Donna Mills is the Executive Director of Central Oregon Health Council. The Council convenes stakeholders across the health ecosystem to create and implement programs in service to the mission of better health, better care, and better value for healthcare in the Central Oregon Region. As a seasoned healthcare professional with experience in leadership positions in healthcare, finance, and operating management, Donna has a proven track record recommending and executing business and financial solutions and initiatives, ultimately contributing to an organization’s financial results.
- When stakeholders focus on the populations they all serve, rather than on the needs of their respective organizations, the conversation changes and the door to collaboration opens.
- Rather than duplicating efforts and competing for resources, organizations should share with one another their work in a particular area and look for opportunities to collaborate in ways that advance the goals further then when they operate independently.
- Past tensions ease when you bring unlikely partners around the table and create an open dialogue.
- Deep, meaningful relationships are the bedrock for developing collaborative solutions among diverse stakeholders.
TLD Group: Can you tell us about the Central Oregon Health Council (COHC) and your role in the organization?
Mills: The Council was founded in 2011 as a governing body to provide PacificSource Community Solutions – the region’s coordinated care organization (CCO) – with community oversight, involvement, and transparency. The Council’s board is made up of stakeholders from healthcare providers, local governments, educators, community-based and non-profit organizations, and other entities in the region. These partners came together to create a Regional Health Improvement Plan (RHIP), which is defined by The Centers for Disease Control and Prevention (CDC) as “a long-term, systematic effort to address public health problems on the basis of the results of health assessment activities and the health improvement process.” In essence, the improvement plan defines the vision for the health of the community through a collaborative process and offers strategies to improve the health status of that community. My first official duty when I became the Executive Director of the Health Council was to finalize and launch the improvement plan. The first step was to create the Regional Health Assessment (RHA), in partnership with the local Health Departments and other stakeholders, to determine the community’s top health concerns. Themes from the data were then prioritized based on impact, preventability, controllability, and feasibility. The stakeholders, along with the COHC Board, went through a vetting process to narrow the number of areas of focus. This resulted in 8 pillars of health to be addressed by the RHIP:
- Behavioral Health: Identification and Awareness
- Behavioral Health: Substance Use and Chronic Pain
- Cardiovascular Disease
- Oral Health
- Reproductive and Maternal/Child Health
- Social Determinants of Health Part One: Education & Health
- Social Determinants of Health Part Two: Housing
The current process includes workgroups aligned with each of the RHIP areas of focus, who collectively decide how they can impact change and improve the health of our communities. Each of these groups, with a COHC facilitator, uses the Lean tool known as an A3 to fully understand gaps, measures, and impact to the current metrics. Upon completion, they will look at strategic investment opportunities and requests; they may consider several key tactics such as funding, aligning incentives, contracts, policy, demographic focus, maintenance and/or aligning efforts. Each workgroup is seeded with $250,000.
TLD Group: Can you tell us about how you work with your board to gain traction on the region’s health improvement plan (RHIP)?
Mills: When I was hired, the board had a strategic plan on the books, but it just wasn’t moving forward. It became apparent to me that the board was not very cohesive; they could not take off their organization’s “hat” when they were in the board room. Frankly, I don’t want them to – they are on the board because they have the perspective of their stakeholder group. But the purpose of the Council, and the reason they are sitting on the board, is for them to be able to talk about a broader set of health goals and translate it back into their organization. For that reason, I charged my board members with the task of incorporating the RHIP into their own organization’s strategic plans. They agreed, and began to bring the goals and mission of the RHIP back to their own organization’s board and interwove it into their strategic plan.
TLD Group: What are some examples of cross sector partnerships that have been successful within the Central Oregon region?
Mills: When the RHIP was completed, we put an ad in the paper to recruit volunteers, and they essentially self-identified which pillars they felt they could impact. We then did a gap analysis to determine other stakeholders that should be in this representation area. For example, in the Oral Health workgroup, one of the goals is to provide dental care in non-traditional settings. The low-hanging fruit would be to engage the school systems, homeless camps, or even churches. I have a great liaison with one of the larger churches who does a lot of community outreach. I asked that person if they could come to the group, share with us what work they were doing and how they were doing it, and brainstorm ways we could work together.
Another thing that we do is have each of the players present the work they’re doing within their own organization to educate one another and determine if there are opportunities for collaboration. Oftentimes, workgroups within the Council are competing for funding to support their initiatives. However, in some cases we have found that groups are duplicating efforts, yet their initiatives could be streamlined by establishing partnerships. As an example, we had found that there were three different organizations within the same workgroup that were each running their own reading programs. Rather than competing for funding for their respective programs, they decided to pool their resources to advance their goals further than any stakeholder could do independently.
TLD Group: How do you create collaboration among organizations that have competing priorities?
Mills: The biggest challenge is establishing credibility for the Council. The problem is that there is a lack of understanding about the Council’s purpose and the projects the workgroups are supporting. To me, the Council represents all citizens of the region of Central Oregon. It’s not just the governing body of the CCO – it’s about the community, and about population health. When we’re in a Health Council meeting of any sort, there are definitely competitors in the room, but the underlying mission of the Council is to promote better health for the people we serve. When you can get the focus on the citizens as opposed to what “my” organization is here to do, it changes the conversation and opens the door to collaboration.
TLD Group: What is an example of your greatest challenge and how did you overcome it?
Mills: I have heard it said that all problems were at one time a solution. Stepping into a new role can be daunting. The trick is to ignore all back stories. Knowing the players in a community or region can have its advantages, but in most cases the ignorance regarding history, can serve you well. In this case, there were definitely some long-held grudges, and resentments. By inviting the least likely partners to the table, and speaking from a position of ‘new’ it is amazing how some of these tensions ease. Of course, some have taken longer than others, but we are still a work in progress. Another challenge that I struggle with is having enough time to be engaged with all of my Board members. There are 14 of them and one of me. I am experimenting with two per month to try to engage them all to the best of my ability.
TLD Group: What is your greatest success as Executive Director of the Council?
Mills: This is a community success. There is nothing I can do alone that would have brought Central Oregon to the place it is today. The meaningful and deep-rooted relationships are the bedrock of the work we have been able to accomplish. I am grateful to have been in the right place at the right time. The leadership of the Health Council outlined a vision that resonated with me and they empowered me to go after that vision. To say that we have only just begun is an understatement.