susanna cooper, mph moapc coordinator, city of quincy
TRANSCRIPT
Shared Leadership: Working Together
in Prevention Across Towns
Susanna Cooper, MPHMOAPC Coordinator, City of Quincy
Background on the Quincy MOAPC Cluster
Participating communitiesQuincyBraintreeWeymouthStoughtonRandolph
Communities were selected based on past history of collaboration with Impact Quincy, need, and capacity to implement programs
MassCALL22008-2013: City of Quincy awarded
MassCALL2 to address rising rates of fatal and non-fatal opioid overdoseImpact Quincy (IQ) subcontracts
Local strategies included OD prevention education to high risk
individualsEstablishing a Quincy Learn to Cope chapterQuincyoverosehelp.org Train the trainer overdose signs and first aid,
to be presented to service providers, health officials, law enforcement, etc. in Quincy, Braintree, and Weymouth
MassCALL2Frustration with limitations of grant and
inability to outreach to neighboring communities doing similar work
Appealed to DPHPre-existing relationship with stakeholders in
Braintree and Weymouth
DPH realized that with the same amount of money, you can take a regional approach and make a bigger impactGreater return on investment
MassCALL2 Final Strategies & Collaborations
Between 2008 and 2013 IQ:Instituted semi-annual Drug Take Back Day in
collaboration with Quincy, Braintree, Milton, and Weymouth
Established Braintree Drug Task Force Now called the Mayor’s Partnership on Substance Abuse
Worked with DA to install MedReturn kiosks in 24 Norfolk County communities
Organized an overdose vigil, collaborating with Braintree, Weymouth, and Randolph
Preparing for the MOAPC RFRQuincy, Braintree, Randolph, and Weymouth identify opioid
abuse and overdose as major public health issues in their communities
Representatives come together in July of 2012 stating their commitment to prevention work regardless of funding status Crucial for sustainability
With knowledge that a new RFR would be released in early 2013, the plan was to apply as a cluster of municipalities
First meeting included representatives from municipalities (mayors, health dept), law enforcement, and pharmacists
Hired Interaction Institute for Social Change (IISC) to facilitate
Formation of the “Design Team”The meeting in July was too ‘touchy feely’ for some, and
caused frustration among ‘action oriented’ individualsReassess purpose and best practice
Design Team was formed as a smaller group who would meet often, get input from stakeholders, and use input to inform a strategic plan moving forward
Design Team would eventually become the MOAPC Cluster Stoughton inquired about partnering, and was selected
based on data and high capacity to implement prevention strategies
January 2013: DPH Releases the MOAPC RFR
When the RFR was released, our Design Team was already far ahead of the curve
Coordinator worked to tailor IISC facilitation based on group needs
Prior to the release, we had coordinated an assessment
Each community spent 3-4 months collecting data and conducting key informant interviews
Assessment process helped me to “assess capacity” across all 5 communities
IISC facilitators helped us to develop timelines and action steps, and kept meetings tightly facilitated
Regional Opioid ConferenceIQ sponsored a conference in collaboration with our selected
MOAPC communitiesIssues with autonomy and ability to make decisions as a newly
formed Design Team
Conference was being funded with MassCALL2 dollars; this was not made clear
MOAPC communities wanted to use this conference as an opportunity to do capacity building and more data collection; feared this was getting overlooked as we finalized the agenda
Highlighted successes and past collaboration, but there was confusion as to who could design the agenda, present, and make decisions
Conference was extremely successful, but the experience led to awareness that we NEEDED a decision making process for our group
Decision MakingImperative to have a well thought out decision making processAfter the experience with the conference,
cluster members were concerned that they were giving “token input”
Often people think they are at the “consensus table”, when really they’re at the “input table”
Evaluating Realistic ScenariosAs you begin your work, you may begin to see
barriers that hinder your ability to make a final decisionSchool board does not approve a projectMayor/Town Manager does not give you full
supportBudgetary constraints??
Example: In our cluster, there was concern that even
though the group was deemed a “decision making body”, the Program Director would not approve of the final decision
Cluster’s Proposed Solutions
Agree to keep in constant contact with Program Director (PD)
A month prior to any due date, submit what we need to PD so that we have a two week window to make changes
Plan for PD to be at this table for high stakes decisions or for decisions he is most invested in
Know what the constraints are beforehandFigure out how to leverage PD’s wisdom and
knowledge
Consensusa definition
The leader has no more authority in the decision than anyone else. We are equal in power at this table.
Once group agrees to go forward with something, everyone supports the decision and is willing to help implement that agreement.
Consensus may not be reached in the allotted meeting time, so we must have a fallback plan“if by the end of this hour if we cannot reach
consensus, the decision will be made in this way”Option: Delegate to an appointed person or
subcommittee
How our cluster makes decisions…We will make decisions by consensus
Fallback: if we cannot reach consensus in time allotted, we will accept a majority vote (4 out of 5 communities) Each community has one voice regardless of
how many reps. are at the table TA Provider does note vote
For high stakes decisions:We will make provisional consensus agreements
if someone is absent OR if Alejandro needs to be involved
Alejandro is a separate voice representing Bay State (grant holder) and not part of the Quincy voice
High stakes decisions are:Intervening variablesStrategies What we’re prioritizing out of the data +
methods we are usingPilot strategies
Real Examples of Consensual Decisions
Intervening variables, strategies, and logic model
Core measure questions for youth health surveysLooking for consistency in questions asked across our
region
Allotting additional funds for data analysis
Allotting additional funds to support specific cluster communities (projects that would benefit MOAPC)
In all of these scenarios, we have used our decision making method to reach consensus
Where We Are Today Strategic plan was approved by DPH in Spring of
2014
Selected strategies:Provide overdose prevention education to
substance using inmates at Norfolk County House of Corrections
Educate around Good Samaritan Law and the importance of calling 9-11 for active users and peers
Develop a social marketing campaign to middle school parents
Implement Scope of Pain training for regional prescribers
Development of educational materials for parents
ChallengesStrategic Prevention Framework (SPF)
Not everyone likes to “move slow to move fast”Sometimes “process” is a difficult sell
Every community has different capacity and different ability 2 communities are funded by DFC, 2
communities are unfundedDevelopment of culturally appropriate
strategies and materials
