AMCHP Leadership Lab Application. Overview

Transcription

1 AMCHP Leadership Lab Application Overview State and territorial Title V staff are entrusted with carrying out the mission of Title V to improve the health of all mothers, children, including children with special health care needs, and their families. To achieve this laudable aim, staff are required to exhibit leadership skills on a daily basis, from communicating the importance of Title V to creating a vision for success, to creating a culture of co-creation and collaborating with stakeholders to aligning activities. AMCHP believes that leadership is a skill that you work on and develop throughout your life. For nearly 20 years, AMCHP has supported the development of maternal and child health leaders family leaders, MCH, Title V and CYSHCN Directors through formal and informal learning opportunities, experience, dialogue, feedback, peer-to-peer learning, mentoring, coaching, and more. To meet the expanding needs of Title V staff, AMCHP redesigned our approach to leadership development by launching the Leadership Lab. The Leadership Lab is a unique developmental activity for state and territorial Title V staff who have the desire to pursue greater leadership responsibility. The Leadership Lab is structured to allow Title V staff to learn from one another across the workforce (Family Leaders Cohort, New Director Leaders Cohort, Leadership Institute for CYSHCN Directors (LICD), Next Generation MCH Leaders Cohort (age 45 or less), and MCH Epi Peer-to-Peer Cohort (P2P MCH Epi-Net)), as well as those with similar roles. The Leadership Lab requires a 10-month commitment by the participants from December through September. During the program year, participants are matched with a mentor/peer and are charged with crafting an individual development plan, completing selfdirected learning modules, participating in quarterly webinars, and peer-to-peer calls. Please note the application process is competitive for the Family Leaders Cohort, Next Generation MCH Leaders Cohort, and Epi-Net P2P Cohort due to the travel funding associated with these programs. All applications are due by Tuesday, November 3, :00 pm ET. Thank you for your interest in the Leadership Lab. Please click next to complete your application. 1

2 1. Please provide your demographic information. Name: Company: Address: Address 2: City/Town: State: -- select state -- ZIP: Country: Address: Phone Number: 2. Job Title 3. Years in current position Please note the following three questions are optional. 4. Sex Male Female 5. Ethnicity Hispanic or Latino Not Hispanic or Latino 2

3 6. Race (Check all that apply) American Indian or Alaskan Native Asian Black or African American Native Hawaiian/Pacific Islander White Other (please specify) Please complete the following questions. Use the designated space and length suggestions to guide your responses. AMCHP will utilize this information for planning purposes, mentoring/coaching matching, and collaborative project assignments. 3

4 7. Which of the following leadership skills would you consider to be your biggest strengths? *Please choose no more than three.* Critical Thinking Cultural Competency Change Management Developing Others Through Teaching and Mentoring Engaging Strategic Partnerships (i.e. MCH, Medicaid, Families, Hospitals, etc.) Ethics & Professionalism Family-Centered Care Incorporating Family Involvement & Family-Centered Care Interdisciplinary Team Building Messaging & Social Media Negotiation & Conflict Resolution Persuasion & Communication Skills Policy and Advocacy Priority Setting/Prioritizing Reacting Proactively Provisioning Programs Strong MCH Knowledge Base/Context Working with Communities and Systems Evidence-based Programs Other (please specify) 4

5 8. Which of the following leadership skills are you interested in developing/refining? *Please choose no more than three.* Critical Thinking Cultural Competency Change Management Developing Others Through Teaching and Mentoring Engaging Strategic Partnerships (i.e. MCH, Medicaid, Families, Hospitals, etc.) Ethics & Professionalism Family-Centered Care Incorporating Family Involvement & Family-Centered Care Interdisciplinary Team Building Messaging & Social Media Negotiation & Conflict Resolution Persuasion & Communication Skills Policy and Advocacy Priority Setting/Prioritizing Reacting Proactively Provisioning Programs Strong MCH Knowledge Base/Context Working with Communities and Systems Evidence-based Programs Other (please specify) 5

6 9. Which of the following topics are you interested in learning more about? Check all that apply Care Coordination Cultural Competency Change Management Family Planning Reproductive Health Social Determinants Child Health Adolescent Health Infant Health Women s Health CYSHCN Standards Affordable Care Act Data and Evaluation Family Centered Care/Family Involvement Financing of Care Budget/Funding Allocation Future of Title V Health Information Technology MCH 101 [Title V legislation, the role of federal agencies (CDC, MCHB, etc.), Medicaid] Medical Homes Messaging & Social Media Needs Assessment Systems Thinking & Integration Strategic Planning Quality Improvement Evidence-based Programs Other (please specify) 6

7 10. Where is your state in the next phase of completing your state action plan for the Title V Block Grant? 11. What professional development skills do you feel you need to be a change agent in implementing the transformation of your state's Title V Block Grant? 12. Prior to the Annual Conference, there is one event connected to this program, an all day event on Friday, January 22, As a requirement of the program you are required to participate in this event. Are you available to participate in the all day event on Friday, January 22, 2016? (Please note travel scholarships will be provided to Family Leaders, Next Generation Leaders, and state MCH Epidemiologist) Yes No 13. Please select the specific cohort that you would like to apply to within the Leadership Lab. (to learn more about each specific cohort click here) Family Leaders Cohort New Director Leaders Cohort (MCH and Title V Directors) Leadership Institute for CYSHCN Directors Next Generation MCH Leaders Cohort MCH Epi Peer-to-Peer Cohort (P2P MCH Epi-Net) 7

8 AMCHP Leadership Lab Application Next Generation MCH Leaders Cohort Thank you for your interest in AMCHP s Next Generation MCH Leaders Cohort (Next Gen Leaders). This is a 10-month program geared towards next generation professionals (age 45 or less) that want to develop their leadership skills at the state and/or national level. This program is designed to assist the Next Gen Leaders to expand their Title V network, MCH knowledge, and skills to be future Title V leaders. Eligibility To be considered for the Next Generation MCH Leaders Cohort, applicants must meet the following criteria: Currently works in a Title V program. Must be age 45 or less. Must have support from your supervisor, and /or Title V, MCH or CYSHCN Director to submit your application. If necessary, work with your Title V organization to have support to participate in bi-monthly virtual trainings, peer coaching calls, and attend the in-person kick off meeting and the AMCHP annual conference. Agree to actively participate in the 10 month program. Must have support from your supervisor to participate in the Program throughout December 2015 September Have not previously participated in an AMCHP leadership development program. Committed to your leadership growth. Committed to stretching yourself. Must be willing and have the support needed to commit approximately 1-2 hours per month for program requirements. Benefits of participating in the Next Gen Leaders Cohort: Gaining a greater understanding of Title V Increasing your understanding of AMCHP and the tools and resources available Widening your network of next generation and Title V leaders Giving and receiving mentoring from your peers Increasing your knowledge related to key MCH and leadership topics Attending the AMCHP Annual Conference. Through support from the Maternal and Child Health Bureau, AMCHP will award scholarships to Next Generation Professionals as Next Gen Leaders. The scholarship covers the costs associated with attending the conference (conference registration, travel, hotel accommodations, and per diem) Cohort Components Cohort components of the Next Generation Leaders Cohort include one face-to-face meeting at AMCHP Annual Conference on Friday, January 22, 2016; an invitation-only listerv; ongoing peer learning and peer coaching; and a series of quarterly webinars targeted around leadership development and pertinent topics to support you in your state role. Instructions Please complete the following program specific questions. Use the designated space and length suggestions to guide your responses. AMCHP will utilize this information for planning purposes, mentoring/coaching matching, and collaborative project assignments. 29

9 53. Are you age 45 or less? Yes No 54. What is your age range? What has been your role in Title V? Please address the following areas in answering this question (350 words or less) [20 points]: Describe your state role(s) (e.g., Title V funded program staff) Responsibilities. Leadership experience. 56. How do you intend to share information, resources, and tools with Title V staff in your state if selected to participate in this program? (350 words or less) [20 points] 30

10 57. If you are selected to be a Next Gen Leader, how might AMCHP support you? Please address the following areas in answering this question (350 words or less) [20 points]: How do you anticipate applying your leadership skills to your position? How would you like AMCHP to support in your leadership development? 58. Indicate how you would like to benefit from participating in the Next Gen Leaders Cohort. Check all that apply. For benefits not listed, enter this information in the row titled Other. Broaden my network Understand emerging issues from the national level Obtain a comprehensive view of Title V/breadth Develop a cadre of MCH peers Have a better understanding of the MCH (big) picture Develop/increase skill level in the MCH Leadership Skills Other (please specify) 59. Please provide a general overview of your state Title V program structure. 60. Based on the information you have provided above, would you prefer to be matched in a peer coaching group with peers that have a similar Title V program structure. Yes No 31

11 61. Personal Statement: Your personal statement helps reviewers better understand your uniqueness, desire and ability to be a successful Next Gen Leader. In the space below, please describe your interest in the Next Gen Leaders. Your personal statement should address things like: (600 words or less) [40 points] How being in the Next Gen Leader Cohort would further develop you as a leader in your state. What is important to you about developing your leadership skills? What your career goals are. How you expect this program to support your development. How you want to develop or expand your leadership capacity. How you plan to connect with your peers. Why you want to participate in this program. What you want to gain from participating in the program. 32