Book Club Webinar 2

We had a book club webinar yesterday to talk with current MAPH students about their progress in terms of industry analysis, community need, competitors and partners, marketing, and project operations. Some of the following issues, thoughts, and suggestions were raised. Do you have any further advice for our community of practice?

Issue: When your community health assessment identifies a problem, but industry analysis reveals a barrier to meeting that problem in a sustainable way.

Example: We have developed an obesity prevention program that will be a summer camp for children. Industry analysis revealed that one success factor is being able to charge enough to pay for the health care and physical education personnel who will work for the program. Alternatively, a success factor is to have a pool of professionals available for volunteer work. We won’t be able to charge enough, so that becomes a barrier for us. We are in a rural county with low income population. We don’t have a large number of professional volunteers to call upon either.

Some ideas: 1) broaden your area of reach. Look to make it a region-wide program rather than just for your county; 2) start smaller; 3) see if insurance will pay, if children are referred by physicians; 4) partner with another group running a summer camp (YMCA?), and be part of their program; 5) charge a sliding-scale fee; 6) consider things that could be offered in-kind to support the program.

Issue: We’ve got a community health assessment telling us exactly what the public should do to be more healthy. How do we communicate with people about the need to change behavior, environment, etc. without insulting or patronizing them?

Thoughts: Public health workforce needs development in social marketing. We need to learn how to talk with people and understand their struggle. We don’t want to send the message – “your neighborhood is run-down and has bad grocery stores and no sidewalks” or, “you are overweight and need to exercise more and eat better” -- because these messages are not going to encourage change. The message of need has to first come from them, and it has to be communicated respectfully. Sometimes public health people are too focused on the big picture and all the problems that need to be solved. We need to step back and give people space, “partner with people,” listen to them and have respect for their understanding of their own community and its strengths and challenges.

Issue: We’ve brainstormed and identified partners who “have what we need,” but they aren’t interested in working with us. It may be the economic times, or it may just be the small relative scale of the project we’re planning, but we can’t make headway getting partners on board.

Suggestions: think of the partnership as more than a one-shot deal, more than just what they can give you: think of it strategically and long-term. If you can, get on their board, or on the board of some other community project they’re involved with. If you are not the appropriate person in your organization to do this, identify the colleague who is appropriate, and try to get him or her involved. This way the potential partner will see the value you bring to the table and may be more apt to consider you a potential partner. Also, try to find out why the potential partner is not interested. Is it a current circumstance, like the economic downturn, or are they truly not interested in the project? If the latter, find out what they are interested in, and come back later with a different plan, closer to their interest. Either way, if you become involved with their organization in some way, they will be able to see the value of working with you.

Issue: We have not really communicated with our superiors about our project since we first were accepted to the Management Academy. Our project has changed a lot since then.

Suggestions: The Management Academy curriculum has begun including very early discussions with business plan advisors, to troubleshoot before teams even begin so that project change may become less of an issue going forward. The risk here is that your project may have changed to the extent that you need some of your colleagues to help you in its operation. If they don’t know what you’re working on, will they be willing to be part of it when the time comes to implement? Another risk is that your boss may not give you the resources or other support you need if he or she feels you have not communicated well. Try to get a standing agenda line at your staff meetings for talking about your Management Academy progress.

Issue: We’re facing budget cuts of 23%, and have been asked to plan for an additional 15% on top of that. All we’re talking about at staff meetings is this reality.

OK, so maybe new programs are not what your staff meetings are about right now. Fair enough. Keep plugging away. Remember we’ve been through rough times before. Remember that broader support for your programs, in the form of partnerships and ample communication with political and other stakeholders, is going to carry you through.

To our readers: Please help our scholars with the issues they have raised! Have you faced similar challenges? What advice do you have? Thanks to all who participated.
-- Anne

More fiscal issues

Following up on Steve’s post, I visited the discussion forum for the web cast on Public Health Survival: Leadership in a Falling Market (which is now posted). One of the respondents wrote in to tell about his predicament – to save money, the City Council had dismantled his public health department, transferring some functions to other departments, cancelling others, and leaving this respondent as a “department of one.”

I was shocked by the drastic nature of this city council’s actions, and it struck me that a lot of drastic stuff might be going on out there that we in academia are not fully aware of. It would help us to know what is going on for you… that way we can think about things we could do or offer that would better serve you through these trying times. In any event, as a community of practice, it would be good for us all to know what’s going on and how different individuals, organizations, and communities are dealing with it. For example, the man who is the only member of his department is working on changing his role from one of “directing and controlling to one of advising and consulting,” he said on the discussion forum. Ideally, he is drawing upon connections he’s made in the past to work with others who are now doing the work he and his colleagues used to do. He asked, at the end of his post, whether there were any role models for such a drastic transformation. All I could think of was the importance of making sure you have a community of people and organizations who understand what public health is and why it is important to them that the public stay healthy and safe: that way you'll never truly be a "department of one." But I'd rather hear from you...

If you get a chance, please write in with your stories about “providing leadership in a falling market” – whether yours personally, or those you have heard from others, and what you are doing right now to cope with the challenges of these times. And we realize there are still the day-to-day challenges – what is getting cut in your health department? Are you seeing a change in your clientele as a result of the economic downturn? Also, if you’ve undertaken public health business planning in the past, are you having any positive results of work you’ve done building partnerships, using business practices, and the like?

- Anne

Fiscal issues

If you didn't see it live, take a look at the webinar on public health survival in a falling market-- should be archived at the site in the next week or so.

Here are two things that came out of the session that stuck with me and that seem to apply to our continuing discussion here:

• Reach Out To Partners: Now may feel like the time for your organization to circle the wagons, pull back, go into your shell.It isn't. Jim Marks at Robert Wood Johnson Foundation says now is the time to reach out, and Bobby Pestrunk, the new director of NACCHO, agrees. Here's my take on why: resource deficits make it tough on many different organizations that are trying to make communities more healthy. Bobby points out "your partners are hurting too." The fiscal crisis makes it more important-- and perhaps paradoxically easier-- for you to work together now. Leah Devlin (state health director in NC) talks about going after big grants and lining up health care partners, for instance.
  
• Look For New Resources: Of course. Yes, the budget is shrinking. Some things that your organization had been doing will no longer be possible. So what things do you stop doing? The opportunity here is to stop doing things that are inefficient and unimportant... and use the newly-discovered time and energy to do something new, different, more effective, more useful to your constituents, more valuable to your funders, more timely and relevant. As recently as last year, I had public health leaders tell me that their plates were too full, they had more programs and partners than they could track, and that they wished they could get out of some of their long-term commitments!
  

I'll stop there and listen to what you think--

--Steve Orton