the us land grant extension system opioid crisis response ...€¦ · energize the experience,...

Opioid Crisis Response Workgroup Planning Sessions Report – Sept 26, 2018 - of 24

The US Land Grant Extension System

Opioid Crisis Response Workgroup

Strategic Planning Sessions Report Out (Behavioral Health Strategic Plan & Opioid Crisis Response PLAN)

Facilitated & Prepared

by Steven H. Cady, Ph.D.

September 26, 2018


Section 1

Executive Summary

This report provides the output information generated from a planning process with the US Land Grant

Extension System, Opioid Crisis Response Workgroup. The process entailed sessions with the workgroup

or the chair, Mark Skidmore, focused on developing a strategic response framework for the opioid crisis

that will serve as a guide for cooperative extension’s system-wide programming into the future. The

outcomes from four workgroup online meetings and one onsite meeting were to:

❏ Collaboratively develop content for the Behavioral Health Strategic Framework that is unique,

compelling, and capable of taking on a life of its own.…

❏ Craft an Opioid Crisis Response PLAN that leverages Extension’s unique competencies and advantages

in ways that fill gaps not being met.

❏ Facilitate the pre-meetings to serve as a foundation for deeper meaningful work in the onsite meeting. Note

- do only together in person what you could not otherwise do. Through the process, the aim will be to

energize the experience, wisdom, and expertise of the group - individually and collectively. In addition, we

will use the meetings to enrich the relationships among the team that will serve longer-term impactful work

together in a variety of ways.

The Extension Opioid Crisis Response Workgroup is collaboratively developing a report to be delivered

as part of a system-wide solution. Of the activities requiring coordination is the need to develop a

strategic framework. From working documentation, the following was stated, “Overdoses are now the

leading cause of death of Americans under the age of 50, the impacts of which are being felt in every

region of the country, affecting both rural and urban places. Most of these fatalities are tied to heroin or

prescription painkillers. In many states, universities within the Land Grant system are responding to the

crisis. However, the Extension Committee on Organization and Policy (ECOP) believes that a

coordinated effort within the Land Grant system could provide a larger and more effective response the

ongoing crisis.”

The document provides a report out from the workgroup’s planning sessions. The process for moving

forward, the next steps are:

1. Summarize Discussion

2. Provide Recommended Strategy Statement

3. Leadership Team

4. Process Design Team

5. Strategy Team

a. Formalize Plan

b. Operationalize Goals

6. Action Planning

a. Best Practices

b. Appreciative Inquiry

c. Projects Prioritization

7. Project Management


Section 2

Table of Contents

Sections Pages

1. Executive Summary 2

2. Table of Contents 3

3. Behavioral Health Strategic Analysis

3.1. Resources

3.2. SOAR Framework

3.3. Strengths

3.4. Opportunities

3.5. Aspirations

3.6. Results

4

4

5

6

7

8

9

3. Behavioral Health Strategic Plan (Proposed)

3.1. Behavioral Health Definition

3.2. Strategy Framework

3.3. Vision

3.4. Mission

3.5. Goals

3.6. Objectives

10

10

13

14

14

15

16

4. Opioid Crisis Response PLAN

4.1. Context

4.2. Purpose & Outcomes

4.3. Leadership & Stakeholders

4.4. Actions

4.5. Needs

18

19

20

21

22

24


Section 3

Behavioral Health Strategic Analysis

The workgroup conducted a strategic analysis of the extension’s behavioral health internal and external

environment. The workgroup considered Behavioral Health broadly, within Extension and its niche,

recognizing that the opioid crisis is one of several challenges being faced across the country. They

reviewed all the strategic resources (literature review and survey, plus other information as appropriate),

fill out the strategic analysis template called SOAR that is described below. The following links provide

the resources used to complete the analysis:

Resource Materials

https://tinyurl.com/OpioidWorkgroupReadings

Meeting Agendas https://docs.google.com/presentation/d//edit?usp=sharing 1FYl8-5bsB78Yihmb-

RA6o9GfsCWZF1aK4GUxayAyxdY

Working Documents

https://drive.google.com/drive/folders/1TNyjvUdsb4jDSyI41ekYxIwiqn0yFxa4?us

p=sharing

Meeting Recordings https://youtu.be/oI3PGXZjZR4

Each member of the team filled in the table below with their personal view on the four quadrants. They

provided an assessment based on the resources provided and individual perspective, bringing their

individual work to the first online planning session. The teams utilized tools and frameworks as shown

below, along with additional resources to conduct their analysis.

A draft of this report was shared with the group. The workgroup was asked to review and provide

comments. Comments are provided here for future reference. Post Sessions Comments from Workgroup:

“I love all of the first SOAR sections, except the "results" section doesn't fully make sense to me. For

example, why is MHFA mentioned, but no other program? I missed more than one call, so I may just be

out of the loop here... but how/why were these measures chosen? (You don't have to answer that in an

email, but that's my question from having been on earlier calls and now seeing this document). I saw

MHFA echoed again later in the objectives. From our point of view in Utah, we're moving away from

MHFA. It's good for what it's good for: it's helpful for people who have little-to-no contact at all with

behavioral health topics, and need a primer and introduction -- it can help reduce stigma in those contexts.

And we're certainly not getting rid of it as a program in Utah; there are places it is still needed. But it's

also not where we're putting additional resources as a state system. It really doesn't do much to bridge the

gap to help support knowledgeable and passionate community members to do behavioral health

volunteering or programming. We see it as a good first step, but not something that is creating systems

change or advancing more substantive community level engagement. Sometimes I even worry we use

"number of people trained in MHFA" as a problematic proxy for suggesting our systems are equipped for

behavioral health efforts -- when really everyone could be trained in that, and we still wouldn't be close to

equipped to do substantive work in behavioral health. Those are my two cents. Overall, I really liked the

SOAR analysis in particular, and so appreciate all of your hard work. This looks incredible.”

https://tinyurl.com/OpioidWorkgroupReadings

https://docs.google.com/presentation/d/1FYl8-5bsB78Yihmb-RA6o9GfsCWZF1aK4GUxayAyxdY/edit?usp=sharing



https://drive.google.com/drive/folders/1TNyjvUdsb4jDSyI41ekYxIwiqn0yFxa4?usp=sharing

https://drive.google.com/drive/folders/1TNyjvUdsb4jDSyI41ekYxIwiqn0yFxa4?usp=sharing

https://youtu.be/oI3PGXZjZR4


The SOAR model was used as the template to guide and organize the analysis. SOAR is a positive

approach to strategic planning that allows an organization’s stakeholders to construct its future through

collaboration, shared dialogues, and commitment to action. A fundamental difference between SOAR and

other strategic planning models and methods is a broad representation of stakeholders who maintain an

interest in the organization’s success is invited. SOAR purposefully engages in a series of conversations

worth having to identify and leverage strengths and opportunities, to create shared aspirations, goals,

strategies, and commitments to achieving its vision and serving its mission (adapted from www.soar-

strategy.com).

http://www.soar-strategy.com/

http://www.soar-strategy.com/


Strengths - What can we build on?

Item Label Definition Description

Embedded in

Communities

We are strongly rooted in

communities.

Extension has a long history of being engaged in the

communities we serve. These long-standing relationships cannot

be easily replaced. Extension professionals already facilitate

capacity-building, thus they are in a position to provide more

targeted direction on behavioral health topics. Furthermore,

Extension is committed to working with individuals and

communities long term, not just when the money is there.

Audiences We work with people from

all walks of life.

We have a wide reach and work with all types of audiences. We

connect with individuals, families and communities on a range of

topics, at different points in the lifespan, and in numerous

contexts. Mobilization of our network to address the ongoing

opioid crisis could result in a large collective impact because of

our ability to reach diverse audiences.

Openness We exhibit a willingness to

consider mental/behavioral

health as a program area.

Addiction is increasingly recognized as a health issue rather than

a personal or moral failure. People within and across state

systems recognize the importance of emotional, mental and

behavioral health and have a desire to make a difference. Many

have expressed interest and are willing to engage and contribute

in efforts to address the opioid crisis and related problems.

Adaptability Extension is a living,

breathing organism that can

change with the changing

times.

Lifelong learning and growth are values of Extension, and

adaptability is a defining strength. With training, we can adapt to

provide education on mental and behavioral health topics. We

have adapted in the past, and we can do it again.

Respect and

Trust

Our network is a respected

and trusted source of

information.

Extension professionals are a trusted source of unbiased,

accurate information. As a public sector educational

organization, Extension is not trying to sell products, profit or

push private interests. Staff are committed to providing current,

scientifically accurate information in the best interest of the

people we serve.


Opportunities: What are our stakeholders asking for?

Item Label (1-3

Words)

Definition (1 Sentence

Only)

Description (Approx 5 Sentences)

Many potential

partners

There are many potential

partners ready to work with

Cooperative Extension but

may not know about us.

Extension is known as the best kept secret. People even within

the Universities do not understand Extension. These are all lost

opportunities. We need to get out of our comfort zones and truly

reach out to every potential partner and tell them what he have to

offer. Ask yourself, who are 5 new partners I can reach out to

today?

Awareness and

education

Many people want basic

information about

addiction, the opioid crisis,

its root causes, and what

they can do about it.

Even though the information is everywhere people still are

searching for the basic information. How can we continue to put

the most up to information out there on a consistent basis where

people can find it? Consider all ages and levels of understanding.

Do not assume they know how to get to the information.

Utilize social

media

Social media presents a

great opportunity to engage

in a social marketing

campaign.

If we want to reach the populations who have the biggest needs at

that moment in time, we must learn to reach them through their

preferred modes of communications. When we just “post” things

we are not engaging the younger population. We are just

throwing information at them. We need to learn to engage and

create an interactive environment through social media.

Ideas that work People are not willing to

invest in things that they

are not sure will work.

They want evidence based

solutions that are tested.

Most laypersons do not know what evidence based

solutions/practices/research is but that is what Extension’s job

is...to evaluate the benefit-cost of programming to decide what

works. It is our job to educate stakeholders on the benefits of

spending money on programs, to bring families together for

weeks to learn together, and to conduct evaluation on what we are

teaching. We need to think beyond the financial realm but more

importantly we need to educate stakeholders what benefits they

will receive by participating in what we provide.

Inventory of

resources

Extension assess its

resources and education

about addiction

education for behavioral

health specialists; increase

education about addiction

Extension needs to continually review and educate themselves on

what resources are out there to regarding behavioral health.

Resources from the federal level change frequently and as

specialists we need to continually analyze what information to

share with the public as they look to us for expertise.

Identify a focus Determine what Extension

can manage and focus on in

the field of behavioral

health and the opioid crisis

While we want to be everything to everyone, we can’t be.

Extension many times is crisis oriented as we need to address

whatever the current issue is that the people in our state are

experiencing. We can also build in proactive preventative

programs and resources to help before the crisis ever appears.


Aspirations: What do we care about?

Item Label Definition Description

What We Offer We need to be able to point

to some clear examples of

successes and resources

relevant to the opioid crisis.

As a system, we need to have a clearer idea of what our roles,

programs and contributions have been and should be in the

behavioral health arena. Regarding staff who may be resistant or

reluctant to adopting behavioral health as an area of

programming, we need to help them get on board by pointing to

our commitment do what is required, not just what we want to do.

Community needs should be the driving force of our

programming.

Address All

Groups

Increasingly address

challenges across diverse

populations.

We need to be ready and able to tackle problems that exist within

marginalized communities. There are issues that

disproportionately affect other groups (POCs, LGBTQIA+, etc.).

We need to live up to our mission to provide education in

equitable and inclusive ways by reaching audiences that have

historically not been involved. This might require some creative

and innovative strategies.

Capacity

Building

Empowering communities

to address their own

challenges.

Rather than adopting the mindset that we are the experts with the

task of “rescuing” a community, we need to serve in a more

facilitative, capacity-building role. Ultimately, the goal is to equip

and activate communities to address their own challenges by

incorporating lived experiences, community needs and

strengths/assets. We can provide resources and assistance to

supplement them in this process.

ACEs, 4-H and

other Extension

Involvement in

Kid’s Lives

Overcoming ACEs through

relationships with caring

adults.

Adult involvement helps counteract negative experiences in the

lives of youth who have ACEs. A baseline understanding of

ACEs, risk and protective factors is essential for our staff who

work with populations likely to be high in ACEs. Additionally,

we need to recognize and appreciate 4-H volunteers for their

contributions.

Post Sessions Comments from Workgroup: “I would like to see us have more information in those boxes

about ACEs. I think we need to do more than 4-H and positive relationships with caring adults. In my

opinion, the most effective prevention and intervention will be working to establish trauma-informed

schools encouraging schools to adopt and implement the Good Behavior Game (GBG) curriculum which

is an evidenced-based best-practice. Also, one measurement tool could be the ACE questionnaire.”


Results: How do we know we are succeeding?

Item Label (1-3

Words)

Definition (1 Sentence

Only)

Description (Approx 5 Sentences)

Measures

Number of

Extension

personnel trained

in Mental Health

First Aid

Track the number of

extension personnel who

receive the one-day

certification.

For everything we do with Extension, we need to track the

number of professionals trained, people who participated in the

program, direct contacts and indirect contacts (outputs). We need

to continually show we are reaching out to others to inform and

educate the public through more than just flyers and newsletters.

Decrease in

deaths, Less

prescriptions,

Referrals to

mental health

professionals

Track these numbers over

time.

Outcomes are essential to the sustainability of everything we do.

This ties into the Opportunities “ideas that work” as we would not

want to continue to offer programming if we cannot proves that

we have results.

Projects

Instructor

Training

Regional or Multi-State

Instructor Training for

MHFA

Regional or Multi-State Instructor Training for MHFA

Social media

campaign

Leverage inbound

marketing strategies.

Develop and implement an integrated social and mixed media

strategy that not only creates awareness, it also engages the

country in a deeper dialogue.

Extension as a

system has

partnered with

public health to

train County

Agents etc.

Extension is a community

partner in offering

stakeholders information

sessions.

We need to measure our outputs in regards to new partnerships

formed and workshops/trainings delivered.

Post Sessions Comments from Workgroup: “I would add, relative to prevention and intervention of

childhood trauma, a metric of how many K-6 schools were implementing and delivering the GBG

curriculum. Another metric would be the CDC – Behavioral Risk Factor Surveillance System (BRFSS)

which is a national measurement tool with questions about drug use and suicidality. A couple years ago,

the Executive Director of our state Childwise Institute wrote a great editorial entitled “Four ACES is not

a Winning Hand.” Available at this link https://www.childwise.org/1015/”

https://urldefense.proofpoint.com/v2/url?u=https-3A__www.childwise.org_1015_&d=DwMGaQ&c=nE__W8dFE-shTxStwXtp0A&r=EaKVagw6lvzi31WN7VF4tQ&m=Sj_wrnv0865MYigswEAQJClD2Qt7MqhHUmUgcVrhDaA&s=OkBUni0ZpyIX9mkHbLfqzX0Edc0d6mCCHF1dzIjv25U&e=


Section 4

Proposed Strategic Plan

A strategic plan is a concise statement that guides decisions, priorities, and actions over time. The

workgroup members, first, worked independently to develop their version of the strategic plan by using a

template, reviewing resources, and bringing their individual work to the whole group. Online sessions

were held to share and connect the individual perspectives and plans. The Chair, Mark Skidmore, took the

workgroup’s discussions and proposed a draft during the in-person meeting. At the in-person session, a

draft behavioral health strategic plan was presented. The workgroup enriched the plan as shown below.

Behavioral Health Definition

During the in-person session, the workgroup reviewed the following draft definition of behavioral health.

The group decided that a standard accepted and understood definition was necessary in order to set the

context for the strategic plan statement.

Behavioral health (BH) is broadly defined as mental health, behaviors, and substance use

or misuse across the lifespan, including variations by gender, gender identity, race,

ethnicity, trauma, occupational status, veteran status, and socioeconomic status.

Behavioral health includes mental illness as well as mental well-being (eXtension

Behavioral Health Impact Collaborative https://www.extension.org/behavioral-health-

application/).

Then, the workgroup brainstormed suggestions and questions that were written and shared on post-it

notes. These were gathered and are typed up below. The group

https://www.extension.org/behavioral-health-application/



The workgroup discussed the need for an agreed upon definition of behavioral health in order to set the

stage and give context for a strategic plan statement. During this segment of the planning session, the

workgroup brainstormed a list of recommendations and questions to consider in formulating a definition.

Recommendations for a Definition

Post It Notes

● Have members of the intended audience (general

public) review the definition. Does it make sense

to them?

○ 1- scratch the second sentence ‘Behavioral

health doesn’t look at anything - The term

describes an aspect of health.

○ 2- Add “unique” in front of variations

● Mention signs and symptoms, maybe

remove/reword “looks at how behaviors impact

someone’s health”?

● Consider calling it “Behavioral Health & Mental

Wellness” as what you’re defining rather than

just “behavioral health”

○ 1- should read “broadly defined, BH is…

○ 2 should read “For the scope of Extension,

BH is defined… (Statements could reflect

“non-diagnoses” behavioral health)

● Consider the language - behavioral modifies

“health”. Common definition of health is

complete physical, mental & social well-being

(WIFO)

○ *behavioral influences - behavioral aspects.

○ Consider the literature of relevance -

Novella/SAMSHA

○ Consider the audience so 2 part definition -

General BH describes the behavioral

aspects (specific Extension)

Recommendations for a Definition

Post It Notes

● Who is your audience: administrators,

researchers, field faculty, community

● Keep both statements. It allows for a basic

understanding first and then goes into details

more broadly.

● Behavior is how person functions

● Suggest promotion of health lifestyle within

social context.

● Make sure addiction etiology is defined first.

● Behavior suggest blame game. Would be a

problem for people suffering from addiction.

● Would like to see both statements (1&2) used. I

feel that 1 is more word descriptive and will

appeal to a broader audience. Where 2 is

beginning to refine the direction for those who

are working in this area.

● Begin with general laymen definition (1) &

integrate with more scientific description (2)

● The Main definition suggest that behaviors

influence one’s mental and physical health.

Others suggest that behaviors present as a result

of mental health or distress. I think it is a

bidirectional reactionalization.

● Please don’t lose the influence of context or

environment (ACES, bullying, job loss, et.) on

mental health

● I combining(1) and (2) eliminate redundancy


The comments above were used to craft the following two part definition, one that is for the layperson

and the other for the academic. What follows is a starting point. Members of the workgroup also serve on

the Behavioral Health committee. They have agreed to bring this information forward to the Behavioral

Health Impact Collaborative for further discussion.

1. Behavioral health describes the connection between behaviors and the health and well-being of

the body, mind and spirit. Behavioral health looks at how behaviors impact someone’s health —

physical and mental. Maine Access Health Foundation’s Statement

2. Behavioral health (BH) is broadly defined as mental health, behaviors, and substance use/misuse

across the lifespan, including variations by gender, gender identity, race, ethnicity, trauma,

occupational status, veteran status, and socioeconomic status. BH includes mental illness as well

as mental well-being (Extension Behavioral Health Impact Collaborative

https://www.extension.org/behavioral-health-application/).

Following this definition is the next set of statements for the strategic plan. During the in-person meeting,

the group reworked the draft into the following statement.



Behavioral Health

The Strategic Plan Statement

“We need some kind of simple minded criteria for making our decisions…” Henry Mintzberg

See video at www.henrymintzberg.com

Strategy is a clear intentional statement of values; and values are those ideas about the future that are

important for each of us to focus upon realizing in the present. They guide us in how we choose to interact

with the world and react to whatever arises. While we may be living our values to some degree, they call

us to go beyond our current selves and bring out our best self in each moment. Values guide our decisions

and actions… hence, strategy is the key to transformation on a personal and organizational level. There are

five components to a strategy and often these components have a variety of labels that differ from one

setting to the next. The key concept to remember is the definitions tend to be the same; the labels vary. Be

clear about your definitions and go in search of the label that will serve as the anchor. Then create a

distinctive strategic framework that emanates from the head and heart. Clarity in the key components of

one’s strategy is the key to meaningful change.

There are four core elements to a strategy statement that must be considered together: Vision, Mission,

Goals, and Principles. To consider these four elements in isolation is insufficient to understanding the

whole strategy. A common problem when considered in isolation is a statement with redundant concepts,

words, and phrases used across the four element. When concisely and meaningfully developed, these four

drive the main objectives that translate the strategy into action.

Vision Mission

Goals Principles

Objectives

http://www.henrymintzberg.com/


Vision

A vision is the scope of your mission. This is a one sentence statement that describes how big and best

you choose to be in living your mission. Often times, the “big” is addressing location for making the

difference such as geography, saturation, and penetration. While the notion of “best” has to do with your

level of expertise and recognition. One way to think of this is in terms of what best looks like. When the

target population is at its best, what does it look like. It is aspirational and connects at what we yearn to

be. Sometimes, it is associated with the words “Number 1, Leader, Champion, Winner, …” There is an

element of recognition in terms of popularity or accolades. The vision is timeless and is set as an ideal

that is strived towards, as opposed to achieving and then done. Hence, it is lofty. And, in some cases, the

vision is realized. And this is the fundamental belief that one day this yearning will be achieved. The

vision for extension with regard to behavioral health is:

We envision communities in which all individuals and families experience optimal

behavioral health and wellness.

Mission

A mission is the positive difference made in the world because you exist through using a specific talent or

competency. The focus is purposefully outward on those who reside beyond your immediate circle as a

person and organization. The vision for extension with regard to behavioral health is:

Our mission is to harness the transformative power of Extension’s deep network of

strategic partnerships, capacity building, and educational competencies to address

behavioral health needs.

There are two components to a mission:

1. Core Result / Difference. The focus is on a positive difference being created in the world. It

answers the question, "how will the world be different as a result of my being here, us being

together?" It is seen through the eyes of those people, places, and things that you touch.

2. Core Talent / Competency. This is the key activity that causes the core difference to happen.

This is often based on a special action/activity that you find invigorating... your gift. It answers

the question, "how do I ensure that the core result is accomplished?" It is based on what you do

that is unique, hard to imitate, and done well.

Core Talent /

Competency

Core Result /

Difference Mission


Goals

Goals are a list of general “bucket areas” within which to accomplish results over the long-term. These

are broad directions and areas for achievement. They are end-states that are focused on what is important

to be accomplished. Sometimes the goals can be thought of as areas to improve, create, or achieve? Here

are some tips:

1. Create a one to three word label or short phrase for each of the goals. This is an anchor in that it is

easy to remember.

2. Write a one-sentence present tense statement that describes what the goal looks like when fully

achieved.

The goals created by the workgroup are as follows. We will work internally and externally to:

1. Communicate & Advance the BH Strategic Plan

2. Expand & Deepen Networks

3. Broaden & Share BH Knowledge Base

4. Build & Improve Capacity in BH

5. Build & Improve BH Competencies

a. Enhance & Promote Resilience

b. Reduce Stigma & Increase Empathy

6. Increase & Leverage Resources

7. Demonstrate & Learn from Results


Objectives

The values stated above are broad enough to allow for flexibility and innovation, while also providing the

kind of focus needed to develop concrete measures of progress being made (i.e., action plans). Objectives

are the detailed specifics of the mission, vision, goals, and principles. Is an objective a value? Yes, in that

it is an extension of the previous four components. There are two ways to make the values more concrete

through objectives.

1. Infinite Objectives (tracked measures) are those things that you measure consistently over time and

track for trends. There is no end to tracking these measures. It can be things like sales (calls made,

units sold, satisfaction), health (weight, blood pressure, etc.) to finances (income, assets, etc.).

These have clear patterns or timing for measurement and evaluation. a. Measures - measureable trends tracked over time with tolerance levels.

b. Processes - production and programmatic processes that deliver competitive

advantage.

2. Finite Objectives (projects and initiatives) are one-time projects or initiatives to be completed with

a target beginning and ending date. The objective can also take the form of a target number to

achieve (e.g., units produced by a certain date). Objectives have clear ending or targeted completion

dates. a. Targets - aims to achieve by the organization.

b. Tasks - tangible creations with steps that are to be completed.

When infinite and finite objectives are stated, they are stated in terms of specific, measurable, action

oriented, realistic, and timely criteria (SMART). These have steps and measures that are SMART (see

below). Objectives are accomplished within the context of the goals. The reason is due to the notion that

goals are connected to the mission and vision. Often a matrix can be used to show how the objectives and

initiatives map onto the values. In addition to a matrix, it is important to put the finite objectives into a

timed flow chart that breaks the objective down into the necessary steps to see it completed (steps/sub-

steps, measures, leader(s), others involved, required resources, roadblocks & solutions).


The workgroup brainstormed an initial list of possibilities for consideration. However, these were left as a

brainstormed list and not priorities nor vetted. Time did not permit for this detailed discussion. The

workgroup main interest was in the four elements of vision, mission, goals, and principles in order to set

context for developing the Opioid Crisis Response Plan in Section 5 of this document.

Finite Objectives - Projects Infinite Objectives - Measures

1. Mental Health First Aid (MHFA).

Provide MHFA training for Extension,

our networks and in communities

2. Training for MHFA. Send Extension

personnel to classes to become

certified MHFA Instructors

3. Strengthening Families Program

(SFP). Increase the number of SFP

programs being offered

4. Capacity Building. Engage with

communities to strengthen the capacity

of communities to identify and address

emerging behavioral health challenges

5. County Agent Capacity Building

Training. Train in county agent

capacity-building strategies within the

context of addressing behavioral

health issues.

6. Social media campaign. Reduce

stigma around asking for help

7. 4-H Personnel Training. Train in

identification and providing support to

at risk children who are in our

programs.

1. Programs. Number of educational programs

delivered.

2. Improvement in Well-being. Measurable

improvement in well-being (reductions in

smoking, alcohol abuse, drug abuse, obesity,

stress levels, etc.)

3. Benefit-Cost Evaluation. Compare the benefits of

reductions in behavioral health problems (loss of

life, lost productivity, costs on family, healthcare

costs, etc.) with costs of educational

programming. …

4. Determine the number of Extension professionals

across all systems who have completed the one-

day MHFA training. Increase this in areas with

few trained Extension professionals.

5. Extension staff providing referrals to mental

health professionals or formal services of some

kind (could be housing services, detox facility,

etc.)—need to track this information.

6. Longer term: Drug-related mortality rates and

suicide rates should decrease.


Section 5

Opioid Crisis Response Plan

The P.L.A.N. is a concise project planning tool that will help you and your teams achieve success in

managing any project. It allows for a more innovative and creative approach to project management. It

supports you, the project manager, and your project team in improvising new and unique solutions. It

defines excellence and sets the stage for high performance. The P.L.A.N. is a collaborative tool, that

when properly implemented, develops winning solutions and more predictable results. It provides

sustainable implementation and sustainable ownership.

The acronym P.L.A.N. represents four key elements to project planning. These elements are Purpose &

Outcomes, Leaders, Action Steps, and Needs. It contains the simple, yet highly impactful ingredients for

accomplishing any type of project, large and small, with predictable success. Its use includes projects in

“for-profit” commercial and non-commercial businesses, volunteer and non-profit organizations,

government, healthcare, manufacturing, service, and a vast array of other businesses, communities, and

organizations. It may be used for construction, remodeling, or demolition projects, as well as projects at

home. It may also be used to plan events such as weddings, conferences, seminars, concerts, fairs, plays,

and so forth; to name just a few. These projects may also include areas of academia where term papers,

group projects, proposals, or dissertations are involved. You will learn to create a P.L.A.N. for every

project, change process, continuous improvement initiative, or new venture. There is no limit to the

invaluable resource and project planning tool the P.L.A.N. provides and brings forth.

The P.L.A.N. is for use by the novice through the veteran project manager, students, caregivers, parents,

teachers, homeowners, managers, entrepreneurs, and organizational leaders; anyone who has a project.

More often than not, it may be used by the “unintended or accidental” project manager whose career or

position title does not include the words project or manager. It is for use by individuals, groups, teams,

and whole organizations. It is understandable and user friendly. The P.L.A.N. is intended to be an

accessible and scalable tool that can be adopted across any system or organization. Used properly, and as

designed, it can save time and money for the individual, team, or organization undertaking any project or

implementing any initiative.

The creators of the P.L.A.N. took an evidence based model approach in the development of this project

management tool. This evidence model will help you, the project manager; determine “How well are you

on components of your project?” Use of the P.L.A.N. tool will help you, the project manager; achieve

predictable results that are on target, with what was intended. These “intended results”, or “robust

results” as they may be also referred to, will be achieved in-spite of unexpected events that may occur

during your project or initiative. Ask yourself, “How good are you in achieving your desired or specified

results?” “How robust are your plans or your planning process?” It will provide valuable, easy to

implement tools for project management.

You will be taught how to use the P.L.A.N. tool; maximize its effectiveness; learn how project

management need not be complicated; and organize your projects for success. A framework will be

provided to guide you through the steps of the P.L.A.N. If this is what you are seeking, desiring, or

looking for in your projects; then the P.L.A.N. is for you!


The US Land Grant Extension System

Opioid Crisis Response PLAN

Context

(presenting issue)

Approximately 54 million people in the United States have misused prescription medications including

opioids, resulting in more than 115 fatalities every day (NIDA, 2018). The reasons for the emergence and

escalation of the opioid crisis are numerous and complex. A critically important contributing factor was

misleading information released in the mid-1990s about the degree to which opioid painkillers are

addictive, which led to wide scale use of opioid painkillers (Avorn, 2017; Hansen & Netherland, 2016;

Van Zee, 2009). Today, the annual societal costs of opioid overdose, misuse, and dependence are

estimated at $78 billion (NIDA, 2018)., a figure that includes direct healthcare, child protection, lost

productivity, and criminal justice. The resulting impact on family well-being and community vitality,

particularly in rural areas, is often less quantifiable, but nevertheless devastating.

Among the hardest hit by the opioid crisis are the individuals, families, farms and communities we serve.

Extension is uniquely positioned for prevention, outreach, and education. While our federal, state and

local partnership model is a valuable asset, potential collaborators’ knowledge of Extension’s capacity to

respond effectively to this crisis could be increased. In order for Extension to effectively address the

crisis, Extension Committee on Organization and Policy (ECOP) has commissioned the Extension Opioid

Crisis Response Workgroup to assess the current capacity of Extension to develop a strategic framework,

informed by relevant literature, for coordinating a system-wide effort.


Purpose & Outcomes

The purpose describe how will lives be different, better off, once the plan is implemented. Make this a

one sentence response. The outcomes list the results that will be achieved. Imagine you are pleased and

proud of what the behavioral health community within Extension has accomplished with regard to the

opioid crisis. Provide a bulleted list of three to five outcomes:

Purpose: - Promote behavioral health and wellness through science-informed prevention,

education and outreach, to address the opioid-related crises.

Outcomes:

❏ Increase sustainable, multilevel partnerships (local, state, federal) to address opioid issues in

communities.

❏ Increase knowledge, skills, competencies of Extension Professionals to respond effectively to

the crisis and other behavioral health challenges.

❏ Increase the availability of education, prevention, and services for individuals and families in

the communities.

❏ Enhance individual, family, and community resilience to reduce the likelihood of opioid

issues.

❏ Reduce the prevalence of opioid and other substance misuse in the community.

❏ Empower the community to be more involved in every stage of planning and

implementation.

❏ Lift up the voices and involvements of persons in recovery, afflicted families and

vulnerable populations at every stage of strategic planning and implementation.

Note. Several comments were suggested that could be placed in other sections. Those include: logic

model terms, focusing on prevention and education, reaching consensus on evidence based

terminology, considering how outcomes will be measured, and ensuring that we will reach a diverse

audience.


Leaders & Stakeholders

This sections answers three questions. First, who will lead and facilitate the implementation of this plan?

Second, what groups will work together to coordinate the detailed implementation? Finally, who else will

need to be involved to ensure the plan is successfully implemented?

1. People Affected

a. Individuals with substance misuse/use; families and supportive persons engaged with

individuals with substance misuse/use; community members of high prevalence areas.

b. The role is to inform all phases of the plan including priority setting, implementation

strategies, outcome measures and dissemination.

c. Inform the application of science-based knowledge in the local context.

2. National Extension Organization

a. ECOP will develop and disseminate the system-wide plan and create a sense of urgency

in the system.

b. Engage national level partners such as USDA Rural Development, SAMHSA, HRSA,

and others to reduce duplication of services and increase efficiency.

c. Establish system for monitoring outcomes.

d. Mobilize the knowledge base of the land grant system to inform federal policy.

3. State Extension Organization

a. If it doesn’t exist each state needs to form a leadership team at the state level.

b. Identify state stakeholders to inform, implement and sustain plan.

c. Explore opportunities to collaborate with neighboring states or shared issues such as

demographics, etc.

d. I.e. Engage university researchers, social service agencies (i.e. healthcare, law

enforcement, treatment facilities, Department of social services …), policy makers,

response teams, business leaders, foundations; funding opportunities.

4. Local Extension Organization

a. Define role i.e. lead a collaborative; join a collaborative; do own program separately.

b. i.e. Engage university researchers, social service agencies (i.e. healthcare, law

enforcement, treatment facilities, Department of social services …), policy. makers,

response teams, business leaders, foundations; funding opportunities

c. Local education efforts on response (stigma; judgement, empathy); competency

(assessment of factors, ACES … and resiliency).


Action Steps Actions describes the steps to be accomplished by filling in the following table. Each step engages leaders

and stakeholders in order to achieve the purpose and outcomes. This is a starting point to the project

management process. Often, the following action items are elaborated with more details and sub-steps,

etc.

Key Action Who is

responsible?

Measures of Success

Finish the literature review (Part IV) and prepare

document for sharing; add information on contributing

factors into Part II from Annie and Mary Ellen

Alison, Dick,

Mark

Complete, well-articulated

document made available for

sharing by (when?)

Framework/guidance that will include a logic model with

short and long term goals; determine if there is one

common activity or intervention that can be implemented

in all of CES

EOCRW

Will require

follow-up virtual

meeting(s)

Determine what transition to Behavioral Health Impact

Collaborative looks like

EOCRW/BHIC Clear transition and articulation

of scope and responsibilities

carrying over from EOCRW

All requested documents are provided to ECOP in early

September

Extension Opioid

Crisis Response

Workgroup

Mark and Alison

will complete any

outstanding tasks

Members of the workgroup feel

we have produced valuable work

that provides clear direction for

CES

ECOP is satisfied with our efforts

Opioid Crisis website is updated to include all relevant

documents; website to include strategies and

recommendations

Rosa (once all

documents and

relevant info is

complete)

ECOP provides a formal statement based on our report,

and suggests strategies and recommendations that could

be implemented at state and local levels

ECOP Degree to which individual state

Extension respond and

successfully implement actions

Training for community educators on recommended

strategies (e.g., through professional Extension

organizations) ● Increase knowledge and reduce stigma related to

behavioral health

● Increase awareness of Extension best practices

● Educate on how the opioid crisis affects your work, life

and how you live

● Identify and adopt evidence-based programs that reduce

addiction

Professional

Extension

organizations;

eXtension

Behavioral Health

Impact

Collaborative

Educators and specialists expand work with communities

and other partners to implement activities to address the

crisis

CES leadership,

educators and

specialists

Educators and specialists begin to

take action

Reductions in opioid use,

addiction, and fatalities


Linking with groups that engage in advocacy, and

providing information and analysis to inform policy and

funding prioritization that will emphasize prevention

All levels of CES

Development of an HIA (Health Impact Assessment), a

neutral, fact-finding, nonpartisan document.

eXtension

Behavioral Health

Impact

Collaborative (?)

Develop local, state, regional, national and interagency

collaboration in order to:

● Break down silos

● Work smarter, not harder

● Share resources (perhaps via information portal)

● Provide trainings and/or forums on substance use

disorders

● Obtain funding through innovative strategies, such as

braided funding and private-public partnerships

Evaluation/Research

● Prioritize common language and understanding of

behavioral health and evidence-based prevention (e.g.,

clarify use of the terms “research-based” and “evidence-

based”)

● Develop a guiding science-practice framework and

corresponding logic model

● Standardized outcome measures

● Uncover examples or models that could facilitate meeting

goals


Needs

The “N” in P.L.A.N. is defined as the various needs related to completing the project. These are the

resources and tools you need to work successfully. These also include tools, technology, materials,

staffing/people. budget/dollars, and, of course, time allotted to work on the project.

● Funding (Budget)

○ Funding for capacity building.

○ Consistency or predictability for funding across multiple years.

○ Innovation funding - thinking out of the box through public and private partnerships.

○ Strategic, intentional funding.

● Leadership

○ Champions to our mission at national (ECOP), state (Extension Directors) and local.

○ Champions should cross all extension areas (agriculture, econ develop, etc.) to build

capacity within extension.

● Staffing & Support

○ Professional staff support.

○ Volunteers.

○ Champions should cross all extension areas (agriculture, econ develop, etc.) to build

capacity within extension.