What impact do these power dynamics and differentials have? Why do they matter? How do they show up? by Hunter Gatewood

expectations around time

SignalKey — 2024-07-22 15:07:27 UTC

Money

SignalKey — 2024-07-22 15:07:27 UTC

Power Dynamics

SignalKey — 2024-07-22 15:07:27 UTC

In the case of CalAIM and MediCal, there are power dynamics of knowledge and familiarity which organizations who are new to Medi-Cal don't have e.g. contracting, regulations, MCP understanding.

Different languages/terminology

SignalKey — 2024-07-22 15:07:27 UTC

Service Delivery and Program Implementations

SignalKey — 2024-07-22 15:07:27 UTC

Larger staff

SignalKey — 2024-07-22 15:07:27 UTC

Community Based social services agency hold the power to the community and individuals. They are the gate keepers with deep understanding of the dynamics of their community. They have a stake in uplifting the community.

SignalKey — 2024-07-22 15:07:27 UTC

Physical space (facilities, size, geography, etc)

SignalKey — 2024-07-22 15:07:27 UTC

Different regulations/requirements

SignalKey — 2024-07-22 15:07:27 UTC

Data

SignalKey — 2024-07-22 15:07:27 UTC

Sometimes the parties who are working together have data that their partners don't have access to that may impact their ability to do their work effectively.

Reputation, name recognition

SignalKey — 2024-07-22 15:07:27 UTC

Influence and Visibility

SignalKey — 2024-07-22 15:07:27 UTC

Number of people served

SignalKey — 2024-07-22 15:07:27 UTC

Standing, social status

SignalKey — 2024-07-22 15:07:27 UTC

Relationships with state government can be imbalanced

SignalKey — 2024-07-22 15:07:27 UTC

Political power

SignalKey — 2024-07-22 15:07:27 UTC

Outcomes are another way to garner power and expertise within organizational programs.

SignalKey — 2024-07-22 15:07:27 UTC

healthcare entities have lobbying and political power

SignalKey — 2024-07-22 15:07:27 UTC

June advisor comment re impact: "understanding of respective priorities, values, perspectives and mission"

SignalKey — 2024-07-22 15:07:27 UTC

Often because shared understanding doesn't exist and these conversations don't happen, folks miss where they can build trust and transparency which then exacerbates power dynamics

June advisor comment re impact: "Historical power imbalances needs to be taken into account, especially political power and privilege."

SignalKey — 2024-07-22 15:07:27 UTC

Knowledge of the community and the individuals being served

SignalKey — 2024-07-22 15:07:27 UTC

Knowledge of medi-cal

SignalKey — 2024-07-22 15:07:27 UTC

Personal connections in their respective fields

SignalKey — 2024-07-22 15:07:27 UTC

Building relationships with the community is a form of power

SignalKey — 2024-07-22 15:07:27 UTC

"and specifically staff with MediCal expertise"

SignalKey — 2024-07-22 21:10:09 UTC

"government money"

SignalKey — 2024-07-22 21:10:52 UTC

physical space

SignalKey — 2024-07-22 21:11:16 UTC

Power comes in different forms and successful social services programs that support equity have power.

SignalKey — 2024-07-22 21:16:49 UTC

How to run harmonious teams as an effective leader - CCALAC

2024-07-25 20:21:59 UTC

Funding allocations and security - CCALAC

2024-07-25 20:22:47 UTC

Being able to leverage the voices of the community -CCALAC

2024-07-25 20:23:37 UTC

Number of member FQHCs served in LA County - CCALAC

2024-07-25 20:24:52 UTC

Start here: EXAMPLE (pulled from advisor note below with additions by Addie and Hunter): Between health care agencies and housing/homeless CBOs: Pressure on CBO to adopt healthcare technologies and formats (HIPAA, EHR). Health care agencies assume that homelessness services don't have their own documentation standards, regulatory structures, etc. (HUD, HMIS) Impact: impasse. Another impact could be: CBO is forced to do what health care requires, and has to use additional labor and cost.

SignalKey — 2024-07-26 18:45:46 UTC

2024-08-12 23:35:56 UTC

Health plans hold a significant amount of the funding available, so CBOs are somewhat necessarily beholden to the needs of the health plans. That said, the health plans know that in many cases the key to serving the community well is partnering with the organizations who are already engaged with our members, and often already providing the services that are reimbursable under CalAIM. There is definitely a significant knowledge gap and an infrastructure gap, though one that has been improving, for many CBOs to have the ability to contract with health plans. We have worked really hard to provide funding to bridge the infrastructure gap and participate in the county PATH meetings to bridge the knowledge gap, and I think that’s been fairly successful, though that success looks a little different county to county.

CBO whois in partnership with a hospital

2024-08-19 16:59:20 UTC

The timing of growth and scale differs for us vs our partner. We want to move more slowly and thoughtfully to ensure our sustainability, but this has been challenging as we feel pressure to move based on timelines defined by others.