Tribal Self-Governance Health Care and Social Services Delivery Effectiveness Evaluation Feasibility Study: Draft Communications Plan

Submitted to:

Andrew Rock, Task Order Manager

Office of Planning and Evaluation

Department of Health and Human Services

200 Independence Ave., SW, Suite 447-D

Washington, DC  20201

Delivery Order 27

Under Contract No. HHS-100-97-0017

Submitted by:

Westat

1650 Research Blvd.

Rockville, MD  20850

Overview and Objectives

An essential feature of Tribal Self-Governance is the tribal management of health or social service programs.  The Tribal Self-Governance Evaluation Feasibility Study, being conducted by Westat, Project HOPE Center for Health Affairs, and Kauffman and Associates, Inc., will provide the Office of the Assistant Secretary for Planning and Evaluation (ASPE) with in-depth background information and detailed review of issues and data systems that may affect the extent to which a rigorous and defensible evaluation of Tribally managed health and social services programs of the Indian Health Service and other non-IHS programs can be conducted.  While a number of assessments of Tribally managed services programs have been conducted, these have been primarily qualitative in nature.  ASPE is interested in determining the feasibility of conducting an evaluation that examines both processes associated with successful Tribal management of health and social services programs and impacts of Tribal management on outcomes, such as:  access to care, services, quality, costs, financial performance and resources, customer satisfaction, and program stability.

A critical element of the success of this project is openness with respect to activities conducted and the process through which the project is developed and implemented.  Communications throughout the project will be designed and directed to three distinct groups:

• Tribal leaders and members of national AI/AN organizations with an interest in Tribal self-governance and its future, including those who have advised DHHS on an ongoing basis on the development and planning for new DHHS programs that are being considered for self-governance.

• The Technical Working Group that will advise the project team and review and comment on design plans and on interim and draft reports.

• The Government Task Order Managers (TOMs) and other interested and involved federal agency staff.

This Draft Communications Strategy Report presents the project team’s plans for communications throughout the project with each of these groups.  It was developed with input obtained during the initial project meeting and subsequent discussions with the project TOM.

Communication with Tribal Leaders, Members of the DHHS Title VI Advisory Group, and AI/AN National Organizations

The Evaluation Feasibility Study is just one component of the DHHS efforts to support effective Tribal Self-Governance.  Since the inception of the Title VI, Self-Governance demonstration feasibility study, mandated by Congress, examining potential new programs for Tribal Self-Governance, DHHS has actively consulted with the Tribes.  A Title VI Advisory Group, comprised of Tribal Leaders with a commitment to self-governance and their designees, has worked closely with DHHS throughout that earlier process.  In addition, DHHS has made information regarding the Title VI Self-Governance demonstration feasibility study available to all interested persons through its website and through direct mailings to Tribes and other stakeholders.

The current Evaluation feasibility study intends to continue this practice of active consultation and information dissemination.  Specific communication activities that will be undertaken include:

• A project description, explaining the project and its objectives, will be sent to all Chairpersons or Presidents of Federally-recognized Tribes, with a background letter.  The packet sent will include contact information for the DHHS TOMs and for each of the Co-Principal Investigators, as well as the DHHS website address where ongoing information about the study and its progress will be maintained.  Interested individuals will be encouraged to provide comments and inquiries, via the website or through telephone or email to the TOMs or the Co-Principal Investigators.

• The Principal Investigators will conduct presentations and question-and-answer sessions on the project at national or regional AI/AN meetings, to the extent possible within the budget constraints of the project.  Both Co-Principal Investigators attended the Self-Governance meeting before the National Council of American Indians annual meeting in San Diego, California on November 8, 2002 to discuss and answer questions about the project that attendees may have.  Other opportunities will be sought, both nationally and regionally, throughout the project, to offer progress reports and obtain feedback and suggestions.

• Final project reports and monthly progress reports will be made available to the Title VI Advisory Group and its designees throughout the project.  The project team is also willing to meet, by telephone or in-person (within the project budget limits), with the Advisory Group or its designees to discuss the project and answer any questions that may arise.  In addition, Westat will support a monthly conference call-in telephone number that can be used independently by the Title VI Advisory Group to convene and discuss issues related to Self-Governance and the Evaluation Feasibility Study.

• As practicable, conference calls or meetings between the project team and tribal leadership will be arranged on an ongoing and impromptu basis, in order to provide additional avenues for input by Self-Governing Tribal leaders.

The goal of all of the communication and information dissemination activities discussed in this report is to ensure that the project and its development are conducted as an open and ‘transparent’ process and to glean the maximum useful advice and input from the Tribes in the conduct of the study, while seeking to assure a balanced inquiry and lead to valid objective advice that can be provided to DHHS.  The project team will make extensive efforts to provide information to all interested parties throughout the project and will welcome and respond to inquiries, requests for information, comments, and suggestions.

Communications with the Technical Working Group

As the critical core advisory group for the project, the Technical Working Group (TWG) will be established by early January, 2003 and hold its first meeting in early February.  The TWG will be comprised of 10 Tribal leaders, directors of Tribally-managed health and social services programs, representatives of Tribal organizations (plus other informal, ex officio, research and data experts).

The TWG will be expected to advise and comment on all aspects of this project and, thus, communications and sharing of information on an ongoing basis with the TWG (as with the Tribal Leaders above) is essential.  Thus, the Communication Strategy for this group is one that is ongoing and goes beyond the routine approach of providing information only to support formal scheduled meetings of the TWG.  Key elements of this process for TWG members include:

• TWG members will be provided with the Project Description, Project Work Plan, the address of the DHHS website containing all background information on the DHHS Self-Governance project and specific information on this feasibility study, and the Summary of the Initial Project Meeting immediately upon their agreement to participate in the TWG;

• TWG members will be provided, by mail or electronically, copies of each month’s summary of the Monthly Conference Call and the Monthly Progress Report;

• TWG members will also receive all subsequent final deliverables/reports, as the TOMs approve them;

• Prior to each TWG meeting, TWG members will be provided with draft documents, a list of issues, and background for discussion of each issue.   Following the TWG meeting, a summary of the discussion and the resolutions reached on how best to address each issue;

• TWG members will be encouraged to contact the TOMs and the Co-Principal Investigators by telephone or email at any time during the project, to ask questions and to discuss any issues that they would like to have considered by the project team.

Communications with the Government Task Order Managers and Interested Federal Agency Staff

Communications among the Westat team, the government TOMs, and other interested federal agency staff will be an ongoing and frequent activity throughout the project.  Most of the key elements of this component of the Communications Strategy are usual elements of well-managed projects, including:

• A monthly conference call with the TOMs, and with other interested federal agency staff, to discuss progress and outstanding issues;

• A summary of the monthly conference call, documenting issues and progress, will be prepared and sent to the TOMs for approval and then distributed to all monthly conference call participants;

• A Monthly Progress Report, documenting all project activities, deliverables, schedule adherence or changes, and outstanding issues, will be prepared and sent to the TOMs;

• Frequent informal telephone meetings will be held with the TOMs to discuss project activity details and issues as key tasks are initiated and to obtain guidance as new issues arise;

• All formal deliverables will be submitted in draft form initially, to permit the TOMs to review and suggest changes prior to wider dissemination of these reports.

In addition, the discussion of the project communications strategy at the initial project meeting also suggested that the DHHS website established for the project continue to broadcast what is happening with the project.  This website and the information it contains will be an important component of the project Communications Strategy, providing a central source of information to all interested federal agency staff, Tribal leaders, AI/AN organizations, and the Technical Working Group that will advise the project.  To ensure that there is wide awareness of the website and its contents, the project team and the TOMs will contact other federal agencies and national AI/AN organizations to request that information and a link to the DHHS Self-Governance website be placed on these agencies/organizations websites.  Throughout the project, the project team will provide to the TOMs an electronic copy of all communications and reports that the TOMs choose to place on the website; final versions of these documents will be converted into HTML format for posting on the Web.