1. A Cadillac for the Price of a Chevy? Consulting for Development of Realistic CHA/CHIP Workplans Laurie Call, Julia Heany and Jennifer McKeever 1

2. 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 Learning Objectives 2

3. 3 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?

4. 4 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

5. 5 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

6. 6 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

7. 7 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? 7

8. 8 Other Questions… What other questions do you ask clients to understand their needs? What do the questions yield?

9. From Questions to Advising and Tools… CHA /CHIP Models Leadership/Advisory Structures 9

10. 10 Effective Leadership/Advisory Structures for CHA/CHIP Levels of stakeholder buy-in and engagement needed: Current Level of Stakeholder Involvement Level of Stakeholder Involvement Needed to Achieve Goals Where are the gaps? What needs to be built? Who needs engaged? Understanding this helps determine the structure needed.

11. 11 Identifying Community Partners Worksheet 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? How can we support the engagement of this organization or individual? 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

12. Partnership Recruitment ORGANIZATIONAL SECTOR ("X" in sector; can X more than one box)ENGAGE LEVEL POTENTIAL ENGAGEMENT METHOD FOR CHA/CHIP Organization or Audience/Population Key contact Role/ Title Business Hospital/ Health care Commty Orgs Gov’tYouth Funder /Fdtns Housing School /Univ Faith Focus on priority population s (Latino, homeless, youth) Already engaged in another initiative via interviews, focus groups, or other? Priority level (1,2,3) KII Focus group Survey Event/ Mtgs Email CHIP work

13. 13 Sample Tool - ToP Circles of Involvement See NACCHO ToP Activity

14. 14 Circles of Involvement See NACCHO ToP Activity

15. Circles of Engagement Core Circle

16. 16 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. RecruitmentEngagementRetainment

17. Presenting and Reporting Comments and Questions Extensive Discussion Convergence and Alignment Ownership and Commitment When Designing Processes 5 Levels of Involvement Lower Time Commitment Higher Time Commitment Consider the Level of Involvement Needed Determine/ Design the Activity Determine Time Estimate Adapted from: Community at Work 2007, Sam Kaner, Facilitators Guide to Participatory Decision Making, 2 nd Ed. 17 Good Reminder…

18. Tool to help further define roles for key processes 18 MPHI Tool Remember… The more we tell people what is expected of them; the more accurately they can commit to their role.

19. Leadership Team Stakeholder Advisory Committee Community and All Local Public Health System Representatives Action Team 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. 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 3-5 members Usually 20 + members

20. Leadership Team StakeholdersCommunity Action Team Sample Structure Variety of Assessment and Planning Activities Evaluation Team There are many options for structures. Level and type of partners and stakeholders Impacts the structure selected.

21. 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 Helping Clients Match a Model/Process with Resources 21 From the PHABulous CHA/CHIP session

22. 22 Community Health Assessment and Improvement Processes Prepared by NACCHO http://www.naccho.org/topics/infrastructure/CHAIP/uploa d/CHA-and-CHIP-Processes-JJE.pdf

23. 23 Community Health Assessment and Improvement Processes Prepared by NACCHO 23 http://www.naccho.org/topics/infrastructure/CHAIP/uploa d/CHA-and-CHIP-Processes-JJE.pdf

24. 24 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?

25. 25 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?

26. Developing Consulting Agreements 26

27. 27 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??

28. 28 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?

29. 29 Developing Effective Consulting Agreements 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. See Sample Contract /Agreements with Resource Materials

30. 30 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!

31. 31 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?

32. 32 Defining Roles in Consulting Agreements/ Workscopes Key ActivityPHI RoleProcess DeliverableXYZ RoleHours/ Cost 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 coaching session including action items/ due date Prepare coaching prep form and submit to coach 1 day prior. Establish coaching calendar. Gather community input regarding themes and strengths Provide guidance on methods and tools. Summary of suggested models and tools. Select model and tools. Train health educators to collect data Tailor materials to tools/ method and location. Training agenda and materials Recruit health educators. Copy training materials. Coordinate training logistic

33. 33 Sample Workplan MPHI Tool Includes good documentation for accountability and QI…scheduled vs. actual started date and completion dates, who, comments, accomplished.

34. 34 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.

35. 35 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

36. 36 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.

37. 37 Potential Resources to Support CHA/CHIP Public Health Institute Federal National Orgs Foundation LocalState

38. 38 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?

39. Laurie Call Center for Community Capacity Development Illinois Public Heath Institute Laurie.call@iphionline.org 312.850.4744 or 217.679.2827 Contact Information 39