1. Silos to Circles A New Continuum Conversation How Do We Go From Here……To Here? Silos Acute/ Ambulatory Public Health Home and Community Based Services Long-Term Care + ++ +++

2. Many change initiatives underway—could they be better connected and leveraged? How can successful models be taken to scale faster? Public HealthAcute / AmbulatoryLong-term Care Social Services SHIP Statewide Health Improvement Plan Cross-Continuum Activities Minnesota Senior Health Options (MSHO) Hennepin Health Generation Next Southern Prairie Community Care East Metro Mental Health Roundtable Integrative Health / Catalyst SIM (State Innovation Model grant) vision Integrated Health Partnerships RFP (DHS) Accountable Health Communities RFP (MDH ) Center for Community Health Back Yard Initiative Healthy Communities Partnerships Diabetes Collective Impact project Healthy Minnesota Partnership Health Care Delivery System demos (e.g., NW Alliance) Pioneer ACOs NCQA ACOs Health Care Homes Aligned Incentive Contracts ICSI MN Community Measurement Community Projects RARE Honoring Choices Choosing Wisely ACT on Alzheimer’s Citizen Engagement ICSI/Citizens League / TPT MN 2020 Long Term Care Imperative Aging Services & Stratis Futures work LSS “My Life My Choices” Altair Social Services ACO Policy Ideas Health Outcome Trusts Community Health Business Models A Partial View:

3. Our Work Thus Far Writing a Prequel for Collaborating on Changes Efforts Building Coalition – shared ownership is developing Emerging interest in – fertile areas of opportunity to test continuum-based reform models (e.g. mental health, post-acute) – models to learn from (e.g. other states, other “quasi public good” governance models) – joint legislative priorities (e.g., aligning CHNA process and timelines)

4. Disciplined and higher performing constructs that accelerate change. Centralized tools for solution development. Shared ownership of solutions and implementation. 4 New Constructs Needed to Address Large-Scale Systems Issues/Social Change

5. Precursors for Collective Action Collaboration Complex Issue Urgency/Need for Change Influential Champion(s) Adequate Financial Resources 6/4/2016 Channeling Change: Making Collective Impact Work: SSIR, 1/26/2012, John Kania and Mark Kramer

6. Five Conditions for Collective Impact 6 Common/shared agenda Mutually reinforcing activities Continuous monitoring/shared measurement Continuous communication Backbone support

7. Essential Functions of Backbone 7 Backbone support helps a collaboration Hold guiding vision and strategy through neutral/shared forum and process Support aligned activities Gauge and share progress Build public will Advance policy Mobilize funding

8. Concurrent/mutually reinforcing activities 8

9. © 1996-2009 Brokenness to wholeness Statement for invitation: We will work collaboratively on shared priorities that will foster wholeness for our currently fragmented continuum. Our opportunity is to collectively promote health at all life stages with services that are integrated, culturally appropriate, sustainable and that honor our shared humanity. Core Group Vision for invitation – drafted 1.5.2015 Silos to Circles Promote health with upstream stability Capacity for our shared humanity Measuring health and well-being at all life stages Collaborative, integrated, respectful and culturally appropriate New map of health Brokenness to wholeness to thriving to living to being Fragments to continuum Household Person Centered Thinking Value health as people define health Sustainable reward for those providing care Prioritizes and supports preventive practices Consider social determinants, transportation, food, education and impact on 1 or others Daily living needs are met Economic stressors Defining measurable outcomes Maximizing life at all life stages Well-being is redefined and central to work (measurement too) Healthy body, mind, soul Treated with respect Community that is collective, active, and sustainable Collaborative, holistic solutions Integrated, culturally meaningful system of wellness Seamless network that makes a continuum New map of health care Working together on important priorities Choose areas with greatest opportunity to create something new

10. Structure and governance 10 Multi-layered governance and structure: advisory, oversight, implementation groups