Strategies for Achieving
Sustainability
Integrating Professional for Appalachian
Children (IPAC)
Jane Hamel-Lambert, MBA, PhD, President, IPAC
Sherry Shamblin , Chair, Board of Directors, IPAC
ORHP All Grantee Meeting, Washington, DC
Peer to Peer Sustainability Panel
August 2, 2010
Overview
 Integrating Professionals for Appalachian
Children
 Seven Strategies for Achieving Sustainability
 Exemplar: Tri-County Mental Health &
Counseling Services, Inc
 Vertical network: participating
agencies… child serving
systems… mental health,
medicine, speech language,
audiology, nursing, schools,
early intervention … and
parents.
 Legal Status: 501(c)3
 Governance Structure:
Independent Board of
Directors,15 person; bylaws
(corporate regulations)
Vision & Mission
IPAC’s vision is to ensure healthy
development for all children.
Mission: By leveraging our expertise and
integrating our resources, IPAC will
develop innovative, culturally-sensitive
programs that address the critical and
complex challenges impacting the health
and mental health of our region’s children
and families.
Rural, Appalachian, Southeast OH
 Professional
Shortages: HPSAs,
MHPSAs, Dental
 Medically
Underserved Areas
(MUAs)
 High Poverty
 High Unemployment
 Low Educational
Attainment
What was happening …
Grandma’s
FP
Physician
OT
Sensory
Integration
ER
Zanesville
Mom’s
FP
Physician
Endocrine
Children’s
Hospital
GI
Children’s
Hospital
Visual
Tracking
Therapy
Auditory
Processing
Evaluation
Head Start
Home
Services
Local
Hospital
ER
Public
School
OU
Therapy
Associates
GI
Specialist
Local Hosp
Redesigned Services
Family
Navigator
OU Psych &
Social Work
Clinic
UMA
Pediatrics
IPAC’s Vision for Change
Ensure healthy development for all kids by
improving our community’s ability
 to identify,
 to refer, and
 to provide
comprehensive, coordinated care to young
children with developmental and behavioral
concerns.
Network Development
“….to develop a formal network with the
purpose of improving the coordination
of health services in rural communities
and strengthening the rural healthcare
system as a whole.”
 Office of Rural Health Policy http://ruralhealth.hrsa.gov
Balancing Strategy & Structure
Strategy: Collaboration & Capacity
Building
 Interagency collaboration
 Blend wisdom of “doers and
directors”
 Build balanced communityuniversity partnership
Structure: Non-Profit Organization
 Bylaws, 501(c)(3) status,
bank account
 15 member board of
directors, organized around
7 constituency groups
Clinical Programs Achieve Vision
 Developmental
Screening in Primary
Care and Childcare
Settings
 Family Navigator
Program
 Local Interdisciplinary
Assessment Team
 Co-locating behavioral
health providers in
primary care
Interagency Collaboration
Two Sustainability Challenges
Sustain the Programs
Fiscal challenge: clinical services generate revenue
Culture of collaboration (3 separately owned)
Sustain the Network:
“We are the keepers of our culture”
building trust takes time
building a network is a long-term commitment
celebrate the successes
share responsibility for challenges
transparency regarding budgets, decisions
prudent fiscal management
Grant Funding
Net Planning ($85,000):
Focused on deciding what being
a network would mean,
designed the infrastructure
(board, bylaws, legal structure).
What will the network will do?
Network Development ($540,000):
Two goals
 Network self-sustaining

Incorporate, network policies,
leadership, membership, dues
structure, communications (internal
& external stakeholders),
collaboration skills
 Build integrated health delivery
system through interagency
collaboration/programs
Outreach Grant ($375,000):
Programmatic agenda: ECMH
consultation for preschools, plus
workforce development trauma
and autism trainings.
SAMHSA Project LAUNCH (3.5 mil):
 Programmatic agenda: Regional
expansion and diversification of
programs (i.e., health and
wellness), workforce
development
 Network Agenda: board
development, membership,
functions, communication
Sustainability: Facets other than Funding
 Partnership and Collaborative Capacity Development
 Shared identity, logos… mugs, magnets, stationary
 Shared clinical focus: young kids, interdisciplinary
 Core values: Integration, Access, Collaboration
 Stakeholders: doers/directors, univer/community
 Incorporating brings substantial structure
 You are an organization (not just a program)
 Governed by a board of directors (power assigned)
 Bylaws set expectations (attendance, who gets on the
board/how you get on the board, etc)
Plan, plan, plan …
“There are good ideas and then there are good
ideas with a plan. The former often die on the
vine, having nowhere to go. The latter create
companies.” (www.hivelocitymedia.com, July
2010)
Grants … work plans sets goals, objectives and activities on
timeline…
Create a Sustainability Plan…network committees to
examine dues structure, board structure, revenue
generating strategies, personnel needs. What are you
operational expenses; how are you paying your bills.
Identify consultants, go to management trainings, read.
IPAC Operational Snapshot
Revenues:
 Bank account opened with a donation
 Dues structure… know why your charging what you do charge. We
started at $500/yr, now $1000/yr…
Annual Expenditures
 Directors and Officers liability insurance (approx $1300 per year)
 Server for website (approx $330 per year)
 Filing taxes .. Donated services local CPA
Slow Growth (board paces growth)
 Contract for Coordinator, Interdisciplinary Assessment Team ($3180)
 Personnel (?$15,000): part time employee (a) website,
communications (b) professional develop programs for revenue
 Employment: HR consultant paid through another grant; legal
consultation costs loom
 President is volunteer (no cost) but capacity is limited
Seven Strategies for Sustainability
1.
2.
3.
4.
5.
6.
7.
Care about the emerging culture of your network (trust,
transparency, respect, conflict management)
Strengthen organizational identify: shared vision/purpose, jointly
agreeing on the problems to solve, then jointly designing solutions,
anchors ownership and responsibility
Visual Representation of you Network: logos, website, stationary,
newsletter.
Build capacity of network: leadership, management, strategic
planning, fiscal/accounting, communications
Find ways to diversify revenue streams (grants, donations, dues, in
kind services, revenue generating programs)
Fiscally prudent decision making… grow at a pace you can afford
Plan, plan, plan… know where you are, know where you want to
go, and know how you intend to get there..
……and celebrate the successes along the way!
Tri County Mental Health and
Counseling Services, Inc
 Sherry Shamblin, PCC-S
Exemplar
Sherry Shamblin
 From Network Participant
to Network Leader
 From Provider to
Department Director
Tri-County Mental Health
 From Network Skeptic to
Network Supporter
 From Isolated Competitor
to Collaborative
Community Partner
Changing Agency Culture
CEO: 2007
“Collaboration might
be good for
services, but its
not good for
business.”
CEO: 2009
“Membership in IPAC has led to several
direct benefits for our
organization...valuable assistance in
obtaining new funding to expand our early
childhood services. The collaboration
fostered within the IPAC network also
helped us to establish a successful
behavioral health/ primary
care integration service delivery model…
The Interdisciplinary Assessment Team…
helpful resource for children served by
our clinical staff, while the trainings
sponsored by IPAC have increased the
capacity of our staff to deliver
standardized assessments to young
children.”
Growth contributes to sustainability but growth is interconnected
Growth of
an agency
Growth of
a board
member
Growth of
Network
LEVERAGING THE NETWORK TO ACHIEVE SUSTAINABLE
ORGANIZATIONAL CHANGE
 Administration has changed attitudes about partnerships, about the
potential of grants to support innovation, about services delivery.
 From a single early childhood mental health (ECMH) provider to a
ECMH Department
 Expanded EMCH staff from 1 – 4 with grant funding; 5th funded
through state EMCH dollars
 ECMH Director is on agency leadership team shaping direction of
organization
 Expanded services offered: co-located behavioral health providers in
primary care; ECMH in new settings, use of evidenced-based
models, conducting developmental screenings
LEVERAGING THE NETWORK TO ACHIEVE SUSTAINABLE
ORGANIZATIONAL CHANGE
 Emerging Community Based Participatory Research
Committee
 Accessing national expertise through technology
 State and regional ECMH training including other mental
health agencies
 Initiating and leading EMCH workforce development
opportunities with Ohio University’s counseling department.
HOW EACH IPAC GRANT CONTRIBUTED
 STAYING ON TRACK: EXPANSION OF CHILDCARE TRAININGS,
TEAM BUILDING WITH OTHER FUTURE NETWORK PARTNERS
 NET PLAN: TRAINING, EXPOSURE TO NEW IDEAS
 NET DEV.: TRAINING, SKILL DEVELOPMENT, LEADERSHIP
OPPORTUNITIES, EXPANSION OF CHILDCARE CONSULTATION,
CO-LOCATED SERVICES, IAT ACCESS, INCREASED
TRUST/COHESION WITH NETWORK PARTNERS
HOW EACH GRANT CONTRIBUTED:
 OUTREACH: GRANT WRITING EXPERIENCE, INTRODUCTION
TO CBPR, LEADERSHIP DEVELOPMENT, ECMH SCHOOL
PARTNERSHIPS
 SAMHSA PROJECT LAUNCH : ECMH DEPARTMENT,
EVIDENCED-BASED MODELS, EXPANSION OF PRIMARY CARE
VENTURES, OPPORTUNITIES TO TRAIN/ DEVELOP REGIONAL
WORKFORCE
Why We Needed IPAC & What We’ve Given IPAC
Support
OPPORTUNITY
CAPACITY DEVELOPMENT
Contact information:
Jane Hamel-Lambert, MBA, PhD
Ohio University
740-593-2289
Hamel-lj@ohio.edu
Sherry Shamblin, PCC-S
Tri-County Mental Health and Counseling Services, Inc.
740-592-3091, x4631
sshamblin@tcmhcs.org
Photo credit:
Larry Hamel-Lambert at hamel-la@ohio.edu