November 2018 - FAB Meeting #7

November 8, 2018 from 6-8pm

UB backbone staff present:
David Harrington
Kassa Belay
Dionne Grayman
Nysheva-Starr
Jason Ludwig

Number of FAB members present: 16/25

Accomodations: Dinner and childcare provided

Agenda/Minutes:

Takeaways:

  • FAB members edited and discussed changes to UB’s Theory of Change in order to bring that document into alignment with the FAB’s “Lift-off” Aspirations

Objectives:

  1. More fully understand a Theory of Change and its role in our work

  2. Incorporate “Lift Off” aspirations and racial equity into UB’s Theory of Change

Introductions/Recap:              

  • Introduction of two new prospective FAB members

  • Mindfulness Moment

  • Image Theater: FAB members and UB staff used physical movement to illustrate concepts such as “trust,” “oppression,” “friendship,” etc.

  • Recap of Survey Scores: October FAB meeting received highest scores of any meeting so far

  • Recap of PAT goals set at October PAT meeting

  1. PAT members will disrupt inequities and systemic racism, starting with our own work

  2. PAT members will collaborate with organizations/programs aligned with UB's mission in order to share resources (e.g. Professional Development training) and co-create projects that benefit the Brownsville community and its families in a sustainable way

  3. The PAT's agreed upon "Values for Collaboration" should be permanently present in our collective work

  • Recap of November PAT meeting by FAB members who were in attendance (meeting minutes here)

    • Discussed the Learning Landscape group’s consensus on having a supermarket as pilot location installing educational signage

    • Discussed being surprised at PAT’s interest in FAB work, and also talked about PAT discussion about equity vs. equality

    • Discussed that it was good to have the PAT hear back from families, and produce some “productive discomfort”

  • Recap of “Equality, Equity, Justice” Graphic: FAB members agreed that equity equates to “leveling the playing field”

Discussion of Next Steps for DTB Projects

  • Learning Landscapes: The LL group is beginning the process of identifying a grocery store in Brownsville to be a pilot location for installing educational signage. FAB members signed up to volunteer to approach different stores in Brownsville about becoming a Learning Landscapes pilot site (sign-up sheet here)

  • Family Co-op: Will begin discussing how the Grundy County approach to building a Family Co-op can be adapted to Brownsville’s cultural context.

  • Books for Brownsville: Beginning search for consultant

What is a Theory of Change?

  • A TOC is a statement or diagram that illustrates how an organization will achieve its goals.

    • Maria discussed how a TOC can aim for both personal and professional change

  • TOC’s can look a variety of ways, however, they should identify:

  1. A problem to be solved

  2. Inputs, or actions taken to solve the problems

  3. Outputs, or the results of those inputs that will help us reach the desired outcome

  4. Outcomes or the long term results that would solve the problems

  • Review of UB’s TOC:

    “Our theory of change is grounded in the insight that poorer outcomes for children in Brownsville stem from social and professional disconnections that result in infants and toddlers not receiving the benefits of well-coordinated and culturally-attuned, social, health, and educational services. Service providers themselves cannot operate as effectively as possible (e.g. They do not have the capacity or the knowledge to follow up on referrals or to coordinate services for the same clients), and relationships between families and providers break down (e.g. Families do not trust or feel like their perspectives are heard by some providers). Both situations result in missed opportunities to deliver the most timely and consistent support to children in Brownsville, and the community is left with gaps in services and relationships.”

  • Discussion of how UB and FAB can incorporate “lift-off” aspirations and equity lens into TOC. One member thought that the TOC already incorporated some lift-off aspirations, insofar as it is concerned with social and professional disconnections and provider-client distrust.

Group Work

  • Pick out the aspirations from the “Lift off” document that speak most to us:

    • Which aspirations from the Lift Off exercise are already present in the current TOC, even if they use different words?

    • Which aspirations are missing and should be added into the TOC?

  • Discussion notes, which will be used in the revision of the TOC:

    • Replace the word “poorer”

    • Add in “cultural disconnections”

    • Incorporate language about preventing patient-provider relationships from breaking down, and also about “implementing patient-centered care”

    • Add language related to “resisting cultural barriers”. Several parents shared experiences about having to adjust to the culture of a provider rather than the provider adjusting their practice to fit the community in which they work

    • Incorporate language about having providers who “look like us” (reflect the cultural and social values of Brownsville) as well as “changing the narrative” about Brownsville

    • Feature language about both patient and provider accountability (i.e. creating a maximum number of patients a provider is allowed to see, and “following through on referrals”)

    • Mention that providers should be thinking about more than just “the bottom line” when providing services

    • Several FAB members wanted to see language about empowering families and taking differentiated approaches to providing services incorporated into the TOC

    • “Opportunity”, “empowerment”, “equity”, and ”justice” should be mentioned

    • Resist the imposition of cultural values on the part of providers onto clients

    • Edit for brevity and jargon

    • Service providers often don’t “appreciate the humanity” of their clients and tend to “see people as numbers” so group appreciated the emphasis on this theme in the TOC

    • A premium should be placed on participatory planning and local resident input

    • A parent who works professionally with a service provider in Brownsville objected to some of the language that says that providers aren’t well-connected to each other and aren’t serving the community well, and she spoke about how she connects with families and her department works hard to follow up on referrals.

    • This was countered by a parent who talked about experiences she has had where she didn’t feel like she was being treated like a person, had to do the research and request and follow up on a referral for a child with special needs herself, and felt abandoned by the process.

    • There were also conversations about difficulty accessing services due to long wait times, the costs and difficulty of transportation (especially for children with special needs and mothers with multiple children).

    • It seemed like there was some concession by the service-providing parent to the parents with difficulty accessing services by the end.

    • One parent who wanted other parents to take more responsibility for the services their kids receive (e.g. keeping appointments) because we have to keep in mind the fees/payments at stake … You have to book 4 medicare patients to make up for one private insurance patient and some of those 4 won’t even show up.

    • Another parent gave impassioned pushback about her experience getting services for her children in wealthier neighborhoods. She had the same Medicare insurance paying the same fees, but in that neighborhood the provider had figured out a way to make that work, and we shouldn’t accept a lesser situation here in Brownsville.

    • “It seems like the system is setup to fail children” summed up many of the parents’ comments

FABDavid Harrington