Work planning 201: Flexible Funding Arrangement Presented by Terri-Lee Chisholm and Kathleen Gibson FNIHB-AB June 13, 2016

Overview Work planning Why is planning important? What is a work plan? What do you need to develop a work plan? Tools and Templates to help you Required Components of a Work Plan Goals, Objectives, Activities and Outcome Measures How can Program Managers help you? PLO Contact information

Work planning is process by which you identify a goal or measure of change to improve the overall health of a community. The work planning process helps identify the objectives, activities, schedule of activities, and outcome measures to help you achieve your intended result. It is also a process to plan the management of work load and staff who perform that work. Work planning is rooted in a desire for quality assurance and continuous improvement. Work planning

Why is work planning important? Identifies the community priorities, goals and objectives. Identifies and builds on community strengths. Allows for a collaborative approach to health. Leads to accountability and responsibility by the health workers. Provides an opportunity to consistently build on existing information/data. Provides an opportunity to include indigenous knowledge and practices in planning and implementation. Creates community ownership. work planning implementationevaluation outcome identification

What is a work plan? A document to guide the delivery of all health programs and services, the result of a work planning process. A description of how mandatory public health services will be delivered. A living document that can be adapted to meet changes in needs, situations and priorities. Work plans serve as an essential foundation to the successful implementation of health programs and services, no matter the type of funding arrangement. Work planning Set Flexible Block

What do you need to develop a work plan? Information from community engagement (meetings, focus groups) Community Asset Mapping (current activities and resources) Community health priorities Available community data Program compendium Program plan schedule Work planning tools Evidence-based activities/information Best and promising practices Dedicated time Staff engagement Leadership participation Realistic goals Planning is important no matter what type of funding arrangement you have!

7 Tools and Templates to help you Available from your PLO: Program Compendium Program Plan schedule Guide to developing A Multi-year Workplan For The Flexible Funding Model Community Based Reporting Template (CBRT) Asset Mapping Regional Guide to Assessing the Development of a Health Plan List of Program Managers Program Areas: Specific program information Tracking tools (available on Onehealth) >> What tools do you use?

8 Required Components of a Work Plan Community Profile Mission and Vision Statements List of Chief and Council members Organizational Chart Current community health priorities Goals: what is the program intended to achieve? Objective: what needs to be done to achieve the goal? Activities: list of possible actions designed to meet the objective Schedule of Activities: timeline Outcome measure: how will you know you are successful in reaching your objectives??

A goal is the overall statement about the health status or health outcomes you want to achieve in your community. Goals are usually long-term and represent a broad vision of your priorities. Answers to this question can be your goals. In 5 years time, what do you want your community to look like with respect to YOUR COMMUNITY PRIORITIES such as Mental Wellness? Chronic Disease? Youth Suicide? Prescription Drug Use? Early Childhood? Environmental Health? Communicable Disease? CPNP Example: To improve maternal and infant nutritional health, wellness and development. Goals or Where are You Going? 9

Objectives are changes that need to take place in your community before you can reach your goals. You can ask the following question to help you develop objectives. –What type of changes need to occur so that your community looks like what you want in 5 years? Some objectives will be ongoing over the 5 years of your funding arrangement. Others may only take one or two years to complete. Objectives or How Will You Get There? 10

Useful objectives are SMART and outline the who, what, when, where and how you will reach your goal. Specific – What is the specific task? Measurable – What will you measure? What are the guidelines? Achievable – Can you do the task? Realistic – Do you have enough resources? Time-bound – What are the start and end dates? When you write an objective, if you can answer all of these questions, you will have a solid objective. A bit more about Objectives 11

Objective: Increase breastfeeding support, initiation and duration rates. Is this a SMART objective? Specific? – What is the specific task? Measureable? – What will you measure? Achievable? – Can you do the task? Realistic? – Do you have enough resources? Time-bound? – What are the start and end dates? Let’s do an example – still on CPNP

Specific Inform prenatal women about the benefits of breastfeeding; connect with local lactation consultant to support postnatal women Measureable Number of mothers who initiate breastfeeding; number or percentage of mothers who breastfeed past 6 months; number of women who were prescribed a breast pump at delivery AchievableYes. Staff can do teaching and follow up. Realistic Maybe. Staff capacity can be an issue. Partnerships with nursing, knowledge keepers, MCH could help. Time-boundOngoing initiative for the duration of your funding arrangement Original objective: Increase breastfeeding support, initiation and duration rates. 13 New objective: From , support collaborative breastfeeding initiatives that increase initiation and duration of breastfeeding in all mothers.

Activities are specific and realistic tasks that need to be done to achieve each objective. Activities should consider funding, staff knowledge, qualifications, and overall workload. Some activities are mandatory depending on the program. It is helpful to identify who will carry out the activities. This is not a person’s name but instead a position (like CHR, NNADAP, MCH, Home Care Nurse) It is good to identify any partners (other programs or organizations) that are also working on these activities. The schedule of activities can be a specific date (if known), a time of year (spring, summer, winter or fall), and/or a specific year. It can be helpful to ask: –What needs to be done in the first year? The second year? The third year? The fourth year? The fifth year? Activities or What Will You Need To Do? Schedule of Activities or When Will You Need to Do It? 14

. Potential Activities for CPNP Example 15 ACTIVITIESSCHEDULE CHR to develop a prenatal class on the benefits of breastfeeding in collaboration with local knowledge keepers, MCH, and nursing. May 2016 CHR to implement the prenatal class on the benefits of breastfeeding. September 2016 – March 2021 CHR to revise prenatal class annually on breastfeeding based on new knowledge and feedback from participants/colleagues. Summers CHR and MCH provide information to prenatal women about local lactation consultant services CHR and Nurse inform prenatal women on NIHB health benefit of breast pump prescription available at birth As required based on birth rates Nurse to provide one-on-one engagement with postnatal mothers to support continued breastfeeding As required based on birth rates

An outcome refers to the changes that you expect to happen in your community because of the activities you are doing. An outcome measure is the actual information you collect about your activities. Often you need this information for your CBRT. A helpful question to ask is: –What things could you be checking to know that everything is on track to meeting your objective? If you made a SMART objective, some of the measures could already have been identified. There are often many outcome measures than can be tracked. Just pick the two or three changes that are the most important for your community. It is better to do a few things well than be stretched too thin. Outcome Measures or How Will You Know You Have Done It? 16

Number of women who initiate breastfeeding Number or percentage of mothers who breastfeed past six months Number of women who were prescribed a breast pump at delivery Number of women and partners who attend the prenatal class on breastfeeding Number of women who engage a lactation consultant These can be used to determine an outcome to help you to know how well your program is working. Recall an outcome is about changes you want to see. By 2021, 50% of women exclusively breastfeed for at least 6 months. By 2021, 20% of women breastfeed for more than 6 months. Potential Outcome Measures for CPNP Example 17

Goal: To provide the support and resources to community members to reduce prescription drug abuse in the community. Objective: Increase awareness, prevention and intervention activities to decrease prescription drug abuse focusing on a community based solution including traditional and cultural resources. Is this a SMART objective? Specific? – What is the specific task? Measureable? – What will you measure? Achievable? – Can you do the task? Realistic? – Do you have enough resources? Time-bound? – What are the start and end dates? Let’s do an example – Mental Wellness

From , support collaborative initiatives that decrease __________________. Tip: Useful objectives are SMART and outline the who, what, when, where and how you will reach your goal. Recall: There can be multiple objectives addressing the same goal. Many community priorities are shared between internal and external stakeholders and partners. New objective

Recall: Activities are specific and realistic tasks that need to be done to achieve each objective. Activities should consider funding, staff knowledge, qualifications, and overall workload. Some activities are mandatory depending on the program. Identify which position within Health will carry out the activities. (like NAYSPS, MW workers, NNADAP, MCH, Home Care Nurse, Doctor, Pharmacy,). Identify any partners (other programs or organizations) that will assist you in reaching your goals and objectives (like Pharmacy, Harm Reduction agencies, AHS, NIHB). The schedule of activities can be a specific date (if known), a time of year (spring, summer, winter or fall), and/or a specific year. Strategic planning over time may require you to answer the questions: –What needs to be done in the first year? The second year? The third year? The fourth year? The fifth year? Activities or What Will You Need To Do? Schedule of Activities or When Will You Need to Do It?

ACTIVITIESSCHEDULE Provide evidence based prevention and intervention activities including: Prevention of overdoes fatalities by training health staff and community members with use and distribution of naloxone kits. Partnering and collaborating with AHS and harm reduction agency (name) to complete training and distribute naloxone kits. Prevention of overdose fatalities utilizing health staff (PHN and NNADAP) to train staff members including staff outside of health portfolio (youth workers and SA). Quarterly (May, Aug, Dec and Feb of 2016). Quarterly (May, Aug, Dec and Feb of ). The Health Director in partnership with AHS and partners to offer suboxone treatment in or to close proximity of community Potential Activities for Mental Wellness Example

ACTIVITYSCEHDULE NNADAP and PHN to coordinate with TSAG to provide clinical video conferencing to Suboxone clinic when required for clients NNADAP to assist clients in preparing for and meeting requirements for accessing suboxone treatment. NNADAP worker to develop a checklist to review with clients to include in the client file Completed by June 2016 NNADAP to ensure all current and new health staff receive and complete Prescription Drug Abuse online training (onehealth) Current staff: completed by September 2016 New staff: completed within first 4 months of employment. Potential Activities for MW Example cont’d

ACTIVITYSCHEDULE NNADAP and HD to implement interagency meetings regarding PDA Quarterly meetings commencing Oct 2016 for Three meetings per year for NNADAP working with a Knowledge Keeper and/or other internal programs (BFI/BHC) and NIHB (med trans) to offer access to traditional/cultural supports and resources. NNADAP to complete community mapping exercise to identify opportunities for client engagement Completed by Sept 2016 Reviewed and updated each fiscal year by June. NNADAP, NAYSPS and MW workers receive one targeted PDA training opportunity. Each fiscal year. Potential Activities for MW Example cont’d

Recall: An outcome refers to the changes that you expect to happen in your community because of the activities you are doing. An outcome measure is the actual information you collect about your activities. Often you need this information for your CBRT. A helpful question to ask is: –What things could you be checking to know that everything is on track to meeting your objective? There are often many outcome measures than can be tracked. Just pick the two or three changes that are the most important for your community. It is better to do a few things well than be stretched too thin. Outcome Measures or How Will You Know You Have Done It?

100% of Health staff trained to administer naloxone kits. Percentage of community members educated and trained to use naloxone kits. Look to increase percentage each year between An increase each year of naloxone kits being distributed in community. 100% of Health staff receive PDA online training offered on onehealth.ca Decrease in missed or late appointments for clients at suboxone treatment. Look to decrease each year by 60%. Increase accessibility of suboxone treatment in community; measuring changes in access points including: 1 st yr: video conferencing to suboxone clinic; 2 nd yr: offer suboxone at closest pharmacy in or closest to community; 3 nd yr: PHN and on reserve doctor offer suboxone at health center. Recall: an outcome is about changes you want to see. Potential Outcome Measures for MW Example

Why is work planning important? Identifies the community priorities, goals and objectives. Identifies and builds on community strengths. Allows for a collaborative approach to health. Leads to accountability and responsibility by the health workers. Provides an opportunity to consistently build on existing information/data. Provides an opportunity to include indigenous knowledge and practices in planning. Creates community ownership. work planning implementationevaluation outcome identification

27 How can FNIHB Program Managers help you? Offer programming guidance and advice. Provide links to evidence-based information and tools Best practices Activities Evaluation Provide links to FNIHB/Health Canada resources. Brainstorm with your team Goals and objectives Activities Outcomes Review your workplan BEFORE they are submitted.

Zone Managers: Jack Kennedy (Treaty 6, 7, 8 & NGO’s) Contact Information Program Liaison Officers: Rose Leclair (Treaty 6 West) Darlene Peacock (Treaty 6 East) Claude Sound (Treaty 7) Denise Gugel (Treaty 8 NPTC & ATC) Cheryl Watson (Treaty 8 WCTC, BHC, T8) Candace Oliver (Treaty 8 LSLIRC & KTC) Monica Michel (NGOs) Thank you!