Introduction of PANEL Review Survey Format and Findings Share Comments from Las Vegas NAO Workshop

Discuss Next Steps

Goals for Today’s Session

Mary Mitchell, Executive Director Manhattan-Staten Island AHEC.

Susan Moreland, Executive Director North Louisiana AHEC.

Richard Kiovsky, Program Director Indiana AHEC Program.

Richard Perry, Program Director Oklahoma AHEC Program.

PANEL

SURVEY OF AHEC CENTER AND PROGRAM

LEADERSHIP ON RELATIONSHIPS: CHALLENGES AND BEST

PRACTICESNational AHEC Organization

2010 Annual ConferenceLas Vegas NVJune 23, 2010

Purpose of Survey Survey Format Survey Results Group Breakout Groups Report Back Open Discussion and Next Steps

Plan for the Las Vegas Workshop

“There are different demands and pressures on program offices and centers and there will naturally be areas of tension. We (the NAO) would like to begin to identify some of these sources of conflict and challenge and, also identify some “best practices” from centers and programs offices that have successfully addressed these issues”.

January, 2010

Purpose of Survey

Demographic data of PO or Center identified

Anonymous with National Aggregate Pooling

16 issues identified requiring regular interaction between Program Office and Centers – rated by “time” and “challenges”.

Levels of interaction assessed on same 16 parameters – “hands-off” and “hands-on”

Most problematic areas identified Possible solutions or “best-practices”

Format of Survey

16 Issues Identified Revenue/fund-raising

for Centers Budget Management Fed/St $$Allocation Program Planning Contract Management Networking Legislative Advocacy Grant Writing Revenue for PO

Program Deliverables HRSA Competitive

Renewal Data Collection and

Analysis Progress Reports AHEC Boards Capacity Building PO Expectations of CD

to provide timely info

N = 89 responses. 38% of total centers. Tenure: almost normal curve. 52%<5 yrs. Center established: 75% > 5 yrs,

55% >10 years. Structure: 501c3 – 53%. Hosted – 47%.

Data: Center Directors

Challenges in Relationship with Program Office = wide range, but a few issues predominate.◦ Revenue and Fundraising: 54%◦ Data Collection/Analysis 36%◦ Program Outcomes (Deliverables impacting Perf. Meas.)**** 34%◦ PO Expectations of CD’s to provided timely information32%◦ Legislative Advocacy 30%

Issues Requiring “Regular Interaction” with Program Office ◦ Data Collection/Analysis: 58%◦ Program Outcomes (Deliverables) 57%

◦ Legislative Advocacy 56%◦ Program Planning 56%◦ Progress Reports 52%

Data: Center Directors

Most Frequently Mentioned “Difficult Problems”:

Comments: Center Directors

Lack of Common/Stable Set of Priorities

Mentioned multiple times – how do we solve this issue?

Instability of Funding Re-authorization of $125 M is critical – do our legislators know?

Lack of Involvement/Leadership from Program Office

Why?

Lack of Communication and Punctuality of Information

Any best practices on this issue?

No challenges currently Rare, but good!

Results (High to low) Panel Observations

“The Program Office wants to develop a system to distribute funds to the centers – problem is there is no method that is equitable. Holding new AHEC centers to higher standards than older ones just doesn’t work”

“Program Directors over the last 10 years have increasingly become more part-time, about 40% FTE. However, they often devote about 15% real time to the AHEC Program. At this time, we need committed leaders more than ever”

“It’s very difficult to serve 2 masters! As a non-profit 501c 3 with dwindling state and federal support, it’s very difficult to meet the mandates of the Statewide program submission at both the State and Federal levels.”

Illustrative Comments: Center Directors

Program Office views relationship as top/down vs. collegial. Centers view PO relationship as support”

N = 43 responses. 83% of total programs.

Program Established: 75% > 10 yrs Tenure: 52%<5 yrs. 24%>10 yrs. Previous Center Director?: 79% NO Previous AHEC Staff?: 79% NO Structure of centers:

501c3: 30% Hosted: 26% Mixed: 44%

Data: Program Directors

Challenges in Relationship with Centers◦ Statewide Revenue and fundraising 63%◦ Revenue/fundraising for CENTERS 54%◦ Program Outcomes (Deliverables impacting Perf. Meas):42%◦ Technical Assistance 37%◦ Capacity Building (Board Dev. & Board Issues) 37%

Issues Requiring Regular Interaction with Centers ◦ Program Outcomes / Deliverables81%◦ Program Planning 81%◦ Collaborations/Networking 79%◦ Budget Management 72%◦ Coordinating Progress Reports 72%

Data: Program Directors

Most Frequently Mentioned “Difficult Problems:”

Disagreement with/Resistance to Program Office Goals/PO Leadership/Expectations of PO: 34%

Comments re: “center & host agendas and goals conflict with state AHEC goals”

Funding/Invoices: 29%

Comments: Program Directors

Illustrative Comments: Program Directors“When a center is a 501c3, it takes the center board, center director, and the program office to make it their top priority to work together. Different agendas and accountability issues makes it hard to get things accomplished.”

“Centers think they are the entire program, can do whatever they want, and regard the PO as a nuisance.”

[Individual centers] “need to understand the larger picture of how the entire program operates within the state.”

“Centers expect the PO to provide for most or all of their financial needs and take variable responsibility for funding their own projects, don’t do advance planning for sustainability of funding, programs and staff.”

Rate 1-5,with 1 being “hands off” and 5 being “hands on,” the level of collaboration your center/program has with your program/centers on the following issues: (%=very or somewhat “hands on”, rating 4 or 5)

Issue Centers Program Progress Reports 27% 65% Revenue/Statewide 24%**** 62% Federal/State $ Allocation 47%***

62%

“Hands On” Collaboration

Issue Center Program

Provide Timely Information 37% 60%Competitive Renewal 47%

59%Program Outcomes 36% 58%Technical Assistance (Data) 36% 56%Legislative Advocacy 31% 53%Contract Management 31% 46%Collaboration/Networking 23% 45%Grant Writing/Management 16% 43%Program Planning 21% 42%

“Hands On” Collaboration, Cont’d

What Did We Learn from Vegas?

CD/PD Survey on Relationships:Round Table Discussions

8 round table topics:◦Communications◦Fundraising◦Conflict between Center/Host Agenda and

State Goals◦Contract Management◦Data/Technical Assistance/Reports◦Program Planning for Competitive Renewal◦Capacity Building/Board Development◦Program Outcomes/Deliverables

4 Primary Needs for Better CD/PD Relationships

Joint planning, decision making, responsibility rather than direction by fiat or one-directional.

Mutual Respect. Clarity and agreement on roles and

expectations. Congruence among goals – local/center,

state and federal.

3 Solutions

Create a culture of open communication among all stakeholders

Regular opportunity for full explanation and discussion of points of view.

Clearly stated expectations by all.

Suggested Direction for NAO Orientation and Training

Input / Process/ Solutions Output / Result / Needs

Respect (give) Respect (get) Clarity and agreement on roles (People know where they fit)

Clearly stated expectations Understanding of expectations (People know what they are supposed to do).

Joint Planning Congruence of goals and agenda

Full explanations People share in decision- making, information sharing, responsibility & buy-in

So, What Now? There is nothing new to these ideas as to

how to have strong personal and organizational relationships with others.

But, our membership identified these relationship issues as those that are most problematic when dealing with the ‘other’ group (center director or program director).

Next Steps:

◦SHARING – Group Work

◦How would YOU like to be involved?

◦What can YOU do to affect change in some of the problem areas in your state/region?

So, What Now?

Competing Pressures in AHEC Center and Program

Relationships

Program Director

Center Director(s)

Community/Board/Funders Staff

Funding Agenc(ies) UniversityPrescribed or FormalStructure

Reality

Developmentalor OrganicStructure