Creating Change through CrossSector Collaborations Change Management Webinar

Creating Change through Cross-Sector Collaborations Change Management Webinar Series Better Health Together

About me • Independent health & social policy consultant • Worked with BHT and ACHs across the state for last 3+ years • Also work with states Medicaid agencies, Medicaid managed care plans and organizations focused on health care and social services • 20+ years experience working in health and social systems / cross-sector initiatives • Helped lead health systems transformation efforts for State of Oregon: • Founding Director of Oregon Transformation Center • Implemented Oregon Healthy Kids Program • Past work includes child and family policy advocacy (Families USA, Children First for Oregon, co-chair Human Services Coalition of Oregon) Cathy Kaufmann, MSW Kaufmann Strategies

What is Change Management? • Change is hard – in fact, so hard that most (75%) change efforts fail • Change Management is a systematic approach to helping people and organizations successfully implement change • Change management is not project management • Project Management: Technical side of moving from the current to the future state • Change Management: People side of moving from the current to the future state • Cross-Sector Collaborations are the only way to truly manage change at the community level

• What cross-sector collaboration is and why it matters • Models of cross-sector collaboration Today’s Presentation • • Needle Moving Collaboratives Comprehensive Community Initiatives Turning Outward model Collective Impact model • Resources and tools to support cross-sector collaboration • Q&A

What is Cross. Sector Collaboration? • Cross-sector collaboration is “alliances of individuals and organizations from the nonprofit, government, philanthropic, and business sectors that use their diverse perspectives and resources to jointly solve a societal problem and achieve a shared goal” -Becker & Smith, 2018

Why is Cross-Sector Collaboration Important? • Increasing awareness that complex problems can’t be solved with siloed solutions • Cross-sector collaborations help organizations abandon their individual agendas in favor of a collective approach • This approach can be more effective than solutions embodied within a single organization

Models of Cross-Sector Collaboration

Needle Moving Collaboratives • President Obama created the White House Council for Community Solutions to demonstrate the power of engaging “all citizens, all sectors working together. ” • The Council decided to look beyond individual programs and instead examine communities that are solving problems together and moving the needle in a way that improves results for the whole community • They worked with The Bridgespan Group to identify effective needle-moving collaboratives (those that have achieved at least 10 percent progress in a community-wide metric), understand the keys to success, and recommend ways to drive more collective impact

Needle Moving Collaboratives: 5 Core Elements for Success 1. Shared vision and agenda 2. Effective leadership and governance 3. Alignment of resources 4. Dedicated staff capacity and appropriate structure 5. Sufficient funding

Five Characteristics of Needle Moving Collaboratives: 1. Shared Vision and Agenda • Developing a common vision and agenda is one of the most time-consuming and challenging of all the tasks a community collaborative undertakes, but it is one of the most vital. • Establishing quantifiable goals can catalyze support and build momentum. • Developing a clear roadmap can help organizations look beyond narrow institutional interests to achieve broad goals. • Successful collaboratives usually conduct extensive research and data collection to understand both the problem and how systems will need to shift over time. • Community members should actively share in the process, or collaboratives may pass up an opportunity to get better results and sustain their accomplishments over the longer run.

Five Characteristics of Needle Moving Collaboratives: • Successful collaboratives need a strong leader to fully engage stakeholders and coordinate their efforts. 2. Effective Leadership and Governance • The biggest challenge is not so much bringing decision makers to the table but keeping them there for years of hard work ahead. • To achieve such a feat, it is important for the collaborative’s leader to be highly respected by the community and viewed as a neutral, honest broker. • The leader must work to create and maintain a diverse and inclusive table where both larger organizations and smaller grassroots organizations have a powerful voice. • Highly structured governance is not required, but decision-making rules must be very clear

Five Characteristics of Needle Moving Collaboratives: 3. Alignment of Resources • Successful collaboratives pursue a logical link between the goals they seek, the interventions they support and what they measure to assess progress. • Sometimes collaboratives push for new services to fill in gaps, but much of their work focuses on “doing better without spending more”— to align existing resources and funding with the most effective approaches and services to achieve their goals. • In many cases, this will mean working together to target efforts towards particular populations, schools or neighborhoods rather than operating in a more ad hoc manner • Effective collaboratives make extensive use of data at every stage of their work: • To define the problem; • To set and collect output measures; and • to provide an agreed-upon set of outcome measures that would be used to define success.

Five Characteristics of Needle Moving Collaboratives: 4. Dedicated Staff and Appropriate Structure • Having a dedicated staff is critical to success • Staff structure must be appropriate to the collaborative’s plan and goals. • Staff create agendas, facilitate meetings, push the work ahead between meetings, keep members informed about current progress and maintain relationships with the broader partner group • There is no predetermined right size for a collaborative’s staff. Effective staff teams can range from one full-time strategic planning coordinator to as many as seven staffers for more complex, formalized operations. • In general, dedicated resources should focus on the following roles: • • • Convening Facilitation Data Collection Communications Administration

Five Characteristics of Needle Moving Collaboratives: • Collaboratives require funding both to maintain their dedicated staff and to ensure that nonprofits have the means to deliver high-quality services. 5. Sufficient Funding • Even though the first job of most collaboratives is to leverage existing resources, truly needle-moving collaboratives had at least a modest investment in staff and infrastructure. • This investment often included in-kind contributions of staff or other resources from partners. • Sustainable funding itself becomes one of the collaborative’s key objectives, as does “funder discipline”—sticking with the plan rather than developing individualized approaches or continuing to fund activities that aren’t part of the strategy.

Comprehensive Community Initiatives • In the 1980 s-90 s a broad set of initiatives was launched which placed ‘community’ at the heart of anti-poverty policy in poor urban neighborhoods. • These efforts were called ‘comprehensive community initiatives’ or CCIs. • Many CCIs elect to work through a new collaboration of some form, with no single agency taking the lead.

Comprehensive Community Initiatives • CCIs are usually made up of residents and non-residents who are perceived to have access to outside resources or power. • CCIs seek to create new or improve existing assets in a neighborhood or community to help build its physical and/or social infrastructure. • Key goal is to develop the capacity of residents and institutions to define and solve neighborhood challenges • Their Degree of formality varies widely, from temporary ad hoc collaboratives to formal boards that create new, independent 501(c)(3) organizations. • Creating a new collaboration is seen as necessary in some of the most depleted neighborhoods, either because they lack neighborhood institutions or because those that exist are unlikely to be able to deal with all the demands that a CCI places on an organization.

• Aspen Institute has studied and promoted CCIs. Key Features of CCIs • CCIs are: 1. 2. 3. 4. 5. 6. Comprehensive Holistic Multisectoral Long-term Developmental Concerned with both the process and outcome

• "Turning outward" is a step-by-step process developed by The Harwood Institute for Public Innovation. • It entails taking steps to: Turning Outward Model • Better understand communities; • Changing processes and thinking to make conversations more community-focused; • Being proactive to community issues; and • Putting community aspirations first. • Too many leaders and organizations are turned inward, focused—often unintentionally—on themselves and their organizations at the expense of their communities • The practice is rooted in a mindset of “using the community as your reference point for creating change, and not your conference room. ”

The Turning Outward Model is Rooted in 5 Big Ideas 1. 2. 3. 4. 5. Community ownership Strategies that fit the community A sustainable enabling environment A focus on impact and belief The story a community tells itself

The 5 Big Ideas of the Turning Outward Model: 1. Community Ownership • Taking effective action in communities depends on genuine ownership by the larger community. • Data is an important piece of this, but not enough. • Public knowledge (not just expert knowledge) is extremely valuable • This only comes from authentically engaging the community.

• Communities are in one of five stages (“community rhythms”)—and the key is to know which stage a community is in at any given time. The 5 Big Ideas of the Turning Outward Model: • • • Waiting Place Impasse Catalytic Growth Sustain and Renew • Most communities are in one of the first 3 stages 2. Strategies that Fit the Community • The five stages of community life help explain why some communities move faster and others slower when it comes to change. • Each stage has its own implications, or do's and don'ts. • The same strategies may work in one community, but not another. What it takes to accelerate and deepen change varies, given the stage a community is in.

The 5 Big Ideas of the Turning Outward Model: 3. A Sustainable Enabling Environment • Collaboratives must create a sense of possibility, the right “enabling environment” • These are the underlying conditions that allow change to occur and for the community to change how it works together • Without the right enabling environment, well-intentioned efforts will not work

• Collaboratives usually believe in having impact – but equally important but often overlooked is “belief” The 5 Big Ideas of the Turning Outward Model: • Belief is that intangible factor that prompts and prods people to step forward and engage 4. A Focus on Impact and Belief • It makes people willing to join with others and enables people to transcend their self interests to forge common interests • How you do your work is as important as what you do.

• The stories people tell about community shape their mindsets, attitudes, behaviors, and actions. The 5 Big Ideas of the Turning Outward Model: • These stories affect people’s sense of possibility and hope. 5. The Story a Community Tells Itself • They are the greatest hidden factor to whether a community moves forward or not. • Collaboratives must create authentic, “cando” narratives that combat negative ingrained narratives and give people a sense of hope the community is on a new trajectory.

• The concept of collective impact was first articulated in the 2011 Stanford Social Innovation Review article Collective Impact, written by John Kania, Managing Director at FSG, and Mark Kramer, Kennedy School at Harvard and Co-founder FSG. Collective Impact Model • Collective Impact is a cross-sector partnership framework that “brings people together, in a structured way, to achieve social change. ” • There are five conditions of Collective Impact: 1. Start with a common agenda 2. Establish shared measurement 3. Foster mutually reinforcing activities 4. Encourage continuous communication 5. Have a strong ”backbone”

Collective Impact: Principles of Practice • Design and implement the initiative with a priority placed on equity • Include community members in the collaborative • Recruit and co-create with cross-sector partners • Use data to continuously learn, adapt and improve • Cultivate leaders with unique system leadership skills • Focus on program and system strategies • Build a culture that fosters relationships, trust and respect across participants • Customize for a local context

1. Do we aim to affect a needle-change (i. e. , 10% or more) on a community-wide metric? Five Questions to Ask before Using Collective Impact 2. Do we believe a long-term (3 -5+ year) investment is needed by diverse stakeholders to achieve success? 3. Do we believe cross-sector engagement is essential for community-wide change? 4. Are we committed to using measurable data to set the agenda and improve over time? 5. Are we committed to having community members as leaders, partners and producers of impact?

Resources & Tools

Readiness for Cross-Sector Collaboration • Public Health Foundation developed a matrix for potential cross-sector collaborative members to use to prepare for a change initiative • The matrix provides a structure for members to discuss what they have in common, their differences, barriers holding them back from collaborating, and what it will take to collaborate. • After going through this process, the collaborative is ready to determine the focus areas of the crosssector initiative.

Cross-Sector Collaboration Readiness Matrix 1. Commonalities 2. Differences 3. Barriers 4. Collaboration Areas

Tamarack Institute Tools • Building community readiness for collective impact tool • Individual organization readiness assessment tool • Building resilient and sustainable Collective Impact initiatives tool • Community engagement tool • Tool for developing strong backbone organizations • Evaluation tool

Questions?