Session F5a
Saturday, October 18, 2014
Promoting Learning Communities to Support
Integration, Innovation, and Impact
Becky Hayes Boober, Ph.D., Senior Program Officer, Maine Health Access Foundation
Alejandra Posada, M.Ed., Director of Education and Training, Mental Health America of Greater Houston
Rick Ybarra, M.A., Program Officer, Hogg Foundation for Mental Health
Collaborative Family Healthcare Association 16th Annual Conference
October 16-18, 2014
Washington, DC U.S.A.
Faculty Disclosure
I/We have not had any relevant financial relationships
during the past 12 months.
Learning Objectives
At the conclusion of this session, the participant will be able to:
• Describe at least three examples of learning community
structures that lend themselves to varying contexts.
• Define at least three challenges and strategies to
address such challenges.
• Identify at least three opportunities to advance learning
communities.
• List three resources to help organizations design and
implement learning communities.
Bibliography / Reference
Brown Levey, S.M., Miller, B.F. & deGruy III, F.V. (2012). Behavioral health integration: an essential element of
population-based healthcare redesign. Translational Behavioral Medicine. Published online Jul 26, 2012.
Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717906/.
Grantmakers for Effective Organizations and Research Center for Leadership in Action (NYU Wagner). (2012).
Learn and Let Learn: Supporting Learning Communities for Innovation and Impact. Available at
http://www.geofunders.org/resource-library/all/record/a066000000AhjF4AAJ.
Grantmakers in Health & Hogg Foundation for Mental Health. (2013). A Window of Opportunity: Philanthropy’s
Role in Eliminating Health Disparities through Integrated Health Care. Available at
www.gih.org/files/FileDownloads/Eliminating_Health_Disparities_through_Integrated_Health_Care_August_2
013.pdf.
Linkins, K.W., Frost, L., Boober, B.H. & Brya, J. (2013). Moving from partnership to collective accountability and
sustainable change: Applying a systems-change model to foundations’ evolving roles. Foundation Review, 5:2,
52-66.
Simon, L.P., Slichta, A. & Monroe, A.F. (2014). Improving Care and Service Coordination for Vulnerable
Populations Through Collaboratives: One Funder’s Approach, Impact, and Implications for the Field. The
Foundation Review. 6:2, 10-26.
Learning Assessment
• A learning assessment is required for CE
credit.
• A discussion and question and answer
period will be conducted at the end of this
presentation.
Maine and Texas IHC Learning Communities –
Key Messages and Lessons Learned
• Engagement and inclusivity
• Creating opportunities for participants to
learn from each other and for relationshipbuilding
• Access to technical assistance, experts,
consultation
• Ongoing support and communication
• Evaluation emphasis leading to strategic
learning and capacity building
The Maine Experience
History of IHC in Maine
• 2006-2013: 42 Clinical Practice and Systems
Transformation Grant Awards
• 2010-2012: 5 Integrated Care Learning
Academy Grant Awards
• 2012-2014: 2 Foundation-initiated Integrated
Care Systems Grant Awards
• 2008-2014: Learning Community Activities
• 2014-2018+: DHHS assumes IC learning
community leadership through contracts
Maine IHC Learning Community
• Quarterly Learning Community meetings
– Based on grantees’ developmental level in integration
– Included inter/national keynote speakers to stretch
their thinking
– Opportunities to learn from each other (workshops,
work sessions)
– Topics for Leadership and for Clinical Levels
– Days’ Evaluations, Progress Reports, Cross-site
Evaluation informed topics
– Networking Time (Never Enough!!)
– They continued to attend after funding ended
Maine IHC Learning Community
•
•
•
•
Reimbursement Training
Reimbursement Coaching Contract
Integrated Care Training Academy
Evaluation as Tool
– Site Self Assessment (Cross-site Training, Discussion)
• Taking Learning to the Next Level of Influence:
Integrated Care Policy Committee
What Worked
• Hearing from the Experts (Stretching Them)
• Opportunities at Meetings to Learn from Each
Other
• Relationship-building Activities
• Support of Efforts for Engagement between
Meetings (Peer-to-peer Learning)
• Inclusion of Non-grantees
• Collective Policy Impact
What Didn’t Work as Well
• Web Portal Engagement
The Texas Experience
History of Integrated Health Care in TX
• Multi-year, multi-site grant program begun in
2006 implementing collaborative care model
• Statewide conference in 2008; Resource guide
published
• Multi-year learning community begun in 2009
• Office of Minority Health / Hogg collaboration
(2012). Lit review, consensus report on eliminating
health disparities through IHC, and funders report
published
• 2012-2015 planning and implementation grants
Texas IHC Learning Communities
• Statewide learning communities funded by the Hogg
Foundation for Mental Health and facilitated by Mental
Health America of Greater Houston
• Two learning communities
– 2009 – 2011: Open invitation to sites across the state to participate
(17 “teams,” some consisting of two partner organizations)
– 2012 – present: Primarily for the Hogg Foundation’s integrated care
grantees and partner organizations (10 grantees plus partners)
• Diverse participants
– Wide range of organizations including FQHCs, community mental
health centers, and private non-profits
– At different stages in the process (planning, implementation, state
leaders) and taking different approaches
Engagement and Inclusivity
• Challenge of balancing inclusivity with optimal
level of engagement
• Participant activation – “What’s in it for me?”
Shared Learning & Relationship-Building
• Challenge of geography in a BIG state
• Diverse opportunities to connect both longdistance and in-person – Monthly conference
calls, webinars, web portal, listserv (Google
group), site visits, annual grantee meetings
• Funding for travel to site visits and grantee
meetings
Access to Expertise
• For the coordinator (MHA Greater Houston):
– First learning community – Ongoing consultation from
both state and national experts (National Council)
– Second learning community – MHA built internal
knowledge/capacity during the first LC; same level of
consultation no longer necessary
• For the participating organizations:
– Funding for consultation available through MHA’s grant
– Flexibility in terms of both content and format
– Making it “easy” for organizations to access consultation
Ongoing Support & Communication
• “Three Bears” version of communication – Not too
much, not too little, just right…
• Weekly e-mails – Information about learning
community activities but also other resources and
learning opportunities (e.g., CFHA webinars, CIHS
resources) compiled in an easy-to-access format
• Create sense (and actuality!) of “being supported” –
Regular communication, availability, openness
Evaluation Emphasis
• Promote a “culture of evaluation” (For a brief, practical piece on this topic,
see http://www.fieldstonealliance.org/client/tools_you_can_use/06-2007_evaluation_culture.cfm)
• Weave into the various LC activities
• Emphasize evaluation as a process to continually improve programming as
opposed to “something I have to report or I’ll lose my funding”
• Recognize the value of challenges/things that don’t go as planned –
Opportunities for learning
• “Consultation model” of evaluation to help build internal evaluation
capacity
• Strategic learning for participants, facilitator, and foundation
• Evaluation executive summary from first learning community http://www.hogg.utexas.edu/uploads/documents/TLC%20Summary%20R
eport_final1.pdf
Challenge of Sustainability
• Programmatic
– Flexibility – Needs to evolve to meet changing needs
– Participant “burn out” – Keeping it fresh and relevant
• Financial
– As LC evolves, funding may also need to evolve – New
funders interested in evolution of LC? Fee to participate?
– What can be done without a great deal of funding? What
are the “low hanging fruit”?
Final Thoughts
• One size does not fit all
– No single “right” or “wrong” way
– Certain key elements are essential ingredients
– Start with the essentials and tailor to the specific
circumstances
• A final challenge – THINK COLLECTIVE IMPACT!
Discussion & Questions
Some guiding questions for discussion:
• Have you engaged in learning communities/ shared learning
endeavors? Do the themes we discussed resonate with your
experience? Are there other “key messages” or “lessons
learned” that are particularly salient in your experience?
• What could you do to advance shared learning in your
community? First steps towards a learning community? Next
steps for an already existing learning community?
• What opportunities for collective impact do you see in
learning communities?
Contact Information
Becky Hayes Boober, PhD
Senior Program Officer
Maine Health Access Foundation
bhboober@mehaf.org
http://www.mehaf.org/integratedcarelearningcommunity/
207-620-8266, ext. 114
Rick Ybarra, MA
Program Officer
Hogg Foundation for Mental Health
rick.ybarra@austin.utexas.edu
http://www.hogg.utexas.edu/
512-471-9154
Alejandra Posada, MEd
Director of Education and Training
Mental Health America of Greater Houston
aposada@mhahouston.org
http://www.mhahouston.org/
713-520-3473
Session Evaluation
Please complete and return the
evaluation form to the classroom monitor
before leaving this session.
Thank you!