Module 2: Coordinating the Planning Process

Module Introduction

Module 1 provided an overview of the foundational knowledge needed to begin the public health planning process. The remaining Planning Fundamentals modules provide detailed information about the planning process, in the same step-by-step order that you will follow to create and implement your state plan.

Module 2 focuses on coordinating the planning process, including working with partners, pre-planning, and launching the process of creating a state plan.  This is similar to identifying what resources you have, and what tools you need, to begin planting your garden. Careful planning at this point will set the stage for success.

Module 2 Learning Objectives:

Upon completion of this module, you should be able to:

• Describe the benefits of working in a coalition and four strategies for working with coalition partners.
• List seven types of key partners who should be involved in the planning process and describe how to recruit them.
• Explain how organizational structure, clear roles and responsibilities, and collaborative planning methods support the planning process.
• Summarize steps involved in pre-planning and launching the planning process.

Time estimate for completion:

It should take approximately 75 minutes to complete this module.

Section I: An Introduction to Planning with a Coalition

Introduction

Your state plan reflects all of the proposed work to be done to prevent and reduce the burden of diabetes or chronic disease in your state. The plan reflects both the work of the state health department and the work of its partners. This plan should be developed through a collaborative planning process.

Before launching the state planning process, it is important to consider the benefits of working in a coalition, your role in convening key partners, and effective strategies for working with those partners to create and implement a state plan.

Section I: An Introduction to Planning with a Coalition cont'd

Working with Coalitions

Since the late 1990s, the majority of Funding Opportunity Announcements (FOAs) for chronic disease prevention and control and risk factor reduction programs released by the CDC’s National Center for Chronic Disease Prevention and Health Promotion have included two requirements:

• Building and maintaining a state coalition
• Developing a state plan that addresses the prevention and control of a particular chronic disease or multiple chronic diseases

State coalitions are expected to work with state department of health
staff to develop and implement a state plan.

The types of state coalitions and partner groups  will vary by state.  In the example of creating a diabetes state plan, some of these groups might include:

• Legislatively-mandated Diabetes Advisory Councils, with predetermined membership representing key governmental agencies and organizations
• Diabetes Action Networks or Diabetes Coalitions established by the state department of health or other external organizations such as the state chapter of the American Diabetes Association
• A combination of a legislatively-mandated advisory council and a more informal grassroots diabetes network

Throughout the Planning Fundamentals course, the term “coalition” will be used to describe all of the different arrangements that you may have with partners.

Section I: An Introduction to Planning with a Coalition cont'd

The Benefits of Working in a Coalition

No matter how your coalition is constituted and organized, coalition members should be invited to participate in the state planning process. Their participation should have been explained as one of the functions of their membership in the coalition.

Working with coalition members to develop and implement the state plan has many benefits. Working in a coalition:

• Helps create a more diverse vision for the plan
• Provides access to additional resources
• Generates support and enthusiasm for initiatives
• Provides access to hard to reach groups and communities
• Builds a greater foundation for change and sustainability
• Allows the plan to address large-scale issues that individual organizations cannot manage alone

Section I: An Introduction to Planning with a Coalition cont'd

The Role of the State Health Department

State health department staff often act as conveners for the planning process and are primarily responsible for maintaining the relationships that underpin the process. Key responsibilities of the state health department staff include:

• Getting buy-in from coalition members to participate in the planning process and to commit their resources to support implementation
• Building and maintaining relationships with coalition members
• Coordinating communications during the state planning process

Staff ensure that the planning process is conducted using strategies that reinforce positive relationships between and among the state health department and other coalition members. These relationships should be based on principles of reciprocity, in which the state health department staff and coalition members both derive benefits from the relationship.

Section I: An Introduction to Planning with a Coalition cont'd

Managing the Coalition Planning Process

Managing the planning process with a state-level coalition requires:

• Communication skills to stay in touch with members
• Planning skills to set up meetings
• Writing skills to prepare agendas, minutes, and reports
• Meeting management skills
• Skills in coordinating logistics
• An understanding of group dynamics and processes
• Project management skills
• Knowledge of each coalition member’s organization, the members themselves, and their relationships with each other

Section I: An Introduction to Planning with a Coalition cont'd

Strategies for Working with Coalition Partners

The following are four strategies that coalition members can employ when working together. Each of these strategies falls on a continuum and builds upon the other:

Hover your mouse over each strategy for a definition.

These strategies are described in detail in the Matrix of Coalition Strategies. Each of these strategies can be appropriate for different circumstances. As the coalition convener, state health department staff can work with coalition members to decide what strategies are most appropriate for the state planning process.

All of the  strategies are more effective in producing results when the following core elements are present:

• A common vision and purpose
• Meaningful power sharing
• Shared decision-making
• Mutual learning
• Mutual accountability for results

Section I: An Introduction to Planning with a Coalition cont'd

Section I Summary & Activity

Section I provided an overview of the state health department’s role in managing the coalition, the benefits of working in a coalition, and strategies for working with partners to create and implement a state plan.

Now, think about how these concepts apply to your coalition. Watch the video below to be introduced to members of the Kentucky Diabetes Network (KDN), Kentucky’s statewide diabetes coalition. Then, answer the questions that follow. Click here for a worksheet to record your answers.

1. The partners in this video each bring different tools, resources and abilities to their coalition including: (1) connections in the business community, (2) experience with local coalitions, (3) knowledge about cultural competency, and (4) advocacy skills. List five members of your coalition and what they bring to the table in terms of skills, experience, and connections.
2. One of the partners joined the network because his company was “trying to become a part of the larger diabetes community.” What are some of the reasons that key partners are involved in your coalition? How does you coalition secure “buy-in” from partner organizations?

The next section discusses how to ensure that the right organizations are involved in the planning process and how to recruit key partners.

Section II:
Involving All the Right Partners in the Planning Process

Key Partners in State Planning

Before launching the state planning process, state health department staff should work to ensure that all key stakeholders are represented. In addition to inviting current coalition members to participate in the process, staff should reach out to inactive members of the existing coalition, as well as to other stakeholders who have an interest in addressing the burden of diabetes or chronic disease in the state.

There are several types of partners that should be involved in the planning process, as outlined in the Key Partners Diagram below. In this diagram, the state health department is shown playing the role of coordinator/convener, but there should also be lines connecting the partners together so that the diagram looks more like a web.

Key Partners Diagram

Hover over each of the Key Partners in the diagram for more information

Click here for more information on each type of partner

Section II:
Involving All the Right Partners in the Planning Process cont'd

Assessing Membership

Before beginning the state planning process, you can work with existing coalition members to compare the list of active coalition members to the key partners groups discussed previously, in order to determine which types of agencies or organizations are missing from the coalition. While it may be easy to identify partners in the categories of Health Care Providers, Health Care Organizations, and Advocacy Organizations, you should also broaden your scope to include other public and private agencies at the state and community levels. Also, the individual representatives of the categories should be diverse in terms of age, gender, and socioeconomic status.

After conducting this assessment, the membership of your existing coalition, especially the Steering or Executive Committee, can help determine which additional organizations need to be invited, and whether they should be asked to participate only in the planning process or be encouraged to join the coalition.

Some partners recruited to participate in the planning process may end up joining the coalition as regular members, while others may not wish to join the coalition on a long-term basis. The members of your existing coalition plus these additional key partners will form the group that will develop the state plan. Throughout the Planning Fundamentals course, the term “coalition members” may be used to describe both regular coalition members as well as these additional partners.

An effective way to gain knowledge and understanding about your coalition’s membership is to ask each member to complete an assessment survey when they join the coalition and to re-take it every year. Annual assessments conducted prior to beginning the planning process can combine several different types of questions to give you a larger overview of your coalition. Questions can be included that gather information on members’:

• Agency/organization information
• Experience and skills related to planning
• Interests and how well these interests are represented on the coalition
• Expectations of the coalition
• Assessment of the coalition’s functioning and effectiveness during the past year

Results of your coalition membership assessment should be routinely shared with coalition members, as should information about any gaps in representation.

Section II:
Involving All the Right Partners in the Planning Process cont'd

Recruiting Members from Targeted Organizations

When recruiting partners for the state planning process, you will be targeting organizations, agencies, and associations, instead of specific individuals. A useful process is to:

1. Approach the leadership of these entities first and explain the purpose of the coalition, as well as the extent of the expected participation and the benefits that their organization will derive from participation.
2. Ask the leadership to identify a representative to participate in the planning process.
3. Meet with the representative to ensure that he or she fully understands what will be expected.
4. Clarify with the leadership what authority the individual will have to express opinions, make decisions, or commit resources on behalf of the organization or agency.
   

It is very important that all expectations are clearly communicated to the coalition membership, the organizations’ representatives, and to the leadership of the organizations and agencies that they represent.

Section II:
Involving All the Right Partners in the Planning Process cont'd

Representing Local Interests

When recruiting agencies, you can focus on the state-level organization that represents the interests of local level institutions. However, you may want to include representatives from local community health coalitions and planning groups, particularly:

• Those from geographic areas with a high prevalence of chronic disease and related risk factors (e.g. obesity or physical inactivity).
• Those from organizations that represent disparately affected populations, especially culturally and linguistically distinct minorities.

In including these representatives, you are ensuring that their perspective on the burden of chronic disease is represented and that the interests of their communities are protected.

Section II:
Involving All the Right Partners in the Planning Process cont'd

Section II Summary & Activity

Section II described key partners that you need to work with to create and implement your state plan. It also discussed how to identify gaps in your current coalition’s membership and how to recruit from organizations or agencies to fill those gaps. Once all of the necessary stakeholders have been identified and recruited, the planning process can begin.

Now, think about how these concepts apply to your coalition. Watch the video below, in which members of the Kentucky Diabetes Network (KDN) and Kentucky state health department staff talk about involving the right partners in the planning process. Then, answer the questions that follow. Click here for a worksheet to record your answers.

1. In the video, examples of the broad membership of the Kentucky Diabetes Network (KDN) are described and the value of a diverse coalition is discussed. Which key partner groups do you think are well-represented in your coalition? Which groups do you think are not as well-represented? How could you help recruit new members from under-represented groups?
2. What are some ways to keep partners committed to the planning process?

The next section discusses how to put systems and structures in place for the planning process that will help pave the path to success.

Section III
The First Steps in the Planning Process

Pre-Planning

The first step to developing a state plan is pre-planning. The state health department can convene at least one meeting of the existing coalition, and additional meetings with the coalition Steering Committee, to outline, plan, and discuss in detail the collaborative planning process that will be used to develop and implement the state plan. These meetings should include discussion and review of:

• An overview of the public health approach to planning (covered in Module 1)
• Which stakeholders are not yet at the table and how to recruit them (covered in Sections I and II of Module 2)
• Structuring the planning process
• The roles of state health department staff members and facilitators
• Meeting logistics

Section III
The First Steps in the Planning Process cont'd

Structuring the Planning Process

The planning process should be structured in a way that will enable success and will build ownership of the state plan among all participants. This includes putting systems into place that allow for:

• Involving all invited participants in the planning process
• Establishing a shared vision of the planning process
• Fostering consensus on decisions best for the group (not the individual)
• Agreeing to disagree on some decisions
• Creating successful communication processes among participants

There are several ways to ensure that these systems are in place through the organization of a planning group, the clear delineation of roles and responsibilities, and the use of effective collaborative planning methods.

Section III
The First Steps in the Planning Process cont'd

Charters and Interagency Agreements

You and your coalition partners can develop a charter that will create a framework for effective collaboration. The charter will guide the planning process by laying out the guidelines and expectations for participation, defining norms and operating protocols, and presenting options for addressing challenges. This planning charter should be a separate document from the charter for your state coalition and should reflect input from all organizations, agencies, and individuals who have agreed to participate during the planning process. Click here for a list of items to include in this charter. Many of these items will be described in detail throughout this section of the module.

In some cases, a member may request a formal interagency agreement delineating responsibilities, such as a Memorandum of Understanding (MOU), Memorandum of Agreement (MOA), Letter of Support (LOS), or Letter of Agreement (LOA). Click here to read about the elements of an interagency agreement.

Section III
The First Steps in the Planning Process cont'd

Organizational Structure

The state health department begins the state planning process by creating a collaborative planning group comprised of members of the existing state coalition plus any additional key stakeholders not currently involved in the coalition. 

The principles and methods used to organize the collaborative planning group are similar to those used to organize and coordinate the state coalition as described in the previous section.

The term planning group will be used throughout this course to describe partners who are actively engaged in the planning process.

The leadership of the coalition, especially the Steering or Executive Committee, can help determine who should be asked to participate in the group.

The organizational structure of the planning group will influence how well it works in achieving its goals. It is important to remember that organizational structure needs to be both functional and simple. The basic organization of a planning group consists of the group at large, or the entire membership, and its division into smaller workgroups.

The diagram below shows a simple approach to organizing the planning process that can be modified as decisions are made during the process:

Section III
The First Steps in the Planning Process cont'd

Planning Group Membership Responsibilities

It is critical to the functioning of your planning group that each member’s roles and responsibilities are appropriate and clear from the beginning. There are some general responsibilities that should be undertaken by each member:

1. Participate in determining the direction of the planning process
2. Commit to the collaborative nature of the planning process: regularly attend meetings, follow rules established by the group, be inclusive, and accept others’ viewpoints
3. Serve as a liaison to his or her organization or community to ensure appropriate information and feedback is gathered and relayed to the planning group, and vice versa
4. Provide access to data sources and/or collect additional data as appropriate
5. Suggest content for the state plan
6. Provide input on prioritizing goals, objectives, strategies, and activities
7. Accept and complete workgroup assignments
8. Provide access to resources to implement proposed activities in the state plan
9. Promote the state plan when and wherever possible
10. Support the dissemination of the state plan and related materials to a wide array of audiences

It is important that all coalition members involved in the planning process understand and accept these responsibilities. Having them in writing, perhaps through the use of charters and interagency agreements, can be helpful.

Section III
The First Steps in the Planning Process cont'd

The Role of State Health Department Staff in the Planning Process

It is important that all coalition members involved in the planning process understand their responsibilities, and it is critical that the roles of the state health department staff are clear as well.

The staff should provide technical assistance and support throughout the planning process. Their roles include:

• Supporting logistics
• Managing contracts to support the process
• Recruiting participants
• Documenting the content of planning sessions
• Setting dates for meetings and due dates for workgroup assignments
• Working with a facilitator to make the planning process collaborative

More specifically, they will be representing the state health department and its initiatives, and the department’s epidemiologist, evaluator, and other program staff will serve as informational resources during different phases of the planning process and as members of workgroups. While the state health department should be well-represented throughout the planning process, it is important to not dominate the process or attempt to take on all responsibilities. Using facilitators during the planning process can help avoid this issue.

Section III
The First Steps in the Planning Process cont'd

The Role of the Facilitator in the Planning Process

Using an experienced facilitator can help reduce expectations among the participants that the state health department is the lead organization to do all of the work. The facilitator can assist in a variety of tasks, like planning meetings, developing agendas, facilitating meetings, and providing summary reports on meetings and planning products.

To be most effective, the facilitator should:

• Have experience with collaborative, participatory approaches to planning, consensus-building, and decision-making
• Be comfortable working and communicating with a broad spectrum of partners from different socio-economic and professional groups
• Have an understanding of public health and state planning
• Take steps to ensure they understand the goals of the meeting and the organization
• Keep the group on task
• Promote democratic decision-making
• Be neutral and inclusive of all, laying the foundation for trust among group members
• Maintain focus on how people participate in the process, not just on what gets achieved

Facilitators with experience in working with community organizations and coalitions are good candidates to work with state planning groups.

Section III
The First Steps in the Planning Process cont'd

Collaborative Planning Methods

Having a simple and effective organizational structure and clear membership roles and responsibilities are crucial to collaborative planning. In addition, the planning group can agree to utilize the following collaborative planning methods to support the process:

While these participatory, collaborative processes can take more time than other ways of proceeding, they can result in greater commitment and buy-in from participants when creating and implementing the state plan.

Section III
The First Steps in the Planning Process cont'd

Collaborative Planning Methods: Consensus Building

Consensus is a commitment to a decision based on the collective wisdom of all participants. Consensus building can be used to address procedural questions as well as substantive issues. Consensus building means making decisions by the united consent of all participants. Consensus does not imply unanimity of opinion or complete agreement, but it does involve seeking decisions with which everyone is reasonably comfortable and can support.

Consensus building depends on active listening to all as well as a commitment by everyone to be an active participant in the discussion. The general steps to consensus building are:

1. The whole group examines the problem or issue from multiple perspectives.
2. The group brainstorms and discusses possible solutions or paths of action. All viewpoints are discussed with a spirit of respect and mutual accommodation.
3. The group works together to synthesize these ideas to develop a solution that everyone can approve.

Consensus is reached when all coalition members believe that they have arrived at the best decision that can be made at this time.

It is possible for a coalition member to disagree with a particular decision but agree to support it. This happens when agreement is made based on the best interest of the coalition. A decision may not be a member’s first choice, but they can live with it, especially if the concerns they have raised have been adequately addressed.

Section III
The First Steps in the Planning Process cont'd

Collaborative Planning Methods: Conflict Resolution

Conflicts often arise when managing complex and important projects in which different interests are invested. Conflict occurs when the exploration of different perspectives on an issue leads to a disagreement and the parties involved perceive a threat to their needs, interests, or concerns. Conflict often results in a breakdown in communication and halts consensus building, so it is important to be prepared to address conflict during the planning process.

Conflict resolution involves the development of procedures for identifying the conflicts that are likely to arise, as well as systems through which conflicts can be constructively managed and transformed into productive learning experiences for all partners. Conflict resolution requires creative problem-solving strategies that overlap with those used to reach consensus when conflict is not present.

Click here for a list of key consensus building and conflict resolution processes, including processes to guide individual participation, procedures to guide meetings, and ideas to address substantive issues.

Section III
The First Steps in the Planning Process cont'd

Collaborative Planning Methods: Group Decision-Making Processes

Group Decision-Making Processes are employed when the group needs to make a decision. There are a variety of group decision-making techniques that can be employed, and you can use one technique or a combination of them during the collaborative planning process. Click here for a list of decision-making processes.

Section III
The First Steps in the Planning Process cont'd

Collaborative Planning Methods: Supporting Factors

These essential collaborative processes reflect inclusivity and mutual respect, and depend upon active participation by all group members. Several factors contribute to these processes and are key to creating a truly collaborative environment:

Section III
The First Steps in the Planning Process cont'd

Communication Systems

A well-thought-out internal communications plan will support the flow of information between the external facilitator and the state health department, between the state health department staff and the members of the planning group, and between planning group members when they divide into workgroups.

Key elements of your internal communications plan include:

• How and when you share information about the planning process, including scheduled meetings, meeting minutes, and workgroup products
• Desired intervals for reminders and notices regarding meetings and deadlines
• How and when you share information with the leadership of organizations and agencies represented by the planning group members
• How and when you share information about the planning process with the media

You and your partners may decide to create a members-only access web-page, a WIKI or listserve, or other electronic methods to maintain notices and records. This information should also be included in your internal communications plan.

Section III
The First Steps in the Planning Process cont'd

Different Types of Meetings

During the planning process, planning group members will be asked to attend meetings of the whole, large group, as well as small, workgroup meetings that focus on completing workgroup assignments. Progress on these assignments will be reported on at subsequent large group meetings.

Information about all meetings, workgroup assignments, and the status of the work being accomplished will be routed through the state health department staff. Agendas and minutes for large group meetings are the responsibility of the external facilitator, with input from the staff.

In subsequent Planning Fundamentals modules, you will be able to download suggested agendas for meetings that will take place during different steps of the planning process.

Agendas and minutes for small workgroup meetings are the responsibility of the members of the workgroups and also should be shared with the state health department staff.

In-person participation at all meetings should be strongly encouraged, but electronic meeting formats such as webinars, conference calls, or Skype technology can be used to allow individuals who cannot attend in person to participate.

Section III
The First Steps in the Planning Process cont'd

A final note on Pre-Planning: Managing Logistics

During pre-planning, all arrangements for logistics for the planning process should be finalized. In general, this would include:

• Arranging meeting venues that have space for the entire planning group and for small group breakout sessions
• Creating a timeline and calendar showing dates and times for proposed meetings and deadlines for possible decisions and work products
• Securing services and finalizing contracts with the external facilitator and other support services (such as copying/printing)
• Setting up communications systems

Having the logistics planned out in advance will make the subsequent steps in the planning process go more smoothly. Click here to download a more detailed list of logistics to consider, based on the example of creating a diabetes state plan.

Section III
The First Steps in the Planning Process cont'd

Section III Summary & Activity

The preceding section covered initial steps in the planning process.

Now, think about how these concepts apply to your state planning process. Watch the video below, in which Kentucky Diabetes Network (KDN) members and state health department staff from Florida and Kentucky talk about their approach to organizing the planning process. Then, answer the questions that follow. Click here for a worksheet to record your answers.

1. In the planning process, what is the role of the state health department staff? What roles can partners play?
2. The staff in the video made several suggestions for organizing the planning process. What ideas were presented in the video that you would like to use in your planning process?

Summary

Module 2 Summary

Module 2 discussed coordinating the planning process with your partners in order to create and implement your state plan. This module described:

• the benefits of working with partners,
• strategies you can use to ensure mutually-beneficial relationships; and
• the main types of key partners that should be involved in the planning and recruitment approaches.

In addition, ways to support the planning process were described, including:

• collaborative planning methods,
• appropriate organizational structure; and
• providing members with clear roles and responsibilities.

Finally, Module 2 covered the first steps in the planning process: pre-planning and launching the process with an initial meeting of the planning group. Module 3 will focus on the next step in the planning process: examining relevant data and defining the problem in your state.

You can download a PDF of helpful resources for more information.

Continue the course with Module 3: Using Data in Health Planning.