Responding to the Call:

1. Moving from State Oral Health Plan (and Policy Tool) to Action February 11, 2011 Marcy Frosh Colin Reusch Children’s Dental Health Project Responding to the Call:

2. TWO BIG THEMES: • Continue planning and priority setting with attention to: • Key elements for successful strategic “management” • Continue role as INNOVATORS with focus on: • How State Oral Health Plan/Policy Tool objectives are met

3. Theme #1: Implementing a Strategic Plan What the experts tell us: • A 2005 study of strategic planning was conducted by municipal governments • Study revealed factors useful in predicting the success of strategic planning in the public sector. Source: Poister, Theodore H. and Gregory Streib (2005). Elements of strategic planning and management in municipal government: status after two decades. Public Administration Review, 65(1), 45-56.

4. Study findings • Factors can be classified under one of five key components of the strategic planning process: • Stakeholder Involvement • Planning Elements • Budgeting Process • Performance Management • Performance Measurement

5. A few factors have the MOST impact Of all the factors identified, 7 were found to account for nearly half of the overall impact of a strategic plan.

6. 7 Factors that Dominate – #’s 1-4 Performance Management: • Objectives for department heads and managers come from the overall strategic plan. • Annual evaluations of department heads are based on accomplishing strategic goals and objectives. • Performance data is tracked over time to assess results of strategic plan. • Performance measures associated with the strategic plan are regularly reported to the public.

7. 7 Factors that Dominate – #’s 5-7 Budgeting Process • Budget requests and resource allocations are closely tied to strategic goals and objectives. Planning Elements • Feasibility assessment of proposed strategies is conducted (NOTE: This is an important element of the Oral Health Policy Tool and any strategic plan) Stakeholder Involvement • Citizens and other external stakeholders are involved in developing the strategic plan.

8. CDC Cooperative Agreement helped you to “dress for success” CDC has provided a “blueprint” for : • Logic model for a state plan • Sample components • Review index tool • Framework and flow charts • Funds work with Oral Health Policy Tool

9. New phase: Strategic Management Strategic Management Strategic planning+Performance Management • Both are processes that are repeated • Regular revisiting and evaluation are critical • Engage stakeholders at each level • Performance of management and ground-level staff equally important • Key: produce and learn from measurement data

10. What about moving on Identified Policy Priorities?

11. Fits under State Oral Health Plan (SOHP) + Policy Tool “priorities”? Both SOHP + Policy Tool appear to support action onPreventive Services for Children • State Oral Health Plan “Vision Element” suggests making MANDATORY the currently OPTIONAL Dental Component in the MDEC Early Childhood Screening program standards. • Policy Tool Priority #1 – Children ages 0-5

12. Making the case for early prevention Tap INNOVATIVE data collectionideas from a August 2009 MN Oral Health Stakeholder Meeting: • collect oral health related data on school-aged children.* What number of school days lost to dental concerns? School readiness is a cross-cutting concern! • Survey parents on understanding of the importance of preventive dental care? Address root causes – do parents believe they can influence? • Identify dental activities are already occurring in the school (dental volunteers, sealants, etc.)? What lessons can be learned? And for earlier ages: • What are primary care doctors doing on prevention; e.g. varnishing? * MN example: Bloomington, MN study (2003-07) revealed 1 in 4 students with visible dental health needs

13. Policy change CURRENT: Minnesota Statutes 121A.17 SCHOOL BOARD RESPONSIBILITIES. (d) A board may offer additional components such as nutritional, physical and dental assessments

14. Challenges If, for example, there is a focus on a School-Entry Screening only: Challenges: • Very limited evidence of effectiveness of screening because data on referral & treatment has not been available • Clear evidence that onset of dental disease happens well before school age (Policy Tool exercise may have focused on this as part of priority setting)

15. Performance Indicators (e.g., comparing values or positions) For Example: 1) Support a policy that will identify # of children screened, referred and treated • Baseline 1200 • Target 5000 • Actual 2100 • Support a policy that will identify extent of utilization of expanded pediatric preventive oral services for ages 0-5 • Baseline 1200 • Target 5000 • Actual 2100 • Describes more than one dimension! • Inputs/outputs described at different stages of performance!

16. Theme #2 - Is this innovative? It COULD be ! SC is one of the few states innovating with a “screening” law pilot program* that focuses and measures implementation with high-risk children and includes referral & treatment What innovative things can be done to address prevention for kids ages 0 to 5? *See SC’s “Word of Mouth” publication at: http://www.scdhec.gov/administration/library/CR-009945.pdf

17. How can stakeholders be STRATEGIC aboutinnovating on new policy initiatives? • It can’t hurt to follow a CHECKLIST! See list of 16 checklist items in PART II of The Policy Tool Guidebook: Steps for Creating a Success Health Policy Tool Session (2009). Access at www.cdhp.org.

18. Checklist to move from plan to action . . . A few examples

19. 1-State the Priority Initiative • Frame policy as a SMART objective. • Know your goal with absolute clarity. • What do you want to accomplish? • What do you want the policymaking authority to do? Specific Measurable Achievable Realistic Timed

20. 9-Identify Others’ Success Stories • Identify efforts from other states that have succeeded in attaining what you seek. • How similar and different were those efforts from yours? • What were the lessons learned? Policymakers are favorably disposed to replicating successful efforts from other states!

21. 13- Check to ensure what’s allowed • Regularly update yourself on specific rules on advocacy and communications in your state -- NEW ADMINISTRATIONS HAVE NEW RULES! • Comply with AR-12 Lobbying Restrictions (PA 3022): CDC Grantees must avoid using CDC funds from being used to influence or promote pending legislation.

22. 14-Refine Your Policy Action Plan Work with coalition members, partners, and messengers to: • Have a unified voice! • Agree on exactly who will do what, when, and with whom to carry out the plan. • Determine how and by whom the process will be tracked, re-evaluated, modified, and sustained.

23. 16- Be prepared with alternatives

24. What do colleagues from other states say is most important? Assemble a passionate Policy Committee that demonstrates entrepreneurial spirit, builds trust, and stays accountable to the Coalition!

25. Given these ideas . . . What would you add?

26. Let’s recap our 2 BIG THEMES: • Continue planning and priority setting with attention to: • Moving from strategic planning to strategicmanagement • Continue Minnesota’s role as INNOVATORS with focus on: • Innovate in movingState Oral Health Plan/Policy Tool objectives forward

27. Resources • State Oral Health Plan Comparison Tool. Children’s Dental Health Project (2010). Link to www.cdhp.org • CDHP/ASTDD. “State Laws on Dental Screening” for School-Aged Children. (2008) Link to: www.cdhp.org • Poister, Theodore H. and Gregory Streib (2005). Elements of strategic planning and management in municipal government: status after two decades. Public Administration Review, 65(1), 45-56. • Kates, Jennifer, Katherine Marconi and Thomas E. Mannle. Developing a performance management system for a Federal public health program: the Ryan White CARE ACT Titles I and II.Evaluation and Program Planning, 2001, vol. 24, issue 2, pages 145-155.

28. Thank you so much! Visit CDHP at: www.cdhp.org