Stewardship Group

February 12, 2019 - Stewardship Group Meeting Summary

February 12, 2019 at 12:00 pm

San Diego Accountable Community for Health Stewardship Group Meeting Summary February 12, 2019

Welcome and Introductions 

Kitty Bailey welcomed the Stewardship Group and attendees introduced themselves. The group reviewed the December 2018 meeting summary and it was unanimously approved as the final version to be posted on the ACH website.
CACHI Update and Survey 

Kitty shared that CACHI funders are discussing extending funding for two more years as they see the value in the work being done but also recognize it takes time for the work to build. Each CACHI site would receive 150k each year for two more years. Kitty invited members to participate in the evaluation survey sent out recently to all workgroup members by CACHI and agreed to share the survey with any members who could not locate the original email. 

Stakeholder Update 

Kitty provided a brief update on the convening of Stakeholders on January 29. At the Stakeholder meeting, the approximately 70 attendees received updates from backbone staff and shared their own perspectives on equity during a group activity. Stewardship Group members shared their feedback from the Stakeholder meeting, including support for providing a refresher of the SD ACH purpose each time as it is vital to keeping everyone focused on the overall aims and that the group activities are powerful for creating meaningful conversations across sectors.  

CA Wellness Trust Proposal 

An opportunity to co-sponsor an upcoming convening was presented. The California Alliance for Prevention has requested that the San Diego Accountable Community for Health allow for the SD ACH name to be used on marketing material as a non-monetary sponsorship for their convening in San Diego regarding the concept of creating a CA Wellness Trust. After some discussion the group found no reason not to allow use of the ACH name and approved the request. The group requested to approve any further commitment if it arises before moving forward. Members suggested that Kitty inquire about one of the breakout sessions of the convening being an introduction to the work happening at the SD ACH. 

Workgroup Updates 

Data and Metrics  
Alaina Dall described the wealth of data that have collected and the goals the SD ACH has, and introduced the Results Based Accountability framework to align all of these variables. The model was created in 2005 and since its release has proven to be a successful approach to data-driven decision making to solve complex social problems. The model starts with the end goal and works backwards to determine the “means” of achieving that goal. Alaina noted that the framework uses a common knowledge, is rooted in common sense, and allows for stakeholders to work from a common goal. The framework allows for whole population health and client-specific population health to be acknowledged as separate but connected in working towards the same goal. The group reviewed a pathway example, showing the end goal and the detailed means working from program outcomes in multiple domains to population outcomes at the region-wide level. 

During a discussion on the model, the group recognized this framework as a way to connect all of the program work identified through the Portfolio of Interventions to population health outcomes. The model allows for individual programs to see where they are contributing to the overall goal and identifies areas in which the work needed along the pathway does not exist so that the ACH can either create or coordinate that work to close the gap. The group also identified this as a way for organizations to document their impact on population health which can be used to promote their work for funding opportunities, resulting in mutual enforcement. 

Community and Resident Engagement (CREW) 
Kitty introduced Kathryn Shade, the first workgroup Chair, and shared the plans for all workgroups to have Chairs. Kathryn introduced the new purpose statement to the group and explained the reasoning behind updating the language. The new purpose statement now includes language to express the actual work being done in the workgroup. The Stewardship Group reviewed the final CREW charter and approved it unanimously.  

Kathryn presented the Code of Civil Discourse, a resource from the National Conflict Resolution Center which has been adopted by governing bodies including the City of Del Mar, for guidance for working together harmoniously. In addition to CREW adopting these guidelines, the Collective Action Workgroup recently adopted them and after each attendee reviewed their individual copy, the Stewardship Group unanimously approved the adoption of the Code of Civil Discourse. The Code will be brought to the Data and Metrics Workgroup and the Sustainability and Wellness Workgroup for review for potential adoption. The group agreed that these guidelines are especially important as the SD ACH continues to dive into discussions on equity. 
Kathryn introduced the 2019 goal for CREW to “Develop, implement and share a best practices tool to guide all of the ACH work built on the core values of accountability, equity, inclusivity, and neutrality that encompasses social and racial justice”. To achieve this goal, CREW will lead the development of a tool, guide, or checklist for all ACH workgroups to utilize and to help ensure their work is consistent with ACH core values and an equity lens is applied to all ACH work. A subcommittee is meeting more frequently than the larger workgroup to keep momentum going on the tool. CREW is aiming to bring a draft equity tool back to the Stewardship Group in April with a dissemination target of June 2019.  

Neighborhood Networks 

Kitty shared an update on the Neighborhood Networks process with the group. Conversations are advancing with two interested health plans to determine a plan for a pilot over summer. There are also discussions happening with Health Home leads those from these health plans so that efforts may be aligned. There is potential for the ACH to become subcontracted for this work in the future, most likely for members without a community clinic health home, to provide the required community-based care for the Medicaid health plans.  

Be There San Diego is holding two strategy sessions in March: one on March 5th with Mark Redding to learn more about the Pathway HUB model and strategize ways to implement it in the SD ACH work, and a three-day design lab session from March 19th to March 21st with local community health workers.  
Stewardship Group members discussed potential improvements to the Neighborhood Networks diagram, including the addition of an illustration of “equity” as the overall goal and an overarching governing body.  

Collective Action Workgroup (CAW) 

Cheryl Moder presented updates to the group on CAW activity within the four domains of the Portfolio of Interventions: mutually reinforcing; impactful, comprised of high-quality programs; accountable to and reflects the voice of the community; balanced across all domains, factors, regions ages, populations, time to impact, etc. Cheryl described the work happening at many levels including the county-wide and regional efforts.  

She also announced the capacity building opportunities including a four-part data series which will focus on data collection and evaluation methods, as well as a best practices session on Results Based Accountability. Additionally, a “Best Practice Academy” webinar series will be offered multiple times a year which will highlight best practices and innovative efforts of SD ACH partners and other experts.  

Partnership with Live Well San Diego  

Kitty shared progress on Be There San Diego’s (BTSD) partnership with Live Well San Diego  (LWSD) and informed the group that the funding will go to the UC San Diego accounts of BTSD. The BTSD team is working with the County to determine how to align the SD ACH and LWSD efforts and transfer ownership out of the County to encourage more participation. Dale Fleming, County of San Diego HHSA, followed up to note that this work will be about aligning multiple efforts instead of derailing one or the other. This will potentially allow for efforts to coexist while engaging across regions and sectors. The group shared the feeling that the communications piece of this work will be highly important, so the public understands the transition.  

Cheryl Moder provided an example of how this work is already underway in North County through the partnership of the LWSD Community Leadership Team in North County and the SD ACH subcommittee working on the North County pilot around nutrition. The two have partnered to align efforts and the LWSD Community Leadership Team in North County has agreed to incorporate the pilot into their Community Enrichment Plan. This will kick off collaborative efforts using a strength-based approach for aligning existing work. Members discussed the importance of reminding newly engaged stakeholders of the First Aim of the SD ACH and the overarching equity focus even though single protective factors will be focused on at a time.  

Stewardship Group Design for Year 3 and Beyond 

Kitty reminded the group of the participation guidelines that every Stewardship Group member agrees to by participating and presented an illustration of members broken down by sector. Attendees agreed that the business sector needs more engagement. Attendees also agreed that when looking to engage new members, the group should think about their fit as well as the possibility that they will be able to attend frequently. Dr. Rodney Hood suggested Janedra Sykes from Multicultural Health Foundation to join the group as her experience with business and community-clinical linkages would be a good fit for the group. Steve Hornberger suggested that members from the County of San Diego regional leadership teams should be engaged because of the upcoming partnership with LWSD. He also highlighted the importance of engaging stakeholders who have knowledge in healthcare policy so that the work can move forward being informed by future policy changes.  

After some discussion on a standard process for vetting suggestions for new members, the group agreed to keep the process more informal and relationship-based. The group approved the SD ACH backbone staff to follow up with suggestions and make recommendations back to the larger group on accepting the new member.  Kitty requested that all members consider suggestions for business sector members to bring back to the next meeting for discussion.   

Date and Time

February 12, 2019 12:00 pm
February 12, 2019 02:00 pm

ACHs build on prior efforts to coordinate and integrate various organizations, programs and services by linking their activities together in a coherent and reinforcing portfolio of interventions across five key domains.