Implementing the Vision: Growing a Healthy Communities Initiative

Iulia Weaver

When Delaware County, Indiana, embarked on its healthy communities plan- ning process, community leaders worried that the effort would simply end up as another study on a shelf, gathering dust. One steering committee member cautioned that if people thought this was simply another plan with no action, they would run screaming from the room. Although Delaware County and its county seat, Muncie, have the distinction of having been studied thoroughly in the sociological literature as “Middletown,” their experience of too many studies and not enough action is not unique.

The action component, or what is commonly called the implementation phase, is critical to the success of any healthy community initiative. Otherwise, the community would simply have another study on the shelf and a great many frustrated hopes. The implementation phase is challenging for many reasons: The projects are often complicated, funding must be “creative,” and groups try new relationships and power configurations that they have never tried before. Moreover, the goals of the effort are often to fundamentally change the way the community functions and transform the values that drive individual choices and behaviors.

Growing a healthy community is not a simple thing. This work is organic, with lots of variables and surprises. It is in some ways like gardening in that growing a healthy community requires good planning, preparation, and hard work. Yet even with the best preparation, there will be surprises and aspects we cannot control. There are substantial lessons to be learned from successful healthy community efforts, however, that can be helpful as communities nego- tiate these complexities.

Growing a Healthy Community Each healthy community is unique in some way, and each develops its own way of implementing its vision. But despite the variety, there is a common

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thread in the way successful communities approach this work. They effectively integrate two intersecting tasks: implementing short-term projects and work- ing toward long-term systems change.

Making progress on the projects and programs identified during planning is critical to the success of any healthy community initiative. Projects and pro- grams, whether new health and human services, community forums, or the effective coordination of existing efforts, are important. These efforts can increase the health status of the community, provide evidence that the initia- tive is moving forward, and serve as the building blocks of change.

At the same time, the community needs to keep a constant eye on the long-term goals of the initiative and continually nurture the process of change. Communities have done this by keeping projects and activities connected to the vision, and by monitoring themselves to make sure that they are practic- ing the values they preach. They build the capacity of the community to com- municate, plan, allocate resources, and solve problems.

One way to think about how these two types of activities are bound together is to consider the way a gardener approaches the work of growing a healthy garden. Some gardeners strive to create a bed of beautiful flowers in brilliant colors, others concentrate on growing the perfect strawberry. Regard- less of the particular design of the garden, the gardener has two ongoing, com- plementary tasks: continuously building the capacity of the garden to support healthy growth and planting and tending the individual plants. Every garden- ing enthusiast knows that while the tulip and the strawberry need to be care- fully tended in their season, the work of building the garden lasts throughout the year and, indeed. is really only accomplished over many years. The beds must constantly be weeded, the soil enriched, and the plants moved to the spot where they can really thrive.

The cyclical, organic nature of this work is important to keep in mind when communities begin to implement their action plans so that during imple- mentation the implementors are able to focus on the work as well as to con- tinue nurturing the process-just as the gardener plants and nurtures the visible plants while continuing to prepare the soil and build the garden for more things to come.

Tending the Plants: Implementing Short-Term Projects As discussed earlier, the projects and activities attempted in a healthy com- munity initiative are complicated, do not necessarily have adequate sources of funding, and include new relationships and power structures. Moreover, most of the work of healthy community initiatives is done by committed volunteers or stakeholders who either are not paid for their contribution or add these duties to an already full plate of work. The following are some of the common mishaps that can keep plants from growing healthy and strong and some sug- gestions for overcoming them:

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Losing Momentum While Movingfrom Planning to Action. Some com- munities are understandably tired after a long communityurlde planning process and wish to slow down or take a break. Others simply do not have a plan to manage this transition. Some groups are not clear about who has responsibility for implementation.

To avoid these problems, I offer the following suggestions. First, if the group wants to take a break, be sure to mark the end of the planning process with a celebration, agree on a short break (perhaps a month or two in the sum- mer or around the holidays), and agree on a restart date. Second, create a plan for the transition from planning to action. Consider including an organizational or institutional “home” for each initiative, and an interim governing or coor- dinating body. Third, hire a coordinator to help during the transition. The coordinator’s time might be donated by an organization in the community, or it might be paid for in some other way. Major duties might include organizing work group meetings, writing a newsletter or engagng in other forms of com- munication, and staffing the steering group.

Getting Stuck in a 501(c)(3) Nonprofit Tax-Exempt Status Application. There are a variety of ways to ensure that someone is accountable for coordi- nating initiatives. One way is to utilize existing resources of organizations such as the United Way or a public health department. Other communities choose to develop a new nonprofit organization to carry out the work. One roadblock to avoid is getting bogged down struggling with the 501(c)(3) application. Groups often feel that everything else should be put o$ hold until all the founding documents are filed.

The following suggestions are offered to avoid mishaps with the applica- tion. First, for technical assistance with the paperwork, contact a local associ- ation of nonprofit groups, if the community has one. Second, get a lawyer to help file your tax documents. Third, make group decisidns about the govern- ing structure and the general operating procedures of the organization but allow a small group to do the actual writing. Finally, continue working on other objectives while setting up the new organization. Use another commu- nity nonprofit as an umbrella organization to get the work done.

Keeping Stakeholders Involved Oftentimes, groups lose stakeholder par- ticipation during implementation. Stakeholders get tired or get involved in other things. Often, professionals take a larger role at this time and volunteers feel that their participation is no longer necessary. Others simply do not know what role they should play.

To avoid these problems, I offer the following suggestions. First, be clear about the role of stakeholders during implementation. Are they supportive of the work? Do stakeholders serve on committees or action groups? Would someone who participated in a focus group or volunteered as a mentor be a stakeholder?

Second, develop a communications strategy for all stakeholders, includ- ing those who are not active at the present time. Reach out to potential new

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stakeholders by inviting them to participate in a specific initiative, to volun- teer for a particular effort, or to attend a lecture or training. Avoid inviting folks to attend informational meetings. Weld County, Colorado, for example, hosted a successful Community Renewal Day for its stakeholders with time for leam- ing, sharing, and getting reconnected to the initiative.

Finding Community Leverage Pointsfor Funding. Some groups want to raise $20 million to upgrade housing stock in their community, while others need $20,000 to hire a half-time coordinator to help organize a largely volun- teer effort. Whatever the amount, virtually all healthy community initiatives seek new funding for some effort.

The following suggestions are offered for fundraising. First, be clear about priorities-for short-term goals and objectives as well as the effort’s long-term role in growing a healthy community-and do not be sidetracked by someone else’s agenda, even if it comes with funding. Second, develop partnerships with institutes of higher learning, churches, neighborhood organizations, and schools and develop services that they need and would be able to pay for, such as leadership training and research. Third, develop a funding plan that includes in-kind contributions, local money (including memberships and private dona- tions), and large grants.

Building the Garden Even as communities do the hard work of implementing projects, even as they nurture the seedlings and tend their plants, it is important also to focus on systems change, to continually build up the garden so that it will continue to be fertile. For example, members of the Springfield Community Health Partnership in Springfield, Massachusetts, have created a new community organization to facilitate good community planning and decision making to improve the health status of the community. A short-term project to increase childhood immunization has served to build partnerships and new working relationships among public and private health care providers, schools, and other child-serving agencies.

There are numerous strategies that communities can utilize to support systems change and to ensure that the healthy communities process of inclu- sive decision making is ongoing. Some communities develop leadership pro- grams that teach collaborative leadership skills and donate staff time to support community collaborations. Some of the most widely used strategies are described below.

Developing an Ongoing Mechanism, Place, or Organization to Nurture Systems Change. The Healthy Boston initiative helped create neighborhood coalitions to serve as ongoing vehicles for community-based planning and problem solving. More than a dozen coalitions are still active, doing commu- nity planning, garnering resources, and serving as focal points for communi- cation and collaboration. Mesa County, Colorado, has developed a citizen

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planning and problem-solving body called the Civic Forum. This group helps organize safe public forums for discussing tough issues such as local gover- nance structures, land use, and collaboration among child-serving agencies.

If the community decides not to develop new community organizations, make a plan regarding who will be responsible for continuing the process. Make sure someone is responsible for reconvening the group to evaluate progress, review the vision, and continue the process of planning.

Taking Time to Develop Strong Community Leadership. Put resources into developing a strong governing board.

In South Carolina, the Department of Health and Environmental Control (DHEC) seeks to support healthy communities initiatives at the local level. The department’s attention is focused on building more capacity and support for these efforts for the long-term. DHEC is committed to the process. DHEC, with the help of the National Civic League, provides a year-long training program to local leaders so that they can build their skills and capacities. The organi- zation is also developing new partnerships with other statewide groups such as the Department of Health and Human Services and the Department of Edu- cation, the South Carolina Hospital Association, and the Downtown Associa- tion. If a community lacks a leadership program, it needs to develop one.

Many communities, such as the Naugatuck Valley in Connecticut, have chosen to staff their initiatives with coordinators instead of directors. A coor- dinator’s function is to provide support to volunteers, stakeholders, and com- munity partners who do the lion’s share of the work.

Celebrating. People are more likely to show up if they are having fun. Thank leaders, volunteers, and community partners. Host a volunteer appre- ciation dinner. Have a nice meal with the governing board. Celebrate accom- plishments. Announce positive outcomes, new partnerships, and new funding resources in a newsletter or in the local media. Have fun. Participate in the local community festival or holiday parade. If the community does not have such events, consider organizing them.

Conclusion Implementing a healthy community vision is neither easy nor predictable but the rewards can be enormous. If a community can balance the tasks of imple- menting projects with the sustained effort of nurturing the process, the com- munity can make great strides in improving its quality of life-making circumstances better for residents right now-while also developing new struc- tures and habits of community problem solving that can truly sustain a healthy community.

A friend of mine grumbles about the unpredictability of gardening. “You work and work and work and you can still lose everything with hail or early snow or late rain.” And yet year after year, she takes the risk. She tends her plants and prepares the beds for next year.

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Julia Weaver is director of the Healthy Communities Programsfor the National Civic League. She has provided technical assistance to government agencies, nonprofit organizations, reli- giow groups, social services and health collaboratives, and communities in areas that include strategic planning, advocacy, program development, coalition building, policy development, and community outreach strategies.