Catherine Saucedo Deputy Director Smoking Cessation Leadership Center

1. A Strategic Model and Model Strategies: SAMHSA-SCLC Address Tobacco Use in Behavioral Health SAMHSA Policy Academy2014 Catherine Saucedo Deputy Director Smoking Cessation Leadership Center

2. Topics for Today • Performance Partnerships – Making measureable progress to strengthen healthy lifestyles • Example of Performance Partnership – SAMHSA Leadership Academies for Wellness and Smoking Cessation

3. SCLC Aim • Increase the number of quit attempts • Aims to normalize tobacco treatment among health professionals • Broaden access to cessation tools and resources

4. Partners

5. Partners

6. Work with SAMHSA • Partnered with past and current SAMHSA administrators • Created SAMHSA’s Tobacco-Free Initiative • Trained SAMHSA staff in Washington • Led to • 100 Pioneers for Smoking Cessation Virtual Leadership Academy and • State-Level Leadership Academies for Wellness and Smoking Cessation • Policy Academy 2014 In-Service Training Poster: July 7, 2008

7. Pioneers and Academy States • SAMHSA Pioneers and Academy States • Yellow = 100 Pioneers Phase I • Blue = 25 Pioneers Phase II • Pink = 8 Academy States

9. Performance Partnership Three phases that catalyzes a group of leaders to take action towards a specific measurable result. Phase 1: Preparation (3 months) • Defining purpose • Identifying partners • Developing baseline and supporting data Phase 2: Performance Partnership Summit • Leaders Answer 4 Questions to Create an Action Plan • Leaders personally commit to take action steps to implement the Action Plan strategies Phase 3: Execution (On-going) • Leaders being accountable for commitments to Action • Leaders implementing strategies to achieve measurable results

10. Performance Partnership Model - SAMHSA Leadership Academies • Model developed in the 90’s during Clinton-Gore administration • Has produced a variety of measurable results from reducing child abuse and teen pregnancy to salmon restoration and bay cleanup, and tobacco cessation

11. A Way to Stretch Scarce Resources • Partnerships can be greater than the sum of the parts • Population-based approaches are feasible with partnerships • Can make a big dent in the smoking prevalence rate and improve the health of our communities

12. The Performance Partnership Model • Group organized around a specific, measurable result • A results-based accountability facilitator takes each group through a series of steps to determine a baseline, a target, multiple strategies, and an impact measurement plan. • Questions are the basis of the action plan

13. The Four Questions • Where are we now? • Where do we want to be? • How will we get there? • How will we know we are getting there?

14. Where are we now? Setting the Baseline • Need a jumping-off point against which to measure progress • Statistical baselines are good– teen pregnancy rates, school dropout rates, childhood immunization rates • In the case of smoking– number of clinicians that intervene with smoking patients or percentage of smokers with behavioral health disorder

15. Robert Wood Johnson Foundation – county health rankingshttp://www.countyhealthrankings.org/Interactive Tobacco Map Provides Latest Data on State Smoking Lawshttp://www.rwjf.org/publichealth/product.jsp?id=56548CDC Behavioral Risk Factor Surveillance Systemhttp://apps.nccd.cdc.gov/brfss/NISdUH - ALA County benchmarks

16. Adopting the Baseline It all starts with the Gallery Walk

17. Trend Over Time Data

18. Where do we Want to Be? Setting a Target • This requires complete agreement on a single measurable outcome • Agreement on the what rather than the how • This provides the focus for the partnership

19. Baseline and Target

20. How Will We Get There? Multiple Strategies • No one party owns the answer to “How will we know we are getting there?” • Allow a wide array of strategies– even competing strategies– to be used by the various partners • Loose governance structure • This maximizes engagement and commitment among partners

21. How will we know we are getting there? Evaluation • Devise a measurement strategy • Both process and outcome measures are needed • If measures are moving in the wrong direction, regroup and rethink strategies • Publicize progress to keep partners involved

22. MS Summit Capturing strategies, forging new partnerships , creating an action plan

23. State Academies Lessons Learned

24. Celebrate Successes • As you progress toward your goal, honor those who are making a difference • Share what is working with partners and community • Use data to manage, motivate, and celebrate

25. Catalytic Leadership • A style of leadership placing the good of the community and the accomplishment of an agreed upon outcome over personal gain or recognition • Leader engages and motivates others to take on leadership roles, engaging everyone to work towards a common vision

26. Performance Partnerships • Circumvent hierarchy and turf.

27. Performance Partnerships • Focus on measurable results tied to a vision. MEASURABLE RESULTS VISION

28. Performance Partnerships • Draw from all sectors and all levels of government using an open door policy. Don’t forget to include non-traditional partners.

29. Performance Partnerships • Focus on better use of existing resources. • people • money • time

30. Performance Partnerships • Employ multiple strategies. Allow partners to “agree to disagree” on the strategy as long as they agree on the result.

31. Performance Partnerships • Measure progress frequently. Measure today!

32. Performance Partnerships • Agree to flexibility in exchange for accountability.

33. Performance Partnerships • Generally, use an inductive approach rather than a deductive approach--just get started!

34. Performance Partnerships • Tolerate mesy messyn messiness and asymMetRy.

35. Performance Partnerships • Encourage self-organizing efforts.

36. Performance Partnerships • Reward progress, but remember rewards don’t have to be financial. • They can include lots of positive attention, flexibility, increased trust and other non-traditional benefits.

37. Performance Partnerships • De-emphasize programs. Emphasize partnerships and cross-sector initiatives.

38. One Example of a State Initiative • The New California Gold Rush

39. Sustaining the Partnership After the summit and beyond

40. What Happens Next • Immediately solidify and start implementing the action plan • Model very fast pace of action • Plan is a work in progress and can be continually updated • Hold frequent early meetings or phone calls to sustain momentum

41. Assigning Tasks • Invite partners to sign up for various strategies during the summit and after • Allow self-organization; each group can do it differently • Can be subcommittees, individuals, task force responsibility

42. Riding Herd on the Partnership • Catalytic leader keeps eye on implementation of the plan • Keep communication going • Watch for breakdowns; step in to try to help • Reminds the group they are capable of making change on their own, as individuals, a full partnership or a task force within the partnership

43. Think Ahead Toward Sustainability • Look for partners who will keep going • Look for a mix of resources to help that happen– funds, leadership support, administrative support, and worker bees

44. Strengthen Relationships • Work to build trust and rapport with each partner • Encourage information sharing and trust among partners • Celebrate successes very frequently– keep the tone upbeat and positive • Announce progress to motivate partners to keep going

45. What To Do with Difficult Partners • Keep emphasizing pursuit of the result and flat organization • Many who crave control or don’t care about the result will drop out • Create a climate that makes inordinate power grabs or dominance unacceptable through careful use of language of results • Emphasize that the partnership is not about money, but results

46. Partnership know how

47. Get Your Data Organized First • For your locality, have an answer to the question, “Where are we now?” • If you have comparison data for neighboring localities, it can be useful to spark competitive spirit. • Look for recent surveys and studies, contact state health and tobacco control agencies, use Internet to search for more information • Start thinking of a good, inspiring name for the partnership and build consensus for adopting it

48. Defining the Challenge • Need to answer the question, “Why should I get involved?” • Clarify the case for joining the partnership • Recruiting people who want to make a difference

49. Scouting for Key Partners • Who cares most about the result? • Who can bring resources to the table? • Who can work collaboratively? • Who might some unorthodox players be– not just the usual suspects?

50. Persuading them to join • Make the pitch one on one • Use your data • Appeal to altruism– it’s the right thing to do • Explain that all will share accountability for the result, and no one person will have to do it all • Urge potential partners to bring resources to the table– resources of any kind, from funding to person power