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A Cadillac for the Price of a Chevy? Consulting for Development of Realistic CHA/CHIP Workplans Laurie Call, Julia Heany and Jennifer McKeever. Learning Objectives. Participants will be able to…
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A Cadillac for the Price of a Chevy? Consulting for Development of Realistic CHA/CHIP Workplans Laurie Call, Julia Heany and Jennifer McKeever
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 • Understand resource needs and potential resources to support CHA/CHIP
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?
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
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 • Data analytics • Stakeholder engagement • Facilitation • Project management • Communications • Leadership buy-in/ support to remove barriers/ make decisions
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 • 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
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?
Other Questions… • What other questions do you ask clients to understand their needs? • What do the questions yield?
From Questions to Advising and Tools… CHA /CHIP Models Leadership/Advisory Structures
Effective Leadership/Advisory Structures for CHA/CHIP Levels of stakeholder buy-in and engagement needed: Current Level of Stakeholder Involvement Where are the gaps? What needs to be built? Who needs engaged? Understanding this helps determine the structure needed. Level of Stakeholder Involvement Needed to Achieve Goals
Identifying Community Partners Worksheet How can we support the engagement of this organization or individual? Why might this organization or individual want to be involved? What stake do they have in the issue? Why is the involvement of this organization or individual important to the success of the plan? What role would we like this individual or organization to play? Name of individual and/or organization MPHI Tool, Adapted from material in The Community Toolbox: ctb.ku.edu
Sample Tool - ToP Circles of Involvement See NACCHO ToP Activity
Circles of Involvement See NACCHO ToP Activity
Circles of Engagement Circle of Possibility Circle of Information & Awareness Circle of Champions Circle 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.
Good Reminder… When Designing Processes 5 Levels of Involvement Consider the Level of Involvement Needed Determine/ Design the Activity Determine Time Estimate Higher Time Commitment Lower Time Commitment Adapted from: Community at Work 2007, Sam Kaner, Facilitators Guide to Participatory Decision Making, 2nd Ed.
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
Sample Common MAPP Structure Provide oversight for CHA/CHIP. Staff and lead the process. Provide resources to conduct assessment and planning Usually 3-5 members 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. 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. Usually 20 + members Participate in LPHS assessment. Review Assessment results to identify priority issues. Participate and lead action teams.
Sample Structure There are many options for structures. Level and type of partners and stakeholders Impacts the structure selected. Variety of Assessment and Planning Activities Evaluation Team
Helping Clients Match a Model/Process with Resources • Assessment & Planning Models • • 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 • • Moving from Vision to Action • • Asset-Based Community Development • • Theory of Change • • PRECEDE/PROCEED • • County Health Rankings & Roadmaps to Health ‘Take Action’ Cycle From the PHABulous CHA/CHIP session
Community Health Assessment and Improvement Processes Prepared by NACCHO http://www.naccho.org/topics/infrastructure/CHAIP/upload/CHA-and-CHIP-Processes-JJE.pdf
Community Health Assessment and Improvement Processes Prepared by NACCHO http://www.naccho.org/topics/infrastructure/CHAIP/upload/CHA-and-CHIP-Processes-JJE.pdf
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?
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?
Value of Working with PH Institutes CHA/CHIP… • 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??
Developing Effective Consulting Agreements See Sample Contract /Agreements with Resource Materials Key Components • Scope of Work (see next slide) • 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.
Scope of Work Beyond the Obvious… • Conducting the Work • Project management time and role • Planning calls • Coaching • Developing facilitation plans • Debriefing the work • Reporting • Providing specialized expertise • Material development with feedback loops/ revisions • Other? It’s clear to clients the time we scope for the time they see us…but we do much more!
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?
Sample Workplan Includes good documentation for accountability and QI…scheduled vs. actual started date and completion dates, who, comments, accomplished. MPHI Tool
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.
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
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.
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?
Contact Information Laurie Call Center for Community Capacity Development Illinois Public Heath Institute Laurie.call@iphionline.org 312.850.4744 or 217.679.2827