Western Wellness Foundation

Report date
February 2018

What has been most instrumental to your progress?

a) Throughout the grant term, convening and participating in stakeholders meetings and the sharing of a wide range of perspectives was instrumental to our progress. During these meetings (and in smaller group conversations initiated and made possible by the larger meetings), diverse special interest group participation was encouraged and stimulated. We were surprised to learn that often the major stakeholders (city and county representatives, business and education leaders, social service agencies and a range of local nonprofit organizations) in our small community had never had face-to-face, real-time conversations. The expanded perspectives these meetings and interactions led to allowed a truer engagement with our “new," expanded community—an additional demographic of 10,000 younger, culturally diverse newcomers with a wide range of skills and interests. Overall, this process led to a broader collective understanding of both the needs and the opportunities of our “new” oil boom and post oil boom community. Reviewing the years of our grant period, the positive change we saw was often the reversal of former attitudes of passivity and acceptance of entrenched positions.
b) Outreach to gather community input, the compilation of this data, and the careful, continuing consideration of its findings was essential in both making progress and informing further direction in our work. Outreach was implemented through small group meetings and individual conversations between our contracted facilitator and various community sectors (especially the nonprofit sector), and especially through a community survey (distributed to the public via postal mail with local utility bills). We had an unexpectedly high response rate to this survey, which yielded surprising and encouraging responses. The compilation of the survey data ultimately broadened our focus, and turned out to be our most important tool in achieving inclusivity, in realizing a wider range of “newcomer” perspectives and increasing our understanding of the full range of issues involved. The survey results were most instrumental in discovering new, more effective and sustainable approaches to our originally defined community problem.
c) Meeting, sharing ideas, outreach to gather new information and diverse perspectives—these efforts led to raising community awareness, creating a stronger sense of community identity, and a concerted will to change and improve through group action. Over the two years, we developed our community’s “problem-solving muscles” and used them to initiate, help or support groups addressing a full spectrum of community needs. Examples: planning the development of technical college-level certification courses through partnerships in business and education, to promote workforce development; helping build a regional arts council for SW North Dakota; furthering the development of the Patterson Lake development project; initiating the development of a cultural placemaking plan for the City of Dickinson; promoting a downtown economic and revitalization initiative utilizing public art to nurture small businesses and increase foot traffic; and, with the added urgency of our growing opioid crisis, conversations to launch a local drug addiction treatment center, fully certified and staffed.

Key lessons learned

a) Not only is change difficult (for a formerly homogenous community, deeply rooted to the land), it is a moving target when the community is undergoing a period of economic and demographic volatility. Our defined community need at the beginning of our grant period (during the oil boom) was the difficulty our “newcomer” and disrupted existing population experienced in accessing essential social services and available aid. When the energy sector experienced a strong downturn in 2015, our community need revised from service and aid agency co-location (for a booming, newly diverse population) to dealing with a multi-faceted drug abuse problem—opioid and heroin abuse, trafficking, law enforcement and court overload, and lack of addiction treatment options. So, we learned that flexibility is key to community innovation effort and process. The built-in flexibility of our Community Innovation grant allowed us to pivot our efforts toward addressing this new need, using our existing resources and assets—all that we had learned and the relationships we had developed over the first twelve months of our grant period.
b) “Top down” or previously conceived solutions—no matter how seemingly sensible—cannot successfully be forced upon diverse groups. Arranging for “safe” small group or individual conversations allows the presentation of alternative solutions and discussion. This facilitates the process of sharing perspectives and seeking common goals, which allows the generation of alternative solutions “from the bottom up," percolating upward, that have a greater likelihood of lasting success. (It also gave us more insight into what were the true priorities in considering community needs.) This part of the process takes time and patience. Our younger, newly diverse community IS interested and is open to change, but they are only willing to be engaged at their level of ability and access—not necessarily at ours. The community survey we distributed with utility bills was unexpectedly successful (both in number of responses and in lengthy comments), but the follow-up focus groups we attempted to schedule were a failure. Respondents were not willing or able to give up their personal time for discussion at a non-negotiable time and place.
c) Innovation means change, and change will be difficult, for some more than others. When you change the way people have always done things, you are changing their process—and they may consider that you are attempting to change their lives (which, in a sense, you are.) When you are pursuing innovation, be on the lookout for unintended consequences. As the months passed and our work took shape, we should have stood back and thought about how other comparable innovations in our community had fared—the ones that succeeded, and the ones that failed: Dickinson’s West River Community Center, a 165,000 sq. ft. multi-faceted sports and recreation facility, cost $21 million to build, took over 20 years to plan and 18 months to build. Every sector of our community was strongly involved, engaged, and held a strong negative or positive bias about it during the years before it was built. Today it is a huge success; it is truly shared by everyone, and everyone is proud that we accomplished it together. We could have learned a great deal from the stakeholders who met and met and finally succeeded in establishing the consensus required for the Center's creation.

Reflections on the community innovation process

Increase collective understanding of the issue. Using a utility bill insert for our survey, a local newspaper flyer insert for broad-based communication, and small group meetings and individual conversations for honest exchanges of opinion were our primary process methods. This was essential to address the challenge of working with a suddenly near-doubled population and a new demographic of younger residents arriving from across the country. The work of this project included creating a collective understanding on all levels of how the community can utilize its existing assets--while including the interests and concerns of the newer, more diverse residents--to work on essential quality of life concerns. We communicated this process as a unique opportunity to utilize both the existing and the new demographic/cultural groups to create a more vibrant, growing city with a new vitality.

Progress toward an innovation

We have made progress toward an innovation, though not the innovation we had earlier projected—due a change in the community need being addressed. You can consider the CI processes as the “internals” of the half-circle diagram, and the community identified need at the edge as the driver or portal of the “internals.” All that is outside the diagram would be the “externals,” or the community’s environment. Our community’s environment changed dramatically after we progressed through “increasing collective understanding," building stakeholder engagement and relationships, and working together to generate ideas. Consequently, the identified need (client-driven access to human and social services) changed—but we continued our processes, moving forward toward an innovation (now, in addressing substance abuse issues), without any real interruption, in the internal process work over the 24-month grant period. We are closer now to a more effective, sustainable (though revised) innovation than we were before we began, because we have been successful in developing a culture of innovation. The process work (the “internals”) remains the same, though the need and the innovation have changed.

What it will take to reach an innovation?

The community need we are now addressing is the lack of local and regional treatment services for substance abuse, and the innovation we are now working toward is a centralized full-spectrum regional delivery center (that is “effective, equitable and sustainable”) offering substance abuse treatment services. Those immediately affected by our need are not only those who HAVE substance abuse problems, but also medical providers, law enforcement and our court system. So, we will have many additional new stakeholders involved, who must be included and engaged. Developing a regional treatment center will have a heavy financial cost, and a consideration of the system’s financial sustainability will involve the state and federal government funding (and, consequently, political issues). Workforce development will be an additional issue. A public-private integration of treatment services and collaboration on service development will be essential—and extremely difficult to achieve. But a development of service-provider integration and collaboration would be necessary to “using existing resources and assets effectively” as well as future sharing of ownership and decision-making.

What's next?

The project has continued, and will continue without interruption. Though our organization no longer leads the project coalition group, we are an active member. Our group—which meets monthly—includes representatives from the City of Dickinson, U.S. Sen. Heidi Heitkamp’s office, U.S. Sen. John Hoeven’s office, ND Human Services Dept., Heartview Treatment Center, various regional and local private addition treatment providers and is led by the CEO of Dickinson's CHI St. Alexius hospital. Currently the focus of our effort is to obtain federal funding for a substance abuse treatment facility to be located within the former Hospital Building (which is still owned by CHI). This 10-bed facility would serve the SW region and would be staffed by CHI; it would offer ASAM Level 4 hospital detoxification services. It is projected that other addiction treatment providers would co-locate in the building. If funding were to be in place within the next 12 months, necessary renovation work could begin and the new facility could be operational within the following 12 months. Strong, widespread public consensus and support for this project has been achieved and is now in place.

If you could do it all over again...

Before you begin, think about past community projects of a similar scale and scope that have worked, and ones that have failed. Which projects have worked and been sustained and which haven’t? And why? What processes helped the successful projects to continue to move forward? Think about the past five years and future five years in a time continuum with these projects—successes and failures—added in. Be humble enough to know there’s so much you don’t and can’t know. Be aware of the likely intrusion of unintended consequences that you can’t foresee. Be patient, remain flexible, go slow. Community innovation shouldn’t be a heavy push. Tread lightly, because you’re walking on people’s lives.

One last thought

There is an optimism, new ideas, new business opportunities and new initiatives that are now in place and moving forward. The facilitation of conversations and broad dissemination of the community input we received has kickstarted many local projects--in recreation, the development of Patterson Lake; in public art, a $20,000 collaboration between the NEA, the City of Dickinson and local artists; in education, the development of technical/vocational courses through the local university and the public school system to promote workforce development; and a downtown economic initiative to revitalize the area, to enhance the aesthetics and to give the city a more contemporary “restyling.” The creation of a regional arts council will continue (due in part to support from the Bush Foundation’s support of Change Network ND), providing the community with the means to develop a creative placemaking plan, and to increase arts opportunities for children and adults. The success achieved with these projects has been due to a basic rural community approach: ask residents what they think, then follow up with communication, viable solutions, and a request for their engagement and support.