also unmute your phone and come on if that works for you.

What about an says for people with hearing disabilities?

What the CHII, I don't know, Yochai, if you want to talk about.

Carol is asking about when, tell me if I am, Carol, if I am clarifying right.

If you are asking about does the CHII assessment address access issues and needs for people with

hearing impairments?

OK.

>> Yochai: Yes.

The CHII was designed to be cross disability.

So there's certain specific pieces that get at program materials and staff training that would

relate to people with hearing difficulties.

As well as the GRAIDs resource that I mentioned also gets at specific strategies for planning policy

systems and environments to make sure that they are inclusive.

That might be programmatic as well.

And sometimes related to health care as well.

Health care is one of the sectors.

Kind of the importance of having an interpreter as part of someone's health care experience is part

of that example of that.

>> I would like to add, too, if someone that is deaf and/or hard of hearing and wants to join their

DSAC or participate in these community meetings, I also have a colleague here in the county that I

work for that helps coordinate ASL interpretation and so they can contact me and I will forward

their name to my colleague and we can get that set up.

>> Angela: Great.

Thanks.

Are there any other questions?

Again, I will be sending out a link to the recording of this along with an evaluation.

And then if anyone would like the slides, just separately, and not having to go into the recording,

if you email me with that request, I can send you the power point presentations if anyone is

interested.

Well, you can always email me, too, if you come up with a question later.

I can direct you to the speakers if you weren't able to jot down their contact information.

I would be more than happy to forward any questions that you may have later.

That you come up with.

>> Yochai: I would also like to, kind of point out again that I think one of the key messages is

that a lot of the resources and kind of local community input from Joseph and the DSACs is ready to

go.

And it's something that whatever, I talked about this model for community change that in some ways,

people might be worried, where do you fit in the model?

Or do you have to start at the beginning?

I would encourage people to kind of consider wherever they are starting out at and wherever they are

at already, and thinking about trying out, how can we get inclusion to be a part of whatever it is

we are working on, whatever initiative related to policy systems, and environmental changes.

And how can I use these resources to help make that inclusive.

And NCHPAD has kind of this team of expert information specialists that want to work with you and

want to help provide technical assistance to make that a reality.

At the national level.

And then Joseph and Angela are there at the State and community level as well.

>> Angela: Yeah.

Thanks, Yochai, for that clarification and summary.

And I just want to just second that the materials that Yochai has put together again with NCHPAD is

very well packaged.

You don't have to create anything.

Start off from scratch.

It's just a process that you implement.

And all the materials are handed to you well packaged.

So they've done wonder FM work and it's evidence-based and it's really a neat program.

Like Yochai said you get lots of technical support at the national level.

Joseph, West and I are available at the local level to provide technical assistance and support.

>> Yochai: I was going to say as well as connecting to Mac or Darrin for any specifics about what

they learned, they can be I am sure a very useful peer support and help to share what they learned

as well and what worked well.

>> Angela: Definitely.

Yes, thank you.

And then, Jean, your question about resources for people who experience intellectual disabilities,

if you are asking for anything more general, if you want to email me, I can see about that.

But, again, I think the CHII does cover broadly all disabilities.

And looking at their needs and access issues can be and the barriers and things.

So if that's your question specifically for this project, it does look at that as well.

>> Yochai: Same with the different NCHPAD resources that would be available to share and the

strategies.

Definitely would involve intellectual disability as well.

>> Angela: I am going to put their website in here.

That is great.

Am I getting this right?

Is that right there?

Did I type that?

>> Yochai: I think it's an H and the P.

>> Angela: Ignore mine.

Go with Yochai's.

Sorry about that.

All right.

Well, if there aren't any more questions, I want to again thank all of our presenters and I want to

thank everyone who joined.

Really appreciate your time today.

And we hope to hear from you.

So anything else anyone else wants to say?

OK.

Thanks, everyone.

Have a great day.