1. Capacity Building Continuous Improvement Model Charles L. Henry, Director Lela Hung, Director of Special Projects County of Los Angeles Department of Health Services Office of AIDS Programs and Policy August 25, 2003

2. Los Angeles County 4,082 Square Miles 9.8 Million Residents Latino/a 44.6% White 31.1% Asian 12.3% African-American 9.7% Native American 0.5% Pacific Islander 0.3% Proportion of State Population: 28% Proportion of State AIDS Cases: 35% Living with HIV/AIDS: 53,000 (Estimated) 2

3. 3 Program Context Number of Providers115 Contracts for Services400 + Service Modalities45 + Community Based Organizations108 Providers in Communities of Color65 Community Planning Bodies HIV Prevention Planning Committee30 Commission on HIV Health Services49 HIV Strategic Planning Oversight18

4. 4 Capacity Building Global Context Programmatic Educational Services  Training, Certification, Symposia Information Systems Prevention Services  Technical Assistance for Providers Financial Services  Technical Assistance for Providers Care Services  Technical Assistance for Providers

5. 5 Capacity Building Global Context (Cont’d) Programmatic (Cont’d) Planning and Development  Training, Skills Building Public Affairs  Community Development Initiative (African- Americans, Latino/a)

6. 6 Capacity Building Global Context (Cont’d) System Level Coordinated Provider Networks Service Provider Networks Multiple Morbidity Initiatives HIV/STD Integration  Planning  Testing  Prevention Organizational Development Capacity Building Initiative

7. 7 Capacity Building Philosophical Framework Culture Respect Trust Relationship Management

8. 8 Capacity Building Identifying Need Performance Deficiencies Organizational Challenges State Of Emergency Declaration AIDS Service Agencies Create For Immediate Response Limited Involvement In Broad Nonprofit Management Sector

9. 9 Capacity Building Resource Deployment Management Commitment Funding Dedicated Staff Sustained Investments Partnerships among Multiple Entities Sustained, Hands-on Engagement Local, Comprehensive, Intensive

10. 10 Capacity Building Ten-Component Model Audience Specific Outreach Managing Relationships among Entities Foundations and Corporations Government Agencies Management Service Organizations Community-Based Organizations Planning Bodies

11. 11 Capacity Building Ten-Component Model (Cont’d) Organizational Survey Direct Community–Based Organizational Support Staff and Consultant Support New Leadership Orientations Innovative Leadership Development Resource Center

12. 12 Capacity Building Ten-Component Model (Cont’d) Private Funders Council Private Support Leverage Technology Support

13. 13 Capacity Building Targets Organizations with HIV/AIDS Budget Less than $5 Million Minimum Thirty Percent of Agency’s Budget Committed to HIV/AIDS Services Community-Based Organizations in Communities of Color Demonstrated Link between Requested Capacity Assistance and Improved Services Agencies Heavily Dependent on Government Funding

14. 14 Capacity Building Activities Year 1 Upgrades Information Systems Equipment Facilities Program Development Staff Training Fundraising Fiscal Systems Audits Software

15. 15 Capacity Building Activities Year 2 Upgrades Information Systems Equipment Facilities Program Development Staff Training Fundraising Fiscal Systems Audits Software Organizational Development Planning Strategic Planning Board Development Needs Assessment Evaluation

16. 16 Capacity Building Activities Year 3 Upgrades Equipment Program Development Staff Training Fundraising Fiscal Systems Audits Software Organizational Development Planning Strategic Planning Board Development Needs Assessment Evaluation Organizational Infrastructure Survey Resource Center Service Coordination Public Health Integration

17. 17 Capacity Building Activities Year 4 Program Development Staff Training Fundraising Organizational Development Planning Strategic Planning Board Development Needs Assessment Evaluation Fiscal Systems Audits Software Organizational Infrastructure Survey Resource Center Broadened Private Funding Support Partnership with Management Service Organizations

18. 18 Capacity Building Activities Year 5 Program Development Staff Training Fundraising Organizational Development Planning Strategic Planning Board Development Needs Assessment Evaluation Fiscal Systems Audits Software Organizational Infrastructure Survey Resource Center Leadership Development Executive Directors Forum New and Interim Executive Directors Orientation Finance Directors and Staff Orientation Broadened Private Funding Support Partnership with Management Service Organizations

19. 19 Assessing Effectiveness History of Organizational Performance of Agency through Contract Monitoring Program Indicators Fiscal Fitness Timeliness of Contract Compliance Agency Budget Growth Ratio of OAPP to non-OAPP Funds Ratio of Government to Private Funds First Time Fundraising Events Completion of Contract/Program Mapping Exercise

20. 20 Lessons Learned DO… Start With Assets and Respect Build Long Term Relationships Build Trust Relationships Understand That Capacity Building is a Dynamic Process Understand that Capacity Building Takes Time

21. 21 Lessons Learned (Cont’d) DO… Build Organizational Leadership for Continuous Quality Improvement Respond to the Epidemic through Improvement in Entire System-an Agency Is Part of That System Utilize Leveraging Opportunities

22. 22 Lessons Learned (Cont’d) DON’T... Treat Capacity Building Activities As a One- time Event Approach Capacity Building from a Deficit Model Expect Isolated Activities to Result in Broad Organizational Change

23. 23 Acknowledgements This model was developed through the contributions of subject matter experts, including Joseph O’Neill, MD Christopher Bates Patricia Ware Janet Cleveland Miguel Gomez Paul C. Light, Ph.D. Honorable Yvonne B. Burke Joanne Messore Victoria Rayle Helen Hunter Claudia Lee Melanie Sovine, Ph.D. Emily Gantz McKay

24. 24 OAPP Staff Focus Group Participants (June 4, 2003) HRSA Core Consultants (April 16, 2003) CompassPoint Fund for the City of New York Peter F. Drucker Foundation Venture Philanthropy Partners Mosaica, Inc. GEO Funders Resource Center, NYC MHRA/FITA The Foundation Center Packard Foundation Organizational Development Projects Center for Non-Profit Management, LA