AREA SERVED *
Please select the areas that your organization serves in Santa Barbara County
LEVEL OF CARE SERVED *
Please specify what level of care your organization addresses. (schools can choose prevention)
2024 PARTNER COMMITMENT PARTNER COMMITMENT * YES No, we do not plan to continue as a partner.
Our organization/school is committed to the vision, goals, and objectives and being an active PARTNER of the YouthWell Community Collaborative.
We will continue to work together towards systemic change to eliminate stigma, fill the gaps, and remove barriers to services so that all youth and their families can access the care they need in a timely manner through a warm handoff.
We prioritize prevention and early intervention with the goal of connecting youth through age 25 and families in Santa Barbara County to mental health resources.
PARTNER QUARTERLY MEETINGS * YES NO
The Community Collaborative meets quarterly. We ask that partnering organizations send a leader from your organization to attend. A leader in our organization (ie: CEO/Superintendent) will attend quarterly meetings, and respond in a timely way to email communication. VIEW LIST OF
PARTNERS YOUTH LINKAGES NETWORK MONTHLY MEETINGS * YES NO MAYBE
The YOUTH LINKAGES NETWORK [formerly: Behavioral Health Linkages Team] meets monthly and is optional to attend. Will you be sending someone in your organization or school district to attend? Hosted by YouthWell, SBCEO, and SB County BWell. Educate 40+ resource navigators, probation officers, local crisis lines, and school counselors so that they are better equipped to support families.
LEARN MORE COMMUNICATION * YES NO
In order to increase communication and awareness, we will do our best to keep YouthWell updated on our organization’s related activities so that they can be promoted in the community.
We will disseminate relevant information (ie: workshops, promoting resource directory & calendar) to staff, board members, families, and community members connected to our organization.
DIRECTORY & CALENDAR * YES NO
Our organization/school is committed to keeping our information up to date in the online Resource Directory and adding our classes and trainings to the Community Calendar. We understand this benefits families, school counselors, and resource navigators in accessing information more quickly.
RESOURCE RACK CARDS & POSTERS * YES, we would like to order rack cards NO, we are not interested in providing at our org or school We have already ordered and received rack cards
YouthWell has designed 4x9 double-sided community resource rack cards & 11x18 posters in both English and Spanish with resource information and fun tools for practicing self-care for schools and organizations in Santa Barbara County. https://youthwell.org/materials/
MEMBER CONTRIBUTION MEMBER FEE * $0 $150 $250 $500 $1,000 $1,500 $2,500
We ask that each partner make a financial contribution to the work of the collaborative.
We do not want a financial reason to keep any organization from joining so please contact us if this is a hardship.
To show our commitment, our organization agrees to pay a YouthWell Community Collaborative membership contribution for 2023.
SUGGESTED AMOUNTS [ORGANIZATIONS]:
-$2,500 Youth Mental Health Leader (non-profit, business, government agency)
-$1,000 10+ employees (non-profit, business, gov't agency)
-$500 4-9 employees (non-profit, business, gov't agency)
-$150 1-3 employees (non-profit, business, gov't agency)
SUGGESTED AMOUNTS [SCHOOLS]:
-$2,500 Youth Mental Health Leader
-$1,500 School District with 10,000+ students
-$1,000 School District with 5,000+ students
-$500 School District with 1,000+ students
-$250 School District or Independent Schools with 1-900 students
INVOICE * No, I can use blank invoice provided Yes, send invoice I will not be making a financial contribution.
Do you need an invoice emailed to you in order to submit for payment? (As an option, we have provided a blank invoice on this page that you can fill in the amount and print. You can also print our W9.)
PAYMENT * YES, I will mail a check. YES, I will pay with credit card. No, I will not be making a financial contribution.
Make check payable to:
COMMUNITY PARTNERS for YOUTHWELL
Mail check to:
P. O. Box 741265, Los Angeles, CA 90074-1265
PARTNER SURVEY PARTNER PRIORITIES *
Each year, we want to check in with our partners to ensure we are working together towards common goals. We also want to learn how we can better support your organization or school district. We welcome your input. WE WANT YOUR INPUT...
1. in order to understand how the Collaborative can support the priorities of your organization
2. on how we utilize the time at our quarterly meetings to make them productive.
Please check the top priorities for your org/school being a partner. Is it the information learned from the meetings? Is it the resources YouthWell provides to support your staff and families in educating families about services?
REFERRALS - SERVICES NEEDED *
Please specify the LEVEL OF CARE your org/school is most often needing for the youth that you serve.
MEETINGS - COLLABORATIVE *
What would improve or add to quarterly meetings that would benefit you & your organization and work you do with youth?
COLLABORATIVE BENEFITS & STRENGTHS *
What does your organization see as a benefit of their partnership with the Community Collaborative?
What are the strengths of the Collaborative and where could we improve? **If you are new to the collaborative, feel free to skip this question.
SUPPORT NEEDED *
What kind of support would benefit you going forward from the COLLABORATIVE and in partnering in the future to support the work you are doing around youth mental health?
CONTACT & SIGNATURE NAME *
CEO/, Executive Directory, Superintendent, or director that will be attending quarterly meetings and staying informed with the work of the collaborative.
Please put the name of the person filling out this form.
FIRST & LAST