1. A NEW CONTINUUM CONVERSATION

2. PARTNER ORGANIZATIONS

3. Mental Models for Collaborative Work 3 We I YouUs If this… …then how Collaborative Organization

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

5. 5 SILOS TO CIRCLES CORE GROUP ROSTER NAMEORGANIZATION Siyad AbdullahiThe Language Banc Cathy BarrHealth East Joan ClearyMCHWA Valerie DeforHealthForce MN Frank FernandezBlue Cross/Blue Shield MN Renee FrauendienstStearns County Public Health Kerri GordonAllina Health Steve GottwaltMRHA Sean KershawCitizens League George KlauserLutheran Social Services Suzanne KoepplingerGeorge Family Foundation Jennifer LundbladStratis Health Sanne MagnanICSI Jan MalcolmAllina Health Joan McCuskerWilder Foundation Rebecca MelangCSH Alyssa MellerMRHA Kami NorlandMRHA Joan PenningtonHealth East Josephine PufpaffCSH Sheila RiggsUniversity of Minnesota Sue SeversonStratis Health Dawn SimonsonMetro Area Agency on Aging Diana Vance-BryanCatholic Charities Twin Cities Amy WardWilder Foundation Donna ZimmermanHealthPartners

6. 6 Mission and Vision Promote health at all life stages with services that are integrated, culturally appropriate, equitable, sustainable and that honor our shared humanity. We will work collaboratively on shared priorities that will foster wholeness for our currently fragmented continuum, so that we can collectively:

7. 7 Cause And Effect: Where to Channel Our Efforts to Realize Our Vision Cause And Effect: Where to Channel Our Efforts to Realize Our Vision Promote health at all life stages with services that are integrated, culturally appropriate, equitable, sustainable and that honor our shared humanity. Value: Quality/Cost Value: Quality/Cost Transparency/Info / Data/Technology/ Interoperability Shared Language / Culture / Fear Navigation/ Coordination/ Trusted Advisor Shared Priorities Shared Priorities Regulations Reimbursement / Funding Communication Across Trust / Control / Choice We will work collaboratively on shared priorities that will foster wholeness for our currently fragmented continuum, so that we can collectively:

8. 8 Community Health Data MDH CHNAs 1 MHA CHNAs 2 HealthEast Community Conversations 3 Mental HealthObesity Alcohol/Sub Abuse Patient Edu / Wellness / Nutrition Tobacco Use Chronic Disease Prevention Access to Healthy Foods Domestic Violence Transportation Financial Vulnerability ✔✔ ✔✔ ✔ ✔✔✔✔ ✔✔✔✔✔ Access to Care & Resources ✔ 1 MDH data includes 25 CHBs (8 Metro, 7 SE, 2 SC, 3 Central, 2 NE, 3 NW. 2 MHA data includes CHNAs from 84 hospitals spanning the state 3 HealthEast data includes a synthesis from East Metro Health and Well-being Community Conversations

9. 9 Overarching Approach To Initiative We will test our collaborative capacity and identify potential breakthrough opportunities in two principal focus areas Design Team Focus Areas Chronic Disease: Prevention & Management Behavioral Health Charge for Design Teams 1.Analyze the current landscape in the focus area 2.Identify shared goals that could foster the vision 3.Propose specific initiatives in which we might pilot breakthroughs in collaboration that would improve our work across the continuum and the resulting outcomes Core Grou p

10. 10 What’s in Scope What We Are Doing Setting parameters within which we will test and discover breakthrough approaches to integration What We Are Not Doing Solving all challenges linked to behavioral health or chronic disease

11. 11 Design Team Guidance and Charges Design Team Role, Process and Timeline April-May 2015  Establish the charge and key questions that the design teams will answer  Articulate terms and realities of work (e.g. answer key questions, suggest breakthroughs, share with core team, work may or may not go forward)  Core team members invite design team participants (using template language)  Lab support finalizes team list and coordinates development of issues paper Setting System ContextSetting Person-Centered Context June-September 2015  White Paper/Issues Briefing  Synthesis of Critical Data Sets  Dialogue sessions  Design Team Output: o Fill in gaps, develop and learn from stories o Identify and answer the big questions, including the following:  What are the greatest needs in navigating the system?  What gets in the way of achieving right levels and use of care?  How do life stages impact the discussion?  Propose potential breakthroughs* that could be achieved in this area to foster the vision and outline how the breakthrough could be modeled or tested in a pilot, demonstration or initiative  Include in the proposal how any successful pilot could be scaled and spread *Breakthrough could include: - Scrapping and redesigning all or part of the system - Putting existing components of system together differently to create new whole and achieve desired results *Breakthrough is NOT tinkering with broken parts of system or adding new broken parts

12. Inputs -Landscape briefs in Behavioral Health and Chronic Disease -User/Provider dialogues -Economic analysis relating to costs of fragmentation -Scan of success factors, barriers and applicability of other complex integration efforts Outputs -Design teams recommend one or more breakthrough integration opportunities -New design simulation, implementation, study and adaptations -Design teams identify policy enablers and barriers to change -Innovations impact environment to make healthy choices easier and recognize that people live in families and are not just individuals -Learnings report (using stories) Impact -Increased collaborative capacity and effectiveness -Paths to scalable, spreadable system reforms -Measureable change for people living in community 12 What We Are Aiming For Mutually Reinforcing Activities

13. Refine Initiati ves Recommend/ Simulate One or More Initiatives that Would Foster Vision Desig n Teams Core Group Set Vision + Mission + Design Team Scope + Charge Jan-May 2015June-Aug 2015 Implemen t or Not Create Shared Goals & Explore Possible Approaches Assess Current Landscape Sept-Dec 2015 System User/ Provide r Issues Briefs Shared Learning Scanning Economic Analysis

14. 14 Questions

15. 15 The Complex Collaboration Experience 1. Circle up 2. Demonstrate the toss 3. With 1 object, explain that every member of the group must touch the object only once until all have touched it once 4. The sequence of each person touching the object must be the same every time we do this 5. Establish a sequence with the one object (as many times as needed) 6. Once sequence is established, introduce objects 2 and 3 7. Ask group to estimate how long will it take you to complete the sequence for all three objects (or three times) 8. Before they decide, give them the two rules 9. Have them decide on time and then do it 10. Ask them to improve their time Instructions

16. 16 The Complex Collaboration Experience

17. 17 The Complex Collaboration Experience 1. Everyone must touch the objects once 2. They must be touched in the same (human) order There Are Only Two Rules

18. 18 Where Do You Fit In The System? WHOLE PERSON Family Equity/Access Community Home care Engagement programs Housing Community supports/faith Congregate care settings Acute Care Culture Neighbor Mind Culture Spirit Body Biology Biography Beliefs Equity/ Access Habits/ Behaviors Connectedness/Effectiveness Education Environment Economics Employment WHOLE HEALTH CONTRIBUTORS WHOLE HEALTH RESOURCES Prevention/ self care Primary Care Transitions care Integrative holistic health Energy Housing

19. 19 Briefing Paper Review What are two high priority themes that emerged in the background briefs that will be critical as you meet your charge?

20. 20 Design Team Guidance and Charges Design Team Role, Process and Timeline April-May 2015  Establish the charge and key questions that the design teams will answer  Articulate terms and realities of work (e.g. answer key questions, suggest breakthroughs, share with core team, work may or may not go forward)  Core team members invite design team participants (using template language)  Lab support finalizes team list and coordinates development of issues paper Setting System ContextSetting Person-Centered Context June-September 2015  White Paper/Issues Briefing  Synthesis of Critical Data Sets  Dialogue sessions  Design Team Output: o Fill in gaps, develop and learn from stories o Identify and answer the big questions, including the following:  What are the greatest needs in navigating the system  What gets in the way of achieving right levels and use of care  How do life stages impact the discussion  Propose potential breakthroughs* that could be achieved in this area to foster the vision and outline how the breakthrough could be modeled or tested in a pilot, demonstration or initiative  Include in the proposal how any successful pilot could be scaled and spread *Breakthrough could include: - Scrapping and redesigning all or part of the system - Putting existing components of system together differently to create new whole and achieve desired results *Breakthrough is NOT tinkering with broken parts of system or adding new broken parts

21. 21 Comparing Notes Across Design Teams Given the high priority themes, what questions do you have that must be answered before moving forward? What additional background information or support will help you in meeting your charge?

22. 22 Questions for Those Who Use or Deliver System Services Examples What are your sources of health and well- being? What/who do you trust in fulfilling your health needs, and what/who do you not trust? What is the first thing you do if/when you get sick? What helps you not get sick? Has your belief system ever collided with a need for health care?

23. Appendix