A Cadillac for the Price of a Chevy?

Consulting for Development of Realistic CHA/CHIP Workplans

Laurie Call, Julia Heany and Jennifer McKeever

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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

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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?

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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

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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

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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

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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?

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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 ModelsLeadership/Advisory Structures

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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.

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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

Partnership Recruitment

ORGANIZATIONAL SECTOR ("X" in sector; can X more than one box) ENGAGE LEVELPOTENTIAL ENGAGEMENT METHOD FOR CHA/CHIP

Organization or Audience/Population

Key contact

Role/Title Business

Hospital/Health

careCommty

OrgsGov’t Youth Funder

/Fdtns Housing School/Univ Faith

Focus on priority

populations (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

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Sample Tool - ToP Circles of Involvement

See NACCHO ToP Activity

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Circles of Involvement

See NACCHO ToP Activity

Circles of Engagement

Core Circle

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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.

When Designing Processes

5 Levels of Involvement

Lower Time Commitment

Higher Time Commitment

Consider theLevel of Involvement

Needed

Determine/ Design the Activity

Determine Time Estimate

Adapted from: Community at Work 2007, Sam Kaner, Facilitators Guide to Participatory Decision Making, 2nd Ed. 17

Good Reminder…

Tool to help further define roles for key processes

18MPHI Tool

Remember…

The more we tell people what is expected of them; the more accurately they can commit to their role.

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 repsIdentify 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

Sample Structure

Variety of Assessment and Planning Activities

Evaluation Team

There are many options for structures.Level and type of partners and stakeholdersImpacts the structure selected.

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

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From the PHABulous CHA/CHIP

session

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Community Health Assessment and Improvement Processes Prepared by NACCHO

http://www.naccho.org/topics/infrastructure/CHAIP/upload/CHA-and-CHIP-Processes-JJE.pdf

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Community Health Assessment and Improvement Processes

Prepared by NACCHO

23http://www.naccho.org/topics/infrastructure/CHAIP/upload/CHA-and-CHIP-Processes-JJE.pdf

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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?

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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?

Developing Consulting Agreements

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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??

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Making Decisions to Accept Work…

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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

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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!

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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?

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Defining Roles in Consulting Agreements/ Workscopes

Key Activity PHI Role Process Deliverable XYZ Role Hours/ Cost

Bi-weekly coaching Calls on Process from April 2013 – May 2014.

Provide conference call linePrepare 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

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Sample Workplan

MPHI Tool

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

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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.

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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

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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.

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Potential Resources to Support CHA/CHIP

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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?

Laurie Call

Center for Community Capacity DevelopmentIllinois Public Heath InstituteLaurie.call@iphionline.org312.850.4744 or 217.679.2827

Contact Information

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