Seamus McCarthy, CEO and president of Yamhill Community Care, proudly recalls the $1 million his organization invested eight years ago in a program designed to equip children with skills to help them lead healthier lives. This investment went toward implementing a new curriculum and training teachers in three schools across Yamhill County. The initiative, called the PAX Good Behavior Game, has since expanded, benefiting countless students in the region.

“We’re seeing fewer chronic diseases like high blood pressure, diabetes, and heart issues in these students as they grow up,” McCarthy said. “Kids who have gone through this intervention in elementary school now, as adults, are healthier.” The PAX program, while not focused specifically on substance abuse, has been shown to help prevent addiction later in life, said Anthony Biglan, a prevention scientist at the Oregon Research Institute who was consulted by Yamhill about the program.

This initiative is particularly relevant as Oregon faces an escalating drug crisis and rising youth overdose rates. According to federal data, at least 354 youths in Oregon have died from drug overdoses since 2018, with fentanyl increasingly present in the drug supply. An investigation by The Lund Report revealed that many Oregon school districts are struggling to meet state requirements for up-to-date, research-backed substance-use prevention programs. State agencies provide little support or accountability for these efforts, which has left many districts to rely on grassroots support.

Yamhill Community Care, one of 16 entities funded by the state to oversee care for low-income members of the Oregon Health Plan, has become an example of how regional health organizations are stepping up to provide valuable prevention initiatives. These organizations, funded by Medicaid dollars, are required to oversee health care and spend on community health improvement efforts, including prevention programs.

Yamhill’s investment in the PAX Good Behavior Game is just one example of the growing role health organizations play in supporting schools. Biglan, the prevention scientist, said that if more organizations take this approach, prevention efforts could increase significantly across the state.

While PAX is not a substance-use prevention program, its impact on youth health is significant. The game helps children regulate their emotions and impulses—skills that are crucial for long-term mental and physical health. By teaching self-regulation and providing a structured environment, the PAX Good Behavior Game also promotes academic success. The program started with a small group of teachers in just three schools in Yamhill County but quickly expanded as teachers and districts requested its implementation. Word of mouth led to its spread across the region, and Yamhill soon saw a demand for the program in other districts as well.

Yamhill wasn’t the first to introduce PAX into Oregon schools. In 2013, Trillium Community Health Plan began its own PAX initiative in Lane County, as part of nearly $1 million in spending on youth programs. Similarly, AllCare Health launched a similar program in 2015, expanding it to 10 out of 11 school districts in Jackson and Josephine counties. AllCare’s Josh Balloch explained that while his organization initially spent more than $600,000 on the program, challenges with Oregon Health Plan rules and the pandemic forced them to transfer the program to the Southern Oregon Educational Services District.

While these regional care organizations are primarily focused on healthcare, they also invest in early childhood development and prevention programs. Becca Thomsen, a spokesperson for CareOregon, which operates two Oregon Health Plan organizations in the Portland area, highlighted the importance of connecting school staff with behavioral health providers. CareOregon funds annual summits called “Behavioral Health in Schools,” which aim to increase access to treatment and provide education on evidence-based practices for youth.

PacificSource, which operates four Oregon Health Plan organizations, has also invested heavily in prevention programs targeting vaping, overdose prevention, and binge drinking among young adults. Biglan believes that all Oregon Health Plan organizations would benefit from investing in school-based prevention programs, especially those that address risk factors for substance use disorders and other chronic diseases. These interventions, he argues, help improve the health of the populations they serve, benefiting both families and communities in the long term.

The PAX Good Behavior Game exemplifies how school-based programs can address broader health issues, from emotional regulation to academic performance, while simultaneously providing long-term benefits such as reduced substance use and chronic health problems. Despite the challenges schools face in implementing such programs, especially with limited state support, McCarthy’s initiative in Yamhill County serves as a model of how regional health organizations can make a significant impact on youth health.

In conclusion, while Oregon struggles with a drug crisis that affects its youth, there are signs of progress in school-based prevention efforts. Organizations like Yamhill Community Care, along with other regional health entities, are stepping up to fill the gaps left by the state. By investing in evidence-based programs like the PAX Good Behavior Game, these organizations are helping to build healthier communities and reduce the risk of addiction and chronic disease among future generations. The challenge remains for the state to better coordinate these efforts and provide consistent support to schools, ensuring that effective prevention strategies are implemented across the state.