To eliminate inequities and advance health equity at the Minnesota Department of Human Services in collaboration with impacted communities
What has been most instrumental to your progress?:
In the first year of the grant, we recorded several accomplishments instrumental to meeting our grant goals. First, we recruited and created buy-in from staff members and executive leadership across the agency. In a complex and expansive organization such as DHS, fostering agency-wide participation and buy in is essential to making lasting change. In the two community engagement events held so far, the Assistant Commissioners of each administration attended (one for a short period, but her Deputy stayed for the full day event). The attendance of senior leadership at these events and willingness to put money and staff time towards these community engagement events suggests a commitment to this project and potential institutionalization of increased community engagement.
We organized a series of events and trainings. In the first event, agency partners, DHS leadership, and community members attended a session focused on the social factors and historical trauma which contribute to inequity. The speakers, a Hmong man, an African American man, and an American Indian woman, shared stories of trauma, experienced by themselves, their families, and their communities. Their stories had a deep impact attendees, including high level agency leadership. This event was important in order to provide a common baseline understanding of the issues of equity and the need to better engage communities.
Grant participants also attended two participatory leadership trainings focused on creating inclusive and open engagement, honoring all perspectives and cultural practices. These skills will allow them to facilitate their community engagement events, but will also allow them to apply and share their skills with their colleagues in the future. This sharing of knowledge is an essential component of the year 2 grant goals of continuing to embed authentic community engagement in DHS culture and business practices, with a focus on reducing inequities.
We have held two community engagement events, with several more events in the planning stage. The first event focused on the effect of current and historical trauma in the American Indian community on their relationship with government institutions. We fostered an honest sharing of perspectives between community members and DHS employees, and between American Indian and non-native participants by using the World Café modality. Despite the heavy subject matter, it was a positive experience for attendees and they agreed to future meetings going forward.
In the second event, focused on engaging the African-American community in the Rondo Neighborhood of St. Paul. Attendees addressed the persistent disparity in families successfully on public assistance and becoming self-sufficient. Honest and open conversations were facilitated with the World Café modality. At the end of the event, the Assistant Commissioner expressed the need to continue to engage communities to effectively address inequities. While these events were only first steps, events that allow DHS staff, senior leadership, and community members to engage with each other lay the groundwork for future efforts.
Key lessons learned:
One lesson that we learned as project managers is the need for clear, and often redundant, communication about expectations of grant participants. When we realized that participants were experiencing confusion about the exact expectations and their role in accomplishing the goals of the grant, we responded in several ways. We devoted two of our monthly cohort meetings to addressing confusion, using the World Café and Technology of Participation techniques that grant participants were trained in, to facilitate honest discussions and allow for more clarity of expectations and grant goals.
We also developed roles and responsibilities and community engagement event planning documents and met frequently with groups to guide participant’s planning and implementation of community engagement events according to the goals of the grant.
Another lesson that we learned is the difficulty of managing a project across a complex agency, and the need for flexibility and to focus on what you can control. With participants from various administrations, each with their own executives, managers, priorities, and work cultures, it is a delicate balance to allow participants and their colleagues to identify topics and set timelines that work for them, but also adhere to the expectations of the grant. In one case, an administration’s executive leader, after spending some time considering community engagement options, decided that her administration would not participate in an event. While disappointing, this occurrence was out of our control and we did not let it affect our work in planning engagement events with other administrations or our pursuit of grant goals. In other cases, the timeline proposed in the project charter has not been feasible for participants or their administration. We learned that through flexibility and negotiation we can still accomplish the goals of the grant, despite unforeseen delays.
Reflections on inclusive, collaborative or resourceful problem-solving:
Inclusiveness is the key element that has driven the success of our project. The meaningful engagement of key stakeholders by going into communities experiencing inequities and authentically engaging them in a culturally appropriate manner is a central goal of the community engagement events, one of the primary goals of the grant itself, and a key element in addressing inequities.
The event has been collaborative in the way the meetings are facilitated, there is not one person speaking, but active participation of everyone guided by questions prepared in advance with staff who know the communities.
We have endeavored to appreciate the knowledge and wisdom in the room by engaging in active listening, a skill learned and practiced during the training sessions. DHS leadership thanked the audience and promised to follow up in their responses, updates and progress report, after learning from the audience that it was their wish to do so.
The approach to each event is to set a living room space in which all are invited, food is served and very short presentations are made to set the context. Copious notes are taken & shared with the audience. Evaluations follow each event.
Other key elements of Community Innovation:
One key element of our community process is creating the appropriate setting for often difficult conversations. For every event, we provide food – catered by a culturally appropriate company when possible – and hold events in spaces familiar to the community we are attempting to engage. Incorporating cultural artifacts, spiritual rituals, and testimonials from people from the community sets the tone for a productive and participatory meeting, making clear that they are not at a typical DHS listening session. The major goal is to make everyone who joins the conversation to feel welcomed, valued and to have a sense of belonging. Care in cultural aspects of the space by decoration, sounds or food served is provided with the intent that DHS is preparing the table to listen and respond to the ideas brought to the agency leadership’s attention.
Understanding the problem:
Our work has reaffirmed the need for more authentic and meaningful engagement with communities experiencing disparities. It has given white DHS staff and executive level leaders an opportunity to engage with communities of color in truthful and often emotional conversations about trauma and differential experiences between communities that lead to inequities. Building capacity for community engagement and understanding of racial justice issues are essential to addressing inequities. These conversations have led to positive responses from DHS employees, and are a positive first step towards establishing a more broad culture of engagement at DHS. Monthly meetings of the grant cohort supported by community core teams are held to continue to build team cohesion, opportunities for learning, such as the visit to the RACE exhibit at the Science Museum following by de-briefing with the intent that we all gain a greater understanding of the history and experiences of individuals who experience disparities to health and human services access and delivery.
If you could do it all over again...:
Managing participants, each with their own full time responsibilities, supervisors, and executive level leaders, is difficult. Prepare documents that clearly lay out roles and responsibilities, and be prepared to address an array of challenges and obstacles as each participant goes through the process of selecting and planning a community engagement event. These steps would have avoided confusion, frustration and deep conversations that employees brought to the discussions before they could more fully engage. It is also a challenging change in the way employees do their work. An evaluation of the employees’ experiences, their perceived attitude towards this grant process and an examination of any transformational change is under way for implementation.
One last thought:
The events held under the auspices of the Bush Foundation, leveraged by state funding has spurred discussions at the executive level of the agency in which assistant commissioners share in their experiences, compare notes and report of their learning. For example, when assistant commissioner Jim Koppel attended the event at the historic Rondo neighborhood, the Chief of Staff commented on the success of the event. The event in the American Indian community will generate four additional meetings, in which participants first agreed to meet each quarter, and then chose each season as future meetings: fall, winter, spring and summer.