Engaging executive leaders

• To what extent do our executive leaders ensure that engagement with PWLE is explicitly tied to organizational goals and priorities?
• What policies are in place to ensure PWLE are embedded into our organizational governance structure and key committees?

• Integrate the priorities of PWLE into the strategic direction – Executive leaders learn about and explicitly include the goals and interests of PWLE within the organization’s strategic plans and goals.
• Create formal governance pathways for PWLE leadership – Executive leaders ensure representation of PWLE in governance by establishing bylaws and policies that require PWLE to hold seats on high-level, decision-making bodies.
• Include PWLE on high-impact committees – Executive leaders ensure PWLE are included on important standing committees, such as the Policy Committee, Administrators Committee, Finance Committee, and Quality Improvement Committee, allowing them to participate in high-level discussions about the organization’s work.

An executive leader from Community Health Plan of Washington  reflects on their role in supporting work with PWLE:

“There are two key actions [I’ve taken as a leader]. One was putting financial backing into a community advisory council. My department is solely responsible for the financial support of it, which I’m really proud to do. With the support of our CEO, I built a budget to make sure that the community advisory council was a fully funded entity. We also are truly aligned with our strategic goal. It’s under our strategic goal five as one of our initiatives. It’s spoken about on a regular basis when we bring forth updates around those particular strategic plans. It’s always in the forefront of our minds, which I think has been very important in elevating the importance of this work.”

At the National Health Care for the Homeless Council, a minimum of 20% of the Board must be people who have experienced homelessness.

Community Care’s bylaws require one-third of the Board of Directors to be members of the organization’s health plans.

• How do our executive leaders demonstrate commitment to engaging PWLE?
• In what ways do our executive leaders support and reinforce consistent communication across the organization about our engagement work?
• What accountability structures do our executive leaders use to ensure staff across the organization are responsible for responding to and acting on insights from PWLE?

• Reinforce the value of engaging with PWLE across the organization – Executive leaders need to put mechanisms in place to hold departments accountable for responding to input from PWLE.
• Build and sustain a culture that values input from PWLE – Executive leaders should ensure consistent messaging and champion the value proposition of engaging PWLE in all aspects of the organization’s work.
• Advocate visibly for engaging PWLE – Executive leaders take the lead in ensuring partnership remains a core practice, even when competing priorities arise.
• Communicate continuously about engaging PWLE – Executive leaders should find ways to encourage regular updates on engagement work across multiple forums, including the senior and executive leadership teams, key committees, and the organization’s Board.
• Promote accountability through reporting and feedback mechanisms – Executive leaders must promote accountability by supporting systems that move insights and feedback from PWLE through the organization in ways that drive change.
• Tie organizational performance to PWLE engagement protocols – Executive leaders may tie organizational performance to goals for engaging PWLE, such as offering incentive pay (bonuses) or including feedback from PWLE who serve in partnership roles during staff performance reviews.

For Community Health Plan of Washington(CHPW), including engagement with PWLE in their strategic plan helps them to justify and prioritize the work.

“Having tried to get people to do something about member feedback before, without having that buy–in across several leaders, you just don’t make any progress. People don’t sense the prioritization around it. One of the biggest successes [at CHPW] is that we tied our engagement work to strategic planning. It’s night and day from my perspective. Our organization really operates on prioritization through our strategic plan. That helps a ton when you know that your work is directly impacting a strategic plan target, and if you don’t hit that target, it’s going to impact your bonus.”

Community Health Plan of Washington ties Member Advisory Council (MAC) work directly to strategic plan targets, linking successes to organizational performance goals, such as Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores, to drive leadership engagement.

“I think this has been an evolution. In the beginning, it was a lot of leadership just being there, not really engaged or not really having the buy-in of why this is important for the work that I’m doing. But we were able to translate engagement and show how it is directly tied to our CAHPS performance. We’re not doing well on this CAHPS performance measure, we need to do something, and the members are telling us what they want. That has a financial impact on our organization. I think that connection was really important to make for the leaders. And now I think what we’re seeing is that leaders are more engaged.”

• To what extent do our executive leaders support engaging PWLE by dedicating resources and addressing operational challenges?
  • What additional support from executive leaders would be helpful?
• How do we currently fund and resource our engagement work with PWLE?
• What additional resources would we need to advance our work?

• Provide sustainable funding and resources for engaging PWLE –  Executive leaders allocate the budgets for engagement efforts and necessary resources such as technology, transportation, accessibility supports, and compensation for PWLE.
• Staff for effective engagement – Executive leaders structure dedicated staff roles to engage PWLE and ensure staff have the necessary support and training needed to engage PWLE effectively.
• Address organizational barriers to engagement – Executive leaders take responsibility to understand and address organizational barriers such as policies or rules that complicate engagement with PWLE including: onboarding requirements (e.g., background checks) or cumbersome compensation processes.
• Explore diverse funding strategies – Executive leaders identify both long-term and project-specific funding sources, including:
  • Medicaid funding through mechanisms like 1115 Medicaid Waivers or cooperative agreements with federal agencies like the Health Resources and Services Administration (HRSA)
  • Grants from corporate and philanthropic sources for project or community specific engagement (e.g., supporting PWLE as advisory committee members on a grant to expand access to cancer screenings)
  • Departmental budgets that integrate  funding for engaging PWLE

For Community Health Plan of Washington, support from executive leaders has been crucial in securing necessary resources for the work.

“Our [executive leader] has been present in this work since the beginning. She’s there to offer support. A lot of last year was us really pushing to have additional staffing to support our Advisory Councils because we were growing and we needed that support. And thankfully because leadership on the clinical service side advocated for it, we were able to hire a coordinator and get that support that we needed. There’s a lot of support there and recognition of why this is important and why we need additional staff and resources.

One of the big pieces for us to engage PWLE was the need for a Zoom account to meet our members where they’re at. Leadership was able to support us with that. We were also able to secure resources for staff incentives to refer members. These incentives were provided to people who were part of the care management team; care advocates, or case managers who talked to their members and referred them to this program; and customer service staff who made the pitch for us.”

• How often do our executive leaders hear directly from PWLE in group settings, including attending committee meetings?
• To what extent do executive leaders create opportunities for PWLE to present in other organizational forums?
• How actively do our executive leaders build relationships with PWLE?

• Establish formal engagement with PWLE in leadership roles – Executive leaders need to plan to meet regularly with PWLE in leadership roles, such as Advisory Council Chairs or organizational committee members.
• Participate in community advisory meetings – Executive leaders should plan on routinely attending these meetings and engage authentically with members in these spaces.
• Create pathways for direct communication and accountability – Executive leaders must ensure PWLE can raise concerns directly to them and take responsibility for addressing issues.
• Build relationships with PWLE beyond formal roles – Executive leaders should put intentional effort into building relationships with PWLE that extend beyond roles or titles. This can look like:
  • Attending community events outside of regular work hours
  • Developing  informal connections, including sharing appropriate personal experiences
  • Providing opportunities for casual check-ins without a set agenda
  • Following up with advisory committee members around significant life events (e.g., hospitalization)

Pediatrics Northwest’s Care Transformation Committee, which includes executive leaders such as the CEO, regularly hears firsthand from Community Health Workers (CHWs) during meetings. CHWs present stories and themes drawn from family-centered engagement events, ensuring that the perspectives of PWLE are shaping high-level planning and organizational learning.

Community Care’s senior leaders are invited to every Advisory Board meeting and often attend, engaging in conversations with members and demonstrating appreciation for their contributions. Frontline staff report that leaders, “welcome all kinds of feedback,” and, “don’t shy away from something that might be difficult.” Through their interactions, leaders model and demonstrate appreciation for the contributions of PWLE. Advisory Board members have noted that having leaders attend meetings, ask questions, and reflect on what people have said is meaningful. These interactions create a sense of safety and help PWLE trust that what they share is important to the organization.

National Health Care for the Homeless Council’s CEO has monthly meetings with the Chair of their Consumer Advisory Board to discuss issues, support needs, and review council procedures. During meetings with mixed stakeholder groups, the CEO purposefully asks for the consumer point of view, if it has not been voiced, ensuring PWLE perspectives are heard across various forums.

• To what extent does our organization foster a culture that centers wellbeing, safety, and inclusion–not only in our work with PWLE– but across the organization?
• What actions do executive leaders take to build this type of culture, and what additional actions would I like to see?
• How do staff, partners, service recipients, and PWLE in partnership roles experience or describe our organization’s culture? Are there notable similarities or differences?

Everyone–PWLE, employees, partners, and people receiving services–benefits from organizations that are inclusive, trauma-informed, and culturally responsive. Building such an organizational culture is a complex, multi-layered, and long-term process. Executive leaders play a critical role in shaping a positive culture that fosters trust, strengthens meaningful partnerships, and drives  better outcomes.

• Emphasize the value of partnership with PWLE – Executive leaders help promote engagement as a core organizational value and visibly reinforce respect forPWLE.
• Welcome and orient new team members – Executive leaders should  take time to introduce themselves to new staff and PWLE who are working with the organization, ensuring they feel valued from the start.
• Foster a safe and inclusive environment – Executive leaders need to encourage all opinions, create spaces where questions are welcome, and set a tone that balances power dynamics between professionals and PWLE.
• Prioritize staff wellbeing – Executive leaders support implementing HR practices that prioritize staff health, safety, and work-life balance.
• Invest in internal education – Executive leaders must make it a point to invest in training opportunities such as trauma-informed facilitation, historical context, and cultural competency, ensuring staff understand the complexity and nuances of engaging diverse communities with respect.
• Support inclusive hiring practices- Executive leaders should champion hiring practices that prioritize staff who share the lived experiences of the communities served.
• Uphold a human-centered approach – Executive leaders recognize the personal nature of the work, acknowledge the risk of re-traumatizing individuals, and emphasize viewing staff, patients, and families as humans first.

A lived experience advisor from Community Care reflects on the importance of belonging:

“As a person with lived experience, I was asked to serve on a national advisory board of a large organization. I was a little terrified, because these are a lot of really smart people. I’m feeling like ‘I don’t know if what I have to say is as meaningful,’ or ‘am I going to say it wrong?’ But it was through building relationships, and through building trust, and through people saying to you, ‘Yeah, you’re right on target with what you’re saying,’ or ‘we appreciate what you say.’ It makes you feel comfortable. I always keep that in the back of my mind because I’ve been through similar situations myself and I want our members to feel as comfortable as possible when they’re sharing. I think our leadership has always been open to having really honest conversations, and they have worked really hard to build relationships with our members.”