John Sayles is the CEO at the Vermont Foodbank. In this interview he shares the story of the Cal-Essex Accountable Health Community, a Collective Impact initiative taking root in the Northeast Kingdom.
BBVT: What brought this group together?
John Sayles: The group was started in about 2013 by Paul Bengston at the Northeastern Vermont Regional Hospital, Patrick Flood at Northern Counties Health Care, Doug Bouchard at Northeast Kingdom Human Services, Joe Patrissi at Northeast Kingdom Community Action, Lisa Viles at the Northeast Kingdom Council on Aging, and Merten Bangemann-Johnson, RuralEdge Director at that time. And, of course, Laural Ruggles and Pam Smart of NVRH. They got together and realized that they were all serving the same people but not coordinating what they were doing. They were intrigued by concept of Collective Impact and how could it be done in the Northeast Kingdom.
How did the Vermont Foodbank get involved?
I heard about it at a governor’s council on pathways from poverty meeting when Patrick Flood and Joe Patrissi were talking about doing Collective Impact in the NEK. I shared that I had been doing some work on that nationally and asked if I could come to their meeting. I was so impressed with the work that they were doing that I asked to keep coming back.
How is the group structured?
Seven organizations have officially signed the MOU. We received a one of five three-year, $280,000 grants through Feeding America. The purpose of the grant is to create a structure behind the work that we’re doing and figure out how to create a backbone organization, and actually spend the time and the resources to create shared outcomes and the indicators.
You are familiar with both RBA and Collective Impact at this point. How do you see the two working together?
Feeding America and the Arnold Foundation hired the Urban Institute to be the national evaluator. The Urban Institute decided that results-based accountability would be a useful tool to be able to evaluate these five separate initiatives across the country against each other when each is going to be so different. RBA is good at that, at taking a lot of variance and creating something where you can look apples-to-apples at what people are doing.
I think that RBA and Collective Impact work together just beautifully. Collective Impact is not at all about what any one individual organization is doing, so it’s not about your typical kind of metrics, not about performance measures. Really, to do Collective Impact right you have to have population-based outcomes. Having a structure that helps everyone in the group get their head around difference between population level outcomes and program measures is really helpful.
Is there an outcome or indicator that you are working on in particular?
We have our five population level outcomes. In particular we are working on “our population is healthy.” A lot of what we’re doing is very healthcare focused. Some of the driver for this is healthcare innovation and change happening in the State of Vermont. In addition to being the Cal-Essex Accountable Health Community we’re also the community collaborative under the Blueprint for Health , so we’re reporting to the Blueprint, and the One Care VT regional clinical performance committee, one of the committees that evaluates health outcomes and clinical outcomes for the statewide accountable care organization. The idea was, we’re all meeting together anyway, let’s integrate different things that are happening in the community into this one group instead of trying to replicate groups over and over again.
How have you approached getting the steering committee and backbone up and running?
We meet once a month. The hospital is the hub, and we meet there. Paul and Laural at NVRH provide all the technical support we need for that. The amazing thing about this initiative is that it has been going on almost three years, and it’s still all CEOs and executive directors coming to the leadership meetings. We have a very open and inclusive culture. Anyone and everyone is invited to come to the meetings, listen to what’s going on, and participate. I think it’s great. In a community like the NEK people want to know what is going on. It really feels that it is our backyard.
Where are you now and what’s next?
Right now we have determined population level outcomes, we have determined our indicators for those outcomes, we have done a scan of the environment to see what groups are out there already working on these issues.
One of the interesting things about Collective Impact, you set your leadership table and then you have work groups in the community working on different aspects of your shared outcomes. But in NEK there are already groups working on these things. It would be insulting to them to start new groups. So right now we’re in process of creating deeper relationships with all of these groups.
We have Susan Ohlidal onboard full-time. She is our project coordinator and community liaison, building relationships with people and groups. Our next stage is to help those groups understand what we are trying to accomplish and then get buy-in. Not to take over, but to get them to share their success with our project so that we can all measure it together.
A lot of groups in Vermont are taking their first steps toward Collective Impact. Do you have any advice for people taking on Collective Impact in rural environments?
The biggest things are: know that this is going to take time, just getting everybody on the same page and figuring out your shared goals can take two years. And in those two years, you’re learning about each other and building trust. That’s one of the amazing things about this group in the NEK, the level of trust among the people at the table. If you don’t have that trust you’re not going to succeed. You can build that trust by creating small wins which is what we did. There were little discreet projects that we were able to all work together and share information and share resources and accomplish them. And then we were able to celebrate that. It has really given us the momentum to keep moving forward.