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Ten Places Where Collective Impact Gets It Wrong April 8, 2016

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The following was published in the Global Journal of Community Psychology Practice (www.gjcpp.com) in March 2016 .

Summary Table: Ten Places Where Collective Impact Gets It Wrong

Tom Wolff Ph.D

1)      Collective Impact does not address the essential requirement for meaningfully engaging those in the community most affected by the issues.

2)      A corollary of the above is that Collective Impact emerges from  top-down business consulting experience and is thus not a true community development model.

3)     Collective Impact does not include policy change and systems change as essential and intentional outcomes of the partnership’s work.

4)      Collective Impact as described in Kania and Kramer’s initial article is not based on  professional and practitioner  literature or the experience of the thousands of coalitions that preceded their 2011 article.

5)      Collective Impact misses the social justice core that exists in many coalitions.

6)      Collective Impact mislabels their study of a few case examples as “research”.

7)       Collective Impact assumes that most coalitions are capable of finding the funds to have a well- funded backbone organization.

8)      Collective Impact also misses a key role of the Backbone Organization – building leadership.

9)     Community wide, multi-sectoral collaboratives cannot be simplified into CI’s five required conditions.

10)  The early available research on Collective Impact is calling into question the contribution that CI is making to coalition effectiveness.

Tom Wolff & Associates,Leverett, MA. tom@tomwolff.com, www.tomwolff.com

http://www.gjcpp.org/en/resource.php?issue=21&resource=200

 

Would love your thoughts. Please  share and disseminate.
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The Emerging Non Profit World in Saudi Arabia: A Promising Glimpse January 8, 2015

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Tom Wolff addressing conference in Khobar, Saudi Arabia

Tom Wolff addressing conference in Khobar, Saudi Arabia

SA Conference

The email arrived out of the blue in June of this year. The email was titled, “Invitation to speak at top Saudi NPO Conference!” They were inviting me to give a keynote address in early November at the annual non-profit conference at King Fahd University of Petroleum and Minerals in Khobar in the Kingdom of Saudi Arabia. I was baffled – how did they find me? Why did they want me? What were they asking of me?

The last question was made clear in their email: “Knowing you are an expert, academic and consultant in the field of community development, we would like to invite you to speak at our conference and give a keynote presentation about community development and the role of the non-profit sector in light of the roles of the other two sectors (public, business).”

So,over the next few weeks and months we talked, emailed and negotiated the topic and content of my talk. Ultimately it was titled: Enhancing Collaboration Across Government, Business and Non Profits: Building Healthy Communities in Saudi Arabia.  Throughout that time I wondered what they really wanted from me, what was awaiting me, and what was happening in Saudi Arabia. I let them know that all my community development work and healthy communities work is based on core principles of democracy and was that going to be okay to discuss in the Kingdom of Saudi Arabia (KSA)? They reassured me that it would be fine. So, I proceeded with their support to acquire a visa and booking flights etc.

I read a few books on visiting Saudi Arabia and started to learn about the country as best I could from here in the US. I learned about the ‘religious police’ who enforce the wearing on burkas for  women. I watched a wonderful Saudi movie, Wajdja, (from a female director) about a girl wanting to ride a bike (not acceptable). I checked out the websites on “women driving in Saudi Arabia” – which states that this is the only country in the world where women can’t drive. I learned that a large percent of the Saudi work force (especially lower level jobs) were performed by foreigners (ie 1.5 million from the Philippines). I read on the visa application that violations of Saudi drug laws were punishable by death. I was fascinated and remained baffled.

I was told that there are 1400 non-profits in Saudi Arabia, 700 of them being Islamic teaching organizations. That leaves 700 doing the work that non-religious non-profits do here in the US. That’s not many non-profits, I imagine we have 700 non-profits just here in western Massachusetts.

They later informed me that on top of the keynote they also wanted me to offer a 6 hour workshop on the actual ‘how to’s’ of community development and to consult on some of their projects while I was there — it was going to be a busy visit.

Just before leaving,  I learned of the amazing roster of presenters that they had lined up for this two day event:  Bunker Roy and Meagan Carnahan of the Barefoot College in India; Iqbal Quadir  from MIT focused on inclusive ventures in low income countries ie. Grameenphone in Bangaladesh; Aaron Hurst on the  Purpose Economy and  Pro Bono as a Powerful Solution; Rodrigo Baggio  of Brazil Center for Schools on Digital Inclusion in Rio’s favelas; Tony Meloto who  builds sustainable communities in slum areas in the Philippines, Farm Village Universities; Robert Ashcroft from Arizona State University on  Creating and Sustaining Non -profit Workforce; Michael Grogan from Calgary, Canada on Workforce development in non-profit sector;, and Stephen Brien from England on Social Impact Bonds. This was a much more fascinating line up of speakers than I have heard at a US non-profit conference in decades.

Most of them were much more prominent on the global scene than I was ie. Bunker Roy one of “ the 100 most influential people in the world” and Rodrigio “top leader in South American to watch” both by Time Magazine. But as my visit evolved it became clear that my host, Salem Aldini (a professor of mechanical engineering), was planning to  develop a Non Profit Institute at King Fahd University and to launch community development projects across the country starting with a few pilots. This was my area  of expertise.

So I began to understand that I was chosen as someone who could convey specific processes and tools for their hand- picked audience of 150 non- profit and family foundation leaders. I could also expose them to tools in the Community Tool Box (ctb.ku.edu) which is  translated into Arabic.

During my four days I began on day one by working with a small group consultation with the faculty who would be the facilitators in my upcoming six hour workshop, gave the kick off keynote address, followed by an afternoon discussion session.  Then, two days later, a consultation to the teams planning the community development pilot and another team working on youth interventions who were looking for innovative ways of assessing youth needs. Finally I delivered a six hour workshop to a small hand chosen group of 35 non- profit and foundation leaders. It was a workout for them and me.

The Saudi faculty, foundation and non- profit leaders whom I met with in the small group consultations were very serious about trying to bring community development innovations to the Saudi non- profit and foundation world. They asked lots of questions, took lots of notes. Clearly , they were most curious about this work. This is startling in light of the repression and limited practice of democracy in Saudi Arabia. We often got to the point in a discussion, especially when talking about evaluation and documentation,  where they said that although the government collects data it is generally unavailable to those in the university , foundation and the non-profit world.

In one small group I did learn of people working at the community level bringing the three sectors (business, government, non- profit) together to address crises over the last few years such as: the flooding  in Jeddah, the influx of Kuwaiti refugees after the Gulf War, and helping female teachers get transportation to work.

The second class citizenship of women was always present in our discussion. The keynote audience was all male in the auditorium, while the talk and slides were also shown in a separate conference room to the women. At the buffet breakfast one morning a woman in full burka addresses me;  she was a participant in the other room – liked my talk but complained about Bunker’s Barefoot College because it took the Grandmas away from villages to become solar engineers. Why not take the men? She is Secretary General of the International Islamic Women’s Association. I asked if it was alright for me to sit with her for breakfast (I was fascinated). Although, she said ‘yes’, when I sat down she spent all her time of the cell phone – so I assumed it was not really acceptable and I moved.

A few people attending the conference explained to me that Mohammed both worked and prayed  side by side with his wife – so that the precedent for the separation of the women was not really clear.

Of course, in most cultures, to my knowledge women do the core community building work , often below the radar. That has been true in almost all my community development and coalition building work in the US. But in KSA,  it is tricky to build coalitions because men and women have to be separate – we were deep into a conversation about a planned model community development project in a limited geographic area (a city neighborhood) when I asked whether we would be able to mobilize the men and the women together – I was told “no”, that it would be two separate but coordinated efforts – mind boggling to an American community builder.

But interestingly enough, at 9 PM in my workshop all of a sudden a number of the men left – I was later told that they had promised their wives that they would be home by 9 PM!

Religious questions often surfaced during my visit. In almost all the question and answer sessions there would be statements about what the Koran said. Often these questions were not really questions but some statement of Islamic teachings that might or might not relate directly to what had just been said. Many of the Saudis were eager for us to leave with a better understanding of Islam. To that end, we were presented with copies of the Koran and a six set DVD set on understanding Islam.

My workshop was entitled “Enhancing Collaboration with Government Business and Non Profits – A workshop on Tools and Processes for Success.”  It included an overview of collaboration, and the five key principles of collaborative solutions from my book (The Power of Collaborative Solutions). I helped them take a view of non-profit functions beyond individual, remedial work done by professionals and to expand to working with families, tribes, the whole society and going beyond remediation to include prevention, development and empowerment as legitimate non-profit functions. This seemed to be an important expansion of scope for them. We covered planning tools such as: coalition start up and planning, SWOT Analysis, visioning, force field analysis, developing a road map, barriers, tools for engaging the community and finally  collaborative leadership. The Community Tool Box was demonstrated. The participants were eager to engage with all the material but it was hard to tell exactly how much they would actually take back with them and use. Doing an English/Arabic bilingual workshop for 35 participants over six hours with two breaks for prayer was a new experience for me. Having all the worksheets translated into Arabic was wonderful but it made it impossible for me to indicate which was the appropriate page. They all seemed to humor me as we proceeded, and I will be anxious to see the evaluations. The informal feedback after the workshop was very positive.

Some startling other learnings:

So what did I bring home?

I loved the adventure and foreignness of the whole experience in a totally different culture.

I was excited by the opportunities that Salem Aldini has opened up for a developing non-profit world in KSA

I am eager to help in the next phases of their progress. Many participants indicated that they were eager to have me come back – but in all honesty I am not sure that that wasn’t just Arabian hospitality and warmth. On the other hand, Salem informed me that he arranged for my visa to be good for five years (the visa is in Arabic so I have no idea what it says) – so maybe I will return. I would enjoy that.

Also, I was able to reflect on how my enthusiasm for the future of non-profits in KSA did not match my experience of the non- profit world in the US in 2014. Here, I see the non- profit world becoming increasing conservative, become averse to risk, and to sticking their neck out and naming the issues that stare us in the face (racism, economic inequality, etc.). Maybe we in the US can re-capture that sense of adventure that comes from an emerging non-profit sector – but I am not sure what will make that happen.

Tom Wolff

December 2014

 

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Tapping our passion for addressing systemic racism and social justice: Keeping your coalitions going after your grant money runs out October 29, 2013

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Over my forty years in the nonprofit world I have seen many multi-site coalition efforts come and go. They rise and fall with the funding whims/fads of government whether it is substance abuse, violence prevention, teen pregnancy prevention etc. I’ve never seen one of these multi- site networks of coalitions sustain themselves without either new funding or the support of the original lead organization.

The New England Racial Justice and Health Equity is the exception, so it is story worth telling.

The original network of Health Equity and Racial Justice coalitions was created by CDC REACH (Racial and Ethnic Approaches to Community Health) grants awarded to the Boston Public Health Commission’s Center for Health Equity and Racial Justice. The BPHC Center funded efforts at 13 sites across New England from Manchester NH to Springfield MA and Bridgeport Ct and obviously in the Boston area as well. I was a consultant/trainer to the Center and many of the New England sites over the five years of funding.(See below for references to the Center’s work and to my writing about their work).

The core approach of addressing health equity was through a model (see chart) that acknowledges the critical role of systemic racism in health outcomes.

racism-health-outcomes

The goals of the coalitions were to create policy changes to address systemic racism in the social determinants of health (exs. food access, educational disparities).

The issue of racism was central to these efforts from the start. For example the first BPHC brochure focused on breast and cervical cancer in Black women. The brochure language was explicit: “If you are a Black woman living in Boston and you have a greater chance of dying from breast or cervical cancer than a White woman. Why? Racism may play a key role in determining your health status. It may affect your access to health services, the kind of treatment you get and how much stress your body endures.”

Based on this health equity framework each team at all 13 sites went thru anti-racism training and learned to re-frame their community health issues in racial justice /health equity terms. This led to struggles to come to grips with racism in both their community and in themselves regardless of their racial and ethnic identity. Over time each community faced significant ‘push back” from some forces in the community to the explicit focus on and use of the term ‘racism’. In fact,  most efforts to address health disparities in the U.S. avoid explicitly using this term and instead create programs that ‘blame the victim’ i.e address health disparities in diabetes in Black men by running programs for Black men on eating well.

By acknowledging that racism is the core issue in health disparities we stirred the social justice roots of the staff and communities at the sites. This was powerful enough to keep the discussion going after the money ran out. At the last meeting before the funding ran out in October 2012 the leaders and staff from many communities expressed the desire to keep meeting. The CDC no longer was providing money, and the BPHC being a city health department could not take responsibility for organizing a New England wide group; but the group was determined. There was a strong desire to keep the discussion of race and the struggle for social justice alive.

So we named ourselves the New England Racial Justice and Health Equity Coalition and have kept meeting quarterly on a purely voluntary basis. One site acts as host for each meeting and designs the meeting, and provides the food. Sometimes if the site is short of resources we pass the hat to cover food costs.

At the first meeting we did ‘push back circles” a process designed by one site to allow the group to role play real examples where they experienced difficult ‘push back’ around racism from their community. However, this time in the role play they have three coaches to help them with feeling supported, finding the language to respond, and managing their emotions. Everyone found the experience very helpful and brought their learning back to their communities.

This process of quarterly meetings has now lasted for a full year. Part of each meeting is now spent in ‘affinity’ groups with the White participants, and communities of Color meeting separately for part of the meeting. This allows for a different level of discussion on race than usually occurs in mixed groups. As a White man I have certainly found this approach allows me to explore how I can use my White privilege to best advantage in moving this work forward without making things worse.(see the work of  Tim Wise as an outstanding example of understanding white privilege (http://www.timwise.org).

I have learned many things in the process of this experience. The lesson around sustainability seems to be that when we tap into people’s strong passions for social justice we are able to keep many people at the table even when the money has disappeared. Thus, we have another great reason to keep issues of social justice high on our agenda.

After the Trayvon Martin trial there was a national outcry for discussions of race in America. Is there a place for in your community for those discussions? And for tackling the work on health equity and racial justice through a transformative change lens?

 

References:

The Center for Health Equity and Social Justice’s work has been published and is available at (http://www.bphc.org/chesj/Pages/default.aspx)

I have also written about this work (http://www.tomwolff.com/collaborative-solutions-newsletter-summer-10.htm), and have had articles and videos published in the Global Journal of Community Psychology Practice See below:

What else is new at Tom Wolff and Associates?

New Publication:

“A Community Psychologist’s involvement in policy change at the community level: Three stories from a practitioner”   by Tom Wolff, PhD, Amherst MA, USA.

In the Global Journal of Community Psychology  Practice: Peer reviewed http://www.gjcpp.org/en/article.php?issue=14&article=68

“As a community psychology practitioner who works with local communities policy change has always been an integral part of my work. This paper will illustrate that influencing social policy for community psychologists working in communities is a natural part of their everyday activities. Every dilemma faced by communities not only has programmatic solutions but also root structural causes that require policy changes. Often our task is to build the capacity of the community to become effectively involved with local office holders on issues of policy change.”

A familiar resource in a brand new package:  The Community Tool Box    http://ctb.ku.edu

I have been a member of the Community Tool Box team for the twenty years of its existence. We are very excited to announce a new look for the tools you love!

The Community Tool Box team just launched a new site, full of tools to change our world. If you’re not yet familiar with the Tool Box, it contains over 7,000 pages of practical information for skills such as those related to community assessment, strategic planning, intervention, evaluation, advocacy, and sustainability. The Tool Box is now used by over 4.4 million unique users from 230 countries worldwide, and builds the skills of professionals and local leaders working collaboratively to improve socially-important issues.

Exciting updates to the Tool Box include:

Old user or new just check out the new look:     http://ctb.ku.edu

 

Some recent clients at Tom Wolff & Associates:

Connect 2 Protect, HIV Prevention, Fenway Institute Ongoing Consultation 2013

Metrowest Health Foundation, Leadership Training, Framingham , MA.  March 2013

Kansas Health Foundation, Recognition Grant Conference, Coalition Building Training, March 2013

Oklahoma State Health Department. Public  Health Leadership Institute ,June 2013

Healthy Wisconsin Leadership Institute, Training on Sustainability, June 2013

Family Crisis Center of East Texas, Day long retreat, Nacogdoches TX. August 2013

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Where oh where have all the grassroots gone? May 30, 2013

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In my trainings on coalition building and community development to non-profit human service and health providing organizations  I always emphasize the importance of engaging those most affected by the issue – sometimes called the grassroots communities. Depending on the focus of the work this can mean:  youth, immigrants, communities of color, survivors of domestic violence, the LGBT community, etc. We cannot do authentic community work without their voices at the table as shared decision makers. In my experience when we do not have them at the table we develop programs that are more likely to be ineffective.

At the start of my trainings I often explore this issue using an experiential tool called ‘Stand and Declare’. I place a statement on the screen and ask participants to go to one of five stations around the room that are marked strongly agree, agree, neutral, disagree, and strongly disagree. They then talk about why they chose that position. One statement I have used in this exercise for almost a decade is “In our community work we always engage those most affected by the issue and they willingly come to the table and participate actively”.

Working with these non- profit providers over the years I have always received more ‘disagree’ than ‘agree’ statements. The grassroots approach has never been the way that the mainstream of  health and human services have functioned in the last decades. However, recently in the group discussions that follow I have seen a very disturbing trend. Increasingly there are fewer and fewer people who not only disagree but who do not actually even try to engage the grassroots anymore. Although most folks seem to still agree that we “should” do this, in fact very few even try to engage the most affected community.

This is very disturbing for those of us who believe that this is the basic building block of any authentic community building effort in the non-profit, health sectors and beyond. How can we design programs for communities without having them at the table?

One advocate for this grassroots approach is Barbara Ferrer, the Commissioner of Public Health for the City of Boston. She puts it this way: “The role of a public health department is to create a space for residents to come together to define a problem, to define the solutions, and then enter into a dialogue with us—not the other way around. Not we define the problem, we define the solution, and then we invite you in to help us implement the solution, which is what we’re most comfortable doing.”

The ones who succeed at this tell us consistently that there are a series of efforts that we must make to adapt our practices so that the community can come to the table. These include: holding the meeting in the evenings, providing child care and transportation, feeding the group, providing translation services if needed, and even providing a stipend (a coupon for a local grocery store etc.).

So what is happening? Why don’t we seemingly do this anymore?

          Maybe we don’t want to share power and no one is pressuring us to do it.

          Or is it that government and foundation funders seem to demand this kind of involvement less often ( in the past it was the serious demands from funders that often drove the nonprofits to bring the grassroots to the table). In one state the Sexual Assault Prevention Coalition coordinator told me that her Rape Prevention Education Grant to the CDC was turned back to her because she used the phrase “grassroots”. She was told to remove the word if she wished funding.

          Could it be that the adaptations above (transportation, baby sitters, etc.) are too much to provide? So it becomes more difficult than the nonprofit world wants?

          Or is it the arrogance of the helping world is growing during tighter financial times, especially as we have more large mega-agencies and fewer small community non-profits

          Maybe we settle for the usual suspects who are the gatekeepers (i.e. the easy to reach minister) rather than do the hard work of identifying and recruiting the grassroots community.

I know very well that a small handful of people in the non-profit human service and health world are doing terrific work at still engaging the grassroots community and we should identify and celebrate those efforts (maybe on these pages)

On the other hand if you also have seen this negative trend what is your guess as to why it is happening?

And what can we do about it?   What have you observed?

 Tom Wolff, Tom Wolff & Associates, Amherst, Massachusetts    May 2013

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Managing competition and turf in coalitions: Ask Dr. Coalition November 15, 2011

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Dear Dr. Coalition,

In my local coalition all the organizational members talk about working for the good of the community. But in reality they are driven by their own self interest. They spend much of their coalition time protecting their territory. Turf wars seem to dominate.

So we really don’t identify what the community needs and coordinate our resources for the good of the community

Any ideas?

Frustrated by turf wars in Illinois

Dear Frustrated,

A clear and explicit goal of coalitions is often to promote coordination, cooperation and collaboration. – to do together that which we cannot do apart. But it comes as no surprise that turf, territoriality and competition among coalition members is a major barrier to coalition success. The capacity of one organization to feel competitive with another often amazes me.

This competition can be just among health and human service agencies as the compete for clients and contracts , but it also can be between private sector and public sector, between local government and state government, or between local government and the community. A new request to provide a service might be issued by the state and two or three different agencies – all members of the same coalition- might begin to compete for that contract, seemingly undermining the coalition’s goal of cooperation.

One would hope that having declared themselves wanting to be part of a coalition, these turf battles would decline – but instead they often escalate.

So what can we do?

A good clear first step is to create a common vision (see The Power of Collaborative Solutions for an easy visioning exercise). This will set up your common goal for all to see.

Then identify (brainstorm) the steps that are needed to reach the vision. This will set out some doable steps that you can take together.

Use priority dots to pick your starting point. Next you are off and running in a direction to meet the community’s needs and hopefully reduce the turf issues.

Here is the bottom line: I know it may sound like heresy to say this, but we need to get competition out of the helping system; it seems to cause much more harm than good. Competition and helping do not necessarily go well together. We need to replace competition with cooperation and collaboration.

Dr Coalition

Dear Reader: What would you suggest to Frustrated in Illinois?

And what coalition dilemmas are you struggling with?

Please comment below:

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New Hospital Community Benefit Requirements: Who Will They Benefit? August 22, 2011

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I was recently invited to present at a Centers for Disease Control and Prevention (CDC) meeting in Atlanta regarding new requirements in the recently passed Affordable Health Care Act and also in new IRS regulations concerning Hospital Community Benefits.

Yes, the IRS is regulating hospital community benefits!

Sounds boring? Think again. This is a real opportunity for communities to partner with local hospitals on key community issues.

What are Community Benefits? Non profit hospitals earn their non-profit status by demonstrating that they have met community health needs that have been determined by a community health needs assessment. This can be a meaningful community collaboration process or it can be window dressing. So, new regulations by HHS and the IRS are trying to ensure that the process has meaning.

A number of years back I was involved in a process of voluntary community benefit guidelines for hospitals and HMOs being piloted by then Massachusetts Attorney General Scott Harshbarger. Through the trials and tribulations of that process we all learned many lessons that can be brought to bear on this present effort. My role, as the founder of  Healthy Communities Massachusetts, in this earlier process was to organize the community side of the equation – local groups that mobilized to hold their community hospitals accountable.

What we discovered was that a few hospitals took the community benefits process seriously and did a great job of partnering with their local communities and developing effective, responsive and relevant community programs. However, most hospitals tried to do the minimum. Their Community Benefits Committees did not represent those most affected by the issues from the grassroots in their community but rather represented the “usual suspects” like local community non-profits, many of whom already held contracts with the hospital.

It was a major effort just to get many of the hospitals to submit their annual reports that described their required community assessments and their community benefit activities in the community. Most fascinating was that when we looked at the reports in many cases we saw almost no correlation between the community assessments and what the hospitals actually did. Their community needs assessment process may have determined that their community need was X and yet they provided Y because Y was more in tune with their mission and plan. Clearly this voluntary process needed more bite to be effective.

So fast forward to 2011, and we see potentially much the same scenario. At this excellent conference, we heard of outstanding examples of hospitals doing a great job of community benefits. I think of the work of Dory Escobar at St Joseph’s Health System in Sonoma County California. Dory is the Director of Healthy Communities and is a community organizer and her work represents those values. Her organizational framework has three areas: Advocacy Initiatives, Healthy Communities Programs and Community Health Programs. (See www.stjosephhealth.org).

We also heard of valuable tools from Julie Willems Van Dijk (U.Wisconsin) like a county system of health rankings. The Rankings are based on a model of population health that emphasizes the many factors that, if improved, can help make communities healthier places to live, learn, work and play. Building on the work of America’s Health Rankings the University of Wisconsin Population Health Institute has used this model to rank the health of Wisconsin counties every year since 2003. Rankings are now available for all counties in the country www.countyhealthranking.org.

Check it out for your county.

When I had my ten minute chance to present -(http://nnphi.org/CMSuploads/Panel%207%20-%20Wolff.pdf ) –

I urged hospitals to engage in true collaboration with those most affected by the issue in the community – with true collaboration described as relationships where we enhance the capacity of each other. I also suggested that community engagement go beyond the needs assessment stage of the process. Rather community partners need to share decision making throughout the community benefit process including setting priorities, implementation, and evaluation. I used the work of the Center for Health Equity and Social Justice at the Boston Public Health Commission as a model of this approach (see http://tomwolff.com/collaborative-solutions-newsletter-summer-10.htm).

So what happens from here on out?

These new regulations are an occasion for all of us to engage with our local hospitals. We must ask what they will be doing to meet these new requirements and tell them how we would like to partner with them in the process of creating their community needs assessment and then continue to work with them on the implementation of their community benefit programs that will meet the identified needs.

My good colleagues at the Community Tool Box (http://ctb.ku.edu) at the University of Kansas have been contracted by the CDC to develop “Recommended Practices for Enhancing Community Health Improvement”. This will be a very comprehensive tool kit based on the wonderful resources of the Community Tool Box for the community needs assessment process.  I will try to keep you informed as to when these resources will go public.

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Time to Transform our Health and Human Service System July 22, 2011

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The time has come for us to rethink and transform the health and human services system in this country. These services cover a vast array of organizations providing a very broad range of services and consume large parts of federal, state and local budgets. The services are often critical for the consumers but the core premises on which the system is based and the system of delivery itself is highly dysfunctional.

The delivery system is characterized by:

1)      A focus on individuals not communities and ignores the environment in which the individual lives

2)      Focuses on the deficits of the individual and the community not their strengths and assets

3)      Services remain targeted at crises and remedial services ignoring how prevention could prevent the problem from occurring in the first place by catching issues upstream

4)      Our systems fail to respond to the diversity of our communities much less address issues of structural oppression, racism etc.

5)      Our helping systems excessively rely on professionals and fail to acknowledge and engage the natural helping systems of families and neighborhoods. Increasingly our helping systems have become detached from the communities they serve.

6)       Our helping system fails to engage those most affected by the issue as equal partners in planning, delivering and evaluating their interventions.

7)      As a system the health and human services in any given community tends to be: competitive rather than collaborative; fragmented so that individuals are treated for distinct problems rather than as whole beings; efforts are duplicated due to lack of information rather than coordinated

8)      Finally the helping system and many of those working in the system have lost their spiritual purpose. They may have chosen their fields with hopes of addressing the common good and now end up counting billable hours.

These system dysfunctions are discussed at greater length in my book The Power of Collaborative Solutions www.tomwolff.com

I have been preaching these dysfunctions and their solutions for decades so it was  a delight to find a fellow traveler and another community psychologist on this campaign in Isaac Prilleltensky , the Dean of  the School of Education at the University of Miami.

Isaac contrasts systems that he describes as SPEC vs DRAIN with SPEC systems standing for systems based on  Strength, Prevention, Empowering and Community. While DRAIN stands for Deficit, Reactive, Arrogant, Individual.

More details on Isaac’s system are available at their web site: http://www.specway.org/wiki/collaboration

Many of us have some stories of individual systems, agencies or interventions that have been able to move from SPEC vs DRAIN (see community stories in my book, or previous issues of my Collaborative Solutions Newsletters  www.tomwolff.com ). These stories need more public airing.

However, the urgent questions now facing all of us are how do we transform our dysfunctional helping system to a strength based system that addresses the system shortcomings noted above and moves in new positive directions.

The present fiscal crisis is leading to dramatic cuts of funding to this helping sector but as noted in my last newsletter (Thriving and Surviving in Hard Times) this is not leading to system transformation but rather retrenchment to a more dysfunctional system. We are cutting prevention and keeping remediation, cutting community wide healthy community programs and keeping services for individuals, etc.

I’d love to hear your thoughts on how to convert our dysfunctional helping systems to ones that are focused on communities, prevention, strengths, our community’s diversity, build on community helping systems, bring those most affected by the issues to the table as equal partners, operate collaboratively, and engage our spirituality as the compass for social change. What are your ideas for transformation of our nation’s health and human service systems.

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More Musings on Community Transformation Grants June 1, 2011

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In my last post I told you about the upcoming Community Transformation Grants. (http://www.cdc.gov/communitytransformation/)

Here are some of my thoughts as I’ve listened and read about what people are saying on this topic:

This is the largest amount of $ we have seen for community prevention in a very long time– over $100 million next year and potentially $900 million over the next five years. So everyone is drooling.

Thanks goes to the Obama Administration for proposing it and to all who lobbied this through despite opposition.

But it is over promised and over committed money. All kinds of federal programs that are facing cut backs are being told that this single pot of $ is going to be their savior. This includes: substance abuse prevention programs, tobacco prevention programs, health disparity programs, food and fitness programs, and all programs funded under the Recovery Act. Clearly there will be winners and losers. So watching and influencing the process at the state level will be crucial.

Now comes the hard part. With only 75 entities to be funded we can be pretty sure that all 50 states will apply and will likely end up being 2/3 of the awardees.

So what is happening in the states? How much input are the state health departments and public health departments getting?  Will they look all across their states at the most successful programs addressing the needs in the RfP or will they choose to mainly include their own department funded programs that are facing budget cuts due to fewer state dollars.

Will the programs that get included address the needs of communities of color and other communities experiencing health inequities?  Will the voice of those most affected by the issues be included in the application? Usually we apply first, state our priorities, and then invite the community in later after we get funding. Will the process be different this time?

If these grants are to live up to their name of “Community Transformation”  and really transform communities (a bold stroke right there) they will need to look like the best community prevention programs that we have seen in recent years.

These exemplars are based on a healthy community model that requires:

serious community engagement and community power,

support of a broad community coalition

understanding health from a Social Determinants of Health perspective

aiming to create systems and policy change

addressing issues of social justice

shifting  from social service to social change models

Some resources that you may find helpful:

Building a Regional Health Equity Model from the Boston Public Health Commission

http://journals.lww.com/familyandcommunityhealth/Fulltext/2011/01001/Building_a_Regional_Health_Equity_Movement__The.6.aspx

A recent Tom Wolff & Associates Collaborative Solutions Newsletter http://tomwolff.com/collaborative-solutions-newsletter-summer-10.htm#center

The Community Tool Box – always a great resource http://ctb.ku.edu

And of course : The Power of Collaborative Solutions  www.tomwolff.com

Please share with all of us what you are seeing in your community? Your state? Add your comments above.

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Community Transformation Grants Are Here at Last May 17, 2011

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New healthy community funding is  now available – check this out.

This announcement just came across my desk:

The U.S. Department of Health and Human Services has announced the availability of over $100 million in funding for up to 75 Community Transformation Grants. Created by the Affordable Care Act, these grants are aimed at helping communities implement projects proven to reduce chronic disease, violence and injury, and improve mental health and equity. It is noteworthy that, this round of funding increases the grant cycle to a five-year period ($900 million), which will allow communities more time to tailor and implement strategies, engage communities and ultimately shift norms around healthy eating and physical activity. It will also engage multiple sectors, encouraging community-based organizations, local and state governments to work together to build sustainable, effective change. This funding cycle emphasizes health equity, with specific outcomes geared towards improving health among those who face the greatest disparities, along with resources dedicated directly towards building capacity.

The language in the CDC announcement http://www.cdc.gov/communitytransformation/ suggests that the purpose of the CTG grants is to create healthier communities by 1) building capacity to implement broad evidence and practice-based policy, environmental, programmatic and infrastructure changes, as appropriate, in large counties and in states, tribes and territories, including in rural and frontier areas and 2) supporting implementation of such interventions in five strategic areas….and demonstrate progress in the following performance measures…1) changes in weight, 2) changes in proper nutrition, 3) changes in physical activity, 4)changes in tobacco use prevalence, 5) changes in emotional well being and overall mental health changes…

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New Newsletter Available: Thriving and Surviving Devastating Funding Cuts May 3, 2011

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A new issue of our Collaborative Solutions Newsletter has just hit the web. This issue is entitled: “Thriving and Surviving Devastating Funding Cuts: Collaboration and Community Building as the Answer – Part One of Survival Tips”

The issue covers:

The present crisis

Time for a new approach: Collaboration, community building and systems change.

Four specific strategies

Focus on sustaining what you have developed

Engage the people in the community and build their support for your efforts

What is new at TW & Associates

Take a look  HERE and let us know what you think

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