MRHA Strategic Plan FY14-FY16 1. FY 14 - FY2016 Strategic Plan June 2013

Transcription

1 MRHA Strategic Plan FY14-FY16 1 FY 14 - FY2016 Strategic Plan June 2013

2 MRHA Strategic Plan FY14-FY16 2 Executive Summary The Maryland Rural Health Association (MRHA) convened on February 25, 2013 to review the organization s current strategic plan. The strategic planning meeting consisted of the Executive Director, Michelle Clark, MSW, MPH and Board Members. The group was presented a general overview of the organization s current status of achieving its goals and objectives identified at the last strategic planning meeting in This was followed up by a series of break-out sessions focusing on the organizations key strategic issues: advocacy, organizational capacity, and educational programs/conference. From these sessions a list of activities and performance measures that align with the goals and objectives of the aforementioned strategic issues were identified. These plans are presented in the following strategic plan, and are to be implemented over the next 3 years to aid the MRHA in addressing the widespread issues of its three growing rural regions to optimally achieve its mission and vision. The MRHA recognizes an organization is only as strong as its members, and values the support and involvement of its members for they are critical to the future success of the organization. During a time of uncertain federal budgets, implementation of health reform, and the eve of Maryland s New Health Benefit Exchange; the MRHA needs to find new innovative approaches to gain new members who are committed to the health care needs of rural Maryland and the growth of the MRHA.

3 MRHA Strategic Plan FY14-FY16 3 Introduction The Maryland Rural Health Association (MRHA) is a non-profit organization. The MRHA was formed in January 1995 as a result of Maryland's first annual Rural Health Conference hosted by the Maryland State Office of Rural Health (SORH). The nucleus for the formation of the MRHA was a committee of rural health representatives interested in furthering rural health activities in the state and a core group of Conference attendees. The MRHA has been meeting ever since, serving as a primary advocate for quality rural health care in Maryland. Membership is comprised of health departments, hospitals, community health centers, health professionals, and community members in rural Maryland. The MRHA counts 43 organizations and over 5,000 individuals within our membership. The MRHA s organization is comprised of an Executive Director and 9 to 15 Board of Directors who try to meet the growing needs of its stakeholders. Of Maryland s 24 jurisdictions, 18 are considered rural by the state, and with a population of over 1.3 million they differ greatly from the urban areas in Maryland. The slogan of the MRHA is Improving the Health of Rural Maryland. Mission Statement The Maryland Rural Health Association is a non-profit organization whose mission is to educate and advocate for the optimal health of rural communities and their residents. Mandates Per the MRHA s annual technical assistance grant application with the National Rural Health Association, the MRHA must pay membership dues to the NRHA, to support annual statewide conferences, develop strategic plans and or board retreats, focus on membership and marketing, in addition to, pay for travel and registration of staff to the NRHA s annual conference and/ or policy institute. as Additionally the MRHA must comply with the NRHA s policies on how to build and maintain an effective state rural health association. Due to the NRHA receiving federal funds from the Office of Rural Health Policy (ORHP), under the U.S. Department of Health and Human Services (HHS), individual state rural health associations cannot lobby. The MRHA is also required to advocate for the needs of Maryland s rural communities per their mission. However, advocacy efforts are supported by membership and not Federal or state funds; therefore, the MRHA has a vital need to increase its membership recruitment efforts. The fiscal year of the association is July 1st through June 30th annually. The principal office of the Maryland Rural Health Association shall be located in the State of Maryland as determined by the Board of Directors. The MRHA must have an Executive Director and a Board of Directors. Board Members are expected to serve on committees and chair committees that guide programs and activities (legislative, conference, financial). The MRHA has traditionally been a working or administrative board where the Directors serve as the primary volunteers and staff for the organization. However, in recent years MRHA has been transitioning to a board that completes its mission through setting policy and programs for an Executive Director to implement. The Executive Committee is to submit an annual review of the Executive Director as

4 MRHA Strategic Plan FY14-FY16 4 well as manage the Executive Director work-plan. The Board of Directors and Executive Director have a set of policies and procedures they have to follow based on statutes developed by the NRHA and the organization itself. Reflection on Organization As a part of the strategic planning process, the Executive Director and 11 members of the Board of Directors were asked to reflect on where the organization was and is going. Some points include: MRHA has come a long way from fiscals in excel spreadsheets to quick books with accounts and clear programmatic budgets The membership has increased but needs to continue including more hospital members and stakeholders at the table The organization is at a point where we can start focusing on the rural health care needs and increasing access to healthcare The organization has somewhat been a victim of success almost been trying to do too much as visibility increased The Rural Health Conference been a huge success and needs to keep growing The group identified having an Executive Director as the overall current strength of the organization. Staffing contributes to the group s overall organizational level as well as their planning initiation. Through this direction, the MRHA is slowly being recognized as a rural health policy leader within the state. The MRHA has successfully brought together stakeholders with expertise on rural health issues, through development of the annual rural health conference. Strategic Issues Five strategic issues have been identified as priority areas for Fiscal Years The issues consist of membership, advocacy, finances, organizational capacity, and educational programs/conference. In tackling these issues, the MRHA strives to improve the sustainability of the organization (overall capacity and financially), provide a clear direction to its leadership and the community, cater to its members and fulfill its mission. 1. Membership-How best might the organization increase membership to be more inclusive of Maryland s demographics and variety of rural stakeholders, students, and volunteers interested in fulfilling the mission of MRHA? The MRHA works for quality rural health care for Maryland s rural communities and their residents, and depends on the support of individuals and organizations. A stronger MRHA with a larger and active membership is the best way to ensure quality health care for rural Maryland (Maryland Rural Health Association, 2013, Membership). Increasing membership is critical to the sustainability of the MRHA. The MRHA is a membership based organization that thrives off the financial and programmatic support of its members. Expanding membership attracts new members and prevents burn out among the current Board and organizational members. By attracting new members, the MRHA is also assisting the state s rural health

5 MRHA Strategic Plan FY14-FY16 5 workforce and community development efforts by growing their own health care professionals and rural health leaders. Having rural leaders and health care professionals already familiar with the vast demographic and environmental challenges of Maryland will aid in continuously improving the health of rural communities. The MRHA has made it membership its primary strategic issue for the next three years. The MRHA wants to increase membership from diverse groups (race, age, educational background, religion, profession, gender, agency, etc.) and geographical areas across Maryland. Discussion took place around what organizations needed to be solicited to become members and will have the assistance of Board Members to assist with solicitation of rural hospitals and community health centers. The Executive Director and Membership Committee are also in the process of developing an updated website to drive the recruitment campaign. In order to increase its membership numbers and re-engage its current members, the MRHA must increase its visibility within the state and inform interested individuals and organizations of the benefits and life-long connections that come with sustained membership. The MRHA offers a variety of membership levels. People may choose to join as an individual, organization, honorary, student, or as an ex-officio member. Membership is renewable annually and includes a number of benefits. More specifically, individual membership is for individuals who are passionate, curious, and active in the many facets of Maryland rural health care (Maryland Rural Health Association, 2013, Membership). Individuals receive all the MRHA membership benefits and discounted registration for the annual MRHA conference. Organizational membership, on the other hand, is designed to support hospitals, rural and community health centers, health systems, and organizations that need to stay abreast of rural health matters (Maryland Rural Health Association, 2013, Membership). Through increased numbers, the MRHA is able to effectively represent the number of people it is truly advocating for when working towards improving the health of rural Maryland (Maryland Rural Health Association, 2013, Membership). Another critical component of membership is partnerships. The MRHA continues its strong working relationships with the Maryland SORH and the RMC through collaboration on the Rural Action Assembly conference. The MRHA also continues to work with the five Regional Rural Councils as well as, the University of Maryland, School of Medicine; the State Department of Aging; the Maryland Hospital Association; the Maryland Association of Public Health, Maryland Academy of Family Physicians, the two rural Area Health Education Centers; Community Health Centers and their member organizations. Key issues identified at strategic planning and outlined in plan are the: Need to develop a plan and cultivate strategic partnerships to be part of the Legislative Committee Need to create a plan to grow membership revenue to at least 25% of the budget for sustainability. Currently membership fees only account for about 13% of revenue of organization 2. Advocacy-How best might the organization enhance advocacy efforts within the state to support the growing heath care needs of rural Maryland?

6 MRHA Strategic Plan FY14-FY16 6 One of the MRHA s ongoing operational issues is advocacy. The MRHA is a member serving organization which advocates for the health care needs of rural communities in the state of Maryland. Maryland is a progressive state and paves the way for instrumental legislative bills that affect the health and quality of life of its residents. However, the rural voice of Maryland is not always brought to the forefront and legislators can fail to address their issues, as opposed to their suburban and urban counterparts, when posing new laws for the state. As a result, the MRHA has to acquire the resources and support needed to ensure rural Maryland s voice is heard during the State s annual legislative session. The role of the MRHA is to raise awareness for a few key issues (rural health funding and rural workforce) and allow other organizations with strong lobbying arms to testify on key health issues. Planning reiterated that with a broad mission the Association must continue to track state efforts as it is doing every state legislature session with a wide umbrella. That while targeting on one or two main issues could focus more advocacy efforts it does not fit the broad mission of the organization. One of the question raised on planning in February and in past with the Association is to develop 501 c(4) with membership dollars to do more lobbying with less restrictions than the 501 c(3) affords. While this was discussed there was not buy in or strong voice to do this now or in the next three years of strategic planning. However, this idea is being implemented by other state RHAs and should be revisited by Maryland as the organization grows in capacity. Also discussed was the split between State and Federal advocacy. With a strong National Rural Health Association state advocacy was identified as the priority. Activities under federal advocacy focus on engaging and potentially sponsoring members and local communities to do this work more directly with MRHA. The MRHA is to become the leading rural health policy center in the state and will lead the path to improve rural health care for all rural communities through the implementation of the State s health care reform act and the assistance of its partners. The current legislative agenda includes the following topics: implement requirements of the new health care reform law keeping in mind unique rural health needs, funding for rural communities, rural Maryland safety net, workforce shortages, and telemedicine and health information technology. Key issues identified at strategic planning and outlined in plan: Develop year round presence in Annapolis with not just rural legislators but also the administration and urban legislators Develop a legislative agenda that will include main legislative priorities for the upcoming session earlier than normal and keep it at the forefront of the organization. Create talking points for use by directors and members that could be used when speaking at the local level and to Federal and State legislators to communicate rural health needs. 3. Finances-How might MRHA achieve financial sustainability? Ensuring the MRHA is financially stable is an ongoing operational issue that the Executive Director and Board of Directors tackle annually. The MRHA receives an annual grant from the NRHA in the amount of $9,500. The NRHA allocates a percentage of its Federal

7 MRHA Strategic Plan FY14-FY16 7 funding from the ORHP to each state rural health association in the country. All of this money is used to support the Executive Director s salary. Additional funding sources include the SORH, RMC, and the Maryland Department of Aging. Without additional funds and/or a potential budgetary cut, the MRHA will not be able to carry out its daily tasks. To become financially sustainable, the MRHA has to find new funding streams to cover personnel, cater to members, provide advocacy efforts, produce educational programs and host the conference. Additionally Federal grant funding may be cut due to the sequester. As outlined above MRHA has to increase its membership numbers to keep the organization thriving. Furthermore, the MRHA must consider how it wants to increase the budget: through grant writing or fundraising, or a combination of both. MRHA needs to identify what percentage of staff time is allocated for each activity, track, and plan for future growth and staffing capacity. There was strong consensus at the planning that increasing the capacity of the Executive Director through extra hours was an investment worth making at this juncture in the Association s evolution. After three years of paid staff the organization has not dipped into its reservefunds. However new revenue streams needed to be found beyond just state funding and foundation, business, and academic partnerships should be explored in the next three years. Key issues identified at strategic planning and outlined in plan include: Develop business plan to include evaluating future funding streams to support increased staffing and operational support for the organization Increase ED time from 20 hours to 30 hours and potentially long term FTE Hire in next two years a part time administrative support 4. Organizational Capacity-How might MRHA be re-structured, given that its organization currently only operates with an Executive Director and Board Members, to ensure the organization addresses the needs of its stakeholders and accomplishes daily tasks? The MRHA s effort to improve its organizational capacity reflects an operational strategic issue. To achieve an ideal structure, the MRHA needs to develop a long term business plan to not just include additional finances but how it will support organizational capacity. The MRHA moved to a model of hired staffing, which increased membership. The organization also held three successful statewide rural health conferences, and secured grant funding from two separate state agencies. Over 1000 people weresent quarterly newsletters via a dissemination list. The MRHA has also taken on a larger voice in state-wide rural health policy and will continue to administer a scholarship fund for rural students. All these activities have maxed out current staffing capacity. The MRHA s organizational capacity aligns with the mission of the organization because if the organization does not grow in staff size or diversify its board, then the MRHA will not be able to provide educational and advocacy efforts to its members and rural stakeholders on rural health care policy. To ensure the success of the Board, it is recommended that the board review its attendance and composition annually, and ensure committees are meeting and active annually. Key issues identified at strategic planning and outlined in plan:

8 MRHA Strategic Plan FY14-FY16 8 The key to growing capacity will be the need for MRHA to find supplemental funding to increase the Executive Director s work hours from part-time to full-time and eventually hire an administrative assistant to be able to carry out more the organization s daily tasks and continue to meet the needs of its stakeholders Board composition and diversity needs to be continually addressed and evaluated. The MRHA board priority should be to attract new board members to bring new ideas and energy to the mission of the organization. 5. Educational Programs/Conference-How can MRHA improve its educational programs and annual conference to meet the needs of its stakeholders? The MRHA s efforts to improve its educational programs and annual conference are an ongoing strategic issue. After three successful conferences that have stayed stagnant with participants and subject matters the MRHA will partner with the SORH and the RMC to host the Rural Action Assembly in FY14. The conference hopes to pull together 200 stakeholders to address rural issues and create a focused legislative agenda. The MRHA will move beyond a traditional health conference and help the conference focus on issues such as agriculture, economics, and sustainable communities. Promotion of rural health issues, developing programs, and hosting the annual conference will pull together rural health stakeholders and those interested in rural health from across the state to bring quality, affordable, and accessible care to Maryland s rural regions. The MRHA also identified an emerging need to educate policymakers and stakeholders on rural health issues as the Affordable Care Act is enacted and the community integrated medical home model is implemented. MRHA will look at grant funding that might help facilitate education and networking on this important emerging programmatic change in rural Maryland. Key issues identified at strategic planning and outlined in plan: Create a conference agenda that includes looking at improving health beyond just the health delivery and public health system and as part of sustaining rural communities. The attached chart summarizes how the MRHA plans to monitor and evaluate the progression of their strategic plan. The chart outlines beyond what was given as input from strategic planning on February 25, 2013 and will be presented at Directors Meeting June 10, 2013 for input and adoption of activities. The chart includes a project timeline, a list of responsible resources, staff time for each goal and objectives activities, a performance measure to serve as a benchmark and the desired outcome/impact the MRHA expects for each goal.

9 MRHA Strategic Plan FY14-FY16 9 Appendix A. MRHA Board of Directors B. MRHA Stakeholders C. Current MRHA Organizational Members.

10 MRHA Strategic Plan FY14-FY16 10 A. MRHA Current Board of Directors Fiscal Year 13 Pam Christoffel Washington County Resident/Health Consultant Walter's View Hagerstown, MD Phone: Jacob F. Frego Executive Director, Eastern Shore AHEC P.O. Box 795 Cambridge, MD Phone: , Fax: Debbie Goeller, President Health Officer Worcester County Health Department 6040 Public Landing Road P.O. Box 249 Snow Hill, MD Phone: Fax: Denise Matricciani Vice President, Government Relations Maryland Hospital Association 6820 Deerpath Road Elkridge, MD Phone: Fax: Annapolis Office (during session): Phone: Fax: Michael Meit Co-Director, NORC Walsh Center for Rural Health Analysis 4350 East West Hwy, Ste 800 Bethesda, MD Phone: Mark J. Rajkowski, Treasurer Executive Director West Cecil Health Center, Inc. 535 Rowlandsville Rd Conowingo, MD Phone: Mike Shaw, Secretary Calvert Memorial Hospital 100 Hospital Rd Prince Frederick, MD Phone: Robert Stephens Garrett Co. Health Department 1025 Memorial Drive Oakland, MD Phone: Fax: Susan Stewart, Vice President Executive Director Western Maryland AHEC 11 Columbia Street Cumberland, MD Phone: Fax: Earl Stoner, Health Officer Washington County Health Department 1320 Pennsylvania Avenue Hagerstown, MD Phone: , Fax: Lori Werrell, Director of Health Connections St. Mary's Hospital, Member of MedStar Health Point Lookout Road Leonardtown, MD Phone:

11 MRHA Strategic Plan FY14-FY16 11 B. MRHA Stakeholders Internal Stakeholders Executive Director Board of Directors Non-voting State Agencies (State Office of Rural Health & Rural Maryland Council) Staff Volunteers External Stakeholders National Rural Health Association Rural Hospitals in Maryland Area Health Education Centers - Eastern Shore and Western Maryland National Organization of State Offices of Rural Health United States Department of Agriculture Maryland Department of Agriculture Maryland Department of Natural Resources Community Action Groups NORC at the University of Chicago Public Community Rural Residents State Rural Health Associations Office of Rural Health Policy United States Department of Health and Human Services, Health Resources and Services Administration Federal Communications Commission Rural Health Resource Center Maryland Department of Health and Mental Hygiene County Health Departments County Health Officers Press Rural non-profit organizations Rural small businesses Maryland s Governor and Lieutenant Governor Maryland Legislature MRHA s organizational members Mid-Atlantic Telehealth Resource Center Maryland Broadband Cooperative Maryland Agriculture and Educational Development Fund

12 MRHA Strategic Plan FY14-FY16 12 C. Current MRHA Organizational Members Allegany County Health Department Allegany Health Right American Heart Association Atlantic General Hospital Calvert Memorial Hospital Caroline County Health Department Cecil County Health Department Center for Children Inc. Charles County Health Department Chester River Health System Choptank Community Health Center Dorchester County Health Department Eastern Shore Area Health Education Center Empower Systems Frederick County Memorial Hospital, Inc. Garrett County Health Department Garrett County Memorial Hospital Harford County Health Department Kent County Health Department Maryland Association of Retired Persons (AARP) Maryland Academy of Family Physicians (MAFP) Maryland Association of County Health Officers (MACHO) Maryland Community Health Resources Commission (MCHRC) Maryland Hospital Association (MHA) Mid-Atlantic Association of Community Health Centers Mount Laurel Medical Center National Association of Multiple Sclerosis NORC Walsh Center for Rural Health Analysis Peninsula Regional Medical Center Rural Maryland Council Somerset County Health Department State Office of Rural Health St. Mary s County Health Department St. Mary s Hospital Talbot County Health Department Three Lower Counties Community Services Inc. Tri County of Southern Maryland University of Maryland School of Medicine Tri State Community Health Center Washington County Health Department Western Maryland Area Health Education Center West Cecil Community Health Center Wicomico County Health Department Worcester County Health Department