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Creating New Governance Structures

Creating New Governance Structures
(Fall 1994 Networkshop)

California: A Collaboration

From California, presenter Judith Chynoweth, Executive Director for the Foundation Consortium for School-linked Services, described the history, structure, and goals of the Healthy Start initiative. Rachel Lodge, Director of the Healthy Start Field Office, described Healthy Start and discussed barriers to implementing collaborative governance structures at the local level.

Judith Chynoweth described the California Partnership for Comprehensive, Integrated, School-linked Services as the intersection of two "circles" of collaboration. The first is a collaboration of 15 charitable foundations "to improve outcomes for children and families." The second represents a collaboration between the Governor, the independently elected State Superintendent of Schools, and the state agencies who serve children and families (the Department of Education and the Health and Welfare Agency, with its departments of Social Services, Health, Mental Health, and Alcohol and Drug Abuse). The Partnership is created where these two circles intersect. Partnership efforts were focused initially on legislation (Healthy Start, Senate Bill 620) providing state funds to school districts for collaborations at the local level. After negotiations during a year of "struggle and pain," the Partnership signed an Agreement in Principle with the following objectives:

• to create models of comprehensive, integrated, school-linked services at the local level (Healthy Start legislation);
  
  
• to create stable finance mechanisms (at present, a Medicaid billing option for school districts and a requirement for reinvestment of Federal funding into expanded services); and
  
  
• to create significant, sustained changes in the service systems (a new objective that presents great challenges to existing state structures).
  
  

Rachel Lodge explained that Healthy Start funds were first distributed to communities in the spring of 1992. At the time there were a number of significant recognitions: that many students have problems beyond the capacity of schools to address, that the current service system was severely fragmented, and that an existing school-reform movement could draw schools into new collaborations. Competitive grants are awarded to school districts that meet certain criteria (essentially, those qualifying as serving low-income areas). At present, California has 65 Healthy Start sites in implementation, with 170 in planning.

Because the character and objectives of communities vary widely, the nature of Healthy Start governance structures is driven by site conditions. Although program applications must include documents demonstrating significant collaboration among school, community, county and city service agencies, non-profit organizations, and families, no "list" of specific participants or representatives is prescribed and outcomes are locally determined (and thus vary from site to site). Some sites are governed by structures newly created via formal agreements among collaborators; others are governed by already existing collaborations that have been in place for some time and are now taking on the direction of the local Healthy Start initiative.

California is in the process of addressing some issues that have emerged as the Healthy Start initiative develops:

• Structuring. Perhaps the most effective local efforts draw leadership from the highest level in the county together with both mid-level decisionmaking and with community-based, family-oriented subcommittees. Real integration of higher- and lower-level bodies is difficult to establish but critical.
  
  
• Proliferation of collaborative groups. In some geographic areas 40 or 50 interagency collaborations exist with only limited interconnections.
  
  
• Early and strong family participation. This focus is important not only in making a program meaningful to the community but also as an intervention in itself, allowing families to gain control over issues that are of concern to them.
  
  

Chynoweth concluded the discussion by enumerating the following lessons learned from the Healthy Start experience:

1. Efforts to establish governance structures and facilitate service integration must move from "top-down, bottom-up, and middle-sideways" directions simultaneously. Illustrating this point, Chynoweth pointed to critical mid-level agencies. In California, while Healthy Start money goes directly to schools, money for social services is channeled through the county; yet no efforts were made by the state to include county-level government in planning and implementing Healthy Start collaborations. When Healthy Start created a greater demand for funding and collaboration than the state could accommodate, most Healthy Start sites made connections on their own with their respective county governments. Subsequent recognition of counties' limitations in responding to the need for school-linked services in a broad and systematic way resulted in a state-sponsored capacity-building policy academy for nine counties.
   
   
2. Local experimentation and capacity building is critical. Public policymakers at the top cannot adequately understand realities at the local level.
   
   
3. A big vision needs a specific work plan. The goals of the Agreement in Principle have enabled California's initiative to move forward.
   
   
4. State-level agencies and systems must also be committed to internal change if they expect local communities to change.
   
   
5. Outside forces can be stabilizing to the initiative. In California, the foundations have provided resources, continuity, and pressure to keep a "right focus."