CHIP Update Holiday Edition

Dear Community Partners and Key Stakeholders,

We are very fortunate to work with such a dedicated group of individuals and organizations on the CHIP Advisory Committee and our throughout the community. Your engagement and support will help to move the needle on our disparate infant mortality and mental health focus areas. 

We thank you for your service and wish you a wonderful holiday season!

 Jan and Frank  

Before many of you begin taking time away to spend with family and friends during holiday celebrations, please note that the first CHIP Advisory Council meeting will shift to the second Thursday (January 9th) and will be open to anyone who would like to attend.  AARP and ABIPA will be hosting a screening of The Power to Heal: Medicare and the Civil Rights Revolution.  This powerful film tells the story of the historic struggle to secure equal and adequate access to healthcare for all Americans and is being hosted by ABIPA and AARP.  You can view the film trailer here (although it does a poor job of providing a sense of this documentary's power).  

Given we will provide breakfast, please take a minute to RSVP at http://bit.ly/PowerToHeal_RSVP, even if you normally attend.  And please share!

We also want to provide a quick update on the Buncombe County Board of Commissioners presentation on December 3rd as well as thank those of you who showed up to demonstrate your support!  We were very pleased with the response we received. The Commissioners were receptive and many of them clearly expressed their support for our work to address Birth Equity and Mental Health & Well-being as well as the work to advance cross-sector collaboration to undo racism. Several commissioners specifically spoke to the value of what we shared to developing the county strategic priorities  The video from that meeting has not yet been posted, but you can view the slides here.

With gratitude from the whole CHIP Team, 
We wish you joy, peace and hope as we move into the new year!

November CHIP Update

Dear Community Partners and Key Stakeholders,

We are so pleased to announce that our Community Health Improvement Plan (CHIP) has been approved by the NC Department of Public Health. The plan is now publicly available for you to view and use to inform your work, as is the Community Health Assessment (CHA).  It is important to stress while the CHA is a final document, the CHIP is a living and evolving document and will change over time.  The online document articulates that this is an early plan with much of the focus on process.  The next phase of the work is just beginning and we look forward to engaging each of you and our larger community over the coming months.  In the next day or so, we will be sending out a summary of the work to date broadly to all who contributed to the development of the CHA and CHIP.  

• To access the Buncombe County CHIP Plan for 2018-2021 visit: http://bit.ly/BuncombeCHIP2018_2021

• To access the Buncombe County 2018 CHA                                visit: http://bit.ly/Buncombe2018CHA

Our CHIP staff had the opportunity to provide an update on our CHIP Plan to the Buncombe County Health and Human Services Board on October 25th. The presentation was well received and generated some thoughtful discussion, particularly around the overarching strategy of Advancing Cross-sector Collaboration to Undo Racism and the role of the HHS Board in pushing this work forward. 

Commissioner Edwards requested that staff present on the CHIP process and strategies to the Buncombe County Board of Commissioners before the board finalizes their Strategic Priority work in at the end of this year. The CHIP presentation will be at the upcoming County Commissioners' meeting on Tuesday, December 3rd at 5 PM, at 200 College Street (Room 326) - we welcome you to join and invite any community partners you think may be interested!

The County Commissioners are looking for more community input on the next Buncombe County Strategic Plan through the first week of December. Please go to a public input session and share your voice on what you believe is most important for the County to prioritize over the coming years: 

• Monday, Dec. 2           1:00 - 3:00      Big Ivy Community Center 
• Wednesday, Dec. 4     2:30 - 4:30      Black Mountain TownHall  
• Wednesday, Dec. 4     5:30 - 7:30      Arthur R. Edington Center
• Friday, Dec. 6              5:30 - 7:30      Enka-Candler Library
• Saturday, Dec. 7         11:00 - 1:00     Skyland Fire Department

The CHIP Advisory Council is pleased to announce Emma Olsen as our new chair. Emma is Director of Partnerships and Evaluation for the NC Center for Health and Wellness and comes to this role with deep knowledge of RBA and our CHIP process. In fact, Emma interned with CHIP in 2014 and first brought Results Based Accountability and the online scorecard to our attention as a tool for sharing data and communicating progress.  You can read Emma's bio here.

Our CHIP process identified advancing Cross-sector Collaboration to Create a Trauma-Responsive and Resilience-focused Community as one of two strategies with a key emphasis on services and supports for our youngest community members and communities of color. Our strategy conversations recognized the challenges and progress our schools are making and stressed the importance of identifying community-based approaches to support the work happening in schools, and in ensuring supports extended to teachers and parents. With this context, we have asked David Thompson, Director of Student Services with Buncombe County Schools and Shane Cassida, Executive Director for Student Support Services with Asheville City Schools to attend our December 5th CHIP Advisory Meeting to report on their collaborative approaches to address equity and create trauma-responsive environments to support social emotional learning and the mental health and well-being of students and how they are measuring progress.  

Keep up-to-date on more timely information and partner updates on our Facebook page. You'll also find resources and learning opportunities on our blog pages. We try to keep up-to-date on postings related to ways to support our partners and engage in advocacy.  
Please help us better support your organizations and advocacy platforms by sharing your info on our Blog and Facebook pages. And, of course, you can send content to Terri at anytime.
With gratitude,

The CHIP Team!

September CHIP Update

Dear Community Partners and Key Stakeholders,

The CHIP process in August has focused on multiple meetings and input sessions with key stakeholders to provide additional insight and input into what was learned from our June and July Talk to Action community conversations for both Birth Outcomes & Infant Mortality and Mental Health. In August we presented the outcomes of these community sessions to our CHIP Advisory who walked through and absorbed the products of those conversations and then provided input into what they felt might be missing or additional strategy possibilities. This also provided additional information to our Advisory as they begin to consider what their larger work and structure is moving into this CHIP cycle. 

Next week we will submit our CHIP Action Plan to the state. While we have identified broad focus areas for our work ahead and general strategy directions, we are very much in the early stages of learning from our community to clearly articulate the steps we will need to impact Birth Equity and Mental Health.  Consequently, the plan being submitted focuses largely on the action steps we will be taking over the next 6 months to fully develop and/or clarify partnerships, detailed action plans, roles and responsibilities as well as the structures needed to evaluate and sustain our work together.

At this week's CHIP Advisory we will share what our team has been learning from others about potential approaches to more effectively implement collective impact in Buncombe County and possible ways to alter our structure to better achieve success.  Part of this includes building on what we have learned from the past few years about elevating community leadership and how we can do this better.  We plan to convene a team to develop an application and selection process to more successfully identify community leadership.  You can find some of the resources from ACE Nashville and other organizations we have learned about with support from Robert Albright at FSG, the organization that was in the forefront of articulating the concept of Collective impact in the Stanford Social Innovation Review in January 2011 on our CHIP Resources page under Collective Impact. 

A couple of key updates to our ongoing work to advance Birth Equity: 
There were great strides in July – August in the work towards becoming a Breastfeeding Family-Friendly Community. Both Buncombe County and Asheville City governments adopted resolutions in support of becoming a Breastfeeding Family Friendly Community! The Buncombe County Breastfeeding Coalition, convening for the first time in July, will support this process forward. Many local community partners highlighting the importance of supporting breastfeeding during National Breastfeeding Awareness Month in August and The Mountain Xpress featured the 10-step process our community is pursuing in their August 1st cover article. Many thanks go to Buncombe HHS and the Buncombe Partnership for Children for their leadership on this important work.

Our CityMatCH Equity Institute Travel Team in Minneapolis

August launched the start of our community’s 3-year participation in CityMatCH’s Institute for Equity in Birth Outcomes learning collaborative! CityMatCH is a national organization of city and county health department maternal and child health (MCH) programs and leaders. Their mission is to strengthen public health leaders and organizations to promote equity and improve the health of urban women, families, and communities. Our Buncombe travel team, attended the 4-day inaugural session last week where we were inspired by leaders in the field including Dr. Arthur James, Dr. Vijaya Hogan, and Dr. Renée Canady, and learned from other communities across the country engaging in equity work. Our travel team will be sharing what they learn with our larger local collaborative and we anticipate our Buncombe CHIP partner's participation will push us to authentically engage community partners, use data more effectively, and evaluate our work in promoting equity in our institutions as well as in our community. We are excited to see how the guidance of the Institute will help shape our collaborative birth equity work moving forward.

Keep up-to-date on more timely information and partner updates on our Facebook page. You'll also find resources and learning opportunities on our blog pages.  We try to keep up=to=date on postings related to ways to support our partners and engage in advocacy.  One upcoming annual event that any of us look forward to each year (and talk about what we heard the rest of the year) is Pisgah Legal's Justice Forum. Visit our support page to learn about this year's powerful speaker.  Please help us better support your organizations and advocacy platforms by sharing your info on our Blog and Facebook pages.  And, of course, you can send content to Terri at anytime.

In appreciation of all you do!

The CHIP Team!

August Monthly Update

Dear Community Partners and Key Stakeholders,

June and July have been busy months for our CHIP process! June launched our Talk to Action community conversations for both Birth Outcomes & Infant Mortality and Mental Health at the YWCA. We are so grateful for and inspired by all of you who set aside an evening or more of your time to take part!

Our Talk to Action participants were engaged and the conversations were rich, providing a good foundation for moving forward. We are still sifting through and organizing all the input but soon will be able to share the meeting notes and outcomes publicly. Common themes across both focus conditions were engaging community, justice system and healthcare leaders to undo racism and promote equity and well-being at both the organizational and community-wide levels, with a strong focus on supporting youth and school-based initiatives.

We continue to meet with individuals with expertise on equity in birth outcomes and mental health, and factors that influence these conditions. We are working to build new connections with folks doing relevant community work, such as those working within the justice system to address racial inequities and increase support for those with mental health vulnerabilities.

Next steps for our CHIP process are sharing the stories and strategies that came out of the Talk 2 Actions with other groups and individuals who can help us further understand the context of this work in our community and continue to refine next steps.  We will be gathering input from the CHIP Advisory Council at our August meeting, and with youth in the next few weeks.  We are happy to continue reaching out to additional individuals and groups to get input and feedback over the coming months as new stakeholders are identified.

A draft of our Community Health Improvement Plan will be submitted to the NC Division of Public Health in September. It is important to underscore the word draft here.  While we will submit a fairly detailed work plan, as we begin to convene individuals to take action and identify those in the community who can champion this community-led work, the CHIP plan almost certainly will evolve and change as we learn more from our community and each other.

Social Determinants continues to be an area of interest and learning across the community, the state and nationally.  The CHIP team is revisiting our CHIP Advisory Council's work around a Social Determinants and Health Equity that we started several months ago and we hope to reconvene a small team fairly soon to continue developing our own language for what we mean when we say SDoH. In the meantime we encourage you to check out the resources on SDoH found on our CHIP blog Resource page.  If you were not able to attend the recent Social Determinants of Health Conference at MAHEC in June (or just haven't downloaded the materials) you'll find a link here.  The conference included a keynote by Dr. Betsy Tillis on the North Carolina Response to Social Determinants of Health.  Presentation materials on the following topics were also made available: innovative strategies from communities across the country (Carrie Lee Carroll with the RWJF Culture of Health Prize at University of Wisconsin Population Health Institute), how local public health departments are addressing SDoH (Laurey Stradley, Alliance for a Healthier Generation) and a presentation from our CHIP team on our local journey to leverage collective impact to address SDoH.  You can find these presentations on our Resource page under Social Determinants of Health heading.

Keep up-to-date on more timely information and partner updates on our Facebook page. You'll also find resources and learning opportunities on our blog pages as well as ways to support our partners and engage in advocacy. To share your info on our Blog and Facebook pages, send content to Terri at anytime.

In appreciation of all you do!

The CHIP Team!

May 2019 CHIP Update

Dear Community Partners and Key Stakeholders,

Equity and Inclusion are much on our minds, especially as CHIP is working to develop our process to hear and engage diverse voices so that we can better understand the story behind the data that led us to elevate Birth Outcomes & Infant Mortality and Mental Health as focus health conditions. At our last CHIP Advisory Meeting we continued to use tools from the ABLe Change Engagement Model, to guide us in thinking about the continuum of community engagement as well as how to engage the range of voices in the way that bests respects their expertise and preferences for informing and/or participating. We often use a more detailed framework to talk the the community engagement continuum that may be helpful in considering how to engage community voices. And since it has shown up at meetings and workshops 3 times this month, it seems apparent that we are meant to share this version with you.  Let us know if it is helpful. In the meantime we continue to talk to CHIP partners about the voices that should be part of this work moving forward, whether it is hearing from and learning from their stories, co-developing strategies or supporting their innovative practices. We will be identifying dates and locations for community conversations in the next month and begin contacting you and other stakeholders as soon as we can.

A small group of CHIP Advisory met earlier this month to continue the work on shared language around Social Determinants of Health, building on the the concepts and values that were identified by CHIP Advisory in February.  This working group will meet at least one more time before draft language is brought back to the advisory to finalize as well as identify what specific tools we need in our SDoH toolkit.  And, as folks throughout the state are having substantive conversations around SDoH, we wanted to alert you to mark your calendar for Social Determinants of Health and it's Impact on North Carolina on June 18th at MAHEC.

April 11 - 17th was the second annual Black Maternal Health Week organized by the Black Mamas Matter Alliance (BMMA). BMMA is a Black women-led cross-sectoral alliance that envisions a world where Black mamas have the rights, respect, and resources to thrive before, during, and after pregnancy. BMHW asks that we be intentional about centering Black women’s voices, stories and thought leadership. Cindy McMillan is one of the inspiring leaders and doulas from SistasCaring4Sistas that we are honored to work alongside. Please read Cindy's powerful call to action in honor of Black Maternal Heath Week here.

Our team of Evan, Hannah, Zo and Terri just returned from Nashville for the second in our Collective Impact Learning Cohort workshops. This workshop was entitled Implementing Equity Frameworks: Creating Systematic Change and provided many tools and resources that we will be sharing with you in the future. One easy-to-share takeaway from the training was this excellent Resources for Implementing Equity Frameworks list from the course faculty that we have added to our resource page.

And finally, we have presentations coming up at our next CHIP Advisory that we think you will be interested in. At our last meeting is was apparent that there still is not a clear understanding of the framework that we are using to think about, organize and take action around our focus health conditions over the next several months. We've asked Erin Braasch with WNC Health Impact to spend a little bit of time unpacking guiding questions and our process from a less "in the weeds" perspective that we think will be helpful for many of you.

We are also very excited to share a presentation on the CHA Listening Session qualitative data analysis at our CHIP Advisory Council meeting on May 2nd! Liane Ventura has been interning with us this spring semester from the East Tennessee State University, Master of Public Health Program and has conducted a in-depth analysis of the listening sessions that we believe you will find very informative.  For those of you who do not attend the CHIP Advisory, her presentation slides and the report will be available soon on our CHIP blog.

Keep up-to-date on more timely information and partner updates on our Facebook page. You'll also find resources and learning opportunities on our blog pages as well as ways to support our partners and engage in advocacy. To share your info on our Blog and Facebook pages, send content to Terri at anytime.

In appreciation of all you do!

The CHIP Team!

April CHIP Update

Dear Community Partners and Key Stakeholders,

We are well-underway in the process of moving from the Community Health Assessment (CHA) to the Community Health Improvement Process (CHIP) where we identify where we focus our efforts, identify strategies and develop action plans.  If you have been part of our CHIP or similar efforts elsewhere, in hindsight we often question whether we have engaged all the needed stakeholders. This CHA/CHIP cycle we are trying to spend more time upfront thinking about engaging community voices and stakeholders. During the CHIP Advisory meeting last month, using tools from the ABLe Change Engagement Model, members were asked to identify which stakeholders should be included in addressing Birth Outcomes & Infant Mortality and Mental Health. We engaged in a process to consider those who are experiencing the health condition; providing services; supporting efforts to address the condition; and/or making decisions that affect the condition. Of those, we then identified who are already included and which partners are currently excluded. From this exercise, a long list of current and potential partners were named. 

This Thursday the CHIP Advisory will be guided to consider the ways in which groups and individuals may engage to impact the focus health conditions. We will continue to identify stakeholders who have experienced poor birth outcomes, infant loss, and/or mental health issues; those who provide services and support these focus areas; and those who makes decisions that impact our focus health conditions in Buncombe County. Finally, we will consider at what stages and processes various stakeholders should be engaged and how to move forward to recruit them to partner in the CHIP. 

In last month's Update we highlighted the process the CHIP Advisory began around Social Determinants of Health. We revisited this process at our March meeting and a working group was formed with the focus to draft shared language for CHIP Advisory and partners to consider using when discussing Social Determinants of Health that underlie our focus health conditions and is the foundation of our community-based work. We look forward to bringing this working group together soon.

Natalie S. Burke of CommonHealth ACTION, keynote speaker from Monday's Health Equity in Action conference at MAHEC, spent much of her time emphasizing the importance of language and challenged us to reconsider when we use the words: vulnerable, empower, under-served, non-white and community. To read more about her thoughts onto better ways to communicate challenging issues check out How to Fix a Broken Tongue. The conference focused on addressing Health Equity in Buncombe County and the creation, implementation, successes, and continued work to address Birth Outcomes and Infant mortality by Mothering Asheville. To view some of the highlights, visit Natalie Burke's twitter feed @natalie4health.

Keep up-to-date on more timely information and partner updates on our Facebook page. You'll also find resources and learning opportunities on our blog pages as well as ways to support our partners and engage in advocacy.  To share your info on our Blog and Facebook pages, send content to Terri at anytime.

In appreciation of all you do!

The CHIP Team!

March 2019 Update

Dear Community Partners and Key Stakeholders,

This month we will begin to identify the voices that need to be included in defining how we will move forward to improve and expand efforts around our newly identified focus health conditions.... improved mental health and birth outcomes, keeping the focus on health equity throughout our work.  This week's CHIP Advisory Council will participate in a process to begin to tease out the different ways to consider who we need to involve and the best way to incorporate their voices.  We will also be reaching out to all our partners to inform this important first step.  This could take the form of a quick survey or community conversations, but you should be seeing opportunities to participate in the near future.

In our February Update we highlighted the importance of having a shared understanding and shared language around social determinants of health and we began to "unpack" this at our February CHIP Advisory meeting.  You can view the slides we shared at the February Advisory meeting here.  Many of those attending found helpful how we presented the "lens" you use if your definition of social determinants leans more toward a focus on health, on health care or health equity.  

We also began a conversation to identify what learning opportunities and resources we need to better understand SDoH, to know how to talk about it with leaders and stakeholders and to identify ways to begin more effectively addressing those social and economic factors that strongly influence health.  We will intentionally be sharing materials, both on our CHIP Resources page, via email and on Facebook.  We shared a recent webinar and information about a new documentary from Health Leads entitled What Counts that highlights how health care organizations are approaching the social needs of their clients and beginning to broader their conversation around social determinants of health.  You can find a link to the documentary on  our CHIP Learn Page.

The annual County Health Rankings report from University of Wisconsin and Robert Wood Johnson Foundation will be released in mid-March.  This report highlights how health is influenced by where we live, learn, work and play in individual communities across the country and offers opportunities to consider where we are doing well and where we can improve.  The media generally does stories around the Rankings and we hope that many of you will be available to highlight your work or concerns.  If you are interested in being available for interviews, please contact Zo Mpofu.  

We want to offer a shout out Maggie Adams and Cindy McMillan for sharing lessons from their work with Mothering Asheville and Sistas Caring 4 Sistas in a national webinar hosted by the Robert Wood Johnson Foundation on Policies & Programs to Help Build a Culture of Health!

Keep up-to-date on more timely information and partner updates on our Facebook page. To share your info on our Blog and Facebook pages, send content to Terri at anytime.
In appreciation of all you do!

The CHIP Team!

February Update

Dear Community Partners and Key Stakeholders,

Social Determinants of Health is something you increasingly hear discussed in many and diverse spaces.  However, as this term is used more frequently it becomes clear that not everyone is using it the same way. Case in point, earlier this week I shared an article from Health Affairs on our CHIP Facebook page that stressed the need to distinguish between "social needs" and "social determinants of health". It is challenging to work across organizations and disciplines if we don't have a shared understanding and aren't speaking the same language and shared language is a core element of the framework that we used to help guide our CHIP work. In February our CHIP Advisory will beginning addressing this challenge by ensuring common definition of Social Determinants of Health.  We'll also looking at what our Advisory and our partners need to better understand SDoH, know how to talk about it with leaders and stakeholders and identify ways to begin more effectively addressing those social and economic factors that strongly influence health.  For those of you on CHIP Advisory we encourage you to take a few moments to read the Health Affairs article referenced above.  We've also added this article to our CHIP Resources page for easy access in the future.   

You'll also find the link to a new documentary from Health Leads entitled What Counts. Health Leads is promoting this documentary as a tool to foster conversation in health care communities around social determinants and they are hosting an online documentary screening and discussion of the film on Thursday, February 7th.  We have a reserved a room a MAHEC if some of you would like to view it together and follow with some of our own conversation. Of course you can view the documentary and/or participate in the screening and discussion at your own computer.  You'll find the details on our CHIP Learn Page.

Collective Impact is also something being discussed a great deal in our community that is not necessarily well-understood.  CHIP has aspired to be a collective impact process although our approach has been less than perfect. (the "field" is evolving and there is still much to be learned. This year CHIP MAHEC and Buncombe HHS staff will participate in a learning cohort led by the Center for Non-profit Management based in Nashville, Tennessee.  We will be sharing resources and our learning with you as well as using this opportunity to help us more effectively guide our CHIP process so that the amazing work across our community is better aligned for success.  Again, check out our Resources Page.  

Prior to attending our first Learning Cohort session in Nashville, Our MAHEC/Buncombe Co HHS team took a survey to assess how we are doing as a "collective impact process" as both a way to inform our learning but also as a tool to help us evaluate our process moving forward.  You're perspective in this assessment would be valuable and we would like to invite you to take this same survey.  Please let us know if you have any difficulty accessing the survey tool

In closing, we are extremely excited to introduce Hannah Legerton who we welcomed as our new Health Improvement Specialist on January 23rd.  Hannah has masters degrees in both social work and public health with extensive experience working in the fields of maternal child health and on social justice issues.  Some of you may know Hannah from 2014 when she interned with the CHIP team at Buncombe County HHS.  She is also an Asheville native.  We'll have her bio posted on our CHIP Staff page in the next few days.

In the meantime, our existing work around Birth Outcomes and Diabetes continues. Maggie Adams and Cindy Williams with Mothering Asheville shared a wonderful update on their work at our last CHIP Advisory.  You can click here to view the slides from that presentation as well as a short video clip that talks about the work of Mothering Asheville. 

We are in the middle of a roller coaster winter and our January Diabetes New Year meeting needed to be postponed due to the recent "polar vortex" event.  This group will now be meeting on February 12. For more information about that meeting contact Nicole Vertel. And you can follow updates for this group on our Diabetes Page.

Food Security partners reconvened their larger workgroup in mid-January with a great group of participants. Look for updates to this work at our Food Security Page in a couple of weeks. 

Keep up-to-date on more timely information and partner updates on our Facebook page. To share your info on our Blog and Facebook pages, send content to Terri at anytime.

In appreciation of all you do!

The CHIP Team!