Revisiting the Critical Elements
of Comprehensive Community Initiatives

A Study Conducted by Staff of
The Office of the Assistant Secretary for Planning and Evaluation,
United States Department of Health and Human Services

By
Bruce Gray
Angela Duran
Ann Segal

February 1997

The ASPE Study Team included Kathleen Bond, Disability, the Office of Disability, Aging and Long-Term Care Policy, Barbara Broman, the Office of Human Services Policy, Angela Duran, the Immediate Office of the Assistant Secretary, Bruce Gray, the Office of Human Services Policy, on detail from the Health Resources and Services Administration, Emily Novick, the Office of Human Services Policy, Ann Segal, Team Leader, the Office of Human Services Policy, Richard Silva, the Office Human Services Policy, Carolyn Taplin, the Office of Health Policy, and Hal Wolman, the Office of Program Systems.

ACKNOWLEDGEMENT

We would like to thank the administrators, board members, and staff of the following organizations, as well as those residents and administrators from collaborating institutions with whom we met. Visiting the initiatives and meeting with such a committed, wise set of people humbles and enriches those of us involved in policy development. We are extremely grateful for their participation, enthusiasm and honesty. We offer the cross-initiative lessons and insights that they shared with us in the hope that such information will prove valuable to the field.

Center for Family Life in Sunset Park

345 43rd St.

Brooklyn, NY 11232

Sister Mary Paul, Director of Clinical Services

Codman Square Health Center

6 Norfolk St.

Dorchester, MA 02124

Bill Walczack, Executive Director

Dudley St. Neighborhood Initiative

513 Dudley St.

Roxbury, MA 02119

Greg Watson, Executive Director

Eastside Community Investments, Inc.

26 North Arsenal Ave.

Indianapolis, IN 46201

Dennis West, President

Greater Germantown Housing Development Corporation/Germantown Settlement/Wister Neighborhood Council

48 East Penn St.

Philadelphia, PA 19144

Stephen Kazanjian, Executive Director/CEO (GGHDC)

Emanuel Freeman, Executive Director (GS)

Grace Hill

2600 Hadley St.

St. Louis, MO 63106

George Eberle, Jr., President

El Puente

211 South Fourth St.

Brooklyn, NY 11211

Luis Garden Acosta, President and Founder

Local Investment Commission

3100 Broadway, Suite 226

Kansas City, MO 64111

Gayle Hobbs, Executive Director

Marshall Heights Community Development Organization, Inc.

3917 Minnesota Ave., N.E.

Washington, D.C. 20019

Lloyd Smith, President and CEO

New Beginnings

Department of Social Services, Room 843

1255 Imperial Avenue

San Diego, CA 92101

Connie Roberts, Director

New Community Corporation

233 West Market St.

Newark, NJ 07103

Monsignor William Linder, Founder

Sandtown-Winchester Community Center

1114 North Mount St.

Baltimore, MD 21217

Ronica Houston, Executive Director

Swope Parkway Health Center

3801 Blue Parkway

Kansas City, MO 64130

E. Frank Ellis, President

The Walbridge Caring Communities Program

5019 Alcott Avenue

St. Louis, MO 63120

Khatib Waheed, Director

A special thanks to Anita Miller, Program Director, Comprehensive Community Revitalization Program (New York), Mitchell Sviridoff, Professor Emeritus and Senior Fellow in Urban Policy at The New School for Social Research (New York), and Bob Bolter, President, Jubilee Enterprise of Greater Washington (D.C.), for their advice and assistance.

Contents

Introduction

Background

Initial Project Development

Visit Methodology

Principal Reasons Why Initiatives Have "Survived"

Key Elements

Mission/Vision/Philosophy

Leadership/Management

Responsiveness

Community Participation

Collaboration

Finance

Final Thoughts

I. INTRODUCTION

This report is based on a study of a set of comprehensive community initiatives (CCIs) from across the nation. Those CCIs chosen were subjectively judged to be successful in moving toward their goals by informed experts and met the following criteria: they have been operational for at least the past five years; they are focused on improving the status of children and families; they use multiple funding sources; they provide multiple services and supports; and they are large enough to have the potential for significant impact in a community.

The study focuses on the lessons and insights gained through the experiences of these initiatives. Project analysts first reviewed the conventional wisdom concerning elements necessary for such efforts to survive (used as a proxy for success), then conducted site visits that involved extensive discussions with executive directors, staff, board members, community residents, and partner agency administrators. The wisdom offered during these discussions is distilled here in the hope of informing the field and guiding federal activities.

The study was conducted by staff of the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services. The office is responsible for policy development, policy analysis, planning, and evaluation and research related to all issues of concern to the Department, including linkages of Department programs to other public and private sector services and supports.

II. BACKGROUND

For many years, experts in the field of child and family services have encouraged the development of comprehensive support strategies. This approach reflects the understanding that the needs of children and families vary greatly--individually, as a family unit, and over time--and that a number of children and families have a multiple set of needs that must be met in order to move toward self-sufficiency. No one service or support can be expected to yield significant results if a child or family is overwhelmed by unaddressed problems. In recent years, many experts in the field of child and family services have broadened their vision to include a stronger focus on community development and employment as crucial to achieving their goals.

Experts in the field of economic development have also come to recognize that their success depends on broadening their strategy. Until the early 1990s, these experts had largely focused on reclaiming a neighborhood through improved housing and employment opportunities. They have subsequently begun to include a wide variety of health and social services for the community in their plans, recognizing that many people need such supports to achieve and maintain self-sufficiency.

As those from various fields have moved closer toward adopting a shared view of what is needed to gain positive outcomes for children, families, and communities, numerous articles and books have articulated the principles and steps believed most important to building comprehensive support systems. These lessons were culled from observations of the early initiatives, which were most often funded by foundations or government grants. Perhaps the most frequently identified lessons have been that making significant changes in service systems and revitalizing communities is extremely hard and often frustrating work and that each effort is idiosyncratic, formed by the circumstances of the community and the resources available.

Those who believe in comprehensive change strategies and recognize the difficulty of achieving them have long advocated rigorous evaluation to prove its value. In a day of cynicism about interventions for vulnerable populations and a day in which evaluation has become an increasingly influential part of the budget decision process, having proof of success can be essential. However, few experts in the field would argue that there is a reliable evaluation design for the type of community-wide initiatives that feature multiple intervention strategies. Consequently, though evaluators are making progress in this area, it remains difficult at this time to document success or test the elements of success for CCIs.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the United States Department of Health and Human Services has long maintained a commitment to encourage the creation of comprehensive, community strategies for assisting low-income children and families. This commitment has led the Office over time to support related policy analyses, planning grants, case studies, technical assistance materials, and evaluations, as well as to support the development of new evaluation strategies and related legislative and regulatory proposals.

III. INITIAL PROJECT DEVELOPMENT

As the Federal Government, states, and communities undertake significant changes in the way they do business, it is unclear to what extent communities will take advantage of this shift in decision-making authority to the local level by restructuring their services and support systems. As decisions are made, it is important for all those involved in policymaking, and in the creation and support of comprehensive initiatives, to re-examine the early lessons found in existing literature. How have those lessons held up over time? What revisions or expansions to the lessons are required?

In 1996, then-Assistant Secretary Peter Edelman approved a plan to have ASPE staff conduct such an analysis. In an ideal situation, the analysis would have assessed both successful and failed initiatives. However, ASPE was faced with limited resources for such a study, as well as with an inability to interview a wide range of participants in initiatives that had failed. In addition, the absence of strong evaluation findings made it difficult to identify successful initiatives. Consequently, this Office decided to use two tests as proxy measures of success: (1) "survivability," defined as being operational for at least five years and having multiple funding sources (so that one, single source of funding does not explain survival) and (2) the judgment of a number of experts in the field that they believe an initiative is having a real impact on its community. The decision to select this proxy was based on the idea that for a comprehensive initiative to survive over time in a community and to garner the resources needed to survive, it must be perceived as having significant value for that community.

Once a proxy for success was developed, a study team of ASPE health and human services analysts was recruited, under the direction of Ann Segal, Deputy to the Deputy Assistant Secretary for Human Services Policy, to reassess the elements of success. The team began by defining broad eligibility criteria for the initiatives to be studied. (See Introduction) The team then reviewed the literature and interviewed a set of experts to identify both those elements cited as essential for success and candidate initiatives that met the established criteria.

The team ultimately selected a set of fourteen initiatives representing varied developmental paths and origins (e.g., health, community development, education, social services), and identified five areas in which they sought to test the conventional wisdom as to what makes a CCI program succeed: leadership/management, comprehensiveness, community participation, collaboration among community partners, a family-centered orientation, and financing. It was initially assumed that these terms and phrases would prove useful in grouping the information gathered. For the most part, they serve as subject headings in Section VI below.

In two cases, however, the initial labels proved inappropriate. Contrary to our assumption, "comprehensiveness" was rarely mentioned; it apparently connoted too great a focus on a possible end result of community change, rather than the process itself. Consequently, it was replaced with the concept of "responsiveness," which better embodies the respondents' belief in the importance of an organic growth process related to community needs. Secondly, the concept of a "family-centered approach" was identified only by some of the front-line human service workers, and therefore, it did not prove to be a useful organizing principle for this study of broader, comprehensive community initiatives.

The final result is that the data from our interviews and observations are organized around the following themes:

1. Leadership/Management
2. Responsiveness
3. Community Participation
4. Collaboration
5. Finance

IV. VISIT METHODOLOGY

During the summer of 1996, project analysts visited the selected initiatives and interviewed a variety of people--executive directors, staff, board members, community residents, and partner agency administrators--working with and served by each initiative. Project staff consistently sought to meet with individuals from various professional levels and perspectives. Interviews tended to last from one to two hours and were loosely based on a discussion guide developed by project members and field tested at one site.

The intent of this study was not to develop case studies or to profile the initiatives. The intent instead was to gather together lessons and insights that could be shared with those in the field striving for similar results. Interviewees were guaranteed confidentiality, unless they wished otherwise, and were assured that the findings would not be used in any program audits. After the visits were completed, all findings were discussed with the entire team and a draft report was prepared. That draft was reviewed by all team members, selected experts, and various initiative representatives.

Four additional caveats should be stated at the outset.

• There is no single template, or limited set of models, for such initiatives. Project members never assumed or claimed as much, nor did those interviewed. Context largely dictated the decisions and actions of each initiative. Consequently, the lessons learned from the projects profiled in this report may not be applicable to other communities.
• Project staff recognize that our selection criteria eliminated from consideration many initiatives whose directors, staff, and residents would have provided valuable advice on community revitalization. Even among those eligible, moreover, selection was not random, but based on considerations of initiative origins, geographic balance, and project logistics, to name but a few. What we present in the following pages is representative only of those initiatives visited, if even that much may be claimed.
• Project staff decided not to define terms such as "resident" and "community" in advance, but rather to accept the operational definitions applied at each site. Consequently, the meaning of such terms varied widely not only from site to site, but among interviewees at a single site. Project staff made every reasonable effort to probe interviewees for specific meanings when such terms were used.
• Many of the sites acknowledge that they are still far from where they would like to be in terms of initiative "success." As one board chair put it, "we don't think we have anything more than a start."

V. PRINCIPAL REASONS WHY INITIATIVES HAVE "SURVIVED"

The following are, in essence, those primary lessons learned from those interviewed concerning the survival and success of their community-change initiatives.

• Most of the sites took advantage of a catalytic event early in their development. Several grew out of street riots and subsequent business closures in their communities. According to one executive director, the planned closing of the only branch bank in the community "initiated the hell out of people." Other initiatives formed in the wake of tragic deaths and general gang violence, or were galvanized by city planning processes which largely ignored local input.
• The sites tended to expand organically as needs arose and related opportunities were identified or developed. While most initiatives had a strategic planning process and document, these provided general parameters rather than a rigid guide. "It's more like improvisational jazz," explained one interviewee. "There's no 'score' available." This flexibility applied to both strategies and tactics. According to one staff member, a successful initiative "has to live with a lot of ambiguity and tension." How initiatives chose to deal with such tension played a significant role in their survival.
• A sustained and visible signature development or effort is apparently critical to initiative success. Housing development is perhaps the most notable example of such an effort. One executive director noted that "people like to see well-maintained buildings," particularly homes. Other signature efforts include a shopping mall, open space development, and weekly drug marches. Each of these visible improvements apparently persuaded residents that the initiative could produce results and was there "to stay." Such obvious benefits, in the form of "small steps," are also needed early on to create and sustain momentum.
• Most initiatives studied had charismatic leaders with either an entrepreneurial bent or an ability and willingness to hire such individuals. Many of the initiative administrators visited spoke of developing for-profit affiliates and running their organizations like a business, with an eye on bottom-lines and self-supporting service programs.
• Descriptions of what "collaboration" entails varied widely among sites. If defined as a joint governance structure, collaboration is rare and not a priority for most of the sites visited. Forming alliances between autonomous organizations, however, was frequently cited as a key element of success and growth.
• The presence of a solid working-class population base in the community is crucial to leveraging outside resources. Without even a modest base of economic clout, it is extremely difficult to leverage such resources.

• Those interviewed stressed the importance of adequate, stable, and flexible financing. Decategorization of funding was acknowledged as an "enabling or facilitating" trend. It was not generally cited, however, as a "necessary condition" for change.

VI. KEY ELEMENT DISCUSSIONS

Mission/Vision/Philosophy

Various interviewees made the following points regarding the mission, vision, and philosophy of their initiatives:

• The vision and mission are clear, well-understood, and shared by the executive director, staff, board, partners and community alike. The leader has a clear sense of what is needed, as well as the ability to pursue a vision faithfully but with flexibility and responsiveness to opportunities. Various executive directors spoke of "keeping the vision in the details" and sticking to concrete service needs. One interviewee quoted a Sufi proverb: "Look to the stars, but first, tether your camel."
• The initiative's desired goals and outcomes are whatever the community wants them to be. For some initiatives, the philosophy is to facilitate empowerment, even to the extent that there are no right or wrong outcomes. One initiative staff member maintained that "the neighborhood council is the hub organization and we're all the spokes."
• The mission is sustained and frequently revitalized. Various interviewees mentioned the need periodically to renew an initiative's sense of purpose. One director of a community health center argued that many centers have gotten away from their original mission: "We've forgotten how to advocate and agitate. We've forgotten how to make a ruckus." Others spoke of the need to nurture new leadership in order to sustain mission.
• Leverage of existing resources and programs is the primary operational principle for survival and growth. As one administrator said, "It is important to keep building on what we do well." The director of finance for the same site elaborated on this theme: "Everything we do here feeds off other things." This notion of leverage is consistent with the incremental, organic growth process advocated by most of those interviewed.

Management/Leadership

Almost every site mentioned strong leadership and management as a reason why its organization has survived as long as it has. Below, we describe some of the specific points about leadership and management that were made by those interviewed.

• The leader and staff have the ability to develop and maintain a sense of hope and momentum, as well as to choose and pursue resonant issues and themes. In one community, the smell from illegal garbage dumping was so bad that children were vomiting just from walking outside. Tired of surveys and inaction, residents began a campaign titled "Don't Dump on Us"; the phrase clearly implied far more than just garbage and effectively galvanized the community. Another initiative managed to "keep the mythology (of its success) going" beyond an initial housing redevelopment; in the three years after the renovation was completed, 38 businesses started up in the community. Both initiatives used the media effectively. "If people think things can get better," the administrator of the latter initiative argued, "they will get better."
• Planning and action are blended and balanced. "Plan and do simultaneously," counseled one administrator. Don't wait for that elusive "comprehensive planning moment," when everything comes together, but rather find workable points of entry into even the most significant problems. Most interviewees warned against initial comprehensive planning without quick, tangible results (e.g. "we didn't need a plan to tell us we had no doctors or supermarkets"). Others, however, argued that initial planning should be conducted as "total, unlimited, unrestricted dreaming" and that participants should not focus on specific strategies until an adequate level of "commonality" has been achieved among those involved. Both positions, however, tended to advance planning first and foremost as an opportunity to "build neighborhood ownership" and to achieve consensus around a plan of action.

The Leader

At almost every CCI, interviewees spoke of the importance of a strong, caring, and committed leader. Below are some of the descriptions commonly heard and examples offered:

• The leader is "charismatic." He or she is able to inspire commitment and confidence from those around him or her, especially residents of the community. The descriptions heard from staff, residents and board were essentially consistent: "he still has fire in the belly...she sees the future . . . he's for the neighbors . . . he's down to earth." Specific styles, though, understandably differed. Leaders developed trust and demonstrated commitment to residents by such actions as living in the community, maintaining an open door policy, and taking "the time to know people's names and how old their kids are."
• The leader is willing to hire staff who are "smarter" than himself or herself. Strong leaders bring in staff who add to what they know and who aren't afraid to either take initiative or disagree when appropriate. "You always hire people that are brighter than you," noted one administrator, only partly in jest. The leader also develops leadership throughout the organization by extending appropriate authority and autonomy.
• The leader and/or the board are able to develop buy-in from at least one significant political player or level of government. Strong leaders have an easier time developing political access if they can offer legitimate quid pro quos, such as community support. The leaders generally demonstrated an ability to work effectively at both the grassroots level and upper political and corporate echelons. One executive director was described as "an interesting combination of 1960's grass-roots activist and experienced 'player' within the state and city power structure."
• The leader is there long enough to create "buy-in." Effective founding administrators are there long enough to develop stability and organizational momentum. They tend to create continuity through members of the board and the residents, to develop strong external supporters, and to introduce solid management and fiscal practices. Integrating all these pieces takes time, sometimes perhaps a decade or more. A stable second level of implementers is critical, especially when the leadership does change.
• The leader is bold and willing to take risks. One executive director held a press conference in 1979 condemning the incumbent mayor for neglecting his community. This resulted in a dialogue which ultimately led to formal mayoral dedication of a new facility 3 days before the 1980 election. The same administrator also successfully solicited the chair of a citywide bank to lead his organization's capital campaign. As a young banker, the chair had served for two months in a branch located in the initiative community. Based on this knowledge, the administrator sent an unsolicited promotional package--complete with balloons--to the chair extolling the business opportunities available in the community, then followed up with a phone call and request that they meet.

Many of the sites visited have engaged in extremely ambitious undertakings. One offered to build a road abutting its facility if the city would agree and allow it to issue a bond. The initiative had a track-record of such undertakings; several years earlier, it had raised the ground for its new center by 40 feet. Another site, a community health center, purchased a former nursing home. At the time, the center had very little cash to invest in renovation and faced grim fundraising prospects. The purchase energized the community, however; funds were eventually secured, and today, the health center is located in the renovated space. "Be bold," counseled one director of finance. "Don't take no for an answer."

• The leader owns his or her mistakes and learns from them. One executive director argued that "you have to be willing to eat crow" at times. Another spoke of recognizing one's own limits: "I back off when I see myself as a problem." Initiative leaders also tended to support the need for staff and residents to make, and learn from, mistakes. At one site, various members interviewed echoed what would appear to be a well-established initiative "mantra": "Our mistakes are our greatest learning opportunities."
• The leader is patient. Community process takes a long time. It took four years for one initiative to arrange for appropriate funding to move forward on a housing development project. Early on, the city had accepted the neighborhood plan and offered funds, prompting residents to demand why the initiative was "dragging its feet." Initiative administrators, however, continued to hold off closing on a significant loan because they felt the issue of affordability had not been adequately addressed. They needed time--and more funding than then available--to narrow the gap between the estimated price of the housing and what staff considered an affordable price for area residents.
• The leader and staff generally have a good sense of humor and a keen understanding of its uses. Humor can diffuse many tense situations and create unexpected opportunities. One initiative sought eminent domain over a particularly distressed portion of its neighborhood. When initiative administrators first met with city officials to make their case, the tension was palpable. To diffuse the situation, the initiative director started his presentation by announcing that he and his fellow residents sought eminent domain over the following geographic area. He then proceeded to unfurl a map of Planet Earth. The initiative was eventually successful in its quest.

The Staff

Solid leadership capacity was not limited to the executive staff of those initiatives visited, but was well-cultivated throughout the organization. Interviewees revealed the following characteristics of staff as similarly crucial to initiative success.

• Staff are committed and consistent. Many staff revealed "a real desire to affect people's lives" and a deep-seated commitment to the communities in which they work. (See the Community Participation section for specific examples.) They also tended to acknowledge that "there is no finish line" and that "you can't fix the system with a career."
• Staff are both well-trained for specific responsibilities and cross-trained for others. The extent and quality of such training varied dramatically even among this small and selective sample of initiatives. Where valued, however, such training contributed greatly to staff morale and efficiency. At one site, staff are eligible after six months for considerable support should they decide to pursue additional training or education. "At other agencies," a staffer explained, "you have to beg to go to conferences, and even then you often end up paying some out of your own pocket." Staff are also often cross-trained to take on each other's responsibilities.

The Board/Governance

Initiatives use a range of board and governance structures to get people from the entire community involved in making decisions. On the one hand, they may have an executive board with a range of members including residents, service providers, philanthropists, and business, civic, community and political leaders. On the other hand, they may have smaller neighborhood advisory bodies comprised of just community leaders and residents and a separate board strictly for fund-raising purposes.

The range of decision-making authority also varies. Boards may just provide a rubber stamp approval of staff or community proposals or actually develop ideas and implementation plans and present them for a vote. In one example, neighborhood advisory groups develop proposals which are then sent to an overarching board for approval.

While the structures and decision-making may vary, there are nonetheless certain lessons to share regarding such bodies:

• Boards are made up of people with a range of expertise. One executive director spoke of tapping into "different types of prestige," from community activism to high-level politics. Several administrators maintained that "(residents) are your best advocates when you need help from the city." Others argued that you need talented members who understand "the business" and have the right "skill sets." One initiative has quite consciously cultivated power brokers who do business in or live in the city and the surrounding area, while several others have formed separate boards to give technical advice or to help raise money. Establishing such a board, if it is to be effective, requires adequate political clout and savvy.
• The board is informed, functional, and relevant. Some boards lapse into a small circle of decision-makers, due either to unlimited terms and little rotation or an overly dominant core group. One administrator realized the latter was a problem when board members who were relatively quiet during monthly board meetings subsequently approached her to complain that certain issues had not been brought up. It is also important to keep all board members informed and committees functional.
• Board members are aware of their role as representatives. Elected officials around the country often talk about the "them" they are representing. The attitude at many of the sites visited is significantly different. One initiative board member summed it up nicely: "I was elected to represent us."

RESPONSIVENESS

By definition, all the initiatives visited were "comprehensive," yet as previously mentioned, few of those interviewed, without being prompted, described their initiatives as "comprehensive" or claimed that they offered "comprehensive" services. "The goal of the initiative is to meet the diverse needs of the population," one executive director told us. "It isn't to be comprehensive in some abstract way." Most, however, did speak in terms of strategies of incremental growth and of being responsive to community and individual needs. Consequently, study team opted for the concept of "responsiveness" as a more appropriate heading for this section.

Interviewees made the following main points about responsiveness:

• The initiatives visited tended to expand organically as needs arose and related opportunities were identified or developed. One health center, for example, got into housing development after community residents initially opposed the construction of its proposed new substance abuse treatment facility; the community already had enough urban problems, the residents explained. Through a number of following meetings, however, eventually a compromise was reached: in exchange for the neighborhood's support of a zoning change needed to build the facility, the center committed itself to assisting in neighborhood revitalization. This commitment resulted in the birth of an affiliated community development corporation.
• An organic, incremental growth process focuses attention on the importance of small steps. "Small steps should mean a lot," one administrator explained, "because there aren't going to be any giant leaps." Another administrator voiced a related concern: "If you don't stand for the little things, then the big things will overwhelm you." Examples of such "small steps" include getting the commuter rail to stop at a nearby station that it traditionally bypassed and organizing a group of adults to applaud and cheer on kids each morning as they arrived at school and got off the buses.
• Being "responsive" to community and individual needs requires a balance between inclusiveness and pragmatism. The sites generally saw this tension as beneficial. At most sites, services and activities were not limited to a subgroup of the community or even to residents; individuals were helped no matter what their place of residence. The general approach was to be all-inclusive with respect to services offered, if not necessarily outreach. "When somebody comes with a problem," staff at one initiative explained, "you need to be part of the solution."

Most administrators, however, stressed the importance of knowing when you are taking on more than you can reasonably and effectively handle. One executive director claimed that "the way in which we fulfill our mission is to recognize that we can't be all things to all people. We have to maximize our resources by collaborating with others."

• Most of the initiatives also appeared to be very adaptable. Sites generally handled the "tension" incumbent with growth and survival using flexible tactics. For example, one human service initiative branched temporarily into housing development and management. "We can step into development, then out," claimed a staff member, "and feel no need to call ourselves a community development corporation." Staff, though, were quick to point out that they stopped "building homes" when a more appropriate agent agreed to assume the responsibility.
• Initiative administrators would like to focus more on prevention, but responsiveness leads instead to addressing problems. It is the problems that generate community involvement and community support. One administrator wryly noted, "We all give lip service to prevention."
• A sustained and visible signature development or effort is apparently critical to initiative success. As noted in Section V, the majority of initiatives visited took advantage of an initial catalytic event and subsequently developed a successful, signature effort. Though housing is perhaps the most notable example, the variety of alternative efforts is in itself remarkable.

• For many initiatives, economic development has been the most difficult "piece" in the community revitalization puzzle. Those initiatives with human services origins in particular have struggled to incorporate economic development strategies. Some interviewees maintain that this is due to an organizational culture leery of private sector entrepreneurship.

In contrast, those initiatives that began as community development corporations have made the most progress in pursuing economic development. As one administrator put it, "the best base (for such development) is...with CDCs because they're entrepreneurial; they know how to do deals." One CDC-based initiative persuaded a grocery store chain not only to open a supermarket in the community but also to delegate much of its hiring to the initiative. As the director of finance for the initiative noted, "everything we do now is economic development and community development."

Even the most enthusiastic advocates of pursuing economic development, though, counseled realism. One administrator put it bluntly: "We know we're not going to get a Bloomingdale's here."

• Job creation, training, and placement were routinely cited as the most important next step. "The most important services we provide," explained one executive director, "are those that directly assist people in the development of the financial capacity to sustain themselves — job creation, training and development." However, many noted that a job training/creation/placement effort must be comprehensive and well-integrated; otherwise, individuals are "just locked into a job."
• Success itself introduces a new set of opportunities and obstacles. "Everybody loves a success story," we were told on more than one occasion. Successful initiatives, however, risk losing their focus and spreading their efforts too thin by responding to outside requests or overextending their resources. They also sometimes face the unintended consequences of their efforts. Success in housing rehabilitation, for example, can lead to gentrification and rising property values, which in turn may force out current and long-time residents.
• Even the most successful initiatives are subject to broader socio-economic changes largely beyond their control. Many administrators spoke of the need to keep abreast of such changes, to plan accordingly, and to advocate where appropriate. The impact of welfare reform and health care systems changes, for example, will be significant. One executive director argued that if an initiative cannot, over time, successfully address the consequences of such factors as crime and unemployment, it will lose broad resident support no matter how effective it may be in other ventures.

COMMUNITY PARTICIPATION

Resident involvement was universally cited as a key element of initiative survival. However, staff, administrators and residents alike offered important qualifications to this position. The following section is organized into three subsections: Effective Community Outreach, Sustained Resident Involvement, and Primary Challenges to Community Participation.

Effective Community Outreach

To survive, various staff and administrators argued, initiatives must use effective outreach and provide for substantive, beneficial, and enjoyable resident involvement. Those interviewed offered useful advice on soliciting and maintaining such involvement.

• Initiative staff and others involved in community revitalization, either directly or indirectly, should be realistic about the time and interest people may have to participate. "Somehow," cautioned one administrator, "we have an assumption that community residents have the time and see a reason to be involved because we think it's good for them to do it. I'm not involved, though, in my own neighborhood efforts either." It is important to recognize that residents being paid minimum wage often must work 2-3 jobs and simply do not have enough time to get involved in the ways people with more resources may be able to do. Any time volunteering, moreover, is likely time not spent with their families.
• "People don't resist change," one board committee chair argued, "they resist being changed." A common assumption worth careful review is that individuals tend to resist change. Various interviewees refocused the issue to be one of who is initiating and controlling that change.
• All sites recognized that it is not simply a question of stepping aside to let residents lead. Resident involvement is often difficult to solicit, much less to sustain. The more successful initiatives consequently tended to pursue active outreach strategies that are both imaginative and persistent. "The idea," admitted one executive director, "is to truly understand what the interests and needs of the community are." One site sponsors an annual "State of the Village" stage presentation at which skits are delivered trilingually in alternating phrases. At another site, outreach workers make presentations and hold discussions in widely-used communal locations such as laundromats. A third initiative uses its primary mission--health care--to launch additional service programs, specifically by leafleting or mailing out a packet of health care materials prior to the arrival of new residents.
• One common outreach theme is patience and a long-term perspective. A client at one initiative was offered a gauze-and-iodine sterilization kit for his injury. When he offered to pay the director for the kit, the director suggested instead that he come in and share some time. If one individual gets involved, various staff argued, then others may become curious. Another effective approach is encouraging neighbor interaction. "The more people you know in your neighborhood," argued one executive director, "the stronger you tend to be as a neighbor." One initiative even requires car pooling to its various awards ceremonies.
• Another crucial theme is recognizing the importance of, and incorporating where appropriate, community ritual and tradition. One executive director emphasized the "role of ritual" in rebuilding communities and lamented its general absence in most distressed areas. During the past summer, his organization funded 150 block parties at $300 for each party. Such gatherings, particularly when thematic (e.g. Jamaican Independence Day), often lead to a stronger social infrastructure.

Two qualities of staff seemed to contribute most in attracting resident involvement:

• Commitment. In one community, a family's house was firebombed because of their active opposition to local drug activity. Staff of the initiative in question provided counseling, overnight security for the next two weeks, clothes, and food. Several years earlier, after a child was killed by gunfire, many of the same staff helped to organize a vigil, made the funeral arrangements, and generally assisted in whatever way needed. "We practice what we preach," explained one of the staff members.
• Compassion. Staff involved in the drug marches at one initiative have made great efforts to involve drug dealers and users in developing solutions. "A lot of them want to go straight," said one staff member, "but what do we have to offer them? Yet we tell them, 'We're not here to judge you; we're here to help you.'"

Sustained Resident Involvement

• Staff should strive for resident involvement that is worthwhile, easy, and fun. "Making it worthwhile" refers to offering not only substantive roles for residents, but, on a limited basis, material incentives as well. One initiative offers residents free bowling in the basement of a church, a refurbished gym, and $25 to attend their basic "citizen involvement" training. Staff are quick to point out, however, that while the stipend works well to bring neighbors in, it should not be used more than once; only the strength and relevance of the program or class will ensure continued involvement.

"Making it easy" has two primary facets: 1) providing multiple "entry points" for initiative services and activities, and 2) recognizing that many residents, particularly those with very low self-esteem, will be extremely apprehensive about getting involved.

As for the third criteria for "Making it Fun," one administrator put it nicely: "People get together to have fun and to do things that will benefit them...If you tell them it's work, they won't come." Unfortunately, the importance of making it fun is often overlooked in the rush to "design and implement programs."

• Many staff spoke of the need for residents to overcome their sense of "reliance." Making involvement worthwhile to residents requires a quid pro quo on more than a material basis: residents must understand and accept their responsibilities, and staff must allow for genuine resident leadership. One executive director noted that "no matter how well we do our job, we can't create real change without changing the environment."
• As previously mentioned, an important aspect of this "culture change" is a genuine willingness on the part of the initiative administrators to follow the residents' lead. Various executive directors mentioned the importance of not only consulting residents, but consulting them on very specific issues. For example, residents at one initiative were instrumental in determining, with staff help, the design of a new facility, including whether or not to use stucco or brick, and how much glass to include. The residents chose a design with significant quantities of glass as a statement that they were not afraid of vandalism; to date, none has occurred.
• Changing the culture necessarily involves resident skills-building. Staff at various initiatives spoke of residents developing a skill base and "level of engagement" that eliminates reliance on any single individual or organization as the "solution" to their problems. One staff member, with his thumb and forefinger almost touching, argued that "most people are just that far away from some kind of success." Seeing even the least skilled residents as capable of success, however modest at first, is characteristic of the sites visited. Resident skills-building is formally structured at some of the initiatives (e.g. a neighborhood "college" to provide training), informally at others.
• All initiatives cited the importance of hiring from within the community. In at least one case, 75-80% of the employees are local hires; in another, all employees--80% of whom live within the area-- are involved in one or more local activity. One administrator has a well-known policy that he will allow only a few senior managers to be hired from outside the community each year. Board members, staff and volunteers who live in a community tend to "resonate with what is happening" there. The current director of one program moved into the area after being promoted from assistant. Prior to his move, he placed a low priority on the problem of trash in the streets; his perspective subsequently changed. (Others argued, however, that limiting hiring to local residents, particularly among upper management, can badly handicap an initiative. The disagreement is over degree; local residency is seen as an important--if not critical--factor in all hiring.)

Primary Challenges to Effective Resident Involvement

• Identification of and Outreach to Subgroups. One initiative that had extensive community resident involvement suddenly realized that no renters in the community were represented on their board. The definition of "the community" has to be carefully considered.
• Transiency. One community visited, for example, has a high resident turnover rate and over 27 different languages represented in the population. In contrast, other communities visited have a relatively stable resident base where "people know people who will be helpful to them." One indicator of stability is the percentage of the population who are homeowners. Another is how long people have lived in that neighborhood.
• Chronic poverty. One of the greatest challenges facing such initiatives is getting the poorest individuals involved. As one administrator told us, "they need to help themselves first."

• Racial tensions. Though one executive director argued that "people get sidetracked by race" when it is class that is most important, racial strife remains a key factor in community revitalization. One community faced a potentially violent conflict between its Hasidic and Black residents, who did not understand each other. For example, one Black youth asked a rabbi why owning a station wagon was part of the Hasidic faith because he did not realize that large families, not religion, resulted in the use of large cars. Further violence was averted through educational and trust-building activities and by a united alliance against industrial pollution in the neighborhood.
• "Spring boarding." The more talented residents often "springboard" out of distressed communities as their skills--and job marketability--increase. While those who mentioned this spoke of it as a sign of success, such "spring boarding" nevertheless creates a vacuum in skills and leadership.
• The use of "experts". Many acknowledged that the "community is a repository of experts." Most interviewees felt that while outside experts are valuable, they should be used as resources rather than as guides and should offer advice rather than dictate "solutions."
• Unmet expectations. Residents tend to have "long memories" and little patience for delayed results. In one community, city government promised a great deal through sales tax revenue and conducted extensive planning with great fanfare; nothing, however, came of the promises.
• Organizational inertia. Initiatives which focus too much on "process" risk overemphasizing planning and formal deliberation. By the time the current administrator of one initiative had been hired, the board's original four standing committees had mushroomed to 17. Whenever the board reached a critical point in decision-making, they would form a subcommittee to further review the issue. This enervated board members and led to decreasing attendance until the situation was corrected.

COLLABORATION

Collaboration, according to one executive director , "is ultimately a question of money, power, and control." Descriptions of what "collaboration" entails varied widely among sites. For the purposes of this study, initiatives were defined as "collaborative" if they involved three or more partners from separate, independent entities/organizations and separate domains (e.g., health, education, community development) who share responsibility for decision-making and for providing resources through a joint governance structure. So defined, collaboration at most of the sites visited is rare and a low priority at best. Various administrators claimed such collaborations are too often based on chasing money, and result in either "circus tent" situations or "shotgun marriages." "If fees are attached," argued one collaborator, "that says this is not a partnership."

On the other hand, forming alliances between autonomous organizations was frequently cited as a key element of initiative survival. Alliances offer more provisional arrangements, based on mutual benefit, that do not formally limit an organization's autonomy. Consistency is crucial in developing and maintaining such partnerships. "The city knows," said one interviewee, "that (our organization) will not embarrass them." Politicians and high-level bureaucrats also appreciate initiative administrators and staff who understand and largely accept the constraints and culture they face. At one site, a state agency director has occasionally taken political risks in supporting the initiative's development. It is important, explained one interviewee, that those in the community realize how hard it is sometimes for government officials to respond to community requests.

• Alliances take time and effort, but there is a realization that it is crucial to success. One interviewee stated that "we just can't go back to the old way of doing things. No one agency can achieve its mission alone."
• Many of the sites have developed innovative partnerships with government agencies, including the police. One initiative is training the staff of a local police station to use the site's computerized neighborhood bartering system. Among other benefits, this will enable officers to better identify alternatives to Child Protective Services for distressed youth. Another initiative, whose neighborhood is traditionally a dumping ground for disgruntled or new police officers, has worked with the city police department to change both attitudes and staffing patterns, particularly about community policing. Site staff successfully solicited 500 signatures to request a community policeman. The community's anti-crime efforts are now fully linked to the local station.
• Several sites have also developed innovative partnerships with the corporate community. Various interviewees spoke of the "need to transfer some of the challenges from the residents onto the major institutions in the community." Several administrators also argued that nonprofits should stress mutual benefits, rather than moral obligation, when soliciting such corporate involvement. For example, one site has entered into an unusual relationship with a local bank, due in large part to a city and state initiative offering private-sector entities state corporate income tax credits if they partner with a community-based organization. Bank personnel are intimately involved in site efforts: bank members sit on the site's board, the new director of the site's housing development affiliate is a former bank executive, and bank staff are paired with site employees to provide professional mentoring in a variety of fields, such as finance and public relations. Another innovative corporate-community partnership among the sites addresses unemployment. A local Safeway looks to the initiative to recruit, hire, and counsel its entry-level employees. The Safeway is also committed to transferring the more successful of these hires to neighboring Safeways, thereby providing career mobility and creating new job openings in the community.
• The involvement of school districts in most of these initiatives has been limited. Several executive directors spoke of bureaucratic in-fighting and highly politicized processes as reasons why they have not done more with the schools. In several locations, busing has restricted the usefulness of community organizing around educational issues. This is troublesome since the school does not necessarily serve community residents. A solid educational system and after-school use of school facilities are routinely mentioned as a critical component of community revitalization. In addition, without strong schools, it is difficult to retain professionals with families.

Where successful, alliances tended to demonstrate the following features:

• Lead personalities are compatible. "Believe me," argued one executive director, "every bit of it (partnering) is about social relationships." A board member from another initiative echoed this sentiment: "It's personalities." Solid partnerships require talented administrators smart enough to stay goal-oriented and to de-emphasize their differences. "It's important," added one administrator, "to check your ego at the door."
• Partners are established and mature. Many of the institutions with which these initiatives partner have existed for at least ten years and have a successful track record. As one partner stated, "nobody wants to play with a loser." In addition to longevity, the partners are "healthy" both in financial and staffing terms; "When you're healthy, you don't have anything to hide. And when you don't have anything to hide, you don't mind folks sitting with you."

  Organizational clarity and tolerance are critical factors in achieving such maturity. "You need to first clarify internally who you are and what you are," explained one administrator. Mature partners, moreover, share the credit, "stay out of blame," and nurture broad community support for their efforts, since "political people," as one resident noted, "will not work with a divided community."

  Even among mature partners, however, tensions usually exist, particularly over funding. Such tension is beneficial, various interviewees argued, if the partners are mature, the personalities compatible, and the mission shared. "Where there's no confrontation or controversy," argued one partner, "there can be no growth. Tension stretches you." Another staff member cautioned, though, that "drive-by debates" should always be avoided.

• Partners respect one another and are competent. Each organization needs to understand that it is unacceptable to take over or interfere with a partner's vital functions. This awareness depends on mutual respect, which should develop naturally from each partner being skilled and knowledgeable in their respective areas of expertise. A foundation which provided funding to one site once invited outside "experts" to attend a joint initiative-foundation meeting on a specific project. Though the foundation had not told initiative administrators of the invitation, the "experts" proceeded to offer unsolicited recommendations concerning project management. The occasion badly damaged the sense of trust underlying this partnership.
• Partners must agree to a shared mission and structure for the partnership. The joint mission should be consistent with the respective individual missions. Most administrators cautioned against "chasing after the dollars." In the few sites where a separate, collaborative governing mechanism had been established, the form and origins differed. One collaborative had formed quickly under the direction of several lead state agencies, while another had evolved slowly and organically. The latter involves an inter-agency group that has been meeting for the last 3-4 years; only within the last year, however, have the partners identified a need for some formal governance and budget structures. The lead agency of this collaboration argues that the early informality was necessary to build trust. Several other sites counseled that it is always important to have written contracts where financial issues or exchanges are involved.
• Roles are clearly defined. Most importantly, there should be a lead agency, even if that role is rotated. "I don't know what 'shared leadership' is," noted one collaborator. "Someone has to be in charge." The lead agency, however, must be careful not to dominate, but rather to convene and facilitate communication. According to one administrator, "a primary reason for our success is our role as a facilitator, which enables us to keep a perspective that cuts across political lines." Clear roles and communication can minimize friction. "Mistrust," argued one board member, "might mean you just don't understand each other."
• Every partner sees a benefit to itself and to the people it serves. No one agency can achieve its mission alone. Staff can experience a fundamental change in thinking when they work with partners.

FINANCE

Those interviewed stressed the importance of adequate, stable, and flexible financing. However, as pointed out in Section V, decategorization of funding was rarely cited as a "necessary condition" for change. Administrators appeared to be far less unified on this issue than study team members had anticipated.

Adequate

• Initiatives should sustain a consistent revenue base, but not at the expense of organizational mission. One interviewee stated nicely what many others also mentioned: "funding has to be commensurate with the job we are expected to do." No one interviewed questioned the value of a consistent revenue base adequate to support initiative efforts. However, most of those interviewed counseled against "chasing dollars"; opportunities should be aggressively pursued only where consistent with mission, circumstances, and timing. One administrator claimed that "we've turned down money if we haven't liked our partner or if it didn't fit with our mission." Others spoke of first determining needs, then finding appropriate funds, rather than identifying available funding and subsequently making efforts "fit."
• One initiative received a small foundation grant to improve the infant mortality rate in its community. When site staff did an unscientific survey of the community, however, they found that only 3% of the residents felt that such an effort should be a priority. The initiative subsequently turned down the grant, much to the admiration of foundation personnel; the two have maintained a strong relationship ever since.
• Real, sustained change in the way services and supports are provided in a community means that government must become a funding partner.Several of the initiatives noted that the political and financial support of city leaders contributed substantially to their status. The vast majority of funding in communities for services and supports for low-income children and families is public funding; the only way to create real systems change is to leverage some of those dollars.
• Initiatives should have adequate funding for administrative functions. This is an issue of both adequacy and flexibility. Initiatives need a revenue stream that can support their overhead costs. Inadequate funding often jeopardizes the administrative functions necessary for long-term planning, growth and survival. Many funders, however, will not allow the use of their funds for general administrative costs. United Way funds are an exception. However, a number of initiatives reported that United Way funding has declined over the past several years. One initiative noted an annual 3 to 5% reduction in United Way contributions.
• Initiatives may significantly benefit from developing for-profit ventures and other sources of capital to subsidize initiative programs. Many of the initiatives visited have developed effective methods for raising capital, such as for-profit affiliates (e.g. real estate development). One site receives 95% of its discretionary revenue from a community shopping center of which it is a minority (40%) owner. Others rely on a single program to "subsidize" other neighborhood service efforts. Diversified revenue streams, argued one executive director, enable administrators "to pull rabbits out of a hat when needed."
• Initiatives benefit from developing corporate involvement and understanding, rather than simply financial support. Opinions differed dramatically over how much effort to spend on soliciting corporate support. That issue aside, the sites that had the strongest corporate backing tended to involve their corporate sponsors in ways far beyond simply writing a check, and generally recognized the importance of developing mutually-beneficial relationships. (See the example described in the Collaborationsection.)
• Given the current funding and financing environments, initiatives need to develop and pursue imaginative strategies to effectively benefit their communities. Many initiatives, for example, have implemented innovative programs to capture multiple in-kind contributions. One site has a full-time director of volunteers; site volunteers now often come from out-of-state to help rebuild homes.

Stable

• Initiatives require early funding stability. The sites generally were supported at the outset by an adequate, relatively long-term funding commitment. While one site started with multiple sources, most began with a narrower revenue stream and slowly diversified. The initial financial commitment may come from within the community itself. At one initiative, local board members occasionally wrote personal checks to help meet urgent payroll costs during the early years.
• Initiatives benefit greatly from on-going funding stability. One site, for example, has received two significant ten-year grants, the first from a national foundation, the second from a regional bank. Needless-to-say, such support enables the initiative to pursue long-term strategies without being pressured to demonstrate results prematurely.

Flexible

• Decategorization of funding is an "enabling or facilitating" tool, though not a "necessary condition" for change. Initiatives noted that decategorized funding rarely remained "decategorized," since every government and private funder ultimately targets funds for particular purposes. One interviewee noted that her initiative was not ready for decategorization: "First we have to restructure our service system and change our culture." Agencies are often unwilling to delegate their responsibilities to another agency or caseworker that does not have specific expertise in their areas. Another interviewee noted that staff and organizations have to be ready to use decategorized funds or decategorization becomes meaningless and possibly even detrimental to community revitalization.

Financial Planning & Management

• Initiative administrators tended to demonstrate strong financial management skills and a long-term (3 yrs. minimum) funding perspective consistent with initiative goals, objectives, and programs. Where an executive director did not have the requisite financial experience, he or she had often hired an extremely capable financial director. Various administrators stressed the importance of intimately knowing bottom-line costs, and of frequently updating such knowledge rather than waiting until the end of the fiscal year.
• Initiative administrators tended to take appropriate risk. Site administrators often balanced shrewd financial management with appropriate risk-taking. As previously noted, in one case, an organization purchased a nearby nursing home with little cash left over to pursue the renovation. Had they waited to acquire the necessary renovation funds, the opportunity would have been lost. The momentum generated from the bold move, and skillful fundraising, resulted in subsequent success; the former home is now the site's main facility.
• Initiative administrators tended to avoid premature funding. A state agency offered $100,000 to one site before it had worked through certain basic operational issues. Site administrators were fortunately seasoned enough to argue successfully for a delay.
• Initiatives generally had strong and widespread community support. According to one executive director, "if the community presents division, the funders will walk away." Sustained community "solidarity" is thus often an effective catalyst for additional foundation support.
• Initiatives need effective evaluation tools for demonstrating success. "It is hard to show measurable differences when the people you serve are so needy," one interviewee pointed out. Showing such change, however, has become progressively more critical to renewed or new funding. One administrator put it succinctly: "To survive, we have to deal with the evaluation question." Especially problematic is the need to show progress toward long-term goals.

Effectively demonstrating success, however, does provide an opportunity to shape government and foundation priorities. Thanks largely to the experiences of one site, a regional foundation has revised grant making guidelines to reflect the importance of community participation.

VII. FINAL THOUGHTS

The insights from this study are presented to assist those working to create effective, comprehensive community strategies for working with low-income children and families. We fully recognize that there is, and should be, a variety of strategies, and elements of strategies, that lead to positive change. Each initiative we visited was unique, but certain shared themes and elements did emerge during the project's numerous interviews. In general, project visits revealed a more fluid, tactically-nimble approach to community development than existing writings portrayed. Initiative growth tended to be organic in response to highly contextualized needs and related opportunities. One interviewee compared the approach to jazz improvisation, with elements provisionally arranged based on a solid thematic foundation.

One fundamental challenge of this approach is to integrate effectively strategic planning. Most interviewees argued that while such planning is important, it is most useful in conjunction with quick, tangible results--"Plan and do simultaneously"--rather than build toward a single "comprehensive planning moment." The selected initiatives also tended to take full and timely advantage of a catalytic event, to sustain this momentum with a visible signature development or effort, to focus their service strategy on leveraging existing resources and programs, and to keep the initiative's sense of mission vibrant.

This last condition--periodically revitalizing the sense of mission--has a great deal to do with leadership. The conventional wisdom posits that charismatic leadership is an element of success. While interviews confirmed this, the charisma was not generally isolated in one person, but tended instead to be found throughout the organization. Many of the executive directors interviewed extend authority and autonomy to staff and freely recognize and honor the skills of others. Directors and staff alike also revealed remarkable levels of commitment and patience. Most of their initiatives, as they pointed out, have taken years to achieve their current levels of effectiveness and stability.

Perhaps most notably, the administrators demonstrated that the entrepreneurial spirit is alive and well within the not-for-profit sector. The success of these initiatives is due in large part to the entrepreneurial skills and energy of those involved and to their willingness to make many tough business decisions based on bottom-line accounting considerations.

Three final findings deserve special attention here. In keeping with the theme of flexibility, the initiatives tended to shy away from formal collaborations that involve joint governance structures, preferring instead to form alliances as needed that do not limit organizational autonomy. The emphasis is on partnering to achieve certain objectives, rather than on creating additional organizational structures or true shared accountability. Second, while it was noted as a constant challenge, the initiatives reflected a remarkable degree of community involvement and support. This level of support, however, is conditional; involvement of residents has to be both substantive and sustained and initiative activities should be driven by resident-identified community needs. Finally, contrary to expectations, decategorization of funding was not considered a "necessary condition" for change. Many administrators have apparently developed effective methods for minimizing the negative aspects of categorical funding. What was clearly emphasized as more important than decategorization was a sustained funding commitment. Genuine change takes time. Initiatives must be accountable for their efforts from the outset, yet must be allowed to grow organically.

The ASPE study team learned a great deal while conducting this project. We feel privileged to have met with such a diverse, committed group of administrators, staff, residents, and organizational partners. Their skill, energy, and patience are remarkable. We also appreciate the added wisdom of the recognized experts with whom we also consulted. We hope others will benefit from the lessons and insights shared in this document, and we welcome comments in this continuing dialogue.