MARCH 2021 Newsletter

The Hard Work of Collaboration

…and how it can be a first step toward a better service delivery system

STORY OF GREATER HOUSTON COLLABORATIVE FOR CHILDREN

Not Just Another Meeting…

In 1996 many of the major foundations in Houston began meeting to dialogue around the concept of collaboration. Dr. Maconda Brown O’Connor, Board Chair of the Brown Foundation, and Dr. Charles Bonjean, Executive Director of the Hogg Foundation for Mental Health initiated the conversation. They brainstormed and built on what was supposed to be a committee to plan an annual conference on mental health into what ultimately became a plan to launch the Greater Houston Collaborative for Children! Dr. O’Connor was not interested in planning another meeting where people came and then went home accomplishing very little. She wanted to be part of planning something that would last to positively impact children in Houston. Dr. Michele Sabino, a Grant Officer with The Houston Endowment, was inspired by the concept of collaboration and became a strong advocate and facilitator of the effort. Three other foundations that were also around the table were the Cockrell Foundation, the Greater Houston Community Foundation (who served as fiscal agent for the collaboration) and the Powell Foundation. 

As the group was meeting to discuss the purpose of the collaboration, Nancy Powell Moore, of the Powell Foundation, mentioned that she had seen a recent segment of Diane Sawyer’s Prime-Time Live show on the topic of early brain development. On the program, Sawyer stressed “the importance of pathways for learning laid down at an early age, that, if not developed at the appropriate time, their potential was lost.” The news segment also emphasized that “loving interaction between parents and children change a child’s brain chemistry and gets the child ready to learn.”[ 1 ] Out of these conversations about collaboration and the growing awareness of the life-changing impact of meaningful interactions between adults and young children, a decision was made to test the concept of collaboration to improve early education in Houston. After many meetings and a great deal of research and data gathering, the Greater Houston Collaborative for Children (GHCC) was born.   

The initial focus of GHCC was to provide multi-year financial support to two significant collaborations, selected through a competitive request for proposal (RFP) process. The Bridge/El Puente, led by Neighborhood Centers (NCI, now BakerRipley), brought together a range of engaged, committed community partners to provide family support services. NCI was also able to build on their existing programs for newly arrived immigrant families living in the Gulfton area. The second collaboration, Family-Centered Child Care Collaborative (FCCCC), was led by Initiatives for Children (IFC) with a goal of strengthening the ability of childcare centers to meet the growing needs of families affiliated with their programs.   

The foundations created an Executive Council to provide oversight to the projects and to learn about the benefits and barriers to collaboration. The funders functioned as a collaboration as well, pooling their resources and making major decisions as a group. The Executive Directors of both of the lead agencies were members of the Council which was and still is unusual but at the time was tremendously helpful -- giving funders direct information on the benefits and challenges associated with collaboration. Lastly, two well-known representatives of the health and human services community, Dr. Peggy Smith, Professor, Baylor College of Medicine, Teen Health Clinic, and Regenia Hicks, Harris County Mental Health, were also invited to serve on the Executive Council. A formal evaluation through the University of Houston produced annual reports that focused on the impact of collaborative service delivery as well as the collaborative process.  

At the end of the five-year experiment, NCI took on the management and fundraising for The Bridge/El Puente which, through their appreciative inquiry process, led to the creation of a beautiful community center that provides a range of services for the Gulfton and Sharpstown neighborhoods. In 2004, GHCC and IFC merged to form Collaborative for Children, which continues to serve families with young children and improve the quality of childcare in the Greater Houston area.   

So, did the collaboration process work? What was accomplished as a result of the effort? What are the critical components of collaboration that need to be nurtured in order for it to succeed? What are the challenges of collaboration? Let’s take these one at a time.

NECESSARY COMPONENTS FOR COLLABORATION:

assess your collaboration

In general, collaborations are more successful if partners can answer “yes” to most of these questions:  

• Has a community challenge or opportunity been identified that would be better addressed through a coordinated, multi-faceted approach?

• Is a formal collaboration the best way to address a clearly identified issue?

• Is there a clear vision for the collaboration (a picture of what the community will look like when the collaboration is successful)?

• Are the leaders of each of the partner organizations willing to actively participate in meetings to develop a plan on how to best address the identified issue?

• Is there agreement on how meetings will be coordinated and facilitated so that partner leaders can focus on addressing the content of the meeting agendas?

• Is there a willingness to put organizational egos and recognition aside to focus on the best way to solve the problem (or address the opportunity)?

• Are partners willing to be flexible and consider changing their approach to service delivery to enhance overall service delivery for clients?

• Is there an upfront commitment to evaluating the process, the progress and the outcomes of the collaboration?

CHALLENGES OF COLLABORATION:

Impacts, Issues, and Solutions

summary

Collaboration can be exciting and provide a sense of “we are in this together” – enabling groups to accomplish something for their clients, for the community that they could not do on their own. There is a sense of camaraderie and an opportunity to address (and have an impact on) a significant community issue. In some cases, forming a collaboration may not be the best response to addressing a difficult community issue. Maybe what is needed is better coordination or consolidation of community resources. However, if the right conditions exist and the right partners come together with just the right blend of courage and humility, collaboration can lead to positive change that helps communities achieve what they most desire – better outcomes for the people served.  

[ 1 ] The three longitudinal studies were the High Scope Perry Preschool Project, the Chicago Child-Parent Center study and the Abecedarian Project.

Collaboration before it was a “thing”

Collaboration is not a new idea. One of the first collaborations that I was involved with, over 25 years ago, was called Communities Conquering Cancer (CCC). The idea for the collaboration came out of conversations among colleagues in different health care systems, CHI St. Luke’s Health (previously St. Luke’s Episcopal Hospital) and the Kelsey Seybold Clinic. The partnership, which eventually grew to seventeen health care providers, was created to: (1) provide a comprehensive continuum of breast health services for low-income women, (2) build partnerships among Houston’s health and human service institutions to improve quality and maximize resources, and (3) create a model for cost-sharing among partners that reduces barriers to accessing service as well as lowers financial risk for service providers. The limited public resources available for breast cancer screening and treatment at the time meant that low-income women were frequently not diagnosed until cancer had spread, making treatment more challenging and more expensive.

While these two partners saw patients in their Medical Center clinic and hospital, they realized that to get information to women earlier about the importance of regular mammograms and to make them more easily accessible and affordable, they would need to go outside of the Medical Center and into the community. Additional partners were also invited to participate in the conversation including  American Cancer Society, Harris County Hospital District,  MD Anderson Cancer Center and The Rose, and they worked together to define the purpose of the collaboration and how each partner could contribute to building a more comprehensive continuum of care.  

Once it was clear how the collaboration would work -- from raising awareness, screening, diagnosis to treatment – and what partners would provide at each step in the continuum, they identified a neighborhood with limited health care resources in northwest Houston to pilot the newly developed continuum. St. Luke’s provided initial funding and each of the partners signed a Memorandums of Understanding documenting their commitment. Over a four-year period, over 2,300 women benefited from resources through the collaboration, some women returning for their second and third annual screening over that period.  

Dorothy Gibbons, the Co-Founder and CEO of The Rose, said “CCC broke open the awareness of terrible gaps in services for the uninsured.” Over the last 25 years, while there have been some improvements in breast health resources for low income, uninsured women, Gibbons says that “there are still major challenges” for this group of women. Below is a summary of some of the improvements and continuing challenges for low income, uninsured women in accessing breast health care:

While CCC revealed this little known and under-reported issue, on balance, there are still significant issues in the accessibility and affordability of breast health care for low- income, uninsured women. Texas has an opportunity to improve this in this coming legislative session. Make your voice heard!  

19 FACTORS INFLUENCING SUCCESS

What Makes It Work

(From the Collaboration Handbook, Creating, Sustaining and Enjoying the Journey and Collaboration:  What Makes It Work by Paul Mattessich and Barbara Monsey of the Wilder Research Center.)

next issue

The June 2021 newsletter issue will focus on the value and cost-benefit of strategic planning in this rapidly changing environment. The Houston Area Urban League and their recent strategic planning process will be featured.