05/09/08 1

Building Momentum and Expanding Your Program's Partnerships - Inclusion

Walter L. ShepherdDirector

NC Comprehensive Cancer Program&

Executive DirectorNC Advisory Committee on Cancer Coordination & Control

Why I'm Here?While I'm Here....

479

184

Two Organizational Modelsfor CCC Partnerships

Prescriptive• Representation is prescribed, typically

through enabling legislation

Collaborative• Representation is selected/elected

from among stakeholders

Advantages

Prescriptive• Legislative-connection

• Ensures representation of specific organizations

• Reduces rivalry among stakeholders

Collaborative• Broad representation

• Can ensure greater diversity• Can ensure network for

implementation

Almost 50 years to get it right…..

t

t

50 Years of Cancer Prevention & Control Planning

1957 The Commission to Study the Cause and Control of Cancer in North Carolina established by the Legislature.

1967 The Co1957 The Commission to Study the Cause and Control of Cancer in North Carolina established by the Legislature.

1967 The Commission to Study the Cause and Control of Cancer in North Carolina made a permanent study commission.

1967 Governor’s Commission to Study the Cause and Control of Cancer convened.

1991 Statewide Coalition for Cervical Cancer Control created.

1992 Study Commission on Cancer Prevention and Control created by the Legislature.

1993 The North Carolina Advisory Committee on Cancer Coordination and Control formally established through legislative action.

1998 Funding provided by CDC to North Carolina as one of fivestates and one tribal health boards to pilot national comprehensive cancer control.

2006 NC Cancer Partnership created

North Carolina 1993

Prescriptive• Long history of government

involvement/participation – since 1957• Major legislative buy-in

• Key legislators involved & moved policy agenda

• 33 Appointed Individuals• Evolved into a “Small Table”

environment• Participants & Spectators

North Carolina 2005-2006

“In a Rut”• Original members rotated off• Two 5-year Plans completed

• 3rd 5-Year Plan was in-process• Interest/participation had diminished

• NC CCP was “broken”• Participants & Spectators

• No one sure what this process was all about

• No accountability to stakeholders

North Carolina April, 2006

“The Revolution”• Created the NC Cancer Partnership• Initiated the “Big Table” philosophy

• Everyone Is Welcome - Inclusion• Abandoned the 5-Year Plan Process

• Re-defined what’s important • It’s all about Survivorship

• Partnerships must be made; they don’t just happen

• Partnerships must be worked everyday

Collaborating to make a difference in the lives of North Carolinians with cancer, their

families, and their communities.

An opportunity for every Cancer stakeholder to have an opportunity to participate and

contribute.

05/09/08 10

NC Advisory Committee on Cancer Coordination & Control

34 Appointed Members

Executive CommitteeChair & Vice Chair

Subcommittee Chairs & Associates

Subcommittees•Care

•Early Detection•Prevention•Evaluation

•Legislative/Education

1993 - 2006

05/09/08 11

NC Advisory Committee on Cancer Coordination & Control

34 Appointed Members

Executive CommitteeChair & Vice Chair

Subcommittee Chairs & Associates

Subcommittees•Care

•Early Detection•Prevention•Evaluation

•Legislative/Education

NC Cancer PartnershipOpen Membership

Steering Committee13 - 15 Members

Workgroup Leaders

Cancer Workgroups19 Groups

Regional Cancer Partnerships6 Regions

2006 - Present

Work Groups CreatedBreast Cancer

Gynecological CancersChildhood CancersColorectal Cancer

Cancer & Young AdultsLung Cancer

Prostate CancerSkin Cancer

Other CancersClinical Trials

DisparityPalliative Care/Pain

SurvivorshipWorksite Cancer InitiativesCancer & the Environment

Personal BehaviorsGenomics

Patient Navigation

05/09/08 13

Work Groups

~12 – 15 MembersRepresentative – Geographic, Demographic, Clinical/Non-Clinical

Establish Common GroundDevelop Timeline for Activities

Survey/Research the Issues/ProblemsDetermine Existing Activities/Resources

Coordinate with Other Work GroupsDevelop Specific Goals, Objectives, Strategies & Evaluation

MeasuresDetermine Resources Required

Transmit Report to Advisory Committee & SubcommitteesAssist with Implementation

Review Evaluation Results & OutcomesRevise Goals, Objectives, Strategies

Cherokee

Graham

Clay

MaconJackson

Swain

Transylvania

HendersonPolk

Haywood

Madison

Buncombe McDowell

Yancey

Mitchell

Avery

Watauga

Rutherford

ClevelandGaston

Lincoln

CatawbaBurke

Caldwell

Ashe

Wilkes

Mecklenburg

Cabarrus

Union Anson

AlleghanySurry

Yadkin

AlexanderIredell

Rowan

Davie

Stokes

Forsyth

Stanly

Richmond

Scotland

Davidson

Rockingham

Guilford

Randolph

MontgomeryMoore

Lee

Caswell

Alamance

Orange

Durham

ChathamWake

Hoke

Robeson

CumberlandSampson

Bladen

Columbus

BrunswickNew

Hanover

Pender

Onslow Carteret

Jones

Craven

Pamlico

Duplin

Harnett

Johnston

PersonGranville

VanceWarren

FranklinNash

Wilson

Wayne

Pitt

Lenoir

Greene

EdgecombeMartin

Beaufort

WashingtonTyrrell

Dare

Hyde

Halifax

Northampton

Bertie

Hertford

Gates

Chowan

Perquimans

Currituck

CamdenPasquotank

ACOS CoC Approved Facility

Medical School / Major Academic Medical Center

NC Cancer Partnership Regions

Western

South Central

Southeastern

North Central Central Northeastern

Non-CoC Facility

The assurance that the views, perspectives, and needs of all affected communities are included and involved in meaningful manner in the planning/implementation process.

Inclusion

• Enhance credibility• Implement program change• Advocate program changes• Fund, authorize, expand programs

From Tom Chapel, May 14, 2008

Who Do We Need Most?

Steps Taken for Inclusion Give All Stakeholders a Voice...but

Start by Reminding Everyone What It's All About Answer the Question: “What's in It for Me?”

It’s Not the State’s Plan….It’s the People’s Plan. Perspective: Focus on a Few vs. Anything Goes

My Plan is Your Plan.; Your Plan is My Plan A “Living Plan” Should/Can Be Changed as Necessary. Formal Adoption of Plan by Organizations & Individuals.

Develop Specific Action Plan with Organizations. Formal Connection with Major and Minor Organizations.

Get the Plan “Out There” - 400 per month, visits, talks, events Listen, Act, Report Connect the Dots

CCCP Can Make It Happen – “We're Like Switzerland” Assume Leadership of Efforts Where There's a Void

Build Capacity Where It's Needed Eliminate Duplication & Share Resources

Monitor Participation/Participants Don't Be Afraid to Stick Your Neck Out

Some Results from Inclusion NC Survivorship Summit

NC Cancer Centers’ Collaborative NC Oncology Navigator Association

NC Cancer Clinical Trials' Clearinghouse Pilot Projects/Regions wth Early Adopters

Visits to all CoC (& other) Centers Incubate and/or Help Create New Organizations

Help Established Organizations Renew Their Efforts Adoption of Plan by Funding Organizations as Part of RFA Process

Customized Cancer Plan 19 Work Groups – typically >50% Members Are Survivors/Advocates

www.NCCancer.com NC Medical Journal Special Issue on Cancer – circ. 36,000

Community-Based Organizations' Training Initiative

PARTNERSHIPS

• American Cancer Society

• NCI Cancer Information Service• Comprehensive Cancer Collaborative of NC (CPCRN)• NCI-Designated Comprehensive Cancer Centers (3)

• American College Surgeons – Commission on Cancer (38)• Non-approved Cancer Centers (6)• NC Academy of Family Physicians

• NC Medical Society• Old North State Medical Society

• NC Hospital Association• NC Oncology Society• Komen for the Cure

• University of North Carolina • Duke University

• NC Cancer Centers' Collaboration (sponsored)• NC Oncology Navigator Association (sponsored)

• NC Cancer Clinical Trials' Clearinghouse (sponsored)

• Plus many other state & local organizations and agencies

05/09/08 20

“The Vision”

That North Carolina’s collective effort will enable the state to become the national leader in responding to the many challenges

associated with cancer, including:

• The promotion of healthy lifestyles & preventive behaviors• The provision of universal access to screening & early

detection resources• Patient- & family-centered care that is accessible & affordable

• A cancer survivorship approach that is a collaboration between the patient, the family, the community & the health care system

• The elimination of all disparities related to access to all resources & services

Major Themes in the NC Cancer Plan

• Site Specific• Healthy Behaviors – Eating Smart, Moving More; Tobacco

Use; Infectious Agents; Alcohol Use• Cancer & the Environment

• Genetics• Clinical Trials

• Palliative Care – Pain; Hospice; End of Life Care• Data/Surveillance

• Professional Education & Awareness• Survivorship

• Access to Services• Public Awareness• Cost & Financing

Major Activities in the NC Cancer Plan

• Making Cancer Survivorship the Centerpiece• Creating & Enhancing Partnerships – Local, Regional,

Statewide• Eliminating Disparities of All Types

•Making the Public More Aware & Engaged• Enhancing Professional Education & Involvement

• Ensuring an Appropriate Workforce – Quantity, Quality, Distribution

• Ensuring Access to All• Increasing Funding & Resources

• Increasing Data/Surveillance• Supporting Research & New Technology• Determining & Implementing New Policies

www.NCCancer.com