Building Community (Health): Lessons Learned in One Community

1. Building Community (Health): Lessons Learned in One Community Leslie L. Clarke, Ph.D. Kari Ellingstad, M.P.H. Bill Little, MBA, M.P.H. Sarasota County Health Department Community Health Improvement Partnership

2. CHIP: Community Health Improvement Partnership • Started just prior MAPP • Built with Foundation and hospital funding • Initiated by Foundation & non-profit community engagement org. with support of HD • Now managed by HD with fuller integration into HD planning and goals

3. What we are learning (good and bad) • What seems to works • What doesn’t work • Major mistakes

4. Shared control (identifying problem, collecting data, solution building) leads to community ownership What worked: Involving Citizens in all phases • Data Committee decided what data to study, how to present it, etc. • Ad hoc Survey Committee developed survey What didn’t work: Too much data. • Need more executive summaries/white papers • Published more results • Subcommittee to review and summarize data Major Mistake: Problem focus • Use an asset-based focus to build on what was working

5. Work Local but Think Regional What worked:Community Health Action Teams • Citizens focused on their towns and neighborhoods • Mapping health data at the zip code level • Local strategic plans (that can interface with regional plan) What didn’t work:Not enough study of communityor region • Should have done more study of demographics- focus on poverty-health linkages • Too many agency presentations not enough anecdotes • Didn’t engage enough key community leaders • Many cross-county challenges to communities; needed data Major Mistake:Developed regional focus late in process • Create both levels of focus simultaneously; establish need for each other

6. Visioning – at the Right Stage What worked:Envisioning achievable future • Completed SWOT early on • Focus on the practical – what can we impact • Develop long-term plan: 5-10 years out What didn’t work: Not done soon enough • Should have done right after reports were complete • Left with problem orientation and not vision • Should have had committee members engaged in city envisioning processes Major Mistake:Should have developed vision earlier • Use data and agency strengths to do visioning • Summarize and cross-correlate community assets

7. Partnerships, Built on Relationships, are Critical What worked: Citizens & agencies as partners • Citizens valued for their knowledge and perspectives • All opinions are welcome; use consensus for decision-making • Rules for meeting process helps • Annual Community celebrations to recognize all involved What doesn’t work: Did not engage all volunteers in ways that fit their interests/skills • Learn what each person wants from their involvement; work to find ways to meet need (if appropriate) • Learn what talents each member/agency has to offer – assign based on talent and interest • Provide information in many formats for different types of learners Major Mistake:Not engaging key citizens one-on-one • Personal invitation key; personal assignment of task • Need more recognition of citizen and agency volunteers • Train volunteer leaders to engage new members immediately

8. Link Local Agencies: Use Common Vision that Came from the Community What worked: Agencies working together toward local goals • Development of goal from community reduces agency turf issues • Support collaborative grant applications on behalf of community • Build on what works: YMCA programs; Goodwill programs What doesn’t work: Engaging Voluntary orgs in vision • Voluntary organizations (Rotary, Chambers, Sertoma) have own mission; don’t engage in others’ • Don’t have community group try to fit mission of agency Major Mistake: Share mission and goals of agencies early • Like citizens, need to ask agencies what they need to get from participation • Agencies are not always used to working together; provide opportunity for collaboration

9. Some Examples of Lessons Learned: New CHIP/HD Initiatives

10. Community Solution Building:Diabetes In-Home Care Project and CHIP Centers Shared Control • CHATs identified and owned senior isolation and lack of access to health information and wellness as key problems • Citizen committees developed the Care Team solution and CHIP Centers concept • Pursued funding and are implementing interventions in collaboration of key agencies Agency Collaboration • partnership with 5+ local providers to implement • partnership with USF to add research component and for funding

11. Regional Solution Building:Health Leadership Project Working Local and Regional Realized we were missing regional perspective. • Established Health Leadership Project to engage Hospital CEOs and HD Directors in quarterly meetings to discuss regional, community health issues and how to work together • Bringing national experts to meet with leaders Partnerships built on relationships • SCOPE facilitated first meeting with focus on individuals getting to know one another; moved beyond institutional identities and concerns • Asked for 1 year commitment to process, made publicly Shared Control • Holding community forums with national experts as presenters on key health issues – to educate community as well as leaders

12. Visioning at Regional Level:Health Scorecard Visioning The Health System Assessment is done. Now what? How to make health system changes. • Crafting Health Scorecard to direct county and regional focus on shared health outcome goals. • Once goals established, learn what is being done and what is needed to implement improvements • Scorecard should help direct county funding Regional and Community Focus • Establishment of County/Regional goals will give community groups common goals to target. • Health Scorecard will be integrated into County Health Department planning and County Balanced Scorecard measures

13. Visioning for Public Health:Public Health Performance Standards Assessment Shared Control Realized we had not engaged all sectors in health planning • Used PHPSA process and CHIP committees to engage more sectors in assessment • Using Public Health System model to communicate shared responsibility for public health and advance planning Partnerships and Collaborations • PHPSA provides opportunities for broad partnerships across many agencies; working together in many areas, how to expand Visioning • Will be continuing to envision community health using 10 essential services as guidelines and using community visions to inform planning

14. Future Challenges • Developing solutions to covering the uninsured and growing costs of insurance • Public Health Information exchanges – how to develop across community • Continued funding for all initiatives