Monday, July 29, 2019

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 u
s 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!

Sunday, April 28, 2019

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!

Tuesday, April 2, 2019

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!

Tuesday, March 5, 2019

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!

Sunday, February 3, 2019

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!

Friday, December 28, 2018

January Update

Dear Community Partners and Key Stakeholders,

As we welcome a new year and a new CHIP cycle we want to thank you so much for sharing this journey from CHA to CHIP! At our December CHIP Advisory meeting, we voted on two Focus Conditions to move forward in our 2018-2021 CHIP cycle. And on December 21st, the Buncombe County Health and Human Services Board endorsed and approved our recommendation to focus on Mental Health for this next three year CHIP cycle and Birth Outcomes and Infant Mortality as our focus for an expanded 10 year cycle!  We hope you feel that your voice has been included in this CHA/CHIP process and we are committed to continue to work to better engage the community and those most impacted by these conditions as we move forward.  

Don't forget that you can review our CHA/CHIP process notes and materials on our blog resources.  You'll find a link to a directory of CHA documents on the right-hand menu bar with links to all the meeting materials (minutes, slides and supporting materials), data summaries for standout health conditions and materials that describe (and supported) the methodology used to get us to our new Focus Health Conditions.  And, as always, feel free to reach out with your questions and data needs.

With the New Year we continue to work on improving our CHIP Operating Guidelines to provide more meaningful opportunities for engagement, broader leadership and improved communication.  We will spend time in February considering approaches to addressing the social determinants of health that influence so much of our community's health and well-being.  Beginning in March we will be reaching out to all of you to help us identify the stakeholders that need to be involved in shaping our work around Mental Health and with Birth Outcomes and Infant Mortality.  In May we will be engaging many of you along with key stakeholders across the community in in a robust process to focus this new work and identify the strategies and process that can help us change the trajectory of these Focus Health Conditions.

In the meantime, our existing work around Birth Outcomes and Diabetes continues. Our Diabetes partners shared a wonderful update on their work at our last CHIP Advisory and you can view the slides from that presentation here.  After much process work and planning their will be a meeting of our larger diabetes workgroup this month and a long awaiting reconvening of Food Security partners.  You can learn more about this at our at our separate work group blog sites:
Don't forget to visit our additional blog pages to learn more on how you can Engage on important issues related to our CHIP priorities and Social Determinants of Health, Support our many partners, Learn.  In particular, we invite you to visit the Resources page where we have posted a number of articles on Collective Impact lessons learned and best practices.  Our CHIP support team will also be participating in a learning cohort with the Center for Nonprofit Management this year  We'll be talking about this opportunity and why a renewed focus on collective impact at our January Advisory meeting.  We'll also be reaching out to you in early January to give us a baseline assessment on the status of and support for CHIP as a collective impact approach.
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!

Monday, December 3, 2018

December Update

Dear Community Partners and Key Stakeholders,

Our journey from CHA to CHIP is nearing a close. In August we received over 200 pieces of data from WNC Health Network

Our CHIP Advisory worked with our Buncombe CHA data team throughout October and early November to review the stand-out data from publicly available resources such as the NC Center for Health Statistics, the WNC Regional Telephone Survey and the Key Informant Interview that some of you participated in.  Using a filter of the relevance, impact and the feasibility of addressing these conditions, they helped narrow the list of stand out health conditions to 5.
 We further considered these health conditions in regard to what community members felt were important and pressing issues as well as information from public sources around social determinants of health. And on November 1st we revisited the data that had been shared and had conversations about what it would mean for each of these to be the Focus Health Conditions for as much as the next 10 years. Those present at that meeting voted for 2 Focus Health Conditions to move forward, with one for a 3 year CHIP cycle and another for a 10 year CHIP cycle. We also reached out to Advisory members who were not able to attend that meeting to obtain their vote.  We meet next Thursday to finalize this decision.  The Buncombe County Health and Human Services Board will be asked to endorse our recommendation at their December Meeting.


You may notice that we haven't used the term CHIP Priorities and that's intentional. We realize that it is important to stress that when health conditions are no longer the primary focus of CHIP that they are still priorities. We will continue to support community work around previous "priorities" as much as we can while giving lift to our designated Focus Health Conditions.

Throughout this process there has been a profound interest and concern in how we move forward in a way that ensures that social determinants are woven through our CHIP work. Especially as it relates to racism. We don't know exactly what type of structure or process this will require but we will be working to address this challenge over this next year. Critical to ensure that we are doing this is making sure the right voices are involved with this work. Once we confirm our Focus Health Conditions, we will spend the next couple of months identifying these voices.

You'll find a link to a page that describes and includes links to all the documents related to this process on the right-hand menu bar on our Blog, including meeting slides and minutes.

With the months-long in the weeds data process, it's helpful to remember that we are in Phase 1 of the CHA/CHIP process. We look forward to moving past the data and into the Strategic Planning process.

Don't forget to visit our additional blog pages to learn more on how you can Engage on important issues related to our CHIP priorities and Social Determinants of Health, Support our many partners, Learn, and access Resources.  

Don't forget each of our priority work groups has a separate blog page which you can find at the following links:
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!