Prepared by Emily Gantz McKay and Hila Berl Relationship between the Planning Council (PC) and the Recipient: What the PC, PCS Staff, and Recipient All Need to Know Prepared by Emily Gantz McKay and Hila Berl EGM Consulting, LLC Note: This training is designed for planning councils as described in the Ryan White legislation, rather than other types of planning bodies. Planning councils have legislative responsibilities and are independent entities that work closely with but are not responsible to the recipient. Jurisdictions with planning bodies that lack such legislative guidance may have a very different relationship, though much of this training module is likely to be relevant if the planning body plays roles similar to those of a planning council. This model training unit is based on training provided for several EMAs and TGAs by Mosaica and EGM Consulting, LLC, and was revised for the PCS Compendium by EGM Consulting through Task Order TA003111, funded through MSCG/Ryan White Technical Assistance Contract. From: Compendium of Materials for Planning Council Support Staff. EGM Consulting, LLC. 2018.
 Available at: www.targetHIV.org/planning- chatt/pcs-compendium

Goals of the Training To support a productive partnership between the Ryan White HIV Health Services Planning Council (PC) and the Ryan White HIV/AIDS Program (RWHAP) Part A recipient To provide information and skills for participants to use in preventing and resolving tensions and/or conflict between the PC and the recipient To ensure that PC members, PCS staff, and recipient staff all can explain and differentiate the roles of the recipient and the PC in a RWHAP Part A program

Training Objectives At the end of the session, participants will be able: To identify and differentiate the roles and responsibilities of the PC, the recipient, and the Chief Elected Official (CEO) – including which roles are shared and which are carried out by only one entity To identify typical pressure points between the PC and recipient, and describe ways to prevent, minimize, or resolve them To describe the main components of a Memorandum of Understanding (MOU) between the PC and recipient, and the role of an MOU in contributing to a positive relationship between the PC and recipient

Roles and Responsibilities of the PC and Recipient

Planning Council, Recipient, and CEO Roles & Responsibilities Task CEO Recipient Planning Council Determine Planning Body X   Establish Planning Body Carry Out Needs Assessment Do Comprehensive Planning Set Priorities* Allocate Resources* Manage Procurement Monitor Contracts Evaluate Effectiveness of Planning Activities Evaluate Effectiveness of Care Strategies Do Quality Management  [Care Standards & Committee Involvement] Assess the Efficiency of the Administrative Mechanism* The key planning responsibilities of a PC: Comprehensive Planning: Develop a comprehensive plan for the organization and delivery of health and support services Needs Assessment: Determine the size and demographics of the population of individuals with HIV/AIDS and determine the needs of this population Priority Setting and Resource Allocations: Establish priorities for the allocation of funds within the eligible area, including how best to meet each such priority and additional factors that a recipient should consider in allocating funds under a grant Plus some supporting roles, mostly carried out in collaboration with the recipient Note: Evaluating the cost and outcomes effectiveness of services is an optional PC role. One other special role that is often not fully understood: Assessment of the Administrative Mechanism: Assess the efficiency of the administrative mechanism in rapidly allocating funds to the areas of greatest need within the eligible area * Sole responsibility of RWHAP Part A Planning Councils

Roles of Planning Council Support (PCS) Staff Assist the Planning Council to carry out its legislative responsibilities and to operate effectively as an independent planning body Staff committees and Planning Council meetings Provide expert advice on Ryan White legislative requirements and HRSA/HAB regulations and expectations Oversee a training program for members Encourage member involvement and retention, with special focus on consumers Serve as liaison with the recipient Help the PC manage its budget Be involved only with supporting RWHAP Part A-related activities

Discussion: PC Support Staff Roles Discuss in small groups: Are the following appropriate Planning Council staff roles? Why or why not? Are there situations under which they would be appropriate? Preparing letters to go from the Planning Council to the City Council or State legislature, urging specific legislative action such as an increase in the HIV/AIDS budget? Helping the recipient by staffing a regular monthly meeting with RWHAP Part A providers? Helping to prepare the annual RWHAP Part A competitive application?

Recipient Staff Roles with the Planning Council Attend and make a recipient report at PC meetings Regularly provide agreed-upon reports (e.g., cost and service utilization data) Provide advice on areas of expertise without unduly influencing discussions or decisions Assign staff to attend committees except where recipient participation is not requested Collaborate on shared roles Carry out joint efforts such as task forces and special analyses consistent with roles and resources Note: Roles with planning bodies that are not PCs can be quite varied, depending on planning body structure & level of activity

HRSA/HAB Expectations for PCS Staffing PCS function can be contracted or provided through municipal staff PC staff are hired and supervised according to local personnel policies and procedures, but work for the Planning Council RWHAP Part A Manual says the PC “works in partnership with the grantee but not under its direction” (p 108) PC Executive Committee participates along with supervisor in evaluation of PCS Director Boundaries between the two entities are maintained by both parties

Relationships and Pressure Points

Relationships: Not Limited to Recipient-PC 03/13/102 Relationships: Not Limited to Recipient-PC Between the Recipient and: Planning Council Administrative Agency (if one exists) Mayor’s/Board of Supervisors’ Office PLWH Community Providers of RWHAP Part A services Other HIV/AIDS providers HRSA/HAB/DMHAP Within the PC: Membership PC Support staff Between the PC and: Recipient Mayor’s/Board of Supervisors’ Office Administrative Agency (if one exists) PLWH community Providers of RWHAP Part A services Other HIV/AIDS providers HRSA/HAB/DMHAP Mosaica for NHCC 4

Pressure Points between the PC and Recipient “Pressure points” are situations that can cause tension or conflict between the PC and recipient Some pressure points are natural and should be expected Pressure points should be predicted where possible, so they can be minimized or resolved before becoming significant points of conflict For example: because both recipient and PC support funding come from the up to 10% of funds allocated for administration, there is normally some tension in terms of how much funding should be made available to the PC

Causes of Relationship Problems Different views of what is right or desirable Determination to get a specific result, regardless of the views of the other group Passion for making change Desire to control resources Insufficient knowledge of Ryan White HIV/AIDS Program and its rules – including the roles of both entities Real or perceived lack of mutual respect Personality clashes Belief that the other group has not observed boundaries

03/13/102 Small-Group Discussion: Identifying “Pressure Points” between PC and Recipient Work with 1-2 other people Identify and describe what you see as 2-3 key current pressure points between the PC and recipient Be prepared to share your list Mosaica for NHCC 4

Tools for Addressing Pressure Points 03/13/102 Tools for Addressing Pressure Points Local standards & behavior, including: Policies and procedures such as: Code of conduct Bylaws Ethical behavior Memorandum of Understanding (MOU) Leadership: roles and behavior Conflict of interest policies Federal guidance: Grievance procedures Ryan White and other federal legislation Alternative dispute resolution methods HRSA guidance – in policies, letters, application guidance, manuals and guides, National Monitoring Standards Sound practice Mosaica for NHCC 4

Using Leadership & Communication to Address Pressure Points Create a safe environment Ensure training and provide reminders of roles and boundaries Share information widely Encourage open discussion – and listening Model respectful behavior Establish and enforce behavioral groundrules Separate the issue from the individual Remind group of its purpose Take responsibility and assert leadership influence Ensure that decisions are based on defined procedures and criteria

Using an MOU between the PC and Recipient 03/13/102 Using an MOU between the PC and Recipient Clarifies roles & expectations of recipient and Planning Council Describes expected communications and interaction Specifies information sharing/reporting, with due dates Provides time frames and deadlines Specifies a means of resolving conflicts Calls for regular review and updating of document Best Practice: Develop an MOU to prevent conflict, rather than waiting until conflict occurs and using it to help resolve tensions Mosaica for NHCC 4

Actions for Working Together Effectively Understand that “pressure points” always exist but can be managed Understand each other’s roles – which may require joint training Recognize and observe boundaries Recognize the benefits of a collaborative and respectful working relationships Clearly define mutual expectations Acknowledge time and resource limitations of both entities Use an MOU to specify mutual expectations Review and revise Bylaws and policies

Action Steps Discuss and agree on the following: What if any policies or procedures need to be changed to help ensure that boundaries are respected and the relationship is mutually beneficial? What if any new policies or processes need to be developed? What other action is needed to encourage a positive relationship? Who will be responsible for implementation and monitoring?

External Sources of Assistance DMHAP Project Officer Peers from other EMAs and TGAs (PCS staff, recipient staff, PC leadership) Consultants arranged through DMHAP

Sum Up

Planning Council, Recipient, and CEO Roles & Responsibilities: Checking Knowledge: Fill in the chart to identify roles and responsibilities of each entity Task  CEO Recipient Planning Council Determine Planning Body Establish Planning Body Carry Out Needs Assessment Do Comprehensive Planning Set Priorities Allocate Resources Manage Procurement Monitor Contracts Evaluate Effectiveness of Planning Activities Evaluate Effectiveness of Care Strategies Do Quality Management Assess the Efficiency of the Administrative Mechanism The key planning responsibilities of a PC: Comprehensive Planning: Develop a comprehensive plan for the organization and delivery of health and support services Needs Assessment: Determine the size and demographics of the population of individuals with HIV/AIDS and determine the needs of this population Priority Setting and Resource Allocations: Establish priorities for the allocation of funds within the eligible area, including how best to meet each such priority and additional factors that a recipient should consider in allocating funds under a grant Plus some supporting roles, mostly carried out in collaboration with the recipient Note: Evaluating the cost and outcomes effectiveness of services is an optional PC role. One other special role that is often not fully understood: Assessment of the Administrative Mechanism: Assess the efficiency of the administrative mechanism in rapidly allocating funds to the areas of greatest need within the eligible area

Questions and Discussion