MCHB 2006 Federal/State Partnership Meeting

CHARTING A VISION FOR MCH - PART II

October 15-18, 2006

MARIE McCORMICK: Can everybody see from back there where the dots are? If you just point me to where you see a lot of dots. So we want to get a sense of where this group thinks the major trends are. If you can't, stand up and move up here and help me out and then we'll go back to the tables.

But where do you see dots clustered. Wars. Awareness of events around ‑‑ increase in wars, and in that it says decrease in awareness of events around the world.

So that's one. Then another one is an increase in the rich‑poor gap. Where else do you see a lot of dots?

UNKNOWN SPEAKER: A lot of red dots ‑‑

MARIE McCORMICK: Don't worry about the color for now.

UNKNOWN SPEAKER: No, I just can't read it.

MARIE McCORMICK: I see. An increase in the destruction of family structure, that one?

UNKNOWN SPEAKER: Yes.

MARIE McCORMICK: Okay.

UNKNOWN SPEAKER: There's another one.

MARIE McCORMICK: This one?

UNKNOWN SPEAKER: We can't see the yellow dots.

MARIE McCORMICK: I know. An increase in uninsured. And there are a lot of dots. One, two, three. Bunch of yellow. (Counting) there's a lot of dots there. Let me see if I can see where are there a lot of dots.

We don't normally use yellow dots, I'll say. So they are hard to see.

There are ‑‑ up here, there's some yellow dots here.

This one has a number, an increase in grandparents raising children and the ones associated with that. An increase in teens and parents STD. They're really kind of spread out in this map. Sometimes you'll see there are a lot of dots around just a couple but here they're rather spread out. Any other major ones that it looks like we're missing?

No? Did we capture the major ones, the ones that have the most dots?

UNKNOWN SPEAKER: We can't tell.

MARIE McCORMICK: You can't tell. Want to come up? I don't want to miss what's important. Couple of people at least come up and help us count. That would be helpful.

MARIE McCORMICK: An increase in family disruption and increase in exposure to hazards.

UNKNOWN SPEAKER: (Inaudible).

MARIE McCORMICK: Which one at 1:00?

UNKNOWN SPEAKER: The one with all the red dots.

MARIE McCORMICK: Destruction of family structure. Could be.

Anything else that's a major trend that you see.

UNKNOWN SPEAKER: Decrease of funding.

MARIE McCORMICK: Decrease of funding of MCH. Where is that? A decrease in social connectedness. So five or six. So kind of where the major ones ‑‑

UNKNOWN SPEAKER: I have a question. The mechanics of this. If this person, in the exercise, one person felt very strongly about one of the trends and puts all the dots in one trend (inaudible) how do you, I mean how do you balance one person's view to the work group.

MARIE McCORMICK: Couple things first there's 65 people and everybody has seven dots. It's not as (inaudible) but this is just one way to look at the data. In a regular Future Search, in stakeholder groups we would have each stakeholder group pick the trends that they think are most important.

UNKNOWN SPEAKER: Can I ask another procedural question?

MARIE McCORMICK: Sure.

UNKNOWN SPEAKER: Is this line map in a group of 64, is the line map made up of group of 64 activities.

MARIE McCORMICK: Yes, it's group of 64 and people go to their eight different stakeholder groups and make sense of the data. But it starts just like we did here and then goes to stakeholder groups.

UNKNOWN SPEAKER: The amount of time in a Future Search conference given to the (inaudible).

MARIE McCORMICK: Making the mind map is about 45 minutes. And then there's another at least hour, does that sound right to you, at least hour, maybe hour and a half, to then make sense of it in different ways.

UNKNOWN SPEAKER: When you were up there doing the counting, sort of a side comment you made was the fact that (inaudible) it was pretty well distributed. And I don't want to go and make an assumption because we've all seen the way you divide the word "assume," would the concentration of dots be less evenly distributed if a committee had picked a topic that the group was going to discuss that was more specific than just MCH leadership?

MARIE McCORMICK: Maybe or maybe not. But this is just one shot of the data.

UNKNOWN SPEAKER: And a committee would have selected the theme.

MARIE McCORMICK: They would have selected the theme. Whether or not that would mean the dots were more or less disbursed, I think that could vary.

UNKNOWN SPEAKER: I just would ‑‑ it would seem to me if the committee were going to do a mind search and bring a group of individuals together that they might be looking at a more specific issue and that the MCH leadership legacy and vision is kind of like a broader issue and that might have resulted in the rope being more spread out.

And I didn't know. I'm dependent on trying to draw on y'all's experience, could that be the case.

UNKNOWN SPEAKER: The task that's real important for this organization, a stakeholder should deal with and then you do a very good job of getting diversity in the group, the results are probably more like unpredictable, because you hear from voices you have not heard from before. And there are things that will emerge that you perhaps hadn't counted on.

So you're dealing with a whole system here.

You make a change in the system you get things you intended to happen. You get a lot of stuff you didn't intend to happen and a lot of stuff you're clueless what happened.

So when that begins to occur, and people start to understand or make sense of what they see, you know, you'll see dots spread in places that you hadn't counted on.

But that's part of it. Let's confront the whole system. Let's not lull ourselves to sleep and think we just picked the top ones, we'll fix this.

Let's understand that, you know, we've got a system here with lots of things that are interconnected, interdependent, and then let's see where we might take this.

But first let's get grounded in the system.

MARIE McCORMICK: In a Future Search we look at it together and then we ask the stakeholder groups to build their own mini mind map of the few trends that from their stakeholder group perspective are the most impactful.

UNKNOWN SPEAKER: I guess the reason for my question was, you know, to move something forward like this usually you have a group of individuals that sell the concept of the process to and then they take over and normally infuse a topic that meets their personal agenda. And I wonder if selecting the topic was going to limit the amount of discussion or, if your experience, once they open that up to the stakeholders, then it goes where it's going to go and it's more self‑directing by group.

MARIE McCORMICK: I have to say if you've picked your planning committee correctly, and it represents the whole system, what you've said about picking the task isn't necessarily true.

You're really trying to pick a task that has meaning for the system. So I mean I really think it doesn't ‑‑ it isn't ‑‑ the task puts the boundaries around it.

But I don't think it influences so much how these dots are spread. I really don't.

UNKNOWN SPEAKER: There's a critical question that the planning committee will make after the first meeting. And that question is: Who should be in the room that's not here so that hopefully you've got a representative body of the diversity that you will eventually have to help shape what that task or theme will be.

MARIE McCORMICK: If you have all the same people picking the task, all the same people that's not a good planning committee. You really want the whole system at the planning table at well.

Did you want to add something?

UNKNOWN SPEAKER: We're going to do that this afternoon.

DICK AARONSON: Yeah, we'll have at 3:45 this afternoon we'll have a section where we actually start to plan for Future Search. So that's an opportunity for you all to do that. The second thing I really wanted to emphasize here, I hope you're starting to see how this approach and these principles could be applied in the daily leadership of maternal and child health and not just in a two and a half day Future Search conference. And that's something that I think we might talk about tomorrow morning at the final session about how this applies to our daily practice of MCH leadership.

MARIE McCORMICK: So I think I'll move us along. So what I'd like you to do is first let me tell you what we would do in a Future Search, the whole thing. Then I'm going to tell you the part we'll do here.

So normally in our stakeholder groups we would do two kinds of analysis. The first is as a stakeholder group we'd have us draw a little mind map of the trends from your perspective as you see as most important and then you'd make a list of what your stakeholder group is doing now and what you'd like to be doing in response to these trends.

And what we say about this is own it don't moan it. So it's your stakeholder group. This is where we're not pointing fingers at other groups and saying they're not doing this, we wish they were doing this, but this is ‑‑ these are what we see and here's what we as a specific stakeholder group are doing and what we'd like to be doing.

From there normally we go into a number of people referred to this yesterday in the panel into prouds and sorries.

So what we're doing and not doing is at one level. Then we go into the emotional about what we're proud of and what we're sorry about. The affective piece, as a stakeholder group that we're responding to these trends.

As always in a Future Search after the small group discussion we go to the whole group and make sense of it together.

So what we'd like to do now is take about maybe five minutes in your stakeholder group to make a list of ‑‑ there are sheets of paper that Cynthia will give out.

If you could get someone in your group to be a recorder/reporter. And as a group decide on just a few things that you are doing as a group, as a stakeholder group, that you're doing now in response to the trends that you see here and what you'd like to be doing.

So things you're not yet doing but you'd like to be doing. And you can, if you want, pick a couple of trends that you're focusing on that are really important from your perspective. Or you can take the trends as a whole, if that makes more sense to your group.

Okay. So just take about, let's say, about five minutes. On a sheet of paper then we'll hear from each group. So whoever jots down what you do, we're going to ask you to report out to the large group. So what you're doing now and what you'd like to be doing.

All right?

UNKNOWN SPEAKER: Can you flip back to the list of issues, the issues that ‑‑

UNKNOWN SPEAKER: That raises a good question you don't have to choose necessarily the issues that came out having a large number of dots. Because as the stakeholder group.

MARIE McCORMICK: They don't have to be this. It's just as the whole group sees it. But I'll hang them up just for your information.

I hate to do this because I can feel the energy in the room and the good conversations that are happening. But to make sure we get you out of here at the promised time, which is another important rule of Future Search, is that we really stay on time and task, so I'm going to ask for report‑outs from the group.

And I'd ask you to name your stakeholder group so we know from what perspective you're coming and then to give a short report minute or so on what you're doing now and what you'd like to be doing.

Who would like to go first?

ANN SWENFORD: Get it over with. I'm Ann Swenford. This is the state MCH group. What we're doing now the trend we picked was the family structure issues, the decrease, the big variety of family structures.

What we're doing now involving family representation on all decision making bodies, holding workshops for parents to connect with kids so they know how to connect, using family champions grant, where family members are selected to help develop policy, soften our eligibility criteria, involve community advocacy groups.

What we want to do: Improve collaboration with child welfare, implement family‑centered early child care system, improve education of young single mothers, improve our leverage points, and by that we mean knowing when and where to intervene in a situation to break the cycle that the situation sets up.

MARIE McCORMICK: Lot of good work for a very little bit of time.

Next.

UNKNOWN SPEAKER: Our group is the ‑‑ my name is Mary Moss and our group is the community family and others. What we're doing now is educating providers, advocating for children and others in the community, securing provider services and awareness for culturally competent family‑centered care in a medical home.

Right now it's more pieced together. So if we go back to what we want to be doing with the educating providers, expand the education to the providers. For advocating for children and others, it's providing the needed services, expanding and developing it, to establish a voice similar to the AARP, and, so that there's like a shared group that's working together and advocating on behalf of families and children.

And actually providing culturally competent family‑centered care and providing a medical home instead of just piecemealing it, actually providing it is what we'd rather do, and be part of ‑‑ be part of a political decision making group.

So when policies are being decided, have a voice at that table for recommendations.

MARIE McCORMICK: Wonderful. Thank you.

Normally we'd be hanging up all this work around the room building our database of all the people in the room.

MARIE MANN: Marie Mann. We're the federal group and we were just selective in some of the activities. But currently we have public awareness and educational efforts specifically around violence and the need to decrease violence, the understanding of bullying and to decrease bullying, and specifically around obesity.

As others have talked about, there's increased awareness and focus on the need for culturally linguistic effective services and certainly we're committed to promoting community‑based family‑centered culturally effective coordinated comprehensive and compassionate services and then the training and research and education focusing on MCH issues and certainly the training of MCH leaders.

MARIE McCORMICK: Thank you. There's a back.

MARIE MANN: That's what we're currently doing. And now the wish list is we would desire more public/private partnerships and opportunities desire for increased committed MCH leadership and certainly we'd desire increased optimism with decrease in wars and poverties and hunger and certainly increase in need for social connectiveness and increase in compassion.

MARIE McCORMICK: So we're almost out of time. But there's just a couple of things I want to ask. So as you listen to each other, what did you hear? What did you hear? Did you hear things in common? What are the messages you're beginning to hear.

UNKNOWN SPEAKER: (Inaudible) federal state to community, there's just an awful lot of passion about whatever issue is up there. And that's just a commonality right here, which is a wonderful thing, because that's the start. People who are dedicated, committed to improving lives of families.

MARIE McCORMICK: What else do you hear?

UNKNOWN SPEAKER: I hear a very liberal kind of political trend, which I suggest is probably a flaw in the invitations to the table.

MARIE McCORMICK: And that is ‑‑ really, when you're putting together participants, we do not only look at different stakeholder groups but we'll have another list of kind of diversity criteria that are important to make sure that you've covered. So I know you're joking a little bit here, but really that is something that you look at. You look at is age important, is male and female important. Is race important. Depending on what you're doing, are the faiths important, differences? That's something that you try to look at when you're putting together the 64 people, absolutely.

So one more question: Stepping out of our role as being participants in this and kind of looking at what we just did, what differences do you see in what we did here today and what we tried to describe to you in terms of the whole process, what differences do you see in that and how things are done on a regular basis.

UNKNOWN SPEAKER: In my opinion, the (inaudible) which we always do so that's the same. And the things that we did ‑‑

MARIE McCORMICK: It's on.

UNKNOWN SPEAKER: It's on. But all in all I think we came from a different level where people are at. And I don't think people (inaudible) they don't want to step over. But we've got to and it's a must and that's the only way we're going to get to where we're supposed to be.

MARIE McCORMICK: How about others? Mary.

UNKNOWN SPEAKER: The one thing that I noticed that's different, and it comes I think more from my experience in working, it's actually asking people's opinions and validating what their opinions are instead of assuming what their opinion is or assuming that you know a whole lot better than they do.

So I'm going to create this wonderful program to fix you. Instead, it's you're part of the solution. We value you being here and let's try and look at it just a little bit different.

UNKNOWN SPEAKER: There was kind of freedom from the assumed or real barriers to change by the brainstorming process. We didn't talk at all about what we wouldn't be able to do.

MARIE McCORMICK: And we're not even in the part where you really do that. Present, somebody commented on boy this is pessimistic and we hear that a lot when we hear the mind map and we know that and we go home and we sleep and when we come back and continue on with your on work, then the next day is about the ideal. And notice that it is the ideal future.

And part of our instruction is don't think about the barriers, don't think about we don't have the money or blah, blah, blah, we haven't done this before. Dream big. And then we'll worry about what we can act on together. But let's not put those barriers up when we're dreaming.

So this was if you felt the freedom today, this is just the beginning of the freedom of exploration.

So I know we're out of time so I want to thank all of you for coming and I want to invite you to a few things. There's another part one today at 1:45. We'll be doing the same thing, but sometimes it's very interesting to see the different mind maps, the different conversations.

So you're certainly invited to come to that and/or to tell your friends and colleagues to come to that.

There's also part two, where you begin planning a Future Search for your group, starting to understand some of that. So we invite you to come to that.

And also you see that there are four of us. Please don't hesitate to grab any of us at lunch or at any time to hear more about Future Search. We all as you can tell are big advocates. And finally Dick is holding up a sheet. So make sure we have your name, contact information.

UNKNOWN SPEAKER: And the part two is at 3:30.

MARIE McCORMICK: Part two is at 3:30. Thank you all so much for coming and give all of you a round of applause for your wonderful participation.