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Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org Responding to the Call: Moving from State Oral Health Plan (and Policy Tool) to Action February 11, 2011 Marcy Frosh Colin Reusch Children’s Dental Health Project

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Page 1: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Responding to the Call:

Moving from State Oral Health Plan (and Policy Tool) to Action

February 11, 2011Marcy Frosh Colin Reusch

Children’s Dental Health Project

Page 2: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

TWO BIG THEMES:

1. Continue planning and priority setting with attention to:

Key elements for successful strategic “management”

2. Continue role as INNOVATORS with focus on:

How State Oral Health Plan/Policy Tool objectives are met

Page 3: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Theme #1: Implementing a Strategic Plan

What the experts tell us:• A 2005 study of strategic planning was conducted by

municipal governments

• Study revealed factors useful in predicting the success of strategic planning in the public sector.

Source:

Poister, Theodore H. and Gregory Streib (2005). Elements of strategic planning and management in municipal government: status after two decades. Public Administration Review, 65(1), 45-56.

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Study findings

• Factors can be classified under one of five key components of the strategic planning process:

– Stakeholder Involvement – Planning Elements– Budgeting Process– Performance Management– Performance Measurement

Page 5: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

A few factors have the MOST impact

Of all the factors identified, 7 were found to account for nearly half of the overall impact of a strategic plan.

Page 6: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

7 Factors that Dominate – #’s 1-4

Performance Management:1. Objectives for department heads and managers come

from the overall strategic plan.2. Annual evaluations of department heads are based on

accomplishing strategic goals and objectives.3. Performance data is tracked over time to assess results

of strategic plan.4. Performance measures associated with the strategic

plan are regularly reported to the public.

Page 7: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

7 Factors that Dominate – #’s 5-7

Budgeting Process5. Budget requests and resource allocations are closely tied

to strategic goals and objectives.Planning Elements6. Feasibility assessment of proposed strategies is

conducted (NOTE: This is an important element of the Oral Health Policy Tool and any strategic plan)

Stakeholder Involvement7. Citizens and other external stakeholders are involved

in developing the strategic plan.

Page 8: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

CDC Cooperative Agreement helped you to “dress for success”

CDC has provided a “blueprint” for :

• Logic model for a state plan• Sample components• Review index tool• Framework and flow charts• Funds work with Oral Health Policy Tool

Page 9: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

New phase: Strategic Management

Strategic ManagementStrategic planning + Performance Management– Both are processes that are repeated– Regular revisiting and evaluation are critical– Engage stakeholders at each level– Performance of management and ground-level staff

equally important– Key: produce and learn from measurement data

Page 10: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

What about moving on

Identified Policy Priorities?

Page 11: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Fits under State Oral Health Plan (SOHP) + Policy Tool “priorities”?

Both SOHP + Policy Tool appear to support action on Preventive Services for Children

State Oral Health Plan “Vision Element” suggests making MANDATORY the currently OPTIONAL Dental Component in the MDEC Early Childhood Screening program standards.

Policy Tool Priority #1 – Children ages 0-5

Page 12: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Making the case for early prevention

Tap INNOVATIVE data collection ideas from a August 2009 MN Oral Health Stakeholder Meeting:

• collect oral health related data on school-aged children.* What number of school days lost to dental concerns? School readiness is a cross-cutting concern!

• Survey parents on understanding of the importance of preventive dental care? Address root causes – do parents believe they can influence?

• Identify dental activities are already occurring in the school (dental volunteers, sealants, etc.)? What lessons can be learned?

And for earlier ages:• What are primary care doctors doing on prevention; e.g. varnishing?

* MN example: Bloomington, MN study (2003-07) revealed 1 in 4 students with visible dental health needs

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Policy change

CURRENT: Minnesota Statutes 121A.17 SCHOOL BOARD RESPONSIBILITIES.

(d) A board may offer additional components such as nutritional, physical and dental assessments

Page 14: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Challenges

If, for example, there is a focus on a School-Entry Screening only:

Challenges: • Very limited evidence of effectiveness of screening because data on referral & treatment has not been available

• Clear evidence that onset of dental disease happens well before school age (Policy Tool exercise may have focused on this as part of priority setting)

Page 15: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Performance Indicators (e.g., comparing values or positions)

For Example: 1) Support a policy that will identify # of children screened, referred and treated

– Baseline 1200– Target 5000– Actual 2100

2) Support a policy that will identify extent of utilization of expanded pediatric preventive oral services for ages 0-5

– Baseline 1200– Target 5000– Actual 2100

Describes more than one dimension! Inputs/outputs described at different stages of performance!

Page 16: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Theme #2 - Is this innovative?

It COULD be !SC is one of the few states innovating with a “screening” law

pilot program* that focuses and measures implementation with high-risk children and includes referral & treatment

What innovative things can be done to address prevention for kids ages 0 to 5?

*See SC’s “Word of Mouth” publication at: http://www.scdhec.gov/administration/library/CR-009945.pdf

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

How can stakeholders be STRATEGIC aboutinnovating on new policy initiatives?

It can’t hurt to follow a CHECKLIST!

See list of 16 checklist items in PART II of The Policy Tool Guidebook: Steps for Creating a Success Health Policy Tool Session (2009). Access at www.cdhp.org.

Page 18: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Checklist to move from plan to action

. . . A few examples

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

1-State the Priority Initiative

• Frame policy as a SMART objective.

• Know your goal with absolute clarity.– What do you want to

accomplish?– What do you want the

policymaking authority to do?

SpecificMeasurableAchievableRealisticTimed

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

9-Identify Others’ Success Stories

• Identify efforts from other states that have succeeded in attaining what you seek.

• How similar and different were those efforts from yours?

• What were the lessons learned?

Policymakers are favorably disposed to replicating successful efforts from other states!

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

13- Check to ensure what’s allowed

• Regularly update yourself on specific rules on advocacy and communications in your state

-- NEW ADMINISTRATIONS HAVE NEW RULES!

• Comply with AR-12 Lobbying Restrictions (PA 3022): CDC Grantees must avoid using CDC funds from being used to influence or promote pending legislation.

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

14-Refine Your Policy Action Plan

Work with coalition members, partners, and messengers to:– Have a unified voice!

– Agree on exactly who will do what, when, and with whom to carry out the plan.

– Determine how and by whom the process will be tracked, re-evaluated, modified, and sustained.

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Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

16- Be prepared with alternatives

Page 24: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

What do colleagues from other states say is most important?

Assemble a passionate Policy Committee that

demonstrates entrepreneurial spirit, builds trust,

and stays accountable to the Coalition!

Page 25: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Given these ideas . . .

What would you add?

Page 26: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Let’s recap our 2 BIG THEMES:

1. Continue planning and priority setting with attention to:

Moving from strategic planning to strategic management

2. Continue Minnesota’s role as INNOVATORS with focus on:

Innovate in moving State Oral Health Plan/Policy Tool objectives forward

Page 27: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Resources

• State Oral Health Plan Comparison Tool. Children’s Dental Health Project (2010). Link to www.cdhp.org

• CDHP/ASTDD. “State Laws on Dental Screening” for School-Aged Children. (2008) Link to: www.cdhp.org

• Poister, Theodore H. and Gregory Streib (2005). Elements of strategic planning and management in municipal government: status after two decades. Public Administration Review, 65(1), 45-56.

• Kates, Jennifer, Katherine Marconi and Thomas E. Mannle. Developing a performance management system for a Federal public health program: the Ryan White CARE ACT Titles I and II. Evaluation and Program Planning, 2001, vol. 24, issue 2, pages 145-155.

Page 28: Children’s Dental Health Project | 1020 19 th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 |  Responding to the Call: Moving from

Children’s Dental Health Project | 1020 19th Street NW, Suite 400 Washington, DC 20036 | 202.833.8288 | www.cdhp.org

Thank you so much!

Visit CDHP at:www.cdhp.org