Georgia Apex Program Explained for Students (Easy Guide)

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Georgia Apex Program The Georgia Apex Program is a school-based mental health (SBMH) program designed and funded by the Office of Children, Young Adults & Families at the Georgia Department of Behavioral Health and Developmental Disabilities. DBHDD contracts with the Center of Excellence for Children’s Behavioral Health to evaluate the program and provide technical assistance. Three-Tiered Approach to SBMH Examples include: • Individual therapy • Crisis intervention • Behavioral assessment Examples include: • Group therapy • Targeted screening • Skills training Examples include: • Mental Health First Aid training • Mental health awareness events • Anti-bullying campaigns Adapted from: Bieber. B. Hotchkiss. H. & Palmer, B. (2007). A Guide to School Mental Health Services. Denver CO: Colorado Department of Education. Apex Journey T h e Department of Behavioral Health Developmental a n d .859 Disabilities provides fundingto partnering mental health provider organizations. EmbeAddpedx t h e r a p i s t s edivorp mental health servicest o studentsi nxeAp schools. D•B.H.D:D Partnering provider organizations provide data and feedback tot h e Centero f Excellence f o rChildren’s Behavioral Healthat Georgia Health Policy Center’ T h e Center of Excellence ofr Children’s BeHheaavlithoral evaluates theprovideddata and reports findingst oDBHDD to informt h e agencyo n community needs. Apex schools romal Partnering Apex 2 dachand fedback t othe Centerof Excellence for Children’s Behavioral Health Youth a n d their familiesp r o v i d edata and feedback tothe Center of Excellence for Children’s Behavioral Health ApexCommunityPartnerships Mental health provider organizations Partnperionvgider organizations embed therapists i n t oApex schools. CENTER OF EXCELLENCE FOR Youth and familes CHILDREN’S BEHAVIORAL HEALTH integratingresearch,policy,a n dpractice Apex Key Contributors Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) Apex School Partners Youth and Families DBHDD Community-Based Mental Health Providers Apex Therapists Center of Excellence for Children’s Behavioral Health Georgia Department of Education State agency with oversight of public mental health system for children, youth, and adults; funds Apex programming. K-12 public schools and school districts implementing programming. Direct beneficiaries and active participants of the Georgia Apex Program. Community-based mental health agencies throughout the state that place mental health professionals in Apex schools. Mental health professionals embedded in their community schools. University-based research center that conducts program evaluation and provides technical assistance support to the community-based mental health providers. State agency that provides publicly available data regarding the educational outcomes and well-being of students. Apex Programmatic Goals Detection: Provide early detection of child and adolescent behavioral health needs. Access: Improve access to mental health services for children and youth. Coordination: Sustain increased coordination between Georgia’s community mental health providers and local schools and school districts in their service areas. Apex Evaluation Goals Demonstrate the program’s ability to achieve intended outcomes Identify facilitators and barriers to sustainability and replication Provide additional information and support Apex partners and families Report Icons Key Throughout the presentation, you will see icons in the corner of each slide. These icons correspond to the programmatic or evaluation findings that the slide is reporting. Detection (Programmatic): These slides are about early detection. Access (Programmatic): These slides report on access to care. Coordination (Programmatic): These slides focus on coordination of care. Barriers and Facilitators (Evaluation): These slides report on facilitators and barriers. Outcomes (Evaluation): These slides report on intended outcomes. Provide Info (Evaluation): These slides provide insight to Apex partners and families. Apex Year 9 Measures Data Collection Tool Monthly Progress Report (MPR) Yearly Therapist Survey (YTS) Information Collected School and service data School service and provider data (engagement across tiers, diagnoses, staffing) Therapist satisfaction and facilitators and barriers to applying the Apex model Respondent(s) Apex provider agency Apex provider agency Frequency Monthly (July 2023-June 2024) Year End Apex Report (YEAR) Yearly (July 2024) Twice yearly (November 2023 and June 2024) Mental Health Planning and Evaluation Template (MHPET) Collaboration between Apex providers and school partners Apex provider agency Apex therapist Yearly (June-July 2024) Child and Adolescents Needs and Strengths (CANS) Caregiver Survey and Caregiver Interviews Level of functioning, exposure to trauma, needs, and strengths Caregiver perspective on child’s mental health progress, self- efficacy Facilitators and barriers to implementation of SBMH services Apex provider agency Caregivers Apex provider/school partners (school and/or district level) Intake; every 90 days until discharge Ongoing Yearly (March-June 2024) School Partner/Provider Focus Group Apex: By the Numbers (2023-2024) Characteristics of the Georgia Apex Program Georgia Apex Program Services by School Level School Level Number of Apex Schools Percentage of Total Services Apex Schools Provided Elementary 347 43% 98,273 Middle 195 24% 59,379 High 209 26% 65,949 Alternative 40 5% 4,092 Other* 17 2% 3,838 Total 808 100% 231,531 * Other includes schools with more than one designation (e.g., sixth to 12th grade), magnet schools, and preschools. Source: MPR 2023-2024 Georgia Apex Program Students by Grade Middle and early high school serve the highest percentage of Apex students 11% 10% 6% 5% 3% 6% 7% 7% 0.60% Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Source: YEAR 2024 8% 8% 9% 9% 9% Percentage of Apex Students per Grade Georgia Apex Program Regional Representation Across the State ● 6 regions ● 124 counties ● 133 school districts ● 808 schools Source: MPR 2023-2024 Geographic Areas of Apex Schools City: inside principal city Suburb: outside principal city 12% 18% 23% 47% but inside urban area 47% Town: inside urban cluster but outside urban area Rural: outside urban cluster and urban area of Apex schools are in rural areas Designations from National Center for Education Statistics (NCES) 2023 Source: MPR 2023-2024, Master List 2023-2024 Georgia Apex Program Schools and Providers in Year 9 30 behavioral health provider agencies 468 Apex staff from provider agencies 808 schools involved* in Apex 750 schools reporting engaged** partnerships *Involved means submitting one or more months of data in Year 9 **Engaged means schools submitted three or more months of data in Year 9 Source: MPR 2023- 2024 and YEAR 2024 Georgia Apex Program Students in Year 9 6,328 students received first- time Apex services 31,490 referrals for school-based mental health made 16,121 students served by the Georgia Apex Program Source: MPR 2023-2024 and YEAR 2024 Georgia Apex Program Services in Year 9 15,792 Tier 1 services* provided 20,151 195,588 Tier 2 services Tier 3 services provided provided * Note: The Tier 1 number refers to the number of universal prevention activities provided in Apex schools. The number of students impacted would be closer to the Apex school enrollment number of 584,842 students. Source: MPR 2023-2024 231,531 services provided by the Georgia Apex Program in Year 9 26% increase from Year 8 Source: MPR 2023-2024 Georgia Apex Program Service Settings in Year 9 121,356 services provided in the school 37,581 services provided via telehealth 8,946 services provided in the home Source: MPR 2023-2024 Access Improve access to mental health services for children and youth Telehealth Services 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 Source: MPR 2023-2024 4,220 Telehealth services peak in the summer, ensuring continuity of care for many students 3,226 2,994 4,158 3,455 Ju l Aug Sep Oct Nov Dec Jan Feb Mar Apr May Ju n 3,307 3,248 2,674 2,583 2,227 2,873 2,616 2023-2024 School Year Number of Telehealth Services Reported Telehealth services increased by 9% from Year 8 16,121 students served by the Georgia Apex Program in Year 9 2% increase from Year 8 Source: YEAR 2023-2024 Evidence-Based Practices Used Most Frequently by Apex Provider Agencies Experiential therapy Narrative therapy Art therapy Solution-focused (brief) therapy Dialectical behavior therapy (DBT) Play therapy Motivational interviewing (MI) Mindfulness Trauma-focused CBT Cognitive behavioral therapy (CBT) Source: YEAR 2023-2024 18% 39% 46% 52% 61% 67% 73% 79% 82% Percent of Provider Agencies Reporting Use 100% Apex Payer Source Other Self-pay WellCare Amerigroup Familes 360 Other government PeachCare for Kids DBHDD fee-for-serivce Private insurance Charged to Apex grant Medicaid CareSource Amerigroup PeachState 108 Medicaid and care 121 96 66 242 560 563 management organizations (CMOs) accounted for 79% of billed students* 975 1,543 1,672 2,592 3,550 5,068 *Students can be billed to more than one payer source. Source: YEAR 2023-2024 Barriers to Mental Health Access Addressed by Apex Therapists Limited office hours Staff capacity Distance (i.e., mental health care prohibitively far away) Cost or financial Transportation Time (i.e., caregivers taking off work) 32% 33% Apex therapists reported that their role helped address these common 37% barriers to mental health care 43% 47% 62% Source: YEAR 2024 Coordination Sustain increased coordination between Georgia’s community mental health providers and local schools and school districts in their service areas Apex Therapists and Family Involvement 27% 55% Mental health staff have completed all trainings and accreditation Families and partners are involved in implementation of services Mental health activities have been developed with partner and family input 1 (not at all in place) 2 3 4 5 6 (fully in place) 24% 59% 26% 58% Source: MHPET 2023-2024 Apex Identification, Referral, and Assessment Staff uses data to inform response and outcome The mental health intake process is comprehensive while minimizing barriers to service Referrals are responded to swiftly There is a shared referral process in place Apex staff identify youth at risk for or presenting with behavioral or emotional difficulties 1 (not at all in place) 2 3 4 5 6 (fully in place) 16% 74% 18% 73% 20% 72% 15% 76% 18% 73% Source: MHPET 2023-2024 Apex Identification, Referral, and Assessment Treatment plans are reviewed and adjusted to meet student and family needs Treatment plans are uniformly completed and accurately match program services Psychiatric consultation is available to provider staff to assist in the assessment and treatment of youth Mental health activities and services are designed to meet the needs of diverse groups Mental health prevention and intervention services are based on evidence of positive impact 23% 67% 23% 70% 21% 64% 28% 57% 23% 61% 30% 47% A range of activities and services are provided for students in general and special education 1 (not at all in place) 2 3 4 5 6 (fully in place) Source: MHPET 2023-2024 Early Detection Provide early detection of child and adolescent behavioral health needs 31,490 total referrals for Apex services received in Year 9 43% increase from Year 8 Source: MPR 2023-2024 6,328 first-time Apex students served in Year 9 38% increase from Year 8 Source: MPR 2023-2024 Apex Referral Reasons Drugs and alcohol Positive health/wellness screening Sel f-h arm Grief/loss Suicide (ideation, attempt) Trauma Behavior (outside classroom) Academic performance issues Anx iety Classroom conduct Depression 1% 1% The top referral reasons are depression, anxiety, and behavior 12% 13% 13% 14% 15% 16% Source: YEAR 2023-2024 4% 5% 5% Apex Student Diagnoses Other neurodevelopmental disorders Bipolar-related disorders Other Conduct disorders Trauma or stressor-related disorders Adjustment disorder Anxiety disorder Depressive disorder Attention deficit hyperactivity disorder 1% 1% Attention deficit hyperactivity disorder was the top diagnosis — impacting classroom conduct and grades, two of the top referral reasons 4% 11% 11% 12% 13% Percent of Reported Diagnoses* *Students can have more than one diagnosis. 20,584 diagnoses were reported. 17% 28% Source: YEAR 2023-2024 Barriers and Facilitators Identify facilitators and barriers to sustainability and replication of the Apex Program 98% of provider agencies have experienced issues with a payer source Apex Payer Source Most commonly, private insurance was the most difficult payer source to bill. 67% of providers reported difficulty with private insurance 49% of providers reported difficulty with CMOs 9% of providers reported difficulty with Medicaid 21% of providers reported difficulty with another source Source: YEAR 2024 70% of provider agencies have experienced issues getting services reimbursed Apex Payer Source Most commonly, community support individual (CSI) services were the most difficult service to bill for or get reimbursed. 75% reported difficulty with CSI 35% reported difficulty with group therapy 35% 10% reported difficulty with reauthorizations reported difficulty with family therapy Source: YEAR 2024 Barriers to Staffing 94% of providers have experienced turnover in the past year Providers report that therapists have the highest rate of turnover. The most common reasons for leaving were workload and salary. 56% of providers reported therapist turnover 36% of providers reported community support individual turnover 68% of exiting staff reported workload as a reason for leaving 53% of exiting staff reported salary as a reason for leaving Source: YEAR 2024 Barriers to Providing Apex Services — School Level 82% 79% 79% or more of the 30 Apex provider agencies reported that one or more Apex therapists experienced difficulty with schools prioritizing time or space for service delivery Schools not prioritzing time Difficulty finding space in schools Difficulty with school staff/admin School policies Source: YEAR 2024 42% 33% Percentage of Providers Reporting Barriers to Providing Apex Services — Other Barriers 76% 73% 70% or more of the 30 Apex provider agencies reported that one or more Apex therapists were unable to provide services due to payer source issues or lack of family engagement Difficulty with payer source Lack of caregiver engagement Language barrier 9% COVID-19 30% Source: YEAR 2024 Percentage of Providers Reporting Tier 1 Facilitators and Barriers — as Reported by Apex Therapists Facilitators reported supportive school 35% administration 73% 48% 40% Source: YTS 2023-2024 reported supportive employer Barriers reported being unsure of Tier 1 needs at their school 28% reported adequate 24% resources provided by employer reported inadequate funding reported unsupportive school administration Tier 2 Facilitators and Barriers — as Reported by Apex Therapists 58% 48% 40% Facilitators reported supportive school 49% administration reported supportive 28% employer reported Tier 2 needs are clearly communicated by schools Barriers reported inadequate caregiver engagement reported inadequate funding 24% reported inadequate or no resources provided by schools Source: YTS 2024 Tier 3 Facilitators and Barriers — as Reported by Apex Therapists 70% 69% 58% Facilitators reported supportive school 62% administration reported supportive 24% employer reported adequate 22% resources provided by employer Barriers reported inadequate caregiver engagement reported inadequate funding/difficulty billing reported inadequate or no resources provided by schools Source: YTS 2024 Outcomes Demonstrate the program’s ability to achieve intended outcomes 1,524 students discharged due to completing treatment goals in Year 9 40% increase from Year 8 Source: MPR 2023-2024 Therapist Insights: Impact of Apex Services 54% 41% I feel my services have a positive impact on my students’ behavior outside the classroom. I feel my services have a positive impact on my students’ classroom conduct. I feel my services have a positive impact on my students’ academic functioning. Strongly disagree Disagree Agree Strongly agree 60% 36% 53% 40% Source: YTS 2024 Therapist Insights: Impact of Apex Services I feel my services have a positive impact on my students’ overall mental health. I feel my services have a positive impact on my students’ social-emotional health (e.g., getting along with their peers). I feel my services have a positive impact on my students’ functioning at home. Strongly disagree Disagree Agree Strongly agree 49% 49% 60% 37% 59% 30% Source: YTS 2024 Caregiver Survey: Child’s Mental Health Progress 81% of caregivers reported their child is better able to do things they want to do 78% of caregivers reported that their child gets along better with friends and other people 77% of caregivers reported that their child is better at handling daily life Source: Caregiver Survey 2023-2024 Caregiver Survey: Caregiver Satisfaction and Work Life 94% of caregivers reported being satisfied overall with the services their child has received 82% of caregivers reported being able to spend more time at work since their child can receive behavioral health services while at school 80% of caregivers reported being satisfied with their family life right now Source: Caregiver Survey 2023-2024 Caregiver Survey: Caregiver Efficacy 92% of caregivers reported that they have improved in their ability to advocate for the needs of their child 91% of caregivers reported that they know how to access appropriate resources for their child 88% of caregivers reported that they are more equipped to respond to their child’s symptoms Source: Caregiver Survey 2023-2024 Caregiver Insights “[My daughter is] able to better express herself or advocate for herself, sometimes. I mean, sometimes I still see her slump back into that old behavior. She’s able to self-recognize, OK, I’ve missed it here, or I’m shutting down. So those are the positive ones. And I think becoming just more comfortable with who she is.” “I like the fact that not only does the therapist communicate with me, she also communicates with the school therapist, and the school therapist communicates with them. So that if there’s some issue, there’s a network of people who are all looking out for [my son] at one time, versus [having] me just go to this building and wait for an appointment.” “I would say that I have really enjoyed the program. My daughter [has] been doing the program [for] three years now. Communication with the supervisor down to the therapist [is] wonderful. It’s a great program and I would recommend it to anybody that’s able to get it.” Source: Caregiver Interviews 2024 Additional Information Provide information to support Apex partners and families During the 2023-2024 school year, Apex therapists responded to: Apex Crisis Response Apex therapists are uniquely positioned to respond to mental health crises in the schools where they are embedded. 1,214 Apex students at Apex schools in acute crisis, a 10% increase from Year 8 530 Non-Apex students at Apex schools in acute crisis, a 16% increase from Year 8 Source: MPR 2023-2024 Provider Insights “What’s been helpful for me is my school gives me the master schedule so I know when things are happening … and being able to talk to teachers … checking in with the teacher and seeing when would be the best time. … So I think just that constant communication is really helpful.” “[Receiving mental health services is] more acceptable in the student population, the parents, everybody. ” “The fact that my school gave me a shirt that everyone wears on certain days or they include me in the lunches and stuff like that. I really appreciate even those small things that [help] me feel embedded in the school and a part of the school as well.” “[Apex funding has] allowed me to see more children due to them either not having insurance or having a private insurance that we were waiting to be dropped. So it just opened up more kids for me to see.” Source: Provider Focus Groups 2024 Provider Insights “We’ve been able to see how significant it is to be able to go into the schools, because due to some of the areas, parents don’t have the ability to come in for sessions, individual or family group. So having that ability to be able to render services within the school system is crucial to a lot of parents.” “Hey, the kids get better. I mean, that’s the cool thing. … A little self-esteem is built there and the child is passing in school and their relationships in the classroom improve, relationships with the teachers improve, relationships at home improve.” “But oftentimes students will let their friends know that they are receiving counseling services and sometimes that leads to self-referrals being made. The kids, they want to come and make a referral themselves and talk about things that they have going on.” “Having Apex counselors in the school has increased the visibility of mental health therapy. … Kids see you in the hallway and they’re like, ‘That’s my counselor. You need to go see her.’ … I love that they’re so comfortable having those conversations with each other, and they check on their friends.” Source: Provider Focus Groups 2024 School Partner Insights “They had somebody that they felt was an advocate that they could talk to other than just administration, school counselor type. So, they really appreciate having that third-party person to go to and they felt safe, and it was a good environment for them.” “We saw that parents got heavily involved in the process, which made it better for the student. Apex was able to bring some of our parents to see how everything that’s going on in their life can affect education. One kid is going on to the next grade, but it was really rough for two years until [he] was able to break down the barriers so the parents can open up and the student opened up and he’s on a good path now.” “One of our therapists that covers one of our middle schools, even though we’re out for school, she still makes sure that she’s available for our students and their families even in the summer and during the school breaks. When we’re out for fall break or spring break, she still makes herself available. So that means a lot. And that helps us out a lot as well overall within our schools.” “One thing that we’ve done this summer is we’ve opened up one of our schools, even though we’re closed down, so the therapist can come in and still provide services in our county.” Source: School partner focus groups 2024 School Partner Insights “His behavior changed a lot, which impacted … it made the classroom more positive. So, I can’t say that for all students, but for that one particular kid, it really did help with the classroom environment.” “We’ve had some successes where we’ve had some students who have become more academically successful, because they’ve been able to sit and focus more with the strategies [the therapist has] given them. And just being able to have somebody who’s not their teacher, who’s not their parent, who is somebody on a consistent basis who can sit and listen to them, is really just helpful.” “We’re fairly rural so having Apex here has helped us give the opportunity for our families to have mental health services. Otherwise, they wouldn’t be able to with work schedules and everything else. We’ve seen several kids who have academically grown over the last year because they’ve been able to have access to mental health services through Apex.” “I did have one student in particular that I referred back in March for some anxiety and some explosive behaviors that she was having, and she actually came to me and thanked me for the referral and just said, we’re working on coping skills. And she was able to communicate that stuff with me and she was a seventh-grade student.” Source: School partner focus groups 2024 Apex Year 9 Recap and Considerations for Year 10 Apex Year 9 Recap • The Georgia Apex Program provided 195,588 services in Year 9. • 16,121 students were served by the Georgia Apex Program. • The Georgia Apex Program served 6,328 first- time students. • Providers reported Apex improving access to care. • Staffing is one of the biggest challenges facing Apex. Considerations for Apex Year 10 ● Enhance telehealth integration o Expand telehealth services and improve accessibility o Measure impact on service delivery and client outcomes o Optimize staff utilization, reduce burnout, and increase job satisfaction through improved embedding and community connections ● Strengthen Apex workforce o Improve staff retention through increased resources/funding ● Expand program reach and impact o Increase the number of schools and students served o Measure the individual and collective impact of the program answer the following questions 2. Overview/Executive Summary: Description of the initiative, program, or organization, including its aims and objectives, the purpose and application of evaluation, the users and uses of the evaluation plan (approach, stages, design, and methods), the actual activities undertaken, and any resulting conclusions (if applicable). 1 page 3. Problem background and justification based on a literature review and community needs assessment. What does the scientific literature indicate about the problem being addressed and the intervention strategies employed? Include relevant citations. Did you conduct a community or needs assessment, or have others done one? Describe what was done and what was learned. What else would you have liked to see included in a community or needs assessment? Could this still be done? If so, make some recommendations for the organization. Address because the initiative is needed. Is it addressing a public health concern? Are limited programs available? Why is this evaluation needed? 2-4 pages 4. Initiative/program background: Describe the initiative being evaluated. What are the objectives of the initiative? Are they clearly described? If not, please indicate how you have (or would like to) modify them. Describe the theoretical framework guiding the initiative. Describe the actual initiative. Use a combination of text and figures, and tables. 2-4 pages 5. Logic Model: Include a logic model of the initiative that incorporates evaluation activities. This piece is crucial as it guides the work to be done. The diagram itself should be 1 page. Additional text (up to 1 page) may be included. 6. Evaluation plan (and any results if collected): Include the following components in this section: a) Introduce the evaluation plan. Indicate the aims of the evaluation, the stages of evaluation (e.g., process, impact) if only a piece of a more extensive program is being evaluated, who the stakeholders are and how they have been involved, and any other information to introduce the evaluation plan. (1-2 pages) b) Evaluation design and justification. Indicate what type of evaluation design (e.g., quasi-experimental, pre-post-post design with assessments at baseline, upon completion of initiative, and at 3 months follow-up) Is this design being used, and why was it chosen? Describe the sample and justify why these individuals and the number of participants were selected. It is optional to include a statistical justification for your sample size. (Up to 1 page) c) Timeline and description of data collection plan. Include a timeline with the specific tasks to be done and when they will be done. Use a table or figure and accompanying text. (1-2 pages) d) Describe the evaluation process and tools. Please include a description of the process evaluation to be implemented and its components. Include both qualitative and quantitative components and describe them. Indicate why it is essential (or not) to emphasize the process evaluation significantly. All tools should be briefly described in a short table with some text explaining the tools, why they were selected or developed, and any available psychometrics. Additionally, essential tools should be included in an appendix. Students should develop at least some of the tools using principles discussed in class, although some items can be taken (and adapted) from existing tools. 2-4 pages + surveys) e) Describe the impact and outcome evaluation tools. Please include a description of the impact/outcome evaluation to be implemented and its components. Include both qualitative and quantitative components and describe them. All tools should be briefly described in a short table with some text explaining the tools, why they were selected or developed, and any available psychometrics. Additionally, essential tools should be included in an appendix. Students should develop at least some of the tools using principles discussed in class, although some items can be taken (and adapted) from existing tools. 2-4 pages + surveys f) Findings and presentation. Prepare tables and figures for the “data’ presentation. Since no actual data collection will be done, prepare “dummy” or “skeleton” tables that show how your results will be presented. Additionally, text may be used to describe the “data” presented. A clear plan for a future presentation will be beneficial and help plan the evaluation. 2-5 pages 7. Budget and Budget Justification: Include a budget (in tabular format) and a detailed budget justification that explains the underlying details. Try to be realistic about the costs involved. 1-2 pages 8. What has been learned through this process? Recommendations for next steps: Describe what was learned from this process and provide recommendations for the organization on how to conduct the evaluation effectively and learn from the results. 1-2 pages 9. Final reflections: Given the reality of working with real-life programs, students may encounter different situations. For example, in some instances, programs will be in their early stages, whereas in other instances, programs may be fully operational and ready for evaluation. Students may also find that some initiatives have fine-tuned theory-based objectives while others do not. In some cases, a needs or community assessment may have been conducted; in others, this has not been done. Given that programs may be at different stages and the semester progresses quickly, students’ ability to plan an evaluation will also vary. While all these situations can make things a bit messy, experiencing real-life situations is essential. Thus, in addition to the evaluation plan, students will submit a “Reflections” paper describing their experience with this evaluation (What did you enjoy? What did you learn? What did you find challenging? What obstacles did you encounter? What would have been helpful to know? What did you learn for next time?). 1-3 page 10. Additional sections: References (the grade will be reflected in the total grade for the literature review and other relevant sections, such as tools), and Appendices (including surveys, extended tables, etc.).

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