Transcript Slide 1

A Cadillac for the Price of a Chevy?
Consulting for Development of
Realistic CHA/CHIP Workplans
Laurie Call, Julia Heany and Jennifer McKeever
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Learning Objectives
Participants will be able to…
• Identify key questions to ask as a consultant to advise on the
selection of a CHA/CHIP process/model
• Recommend options for effective leadership/advisory structures
for CHA, CHIP and Implementation/Monitoring
• Describe strategies for defining and communicating roles for all
parties engaged in a consulting agreement for CHA/CHIP support
1.Understand resource needs and potential resources to support
CHA/CHIP
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Rationale and Challenge
Rationale
• Provide high-quality, capacity building service and leadership for
our clients to lead and manage engagement, the process and
beyond.
• Helping to build sustainable approaches for effective CHA/CHIP
processes…not just a focus on the end product/deliverable.
Challenge
• Developing capacity building plans when clients are hiring an extra
pair of hands with specialized expertise.
• Other challenges?
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Helping Clients Understand Their Needs
In relation to…
•Goals and Requirements of Accreditation, Governing
Body or IRS Rules
•Selection of CHA/CHIP Model/ Process
•Effective Leadership/ Advisory Structures
•Level of Engagement and Partnership Needed
•Resource Needs (staff, time, financial etc.)
•Outside Expertise Needed
•Existing Capacity / Capacity Building Goals
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Helping Clients Determine Resource Needs
• Time
– Due date/ Goal date
– How much time the client can “really” dedicate
– Balance of time with CHA, CHIP and monitoring/eval plan
• Staff Expertise
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Data analytics
Stakeholder engagement
Facilitation
Project management
Communications
Leadership buy-in/ support to remove barriers/ make decisions
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Helping Clients Determine Resource Needs
• Existing Data/ Infrastructure (internal or external)
– Types, quality and value of data already collected or maintained
– Existing assessment/planning processes going on
• Stakeholder Engagement / Relationships
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Current vs. ideal level of engagement
Existing stakeholder groups / infrastructures to build on
Partner analysis – level, type, history of the relationships
Relationship with the community/ stakeholders/ history
• Budget
– Type of budget to complete CHA/ CHIP and support
implementation
– Restrictions on the use of funds
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The “Big” Questions…
• What type of deliverables are you expecting?
– What type of product do you want?
• What roles are you expecting to fill? Expecting us to
fill? Expecting stakeholders to fill?
• What do you expect to happen as a result of this work?
– What do you want to be different in a year or two?
• If you have experience with this type of work in the
past, what do you want to be different this time?
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Other Questions…
• What other questions do you ask clients to understand
their needs?
• What do the questions yield?
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From Questions to Advising and Tools…
CHA /CHIP Models
Leadership/Advisory Structures
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Effective Leadership/Advisory Structures for CHA/CHIP
Levels of stakeholder buy-in and engagement needed:
Current Level of Stakeholder Involvement
Understanding this helps
determine the structure needed.
Where are the gaps?
What needs to be built?
Who needs engaged?
Level of Stakeholder Involvement
Needed to Achieve Goals
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Identifying Community Partners Worksheet
Name of
individual
and/or
organization
Why might this
organization or
individual want
to be involved?
What stake do
they have in the
issue?
MPHI Tool, Adapted from material in
The Community Toolbox: ctb.ku.edu
Why is the
involvement of
this organization
or individual
important to the
success of the
plan?
How can we
support the
engagement of
this organization
or individual?
What role would
we like this
individual or
organization to
play?
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Partnership Recruitment
ORGANIZATIONAL SECTOR ("X" in sector; can X more than one box) ENGAGE LEVEL
Organization or
Audience/Population
Key
contact
Role/
Title
Focus on
priority
Hospital/
Funder
School
population
Business Health Commty Gov’t Youth
Housing
Faith
/Fdtns
/Univ
s (Latino,
care
Orgs
homeless,
youth)
Already
engaged in
another
initiative Priority
via
level
interviews, (1,2,3)
focus
groups, or
other?
POTENTIAL ENGAGEMENT
METHOD FOR CHA/CHIP
KII
Focus
Event/
CHIP
Survey
Email
group
Mtgs
work
Sample Tool - ToP Circles of Involvement
See NACCHO ToP Activity
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Circles of Involvement
See NACCHO ToP Activity
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Circles of Engagement
Core Circle
What do we need from stakeholders?
The more we tell people what is expected of them; the
more accurately they can commit to their role.
Recruitment
Engagement
Retainment
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Good Reminder…
When
Designing
Processes
5 Levels of Involvement
Consider the
Level of Involvement
Needed
Determine/ Design the
Activity
Extensive
Discussion
Comments
and
Questions
Convergence
and
Alignment
Ownership
and
Commitment
Higher Time Commitment
Presenting and
Reporting
Determine Time
Estimate
Adapted from: Community at Work 2007, Sam
Kaner, Facilitators Guide to Participatory
Decision Making, 2nd Ed.
Lower Time Commitment
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Tool to help further define roles for key
processes
Remember…
The more
we tell
people what
is expected
of them; the
more
accurately
they can
commit to
their role.
MPHI Tool
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Sample Common MAPP Structure
Provide oversight for CHA/CHIP.
Staff and lead the process.
Provide resources to conduct
assessment and planning
Provide feedback and guidance.
Participate in assessments.
Identify and engage LPHS reps
Identify and prioritize issues
Assist in leading action teams.
Monitor action plan implementation.
Participate in LPHS
assessment. Review
Assessment results to
identify priority
issues. Participate
and lead action
teams.
Action
Team
Leadership Team
Usually 3-5 members
Stakeholder Advisory
Committee
Usually 20 +
members
Community and All Local Public Health
System Representatives
Action
Team
Action
Team
Action
Team
One action team is
assigned to each
priority issue. Action
teams develop
measurable action
plans, work
collaboratively with
Leadership team and
other stakeholders to
implement and
evaluate action plans.
Action
Team
Leadership Team
Sample Structure
There are many options for structures.
Level and type of partners and stakeholders
Impacts the structure selected.
Action Team
Action Team
Stakeholders
Community
Action Team
Action Team
Variety of Assessment and
Planning Activities
Action Team
Evaluation Team
Helping Clients Match a Model/Process with Resources
Assessment & Planning Models
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• Assessment Protocol for Excellence in Public Health (APEX – PH)
• Mobilizing for Action through Planning and Partnerships (MAPP)
• Association for Community Health Improvement Model
• Planned Approach to Community Health (PATCH)
• Home Town Health
• Community Change Model
• Community Health Assessment and Group Evaluation (CHANGE)
• The Community Toolbox
From the
• Moving from Vision to Action
PHABulous
CHA/CHIP
• Asset-Based Community Development
session
• Theory of Change
• PRECEDE/PROCEED
• County Health Rankings & Roadmaps to Health ‘Take Action’ Cycle
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Community Health Assessment and Improvement Processes
Prepared by NACCHO
http://www.naccho.org/topics/infrastructure/CHAIP/uploa
d/CHA-and-CHIP-Processes-JJE.pdf
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Community Health Assessment and Improvement Processes
Prepared by NACCHO
http://www.naccho.org/topics/infrastructure/CHAIP/uploa
d/CHA-and-CHIP-Processes-JJE.pdf
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Choosing a Framework
We ask clients to consider how they will ensure the
process will…
•Fit with needs and willingness of partner organizations
•Align with the goals of partner organizations
•Adequate fit with time and resources they and partners are ready to
invest
•Meets necessary guidelines and expected results
•Engage community members throughout the process
•Include local public health system representatives throughout the
process
•Address social determinants of health
•Leverage local, state and federal resources, and
•Use quality improvement or quality planning techniques?
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Group Discussion
Reflect on examples of successful CHA/CHIP
development, implementation and monitoring…
•Which structures or partnerships were most effective?
•What strategies helped ensure accountability to the
process and outcomes for a truly community owned
process?
•How, if applicable, did you help the partners reach this
level?
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Developing Consulting Agreements
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Value of Working with PH Institutes CHA/CHIP…
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Strong assessment and planning experience (and more!)
Institutes are conveners and linkages
Can be trusted; We work in the trenches with you.
Understand the value of and nuances of collaboration
Serve as a conduit and link to public health
Interest in building capacity – 2 for 1
Institute Accreditation Business Plan – Priority of Best
Practices (link to national partners)
• Draw on capacities of network of Institutes
• Others??
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Making Decisions to Accept Work…
Does the work align with vision and mission of the
Institute?
Are there adequate resources for the work? (time, $,
client participation etc.)
Do we have the capacity internally or contractually?
Is the client doing it for the right reasons?
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Developing Effective Consulting Agreements
Key Components
See Sample Contract
/Agreements with
•Scope of Work (see next slide)
Resource Materials
•Timeframe - Begin and end date
•Opportunity to Amend - Plan for re-assessing scope and
budget or contingency planning
•Deliverables – Clearly defined process and outcome
deliverables
•Budget – Financial agreement and payment schedule
•General Contractual Requirements – Confidentiality,
insurance/liability, intellectual property/ownership etc.
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Scope of Work Beyond the Obvious…
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Conducting the Work
It’s clear
Project management time and role
to clients
the time
Planning calls
we scope
for the
Coaching
time
Developing facilitation plans
they see
us…but
Debriefing the work
we do
Reporting
much
more!
Providing specialized expertise
Material development with feedback loops/ revisions
Other?
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Some Lessons Learned
• Develop a menu of services – range of costs, helps
clients be in role of choosing what fits best.
• Develop agreements on “sets” of deliverables.
• Keep the final deliverables somewhat open-ended.
Agree on one deliverable with options to add others
later. (start with only wanting the 200 page report,
later adding executive summary, PPT presentations,
etc.
• Develop a price for set of deliverables / vs. tracking
hours
• Others?
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Defining Roles in Consulting Agreements/
Workscopes
Key Activity
PHI Role
Process Deliverable
Bi-weekly
coaching Calls on
Process from April
2013 – May 2014.
Provide conference
call line
Prepare coaching
based on XYZ
reported needs
One page summary of
Prepare coaching
coaching session including prep form and
action items/ due date
submit to coach 1
day prior.
Establish coaching
calendar.
Gather community Provide guidance on
input regarding
methods and tools.
themes and
strengths
Train health
educators to collect
data
Tailor materials to
tools/ method and
location.
XYZ Role
Summary of suggested
models and tools.
Select model and
tools.
Training agenda and
materials
Recruit health
educators. Copy
training materials.
Coordinate training
logistic
Hours/
Cost
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Sample Workplan
Includes good
documentation
for accountability
and
QI…scheduled vs.
actual started
date and
completion
dates, who,
comments,
accomplished.
MPHI Tool
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Building “Capacity Building” into Agreements
• Regular “Coaching” meetings (weekly, bi-weekly etc.)
• Feedback on work products
• Audio recording of facilitated meetings for future use
• Train health educators to facilitate focus groups, Model focus
group facilitation, Debrief, Observe and provide feedback to
health educators when they facilitate.
• Collaborative agenda development and debrief meetings
• “Big Picture” training; Just in time training
• Actionable meeting minutes – provide a good record for next steps
and future replication.
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Sample Actionable
Coaching Mtg Notes
• Used for every coaching
call to document actions,
discussion, due date etc
• Progress column allows for
tracking/ checklist and
way to start the next
meeting
• Documents process
deliverables
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Other Capacity Building Activties
• Ideas for building “capacity building” into consulting
services.
• Ways the capacity building be negotiated and reflected
in the agreement with the client.
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Potential Resources to Support CHA/CHIP
Federal
State
Public
Health
Institute
Local
National
Orgs
Foundation
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Better Together
• Models for Collaboration (HIA)
– CDC proposal
• Share your ideas/knowledge with NNPHI
• Consensus Workshop: What are YOUR ideas for how we
can collectively move forward?
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Contact Information
Laurie Call
Center for Community Capacity Development
Illinois Public Heath Institute
[email protected]
312.850.4744 or 217.679.2827
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