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Each qualifying facility or campus will have an Advisory Committee to guide this program. The committee should include a diverse cross-section of campus professionals, employees, and others, with a minimum of three members. Whenever possible, the committee should include representatives from the following groups:

• Facility managers
• Grounds managers
• Administrators
• Marketing, communications, or community relations staff
• Community benefit staff
• Healthcare providers
• Patients, patient advocates, or residents
• Community forestry advocates or officials

While responsibility for care of trees at the facility may ultimately lie with the facility grounds manager, the Advisory Committee can provide input on future plantings and advocate for a sustainable tree care plan for the campus. It can also develop plans for community events and projects, promote experiences with trees and forests for patients and staff, and conduct outreach in the community on the benefits of trees to human health.

Progress in any endeavor—the ability to achieve stated objectives and goals—starts with a plan. A good tree care plan starts with an understanding of what exists today and then offers a vision of the future. It can also provide patients, visitors, and employees an understanding of the value of trees and how they contribute to a facility dedicated to healing.

Qualifying plans will govern management practices, both for staff and contractors. It will describe standards for managing trees, with planned schedules for treatments, such as pruning, fertilizing, integrated pest management (IPM) practices, planting and removals. The Plan is a permanent feature of the program, but is a living document, so we suggest that the Plan be updated at least every five years.

For facilities with little or no landscape space for trees on their own property (due to building footprints and mandated parking requirements), facilities may craft a plan for the street, boulevard, or park trees near or adjacent to the campus. In such cases, the facility must take on some level of active engagement for tree management activities, through written agreement with the local municipal authority.

The Facility Tree Care Plan will, at minimum:

1. Identify the site manager with responsibility for executing the plan.
2. Include a site map of the property, showing existing trees, forests, and other landscaping, as well as potential planting areas.
3. Include a statement that the facility will adhere to tree care industry standards and best practices for planting, landscaping, maintenance, and removal.
4. Include tree protection standards for construction projects, including procedures for contractors, penalties, and an enforcement policy.
5. Include at least one goal for tree planting or management that will guide activities for the next five years.

The healthcare facility seeking recognition will develop, lead, and/or fund one or more community forestry projects during the year, primarily at off-campus locations. The intent of this standard is to develop meaningful connections between the facility and local community forestry initiatives that benefit residents, patients and employees.

Projects may include tree planting, tree maintenance, tree inventory, tree monitoring, or other practices consistent with the goals of the community forestry plan, if one exists. Activities may occur on private or public property, so long as community residents benefit from the project.

Projects must be sponsored in some way by the healthcare facility, either through direct expenses or in-kind services, such as volunteer time. Projects on city property must be coordinated with appropriate city departments and conform to best practices for tree planting and care.

Community forestry project ideas include, but are not limited to:

• Volunteer tree planting or tree maintenance on city streets or in a city park
• Projects in partnership with the local Tree Board in support of Tree City USA status
• Tree inventory (streets, parks, or other property in the community)
• Tree care in a local arboretum that is accessible to the public
• Cooperative service project with a local Tree Campus USA college or university
• Collaboration with a community service organization or tree non-profit group
• Tree giveaways for employees and residents

During the year, the facility will sponsor at least one celebration event—such as Arbor Day—or an awareness campaign that highlights the connection between trees, nature, and human health.

There is compelling research that trees, forests, and outdoor activity can improve human health outcomes. Putting that research into practice at the local level can reduce hospital stays, improve outcomes for chronic disease, improve many psychological disorders, and lower overall treatment costs. Healthcare facilities can foster a variety of awareness and education campaigns to inform patients, families, employees, or community residents about the value of trees and forests to healthy lifestyles.

Celebration events can be held wherever the community Arbor Day observance is held, or even on campus when the event is open to the public. Arbor Day provides a golden opportunity for employees, patients, visitors, and the community to celebrate all the ways trees benefit our lives—especially the ways that trees improve human health.

This standard can be met through a variety of ways, such as:

• Hallway posters explaining how views and experiences in nature can reduce stress, improve cognitive function, and have a calming effect
• “Walk with a Doc” programs that connect patients and providers in outdoor settings in the community
• Educational campaign on trees and forests and their connection to human health, for staff, patients, or the public
• Advertising campaigns for the public on the benefits of city trees on local transit, in libraries, or other public facilities
• Arbor Day Health Fair at city hall or at the facility
• Sponsorship of the city Arbor Day event at a local park

One measure of the connection between trees and health in the community is the annual financial investment in tree projects, education events, and community outreach—both on and off-campus. Though not mandatory, it is suggested that the facility work towards an annual investment of $2 per employee (Full-Time Equivalent), either as cash or in-kind expenses, or in combination.

Facilities will be asked to record the costs associated with each of the preceding standards, from all sources within the organization. Costs may include, but are not limited to:

• Costs for implementing the Facility Tree Plan, specifically the goals and objective(s) identified in the plan.
• Out-of-pocket costs for: trees, equipment, and supplies purchased for facility or community tree planting or maintenance (pruning, watering, mulching, weed control, etc.) projects.
• Costs associated with Arbor Day events, other celebrations, or public education materials and campaigns.
• Value of service on the Advisory Committee, or labor by employees on tree projects (for example, the National Volunteer Rate assigns a value for one hour of volunteer time at $25.43 in 2019).
• Costs associated with facility staff training or certification associated with tree care (i.e., Certified Grounds Manager, Certified Arborist, Certified Treecare Safety Professional, etc.).
• Direct cash donations from the facility to the municipal forestry program or local non-profit group for management, tree planting, or tree care projects.