Chapter 5: Title V as a Foundation for Family Health
If You Don't Know Where You Are Going, You Will End Up Somewhere Else!
In The Wizard of Oz, Dorothy lamented her fears, "Lions! And tigers! And bears! Oh, my!" Planning and managing resources may seem fearsome, but they don't have to be so overwhelming. This chapter offers basic information about family involvement, the strategic planning process, leadership, budget administration and strategies for managing scarce resources.
Family Involvement
When the chair of a policy level group of professionals invited the new parent representative to offer her views and perspectives on issues under discussion at her first advisory meeting in the 1980s, she said, His behavior demonstrated respect for my opinion, made me feel welcomed and supported, and specifically created the opportunity for my comments. - Betsy Anderson, director, National Parent Resource Center, Boston, Mass.
As raised in the first chapter of this guide, CSHCN programs provide leadership for promoting family involvement in Title V programs. Family involvement in the planning, development and evaluation of all aspects of maternal and child health programs is important to assuring program effectiveness and accountability. National surveys have shown that, increasingly over the last decade, programs are hiring family representatives on staff. Most serve their organizations in more than one area, but nationally there continue to be fewer family representatives in MCH programs, particularly immunization and prenatal care.
One approach to securing family involvement is to develop a parent advisory committee. Staff and parents should mutually set meeting agendas and hold meetings on a regular basis. During meetings, families can help review new policies, brochures and literature to be used by families, and annual report accomplishments. The council may discuss policies that parents find problematic, help develop the strategic plan, participate in the needs assessment, help develop the block grant application and provide advice on the budget. Besides policy making, families can participate in outreach work and training activities for both professionals and families.
For parents to be effective in their role as advisors to Title V programs, they must be provided with education about the block grant and their role. Take the time to ensure they are oriented completely so they feel comfortable and able to participate fully. They should receive information about the work of the advisory committee, the culture of the organization, and the "dos and don'ts" of their new role. A mentor program where seasoned parent advisors and professional staff provide training to new parent advisors is an excellent approach. It might be especially effective to use the experienced parents of CSHCN to assist in engaging families from other Title V programs. Listen to what parents say about the importance of their input. They need to feel welcomed at meetings, including understanding any jargon or acronyms. More than anything, parents want to feel that they are truly making a difference. When you hear someone make a great comment at a meeting, tell her so.
Figure out how to pay for parents to be involved in Title V programs. In some states, you may be able to use the agency contracting process to reimburse parents for their expenses. In others, you may need to secure an administrative rule or even special legislative approval to pay parents for their participation in an advisory capacity. Explore avenues within your system that might be used, develop a proposal and get clearance from agency leadership.
Including families from the beginning of program planning is the right thing to do! Smart businesses have known for decades that consumer input is invaluable to develop goods and services that the public will buy. Health care can put those same marketing principles to use in planning services and allocating scarce resources. We can ensure that our services are targeted to best meet family needs without wasting funds on unnecessary frills or errors in judgment about what we think families want and will use. Families can be our programs' target marketers who know where and how to reach under-served families. Remember that families are better able to use services if they are educated and aware of their options.
Expand your definition of parent involvement. Parents can be members of task forces, advisory board members, program evaluators, co-trainers of pre-service or in-service training sessions, paid program staff, paid program or policy consultants, mentors for other families and professionals, grant reviewers, participants in the needs assessment process, reviewers of the block grant application, and much more. The unspoken value of parents familiar with the Title V programs is their ability to strongly advocate for programs that serve them well. Parents who know how to interact with legislators should be your new best friends. The old adage "make your friends before you need them" definitely applies here! Once families understand the impact of budgetary decisions upon their families, they can be eloquent and powerful.
Framework for Strategic Planning and Management
The primary reason to plan is to have a clear purpose and direction for your program; decide how to use available resources; identify the resources that need to be developed; and translate the plan's priorities, goals and performance measures into work assignments for staff. Planning intends to answer these questions:
(1) Where is the organization now?
(2) Where does it want to go?
(3) What does it have to do to get to where it wants to go?
Performing the activities needed to answer these questions is a continuous and cyclical process.
There are many types of plans and a host of planning methods. The annual MCH Block Grant application can, and should, be the annual strategic plan for the program, but even that needs translation to a more functional work plan for each program and staff member.
A quick review of one type of planning process may be useful to a new Title V leader. There are numerous references available for a more in-depth look at planning strategies. If you are unfamiliar with planning, or your skills are rusty, you may want to spend time refreshing your knowledge in this area. You may also find that your state has designated employees to help guide managers t